I thought everyone would be interested in what is happening in other countries. Had a call this morning with a co-worker that lives in Germany. She mention the following:

1. Most indoor venues, including restaurants, bars, concert halls, etc. require either proof of vaccination or a negative Covid test in the last 24 hours (not 48 or 72 like we are seeing in the US).
2. To get a Covid test, there are easily accessible locations throughout the cities where you can get a Covid test and the results in less than 30 minutes. The cost of the test is 20 euros and it is not covered by the government or insurance - it must be paid out-of-pocket.

The thinking behind the Covid test requirement is it will drive more people to get the vaccine, since it will help them avoid the 20 euro cost every time they want to go to an indoor establishment. You are able to eat and do other things outside without the vaccination/Covid negative requirement, so this is what a lot of people are doing.

Charging for Covid tests is also starting to happen in the US. For example, unvaccinated students at Meredith College are required to be regularly Covid tested to attend classes this semester and they are being billed for the cost of the tests. I have heard some businesses will also be charging their employees who are unvaccinated for the cost of the Covid tests.

Hmmmmm, was this a poster here? A New Orleans restaurant owner decided to require proof of vaccine.

F-bombs and hate mail: Restaurants take heat when they ask for proof of vaccination - CNN

This part really made me laugh about it could have been someone here:
The restaurant also got some messages criticizing its rule. One message viewed by CNN Business states conspiracy theories, calling Covid fake and the Earth flat. May tried to explain his thinking behind the vaccine requirement by reaching out to some of the critics. "I called as many people [who complained] as I could to say that for me, it's an issue of courtesy," May explained. "It's no different than opening a door for somebody. That's the way I feel about it."

packgrad said:

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GuerrillaPack said:

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Just went to the Chipotle at South Pointe Mall in Durham for the first time since the recent Durham County mask "mandate". They had a sign on the entrance about it, but specifying the medical exemption. I walked in without a mask, and told the first employee I saw that I have a medical exemption. She nonchalantly said "that's fine" and didn't really seem to care at all. Traffic in the store is much lower than usual. Only one other customer was in there when I ordered. No doubt that the mask mandates drive down business.

Also, the manager was interacting with employees without a mask on.

When you see a sign saying "Mask Required To Enter" it seems intimidating. But most places are just putting up those signs to give the appearance of complying with the local ordinance, and most businesses don't want to enforce it and probably aren't. Once you talk to an employee, probably 95% of them don't care if you don't wear a mask for ANY reason. And once you claim a medical exemption, they can't require you to wear one.

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Ate at Sammys on Avent Ferry today. They don't require masks either.

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My wife and I just ate at Shuckers in Wake Forest and they do not require masks either. It is recommended for unvaccinated people, according to the sign on the door. Of course, there is no mask mandate in Wake Forest, so it makes sense they would not require masks. Most of the staff did not have masks on and only a few customers had them on. Went to a restaurant earlier this week and only staff had on a mask. One person entered to pick up their to-go order and they were wearing a mask. No one else had one on and there were no notices on the door as you enter. Since they are in Raleigh, I will not list the name of this restaurant.

I have noticed fewer businesses requiring masks this time around, even in Raleigh.

packgrad said:

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GuerrillaPack said:

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Just went to the Chipotle at South Pointe Mall in Durham for the first time since the recent Durham County mask "mandate". They had a sign on the entrance about it, but specifying the medical exemption. I walked in without a mask, and told the first employee I saw that I have a medical exemption. She nonchalantly said "that's fine" and didn't really seem to care at all. Traffic in the store is much lower than usual. Only one other customer was in there when I ordered. No doubt that the mask mandates drive down business.

Also, the manager was interacting with employees without a mask on.

When you see a sign saying "Mask Required To Enter" it seems intimidating. But most places are just putting up those signs to give the appearance of complying with the local ordinance, and most businesses don't want to enforce it and probably aren't. Once you talk to an employee, probably 95% of them don't care if you don't wear a mask for ANY reason. And once you claim a medical exemption, they can't require you to wear one.

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Ate at Sammys on Avent Ferry today. They don't require masks either.

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If you are ever in CLT, look for Rusty's Deli near South Park. Been around 40+ years or so. Old school, smallish place. Went there last Saturday, they had no signs, no employees were wearing masks, and I only saw one or two take-out customers who were, none who ate-in.

Mormad said:

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https://jamanetwork.com/journals/jama/fullarticle/2783644

Article about expectations for flu this year

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A little bit of post hoc fallacy in the "Unmasking Flu Season" section.

Quote:

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:The unexpected but welcome plummeting of influenza cases during the COVID-19 pandemic "certainly showed that many of the social-distancing things we were doing were very effective,"

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There are an astonishing number of variables. Although Budd seems to acknowledge that more than Schaffner in the article.

Quote:

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In Japan, as well as in some other parts of Asia, it has long been customary for people to wear masks when sick, but "I don't think there is any evidence that flu seasons have been milder in Japan," epidemiologist Benjamin Cowling, PhD

"I would encourage people to consider wearing masks"

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More public health logic for you.

Even the article earlier acknowledges "the flu was essentially nowhere". To then go back and attribute it to NPIs that showed no significant impact to COVID but somehow stopped flu seems a little naive. Especially since the flu was basically nowhere and that includes locations that did not significantly implement NPIs.


My take away is "We don't know what flu season will look like" and public health needs to stop with the post hoc fallacies.

EDIT: TLDR: Stay home if sick.

New paper by Guerra / Guerra:
"We calculated total COVID-19 case growth and mask use for the continental US with CDC data [for fall/winter season]. We did not observe association between mask mandates or use and reduced COVID-19 spread."https://t.co/pwuI5lKu4H

— Jay Bhattacharya (@DrJBhattacharya) August 28, 2021

Quote:

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Our main finding is that mask mandates and use likely did not affect COVID-19 case growth. Mask mandates were associated with greater mask use but ultimately did not influence total normalized cases or post-mandate case growth. Higher mask use [rather than mandates per se] has been argued to decrease COVID-19 growth rates [11] . While compliance varies by location and time, IHME estimates are derived from multiple sources and densely sampled. Even when accounting for population density, higher mask use was not associated with lower Ln or fold maximum growth rates or lower Fall-Winter case growth among continental US states. By contrast, mask use-growth rate association was highly significant at minima. This antinomy warrants consideration. Mask use did not predict normalized cases at growth minima or maxima, whereas there were more cases in the highest than the lowest mask use quintile before minima.

...

In conclusion, we found mask mandates and use to be poor predictors of COVID-19 spread in US states.

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Mask mandates for indoor and outdoor (yes they appear to be coming back) will have little to no effect in slowing and reversing the current Covid Summer wave. The Sumer wave will reverse when more people get vaccinated and the virus runs out of victims from the unvaccinated population that lack prior infection immunity. This is how and why the Winter Wave ended and it is how and why the Summer Wave will end.

Mask mandates are an attempt of politicians and health policy advisors to make it appear they are "doing" something. Restrictions on outdoor gatherings (concerts/sporting events/etc) make it appear they are "doing" something, but they will have limited impact on the Summer Wave. In fact, outdoor gatherings should be encouraged, particularly in Southern states where the Summer Wave was propelled by people moving indoors. It is effectively Winter in the Southern states. In the South in the Summer, people move indoors where it is air conditioned and humidity is low - a perfect environment for the spread of a respiratory virus.

Bottom line, if you are unvaccinated, you have a much higher risk than a vaccinated person of becoming infected. If you become infected, you have a much higher risk of having a bad outcome than a vaccinated person. If you have immunity from prior Covid infection, you are much better protected than the unvaccinated person. Your risk of serious illness, hospitalization, and death is much lower than someone who is unvaccinated and it may be better (see the study I linked yesterday) than the protection from some vaccines.

The CDC, health policy advisors, and politicians are doing a horrible job in communicating the protection people with prior infection immunity have from serious illness. They are lumping this population in with the unvaccinated and it is a mistake. Any guidance with regards to vaccinated and unvaccinated people must include provisions for the previously infected that are inline with vaccinated individuals. Failure to do so, only breads further distrust in those institutions.

I do believe the Summer Wave is close to its peak in the South and other areas of the country. Despite the continued rise in cases, hospitalizations, and deaths, the rates of increase are definitely slowing down. Delta has created more cases, due to its higher transmission levels and it is also creating people with future immunity and protection from future infection. It is a hard way to get out of a wave of infection, but it is a natural process. Vaccines make it much less painful of a process, but many people have chosen to do this the hard way.

So my advice:
1. If you are unvaccinated, get vaccinated. It will be of benefit to you and will be of benefit of those around you who are unvaccinated.
2. If you are vaccinated, feel confident in the vaccines to protect you from serious illness, hospitalization, and death. Will there be exceptions? Yes. Will we see some vaccinated people become infected and become seriously ill? Yes. There are some people for whom the vaccines are not as effective. It is an extremely rare condition, but it will happen. For the vast majority of those who are vaccinated, they are very well protected from infection and if they become infected, protected from serious illness, hospitalization, and death.
3. If you have been previously infected, you should be protected from serious illness, hospitalization, and death. Just like vaccinated people, there are exceptions to this and you do need to consider how much risk you are willing to accept. I would also advise you consult your doctor about getting at least one dose of a vaccine, since doing so appears to offer even better protection.
4. For schools, we have to stop quarantining vast populations when an exposure occurs. If kids are sick, they need to stay at home. if they are well, they need to be in school. If an exposure happens and the kids have masks on, only the sick should be quarantined. The ones who are not sick should be in school.
5. For outdoor events, masks should not be required. As I said above, outdoor events should be encouraged and they should not be something people fear.

Daviewolf83 said:

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Mask mandates for indoor and outdoor (yes they appear to be coming back) will have little to no effect in slowing and reversing the current Covid Summer wave. The Sumer wave will reverse when more people get vaccinated and the virus runs out of victims from the unvaccinated population that lack prior infection immunity. This is how and why the Winter Wave ended and it is how and why the Summer Wave will end.

Mask mandates are an attempt of politicians and health policy advisors to make it appear they are "doing" something. Restrictions on outdoor gatherings (concerts/sporting events/etc) make it appear they are "doing" something, but they will have limited impact on the Summer Wave. In fact, outdoor gatherings should be encouraged, particularly in Southern states where the Summer Wave was propelled by people moving indoors. It is effectively Winter in the Southern states. In the South in the Summer, people move indoors where it is air conditioned and humidity is low - a perfect environment for the spread of a respiratory virus.

Bottom line, if you are unvaccinated, you have a much higher risk than a vaccinated person of becoming infected. If you become infected, you have a much higher risk of having a bad outcome than a vaccinated person. If you have immunity from prior Covid infection, you are much better protected than the unvaccinated person. Your risk of serious illness, hospitalization, and death is much lower than someone who is unvaccinated and it may be better (see the study I linked yesterday) than the protection from some vaccines.

The CDC, health policy advisors, and politicians are doing a horrible job in communicating the protection people with prior infection immunity have from serious illness. They are lumping this population in with the unvaccinated and it is a mistake. Any guidance with regards to vaccinated and unvaccinated people must include provisions for the previously infected that are inline with vaccinated individuals. Failure to do so, only breads further distrust in those institutions.

I do believe the Summer Wave is close to its peak in the South and other areas of the country. Despite the continued rise in cases, hospitalizations, and deaths, the rates of increase are definitely slowing down. Delta has created more cases, due to its higher transmission levels and it is also creating people with future immunity and protection from future infection. It is a hard way to get out of a wave of infection, but it is a natural process. Vaccines make it much less painful of a process, but many people have chosen to do this the hard way.

So my advice:
1. If you are unvaccinated, get vaccinated. It will be of benefit to you and will be of benefit of those around you who are unvaccinated.
2. If you are vaccinated, feel confident in the vaccines to protect you from serious illness, hospitalization, and death. Will there be exceptions? Yes. Will we see some vaccinated people become infected and become seriously ill? Yes. There are some people for whom the vaccines are not as effective. It is an extremely rare condition, but it will happen. For the vast majority of those who are vaccinated, they are very well protected from infection and if they become infected, protected from serious illness, hospitalization, and death.
3. If you have been previously infected, you should be protected from serious illness, hospitalization, and death. Just like vaccinated people, there are exceptions to this and you do need to consider how much risk you are willing to accept. I would also advise you consult your doctor about getting at least one dose of a vaccine, since doing so appears to offer even better protection.
4. For schools, we have to stop quarantining vast populations when an exposure occurs. If kids are sick, they need to stay at home. if they are well, they need to be in school. If an exposure happens and the kids have masks on, only the sick should be quarantined. The ones who are not sick should be in school.
5. For outdoor events, masks should not be required. As I said above, outdoor events should be encouraged and they should not be something people fear.

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Front-page news in Berlin: public health officials will no longer order contact tracing and quarantines for students who might have been exposed to Covid in school. Only the kids who actually test positive will be sent home for remote learning. 1/2https://t.co/Jfvw99H1WK

— Alec MacGillis (@AlecMacGillis) August 28, 2021

It's a cult. They don't care about any of those reasonable points.

caryking said:

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On this forum, we have a bunch of physicians, ER folks and others...

So, I have a question... for those that have not been vaccinated for a number of reason (Hesitant, Health Issues, or down right trust issues), what advice would you give those people that catch Covid 19?

in other words, what Therapy should be used?

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Most won't need any therapy

Some will need steroids

A few will need oxygen, and if admitted for it will get antivirals per protocol

Some may benefit from outpatient mAbs. Results are varied.

I think ivermectin (at human dosing) is a potential benefit. Some promise thus far? Study at oxford on going.

Very, very few will need intubating when looking at the entire infected population. Intubating doesn't kill patients, but covid patients once sick enough to need intubating don't have a very good prognosis.

GuerrillaPack said:

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caryking said:

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On this forum, we have a bunch of physicians, ER folks and others...

So, I have a question... for those that have not been vaccinated for a number of reason (Hesitant, Health Issues, or down right trust issues), what advice would you give those people that catch Covid 19?

in other words, what Therapy should be used?

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Don't go to a hospital. They'll stick you on a ventilator, and that's what will actually kill you.

Once you are in a hospital, you are in their clutches. If you reject the "treatment" that the hospital recommends, they can deny your insurance for the entire visit, and you could be stuck with tens of thousands of dollars in a bill. With all of the extra federal money that goes to "covid cases", that means your hospital stay will be astronomical.

It's a freaking cold/flu. Just stay home, eat healthy and take it easy.

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That's not my experience, and i bet not PA's, but maybe our hospitals just do it right. Who knows?

caryking said:

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On this forum, we have a bunch of physicians, ER folks and others...

So, I have a question... for those that have not been vaccinated for a number of reason (Hesitant, Health Issues, or down right trust issues), what advice would you give those people that catch Covid 19?

in other words, what Therapy should be used?

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I had it in November and it was almost nothing to me.

Night sweats- 1 night
Fever gone next day
Took ibuprofen 2 days for aches
Lost sense of taste and smell 3 days.

I've had the flu. It kicked my ass. Covid was nothing compared to the flu for me. From my experience I see no reason to need a vaccine for it, for myself.

Others I get need it for whatever reasons there may be but I have no fear when it comes to Covid, none, off of my experience.

I don't understand the push to get everyone vaccinated. I do not need one. No one gets a flu shot "to protect everyone else", you get one for yourself. Why is Covid any different?

If you feel like you want one, get one. If you don't, dont.

I largely agree with what you say, down to a similar issue I had, symptoms-wise, back in Jan 2020. Two things that bother me about Covid. It seems to be unpredictable in its impact on a given individual plus the fact that symptoms don't seem to be uniform. Last year, a common complaint was loss of taste, for example, I'm not hearing that one very often these days.

Just wanted to post a thank you to the folks from the medical community who are posting their thoughts, experiences, and data on this. It's sad when a sports forum is the most trustworthy source of information that we have but it's not close - I don't believe a thing I read from the media any more, regardless of who is associated with it. This thread has been both entertaining and informative.

WarrenPeace said:

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caryking said:

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On this forum, we have a bunch of physicians, ER folks and others...

So, I have a question... for those that have not been vaccinated for a number of reason (Hesitant, Health Issues, or down right trust issues), what advice would you give those people that catch Covid 19?

in other words, what Therapy should be used?

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I had it in November and it was almost nothing to me.

Night sweats- 1 night
Fever gone next day
Took ibuprofen 2 days for aches
Lost sense of taste and smell 3 days.

I've had the flu. It kicked my ass. Covid was nothing compared to the flu for me. From my experience I see no reason to need a vaccine for it, for myself.

Others I get need it for whatever reasons there may be but I have no fear when it comes to Covid, none, off of my experience.

I don't understand the push to get everyone vaccinated. I do not need one. No one gets a flu shot "to protect everyone else", you get one for yourself. Why is Covid any different?

If you feel like you want one, get one. If you don't, dont.

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This is myopic as ****.

You have no fear of COVID because you had a milder case. You wouldn't be all "COVID ain't ****" if you'd gotten really sick, or had a really sick family member or had a friend or family member die.

Over 600,000 Americans have died and tens of millions have been hospitalized or seriously ill.

What would those numbers need to be before you'd "understand the push to get everyone vaccinated?" How many millions would need to die? How many tens of millions would need to get seriously ill?

It ain't all about you and your experience man. You don't live on a tiny island nation, population of one. Lots of other Americans out there having different experiences than you.