Medical Discussion of Coronavirus

[artemis]

Except now the goalposts will move to “they rushed it through approval so it’s still NoT lEgItImAtE.”

Of course. The excuses are endless. But this removes a big hurdle when it comes to employers mandating employees to get vaccinated.

[Jaqen Haghar MD]

Thoughts on South Florida physicians protesting unvaccinated patients?

I wonder what this was? I don’t think it was a real “walkout”, but I can’t find many details. I’d bet everyone stood in the parking lot at lunchtime for 2 minutes, as a publicity stunt. Anyone know anything?

Here, we’ve likely gone over the hump now. We have given close to 1,000 doses of monoclonals out of the ED here at this point. The Covid units opened back up, freeing up hospital beds. Volumes in the ED have gone from record breaking, to just busy. I still see a bunch of new Covid patients per day, but it’s not twenty a day, like it was a couple weeks ago. I’m hoping we are in the burnout phase of this wave, but school is starting, so we shall see if it’s just a lull.

Nurses are tired, but many are happy, as they are making up to $1,000 per shift around here if they play their cards right. The docs here are beat up, but nobody is cracking. I see 1-2 vaccinated infections per shift, but I did see 6 breakthroughs on one shift - most are doing well. Nurses can make $90k for three months if they are willing to travel a little bit.

Unvaccinated cases are the ones not doing well, middle aged and chubby seem to do poorly. Pretty consistently at most places 90/10 breakdown for admission at this point.

[Lithium]

I'd like to hear more about that (so far I've not seen much about it in the media). I can certainly understand their motivations.

Pfizer got got full FDA approval. Moderna is expected to receive it by the end of September. So much for the "it's experimental!" excuse.

I just read a couple of stories. It sounds like it was a symbolic gesture, which I can’t imagine will have that much of an impact on people who are acting on selfish motivations.

I also read that Trump got booed for urging his crowd to get vaccinated. If even he can’t persuade the remaining vaccine resistant, then we’re really past the point of using carrots and trying to beg and convince people.

I think for a lot of the vaccine resistant, the doom and gloom on the news doesn’t feel that real. They see Trump got COVID before he got vaccinated and he’s still the same big orange carnival barker he was in 2019. Who’s the most famous person to die of COVID? Is it still Herman Cain? No one in my close family has had it, and I don’t even have any acquaintances that have gotten very sick or been in the hospital. I can see why a lot of people underestimate the risk.

[Ekanive23]

Thank you for this!

Why not remdisivir any more?

Also, where do monocolonals fit in? In your above scenario, patients have passed that point?

With delta, how often are you seeing young, truly healthy patients (ie, under 50 or under 40, not obese, not diabetic, etc)?

Rem data is of poor quality.
90 percent roughly delta and yes I have always 1-3 of my covids in the 30-60 range.

I had a 26 year old get toci a week after deliver. Only was overweight.

36 year old obese 34 BMI. Pre diabetic on optiflow 60/70

61 year old with cabg htn hld but all stable for last decade. In great shape currently.

53 year old overweight no medical problems.

59 year old hypertension. Barely overweight.


all that I treat are unvaccinated.
the only vaccinated ones I have had, are patients the Er got squeamish with and get admitted overnight after someone turns it up to 2 L ... when it’s not needed. I then get to bill a same day discharge if it was after midnight cause they rarely ever stay more than one day.

monoclonals are for my pre op patients that test positive incidentally. No covid symptoms that warranted admission.

[Jaqen Haghar MD]

https://www.youtube.com/watch?v=HXgPNA19YKo

I’m watching this right now on HBO. A reminder that there are places where forums and discussions like this are not allowed and their creators and contributors are “disappeared”.

“Death is the solution to all problems. No man, no problem.” -Stalin.

[Lithium]

https://www.cnn.com/2021/08/24/healt...day/index.html

This is a prime example of why I don’t understand why the Biden administration still allows this buffoon on TV. He really just seems to be pulling these predictions out of his rear end at this point. Apparently he had predicted “good control” in fall of 2022 but then walked it back to the spring. I wonder how much pressure he got before he went on TV. Why can’t he just borrow one of WCI’s favorite phrases - “I wish I had a good answer for you Anderson, but my crystal ball remains cloudy”? I bet Jim could actually do a better job, at least in front of the microphone.

[Panscan]

https://www.cnn.com/2021/08/24/healt...day/index.html

This is a prime example of why I don’t understand why the Biden administration still allows this buffoon on TV. He really just seems to be pulling these predictions out of his rear end at this point. Apparently he had predicted “good control” in fall of 2022 but then walked it back to the spring. I wonder how much pressure he got before he went on TV. Why can’t he just borrow one of WCI’s favorite phrases - “I wish I had a good answer for you Anderson, but my crystal ball remains cloudy”? I bet Jim could actually do a better job, at least in front of the microphone.

The way people are looking at data is so stupid. We should be concerned with how effective the vax are at preventing hospitalization and severe disease, which is very effective. All these claims on waning efficacy and etc essentially rely solely on asymptomatic and minors infections which is such a stupid endpoint.

[Sampter]

The way people are looking at data is so stupid. We should be concerned with how effective the vax are at preventing hospitalization and severe disease, which is very effective. All these claims on waning efficacy and etc essentially rely solely on asymptomatic and minors infections which is such a stupid endpoint.

It's the anti-vaxers pushing it.

[pulmdoc]

One week after the start of school, the local public school system (masks optional) has had 1.5% of all the students test positive for COVID, with >10% of students and staff in quarantine already. The other major public school district (50k kids in metro) are at 1% positive in a week and 20% of students/staff quarantined for contact. My kids' school (mask mandate while inside) has had 0 positive tests to date. Coincidence????

[gap55u]

Re vaccination — I’m outpatient primary care and really not face-to-face with Covid a lot — but have had lots of patients with unnecessary disease and obviously worry about friends/family/kids that cannot vaccinate and are at risk; or breakthrough Covid. I am increasingly angry with “I’ve done my own research” and associated bullshit. One dip ************************ refused the vaccine and wanted ivermectin; plaquenil, zpack and “walk-in monoclonal antibody referral” after an exposure. And was not quarantining when we talked. Idiots! He seemed honestly surprised when I said we have too many already-Covid-positive patients to treat. And I had another patient (seen by video) FLY HOME WHEN SICK with obvious Covid symptoms. Jesus. And I have people arguing with me about mask use. Ugh.

[snowcanyon]

The way people are looking at data is so stupid. We should be concerned with how effective the vax are at preventing hospitalization and severe disease, which is very effective. All these claims on waning efficacy and etc essentially rely solely on asymptomatic and minors infections which is such a stupid endpoint.

Israeli data indicate that a booster decreases hospitalizations in elders.

[MaxPower]

For those with experience as intensivists or who work in the ICU, what do the mortality rates for mechanically ventilated patients look like now vs fall 2020? As this seems to be more a pandemic of the unvaccinated/young, I would expect mortality rates to decrease, but I’m just curious if that is accurate or not.

[Tim]

For those with experience as intensivists or who work in the ICU, what do the mortality rates for mechanically ventilated patients look like now vs fall 2020? As this seems to be more a pandemic of the unvaccinated/young, I would expect mortality rates to decrease, but I’m just curious if that is accurate or not.

It would be interesting to see data presented without a message. The focus could shift to not what has been accomplished, but drilling down and identifying the remaining problems and solving them. No statistics on the unvaccinated, which seem to be the highest risk.

[artemis]

I am increasingly angry with “I’ve done my own research” and associated bullshit. One dip ************************ refused the vaccine and wanted ivermectin; plaquenil, zpack and “walk-in monoclonal antibody referral” after an exposure.

Most of these people couldn't research their way out of a paper bag. Does Mr. Horse's-You-Know-What know that the cost of Regeneron is over $1,000 per dose? Vaccine's free and does the same thing IF you get it and are unfortunate enough to have a breakthrough infection (of course, most vaccinated people don't have breakthrough infections and thus don't get sick at all).

I wonder if insurance companies could increase their premiums on vaccine-refusnicks? They do that with smokers, after all. Money talks, and if people had to pay an extra $100-200/month for their health insurance if they remained unvaccinated, I suspect a lot of them would decide in favor of the vaccine.

[Sampter]

Most of these people couldn't research their way out of a paper bag. Does Mr. Horse's-You-Know-What know that the cost of Regeneron is over $1,000 per dose? Vaccine's free and does the same thing IF you get it and are unfortunate enough to have a breakthrough infection (of course, most vaccinated people don't have breakthrough infections and thus don't get sick at all).

I wonder if insurance companies could increase their premiums on vaccine-refusnicks? They do that with smokers, after all. Money talks, and if people had to pay an extra $100-200/month for their health insurance if they remained unvaccinated, I suspect a lot of them would decide in favor of the vaccine.

Delta airlines is actually charging employees more for their insurance if they are unvaccinated, I believe $200 a month.