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  • Originally posted by Kamban View Post

    People are cheap. They don't want to pay for any mask if that good ole cloth mask can be washed and resued forever.
    Why wash it? The black hides everything doesn't it?

    Our County Health ran hospitals use physicians from the medical groups associated with med schools. The County has had budget problems. Sooooo, staffing of nursing staff is the County responsibility. The nursing shortage is probably real (I wonder if they emphasize NP's) but seems to be most severe in the County hospitals. The other hospitals in the county seem to not have like staffing problems. 24 hours wait time is blamed on the shortage. The perception of the public is to avoid the County hospitals for any medical needs if possible. Not exactly well run or well funded. The letters and publicity are always after the fact. This is hurricane season, the hospitals seem to be always in a status of an accident waiting to happen. Staffing, budget are always blamed after the fact. It is a tough job. No one ever complains until after the fact.

    https://www.click2houston.com/news/l...er-wait-times/

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    • Originally posted by Kamban View Post

      This is another thing that has been bugging me for some time. Who is paying for all the weekly PCR testing. Those tests are not cheap even if they are done on a large scale. And then all the supplies for swabs, precautions / protection costs, labor for person doing the swabs, transportation, lab personnel, checking on results and taking action on it.

      Is the insurance paying for it. Or the overstretched hospital resources. Or the fed insurance for fed employees, which ultimately falls back on the tax payers. or plain old Medicare / Medicaid. Time to make the person pay for it out of pocket if they want to not take the vaccine. No UI if no vaccine. Only monetary hurt will make them take the vaccine.
      We the taxpayer of course.

      Agree. The unvaccinated should pay the surcharge . Can see it now at restaurants and venues. Swab/antigen testing is sufficient enough for large scale cheap results.

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      • Originally posted by Jaqen Haghar MD View Post
        I actually forgot to mention that I’ve had two patients that had Covid, then the vaccine, and now covid again. They were both OK though, and went home. Middle age, pretty healthy. I guess delta is probably different enough, so I wonder if more vaccines would really help.
        I have had 2 patients like this as well. One was immunosuppressed and Ab titer after initial infection was negative. Second one I don't have Ab status but hospitalized with both infections..

        Herd immunity is about trying to protect these folks; we know some people will have a poor response to vaccination, or are unable to take the vaccine (anaphylaxis, myocarditis after first shot etc) but if community prevalence is low enough they will still be ok. COVID appears to be contagious enough with short enough immunity that eradication of disease through herd immunity is unlikely to happen.

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        • As far as Covid monoclonals, we give them out widely. We preferentially give Regen-COV as the delta variant has resistance to Lily's BAM monoclonals.

          The data supports reduced hospitalization and reduced death with monoclonals. Something around a 70% reduction of those severe outcomes. You have to have a risk factor for a severe outcome to meet criteria, but almost everyone meets criteria. A BMI >25 meets criteria and that covers something like 72% of the adult population right there. And any comorbidities such as asthma or DM count as well.

          Late last year, we set up an infusion center adjacent to the ED for monoclonal infusion therapy. We are giving it out to every high risk patient with a new diagnosis. But it is too late to give monoclonals for patients who require hospitalization or supplemental oxygen. They do not meet criteria under the EUA as the early studies demonstrated no benefit, with the explanation that it is likely too late for monoclonals to make a difference by the time they get this sick.

          It's sad, those patients struggling to breath who go on high flow or get intubated. Their last words are, "Doc, I changed my mind, give me the vaccine! Please!!!" And sadly, we have to tell them that it is too late. But we do tell their families that they want them to be vaccinated. You can honor the dead by making the choice that they did not get the opportunity to make.

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          • There was an interesting article published in Nature.

            The thought on mixing and matching vaccines. The adenovirus vector vaccines lead to the strongest T cell immunity. The mRNA vaccines lead to the strongest Ab mediated immunity. If you get both types, the thought is you maximize both T cell immunity and Ab immunity.

            Oh well, I already got 2 Pfizer and 1 Moderna. I am going to wait for more data on risk vs benefit before I consider getting a J & J to specifically boost my T cells.

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            • Whoah! Talk about timing. I just finished typing my post and this came across my newsfeed.

              San Francisco DOH is now proclaiming mRNA vaccines will be allowed for those who first got J & J.

              https://www.cnn.com/us/live-news/cor...16ec13b1ad9750

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              • https://www.nbcnews.com/politics/whi...ssure-n1275860

                For anyone who still thinks that the CDC hasn’t become politicized.

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                • Originally posted by HikingDO View Post
                  https://www.nbcnews.com/politics/whi...ssure-n1275860

                  For anyone who still thinks that the CDC hasn’t become politicized.
                  Totally what the CDC was created to do, right? Won't this give renters the incentive to not get vaccinated and spread COVID in order to keep their area transmission level high so this order still stands for them and they won't get evicted? The CDC can't get out of its own way.

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                  • Originally posted by CordMcNally View Post

                    Totally what the CDC was created to do, right? Won't this give renters the incentive to not get vaccinated and spread COVID in order to keep their area transmission level high so this order still stands for them and they won't get evicted? The CDC can't get out of its own way.
                    Man, I thought I was pessimistic!

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                    • Originally posted by G View Post

                      Man, I thought I was pessimistic!
                      Or optimistic, depends.
                      https://www.usatoday.com/story/news/..._medium=UpNext

                      Data driven I suppose. Follow the science. Like the ones that sublet and don’t wanna pay the landlord? Must have been a new study. Realistically, I suppose the renters will make the landlord whole. I can’t wait for CDC to release the data. It is a joke now. Not to funny for landlords.

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                      • Originally posted by HikingDO View Post
                        https://www.nbcnews.com/politics/whi...ssure-n1275860

                        For anyone who still thinks that the CDC hasn’t become politicized.
                        Didn’t the Supreme Court state that further extensions had to come from Congress?

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                        • Originally posted by Lithium View Post
                          Didn’t the Supreme Court state that further extensions had to come from Congress?
                          I think they basically said the current one (at that time) could stay in place since it was ending soon but would rule against another one.

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                          • Originally posted by CordMcNally View Post

                            Totally what the CDC was created to do, right? Won't this give renters the incentive to not get vaccinated and spread COVID in order to keep their area transmission level high so this order still stands for them and they won't get evicted? The CDC can't get out of its own way.
                            How is this even their business? I am worn out and thankful every day that my tenants have been paying their rent despite what feels like incentives not to pay. How is it ok that tenants get a moratorium on rent for this prolonged period and landlords get what? the shaft?

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                            • Originally posted by CordMcNally View Post

                              I think they basically said the current one (at that time) could stay in place since it was ending soon but would rule against another one.
                              And it ended. Basically they’re just governing by fiat, checks and balances be damned.

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                              • Originally posted by StateOfMyHead View Post
                                How is it ok that tenants get a moratorium on rent for this prolonged period and landlords get what? the shaft?
                                “She got the gold mine, I got the shaft.”

                                - Jerry Reed

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