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COVID-19 vaccine discussion


Texas Jeff

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2 hours ago, JimmyJames said:

It is way past time to stop catering to these anti-vaxxer idiots. If you don’t have the vaccine you don’t get on the plane. If you don’t have the vaccine and don’t have a medical excuse you’re fired. If you don’t have the vaccine you don’t get to go to restaurants, cruises, concerts, bars, etc. And when the vaccine is authorized for under 12, you don’t have the vaccine little Johnny doesn’t get to go to a public school.  Same as many other vaccines that are not politicized. 
 

Fuck these people. Because while it’s bad now it is very likely to get much worse this fall and winter. 

All that, plus a healthcare premium surcharge of roughly 10k/year per unvaccinated person who wants the rest of the insurance pool to pay for their personal choices.  
 

And hospitals should double the bills of the unvaccinated and give the money to all the housekeepers, clergy, cafeteria workers, and nurses — who are quitting instead of being needlessly put in harm’s way with no end in sight.  

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1 minute ago, Surly Bevo said:

Yea I guess those really smart motherfuckers that researched, studied and developed a vaccine that means you don't have to die just wasn't part of the plan.

Intellect is a tool of the devil. Snake under the tree of good and evil shoulda told ya.

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1 minute ago, Surly Bevo said:

If I die it's because God wanted me home....LOL.  Yea I guess those really smart motherfuckers that researched, studied and developed a vaccine that means you don't have to die just wasn't part of the plan.

Or you know maybe all the years of people confronted with the massive dumb in the world around them saying, "we could use a good plague" is what god is really trying to work with here and a lot of us are fucking up his attempt to answer those prayers by trying to talk sense into people

I suppose I could go play in traffic or jump out of an airplane sans fall arresting device and whether I live or die is God’s will. 
 

if you go and get the vaccine, would that retroactively have been God’s will since it happened?

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17 minutes ago, Surly Bevo said:

Or you know maybe all the years of people confronted with the massive dumb in the world around them saying, "we could use a good plague" is what god is really trying to work with here and a lot of us are fucking up his attempt to answer those prayers by trying to talk sense into people

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15 hours ago, Victor Lazlo said:

That’s not what the discussion was about.

It was about the 1% of previously infected that got a reinfection.

And that a vaccine would mitigate that 1% by a factor of 60%. 

Intuitively this is correct but you are using data on absolute risk from one study and laying that on the new study showing relative risk for reinfection in vaccinated  vs unvaccinated. I looked for but could not find absolute risk for the subgroups in the new study. But I agree given what we know from published absolute risk of reinfection, the number needed to treat for a relative risk of 1.5 to result in a clinically significant reduction in reinfection is huge

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31 minutes ago, Muy Frio said:

Moving on from natural immunity discussion. a little outside perspective. 

 

It's a concern in the USA because there's a bunch of chuds fighting every possible public health measure on the basis of MUH FREEDUM. Half the country's leadership is still actively downplaying the virus and putting ANTI-public health measures in place.

And there's also a small army of people out there spreading disinformation thats being echoed by said anti-public health political leaders

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2 hours ago, Paul Wesley said:

All that, plus a healthcare premium surcharge of roughly 10k/year per unvaccinated person who wants the rest of the insurance pool to pay for their personal choices.  
 

And hospitals should double the bills of the unvaccinated and give the money to all the housekeepers, clergy, cafeteria workers, and nurses — who are quitting instead of being needlessly put in harm’s way with no end in sight.  

I fully expect the insurance companies to start asking for proof of vaccination.  They already inquire about tobacco use.  

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I

1 hour ago, Captainant said:

It's a concern in the USA because there's a bunch of chuds fighting every possible public health measure on the basis of MUH FREEDUM. Half the country's leadership is still actively downplaying the virus and putting ANTI-public health measures in place.

And there's also a small army of people out there spreading disinformation thats being echoed by said anti-public health political leaders

I clicked that link, and the anti-maskers were all over some idiotic woman talking about there isn't evidence to support kids wearing masks.   Sigh.  Her post spawned another thread of stupidity with a crowd cheering them on and sharing their stupid.   

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21 minutes ago, dcbc said:

I fully expect the insurance companies to start asking for proof of vaccination.  They already inquire about tobacco use.  

I hope they do. And if you can’t show proof of vaccination your insurance rates skyrocket.
 

That’s how it works. You can smoke or dip if you want to, and as a result you get to pay more for insurance. 

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3 hours ago, JimmyJames said:

I hope they do. And if you can’t show proof of vaccination your insurance rates skyrocket.
 

That’s how it works. You can smoke or dip if you want to, and as a result you get to pay more for insurance. 

You are proposing to make people of color second class citizens. 

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11 minutes ago, Pato del Muerto said:

What do you think that screenshot is saying?

Yeah it's MSNBC should've known. Boomer status unlocked. 😵

 

Anyway grab the real stats and let's have a look. Seeing lots of different conflicting things.

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10 minutes ago, PenelopeWitherspoon said:

Then they need to get the vaccine.  It is available for free.  They are choosing to be second class citizens.

Johnson and Johnson right now is getting their asses sued off for targeting blacks with baby powder ads, when they knew the baby powder caused cancer.

Also, isn't natural immunity from getting though covid something to consider? Those antibodies are broad and robust. 

Also soon there should be some great data starting to come out about (almost) fully vaccinated countries like the UK and Iceland. 

Maybe wait for the data and studies to come to a conclusion before having separate drinking fountains ;)

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9 minutes ago, EE2B said:

This was posted by an ER doc from a local hospital:

I have been mostly silent on the COVID surge but I feel it’s a duty and responsibility for healthcare professionals to report what we are seeing and confront some of the unbelievable and irresponsible mis-information out there.

This is long and reflects many opinions and observations. Those opinions and observations are mine and mine alone and do not reflect upon any healthcare institution or governmental agency. I admit that I did not consider Facebook memes or posts by non-healthcare workers, nor conspiracy websites in formulating my opinions. My opinions are based on possessing an actual medical degree and board certification as well as over 30 years of medical experience (28 of which have been in Emergency Medicine).

Hospitals in Texas, Louisiana, and Arkansas (as well as many other areas) are overwhelmed with COVID cases right now. Of the COVID, about 75% is delta variant.

Delta is much more contagious than the previous strains were. Sadly, the majority of the really sick people I have been seeing are presenting 7 to 10 days AFTER diagnosis and after failing “treatments” that don’t work such as Rocephin, Zithromax, Levaquin, Augmentin, and the ever-present and thoroughly debunked hydroxychloroquine emoji849.pngemoji849.png all prescribed by folks who apparently do not understand what a virus is. (The jury is still out on ivermectin…. I personally do not believe it works, but there is some junk science saying it does. You can judge for yourself). In my opinion, if your PCP is treating you with antibiotics or hydroxychloroquine for the COVID virus, you need a new PCP. A concomitant bacterial pneumonia with COVID (which is a viral pneumonia) in the outpatient setting is exceedingly rare and the risk vs benefit ratio on hydroxychloroquine isn’t a debate anymore.

The relevance of the time course I am frequently seeing from diagnosis to severe illness is important because by that time, people are out of the window for monoclonal antibody therapy which was in my opinion (including my own personal experience) beneficial for non-delta COVID. This means there isn’t a lot we have to offer unless you’re critically ill.

There seems to be a misconception about what this COVID surge and hospital capacity means to the average person. First of all, when the COVID units and the hospital beds are full, admitted patients back up into the ER waiting on beds to open up. This occupies ER beds and ER nurses and leaves sick patients in the lobby with no where to put them and few staff members to take care of them. Only the most critical people can be seen. This doesn’t mean urgent cases, this means critical. Sadly, this means that your kid’s broken arm, won’t be seen quickly and you will have to wait. We don’t like it either, but it’s reality right now. Second, when tertiary referral centers are full (which they are), they refuse transfers for sub-specialty care (which they are). So, if you (or your family) develops a condition (including serious trauma) that a community hospital can’t manage, you may be held at a hospital that can’t take adequate care of you because there is nowhere to send you (yes, this is happening).

During the previous surge of COVID, several things were different than they are now:

1) VOLUME: Patients stayed home and didn’t come to hospitals. So hospitals saw far fewer patients than normal and only the sickest patients came. Volumes are now back close to pre-COVID levels.

2) STAFFING: Before, both state and federal agencies paid for and sent staff (nurses, techs, respiratory therapists) to hard hit areas to help. Healthcare workers were offered very good money to travel and those who could left in droves. These assistances are largely no longer available and hospitals and ERs are having tremendous staffing trouble.

3) CURVE: Lots of misconceptions surrounded the “flattening the curve” terminology. It was not an attempt to eradicate COVID. It was an attempt to spread out the infections over time so that the health care system was not overwhelmed. With the re-opening of our society and few people masking, we are seeing a surge like we did not see before. We’re seeing the spike that was feared and somewhat mitigated before.

4) FATIGUE: As health care workers, we are tired. We are short-staffed, overwhelmed, over-worked, and we are tired of getting yelled at and complained about when we are barely holding things together. This is leading to attrition of personnel which only compounds the problem. If you’re in the ER or the hospital, you may not get your drink or your warm blanket in a timely manner while we are off tending to critical patients. If you’re there for non-urgent issues, attention, or hypochondria, we’re probably not gonna be very accommodating. Recognize that the people there working are doing the best they can during some very challenging times. If you’re our priority at any given moment, you’ve got problems!

As for the vaccine:

1) This was developed and encouraged under the Trump administration and continues to be encouraged by the Biden administration. It is NOT a political issue.

2) The vaccine is NOT “experimental”. The technology used to create the vaccine has existed for years and was developed in order to allow rapid creation of vaccines for just such a scenario. The vaccine was tested on thousands and determined to be safe before release. True, it was rushed to market due to the circumstances and true, we aren’t certain there will be no long term effects but it is doubtful there will be any.

3) The vaccine DOES provide protection against delta variant. I have personally not seen a single COVID patient who has been immunized and I have seen and admitted a lot of COVID patients recently. When last I checked, our hospital did not have a single admitted COVID patient who was immunized. I do know of people who have gotten sick and provider stories of vaccinated patients with COVID, but the overwhelming data shows that these folks have a mild illness. Of the COVID deaths during this surge, a tiny fraction (less than 1%) have been fully immunized.

4) People getting COVID even though vaccinated isn’t unexpected or unusual. NO vaccine is 100% effective. This is NOT a logical reason not to be vaccinated.

5) There are NOT large numbers of people having severe reactions to the vaccine. Don’t be misled by isolated cases and propaganda. As with any medication or vaccine, there will be side effects in a small number of people and even death in a tiny fraction. In medicine, we always consider risk versus benefit for any therapy. To make an analogy here, every year there are people injured and killed BECAUSE they were wearing a seat belt. But a vast majority more are saved from serious injury by the belt. Using the small number of people harmed by the belt as justification not to wear it is illogical.

6) There is so much misinformation out there about the vaccine that it is hard for non-medical people to separate the facts from the fiction. Consider that the overwhelming majority of healthcare experts support the vaccine and we have NO agenda to promote it. We are not paid to promote it. We are making our recommendations based on understanding the effects of a pandemic and understanding the science behind the vaccine, as well as our own observations. There is some extremely crazy (and frankly downright stupid) stuff out there quoted by lay people with a Facebook medical degree. Before you make a decision about the vaccine, consider all of the information you can find and consider the credentials of those who are making the recommendations. Please do your research with an open mind and don’t look for and consider only sources that agree with your a priori opinion.

I have long tired of the statements that masks don’t work promoted by folks who don’t want to wear one. Of course they work. They are also not harmful to your health. (If they were, surgeons and OR nurses would have been dying off for years.) I would point out that this last winter because of masks, social distancing, & sanitizing, we saw very very few cases of flu and RSV (like COVID, these are also viruses). As soon as masks started coming off, we began to see large numbers of cases of RSV in children. In 30 plus years of medical practice, I have NEVER seen a summer outbreak of RSV. In addition, I would point out that shortly after mask mandates ended, the COVID surge began. Clearly, they did work. Like anything else, masks weren’t 100% effective but that doesn’t mean they were ineffective.

To be clear, I am not advocating closing our society again, mask mandates, or mandatory immunization. But I think if more people believed those of us on the front lines and paid attention to what is happening right now and listened to reputable authorities on vaccines and masks, maybe we could mitigate the current situation without those mandates returning.

Those of us in healthcare are not lying to you or trying to misconceive you. We have NO incentive to do that. This is not a conspiracy or attempt to control your behavior or inject you with trackers or alter your DNA. That is completely illogical and frankly crazy. The virus isn’t and never was political. The virus is some RNA floating around out there surrounded by spike proteins that are neither red or blue.

Those of us on the front lines of healthcare have no agenda except to keep you and your family safe and healthy. Please take heed and if nothing else, please stop calling us liars, conspirists, and reactionaries. To my observations, the current hysteria is coming from the anti-COVID, anti-vaccination crowd. We are merely reporting what we’re seeing and what we have concluded based on knowledge, training, and expertise.

PS: calling an ambulance for non-emergent issues will NOT get you seen faster. If you are less ill than those waiting in the lobby, you will be sent to the lobby to get in line.

If you have managed to make it this far through my musings, thank you for your consideration.

Curious about Ivermectin. They pass it out in India for COVID along with zinc.

Pfizer is coming out their their own similar treatment

https://www.pfizer.com/news/press-release/press-release-detail/pfizer-initiates-phase-1-study-novel-oral-antiviral

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1 minute ago, Zeus said:

Curious about Ivermectin. They pass it out in India for COVID along with zinc.

Pfizer is coming out their their own similar treatment

https://www.pfizer.com/news/press-release/press-release-detail/pfizer-initiates-phase-1-study-novel-oral-antiviral

Zinc helps stop viruses from replicating early in infections. Ivermectin is an antiparasitic with no known application for viruses. People are grasping at straws with ivermectin.

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18 minutes ago, Zeus said:

Curious about Ivermectin. They pass it out in India for COVID along with zinc.

Pfizer is coming out their their own similar treatment

https://www.pfizer.com/news/press-release/press-release-detail/pfizer-initiates-phase-1-study-novel-oral-antiviral

How is Pfizer's protease inhibitor similar to Ivermectin? Is it similar in structure? Is it a similar mechanism of action? BTW, the Pfizer early data is promising.

Here is the link to the clinical trial: https://clinicaltrials.gov/ct2/show/NCT04960202

Here is the link to the description of the drug: https://cen.acs.org/acs-news/acs-meeting-news/Pfizer-unveils-oral-SARS-CoV/99/i13

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12 minutes ago, Schulz2.0 said:

Zinc helps stop viruses from replicating early in infections. Ivermectin is an antiparasitic with no known application for viruses. People are grasping at straws with ivermectin.

This study indicates there is some benefit from ivermectin.

Quote

Conclusion

Two doses of oral ivermectin (300 μg/kg/dose given 72 hours apart) as chemoprophylaxis among HCWs reduced the risk of COVID-19 infection by 83% in the following month. Safe, effective, and low-cost chemoprophylaxis has relevance in the containment of pandemic alongside vaccine.

 

https://www.cureus.com/articles/64807-prophylactic-role-of-ivermectin-in-severe-acute-respiratory-syndrome-coronavirus-2-infection-among-healthcare-workers

 

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5 minutes ago, unoriginal said:

Scholarly Impact Quotient™ (SIQ™)

Scholarly Impact Quotient™ (SIQ™) is our unique post-publication peer review rating process. SIQ™ assesses article importance and quality by embracing the collective intelligence of the Cureus community-at-large. All registered users are invited to contribute to the SIQ™ of any published article. (Authors cannot rate their own articles.)

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22 minutes ago, Bevo said:

How is Pfizer's protease inhibitor similar to Ivermectin? Is it similar in structure? Is it a similar mechanism of action? BTW, the Pfizer early data is promising.

Here is the link to the clinical trial: https://clinicaltrials.gov/ct2/show/NCT04960202

Here is the link to the description of the drug: https://cen.acs.org/acs-news/acs-meeting-news/Pfizer-unveils-oral-SARS-CoV/99/i13

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996102/

Results: Ivermectin was found as a blocker of viral replicase, protease and human TMPRSS2, which could be the biophysical basis behind its antiviral efficiency.

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50 minutes ago, Zeus said:

Johnson and Johnson right now is getting their asses sued off for targeting blacks with baby powder ads, when they knew the baby powder caused cancer.

Also, isn't natural immunity from getting though covid something to consider? Those antibodies are broad and robust. 

Also soon there should be some great data starting to come out about (almost) fully vaccinated countries like the UK and Iceland. 

Maybe wait for the data and studies to come to a conclusion before having separate drinking fountains ;)

Maybe you should read the shit about Delta.  Delta doesn't fucking care if you have already been infected.  Get the fuck out of here.

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8 hours ago, Paul Wesley said:

All that, plus a healthcare premium surcharge of roughly 10k/year per unvaccinated person who wants the rest of the insurance pool to pay for their personal choices.  
 

And hospitals should double the bills of the unvaccinated and give the money to all the housekeepers, clergy, cafeteria workers, and nurses — who are quitting instead of being needlessly put in harm’s way with no end in sight.  

need to do this for fat people, smokers, drug users, vapers also.  agree that 10K per year should cover it.

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The UK upgraded the risk of Delta July 23 due to an increased chance of re-infection over Alpha.

At least equivalent CFR to Alpha, but they have low confidence in that number due to a small sample. 

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1005395/23_July_2021_Risk_assessment_for_SARS-CoV-2_variant_Delta.pdf 

 

Public Health England is widely being cited as saying Delta is 46% more likely to re-infect previously infected than Alpha, but I can't actually find where it's written in their reports, so take it with a grain of salt for now just in case. 

https://www.standard.co.uk/news/uk/delta-public-health-england-jenny-harries-india-kent-b947397.html

https://www.theguardian.com/world/2021/jul/23/phe-upgrade-delta-variants-risk-level-due-to-reinfection-risk

 

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1 hour ago, Pods said:

The UK upgraded the risk of Delta July 23 due to an increased chance of re-infection over Alpha.

At least equivalent CFR to Alpha, but they have low confidence in that number due to a small sample. 

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1005395/23_July_2021_Risk_assessment_for_SARS-CoV-2_variant_Delta.pdf 

 

Public Health England is widely being cited as saying Delta is 46% more likely to re-infect previously infected than Alpha, but I can't actually find where it's written in their reports, so take it with a grain of salt for now just in case. 

https://www.standard.co.uk/news/uk/delta-public-health-england-jenny-harries-india-kent-b947397.html

https://www.theguardian.com/world/2021/jul/23/phe-upgrade-delta-variants-risk-level-due-to-reinfection-risk

 

I agree with you that we need better data to draw firm conclusions.

We don’t know their baseline that they used to determine that Delta is 46% more likely to reinfect.

Those articles that you posted clearly state that “Reinfections remain a rarity though, accounting for only 1.2% of the 83,197 cases analyzed.”

If, as cited in the articles that you posted, reinfection rates are 1.2%, then they may have started with a baseline of .77% with Alpha to arrive at the 1.2% after a 46% increase.

But, as you say, take it with a grain of salt. I agree with you that we need better data, and more time to analyze the data to understand what is going on.

The articles that you posted also state that, from June 21 to July 19, 30% of COVID patients admitted to the hospital in England had been fully vaccinated.

That doesn’t seem good. Hopefully our vaccines are better than their Oxford vaccine  

 

 

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