Coronavirus: What questions do you have?

[kuririn]

If someone contracted Covid previously and recovered do you still recommend that they get the vaccine?
I know you mentioned that the vaccine(s) "supercharge" the immune system.
Also, if someone recovered from the disease are they still able to carry infectious viral loads if re-exposed?
(i.e. can they still be a threat to others)?

 

[BABAR]

80% of Idaho hospitals are one level away from health care rationing.

https://www.idahostatesman.com/news/coronavirus/article247780380.html

Most people in the state still believe it is a hoax. The stores are packed. Then there are the anti-maskers.

My daughter works in ER and is totally burned out and I worry about her constantly and for my son who works in retail.

In Boise Protesters not only showed up outside the government building location of a council meeting where government members were discussing mask and social distancing and business closure decisions (that’s legit, they have a right to that) but also were pounding on the doors of the council members homes (that’s crossing the line in my book.). One of the council members left the meeting in tears because her 12 year old kid home alone called her to say protesters were pounding on the door.

Shall we just pass the keys to asylum over to the inmates?

Interestingly, a significant portion of nurses are DECLINING the vaccination at present.

 

[Marc_G]

I would gladly line up for the vaccine but apparently there are at least 23 million in front of me, probably more.

 

[Marc_G]

Politically we had a massive lost opportunity. Last January I read an article that talked about how the upcoming virus should be treated like a war. Politicians need to frame it like a war and get everyone mentally prepared for it.

During the bombing of London did people say it was against their freedoms to force them to turn off their lights at night?
Did idiots go out and party in the streets and brag about it? I doubt it.

If this covid fight was framed as a war:
1. It would be considered unpatriotic to not wear mask or go out and party. Sports would be put off for a year.
2. Politicians would spend the money that we need to spend
3. In January the war powers acts would have been applied in a sensible and consistent manner to build up PPE etc.

The USA per capita death rate is much higher than Canada was it worth it over "emails"??

This would have been great, but it was perceived as not politically expedient by the powers that be at the time the call was made.

While it could be an interesting discussion, it would be too political for this forum so I will just leave it there.

 

[BABAR]

I would gladly line up for the vaccine but apparently there are at least 23 million in front of me, probably more.

Try 7.8 billion (not necessarily in front of you, though.)

 

[cwbullet]

If someone contracted Covid previously and recovered do you still recommend that they get the vaccine?

Yes. The immune response is superior and last longer from the vaccine.

I know you mentioned that the vaccine(s) "supercharge" the immune system.
Also, if someone recovered from the disease are they still able to carry infectious viral loads if re-exposed?
(i.e. can they still be a threat to others)?

Yes, if you are infected a second time, you can pass the virus.

 

[cwbullet]

Politically we had a massive lost opportunity. Last January I read an article that talked about how the upcoming virus should be treated like a war. Politicians need to frame it like a war and get everyone mentally prepared for it.

During the bombing of London did people say it was against their freedoms to force them to turn off their lights at night?
Did idiots go out and party in the streets and brag about it? I doubt it.

If this covid fight was framed as a war:
1. It would be considered unpatriotic to not wear mask or go out and party. Sports would be put off for a year.
2. Politicians would spend the money that we need to spend
3. In January the war powers acts would have been applied in a sensible and consistent manner to build up PPE etc.

The USA per capita death rate is much higher than Canada was it worth it over "emails"??

It is difficult to compare Canada to the US. We have done way more tests than in Canada pre capita and we have over 1% more of our population over 65. That being said, Canada is less obese and better control over chronic diseases. I doubt it had anything to do with them treating COVID better.

 

[cwbullet]

It is not feeling a lot like Christmas. I am prepping to vaccinate a large number of medical and essential workers. We are testing hundreds every day and have a huge number of positives. The good news, if there is any, is that the death rate is not increasing.

 

[cwbullet]

This is our local positives over time. Huge historic spike at the end.

 

[NateB]

I am scheduled to receive my vaccine on Thursday. We talked with some of our counterparts in another state this afternoon and their team started to receive them yesterday. We are supposed to have 10,000 doses by next week for our region with the vaccine clinic set up 6 days a week.

It was also interesting to hear how they are transporting covid cases in their RW and FW aircrafts.

 

[rocketsaway]

An article in my local news had a link to see where I would be in line for the vaccine.
It asked questions like, age, comorbidity, type of work , county, etc.
According to a state govt site, Im considered essential worker, school bus driver.
The questionnaire results were that Im #44,000 out of 628,000.

Who will know that Im #44,000 in line ?

 

[NateB]

I think that place is line is purely an estimate based upon the criteria you entered. Go back to the link and enter in other things and see how it changes.

I received an email form the physician in charge of infection control for my hospital which stated I was due to register, an invite code, and a link to a website from the Indiana Dept of Health. On that site, I had to register with personal information, my employer, and affirm that I am a health care worker. It then gave me a couple days to pick for an appointment.

Since then, I received another email from the State EMS Commission stating that all EMS providers were eligible for vaccines and a link to the same page. I did not try to register again, but I assume the database would catch the duplicate name and birthday.

My director at work had submitted names of everyone in our department involved with direct patient care and I assume that is how they are building the eligibility list. For the EMS commission, they certainly just used current licensure to send out the emails. Some police officers I know have been asked if they want to get the vaccine, so I suspect the health department is asking each public safety department how many vaccines are desired to determine need and when each person will get it.

I have not heard about any vaccines outside of healthcare and public safety yet. I have several family members who are teachers and they should be near the top of the list with other essential employees as well.

 

[boatgeek]

I have a couple of million people ahead of me, so it's going to be a while. I can technically claim essential worker status since one of our customers is building boats for the Navy. On the other hand, I can work from home 95%+ of the time. On the third hand*, I've been out on the job site a couple of times when none of the 20 people on the boat were wearing a mask. Regardless, I wouldn't feel right jumping ahead of grocery workers and teachers, but I might try to get a jump on the people who are exclusively working from home.

* "Give me a one-handed economist" -Harry Truman

 

[cwbullet]

We will start immunizing really soon. I am contemplating being the first to set an example for my staff.

 

[NateB]

We will start immunizing really soon. I am contemplating being the first to set an example for my staff.

That might help ease people's concerns. Our medical director was among the first and he put together a nice presentation which he went over this evening in our normal monthly QA meeting. He went over how this one works, what is in it, what to expect, and why he took it and why he is getting his family vaccinated.

From his information, side effects are minimal and serious side effects like Gillian-Barre have a lower incidence than other vaccines. I trust that it is safe for myself and my family.

 

[ksaves2]

In Boise Protesters not only showed up outside the government building location of a council meeting where government members were discussing mask and social distancing and business closure decisions (that’s legit, they have a right to that) but also were pounding on the doors of the council members homes (that’s crossing the line in my book.). One of the council members left the meeting in tears because her 12 year old kid home alone called her to say protesters were pounding on the door.

Shall we just pass the keys to asylum over to the inmates?

Interestingly, a significant portion of nurses are DECLINING the vaccination at present.

It's absolutely wrong to bother politicians and their kids. May God condemn to Hades anyone who does so. That said, one can write or email their representative(s) and state their views succinctly. I'm getting the vaccine as soon as it can come to me. I have all the time to wait at home in isolation as the folks who are on the front lines need to get it first.

I've written politicians rarely by gosh, they reply and respond with some of the finer points of the issue at hand. Yeah, it was in the letter writing days.

I really appreciated that as they are the ones on the "hotseat" to do the work of government and try to keep the constituency happy even if I don't agree with them. Be respectful and it's surprising what you can hear from your elected representatives if one so chooses to write to them.

Oh, BTW I used to M.D. for a living but retired July 1st, 2020. Going to get back into rockets big time soon as I'm holed up at home for now with my autistic spectrum son. He's doing great and gives me someone to talk too as my lovely spouse died in January 2019. He does have speech and although will be a forever 8 year old he is not violent anymore at age 26.

I'll be able to take him to out of town rocket launches with no problem and stay at a hotel. He likes eating out but that has been no longer possible with the Covid thing.
All the best,
Kurt Savegnago

 

[NateB]

I've written politicians rarely by gosh, they reply and respond with some of the finer points of the issue at hand.

I have written my representative on a number of occasions, usually I get a canned reply. Last Winter (pre-covid) I wrote about a bill in committee regarding ERs going on ambulance diversion and how it is a problem within our district as well. I first got a canned reply about how the representative isn't on the committee in question, but he would take my thoughts under consideration. I figured that was the end of it until several weeks later when I actually got a phone call from a staffer in his office. Maybe the system does work, at least once in
a while.

 

[afadeev]

It is difficult to compare Canada to the US. We have done way more tests than in Canada pre capita and we have over 1% more of our population over 65.

Actually, that's a dead wrong statement.
Canada is the closest proxy there is to the US: economically, demographically, culturally, and politically.

They are a bit further North, and have ~10% of the US population, 10% of the US GDP, and very similar GDP per capita and rate of urbanization.
https://en.wikipedia.org/wiki/Compa...37,058,856 while,ten times larger than Canada
Canadian demographics skew a little older than the US, with lower birth rate but higher net migration rate.
Canada has 18.98% of its population over 65, while the US is 16.85% over 65:
https://www.indexmundi.com/factbook/compare/canada.united-states/demographics

That being said, Canada is less obese and better control over chronic diseases. I doubt it had anything to do with them treating COVID better.

Canada also spends about 1/3rd less on the Healthcare sector (10.6% for Canada vs. 17.1% of GDP for US), but their infant and maternal mortality rates are significantly lower than those in the US.
Canadian life expectancy is also ~3 years longer than that of the US counterparts.

Canada currently also happens to have a semi-competent Federal government (while you know what we've got), and a national Covid-19 response policy (none of our "each state for themselves" stupidity), and has 367 deaths for 1 Mil of population from Covid-19, while the US is tracking 958 deaths for 1 Mil of the population from the same.
That's 2.61 times fewer deaths per capita.

That should give an independent observer a pretty good proxy on how many lives in the US that could have been saved.

I don't know if that's because they treat Covid better (they do achieve better medical outcomes with everything else), or just because their country has been taking pandemic mitigations measures seriously, nationwide, year to date.

Basically, Canadian medical system is more frugal, but between the medics and its politicians, Canada has been significantly more effective at keeping its citizens alive.

*just @#$%ing sad*

 

[NateB]

When I went for my vaccine today, one of the questions they asked when registering me was if I had received any antibody therapies recently. Is there an interaction between the vaccine and these drugs, a concern for one, or just academic?

 

[cwbullet]

Actually, that's a dead wrong statement.
Canada is the closest proxy there is to the US: economically, demographically, culturally, and politically.

They are a bit further North, and have ~10% of the US population, 10% of the US GDP, and very similar GDP per capita and rate of urbanization.
https://en.wikipedia.org/wiki/Compa...37,058,856 while,ten times larger than Canada
Canadian demographics skew a little older than the US, with lower birth rate but higher net migration rate.
Canada has 18.98% of its population over 65, while the US is 16.85% over 65:
https://www.indexmundi.com/factbook/compare/canada.united-states/demographics


Canada also spends about 1/3rd less on the Healthcare sector (10.6% for Canada vs. 17.1% of GDP for US), but their infant and maternal mortality rates are significantly lower than those in the US.
Canadian life expectancy is also ~3 years longer than that of the US counterparts.

Canada currently also happens to have a semi-competent Federal government (while you know what we've got), and a national Covid-19 response policy (none of our "each state for themselves" stupidity), and has 367 deaths for 1 Mil of population from Covid-19, while the US is tracking 958 deaths for 1 Mil of the population from the same.
That's 2.61 times fewer deaths per capita.

That should give an independent observer a pretty good proxy on how many lives in the US that could have been saved.

I don't know if that's because they treat Covid better (they do achieve better medical outcomes with everything else), or just because their country has been taking pandemic mitigations measures seriously, nationwide, year to date.

Basically, Canadian medical system is more frugal, but between the medics and its politicians, Canada has been significantly more effective at keeping its citizens alive.

*just @#$%ing sad*

Actually, your argument is flawed. We will agree to disagree. Canada is not comparable to the US. We have more of the population over 65 and a much more sedentary and obese population. Also, Canada is much less racially diverse. Remember, Americans of Hispanic or African heritage have a higher risk of death due to covid.

Medicine in Canada is not creating a lower risk of death. It is the inherent risk of the population and not the medical system that is creating higher numbers in the US. Part may be genetic but it probably cultural differences and age. The US has nearly 5 times as many African Americans and twenty times the Hispanic population.

The risk for badness from COVID between the US and Canada is not an Apples to Apples discussion. It is not even close.

What does the US have to be proud of? We have a higher success rate compared to other countries of surviving admission. Why? We have new treatments that are not available in Canada or around the globe. My hospital leads the world in several experimental treatments. Our fatality rate in the last 3-4 months is greatly reduced.

 

[cwbullet]

Update: Hospitals are full. I worked till midnight last night in our ICU. It was busy. I am not an ICU doc, but they needed help and with the right support and some supervision, I can do almost anything. This year, I have done things I have not done in 22 years.

 

[Marc_G]

Chuck, I get your points about differenc s between US and Canada. But couldn't a big part of the difference in outcomes be attributable to the fact that Canadians tend to listen to their government health regulations more than here in the US? I don't recall seeing in the news rogue Canadians flouting the rules.

 

[Peartree]

Serious question of a slightly different sort. My wife is an immune suppressed, transplant recipient. I noticed that in one or more articles about the clinical trials of the new vaccines, and the emergency approvals for their use, that these vaccines were not tested on children, pregnant women, or immune suppressed patients. One article specifically said that they weren't yet sure how the emergency authorization would treat these groups since they really had no data that would allow them to understand the risks. Another noted that since these vaccines do not include any virus, alive, dead, or otherwise, that they should, in theory, be safe for immune compromised patients, but again, without data it would be something of a guess. For now, I told my wife to wait for her Cleveland Clinic transplant docs to recommend or not recommend getting the vaccine but so far, we haven't heard anything. Other than the fact that I live with an immune suppressed person, I should be really low on the priority list. I'm young-ish (50's), work at home most of the time, and have little reason to be around anyone most other times. But, when it comes to flu shots and pneumonia shots, they always recommend that I get one because I live with an immune suppressed person.

Do you have any insight into how CDC and FDA might make recommendations for the vaccine in regard to immune suppressed patients (or their families)?

 

[KC3KNM]

Chuck, I get your points about differenc s between US and Canada. But couldn't a big part of the difference in outcomes be attributable to the fact that Canadians tend to listen to their government health regulations more than here in the US? I don't recall seeing in the news rogue Canadians flouting the rules.

There are a lot of factors that were pointed out that obviously add to it but aren’t the root cause. Are African Americans and Hispanics actually genetically predisposed to get more sick from COVID, or is this due to systemic healthcare issues leading to them already being in worse shape? Could it be that folks from those demographics are historically lower educated, poorer and likely to work in "essential" fields and can't take time off... and thus more likely to catch it and not get treatment? Might play a part in flaunting the mask and social distancing restrictions. Seems the obesity rates and higher deaths in minority and poor populations are more a symptom than the culprit itself. I think our healthcare system has failed us for some time and it’s coming to a head under COVID.

 

[Peartree]

There are a lot of factors that were pointed out that obviously add to it but aren’t the root cause. Are African Americans and Hispanics actually genetically predisposed to get more sick from COVID, or is this due to systemic healthcare issues leading to them already being in worse shape? Could it be that folks from those demographics are historically lower educated, poorer and likely to work in "essential" fields and can't take time off... and thus more likely to catch it and not get treatment? Might play a part in flaunting the mask and social distancing restrictions. Seems the obesity rates and higher deaths in minority and poor populations are more a symptom than the culprit itself. I think our healthcare system has failed us for some time and it’s coming to a head under COVID.

This is probably a question for another day and it certainly exceeds the scope of this thread.

 

[KC3KNM]

This is probably a question for another day and it certainly exceeds the scope of this thread.

I feel it’s relevant to the discussion between Chuck and afadeev and within the same frame if we’re talking about why Canada isn’t struggling like the US with COVID. Feel free to delete it if it’s that far off.

 

[Marc_G]

I'm curious about Chuck's views (and others') about "leaders getting vaccinated publicly to instill confidence" from the context of "is it skipping the line?"

Personally, I'm not offended by top leaders like Pence / Trump / Biden / Governors / Fauci getting vaccinated out of sequence. I know some will see it as misuse of priveleges of office, but a couple hundred doses publicly administered this way could have a greater good impact that to me outweighs the line skipping aspect.

Now if it went much farther than that, will all Senators/Congresspeople and spouses... That would be over the line to me, that's abuse of office in my book. Just my opinion.

Obviously I think those most at risk should be at front of the line, and I'm not one of those so I wait my turn. Bravo to the health professionals setting a good example showing public support and getting vaccinated to de-risk their work with patients.

 

[BABAR]

Actually, that's a dead wrong statement.
Canada is the closest proxy there is to the US: economically, demographically, culturally, and politically.

They are a bit further North, and have ~10% of the US population, 10% of the US GDP, and very similar GDP per capita and rate of urbanization.
https://en.wikipedia.org/wiki/Compa...37,058,856 while,ten times larger than Canada
Canadian demographics skew a little older than the US, with lower birth rate but higher net migration rate.
Canada has 18.98% of its population over 65, while the US is 16.85% over 65:
https://www.indexmundi.com/factbook/compare/canada.united-states/demographics


Canada also spends about 1/3rd less on the Healthcare sector (10.6% for Canada vs. 17.1% of GDP for US), but their infant and maternal mortality rates are significantly lower than those in the US.
Canadian life expectancy is also ~3 years longer than that of the US counterparts.

Canada currently also happens to have a semi-competent Federal government (while you know what we've got), and a national Covid-19 response policy (none of our "each state for themselves" stupidity), and has 367 deaths for 1 Mil of population from Covid-19, while the US is tracking 958 deaths for 1 Mil of the population from the same.
That's 2.61 times fewer deaths per capita.

That should give an independent observer a pretty good proxy on how many lives in the US that could have been saved.

I don't know if that's because they treat Covid better (they do achieve better medical outcomes with everything else), or just because their country has been taking pandemic mitigations measures seriously, nationwide, year to date.

Basically, Canadian medical system is more frugal, but between the medics and its politicians, Canada has been significantly more effective at keeping its citizens alive.

*just @#$%ing sad*

This is also a factor in the death rate

Among men, the prevalence of obesity was over 8 percentage points lower in Canada than in the United States (24.3% compared with 32.6%) and among women, more than 12 percentage points lower (23.9% compared with 36.2%) (Figure 1).



https://www.cdc.gov/nchs/products/databriefs/db56.htm#prevale

 

[Cl(VII)]

I'm curious about Chuck's views (and others') about "leaders getting vaccinated publicly to instill confidence" from the context of "is it skipping the line?"

Personally, I'm not offended by top leaders like Pence / Trump / Biden / Governors / Fauci getting vaccinated out of sequence. I know some will see it as misuse of priveleges of office, but a couple hundred doses publicly administered this way could have a greater good impact that to me outweighs the line skipping aspect.

Now if it went much farther than that, will all Senators/Congresspeople and spouses... That would be over the line to me, that's abuse of office in my book. Just my opinion.

Obviously I think those most at risk should be at front of the line, and I'm not one of those so I wait my turn. Bravo to the health professionals setting a good example showing public support and getting vaccinated to de-risk their work with patients.

I see this as using a shot where it will do the most good for public health, so I think it is a good idea. Driving to work this morning I heard a story about a hospital in Midland, TX that was giving some of its first allotment of vaccine to other organization members in Midland who are also in the first vaccine group, but weren't supposed to get these shots. This is because less than 1/3 of the first wave hospital staff that these shots were intended for were getting the vaccine. There are apparently rules about not sending allocated doses to another facility, which I can see to avoid a weird/dangerous secondary market between providers.

The next story I heard was about Pence getting the vaccine on TV. Being that Midland is a fiercely conservative area, I can see Pence publicly getting the shot influencing at least a few folks from that hospital to get protected. Project that nationally, and I think that shot (and some selected others) are very well used from a public health point of view.

 

[Bill S]

This is probably a question for another day and it certainly exceeds the scope of this thread.

I can certainly see where discussing minorities cultural situation and lack of access to "healthy" food has great potential to get all political, so its best we skip that one.