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Mom got her booster today.

My ICU nurse friend lost a 40 yr old male pt today, no underlying issues - unvaccinated, was then waiting for the family of a 60 year old male pt to decide to withhold care so he can die - I don’t know his vaccination status, and then sent home a fully recovered 90 year old woman - vaccinated.

My spouse reported a co-worker (male, mid 40’s) had contracted COVID, ended up in the hospital for a few days and required a little bit of help breathing, seemed to be doing well, released from the hospital, 2 days later back in the hospital with oxygen level at 60%, is on a vent now. I expect he’ll die. He was unvaccinated. Not anti-vaxxer, not against vaccines, wore his mask properly at work, simply didn’t think there was a significant need for vaccination.
 
Mississippi is just days away from overtaking New Jersey in COVID death rate. Mississippi is ready to take back its rightful place among the states (i.e. ranked dead last).

Meanwhile, Louisiana is days away from surpassing the COVID death rate of New York. Alabama isn't far behind.
And it's happened. Mississippi now has the COVID highest death rate among the states. Louisiana is third, ahead of New York and behind New Jersey, which it will probably pass in a few weeks also.

What a waste. Tens of thousands of wasted lives because of misinformation among conservatives. Completely pointless, stupid to die of COVID when there's a vaccine readily available.
 
Some of the neighbors to the north are struggling as well:

Canada: Alberta healthcare system on verge of collapse as Covid cases and anti-vax sentiments rise

"Alberta has long boasted of its loose coronavirus restrictions – including advertising the previous months as the “best summer ever” as it rolled back those few restrictions. It has also been the site of North America’s highest caseloads.
...
“Our healthcare system is truly on the precipice of collapse,” the physicians wrote. “Hospitals and ICUs across the province are under enormous strain and have reached a point where it is unclear if, or for how much longer, we can provide safe care for Albertans.”
The province has cancelled elective surgeries as resources and space are allocated to Covid patients. ICU beds, meanwhile, are at capacity.
“As soon as those breathing tubes come out, we’re kicking people out of ICU to make space for someone else,” said another nurse. “It’s getting bleak. It’s hard to watch.”
Medical staff in Edmonton, the provincial capital, warned they would soon have to triage incoming patients to determine who could receive lifesaving care.
...
One nurse pointed to the bitter irony that those most skeptical of public health measures are those most affected by the current wave.
“All these decisions from the government are clearly to satisfy their voter base,” she said. “But what a lack of insight to see that it’s their base that’s dying and causing us to resort to battlefield medicine.”
...
“All these decisions from the government are clearly to satisfy their voter base,” she said. “But what a lack of insight to see that it’s their base that’s dying and causing us to resort to battlefield medicine.”
In recent weeks, a number of anti-vaccine protests have been held across the country, including out front of hospitals in Calgary and Edmonton,
..."
 
And it's happened. Mississippi now has the COVID highest death rate among the states. Louisiana is third, ahead of New York and behind New Jersey, which it will probably pass in a few weeks also.

What a waste. Tens of thousands of wasted lives because of misinformation among conservatives. Completely pointless, stupid to die of COVID when there's a vaccine readily available.
Loss of life is tragic in countless ways, let’s be clear about that.

I’m not, however, giving anyone a pass who’s chosen not to get vaccinated based on the reasoning (misinformation among conservatives) you’ve provided. First, I think that’s a complete bs reason in that it’s not about that and there’s plenty of non-conservative misinformation going around.

One big reason my ICU nurse friend has heard from the dying unvaccinated is that they don’t trust the government/politicians. In those cases it doesn’t actually matter what government/politicians say (true, false, exaggerated, embellished etc…), these people are so suspicious they don’t believe any of it.

I completely understand that as an individual who also don’t trust government/politicians to be telling the whole truth or to be looking after my and everyone else’s best interests etc…, BUT that doesn’t stop me or anyone else with half a brain to go looking for the truth and digging until I find it. It doesn’t stop me from critical thinking, from weighing risks, from making decisions in my best interest.

The only grown adults getting any kind of a pass from me are those who for whatever reason have truly led such a sheltered life with minimal education that they simply can’t know and therefore not grasp the concept of viruses, vaccinations and the like.
 
And it's happened. Mississippi now has the COVID highest death rate among the states. Louisiana is third, ahead of New York and behind New Jersey, which it will probably pass in a few weeks also.

What a waste. Tens of thousands of wasted lives because of misinformation among conservatives. Completely pointless, stupid to die of COVID when there's a vaccine readily available.

1 in 500 Americans has died from covid.

1 in ~327 Mississippians (right?) has died from covid.

And that's just what has been reported. A lot of March-May 2020 death counts went underreported.
 
The IHME data at the macro level for the US now indicates a downward trend for daily confirmed new cases.


View attachment 709227 View attachment 709229

A slight pop in the 7-day average on Monday due to last Monday's holiday where many states did not report, but now back on a downward trend.

1631799654543.png


Hospitalizations have crested, but aren't rapidly declining yet. Deaths are way up and continue to rise. We're nearing the 2k/day mark again for the U.S.
 
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"The modern anti-vaccination movement in America has often been associated with a stereotype of left-wing, coastal, white, wealthy moms — those “crunchy granola” types. In recent years, outbreaks of vaccine-preventable diseases, spurred by low vaccination rates in children, emerged in wealthy, liberal places like Marin County, California, and Boulder, Colorado.

But while the public narrative focused on these left-wing enclaves, they were far from the only regions affected by outbreaks of vaccine-preventable disease: Conservative communities of Orthodox Jews, some of whom also reject vaccines, have also seen spikes in cases, for example. And polls over the past two decades have consistently found Republicans are just as likely as Democrats to hold vaccine-hesitant views."

If only we had data for the current pandemic. Oh wait, we do.
1631799883223.png


As of September 13, 2021, 52.8% of people in counties that voted for Biden were fully vaccinated compared to 39.9% of Trump counties, a 12.9 percentage point difference.


As of late August, the % of people who said they're vaccinated:
 
Not anti-vaxxer, not against vaccines, wore his mask properly at work, simply didn’t think there was a significant need for vaccination.
The message that primarily old people are at serious risk (true) pushed by both the public health authorities and the misinformationists is really hurting us. Many people just don’t seem to have a concept of how dangerous it is (relative to typical contagious diseases). There are very few such contagious diseases in the modern age that represent such a serious risk of hospitalization to the young and healthy.

The reality is that this is a very dangerous disease for all ages, possibly with children excepted - but even for them it likely represents one of the most serious contagious diseases they will face in their childhood.

But I think from early in the pandemic the message seemed to skirt around the risk to the young - even Dr. Fauci said early on the main risk was to the elderly (which is strictly speaking true…but sends the wrong message). Nuance is tough I guess.

Oh well. People have to get vaccinated! Then it's more like the flu.
Necessary is one thing...and it depends on your definition. (It's also not clear the headline here is correct - it sounds like the MRNA CEO is talking about shots beyond the third one...and he thinks the third one is helpful. The link has one headline and the article itself has a different headline.)

This is all kind of silly. We know antibody levels decline and that is going to increase infections. We know the booster dramatically increases those levels and will definitely reduce infections - and it's very likely that there is minimal risk of side effects if you only select people who had no ill effects from the first two vaccines. While first vaccinations are clearly the priority and the most effective way to reduce infections & severe illness, the right way to maintain confidence in public health is to protect people from infection. Aren’t we trying to reduce infections, not just severe illness? I thought that was the whole point. Reducing infections in the vaccinated also helps protect the unvaccinated and vulnerable - so it's not just a selfish choice.

So we should do boosters (for elderly, vulnerable, and HCW (we can't have absences due to illness!) first, then everyone)! The evidence is pretty clear they reduce infections, even if efficacy against severe disease is not much changed (to be clear, it seems to mean more severe cases for a given number of exposures - because there are more infections - but given infection, efficacy seems to have changed not at all).

My prediction is that the data won't be there to support it for everyone for a while yet, so we'll be playing catchup in November as we see breakthrough infections rise and become problematic. Hopefully that prediction is wrong. I'd like to see widely available boosters for every vaccine recipient, including Moderna recipients, by October sometime.

I guess I'm just an observer now though. Glad I took the initiative before the resistance to protecting individual health had an opportunity to harden.

It's shameful that they didn't do a third dose RCT at the same time as the other trial. Pfizer is doing one now, but it is so late...
 
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There’s a social media controversy brewing in my region. The school board in one county near us just voted to mandate COVID vaccine for all currently eligible school children and in the future when the eligibility drops to a younger age group.

No medical exception. No religious exception. No buts or ifs. Even though other required vaccinations have exceptions, they are making this one mandatory. If a child does not get the COVID vaccine, schools will move the child into remote learning.
Why is the above controversial? This county is one of the lowest (if not the lowest) demographics in the greater region. The racial make-up is predominantly Hispanic and Black. Its a low-income area. They likely had the hardest time last year doing remote work and transitioning back into in-person this year.
 
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There’s a social media controversy brewing in my region. The school board in one county near us just voted to mandate COVID vaccine for all currently eligible school children and in the future when the eligibility drops to a younger age group.

No medical exception. No religious exception. No buts or ifs. Even though other required vaccinations have exceptions, they are making this one mandatory. If a child does not get the COVID vaccine, schools will move the child into remote learning.
Why is the above controversial? This county is one of the lowest (if not the lowest) demographics in the greater region. The racial make-up is predominantly Hispanic and Black. Its a low-income area. They likely had the hardest time last year doing remote work and transitioning back into in-person this year.

Until there is FULL FDA approval for the pediatric population, as a physician, I have issues with this.

FIRST thing they teach us in Pediatrics - kids are NOT "little adults". They commonly react very differently to things compared to adults. CASE IN POINT - the myocarditis we are seeing in the 12-17 yo male vaccine recipients.

If there is a non-emergent FDA, full approval, I don't have a problem with this vaccine requirement for kids and school attendance (we do it for other vaccines). But for a vaccine that is not even EUA in kids? Nope. Too soon.
 
Until there is FULL FDA approval for the pediatric population, as a physician, I have issues with this.

FIRST thing they teach us in Pediatrics - kids are NOT "little adults". They commonly react very differently to things compared to adults. CASE IN POINT - the myocarditis we are seeing in the 12-17 yo male vaccine recipients.

If there is a non-emergent FDA, full approval, I don't have a problem with this vaccine requirement for kids and school attendance (we do it for other vaccines). But for a vaccine that is not even EUA in kids? Nope. Too soon.
My in-law who’s a peds as well said the same thing when he heard this news.
I’m not sure whether something like this is even legally allowed, for the board to make a sweeping decision like this.
 
Idaho's health department declared a statewide move to crisis standards of care today, which basically means they are triaging at the hospital based on urgency, because of being overwhelmed by covid patients:
Idaho . GOV document: https://coronavirus.idaho.gov/wp-content/uploads/2021/09/CSC-Statewide-Declaration.pdf

Back in March:
DhLXAtj.jpg
Idaho rations health care statewide amid massive COVID surge mentions "Idaho is one of the least vaccinated U.S. states, with only about 40% of its residents fully vaccinated against COVID-19. Only Wyoming and West Virginia have lower vaccination rates."

Alaska was also mentioned earlier. I found Alaska joins Idaho in rationing health care as hospitals are packed with COVID patients, and WHO says Africa is being left behind in vaccine push.
 
My in-law who’s a peds as well said the same thing when he heard this news.
I’m not sure whether something like this is even legally allowed, for the board to make a sweeping decision like this.
Until there is FULL FDA approval for the pediatric population, as a physician, I have issues with this.

FIRST thing they teach us in Pediatrics - kids are NOT "little adults". They commonly react very differently to things compared to adults. CASE IN POINT - the myocarditis we are seeing in the 12-17 yo male vaccine recipients.

If there is a non-emergent FDA, full approval, I don't have a problem with this vaccine requirement for kids and school attendance (we do it for other vaccines). But for a vaccine that is not even EUA in kids? Nope. Too soon.
What about the risks of not getting vaccinated. What are you recommending for kids over 12?
 
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What about the risks of not getting vaccinated. What are you recommending for kids over 12?

The risks of not getting vaccinated (death, hospitalization, long-COVID) are VERY low for children 17 and under, and EXTREMELY low for children 11 and under. Like, around the same level of seasonal influenza.

Reports will vary by source, but 412 deaths in the 0-17 yo age group per this source since the pandemic began:
To put that in context, we see as many deaths per year from things like seasonal influenza. By comparison, we've seen 20-30X more deaths from COVID in adults compared to seasonal influenza. So the older you get, the harder it hits.


I recommend females 12 and up get both shots. There are VERY few side effects in that group. With males, I'm iffy on that 2nd shot (that's almost all the myocarditis out there), as I've previously pointed out in this thread. I believe we need more data on how strongly kids develop antibodies after the first shot (I'm betting it is worlds better than adults - making that second shot less necessary).

Anyone with immunocompromise or comorbidities (obesity, diabetes, etc.) should get both shots if they fall within the EUA guidelines. Per my colleagues, these are the bulk of patients in the pediatric ICU right now - those with some comorbidity that puts them at elevated risk.

I have children in the 7-11 range, so this question hits close to home.