The General [Coronavirus] Discussion Thread: Vaccines!

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  • PhyphorPhyphor Building Planet Busters Tasting FruitRegistered User regular
    Orca wrote: »
    From a triage standpoint, I could even see pulling EMTs off ambulance duty for this

    That would never fly in part because the optics would be awful, but from a "maximizing benefit for the population" standpoint I suspect we'd come out ahead.

    Moot point of course. It's a thing that sounds like a great idea up until I'm the one that needs the ambulance.

    That's probably not worth it. The people going to an overnight vaccine clinic aren't high risk elderly people, and you're nowhere near enough to the threshold where spread gets curtailed, so you're trading possibly not responding to a serious call right now with might prevent some illnesses later, but very possibly not preventing any deaths

  • RedTideRedTide Registered User regular
    One of the biggest issues with Emergency Medicine in general but including EMTs and Paramedics is burnout - and that was before the past year.

    And I'll tell you this right now.

    There isn't probably an ambulance service or medic provider that I would call overstaffed in the entire country.

    Local governments and hospitals are always trying to figure out the bare minimum and trying to hover above it.

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  • OrcaOrca Registered User regular
    Phyphor wrote: »
    Orca wrote: »
    From a triage standpoint, I could even see pulling EMTs off ambulance duty for this

    That would never fly in part because the optics would be awful, but from a "maximizing benefit for the population" standpoint I suspect we'd come out ahead.

    Moot point of course. It's a thing that sounds like a great idea up until I'm the one that needs the ambulance.

    That's probably not worth it. The people going to an overnight vaccine clinic aren't high risk elderly people, and you're nowhere near enough to the threshold where spread gets curtailed, so you're trading possibly not responding to a serious call right now with might prevent some illnesses later, but very possibly not preventing any deaths

    I'm not talking overnight, I'm talking 8-8 urgent care clinics like the one down the street from me. Overnight means emergency rooms and we do not want to fuck with those.

    But it's moot point anyway.

  • tinwhiskerstinwhiskers Registered User regular
    I like how problems like "How do we staff something more than 8 hours a day Monday through Friday" are apparently the sort of brick walls we can't expect the government to overcome even with months of notice.

    Its giving people a shot into their arm. Pretty sure you can train someone to do that competently in less than the 12 months they've had to figure this out in.

    Giving this to hospitals was a mistake. McDonalds would be doing a better job of it.

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  • RedTideRedTide Registered User regular
    I like how problems like "How do we staff something more than 8 hours a day Monday through Friday" are apparently the sort of brick walls we can't expect the government to overcome even with months of notice.

    Its giving people a shot into their arm. Pretty sure you can train someone to do that competently in less than the 12 months they've had to figure this out in.

    Giving this to hospitals was a mistake. McDonalds would be doing a better job of it.

    There should have been a federal effort a la census takers to get people trained to give jabs and handle the paperwork on the ground.

    You tell the hospitals to spend whatever is necessary and all they're going to do is figure out how to min/max their bills or do it in the way that's least impactful to their day to day operations.

    On top of that people should have had their assignments a month prior to roll out.

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  • tbloxhamtbloxham Registered User regular
    Once again, "X is a calling" is short for "I'm going to shame you into accepting abusive work conditions while doing X."

    You don't need healthcare workers to give the damn shots. You need one nurse per site to monitor for allergic reactions and respond if they occur. And it doesn't even have to be a nurse. You get VASTLY higher rates of unexpected severe and deadly allergies in every single school in the USA because of kids randomly bringing peanuts in and giving them to their mates, one of whom is allergic. And in that situation you just train a few staff members on how to use an Epipen.

    You MAYBE need a pharmacist to effectively prep the dose volumes, but I genuinely don't believe that because intramuscular injections of specific volumes is something that millions of American diabetics do every day.

    Should nurses and doctors work 24/7. No. They shouldn't. Should the clinics be open 24/7. Yes, yes they should. Oh no, its impossible! But wait, its not, because delivering vaccines is easy. Retired staff could do it. Medical students could do it. Anyone in this thread could do it. Its not hard! There are whole companies dedicated to like, running out flu vaccines at offices. They come in, bring the team, and get to work vaccinating a couple of thousand people in a day.

    As for paperwork? No paperwork. Or have them do the damn paperwork AFTER they get the vaccine. Issue a blanket, "If you come to a vaccine clinic, you accept the risks of vaccination" law so everyone is completely indemnified and we no longer need to have any kind of consent nonsense. Mandatory, fast, universal.

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  • evilmrhenryevilmrhenry Registered User regular
    RedTide wrote: »
    I like how problems like "How do we staff something more than 8 hours a day Monday through Friday" are apparently the sort of brick walls we can't expect the government to overcome even with months of notice.

    Its giving people a shot into their arm. Pretty sure you can train someone to do that competently in less than the 12 months they've had to figure this out in.

    Giving this to hospitals was a mistake. McDonalds would be doing a better job of it.

    There should have been a federal effort a la census takers to get people trained to give jabs and handle the paperwork on the ground.

    You tell the hospitals to spend whatever is necessary and all they're going to do is figure out how to min/max their bills or do it in the way that's least impactful to their day to day operations.

    On top of that people should have had their assignments a month prior to roll out.

    We already have a setup for giving vaccines to the American public. It's called pharmacies. I've gotten my flu shot at the grocery store; it's not a big deal. They have people specifically trained to give vaccines there, they know how to do the paperwork, and most people go to the store at some point. There's no need to be screwing around with retraining here.

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  • OrcaOrca Registered User regular
    That's a really good point. This is, after all, just another flu shot*.

    * against a particularly deadly flu

  • CelestialBadgerCelestialBadger Registered User regular
    According to Google, every year 45% of Americans get flu shots. Of course, flu shots are easier to store and don't need 2 doses.

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  • Inkstain82Inkstain82 Registered User regular
    The 7-day average hospitalizations for the us on COVIDtracking.com just had its first downward day since September

    I think it’s very likely we are hitting the tipping point right now.

  • StarZapperStarZapper Vermont, Bizzaro world.Registered User regular
    The numbers should start coming down this week, we're 2+ weeks out from the Christmas/New Years gatherings. It's really going to depend on how much Americans have been behaving though, so we'll see. The vaccines should start to have an impact pretty soon too.

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  • Inkstain82Inkstain82 Registered User regular
    The way I look at it, even if you assume we are catching 1 in 3 infections, we have been averaging from 1 to 1.5% of the population being infected every week since Halloween.

    So even if people are acting exactly the same as we were 10 weeks ago, that’s still a 10-15% reduction in transmission rates. Even without vaccinations, that would get us below 1 sometime around now.

    This is not a “hooray, we are beating Covid” thing. It’s just that we managed to bungle it so badly, killing hundreds of thousands of people, that the fire is starting to burn itself out enough that our half-assed measures can handle it.

  • TetraNitroCubaneTetraNitroCubane The Djinnerator At the bottom of a bottleRegistered User regular
    edited January 14



    Wow. LA County officials estimate that 1 in 3 people in the county has been infected with the coronavirus since the pandemic began. ONE IN THREE.
    About a month ago, on Dec. 9, that figure was estimated to be 1 in 5. 🙃

    Soumya Karlamangla is a health reporter for the LA Times.

    That's fucking dire.

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  • notyanotya Registered User regular
    edited January 14
    If LA has had 1 in 3 infected then the mortality rate must be much lower than we thought..... like MUCH MUCH lower. Our population is 10 million.

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  • TetraNitroCubaneTetraNitroCubane The Djinnerator At the bottom of a bottleRegistered User regular
    edited January 14
    notya wrote: »
    If LA has had 1 in 3 infected then the mortality rate must be much lower than we thought..... like MUCH MUCH lower. Our population is 10 million.

    Perhaps, but if those numbers are accurate, then in the last month there have been 1.3 million infections. That would mean people who haven't gotten to the critical phase of the infection yet, and might portend a surge of deaths on the horizon. Again, if those estimates are accurate, which is hard to say.

    Additionally, as time has gone on, we've gotten better at keeping people alive from this nasty bastard. But remember: This doesn't count the number of people who wind up with long term disabilities, lingering health issues, and otherwise nasty fallout from the virus. "Not dead" isn't the only metric to care about!

    Lastly, the number of recorded deaths currently is almost certainly a gross underestimate.

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  • Inkstain82Inkstain82 Registered User regular
    edited January 14
    notya wrote: »
    If LA has had 1 in 3 infected then the mortality rate must be much lower than we thought..... like MUCH MUCH lower. Our population is 10 million.

    12,300 deaths so far out if 3,300,000 infections would be an IFR of about 0.35%, but it will go up a little bit as current infections haven’t had a chance to die yet. Something around 0.4-0.5% is pretty much right in line with current ifr estimates

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  • notyanotya Registered User regular
    notya wrote: »
    If LA has had 1 in 3 infected then the mortality rate must be much lower than we thought..... like MUCH MUCH lower. Our population is 10 million.

    Perhaps, but if those numbers are accurate, then in the last month there have been 1.3 million infections. That would probably mean a surge of deaths on the horizon. Again, if those estimates are accurate, which is hard to say.

    Also, the number of recorded deaths currently is almost certainly a gross underestimate.

    maybe worldwide, but i doubt it's that far off here in LA. It's not like what happened in NYC.

  • Inkstain82Inkstain82 Registered User regular
    LA isn’t the only place with 33% prevalence. COVID-19-projections has it at ~25% nationally, and that’s with an error band that could go higher than 33%

  • tbloxhamtbloxham Registered User regular
    Inkstain82 wrote: »
    The 7-day average hospitalizations for the us on COVIDtracking.com just had its first downward day since September

    I think it’s very likely we are hitting the tipping point right now.

    Victory! Reopen indoor dining and gyms nationwide immediately!

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  • SiliconStewSiliconStew Registered User regular
    notya wrote: »
    If LA has had 1 in 3 infected then the mortality rate must be much lower than we thought..... like MUCH MUCH lower. Our population is 10 million.

    Not really. It has killed 1.3% of the nearly 1 million positive cases in LA county. Adding another 2 million estimated asymptomatic/untested cases to that drops the death rate to 0.44% which as I recall is in line with the expected average death rate across all ages for Covid.

    Just remember that half the people you meet are below average intelligence.
  • OrcaOrca Registered User regular
    tbloxham wrote: »
    Inkstain82 wrote: »
    The 7-day average hospitalizations for the us on COVIDtracking.com just had its first downward day since September

    I think it’s very likely we are hitting the tipping point right now.

    Victory! Reopen indoor dining and gyms nationwide immediately!

    :mad:

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  • zagdrobzagdrob Registered User regular
    I predicted we would have peaked at 5k deaths the week after Christmas and am so very thankful I was wrong and we aren't getting close to the growth I anticipated.

    What we are seeing is still terrible.

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  • Inkstain82Inkstain82 Registered User regular
    zagdrob wrote: »
    I predicted we would have peaked at 5k deaths the week after Christmas and am so very thankful I was wrong and we aren't getting close to the growth I anticipated.

    What we are seeing is still terrible.

    Depending on reporting spurts, I don’t think a 5k deaths reported day is out of the question in the next few weeks

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  • LilnoobsLilnoobs Alpha Queue Registered User regular
    Let's be honest, add about 20% to all the numbers at least.

  • tbloxhamtbloxham Registered User regular

    From the New York Times, but since it’s one of their in news stream articles there seems to be no way to actually find the damn link to the thing to share. It’s from an article discussing slow vaccine rollouts in California, but there is good news inside

    “ Dr. Lubarsky said that as of Tuesday, roughly 12,000 of the system’s 13,000 staff members had received at least their first vaccine doses by opening up the process, and that patient vaccinations were set to begin soon.

    “We said, ‘If somebody jumped the line, shame on them,’” he said. “If they showed us their ID and worked in the hospital — it was a bit of an honor system.”

    [Read four opinion pieces by experts about how to fix the vaccine rollout.]

    As a result, he said, the rate of Covid-19 transmission among staff has dropped significantly. In recent weeks, an average of 135 employees were “getting Covid and going home.” This week, he said, that number is in the 20s.”

    Assuming that’s not just a data glitch for some lucky week, that’s the first data point I’ve seen that says, “In the wild, if you give a big fraction of people dose 1 and wait a week or two, infections fall a lot”

    Clearly, everyone needs dose 2 as well, but, it’s good to see a little bit of good news buried in the rest of the story about the California vaccine disaster.

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  • ShadowfireShadowfire Vermont, in the middle of nowhereRegistered User regular
    The kid's Covid test came back overnight. Negative.

    Whew!

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  • Fuzzy Cumulonimbus CloudFuzzy Cumulonimbus Cloud friend pelican soft and relaxing mouthRegistered User regular
    StarZapper wrote: »
    The numbers should start coming down this week, we're 2+ weeks out from the Christmas/New Years gatherings. It's really going to depend on how much Americans have been behaving though, so we'll see. The vaccines should start to have an impact pretty soon too.

    Thats an erroneous assumption. It takes about a month to accurately reflect last month in the number of cases.

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  • tbloxhamtbloxham Registered User regular
    StarZapper wrote: »
    The numbers should start coming down this week, we're 2+ weeks out from the Christmas/New Years gatherings. It's really going to depend on how much Americans have been behaving though, so we'll see. The vaccines should start to have an impact pretty soon too.

    Thats an erroneous assumption. It takes about a month to accurately reflect last month in the number of cases.

    I'd say it takes a month to reflect it in hospitalizations and a month to have full effects on case levels. At the two week point is where you start to see the effects of of a change in behavior. We've already seen Christmas, we still need to see what new years did, and then hopefully in a week or so we'll start to see the effects of vaccines.

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  • Fuzzy Cumulonimbus CloudFuzzy Cumulonimbus Cloud friend pelican soft and relaxing mouthRegistered User regular
    Also I don't think there have been enough vaccinations to start being reflected in case numbers.

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  • tbloxhamtbloxham Registered User regular
    Also I don't think there have been enough vaccinations to start being reflected in case numbers.

    Unfortunately we don't actually know the breakdown of who is catching the damn virus. We know that there are enormous numbers of deaths in old people and it seems possible that there are enormous numbers of cases in healthcare workers, but we don't know. The targetted vaccinations of those groups might start showing up on the data.

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  • Inkstain82Inkstain82 Registered User regular
    Two weeks are plenty to start seeing most of the effects on something that affects cases and hospitalizations. The lag time isn’t *that* big. In theory, hospitalizations come after cases, but the reporting from hospitals is a lot more reliable and prompt, so they end up being pretty close to synchronous.

    Vaccinations won’t have a big impact on case right away. They’ll have a big effect on hospitalizations very soon though.

  • Fuzzy Cumulonimbus CloudFuzzy Cumulonimbus Cloud friend pelican soft and relaxing mouthRegistered User regular
    Inkstain82 wrote: »
    Two weeks are plenty to start seeing most of the effects on something that affects cases and hospitalizations. The lag time isn’t *that* big. In theory, hospitalizations come after cases, but the reporting from hospitals is a lot more reliable and prompt, so they end up being pretty close to synchronous.

    Vaccinations won’t have a big impact on case right away. They’ll have a big effect on hospitalizations very soon though.
    The lag time for truly accurate capture of covid data has been around a month since we started and I think the thread has had this discussion several times. The big picture shows up at month intervals. Two week intervals is the bare minimum to see covid trends.

    There are not enough people vaccinated to have a big effect in hospitalizations yet. It is also completely unchecked in the US at this point.


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  • Inkstain82Inkstain82 Registered User regular
    edited January 15
    Inkstain82 wrote: »
    Two weeks are plenty to start seeing most of the effects on something that affects cases and hospitalizations. The lag time isn’t *that* big. In theory, hospitalizations come after cases, but the reporting from hospitals is a lot more reliable and prompt, so they end up being pretty close to synchronous.

    Vaccinations won’t have a big impact on case right away. They’ll have a big effect on hospitalizations very soon though.
    The lag time for truly accurate capture of covid data has been around a month since we started and I think the thread has had this discussion several times. The big picture shows up at month intervals. Two week intervals is the bare minimum to see covid trends.

    There are not enough people vaccinated to have a big effect in hospitalizations yet. It is also completely unchecked in the US at this point.


    We will just have to agree to disagree on both accounts.

    It takes a very small number of vaccinations to have a very large impact on hospitalizations. The 2% most vulnerable of the population accounts for about 40% of hospitalized Covid cases. Although I don’t think the current drop is vaccinations, it’s just old fashioned population immunity in a large wave.

    This is all happening right on schedule. Week over week, hospitalizations (total US) just dropped for the second day in a row after not having dropped week-over-week on any day since September. Cases are about to drop for the third day in a row outside of holiday reporting for the first time since then as well.

    And this is exactly what the math predicted. All through the fall we were exhibiting transmission rates somewhere in the vicinity of 1.1ish, and we removed 10-20% of the susceptible pool through infection over that time.

    In the next month, the impact of vaccinating long-term-care residents and HCWs will show up and hospitalizations should drop even more rapidly.

    The wild card is of course if people see all this happening and loosen their behaviors. It only works if people stay at least as careful as they are now.

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  • dispatch.odispatch.o Registered User regular
    edited January 15
    I know the testing numbers have had some strange goings on since December in Oregon. I don't know if it's just fewer people who are symptomatic and a lack of upcoming holidays or actually fewer sick people which seems unlikely given the number of daily deaths has been climbing.

    I believe we were running somewhere around 180k tests a week from early/mid December to just before the end of the year. I think now it's dipped to around 105k tests a week.

    Going by the things people I know are saying, they cared way more about getting tested when they thought they might kill Grandma when they go visit and saw a negative test as "permission" to have a normal holiday. There's no incentive like that now.

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  • webguy20webguy20 I spend too much time on the Internet Registered User regular
    edited January 15
    dispatch.o wrote: »
    I know the testing numbers have had some strange goings on since December in Oregon. I don't know if it's just fewer people who are symptomatic and a lack of upcoming holidays or actually fewer sick people which seems unlikely given the number of daily deaths has been climbing.

    I believe we were running somewhere around 180k tests a week from early/mid December to just before the end of the year. I think now it's dipped to around 105k tests a week.

    Going by the things people I know are saying, they cared way more about getting tested when they thought they might kill Grandma when they go visit and saw a negative test as "permission" to have a normal holiday. There's no incentive like that now.

    Watch the hospitalizations and deaths. They seem to be fallowing the standard 2nd/3rd wave trends. It doesn't seem like we got hammered too hard beyond the standard "we're fucked".

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  • TetraNitroCubaneTetraNitroCubane The Djinnerator At the bottom of a bottleRegistered User regular
    Post-COVID lungs worse than the worst smokers' lungs, surgeon says
    A Texas trauma surgeon says it's rare that X-rays from any of her COVID-19 patients come back without dense scarring. Dr. Brittany Bankhead-Kendall tweeted, "Post-COVID lungs look worse than any type of terrible smoker's lung we've ever seen. And they collapse. And they clot off. And the shortness of breath lingers on... & on... & on."

    "Everyone's just so worried about the mortality thing and that's terrible and it's awful," she told CBS Dallas-Fort Worth. "But man, for all the survivors and the people who have tested positive this is — it's going to be a problem."
    She says patients who've had COVID-19 symptoms show a severe chest X-ray every time, and those who were asymptomatic show a severe chest X-ray 70% to 80% of the time.

    "There are still people who say 'I'm fine. I don't have any issues,' and you pull up their chest X-ray and they absolutely have a bad chest X-ray," she said.

    That's not 1-2% of people getting long COVID. That's a majority of people infected having a life-changing disability.

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  • GilgaronGilgaron Registered User regular
    70-80% would be pretty terrible, I can only hope that is an artifact of the fairly small population of patients that would've been sent for an X-ray... but yes, the long term morbidity has been a big concern of mine. And if we end up with a large percentage of the population with lung scarring, even if they can go by their day to day ok, it'll likely increase seasonal influenza morbidity and mortality.

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  • urahonkyurahonky Dayton, OHRegistered User regular
    Woo... Wife's PCR is negative. Hopefully I'll get my results tomorrow.

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  • TetraNitroCubaneTetraNitroCubane The Djinnerator At the bottom of a bottleRegistered User regular
    Gilgaron wrote: »
    70-80% would be pretty terrible, I can only hope that is an artifact of the fairly small population of patients that would've been sent for an X-ray... but yes, the long term morbidity has been a big concern of mine. And if we end up with a large percentage of the population with lung scarring, even if they can go by their day to day ok, it'll likely increase seasonal influenza morbidity and mortality.

    Yeah, agree completely. Part of me feels like there's absolutely no way that number can be accurate. But I also believe that the long-term prospects for people are worse than anyone wants to admit.

    The hell of it is, we're going to need years of study and data collection to be able to say for sure.

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  • tbloxhamtbloxham Registered User regular
    Gilgaron wrote: »
    70-80% would be pretty terrible, I can only hope that is an artifact of the fairly small population of patients that would've been sent for an X-ray... but yes, the long term morbidity has been a big concern of mine. And if we end up with a large percentage of the population with lung scarring, even if they can go by their day to day ok, it'll likely increase seasonal influenza morbidity and mortality.

    Yeah, agree completely. Part of me feels like there's absolutely no way that number can be accurate. But I also believe that the long-term prospects for people are worse than anyone wants to admit.

    The hell of it is, we're going to need years of study and data collection to be able to say for sure.

    What i will say is that every anecdotal report about covid is catastrophic. Every detailed study returns numbers which are merely bad. Statistically significant studies are all showing 2% or so of symptomatic cases still have symptoms at month 3.

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