COVID-19

[Wyldnwoody44]

I'm curious, and I have no idea, but the tests in the past were only around 60% either sensitive or specific, there were a fair amount of false outcomes. I am curious if the tests are now better (as they should be) but there are so many variables, I wonder if this "spike" would have been similar with more accuracy, just food for thought. 

[Brawndo]

It’s a good thought Wyld, but wouldn’t the Number of Hospitalizations in the US which is over 85,000 and still rapidly climbing, compared to a high 65,000 of the Spring indicate that the actual case load is indeed higher now? 
 

PA in an altruistic society the most vulnerable in a population should receive the vaccine first namely those in SNF. 
 

The issue is that the WHO estimates that a large percentage of all COVID Cases are actually Health Care Workers. 

 

From the Washington Post September 17th

Health-care workers are at higher risk of contracting covid-19, and that is not simply down to testing differences,” said Angharad Davies, a clinical associate professor at Swansea University who has advocated for widespread testing of British doctors.

McDeavitt and Davies both pointed to a study published in the Lancet this summer that looked at 100,000 front-line health-care workers in Britain and the United States, and found their risk of infection compared with people in the general community was three times greater, even after taking differences in testing into account.

Nurses in particular make up a majority of the cases as they have prolonged exposure with their patients. 
As Kas mentioned it’s putting strain on existing staffing models. As the number of people hospitalized continues to increase this strain is only going to get worse as the number of HCW getting sick rises. It makes sense to vaccinate those medical personnel that work in a hospital or other settings that come in direct contact the COVID Patients First, this would include those who work in SNF. 

[Wyldnwoody44]

@Brawndoah yes, the hospitalization numbers kinda defeat that line of thinking. Have you seen more numbers with less severity lately? 

[Brawndo]

10 hours ago, Wyldnwoody44 said:

@Brawndoah yes, the hospitalization numbers kinda defeat that line of thinking. Have you seen more numbers with less severity lately? 

It’s a mix, we are keeping patients on the floor long that would have been in the ICU in spring.  We are keeping patients who are on High Flow Oxygen with settings up to 60% and 30 Liters flow. I had a 36 yo Code on Saturday she’s still vented in the unit. 

[miles]

i dont want to sound super negative and backwards, but im glad the first round of vaccines arent going to the doctors and nurses. Imagine if it turns out really bad and there are horrible side effects and every doctor/nurse is out of commission.  There are about 1 million doctors in the country, so there will be plenty of vaccine to hit them all, but im just glad im not the one making the decision

i know that realistically wont happen because there was trials, but those trials were rushed (for good reason)

Edited November 25, 2020 by miles

[Stoner]

12 minutes ago, miles said:

i dont want to sound super negative and backwards, but im glad the first round of vaccines arent going to the doctors and nurses. Imagine if it turns out really bad and there are horrible side effects and every doctor/nurse is out of commission.  There are about 1 million doctors in the country, so there will be plenty of vaccine to hit them all, but im just glad im not the one making the decision

i know that realistically wont happen because there was trials, but those trials were rushed (for good reason)

Dr. Fauci hits back on the idea that the process was rushed or that safety was compromised. He was talking yesterday about technical advances that sped up the process this time. Also, pharma companies have been producing vaccines "at risk," which means producing them before approval so they're ready to go if the OK comes. If. They could also lose tons of money using this approach.

Remember that back in the early days (March maybe?), Dr. Fauci said vaccines take a long time to produce but that we could have one by January. So we're really pretty much on the normal schedule he envisioned.

Finally, the reason vaccines aren't being distributed right now is that they're waiting for enough time to pass to be sure there won't be serious side effects in a 60-day window.

[Stoner]

12 hours ago, Brawndo said:

It’s a good thought Wyld, but wouldn’t the Number of Hospitalizations in the US which is over 85,000 and still rapidly climbing, compared to a high 65,000 of the Spring indicate that the actual case load is indeed higher now? 
 

PA in an altruistic society the most vulnerable in a population should receive the vaccine first namely those in SNF. 
 

The issue is that the WHO estimates that a large percentage of all COVID Cases are actually Health Care Workers. 

 

From the Washington Post September 17th

Health-care workers are at higher risk of contracting covid-19, and that is not simply down to testing differences,” said Angharad Davies, a clinical associate professor at Swansea University who has advocated for widespread testing of British doctors.

McDeavitt and Davies both pointed to a study published in the Lancet this summer that looked at 100,000 front-line health-care workers in Britain and the United States, and found their risk of infection compared with people in the general community was three times greater, even after taking differences in testing into account.

Nurses in particular make up a majority of the cases as they have prolonged exposure with their patients. 
As Kas mentioned it’s putting strain on existing staffing models. As the number of people hospitalized continues to increase this strain is only going to get worse as the number of HCW getting sick rises. It makes sense to vaccinate those medical personnel that work in a hospital or other settings that come in direct contact the COVID Patients First, this would include those who work in SNF. 

Let's hope there's enough vaccine to vaccinate healthcare workers and the vulnerable at roughly the same time. The tricky part is figuring out who is the most vulnerable. We have probably north of 100 million people who have underlying conditions of some sort. Not all of them can go to the front of the line.

[Wyldnwoody44]

44 minutes ago, Brawndo said:

It’s a mix, we are keeping patients on the floor long that would have been in the ICU in spring.  We are keeping patients who are on High Flow Oxygen with settings up to 60% and 30 Liters flow. I had a 36 yo Code on Saturday she’s still vented in the unit. 

 

45 minutes ago, Brawndo said:

It’s a mix, we are keeping patients on the floor long that would have been in the ICU in spring.  We are keeping patients who are on High Flow Oxygen with settings up to 60% and 30 Liters flow. I had a 36 yo Code on Saturday she’s still vented in the unit. 

Ah gotcha, so we are changing the approach to oxygenation. Is this because of lack of space or because the intubations weren't always the best initial choice? Hi flow or Venti mask are keeping patients more stable? Or is it still a slippery slope? You def deal with more than I, though it's picking up even in my area. 

[dudacek]

4 minutes ago, PASabreFan said:

Let's hope there's enough vaccine to vaccinate healthcare workers and the vulnerable at roughly the same time. The tricky part is figuring out who is the most vulnerable. We have probably north of 100 million people who have underlying conditions of some sort. Not all of them can go to the front of the line.

Like Canadians. We pre-bought vaccines months ago from all three companies nearly ready to release them.

But apparently we aren't getting them right away because they are going to the US and Britain first.

I don't know, but suspect, we are probably way ahead of poorer countries. Should the most vulnerable in Eqypt or Denmark or Thailand be getting them before the average Joe in Alberta and Kentucky?

[Weave]

Positive test of an employee today.  Starting to hit closer to home for me now.

[Wyldnwoody44]

So odd, literally EVERYONE I know is texting me, my sister has it, my close friends have it, other employees have it. Friends' kids are positive. Either I'm immune or I had it last year. They're all fine, head colds and sore throats, but the number of things popping up in the last 24 hours is huge. 

[Brawndo]

4 hours ago, Wyldnwoody44 said:

 

Ah gotcha, so we are changing the approach to oxygenation. Is this because of lack of space or because the intubations weren't always the best initial choice? Hi flow or Venti mask are keeping patients more stable? Or is it still a slippery slope? You def deal with more than I, though it's picking up even in my area. 

Yeah it’s because more the poorer outcomes associated with intubation.  We keep them on high flow or bipap and hit them with Lasix trying to dry out their lungs. 

[Brawndo]

4 hours ago, dudacek said:

Like Canadians. We pre-bought vaccines months ago from all three companies nearly ready to release them.

But apparently we aren't getting them right away because they are going to the US and Britain first.

I don't know, but suspect, we are probably way ahead of poorer countries. Should the most vulnerable in Eqypt or Denmark or Thailand be getting them before the average Joe in Alberta and Kentucky?

The biggest hurdle is going to be Modera and Pfizer’s Vaccines require extremely cold temps making transportation and distribution to Countries such a Egypt and Thailand much more difficult. Astra Zeneca’s Vaccine does not require the same storage, that one should be prioritize for distribution to these areas to help meet their demands

[Eleven]

5 hours ago, dudacek said:

Should the most vulnerable in Eqypt or Denmark or Thailand be getting them before the average Joe in Alberta and Kentucky?

Yes

[PerreaultForever]

covid got Fred Sasakamoose, the first indigenous hockey player to play in the NHL. 

https://www.cbc.ca/news/canada/saskatoon/sasakamoose-covid-19-indigenous-hockey-nhl-chicago-leach-lacquette-1.5816236

 

[Eleven]

On 11/26/2020 at 2:31 AM, PerreaultForever said:

covid got Fred Sasakamoose, the first indigenous hockey player to play in the NHL. 

https://www.cbc.ca/news/canada/saskatoon/sasakamoose-covid-19-indigenous-hockey-nhl-chicago-leach-lacquette-1.5816236

 

The only way that name could be more Canadian is if the first name had been Gordon.

[dudacek]

A Bloomberg ranking of where the virus has been handled most effectively with the least amount of disruption to business and society

https://www.bloomberg.com/graphics/covid-resilience-ranking/?utm_source=pocket-newtab

[Marvin]

On 11/25/2020 at 4:15 PM, Brawndo said:

The biggest hurdle is going to be Modera and Pfizer’s Vaccines require extremely cold temps making transportation and distribution to Countries such a Egypt and Thailand much more difficult. Astra Zeneca’s Vaccine does not require the same storage, that one should be prioritize for distribution to these areas to help meet their demands

According to my sister (she is with a company working on treatments and recovery from COVID-19 rather than vaccines), Dry Ice prices are through the roof because Moderna's and Pfizer's vaccines need the extreme cold.

[North Buffalo]

More people on rebreather masks here... we have whole floors dedicated to them... They people in ICU with covid and are intubated imo stand little chance.  I can count on 1 hand the number of folks who have been intubated and have covid that have been discharged since April.

[Wyldnwoody44]

A lot of venti/non rebreathers and using a decent amount of vapotherm as well. I've intubated 2 patients this week, they were both Covid negative. 

But the small area seems to be finally catching up, seeing a lot of + patients coming in, many from nursing facilities. The mortality is significantly less in older people around here, at least compared to what I was expecting. 

[LGR4GM]

3 hours ago, North Buffalo said:

More people on rebreather masks here... we have whole floors dedicated to them... They people in ICU with covid and are intubated imo stand little chance.  I can count on 1 hand the number of folks who have been intubated and have covid that have been discharged since April.

Sad to hear. 

[Weave]

1 hour ago, Wyldnwoody44 said:

A lot of venti/non rebreathers and using a decent amount of vapotherm as well. I've intubated 2 patients this week, they were both Covid negative. 

But the small area seems to be finally catching up, seeing a lot of + patients coming in, many from nursing facilities. The mortality is significantly less in older people around here, at least compared to what I was expecting. 

How does Vapotherm help?

[LGR4GM]

14 hours ago, Marvin, Sabres Fan said:

According to my sister (she is with a company working on treatments and recovery from COVID-19 rather than vaccines), Dry Ice prices are through the roof because Moderna's and Pfizer's vaccines need the extreme cold.

https://www.npr.org/sections/health-shots/2020/11/30/940037920/more-good-news-for-modernas-covid-19-vaccine-candidate

Quote

The biotech company Moderna released new data Monday morning that strengthens the case for its COVID-19 vaccine. It concludes the vaccine is 94 percent effective – and strongly protects against serious illness. Based on these latest findings, the company plans to submit an application for emergency use authorization to the Food and Drug Administration today. (based on 

My understanding is that the Moderna vaccine can be safely stored for 30 days in a normal fridge (45 degrees I think is the temp). 

Quote

Moderna boasting a shelf life of up to six months in a regular freezer, and up to 30 days in a standard refrigerator. Pfizer, on the other hand, said its vaccine must be stored at temperatures of minus 70 degrees Celsius or below.

https://www.foxnews.com/health/when-will-modernas-coronavirus-vaccine-be-ready-to-ship

[Wyldnwoody44]

41 minutes ago, Weave said:

How does Vapotherm help?

The warm air helps alleviate symptoms via nasal cannula, it helps open up airways and also really helps in patients who are having difficulty breathing, basically decreases breathing effort in patients with significant congestion. Plus the mask free delivery helps with patients being able to tolerate it compared to bipap or other masked breathing devices. 

[LGR4GM]

Rough timeline of vaccine distribution based on available doses and likely order of vaccination. Basically healthcare workers will go in January with elder care workers and elder care residents also in this phase 1. Phase 2 probably starts in march and would be k-12 and childcare workers, high risk individuals, those over 65+. Phase 3 probably starts in June (some think May) and that would be all people left. Theoretically, depending on how many vaccines get approved and manufacturing rates, we could see 70% rates by late July. These are estimates but good enough to give us a rough timeline. 

https://www.cnn.com/2020/11/30/health/covid-vaccine-questions-when/index.html