Medical Discussion of Coronavirus

[setsail26]

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?

I would argue that a country with less likelihood of getting COVID is more free. People have more opportunities to live their lives how they want if fewer people have COVID. Sounds like freedom to me. I just think that for a lot of people, "freedom" means that I can do whatever the ************************ I want. Your freedom and my freedom are inextricably linked, and both need to be taken into account.

[Tim]

I would argue that a country with less likelihood of getting COVID is more free. People have more opportunities to live their lives how they want if fewer people have COVID. Sounds like freedom to me. I just think that for a lot of people, "freedom" means that I can do whatever the ************************ I want. Your freedom and my freedom are inextricably linked, and both need to be taken into account.

But Hawaii is going to get killed. Very few will qualify for items in short supply. Distributing to states by population makes an assumption the demographics and prevention are effective and balanced. You are 100% correct that individual, state, and reasonable compromises need to be reached. Once one gets Covid, then you have a fact with responsibilities. CDC in allowing states and hospitals to allow Covid positive individuals is a reality. What do you suggest? The NCAA has the "death penalty", 4 years. Should the state shutdown the hospital or should the CDC shut down the state? Purely argumentative based only on your original sentence. Not intended offend, it is simply that the dig in the heels at all costs and using incomplete statistics will not solve the social/political problems.
We are still in a learning curve grasping for answers where they don't exist.
Stay healthy.

[setsail26]

Race is not like a medical condition or age. Pure and simple. Drinking the kool aid. Being female does not cause death. Being male does not cause death. Race does not cause death. Yes they have different statistical results, but it is not from medications. The goal is not to have everyone die at the average age of 84.5 years.
That is WOKE, racist and equity using silly logic. Everyone should be treated equally considering the medical factors.
Apologies in advance. The CDC has been hijacked.
"Woke (/ˈwoʊk/ WOHK) is an English adjective meaning 'alert to racial prejudice and discrimination' that originated in African-American Vernacular English (AAVE). Beginning in the 2010s, it came to encompass a broader awareness of social inequalities such as sexism, and has also been used as shorthand for left-wing ideas involving identity politics and social justice, such as the notion of white privilege and slavery reparations for African Americans."

Nonsense. Even in your Utah example age gets more points than race. Just because race is included doesn't mean that it is racist. I will try one more time. People of color are twice as likely to die of COVID. This is called a risk factor. It doesn't matter why it is a risk factor. Just like I can't tell you why hypertension is a risk factor for COVID death, even though it is. We can guess, but we don't know. Again, it doesn't matter why a risk factor is a risk factor. It just is. CDC made some guess as to why, and I agree the messaging is painful. As is most of their messaging these days.

Let's try an example. One patient with COVID is 35, White, and obese. One patient with COVID is 35, normal weight, and Latino. They have the same chance of death from COVID based on the statistics that we have (I know it isn't exact, but let's pretend.) You would prioritize the obese person over the person of color. Why? They have the same chance of death. If they have the same risk score, they should be treated the same.

Yes, individual are unique. Sometimes risk factors don't predict the outcome. But you can say that about any risk factor.

Also, the guidelines for distribution of monoclonals and oral therapy are done by each state. So you just called Utah woke.

You have offered zero scientific rebuttal. It feels racist to you. I already said you can have whatever feelings you want. But that's not science, and you have pushed over and over for science. Maybe you are having trouble overcoming your biases and viewing the science objectively. You have basically said "I have Black friends" and "People who wish to take race into account on anything are woke." Notice that I have discussed your thought processes, rather than call you names or lump you into groups that I have no idea whether you belong in or not.

[triad]

Anyone using MABs on kids? Vaccinated kids? BMI is a criteria and that would mean lots of kids would qualify - I don't know what's the status in terms of supply and current usage.

aren't kids at very low risk of dying? i assume they should go to an old antivaxxer who is more at risk of death.

[gap55u]

Lordosis — the CDC put out their very confusing exit isolation at day 5 if no fever for 24 hours no antipyretic and all symptoms improving. But wear a “well-fitting mask” for 5 more days- with no further guidance on what that means. For health care workers, under emergency operations, can return at 5 days and no symptoms.

With omicron, cloth doesn’t seem to be enough. A cloth mask with filter may just leak even more around the edges. Surgical/isolation is better but not great. Kf94/kn95/n95 is best for both the infected person and others.

oh, and try getting a kid with Covid to mask indoors with their siblings for 5 days after they exit isolation but still need to mask in the home and out. Living that dream now. One got omicron despite our being careful. I just wear an kn95 in my kid’s room so they don’t have to mask there and try to get everyone to mask up outside their room. Return to school is allowed under new guidance as no fever, all symptoms improving - yet all the kids remove masks to eat lunch at school. 🤷🏼♂️

[Tim]

“It just is. CDC made some guess as to why, and I agree the messaging is painful.”
Yes I disagree that a perfectly healthy otherwise Hispanic patient gets priority over a white patient that has a 1 point medical issue.
Utah is not racist, CDC is not racist. The guidelines are based on as you say a guess that CDC stated as being the Hispanic has suffered from poor opportunities, thus poor healthcare that were cited as the basis.
It might have something to do with rural and underserved demographics of the hard to reach demographics and vaccination rates. Just my guess which is just as valid. Seeking healthcare is a problem for some segments is a problem..
A problem self imposed and extremely difficult to change behaviors. For 2 years I have dealt with this. Poor decisions in my extended family have been a problem. Omicron caused us to cancel Christmas.
I personally have isolated the 94 yr old MIL, taken her to the Covid death of her son. Everyone wanted to give her a hug. NO! Ten feet away. Turns out 12 people ended up with Covid. Not because they were Hispanic, but because of poor decisions. That is what is driving the numbers. If they get sick, Hispanic’s don’t get 2 points. Turns out 12 weren’t vaccinated. Sorry for there behaviors. No extra credit for poor decisions. The one that died waited too long to head to the ER. The ones that ended up hospitalized now act differently. Their kids and cousins continue to make poor choices. Not in my house. Mostly cultural. It is not because they are Hispanic, it is because of their behaviors. No, the choice does not deserve 2 points. Give the medicine to the person with the medical condition., not the Hispanic. The numbers you call “science” are the results, not the cause.
I appreciate the care not “classifying”. Underlying the CDC guess is a reflection of the stated goals based on politics, not what I consider “science”. I think my extrapolation is reasonable. Race was not the cause of greater infections and should not be used for allocations. It is not emotional, it is where the rubber meets the road. I have no reason to project this over a total demographic. It is better than the systematic white privilege use by the WOKE CDC recommendations or as you say guesses.
The real question is why are we allocating now? Racial profiling leads to poor decisions. It is the behaviors, not the race. Agree to disagree. I have tried to get everyone vaccinated. No 2 points for race. I think it is either lazy or political.

[Shant]

Nonsense.

[Tim]

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?

California and Arizona have opened up immediate return for asymptotic healthcare workers.
The good news, the staff is completely vaccinated, as healthcare workers, they have access to testing and steps are being taken to beef up contact tracing. New vaccines will be available in March.
Schools will be open due to success negotiations with unions. Oh, a new unit in DOJ is formed to investigate domestic terrorists for the rising danger to school boards and healthcare officials.
A lot of activity. States and hospitals and healthcare workers are free to isolate as they see fit. Rules are rules, except when they don’t work.
I just saw a Ca. nurse that was terminated due to vaccine status, switching from hospital to the “wellness/prevention” work to make a living (whatever that is).

I am confident the Medicare won’t do a thing to prevent asymptotic healthcare workers as long as they are vaccinated.
When and if you need zero days, the option is open. No state will close the hospitals as long as staff is vaccinated.

[okayplayer]

Sorry for my ignorant question. My mom is severely immunocompromised and has had no antibody response to repeated attempts at vaccination. Is Evusheld a reasonable option if she is able to find somebody to give it to her (seems to be in very short supply and her oncologist said it is only being given to inpatients currently in their health system)?

It is way out of my wheelhouse so I’m hoping somebody here is familiar with it.

[billy]

Sorry for my ignorant question. My mom is severely immunocompromised and has had no antibody response to repeated attempts at vaccination. Is Evushield a reasonable option if she is able to find somebody to give it to her (seems to be in very short supply and her oncologist said it is only being given to inpatients currently in their health system)?

It is way out of my wheelhouse so I’m hoping somebody here is familiar with it.

My wife was similar (no response) so when she caught covid I had the ability to get her monoclonal antibodies at my hospital. Granted pre omicron, but I had the number for our infusion center managers/schedulers readily available. Perhaps try to find out now where she can go for antibodies if/when she catches covid so that you have all the logistics down to bring her in.

Does evushield work against (well to prevent) omicron, or is it like regeneron and not really targeting the correct spike protein?

[snowcanyon]

I would argue that a country with less likelihood of getting COVID is more free. People have more opportunities to live their lives how they want if fewer people have COVID. Sounds like freedom to me. I just think that for a lot of people, "freedom" means that I can do whatever the ************************ I want. Your freedom and my freedom are inextricably linked, and both need to be taken into account.

Agreed.

[StarTrekDoc]

Evusheld should work . If you have to trouble finding it, make a call down to soflorida private mobile clinic. They appear to have gotten the lions share of FL allotment

[Perry Ict]

I would argue that a country with less likelihood of getting COVID is more free. People have more opportunities to live their lives how they want if fewer people have COVID. Sounds like freedom to me. I just think that for a lot of people, "freedom" means that I can do whatever the ************************ I want. Your freedom and my freedom are inextricably linked, and both need to be taken into account.

Okay, I think everyone would live to live a life free of Covid, but I'm still unclear which people you are accusing of infringing on your freedoms as an individual? People who are against lockdowns? Or the unvaccinated? People who oppose mandates? And what's an example of how these people, whoever they are, are preventing you from being free as an individual?

[PedsCCM]

Well, we're getting killed. Midwest state with overlapping delta and now omicron over the last 4-8 weeks. Delta has crushed us with really sick patients and omicron has wiped out a big chunk of our staff. Thankfully we implemented mandatory vaccines at the beginning of Sept so no staffing changes from that recently. Peds is getting hit really hard (covid + all the other viruses) so we cannot help the adult ICU's this time around. Elective cases are canceled and PACU/cath lab nurses are helping us staff the PICU. Supply chain problems have made central lines and other supplies hard to come by. We haven't had to use expired lines yet (we've come really close...) but we are trimming 4Fr PICC's down to make central lines for the little patients. The frustration and disbelief from patients and families is just another drop in the already full bucket of ************************. There's a ton of skepticism regarding our care but they still come to us - just angrier and more convinced that FB and Twitter holds the Truth and we're incompetent or liars. I cannot imagine what it's like to round in the MICU at this point. Our EM residents tell us the giant academic ED has frequently doubled their capacity - one bed in the room with the other in the hall outside the room. Various state representatives loudly tell the news outlets that we're lying and not as full as we claim. They just never seem to have time to take us up on the offer to tour our hospitals...

[snowcanyon]

Okay, I think everyone would live to live a life free of Covid, but I'm still unclear which people you are accusing of infringing on your freedoms as an individual? People who are against lockdowns? Or the unvaccinated? People who oppose mandates? And what's an example of how these people, whoever they are, are preventing you from being free as an individual?

Well, I'm not free to get care in the hospital. I'm not free to get blood. I'm not free to get monoclonals or paxlovid, because they are only going to the unvaccinated. I'm not free to be free of further mutations of the coronavirus.