Medical Discussion of Coronavirus

[G]

I walk into patient rooms announcing "Your healthcare hero is here", only the nurses laugh...

Hey, not all superheroes wear capes.

[CordMcNally]

For those of us who don't treat COVID-19:

When a patient is admitted to the hospital, but doesn't need ventilation, what is the typical situation there?

They are hypoxic, so they need oxygen, steroids, monoclonals, and if all goes well they turn around and can go home in a few days?

Oxygen, dexamethasone, and prone positioning are about it. If you're being admitted to the hospital it's likely too late for monoclonals although that doesn't stop people from giving it because it makes them feel like they're doing something. Same thing with convalescent plasma although that has fallen out of favor and remdesivir has many questions around it. If the patient stabilizes their sats on nasal cannula then they're usually discharged on home oxygen, a pulse oximeter, and best wishes.

Many patients usually ask what they can do to start feeling better and I'll usually be honest with them and tell them the best thing they could have done was get vaccinated months ago. If you're getting admitted to the hospital unvaccinated with COVID then your fate has basically been decided...we're just waiting to see what that end result ends up being.

[AR]

Got my son's pfizer booster. He's on Humira. RiteAid. No line. no questions asked. Starting school next week. total masking and been in school F2F all last year without problems. He was happy to get another corona shot!

Isn't there a question on the consent form that asks if you had another COVID vaccine?

[eyecandy]

Oxygen, dexamethasone, and prone positioning are about it. If you're being admitted to the hospital it's likely too late for monoclonals although that doesn't stop people from giving it because it makes them feel like they're doing something. Same thing with convalescent plasma although that has fallen out of favor and remdesivir has many questions around it. If the patient stabilizes their sats on nasal cannula then they're usually discharged on home oxygen, a pulse oximeter, and best wishes.

Many patients usually ask what they can do to start feeling better and I'll usually be honest with them and tell them the best thing they could have done was get vaccinated months ago. If you're getting admitted to the hospital unvaccinated with COVID then your fate has basically been decided...we're just waiting to see what that end result ends up being.

And I’d add the best thing they can do is to keep their loved ones safe and tell all their friends and family to be vaccinated if they haven’t been yet.

[Hatton]

Isn't there a question on the consent form that asks if you had another COVID vaccine?

no

[Tangler]

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.

I don’t know the answer about masks and kids. I think good masks help. But you have to wear them.

The chances of 3-5 year olds wearing a mask effectively for 8 hours? Seems low to me.

No dog in fight. Don’t have kids, and don’t teach kids.

I don’t know how the answer, but my guess is the effectiveness is not great for the little rascals.

Any harm? Also no clue. But doubt it. Just unlikely to work IMO.

What about kids 6-18?

I really don’t know, but i think it is hard for me to wear an N95 for 6-12 hours and i have been wearing masks every working day for over 20 years.

My thoughts: vaccines work, get it. N95 work, try to wear it when around people/patients.

Protect the old and sick.

Also seems like a booster for the old / immunocompromised makes sense.

I would like a booster too. My vaccinated brother got sick for a week and he is fairly healthy.

Also, i think it is silly that people are fighting over masks for little kids.

I don’t see many adults with masks. The NFL stadiums were full with no masks today. The store, same. Lots of half measures, mask with nose out etc.

I’m wearing an N95 in the store but i am trying to keep my mother in law safe (she has CA and is on chemo and is 81 and lives with us).

If i was 20 and single i think i would be less likely to wear a mask.

[StarTrekDoc]

Isn't there a question on the consent form that asks if you had another COVID vaccine?

Nope.

[StarTrekDoc]

And I’d add the best thing they can do is to keep their loved ones safe and tell all their friends and family to be vaccinated if they haven’t been yet.

Yeah, but chances are they are unvaccinated by choice and the patient doesn't care about setting example. It's about them after all.

[AR]

Nope.

no

I just tried making an appointment online for Moderna at my local pharmacy and the question popped up on the form to make the appt.

[Tangler]

I just got a booster. I got a moderna shot at Target. CVS pharmacy in store. No questions really. I feel relieved.

Did you get a different booster? Does it matter which you get? Can you get a different one than your original? do they all create antibodies to the spike protein?

[Tangler]

Interesting. Might be best to get a different booster!

https://www.nature.com/articles/d41586-021-01359-3

[doctorbone]

Does a booster shot work better against delta? I’m not sure why a booster shot would be effective against delta since it’s the original vaccine.

[Tangler]

Does a booster shot work better against delta? I’m not sure why a booster shot would be effective against delta since it’s the original vaccine.

Vaccines work against delta. Far less death. They just seem to have lost a little punch (especially for people who got them last Jan) and a booster could be difference between getting sick for a week or being sick for a day IMO. All a wild guess, but that is where i am on this evolving adventure.

[StarTrekDoc]

Currently those vaccinated getting into trouble remain the high risk folk with underlying immune response.

The theory is that they either didn't get a high enough immune response with the initial two doses or a waning immunity and titers putting them at risk.

We're thinking more the former than the latter but probably a combination of BOTH the reason why they are getting into trouble more as the sentinels just aren't enough to defend against Delta's increased virility.

[FIREshrink]

Oxygen, dexamethasone, and prone positioning are about it. If you're being admitted to the hospital it's likely too late for monoclonals although that doesn't stop people from giving it because it makes them feel like they're doing something. Same thing with convalescent plasma although that has fallen out of favor and remdesivir has many questions around it. If the patient stabilizes their sats on nasal cannula then they're usually discharged on home oxygen, a pulse oximeter, and best wishes.

Many patients usually ask what they can do to start feeling better and I'll usually be honest with them and tell them the best thing they could have done was get vaccinated months ago. If you're getting admitted to the hospital unvaccinated with COVID then your fate has basically been decided...we're just waiting to see what that end result ends up being.

Thanks, I ask because in some states, it seems hospitalizations are soaring but ICU admissions are not, is this because there are many vaccinated or because they are young or some other factor? Some as always is because ventilation/ICU admissions/deaths are trailing data points but, for example, in the UK deaths never soared despite the delta surge.