Medical Discussion of Coronavirus

[Tim]

All in favor of vaccine mandates raise your hand. (Just a bad joke). Yes, vaccines are free. (Just another bad joke). Most will have three. (The joke is most aren’t very effective against Omicron)
All considering a fourth booster might wait.
https://www.cnbc.com/2022/01/10/omic...-too-late.html
Pfizer and Moderna are coming out with a new improved vaccine. At least Pfizer and Moderna admit, Omicron might have passed before it is available in March or so.
Wack a mole is not won by reacting too late.
The identification and delivering effective vaccines just in time is the challenge. As one CEO said, it might have some value.
The concept of any vaccine or up to date is a mistake. It doesn’t take five shots in sequence. That is the path. Effective vaccine available when needed is the goal. We need a warp speed 2 process from identifying to shots in the arm.. Therapeutics too.
It makes no sense to penalize people for not taking current vaccines that don’t prevent infection or spread.
https://www.cnbc.com/2022/01/10/omic...-too-late.html
This emphasis on testing and messaging need to be changed to delivering vaccines that are needed. It is surprising how easy people react to products that work.

[CordMcNally]

This requirement that insurance companies cover home tests is just another ridiculous unfunded government mandate. I don't know of any studies demonstrating efficacy in getting more home tests as a method in infection control, I have only heard of anecdotes including in our own government where people thought that they were safe because everyone was "tested" and the event being a super-spreading event. That was before this omicron business when a lot of the tests on the market may not even have the same sensitivity when compared to the previous variants. Insurance are not going to absorb the costs by cutting the pay of their executives or decreasing their profits, the cost is just going to be passed along in the premiums for everybody. Then you will have a low percentage of people using a disproportionate amount of testing and the cost just being paid for by everyone else who is more sensible about it all. I don't understand why I have to fill out pre-authorization forms to obtain fda approved medications shown in randomized controlled trials to have patients obtain medications with a high copay and and the government can just decide based upon what cdc "scientist" thinks sounds like a good idea one week and just mandate it for everybody. The other ridiculous part is the shortage of tests available right now, I'm not sure how declaring that they will all be free one day will help increase the supply. I think that the problem is that a lot people don't grasp the concept of "insurance". Insurance is supposed to be a pool of money everyone contributes into to cover the cost of events that an individual could not afford, not just some mechanism to make as many things "free" as possible.

I've had a not insignificant number of people who have come in with viral symptoms and said it 'couldn't be COVID' because they had a negative home antigen test. They've mostly all had positive PCR tests.

[setsail26]

“Seems” is not a scientific conclusion. Correlation doesn’t support the conclusion. The official reason is people of color have been denied proper health is our racist society. Equity.
I have absolutely no problem with prioritizing scarce medications to those that need it the most. Actually, some may be so far along with complications, they might be denied. Tough choices.
The medical condition of a white, black, Asian and Latino should be used. Four candidates. Why choose based upon race? Do the white and Asian deserve denial? Or do you do all blacks first, then Latinos? Before you unload, I have black, Hispanic, white and mixed of each in my extended family. I am opposed to discrimination in all forms. Each is an individual and gets treated equally (except for my wife). Where I would seek guidance would be a mid 30’s obese vs a health 94 year old. I could actually go with the 30 year old. More years of benefit unless the advice was the weight problem was too much. Tough choices. Suitable candidate and advice, I would call race in the criteria “prejudice”. Predetermined based on race without considering the individuals.

Omicron has left the medical community in the dust. A vaccine is to prevent infection. Our vaccines no longer do that with Omicron. Vaccines are being used as treatments. The effectiveness is so terrible in prevention, they would have never been approved! Even the WHO knows that.
https://www.wsj.com/articles/omicron...od=popular_AMP
“It would be irrational, legally indefensible and contrary to the public interest for government to mandate vaccines absent any evidence that the vaccines are effective in stopping the spread of the pathogen they target. Yet that’s exactly what’s happening here.”

Delta it worked, Omicron it didn’t.
I am vaccinated but some of the people in my extended family need to work, need to get vaccinated but don’t deserve priority based on skin color. Don’t mandate a vaccine, kick them out of work and then tell me they deserve priority. Raw race data is racist and needs to be trashed.

For clarity sake, I am talking about deciding who to give truly scarce treatment resources, monoclonals and oral covid antivirals.

You are confusing the reason for a fact with the fact itself. People of color do worse with COVID. This is a fact. They are more likely to die. You are making judgements about how this fact came to be. I am not. We give older people more priority, we give people with hypertension more priority, we give obese people more priority, we give people with diabetes more priority. It is also a fact that all those people are more likely to die. Do you say we are prejudiced against non-obese people, or younger people? You do not. You do understand it is not ethical to take each individual and say "hmm, I think this person's life is worth more" right? There is a scoring system. It includes factors that increase risk of death. You give meds to people with higher scores. No prejudice, no ethical problem. I said you could disagree all you want, but understand that your disagreement is from your feelings and not from logic or science. In fact, I haven't even given my opinion, merely stated that facts of the situation. Including significant risk factors in a non-judgemental way is science.

Also, "I have such and such family and friends" is never a useful thing to say. Who you are, who you know, and who you are related to has absolutely nothing to do with this area of discussion. I'm not questioning views on race, just pointing out the I am taking about facts and you are talking about feelings. Some of us probably have feelings about other risk factors (obesity anyone?) but that doesn't mean we shouldn't use them in evaluating who to treat. Oh, and data can't be racist.

[Lordosis]

I've had a not insignificant number of people who have come in with viral symptoms and said it 'couldn't be COVID' because they had a negative home antigen test. They've mostly all had positive PCR tests.

Completely agree. Home tests are garbage. It seems like when they are positive they are reliable but a negative does not make me feel better.

maybe people are not swabbing deep enough?
Maybe it is too early on the course?
Maybe they think it is a pregnancy test and pee on it?

[Tim]

For clarity sake, I am talking about deciding who to give truly scarce treatment resources, monoclonals and oral covid antivirals.

You are confusing the reason for a fact with the fact itself. People of color do worse with COVID. This is a fact. They are more likely to die. You are making judgements about how this fact came to be. I am not. We give older people more priority, we give people with hypertension more priority, we give obese people more priority, we give people with diabetes more priority. It is also a fact that all those people are more likely to die. Do you say we are prejudiced against non-obese people, or younger people? You do not. You do understand it is not ethical to take each individual and say "hmm, I think this person's life is worth more" right? There is a scoring system. It includes factors that increase risk of death. You give meds to people with higher scores. No prejudice, no ethical problem. I said you could disagree all you want, but understand that your disagreement is from your feelings and not from logic or science. In fact, I haven't even given my opinion, merely stated that facts of the situation. Including significant risk factors in a non-judgemental way is science.

Also, "I have such and such family and friends" is never a useful thing to say. Who you are, who you know, and who you are related to has absolutely nothing to do with this area of discussion. I'm not questioning views on race, just pointing out the I am taking about facts and you are talking about feelings. Some of us probably have feelings about other risk factors (obesity anyone?) but that doesn't mean we shouldn't use them in evaluating who to treat. Oh, and data can't be racist.

"“Racial and ethnic minority groups have historically not had broad opportunities for economic, physical, and emotional health, and these inequities have increased the risk of getting sick and dying from COVID-19 for some groups,” the CDC writes. “Many of these same factors are contributing to the higher level of obesity in some racial and ethnic minority groups.”
These are the facts supporting the CDC guidelines. This is not science. It is messaging. The physical risk of the person in front of you should guide your decision.
Skin color is not a reason for priority. You may have a larger percentage of whites or asians or mexicans or blacks. So be it. The only relevant fact mentioned that seems to have a medical validity is obesity. Is broad opportunities a medical condition? Neither is skin color a cause. As a matter of fact, race was included in the original discussion for determining the vaccine priorities. It was debated by the committees. Covid does not discriminate based on skin color. The underlying conditions are the criteria. As a matter, economic status was considered. That was discarded as well. Covid does not care about race or economic status, high risk segments were identified and have not changed much. Some medical conditions have been added. Race was not one of them. Consciously or sub consciously.

[StarTrekDoc]

Completely agree. Home tests are garbage. It seems like when they are positive they are reliable but a negative does not make me feel better.

maybe people are not swabbing deep enough?
Maybe it is too early on the course?
Maybe they think it is a pregnancy test and pee on it?

Yes. They all apply

-almost always first postexposure why too early and fail to retest until sx and then comes to office/uc/ed
-asx sensitivity 50-70%; sx 70-85% for the antigen tests.

So not completely garbage, just something that's hit/miss. With sequential testing, it improves -- think FIT testing

[Tim]

https://coronavirus-download.utah.go...2-06152021.pdf

Read it and tell me it is not racist. The official state scoring system. RACE counts as much as ANY existing medical condition. This is not isolated, multiple states are count race equal to or greater than any existing medical condition. The is the CDC going all in on the promise to make up for past sins of the whites. Not a tie breaker, the medical science if intended to discriminate.

[FunkDoc83]

Completely agree. Home tests are garbage. It seems like when they are positive they are reliable but a negative does not make me feel better.

maybe people are not swabbing deep enough?
Maybe it is too early on the course?
Maybe they think it is a pregnancy test and pee on it?

Are the lay public dumb enough to pee on it? Lol.

[Perry Ict]

Freedom is a tough one. It's great for you to be free to do what you want, but it also involves me being free from you doing what you want to me.

Who is the "you" in this statement as it relates to Covid?....the unvaccinated? And if so, what are they "doing" that infringes on your freedom?

[CordMcNally]

Are the lay public dumb enough to pee on it? Lol.

Probably the same people that bring in a Tupperware container of their own feces.

“Settle down there, dude. Just tell me what it looked like and I’ll take your word for it. Besides, Show and Tell isn’t on Tuesdays.”

[Tim]

Probably the same people that bring in a Tupperware container of their own feces.

“Settle down there, dude. Just tell me what it looked like and I’ll take your word for it. Besides, Show and Tell isn’t on Tuesdays.”

My vet has me bring a stool sample. Silly me tried to crap in a baggie. Who would have thought you needed the dog stuff. Be specific.

[Lordosis]

Are the lay public dumb enough to pee on it? Lol.

No joke this really happened 2 weeks ago.

There was a bag of rice on our office lab counter. I inquired about it because it was odd. I figured someone dunked their phone. One of the nurses investigated and buried in the rice was a urine cup with urine inside.

We were all perplexed until I suggested maybe they misheard ice.

[Kamban]

No joke this really happened 2 weeks ago.

There was a bag of rice on our office lab counter. I inquired about it because it was odd. I figured someone dunked their phone. One of the nurses investigated and buried in the rice was a urine cup with urine inside.

We were all perplexed until I suggested maybe they misheard ice.

That is so funny :-)

We sometimes give medicines with cold packs to take home and self inject at a later date. We emphasize - Cold pack in the freezer and medicine in the fridge until use. And still there is the one person who puts the cold pack in the fridge and the medicine in the freezer.

[Lordosis]

That is so funny :-)

We sometimes give medicines with col packs to take home and self inject at a later date. We emphasize - Cold pack in the freezer and medicine in the fridge until use. And still there is the one person who puts the cold pack in the fridge and the medicine in the freezer.

Better than injecting the cold pack solution I guess?


Anyway back to covid. Are all states doing this 5 day return if symptom free or is this just NYS?

[snowcanyon]

https://coronavirus-download.utah.go...2-06152021.pdf

Read it and tell me it is not racist. The official state scoring system. RACE counts as much as ANY existing medical condition. This is not isolated, multiple states are count race equal to or greater than any existing medical condition. The is the CDC going all in on the promise to make up for past sins of the whites. Not a tie breaker, the medical science if intended to discriminate.

These criteria were picked to decrease hospitalizations, ICU admits, and death rates. Since persons of certain racial groups are hospitalized at a higher rate, this was another factor used, like medical conditions and age, to determine who would benefit most from treatment. They also include age, but no one is accusing it of being ageist, and gender, and no one is accusing it of being sexist.