live and let die?

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One side is listening to science with regard to mask wearing: any kind of vapor barrier that will limit the expulsion (via nose or mouth) of droplets containing viral particles will limit the likelihood of infection. This has been fairly extensively studied (plenty of recent studies on air travel with infected patients), and is the basis for surgeons wearing masks in the OR. It doesn't definitively protect the wearer, but when adopted by a large group of people the risk of transmission is greatly reduced. The anti-mask crowd is just as hysterically ignorant as the anti-vax crowd, and they'll let you know it too. I and other family members have been accosted on several occasions by people claiming knowledge that the whole thing is a joke or plot or fake. It's just amazing. And I am a dyed-in-the-wool Edmond Burkian conservative (that's read 'conservative', not 'Republican', not 'GOP', definitely not 'Trump supporter).

I think the statistics are still off for mortality--all our stats on mortality for other viruses, say influenza, include statistically theorized asymptomatic caseloads, statistically theorized numbers of patients that did not seek care, etc. Most of the COVID stats are just raw data comprised of positive & negative tests and deaths. People claim large numbers of asymptomatic or subclinical undocumented, but they haven't been factored into the current stats.

And you always have to consider the varying degree of experience people have, because people do experience vastly different symptoms. Yes, odds are in your favor like any other illness, but until you have a friend, family member or colleague die after an extensive battle in the ICU, there's a good chance you won't take it as seriously as someone that has.
Not trying diminish the grief and horrible sequelae of those impacted by bad outcome COVID infection.

From listening to lectures and reports by ICU docs, some have suggested that patients may have been inadvertently harmed by medical and ancillary professionals using ventilators cavalierly with unintended lung damage leading to DIC and renal failure when they assumed that a low O2 sat pulse ox reading was sufficient metric for treatment.

Also read reports that in crowded hospital settings, ventilators were used on infected patients to prevent expired aerosolized virus from infecting other patients and health care workers because vents as a closed loop can ensure that expired air from infected patients can be cleaned through HEPA filters integrated to the system.

There are also numerous reports that even low 02 sat symptomatic patients were treated by circumventing ventilation and recovered by being placed in prone position while receiving oxygen by nasal cannula and supportive therapies such as steroids.

During my ICU rotations the most experienced attendings were hesitant to vent patients due to concerns related to exacerbatIon of respiratory decompensation and potential contribution to vent induced DIC and renal failure. Other reported complications included coagulopathies in a setting of hypoxia leading to arrhythmias and cardiac arrest.

Is it possible that much of the infection data and deaths are conflated to a number to beat down an incumbent with almost religious fervor?

Why do some media outlets insist on reporting mere detection of virus in a binary fashion without fleshing out factors like viral load as it relates to disease course?

This seems like an unscientific response potentially capitalizing on fear as a ploy for control and possible manipulation.

By now with so many nations impacted, the scientific community should better understand the difference between mere detection of virus versus true epidemiological relevance.
With all the disparate information being purported by “scientists”, it is difficult to believe in any report’s objectivity.

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Not trying diminish anyone’s grief that has succumbed to COVID. I’m not sure how many people were killed by medical professionals using ventilators incorrectly and causing DIC and renal failure just using pulsox as the read out early on. Some used ventilators to keep patients on a closed loop and to prevent viral spread where O2 support by nasal cannula may have been sufficient to prevent ventilator induced ARDS etcp. All this data and deaths are conflated to a number to beat down an incumbent with almost religious fervor. Also the fact that the media calls all cases detected without really fleshing out what PCR detection in a binary test with no data on viral load and infectivity demonstrates the pure unscientific fear factor. You would think by now we would understand the difference between pure detection of virus versus what it really means epidemiologically would be fleshed out with all of our wonderful “scientists” that are supposed to be objective.

How’s life under that tin foil hat?
 
One side is listening to science with regard to mask wearing: any kind of vapor barrier that will limit the expulsion (via nose or mouth) of droplets containing viral particles will limit the likelihood of infection. This has been fairly extensively studied (plenty of recent studies on air travel with infected patients), and is the basis for surgeons wearing masks in the OR. It doesn't definitively protect the wearer, but when adopted by a large group of people the risk of transmission is greatly reduced. The anti-mask crowd is just as hysterically ignorant as the anti-vax crowd, and they'll let you know it too. I and other family members have been accosted on several occasions by people claiming knowledge that the whole thing is a joke or plot or fake. It's just amazing. And I am a dyed-in-the-wool Edmond Burkian conservative (that's read 'conservative', not 'Republican', not 'GOP', definitely not 'Trump supporter).

I think the statistics are still off for mortality--all our stats on mortality for other viruses, say influenza, include statistically theorized asymptomatic caseloads, statistically theorized numbers of patients that did not seek care, etc. Most of the COVID stats are just raw data comprised of positive & negative tests and deaths. People claim large numbers of asymptomatic or subclinical undocumented, but they haven't been factored into the current stats.

And you always have to consider the varying degree of experience people have, because people do experience vastly different symptoms. Yes, odds are in your favor like any other illness, but until you have a friend, family member or colleague die after an extensive battle in the ICU, there's a good chance you won't take it as seriously as someone that has.

random topic for discussion:
Given the facts that the SARS-COV-2 is highly infectious, airborne and has induced a previously unheard of panic in the human civilization not seen since the bubonic plague outbreak in Europe in the 14th century.
AND
The prospective vaccines at best will be 70% effective vs. the current most common genotype of the virus.
AND
A large number of people either wont have access or wont take the vaccine.
AND
Coronaviridae experience the same genetic drift other non-edited viral replication processes experience allowing it to regularly evade even the partially effective vaccine requiring new vaccines.

LOGICAL COROLLARY: We will be now wearing masking, social distancing and restricting travel INDEFINITELY.
The current status quo has literally no outcome scientifically plausible that will alter the above the facts or the logical corollary (even if an expensive anti-viral is identified in used in rare ICU cases).

The current status quo will continue for the next 2-3 decades with waxing and waning results worldwide.

There is a permanent alteration coming to socialization, education, family dynamics, micro and macro economic functioning, healthcare & general commerce and travel more dramatic than anything seen in the recent centuries of human civilization.

THEORETICAL: Civilization moves either to state of fascist, dictatorial control or one of anarchy under the above transformative conditions.
 
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LADoc, just an aside. . . you have a lot of creative energy for a pathologist, and a knack for entertainment. Have you thought about writing airport fiction like Tom Clancy-type novels? I would totally read.
 
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The virus will definitely alter civilization. I think our best bet is to ramp up AMERICAN MANUFACTURING of therapeutics with antibodies And possibly cytokines inhibitors being our best option like the Regeneron drug.

What happen to Americans? We are turning into the PANSY ASS FRENCH.

We have nothing to fear but fear itself!

TRUMP TRUMP TRUMP!!
 
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What is the clinically valid Ct?

Sorry, I noted after I wrote it that the statement is vague. Ct is an analytical benchmark; the clinical validity is of the assay. What I meant is to demonstrate the clinical validity of a test (wherein the ct threshold value is demonstrated). If the test is for presence/absence of virus above "noise" then the ct value reflects that. If the test is to determine a different value, such as an "infectious" level of virus particles, then the validation for that test (and required ct) would need so be set with validity demonstrating effectiveness with samples known to be from infectious individuals rather than simply those who may have virus present. I would argue this is a silly distinction to make. Theoretically, with knowing the [input] and ct count, you should be able to identify the absolute # of viral particles. Each test needs to be independently validated to demonstrate analytical validity, setting the ct separating signal from noise. For different tests the ct will be different and established for this purpose. If this is done by the manufacturer (typically in FDA-approved tests), then this is simple for subsequent users. If this is done by independent labs as part of an LDT, then you need a robust validation with a lot of contrived and clinical samples to calculate the sensitivity, specificity, and confidence intervals for both at the defined ct set. If one test can demonstrate clinical validity and others are measuring the same analytes, there is no need for those tests to also demonstrate clinical validity.
 
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I understand this part but I still don’t know how a Ct is determined beyond detection To better understand viral load and consequences of viral load as it pertains to infectivity. I understand that higher Cts can introduce noise and result in false positives.

What I don’t understand is why all events are still called detection?

When will there be real analysis of the data as it relates to viral load or other metrics as they relate to severity?

Is merely detecting the virus by RTPCR in a determined number of cycles enough to understand and report out what is happening to individuals with a wide spectrum of clinics manifestation?
 
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random topic for discussion:
Given the facts that the SARS-COV-2 is highly infectious, airborne and has induced a previously unheard of panic in the human civilization not seen since the bubonic plague outbreak in Europe in the 14th century.
AND
The prospective vaccines at best will be 70% effective vs. the current most common genotype of the virus.
AND
A large number of people either wont have access or wont take the vaccine.
AND
Coronaviridae experience the same genetic drift other non-edited viral replication processes experience allowing it to regularly evade even the partially effective vaccine requiring new vaccines.

LOGICAL COROLLARY: We will be now wearing masking, social distancing and restricting travel INDEFINITELY.
The current status quo has literally no outcome scientifically plausible that will alter the above the facts or the logical corollary (even if an expensive anti-viral is identified in used in rare ICU cases).

The current status quo will continue for the next 2-3 decades with waxing and waning results worldwide.

There is a permanent alteration coming to socialization, education, family dynamics, micro and macro economic functioning, healthcare & general commerce and travel more dramatic than anything seen in the recent centuries of human civilization.

THEORETICAL: Civilization moves either to state of fascist, dictatorial control or one of anarchy under the above transformative conditions.
In almost every civilization template there is first the disaster and then the reorganization into the monolith to prevent another disaster then disintegration..... from deluvian through the pharaohs to Rome and beyond. I hope not for us as this pandemic which although deadly and highly infectious is likely one of the least destructive when compared to the famines, plagues, and wars of antiquity or recent history. Unfortunately I have never met so many that have so much compared
to any other time in human history willing to so easily despair and hand it over.
 
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Just as an aside to all this, not sure if this pandemic related but anyone else noticing it now seems to be culturally acceptable to send random nude pics to people you barely know?

Its like millennials are trying the make the dick pic the new handshake or something.

If anyone here applies for a job from me you are advised NOT to send nude pics unless it is really incredible or something. Like Guinness book of worlds records or classic Playboy worthy.
 
This is sounding more like r/conspiracy.
 
random topic for discussion:
Given the facts that the SARS-COV-2 is highly infectious, airborne and has induced a previously unheard of panic in the human civilization not seen since the bubonic plague outbreak in Europe in the 14th century.
AND
The prospective vaccines at best will be 70% effective vs. the current most common genotype of the virus.
AND
A large number of people either wont have access or wont take the vaccine.
AND
Coronaviridae experience the same genetic drift other non-edited viral replication processes experience allowing it to regularly evade even the partially effective vaccine requiring new vaccines.

LOGICAL COROLLARY: We will be now wearing masking, social distancing and restricting travel INDEFINITELY. The current status quo has literally no outcome scientifically plausible that will alter the above the facts or the logical corollary (even if an expensive anti-viral is identified in used in rare ICU cases).

The current status quo will continue for the next 2-3 decades with waxing and waning results worldwide.

There is a permanent alteration coming to socialization, education, family dynamics, micro and macro economic functioning, healthcare & general commerce and travel more dramatic than anything seen in the recent centuries of human civilization.

THEORETICAL: Civilization moves either to state of fascist, dictatorial control or one of anarchy under the above transformative conditions.
Some outposts of the Western world will be allowed to function as things were pre-covid. For example, a prominent forensic pathology social media star has packed up and moved to New Zealand because Trump’s handling of the virus was an “unmitigated disaster.” I did find it odd though that in the same article, this pathologist stated she was looking forward to her children returning to school and also having BBQs with her new New Zealand neighbors. Both of those activities are currently considered suspect by the covid intelligentsia.
I agree with LADoc though. As we move into 2021, I can see all international travelers being required to provide proof of a recent negative covid test or vaccine prior to any travel. Maybe there will be a market for airport point of care testing of covid?
 
This is sounding more like r/conspiracy.
Just as an aside to all this, not sure if this pandemic related but anyone else noticing it now seems to be culturally acceptable to send random nude pics to people you barely know?

Its like millennials are trying the make the dick pic the new handshake or something.

If anyone here applies for a job from me you are advised NOT to send nude pics unless it is really incredible or something. Like Guinness book of worlds records or classic Playboy worthy.
Is this called getting
-Toobined
-Weinered
-Epsteined
-Weinsteined
or Babulinskied?

I’m losing track of all the conspiracies out there.
 
Just as an aside to all this, not sure if this pandemic related but anyone else noticing it now seems to be culturally acceptable to send random nude pics to people you barely know?

Its like millennials are trying the make the dick pic the new handshake or something.

If anyone here applies for a job from me you are advised NOT to send nude pics unless it is really incredible or something. Like Guinness book of worlds records or classic Playboy worthy.

I hope that really old pathologist in your group didn't send you any nude pics. That guy looks like he is pushing 80.
 
Some outposts of the Western world will be allowed to function as things were pre-covid. For example, a prominent forensic pathology social media star has packed up and moved to New Zealand because Trump’s handling of the virus was an “unmitigated disaster.” I did find it odd though that in the same article, this pathologist stated she was looking forward to her children returning to school and also having BBQs with her new New Zealand neighbors. Both of those activities are currently considered suspect by the covid intelligentsia.
I agree with LADoc though. As we move into 2021, I can see all international travelers being required to provide proof of a recent negative covid test or vaccine prior to any travel. Maybe there will be a market for airport point of care testing of covid?

I thought that was odd of her for saying that as well.

I got the impression the move was more a response to frustration with her employer and people she deals with.
 
Some outposts of the Western world will be allowed to function as things were pre-covid. For example, a prominent forensic pathology social media star has packed up and moved to New Zealand because Trump’s handling of the virus was an “unmitigated disaster.” I did find it odd though that in the same article, this pathologist stated she was looking forward to her children returning to school and also having BBQs with her new New Zealand neighbors. Both of those activities are currently considered suspect by the covid intelligentsia.
I agree with LADoc though. As we move into 2021, I can see all international travelers being required to provide proof of a recent negative covid test or vaccine prior to any travel. Maybe there will be a market for airport point of care testing of covid?
This has happened before....although “masked” attenuated in our collective memory and historical selectivity by the depression and WW2. There was a catastrophic global pandemic with much higher death toll and similar power grabs and chaos. We got through it.

 
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I hope that really old pathologist in your group didn't send you any nude pics. That guy looks like he is pushing 80.

You have now scarred me mentally. I must retreat into my hot tub and drink Octoberfest beer to forget....
 
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