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

Good question! All of those things would be fine by me. But since the CDC can only recommend things and their credibility has been damaged, of course they will be ignored.

It’s each person for themselves now. I get it. I am only interested in protecting myself from covid now, since most don’t want to take covid seriously. Won’t consider donating blood (and my family is O+ and O-). Not about to sit there while others are either unmasked, mask below nose, or maybe not even masked at all. Won’t volunteer in the schools anymore, or any kind of in-person volunteering. Not going to indoor restaurants, and not going to crowded places.

Things I’d done/wanted to do at one time aren’t happening. No more lunches with friends, no more indoor party or event invite acceptances, no more book clubs, etc. I feel sad about this sometimes.

4 Likes

I agree that the CDC has managed the pandemic poorly, and its reputation damaged. It’s become clear that CDC is influenced by politics/the political cycle which impacts their policies, among other things.

With that said, with the available vaccines and treatments, covid is not severe enough to mandate masks and other behavior (at least for now). It is less severe than a number of viruses that we don’t have mandates for.

I am sorry that you feel you can’t live life more ‘normally’, but even reinstating mask mandates, or requiring vaccines wouldn’t make covid go away, and those mandates do have tradeoffs/consequences. I don’t think it’s likely that many will be able to avoid covid for the rest of their lives. I am also not sure I understand the donating blood issue?

3 Likes

Of course, contagious diseases mean that personal choices regarding them have external effects on others, so your outcome is not fully determined by your own personal choices, but can be heavily dependent on the choices of others. Societies since ancient times have had rules against acts that produce negative external effects on others. Of course, what those rules should be can be the subject of political disagreement within society.

3 Likes

However, it has a combination of contagiousness (compared to non airborne viruses like ebola and monkeypox), immunity escape (compared to measles), and just enough severity for enough of the population (the growing >65 age group) that many are still much more concerned about it. Also, the incomplete information about long COVID means that some will assume the worst in that aspect.

5 Likes

There are two different potential types of rules to prevent “negative external events” here. The first is that typically associated with contagious diseases like say Ebola where restrictions are imposed in an attempt to eliminate the disease. Most mandated childhood vaccinations fall into that category. Only China is still in that position vis-a-vis Covid, and I don’t think there’s anyone left in the US who truly believes that it can be eliminated through vaccinations or other restrictions.

The second type of rules is seeking to prevent increased healthcare spending, higher deaths, long term illness, etc. That is much more similar to whether you should mandate other types of healthy living. Generally as a society we might encourage that through public health campaigns or taxes on alcohol and cigarettes, but we leave it to individual choice. Mandates are uncommon and where these exist (such as for recreational drugs) they are often unpopular and widely ignored.

4 Likes

Exactly.

The so-called childhood vaccines have a high acceptance for four reasons: 1) they are required to attend school in all states; 2) they are called childhood diseases for a reason – they affect children (unlike covid), adn parents are loathe to send their kid to school to contract polio; 3) they are highly effective (unlike flu vax in many years); 4) they are not on an Emergency approval. For the latter, consider the fact that the states first and longest to lock down – blue states – are barely considering mandating covid vax for school. LA Unified tried, but found out that they don’t have legal authority, which resides in teh State Govt, yet the State hasn’t touched the topic.

OTOH, a 40-50% use rate for flu vaccines is pretty good, IMO, particularly for something that has such a low effectiveness rate.

2 Likes

Pfizer and Moderna two dose initial vaccine (but not the new bivalent booster) do have full approval now.

1 Like

Do you know if CV is more contagious than the typical seasonal flu? I assume so but do not know the size of the differential.

do they have full approval for children, < 11?

Good point, nether have full approval for under 11, only Pfizer for 12+. But, real world data is much greater in terms of patient numbers than any clinical trial data (for holdouts who are waiting for full approval).

yes, I’m a big believer in the millions upon millions of vaccines given with few issues. But is it ethical for a State to mandate covid vaccines in elementary schools (as suggested by ChangetheGame upthread) when such Vaccines are still under a EUA? (This ignores the fact that covid has minimal effect on kids in general.)

2 Likes

R0 of typical flu is about 1.3.

For comparison, ancestral COVID-19 had an R0 of about 2.9, while Omicron variants have R0 of 8 or higher.

R0 is the number of people one infected person will infect in the absence of immunity (from vaccination or previous infection) and in the absence of other mitigation measures (e.g. social distancing and masking for flu or COVID-19).

2 Likes

Thank you! I had not realized that Omicron’s R0 was that much higher than the ancestral’s. Appreciate you providing the stats.

Nice to learn about RO and know it’s articulated in this way. I wonder how the antiviral spray affects the R0.

Assuming you mean the nitric oxide nasal spray…

SARS-CoV-2 accelerated clearance using a novel nitric oxide nasal spray (NONS) treatment: A randomized trial - The Lancet Regional Health - Southeast Asia indicates that, in patients with symptomatic COVID-19, nitric oxide nasal spray given 6 times per day (2 sprays per nostril) reduced the median time to clearance from 7 days to 3 days.

That would suggest that, if the variant in question has an R0 of 8, the patient did the nitric oxide nasal spray as above, and neither the patient nor anyone else did anything else to prevent spread, and no one else had pre-existing immunity, Rt would be about 3.4 due to the shorter time that the virus is in the patient’s nose. (Rt is the effective reproduction number, taking into account pre-existing immunity and any mitigation actions to reduce spread.)

(But also note that current variants probably have R0 significantly higher than 8, like maybe 12, which is getting into measles territory.)

2 Likes

I understand and respect your different perspective (my Dad has a similar one). I was pretty cautious for the 1st year and then again during the Omicron outbreak last winter and have not had any serious outcomes among my acquaintances, friends, and family since the vaccines became widely available which definitely skews my perspective. I am also not a big “what if” guy, so Long Covid/future diseases possibly triggered by a Covid infection, while concerning, does not move the “needle“ enough for me, especially as someone who is up to date with vaccinations and who is a “true believer” in the scientific breakthroughs we have witnessed with vaccines and Covid treatment options. I have also worked on losing weight and living a healthier lifestyle (partially successful) so that any future Covid infection has “less to work with”.

For me, knowing that Covid will likely be here in some form in 100 years has guided my own “process” towards moving back to a pre-pandemic lifestyle. So I have eaten at indoor restaurants with friends (during non-peak hours), travelled quite a bit, grocery shop (during non-peak hours) etc., while rarely wearing a mask. I always have one handy for a crowd if needed, however. I hope that a day comes when Covid is being “controlled” at a level that you are comfortable enough to enjoy some of the things you had to give up to stay safe.

9 Likes

Knowing that masking either won’t be required or not enforced (what’s happening in some medical offices/facilities where I am), I would not subject myself to sitting somewhere (which could be poorly ventilated) near unmasked/improperly masked people for the amount of time it takes to donate blood. “So mask yourself!” I can see people saying. Yes, BUT I get annoyed/anxious if I have to be around someone who isn’t doing likewise for more than a few minutes. Since I would be a volunteer donating MY blood, MY comfort counts.

6 Likes

Thank you for your very respectful reply. It’s unusual.

I may be closer in age to your father than I am to you (don’t know your age, as this site has parents from 40s to 80s).

1 Like

Since masking isn’t required or enforced in some medical offices where you are, how are you dealing with getting regular wellness care and screenings? My apologies for repeating the issue if you’ve already addressed that earlier.

Getting the first appointment of the day is one strategy.

MD’s are also testing for COVID in offices around here. Even with masks, I try to get the first appointment or an early one.

4 Likes