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Heme Doc

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Posts posted by Heme Doc

  1. 9 hours ago, troph said:

    cardiologist report - 98% certain my heart is fine (took another ekg reading) - said most of his patients come in with symptoms and don't have heart problems.  Last step with him is stress test with an echo in 10 days.  he said everything else after the heart muscle is ruled out is no biggie - pericarditis, pleurisy, muscle/skeletal, pinched nerve, stress/anxiety.  said he wasn't sure about my BP it was high but that could be from a lot of things including the physical distress, anxiety, being there, etc. so I'm supposed to monitor that.  bought a monitor and will have it tomorrow.  he did confirm they are seeing odd symptoms like mine after vaccines and he will want to explore that if the echo shows an issue.  said if the heart is ruled out and it goes away then no big deal. if it persists we can keep looking.  I told him I thought it was getting better, but then after I left I had a major episode again.  distressing like a mfer.

    Did cards discuss utility of cardiac MRI to help diagnose you?

  2. 21 minutes ago, Bozo_Casanova said:

    It's still anecdotal at this point, but the spread among school age kids in areas where B117 is becoming dominant and schools are well attended like Minnesota and Michigan is strongly indicative, according to Osterholm, Hotez and others. You're obviously in a better position to evaluate that claim than I am, but Osterholm has had a very good track record on this so far. 

    Thanks for the reply.  I think it’s highly likely B117 spreads more readily among kids (the same as adults) and I suspect we will get more data on this soon.  Hopefully the FDA will expand the Pfizer authorization to younger kids (ages 11-15) soon.  

  3. Time for a rant about shitty vaccine messaging...last week edition.

    Last week the CDC director made “controversial” comments that vaccinated people don’t carry/transmit the virus.  Then the CDC walked it back the next day and you got headlines from major media outlets like the NYT saying “Can vaccinated people carry the virus?  We don’t know, scientists say”

    Imagine if the NYT did the same article with the headline “Can masked people spread the virus?  We don’t know, scientists say”

    It would be anti-mask fodder!  Why is this same type of bad messaging allowed for vaccines?  Especially when vaccines are undoubtedly a metric fuck ton better than masks when it comes to ending this pandemic and protecting individuals and the population in general.

    When it comes to masks (which I wear without issue), the evidence is completely oversold for the sake of increased compliance (which I’m ok with), but the vaccine data is undersold without any thought to how this might affect uptake!  


    It must be communicated clearly.  Vaccines kick ass and  >>>>>>>>>masks (and other NPIs).  And vaccines do (though not quite 100%) stop transmission.  And once everyone has a chance to get vaccinated, mandatory masking can fuck right off (people can still mask if they choose)

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  4. 22 hours ago, Bozo_Casanova said:

    While brain geniuses debate whether the slope slips merely to the Soviet gulags in the 50s or all the way to Cambodia in 1977, the data is emerging that unlike the original variant, B117 spreads readily among and sickens schoolkids. 
    But sure, let’s just vaccinate the vulnerable and churn out more variants for freedom. 

    I’m genuinely interested in seeing data that suggests B117 variant causes more severe disease in kids (compared to ancestral strain) and spreads more easily in kids (compared to adults).  We know that B117 transmits more easily than the ancestral strain and probably causes more severe disease, but I haven’t seen anything specific to B117 in kids
     

    I think we should vaccinate everyone, even those not at risk of severe disease so we can really halt spread of this thing.  Current US vaccines work very well against B117, which is good since it’s quickly becoming the dominant strain.  

    • Like 2
  5. 6 hours ago, Borachio said:

    I thought you guys would be interested in this.  I am in the Moderna trial and had my second dose the 3rd week of September.  Two weeks after my second dose I had a spike protein antibody test done at the lab I work at.  (Euroimmun ELISA test for the qualitative determination of IgG antibodies to the S1 domain of the spike protein, for you medical types.)

    A result value greater than 1.09 is positive, below is the reference range.

    Back in Oct., two weeks after my second dose, my result value was 8.99, which was flagged as high.  I had the same test done 2 days ago, 6 months after being "fully vaccinated" and my result value is now 6.88, which is still being flagged as high.  It only dropped 2 points in 6 months!  Is that good?  That seems good.   I'm a 43 year old male for reference.

    That doesn't even include the T Cells waiting inside the castle to kick some butt if needed.   Yay science!

    Interpretation:
    Ratio <0.8 Negative
    Ratio 0.8-1.09 Borderline
    Ratio >1.09 Positive

    Very nice!

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  6. 39 minutes ago, GreenspointTexas said:

    Nevermind the fact that you had to dig a few weeks back to get to that post but what you quoted me saying does not contradict what Anastasis is saying. Of course vaccines decrease transmission. There still isnt enough evidence at this point to know whether they completely stop asymptomatic transmission (they likely wont ever completely “stop” it). CDC says the same and still advocates wearing a mask. No reason AT THIS TIME to tell people who are vaccinated to stop wearing masks. 

     

    With less than 15% of the population vaccinated, I have no clue why someone wouldnt wear a mask in public at this point. When we have 70% of the population vaccinated, its a different conversation. 
     

    We still arent at the point of “Im vaccinated, goodbye masks forever!” As much as yall hate wearing masks for a few minutes out of your day, its really best to continue wearing them until more are vaccinated

     

    https://www.cdc.gov/coronavirus/2019-ncov/more/fully-vaccinated-people.html

    Agree with this.

    Vaccines stop transmission, although not 100%.  So until more folks vaccinated we need to continue to be cautious.  

  7. 22 hours ago, XYZ said:

    So, do these mRNA covid vaccines prevent transmission of the virus or not? Why isn’t this known yet? Or is it known but they don’t want to spill the beans? Like, if it does prevent transmission, then vaccinated people can stop all of this social distancing stuff three weeks after getting the vaccine. If, on the other hand, it doesn’t prevent transmission, then we are kind of fucked.

    1.  Yes.  They absolutely do

    2.  It is known.  Just not reported on as much.  Here’s some recent data from Israel

    https://www.nejm.org/doi/full/10.1056/NEJMoa2101765

    and Mayo Clinic

    https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab229/6167855

    They do prevent transmission.  Nothing is fucked here, dude.  

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  8. 6 hours ago, midtown said:

    As I've said before.  Can the CDC and other experts talk about this?  Or should we just continue to tell people science sucks and we have to wear masks for ever.

     

    https://abcnews.go.com/Health/pfizer-vaccine-shows-94-effectiveness-asymptomatic-transmission-covid/story?id=76389615

     

    It’s fucking maddening and infuriating.  

    Lots of data now showing that this vaccine is really good at preventing infection...period.  Not just symptomatic infection.  And if you can’t get it, how the fuck are you going to spread it?  Then why do you need to wear a fucking mask?  I’ll wear a mask if you want me to.  But right for me, a vaccinated person, the mask probably does as much to protect me as wearing a monacle.  At least the CDC said vaccinated people don’t need to wear masks or distance when around other vaccinated individuals 

    My office mandates masks in everyone entering the building (obviously).  Like 80% of my patients in clinic have already been fully vaccinated.  Both me and the patient still wear masks in the room.   I leave the patient room and then go back to the nurses area to shoot the shit with my partners and nurses (all vaccinated).  We all take our masks off.  

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  9. 4 hours ago, Anastasis said:

    @Heme Doc, what are your thoughts about getting a quantitative S antibody test to confirm sufficiency of immune response?  

    It’s a good idea in principle.  And labs now carry it.  But the question I don’t know the answer to is:  What level of antibody is associated with protection from infection?  
     

    So you could get the test and find that you’ve got antibodies which would make you feel really safe, especially if at high levels.  I haven’t taken the test personally but definitely thought about it.  Would be interested to know my titers now 6 months after my 2nd Pfizer shot
     

     

    • Hook 'Em 1
  10. 18 hours ago, Pato del Muerto said:

    My county health officer posted the following:

    https://www.biorxiv.org/content/10.1101/2021.02.27.433180v1?fbclid=IwAR29LFoenLjZWkl8MpJJfwiNrwYylHshGj1ynf-leD7vHAa-uQiPepEJHC0
     

    I didn’t read it yet but his synopsis is that 1) it’s not yet peer reviewed, and 2) it shows that the vaccines provide cell mediated immunity that is effective against the known variants, even though antibody production is not. 
     

    docs care to comment?

    I’ll bite...

    This study is very reassuring and well done.  Even if antibodies to COVID wane over time or the virus mutates where your antibodies are less effective, you’ve still got your T cells primed to kick ass and they don’t care as much about how the virus has changed.  

    Think of your antibodies like the castle gate.  They protect you from the virus getting in but the virus may figure out a way around that.  But your T cells are like the army waiting behind the gates in case it gets through and still whip its ass.  

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  11. 9 hours ago, midtown said:

    What I find so confusing is with this type of data continuing to emerge is why the talking heads continue to predict doom for years.  I get why the media does it but at some point someone has to start to talk about the good news and give pandemic fatigued people some hope.    I am pro rules, pro mask but to keep throwing out the "masks forever" is just dumb with this kind of data.   Either we believe in the science and the glory of these vaccines or we don't.  We are already fighting the anti-vax morons why give them more ammo?

    Oh and FDA released JNJ results.   Solid. 

    Totally agree.  The vaccines are awesome and there’s no benefit to keep acting like they’re not.  Paper from NEJM today shows Pfizer vaccine in Israel reduced asymptomatic infections by 90% one week and beyond 2nd dose.  Symptomatic infections at that point were basically nil.

    https://www.nejm.org/doi/full/10.1056/NEJMoa2101765?query=featured_home

    Fuck the masks forever crowd.  Vaccines are coming for you.  

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  12. 11 hours ago, Anastasis said:

    Cross posting to this thread cause more relevant. Get shots in arms. 

    https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3790399 

    Methods: The SIREN study is a prospective cohort study among staff working in publicly funded hospitals. Baseline risk factors, vaccination status (from 8/12/2020-5/2/2021), and symptoms are recorded at 2 weekly intervals and all SARS-CoV-2 polymerase chain reaction (PCR) and antibody test results documented. A mixed effect proportional hazards frailty model using a Poisson distribution was used to calculate hazard ratios to compare time to infection in unvaccinated and vaccinated participants to estimate the impact of the BNT162b2 vaccine on all (asymptomatic and symptomatic) infection.

    Findings: Vaccine coverage was 89% on 5/2/2021. Significantly lower coverage was associated with prior infection (aOR 0.59 95% confidence interval [CI] 0.54-0.64), female (aOR 0.72, 95% CI 0.63-0.82), aged under 35 years, being from minority ethnic groups (especially Black, aOR 0.26, 95% CI 0.21-0.32), porters/security guards (aOR 0.61, 95% CI 0.42-0.90),or midwife (aOR 0.74, 95% CI 0.57-0.97), and living in more deprived neighbourhoods (IMD 1 (most) vs. 5 (least) (aOR 0.75, 95% CI 0.65-0.87). A single dose of BNT162b2 vaccine demonstrated vaccine effectiveness of 72% (95% CI 58-86) 21 days after first dose and 86% (95% CI 76-97) seven days after two doses in the antibody negative cohort.

    Conclusion: Our study demonstrates that the BNT162b2 vaccine effectively prevents both symptomatic and asymptomatic infection in working age adults; this cohort was vaccinated when the dominant variant in circulation was B1.1.7 and demonstrates effectiveness against this variant.

    Thanks for posting.

    I also want to point out that this showed 86% effectiveness of the Pfizer vaccine to prevent ALL infection (not just symptomatic) one week after the 2nd dose.  These folks were all getting every 2 week PCR swabs and every month antibody tests.    So that means AT LEAST 86% reduction in transmission (if you can’t get it, you can’t transmit it), which is fantastic. 

    • Like 1
  13. 22 hours ago, Liquor and Poker said:

    So my wife just read a Q&A with a doctor where someone asked “Everyone in my family has had both shots. Can we all get together?”  And the doctor said “no because we just don’t know.” WTF?

    That doc is a fucking dumbass

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