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wathe

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Everything posted by wathe

  1. Quoted For Truth. I am a frontline HCW who is getting pretty darn cranky and burnt out. Health care is not McDonald's. The consumer-driven, customer picks-what-they-want and would-you-like-fries-with-that, where doctors-are-really-just-technicians-who-take-your-orders model that seems to be prevalent in the US (but only for those who can pay) is weird to the rest of the world.
  2. Canada does have that data, at least up to July 14, and we aren't seeing spikes in populations that were vaxed early.. Testing for symptomatic nursing home residents remains assertive. Though there are other reasons why we might not be seeing it yet (still largely have public health precautions in place and numbers are relatively low at this time).
  3. ****Please do not quote this bit****. I hear you, loud and clear regarding burnout. Our third wave in April had us within a hair's breadth of total system collapse - tent wards in parking lots, multi ICU transfers by ambulance bus without patient consent required, CCU and Endo suite converted to covid ICUs. Nearish big children's teaching hospital converted its ICU take adults and filled it. Our nearish to the GTA hospital took nearly 200 covid transfers. We have similar (though perhaps attenuated) healthcare worker burnout leading to a staffing crisis. Staff are quitting, moving to other jobs, or on "stress leave". We are now chronically short-staffed. I worked 6 nurses short (that's nearly 50% ! ) on the first long weekend of the summer, which coincided with the first weekend of our first stage of reopening, in a hospital in a tourist area (and the tourists, of course, all came to fall off their mountain bikes and dive off their docks onto rocks and crash their boats.....). It was terrible. Emergency dept volumes are up; people have had poor access to primary care a year and a half now, poor access to elective procedures etc and are landing in the ED. Local rural hospital MD groups are asking us to help them out because they can't cover their emergency department shifts. It's a mess. Staff are burnt out and cranky. A fourth wave would destroy us. I really feel for you in the US who are facing that reality. ****end of bit to please not quote**** All our nursing home patients and front line health workers were vaxed in January (and into Feb) though, including me, so we do have early vaxed cohorts who are relatively vulnerable. I am going to choose to cling to the fact that we haven't seen any evidence of waning immunity yet, and reluctantly accept the fact that it might just be too early to know. And be thankful that my province was "scared straight" by our April wave and is prudently reopening in a slow and cautious manner. Maybe it's just a coping strategy and I'm failing to be objective, but I'm going to go with it. 'Cause I still have to show up to work every day and put on my caring face.
  4. Apparently, in Ontario, we just stopped routinely testing asymptomatic fully immunized nursing home staff, as of July 14. I hadn't seen that in the news, had to go looking for it.
  5. We've had breakthrough cases in nursing homes too, but they don't seem to be increasing with time. This graph, pulled from a public health report on nursing home breakthrough cases, shows symptomatic breakthrough cases arranged by days since vaccination, up to almost 5 months. By June 30, delta comprised about 50% of cases here. No signal to suggest waning efficacy. (Yet)
  6. Our nursing home vaccination rates are really high: As of July 12, virtually all residents in long-term care homes have received two doses of vaccines, as have 91 per cent of caregivers and 87 per cent of staff.
  7. Right. We had a truly horrific local nursing home outbreak here in early to mid-January with B.1.1.7 (pre-vaccination). 100% of residents got sick, more than 50% died. More than 100 staff got sick, several were hospitalized, one died. It was horrific. Covid rips through nursing homes. If VE is waning to as low as 16%, we really should be seeing some signal in this population by now, and we just aren't. Which is wonderful!
  8. I don't know. There are lots of reasons why we (Ontario) might not be seeing the same efficacy drop that Isreal has: The proportion of our population that was vaxed early is really low (we had very significant supply issues until mid-April), we aren't really re-opened yet, we still have lots of public health measures in place, masking compliance in indoor public spaces is pretty darn good, and vax rates are high (81% of 12+ have had their first dose, 70% fully vaxed). It very well may be that we just haven't been tested yet. Alberta is going to be our proving ground. They're opening up quickly and dropping most public health measures. We'll know in about a month or so, I guess. I am reassured by the hospitalization and death data. The confidence intervals are tighter.
  9. I wish I could find the raw data upon which that last bar graph is based (the one suggesting 16% vaccine efficacy for those immunized in January). The confidence intervals are really, really wide. 16% efficacy simply does not match what I am seeing on the ground: Most HCW and very vulnerable elderly (nursing home residents) were vaccinated with Pfizer here in Jan and Feb - in fact, they were the only ones vaccinated that early. Delta comprises 70% of cases here***. And we just aren't seeing spikes in cases in either of these populations. We really should be seeing spikes in nursing home cases if VE (equivalent to relative risk reduction as per the paper linked for methods) is only 16%. Nursing home residents are tested regularly, as are nursing home staff^^^, so a spike in this population would be unlikely to be missed, even if all cases were asymptomatic. Our local and provincial numbers are low though, and we still have public health measures in place (mandatory masking in indoor public places and some gathering limits), so maybe we just haven't been put to the test yet. ETA - our numbers are low, but there is enough Delta floating around that we should be seeing at least some signal in the population that was vaxed early. And we just aren't. *** ETA again - nope, the proportion of delta went up while I wasn't looking, apparently. It comprises 84% of cases now. ^^^ Late edit: apparently we stopped routinely testing fully vaccinated, asymptomatic staff as of July 14.
  10. Donating blood because you are worried you might have an infectious illness is still unethical IME, even if you think you will be negative and you just want to be sure. OP's exposure history (covid positive person in the household, IRRC) is not low risk.
  11. Some version of briefly and succinctly stating your disagreement then change the subject: "I disagree. Isn't this bean dip delicious? I wonder what's in it. Do you taste a hint of cilantro? ..." Then deflect and change the subject again when they persist: "I'd really rather not argue. You know, come to think of it, I think Susie grows her own cilantro. Have you seen her garden?..." And so on. It's the only way. There is no other way to gracefully deal with this IME.
  12. Well both of course! Plus masking and ventilation and distancing and hand hygiene..... If I really had to choose: Vaccinated. Vaccination has the better chance of preventing exposure, I think. Keep the metaphorical horse in the barn, so to speak. Testing will tell you when the horse is out of the barn - that you loved one has likely already been exposed. (I guess it depends on how often routine testing is happening. Weekly? Not enough to prevent exposure. Daily? Probably not practical.)
  13. I don't think that there is a blood test to screen for active covid. Tests for antibodies to previous infections, yes, but not for active Covid infection. Canadian Blood Services states on their website that " There is no Health Canada or FDA approved test to screen blood for COVID-19". Maybe there is such a thing in the US, but my google skills are failing to find it. I also think that it is unethical to donate blood while knowingly ill.
  14. Can you point me to where you posted this? I was away for a few weeks and have totally lost track of the forum. Thanks
  15. That's a tough one. Some of hard plastic respirator style masks might be metal-free - something like Castle-grade maybe Cheapie solution is to use a surgical mask from which your've removed the wire, under a well-fitting cloth mask, or surgical mask alone with medical tape across the top to fix the gaps.
  16. Quoting myself to add, for any interested, that safety glasses (properly called spectacles with side shields here) do not protect adequately against droplets or splash. They are meant for protection against "impact" - bits of metal or wood that fly off while using power tools or hammering, for instance. Which is why our healthcare PPE standard specifies goggles or face shield when droplet contact protection is required. At my hospital we use face shields - cheap, disposable, decent comfort, regular glasses fit well underneath, not much fogging. Goggles are tend to fog, often badly, and are less comfortable, leading to much worse user compliance. They are also expensive (upfront cost plus constant cleaning/reprocessing) and not always compatible with prescription eyeglasses. Some staff wear their own goggles, but most are giving up the practice in favour of face shields (myself included).
  17. Re goggles and face shields: They both protect against droplets and splash only. Neither will fully protect the eyes against aerosols - but as eyes don't breathe/inspire air into the respiratory tract, protection against droplets and splash is adequate. Even the very best fitting goggles worn for health care PPE are vented. The vents are indirect (meaning they face backward so liquid can't splash into them by gravity), but don't have any sort of filter. Goggles are not airtight.
  18. I agree. It would be helpful from a public health/population risk point of view to have a set of criteria or definition for "outdoor event". But for assessing my own personal risk, I take some comfort from the idea that my version of an outdoor exposure is different than these events that are spreading covid.
  19. I'm clinging to the idea that most of these" outdoor events" aren't really truly exlusively outdoor, open-air events. Most of the them seem to have an indoor component (traveling together, lodging together, clustering in indoor spaces during the outdoor event like bars and bathrooms, in tents or shelters - not really open air).
  20. Really no logical reason. It's weird. Alcatraz Smedry's awesomeness?
  21. There aren't as many older getting admitted, for sure, but they never crowded out the younger ones. We made room. Still have a tent ward in the parking lot, patients admitted to hallways and other "non-traditional care spaces" etc.
  22. No. Our hospitals are still full*, and our covid admission criteria are pretty stringent. I do think that fewer older people are getting sick, because they are more likely to be vaccinated. Our proportion of hospitalized are younger partially because of that, I think. ETA: not full of covid patients anymore, just business-as-usual full same as pre-pandemic. The covid patients we do have are definitely trending younger.
  23. We're going through this right now with DS12's first pair of glasses. He's also weirdly excited about them. We've bought a very robust set of frames from Costco. They'll be ready for pick up next week. For safety glasses, we're using the kind that go overtop of regular glasses, like these. We haven't considers sports glasses, because his sports don't really need them, I don't think (gymnastics, swimming, volleyball, cycling). We'll consider them only if the regular glasses are a problem. Has your DS read Alcatraz vs the Evil Librarians? This book series makes glasses super cool.
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