Medical Discussion of Coronavirus

[snowcanyon]

Theatre. Yep.

Temperature checks. Cleaning the floors in the lobby, Shutting down flights one week after discovery of something that already spread weeks ago. Home free testing and n95 masks for all -- theatre.

There's no more slowing the spread as Omicron just spreads.

Society help to is manage this endemically as we always have:
1. Immunizations
2. Oral therapeutics

Masks can help the individual now but that's about it. want to reduce YOUR risk? mask up.

Systemwide -- immunize and SCOTUS ruled -- workplace up to the employer and insurances can dictate to their clients.

So go work for the employer who matches your convictions/scruples/beliefs

Follow your insurance dictates or get one that matches yours.


--The Omicron surge isn't over here in San Diego. 14k cases yesterday and steady: 10-14k - off peaks, but hasn't subsided quite yet as schools driving the plateau a bit. Hospitalizations steady. ICU steady.

--and my daughter's roommate just COVID+ a second time (delta over summer). joy.

Well, unless you are in China or New Zealand it appears. We will see how they do.

I'd have to say I'd be concerned if we got rid of masking in hospitals- patients deserve the best option to be safe, even if it's imperfect. Immunosuppressed and the elderly and others who have no choice and who generally isolate. Free N-95s for them would also be a help.

Paxlovid is really hard to make and the reagents hard to source, so I wouldn't hold my breath on that- it will be very hard to increase production, apparently. So no oral therapeutics for the vaccinated for awhile.

[Tim]

Mountain Dew is harvested on only the coolest of mornings deep in the Appalachian Mountains. Straight from the ground like Mother Nature intended.

Once on a camping trip, we lost the corkscrew. Had to survive on food and water for 3 whole days!

[snowcanyon]

We dropped off pretty fast. I have not seen a COVID patient in the last 3 shifts. They seem to have dried up relatively quickly. Volumes are dropping of fast overall.

Sending free COVID tests to people’s houses in the mail, and giving out free N95s is a colossal waste of time, money, and effort, and is basically political panicking and desperation over recent poll numbers.

Curious, are you a high or low vax area? Curious if that affects the peak and drop off. We are low vax, but hope we will have a drop off.

[Tim]

We dropped off pretty fast. I have not seen a COVID patient in the last 3 shifts. They seem to have dried up relatively quickly. Volumes are dropping of fast overall.

Sending free COVID tests to people’s houses in the mail, and giving out free N95s is a colossal waste of time, money, and effort, and is basically political panicking and desperation over recent poll numbers.

I will get my 4 free test kits they said in about 12-14 days. My understanding is they have ordered the Post Office to ramp up deliveries with unlimited overtime.
I will add them to the current stockpile of 12 we have. The might come in handy is we get a surge of visitors for the MIL. Who knows. The CDC told me home test kits were essential.
BTW, does anyone need unopened seal MS Office Pro 2003? I have a couple of those too. I got those for free too. I am not sure I need to add free masks. We hardly ever go anywhere except out to dinner and a beer run. Which reminds me, I need to make a beer run tomorrow. Could it be alcohol is effective preventing Covid?
Liquor stores were open during the stay at home mandates. They must have had science behind it. Right?

[CordMcNally]

Curious, are you a high or low vax area? Curious if that affects the peak and drop off. We are low vax, but hope we will have a drop off.

Being vaxxed or not doesn’t appear to have any effect on the case numbers with omicron. The peak and drop off seems more related to when the cases started. The places where cases started early are dropping off. The places where cases took a little longer are still peaking.

[snowcanyon]

Being vaxxed or not doesn’t appear to have any effect on the case numbers with omicron. The peak and drop off seems more related to when the cases started. The places where cases started early are dropping off. The places where cases took a little longer are still peaking.

Oh, interesting. Our ID/epi docs were concerned that low vax areas might drop off slower.

[Jaqen Haghar MD]

Curious, are you a high or low vax area? Curious if that affects the peak and drop off. We are low vax, but hope we will have a drop off.

Locally here, I’d say we have a relatively high vaccination rate. Worked again last night. No COVID patients. No positive tests. 4th shift in a row.

I never did admit one for COVID respiratory symptoms during this wave. We were swamped with Covids for a while there. The vast majority went home. I did admit some patients for other reasons that turned out to subsequently test positive (gi bleeders, high risk chest pain, hip fractures, etc…).

This wave was vastly different than August, where we had record numbers of patients every day and multiple unvaccinated hypoxic COVID admits every shift for delta infections. Inpatient numbers were higher with August delta, but new, bigger ED visit records where again set with Omicron this past month, though inpatient numbers were significantly lower this wave.

Most of the COVID patients I saw this wave were vaccinated, I’d bet due to most people being vaccinated locally here.

Waves seem to travel fast and furious here in Florida, as most people don’t wear masks, and gatherings don’t stop, and businesses don’t close or require masking here. There are essentially no restrictions, and few people seem to worry about COVID these days.

The State has gone from 120,000 cases per day to 20,000 cases per day very quickly. And those testing positive now, don’t seem to be coming in. In the ED, we are having almost no cases now. There was only one COVID patient in the ED for the day. Overall ED volumes are now on the low side.

[CordMcNally]

Oh, interesting. Our ID/epi docs were concerned that low vax areas might drop off slower.

I don’t think vaccination really decreases your risk of infection at this point, but does appear to decrease your chance of severe infection and death. Some of the most vaccinated countries currently have the highest case rates. Israel, home of the 4th shot, I believe has had the most cases per capita recently.

[MaxPower]

I don’t think vaccination really decreases your risk of infection at this point, but does appear to decrease your chance of severe infection and death. Some of the most vaccinated countries currently have the highest case rates. Israel, home of the 4th shot, I believe has had the most cases per capita recently.

Which is why we need to stop reporting/caring about positive case numbers, which at this point are mostly irrelevant, if not entirely irrelevant. Hospitalizations and ICU admissions for Covid are the only important metrics at this point.

[Lordosis]

Which is why we need to stop reporting/caring about positive case numbers, which at this point are mostly irrelevant, if not entirely irrelevant. Hospitalizations and ICU admissions for Covid are the only important metrics at this point.

Big numbers make big ratings.

[FIREshrink]

Which is why we need to stop reporting/caring about positive case numbers, which at this point are mostly irrelevant, if not entirely irrelevant. Hospitalizations and ICU admissions for Covid are the only important metrics at this point.

Can you tell me what is the best predictor of hospitalizations three weeks from now?

[MaxPower]

Can you tell me what is the best predictor of hospitalizations three weeks from now?

Probably the number of cases in the unvaccinated with multiple co-morbidities, or extremely elderly vaccinated or not. Can you tell me from the current data of case numbers how many of those cases there are? And then can you tell me what hospital systems do in the three week lead time between total case numbers and the surge?

[StarTrekDoc]

The nature of admits is certainly changing with omicron since it's hitting the vaccinated+boosted.

Delta: 75/25 unvac/vac - unvac was 'luck of the draw' on admits - daily census peaked: 40

Omicron: 55/30/15 unvac/vac/boosted -- daily census : 140 -- still hasn't come off the highs for past week but stabilized. The sick/high risk are getting hit now despite being cautious given the nature of Omicron and since they have such low reserves, getting admitted -- but usually turning around readily --- unvac sick luck of the draw

Thankfully our system numbers + is waning already off highs and down 50%; still 200% above baseline and wondering where the new baseline is going to be.

[Rando]

Probably the number of cases in the unvaccinated with multiple co-morbidities, or extremely elderly vaccinated or not.

I think this is probably right but there are just too many variables on top of that. You can't make specific predictions of hospitalizations other than to say there's an awful lot of COVID out there so we'll probably see a lot of admissions. In that sense knowing there are a lot of cases has some value in a general way.

To me the big unknown variable this time is testing. There's a ton of testing going on both rapid and PCR, and a ton of those rapids never get reported. To predict a percentage of positives that will be hospitalized is impossible

[nephron]

If I were conspiratorial, I would suggest that providing everyone and their mother with a home test is a great way to lower the number of people with covid. I have seen quite a few patients report positive home tests to the outpatient hd units and to the ER's. At this point, the only way I see this pandemic ending is for some new variant to be as benign as the common cold, but be indistinguishable to testing as the more lethal strains. This would negate all of these testing infection control measures different governments have set up. Just test when you are admitted to the hospital and are going to be treated with something. That's probably the only way you can contain the virus given the large number of people in the world who are refusing the vaccine or still unable to get the vaccine. Some benign strain could infect everyone and give us all herd immunity over the more virulent strains. It would probably involve doing some gain of function research in a hidden lab with secret funding so people would not get all upset.