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Heme Doc

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Posts posted by Heme Doc

  1. 14 minutes ago, UnivTex34 said:

    This is complete dogshit “science/modeling” and contradicts existing knowledge and CDC guidance.  There’s no data showing that masking vaccinated people is going to affect jack shit.  Cities can eat shit if they want to start mandating masks again for vaccinated individuals.  
     

  2. It’s oddly worded that it’s “a form of Hodgkin’s lymphoma”.  Hodgkin’s doesn’t have forms.  It’s just Hodgkin’s (often referred to as Classical Hodgkin’s lymphoma). Unless they’re referring to various pathological nuance like mixed cellularity Hodgkin’s or nodular sclerosing Hodgkin’s.  But none of that really matters.  Hodgkin’s is all treated more or less the same and has an excellent prognosis in general.  
     

    Maybe he has nodular lymphocyte predominant Hodgkin’s which is a terrible name and isn’t really Hodgkin’s at all.  

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  3. 8 hours ago, Larry T. Spider said:

    Friend went in for a procedure and tested positive. She’s been vaccinated, only around other vaccinated people, wears a mask, and has no symptoms. Went and got a second rapid test which was negative. She is waiting on the results of a pcr test that we also expect to be negative. I’m guessing she will still be reported as a Travis county positive case. Second and third tests were done by a different group.

    They need to STOP TESTING ASYMPTOMATIC VACCINATED PEOPLE!  This pre procedure testing actually go against CDC guidance

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  4. 9 hours ago, CooterBrown said:


    I thought that vaccinated folks could still get and transmit Covid. Is that not correct? There was someone upthread or on another thread who is vaccinated, got covid, and quarantined. Was there no need for that precaution?

    I think the data shows fairly convincingly that a vaccinated person who is asymptomatic is not generating enough viral load to transmit.  If you’re symptomatic, that may be another story.  
     

    So testing symptomatic folks:  fine.  If you test positive and have symptoms, then quarantine.  Vaccines only 95% effective at preventing symptomatic disease

    Testing asymptomatic people:  dumb

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  5. 18 hours ago, HouTex said:


    Well, my 91 year old father was fully vaccinated in mid February and got Covid in late April from a caregiver (we think but can’t be sure). He had no symptoms though and was only tested because he went to the hospital for other issues. So he was one of the new cases that day.

    New case numbers are interesting, but I’m mainly concerned about hospitalisation and ICU stats. Both are near the early April 2020 numbers in SE Texas. I’m guessing it’s the same throughout Texas.

    He didn’t get COVID.  “COVID” is the illness you get from the virus.

    He breathed in some SARS-COV2 virus.  But it didn’t make him sick.  Because he was vaccinated.  And his immune system kicked the shit out of the virus.  And they found dead virus pieces in his nose.  Which he can’t transmit to anyone.  Hospitals need to quit this dumbass policy of testing asymptomatic fully vaccinated individuals.  All his positive test tells you is that his vaccine WORKED.  

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  6. And to pile on the absolute shitty CDC messaging further...

    https://www.google.com/amp/s/news.yahoo.com/amphtml/cdc-exaggerating-risk-outdoor-covid-135958591.html

    Today they said that less than 10% of transmission occurs outdoors.  Thanks for that misleading stat assholes!  Outdoor transmission probably accounts for less than 0.0001% of transmission.  Maybe you’d like to tell us next how less than 50,000 swimmers die each year from shark attacks!

  7. 10 hours ago, Snake Diggity said:

    This is such a shitty, wrong comment.

     

    Pandemic ain’t over for the 100 people getting sick every day, or the 10-20 people getting put in the hospital every day.  And that is just in Austin.

    I think it’s a pretty fair comment.  Those getting sick and hospitalized are primarily the unvaccinated.  Most of them could have gotten a vaccine by now.  I drive by 3 places on my 10 minute drive in to work that advertise that they have free vaccines.  I tell my immune competent vaccinated patients that their personal pandemic is over.  If you want it to be over...get vaccinated .  

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  8. I like how vaccines are often presented as a useful “tool” against COVID.  Masks, distancing, hand hygiene are tools.  The vaccine is the SOLUTION.  
     

    If COVID is a grizzly charging at you, the vaccine is your shotgun.  Your other “tools” like masks, distancing are like a pointy stick and your fist.  

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  9. On 4/28/2021 at 9:30 AM, StruggleBus said:

    22 year old employee of mine has double pneumonia from covid right now. Frustrating because he chose to pass on the vaccine. I'm sure there will be thousands of people over the next year that get severe covid and will seriously regret not getting vaccinated. 

    At least it’s not triple or quadruple pneumonia.

    • Haha 1
  10. Just now, Heme Doc said:

    If Pfizer said “Hey HemeDoc, come back and participate in this trial for our new COVID vaccine booster”, I’d only say “Yes” if it were powered for clinical endpoints (not immunologic endpoints).  So half the participants get the booster and half get placebo and let’s see who gets more sick with more COVID.  

    Plus, this thing has been going on for over a year.  If immunity only lasts a year, then why aren’t we hearing more about all the re-infections and hospitalizations from people infected a year ago?  Very likely immunity lasts more than a year.   Your antibodies wane a bit over time but we know you’ve got your T cells and memory B cells at the ready to kick ass.  Antibodies are easy to measure but not the only part of the immune system

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  11. 18 hours ago, InkaUtexas said:

    Just saw this article. 

    Pfizer CEO says third Covid vaccine dose likely needed within 12 months

    Pfizer CEO Albert Bourla said Thursday people will “likely” need a booster dose of a Covid-19 vaccine within 12 months of getting fully vaccinated.

    He also said it’s possible people will need to get vaccinated against the virus annually.

    “It is extremely important to suppress the pool of people that can be susceptible to the virus,” he told CNBC’s Bertha Coombs during an event with CVS Health. He added the vaccines will be an important tool in the fight against highly contagious variants.

     

    https://www.cnbc.com/2021/04/15/pfizer-ceo-says-third-covid-vaccine-dose-likely-needed-within-12-months.html

    If Pfizer said “Hey HemeDoc, come back and participate in this trial for our new COVID vaccine booster”, I’d only say “Yes” if it were powered for clinical endpoints (not immunologic endpoints).  So half the participants get the booster and half get placebo and let’s see who gets more sick with more COVID.  

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  12. 1 hour ago, Brisketexan said:

    Skimmed some of that.   Do I read right that, to the extent that there is a issue here, it has solely presented in women under 50?  Thus....the solution could be to amend the EUA and/or guidance (however that is done) to allow use of J&J for men, and women over 50?  Or something like that?

    I think that would be a very reasonable response to the data we have

  13. 2 hours ago, washparkhorn said:

    Ana or anyone - what is causing the immune response to platelet factor 4 in the J&J vaccine? Do we know why some heparin patients develop the same/similar syndrome?

    Hey, I’m anyone!

    Its likely due to the immune system making antibodies against the viral vector for these vaccines (AZ and J&J) and then those antibodies cross react to platelet factor 4 and cause platelet activation (resulting in clots - not sure why the predisposition to clots in unusual locations like cerebral sinuses) and platelet aggregation resulting in thrombocytopenia.  I would treat the same as a patient with HIT (heparin induced thrombocytopenia) since the mechanism of disease seems the same.   I’d use an alternative anticoagulant like argatroban initially then transition to warfarin or maybe DOAC like Eliquis.  But what the hell do I know?  I’m just spitballing here

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  14. https://www.nytimes.com/2021/04/13/us/politics/johnson-johnson-vaccine-blood-clots-fda-cdc.html#click=https://t.co/NkjtHukwHQ
     

    Shit.  Not good.  A major mistake IMO

    I guess it’s time for ol HemeDoc to weigh in vis a vis the clotting and platelet issues surrounding the AZ vaccine and now maybe J&J...so let me wave something shiny in front of you monkeys.

    The AZ vaccine has reported a rare form of blood clots plus low platelets. ~60% involve veins of brain.  Almost all after 1st dose. 

    Risk from the UK is about 1 in 250,000 people

    Risk of dying: 20-25% of people with these clots have died

    Approximately half of the deaths in the UK (11 of 19) were under age 50. 

    The benefits of the AZ vaccine according to regulators appear to outweigh risks in all except those less than age 30.

    While blood clots occur at a certain rate in population what is unusual about these clots is the association with low platelets. Platelets help make blood clots & when platelets are low we are at risk of bleeding not clotting. 

    Low platelets in context of blood clots is unusual.  This type of combination of low platelets and blood clots occurs in patients exposed to heparin (HIT).  It can also occur with hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, and sometimes with antiphospholipid antibody syndrome.

    Emerging data suggest that the mechanism of the clots may involve antibodies generated (presumably by the vaccine - most likely the adenovirus vector) that target platelet factor 4 (PF4), similar to the process that happens in some people after exposure to heparin (HIT)

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