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Covid II: Medical Info and Implications


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9 minutes ago, pogi said:

Like I said, totally different methodology, totally different controls, totally different authors, totally different study, and importantly - this one has not been withdrawn.  You can't compare the two.  In the same way, you can't downplay all chloroquine studies because 1 or 2 were withdrawn.   The UofU study, by the way, directly addresses post mandate surges in their data, which the study you reference doesn't appear to.  It was much more comprehensive in scope with more controls and covered a much larger span of time across the entire nation on state and county levels, with mandates starting at different time periods in the pandemic. 

I would also note that the study you reference doesn't refute it's results, it simply suggests that further study is needed.  Lets wait and see what their new results with the recent surge suggests.  You dismissal of both of these studies is premature.  Furthermore, I linked to other studies by the CDC and others which corroborates the data too.   One withdrawal for further study is not evidence that mandates don't work.   I would have you note that a withdrawal of a study by the author for further study is very different from a retraction of a study that has been disproven.  https://sites.kowsarpub.com/hepatmon/knowledgebase/display/withdraw-vs-retraction.html

I have not dismissed the MIT/UCSF study.  I have used to show what I think is responsible research from people associated with infectious disease fields in researching Nation wide data related to a global pandemic. I think it is responsible for the MIT/UCSF researchers to admit data points might have changed due to nation wide surge. 

My concern is not about mask mandates work or not, it is about people citing an economist in references to infectious diseases, instead of waiting for those associated with infectious disease research to complete further analysis.  Basically I would be suspect of a article about economics written by an Infectious disease expert.

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1 hour ago, provoman said:

I have not dismissed the MIT/UCSF study.  I have used to show what I think is responsible research from people associated with infectious disease fields in researching Nation wide data related to a global pandemic. I think it is responsible for the MIT/UCSF researchers to admit data points might have changed due to nation wide surge. 

The MIT group wanted to study the results during a surge.  The UofU group already studied the results of mandates during a surge and found that they are effective even during a surge.  Nothing irresponsible about it. 

1 hour ago, provoman said:

My concern is not about mask mandates work or not, it is about people citing an economist in references to infectious diseases, instead of waiting for those associated with infectious disease research to complete further analysis.  Basically I would be suspect of a article about economics written by an Infectious disease expert.

I would be concerned if they were studying information that required infectious diseases expertise.  They were simply studying numbers - and only as it related to consumer confidence.  Raw numbers.  Period.  This doesn't require medical expertise or epidemiological knowledge.  All it requires is raw hard data, which was provided to them by health departments.  There is absolutely no reason to question their qualifications in collecting and comparing that raw data.  It is just numbers - no medical expertise needed.  Where medical experience might come in handy is in interpreting that data in relation to infectious disease and its implications on community health.  All they did however, is point out that numbers dropped by 13% after mask mandates were implemented and interpreted how that might affect consumer confidence.  No medical analysis or interpretation whatsoever.  There is no reason for any medical expert to question that data. They were not doing some technical assessment of mask efficacy itself.  No, they were studying mask mandates, which is a government function - it is therefore completely within their realm of study, especially as it relates to how government mandates affect consumer confidence as it relates to their efficacy. 

Either way, my point doesn't hinge on this study.  I have sited CDC studies which show that mandates work too.  Are they expert enough for you in infectious disease?  The fact that they corroborate each other gives me even greater confidence in the Uof U study. 

Edited by pogi
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EDH:

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Coronavirus was likely in the United States earlier than thought, a study says. After the virus that causes COVID-19 disease was first discovered in Wuhan, China, in December 2019, investigators identified the first U.S. case in January 2020. In a study published Monday in the journal Clinical Infectious Diseases, scientists with the CDC analyzed blood samples collected by the American Red Cross and found COVID-19 antibodies in some samples dating back to mid-December. “These findings suggest that SARS-CoV-2 [virus] may have been introduced into the United States prior to January 19, 2020,” concluded the authors.

 

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This is good news, from USA Today....

https://news.yahoo.com/cdc-cuts-recommended-quarantine-time-162614620.html

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The U.S Centers for Disease Control and Prevention reduced the recommended days a person must quarantine after exposure to COVID-19 from 14 days to 7 or 10 days.

The new guidelines announced Wednesday say individuals who have close contact with an infected person can end their quarantine after 7 days if they receive a negative test, or after 10 days without a test.

The CDC defines close contact as exposures adding up to a total of 15 minutes spent 6 feet or closer to an infected person.

 

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EDH:

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The United Kingdom has approved Pfizer's vaccine for use beginning next week. The BBC said Wednesday that Britain’s Medicines and Healthcare products Regulatory Agency (MHRA) has officially approved the vaccine produced by Pfizer–BioNTech. The United Kingdom has ordered 40 million doses of the vaccine (enough to inoculate 20 million people), with the initial 800,000 doses arriving next week. Scottish First Minister Nicola Sturgeon said the first people in Scotland may be immunized on Tuesday. Frontline hospital staff, elderly people in care homes, and other vulnerable populations have priority to receive the vaccination first.

 

 

 

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The CDC will prioritize vaccine distribution to healthcare workers and those in long-term care. A CDC panel on Tuesday has officially decided that frontline healthcare workers and residents of long-term care facilities will get the coronavirus vaccine first, reported the Wall Street Journal. Federal officials have said they expect about 40 million doses to be available in December. Initial immunizations are to be given in two doses three or four weeks apart.

 

 

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Homeland Security warned about fraudulent vaccines. Steve Francis, assistant director for global trade investigations with Homeland Security Investigations, told the Associated Press Monday that U.S. consumers should be on the alert for scams regarding fraudulent vaccines. The agency has already analyzed more than 70,900 websites suspected of being involved in some type of COVID-19 fraud. Homeland Security cautions the public to only get a vaccine from an approved medical provider, to not respond to calls seeking personal information, and to not click on social media posts claiming to sell cures.

 

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I am thinking this is too depressing to post, but it feels like a milestone...here’s hoping it starts falling soon:

EDH

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The COVID-19 deaths in a single day shattered records. Figures from Johns Hopkins Coronavirus Resource Center show that the United States registered at least 3,157 deaths from coronavirus over a 24-hour period on December 2. That number is 20 percent higher than on any other day of the pandemic, and higher than the 2,977 who died in the September 11, 2001 attacks, according to ABC News.

 

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On 12/4/2020 at 4:15 AM, Calm said:

I am thinking this is too depressing to post, but it feels like a milestone...here’s hoping it starts falling soon:

EDH

 

In 2018 there were roughly 7778 deaths per day in the US; so that is scary that presently so many deaths are attributed to single cause in a day.

Edited by provoman
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While Calm did give the CDC’s recommendations on vaccine distribution the distribution itself is being handled (for good or ill) at the state level. The federal government’s announced plan is to distribute the first batch of vaccine to each state proportional to its adult population.

Most likely states will vaccinate healthcare workers first but there is no guarantee of that. We can expect a few scandals of friends of someone prominent in state government getting priority. The distribution plan also has some issues.

Here is one commentary on the plan. I have read a few and this one is among the best I saw: https://www.usnews.com/news/best-states/articles/2020-12-04/operation-warp-speeds-initial-vaccine-distribution-plan-has-winners-and-losers-among-states

The US is also still on a timer for a federal government shutdown on Friday. Congress appears to be trying to come up with a one week stopgap bill but the process could break down and a shutdown would almost certainly delay or impede vaccine distribution to some extent.

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11 hours ago, bsjkki said:

Covid fatigue...poor messaging by health officials with and rising numbers in spite of mitigation leads to people becoming more non-compliant.

https://news.yahoo.com/many-arent-buying-public-officials-130038983.html

I think this was specifically addressing LA Counties strict orders to not socialize outside, even with masks and distancing - which I think is overboard, by the way. 

The alternative messaging some suggest in the article:

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When it comes to the COVID-19 pandemic, a harm-reduction approach would encourage masking and social distancing instead of demanding that people have no contact at all with friends or family they don't live with. In other words, even during a pandemic, abstinence-only isn't effective.

"Encourage masking and social distancing..."???  That's the better messaging approach?  What do they think health officials have been doing for the last 8 months? 

The response from LA health official:

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“We don’t really have any choice but to use all tools on hand to stop the surge,” Ferrer said. “This is not forever.” 

When asked why the county does not try borrowing some principles of harm reduction, Ferrer said that attempts to give more control to people and businesses have failed in L.A. County. It only works if people keep their masks on and properly distance, and that isn't happening, she said.

If people "are fatigued and don’t really want to continue to take these basic precautionary steps, then this approach doesn’t work as well as it ought to," she said. If even a small fraction of people don't comply with the safety measures, that can still lead to thousands of cases and even deaths, she said.

 

Agreed.

I see some good points from both approaches.  I think the harm-reduction approach might be more effective and appropriate for certain scenarios and when numbers are not at critical levels, but when issues have become as political and polarized as they are, many people aren't going to listen to recommendations - and when numbers are uncontrolled by recommendations alone, we need more tools at our disposal.   Maybe not all will follow mandates/restrictions either, but I think a higher percentage will follow a mandate more than a recommendation.   While I think LA has gone overboard with some of their restrictions, I think mandates in general are an effective tool.  I have already shown multiple studies with mask mandates which prove this to be true. 

Edited by pogi
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From the FDA's lips to God's ears, I hopeFDA Says Pfizer COVID-19 Vaccine Is Safe and Effective, Approval Coming in Days

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The Food and Drug Administration says that Pfizer’s COVID-19 vaccine is safe and effective. Their analysis finds “no specific safety concerns identified that would preclude issuance of an [emergency use authorization].” FDA approval of the vaccine is expected within days.

...

There are some side effects from Pfizer’s vaccine, but serious reactions were rare. A majority of volunteers in the vaccine study experience reactions at the injection site of the vaccine, as well as headaches and fatigue.

The data suggests that the vaccine is 95 percent effective after two doses, taken 21 days apart. The vaccine is 82 percent effective after the first dose.

Thanks,

-Smac

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https://www.newscentermaine.com/article/news/health/mental-health/covid-19-isolation-drives-brunswick-teenager-to-suicide/97-29f1a948-139b-4e1f-8750-841f239201e1

"BRUNSWICK, Maine — A teenager in Brunswick died by suicide on Friday. Now his family is speaking out, and says it's not about them, but about other teens who are feeling the same way during the pandemic.

Spencer Smith left a note for his parents, writing about feeling locked in the house and growing apart from his friends. "

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1 hour ago, bsjkki said:

https://www.newscentermaine.com/article/news/health/mental-health/covid-19-isolation-drives-brunswick-teenager-to-suicide/97-29f1a948-139b-4e1f-8750-841f239201e1

"BRUNSWICK, Maine — A teenager in Brunswick died by suicide on Friday. Now his family is speaking out, and says it's not about them, but about other teens who are feeling the same way during the pandemic.

Spencer Smith left a note for his parents, writing about feeling locked in the house and growing apart from his friends. "

That is sad, but going back to normal will not solve that problem.  If anything, it will exacerbate it with fears, deaths of loved ones, collapse of health care system, etc. it would only send many into a deeper isolation and depression.  

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Did a bit of a dive into vaccine news. It looks like the US will have about 100 million vaccines (200 million doses) with about a quarter coming this year and the rest early next year. The bad news is that there will likely be little supply coming in after that until summer of next year. The final authorization is expected by tomorrow. The Moderna vaccine decision is expected by the 17th. Moderna’s long-term distribution is less clear but the US should get about 10 million vaccines this year but there is less likely to be a gap in receiving them as they have not pre-sold as many doses. Moderna has a distribution advantage because its storage requirements are less difficult than Pfizer’s.

There are others that might hit.

Most decisions about who will get vaccinated first will be made on the state level. Health care workers are generally at the top of the list followed by long term care facilities and then those with condition making Covid more dangerous. The other wild card that may take some doses is the military. The military has understandably not been open with the spread in its ranks due to national security concerns so it is not known how many are currently infected and how bad it is in the military.

There are talks in the incoming administration about making the vaccination mandatory but no decisions have been made. Supreme Court precedent is on the side of allowing governments to mandate vaccination but it is old precedent (1905 if I remember right so who knows). It is more likely to be mandatory on state and local levels at least for school attendance.

It is unlikely we will have enough vaccine to inoculate everyone until summer of next year at least and that is a best-case scenario. Still, the end is closer than it has been.

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28 minutes ago, The Nehor said:

The bad news is that there will likely be little supply coming in after that until summer of next year

Why?

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Just now, Calm said:

Why?

Pfizer pre-sold a lot of their coming inventory. After the initial purchase the US declined to purchase additional doses several months back.  Other nations did buy in early. If I remember right the EU and the UK bought most of the early stock. Expect to see a lot of cases of “vaccine tourism” early next year.

It is possible they will be able to ramp up production and get to unsold vaccines earlier but I doubt it. Ramping up vaccine production is difficult and I would expect delays rather than unexpected early successes.

Logistics are also going to be a nightmare. The vaccine needs a cold environment to be stored in. While most major hospitals can adapt to this requirement rural areas may have problems. I expect we will lose some doses to accidental spoilage.

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2 minutes ago, The Nehor said:

Expect to see a lot of cases of “vaccine tourism” early next year.

Will help the travel and hospitality industry I guess.  

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3 minutes ago, The Nehor said:

While most major hospitals can adapt to this requirement rural areas may have problems. I

Might be wise to have them drive into the city to get them in most cases. These days how rural is most rural?  Couple of hours drive?

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5 minutes ago, Calm said:

Might be wise to have them drive into the city to get them in most cases. These days how rural is most rural?  Couple of hours drive?

Problem is a lot of the early distribution will be to healthcare workers and people in long-term care facilities who may be less able to travel (due to different reasons).

One sad reality of this vaccine is that it will be even harder to distribute in less developed nations and it looks like many of them will be getting virtually no vaccine. There was hope of an international distribution agreement to try to include all nations in a deal to more equitably distribute the vaccine but it has (for various reasons) devolved into every nation for itself.

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1 hour ago, The Nehor said:

Pfizer pre-sold a lot of their coming inventory. After the initial purchase the US declined to purchase additional doses several months back.  Other nations did buy in early. If I remember right the EU and the UK bought most of the early stock. Expect to see a lot of cases of “vaccine tourism” early next year.

It is possible they will be able to ramp up production and get to unsold vaccines earlier but I doubt it. Ramping up vaccine production is difficult and I would expect delays rather than unexpected early successes.

Logistics are also going to be a nightmare. The vaccine needs a cold environment to be stored in. While most major hospitals can adapt to this requirement rural areas may have problems. I expect we will lose some doses to accidental spoilage.

We postponed a trip in October to next Spring.  I have wondered if getting it in Europe when/if we go would be the best/easiest way.

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10 minutes ago, Rain said:

We postponed a trip in October to next Spring.  I have wondered if getting it in Europe when/if we go would be the best/easiest way.

Unless you can make arrangements or have connections I doubt they will give the vaccine to non-citizens. I expect those with connections will use them. I also expect that some of the relatively small quantity of vaccines going to undeveloped nations will be "sold" in this way.

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16 minutes ago, The Nehor said:

Unless you can make arrangements or have connections I doubt they will give the vaccine to non-citizens. I expect those with connections will use them. I also expect that some of the relatively small quantity of vaccines going to undeveloped nations will be "sold" in this way.

I know.  It was just thoughts.  My husband worked in France for several months each year in one of the cities we hope to be in and ended up getting medical care while there.  It was so much easier to deal with than here.  

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