Medical Discussion of Coronavirus

[xraygoggles]

We don’t ever want to see the Spring 2020 lack of volume again.

100% - that was truly an existential period for quite a few docs and practices. Those 2 months or so of greatly diminished patient volume was both eerie & tranquil at the same time.

[triad]

Do we, you, have enough cases of omicron in COVID naive patients to compare? What percent of patients with omicron today never contracted any Covid variant and have never been vaccinated?

How much less virulent is it?

We all want this to be true!

just looking at the other countries who have had their omi spikes start going down they haven't seen much impact on hospitalizations. seems like omi can't get into the lungs as easily as previous variants so would make sense that its much less deadly.

[StarTrekDoc]

Silver lining and great 2021 year end gift from omicron would be it primes everyone's system enough to stay ahead of Pi those afterwards while taking out Delta for the count

[Jaqen Haghar MD]

Well, another couple of shifts of Omicron everywhere, ED packed, big waits, most testing COVID positive just about, still zero COVID admits for me. Patients are definitely less sick with this one. Definitely jamming up the place though.

Multiple new record breaking days of case numbers for the state. ICU beds occupied with COVID patients falling, admitted COVID patient numbers flat over the same period. Hopefully the latter trend holds.

[Dont_know_mind]

Silver lining and great 2021 year end gift from omicron would be it primes everyone's system enough to stay ahead of Pi those afterwards while taking out Delta for the count

That would be a good outcome and looking increasingly likely.

Best wishes to everyone for the new year.

[Tim]

That would be a good outcome and looking increasingly likely.

Best wishes to everyone for the new year.

Found out a shocker or 2 yesterday.:
Extended Family is irresponsible has been my conclusion for quite awhile based on other situations. No being judgmental, just how reliable they are.
One niece: had be using her mother for childcare.
Another niece turns out to be an anti-vac for her whole family.
Both of their parents live in the same house and had hosted the 94 yr old grandmother for a week.
Each niece has 4 children + 2 adults.
100% tested positive for Covid prior to Christmas.
So that is 16 people (12 positive + 4 exposed) that have been in proximity to MIL.
Additional lesson learned.
The only way I pieced this together was my daughter was told in confidence and I am not allowed to communicate this to family. Needed to know to isolate the 94 yr old MIL. It is a good thing we canceled the Christmas Eve large extended family get together. Another nephew had a smaller get together that we were invited to attend.
I have no idea if they were symptomatic or just selfish. I strongly support any type of Covid screening or testing. People are hiding it, to avoid personal inconvenience or restrictions. I hope the severity is much less with Omicron.
Covid fatigue is changing behaviors, and not for the better.

[snowcanyon]

Well, another couple of shifts of Omicron everywhere, ED packed, big waits, most testing COVID positive just about, still zero COVID admits for me. Patients are definitely less sick with this one. Definitely jamming up the place though.

Multiple new record breaking days of case numbers for the state. ICU beds occupied with COVID patients falling, admitted COVID patient numbers flat over the same period. Hopefully the latter trend holds.

That's great to hear. I wonder why the NE, with high vax and boost rates, is imploding so fast?

[G]

That's great to hear. I wonder why the NE, with high vax and boost rates, is imploding so fast?

I thought it was FL?

We haven't gotten the omicron spike yet. I did admit one unvaccinated hypoxic covid patient yesterday. Me: "Sir, as I suspected, you have COVID." Him: "OK, but why am I so short of breath?" Me: "Um...because you have COVID." Him: "So you're saying all the tests were okay and there is nothing else wrong?" Me: [closes the door and walks away]

[Tim]

Can someone explain the changes the CDC is making. The changes in responsibilities back to the states, distributions of all types of testing and therapeutics still controlled by the CDC. But vaccines and testing are now mandated but you might have a problem getting tested and the quarantine guidelines are modified but it is NOW the states responsibility? Something new every day. It is getting confusing who is on first base.

https://news.yahoo.com/texas-runs-monoclonal-antibody-treatment-114925210.html

It may have been a good choice to restrict monoclonal supplies to states that were using them. Now the allocations are based on population. Shortage of tests are on the agenda as well.
I hear the testing supply will ramp up in late January. Such is life. The supply chain was ramped down in October with manufacturers not getting commitments.
Such is life.
"On Monday’s call, Biden said a “federal response” is not the key to fighting the COVID-19 pandemic, but calls for a “state-level” solution. The bite pointed to long queues at test sites over the Christmas weekend in the middle of the omicron climb. He said: “Seeing how hard it was for some people to get a test this weekend shows we have more work to do.” This was supposedly on a conference call to the governors.

I hope this doesn't deteriorate to the PPE and vent shortages. The good part is solutions are available, just not now. More political messaging. Omicron is taking its own path.

[StarTrekDoc]

100% tested positive for Covid prior to Christmas.
So that is 16 people (12 positive + 4 exposed) that have been in proximity to MIL.

Covid fatigue is changing behaviors, and not for the better.

That sucks. Hope MIL shows why she's 94.

[StarTrekDoc]

Numbers: San Diego County
Fully Vac 80%
Boosted 25%

County
Test+ numbers surpassed peak Delta surge levels over summer and still upward this week at 2600/day. Models anticipate 3000-4000 peak in 1-2 weeks (but unknown with school back)

Hospital specs:
ED up 40%
Hosp steady - still 75/25 : unvac/vac
ICU steady; still all unvac.

-MAB infusions completely overrun. triage usage on risk calculator
-no orals yet -- 1-2 weeks at county level anticipated.
-Omicron will hit you regardless of vac status. I appears sx consistently less with boosted and vaccinated still; but Omicron breaks through relatively easily -- especially at dinner parties.

MY GUESS: This will explode further with return to school kids in two weeks. Most kids unvac or barely 2 shots.


My Rec: swab ALL party participants for any indoor party event.

[CordMcNally]

My Rec: swab ALL party participants for any indoor party event.

My Rec: you're going to get it so do what you can to protect yourself and go about your life at your particular comfort level.

[Tim]

That sucks. Hope MIL shows why she's 94.

She made it past the one year mark with the major hip surgery. She told my wife she is done with staying different places, My house or the house we keep for her and another BIL. He is the one that was afraid of needles, but got vaccinated. The only problem is he can't help her with messes or bathing. Limited days. Maybe next summer we can have another birthday bash. Hoping for a down time in the surges. She is making due with scratch offs. She stayed up until midnight on Christmas Eve. Big event for her and us.
She even toasted with our clan.

[StarTrekDoc]

My Rec: you're going to get it so do what you can to protect yourself and go about your life at your particular comfort level.

Mitigate where one can -- not unreasonable for family gatherings, especially in setting where differing tolerances on risks and status will be had. -- eg: see Tim's dilemma of family outings and exposure to 94 yo MIL.

Most reasonable people for family, irregardless of tolerance, will agree to a swab to mitigate risks for all stakeholders and gather with common ground.

[Jaqen Haghar MD]

That's great to hear. I wonder why the NE, with high vax and boost rates, is imploding so fast?

I’m in FL. In general, the pattern through all the waves has been to hit hard and fast here early, then to finish months later in the Northeast.

The Northeast was getting hammered by Delta the past month, and were in the thick of a Delta surge as Omicron started up. Our delta blew through here in August and fizzed out in early September.

Now it appears we are in a massive pure Omicron surge here.

By the timing and numbers, the Northeast is getting a double-whammy. Delta will provide the sickos, and Omicron will boost numbers and clog up everything as it seems to easily infect vaccinated and the prior COVID infected. …..at least that’s my theory.

There is a real question about our hospital systems in general, highlighted by the pandemic. In the US, it appears we operate our hospitals in a “lean assembly line” model. Maximum productivity and full capacity at baseline. Maximizing workload and profitability. With COVID surges, you see a great variability in the ability to cope between systems. One hospital down the street has the flexibility and resources to accommodate quick changes, while the university or county system a few miles away implodes from a quick increase in volume.

I’ve noticed that systems that have a hard time tackling a typical Monday rush, crumble when volumes double overnight. Of course, it’s hard to make a quick 90 degree starboard turn when you’re piloting the titanic though.