Medical Discussion of Coronavirus

[Kamban]

All of the above are true. The devil is in the details of the mandates and enforcement. There is a big difference between "zero tolerance" and focusing on the objective. Both sides need to make reasonable efforts to comply with the mandates and the mandates need to have reasonable terms.

What is reasonable. I think giving one of the three choices of available vaccine is reasonable. Giving enough time to get vaccinated and availability of vaccine was reasonable early on but that is not the case any more.

Weekly testing and mask mandate is a poor alternative. I don't have the time as an employer to see if my employee has carried out weekly testing and is wearing the N95 at all times. I have time for only one time vaccine certificate check.

[tex]

I wish there was some information on efficacy of the vaccine based on reactions to the vaccine.

There's this, if you haven't seen it: https://jamanetwork.com/journals/jam...rticle/2782821

~1000 vaccine recipients
5% reported clinically significant symptoms after 1st mRNA vaccine dose
43% reported symptoms after 2nd
>99.9% have strong antibody response 2+ weeks after the second

[pysibal]

Yep, I doubt most of those saying they will quit actually will quit and if they do going to remote location, where a large number of residents don't believe in the risk of COVID, at a hospital likely overrun with COVID cases doesn't sound appealing to me even with a hefty bonus. I'm guessing we will see MSN stories about healthcare workers who did just that and contracted COVID with a poor outcome which would be unfortunate.

The hospital in my location (which most would consider the middle of nowhere) is about 15-20% COVID patients, 80-90% unvaccinated. I don't know that we are "overrun" per se but we are indeed struggling with patient volumes but the issue is more about staffing than physical space. Partly burnout I suspect, and partly people needing to take time off due to quarantining / exposures.

[Tim]

If the terms are too reasonable they are not mandates.

Actually, this is more a function of the enforcement. Just because and "authority" exists, does not mean "punishment" is actually warranted and to what extent. Just as there are "over zealous" (for lack of a better word) law enforcement, the power of enforcing compliance is a slippery slope, particularly for minors.
Big difference between a grade school teacher dealing with a student casually pulling a mask off as opposed to a student defying the guidelines (with parental support).
Make no mistake, there are many situations that get out of hand that some want to assume enforcement. I have no problem pulling a family off a flight that refuse to wear masks. That is different than parents struggling with a 3-4 year old. Good faith efforts I think the goal should be a positive response of assistance rather than punitive.
Mandates and enforcement are needed in situation.Compliance will never be 100%, it was not expected to be as well.

[Tangler]

What is reasonable. I think giving one of the three choices of available vaccine is reasonable. Giving enough time to get vaccinated and availability of vaccine was reasonable early on but that is not the case any more.

Weekly testing and mask mandate is a poor alternative. I don't have the time as an employer to see if my employee has carried out weekly testing and is wearing the N95 at all times. I have time for only one time vaccine certificate check.

The hammer is coming down.
Unvaccinated will lose freedom.
Kamban, your post quoted here and the one above where you list where/what should be off limits for unvaccinated.
This is happening.

Yesterday NFL players were cut and many coaches admitted that unvaccinated players were more likely to be cut.

Surprisingly the Patriots cut their starting QB (Cam Newton) who is unvaccinated.

The vaccination might not have been the main reason (Mac Jones = better QB) but vaccine probably played a role.

Patriots Coach and owner may have just sent a message.

1. Bad example from a leadership position.
2. Another risk that is totally preventable
3. NFL regulations are harsh for unvaccinated and make a player who is unvaccinated is potentially unavailable for critical games/practice.

The tide is changing. The time for talking and being understanding is diminishing.

Going unvaccinated affects others.

You can go that route, but don’t expect it to be pleasant when it creates problems for others (not just you).

I wonder when life insurance carriers and heath insurance providers increase premiums for unvaccinated?

Wonder if they will test for covid antibodies like they test / screen for cholesterol, dangerous activities. and tobacco.

[artemis]

I wonder when life insurance carriers and heath insurance providers increase premiums for unvaccinated?

Wonder if they will test for covid antibodies like they test / screen for cholesterol, dangerous activities. and tobacco.

I think that depends on how long the virus continues to cause a dangerous pandemic. We don't do those things now for seasonal influenza, but that is endemic with a much lower mortality and morbidity rate. Once COVID becomes "just the flu" in terms of its mortality and morbidity (which will eventually likely happen), I can see those approaches being dropped (unless those companies have adopted them for seasonal influenza immunization as well, which I suppose is a possibility now that they have become aware of just how many hospitalizations and deaths "just the flu" actually causes in most years).

Perhaps this will spur more interest in making sure adults as well as kids stay up-to-date on their immunizations? We have fairly good mechanisms to ensure that kids stay current, but we've been pretty laggard with adults. If that changes, that will be a good thing.

[DrSam]

Maybe already posted elsewhere in this thread...I haven't gone searching...but in case not already posted, this article caught my eye today.

https://www.washingtonpost.com/world/2021/09/01/masks-study-covid-bangladesh/

[jz-]

^^^^above.

This is an early release coverage with the author stating,

they may have only a small effect on symptomatic coronavirus infections, and possibly none at all.

.

...........may have OR may not have.

[FIREshrink]

Maybe already posted elsewhere in this thread...I haven't gone searching...but in case not already posted, this article caught my eye today.
https://www.washingtonpost.com/world...id-bangladesh/

Here's a slightly more medicalized release. The link to the preprint study is in the body

https://med.stanford.edu/news/all-news/2021/09/surgical-masks-covid-19.html

[Tim]

^^^^above.

This is an early release coverage with the author stating,

they may have only a small effect on symptomatic coronavirus infections, and possibly none at all.

.

...........may have OR may not have.

The conclusion is much different than the topic paragraph.

"“I think this should basically end any scientific debate about whether masks can be effective in combating covid at the population level,” Jason Abaluck, an economist at Yale who helped lead the study, said in an interview, calling it “a nail in the coffin” of the arguments against masks."

Pride of authorship seems to be included in the article rather than the data driven conclusions.

"“I think a big error would be to read this study and to say, ‘Oh, masks can only prevent 10 percent of symptomatic infections,’ ” Abaluck said. The number would probably be several times higher if masking were universal, he said."

Statistical conclusions vs opinions count. The opinion does not need data. No doubt, masks help and the question of masks for vaccinated or previous infection also need study.

[Tim]

The two top FDA regulators with responsibility for vaccines are resigning. I find this rather contrary to having trust in our CDC and FDA. Maybe this is nothing, but it is worth considering in the influence of politics in our healthcare system.


https://www.yahoo.com/news/two-top-f...hssrp_catchall

"I do not understand your question. Probably because I do not understand why you think there is an end to the process. The point of science is to continuously question, examine the evidence and iterate, not to get to an end point."

Shant I guess we can play word salad, there is a process to organize data and determine conclusions. My question was about data, Seems two scientists with 30 years of responsibility area asking the same question. I understand the conclusions desired by the White House. Never ending governance issue, "Here is the desired result, go get it."

[Rando]

Sorry for another link to the Bangladesh study but this is the original pdf:

https://t.co/8uKPXAvvnU?amp=1

I don't think this is going to change many minds. The thing that jumps out at me is they are touting relative risks of pretty small incidences. They aren't using common clinical endpoints like hospitalizations or deaths from COVID, they are using serology changes and WHO-Defined COVID-19 Symptoms. They show no benefit from masking in people under 50.

Anyway as an example using symptomatic seroprevalance:

"unmasked" controls: 0.76%
"masked" subjects: 0.69% They are saying this is relative risk reduction of 9.3%.

However in absolute numbers this a difference of 7 people in ten thousand. And remember these are not hospitalizations or deaths, they are cases and exactly what percentage of actual cases they are catching is unclear. And they are using fingerstick serology testing which is not really used much here in the US.

[StarTrekDoc]

I think that depends on how long the virus continues to cause a dangerous pandemic. We don't do those things now for seasonal influenza, but that is endemic with a much lower mortality and morbidity rate. Once COVID becomes "just the flu" in terms of its mortality and morbidity (which will eventually likely happen), I can see those approaches being dropped (unless those companies have adopted them for seasonal influenza immunization as well, which I suppose is a possibility now that they have become aware of just how many hospitalizations and deaths "just the flu" actually causes in most years).

Perhaps this will spur more interest in making sure adults as well as kids stay up-to-date on their immunizations? We have fairly good mechanisms to ensure that kids stay current, but we've been pretty laggard with adults. If that changes, that will be a good thing.

Please stop with the flu comparisons.

Covid killing 600k annual vs 60k annual flu.

Covid is not the flu. We also have a highly effective vaccine that dramatically lowers risk of hospitalization and death.

[CordMcNally]

Surprisingly the Patriots cut their starting QB (Cam Newton) who is unvaccinated.

The vaccination might not have been the main reason (Mac Jones = better QB) but vaccine probably played a role.

Patriots Coach and owner may have just sent a message.

I think the message they sent was that if you’re no longer good at football then you won’t be on their team.

Cam should have gotten vaccinated. Not because of COVID but because he needs to be trying everything he can to get better at football.

[pulmdoc]

Here's a slightly more medicalized release. The link to the preprint study is in the body

https://med.stanford.edu/news/all-news/2021/09/surgical-masks-covid-19.html

This study is not nearly as exciting as the authors think it is. It was an enormous study, but the incidence of masking in both groups was very low (13 vs 42%) and their followup (COVID antibodies) was only 40%, which isn't very good. It showed a reduction in the intervention group but an absolute reduction of less than 1%. In a population of 378k that's 3780 less infections.