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wathe

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Posts posted by wathe

  1. 25 minutes ago, kbutton said:

    But people think of these events as safe, and we aren't really getting out a clear message about what indoor/outdoor differences entail. I would really like to have solid information on things like open-sided tents and shelters (including information about size of tent and number of people), open porches with a roof, even screened in porches where air moves, but less than with no screens.

     

    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.

    • Like 6
  2. 56 minutes ago, calbear said:

    Regarding outdoor event...there was this article documenting an outdoor wedding in Texas. 

    https://www.forbes.com/sites/brucelee/2021/07/12/outdoor-wedding-6-fully-vaccinated-infected-with-covid-19-delta-variant/?sh=6bce51fa6c49

    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).

    • Like 8
  3. 38 minutes ago, BaseballandHockey said:

    I am glad mine isn’t the only one!  Does he have a reason that makes sense?

     

    Yeah those sound more doable with regular glasses.

    We will check it out! 

    Really no logical reason.  It's weird.  Alcatraz Smedry's awesomeness?

    • Like 1
  4. 1 minute ago, Not_a_Number said:

    Yeah, I was wondering if the difference in distribution was just that there aren't as many older folks getting admitted and crowding out sick younger folks. But you'd definitely have a better sense of that than I would. 

    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.

    • Like 1
    • Sad 1
  5. 6 minutes ago, Not_a_Number said:

    Do you think the people getting really sick are younger, or are they just more likely to be admitted to the hospital, whereas before they'd be really sick at home due to full hospitals? 

    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.

     

    • Like 1
  6. 53 minutes ago, TCB said:

    The people getting really sick are younger, but of course that could be a vaccination issue. To us they seem sicker than earlier waves and also to become sicker more quickly. Honestly though, after all this time it is hard to be completely objective about such things. The one objective thing we definitely know from our experience is that vaccines prevent serious illness.

    Same experience here.

    • Sad 2
  7. 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.

     

     

    • Like 2
  8. 45 minutes ago, Not_a_Number said:

    Question: how does one interpret these numbers? I know that for the vaccine trials, some things were reported with equal likelihood for placebo and treatment, lol. How are these numbers being separated out?

    With many, many grains of salt*.

     It's an old drug, developed in the 70's and 80's.  (*** removed***) The burden of disease that this drug was developed to treat was/is huge, and the drug was developed for the developing world - I suspect that the trials might not meet modern standards.  The sociological and economic threads in the story of the drug are interesting, to say the least.

    For interest, a fascinating article about the history of the ivermectin.

    *ETA: Maybe a dumptruck load of salt.  Or an entire salt mine....

    ***nevermind, they stated how many were in the trial.  I am a goof.

    • Thanks 4
  9. Some of the listed ivermectin side effects/ adverse reactions are a result of the drug interacting with the parasitic infection it's used to treat.  Those specific side effects wouldn't be relevant for covid treatment.  That said, we don't know if there are covid disease specific side-effects, and won't know until we have good, large trials and real world experience.

    I think that TPTB are correct to advise against ivermectin use at this time.  It will never get approved for prevention, I don't think, because we already have a very safe and effective prevention measure (vaccine!).  Drugs for prevention have to be very very, safe because, when taken by large numbers of people over long periods of time, even the rare adverse events are going to happen again and again (which we see with vaccines and allergic reactions and myocarditis and VITT, the former at a rate that we accept, the later at a rate that we currently don't; we've paused AZ use in Canada). With vaccines, we accept these adverse events because we have extremely robust evidence to show that vaccines work, and that the benefit far, far exceeds the risk.  

    I think that for ivermectin,  used for prevention on a population scale, 1) The adverse event rate will be too high to be acceptable, and 2) we do not have robust evidence to show that it actually works.

     I think the same argument is valid against treatment with ivermectin at this time. We generally accept more adverse event risk for treatment, but in order to accept the risk on a population level, we have to have robust evidence that the treatment works (that the benefit outweighs the risk).  At this time, we do not have robust evidence to show that ivermectin doesn't do more harm than good.

     

    • Like 7
    • Thanks 2
  10. 3 hours ago, Not_a_Number said:

    Here’s the list of side effects of ivermectin on webMD:

    https://www.webmd.com/drugs/2/drug-1122/ivermectin-oral/details
     

    I don’t love these lists, since they include everything but the kitchen sink and don’t include rates. I’m genuinely having trouble finding rates, though.

    Here are some quotes:

     

    Headache, dizziness, muscle pain, nausea, or diarrhea may occur.

     

    Tell your doctor right away if any of these rare but very serious side effects occur: neck/back pain, swelling face/arms/hands/feet, chest pain, fast heartbeat, confusion, seizures, loss of consciousness.

    A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

    Look for monographs.  They usually have lists of side-effects, with frequencies, and often quote sources. Ie Merck monograph for Ivermectin

    • Thanks 1
  11. 49 minutes ago, Not_a_Number said:

    What do they do instead? 

    Most famously, as the third wave was really heating up in April, the science table advised paid sick leave, limiting mobility, closing all but essential workplaces, expediting vaccination of essential workers.  The government ignored Science Table recommendations, and instead closed playgrounds and increased police powers. There was quite a brouhaha over that.

    • Confused 3
  12. 3 minutes ago, Not_a_Number said:

    What do they do instead? 

    They sometimes listen, sometimes don't.  And sometimes listen selectively.

    They listened very poorly prior to and in the early days of our disastrous 3rd wave.  I think they learned their lesson.

    We're now in the midst of a very cautious, phased re-opening.  They've been listening nicely this time around..

    • Like 2
  13. 24 minutes ago, Ausmumof3 said:

    65 for NSW today so moving in the right direction

    10 for Vic

    3 for QLD

    had my first Pfizer so far so good!  Arm is a little dead.

    Congrats on your vax!

    • Like 1
    • Thanks 1
  14. 4 minutes ago, Not_a_Number said:

    Thanks for the recommendation! I always like hearing about people who are worth listening to. Sometimes all the opinions get overwhelming... 

    They are the group our provincial government is supposed to listen to for advice......

    • Like 1
  15. I don't generally review primary data myself, unless it is a topic of particular interest (I looked at the mRNA vaccine trial data quite closely, for example) because it is absolutely impossible to read the primary data on everything and still have time to practice.

    I rely on professional medical reviewers who are vetted, and who cite primary sources (so I can check up on them from time to time) .  For covid, UpToDate is one of my favourites. It's a professional reference resource that is $$$$ to subscribe to, but has made its covid pages free to all during the pandemic. The Ontario Covid-19 Science Advisory Table is my favourite local covid resource. These types of resources look at data through an individual patient lens and also a public health/systems lens. They know what they are doing with respect to critical appraisal of evidence.  For what it's worth,  both recommend against Ivermectin*.

    ETA I know some of the Ontario Science table people IRL.  They've earned my trust - they are Very Smart People who Know What They Are Doing.

    *ETA again except in very specific circumstances of covid, immune compromise and strongyloides co-infection - but in that case the ivermectin is to treat the parasite, not the covid.

    • Like 3
    • Thanks 7
  16. 3 hours ago, Danae said:

    Don’t project your PCP’s ridiculousness onto the rest of the US.  Practices here are seeing people as normal.  Many have a separate waiting area for people with respiratory symptoms, or ask you to wait in your car until called, but people are being seen and treated.

    She might mean this (PCP's declining to see patient with URI symptoms), 'cause that's definitely still happening in some communities, but I think she instead means that PCP's aren't treating respiratory symptoms with the treatments that she believes are indicated, which might include non-mainstream treatments, or treatments outside standard practice guidelines.  I think that interpretation fits better with the theme of the posts leading up to this one.  

    Perhaps @Halftime Hopewill clarify.

     

     

    • Like 2
  17. 42 minutes ago, Terabith said:

    Our doctors will not see anyone with anything remotely upper respiratory, or gastrointestinal.  They tell everyone to go to urgent care.  I could get a tele-health appointment with my doctor for a sinus infection, but when I thought I had an ear infection, they said I had to go to urgent care, because ear infection might have been caused by something respiratory, and they aren't seeing people who are sick with potentially contagious ailments.  Which is kind of a nice gig for doctors, but kinda sucky for the urgent care folks.  

    We have this problem here now.  some family practices still aren't seeing patients in person, or are declining to see respiratory illness.  So we end up seeing these people in our over-crowded, understaffed emergency department.  For complaints that really should go to primary care.  The patients wait a long time to have their non-emergencies seen (because, of course, in an emergency department, they get bumped by emergency cases) and then get upset because their "doctor called ahead" and somehow this gives people the idea that I am waiting for them with nothing else to do......

    Emerg staff are so very tired.

    • Sad 13
  18. 32 minutes ago, Corraleno said:

    https://www.tennessean.com/story/news/health/2021/07/13/tennessee-halts-all-vaccine-outreach-minors-not-just-covid-19/7928701002/

    Excerpt:

    The Tennessee Department of Health will halt all adolescent vaccine outreach – not just for coronavirus, but all diseases – amid pressure from Republican state lawmakers, according to an internal report and agency emails obtained by the Tennessean. If the health department must issue any information about vaccines, staff are instructed to strip the agency logo off the documents.

    The health department will also stop all COVID-19 vaccine events on school property, despite holding at least one such event this month. The decisions to end vaccine outreach and school events come directly from Health Commissioner Dr. Lisa Piercey, the internal report states.

     

    https://www.tennessean.com/story/news/health/2021/07/12/covid-19-tennessee-fired-vaccine-official-michelle-fiscus-fears-state/7945291002/

    Excerpt from a statement by TN's top vaccine official, who was fired yesterday:

    "It is the mission of the Tennessee Department of Health to “protect, promote and improve the health and prosperity of the people of Tennessee” and protecting them against the deadliest infectious disease event in more than 100 years IS our job. It’s the most important job we’ve had in recent history. Specifically, it was MY job to provide evidence-based education and vaccine access so that Tennesseans could protect themselves against COVID-19. I have now been terminated for doing exactly that.
    ...
    What's more is that the leadership of the Tennessee Department of Health has reacted to the sabre rattling from the Government Operations Committee by halting ALL vaccination outreach for children. Not just COVID-19 vaccine outreach for teens, but ALL communications around vaccines of any kind. No back-to-school messaging to the more than 30,000 parents who did not get their children measles vaccines last year due to the pandemic.  No messaging around human papilloma virus vaccine to the residents of the state with one of the highest HPV cancer rates in the country. No observation of National Immunization Awareness Month in August. No reminders to the parents of teens who are late in receiving their second COVID-19 vaccine. THIS is a failure of public health to protect the people of Tennessee and THAT is what is “reprehensible”. When the people elected and appointed to lead this state put their political gains ahead of the public good, they have betrayed the people who have trusted them with their lives.
    ...
    I have been terminated for doing my job because some of our politicians have bought into the anti-vaccine misinformation campaign rather than taking the time to speak with the medical experts. They believe what they choose to believe rather than what is factual and evidence-based. And it is the people of Tennessee who will suffer the consequences of the actions of the very people they put into power."

     

    I saw the NYT version of the story.  It beggars belief.

    “Nobody else in this state needs to die from Covid-19 because we have effective vaccines,” she said. “And the fact that we have elected and appointed officials that are putting barriers up to protecting those Tennesseans is, I think, it’s unforgivable.”  

    • Like 8
  19. 6 hours ago, regentrude said:

    Several folks mentioned using positivity rates as a measure. Why? Wouldn't the positivity rate entirely depend on how many and how sick people test? If there's a ton of testing, like mandated on schedule,  rate will be much smaller than if there's only a few sick folks testing and noone else.

    It's correlated well here with hospitalizations and deaths, but percent positivity rises earlier, while hospitalizations and deaths lag behind.

    Lots of people are getting covid tests who don't have symptoms here:  Nursing home staff are all tested weekly, every hospital inpatient gets a covid test at the time of admission, no matter what the reason for admission (including obstetrics, orthopaedics, etc), all patients  getting discharged to a nursing home get another test before discharge, all patients having surgery for any reason get a covid test etc.  

    • Like 3
  20. 1 minute ago, wathe said:

    Provincial.  My health unit rate is slightly lower (0.5%), but we are close to Toronto (0.7%) and adjacent to another health unit with a positivity of 1.4%.  We are also an area that attracts a lot of seasonal travellers.

    Quoting myself to say that I pick whichever one is worse, local vs provincial.  

    • Like 1
  21. 7 minutes ago, mommyoffive said:

    What positivity rates are you guys using?  Your state's or county's? 

    Provincial.  My health unit rate is slightly lower (0.5%), but we are close to Toronto (0.7%) and adjacent to another health unit with a positivity of 1.4%.  We are also an area that attracts a lot of seasonal travellers.

    • Like 1
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