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7/24/2020 #COVID Update. I've worked two weeks here in Yuma, Arizona so I can discuss what I'm seeing. The first shift had a few hypoxic super sick COVID patients, but since then I've seen more of the less sick COVID patients. Hopefull I don't jinx myself
1/
To recap there are 5 main COVID types:
1. Asymptomatic
2. Viral symptoms - fever, body aches
3. Exertional SOB/hypoxia
4. Hypoxic but looks well; #HappyHypoxic
5. Gasping for breath; respiratory distress - needs intubation/non-invasive ventilation 2/
1. Asymptomatic
2. Viral symptoms - fever, body aches
3. Exertional SOB/hypoxia
4. Hypoxic but looks well; #HappyHypoxic
5. Gasping for breath; respiratory distress - needs intubation/non-invasive ventilation 2/
Some atypical presentations in older patients I saw today
1. New atrial fibrillation w/COVID lungs
2. Abdominal pain w/diarrhea resulting in hypotension with CT abdomen and pelvis notable for COVID lungs!
Both stable well appearing, with mild hypoxia in the low 90s. 3/
1. New atrial fibrillation w/COVID lungs
2. Abdominal pain w/diarrhea resulting in hypotension with CT abdomen and pelvis notable for COVID lungs!
Both stable well appearing, with mild hypoxia in the low 90s. 3/
The younger patients today were in their 20-30s with viral symptoms, but no hypoxia with the added stress of having to self isolate from their children. 4/
I'm pleased with the less severe cases that I'm seeing. Overall social distancing and wearing masks is working. However, our ICUs are still filled with the super sick COVID patients that take 4-6 weeks to turn around, if they do. 5/
The volume and acuity in the emergency room is nowhere near that of NYC, likely because of the decreased density of people and lessons learned. On the floors and especially the ICUs is a complete different story, where patients die on ventilators & require many resources. 6/
I needed a glimmer of hope, because it's been a rough 5 months and a lot of exposure to the virus. However, I'm still reminded that we still don't have a vaccine or effective treatment; we're using dexamethasone and azithromycin - some get remdesivir 7/
Reinfections? Friends of mine in Vegas believe they got infected with #COVID in March, now think they are reinfected with #COVID for a second time, which is concerning - described lungs on fire and short of breath. (sounds like covid!) 8/
Stay vigilant because there is a lot that we still don't know about this virus, like reinfections? and long term effects. Decreasing viral spread and hospital admissions will allow limited resources like ECMO and hi-flow to those who will benefit the most. #StayAtHome 
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