COVID-19: Chapter 8 - Ongoing source of viral information, and a little fun

I will press x to doubt 100% of the time that her doctor told her not to get the vaccine. I dont believe it even a little bit.

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30 years ago it was fun to point out inconsistencies in religion. No buzz in it after a while.

Oops think this was intended for the atheist thread

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@CaffeineNeeded , or anybody else with knowledge of the front lines -

All of the antivaxxers on my social feeds are also adamant believers in HCQ or ivermectin or zinc or whatever. Have you seen many people come in that are surprised theyā€™ve gotten a bad case of Covid even after taking all that stuff?

They ā€˜regretā€™ pieces in the media never mention if they also believed they were covincibile because of the Front Line Doctors regimenā€¦

https://twitter.com/jljcolorado/status/1424567786651664384

Lol wut? Thatā€™s fucking ludicrous. Measles says hello.

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Yeah it might be. I figured Iā€™d post it here and let others poke holes. But that Larry Brilliant guy does have a pretty amazing pedigree.

https://twitter.com/BaoGTran/status/1424192723146338307

https://twitter.com/BaoGTran/status/1424415817995722758

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I used to prescribe hcq and azithromycin to every single admitted patient that didnā€™t have a prolonged QTc on their ekg (basically the time for your heart to reset and get ready for the next beat).

People still fucking died so I guess yeah?

I have a whole speech about how none of the medicines that we think work actually show a net benefit for people with covid pneumonia unless you have low oxygen levels. Most people get it. Havenā€™t had people specifically ask for hcq since April 2020.

Saying anyone probably will survive VV ecmo (basically think of it as a lung bypass) seems optimistic. Heā€™d know better than me tbh though.

Scary thread.

@spidercrab, you may find this interesting re: the stable CFR mystery:

Things may be even worse than that, though. In general, epidemiologists expect a lag of a week or two, perhaps more, between case peaks and death peaks ā€” essentially the time it takes for a new case to progress through the full course of disease. Early in the pandemic, the lag was a bit longer, though in the U.S. during the winter surge, the gap between peaks was less than one week. And comparing case data from even one week ago with todayā€™s death data reveals an even grimmer picture: about 75,000 cases per day then yielding the current average of 500 deaths, suggesting the mortality rate had fallen by less than half since winter. If you work from two-week-old data, it suggests that the mortality rate had hardly fallen at all. Applying the winter ratio to the case load from July 24 would predict an average of 600 daily deaths. On Friday, there were 763.

Eric Topol, whoā€™s being interviewed there, followed up with this tweet:

https://twitter.com/EricTopol/status/1424407035991396352

Iā€™m not sure it all makes intuitive sense to me yet. I guess the optimistic take is:

  1. The hospitalization rate really is way down due to vaccination among the most vulnerable populations, but
  2. We still see a lot of hospitalizations because we have a TON (like 500k) infected people out there, but
  3. We donā€™t see those cases because testing is so feeble.

A pretty good test of this theory could be schools opening with mandatory surveillance testing for kids. Atlanta schools have this with an opt-out, which will make it less reliable, but hopefully some districts out there will make it mandatory. As the prophet says, school cases are mostly reflective of community spread, but even infidels will see that you canā€™t blame schools for kids who are infected when they show up the first day. If surveillance testing shows that 2% or some other wild number of kids have active infections acquired in the community, perhaps you can take that as a proxy for the real infection rate among other unvaccinated groups. If that proxy is much higher than the reported case numbers, then thereā€™s your under-detection.

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What bugs me a bit about this theory is that thereā€™s no reason for the age-specific hospitalization rates to have changed, but they would need to have gone way up to explain the data weā€™re seeing (right?). It makes sense to me that we could have more of a ā€œdetection gapā€ as older people get vaccinated. More younger people get infected but donā€™t get sick enough to get tested, so those infections go under the radar. But it used to be the case that even after you accounted for that, the younger people who were sick enough (or who just got tested for whatever reason) were still way less likely to be hospitalized. And thatā€™s the relationship thatā€™s breaking down. Youā€™d need some explanation for why some people who would have been tested 6 months ago are now not getting tested. I guess that could be a lot of thingsā€“less precautionary testing before going to visit grandma now that sheā€™s vaxxed, or just general defeatism about COVID leading people to not get tested when they otherwise would. I donā€™t know if Iā€™ve seen this anywhere, but it would be really interesting to have a breakdown of cases between symptomatic testing and surveillance testing. In January, what percentage of positive 35-year-olds were tested because they were travelling internationally or their employer required it vs. getting a test because they had symptoms? It would be interesting if that figure changed over the last 6 months.

I donā€™t know, when my sister was pregnant her doctor told her not to get the vaccine because she works from home and was taking the proper precautions. The doctor did tell her that if she had to work in the public she would recommend her getting it.

Edit: She never posted that on her social media to use it as an anti vax argument and still agonized over the decision. I only know because she called me to talk about it.

She wouldnā€™t even tell my Mom because she didnā€™t want her to have an excuse not to get the vaccine.

There are roughly a million doctors. If 1% of them are anti-vaccine curious or worse, thatā€™s 10,000 idiots, every one of which will be amplified endlessly on Facebook.

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Genuinely not trolling by posting this, but for all the parents ITT who are wrestling with what to do about sending kids to school, this is a good (long) discussion about how to organize your decision process:

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Woo boy, hard to believe you would post something from her in good faith

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Why, who is she?

Re: nursesā€¦

Can confirm that morale is pretty low among the nurses I work with. When staffing is trending lower and census is trending higher, itā€™s more stressful on everyone, and people leave. Which makes staffing worse, so administration brings in more travel nurses to cover short-term gaps. Iā€™d say about a third of the nurses on any given shift I work now are travel nurses, who have to be trained up on our facility to be effective, and are only here for 13 weeks. When I started, everyone asked if I was a traveler, and seemed surprised when I said no, I chose to work here full time of my own volition.

The fact that they make somewhere between 30-60% more than what I make, naturally breeds resentment. It isnā€™t a sustainable solution to an ongoing problem.

I really like the area I live in, and my facility, so I plan to stay awhile. Iā€™m still new to emergency nursing, and thereā€™s lots of specialized certifications I can get for free while Iā€™m full time here. But once I have a year or three or five of ED experience, and no longer rentā€¦ Iā€™ll definitely start traveling.

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If Iā€™m thinking objectively, it seems like it is much more dangerous to send kids to school this year than it was last year, but there seem to be close to zero resources for remote learning, even in blue places?

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Ofc Oster has a substack, should have seen that coming,

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