Medical Discussion of Coronavirus

[burritos]

Immune dysregulation is REALLY complicated. Multiple pieces of this can lead to coagulopathy, endothelial damage, etc. I’m sure low insulin levels and low blood glucose levels are protective - but I would guess they’re probably not absolutely protective. If the dysfunction were really restricted to one cell line, wouldn’t we have figured it out by now?

Just musing out loud. Immunity is probably as complex and neuronal function. Imo immunity has intelligence.

But before immunity enters the picture(which it always is), I feel that autophagic flux is crucial to prevent immunologic overrun. Specifically xenophagic flux.

We are constantly surrounded by by trillions of viruses and bacteria. These microbes often hijack and intrude intracellularly to avoid immune cells and to reproduce. If autophagic flux is slow, the microbes have the time to reproduce. If autophagic flux is fast, the compartments that microbes are housed in fuse with lysosomes at a rate which prevent excess replication. Low insulin=high autophagic flux. The proxy is that you aren't eating/or exercising a lot thus intracellular recycling is upregulated. The hack is to eat low carb/exercise/fast. But even if you are exercising, if you are scarfing down gels and carbs, insulin stays high, autohphagic flux remains low. Viral replication is given an opportunity to exceed autophagic capacity. = viral achieve escape velocity. NOW immunity comes in.

[Lordosis]

The saga continues ☹️

The first day the whole family was off quarantine my wife develops mild congestion. Fingers crossed we went to bed that night to awaken to an absence of her sense of smell. Test came back positive this morning...

Another 10 days in the hole.

Thankfully her symptoms appear mild as well but this is horribly inconvenient.

[Tim]

The saga continues ☹️

The first day the whole family was off quarantine my wife develops mild congestion. Fingers crossed we went to bed that night to awaken to an absence of her sense of smell. Test came back positive this morning...

Another 10 days in the hole.

Thankfully her symptoms appear mild as well but this is horribly inconvenient.

What a trooper. Wife sacrificed to extend the family time. Lots of value in modeling early retirement with young kids. Is all that togetherness turning out as expected? Hope she weathers it well and your family gets back to normal. Well at least as much as possible.

[Tim]

““Unless we vaccinate everyone in 200 plus countries, there will still be new variants,” he said, predicting that the coronavirus will eventually become a “forever virus” like influenza.
Probability of ‘super variant’
Brilliant said his models on the Covid outbreak in San Francisco and New York predict an “inverted V-shape epidemic curve.” That implies that infections increase very quickly, but would also decline rapidly, he explained.

If the prediction turns out be true, it means that the delta variant spreads so quickly that “it basically runs out of candidates” to infect, explained Brilliant. “

https://www.cnbc.com/2021/08/09/covid-epidemiologist-larry-brilliant-on-delta-variant-vaccinations.html

Interesting thoughts. The deep thinkers here and in CDC are better equipped. We need to take the politics out of this. That process is too slow. Our county judge urged “civil disobedience” by the school districts. Year long policy changes (vaccines and masks) in disobeying state mandates. I didn’t think local government entities were “civil”.

My take is that we are in the dark now how to provide identification and fast responses to new variants and how to contain them. It’s almost like sending fire trucks after the house fire burned out. Using techniques for global, national and states take too long. Damage already done.

By the time San Fran and New Your hits Labor Day, maybe Delta burnt out.

They airlifted a toddler 150 miles due to no pediatric ICU beds available in a urban metro of
7 million people. Anecdotally the specific outbreak areas need short term science based capacity relief. FEMA has provided short term staffing backups. This to me is the biggest risk.

Global strategies would be great, at some point we need tactical responses, boots on the ground and fire trucks in time. The political solutions won’t work, by design they take time.

I hope this surge convinces everyone to get vaccinated, a local volunteer fire department works.

[CordMcNally]

The saga continues ☹️

The first day the whole family was off quarantine my wife develops mild congestion. Fingers crossed we went to bed that night to awaken to an absence of her sense of smell. Test came back positive this morning...

Another 10 days in the hole.

Thankfully her symptoms appear mild as well but this is horribly inconvenient.

This is awful, man. I'm so sorry you guys are having to go through this. Hopefully she continues to just have mild symptoms.

[Sampter]

We're at a plateau in SW MO after 6 weeks of this. Vaccination rates still abysmal. Several physicians willing to retire early/get fired over the hospital vaccine mandate.

Are they blowing smoke or for real? Seems like as a physician and any healthcare worker honestly duty to keep patients safe is #1.

I guess they could go work for Walmart instead....oops.

https://www.nytimes.com/2021/07/30/business/covid-vaccine-mandates-rto.html

[Lordosis]

This is awful, man. I'm so sorry you guys are having to go through this. Hopefully she continues to just have mild symptoms.

Thanks. I feel like a jerk complaining because it really is just an annoyance and we all have done well. Like most people I talk to expected this to not be an issue by this point. But unfortunately it is obvious I was naïve.

[Tim]

Thanks. I feel like a jerk complaining because it really is just an annoyance and we all have done well. Like most people I talk to expected this to not be an issue by this point. But unfortunately it is obvious I was naïve.

You are not complaining. You gave a straight status update and how it is disrupting and making life difficult. In an attempt to humor you, thank the wife for sacrificing and giving you a trial run of what early retirement would look like with 4 kids and her in house in remote area with few contacts with the outside world. The benefit is huge, retiring early is sometimes not what you expect. 24 hours a day is different. Thank you .

[Brains428]

Are they blowing smoke or for real? Seems like as a physician and any healthcare worker honestly duty to keep patients safe is #1.

I guess they could go work for Walmart instead....oops.


https://www.nytimes.com/2021/07/30/b...dates-rto.html

The early retirement I believe is for real. The other 3 I've heard of through the grape vine have until the end of next month to comply. There is one other large health system in town that hasn't required vaccine, but it's likely they will require it once EUA is lifted and it's fully FDA mandated. Also, it's likely they all have a pesky non-compete to deal with.

Another physician I know personally, is hoping to get some exception based on natural immunity. I don't expect it to work. I would be very surprised if that person decided to quit, but who knows.

[G]

The early retirement I believe is for real. The other 3 I've heard of through the grape vine have until the end of next month to comply. There is one other large health system in town that hasn't required vaccine, but it's likely they will require it once EUA is lifted and it's fully FDA mandated. Also, it's likely they all have a pesky non-compete to deal with.

Another physician I know personally, is hoping to get some exception based on natural immunity. I don't expect it to work. I would be very surprised if that person decided to quit, but who knows.

I'm curious what the rationale is for not getting it. Concern for mRNA vector, side effects, inconvenience? Gives me pause when smart people aren't following the party line.

[Lithium]

I'm curious what the rationale is for not getting it. Concern for mRNA vector, side effects, inconvenience? Gives me pause when smart people aren't following the party line.

Smart people can really be dumb. I’ve known MD’s who don’t believe in evolution, who believe in various elements of QAnon, etc. If memory serves, Rand Paul remains unvaccinated.

[snowcanyon]

Great, looks like Moderna is superior to Pfizer, which I had always suspected- like many healthcare workers, I was stuck with Pfizer. Who is doing what for a Moderna booster?

[Tim]

Smart people can really be dumb. I’ve known MD’s who don’t believe in evolution, who believe in various elements of QAnon, etc. If memory serves, Rand Paul remains unvaccinated.

Not a big fan of Rand Paul. His father was way out there libertarian. Whether you agree with him or not there are a number of reasons that catching covid could lead to a better immunity. "Better* to me is not a reason to not take the vaccine. My take is the vaccine works on a target and the actual infection works for a broader immunity. Trash me but I am an observer only. Paul is a libertarian and has chosen to use those principles for his opinion.I don't think Fauci and CDC have data to refute Paul's position. A lot of "it is logical to project that the best course is XYZ." Both sides may be right and both may be wrong.

The senate testimony exchange between he and Fauci was very interesting.
Fauci refuse to answer the specific question. Carefully worded denial and then attacked. No answer to the question, did you fund gain of function research. Denial was I did not fund the research for this virus. That was not the question.

[billy]

I'm curious what the rationale is for not getting it. Concern for mRNA vector, side effects, inconvenience? Gives me pause when smart people aren't following the party line.

eh, theres a vascular surgeon at my place that goes on anti-this vaccine rants- stating its not a "vaccine" (mRNA version), its forced on us, natural herd immunity, masking is preventing his immune system from working etc etc- this is full blown right wing conspiracy theory nutjob level. And the sad thing is, the two hospitals he works at were both slammed with covid last year. He saw what it did at the other hospital placing central lines in these patients.

[Lithium]

Not a big fan of Rand Paul. His father was way out there libertarian. Whether you agree with him or not there are a number of reasons that catching covid could lead to a better immunity. "Better* to me is not a reason to not take the vaccine. My take is the vaccine works on a target and the actual infection works for a broader immunity. Trash me but I am an observer only. Paul is a libertarian and has chosen to use those principles for his opinion.I don't think Fauci and CDC have data to refute Paul's position. A lot of "it is logical to project that the best course is XYZ." Both sides may be right and both may be wrong.

The senate testimony exchange between he and Fauci was very interesting.
Fauci refuse to answer the specific question. Carefully worded denial and then attacked. No answer to the question, did you fund gain of function research. Denial was I did not fund the research for this virus. That was not the question.

It took me 30 seconds to find this: https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e1.htm

I don’t want to get into the politics too much as I’m not on Team Fauci either. I didn’t get the sense that Fauci really refuted him, but RP’s attacks just seemed like political grandstanding.