Coronavirus (Covid-19) informational thread

[iOS Geek]

My hospital is loosening our visitor restrictions this week. For my department, that doesn't mean much because we were one of the only ones that never stopped allowing them. All we did was cut back to only allowing a support person for a mother in labor...and then both parents were allowed in the NICU. The catch was that if you were the "support person" you were the only one allowed to come in in a 24-hour period. You could come and go as you please in that 24-hour period, but you couldn't "tag yourself out" and swap with someone else. The other person had to have their own 24-hour period.

We're dropping that 24-hour rule. As for other departments are going to begin allowing visitors again (in limited quantities). Given that I'm in charge on my floor, I've had to be the department d-bag a few times. So in all honesty, I'm glad for the change.

 

[TechRunner]

My hospital is loosening our visitor restrictions this week. For my department, that doesn't mean much because we were one of the only ones that never stopped allowing them. All we did was cut back to only allowing a support person for a mother in labor...and then both parents were allowed in the NICU. The catch was that if you were the "support person" you were the only one allowed to come in in a 24-hour period. You could come and go as you please in that 24-hour period, but you couldn't "tag yourself out" and swap with someone else. The other person had to have their own 24-hour period.

We're dropping that 24-hour rule. As for other departments are going to begin allowing visitors again (in limited quantities). Given that I'm in charge on my floor, I've had to be the department d-bag a few times. So in all honesty, I'm glad for the change.

Sounds like the birth center at the hospital where I worked (patient-facing, non-medical role) until last October. Those poor nurses (a group of absolute rock stars, IMO) took a lot of crap from people for just following policy. I'm glad for you that things are finally drifting back towards normal.

 

[dk001]

As I read this thread and many other avenues, the conflicting information from reputable agencies is concerning. Here is a good example on one of these using data from my State (California). It is concerning how the average person can be sure of receiving the latest and most applicable / accurate information.

 

[poorcody]

As I read this thread and many other avenues, the conflicting information from reputable agencies is concerning. Here is a good example on one of these using data from my State (California). It is concerning how the average person can be sure of receiving the latest and most applicable / accurate information.

The potential flaws the YouTuber presented are spelled-out right in the study.

A true gold-standard study on mask usage (e.g. randomized, placebo-controlled, double-blind, etc.) would require you to put people in rooms with different masks and expose them to COVID. In other words, it would be unethical. So you often have to rely on studies of lower standards that inherently have flaws. Everyone in science understands this. It's also one reason you should probably never take any study on its own.

It's easy for the guy in the video to sound clever but he's trying to make the routine sound scandalous.

 

[dk001]

The potential flaws the YouTuber presented are spelled-out right in the study.

A true gold-standard study on mask usage (e.g. randomized, placebo-controlled, double-blind, etc.) would require you to put people in rooms with different masks and expose them to COVID. In other words, it would be unethical. So you often have to rely on studies of lower standards that inherently have flaws. Everyone in science understands this. It's also one reason you should probably never take any study on its own.

It's easy for the guy in the video to sound clever but he's trying to make the routine sound scandalous.

That is my point though. The average Joe/Jane/Jerry will not know this nor know anything about it. They just trust what is communicated at the headline level not understanding the underlying finding weaknesses, assumptions, or gaps.

 

[SactoGuy18]

I really wonder why the CDC didn't recommend losing weight and getting enough Vitamins B6, C, D, E and K and supplemental zinc on a daily basis way back in the spring of 2020. Why, no money in selling more vitamin supplements?

 

[Mainsail]

As I read this thread and many other avenues, the conflicting information from reputable agencies is concerning. Here is a good example on one of these using data from my State (California). It is concerning how the average person can be sure of receiving the latest and most applicable / accurate information.

Wow. I was about to post the same video. Of course, it is important to not take too much stock in one academics opinion about a study, but I found the guy to be pretty credible. That said, there were some parts of his presentation that kind of went over my head. So, perhaps there are others on this thread that have better insight.

I have only seen one other video by this guy, and in that one he was critical of the use of meta data that showed that lock downs were ineffective in preventing deaths. So, he seems to play it down the middle by criticizing bad study methodology regardless of the political narrative. Basically, he just does not like shoddy science. He seems to be a real data wonk.

Anyway, here are my three major take-aways from the video:

• The study was terribly flawed (~10 major issues) and does not pass scientific rigor.
• While flawed, the study is being used by the CDC to support the government's narrative about masks. This is antithetical to how science should work and be used.
• This study could be very damaging because it will harm the long-term credibility of the CDC and the scientists associated with this study.

I would love to hear other peoples opinions. Perhaps I am being bamboozled.

 

[Mainsail]

That is my point though. The average Joe/Jane/Jerry will not know this nor know anything about it. They just trust what is communicated at the headline level not understanding the underlying finding weaknesses, assumptions, or gaps.

Agreed. If the study is this flawed, it should not be used by our government agencies as a tool for promoting or promulgating a narrative about masks. Perhaps there are good reasons to wear a mask, but don't use a flawed study to promote it. Another CDC self-inflicted credibility wound.

 

[dk001]

Wow. I was about to post the same video. Of course, it is important to not take too much stock in one academics opinion about a study, but I found the guy to be pretty credible. That said, there were some parts of his presentation that kind of went over my head. So, perhaps there are others on this thread that have better insight.

I have only seen one other video by this guy, and in that one he was critical of the use of meta data that showed that lock downs were ineffective in preventing deaths. So, he seems to play it down the middle by criticizing bad study methodology regardless of the political narrative. Basically, he just does not like shoddy science. He seems to be a real data wonk.

Anyway, here are my three major take-aways from the video:

• The study was terribly flawed (~10 major issues) and does not pass scientific rigor.
• While flawed, the study is being used by the CDC to support the government's narrative about masks. This is antithetical to how science should work and be used.
• This study could be very damaging because it will harm the long-term credibility of the CDC and the scientists associated with this study.

I would love to hear other peoples opinions. Perhaps I am being bamboozled.

His personal biases aside, he is pretty spot on.
My biggest question with all the information floating around, why would the CDC even attempt to use this as it is heavily flawed. Folks need accurate facts they can easily understand and trust, not stuff like this.

 

[Mainsail]

It is probably just a coincidence, but today, a large number of states (mostly blue) announced plans to end mask mandates. CDC guidance is unchanged, but these states are going their own way. Dr Wen on CNN supported the states' move. She indicated that the CDC has lost a lot of credibility and relevance.

 

[poorcody]

My biggest question with all the information floating around, why would the CDC even attempt to use this as it is heavily flawed.

Because it's not heavily flawed. It is in the range of typical weaknesses of most studies. That's why it passed peer-review and the CDC's review. Again, the YouTuber is just sensationalizing the routine. Grab any bunch of studies and read the standard disclosures of limitations... science is messy, but good science doesn't hide the mess.

 

[dk001]

Because it's not heavily flawed. It is in the range of typical weaknesses of most studies. That's why it passed peer-review and the CDC's review. Again, the YouTuber is just sensationalizing the routine. Grab any bunch of studies and read the standard disclosures of limitations... science is messy, but good science doesn't hide the mess.

If you have ever done any test negative studies of this type, and the CDC does call it out, the underlying base comparison is heavily flawed. It should never have been used for something like this. It could be indicative at best. That is even a stretch.

That comes back to the visual; when driving public directives around COVID using data the CDC and others should be solid in the conclusions using solid data that the public can easily understand.

 

[Mainsail]

If you have ever done any test negative studies of this type, and the CDC does call it out, the underlying base comparison is heavily flawed. It should never have been used for something like this. It could be indicative at best. That is even a stretch.

That comes back to the visual; when driving public directives around COVID using data the CDC and others should be solid in the conclusions using solid data that the public can easily understand.

I agree. The CDC never should have used this study to promote mask wearing. The ends don't justify the means. Reference: noble-lies-are-a-public-health-hazard

I really don't know how much worse CDC's and other government officials' credibility can get. It is death by a thousand paper cuts. It is so bad that even blue state governors are circumventing CDC masking requirements. This pretty much puts an end to the narrative that Health Officials' guidelines and requirements should not be questioned, or that merely questioning guidelines is a selfish act that will lead to misinformation and bad behavior.

 

[poorcody]

If you have ever done any test negative studies of this type, and the CDC does call it out, the underlying base comparison is heavily flawed.

That sentence doesn't even make sense.

 

[bradl]

That sentence doesn't even make sense.

Agreed. This is trying to use a test to prove the negative after those same tests were used to prove a positive, and then claiming that the positive results were wrong. That makes no sense.

BL.

 

[dk001]

@poorcody @bradl

"The test-negative design (TND) is a variation of the case-control study design, in which the same clinical case definition is used for enrollment of both cases and controls. Laboratory testing is subsequently used to distinguish which patients were cases and which were controls. An important advantage of this approach is the efficiency of enrolling cases and controls in the same location with the same case definition, thereby assuring that they have arisen from the same source population and reducing potential selection biases due to differential healthcare-seeking behavior."

Now look at the study and what the base comparison between positives and negatives. The underlying "reason(s)" for getting a test and the use of masks in relation to the "reason(s)" are not the same for the two.

If all these were the result of "required by employer" (example) or some similar cause the study and the use of masks would validate the data comparison. There wasn't. It is indicative at best.

btw - the dta from this study was not used to prove a positive as far as I know. If it was kindly point that out.

 

[iOS Geek]

You can now add Illinois to the list of states ending their mask mandates. Our governor put the end date as February 28th

 

[poorcody]

New York State is ending their mask mandate today. We had two days in a row of ~20 cases per 100K per day, which best I can tell hasn't happened since the summer. Incredible considering we peaked at ~380 just one month ago.

As much as the numbers are pointing toward reduced precautions, it sounds like it is in part a political decision as well. NY Times covered it well this morning. Health experts seem to be saying we are close but not quite there, whereas the public is starting to tilt toward "moving on".

 

[dk001]

After this mess is all said and done, or in a far better place, I really hope, without politics, groups get together and really look at what worked and what didn't in an effort to develop a far more robust method going forward.

This has been brutal with far too many guesses and assumptions.

 

[iOS Geek]

New York State is ending their mask mandate today. We had two days in a row of ~20 cases per 100K per day, which best I can tell hasn't happened since the summer. Incredible considering we peaked at ~380 just one month ago.

As much as the numbers are pointing toward reduced precautions, it sounds like it is in part a political decision as well. NY Times covered it well this morning. Health experts seem to be saying we are close but not quite there, whereas the public is starting to tilt toward "moving on".

What really gets me about Illinois‘ announcement…is that Pritzker said they will still be mandated in K-12 schools. That seems odd to me specifically because he threw a fit last week when a judge blocked the mandate for schools but said school districts can mandate it themselves). Now, he makes the announcement and calls out K-12 schools directly saying it will still be mandated. Maybe I’m just not listening hard enough, but I haven’t heard anything about hospitals yet.

I will assume they will still be required in hospitals (and mine will continue to do so, if the state doesn’t). But to directly call out schools and NOT hospitals seems…odd. I’d actually call it a little suspicious. You stomp and throw a fit because the school one was blocked. So you appeal that ruling and then announce you’re going to pull the mandate for everything except the one you threw a fit about.

I guess my question is why did he only mention schools? Why not nursing homes and hospitals? What about colleges? He made the announcement this morning, but I believe he’s holding a press conference this afternoon. If that’s the case, I hope he clears this up, because for now something seems off.

As for your statement about it being a political decision…I’d agree for three reasons. 1) Our governor only offered very vague statements on the “when”…until California announced they are ending theirs. Once they did, he really seemed to accelerate. 2) because he called out schools just days after throwing a fit about the ruling. And 3…he’s up for re-election this year and he knows people aren’t happy with him...as evidenced by his new interest in fighting crime (which we’ve seen a lot of increases in that people are blaming his policies for, because some of those policies have clearly backfired. The big talking point here is that he has “made things easier for criminals”) and he is also providing tax relief to help people due to the financial hit we’ve all taken from COVID (and ironically, some of the things he’s lowering taxes on…are things he RAISED taxes on over the last few years). I don’t think it’s any coincidence that this announcement came when it did. He knows he’s not popular right now and November isn’t far away.

EDIT: The press conference clarified it. Our mandate is being lifted February 28th (as mentioned above). It remains in place for schools, transportation, and healthcare.

 

[Gregg2]

This is clearly classic insanity. The focus keeps getting off of the science and filtered by politics. A robust set of mitigation strategies, left in place long enough, would have had us in a much better place by now.

 

[Mainsail]

This is clearly classic insanity. The focus keeps getting off of the science and filtered by politics. A robust set of mitigation strategies, left in place long enough, would have had us in a much better place by now.

But would it? California had mask mandates. Florida and Texas did not. And if you look at the COVID cases during the Omicron wave, none of these states flattened the curve. California's cases went straight up and then straight down. Same with other large states without mandates. There was no flattening the curve regardless of masking policy. Also, there are negative impacts to mandates and mitigations to other elements aspects of life that must be weighted against their benefits.

Optimally everyone in the US that is eligible would get vaccinated, but that ship has sailed. Those that have rejected vaccination will not be moved by government programs and pressure. They have dug in. I am a big supporter of vaccinating adults, especially those that are most vulnerable to hospitalization and death. Unfortunately, while very effective against serious illness and death, vaccination has not proven to be very effective against Omnicron infection. So, the benefits of vaccinating young people (very unlikely to get severely ill) and mask mandates in schools to slow the spread seems substantially less with Omicron.

I am not sure how much better of a place we need to be in before there is a change of policy. Estimates are that 90% of the population now have some form of immunity (natural/vaccinated). We have treatments. We have testing. Cases are plummeting. Hospitalization are plummeting too, but the data is questionable at best, since there is no distinction between those hospitalized "with" vs "because" of COVID.

Finally, we have a public that has grown cynical of government programs and officials that have lost credibility, such as: Hypocritical politicians that don't follow the guidance they put in place for others or, "Noble lies" told by Health care officials to influence behavior. Experts and officials have burned all of their chips. The public is done.

Time to stop using a broad ax approach and focus mitigations and prevention on those most vulnerable. 75% of deaths are over 65. A huge percentage of deaths are obese. How about a medical surveillance program for the 90% that have the highest likelihood of serious illness and death? At most universities, College kids are required to be vaccinated and tested weekly. These are the people least likely to get severely sick. Meanwhile, there are no such medial survellience programs for the most vulnerable. Insane.

 

[dk001]

But would it? California had mask mandates. Florida and Texas did not. And if you look at the COVID cases during the Omicron wave, none of these states flattened the curve. California's cases went straight up and then straight down. Same with other large states without mandates. There was no flattening the curve regardless of masking policy. Also, there are negative impacts to mandates and mitigations to other elements aspects of life that must be weighted against their benefits.

Optimally everyone in the US that is eligible would get vaccinated, but that ship has sailed. Those that have rejected vaccination will not be moved by government programs and pressure. They have dug in. I am a big supporter of vaccinating adults, especially those that are most vulnerable to hospitalization and death. Unfortunately, while very effective against serious illness and death, vaccination has not proven to be very effective against Omnicron infection. So, the benefits of vaccinating young people (very unlikely to get severely ill) and mask mandates in schools to slow the spread seems substantially less with Omicron.

I am not sure how much better of a place we need to be in before there is a change of policy. Estimates are that 90% of the population now have some form of immunity (natural/vaccinated). We have treatments. We have testing. Cases are plummeting. Hospitalization are plummeting too, but the data is questionable at best, since there is no distinction between those hospitalized "with" vs "because" of COVID.

Finally, we have a public that has grown cynical of government programs and officials that have lost credibility, such as: Hypocritical politicians that don't follow the guidance they put in place for others or, "Noble lies" told by Health care officials to influence behavior. Experts and officials have burned all of their chips. The public is done.

Time to stop using a broad ax approach and focus mitigations and prevention on those most vulnerable. 75% of deaths are over 65. A huge percentage of deaths are obese. How about a medical surveillance program for the 90% that have the highest likelihood of serious illness and death? At most universities, College kids are required to be vaccinated and tested weekly. These are the people least likely to get severely sick. Meanwhile, there are no such medial survellience programs for the most vulnerable. Insane.

Well said.
Here in Cali I am seeing, in schools, if even a symptom can be associated with COVID, they go Ape S**t and apply draconian measures. One size (the most restrictive) fits all.
Even if you previously had it and/or been vaccinated.

Something needs to give.

 

[Cave Man]

This is clearly classic insanity. The focus keeps getting off of the science and filtered by politics. A robust set of mitigation strategies, left in place long enough, would have had us in a much better place by now.

Do you know what you get when you mix science and politics?

Politics.

 

[SactoGuy18]

After this mess is all said and done, or in a far better place, I really hope, without politics, groups get together and really look at what worked and what didn't in an effort to develop a far more robust method going forward.

This has been brutal with far too many guesses and assumptions.

Post of the year on MacRumors. ??

Personally, I think while the earlier variants like Alpha and Delta did require more physical separation and the use of masks, the current Omicron variant is essentially (in my opinion!) a coronavirus-based cold virus and should have been treated as such. We need to stop politicizing this pandemic and should have carefully made an agreement on how to deal with it properly.