Medical Discussion of Coronavirus

[StateOfMyHead]

Our region is at over 85% fully vaccinated for those older than 11 years and the recommendation was just made to drop booster interval to 84 days for those age 18 and over. Restrictions have also been reinstated on most indoor facilities to 50% capacity again. And unfortunately, local medical school will start back in January with Zoom again (except for clinical skills) for at least 2 weeks after having been in person since the end of October. Masking in indoor spaces is still mandatory and has not changed at any point.

Two of the hospital systems where I work have ICU admissions up 2-3xs compared to 3 weeks ago. There have been a couple of high profile, fully vaccinated people test positive recently which I find disappointing. I look to leaders to set a good example. I guess social distancing has fallen out of vogue.

[artemis]

There have been a couple of high profile, fully vaccinated people test positive recently which I find disappointing.

Unfortunately I don't think social distancing alone will prevent that. Omicron is just too contagious. And obtaining a properly-fitted N95 or KN95 mask is going to be increasingly difficult as this wave grows. From what I am hearing, though, most people who've had at least two (and ideally three) doses of one of the mRNA vaccines aren't getting really sick from their breakthrough infections.

Fingers crossed this is the wave which will infect enough stubbornly unvaccinated people to put an end to these pandemic waves via T-cell immunity! But we'll have to wait and see how things play out. I keep falling into the over-optimistic camp when it comes to this virus and how it will behave.

[Kamban]

So now according to CDC, Omicron is now 73% of all new infections.

If it is truly as benign as some claim it was in S. Africa, we should have infections, breakthrough infections and lot of epidemiological data but not much in way of hospitalizations, ICU transfers and deaths. I am not sure it will be the case in unvaccinated people having the Omicron.

[CordMcNally]

I look to leaders to set a good example.

If you look towards politicians for leadership then you’re looking in the wrong place. The era of lockdowns, but not for politicians, and celebrities singing ‘Imagine’ from their estates are past us. Everyone who wants to give themselves a higher shot at better outcomes have had their chance. I think 3-4 real hard months is better then what we’ve been doing.

[snowcanyon]

If you look towards politicians for leadership then you’re looking in the wrong place. The era of lockdowns, but not for politicians, and celebrities singing ‘Imagine’ from their estates are past us. Everyone who wants to give themselves a higher shot at better outcomes have had their chance. I think 3-4 real hard months is better then what we’ve been doing.

Why would it end after 3-4 months?

[CordMcNally]

Why would it end after 3-4 months?

It may not but at least the vast majority would have some natural immunity. I would certainly be surprised if that approach lasted 21 months.

[snowcanyon]

It may not but at least the vast majority would have some natural immunity. I would certainly be surprised if that approach lasted 21 months.

Looks like omicron blew that theory out of the water- unvaccinated will get reinfected several times a year as long as the virus circulates. Some virologists think that reinfection with Covid19 will actually be more severe in those over 50.

The UK has extremely high baseline mixed natural/vaccinated immunity, and they are getting crushed by omicron.

The virus mutates incredibly quickly- faster than anticipated. Seems unlikely this strategy would work. It certainly didn't with measles, polio or smallpox. Is there robust science behind this theory?

[Tim]

Looks like omicron blew that theory out of the water- unvaccinated will get reinfected several times a year as long as the virus circulates. Some virologists think that reinfection with Covid19 will actually be more severe in those over 50.

The UK has extremely high baseline mixed natural/vaccinated immunity, and they are getting crushed by omicron.

The virus mutates incredibly quickly- faster than anticipated. Seems unlikely this strategy would work. It certainly didn't with measles, polio or smallpox. Is there robust science behind this theory?

Each variant seems have a pattern in each area, the surge bell curve.
The ironic part is the different levels of vaccinations and preventive measures don’t seem to stop the spread. Vaccines do substantially impact the severity, no doubt.
Seems that each new variant finds a weakness and runs it’s own course.

I am not sure measles, polio or smallpox are the variants, would the flu with its variants be a better comparison?

Omicron will run it’s course. Preventing the next variant and therapeutics don’t seem to be a priority. Therapeutics could prevent hospitalizations and deaths. We just might need to shift gears and adapt to coping techniques for new variants. That would be in addition, not a replacement. Who knows what the next variant will be. Reduce hospitalizations and deaths and learn to live with Covid seem to be the long term goals. Eradication seems impossible or impractical.

[Jaqen Haghar MD]

Well it’s on, Omicron….

We went from from zero to sixty pretty quick. This past week we took off again. Since delta blew through here over the late summer, I assume it’s mostly Omicron now. Lots of COVID again, suddenly. Had three cases of COVID infection in triple vaccinated patients yesterday. Lots of double vaccinated infections, and and some unvaccinated infections. (I think b/c most here are vaccinated at this point). One guy today was vaccinated and this is his 3rd COVID infection in 18 months…. That was a first for me.

Very few admissions though. Mostly flu-like infections and sniffles so far. Almost all going home. Very few hospital inpatient Covids…. But it’s early. We’ll see if it holds true in a few weeks as the infected ripen.

[CordMcNally]

Looks like omicron blew that theory out of the water- unvaccinated will get reinfected several times a year as long as the virus circulates. Some virologists think that reinfection with Covid19 will actually be more severe in those over 50.

The UK has extremely high baseline mixed natural/vaccinated immunity, and they are getting crushed by omicron.

The virus mutates incredibly quickly- faster than anticipated. Seems unlikely this strategy would work. It certainly didn't with measles, polio or smallpox. Is there robust science behind this theory?

But those reinfections don’t seem severe. So what’s the plan? Vaccination passports and restrictions while the virus does what it’s going to do anyway?

[Sampter]

It will be quite interesting as it appears that only one monoclonal ab has effectiveness (lab study) to Omicron and it is in very short supply. This message should be made quite clear to the public in order to potentially sway some unvaccinated counting on monoclonals to get vaccinated.

[Perry Ict]

But those reinfections don’t seem severe. So what’s the plan? Vaccination passports and restrictions while the virus does what it’s going to do anyway?

Exactly. Whether more restrictions/lockdowns will have the intended effect is questionable anyway; instead we should encourage more people to get vaccinated and go on living our lives.

[Kamban]

Well it’s on, Omicron….

We went from from zero to sixty pretty quick. This past week we took off again. Since delta blew through here over the late summer, I assume it’s mostly Omicron now. Lots of COVID again, suddenly. Had three cases of COVID infection in triple vaccinated patients yesterday. Lots of double vaccinated infections, and and some unvaccinated infections. (I think b/c most here are vaccinated at this point). One guy today was vaccinated and this is his 3rd COVID infection in 18 months…. That was a first for me.

It is amazing that it was on Nov 24th at SA researchers reported to WHO about the Omicron variant. Every country started to shut its doors but to what avail. It is Dec 22, less than a month later and it is the most dominant strain in the world and 75% of cases here. It has spread faster than a California wildfire.

As this dies down another strain with more mutations ( will it be Pi or Rho) will emerge and before anyone can react it will go around the world infecting everyone.

The question is whether we should be encouraging everyone with sniffles and cold to get tested for Coronavirus and isolate and mask and disinfect everything and do those silly measures. Or just ask people with only severe symptoms to seek ER help and encourage vaccinations just to avoid deaths. The messaging should be - Take vaccination to avoid being dead. You will get COVID-22 anyway, whether you are vaccinated or not.

[Tim]

Exactly. Whether more restrictions/lockdowns will have the intended effect is questionable anyway; instead we should encourage more people to get vaccinated and go on living our lives.

Prevention- vaccine
Diagnosis- testing
Treatment- therapeutics
Basic health taught in 7th grade for just about any health problem. All the other are band aids for any other short comings. We are wasting so much efforts on non-productive efforts to fill the gaps. Placing blame and taking credit is non-productive. Healthcare is non-judgemental. Our policy should be on improving each of the three pillars. I really do not blame either party for the pandemic. I wish they would focus on each of the components. 100% compliance on anything is impossible.
That is why we have prisons. And look how effective that is for Covid.

This might work for therapeutics. Maybe not. Quantities insufficient for mass availability. the goal is to keep people out of the hospital.

https://www.ktnv.com/news/covid-treatment-pills-expect-fda-approval-this-week

[CordMcNally]

You will get COVID-22 anyway, whether you are vaccinated or not.

I think this should be the messaging going forward. Workplaces open, schools open, masks optional.