Just the Facts, the Crown virus.

[doc henderson]

we tend to ask patients now that come in short of air and hypoxic, that turn out to be covid +, if they are vaccinated.  they will not look us in the eye, when they say no.  I think i will have to cancel the family reunion this year, that we normally have every labor day.  not due to covid itself, but because we are so busy, that I will not be able to be off to prepare and be home.  also some of my elderly relatives, are not vaccinated.

[Brian_Rhoad]

I was in the hospital 5 days with covid. I had some very interesting discussions with the doctors and nurses about covid. Their opinions about covid are very different from what we are getting from the news media and government. 

Firstly masks are for the sick and those dealing with the sick. The masks must be N95 and properly fitted to do any good. Proper handling of the mask is the biggest problem. Wearing a mask and taking it off and putting it in your pocket or hanging it from your rear view mirror in you car does nothing to prevent you from getting covid.

The vaccine won't keep you from getting covid. It may keep you from getting it as bad as you would without it. It should be a personal choice as the whether or not you get it. There has been deaths from covid of vaccinated people.

Every person/patient is different. The covid virus affects people in different levels of seriousness. Some have no symptoms while others die from it. The persons health problems may or may not have any effect on how they recover or don't recover from covid. Healthy people with no health problems have died from covid while people who have many serious health problem have recovered.

The most important opinion from the doctors and nurses is to not live your life fearing covid to the point where you don't do the normal day to day things that make us happy. 

My getting covid has built up my immunity better than any vaccine would. No guarantee that I won't get it, but if I do it won't be as bad. 

[Lostinmn]

So I'm not hearing a peep about natural immunity from having covid previously. Seems nobody wants to mention it. I had it back around last Thanksgiving and although it sucked I'm no worse for wear and came through it ok. What's the word?

Brent

I just read an article about study that does show natural immunity is better, but HUGE caveat regarding the risk to acquire said immunity over vaccination route.  
Having SARS-CoV-2 once confers much greater immunity than a vaccine?but no infection parties, please | Science | AAAS
Well worth the read, I just hope it stays in context.  Vaccination/boosters still appears to be a much safer avenue to protect your health.

full study report for those that like more detail: Comparing SARS-CoV-2 natural immunity to vaccine-induced immunity: reinfections versus breakthrough infections | medRxiv

[doctorb]

And like the vaccine, natural immunity wears off too.  Many examples of that.  Take Lamar Jackson, Raven's quarterback.  Had Covid last November.  Banked on natural immunity and, therefore, did not take the vaccine.  Got Covid again in July.  Wiped him out "pretty good".  

Immunity to many viruses is fleeting and can decrease substantially over time. While comparison of the protections afforded by natural immunity to that provided by the vaccine are reasonable and need to be further studied, one thing is for sure.  Just because you've had Covid once doesn't preclude you from having it again.  And, yes, the second time around is not always an easier trip....

https://www.cnn.com/videos/us/2021/08/25/colorado-fitness-coach-coronavirus-vaccine-affil-pkg-vpx.kusa

I find the discussions about acquired natural immunity versus vaccine can tend to be polarized, although certainly less so than other Covid subtopics.  The reality is that it's a myth to think that once you've had the disease, and survived it, you are invincible and fully immune.  That's not the way it works.  

Do you guys remember last Spring (2020) when a percentage of pundits felt we should just "rip the bandaid off (open everything back up) and let this thing run it's course"?  We now know that would not have worked and we'd be worse off. Where are those pundits now?

[doc henderson]

Just to keep things in context.  the mitigation of distance, mask, and vaccine, is to keep it so an area or community can handle the cases.  the problem now is nurse shortage.  so our hospital that can have 200 people in, is limited to less than 100 patients.  we go on diversion since the working nurses on the schedule are maxed out on patients.  we had ortho night with 3 complex fractures.  the ortho doc wanted them transferred.  we used "mission control" as all the less than an hour tertiary care centers were on diversion.  they found us beds in Wisconsin.  Our community has about 45K people.  If a spreader event got 100 people sick, we would be overwhelmed, and may not have anywhere to send overflow.  If we all got it at the same time, then it might die down, after we all pass the infectious period.  Of course, I would not be at the hospital, I would be home with my guns at the ready to protect my family from the riots and desperate people doing what they need to do to survive.  Many more people would die, and suffer in the process, but at least it would be over, till the next time.  the idea of the vaccine, is to try to get enough people relatively immune as to not over-run the health care system.  Our ED has 18 beds, 4 nurses, and 4 tech if we are fully staffed.  to get more nurses, we can shut down all elective surgeries and procedures.  We always have one doc on, and 2 mid-levels throughout the day.  We will still have heart attacks and other emergencies.  Minor things will be triaged and told to wait.  after 6 hours they will leave and go home to fend for themselves.  We are seeing 70 to 85 pt. a day, our normal is about 65.  just adding 20 more to that number, or increasing how sick they are, pushes us over the top. We suspect a few pt.s have gotten covid in the hospital.  getting covid after having it before or getting vaccinated, does reduce you chance of being really sick.  It makes you less likely to pass it to someone else.  to my knowledge I have not had the disease, and my face it 12 inches from the seriously ill patients who have it during intubation.  we respond to emergencies all over our hospital.  all of our cases but one is the delta variant, and I have admitted only one vaccinated pt. to the hospital with covid.  she was 101 y/o.

[Texas Ranger]

my daughter works for a company that manages delivery of hospital employees, nurses primarily.  She says that they are  fighting federal and state rules that prevent importing nurses..  Bring in nurses from other countries is controlled by the State Department, it may take years to get a permit to come in (green cards, ya know).  Some States have laws that do not recognize credential from all other states.  So, foreign nurse personnel are a slow trickle, and states have to have agreements with the other states to transfer credentials.

Ridiculous bureaucrats defending their little fiefdom

[Don P]

Oh those pundits are still around Doc B.
Statewide we are back up to a 10% positivity rate this week, the highest since early Feb. Our area got a distinction of being highest in the state per capita and second in the nation. I don't believe we have peaked yet but bound to be close, till the unvacc'ed cook up and broadcast another variant. The common thread, rural, reactionary, lower education... Most of my neighbors bless their hearts. Sturgis apparently was a spreader event that just like the ripples from a stone cast in water it is going out from there and back home. You don't need to be a weatherman to know which way the wind blows.

A friend has had it twice, and the vaccine after that. One of the beef processors, the unvaxed son at 34 and healthy died, the Dad is in ICU. It's a roll of the dice, or roulette with a scattergun.

J&J has published a very small study after giving some people another dose 6 months out, it did boost the antibody level 9fold. What it needs to be to be efficacious is unknown though.

[Larry]

We have a great biker rally in September.  Bikes, Blues, and BBQ.  Attracts some 250,000 from outside the area plus the locals.  Never causes much trouble and brings lots of $$$'s to the area.  Fun time for all.  I even enjoy it!

The local hospitals are asking for the rally to be cancelled.  They are filled to capacity with covid patients, mostly not vaccinated.  From past experience the rally does generate some trauma accidents so they brought in extra help and were prepared.  This year no icu beds, and no extra help.  I can understand their position.

It's open for discussion now, so I'll watch to see how it plays out.

Canceled.  That didn't take long.  The University of Arkansas provides parking space along with space for events, and vendors.  They said no way.

I had a vision if the event was held.  Trauma cases waiting on the street for a bed because they are all filled up, mostly with the un-vaccinated.

[doc henderson]

be safe and God bless folks.  I am off to work.

[Ianab]

my daughter works for a company that manages delivery of hospital employees, nurses primarily.  She says that they are  fighting federal and state rules that prevent importing nurses..

While you are probably right about the bureaucrats, it's not like other States or even Countries have an excess of Nurses and Drs to spread around. Pandemic means it's affected every country to some extent. 


One of the issues with vaccination and testing here has been getting enough staff to operate the centres. Nurses all have their regular full time jobs with the normal sick and injured. So Uni students have been recruited to help staff the centres. They aren't trained to give vaccines, but they can look after the paperwork, checking folks in and out etc, and that frees nurses up to do the actual jabbing or swabbing.  And that's Without having a ton of extra Covid cases clogging up the Hospitals. 

[doctorb]

With all the "retirements" of nurses and docs, I have to wonder.   Do you think it's because the disease is everywhere and they have different risks....the risk of getting the disease or the risk of taking it home or spreading it to others?  Or is it because they see the results of the disease and can't believe people are so slanted that they just won't accept reality?  This thread is titled, "Just the facts...."  I can tell you it's a fact that the nurses are incredibly demoralized over the incredible need for care of this infection, and the lack of real truthful discussion about it.  One of them told me the other day, "I just want to slap somebody."   For those of you outside of medicine, that's quite a strong statement from a nurse.

My personal belief is that they would work until they'd drop, if they had to, or if they thought it would do any good, but it's very demoralizing to be willing to do that in the face of a portion of the population that only accepts "alternative facts."  Nurses don't mind losing a well designed and executed medical battle.  If the team was pulling the wagon in the same direction, and all agreed on the plan, nurses can justify for themselves that they have done all they could, and they lost the battle.  This is different. They feel like they have one hand tied behind their backs and duck tape across their mouths.  They ain't happy, and justifiably so.

And yet we still have the argument about whether the Covid vaccines work?  News flash!   They are not a get outta jail free card.  However, you will be able to keep playing the game.

[doc henderson]

my wife is a pharmacist, and she and the pharm techs now give the vaccine in the pharmacy front area.

[Mooseherder]

The trend was headed that direction before this fiasco.  All skilled labor was facing shortages.  We needed 40,000 welders before the pandemic.  I won't get into the reasons for the demoralized crews here.  Plenty of that discussion elsewhere.  Our neighbor is a Pharmacist for a national chain here.  The smaller towns Pharmacies are closed 2 days a week now because of the Pharmacist shortage.  Name the occupation, same story.

[Don P]

I know 3 nurse practitioners who have thrown in the towel in the last 6 months. This wasn't from any pre existing situation. All very well qualified with good spirit. They were all capable of retiring but none had mentioned anything like that before the pandemic. We are chewing up the front line.

[doc henderson]

we just had a meeting with our finance guy to see what early retirement would look like.  I am 60 and my wife turns 57 on the 30th.  we could do it, but goes against the grain.  

[gspren]

we just had a meeting with our finance guy to see what early retirement would look like.  I am 60 and my wife turns 57 on the 30th.  we could do it, but goes against the grain.  

My wife and I retired end of August 2011, I was 59 and she was 55, no regrets but it's a very personal decision.

[doc henderson]

It is scary if you are used to working.  i like my job when it is manageable.  covid +s in 20s and 30s going home, 50 and 60s in hospital, will be on vent in am.

[JJ]

God speed Doc!

          JJ

[doc henderson]

Thanks JJ.  

[Gary_C]

With all the "retirements" of nurses and docs, I have to wonder.   Do you think it's because the disease is everywhere and they have different risks....the risk of getting the disease or the risk of taking it home or spreading it to others?  Or is it because they see the results of the disease and can't believe people are so slanted that they just won't accept reality?  This thread is titled, "Just the facts...."  I can tell you it's a fact that the nurses are incredibly demoralized over the incredible need for care of this infection, and the lack of real truthful discussion about it.  One of them told me the other day, "I just want to slap somebody."   For those of you outside of medicine, that's quite a strong statement from a nurse.

What surprises me is the nurses and healthcare professionals in the Twin Cities have overall low vaccination rates for Covid-19 and they are loudly protesting mandatory vaccination mandates by their employers. Some have even said they will quit rather than get the vaccine.

It's hard to make sense out of what is going on these days.  

[Gary_C]

Finally some real data and from Science Magazine too. But the researchers caution that you should not have "infection parties." Another caution is though the differences are huge between the groups, the actual numbers of infections is relatively small for both groups. In other words, the two best groups to be in are either the infected or the vaccinated and never the unvaccinated and uninfected group.

Having SARS-CoV-2 once confers much greater immunity than a vaccine

The study, led by Tal Patalon and Sivan Gazit at KSM, the system's research and innovation arm, found in two analyses that people who were vaccinated in January and February were, in June, July, and the first half of August, six to 13 times more likely to get infected than unvaccinated people who were previously infected with the coronavirus. In one analysis, comparing more than 32,000 people in the health system, the risk of developing symptomatic COVID-19 was 27 times higher among the vaccinated, and the risk of hospitalization eight times higher.

Nussenzweig's group has published data showing people who recover from a SARS-CoV-2 infection continue to develop increasing numbers and types of coronavirus-targeting antibodies for up to 1 year. By contrast, he says, twice-vaccinated people stop seeing increases "in the potency or breadth of the overall memory antibody compartment" a few months after their second dose.

For many infectious diseases, naturally acquired immunity is known to be more powerful than vaccine-induced immunity and it often lasts a lifetime. Other coronaviruses that cause the serious human diseases severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) trigger robust and persistent immune responses. At the same time, several other human coronaviruses, which usually cause little more than colds, are known to reinfect people regularly.

[Ianab]

I can understand that naturally acquired immunity from fighting off the disease IS probably better than the vaccine. But some folks have caught the virus twice, but luckily that seems rare. But there are still "break trough" cases there.  Big problem is that a lot more folks will die getting immunity that way.  

I'd say the "safest" would be vaccinated, and THEN fighting off the virus with a mild case. 

Either way, one should work as a booster for the other.

[doc henderson]

we did 28 tests, and although my ratio was 50% +, overall 6 out of 28 were + in the lab.  some are routine for admission to the hospital to keep infected folks separated (quarantined).   21% +.

[SwampDonkey]

As far as nurses crossing borders to work, I believe there are at least 1500 living in Canada that cross daily to work in US healthcare facilities. I know it was a big news item a few months back about nurses crossing to work in Michigan around Detroit. ;)

Pharmacies here have been delivering vaccines all along during the rollout. Anyone I know of got their shots at a pharmacy.

[Ed_K]

 I got both of the pfizer shots back in April an June. Last week I got an antibody test done, this morning thru an e-mail I was told I have 0 antibody's in my system. Being that I take anti viral drugs for my cancer I'm assuming that is the reason for the 0 antibody to the covid 19 virus. If it wasn't for my guess on on being on anti viral's I'd wonder why bother getting a covid anti virus shots. My Cancer Dr. said he had no preference on which shot (pfizer or modurna) that I should get for a 3d shot? But why bother.
 I have been wearing a mask since 2017 and using hand cleaner and what not I wonder how many people complaining about getting this shot would like to live like I do.