Jump to content

Menu

wathe

Members
  • Posts

    3,214
  • Joined

Posts posted by wathe

  1. 3 hours ago, SDMomof3 said:

     

    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.

    • Like 16
  2. 21 minutes ago, Murphy101 said:

    Of course I don’t think she should donate while knowingly sick.  But I thought she said she isn’t sick and thinks she’s most likely negative but just wants to be sure. Some donation places offer screening from your car or and separate out people as they donate.  Last time I went they had separate rooms that were sanities between each person.  Either way once my self isolation was done - I’d donate and ask about antibodies. 

    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.

    • Like 7
  3. 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.

     

    • Like 13
  4. 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.)

     

     

    • Like 9
    • Thanks 1
  5. 41 minutes ago, Murphy101 said:

    If you are going to self isolate anyways - I’d just go donate blood or plasma. They check there for free, heck you can even get paid for testing that way! They say it can take 3-6 weeks for the results of all the tests comes back, but I and my friends who donate have all gotten ours within 3 days. I don’t *think* you can get more accurate than a blood draw.

    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.  

    • Like 5
  6. 2 hours ago, SeaConquest said:

     We have seriously learned nothing and all my ICU nurse friends in other states are so over helping people who refuse to help themselves. I mean, of course, they will help people. It's their jobs, but people aren't volunteering and all gung ho anymore. That ship has sailed.  

    Yep.

    • Like 1
    • Sad 4
  7. 37 minutes ago, KSera said:

    A note on ease of breathing. If you look at the mask data chart I shared recently, there’s a column for pressure drop. That’s actually important, because in addition to indicating how easy and comfortable it is to breathe in, masks with too great a differential will actually cause more air to go around the sides of the mask. That particular chart also indicates whether the mask collapses when you breathe in, or not. For sports, obviously not collapsing is much preferred. Unfortunately, that chart does not include a lot of the masks being discussed in this thread, though. It has predominantly KF94s and N95s, though it does have some reusable masks tested as well.

    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

     

    • Like 1
  8. 12 hours ago, wathe said:

    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.

    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).

    • Like 4
  9. 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.

    • Like 9
    • Thanks 1
  10. 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
  11. 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
  12. 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
  13. 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
  14. 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
  15. 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
  16. 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
  17. 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
  18. 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
  19. 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
  20. 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
  21. 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
×
×
  • Create New...