Coronavirus COVID-19 - Global Health Pandemic #86

[margarita25]

That's good news! I wonder if we'll have to take a vaccine on a yearly basis in order to keep the virus at bay? Or, will it be a one-and-done thing?

This is actually part 2 of the interview I posted in the previous thread. Dr. Gupta mentions two doses, and says they may be needed annually. (Eta: lol at Stephen Colbert, “stack the vac”)

Also, Dr. Gottleib says two doses is needed a month apart for Moderna, Pfizer candidate (he’s on the board):

 

[GRT]

I can understand if the person is terminal, but underlying conditions do not consistently mean terminal. COVID would enhance the death possibility.

When a patient is on Hospice, they are terminal. They cannot enter the Hospice program until a doctor says they are not expected to live more than 6 months and diagnosis down with a terminal illness or disease or condition.

 

[dixiegirl1035]

DBM re PICU status by CDC now combines Pneumonia/Influenza/Covid numbers

 

[nhmemorymaker]

Quite honestly, what I would like for the health care workers is for them all to be THANKED for the huge service they are giving in every country.
Instead of petty and unfair insinuations being thrown around about them, to great crowds of people, being televised to an entire country and around the world.

Do people think this doesn't hurt these workers deeply? I would bet it does. As if they don't have enough on their plate already. SMDH


Eg: today (BBM)

Federal Health Minister Greg Hunt has thanked health care workers across the country as Australia achieves a day with no locally acquired cases for the first time in nearly five months.

Australia records first day without locally acquired COVID case since June

His words were a direct assault on our medical profession---THAT is the issue of where this discussion began.

Trying to discuss Medicare and the extraordinary complications, competitiveness between states on HOW they get money is an administrative issue---paperwork people with some power will always manipulate a bit to get more expenses covered. Just look at your Medicare bills---we have faced this for decades.........

And, I do remember appreciating your information from your relative in Hospice back in earlier threads. It was very informative. Certainly made me want to understand Hospice, and how they are dealing with Covid much more. thanks for that.

It is so clear that Hospice is suffering greatly with Covid, the cases, the strains...........and certainly the billing. In actuality, the Hospice Market is as complex as the Medicare Market.

COVID, MA Carve-In Can Complicate Hospice Revenue Cycle Management - Hospice News

I think the issue that was originally brought up by Cagney in the UK, and responded to by many of us in the US is, why would anyone whack-a-mole our medical professionals when they are our only salvation with this disease.............

And as Tigerlily indicated, he has "falsely accused the DOCTORS".

 

[margarita25]

As the beautiful fall leaves turn to brown,

and the number of cases rise in our towns,

one can surmise,

that deaths too will rise,

Begone, this virus with the crown!

 

[nhmemorymaker]

All I’ve heard throughout this pandemic from experts though is that deaths are likely underreported, not overreported.

Excess COVID death study: 75K more died in US than previously recorded

And we know how Trumps words will be taken by his supporters because anyone on social media sees it everyday. They take those words and plaster them all over FB and twitter in the form of “covid deaths are FAKE NEWS” or the like, and the result is the same as it’s been throughout - many people not taking this virus seriously.

And the numbers rise and the deaths rise.

Words matter.

No question in my mind that they are underreported.....
States manipulating data is one issue.
But there are loads of people out there who are afraid, or hate doctors and never go to a doctor for a formal diagnosis.
AND there are people who truly want to deny even having it. Certainly, in my broader neighborhood/county friends tell me a lot.--people refusing to get checked because they might have to go in quarantine or isolation.

moo moo

 

[dixiegirl1035]

This is actually part 2 of the interview I posted upstream. Dr. Gupta mentions two doses, and says they may be needed annually. (Eta: lol at Stephen Colbert, “stack the vac”)

Also, Dr. Gottleib says two doses is needed a month apart for Moderna, Pfizer candidate (he’s on the board):

I cannot recall. Of the two first anticipated vaccines (Moderna & J&J)... what are both requirements for storage? IIRC one vaccine had to be kept in dry ice/liquid nitrogen, but it may not have been one of the two. Am I recalling correctly?

Are any of them lyophilized for shipment/storage, or minimally ok at shelf temp? Has anyone kept up on such?

Hopefully, when the vaccines are distributed to the masses that there will be the ability for storage for the masses. And hopefully, there will be ability by health departments to do massive injections vs. needing to go to a local CVS/Walgreens and do one by one etc as some communities just don't have them.

 

[nhmemorymaker]

The deaths may well be under-reported, but that doesn't change the fact that "presumable" deaths have been added that did not test positive for the virus and other deaths are being counted as covid deaths when the patient tested positive but the virus might only have been a contributing factor.

Those facts have nothing to do with some people spreading false news or not understanding what's happening.

But, likewise, there's no reason to pretend those things are not happening when they are.

I definitely see what you are trying to say here. I agree that this is an issue regarding "cause of death".

But I have read some more theoretical articles of how hard this is to determine, with absolutely no National plans, definitions, practices etc to accurate tally.

It almost becomes a moral or ethics issue. How can we argue two sides of this issue?? We would never get out of that rabbit hole!!!!!

So I try to determine WWID.... a take on the infamous "what would Jesus do, right?".
So what would I Do, how would I want it stated for me at the time of my death.

If I still had a thriving happy life with diabetes, COPD, or congestive heart failure, managed well with the meds I am on--- Would I want to be classified as a COPD death or a covid death. I had plenty of more years left with minor COPD.

So maybe the death certificate should say "Weakened Immune System" rather than COPD or Covid.

And then I think of all the Americans with high BMI, as we clearly know that statistically they are more vulnerable to Covid.

Would I want my death certificate to say Obesity as the cause of death? Would I want my mother, or my brother going down as dying of Obesity?

On a truly emotional level, this issue of how to call a death is quite thought provoking.

 

[margarita25]

I cannot recall. Of the two first anticipated vaccines (Moderna & J&J)... what are both requirements for storage? IIRC one vaccine had to be kept in dry ice/liquid nitrogen, but it may not have been one of the two. Am I recalling correctly?

Are any of them lyophilized for shipment/storage, or minimally ok at shelf temp? Has anyone kept up on such?

Hopefully, when the vaccines are distributed to the masses that there will be the ability for storage for the masses. And hopefully, there will be ability by health departments to do massive injections vs. needing to go to a local CVS/Walgreens and do one by one etc as some communities just don't have them.

I recall Dr. Mike mentioning “cold storage”, but that’s all I’ve got for you.

 

[nhmemorymaker]

I call them Archie Bunkers.

tee hee........... yeah or more broadly AOWM.. mooooo moooo moooo

 

[CSIDreamer]

I definitely see what you are trying to say here. I agree that this is an issue regarding "cause of death".

But I have read some more theoretical articles of how hard this is to determine, with absolutely no National plans, definitions, practices etc to accurate tally.

It almost becomes a moral or ethics issue. How can we argue two sides of this issue?? We would never get out of that rabbit hole!!!!!

So I try to determine WWID.... a take on the infamous "what would Jesus do, right?".
So what would I Do, how would I want it stated for me at the time of my death.

If I still had a thriving happy life with diabetes, COPD, or congestive heart failure, managed well with the meds I am on--- Would I want to be classified as a COPD death or a covid death. I had plenty of more years left with minor COPD.

So maybe the death certificate should say "Weakened Immune System" rather than COPD or Covid.

And then I think of all the Americans with high BMI, as we clearly know that statistically they are more vulnerable to Covid.

Would I want my death certificate to say Obesity as the cause of death? Would I want my mother, or my brother going down as dying of Obesity?

On a truly emotional level, this issue of how to call a death is quite thought provoking.

The thing is, causes of death need to be accurate not emotional. I know what you mean, though. If my sister committed suicide, would I want it on her death certificate or would I want something nicer? We need the truth. The fact of the matter is my sister's death certificate isn't national news, and obesity does kill people. Her obesity came long before the associated health issues. KWIM?

 

[nhmemorymaker]

Shocking and very very dangerous

Just like with Cagney in the UK, I feel I have to be part of the whole of America to say "sorry we are just numb to your way of looking at this"
so be it.
And trying to defend the "us, in the US" who don't feel as callous and numb as we look..........

I gotta go dig some weeds...i always feel better when i get out in my dirt.

 

[nhmemorymaker]

The thing is, causes of death need to be accurate not emotional. I know what you mean, though. If my sister committed suicide, would I want it on her death certificate or would I want something nicer? We need the truth. The fact of the matter is my sister's death certificate isn't national news, and obesity does kill people. KWIM?

Unfortunately suicide IS suicide. But is Obesity really the cause of death? So maybe if we know your sister is an overeater she should be classified at death with Obesity and Overeating; but I know my brother has genetic low motabolism for his Obesity, so he goes down as Covid?

ALL I am trying to say is that I agree... Deaths should be accurate, just as you are saying. BUT with absolutely no National Plans or guidance, who can possibly make that determination???????

 

[CSIDreamer]

Unfortunately suicide IS suicide. But is Obesity really the cause of death? So maybe if we know your sister is an overeater she should be classified at death with Obesity and Overeating; but I know my brother has genetic low motabolism for his Obesity, so he goes down as Covid?

ALL I am trying to say is that I agree... Deaths should be accurate, just as you are saying. BUT with absolutely no National Plans or guidance, who can possibly make that determination???????

I think the CDC has guides for classifying deaths. Give me a minute to find it.

COVID-19 Death Data and Resources - National Vital Statistics System

 

[dixiegirl1035]

Back in the old days we had a :deadhorse: icon. Miss those.

Yes, death certificates have primary and secondary causes on them.

And docs would be expected no matter what the underlying diabetes/COPD etc to perhaps be the primary, the COVID per DRG's would be expected as secondary, no matter. MOO.

I really don't understand the push back on such here as to why the issue of adding COVID is an issue as those folks with diabetes, overwieght, COPD, their race, their ???? was #1 on the sheet and COVID was also. Don't they deserve the same efforts and drugs as others that might raise the DRG reimbursement.

I truly have sat on sidelines for these discussions for weeks and do not understand why it is an issue for some to add COVID to the death certificate alongside other conditions. Not asking that I be convinced as I've followed for weeks, did DRG time studies in the 80's (and yep, they were precedent for where we are now, but I digress) .. I think all have tried and given their best to educate others... so :dead horse: to me... moving on as I just can't understand why adding COVID is an issue if they have such.

 

[margarita25]

“It’s going to disappear”, the economy, your social life and overall life as you know it, and perhaps even your life itself, or the life of someone you know.

(eta: just my 2 cents re: this outlandish notion of a miraculous “disappearing” act / insert poetry part two)


Who knew it was Whodini?

WHO KNEW it’s wasn’t Whodini.

As should everyone by this point.

 

[HongKongPhooey]

There was that big hoo ha here a couple of months ago, when it transpired that everyone who had Covid when they died was being reported as a Covid death. So they changed it, with anyone who died within 28 days (if I remember correctly) of a Covid diagnosis is reported as a Covid death. Our numbers dropped overnight in their thousands.

ETA Still by no means an exact science though, is it?

 

[10ofRods]

Back in the old days we had a :deadhorse: icon. Miss those.

Yes, death certificates have primary and secondary causes on them.

And docs would be expected no matter what the underlying diabetes/COPD etc to perhaps be the primary, the COVID per DRG's would be expected as secondary, no matter. MOO.

I really don't understand the push back on such here as to why the issue of adding COVID is an issue as those folks with diabetes, overwieght, COPD, their race, their ???? was #1 on the sheet and COVID was also. Don't they deserve the same efforts and drugs as others that might raise the DRG reimbursement.

I truly have sat on sidelines for these discussions for weeks and do not understand why it is an issue for some to add COVID to the death certificate alongside other conditions. Not asking that I be convinced as I've followed for weeks, did DRG time studies in the 80's (and yep, they were precedent for where we are now, but I digress) .. I think all have tried and given their best to educate others... so :dead horse: to me... moving on as I just can't understand why adding COVID is an issue if they have such.

To me, it's a job for the medical examiner and for doctors. Did the person have GGO's? Were their epithelial cells attacked? Regardless of underlying causes, if they were known to have COVID and then they have damage to their lungs, hearts, brains or any other place epithelial cells reside (almost the whole body), and then they died...COVID should be listed as a CoD.

Almost everyone has some weakness in their body that can be exploited by COVID. An autopsy would be great, but if there are symptoms (new ECG patterns, x-rays, recently (say, 6 months) of systemic symptoms consistent with destruction of epithelial cells, etc., then of course COVID should be on the certificate.

The main purpose of reporting it in the first place, from my POV, is for CDC and others to track what is going on. Doesn't matter if it's mostly obese/overweight people dying or if the people had diabetes. If COVID did something to their bodies that made them sicker and then they died (perhaps it should be a longer period of time - we don't know yet), then put COVID on the certificate.

Frankly, the fact that non-medical people are weighing in publicly on this topic (not us here on WS, I mean actual public figures) is unprecedented and completely inappropriate.

One overlooked issue are the neuro-effects of COVID, which include paranoia and subsequent anxiety, lowered cognitive functioning (10 IQ points!), and possible mania. If people die due to these things (and I think we're seeing some of that), they will likely never be counted and will simply be part of excess deaths.

 

[Trino]

There was that big hoo ha here a couple of months ago, when it transpired that everyone who had Covid when they died was being reported as a Covid death. So they changed it, with anyone who died within 28 days (if I remember correctly) of a Covid diagnosis is reported as a Covid death. Our numbers dropped overnight in their thousands.

ETA Still by no means an exact science though, is it?

No. 28 days? There are people who have died within days of COVID. Whose idea was 28 days?

 

[margarita25]

Bringing forward some posts from the last thread / first post courtesy of @SouthAussie (South Aussie, thank you very much for all your information and links, you have been invaluable to these threads. As your country is doing well, you could have chosen to just enjoy your own great situation, but you, and others internationally, have been here to provide resources and support to us in the US. Please know you are greatly appreciated, and I always look forward to your informative posts.):

There is a report here from December 2016, by the Pandemic Prediction and Forecasting Science and Technology Working Group. What happened to them? They seemed to be on top of it.

Urgency of Action
The next pandemic pathogen could emerge any day. Perhaps it already is circulating in a non‐ human reservoir, but has not yet had the opportunity to infect humans. Changes in climate, ecosystems, or human settlements and behavior could provide that opportunity. Or perhaps it will arise from a precursor microbe, after poorly‐understood evolutionary drivers bring about the genomic changes necessary to infect and be transmitted among humans. The next outbreak to devastate agriculture or ecosystems also could emerge at any time, and spread quickly through a highly networked world. Interdisciplinary collaborations of mathematicians, computer scientists, microbiologists, epidemiologists, veterinarians, and other scientists to understand and predict these processes are not esoteric, academic pursuits. These collaborations are vital investments that could provide tangible benefits to public health, economic vitality, and security.

The needed collaborations stretch well beyond the expertise and resources of any one part of the Federal government, or of the Federal government as a whole. The PPFST WG will continue its efforts to bring Federal agencies together, and join then with non‐Federal partners and civil society, to advance outbreak modeling S&T, and catalyze its implementation against the rising threat of emerging infectious diseases.

https://obamawhitehouse.archives.go...diction-federal_efforts_and_opportunities.pdf