wuhan - coronavirus

[Shoeless]

4 hours ago, Jean in Newcastle said:

This was happening in the US in the early days. People didn’t realize how it could sneak up on them. Perhaps they still don’t in some areas. 

My cousin's spouse insisted he felt fine despite the pulse ox reading 81%. He ended up hospitalized for about a week, only because she argued with him about it and wouldn't let up.

When you don't have enough oxygen going to your brain, you can't figure out that you need help. 

[Melissa Louise]

4 hours ago, Jean in Newcastle said:

This was happening in the US in the early days. People didn’t realize how it could sneak up on them. Perhaps they still don’t in some areas. 

Do you think it's OTT if I bought an oximeter? 

[Shoeless]

1 minute ago, Melissa Louise said:

Do you think it's OTT if I bought an oximeter? 

Definitely buy one. It's not a crazy thing to do. 

[Danae]

Just now, Melissa Louise said:

Do you think it's OTT if I bought an oximeter? 

I bought one in March 2020, and one for my parents, and urged my siblings to buy them for their households. 

[Rosie_0801]

5 hours ago, Jean in Newcastle said:

We don’t either. 

I beg your pardon. I thought people had mentioned having to pay earlier in this thread.

[ScoutTN]

32 minutes ago, Melissa Louise said:

Do you think it's OTT if I bought an oximeter? 

No! Buy one.

[ktgrok]

22 minutes ago, Rosie_0801 said:

I beg your pardon. I thought people had mentioned having to pay earlier in this thread.

Tests at the county or state run sites are free. Tests at a pharmacy are free, but it can take days to get an appointment - was 4 days last I checked. An urgent care or doctors office can do them, and the test may be free, but the appointment may not be - at a regular doctor's office you will pay an exam fee. Over the counter tests are about 20 bucks for a 2 pack. 

[wathe]

10 hours ago, Ausmumof3 said:

I agree.  I have to be honest my mask feels kind of ineffective when I’m in a small room for several hours with people.  For half an hour or an hour it might be ok but feels like the concentration of germs after 4-5 hours is too high for it to really work.  Don’t get me wrong I still think it’s worth it for the occasional contract risks just not where a pool of people are together all day.

 

10 hours ago, Not_a_Number said:

Exactly. I mean, if everyone had their mask taped their face and no one ever ate or drank and everyone was super rigorous, then maybe it’d be enough. But we’re talking real-life use with a variant with extremely high viral loads.

We’re currently masking in crowds outdoors. I figure the masks will help if there’s a stray cloud of virus or something. I just don’t trust them in a room where the particles have been building up.

Except that they really do seem to work in healthcare here - call it the Health Care Anomaly?  We're now 18 months into this with pleated earlobe masks for HCW in an overcrowded ED (packed WR, hallway chairs everywhere, wandering patients, people EVERYWHERE) with a good portion of patients not masked (dementia, physical or intellectual disability, respiratory emergency, altered level of consciousness, intoxication, {ETA or just non-compliant}) or improperly masked.  And we haven't had a single outbreak in my department - despite a steady stream of covid positive patients coming through.

HCW are better than most at wearing them properly, but really not as good as you'd think.  There is plenty of sneaking them off for a drink and snacks at the desk on nights.

We probably have better ventilation than most other public buildings, but not that much better than most newish construction, I don't think.  Odours definitely linger LOL.

ETA ; the ventilation in our positive pressure iso rooms is great when we flip them to PP mode.  We only have 3 of those though, so not representative....  The Covid + patients end up anywhere we can find a spot for them, including hallway chairs.  (we often don't know they were covid + until tests come back the next day)

Edited August 26, 2021 by wathe

[KSera]

1 hour ago, Melissa Louise said:

Do you think it's OTT if I bought an oximeter? 

Joining the chorus of buy one. I bought one early March 2020 as well, and had my parents do the same, and ours has come in handy. The price went up a good deal by April, but when I looked recently, was back down to where I could find a decent one well under $20 USD.

[Ausmumof3]

1 hour ago, Melissa Louise said:

Do you think it's OTT if I bought an oximeter? 

No I think it’s sensible particularly with underlying conditions.

[Jean in Newcastle]

1 hour ago, Melissa Louise said:

Do you think it's OTT if I bought an oximeter? 

Not at all. I think it’s wise. 

[Jean in Newcastle]

1 hour ago, Rosie_0801 said:

I beg your pardon. I thought people had mentioned having to pay earlier in this thread.

Ktgrok did a great job answering. 

[TCB]

1 hour ago, Melissa Louise said:

Do you think it's OTT if I bought an oximeter? 

Not at all. Buy one. I’ve bought one for each set of grandparents, sent one to college with my dd and have one here at home. In this situation it’s something that would be good for all of us to have in our first aid kit.

[TCB]

1 hour ago, Rosie_0801 said:

I beg your pardon. I thought people had mentioned having to pay earlier in this thread.

There are sometimes free testing options here, where I am, but often you have to pay.

[Ausmumof3]

Are there any of the cheaper end pulse oximeters that are better than others?  I see that some of them aren’t supposed to be that accurate.

[freesia]

1 hour ago, Melissa Louise said:

Do you think it's OTT if I bought an oximeter? 

I bought one a year ago.  I definitely don't think it's OTT.   I've used it--it's been very comforting.

[Ausmumof3]

49 minutes ago, wathe said:

 

Except that they really do seem to work in healthcare here - call it the Health Care Anomaly?  We're now 18 months into this with pleated earlobe masks for HCW in an overcrowded ED (packed WR, hallway chairs everywhere, wandering patients, people EVERYWHERE) with a good portion of patients not masked (dementia, physical or intellectual disability, respiratory emergency, altered level of consciousness, intoxication, {ETA or just non-compliant}) or improperly masked.  And we haven't had a single outbreak in my department - despite a steady stream of covid positive patients coming through.

HCW are better than most at wearing them properly, but really not as good as you'd think.  There is plenty of sneaking them off for a drink and snacks at the desk on nights.

We probably have better ventilation than most other public buildings, but not that much better than most newish construction, I don't think.  Odours definitely linger LOL.

ETA ; the ventilation in our positive pressure iso rooms is great when we flip them to PP mode.  We only have 3 of those though, so not representative....  The Covid + patients end up anywhere we can find a spot for them, including hallway chairs.  (we often don't know they were covid + until tests come back the next day)

That is encouraging!  Are you using proper N95s though or cloth/standard surgical masks?

One model I read implied about 8x reduction with masking and 16x with an open window.  It’s the sealed up stuffiness of the school environments here thats bothering me.

On a separate non Covid note I’ve come across a lot of info on sick building syndrome with modern buildings designed for energy efficiency with air conditioning and heating etc and not having adequate ventilation and it’s playing on my mind a lot.  I do think there was more wisdom than we give credit for in the late 19th century obsession with air quality.

[Not_a_Number]

9 minutes ago, Ausmumof3 said:

 I do think there was more wisdom than we give credit for in the late 19th century obsession with air quality.

I know. I've been thinking about this a lot. 

[wathe]

14 minutes ago, Ausmumof3 said:

That is encouraging!  Are you using proper N95s though or cloth/standard surgical masks?

One model I read implied about 8x reduction with masking and 16x with an open window.  It’s the sealed up stuffiness of the school environments here thats bothering me.

On a separate non Covid note I’ve come across a lot of info on sick building syndrome with modern buildings designed for energy efficiency with air conditioning and heating etc and not having adequate ventilation and it’s playing on my mind a lot.  I do think there was more wisdom than we give credit for in the late 19th century obsession with air quality.

Pleated disposable earloop procedure masks.  A level below true surgical masks.  Definitely not fancy!

N95 reserved for AGMP's (aerosol generating medical procedures) only.

Edited August 26, 2021 by wathe

[wathe]

2 hours ago, Melissa Louise said:

Do you think it's OTT if I bought an oximeter? 

We have one, and one for each household of extended family.  It's a very sensible purchase.

[Corraleno]

Bringing this over from the thread on 3rd doses. Preprint on a new variant from South Africa that is related to the Peruvian variant (Lambda / C.37). Two interesting take-aways: (1) it has mutations associated with both improved ACE2 binding and antibody escape and (2) they suggest that the much-higher-than-normal level of mutations in this variant might be the result of "prolonged viral infection" in a single individual.

"We have identified a new SARS-CoV-2 variant assigned to the PANGO lineage C.1.2. This variant has been detected throughout the third wave of infections in South Africa from May 2021 onwards and has been detected in seven other countries within Europe, Asia, Africa and Oceania. The identification of novel SARS-CoV-2 variants is commonly associated with new waves of infection. Like several other VOCs, C.1.2 has accumulated a number of substitutions beyond what would be expected from the background SARS-CoV-2 evolutionary rate. This suggests the likelihood that these mutations arose during a period of accelerated evolution in a single individual with prolonged viral infection through virus-host co-evolution19–21. Deletions within the NTD (like Y144del, seen in C.1.2 and other VOCs) have been evident in cases of prolonged infection, further supporting this hypothesis22–24.

C.1.2 contains many mutations that have been identified in all four VOCs (Alpha, Beta, Delta and Gamma) and three VOIs (Kappa, Eta and Lambda) as well as additional mutations within the NTD (C136F), RBD (Y449H), and adjacent to the furin cleavage site (N679K). Many of the shared mutations have been associated with improved ACE2 binding (N501Y)25–29 or furin cleavage (H655Y and P681H/R)30–32, and reduced neutralization activity (particularly Y144del, 242-244del, and E484K)17,33–39, providing sufficient cause for concern of continued transmission of this variant. Future work aims to determine the functional impact of these mutations, which likely include neutralizing antibody escape, and to investigate whether their combination confers a replicative fitness advantage over the Delta variant.

The C.1.2 lineage is continuing to grow. At the time of submission (20 August 2021) there were 80 C.1.2 sequences in GISAID with it now having been detected in Botswana and in the Northern Cape of South Africa."

Source: https://www.medrxiv.org/content/10.1101/2021.08.20.21262342v2.full.pdf+html

Edited August 27, 2021 by Corraleno

[Ausmumof3]

https://medium.com/@matt_11659/australian-public-fed-nonsense-as-country-heads-to-irreversible-decision-99350b80125c
 

Some discussion around the Doherty Institute modelling for Australia

“It doesn’t look like anyone has actually read the report.

They only run the simulation for 180 days.

Source: Doherty Report.

For example, looking at daily new infections, the new infections per day don’t even peak before the model cuts off at 180 days for the 80% vaccine coverage scenario:

Figure 1: The modeling only goes for 180 days, making the high vaccination scenarios look better Source: Doherty Report.

So the model is producing garbage.

They’ve simply stopped the simulation before the effects of opening up play out.

There’s no reason I can think of to cut a model off at 180 days other than to fudge the data. Furthermore, respiratory viruses are seasonal and you’ll have different results whether the 180 days are in summer or winter.”

 

Ugh!

 

 

[vonfirmath]

2 hours ago, ktgrok said:

Tests at the county or state run sites are free. Tests at a pharmacy are free, but it can take days to get an appointment - was 4 days last I checked. An urgent care or doctors office can do them, and the test may be free, but the appointment may not be - at a regular doctor's office you will pay an exam fee. Over the counter tests are about 20 bucks for a 2 pack. 

Yes. We paid our co-pay for the appointment. Ouch

[Ausmumof3]

ATAGI has approved Pfizer for kids 12-15

This will help 2/3 for us!

[Melissa Louise]

Mandatory vaccines for all public school and public preschool teachers in NSW. 

[Ausmumof3]

882 for NSW. 2 deaths, both had had a single dose of the vaccine. Not super familiar with NSW suburbs but apparently Camden and Penrith are having higher cases and may be added to LGAs of concern if things don’t improve. HSC exams are being delayed for Yr 12 in NSW to November.

Vic had 79 cases. 19 in quarantine.

Re schools going back in NSW.

• Kindergarten and Year 1 students will return from October 25
• Year 2, 6 and 11 will return from November 1
• Year 3, 4, 5, 7, 8, 9 and 10 will return from November 8

Year 12 students are already able to return to classrooms in a limited way and this will continue for the remainder of term three. Year 12s will have full-time access to school campuses from October 25.

[Melissa Louise]

41 minutes ago, Ausmumof3 said:

ATAGI has approved Pfizer for kids 12-15

This will help 2/3 for us!

Book that appointment!

[Ausmumof3]

Just now, Melissa Louise said:

Mandatory vaccines for all public school and public preschool teachers in NSW. 

Amazing!

[Ausmumof3]

Just now, Melissa Louise said:

Book that appointment!

Yeah still 16 and over on the SA health site but trust me I’ll be refreshing it all day.  Only thing is oldest is due a follow up tetanus in September so I have to figure out spacing etc. 

[Melissa Louise]

1 minute ago, Ausmumof3 said:

Amazing!

I will feel somewhat better knowing that. I return Oct 25 - still reserving judgement depending on conditions of return. Will quit if kids aren't masked, at a minimum. 

[Ausmumof3]

Just now, Melissa Louise said:

I will feel somewhat better knowing that. I return Oct 25 - still reserving judgement depending on conditions of return. Will quit if kids aren't masked, at a minimum. 

Sounds like they are really emphasising masking so that should be good.  I’m disappointed about the total lack I’d focus on ventilation in Australia - feels like we’re a long way behind on this than the rest of the world. 

[Ausmumof3]

re mitigation in schools -
We will return to our level three COVID restriction settings with all school principals aware of that, [they have been] in place for some time."

"What it will mean [is] things like staggering break times, not mixing your group cohorts, not having assemblies, band, choir, those activities were children might gather together, we won't have any external visitors to school site and the mask wearing is a really important element."

"Mandatory mask-wearing for all our staff and school sites. Mandatory mask-wearing for all high school students and for the first time we will strongly encourage our primary school students to wear masks

[Melissa Louise]

1 minute ago, Ausmumof3 said:

Sounds like they are really emphasising masking so that should be good.  I’m disappointed about the total lack I’d focus on ventilation in Australia - feels like we’re a long way behind on this than the rest of the world. 

Yes. I have seen it mentioned in a few department bits and pieces, but it's not front and centre. 

[Melissa Louise]

Just now, Ausmumof3 said:

re mitigation in schools -
We will return to our level three COVID restriction settings with all school principals aware of that, [they have been] in place for some time."

"What it will mean [is] things like staggering break times, not mixing your group cohorts, not having assemblies, band, choir, those activities were children might gather together, we won't have any external visitors to school site and the mask wearing is a really important element."

"Mandatory mask-wearing for all our staff and school sites. Mandatory mask-wearing for all high school students and for the first time we will strongly encourage our primary school students to wear masks

Strongly encourage in primary is weak. They need to mandate (other than for those kids who can't). 

[KSera]

2 hours ago, wathe said:

Pleated disposable earloop procedure masks.  A level below true surgical masks.  Definitely not fancy!

N95 reserved for AGMP's (aerosol generating medical procedures) only.

Clearly those have been pretty effective where you are, but there was a UK study of healthcare workers that found a big improvement when they went from surgical masks for everything but AGP to FFP3 for everything. One of the things is that studies of aerosol generation itself show that there are a lot of activities that actually produce more aerosols than the things that are classified as aerosol generating procedures. just talking produces a large amount of aerosols.

https://www.bbc.com/news/health-57636360

It’s just one study and the study needs to be replicated, but the results were fairly compelling. Doesn’t indicate surgical masks didn’t work to reduce infections, just that better masks work even better.

[wathe]

15 minutes ago, KSera said:

Clearly those have been pretty effective where you are, but there was a UK study of healthcare workers that found a big improvement when they went from surgical masks for everything but AGP to FFP3 for everything. One of the things is that studies of aerosol generation itself show that there are a lot of activities that actually produce more aerosols than the things that are classified as aerosol generating procedures. just talking produces a large amount of aerosols.

https://www.bbc.com/news/health-57636360

It’s just one study and the study needs to be replicated, but the results were fairly compelling. Doesn’t indicate surgical masks didn’t work to reduce infections, just that better masks work even better.

Yes.  Our mask policy is based on both efficacy and resource management.  N95's are significantly more expensive, still not plentiful, and hard to work in.  I think the thinking  is that good enough is good enough, and upgrading to n95 all the time for everything fails a cost/benefit analysis.  There are lots of HCW who aren't happy about it (myself included).

The point I'm making is that surgical masks aren't useless - they're actually pretty good.

 No doubt that properly worn, fit-tested n95 is better.)

[Ausmumof3]

70 cases for NZ (all in Auckland) and 21 for ACT

[Ausmumof3]

10 minutes ago, wathe said:

Yes.  Our mask policy is based on both efficacy and resource management.  N95's are significantly more expensive, still not plentiful, and hard to work in.  I think the thinking  is that good enough is good enough, and upgrading to n95 all the time for everything fails a cost/benefit analysis.  There are lots of HCW who aren't happy about it (myself included).

The point I'm making is that surgical masks aren't useless - they're actually pretty good.

 No doubt that properly worn, fit-tested n95 is better.)

Yeah I don’t think they’re useless I just don’t think in the context of schools as worn by primary students they’re enough on their own.

[Ausmumof3]

Anyone else in Mere Motherhood on Facebook?  It’s been pretty anti vax for a while other than a few brave souls.  Today there is a thread on which many people share their experiences with the virus and how terrible it was and how they have anxiety and depression afterwards and yet… still no one is saying - maybe we should have vaccinated.  Instead there’s all this “I believe there’s a spiritual element to this virus”.  Um… no.  It’s a neurological biological thing that can be observed scientifically.  I know my theology is not very mainstream but this is something I just can’t get my head around at all.

 

[wathe]

7 minutes ago, Ausmumof3 said:

Yeah I don’t think they’re useless I just don’t think in the context of schools as worn by primary students they’re enough on their own.

Combined with good ventilation and not crowding, they are probably the best possible realistic option at a population level though.  Cheap, easily available, easy to tolerate, and pretty good efficacy.   Teacher can have a box of spares on her desk.

N95's on primary students probably aren't realistic, I don't think:  expensive, uncomfortable, and require fitting.  Some families will go through the trouble and expense of finding a good respirator-style mask for their kid (n95, kn94, happy mask, whatever), and some kids will be able to tolerate them - but not very many will go through the trouble and expense, I don't think.

[wathe]

11 minutes ago, Ausmumof3 said:

Anyone else in Mere Motherhood on Facebook?  It’s been pretty anti vax for a while other than a few brave souls.  Today there is a thread on which many people share their experiences with the virus and how terrible it was and how they have anxiety and depression afterwards and yet… still no one is saying - maybe we should have vaccinated.  Instead there’s all this “I believe there’s a spiritual element to this virus”.  Um… no.  It’s a neurological biological thing that can be observed scientifically.  I know my theology is not very mainstream but this is something I just can’t get my head around at all.

 

For real.  You can't make this stuff up.

[Not_a_Number]

Just now, wathe said:

Combined with good ventilation and not crowding, they are probably the best possible realistic option at a population level though.  Cheap, easily available, easy to tolerate, and pretty good efficacy.   Teacher can have a box of spares on her desk.

The problem is that we aren't GOING to have good ventilation and not crowding 😕 . 

 

Just now, wathe said:

N95's on primary students probably aren't realistic, I don't think:  expensive, uncomfortable, and require fitting.  Some families will go through the trouble and expense of finding a good respirator-style mask for their kid (n95, kn94, happy mask, whatever), and some kids will be able to tolerate them - but not very many will go through the trouble and expense, I don't think.

Happy Masks are actually the easiest masks for us to keep on of the one's we've tried 🤷‍♀️. They are high on the nose so they don't slide down. We've also ordered some KF94s, and I can vouch that our friends who use them are some of the only other people we know whose masks stay on right, too... 

[Not_a_Number]

12 minutes ago, Ausmumof3 said:

Anyone else in Mere Motherhood on Facebook?  It’s been pretty anti vax for a while other than a few brave souls.  Today there is a thread on which many people share their experiences with the virus and how terrible it was and how they have anxiety and depression afterwards and yet… still no one is saying - maybe we should have vaccinated.  Instead there’s all this “I believe there’s a spiritual element to this virus”.  Um… no.  It’s a neurological biological thing that can be observed scientifically.  I know my theology is not very mainstream but this is something I just can’t get my head around at all.

 

Ugh. I'm not in there and now I'm glad. I can't tolerate this kind of nonsense. 

[wathe]

Just now, Not_a_Number said:

The problem is that we aren't GOING to have good ventilation and not crowding 😕 . 

 

Happy Masks are actually the easiest masks for us to keep on of the one's we've tried 🤷‍♀️. They are high on the nose so they don't slide down. We've also ordered some KF94s, and I can vouch that our friends who use them are some of the only other people we know whose masks stay on right, too... 

Right.  But you are a motivated, exceptional parent - an outlier is the world of public health.  We're talking population basis, public school population here.  

[Not_a_Number]

2 minutes ago, wathe said:

Right.  But you are a motivated, exceptional parent - an outlier is the world of public health.  We're talking population basis, public school population here.  

I mean, I see that most people won't buy them, I guess. It's just that I haven't found them to be super high on effort after purchase. 

[Mrs Tiggywinkle]

28 minutes ago, wathe said:

Yes.  Our mask policy is based on both efficacy and resource management.  N95's are significantly more expensive, still not plentiful, and hard to work in.  I think the thinking  is that good enough is good enough, and upgrading to n95 all the time for everything fails a cost/benefit analysis.  There are lots of HCW who aren't happy about it (myself included).

The point I'm making is that surgical masks aren't useless - they're actually pretty good.

 No doubt that properly worn, fit-tested n95 is better.)

I worked a cardiac arrest today in 100 degree heat in a stuffy auto shop.   I cannot imagine wearing an N95 doing that; trying to intubate with the sweat dripping into my surgicaL mask was bad enough.

I think a lot of people underestimate how miserable the properly worn N95s can be.

[Mrs Tiggywinkle]

16 minutes ago, Ausmumof3 said:

Anyone else in Mere Motherhood on Facebook?  It’s been pretty anti vax for a while other than a few brave souls.  Today there is a thread on which many people share their experiences with the virus and how terrible it was and how they have anxiety and depression afterwards and yet… still no one is saying - maybe we should have vaccinated.  Instead there’s all this “I believe there’s a spiritual element to this virus”.  Um… no.  It’s a neurological biological thing that can be observed scientifically.  I know my theology is not very mainstream but this is something I just can’t get my head around at all.

 

I am, and I just can’t with that thread.   My real concern is how many scientifically illiterate people are homeschooling their children.

[wathe]

3 minutes ago, Not_a_Number said:

The problem is that we aren't GOING to have good ventilation and not crowding 😕 . 

Neither does my emergency department.......haha (I wish I were joking)

When applying a mask mandate to a whole population (public school children), you really have to balance what's theoretically best with what's actually achievable.  How much more effort would be required for what amount of diminishing return.  And I think that disposable masks make this compromise very well in public school settings..  

[wathe]

3 minutes ago, Mrs Tiggywinkle said:

I worked a cardiac arrest today in 100 degree heat in a stuffy auto shop.   I cannot imagine wearing an N95 doing that; trying to intubate with the sweat dripping into my surgicaL mask was bad enough.

I think a lot of people underestimate how miserable the properly worn N95s can be.

Truth

[wathe]

8 minutes ago, Not_a_Number said:

I mean, I see that most people won't buy them, I guess. It's just that I haven't found them to be super high on effort after purchase. 

Easy for you - a high functioning, organized and motivated person.

Hand wash only ...... not a chance on a population basis.   Absolutely not realistic for those living on the margins, with social and family dysfunction, etc.  A non-trivial number of kids are going to be using one of the spares from the box on the teacher's desk, on a daily basis.

Edited August 27, 2021 by wathe