COVID Developments and News

[Atmo]

Originally Posted by Lantanafrs2

In the unwoke evil empire of Florida, covid cases are beginning to decrease as are hospitalizations. Hopefully the delta surge doesn't migrate to the north. Too many people doing the right thing up there

I read that the 20% decline in hospitalizations may be due to using officially recommended monoclonal antibodies.

Except the Feds decided to get involved because DeSantis so we'll need to wait for Kimmel's opinion to see where this goes.

https://pjmedia.com/uncategorized/st...s-now-n1476240

[Irace86.2.0]

Originally Posted by Atmo

I wonder if "everyone" hears it? This comes full circle to a post I made about the AIDS epidemic that's killed more people worldwide over time than COVID, and the CDC says that about two-thirds of the US deaths are directly attributable to known risky behavior among men. Would an HIV positive patient get any grief? Of course not, nor should they, nor should they or others lose any civil liberties by questionable emergency decrees that don't seem to be working as planned to lessen COVID infections, vaccinated or not, like Israel is seeing currently.

Well, in the US, developing AIDS from HIV is not definite. In fact, most people with HIV take medications that lower their viral loads so much that they no longer show up positive on HIV tests, nor are they capable of transmitting it to a sexual partner. Typically people who die of AIDS secondary to HIV infection are IV drug users who repeatedly expose themselves and/or are non-compliant patients. These patients do get the lecture about being non-compliant and about exposing others. Their illness is reported to public health, and they may contact others who may have been exposed and also lecture the patient who is non-compliant.

While HIV is bad, and while HIV is not always something that is avoidable, this pandemic is on a totally different level. Since 1981, so 40 years, 700k people have died of HIV in the US, and we currently have seen 650k deaths from COVID in less than 2 years. That is 35k deaths a year from AIDS related to HIV and that is mostly due to non-compliance. That 35k a year doesn't overwhelm our hospital system, but what is similar is that the vast majority of HIV patients in the US that are suffering from AIDS are non-compliant patients just like these non-compliant, unvaccinated patients, so there is some similarity.

Unfortunately, some areas are being forced. They aren't turning away unvaccinated patients, but now they are not showing up to all 911 calls, they are rationing care, they are running codes/resuscitations shorter than normal, they are calling deaths on scene instead of transporting to the hospital, they have limited family access, they are turning away those that need elective surgeries, etc. These things that were mentioned in the article above and that we have seen in many parts of the world are directly affecting these unvaccinated COVID patients, but they also are affecting others when the unvaccinated COVID patients overwhelm the health system. Someone's daughter with cancer has to deal with that. Someone's father who needed a valve replacement and died has to deal with that. Someone's demented grandmother who accidentally overdosed on her pain meds instead of taking her other pills may have just died. Maybe the young man with the appendicitis can't get a ride to the hospital in an ambulance, so he chances it and passes out from the pain in the car and gets into a crash. I could go on.

People are frustrated with the unvaccinated for good reasons. Again, they shouldn't be avoiding the hospitals if they need care, but they should consider the impact they are having on the hospital system.

Just so it is clear, even the hospitals that are not overwhelmed are hurting. We have lost over forty nurses just in the ER to retirement, COVID fatigue, other hospitals, etc. We are constantly short. We lost four people in the lab just in the last two weeks. Most days, they don't have the capacity to send a phlebotomist to the ER/waiting room for draws. Our central supply staff has half a dozen new staff
because of turnover and attrition. Our supply chains are still strained. Last week we didn't have blood pressure cuffs in standard adult sizes, but sometimes it is pigtails or start kits or meds or whatever. Our supplies change each week to different vendors with equipment that sometimes explicitly says, "not for medical use", and again, we are not nearly as bad as some of these areas. We have recently hired travelers and have a $10k hiring bonus for new nurses. They are giving bonuses and incentive pay for just showing up to our shift just to try and get bodies into the hospital. I could go on and on. These are things every industry is dealing with, as it relates to staffing and supplies, but the difference is when it is the hospital, people get hurt, live in pain, get debilitated or die. It's different. Outside of law enforcement or some other examples, it is different, and the remedy is simply getting the vaccine.

[Irace86.2.0]

Originally Posted by Atmo

I read that the 20% decline in hospitalizations may be due to using officially recommended monoclonal antibodies.

Except the Feds decided to get involved because DeSantis so we'll need to wait for Kimmel's opinion to see where this goes.

https://pjmedia.com/uncategorized/st...s-now-n1476240

The feds were always involved, and if supplies are limited then each state will get a proportional amount of supplies based on their population size and their current needs.

https://www.phe.gov/emergency/events...x-Playbook.pdf

[Atmo]

Originally Posted by Irace86.2.0

Well, in the US...

The CDC says 65% of new HIV diagnoses in the US during 2019 were from male-on-male sexual contact. 7% was injection drug use. Maybe that's changed.

I'm really concerned about what will happen in my and other states forcing vaccinations that's causing some front line health care professionals to instead retire or resign.

[Atmo]

Originally Posted by Irace86.2.0

The feds were always involved, and if supplies are limited then each state will get a proportional amount of supplies based on their population size and their current needs.

https://www.phe.gov/emergency/events...x-Playbook.pdf

Five days ago the ordering process was updated with new requirements limiting distribution to HHSProtect accounts after review of all orders. Any new layer of bureaucracy tends to slow things down and delivery of mAb's is time sensitive.

https://www.phe.gov/emergency/events...3Sept2021.aspx

[weederr33]

Originally Posted by Atmo

The CDC says 65% of new HIV diagnoses in the US during 2019 were from male-on-male sexual contact. 7% was injection drug use. Maybe that's changed.

I'm really concerned about what will happen in my and other states forcing vaccinations that's causing some front line health care professionals to instead retire or resign.

Let them resign then.

[MuseChaser]

Originally Posted by weederr33

Let them resign then.

Because they're not needed? Because there are lots of people in line waiting to take their place? Because being able to provide fully-staffed health care is not important?

From our local news site, today...

https://www.syracuse.com/coronavirus...kers-warn.html

Additionally concerning, at least to me, is that they don't even make allowances for religious reasons, which seems to be at least part of most other mandates I've seen.

[Irace86.2.0]

Originally Posted by Atmo

The CDC says 65% of new HIV diagnoses in the US during 2019 were from male-on-male sexual contact. 7% was injection drug use. Maybe that's changed.

I'm really concerned about what will happen in my and other states forcing vaccinations that's causing some front line health care professionals to instead retire or resign.

We were talking about deaths from HIV associated AIDS, and I said deaths are mainly associated with non-compliance because medications exist that basically "cure" people of HIV in the sense that the virus is not detectable or the virus is not communicable. You are confusing HIV infection (new diagnosis) demographics with death demographics. The two aren't necessarily the same or proportional. Deaths are mostly from non-compliance, which mostly comes from drug users or people with socioeconomic situations that make it hard for them to get medications. Most people who die of HIV associated AIDS, are addicts, or are homeless-types and non-compliant by personal choice, or they are homeless-types with mental health issues that make it hard for them to be organized enough to seek out and take their HIV meds.

The majority of people with HIV don't develop AIDS, and they live a long life, and to the point, they are not a burden on the healthcare system like unvaccinated patients are by any means, so again, the two aren't comparable. We rarely see HIV positive patients in the ER, and in the last 10-15 years, I haven't seen a patient that was in the ER because they had AIDS. I had one guy one time who was methed out pacing in the room, and I asked why he was here, and he said he has HIV, and I said, "yeah, but why are you here?" and he said in frustration, "I'll just wait for the nurse. Leave." The nurse walked in and asked, "what brings you in today?" and he said, "I have HIV," and she said, "But why are you here today." He left in frustration, but he didn't really have a complaint, and outside of maybe a few dozen over the years that we knew were HIV positive or virally negative, no patient was there for AIDS complications.

https://www.cdc.gov/nchhstp/newsroom...s-release.html

As far as healthcare workers quitting over the vaccine, I know of no one at my hospital. A few have threatened it, or they have threatened to use all their PTO, which that hasn't been approved, but they haven't done that, nor do I expect them to do that. I could imagine someone close to retirement wanting to retire early, but I don't know of any. We have lost more nursing to early retirement because of the pandemic, or who have voluntarily left the workforce with plans to return after the pandemic ends. I do know of several unvaccinated workers who have since gotten the vaccine. One said she would just do the J&J vaccine because she doesn't want to have to do two shots. Others have caved from the Delta variant or from the vaccine mandates.

[Irace86.2.0]

Originally Posted by Atmo

Five days ago the ordering process was updated with new requirements limiting distribution to HHSProtect accounts after review of all orders. Any new layer of bureaucracy tends to slow things down and delivery of mAb's is time sensitive.

https://www.phe.gov/emergency/events...3Sept2021.aspx

What sounds unreasonable about that? Sounds like they may have concerns about allocations going to people who don't qualify for these infusions, which should only be for high risk groups, so utilization concerns. They probably wouldn't care that much if the treatment wasn't in short supply.

[Atmo]

Originally Posted by Irace86.2.0

What sounds unreasonable about that? Sounds like they may have concerns about allocations going to people who don't qualify for these infusions, which should only be for high risk groups, so utilization concerns. They probably wouldn't care that much if the treatment wasn't in short supply.

In the small treatment window available (10 days the article said), time is everything. Since every request must be vetted, any treatment for all groups will be delayed.

[Atmo]

Originally Posted by Irace86.2.0

As far as healthcare workers quitting over the vaccine, I know of no one at my hospital.

Does your state mandate vaccinations? That's what the problem is in OR and WA. It's a binary choice for those affected, get vaxxed or you're fired. That's why some who are eligible are cashing out with early retirement, the others are left to fend for themselves.

[Irace86.2.0]

Originally Posted by MuseChaser

Because they're not needed? Because there are lots of people in line waiting to take their place? Because being able to provide fully-staffed health care is not important?

From our local news site, today...

https://www.syracuse.com/coronavirus...kers-warn.html

Additionally concerning, at least to me, is that they don't even make allowances for religious reasons, which seems to be at least part of most other mandates I've seen.

I thought there was a mandate to get the vaccine by a certain date in California, and maybe until then people need to do the two COVID tests per week. There might be exemptions for religious reasons with just doing two swabs a week, and I know people are doing these swabs. Most are openly defiant and stubborn about the situation--martyrs to the end.

People seem to be using a religious excuse when all they have is a political excuse. Several coworkers have stated matter of fact that they have used the religious excuse despite the fact that they are Catholic, for instance, and the pope has been vaccinated. We ask each and every patient if they have religious beliefs that will impact their care, and very, very rarely do people say yes. Everyone who currently is employed in healthcare has vaccinations because it is already required. Many places of work don't allow exemptions for even the seasonal flu shot, let alone Hepatitis or other vaccines. Everyone in healthcare has to get a blood test or two-part PPD test for TB each year, so this is allllllllllll political.

[wbradley]

If someone declines vaccination and is allowed to work (at someone's additional expense) on condition of providing a negative PCR twice weekly, it must be specified only through nasal swab. Personally, I can't tolerate another swab 3" up my nose. I didn't spend my youth snorting whatever, the passages don't tolerate deep probing. But someone who is so opposed to this one vaccination, despite probably already having been vaccinated several times from childhood onward, they can handle their frontal lobe and a Q tip kissing cotton.

[Irace86.2.0]

Originally Posted by Atmo

In the small treatment window available (10 days the article said), time is everything. Since every request must be vetted, any treatment for all groups will be delayed.

Delays will also exist if the product runs out, and effectiveness also goes down if the treatments aren't going to high risk groups. If there are abuses in the system then it has to be met. What type of delay are we even talking about? Minutes, hours, days, or is this just an assumption that a significant delay will exist?

Originally Posted by Atmo

Does your state mandate vaccinations? That's what the problem is in OR and WA. It's a binary choice, get vaxxed or you're fired. That's why some who are eligible are cashing out with early retirement, the others are left to fend for themselves.

Frankly, like I said above, the religious nonsense is nonsense. I plan to go into work and say wearing a mask and using gloves and washing my hands are all against my religion. They would say, if your religion precludes you from being able to maintain infection control standards then find another career. I don't see the case for special treatment. I don't think COVID is going away, so we may expect future vaccines as a standard in hospitals for employment like we do other vaccines and annual testings, so these people need to leave or get the shot.

Individual states can figure out their needs. Some areas of the country had nurses who were positive with active COVID come to work because they were desperate for able bodies, so if that is the case then they can choose to suspend the mandates, but the mandates are coming eventually.

2. Workers may be exempt from the vaccination requirements under section (1) only upon providing the operator of the facility a declination form, signed by the individual stating either of the following: (1) the worker is declining vaccination based on Religious Beliefs, or (2) the worker is excused from receiving any COVID-19 vaccine due to Qualifying Medical Reasons.

a. To be eligible for a Qualified Medical Reasons exemption the worker must also provide to their employer a written statement signed by a physician, nurse practitioner, or other licensed medical professional practicing under the license of a physician stating that the individual qualifies for the exemption (but the statement should not describe the underlying medical condition or disability) and indicating the probable duration of the worker’s inability to receive the vaccine (or if the duration is unknown or permanent, so indicate).

https://www.cdph.ca.gov/Programs/CID...quirement.aspx

https://californiahealthline.org/new...cine-mandates/