#i think... i took 2 combination tests and both times its been negative for covid flu and rsv

[surskip]

im sick 🙁 work starts at 8:30 am and it is 3:06 am right now... we are supposed to give a whole day of heads up but i think that i should not go into work tomorrow #strepthroat #streplife maybe i will become the world first strep throat influencer. Day in my life of have strep throat. Day 1: owwww

[squidproquoclarice]

What’s Arthur’s recovery treatment like in Sunrise in terms of medically, because it was really interesting to see such a realistic view on how he would recover from the drastic effects of TB. And the way you wrote that the TB although dormant is always gunna be there with him for the rest of his life was a good other aspect to his character, and added to the strength he has, considering the stigma too attached to the disease at that time, and especially once you get to the last chapter and see how far he’s come from the first chapter, I was just like good for him. It was great.

Combining this with another similar Ask:  “Can you talk about Arthur’s proceduree with the cactus? Just that him living one with those scars of treatment.. it’s great for the story”.   ~~~~~~~~~~~~~~~~~~~~~~ So as I’ve remarked on his gunshot wound, I hate “Hollywood” medicine and how it gives us such an inaccurate impression of what treatment and recovery for something is like.  It was important to me that I depicted the actual process of dealing with tuberculosis recovery realistically, both medically and for the period.  I didn’t want to just skip ahead to three years later and go “And Arthur was well again”.  I also absolutely didn’t want to go the route that I’ve seen of claiming “nonspecific magic Indian cure from Rains Fall” because holy shit, that’s exoticism-as-Other and racism.   Arthur is badly off at the end of Chapter 6.  His TB has run him down to the point where, combined with his fight injuries and hypothermia, it was too much for him in-game.  That’s really not something you can sleep off for a few days or get rid of by popping a few DayQuil.   Being as antibiotics were several decades in the future, TB was everywhere at the time of RDR2.  It was one of the leading causes of death in 1900 America at 194 deaths per 100,000 people.  To give you a comparison to another deadly communicable respiratory disease that kills slowly, leaves chronic impact to survivors, and has huge impacts to society, daily life, and public health?  As per Johns Hopkins University stats, the current American COVID-19 death rate is 149 deaths per 100K.  That’s how bad TB was.      Tuberculosis wasn’t a guaranteed death sentence like people assume from the game.  But yes, it was very likely.  Roughly 1/2 to 2/3 of people who contract active tuberculosis die within five years without antibiotic treatment.  Although interestingly, those who make it to 5 years in untreated tuberculosis then show a 60% spontaneous remission rate. So making it to 5 years was unlikely, but your odds got pretty decent at that point. Arthur's a resilient man who's beaten the odds before, so I figured it wasn't impossible for him to do so again. In terms of actually getting into the details of medical treatment, 1900 is an interesting point in TB history.  It's sort of a transition point between two regimens of treatment.  

The first is the post-Civil War "rest cure" (advised to Arthur by Dr. Barnes in St. Denis) of going to a climate thought to be more helpful to TB sufferers, and from there getting as much rest and fresh air as possible, and just hoping for the best.  TB was actually a significant part of the Old West as plenty of people came westward for that supposed better climate.  What the ideal climate was varied depending who you asked (hot, hot and dry, mountainous, forest, etc.), and spoiler alert: climate doesn't really affect TB recovery.  Getting away from crowded cities was probably the more effective thing. That relied very heavily on patient initiative, though, and the ability of a family to provide any necessary care, as well as to uproot and move to another place.  Obviously for those in poverty, not likely to happen.  We see this with Thomas Downes, who clearly is poor enough that he wouldn't have had that option.  Many didn’t.  Many died because they simply couldn’t stop working, let alone move halfway across the country.  There were a few sanatoriums/well-known rest places, but they were few and far between.       After 1900, and increasingly after WWI, the notion turned more to TB as an issue requiring direct medical intervention rather than letting people quietly hope for the best.  That led to patients often undergoing quarantine and a formal treatment regimen (which still relied a lot upon rest and fresh air) in either a private or government-run sanatorium.  People went in until they recovered enough to show numerous consecutive negative TB tests and the disease had become latent, or they died.  Some took years to leave, and some took years to die.  This is the institutional phase of TB treatment, and it lasted until it got increasingly superseded by the antibiotic phase post-WWII. What I did with Las Hermanas was create something in that transition phase.  It's a TB ward with a more structured treatment regimen, but there's not the strict bureaucratic oversight and total isolation of patients from family and the world that you see later.  I did bring that notion in later in 1907 with Sadie seeing a poster in New Hanover for the new state-run Six Points TB Sanatorium advising that TB patients would be quarantined there. Las Hermanas' treatment is more the hallmark of a forward-thinking doctor.  Felipe Garcia's trying different things in treatment with that mentality, and taking the unusual step of keeping families with patients (which wouldn't be the case later).  It's something that worked on a micro level, but probably couldn't have happened on a macro level as a nationwide program, so Arthur and Sadie are lucky to have hit upon it.  The total bed rest for a while to start to give the lungs a chance to recover is accurate to some TB treatments of the time, and also later. The treatment there at Las Hermanas does include artificial pneumothorax.  Again, Felipe's a bit ahead of the curve.  It was a known treatment at the time, having been reported, as he says, at an AMA conference in Denver several years before.  It had been noted that spontaneous lung collapse (pneumothorax) in a patient actually had i,proved their TB, and the idea of inducing that collapse deliberately (e.g., "artificial" pneumothorax) got kicked around some.  But it didn't really become commonplace as a treatment until post-1912 with Italian physician Carlo Forlanini "rediscovering" the technique and getting visibility for it--he'd actually been among its pioneers thirty years earlier.  But the fascination with microbiological advancements, including Robert Koch's identification and description of the tuberculosis bacteria in 1882, meant it got sort of shelved for a while.  Again, this increasing use post-1912 is also coinciding with the rise of sanatoriums, where controlled treatment regimens under a doctor’s close direction were more possible. Essentially what happens in classic artificial pneumothorax (AP from here on in) therapy is introducing gas--either air or nitrogen--into the cavity surrounding the lungs (*not* the lung itself) via needle and bellows apparatus.  For video of classic AP being performed around 1925 in a patient in Chicago, watch the first 3 minutes of this video.  It does a good job showing exactly what the procedure looked like, what the equipment looked like, etc. Side note: local anesthetic was definitely used in later years because being jabbed with a decent sized needle deeply enough to puncture your chest wall is not fun.  It's very possible Felipe might have used it, as local anesthetic was a concept known and somewhat used at the time.  It very likely would have been a localized injection of cocaine as more familiar, still-used local anesthetics like lidocaine and novocaine were years in the future.  But, hey, for a cowboy game that's period accurate enough that it gives you cocaine gum, using cocaine as a local anesthetic isn't unreasonable.  ;) The AP apparatus, once it was hooked up, put enough gas in there to cause enough pressure and force to induce a partial or full collapse of an infected lung.  That would help rest that lung or that part of it from struggling to breathe, and also provide an oxygen-deprived environment that would help kill the TB bacteria swarming in the lesions and cavities they had chewed into the tissue of the lungs. Bonus: breathing on one or one-and-partial lung also probably generally obliged patients to rest more. For one quick set of statistics, 23 of 40 patients with lungs successfully collapsed by AP in 1913 showed dramatic improvement in their TB.  So not a magic bullet, but a tool that perhaps upped your odds when done right.  There were more severe AP methods also used later, including phrenectomy and thoracoplasty, but those wouldn't have been seen in 1899 in this case. The problem is that the AP gas pumped into the pleura would eventually leak out, or be absorbed by the body tissue.  There's a somewhat vivid detail in Thomas Mann's "Magic Mountain", a 1924 novel about a TB sanatorium, of a whistling sound issuing from the AP hole.  So the AP process had to be repeated at regular intervals, often called "refills", usually cited as about two weeks from what I read.  AP treatment often continued after symptoms stopped, because they wanted to be damn sure that they hadn't treated only enough to just get ahead of the TB or that this wasn’t just a temporary up-cycle, and the disease was well and truly in remission. They confirmed this in later years with actual tests for TB at regular intervals to track that progress.  I kept that two week refill schedule for Arthur, and also its effect on keeping him tethered to Las Hermanas for a few more years even after he has a more normal, active life.  I think (?) I wrote him as stopping treatments sometime in late 1902, so roughly three years total, and two years post-release as no longer actively symptomatic. All in all, I wrote a treatment that wasn't widespread at the time, but would have been very possible with the knowledge and equipment available.  I went the AP route in the end because I wanted to give Arthur more than just bed rest both for higher survival odds, and also because I think now-obsolete medical history in fiction is interesting. The effects are some of the things I noted in Arthur throughout Sunrise.  Getting jabbed with a needle every two weeks for years is going to produce some scars on the skin.  It would be a tight cluster given you wanted to place your needle very carefully, but they would exist.  We see something similar now with "track marks" in those addicted to intravenous drugs, and I think I noted Arthur or Sadie remembering Swanson having something like it in his arm from years of addiction to injected opiates.    Working on that one or one-and-partial lung during all AP refills also means that Arthur is incapable of really hard daily physical labor, even after being released from Las Hermanas.  The lung capacity, and the stamina, just isn't there.  That was one factor that impacted his ability to get a regular job, which has the effects we see in 1904 of them worrying about money. That's also because even after he's got two fully-inflated and working lungs in later years, he's still not 100%.  While the lesions on the lungs may heal and send the TB into remission, they don't become healthy lung tissue again.  They become scars that still would be visible in later years when X-rays became more common.  So there's a lack of both flexibility to contract/expand and surface area for oxygen exchange that were there with healthy tissue.  In other words, Arthur's lungs are permanently running on a reduced capacity.  His stamina and strength and resilience are going to be affected. He's never going to be exactly what he was before becoming sick due to permanent effects of the damage, as well as just the fact of him going from 36 to 48 and thus just getting into middle age.  If Sunrise was an actual playable game using the RDR2 system, I'd depict that as Arthur's Stamina and Health cores being permanently damaged and capped at a lower level than before.  Probably down 3 bars for the Wapiti chapter and his first six months at Las Hermanas (due to the near-death status initially and then massive muscle and strength loss from all that bed rest), down 2 for the next six months at Las Hermanas and all of 1901 after his release, and down 1 for 1904/1907/1911 and the rest of his life. The other thing is Arthur can't be "cured" with the medicine of the time.  That was pretty much impossible in the pre-antibiotic era given the bacteria could never be entirely killed off in the lungs.  The best you could do was get strong and healthy enough for your immune system to effectively keep the ones left contained and inactive.  So while TB survivors could live healthy, happy lives, they knew that there was always a chance that TB could always come back.  Hence Felipe chewing Arthur out more than once for pushing himself too hard and risking getting run down enough for the TB to have an easier time gaining a foothold again. So his lifestyle's permanently changed in some ways.  He learns to recognize the signs of approaching exhaustion, and having to back away from it and slow down or rest.  Sadie's necessarily become attuned to this as well.  Arthur has to learn his own limits for the sake of self-care, and I think that's not a bad thing given he'd never had any real sense of self-preservation before.  He can't just keep pushing like he used to do, telling himself he'll make up for it later.  He has to commit to taking care of himself for his sake as well as Sadie's well-being, because he knows she can't lose him, just like he can't lose her.  He has to do it later for their children too.  Recognizing that taking care of yourself for the sake of your loved ones is actually protecting and showing them love too, rather than selfishness, is a big step forward for him.  I'll do the work to take care of myself so I can better be here for you, so I don't cause you the pain of watching me suffer or die, plus the emotional and financial and logistical burdens of my not being there. As first Anon noted, he and Sadie tend to keep hush about it unless they can trust someone, given the stigma associated with TB due to fear of the disease.  At some points, Arthur has to wonder if this person knew the truth about him whether he'd be more of a pariah as a notorious outlaw or as a TB survivor.  It didn't necessarily matter that the disease was latent.  All people had to hear was "tuberculosis".  So something like the fact Drew MacFarlane as the father of a TB victim himself not only doesn't stigmatize Arthur, but is willing to work around the TB restrictions, means a lot to both Arthur and Sadie.

[whimsically-ominously-auspice]

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A post shared by ABC World News Tonight (@abcworldnewstonight) on Apr 6, 2020 at 1:23pm PDT

In other world news...

Hospitals are to remain open for the emergency sick

Heart attacks. Persons doing home improvement that have incidents requiring medical care. Children amd adults thaf have bronchitis that can turn into pneumonia. Bronchitis MUST be treated with traditional medicine then the patient is to be sent home.

Not stroke victims. Not COVID-19. All hospitals received information on who to treat. And how.

These scientists and medical field professionals developing tests and releasing them. They're interfering with the natural process of the evolution and progression of Earth and shall be arrested. These medical field people making gallons of,hand sanitizer an bars as well. They don't know what the fuck they're doing nor why. They're just doing it. How many police officers infants could been killed because they gave them bottles of bar/distillery/brewery made hand sanitizer? Way too many. All of them could have been killed. I have a partial mind to arrest them for attempted murder. Idk who they are or what their actual attempt was. Do you? Are those home grown terrorists or Just people thinking they know best without thinking at all?

That is how people die. And without natural selection. Any infant or young child. Any raging alcoholic that would drink mouthwash to get drunk.

Unfortunately, what the Pakistani police did is protocol.

The hospital workers were not in the hospital doing their job to care for the sick and injured.

They were fighting for a way to care for people -- illegal aliens that will purposely harm us to rule the Earth -- and that it wrong. And so it appears they were arrested.

Now they must check the status via DNA4U -- good but misguided humans get a 3 day time out in a normal jail facility where they are treated to 3 square meals per day and one snack including juice. Then evil humans and aliens are turned over to dinosaurs alive.

Unfortunately that is protocol.

Stay in hospitals and care for the PROPER patients.

Its allot less stressful for the hospital to follow protocol. In and out patients. Notify police of home address where suspected or tested positive COVID-19 are for checking for bodies. In some towns they want bodies put at the curb. Others they don't.

The hospital creates a list. The police do welfare checks from that list.

Teamwork.

In the USA when a patient is near death an ambulance can be called or the police may use a gifted wheelchair to roll the patient to their cruiser and drive them to the hospital themselves with lights and sirens. A certain number of days must pass before doing so.

COVID-19 are to remain with their families. We're not monsters.

This information is written correct.

Patient has COVID-19. A Corona Virus survivor.

It includes a question. Should it be coronavirus to seperate it from Corona Virus?

I questioned the Team and they agreed IF Corona Virus is used for Corona Virus only and coronavirus is only used for COVID-19.

So if any human goes in and comes out fine after being labeled human (although may be a COVID-19 carrier) then it's Corona Virus.

If a person goes in and is labeled Alien or Evil human and has COVID-19 active then they come out okay with survival of coronavirus.

Yes that is accurate and defining and organized. I think most readers will find that to be well. I really like that Mr Muir and ABC.

Thank you.

I received this this morning. My brother got one the other day and sent him to a tail spin.

These are to alert to remind you to stay home and how long and why.

This says COVID-19 which means aliens exist. Which means danger of kidnapping as many are human trafficking.

It means that COVID to COVID spreads ACTIVATION. So if I'm an alien then i can get COVID symptoms if i go out. Which also means ventilators are being used. So if I get activated as an alien do not go to the hospital to die. There is no treatments! Self care at home is one to two doses of Nyquil and if you want to have energy then 2 multivitamins. I am told multivitamins have a well stock. Shelves may not look great but they're being replenished.

Multivitamins: last weekend I bought a whole bottle of vitamins for about $9 with 160 pills. If i took 2 per day it would last 80 days. It would last a family of 4 taking 2 per day 20 days. I bought the mini (petites) pills. And the dose is 2. And so dying and i want an energy day i would take 2 because i took 2 and I felt energy.

I take two of the regular and I don't feel s difference But it's also not a recommended brand of what i have.

So Centrum and One a Day are the only recommended. Only two bottle per month limit.

Nyquil isn't limited except in purchases. So its only 2 per purchase which is then 2 per 4 days. Each bottle should last more than a half day or at least a half day in severe cases. If you need more than 2 because you are unable to go to the store or send someone every 4 days then you must notify the pharmacy thus the shelf can be replenished. Then the limit is 5. AFTER speaking to the pharmacy. Best option is to gather the Nyquil and pay in the pharmacy. Paying some One $20 to run the errand that is human is the Best option.

Some places have delivery. Like Wal-Mart does have delivery but i am quite sure you need to live in a certain area in town to qualify. If you can get a pizza delivery you can probably get Wal-Mart delivery.

STAY HOME does indicate that there could be severe punishment and fines if i am out. I do know one local police force is out looking for people that are out often. And Idk what all they're doing, personally but im quite sure they're keeping track. Denise and i don't have working auto so my Uncle Dad has to run us both around as well as his own errends. So we try to combine them. I have Nathaniel pick up my mail instead of traveling that distance and causing gas use for my Uncle Dad he wouldn't otherwise use.

And it does say that its the simple ruling until April 30

Which also means no picket lines or anything rambunctious. Don't go to Santa Fe with signs stating this shit is unfair..

It is unfair. I don't like it to be 100% honest. But it does have a valid point. And a very strong argument.

So just hang in there with the rest of us. Keep the negativity to a minimum. It makes the rest of us want to kill ourselves.