COVID/Coronavirus non-political DISCUSSION thread

[The-Real-Deal82]

No mask policy was announced at my place of work by the end of play yesterday. I emailed in asking if it was still being proposed and got a one line answer back saying it’s being announced today. People who work on our factory floor have been voicing their concerns for weeks apparently and they’ve been putting it off for reasons i’ll probably never understand.

 

[rpmurray]

If the 95% effectiveness works then I shall be very happy that I can't spread it to others....

Taking the vaccine only works to protect you. You can still be a carrier that spreads it to others who aren't vaccinated.

 

[poorcody]

Other than touch/physical contact -
How does a vaccinated person able to spread the virus if they are now unable to become infected ?

I thought if you are not infected due to vaccine, your body is not multiplying viruses, not spewing out respiratory droplets nor contagious...

Technically the vaccine doesn't prevent you from being infected. It only prevents the infection from causing you significant harm.

The official line is that we can't assume a vaccinated person can't pass it along to someone else, primarily because there are no studies to show that yet. I heard a doctor on the radio say the other day, though, that no previous vaccine allowed people to pass the targeted infection, so he is confident that will be the case here too.

 

[AustinIllini]

Taking the vaccine only works to protect you. You can still be a carrier that spreads it to others who aren't vaccinated.

We don't actually know that for sure yet.

 

[gnasher729]

Taking the vaccine only works to protect you. You can still be a carrier that spreads it to others who aren't vaccinated.

I thought this thread was not about "Political opinions" and "Pro and against vaccine". If you are protected, you are protected. You can't get Covid, you can't spread it. Only if you are one of the unlucky ones who didn't get full protection, that's when you can get and spread Covid.

We don't actually know that for sure yet.

More precisely: There is no evidence for this at all yet.

 

[photogramps]

If you are protected, you are protected. You can't get Covid, you can't spread it.

Can you post an authoratative link please.

 

[44267547]

So this was reported it in my state about a month ago:

CDC report: Double-masking can block more than 90 percent of viral particles

The report is the first from the CDC looking at how well different mask-wearing techniques protect people.

www.nbcnews.com

One standard cloth mask has the capability of blocking about 40% of C/19 virus particles, where-as two cloth masks combined, has the capability of blocking 90% C/19 virus particles.

I use N95s, [which is a five layer mask], and then I actually have them sterilized after so much usage.

But I agree with what the article is saying, does the CDC really believe that people will actually wear two masks when we can’t even get them to wear one properly covering their entire mouth and nose? I think there are some that will take advantage of wearing two masks for the added protection, but there’s a level of comfortability for some and then of course responsibility that the majority probably won’t take wearing two. Nonetheless, interesting news.

 

[4sallypat]

Just after I got my 2 doses of vaccine, and feeling relieved, I have to hear that there are 3 new variants that may dominate the country - the UK variant by end of March !

https://www.cdc.gov/coronavirus/2019-ncov/transmission/variant.html

 

[bunnspecial]

I've been seeing a whole, whole lot of discussion lately about the general the general population wearing N95s/KN95s, and I've heard it mentioned on the news and other places(AFAIK, it's still not in the CDC guidelines).

That concerns me for a few reasons. The big one is that they're still not exactly plentiful, and to me it's far more important that people in direct contact with or treating COVID patients have them.

More importantly, though, one of the critical design parameters of an N95 is that it needs to properly seal to your face. If your job ever involves you wearing one, you will be fit tested for the appropriate size, a process that involves actually making sure that it does seal properly. One fit test I'm familiar with involves aersolizing a saccharin solution and making sure that you can't taste it, and continuing to test with your head in different positions and while moving around. Aside from improper fit, though(they're not one size fits all) things like certain types of facial hair can prevent them from sealing properly.

N95s are restrictive enough that if they don't seal to your face properly, they potentially offer even less protection than the common cloth or paper disposable masks. Air will take the "path of least resistance" and if improperly sealed, you can end up breathing mostly unfiltered air.

All of that aside, the common "disposable" N95/KN95 is intended to be just that-disposable. If they become damaged, soiled, wet, or otherwise just go through a day's use, they should be discarded. During the PPE shortages, there have been some reuse and sterilization protocols put into place as an emergency measure. The guidelines I saw for these were that each one be carefully inspected for soiling or other damage before being sterilized, and that a single one be sterilized a maximum of two times(3 uses). I had volunteered at my previous employer to work with the sterilization system they had bought, but was furloughed before I could be trained on it.

Short answer-I'm going to have a hard time being convinced that N95s are a good idea for anyone who hasn't been trained on their proper use and fit tested. There's a lot more to them than being just a fancy mask.

 

[A.Goldberg]

I've been seeing a whole, whole lot of discussion lately about the general the general population wearing N95s/KN95s, and I've heard it mentioned on the news and other places(AFAIK, it's still not in the CDC guidelines).

That concerns me for a few reasons. The big one is that they're still not exactly plentiful, and to me it's far more important that people in direct contact with or treating COVID patients have them.

More importantly, though, one of the critical design parameters of an N95 is that it needs to properly seal to your face. If your job ever involves you wearing one, you will be fit tested for the appropriate size, a process that involves actually making sure that it does seal properly. One fit test I'm familiar with involves aersolizing a saccharin solution and making sure that you can't taste it, and continuing to test with your head in different positions and while moving around. Aside from improper fit, though(they're not one size fits all) things like certain types of facial hair can prevent them from sealing properly.

N95s are restrictive enough that if they don't seal to your face properly, they potentially offer even less protection than the common cloth or paper disposable masks. Air will take the "path of least resistance" and if improperly sealed, you can end up breathing mostly unfiltered air.

All of that aside, the common "disposable" N95/KN95 is intended to be just that-disposable. If they become damaged, soiled, wet, or otherwise just go through a day's use, they should be discarded. During the PPE shortages, there have been some reuse and sterilization protocols put into place as an emergency measure. The guidelines I saw for these were that each one be carefully inspected for soiling or other damage before being sterilized, and that a single one be sterilized a maximum of two times(3 uses). I had volunteered at my previous employer to work with the sterilization system they had bought, but was furloughed before I could be trained on it.

Short answer-I'm going to have a hard time being convinced that N95s are a good idea for anyone who hasn't been trained on their proper use and fit tested. There's a lot more to them than being just a fancy mask.

I too have a lot of concerns about this. For most people in the general public I think it's overkill and cost prohibitive. Maybe it's appropriate for someone at high risk who needs to go out in a crowded space- but if they have breathing issues then it's not worth it. Fit is the biggest issue when it comes to how well any mask is going to work. You average surgical or particulate mask is going to cost $0.30 at the moment, whereas a N95 is more like $10. Reusing N95's probably isn't going to be the safest practice. Plus, N95 supply is still fairly limited and its use should be prioritized. I don't think most people realize just how uncomfortable N95's are to wear either.

I have the ability to get N95's quite easily, but I opt not to wear them when not dealing outside of work unless I find myself in some precarious situation that I am forced to be in with lots of people (very rare). It's not worth wasting them, if I get sick I'm unlikely to have serious complications, and the lack of comfort doesn't make it worth it to me.

I think this whole double masking thing stems from people seeing medical staff wearing two masks- this is largely for 2 reasons- 1. Some N95's have the exhalation valve requiring a second mask to provide protection to others and 2. to extend the life of N95's. Typical medical protocols calls for changing masks between every patient. This is not really feasible given supply constraints. Wearing a surgical mask over the N95 allows for the cheap, plentiful surgical mask to be changed between patients without having to change the costly, limited supply N95's.

The two mask theory now as I best understand (surgical mask + cloth) is to improve the seal of the surgical mask around the cloth mask. I would assume the surgical mask does a better job on average protecting droplets and aerosols than cloth masks (which is probably hard to measure given endless materials available). I think it's fair to say a disposable mask under a cloth mask would also be more hygienic.

I've never been very impressed with the fit of KN95's personally, but maybe that's just my face. At least they are more available.

That seems like a fair practice. But double masks with N95's (and in many situations KN95's) seems rather wasteful and I'm not sure would provide that much benefit to the general public. Especially outside of high high risk areas (those where the risk of close contact with a covid+ patient is low).

 

[bunnspecial]

I too have a lot of concerns about this. For most people in the general public I think it's overkill and cost prohibitive. Maybe it's appropriate for someone at high risk who needs to go out in a crowded space- but if they have breathing issues then it's not worth it. Fit is the biggest issue when it comes to how well any mask is going to work. You average surgical or particulate mask is going to cost $0.30 at the moment, whereas a N95 is more like $10. Reusing N95's probably isn't going to be the safest practice. Plus, N95 supply is still fairly limited and its use should be prioritized. I don't think most people realize just how uncomfortable N95's are to wear either.

I have the ability to get N95's quite easily, but I opt not to wear them when not dealing outside of work unless I find myself in some precarious situation that I am forced to be in with lots of people (very rare). It's not worth wasting them, if I get sick I'm unlikely to have serious complications, and the lack of comfort doesn't make it worth it to me.

I think this whole double masking thing stems from people seeing medical staff wearing two masks- this is largely for 2 reasons- 1. Some N95's have the exhalation valve requiring a second mask to provide protection to others and 2. to extend the life of N95's. Typical medical protocols calls for changing masks between every patient. This is not really feasible given supply constraints. Wearing a surgical mask over the N95 allows for the cheap, plentiful surgical mask to be changed between patients without having to change the costly, limited supply N95's.

The two mask theory now as I best understand (surgical mask + cloth) is to improve the seal of the surgical mask around the cloth mask. I would assume the surgical mask does a better job on average protecting droplets and aerosols than cloth masks (which is probably hard to measure given endless materials available). I think it's fair to say a disposable mask under a cloth mask would also be more hygienic.

I've never been very impressed with the fit of KN95's personally, but maybe that's just my face. At least they are more available.

That seems like a fair practice. But double masks with N95's (and in many situations KN95's) seems rather wasteful and I'm not sure would provide that much benefit to the general public. Especially outside of high high risk areas (those where the risk of close contact with a covid+ patient is low).

Out of curiosity, assuming cost was NOT a factor(if an N95 was similar in price to say a disposable surgical mask, which we know won't happen), what are your thoughts on people wearing them who are not properly trained or fit tested?

Aside from that, there seems to be a lot of misconceptions out there about them. Working from home(mostly) these days, I often turn on the local NBC affiliate, which scrolls through local and national news, more as background noise than anything. At some point the other morning discussing the new double mask recommendation, it was mentioned by a "medical expert" that when double masking with N95s, the N95 should be worn OVER a surgical mask. I wanted to scream at the TV-putting anything other than skin under the edge of an N95 defeats the whole purpose!

Also, I've talked a lot with my wife about some of their current protocols re: PPE. Back pre-COVID, if a patient was on isolation, all of their PPE-gowns, shields, N95s, was discarded every time they left the room and going back in you were supposed to get fresh. With COVID, that's out the window, and PPE gets used for the entire shift unless it's damaged.

Last thing with wearing N95s in public-there again at my wife's hospital they only wear them when treating COVID patients or patients with another disease that would traditionally call for them. Otherwise, it's a standard surgical mask all day.

I've only worn a KN95 a few times. The last was when I went into someone's lab to fix their GC-MS, and they handed me one before I walked in and wouldn't let me in without it on. And yes, I found the fit quite poor on it to the point that I don't think there's any way I could have made it seal properly.

 

[4sallypat]

When this pandemic started, I had from work a bunch of the N95 3M 8511 filters with exhalation valve which lasted me a year now...

Just when I was down to 10 masks...

Now my work place re-ordered the 3M N95 filters and I have a steady supply along with :

• Tons (cases) of Lysol disinfectant wipes,
• Alcohol sanitizer dispensers,
• Foaming quaternary ammonium hand pumps,
• Silver ion based surface cleaners rated for C19 virus (30 seconds),
• Clorox 360 Total spray (ionized disinfectant spray gun) that the maintenance folks use daily in all rooms.
• 24 hours a day HVAC w/ MERV 13 filters in all rooms.

My work place is much safer than my home because of so much PPE they bought using Federal CARES act monies!

 

[A.Goldberg]

Out of curiosity, assuming cost was NOT a factor(if an N95 was similar in price to say a disposable surgical mask, which we know won't happen), what are your thoughts on people wearing them who are not properly trained or fit tested?

Aside from that, there seems to be a lot of misconceptions out there about them. Working from home(mostly) these days, I often turn on the local NBC affiliate, which scrolls through local and national news, more as background noise than anything. At some point the other morning discussing the new double mask recommendation, it was mentioned by a "medical expert" that when double masking with N95s, the N95 should be worn OVER a surgical mask. I wanted to scream at the TV-putting anything other than skin under the edge of an N95 defeats the whole purpose!

Also, I've talked a lot with my wife about some of their current protocols re: PPE. Back pre-COVID, if a patient was on isolation, all of their PPE-gowns, shields, N95s, was discarded every time they left the room and going back in you were supposed to get fresh. With COVID, that's out the window, and PPE gets used for the entire shift unless it's damaged.

Last thing with wearing N95s in public-there again at my wife's hospital they only wear them when treating COVID patients or patients with another disease that would traditionally call for them. Otherwise, it's a standard surgical mask all day.

I've only worn a KN95 a few times. The last was when I went into someone's lab to fix their GC-MS, and they handed me one before I walked in and wouldn't let me in without it on. And yes, I found the fit quite poor on it to the point that I don't think there's any way I could have made it seal properly.

I think you probably know the answer to that. I can see the argument for properly training and fitting high risk people if they MUST venture out in risky situations, but those people should really be not venturing out to begin with. I’m not sure it’s fair to say an improperly fit or donned N95 mask is going to be more dangerous than an improperly fit surgical or cloth mask, I’m not aware of any data to suggest that, but I think it’s generally a waste to use such masks in the general public in pretty low risk circumstances. But given the scarcity and cost there’s no sense in wasting a mask if it’s not going to be used properly.

As I have said many times before I think there has been an astonishing lack of mask education by the public health authorities- how to don a mask and remove in a hygienic manner, how to keep them clean, when to change them, etc.

I have never heard of the recommendation to wear an N95 over a surgical mask... I suppose maybe the N95 could seal over the surgical mask... but it doesn’t make much sense to me.

Yup, there’s definitely a lot more conservation of PPE... granted pre-COVID N95 respirators were really not something commonly used unless working around highly toxic chemotherapy or in some sort of uncommon infectious disease situation where inhalation is a serious concern and the patient is in a quarantine room (most “common” would probably be Tuberculosis, but also things like anthrax, measles, smallpox- all not very common things in the US) you’re dealing with a patient being hospitalized who has been exposed to toxic chemicals and has not been stripped and washed.

My general hospital require full PPE garb including N95 in the ER and COVID+ patients. Outside of that it’s pretty much surgical masks. Sterile compounding now requires an N95. My psych hospital for a while was mandating N95’s for extra protection of staff from infecting patients, mainly. I believe they are still requiring N95’s during the intake process for inpatient evaluation and staff working in the quarantine areas where patients are held for a few a period until they are absolutely confirmed negative for COVID (it doesn’t make a ton of sense logically but oh well- I think our true success in preventing a COVID outbreak was compartmentalizing staff and units as much as possible).

I know people working at mass vaccination sites (thousands of people per day) and they were not issued N95’s. Not sure I think this is the best idea, but it’s also really not that unexpected.

By the design I don’t see how KN95’s can fit anyone particularly well. There’s no real force creating a 360 seal around the edge of the mask along the face. It’s more like 2 vertical areas of tension on the cheeks from each ear loop- with little pressure above/around the nose and chin. When I breath out with a KN95 I instantly have fog on my glasses (if I haven’t used lens defogger- the most valuable substance on earth ATM second to the COVID vaccine). This clearly indicates an improper fit. It can be remedied slightly with a surgical mask, but I have little confidence it’s really doing what I’m intending it do.

At my residential program, I have 4 days worth of N95’s staff and KN95’s for residents in case of some sort of catastrophic outbreak response. 2 different brands of N95. It would not be a very good situation if that happened. We have plans, but it would be extremely difficult to contain if it happened.

 

[Clix Pix]

I've been perfectly fine with my surgical masks and have no plans to try and get my hands on an N95..... As far as doubling up, I'd rather go with two surgical masks than a surgical mask and some sort of cutesy pretty cloth mask that some home seamstress on Etsy created out of fabric from old clothes worn by her family...... No thanks! I don't want to deal with having to wash any cloth masks after each use, either. I much prefer using disposable masks that I can simply discard when returning home from an excursion to the grocery store.

 

[The-Real-Deal82]

I’ve got about 60 N95 masks which I’ve had for about 5 years now but since the pandemic began, I’ve not been in a situation where I’ve really needed them. We had a spot check by public health at work last week to make sure everybody was wearing masks in the workplace. I couldn’t resist saying in a meeting that it was a good job I highlighted the previous situation of nobody wearing them and how much trouble we could have been in. The site Director still only talks to me through gritted teeth lol.

I’m still avoiding shops, public spaces and getting our shopping delivered weekly. I feel sorry for those people who have no choice but to rely on public transport in these times.

 

[Gregg2]

When the pandemic started, the company I work for donated our small supply of N-95 masks for redistribution to local medical facilities. I have a very old one, but I have not worn it. I didn't want to wear it in public when there was such a shortage on the front line, and I feel the same still.

 

[4sallypat]

When the pandemic started, the company I work for donated our small supply of N-95 masks for redistribution to local medical facilities. I have a very old one, but I have not worn it. I didn't want to wear it in public when there was such a shortage on the front line, and I feel the same still.

I re-use mine about a month before I toss it - sterilize and clean it every day.

I figure if my health work place offers them to their employees, I should be able to use it.

 

[Madhatter32]

I have one N95 mask that is a year old already. I am looking to replace it but cannot seem to find any.

 

[44267547]

I have one N95 mask that is a year old already. I am looking to replace it but cannot seem to find any.

My best advice, keep an eye on Amazon for the K-N95’s (A.K.A-Birds beak style). I have a friend that lives south of me that was able to find ‘A six pack’ bundle I think for somewhere around ~$35. Now, there is some inflation involved there for obvious reasons, but if you put it on your ‘watchlist’, you’ll be notified when they’re in stock.

 

[bunnspecial]

I think you probably know the answer to that. I can see the argument for properly training and fitting high risk people if they MUST venture out in risky situations, but those people should really be not venturing out to begin with. I’m not sure it’s fair to say an improperly fit or donned N95 mask is going to be more dangerous than an improperly fit surgical or cloth mask, I’m not aware of any data to suggest that, but I think it’s generally a waste to use such masks in the general public in pretty low risk circumstances. But given the scarcity and cost there’s no sense in wasting a mask if it’s not going to be used properly.

I'm sure I'm exaggerating about poor fit being dangerous, although I'd be interested to see it studied. Anecdotally, I find that my glasses seem to fog worse with a KN95 than with a poorly fitting cloth mask. That's certainly not a measurement, though. I'd be willing to go out on a limb and say that a poorly fitting N95 or KN95 probably offers little benefit over a cloth or paper mask.

And yes, I agree, they REALLY shouldn't be wasted by people who aren't using them properly.

Comments in this thread have reinforced one of my other big concerns-that these disposable, one time use devices are being reused for a MONTH, or well beyond what they were designed to do. Even if they fit you properly when new, I can't imagine them maintaining after regularly use for that amount of time. As I mentioned, previous emergency sterilization protocols I'm familiar with permit two sterilizations(3 uses total). At $5-10 each, I'm not surprised people use them well beyond their intended use, but these things are disposable for a reason.

Re: their previous use in hospitals, one of the things my wife has talked about that previously meant full isolation protocols(including gowns and N95s) in her hospital was being MERSA positive. Since her floor has a lot of patients who are there for long stays or regularly there, they tend to have a fair few who are MERSA positive. Their current protocols call for isolation only with active MERSA infection, and to various extents for the sake PPE conservation, they've also made judgement calls on how "bad" your active infection is before going into isolation.

 

[A.Goldberg]

I'm sure I'm exaggerating about poor fit being dangerous, although I'd be interested to see it studied. Anecdotally, I find that my glasses seem to fog worse with a KN95 than with a poorly fitting cloth mask. That's certainly not a measurement, though. I'd be willing to go out on a limb and say that a poorly fitting N95 or KN95 probably offers little benefit over a cloth or paper mask.

And yes, I agree, they REALLY shouldn't be wasted by people who aren't using them properly.

Comments in this thread have reinforced one of my other big concerns-that these disposable, one time use devices are being reused for a MONTH, or well beyond what they were designed to do. Even if they fit you properly when new, I can't imagine them maintaining after regularly use for that amount of time. As I mentioned, previous emergency sterilization protocols I'm familiar with permit two sterilizations(3 uses total). At $5-10 each, I'm not surprised people use them well beyond their intended use, but these things are disposable for a reason.

Re: their previous use in hospitals, one of the things my wife has talked about that previously meant full isolation protocols(including gowns and N95s) in her hospital was being MERSA positive. Since her floor has a lot of patients who are there for long stays or regularly there, they tend to have a fair few who are MERSA positive. Their current protocols call for isolation only with active MERSA infection, and to various extents for the sake PPE conservation, they've also made judgement calls on how "bad" your active infection is before going into isolation.

I would make the same assumption that a poor N95/KN95 probably doesn’t have much superiority to a surgical mask.

Yeah, it’s quite concerning to see masks that have clearly been used well past their prime. In my experience this is very common with the elderly- wearing a disposable surgical mask that’s discolored, stained, material pulling, etc. And even if the mask isn’t clearly worn out, there is the inherent problem the the general public touching things in a store, leaving, taking their mask off, putting it in their pocket, then later putting the mask back on without sanitizing their hands.

Honestly, forget all this stuff about double masking. The CDC should begin btalking about disposing single use masks, regularly cleaning cloth masks, and washing your hands before and after taking on/off the masks. It baffles me why there isn’t a bigger effort on the federal or state level to promote best practices.

It’s been a while since I’ve dealt with MRSA as I don’t normally work in a general hospital, but yes MRSA patients are isolated and PPE is required and a big red sign gets put on the door, though N95’s wouldn’t be commonly worn. I suppose if there was a risk of MRSA aerosols (MRSA staph pneumonia, though this isn’t particularly common) an N95 might be warranted. Otherwise it seems a bit wasteful to use N95’s generally for other types of infections.

I don’t believe I’ve ever seen MRSA carrier patients without an active infection be isolated. As it is 1%+ of the population carries MRSA and 5% of HCW’s, and hospitals are breeding grounds for MRSA infections and strain mutations despite all the precautions taken.

It’s pretty scary to see the emergence of even more resistant strains of pathogens, like VRSA (vancomycin resistant staph aureus). Vancomycin is a pretty heavy duty antibiotic as it is and your treatment options start getting very slim at that point, especially if the patient has other major health issues or drug allergies. We’re likely to have serious problems with resistance in the future, sooner rather than later if we’re not careful. And there isn’t much in the development pipeline to look forward to.

 

[Gregg2]

If you missed the first episode of the COVID spike due to things being opened too soon, the rerun was just released. Stay tuned for the thrilling roller coaster ride back to the top.

 

[bunnspecial]

It’s pretty scary to see the emergence of even more resistant strains of pathogens, like VRSA (vancomycin resistant staph aureus). Vancomycin is a pretty heavy duty antibiotic as it is and your treatment options start getting very slim at that point, especially if the patient has other major health issues or drug allergies. We’re likely to have serious problems with resistance in the future, sooner rather than later if we’re not careful. And there isn’t much in the development pipeline to look forward to.

Thanks for the subtle correction

In any case, I'll ask her about their non-COVID MRSA isolation protocols, as I'm almost positive she said patients known positive even without active infections are still kept on isolation on her floor. If that's correct, I would guess it's because of the number of immunocompromised patients they have and probably try to avoid spreading to others as much as possible.

I know antibioitic resistance is drifting way off topic, but I recall a dinner conversation a number of years back with a good friend of mine. This friend wrapped up a PhD in bioinformatics two years ago and is set to graduate from medical school this spring(and then head off for a post doc at Los Alamos National Lab rather than doing residency). He's a sharp cookie.

That aside, this conversation was early in his medical education but he's a darn good biochemist. He speculated that antiobiotic resistance in bacteria was evolutionary "baggage" that would eventually go away given enough time and lack of exposure to the particular antibiotic or class of antibiotics. He suggested a rotating list by the WHO of "okay" antibiotics to use in a given period of time.

I'm not sure if there's any merit to that or not. At the time I couldn't find anything in literature discussing it one way or another. I floated it past a couple of biochem colleagues who gave responses ranging from "Hmm, interesting idea, I'll think about it" to "No, I don't think so." Those responses were honestly pretty well predictable based on the person I asked and their likelyhood to "think outside the box." I don't have that many biologist contacts to float an idea like that past.

Do you know if that's something that has been observed?

 

[A.Goldberg]

Thanks for the subtle correction

In any case, I'll ask her about their non-COVID MRSA isolation protocols, as I'm almost positive she said patients known positive even without active infections are still kept on isolation on her floor. If that's correct, I would guess it's because of the number of immunocompromised patients they have and probably try to avoid spreading to others as much as possible.

I know antibioitic resistance is drifting way off topic, but I recall a dinner conversation a number of years back with a good friend of mine. This friend wrapped up a PhD in bioinformatics two years ago and is set to graduate from medical school this spring(and then head off for a post doc at Los Alamos National Lab rather than doing residency). He's a sharp cookie.

That aside, this conversation was early in his medical education but he's a darn good biochemist. He speculated that antiobiotic resistance in bacteria was evolutionary "baggage" that would eventually go away given enough time and lack of exposure to the particular antibiotic or class of antibiotics. He suggested a rotating list by the WHO of "okay" antibiotics to use in a given period of time.

I'm not sure if there's any merit to that or not. At the time I couldn't find anything in literature discussing it one way or another. I floated it past a couple of biochem colleagues who gave responses ranging from "Hmm, interesting idea, I'll think about it" to "No, I don't think so." Those responses were honestly pretty well predictable based on the person I asked and their likelyhood to "think outside the box." I don't have that many biologist contacts to float an idea like that past.

Do you know if that's something that has been observed?

Of course.

The way we do it is to keep the immune suppressed patients in isolation rooms with positive pressure to try and keep out airborne pathogens. Then again, the guidelines with MRSA may have changed since I worked in a general hospital under normal operating conditions. Hard to believe it’s almost been 10 years. The redeployments I’ve had during COVID have been to a non-icu COVID unit where everyone is in isolation to begin with.

Yeah, I’m not sure about that theory. I’ve never heard of such a theory but I’m not a microbiologist or virologist or geneticist. That might be possible but I would think IF the resistance mechanism is not retained, it would take quite some time for it to disappear. I would also think it depends on what the specific mechanism- like an altered surface protein doesn’t have much reason to revert to normal, but I suppose more active mechanisms that consume extra resources (ie coagulase production) might have a biological incentive to disappear.

Antibiotic rotation is a strategy we use, especially with empiric treatment (prescribing without a culture to confirm susceptibility), to reduce the selective pressure for resistance to arise. Antibiotics are pretty notorious though for having a lot of allergies, drug-drug interactions, and medical contraindications so it happens all the time you can’t choose your first choice of antibiotic. There is a lot more thought that goes into prescribing these days. Hospitals keep track of the resistance statistics of pathogens cultured in the geographic area so more intelligent choices can be made when using empiric treatments. But there still is an incredible amount of overprescribing in the outpatient setting.

 

[44267547]

State update:

The vaccine aside, our state is really progressing with a downward trend in cases every single day for the last three weeks, with the exception of our death rate still holding steady for the geriatric graphic. We actually have one made hub where C/19 patients are extradited to, and even that floor is no longer at full capacity. As matter fact, we had one city north of me 20 minutes that was averaging 650 cases a day with a population of 175,000 people around late October, and now they’re down to maybe 18 cases on a daily basis. We are now opening more vaccination sites to prepare for larger swaths of people to inoculate, even Walgreens and CVS have launched their programs.

I think a large part of why were seeing a downward trend isn’t necessarily that C/19 is ‘making its rounds’, I suspect the colder temperatures have forced people who reside together to stay indoors, and there’s no real major public events diringthat would allow crowding with the exception of bars, I’m seeing more masking all the time, which I think people are finally absorbing the functionality of why the importance of masking is necessary and of course, with the enforcement of employers/businesses requiring it.

What’s even more interesting, In the midst of the pandemic in my region, cold/respiratory illnesses are hardly existent at all, which this time last year, we had local news media articles talking about upward trends.

Aside from that, I really don’t think it’s just about the masking, even though I think it’s a crucial piece. It’s about the frequency of washing hands, keeping your hands away from your face, don’t touch your food unless you washed your hands first, the most simplest of things that we learned in middle school (Which most adults still can’t grasp), I think people are applying these practices into their life and passing those along to their other family members. It really is a trendsetter that I see employees sanitizing high touch points for doorhandles, the importance of wiping down grocery cart handles prior to handling your groceries, there’s even some restaurants that actually wipe down your debit card for you after they use it, those are the things that make a difference.

And as an investor into the restaurant industry, all employees have to mask from when they start their shift until they end their shift. And by doing that, I think the restaurant industry is a major contributor to keeping pathogens from being spread, being how often people -dine in and order out-.

The one thing I would like to still see practiced I think that’s losing some of its significance is social distancing. In the beginning, a lot of restaurants were doing a great job of making sure that 6 foot rule was really applied, and now that our cases are down, I think some of these restaurants are becoming lax where social distancing doesn’t apply, because that means more capacity equals more money, and that’s why I don’t want to see these owners become complacent. The reason I’m harping so much on restaurants, is because it’s so easy for them to spread C/19 into our communities, especially where I live, we have over 350 restaurants, so for example, if you take a third of those restaurants that aren’t applying the necessary techniques to combat C/19, you can see the damage it can do very quickly. [And that includes bars.]

Looking ahead to what’s planned, our state has a lot of major functions that will be happening this spring/summer that were initially canceled last year, but with a totally set bar of ground rules that have to be followed due to the pandemic, and some events are extenuated into late summer to allow the vaccination to continue to make its course.

That’s great that the vaccination is here and it’s becoming more widespread every day, but that’s still not the answer. We still need a collaborative effort by everybody to keep our cases down through all the things Have been harped on to us for the last 10 months, and I don’t know about anybody else, but I want to enjoy my summer for 2021 (Yup, I have travel plans, car rally’s & shows, ect) and that’s only going to happen if we set the example moving forward, and then when 2022 arrives, we can look back and say ‘We did it’.

Press on.