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  1. #22151
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    Sunday morning epi musings:

    With the antigen home test we always knew that it might take two tests over two days to have good sensitivity. This was known and why the tests came in two packs. The message was "if you are sick, stay home, please test."

    The message isn't changed, but anecdotally, these tests now seem less sensitive. I was recently exposed when someone who thought they were having allergies tested negative 2 days in a row, then the day after the bbq, that person tested positive. Then I developed allergy type symptoms. I isolated 5 days, tested negative 3 days in a row on sx days 3-5, and went out masked for the next 5.

    Did I have COVID? Don't know. Had I been quite social before then? Yes. Did I hang out after with two friends who were also on (unrelated) COVID watch and also testing negative? Sure.

    For over a year during the pandemic, I used to say to healthcare workers "COVID isn't the only thing your patient can have, but your patient almost certainly has COVID" in the context of respiratory infectious diagnosis. At first there were no other circulating RVs except rhinovirus. Then the masks started to come off, and there were other circulating pathogens, but they were still eclipsed by the hyper-contagious COVID variants. Now "almost certainly" is just "likely." COVID is still number one, but it isn't the only one.

    Do the tests still work?

    On Friday an Epi from the state suggested continuous testing for up to 6 days might be needed. I thought this was extremely absurd for the average person.

    The current way of thinking, data supported, is that if you are testing antigen negative with good procedure, you are at least significantly less contagious, or likely not contagious. You don't have enough antigen you are just not shedding as much, or any, replication competent virus, particularly if you have some level of immunity (and almost everyone does now), particularly if you are on the recovery end of the illness, thus the idea of using antigens to clear early from isolation.

    So did the viral antigen dynamics change vs the tests? Or is this a manifestation of antigen levels in people with significant immunity from vaccination/infection?

    If there is a new way of thinking that we need to test for 6 days, it needs to be data supported. If the reasoning is that the antigen tests have severely degraded clinical sensitivity (ability to positively detect transmissible infection), then we need different tests (updated antigen or use PCR). Such a message is not being put forth outside of discussion on my state epidemiology call.

    I've said this repeatedly, testing is hard and complex, even for the medical professional.

    Hospitalizations are manageable. Staffing impacts are the primary. This is the end of the Deceleration Phase that Fauci described at the end of the Pandemic->Endemic transition.

    Go out, enjoy a social summer, don't stress. You might get Rona, but you'll be OK. You won't get the pox, polios, marburg, yellow fever, or whatever else the 24 hour news cycle is yammering about. Stop stressing. Wash your hands. Wear a mask in crowded and poorly ventilated places. If you are stick, stay home. I still like antigens to clear COVID iso, especially if you are around the vulnerable.

    /Sunday morning epidemiology musings
    Quote Originally Posted by blurred
    skiing is hiking all day so that you can ski on shitty gear for 5 minutes.

  2. #22152
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    FWIW I already had polio. It wasn't that bad. I don't see why people stress about it.

  3. #22153
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    Is there newer/better data about long covid than the cdc’s report about 1 in 5 between 18(?) and 65 years of age? Among the middle-aged adults people that I was hanging out with yesterday, it was 1 in 4. 0 in 5 for the children (under 18).

    Is there clear correlation between infectiousness and RAT results at the beginning of infection? Mina still pushes that symptom onset means different things if you are vaxed or previously infected versus fully naive. For those that have some immunity, “early symptoms now reflect immunity starting and ramping up, rather than virus harming.” And he’s still stating one becomes infectious/contagious after the virus begins “harming.”

    I’m California, there’s still confusion about when to exit isolation. CDC says one thing, California says another (basically test to exit). Some PCP in CA are following the CDC and not the state and some counties have not updated their recs to includes the state’s newer rec. I believe this is a messaging/outreach problem. Biden announced that he’s following “test to exit,” cdc director has stated that this should still not be the cdc policy and that (apparently?) the cdc policy should not be updated based on newer data specific to current infectious variants.

    Personally, I’m still not excited about getting infected. I do not have much time off available, I have fun plans, I’m not excited to spread it amongst my family. hearing my preciously(?) strong, fit, and healthy SIL describe her new struggle to swim across a short pool is opposite how I’d like to be spending my next 2+ months.

  4. #22154
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    Nobody wants COVID. Everyone will get COVID.
    Quote Originally Posted by blurred
    skiing is hiking all day so that you can ski on shitty gear for 5 minutes.

  5. #22155
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    To Vaccinate or Not---The Rat Flu Odyssey Continues

    Some people don’t seem to care if they catch it.

    And therapeutics continue to improve, vax that brings mucosal immunity continue to progress in their trials, and growing observations and government acknowledgement of higher severity with reinfections for some.

    Hearing from a friend who is an industry leader and decision maker , which includes close attention in ethics, that they do not have an answer for the people (including employees) that are immunocompromised about how they should be living and enjoying their life. This is somebody who establishes corporate policy that sets trends in an industry that many other industries will follow.

    Still hearing from people that should know better (eg MPH), that they are glad they finally got it and got that over with, and they likely did not catch the ba.5.

    And then there’s this, people with previous infection of common endemic coronavirus that are showing pre-existing immunity to covid 19: https://www.cell.com/cell-host-micro...elatedArticles

  6. #22156
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    There were people who had OG rona (Wuhan-1) who then got Alpha or Beta or Gamma, and then got Delta. We had that data mid 2021. Any vestiges of the concept of 'getting it over with' should with the Omicron B.1 reinfection data out of South Africa at the end of 2021. That subvariants are escaping other subvariants calls into question the meaning of term variant.

    Anyone still thinking it COVID is one-and-done, well... hope they got the flu over with too!

    Click image for larger version. 

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    As was said, therapeutics, vaccines, and cumulative immunity have largely remove the severe disease and pandemic impact threats. We have a still-rapidly-evolving unbelievably fit and transmissible airborne respiratory virus transitioning into the worlds most prevalent endemic respiratory infectious disease. How frustrating... but it is the world we find ourselves in.
    Quote Originally Posted by blurred
    skiing is hiking all day so that you can ski on shitty gear for 5 minutes.

  7. #22157
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    Quote Originally Posted by summit View Post
    Nobody wants COVID. Everyone will get COVID.
    I intend to minimize my chance and frequency of infection until folks like whomper's precious SIL are swimming across pools. So far very few in my circle have been infected. If I take that as 5% over 2.5 years, that's about 50-50 for one or more infections during the remainder of my life. A lot of people will get Covid but not everyone. A lot of people will get Covid many times.

  8. #22158
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    Quote Originally Posted by LongShortLong View Post
    So far very few in my circle have been infected. If I take that as 5% over 2.5 years, that's about 50-50 for one or more infections during the remainder of my life. A lot of people will get Covid but not everyone. A lot of people will get Covid many times.
    Your circle is better than mine. Congrats.

    Quote Originally Posted by summit View Post
    Nobody wants COVID. Everyone will get COVID.
    The literalism with which rounding errors are presented as fact is probably the leading Achilles heel of American medicine.

  9. #22159
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    Quote Originally Posted by summit View Post
    Nobody wants COVID. Everyone will get COVID.
    Test popped positive today in about 20 seconds. Happy Pie and Beer Day!
    "boobs just make the world better really" - Woodsy

  10. #22160
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    Quote Originally Posted by old goat View Post
    FWIW I already had polio. It wasn't that bad. I don't see why people stress about it.
    Is it really just the flu?
    I have been in this State for 30 years and I am willing to admit that I am part of the problem.

    "Happiest years of my life were earning < $8.00 and hour, collecting unemployment every spring and fall, no car, no debt and no responsibilities. 1984-1990 Park City UT"

  11. #22161
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    Quote Originally Posted by LongShortLong View Post
    A lot of people will get Covid but not everyone. A lot of people will get Covid many times.
    Yeah, I think the take that everyone will get it is a self-fulfilling prophecy. It's like saying "oh well, there's nothing we can do"

    Some people have never had old fashioned influenza. Some people haven't had food poisoning. It's possible to visit Mexico or India and not get Montezuma/Delhi Belly.

    The odds aren't in your favor, but neither is the lottery, or getting drafted by a pro team, or acting in a Hollywood movie, or making a scientific breakthrough. Fatalism guarantees bad outcomes.

  12. #22162
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    I dunno.

    Everyone lives different lives. This shit has been going on for a long while. I think for a lot of people Summit nails it. For others probably not. So many variables.

    We were among the most cautious for so long. Now, not so much. Who's to say the exact proper path forward. We debate it all the time. Covid weighs but so does raising my kids and giving them experiences.

    On another note, we kind of blasted through our supply of home tests here lately, which we stocked up on and bought before the free tests were available. Went online for the free tests and judging from my inbox I have an entire truckload coming since none have come to this address yet.

    Sent from my SM-G991U1 using Tapatalk

  13. #22163
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    Quote Originally Posted by uglymoney View Post
    I think for a lot of people Summit nails it. For others probably not. So many variables.
    Yep. The best path forward for Americans is blunder ahead doing what we feel like, hoping that scientists and other leaders will fix any problems before they get too bad. It's worked ok for most problems, so far. Polio is gone. Missile gap, what's that? Peak oil surpassed (anybody holding barrels waiting for $200?). We used to live with smallpox. It'll be ok.

  14. #22164
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    Quote Originally Posted by LongShortLong View Post
    Yep. The best path forward for Americans is blunder ahead doing what we feel like, hoping that scientists and other leaders will fix any problems before they get too bad. It's worked ok for most problems, so far. Polio is gone. Missile gap, what's that? Peak oil surpassed (anybody holding barrels waiting for $200?). We used to live with smallpox. It'll be ok.
    My crystal ball isn't as clear as yours.

    Sent from my SM-G991U1 using Tapatalk

  15. #22165
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    Quote Originally Posted by jono View Post
    The literalism with which rounding errors are presented as fact is probably the leading Achilles heel of American medicine.
    Probably 100%
    Quote Originally Posted by blurred
    skiing is hiking all day so that you can ski on shitty gear for 5 minutes.

  16. #22166
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    Quote Originally Posted by uglymoney View Post
    …Covid weighs but so does raising my kids and giving them experiences.
    I think it’s not really an either/or scenario in regards to the kids. I believe it is possible to raise kids while maintaining reasonable precautions, and not have their lives ruined. Most kids I know don’t seem to mind wearing masks inside, and did mostly ok with zoom school, and still manage to have friends etc. they’re way better at this than the adults I know, but the kids haven’t been fully brainwashed yet.
    ... jfost is really ignorant, he often just needs simple facts laid out for him...

  17. #22167
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    And I didn't say it was either or I said weigh it.

    Edit....deleted a bunch of shit.

    I don't really have a point of view to share here. Mostly that I don't know, am probably wrong anyway, and certainly the ground we have settled on for now is completely reprehensible, unless you think just like me, which is impossible.
    Last edited by uglymoney; 07-25-2022 at 03:30 AM.

  18. #22168
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    Quote Originally Posted by summit View Post
    Probably 100%
    Indubitably

  19. #22169
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    Quote Originally Posted by uglymoney View Post
    And I didn't say it was either or I said weigh it.

    Edit....deleted a bunch of shit.

    I don't really have a point of view to share here. Mostly that I don't know, am probably wrong anyway, and certainly the ground we have settled on for now is completely reprehensible, unless you think just like me, which is impossible.
    No I know, just discussing one of the many unknowns we have created in this whole mess!!!
    ... jfost is really ignorant, he often just needs simple facts laid out for him...

  20. #22170
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    We had our company's anniversary party on Friday. 100 people packed into an event space with much drinking and merrymaking. It was the first time we had the company party in 2.5 years.

    Today, i have covid. My kid came down with it yesterday and i didnt start feeling symptoms till last night. I wonder how many people will be sick this week....

  21. #22171
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    The possible superspreader work party, makes me think back to the potential for OSHA regs or guidance and employer-provided health insurance. I was told over the weekend by a well informed legal person to not expect anything from OSHA, even though they had a hearing last spring on COVID and the potential for developing guidance. Regarding health insurance, I wonder if the insurance industry will be reacting if their payout costs significantly increase from COVID related illnesses due to employer-sponsored events or employer policies that put staff in harms way....

  22. #22172
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    Quote Originally Posted by bodywhomper View Post
    The possible superspreader work party, makes me think back to the potential for OSHA regs or guidance and employer-provided health insurance. I was told over the weekend by a well informed legal person to not expect anything from OSHA, even though they had a hearing last spring on COVID and the potential for developing guidance. Regarding health insurance, I wonder if the insurance industry will be reacting if their payout costs significantly increase from COVID related illnesses due to employer-sponsored events or employer policies that put staff in harms way....
    I don't think anyone's got a gun to their head demanding they not wear masks in said environments.. But peer pressure is strong.

    There's also the pressure to sit in fish bowl conference rooms for 2 hours with 10+ other collogues where none of them are wearing masks.
    Last edited by SumJongGuy; 07-26-2022 at 05:09 PM.
    Go that way really REALLY fast. If something gets in your way, TURN!

  23. #22173
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    Quote Originally Posted by bodywhomper View Post
    The possible superspreader work party, makes me think back to the potential for OSHA regs or guidance and employer-provided health insurance. I was told over the weekend by a well informed legal person to not expect anything from OSHA, even though they had a hearing last spring on COVID and the potential for developing guidance. Regarding health insurance, I wonder if the insurance industry will be reacting if their payout costs significantly increase from COVID related illnesses due to employer-sponsored events or employer policies that put staff in harms way....
    Why would OSHA do anything when the SCOTUS will just shoot it down. Because Freedom.

  24. #22174
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    Won’t scotus apply the new standard of whether it’s a “major question.” All I know is that OSHA had a public hearing and several top tier aerosol academics testified.

  25. #22175
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    Quote Originally Posted by bodywhomper View Post
    Won’t scotus apply the new standard of whether it’s a “major question.” All I know is that OSHA had a public hearing and several top tier aerosol academics testified.
    Sorry "COVID" is not mentioned anywhere in The Constitution so suck it libtards!
    Go that way really REALLY fast. If something gets in your way, TURN!

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