Just the Facts, the Crown virus.

[Gary_C]

 We have chosen to politicize this which is a shame. 

I am sorry I started this discussion. Don P was exactly right when he said the above but now regardless of who ends up being the winner it's time to stop the juvenile blame game and contest to see who is doing better or not in dealing with this very dangerous virus. 
There is a lot of evidence that Sweden with their hands off approach is no worse than other countries in the harmful effects from this virus. The EU countries have destroyed their economies with shutdowns but are still willing from desperation to do it again. It may well turn out that all our efforts were futile in stopping this virus and herd immunity thru exposure or a vaccine were the only good path out of this pandemic. Only time will give us the answers and we are not there yet.
There is solid evidence the virus is seasonal and the total death rate this year is little different from any other year. That is little comfort to those that have lost loved ones but it may signal the worst is behind us. That is especially true today when we hear about a vaccine that is 90% effective and soon will be approved. 

[doc henderson]

hope the vaccine is out soon and it works as well as we think.  If we had done no mitigation, we would have all had the virus by now.  and it would be over.  God help you if you needed a ventilator, cause the hospitals would have been over run, and no staff as they were all out sick.  front doors locked and armed military reserves blocking the entrance.  cannot ask the state next door for help, if they are as bad off as you.   mitigation works to slow the spread.  keeps the sick numbers below what the hospitals can work with.  breathing is one thing, but a cough or a sneeze can go 20 feet.  if your mom told you to cough into your elbow, well I think a cloth in front of your mouth and nose is prob. better.  some viral particles may float in the air, but the largest number are prob. carried with moisture and droplets with coughing, sneezing.  prolonged exposure (more than 15 minutes) is also predicative of infection/transmission.  Many of us working with dozens of cases a day, have still not had it.  wearing masks, cannot social distance and listen to heart and lungs.  sanitizer to stop spread to the next.  most of our hospital employee cases were trace to outside the ed from non hospital sources.  We escalate from pleated masks, to N95, to papr devices. based on risk.  half the folks who "know" they have covid, are still negative, even health care workers.  the mitigation measures including the masks have to be helping, or doing the math, we would have all had it.  more folks dead due to overwhelmed resources.  if a town is hit by a tornado, lots of people can help.  if every town is hit by a tornado, no one can help anyone.  We are wearing the masks to help those around us.  If it was ebola we would all be dead.  many people die from influenza and we are used to that.  those numbers are down in other countries (Australia) due to the mitigation for covid.  If you are old, or on chemo, or have sever chronic illness, you may not survive no matter what.  If we all got it at once, more would die due to rationing, and not enough beds in hospital.  as it is now we are limited due to staff out sick.  almost 1/3 to 1/2 of all patients are covid + in our hospital.  we are mitigating, not preventing.  hope this is over soon.  antivirals, vaccine, antibodies.  we will see.  some reinfection.  the antibodies may get you over it, but rob you of a prolonged immune memory and response in the future (like rho gam)   .  many of the early touted drugs, have been proven not to work.  lets sit back and see where this goes.  we should know the facts in about 10 years.

[firefighter ontheside]

I read news today that Pfizer's vaccine is shown to be 90% effective in its trials.  That is better than they had hoped for and is good news.  May be out before the end of the year.  I guess the plan is to make it available for front line workers first.  Docs, nurses, first responders.  

[Ianab]

I read news today that Pfizer's vaccine is shown to be 90% effective in its trials.  That is better than they had hoped for and is good news.  May be out before the end of the year.  I guess the plan is to make it available for front line workers first.  Docs, nurses, first responders.  

Here's hoping. 90% is "close enough" to work. If you can get 90% of the population vaccinated, with a 90% effective vaccine, then that should create the "herd immunity" that's needed. and the virus will die out due to not finding enough fresh victims. 
Obviously it's going to take time to get the vaccine distributed, maybe 6-12 months? But yes start with the front line health people, the international pilots, anyone that wants to travel internationally, etc. Then work down the list until you run out of arms to jab. 
I can see people needing a vaccination certificate to cross any international border becoming a requirement once there is a useful vaccine, especially into countries that have low case numbers. 

[Sedgehammer]

I read news today that Pfizer's vaccine is shown to be 90% effective in its trials.  That is better than they had hoped for and is good news.  May be out before the end of the year.  I guess the plan is to make it available for front line workers first.  Docs, nurses, first responders.  

Here's hoping. 90% is "close enough" to work. If you can get 90% of the population vaccinated, with a 90% effective vaccine, then that should create the "herd immunity" that's needed. and the virus will die out due to not finding enough fresh victims.
Obviously it's going to take time to get the vaccine distributed, maybe 6-12 months? But yes start with the front line health people, the international pilots, anyone that wants to travel internationally, etc. Then work down the list until you run out of arms to jab.
I can see people needing a vaccination certificate to cross any international border becoming a requirement once there is a useful vaccine, especially into countries that have low case numbers.

I sure hope one isn't needed. With the mortality rate so low already for the vast majority, I can see no need. Once this has been around a year or two, it'll be like the flu more or less most likely. 

[LeeB]

What happened to 'Just the Facts, the Crown virus.'? Sure seems like this topic has gone away from that and more into opinions.

[Gary_C]

Here it is.

Just the facts MAN!

[Ianab]

I sure hope one isn't needed. With the mortality rate so low already for the vast majority, I can see no need. Once this has been around a year or two, it'll be like the flu more or less most likely. 

Currently the US is seeing over 1,000 deaths per day. Give it another year and that's maybe 365,000 reasons we need a vaccine, and that's only in the US. Let 75% of the worlds population get it, even at 0.5% fatality rate and, well you can do the maths. Completely uncontrolled you can be be fairly certain the fatality rate will be higher as medical resources are overwhelmed. 

Don P has got it. 

I'm not talking about the constitution here I'm talking about the things that were drilled into me at home. My shoulders were not made big to carry my big mouth around whining about "me". Take care of those around me first. No I will not win every time, hold the door till everyone gets out, make sure everyone else gets home. This in my mind goes along with that thinking, if they tell me that wearing a mask is in the best interest of those around me so be it. If I doubt the efficacy of that advice put a sock in first for better filtration, then put on the mask. When everyone is on solid ground, we can talk about whether it worked.

That's what has got NZ though this so far, with so little damage. It was an attitude from the top, that science / facts and teamwork was the way to go. Not our imagined isolation, or low population, or being "sheep". The Government can't pass a law banning Corona Virus, or wish it away, it's the People that need to act to suppress it, and this is the coach giving the team the game plan. Smart politics, we bought into it, and it worked. 

It wasn't even masks, because in the initial outbreak they weren't even recommended. (conflicting science and not enough masks anyway).  Now the science suggests the masks do offer an overall positive benefit, and there are plenty on the shelves. But if there is a new uncontrolled outbreak, and alert levels increase again, then most places that would benefit from mask wearing will be closed short term in that region. Then masks are for public transport and unavoidable close contacts. If you need to be wearing a mask, then you don't need to go to a restaurant. Let the Uber Eats guy collect it from the shop window and drop it off at your door, with no one getting within 6 ft of each other. 

Sorry Lee, some of this post is opinion, but it's also the "facts" of what's been happening here in NZ. The Govt here also admit that their responses haven't been perfect. But admitting that, and trying to prevent the same slip-ups happening again basically increases the populations general trust. There hasn't been any serious blame game and sacking of expendables. Just a Kiwi, "Well that didn't quite go to plan, lets do xyz so it doesn't happen again". Semi-political, but NZ has also had an election. The minority ruling party (in a coalition with 2 other parties) won by such a landslide that they are now able to govern alone, and the previous larger opposition party got about 1/2 the number of votes. A single party over 50% has never happened since the election system was changed to MMP. That's partly due to the PMs "leadership" and partly due to the main opposition party shooting themselves in the foot multiple times.  

And a big part of science is looking at what others are doing, learning from their mistakes and successes, and applying it to your current problems. What has Taiwan and Bhutan (of all places?) done that's worked so well? Maybe it wont translate, or maybe there are some lessons that apply?  You don't KNOW until you sit down and actually analyse things. WHY has Bhutan had zero deaths? They have had some cases, and done lots of testing, but no one died. Science wants to know WHY. :P

[nativewolf]

Yep Ianab it confounds many of us that some small # of people seem to want to ignore scientific advice given or empirical evidence offered by countries such as New Zealand.  New Zealand is a testament, congratulations on such a well run and mannered country!   You Kiwis developed a comprehensive plan, stuck with it, and came out great.  

Your comment on Bhutan is interesting, I had some students from Bhutan and had to turn down an invite to teach there.  What a country, if they saw our "steep" ground they'd laugh at us.  

I personally agree with @doc henderson that lets hold off on embracing the phizer news all too quickly, it was a small rushed trial and a longer look may change the facts.  You stick with it @doc henderson , hope this current flush of outbreaks does not last too long or create so much work you can't mill.  The stock market sure spoke though, they know how important a vaccine is to our country.  

[nativewolf]

Well, that seems to have lit a fire.
Here's where I'm coming from. We are in trouble. The smart people say this will help. They never said it was a cure, it will help. In the middle of this we have people raising cain about their "rights". I was raised a little differently I guess. There are several responsibilities that come before my "rights", no I'm not talking about the constitution here I'm talking about the things that were drilled into me at home. My shoulders were not made big to carry my big mouth around whining about "me". Take care of those around me first. No I will not win every time, hold the door till everyone gets out, make sure everyone else gets home. This in my mind goes along with that thinking, if they tell me that wearing a mask is in the best interest of those around me so be it. If I doubt the efficacy of that advice put a sock in first for better filtration, then put on the mask. When everyone is on solid ground, we can talk about whether it worked. This bs in the middle of the fire is exactly that. I'm hopeful for the vaccine they talked about today.

@Don P  Many thanks for getting this out there. 

[Sedgehammer]

Why can empirical evidence be used for masks and not the gold standard of double blinded studies, but empirical evidence cannot be used on medications that doctors said worked? Same evidence is in play. Politics? Double standards?

No one is saying NOT to wear a mask if you want to do so. I am saying that certain mask types look to have little benefit and that it is something that should not be forced. There is nothing here about politics, leastwise in my posts about.  

I've stated several times my wife wears a mask everyday. It's an N95. There's a reason she wears it. She sees patients with covid. 

[kantuckid]

Having been into three separate dental offices in past week I can says that each had it's own protocols in place and there were obvious differences. I would assume that those making those decisions were professionals and that their decisions could be called FACTS? 
Facts in science are varied, that's a fact too.  :D
I see zero way that covid can be discussed while also totally ignoring the politics of the time it's been dealt with (or not). 
Walking on a medical campus last Thursday I saw most medical staff wearing a mask outdoors while many others did not. Some in both camps were old vs. young. 
Take yer pick huh? 

[doc henderson]

there is plenty of politics involved and what we are trying to avoid in this thread.  it becomes difficult.  some things thought to be "obvious"  or factual 6 months ago, have mostly been disproven.  docs always are trying to differentiate.  That is why it can be hard to get us to agree.  we have had 2 patients assaulted when asking someone to wear a mask in a store.  The whole freedom of "speech" meaning you do not have to wear a mask?  It is courtesy to wear a mask in someone elses store or home that requests it.  or stay home.  I do think it makes common sense to wear any kind of face covering in a close public space.  not a fact.  we are in month 10.  as I have said, many current facts will be disproven over the next 10 years.  lets take it down a notch.  If there is a chance that a mask can help "reduce" the chance of spread to vulnerable folks, lets do it, or stay home.  the overall death rate is low, but not if you are over 80.  I am sure older people are afraid to go to a grocery store when half the people are not mitigating.  sanitize, distance, masks.  We have old folks found dead in their homes, afraid to come to the hospital for chest pain, cause they do not want to get covid.  that would have been a preventable death.  A very strong opinion is still just an opinion.

[kantuckid]

"Delicately", well said Doc. 

That said I'm eating lunch now after managing to smash off my left middle finger nail setting a 6x10x10' oak beam in place on foundation bolts.
 Got a brand new Nurse Practitioner in training who was squeamish over cutting the skin loose from the edge of my fingernail. I asked her if she had been around ER stuff yet and she said "yes, my last gig was ER but not me cutting other peoples skin"- :DHA! 
Now I'm up to date on tetanus shots again too. 

[barbender]

I remember a squeamish young nurse in the ER, I was thinking to myself, "I don't know if you're cut out for this"😊

[Larry]

I have a United Health Care Medicare advantage plan paid for by my past employer.  They came up with something new called WellAtHome.  I signed up for it.  They send out a Covid-19 test kit, thermometer, and a dose of Tamiflu.  According to the instructions if I feel sick I'm supposed to call in and a Doctor will tell me if I need to take the Tamiflu or do the Covid test.  I haven't got the kit yet.

It sounds good to me.  If I get the flu I don't have to make a Doctor appointment, sit in a waiting room, or get in line at the pharmacy.  Plus it saves a couple of days time which they say really helps with Tamiflu.

So to my Doctor friends is this a valid program?  Anything that I need to be aware of?

Today I got my test kit.  Has a dose of Tamiflu and a Covid-19 at home test along with a temperature gauge.  Fed-Ex delivered it and a couple of hours later I get a text asking me to check my temperature so they can establish a base line I suppose.

United Health Care didn't send me this kit because they are nice people.  They sent it because they hope it will save them money.  Seems like a win-win to me.

[kantuckid]

My wife and I both are on KY teacher retirement which includes a paid for Medicare United Health Care Supplemental plan and a paid for Rx plan via Express scripts. We pay the Medicare premium monthly out of pocket, like a bit over a $100 bucks. 
They have lots of plans but not that one it seems. FWIW, I signed up a few years back for one of what I'll call "their brainstorms" to save them moolah. it was an RN nurse who was said to streamline your care and do wellness checks. This lady around my age from WI, a retired RN would call me constantly! it got to the point where my wife would say your girlfriend the nurse is on the phone again and what was well intended got to be pesty in the end and I stopped the calls. 
They do pay me $$$ to get my annual wellness check.
 I lie and don't tell them I get my 6 month meds renewal at that same visit. It's not kosher but I figure the medical system is already overloaded enough that I'm doing them a favor as it is and actually saving them money. 
On Medicare I've not seen any billing yet for the two pre-procedural covid test I've had to date? 
One last summer, one last week. So maybe on Medicare they are free anyway, just not at home is my point? Not even seen a $4 Medicare co-pay. 
I signed up for a covid vaccine test with a large hospital in LEX, KY this week. I read about it in the newspaper and went online to a website with a form to apply. The article leading me to sign up said there are scams now (big surprise huh?) on covid research but this ones legit and under Baptist Hospital who got the gvmnt. contract. it said they needed seniors in my age group, so I felt good about signing up.  

[Sedgehammer]

@Larry Have you ever done an at home test before? If it's the same type of swab test that I had before my surgery, it will be hard to force yourself to stick it in far enough, as it so over whelms the senses. It really needs to go to the back of your head it feels like. 

@kantuckid Good you signed up for the vaccine. People in your age group should be the first to get it imo. 

[kantuckid]

Actually what I signed up for was as a participant in a vaccine trial, experimental research project funded by the USA gvmnt, not just to "get a shot" per se. As explained on the website the vaccine at that point I'd get it would have not been as widely tested as when offered to the public as we've seen in the news- frontline healthcare folks first, then seniors my age, so on. 
Go to:  stopcovidky@uky.edu  

They call it a "Investigational Vaccine Study"-a "pre-screening release survey" is what I signed up on. I'm sure there are other study places around the country where the same research is underway. It includes people of many age groups not just the ones we think of as the high covid risk groups. 

[Larry]

@Larry Have you ever done an at home test before? If it's the same type of swab test that I had before my surgery, it will be hard to force yourself to stick it in far enough, as it so over whelms the senses. It really needs to go to the back of your head it feels like.

Never done the test or been tested.  I don't know if its the swab test or something else.  The box says do not open until directed.

[kantuckid]

The first test I got at a hospital and felt like an IQ test using an engine dipstick. The most recent one i got at another hospital and the swab was circled far less deeply into my sinus in a not so obnoxious fashion-quite an obvious difference!

[Sedgehammer]

 :D :D :D an IQ test with a dipstick, that's a good one @kantuckid 
That second test might not have been accurate. 

[doc henderson]

it is supposed to go to the back of the nose, almost in your throat.  the second test is more comfortable, but can be less sensitive.  (literally).  but means you might miss the dx.

[kantuckid]

It was done by one of two people in a long, double line of cars at our regional hospital.
 I would be left to assume that those two people were trained and not endangering all those who provided medical services to many of us who were being tested plus our friends, families and co-workers, etc? 
 Not that I personally know one test from another. 

[Real1shepherd]

I'm not gonna read through 40+ pages to catch up, but......this virus is especially dangerous because we don't have herd immunity. It's many times more deadly than the flu for that reason. Sweden's attempt to try and get herd immunity without a vaccination was a mistake.

In modern days, it takes a vaccination program to get herd immunity without loosing millions of lives....look at all the human diseases we beat using vaccinations....look at what happens when the 'no vaccinations for my kids' crowd don't vaccinate....diseases start to come back that were nearly extinct.

Currently the 19-25yr olds are spreading COVID like wildfire to their grandparents and to people over 65. I'm in that age group and would be lying if I said I wasn't concerned. They're usually asymptomatic and don't really care about masks and sheltering. It's their 'right' to spread the disease....just ask them.

So for me anyway until there's a vaccine....I'm wearing a mask and keeping my distance from smug 19-25yr olds....I don't care what they think because it's my life to preserve.

Some countries that had COVID are being hit by a second and even a third wave. I find that especially scary because for all the facts about COVID so far, there's more questions. Just because many of you think this is a joke and you're going to survive anything like Trump did without reasonable precautions, that's false wisdom and Fool's Paradise. And at the very least, it's not very brotherly.  

Kevin