PlagueWatch 2020-23 - Coronavirus

[mph]

I did not find Ross Douthat's article useful at all. He uses the example of a document presented by a political organization (which is what the CDC has become) as evidence that you can't trust the science? I read that document too and found it to be way too political to be completely trusted. The CDC should not be designing the vaccination roll out, there should have be a new, independent panel of medical ethicists and infectious disease experts charged with designing a plan and it should have been put in place at the same time that the research on the vaccines was funded. It's still not too late but hoping that we get such a panel right now is a pipe dream. We are where we are because of the failures of our political leaders. We will continue to be failed by our political leaders as long as we continue to mistrust experts. It shouldn't be "trust the science", it should be "trust those who have the experience and knowledge to know what they are talking about". When it comes to how to manage a pandemic, there is one thing Douthat gets right, we should have all listened to Dr. Fauci from the beginning. Beyond that, this opinion piece is not worth reading.

Douthat’s article is clearly political. Both the content and they fact it’s an editorial make that clear. But, Douthat isn’t using “political” as a synonym for “partisan” and neither should we. In the article “political” describes a distinct category of decisions that cannot be determined by science alone.

Douthat is very clear that his argument is not “you can’t trust the science.” His argument is we need to clearly differentiate between scientific decisions and political decisions. Doing so will increase confidence in both our scientific experts and our political leaders.

Scientific questions: is the vaccine effective, is it safe, do masks work, how is COVID spread, does it spread in schools, what is the CFR, etc.

Political questions: who should get the vaccine first, should it be mandatory, should we require people to wear masks, should schools/businesses/churches be open, etc.

IMO, a contributing cause to the decline in our trust of scientific expertise is a failure to distinguish between the two categories. We drag experts into political controversies and make it sound like science answers questions it was never designed to answer. It’s not just COVID, but a host of other issues where science and public policy intersect. Scientific expertise is necessary, but not sufficient to tackle these issues:

When we look back over the pandemic era, one of the signal failures will be the inability to acknowledge that many key decisions — from our vaccine policy to our lockdown strategy to our approach to businesses and schools — are fundamentally questions of statesmanship, involving not just the right principles or the right technical understanding of the problem but the prudential balancing of many competing goods.

[JasonEvans]

Just wanted to chime in with a personal story.

My mother-in-law (lives in Philly) started feeling unusually about a week ago. No other symptoms. Then, she started getting confused. She stopped checking her email and when we spoke to her on the phone, she was clearly a little bit out of it (seemed a bit like she was drunk). No respiratory symptoms at all, just tired and somewhat confused. Well, she got a Covid test and she has it (the test came back "presumed" but not 100% confirmed).

My sister-in-law is staying with her for the moment. My mother-in-law is in her upper 70s so we are obviously quite worried.

In my extended family, this is the first person other than a college student (two of my nephews -- one at UGA, one at Miami -- neither of whom showed any meaningful symptoms) who has gotten it. There are 22 of us in the extended family so we feel pretty fortunate that none of us have had much of a problem thus far.

[aimo]

A few questions for our knowledgeable DBR folks:

1) Do they test for COVID before administering the vaccine to individuals?

2) Did they do the above in the clinical trials of the vaccine?

3) What are the ramifications of getting the vaccine if you are already positive?

(These are just questions that popped into my overactive brain, and doesn’t represent any current conditions in the TruBlu household.)

Thanks to all for your previously posted information. It’s much appreciated!

I am not one of the knowledgeable ones, but I got my vaccine this morning. They did not test first. We were told it was not a concern. 2nd shot scheduled for 1/11, immunity within two weeks after that.

[mph]

Just wanted to chime in with a personal story.

My mother-in-law (lives in Philly) started feeling unusually about a week ago. No other symptoms. Then, she started getting confused. She stopped checking her email and when we spoke to her on the phone, she was clearly a little bit out of it (seemed a bit like she was drunk). No respiratory symptoms at all, just tired and somewhat confused. Well, she got a Covid test and she has it (the test came back "presumed" but not 100% confirmed).

My sister-in-law is staying with her for the moment. My mother-in-law is in her upper 70s so we are obviously quite worried.

In my extended family, this is the first person other than a college student (two of my nephews -- one at UGA, one at Miami -- neither of whom showed any meaningful symptoms) who has gotten it. There are 22 of us in the extended family so we feel pretty fortunate that none of us have had much of a problem thus far.

Happy to hear your mother-in-law has relatively mild symptoms. I’ll be praying it passes quickly. We’ve also been blessed to have very few extended family members test positive with no hospitalizations. My wife’s 90+ year old great aunt tested positive and didn’t tell anyone in the extended family until she recovered. Didn’t want to worry anyone.

[Mtn.Devil.91.92.01.10.15]

Curious to get a take from Those Who Know here...

My parents - Duke class of '68 - are certain in the elevated risk category for age as well as pre-existing conditions. They have been extraordinarily careful since March and it has taken a toll on their psyche.

I have been encouraging them to contact their PCP about getting in line for the vaccine, but they se to think it isn't likely to happen for a long time, and that there are lots of other folks who "need it worse" than them.

Anyone in the know here in NC - what's the most efficient way for them to join the queue, and if they do, how long will it likely take for them to receive the vaccine?

Thanks in advance. I appreciate the knowledge of this board so much!

[MChambers]

Thoughtful story about the new strain of the coronaviruss in the UK:

https://www.sciencemag.org/news/2020...emains-unclear

tl;dr we don't know squat yet.

[Mike Corey]

Jason, keeping your mother in law in my prayers.

[MChambers]

The gummint on Friday started releasing a report called the COVID-19 Community Profile Report. Should have been done months ago, of course, but it's got great info. https://publicintegrity.org/health/c...19-data-shows/

[Bostondevil]

Douthat’s article is clearly political. Both the content and they fact it’s an editorial make that clear. But, Douthat isn’t using “political” as a synonym for “partisan” and neither should we. In the article “political” describes a distinct category of decisions that cannot be determined by science alone.

Douthat is very clear that his argument is not “you can’t trust the science.” His argument is we need to clearly differentiate between scientific decisions and political decisions. Doing so will increase confidence in both our scientific experts and our political leaders.

Scientific questions: is the vaccine effective, is it safe, do masks work, how is COVID spread, does it spread in schools, what is the CFR, etc.

Political questions: who should get the vaccine first, should it be mandatory, should we require people to wear masks, should schools/businesses/churches be open, etc.

IMO, a contributing cause to the decline in our trust of scientific expertise is a failure to distinguish between the two categories. We drag experts into political controversies and make it sound like science answers questions it was never designed to answer. It’s not just COVID, but a host of other issues where science and public policy intersect. Scientific expertise is necessary, but not sufficient to tackle these issues:

But then he attributes the CDC's political document to science. The CDC's document is not science, it's politics dressed up to look like science.

Who should get the vaccine first is neither a scientific question nor a political question, it's an ethical question. So are most of the rest of the questions you assign to political. Granted, politicians will make most of those decisions, but that doesn't make them political in nature. I agree there are a host of other issues where science and public policy intersect and science cannot answer all of those questions, but the reason, IMO, we don't trust scientific expertise is because politicians want to skip over the ethics. And there are, in very many issues, lots of differing points of view on what is the most ethical way to approach problems. When you really start to consider the ethics of any issue, there is almost never one right approach, competing interests or competing priorities will always muddy the waters, and not having one answer, IMO, goes so against the American psyche that we wind up not making any decisions at all. So, going back to my original beef with Nate Silver - deciding that age should be the only thing we consider in the rollout of the vaccines and then using his statistical expertise to prove his agenda is way too simplistic. I could even argue unethical, but, I will give Silver and others the benefit of the doubt because I think they are making good faith efforts, they just don't have the knowledge and expertise of people who have been researching medical ethics/decision making when resources are scarce for longer.

Let me add that I am not actually arguing against vaccinating by age, I'm arguing that the analyses I've seen putting forth that variable as the only one that should matter in determining who gets the resource first leave out a lot of competing interests.

[rsvman]

A few questions for our knowledgeable DBR folks:

1) Do they test for COVID before administering the vaccine to individuals?

2) Did they do the above in the clinical trials of the vaccine?

3) What are the ramifications of getting the vaccine if you are already positive?

(These are just questions that popped into my overactive brain, and doesn’t represent any current conditions in the TruBlu household.)

Thanks to all for your previously posted information. It’s much appreciated!

1) They do not test for COVID prior to administering vaccine. For me there was a form that we had to fill out, saying that we were not currently sick and that we had not had known contact with someone with COVID or suspected COVID within the prior 14 days.

2) To my knowledge, testing for COVID was NOT done in the clinical trials. Had it been done, it would have set a clinical precedent that would have required everybody to get tested prior to getting vaccinated, which would have added another layer of complexity to an already complex situation.

3) Nobody really knows the answer to this question, but we do have a lot of experience giving other vaccines to people who have already had the disease in question, and we have not seen any real problems emerge in that setting. As an example, I'm old enough that I contracted measles as a kid. When I got into the Army, they insisted on giving me measles vaccine, anyway. No problems. We also often revaccinate kids that have been adopted from overseas, even though they have vaccine records that show they were previously vaccinated. We do not have problems in this setting, either.


I got the first shot this morning. The same person who gave me my flu vaccine gave me the shot. She is really good, and I didn't feel the flu vaccine hardly at all. Unfortunately, this morning when she stuck the needle in I think she went through a little nerve. I got an electric shock type pain, but it didn't last very long. They made me sit in a little room with a few other vaccinees for 15 minutes after getting it to make sure I didn't have an immediately allergic reaction. When they saw I was an ID doctor they started asking me questions about the virus, the mutated virus in Europe, the vaccine, when protection would start, etc., etc. So, essentially I spent most of the 15 minutes pontificating. When I left, they were saying, "Thanks. I look forward to your video lecture series." It was pretty funny.

So far, after the initial ouchy bit, I have felt pretty good. Weirdly, I am having a bit of referred pain to the outside of the elbow. Probably from the nerve that got tweaked. I'm sure the actual vaccine site will get sore later. I saw one of my colleagues this morning who got the shot Friday. He said that he had very severe pain at the injection site that rivaled what he felt when he got yellow fever vaccine, but most people have been saying they only had mild discomfort. I got the yellow fever vaccine in the Army, and it was pretty bad, although for my money the worst of them was the plague vaccine. Yikes! That one really hurt, and the pain in the arm lasted for almost a week. (The only plus side was that they exempted me from the push-up portion of the physical fitness test because of it.)

[CDu]

It's been several days now since Mrs. CDu got dose #1, and I can happily report that she has had no side effects other than being generally annoyed with me. But that's definitely not a treatment-emergent event .

The CDu clan is looking forward to her second dose in ~2.5 weeks.

CDu Jr and his old man will have to wait several months before we get a shot.

[aimo]

So far, after the initial ouchy bit, I have felt pretty good.

My experience was like yours. Get the shot, wait 15 minutes. I barely felt the shot. Not even the sting of the flu vaccine. Felt nothing for several hours. A little while ago, I lifted my arm and felt the familiar tightness/soreness of post-shot. That's it. My co-workers who got theirs last week have all reported zero immune responses.

[devildeac]

1) They do not test for COVID prior to administering vaccine. For me there was a form that we had to fill out, saying that we were not currently sick and that we had not had known contact with someone with COVID or suspected COVID within the prior 14 days.

2) To my knowledge, testing for COVID was NOT done in the clinical trials. Had it been done, it would have set a clinical precedent that would have required everybody to get tested prior to getting vaccinated, which would have added another layer of complexity to an already complex situation.

3) Nobody really knows the answer to this question, but we do have a lot of experience giving other vaccines to people who have already had the disease in question, and we have not seen any real problems emerge in that setting. As an example, I'm old enough that I contracted measles as a kid. When I got into the Army, they insisted on giving me measles vaccine, anyway. No problems. We also often revaccinate kids that have been adopted from overseas, even though they have vaccine records that show they were previously vaccinated. We do not have problems in this setting, either.


I got the first shot this morning. The same person who gave me my flu vaccine gave me the shot. She is really good, and I didn't feel the flu vaccine hardly at all. Unfortunately, this morning when she stuck the needle in I think she went through a little nerve. I got an electric shock type pain, but it didn't last very long. They made me sit in a little room with a few other vaccinees for 15 minutes after getting it to make sure I didn't have an immediately allergic reaction. When they saw I was an ID doctor they started asking me questions about the virus, the mutated virus in Europe, the vaccine, when protection would start, etc., etc. So, essentially I spent most of the 15 minutes pontificating. When I left, they were saying, "Thanks. I look forward to your video lecture series." It was pretty funny.

So far, after the initial ouchy bit, I have felt pretty good. Weirdly, I am having a bit of referred pain to the outside of the elbow. Probably from the nerve that got tweaked. I'm sure the actual vaccine site will get sore later. I saw one of my colleagues this morning who got the shot Friday. He said that he had very severe pain at the injection site that rivaled what he felt when he got yellow fever vaccine, but most people have been saying they only had mild discomfort. I got the yellow fever vaccine in the Army, and it was pretty bad, although for my money the worst of them was the plague vaccine. Yikes! That one really hurt, and the pain in the arm lasted for almost a week. (The only plus side was that they exempted me from the push-up portion of the physical fitness test because of it.)

48 hours+ later and 95% of my injection site soreness is gone and no residual arm pain. Daughter got 1st dose yesterday AM and has minimal residual soreness and took 400 mg of ibuprofen once last PM. Son gets the Moderna shot 12/23.

[Mike Corey]

I just wanted to say it makes me so happy every time I read about one of you or your family members receiving these vaccines. Thanks to each of you for all you do and will be doing--and all you are enduring, and will endure.

[LasVegas]

Speaking of pain relievers after a vaccination, I remember reading an article awhile back about how pain relievers may decrease the effectiveness of a vaccine. Does anyone have any insight into this?

On a related note as a nurse, many of these covid vaccination injection videos make me cringe. Not very good technique by the administer in a lot of them. Also I see a lot of arms that are very tense. As a patient, make sure that arm is as loose as can be.

[summerwind03]

Speaking of pain relievers after a vaccination, I remember reading an article awhile back about how pain relievers may decrease the effectiveness of a vaccine. Does anyone have any insight into this?

On a related note as a nurse, many of these covid vaccination injection videos make me cringe. Not very good technique by the administer in a lot of them. Also I see a lot of arms that are very tense. As a patient, make sure that arm is as loose as can be.

I think for kids they say not to give pain reliever in advance, but that it is ok to give afterwards. I will be curious what the folks in the medical community have to say on this topic.

[TruBlu]

As an experienced survivor of USN boot camp, with approximately 2,750 vaccinations, I can tell you the best method of decreasing the arm pain after a shot is exercise. I was told this by my dad (also USN). After getting as many as 4 shots in one day, I would immediately start pushups, chin-ups, and other arm movements. The next day ... no pain. The rest of my boot camp company, who babied their arms were miserable.

Of course, consult your doctor.

[BlueTeuf]

As an experienced survivor of USN boot camp,

As an experienced survivor of USMC OCS*... I say never admit to pain. Just ignore; it doesn't exist.

In the process, feel free to ignore any impacts on your personal health, team productivity, marriage, sanity, reputation, etc.

Actually, you can tell your Navy Corpsman. They will keep your secret. And funnel you Vitamin M - 800mg.




*a little like boot camp

[aimo]

Speaking of pain relievers after a vaccination, I remember reading an article awhile back about how pain relievers may decrease the effectiveness of a vaccine. Does anyone have any insight into this?

On a related note as a nurse, many of these covid vaccination injection videos make me cringe. Not very good technique by the administer in a lot of them. Also I see a lot of arms that are very tense. As a patient, make sure that arm is as loose as can be.

We were told not to take anything BEFORE the shot, but afterwards if there was discomfort later - Tylenol is OK.

[budwom]

We were told not to take anything BEFORE the shot, but afterwards if there was discomfort later - Tylenol is OK.

Tylenol, or perhaps three stiff gin and tonics and you're good to go.