Medical Discussion of Coronavirus

[artemis]

Is paxlovid readily available? that is supposed to be 90% effective last I heard

Availability is a problem in many areas, unfortunately.

Since people can self test at home, I think for epidemiological purposes testing waste water will need to be continued for some time. That not only allows us to see if an area is beginning a surge, it allows us to screen for potential new variants in the population. And it doesn’t compromise any individual’s privacy, so there’s no rational reason for anyone to object to it.

[Tangler]

Masks forever? Everywhere? N-95?

Regional differences are interesting.

I was in AL last week. No one wearing masks except in the airport / plane. I am now in MA and some people wear masks walking outside by themselves.

For me, something in between makes sense. I am fully vaccinated and relatively healthy.

I wear a mask to prevent annoying people and to comply with regulations and to avoid getting elderly sick but for it to work I think you need a tight fitting N-95 and you have to avoid touching it or your face and you must wash your hands constantly.

If you are wearing a mask to "follow the rules" for example a loose fitting mask on a plane that you take off to drink a coke and eat a snack then I think it is largely for show.

If you wear an N-95 for your entire 12 hour travel period and never touch it and wash your hands with hand sanitizer every 5 min after you touch anything, that is probably very effective.

I guess I am somewhere in the middle. At some point we need to let people decide what they want to do and how they want to live.

The old grandma saying: "people convinced against their will are of the same opinion still" is true.

I have changed my mind regarding many things with time. In the beginning (2 years ago) I was very worried about covid.

At that time, I was in favor of mask mandates and isolation to flatten the curve and then when we had a vaccine, I was in favor of vaccine mandates.


Now, I realize those things just don't work in a free country.

Even if you force someone to wear a mask are you going to force them to stop touching it constantly or to make sure if fits tightly or force them to shave the facial hair or to "upgrade" to a properly fitting N-95?

Same for the vaccine. I am very pro-vaccine and thought it was a good idea to "encourage" people to get it.

I was in favor of mandating it, because I thought there were old and ill people who really benefited from it.

I still think the old and the frail need to be vaccinated, but do I really want to live in a totalitarian country where we force people to do things that are good for them?

How many boosters? How often? Every year? Every 6 mo? Every 3 Mo?

Are we going to force the smokers to stop or the drinker to stop? How about people driving too fast? Eating too much sugar / carbohydrates?

It certainly would be in their best interest to "encourage" many of these things but do I want to fire them from their job when inflation is insane and gas prices jumping?

I think we should provide every incentive for people to be healthy but I don't know where we draw the line.

Where is the line?

I certainly don't want some arbitrary bureaucrat (who could possibly be motivated by political / social ideas rather than scientific data ) deciding.

It is complex. My wife is crazy / worried about her momma, still.

My wife's mom has CA and lives with us.

When I came back to MA from AL I took a covid test and had a temp check and spend the first 24 hours isolated from her mom "just in case". (spent the night in the basement and after 24 hours of no symptoms and and negative tests I was "cleared" to come upstairs.

Was I "perfect" during my travel? Nope, but I tried to be fairly careful.

I wore an N-95 for 90% of my miserable 12 hour travel time.

Should / could an ordinary citizen wear and N-95 correctly for 12 hours without taking it off for food / drink?

I don't want to fight with anyone about what they should / could do to improve their life and health.

I was visiting with an elderly women in AL and discussing life and this wise old Octogenarian told me: "Tangler.........everybody has to go up fools hill"

I guess this country is set up to allow you to make your own path. I hope it stays that way.

[spiritrider]

https://www.fiercepharma.com/pharma/...s-paxlovid-and
Pfizer hopes you are incorrect.

The cynic in me thinks; "of course they do."

Disclaimer: I have no medical or scientific knowledge, but may have half a clue when reading and comprehending the NEJM.

Pfizer while touting the recently published Israeli study on the effectiveness/protection their 2nd booster/4 dose against Omicron. While elsewhere suggesting a 5th or even 6th dose maybe necessary.

Maybe it is because in my reading of the study it is underwhelming. The increased effectiveness against infection starts diminishing after four (4) weeks and is mostly gone after eight (8).

While there is significant protection against severe illness, the study is really too short to give even near-term projections on half-life.

What a great product. The less effectiveness/protection it provides, the more doses are required and the more billion$ in profits.

[Tim]

The cynic in me thinks; "of course they do."

Disclaimer: I have no medical or scientific knowledge, but may have half a clue when reading and comprehending the NEJM.

Pfizer while touting the recently published Israeli study on the effectiveness/protection their 2nd booster/4 dose against Omicron. While elsewhere suggesting a 5th or even 6th dose maybe necessary.

Maybe it is because in my reading of the study it is underwhelming. The increased effectiveness against infection starts diminishing after four (4) weeks and is mostly gone after eight (8).

While there is significant protection against severe illness, the study is really too short to give even near-term projections on half-life.

What a great product. The less effectiveness/protection it provides, the more doses are required and the more billion$ in profits.

You are a deep thinker. I am not. With the prior infection being factored in, should I get vaccinated on the government dime for billions in profits subsidized for what seems to be political purposes? Hard to separate the “science” from “political science” and plain old “profit”.

[spiritrider]

While I think everyone should get vaccinated and the first booster. I'm on the fence about more boosters. I will probably get the 2nd booster. When is another question.

Here again, with no medical/scientific knowledge. What is the potential long term effects on your immune system of getting four (4) doses of a vaccine in approximately a year. With more potentially in the pipeline.

We are more than two years into this pandemic and it feels more like whack a mole than anything else.

[Sampter]

While I think everyone should get vaccinated and the first booster. I'm on the fence about more boosters. I will probably get the 2nd booster. When is another question.

Here again, with no medical/scientific knowledge. What is the potential long term effects on your immune system of getting four (4) doses of a vaccine in approximately a year. With more potentially in the pipeline.

We are more than two years into this pandemic and it feels more like whack a mole than anything else.

Likely little to no risk of long term negative effects. Most of us get yearly influenza vaccines without issue. This guy seems fine too.

https://www.latimes.com/world-nation...tificate-fraud

[StarTrekDoc]

Tangler as all things not so black and white and things really have changed from Feb 2020 to now. Knowledge of covid, prevention in vaccines, therapeutics and even the virality of covid itself. All playing factors.

Staged Mitigation.
best defense . Vaccine initial Three shots for all people. Think childhood vaccines or HPV.

Intermittent exposure reduction.
Stay at home as needed, especially during surgery. Just like flu season.
Masking with quality n95 level mask when in public high density areas and especially poor circulation.
Q4-6 boosters for high risk individuals to lower hosp/death risk a la flu shot.
Antivirals for high risk a ala tamiflu.

It's always been about risk mitigation, hosp risk and death prevention. All the above do that.

We do this for every disease process. Not one single agent is going to perfect.

Takes combination of things to lower risk for morbidity and mortality.

[CordMcNally]

Likely little to no risk of long term negative effects. Most of us get yearly influenza vaccines without issue. This guy seems fine too.

https://www.latimes.com/world-nation...tificate-fraud

To be fair, COVID and the flu vaccines are different types of vaccines so making the assumption of safety between the two is without merit.

We see people not uncommonly with blood alcohol levels over 500. They're 'fine'. If my BAC was over 500 I would be dead.

[CordMcNally]

I can't say I'm on board for boosters in perpetuity at this point. The pharma companies have absolutely zero incentive to NOT recommend them. The release of information and study results mainly through press releases only to find out the actual data isn't what they made it out to be is also not something to feel great about.

[Kamban]

At the present time the only reason I would take a 4th booster shot is it was required for travel or there comes a new variant that is more deadly and I would hope the booster will give me additional protection. And the vaccines remain free.

And I agree that one cannot compare a new mRNA vaccine with risks of myocarditis and other side effects a linfluenza vaccine that are live attenuated or inactivated.

And spiritrider is 100% correct. It is just the pharma companies stringing the public along with fear mongering so that the government orders more shots and the public is cowered into getting more shots.

[Sampter]

To be fair, COVID and the flu vaccines are different types of vaccines so making the assumption of safety between the two is without merit.

We see people not uncommonly with blood alcohol levels over 500. They're 'fine'. If my BAC was over 500 I would be dead.

Not sure the comparison to alcoholics. Of course flu and Covid vaccines are different. Babies get 4 doses of multiple vaccines within 18 months, again I am fully aware they are different than Covid vaccines.

I'm not saying every person should get 4 Covid vaccines a year. 4th doses are for high risk people who for the most part don't have a long expected lifespan. Any potential "long-term" side effects is mostly irrelevant in these people. Even on the CDC page for people > 50 who are not immunosuppressed can consider the 4th dose, but doesn't say recommend.

I believe that independent experts need to review data to keep Pfizer/all drug companies honest on these vaccines/all drugs and not just trust Pfizer that we all should get them every 8 weeks for life.

[Tim]

Tangler as all things not so black and white and things really have changed from Feb 2020 to now. Knowledge of covid, prevention in vaccines, therapeutics and even the virality of covid itself. All playing factors.

Staged Mitigation.
best defense . Vaccine initial Three shots for all people. Think childhood vaccines or HPV.

Intermittent exposure reduction.
Stay at home as needed, especially during surgery. Just like flu season.
Masking with quality n95 level mask when in public high density areas and especially poor circulation.
Q4-6 boosters for high risk individuals to lower hosp/death risk a la flu shot.
Antivirals for high risk a ala tamiflu.

It's always been about risk mitigation, hosp risk and death prevention. All the above do that.

We do this for every disease process. Not one single agent is going to perfect.

Takes combination of things to lower risk for morbidity and mortality.

A lot of unknowns here.
Start with the first premise:
Staged Mitigation.
best defense . Vaccine initial Three shots for all people. Think childhood vaccines or HPV.

That premise does not seem to be in place yet for Covid. This seems to be based on assumptions. If then, then else with prior experience is wise.
Like with an case, starting with a BUT invalidates the logic. I don't see the health benefit yet for childhood vaccines. Let's start over from the beginning. Just saying there is much to learn about the risk/benefits.

[StarTrekDoc]

A lot of unknowns here.
Start with the first premise:
Staged Mitigation.
best defense . Vaccine initial Three shots for all people. Think childhood vaccines or HPV.

That premise does not seem to be in place yet for Covid. This seems to be based on assumptions. If then, then else with prior experience is wise.
Like with an case, starting with a BUT invalidates the logic. I don't see the health benefit yet for childhood vaccines. Let's start over from the beginning. Just saying there is much to learn about the risk/benefits.

The evidence is quite solid of initial vaccination benefit in hospitalization/death vs unvaccinated. If one cannot agree with that statement, need to really look at the delta and omicron hosp/death of these groups. It's significant across ALL age groups and risk groups.

[Tim]

The evidence is quite solid of initial vaccination benefit in hospitalization/death vs unvaccinated. If one cannot agree with that statement, need to really look at the delta and omicron hosp/death of these groups. It's significant across ALL age groups and risk groups.

I have not seen any evidence of vaccinating newborns. Most seem to point to the vaccinating of newborns. To be honest, I couldn't even tell you what the sequence is. I do trust the "science" and fully support the recommendations in place. There is a risk/benefit for vaccinations that I trust.
https://thewell.northwell.edu/covid/...e-kids-under-5
Yes I am suspicious of relying on Pfizer recommending three doses because 2 did not work. Can it help, will it cause damage, and what is the benefit? Gotta protect the kids. So, I respectfully disagree that the evidence and process for kids is clear. And the next question is the next variant.
I 100% agree with your position that everything is not black and white. No emergency authorization let alone final approval.

[CordMcNally]

Not sure the comparison to alcoholics.

That comparison was mainly to the link about the guy that got 90 COVID shots but I also understand you didn't really mean that it's safe just because one person got 90 shots.

I believe that independent experts need to review data to keep Pfizer/all drug companies honest on these vaccines/all drugs and not just trust Pfizer that we all should get them every 8 weeks for life.

It would be easier if these companies would release all of their data. To my knowledge, I don't believe that has been the case for Paxlovid but I quit following it over the last few weeks as cases plummeted.