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Aemon Stark

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About Aemon Stark

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    Land of Wind and Rain
  • Birthday August 2

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    A Song of Ice and Fire, of course, math, science, medicine, philosophy, history (especially ancient and medieval!)... and, more fun, movies, books, writing, enjoying fine ales, running, swimming, photography, and many other electrifying things

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  1. Aemon Stark

    So What Do You All Think of Zack Snyder?

    I think I've only ever seen 300 and it was a schlocky mess.
  2. Aemon Stark

    Canadian Politics: Revenge of the small minds

    We need that kind of war mobilization now. Yesterday. We need the PPE especially.
  3. Aemon Stark

    M-m-m-my Corona! NCOVID-19 #5

    What's more is that high levels of oxygen introduce a lot of free radicals and, sometimes, cell damage. So for people with poor oxygenation, we try to optimize lung function and gas exchange rather than just cranking up the fraction of O2. Being on 100% oxygen is bad. Also in the last thread Ran said something about people being recommended paracetamol over acetaminophen. Of course, these are the same thing, and I expect he meant ibuprofen. #europeans
  4. Aemon Stark

    COVID19/4 Keep calm and wash your hands

    I hope you're doing okay, but it's important to point out that there have been no completed randomized controlled trials (or even prospective cohort studies) supporting any of this. There may indeed be a role for chloroquine (and other anti-malarials?) but extra high doses of Vit D might only lead to toxicity. Also, any physician recommending against a vaccine because of "immune-booster" supplements is committing borderline malpractice. Can the supplements, get the flu vaccine. If there were a COVID-19 vaccine (and there will be... in 12-18 months), would this reasoning apply? The respiratory syndrome associated with severe COVID-19 is "ARDS" or "Acute Respiratory Distress Syndrome". It can cause short-term fibrotic changes, but generally lung function returns to baseline within a few months to a year. Assuming you get there. That sounds quite anti-Dentite. My hospital is preparing - and well enough I'd say. Visitors are restricted except to palliative care, pediatric patients, and obstetrics/babies. And even then, only one at a home with screening at the door. In the meantime, we've almost cleared out an entire ward for isolation use. We haven't quite settled on our approach for allocation of ICU beds, but the recovery room will likely take the non-COVID-19 patients at a certain point to maintain some degree of separation. It may all be unnecessary and I really hope it turns out that way. We have one case so far, something like another 150-200 tested without any positive results. Schools are closed along with most other things. Stores are stocked well enough for now. And we are on an island so that doesn't hurt. But I think we'll be as ready as we can be. We're going to some simulation exercises within a few days to really get things ready. I'm also part of a few social media groups for physicians about the virus. Mostly there are a lot of memes and comments about "flattening the curve", but also a lot of anxiety and concern - and some is about the financial side with most "elective" things being cancelled. (I was going to be away this week and next so didn't have much of anything booked anyway.) This does mean a big hit for some, but the complaining seems awfully selfish and tone deaf. No one is getting through this unscathed. I felt a LOT of anxiety about the virus and the consequences of social distancing late last week and over the weekend. At some point, I decided that this is, essentially, a war, and we must mobilize our resources and accept necessary sacrifices to get through it.
  5. Aemon Stark

    COVID19/4 Keep calm and wash your hands

    Only 600?? We supposedly have 98 in NL, though I suspect that overcalls some beds that aren't truly fully capable ICU beds. Either way, that's for half a million people. A lot of issues in sepsis amount to this kind of immune "overreaction" - which is why people going on about how "strong" their immune system betray a complete lack of knowledge of how this works. We're not very good at finding effective immune-modulators in sepsis or ARDS or viral pneumonias generally. But antivirals might help - except which ones? Chloroquine, which is an old anti-malarial, might be good. We won't really know for a while. Anti-inflammatory diets are more faddish than anything else for this sort of thing.
  6. Aemon Stark

    COVID19/4 Keep calm and wash your hands

    They're kinda like the people welcoming the arrival of the aliens in Independence Day.
  7. Aemon Stark

    COVID19/4 Keep calm and wash your hands

    Nothing is as bad as Outbreak, but even Contagion with the dramatic meningitis and seizures is fairly crazy over the top (even if chillingly prescient in other ways). The major difference between SARS-CoV2 and Influenza is the current lack of a vaccine or treatment with a good evidence base. There probably will be a vaccine - maybe within the year, maybe longer - but at this early stage we're mainly looking at "best supportive care". It's certainly possible it could end up being a seasonal event, with regular annual influenza-like epidemics. Or it could go the way of SARS-CoV1 and disappear. There's not enough known about how this virus might evolve over the medium to longer term to know for sure.
  8. Aemon Stark

    COVID19/4 Keep calm and wash your hands

    We've got our first case: COVID-19 reaches N.L. as 1st presumptive case announced
  9. Aemon Stark

    Canadian Politics: Revenge of the small minds

    I bought yesterday. Just as well that I don't actually have much exposure. I only buy once or twice a month so it will be the next pay period until I do again. #dollarcostaveraging
  10. Aemon Stark

    Canadian Politics: Revenge of the small minds

    TSX was a bloodbath today. Gonna see how things go tomorrow, but it's a good time to buy anyway...
  11. Aemon Stark

    Does the flu shot actually work?

    Just a comment, but influenza susceptibility - and even the potential for a serious infection - has little do with whether you have a "working" immune system. People who are immunocompromised (whether from HIV or chemotherapy or whatever) get all kinds of weirder, and often worse, infections, but just about anyone can get influenza. And while seasonal influenza *generally* hits the elderly and frail hardest, it's hard to predict who might have an exaggerated immune reaction leading to serious illness.
  12. Aemon Stark

    Star Trek Thread: Set Picard to Stun (spoilers)

    I watched it pretty faithfully throughout its run. But it could have been so much more. I don't know if the Maquis stuff always worked so well in the first season, but at least it added an interesting dynamic. Then it just disappeared - would have been a lot better if a character like Seska had not turned out to be a Cardassian agent - having that conflict around on the ship would have been much better and more interesting. The first two seasons also suffered at the time (and especially now) with the worst alien villains of all - the Kazon.
  13. Aemon Stark

    Coronavirus (COVID-19)

    If you're going to discuss a novel coronavirus, it's best to stick to appropriate technical terms. Otherwise I have no idea what you're doing here apart from trolling. If you have something new to contribute to this discussion, by all means do so. Otherwise I'd request this line of argument end here and now (cue mods).
  14. Aemon Stark

    Coronavirus (COVID-19)

    No no no. You cannot just make up your own meanings for technical terms. Influenza is not spread through "airborne droplets" but through close contact with infected individuals, fomites, and respiratory secretions. I'm not sure why you're referring to influenza as "ordinary" flu - it kills hundreds of thousands of people worldwide every year. This is disingenuous nonsense. There is no "ordinary English" meaning for "airborne transmission". You're simply shifting the goal posts of your unsupportable argument. And, for reference, certain viruses like SARS can become aerosolized in certain circumstances. Generally SARS only spread via droplets and close contacts, but there is a risk of aerosolization during airway management or invasive suctioning. Which is why I sometimes will wear an N95 when intubating patients with uncertain respiratory illnesses (recently that was with a guy who ended up having RSV which it isn't necessary for).
  15. Aemon Stark

    Star Trek Thread: Set Picard to Stun (spoilers)

    There are so many episodes of Voyager that I've seen - many more than once - and scarcely remember. I'm thinking of some of the dark stretches of the first three seasons especially, stuff like Ex Post Facto or Rise.