Will Pain Medicine Ever Go Back to "Normal" After COVID?

[drusso]

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When will we go back to dinners and drinks with reps, thought leader "focus groups," Instagram whoring, etc?

 

[Dr. Ice]

When will we go back to dinners and drinks with reps, thought leader "focus groups," Instagram whoring, etc?

Never

 

[SommeRiver]

I don't see why any of that is on hold now TBH.

 

[Disciple]

When will we go back to dinners and drinks with reps, thought leader "focus groups," Instagram whoring, etc?

Maybe it will just be “different”. My ex-military sniper pharma rep said he would give me lessons at the range.

Actually, our restaurants are finally reopening for indoor, end of the month.

Getting my vaccine and back to drinks and steaks.

 

[Agast]

When will we go back to dinners and drinks with reps

That one I never really understood. I’d rather pay for dinner with my husband than have free dinner with a rep.

 

[drusso]

What's the basis for people's optimism?

 

[lobelsteve]

What's the basis for people's optimism?

Lots of westies posting outdoor pics with blue skies.

 

[SSdoc33]

we have another year of this.

just b/c you get a shot, you are not necessarily out of the woods. masks until next summer at the earliest. this sucks

 

[Ferrismonk]

Honestly, I think we could go back to normal now, however the media has everyone in such a frenzy I don't think it'll ever go back to "normal".

Fact is, it is always safer, for most any communicable disease, to wear a mask everywhere and social distance. As long as people value their safety (or politicians value control) above individual freedom and liberty, we'll continue this mask-wearing social-distance experiment. It's a value judgement more than anything else.

 

[SSdoc33]

Honestly, I think we could go back to normal now, however the media has everyone in such a frenzy I don't think it'll ever go back to "normal".

Fact is, it is always safer, for most any communicable disease, to wear a mask everywhere and social distance. As long as people value their safety (or politicians value control) above individual freedom and liberty, we'll continue this mask-wearing social-distance experiment. It's a value judgement more than anything else.

so much wrong with your take.

its not a value judgement, its not a social-distance experiment, its not about political control, its not the media's fault.

its about keeping people alive. that has to be the first priority. if your "individual freedom and liberty" is infringed upon, yes that stinks, but it has to happen right now. we know what happens when we don't follow the guidelines.

 

[drusso]

so much wrong with your take.

its not a value judgement, its not a social-distance experiment, its not about political control, its not the media's fault.

its about keeping people alive. that has to be the first priority. if your "individual freedom and liberty" is infringed upon, yes that stinks, but it has to happen right now. we know what happens when we don't follow the guidelines.

Sweden made all the right choices. We should emulate Sweden.

Sweden has escaped a second coronavirus wave so far. The question is why

Sweden’s relatively low-key approach to coronavirus lockdowns captured the world’s attention, but the strategy's effectiveness remains unclear.

www.latimes.com

"The way Sweden’s strategy was viewed outside the country seems to depend largely on what stage of the pandemic the observer was experiencing at the time. Initially, many abroad were incredulous at images of Swedes dining with friends in restaurants or sipping cocktails on the Stockholm waterfront. Some were envious that Swedish businesses were not forced to close."

 

[SSdoc33]

Sweden made all the right choices. We should emulate Sweden.

Sweden has escaped a second coronavirus wave so far. The question is why

Sweden’s relatively low-key approach to coronavirus lockdowns captured the world’s attention, but the strategy's effectiveness remains unclear.

www.latimes.com

"The way Sweden’s strategy was viewed outside the country seems to depend largely on what stage of the pandemic the observer was experiencing at the time. Initially, many abroad were incredulous at images of Swedes dining with friends in restaurants or sipping cocktails on the Stockholm waterfront. Some were envious that Swedish businesses were not forced to close."

so, 1 million deaths american sounds pretty good to you?

Sweden tried “Herd Immunity” to deal with Coronavirus; it resulted in a death rate many times larger than its neighbors.

Sweden tried “Herd Immunity” to deal with Coronavirus; it resulted in a death rate many times larger than its neighbors.

www.wmnf.org

World Health Organization COVID-19 death rates per million.

Country	Deaths/million
United States	597.07
Brazil	634.81
Sweden	580.64
Norway	49.07
Finland	61.18
Denmark	109.6

 

[clubdeac]

so, 1 million deaths american sounds pretty good to you?

Sweden tried “Herd Immunity” to deal with Coronavirus; it resulted in a death rate many times larger than its neighbors.

Sweden tried “Herd Immunity” to deal with Coronavirus; it resulted in a death rate many times larger than its neighbors.

www.wmnf.org

World Health Organization COVID-19 death rates per million.

Country	Deaths/million
United States	597.07
Brazil	634.81
Sweden	580.64
Norway	49.07
Finland	61.18
Denmark	109.6

That's not the end of the story though. While most all other European countries are seeing a second wave, Sweden is not. The reason being of course is b/c they did not lock down. It's too early to tell yet which strategy works better or at all.

 

[hyperalgesia]

Our mitigation efforts were never advertised as changing the final outcome of the virus. They were supposed to just prevent healthcare capacity overload.

Somewhere along the line, liberals started to imagine their government could legislate the virus out of existence.

 

[deleted131481]

Our mitigation efforts were never advertised as changing the final outcome of the virus. They were supposed to just prevent healthcare capacity overload.

Somewhere along the line, liberals started to imagine their government could legislate the virus out of existence.

Flattening the curve until a vaccine comes out would change the final outcome in terms of death toll.

That is assuming the vaccine is semi-effective.

 

[Disciple]

we have another year of this.

just b/c you get a shot, you are not necessarily out of the woods. masks until next summer at the earliest. this sucks

Masks are fine. Capacity limits and proper spacing is fine.

Keeping businesses completely closed is unnecessary at this point.

 

[drusso]

Masks are fine. Capacity limits and proper spacing is fine.

Keeping businesses completely closed is unnecessary at this point.

I feel bad for the small businesses and their families who were economy devastated due to the draconian actions of some governments.

 

[Ferrismonk]

so much wrong with your take.

its not a value judgement, its not a social-distance experiment, its not about political control, its not the media's fault.

its about keeping people alive. that has to be the first priority. if your "individual freedom and liberty" is infringed upon, yes that stinks, but it has to happen right now. we know what happens when we don't follow the guidelines.

That's a value judgement...

Yes, we know what will happen. 99.5% of those who get infected will be just fine.

 

[SSdoc33]

Masks are fine. Capacity limits and proper spacing is fine.

Keeping businesses completely closed is unnecessary at this point.

Which businesses? Bars simply cannot be open right now. Gyms? Maybe but with big capacity limits. I don't want to eat inside a restaurant and most people i know dont either. Hair salons? Convenience stores? Hardware stores? Movie theaters?

These small business can operate but they need to have restrictions. I feel bad for them as well but Covid took away their livelihoods, not the government.

 

[SSdoc33]

That's a value judgement...

Yes, we know what will happen. 99.5% of those who get infected will be just fine.

Outright misinformation. 3 % will die, 97% will live, some with long term health consequences.

 

[SSdoc33]

That's not the end of the story though. While most all other European countries are seeing a second wave, Sweden is not. The reason being of course is b/c they did not lock down. It's too early to tell yet which strategy works better or at all.

Actually, nobody knows why they are not spiking right now. It is not bc of herd immunity.

If history of your posts is any indication, i suspect sweden will soon have a second wave and you will be wrong again. Ill be sure to point that out when it happens

 

[hyperalgesia]

Actually, nobody knows why they are not spiking right now. It is not bc of herd immunity.

Nobody, except you, apparently...

 

[SSdoc33]

Nobody, except you, apparently...

Ffs, do your research....

Sweden has escaped a second coronavirus wave so far. The question is why

Sweden’s relatively low-key approach to coronavirus lockdowns captured the world’s attention, but the strategy's effectiveness remains unclear.

www.google.com

Whether this is due to the Swedish government’s strategy, however, is still uncertain.

 

[hyperalgesia]

Ffs, do your research....

Sweden has escaped a second coronavirus wave so far. The question is why

Sweden’s relatively low-key approach to coronavirus lockdowns captured the world’s attention, but the strategy's effectiveness remains unclear.

www.google.com

Whether this is due to the Swedish government’s strategy, however, is still uncertain.

That might be a real quagmire for the LA Times and the "Associated Mess" and all their experts. A real head-scratcher.

But to the rest of us, "herd immunity" is not all or nothing. We have a diverse population who are doing all different things that make them anywhere from highly vulnerable to completely immune. When the most vulnerable get the virus, spread it to other vulnerable people, and develop immunity along the way, all while the less vulnerable are able to isolate themselves, you see a curve like Sweden's.

 

[VA Hopeful Dr]

Outright misinformation. 3 % will die, 97% will live, some with long term health consequences.

Not really.

I'm in SC, our death rate is around 2%. But given that our percent positive rate is still above 10% (15 most days) we know we're missing cases so the death rate is almost certainly less than 2%.

This also hasn't been out long enough to know about truly long term health consequences.

 

[Tramadeezy]

I think several prevalence studies have shown random positive rates in the teens. Cdc says case rate could be 10x higher. Hard to buy into 3% death rate if you believe those numbers.

 

[SSdoc33]

Not really.

I'm in SC, our death rate is around 2%. But given that our percent positive rate is still above 10% (15 most days) we know we're missing cases so the death rate is almost certainly less than 2%.

This also hasn't been out long enough to know about truly long term health consequences.

im sorry. 2 will die then. not 3.

SMH

 

[SSdoc33]

I think several prevalence studies have shown random positive rates in the teens. Cdc says case rate could be 10x higher. Hard to buy into 3% death rate if you believe those numbers.

i also tend to believe that the case fatality rate is lower than the current numbers suggest.

but the fact remains that if we go down the herd immunity path (which is what some posters seem to be advocating for) then we are still looking at 1-2 million american deaths.

 

[SSdoc33]

That might be a real quagmire for the LA Times and the "Associated Mess" and all their experts. A real head-scratcher.

But to the rest of us, "herd immunity" is not all or nothing. We have a diverse population who are doing all different things that make them anywhere from highly vulnerable to completely immune. When the most vulnerable get the virus, spread it to other vulnerable people, and develop immunity along the way, all while the less vulnerable are able to isolate themselves, you see a curve like Sweden's.

dont be lazy and criticize the source. criticize the content.

drusso linked to the exact same article as i did, but strangely you didnt mention a peep when he posted it.

 

[VA Hopeful Dr]

i also tend to believe that the case fatality rate is lower than the current numbers suggest.

but the fact remains that if we go down the herd immunity path (which is what some posters seem to be advocating for) then we are still looking at 1-2 million american deaths.

im sorry. 2 will die then. not 3.

SMH

How odd that these 2 posts were back to back. Especially since my post that you snarked back at said the exact same thing that I put in bold above.

Snark isn't necessary and if we're to maintain what credibility we have we need to be accurate if we're trying to convince people of the need to take significant actions that will affect their lives in significant ways.

The CFR is very odd in this. In countries with low percent positive rates and high amounts of testing, we're still seeing weirdly high CFRs. Compare that to places like us with high percent positives and not super high testing rates per population yet we have low CFR (this being despite hospitals doing lots of testing on critically ill/deceased patients). On the whole, our population is younger than lots of the places with better testing like most os Europe but the same as NZ and Australia. We have more ICU beds and CC-trained doctors per capita than pretty much anywhere, but most OECD countries aren't getting overwhelmed. So I really am confused why the numbers are so different place to place.

 

[SSdoc33]

How odd that these 2 posts were back to back. Especially since my post that you snarked back at said the exact same thing that I put in bold above.

Snark isn't necessary and if we're to maintain what credibility we have we need to be accurate if we're trying to convince people of the need to take significant actions that will affect their lives in significant ways.

The CFR is very odd in this. In countries with low percent positive rates and high amounts of testing, we're still seeing weirdly high CFRs. Compare that to places like us with high percent positives and not super high testing rates per population yet we have low CFR (this being despite hospitals doing lots of testing on critically ill/deceased patients). On the whole, our population is younger than lots of the places with better testing like most os Europe but the same as NZ and Australia. We have more ICU beds and CC-trained doctors per capita than pretty much anywhere, but most OECD countries aren't getting overwhelmed. So I really am confused why the numbers are so different place to place.

it wasnt snark.

my point is that when you go from 3 to 2% death rate, it is still a lot of deaths.

the numbers aren't easy to figure out. i agree. if everyone used the same guidelines then we would have much better data. this is where reliance on a central body (the WHO) would help. not to make everything political, but trumps disdain and lack of funding for the WHO compound the mess.

btw, who is going to win your senate race down there in SC?

 

[lobelsteve]

it wasnt snark.

my point is that when you go from 3 to 2% death rate, it is still a lot of deaths.

the numbers aren't easy to figure out. i agree. if everyone used the same guidelines then we would have much better data. this is where reliance on a central body (the WHO) would help. not to make everything political, but trumps disdain and lack of funding for the WHO compound the mess.

btw, who is going to win your senate race down there in SC?

If Hilary would have won, no one would have died. Except in Benghazi.

 

[callmeanesthesia]

What worries me in the most are the studies showing long term cardiovascular effects in a much larger percentage, even in those who had a relatively minor illness. Even 0.5% death rate, if applied to the whole US population, is bad enough but the long-term ramifications of a herd immunity strategy could be tens of millions of cases of heart failure. No way of knowing yet.

Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From COVID-19

This cohort study evaluates the presence of myocardial injury in unselected patients recently recovered from coronavirus disease 2019 (COVID-19).

jamanetwork.com

 

[VA Hopeful Dr]

it wasnt snark.

my point is that when you go from 3 to 2% death rate, it is still a lot of deaths.

the numbers aren't easy to figure out. i agree. if everyone used the same guidelines then we would have much better data. this is where reliance on a central body (the WHO) would help. not to make everything political, but trumps disdain and lack of funding for the WHO compound the mess.

btw, who is going to win your senate race down there in SC?

Fair enough, I read too much into it. My apologies. I agree Trump didn't handle this well but with America being America I don't think anyone could have handled this well here. Just somewhat less badly.

I still think Graham is going to pull it out. He's had the same percent pretty much every single election which is actually higher than Strom Thurmond's last election. So it'll be closer than usual but he's still pretty well liked down here.

 

[SSdoc33]

If Hilary would have won, no one would have died. Except in Benghazi.

now THAT is snark

 

[Ducttape]

That's not the end of the story though. While most all other European countries are seeing a second wave, Sweden is not. The reason being of course is b/c they did not lock down. It's too early to tell yet which strategy works better or at all.

Mask sales surge in Sweden after it warns it may advise wearing them

Unlike most other European countries, Sweden has kept many businesses, restaurants and most schools open, while not recommending the use of face masks.

www.dailymail.co.uk

(fwiw, biased information source)

Masks are fine. Capacity limits and proper spacing is fine.

Keeping businesses completely closed is unnecessary at this point.

if you are talking about the whole country, maybe so. but individual states or local communities may need to shut down and unfortunately it is immediately a political issue.


with regards to Sweden:

10 takeaways from Sweden’s controversial approach to the coronavirus pandemic

Individual responsibility — not strict government intervention — is at the core of the country’s strategy. How’s it working and what lessons are there for the rest of us?

www.ocregister.com

I think point #9 and 10 are most apropos.

 

[Ferrismonk]

Outright misinformation. 3 % will die, 97% will live, some with long term health consequences.

Coronavirus (COVID-19) Overview

COVID-19 is a new type of coronavirus that causes mild to severe cases. Here’s a quick guide on how to spot symptoms, risk factors, prevent spread of the disease, and find out what to do if you think you have it.

www.webmd.com

 

[clubdeac]

Again, the true CFR is somewhere b/w 0.3-0.6%. Please quit saying it's 2-3%. I thought we debunked this conspiracy theory months ago

 

[SSdoc33]

That's not the end of the story though. While most all other European countries are seeing a second wave, Sweden is not. The reason being of course is b/c they did not lock down. It's too early to tell yet which strategy works better or at all.

Mazel tov. it took you an entire 2 days to be proven wrong. to be fair, most of your comments are disproven immediately

COVID rising again in Sweden amid return to 'hugs and parties': PM

Some areas of Sweden are seeing a worrying resurgence of coronavirus infections because many people seem to have set aside months of caution in favour of full-on social life once again, its prime minister said on Thursday.

www.reuters.com

 

[clubdeac]

Mazel tov. it took you an entire 2 days to be proven wrong. to be fair, most of your comments are disproven immediately

COVID rising again in Sweden amid return to 'hugs and parties': PM

Some areas of Sweden are seeing a worrying resurgence of coronavirus infections because many people seem to have set aside months of caution in favour of full-on social life once again, its prime minister said on Thursday.

www.reuters.com

Took only 43 minutes to disprove your post. To be fair, most or your comments are disproven immediately.

Sweden COVID - Coronavirus Statistics - Worldometer

Sweden Coronavirus update with statistics and graphs: total and new cases, deaths per day, mortality and recovery rates, current active cases, recoveries, trends and timeline.

www.worldometers.info

 

[SSdoc33]

Took only 43 minutes to disprove your post. To be fair, most or your comments are disproven immediately.

Sweden COVID - Coronavirus Statistics - Worldometer

Sweden Coronavirus update with statistics and graphs: total and new cases, deaths per day, mortality and recovery rates, current active cases, recoveries, trends and timeline.

www.worldometers.info

 

[Ducttape]

I think if you look at the Daily New Cases curve, on first glance, it looks as if there is no real change in the number of new cases.

however, use the 7 day moving tracker, and the graph changes.

for example:

from August 31, the rolling 7 day average was as low as 114 new cases per day. it currently is at 326 new cases.

 

[clubdeac]

CASES MEAN NOTHING!!!!! Cases have been increasing almost everywhere. However deaths have remained stagnant in most states and other countries. There is a huge disconnect here

 

[SSdoc33]

CASES MEAN NOTHING!!!!! Cases have been increasing almost everywhere. However deaths have remained stagnant in most states and other countries. There is a huge disconnect here

yes. the disconnect is that you have no idea what you are talking about. "deaths remain stagnant"? WTF? you just posted the site which shows a steadily rising death toll.our death total continues to climb daily. up well past 200K.

i think what you are trying to say is that that death RATE has gone down. that is true, as healthier/younger people get the virus and we get better at treating it.

 

[Ducttape]

CASES MEAN NOTHING!!!!! Cases have been increasing almost everywhere. However deaths have remained stagnant in most states and other countries. There is a huge disconnect here

that is inaccurate. the number of cases do matter with the appropriate context in which that number is reported. that's why you need to look at the infection rate in addition to the number of cases.

remember that deaths typically lag case discovery by about 2-3 weeks, just as diagnosis usually lags exposure by about 3 weeks.

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please do not conflate CFR and IFR. case fatality rate is the rate of deaths with respect to the known cases. IFR is the actual rate that the disease kills someone. the CFR is currently 2.9%, but that is because of more testing here than elsewhere. more testing will lower the CFR.

the IFR is probably around 0.6%. there is no evidence that CFR is 0.3%, particularly since the, well, kill rate of the virus is suspected to be 6 times that of seasonal flu (which is 0.1%). CFR in the US is 2.9% and not 0.6% but it would be lower and closer to 0.6% if we did more testing.



and a low CFR does not obviate the fact that there are more deaths in the US from COVID than in any other country so far. just because the US probably keeps better records does not obviate the fact that 200,000 Americans are dead from the disease and we could have and can do better.... look at the website you posted and check out what would happen...

IHME | COVID-19 Projections

Explore forecasts of COVID-19 cases, deaths, and hospital resource use.

covid19.healthdata.org

 

[clubdeac]

yes. the disconnect is that you have no idea what you are talking about. "deaths remain stagnant"? WTF? you just posted the site which shows a steadily rising death toll.our death total continues to climb daily. up well past 200K.

i think what you are trying to say is that that death RATE has gone down. that is true, as healthier/younger people get the virus and we get better at treating it.

Let me use a graph since you may understand pictures better than words. Cases have skyrocketed as testing has increased. Ssdoc, can you tell the class what the bottom line is showing on the graph

 

[clubdeac]

that is inaccurate. the number of cases do matter with the appropriate context in which that number is reported. that's why you need to look at the infection rate in addition to the number of cases.

remember that deaths typically lag case discovery by about 2-3 weeks, just as diagnosis usually lags exposure by about 3 weeks.

-------
please do not conflate CFR and IFR. case fatality rate is the rate of deaths with respect to the known cases. IFR is the actual rate that the disease kills someone. the CFR is currently 2.9%, but that is because of more testing here than elsewhere. more testing will lower the CFR.

the IFR is probably around 0.6%. there is no evidence that CFR is 0.3%, particularly since the, well, kill rate of the virus is suspected to be 6 times that of seasonal flu (which is 0.1%). CFR in the US is 2.9% and not 0.6% but it would be lower and closer to 0.6% if we did more testing.



and a low CFR does not obviate the fact that there are more deaths in the US from COVID than in any other country so far. just because the US probably keeps better records does not obviate the fact that 200,000 Americans are dead from the disease and we could have and can do better.... look at the website you posted and check out what would happen...

IHME | COVID-19 Projections

Explore forecasts of COVID-19 cases, deaths, and hospital resource use.

covid19.healthdata.org

You’re right, I meant IFR as this really is more important and more accurately reflects the likelihood of dying if you contract the virus as opposed to the likelihood of you dying if you contract the virus AND have symptoms - CFR

 

[SSdoc33]

Let me use a graph since you may understand pictures better than words. Cases have skyrocketed as testing has increased. Ssdoc, can you tell the class what the bottom line is showing on the graph

i guess you were absent the days they taught EVERYTHING in medical school.

even the graph you posted (which is extremely flawed b/c of the scale of the Y-axis ) shows steadily increasing deaths.