COVID: Omicron and other topics

[thegenius]

I guess we don't really have an ongoing COVID thread...or if we did it hasn't been used in several months.

Anybody ever listen to ZDoggMD podcasts?

Omicron Panic, Natural Immunity, Fluvoxamine (w/Drs. Marty Makary & Vinay Prasad)

Dr. Marty Makary AND Dr. Vinay Prasad TOGETHER. It's the COVID apocalypse y'all 🔥

zdoggmd.com

That one was from Dec 2021. I think they bring up some good points about boosters, myocarditis, one-size fits all for vaccination, etc. But zdoggmd and his guests have such a mocking tone they seem sanctiminious. Lots of monday morning quarterbacking about how poorly we did things a few years ago.

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[bravotwozero]

Yeah I’m a zdogg fan. Balanced viewpoint, but I agree with the Monday morning quarterbacking.

The CDC made themselves an easy target though, with a lack of evidence based studies to support some of their positions, and poor overall communication to the public.

 

[thegenius]

Well that link above kind of pissed me off...but I listened to some of his other podcasts/videos and they weren't that bad

 

[Birdstrike]

I didn't watch this particular episode, as I find the 'rona a total bore. But ZDogg is usually pretty good. His music videos are the best.

 

[xaelia]

Just thinking about Marty Makary and Vinay Prasad mixing in valid critiques and nuances with their typical brand of condescending never-wrong brilliance ... vomit.

He has been captain unhelpful throughout this pandemic, preaching to his bubble of COVID mask- and seriousness-deniers while blocking anyone who dares challenge him.

I mean ... what the F:

 

[DocEspana]

Just thinking about Marty Makary and Vinay Prasad mixing in valid critiques and nuances with their typical brand of condescending never-wrong brilliance ... vomit.

He has been captain unhelpful throughout this pandemic, preaching to his bubble of COVID mask- and seriousness-deniers while blocking anyone who dares challenge him.

I mean ... what the F:

something bad like the kid goes and robs a store with a nerf gun? Or bad like sleeps in on a school day? Because I cant figure out what in the world he is implying otherwise because I understand how masks work and dont work.

 

[WilcoWorld]

something bad like the kid goes and robs a store with a nerf gun? Or bad like sleeps in on a school day? Because I cant figure out what in the world he is implying otherwise because I understand how masks work and dont work.

He's using the reader's imagination to suggest something false, so that he can use that falsehood to make an argument while maintaining deniability. It's a very Trump-y tactic.

 

[Southpaw]

I've read valid critiques and points from each of them before, but that particular episode was truly awful. Holier-than-thou condescencion perhaps gets them views and dollars, but doesn't make them right. I suggest they put on scrubs and come care for some actual hospitalized COVID patients and talk with their familes before they continue this crap.

 

[gutonc]

Just thinking about Marty Makary and Vinay Prasad mixing in valid critiques and nuances with their typical brand of condescending never-wrong brilliance ... vomit.

He has been captain unhelpful throughout this pandemic, preaching to his bubble of COVID mask- and seriousness-deniers while blocking anyone who dares challenge him.

I mean ... what the F:

I used to work with him. Don't miss that one bit.

 

[DocEspana]

my take on zdogg has always been, and will always be this.

he makes good humorous videos and songs. His skits are great. His 'podcast' skills were always pretty lacking, but we let it slide and few people actually watched. His private practice venture 7-8 years ago really changed him though. Made him delve into tons of topics that he probably doesnt have any real credibility on and it made him SERIOUSLY sell out to the NP community. He has essentially dedicated his online presence (except for the skits/songs) to saying and doing whatever best boosts his bottom dollar and whatever best drives people to his concierge care business.... which might actually be closed now, I remember it being close to closing a few years back and never really following up on it beyond that.

 

[Rekt]

Zdog is an absolute clown. Massive pretend level provider sympathizer. Used to have decent skits years ago, but now grasping at anything to stay relevant.

 

[Matthew9Thirtyfive]

I’m not sure how any physician can take zdogg seriously. He is the biggest midlevel sellout.

 

[RustedFox]

I’m not sure how any physician can take zdogg seriously. He is the biggest midlevel sellout.

Yep.
He's a better comedian than he is anything else.

 

[Dr Mantis Toboggan]

My hospital is getting pounded with bad covid cases (old school saturating at 50% etc). We have tons of unvacc’d olds etc. if this is omicron, not really buying that its more mild.

 

[gutonc]

My hospital is getting pounded with bad covid cases (old school saturating at 50% etc). We have tons of unvacc’d olds etc. if this is omicron, not really buying that its more mild.

I think it's more mild than Delta...in the vaxed population at least. But the unvaxed ancients still seem to be playing the same game of trying to die but not doing a good enough job of it.

 

[RustedFox]

I think it's more mild than Delta...in the vaxed population at least. But the unvaxed ancients still seem to be playing the same game of trying to die but not doing a good enough job of it.

I'm really sick of this.
So, so, so many turbo chronically ill boomers at my shop who want "everything to be done!"

Grandma is 88. She has no quality of life. Let her go. Let "the good Lord call her home".

 

[thegenius]

I'm really sick of this.
So, so, so many turbo chronically ill boomers at my shop who want "everything to be done!"

Grandma is 88. She has no quality of life. Let her go. Let "the good Lord call her home".

The good Lord is in the hospital, wears a white coat, and prescribed medicines…dammit!

 

[RustedFox]

The good Lord is in the hospital, wears a white coat, and prescribed medicines…dammit!

When something goes well in the hospital; it's "God be praised!"

When something goes poorly in the hospital; it's "Which doctor is negligent?!"

 

[BoardingDoc]

When something goes well in the hospital; it's "God be praised!"

When something goes poorly in the hospital; it's "Which doctor is negligent?!"

I told someone they were going to be fine a couple of days ago after I treated their minor fracture. She said "thank Jesus!"
I immediately responded, "my name is Dr. Boardingdoc, not 'Jesus'."

The nurse giggled. The patient did not.

 

[Matthew9Thirtyfive]

I told someone they were going to be fine after I treated their minor fracture. She said "thank Jesus!"
I immediately responded, "my name is Dr. Boardingdoc, not 'Jesus'."

The nurse giggled. The patient did not.

Never really understood that trope. It’s possible to be thankful to both God and the doctor.

 

[RustedFox]

Never really understood that trope. It’s possible to be thankful to both God and the doctor.

Then is it also possible to curse God for the poor outcomes; especially when the medicine was done well and correctly?

 

[BoardingDoc]

Never really understood that trope. It’s possible to be thankful to both God and the doctor.

It was said and meant as a joke. That said, I also agree with @RustedFox in that there is a sizeable sunset of patients who are quick to credit god but blame man.

 

[Apollyon]

It was said and meant as a joke. That said, I also agree with @RustedFox in that there is a sizeable sunset of patients who are quick to credit god but blame man.

Some people haven't been doctors in the US south, or even doctors, at that.

 

[Matthew9Thirtyfive]

Then is it also possible to curse God for the poor outcomes; especially when the medicine was done well and correctly?

I think you misunderstood me (might not have been clear). Just as much as I’m saying it’s possible to be grateful to both and that we shouldn’t assume they are only thanking God, I’m saying that the people who are only verbally expressing thanks to God should also be expressing thanks to the physician because one doesn’t preclude the other.

 

[RustedFox]

I think you misunderstood me (might not have been clear). Just as much as I’m saying it’s possible to be grateful to both and that we shouldn’t assume they are only thanking God, I’m saying that the people who are only verbally expressing thanks to God should also be expressing thanks to the physician because one doesn’t preclude the other.

Oh, I understood you. Did you understand me?
I'd like to see people place their frustrations correctly upon the Will of the Almighty instead of "a physician, any physician" and seek legal recourse when the outcome is not desirable.

I observe the Christian faith to a degree. I attend a men's Bible study group on Thursday nights.
I can't help but be puzzled (and often point out) the logical contradictions that occur sometimes, as God has blessed us with the ability to so reason. I try to take the lessons from scripture, and apply them in my life; it's just that God has also blessed me with the ability to not let my sensitivities get in the way of my sensibilities.

If it is "all part of God's plan", then let it be so, and do not seek vengeance upon a physician who has committed no act of negligence.

 

[Matthew9Thirtyfive]

Oh, I understood you. Did you understand me?
I'd like to see people place their frustrations correctly upon the Will of the Almighty instead of "a physician, any physician" and seek legal recourse when the outcome is not desirable.

I observe the Christian faith to a degree. I attend a men's Bible study group on Thursday nights.
I can't help but be puzzled (and often point out) the logical contradictions that occur sometimes, as God has blessed us with the ability to so reason. I try to take the lessons from scripture, and apply them in my life; it's just that God has also blessed me with the ability to not let my sensitivities get in the way of my sensibilities.

If it is "all part of God's plan", then let it be so, and do not seek vengeance upon a physician who has committed no act of negligence.

Oh I agree.

 

[thegenius]

I’m not sure how any physician can take zdogg seriously. He is the biggest midlevel sellout.

What do you mean? He supports midlevels and their encroachment into MD duties?

 

[Siggy]

It was said and meant as a joke. That said, I also agree with @RustedFox in that there is a sizeable sunset of patients who are quick to credit god but blame man.

 

[aafisahar]

God's plan wasn't working out, that's why you see us. Our whole job is to thwart God's plan.

 

[Dr Mantis Toboggan]

What do you mean? He supports midlevels and their encroachment into MD duties?

Anybody who needs a subscription base does this (EMRap etc). Won’t make any money off of just physicians.

 

[turkeyjerky]

Anybody who needs a subscription base does this (EMRap etc). Won’t make any money off of just physicians.

It's a growth market. ABEM next?

 

[thegenius]

I didn't watch this particular episode, as I find the 'rona a total bore. But ZDogg is usually pretty good. His music videos are the best.

I'm really quite bored of it too.

I just joined a pickleball league. One of our opponents just cancelled a match because of a covid exposure. My text read something like "I'm an RN, and even though I was in full PPE, one of my patients tested positive for COVID. So I have an exposure and I don't want to get you sick."

As I'm new to the league and don't know any of these people, I kept my mouth shut. I so badly wanted to reply.

 

[MechEDoc]

My text read something like "I'm an RN, and even though I was in full PPE, one of my patients tested positive for COVID. So I have an exposure and I don't want to get you sick."

Did you thank her for her service as a front line hero? Make sure to reply all when you do so...

 

[thegenius]

Did you thank her for her service as a front line hero? Make sure to reply all when you do so...

LMAO
I should. I totally should!
God I want to

 

[thegenius]

Did you thank her for her service as a front line hero? Make sure to reply all when you do so...

You know...sucks to be a second line hero. Those guys and gals are CHUMPS.

 

[xaelia]

I like to think of myself as a second line hero, tweeting real hard at people from here in my oasis.

I didn't see a single COVID patient in all of 2021.

Still waiting for my first of 2022, but we only have about 20 new cases (only Delta) per day in the entire country.

 

[Matthew9Thirtyfive]

What do you mean? He supports midlevels and their encroachment into MD duties?

His fan base is like 95% midlevels and nurses and he panders to them relentlessly. During the stop scope creep stuff he essentially refused to support it. He said some halfass supporting comment that he knew wouldn’t piss off too many midlevels and then talked about how great they are.

 

[Matthew9Thirtyfive]

You know...sucks to be a second line hero. Those guys and gals are CHUMPS.

Rear of the spear.

 

[Angry Birds]

C'mon now, we all wish we were ZDogg: $$$$. I wonder if he still practices clinical medicine?

 

[Matthew9Thirtyfive]

C'mon now, we all wish we were ZDogg: $$$$. I wonder if he still practices clinical medicine?

He does not (or at least he didn’t as of a few years ago). His practice went under and afaik he only does his online content stuff. I did hear that he occasionally does some locums stuff.

 

[WilcoWorld]

You know...sucks to be a second line hero. Those guys and gals are CHUMPS.

Unless you're in NOLA

Second Line

 

[Birdstrike]

Meta-analysis from researchers at Johns Hopkins, Sweden and Denmark:

"This meta-analysis concludes that lockdowns have had little to no public health effects, they have imposed enormous economic and social costs where they have been adopted. In consequence, lockdown policies are ill-founded and should be rejected as a pandemic policy instrument."

https://sites.krieger.jhu.edu/iae/files/2022/01/A-Literature-Review-and-Meta-Analysis-of-the-Effects-of-Lockdowns-on-COVID-19-Mortality.pdf

Lockdowns are dumb.

 

[aafisahar]

Meta-analysis from researchers at Johns Hopkins, Sweden and Denmark:

"This meta-analysis concludes that lockdowns have had little to no public health effects, they have imposed enormous economic and social costs where they have been adopted. In consequence, lockdown policies are ill-founded and should be rejected as a pandemic policy instrument."

https://sites.krieger.jhu.edu/iae/files/2022/01/A-Literature-Review-and-Meta-Analysis-of-the-Effects-of-Lockdowns-on-COVID-19-Mortality.pdf

Lockdowns are dumb.

Maybe, I think covid was probably too mild to justify lockdowns but at the time, there were too many unknowns. Health systems definitely weren't prepared at the start of the pandemic and lockdowns helped prevent many of them from being overrun. In the US, at least in my part of the woods, no one cared about isolating after the first round and it was basically business as usual.

 

[thegenius]

Maybe, I think covid was probably too mild to justify lockdowns but at the time, there were too many unknowns. Health systems definitely weren't prepared at the start of the pandemic and lockdowns helped prevent many of them from being overrun. In the US, at least in my part of the woods, no one cared about isolating after the first round and it was basically business as usual.

Yea I'm not going to monday morning quarterback lockdowns in the first 6-9 months of the pandemic, but I agree now they would be "dumb" or ineffective.

I would love to test the resolve (actually not really...but you know what I mean) of those who say they are dumb and "it's just another virus" when the next novel virus gets introduced into the population in the future, and it has a CFR of ~5% with R0 of 4. Remember COVID was calculated to have one of about 2%...and that resulted in almost 1M people dead in the US alone over 2 years.

 

[turkeyjerky]

Yea I'm not going to monday morning quarterback lockdowns in the first 6-9 months of the pandemic, but I agree now they would be "dumb" or ineffective.

I would love to test the resolve (actually not really...but you know what I mean) of those who say they are dumb and "it's just another virus" when the next novel virus gets introduced into the population in the future, and it has a CFR of ~5% with R0 of 4. Remember COVID was calculated to have one of about 2%...and that resulted in almost 1M people dead in the US alone over 2 years.

Doubt you'd be impressed. These are the same types of people who come in whining and demanding "the antibodies" the second they have some sniffles.

 

[thegenius]

Doubt you'd be impressed. These are the same types of people who come in whining and demanding "the antibodies" the second they have some sniffles.

A fun exercise is what CFR and R0 would a virus have to have to justify a lockdown. The problem is I think it's impossible for any lockdown with the size of the US to work. Ever. Even if everybody wanted a lockdown.

 

[Birdstrike]

A fun exercise is what CFR and R0 would a virus have to have to justify a lockdown.

Probably none. Because any virus contagious enough to get anyone thinking about something as extreme as a lockdown, isn't going to go away, just because some politicians decided to have a lockdown.

 

[Birdstrike]

More and more studies are coming out showing the value of natural immunity.

JAMA - Natural Immunity Study, from Johns Hopkins University, 2/3/22

Previously infected
99% with antibodies
Durable, at nearly 2 years

Prevalence and Durability of SARS-CoV-2 Antibodies Among Unvaccinated US Adults by COVID-19 History

This study uses serologic testing to characterize natural immunity and the long-term durability of SARS-CoV-2 antibodies among unvaccinated US adults by history of COVID-19 infection.

jamanetwork.com

Were vaccines wasted on those who were already immune during the many months they were in short supply?

Did people who posed no greater risk than those who were vaccinated get fired, disparaged and humiliated, for no good reason?


Disclosure: I'm vaccinated, boosted and have had COVID-19.

 

[thegenius]

This study is one level above nonsense. It's not quite meaningless data. You are applying your reasoning of "durable", but this study does not show that these people are immune. It just shows they have at least one detectable antibody floating around in their blood. That doesn't speak to durable.

So far, still the best measure we have of how good any immunity is at preventing moderate to severe disease is querying people in our emergency departments and hospitals with COVID-19. For delta, about 90% of people we saw in the ER and admitted were not vaccinated. It's lower for omicron, probably still around 75% in my estimation.

The vaccines against COVID-19 are one the true triumphs of our health care system.

Even the study itself says having antibodies doesn't prove immunity. it's right there in the discussion! doh!!!!

Did people who posed no greater risk than those who were vaccinated get fired, disparaged and humiliated, for no good reason?

You cannot conclude that

 

[Birdstrike]

For delta, about 90% of people we saw in the ER and admitted were not vaccinated.

The study was not about vaccine based immunity. No conclusion can be drawn about vaccines or vaccine based immunity from it. The study looked at naturally acquired immunity, specifically. The vaccine discussion is separate.