Medical Discussion of Coronavirus

[Jaqen Haghar MD]

Interesting how you guys got so much. Our healthsystem has 9000 employees. We got 3000 for the first drop.

The hospital works in mysterious ways, with mysterious motivations, but I suspect I know the reason for mass availability. $$$

[Lordosis]

We got enough to for 1/9th of our employees. At least in this first allotment. Hopefully we get more and people actually take it.

[FunkDoc83]

We got enough to for 1/9th of our employees. At least in this first allotment. Hopefully we get more and people actually take it.

I'm sure you've heard the weird fringe conspiracy type online people are saying about the vaccine (make you sterile, tracking devices, etc..), but I couldn't believe some of the people I work with actually saying some of this stuff out loud as reasons to avoid the vaccine. I've tried to hold my tongue because I think it needs to be an individual choice and I know not everyone is a good candidate for the vaccine, but most people are. Have you had any of this kind of thing out in NY?

[Tim]

My state has a 4 phase rollout. Phase II is by far the trickiest to parse out unless your occupation is specifically mentioned:

phase 1: NH residents/staff and medical staff directly caring for hospitalized covid patients.

phase 2: first responders, medical staff at elevated risk but not phase 1, "critical government employees," high risk such as prisons, meatpacking plants etc

phase 3: age>65, comorbidities making severe disease more likely, essential workers not previously covered

phase 4: everybody else

I'm assuming outpatient docs will fall into phase 2 but no clear guidance from SDH yet.

Where do prison populations and the staff fall?
Explain the rational why a person say 90 with family assistance rather than spending for the nursing home is in phase 4?
One is a lack of ability to take safety precautions and the other is safety precautions but at the wrong address. Both have vastly more risk than everybody else.
Not an argument, simply a question.

One example of using database information, one criteria for phase one was ED service taking call. Since call rotation was not a field in the data use, not one doctor that rotates trauma call was originally identified. They since made them eligible but identifying and notifying them was difficult. Informal word of mouth was used. Not the best, but so what. Vaccine is available.

[ginmqi]

Meatpacking plants? Why? Just close quarters? Does that apply to all industries?

I'm guessing it's part of the food supply/chain, and someone told me that the operation of the meat plants uses a LOT of water sprays/washes as part of the operation...so I can imagine with water droplets flying EVERYWHERE that it can be quite an infectious environment even if you social distance. Not to mention people's flimsy paper masks getting wet/moist too....I suspect there will be very interesting studies published in the future regarding the infectiousness of such plants....

[ginmqi]

Mutation in the spike protein identified in UK apparently.

A new variant of the virus that causes COVID-19 (SARS-CoV-2) has been identified across the South East of England

The strain was identified due to Public Health England’s (PHE) proactive and enhanced monitoring following the increase in cases seen in Kent and London. The variant has been named ‘VUI – 202012/01’ (the first Variant Under Investigation in December 2020).

As of 13 December, 1,108 cases with this variant have been identified, predominantly in the South and East of England.

PHE is working with partners to investigate and plans to share its findings over the next 2 weeks. There is currently no evidence to suggest that the strain has any impact on disease severity, antibody response or vaccine efficacy.

High numbers of cases of the variant virus have been observed in some areas where there is also a high incidence of COVID-19. It is not yet known whether the variant is responsible for these increased numbers of cases. PHE will monitor the impact of this in the coming days and weeks.

It is not uncommon for viruses to undergo mutations; seasonal influenza mutates every year. Variants of SARS-CoV-2 have been observed in other countries, such as Spain.

This variant includes a mutation in the ‘spike’ protein. Changes in this part of the spike protein may result in the virus becoming more infectious and spreading more easily between people.

https://www.gov.uk/government/news/p...in-of-covid-19

I assume there are efforts on-going to monitor strain mutations here in the US as well?

This seems concerning.....

[StarTrekDoc]

If mutation in spike, it may actually lower the infectious properties (vs worse). The beauty of the mRNA vaccine is we should be able to pivot on the molecule within days of a prevailing mutation comes into more dominance and change production quickly without the long tail like a flu vaccine has.

[pulmdoc]

Where do prison populations and the staff fall?
Explain the rational why a person say 90 with family assistance rather than spending for the nursing home is in phase 4?
One is a lack of ability to take safety precautions and the other is safety precautions but at the wrong address. Both have vastly more risk than everybody else.
Not an argument, simply a question.

One example of using database information, one criteria for phase one was ED service taking call. Since call rotation was not a field in the data use, not one doctor that rotates trauma call was originally identified. They since made them eligible but identifying and notifying them was difficult. Informal word of mouth was used. Not the best, but so what. Vaccine is available.

Prisons are phase 2, which I think is appropriate, no social distancing possible and several big outbreaks here.

The 90 year old at home would be phase 3, not 4. Presumably, its a matter of both vulnerabity and contagiousness both. I didn't write the rules, just reporting them.

I've been told that the expectation is to move into phase 3 within a matter of a few weeks as the relative size of phase 1 and 2 people is relatively small compared to phase 3/4. thats when the jostling in line will begin (I hope, worried people will put it off).

[Tim]

Prisons are phase 2, which I think is appropriate, no social distancing possible and several big outbreaks here.

The 90 year old at home would be phase 3, not 4. Presumably, its a matter of both vulnerabity and contagiousness both. I didn't write the rules, just reporting them.

I've been told that the expectation is to move into phase 3 within a matter of a few weeks as the relative size of phase 1 and 2 people is relatively small compared to phase 3/4. thats when the jostling in line will begin (I hope, worried people will put it off).

I apologize for the prisons, your post had considered it. "comorbidities" is my question related to the elderly, seems to require a preexisting condition. Age was not much of a factor in the NY Times calculator. Without an existing problem on the list, one is out of luck. Each state will be different under the current plan. So, I am sure we will find out sooner or later. No response needed, the age question is a sore spot.

[Lordosis]

I'm sure you've heard the weird fringe conspiracy type online people are saying about the vaccine (make you sterile, tracking devices, etc..), but I couldn't believe some of the people I work with actually saying some of this stuff out loud as reasons to avoid the vaccine. I've tried to hold my tongue because I think it needs to be an individual choice and I know not everyone is a good candidate for the vaccine, but most people are. Have you had any of this kind of thing out in NY?

Yeah I am rural so many of the billhillies are against it. Pretty much the same group who are anti flu shot. I have not come across a physician who was actively against it.

[Hatton]

my hospitals guidelines are 90 days. Good luck to your wife! Hope she has an easy course.

To the ones who were in the trials, have you all been unblinded yet? Any surprises, like you thought you got the placebo but got the vaccine or visa versa?

I did the Pfizer trial. They have unblinded it for healthcare workers and residents of nursing homes only. If I got the real vaccine my second shot did produce a much larger painful skin reaction.

[artemis]

I apologize for the prisons, your post had considered it. "comorbidities" is my question related to the elderly, seems to require a preexisting condition.

No. Anyone age 65 or older is in Phase 3, whether or not they have comorbidities. Anyone younger than age 65 with comorrbidities which are associated with a worse COVID outcome is also in phase 3.

[artemis]

Hopefully we get more and people actually take it.

That’s what worries me. There were a lot of open slots when I signed up for my vaccination; I hope that’s not because a lot of eligible people are opting out. We need to get as many people immunized as quickly as possible if we’re going to ever get this plague under control. If hospital personnel are avoiding the vaccine, that’s an ill omen.

[Lordosis]

That’s what worries me. There were a lot of open slots when I signed up for my vaccination; I hope that’s not because a lot of eligible people are opting out. We need to get as many people immunized as quickly as possible if we’re going to ever get this plague under control. If hospital personnel are avoiding the vaccine, that’s an ill omen.

I think there will be plenty of people who want it to eat up the supply for several months. But we will get to the point where supply is not the issue and public opinion is. My WAG is summer.

[Peds]

I did the Pfizer trial. They have unblinded it for healthcare workers and residents of nursing homes only. If I got the real vaccine my second shot did produce a much larger painful skin reaction.

wait so you dont know yet?
im trying to remember, did you have negative antibodies?