Medical Discussion of Coronavirus

[Hatton]

Lets all remain civil and apolitical. No point in rehashing any mistakes made.

[Tim]

Doubtful that vote for freedom included a disclaimer that they would not infect others or seek out hospital care if they got COVID.

You're not allowed to smoke in really any indoor public place in America any more due to the impact of second hand smoke. Second hand smoke kills under 50,000 people every year. How many people did second hand covid kill in the last two years?
https://www.cdc.gov/tobacco/data_sta...eart%20disease.

There seems to be a blending of blame. Being contagious and intentionally infecting people is not the same as one not being vaccinated.
What is the crime? Not being vaccinated or unintentionally getting sick or unintentionally spreading the infection. One could define it as getting covid, period.
Our politics have led many to assume guilt prior to any trial (and after a trial even).

[nephron]

It will be interesting to look back years later on what if any "mitigation" policies had on the spread of covid. I was telling my wife that if I had absolute control and knowledge of everybody's symptoms, I could probably eradicate covid in 2 weeks via isolation/masking/testing/etc. The problem with mitigation efforts, particularly with an extremely contagious disease, is that you have to consider human behavior in response to whatever policy you enact. You would think that individual states would be a natural randomized controlled trial to see which mitigation efforts were effective, but I don't think that it is fair to compare sunny Florida to New York in November. I don't know if Florida even has a subway system. I think that viral transmission is largely driven by individual behaviors as well. If you talk with people who are infected, they oftentimes can identify who they think they got it from. This booster business has been another disaster driven by the cdc/fda. I am seeing a lot of patients who reported 2 shots as approved by the fda who are in the hospital now because they did not get the booster because there was so much confusion being driven by the messaging by those in charge and those who felt it would be immoral to advocate for a 3rd shot when people in other countries did not have any. It's the classic "finish your dinner because people in x are starving" not realizing that by not finishing your dinner, you can't really divert your leftovers over to x. They were throwing away large amounts of vaccine while "experts" were contemplating the morality advocating for a third shot for people, it is very frustrating.

[pulmdoc]

Are we, though? The US peaks have been spring, summer, winter, and late summer. Florida's has been summer, winter, and summer and their cases have been dropping the later into November that they get. Some states have seen some seasonality but this hasn't been close to the seasonality of something like the flu.



Kind of the same way politicians pat themselves on the back with lockdown/mask mandates when cases go down but not when the cases go up after they instituted those measures.

It's definitely not as uniformly seasonal as influenza, where the lab won't even test specimens May-September and no parts of the country get it at different times. However, as you said yourself, Florida (Southern, super hot summer) has had surges in summer, winter, summer, precisely when people are indoors. If you compare that to the upper Midwest, their summer cases were much lower but they started spiking by Halloween and are now the worst hit areas.

I think this is tremendously important going forward in anticipating future surges both in terms of triaging resources and when precautionary measures are more/less effective.

[Sampter]

There seems to be a blending of blame. Being contagious and intentionally infecting people is not the same as one not being vaccinated.
What is the crime? Not being vaccinated or unintentionally getting sick or unintentionally spreading the infection. One could define it as getting covid, period.
Our politics have led many to assume guilt prior to any trial (and after a trial even).

This is an interesting point. In my neck of the woods some people seriously consider Covid essentially a hoax. People will knowingly continue their normal business while sick with Covid. Should this be a crime? Having sex with someone if you have HIV without disclosing it is a crime.

[Jaqen Haghar MD]

It's definitely not as uniformly seasonal as influenza, where the lab won't even test specimens May-September and no parts of the country get it at different times. However, as you said yourself, Florida (Southern, super hot summer) has had surges in summer, winter, summer, precisely when people are indoors. If you compare that to the upper Midwest, their summer cases were much lower but they started spiking by Halloween and are now the worst hit areas.

I think this is tremendously important going forward in anticipating future surges both in terms of triaging resources and when precautionary measures are more/less effective.

This really isn’t true for Florida. The 4 peaks here were Summer, Winter, Spring, and Summer. Winter and Spring are the milder, outdoor, open window seasons. The most recent surge peaked in August and dropped precipitously by September, where there was no temperature change here essentially, and the unvaccinated kids were getting back to school, crowded indoors.

I agree that it has a lot to do with gathering indoors, which is highly seasonal up North, but this is an oversimplified and uh-hum… convenient… explanation for Florida’s pattern of cases.

When you live and work in the thick of things, then watch the national news, saying things about you, that you aren’t actually experiencing at ground zero, you start to wonder where all this comes from.

At certain times during the pandemic, I’ve read social media posts from colleagues about how bad they have it, only to look at their numbers and realize that I’ve likely personally treated more Covid cases than their entire hospital system has seen, based on their official reported numbers at the time.

I know there are a lot of variables at play here, but I have a hard time processing these inconsistencies.

[CordMcNally]

However, as you said yourself, Florida (Southern, super hot summer) has had surges in summer, winter, summer, precisely when people are indoors.

I don't know if I would classify most of Florida in the winter as indoor weather. Snowbirds would probably disagree, too.

[jacoavlu]

well thank goodness we have the LA times to keep us all safe

Omicron variant adds new peril to holiday season in California and beyond

https://www.latimes.com/california/story/2021-11-27/new-covid-variant-raises-serious-concerns-for-california-in-holiday-season

(reminder peril means grave risk; serious and immediate danger)

article of course goes on to say that no cases have been detected in US, and other than it has “more mutations!” we basically don’t know anything yet - whether existing vaccines are effective; whether immunity from prior infection is protective; whether this variant is more or less contagious or causes more or less severe illness

[CordMcNally]

well thank goodness we have the LA times to keep us all safe

Omicron variant adds new peril to holiday season in California and beyond

https://www.latimes.com/california/story/2021-11-27/new-covid-variant-raises-serious-concerns-for-california-in-holiday-season

(reminder peril means grave risk; serious and immediate danger)

article of course goes on to say that no cases have been detected in US, and other than it has “more mutations!” we basically don’t know anything yet - whether existing vaccines are effective; whether immunity from prior infection is protective; whether this variant is more or less contagious or causes more or less severe illness

I've seen everything from there's concern a new variant could be as infectious as Delta and as deadly as Ebola to people pumping the brakes saying we know nothing about any of the data about this variant. I tend to side with the people making more reasonable statements.

[jacoavlu]

I've seen everything from there's concern a new variant could be as infectious as Delta and as deadly as Ebola to people pumping the brakes saying we know nothing about any of the data about this variant. I tend to side with the people making more reasonable statements.

yeah the article linked actually was a bunch of nothing. “may” “could” etc. but of course most people just read and retweet headlines, don’t read articles or seem to absorb things that aren’t said. shameful headline

[setsail26]

Are lockdowns and kids not going to school still a thing? Totally serious question. I'm in one of the three states with highest COVID cases right now. And a blue(ish) state to boot. No lockdowns. No mask mandates. All kids going to school in person except I think a couple districts on distance learning. Are there a lot of restrictions going on in other states? I'm sure New York and California are special as usual, but other places?

[FIREshrink]

Are lockdowns and kids not going to school still a thing? Totally serious question. I'm in one of the three states with highest COVID cases right now. And a blue(ish) state to boot. No lockdowns. No mask mandates. All kids going to school in person except I think a couple districts on distance learning. Are there a lot of restrictions going on in other states? I'm sure New York and California are special as usual, but other places?

Statewide masks indoors, schools included. But all in person learning this school year.

[TXDoc21]

What ever we can do to figure out how to live with the virus is the way to go. No way we are ever going to get rid of it at this point. Time to get back to life and do the best we can. Lockdowns only delay the inevitable.

For the record I’ve had three vaccines.

[AR]

What ever we can do to figure out how to live with the virus is the way to go. No way we are ever going to get rid of it at this point. Time to get back to life and do the best we can. Lockdowns only delay the inevitable.

For the record I’ve had three vaccines.

"live with" is doing a lot of work here. Just about everyone would agree with your statement as written. But something as simple as mandatory masks on planes can be either a perfectly acceptable way to "live with the virus" or a completely ridiculous violation depending on your viewpoint.

So, yeah, we need to figure out how to "live with the virus".

But before that we have to define and get some buy in from most people on what "living with the virus" should entail.

[FIREshrink]

I've seen everything from there's concern a new variant could be as infectious as Delta and as deadly as Ebola to people pumping the brakes saying we know nothing about any of the data about this variant. I tend to side with the people making more reasonable statements.

Agree we don't know.

But you don't get a second chance here. If it did turn out to be "as bad as Ebola" and we did nothing... Then what?

Imagine the pre covid world. And someone says, we have discovered a new virus in South Africa, it is novel, highly infectious, probably has a mortality rate of at least half a percent, and no one is immune. Wouldn't you expect your government to try to block importation of that virus to your country, or at least try?

At some point governments can't do nothing if they truly fear a game changing variant.

A delay of two weeks doesn't do much, though, unless governments really ramp something up in those two weeks. And since we don't know much about omicron it's pretty hard to know what actions we should take. Aggressive PR campaign for boosters? Distribute 30,000,000 genetic sequencing kits? Break out the emergency ventilator supply?

Probably the travel ban slows the entry of omicron by a matter of days and we do nothing with those days and thus accomplish nothing.