Day to Day Sings & Symptons…DAY 1 to 22

Day to Day Signs and Symptoms of Coronavirus DAY TO DAY SYMPTOMS OF COVID-19 Before proceeding, please note that this general overview is compiled for initial self-assessment only and should vary for each individual. If you are not feeling well, you ought to immediately consult a medical man to possess an accurate diagnosis and proper treatment of COVID-19. The typical daily symptoms are concluded from the study of 138 patients at Zhongnan Hospital of Wuhan University and another study involving 135 patients from Jinyintan Hospital and 56 patients from Wuhan Pulmonary Hospital.

These symptoms are broken down into:

DAY 1 to DAY 2 the start symptoms are almost like the cold with a light pharyngitis and neither having a fever nor feeling tired. Patients can still consume food and drink as was common .

DAY 3 The patient’s throats start to feel a touch painful. Body temperature reads at around 36.5° celsius. Although it’s uncommon, other symptoms like mild nausea, vomiting or mild diarrhea are possible to set in.

DAY 4 Throat pain becomes more serious. Other symptoms like feeling weak and joint pain start to manifest. The patient may show a temperature reading between 36.5° to 37° celsius.

DAY 5 to DAY 6 Mild fever starts. The patients show a temperature reading above 37.2° celsius. The second most common symptom, dry cough, also appears. Dyspnea or breathing difficulty may occur occasionally. Most patients during this stage are easily feeling tired. Other symptoms remain about the same. These four symptoms are among the top five key indications of COVID-19 according to the final report of the initial outbreak conducted by the joint mission of China and WHO.

DAY 7 get more serious coughs and breathing difficulty. Fever can get higher up to 38° celsius. Patients may develop further headache and body pain or worsening diarrhea if there’s any. Many patients are admitted to the hospital at this stage.

DAY 8 to DAY 9 On the 8th day, the symptoms are likely to be worsened for the patient who has coexisting medical conditions. Severe shortness of breath becomes more frequent. Temperature reading goes well above 38°.

DAY 9 is that the average time when Sepsis starts to affect 40% of the patients.

DAY 10 to DAY 11 Doctors are ordering imaging tests like chest x-ray to capture the severity of respiratory distress in patients. Patients are having loss of appetite and should be facing abdominal pain. The condition also needs immediate treatment in ICU.

DAY 12 to DAY 14 For the survivors, the symptoms can be well-managed at this point. Fever tends to urge better and breathing difficulties may start to cease on day 13. But Some patients should be suffering from mild cough even after hospital discharge.

DAY 15 to DAY 16 Day 15 is the opposite condition for the rest of the minority patients. The fragile group must prepare for the possibility of acute cardiac injury or kidney injury.

DAY 17 to DAY 19 COVID-19 fatality cases happen at around day 18. Before the time, vulnerable patients may develop a secondary infection caused by a new pathogen in the lower respiratory tract. The severe condition may then lead to blood coagulation and ischemia.
DAY 20 to DAY 22 The surviving patients are recovered completely from the disease and are discharged from the hospital.

STAY HOME & STAY SAFE

Are products really ‘Made In China’ ???

Made in China. We’ve become accustomed to seeing the label on products manufactured in the world’s second biggest economy. But buying one of these products in China instead of say, the U.S., doesn’t guarantee you’re getting a better price. Chinese tourists have built a reputation for being big spenders abroad, spending a whopping $277 billion in 2018, much more than any other nationality. A lot of times, people think that purchasing something in China will be inexpensive, but that isn’t always the case. So how much of a difference are we talking? If we bring four products from four popular western brands to compare. Starbucks, H&M, Adidas store, a Godiva store. To keep things consistent, we will be using 2019’s average foreign exchange rate. The products compared are:

A standard black t-shirt at H&M.
Starbucks Grande Cappuccino.
Godiva Chocolates.
An Adidas hat.

Now let’s compare:

The shirt at H&M is priced nearly the same in the U.S. and China.
A Grande Starbucks cappuccino will cost you $4.63 in Beijing, but in Los Angles, California, $3.95.
This case of Godiva chocolates, called Pearls, is priced at $7.24 in Beijing, but only $3.95 in LA.
The Adidas hat will set you back $42.27 in China, nearly double the price of a similar hat in the U.S.

This experiment has made clear that pricing are complicated. So much so, that websites have popped up like the Mac Index, a site that compares Apple product prices from around the world. So many ads for Apple here in this area. According to an analysis done by Tech Insights, the cost to make an Apple iPhone 11 Pro is $490.50. Yet according to The Mac Index, the price to buy one is $1,318 in Japan, $1,477 in the U.S., $1,658 in Mainland China and more than $2,000 in Turkey and Peru. Prices vary across countries due to factors like demand, tariffs and tax refunds. And then there’s the supply chain: the network of people, organizations, activities, information and resources involved in the creation of a product.

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Apple’s current CEO Tim Cook is considered by some to be a mastermind in supply chain. He first joined Apple in 1998 with a mandate to clean up the company’s manufacturing and distribution. Over time, he closed factories and warehouses, instead opting for contract manufacturers in China. That’s great for Apple’s profit margins, but it’s certainly not praised by President Trump, who has asked Apple to make its products in the U.S. If, say, iPhone production was moved to the U.S., instead of China, different analyses show the price for the consumer could go up from anywhere from $30 or $40 to hundreds of dollars to even $30,000-100,000. That’s partially why, despite Apple pledging to invest more money in American manufacturing, it maintains China as its hub for making its gadgets.

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That’s Omar Slim, a senior portfolio manager at global asset manager, PineBridge. When you hear about made in this country or that country is really quite relative and it’s a simplification of things because it’s most likely made in a number of countries. Here’s an example. Let’s say we want to make lasagna for dinner. If Jeff cooks the ground beef and prepares the cheese, Sarah makes the tomato sauce and layers the ingredients into a pan; and Blair, who bought all the ingredients, puts it in the oven, who gets the credit for making the lasagna? Now, let’s apply that to Apple’s iPhone. While the phone might say ‘Made in China,’ some of its parts come from other parts of Asia, Europe and even the U.S. Even though an iPhone may be assembled in China, it’s still tariffed in China as a U.S. product because Apple is an American company. The brand makes that clear with by, ‘Designed by Apple in California. How they’re treated in terms of customs, they will be treated as a U.S. product. So regardless of where they come, it’s essentially a U.S. product. Same for Chinese products going into the U.S. and same for, for instance, European cars.

China became a popular manufacturing hub in the 1980s after it started to open to the world. It became known for its cheap labor costs, lax regulations and business-friendly environment. As China’s manufacturing sector grew, it took the crown from Germany as the world’s top exporter in 2010. While Made in China has become synonymous with cheap and low-quality products, China is hoping to change that. In 2015, it launched a Made in China 2025 initiative, which aims to shift its economy from low-end manufacturing to high-end, high-tech products. In 2017, Tim Cook said China lost its place as a low labor cost manufacturing nation many years ago. The U.S.-China trade war resulted in a tit-for-tat increase in tariffs on many products.

With increasing costs being passed on to consumers, many companies are looking to diversify their supply chain, instead of being so reliant on China. That sentiment has only grown, following the coronavirus pandemic’s hit on the global manufacturing industry. Along that supply chain, there will be some companies, that instead of manufacturing it in China, if they could, they could try to replace. In fact, companies including Apple, Microsoft and Google are reportedly looking into moving some of their hardware production from China to Vietnam or Thailand. But that might be harder than it sounds. The other countries will have a hard time to compete along with the fact that the infrastructure is shown that it’s quite good, along with the fact that in certain countries would not want to compromise the relationship with China.

The reality today is that a product likely has many components which are sourced globally. A phone may be designed in the U.S, but its screen is sourced from South Korea, the sensors and microchips may be from Taiwan or Germany, with its assembly in China. So, the next time you see a product with the words, “Made in China,” remember that the full story is seldom pure, and never simple.

Dexamethasone- Corona Vaccine Update!!!

Finally some good news today dexamethasone is now being called a major breakthrough based on a recent randomized controlled trial in the UK. Dexamethasone also known as Decadron is an example of a glucocorticoid are sometimes referred to as corticosteroids other examples of glucocorticoids include hydrocortisone methyl prednisolone prednisolone, prednisone beta methazone and triamcinolone so glucocorticoids are a class of steroid hormones that bind to the glucocorticoid receptor in the body cortisol aka hydrocortisone is the glucocorticoid.

We naturally make in our body it’s essential for life it regulates or supports various cardiovascular metabolic and homeostatic functions it also plays a big role in our immune system especially when it comes to reducing certain aspects of inflammation this is why we use them all the time in medicine we sometimes give these steroids for asthma copd rheumatologic type diseases and countless more diseases. Sometimes it is also given for steroids for meningitis and also for some forms of cancer we also give them in the early course of severe ards acute respiratory distress syndrome whether that ards is due to infection such as pneumonia or vaping lung injury or whatever the cause for severe ards we typically give methylprednisolone or solumedral at a dose of one milligram per kilogram per day. So, for most people that ends up being around 80 milligrams per day so this is the equivalent of 15 milligrams of dexamethasone the idea here is to suppress the cytokine storm that has taken place meaning that the massive amount of inflammation that causes lung damage and can indirectly cause damage to other organs as well our body naturally makes cortisol in our adrenal glands specifically in the zona fasciculata of the adrenal cortex the adrenal gland then secretes cortisol into the bloodstream and the cortisol travels to different tissues of the body and then binds to the glucocorticoid receptor inside cells it then stimulates the cell to make more anti-inflammatory proteins and causes the cell to make less pro-inflammatory proteins but giving someone glucocorticoids meaning steroids to someone who has an infection is somewhat of a tricky thing because the fear is that if you suppress the body’s immune system it has the potential to make the infection worse. Sometimes the body’s immune system does more damage than the actual infection for example in cases of meningitis that is due to either streptococcus or tuberculosis we give steroids because the medical evidence shows that they have better outcomes when we do so and giving someone steroids for viral pneumonias like influenza is more controversial because doing so generally leads to worse infection with that said if the viral pneumonia is so bad to the point of causing severe ards most doctors will give steroids in that situation. So this is why, the general medical guidelines so far recommend against giving steroids for covert pneumonia unless the patient has severe ards and we’ve been waiting for randomized controlled trials to come out for steroids in covid and here we are now with this study so in march of 2020 the recovery trial which stands for randomized evaluation of covid-19 therapy was one of the randomized control trials that actually looked at several different potential treatments for covid which included low-dose dexamethasone this trial was done in the UK.

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Over 11 500 patients in it so this trial has not been peer reviewed as of has not been published in the journal yet so everything I know so far is based on what’s been released to the general public in this trial over 2100 patients were randomized to receive dexamethasone specifically six milligrams once per day for 10 days and this group was compared with over 4 300 patients that were randomized to the standard care alone so 6 milligrams of dexamethasone is the equivalent of 32 milligrams of methylprednisolone so this is about half the dose we would typically use for someone with severe ards so among the patients who received standard care alone 20-day mortality was highest in those who required mechanical ventilation this was 41 and then intermediate in those patients who required supplemental oxygen only this was mortality rate of 25 percent and the mortality rate was lowest among those who did not require supplemental oxygen in which that mortality rate was 13 for patients who were on mechanical ventilators dexamethasone reduced mortality from 41 percent to 28 percent for patients who needed supplemental oxygen it reduced mortality from 25 percent to 20 percent and there was no benefit among those patients who do not require supplement oxygen in other words if someone only had mild disease there was no point in giving dexamethasone so based on these results one death would be prevented by the treatment of around eight ventilated patients. So that’s the number needed to treat for ventilated patients and then the number needed to treat for the ones who required supplemental oxygen that number needed to treat would be 25 so these preliminary results are significant but it doesn’t mean that dexamethasone is a miracle drug it’s certainly not a cure but it does seem to help based on these numbers index and methazone could be of huge benefit and not just rich countries but poorer countries as well because this drug is very cheap and is widely available so this is great news and very exciting but there are still a lot of questions that need to be answered like what is the ideal dose should we use higher doses in patients who are mechanically ventilated with ards and when will it be approved for use in the united states and we’ll get these answers pretty soon now another.

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Interesting question is should we give decadron dexamethasone to people who have mild disease now even though this study didn’t show any benefit the reason why i bring this up is because some people start out with mild disease and then go on to have moderate or severe disease and we have no way of predicting who goes on to do that and also it happens very quickly lots of times someone could be doing just fine and then all of a sudden within hours they all of a sudden are deteriorating and they have severe disease so should we give those patients decadron regardless is there any harm doing so that’s another question that remains to be seen.

How to open a Franchise without money- US…

let’s talk about to open a franchise with no money so the first thing you can do, if you want to open a franchise with no money down is go to your friends and family look. I understand that that’s something that you may not want to do sometimes that’s a toughest conversation asking friends and family for money but I would assume if you’re willing to open a franchise and you have some skill sets you have a certain level of intelligence and a certain level of ambition so assuming that you have a good reputation and a good rapport with your friends and family then that’s the first place that you can go to get money to fund your franchise.

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Now when you’re approaching them for the money it’s important to be tactical and strategic about it and you don’t just say hey! can I borrow ten thousand dollars can I borrow twenty thousand dollars can I have fifty thousand dollars you have to go into it strategically so go into it with a business plan this is the franchise that I want to buy this is the amount of money that I need to get started this is a lot the amount of money that I think I will make with the franchise this is the time period which I can pay the money back to you and get on that loan repayment plan, another way to approach getting money from feds and friends and family to fund your franchise is to ask them to be a partner with you so although they may not want to work in the franchise themselves maybe they’re more willing to give you money or lend you money for the franchise if they are an owner or an investor with you so maybe you’re the one that runs the franchise and you handle the day-to-day operations the sales managing the staff managing the overall business and they get a percentage of the profits as a way of paying them back.

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The next way that you can fund a franchise is to get a loan and before you read about that real quick with the franchise so now in getting a loan to open a franchise business it’s important to note that one you’re going to need to have good credit and two you’re going to need to have an income that can support paying back. The loan and three the likelihood is you are still going to need money for the down payment on that loan if you get us an SBA loan which is Small Business Administration they require a minimum of 10% down from you in order to fund that business so what does that mean if you need $100,000 for your franchise business then that means you need to come up with $10,000 in order to here that loan so the question is how will you come up with that $10,000 and there’s a number of options that we’ll go over in a second of how you can do that one way you can do that is what we already talked about which is getting money from friends or family it’s so even with the Small Business Administration having a ten percent minimum requirement that you have to put towards the loan in order to open a business.

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Most lenders that issue SBA loans are going to require anywhere from 20% to 30% in order for you to secure that loan so again in that example if you’re looking to open up a business that’s a total of $100,000 you’re going to have to figure out a way to come up with twenty to thirty thousand dollars in order to secure that loan and so in a second I’m going to tell you about a strategy of exactly how you can do that without having to ask your friends or family for money another way that you can fund a franchise without having any money so to say is seeing if you have any 401k or retirement plans now as someone who has managed over a hundred million dollars over the course of career as a financial advisor typically. I would not recommend for someone to take money out of their 401k and that’s not what I’m recommending to you. So, I want to make sure that you get that clear because there are severe penalties and tax consequences that you should consult the tax advisor about but there are ways that you can leverage your 401k so if you’re still working with your employer you can take out a loan against your 401k in order to fund a business and when you take out a loan there’s one thing that you have to be very careful about the thing that you have to be careful about is that if you leave that employer and you have an outstanding loan they are going to make you repay that loan within a certain period of time usually it’s 60 days if that is the case if you don’t come up with the money and repay the loan for the 401k they count it as an early distribution you’re going to have to pay taxes on that money depending upon if it’s a pre-tax 401k and you may have to pay some penalties. 2 guys opened up first location they were going to need 300 just over $300,000 in order to get first location open so they had a significant equity in their home at that time and want to went ahead and apply for a home equity loan they secured a three hundred and ten thousand dollar home equity loan use that home equity loan to fund the business and to pay for the business about a year or so later they actually wind up moving they sold their house the home equity loan was paid for paid off and now they own the franchise in the business completely outright don’t have any loans on the business and then the last way that you can potentially buy or open a franchise with absolutely no money is to talk to the franchiser again it’s not about the resources it’s about your resourcefulness so it never hurts to ask them and to make a pitch if you’re truly excited and confident about the opportunity.

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