Medical Discussion of Coronavirus

[Lordosis]

I worry this will discourage staff from getting vaccinated- they would rather have the Covid leave, I think.

That is awfully pessimistic. Even still I think it would not matter much. 99% of people have already made up their mind and I doubt this would tip anyone over. Large financial consequences like losing a job might get a few more but as we have seen it will not work for everyone.

[coastal]

This is what worries me the most. Fully vaccinated and boosted. Not too worried about getting sick but if I had to cancel 10 days of clinic/surgeries, it would be a major pain. I sure hope cdc will shorten the recommended quarantine days for the vaccinated.

I’m lucky - was scheduled off for a bit over the holidays. Will end up cancelling two clinic days and one OR. January is wicked busy and I’m struggling to find OR time for time sensitive cases. If this happened even a week later I’d be screwed. I’m employed, but friends in private practice are certainly nervous right now.

In terms of being “sick”, it’s been a nothing for me so far. Only tested because we have parents visiting.

[Kamban]

A friend of mine who is 66 told me that his concierge doc told him he did not need a booster?? New concierge doc?

Must be employed by WHO.
They are decrying countries encouraging booster since it will take away vaccine from poorer countries and prolong the pandemic. What nonsense.

[StarTrekDoc]

I’m lucky - was scheduled off for a bit over the holidays. Will end up cancelling two clinic days and one OR. January is wicked busy and I’m struggling to find OR time for time sensitive cases. If this happened even a week later I’d be screwed. I’m employed, but friends in private practice are certainly nervous right now.

In terms of being “sick”, it’s been a nothing for me so far. Only tested because we have parents visiting.

Would patients be concerned if they knew you were covid+ and operating on them? Going to work contagious/sick is what perpetuates this and deepens the surge -- all what we're trying to mitigate.

Yes, it sucks. Our freshman daughter tested positive and isolated 10 FULL days -- completely asymptomatic. No test out. Nothing. Sucked every singe minute.

Yes, 10 days is overkill and there should be parameters to shorten and 'test out with 2 negative Ag Tests' in critical areas, like essential life-threatening surgeries. Has the wheels of CDC moved on this since Delta? nope. We do have the data on 5 days on normal immune vaccinated folk is quite sufficient, and using Ag testing as a backstop verification. -- but this is our reality right now where we can't even get enough Ag testing going on year 2.

[Rando]

To be fair, currently it seems telling Americans to get X means 50% will get X and 50% will not. Who will and who won’t depending on the hue of the messenger.

I think something like 95% of people over 65 have received at least one dose and 88% two doses. Traditionally this is the age group also felt to be most susceptible to misinformation (such as from partisan news networks). So it's too simplistic to say it's all red and blue. My guess is this older group perceived clear benefit from getting the vaccine and younger people saw less benefit, which isn't totally unreasonable.

In pandemics a large percentage of the population not trusting or being skeptical of the government is a disadvantage if you're trying to get everybody vaccinated, but in "normal" times it has benefits. I think physicians should be continually questioning and asking for evidence, but not all doctors agree with me. To tailor the messaging so people buy into it is not going to be one size fits all. So the messaging which so far seems to me heavily politically driven under two presidents is going to leave some gaps.

[snowcanyon]

Well, CDC went even further and said actively infected caregivers can go back to work caring for patients. Not the general public though.

Avoid the hospital. At any cost.

[G]

Well, CDC went even further and said actively infected caregivers can go back to work caring for patients. Not the general public though.

Avoid the hospital. At any cost.

That is an interesting interpretation of the CDC guidance.

[StarTrekDoc]

Just to clarify misinformation....

Guidelines for exposure for HCP. Check symptoms with precautions. No isolation

positive hcp. Isolate 10 days.

updated too.

https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html

[Perry Ict]

Actually I remember when he was all about the vaccine.

He was talking about the virtues of "operation warp speed", saying it was amazing!

Kamala Harris then was asked and she said: "I don't know if I would trust a vaccine put out by this administration = Trump"

Don't get me wrong. I am very pro vaccine. I also not a huge Trump fan.

But I don't think he is to blame for the Anti-vaccine nonsense.

I think the anti-vaccine crowd just hates Biden and hates people telling them: "You MUST do this or else____"

That kind of forced stuff.........that goes over really well in a country that fought for independence from tyrannical rule at its founding.

Americans don't like to be told what to do.

https://www.politico.com/news/2020/0...vaccine-409320

All valid points. I'd just add that, not only is this NOT a strictly Republican or Democrat issue (as you implied, it depends on who is in charge and in a position to take credit/blame), it also isn't just a US issue. Recently, Jeremy Corbin, arguably the leader of the left wing in the UK, came out against vaccine mandates (he is pro-vaccine, anti-mandate). There have also been protests in the UK, Italy, and elsewhere across the world against some of the new measures being taken. Just something to be aware of, that this is a more universal debate/conflict not limited to the US.

[snowcanyon]

Just to clarify misinformation....

Guidelines for exposure for HCP. Check symptoms with precautions. No isolation

positive hcp. Isolate 10 days.

updated too.

https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html

Nope. If there are "crisis" standards, infected caregivers are advised to work. Pretty easy for hospitals to invoke "crisis" to avoid sick time.

With tens of thousands of nosocomial infections last year, and the data from Dana-Farber on the high fatality rate of vaccinated cancer patients with breakthrough cases. there is a lot to be concerned about.

[StarTrekDoc]

Crisis does have implications and standards spelled out -- including disclosure that they are operating under such conditions and what that means. I maybe easy to invoke, there are implications for such -- and probably will happen in places where it's probably not a big deal from the patients demanding ivermectin concurrently.

[StateOfMyHead]

Nope. If there are "crisis" standards, infected caregivers are advised to work. Pretty easy for hospitals to invoke "crisis" to avoid sick time.

With tens of thousands of nosocomial infections last year, and the data from Dana-Farber on the high fatality rate of vaccinated cancer patients with breakthrough cases. there is a lot to be concerned about.

The most recent hospital email about testing and working actually read to me like "don't ask don't tell". Maybe I misinterpreted but it wouldn't be surprising with the current staffing issues. I would strongly prefer not to have my family cared for by staff with COVID even if asymptomatic.

[StarTrekDoc]

The most recent hospital email about testing and working actually read to me like "don't ask don't tell". Maybe I misinterpreted but it wouldn't be surprising with the current staffing issues. I would strongly prefer not to have my family cared for by staff with COVID even if asymptomatic.

The contingencies would 'probably' be covid+ staff get moved to covid wards. Would be nightmare scenario for RM (and patients) to have covid+ chemo nurse doing same duties.

[StarTrekDoc]

On covid news:

we hit highest positives since last year -- surpassing Delta surge.
starting to see ED visits bumping up as expected and level of severity creeping up.
hospitalizations so far stable -- still too early -- check back in 1-2 weeks

Bad news:
MAB capacity overrun - triage to highest risks now
oral therapeutics just starting deliveries to county and will take another few days with extreme limits
requests for ivermectin increasing

[Lordosis]

We were running a regeneron mab clinic that we just shut down because I guess it is ineffective against omicron. I guess there is a new one but limited availability. Also only approved for IV at the moment.

Local data shows 80% omicron