Coronavirus in the United States - news and thoughts

Preliminary research, but some disturbing findings.


Covid-19 could lead to cognitive decline, especially among older adults, new research suggests

https://www.washingtonpost.com/life...cef096-f07d-11eb-a452-4da5fe48582d_story.html

 

I was informed yesterday that there is a shortage of Bamlanivimab and etesevimab in Central Florida. These are the MABs combo that we have been giving patients for a while now.

I've always thought it was kind of weird that more patients weren't getting these more proactively nationwide instead of only when they showed up at the hospital suffering with more severe symptoms. I guess it's difficult to determine who should get these expensive drugs more prophylacticly and who won't really need them. It's kind of a catch 22. Most people won't need them and will do fine without them but if they are best used before worsening symptoms occur how do you determine who's going to have worsening symptoms? My best guess would be to develop a specific algorithm taking into account age, current symptoms and co-morbidities.

Our Covid patient population is heavily skewed Hispanic even though our hospital is not situated in a highly Hispanic area. All of my patients yesterday were obese Hispanic folks who, save for the one homeless guy living out of his truck (go figure), were not vaccinated. Two of them were husband and wife, which BTW, is not an uncommon occurrence. We lost another husband on Monday and his wife was intubated yesterday. And it's not just the ones who are currently in the hospital who have Covid. I had a 34 year old who had 9 other immediate family members who were positive. Another guy's mother and fiancee were positive. He was my worrisome patient all day yesterday. I spent most of my time trying to keep his O2 levels up going from nasal cannula to non rebreather mask, to hi flow nasal cannula and rebreather mask to heated hi flo nasal cannula to heated hi flow and non rebreather. I spent most of my day staring at his monitor wishing the levels up. Sadly, near the end of shift I sent him to a positive pressure room where we can use bi-pap. If that doesn't work it's intubation.

On the positive side we sent a bunch of people home yesterday too. Unfortunately those beds were filled by the dozens of people holding in ERs across the system.

 

You can get pretty sick from Covid even vaccinated. It will still be far better - save you from hospitalization or worse. But you can get very sick. Hope you're not

 

It will depend upon how durable the memory-B and memory-T cells are. If anyone asserts that they know the answer right now they are either lying or trying to extrapolate from 1 years worth of data based on historical precedent.....which frankly is a fancy way of saying "guess" at this point, so see the first part of my comment.

 

I actually had it last year and didn't know I did, got the antibody test and came up positive in November 2020 but so far it just feels like a cold or allergies which it might very well be

 

Friend of mine received casirivimab and imdevimab as early as last December or January. His family member is a viroligist at johns Hopkins and is the only reason he was aware of them and had to request them otherwise they would not have been offered. Another friend's mother is currently being treated for cancer and came down with covid however they administered it to her without having to request it. Apparently it is still scarce and few hospitals even have them.

 

This new CDC report gives you an honest view of this scamdemic...

https://www.cnbc.com/2021/07/30/cdc...tts-covid-outbreak-were-fully-vaccinated.html

 

There is no shortage due to supply issues----the distribution of Bamlanivimab and Etesevimab have been halted per the ASPR and FDA note of June 25. This MAB combination has been found to be ineffective against the B.1.351 (Beta) and P.1 (Gamma) variants. Subsequent to this letter, they have also been shown to have very limited effectiveness against the Delta variant. They have been replaced by the Regeneron MABs either casirivimab and imdevimab (REGEN-COV) or sotrovimab.

https://www.phe.gov/emergency/event...mlanivimab-etesevimab-distribution-pause.aspx

 

Hope you're OK - this one is supposed to be far worse. Relying on this:

Another disconnect is what we think of as “severe illness” and what is actually severe illness. My colleague said he could not imagine describing the illness he had experienced as anything other than “severe”—he was unable to do anything for 36 hours and said it was on par with having debilitating food poisoning. But when I asked a couple doctors about this, they disagreed with his ranking. “Technically, it sounds like he had a mild bout of COVID-19, by strict case definitions,” emergency physician and sometime Slate contributor Jeremy Samuel Faust wrote to me. “Mild does not mean pleasant. In fact, you can have fever, chills, body aches, and feel downright terrible for a week or more and still be categorized as ‘mild.’ ”

To approach even a moderate (or severe) case of COVID, “there must be significant lung involvement as evidenced by low oxygen levels, for example,” Faust said. “It really can be miserable. But you’re at home, not in the ICU.”

Hanage told me that a vaccinated friend of his had just had a mild case that lasted four days. And that still means the vaccines are doing what scientists like him believed they would. “Vaccination effectively removes the threat of nationally overburdened healthcare—even though locally serious outbreaks remain not only possible but likely,” he said.


What Vaccinated People Should Really Know About the Delta Variant’s Threat to Them

 

Contractors that rely heavily on hispanic labor are suffering manpower shortages in SW Florida right now

 

Interesting. We were continuing to use those MABS after June 25th. Perhaps it was the remnants of the "throw everything at it" idea since there hasn't really been much else except for steroids, Remdesivir and convalescent plasma. And now they're saying Remdesivir may not be very helpful.

We're now running a double blind study on a new medication. I haven't had the time to read up on how it works but I did just get an email on it. I'll post it here when I get the chance.

 

I don’t believe we have that data yet. Friend of mine got COVID in 2020, then get a double shot of Pfizer and now just recently tested positive for COVID. Shows how infectious this delta variant is and how evasive it is.

 

thank you for what you bring to this discussion. it is appreciated

 

Utah Republican Governor sees the light. pushing vaccine and ordering state to provide kn95 masks to kids since they cannot get vaccinated

Utah will give KN95 masks to children as the Delta variant fuels hospitalizations nationwide - CNN

Utah will give KN95 masks to children in schools
Republican Gov. Spencer Cox said he's fed up with people who can get vaccinated but choose not to. So to help protect children too young to get vaccinated, "I have instructed our teams to provide a KN95 mask for every child that wants one in the state," Cox said Tuesday.

"We are purchasing those now. We will make those available to schools so that children and parents who want their child to be masked ... will have the opportunity to have available at no cost to them a KN95 mask."

The governor said neither he nor schools have the authority issue mask mandates, but local health departments and county elected officials can decide on a mask mandate for their schools for 30 days at a time. Cox said the pandemic is a "pandemic of the unvaccinated," which the CDC director has also said. The governor said he's frustrated that those vaccinated against Covid-19 have to wear masks to help the unvaccinated.

 

Louisiana having to ration care.

Utah will give KN95 masks to children as the Delta variant fuels hospitalizations nationwide - CNN

The ICU of Louisiana's largest hospital is stretched to its limit. As of Monday, 23 people were waiting for space to open up in the ICU, said Dr. Catherine O'Neal, chief medical officer of Our Lady of the Lake Regional Medical Center in Baton Rouge.
"You have people with chest pain sitting in an ER right now while their families sit in the waiting room. And they are wringing their hands. And they are calling everybody they know" to get into an ICU, O'Neal said.
About two weeks ago, the hospital had 36 Covid-19 patients. As of Monday, it had 155. .
"No one diagnosis should take up one quarter of your hospital," O'Neal said. "We no longer think we're giving adequate care to anybody because these are the darkest days of the pandemic."

 

Elective surgeries n Florida and Louisiana being delayed/cancelled due to staffing shortages related to covid. bad time to need a hospital since all resources are being consumed by unvaccinated covid patients

Florida hospitals begin postponing elective surgeries as another record set for COVID-19 daily admissions | National | bakersfield.com

FORT LAUDERDALE, Fla. — As the number of people hospitalized for COVID-19 in Florida rose to an all-time high Wednesday, the state’s hospital systems started making plans to suspend elective procedures.

Memorial Healthcare System announced Wednesday its five South Broward hospitals will suspend elective medical procedures “to conserve critical resources for the care of COVID-19 patients.”

“The current surge in COVID-19 cases in Florida has led to daily hospitalization rates not seen since the major spike last summer,” the hospital system announced in a written statement. Memorial had 526 COVID-19 patients admitted as of Tuesday, up from about 400 only three days prior. Memorial has seen nonstop people arriving with symptoms of the virus in the emergency departments at its hospitals, according to nursing managers.


Memorial’s hospitals will continue to treat patients who need emergency care for non-COVID reasons, and the rehabilitation and cancer centers remain open.

Across the state, hospitals are reporting record COVID-19 admissions as the delta variant of the virus continues to spread. There were 12,408 people hospitalized for COVID-19 in Florida on Wednesday, breaking the state’s COVID hospitalization record for the third day in a row, according to data from the U.S. Department of Health & Human Services. About a fifth of those hospitalized — 2,494 people — are in intensive care, occupying nearly 39% of Florida’s ICU hospital beds.

 

Here's a synopsis of the medication that we're studying. I'm not a virologist so I can't speak specifically to the mechanism of action but I'm anxious to see how it works. It appears to defeat the cytokine storm that you see that causes rapid deterioration in patients.

 

More Data showing no evidence of "long covid". Kids who tested negative “experience greater symptom burden throughout their illness” than kids who tested positive for covid.


DEFINE_ME

 

Yep - same here. Woke up with a sore throat yesterday. Sinus congestion last night and it feels like a cold. Have a gig today. Outdoors, but playing in a band with 20 people. Taking an over-the-counter test right now.

 

Damn. So senseless.