North Dakota's deaths will be rising sharply soon...just like in the rest of the US, really. 170,000 new cases yesterday.
Wait, so you run out of beds, and send a highly infectious person back to a nursing home? That seems..... Bad? I mean, you're taking an infectious person and putting them in an area of high risk people.
Where else could you put them?
Motel rooms? Alot of states have done that for homeless already, doing it for covid patients doesn't seem like a stretch.
It's a bit more complicated than that. A nursing home, also known as a skilled nursing facility or long term care facility, is equipped to provide additional services that an apartment or even assisted living facility is unable to provide. This includes medication management, assistance with transfers in and out of bed, toileting and other hygiene, meal preparation, and 24 hour supervision if needed.
Without nursing supervision and assistance, you're looking at an increased risk of catastrophic falls, medication noncompliance or mismanagement, pressure ulcer risks from bedbound status or soiling the bed, malnutrition, and basically neglect due to discharging a person to a place with requirements for functional independence that the patient isn't ready to reach yet.
Now, converting a hotel to an improvised nursing home is actually a great idea, but that requires a lot of set up beforehand and a massive logistics undertaking. I'm not sure that the homeless motel solution states have implemented passes muster for debilitated hospital patients.
This is why it was so important that China was able to build an isolation hospital almost immediately, to segregate people recovering from COVID-19 but also take care of them. The hospitals near me that actually were retrofitted to accept acute COVID-19 patients ran out of money and had to shut down very recently. The hospital where the COVID-19 patients will be diverted to is also running out of money and is in danger of being shut down. If all these better solutions fade from possibility, the only remaining option of least harm may be going back to nursing homes with precautions and hoping for the best.
I understand totallym. My gf is a nurse and works at one of these facilities.
Off topic, if you got money, can afford a house, and turn that into a 5 person living facility, you're in the money. That's how my gfs company works. They have 5 houses. Anyways
You rent out a hole motel. Not a hotel with a 100 rooms, but a motel with obe of those cheap pools. And you make it an off-site hospital. Move medical equipment there, station nurses and staff there
Rent it out and turn it into a hospitalm. It's good for patients and the economy!
BlackDragon480Bluster KerfuffleMaster of Windy ImportRegistered Userregular
The nursing home/long term care situation is just bananas. While I'm not a medical professional I started as an IT guy at a long term/rehab facility bout 15 years ago and then crosstrained as a facilities guy (Ive got experience dealing with OSHA and have worked with lots of chemicals) and was eventually put in charge of bio clean up and isolation protocols for highly contagious individuals, i.e. how can I make as safe an environment for both the patient/resident and the staff. I still have my MSDS binder and have kept up on newer guidelines from the CDC and AMA.
Most places will have the equipment on site to make a pseudo-cleanroom or two in 24 hours or so, if given notice of a potential spreader of something like COVID or MRSA. But getting multiple people from the hospital that are known to be infected...you'd have to be considering how to isolate the atmosphere/airflow from a room and limit the air mixing from non infected rooms and halls, how much PPE we'd have for the aides and nurses that're working with them and whether to have staff strictly assigned a patient/resident list they'd work with exclusively, to limit the number of people interacting with the infected persons.
It'd be a logistical headache at the best of times to get a gaggle at once, but the way supply chains are still not back to 100% and dealing with state health agencies and governments that either don't give a fuck or don't have the resources or connections to get these facilities what they need to help prevent/contain massive spreader events in their facilities...*screams into the void impotently*
No matter where you go...there you are. ~ Buckaroo Banzai
Nursing home / long term.care in the US is insane just by any standard. Broken in so many ways top to bottom.
When people get out of ICU there needs to be somewhere to send them and most hospitals are limited in rooms beyond recovery and short term care.
Sending people home and doing nurse visits or sending to nursing homes / care facilities is the normal way of doing things. With nursing homes and testing you can usually do good isolation and quarantining and hopefully keep COVID from burning through the population.
Nursing homes have mostly one done ok once there is sufficient testing and isolation but relaxing that is gonna be really bad. I don't think this is the breaking point, it's all the people doing Thanksgiving with their 65+ family that insists on them doing it that are going to be terrible.over the next month.
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Red Raevynbecause I only take Bubble BathsRegistered Userregular
Sounds like Washington state has a batch of new restrictions coming tomorrow, to include limiting grocery and convenience stores to 25% capacity.
Gov. Jay Inslee will announce sweeping new restrictions Sunday to curb surging COVID-19 cases, including a ban on indoor social gatherings and indoor service at restaurants and bars, and sharp occupancy limits for retailers, according to industry officials briefed by the governor’s staff
Has anyone ever looked at those restrictions? Limiting to 25% is a joke. Limit them to 10% or don't bother.
Yeah, at some point, just staffing up, and utility and cleaning costs, at a certain level of capacity it's going to be more expensive to open up, than to stay closed.
Has anyone ever looked at those restrictions? Limiting to 25% is a joke. Limit them to 10% or don't bother.
Yeah, at some point, just staffing up, and utility and cleaning costs, at a certain level of capacity it's going to be more expensive to open up, than to stay closed.
But more to the point, at 25% capacity my store is practically shoulder to shoulder packed. That capacity space includes employee only areas like break rooms and warehouses. 130 people in a store filled with shelving and displays is still a ton of people.
RingoHe/Hima distinct lack of substanceRegistered Userregular
edited November 2020
I'm mostly enthused by shutting down restaurants and bars again, grocery stores are less of a priority here due to them all having lots of floor space and good airflow
Has anyone ever looked at those restrictions? Limiting to 25% is a joke. Limit them to 10% or don't bother.
Yeah, at some point, just staffing up, and utility and cleaning costs, at a certain level of capacity it's going to be more expensive to open up, than to stay closed.
But more to the point, at 25% capacity my store is practically shoulder to shoulder packed. That capacity space includes employee only areas like break rooms and warehouses. 130 people in a store filled with shelving and displays is still a ton of people.
In my neck of the woods there's currently provincial regulations on business capacity and a separate thou-shalt-not-pass set of limits for gatherings of different types depending on whether you're indoors, outdoors, can or can't maintain distancing, etc. Basically, "X percent of capacity or Y people, and if the two are in conflict the latter wins." There's two sets of broad gathering limits indoors: if a business can reliably keep people two meters apart from one another the limit is two hundred, but if they can't it drops down all the way down to ten.
Grocery stores here are technically the larger limit; in practice they start telling people to line up outside before that point to leave some wiggle room in the interior distancing. Most smaller stores tend to have their own limits - a convenience store might legally be able to have ten people but they often have signs on the door saying "three customers at a time" or whatnot.
So, Pfizer announced their vaccine is 90% effective, then the Russians announced that Sputnik V is 92% effective (although, how they got that percentage from sample size of 20 I have no idea), and now Moderna's is 94%?
Well, with 95 cases each in the Pfizer and moderna trials 1 case more or less makes already a good difference, so I'd say they're all in the same ballpark.
So, Pfizer announced their vaccine is 90% effective, then the Russians announced that Sputnik V is 92% effective (although, how they got that percentage from sample size of 20 I have no idea), and now Moderna's is 94%?
This implies that the next one to announce will be 96% effective. The third vaccine after that will go back in time and de-infect someone who has already had covid.
It’s hard to know what probability numbers people are reporting really. In reality their experiments are all returning a range. 99% certain effacacy lies between 99% and 82% for example, based on 4 infections in vaccinated group out of 95 infections total. We don’t know what they are reporting. It’s not the 99% high performance or something, but it might be the ‘mode’ probability (X/Y) or some kind of single tailed, “95% certain better than this” number.
It’s also tough because you are comparing two groups, placebo vs control. Do you compare the 90% best performance of the placebo to the 90% worst performance of the vaccine? Then call that the 99% certainty Better than that level? Compare the reduction on a percentile by percentile level?
Regardless, they seem to work pretty well. Better than we’d hoped. Also, Moderna reported the number of severe cases, and they were all in the placebo group. Not enough data to say whether the vaccinated group is less likely to get severe cases if they do get sick, but, a strong data point to say that it is not the case that the vaccine simply protects people who would have got mild disease from getting any disease, but does nothing for those who would have gotten very sick.
Effectively it’s (numbers used, but I’m not confident these aren’t just numbers news agencies are guessing, or just those being presented to make the number ranges easier to understand)
5 vs 90 for infections
0 vs 11 for ‘severe’ infections
So, Pfizer announced their vaccine is 90% effective, then the Russians announced that Sputnik V is 92% effective (although, how they got that percentage from sample size of 20 I have no idea), and now Moderna's is 94%?
This implies that the next one to announce will be 96% effective. The third vaccine after that will go back in time and de-infect someone who has already had covid.
Extrapolating is fun! :P
Technically this is sorta possible. An mRNA vaccine is sorta like a completely novel virus we’ve brewed up which can’t replicate itself. You could make a vaccine virus which was completely benign, but gave protection against a dangerous virus. Vaccinated people could then ‘infect’ others with the vaccine. That would give a greater than 100% effectiveness.
We don’t do this because while it’s technically an amazing idea, it’s also seemingly quite risky. You’d need to give key features of a dangerous virus to a benign one, while maintaining its ability to replicate effectively and infect people. Then you need to either somehow stop the virus mutating to remove the key feature, and stop it using it to kill you.
You’d probably be on more solid ground modifying the existing virus to delete sections which cause it to kill us but don’t help it’s spread. Figuring out how to, for example, remove its ability to enter the bloodstream. But that would be incredibly hard and might not reduce the IFR of the virus that much, which means there would be severe moral issues with infecting people with the virus to test it.
So, Pfizer announced their vaccine is 90% effective, then the Russians announced that Sputnik V is 92% effective (although, how they got that percentage from sample size of 20 I have no idea), and now Moderna's is 94%?
This implies that the next one to announce will be 96% effective. The third vaccine after that will go back in time and de-infect someone who has already had covid.
Extrapolating is fun! :P
Technically this is sorta possible. An mRNA vaccine is sorta like a completely novel virus we’ve brewed up which can’t replicate itself. You could make a vaccine virus which was completely benign, but gave protection against a dangerous virus. Vaccinated people could then ‘infect’ others with the vaccine.
I don't see how this would be at all possible, as a virus's ability to replicate by hijacking cell machinery in a cascading fashion is what makes them dangerous in the first place.
So, Pfizer announced their vaccine is 90% effective, then the Russians announced that Sputnik V is 92% effective (although, how they got that percentage from sample size of 20 I have no idea), and now Moderna's is 94%?
This implies that the next one to announce will be 96% effective. The third vaccine after that will go back in time and de-infect someone who has already had covid.
Extrapolating is fun! :P
Technically this is sorta possible. An mRNA vaccine is sorta like a completely novel virus we’ve brewed up which can’t replicate itself. You could make a vaccine virus which was completely benign, but gave protection against a dangerous virus. Vaccinated people could then ‘infect’ others with the vaccine.
I don't see how this would be at all possible, as a virus's ability to replicate by hijacking cell machinery in a cascading fashion is what makes them dangerous in the first place.
There are many viruses, even one of the coronaviruses which are incredibly infectious but cause no symptoms at all in almost everyone they infect. HKU1 for example is a coronavirus identified in 2005, is very very infectious, but causes no symptoms in almost everyone it infects.
Even polio is asymptomatic in about 80% of those infected.
Viruses routinely infect people swiftly and aggressively with few to no symptoms, and certainly little to no deaths. Virus danger is not just caused by them killing cells in an out of control fashion, its often a very tiny nudge which can push them from lethal to benign.
Vaccines usually rely on making a virus which is still technically dangerous to your cells, but can't replicate very well but does produce a strong immune response. You could do the opposite and make a virus which reproduces well, but poses little danger to you. Technically that's what the virus itself 'wants' to do over time.
"That is cool" - Abraham Lincoln
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MayabirdPecking at the keyboardRegistered Userregular
Six countries and the Faroe Islands have now reported mink-related SARS2 mutations that have jumped back to humans. Denmark and the Netherlands we already knew about (the Faroes are a Danish territory also), but also now South Africa, Switzerland, Russia and the US. Poland is about to start testing their mink, and if they do genetic testing they'll probably find some too. Mind you, so far other than the "cluster 5" variant from Denmark, all of them so far seem to be minor mutations that are still affected by regular antibodies and have similar levels of spread and so forth, but the more times this happens, the more likely that a new and far worse mutation could occur. Greece has just started culling its mink farms out of caution.
There are 3 states reporting over 500 hospitalizations per million people: ND, SD, and now NE.
Wyoming's positivity rate is over 75% (Johns Hopkins tracker is currently showing 77%).
And two pictures off the internet. One of them shows new cases per million as of a couple days ago, and one of them is an edit which I would've done if someone else hadn't already done it.
Basically, they were lucky and a random person gave a blood sample just a week before getting infected with Covid-19, so they could be reasonably sure the immune reaction that happened was from Covid-19, and not some other coronavirus
Findings are that apparently, the immune system is building a long term response to Covid-19 (t-helper cells if I understood it correctly?), and that this long term response usually means years of immunity, and they see no reason why this shouldn't be the case in most people.
So a good vaccine + long term immunity, which is obviously good. Faint hope!
Based on analyses of T cells in connection with other viral diseases, the research team has no reason to believe that the value of these cells will suddenly drop dramatically after a short time. "We know from other infectious diseases that such cells play a decisive role in preventing renewed infections with the same pathogen," Hofmann explains on the phone. "We are therefore confident that this is also the case with Covid-19. And this is very likely to be the case in the vast majority of patients, even if they only had mild symptoms. This is because the researchers found the memory cells not only in one subject, but in almost 90 percent of the 26 subjects they examined. All were only slightly ill.
Nobody can say with absolute certainty exactly how long the immunity will last, but the coronavirus has not been around long enough to do so. "But so far we have not seen anything in the examined T-cells that should cause us concern," says Hofmann. At the moment, there is nothing to suggest that the immunity couldn't last for years.
Translated with www.DeepL.com/Translator (free version)
Edit: fixed a crucial error in the machine translation
Basically, they were lucky and a random person gave a blood sample just a week before getting infected with Covid-19, so they could be reasonably sure the immune reaction that happened was from Covid-19, and not some other coronavirus
Findings are that apparently, the immune system is building a long term response to Covid-19 (t-helper cells if I understood it correctly?), and that this long term response usually means years of immunity, and they see no reason why this shouldn't be the case in most people.
So a good vaccine + long term immunity, which is obviously good. Faint hope!
Based on analyses of T cells in connection with other viral diseases, the research team has no reason to believe that the value of these cells will suddenly drop dramatically after a short time. "We know from other infectious diseases that such cells play a decisive role in preventing renewed infections with the same pathogen," Hofmann explains on the phone. "We are therefore confident that this is also the case with Covid-19. And this is very likely to be the case in the vast majority of patients, even if they only had mild symptoms. This is because the researchers found the memory cells not only in one subject, but in almost 90 percent of the 26 subjects they examined. All were only slightly ill.
Nobody can say with absolute certainty exactly how long the immunity will last, but the coronavirus has not been around long enough to do so. "But so far we have not seen anything in the examined T-cells that should cause us concern," says Hofmann. At the moment, there is nothing to suggest that the immunity couldn't last for years.
Translated with www.DeepL.com/Translator (free version)
Edit: fixed a crucial error in the machine translation
It seems that from this study, and many like it, that the consensus is that most people who are infected will be sufficiently protected so as to not get sick again for a long time.
The trick the virus seems to be able to play is that the strength of the immune response seems to be highly variable, so some people don't seem to build these markers of a long term immune response at all. These people are relatively uncommon once t and B cell response is included, but, its probably between 1 and 10% of those infected. These people may have other responses, or maybe never even have actually gotten that infected with Covid, but, they do exist and so don't count on immunity of any sort for you as an individual post infection. You very probably DO have it, but you wouldn't get in a car which had a 5% chance of exploding.
MayabirdPecking at the keyboardRegistered Userregular
Mexico has reached 100,000 official COVID deaths. The excess deaths were at nearly 200,000 in August though, so it's almost certainly more than double that. It has become the primary cause of maternal mortality and is the third leading cause of death in Mexico in general, just like in the US.
Also just like in Mexico, the American hospital systems are coming apart, just as predicted. Over 1000 hospitals, nearly 1/5 of the national total, are reporting critical staffing shortages. Not just, shortages, but critical shortages. Doctors and nurses are getting sick and/or burning out. Over 900 staff just at Mayo Clinic were out with COVID. There is no slack. People can't be requested to come from out of state, because all the states are being hit. Patients were being sent to other states, but that margin has also run out. More people are getting hospitalized, but the effective staffed beds are declining. All that talk of "flattening the curve" were to prevent this scenario, and now it's happening, just before the really big impending Thanksgiving surge starting in about two weeks.
Americans, I said this in the discussion thread, but if you can, stock up on supplies now so you can lock yourself down as much as possible for at least the next two months. There is not going to be any national help coming until late January, at the absolute earliest. It's bad, and it is going to be getting much, much worse. I have seen worst case estimates of 10,000 daily deaths in the US. Do whatever preparations you can.
Mexico has reached 100,000 official COVID deaths. The excess deaths were at nearly 200,000 in August though, so it's almost certainly more than double that. It has become the primary cause of maternal mortality and is the third leading cause of death in Mexico in general, just like in the US.
Also just like in Mexico, the American hospital systems are coming apart, just as predicted. Over 1000 hospitals, nearly 1/5 of the national total, are reporting critical staffing shortages. Not just, shortages, but critical shortages. Doctors and nurses are getting sick and/or burning out. Over 900 staff just at Mayo Clinic were out with COVID. There is no slack. People can't be requested to come from out of state, because all the states are being hit. Patients were being sent to other states, but that margin has also run out. More people are getting hospitalized, but the effective staffed beds are declining. All that talk of "flattening the curve" were to prevent this scenario, and now it's happening, just before the really big impending Thanksgiving surge starting in about two weeks.
Americans, I said this in the discussion thread, but if you can, stock up on supplies now so you can lock yourself down as much as possible for at least the next two months. There is not going to be any national help coming until late January, at the absolute earliest. It's bad, and it is going to be getting much, much worse. I have seen worst case estimates of 10,000 daily deaths in the US. Do whatever preparations you can.
Um
The data is collected in most cases directly from hospitals to a new federal platform, set up suddenly in July by the Department of Health and Human Services with a relatively unknown contractor called Teletracking. The move stripped CDC of the responsibility to collect and analyze this data, and prompted a huge outcry. The new system, called HHS Protect, has been marred by inaccuracies and limited transparency.
I can't say I'm filled with confidence wrt the article when they put in a "Yeah so this could be all bullshit, and here's how in the past we've reported on how this is probably all bullshit" clause in there.
Oxford and Astra are selling it for no profit, and it’s very much a big standard vaccine which has been used for all sorts of stuff in the past. I believe it may even be shippable at room temperature as a dessicated powder which can be reconstituted.
Hopefully the dosing regimen can be tweeked to give really solid resistance like 90%. Otherwise I’m glad it exists, but in many nations (the US) where the virus is rampant personal safety will be important for those early healthcare worker and old people doses.
For Western nations the vaccine cost for all of these is trivial, the most expensive one is $30. The reason we need many vaccines the coming year is the limited production capability. A 70% efficient vaccine introduces some ethical considerations into who to vaccinate... I wonder how the models would look if you gave that to the groups that you expect are the most active spreaders and gave the 90% to the most vulnerable.
For Western nations the vaccine cost for all of these is trivial, the most expensive one is $30. The reason we need many vaccines the coming year is the limited production capability. A 70% efficient vaccine introduces some ethical considerations into who to vaccinate... I wonder how the models would look if you gave that to the groups that you expect are the most active spreaders and gave the 90% to the most vulnerable.
I believe with Oxford now effective, that takes us to the ability to vaccinate about 3 billion people next year with production on already on the table. It also more than triples the speed at which we can vaccinate.
You may be right though, that we could deploy the 90% or greater vaccines in healthcare workers and older People, and use the 70% one for the general public. More likely though is that nations with the proper cold chain to distribute will take all the 90% vaccine in the early stages, and the 70% ones go to nations and areas which can’t do that.
Honestly, let’s just hope the modified dose regimen supposition holds.
For Western nations the vaccine cost for all of these is trivial, the most expensive one is $30. The reason we need many vaccines the coming year is the limited production capability. A 70% efficient vaccine introduces some ethical considerations into who to vaccinate... I wonder how the models would look if you gave that to the groups that you expect are the most active spreaders and gave the 90% to the most vulnerable.
I believe with Oxford now effective, that takes us to the ability to vaccinate about 3 billion people next year with production on already on the table. It also more than triples the speed at which we can vaccinate.
You may be right though, that we could deploy the 90% or greater vaccines in healthcare workers and older People, and use the 70% one for the general public. More likely though is that nations with the proper cold chain to distribute will take all the 90% vaccine in the early stages, and the 70% ones go to nations and areas which can’t do that.
Honestly, let’s just hope the modified dose regimen supposition holds.
Apparently the Oxford one is 90% effective when you receive a half dose, then a full dose a few months later.
If you get the full dose up front, its 70%.
So yeah, a combination of the 90% one for urgents immunizations, combined with the oxford one for general, less urgent cases seems promising.
For Western nations the vaccine cost for all of these is trivial, the most expensive one is $30. The reason we need many vaccines the coming year is the limited production capability. A 70% efficient vaccine introduces some ethical considerations into who to vaccinate... I wonder how the models would look if you gave that to the groups that you expect are the most active spreaders and gave the 90% to the most vulnerable.
I believe with Oxford now effective, that takes us to the ability to vaccinate about 3 billion people next year with production on already on the table. It also more than triples the speed at which we can vaccinate.
You may be right though, that we could deploy the 90% or greater vaccines in healthcare workers and older People, and use the 70% one for the general public. More likely though is that nations with the proper cold chain to distribute will take all the 90% vaccine in the early stages, and the 70% ones go to nations and areas which can’t do that.
Honestly, let’s just hope the modified dose regimen supposition holds.
Apparently the Oxford one is 90% effective when you receive a half dose, then a full dose a few months later.
If you get the full dose up front, its 70%.
So yeah, a combination of the 90% one for urgents immunizations, combined with the oxford one for general, less urgent cases seems promising.
Fingers crossed for supply lines, staffing, etc.
Aren't all the vaccines so far multiple doses spread apart?
For Western nations the vaccine cost for all of these is trivial, the most expensive one is $30. The reason we need many vaccines the coming year is the limited production capability. A 70% efficient vaccine introduces some ethical considerations into who to vaccinate... I wonder how the models would look if you gave that to the groups that you expect are the most active spreaders and gave the 90% to the most vulnerable.
I believe with Oxford now effective, that takes us to the ability to vaccinate about 3 billion people next year with production on already on the table. It also more than triples the speed at which we can vaccinate.
You may be right though, that we could deploy the 90% or greater vaccines in healthcare workers and older People, and use the 70% one for the general public. More likely though is that nations with the proper cold chain to distribute will take all the 90% vaccine in the early stages, and the 70% ones go to nations and areas which can’t do that.
Honestly, let’s just hope the modified dose regimen supposition holds.
Apparently the Oxford one is 90% effective when you receive a half dose, then a full dose a few months later.
If you get the full dose up front, its 70%.
So yeah, a combination of the 90% one for urgents immunizations, combined with the oxford one for general, less urgent cases seems promising.
Fingers crossed for supply lines, staffing, etc.
Aren't all the vaccines so far multiple doses spread apart?
Yeah, I imagine all the vaccines will start helping from the time you get the first shot, but all numbers thus far quoted are for efficacy 7 days after the second shot, which is 3-4 weeks after the first. So, ~30 days till quoted efficacy.
I do hope the modified regime holds for Oxford. It a bit weird that it would work that way, but, I guess they tested it so they must have had some confidence in it.
"That is cool" - Abraham Lincoln
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That_GuyI don't wanna be that guyRegistered Userregular
I wish there was some way of preordering the vaccine so I could get on a list early. The company I work for provides IT services to hospitals, urgent care, and doctors offices. I think that makes me a frontliner but IDK if everyone would agree.
Im a bit concerned about the distribution process tbh. Normally it wouldn't bother me but so many states don't seem up to the task. I figure my employer will probably sort it out as I work at a hospital but there are a lot of vulnerable people reliant exclusively on Medicare.
I do hope the modified regime holds for Oxford. It a bit weird that it would work that way
One plausible explanation I saw as to why that could be the case is that the Oxford vaccine uses a modified chimpanzee adenovirus unlike the other two vaccines that have been successfully tested, and that the full dose might have caused the participants bodies to rapidly attack the adenovirus vector in addition to the spike protein from infected cells.
The Oxford/AstraZeneca vaccine can be stored between 36° and 46°F, and according to the press release can be stored for six months at those temperatures.
Rollers are red, chargers are blue....omae wa mou shindeiru
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BrodyThe WatchThe First ShoreRegistered Userregular
I wish there was some way of preordering the vaccine so I could get on a list early. The company I work for provides IT services to hospitals, urgent care, and doctors offices. I think that makes me a frontliner but IDK if everyone would agree.
I assume its something employers as a whole will have to apply for, rather than having each employee go out and try to get themselves vaccinated on their own, at least for the first wave or two.
"I will write your name in the ruin of them. I will paint you across history in the color of their blood."
Gf is sick, daughter has the sniffles and. Slight temp (she's one) me and momma getting tested tomorrow. So weird it something we have to do. If I catch this I'm stealing and airplane and taking it as high as I can. One last ditch effort to have an amazing time, and die in my own terms
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I understand totallym. My gf is a nurse and works at one of these facilities.
Off topic, if you got money, can afford a house, and turn that into a 5 person living facility, you're in the money. That's how my gfs company works. They have 5 houses. Anyways
You rent out a hole motel. Not a hotel with a 100 rooms, but a motel with obe of those cheap pools. And you make it an off-site hospital. Move medical equipment there, station nurses and staff there
Rent it out and turn it into a hospitalm. It's good for patients and the economy!
There was a fire at a Romanian ICU caring for COVID patients on ventilators. At least 10 are dead, and one doctor who tried to save patients from the flames is in critical condition.
Most places will have the equipment on site to make a pseudo-cleanroom or two in 24 hours or so, if given notice of a potential spreader of something like COVID or MRSA. But getting multiple people from the hospital that are known to be infected...you'd have to be considering how to isolate the atmosphere/airflow from a room and limit the air mixing from non infected rooms and halls, how much PPE we'd have for the aides and nurses that're working with them and whether to have staff strictly assigned a patient/resident list they'd work with exclusively, to limit the number of people interacting with the infected persons.
It'd be a logistical headache at the best of times to get a gaggle at once, but the way supply chains are still not back to 100% and dealing with state health agencies and governments that either don't give a fuck or don't have the resources or connections to get these facilities what they need to help prevent/contain massive spreader events in their facilities...*screams into the void impotently*
~ Buckaroo Banzai
When people get out of ICU there needs to be somewhere to send them and most hospitals are limited in rooms beyond recovery and short term care.
Sending people home and doing nurse visits or sending to nursing homes / care facilities is the normal way of doing things. With nursing homes and testing you can usually do good isolation and quarantining and hopefully keep COVID from burning through the population.
Nursing homes have mostly one done ok once there is sufficient testing and isolation but relaxing that is gonna be really bad. I don't think this is the breaking point, it's all the people doing Thanksgiving with their 65+ family that insists on them doing it that are going to be terrible.over the next month.
https://www.seattletimes.com/seattle-news/health/inslee-to-ban-indoor-gatherings-and-dining-plus-issue-more-covid-19-restrictions-for-washington-state-industry-sources-say/
Yeah, at some point, just staffing up, and utility and cleaning costs, at a certain level of capacity it's going to be more expensive to open up, than to stay closed.
But more to the point, at 25% capacity my store is practically shoulder to shoulder packed. That capacity space includes employee only areas like break rooms and warehouses. 130 people in a store filled with shelving and displays is still a ton of people.
Also, Germany does a great PSA:
In my neck of the woods there's currently provincial regulations on business capacity and a separate thou-shalt-not-pass set of limits for gatherings of different types depending on whether you're indoors, outdoors, can or can't maintain distancing, etc. Basically, "X percent of capacity or Y people, and if the two are in conflict the latter wins." There's two sets of broad gathering limits indoors: if a business can reliably keep people two meters apart from one another the limit is two hundred, but if they can't it drops down all the way down to ten.
Grocery stores here are technically the larger limit; in practice they start telling people to line up outside before that point to leave some wiggle room in the interior distancing. Most smaller stores tend to have their own limits - a convenience store might legally be able to have ten people but they often have signs on the door saying "three customers at a time" or whatnot.
https://www.cnbc.com/2020/11/16/moderna-says-its-coronavirus-vaccine-is-more-than-94percent-effective.html
This implies that the next one to announce will be 96% effective. The third vaccine after that will go back in time and de-infect someone who has already had covid.
Extrapolating is fun! :P
It’s also tough because you are comparing two groups, placebo vs control. Do you compare the 90% best performance of the placebo to the 90% worst performance of the vaccine? Then call that the 99% certainty Better than that level? Compare the reduction on a percentile by percentile level?
Regardless, they seem to work pretty well. Better than we’d hoped. Also, Moderna reported the number of severe cases, and they were all in the placebo group. Not enough data to say whether the vaccinated group is less likely to get severe cases if they do get sick, but, a strong data point to say that it is not the case that the vaccine simply protects people who would have got mild disease from getting any disease, but does nothing for those who would have gotten very sick.
Effectively it’s (numbers used, but I’m not confident these aren’t just numbers news agencies are guessing, or just those being presented to make the number ranges easier to understand)
5 vs 90 for infections
0 vs 11 for ‘severe’ infections
Technically this is sorta possible. An mRNA vaccine is sorta like a completely novel virus we’ve brewed up which can’t replicate itself. You could make a vaccine virus which was completely benign, but gave protection against a dangerous virus. Vaccinated people could then ‘infect’ others with the vaccine. That would give a greater than 100% effectiveness.
We don’t do this because while it’s technically an amazing idea, it’s also seemingly quite risky. You’d need to give key features of a dangerous virus to a benign one, while maintaining its ability to replicate effectively and infect people. Then you need to either somehow stop the virus mutating to remove the key feature, and stop it using it to kill you.
You’d probably be on more solid ground modifying the existing virus to delete sections which cause it to kill us but don’t help it’s spread. Figuring out how to, for example, remove its ability to enter the bloodstream. But that would be incredibly hard and might not reduce the IFR of the virus that much, which means there would be severe moral issues with infecting people with the virus to test it.
I don't see how this would be at all possible, as a virus's ability to replicate by hijacking cell machinery in a cascading fashion is what makes them dangerous in the first place.
There are many viruses, even one of the coronaviruses which are incredibly infectious but cause no symptoms at all in almost everyone they infect. HKU1 for example is a coronavirus identified in 2005, is very very infectious, but causes no symptoms in almost everyone it infects.
Even polio is asymptomatic in about 80% of those infected.
Viruses routinely infect people swiftly and aggressively with few to no symptoms, and certainly little to no deaths. Virus danger is not just caused by them killing cells in an out of control fashion, its often a very tiny nudge which can push them from lethal to benign.
Vaccines usually rely on making a virus which is still technically dangerous to your cells, but can't replicate very well but does produce a strong immune response. You could do the opposite and make a virus which reproduces well, but poses little danger to you. Technically that's what the virus itself 'wants' to do over time.
Meanwhile, in the dumpster fire that is the US
Wyoming's positivity rate is over 75% (Johns Hopkins tracker is currently showing 77%).
And two pictures off the internet. One of them shows new cases per million as of a couple days ago, and one of them is an edit which I would've done if someone else hadn't already done it.
Basically, they were lucky and a random person gave a blood sample just a week before getting infected with Covid-19, so they could be reasonably sure the immune reaction that happened was from Covid-19, and not some other coronavirus
Findings are that apparently, the immune system is building a long term response to Covid-19 (t-helper cells if I understood it correctly?), and that this long term response usually means years of immunity, and they see no reason why this shouldn't be the case in most people.
So a good vaccine + long term immunity, which is obviously good. Faint hope!
Translated with www.DeepL.com/Translator (free version)
Edit: fixed a crucial error in the machine translation
https://www.spiegel.de/wissenschaft/medizin/corona-warum-die-immunitaet-jahre-anhalten-koennte-und-was-das-fuer-einen-impfstoff-bedeutet-a-fd678317-628b-41d1-a4b2-dc2eca2915ab
It seems that from this study, and many like it, that the consensus is that most people who are infected will be sufficiently protected so as to not get sick again for a long time.
The trick the virus seems to be able to play is that the strength of the immune response seems to be highly variable, so some people don't seem to build these markers of a long term immune response at all. These people are relatively uncommon once t and B cell response is included, but, its probably between 1 and 10% of those infected. These people may have other responses, or maybe never even have actually gotten that infected with Covid, but, they do exist and so don't count on immunity of any sort for you as an individual post infection. You very probably DO have it, but you wouldn't get in a car which had a 5% chance of exploding.
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Also just like in Mexico, the American hospital systems are coming apart, just as predicted. Over 1000 hospitals, nearly 1/5 of the national total, are reporting critical staffing shortages. Not just, shortages, but critical shortages. Doctors and nurses are getting sick and/or burning out. Over 900 staff just at Mayo Clinic were out with COVID. There is no slack. People can't be requested to come from out of state, because all the states are being hit. Patients were being sent to other states, but that margin has also run out. More people are getting hospitalized, but the effective staffed beds are declining. All that talk of "flattening the curve" were to prevent this scenario, and now it's happening, just before the really big impending Thanksgiving surge starting in about two weeks.
Americans, I said this in the discussion thread, but if you can, stock up on supplies now so you can lock yourself down as much as possible for at least the next two months. There is not going to be any national help coming until late January, at the absolute earliest. It's bad, and it is going to be getting much, much worse. I have seen worst case estimates of 10,000 daily deaths in the US. Do whatever preparations you can.
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Um
I can't say I'm filled with confidence wrt the article when they put in a "Yeah so this could be all bullshit, and here's how in the past we've reported on how this is probably all bullshit" clause in there.
Oxford and Astra are selling it for no profit, and it’s very much a big standard vaccine which has been used for all sorts of stuff in the past. I believe it may even be shippable at room temperature as a dessicated powder which can be reconstituted.
Hopefully the dosing regimen can be tweeked to give really solid resistance like 90%. Otherwise I’m glad it exists, but in many nations (the US) where the virus is rampant personal safety will be important for those early healthcare worker and old people doses.
I believe with Oxford now effective, that takes us to the ability to vaccinate about 3 billion people next year with production on already on the table. It also more than triples the speed at which we can vaccinate.
You may be right though, that we could deploy the 90% or greater vaccines in healthcare workers and older People, and use the 70% one for the general public. More likely though is that nations with the proper cold chain to distribute will take all the 90% vaccine in the early stages, and the 70% ones go to nations and areas which can’t do that.
Honestly, let’s just hope the modified dose regimen supposition holds.
Apparently the Oxford one is 90% effective when you receive a half dose, then a full dose a few months later.
If you get the full dose up front, its 70%.
So yeah, a combination of the 90% one for urgents immunizations, combined with the oxford one for general, less urgent cases seems promising.
Fingers crossed for supply lines, staffing, etc.
Aren't all the vaccines so far multiple doses spread apart?
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Yeah, I imagine all the vaccines will start helping from the time you get the first shot, but all numbers thus far quoted are for efficacy 7 days after the second shot, which is 3-4 weeks after the first. So, ~30 days till quoted efficacy.
I do hope the modified regime holds for Oxford. It a bit weird that it would work that way, but, I guess they tested it so they must have had some confidence in it.
The Oxford/AstraZeneca vaccine can be stored between 36° and 46°F, and according to the press release can be stored for six months at those temperatures.
I assume its something employers as a whole will have to apply for, rather than having each employee go out and try to get themselves vaccinated on their own, at least for the first wave or two.
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