JVBT

This is an old post, I realize, but I just purchased a Venu SQ smart watch and Ilke it, but the second hand goes dim after < 15 seconds. How do nurses who use smart watches take a pulse or count an RR if the watch face doesn't stay illuminated?

I agree. However, how possible was / is this, realistically? What happened, happened on a mass scale, and there are opportunists everywhere, ready to take advantage and have a huge impact. So, sometimes the media is just covering those who are using a mass event to gain money and/or followers, and thereby inadvertently amplifying their message. It's a tough one, that's for sure.

I would tell him that cases were coming from Europe in addition to China, and the virus was likely circulating in December in the US.

This is exactly correct and thank you for writing this for all to see and learn. As Scott Gottlieb (yes, Media Master and Pfizer board member Scott Gottlieb) says, "we know their viral titers fall much more quickly than those who are unvaccinated. So maybe after a day or two or three, they're much less likely to spread the virus than someone who remains unvaccinated." It is important that accurate information be presented among ourselves and vital that we transmit accurate information to our patients.

I just looked up hospitalizations by age. On Oct 16, the 18-49 year old age range has about 800, while the 65 and over have a little fewer than 200 more than that, so your comment tracks. I'll keep trying to find good data on ICUs and ages.

Is there no byline? If not, why not? I agree with just about everything in this (authorless) piece and really appreciate it. I may start a thread of my own, but lately, it seems that the comments section of another online resource I use, Medscape, has been taken over by anti-vaxers. I've watched videos and read articles by the people who are in charge of Medscape and know that they are for sure NOT anti vax, but there's no one minding the store in the comments section. I say this mostly because my own comments, sticking up for masking, sticking up for vaccination, are either not published or are seriously delayed.

Yes, it's dependent on vaccination, which is my point. And I think we can tell some things about Delta, based on how it's passed through other countries. I don't think it's unforeseen that with the uptick in cases, we are seeing a concomitant uptick in vaccinations. No, we can't predict with 100% certainty. Never could, never will be able to.

But don't you think we actually do have a way this thing is gonna go? I mean, you could pretty accurately track the gradual increase in cases with the slowdown of the vaccinations. One has something to do with the other in terms of mass public health. All of which is to say, if we can really ramp up vaccinations and basic prudent behavior, we will have a very good idea which way this is going to go.

Question for those nurses working with patients staying in your facility two weeks or even longer: how do things go in your setting with patients who refuse to get vaccinated?

Cases are definitely on the increase now, even if slight.

Nearing the end, and O my Lord, he's talking about the "globalists" and vaccination as a way to enact behavioral norms. (Because he says you have to be vaccinated to go to a, wait for it, Dallas Mavericks game.) This man is OFF THE RAILS officially now. That is what I meant above when I asked if all the world's gone crazy.

At about a quarter of the way through I was finding myself agreeing with him on many things. But towards the end of this exceedingly long video, I asked myself has all the world gone crazy? In my view, he would have had a lot more credibility had he not hit all the Tucker Carlson conspiracy checkpoints, happily ticking them off and moving on, predictably, to the next one. It's just too (to use his word) binary. I am massively pro-vaccine but also think we needed to have done much more to treat patients early. Early in the video, he cites Sweden positively. It's his perfect right to do so, but I'm not 100% sure that Sweden's strategy was correct, as proven over time. He goes on to mildly denigrate the decision not to allow academic meetings, the life blood of his profession, and question other things done early on. The crux of the video at about a quarter of the way through though, to me is when he discusses early treatment. He says that the medical community settled into a groupthink ,supported by the medical societies and agencies, not to touch the (out)patient; keep them at home. He is far from alone in pointing out the inadvisability of this both retrospectively and in real time (Spring and Summer 2020). Early on in treating Covid, he says we waited very/too late before giving the anti viral. The federal agencies were inept in their perception of the problem, he says. Doctors were frightened, waiting for the societies for support, opposite from what has always been: early innovation by doctors, small studies, empiric treatment, then sponsored larger RCTs, etc. in that order. Then guideline bodies issue guidelines. The federal agencies would follow the guidelines! Early empiricism starts it out. And he is 100% correct that we never launched Covid treatment centers and developed ways to treat early Covid. What has been "my thing" since the beginning was ... what did doctors' offices do? They closed down and went to video quickly. I will never ever forget that or forget the uselessness of the e-messages I received from my own doctor's group to, basically, stay the heck away. I have worked in doctor's offices in the past and will in the future, I know so many who do and they are good people, but I cannot express the outrage I experienced receiving those messages. I will keep listening, and though I agree with much of what he is saying about early treatment, the only glaring obvious asterisk is that this is all happening during a pandemic. Finally, for him to cast massive aspersions on docs for refusing to treat early and call it malfeasance, while denying the efficacy and absolute necessity of vaccines is, well, malfeasant. I don't think that word exists, but you know what I mean.

There is still time to turn the increasingly swaying ship around. People are practically walking down the street desperate to give vaccines. What is the key to unlocking this asinine hesitancy? That seems to be the $64,000 question.

Something - not Texas - is definitely up. Last week, our percentage decrease in cases day by day was increasing impressively, usually about 25% on up. Now it's down to a -0.2% decrease, a fairly steep fall off. The seven-day average now appears to be plateauing, even if only for a short while. No one's wearing masks, so many of the unvaccinated will be infected, as well as some vaccinated, no doubt. The cases leveling off may be coinciding with the virtual vaccination standstill, I don't know.

The rapid decrease of cases in the US is certainly decreasing, but I don't think Texas went from ~1,000 cases per day to 9,000.

There are vaccines, they are just not used in the US. FWIW, I have heard, but don't know for sure, that the TB vaccines are mostly used to prevent an encephalopathy in children as opposed to respiratory complications in adults, but that is second hand.

I tend to think that what's going to happen is that, due to lack of vax availability, vaccine disinformation, vaccine hesitancy, denial and refusal, is that the virus will simply remain endemic in this country. We still have TB, and of course TB exists in other parts of the world, so coronavirus (SARS2) will also be endemic in other parts of the world. I wish it would go away, but for now, what's happened with TB is the model I use. I may well be wrong.

Also strongyloides.

California is a huge state, not affected by Covid uniformly. The Bay area has been notable for taking the virus seriously, its diligence, good planning, masking and vax rate.

Not that I'm any kind of expert, but what I'm hearing is that naturally acquired immunity lasts up to the present date. In other words, when they started measuring antibodies, if they were 6 months out from infection, the result was that it lasted 6 months. If the person was 8 months out from infection, the result was immunity lasting 8 months, and so on. An interesting study recently been published, called Longitudinal analysis shows durable and broad immune memory after SARS-CoV-2 infection with persisting antibody responses and memory B and T cells. Very interesting! Since this is a thread asking for how things are now - I'm feeling good at my facility, sensing the beginning of the end, though there are still (ahem) unvaccinated personnel who take off their masks walking through hallways. That will never stop rankling, I suppose. Sigh.

From what I understand, the one person we know of who died after the J&J vaccine was also given heparin, now known to be a contraindication in this particular case. There is at least one other person (for a total of 6 known affected) in critical condition. I so appreciate the measured tone of this conversation so far.

A rare sign of hope.

Right. It involves talking it through. There have been some interesting papers, shows, podcasts on how to talk through the thinking of someone against vaccines. I think you're right, you won't be able to convince them with the data or the science. (Sorry to be repeating myself here.) The mRNA platform has been developed for over a decade with the vaxes against dengue, the CMV, and a couple of others. This is not new technology.

Ireland has had over 3,000 deaths from Covid this year. Their yearly flu deaths are max 500. You sound like you've been listening to Ivor Cummins, someone I've liked for his challenge to prevailing cholesterol wisdom, but who has suffered economically in the lockdowns there, and as a result has come out vociferously and IMHO disingenuously against them. Sorry you experienced an overreaction in the ED. Many times, many people cannot get even cursory attention there.

The mRNA platform used by Moderna and Pfizer (two manufacturers of the Covid vax) is not new and, according to a Nature article I found online, has been well researched since at least 2008. Source: https://www.nature.com/articles/nrd.2017.243