Conoravirus ...

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Re: Conoravirus ...

Postby BeauV » Tue Nov 10, 2020 7:30 pm

All, a friend just sent me this COVID-19 Risk Calculator. It's built as a spreadsheet and seems to do an amazingly good job of estimating risk. We normal humans are terrible at accurately estimating risk. EG: couples will drive to the airport together in the same car but refuse to fly on the same plane because they're worried about both dying in a plane crash and leaving the kids parentless. (Despite the simple and obvious fact that driving to the airport is by FAR the most dangerous part of their entire day.)

Link here, read the "Read Me" tab
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Re: Conoravirus ...

Postby Tigger » Thu Nov 12, 2020 1:36 pm

Here's a good graphic.

Screen-Shot-2020-11-12-at-9.10.51-AM.png
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Re: Conoravirus ...

Postby Benno von Humpback » Thu Nov 12, 2020 6:01 pm

Yeah, the rising numbers have me thinking about cutting back on the group rides. Thinking...
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Re: Conoravirus ...

Postby BeauV » Thu Nov 12, 2020 7:49 pm

Chicago is closing down. Many more cities will follow. Cases are growing at over 150,000/day.

This is going to get very very ugly because so many sick people are now walking around without masks and without any concern for others. It'll take at least a month to slow this down, even if everyone cooperates. They will not cooperate. So a lot of folks are going to die.
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Re: Conoravirus ...

Postby Jamie » Thu Nov 12, 2020 8:53 pm

I was thinking about going to my parents for Christmas, but I feel like I'm tempting fate.
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Re: Conoravirus ...

Postby Benno von Humpback » Thu Nov 12, 2020 8:56 pm

For Thanksgiving, we are going to host my brother who has been living in Upstate NY. He's driving down. Gives me a slight case of the whim-whams, but hey...
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Re: Conoravirus ...

Postby BeauV » Fri Nov 13, 2020 5:57 am

We aren't going anywhere anytime soon, no one is coming here. There are only two situations in which we'll lower our defenses:
1) Treatments reduce the long term side effects of surviving COVID-19, we are a lot less worried about death than we are about being crippled for life.
2) A vaccine works and we've received it.

We've been locked down pretty damn tight since March 1st, and have been hiding since early February. We're not going to blow it after 9 months for a turkey dinner someplace. It'll just be me and the Admiral. Some of the kids are going to see their other parent, but even they are eating outdoors (a luxury one has in a warmish climate).

Our best guess is that we are about halfway through this mess, best case, and Item #2 above will arrive for us non-essential old folks in July or August at the earliest.
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Re: Conoravirus ...

Postby Benno von Humpback » Fri Nov 13, 2020 7:04 am

There's nothing but good news on the vaccine front and masking keeps looking better and better. We have to get through the winter somehow, but I am optimistic for the second half of the year.
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Re: Conoravirus ...

Postby Jamie » Fri Nov 13, 2020 8:37 am

I just got a carton of N95 type masks from friends in Korea.

It’s a bit embarrassing how almost a year in, theses aren’t freely available in the US. The ability to get tested has somewhat improved through organizations like CVS.
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Re: Conoravirus ...

Postby kimbottles » Fri Nov 13, 2020 9:43 am

Jamie wrote:I just got a carton of N95 type masks from friends in Korea.

It’s a bit embarrassing how almost a year in, theses aren’t freely available in the US. The ability to get tested has somewhat improved through organizations like CVS.


I have been tested several times as part of the protocol of getting cancer treatments. I will be tested again on Dec 9th in order to get the chemo port removed on the morning of the 11th. I also get a colonoscopy later that day. (Am I a lucky guy or what?)

They restarted my radiation treatments yesterday, so IF we can avoid any more delays for damaged skin I should be finally FINISHED next Tuesday!

I am ready to be finished.
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Re: Conoravirus ...

Postby Jamie » Fri Nov 13, 2020 9:59 am

kimbottles wrote:
Jamie wrote:I just got a carton of N95 type masks from friends in Korea.

It’s a bit embarrassing how almost a year in, theses aren’t freely available in the US. The ability to get tested has somewhat improved through organizations like CVS.


I have been tested several times as part of the protocol of getting cancer treatments. I will be tested again on Dec 9th in order to get the chemo port removed on the morning of the 11th. I also get a colonoscopy later that day. (Am I a lucky guy or what?)

They restarted my radiation treatments yesterday, so IF we can avoid any more delays for damaged skin I should be finally FINISHED next Tuesday!

I am ready to be finished.


Sadly they won't even let you smoke after a colonoscopy.

We too can't wait until you are finished and back to spending time on FL.
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Re: Conoravirus ...

Postby LarryHoward » Fri Nov 13, 2020 10:20 am

Was it good for you?

I was pretty annoyed that chin to knees CTs every month or so and 12 rounds of high dose chemo didn’t get me a pass on a colonoscopy. Darn Medical unions.
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Re: Conoravirus ...

Postby BeauV » Fri Nov 13, 2020 12:34 pm

Benno von Humpback wrote:There's nothing but good news on the vaccine front and masking keeps looking better and better. We have to get through the winter somehow, but I am optimistic for the second half of the year.


Me too! I'm on a number of Board and we're currently planing out 2021. We expect to move to relatively safe operations in the third quarter. Of course, there will be bumps along the way, but by late summer I really do think that we'll be through the worst of it. (I can't believe I'm writing this!)

One of the orgs. I work with has a number of UCSF folks involved and the data has been both scary and now encouraging. The scary bit is that this winter is going to be genuinely awful. Little Santa Cruz just went back into almost completely lock-down, and we're nowhere near as bad off as the northern mid-west. But, in the middle of that, the vaccine data really is positive.

Eric, I have a question: Given something like 25-30 percent of common colds are caused by a coronavirus, do you think the vaccine technology Pfizer is using for the COVID Vaccine will apply to them too, or even accidentally vaccinate against them? Or, is the vaccine more specific to COVID than that?
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Re: Conoravirus ...

Postby Benno von Humpback » Fri Nov 13, 2020 1:49 pm

BeauV wrote:
Eric, I have a question: Given something like 25-30 percent of common colds are caused by a coronavirus, do you think the vaccine technology Pfizer is using for the COVID Vaccine will apply to them too, or even accidentally vaccinate against them? Or, is the vaccine more specific to COVID than that?

I'm not really qualified to answer that question, but to the extent that there's any homology between the other virus and the piece of the Cov-2 spike complex the vaccine is directed against, there could be some protection. Some antibodies to other coronaviruses in healthy people do cross react with pieces of Cov-2.
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Re: Conoravirus ...

Postby BeauV » Fri Nov 13, 2020 6:03 pm

Benno von Humpback wrote:
BeauV wrote:
Eric, I have a question: Given something like 25-30 percent of common colds are caused by a coronavirus, do you think the vaccine technology Pfizer is using for the COVID Vaccine will apply to them too, or even accidentally vaccinate against them? Or, is the vaccine more specific to COVID than that?

I'm not really qualified to answer that question, but to the extent that there's any homology between the other virus and the piece of the Cov-2 spike complex the vaccine is directed against, there could be some protection. Some antibodies to other coronaviruses in healthy people do cross react with pieces of Cov-2.


Thanks!
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Re: Conoravirus ...

Postby Ish » Fri Nov 13, 2020 8:53 pm

kimbottles wrote:
Jamie wrote:I just got a carton of N95 type masks from friends in Korea.

It’s a bit embarrassing how almost a year in, theses aren’t freely available in the US. The ability to get tested has somewhat improved through organizations like CVS.


I have been tested several times as part of the protocol of getting cancer treatments. I will be tested again on Dec 9th in order to get the chemo port removed on the morning of the 11th. I also get a colonoscopy later that day. (Am I a lucky guy or what?)

They restarted my radiation treatments yesterday, so IF we can avoid any more delays for damaged skin I should be finally FINISHED next Tuesday!

I am ready to be finished.


I'm sure you are.

I don't care too much about colonoscopies, it's the prep that gets me.
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Re: Conoravirus ...

Postby Steele » Sat Nov 14, 2020 8:53 pm

I have mentioned that I am a primary care doc, with lots of at risk elderly patients, and many others with chronic illnesses that put them at risk. I am asked many times a day about travel, family get-togethers, random testing etc. I almost want to bellow at them "are you nuts!" We are perhaps 6 months away from turning the corner on this thing, you have made it this far, why the hell would you fly to Topeka for Thanksgiving. Then I get the "I don't want to be the first one to get the vaccine". I try to point out that these trials have 30-40 thousand participants, so you will not be the first, you will be the 20,001st person. Seattle is pretty democratic, these are not Trump accolytes. The lack of a cohesive intelligent message is costing thousands of lives, and people still do not get it. Now I am depressed and need a second Manhattan.

Beau and Kim, stay safe. I am looking forward to sharing a good Cabernet (Walla Walla of course) in Blakely Harbor with Susan and Kim. Mosly Susan... ;)
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Re: Conoravirus ...

Postby kimbottles » Sat Nov 14, 2020 9:19 pm

Steele wrote:I have mentioned that I am a primary care doc, with lots of at risk elderly patients, and many others with chronic illnesses that put them at risk. I am asked many times a day about travel, family get-togethers, random testing etc. I almost want to bellow at them "are you nuts!" We are perhaps 6 months away from turning the corner on this thing, you have made it this far, why the hell would you fly to Topeka for Thanksgiving. Then I get the "I don't want to be the first one to get the vaccine". I try to point out that these trials have 30-40 thousand participants, so you will not be the first, you will be the 20,001st person. Seattle is pretty democratic, these are not Trump accolytes. The lack of a cohesive intelligent message is costing thousands of lives, and people still do not get it. Now I am depressed and need a second Manhattan.

Beau and Kim, stay safe. I am looking forward to sharing a good Cabernet (Walla Walla of course) in Blakely Harbor with Susan and Kim. Mosly Susan... ;)


Please bring Julia with you, Thanks.
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Re: Conoravirus ...

Postby BeauV » Sat Nov 14, 2020 10:00 pm

Steele wrote:I have mentioned that I am a primary care doc, with lots of at risk elderly patients, and many others with chronic illnesses that put them at risk. I am asked many times a day about travel, family get-togethers, random testing etc. I almost want to bellow at them "are you nuts!" We are perhaps 6 months away from turning the corner on this thing, you have made it this far, why the hell would you fly to Topeka for Thanksgiving. Then I get the "I don't want to be the first one to get the vaccine". I try to point out that these trials have 30-40 thousand participants, so you will not be the first, you will be the 20,001st person. Seattle is pretty democratic, these are not Trump accolytes. The lack of a cohesive intelligent message is costing thousands of lives, and people still do not get it. Now I am depressed and need a second Manhattan.

Beau and Kim, stay safe. I am looking forward to sharing a good Cabernet (Walla Walla of course) in Blakely Harbor with Susan and Kim. Mosly Susan... ;)


We are doing our damnedest to stay safe.

I wrote to all my kids earlier today basically saying: "The best information we have is that the optimistic prediction is that a vaccine stops this pandemic in mid-summer, the pessimistic prediction is that it takes another year. This is not a sprint, it is the longest marathon you'll ever run in your life; at least a hope it is. We all need to hang tough and not stumble by rationalizing risky behavior." So far, the response has been "Yes, Dad." I do have to remind them at least once a month.
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Re: Conoravirus ...

Postby BeauV » Wed Nov 18, 2020 1:57 pm

As some of you might have noticed, much of CA has slipped back into the worst category. Even little Santa Cruz, which had been doing well, is now shutting down broadly. Unlike prior spikes, when the virus was intense in a small number of places, this is getting intense in a large number of places.

I have a dear friend who is a consultant to Hospitals and the largest chains like Kaiser, United Healthcare, etc.... She told me yesterday that one of the big-5 organizations has now closed one hospital and has over 200 clinics that are about to close simply because they can not staff them. Too many of the staff have come down with COVID to safely keep the operations open. Her prediction is that we'll have dozens of hospitals closed due to a lack of staff, and hundreds of clinics as well. No one wants to do this, but there simply aren't enough healthy medical staff to keep them open. Her estimate is that the total population of medical professionals is shrinking as people get sick, and as they leave the field because they can't put up with the months of constant long hours, watching people die, and seeing many in our country ignoring or ridiculing the disease they are fighting every day.

I don't think most folks have internalized these facts. This is especially true in rural areas, where the concentration of medical services into a small number of massive corporations has resulted in defunding services in sparsely populated areas over the last 20 years and there is a higher concentration of people who simply don't believe the disease is nearly as bad as it provably is.
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Re: Conoravirus ...

Postby TheOffice » Wed Nov 18, 2020 3:00 pm

Beau,

I read that 900 employees at Mayo are positive.

At Sue's hospital (Hopkins Bayview) they converted an ortho unit to treat Covid patients. I suspect that elective surgery will again come to a halt, so closing clinics may have less of an impact than we think as surgical staff is redirected. Sue is seeing a positive patient in L&D nearly every day now. It was nearly unheard of up until now. Hopkins does not test visitors or employees. Visitors are restricted to birthing and dying. The emergency department/Covid units have to be more depressing than a White House staff meeting. All those idiots at Sturgiss and other gatherings are now seeing the consequences of their actions.
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Re: Conoravirus ...

Postby BeauV » Wed Nov 18, 2020 4:50 pm

TheOffice wrote:Beau,

I read that 900 employees at Mayo are positive.

At Sue's hospital (Hopkins Bayview) they converted an ortho unit to treat Covid patients. I suspect that elective surgery will again come to a halt, so closing clinics may have less of an impact than we think as surgical staff is redirected. Sue is seeing a positive patient in L&D nearly every day now. It was nearly unheard of up until now. Hopkins does not test visitors or employees. Visitors are restricted to birthing and dying. The emergency department/Covid units have to be more depressing than a White House staff meeting. All those idiots at Sturgiss and other gatherings are now seeing the consequences of their actions.


I hadn't heard about Mayo - that's terrible.

A few minutes ago I got off a zoom with the COVID advisory committee for one of the boards I'm on. The near term does not look good at all. One of the members is a senior medical type at UCSF Medical. He took the group through the sensitivity and accuracy of the Antigen and PCR tests for COVID. What our Board hadn't realized, despite me sending the information twice, is that the Antigen has a 50% false-negative rate during the first few days after infection. (This is why Elon Musk was carping about getting four tests: two positive and two negatives.) The PCR test is a lot better, but during the first few days after exposure, it can still have up to a 30% false-negative rate. One fellow board member said: "What F**K good is a test with a 50% false-negative rate!??!!" He has a point.

A crushing side effect of all this overloading of the medical system is that people who have other problems (EG: Heart Attack, Stroke, Broken Bones, etc...) are finding themselves having to measure the risk of heading into the hospital or even being turned away by a hospital or clinic. That critical few hours right after a heart attack or stroke are being lost. Those folks don't show up on the COVID numbers, but it is real harm and it's getting ugly.
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Re: Conoravirus ...

Postby TheOffice » Thu Nov 19, 2020 9:07 am

The test used at Hopkins has a 38% false negative, so these numbers are in line with what Sue sees.

Hospitals are also going broke between losing revenue from the drop in elective surgery, the cost of PPE and the non-paying Covid patients. They need another bail-out in the next stimulus bill.

Perhaps this will spur Medicare for all or some universal coverage?
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Re: Conoravirus ...

Postby Steele » Thu Nov 19, 2020 11:45 am

We have been lucky until just recently. Over the last week there has been a pronounced increase in staff being sent home because of exposures to covid. Almost all have been contacts outside of work. Even if they do not get sick we still have to wait a few days after exposure to test, to reduce the risk of a false negative as already described here. It takes another day or two to get results, so even the best case can take a healthcare worker out for a week. When things get desperate we end up working even if there is a personal risk of illness, and some of the worst hit states are allowing known positive casese to continue to work if there is no other choice.

Yesterday I listened to a few very sad interviews on NPR of nurses working in places like Montana and the Dakotas. They described stepping out of the hospital after very long exuasting shifts and seeing groups of people nearby not using masks. Some have been accosted on the way home after stopping at the grocery store and were berated for wearing a mask. Others described paitents in the ICU with covid still in denial that it even exists. It is demoralizing, and some have decided to quit when they are needed most.

Seattle is starting to shut down elective procedures this week as a precaution. Outpatient care is still at 100%, but may need to be curtailed again as much from shortage of personnel as the virus itself.

Joel and Beau's points about the economic fall out are true. Another point is there is minimal if any profit in taking care of covid patients. Most are medicare or Medicaid since that is the population most at risk of severe illness, we are lucky to break even with those programs. The profit is found in commercial insurance carried by younger workers and elective procedures like joint replacement and colonoscopies. There was a pretty large round of layoffs in the healthcare industry in our area after the spring spike in cases, and this spike may be worse.
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Re: Conoravirus ...

Postby LarryHoward » Thu Nov 19, 2020 12:35 pm

I suspect that anyone who is out and about in any manner has been exposed but perhaps not to the 15 minute CDC standard. Unfortunately, you have to presume infection for any health care worker who is knowingly exposed. The consequences are pretty significant if you do anything else.

The financial damages continue to expose just how crazy our system is. As a Medicare recipient, I look at billed (retail?) price and often see 20% or less as an "agreed price" for services. I've mentioned before that my cancer treatment 3 years ago was billed at close to $2M all up. The only thing I say in the reams of paper that was paid at "retail" was the Nulasta shots at $5K per. I think my 6 hour surgery got paid out at around $2,000 - for arguably the best in the US surgical team. My recent Proton therapy, including prep work and follow up, was billed about at $80K plus. Actual Medicare approved and accepted payments were less than $10K. Given my Medicare premiums are a bit under $5K annually, a bargain for me in any calculation but it does beg the question as to what it costs and what is reasonable compensation to the health care providers.
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Re: Conoravirus ...

Postby kimbottles » Thu Nov 19, 2020 12:42 pm

I am hoping to get my chemo port removed Dec 11 (if I pass the Covid test again.) And I am scheduled for an overdue colonoscopy several hours after the morning port removal.

I wonder if I will get either procedure done on schedule. (They are scheduled the same day as I have to stop taking my anticoagulant two days before either, so might as well link them together and only stop the DVT meds once.)

Interesting times.
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Re: Conoravirus ...

Postby TheOffice » Wed Nov 25, 2020 11:22 am

Woke up this morning with a sore throat and cough. I am in a mile and a half line for a rapid test. After an hour and 20 minutes I’m gone 3/10 of a mile. Stay tuned
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Re: Conoravirus ...

Postby TheOffice » Wed Nov 25, 2020 3:32 pm

This morning I woke up with a sore throat and tight chest. Decided to get a rapid test.
Tried to get an appointment. Everyone was booked.
There were two locations near me that don't require appointments. First had a long line outdoors. Drove to the second which had a 1.5 mile line of cars. Decided to go back to the first location. By then, they were full.
Back to the drive in. Waited an hour and a half. Moved 1/2 a mile. Then the guy in the golf cart said they only had 450 tests and I was out of the money. Screwed myself at both locations.

Went to Patient First. The test only appointments were booked until next week, but if I want to pay for a Dr. visit I can probably get tested. Explained I needed a rapid so Sue can work this weekend. Rapid came back negative, so they gave me a PCR test, Results in 2-5 days. I'm in the basement on quarantine. Luckily the gas fireplace and TV are working.

Happy friggin Thanksgiving.
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Re: Conoravirus ...

Postby Slick470 » Wed Nov 25, 2020 3:47 pm

That sucks, sorry to hear Joel. Hopefully the test will come back negative, but that doesn't give you back the time you're stuck in the basement.
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Re: Conoravirus ...

Postby TheOffice » Wed Nov 25, 2020 3:50 pm

Thanks. At least I can sail solo!
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