Going back to this:
If it takes less to be contagious now, how valuable is a negative test result in terms of confirming (at least) a non-contagious status? @Mofro261, this is right in your wheelhouse, correct?
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I read high value to confirm that one is no longer infectious.
Extended school closings bad actually?
https://www.nytimes.com/2022/05/05/b...ning-loss.html
Also compounded by the fact that most legislators are rich and send their kids to private schools which mostly opened in fall 2020.
Quotes:
The Covid closures have reversed much of that progress, at least for now. Low-income students, as well as Black and Latino students, fell further behind over the past two years, relative to students who are high-income, white or Asian. “This will probably be the largest increase in educational inequity in a generation,” Thomas Kane, an author of the Harvard study, told me....
Together, these factors mean that school closures were what economists call a regressive policy, widening inequality by doing the most harm to groups that were already vulnerable...
Were many of these problems avoidable? The evidence suggests that they were. Extended school closures appear to have done much more harm than good, and many school administrators probably could have recognized as much by the fall of 2020.
In places where schools reopened that summer and fall, the spread of Covid was not noticeably worse than in places where schools remained closed. Schools also reopened in parts of Europe without seeming to spark outbreaks.
Update on reaction to double vax of Covid #4 and Shingrix #2 at same time
Shots were 1000 Tuesday
At about 2000 I started downhill, by 2200 I had all the major reactions.
Felt like shit all day yesterday but OK this AM.
Intensity of reaction was no worse than either Covid #3 or Shingrix #1 taken two mos apart.
Duration of reaction was shorter.
Covid is a "regressive policy" as well.
Pandemics have consequences, and like the consequences of anything, the vulnerable are hurt worse. Some covid policies will turn out to have been good, some mistaken, some ridiculous (closing parks, telling people not to leave the county or drive more than 30 miles). In retrospect. Authorities made the best judgements they could based on limited knowledge of a novel virus. For every potential policy, enacted or not, you could find experts for and against.
Good point.
Another good point.
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IDK, I see a lot of questioning about recent decisions by authorities. Like the whole “prevention” part of the CDCs title. The continual ramping down in surveillance and funding, the continually fucked up and confusing messaging, the lack of supporting science in supposedly science-based policy, the infighting about the definition of “aerosol” that stagnated policy and public re-education, etc.
A negative Ag after a positive /symptomatic infection is a good correlate to no longer transmissible. A negative without a pos or symptoms gives you a result for that time point only, and can miss pre-symptomatic or asym. early Infections during day 0-3.
Was sneezing a bit yesterday, stuffy last night but nothing that felt like real sickness and more like allergies. Dammit tested pos at work this morning.
Bummer mofro.
Maybe the missus and I did have covid a couple weeks ago? No sore throat or classic symptoms (had a very wet cough, no headache, no chest tightness, but sneezing and gushing snot), at home test (iHealth COVID-19 Antigen Rapid Test) was negative twice.
I'm probably gonna get in trouble for this. Am I the only one who hears "Shingrix" as if it was written by someone speaking Engrish?
Good luck, Mofro ! skiJ
With the general decision that "it's over," it isn't surprising to see all the "normal" bugs come back. While masking and distancing etc were only partly successful against covid, it devastated most other diseases.
3 positive tests so far from a weekend bbq. I stayed outside, and negative so far.
Of course, doncha remember, "Its no worse than the flu".
https://www.google.com/search?client...e+than+the+flu
You moved to D.C.? :fm:
Good luck Mofro!
No. Because the effort against Covid, while not enough to contain Covid, did contain all the other respiratory diseases. Quick analogy, firefighters dump a bunch of water on a fire. Most fires go out. The wind-driven one does not. Some conclude water (masking) doesn't work. The "prevent respiratory disease" strategies did work. We just need a little more to also beat Covid. (setting aside that people don't want to, and disease returns when we stop countermeasures)
My wife and I had a bout of something just like that a few months back. I racked it up to flu. Mostly because of the very wet cough. According to one of the big medical websites I looked at, the covid cough is usually a dry cough. That’s consistent with what I experienced this time when I tested positive, mostly dry cough, with some small chunks flying out towards the end.
My wife just experienced this. Had a fever which turned into a brief bad headache and then cold-like symptoms. Took a test about 24 hours after the symptoms started - negative. Chalked it up to a bad cold that we thought our daughter recently had (also tested negative). My wife then tested again 6 days later (was still a bit tired w/ a stuffy nose) and was positive. Not sure how I didn't catch it sleeping next to her, etc. (never tested but didn't have any symptoms). We're guessing that our daughter had it as well. In retrospect we would have tested her again a few days after but just figured it was a typical cold.
You just got a "free" asymptomatic booster. My wife/kid did same when I had it over the New Year, totally asymptomatic.
Theory on popping positive a bit later in vaccinated, immune system is primed, recognizes spike protein, creates immune response (you feel like shit), but viral load still too low to test positive. Similar to allergic reaction. First time you eat peanuts, your body will prime its immune system. Second time you eat them you are in the ED getting epinephrine.
Many (some?) people that were asymptomatic or had very mild symptoms when infectious are still suffering from long covid.
What response do you find more appropriate?
Here’s an interesting preprint on the prevalence of long covid: https://papers.ssrn.com/sol3/papers....act_id=4099429
Here’s what Topel has to say about it: “A systematic #LongCovid review of nearly 200 studies and over 120,000 participants, reinforces the high frequency of symptoms > 6 months, not linked to severity of acute illness, and potential for marked disability”
And he included this graphic:
Attachment 415559
^^^ Well that's just too bad for them. The rest of us need to just get on with living our lives.. amirite??
I've been looking at photos posted by some friends on a cruise right now. They've been waiting forever to go do that, something they really dig. Glad they finally got to go do that.. However, what are the odds of these NOT being SS COVID Parties? Anybody know whether or not they're even bothering to test at this point? Nobody in the photos is wearing masks.
And these folks were totally pro mask when it was required and got all the boosters they can get. They know the risks and accept them.
Personally, I'm still covering up some places where it's not required, but comfortable raw dog most places.. My sister, on the other hand has no choice with Lupus. I don't have an answer for how to keep everyone safe. But, with seemingly 20% of the general population still infected but most with vax protection there seems to be more risk than pre covid for everyone still..
The pivot to long covid is the new Twitter fad for the likes of Topol to remain relevant. I think long covid exists in some, I also think a large proportion of patients with long covid are suffering psychosomatic complaints and have significant underlying/pre-existing anxiety/depression.
Any person with a predisposition for anxiety/depression who gets covid is going to have a MUCH higher likelihood of assuming they will never return to normal health. It's a recipe for disaster, and we are seeing that now. Tell people they have a disease, and they will believe you. Tell them they may never recover, and they won't.
I've been at this healthcare shit for 25+ years, and while I think there is something to "long covid", I believe we are destroying our populations mental health with how the media and laypeople portray it.
Anxiety is more dangerous than Covid at this point I think. There’s a lot of hand wringing going on about Covid for a lot of people, meanwhile across all levels of healthcare workers it’s pretty much back to business as usual. Media, whatever the format, stokes the fear.
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How do you guys in healthcare account for the lost feedback that happens when a patient stops complaining about something after being diagnosed as psychosomatic?
For purposes of calibrating your expectation of psychosomatic causes, does an end to objection serve to confirm the diagnosis, or how do you adjust for that?
This is an excellent post, -Unicorn - Thank you...
however, when Jeff cannot accompany his 90+ year old dad in failing health to his dad's hospital room Because the hospital is still taking covid Precautions, at least that hospital is still contributing to 'covid anxiety' .
Thank you ! I appreciate the stress that front-line medical care workers have endured over the last two years, and acknowledge I probably cannot imagine the worst situations...
as long as I am here, I am going to say covid is neither a (peanut) allergy nor anaphylaxis.
I will leave that at that.
400,000 new cases a week ago - we are not ,,, covid is not done with us yet.
Good luck. skiJ
Usually visitor restrictions are the result of state and/or local health department mandates. The pressure to continue those restrictions come from the constituents of the policy makers.
If we didn’t have a state mandate for masks, vaccines and visitor restrictions it would be business as usual at my hospital.
I’m not saying that covid is over and we won’t have a deadly surge, but right now people just aren’t that sick. It’s anxiety brought on by media hysteria
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Our infectious disease doctors usually follow local, state and federal guidelines. I imagine it’s the same most places
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Someone comes to ED for chest pain or difficulty breathing, has zero cardiac risk factors, but has some display of symptoms compatible with anxiety. Rule out life threatening stuff, CONSIDER anxiety in your differential diagnosis. Rarely would you tell such a patient “you’re not having a heart attack this is anxiety”. Rule out what it likely isn’t, consider psychosomatic as a differential.
In terms of long covid, normal labs, no lung pathology, normal cardiac mri, blah blah blah…….could these symptoms be psychosomatic? It’s a consideration, not a black and white issue.
Because they can get on disability and not have to return to their shit jobs. Damn right they're gonna care.
For everyone with a psychosomatic symptoms given a diagnosis of a physical illness there is someone--or more likely 3 people--told it's all in the head when they have a real physical illness. (We could spend hours discussing the concept that the mind and the body are not separate, that disease is a combination of the pathology and how it interacts with the person's life, feelings, and thinking. But we'll save that for another day, or better yet, for never.)
26 year old guy--full blown Munchausen Syndrome, with no medical risk factors--comes in to the ER with RLQ pain and a scar to match, but swears he still has an appendix. My partner bites, operates, no appendix. Then the guy comes back in having removed his stitches and pulled his incision apart. He gets patched up. He does this twice. Then he shows up complaining of chest pain. Yeah, right. Except his ST segments are off the top of the page. While he's up in the ICU refusing a central line he arrests. Gets resuscitated, shipped off for cardiac surgery for his multiple vessel coronary artery disease.
My guess is that some long covid will turn out to have identifiable physical pathology and some will be anxiety or other mental disorders, and that it will take years to sort it all out.