Inside Medicine. What Are You Seeing? [COVID-19 medical news]

^^, that’s interesting @Creekland. An article from our local paper about a week ago quoted a San Diego County health officer as saying that they are seeing that frontline workers who wear masks all day are experiencing severe pandemic fatigue and once they get off work are letting off steam in social situations without masks or distancing; and he specifically mentioned healthcare workers as being particularly vulnerable to this mindset.

(BTW, I’m in no way criticizing healthcare workers; I’m in awe of their courage and hard work throughout all this, and in the advances in treatments they’ve made since the beginning of the pandemic. )

I have a longtime relationship with a young healthcare worker (have known them since they were 3 or 4 years old, now 26 or 27). This person works in a pediatric ICU and is a very dedicated individual when it comes to working for/with these children.

I have been disturbed, however, to see LOTS of Facebook photos of my friend and SO at weddings, unmasked and cheek to cheek with similarly aged close friends. Also posted are many photos of engagement parties or showers, none of the participants wearing masks or practicing any social distancing whatsoever. Comments to these photos tend to be “you guys look amazing?” “How fun!” Etc.

I’m a bit flabbergasted to be honest. And praying that no one comes to any harm from these actions. I can only guess that perhaps my friend and their friends have severe pandemic fatigue and think that since they haven’t gotten it by now, it’s not something to worry about so much that they would miss out on their friends’ big days. I don’t know…

Looked at another way: if health care workers – those intimately involved and knowledgeable about disease – are getting COVID fatigue, it should not be surprising that the masses are too.

Which is why this winter will likely see a surge in cases in many areas, since the fatigue that results in relaxed social distancing behavior (which I have observed among many, not just health care workers) will be combined with the season of traditional family gatherings and weather that will be less pleasant to have events and activities outdoors.

I agree that I’m seeing it everywhere. I think the “problem” with it getting to health care workers is that the rest of society is counting on them to take care of folks who get it bad. What if there aren’t enough? I read a headline the other day from BBC that said an area in Belgium is asking its asymptomatic doctors to stay on duty or else their system is in danger of collapsing. What if their patient gets a bad case from the doctor?

We’ve done better on deaths lately because the health care folks have learned so much more. What if they aren’t around in the numbers needed? (Or meds end up in short supply?)

People think short term and many appear to have decided to take their chances, but the stats still say X percent will need medical care to get through this. Those stats aren’t going away.

Another reason to get your flu shot: https://www.scientificamerican.com/article/a-flu-shot-might-reduce-coronavirus-infections-early-research-suggests/

Sounds too early to make any real conclusions but let’s hope it helps.

@Nrdsb4 the misconception that masks are to protect ourselves is rampant. Even if those you are seeing in Facebook feel that if they haven’t gotten it yet, they are safe, that ignores the risk that they pose to others.

I went into the phone store and the sole employee put on his mask when I entered. Another misconception. He did that to protect himself. To protect the customer and avoid aerosol, he should have it on all the time.

I really hate to see health care workers singled out. The ones I know strip and shower when they get home, and put their clothes in the wash right away.

Young people, in general, are getting together in risky ways. It’s not a matter of health care professions, I would think, but the feelings of invulnerability that youth feel in many contexts.

Again, they need to understand the risks they pose to others and that that risk will spill out to vulnerable people who are not at the gathering. But asking for that kind of altruism is a big ask and that is one reason for the current surges.

My brother is an ophthalmologist who says he sometimes walks into a room and a patient will rush to put their mask back on. They think they only need it on when he’s in the room. He politely explains that will see the next patient while the respiratory droplets settle. Usually comes back about 15 to 20 minutes later.

Was happening more earlier in the pandemic – now his techs tell the patients not to take off their masks while waiting!! He said they honestly just don’t know.

Also, the fact that he has seen dozens of patients a day since April (they only closed for a couple of weeks) and hasn’t gotten COVID tells me masks work! Eye docs are pretty close to folks’ faces during an examination, after all.

I’m hopeful. It makes sense, although being logical and being true about CoVid are not necessarily the same thing.
What I would like to see is a study comparing children’s vaccine status with their likelihood to be infected with this virus.

That news about post-Covid problems potentially being caused by autoimmunity, that’s bad . Consider other autoimmune conditions: rheumatoid arthritis, lupus, asthma, Sjogrens. They don’t go away. You don’t get cured. There’s no arthritis cure, no getting better from lupus. There are treatments, but the conditions don’t go away.

I have families in Taiwan. I see them on FB going about their business, living their lives, but I see them wearing masks whenever they are out in public and have masks off when they are with their families. They use technology for contact tracing. They do not have extensive testing, only test when there is a hot spot via contact tracing.

We in the States look at mandating masks and contact tracing as infringement of personal freedom, but look at where we are - a lot of us are not free to do what we want to do. I do think we could go about with our lives if we just follow few basic rules - wear mask, wash hands, small gatherings.

Off my soap box.

Just wanted to follow up on my father. Spoke to a doctor today and he said they have continued to give him Covid tests every few days. Except for the initial one upon admission they have all been negative. He said they are testing for two reasons. The first is that if he is testing negative they don’t need to use all the Covid PPE and the nurses and therapists can respond quicker and give better care. The second is that his assisted living requires a negative test within a certain time period before they will let him back into his apartment (this may be NY state rule).

He will most likely be released soon (Monday?)- they have finished his antibiotics and are weaning off of oxygen and steroids.

Here is an incredibly clear visualization of the way coronavirus spreads through the air in an enclosed room.
A room, a bar and a classroom: how the coronavirus is spread through the air
https://english.elpais.com/society/2020-10-28/a-room-a-bar-and-a-class-how-the-coronavirus-is-spread-through-the-air.html

I’m watching my son’s email again today (playing secretary) and this one caught my eye. It’s not surprising, but in the pandemic it seems it has the potential to be even a greater problem than it is in normal life.

"Majority of adult patients may be worried out-of-pocket health care costs could lead to bankruptcy, survey suggests

PatientEngagementHIT (10/29, Heath) reports 56% “of adult patients are worried their out-of-pocket health care costs could lead their household into bankruptcy, according to new data from HealthCareInsider.com in partnership with YouGov.” In a survey of around 1,500 adult patients, 28% “said they currently carry medical debt,” and 32% “said they only had $500 or less in their savings accounts to cover a medical bill.”"

Good discussion between Dr. Eric Topol and Dr. Paul Offitt regarding covid 19, vaccines and their approval and distribution processes.

Among many other issues, they discuss the situation where some proportion of vaccinated people (using an example of a vaccine with 75% efficacy) may still be able to spread the virus, hence, they believe we will be distancing and wearing masks through all of 2021.

https://www.medscape.com/viewarticle/938494#vp_1

Thanks for posting, very informative! One thing that seems weird…I wonder why they chose to demonstrate the restaurant for 4 hours and the school for only 2 hours. I don’t know anyone in covid times lingering at restaurants for anywhere near 4 hours. An hour and a half might be a more useful/realistic demonstration. I’d be curious about the spread in that more realistic timeframe. Whereas a school, they are there a lot longer than 2 hours, and even 4 wouldn’t really capture it. It makes me wonder if there was a motive the designer had (ie make restaurants appear scary but school seem safe)? Why wouldn’t they just show what happens in the rooms during the same amount of time (ie one hour for all scenarios) or for hours that more closely represent how people use those rooms? By the way, I am in favor of schools over restaurants, as I consider them more useful/important, but I just hate being manipulated, and their choice of odd timeframes feels like manipulation to me.

But beside my above complaint, this was a very useful visual demonstration!! Thanks for sharing.

Things mentioned:

Page 1, 2: BLA versus EUA.

Page 3: Possibility that a vaccine could induce stronger immunity than natural infection (as with tetanus, HPV, HIB).

Page 4: SARS-CoV-2 may induce immune reaction against one’s own immune system.

Page 4: Protectiveness of natural infection versus subsequent infection.

Page 5: Vaccine lack of protectiveness against asymptomatic contagious infection in animal studies.

Page 6: Social distancing versus masks versus vaccine.

Page 7: Professionals as well as the general public are skeptical of the FDA.

El País is a newspaper based in Spain. Perhaps the common time frames in restaurants may differ there compared to the US where most people posting here live?

However, what is said is not too surprising, since it is known that enclosed poorly ventilated spaces with other people are the riskiest places to be in terms of getting the virus.

A great visual explanation of how masks work: https://www.nytimes.com/interactive/2020/10/30/science/wear-mask-covid-particles-ul.html

Immunocompromised person had asymptomatic contagious COVID-19 infection for 70 days.

https://www.livescience.com/woman-sheds-infectious-coronavirus-70-days.html