wuhan - coronavirus

[Harriet Vane]

3 hours ago, Dreamergal said:

India is buckling.

https://www.cnn.com/2021/04/21/india/india-covid-hospital-shortage-intl-hnk/index.html

The thing is the health care system on a given day is quite robust. Doctors come back all the time after spending time studying in various countries. People come from the Middle East, Africa, Russia to have treatments. But there is only so much a system can take.

Now there are reports of people dying from lack of oxygens in ventilators. 

https://www.reuters.com/world/india/oxygen-supplies-run-low-india-grapples-with-coronavirus-storm-2021-04-21/

They are moving Industrial oxygen for hospitals the last I heard.

I knew a few people who were sick and died during the first surge, but not like this. Hospital beds are at a premium. It is just heart breaking and feeling so helpless.

I am grateful my parents, inlaws and brother's family are ok so far and feeling selfish for feeling so. The extended family has so many isolating or were in hospitals. But even that is a mercy because this is the peak and so many people are not getting beds. 

I just pray, I don't know what else to do. 

@Dreamergal, I have enjoyed getting to know you since you joined the forums. I am heartbroken about all the suffering in India and in the world. I prayed for your family today.

[SoCal_Bear]

Patients With Long COVID Face Lingering Worrisome Health Risks, Study Finds

https://news.yahoo.com/patients-long-covid-face-lingering-185649476.html

[Ausmumof3]

https://www.abc.net.au/news/2021-04-23/tga-reviewing-three-blood-clot-cases-astrazeneca-covid-vaccine/100091546

 

3 more cases of blood clots with AZ in Australia including one in an eighty year old man.

[Ausmumof3]

Quoted from the article 

"Whilst meeting the international and UK criteria, two of the three cases appear to be milder forms of the syndrome that were recognised very early by the treating health professionals and are responding well to treatment, and in one of the cases platelet counts were depressed to a limited extent and the patient developed symptoms unusually late (26 days after vaccination)."

The TGA said one of the cases involved a blood clot in the brain, which caused a headache, a nosebleed, nausea and vomiting.

The other two cases presented in more common ways — deep vein thrombosis in the calf and upper leg — although clots in the lungs and brain were later found.“

 

I did wonder if 20 days was going to be a definite upper limit or not.

[Ausmumof3]

Perth is going into a three day lockdown due to one of the cases from the hotel being out and about in the community for five days.  NZ is pausing travel with WA.

Apparently the rooms where the spread occurred did have HEPA filters fitted.  

[SoCal_Bear]

Coronavirus: The risk going forward is 'general confidence in vaccines'

There are bar charts by ethnicity, age, political affiliation for United States that are on here. Asians are missing again, but from other sources, the likely to vaccinate survey in December 2020 was 83%.

https://finance.yahoo.com/news/coronavirus-confidence-vaccines-155052501.html

[Faith-manor]

The UK variant is beginning to dominate here in Michigan. More young people are getting it, and two weeks ago the hospitals were totally overwhelmed. But, cases are beginning to drop, slowly.

We have about 31.5% ish fully vaxed. If there had not been a pause on JnJ, several universities had scheduled mass vaccinations for last week. College students seem to be happy to get in line for shots. But we have a high rate of hesitancy in rural areas.

I am worried because this third wave has been horrific, and now it looks like Washington State is going up badly again!

[Jean in Newcastle]

4 minutes ago, Faith-manor said:

I am worried because this third wave has been horrific, and now it looks like Washington State is going up badly again!

Really?  I wonder if I'm looking in the wrong place.  I just checked Worldometer and total new cases aren't even near what it was in the winter.  And neither are daily deaths from Covid.  (It is rising a bit - I just am not seeing it going up badly at this point.) 

[SeaConquest]

2 hours ago, calbear said:

Coronavirus: The risk going forward is 'general confidence in vaccines'

There are bar charts by ethnicity, age, political affiliation for United States that are on here. Asians are missing again, but from other sources, the likely to vaccinate survey in December 2020 was 83%.

https://finance.yahoo.com/news/coronavirus-confidence-vaccines-155052501.html

The party ID and age breakouts are so depressing. 

[Faith-manor]

19 minutes ago, Jean in Newcastle said:

Really?  I wonder if I'm looking in the wrong place.  I just checked Worldometer and total new cases aren't even near what it was in the winter.  And neither are daily deaths from Covid.  (It is rising a bit - I just am not seeing it going up badly at this point.) 

I saw it on a local news site. Maybe that site is wrong! There have certainly been a lot of reporting errors this past year.

[Faith-manor]

This isn't the initial story I read. The other is behind a paywall for local news, and my guess is you don't want to subscribe to that! 

https://www.kitsapsun.com

 

It indicates a 19.1% rise in the last week. When Michigan did started to experience similar numbers, it was the precipice of a third wave. We have had some counties experiencing 30-33% positivity. Thankfully, it is beginning to drop.

[Faith-manor]

One more article about Washington State. I am very concerned for them.

 

https://abcnews.go.com/US/washington-state-verge-4th-covid-19-wave-officials/story?id=77255377&cid=clicksource_4380645_1_heads_hero_live_hero_related

[Jean in Newcastle]

2 hours ago, Faith-manor said:

One more article about Washington State. I am very concerned for them.

 

https://abcnews.go.com/US/washington-state-verge-4th-covid-19-wave-officials/story?id=77255377&cid=clicksource_4380645_1_heads_hero_live_hero_related

Thanks. I knew that three counties were rolled back to phase 2 but I didn’t know that the rates were increasing that much. 

[Corraleno]

48 minutes ago, Jean in Newcastle said:

Thanks. I knew that three counties were rolled back to phase 2 but I didn’t know that the rates were increasing that much. 

It's happening in Oregon, too, mostly from a combination of new variants (we have a LOT of the California variants now, which are more contagious and associated with higher viral loads, as well as a lot of B117 and a sprinkling of B1351 and P1) plus reopening things (including schools).

The biggest jump in cases is among young people, very few of whom have been vaxed yet — we had a slow rollout here, with under-65s eligible just this week. I think you guys are doing somewhat better in terms of vax rate, but are probably seeing the similar levels of spread with the variants, and big increases primarily in young people.

[Wheres Toto]

I'm surprised but thrilled to see NJ is over 55% vaccinated.   I know a few people who are hesitant or not planning to vaccinate but not many.  I've been more surprised by how many people I know evidently have either conditions or jobs that allowed them to get vaccinated months ago.   

I get my second shot tomorrow.   

[Penelope]

https://www.timesofisrael.com/israel-said-probing-link-between-pfizer-shot-and-heart-problem-in-men-under-30/
 

Israel investigating 62 possible vaccine-associated myocarditis cases, with 2 deaths, primarily in men under 30. After second dose of Pfizer.

I’ve seen this raised as a question for multiple cases in the US, too, myocarditis and pericarditis after Pfizer in younger people, though I don’t know if there are articles about that. It is physicians in different areas saying they have seen it, in the past month. So I’m expecting to see something more about this eventually.

Edited April 24, 2021 by Penelope

[mommyoffive]

17 hours ago, Corraleno said:

It's happening in Oregon, too, mostly from a combination of new variants (we have a LOT of the California variants now, which are more contagious and associated with higher viral loads, as well as a lot of B117 and a sprinkling of B1351 and P1) plus reopening things (including schools).

The biggest jump in cases is among young people, very few of whom have been vaxed yet — we had a slow rollout here, with under-65s eligible just this week. I think you guys are doing somewhat better in terms of vax rate, but are probably seeing the similar levels of spread with the variants, and big increases primarily in young people.

Oh wow, that is slow!  Is it open to everyone under 65 now?   

Here in Wisconsin we opened up to everyone 16 and up on April 5th.  It was opened to people with lots of different pre-existing conditions 16 years and old on March 22 or right around then.  You didn't have to have proof of anything condition either.  

[ktgrok]

6 minutes ago, Penelope said:

https://www.timesofisrael.com/israel-said-probing-link-between-pfizer-shot-and-heart-problem-in-men-under-30/
 

Israel investigating 62 possible vaccine-associated myocarditis cases, with 2 deaths, primarily in men under 30. After second dose of Pfizer.

I’ve seen this raised as a question for multiple cases in the US, too, myocarditis and pericarditis after Pfizer in younger people, though I don’t know if there are articles about that. It is physicians in different areas saying they have seen it, in the past month. So I’m expecting to see something more about this eventually.

This is something that can happen with flu vaccine as well - seems to be linked to people on certain meds perhaps, in flu vaccine cases. 

and of course, myocarditis happens more often with Covid infection (and flu infection, for that matter) than with vaccine.

[Penelope]

8 minutes ago, ktgrok said:

This is something that can happen with flu vaccine as well - seems to be linked to people on certain meds perhaps, in flu vaccine cases. 

and of course, myocarditis happens more often with Covid infection (and flu infection, for that matter) than with vaccine.

Yes. It just shows that there is a lot of info still to sort through. It’s amazing that we’ve given out so many millions of vaccines so quickly. But data crunchers have a lot of reports to go through. 
 

It does make me think about our reporting system in the US. It’s all voluntary and only captures a fraction of adverse events. Do countries with centralized records do a much better job with picking these things up sooner and addressing them? 
It was interesting to me how the EU was talking about Johnson and Johnson adverse events before the US, when all the doses had only been given in the US. Whether or not it is true, it sort of looks like they were more on top of our data than we were. 🧐

[Faith-manor]

10 minutes ago, Penelope said:

Yes. It just shows that there is a lot of info still to sort through. It’s amazing that we’ve given out so many millions of vaccines so quickly. But data crunchers have a lot of reports to go through. 
 

It does make me think about our reporting system in the US. It’s all voluntary and only captures a fraction of adverse events. Do countries with centralized records do a much better job with picking these things up sooner and addressing them? 
It was interesting to me how the EU was talking about Johnson and Johnson adverse events before the US, when all the doses had only been given in the US. Whether or not it is true, it sort of looks like they were more on top of our data than we were. 🧐

According to my sister, a resident of France, in general the EU is much more organized and prompt at evaluating medical data, far more than she experienced here. She always has cutting edge medical news weeks and months in advance of me getting it here. So now I make her translate it for me and send it. My French is mighty rough so I don't trust myself to read it anymore.

[Penelope]

https://www.ndm.ox.ac.uk/files/coronavirus/ciscommunityvaccinationpaper20210417complete.pdf
 

Large real-world community study in the U.K. demonstrates effectiveness of both Pfizer and Astra Zeneca vaccines against (asymptomatic and symptomatic) infections, about 70% after two doses. 
Prior infection without vaccination protected just as well, but tended to have higher viral loads when reinfected than breakthrough infections after vaccination. They were 90% effective against symptomatic infection. 👍

There was no difference in rates of breakthrough infection after Astra Zeneca vs. Pfizer.

Quote

Results Odds of new SARS-CoV-2 infection were reduced 65% (95% CI 60 to 70%; P<0.001) in those ≥21 days since first vaccination with no second dose versus unvaccinated individuals without evidence of prior infection (RT-PCR or antibody). In those vaccinated, the largest reduction in odds was seen post second dose (70%, 95% CI 62 to 77%; P<0.001).There was no evidence that these benefits varied between Oxford-AstraZeneca and Pfizer-BioNTech vaccines (P>0.9).There was no evidence of a difference in odds of new SARS-CoV-2 infection for individuals having received two vaccine doses and with evidence of prior infection but not vaccinated (P=0.89). Vaccination had a greater impact on reducing SARS-CoV-2 infections with evidence of high viral shedding Ct<30 (88% reduction after two doses; 95% CI 80 to 93%; P<0.001) and with self-reported symptoms (90% reduction after two doses; 95% CI 82 to 94%; P<0.001)

 

Edited April 24, 2021 by Penelope

[Corraleno]

38 minutes ago, Penelope said:

https://www.ndm.ox.ac.uk/files/coronavirus/ciscommunityvaccinationpaper20210417complete.pdf

There was no difference in rates of breakthrough infection after Astra Zeneca vs. Pfizer.

I found that study very difficult to read, but this jumped out at me:

"There was no evidence that reductions in odds of new infections differed between the Pfizer- BioNTech and Oxford-AstraZeneca vaccine (Figure 4A; Supplementary Table 7) whether the vaccine was received 0 to 7 days ago (P=0.965), 8 to 20 days ago (P=1.00), or ≥21 days ago (P=0.998) for Pfizer-BioNTech ≥21 days ago, one dose only, vs Oxford-AstraZeneca ≥21 days ago, one or two doses). There was also no evidence that reductions in odds of new infections differed between those post second Pfizer dose and those not vaccinated but previously PCR/antibody-positive (P=1.00)."

So they're saying that there was no difference between AZ and Pfizer 0-20 days after the first dose, or more than 21 days after ONE dose of Pfizer or one or TWO doses of AZ.

Why are they comparing one dose of Pfizer to two doses of AZ??? Where is the data comparing efficacy 14 days after the second dose of Pfizer? The only comment about the infection rate after 2 doses of Pfizer is that it was equally as effective as prior infection with covid.

It should also be noted that the UK waits 3 months before the second shot, which the Brazilian study accidentally showed provided better efficacy for the AZ vaccine, but there is no reason to believe that 3 months is better than 3 weeks for Pfizer. So they are not using Pfizer the way it was designed to be used, and they're still not reporting the efficacy after the 2nd dose.

I'm getting really suspicious of these unpublished press-release-style "studies" by Oxford scientists trying to show that their vaccine is just as good as the mRNA vaccines.

ETA: Who wants to bet that John Campbell will have a video up in the next couple of days touting this study as incontrovertible proof that AZ works just as well as Pfizer?

Edited April 24, 2021 by Corraleno

[ktgrok]

1 hour ago, Penelope said:

Yes. It just shows that there is a lot of info still to sort through. It’s amazing that we’ve given out so many millions of vaccines so quickly. But data crunchers have a lot of reports to go through. 
 

It does make me think about our reporting system in the US. It’s all voluntary and only captures a fraction of adverse events. 🧐

I hear people say this a lot, as a criticism...but would you want a NON voluntary system instead? What does that look like? I mean, I don't care, but it seems some would be against it. Are we talking mandatory public health reporting like with certain communicable diseases? Or?

 

Edited April 24, 2021 by ktgrok

[Penelope]

 Encouraging study from Australia on the prevalence of long-Covid type symptoms in children.
https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(21)00124-3/fulltext#.YH_tah0EQDo.twitter

Quote

Our cohort comprised of 171 children (median age 3 years [IQR 1–8]): 90 (53%) boys and 81 (47%) girls. Most children had mild disease (100 [58%]) or were asymptomatic (61 [36%]), and nine (5%) children had moderate disease. The few hospital admissions (14 [8%] children) were generally brief and were for observation or fluid rehydration. One (1%) child with complex congenital heart disease had severe COVID-19 pneumonitis with acute respiratory failure (appendix p 3). Two (1%) children had post-acute COVID-19 inflammatory conditions temporally associated with SARS-CoV-2: a 7-year-old child with paediatric multisystem inflammatory syndrome who required intensive care management, and an 11-month-old child with Kawasaki disease.

Follow-up data at 3–6 months were available for 151 (88%) of 171 children, of whom 54 (36%) were asymptomatic and 97 (64%) were symptomatic (ie, with mild, moderate, or severe disease) with acute COVID-19. 12 (8%) children had post-acute COVID-19 symptoms, all of whom were symptomatic with acute COVID-19 (table). The most common post-acute COVID-19 symptoms were mild post-viral cough (six [4%] of 151 children), fatigue (three [2%] children) or both post-viral cough and fatigue (one [1%] child). The duration of post-viral cough ranged from 3 weeks to 8 weeks and of post-viral fatigue ranged from 6 weeks to 8 weeks from the time of symptom onset. At the most recent review in March, 2021, all 151 children had returned to their baseline health status and post-acute COVID-19 symptoms had resolved. Follow-up data for 20 children were not available; seven (35%) of these children had asymptomatic COVID-19.

 

[wathe]

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.

 

[Penelope]

1 hour ago, Corraleno said:

I found that study very difficult to read, but this jumped out at me:

"There was no evidence that reductions in odds of new infections differed between the Pfizer- BioNTech and Oxford-AstraZeneca vaccine (Figure 4A; Supplementary Table 7) whether the vaccine was received 0 to 7 days ago (P=0.965), 8 to 20 days ago (P=1.00), or ≥21 days ago (P=0.998) for Pfizer-BioNTech ≥21 days ago, one dose only, vs Oxford-AstraZeneca ≥21 days ago, one or two doses). There was also no evidence that reductions in odds of new infections differed between those post second Pfizer dose and those not vaccinated but previously PCR/antibody-positive (P=1.00)."

So they're saying that there was no difference between AZ and Pfizer 0-20 days after the first dose, or more than 21 days after ONE dose of Pfizer or one or TWO doses of AZ.

Why are they comparing one dose of Pfizer to two doses of AZ??? Where is the data comparing efficacy 14 days after the second dose of Pfizer? The only comment about the infection rate after 2 doses of Pfizer is that it was equally as effective as prior infection with covid.

It should also be noted that the UK waits 3 months before the second shot, which the Brazilian study accidentally showed provided better efficacy for the AZ vaccine, but there is no reason to believe that 3 months is better than 3 weeks for Pfizer. So they are not using Pfizer the way it was designed to be used, and they're still not reporting the efficacy after the 2nd dose.

I'm getting really suspicious of these unpublished press-release-style "studies" by Oxford scientists trying to show that their vaccine is just as good as the mRNA vaccines.

ETA: Who wants to bet that John Campbell will have a video up in the next couple of days touting this study as incontrovertible proof that AZ works just as well as Pfizer?

While this could be a national pride thing, I really don’t believe  that every scientist at Oxford has a vested interest in proving something about Astra Zeneca. 
Are there specific names or relationships that stand out as conflicts of interest at Oxford?

And this one isn’t a press release. 
That does seem strange if they are comparing one dose of one vs. two of another.

I haven’t looked at it closely to see how the numbers were broken out, but I read it as AZ is just as effective against asymptomatic and symptomatic infection combined. And maybe it is. A real world situation is not the same as a trial, and when you look at a huge group of people, the most important point is probably that large numbers of them got an effective vaccine, because that reduces the chance of infection for everyone.

 

 

Edited April 24, 2021 by Penelope

[ktgrok]

1 hour ago, Penelope said:

 Encouraging study from Australia on the prevalence of long-Covid type symptoms in children.
https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(21)00124-3/fulltext#.YH_tah0EQDo.twitter

 

I'm glad all they tracked returned to baseline, but having 2 of less than 200 children have either Kawasaki or MISC is higher than I expected, and that's in very young children, median age of 3. 

And 8% had symptoms up to 2 months out. That's not just a cold. 

 

Edited April 24, 2021 by ktgrok

[Corraleno]

15 minutes ago, Penelope said:

(1) While this could be a national pride thing, I really don’t believe  that every scientist at Oxford has a vested interest in proving something about Astra Zeneca. 
Are there specific names or relationships that stand out as conflicts of interest at Oxford?

(2) And this one isn’t a press release.

(3) I haven’t looked at it closely to see how the numbers were broken out, but I read it as AZ is just as effective against asymptomatic and symptomatic infection combined. Which, why wouldn’t it be? A real world situation is not the same as a trial, and when you look at a huge group of people, the important point is probably that they got an effective vaccine, because that reduces the chance of infection for everyone.

(1) Seven of the authors of that paper work for the Nuffield Dept of Medicine at Oxford, which includes the Jenner Institute Laboratories where the vaccine was developed. 

(2) It's an unpublished, unreviewed study that carries no more weight than a press release.

(3) The paper claims that AZ and Pfizer have the same rates of efficacy, but what it really seems to say is that 1 dose of Pfizer is about as effective as one or two doses of AZ. But Pfizer was never designed to be a one dose vaccine.

 

 

[Penelope]

1 hour ago, Penelope said:

While this could be a national pride thing, I really don’t believe  that every scientist at Oxford has a vested interest in proving something about Astra Zeneca. 
Are there specific names or relationships that stand out as conflicts of interest at Oxford?

And this one isn’t a press release. 
That does seem strange if they are comparing one dose of one vs. two of another.

 

 

Okay, so they did this from December through April, so the percentages who had second doses were very small. It looks like the numbers of visits (not people) where someone had had a second dose of AZ was very small, 3.5%, so they put those in with the AZ visits with only one dose. 
 

I can’t find where it gives percentages of visits after second dose of Pfizer, but since AZ rollout started about a month later than Pfizer, there may be more second doses of Pfizer. Maybe it’s there, but this one is a PITB to read. 😝
 

The visits for surveillance testing were also only once per month after the first month, so they admit infections could be missed in all groups. 

Edited April 24, 2021 by Penelope

[Ausmumof3]

1 hour ago, ktgrok said:

I hear people say this a lot, as a criticism...but would you want a NON voluntary system instead? What does that look like? I mean, I don't care, but it seems some would be against it. Are we talking mandatory public health reporting like with certain communicable diseases? Or?

 

Even if it was voluntary but they made a follow up phone call to actually ask rather than relying on people calling in it would probably help.  Also in my experience they don’t record some things.  Like my dd had blood in bowel movements after rotavirus and our vaccine help line wasn’t really interested in that.

[Penelope]

20 minutes ago, Corraleno said:

(1) Seven of the authors of that paper work for the Nuffield Dept of Medicine at Oxford, which includes the Jenner Institute Laboratories where the vaccine was developed. 

(2) It's an unpublished, unreviewed study that carries no more weight than a press release.

(3) The paper claims that AZ and Pfizer have the same rates of efficacy, but what it really seems to say is that 1 dose of Pfizer is about as effective as one or two doses of AZ. But Pfizer was never designed to be a one dose vaccine.

 

 

I didn’t know #1. To play devil’s advocate a little, is everything that comes from NIH about mRNA suspect since they helped developed that technology and hold a patent to do with the Moderna vaccine? 
 

I think real data is vastly superior to a press release.

This is just devil’s advocate, too, but as to preprints, publication takes time. Some of what comes out as headlines is based on preprints. We’d all prefer peer-reviewed and published, but it’s slow. And we can’t pretend that something being published in a journal means it is good science or necessarily better than something that isn’t yet published.

For #3, I’m not sure the paper is doing that, though I have no vested interest in whether it is or not. It looks like numbers of second doses were pretty small. 

All that has been actually published for Pfizer in regard to efficacy is reduction in symptomatic cases shortly after the second dose at a time when wild type was circulating at relatively lower prevalence. So any data about vaccines and mixes of different vaccines in a real world setting from many different countries in different populations is welcome, I think. 

 

 

 

 

 

Edited April 24, 2021 by Penelope

[TCB]

24 minutes ago, Corraleno said:

(1) Seven of the authors of that paper work for the Nuffield Dept of Medicine at Oxford, which includes the Jenner Institute Laboratories where the vaccine was developed. 

(2) It's an unpublished, unreviewed study that carries no more weight than a press release.

(3) The paper claims that AZ and Pfizer have the same rates of efficacy, but what it really seems to say is that 1 dose of Pfizer is about as effective as one or two doses of AZ. But Pfizer was never designed to be a one dose vaccine.

 

 

Part of the issue may be that they don’t have much data on 2 doses of Pfizer. My dad, 84, got the Pfizer vaccine and had to wait 3 months for the second one, which he just got fairly recently, but he was in the group to be given the vaccines earliest.

[TCB]

@Dreamergal I am so sorry about the situation in India! I have been in tears reading the news about it the last few days. I am praying.

[ktgrok]

A few times people have questioned why Florida is doing "so well"....I have replied that we fudge the numbers 🙂

Just came across this article by accident, it's old, but explains the issue a bit. https://www.sun-sentinel.com/coronavirus/fl-ne-coronavirus-positivity-rate-florida-explainer-20201014-tfho3kvw7jaabmlv2d7gwndgii-story.html

[Penelope]

2 hours ago, ktgrok said:

I hear people say this a lot, as a criticism...but would you want a NON voluntary system instead? What does that look like? I mean, I don't care, but it seems some would be against it. Are we talking mandatory public health reporting like with certain communicable diseases? Or?

 

I have general confidence in the system, but we are in an unusual situation. Maybe this is another area where a huge event is showing that the system could be better, or maybe it’s fine, I really don’t know.

CDC does have a separate monitoring system with database called the VSD, but it is limited to certain health systems in certain areas. https://www.cdc.gov/vaccinesafety/ensuringsafety/monitoring/vsd/index.html
I don’t know if they picked up the recent rare events within that system or not.

[TCB]

@wathe I’m thinking of you all there and praying for strength to keep going. I can’t imagine how exhausted you must all be. 

[Longtime Lurker]

6 hours ago, ktgrok said:

I hear people say this a lot, as a criticism...but would you want a NON voluntary system instead? What does that look like? I mean, I don't care, but it seems some would be against it. Are we talking mandatory public health reporting like with certain communicable diseases? Or?

 

I think people are not criticizing the fact that it is voluntary, but rather pointing out that a voluntary reporting system could be biased. Selection bias, maybe? @Not_a_Numberdo you know what kind of bias this would be?

 

Edited April 25, 2021 by Longtime Lurker
Adding a question

[Not_a_Number]

8 hours ago, Penelope said:

 Encouraging study from Australia on the prevalence of long-Covid type symptoms in children.
https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(21)00124-3/fulltext#.YH_tah0EQDo.twitter

 

This isn’t a study of kids. This is a study of preschoolers 😕 . I was feeling all encouraged until I saw that the median age was 3 years!!

[wathe]

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.

[Not_a_Number]

1 hour ago, Longtime Lurker said:

I think people are not criticizing the fact that it is voluntary, but rather pointing out that a voluntary reporting system could be biased. Selection bias, maybe? @Not_a_Numberdo you know what kind of bias this would be?

 

Yeah, that’s selection bias. Self-selected samples are notoriously terrible. Like all the people who wrote in to Ann Landers to report that they regretted having kids 😉 .

https://www.econlib.org/archives/2008/06/selection_bias_1.html

[Shoeless]

7 hours ago, Dreamergal said:

People in India are dying through lack of oxygen. These are not poor people but in private hospitals where they either pay through the nose or insurance pays. I shudder to think what will happen to really poor people.

I have heard of people who are stuck in hospitals and not released while insurance claims are being processed while others wait outside for a bed. 

The Delhi High Court has threatened to hang people which is the death penalty there if they disrupt oxygen supply.

https://www.thehindu.com/news/cities/Delhi/wont-hesitate-to-hang-anyone-found-obstructing-oxygen-supplies-warns-delhi-high-court/article34399311.ece

I wish it was satire and instead it is horrifyingly true.

The peak is still not reached. It is somewhere in May. At it's peak they are predicting 500k a day cases and around 5000 deaths. They do not have a precise count of the dead. They are conducting mass cremations round the clock. There are reports on social media where someone is in a crematorium for one family member and looking for oxygen for the other.

It was not this bad a month ago.

I have words to say, swear words in multiple languages which was a hobby of mine when I was young and foolish. Instead I pray, grateful every time I see my family on video alive and healthy and feeling like a horrible person for feeling so when the world outside their door literally burns.

I feel so helpless and it is so hard to watch. Please, if you are the praying kind, please pray. 

I am so sorry, Dreamergal.  I feel like I have come to know something of India from your posts this year. To say that I am heartbroken over what is happening there is insufficient.  I am keeping your family and friends in India in my heart. ❤️ 

[Longtime Lurker]

9 minutes ago, Not_a_Number said:

Yeah, that’s selection bias. Self-selected samples are notoriously terrible. Like all the people who wrote in to Ann Landers to report that they regretted having kids 😉 .

https://www.econlib.org/archives/2008/06/selection_bias_1.html

Interesting! And, yes, that makes sense. People who are dissatisfied with a product are more likely to leave a negative review than satisfied people are to leave a positive review. So then does it follow that people with more severe vaccine reactions are more likely to join v-safe? Which would result in a bias towards negative reactions. Especially since you can join after the fact. On the other hand, maybe those who take the time to join are more serious about contributing to the public good and thus also are more likely to downplay (even if unconsciously) their reactions?

[Starr]

9 minutes ago, wathe said:

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.

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. 

[wathe]

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.

 

Edited April 25, 2021 by wathe

[Ausmumof3]

Perth had one late night community transmission case last night then no more today.  Really hoping this is it.

[Not_a_Number]

8 hours ago, Longtime Lurker said:

Interesting! And, yes, that makes sense. People who are dissatisfied with a product are more likely to leave a negative review than satisfied people are to leave a positive review. So then does it follow that people with more severe vaccine reactions are more likely to join v-safe? Which would result in a bias towards negative reactions. Especially since you can join after the fact. On the other hand, maybe those who take the time to join are more serious about contributing to the public good and thus also are more likely to downplay (even if unconsciously) their reactions?

I'd expect V-Safe to select for people who had a bad reaction, personally, although I don't feel certain about that. But either way, the sample isn't worth much. 

[TCB]

8 hours ago, wathe said:

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.

 

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. 

[Longtime Lurker]

35 minutes ago, Not_a_Number said:

I'd expect V-Safe to select for people who had a bad reaction, personally, although I don't feel certain about that. But either way, the sample isn't worth much. 

That makes sense. It seems like a lot of people might not bother to sign up for V-Safe initially, but then if they have a bad or unusual reaction, they might think," Oh! I should report that!" and then they sign up. I am guilty of that myself. I intended to sign up but never actually did. I didn't have any unusual reactions so I justified skipping it because I didn't have anything to add. Except that actually not having a bad/unusual reaction IS something to add. 

[Not_a_Number]

3 minutes ago, Longtime Lurker said:

That makes sense. It seems like a lot of people might not bother to sign up for V-Safe initially, but then if they have a bad or unusual reaction, they might think," Oh! I should report that!" and then they sign up. I am guilty of that myself. I intended to sign up but never actually did. I didn't have any unusual reactions so I justified skipping it because I didn't have anything to add. Except that actually not having a bad/unusual reaction IS something to add. 

Exactly 🙂. 

With selection bias, it's often actually hard to figure out which way the bias leans! I remember there was a lot of discussion of that last year with the self-selected samples for the early antibody tests in California... you could plausibly argue that the people who selected themselves were more or less likely to have antibodies than the rest of the population! 

But either way, a non-random sample isn't worth much. And getting a reasonable approximation of a random sample outside the context of a controlled study is tricky, so this is all quite interesting and hard. 

[Pawz4me]

1 hour ago, Not_a_Number said:

I'd expect V-Safe to select for people who had a bad reaction, personally, although I don't feel certain about that. But either way, the sample isn't worth much. 

I am totally not a stats/research person, so forgive me if this is a stupid question, but --

Couldn't they compensate for that in some way? For example, I signed up with VSafe on the same day I got my first vaccine. I just thought it would be neat to contribute to the data. It seems like people who do/did that are less likely to have signed up just to complain. So they could compare those responses to the responses of people who signed up several days after a vaccine?