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Preparing for Serious Illness Like COVID 19

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Biguglygremlin +0 points · 6 months ago Original Poster Sleep Enthusiast

There is a high probability that many CPAP users will eventually be exposed to the Corona Virus

If I/they/we become seriously ill will we be able to manage the equipment effectively.

The CPAP could be a life saver for someone with an acute respiratory disease when respirators are in short supply.

But what if someone became seriously congested and dependent on others to manage everything?

If I found myself in that situation would my current equipment still be effective?

I've been using nasal pillow masks for almost 6 years now but they only work with preemptive measures to ensure that the sinuses are clear and constant vigilance to maintain correct positioning, direction and tension etc.

I doubt that others could or would manage these factors effectively on my behalf.

Would a full face mask be more versatile and more manageable in extreme circumstances?

I'm thinking of purchasing one specifically for this kind of situation but which one would be the most practical choice?

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Sierra +0 points · 6 months ago Sleep Patron

In all of this TV coverage with all kinds of medical experts offering their advice on COVID, I recall one doctor responding to a question about using a CPAP instead of a hospital ventilation device. The answer was basically, "no", that a CPAP cannot function like a ventilator in that it essentially cannot force a person to breathe. In my non medical professional opinion I think a CPAP could help assist breathing though. There is a slightly different version of the CPAP called an ASV that is often used for central apnea, that does monitor your breathing and actually can step in and to some degree force the breathing. There are also some BiLevel machines that have a backup rate, which attempts to force breathing to a certain extent at a fixed rate. A BiLevel machine can also do more to assist breathing more than a CPAP. A CPAP typically can only put about 3 cm of pressure on inhale compared to exhale. A BiLevel machine can provide quite a bit more pressure support, and it also can go up to 25 cm of pressure, compared to 20 cm with a standard CPAP (or APAP).

But, back to your question, both myself and my wife came down with a very nasty cold back in January. The symptoms were very similar to what is attributed to COVID. I found that my APAP which is currently set to a fixed pressure of 11 cm and no EPR after I go to sleep, provided a lot of assistance in breathing while I had the cold. I suppose it might have provided more assistance with a higher pressure and the EPR turned on at 3 cm, but I never found it to be necessary. As for your mask, as long as you can use the CPAP without opening your mouth at the pressure you need, a nasal mask should be just fine.

Hope that helps some,

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Biguglygremlin +0 points · 6 months ago Original Poster Sleep Enthusiast

Yes it seems to me that those of us with very severe Apnea would need a working CPAP at least up until a respirator became necessary and especially when difficulty breathing is one of the dominant symptoms and I do believe that the CPAP does help breathing even without the Bilevel function.

However I really don't think that the nasal pillows are manageable by a third party, at home or elsewhere, especially if they have no real experience with this equipment.

I'm not sure that a full face mask would be much better because I have had almost no experience myself with a full face mask but it seems to me that medical carers would feel more confident or have more familiarity with the concept of a full face mask.

The chaos of this virus is costing money in many unexpected ways. Money that I just don't have, so I am not looking to spend money if it serves no purpose but I suspect that a full face mask, as much as I dislike the idea, might be a good investment in the long run.

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Sierra +0 points · 6 months ago Sleep Patron

I have a ResMed F20 full face mask that is sitting in a box somewhere. I hated it. At the time I tried using it I had my machine in auto mode with pressures going up to 15 cm or so. It seemed determined to leak, making farting noises, and blowing air into my eyes, despite all attempts to make the straps looser and tighter. I just gave up on it, and I would have to be really desperate to try it again. I have heard that some people use a full face mask when they get a cold because their nose becomes congested. The cold I got was a dry cough type and there was minimal nasal congestion. And, even when I do have nasal congestion, I find that the air pressure keeps one side or the other, or both open.

What I found most effective with the cold we got was Benylin Dry Cough Nigh syrup. That was what got us through the cold. It stopped the cough and let me sleep. We have stocked up on it, just in case we get the COVID.

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Biguglygremlin +0 points · 6 months ago Original Poster Sleep Enthusiast

Ok thanks Sierra for your good advice.

I might try to get some of that syrup.

I rarely get a cough so I don't usually have anything like that on hand.

If I was really sick and had wound up the pressure to compensate for congestion it would be more than just the mask that was making farting noises, but I think I'd be a bit beyond caring at that stage.

So you figure that what you had was very similar to the new virus?

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Sierra +0 points · 6 months ago Sleep Patron

My wife is convinced that we had COVID, but I think it is virtually impossible. We were in Mexico from Jan 6 to Jan 20, and got the "cold" almost immediately after our airline trip home. The first case in Canada was diagnosed about Jan 23, and I recall all of the first wave of cases were clearly related to travel from China. It seems really unlikely that the virus could have gotten to Mexico or on the plane that quickly. That said about the only symptom we were missing from a full COVID diagnosis was that neither of us had a high fever. The main symptom was a brutal dry cough.

One thing to keep in mind if you do get in trouble is that your CPAP may have the ability to accept oxygen. You would need a doctor to prescribe it, but I believe some people with breathing issues use an oxygen supplement as a normal practice.

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SleepDent +0 points · 6 months ago Sleep Commentator

I am a dentist working in dental sleep medicine. Unfortunately, I have some really bad news for the people on this forum. In a post dated 3/22/20 the American Academy of Sleep Medicine states that the use of CPAP by patients with COVID-19 infections does, indeed, pose a significant risk to other family members in the household because it disseminates the virus into the air regardless of what face mask you use. Please check out the FAQs on their web site about this. There is also some risk of spread during the routine cleaning process. Oral sleep apnea appliances are specifically cited as being a safer alternative, as are some other things. Now, I am not suggesting that you dump your CPAPs, but you MUST be absolutely sure that you are totally isolated from other household members and it may make some sense to move some very vulnerable family members(or yourself) to a different location. Arthur B. Luisi, Jr., D.M.D.. The Naples Center For Dental sleep Medicine.

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Sierra +0 points · 6 months ago Sleep Patron

If one is in full isolation due to having COVID you have to stay in a separate bedroom and bathroom, with no interaction with other family members. Without that, all members in the house will get it sooner or later. We all have to exhale one way or another, and I don't really see how a CPAP would make it any worse. One of the main suspected mechanisms for the rapid infection rate in Italy has been blamed on family members not self isolating in the home, from other family members.

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Biguglygremlin +0 points · 6 months ago Original Poster Sleep Enthusiast

Oh how I do love 'experts' and statistics, although what I was able to find at the above site, was more like a disclaimer, with no rationale provided.

I wracked my poor brain for a while to find a situation in which that potential might apply, and once I got past the point that Sierra makes, which is essentially that the only viable alternative was to simply stop breathing, and my own view that most of us 'oldies' are more likely to be the destination than the source, it occurred to me that if we transplant the scene into a hospital ward then the CPAP machine might become problematic, depending on what containment systems are in place, and certainly there would be issues to do with cleaning and maintenance.

I really can't see how it would increase the risk at home. In fact a full face mask or chin strap would serve to suppress any droplets from coughing. Not that that would make any difference because anybody else sharing the same space will be infected anyway.

I had wondered about the oxygen. It might be interesting to know more about although I really hope things don't get to that stage.

I didn't intend this thread to become apocalyptic.

I am not personally stressed or anxious about this virus, although obviously new rules and concepts do apply. For me it is interesting and challenging. Yet another puzzle to be solved.

I intended this thread to be about being prepared and if SleepDent's observations reflect the views of the medical staff at large then it is something we do need to be aware of.

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Sierra +0 points · 6 months ago Sleep Patron

I did a quick search and found this article:

The Complete Guide to Using Oxygen with a CPAP

It looks like any CPAP can be used with the purchase of a $5 adapter to get the oxygen into the air stream. However the cost of the oxygen tank and regulators may be quite a bit more than $5.

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Biguglygremlin +0 points · 6 months ago Original Poster Sleep Enthusiast

I looked into this option and figured that I could set something up for around $100 but it would only last for a few hours of continuous use. The next level up would cost around $800 and last for a few days. Those figures are using a combination of medical and industrial equipment.

I doubt that I will do anything in the near future and I don't think it is advisable to recommend this approach to CPAP users in general.

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SleepDent +0 points · 6 months ago Sleep Commentator

Remember that the exhaust air coming out of the vent ports on the masks is STILL PRESSURIZED. There would clearly still be potential to expel virus particles out of these vent ports for a significant distance. Dr. Luisi

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Sierra +0 points · 6 months ago Sleep Patron

Yes, that is a bit of an issue. Some masks are much worse than others however. Full face masks use the most purge air, and the nasal masks the least. Some masks attempt to diffuse the air stream, while others do not. The worst mask I have used for blowing air in a high velocity is the ResMed Swift nasal mask. The exhaust is like standing behind a jet plane. There is zero attempt to diffuse the exhaust. The best mask I have used is the ResMed AirSense F10 nasal pillow. It does an excellent job in diffusing the exhaust. You can't feel it or hear it.

BUT, the important point is that if someone is in bed with you or even in the same bedroom, and you have COVID-19, then they are going to get it too, regardless whether or not a CPAP is used. That is virtually 100% certain. The only way to contain it is to use a different bedroom, bathroom, and maintain the 2 meter physical distancing.

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Sherry +0 points · 6 months ago Sleep Commentator

This is what I heard: There is concern that CPAP machines may aerosolize the virus. This should be addressed by moving to a separate room and even asking housemates not to enter that room for several hours after the CPAP was in use to minimize any virus in the air. Some Doctors may be advising against use of CPAP for those infected as a conservative approach to minimize transmission to others in the household. I would check with your provider for direction in using CPAP with the virus.

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Biguglygremlin +0 points · 6 months ago Original Poster Sleep Enthusiast

For those of us with very severe Apnea not using the CPAP is not an option, unless there is another device available. (like a ventilator)

I understand the concerns but a good sneeze would have the same effect, so if we are going to apply every possibility of proximity and drift and airflow and duration and surface contamination etc etc then add in the human factor, we would need to move to another planet.

All we can do is be informed, be sensible and be careful.

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Sierra +0 points · 6 months ago Sleep Patron

The main difference between a ventilator and a CPAP/BiPAP/ASV) seems to be that the ventilator is more invasive compared to a normal mask. A tube is actually inserted to direct air/oxygen to and from the lungs. Air exhausted is filtered to remove an virus material to prevent contamination of the room. Here is a news article that explains a bit about it.

What is a Ventilator?

For those of us on a CPAP it seems to me that staying at home and self isolating may be a better approach than going to a hospital if medical advice supports that approach. Our treatment in the hospital may be compromised to prevent spread of the virus, by taking away our CPAP. Something to be discussed with your doctor if one does get diagnosed with COVID.

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Biguglygremlin +0 points · 6 months ago Original Poster Sleep Enthusiast

I suspect that many older people who don't get out much will have to deal with this virus without getting diagnosed.

Not that it's a good idea to avoid diagnosis but many of our governments, for reasons mostly to do with politics and economics, are not making testing available to the majority of their citizens no matter what symptoms they might have.

So I figure that it will be treated by many of us like most other infections that we deal with at home, unless it becomes life threatening, at which point medics, doctors and hospitals will need to be involved and, if it is serious enough, they will run diagnostic tests for their own safety.

I can see the point you are making about avoiding hospitals Sierra, and agree with it in pretty much all circumstances including this virus, while ever it is safe and sustainable, but I doubt that a GP would have any leverage with the hospital system and I don't think any hospital in Australia would offer credible assurances in advance because many of their decisions are made and unmade on the spur of the moment, so it would all come down to changing cirumstances, availability and priority.

I guess that is a good argument for effective preparation and communication.

Perhaps preparing a brief medical history clearly noting relevant details and medications as well as the severity of Apnea and the machine settings.

Letting those we share our lives with know about the medical history and showing them how to pack and prep the CPAP in case it is possible to use it later.

One of the greatest risks is that the patient might be too sick to do what needs doing and perhaps even too sick or confused to communicate effectively.

Hopefully none of these considerations will be needed but, according to the concepts espoused by Murphy, being unprepared is not a good option.

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Sierra +0 points · 6 months ago Sleep Patron

BUG,

The good news here is that it seems like Australia is having a very low death rate from the COVID-19. I also understand that Australia has the highest per capita testing rate in the world. Seems like a good place to be. Australia is down there in the same low zone as China and Japan. Both of those would have to be viewed with some suspicion as to accuracy. I suppose in Australia it has been summer and now you are going into fall, and spread may pick up if it behaves like the flu virus... In any case here is a link to the best representation I have seen on the data.

COVID-19 Death Rate per Million People

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Skyemac11 +0 points · 6 months ago

They were also very fast to stop air travel risks.

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Biguglygremlin +0 points · 6 months ago Original Poster Sleep Enthusiast

I do like that graph Sierra. It's quite clever for the amount of information it needs to display.

Yes Australia is well positioned for many situations including this virus. Being a vast area surrounded by oceans with relatively few people does have it's advantages.

The charts are obviously derived from whatever numbers each respective government has made claim to and I doubt that any countries have or could give an accurate account of the number of persons with the virus at any specific time because all the factors are so transient and because he who controls the testing controls the numbers.

In our country as with many the testing was originally limited to very sick incoming travellers and is now limited in general to severe cases in hospital and to medical workers.

There is no way of really knowing who is or is not infected nor how this will play out in the weeks, months and years ahead.

We've had a busy few months recently with fires, floods and pandemic. It will be interesting to see what the new normal might be once the dust settles.

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Sierra +0 points · 6 months ago Sleep Patron

I think this presentation of data is one of the most credible because it is based on reported deaths. Yes, that number is grim and can be inaccurate. But, in the range of numbers available in the public, it is probably the most accurate. Another one to look at is the % of tests that are positive. It is a rough indicator as to how bad things are. For example in New York, 35% are coming back positive. In Alberta where I am, the tests have been coming back positive about 2% of the time. It is rough though, because it depends on the number of tests being done.

Keep an eye on the % positive tests in Australia. It should be very indicative because Australia is testing responsibly. Also keep an eye on that graph. It is an even better indicator of whether things are going well or badly.

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Biguglygremlin +0 points · 6 months ago Original Poster Sleep Enthusiast

I'm at a considerable disadvantage when it comes to watching current events because, as much as I do love charts and graphs and statistics, I love them BECAUSE they are so adaptable and dishonest and so much fun to play with.

Our criteria for testing is much the same as most countries. We are only supposed to be testing those who are really sick, with the full range of symptoms and even then only if they are already in hospital. Any other tests were initially used on incoming travellers to place the blame on other countries and on medical workers to protect them and to prevent spread in vital areas.

If someone is ill at home with all the COVID19 symptoms they are not tested and they are discouraged from presenting at the hospitals. In UK for quite some time those who died at home, even if it was from the virus, were not counted. Similar methods might well apply to other countries.

Then there is the fact that even those tests that are done and show as negative are generally somewhere from 40% to 80% inaccurate and presumably that would also impact on the supposed cause of death.

I guess my point is that as with all things human, especially when politics becomes involved, everybody has an agenda which distorts the data so we can never know what is really happening at any given time.

I waited and watched to see if the other side of the equation would be released, the demographics for all the negative results, because it would tell us where the major omissions were and give some credence to the the positive data, but in the few instances where my wife stumbled across data, and sent me the link, it was redacted before I could even open it.

I suppose in retrospect that, once the virus is loose in the general population, the only number that really matters is the number of deaths, but only in comparison to the total number of deaths from all causes compared to the average number of deaths for the same period in previous years.

A simple example of this method is that apparently in New York the number of persons dying at home has increased from 20 to 200 per day and presumably the majority of those extra 180 deaths are COVID19 related although they are probably not being counted as such.

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Sierra +0 points · 6 months ago Sleep Patron

The other thing that brings it back to reality is when they have refrigerated transport trucks backed up to the loading docks at hospitals like they have in New York. When the hospital morgues and funeral homes are overwhelmed, then you know you have a real problem.

The countries, like Sweden that didn't take this seriously are paying a heavy price. And the even sadder part is that the UK, and Sweden are on the same trajectory as Italy. That group is second only to Spain and Belgium in how quickly the death rate is going up.

It seems to me that once you have the virus loose and spreading in the country, the war is pretty much lost. It is very difficult to put the toothpaste back in the tube, even when you lock down the whole country. Australia has an opportunity to not let it get that bad.

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SleepDent +0 points · 5 months ago Sleep Commentator

Unfortunately, you have it right. In many countries, including my own, the USA, they blew the initial opportunity for containment. Now the toothpaste IS out of the tube. Huge numbers of people are going to get sick and die and we just have to take our licks until they get enough testing done, plus vaccines, and discovering medical treatments. This is going to take serious amounts of time and, meanwhile, the economy will tank and go into recession or depression. Just shows you the price you pay with these things unless you are super sharp. Dr. Luisi

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Biguglygremlin +0 points · 5 months ago Original Poster Sleep Enthusiast

I really don't think there is an opportunity for containment of this particular virus.

I think that any country prepared to destroy itself economically and in many other ways can delay the process and buy time but unless that country remains locked down forever it will eventually be impacted.

This virus is just too effective at stealth and contagion so until we have a tried and proven treatment and immunisation it will continue to infect and re-infect communities.

When it first surfaced I thought this virus was the ideal one to use as a practice session for when the real thing (a more dangerous one) comes along.

Unfortunately I don't think it has been handled that well and it's hard to believe that we will learn the right lessons from this experience.

Which brings me back to my original question. Which mask would be most effective if others had to maintain it on my behalf?

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Sierra +0 points · 5 months ago Sleep Patron

I suspect the hospital will have their own mask and machines, and they probably will not allow the use of your own machine in the hospital, if it comes to that.

Things are not very good in Canada. About 50% of deaths are occurring in seniors homes. Almost all homes are now locked down so nobody, including relatives, cannot visit. It has also uncovered some home mismanagement in addition to COVID, and in some cases police are now conducting criminal investigations. In one home of 60 residents, half have now died of COVID.

If you know anyone in a long term care home, you may want to think about getting them out, until this is over. If the virus gets into a Home, it goes through the place like a wildfire. My mother is in a home, that is now locked down, and getting her out is not an option. Thankfully there have been no deaths in care homes in the province where she is located.

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Biguglygremlin +0 points · 5 months ago Original Poster Sleep Enthusiast

I hadn't really expected to be allowed to take my decrepit old S9 machine into hospital Sierra.

It would be too much of an embarrassment anyway in it's present condition!

However I have had multiple episodes of encephalitis and a couple of bouts of pneumonia since I have been on CPAP, and stayed home each time, so I know how zoned out I can get when I am really sick and that there is a potential of becoming dependent on my wife and other family members.

There is also the possibility that my wife may become sick with this or some other respiratory illness and benefit from temporary breathing assistance because I know that she would be very reluctant to go to hospital while ever it could be avoided. (Don't try this at home folks!)

So it seems to me that a nice shiny new full face mask, as much as I dread the concept, might be a good investment in the long run if it is more versatile?

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Sierra +0 points · 5 months ago Sleep Patron

You may be interested to know that the US FDA have given emergency approval for certain devices to used for COVID-19 treatment, as an alternative to a ventilator. The list is at the link below. One ResMed BiPap consumer level product has been given this emergency approval; AirCurve ST. See the bottom of page 2.

Emergency Approval List

Also here is a paper from ResMed that says CPAP and BiPAP may play a part in the early treatment or less severe cases of COVID. A quote:

"In a discussion paper published on 5 March 2020, the U.S National Academy of Medicine indicated that the use of non-invasive ventilation therapy, such as continuous positive airway pressure (CPAP) or bilevel positive airway pressure (bi-level PAP), could be a way to forestall the need for intubation and reduce days on a ventilator.10 Since then, there has been a growing evidence base on the significance of supplemental oxygen combined with either CPAP and bi-level PAP in the early stages of COVID-19, and in the prevention of further respiratory deterioration in patients with the disease."

ResMed Ventilators and COVID-19

And some even think that the use of ventilators is being over done. See the link below to a CBC article. Perhaps if people were treated sooner with a CPAP using EPR or better still a BiPAP with oxygen supplementation, an invasive ventilator may not be needed. If one gets to the full ventilator stage, the prognosis is not good.

Ventilators are being overused on COVID-19 patients, world-renowned critical care specialist says

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Biguglygremlin +0 points · 5 months ago Original Poster Sleep Enthusiast

You are very adept at research Sierra.

I've been wondering what practical solutions would negate the perceived risk of using CPAP machines in a hospital environment and then I saw a news flash to a nice shiny new hospital someplace with the patients under a simple lightweight frame covered in clear plastic that started behind the patient and rested on the bed along the sides then curved across the patients waist.

It was such a simple idea but it enabled the patient to have free use of arms and see and talk yet it controlled the air that was being expelled from what seemed to be standard CPAP masks.

Inside those small tents the patients were hooked up to what looked very much like CPAP machines. I can't be certain but it seemed to be such a simple yet effective system.

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Biguglygremlin +0 points · 5 months ago Original Poster Sleep Enthusiast

This looks heavier and more limiting and not as well sealed as the enclosures I saw but it is a similar concept.

COVID 19 Protection Enclosure

There are some small bubbles out there too but they look a bit scary.

So as your research implies, it seems like there might be new ways to use CPAP machines safely in a hospital environment even with an infectious disease.

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Sierra +0 points · 5 months ago Sleep Patron

I believe I have seen similar enclosures in other photos. Seems to me that a basic CPAP along with oxygen supplementation may be a viable option to treat less severe cases of COVID. Setting the EPR to max would help some too. All under a doctor's care of course...

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Sierra +0 points · 5 months ago Sleep Patron

I saw a news report that there has been a rush on pulse oximeters. The meter is not really that expensive, or at least it wasn't before the rush. Combined with SleepyHead or OSCAR it probably is a good tool to use to determine if you are developing a serious cold or COVID. Whether you need one or not probably depends on how available COVID testing is, and what your underling medical conditions may be.

People are buying pulse oximeters to try and detect coronavirus at home. Do you need one?

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Biguglygremlin +0 points · 5 months ago Original Poster Sleep Enthusiast

Yes they have been discussed quite a bit in this forum and a lot of people in Australia suffer from allergies and asthma which could also be monitored by a pulse oximeter although I think more obvious symptoms would normally develop before any significant oxygen reduction could be detected.

I bought a wrist device once, that was suppose to record oxygen levels as well as sleep quality, but I never trusted it so now it's abandoned on a desktop in another state.

For many people too much information fuels unnecessary stress and anxiety so I don't normally dwell on medical things but I have been refused release from hospitals on a number of occasions because my oxygen levels were way too low, so I thought the device might give me a clue as to how to avoid being detained next time.

My conclusions were that the device can't be trusted, for me it's probably normal to suppress breathing when I am in significant pain, and I don't want to live my life focused internally, perpetually worried about my health.

The marketing practices for medical things under our present circumstances interests me more than the devices themselves.

It's hard to tell at what point normal business management and pricing strategies become a form of extortion or gouging.

Medical Supply Company Charging $789 For $40 Box of Masks

Of course governments opening their treasury vaults and competing aggressively against each other doesn't help.

It seems that, for good or ill, this microscopic virus has shaken our world in more ways than we can possibly comprehend.

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Biguglygremlin +0 points · 5 months ago Original Poster Sleep Enthusiast

For those with grandchildren this is another possible twist in the story of COVID 19

Possible Link to Children

The Australian government insists that children are not affected and not spreaders which seems more like an economic decision than a safe medical conclusion.

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Biguglygremlin +0 points · 5 months ago Original Poster Sleep Enthusiast

I finally found some current statistics for provisional deaths with the 5 year averages and the COVID 19 attributions.

UK Death Statistics

According to my limited maths skills the number of deaths above the average that were not attributed to COVID 19 in week 15 were 1,806 and in week 16 there were 3,096 extra deaths that were not counted as COVID 19 but were likely to have been at least indirectly COVID 19 related, especially when you consider that the increases are proportional.

This would seem to indicate that, at least in the UK, the real number of COVID 19 deaths is about 30% higher than the official numbers.

It would be interesting to see these figures across a number of countries.

I know that it seems like I have wandered off track with this thread in an apnea forum but surely this virus is a greater threat to the CPAP community than a leaky mask and the more we can learn about it the safer we will be and that includes evaluating the credibility of the information we are using to make critical decisions.

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Sierra +0 points · 5 months ago Sleep Patron

One of the issues with the UK data is that they have only been reporting deaths due to COVID if they occur in a hospital. Seniors long term care home deaths, or deaths at home are not counted. France was doing that as well. You can see the jump in the trajectory of their deaths when they corrected that.

https://ourworldindata.org/grapher/covid-deaths-days-since-per-million?country=CAN+FRA+NZL+KOR+USA+AUS+BEL+GBR

I don't believe the UK has made a correction, but they are talking about it. It will probably bump the UK up to the second worst in the world after Belgium

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RebeccaR +0 points · 5 months ago Support Team

You are all very well informed and adept researchers indeed. I just wanted to make sure you saw the American Academy of Sleep Medicine recommendations and FAQ page for patients. It's actually quite good and fairly detailed, and of course a very trustworthy source for evidence-based information. https://aasm.org/coronavirus-covid-19-faqs-cpap-sleep-apnea-patients/

Thanks for bringing this important topic to the forum.

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Biguglygremlin +0 points · 5 months ago Original Poster Sleep Enthusiast

You don't like unfounded opinions and wild guesses RebeccaR? :O

That link has some very useful and concise information but it takes all the fun out of making it up as you go along!

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BigFootBitMe +0 points · 5 months ago

I was diagnosed after this virus, pretty much did the sleep study the same day my state went on lockdown. It was the same day Musk delivered those CPAP machines and this topic came up. All I could think was in the 2 - 3 weeks it was going to take to get the insurance company to approve and everything the Dr estimated all the CPAP machines would be sucked up for the virus, I was actually very concerned as my exhaustion level was disabling. My o2 level going down to 63 at night was more then alarming to my Dr. and within 2 days I had a machine delivered. My 02 levels recovered to the low 80's wile sleeping so now I have supplemental oxygen as well. I do not know if there was a run on CPAP machines, I suspect there was. People at that time were buying up everything with any possibility of helping if you caught the virus. Tylenol, decongestants, etc all 100% gone around here.

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Biguglygremlin +0 points · 4 months ago Original Poster Sleep Enthusiast

We are further into the 'other side' illusion than most countries and many of the basic stock items are back on the shelves, but items that are truly essential, and probably sourced from countries that are still in serious circumstances, are very hard to find.

Items like Flu Vaccines and Asthma medications.

Our government is busy removing social constraints because it is the only way to preserve some semblance of 'normal' but I think it will just provide the kinder-ling for the next flareup. :)

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Sierra +0 points · 4 months ago Sleep Patron

I'm sure the rest of the world will be watching Australia carefully as you move into your winter flu season. So far Australia and New Zealand have had very low infection and death rates compared to the northern hemisphere. It will be interesting to see if there is a spike up during the typical flu season.

COVID Fatality Rates

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Biguglygremlin +0 points · 4 months ago Original Poster Sleep Enthusiast

I like the way that graph shows so much information all piled on top of each other but it is very misleading in it's visual impact which makes me wonder who set the parameters and for what purpose.

Australia has less than 4 deaths per million over 64 days

UK has more than 469 deaths per million over a similar period.

Because the Y Axis starts at a percentage and increases exponentially it effectively merges them so the real differences seem to be significantly reduced.

It also creates an artificial curve even in the face of sustained or accelerating growth.

Imagine what the simple data above would look like on a fixed gradient.

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Biguglygremlin +0 points · 4 months ago Original Poster Sleep Enthusiast

I found a site with both linear and log scale graphs of the relevant data.

Graphic Differences

As you can see there are significant differences in the visual impression.

I'm not sure what it all means but I don't think it puts Australia in a good position unless we get a vaccine fairly quickly.

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Biguglygremlin +0 points · 4 months ago Original Poster Sleep Enthusiast

A long time ago I drove out of Hobart across the Tasman Bridge and, some minutes later, as I was winding through the hills to the north in my old Vanguard I heard on the radio that the bridge had collapsed.

Cars went down with the bridge and some drove off the edge afterwards but a couple of cars managed to stop, only just, with their front wheels hanging over the abyss.

This photo says it all: Tasman Bridge Collapse

I think that is how Australia has dealt with this virus so far. Only just managed to stop but now hanging over the abyss.

It's hard to see how we can really move forward, like opening schools and borders and such, without unpleasant consequences, at least until an effective vaccine has been widely distributed.

The final death toll in many countries is likely to finish up close to 1,000 per million if they have an elderly population and in the few locations that it has impacted in isolated locations in Australia it has killed more than 30% of the most vulnerable.

We are still several months from having a vaccine by the most optimistic estimates so it will be interesting to see how we manage to find a balance over that time period.

It's more than just idle curiosity on my part because back in 1975 most of my work was on the other side of that gap and that's also true today.

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Sierra +0 points · 4 months ago Sleep Patron

Was watching one of endless TV programs on COVID today. Part of it caught my eye. In one setting they did a bit of a study on the use of oximeters. What they did is check COVID infected people out in hospital and then send them home with a portable oximeters to use. Of the 20 in the study 19 recovered at home. One was flagged as being in much more trouble based on the oximeter data. That patient was re-admitted to hospital and treated. It was not necessary to use a ventilator, and the individual survived. The conclusion of the study was that an oximeter is useful in monitoring COVID and is a predictor of the severity of the infection. I suspect the CPAP data would also be useful in determining the severity of the infection by measuring flow resistance, and by the shape of the flow curves. It would be a little harder to interpret than oximeter data.

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Biguglygremlin +0 points · 4 months ago Original Poster Sleep Enthusiast

I had thought that oximeters were essentially toys that gave you a reading that should normally be obvious at a glance before it was even applied, but there is the issue that many elderly are barely with-it and some have problems communicating even when there is diligent care available, which is not always the case.

It seems that I was also wrong in a more general sense, because apparently breathing difficulties and oxygen levels can deteriorate significantly, perhaps even fatally, without being blatantly obvious, which is why I thought this article was helpful in better understanding the role of oximeters in COVID-19 management.

Oximeters in Nursing Homes

There is a powerful argument there for monitoring all members of the population who are at risk and not just those who have already displayed symptoms or tested positive.

Of course the same preventative measures could well apply to other respiratory illnesses and viruses.

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KangarooTailStew +0 points · 4 months ago

According to this article COVID-19 might be more than just a respiratory illness.

Coronavirus May Be a Blood Vessel Disease

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