Corona Virus: It's a Marathon, Not a Sprint

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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by Smoove_B »

An interesting update from Doctor Topol:
All indications from genomic surveillance of the virus, wastewater. and the clinical outcomes that are still being tracked (albeit more limited and less periodicity as time goes on), that we’ve (finally) entered an endemic phase. There are no new SARS-CoV-2 variants that have yet cropped up with a growth advantage over XBB.1.5 (the recombinant with 2 significant mutations added on) which is dominant throughout much of the world, or its cousin, XBB.1.9.1. For all the talk about the convergent “variant soup” that preceded the most recent wave, the XBBs took hold and are not giving way to a long list of Omicron family sub-variants (Table below). Moreover, the XBB.1.5 variant ascent to dominance was not associated with a surge of Covid hospitalizations or deaths in the United States or elsewhere in the world, which might have been predicted based on its properties of enhanced transmissibility and immune evasiveness compared with earlier versions of Omicron.
With that out of the way, the bad news:
First, we sit at a very high baseline of daily Covid hospitalizations and deaths in the United States, over 25,000 and about 400, respectively. This is far beyond (double) where we were in June 2021, pre-Delta, when we got down to close to 10,000 hospitalizations and ~200 deaths per day. There’s still circulating virus (currently XBB.1.5) getting people infected and some of the folks of advanced age and immunocompromised are the ones chiefly winding up with severe Covid. The virus is finding the vulnerable people more easily since their guard is let down, abandoning high-quality masks and other mitigations, and the low rate of keeping up with boosters in the last 6 months (the age 65+ rate is 40%).
Then some (reasoned) speculation:
That brings me to the second concern, which is considerably more important. That we will or might see on “Omicron event.” This likely occurred from the hyper-accelerated evolution of the virus within an immunocompromised host that was then transmitted.

...

When 10 scientists who are following the pandemic and the virus evolution closely (including me) were recently asked what are the odds of another Omicron event in the next 2 years, the range was 5-30%, with no one thinking it is zero, and good convergence at the 10-20% level (unpublished data). And that’s in the 2-year window. SARS-CoV-2 will be with us for many years, so over time that likelihood forecast for a Pi new family of variants (and beyond Pi) increases. There are too many routes for us seeing a Pi family of variants as shown in the graphic below. That is why we must prioritize development and validation of next generation vaccines that can achieve variant-proof protection (e.g. against all betacoronaviruses) and have improved defenses against infection that can be accomplished via mucosal immunity with oral or nasal vaccines.
So it would seem we've entered a new phase...

But he does end with some better news potentially regarding Long Covid:
Until now the only way we knew that Long Covid could be prevented was to not get Covid. That’s still the case. But a new randomized, placebo-controlled trial of metformin has yielded exciting results—the first drug to be shown to help prevent Long Covid.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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COVID survivors at increased risk of long-term gastrointestinal conditions
Surviving a bout of COVID-19 can significantly increase the risk of developing a range of long-term gastrointestinal symptoms and conditions—from constipation and diarrhea to chronic acid reflux, pancreatitis, and inflammation of the bile ducts—according to a study published this week in Nature Communications.

The study likely confirms what many long COVID patients already know all too well. But the analysis is among the largest and most comprehensive to evaluate the boost in relative and absolute risks, drawing on medical records from more than 11,652,484 people in the Department of Veterans Affairs databases.

The study was led by clinical epidemiologist Ziyad Al-Aly at the VA Saint Louis Health Care System in Saint Louis. With colleagues, Al-Aly examined medical records of over 154,000 people who had COVID-19 between March 2020 and January 2021. The researchers then compared the COVID survivors' rates of gastrointestinal problems in the year after their infection to the rates seen in two control cohorts. One was a contemporary cohort of over 5.6 million people who went from March 2020 to January 2021 without any evidence of a COVID-19 infection. The other was of 5.8 million people who were tracked for a year before the pandemic, which served as a control for unreported COVID-19 cases in the contemporary cohort.

The researchers found increased relative risks and absolute risk—in the form of the excess burden of disease per 1,000 people—for a range of pre-identified gastrointestinal conditions and symptoms. Compared to the control groups, COVID-19 survivors had more constipation, diarrhea, abdominal pain, vomiting, and bloating in the year after their infection.
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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by GreenGoo »

When my wife had covid, she had major brain fog that lasted for weeks if not months. It impacted her short term memory so greatly that she had to take time off work as a nurse, because she couldn't remember important things such as whether she had already given proscribed medicine etc.

Sure she could have tattoo'd all those things onto her body, but she went into rehab (seriously, brain/memory rehab) instead.

She seems to have fully recovered now though.
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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by Isgrimnur »

GreenGoo wrote: Thu Mar 09, 2023 11:29 am whether she had already given proscribed medicine
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Why is it every time a new revelation for Long COVID comes about, it describes my existing Chronic conditions? I had never connected my GI/inflamation problems to my fatigue and very very long Mono/presumptive Epstein Barr, other than it contributing to my being overweight.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Typo my dude.

But I do always have to pause before I say prescription/subscription.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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No worries. :D
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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by Max Peck »

This is the way the dashboard ends, not with a bang but a whimper.

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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by Smoove_B »

In case you're wondering how far the goal posts are moving, the latest from Dr. Leana Wen:


"We might come to expect some frequency of post-covid symptoms, and the resulting disability, as a “new normal.” In that case, health resources must shift from avoiding the coronavirus to reducing and treating its worst consequences-including long covid."
Just like we do with all chronic illnesses. Forget prevention, let's just focus all of our resources on treating everyone suffering....from the condition we're doing nothing to prevent.

I cannot believe this is being printed in national news media. It's a new low.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Smoove_B wrote: Sun Mar 19, 2023 10:09 am Just like we do with all chronic illnesses. Forget prevention, let's just focus all of our resources on treating everyone suffering....
... until such a time as we can ignore them completely or modify an existing cheap maintenance treatment that we can patent and sell as an expensive maintenance treatment.

No. I'm not a jaded fuck. Why do you ask?
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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by Smoove_B »

LordMortis wrote: Sun Mar 19, 2023 10:45 am No. I'm not a jaded fuck. Why do you ask?
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Smoove_B wrote: Sun Mar 19, 2023 10:09 am In case you're wondering how far the goal posts are moving, the latest from Dr. Leana Wen:
"We might come to expect some frequency of post-covid symptoms, and the resulting disability, as a “new normal.” In that case, health resources must shift from avoiding the coronavirus to reducing and treating its worst consequences-including long covid."
Just like we do with all chronic illnesses. Forget prevention, let's just focus all of our resources on treating everyone suffering....from the condition we're doing nothing to prevent.

I cannot believe this is being printed in national news media. It's a new low.
The thing is, from a certain perspective, she's right.

Regardless of whether you, or I, or many experts think it should be, large-scale prevention is over. That particular ship has sailed, and there is nothing short of bodies lying in the street that will get people to go back to it. It's done. Finished.

And if we're no longer avoiding the damage, the best choice we have left is to mitigate it.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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I was gonna say it, but didn't want to be that guy yet again.
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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by Smoove_B »

Blackhawk wrote: Sun Mar 19, 2023 11:36 am The thing is, from a certain perspective, she's right.
Yeah, the perspective where an entire field of study doesn't exist. I'm beginning to think that's the point - where this is all headed.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Smoove_B wrote: Sun Mar 19, 2023 11:49 am
Blackhawk wrote: Sun Mar 19, 2023 11:36 am The thing is, from a certain perspective, she's right.
Yeah, the perspective where an entire field of study doesn't exist. I'm beginning to think that's the point - where this is all headed.
Or from the perspective where a society has chosen to act as if an entire field of study doesn't exist. Once we (collectively) stepped over that line, the options changed.

Do you honestly think that the country (by which I mean the masses, the business leaders, and the politicians) are going to accept any form of prevention beyond vaccination?

If the answer is no, what should health care do?
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Re: Corona Virus: It's a Marathon, Not a Sprint

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I don't really think I can state it better than has been provided here:
As the truth becomes harder to refute, minimizers will shift from denying the harms of allowing unchecked COVID spread, to saying there’s nothing we can do to stop it.

This is the exact thing that happened with climate. Climate deniers shifted to saying there’s nothing we can do to stop climate change when they realized there was too much evidence to plausibly deny climate science outright. The same is happening with COVID and #LongCOVID.

When COVID minimizers say “we can’t stop it, so let’s give up on prevention & focus on treatments,” please understand that they won’t actually fight for treatments. Their goal is to end all public health protections, but they are trying to disguise it in a more palatable message.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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It's almost as if people are the problem.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Are you suggesting that I (and those of us who have taken similar positions) are COVID minimizers? I've argued and pushed for prevention as hard as anyone here (save a couple.)

I'm saying that the mass prevention plan has failed (due to apathy and politics) and we have effectively been blocked from trying it again.

Quoting myself:

Do you honestly think that the country (by which I mean the masses, the business leaders, and the politicians) are going to accept any form of prevention beyond vaccination?

If the answer is no, what should health care do?

Not in an ideal world, but with the reality that we are facing?
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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by Smoove_B »

No, you're not a Covid minimizer. Leana Wen (and the numerous other clowns I've shared here in the last 2+ years) are the minimizers. My frustrations aren't aimed at anyone here or anyone I know. I realize the world has moved on. As was pointed out to me, I'm like the Japanese solider that was found hiding in Guam in 1972, still fighting WW2.
Blackhawk wrote: Sun Mar 19, 2023 1:28 pmIf the answer is no, what should health care do?
They're not going to do anything other than deal with a new constant baseline level of people with Covid in the hospital, plus whatever number of people that have medical issues associated with Long Covid.

Apparently Covid hit the bullseye for killing just enough people (and maybe just enough of the right people) that it's no longer a problem we should be worried about anymore.

In closing, the current leading causes of death in the United States (by the numbers):
Heart disease: 695,547
Cancer: 605,213
COVID-19: 416,893
Accidents (unintentional injuries): 224,935
Heart disease and cancers represent hundreds of different conditions - collectively #1 and #2. Covid is sitting firm at #3 - death caused by a single virus; it is the only communicable disease in the top 10.

This is why I'm saying I'm finished. If we can't collectively agree that this is concerning (because people like Wen are shouting it's NBD from the rooftops), then really, what the hell am I doing anymore? Fuck it.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Most of them know it is a problem and most of them know the scale of the problem. They have just decided that it benefits them more to conceal that and push people to another path.

Once we get beyond the masses, we're not arguing against ignorance. We're arguing against greed and self-interest. And the sad truth is that people who prioritize greed and self-interest are the people most likely to have the power to influence others.
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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by LordMortis »

Smoove_B wrote: Sun Mar 19, 2023 1:16 pm I don't really think I can state it better than has been provided here:
As the truth becomes harder to refute, minimizers will shift from denying the harms of allowing unchecked COVID spread, to saying there’s nothing we can do to stop it.

This is the exact thing that happened with climate. Climate deniers shifted to saying there’s nothing we can do to stop climate change when they realized there was too much evidence to plausibly deny climate science outright. The same is happening with COVID and #LongCOVID.

When COVID minimizers say “we can’t stop it, so let’s give up on prevention & focus on treatments,” please understand that they won’t actually fight for treatments. Their goal is to end all public health protections, but they are trying to disguise it in a more palatable message.
Boy I learned that line in the last 15 or 20 years. It's like, for instance, increased taxes on the wealthy, repeal and replace once the ACA got pushed through which was never supposed to get pushed through, or gun violence (and in schools no less), teen pregnancy, food insecurity, and on and on and on. Once we concede that our denial of a problem is full of shit, then we insist that we only pretend to care and that we can and should do absolutely nothing. Thoughts an prayers.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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There is a difference between wanting to do nothing and pursuing a futile plan.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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People want to do nothing because they've been told it's futile.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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People want to do nothing because they didn’t die yet and doing something for others is inconvenient. We might have accepted protections to save ourselves.

But apparently too many don’t care enough to help themselves so helping others is right out — especially because the burden falls on the old, infirm, poor and ethnic. We’re not Christian enough to help those people.

Sad.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Captain's Log: March 1114, 2020

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Re: Corona Virus: It's a Marathon, Not a Sprint

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Smoove_B wrote: Sun Mar 19, 2023 2:15 pm People want to do nothing because they've been told it's futile.
Yes, but they were told this in 2020. Trump shouted it from his pulpit and made it a point of pride and a loyalty test.

It isn't a new message. The 'official' message didn't change until that particular battle had already been lost.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Blackhawk wrote: Sun Mar 19, 2023 1:12 pm Or from the perspective where a society has chosen to act as if an entire field of study doesn't exist.
What's the difference?
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Re: Corona Virus: It's a Marathon, Not a Sprint

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GreenGoo wrote: Mon Mar 20, 2023 9:17 am
Blackhawk wrote: Sun Mar 19, 2023 1:12 pm Or from the perspective where a society has chosen to act as if an entire field of study doesn't exist.
What's the difference?
On a practical level? None.

Within the context of the discussion? Whether I'm personally forgetting about the experts when making my point, or whether it is the nebulous 'them' that is ignoring the experts. The experts are getting slapped upside the face either way, but it's not me doing the slapping. And when I'm replying to one of said experts, that's a clarification I want to make.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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My company announced they were officially throwing in the towel. They will follow all local laws in cases of conflict, but otherwise they are treating this as any other respiratory virus. They encourage mask usage if you are sick and you have to stay home if you have a fever, but otherwise there is no tracking or isolation period for COVID.

Not that people have been wearing masks, but it was nice to know if someone tested positive that they were out of work for a week (and came back wearing a mask until 10 days after they were first positive). Now even that's gone.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Twice-weekly local testing for COVID variants to end, scientist says
Rapid testing for COVID-19 variants in Ottawa's wastewater will cease at the end of March, a scientist involved in the work says.

Tyson Graber, an associate scientist with the CHEO Research Institute, recently said on social media and in an email to CBC that while the institute will continue to monitor the wastewater, a "faster and cheaper" method detecting variants of concern (VOC) — in which the lab takes samples twice a week and reports the results weekly — will end this month.

By comparison, other labs in Waterloo, Guelph and London have generally sampled and reported on results every two weeks, he said.

"Identifying emerging [variants of concern] and estimating growth of a VOC in a community is more difficult at this low frequency," he said via email.

Ontario's Ministry of the Environment, Conservation and Parks told the institute earlier this year funding for the faster testing would run out this month, he added.

When reached for comment on Friday afternoon, the ministry said it would provide a response on Monday.
From a public awareness perspective, they've already weaned us off knowning what variants are in circulation locally. They haven't updated the variants-of-concern information on their website since July 2022. There is some regional/local VoC data available elsewhere, but it's difficult to find if you don't know where to look. Even then, it's not up to date -- the most recent provincial surveillance report (March 10, 2023) gives details covering Jan 29 through Feb 25, so you can at least see what was seen a month ago. Luckily things don't change quickly, I guess.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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Blackhawk wrote: Mon Mar 20, 2023 9:44 am The experts are getting slapped upside the face either way, but it's not me doing the slapping. And when I'm replying to one of said experts, that's a clarification I want to make.
When you acknowledge that the experts' opinions mean nothing because of other people and accept this as the status quo, you're absolutely slapping those experts in the face.

What practical difference does this make? Perhaps nothing. Perhaps morale support so Smoove doesn't drink himself to death.

Politics is almost completely out of any one individual's control. So why vote?

I guarantee that the presence or absence of masks is geographically influenced. There are still plenty of people masking up around the world, and even in the US. People care. Some don't. Most, in your area it sounds like. Arguing that no one (or not enough) care so why bother has the same practical effect as arguing against masks.

It's one thing to give up. It's another to express and rationalize that behaviour to others.

edit: well never mind then. I live in the same city as Max. :grund:
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Re: Corona Virus: It's a Marathon, Not a Sprint

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I forgot to post a link to my source for VoC info: Public Health Ontario. From there, I just filter down to Surveillance Reports and look at whatever is most recent.
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Re: Corona Virus: It's a Marathon, Not a Sprint

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GreenGoo wrote: Mon Mar 20, 2023 10:54 am
Blackhawk wrote: Mon Mar 20, 2023 9:44 am The experts are getting slapped upside the face either way, but it's not me doing the slapping. And when I'm replying to one of said experts, that's a clarification I want to make.
When you acknowledge that the experts' opinions mean nothing because of other people and accept this as the status quo, you're absolutely slapping those experts in the face.

What practical difference does this make? Perhaps nothing. Perhaps morale support so Smoove doesn't drink himself to death.

Politics is almost completely out of any one individual's control. So why vote?

I guarantee that the presence or absence of masks is geographically influenced. There are still plenty of people masking up around the world, and even in the US. People care. Some don't. Most, in your area it sounds like. Arguing that no one (or not enough) care so why bother has the same practical effect as arguing against masks.

It's one thing to give up. It's another to express and rationalize that behaviour to others.

edit: well never mind then. I live in the same city as Max. :grund:
You're reading a lot into what I said that wasn't there (or wasn't meant to be.)
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Re: Corona Virus: It's a Marathon, Not a Sprint

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stessier wrote: Mon Mar 20, 2023 10:05 am My company announced they were officially throwing in the towel. They will follow all local laws in cases of conflict, but otherwise they are treating this as any other respiratory virus. They encourage mask usage if you are sick and you have to stay home if you have a fever, but otherwise there is no tracking or isolation period for COVID.

Not that people have been wearing masks, but it was nice to know if someone tested positive that they were out of work for a week (and came back wearing a mask until 10 days after they were first positive). Now even that's gone.
Hospitals/health systems in the area just moved from "masks always everywhere" to masks only required in patient care areas.

Conference rooms, business/admin offices, staff rooms, etc are OK to mask optional.

This applies to transmission levels of "low, moderate, and substantial." Presumably above "substantial" guidance changes.
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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by RMC »

LawBeefaroni wrote: Mon Mar 20, 2023 12:24 pm
stessier wrote: Mon Mar 20, 2023 10:05 am My company announced they were officially throwing in the towel. They will follow all local laws in cases of conflict, but otherwise they are treating this as any other respiratory virus. They encourage mask usage if you are sick and you have to stay home if you have a fever, but otherwise there is no tracking or isolation period for COVID.

Not that people have been wearing masks, but it was nice to know if someone tested positive that they were out of work for a week (and came back wearing a mask until 10 days after they were first positive). Now even that's gone.
Hospitals/health systems in the area just moved from "masks always everywhere" to masks only required in patient care areas.

Conference rooms, business/admin offices, staff rooms, etc are OK to mask optional.

This applies to transmission levels of "low, moderate, and substantial." Presumably above "substantial" guidance changes.
Same with the healthcare system I work for. Really only required in patient facing areas.
Difficulties mastered are opportunities won. - Winston Churchill
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Smoove_B
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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by Smoove_B »

Not really sure what to make of this:
The magnitude and quality of a key immune cell’s response to vaccination with two doses of the Pfizer-BioNTech COVID-19 vaccine were considerably lower in people with prior SARS-CoV-2 infection compared to people without prior infection, a study has found. In addition, the level of this key immune cell that targets the SARS-CoV-2 spike protein was substantially lower in unvaccinated people with COVID-19 than in vaccinated people who had never been infected. Importantly, people who recover from SARS-CoV-2 infection and then get vaccinated are more protected than people who are unvaccinated. These findings, which suggest that the virus damages an important immune-cell response, were published today in the journal Immunity.

...

Taken together, the investigators write, these findings suggest that SARS-CoV-2 infection damages the CD8+ T cell response, an effect akin to that observed in earlier studies showing long-term damage to the immune system after infection with viruses such as hepatitis C or HIV. The new findings highlight the need to develop vaccination strategies to specifically boost antiviral CD8+ T cell responses in people previously infected with SARS-CoV-2, the researchers conclude.
This sounds...not great.
Maybe next year, maybe no go
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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by Smoove_B »

Summary of where we're at


It's our new reality. 100-200K direct COVID deaths per year and 200-300K total excess deaths per year when compared to prior 2020. This has been our steady state for over 10 months. Flu/Pneumonia COMBINED used to be 30-60K per year.
Maybe next year, maybe no go
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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by Smoove_B »

Every zombie movie was wrong:
Well, so much for trusting people to do the right thing. A research letter recently published in JAMA Network Open described how 24.0% of parents in the U.S. surveyed—that’s 63 of 263 respondents—failed to tell others when they either thought or knew that their child had Covid-19. Moreover, 21.1% (67 of 218 respondents) permitted their children to break quarantine or isolation rules. And take a wild guess as to the most commonly given reason for not doing such things to protect others around them. It’s a very freedom answer. They wanted to exercise their “personal freedom” as parents.
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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by Jaymon »

I know, I've said it before. But its still true. Humanity lost this one. Covid won. We all know the reasons why.

Sci-Fi talks about "great filters" that all sapient species must pass through on their journey to ascension. We are currently embroiled in three of them. Will we destroy ourselves with weapons of mass destruction. Will we render our planet unlivable through pollution. And, will we be wiped out through mass outbreak.

While Covid-19 may not be the one that gets us, the groundwork is laid. We has humanity have firmly cemented our opinions on freedom, vaccine, and science. Unless our collective direction changes and we form a consensus about pandemic response and personnel/world health, the next pandemic could kill us all.
Bunnies like beer because its made from hops.
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Re: Corona Virus: It's a Marathon, Not a Sprint

Post by Smoove_B »

Yup. I was just at a meeting this morning and we were talking about the future of the field. I was trying my best to be upbeat but at the end of the day, the writing is on the wall. Not only aren't we ready for the next pandemic, I'm no longer convinced we can ever be.
Maybe next year, maybe no go
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