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Heme Doc

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Everything posted by Heme Doc

  1. Oh, and nobody was vaccinated when this study was done so we don’t know how that data would translate in a population of vaccinated people
  2. Mine too. This is the best data I’ve seen so far regarding effects of community masking. Here’s the link to study that I forgot to include with first post. https://www.poverty-action.org/sites/default/files/publications/Mask_RCT____Symptomatic_Seropositivity_083121.pdf 1. Cloth masks are just as worthless as doing nothing. Not a surprise to me. 2. Surgical masks were better, with benefit limited to those age 50 and up 3. Absolute risk reduction in symptomatic infection (serious problems as to how this is defined) was 1%. It was about 8% of the control group clusters who got symptoms consistent with COVID and about 7% of intervention group. So, clearly not a parachute. All of this risk reduction was seen in people older than 50 and in the surgical mask groups (not cloth masks) 4. Some confounders that intervention group also got education about distancing, etc. in addition to masks. If one were to read this study and come away with the conclusion, “SEE, MASKS WORK!”, I would think they’re fairly simple minded without much critical thinking skill or nuance. I’d say that some mask policies probably help some in certain situations. But more study is needed.
  3. Anybody want to weigh in on the cluster RCT of masking in Bangladesh?
  4. I'm invincible, motherfucker! Pics of nurse? For science…
  5. https://www.nejm.org/doi/full/10.1056/NEJMoa2109072 NEJM article here is the best data I know looking at Ab titers in breakthrough cases in vaccinated people compared to vaccinated controls without breakthroughs. Caveat—this was pre-Delta data. I’m not completely sure the assay they were using but it looked like if you were over 500 then you were pretty safe
  6. 1. You CAN transmit if infected… CAVEAT: if you’re vaccinated you’re MUCH less likely to get infected in the first place (so obvs can’t transmit if not infected). Also, if you are vaccinated and get a symptomatic breakthrough infection (rare, despite what you read), you’re going to be LESS likely to transmit than an unvaccinated person due to your body fighting it off quicker. 2. The vaccine indeed doesn’t make you bulletproof. If you encounter enough virus it may be enough to overtake the antibodies you’ve got, but that doesn’t seem to be the majority of the time. There were always going to be breakthroughs. It doesn’t mean the vaccines don’t work.
  7. Sweet! Happy to be wrong here. I thought you were having scans because you already had Mets and were looking at response to therapy. My mistake. I’d be curious to know if you had antibodies to nucleocapsid indicating prior infection. Glad it sounds like you’re doing well
  8. Holy shit the people running the CDC are so fucking stupid. You’re going to change mask policy for over 300 million people based on this shit? THIS is the best you’ve got?!?!? “Let’s take a self-selected, not-statistically-significant sample of ~200 nondiverse people during a party weekend that was an outlier in many respects, and use it to conclude that breakthrough infections are just as likely to transmit the virus?” FUCK YOU CDC ASSHOLES!!!! Plus they only looked at symptomatic infections. How many asymptomatic vaccinated people would have tested positive but will low titers of virus in their nose? The denominator is screwed up. Symptomatic breakthrough infections having similar viral loads to symptomatic unvaccinated infections would be much less of a problem, both because symptomatic breakthroughs are rare and because people can learn to be more careful (and get tested) when they have symptoms.
  9. Hope you are feeling better. Your onc realizes that metastatic cancer also increases risk for clots, I hope? Like, WAAAAAYYYY MORE than COVID… I’d bet you didn’t have COVID…but what do I know? You could get antobodies checked to find out for sure.
  10. It would have been what happened to India
  11. Same. I’ve not seen any data. And I’m not saying it can’t or doesn’t happen (vaccinated people spreading COVID). Im just saying that it happens at such a low rate that mandating masks for vaccinated people isn’t worth the trade off of potentially fewer people getting vaxxed.
  12. In my opinion, the latest CDC course change Re: masks in vaccinated folks is more about saying they are “doing something” about the current wave and not based in available data. I find it highly unlikely that a large number of current COVID infections are coming from vaccinated people passing it to unvaccinated people. If the CDC has that data, then let’s see it! But I doubt they do. Can vaccinated people still get COVID? Sure. But it’s pretty rare despite hearing all the panic about the breakthroughs. Can those people generate enough virus particles to transmit it to someone else? Sure, but I’m sure that’s quite rare. Will mandating masks for even vaccinated individuals have a significant positive impact on our current wave? I’m highly dubious. Plus it may have negative impacts by causing people on the fence about getting vaccinated choose not to because they’d still have to wear a mask. Prediction: Delta wave will start declining rapidly in next 1-2 weeks and everyone will tout this change in mask guidance as the reason, but it had nothing to do with it. It’s just the nature of waves caused by the Delta variant all around the world. Also, over 60 COVID patients currently in my hospital. We had about ten 1 month ago. ZERO are vaccinated.
  13. Pfizer booster trial update Almost certainly got the booster yesterday and not placebo. Feel very similar to earlier shots. Not awful, but not great. Also had my own antibody test drawn about 2 hours prior to getting the boost. Spike RBD antibodies present with titer of 1,131 (almost 1 year after vax). “Positive” value for assay is greater than 0.7. I might get another titer drawn in a month to see how much it went up or if I could possibly break the machine. So, I’ve got that going for me, which is nice.
  14. I haven’t had COVID, btw. And I’ve been skiing, Disney world, Sedona, Schlitterbahn, and God knows what else just this year.
  15. I’m actually going to go just before and get the assay. Curious to know where I’m at almost one year since getting my first shot
  16. Got the email for Pfizer booster study today. Hope to get the shot next week. The study is looking at 10,000 patients previously vaccinated with Pfizer at least 6 months ago. Double blinded. Half get placebo, half get booster. Kind of a small sample size but we shall see. So while you assholes are dying from breakthrough COVID, I’ll be sitting on a beach, earning 20 percent
  17. Same here. Got mine from 2020 which weren’t used
  18. Right. This would be the logic of why mandates are re-instituted. I can only think of 3 logical reasons for mask mandates at this point. 1. Masking vaccinated individuals will significantly reduce that persons likelihood of getting COVID. 2. Masking vaccinated folks will significantly reduce them spreading COVID to others. 3. Making everyone mask will force unvaccinated people to mask up (which they aren’t doing) at the “cost” of vaccinated people also masking up. Numbers 1 and 2 seem extremely unlikely and contrary to all known data. Number 3 won’t work either because the vaxxed won’t play along (why the fuck should I wear a mask now?) and the unvaxxed won’t either
  19. The data I’ve seen from Israel which is pretty much all Delta shows Pfizer still over 95% effective against severe disease in ages<65 and probably more like 80% effective in over 65. Older folks may need a booster. That Pfizer booster trial is enrolling right now. I’m waiting for my call to come in for it (I was on the original Pfizer trial). I’ll go on my own next month to get antibody titers to see where I’m at one year after my vaccination.
  20. I’m fine with people who are vaccinated and choose to mask up. I do at work every day. I can’t rule out some small benefit of mask wearing in vaccinated folks that certain people would feel worth it given their individual risk tolerance and situation. I just don’t think there’s enough/any data showing that mandating masks, in vaccinated people, is going to accomplish anything meaningful in terms of reduction of hospitalizations, death, etc (the numbers we should care about most). We know vaccinated people can get sick still, but do so OVERWHELMINGLY less than the unvaccinated. We know that transmission is drastically reduced by vaccination as well…but not to zero. Nothing is 100% effective. So I certainly do acquiesce that masks may help some small amount in vaccinated folks. If someone wants to do a prospective study on masks, I’m all for it. I’m a very data driven person. But we have been in the pandemic for a year and a half. The onus is on those wanting to keep restrictions in place to show that they do anything.
  21. Great question. What the fuck more do they want to see in terms of efficacy and safety?
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