Re: Vaccines and Masks

1

The group three numbers really drive home how unhealthy America is. We should really have a healthcare system that works.


Posted by: Moby Hick | Link to this comment | 12-16-20 7:37 AM
horizontal rule
2

If you want to move from group four to group three and have a very poor understanding of risk, you could start smoking.


Posted by: Moby Hick | Link to this comment | 12-16-20 7:40 AM
horizontal rule
3

Those explainers are out of date. Moderna's data released yesterday showed that asymptomatic and spread due to viral load are reduced after one dose- they nasal swabbed everyone at the 28d second injection to catch asymptomatic.
I'll probably butt in line somehow given how many connections we have to Moderna- whether they set some aside for the local community (I used to work one block from the building that's always used in the stock footage) or some other mechanism. Technically I'm considered essential, at least by the criteria for pharma research workers who could still go to work in the first shutdown. My wife will get it early as a k-12 educator.
The big question we're debating is what to do if some kids are vaccinated and some aren't. The two older ones will probably qualify but they studies aren't done for younger kids yet. Our youngest one might be at higher risk due to cardiac history but there's no evidence of that yet. So if four or five of the six of us are vaccinated, do we travel next summer? Does she go to sleep away camp or go back to sports?


Posted by: SP | Link to this comment | 12-16-20 7:47 AM
horizontal rule
4

1: I'm not sure how much of that (though surely some) is the fault of the healthcare system

I initially thought that I was going to be included in group 1, but since I am 100% remote, I fall into the general population which is entirely right.

They gave us an update on the waves and priorities within the healthcare workforce. They don't want everyone in the ICU to get vaccinated the same day in case some people have bad enough side effects that they are off work. We have an app for self scheduling requiring that you answer questions about your role to decide whether you are eligible. That's on the honor system.

Massachusetts broke their roll out into 3 waves. Prisoners, people in homeless shelters, and those in congregate settings, like group homes for the disabled, are in wave 1 - above people with co-morbidities. I know that Colorado wanted to vaccinate guards, but didn't want to put prisoners at the front - even though there have been a lot of outbreaks and it is hard to physically distance in prisons.

I am not sure how they will go about prioritizing essential workers. Tim was essential since he works for pharma and had to go in, it it was not hard for him to maintain distance in his lab.

I know we are working on plans with data analytics and primary care to prioritize our patients who are eligible due to health status (wave 2).

One of the current treatments for outpatients, bam unpronounceable name, is an infusion that is supposed to be given within a narrow window. It may be helpful for folks who are obese. I've been impressed by how they are handling it, since it is in short supply and they need to accept referrals fro. Outside our system. If you meet the criteria, they are applying a social vulnerability factor by zip code to try to capture whether you live in a community that has been hit hard by COVID. After that, it's by lottery.


Posted by: Bostoniangirl | Link to this comment | 12-16-20 8:04 AM
horizontal rule
5

Like in the story by Shirley Jackson?


Posted by: Moby Hick | Link to this comment | 12-16-20 8:07 AM
horizontal rule
6

I was thinking masks would be a good place to advertise you're vaccinated - both to show others the whole community is doing it, and to remind other vaccinated to keep the mask on for now.


Posted by: Minivet | Link to this comment | 12-16-20 8:10 AM
horizontal rule
7

Bamlanivimab- you just have to remember that it fits as a lyric in Black Betty.


Posted by: SP | Link to this comment | 12-16-20 8:10 AM
horizontal rule
8

My point 1 was just trying to say that I'm not sure that that's a failure of our medical/ healthcare system so much as a failure to invest in public health.

4 posted before seeing 3.

K-12 is somewhere in phase 2. I think people who work with covid specimens are in phase 1 even if not patient-facing.

I really believe very strongly that within the essential worker class, it's important for grocery workers to get it before workers who have more ability to distance. So, butt ahead of the final phase, but not too far.


Posted by: Bostoniangirl | Link to this comment | 12-16-20 8:10 AM
horizontal rule
9

I mean, I'm not going to call someone I know to get ahead, but if our company or the city hold a vaccination drive in March I'd feel like I should go so they can reach as many people as possible. Logistically to target people who are high priority they have to do it in ways that might include people who aren't the most important.


Posted by: SP | Link to this comment | 12-16-20 8:16 AM
horizontal rule
10

9: Yeah. Canada bought gobs and gobs of vaccines, enough for multiples of their population. I'm really concerned that we are rushing to vaccinate all of the US before we share with lower income countries.


Posted by: Bostoniangirl | Link to this comment | 12-16-20 8:28 AM
horizontal rule
11

We are definitely doing that and it will definitely happen that way.


Posted by: heebie-geebie | Link to this comment | 12-16-20 8:30 AM
horizontal rule
12

2 Or eat a bunch of donuts?


Posted by: CharleyCarp | Link to this comment | 12-16-20 8:36 AM
horizontal rule
13

That's going to be slower.


Posted by: Moby Hick | Link to this comment | 12-16-20 8:40 AM
horizontal rule
14

11: I know that, and it's horrible. The UK wind Canada are too. India might get some early, because they are manufacturing a lot of it, and some of the pharma CEOs have personal ties to India.


Posted by: Bostoniangirl | Link to this comment | 12-16-20 8:40 AM
horizontal rule
15

13: Put the cigarettes in the donuts, and eat them simultaneously for maximum efficiency. Come on now.


Posted by: heebie-geebie | Link to this comment | 12-16-20 8:45 AM
horizontal rule
16

We're Americans. We're the most efficient county in the world at sabotaging our own health.


Posted by: heebie-geebie | Link to this comment | 12-16-20 8:46 AM
horizontal rule
17

1. Within communities, the likeliest way I can think of for the ordering to mess up is shelf life. "Well, we tried to vaccinate just the first two tiers, but we have 100 doses and we have to use them before they expire." And the worse outreach is to essential workers, the more this will happen.

2. I'm of two minds about international distribution. Africa and south/southeast Asia have controlled it much better without a vaccine, so their cause is less dire. It feels like rewarding failure, but it may genuinely be the most harm-reducing. On the other hand, the vaccine being focused on the global north feels like it might have happened anyway due to power and influence. (The area that really needs it and is not as rich is South America, I have no idea where they're positioned.)


Posted by: Minivet | Link to this comment | 12-16-20 9:15 AM
horizontal rule
18

I am technically an essential worker. In my case, it means if a disaster happens, I am legally required to show up and do entirely unspecified things. (The thought of it is absurd and frightening, given that it would be an effort directed by the same county leadership that has been an unending embarrassment about not understanding that getting people together to work in an office is NOT GOOD, has resisted all the way.)

It should not qualify me for the vaccine, not sure if it will. My job is barely every essential in any meaningless way and I have been working from home and minimizing in person client contact. I do not make sense as a person to be prioritized for vaccination.


Posted by: Mister Smearcase | Link to this comment | 12-16-20 9:34 AM
horizontal rule
19

I have a co-worker on a relevant (large) advisory committee - I've asked him if essential workers include those who can do their essential work from home.


Posted by: Minivet | Link to this comment | 12-16-20 9:45 AM
horizontal rule
20

This state's definition of "high-risk medical conditions" and the Fed's don't quite match. In particular, it must not be the case that MA is counting "obesity" as high-risk, or their group #3 would be much larger than it is. This is causing some consternation.


Posted by: Nathan Williams | Link to this comment | 12-16-20 9:49 AM
horizontal rule
21

I really hope people keep wearing masks after they get vaccinated and don't decide that because they are protected they can just stop since we don't know how well it prevents you from being infected and infective/infectious.

The doctor of a coworker of mine who is gay recommended that he take PREP. He couldn't tolerate it, and he said that everybody he knows is taking it, so nobody wants to wear a condom. Of course, that doesn't protect people from other STIs or people who aren't on PREP. I worry that something similar could happen here.


Posted by: Bostoniangirl | Link to this comment | 12-16-20 9:55 AM
horizontal rule
22

Wait until people try to make their own condoms from a bandana.


Posted by: Moby Hick | Link to this comment | 12-16-20 10:01 AM
horizontal rule
23

I don't mind being late on the list. Being vaccinated doesn't mean that much to me unless my friends and family are also vaccinated. Really, until enough other people are vaccinated that 5 on 5 pickup basketball is a thing again.


Posted by: torque | Link to this comment | 12-16-20 10:03 AM
horizontal rule
24

OK, I'm told the state is trying to factor remote work into their prioritization but that's difficult to do granularly.

My informant is a physician with a desk job and says if offered the vaccine on that basis now he would decline.


Posted by: Minivet | Link to this comment | 12-16-20 10:06 AM
horizontal rule
25

23 is similar to how I feel. Mostly I want my parents and my aunts to get vaccinated ASAP, and other high-risk people that I know.


Posted by: heebie-geebie | Link to this comment | 12-16-20 10:11 AM
horizontal rule
26

If my parents are vaccinated and we're not, would it be safe to visit them over Spring Break? I've got to imagine roughly so.


Posted by: heebie-geebie | Link to this comment | 12-16-20 10:12 AM
horizontal rule
27

Especially if we get tested ahead of time.


Posted by: heebie-geebie | Link to this comment | 12-16-20 10:12 AM
horizontal rule
28

A friend works for a university teaching hospital's medical school's IT department, has been working at home since March, and is scheduled to be in their first round of vaccinations.

My uneasy sense is that this institution is coloring way outside the lines for various parochial reasons, and is unlikely to be alone in this. If the motivation is actually based in efficient use of batches of vaccines, given the extreme care that must be taken with their handling, that's obviously to the good, but I am skeptical.


Posted by: (gensym) | Link to this comment | 12-16-20 10:12 AM
horizontal rule
29

I can see that institutions, like families, would very much like to have people who are together to have the same vaccinated status. Otherwise, they have to have separate rules, keep track, etc.

My feeling here is that once we're very far into group 2 the somewhat shaky consensus on masks will break down completely.


Posted by: CharleyCarp | Link to this comment | 12-16-20 10:20 AM
horizontal rule
30

I have no idea how to prioritize this. I'm just glad my mom is on the early part of the list because I'd like to be able to visit her.


Posted by: Moby Hick | Link to this comment | 12-16-20 10:22 AM
horizontal rule
31

I'm sick of getting noble-lied by the CDC and WHOever. DSquared's was using his formulation that good ideas don't need lies told to sell them in the contrapositive sense: since people are lying to sell us the Iraq war, it's not a good idea. But the direct version also applies: masks are a good idea and people should stop telling lies to sell it.


Posted by: torque | Link to this comment | 12-16-20 10:35 AM
horizontal rule
32

I wear a mask to deter Iran and bolster the House of Saud.


Posted by: Moby Hick | Link to this comment | 12-16-20 10:44 AM
horizontal rule
33

16 is the truth.


Posted by: SP | Link to this comment | 12-16-20 10:44 AM
horizontal rule
34

Can you believe that in 1918 they just had to wait it out?! yegads.


Posted by: | Link to this comment | 12-16-20 11:01 AM
horizontal rule
35

that was me.


Posted by: heebie | Link to this comment | 12-16-20 11:02 AM
horizontal rule
36

I wouldn't exist without the Spanish flu pandemic! (Grandfather was born to a second wife after the first died of it.)


Posted by: Minivet | Link to this comment | 12-16-20 11:10 AM
horizontal rule
37

Less than 700 new cases today statewide, and the moving average shows that the recent peak is definitely receding. We're not going to get to 100k cases by year end, having just under 75k now. Hospitalizations are also significantly down from the peak.

Early in the pandemic, ski towns were a locus of spread. I suppose that'll come back, in some measure, once the season gets going in earnest. (Our hill here isn't open, although some are in other parts of the state. I don't know that we'll get up much before Xmas . . .)


Posted by: CharleyCarp | Link to this comment | 12-16-20 11:14 AM
horizontal rule
38

29: I think the hospitals will require them.

28: Role groups are tricky, but a janitor on a COVID unit will get vaccinated before an ambulatory psychiatrist if the latter is 100% remote - not at the hospital - and a week or so ahead of a primary care doc, not in a respiratory illness clinic.


Posted by: Bostoniangirl | Link to this comment | 12-16-20 11:15 AM
horizontal rule
39

Just got a call from my mom to tell me she tested positive today. Said she'd been feeling under the weather ("like bronchitis") for about a week. Mild so far.


Posted by: apostropher | Link to this comment | 12-16-20 11:18 AM
horizontal rule
40

Oh no, I hope she stays mild.


Posted by: heebie-geebie | Link to this comment | 12-16-20 11:19 AM
horizontal rule
41

Yikes. Hope it stays mild.


Posted by: Moby Hick | Link to this comment | 12-16-20 11:19 AM
horizontal rule
42

37: Do you really think that people won't travel over Christmas?


Posted by: Bostoniangirl | Link to this comment | 12-16-20 11:21 AM
horizontal rule
43

39 Best of luck.

42 I'm guessing it'll be a lot thinner than usual. Fundamentalist churches will gather, for sure.


Posted by: CharleyCarp | Link to this comment | 12-16-20 11:25 AM
horizontal rule
44

Apparently the UK is considering a 5-day grace period to visit families for Christmas. Even if the idea is okay (who knows), 5 days seems excessive.


Posted by: Minivet | Link to this comment | 12-16-20 11:30 AM
horizontal rule
45

Anything less than 12 is War on Christmas.


Posted by: Moby Hick | Link to this comment | 12-16-20 11:38 AM
horizontal rule
46

The Netherlands (and I think Germany as well) have basically cancelled Christmas. Everything non-essential is closed until three weeks after New Years. I only managed to get Christmas shopping done because I heard a rumor they were going to close everything about 6 hours before they did it.


Posted by: Walt Someguy | Link to this comment | 12-16-20 11:43 AM
horizontal rule
47

43: There was less travel at Thanksgiving but still a big increase in cases.


Posted by: Bostoniangirl | Link to this comment | 12-16-20 11:56 AM
horizontal rule
48

We have some very festive snow.


Posted by: Moby Hick | Link to this comment | 12-16-20 12:15 PM
horizontal rule
49

Snow on the Nether regions is probably not as appreciated.


Posted by: Moby Hick | Link to this comment | 12-16-20 12:32 PM
horizontal rule
50

26 and 30 are where I am. I can hold out until late spring or early summer mostly doing what I've been doing, sick of it though I am, but I'd like to go see my parents as soon as they get vaccinated. It's over a year now, when I normally try to get there three or four times a year.


Posted by: DaveLHI | Link to this comment | 12-16-20 12:37 PM
horizontal rule
51

1, 8: I'd blame it on the American lifestyle rather than the health care system, if the distinction matters. Our crappy health care system means that chronic health problems get managed badly and cost more, but you don't get chronic health problems from the health care system, you get them from unsafe work conditions, junk food, and driving everywhere. Maybe I'm splitting hairs but I think of those as different problems than the lack of universal health care.

As for recent exposure, this morning we got word that Atossa's pod leader tested positive. The last pod session was Monday, they're all good about mask-wearing, and none of us have any symptoms, but even so we're keeping to ourselves until Saturday when we can get tested, of course.


Posted by: Cyrus | Link to this comment | 12-16-20 1:49 PM
horizontal rule
52

10: Canada is also contributing COVID-19 aid to developing countries.


Posted by: Just Plain Jane | Link to this comment | 12-16-20 1:59 PM
horizontal rule
53

The US has been blurring the difference between "essential" and "high human contact" workers since March, why stop now? Anyone in not-the-US, not-the-UK, did your polity make the distinction when it was useful?


Posted by: clew | Link to this comment | 12-16-20 2:01 PM
horizontal rule
54

39: I hope your mom's case remains mild, and that she recovers quickly.


Posted by: Just Plain Jane | Link to this comment | 12-16-20 2:05 PM
horizontal rule
55

53: At one point, the bankers were clamoring to get themselves classed as essential. That might have just been the bank tellers.


Posted by: Bostoniangirl | Link to this comment | 12-16-20 2:26 PM
horizontal rule
56

Learned that my younger sister is due to get vaccinated (well, the 1st shot) on Friday. I am glad about this.


Posted by: md 20/400 | Link to this comment | 12-16-20 4:55 PM
horizontal rule
57

One of my younger sisters is about to stab co-workers over their not wearing masks.


Posted by: Moby Hick | Link to this comment | 12-16-20 4:57 PM
horizontal rule
58

For all that I gripe about some aspects of local culture and governance, I haven't yet run into any significant anti-mask craziness or Covid defiance here. I know it exists, but it hasn't affected me personally.


Posted by: DaveLHI | Link to this comment | 12-16-20 5:15 PM
horizontal rule
59

51 - While I agree that there are healthier and unhealthier choices in terms of diet, exercise, etc, I think we need to avoid blaming the victim. Failure to provide universal healthcare, as well as the other social support services that we so catastrophically lack, does absolutely contribute to chronic health conditions. If healthcare is unaffordable, mild issues turn into major ones. If people aren't comfortable with their physicians as allies, they don't see them as the source for good advice. The incessant poverty that is at least partially due to the excessive costs of healthcare forces people to make 'bad' decisions regarding jobs, food, etc. The population of enlightened topless Europe is neither smarter nor genetically superior to Americans, but they are healthier, and it is not a coincidence that the immense burden of chronic health conditions in this country is born by those who have been systemically disadvantaged over hundreds of years.


Posted by: Dr. Oops | Link to this comment | 12-16-20 6:30 PM
horizontal rule
60

51 - While I agree that there are healthier and unhealthier choices in terms of diet, exercise, etc, I think we need to avoid blaming the victim. Failure to provide universal healthcare, as well as the other social support services that we so catastrophically lack, does absolutely contribute to chronic health conditions. If healthcare is unaffordable, mild issues turn into major ones. If people aren't comfortable with their physicians as allies, they don't see them as the source for good advice. The incessant poverty that is at least partially due to the excessive costs of healthcare forces people to make 'bad' decisions regarding jobs, food, etc. The population of enlightened topless Europe is neither smarter nor genetically superior to Americans, but they are healthier, and it is not a coincidence that the immense burden of chronic health conditions in this country is born by those who have been systemically disadvantaged over hundreds of years.


Posted by: Dr. Oops | Link to this comment | 12-16-20 6:30 PM
horizontal rule
61

At least I only hit the button twice....


Posted by: Dr. Oops | Link to this comment | 12-16-20 6:30 PM
horizontal rule
62

A group of organized nutcases are running an ongoing letter-to-the-editor campaign in our local paper telling people all the ways in which covid is a hoax.


Posted by: Spike | Link to this comment | 12-16-20 6:38 PM
horizontal rule
63

I just realized I haven't gone to the doctor during the Trump administration. Is that bad? I wasn't a big believer in annual physicals but I guess I should go at least every five years.


Posted by: SP | Link to this comment | 12-16-20 6:38 PM
horizontal rule
64

You could do worse. My last physical was in 1986.


Posted by: apostropher | Link to this comment | 12-16-20 7:16 PM
horizontal rule
65

You should probably have a look at your blood pressure.


Posted by: Moby Hick | Link to this comment | 12-16-20 7:34 PM
horizontal rule
66

He Who Has Not Been Named (But Really Should Be)'s sister just sent the video from our niece's pre-school Christmas* show. Not one mask, Kids packed shoulder to shoulder. I'm actually having a sort of vicarious panic attack just from watching .

If people around here stop masking because of the vaccine, I probably won't ever leave my house again.


Posted by: Di Kotimy | Link to this comment | 12-16-20 9:23 PM
horizontal rule
67

59 and 60: I, at least, wasn't trying to blame the victim at all. What I was trying to do was suggest that maybe we were placing too much responsibility in the hands of the medical system and not enough into public health type interventions.

There's a question now about spending healthcare dollars on the social determinants of health. So, a Medicaid ACO would pay for housing for some of its sickest patients or try to address needs for education.

Universal healthcare coverage is absolutely essential, but it is not sufficient. Clean air and water, a built environment which encourages exercise, access to recreation, affordable fruits and vegetables, a society where the default choices are healthier is also key. You can prescribe medically tailored meals to individuals with diabetes or other conditions and sometimes, that's the right call, but the medical system is probably not the best way to approach nutrition for most people. Improving the quality of food in schools might be.


Posted by: Bostoniangirl | Link to this comment | 12-17-20 2:13 AM
horizontal rule
68

63: You should probably go every couple of years at your age if you have no other health problems and haven't been in to a doctor's office. You may find that you don't have a doctor anymore. After 3 years withou5 a visit most physicians will treat you as a new patient for billing, and if their panel is full, they might not take you back or make you wait months to be seen for a new patient appointment.


Posted by: Bostoniangirl | Link to this comment | 12-17-20 2:16 AM
horizontal rule
69

Ditto to 65.


Posted by: Bostoniangirl | Link to this comment | 12-17-20 2:17 AM
horizontal rule
70

On the OP, a couple of things. Group 3 being the biggest is no real surprise - there are a lot of old people - and the category "essential" isn't just based on being at risk of getting it but also how many things will break if you do. The bod in 28, for example, may be working from home but that isn't a magic guarantee of perfect safety, and the hospital computers melting down and only someone on a ventilator having the root password to sort it out would not be a good day out. (No problem, we use Solarwinds! Oh...)

But much more generally, the vax is rolling out fast enough I'm seeing several people a day in my twitter feed saying they just got it, it's a mass-manufactured industrial product, so I would just spare myself the NYT ethical consumer page trolley logic fest and get jabbed when my number comes up. Premature, or indeed unnecessary, optimization is the road to madness.


Posted by: Alex | Link to this comment | 12-17-20 3:57 AM
horizontal rule
71

And it's not as if *too many* people getting it in the first phase would be a bad thing.


Posted by: Alex | Link to this comment | 12-17-20 3:58 AM
horizontal rule
72

67 - Which is why I specifically addressed it to Cyrus in 51, who wrote, "I'd blame it on the American lifestyle rather than the health care system, if the distinction matters." I absolutely agree with you, and there are even some parallels to defunding the police, if you lump highly paid medical professionals and administration together and call them the cops. The entire concept of siloed care is outdated, and the best health care is provided by teams of caregivers that range from primary care physicians to nutritionists to social workers to surgeons.

I also think that the current state of affairs leads to an adversarial relationship between patients and their physicians, as is evidenced by the distrust of vaccines and other scientifically supported therapies. (Cue more defund the police analogies...) In the annals of 'If all you have is a hammer, every example you can think of involves a nail,' I was a highly trained niche professional, where I performed 2 kinds of surgeries, dialysis access and transplants. The number of patients who showed up in my office who had no understanding of their situation was staggering. Instead of treating the underlying cause early on (hypertension and diabetes making up the great bulk of cases), these people were undertreated or not treated at all, and then faced with a catastrophe. By the time they got to me they had been failed by the system so completely that there was no reason for them to trust me. Most kidney failure patients are diagnosed less than a year before they end up on dialysis, and kidney failure patients make up 1% of the Medicare population but use almost 7% of the budget. Those extra dollars could be shifted almost completely to primary care (and the other programs that we were speaking of), which would result in a healthier population and make a big dent in the chronic shortage of transplantable organs.

I am under no delusion that access to allopathic medicine is the cure for all ills, but it is, as you say, necessary.


Posted by: Dr. Oops | Link to this comment | 12-17-20 4:55 AM
horizontal rule
73

I keep confusing "allopathic" and "homeopathic".


Posted by: Moby Hick | Link to this comment | 12-17-20 6:38 AM
horizontal rule
74

I still look it up, so yeah...


Posted by: Dr. Oops | Link to this comment | 12-17-20 6:48 AM
horizontal rule
75

Apparently it is the fate of every president to eventually get COVID


Posted by: Barry Freed | Link to this comment | 12-17-20 6:49 AM
horizontal rule
76

Anyway, my doctor is all about my blood pressure, my blood lipids, and how it would be a very good idea if I were more active because of the diabetes thing.


Posted by: Moby Hick | Link to this comment | 12-17-20 7:04 AM
horizontal rule
77

OT: We have a fuckton of snow.


Posted by: Moby Hick | Link to this comment | 12-17-20 9:15 AM
horizontal rule
78

72: My boss had to go on immunosuppressants even though she had been able to live without them for years. She got her first from her Dad, and the 2nd from her Mom, when they did the fancy one with chemo. I'm not sure why her kidneys started to fail at 15, but eventually, she'll probably need another transplant now, and I'm sure the shortage is on her mind.


Posted by: Bostoniangirl | Link to this comment | 12-17-20 9:24 AM
horizontal rule
79

Guess who is not on that list?

Anyone who is pregnant. Even if they'd normally be in #3.


Posted by: Abigail Adams | Link to this comment | 12-17-20 9:54 AM
horizontal rule
80

Babies, hooray!


Posted by: Moby Hick | Link to this comment | 12-17-20 10:10 AM
horizontal rule
81

79: I just watched a presentation on vaccination, and an ob/gym presented. There are no data in pregnant women so they can not recommend it to all pregnant individuals. However, ACOG and other societies do recommend that it be offered to all pregnant persons, and that it should be a personal decision of the patient's based on a discussion with their HCP. No theoretical reason to believe it would be harmful, and pregnancy appears to be associated with worse outcomes for COVID patients. There are various factors to consider but risk of exposure might be one.


Posted by: Bostoniangirl | Link to this comment | 12-17-20 11:00 AM
horizontal rule
82

81 is exactly right. I just looked this up this morning. ACOG and CDC both say no reason not to offer vaccine to pregnant or breastfeeding women with their normal priority group. The animal DART/ReproTox animal data are coming soon, which may put minds at ease.


Posted by: ydnew | Link to this comment | 12-17-20 11:09 AM
horizontal rule
83

Huh. Interesting. Might be time for a new Ob.


Posted by: Abigail Adams | Link to this comment | 12-17-20 11:44 AM
horizontal rule
84

I am moderately cheered to learn that my mom is likely to be vaccinated on the 28th.


Posted by: Moby Hick | Link to this comment | 12-17-20 11:44 AM
horizontal rule
85

Universal healthcare coverage is absolutely essential, but it is not sufficient. Clean air and water, a built environment which encourages exercise, access to recreation, affordable fruits and vegetables, a society where the default choices are healthier is also key. You can prescribe medically tailored meals to individuals with diabetes or other conditions and sometimes, that's the right call, but the medical system is probably not the best way to approach nutrition for most people. Improving the quality of food in schools might be.

BG is Edwin Chadwick?


Posted by: teofilo | Link to this comment | 12-17-20 11:50 AM
horizontal rule
86

79: congratulations!!


Posted by: heebie-geebie | Link to this comment | 12-17-20 11:54 AM
horizontal rule
87

In the ER right now with rapid onset of fever, congestion, dizziness. Urgent care gave me a rapid test I don't trust that was negative, but they said that the slight (hopefully very slight) possibility it's a blood clot/cancer recurrence means I needed to go to the ER. So this should be a fun several hours.


Posted by: J, Robot | Link to this comment | 12-17-20 3:22 PM
horizontal rule
88

87:. Eek! Hope they figure out what this is and fix it quickly!


Posted by: peep | Link to this comment | 12-17-20 3:27 PM
horizontal rule
89

Yes. Best wishes.


Posted by: Moby Hick | Link to this comment | 12-17-20 3:29 PM
horizontal rule
90

Oh jesus! Please keep us updated and get well ASAP.


Posted by: heebie-geebie | Link to this comment | 12-17-20 3:43 PM
horizontal rule
91

Sending you a mental power booster, J.


Posted by: Minivet | Link to this comment | 12-17-20 3:44 PM
horizontal rule
92

87. Yikes! I hope they diagnose it as something minor (and that they are correct) quickly.


Posted by: md 20/400 | Link to this comment | 12-17-20 4:03 PM
horizontal rule
93

79. BABY! HOORAY!


Posted by: md 20/400 | Link to this comment | 12-17-20 4:04 PM
horizontal rule
94

Agreeing with 88 through 92.


Posted by: Bostoniangirl | Link to this comment | 12-17-20 4:12 PM
horizontal rule
95

They took blood, and did an EKG and chest x-Ray, but no word yet on results or if they want further tests, so I'm back to hanging out in the waiting room.

Dr. Oops, did you see the recent ProPublica article on kidney transplants and dialysis centers?


Posted by: J, Robot | Link to this comment | 12-17-20 4:22 PM
horizontal rule
96

Yikes, fingers crossed.


Posted by: Lurid keyaki | Link to this comment | 12-17-20 5:20 PM
horizontal rule
97

Yikes! That's very scary especially right now. Hope it all turns out okay.


Posted by: teofilo | Link to this comment | 12-17-20 6:06 PM
horizontal rule
98

Best wishes J. Robot!


Posted by: Ile | Link to this comment | 12-17-20 6:15 PM
horizontal rule
99

I'm finally in a room, and they're going to do some more tests, but probably not anything too intense.


Posted by: J, Robot | Link to this comment | 12-17-20 6:16 PM
horizontal rule
100

I just did - absolutely horrible, and absolutely unsurprising. One (small) step towards equity was made in 2014 when they at least back dated the waiting time to the date a patient was eligible - either by GFR or start of dialysis. Before that, even if someone was on dialysis for 10 years, their wait time started when they were listed, so referral delays were even more punitive. It's a vicious system.


Posted by: Dr. Oops | Link to this comment | 12-17-20 6:21 PM
horizontal rule
101

And good luck in the ER!


Posted by: Dr. Oops | Link to this comment | 12-17-20 6:21 PM
horizontal rule
102

Oh gosh, J, best of luck.


Posted by: CharleyCarp | Link to this comment | 12-17-20 6:31 PM
horizontal rule
103

Best Wishes, J. Robot


Posted by: chill | Link to this comment | 12-17-20 6:56 PM
horizontal rule
104

Thanks all! They've started an IV and taken a boatload more blood, and now I'm waiting on a CT scan. They also did a deep nasal swab, which really is the pits. Apparently my lungs sound and look good, but I've got an elevated WBC, and they want to rule out serious problems. The doctor said I'll be here for at least a few more hours, so I'm having Mr. Robot drop off my phone charger.


Posted by: J, Robot | Link to this comment | 12-17-20 7:24 PM
horizontal rule
105

"Concierge" medicine means they have a charger for you.


Posted by: Moby Hick | Link to this comment | 12-17-20 8:36 PM
horizontal rule
106

Thinking all the good thoughts for you, J Robot.

Yay babies (assuming you are happy about it), Abigail!

My 11-year-old niece just called* to brainstorm our game plan for tomorrow, when I am leading a Covid-19 vaccine distribution brainstorming discussion for the young people in her History Book Club. They were going to have me show them how to make masks, but not enough of them sew. So instead we will pretend to be federal officials and try to develop our game plan.

They all read a sobering novel about the 1918 pandemic, and of course they're living through 2020, so I expect it may be a pretty emotional conversation.

*Yes, she takes after her Aunt Witt the night owl.


Posted by: Witt | Link to this comment | 12-17-20 8:47 PM
horizontal rule
107

Thinking all the good thoughts for you, J Robot.

Yay babies (assuming you are happy about it), Abigail!

My 11-year-old niece just called* to brainstorm our game plan for tomorrow, when I am leading a Covid-19 vaccine distribution brainstorming discussion for the young people in her History Book Club. They were going to have me show them how to make masks, but not enough of them sew. So instead we will pretend to be federal officials and try to develop our game plan.

They all read a sobering novel about the 1918 pandemic, and of course they're living through 2020, so I expect it may be a pretty emotional conversation.

*Yes, she takes after her Aunt Witt the night owl.


Posted by: Witt | Link to this comment | 12-17-20 8:47 PM
horizontal rule
108

Also, I attended my first Zoom memorial tonight, for a work colleague. She had been ill for a long time (it wasn't Covid) but was still way too young. The service was impressively well done and moving for an online event, but I'm hoping when the world is allowed to gather again I will be able to make it to Los Angeles for the party that her friends and family are going to throw. That's how she wanted to go out.


Posted by: Witt | Link to this comment | 12-17-20 8:50 PM
horizontal rule
109

We also had a Zoom memorial for a work colleague earlier this fall, also not covid and also way to young. Not having an actual funeral or other physical event is a real loss, as necessary as it is.


Posted by: Moby Hick | Link to this comment | 12-17-20 8:59 PM
horizontal rule
110

It was still less awkward than the Zoom holiday party.


Posted by: Moby Hick | Link to this comment | 12-17-20 9:09 PM
horizontal rule
111

I am SO glad my office didn't have a Zoom holiday party. So glad.


Posted by: Witt | Link to this comment | 12-17-20 9:14 PM
horizontal rule
112

Best wishes, J,R.


Posted by: Biohazard | Link to this comment | 12-17-20 9:21 PM
horizontal rule
113

111: We were allowed to expense a delivered lunch.


Posted by: Moby Hick | Link to this comment | 12-17-20 9:25 PM
horizontal rule
114

Fingers crossed, J.R. That sounds very stressful.


Posted by: NickS | Link to this comment | 12-17-20 9:39 PM
horizontal rule
115

Good luck JR.
We had a memorial for a colleague but the organizer used a personal Zoom account and maxed it at 100 attendees. I didn't try to get in after I got bounced once because I would have felt bad if my attendance blocked someone like a family member.


Posted by: SP | Link to this comment | 12-17-20 10:03 PM
horizontal rule
116

Probably going to be here another hour while they push fluids and do one more set of labs. They're pretty stumped beyond "you seem to have an infection somewhere but not your lungs."


Posted by: J, Robot | Link to this comment | 12-17-20 10:49 PM
horizontal rule
117

Headed home. Tentative diagnosis is a UTI, but who knows. Not Covid and not a blood clot, at least.


Posted by: J, Robot | Link to this comment | 12-17-20 11:20 PM
horizontal rule
118

Good news J,B


Posted by: Barry Freed | Link to this comment | 12-18-20 1:04 AM
horizontal rule
119

I mean J,R


Posted by: Barry Freed | Link to this comment | 12-18-20 1:05 AM
horizontal rule
120

J, Robot, how's your fever? I hope you are feeling better.


Posted by: md 20/400 | Link to this comment | 12-18-20 1:19 AM
horizontal rule
121

New job is going very well but the pace is killing me. (It's COVID response.) Selkie has found out she is high priority for vaccine due to a heart thing so great! We are not going north for Christmas though- annoyed about that but it isn't worth the stress.


Posted by: ajay | Link to this comment | 12-18-20 2:11 AM
horizontal rule
122

Warm thoughts, JR. Well done ajay. We will of course hold you personally responsible for all vaccine shortages from now on. And congratulations to Abigail.


Posted by: NW | Link to this comment | 12-18-20 2:23 AM
horizontal rule
123

One group I work with was supposed to have a ZOOM/ socially distant in person lunch event yesterday but it was on Wednesday due to yesterday's snow. I had to miss it, because Tim had an eye exam with dilation that day, but I was looking forward to the decorated face masks.


Posted by: Bostoniangirl | Link to this comment | 12-18-20 3:17 AM
horizontal rule
124

121: Good luck. I hope you get a vaccine quickly too if your job exposes you.


Posted by: Moby Hick | Link to this comment | 12-18-20 7:19 AM
horizontal rule
125

I just found out that we're getting both the Moderna and the Pfizer vaccines here and the vaccination program should be starting in a couple of weeks.


Posted by: Barry Freed | Link to this comment | 12-18-20 7:23 AM
horizontal rule
126

Moderna doesn't have as much experience manufacturing at scale, so my guess s that things won't really ramp up until J and J or Astra Zeneca get approval.


Posted by: Bostoniangirl | Link to this comment | 12-18-20 9:30 AM
horizontal rule
127

Thanks- it won't; I'm not in a patient-facing role. I am trying to organise stuff and therefore have a permanently impatient face instead.


Posted by: ajay | Link to this comment | 12-18-20 9:49 AM
horizontal rule
128

Even if you sit on the patients, it's still a risk


Posted by: Moby Hick | Link to this comment | 12-18-20 9:53 AM
horizontal rule
129

Or if, because they have trouble breathing, they spoon you.


Posted by: Moby Hick | Link to this comment | 12-18-20 9:53 AM
horizontal rule
130

Great to hear, J.

Some heartening news: according to KFF, those saying they wear masks every time they leave the house and might be in contact with other people have risen from 52% in May to 73% in December. (Democrats 70% to 87%, Republicans 37% to 55%.)


Posted by: Minivet | Link to this comment | 12-18-20 9:54 AM
horizontal rule
131

I'm wondering what the peak for the seven day moving average of deaths per day will hit and how high it will be.


Posted by: Moby Hick | Link to this comment | 12-18-20 9:56 AM
horizontal rule
132

131: Looking at the curves per population, a number of states do seem to have peaked in mid-November between 80 and 120 cases per day per 100,000. (IL, MO, CO, MI, WI, IA, MN, NE, MT). A smaller number peaked at the same time but much higher, over 150 (ND, SD, WY, NM).

Another chunk of states might possibly be flattening out? Their curve at least looks flat for the past two weeks or so. (And not looking like a pause for breath.) These predominate in Midwest, Northeast, and Northwest, but none are above 100 right now. Those above 80 are NV, IN, OH, DE, PA, RI, KS, ID, UT. Those lower than 80 are OR, WA, DC, MD, NJ, LA, CT, MA, AR, KY, VT.

Still rising are in the Southwest and Southeast: TN, CA, AZ are especially high and rising (134, 99, 93 respectively); below 90 but still rising are AL, MS, OK, NY, ME, NH, FL, GA, NC.

Texas's curve is weird and I'm not sure what to draw from it. They're at 52 right now.


Posted by: Minivet | Link to this comment | 12-18-20 10:43 AM
horizontal rule
133

Peak cases is a few weeks ahead of peak deaths.


Posted by: Moby Hick | Link to this comment | 12-18-20 10:47 AM
horizontal rule
134

Yep. Deaths is also a noisier stat. Aggregated to the region level it too is declining since a week or two ago in the Plains and Rockies regions; flattened in Great Lakes; and rising everywhere else.


Posted by: Minivet | Link to this comment | 12-18-20 11:10 AM
horizontal rule
135

How is it noisier?


Posted by: Moby Hick | Link to this comment | 12-18-20 11:10 AM
horizontal rule
136

I mean, dead people is dead people but cases depend on who gets tested.


Posted by: Moby Hick | Link to this comment | 12-18-20 11:14 AM
horizontal rule
137

Hospitalizations might be better.


Posted by: Moby Hick | Link to this comment | 12-18-20 11:17 AM
horizontal rule
138

Just there are fewer of them so it's harder to trace a story-telling curve in individual states.


Posted by: Minivet | Link to this comment | 12-18-20 11:23 AM
horizontal rule
139

135: Some percentage of those people die screaming.


Posted by: apostropher | Link to this comment | 12-18-20 11:30 AM
horizontal rule
140

From covid? I kind of doubt it.


Posted by: Moby Hick | Link to this comment | 12-18-20 11:35 AM
horizontal rule
141

Like the passengers in my grandfather's car.


Posted by: JP Stormcrow | Link to this comment | 12-18-20 11:36 AM
horizontal rule
142

Glad things are looking less terrible JRobot. Hope you feel better soon.

Thanks everyone! It was totally unplanned but is surprisingly wanted. Cough, cough, may have been the result of excessive post-election tension relief. Despite seeing the pulsing blob last week, doesn't seem real. Trying to balance between doing all the necessary things but not get too attached. BG, ydnew, I really appreciate the pointer about the vaccine probably being ok. I may have misunderstood my Ob. The whole trying not to spend too much time in the same room together has definitely slowed the rapport building process. I now have some hope that I might not have to quarantine for most of 2021.


Posted by: Abigail Adams | Link to this comment | 12-18-20 11:48 AM
horizontal rule
143

Let me be the first to suggest "Wry Cooter" if it's a boy.


Posted by: Moby Hick | Link to this comment | 12-18-20 11:49 AM
horizontal rule
144

I keep hearing "Police and Thieves" in my head when I read the title of this post:

Vaccines and masks
Oh yeah
Scaring the nation
With disease
Misinformation


Posted by: jms | Link to this comment | 12-18-20 11:56 AM
horizontal rule
145

OT: Amazon is an evil monopoly, but if you send Christmas gifts by it, you can get a picture of how much shit your siblings have piled on the porch.


Posted by: Moby Hick | Link to this comment | 12-18-20 12:40 PM
horizontal rule
146

Hey, remember all that umbrage when Biden said it didn't look like they had much of a plan to distribute the vaccine, and the Admin rushed to say no, they had plans.


Posted by: CharleyCarp | Link to this comment | 12-18-20 1:18 PM
horizontal rule
147

Yeah. Part of what was in my head when I wrote 131 was wondering if they weren't trying to do what they come to make peak deaths happen when Biden was president.


Posted by: Moby Hick | Link to this comment | 12-18-20 1:23 PM
horizontal rule
148

Chani has just called informed me that the UAE is getting the Chinese vaccine which looks to me (and her) like a decision more motivated by geopolitical considerations than public health ones. Does anyone know if the Chinese have publicly released the data on their vaccine trials?


Posted by: Barry Freed | Link to this comment | 12-18-20 2:49 PM
horizontal rule
149

The places I go for reliable vaccine information have all continued to note the lack of data on the Chinese vaccine or the UAE situation, so I think they haven't.


Posted by: Nathan Williams | Link to this comment | 12-18-20 4:54 PM
horizontal rule