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

Reporting in from Middlesex County, MA – compmom has the impression that we are not masking here in the suburbs whereas in my town masking is the norm.

Mask mandates are set by the local board of health, so masking behavior can vary significantly from town to town.

My area is not masking well. Someone else brought up Middlesex County, not me :slight_smile:

Unless the designation has changed since my son was ill, mild Covid means one didn’t have to be hospitalized. One can have a day or two of a slight cough to being quite sick for a week or two - longer for my guy, since he was long haul. It was still “mild Covid.”

Asymptomatic Covid is when one tests ill (aka has it), but there are no symptoms at all.

If anyone knows the official designation has changed, please post. It’s possible I just haven’t seen it.

If it ends up being advantageous to get mild Covid post vaccine, it may be the “best” route for us with Omicron even if it means we’re under the weather for a week or two. None of us are getting younger and Covid coupled with “older” is not likely to be better.

We still need more data for me to feel comfortable with that route. It’s just something to look at right now.

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Yea, many with “mild” COVID report it as being the sickest they’ve ever been. :grimacing:

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Yes I believe the term was created for public health planning, not to be an accurate descriptor of the experience!

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https://www.sciencedirect.com/science/article/pii/S2542454821001260

1 in 5 physicians and 2 in 5 nurses report they intend to leave their jobs within the next 2 years. An additional 1/3 of doctors and nurses intend to reduce/curtail their work hours within the next 12 months.

Reasons for leaving include higher levels of burnout, stress, workload, fear of infection, Covid-19 related depression or anxiety, and number of years in the profession.

“Because multiple studies have demonstrated that intent to leave among physicians correlates with actual departures, these findings are of concern,” the study stated. “Costs of replacing healthcare workers are also substantial. Replacing a nurse may cost up to 1.2 to 1.3 times their annual salary. Replacing physicians may cost $250,000 to more than $1 million per physician. The aggregate cost of physicians reducing or cutting back attributable to burnout alone is estimated at $4.6 billion annually in the United States.”

I wish they would give a comparison to a normal year. How many doctors and nurses leave their jobs or reduce their hours in any given year or two? Is it 1 in 20 assuming a 20 year retirement?

I also wonder if it’s specialty related with those more in contact with Covid having more burnout.

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I stopped into my previous place of employment last week, a hospital critical care floor. Times are desperate. There is some Covid, but the worst are the alcohol withdrawal patients, of which there are many. Plus many with worsening chronic illness. I was a 38 year employee and well ready for retirement. The anti vax nastiness of current Covid patients makes jobs terribly frustrating for the RNs and hospitalists, who have been writing essays on the topic for hospital FB posts. My boss states that hiring is terribly difficult, and one RN applicant has many offers within the hospital.

I was talking to a cardiologist and he was saying that the patients they are seeing right now are very ill. That many have waited because of the pandemic (fear and services being curtailed) until it’s very progressed. I do not know the exact particulars just that they are seeing very sick patients who didn’t get care they needed.

I wasn’t aware that “mild COVID” was anything short of hospitalization. That’s helpful since it resets expectations. I was surprised how sick the folks I knew got. They are better now, thankfully.

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I was surprised too. My guy was a long hauler who had trouble breathing, walking, and more. How in the world was that considered mild?

To me, putting truly mild symptoms in with those who are knocked out at home for a time period is too large of a category. But they didn’t let me make the categories.

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Perhaps it may be better to say “cold like”, “flu like”, “hospital” to describe severity in more common terms.

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Or mild (does not interfere with normal activity), moderate (interferes with normal activity and may require medical intervention), severe (requires hospital visit).

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D2 who tested Covid positive while we were skiing in Utah is pretty much feeling normal again. First day she had a fever and was very achy. Second day a bit better, but slept most of the day. Day 3 felt well enough to walk a mile with me outside. The last couple of days feels fine, but tired so went to bed early. No loss of smell or taste.

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I think the “Mild category” results from date being exclusively from hospitalization. Perhaps they should have “hospitalized” and “not hospitalized.” Then there is no qualitative assessment as “mild.”

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Anyone who understands this stuff.
Vaccinated/boostered person exposed to covid.
Assuming the vaccines are working when covid hits this person they realize what it is and”stop it”
Person tests negative a d no symptoms.
A week later person exposed again to same varient. Would the body/cells remember again and jump into action, or as you get exposed over and over again would you eventually test positive.

So I wonder if the vaccine hesitant (the vaccines haven’t been studied enough/they are too new) and anti-vaxxers would be willing to take the new Merck and Pfizer treatments?? (Certainly they have been studied less and are newer than the vaccines.)

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I assume so because it’s mostly the unvaccinated who have been receiving the antibody treatments (although two of the antibody products don’t work on Omicron so they are off the market now, and the one antibody product that does show some action against Omicron is in very short supply).

It is possible the person was exposed meaning in the company of someone who was positive. But was not infected at all.

Repeated exposure would mean a chance of infection each time.

Asymptomatic infected people still test positive at least on the PCR. Was this person’s test a quick antigen test?

Finally if infected, a person continues to test positive for a period of time, varying with age I believe. (My mother still tested positive 95 days after her COVID).

Few things. Studies are showing that the booster may be good for only 10 weeks. That’s why Israel and some experts including Dr. Hotez are advocating for a 4th shot for healthcare workers - a lot are going down sick. Some 3rd shots were given in August officially (earlier unofficially) so that far away they may have little residual effect. Second - testing negative. Most of the tests are the rapid antigen so that is what I assume you are referring to. First thing to do when there is a new variant is you have to make sure the test can detect that variant. So far all variants are able to be detected. There is a false negative rate with the rapid antigen test. People often test too early once they hear they have been exposed. You have to give time for antigen levels to rise in the body to be detectable. Wait 5 days after exposure. With an incubation time of 3 days with omicron, you could probably test a little sooner. Once symptomatic is probably ok. Also there is a false negative rate associated with improper mechanics of testing - have to make sure the swab gets to the mucosal surface in the nose. Some people swab just at the superficial rim of the nares and that is not deep enough. PCR testing is the best but is difficult to find and has a longer turnaround time. If rapid test negative and symptomatic, then I would want a follow-up PCR test to confirm true negative. You said person tested negative and no symptoms. If truly worried I would repeat a rapid antigen the next day and the next. Three negative days in a row I would say would be a true negative. People test serially and if negative on the first and are a true positive they will eventually turn positive on the subsequent tests. Remember to read the line at the specified time. 15 minutes. Then toss. Do not go back and read later (like an hour later). There is often what’s called an evaporation line that pops up outside of the timeframe to read. In regards to you last question: if the person was a true positive on the first exposure, you would find out by the rapid antigen or PCR testing as I mentioned before. The test would be positive a week later on the second exposure. It could be positive from the first exposure or the second. Some people test positive a month after the initial exposure. If they were a true negative the first time, they could turn positive on the second.

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