To Vaccinate or Not---The Rat Flu Odyssey Continues

[billyk]

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.

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.

[jfost]

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 contention is that it (masks+distance) would have been enough to contain or at least better control covid, but for the “setting aside” part that you mention.

[ColMan]

Y’all are aware that the rapid antigen tests are showing positive typically several days after symptom onset, there supposedly is a timeframe (that can be for several days) of being infectious but not yet testing positive on an antigen test...

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.

[Trackhead]

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.

[bodywhomper]

Many (some?) people that were asymptomatic or had very mild symptoms when infectious are still suffering from long covid.

[Trackhead]

Many (some?) people that were asymptomatic or had very mild symptoms when infectious are still suffering from long covid.

Sure, I know, and that's become the standard response when ever someone discusses mild covid cases.

[bodywhomper]

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:

[SumJongGuy]

^^^ 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..

[jfost]

Sure, I know, and that's become the standard response when ever someone discusses mild covid cases.

Libtards never learn… if 50% of the country didn’t believe in regular covid, why would they suddenly be interested in “long Covid”?!?

[Trackhead]

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:

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.

[MagnificentUnicorn]

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.


Sent from my iPhone using TGR Forums

[jono]

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?

[skiJ]

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.


[/url]

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

[MagnificentUnicorn]

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


Sent from my iPhone using TGR Forums

[bodywhomper]

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


Sent from my iPhone using TGR Forums

At the hospital that you work at, is there a trigger of when to step-up measures or is that reliant on government employee (eg public health officer) stipulated measures?

[MagnificentUnicorn]

Our infectious disease doctors usually follow local, state and federal guidelines. I imagine it’s the same most places


Sent from my iPhone using TGR Forums

[SumJongGuy]

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


Sent from my iPhone using TGR Forums

Things seem to be pretty calm here as well at the local hospitals.. I'm still looking at Europe and Asia for what to expect next here though.. It seems to start ramping up there before it ramps up here.

[bodywhomper]

Our infectious disease doctors usually follow local, state and federal guidelines. I imagine it’s the same most places


Sent from my iPhone using TGR Forums

Is there a mechanism for an off ramp if the guidelines are not following the science? An easy low hanging fruit are the 5 day rule to return back to work (I’m not sure if hospitals are given that same guidance).

[Trackhead]

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?

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.

[old goat]

Libtards never learn… if 50% of the country didn’t believe in regular covid, why would they suddenly be interested in “long Covid”?!?

Because they can get on disability and not have to return to their shit jobs. Damn right they're gonna care.

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?

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.)

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.

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.

[MagnificentUnicorn]

Is there a mechanism for an off ramp if the guidelines are not following the science? An easy low hanging fruit are the 5 day rule to return back to work (I’m not sure if hospitals are given that same guidance).

We’re currently at 10 days off for positive covid test. Generally, guidelines can be interpreted but state and local mandates don’t have an “off ramp” unless the mandates are terminated by the ruling authority. IMO following the science is such a broad catch all, continuing a mask mandate in the hospital right now follows the science, they do work to varying degrees. Pulling the mask mandate for hcws also follows the science because right now every hcw is vaccinated and the risks to the patients and coworkers is very small.

It’s anxiety that keeps people from moving on, this thread is a prime example. People have lingering and long term symptoms from all kinds of viral infections but the ongoing hype about covid and long/post covid is being driven by the news cycle. Yes it’s real in some individuals but society’s generalized anxiety isn’t helping get back to normal. This is just my opinion.


Sent from my iPhone using TGR Forums

[jono]

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.)

Appreciate both points. I didn't want to distract from the anxiety by going full thread drift, because evidence suggests my family's greatest risk factor is underdiagnosis, so I assume a personal bias. It really is a question about thinking, though. In your example of the unlikely patient, if that had been your patient, do you want to let that kind of example stand out as a strong warning or minimize it to avoid getting emotionally hung up on past mistakes?

[skiJ]

There are some interesting concepts here -
I appreciate the point that some covid Policies are the result of bureaucratic input ;
the federal guidelines have been (varied) enough over the last two years, that is challenging ;

goat's claim and example are troubling enough to be worrisome -
Rhetorically, what is the effect of coronavirus on the brain (?)
The idea that three out of four people that are diagnosed with psychosomatic conditions have underlying undiagnosed pathology reminds me of something an old county doctor once told me -
' some things, it's better to learn to live with... '

Medicine ( - and Surgery - ) has come a long way in fifty years...
it's interesting to read 'psychsomatic' is considered a differential diagnosis.
in my experience, I would hope to refer such patients for further assessment and second opinions before diagnosing a psychosomatic/ psychologic ( psychiatric ) condition. especially with a voice with fifty years of experience saying 3/4 of these patients having underlying pathology...

I understand this may be difficult in a not-urban environment -

I don't pay much attention to the popular press / media anymore -
too many reporters want to be part of the story, and columnists bring their own (bias) ;
in the best case scenario, I would read a wide range, but I am old and probably (too) set in my ways...

I liked the claim up-thread that policy makers did they best they could with ever-and-still evolving information
( a couple of claims to the contrary fell flat with me ) --

I urge you to maintain resistance through vaccination ;
while the vaccines aren't perfect, to me the advantages over hoping omicron is going to provide a 'free asymptomatic booster' is definite.

as WrG has shown, we don't know what the long term effects of covid may be - it may be an ongoing matter, to reassess and adjust as necessary...
There is nothing wrong with that.

I'd rather hear that, than
' You may never get better '

( I'd at least seek a second opinion. )

my Thanks - especially to goat and -Unicorn. and Summit and Trackhead, too - for the knowledge of your Experience.

respectfully. skiJ

[jfost]

... Pulling the mask mandate for hcws also follows the science because right now every hcw is vaccinated and the risks to the patients and coworkers is very small.

It’s anxiety that keeps people from moving on, this thread is a prime example. …]

500+ deaths per day x 365 = 182.5k per year

Turns out Masking at the hospital saves a great many infections of all kinds and may be here to stay forever. Why do we need to “move on” from keeping people healthy at our health care institutions?

[MagnificentUnicorn]

500+ deaths per day x 365 = 182.5k per year

Turns out Masking at the hospital saves a great many infections of all kinds and may be here to stay forever. Why do we need to “move on” from keeping people healthy at our health care institutions?

I would bet that the numbers show community acquired infection is driving the pandemic not nosocomial infections. Yes masking helps, for the most part masks protect us from the sick patients.


Sent from my iPhone using TGR Forums