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Nick Hutton

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I got AstraZeneca 2 weeks ago. I felt vaguely tired the next day. I also have two teenagers, regularly work 12 hour days as a Doc and get by on not enough sleep so I can exercise with my kids. I pretty much feel tired every day. It’s hard to separate some of the side effects from day to day symptoms, as evidenced by the number of people in the trials who got significant symptoms after getting the saline placebo.
 

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I got AstraZeneca 2 weeks ago. I felt vaguely tired the next day. I also have two teenagers, regularly work 12 hour days as a Doc and get by on not enough sleep so I can exercise with my kids. I pretty much feel tired every day. It’s hard to separate some of the side effects from day to day symptoms, as evidenced by the number of people in the trials who got significant symptoms after getting the saline placebo.
I think fatqiue and tiredness is part of being a Doc!
 

BABAR

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I think fatqiue and tiredness is part of being a Doc!
Traditionally true, but also likely a very real threat to the health of their patients, the doctors’ families, as well as the doctors themselves. The doctor (and particularly surgeon) “Macho Man” mentality needs to go the way of leeching.

although rarely leeching is still useful


Present-day surgeons occasionally use leeches after reattaching severed body parts, such as fingers, or after tissue graftprocedures. In these operations, severed arteries (which bring oxygenated blood from the heart) are routinely reconnected by suturing. However, veins (which return oxygen-depleted blood to the heart) are thin-walled and difficult to suture, particularly if the surrounding tissue is damaged. If blood flow is restored through the arteries but not the veins, blood to the attached body part may become congested and stagnant. The reattached part will eventually turn blue and become lifeless and at serious risk of being lost. In such cases one or two leeches can be applied to the area. A single leech feeds for approximately 30 minutes, during which time it ingests about 15 grams (0.5 ounce) of blood. After becoming fully engorged, the leech detaches naturally, and the appendage continues to bleed for an average of 10 hours, resulting in a blood loss of about 120 grams. When bleeding has almost ceased, another leech is applied to the appendage, and the process continues until the body has had time to reestablish its own working circulation network—usually within three to five days. On rare occasions a patient may develop an infection from microorganisms that live in the leech gut. This appears to happen only when circulation through the arteries is insufficient.
 

cwbullet

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Traditionally true, but also likely a very real threat to the health of their patients, the doctors’ families, as well as the doctors themselves. The doctor (and particularly surgeon) “Macho Man” mentality needs to go the way of leeching.

although rarely leeching is still useful


Present-day surgeons occasionally use leeches after reattaching severed body parts, such as fingers, or after tissue graftprocedures. In these operations, severed arteries (which bring oxygenated blood from the heart) are routinely reconnected by suturing. However, veins (which return oxygen-depleted blood to the heart) are thin-walled and difficult to suture, particularly if the surrounding tissue is damaged. If blood flow is restored through the arteries but not the veins, blood to the attached body part may become congested and stagnant. The reattached part will eventually turn blue and become lifeless and at serious risk of being lost. In such cases one or two leeches can be applied to the area. A single leech feeds for approximately 30 minutes, during which time it ingests about 15 grams (0.5 ounce) of blood. After becoming fully engorged, the leech detaches naturally, and the appendage continues to bleed for an average of 10 hours, resulting in a blood loss of about 120 grams. When bleeding has almost ceased, another leech is applied to the appendage, and the process continues until the body has had time to reestablish its own working circulation network—usually within three to five days. On rare occasions a patient may develop an infection from microorganisms that live in the leech gut. This appears to happen only when circulation through the arteries is insufficient.
I think I will pass on that medical procedure.
 

CalebJ

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Caleb,

I will not be baited into a "pissing match" with you .

( 1 ) The CDC was the source for what I originally stated.

( 2 ) The CDC link I posted was not the one I originally read ( they have MANY different articles ).

( 3 ) My post was a "composite" of data, in addition the the CDC link ( you would have realized that, if you had looked at the CDC article in detail ).

( 4 ) I have not "backtracked", at all ( the "numbers" were averaged from the ones YOU supplied to reach 97.6% ) . . . Your 91% value "skewed" the survival % figure lower.

( 5 ) As I clearly stated, the IFR changes, as the R-naught of the virus changes.

Take this portion of the chart I previously posted . . .

View attachment 460148


Based on an "R-naught" of 2.0 ( from the chart above )

0-17 = 6 deaths per 1,000,000 cases ( .000006 = .0006 % ) . . . 99.9994 % survivable
18-49 = 150 deaths per 1,000,000 cases ( .00015 = .015 % ) . . . 99.985 % survivable
50-64 = 1,800 deaths per 1,000,000 cases ( .0018 = .18 % ) . . . 99.82 % survivable
65+ = 26,000 deaths per 1,000,000 cases ( .026 = 2.6 % ) . . . 97.40 % survivable
______________________
99.30 % survivable ( AVERAGE )


As I said before, the "IFR" varies, according to the "R-Naught" of the virus.

Dave F.
Thanks for the clarification that you simply made up data and pretended to cite it.
 

Ez2cDave

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Thanks for the clarification that you simply made up data and pretended to cite it.
The "problem" can't be the "message", since the cited source was the CDC . . . So, that only leaves the fact that you don't like the "poster" ( yours truly ) . . . Ignoring the facts, over a petty, "personal vendetta", is foolish, at best.

The illustration was clear, with cited references . . . I'm sorry if you can't comprehend charts and simple math. Until you have something constructive to say, I'm done with you.

Dave F.
 
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afadeev

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Thanks for the clarification that you simply made up data and pretended to cite it.
Bingo!
The gentlemen in question is one of two active users I'm ignoring, precisely for the record of inability to follow a logical argument. On any subject.

The stats may seem clear but they are only significant if you are not the person dying from COVID.
That is absolutely true, but stats do matter for planning, strategy, and social acceptance of mitigation measures to the pandemic.
There would be an order of magnitude lower concern over a virus that would have been "99.8% non-fatal" or with 0.2% fatality rate (as erroneously claimed by some) vs. actual cumulative fatality rate of 1.8% (per Mayo Clinic data). or 1.72% (per JHU)

The difference between the two numbers matters a lot, especially, as you said, to the extra (330M people in US) * (0.018 - 0.002) = 5.28M folks succumbing to an otherwise avoidable fatal outcome.
That's an awful lot of very unhappy family and friends who get to vote in a democratic society.
Maybe less of an issue under dictatorships.


 

CalebJ

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Bingo!
The gentlemen in question is one of two active users I'm ignoring, precisely for the record of inability to follow a logical argument. On any subject.
Yep.

It's frustrating when someone presents data like that with an air of superiority, and a moment spent digging into it proves that they simply made the whole thing up.

It's infuriating when they double down on their lies (yes, I said lies) when called out on it, pretending like the ones who see through it are simply too blind/unaware to comprehend.

Example:
"The illustration was clear, with cited references . "

In reality, the illustration was in blatant contrast with the numbers and calculations presented directly below it. And instead of clarifying things, the response was pure obfuscation and deflection of blame.


Things like this simply shouldn't be tolerated in civilized society.
 

Nick Hutton

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Traditionally true, but also likely a very real threat to the health of their patients, the doctors’ families, as well as the doctors themselves. The doctor (and particularly surgeon) “Macho Man” mentality needs to go the way of leeching.

Thanks for the career advice total stranger. Given my multi factorial answer, should I also give up exercise and tell my kids to get lost in order to be a better physician to fit your ideals?
 

CalebJ

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Thanks for the career advice total stranger. Given my multi factorial answer, should I also give up exercise and tell my kids to get lost in order to be a better physician to fit your ideals?
Is it possible you misinterpreted Babar's post?
 

Nick Hutton

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Touche. A post I made about vaccine side effects turned into a comment about my work life balance. No one ever tells their barista they should work less, but drs seem fair game.
 

cwbullet

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Anyhow, I’m tired today cos I got up early for a cricket, footy, rocketry weekend road trip with my son. Let’s hope my patients understand on Monday!
Man,

I am not offended by you or @BABAR. I know I work too hard. Unlike the younger generation, which I fight to protect, my internship and much of my residency included 100-120 hour work weeks.
 

BABAR

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Is it possible you misinterpreted Babar's post?
I spent 21 years as a military physician, 7 of those in training when there were no rules on residency of fellow work hours. For residency and fellowship I intentionally picked programs which had good reps but were also not known as ”killer” call programs. I still had bad nights followed by bad days once in a while, but wasn’t the routine except for certain internship rotations. Won’t blow my own horn, just say that my fellow trainees from those programs wiped the floors on the boards versus those from traditional killer programs and became just as compassionate and competent docs. we don’t (intentionally) let tired people fly planes or drive trucks, IMO (humble or otherwise) tired people shouldn’t be performing surgery or prescribing pills. Even with best intentions, tired people do dumb things.
 

NateB

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Even with best intentions, tired people do dumb things.
I'm fortunate, we work 12 hour days which are capped at 14 due to the duty time for our pilots. We ran close to a 14 hour day last week, which ended up being 17.5 for me on the clock after we were done charting. Fortunately, those shifts are rare and we typically get off on time or just a little late.

During the first half of my career, I worked 24 hour shifts, with sleep time allowed in between calls. I routinely worked 48s and 72s were common enough. Some guys like it, I don't think shifts like that should be allowed. I never sleep well at a station and had some scary moments driving home on autopilot due to fatigue.
 

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I spent 21 years as a military physician, 7 of those in training when there were no rules on residency of fellow work hours. For residency and fellowship I intentionally picked programs which had good reps but were also not known as ”killer” call programs. I still had bad nights followed by bad days once in a while, but wasn’t the routine except for certain internship rotations. Won’t blow my own horn, just say that my fellow trainees from those programs wiped the floors on the boards versus those from traditional killer programs and became just as compassionate and competent docs. we don’t (intentionally) let tired people fly planes or drive trucks, IMO (humble or otherwise) tired people shouldn’t be performing surgery or prescribing pills. Even with best intentions, tired people do dumb things.
I don’t disagree. Most of the time I spend is not clinical. I am an administrator. I see clinic once a week and that is a short day. I rarely pull call. My big increase in hours is planning for COVID. I have a unique skill set that most do not have. My operational experience allows me to plan for contingency operations. I did it for SARS, MERS, H1N1 and now COVID. It was spared on onslaught during H1N1 but was tested. COVID proved it worth.

The problem with my position is it hard to get someone else to do it. I plan to start scaling back.
 

BABAR

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The problem with my position is it hard to get someone else to do it.
any system human or otherwise with an irreplaceable component is guaranteed to eventually be in deep kimchi....
 

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My got her first shot of Moderna today. She wait patiently until one was available and did not use me as a means to jump the line.
 

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My wife and oldest got their first shots last night at a drive through site at a county fairground an hour north of here. Super smooth and well run.
 

cwbullet

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My got her first shot of Moderna today. She wait patiently until one was available and did not use me as a means to jump the line.
Now I gotta get my 22-year son a shot.
 

Antares JS

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Got my first Moderna on Thursday. I was surprised how long the arm soreness lasted but I didn't have any other issues. Here's hoping the second isn't worse.
 

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Got my first Moderna on Thursday. I was surprised how long the arm soreness lasted but I didn't have any other issues. Here's hoping the second isn't worse.
It was for me and 60-70 percent of Americans. My wife has almost no symptoms.
 

BABAR

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It was for me and 60-70 percent of Americans. My wife has almost no symptoms.
Both about the same for me. Tylenol, Motrin, and a heating pad helped.
 

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50% of American's say they will not get the vaccine. How many will get the booster?
 

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I got the J&J about 1.5 weeks ago. No side effects at all. My wife and daughter got wiped out. Chills, extremely tiredness, etc. but were back to normal in 24 hours. No blood clots yet!
 

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Caleb,

I will not be baited into a "pissing match" with you .

( 1 ) The CDC was the source for what I originally stated.

( 2 ) The CDC link I posted was not the one I originally read ( they have MANY different articles ).

( 3 ) My post was a "composite" of data, in addition the the CDC link ( you would have realized that, if you had looked at the CDC article in detail ).

( 4 ) I have not "backtracked", at all ( the "numbers" were averaged from the ones YOU supplied to reach 97.6% ) . . . Your 91% value "skewed" the survival % figure lower.

( 5 ) As I clearly stated, the IFR changes, as the R-naught of the virus changes.

Take this portion of the chart I previously posted . . .

View attachment 460148


Based on an "R-naught" of 2.0 ( from the chart above )

0-17 = 6 deaths per 1,000,000 cases ( .000006 = .0006 % ) . . . 99.9994 % survivable
18-49 = 150 deaths per 1,000,000 cases ( .00015 = .015 % ) . . . 99.985 % survivable
50-64 = 1,800 deaths per 1,000,000 cases ( .0018 = .18 % ) . . . 99.82 % survivable
65+ = 26,000 deaths per 1,000,000 cases ( .026 = 2.6 % ) . . . 97.40 % survivable
______________________
99.30 % survivable ( AVERAGE )


As I said before, the "IFR" varies, according to the "R-Naught" of the virus.

Dave F.
You got that backwards. IFR does not vary depending on R_0. How deadly the infection is in an average individual does not depend on how fast the pandemic spreads *). Apples and oranges.

As the table is prefaced:
Table 1. Parameter Values that vary among the five COVID-19 Pandemic Planning Scenarios. The scenarios are intended to advance public health preparedness and planning. They are not predictions or estimates of the expected impact of COVID-19.
The numbers you've quoted are parameters for a model. The CDC *assumed* best case scenarios (scenarios 1&2, low IFR, low R_0) and worst case scenarios (scenarios 3&4, high IFR, high R_0) and a reasonable estimate scenario in between (scenario 5).
That's strictly a document for planning purposes that illustrates the bandwidth of plausible scenarios.

Reinhard

*) Unless R_0 is so high, that the health care system becomes overloaded. Then IFR will rise.
 
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