Coronavirus prep

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  • spiriteagle99
    spiriteagle99 Posts: 3,821 Member
    ahoy_m8 wrote: »
    T1DCarnivoreRunner wrote: »
    I don't understand why the vaccine rollout is so terrible. Sounds like some places have extra doses while other places don't have enough. I feel like the phased approach is holding things back in places with extra doses. Those places where they have enough vaccine, but can't give it to anyone because they haven't been told to go on to the next phase yet. Someone needs to take inventory and just get these shots to people. Maybe deploy the national guards and train them to give injections. 100K soildiers working 12 hrs per day would have these vaccines done much sooner. Only question is supply to do that.

    Kind of makes one wonder.... who is coordinating supply for the second doses in 3 or 4 weeks (depending on brand)? Will second dose patients be competing with first dose patients?

    Yes. That's why the original plan was to hold on to half the doses so people could be fully immunized on schedule. Now they have switched to giving more people the first half and worrying about the second dose later. Unfortunately, a lot of people may decide not to go back for the second dose given long lines and limited supply.
  • LisaGetsMoving
    LisaGetsMoving Posts: 663 Member
    @MikePfirrman Spot on!
  • kushiel1
    kushiel1 Posts: 96 Member
    MikePfirrman wrote: »
    For a bit of good news, our dear friends down the street, who are 77, got their first shot today.

    Just one more item about the economy and it being shut down for Covid -- people are mostly assuming jobs are being lost due to restrictions to prevent Covid. Many I'm talking to (as a recruiter) are losing jobs because Covid is out of control.

    My daughter lost her job -- she sold cyber security to hospitals in Ohio, whose budgets are shot now with the Covid onslaught. They are losing money because they can't do the more profitable elective surgeries. My son, on the other hand, lost his job because he couldn't sell solar door to door in CA any longer. I also just placed a woman in Chicago this week that worked for a non-profit healthcare group that had to lay off 200 employees because of the Covid surge there (not because of restrictions). Just as many, or I'd say more, of the layoffs are happening because we failed to contain it, not because of overreaching restrictions.

    Fortunately, I guess out of necessity, there have also been jobs created because of Covid -- Peloton, Zoom, Home Depot, Krogers, Amazon for instance, all have excelled during it. Not that I think that's a good thing, but everything shouldn't be blamed on restrictions to prevent it.

    I think hospitals losing money/laying people off is a combination of BOTH those things. Back in spring when this first started the large hospital chain I work for stopped elective procedures because there was a fear of overloading the system and not having space or staff for Covid patients. Then...they didn't get that huge influx of patients they were expecting. For instance my chain usually had anywhere from 1000 to 1200 people IP at a time (over many hospitals) but in covid we were often at half that. That hit them hard that they couldn't do all those elective procedures that really pay the bills and instead were left with hospital censuses that didn't come near what was expected leading to far less money coming in. And now of course there has been an increase in hospitalizations (both those that are customary this time of year and Covid) and they are having to delay those elective procedures that really pay the bills again because they need to save some space for just in case. The restrictions at the begining put a money crunch on many hospitals and that's being exacerbated now leading to some tough choices to be made.
  • SModa61
    SModa61 Posts: 3,469 Member
    Catching up on the discussion.

    Anyhow, I too had forgotten about the original 2 week action plan until @kushie1 had mentioned it. But I am surprised that @JaneJellyRoll didn’t have a flashback and remember the “15 Days to Slow the Spread” initiative. If anyone else wants a reminder of where we were at last March, here is the surgeon general: https://www.youtube.com/watch?v=HK2ypT2xweA
    I occasionally appreciate going back and listening to what various people had to say in those early days and each iteration since.

    @DNARules I totally agree with your comment about people stating or believing they are compliant when they are not. I can make a list of a few people right off the bat. I wonder if I technically should be on the list, though in my estimation I am making sincere efforts to follow guidelines.

    @ahoy_m8 Good question about second doses. The plus is, if I heard correctly, the second doses are not exact on timing. They cannot be done early, but can be delayed.

    @annpt77 Always said better than I can!
  • GaleHawkins
    GaleHawkins Posts: 8,159 Member
    janejellyroll wrote: »
    kushiel1 wrote: »
    snowflake954 wrote: »
    paperpudding wrote: »
    Lining up for a repeat vaccine every 12 months would be no different to annual flu vaccine.

    I don't see that as a big deal.

    From what I've heard that's what it's going to be. May as well get used to it.

    It'll be a big deal if we have to wear masks and/or continue to social distance in addition to getting a vaccine every 6-12 months. And since we are still being told we need to do those things in addition to getting the vaccine I find this very likely.

    Plus how many people don't get the flu vaccine? Most of the people I know who work for companies who do not require it don't bother with it. Plus you can still get the flu even if you do take it since it's a virus and they mutate.

    In general we were told that a vaccine would get us back to "normal" but people are realizing that is not the case and is unlikely to be the case. Maybe we can't get back to "normal" ever again, but we aren't even going to be close to normal and for many this isn't acceptable.

    I currently don't have a plan to get the vaccine. I'm all for those who wanting it to get it, but for me there's too much unknown about it and I'd rather wait until we actually know the long term effects and efficiency before committing to it. Though as I work in healthcare, though not front lines, I have a feeling work will require it as they do the annual flu shot.

    To the person who posted about California - California has some of the strictest restrictions in the US so what's the explanation for why there is such a severe breakout there? Here in IN we seem to have gone through an outbreak, but when the pt's are questioned they all say they are compliant. Physicians are commenting on the fact that anecdotally they are not seeing non-compliant people getting Covid. My sister in law's mom was hospitalized for Covid after Thanksgiving - she social distanced, wore a mask when leaving the house, and washed her hands all the time but her son brought it home from work (they live together). And he's hugely into following all the restrictions so he wore his mask, washed his hands etc and so did the person who spread the Covid. If we are following the guidelines and still getting Covid which is going to make continuing to follow these guidelines very difficult for some people as why are they going through this and losing their livihood for nothing?

    We (currently) have to do these things in addition to getting vaccinated because there are still so many unvaccinated people. If you're right and people don't bother to take basic precautionary steps like getting vaccinated, then this may be more drawn out.

    If things aren't going "back to normal" due to low vaccination rates and that's unacceptable, what's the alternate plan being proposed? There are people who are complaining about things like wearing masks AND they're complaining about the unknowns of vaccinations. What's the alternative exactly?

    Just turn unknowns into knowns by testing and peer reviews.
  • GaleHawkins
    GaleHawkins Posts: 8,159 Member
    https://www.kcra.com/article/covid-19-long-hauler-treated-in-sacramento-uc-davis-health/35192445

    Long-Hauler is a new pandemic term I guess.
  • rheddmobile
    rheddmobile Posts: 6,839 Member
    edited January 2021
    ahoy_m8 wrote: »
    T1DCarnivoreRunner wrote: »
    I don't understand why the vaccine rollout is so terrible. Sounds like some places have extra doses while other places don't have enough. I feel like the phased approach is holding things back in places with extra doses. Those places where they have enough vaccine, but can't give it to anyone because they haven't been told to go on to the next phase yet. Someone needs to take inventory and just get these shots to people. Maybe deploy the national guards and train them to give injections. 100K soildiers working 12 hrs per day would have these vaccines done much sooner. Only question is supply to do that.

    Kind of makes one wonder.... who is coordinating supply for the second doses in 3 or 4 weeks (depending on brand)? Will second dose patients be competing with first dose patients?

    When my mom got her first dose they gave her an appointment card for the second dose.

    However, it’s my understanding that the second dose can be delayed without lowering the effectiveness when it’s finally given. And since in studies the first dose by itself prevented the illness from becoming severe enough to lead to death, they are thinking that more people not dying is a better priority than fewer people not getting it at all. It’s hard to say whether I agree since even mild cases can have lingering effects, but it makes sense in theory.
  • rheddmobile
    rheddmobile Posts: 6,839 Member
    kimny72 wrote: »
    AnnPT77 wrote: »
    kimny72 wrote: »
    T1DCarnivoreRunner wrote: »
    I don't understand why the vaccine rollout is so terrible. Sounds like some places have extra doses while other places don't have enough. I feel like the phased approach is holding things back in places with extra doses. Those places where they have enough vaccine, but can't give it to anyone because they haven't been told to go on to the next phase yet. Someone needs to take inventory and just get these shots to people. Maybe deploy the national guards and train them to give injections. 100K soildiers working 12 hrs per day would have these vaccines done much sooner. Only question is supply to do that.

    Just my opinion but I think the problem is this needed to be organized from the top down and it wasn't. And I'd bet some states assumed it would be and we're caught unprepared when it wasn't.

    The doctor who gives updates on This Week in Virology works at one of the larger NYC hospitals (I forget which one). He said they were notified back in Nov that they were on the list to get a certain amount of vials for staff vaccinations. So they put a plan together and waited to get more info on timing. And waited. And then 1200 doses of vaccine just showed up on their loading dock one Tues morning in Jan. They had to scramble to look at staff schedules and dept occupancy to come up with a schedule right there on the spot. Luckily they were well organized and they banged out the jabs, but a less well prepared organization might not have been ready.

    I agree,they need to get creative getting in trained personnel to administer the shots and less picky about who their giving them to.

    (This is not a disagreement, rather more just quoting you to continue this subtopic.)

    I agree that some level of central coordination is missing, but I also think that fully-centralized planning might not be ideal, for two general reasons. (BTW, I recognize that I'm oversimplifying, as I go on with this thought.)

    One is that some localities have handled the distribution so far pretty well (within the constraints of supply and such), while others have not. Where would a fully-centralized plan fall on the effectiveness scale? I feel like many people saying "we ought to have a strong central plan" are assuming it would be a *good* plan. Well, maybe. It's challenging to make a good plan, quickly, for a novel situation; and the larger the scale, the harder it gets, IMO.

    The other is that I think more localized governmental entities have a better handle on local constraints and conditions. What will work well for spread-out rural populations with limited big hospitals is probably different than what works in a dense major city with similarly scaled big health-care facilities, for example.

    Now, in reality, it's possible to have central coordination to some degree, with local flexibility within that framework. There's no question in my mind that the federal piece of this, in the US, has been handled poorly.

    The novelty of the situation is very relevant. We don't have some planning luxuries we might in a less urgent scenario.

    I think one of the strengths of the US's multi-tier governmental systems, as a generality, is this: When different approaches to solving problems are tried in different localities, we have an opportunity to review the results, and learn from the best models, over time. In the current situation, the novelty of the needs, and the urgency of getting solutions, isn't really benefiting from that idea of trying multiple approaches in different places and comparing results.

    No one has a moment's time to do a lot of consulting with peers in different localities, as might be the norm in less urgent situations. (That sort of consultation is one of the things that professional associations, etc., are useful for, in many situations. In my professional life, if we needed to do new-thing X, we'd be talking with other similar organizations to see who'd done X, and learning from their experience. This train is just rolling faster than that, at the moment; and no one's done this before. We haven't had time for "pilot projects".) I assume more of that review/consultation/adjustment will happen, over time, since this crisis/process will be going on for a while.

    There's a tendency amongst the public, I think, to expect things to work well right out of the gate (they pretty much never do, IME, but the stakes aren't usually this high, or the results this visible). In other situations new processes sometimes look to the general public like they work well at the start, because trials/pilots were not very well publicized, but were helpful in working out kinks before going full-scale. (In a way, this is similar to the way some people saw the learning process by scientists early on, with findings and results changing the experts' minds, as flip-flopping or wishy-washiness.)

    There's also a tendency to believe that a strong central authority (like a national pandemic czar) and strict authority structures with rigid rules are going to be the best way to get things done. I think that's mostly not true, either.

    I keep reminding myself that all (well, most) of the health systems, governmental entities, etc., are just collections of regular people like me, doing the best they can in these difficult circumstances, and that in most cases they're aware of factors and considerations that I as a non-specialist have no expertise about. It's always pretty easy to second-guess how someone else should be doing a job I'd have no idea how to do myself, if I were challenged to try. 😆

    Good points. I don't think a centralized plan needed to get too granular. More like guidance of how to organize, figure out how many doses they'd need and when, supply pacing, a framework and some kind of platform for communication and scheduling. And a shared database with statistics so areas that are struggling with the roll out could see where it was going more smoothly and maybe see how they were doing it.

    I guess what bothers me is there are people who know how to do this, and in an organized federal system, that know how could be shared with everyone easier. I know that's asking a lot though :tongue:

    I know one of the problems with just giving the extra doses to anyone available is that people were using it as a way to skip the line. This is why we can’t have nice things! I don’t remember the details but they were actually discussing prosecuting one doctor who intentionally didn’t schedule enough qualified people, then called in a bunch of big money donors to fill the extra slots. Of course knowing that someone is getting prosecuted for giving the vaccine to the wrong people is going to make other doctors reluctant to do the common sense thing and use all the doses available rather than wasting them.

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