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My wife and I were actually planning flying out to Montana at a stay-in-cabin just as a fall get-away trip for four or five days, and decided it was best to stay away, [given that it’s a fairly spread out state], but that doesn’t matter, because they clearly are in a state of emergency, which they have critically high counties that are overwhelmed with case-load.

The whole ‘I live in rural counties and deep in the north, therefore I don’t need a vaccine’ myth again has been debunked many times over. But that mindset continues to be part of the problem in this country.

My state's northern county is the lowest vaccinated rate and highest covid rate even though the population size is tiny. All you need is to come in contact with one infected person. Even if you're not infected, if you need an ER (accident, illness, accidental cut), you may be out of luck at overwhelmed hospitals.

We're very careful with where we are traveling these days. We are traveling though. We most recently traveled to MA and VT, two states with very high vaccination rates.
 
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The number of cases in my state have broken out. They were in a range between 3,500 and 4,000 for quite some time and are now at 4,600. It's hard to figure out where the new cases are coming from by the way they are getting reported though. Two areas are Manchester and Claremont. The former is probably our largest city (80,000). The latter is a very small town at the border with Vermont. There are two state testing sites there. They would open up two more. The reasoning is that people will be more likely to get tested if they don't have to pay for it; which makes quite reasonable sense to me. The costs of testing are covered by Federal grants.

This still leaves a lot of areas of the state uncovered by free testing sites. Hopefully the state can contract with private testing companies (usually pharmacies) to solve that problem.

Our active case range is about half of the peak that started rising August 2020 and just kept going up through the holidays and then went down with the vaccine. Our vaccine rate is what I'd consider mediocre. Our hospitals are managing for now. It's quite a stark contrast to our neightbor, Massachusetts with high vaccination rates and a great new-cases-per-day chart.
Yeah, we have been having the same issue next door here in Maine. The area with the highest case rate right now is Androscoggin County. Mostly Lewiston/Auburn.
 
My state's northern county is the lowest vaccinated rate and highest covid rate even though the population size is tiny. All you need is to come in contact with one infected person. Even if you're not infected, if you need an ER (accident, illness, accidental cut), you may be out of luck at overwhelmed hospitals.

We're very careful with where we are traveling these days. We are traveling though. We most recently traveled to MA and VT, two states with very high vaccination rates.
Exactly. In the last month two people that I personally knew have died from COVID, one was a friend's mother who contracted it from a person who delivered their groceries, was only in the house long enough to put them away and was coughing. It infected both my friend and his mom, the mother didn't survive it unfortunately, both unvaccinated.

The other is a neighbor friend who was pro-mask (but no vaccine unfortunately) and went to the doctor for a different issue, and they believe he ended up contracting it there, he battled it for a month and succumbed.

We have to remember that they're reporting one person with the delta variant can infect up to 7 others. Unless I know them and that they are vaccinated, I personally treat everyone as if they have it just to be safe.
 
Numbers are going up in VT, CT, NH, Massachusetts, some upstate NY counties now... question is is it just from people moving inside with cold weather, or has the Delta wave finally reaching the Northeast? Guess we will know in the next few weeks.

I had a neighbor tell me a few weeks ago his grandson (too young to vaccinate) brought home Covid. He gave it to his father, who was fully-vaccinated. The father ended up in the hospital. He has recovered fortunately. I wonder what his fate would have been without a vaccine...
 
Sad news about Collin Powell. On a positive note:

C8096F54-8161-43D1-A9B0-41A1F1406346.jpeg
 
Numbers are going up in VT, CT, NH, Massachusetts, some upstate NY counties now... question is is it just from people moving inside with cold weather, or has the Delta wave finally reaching the Northeast? Guess we will know in the next few weeks.

I had a neighbor tell me a few weeks ago his grandson (too young to vaccinate) brought home Covid. He gave it to his father, who was fully-vaccinated. The father ended up in the hospital. He has recovered fortunately. I wonder what his fate would have been without a vaccine...
Vaccine efficacy is waning for those who got it first and there's concerns boosters aren't being rolled out fast enough here in GB. We're now seeing infection rates higher than at any point since the very peak of the second wave (as bad as it got so far) and hospitals are creeping up from bad winter levels of pressure back towards critical. Deaths are still thankfully lower than in previous waves currently.
 
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Vaccine efficacy is waning for those who got it first and there's concerns boosters aren't being rolled out fast enough here in GB. We're now seeing infection rates higher than at any point since the very peak of the second wave (as bad as it got so far) and hospitals are creeping up from bad winter levels of pressure back towards critical. Deaths are still thankfully lower than in previous waves currently.
I read there is a new variant in the UK discovered in July (AY.4.2), that has slowly been increasing its share of cases, now at 8%. Based on its growing prevalence, it's estimated to have a 10% transmissibility advantage over the original Delta.
 
My concern is two-fold for our local communities:

1.) Our vaccination rates has been on a steady rise for the last month, exceeding our target point and we are on a sharp case decline. However, with the holidays coming, and with ‘social distancing fatigue’, I just don’t see things being stagnant, which will likely increase again.

2.) The ‘Twin-demic.’ Mainly for the unvaccinated and those who contract both at the same time, not a good outcome, and once again, coupling the holidays, all this collaborative effort just seems like it can easily fall apart.

I know plenty traveling are this year, [given they didn’t last last year], and at this point, when you have those sheltering indoors during the winter season, added gatherings, it’s just a concoction for more problems.
 
My concern is two-fold for our local communities:

1.) Our vaccination rates has been on a steady rise for the last month, exceeding our target point and we are on a sharp case decline. However, with the holidays coming, and with ‘social distancing fatigue’, I just don’t see things being stagnant, which will likely increase again.

2.) The ‘Twin-demic.’ Mainly for the unvaccinated and those who contract both at the same time, not a good outcome, and once again, coupling the holidays, all this collaborative effort just seems like it can easily fall apart.

I know plenty traveling are this year, [given they didn’t last last year], and at this point, when you have those sheltering indoors during the winter season, added gatherings, it’s just a concoction for more problems.

New Year's Eve is going to be dangerous.. especially for those in the major cities celebrating it: NYC, Las Vegas, Paris, London, Sydney, etc. Add in the variants to the mix of the close gatherings, and we may see another mutated strain break out in the not-so-distant future.

BL.
 
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I read there is a new variant in the UK discovered in July (AY.4.2), that has slowly been increasing its share of cases, now at 8%. Based on its growing prevalence, it's estimated to have a 10% transmissibility advantage over the original Delta.
As far as I’m aware it’s still Delta/ Delta plus behind the current surge, and the major driver is that virtually all restrictions are now voluntary and very lax in enforcement, we’re 90% back to pre COVID normal… but the COVID vaccines that were keeping things at bay are now waning in effectiveness. It’s like we’re slipping back to square one but no one is willing to take responsibility for themselves and use masks, or keep 1m+ apart etc unless the government steps in and jumps up and down on them to. Honestly it’s quite maddening, people know the drill by now and can see what’s going on but seem to be past caring.
 
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For the first time, Nebraska Medicine (The medical association that links all of Nebraska's public and private hospitals) have had to turn away patients. Not all of it is totally due to COVID; lack of staffing is a contributing factor. But they also are running out of beds in the ICUs as well. This is not boding well going into the winter seasons here.


BL.
 
For the first time, Nebraska Medicine (The medical association that links all of Nebraska's public and private hospitals) have had to turn away patients. Not all of it is totally due to COVID; lack of staffing is a contributing factor. But they also are running out of beds in the ICUs as well. This is not boding well going into the winter seasons here.


BL.

When you consider short staffed hospitals, and then add in rising caseload, it translates to the current predicament, where lack of staffing is a major pitfall pretty much across the country right now. Aside from overworked medical staff, not even signing bonuses in the amounts of ~$25,000 is even drawing in candidates, and for the ones that are applying, they’re not even qualified/under-qualified. Which translates to, how do you treat these spiking numbers when you don’t have enough medical staff, which is why some states are having to recruit employees from other neighboring jurisdictions.

I can understand that social distancing fatigue might be a real thing for some people, but for those who are more strategic, realize that the brighter picture of the future, is having to make the sacrifices again this year by not participating in gatherings, outings, ect. It’s a necessary move in addition to buy more time for the unvaccinated, hold the numbers down.
 
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Numbers are going up in VT, CT, NH, Massachusetts, some upstate NY counties now... question is is it just from people moving inside with cold weather, or has the Delta wave finally reaching the Northeast? Guess we will know in the next few weeks.

I had a neighbor tell me a few weeks ago his grandson (too young to vaccinate) brought home Covid. He gave it to his father, who was fully-vaccinated. The father ended up in the hospital. He has recovered fortunately. I wonder what his fate would have been without a vaccine...

We had the Delta Wave starting around August I think - with things opening up and a lot of traveling. Our vaccination rate in NH isn't really great but it is very good in MA and VT. I read some news articles in VT and I don't think that they have a handle on where it's coming from. It's possible that a lot of this is children in schools. Hospital systems are stressed in NH and VT but not breaking I think but not really in MA (they have massive capacity as it is a regional healthcare hub).

The temps only got colder this week. It has been unseasonably warm in New England up until this week. The fall colors are upon us so we're also getting a lot of tourists into the area though mostly on the weekends. Differences in hotel prices between weekdays and weekends are nuts.

So what's happening on the numbers is still unclear to me but one thing that I do know - we're under 60% for fully vaccinated which alone can explain the higher numbers. Not sure on VT and MA. In the meantime, I planning to get a Moderna booster. An announcement is expected this week (maybe today) allowing mixed boosters. I will get one next week if they approve it.
 
I guess you've not heard of the UK's National Health Service (NHS), which covers pretty much ALL of their medical expenses? Definitely something like COVID-19 tests, whether administered in a clinic or other medical facility or by the consumer at either home or workplace, yes, an important tool during a worldwide pandemic, well, sure in this situation of course the costs are covered.

That said, the citizens of the UK do pay for this through various taxes and such, but when they go to a doctor for a routine exam or a thorough exploration and resolution of some particular medical/health situation that they're facing, they are covered -- a different system from how things work in the US. People in the US can sometimes go bankrupt with overwhelming medical bills during a serious health crisis. That is apparently not the case in the UK.
There are limits to the free part of the service, it has to be said. It literally stops at the border. A few years ago, I needed a range of injections and tablets for a project in India. Because this was an overseas trip, I had to make an appointment at my local hospital (my GP could not help) and secure a private prescription for the necessary meds. I had to pay £20 for a private prescription note alone. The jabs were given for free as they fell within the range of vaccinations/innoculations routinely performed by the NHS, however, malaria tablets cost me an additional £100.

In a similar vein, those wanting to go on foreign holidays are required to get PCR tests before during and after their return depending upon where they have visited. The NHS is not permitted to be involved in the testing procedure which has been outsourced to a range of private entities with a range of eye-watering prices to boot. A number of these have not been able to turn results around in the stipulated period leading to missed/cancelled flights and extended stays in hotels abroad. There does not appear to be much that those affected can do about it, either.

But, as stated earlier, Lateral Flow Tests are free to all and boxes of these (7 tests per box) are proffered to all and sundry at various chemists, supermarkets or even on the street to general uninterest. My understanding is that these were costed originally at about £10 per test but that cost has probably fallen somewhat since. $50 a LFT sounds like profiteering. It would be more reasonable for a PCR test.
 
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There are limits to the free part of the service, it has to be said. It literally stops at the border. A few years ago, I needed a range of injections and tablets for a project in India. Because this was an overseas trip, I had to make an appointment at my local hospital (my GP could not help) and secure a private prescription for the necessary meds. I had to pay £20 for a private prescription note alone. The jabs were given for free as they fell within the range of vaccinations/innoculations routinely performed by the NHS, however, malaria tablets cost me an additional £100.

In a similar vein, those wanting to go on foreign holidays are required to get PCR tests before during and after their return depending upon where they have visited. The NHS is not permitted to be involved in the testing procedure which has been outsourced to a range of private entities with a range of eye-watering prices to boot. A number of these have not been able to turn results around in the stipulated period leading to missed/cancelled flights and extended stays in hotels abroad. There does not appear to be much that those affected can do about it, either.

But, as stated earlier, Lateral Flow Tests are free to all and boxes of these (7 tests per box) are proffered to all and sundry at various chemists, supermarkets or even on the street to general uninterest. My understanding is that these were costed originally at about £10 per test but that cost has probably fallen somewhat since. $50 a LFT sounds like profiteering. It would be more reasonable for a PCR test.

The first of my 12 chemo infusions cost $11,000. Just for the drugs. Negotiated rate for insurance was $1,000. I think that I paid about $1,500. The amounts that you cited are pretty trivial to US prices. This is on top of paying $22,000 for insurance.
 
I was at Costco today and I was looking for alcohol and hand sanitizer as CVS only has the little bottles and my supermarket has stopped carrying it. I had to hunt around at Costco but I found a gallon bottle for $16 in the cleaning section. I think that it would be about $50 online. Isopropyl is $8/gallon. They don't carry Oxygen machines anymore though they do sell Thermoscan and BP machines. And they're cheap. It feels like the pandemic is over - at least the way people are shopping. Most people are wearing masks but I didn't actually see any in the store for sale.

I didn't see any shortages either.
 
The amounts that you cited are pretty trivial to US prices. This is on top of paying $22,000 for insurance.
But look at the difference in taxes. I am originally from Canada where they also have a government funded health care system. A couple of years ago I compared my US taxes with a friend who was in Canada, and even though they were only making about 2/3 of my salary, they were paying 2x in taxes which was much more than what I was paying for my health insurance. Both the same family situation (both single at the time). And try to compare the availability of services in the US vs most other countries. I know when Covid first started I looked up how many ICU beds US had vs other countries and I think for UK it was like 10x more in the US.
 
But look at the difference in taxes. I am originally from Canada where they also have a government funded health care system. A couple of years ago I compared my US taxes with a friend who was in Canada, and even though they were only making about 2/3 of my salary, they were paying 2x in taxes which was much more than what I was paying for my health insurance. Both the same family situation (both single at the time). And try to compare the availability of services in the US vs most other countries. I know when Covid first started I looked up how many ICU beds US had vs other countries and I think for UK it was like 10x more in the US.

You can't really make that comparison as the US runs massive deficits and prints massive amounts of money to pay for a lot of healthcare and military. All of those Canadian taxes go to additional things besides healthcare. They had a very generous UBI program which the US didn't. The US has the best healthcare in the world; if you can pay for it.

A lot of those ICU beds are focused in major metros and aren't particularly useful if you live in a low-density population area. I used to have all of the major cancer centers in the US memorized as it was asked about so often on my cancer forum. We always recommend getting a second opinion if you don't have a nearby major cancer care center nearby. Some people actually move or stay with a relative to get treatment at a top hospital.

One of the problems with ICU beds today is staffing. The shortage isn't beds but staffing.
 
The US has the best healthcare in the world; if you can pay for it.
It really doesn't. Studies have shown that even the richest Americans have somewhat worse outcomes from the health system than average Europeans. (Example.)

(And of course, beyond the rich, America's health care costs are two-times the average of the top 11 economies, and has the absolute worst outcomes by quite a bit.)
 
It really doesn't. Studies have shown that even the richest Americans have somewhat worse outcomes from the health system than average Europeans. (Example.)

(And of course, beyond the rich, America's health care costs are two-times the average of the top 11 economies, and has the absolute worst outcomes by quite a bit.)

Europeans are probably healthier on average than Americans. Our obesity rate is off the charts and Europeans still walk a lot.

When I went for cancer surgery in Boston, I was stunned that most of the people having surgery were from Europe and Canada.
 
Europeans are probably healthier on average than Americans. Our obesity rate is off the charts and Europeans still walk a lot.
Obesity in Europe has almost caught up with us. Americans also exercise more than Europeans. The studies are more sophisticated than that anyway -- they adjust for such factors.

We "over treat" (e.g. why getting too many mammograms actually increases your mortality), over-use drugs, make more errors, are less regulated, are profit- over evidence- driven... lots of problems.

I'm sure you saw people from overseas because Boston has some of the top hospitals in the world. You see people from around the would at top French hospitals too.
 
Obesity in Europe has almost caught up with us. Americans also exercise more than Europeans. The studies are more sophisticated than that anyway -- they adjust for such factors.

We "over treat" (e.g. why getting too many mammograms actually increases your mortality), over-use drugs, make more errors, are less regulated, are profit- over evidence- driven... lots of problems.

I'm sure you saw people from overseas because Boston has some of the top hospitals in the world. You see people from around the would at top French hospitals too.

Caught up? Our rate is 42.4%. Those numbers are nowhere near ours.


Screen Shot 2021-10-19 at 10.44.07 PM.png

-- CDC

I see a lot of obese people in my state but it's "only" one out of three. I think that I would notice if nearly every other people in my state was obese. The best states in the US are around the worst countries in the EU. I was originally floored when I heard that our obesity rate was in the 40s as I think that it was in the low 30s the last time I checked - but that must have been many years ago. No wonder we have a ton of people dying from COVID - we have a lot of people obese and unvaccinated.

Your exercise study is based on surveys; not actual data. It asks if people have an exercise plan and how many days a year they exercise. It doesn't actually measure how much they exercise.

This is a novel cancer treatment developed in the United States several years ago. I know the first patient who received it. They basically re-engineer the patient's own white blood cells to seek out and kill cancer cells. Since this successful case, they've used it to target other cancers. My cancer hospital has a cell manufacturing laboratory for this kind of therapy. I've read in the past two years that the UK has this therapy. I was rather intrigued that they developed it and found out that they just send the blood to the US for analysis and modification and then cells are sent back to go into the patient.

I'm unaware of anyplace else in the world that developed this technology which holds great promise for curing cancer without the crippling approach of chemo, surgery and radiation that we currently use.


I looked at the cancer protocols for several countries in Europe on my particular cancer. They were all basically copied from US protocols and some were out of date. In fact I found the same thing in some of the Asian countries that I looked at.

There are hospitals around the US that have offices for international patients; it's not just Boston.

Sloan-Kettering was the only place you could get a Hepatic Arterial Infusion pump for a couple of decades. If you wanted one, you went there and saw Dr. Kemeny. It is available at other hospitals today but you could only get it at one place since the 1990s.

 
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13 hospitals in Denver Colorado went on divert Tuesday afternoon. Not all of that was caused by Covid patients but the hospitals are clearly way too busy already and having Covid patients doesn't make it any easier.
 
13 hospitals in Denver Colorado went on divert Tuesday afternoon. Not all of that was caused by Covid patients but the hospitals are clearly way too busy already and having Covid patients doesn't make it any easier.

Colorado is on the high-side for vaccinations in the US though it looks like it has peaked at 72% fully vaccinated. The number of people getting vaccinated daily is quite small. Same problem we have in my state though our numbers are 17% lower. We may be getting to herd immunity in some areas with so many getting infected and so many dying. Daily New Cases, Active Cases, and Daily Deaths are headed down. The question ahead of us is will colder weather and the holidays (Halloween end of October, Thanksgiving late November, Christmas, New Years) cause a fifth wave?
 
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