Daviewolf83 said:

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This is exactly what I have been trying to say. People are going to start throwing up their hands and and just do what they want to do. I thought CDC was going to release after vaccination guidance today, but apparently they are still not ready.

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Thanks for this link.
Long term care(assisted living) in NC is still requiring a 14 day quarantine if a resident leaves the facility to go for a ride, get a hotdog, see family etc. even though its been well over 14 days since 2nd dose was administered (Feb 18).

Who are we protecting if the residents have had two doses and it has been well over 14 days since the 2nd dose?

I have contacted the State and was told to contact local health dept. My response to that remark was " the local health dept. is waiting on guidance from the state, what is the guidance?"

https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html


However, vaccinated people with an exposure to someone with suspected or confirmed COVID-19 are not required to quarantine if they meet all of the following criteria:

• Are fully vaccinated (i.e., 2 weeks following receipt of the second dose in a 2-dose series, or 2 weeks following receipt of one dose of a single-dose vaccine)
• Are within 3 months following receipt of the last dose in the series
• Have remained asymptomatic since the current COVID-19 exposure

People who do not meet all three of the above criteria should continue to follow current quarantine guidance after exposure to someone with suspected or confirmed COVID-19.
Additionally, individual and societal benefits of avoiding unnecessary quarantine may outweigh the potential but unknown risk of transmission and facilitate the direction of public health resources to people at highest risk for transmitting SARS-CoV-2 to others. This recommendation to waive quarantine for people with vaccine-derived immunity aligns with quarantine recommendations for those with natural immunity, which eases implementation.


Vaccinated healthcare personnel, patients, and residents in healthcare settings
These criteria could also be applied as a strategy to alleviate staffing shortages when considering work restrictions for fully vaccinated healthcare personnel with higher-risk exposures. Of note, exposed healthcare personnel would not be required to quarantine outside of work.
As an exception to the above guidance no longer requiring quarantine for fully vaccinated people, vaccinated inpatients and residents in healthcare settings should continue to quarantine following an exposure to someone with suspected or confirmed COVID-19; outpatients should be cared for using appropriate transmission-based precautions. This exception is due to the unknown vaccine effectiveness in this population, the higher risk of severe disease and death, and challenges with social distancing in healthcare settings. Although not preferred, healthcare facilities could consider waiving quarantine for vaccinated patients and residents as a strategy to mitigate critical issues (e.g., lack of space, staff, or PPE to safely care for exposed patients or residents) when other options are unsuccessful or unavailable. These decisions could be made in consultation with public health officials and infection control expert

https://www.healio.com/news/primary-care/20210304/study-finds-limited-sarscov2-transmission-in-nc-school-districts?utm_source=selligent&utm_medium=email&utm_campaign=news&M_BT=37352048074

https://jamanetwork.com/journals/jama/fullarticle/2777390?guestAccessKey=6bf57d61-4847-4545-b54d-4149d76a0f35&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jama&utm_content=olf&utm_term=030421

Mormad said:

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https://jamanetwork.com/journals/jama/fullarticle/2777343?utm_source=silverchair&utm_campaign=jama_network&utm_content=covid_weekly_highlights&utm_medium=email

Good opinion piece on covid potentially becoming a new yearly flu and mitigation strategies

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Very interesting article. Thanks for posting. I tend agree with the following quote from the article:

"A winter surge of infection with B.1.351 dominance may occur in 2021-2022. Hospitalization and death rates, however, may be expected to be lower, assuming vaccines remain more effective for preventing symptomatic disease and remain effective for preventing severe disease and death. "

The article did confirm what I have been saying with regards to cases. The vaccines will not prevent infection. So using cases to determine public measures to slow the spread is problematic. It the vaccines are truly reducing severity of illness and correspondingly reducing hospitalizations and deaths, wouldn't hospitalization metrics be a better measure than cases?

As to future mitigation strategies, one area the article did not mention was a heavy reliance on rapid-testing to identify those who are infected. In this case, the infected individuals would be isolated and he rest of society would be allowed to continue somewhat normally. I believe this is an area that the federal government should be investing heavily in now, in preparation for the most likely Winter surge.

As to mask wearing, I do not believe yearly mask wearing by the entire population during the Winter seasons will be accepted in the US and many other countries. As I have pointed out on several occasions, mask wearing is accepted in many Asian countries, but masks are ONLY worn by someone who is sick. Healthy people do not wear a mask. I do recognize that Covid-19 seems to produce a higher number of asymptomatic people, so knowing who is sick is difficult. However, having everyone wear a mask during Winter months will be difficult - even in the Asian countries. This is another reason why I believe at-home and employer administered rapid tests are critical in the future. Those countries that can employ this type of approach will have an advantage over those who are using social distancing/lock-down measures to control the spread.

As to yearly social distancing measures, I do not believe these are possible without significant impacts on the economy. Are we going to continue to limit attendance at entertainment and sporting events during the late Fall and Winter months? Are we going to limit seating in indoor restaurants? Are we going to shutdown schools during these months and only have online learning? I just do not see how this is possible and the way to avoid it, I believe, is through more consistent and rapid testing of the population. Let those who are not infected go about their lives unrestricted and restrict those who do become infected.

In the end, I think we, as a society are going to come to accept getting vaccinated every year (like we do with the flu) and come to accept a certain level of severe infection and deaths, just like we do with the yearly flu. Unfortunately, there are risks in living in our environment and these risks can never be zero. Those who believe we can eliminate all risk from Covid-19 are delusional. Just like other transmitted diseases, we will have to come to live with them, use medicine to mitigate the risks, and go about our lives.

Mormad said:

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https://jamanetwork.com/journals/jama/fullarticle/2777343?utm_source=silverchair&utm_campaign=jama_network&utm_content=covid_weekly_highlights&utm_medium=email

Good opinion piece on covid potentially becoming a new yearly flu and mitigation strategies

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Thanks much Mormad, interesting stuff!

Have you read either recently or during your medical education anything that discussed Spanish flu translating to a seasonal flu?

I briefly looked online and didn't see anything that directly addressed the topic. I assume that it it did not translate to a seasonal flu and would be curious to know what epidemiologists or the medical community think was the reason and how it compares in that regard to Covid. Was it because the Spanish flu penetrated the world population much more deeply and approached or achieved heard immunity?

Here's a good article from an expert immunologist regarding the potential benefits of vaccinating people with long-haul Covid symptoms. It also goes into some of the potential causes for these long-haul symptoms which I found to be very interesting.

Vaccines Seem to Help the Symptoms of Long Covid

Good news on the vaccination front. The US has now passed the UK in daily administered vaccine doses, normalizing for population.

Civilized said:

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Mormad said:

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https://jamanetwork.com/journals/jama/fullarticle/2777343?utm_source=silverchair&utm_campaign=jama_network&utm_content=covid_weekly_highlights&utm_medium=email

Good opinion piece on covid potentially becoming a new yearly flu and mitigation strategies

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Thanks much Mormad, interesting stuff!

Have you read either recently or during your medical education anything that discussed Spanish flu translating to a seasonal flu?

I briefly looked online and didn't see anything that directly addressed the topic. I assume that it it did not translate to a seasonal flu and would be curious to know what epidemiologists or the medical community think was the reason and how it compares in that regard to Covid. Was it because the Spanish flu penetrated the world population much more deeply and approached or achieved heard immunity?

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I have no idea, my friend lol

Vaccine trends look like they're getting back on track. I heard on the radio that yesterday they administered 2.9MM shots.

TheStorm said:

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Three (3) days away from being one (1) year since Rudy Gobert tested positive - and four (4) days away from the date the ACC Tournament was cancelled. What a **** show of a year.

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I mark the start of the pandemic as the last day of the ACC Tournament. I was at he tournament the morning it was cancelled, so I could photograph the State vs Duke game for this website. One of my remote cameras was already in place and I was just waiting for the first game between Clemson and FSU to get started. Bands were already playing songs, teams were warming up, and parents/families were in their seats. Next thing you know, I hear one of the local reporters say that Duke just announced they were pulling out of the tournament. I immediately run out to the arena to get some pictures of the empty arena and pictures of the championship trophy being awarded to FSU. I upload the pictures to James for posting on this website, grab a quick lunch in the media center, and head back to Raleigh.

Due to the restrictions put in place, I have been unable to photograph any NC State or high school sporting events, since the last day of the tournament. The high school I shot athletic and fine art events for many years would not allow me on campus to shoot any events for them (they are still restricting attendance, including restrictions on parents). Hopefully, this will all change soon. What an absolutely crazy year it has been.

Daviewolf83 said:

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TheStorm said:

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Three (3) days away from being one (1) year since Rudy Gobert tested positive - and four (4) days away from the date the ACC Tournament was cancelled. What a **** show of a year.

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I mark the start of the pandemic as the last day of the ACC Tournament. I was at he tournament the morning it was cancelled, so I could photograph the State vs Duke game for this website. One of my remote cameras was already in place and I was just waiting for the first game between Clemson and FSU to get started. Bands were already playing songs, teams were warming up, and parents/families were in their seats. Next thing you know, I hear one of the local reporters say that Duke just announced they were pulling out of the tournament. I immediately run out to the arena to get some pictures of the empty arena and pictures of the championship trophy being awarded to FSU. I upload the pictures to James for posting on this website, grab a quick lunch in the media center, and head back to Raleigh.

Due to the restrictions put in place, I have been unable to photograph any NC State or high school sporting events, since the last day of the tournament. The high school I shot athletic and fine art events for many years would not allow me on campus to shoot any events for them (they are still restricting attendance, including restrictions on parents). Hopefully, this will all change soon. What an absolutely crazy year it has been.

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With all that's gone on this past year, I remember the ACC tournament getting cancelled like it was yesterday.

For me, the start of the pandemic officially begin on March 13th. It was a Friday and things were starting to get a bit frenetic at daycares and schools. That was the last day my kids went to daycare for about 2.5 months and I was not in a good place at the beginning of all this. I don't do well with change and obviously wasn't prepared for this.

>75% of deaths reported today are from over 2 weeks ago. Keep going back to that peak well.

packgrad said:

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Seems like there is more and more availability in smaller counties to get the vaccination. I know of several people that have been able to get vaccinated answering last call messages.

If you want to get vaccinated, but aren't in the groups being vaccinated now, I would suggest checking your providers and surrounding area providers daily or a couple of times a week. Better it goes in your arm than in the trash.

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Good idea - have a friend that's a pediatrician so I started asking around and am now on a standby list for Monroe

A couple of positive developments:

1. As mentioned yesterday, a drug Merck has developed and is now in Phase 2/3 trial is showing good results in reducing the viral load and length of time someone is infected with Covid-19. It involves a 5-day dosing treatment. Could have results in April from the trial. Read more here:

Researchers see promise in Covid-19 pill treatment

Merck has better luck with 2nd Covie-19 drug attempt

2. In testing it appears the Pfizer vaccine does a good job at neutralizing the Brazil variant of the virus. This is very good news and helps to show that some variants can be inhibited by the current vaccines. Read more here:

Study: Pfizer vaccine neutralizes Brazil Covid-19 variant

Texas businesses receiving threats over mask wearing

An unfortunately predictable outcome when governors shift mandate responsibility from the government back to businesses, especially small businesses.

One of the many reasons why mandates aren't simply about how much risk each individual is willing to tolerate for themselves. There are many more downstream effects than that.

packgrad said:

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I still don't get the logic behind saying you're for restaurants opening 100%, but being for a mask mandate. To me, it emphasizes the virtue signaling behind masks. I do not understand the logic behind allowing people to sit beside others maskless 3-5' apart or sometimes shoulder to shoulder, with restaurants operating at 100%, for 30 minutes to an hour, or however long you are there, but you need to wear a mask for the seconds it takes to walk to your seat or to the bathroom. That makes no sense to me.

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Yep, in favor of opening and masking because I think it's the right balance to strike. It's imperfect but all choices during this pandemic are imperfect.

Last time I ate inside a restaurant, in September on a road trip not very near civilization and with few other options, it felt like we had our masks on around half-time. 15-20 minutes to order and waiting for your food (taking them down to sip on a drink) and then basically off for 15 minutes or so while eating.

That's not virtue signaling, that's just math. Wearing a mask half-time is better than wearing a mask none of the time.

And restaurants are the most extreme example; in virtually every other business type, clients and customers can wear their masks full-time with no problem.

I'm also very much in favor of governors not shifting the burden of mask communication to small business owners, who already have a ****-ton on our plate and who have already borne a disproportionate economic burden during the pandemic, just to score political brownie points with their constituents.

There are medical reasons and political reasons to keep mandates in place.

There are only political reasons to end mandates. There's no other reason of consequence to do so.