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Covid-19 miscellany

Elixir

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I see very good reasons for putting the young, including the unborn, into a different category from adults.
Tom

So does the FDA. That's why it has taken hundreds of millions of doses administered and followed up, before they even approved the mRNA vaccines for adults. Use in 12+ year olds is still under emergency use authorization only.
From April 2021, New England Journal (a source that a reasonable person would trust more than what TomC "sees"):


Even at that point though, there were sufficient preliminary indicators to tip the balance in favor of giving mRNA vaccines to pregnant women:

Centers for Disease Control and Prevention (CDC) and ACIP, in collaboration with the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics, have issued guidance indicating that Covid-19 vaccines should not be withheld from pregnant persons.

Resistance to immunizing pregnant females is just a preference for the Devil you know over the Devil you don't, even though the Devil you know (COVID-19) has caused MILLIONS of deaths, and the Devil you don't, is responsible for ZERO deaths.
People are not uniformly rational.
 

TomC

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Resistance to immunizing pregnant females is just a preference for the Devil you know over the Devil you don't, even though the Devil you know (COVID-19) has caused MILLIONS of deaths, and the Devil you don't, is responsible for ZERO deaths.
People are not uniformly rational.

I think I'm being misunderstood here.
I'm not suggesting much of anything other than concerns. I strongly consider folks like the FDA and CDC the experts.

One big concern I had is mostly gone now. That was the speed with which this happened and the possibility that it was being overseen by top staffers appointed for loyalty to Trump, rather than experience and expertise.

That's all.
Tom
 

repoman

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The anti-maskers are also the anti-vaxxers.

And right now a lot of anti-vaxxers are dying.

Poetic justice?

Just get the vaccine and be happy you are very unlikely to get infected and if you do unlikely to die.

In my hospital we had a 35 year old man die from COVID this morning. Didn't get vaccinated. He was obese but there are a lot of obese anti-vaxxers.

Can you give me a rundown of how treatment of covid has evolved to now vs a year ago? Early treatment and treatment in the hospital...

This sucks that I have to say this AGAIN, but I am pro vax for all but the vanishingly rare hyper allergic and have been vaccinated.

Querying treatment is NOT a sure sign of someone being antivax, Jesus Cocksucking Christ...

Can this country walk and chew gun at the same time in regards to keeping mental flexibility?

Now it is mostly the unvaxxed who are getting cut down, but at the same time there is a great deal of opportunity to figure out what can keep the cytokine storm and later clotting from getting out of control for when a NEW disease or non vaccinateable strain of covid pops up. What is your hospital learning on the fly now? How much latitude do the doctors have? Are they robots to the protocols?

Please leave politics and bitching and moaning out of an answer.

I am not a physician. I work as a physical therapist. I also happen to be a pharmacist so I know the drugs. But I do not work as a pharmacist so I don't know the drugs as well as working pharmacists know them.

I'm not sure what you're questioning. Treatments are now standardized throughout the nation. If you have certain signs and symptoms you get certain drugs and treatments. If you get worse they move to secondary treatments.

Specifically people are getting things like Remdesivir an antiviral, Monoclonal antibodies, steroids and antibiotics. Of course with supplemental treatments like oxygen and IV fluids.

They now know a lot of things to not do.

They now try to keep people off the vents as long as possible. In the beginning they were putting them on at the first sign of trouble. A lot of patients are on heated high flow oxygen at high rates. But this keeps many people comfortable.

I was talking to a pulmonologist the other day and he said with this new variant once people are vented and are getting bad there is no drug to help them.

Like I said the treatments are now standardized and evolving. In the beginning of course that was impossible since they knew nothing about the treatment of COVID.

This is a very interesting journal article that I can only dimly gleam from, but I think that you and people you are in contact with are in a position to have a look at:

https://journals.sagepub.com/doi/full/10.1177/2050313X211032089

While a majority of the focus in coronavirus disease 2019 (COVID-19) has been on the common and often fatal lung disease, reports of neurologic dysfunction have been increasing since the pandemic began.1,2 The spectrum of neurologic disease has been broad, from encephalopathy to thromboembolic disease,1,2 among a series of other pathologic mechanisms described by others.3–12 While these reports have not described serotonin syndrome-like manifestations per se, the evidence is mounting in regard to the presence of elevated plasma serotonin levels in COVID-19 patients,13,14 both in severe and non-severe disease, thought to be a result of an intense degree of platelet activation and serotonin liberation from activated platelets due to severe acute respiratory distress syndrome 2 (SARS-CoV-2) infection.13,15,16 Clinically, in two case series, more than 60% of severe COVID-19 subjects exhibited hyperreflexia or myoclonus,17,18 signs relatively specific for serotonin toxicity, occurring at a high enough rate in severe COVID-19 that is unaccountable for by pre-existing use of serotonergic medication. In addition, diarrhea of COVID-19 has also been attributed to an elevated plasma serotonin state.19

Serotonin toxicity is an increasingly recognized condition that carries a significant risk of morbidity and mortality if left undiagnosed and untreated. Studies prior to COVID-19 showed that a sizable portion of delirium encountered in the Intensive Care Unit (ICU) could be attributed to unrecognized serotonin toxicity, with culprits including fentanyl, among other medications.20 Given these lines of biochemical and clinical evidence, it is possible that unrecognized serotonin toxicity may be more frequently present in COVID-19 and may contribute significantly to morbidity and mortality.


Fentanyl being listed as a culprit for serotonin toxicity is interesting. I have seen, can't remember where, that non serotonin tweaking fentanyl alternatives are better.

Yes this is not a 10,000 person RCT, but reports like this are how the ball gets rolling.

Their conclusion:

These case reports raise the possibility that serotonin toxicity may develop spontaneously in patients with COVID-19. Clinicians caring for COVID-19 patients must maintain a high index of suspicion for this reversible entity, even in the absence of identifiable offending serotonergic medications. Serotonin toxicity is reversible with cyproheptadine administration and avoidance of exacerbating serotonergic medication use. While continuing to search for other etiologies, empiric treatment with cyproheptadine may offer a low risk, potentially high reward therapy in this very ill patient population.

So, if this is accurate and widely applicable, the misuse of this information by the people without a decade of being at least a doctor, nurse or pharmacist could be a serious problem.

I remember hearing a doctor talking about both of his parents getting covid and him deciding that their moderate sickness didn't warrant taking it. But he had them monitored closely.

But there might be people who would want to take it at the first sign of a sniffle and not even a positive test. Couldn't that make it worse later as they get used to the medicine and it is less effective when really needed a week or so later?

Another problem, would be that people rushing to get cyproheptadine would accidentally discredit it for no good reason. But self administration by non specialized (not stupid per se) people should NEVER carry that taint over to proper, sensible and monitored usage.
 

Toni

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So does the FDA. That's why it has taken hundreds of millions of doses administered and followed up, before they even approved the mRNA vaccines for adults. Use in 12+ year olds is still under emergency use authorization only.
From April 2021, New England Journal (a source that a reasonable person would trust more than what TomC "sees"):



Even at that point though, there were sufficient preliminary indicators to tip the balance in favor of giving mRNA vaccines to pregnant women:

Centers for Disease Control and Prevention (CDC) and ACIP, in collaboration with the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics, have issued guidance indicating that Covid-19 vaccines should not be withheld from pregnant persons.

Resistance to immunizing pregnant females is just a preference for the Devil you know over the Devil you don't, even though the Devil you know (COVID-19) has caused MILLIONS of deaths, and the Devil you don't, is responsible for ZERO deaths.
People are not uniformly rational.

Or uniformly well informed.
 

blastula

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repoman

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Wow, Israel is doing it right



Antibody green passes for kids aged 3-12. Obviously a great idea.

https://www.haaretz.com/israel-news/israel-kicks-off-covid-antibody-testing-of-1-4-million-children-1.10138637?__twitter_impression=true

A national antibody survey among 3- to 12-year-olds is slated to kick off on Sunday in municipalities around the country, in a bid to measure the extent to which the coronavirus spread undetected among the country’s children over the past year and a half.

The survey is a joint project of the Health Ministry, the Education Ministry and the IDF Home Front Command, with assistance from local authorities and educational institutions. Some 1,400 Home Front Command teams will conduct blood tests at locations around the country, in a bid to reach as many of Israel’s 1.4 million children as possible.

Israel’s authorities hope that a significant proportion of children ages 3-12, who are not currently eligible for vaccination, will be found to have antibodies and will thus be eligible for a Green Pass, exempting them from mandatory isolation should they be exposed to someone COVID-positive, and from COVID-19 testing which is now mandatory in order to enter sites and attractions. They will be able to maintain their daily routine, including attending school, and will reduce the burden on the education and healthcare systems.

There is no way this could happen in the USA in this day and age. Not to mention all the nervous nellies that would be like "but what if?!?" and "It is still not worth ANY RISK EVER!!!!!!!"

Or wait until they get vaccines that as Jimmy Higgins conceded seem to have a faster wane of efficacy than natural infection.
 

Angry Floof

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So does the FDA. That's why it has taken hundreds of millions of doses administered and followed up, before they even approved the mRNA vaccines for adults. Use in 12+ year olds is still under emergency use authorization only.
From April 2021, New England Journal (a source that a reasonable person would trust more than what TomC "sees"):



Even at that point though, there were sufficient preliminary indicators to tip the balance in favor of giving mRNA vaccines to pregnant women:

Centers for Disease Control and Prevention (CDC) and ACIP, in collaboration with the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics, have issued guidance indicating that Covid-19 vaccines should not be withheld from pregnant persons.

Resistance to immunizing pregnant females is just a preference for the Devil you know over the Devil you don't, even though the Devil you know (COVID-19) has caused MILLIONS of deaths, and the Devil you don't, is responsible for ZERO deaths.
People are not uniformly rational.

Or uniformly well informed.

Or uniformly care about factual information.
 

Toni

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J&J is getting into the booster game too.

Johnson & Johnson Announces Data to Support Boosting its Single-Shot COVID-19 Vaccine | Johnson & Johnson

I got this vaccine, but I'm not sure I'll get a booster if offered, until there's data that my covid immunity would have weakened too much to protect me much. Give the doses to people who want it but haven't had any yet.

I got Moderna and to a certain extent, that was my thought as well. My understandings is that, as far as Pfizer and Moderna go, there is plenty of vaccine on the US to give boosters. When it is time, I will get mine, even though I am simultaneously extremely concerned about the vast numbers of people in other countries who don’t yet have access their first dose. Id forgo my 3rd to make it available to someone with zero shots but that does t seem to be how the world’s distribution is working.
 

TomC

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J&J is getting into the booster game too.

Johnson & Johnson Announces Data to Support Boosting its Single-Shot COVID-19 Vaccine | Johnson & Johnson

I got this vaccine, but I'm not sure I'll get a booster if offered, until there's data that my covid immunity would have weakened too much to protect me much. Give the doses to people who want it but haven't had any yet.

I got Moderna and to a certain extent, that was my thought as well. My understandings is that, as far as Pfizer and Moderna go, there is plenty of vaccine on the US to give boosters. When it is time, I will get mine, even though I am simultaneously extremely concerned about the vast numbers of people in other countries who don’t yet have access their first dose. Id forgo my 3rd to make it available to someone with zero shots but that does t seem to be how the world’s distribution is working.

Me too.

I put off getting vaccinated partly because I knew I was very low risk. Both for suffering and spreading C19. I thought there would be hordes of people lining up for vaccination, so everyone could get back to normal life and the economy and such.

When things didn't turn out that way...
Tom
 

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[TWEET]<blockquote class="twitter-tweet"><p lang="en" dir="ltr">During the hearing on Florida's restrictions for requiring students wear masks, one of the attorneys representing parents has been coughing all day. She told the judge she caught covid from her preschooler.</p>— Meryl Kornfield (@MerylKornfield) <a href="https://twitter.com/MerylKornfield/status/1429904535187828736?ref_src=twsrc%5Etfw">August 23, 2021</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>[/TWEET]..
 

ZiprHead

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Kyle Rittenhouse’s attorney, John Pierce who said he would never get the vaccine, even if forced to - is on a ventilator and non-responsive.

Time to pick a new, smarter lawyer.
 

ZiprHead

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[TWEET]<blockquote class="twitter-tweet"><p lang="en" dir="ltr">BREAKING: Delta Air Lines says unvaccinated employees must pay $200 per month surcharge for health insurance. <a href="https://t.co/Lye141Oed9">pic.twitter.com/Lye141Oed9</a></p>— Sam Sweeney (@SweeneyABC) <a href="https://twitter.com/SweeneyABC/status/1430534784074256388?ref_src=twsrc%5Etfw">August 25, 2021</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>[/TWEET]..
 

Keith&Co.

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Kyle Rittenhouse’s attorney, John Pierce who said he would never get the vaccine, even if forced to - is on a ventilator and non-responsive.

Time to pick a new, smarter lawyer.

I think Rittenhouse needs to show some commitment and stick with his original attorney.
Right, go for the sympathy vote. And keep all the gofundme $s sent in for his legal fees.
 

repoman

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Kyle Rittenhouse’s attorney, John Pierce who said he would never get the vaccine, even if forced to - is on a ventilator and non-responsive.

Time to pick a new, smarter lawyer.

He was fired and stole money from Rittenhouse



Only the right wing people here will and SHOULD watch this thought, lol.

Pierce is a scumbag snake, the Avenatti of the right.
 

T.G.G. Moogly

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[TWEET]<blockquote class="twitter-tweet"><p lang="en" dir="ltr">BREAKING: Delta Air Lines says unvaccinated employees must pay $200 per month surcharge for health insurance. <a href="https://t.co/Lye141Oed9">pic.twitter.com/Lye141Oed9</a></p>— Sam Sweeney (@SweeneyABC) <a href="https://twitter.com/SweeneyABC/status/1430534784074256388?ref_src=twsrc%5Etfw">August 25, 2021</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>[/TWEET]..

I never thought I'd see such common sense behavior. This should be applied more widely to people who do lots of other unhealthy things that raise costs. But that is another thread.
 

bilby

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[TWEET]<blockquote class="twitter-tweet"><p lang="en" dir="ltr">BREAKING: Delta Air Lines says unvaccinated employees must pay $200 per month surcharge for health insurance. <a href="https://t.co/Lye141Oed9">pic.twitter.com/Lye141Oed9</a></p>— Sam Sweeney (@SweeneyABC) <a href="https://twitter.com/SweeneyABC/status/1430534784074256388?ref_src=twsrc%5Etfw">August 25, 2021</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>[/TWEET]..

I never thought I'd see such common sense behavior. This should be applied more widely to people who do lots of other unhealthy things that raise costs. But that is another thread.

"Common sense"? Literally every part of that, from the whole idea of 'health insurance', through the concept of that being tied to employment, and on past the arbitrary and rather low-ball figure of $200, to the ultimate stupidity of being allowed to pay to do something that shouldn't be permitted at all, is completely insane.

The 'common sense' option would read: "Delta Air Lines to require all employees to be vaccinated by October 1st, or face dismissal".
 

repoman

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This is an old point that is making the rounds about how many co-morbidities that 94% of covid deaths involved, as I was listening to a podcast where this was raised again.

Many of those are what happened by the time of death from all the complications from getting covid not previous to covid right? Obviously not all as in a patient having a decade of high pressure pressure. But if someone had 125/80 before illness and it went up to 180/120 a day before death, HBP especially "underlying HBP" should not be listed as a co-morbidity.

Not a fan of either side (as if there should even be sides for this issue) cherry picking and using semantic tricks to win a debate. What is even won?
 

Angry Floof

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This is an old point that is making the rounds about how many co-morbidities that 94% of covid deaths involved, as I was listening to a podcast where this was raised again.

Many of those are what happened by the time of death from all the complications from getting covid not previous to covid right? Obviously not all as in a patient having a decade of high pressure pressure. But if someone had 125/80 before illness and it went up to 180/120 a day before death, HBP especially "underlying HBP" should not be listed as a co-morbidity.

Not a fan of either side (as if there should even be sides for this issue) cherry picking and using semantic tricks to win a debate. What is even won?

Well, since about that percentage (mid to high 90s) of cases, hospitalizations, and deaths due to COVID are unvaccinated, not sure how this "point that is making the rounds" (where? GETTR?) is even relevant unless you're saying that getting the vaccination removes co-morbidities. Do you think it does?
 
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