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Thread: The COVID-19 Discussion Thread (OTB)

  1. #1051
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    Quote Originally Posted by Noclevername View Post
    More like insurance companies want to be convinced your illness is serious enough to be worth paying for.

    If I get into a rant about the US healthcare system I'll probably say things that get me banned for life, so I'll bow out of this subject now.
    Perfectly understandable, I will also refrain from any further comment as I really don't know enough to add anything particularly useful..

  2. #1052
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    FWIW, The checklist that I must complete prior to entering the office includes an at-home temperature check. The checklist is allegedly based on CDC guidelines (IIRC 100.4 is the threshold, but I'd have to confirm).
    Earlier in the pandemic, thermometers were difficult to obtain. At one point, my company even offered free thermometers to those who didn't have one. I own an old-ish digital thermometer, which I wanted to replace earlier this year. I had to settle for purchasing a replacement battery. BTW: I also have a very old mercury thermometer. That one is relegated to backup status.

    A thermometer may not be terribly useful - Mrs Extravoice can detect a fever with the palm of her hand - but one sits in my kit of tools, along with an automatic BP cuff and Pulse Oximeter, to support a potential video conference with my physician
    I may have many faults, but being wrong ain't one of them. - Jimmy Hoffa

  3. #1053
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    Quote Originally Posted by ozduck View Post
    I was wondering if part of the reason for a thermometer at home was because of the differences in 'medical systems' around the world.
    They used to be mercury in glass. I remember my father trying it in a cup of tea, it broke spilling mercury but he drank the tea anyway.
    sicut vis videre esto
    When we realize that patterns don't exist in the universe, they are a template that we hold to the universe to make sense of it, it all makes a lot more sense.
    Originally Posted by Ken G

  4. #1054
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    I think to some extent this is just a cultural norm in operation. Some societies are interested in putting a number to a fever, and some aren't. And in societies that measure the number, the number inevitably gets put to societal use, some of which is not necessarily founded in science.
    The danger would arise if clinicians found themselves doing what's called "treating a number"--assigning some spurious salience to a particular numerical value, rather than incorporating it into a bigger picture involving the patient's other signs, symptoms, history and examination. We're all guilty of that impulse on occasion, but we're all trained not to do it.

    Grant Hutchison
    Last edited by grant hutchison; 2021-Jan-03 at 03:24 PM.

  5. #1055
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    Quote Originally Posted by profloater View Post
    They used to be mercury in glass. I remember my father trying it in a cup of tea, it broke spilling mercury but he drank the tea anyway.
    Yes, never put a glass thermometer with a scale that stops at 42°C into a liquid at 60°C.
    Surprisingly difficult to do yourself harm with metallic mercury, though. People have actually injected themselves with the contents of mercury thermometers in an attempt to kill themselves, without success.

    Grant Hutchison

  6. #1056
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    In the USA, 98.6 is some kind of magical number. As in, OMG, it says 98.9! Pretty much nobody realizes it's just a straight conversion of 37C!

    I have a bit of a cough this morning. Probably just some crud in my throat, but can't help being paranoid!
    Cum catapultae proscriptae erunt tum soli proscript catapultas habebunt.

  7. #1057
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    I had a medical appointment last week and dutifully filled in the front desk COVID questionnaire (including temp scan):

    1. Have you travelled outside of Georgia in the last two weeks. (Yes, to see my in-laws and right at two weeks)
    2. Have you been tested for COVID? (Yes, when I went to visit my in-laws - the quick 15- minute test).
    3. Have you been to an area experience COVID outbreaks) (Well, yes, I went to a COVID ward)
    4. Have you been in close contact with anyone with COVID? (Yes, my in-laws, although all visitors wear PPE.)

    I returned the form to the front desk admin. She looked at it and her eyes got a little wide and said "I need to ask in the back."

    When she came out she asked "Are you having any symptoms?"

    Me: "Nope".

    They let me keep the appointment.
    Last edited by schlaugh; 2021-Jan-03 at 04:45 PM.

  8. #1058
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    We've been doing a lot of our appointments virtual of late. But my wife has one coming up that won't be; she's getting the Botox injections for her migraines.
    Cum catapultae proscriptae erunt tum soli proscript catapultas habebunt.

  9. #1059
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    Quote Originally Posted by Trebuchet View Post
    In the USA, 98.6 is some kind of magical number. As in, OMG, it says 98.9! Pretty much nobody realizes it's just a straight conversion of 37C!
    Which in turn is another magic number--a rounded average from the armpits of 25,000 people in Leipzig in 1851.

    Grant Hutchison

  10. #1060
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    I guess it is a sign of the times that I just heard an ad for cremation services on the radio.

    On the topic of thermometers, I suspect my doctor would prefer my having one handy if I schedule a virtual visit. While the actual number may not be critical, it’s certainly is better than having me answer “I think so” to the question of a fever.
    I may have many faults, but being wrong ain't one of them. - Jimmy Hoffa

  11. #1061
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    Quote Originally Posted by Extravoice View Post
    On the topic of thermometers, I suspect my doctor would prefer my having one handy if I schedule a virtual visit. While the actual number may not be critical, it’s certainly is better than having me answer “I think so” to the question of a fever.
    Well, if your answer to "Why do you think so?" was "I dunno, I just reckon I do," maybe so. But if your answer was, "I'm flushed, sweating and shivering at the same time, and my partner says my bare back is hot and sticky to the touch," probably not so much of a problem.

    (I'm reminded of the friend of my mother's, who fell down stairs one day. Despite the gawdawful racket she made on the way down, she still had to shout for her husband three times before he left the television and came to see what the problem was.
    Lying at the foot of the stairs she told him, "I've broken my ankle."
    "What makes you think that?" he asked.
    "Well, can you hold your foot at this angle?" she replied, indicating the affected part.
    At which point he cemented his Useless Husband credentials by fainting.)

    Grant Hutchison

  12. #1062
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    Quote Originally Posted by grant hutchison View Post
    Yes, never put a glass thermometer with a scale that stops at 42°C into a liquid at 60°C.
    Surprisingly difficult to do yourself harm with metallic mercury, though. People have actually injected themselves with the contents of mercury thermometers in an attempt to kill themselves, without success.

    Grant Hutchison
    At school , mercury was kept in a leather bag. We used to plunge our fingers in a bowl of mercury to feel the pressure. In physics experiments , we had a large suspended coil dipping into a dish of mercury to demonstrate magnetostriction. I can visualise it now so as a teaching aid it worked. Lighthouse lights used to be floating in an annular trough for ultra low friction rotation. Now there is hysteria about it although, of course, it is compounds of mercury that are biologically dangerous.
    sicut vis videre esto
    When we realize that patterns don't exist in the universe, they are a template that we hold to the universe to make sense of it, it all makes a lot more sense.
    Originally Posted by Ken G

  13. #1063
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    For kids in the US, a temperature of 100F is the gateway to a lot of treatment they wouldn't necessarily get otherwise. It's the temperature at which kids get sent home from school. It's the temperature at which doctors suggest bringing them in to be looked at. Knowing that your kid's temperature is above or below 100F is important; come to think of it, we should really try to replace that thermometer we had to throw away.
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  14. #1064
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    We Americans are a simple folk. We like our answers simple and our choices binary. Elevated temp: yes/no, determined by a clear dividing line.
    "I'm planning to live forever. So far, that's working perfectly." Steven Wright

  15. #1065
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    Quote Originally Posted by Noclevername View Post
    We Americans are a simple folk. We like our answers simple and our choices binary. Elevated temp: yes/no, determined by a clear dividing line.
    There's an old rule of thumb in medicine. Before you measure something, ask yourself what you'll do if the result is positive, and what you'll do if the result is negative. If the answer to the two questions is the same, then don't do the test.
    For many people, in many parts of the world, under many circumstances, the result is the same whether they find out their body temperature or not: they still stay off work (because they can't concentrate and feel faint every time they stand up); they still keep their kid off school (because they're not well in other ways); they still phone the doctor (because the kid's been like this for three days and has stopped eating).
    But if you live under circumstances when knowing the number makes a difference to what happens next, then of course you're going to want to know the number. That's what I meant about the "pass-code" function of measuring a person's temperature.
    But it functions as a pass-code largely because it's a thing we can measure, rather than because it's a thing of prime importance. (In my past life, I used to spend a lot of time persuading medical students that the same applies to blood pressure--we measure it because it's a thing we can measure easily, not because it brings us great understanding. The measurement always needs context; the number is not an end in itself.)

    Grant Hutchison

  16. #1066
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    Quote Originally Posted by grant hutchison View Post
    There's an old rule of thumb in medicine. Before you measure something, ask yourself what you'll do if the result is positive, and what you'll do if the result is negative. If the answer to the two questions is the same, then don't do the test.
    OT: A coworker took his dog to the vet. The vet said the dog could have an untreatable serious illness, or something with similar symptoms, but treatable with an inexpensive antibiotic. The only way to determine which disease required very expensive test, which he recommended.

    My coworker thought about it for a while and suggested they just give the dog the antibiotic and see what happens.

    If the vet wanted to satisfy his curiosity, he could pay for it himself.
    I may have many faults, but being wrong ain't one of them. - Jimmy Hoffa

  17. #1067
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    Yes, you're right.

    I think the emphasis on temperature is as a way for laymen to reassure themselves in a way that they can easily understand. To know something tangible, a number, when their health is uncertain and worrying.
    "I'm planning to live forever. So far, that's working perfectly." Steven Wright

  18. #1068
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    Quote Originally Posted by grant hutchison View Post
    I think to some extent this is just a cultural norm in operation. Some societies are interested in putting a number to a fever, and some aren't. And in societies that measure the number, the number inevitably gets put to societal use, some of which is not necessarily founded in science.
    I think that's definitely part of it. I think there's also what Gillianren said about schools setting a threshold. In bureaucratic societies I think institutions like to set standards and numbers, and in Japan as in the US, I think there is a threshold where kids will get sent home from school. So if the kid (small kids tend to be this way) is active but has a fever, if you know the fever you'll know if they'll probably get sent home anyways. It may be that people in Europe (and Australia) are less like that.
    As above, so below

  19. #1069
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    I didn’t hear any detail, but in a local news report I was watching, they claimed that there were a lot of spare ventilators going unused in California ICUs because COVID-19 treatment improvements has meant they could keep more people off them. Elsewhere from what I was reading, it sounds like hospitals are regularly using steroids and antiviral medicine and/or monoclonal antibody treatments on admittance, but again there wasn’t much detail in the story.

    Sounds good, though it depends on details. I wonder what the drug availability is like? I had heard they were getting the mortality rate down earlier. Fewer needed ventilators would sure suggest that.

    "The problem with quotes on the Internet is that it is hard to verify their authenticity." — Abraham Lincoln

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  20. #1070
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    Quote Originally Posted by Van Rijn View Post
    I didn’t hear any detail, but in a local news report I was watching, they claimed that there were a lot of spare ventilators going unused in California ICUs because COVID-19 treatment improvements has meant they could keep more people off them. Elsewhere from what I was reading, it sounds like hospitals are regularly using steroids and antiviral medicine and/or monoclonal antibody treatments on admittance, but again there wasn’t much detail in the story.

    Sounds good, though it depends on details. I wonder what the drug availability is like? I had heard they were getting the mortality rate down earlier. Fewer needed ventilators would sure suggest that.
    I say always check the source material. I try never take a media story for granted unless it cites or links to a reliable source for the information, preferably several for confirmation. Skepticism is the watchword.
    "I'm planning to live forever. So far, that's working perfectly." Steven Wright

  21. #1071
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    A factor in all this is going to be that we know much more about the disease now than we did in the first wave, and one of the things we know is that invasive ventilation can do more harm than good in some instances--the initial "heavy on the ventilator" management that came out of China proved to be less appropriate than people expected from analogy with other viral pneumonias. Intensivist colleagues told me, during the summer, that "if they had to do it again" they'd be much less ready to put people on ventilators.
    So management strategies have now been honed to try to keep a lot of people off ventilation. Patients will be sitting in "ventilator spaces", but not receiving ventilation--part of that will be improvements in other management, but part of it will be because of the de-emphasis of invasive ventilatory support in the management tree.

    Grant Hutchison

  22. #1072
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    Quote Originally Posted by grant hutchison View Post
    There's an old rule of thumb in medicine. Before you measure something, ask yourself what you'll do if the result is positive, and what you'll do if the result is negative. If the answer to the two questions is the same, then don't do the test.
    For many people, in many parts of the world, under many circumstances, the result is the same whether they find out their body temperature or not: they still stay off work (because they can't concentrate and feel faint every time they stand up); they still keep their kid off school (because they're not well in other ways); they still phone the doctor (because the kid's been like this for three days and has stopped eating).
    But if you live under circumstances when knowing the number makes a difference to what happens next, then of course you're going to want to know the number. That's what I meant about the "pass-code" function of measuring a person's temperature.
    But it functions as a pass-code largely because it's a thing we can measure, rather than because it's a thing of prime importance. (In my past life, I used to spend a lot of time persuading medical students that the same applies to blood pressure--we measure it because it's a thing we can measure easily, not because it brings us great understanding. The measurement always needs context; the number is not an end in itself.)

    Grant Hutchison
    That actually makes a lot of sense. I personal think the temperature question, especially from employer, is to make some one think and honestly evaluate themselves. That is kind of contrary to what employers used to do.

    10-15 years ago, I worked at a place that offered a $3000.00 bonus to temporary staff at Christmas time, if they didn't miss any days of work between Dec 15th and Jan 15th. By Dec 20th, people were showing up to work only to suffer through their shift puking into garbage cans for $3000. On Dec. 25th, instead of opening gifts, we sat in the emergency room as all three of my kids were puking.

    The upshot of all of this was, the call center had 25% of their workers, the 25% that were regular workers and did not get that bonus out sick for a whole week. They never did that again*.

    (Edit - before you think I am a monster for doing away with other people's bonuses, I personally wrote the new bonus guidelines. $250 bonus at the first week October for successfully completing 6 weeks of training with less than 1 absence, then an additional $250 for every two weeks with 1 absences and no lates all the way to Jan 31st. It was slightly less money, but more reasonably applied.)
    Last edited by Solfe; 2021-Jan-04 at 02:58 PM.
    Solfe

  23. #1073
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    Quote Originally Posted by Solfe View Post
    That actually makes a lot of sense.
    Thank you. I try my best.

    Grant Hutchison

  24. #1074
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    So…someone who has a PharmD degree just chucked all of that away over some delusional belief in conspiracies?

    Whudda world....whudda world.


    A pharmacist who was arrested on charges that he intentionally sabotaged more than 500 doses of the Covid-19 vaccine at a Wisconsin hospital was “an admitted conspiracy theorist” who believed the vaccine could harm people and “change their DNA,” according to the police in Grafton, Wis., where the man was employed.

    Last month Mr. Brandenburg told his wife, who is in the process of divorcing him, that “the world is crashing down around us,” according to a motion she filed last week asking for sole custody of the couple’s two daughters, 4 and 6, after she learned he was under investigation in the incident at the hospital. She said she feared his reaction if he lost his job.

    In her motion, Gretchen Brandenburg said that on Dec. 6, her husband picked up the children and dropped off a water purifier, a large bucket of powdered milk and two 30-day emergency buckets of food.

    “He told me that if I didn’t understand by now that he is right and that the world is crashing down around us, I am in serious denial,” she said in an affidavit. “He continued to say that the government is planning cyberattacks and plans to shut down the power grid.”
    https://www.nytimes.com/2021/01/04/u...?smid=tw-share

    BTW is there anything outside of mutation that can "change your DNA"?

  25. #1075
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    Quote Originally Posted by Selenite View Post
    So…someone who has a PharmD degree just chucked all of that away over some delusional belief in conspiracies?

    Whudda world....whudda world.
    Delusional beliefs in conspiracies seem quite popular these days. Lots of highly irrational behavior around. Luckily, it doesn’t sound like he caused that much damage (with more care, he probably could have managed to fake a lot of vaccinations before caught, or something else equally nasty). No doubt he is right on the local level - the world is crashing down around him, though he bears a great deal of responsibility for that.

    BTW is there anything outside of mutation that can "change your DNA"?
    Some viruses can. We have many examples of viral DNA incorporated into our DNA, some believed to have been carried for millions of years from our ancestors. CRISPR technology can, some other methods also can. However, an mRNA vaccine won’t.

    "The problem with quotes on the Internet is that it is hard to verify their authenticity." — Abraham Lincoln

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  26. #1076
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    Just hearing in the local news that they don’t have enough regular health worker staff in the state to administer vaccine injections as quickly as they would like, so they created an emergency order to bring in dentists to do it as well. Dentists get plenty of experience administering injections, but it still seems a little odd to think of an army of dentists giving vaccinations. Not in dentist offices, though, but in regular vaccination locations.

    "The problem with quotes on the Internet is that it is hard to verify their authenticity." — Abraham Lincoln

    I say there is an invisible elf in my backyard. How do you prove that I am wrong?

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  27. #1077
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    Quote Originally Posted by Selenite View Post
    BTW is there anything outside of mutation that can "change your DNA"?
    A virus. The human genome is studded with bits of DNA called HERVs (Human Endogenous Retroviruses), which are the relics of retrovirus DNA that infected germ cells, and so ended up being passed from generation to to generation. They seem to provide some benefit, but also contribute significantly to disease. Review here.
    There were early concerns that DNA vaccines (like the Oxford vaccine) might end up being incorporated into the genome. There was even an outside possibility that this might happen with an mRNA vaccine (like Pfizer's), if it were administered to someone who was also infected with a retrovirus (like HIV) that could supply the reverse transcriptase to transcode RNA to DNA. But since then we have thirty years of animal experience with these technologies.
    But the story I've just given, stripped of the thirty years of safety research, is undoubtedly the underpinning of the "Covid vaccines will change our DNA" conspiracy theory.

    ETA: Typing while Van Rijn was posting ...

    Grant Hutchison
    Last edited by grant hutchison; 2021-Jan-05 at 02:20 AM.

  28. #1078
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    Quote Originally Posted by Van Rijn View Post
    Just hearing in the local news that they don’t have enough regular health worker staff in the state to administer vaccine injections as quickly as they would like, so they created an emergency order to bring in dentists to do it as well. Dentists get plenty of experience administering injections, but it still seems a little odd to think of an army of dentists giving vaccinations. Not in dentist offices, though, but in regular vaccination locations.
    Dentists are also trained in managing anaphylaxis, so they're a good choice. At the moment in the UK, with the high prevalence of a more transmissible Covid variant, dentists will be safer and more useful if they get involved in mass vaccinations, and delay performing non-urgent aerosol-generating procedures in their surgeries for a while. Meanwhile, they can wait for their own vaccinations to fire up immunity--my dentist got his first dose at the end of December.

    Grant Hutchison
    Last edited by grant hutchison; 2021-Jan-05 at 02:21 AM.

  29. #1079
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    Yes, I’ve been delaying my regular dentist visits because it seemed a really great way to spread the virus. I’ll be more inclined to go after they are vaccinated, though barring emergency I probably will wait until after my vaccination. I know they have made changes to reduce possible transmission but I still am concerned about what might be in the air or on surfaces from other patients.

    I expect dentists aren’t getting nearly as much business either, so this would be work for them, and extremely important too.

    "The problem with quotes on the Internet is that it is hard to verify their authenticity." — Abraham Lincoln

    I say there is an invisible elf in my backyard. How do you prove that I am wrong?

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  30. #1080
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    Quote Originally Posted by grant hutchison View Post
    ETA: Typing while Van Rijn was posting ...
    Meh, you added much more detail that I was unfamiliar with, so I was happy to see your post. I didn’t realize there was a theoretical way mRNA “code” could be incorporated into DNA via a retrovirus, for instance.

    "The problem with quotes on the Internet is that it is hard to verify their authenticity." — Abraham Lincoln

    I say there is an invisible elf in my backyard. How do you prove that I am wrong?

    The Leif Ericson Cruiser

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