Can't shake C19

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luvflyin said:
How much ‘influence’ would you say makes it to the Doctor via the patient.
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That has always been a problem and a challenge. The relentless direct-to-consumer ads on TV make it much worse, I think.

The key way to manage it is to establish trust with a patient so that if I say no - and can reasonably explain why - and they accept it. That doesn’t work for all, of course - but then it isn’t always bad to have the PITAs leave your panel!

This issue is a huge driver in the opioid problem, in my opinion. Providers - docs, nurses, and the rest of the medical staff - need to be unified in messaging to patients about what they need - not necessarily what they want.

Sorry to be hijacking the thread.
 
Rushie said:
I had the regular flu a couple years ago and was sure I was about to die sometime during the second week. Then I turned the corner and recovered, so there is no way to tell if the ivermectin fixed those guys, they might have been about to turn the corner just when they felt the worst which seems typical and also the point you would finally seek help. On the other hand there is a lot of anecdotal evidence that it is effective and there are actual studies:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8248252/

But I don’t know what to believe on any of this; I am totally disgusted by how almost everyone on both sides seem to have lost their rational minds, yes, both sides.

I want to get at the actual truth whatever it is but it seems impossible. You cannot find objective balanced information anywhere. Everyone seems to be in one extreme camp or the other with a political bias or a financial agenda. I cannot believe this country has come to this over a disease that’s killing people.
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Yup on the both sides thing. You’d think that the extremes of each side would be as far apart as possible. To me they are all bunched together as one side. The other side is the rest of us.
 
Llewtrah381 said:
That has always been a problem and a challenge. The relentless direct-to-consumer ads on TV make it much worse, I think.

The key way to manage it is to establish trust with a patient so that if I say no - and can reasonably explain why - and they accept it. That doesn’t work for all, of course - but then it isn’t always bad to have the PITAs leave your panel!

This issue is a huge driver in the opioid problem, in my opinion. Providers - docs, nurses, and the rest of the medical staff - need to be unified in messaging to patients about what they need - not necessarily what they want.

Sorry to be hijacking the thread.
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I'm not completely sure you hijacked this thread. It has taken a turn along the lines of typical human behavior. It seems that money can buy almost anything, but especially power and influence. "Show me the money" rules the day almost every time. Why would we think that covid-19 could possibly not follow this thought. It became painfully clear to me very early on that money, power, and influence were the drivers of the reaction and solutions to this pandemic. The CDC the WHO and the medical profession were very quick to throw support behind any research that involved opportunities to make vast amounts of money and grab ultimate power. After all, that seems to be the way of the world. Everything else be damned.
 
Piper18O said:
The CDC the WHO and the medical profession were very quick to throw support behind any research that involved opportunities to make vast amounts of money and grab ultimate power.
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In our capitalist system, ALL research will involve that risk. That doesn’t translate into it necessarily being the driver for any one player per se. In fact, over the decades, I’ve come to respect the CDC in particular and even the WHO as about as reason-based as possible. Is there corruption within their ranks? I’d be surprised if there wasn’t. Does that mean ALL of their guidance and findings are corrupted? To me, not at all. And at the risk of locking the thread, I think there are more stories bubbling up about non-medical powerful voices/leaders who appear to have financial ties to treatments, etc. Frankly, over the decades, stories of that type of corruption and influence have been dramatically more common than similar stories about the CDC, WHO, or any other similar entity.

If not our American CDC, who is the best source of truth in the world? I can’t think of any better. And just because I don’t like an answer to ANY question in life doesn’t mean the answer is wrong or the answerer is corrupt.
 
Llewtrah381 said:
In our capitalist system, ALL research will involve that risk. That doesn’t translate into it necessarily being the driver for any one player per se. In fact, over the decades, I’ve come to respect the CDC in particular and even the WHO as about as reason-based as possible. Is there corruption within their ranks? I’d be surprised if there wasn’t. Does that mean ALL of their guidance and findings are corrupted? To me, not at all. And at the risk of locking the thread, I think there are more stories bubbling up about non-medical powerful voices/leaders who appear to have financial ties to treatments, etc. Frankly, over the decades, stories of that type of corruption and influence have been dramatically more common than similar stories about the CDC, WHO, or any other similar entity.

If not our American CDC, who is the best source of truth in the world? I can’t think of any better. And just because I don’t like an answer to ANY question in life doesn’t mean the answer is wrong or the answerer is corrupt.
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Your post has a lot of validity. I should probably have said those that are controlling the CDC The WHO, and many aspects of the medical community...
 
Piper18O said:
Your post has a lot of validity. I should probably have said those that are controlling the CDC The WHO, and many aspects of the medical community...
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I absolutely agree: those who CONTROL the CDC haven’t always been aligned with those LEADING the CDC. And that has caused an agency with a world-respected, historically apolitical reputation to have to relentlessly fight a battle it never needed to in the past: to ensure the public they serve understands what is and isn’t scientifically driven guidance. As a (former military) physician who understands how the CDC does and has operated, it has come as a shock to see the misinformation being pumped out about the CDC in particular and even the WHO (a more politically influenced but still a medically credible agency, IMHO).

Let’s face it: a year and a half ago not many of the people criticizing it even knew what the CDC was. I’ve used them as the gold standard for decades - because they are.

Sorry - working really hard to tread the line between clarifying and triggering a lock.
 
Llewtrah381 said:
I absolutely agree: those who CONTROL the CDC haven’t always been aligned with those LEADING the CDC. And that has caused an agency with a world-respected, historically apolitical reputation to have to relentlessly fight a battle it never needed to in the past: to ensure the public they serve understands what is and isn’t scientifically driven guidance. As a (former military) physician who understands how the CDC does and has operated, it has come as a shock to see the misinformation being pumped out about the CDC in particular and even the WHO (a more politically influenced but still a medically credible agency, IMHO).

Let’s face it: a year and a half ago not many of the people criticizing it even knew what the CDC was. I’ve used them as the gold standard for decades - because they are.

Sorry - working really hard to tread the line between clarifying and triggering a lock.
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Not an easy line to walk. what I see as the biggest problem is the fact that things are being done and said because of power and influence that are flat out wrong or at the very least misleading. When that happens, nothing that is said can be trusted. That is how you get entity that you may at one time believe in, and turn it into an entity that can never be trusted, because you never know when the truth has been told. Liars don't necessarily lie lot all the time, but because they are liars, you can never trust them.
 
Piper18O said:
Not an easy line to walk. what I see as the biggest problem is the fact that things are being done and said because of power and influence that are flat out wrong or at the very least misleading. When that happens, nothing that is said can be trusted. That is how you get entity that you may at one time believe in, and turn it into an entity that can never be trusted, because you never know when the truth has been told. Liars don't necessarily lie lot all the time, but because they are liars, you can never trust them.
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Again, I agree with you. But I’ve seen no evidence the CDC in particular has lied. That’s different than saying they’ve always been correct. A lie is intentional. Being in error is not in itself a lie unless it was intentionally dishonest. I haven’t seen CDC do that, despite the “have you stopped beating your wife?” questioning they get from, well, others. What I HAVE seen is them update their guidance as new data emerges, which is exactly what they should do - and have done for decades.

People who lie or manipulate the truth to create the illusion others are lying are sick.

And as I’ve said before in other threads, we should all remember a lie we want to believe is still a lie. Applies to me too.
 
Checkout_my_Six said:
Well doc....you must admit....the CDC sure did bungle the messaging.
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We are supposed to believe everything they say, and take it as gospel. Them and only them. If somebody else comes out with an alternative we must look at them with a discerning and skeptical eye.
The problem is they have changed their views for example on masks about three or four times as I see it. So now I may have no idea what I'm supposed to believe when they come out with an edict or even a suggestion. "Bungled the messaging" is an understatement, regardless of whether it was intentional or unintentional. The results are still the same. To make matters worse they've proven that they have been wrong and we don't even know which time they were wrong. Adding even more fuel to the fire, we are mandated to do things based on what they say. Now people have had enough and they're fighting back. Like the old saying goes fooled me once shame on you fooled me twice shame on me. The bottom line is, it sure is starting to look like this really is all about control.
 
The CDC has skin in the game: they’re accountable for their recommendations and guidance. The world literally is turning to them for it. Senators and Congressmen aren’t executives and have no skin in the game except to get re-elected. We mere mortals anonymously on the internet have even less in the game.

When I was in my residency training a more senior resident said something that has stuck with me today (the senior residents taught the junior residents much of the day to day medicine): we should be really careful to avoid teaching something that’s incorrect. I share some level of responsibility when others treat people based on my incorrect information. That made me want to teach others the best info I had at the time, including “owning it” when new information became available later on. That’s how I’ve chosen to live and, frankly, that’s how I see the CDC and even the WHO doing their best to behave - in a world that’s intentionally misrepresenting facts for ulterior motives.

A lie one wants to believe is still a lie. That doesn’t make the believer a liar - just a victim, whether or not they see it.

Fly safely!
 
Llewtrah381 said:
The CDC has skin in the game: they’re accountable for their recommendations and guidance. The world literally is turning to them for it. Senators and Congressmen aren’t executives and have no skin in the game except to get re-elected. We mere mortals anonymously on the internet have even less in the game.

When I was in my residency training a more senior resident said something that has stuck with me today (the senior residents taught the junior residents much of the day to day medicine): we should be really careful to avoid teaching something that’s incorrect. I share some level of responsibility when others treat people based on my incorrect information. That made me want to teach others the best info I had at the time, including “owning it” when new information became available later on. That’s how I’ve chosen to live and, frankly, that’s how I see the CDC and even the WHO doing their best to behave - in a world that’s intentionally misrepresenting facts for ulterior motives.

A lie one wants to believe is still a lie. That doesn’t make the believer a liar - just a victim, whether or not they see it.

Fly safely!
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Fair enough. But here’s my problem with your science. We can prove that snot droplets and whatnot are stopped or reduced by a mask. Studies show it. So the CDC recommends masks based on that. Now, we can also prove with “science” the fact that two masks will reduce droplet pass through even more. That is a fact. So based on that the CDC recommends double masking.

But it’s based on science that only shows part of the picture. Snot transmission is reduced, yes, but so is air. People are rebreathing their own carbon dioxide. Maybe one mask is tolerable but the public balked at two. Somehow we intuitively feel two is going too far, the marginal increase in benefit isn’t worth the additional aggravation and discomfort.

You can use science to support anything you want when done this way, when showing only part of the picture.
 
Checkout_my_Six said:
So are we back to wearing N95’s or can I just pull up my shirt?
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Just curious: was that a serious question or are you looking to continue the pattern and have this otherwise pretty good conversation get locked? ;)

If it’s serious, I guess it depends on the situation. Remember, N95s are intended to protect others from you, primarily. So, if you’re unvaccinated and are around unvaccinated people, the medically sound answer would be yes, if you can’t maintain 6 feet from others. That apparently sounds like the right answer, too, even if you’ve been vaccinated: apparently even vaccinated people can carry far more of the Delta than the first one, even without symptoms.

Me? I actually got the disease last October and have gotten two doses of Moderna since then. The rampant spread of Delta in the US is due to the unvaccinated, in my opinion. At this stage, sadly, those who won’t get vaccinated are likely never to do so. As much as I want to show compassion, it seems for naught. I don’t wear a mask unless asked to. At this stage it’s pretty Darwinian.

On the other hand, there will likely be more variants, one or more of which will likely break through this vaccine. That, too, is the responsibility of the unvaccinated: the longer the current virus circulates widely the greater the risk of mutation. If we had gotten vaccinated in larger numbers the risk would be greatly reduced. And when that almost inevitably happens, just watch: those resisting vaccination - the ones who will actually be the cause of it, IMHO - will say “See? The vaccine doesn’t work!” Sad but predictable…
 
Rushie said:
People are rebreathing their own carbon dioxide.
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Can you point me to the studies with clinically relevant consequences? Did they do blood gases or just measure the CO2 level under the mask? Big difference. Was blood pH impaired? Thanks!

Just curious: what do you recommend the response be to Covid - just let it spread?
 
Llewtrah381 said:
I actually got the disease last October and have gotten two doses of Moderna since then.
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People who have gotten covid 19 are less likely to get the disease again then those that are vaccinated. If you have had the disease, and then you get vaccinated, does that reduce your exposure even more?
 
Well, folks - this has been fun, mostly. Hopefully the OP got their answers and his wife is better.

Looks like we’re moving to “lock time”!
 
Llewtrah381 said:
I actually got the disease last October and have gotten two doses of Moderna since then.
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People who have gotten covid 19 are less likely to get the disease again then those that are vaccinated. If you have had the disease, and then you get vaccinated, does that reduce your exposure even more?
 
Piper18O said:
People who have gotten covid 19 are less likely to get the disease again then those that are vaccinated. If you have had the disease, and then you get vaccinated, does that reduce your exposure even more?
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I completely agree with your question and logic and can think of only a few very different illnesses where natural infection didn’t provide immunity but the vaccine did (hepatitis B is one). I wondered about the need for the vaccine myself and even wrote to the CDC suggesting, at a minimum, that a first dose of Pfizer or Moderna for people like me be considered a “booster”, with no second shot needed (at the time, to help preserve vaccine doses). They responded and, as I recall, didn’t give a really specific reason but basically indicated there wasn’t enough science at that point to prove it was the right choice.

Remember, all of us have grown up “hoping for a cure for the common cold”. Coronaviruses cause the common cold. The fact that we got a vaccine for this after SARS and MERS is pretty amazing, from my view. These are relatively simple viruses, which, oddly, makes lasting immunity harder.

By the way, the talk about “waning antibody levels” is misleading (and comes mostly from the lay press, though not all of it). All antibody levels tend to wane when the invader is gone. That doesn’t mean the B cells that make them have disappeared - they’re just standing guard quietly. That said, I’m mot personally well-versed on coronavirus immunology.
 
Llewtrah381 said:
Can you point me to the studies with clinically relevant consequences? Did they do blood gases or just measure the CO2 level under the mask? Big difference. Was blood pH impaired? Thanks!

Just curious: what do you recommend the response be to Covid - just let it spread?
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Big question in my mind is did masks help at all through the last surge. Around here (Massachusetts), just about everyone I saw in public places were compliant with mask mandates, yet we still had a surge. It's not useful to just do things so we can say we are doing something.
 
Llewtrah381 said:
I completely agree with your question and logic and can think of only a few very different illnesses where natural infection didn’t provide immunity but the vaccine did (hepatitis B is one). I wondered about the need for the vaccine myself and even wrote to the CDC suggesting, at a minimum, that a first dose of Pfizer or Moderna for people like me be considered a “booster”, with no second shot needed (at the time, to help preserve vaccine doses). They responded and, as I recall, didn’t give a really specific reason but basically indicated there wasn’t enough science at that point to prove it was the right choice.

Remember, all of us have grown up “hoping for a cure for the common cold”. Coronaviruses cause the common cold. The fact that we got a vaccine for this after SARS and MERS is pretty amazing, from my view. These are relatively simple viruses, which, oddly, makes lasting immunity harder.

By the way, the talk about “waning antibody levels” is misleading (and comes mostly from the lay press, though not all of it). All antibody levels tend to wane when the invader is gone. That doesn’t mean the B cells that make them have disappeared - they’re just standing guard quietly. That said, I’m mot personally well-versed on coronavirus immunology.
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I was just wondering about what research has shown. I really haven't seen anything on those that have anti-bodies from the virus plus getting the vaccine, whether it is beneficial or not. Another thing I have wondered is if they will start pushing getting the other vaccines from the companies that you haven't received. (i.e. If you had Pfizer, then you should get Johnson and Johnson and then Moderna or vice versa.) Also, at what point do we say what form of protection we have from this virus is enough. I actually got the virus, my wife got the vaccine. I have been hesitant to get the vaccine because I still have the antibodies.

edit: I have been exposed at least a half a dozen times since my recovery and have never developed any symptoms. That is why I have been hesitant to get vaccinated.
 
azblackbird said:
As a doctor, tell me how we reach true herd immunity if we don’t allow this virus to take its natural course? Just curious… :dunno:
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That’s REALLY easy: vaccination!!!

It’s herd IMMUNITY - not herd INFECTION. The vaccine gives immunity without giving the disease. Much, much safer way to get to herd immunity.
 
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Piper18O said:
That is why I have been hesitant to get vaccinated.
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I think that’s a completely reasonable hesitation. For myself, given the nature of these vaccines, at the start I wondered about the risk/benefit of getting vaccinated after having had the infection. I still think there are some unanswered questions that will literally take years to answer but the more research I do the more comfortable I am with the vaccines. Plus the technology is amazing and a potential game-changer for cancer treatment and possibly other diseases.
 
PaulS said:
Big question in my mind is did masks help at all through the last surge. Around here (Massachusetts), just about everyone I saw in public places were compliant with mask mandates, yet we still had a surge. It's not useful to just do things so we can say we are doing something.
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Is the surge there as great as in other states that unabashedly (and, frankly, politically) blocked mask mandates? I don’t think so. I think that fact helps support the idea that they may not be perfect but they are helping.
 
Rushie said:
People are rebreathing their own carbon dioxide.
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I meant to add this earlier:

Let’s say your statement is true and has clinical significance. Now - are you willing to step back and say “regardless of reason for the mask wearing, it’s harmful and needs to stop”? Should surgeons and OR crews stop wearing them during YOUR surgery because of that? Or, much more importantly (;)), will YOU be the one to campaign for the elimination of Halloween masks? Ya can’t be selective here…
 
The Cleveland Clinic study disagrees with this.
Llewtrah381 said:
That’s REALLY easy: vaccination!!!

It’s herd IMMUNITY - not herd INFECTION. The vaccine gives immunity without giving the disease. Much, much safer way to get to herd immunity.
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Llewtrah381 said:
Citation? Thanks!
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Do a little research on the +90% vaccinated Israelis…. They are struggling with breakthrough cases…many (over60%) have severe cases.

also……. https://wjla.com/news/nation-world/...ar-protection-to-vaccines-israeli-study-shows

“The researchers say their results “question the need to vaccinate” people who were previously infected. They say it’s better to prioritize those who haven't previously tested positive for COVID.”
https://www.deseret.com/coronavirus...n-in-israels-outbreak-among-vaccinated-people

“The people who are not testing positive in the current outbreak are those who have had COVID-19 previously and recovered. These people account for 9% of Israel’s population but less than 1% of recent infections, according to Kovler’s analysis. This has brought new questions about whether natural infections are more protective against the delta variant than vaccinations — but the answer is not yet certain.”

““Israel is as good an example of vaccine efficacy as just about anywhere in the world,” according to The Washington Post. “The delta variant means the virus will probably continue to spread, even among vaccinated people and even in a strongly vaccinated country, such as Israel.””
 
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Checkout_my_Six said:
Do a little research on the +90% vaccinated Israelis…. They are struggling with breakthrough cases…many (over60%) have severe cases.

also……. https://wjla.com/news/nation-world/...ar-protection-to-vaccines-israeli-study-shows

“The researchers say their results “question the need to vaccinate” people who were previously infected. They say it’s better to prioritize those who haven't previously tested positive for COVID.”
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OK - you said “ The Cleveland Clinic disagrees” in response to my answer about attaining herd immunity. Can you cite the Cleveland Clinic study that puts that into question?

And please see my response above to piper180 about vaccination after infection.

And again, I’ll ask - what’s your science-driven medical recommendation for how we DO proceed under the circumstances?

Let’s be honest here: people on blood pressure meds still get complications from those meds AND still die of blood pressure problems. Same for diabetes. Same for lipid diseases. If anyone takes any of those, have they changed what meds they take over the years? I’m betting so. So, if you really don’t “believe” in the vaccine, fine. Then stop those meds and just see what happens.

No, I’m not actually recommending that. I’m pointing out the absurdity of there being a whole bunch of people who “trust” medicine when they want but - and I’d contend for about 90+% political reasons - won’t trust the exact same system for this illness. It just defies reason and is frustrating as h&!! to someone whose life was spent keeping people healthy.

Oh - and from your signature page: “What could I write that would make you believe anything than what you already believe ?”. That…

Rant done.
 
RyanB said:
Explain how it’s not true…
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I did edit my answer to show that I meant the vaccine does not give immunity. If it did we would not have so many vaccinated people with the disease.

To say a vaccine may help with immunity without giving the disease is more correct but the claim that it does give immunity is not correct. It can, it may, it might , but to say it does is not correct. Capeesh?
 
Looks like it may be time to cut off the root beer on this thread, sadly.

Unfortunately some people post on forums for the reason a drunk uses a lamp post: more for support than illumination.
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Llewtrah381 said:
Looks like it may be time to cut off the root beer on this thread, sadly.

Unfortunately some people post on forums for the reason a drunk uses a lamp post: more for support than illumination.
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So now you have to start attacking people that are making a point? Don't go away mad and don't belittle folks.

We don't disagree but clarity is very important for both sides of the discussion.
 
Daleandee said:
So now you have to start attacking people that are making a point? Don't go away mad and don't belittle folks.

We don't disagree but clarity is very important for both sides of the discussion.
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Sorry if you perceive it as a personal attack - absolutely not intended.

Seeing how threads of this general nature have progressed, it seems this one is headed that way too. It doesn’t appear to be reason-based but emotion- based. I find no value, and, my fault, much personal frustration with those. It’s a “gotcha” game with no apparent attempt at a discussion.

Fly safely!
 
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