[What’s the latest on immunity after one dose of the mRNA shots?]

Provincial paper summarizing the evidence.  It's a month old, though.  I haven't had time to go through it either.

[What’s the latest on immunity after one dose of the mRNA shots?]

This Government of Canada site has a section on the evidence for extending dose intervals, with a subsection on duration of immunity following a first dose, with references to studies.  I haven't had time to go through it yet.

[Questions for The Lord of the Rings experts]

35 minutes ago, Plum said:

I bought each of us a copy of the illustrated version of The Hobbit. Start there. I’m glad I got a copy for each of us to follow along to the audiobook with. The audiobook makes all of the songs and poetry so much better. Rob Inglis as the narrator does a really good job. The Hobbit turned out to be dd13’s favorite book. She’s happy to have her own book. 
 

We are using LLfTLotR and they refer to page numbers from an all in one volume. I wouldn’t recommend that all in one volume book unless you are using LLfTLotR. I’d get a set rather than an all in one. 
 

It’s been a wonderful year reading Tolkien and works that inspired him. It’s their favorite part of school. We watch the movie after reading the book. 

Re the bolded, agreed. 

We might sometimes sing "chip the glasses and crack the plates"  while we are cleaning up the kitchen.

[Questions for The Lord of the Rings experts]

12 minutes ago, Plum said:

That’s the one. ❤️

@Plumbeat me to it!  Yes, that's the one.  It's so lovely.

[Questions for The Lord of the Rings experts]

You don't have to read The Hobbit first; the LoTR will still make sense if you don't.  But LoTR will be much richer and better if you do read The Hobbit first.  The Hobbit is the easiest and most readable of the books too.  It's quite fun. 

Our favourite edition of The Hobbit is the one illustrated by Jemima Catlin.  There is an illustration on almost every page, and they are all very detailed and meticulously accurate with respect to the text (the dwarves all have the correct colored cloaks etc)

Yes, you have to read all of the LoTR books, and read them in order - it's one continuous story.  Well, of course, you don't have to do anything, but I would definitely recommend reading them all.

My kids loved these on audio.  They actually prefer Kara Shallenberg's recording of her reading them to her kids.

The movies are worth watching, but they did go quite far "off-book".  Some of the changes we liked, and some we really, really didn't.  We made a school assignment out of comparing movie Eowyn with book Eowyn , from a feminist perspective.

[wuhan - coronavirus]

2 minutes ago, Not_a_Number said:

Do you know what the numbers are looking like? Maybe I'll start a new thread on this. 

I really don't.  Good enough that they aren't even offering HCW a second dose before 4 months.

I've been pretty distracted by this disaster of a third wave.

[wuhan - coronavirus]

Just now, Not_a_Number said:

I hope we keep track of all those people and see how long the immunity from one dose lasts and how well it works. 

I'm realizing that it's been quite hard to study the mRNA vaccines after 1 dose so far, because if you do it too early, it doesn't work very well, but there are only 3 weeks between doses! So you have exactly one week in which to measure things, lol. Not super reliable... 

Second doses are being given at 4 months here (with very limited exceptions).  We'll have a sample size of millions. 

[Are you currently homeschooling?]

3 minutes ago, Not_a_Number said:

True, although I think a fair number of people send kids to high school. 

True enough.  Maybe even me.  One kid thinks he might like to go to high-school, the other wants to school at home forever and ever......  We'll see.

[Are you currently homeschooling?]

1 hour ago, Not_a_Number said:

It's a nice round number? 😄 

No real reason. I just wanted to distinguish people who were close-ish to done and people who were still in the thick of it. I should have really added an option for someone ALL of whose kids are under 10, though. 

My kids are 11 and 13.  No where near close to done, though.  We're still very much in the thick of it, I think.  I mean, you'd have to be finished 6th grade to be even halfway to 12th, right? 🙂

[wuhan - coronavirus]

3 hours ago, TCB said:

I couldn’t interpret the legal jargon in that order. It doesn’t seem to make it clear how far they will expand someone’s role. When the surge was happening in New Jersey a cardiologist friend of one of our ICU Drs was put in charge of a floor of ventilated patients as there weren’t enough intensivists. And in a city in our state, they quickly trained med/surg nurses to run the continuous dialysis machines that many Covid patients were on. Both of those things are pretty far out from normal practice for those people, and I can’t imagine the stress.

I’m so sorry this is happening. I hope you are managing to get some rest. 

I think that this is exactly where this is going to go. 

[wuhan - coronavirus]

1 hour ago, kbutton said:

I don't necessarily read legalese, but I think you'd have to know more about this part:

That regulation might delineate better how far out of the scope of practice people are expected to stretch. 

I am sorry this is not being talked about more openly--you should have better information if you're expected to vary from your scope of practice. The wording makes me think that someone thought through a lot of scenarios last year, documented them in a proposal in case it was needed, and that proposal was signed into law, but not into effect. Then, this newer thing is making it effective. 

My DH got a survey from his (now former) health system last year asking how far outside his scope of practice he would be willing to go. I think everyone got these. I don't know if the state was asking the system to do this or not, but it was pretty sobering just to see the questions. 

I hope additional guidance arrives soon and is not as scary.

I did look at both of those.

One seems to outline the governments powers to override rules and standards in various different sectors (basically setting themselves up to be able to make the regulation published April 21), and the other activates the ability of healthcare institutions to move workers around between facilities and to ignore work contracts with respect to things like shift times, vacations etc.  Nothing to do with scope of practice, as far as I can tell.

We filled out the how-far -will-you-push-your-scope of practice surveys last spring.

I really do think it's going to come to that for some of us.  Surgeons and anethesiologists are under-used right now (OR's shut down for all but emergency surgery).  I think they are going to find themselves asked to do other work.  I know some are working vaccine clinics - but that's not really the best use of their skills.  OR nursing staff are all over the hospital in alternate assignments already.

[wuhan - coronavirus]

42 minutes ago, Starr said:

I was reading something about medical staff being moved around but I thought it said they were qualified on paper but not necessarily comfortable with their staffing situation. Like I was an RN but never worked in the ER and I was never really comfortable going to the ER for a code. I'm not sure where I read it. I started to google and there are many articles. It sounds totally desperate. I so sorry! And then I heard people on CBC complaining about restrictions. 

That's what's actually happening on the ground where I am (that I'm seeing IRL), so far at least. 

ETA: that fact that a regulation like this could go into effect without any announcement or news reporting is really amazing to me.  Not in a good way.

 

[wuhan - coronavirus]

I think we are officially in crisis standards.  The province quietly enacted this regulation April 21.

The gist of it is that a hospital can now assign any health professional to do the job of any other health professional despite any statute, regulation, order, policy, agreement or collective agreement, regulatory college policy, practice standard or guideline, so long as it is necessary in order to respond to the pandemic.

So a nurse can be assigned doctor duties.  Or a doctor can be assigned nurse duties.  Or a PSW assigned RN duties.  Or any number of health care professionals doing the jobs of other regulated health care professionals without the usual training or meeting the usual standards.  

This was not announced (anywhere that I can find, at least), and hasn't been in the news.

This is a very serious thing.  Bleak.  Dire.  Pick your adjective.

WTM peeps who read legalese, please tell me if I'm wrong here.  But I don't think I am.

[wuhan - coronavirus]

The third wave here is stressing health care resources to the max.

The good news: 

• Daily case counts seem to have plateaued in the last week or so
• The lower age limit for AZ vaccine was lowered to 40, and I was able to score a dose for DH!  I'm so grateful to have him vaxxed. 

The bad news:

• ICU admissions and hospital admissions are climbing and not likely to stop for at least another 2 weeks.  We are at 833 ICU admits province-wide (peak of 410 last wave)
• ICUs in the Greater Toronto Area are full, and have been for weeks.  They've been shipping further and further afield.  Transfers are at an all-time high (800+ so far in April, with 2nd wave monthly numbers in the 200's for March, Feb, and Jan, for comparison.) Transfers do not require consent, as per emergency order.
• My local hospital has taken more than 60 transfers from the GTA in the past 2 weeks.  We've filled three wards, filled our ICU and now rapidly filling the make-shift, improvised second ICU.  We've got a ward in a tent in the parking lot.
• All non-essential/non-emergent surgery cancelled, province-wide, to create capacity.
• Lower acuity "alternate level of care" hospital patient are being transferred to nursing homes, consent not required, as per emergency order.
• Staff are being moved all over the place to fill gaps.  Community and homecare nurses are being pulled into hospitals, many hospital staff are being pushed up an acuity level.  While no-one is being placed anywhere were they aren't technically competent on paper, lots and lots of staff are outside their comfort-zone with their new assignments.  This on top of a year's worth of pandemic burnout.
• The provincial coroner has reported 25 deaths at home from covid since April 1, in people who didn't seek medical care.  These were covid cases that deteriorated suddenly and died, found dead by roommates or family.  Many were young.
• Percent fully vaxxed in the province remains at just over 2%.  Percent with a first dose has increased to 28%.  The problem remains supply.  We have the infrastructure to mass vaccinate, but we don't have the vaccines on hand to do it.  (The mood regarding the US export ban is somewhat sour right now.  The news today that the recent AZ shipment from the US was manufactured at the Emergent plant isn't helping, even though the particular doses we got are officially just fine; there is public doubt.  Too late anyway, they are mostly already in arms. One of those arms belongs to my DH.)
• We are still vaxxing 60+ and those with high risk medical conditions.  AZ for 40+ at select pharrmacies, though those doses are pretty much all "sold out" - there was a massive rush Monday when the age limit was lowered and now the wait-lists are a mile long, with no more supply on the horizon.

I think we've got about four more weeks of this.   Our stay-at-home order is due to expire May 20.  I hope it give us enough time.

 

[Covid Vaccine if You Have a Cold?]

Covid symptoms are absolute contraindication.  That would include most cold symptoms.

[Thinking about beekeeping...]

My only beekeeping story is of treating a beekeeper for severe anaphylaxis to bee stings.  She was advised that she might want to consider a new hobby.

[I need a pep talk]

@bolt.

I don't know if you've seen this University of Cambridge risk/benefit decision aid .  I found it really helpful for putting the risk/benefit in perspective.

[I need a pep talk]

12 minutes ago, Pam in CT said:

 

And better is better.  There's nothing noble in holding out for Perfect.  This is the real world; there is no such thing as perfect, only different degrees and dimensions of imperfect.

 

I agree with Pam's entire post, but the bolded sums it up.

The other thing to consider is potential exposure risk that's outside our control, like an unexpected non-covid medical emergency or other situational emergency or urgency (critical house repair, emergency travel).   Partial protection now gives some insurance against that (ETA esp. now while cases are raging).

ETA, I forgot the pep talk part.  Yay OP!

[I need a pep talk]

2 minutes ago, Ottakee said:

THIS.  A good friend of mine is an ICU doctor.  She put out a plea again yesterday to get people vaccinated.  She said she has had ZERO Admissions and ZERO deaths from covid from people that are fully vaccinated.  She said that 3-5% of the vaccinated people that do get covid are only mildly ill.  

She has stories of people in their 40s and 50s struggling to breath and walk across the room.

I can raise her one and tell the same stories about people in their 20's.  Seriously, covid is no joke.

OP, congrats again on your decision.

 

[I need a pep talk]

23 minutes ago, bolt. said:

I was about to book my shot when I got to this info on the booking page:

"The Covishield / AstraZeneca vaccine has been shown to be 60 – 70% effective at preventing symptomatic COVID-19 (compared to 95% for Pfizer and Moderna). All COVID-19 vaccines approved by Health Canada are highly effective at preventing severe outcomes like hospitalization and death. If you receive Covishield / AstraZeneca now, you will NOT receive the Pfizer or Moderna vaccine later this spring.

If you choose not to receive the Covishield / AstraZeneca vaccine, you will be eligible to receive a different available vaccine later this spring (supply permitting)."

And now *I* need a pep talk!

I want to be vaccinated.

I don't know whether I should be vaccinated as soon as I can (now) with this two-thirds efficacy vaccine -- knowing that I could wait for a more effective shot later. Or I could wait?

The health advice is to take whatever is available... but the 'disclaimer' style info I quoted just threw me for a loop. I don't just want protection from severe outcomes. I want to help halt the spread. Is it more helpful to take a two-thirds chance of taking myself out of a transmission chain 'sooner', or stay in the transmission chain for now and get 95% out of it 'later'?

Yes, since the AZ age limit was lowered to 40 in many provinces, lots of us have decisions to make.

I think it depends on your age and exposure level. 

FWIW:  My late 40's family member will be getting his AZ today.  We are in a seriously ugly 3rd wave (and I think you said in another thread that your cases per population were really high too?) and he won't be eligible for mRNA vaccine until probably July.   Less good protection now is more  important than better protection later.  Less good protection now is MUCH better than no protection now.  By July, we will have a much higher proportion of the population vaxed, case rates will be lower, and we won't be in healthcare system overload - full protection won't matter as much then.

If he were in his 20's and never left the house, then maybe we'd wait (higher VIPIT risk, lower covid morbidity and mortality risks, less impressive risk/benefit), though that's a moot point really since AZ isn't available for that age group anyway, but just as an example.

Also FWIW, all my MD colleagues have come to the same conclusion wrt their 40's spouses.  All will get getting jabbed with AZ in the next day or two.

[I need a pep talk]

Congrats on booking.

It's a double good choice - protect yourself and protect others.

[How bad is it?]

I've heard this advice for people with severe eczema that's chronically infected, and for people who are MRSA carriers who are under treatment - to avoid re-infection.  For people without any special medical reasons, I don't think I'd bother.  I mean, I actually don't bother.  I stick my finger in the tub of cream and don't think twice about it.

[Covid 3rd wave JAWM]

12 minutes ago, Halftime Hope said:

Wathe, how are you all doing on early ambulatory treatment?  Any traction on that? We are having growing success in my area with doctors referring immediately for outpatient monoclonal antibody infusions for high-risk patients. (Doesn't do a thing for lower-risk patients, to protect them against long-covid, but it would have kept dh's friend from dying, had it been widely available six weeks ago.) 

I'm so sorry...one of the things that has mattered the most to me, aside from putting dh at risk, is not adding to the burden on healthcare workers.  

 

It's not standard of care here, nor is it available in the community.  Yet.

ETA a link to current local treatment guidelines, for interest.

[Covid 3rd wave JAWM]

2 minutes ago, melmichigan said:

I'm on the border.  Closed for non-essential travel is definitely a misnomer.  There is plenty of travel, even with the risk of such a steep fine.  I'm surprised they haven't announced an extension yet, the current closure is supposed to expire in just a few days.  

I believe it.  The definition of the word "essential" seems to have drifted during this pandemic.

[Covid 3rd wave JAWM]

28 minutes ago, kand said:

What’s the border situation between Michigan and Ontario right now? It doesn’t seem like I’ve been hearing much about the relationship between these two bad outbreaks in Ontario and Michigan, but their geographic relationship makes me wonder if both are sharing a more transmissible variant. Which makes me wonder whether Washington state will also start seeing spill over from what’s happening in Vancouver, BC. Vancouver has been having a big P1 (Brazil) outbreak. Seems like the situation in Washington could change rapidly if that crosses the border. And I’m not sure why it wouldn’t. 

Closed for non-essential travel.  There is still quite a lot of traffic back and forth despite the closure - hundreds of thousands of vehicles per month nationally.  Essential reasons include work, commerce, trade, medical care, and citizens returning home.  Lots of snowbirds still found a way to go south this year, and are now coming home.  And quite a few are using land border taxi services to avoid mandatory quarantine hotels for air-travelers.