The Politics of Covid 19, mask wearing and the vaccination process

[LawBeefaroni]

A lot of those are enforced by law and carry civil penalties. In some states/cities.

For now.

When people can understand (and accept) that at a basic level, wearing a seat belt or handwashing before food handling is in the same vein as wearing a mask, maybe we'll be ok. Until then? We're spiraling.

I still cannot understand why hospital systems and/or national hospital, nurse,doctor, etc... organizations aren't speaking out against a lack of masking in communities nationwide. I would think at this point some of those folks are...tired. Maybe I'm missing something, but why aren't they pushing back? Why aren't they leaning on state and local leaders to enact public indoor masking?

Very tired. We have a mask requirement in all of our buildings and on property. It's exhausting enough enforcing in areas we control 100%. Trying to get people to wear masks everywhere else without government or private business or public support? Sure, we can manage that if we make it a full time job and quit caring for patients. Where do I send the bill?

Hospitals don't operate in a vacuum. The employees also exist in the communities they serve and so they're dealing with COVID while dealing with COVID.

Two more longtime, well-paid healthcare professionals that I have worked with left this week to find a different field. That's been about the average for a while know.

And after the shooting on the 4th, I can tell you that two of our hospitals have largely checked out to deal with it. They were at the parade with families and then got called in to handle the aftermath. Or went back to work on Tuesday to find coworkers trying to cope. Half of my meetings this week were cancelled and the most of the ones that weren't I was the only rep from our side.


I had to make an appointment with an ENT. Next available? December or drive to the suburbs in a month. I was able find a PA to do what I needed next week but that's where we are now as an industry. Understaffed and facing increasing demand. Trying to fight the public health fight on top of it? No thanks. We have doubled security just to deal with mask fights and the general insanity prevalent now.

[Smoove_B]

Thanks for the insight. I can't really say much as my own field has not only been silent (broadly) but actually engaging in capitulation to the general public. It's a giant circle - like the spider man meme where he's pointing to himself. In this case it's the general public, politicians and public health officials saying, "They don't want masks"; it's enraging.

Just based on the anecdotal info I'm seeing online, the BA.5 wave might be the one that completely sucker-punches the entire healthcare industry.

[LawBeefaroni]

The healthcare supply crisis is already here, people just don't know it until they need care. If the long term effects of COVID are even half of what is being predicted there's going to be a lot more dying.


Also not to be overlooked, social support services are at the breaking point as well.

[malchior]

Just based on the anecdotal info I'm seeing online, the BA.5 wave might be the one that completely sucker-punches the entire healthcare industry.

Even if it breaks things itll be like the airline industry. They'll blame it on many things except the virus.

[Max Peck]

Even before the BA.5 wave got underway here, there was a lot of reporting about how close to the breaking point the healthcare system here is, even without significant pressure from COVID. At this point, I think we're just hoping that since the BA.5 wave is happening now instead of in the fall, the tendency for people to socialize outdoors will somewhat blunt the impact. Then it's just a matter of waiting to see if BA.2.75 is going to outcompete BA.5 in fall/winter.

[Smoove_B]

The Fall was likely going to be a mess because of the lack of people that have been vaccinated + lack of people that have been boostered. Now it's just going to be worse because of whatever lingering issues remain after BA.5 washes over us all. Our systems have been stressed non-stop. Unlike the summer and early fall of 2021, we're magnitudes of order higher in terms of cases.

I know people keep saying we're going to just do it, but we cannot. There will be a point when there is collapse - when multiple systems start failing due to illness.

[Zaxxon]

I don't mean to alarm you, but not only will we keep doing it, but we'll continue doing so through and after the collapse.

[Smoove_B]

[Blackhawk]

My thought process has gone from "How to save society from collapsing" to "How to survive society collapsing (without being part of the problem.)"

[Smoove_B]

I'm trying to be realistic but also fully aware that I'm at an elevated risk for poor outcomes overall because of my BMI and existing arteriosclerosis. But no one gives a crap anymore about any of it so I'll continue to wear a mask and hope it significantly reduces whatever infectious dose I eventually inhale.

[Alefroth]

I haven't been paying much attention. Are other countries around the world disregarding it to the extent we are?

[Smoove_B]

For the most part, yes. Though random countries have started requiring masks again in specific locations (indoor shopping) or while doing certain things (public transportation).

But so many places that were ahead of the curve have seemingly given in to the pressures of "returning to normal" - I'm thinking specifically of Australia that just dropped their masking requirements ~3 weeks ago and things are going great for them.

I'll admit I'm not following it as closely as I had been either, but there seems to be insane pressure to pretend like everything is fine - likely related to financial concerns. I'd seen an article last week (two weeks ago?) about how Red states are financially recovering faster (financially) than Blue states and the reason is they've largely been operating like nothing is wrong. Whereas the Blue states had been restricting activities, restricting businesses and so those jobs (and the people) are now gone - moved on to other locations (relocated) or out of business.

Never mind that they did it and are doing it on the backs of the marginalized populations working in these positions (mostly service, hourly wages, etc...) without regard for their health or safety. We know that improving air quality would help tremendously but that would require the federal government to pass laws that require businesses update/upgrade/install air filtration devices and they sure as hell aren't going to spend precious profits on that.

I see it now - nothing else matters but money. It's driving all decisions.

[Smoove_B]

This article (and the associated animations) from New Zealand is so good!

The higher the CO2 readings, the more virus particles are potentially in the air. I became aware of every cough and sneeze. Feeling decidedly unsafe, I glared at a passenger who pulled down their mask to burp.

At 5737ppm, the equivalent of one in every seven breaths I took on the bus was air other people had breathed out. I texted a friend: "OMG, the readings are so high I may as well let the other passengers lick my face!"

I was being a little gross, because even according to a scientist, it is a little gross.

"You can think of it as spit particles, tiny spit particles are what you are breathing in," says University of Auckland aerosol chemist Dr Joel Rindelaub. "It's breath backwash that gets people infected."

He doesn't endorse passenger face-licking, but when CO2 inside the bus is 5737ppm he jokes, "it probably wouldn't even hurt, right?"

[Victoria Raverna]

Here in Indonesia (maybe just the capital Jakarta), people are still wearing masks in public including outdoor locations. I think the government doesn't require us to wear masks outdoor anymore but still people are wearing them.

Thing seem to get back to normal. Mall are crowded. Traffic is as bad as pre-COVID era, but everyone I met are masked.

[Smoove_B]

That would be the exact opposite of here. Americans are apparently largely influenced by crowd behavior and once enough people saw that others weren't wearing masks (~May of 2021), that was the end of that.

Unrelated, you can understand why people distrust pharma:

Not in any way discounting the effectiveness of paxlovid and the critical need to increase distribution, but creepy to see Pfizer executives salivating in an earnings call about how lifting public health measures will cause transmission to rise and increase demand for treatment

As societies abandon other efforts to control covid’s spread, such as mask mandates and physical distancing, Pfizer’s prospects look even brighter, especially now that the company has brought out the first oral covid treatment, Paxlovid.

“People are going to get out there,” Angela Hwang, president of Pfizer Biopharmaceuticals Group, told investors May 3. “We know with all of that, infections are going to increase, and that’s the role that Paxlovid can play.”

[LawBeefaroni]

Unrelated, you can understand why people distrust pharma:

Not in any way discounting the effectiveness of paxlovid and the critical need to increase distribution, but creepy to see Pfizer executives salivating in an earnings call about how lifting public health measures will cause transmission to rise and increase demand for treatment

As societies abandon other efforts to control covid’s spread, such as mask mandates and physical distancing, Pfizer’s prospects look even brighter, especially now that the company has brought out the first oral covid treatment, Paxlovid.

“People are going to get out there,” Angela Hwang, president of Pfizer Biopharmaceuticals Group, told investors May 3. “We know with all of that, infections are going to increase, and that’s the role that Paxlovid can play.”

This is pretty low on the "bad pharma" scale. People don't care and Pfizer recognizes that. And they're being transparent about it on an earnings call, which is public info.

[Smoove_B]

It is, but it feeds into the people still saying this is all a "plandemic" and that pharmaceutical companies are making money off it. They are...because people are stupid. If I could somehow convince the vaccine and mask holdouts that "big pharma" would lose if we all just got vaccinated and wore masks, maybe that would work?

[El Guapo]

It is, but it feeds into the people still saying this is all a "plandemic" and that pharmaceutical companies are making money off it. They are...because people are stupid. If I could somehow convince the vaccine and mask holdouts that "big pharma" would lose if we all just got vaccinated and wore masks, maybe that would work?

I get that, but if you're upset about what Pfizer is saying here then effectively you're upset not with Pfizer but with the fact that they are a private profit-making enterprise in the medical field. Which I mean, maybe we should have at least more socialized drug manufacturing, but we are where we are.

[noxiousdog]

Not only that, it's public info. The last thing you want is corporations hiding things.

[Alefroth]

I went into a Fedex store today and all of the 5 or 6 employees were masked up.

[Defiant]

But would this cause people to have to delay getting the next version when it comes out?

[Smoove_B]

Unknown.

It's a total clusterfuck at this point, once again doing things *months* after it should have already been initiated. Hadn't heard anything at all about any of this happening, which also tracks based on how information has been communicated from feds down to locals all along. Won't surprise me if there's a push for mask mandates again in August (after this current wave has already washed over everyone) that will then need to be yanked in September - long before the midterm elections happen and just as the Fall/Winter surge is starting.

I'll certainly be watching...

[Smoove_B]

White House briefing this morning has Fauci, Jha and Walenski finally speaking on the importance of wearing masks and improving ventilation with new strains circulating. Comments by Walensky about how masking is still recommended by the CDC on all public transportation and they're "still fighting" the lawsuit that removed the mandatory order to do so.

It was asked if boosters would be available to <50 but deferred to the FDA needing to approve it. The Covid team "discusses" it all the time but it's a regulatory decision that needs to go through the FDA and CDC. If only there was some influence over that process.

There's an order for ~105 million doses for the bivalent vaccine through Pfizer, but nothing else has been paid for or arranged. These bivalent vaccines will be available starting in October, but not all at once everywhere. That won't happen until November or December.

Still pushing people that have partial vaccinations (1 or 2) and haven't been received a booster to get additional shots - regardless of whether or not they've been infected (before or after original vaccination). No change in 4 month spacing between last vaccination and booster. Making sure to communicate that if you're eligible now for a booster (focused mainly on people aged 50+) it should be obtained - not to wait until the Fall because of the benefits in protecting against hospitalization and complications right now. And then to get bivalent vaccine in 4 months.

Fauci talking about how we should expect to see increased hospitalizations and ICU patients simply because of the number of people being exposed - which is exactly what we're seeing in NJ - both are trending up again. So while they're still lower than prior to the vaccines, the insane (my words) number of people being exposed and becoming ill is going to increase the proportion of people needing medical care. I wonder what we could do to try and address that? I guess we'll never know.

Some talk about vaccination options - like the nasal spray, but nothing new to share -- still doing studies.

Information about Long Covid will be published by the feds in August, based on request made by President back in March.

Overall the update was weird. They were clearly expressing concern for the current BA.5 surge but then also saying they're doing a great job of managing things so far because "we have the science" that tells us what to do.

[Zaxxon]

Overall the update was weird. They were clearly expressing concern for the current BA.5 surge but then also saying they're doing a great job of managing things so far because "we have the science" that tells us what to do.

It's almost like there's politics involved.

[YellowKing]

Yeah I've been sitting around waiting for < 50 boosters for awhile now. It's been ages since the last booster, and in the meantime I got Covid a couple of months ago so yay.

I was hoping by now we'd have a regular cadence established. Instead every week there's a new variant, nobody knows what age should get what, total clusterfuck.

[stessier]

It was asked if boosters would be available to <50 but deferred to the FDA needing to approve it. The Covid team "discusses" it all the time but it's a regulatory decision that needs to go through the FDA and CDC. If only there was some influence over that process.

I'm actually happy if they don't influence that process. Sure, I mostly trust the current guys, but if they can influence it, so can the bad guys.

[Smoove_B]

"Influence" with respect to have the FDA/CDC stake an official position by a specific date based on review of data and current trends. Right now they're not considering it at all - it's not something being proposed or evaluated. The White House committee is sitting around and saying, "Yeah, they should look at that, might be important..." and then nothing happens.

[stessier]

"Influence" with respect to have the FDA/CDC stake an official position by a specific date based on review of data and current trends. Right now they're not considering it at all - it's not something being proposed or evaluated. The White House committee is sitting around and saying, "Yeah, they should look at that, might be important..." and then nothing happens.

Ah, I thought it was being considered and just taking longer than ideal. My bad.

[Smoove_B]

I think they're trying to grapple with making the recommendation that <50 should be getting more vaccinations with knowing they've already been throwing out doses and won't have enough for potential demand moving forward (because the GOP put a stranglehold on funding).

But thankfully everyone under 50 has the science to keep us safe.

[malchior]

FWIW the FDA just looks like a complete s-show. This vaccine stuff with the government spiderman pointing at each other, the monkeypox vaccine screw up (I should spoiler it because it made me want to scream), or the mishandling of the baby formula situation really leaves me scratching my head. The Democrats were supposed to be the competent administrators solving GOP foul ups. At least that was the conventional wisdom. Are things this dire that even the 'adults' can't get things right? If so, it just adds another layer of despair for me.

[Zaxxon]

Smoove--any time you're in town, my liquor cabinet is open.

[Smoove_B]

At some point there might need to be a national liquor consumption tour, yes.

As bad as the COVID-19 response has been, the Monkey Pox response actually has me more concerned. The reason is that we knew what to do for Monkey Pox - classic public health approach and prevention (vaccines) were available. We knew what groups were at highest risk and how to reach them.

And yet, cases are growing. I don't know if my peers up and down the line are feeling as demoralized over the general status of our field over the last two years as I am, if key people in positions of authority have left and there's brain drain or there's administrative/leadership gaps but this really should have been a textbook response and we're flailing. It really does not bode well for anything else that might be unfolding in the near future.

[Smoove_B]

So they talked about the importance of masks during the briefing this morning, but I guess they know where 95% of Americans will get their information and that I'm part of a wacky handful that actually watched the Q&A live.

We know how to protect against #COVID19 variants.
Stay up to date on vaccines
Stay home if sick
Ask if you are eligible for antivirals if infected
Know your community level & precautions needed

Find your community level:

[Isgrimnur]

At some point there might need to be a national liquor consumption tour, yes.

I'd offer the same, but I have no reason to recommend that you come to Texas.

[Smoove_B]

Alternatively, someone from my state is suggesting you relocate here.

[Isgrimnur]

Alternatively, someone from my state is suggesting you relocate here.

First, in New Jersey you will find a state that unequivocally stands on the side of trusting all of our residents with control of their bodies on the most personal of decisions.

But will they trust me with 16 bullets in a magazine?

[Smoove_B]

I won't kinkshame if you need a body-insertable magazine that holds 16 bullets , but I will humbly suggest you be careful no matter where you live.

Also, I'm a little surprised he didn't mention the recreational weed.

[Isgrimnur]

I don’t need it, but I have yet to see a compelling argument that makes a 16 round magazine a crime when 15 is just peachy.

But that’s a different thread.

[Zarathud]

I am starting to see people move from their Red States (Ohio and Wisconsin) to Chicago. It would be nice to stop shipping clients out to Florida.

[Smoove_B]

Fair!

In on-topic news, indoor mask mandates likely returning to LA County:

The county is already in the “medium” COVID level as defined by the U.S. Centers for Disease Control and Prevention, based on the elevated rate of people being infected with the virus. If the county’s rate of daily COVID- positive patients being admitted to area hospitals tops 10 per 100,000 residents, it will enter the “high” category.

As of Tuesday, that rate was at 8.8 per 100,000 residents.

Public Health Director Barbara Ferrer, echoing projections she gave last week, told the Board of Supervisors Tuesday that she expects the county to enter the “high” activity category within days.

“Given the continued increase, we do anticipate by this Thursday the county will move into that high level,” Ferrer said.

If the county remains in the “high” category for two consecutive weeks, a mandatory indoor mask-wearing mandate will be imposed, she said. Under the current pace, that mandate will take effect by July 29.

Not sure why it takes so long, but at least they're doing something - and it's data based. My state is at ~11/100K (and rising), but there are some counties where it's already ~20/100K.