Corona Virus Disease/(SARS-CoV-2) II

[Travis In Austin]

7 hours ago, Bosco-d-gama said:

Sadly parts of America are seeing enough serious covid19 cases that their health systems are nearing full capacity. We saw this in NYC last spring and in other countries as well. In some areas we’re starting to have concerns about access to health services as covid19 commands attention. Once again rationing of services is possible. Some covid19 victims may receive better care than others for a variety of reasons. As usual medical ethicists are prognosticating. Which patients should get top priority and why?

https://www.nbcnews.com/think/opinion/rising-covid-cases-means-americans-may-face-health-care-rationing-ncna1246635

 

Last spring when covid19 was relatively ‘new’ to our community those who got infected did so less by their own doing and more by happenstance. That’s not the situation now. Today we know more about covid19 and how best to try and contain it. This information has been widely shared and advocated and for too many silly reasons been found to be controversial. Masks are clearly the best strategy to curb the spread of covid19. In countries like New Zealand where the population sincerely embraced preventive measures covid19 is well contained.

 

So the question is this: If you refused to wear masks/etc you refused to assist your community in controlling covid19 and put everyone at risk......   if you got covid19 and required hospitalization should your care be set a a lower priority?

I agree 100%

 

A few questions concerns: Vanderbilt study says localitys that had mask orders in place did much better than those with nothing in place. However, the study may overlook the fact that people who had guidelines in place may also be practicing social distancing. Are both required? 

 

Saw something I have not been able to check out, that most spread is from inside the home. This doesn't make sense to me from an epidemiology standpoint.

 

The numbers for last few days are very discouraging. 

[oldtimer]

14 minutes ago, dwilawyer said:

Are both required? 

Yes.

[Bosco-d-gama]

1 hour ago, dwilawyer said:

I agree 100%

 

A few questions concerns: Vanderbilt study says localitys that had mask orders in place did much better than those with nothing in place. However, the study may overlook the fact that people who had guidelines in place may also be practicing social distancing. Are both required? 

 

Saw something I have not been able to check out, that most spread is from inside the home. This doesn't make sense to me from an epidemiology standpoint.

 

The numbers for last few days are very discouraging. 

Every method available that can impede viral spread matters. So yes, masks and social distancing and hand washing and any layer of added protection will help.

 

You are also correct in that they are finding that many new covid19 transmissions are occurring in home style settings. This is because this is where people let their guard down. They trust that the people they allow in to their homes are smart and safe and covid19 free. And if you have 15 over for thanksgiving and 1 is infected with covid19 most of the rest will get the disease. Essentially it is proof of how infectious covid19 can be. Close contact for a period of time and that’s all you need. The other areas where we see lots of covid19 transmission were the high density eateries/bars etc.  This is why they felt that the Sturgis event was such a disaster. Look at the covid19 rates in the Dakota’s now.

 

People are still not taking covid19 seriously. Here locally we’re seeing the same loose skeptical mentalities and the same surge of covid19 infections. People are just too sheltered from understanding just how awful a systemic infection really is and they do not fear covid19.

[Zen Traveler]

On 11/6/2020 at 7:19 AM, Bosco-d-gama said:

Generally speaking I agree with your comments 100%. I would add this. Covid19 is a difficult contagion to control. The peculiar character of the covid19 sickness renders it tough to keep a handle on. But the real and only practical goal is not to contain covid19 but to stave it off until we have the vaccines/drugstore to combat the infection.

 

9 hours ago, Bosco-d-gama said:

Sadly parts of America are seeing enough serious covid19 cases that their health systems are nearing full capacity. We saw this in NYC last spring and in other countries as well. In some areas we’re starting to have concerns about access to health services as covid19 commands attention. Once again rationing of services is possible. Some covid19 victims may receive better care than others for a variety of reasons. As usual medical ethicists are prognosticating. Which patients should get top priority and why?

 

 

Last spring when covid19 was relatively ‘new’ to our community those who got infected did so less by their own doing and more by happenstance. That’s not the situation now. Today we know more about covid19 and how best to try and contain it. This information has been widely shared and advocated and for too many silly reasons been found to be controversial. Masks are clearly the best strategy to curb the spread of covid19. In countries like New Zealand where the population sincerely embraced preventive measures covid19 is well contained.

 

So the question is this: If you refused to wear masks/etc you refused to assist your community in controlling covid19 and put everyone at risk......   if you got covid19 and required hospitalization should your care be set a a lower priority?

Fwiw, we have 10 beds left out of 74 in the ICU which brings us to 86% occupied. I noticed we are above the threshold  for COVID-19 Percentage of Total Inpatient Hospitalizations and with a record number of 276 New cases today--That doesn't bode well. https://gis-covid19-dentoncounty.hub.arcgis.com/pages/covid-19cases

[oldtimer]

How did you find that out when the MEDIA is clearly putting it on page 6....?

 

Or is someone just parroting the usual line?

[oldtimer]

Lion, rhinoceros, camel!  Ha!  So there!

[Zen Traveler]

11 minutes ago, oldtimer said:

How did you find that out when the MEDIA is clearly putting it on page 6....?

 

Or is someone just parroting the usual line?

Focusing on the media is like blaming the messenger, imo. We all can find crap we disagree with but seldom do I see someone post something that has a common goal. Heck, I actually thought Covid-19 would be one of those things but instead of thoughtful discussion back in March folks were joking about toilet paper and predicting the virus wasn't going to affect us much...Fwiw, the media I was paying attention to seemed to be right on the money and had on pandemic and financial experts discussing the issues. 

[oldtimer]

You never seem to take sarcasm in stride.  

[Bosco-d-gama]

38 minutes ago, Zen Traveler said:

 

Fwiw, we have 10 beds left out of 74 in the ICU which brings us to 86% occupied. I noticed we are above the threshold  for COVID-19 Percentage of Total Inpatient Hospitalizations and with a record number of 276 New cases today--That doesn't bode well. https://gis-covid19-dentoncounty.hub.arcgis.com/pages/covid-19cases

Similar or worse stats here. 

[oldtimer]

https://www.msn.com/en-us/news/us/governor-declares-state-of-emergency-mandates-masks-to-fight-covid/ar-BB1aQH7n?ocid=msedgdhp

[oldtimer]

.

[Travis In Austin]

11 minutes ago, oldtimer said:

Wait.  I mean I'm just going to deny reality because I don't like it.  Something feels stolen.  Be careful of your response I might sue you.  Baselessly of course.

This type of banter seems to me to have a constant undertone of political spectrum or ideology going on. We are not going to have that in this thread because it always devolves into the political - which we are back to with references to "baseless" lawsuits.

 

So I wonder how the thread would go without that type of rhetoric constantly popping up?

[oldtimer]

sounds baseless to me but I'll delete it for you my dearest friend.  Instead of suing you.

Why should baseless be political?  Oh! Oh! Reality interferes.  Crap, I was commenting on our litigious society.

[Travis In Austin]

10 hours ago, Bosco-d-gama said:

Sadly parts of America are seeing enough serious covid19 cases that their health systems are nearing full capacity. We saw this in NYC last spring and in other countries as well. In some areas we’re starting to have concerns about access to health services as covid19 commands attention. Once again rationing of services is possible. Some covid19 victims may receive better care than others for a variety of reasons. As usual medical ethicists are prognosticating. Which patients should get top priority and why?

https://www.nbcnews.com/think/opinion/rising-covid-cases-means-americans-may-face-health-care-rationing-ncna1246635

 

Last spring when covid19 was relatively ‘new’ to our community those who got infected did so less by their own doing and more by happenstance. That’s not the situation now. Today we know more about covid19 and how best to try and contain it. This information has been widely shared and advocated and for too many silly reasons been found to be controversial. Masks are clearly the best strategy to curb the spread of covid19. In countries like New Zealand where the population sincerely embraced preventive measures covid19 is well contained.

 

So the question is this: If you refused to wear masks/etc you refused to assist your community in controlling covid19 and put everyone at risk......   if you got covid19 and required hospitalization should your care be set a a lower priority?

Western medical ethics has never adopted that approach. There are numerous risky behaviors that people engage in that have never put you at the bottom of the list (if you want a liver transplant you have to be off ETOH for at least a year to qualify, unless your MM, but the risky behavior usually has to cease after the treatment is available).

 

Here will be the tougher issue, if a vaccine has been determined to be "safe and effective" and you don't get the vaccine, and contract SARS-CoV-2, and there is one ICU bed left and there is you and someone who took vaccine, should that factor into the decision making matrix?

 

Should employers be able to require that employees get the vaccine? 

[Jeff Matthews]

19 minutes ago, dwilawyer said:

38 minutes ago, oldtimer said:

Wait.  I mean I'm just going to deny reality because I don't like it.  Something feels stolen.  Be careful of your response I might sue you.  Baselessly of course.

This type of banter seems to me to have a constant undertone of political spectrum or ideology going on.

Yeah.  You can tell with Oldie there's a fine line between love and hate.

 

[oldtimer]

1 minute ago, Jeff Matthews said:

Yeah.  You can tell with Oldie there's a fine line between love and hate.

 

It's a thin line...The Pretenders.

[Zen Traveler]

It always strikes me that we can't have political discussions because people cross the line on civil discourse. Insofar as Covid-19 is concerned, Government plays a big role in every country and I agree with Jeff that it's hard to broach the subject without getting "political." 

[Bosco-d-gama]

15 minutes ago, dwilawyer said:

Western medical ethics has never adopted that approach. There are numerous risky behaviors that people engage in that have never put you at the bottom of the list (if you want a liver transplant you have to be off ETOH for at least a year to qualify, unless your MM, but the risky behavior usually has to cease after the treatment is available).

 

Here will be the tougher issue, if a vaccine has been determined to be "safe and effective" and you don't get the vaccine, and contract SARS-CoV-2, and there is one ICU bed left and there is you and someone who took vaccine, should that factor into the decision making matrix?

 

Should employers be able to require that employees get the vaccine? 

There’s risk to oneself and then there’s risk that contributes to the public well being. The proper use of risk aversion methods and becoming vaccinated both fall into the later category. One is aimed at limiting the physical spread of the virus whilst the other contributes to achieving herd immunity. With both applied covid19 could be on the ropes and we could see a recipe for future diseases.

 

Fortunately if we do get to the position of covid19 control these hospital care ethical conundrums will not ever take place. As to whether employers could mandate covid19 vaccinations I don’t know. Perhaps as a requisite for health insurance?? 
 

Tell ya what I’d do right now. Anyone who does not want to mask should be required to get a formal waiver. They can obtain a personal waiver that requires no proof of need or they could get a medical waiver where a physicians statement of need would be necessary. The waivers would have to be presented upon command and anyone unmasked w/o a waiver would be cited/fined/etc.  But I want these anti maskers to make a formal stand and accept culpability for their actions. Then if they ever get covid19 we would see where things go.

[oldtimer]

Is herd immunity a myth?  There have been cases of reinfection some even leading to death of the patient.  Herd immunity from what I can tell is a lie.  Covid is the same type of virus that gives people colds.  How many of us have had a cold?  Did we eventually get another one?  Everyone knows that if you have had a cold you are not immune to getting another one in the future.  Musing...

[Bosco-d-gama]

13 hours ago, oldtimer said:

Is herd immunity a myth?  There have been cases of reinfection some even leading to death of the patient.  Herd immunity from what I can tell is a lie.  Covid is the same type of virus that gives people colds.  How many of us have had a cold?  Did we eventually get another one?  Everyone knows that if you have had a cold you are not immune to getting another one in the future.  Musing...

You may be correct. Immunity imparted from either getting covid19 or getting inoculated for covid19 may not last long. It may require ‘booster’ type shots to sustain the immunity. The notion of herd immunity is real. If enough of a fixed population is immune to any disease the rest of that population that is not immune becomes protected by those who are immune. Can this be achieved for covid19? That is unknown. Fortunately science isn’t relying on vaccination alone to manage covid19. They are deriving other medications aimed at stifling active covid19 infections early. Several of these plan to use nasal spray type applicators.

Too many do not appreciate the quick efforts taken to fast track the work for these new medicines and vaccines. From the top down this was a smart move taken expeditiously. 
 

Corona viruses are tough critters and this we understood from the outset. We have several less serious forms of these that do cause types of common colds. And we had seen other type of novel coronaviruses that were deadly. Fortunately all of those except 1 was contained and ended. The sole outlier is covid19.