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crazydoc said:
My own thoughts on vaccine priorities are as follows:

1) Workers with direct exposure to infected patients
and workers exposed to those workers, perhaps even immediate family that they are living with.
2) People of age 18 to 49 - these are the largest proportion of the infected (in CA, 45% of the population and 60% of the cases), and are the least invested in curtailing its spread (bars, parties, avoiding mitigation measures, exposure in the workplace). Their immunity would have the greatest effect on curtailing the pandemic, though they are probably the least likely to accept vaccination
that is interesting... trading off some additional losses in high risk groups, for more quickly slowing the community spread. The math of which approach saves more lives is not immediately obvious (to me). 
3) People of other ages who work in  essential jobs,
That involves a lot of people. Logical if they are indeed essential. Note: politicians are not essential.
and residents of care homes
that group are already near the top of the list being floated with preference by age (oldest first)... While an economic benefit analysis does not necessarily agree.  Certainly vaccinate nursing home workers at the same time.
4) Under 18's and pregnant women, once it is determined they can be safely vaccinated
Children are not considered high risk for mortality. Are you talking about young women? Is there some research about risk for this group I have not heard about, besides the obvious?

A quick search reveals somewhat reduced immune response for pregnant women, and something like 5% of pregnancies who contract covid suffer serious symptoms (pneumonia, per NIH blog). This is higher than the general public rate which is well lower than 5%. 
5) All others - retired seniors should be last, since they are more able to isolate than others, and contribute the least to a functioning economy (except as consumers.)
why give seniors any at all? They are old and no longer have anything of worth to contribute to society.  ::)
Of course, vaccine availability and emotional responses would make this untenable.
At some point the blowhard politicians need to stop bad mouthing vaccine just because of who promoted the development program. This political badmouthing will reinforce some in the low information public to boycott vaccines when they finally catch up with demand (next year).

JR
 
JohnRoberts said:
Children are not considered high risk for mortality. Are you talking about young women? Is there some research about risk for this group I have not heard about, besides the obvious?

A quick search reveals somewhat reduced immune response for pregnant women, and something like 5% of pregnancies who contract covid suffer serious symptoms (pneumonia, per NIH blog). This is higher than the general public rate which is well lower than 5%.
The vaccine test groups haven't included pregnancy and children, so at least initially they will not be offered the vaccine (unless at risk health worker???) There are plans to start lowering the age in tests to 12yo, but I doubt anyone wants to give it to pregnant women, or that many of them would accept it if offered, because of the long term potential sequelae in the offspring. Maybe it will be offered to women, including children of child bearing age, if they sign a disclaimer that legal recourse is not an option if they do get pregnant within a certain time period of receiving the vaccine, similar to that for isotretinoin.

As far as the elderly , not only do we not contribute much to society, but we suck it dry with SS and Medicare. Best to let us fade into the sunset.
 
Gold said:
That and it's usually the other way around. American's going to Mexico for medical treatment because there is excellent care at affordable prices. If I ever need any major dental work I'm going to Mexico or Ireland.
I have my dental work performed locally.

There is reportedly good budget medical care in India, worth the airfare. I never heard that claim made for Mexico. The one (only) thing I like about Mexico is that they will sell you prescription drugs without a doctor's scrip.

I have been to Mexico several times mostly for business but one drunken crawl to TJ from SoCal when the strip clubs in San Diego wouldn't let us in (we had been drinking).

Good luck...

JR 

PS: I am trying to drink myself to death, and will donate my body to science (to save funeral cost), but they are refusing such donations during Covid
 
Vaccine priorities

I guess almost anyone could make a credible case for being highly prioritized.

But basically all of the above except all 18-49 year olds. No need to sponsor the party scenes -- careful, shitstorm acoming ;)

- In the 18-65 age groups, high priority should be given to parents/people who care for minors living in their households and/or who perform caregiving tasks for parents/family or, if the case, for less-abled kin. The idea here is to minimize potentially high costs and logistical burden on the childcare and social welfare systems.

- The remaining age groups in decending order or, as a different approach that resolves any kind of heated discussion, opt for the proven model of a vaccine lottery by birthday. After the drawing, give people a week to contact the medical authorities to make an appointment -- with the idea to thus easily separate those who do not want a vaccine, those who do not 'believe' in it, and those who are simply too busy partying or doing other things.
 
And another idea whilst sipping on a cup of coffee:

Reserve 15 to 20% of any major batch of vaccines and put it up officially for auction. This way, the rich can fight over it and governments might thus recoup some of the cost of this entire vaccination enterprise.
 
JohnRoberts said:
I have my dental work performed locally.

So do I. I use a Polish dentist who is the best I’ve ever run across. My teeth never hurt after a cleaning. The only one who has ever done that. He doesn’t seem like he’s being careful and the place is cluttered but he does great work. Cheap too. But if I ever need a root canal I couldn’t afford it here.

There are places in Juarez that cater to Americans. They put you in a hotel in El Paso. Pick you up and bring you back.

There is reportedly good budget medical care in India, worth the airfare. I never heard that claim made for Mexico. The one (only) thing I like about Mexico is that they will sell you prescription drugs without a doctor's scrip.

I have been to Mexico several times mostly for business but one drunken crawl to TJ from SoCal when the strip clubs in San Diego wouldn't let us in (we had been drinking).

Good luck...

JR 

PS: I am trying to drink myself to death, and will donate my body to science (to save funeral cost), but they are refusing such donations during Covid
[/quote]
 
Gold said:
So do I. I use a Polish dentist who is the best I’ve ever run across.
My best dentist died, RIP... back a couple decades ago when I realized I was still alive and not going to die young and pretty, I asked Hartley's secretary who his doctor and dentist was, I figured he should know. They were both above average but have since taken the dirt nap.
My teeth never hurt after a cleaning. The only one who has ever done that.
Your teeth shouldn't hurt from a cleaning, while the plan is for them to do a deep dive to find carries. My current dentist, who took over my old dentist's practice doesn't clean teeth himself. Down here they hire attractive young women to do that. I have had the same young lady cleaning my teeth for the last few years and it is pleasant. Coincidentally she wears a ton of eye makeup while spending so much time inches from my face. She is intelligent but not well informed, neither is the dentist but probably typical for the mid south.
He doesn’t seem like he’s being careful and the place is cluttered but he does great work. Cheap too. But if I ever need a root canal I couldn’t afford it here.
Down here the "dentist" refer's root canals to specialists... they get paid well (been there done that twice).
There are places in Juarez that cater to Americans. They put you in a hotel in El Paso. Pick you up and bring you back.
I have spent A little time in both... ironically perhaps the best Mexican restaurant was in El Paso on the America side (perhaps a money thing). I think the strip club they took us to may have been in Mexico, I didn't drive. 

I recall from decades ago, reading stories about American citizens duped into pursuing illegal, ineffective cancer treatments down in Mexico, where anything goes. I have been watching people die from cancer for decades. Cancer sucks.

JR
 
crazydoc said:
I've got pandemic fatigue. Nothing I can do, except avoiding people, can change the effect of this disease on me or anyone else. Though I live in a low population county, there are 70% Trumpsters here, and mitigation measures seem to be of the same ratio, so I expect things to explode (here and everywhere) in the next two months.

Active community cases have gone from 10 to 200 in the last month. There are 2 state and one federal prisons in the county - active inmate cases are at 700+, total inmate cases 1400+, and prison employee active cases 120. Since most of the prison employees live in the county, I expect most of the community cases derive from them, their families and contacts.

I've tried to get information about the demographic origens of the county cases (businesses, family and other gatherings, out of county visitors, prison staff, etc. - nothing to violate individual privacy) for the last several months. Emails to county supervisor and local paper with no results. Phone calls to county public health unanswered until two weeks ago, when I was told they could not give me that information.

So I'm on my own, and the only way to protect myself and my household (all of us old and with multiple comorbidities) is to hunker down and limit exposure to other people. I am lucky to be retired and to live in a low population area where this is possible. I expect many of you have it a lot worse - I'm sorry for that.

I am reminded of a song from my daughter's punk band days (she was the vocalist who's job it was to shout obscenities). This is from the world to me, and back atcha:

https://www.youtube.com/watch?v=-LdYXYNtPJI
regarding your lingering symptoms have you looked into "POTS"

https://www.drugtargetreview.com/news/57007/drug-discovered-for-postural-orthostatic-tachycardia-syndrome-pots/

JR

PS; It looks like Putin has decided to vaccinate doctors and teachers first with his sputnik V vaccine, but they may also be serving as safety/efficacy test subjects.
 
JohnRoberts said:
regarding your lingering symptoms have you looked into "POTS"
I'm afraid you have the wrong idea of what "pandemic fatigue" is. It's a mental condition produced by the effects of dealing with the pandemic in one's life.

Signs of Pandemic Fatigue:
The hallmark sign of pandemic fatigue is a sense of inner weariness. You may also feel:

    Helpless
    Sad
    Worried
    Frustrated
    Irritable


In my case it's frustration and weariness at the asinine way this all has been and is being handled by much of the population and many of the assholes in charge. I am particularly frustrated by the local ignorance/denial of mitigation measures, and the health department's lack of communication and transparency in dealing with it.

There is also now a study showing SARS-CoV-19 antibodies in blood donations in several US states in Dec and Jan.
https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1785/6012472

Certainly not surprising that many people were infected prior to identifying it, due to the low rates of symptomatic and serious disease that it has.

So I guess it ain't the Kung Flu - just shows the Chines were smarter than us in identifying it first.
 
Saw something that mentioned Florida is going to be requesting CT values with all testing. Maybe not verified or relevant??

  From my understanding of one study, CT values can be quite low for Presymptomatic (sp?) people depending on your age (younger,under 18,  seems to yield lower ct regardless of symptoms) . But idk... I guess it can't hurt.

Some info out there that it gets a bit iffy on viral competence after the cycle threshold gets over 30 but I'm not clear on that either....I've posted about this iirc...

One interesting related thing to this is the company Fulgent Genetics.

They are adding flu testing to their covid tests at no charge. Pretty cool...

https://www.globenewswire.com/news-release/2020/09/03/2088271/0/en/Fulgent-Genetics-Adds-Influenza-A-and-Influenza-B-to-all-COVID-19-Tests.html

I was curious what the sensitivity was from their statement in that article...

( “While some non-RT-PCR tests have the potential to deliver faster results, the sensitivity and specificity of our RT-PCR test for COVID-19, especially at low-level viral loads, is critical to minimize both false positives and false negatives. We believe RT-PCR testing solutions are currently the most viable solution for asymptomatic testing, early detection after potential exposure and for preventative screening")


but their description on the test only mentions <40... which seems vague ...

https://www.fda.gov/media/138150/download


Not sure where these test are but looking quick I see Utah is using them, along with Miami-Dade and New York City schools....

Looks like Utah is having some increases now too....

"In the past week, Utah is averaging 3,077 new confirmed cases per day and a positive test percentage of 26.6.

That's the highest rolling positive test percentage the health department has ever reported."

https://www.ksl.com/article/50061989/health-department-reports-2563-new-coronavirus-cases-sunday-in-utah




 
edit...just saw this ...pretty good fortune for them ...I guess it's to be expected....

https://www.yahoo.com/lifestyle/fulgent-genetics-announces-increase-full-130000169.html

"The company now expects to generate at least $300 million in revenue for the full year 2020, an increase of 28% compared to previous guidance of $235 million. This updated guidance represents estimated year-over-year revenue growth of more than 800%"

Then the fortune of being positioned early is pretty interesting....

"In 2019, the company launched its first patient-initiated product, Picture Genetics, a new line of at-home screening tests "


From their investor page....

https://fulgentgenetics.gcs-web.com/

DEC 4 2020


LA County Launches Holiday COVID-19 Home Test Collection Pilot

https://covid19.lacounty.gov/covid19-news/la-county-launches-holiday-covid-19-home-test-collection-pilot/


guess it makes a little sense they would be on top of it and positioned to be where they are.... good for them. Hard work pays off...

https://www.globenewswire.com/news-release/2020/03/17/2001831/0/en/Fulgent-Genetics-Announces-Launch-of-Next-Generation-Sequencing-NGS-Test-to-Detect-Coronavirus-Disease-COVID-19.html

Fulgent Genetics’ joint venture in China, which was established in 2016, recently executed a research agreement for COVID-19 with the Chinese Academy of Medical Sciences and Peking Union Medical College Hospital (“PUMCH”), both for diagnostic and mutation analysis of the virus. Fulgent Genetics, through its China JV and with strong cooperation with PUMCH, began collecting patient samples beginning January of 2020 from the most affected regions of China for research, development, analysis, testing, and validation. "


I guess it's kinda creepy that their management board looks like one you'd find on ancestry dna...lol

https://fulgentgenetics.gcs-web.com/leadership/management
 
crazydoc said:
The vaccine test groups haven't included pregnancy and children, so at least initially they will not be offered the vaccine (unless at risk health worker???) There are plans to start lowering the age in tests to 12yo, but I doubt anyone wants to give it to pregnant women, or that many of them would accept it if offered, because of the long term potential sequelae in the offspring.

Reluctance have anything to do with this??

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7092852/

"Syncytin is a captive retroviral envelope protein, possibly involved in the formation of the placental syncytiotrophoblast layer generated by trophoblast cell fusion at the maternal–fetal interface. We found that syncytin and type I viral envelope proteins shared similar structural profiling,"

"The fusion of lipid bilayers is central to a number of diverse biological processes, such as fertilization, vesicle trafficking, muscle development, placental morphogenesis, and viral infection"
 
https://miami.cbslocal.com/2020/12/06/florida-governor-ron-desantis-ordered-public-health-officials-not-discuss-covid-with-public/

Stand tall, Republicans. I can't imagine why we are settings records daily now. Fake news. DemocRAT hoax.
 
iturnknobs said:
https://miami.cbslocal.com/2020/12/06/florida-governor-ron-desantis-ordered-public-health-officials-not-discuss-covid-with-public/

Stand tall, Republicans. I can't imagine why we are settings records daily now. Fake news. DemocRAT hoax.

...Who was that guy?

Anyhow, there are places to keep an eye on what's going on apart from the main Florida Covid page and what's on tv and in the newspapers.

Here's one....

https://bi.ahca.myflorida.com/t/ABICC/views/Public/COVIDHospitalizationsCounty?%3AshowAppBanner=false&%3Adisplay_count=n&%3AshowVizHome=n&%3Aorigin=viz_share_link&%3AisGuestRedirectFromVizportal=y&%3Aembed=y


Pretty sure it was up to 20000 back in the summer so hopefully it doesn't go there. But it has jumped 1000 in the last month so it should get pretty bad for the next 100 days or so I'd guess...

 
iturnknobs said:
https://miami.cbslocal.com/2020/12/06/florida-governor-ron-desantis-ordered-public-health-officials-not-discuss-covid-with-public/

Stand tall, Republicans. I can't imagine why we are settings records daily now. Fake news. DemocRAT hoax.
I think a similar thing is going on here at my county health department, since this is a heavily republican county with strong "it's a free country - the govmint cain't make me wear a mask" sentiments. They refuse to give out information on how the virus is being spread, though it's obvious it's from the largest employers in the county, the two state and one federal prison employees. Although there is a California mask mandate, there's no proactive push from the department to wear them, and mask use seems to be at the 50% level from my personal observations.

Inmate cases have gone from 630 recovered/0 active to 1322 recovered/475 active (total 1797 inmate cases) over the last month, and community cases from 135 total/14 active to 625 total/329 active over the same period. Just waiting for the thanksgiving surge to hit this next week - I think the county adjusted case rate (daily average new cases per 100k pop) will be over 100, like those currently in the Dakotas.

There's no ICU at the hospital here, so we don't have to worry about it getting overwhelmed.  ::) I limit my trips to town to once a fortnight to get groceries. It's every man for himself - I feel for those who still have to work or have kids in school and can't avoid social interactions.
 
having grown up in a border town in Texas, it was common for folks to go to Mexico for medical and dental and it was also common to have U.S. doctors and dentists with an office on both sides of the border splitting their time between locations.
 
crazydoc said:
I think a similar thing is going on here at my county health department, since this is a heavily republican county with strong "it's a free country - the govmint cain't make me wear a mask" sentiments.

Little parallel to here. The counties like Miami-Dade are not really cowboy country here and tend to have the worst outbreaks..... Looking real quick I see this still holds true...

crazydoc said:
There's no ICU at the hospital here, so we don't have to worry about it getting overwhelmed.  ::)

Well at least the silver lining is they'll be safer from spreading it further....or maybe on the flip side, picking up a nasty HAI  ....
 
scott2000 said:
Little parallel to here. The counties like Miami-Dade are not really cowboy country here and tend to have the worst outbreaks..... Looking real quick I see this still holds true...

I glanced at the search tool. I wonder if the breakouts are "worse" per capita. Doubtful, homework required. I think bad attitude and messaging mixed with human contact is the worst concoction. North Dakota was the worst covid hotspot IN THE WORLD per capita a week or so ago... party affiliation of most citizens.... one guess. Miami proper is not cowboy country, but there is a ring around it of poorly behaving individuals spreading the virus inwards. Chicago is very similar with a ring of cornfields and Trump flags surrounding it. Those people "express" their freedom by going where ever they would like in populated areas while virtually never being safe while outside of "city-proper". May as well be smallpox blankets. Freedom. 'Murica.
 
hodad said:
Wow, that's a great site, and no paywall! Thanks.
So basically, the case rate (number of new cases per day) is a measure of how fast a disease is increasing in a given area, adjusted by population so comparisons can be made with other areas. Fudge factors are applied - average over 7 days, 3 day lag as data comes in, test rate (more tests=more cases) to get an adjusted test rate.
It looks like the data on this map is raw data over the last week, so the county rates need to be divided by 7 to get the raw rate. My county shows 375 cases in the last week - with about a 30k population, this is multiplied be 100/30 to give a total of 1200 cases per 100k. Divide by 7 days gives a raw case rate of 171 cases per day per 100k population. Wow!
Miami-Dade using the same data comes to 71, so covid is increasing more than twice as fast where I live as it is in Miami. Ride 'em cowboy.
 
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