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Is Covid-19 Impacting You, Your Carving or Your Local Mtn.?


barryj

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3 minutes ago, lowrider said:

I've had one slug of Jamesons whisky you president is a ****ing idiot ! ban me now if you must 

Reminds me of the time I bought a round of Jamesons shots when the Red Sox won the 2004 World Series.  A pretty young woman in our crew tossed it back, and then ran outside and tossed it up.  I felt bad that I didn't choose a friendlier shot.

Friendly reminder that political commentary is not allowed.

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I really hope for the sake of all my American friends, not to mention our own safety in Canada, that your country gets a federally mandated lockdown.  If you look at the statistics, you guys are on the same disastrous course as Italy and Spain.

Here in Canada the measures are a provincial responsibility but they are pretty consistent.

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10 hours ago, Pat Donnelly said:

I read an article where they traced Patient 0 (and 1.2 and 3) in Iceland back to a group that had gone to Austria to ski. They even traced it back to a specific bar, and then discovered that people from the bar that week had gone home to 9 different countries. Oy vey.

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Won't comment on the issue. 

To all. Please be careful and_home safe.

 

 

I am living daily with covid treating ER patients.

My 5 years old boy and wife hope to have a better life when this is over. 

I appreciate each day to the fullest.  Even a slight car errand ;).

Snowboarding will truly be a victory for me next year.

 

 

 

 

 

 

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We have been looking at acute respiratory distress or ARDS as the result of Covid-19. 

A Cytokine storm happens , essentially a over reaction of our immune response that fills our lungs with fluid and drowns us.

Something happened over the past few days that got me concerned. For years of going to altitude quickly in Colorado...I have suffered from Altitude sickness. My first experience was winter camping in 1990 a few hundred yards the road from Alta about 8500 feet. That night I suffered from chills, diarrhea, weakness (my aerobic instructor GF hauled all the gear up the hill in the dark).  And when we drove to ASPEN bright and early the next morning and ended up at Aspen Highlands (base elevation 8,040 feet peak 12,392 feet)   I quickly found myself gasping on an Oxygen tank  compliments of Highlands ski patrol . The symptoms didn't really stop until I returned to sea level on a. connecting flight through Phoenix. I suffered near HAPE ( High Altitude Pulmonary Edema). It doesn't hit you instantly, it takes a bit of time for your blood chemistry to change to a threshold level. In my case overnight. But sometimes it can hit sooner if I haven't  slept, or haven't been to altitude in a. long time. I deal with this every season.

I think people's immune systems think they are prepping to fight HAPE and that is what causes the symptoms of ARDS. (Acute respiratory distress)

But here's the thing... if you suffer from AMS (Acute mountain sickness) that could turn into HAPE well the body has the response of breathing more rapidly (which changes your blood chemistry) and that also can turn into tachycardia.

Part of HAPE is your blood chemistry, which as it changes PH ,it can exacerbate the effects of HYPOXIA as you slime your own lungs.  So when you start to hyperventilate, just like when you might hyperventilate to try to free dive deeper (a dumb idea as this causes "shallow water blackout") you don't really increase your O2 level much but you end up purging your C02 and as dissolved C02 falls... carbonic acid falls and your blood PH changes.  You ability to get 02 is partially related to the partial pressure of 02 at altitude. Which you can't change .

 

So hyperventilating speeds onset of HAPE when you get past a certain low point of 02 saturation in your blood. 

SO WTF does this have to do with us , ski resorts, and carving?

Turns out... a shitloard.

I was noticing that it seemed that the primary infectors were travelers from airplanes. Now ..... it is accepted that you are 100 times more likely to contract a respiratory infection aboard an aircraft than on the ground. But there were certain flights that seemed to do this more...

https://www.dailymail.co.uk/news/article-8159323/Member-Colorado-coronavirus-cluster-breaks-silence-illness-spread-Melbourne.html

I got tested as soon as I called it quits for the snowboard season- reentering Orange country. I tested negative. Whew.

But, a few days ago. I had some aches in my calves, a few fevers (not unusual for me actually) headache, and then something alarmed me. Something that I keep careful tabs on ...when going to altitude. I got a numbness/tingling in my 4th and 5th fingers in both hands . And this spread to my shoulders . And these are alarm signals I am acutely aware of because it means I have to fly out of Aspen right away and get to Phoenix or LA immediately to avoid HAPE... (drinking alcohol will also accelerate this).  EXCEPT I wasn't at Aspen highlands or even at 7,945 feet at the base of the Aspen Ajax Gondola.. I was at Sea Level. in Southern California's Dana Point. (About midway between LA and San Diego)

Something was tricking my body into  thinking I was near HAPE.

So Covid-19 , I believe has more leverage on your body at altitude. because then the tipping point to reach HAPE is easier.

So why airplanes? Because airplanes at cruising altitudes from 25,000-35,000 are typically only INTERNALLY pressurized to 5000-6000 feet and in fact many times it is closer to 8000 feet which is why you feel both cold and drowsy until you start to descend and get warmer (PV=nRT). 5000 That's somewhere near Denvers altitude the mile high city at 5,280 ft. . You are not breathing sea level pressure air abroad aircraft . But a lot of aircraft are like Aspen at close to 8000 feet. 

Thats not a big deal on a. short flight...say 90 minutes, because you spend some time climbing to cruising altitude and again a good amount of time in descent mode

BUT.... in a long haul flight from say Sydney to Aspen SYD--SFO-DEN-ASE you are aboard aircraft for a long time. Its a 13 hour flight. plenty of time for your blood chemistry to start changing . And then you land in Aspen at 7,945 feet. You are exhausted , jet lagged, likely dehydrated, and you might have had a drink or two. 

If you stress a population you make it more susceptible to infection. This Aussies were stressed. They were easy to infect. Possibly by a German couple that had symptoms. But just as easily by a Chinese person fleeing Wuhan and now on his way to SFO or LAX. Understand that there are a lot of Chinese that live in Australia. And many were fleeing Wuhan. Some went back and forth regularly from Australia to Uhan on business and now were on their way to a ski holiday... could be Aussies doing business in Wuhan now going skiing too. 

https://en.wikipedia.org/wiki/Chinese_Australians

Stressed populations are easier to infect. The virus can incubate even while they are adjusting to altitude and getting over altitude sickness.. Your immunity goes down when it is not in  homeostasis.

So lets look at the COVID -19 Idaho article posted above.  As it so happens while I was living in Boston I taught Rollerblading (inline skating) to a student, Linda Sharp. who worked for Lotus and was a super smart super elegant black woman who enjoyed my classes as a way to cross train for skiing. She liked it so much that she put together at least 2 classes every season for 7 years with mostly Black employees from Lotus , who would learn too skate and then either cross train for ski season or then prepare to learn skiing as Linda was Boston's chapter  Head of the National Brotherhood of Skiers, a multi city organization ,  the largest ski club in the world. Mostly black members, all who love to ski , snowboard  and carve.

This took some adaptation of my Inline teaching. mostly because the students were not used to tight fitting heavy footwear. And a lot were not comfortable with the chilly late fall classes .

There are other adaptations. First off, people of color have been hit hard by Covid-19. There are reasons.

Only 2.5%-35 of the world exists above 3000 meters. Kilamanjaro aside, Africa isn't a national at altitude like Switzerland. Africans are 6 times more like to suffer from hypothermia than whites. But Africans have some advantages...like they re less likely to become alcoholics because of this. Different body chemistry.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4682545/

 

And africans have another interesting thing.

Sickle cell traits and a high incidence of sickle cell anemia. In Africa Malaria doesn't infect sickle cells people and propagate well. So Sickle cell homozygous people won't die of malaria but they won't thrive well because their 02 uptake in their hemoglobin is severely limited by the sickled cells. Africans without Sickle cell historically died of malaria. But Heterozygous sickle carriers (one parent has sickle cell one does not)  had only slightly sickled red blood cells that could still carry 02 well enough not to kill their hosts, but still not as good 02 carriers as non sickle gene carriers.

The Malaria drug might help sickle cell people suffering from COVID-19 even more than regular people.  And because we have so Manu acute ICU cases of people of color....

Another thing to consider is that Africa has more 02 because the rotation of the earth causes a bulge on the sphere shape of the earth at the mid section making it thicker pulling in more 02 . So evolutionarily speaking africans are not selected for lower 02 environments or altitude.

So we had 700 mostly African Americans , traveling from mostly gateway cities with high air traffic . Boston, NYC, Detroit, New Orleans, Atlanta, Chicago, Newark and Nearlby NJ, Dallas, SFO, Washington DC   etc. and some from London and further arriving in Sun Valley to party like the rockstars they are..They have totally off the hook parties....like insane dance parties, drinking, and well from what I saw a bunch of hook ups. They look forward to this trip all year. Not all of them ski at altitude because the local mountains near their urban areas are quite low in altitude compared to the Rockies. For instance Detroit has low peak elevations , as does West Virginia , DC area etc.  and a good chuck of east coast accept ME,VT, NH. So very few were at all altitude acclimatized.Not all can afford multiple Rocky MT. ski trips a year.

They arrived likely with at least two airline connections. Some would have flown out of SFO, many out of NYC. And could have easily had a COVID-19 positive person on either one of their two flights. 126 showed symptoms at the end of the ski trip.  Figuring 20% -80% show as symptomatic. That means (USING THE INFECTED symptomatic number  of  126 anywhere between  441-504  were infected and asymptomatic and contagious to some degree. So we have anywhere between 567-and 630 that  flew home tired and likely shedding virus to the cabin crews going to multiple airline hubs and final destinations lily urban ones.. The cabin crews would likely have stronger immune systems (more altitude acclimatized as they fly all the time) but some Likely would get infected due to COVID-19 virulence  and go on to infect the frequent business travelers who infect others and so on.

Further up this thread is mention of a Skagit church choir. The elevation of Skagit county is 8,967 feet. Massive infection rate in just 2.5 hours of 49 of 60 participants. So I don't know if the choir members traveled from low altitude to high altitude, but it would seem altitude MIGHT just favor infection. Could have something to do with temperature inversions, fog layers etc and of course aerosolizing from singing like in South Koreas church and New Rochelle..

So how do you treat HAPE? You don't increase the frequency fo breathing... because that will increase your body response to slime the lungs.  You do increase 02. But the best thing is to return the patient from altitude back  back to sea level ASAP. LIKE IMMEDIATELY!

What about Covid-19 people already at sea level ..... uh like me and my symptoms. Well I think the best thing is to pressurize people to at least 2.0 Atmospheres in a hyperbaric chamber (like scuba divers use for decompression sickness. That will simulate a "return to sea level" and hopefully reverse the chemical reactions.

If I go scuba diving for two tanks for 2 hours  at 33 feet and my symptoms disappear I will know.

Agressively ventilating a patient who is getting close to ARDS or just a patient with  a low 02 blood saturation of under 705-50%  (like someone with HAPE) will just change the body's reaction and induce the conditions of HAPE faster. A cytokine storm will brew much faster overwhelming the body. I'm no doctor, but I know when I am experiencing the symptoms of AMS or HAPE at sea level and what makes them go away when I'm at atltitude.... increasing the partial pressure of 02 in my lungs without breathing harder. IE going to higher pressure..

 

So oddly COVID-19 is related to carving as we go on Snow trips, we stress our selves out in altitude adjustment on the flight out and further stress ourselves when we land at even higher altitude than the internal cabin pressure of the planes. People of color with sickle cell, or pre existing high blood pressure, coronary disease etc... are even more susceptible . Also scar tissue is harder to get rid of for people black people as the inflammation response to injury is different making healing more problematic. My heart goes out to those NBS who died and suffer permanent  injury from CoVid-19  because there is a statistical likelihood that some of them were my students and they were a totally cool bunch of guys and gals, and I love snowboarding with them blowing their minds that their rollerblading instructor can also cut good turns in the snow.

 

Edited by John Gilmour
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John, stop blowing out your A__. Go to medical school, do a residency in critical care, work in the field, and then you will earn some respect.

It is better to remain silent and appear a fool, rather than to open your mouth and remove all doubt.

I've worked in Critical Care as a specialist in New Zealand.

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https://www.the-hospitalist.org/hospitalist/article/220301/coronavirus-updates/protocol-driven-covid-19-respiratory-therapy-doing

I didn't go to medical school I was just pre-med at Boston University. I'm no respiratory therapist either.

But I bet when this shakes out for some patients the body thinks it's at altitude when you get the virus and actually being at high altitude in addition  doesn't help. Not for all covid-19 cases but for those that can breathe well and have low 02. 

 And for those of carvers either on long haul flights to ski areas or even driving to ski areas quickly changing altitude over 8000 ft it might change our infection suceptibilty .

 

My ER friends on the east coast think there might be something to my theory.

 

So whats your take on it? I'll take your skilled opinion or Poloturbo over mine  . Have you treated many COVID-19 cases? If so thanks.

Here's the interview of several people treating COVID-19 that made me think it was HAPE.

 

https://rebelem.com/rebel-cast-ep79-covid-19-trying-not-to-intubate-early-why-ardsnet-may-be-the-wrong-ventilator-paradigm/?utm_source=rss&utm_medium=rss&utm_campaign=rebel-cast-ep79-covid-19-trying-not-to-intubate-early-why-ardsnet-may-be-the-wrong-ventilator-paradigm

 

 

Edited by John Gilmour
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6 hours ago, Poloturbo said:

I am living daily with covid treating ER patients.

My 5 years old boy and wife hope to have a better life when this is over. 

I wish all the best for you and your family! 

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John hyperbaric chamber is not the kind of device that's going to help more than 10 people in the USA given the limited number that exist are you suggesting we all go live in a submarine ? If you want to sit at the bottom of the harbor I have a half dozen scuba tanks you are welcome to ! Nice that you are using your life experiences to rationalize what's going on. You have a knack for writing interesting tales and I would buy your book if you ever decide to write one but I would consider it entertainment  you certainly  have had some colourful experiences not so much science and fact.

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On 4/7/2020 at 1:15 AM, BobD said:

This is an interesting paper on the 1918 Flu. It explains why the timing and degree of restrictions is important to overall death toll.

If enough people don't gain immunity in the first wave of infections, then the second wave could be as bad as the first. ... 

There's other stuff in there too. I read an NYT analysis comparing 1918 with this one which chimes with that.

The UK government "fluffed" the original media relations on this whole concept. The Murdoch press (think "Fox News") picked up on what they called "herd immunity" and used it as a negative ("the establishment thinks we're a herd") to try to suppress anti-pandemic action. The government realized that this was of secondary importance so stopped talking about it, so we could all get on with doing what needed to be done.

However it's still an issue. If this is remotely like 'flu or the "common cold", then we'll be waiting a long time for an effective vaccine. Which means broadly that we're all going to get it... the only issue is when, and how good is the care available at that point. I think care will get significantly better, as we learn more about the wee beastie.

 



 

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Bill Gates main point ( along with more testing ) was that if all the states don't do a total lock down were in for a longer fight. I would like to suggest that if all countries aren't playing with the same rule book were looking at a very very long time frame and perhaps country by country travel ban for an even longer time with  many countries being give a no go status for years to come. Pass Ports will be irrelevant a negative covid 19 test will decide where you go and who you meet with. At a time when good government is critical it's unfortunate that in time voting in person will be much more difficult and the chance for fraud and or interference will be more prevalent.

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1 hour ago, lowrider said:

 ( https:/www.covid-19 updates: Canada )    Shows world ranking congratulations USA still #1

Not anywhere close to #1 per capita.  Neither in number of cases (#21) nor deaths (#17).  For morality rate (deaths/cases) we are currently #88.

8 hours ago, Poloturbo said:

I am living daily with covid treating ER patients.

We will keep you in our thoughts Poloturbo!

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8 hours ago, Poloturbo said:

Won't comment on the issue. 

To all. Please be careful and_home safe.

 

 

I am living daily with covid treating ER patients.

My 5 years old boy and wife hope to have a better life when this is over. 

I appreciate each day to the fullest.  Even a slight car errand ;).

Snowboarding will truly be a victory for me next year.

Please stay safe and thank you!

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1 hour ago, Jack M said:

Not anywhere close to #1 per capita.  Neither in number of cases (#21) nor deaths (#17).  For morality rate (deaths/cases) we are currently #88.

We will keep you in our thoughts Poloturbo!

Yeah, but the trend looks really bad. If you look at graphs of cases or deaths per capita your curve looks very similar to Italy or Spain. You’re not there yet because you started later. 

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36 minutes ago, Neil Gendzwill said:

Yeah, but the trend looks really bad. If you look at graphs of cases or deaths per capita your curve looks very similar to Italy or Spain. You’re not there yet because you started later. 

We shall see.  One thing I find puzzling is Sweden.  They have taken a unique and cavalier approach to dealing with the situation, with  minimal restrictions.  Personally I disagree with this, but their case rate is lower than ours - 834 cases per million vs 1210.  However their mortality rate is considerably higher, 8.2% vs 3.2%.  I wonder how this is.

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This topic is affecting our members in ways that we have no understanding of, from a simple inconvenience (lifts are not turning sadness) to life changing events (Unemployed, family member deaths) We have members on the front lines that are sacrificing themselves and their families for the greater good. 

We should be acting like a family and supporting each other spiritually and emotionally.  We need to stay out of the blame game, and move forward with kindness and support.

Please stop with political statements and lets find out if there are ways we can SUPPORT or family of carvers.  

Be healthy, stay safe.  

 

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