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Covid II: Medical Info and Implications


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9 hours ago, The Nehor said:

A friend's brother is in an ICU on a ventilator. Almost did not get one. If he had not had a cousin that worked in one of the hospitals he may not have. This was in El Paso which has a very disproportionately high number of the cases in Texas.

My friend's dad was careflighted to a Houston. A close relative has just entered the ICU in Dallas.

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On 11/13/2020 at 12:59 PM, strappinglad said:

Masks and glasses are problematic. My glasses fog up .That tells me I am losing breath out the top and probably the sides of my mask, which is one of those accordian style masks. I find , however , if I pull the glasses lower down on my nose, they don't fog up. So what if I look like an old grandpa. That is what I am. ! 

Have you tried the bandaid trick?  I have some family that claims it works, but I haven't tried it since I don't wear glasses.

https://www.health.com/condition/infectious-diseases/coronavirus/how-to-prevent-glasses-from-fogging-with-mask

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47 minutes ago, rodheadlee said:

So what are we waiting for? When are we going to get the vaccine? I thought we were worried about people dying?

Very soon, it was announced this morning on the national news, it could be days. Thanks to the help from others I hear, Dolly Parton donated 1 million to help get the vaccine going! So cool!!

Edited by Tacenda
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1 hour ago, rodheadlee said:

So what are we waiting for? When are we going to get the vaccine? I thought we were worried about people dying?

Probably a whole lot of things.  Something of this magnitude and nature takes a lot of organization and infrastructure.

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19 minutes ago, Rain said:

Probably a whole lot of things.  Something of this magnitude and nature takes a lot of organization and infrastructure.

I thought we had a head start on the organization and infrastructure with operation warp speed? I  certainly hope it's not political stalling. 

Edited by rodheadlee
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35 minutes ago, rodheadlee said:

I thought we had a head start on the organization and infrastructure with operation warp speed? I  certainly hope it's not political stalling. 

They are still finishing trials. The infrastructure should be in place. States were asked to have their plan ready by the end of October. Production of the vaccine takes some time so the first doses will go to the elderly who are most at risk and healthcare workers. This information was required to be submitted by Nov. 1. 

"That timeline depends on the Massachusetts-based biotech firm getting positive results next month from its late-stage clinical trial of the vaccine, Bancel said during a Wall Street Journal conference on Monday.

Moderna will analyze how well the vaccine is working when 53 people in its Phase 3 study develop symptomatic cases of COVID-19, the Journal reported. That analysis is expected to take place in November, though the exact timing is tough to predict “because it depends on the cases, the number of people getting sick,” Bancel said.

The company also expects to have enough data on the vaccine’s safety in late November, Bancel said. The US Food and Drug Administration could decide whether to grant an emergency use authorization for the shot in December if Moderna submits an application soon after reaching that safety milestone, according to the Journal."

 

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This controversial study came out  https://www.acpjournals.org/doi/10.7326/M20-6817

The recommendation to wear surgical masks to supplement other public health measures did not reduce the SARS-CoV-2 infection rate among wearers by more than 50% in a community with modest infection rates, some degree of social distancing, and uncommon general mask use. The data were compatible with lesser degrees of self-protection.

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13 hours ago, Rain said:

@pogi  someone on my facebook says Utah is so overwhelmed that the health department is only contacting "immediate household members" of those who test positive for covid.  She says it is "stupid" because "if someone tested positive in my household we would already know."  

She lives near Park City.  She is not fighting against covid prevention.  She is just confused why these are the people contacted and not others.

Do you know anything about this? 

Actually, we are not even doing that any more.  She is right to be concerned, but she is wrong in her understanding of the scope of what we do.  When I first started tracing, we were calling all close contacts (work, social, home, etc.) back 7 days before symptom onset.  As numbers grew we scaled back to only calling close contacts within 2 days of symptom onset.  As numbers continued to grow, we only called household contacts.  Now, we are only calling positive cases directly, and we are implementing what we call a "shared responsibility model".  We are only gathering household information (not contacting them) and educating the index case to call anyone they have had close contact with within 2 days of symptom onset to inform them of potential exposure, etc.  We educate that their household needs to be on quarantine and leave it up to the index case to educate their household about quarantine.  This is what happens when numbers spiral out of control and we simply don't have the manpower to do extensive contact tracing.  We are constantly hiring and can't seem to get on top of the surge.    If we find out that an index case has had an exposure at their work place, we do have a workplace team that reaches out and works directly with work places.  If we find that a student had an exposure at school, we have school liaisons.  We also have teams who work with congregate settings such as, prisons, long term care facilities, etc.  So, it is not exactly true that we are limiting our efforts to the household, but we have indeed put some of the responsibility on the shoulders of the public to make their own calls and educate about social contacts and families, etc.  It is not ideal, but we are hoping people step up and take personal responsibility for the spread of this disease because with these numbers, it is simply not feasible for the County to contact every index case + the dozens of contacts they may have had.  We have over 150 contact tracers now, and we started out with only a dozen or so.    

 

 

 

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Good news. 

https://www.nytimes.com/2020/11/17/health/coronavirus-immunity.html?campaign_id=9&emc=edit_nn_20201118&instance_id=24215&nl=the-morning®i_id=76596540&segment_id=44791&te=1&user_id=b398c07e23a82bbf5ca09b57e179e996


 

"How long might immunity to the coronavirus last? Years, maybe even decades, according to a new study — the most hopeful answer yet to a question that has shadowed plans for widespread vaccination.

Eight months after infection, most people who have recovered still have enough immune cells to fend off the virus and prevent illness, the new data show. A slow rate of decline in the short term suggests, happily, that these cells may persist in the body for a very, very long time to come.

The research, published online, has not been peer-reviewed nor published in a scientific journal. But it is the most comprehensive and long-ranging study of immune memory to the coronavirus to date.

“That amount of memory would likely prevent the vast majority of people from getting hospitalized disease, severe disease, for many years,” said Shane Crotty, a virologist at the La Jolla Institute of Immunology who co-led the new study."

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17 minutes ago, pogi said:

Actually, we are not even doing that any more.  She is right to be concerned, but she is wrong in her understanding of the scope of what we do.  When I first started tracing, we were calling all close contacts (work, social, home, etc.) back 7 days before symptom onset.  As numbers grew we scaled back to only calling close contacts within 2 days of symptom onset.  As numbers continued to grow, we only called household contacts.  Now, we are only calling positive cases directly, and we are implementing what we call a "shared responsibility model".  We are only gathering household information (not contacting them) and educating the index case to call anyone they have had close contact with within 2 days of symptom onset to inform them of potential exposure, etc.  We educate that their household needs to be on quarantine and leave it up to the index case to educate their household about quarantine.  This is what happens when numbers spiral out of control and we simply don't have the manpower to do extensive contact tracing.  We are constantly hiring and can't seem to get on top of the surge.    If we find out that an index case has had an exposure at their work place, we do have a workplace team that reaches out and works directly with work places.  If we find that a student had an exposure at school, we have school liaisons.  We also have teams who work with congregate settings such as, prisons, long term care facilities, etc.  So, it is not exactly true that we are limiting our efforts to the household, but we have indeed put some of the responsibility on the shoulders of the public to make their own calls and educate about social contacts and families, etc.  It is not ideal, but we are hoping people step up and take personal responsibility for the spread of this disease because with these numbers, it is simply not feasible for the County to contact every index case + the dozens of contacts they may have had.  We have over 150 contact tracers now, and we started out with only a dozen or so.    

 

 

 

Thanks.   I figured there was more to it.   Do you mind if I share this on her post?

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16 minutes ago, strappinglad said:

And we wonder why the public is confused?

All the mask studies of airborne viruses before Covid showed little to no help with surgical/cloth mask wearing. I was for trying masks and using them if they help at all. Why not? We had such limited information about this disease. I view the recent spikes across the globe where mask wearing has been taking place, as a sign that the original studies were most likely true. If we all wore N95, masks would help more. In Korea the mask of choice is a KF94 which are equivalent in many ways to the N95. Better masks would help more but the way Americans are currently wearing masks and the mask they are using, it is becoming obvious these masks are not going to stop the spread of this disease. Does it slow it down at all, I think the evidence is showing not really.

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1 hour ago, juliann said:

This controversial study came out  https://www.acpjournals.org/doi/10.7326/M20-6817

The recommendation to wear surgical masks to supplement other public health measures did not reduce the SARS-CoV-2 infection rate among wearers by more than 50% in a community with modest infection rates, some degree of social distancing, and uncommon general mask use. The data were compatible with lesser degrees of self-protection.

"The between-group difference was −0.3 percentage point (95% CI, −1.2 to 0.4 percentage point; P = 0.38) (odds ratio, 0.82 [CI, 0.54 to 1.23]; P = 0.33). Multiple imputation accounting for loss to follow-up yielded similar results. Although the difference observed was not statistically significant, the 95% CIs are compatible with a 46% reduction to a 23% increase in infection."

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Pfizer will be applying for 'emergency use' within days.

https://www.nytimes.com/2020/11/18/health/pfizer-covid-vaccine.html?smid=tw-share

"The drug maker Pfizer said on Wednesday that its coronavirus vaccine was 95 percent effective and had no serious side effects — the first set of complete results from a late-stage vaccine trial as Covid-19 cases skyrocket around the globe.

The data showed that the vaccine prevented mild and severe forms of Covid-19, the company said. And it was 94 percent effective in older adults, who are more vulnerable to developing severe Covid-19 and who do not respond strongly to some types of vaccines.

Pfizer, which developed the vaccine with its partner BioNTech, said the companies planned to apply to the Food and Drug Administration for emergency authorization “within days,” raising hopes that a working vaccine could soon become a reality."

"If the F.D.A. authorizes the two-dose vaccine, Pfizer has said that it could have up to 50 million doses available by the end of the year, and up to 1.3 billion by the end of next year.

However, only about half of its supply will go to the United States this year, or enough for about 12.5 million people — a sliver of the American population of 330 million. Americans will receive the vaccine for free, under a $1.95 billion deal the federal government reached with Pfizer for 100 million doses."

Edited by bsjkki
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https://thehill.com/policy/healthcare/526560-health-officials-say-every-state-will-have-covid-vaccine-doses-within-24?amp&__twitter_impression=true

Federal health officials on Wednesday expressed confidence that every state will have access to at least some doses of a COVID-19 vaccine for distribution within 24 hours after authorization.

"Every jurisdiction will have access immediately upon the initial push of the vaccine," Gen. Gustave Perna, chief operating officer of the Trump administration's Operation Warp Speed, said during a call with reporters. 

Edited by bsjkki
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Kevin, while .I agree with the point of your post, it is mostly political, could you post it in the other thread please and delete it here...

Added:  I realized the thread I was thinking of was locked, so I started a new one for you.

Edited by Calm
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Distribution issues with the vaccine are definitely medical in my view, but let's avoid any political conspiracy or claims being made even if a part of it and post those in the other Covid thread for nonmedical discussion.

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Just saw this:

Quote

A new study indicates there is no statistically significant difference when it comes to wearing a mask or not outside the home to prevent Covid-19 spread.

According to the study, 1.8% of participants with masks got coronavirus. That compares to 2.1% of participants without masks.

A recommendation to wear a surgical mask when outside the home among others did not reduce, at conventional levels of statistical significance, incident SARS-CoV-2 infection compared with no mask recommendation.

ACPJOURNALS Study

The study is from the Annals of Internal Medicine. It is titled:

"Effectiveness of Adding a Mask Recommendation to Other Public Health Measures to Prevent SARS-CoV-2 Infection in Danish Mask Wearers, A Randomized, Controlled Trial."

Read the study here:

https://www.acpjournals.org/doi/10.7326/M20-6817

Thanks,

-Smac

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1 hour ago, smac97 said:

Just saw this:

Thanks,

-Smac

I've wondered about the limitations.   It's been too long since I've had my research class to know how these compare to other studies.

"

 

 

 

Abstract

 

Background:

Observational evidence suggests that mask wearing mitigates transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is uncertain if this observed association arises through protection of uninfected wearers (protective effect), via reduced transmission from infected mask wearers (source control), or both.

 

Objective:

To assess whether recommending surgical mask use outside the home reduces wearers' risk for SARS-CoV-2 infection in a setting where masks were uncommon and not among recommended public health measures.

 

Design:

Randomized controlled trial (DANMASK-19 [Danish Study to Assess Face Masks for the Protection Against COVID-19 Infection]). (ClinicalTrials.gov: NCT04337541)

 

Setting:

Denmark, April and May 2020.

 

Participants:

Adults spending more than 3 hours per day outside the home without occupational mask use.

 

Intervention:

Encouragement to follow social distancing measures for coronavirus disease 2019, plus either no mask recommendation or a recommendation to wear a mask when outside the home among other persons together with a supply of 50 surgical masks and instructions for proper use.

 

Measurements:

The primary outcome was SARS-CoV-2 infection in the mask wearer at 1 month by antibody testing, polymerase chain reaction (PCR), or hospital diagnosis. The secondary outcome was PCR positivity for other respiratory viruses.

 

Results:

A total of 3030 participants were randomly assigned to the recommendation to wear masks, and 2994 were assigned to control; 4862 completed the study. Infection with SARS-CoV-2 occurred in 42 participants recommended masks (1.8%) and 53 control participants (2.1%). The between-group difference was −0.3 percentage point (95% CI, −1.2 to 0.4 percentage point; P = 0.38) (odds ratio, 0.82 [CI, 0.54 to 1.23]; P = 0.33). Multiple imputation accounting for loss to follow-up yielded similar results. Although the difference observed was not statistically significant, the 95% CIs are compatible with a 46% reduction to a 23% increase in infection.

 

Limitation:

Inconclusive results, missing data, variable adherence, patient-reported findings on home tests, no blinding, and no assessment of whether masks could decrease disease transmission from mask wearers to others."

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8 minutes ago, Rain said:

Inconclusive results, missing data, variable adherence, patient-reported findings on home tests, no blinding, and no assessment of whether masks could decrease disease transmission from mask wearers to others."

Remember, the primary purpose of masks has always been to decrease transmission from an infected mask wearer to someone not infected. This study does not demonstrate that. This study solely deals with protection of a mask wearer when there is no control over others who are infected...they may be exposed to Covid positive that are wearing masks or not wearing masks. 
 

They should show imo if anyone in their household got infected before they did and eliminate those in that case imo as they are more than likely to get infected in their home environment and wearing masks outside the home of course isn’t going to have any effect on that. 

Edited by Calm
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