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Covid III: Delta Force


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1 hour ago, The Nehor said:

What I find annoying in this kind or irresponsible journalism is what they imply. They state that it wanes (this is true of almost every vaccine) which is true but never establish by how much. Does it fall to around 90% of previous effectiveness? 80%? 50%? It just seems like alarmism designed to generate clicks.

 

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8 minutes ago, ERMD said:

At this point, I'm not going to convince anyone of anything (this topic is like arguing religion), and I realize that the plural of anecdote is not "data," but my anecdotal evidence mirrors the data on moderate to severe COVID in the vaccinated and unvaccinated populations.

I've been in the Emergency Medicine game for over 30 years now, and I've never seen anything like I have in the past several months.  My part of the country (south/central Texas) missed the real big surge last winter, attributable to masks and distancing.  We weren't so lucky with delta.  I'm at a rural hospital.  Deaths were a daily occurrence, not only in the hospital, but also in the emergency department.  Everyone who died was unvaccinated.  Everyone.  90% of COVID admissions were unvaccinated.  People who were taking ivermectin were hospitalized, required high flow oxygen, then mechanical ventilation, and then they died.  There is a small town not far down the road.  A multigenerational family lived there--grandmother (late 50s), 3 sons (late 20s to early 30s), 1 daughter in-law (late 20s), and a 14 year-old son of the married couple.  All were unvaccinated.  All got COVID.  All but the 14 year-old died.  He now lives with relatives in another state.  4 of the 5 who died were at my hospital.  I intubated 3 of them.  I've intubated teens, young healthy people in their 20s, old and frail people, police officers, nurses, PhD biochemists, farmers, high school coaches, you name it.  All in my little rural hospital.

Ivermectin doesn't work.  When a meta analysis is done of flawed studies, the results of the meta analysis are flawed. The Egyptian study, the Brazilian studies, the Peruvian studies all were poorly conducted or outright falsified.  Paul Malik and Pierre Kory touted Vit C as a miracle drug for sepsis, and they were proven wrong.  No one could duplicate their results.  Now they're trying the same schtick with ivermectin, but this time they're costing people their lives. 

And lives aren't lost just to COVID.  I've had patients who needed to be sent to larger hospitals with more advanced medical capabilities, but those hospitals were past capacity, due to being overwhelmed with COVID patients.  No room where they needed to be meant they died where they were.  Dialysis patients couldn't get dialysis, so they died.  Patients with GI bleeding required all the blood I had in the hospital, and I couldn't get them where they needed to go, so they died.  This is all at one small hospital.  It's happening everywhere, and winter is coming.  Estimates are the 20% of healthcare workers have left their jobs in the past 2 years.  We're tired.  We are emotionally spent.  We are having to do more with less, and this time, instead of people applauding and calling us "heroes," (which I appreciated but didn't particularly like), we are now being yelled at, picketed, protested, called "sheep," and people take off their masks and cough in our faces.  Literally.  We are short nurses, respiratory therapists, radiology technicians, and unit clerks.  I have no idea what the next 3-4 months will bring, but I don't think it will be good.

Thank you for sharing your personal experience and giving a real-life glimpse from the inside. It is so tragic how public health and front line nurses/doctors are being treated.  I know you don’t like to hear it, but you are a hero brother!  Hang in there.

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23 minutes ago, ERMD said:

  Estimates are the 20% of healthcare workers have left their jobs in the past 2 years.  We're tired.  We are emotionally spent.  We are having to do more with less, and this time, instead of people applauding and calling us "heroes," (which I appreciated but didn't particularly like), we are now being yelled at, picketed, protested, called "sheep," and people take off their masks and cough in our faces.  Literally.  We are short nurses, respiratory therapists, radiology technicians, and unit clerks.  I have no idea what the next 3-4 months will bring, but I don't think it will be good.

This is just so wrong.  Sometimes the Flood seems more reasonable. If only we could start over (as in go back in time, not from scratch) with more sensible people in charge or something…

Edited by Calm
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On 11/13/2021 at 1:57 AM, bsjkki said:

PSA: We can all showcase our love of humanity by scrubbing the tracking from URLs, before posting. 

Delete the first ? and everything that follows.

Edited by Chum
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6 minutes ago, Chum said:

PSA: We can all showcase our love of humanity by scrubbing the tracking from URLs, before posting. 

Delete the first ? and everything that follows.

I try to remember to refresh before copying, but too often forget, so thanks for identifying the cutoff point. 

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38 minutes ago, ERMD said:

Ivermectin doesn't work.  When a meta analysis is done of flawed studies, the results of the meta analysis are flawed. The Egyptian study, the Brazilian studies, the Peruvian studies all were poorly conducted or outright falsified.  Paul Malik and Pierre Kory touted Vit C as a miracle drug for sepsis, and they were proven wrong.  No one could duplicate their results.  Now they're trying the same schtick with ivermectin, but this time they're costing people their lives. 

I think I may just bookmark your post for anytime anyone starts making claims otherwise.  It summarizes perfectly what I have read.

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A study of people who've lost their sense of smell shows between 2% & 7% aren't recovering. This maths out to 700k to 1.6M Americans.

Quote

A recent meta-analysis reported the incidence of acute COVID-19 OD as 52.7% (95% CI, 29.6%-75.2%). A prospective study reported the recovery rate from OD to be 95.3% (95% CI, 92.6%-98.0%).

Gizmodo did a followup on the study.

Quote

 

“In the last couple of months, my colleagues and I noted a dramatic increase in the number of patients seeking medical attention for olfactory dysfunction.” study author Jay Piccirillo, a otolaryngologist at Washington University.

Piccirillo and his team estimated a range of cases, based on projections of covid-19’s spread, the odds of someone developing anosmia from infection, and the likelihood of chronic anosmia. In the most likely scenarios, somewhere between 700,000 to 1.6 million Americans (as of August 2021) have experienced a loss or change in their sense of smell lasting more than six months as a result of covid-19 so far.

 

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On 11/12/2021 at 5:09 PM, Hamba Tuhan said:

Day 3 for us of having no active Covid cases in hospital, and day 4 of no Covid-related hospital presentations as well. Great news.

This morning we received some interesting data regarding the Delta outbreak in our jurisdiction:

  • of confirmed Delta infections, 7 per cent have required hospitalisation
  • only 5 per cent of those admitted to hospital were fully vaccinated (5 per cent of 7 per cent equals 0.35 per cent overall), which means that the likelihood of hospitalisation has been exactly 19 times greater for the unvaccinated who fall sick
  • with our high rate of vaccination (96 per cent of everyone age 12+ as of yesterday), currently 21 per cent of confirmed cases are in fully vaccinated people
  • but no fully vaccinated person with a breakthrough Delta infection has been admitted to ICU
  • we still have people in hospital being treated for the damage Delta has done to their bodies, but none of them has an active infection
  • (I personally know two people, a woman in our stake and a man whose mum is a member, who are also recovering at home following stays in ICU, both with serious, potentially lifelong, damage to their lungs and other organs; presumably, there are others)
  • 0.6 per cent of confirmed Delta infections have died

Question.  Was the data about percentage of vaccinated adjusted to compare to the percentage of population vaccinated at the time of hospitalization?

The value of those statistics is greatly dependant on an adjustment for percentage people vaccinated at the time of hospitalization.  Just taking total vaccinated people hospitalizations divided by total covid hospitalizations would not be an accurate method for determining effectivness of the vaccine.

People have been hospitalized by COVID for far longer than people have been vaccinated, so naturally, even if the vaccine didn't work at all, the percent of people hospitalized unvaccinated would be greater than people hospitalized vaccinated due to the limited time that vaccinated people have existed. 

Im not saying the vaccine doesn't work, I am just wondering about methodology of the statistics.  

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52 minutes ago, Danzo said:

Question.  Was the data about percentage of vaccinated adjusted to compare to the percentage of population vaccinated at the time of hospitalization?

The data are exclusively from our Delta outbreak, which only started three months ago, after vaccines were readily available. If that isn't what you're looking for, please ask me again, and I'll try to understand better!

By the way, we're sadly back to having Covid patients in hospital, though only three, and only one in ICU.

Our 12+ vaccination rate as of this morning is 97 per cent.

Edited by Hamba Tuhan
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25 minutes ago, Hamba Tuhan said:

The data are exclusively from our Delta outbreak, which only started three months ago, after vaccines were readily available. If that isn't what you're looking for, please ask me again, and I'll try to understand better!

By the way, we're sadly back to having Covid patients in hospital, though only three, and only one in ICU.

Our 12+ vaccination rate as of this morning is 97 per cent.

That helps.

What was the vaccinata\ion rate three months ago vs now?

Has it been 96% all all along or did it start at a significantly lower rate?

 

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28 minutes ago, Danzo said:

What was the vaccinata\ion rate three months ago vs now?

I've tried to find that number online but haven't been able to yet. My memory is that we were in the high 60s when Delta finally arrived, but that was before approval was granted for inoculating adolescents. For some time, we only had access to Aztra-Zeneca -- which is what I received -- and some people I know were waiting on Pfizer and/or Moderna to arrive for various reasons. That happened a bit before Delta appeared.

Before that, we had gone more than a year with no community transmission of Covid, and our original outbreak was very small (three deaths in total, all returning travellers infected elsewhere), so Delta has been almost our entire experience with infection in the community. Its arrival (we still haven't been able to identify how or even when exactly it crossed the border) and rapid spread in the community certainly boosted our vaccination efforts, with many of the remaining unvaccinated adults queueing up for the jab almost immediately.

Once our national authority approved the Pfizer vaccine for under-18s, we had a mad rush there too. At this point, our least vaccinated demographic is ages 20 to 29.

ETA: It appears that our vaccination rate for 12+ at the beginning of the Delta wave was not quite 40 per cent, higher than that, of course, for the eligible adult population, though I doubt it could have been as great as 'the high 60s' at that rate. Probably more like high 40s?

Edited by Hamba Tuhan
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1 minute ago, Hamba Tuhan said:

I've tried to find that number online but haven't been able to yet. My memory is that we were in the high 60s when Delta finally arrived, but that was before approval was granted for inoculating adolescents.

Before that, we had gone more than a year with no community transmission of Covid, and our original outbreak was very small (three deaths in total, all returning travellers infected elsewhere), so Delta has been almost our entire experience on a practical level. Its arrival (we still haven't been able to identify how it entered) and rapid spread in the community certainly boosted our vaccination efforts, with many of the remaining unvaccinated adults queueing up for the jab almost immediately.

Once our national authority approved jabs for under-18s, we had a mad rush there too. At this point, our least vaccinated demographic is ages 20 to 29.

Thanks.  I don't doubt that the vaccines work. I am a number guy and have learned to expect that most people who report the numbers aren't.

I suspect if the statistics were adjusted due to the percentage vaccinated rate, the percentages would change.  Or, now that you are >96%, we could wait a month and look at the stats after a stable period of percent vaccinated and see how the numbers compare.

It would also be fun to find out, out of the vaccinated people who tested positive, when were they vaccinated?  How does time since vaccination effect hospitalization?

If there is enough data reported on cases, I could throw the numbers into a database, run a few queries and find out all types interesting information. 

The problem is that all I see are single numbers like postive tests. The same people testing positive multiple times? (say they tested positive and and keep testing often to see if its safe to go out). If they had tested positive before, how long before?

Hospitalizations are the worst.  Some people will go to the hospital ER for nothing, while others won't go until they are mostly dead.   I wish they reported length of stay as well as hospitalizations.  then we could compare severity in Vaccinated vs Unvaccinated. 

 

 

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39 minutes ago, Danzo said:

I am a number guy and have learned to expect that most people who report the numbers aren't.

Understood. Some of what I reported was my own work on the raw numbers supplied.

Quote

Now that you are >96%, we could wait a month and look at the stats after a stable period of percent vaccinated and see how the numbers compare.

I intend to keep reporting. I think we might make for an interesting case study.

Quote

I wish they reported length of stay as well as hospitalizations.  then we could compare severity in Vaccinated vs Unvaccinated. 

Yes. I think the fact that, whilst 21 per cent of our cases have been breakthrough infections in fully vaccinated people, none of those has ended up in ICU begins to speak to the issue of severity.

Edited by Hamba Tuhan
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6 hours ago, ERMD said:

At this point, I'm not going to convince anyone of anything (this topic is like arguing religion), and I realize that the plural of anecdote is not "data," but my anecdotal evidence mirrors the data on moderate to severe COVID in the vaccinated and unvaccinated populations.

I've been in the Emergency Medicine game for over 30 years now, and I've never seen anything like I have in the past several months.  My part of the country (south/central Texas) missed the real big surge last winter, attributable to masks and distancing.  We weren't so lucky with delta.  I'm at a rural hospital.  Deaths were a daily occurrence, not only in the hospital, but also in the emergency department.  Everyone who died was unvaccinated.  Everyone.  90% of COVID admissions were unvaccinated.  People who were taking ivermectin were hospitalized, required high flow oxygen, then mechanical ventilation, and then they died.  There is a small town not far down the road.  A multigenerational family lived there--grandmother (late 50s), 3 sons (late 20s to early 30s), 1 daughter in-law (late 20s), and a 14 year-old son of the married couple.  All were unvaccinated.  All got COVID.  All but the 14 year-old died.  He now lives with relatives in another state.  4 of the 5 who died were at my hospital.  I intubated 3 of them.  I've intubated teens, young healthy people in their 20s, old and frail people, police officers, nurses, PhD biochemists, farmers, high school coaches, you name it.  All in my little rural hospital.

Ivermectin doesn't work.  When a meta analysis is done of flawed studies, the results of the meta analysis are flawed. The Egyptian study, the Brazilian studies, the Peruvian studies all were poorly conducted or outright falsified.  Paul Malik and Pierre Kory touted Vit C as a miracle drug for sepsis, and they were proven wrong.  No one could duplicate their results.  Now they're trying the same schtick with ivermectin, but this time they're costing people their lives. 

And lives aren't lost just to COVID.  I've had patients who needed to be sent to larger hospitals with more advanced medical capabilities, but those hospitals were past capacity, due to being overwhelmed with COVID patients.  No room where they needed to be meant they died where they were.  Dialysis patients couldn't get dialysis, so they died.  Patients with GI bleeding required all the blood I had in the hospital, and I couldn't get them where they needed to go, so they died.  This is all at one small hospital.  It's happening everywhere, and winter is coming.  Estimates are the 20% of healthcare workers have left their jobs in the past 2 years.  We're tired.  We are emotionally spent.  We are having to do more with less, and this time, instead of people applauding and calling us "heroes," (which I appreciated but didn't particularly like), we are now being yelled at, picketed, protested, called "sheep," and people take off their masks and cough in our faces.  Literally.  We are short nurses, respiratory therapists, radiology technicians, and unit clerks.  I have no idea what the next 3-4 months will bring, but I don't think it will be good.

Can I copy and post this on Facebook? I’m also in Texas. My husband had both vaccines but still came down with COVID. We are lucky enough to be in a large city with lots of hospitals. I took him to the ER when his oxygen level dropped, he was wheezing, and I had a hard time waking him up. The nurse at the ER said he seemed to be very susceptible to COVID and probably would have been on a ventilator if he hadn’t been vaccinated. Fortunately, he was eligible for the antibody infusion and they had it available. He got it that night and I took him home. It was a rough week after that, but he recovered. Anyway, thank you for what you do! You are a hero, just as the nurse and PA we saw that night were heroes. Imho, modern medicine including mRNA vaccines, monoclonal antibody treatments and the people who administer them are heaven-sent. 

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2 hours ago, Danzo said:

Thanks.  I don't doubt that the vaccines work. I am a number guy and have learned to expect that most people who report the numbers aren't.

I suspect if the statistics were adjusted due to the percentage vaccinated rate, the percentages would change.  Or, now that you are >96%, we could wait a month and look at the stats after a stable period of percent vaccinated and see how the numbers compare.

It would also be fun to find out, out of the vaccinated people who tested positive, when were they vaccinated?  How does time since vaccination effect hospitalization?

If there is enough data reported on cases, I could throw the numbers into a database, run a few queries and find out all types interesting information. 

The problem is that all I see are single numbers like postive tests. The same people testing positive multiple times? (say they tested positive and and keep testing often to see if its safe to go out). If they had tested positive before, how long before?

Hospitalizations are the worst.  Some people will go to the hospital ER for nothing, while others won't go until they are mostly dead.   I wish they reported length of stay as well as hospitalizations.  then we could compare severity in Vaccinated vs Unvaccinated. 

 

 

Severity is best determined by where the patients are, not for how long. The really sick ones die quickly.  Nationwide, the unvaccinated represent about 85-90% of ICU and ventilated patients. Not all in the ICUs are on vents. Many of them are maintained on high-flow nasal cannula, trying to by them time. 

Cities and hospital systems across the country were publicly updating their stats daily this past summer and early fall when delta was rampant. The data are out there. 

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1 hour ago, Peacefully said:

Can I copy and post this on Facebook? I’m also in Texas. My husband had both vaccines but still came down with COVID. We are lucky enough to be in a large city with lots of hospitals. I took him to the ER when his oxygen level dropped, he was wheezing, and I had a hard time waking him up. The nurse at the ER said he seemed to be very susceptible to COVID and probably would have been on a ventilator if he hadn’t been vaccinated. Fortunately, he was eligible for the antibody infusion and they had it available. He got it that night and I took him home. It was a rough week after that, but he recovered. Anyway, thank you for what you do! You are a hero, just as the nurse and PA we saw that night were heroes. Imho, modern medicine including mRNA vaccines, monoclonal antibody treatments and the people who administer them are heaven-sent. 

Very kind of you, and feel free to share. Unfortunately, the stories are not unique and are commonplace across the country. I’m glad y’all are vaccinated. The likelihood of developing moderate to severe disease and death is much less in those who are fully vaccinated, as you have seen. 

Edited by ERMD
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14 hours ago, Danzo said:

Hospitalizations are the worst.  Some people will go to the hospital ER for nothing, while others won't go until they are mostly dead.   I wish they reported length of stay as well as hospitalizations.  then we could compare severity in Vaccinated vs Unvaccinated. 

Hospitalizations only count hospital admissions and not ER visits without admission.  In other words, they have to be bad enough to warrant being admitted.

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