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  • Originally posted by OUSOONERDOC View Post

    Yeah, like I said my example was anecdotal. Also, how could there be any evidence of widespread psychological harm to children from wearing a mask when we are just 20 months into the pandemic. Time will tell and we will just have to agree to disagree. I don't see there to be much benefit in my 5 year old wearing a mask for 6-8hr in school. I will vaccinate them when its available and mask them up if we are forced to. I just think its about as dumb as wearing a mask in a restaurant but being able to take it off at your table or many of the other ridiculous measures that have been put into place with no strong scientific evidence that they serve any benefit but it makes people feel better.

    We definitely saw less cases of your typical viral URI in kids last year. Was that due to kids wearing masks or kids just not being in school and everything being locked down? Id wager it was the latter.
    That’s my take. Seems dumb to me as well.

    My main issue is it just further distracts and divides and is more harmful to society in that way.. but no easy answers at this point to overcome that.

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    • Originally posted by CordMcNally View Post

      Here’s what people want…an end point. They’re tired of all these mandates with no end in sight. People aren’t accepting a rolling end point. They don’t like it when politicians say ‘we’ll just have to see how it goes’. The immunocompromised are at high risk with lots of viruses.

      It’s like Vietnam and Afghanistan. We have no plan and it shows. I would even respect a politician that said we’ll do certain measures until children can get vaccinated and then we’re going full steam ahead back to normal. The German Health Minister said they ‘may’ have to keep COVID restrictions until spring 2022. People are tired of bullshit statements like that.
      I mean, i didn't make up the virus. Donald Trump or Joe Biden didn't invent it. Biology doesn't need to comport with your fantasy to have an end point. Yeah, during WWII people wanted an end point, but they didn't get one, until there it was and WWII was man made. Prior to delta things looked pretty good. Now we have a variant, in some ways acts almost like a different virus, just explosive viral load, R0 2 or 3 times wild type, maybe causes more virulent disease especially lung disease. Record numbers hospitalized in several states. Deaths in those states on the familiar exponential curve. All despite vaccination rates of 35-60%. The fact that delta submerged the health care system in India, Iran, Indonesia, on the verge of doing so in Mississippi, Louisiana - do facts matter or you just die on the pyre of self righteousness because you want an end point?

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      • Originally posted by FIREshrink View Post

        I mean, i didn't make up the virus. Donald Trump or Joe Biden didn't invent it. Biology doesn't need to comport with your fantasy to have an end point. Yeah, during WWII people wanted an end point, but they didn't get one, until there it was and WWII was man made. Prior to delta things looked pretty good. Now we have a variant, in some ways acts almost like a different virus, just explosive viral load, R0 2 or 3 times wild type, maybe causes more virulent disease especially lung disease. Record numbers hospitalized in several states. Deaths in those states on the familiar exponential curve. All despite vaccination rates of 35-60%. The fact that delta submerged the health care system in India, Iran, Indonesia, on the verge of doing so in Mississippi, Louisiana - do facts matter or you just die on the pyre of self righteousness because you want an end point?
        COVID won’t be solely responsible for any healthcare collapses in the US. It’s multifactorial as has been discussed in other threads but you already knew that. Or maybe you didn’t.

        There was at least a goal in WW2. We have no current goal. When we think we have one it immediately changes. If military generals used messaging techniques that have been used over the last 18 months they wouldn’t have any soldiers which is why you’re seeing so many people breaking ranks now.

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        • Originally posted by CordMcNally View Post
          There was at least a goal in WW2. We have no current goal. When we think we have one it immediately changes. If military generals used messaging techniques that have been used over the last 18 months they wouldn’t have any soldiers which is why you’re seeing so many people breaking ranks now.
          Today's problem isn't a lack of a goal. The problems is a complete lack of conviction and even opposition by 30% of the general population.

          Simple question: is Covid a clear and present danger? Will we get a 100% yes in this medical forum? Appears not.

          Until we as a nation AND world get behind a mass vaccination effort to slow the infection and subsequent mutation rate of Covid, it'll continue to be a whack-a-mole state and keeping up with the most recent variant to mitigate illness.

          How is this any different in treating pneumonia that becomes resistant to the most recent therapies? Once PCN resistance came up we just stopped treating PNA? We pivoted; developed new therapeutics. More resistance....so give up, right? let PNA run its course. Forget P13 and P23 or developing quinolones. It's natural. Run it's course. Only kills 1-3% of at risk people, right? Don't give zpak for any cough or cold because the risk of so minimal of sequelae.

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          • Originally posted by StarTrekDoc View Post

            Today's problem isn't a lack of a goal. The problems is a complete lack of conviction and even opposition by 30% of the general population.

            Simple question: is Covid a clear and present danger? Will we get a 100% yes in this medical forum? Appears not.

            Until we as a nation AND world get behind a mass vaccination effort to slow the infection and subsequent mutation rate of Covid, it'll continue to be a whack-a-mole state and keeping up with the most recent variant to mitigate illness.

            How is this any different in treating pneumonia that becomes resistant to the most recent therapies? Once PCN resistance came up we just stopped treating PNA? We pivoted; developed new therapeutics. More resistance....so give up, right? let PNA run its course. Forget P13 and P23 or developing quinolones. It's natural. Run it's course. Only kills 1-3% of at risk people, right? Don't give zpak for any cough or cold because the risk of so minimal of sequelae.
            The opposition is by much higher than 30% of the population. There are many people who are vaccinated and still oppose a majority of the other measures put forth. It's impossible to get 330 million people on board with one thing let alone the world so that goal will never be achievable.

            How is this different than treating pneumonia? Easy, treating pneumonia wasn't ever made political. Making anything political is a sure fire way to impede any kind of progress that needs to be made. Who's fault is it that this has become political? Pretty much everyone that has held a political office during the last 18 months.

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            • Originally posted by CordMcNally View Post

              The opposition is by much higher than 30% of the population. There are many people who are vaccinated and still oppose a majority of the other measures put forth. It's impossible to get 330 million people on board with one thing let alone the world so that goal will never be achievable.

              How is this different than treating pneumonia? Easy, treating pneumonia wasn't ever made political. Making anything political is a sure fire way to impede any kind of progress that needs to be made. Who's fault is it that this has become political? Pretty much everyone that has held a political office during the last 18 months.
              If we vaxxed more people we wouldnt need all these measures. People complain about the prevention and the results, just need to be ignored.

              US messed this up from start by not including kids in trials, was this a pandemic and emergency and respiratory or not? Never made sense. Should have mandated it and drafted people up if necessary and run through supply everday until gone.

              We are choosing to live in this middle worst of all things limbo because a large and vocal minority refuse everything, pretending to be thoughtful and a bunch of other things when theyre just plainly dumb as rocks, some with a death wish that many are seeing granted.

              Shouldnt placate these types, it only increases defiance. Many say 'if you mandate it will get worse'! Where? On your blogs and fb posts? Most of the country is for a mandate and most will do what theyre told, same demo tells you to just listen to cops/authority as well. Will there be some unrest? Sure, short lived and then we're done with it.

              Being weak with idiots and pretending they have any useful input is a poor way of managing a pandemic.

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              • Originally posted by Hatton View Post
                Israel is already giving #3 pfizer to all over 60 and likely to lower this to 50.
                And Pfizer has indicated they have in process a revision. I would assume Israel was definitely in contact, and balanced availabile supply with need. Tough call. The Hatton plan. First available. The CVS was halting J&J. Down to two choices. Which would you choose?

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                • Sometimes you just have to get in the ****** boat and row.

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                  • Originally posted by Tim View Post

                    And Pfizer has indicated they have in process a revision. I would assume Israel was definitely in contact, and balanced availabile supply with need. Tough call. The Hatton plan. First available. The CVS was halting J&J. Down to two choices. Which would you choose?
                    Some of vaccinated friends (also early vax during the trial period) got Moderna today at Target. They are going out of the country late next week. The forms do not ask about vax status.

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                    • Originally posted by Hatton View Post

                      Some of vaccinated friends (also early vax during the trial period) got Moderna today at Target. They are going out of the country late next week. The forms do not ask about vax status.
                      Moderna got FDA approval today for booster.
                      Timing is everything. Ethics, there is not anything close to a shortage today in the USA. You can get it at your grocery store. Big signs, no appointment needed. Things have changed.

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                      • Based on my last two shifts, things are as bad as they were last fall. ER full, hospital full, rolling ambulance diversions, instructions not to accept transfers to our tertiary care center. Hypoxic COVID patients sitting in lobby (with soon to be COVID patients in about 7-10 days) where there is literally not an open chair. Admitting multiple COVID to hospital (ok, they end up boarding in the ER). Biggest difference is there aren't too many ICU players.

                        Quantitatively, positivity is 18%. 7 day moving average is now at early Nov 2020 levels. I guess we will see if these 40 yos need the hospital as much as the 70 yos did last year.

                        I thought of snowcanyon when we got an alert last night: the health system has declared that all patient care have PPE to include goggle/face shield and N95. I am wearing gowns again, but it appears we are low on those. We have gloves, but they are the lunch lady type. I think I will start wearing a hair net again.

                        School opened on Monday. So far 9 (out of 100 or so) schools have sent home kids to quarantine. This of course has downstream effect of taking parents out of the work force.

                        Obviously things are out of control on the hospital side. There is a statewide mask mandate that folks are complaining about. Clearly no appetite for another lock down. Will be interesting to see what happens in the next few weeks. I'm not a market timer, but Wall Street is out of touch with Main Street.

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                        • Originally posted by G View Post
                          Based on my last two shifts, things are as bad as they were last fall. ER full, hospital full, rolling ambulance diversions, instructions not to accept transfers to our tertiary care center. Hypoxic COVID patients sitting in lobby (with soon to be COVID patients in about 7-10 days) where there is literally not an open chair. Admitting multiple COVID to hospital (ok, they end up boarding in the ER). Biggest difference is there aren't too many ICU players.

                          Quantitatively, positivity is 18%. 7 day moving average is now at early Nov 2020 levels. I guess we will see if these 40 yos need the hospital as much as the 70 yos did last year.

                          I thought of snowcanyon when we got an alert last night: the health system has declared that all patient care have PPE to include goggle/face shield and N95. I am wearing gowns again, but it appears we are low on those. We have gloves, but they are the lunch lady type. I think I will start wearing a hair net again.

                          School opened on Monday. So far 9 (out of 100 or so) schools have sent home kids to quarantine. This of course has downstream effect of taking parents out of the work force.

                          Obviously things are out of control on the hospital side. There is a statewide mask mandate that folks are complaining about. Clearly no appetite for another lock down. Will be interesting to see what happens in the next few weeks. I'm not a market timer, but Wall Street is out of touch with Main Street.
                          Isn't the bold a significant improvement? Yes obviously we don't want anyone to get covid, be sick/hypoxic but if you have significantly less critically ill patients and the patients are younger that would be an improvement, no? If the vaccine is working and we have 60% of the population with 1 dose and 90% of high risk groups vaccinated, it's pretty much impossible for it to be as bad as prior peak, right? I guess we could see short term spikes of unvaxxed but a similar duration or extent as last peak seems impossible.

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                          • Originally posted by Panscan View Post

                            Isn't the bold a significant improvement? Yes obviously we don't want anyone to get covid, be sick/hypoxic but if you have significantly less critically ill patients and the patients are younger that would be an improvement, no? If the vaccine is working and we have 60% of the population with 1 dose and 90% of high risk groups vaccinated, it's pretty much impossible for it to be as bad as prior peak, right? I guess we could see short term spikes of unvaxxed but a similar duration or extent as last peak seems impossible.
                            yes, so far, absolutely. my point of the timing is that we will have to see. clearly just playing the odds, a 40 yo is less likely than a 70 yo to go to the unit for all conditions, not just Rona.

                            I was thinking about who is getting tested now compared to a year ago, with respect to the positivity rate. I think the vaccinated folks for the most part are not getting checked (at least that is my observation), so if we have 200+ new cases a day, these are the folks that haven't been vaccinated. you are right, in terms of mortality, common sense suggests that the high risk have either been vaccinated or died.

                            our data show 58% of (documented) 12+ have been vaccinated. adding in undocumented, children, and the other 42%, there is still a lot of folks that can strain the system!

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                            • Originally posted by CordMcNally View Post

                              Here’s what people want…an end point. They’re tired of all these mandates with no end in sight. People aren’t accepting a rolling end point. They don’t like it when politicians say ‘we’ll just have to see how it goes’. The immunocompromised are at high risk with lots of viruses.

                              It’s like Vietnam and Afghanistan. We have no plan and it shows. I would even respect a politician that said we’ll do certain measures until children can get vaccinated and then we’re going full steam ahead back to normal. The German Health Minister said they ‘may’ have to keep COVID restrictions until spring 2022. People are tired of bullshit statements like that.
                              You want an end point? Here's one. I heard it said that we are 6 weeks away from ending the pandemic, but we are always 6 weeks away from ending it. It is a rolling six weeks. If everyone who was not vaccinated got vaccinated tomorrow, we would be mostly done in six weeks (with exceptions for weak immune systems, people sick now and those who get sick between then and now, etc.). It is simplistic and does not account for possible strains that develop abroad that evade the vaccine immunity and other such factors. Of course, there is a snowball's chance in Hades of getting everyone vaccinated.

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                              • Originally posted by VagabondMD View Post

                                You want an end point? Here's one. I heard it said that we are 6 weeks away from ending the pandemic, but we are always 6 weeks away from ending it. It is a rolling six weeks. If everyone who was not vaccinated got vaccinated tomorrow, we would be mostly done in six weeks (with exceptions for weak immune systems, people sick now and those who get sick between then and now, etc.). It is simplistic and does not account for possible strains that develop abroad that evade the vaccine immunity and other such factors. Of course, there is a snowball's chance in Hades of getting everyone vaccinated.
                                Six weeks...I'm going to hold you to it.

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