Yeah, I’m coming up deeply and dreadfully blank. I think the biggest thing that can be done, immediately, is to more heavily weigh patient reports of anxiety, lightheadedness, so on, so when there are some symptoms it’s lent credence even if the Oxygen Sat disagrees. 
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What’s extra infuriating is that there are a ton of quickly googleable studies about how dark nail polish can interfere with pulse ox readings (it’s on my mind because I’m having a minor thing done this week and was told not to wear dark nail polish for this reason). So, 1) why has no one followed the obvious logic that darker skin may also affect the readings and 2) why have we done more studies on nail polish color than skin color??? Ugh.
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So what we are saying is that if you get COVID you may feel fine and still be getting permanent brain (and other) damage from low oxygen, but you can’t tell what’s happening based on symptoms
… and someone with darker skin (🙋) isn’t going to get an accurate reading using today’s tech? Am I understanding or making too many leaps as a layman?
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So my understanding (I am not a doctor disclaimer!) It’s not low enough oxygen to be causing brain damage- the concern is that hidden low oxygen is the state people are in for (sometimes quite a while) before a sharp decline (if they have one). Treatment works a lot better if we catch you at the “low oxygen but no symptoms” phase. So, outcomes will be worse in people we can’t treat as early, because we don’t catch the progression as early. It hides one of the really big warning signs.
Happy to be corrected if anyone interprets this differently.
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Usually, if you typically hang out at an oxygen sat of 98-99%, and then some acute process happens to make your sat go down to, say, 92%, you will feel short of breath, your breaths per minute will go up, you’ll be using additional muscles for the work of breathing, etc. It’s usually pretty obvious when someone is in respiratory distress, no matter what the pulse ox says. (The main alternative is a person having a panic attack, which I’ve seen a lot of where I work.)
But there is something about COVID, where people can look and feel totally fine*, not be in distress at all, but actually be quite hypoxic. Which is why we rely so much on pulse ox readings, and I’ve sent people to the hospital solely based in pulse ox readings.
So it’s very alarming that our pulse ox machines are calibrated for white skin & significantly less accurate in people with darker skin.
*This probably contributed to why, during the April height in NYC, some people took off their oxygen to go to the bathroom, and were later found dead. Also, hospital protocols I read said to put people on ventilators solely based on ABG readings. They could be sitting up, chatting in the phone, but still be severely hypoxemic.
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I hope you are right because this is comforting even while being scary and sad.
I am full of rage…
…and also alarm.
Thank you both for explaining this to me. It is so shitty that we’re all doing our best and minimizing risk almost completely like Ferngully and can still get COVID. And that once you get it, you’re at a disadvantage of you aren’t white. 
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I kinda feel like if we can unlock how Covid does this we’ll have so many potential therapies for things like chronic pain.
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FWIW, I believe that for dark skinned folks you’re supposed to check for color change of the mucous membranes inside your lower lip. I heard this from an EMT friend but am having trouble finding a good source…this one mentions it but it’s hard to find anything more specific.
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It can also be very valuable to have family members who know the person’s normal. My brown and black relative’s colour changes are as obvious and as ominous as the pale people. Until I entered healthcare I didn’t know it was missed or not obvious for some people
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I’m horrified by the photos of large crowds fleeing London in advance of their lockdown. They are going to be spreading this now more contagious strain. 
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It’s more complicated than that; they also have Brexit happening in 12 days. Many had planned trips to stock up on medications and food in France and ireland.
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Oh shit. That’s really bad timing then, yeah. The quotes in the articles I read didn’t mention that, it was more about “I have to get out now so I can see my family for Christmas.”
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So London has tier III restrictions already, and they were allowed to have a Christmas bubble of no more than 5 people. Many many people were isolating to see their parents for Xmas. Abruptly on Saturday there was a u-turn made and they moved to tier IV restrictions in London, no overseas travel allowed (including to Ireland and Northern Ireland) and you can’t have Xmas with anyone outside your household.
The abrupt change when people had be planning for weeks for a 5 person Christmas bubble. Now people who live alone are going to be entirely alone for Xmas.
It was really abrupt, and it might be the right thing because of the new strain emerging in southern UK but it still really sucks.
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Yeah, that’s the story of the pandemic, right? It’s the right thing to do and also it sucks.
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I am enjoying this thread that explains clearly how the vaccine works and from now on I am going to call covid Asshole Protein.
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That’s a great write up.
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My sister’s boyfriend’s mother just told her that “spending just 30 minutes in blue light will kill the man-made China virus, and we’ve all been scammed”. 
Who knew?
Seriously though, I understand that a big part of the problem is either a lack of scientific education or a lack of being taught critical thinking, but I have NO IDEA how to reason with people who believe things like this.
It makes my head hurt to even try to understand how they can logically get to some of these conclusions. I have been trying to look at opinions from both sides to see where people are coming from and where their beliefs are based, but SCIENCE, people. Science. There is no big conspiracy among “scientists” as a whole, I promise
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My best friends FIL is legitimately a scientist. Like, a globally recognized mycologist. He still travels the world to speak… about science. At science conferences. He is swallowing the Fox News bullshit, with some nice QAnon pepper on top, hook line and sinker. I don’t get it. Best Friend’s husband is one of the smartest people I’ve ever met. The times I’ve met her FIL, he has struck me as quite intelligent. WHERE is the critical thinking. WHERE is that education? It’s just. UGHHHHHH. He literally sends her crap about how the RNA will be incorporated into our DNA. You’re a fucking BIOLOGIST YOU KNOW IT WONT AND CANT.
I just. How. How is this possible. I wish this guy was the only person I know with this level of education and success being totally gullible about all this. It blows my mind.
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This is my brain, thank you.
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So everyone in the entire world has to spend the same exact 30 minutes in blue light so all of the virus is killed and you don’t have to keep doing it forever? Sounds perfectly doable.
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