Medical Discussion of Coronavirus

[Rando]

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.
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I have several teachers as patients, and what they tell me is kids do surprisingly well with masks. The exception would be the autistic kids and those with intellectual disabilities.

My concern is about the quality of the masks, which is usually low. If something is to be mandated my feeling is it should be clearly effective otherwise it just fuels further skepticism, and that seems to be especially true with Delta..

[Lordosis]

Dentist appointment coming up.

Have people been asking vaccine status of the staff in these situations? Asking for only vaccinated hygienist?

[Tim]

Dentist appointment coming up.

Have people been asking vaccine status of the staff in these situations? Asking for only vaccinated hygienist?

I did. I was informed exactly that one person (Office, not involved with treatment) was unvaccinated. A separate form with my Covid disclosures and a waiver of liability form too.
To my surprise, “I can’t” (or she can’t) was the apologetic message. All you can ask is a sincere best effort. Same as you expect of your 4 munchkins.

[K82]

Uh...You currently live in it.

The amount of our federal budget going to pay for interest on our debt keeps increasing. I don't see congress decreasing spending. The amount of taxation needed to fund this insanity is not feasible. I don't see how this ends any way but bad.

[Tim]

"One first-year student said they knew of “several” people who were sick, not just asymptomatic. (Anxious not to jeopardize a budding medical career, the student asked to remain anonymous.)
That student is alarmed that the school didn’t send a mass email immediately, after the first indication that students at the orientation had been exposed: “There was radio silence for a couple of days.”

https://www.houstonchronicle.com/news/houston-texas/health/article/Medical-student-orientation-turns-into-COVID-16386716.php

189 Baylor College of Medicine first year medical students are missing out on the White Coat Ceremony! 6% infected but I doubt the actual data will be reported.

• The "messaging" is always "“Baylor followed the CDC guidelines,” said Jennifer Christner, dean of Baylor College of Medicine. The cluster of cases — she doesn’t call it an outbreak — was contained."
• First year medical student seems to be afraid to be identified. Not a good start. It was contained after the fact on a delayed basis it appears.
• That White Coat Ceremony seems to be back to business as usual. No masks and arms around each other.
• "The school took measures, and the chain of infections stopped." I don't believe it, more vaccinated folks will become infected.

[CordMcNally]

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.

It seems like ICU admissions, ventilated patients, and deaths are much lower in our area of the woods, at least. I think that’s held true for many areas. Tough to say the causative factor at this point.

[Zaphod]

The amount of our federal budget going to pay for interest on our debt keeps increasing. I don't see congress decreasing spending. The amount of taxation needed to fund this insanity is not feasible. I don't see how this ends any way but bad.

Yet its still lower than 1980, peaked in 1990 and has been getting cheaper /gdp for decades, for over 40 years this has been wrong, yet so many just keep saying stuff as if it wasnt the case.

https://www.cbpp.org/sites/default/files/styles/report_580_high_dpi/public/atoms/files/1-15-21budf1.png?itok=9dyGnXwf

It ends with some mild inflation and a perpetual time frame making it irrelevant, same way its always been.

Also, about 80% of this is held by the public, that is, the 40% of a 60/40 portfolio. Do you want them to take your access to bonds away, or stop paying any interest at all on them?

Even the nominal payments are tiny compared to past decades ago. This is a nothing burger promoted by charlatans and politicians to fire up the base, on subjects neither of them understand.

Everyone should do themselves a favor and read a book about monetary policy, Cullen Roche has an excellent one, but his blog is also very good and useful.

[StarTrekDoc]

The amount of our federal budget going to pay for interest on our debt keeps increasing. I don't see congress decreasing spending. The amount of taxation needed to fund this insanity is not feasible. I don't see how this ends any way but bad.

Debt ratio remains relatively low. That equation has quickly changed with the combination of tax cuts of the last administration and the Covid spending. Income taxes are at the lowest points for US history.

Worldwide we're on the lower end also.

https://en.wikipedia.org/wiki/Income_tax_in_the_United_States#/media/File:USTaxRevenue1945-2011.jpeg

https://www.oecd.org/tax/revenue-statistics-united-states.pdf

So to say we CAN'T fund our current spend is untrue. We simply DON'T WANT TO raise taxes back to realistic levels to match current spending habits.

[Tim]

Debt ratio remains relatively low. That equation has quickly changed with the combination of tax cuts of the last administration and the Covid spending. Income taxes are at the lowest points for US history.

Worldwide we're on the lower end also.

https://en.wikipedia.org/wiki/Income_tax_in_the_United_States#/media/File:USTaxRevenue1945-2011.jpeg

https://www.oecd.org/tax/revenue-statistics-united-states.pdf

So to say we CAN'T fund our current spend is untrue. We simply DON'T WANT TO raise taxes back to realistic levels to match current spending habits.

That is one of the trade offs. Off course it is like a balloon. Put more air in, heat it, squeeze it something else reacts and not always as expected. Taxes and money supply and interest rates are just a few data points that economics has theories and observations but it is an art not a science in predictions.

[StarTrekDoc]

That is one of the trade offs. Off course it is like a balloon. Put more air in, heat it, squeeze it something else reacts and not always as expected. Taxes and money supply and interest rates are just a few data points that economics has theories and observations but it is an art not a science in predictions.

Hamilton got it right - Just like credit scoring. Debt actually IS good. Too much is isn't. Leveraging good will IS good for the economy to grow. All solid concepts as long as good faith and making good on debts stays. Otherwise inflation and '70s situation can happen again -- but I think we're a ways away from that situation or Japan's stagnation -- thankfully.

[MaxPower]

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.

But do we really think we have a good grasp on who all of those people are? How do you know? For example, I have a chronic auto-immune condition for which I take medication every day. I’m not on immunosuppressants, or steroids (right now), but how do I really know that my two vaccine Pfizer series is good enough?

[StarTrekDoc]

But do we really think we have a good grasp on who all of those people are? How do you know? For example, I have a chronic auto-immune condition for which I take medication every day. I’m not on immunosuppressants, or steroids (right now), but how do I really know that my two vaccine Pfizer series is good enough?

Nope. Population health - general grasps along bell curve and limited data. It's clearly a grey area and constantly evolving as we get more information. This isn't straight forward cath TIMI1 flow - open it up in an hour medicine.

We simply don't have enough data on the Ab titers either to determine what cutoffs are viable or not like we have with Hep B titers. This is just too new and not enough data to determine.

To give some reference - we use Roche's assay.
My mother is on chr pred and cyclo -- yet her titers >250 upper limit of assay
My father is elderly 88+ with titers in 90s.

The current guess area of sufficient 'immunity' is somewhere in 20s. --- we THINK. We simply don't know.

So mother is rec by CDC to redose. are we? Nope, not right now. - She has an overactive immune system and believe that if we rattle the cage once TOO many times with boosters it'll have downstream ramifications of her current underlying issues.

A Guess? Yeah, sure is -- with the best data as possible.

[MaxPower]

Nope. Population health - general grasps along bell curve and limited data. It's clearly a grey area and constantly evolving as we get more information. This isn't straight forward cath TIMI1 flow - open it up in an hour medicine.

We simply don't have enough data on the Ab titers either to determine what cutoffs are viable or not like we have with Hep B titers. This is just too new and not enough data to determine.

To give some reference - we use Roche's assay.
My mother is on chr pred and cyclo -- yet her titers >250 upper limit of assay
My father is elderly 88+ with titers in 90s.

The current guess area of sufficient 'immunity' is somewhere in 20s. --- we THINK. We simply don't know.

So mother is rec by CDC to redose. are we? Nope, not right now. - She has an overactive immune system and believe that if we rattle the cage once TOO many times with boosters it'll have downstream ramifications of her current underlying issues.

A Guess? Yeah, sure is -- with the best data as possible.

I agree. It’s a stab in the dark using preliminary information to probably benefit the most susceptible. But I think I’m going to try and get a Moderna shot sooner than later, just to be as pro-active as I can.

[Hank]

Debt ratio remains relatively low. That equation has quickly changed with the combination of tax cuts of the last administration and the Covid spending. Income taxes are at the lowest points for US history.

Vehemently disagree. Income taxes are at relatively low rates since 1913. They certainly aren’t at the lowest rates for first 137 years of the American republic.

[AR]

Vehemently disagree. Income taxes are at relatively low rates since 1913. They certainly aren’t at the lowest rates for first 137 years of the American republic.

Most people reading that post would make the fairly reasonable assumption that he's only counting the time during which the US has actually had an income tax.

But I guess you got him. Congrats!