Medical Discussion of Coronavirus

[gap55u]

Our family will not be traveling to nor gathering with high risk family members. Regardless of driving or flying, regardless of mask quality.... This is a personal choice, but I would do everything possible to mitigate risk with a 93 year old (quality mask for all, distance, strict
bubble for 2 weeks before, test everyone, eat outdoors if possible). I would rather that to the alternative.

[CordMcNally]

Our family will not be traveling to nor gathering with high risk family members. Regardless of driving or flying, regardless of mask quality.... This is a personal choice, but I would do everything possible to mitigate risk with a 93 year old (quality mask for all, distance, strict
bubble for 2 weeks before, test everyone, eat outdoors if possible). I would rather that to the alternative.

I'd ask the 93 year old what they wanted and then do that.

[Hatton]

I bought two and I am deeply appreciative of StartrekDoc and your recommendation. Planning on at least two more for family members and one for my son in hopes he can make a holiday trip.
Etiquette question:
He might bring a significant other for the Christmas trip. Would it be overbearing to send one for her? 93 year old MIL that has been “isolated” since March. My anxiety would be less if we took the step of getting a good mask. I would tremble seeing her for the first time and seeing a paper disposable mask slipping off the nose. Can you imagine the urge to isolate a guest?
Can you imagine how difficult “millennials” would have understanding a mask lecture or even a mention?
Hatton, please give me your etiquette recommendation. I would even take your advice for the ladies choice!
I am hopeful of preventing a guest from unintentionally catching c-19 and invading our space. I tend to think it’s reasonable to provide a good mask and ask that it be used for the plane flight.

Tim I think giving the SO a better vogmask would be appropriate. If she is offended then she is not serious about joining the family. N95 for the 93 year old?

[StarTrekDoc]

As a Libertarian leaning person -- your house, your rules. Really that simple.

[STM]

Another thank you to StarTrekDoc for the vogmask recommendation. I recently got them for my whole family and I've been very impressed.

[StarTrekDoc]

- we like them and the cambridge masks. Both are good and work nicely -- using the headband really helps all day usage in saves the ears. As Hatton mentioned, pinching the nose really makes a good seal.

Tim - yeah, it's a bit troublesome on the breathing -- it's a lot harder than a cloth mask. You'll notice it more as usage goes on. By about 150+ hours of usage, you'll really start noticing the breathing if you break out a new one and directly compare after each other. IMHO - ship one to her with a welcome to the family note.

[nephron]

You should listen to this:

https://podcasts.apple.com/us/podcast/conversations-with-dr-bauchner/id410339697?i=1000494207535

I’m pretty happy with the FDA only needing 3 weeks to analyze hundreds or thousands of pages of data. I would be skeptical if we got results much quicker than that.

I listened to the podcast. I understand the theory of wanting the fda to review primary data that the drug company submits, but they are literally just duplicating what the drug company's scientist have already done. If I were running the show, I would review the data in paper format (ie whatever they end up submitting to nejm), and decide to approve or disapprove the vaccine based upon the abstract. I might look at table 1 and one or two of the results tables. I know that the data will be incomplete and may end up being refuted by future studies, but I can't see how having government scientist pore over and re-examine primary data collected by drug companies come to a much different conclusion then whatever will be published (will they note 2 patients in the 30,000 checked off nausea but the drug company did not report it as a side effect?). It seems like the idea that recounting the votes may change an election result. They are dependent on what the drug company did or did not do. I just think that with thousands of patients dying on a daily basis, if you have a vaccine which has a purported 95% efficacy, you can't sit on it for several weeks looking over primary data. It's not like they are collecting new data so I don't see them coming to a drastically different conclusion. It's typical government bureaucracy having hours of meetings going over work someone else completed. You can always review the work post distribution and penalize the companies if they falsified data.

[CordMcNally]

I listened to the podcast. I understand the theory of wanting the fda to review primary data that the drug company submits, but they are literally just duplicating what the drug company's scientist have already done. If I were running the show, I would review the data in paper format (ie whatever they end up submitting to nejm), and decide to approve or disapprove the vaccine based upon the abstract. I might look at table 1 and one or two of the results tables. I know that the data will be incomplete and may end up being refuted by future studies, but I can't see how having government scientist pore over and re-examine primary data collected by drug companies come to a much different conclusion then whatever will be published (will they note 2 patients in the 30,000 checked off nausea but the drug company did not report it as a side effect?). It seems like the idea that recounting the votes may change an election result. They are dependent on what the drug company did or did not do. I just think that with thousands of patients dying on a daily basis, if you have a vaccine which has a purported 95% efficacy, you can't sit on it for several weeks looking over primary data. It's not like they are collecting new data so I don't see them coming to a drastically different conclusion. It's typical government bureaucracy having hours of meetings going over work someone else completed. You can always review the work post distribution and penalize the companies if they falsified data.

It personally makes me feel better that the government is going to analyze everything. If you think 50% of America (at any given time) not trusting the government is bad, just wait until 100% of America distrusts the government if they botch the handling of the vaccines.

[nephron]

If people want to listen to our governmental response, 60 minutes has had a few damning broadcasts about our response. The episode on 10/18 described the cdc's response to a cruise ship with infected patients where they flew passengers back on a charter flight only to put them into an international airport to fly home after performing temperature checks and having them fill out surveys. The 11/1 episode describes the brilliant members of the CMS who decided to complete an audit and try to fine the initial SNF in Seattle which had an early outbreak. I don't know why we have a cdc if their only response is to slow our response to a pandemic.

[CordMcNally]

If people want to listen to our governmental response, 60 minutes has had a few damning broadcasts about our response. The episode on 10/18 described the cdc's response to a cruise ship with infected patients where they flew passengers back on a charter flight only to put them into an international airport to fly home after performing temperature checks and having them fill out surveys. The 11/1 episode describes the brilliant members of the CMS who decided to complete an audit and try to fine the initial SNF in Seattle which had an early outbreak. I don't know why we have a cdc if their only response is to slow our response to a pandemic.

Sure, but those incidents affected an exceedingly small number of people relative to the population of the US. You can certainly argue the response of the federal government affects everybody, however, most people don't see it that way. They only see it when it directly affects them.

[Lordosis]

I imagine 3 weeks is much faster then usual. I am okay with that if it is extra manpower working around the clock to make it happen. If it is business as usual that is a different story.

[Tim]

I imagine 3 weeks is much faster then usual. I am okay with that if it is extra manpower working around the clock to make it happen. If it is business as usual that is a different story.

From what I could understand, this has not understood. This is the "final step" of the emergency use approval process. Nothing new, simply the results. The process, scope and the attributes etc. have already been discussed and feedback incorporated. This is PHASE 3, not preliminary or the first time this has come to FDA and CDC.
Steps have not been cut, simply these studies have been moved to the front of the line.
Raw data and the require analysis and anything else the company turns in. Trust but verify. Any questions, the playbook and any FDA analysis can be done. They are not confirming the data with the test subjects. There are less test requirement than for permanent approval. Staffing, priorities and have been ramped up.
Do I expect additional follow-up monitoring? Yes. Do I expect additional issues? Yes. Comes with the early authorization process. Do I expect data falsification, no.
Do I expect "approval" of a immunization with known flaws, no. I expect the FDA to do their job to the best of their ability. They have a plan, I hope it works.

[Balance1969]

As a side note, have you noticed the nose problem with mask wearing? Keeps slipping off and has gaps. The mask is always straight across, ear to ear. Do good masks have nose bridge with a little reinforcement piece for fit? A lot of room for protection by getting a decent mask.

Tim I say this with no studies to quote but if the mask is not covering your nose then it is ineffective. Better mask do have a nose bridge. I really like my Vogmask as recommended by Star Trek Doc because it actually comes in sizes and fits.

- we like them and the cambridge masks. Both are good and work nicely -- using the headband really helps all day usage in saves the ears. As Hatton mentioned, pinching the nose really makes a good seal.

As mentioned earlier in this thread, one of my best friends has Cystic Fibrosis and recently had a lung transplant. If you want to learn a lot about masks, talk to CF people, as masks are a lifestyle for some of them.

The nose bridge, and just as importantly, the seal around the entire mask is very important. Otherwise, the germs are coming straight into your lungs from the weakest link in the mask, be it a gap around the nose, the sides, the bottom, wherever. I think I recall my friend having N95 masks that were custom fit for him and included some sort of plastic around the edges to create a good seal.

Based on that, if you get a Vogmask, make sure to get the head strap that you can use to pull it tight against your face. The ear straps are generally not as efficient for this purpose, which I found with my Vogmask. When I got the Cambridge Mask Pro, it included the head strap.

The CF peeps seem to prefer the Cambridge Mask and I think mine gives a better seal than my Vogmask. You have to be careful if you get one with a vent because some venues/stores will not allow you in if you have a vent. For example, my Cambridge Mask has a vent and the vent is not filtered, so it is less effective preventing the spread of germs to other people. Although, it can be argued that it is just as effective as any other mask that is not sealed properly (which is the majority of masks) because the areas that are not sealed spread germs just as readily as a vent.

My spouse complains the it is harder to breathe with the Vogemask. I think it is an adjustment, haven’t been breathing filtered air.

If it is harder to breathe, that means the mask is working. If it is easy to breath, you aren't breathing through the filter and are just breathing air in through gaps between the mask and your face.

I think "hard" to breathe is a little melodramatic (I know you said "harder"). "Annoying" to breathe is more appropriate and, as you mentioned, it is just an adjustment. Then again, I have fairly robust lungs from playing in soccer leagues year round through age 50 (which was killed by Covid). My wife wonders how I and my workout partner work out wearing a mask, but I don't find it hard at all. (I do try to keep risk low: he gets tested twice a week for his job, we both wear masks, I run a HEPA air filter, and I open two windows to provide outside air circulation).

[MaxPower]

Another thank you to StarTrekDoc for the vogmask recommendation. I recently got them for my whole family and I've been very impressed.

Agreed. Me too. Five total bought.

[Tim]

December is the plan. 975 doses will prove problematic due to the storage requirements especially in small population areas. Reminder, healthcare availability is a problem there not due to cold storage, simply volume.

https://www.houstonchronicle.com/news/houston-texas/houston/article/Houston-hospitals-preparing-for-COVID-19-vaccine-15745191.php