The Vaccine

[Jim_in_Delaware]

Carry on fearmongers! The sky is falling! Bring on the "thumbs down" icon! LOL. You know you want to Swatski, thumbs down king! LOL.

Facts suck huh?

The current CDC page also shows:

TOTAL DEATHS - 634,157
+1,329 New Deaths

Bottom line is that it is insane that this many Americans are dying each day from a virus which there is currently an approved vaccine to prevent.

Jim

 

[2kwik4u]

The current CDC page also shows:

TOTAL DEATHS - 634,157
+1,329 New Deaths

Bottom line is that it is insane that this many Americans are dying each day from a virus which there is currently an approved vaccine to prevent.

Jim

Even if it was a single person a day. The vaccine is worth it.

Call me a Chicken Little, call me a fear monger, call me whatever you like. @Wake_Dude hit the nail on the head. Everything is a calculated risk, and this particular vaccine is amongst the easiest way to mitigate risk in the middle of a pandemic.

Curious if anyone has any data on the long term effects of being on a ventilator are. Didn't die, but I'm certain they won't ever be the same physically. Wonder how many in the hospital are now in life altering debt because they wouldn't get a free vaccine? Sure, they didn't die, but again their life has been forever altered. Wonder how many people have crashed a car and not had the ER supplies and personnel they needed because the hospital was over run with COVID patients.......point being, you can spin the numbers however you want, but death percentage is not the only risk at play here, and to quote survivability alone as your main pillar is short sighted at best.

 

[tabbibus]

Wow, the ANA? That is a straight up legit study. Sorry Chicken Littles, deal with it.

Heard it best this morning from a buddy of mine who refuses to get vaccinated. He states, "Everything in life is a calculated risk....If the odds are in your favor, you base your decision accordingly". Even though I'm vaccinated, I see this line of reasoning.

Last 7 day death rate is (2/100,000) x 100 = 0.002% For all you inept folks out there, that is 2 thousandths of 1 percent.

COVID Data Tracker

CDC’s home for COVID-19 data. Visualizations, graphs, and data in one easy-to-use website.

covid.cdc.gov

Death Rate Since Jan 21, 2020: (191/100,000) x 100 = 0.191% Again, that is 191 thousandths of 1 percent.

COVID Data Tracker

CDC’s home for COVID-19 data. Visualizations, graphs, and data in one easy-to-use website.

covid.cdc.gov

The odds of surviving COVID are pretty frigging good. Sorry, not sorry. If you're in a high risk category, by all means, get vaccinated. But don't give any shit to those who won't.


Carry on fearmongers! The sky is falling! Bring on the "thumbs down" icon! LOL. You know you want to Swatski, thumbs down king! LOL.

Facts suck huh?

I'm confused about why you are spiking the football there. What exactly are you celebrating? What got you so riled up that you start calling people names?

Are we happy they a good portion of nurses don’t understand the science behind the vaccine? Or that they make the choice not to get vaccinated because "it won't affect me"?

I postulated the question a few days ago about why the vast majority of doctors are vaxxed and many nurses are not. I don't remember if it was you or someone else that said it's because nurses are tough and don't want to be told what to do. Again. This misses the point. It's not toughness to disregard science and/or not give two fucks about doing your part to end this pandemic.

My thought? Nurses are a prime population to fall prey of misinformation. Nurses have a background of science and medical training, but no where near what a physician goes through. Add that to the years of experience that many nurses accumulate and you have a good foundation for the Dunning Kruger effect. I'm in no way disparaging nurses. This is a badass profession. And I work with many fantastic RNs and NPs. But, yeah.

Also. Please see below a post from one of the NPs at my ICU. I was asked for more recent numbers and here they are.

 

[2kwik4u]

Just read this article.

It's easy to judge the unvaccinated. As a doctor, I see a better alternative

In the emergency room, questioning Covid-19 patients' motives isn't needed. When they have oxygen masks strapped to their faces, previously passionate arguments about individual liberty and the like deflate like punctured balloons.

www.statnews.com

One paragraph stands out strongly for me.

I recognize that getting vaccinated and wearing masks make many people uncomfortable. It’s a sacrifice, an infringement of their liberty. But suffering the consequences of Covid-19 seems to be a more significant sacrifice, and death the ultimate and irreversible infringement on personal freedom.

I also really do, honestly, believe there has to be some level of civil discourse to get through this. The current method of "picking sides" clearly isn't getting us anywhere......and fast.

 

[swatski]

Wow, the ANA? That is a straight up legit study. Sorry Chicken Littles, deal with it.

Heard it best this morning from a buddy of mine who refuses to get vaccinated. He states, "Everything in life is a calculated risk....If the odds are in your favor, you base your decision accordingly". Even though I'm vaccinated, I see this line of reasoning.

Last 7 day death rate is (2/100,000) x 100 = 0.002% For all you inept folks out there, that is 2 thousandths of 1 percent.

COVID Data Tracker

CDC’s home for COVID-19 data. Visualizations, graphs, and data in one easy-to-use website.

covid.cdc.gov

Death Rate Since Jan 21, 2020: (191/100,000) x 100 = 0.191% Again, that is 191 thousandths of 1 percent.

COVID Data Tracker

CDC’s home for COVID-19 data. Visualizations, graphs, and data in one easy-to-use website.

covid.cdc.gov

The odds of surviving COVID are pretty frigging good. Sorry, not sorry. If you're in a high risk category, by all means, get vaccinated. But don't give any shit to those who won't.


Carry on fearmongers! The sky is falling! Bring on the "thumbs down" icon! LOL. You know you want to Swatski, thumbs down king! LOL.

Facts suck huh?

who are you calling chicken littles?

--

 

[the MfM]

Agencies that provide care for older, vulnerable Mainers sign joint letter requesting delay in vaccination mandate

The organizations are requesting that the state delay implementation of the mandate for their employees for 45 days, or until implementation of a federal mandate.

www.google.com

In the letter to Mills, the organizations expressed concerns about losing workers when staffing is already difficult. The organizations said they "fully agree that it is ideal for every worker who cares for a vulnerable person to be vaccinated. However, the mandate is not allowing sufficient time to get staff vaccinated, to find replacement staff for those who will leave, and to create contingency plans for safely moving residents from facilities that need to close due to inadequate staffing."

 

[Robconn]

Even if it was a single person a day. The vaccine is worth it.

Call me a Chicken Little, call me a fear monger, call me whatever you like. @Wake_Dude hit the nail on the head. Everything is a calculated risk, and this particular vaccine is amongst the easiest way to mitigate risk in the middle of a pandemic.

Curious if anyone has any data on the long term effects of being on a ventilator are. Didn't die, but I'm certain they won't ever be the same physically. Wonder how many in the hospital are now in life altering debt because they wouldn't get a free vaccine? Sure, they didn't die, but again their life has been forever altered. Wonder how many people have crashed a car and not had the ER supplies and personnel they needed because the hospital was over run with COVID patients.......point being, you can spin the numbers however you want, but death percentage is not the only risk at play here, and to quote survivability alone as your main pillar is short sighted at best.

In regard to after affects of long term ventilator recovery, this video may offer some insight.

 

[swatski]

In regard to after affects of long term ventilator recovery, this video may offer some insight.

Let's not forget the cost of covid hospitalizations, as well.
With ICU, the median is somewhere around $250k. Albeit a patient can be slammed with a huge bill, most of it falls on insurance, so who's paying it?

--

 

[2kwik4u]

In regard to after affects of long term ventilator recovery, this video may offer some insight.

Was the scarring and damage to his lungs caused by COVID and the weeks of ECMOor was it from a previous injury/illness?

Clearly lots of other side effects from being in a bed for months.

Glad he's doing better.

 

[the MfM]

Let's not forget the cost of covid hospitalizations, as well.
With ICU, the median is somewhere around $250k. Albeit a patient can be slammed with a huge bill, most of it falls on insurance, so who's paying it?

--

Who’s paying for smokers, diabetic or obese patients? Or alcoholics and drug users?

 

[swatski]

Who’s paying for smokers, diabetic or obese patients? Or alcoholics and drug users?

Are there free vaccines available for those ailments?

--

 

[the MfM]

Are there free vaccines available for those ailments?

--

No, but it’s there choice to be a smoker, obese or an alcoholic. Maybe they shouldn’t be allowed to take up space in the hospitals?

 

[Robconn]

Was the scarring and damage to his lungs caused by COVID and the weeks of ECMOor was it from a previous injury/illness?

Clearly lots of other side effects from being in a bed for months.

Glad he's doing better.

We do our best to employ safer lung recruitment strategies while on a ventilator. With covid, specifically affecting the lungs, I have observed some very stiff lungs in the sickest of patients. Any natural lung elasticity is essentially lost. So ventilating stiff lungs can cause shearing and scarring especially over long periods of time. Some will have a tracheotomy if oraly intubated beyond several weeks in order to prevent breakdown and subsequent infection. Once liberated from prolonged mechanical ventilation, Is followed by extensive pulmonary rehabilitation, speech therapy, physical rehabilitation, maybe cardiac as well. I can only speak of acute care setting. But it is typical of extended hospital stays to require follow up care in order to regain some sort of normalcy and independence.

 

[Jim_in_Delaware]

Who’s paying for smokers, diabetic or obese patients? Or alcoholics and drug users?

So, patients are to blame for type 1 diabetes? I thought this was an autoimmune condition?

Jim

 

[the MfM]

So, patients are to blame for type 1 diabetes? I thought this was an autoimmune condition?

Jim

*Non compliant diabetics

 

[tabbibus]

No, but it’s there choice to be a smoker, obese or an alcoholic. Maybe they shouldn’t be allowed to take up space in the hospitals?

It's a false equivalency. But I suspect you know that.

And I'm not saying I agree, but smokers pay higher premiums. And smoking is an addiction. We punish people who are sick with an addiction. That doesn't feel right. But we sure as heck should charge more if you simply opted not to get the vaccine.

 

[2kwik4u]

@Robconn thank you for the clear and detailed explanation. Appreciate the info.

 

[tabbibus]

@Robconn thank you for the clear and detailed explanation. Appreciate the info.

Yes. Excellent explanation. One of the hard parts of the pre intubation conversation is telling them that while the vent may buy them time, it has a good chance to make things worse.

 

[2kwik4u]

Yes. Excellent explanation. One of the hard parts of the pre intubation conversation is telling them that while the vent may buy them time, it has a good chance to make things worse.

Oof, that's rough.

In the frame of risk mitigation. What can we do as healthy individuals to maintain "pliable" or "not stiff" lungs so that we might have the best chance to minimize the impacts of an intubation should we get there?

In my head, that's general good cardiovascular health. General fitness and frequent "pushes" to places the require deep breathing. I'm far from a doctor though, Im just a mechanical guy.

Thoughts?

 

[tabbibus]

Healthy lungs are very compliant by default. Only certain chronic conditions make them stiff. Things like fibrosis (scarring), certain autoimmune conditions. You basically treat the cause of the fibrosis or the autoimmune disease. Not much you can really do to change this before hand. Counter to what many may think, smoker lungs tend to be veeeery pliable. Too compliant. I call them floppy lungs. This is a different problem all together.

During an acute insult, such as pneumonia (bacterial, viral), or pneumonitis (inflammation from a drug or from aspirating gastric contents) the lungs become acutely stiff. This is part of what we call ARDS, acute respiratory distress syndrome. When intubated, we do what @Robconn mentioned. Basically try and use low pressures and low volumes to minimize further insult to the lungs.

Another way to understand this, is to think about how we breath naturally and how we breath on the vent. Naturally, our diaphragm and intercostal muscles contract and expand the rib cage. Negative pressure is created inside the chest and air is basically sucked into the lungs. Stiff lungs won't expand as much but won't be damaged by this method. On the vent, we PUSH a volume of air at a certain pressure. Positive pressure breathing. This can damage an otherwise healthy lung if you are not careful, and will create big issues on stiff lungs.

Since I've gone full nerd, I always enjoy telling people that breathing out is a passive maneuver. There are no "breathing out" muscles. You can squeeze all you want but you really aren't pushing air out. You are basically removing any forces that may want to expand the lungs.