They act like it's some kind of a "win for our side - we voted down COVID and now it's over - yay!"
St.Louis County Council votes to end mask mandate. pic.twitter.com/QKCDDpq8kb
— Jeff Bernthal (@JeffBernthal) July 28, 2021
Jul 28, 2021
COVID-19 Update
They act like it's some kind of a "win for our side - we voted down COVID and now it's over - yay!"
COVID-19 Update
Delta has upped its game, with infected people shedding up to 1000 times as many virus particles as previous iterations of this novel coronavirus.
And while that doesn't correlate directly to your being 1000 times more likely to get infected, it does increase the chances for anyone - even the fully vaccinated - to be infected, and to become ill.
The good news for vaxxed people is that the vaccines are still very highly effective at keeping you from developing severe disease, which keeps you out of the hospital, out of ICU, and out of the morgue.
Yesterday, July 27th 2021
9,473 people were killed by COVID-19
99.8 % of them were not vaccinated
New Cases: 578,338 (⬆︎ .30%)New Deaths: 9,473 (⬆︎ .23%)
USA
New Cases: 61,581 (⬆︎ .17%)New Deaths: 339 (⬆︎ .05%)
USA Vaccination Scorecard
At Least One Dose: 189.0 million (56.9%)Fully Vaxxed: 163.3 million (49.2%)
The CDC's guidance on masks is a little confusing - like they're trying to find a way to customize it for individual counties. But it just seems to say we're back to masking up indoors and when we're in crowds.
For me, there's no need to make it complicated. When you step outside your own little bubble, wear your mask.
Jul 27, 2021
COVID-19 Update
Yesterday, July 26th, 2021
7,420 people were killed by COVID-19
99.7% of them were not vaccinated
World
New Cases: 449,290 (⬆︎ .23%)
New Deaths: 7,420 (⬆︎ .18%)
USA
New Cases: 35,816 (⬆︎ .10%)
New Deaths: 132 (⬆︎ .02%)
USA Vaccination Scorecard
At Least One Dose: 188.7 million (56.8%)
Fully Vaxxed: 163.2 million (49.1%)
So, here's more evidence that standard practices, like quarantine and testing, work when you actually follow the guidelines and enforce the rules.
Tokyo reports new record for coronavirus infections, but the Games’ bubble holds
In the months leading up to the Olympic Games, the citizens of Tokyo became extremely worried about the prospect of tens of thousands of foreigners coming in and infecting them with the coronavirus.
Their concerns might have been misdirected. On Tuesday, Tokyo reported 2,848 new coronavirus cases, its highest daily count ever and four times the average at the end of June.
Inside the Olympic bubble, the situation appears much more under control.
Over the past three days in Tokyo, there have been an average of only 9,382 tests per day administered, suggesting positivity rates of as high as 30 percent. In Japan as a whole, provisional figures showed more than 7,000 new cases, close to a record set in January.
By comparison, between July 1 and 25, more than 37,000 tests were administered on Olympic arrivals at Japan’s international airports, and just 30 positive cases were found, Tokyo 2020 spokesman Masa Takaya said during a news conference, calculating a positivity rate of 0.08 percent.
Nearly 240,000 screening tests have been carried out on people related to the Olympics over the same time period, and 52 positive cases were found, giving a positivity rate of 0.02 percent, he said.
The total cases found in people connected to the Olympics since the start of July rose by seven, to 155, on Tuesday, although Japanese public broadcaster NHK reported that 14 police officers working on security for the Games have also tested positive.
“The main thing we can do is to continue to give comfort to everyone that . . . we are doing everything we need to do, and we are keeping testing rates very, very high and the infection rate is very, very low,” said International Olympic Committee spokesman Mark Adams.
- more -
And when you fuck around, you find out.
In the South, the delta surge will force impossible choices for ICU doctors like me
The vaccines work. So it’s even worse to have to think about rationing care again.
Covid-19 surges among the unvaccinated are forcing health-care professionals into uncharted moral dilemmas just as they’re battling other stressors. With emerging strains of the SARS-CoV-2 virus now a predominant concern globally, we in the Southern United States are seeing a resurgence of newly infected patients flowing into our ICUs with failing lungs, clotted blood vessels and delirium.
As an ICU doctor in Tennessee, I am further faced with the gut-wrenching reality that in two-thirds of our state’s counties, only about 25 percent of the population is vaccinated against the virus. The state’s overall vaccination rate is under 40 percent. Yet rather than fighting this crisis, Tennessee lawmakers and the state’s Department of Health just fired our top vaccination leader and temporarily halted efforts to promote vaccination to children for all preventable diseases, including pertussis, tetanus and diphtheria, actions that would set us back 100 years in protecting vulnerable children.
This wave of the pandemic is occurring in the wake of one of the most impressive scientific achievements of all time: the development in under a year of a group of highly effective vaccines with the power to beat the virus into submission and bring the situation to an end. And yet, a Washington Post/Kaiser Family Foundation poll in March (when most health-care professionals had long been eligible to get the vaccines) found that only 52 percent of health-care workers were vaccinated, and 18 percent said they didn’t plan to get the vaccine.
These facts prompt dizzying questions, starting for me with:
Should doctors and nurses be allowed to work on the front lines in 2021 without vaccination?
And if things continue to get worse in our area and two covid-19 patients appear to need the same scarce treatment or resource, should medical professionals give the treatment to a vaccinated patient before an unvaccinated patient?
Recently, I was standing next to yet another patient on a ventilator side-by-side with an excellent ICU nurse, whom I have known for more than a decade. I asked the patient if he had been vaccinated. “No, Dr. Ely,” the nurse replied, “but I know PPE works, so I feel safe.” To which I responded, “Well, it’s a personal choice.” But since then, I have been rethinking that answer.
We cannot forget that, as shown in a study reviewing over 400,000 people from 43 investigations who underwent PCR testing, one-third of those infected with SARS-CoV-2 remained completely asymptomatic. During periods of silent infection, we know that intense viral shedding occurs. Health-care professionals, who are routinely around immunocompromised patients who can’t mount an adequate immune response from a vaccine, clearly do become infected with SARS-CoV-2. Many experience severe outcomes, including death.
In fact, the unvaccinated nurse standing over my patient with me could have been shedding virus beneath his N95 without knowing it. What’s worse is that the delta variant, which is the predominant strain now, has figured out how to amplify itself over 1,000-fold in terms of viral load.
It is never my place to judge my patients for their personal choices. But my vocation and that of my colleagues during this public health crisis warrants rapid expansion of a mandatory covid-19 vaccination policy for health-care professionals. Nearly every one of the patients being admitted to hospitals today around the world for covid treatment are unvaccinated. Some who are unvaccinated live in underserved regions or have logistical problems because they are working two or three jobs and can’t take time off. Others have simply decided not to get it, even though it would be easy for them. Whatever the reason, though, patients without the shield provided by a vaccine pose an ongoing real and present threat to the overall safety of our society on multiple levels — especially in the Southern United States. We can’t force these patients to do what we know is the right thing, nor can we change what they read or watch or the difficult conditions in which they might live. But we can control our own actions as people of science. We in health care must pass on the safety benefits of vaccination to the vulnerable patients we serve. Mounting data suggest that the vaccines are associated with decreased asymptomatic infections and an approximate 30 percent reduction in transmission. They work. We should take them.
What about complicated religious and personal exceptions posed by hospital workers? First, most religions wholly endorse vaccination. As the leader of the world’s 1.2 billion Catholics, Pope Francis considers it a moral obligation to take the vaccine. And health-care systems can employ comprehensive programs to review the requests placed by the small minority of people who submit a desire for religious or personal exemption.
There is also a real and growing fear of scarcity in how we treat covid-19 as cases rise. In the United States, hospitals are much busier than a year ago because non-covid patients are more willing to seek medical and surgical care. Many ailments such as heart and lung diseases neglected during the pandemic are further advanced pathologically and more complicated than usual. This creates an excess need for interventions that are also required in covid-19 care, such as extracorporeal membrane oxygenation (ECMO) machines. ECMO is an advanced form of life support that is a very limited resource. It takes blood out of the body to provide oxygen that destroyed lungs cannot, then returns that life-giving blood to the patient’s vital organs.
A very realistic scenario that we and other colleagues may soon face is that the delta-variant-driven surge may create a situation in which only one ECMO circuit remains available in a given hospital. So who should get to use it? I recently asked about this on Twitter. The results of a Twitter poll are obviously not statistically valid, but the majority of over 20,000 votes cast indicated that a vaccinated person deserves to get precious medical resources over an unvaccinated person — no matter who those people are or how they got covid.
Any health-care professional who has to make such an impossible choice potentially incurs moral injury from being forced to make decisions that go against our deeply held beliefs to help all patients. We already know that our front-line essential workers are suffering from PTSD at alarming rates. The wave of distorted facts, either directly espoused or indirectly facilitated by government officials around the country, are having ripple effects that we have not even fully realized yet — effects that will last for decades, if you consider lost careers and those that are never realized by young people watching this unfold and being taught scientific fallacies.
The truth is that our best estimates to date show that the coronavirus vaccines have averted more than a quarter-million deaths and prevented more than 1 million hospitalizations in the United States alone. There is now very solid data that two doses of the mRNA vaccines in use in the United States provide effective protection against the delta variant. We already mandate vaccination for diseases such as influenza with great success among health-care workers. We know how to do this. We have a way out of this pandemic.
As a young boy in Louisiana, I heard my grandmother talk about the “righteous anger” she felt when my great-grandfather’s newspaper was burned down by the Ku Klux Klan because he spoke against injustice by printing articles supporting local Black families. Our current vaccine crisis is another social injustice we must quell. I am especially upset that this public health disaster disproportionately affects people who can least afford more heartache in their lives — people of color, low socioeconomic means and those with physical and mental disabilities. As a physician, I cannot abide the moral consequences unfolding now — especially since, collectively, we know better.
Should doctors and nurses be allowed to work on the front lines in 2021 without vaccination?
And if things continue to get worse in our area and two covid-19 patients appear to need the same scarce treatment or resource, should medical professionals give the treatment to a vaccinated patient before an unvaccinated patient?
Recently, I was standing next to yet another patient on a ventilator side-by-side with an excellent ICU nurse, whom I have known for more than a decade. I asked the patient if he had been vaccinated. “No, Dr. Ely,” the nurse replied, “but I know PPE works, so I feel safe.” To which I responded, “Well, it’s a personal choice.” But since then, I have been rethinking that answer.
We cannot forget that, as shown in a study reviewing over 400,000 people from 43 investigations who underwent PCR testing, one-third of those infected with SARS-CoV-2 remained completely asymptomatic. During periods of silent infection, we know that intense viral shedding occurs. Health-care professionals, who are routinely around immunocompromised patients who can’t mount an adequate immune response from a vaccine, clearly do become infected with SARS-CoV-2. Many experience severe outcomes, including death.
In fact, the unvaccinated nurse standing over my patient with me could have been shedding virus beneath his N95 without knowing it. What’s worse is that the delta variant, which is the predominant strain now, has figured out how to amplify itself over 1,000-fold in terms of viral load.
It is never my place to judge my patients for their personal choices. But my vocation and that of my colleagues during this public health crisis warrants rapid expansion of a mandatory covid-19 vaccination policy for health-care professionals. Nearly every one of the patients being admitted to hospitals today around the world for covid treatment are unvaccinated. Some who are unvaccinated live in underserved regions or have logistical problems because they are working two or three jobs and can’t take time off. Others have simply decided not to get it, even though it would be easy for them. Whatever the reason, though, patients without the shield provided by a vaccine pose an ongoing real and present threat to the overall safety of our society on multiple levels — especially in the Southern United States. We can’t force these patients to do what we know is the right thing, nor can we change what they read or watch or the difficult conditions in which they might live. But we can control our own actions as people of science. We in health care must pass on the safety benefits of vaccination to the vulnerable patients we serve. Mounting data suggest that the vaccines are associated with decreased asymptomatic infections and an approximate 30 percent reduction in transmission. They work. We should take them.
What about complicated religious and personal exceptions posed by hospital workers? First, most religions wholly endorse vaccination. As the leader of the world’s 1.2 billion Catholics, Pope Francis considers it a moral obligation to take the vaccine. And health-care systems can employ comprehensive programs to review the requests placed by the small minority of people who submit a desire for religious or personal exemption.
There is also a real and growing fear of scarcity in how we treat covid-19 as cases rise. In the United States, hospitals are much busier than a year ago because non-covid patients are more willing to seek medical and surgical care. Many ailments such as heart and lung diseases neglected during the pandemic are further advanced pathologically and more complicated than usual. This creates an excess need for interventions that are also required in covid-19 care, such as extracorporeal membrane oxygenation (ECMO) machines. ECMO is an advanced form of life support that is a very limited resource. It takes blood out of the body to provide oxygen that destroyed lungs cannot, then returns that life-giving blood to the patient’s vital organs.
A very realistic scenario that we and other colleagues may soon face is that the delta-variant-driven surge may create a situation in which only one ECMO circuit remains available in a given hospital. So who should get to use it? I recently asked about this on Twitter. The results of a Twitter poll are obviously not statistically valid, but the majority of over 20,000 votes cast indicated that a vaccinated person deserves to get precious medical resources over an unvaccinated person — no matter who those people are or how they got covid.
Any health-care professional who has to make such an impossible choice potentially incurs moral injury from being forced to make decisions that go against our deeply held beliefs to help all patients. We already know that our front-line essential workers are suffering from PTSD at alarming rates. The wave of distorted facts, either directly espoused or indirectly facilitated by government officials around the country, are having ripple effects that we have not even fully realized yet — effects that will last for decades, if you consider lost careers and those that are never realized by young people watching this unfold and being taught scientific fallacies.
The truth is that our best estimates to date show that the coronavirus vaccines have averted more than a quarter-million deaths and prevented more than 1 million hospitalizations in the United States alone. There is now very solid data that two doses of the mRNA vaccines in use in the United States provide effective protection against the delta variant. We already mandate vaccination for diseases such as influenza with great success among health-care workers. We know how to do this. We have a way out of this pandemic.
As a young boy in Louisiana, I heard my grandmother talk about the “righteous anger” she felt when my great-grandfather’s newspaper was burned down by the Ku Klux Klan because he spoke against injustice by printing articles supporting local Black families. Our current vaccine crisis is another social injustice we must quell. I am especially upset that this public health disaster disproportionately affects people who can least afford more heartache in their lives — people of color, low socioeconomic means and those with physical and mental disabilities. As a physician, I cannot abide the moral consequences unfolding now — especially since, collectively, we know better.
Jul 26, 2021
How Close Was That Shave?
Amanpour and Company on PBS - with Michel Martin doing an interview with Susan Glasser.
So the survival of the republic depends entirely on the actions of honorable people.
I'll start this at about 7:55, where Glasser talks about how Trump can't let go of anything that strokes his ego - that it doesn't matter how reprehensible the supporters are, he has to love them for supporting him.
And then, Martin kicks it up a notch at about 8:55, and I get to hear high-status national reporters affirm my contention that in the end, it all comes down to the fact that this whole experiment in democratic self-government is being run on the honor system.
So the survival of the republic depends entirely on the actions of honorable people.
Unfortunately, honor is at dangerously low levels in the GOP.
We ain't done dodging bullets, btw. Don't get comfortable.
Subscribe to:
Comments (Atom)