Coronavirus in the United States - news and thoughts

Requiring someone to take one of these vaccines as a requirement is ridiculous. We have no long term data to support it is definitively safe. And we know it wanes way faster than thought. How many boosters does one need before they should be considered? Which vaccines should count to be considered? Let’s just take a cocktail of all of them…

It is all political and part of the coercion tactics. Just plain wrong and evil. Just like mandates being used to coerce people. For a new drug that the data now shows is not what they sold. And only one of the drugs has approval at this point on top of it. One that may be the least effective with no long term data. Which gets to why a requirement for a Covid vaccine to get a transplant is ridiculous.

 

You say it's all political and there is some truth to it, but mainly in the sense that political governance is about protecting (and promoting) the public welfare. There is no reasonable argument against efforts with vaccines and treatments being all about protecting the public health so that we can get through this pandemic.

Not evil at all, it's a primary responsibility of political leaders.

 

O

Mandating people take a drug with no definitive long term safety data is wrong and evil. Especially for a disease that is not that dangerous to most.

Now working to come up with ways to fight the disease is fine. And the warp speed was fine. If only our public health leaders were competent in how to approach this.

A mass one size fits all approach was just a dumb for this disease. But sadly it was political and has remained that way. A bipartisan problem for sure.

 

Defending against a pandemic spread of a deadly disease is not evil but necessary. It would be evil not to get people to protect themselves so that they can protect the community. On the other hand, there is an evil, if often of ignorance, in the selfishness of people opposing protecting public health measures and/or their indifference to suffering & death, until that is, it's they or their loved ones that gets sick or dies.

Then they get it. At least some anyway.

There is always going to be some risk but that risk is weighed against the much greater harm that comes from an uncontrolled spread of infectious disease. It's why flu vaccines aren't mandatory. Our public health leaders and researchers have done tremendously in bringing the science to bear. The true problem we have is that a large swath of the American public has been swayed by more malevolent actors fomenting opposition by playing on people's fears and ignorance. They unnecessarily add danger to an already dangerous situation.

 

You have the patience and kindness of a Saint. But the likelihood of getting a meaningful response was near nil.

 

I got my booster today and had an immediate reaction......my penis started to grow......then the hot nurse stepped out of the room and it went back to normal.

 

My words mask my shouting at my computer.

 

I respectfully disagree. Two obvious examples of failures in these cases would be: (1) donor tests negative for COVID (sure, test twice), and (2) donor has had COVID within the last 90 days (honestly, could have protection and likely does beyond the 90 days). I just don't see it as a reasonable restriction in light of those two obvious exceptions. Let that donor donate!

Organ donation definitely hits close to home; it's personal for our family, and there's a WIDE range in how these things are handled, not just based on location, but also based on the organ (some of which is supply/demand related). Emotional <> actively campaigning. I've signed rights away to worse than what is being discussed here. How this hits people necessarily will be received differently. I've been faced with far worse liability/ownership type questions than anything related to a donor who wasn't vaxxed, lol.

To me the idea about hypocrisy revolves around the idea that they are more worried about having a high percentage of successful surgeries that they can claim as opposed to trying to extend out as much as possible to help more people even where some of those efforts might fail. I've had a lot of experience around hospitals in the last 20 years (patient, family, advocate, and more). I've seen first hand doctors that are too scared to do what needs to be done and doctors that are complete badasses and never blink at a challenge presented. First and foremost, I think it's important that people understand that this exists. The rules in place at this hospital strike me as being irrational and inconsistent. The concern shouldn't be whether or not a patient is vaccinated, the concern should be whether or not the patient has covid. Given the option to choose between testing for COVID and testing for vaccination status, wouldn't one always pick testing for COVID?

Funny, but I hear ya. A lot of what I've written could have been taken out of context, and I actually appreciate you seeking more detail on what I am saying. The limit is necessarily: (a) the supply of medical solution, and (b) the supply of medical labor. Where a plentiful supply of (a) and (b) exist, the goal is essentially to maximize the life saving potential for as many as possible (maybe think of it in terms of years-saved). Any time one patient could be saved for a presumed 50-year addition, that would always be super-seded where two patients could each have a presumed 40-year addition, and so on and so forth. Those calculations aren't explicit (or obvious, for that matter), but the goals of the most ethical hospitals tend towards maximizing years that can be saved. There will be no transplantable livers discarded or refused on account of an increased potential for a covid test to not pick up an existing positive.

Go GATORS!
,WESGATORS

 

When on a waiting list, financials are taken into consideration. Sometimes the smallest details can get you ahead. So, two ways of looking at this: (1) does the hospital have definitive proof that being vaccinated yields a more successful projection greater than the perceived risk of the vaccination itself, and (2) as a patient, on death's bed, what is your rational argument against refusing the vaccine as a medical risk.

For the case of (1), I take solace in the idea that you can always re-locate if you do not agree with a hospitals policies. At Shands, sometimes people come in from other parts of the country or even other parts of the world because they believe it will help them in their positioning on the magic list. Further, maybe they do have data that shows that the risk of the virus are so ridiculously high compared to the risk of the vaccine that it makes sense for them to pursue that based on success rates. Not sure if a person who is vaccinated and receives and organ from an unvaccinated donor is still considered vaccinated or not.

For the case of (2), you don't know what your principles truly are until you have a loved one on death's bed. Anything that you are willing to die for (or allow a family member to die for) will earn the respect that it deserves; but you'll quickly figure out what you are willing to die for and what you are not. I, personally, can't imagine allowing a loved one to bypass that vaccine option if it meant being helpful on the list.

Go GATORS!
,WESGATORS

 

At some point, the hospital shouldn't be expected to bend over backwards during a period of time in which they are already stretched thin because of Covid because somebody decides to trust a Facebook post over them. If you want to donate, get vaccinated. It really is that simple. If you are okay with doctors putting you under and removing an organ, you should probably just go ahead and listen to them on vaccinations too. That was a pretty universally accepted sentiment before Covid vaccines.

Emotionally pushing a point of view is reasonably viewed as "actively campaigning" especially when you are advocating a specific policy position (i.e., that hospitals shouldn't prevent live organ donation without vaccines).

Still not hypocrisy unless you argue that their interests are different in other contexts. Hospitals have turned down risky surgeries in a variety of contexts for years, possibly even at times where it may have been somewhat beneficial, on average, to do the surgery. That isn't hypocrisy.

Or you could test a person and have them be vaccinated. That seems better than "or."

But that isn't the goal of an ethical hospital. Again, if that was the goal, you would have a lot more killing of healthy patients so that organs can be given to "better" candidates, which would maximize life years. The ethics of a hospital arise first from not harming their patients and then move towards how best to extend life. This is a policy designed to assist with the first part of the equation. Hospitals are, and should be, fundamentally conservative in their risk assessments.

At some point, people need to be adults and understand that their childish behavior in relation to this particular vaccine (i.e., ignoring actual expert medical opinions because it violates their political identity) has negative consequences and it isn't everybody else's responsibility to bend over backwards for their bad choices.

 

But all the requirements to take all the dozens of other vaccines apparently arent ridiculous?

Obviously 10 billion doses worldwide and 2 years worth of data is not enough.

Than who thought?

How many? As many as it takes.

Unlike all of the other vaccine coercion that is OK.

So what was actually sold, and what did it actually turn out to be?

As to approval, for all those who insisted on waiting for full approval, they can choose the approved one. Nobody is forced to take an EUA one. Isn't that what everyone wanted?

Least effective compared to what? Pfizer is more effective than J&J and Aztra Seneca and most other worldwide versions.

The reason it is less effective than Moderna is because Moderna has a stronger dose. If you fear the vaccine, wouldn't you prefer a weaker dose?

Maybe for you. But if I'm going to donate my or loved ones organs I would prefer them go to someone who values their body and life enough to take care of it. Why waste the organs on someone who would rather die in the name of tribal politics?

 

Screening in these circumstances will validate both vaccinated and unvaccinated; ultimately increasing the total number of available donors. I don't think adding COVID to the screening protocols is too much to ask.

Semantics. It's not my problem; and it won't be. No matter what the hospital rules appear to be, make sure you are a bust-ass advocate for your loved one when given the opportunity. Exceptions are made quite frequently. It's one part of life where I strongly recommend being the squeaky wheel.

If they have valid data that shows that testing for COVID is not more effective than just testing for vaccination, then I'm willing to stand corrected. I have a hard time believing that the vaccinated shouldn't be tested and that test shouldn't be more valid than the vaccination status, but who knows, maybe there is data that suggests otherwise.

Sure, but better enough to reject one that is only negative and unvaxxed? I'm skeptical.

Sounds nice, but you'd probably be surprised at the "risk" options that get presented to patients. They try to offload as much of that as possible to remove themselves from liability. You want a blood transfusion, look at what you are signing up for (talk about risk acceptance). You want to go on the vent, that's another list of risk acceptance. Sorry, too jaded from personal experience to think that hospitals look at this stuff from an ethical perspective moreso than from liability perspective. I'm guessing the move is to stave off lawsuits should something go wrong. Fortunately, there are still good doctors out there that will help to challenge hospital policies or help you navigate through the scary liability stuff based on what they believe to be best for your patient (can't emphasize enough the value of finding doctors you trust).

You bend over backwards for organ donors...just ask the people that die every day from not having one available. Sorry we disagree on this, but one view provides for more lives being saved than the other does.

Go GATORS!
,WESGATORS

 

You know what else would increase the number of available donors? More people getting the vaccine. Why not push for that instead?

Trust me when I tell you, I have plenty of experience in this area. I was in my mid-20s making these calls for my family. At one point in time, I had family members in the hospital in 3 different cities in Florida in which I was the primary caretaker. Please don't assume that I don't have experience in this realm.

False negative rate on Covid tests falls to about 20%, and is considerably higher in recent infections:

False negative: How long does it take for coronavirus to become detectable by PCR?

Liability is not completely divorced from the ethics issues. Again, hospitals and doctors are tasked not to do harm. Fundamentally, this is a conservative ethical concern. The idea behind it is to error on the side of natural processes happening rather than engaging in activities to make the situation worse, on the margin. The cowboy doctors are all great until one of them goes off and kills somebody because they were too arrogant to think that it could happen under their care.

If they are willing to be put under, have a doctor remove an organ, and go through the entire prep and recovery to that, but won't take an incredibly low risk vaccine, they really need to examine how they got to that point. And doctors should prioritize their time towards patients that won't make them bend over backwards when that time is a scarce resource, as a transplant surgeon's time is valuable and shouldn't be wasted on trying to find workarounds for some idiot who has decided to undergo an incredibly invasive procedure but thinks that they know better than doctors because they read something on Facebook.

 

False dichotomy, but if you've followed my posts on here, I do encourage folks to get vaccinated. Especially if they are older and have any known risk factors.

And if the recipient is vaccinated? How does that affect things? I don't know enough about the specific risk in terms of COVID, but I do know that a proper risk assessment would allow for a non-vaccinated/uncertain COVID status kidney to either be given a shot or given a stay of, say, 14-21 days for reconsideration.

I don't agree with all of this. Financial liability is a STRONG force over ethics. I understand what you are saying on the "cowboy doctors" but I think that it's not binary also. The best doctors I know of sacrifice some level of liability for ethics. A subjective determination to be sure, but not every "cowboy move" is egregious even from a liability perspective.

I understand what you are saying, and I don't agree with the principle. Where I disagree is that sometimes exceptions are warranted. You can't maximize efficiency AND quality by following rigid principles. Sometimes discretion needs to be applied; sometimes discretion goes against the grain of standards.

Go GATORS!
,WESGATORS

 

You spend much more time making excuses for people not being vaccinated and fighting against the notion that they "should" get them or that not getting vaccines should have literally any negative consequences. Sorry, calling it like I see it here.

Which is a good reason why maybe you shouldn't be proposing solutions, since you don't know the specific risks. You know who likely does have some background in the specific risks? Groups like the Cleveland Clinic.

Financial liability is most often hand-in-hand with the ethics concerns. Again, it prevents somebody from skipping the first ethical step (do no harm) to get to the second of trying to prolong life. It makes doctors more conservative in their decision making, which, on average, is not a bad thing. Doctors are prone to the same biases towards action as many of the rest of us. They overrate their ability to control. And, thus, having a financial incentive to not do that is, on a whole, helpful. Which is not to say that there aren't exceptions, but, on average, I would rather be treated in a country with liability than without it.

Nowhere in any of those cases were there any instances that warranted an "exception." These were people claiming some kind of moral objection to a vaccine that went through the same procedure that every major religion has okayed and that every other vaccine, which I am 99.9% sure they have had, has gone through as well. It is all nonsense. There is not an even remotely rational process by which you decide that you care about somebody enough to give them an organ but can't possibly be expected to take a shot with an incredibly low probability of a poor outcome.

 

The fact there is risk either way is exactly why mandates are evil and wrong.

One of the big myths out there is that those who find mind more risk in taking one of these new drugs do not take the disease seriously. It is pure nonsense to imply that is the case.

 

I agree with the premise you are getting at. The problem here is there is just not enough long term data to know the answers. And to remove a person in that scenario is just wrong. But I agree different doctors/hospitals/etc will have different views in deciding who to give a transplant to.

It just irks me politics has moved its way into that decision. As this is more political than anything.

 

One of the Great Myths being perpetrated right now is that one values their body and life more than another because they take one of these new drugs.

Tribal politics are definitely a thing!

 

My argument is against mandates, not against vaccinations. In general, I take a "you do what you believe is best for your family, and let me do the same for mine" approach. And that angle is more important to me than the push for folks to get vaccinated. I know a scientist who studies infectious diseases; pro-vaccine. He, too, is anti-mandate and is also not vaccinating his adolescent child.

I could see why my view shows more strongly against mandates. But I've reached out to our local hospitals, local government and state government many times to try to encourage the release of more data that could help people be more informed.

I think we are both expressing opinions here (whether they have the data or are concerned about the unknown). I have experience in accepting unknown risks that the hospital can't or won't answer or own liability for. It's a much more empowering position to be in than to be refused the opportunity to own that risk.

A blanket refusal of non-vaccinated donors will have two effects: (1) it will encourage some potential donors to get vaccinated, and (2) it will discourage some potential donors from donating. (1) is a positive, (2) is a negative. I would guess you and I might have different ideas on success ratios when evaluating (1) vs. (2). But like I said, there's additional considerations that can be taken for a non-vaxxed donor that wouldn't be significantly excessive in my view. I understand the "just get vaccinated" frustration that will arise from this. I would imagine others can understand the "just take the donation" frustration just the same.

Go GATORS!
,WESGATORS

 

I want to emphasize again that, at least in FLORIDA, the other vaccine "requirements" have both opt-outs and exemptions. We rely on an information-based campaign of encouragement to promote these vaccines rather than a heavy-handed approach.

Go GATORS!
,WESGATORS