PlagueWatch 2020-23 - Coronavirus

[ClemmonsDevil]

Anecdotal info, but I am getting lots of Hotline calls for my neonatal ventilator company where adult units are taking conventional ventilators from Neonatal Intensive Care Units to use on adults. This is what we saw in March through May of 2020, when we had to help NICUs come up with non-traditional means of ventilation because so many adults were getting intubated that NICUs were scavenged for equipment. One of the things we learned early in the pandemic was that if you were sick enough to get intubated, you were probably going to die. So early and aggressive use of non-invasive ventilation became the rule of the day. You better fix these people before they get sick enough to be intubated. So if mechanical ventilators are becoming scarce again this is at least suggestive of either the Delta variant being worse, or perhaps more troubling, a real issue with resources where so many patients show up at the same time that the hospital staff gets overwhelmed and they can't treat them fast enough and people are getting intubated because adult units are getting overwhelmed. Troubling signs.

[devil84]

Hey, can I ask the medical people here something?

I have a friend who is pregnant. She did not get the vaccine yet, but really wants to. I know that people cannot give cut and dry medical recs, but can anyone offer any thoughts about the potential interaction between the mRNA vaccines and pregnancy? Like, is there a real worry, or is it just general caution?

Thanks!

I'm not a doctor, but I had a daughter who gave birth last August who is still nursing. Obviously the vaccines weren't available when she was pregnant, but she did get her shots while she was nursing, so she did quite a bit of research on how it would affect her baby before getting them. Being a non-front-line health care worker, she was in one of the early waves. She did her research and discussed with several doctors in her OBGYN practice, which is through Duke, where several of the doctors that she sees are professors at DUMC. They overwhelmingly and enthusiastically are urging mothers-to-be and nursing mothers to get the vaccine, with very, very few exceptions, which are mostly the usual medical exemptions for non-pregnant humans.

In related anecdotal information, she had hoped to nurse him for a year. She has changed her mind and will continue to nurse until he is vaccinated, since immunities of all kinds, including this virus, pass to the child through breast milk. Her credentials are that she's a speech language pathologist and is also a certified lactation consultant. (She is not a specialist like an OBGYN or virologist.)

Of course, I'm just a poster on DBR, so your friend should definitely seek out qualified medical opinions for her care. But, according to my daughter's OBGYNs, pregnant women should not hesitate to get the vaccine. Especially since if they get COVID, they and their baby are at greater risk.

[LasVegas]

The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) are saying ALL pregnant women should receive the vaccine.

[Dr. Rosenrosen]

Hey, can I ask the medical people here something?

I have a friend who is pregnant. She did not get the vaccine yet, but really wants to. I know that people cannot give cut and dry medical recs, but can anyone offer any thoughts about the potential interaction between the mRNA vaccines and pregnancy? Like, is there a real worry, or is it just general caution?

Thanks!

Saw this yesterday…

Ob-gyn associations recommend all pregnant people get vaccinated against Covid-19

Two leading organizations that represent obstetricians and gynecologists recommended Friday that anyone who is pregnant should be vaccinated against Covid-19.

The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) said their recommendation is based on evidence from thousands of people who were pregnant that the vaccines are safe to be used during pregnancy. The associations also cite the country's low vaccination rate and the recent increase in cases.

The associations are also strongly recommending their members "enthusiastically recommend vaccination" to their patients.

https://www.cnn.com/2021/07/30/healt...ess/index.html

[Lord Ash]

Thanks, guys, really appreciate it.

[bundabergdevil]

Thanks, guys, really appreciate it.

FWIW, my wife is 8 month’s pregnant. Her doctor (UPenn medical system) advised against it in the first trimester based on available data at the time and lack of testing on pregnant populations during trials. This was right at the beginning of the vaccine being available. They changed their recommendation when she was further along and she has received the vaccine with no issues.


She does have to wear a mask during labor. She’s not happy about that.

[YmoBeThere]

She does have to wear a mask during labor. She’s not happy about that.

Well, you probably shouldn't have handed her this when you told her:

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[bundabergdevil]

Well, you probably shouldn't have handed her this when you told her:

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Hah hah. Imma tell her you said that.

[ClemmonsDevil]

FWIW, my wife is 8 month’s pregnant. Her doctor (UPenn medical system) advised against it in the first trimester based on available data at the time and lack of testing on pregnant populations during trials. This was right at the beginning of the vaccine being available. They changed their recommendation when she was further along and she has received the vaccine with no issues.


She does have to wear a mask during labor. She’s not happy about that.

Babies are pretty much fully formed at 32/33 weeks. Moms could start huffing paint about then and the baby won't be affected at the level of physical development. They just need to grow at that point. Now, because some moms actually DO decide to start doing those things around that time AND I worked in a huge NICU and saw this fairly frequently, there are other issues with getting your baby hooked on drugs.

[tbyers11]

My kids and I just got back from our trip to see family in FL, and I’m as nervous as long tailed cat in a room full of rocking chairs. Just counting the days hoping none of us gets sick. We were among the very few who wore masks in the hotel but did eat multiple meals in the rather crowded restaurants there. They did their best keep tables distanced. But if this thing really is as contagious as the measles, we’re going to be lucky if we avoid having caught this crap from all the morons around us. In retrospect, I wish we had not gone.

Not quite as contagious as measles. Not quite as contagious as chickenpox either (closer but not quite right CDC). This Eric Topol tweet and the data to date show R0 of ~6 for Delta.

Delta is however ~3x more infectious than the original version of COVID and ~2x more infectious than alpha. So masking inside is probably a good idea, even if vaccinated, to help control spread in hot spots (like FL).

Delta's Ro is ~6, meaning an average infected, unvaccinated person, unprotected by prior infection or distancing measures, would pass it on to 6 others
That's bad enough, don't make it worse:
@CNN keeps saying it's 9.
@CDCgov compared it to chickenpox, which has a Ro of 10-12

Delta RO.jpg

[budwom]

It's basically The New, Improved Covid...one way to commemorate the recent death of Ron Popeil, who would have had a cure for this.

[freshmanjs]

Not quite as contagious as measles. Not quite as contagious as chickenpox either (closer but not quite right CDC). This Eric Topol tweet and the data to date show R0 of ~6 for Delta.

Delta is however ~3x more infectious than the original version of COVID and ~2x more infectious than alpha. So masking inside is probably a good idea, even if vaccinated, to help control spread in hot spots (like FL).



Delta RO.jpg

When they cite R0 numbers like this, what situation are they describing? Is it an unvaccinated population? With what behavior?

Obviously the R0 for Delta is below 1 in the UK right now…

[tbyers11]

When they cite R0 numbers like this, what situation are they describing? Is it an unvaccinated population? With what behavior?

Obviously the R0 for Delta is below 1 in the UK right now…

I don't know for sure. And 5 minutes spent trying to find the source article using Lancet, Imperial College and Australia has been unsuccessful. I would guess that the COVID numbers are probably in some sort of masking, unvaccinated situation while the mumps, chickenpox, measles were in a maskless situation. But I hope a COVID based study would control for masking that in the calculation.

My main point was that while Delta is more contagious than COVID that was prevalent in the US prior to ~April 2021 (Wuhan, Alpha) and we should take precautions. However, saying that it is contagious as chickenpox or measles is likely a bit overstating for those that are familiar with respiratory infections.

But, in retrospect, most Americans don't have a good grasp on what an R0 of 18 for measles vs an R0 of 6 for Delta COVID vs an R0 of ~1.5 for seasonal flu means. So comparing Delta to chicken pox or measles might be a good idea to "scare" people into taking it seriously?

[Skydog]

So went on a large family vacation. We all stayed in different condos but my mother in law got COVID symptoms on day 1 of vacation. Didn’t tell us at all and ended up infecting just about everyone in the group. 5/8 adults showing symptoms with all 5 testing positive. 3/6 kids showing symptoms but we didn’t get them tested. We did wear masks when out in large groups or indoors but didn’t think we needed to wear them when conversing with each other at the beach/pool. My double agent mother in law got us all. She is pretty sick right now but looks like she will steer clear of the ED. Everyone else doing fine but are furious with her for not telling anyone. Every adult was vaccinated on the trip as well. This delta variant is no joke.

So assume you are in the 3/8 group? Glad everyone is recovering except your MIL’s reputation.

[LasVegas]

So assume you are in the 3/8 group? Glad everyone is recovering except your MIL’s reputation.

Yep. I am good. No symptoms at all for me or my kids.

[aimo]

My niece (30 yo) put off getting her vaccine, did something careless and stupid and contracted COVID back in April. Felt pretty crappy. Got her vaccine as soon as she could after the fact. She STILL does not have her sense of smell back.

[rsvman]

I don't know for sure. And 5 minutes spent trying to find the source article using Lancet, Imperial College and Australia has been unsuccessful. I would guess that the COVID numbers are probably in some sort of masking, unvaccinated situation while the mumps, chickenpox, measles were in a maskless situation. But I hope a COVID based study would control for masking that in the calculation.

My main point was that while Delta is more contagious than COVID that was prevalent in the US prior to ~April 2021 (Wuhan, Alpha) and we should take precautions. However, saying that it is contagious as chickenpox or measles is likely a bit overstating for those that are familiar with respiratory infections.

But, in retrospect, most Americans don't have a good grasp on what an R0 of 18 for measles vs an R0 of 6 for Delta COVID vs an R0 of ~1.5 for seasonal flu means. So comparing Delta to chicken pox or measles might be a good idea to "scare" people into taking it seriously?

Also worth mentioning that although influenza, chickenpox, measles, and others had an R0 that was fairly homogeneous, for the original strain of SARS-CoV-2 that was not true; in other words, an R0 of 2-ish for something generally meant that each infected person would infect about two others, but with SARS-CoV-2 it was seen that although the R0 was similar, many people didn't infect anyone and then another person might infect 40 people (the so-called "superspreaders"). We talked about this earlier in the thread, but one writer, with an exaggeration meant to illustrate the point, noted that, if Jeff Bezos walked into a bar in which you and 25 other people were seated, the average or mean income of everybody would be in the tens of millions, despite the fact that everybody in the bar besides Bezos was actually making between 50K and 200K, for example. I'm not sure whether, with the Delta variant, we are continuing to see the same sort of strange spread, in which many or even most people do not infect anybody while others infect a LOT of people, but I suspect that perhaps the reason for the higher R0 is because the Delta variant is NOT following that same sort of strange distribution of spreading, but rather is spreading from pretty much everybody who becomes infected. No, I don't have data to back that up right now; that is just my gut feeling.

[CameronBornAndBred]

Yep. I am good. No symptoms at all for me or my kids.

Way to stay away from Grandma, kids!

[freshmanjs]

I don't know for sure. And 5 minutes spent trying to find the source article using Lancet, Imperial College and Australia has been unsuccessful. I would guess that the COVID numbers are probably in some sort of masking, unvaccinated situation while the mumps, chickenpox, measles were in a maskless situation. But I hope a COVID based study would control for masking that in the calculation.

My main point was that while Delta is more contagious than COVID that was prevalent in the US prior to ~April 2021 (Wuhan, Alpha) and we should take precautions. However, saying that it is contagious as chickenpox or measles is likely a bit overstating for those that are familiar with respiratory infections.

But, in retrospect, most Americans don't have a good grasp on what an R0 of 18 for measles vs an R0 of 6 for Delta COVID vs an R0 of ~1.5 for seasonal flu means. So comparing Delta to chicken pox or measles might be a good idea to "scare" people into taking it seriously?

Thanks. I find it a very odd metric to use the way people seem to be using it. I can see usefulness for comparing relative infectiousness of different illnesses when conditions are normed to some kind of comparable baseline (if such baselining is really accurate).

However, saying the R0 of covid is x makes no sense. It obviously changes rapidly. Not static at all. Covid has a pattern of intense waves and then equally rapid dissipation. The R0 is very very different on each side of the curve, just a couple of weeks apart.

[YmoBeThere]

But, in retrospect, most Americans don't have a good grasp on what an R0 of 18 for measles vs an R0 of 6 for Delta COVID vs an R0 of ~1.5 for seasonal flu means. So comparing Delta to chicken pox or measles might be a good idea to "scare" people into taking it seriously?

The last 16 months have revealed that most Americans don't have a good grasp on much at all.