Will you take the mRNA Vaccine Immediately When Available?

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Do you plan on taking either the Moderna or Pfizer mRNA vaccine immediately when available?

  • Yes

    Votes: 170 77.6%
  • No

    Votes: 49 22.4%

  • Total voters
    219
Fair enough. I do during flu season. I personally don't want to get sick with the flu (but I'm not scared of it).

What are your numbers on cognitive impairment? I don't live my life in fear of low-chance theoreticals.
It's not an issue of fear to me, but common sense. I wear a mask as much as possible in flu season because I don't want to get sick, and particularly because I don't want to infect others, especially frail family members. I wear one on planes when visiting my parents because I'm always sitting next to a cougher.

As to fear, I don't find being afraid, or not afraid of an illness a moral issue, or even particularly interesting. I do consider trying to lower morbidity and mortality for all at a minor inconvenience to myself a societal good.

More studies are coming out; here's one.

 
It wouldn’t surprise me if this were the case, tbh. The Covid “fear porn” (as Dr Drew calls it) is an extremely powerful psychological tool.

So is the pressure to note one is "not afraid." The world is scary. It's okay to be afraid. It's not OK to let it rule your life, but it's okay to fear things that are scary, Covid or otherwise.
 
It's not an issue of fear to me, but common sense. I wear a mask as much as possible in flu season because I don't want to get sick, and particularly because I don't want to infect others, especially frail family members. I wear one on planes when visiting my parents because I'm always sitting next to a cougher.

As to fear, I don't find being afraid, or not afraid of an illness a moral issue, or even particularly interesting. I do consider trying to lower morbidity and mortality for all at a minor inconvenience to myself a societal good.

More studies are coming out; here's one.


You sound incredibly reasonable. You wear a mask every flu season, and take extra precautions on a plane. You still do these things with COVID and you haven't changed your risk aversion strategy for COVID. I wish the politicians could be so reasonable.
 
So you have locked yourself in your home and besides work go nowhere so that you can protect others? How long are you going to do that?
Not even close.
I got together with a group and hiked through a park this morning, I just took my kids XMas shopping (with masks on), and tonight I'm getting together with friends to drink whiskey around a fire.

The measures I'm being asked to take in order to decrease my risk of spreading COVID are an inconvenience, but they haven't forced me to put my life completely on hold. I think you're arguing against a straw man.
 
You sound incredibly reasonable. You wear a mask every flu season, and take extra precautions on a plane. You still do these things with COVID and you haven't changed your risk aversion strategy for COVID. I wish the politicians could be so reasonable.
I consider Covid higher risk, because that's what the science says. I do take many more precautions.
 
I agree that health systems and hospitals shouldn’t dictate and prioritize your use of PPE over patient satisfaction metrics. Another sad reality of healthcare as a business.

I’ve never heard people complain in the past that they needed better PPE than a basic surgical mask when taking care of flu patients. Many if not most physicians also didn’t regularly wear a mask during prior flu seasons. That’s one of the reasons I find folks a little fearful and panicked over PPE with this disease.

Before you argue that this isn’t the flu, I’m not arguing it is. That is one of the best comparisons we have regarding our practice with PPE as it relates to widespread viral disease.

I've worn an N95 while caring for suspected flu for the last 10 years. But yeah, I was in the minority with this practice - people would ask why I was putting on "a TB mask" and I'd tell them it's because the surgical masks protect others from me, while the N95 protects me from others.
 
I agree that health systems and hospitals shouldn’t dictate and prioritize your use of PPE over patient satisfaction metrics. Another sad reality of healthcare as a business.

I’ve never heard people complain in the past that they needed better PPE than a basic surgical mask when taking care of flu patients. Many if not most physicians also didn’t regularly wear a mask during prior flu seasons. That’s one of the reasons I find folks a little fearful and panicked over PPE with this disease.

Before you argue that this isn’t the flu, I’m not arguing it is. That is one of the best comparisons we have regarding our practice with PPE as it relates to widespread viral disease.
Because flu shots exist
 
I think almost everyone is going to contract COVID-19 at some point or another regardless of how often or what type of mask they wear.

I’m almost 100% certain that I had it this Spring. I believe many of my colleagues have as well. Most of them likely got it at work. Many who were religious about PPE.

Again, I think almost everyone is going to get it. So I don’t think you can stop the spread to others. Maybe just delay it theoretically.
I mean, you absolutely CAN stop the spread but to do so beyond the slow burn we saw over the summer requires draconian measures that Americans won't tolerate universally.

It kills me - masks and social distancing were to prevent hospitals from getting overwhelmed. That was it. Remember flatten the curve? It wasn't about saving lives or even cutting total cases since as you say we had no idea when/if we'd ever get an effective vaccine or treatment.

I'm not a proponent of this, but now that we have several promising vaccines ready to roll out pending FDA approval this would be the time when lockdowns and whatnot actually could save lives in the long run.
 
It kills me - masks and social distancing were to prevent hospitals from getting overwhelmed. That was it. Remember flatten the curve? It wasn't about saving lives or even cutting total cases since as you say we had no idea when/if we'd ever get an effective vaccine or treatment.

Just to head off an intentional misunderstanding of your post at the pass...

Flattening the curve was about saving lives, just not from COVID. The idea was that, if we kept hospitals from being overwhelmed, you wouldn't have to die from a STEMI b/c the ED & ICU were done filled up with COVID.
 
I don't think people in the ED chose not to wear better PPE solely because they received a flu shot with questionable efficacy.
Perhaps not universally, but I know it's why I don't do anything special in flu season.

And it's efficacy is only questionable in terms of magnitude of benefit.
 
I agree that health systems and hospitals shouldn’t dictate and prioritize your use of PPE over patient satisfaction metrics. Another sad reality of healthcare as a business.

I’ve never heard people complain in the past that they needed better PPE than a basic surgical mask when taking care of flu patients. Many if not most physicians also didn’t regularly wear a mask during prior flu seasons. That’s one of the reasons I find folks a little fearful and panicked over PPE with this disease.

Before you argue that this isn’t the flu, I’m not arguing it is. That is one of the best comparisons we have regarding our practice with PPE as it relates to widespread viral disease.
Yet COVID is more prevalent, more contagious, and more severe than flu.

You can't compare the two, then say "...but don't point out the differences between flu and covid."
 
I wanted to focus solely on PPE and not change the discussion to an argument about what’s worse between COVID-19 and the flu. I brought up TB earlier to make a point and it ended up a fairly fruitless discussion. My point was not to debate the severity of specific diseases, but for folks to examine why certain physicians and society focus on PPE now when they didn’t every flu season.

Did you also wear a N95, P100, PAPR, etc. for every patient or every flu patient during flu season prior to COVID-19?

Solely as it relates to considering the degree of value of PPE, what other infectious disease would you like to use for comparison that is widely present, spreads via airborne transmission and also kills people?
Our standard for flu is a procedural mask, and yes, I wear one. There was an excellent JAMA study showing that a procedural mask is as efficacious as an N-95.

Our standard for Covid at work is a face shield and procedural mask, and I wear that. It is also a newer, more deadly illness. I use airbonre precaustions more frequently, because there is ample evidence of aerosolization and airborne spread. The death rate is much higher than season flu, and the health system is overwhelmed.

It is hard, if not impossible, to compare Covid with any established disease, because we are still learning about it.
 
Our standard for flu is a procedural mask, and yes, I wear one. There was an excellent JAMA study showing that a procedural mask is as efficacious as an N-95.

Our standard for Covid at work is a face shield and procedural mask, and I wear that. It is also a newer, more deadly illness. I use airbonre precaustions more frequently, because there is ample evidence of aerosolization and airborne spread. The death rate is much higher than season flu, and the health system is overwhelmed.

It is hard, if not impossible, to compare Covid with any established disease, because we are still learning about it.

It’s not impossible to compare covid with established flu seasons...we know Covid is less deadly for kids and young folk.

Covid has a rounding error down to ZERO for mortality in the overall ages from 0-49. From 50-64 the ifr is still at 0.4%. Only at above age 70 you hit higher than 1%

Meanwhile flu hospitalizes plus kills orders of magnitude more kids than covid does

Anyone forget the flu season of 2018? (Of course we all did. Hospitals operating at or above capacity is nothing new). ALL of the following are headlines from FLU only two years ago:

"Tallia says his hospital is 'managing, but just barely,' at keeping up with the increased number of sick patients in the last three weeks. The hospital’s urgent-care centers have also been inundated, and its outpatient clinics have no appointments available.”

"Dr. Bernard Camins, associate professor of infectious diseases at the University of Alabama at Birmingham, says that UAB Hospital cancelled elective surgeries scheduled for Thursday and Friday of last week to make more beds available"

“We had to treat patients in places where we normally wouldn’t, like in recovery rooms,” says Camins. “The emergency room was very crowded, both with sick patients who needed to be admitted”

"In CA… several hospitals have set up large 'surge tents' outside their emergency departments to accommodate and treat … patients. Even then, the LA Times reported this week, emergency departments had standing-room only, and some patients had to be treated in hallways.”

"In Fenton, Missouri, SSM Health St. Clare Hospital has opened its emergency overflow wing, as well as all outpatient centers and surgical holding centers, to make more beds available to patients who need them. Nurses are being “pulled from all floors to care for them,”

“it’s making their pre-existing conditions worse,” she says. “More and more patients are needing mechanical ventilation due to respiratory failure”

“From Laguna Beach to Long Beach, emergency rooms were struggling to cope with the overwhelming cases… and had gone into 'diversion mode,' during which ambulances are sent to other hospitals.”

“Hospitals across the state are sending away ambulances, flying in nurses from out of state and not letting children visit their loved ones for fear they’ll spread… Others are canceling surgeries and erecting tents in their parking lots to triage the hordes of… patients.”

“There’s a little bit of a feeling of being in the trenches. We’re really battling these infections to try to get them under control,” McKinnell said. “We’re still not sure if this is going to continue … “

"At Parkland Memorial Hospital in Dallas, waiting rooms turned into exam areas as a medical tent was built in order to deal with the surge of patients. A Houston doctor said local hospital beds were at capacity”

“Dr. Anthony Marinelli says they've seen a major spike in… cases. It's so overwhelmed the community hospital that they've gone on bypass at times -- that means they tell ambulances to bypass this ER and find another.”

“Dr. Atallah, the chief of emergency medicine at Grady, says the hospital called on a mobile emergency department based nearly 250 miles away to help tackle the increasing patient demand. "At 500-plus patients a day you physically just need the space to put a patient in. “







 
😉

We spend a lot more money on healthcare with worse health outcomes than many other countries.

Life expectancy has been declining the last several years despite probable improvement in medical care.

We’re doing something wrong.

I’ve intermittently previously wondered, in theory, if we removed all of healthcare as well as all non-nutritious food such as fast food and soda from society at the same time, would life expectancy go up, down, or stay the same?

I love that you are a doctor and are a skeptic of most of medicine.

Sometimes you just gotta smile at what someone says about your comments and move on to the next thread.
 
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😉

We spend a lot more money on healthcare with worse health outcomes than many other countries.

Life expectancy has been declining the last several years despite probable improvement in medical care.

We’re doing something wrong.

I’ve intermittently previously wondered, in theory, if we removed all of healthcare as well as all non-nutritious food such as fast food and soda from society at the same time, would life expectancy go up, down, or stay the same?
You nailed it. It's not our healthcare system that's the primary driver, it's out fat, lazy populace.
 
I thought life expectancy was down due to overdoses and suicides...
Certainly possible, I haven't ever looked into that.

What I do know is that our obesity and diabetes are the highest among OECD countries by a large margin.
 
You nailed it. It's not our healthcare system that's the primary driver, it's out fat, lazy populace.

And administration.
Google "physicians administrators graph".
There's where all the money goes; right into the hands of the paper pushers who never see and never have seen a patient.
 
Certainly possible, I haven't ever looked into that.

What I do know is that our obesity and diabetes are the highest among OECD countries by a large margin.

I can only hope that the millennials will start to reverse this trend with their super health-conscious ways. The legions of fat Boomers are just spirit crushing.
 
I can only hope that the millennials will start to reverse this trend with their super health-conscious ways. The legions of fat Boomers are just spirit crushing.
If everyone gets in good shape, there will be a lot of underemployed doctors out there
 
If everyone gets in good shape, there will be a lot of underemployed doctors out there

Yet we're in a pandemic now, and the job market is "tight" and the cries of "we need PLPs to fill the doctor shortage gap" echo from coast to coast.

Hmmm.
 
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Yet we're in a pandemic now, and the job market is "tight" and the cries of "we need PLPs to fill the doctor shortage gap" echo from coast to coast.

Hmmm.
Sure, now think what those numbers would be with half as many CAD patients, stroke patients, complications of diabetes patients, and all the other things that stem from being fat and eating junk food.

And in truth us PCP types would get hit worse. I've seen 6 patients so far today. 3 of them had diabetes.
 
Sure, now think what those numbers would be with half as many CAD patients, stroke patients, complications of diabetes patients, and all the other things that stem from being fat and eating junk food.

And in truth us PCP types would get hit worse. I've seen 6 patients so far today. 3 of them had diabetes.

I hear you. I'm not being argumentative (didn't want that to come across; I'm just trying to characterise the situation the best I can).

It's just that it seems like the primary drivers of healthcare "overspending, with worse outcomes" are factors beyond the immediate control of the physician.

1. Administrative bloat.
2. Patient behavior.
3. An incentive to seek inappropriate care.

If the populace is healthier on the whole, the healthcare dollar goes farther. We will still have work, and make a very comfortable living. There will be less "demand" for PLPs. Overall, I see it as a net plus.
 
Certainly possible, I haven't ever looked into that.

What I do know is that our obesity and diabetes are the highest among OECD countries by a large margin.

Yes last year when they came up with the new decline in life expectancy here experts thought that drug overdoses and suicide were 2 of the top drivers. Liver disease also on the rise.

Brief article:
 
Obesity is the primary driver behind everything unhealthy. We have moved more and more to "fat acceptance" because we don't want to shame anyone. So many people now accept that they are fat and don't need to take measures to reduce that. They just assume if they get the sugars, they will just need to take a pill and continue being gourmands.
 
Obesity is the primary driver behind everything unhealthy. We have moved more and more to "fat acceptance" because we don't want to shame anyone. So many people now accept that they are fat and don't need to take measures to reduce that. They just assume if they get the sugars, they will just need to take a pill and continue being gourmands.

Have we really reached "fat acceptance?" This is a common trope (along with the idea of "participation trophies") but what I actually see is that people understand that obesity is unhealthy but that we shouldn't go around mocking people for their weight.
I continue to counsel my patients to quit smoking and lose weight. No boogie man has stopped me from doing this.
 
Does anyone really feel significantly safer depending upon whether or not they wear a surgical mask, N95, face shield, PAPR, combination of several methods, or turn themselves into a bubble boy/girl? I don’t personally find myself feeling remotely any more protected no matter what I use and assume I may or may not become ill. I trust my general focus on health and believe that helps me more than any mask ever will. I’ve continued the same practice just like I always have done in the ED and abroad with exposure to many infectious diseases. Currently, I usually just wear a regular surgical mask for patient encounters even if COVID-19 positive and even though I have ready access to other better PPE options. I’ve seen so many people become infected including those religious about PPE. I still fully believe that we all are going to live the reality of 2019 which roared into the ‘20s. Just like when I’ve ever been exposed to other viral illness in the ED, I’ve found my immunity built up and kept marching on. I know several of you won’t like this post, but please just take a second to consider before dismissing outright.

It's not that I feel significantly safer using proper PPE. It is that I know I am. Science and stuff.
 
Have we really reached "fat acceptance?" This is a common trope (along with the idea of "participation trophies") but what I actually see is that people understand that obesity is unhealthy but that we shouldn't go around mocking people for their weight.
I continue to counsel my patients to quit smoking and lose weight. No boogie man has stopped me from doing this.
Kinda?

 
I don't discuss weight with patients. I used to, and got so many complaints and pushback that I stopped doing it.

Well, how did you do it?
I think it depends on how you say it. I usually say something like, "The number one thing you can do for your health is to quit smoking and -- let's be honest -- we could all afford to lose some weight. Not easy to do but it's really important for your overall health..." etc etc. Then, I talk about intermittent fasting.
 
Well, how did you do it?
I think it depends on how you say it. I usually say something like, "The number one thing you can do for your health is to quit smoking and -- let's be honest -- we could all afford to lose some weight. Not easy to do but it's really important for your overall health..." etc etc. Then, I talk about intermittent fasting.

Something about exceeding structural capacity they were born naturally with.....
 
Well, how did you do it?
I think it depends on how you say it. I usually say something like, "The number one thing you can do for your health is to quit smoking and -- let's be honest -- we could all afford to lose some weight. Not easy to do but it's really important for your overall health..." etc etc. Then, I talk about intermittent fasting.

Honestly, the patients don't listen and don't care. They just want to hear "good boy/girl".

Waste of time, too high of a downside.
 
When you ask a bad question you get a bad answer. Science isn't the problem. It's those asking the wrong questions, and examining those questions in the wrong ways. Hence why many many studies when looked at in a Cochrane review end up showing a wash. Bad question in, bad answer out. Junk food in, obesity out.

Before it's even worth asking if PPE works for a single human-human interaction you have to answer a lot of other questions. These are only a few that I can think of at the moment:
1) Can someone appropriately wear PPE for every human-human interaction?
2) Do viral respiratory diseases ever completely disappear?
3) If they do essentially disappear, what percentage of society is exposed/infected before they disappear?
4) From an evolutionary standpoint, for a species to survive and prosper, is some disease beneficial for strengthening underlying population immunity as a species continues to interact with various other pathogens?
Some others
5) How effective are masks at preventing aerosol spread? (not droplets)
6) If we do nothing would the total number of deaths change?
7) Does social distancing have any impact when aerosols can go 20 feet or more from an infected source?
8) Does 25% capacity afford any benefit at a restaurant versus 50% with "socially distanced tables"
9) Does wearing a mask outdoors have any benefit when not in close contact with others?
10) Why is it safe to fly on an airline, but going to a show with limited capacity and spacing is not safe?
 
Some others
5) How effective are masks at preventing aerosol spread? (not droplets)
6) If we do nothing would the total number of deaths change?
7) Does social distancing have any impact when aerosols can go 20 feet or more from an infected source?
8) Does 25% capacity afford any benefit at a restaurant versus 50% with "socially distanced tables"
9) Does wearing a mask outdoors have any benefit when not in close contact with others?
10) Why is it safe to fly on an airline, but going to a show with limited capacity and spacing is not safe?
In order
- No idea, but as long as the answer is anything better than "not at all" (which there's rough data suggesting it is) it's worth doing.

- Yes, if nothing else due to overwhelmed hospitals.

- Probably. Just because aerosols can travel that far doesn't mean they always do. Plus, innoculant load usually matters and that's likely to be higher at 3 feet than 6 and so on.

- Probably, if for no other reason than this means you have fewer people there if someone who is infected comes in.

- No, and I agree with you that forcing that is stupid.

- Because it turns out that airline air is actually heavily filtered and frequently replaced: How clean is the air on planes?
 
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I don't discuss weight with patients. I used to, and got so many complaints and pushback that I stopped doing it.
I've gone back and forth with this. Initially I did, but I think my approach was wrong. So I went for years without discussing weight. Now I choose to or not based on my rapport with the patient. If I do, then it's a discussion about "the weight," not about them.


Speaking of fat acceptance, we've come a long way. Remember when this was "the fat kid"?
1607420608556.png
 
I've gone back and forth with this. Initially I did, but I think my approach was wrong. So I went for years without discussing weight. Now I choose to or not based on my rapport with the patient. If I do, then it's a discussion about "the weight," not about them.


Speaking of fat acceptance, we've come a long way. Remember when this was "the fat kid"?
View attachment 324614
Watching old movies and tv shows really makes you realize how effed up the “normal” is in the Western world today. The health of society is definitely in crisis, and it isn’t just from covid-19. We do a disservice to public health by ignoring it.
 
Well, he doesn't even compare to the departed Dr.McNinja, who, essentially, said that everything we did, did nothing. And I know and like the guy!
What happened to Dr. McNinja? When did he leave? Why? So many questions...
 
Something about doxxing or threats in the real world or something.

Doxxed to one degree or another.
Aww man, I didn't know that! Lousy.

It's surprising to me, because McNinja struck me as the kind of person who would've said anything he posted here in real life, to your face, without blushing.
 
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Aww man, I didn't know that! Lousy.

It's surprising to me, because McNinja struck me as the kind of person who would've said anything he posted here in real life, to your face, without blushing.
He is, but, he's got a wife and kids, too. If it was just him, he wouldn't be gone. Me, I got nothing to lose.
 
He is, but, he's got a wife and kids, too. If it was just him, he wouldn't be gone. Me, I got nothing to lose.
I seem to remember his wife getting lots of hate for posting a pro-vaccine video on her practice FB page.
 
I don't work inpatient, so I'm low on the list, but my friends who do work inpatient have started getting emails about setting up appointments.

For those not wanting the Pfizer or Moderna vaccines. Will you be ok with getting the AstraZeneca or Johnson and Johnson vaccines?
 
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