Cured Covid-19: “As if you were touching your marrow with a trowel”

They drooled. Sweat. Coughed. Sometimes kept a log of their symptoms. They managed their fear or considered making a will. But they survived. With or without antibiotics. With or without the famous chloroquine of which the Marseille professor Didier Raoult extols the merits. “98% of people recover”, recalls Jérôme Salomon, the director general of health who, since March 17, gives every day the number of Covid-19 patients discharged from the hospital, while comforting the litany of deaths (Wednesday evening, there were nearly 31 000 “cured” discharged from hospital). With data from the hospital environment, “We must add the probable tens of thousands of cured people in town“, Underlines the general direction of health.

Are these survivors now immune? If yes, for how long? The question remains thorny (read page 6-7). Have they all been really infected with the virus? If some have been tested, many have had to rely on a diag

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Pierre-Henri Allain in Rennes

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Stéphanie Maurice in Lille

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Catherine Mallaval

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Stéphanie Aubert in Marseille

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François Carrel in Grenoble

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Gilles Dhers

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Stéphanie Harounyan in Marseille

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Guillaume Tion

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Tania Kahn

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Juliette Deborde

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Jérôme Lefilliâtre

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Guillaume Krempp in Strasbourg

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Diary of a doctor in Ehpad: “In the night, unexpected death is hard”

On the front line with the elderly, Jean-Paul Duplan, 69, is the coordinating doctor of two accommodation establishments for dependent elderly people (Ehpad) in the department of Essonne.

For request of Release, he keeps a logbook of his daily work in the face of the coronavirus. The fight is tough.

This article is the updated version of the logbook published in its first version in the edition of Release April 4-5.

March 25

For how long ?

“Four of the six tests I managed to do came back positive! Now is the time to implement the program that we had defined as a team. Dedicated area set up in the morning of March 23, with a nurse, a nursing assistant, FFP2 protective masks, a disposable gown and overcoats (keep stocks up to date). Contain all residents in their rooms as of today. For how long ? Some have been asking for it for several days, without realizing

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Sylvain Mouillard

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Virologist of the RAS listed the consequences caused by coronavirus :: Society :: RBC

Russian scientists have come to the conclusion that a person who has a coronavirus infection with COVID-19 may face serious brain damage. About it reported The publication “Evening Moscow”, a virologist scientist of the Russian Academy of Sciences (RAS) Felix Ershov.

As scientists have established, COVID-19, like influenza and herpes viruses, can lead to the death of entire sections of this organ. According to Ershov, coronavirus greatly weakens the protection of the human body.

In particular, the virus suppresses the immune system, so an additional so-called somatic pathology can be superimposed on the disease. As with ordinary flu, the patient’s body is weakened, and his immunity is suppressed. Against this background, secondary immunodeficiencies develop in the body.

Often, elderly people are at risk for such a pathology. Because of their immunity, children and youth are much less prone to complications, Yershov noted. According to him, strokes and heart attacks, as well as concomitant diseases: bronchitis, meningitis and others, can also occur as pathologies in the elderly.

As a virologist noted, the main cause of death from coronavirus, as a rule, is not COVID-19 itself, but pathology. In this regard, after the first week of the disease, if it has not receded, antibiotics are actively used in treatment.

Ershov said that traditional antibacterial agents do not act on viruses. According to him, the only antiviral antibiotic today is interferon, which has a direct effect on the stages of intracellular reproduction of viruses.

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Shortages extend to drugs

Faced with the unprecedented scale of the crisis and the influx of patients, stocks are running out. First those of protective masks. Then reagents used in diagnostic tests from Covid-19. And the respirators, whose production is struggling to keep up with demand. Little by little, everything necessary for hospitalization and treatment of patients is running out. Even the most common equipment, the most common drugs.

“Hospital stocks of muscle relaxants, sedatives and painkillers are consumed quickly”, is alarmed by the European Alliance of European University Hospitals, and “At their current rate of consumption, stocks will be empty within a few days in the hospitals hardest hit, and within two weeks for those with the largest reserves.” In their press release published on Tuesday, forty doctors and directors of establishments in France and other European countries call their respective leaders to coll

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Camille Gévaudan

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Resuscitation drugs: “We fear a shortage of stocks”

Damien Roux, university professor and hospital practitioner of intensive resuscitation medicine, works in the medical and surgical resuscitation department of Louis-Mourier Hospital (AP-HP), located in Colombes, in the Hauts-de-Seine. As of last weekend, this doctor was responsible for reflecting – in collaboration with other colleagues from the Public Assistance taking care of Covid-19 patients – on the means of optimizing the use of drugs in the services of resuscitation, due to the ever increasing number of serious patients. “The aim was to anticipate the overconsumption of certain drugs in the same way that we have been trying to increase the number of nurses for the past month»He explains. Except that a week later, the fear of an imminent shortage of certain molecules became a reality in Ile-de-France. “Despite our prospects and our vigilance on the issue, it is clear that suppliers and manufacturers are no longer able to monitor the consumption of drugs or certain medical devices in our hospitals.He warns.

AP-HP Director General Martin Hirsch acknowledged at a press conference on Friday that “stocks are very short on certain drugs.“This Saturday evening, it’s Edouard Philippe who admits the existence of”supply tensions here and there” “We regulate them by ensuring the circulation of these products throughout the territory, because there are stocks. We guarantee it by making sure to encourage increased domestic and global productionAdded the Prime Minister. Update with Professor Roux.

What is the situation of Louis-Mourier resuscitation service today?

We fear the beginning of a stock shortage for the end of the weekend. We have visibility over two days. That is to say, we are not sure that our internal pharmacy will be able to supply us with all of the drugs necessary for optimal patient management. There is great concern because it is very likely that the AP-HP central pharmacy, despite all its efforts, may not be able to meet the demands of all hospitals and that we will end up with shortages during the restocking. This shortage situation is new but ultimately quite logical. Instead of having a variety of patients who require very different treatments, resuscitation services are currently finding themselves with a majority of Covid + patients who need the same molecules. It is this quantity of identical patients, hitherto unknown in our units, which causes the drug shortage.

Which families of molecules are likely to be lacking?

There is a strong tension on hypnotics. These are the molecules we use to keep patients in sleep in intensive care. The equation is therefore simple: if we run out of stocks, we will no longer be able to take care of new patients. It’s a real danger. We also fear a rapid shortage of curares, which allow the patient, once asleep, to prevent him from moving and therefore consume less oxygen. Curares are necessary because they allow these patients with acute respiratory distress syndrome (ARDS) to be completely ventilated by the ventilator. The last other concern concerns antibiotics. As we speak, I do not believe that an AP-HP hospital is lacking. But there is a risk of overconsumption in the days and weeks to come, because these serious patients in intensive care are at high risk of nosocomial infection. As you can see, the supply of these three groups of molecules is essential to save lives.

Your working group’s mission was to think of new protocols to save your stocks. A summary of your recommendations is currently being sent to all AP-HP hospitals. What does it contain?

At this stage, we propose an optimization of the sedation protocols in order to limit any use which is not absolutely necessary. A close relationship between the pharmacy and the resuscitation service is also necessary in order to anticipate any shortage of a molecule to refer to another close molecule. We also underlined the interest of associating other molecules making it possible to reduce the quantity of usual molecules to be administered. More specifically for sedation, one of the recommendations would also be to use the usual method of anesthesia in the operating room. It is a procedure that uses halogenated gases to put people to sleep and that we never use in most resuscitation services. This technique would also limit the use of curares.

At Louis-Mourier Hospital, where are you with your stock of syringe pumps, which allow the infusion of treatments? Some hospital structures already seem to be lacking…

We did the drawer bottoms and requisitioned all the units a little to find as many as possible. But indeed, faced with the impressive influx of resuscitation patients, we had to resolve to work with fewer electric syringe pumps per patient. For the moment, it does not degrade the quality of care but it causes discomfort in work for nurses who must regularly move this type of equipment from one room to another. Unless suppliers, especially Chinese, can quickly send us a large quantity of electric syringe pumps, we will have to modify the way we administer treatments to patients using less precise techniques.


Anaïs Moran

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Less people died from coronavirus than dies daily due to heart disease. But fast foods don’t get empty

Stop panic please. Infections have been and will be for a very long time companions of civilization.

From other infections, people are dying many, many times more than from coronavirus. The epidemic is already developing for several months, it seems that a new infection is not much worse than the flu, from which hundreds of thousands of people die every year. The number of victims of COVID-2019 is now about 5 thousand people.

You probably know people who do not want to vaccinate themselves and vaccinate their children against influenza, hepatitis, pneumococcus, meningococcus, rotavirus, measles. Or those who do not use condoms. Who does not wash his hands. Carefully look at the picture, this is what tens of thousands of people are now dying daily: tuberculosis, hepatitis B, HIV, rotavirus, meningitis, measles. Vaccination with existing vaccines would save many of them.

During the epidemic in China from coronavirus infection a little more than 3 thousand people died. Let me remind you that the epidemic is suspended there. As many in China die from heart disease every day.

No one cares: people continue to smoke, including electronic cigarettes. Continue to drink large quantities of vodka and eat junk food.

Want to be afraid of what death brings? Then you need not be afraid of the coronavirus, but of the crowns that customers of fast food put on themselves all over the world.

Do you shy away from sneezing? And at the same time, you calmly accept cute people who are coming to you in shopping centers to offer new electronic cigarettes. I assure you, on the conscience of every cigarette distributor there are more deaths than a sick Italian. You don’t care because you’re used to it.

Not to mention that they are accustomed to mass child deaths in Africa from malaria, hunger, dehydration.

Death will come for everyone, but living in a developed world, you can delay its arrival for decades.

For years you don’t want to do anything, take care of your body, and get crazy when a new threat arises. Here you put on masks and look for miraculous medicines (no, antivirals do not help, so far – none of the existing ones), you want to protect yourself, right now. Regular kisses to “clip consciousness” – is not your case? And try to think not only about today’s “terrible epidemic”, but about how to deal with new ones that will definitely be.

You try to “buy off” from daily care of your body, as a father who abandoned his family once a year buys the most expensive toy for children. Wow! They remembered that the world is filled with risk factors for death!

Stop the tantrum. Wash your hands; do not go sick to work. Let me remind you that a dramatic decrease in the death rate from infections occurred at the very beginning of the 20th century precisely because people began to adhere to the principles of hygiene. This played no less role than vaccines and antibiotics.

Where did the coronavirus come from.In the wet market, where the coronavirus broke out, visitors were treated to raw bats …

Finally, get standard vaccinations against infections. Everything that is on schedule. Children and the elderly. Weak?

Once again, rejoice that you live in a developed world. Infections were, are and will be. Yes, mortality from coronavirus will increase, yes, it will stay with us.

In a few years, a new viral infection will come, again there will be a panic and a collapse of the ruble. And people will continue to die en masse from other causes.

We can fight infections better and better. Another epidemic is a good reason to equip intensive care units, train doctors and open normal infectious diseases departments. Or at least to carry out water supply and sewerage in them, not all are equipped if you did not know. We are very lucky that the virus is so “sluggish.”

The great power of art will save Italy, everything will work out in a few weeks.

Panic is now doing more harm to the global economy than coronavirus. So spread the message among tenants your housing office. Let’s form the “immune layer”, the layer of adequacy.

And please follow the recommendations RospotrebnadzorDepartment of Health Moscow and Ministry of Health. They are correct and timely. Calm down to quarantine.

Coronavirus: only without hands !.With a slight movement, the handshake turns into a handshake! And from kisses and hugs have to abstain. Coronavirus changes age-old habits. But WHO recalls: the main thing is to wash your hands!

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