Coronavirus thread

[TheRoland]

]he efficacy of vaccine in solid organ tpx patients like myself is likely much higher than the result suggests, but we won't know until better studies come out.

This may be a pretty remedial question, but is the implication that solid organ transplant patients react differently to the vaccine because of immunosuppression?

...

"They were tested in different points in time. They were tested in different populations of people when there were different strains circulating in those different populations of people," Dr. Linda Bell, State Epidemiologist for South Carolina's Department of Health and Environmental Control, said.

This is the part I object most to, because it implies strongly that the results are incomparable because of new strains. This is not right, since J&J sequenced their US cases and they were the same strain that was prevalent in the US during the mRNA trials.

Nothing against going to get a safe and pretty darn effective vaccine. But there's this whole thing about media accuracy norms that drives me nuts.

[pangloss]

Interesting couple of patients this morning.


Both male, 60 and 45. Both had COVID last year, one in June, other in November.


Both had asthma in the very distant past, was well controlled prior to covid on little to no meds.


Now both are in severe persistent asthma stage with breathing tests 30% of where they should be. Failing the strongest asthma meds we have, and there’s no pneumonia or scarring or such on their CT’s.



For me, and others in my practice, this is a new thing. We haven’t been seeing asthma post covid, only scarring/fibrosis and such.

Now two on same day.


cc

How do you distinguish between asthma and something that presents similarly to asthma? Do the patients have off kilter Th2 immune dysregulation? I'm working very closely with an allergist on some Covid stuff and he's not mentioned anything like this. Hopefully it's bad luck on your end and not an emerging PASC state.

Anyway, please don't take my question the wrong way. I ask out of curiosity and not out of any doubt in you expertise. I think that would be clear if we were talking, but it might be lost in the text.

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[ccmdfd]

How do you distinguish between asthma and something that presents similarly to asthma? Do the patients have off kilter Th2 immune dysregulation? I'm working very closely with an allergist on some Covid stuff and he's not mentioned anything like this. Hopefully it's bad luck on your end and not an emerging PASC state.

Anyway, please don't take my question the wrong way. I ask out of curiosity and not out of any doubt in you expertise. I think that would be clear if we were talking, but it might be lost in the text.

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No problems whatsoever.

That's a tricky 1. As of this date and time there is no definitive test that says that a patient has asthma and only asthma coming in nothing but asthma and not something else as the etiology of their symptoms.

It's basically diagnosed based upon clinical presentation, pulmonary function study abnormality which is very non-specific, as well as response to asthma therapy which is also nonspecific as they are pretty much all anti-inflammatory medications.

Just actually listen to an asthma update a few weeks ago and the world asthma experts are more and more pushing the idea that there are multiple different variants of asthma each with its own morphology as well as biochemical abnormality.

Therefore there's a good chance that if we did study these post covid-19 patients and found some new biochemical abnormality, they would most likely lump it in as yet another asthma variant.

Hope that helps.

[Dog Guy]

Here is a Facilitated Learning Analysis of a COVID-19 outbreak on the Cameron Peak Fire in CO last year. It started in August. The article brings out some of the snafus, and links to the full FLA. There will be some very useful information in there for those of you who have a role in planning for and reacting to these events in the future. And there will be these events in the future, either COVID or something else.

https://wildfiretoday.com/2021/04/07...19/#more-81116

[45dotACP]

Seeing a number of 30-50 year olds coming in with COVID now. I guess that could mean the older patients are either dead, vaccinated or have some type of immunity.

Problem is, some of these patients are ridiculously sick. They do still follow the same patterns...overweight with lifestyle diseases. The main difference is that their kids are a lot younger. I hate telling teenagers bad news.

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[ccmdfd]

Seeing a number of 30-50 year olds coming in with COVID now. I guess that could mean the older patients are either dead, vaccinated or have some type of immunity.

Problem is, some of these patients are ridiculously sick. They do still follow the same patterns...overweight with lifestyle diseases. The main difference is that their kids are a lot younger. I hate telling teenagers bad news.

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I've been reading a lot of media reports that jive with what you are experiencing. However, not happening down here. We are currently at our lowest levels ever since this started and they seem to be going down further.

Of course Beach season is getting ready to start and already you can see a difference between this year and last year in terms of the number of people down here as well as how well they are distancing, behaving. So things may change rapidly like they did last summer here.

[45dotACP]

I've been reading a lot of media reports that jive with what you are experiencing. However, not happening down here. We are currently at our lowest levels ever since this started and they seem to be going down further.

Of course Beach season is getting ready to start and already you can see a difference between this year and last year in terms of the number of people down here as well as how well they are distancing, behaving. So things may change rapidly like they did last summer here.

My guess is we're reaping the whirlwind of st patrick's day and easter in a very large, very Catholic metropolitan area.

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[Borderland]

This may be a pretty remedial question, but is the implication that solid organ transplant patients react differently to the vaccine because of immunosuppression?



This is the part I object most to, because it implies strongly that the results are incomparable because of new strains. This is not right, since J&J sequenced their US cases and they were the same strain that was prevalent in the US during the mRNA trials.

Nothing against going to get a safe and pretty darn effective vaccine. But there's this whole thing about media accuracy norms that drives me nuts.

You just had to put the Joker in the deck didn't you.

[Borderland]

Seeing a number of 30-50 year olds coming in with COVID now. I guess that could mean the older patients are either dead, vaccinated or have some type of immunity.

Problem is, some of these patients are ridiculously sick. They do still follow the same patterns...overweight with lifestyle diseases. The main difference is that their kids are a lot younger. I hate telling teenagers bad news.

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I fall into the vaccinated group although never a patient. I'm reading some discussion now about foregoing #2 to get more people with #1 and adding some time between #1 and #2. Apparently the lapse of time between the 2 shots was never really tested so they could get the vaccine into the population with adequate results.

[revchuck38]

I fall into the vaccinated group although never a patient. I'm reading some discussion now about foregoing #2 to get more people with #1 and adding some time between #1 and #2. Apparently the lapse of time between the 2 shots was never really tested so they could get the vaccine into the population with adequate results.

That (boarding house rules) was the operating theory they went with in the UK and it seems to be working for them.