Medical Discussion of Coronavirus

[FIREshrink]

Mostly I've avoided risky indoor activity because my kids weren't vaccinated, my sister is vaccinated but immunocompromised, to do my part to avoid propagating a pandemic virus, and to prevent infecting my patients. By November, my son will be vaccinated, my sister's had her booster, and i think we'll be between waves. We'll probably go out to eat. Sushi just ain't good in a cardboard box.

[G]

Sushi just ain't good in a cardboard box.

But you probably have a lot more comfortable places to sit than those ridiculous bar stools!

[Bmac]

I’ll be honest, if anyone had said that over a year and a half into the pandemic, particularly 9 months after a free and widely available and effective vaccine had been developed, we would be experiencing such a crushing surge in hospitalizations and deaths throughout the country, I would have thought they were nuts. Such a shame that this has been politicized from day one.

[Sundance]

Mostly I've avoided risky indoor activity because my kids weren't vaccinated, my sister is vaccinated but immunocompromised, to do my part to avoid propagating a pandemic virus, and to prevent infecting my patients. By November, my son will be vaccinated, my sister's had her booster, and i think we'll be between waves. We'll probably go out to eat. Sushi just ain't good in a cardboard box.

Have you not gone out to dinner since March 2020?

[FIREshrink]

Have you not gone out to dinner since March 2020?

Only eating outside, or take out.

Ah, one exception, my uncle took us out in Hawaii, very empty restaurant, there was almost no Covid there at the time, we felt ok with that.

[sweetnpsycho]

The vaccine as been politicized and that is a huge turn off. A large group of people think the election has been stolen. The media that demonized the previous president is pushing hard propaganda in support of the vaccine. There isn't enough data regarding the vaccines and their long-term consequences. Or if the vaccine is required for those who previously was infected.

Why didn't these measures take place during the swine flu or avian flu or the first SARS?

Why isn't there a debate between those who are pro-vaccine and those who are anti-vaccine and have people make their own judgement? Now with the vaccine mandate from the current president, this will likely worsen nursing shortages.

How many people who supposedly died from COVID died from other complications but so happened to have COVID? Weren't there financial incentives to label a death due to COVID? How could people get the truth when certain people and certain entities profit in one direction over the other?

Frankly, I'm all about informed consent and there doesn't seem to be much information or much consent.

[billy]

Alright I'll bite for a sec but really read the whole thread before you post if you still question the severity of COVID. I'm pretty confident the 2 mid 30 year olds I intubated in the past few weeks (and died) did not "die from other complications and so happened to have covid." They died because of the complications that occurred due to covid. A 30 year old doesnt suddenly go into renal failure, respiratory failure, become hypercoagulable all at once spontaneously for no apparent reason.

The long term effects of the vaccine argument at this point (when you are basically going to catch covid if unvaccinated- its too prevalent) would be considered if someone can show me the long term data on COVID showing its harmless if you survive. Wait, there is no data for that? So why move the goal posts for vaccines? Things I know- viruses have caused long term consequences, even some that arent immediately apparent, up to and including cancer. Vaccines so far... well can you give me an example of one that caused consequences that present over a year later?

Swine flu avian flu etc never "caught on" bc those viruses burned themselves out before reaching this critical point- I don't remember ever seeing hospital systems crushed for that or ebola, zika, etc. Or other type of sick patients being denied beds due to ICUs being full all over the state. Perhaps AIDs did, I wasnt in medicine for that peak, but I cant think of an example in the past 50 years, can you?

For those previously infected, I cant argue if they want to get tested weekly, wear masks and not be vaccinated.

Everything stated above is non political. Your post seems to be politicized- no point in bringing up thinking an election was stolen- those people wont believe anything an opposing political group will say. Cant even fault trump recently- he was booed trying to tell people to get the vaccine.

[sweetnpsycho]

billy

Cool story, bro. And what about people who die after having COVID vaccine? People can exchange stories all day.

So your argument is that because there is limited data on COVID, you should take action that too has limited data?

Will the vaccine prevent you from getting COVID? Or does it just lessen the symptoms? If it doesn't prevent COVID, then you have two wildcards to contend with instead of 1.

All the major news source says the same things. It is an echo-chamber and there is no diversity of thought. Where is the discourse about it?

[StarTrekDoc]

There's about as much information and informed consent as there can be.

What haven't you heard over the past two years that makes you think there is something known but not disclosed?

I've suggested this to my patients who have the same hesitancy that you voice....suggest that you go to your local hospital and take a look at any ICU. Ask the nurse coming off duty if they think covid is the cause of the patient being in the ICU and recent spike of additional deaths over the past year is normal. Ask if there is a difference between vaccinated patients or not. That will provide a very informed and truth at face value to you.

[StateOfMyHead]

I try to be respectful and often learn from other's differing views but this is unbelievable. In addition to the devastating losses of life, the sheer volume of ignorance that has been exposed during this pandemic has been both shocking and disheartening.

[billy]

billy

Cool story, bro. And what about people who die after having COVID vaccine? People can exchange stories all day.

So your argument is that because there is limited data on COVID, you should take action that too has limited data?

Will the vaccine prevent you from getting COVID? Or does it just lessen the symptoms? If it doesn't prevent COVID, then you have two wildcards to contend with instead of 1.

All the major news source says the same things. It is an echo-chamber and there is no diversity of thought. Where is the discourse about it?

Its laughable to compare the few who had reactions to the vaccine with the 500,000 who died from covid. Especially when looking at the denominators for each. But sure, these are just anecdotal "stories" to compare.

And based on current data, the answer to your question on prevention is "both".

Still waiting to hear of an example when a vaccine has caused long term complications that aren't readily apparent within a year. Meanwhile reduced lung function, renal failure requiring dialysis are already known with covid (*plus you know death), plus all the other examples in history of viruses causing complications. You can spout all you want, but the science is clear on this. I can also share stories of how seatbelts may cause injuries, but I'm still wearing one because I understand the statistical likelihood of which one is more likely to lead to injury.

Perhaps if all sources are saying the same thing, it might not be an echo chamber but actually may be true? Have you actually walked through any ICU in the past year during a surge?

[Rando]

Just had a 37 year old lady die today in my hospital of covid. Had initial infection in August 2020. Not vaccinated and caught it again this August. Spiraled precipitously downward in the last week and spent 9 days prone because they could get her supine or her O2 sats dropped. Not immunocompromised either. Overweight snd recently had a baby. That’s it.

Thanks Max but ultimately this is anecdotal. After poking around the CDC site there have been fully vaccinated patients that have died of COVID, the number looked to be around 1500 in the US as of last month. In order for me to properly counsel a patient with documented history of COVID ideally I want to compare that number to COVID deaths among those with prior infection, and I'm disappointed that I can't. And really with the advent of Delta in the past few months I'm not sure how helpful older data would be even if I had it.

My advice to patients with hx of prior COVID is to get the vaccine anyway as it seems logical, but I feel like I don't have a lot of evidence to back that up.

[billy]

Rando I wonder if any systems are tracking covid admits in patients who had covid previously. As far as I know, mine isnt.

[Tim]

There's about as much information and informed consent as there can be.

What haven't you heard over the past two years that makes you think there is something known but not disclosed?

I've suggested this to my patients who have the same hesitancy that you voice....suggest that you go to your local hospital and take a look at any ICU. Ask the nurse coming off duty if they think covid is the cause of the patient being in the ICU and recent spike of additional deaths over the past year is normal. Ask if there is a difference between vaccinated patients or not. That will provide a very informed and truth at face value to you.

I appreciate your sincere replies. Rhetorically, most discussions about "herd immunity" are a two factor discussion. Vaccine + the natural immunity. There are legitimate questions about natural immunity possibly providing a better protection against "variants" because of the "targeting specific variants of the vaccines". I am vaccinated, but I still have that question. Why is natural infection not a factor in vaccines being mandated?

The "evidence" you cite is probably in the "more likely than not" category rather than "beyond a reasonable doubt". Not sure, everyone is dealing with the same standards for making decisions. For sure, pro vaccine takes the position of "why does it matter". I don't think natural immunity is even mentioned or considered in vaccine mandates. But is definitely was in all discussions of "heard immunity". No idea where it went. I would appreciate an explanation why it is no longer is a factor.

Probably because it is an unknown.

https://cap-press.com/pdf/33733.pdf

https://www.lawinsider.com/dictionary/more-likely-than-not#:~:text=More%20likely%20than%20not%20means%20evidence%20reasonably%20tending,just%20and%20reasonable%20substantiation.%20Sample%201%20Sample%202

More of a decision making theory question. The messaging has completely ignored "natural immunity" and the statistics as well. Vaccinate, un vaccinated and natural immunity are the three factors I see.

https://www.news-medical.net/news/20210608/No-point-vaccinating-those-whoe28099ve-had-COVID-19-Findings-of-Cleveland-Clinic-study.aspx

I have not heard of the Cleveland Clinic being accused of disinformation.

[MaxPower]

Thanks Max but ultimately this is anecdotal. After poking around the CDC site there have been fully vaccinated patients that have died of COVID, the number looked to be around 1500 in the US as of last month. In order for me to properly counsel a patient with documented history of COVID ideally I want to compare that number to COVID deaths among those with prior infection, and I'm disappointed that I can't. And really with the advent of Delta in the past few months I'm not sure how helpful older data would be even if I had it.

My advice to patients with hx of prior COVID is to get the vaccine anyway as it seems logical, but I feel like I don't have a lot of evidence to back that up.

I know, but for people thinking that having covid once already and surviving is enough clearly aren’t correct. I’m pretty sure there are studies showing the highest antibody levels in patients who had covid, got better, then had the vaccine. We obviously don’t know what the magic number is for antibody level yet, but I would guess more is better.