Corona Virus: It's a Marathon, Not a Sprint

[Zaxxon]

Ed Yong with another long long-COVID piece at The Atlantic this morning.

[msteelers]

My mom has gotten much better and has a lingering cough, but that's it. Her 10-day isolation will be up by the end of the week. Luckily, it doesn't seem like my immunocompromised step-father caught it. Or if he did, he was asymptomatic because of his vaccine and antibody treatment.

Now multiple people at my wife's work are coming down with it. She works at a veterinarian's office as a receptionist. It's a small building with 3-4 doctors, the workers are crammed in there like sardines, and my wife is the only one who wears a mask all day long. They used to have a mask mandate for employees, but got rid of that when the CDC said vaccinated people could take their masks off (her employer does NOT require staff to have a vaccine). They also used to keep the clients outside of the building, but a few months ago decided it was time to let the clients back inside (just as Delta started swirling here in Florida).

About a week ago an old man, unmasked of course, sat in the lobby for an hour before going into a small room with two vet techs (also unmasked). He then proceeded to tell them that he had COVID. One of those vet techs later tested positive and even ended up at the hospital for a bit. She's doing ok now, but she's going to miss out on nearly a month of work. And she has two young children at home that were exposed. Another vet tech tested positive around the same time, and nobody has heard from her since, which is a little . And a 3rd vet tech took an at-home test that came back positive today.

Get vaccinated. Wear a mask. Sometimes, it's hard to do the right thing. This isn't one of those times.

[El Guapo]

Very glad to hear that your mom is doing better.

[Zaxxon]

My mom has gotten much better and has a lingering cough, but that's it. Her 10-day isolation will be up by the end of the week. Luckily, it doesn't seem like my immunocompromised step-father caught it. Or if he did, he was asymptomatic because of his vaccine and antibody treatment.

Very glad to hear it.

About a week ago an old man, unmasked of course, sat in the lobby for an hour before going into a small room with two vet techs (also unmasked). He then proceeded to tell them that he had COVID.

People suck.

Get vaccinated. Wear a mask. Sometimes, it's hard to do the right thing. This isn't one of those times.

[El Guapo]

Has your workplace changed its rules at all lately? You'd think this experience would lead them to reinstate indoor mask requirements for the workplace, though that doesn't seem to be that common these days.

[Isgrimnur]

People suck.

[RMC]

Has your workplace changed its rules at all lately? You'd think this experience would lead them to reinstate indoor mask requirements for the workplace, though that doesn't seem to be that common these days.

I work for a hosptial system, and they started to relax mask use for vaccinated employees in non-patient areas. But that only lasted a few weeks, and we are back to mask use 100% of the time in any areas of the hosptial, even if you are alone in your office(but no one enforces that one).

But, my kids start cool next week, and the school district is still mask free. I will say all of my kids are old enough and are now vaccinated, so they are as protected as they can be, and all in good health. Sigh..

[msteelers]

Very glad to hear that your mom is doing better.

Very glad to hear it.

Thanks. The next step is trying to decide when to bring our daughter back over there. The pediatrician and the CDC both say the isolation can end after Friday, but it will come down to our own risk tolerance.

Has your workplace changed its rules at all lately? You'd think this experience would lead them to reinstate indoor mask requirements for the workplace, though that doesn't seem to be that common these days.

I don't think her employers are very good at looking at the big picture. You would think that losing employees for weeks at a time when you are already short-staffed would encourage them to reinstate at the very least the indoor mask mandate. But the office manager and the head doctor have downplayed the seriousness of this throughout the pandemic. And the office manager has stated that she will never go back to wearing a mask and supposedly blamed one of the techs for not being vaccinated.

[El Guapo]

You're not going to believe this, but Joe Rogan has tested positive for COVID after a series of shows in Florida.

Also, his treatments for it apparently included invermectin.

[Smoove_B]

In a video, an exhausted-looking Rogan said that over the weekend he tested positive after having felt run down and feverish. "We immediately threw the kitchen sink at it," he said. "Monoclonal antibodies, ivermectin, Z-Pak, prednisone." Three days of treatment, he claimed, had him feeling like a new man.

Or hear me out - maybe just get vaccinated? Nah. Too easy.

[Daehawk]

If he snacks on Milk Bones and MeowMix he might get super powers.

[LordMortis]

In a video, an exhausted-looking Rogan said that over the weekend he tested positive after having felt run down and feverish. "We immediately threw the kitchen sink at it," he said. "Monoclonal antibodies, ivermectin, Z-Pak, prednisone." Three days of treatment, he claimed, had him feeling like a new man.

Or hear me out - maybe just get vaccinated? Nah. Too easy.

Prednisone is a miracle drug. I don't think it's an antiviral though... Coming down might just be a bitch. He better hope the "Monoclonal antibodies" do the trick.

[LawBeefaroni]

In a video, an exhausted-looking Rogan said that over the weekend he tested positive after having felt run down and feverish. "We immediately threw the kitchen sink at it," he said. "Monoclonal antibodies, ivermectin, Z-Pak, prednisone." Three days of treatment, he claimed, had him feeling like a new man.

Or hear me out - maybe just get vaccinated? Nah. Too easy.

I don't get this. Don't get vaccinated because you don't trust medicine or big pharma or whatever but get COVID and listen to what every quack MD says and pump yourself full of all big pharma has to offer.

[Smoove_B]

Unreal

U.S. COVID update: More than 214,000 new cases, including ~9K backlog from Louisiana

- New cases: 214,606
- Average: 166,421 (+3,975)
- In hospital: 102,168 (+1,275)
- In ICU: 26,117 (-70)
- New deaths: 1,806

[Freyland]

In a video, an exhausted-looking Rogan said that over the weekend he tested positive after having felt run down and feverish. "We immediately threw the kitchen sink at it," he said. "Monoclonal antibodies, ivermectin, Z-Pak, prednisone." Three days of treatment, he claimed, had him feeling like a new man.

Or hear me out - maybe just get vaccinated? Nah. Too easy.

Prednisone is a miracle drug. I don't think it's an antiviral though... Coming down might just be a bitch. He better hope the "Monoclonal antibodies" do the trick.

Prednisone suppresses the immune system. He had better hope the monoclonal antibodies work!
At least his worms won't get out of control.

[Daehawk]

Prednisone is simply a steroid.

[Freyland]

Prednisone is simply a steroid.

I'm not really sure where you are going with this....

[$iljanus]

In a video, an exhausted-looking Rogan said that over the weekend he tested positive after having felt run down and feverish. "We immediately threw the kitchen sink at it," he said. "Monoclonal antibodies, ivermectin, Z-Pak, prednisone." Three days of treatment, he claimed, had him feeling like a new man.

Or hear me out - maybe just get vaccinated? Nah. Too easy.

Prednisone is a miracle drug. I don't think it's an antiviral though... Coming down might just be a bitch. He better hope the "Monoclonal antibodies" do the trick.

Prednisone suppresses the immune system. He had better hope the monoclonal antibodies work!
At least his worms won't get out of control.

Steroids are immunosuppressive but they also reduce inflammation which can cause many of the issues associated with Covid.

[Freyland]

In a video, an exhausted-looking Rogan said that over the weekend he tested positive after having felt run down and feverish. "We immediately threw the kitchen sink at it," he said. "Monoclonal antibodies, ivermectin, Z-Pak, prednisone." Three days of treatment, he claimed, had him feeling like a new man.

Or hear me out - maybe just get vaccinated? Nah. Too easy.

Prednisone is a miracle drug. I don't think it's an antiviral though... Coming down might just be a bitch. He better hope the "Monoclonal antibodies" do the trick.

Prednisone suppresses the immune system. He had better hope the monoclonal antibodies work!
At least his worms won't get out of control.

Steroids are immunosuppressive but they also reduce inflammation which can cause many of the issues associated with Covid.

As a doc, pretty aware of that. Not recommended for use in Covid unless the patient has some level of respiratory failure.

[Octavious]

Hey don't tell me that just because you are a doctor that you know more about medicine! FREEEEEEEDOOOOMMMMMMM

[msteelers]

Has your workplace changed its rules at all lately? You'd think this experience would lead them to reinstate indoor mask requirements for the workplace, though that doesn't seem to be that common these days.

I don't think her employers are very good at looking at the big picture. You would think that losing employees for weeks at a time when you are already short-staffed would encourage them to reinstate at the very least the indoor mask mandate. But the office manager and the head doctor have downplayed the seriousness of this throughout the pandemic. And the office manager has stated that she will never go back to wearing a mask and supposedly blamed one of the techs for not being vaccinated.

Well, the wife showed up to work today and found out a new mask mandate for everyone inside the building is now in place. Better late than never I guess.

[$iljanus]

In a video, an exhausted-looking Rogan said that over the weekend he tested positive after having felt run down and feverish. "We immediately threw the kitchen sink at it," he said. "Monoclonal antibodies, ivermectin, Z-Pak, prednisone." Three days of treatment, he claimed, had him feeling like a new man.

Or hear me out - maybe just get vaccinated? Nah. Too easy.

Prednisone is a miracle drug. I don't think it's an antiviral though... Coming down might just be a bitch. He better hope the "Monoclonal antibodies" do the trick.

Prednisone suppresses the immune system. He had better hope the monoclonal antibodies work!
At least his worms won't get out of control.

Steroids are immunosuppressive but they also reduce inflammation which can cause many of the issues associated with Covid.

As a doc, pretty aware of that. Not recommended for use in Covid unless the patient has some level of respiratory failure.

Makes sense not to resort to the immunosuppressive anti inflammatory as the first line of treatment.
My sister received it in the hospital but probably due to her asthma and other indicators as she progressed which may have called for it. This was earlier in the year so no monoclonal antibody for her (and she might have been too far along)

Forgot you are a doc! What's your specialty if I may ask?

[Smoove_B]

Scrolling up and re-reading...that's something else, msteelers. Anecdotally I've heard very similar things about vet offices in my area. Some had barely any controls in place during the height of the pandemic while others (like mine) didn't allow people in with their pets (unless it was a crisis) and everyone is in masks - even just to walk from the car to the front door. It blows my mind because these are people working with potentially infectious animal diseases all the time but all of a sudden everything they've learned doesn't matter when its COVID.

I am definitely in the camp of people that believes mask refusal about about denying reality. As long as people are visibly wearing masks, it's a constant reminder that things are in crisis right now. So if we don't wear masks, there is no visible indicator anything is wrong - we're all super terrific! But when they see someone in a mask, it sets then into a shame/rage cycle because they're then instantly reminded that things aren't ok. Probably a bit off topic and getting too deep, but this is what I think about at 3am.

On topic:

What we are witnessing across the world with basically the forced infection of children with a virus of unknown future consequences, with a vaccine already available and waiting approval, may go down as one of the greatest mistakes in the history of public health.

[Isgrimnur]

Isn't the history of public health pretty much defined as too little, too late?

[$iljanus]

Oh, why the heck is Rogan getting a Z-pack? Does he have a secondary bacterial infection going on?

As I go to the internet I’ve found a 2021 JAMA paper looking at the effectiveness of Azithromycin in treating Covid. Granted it’s one paper but the conclusion…

Among outpatients with SARS-CoV-2 infection, treatment with a single dose of azithromycin compared with placebo did not result in greater likelihood of being symptom free at day 14. These findings do not support the routine use of azithromycin for outpatient SARS-CoV-2 infection.

https://jamanetwork.com/journals/jama/f ... le/2782166


But hey, we don’t have enough antibiotic resistant microbes in the world so more Z packs please!.

[LawBeefaroni]

Oh, why the heck is Rogan getting a Z-pack? Does he have a secondary bacterial infection going on?

Because it sounds cool. "Kitchen sink" man.

[Zaxxon]

Oh, why the heck is Rogan getting a Z-pack? Does he have a secondary bacterial infection going on?

Because it sounds cool. "Kitchen sink" man.

With a dude like Rogan, I wonder if they actually also literally threw a sink at him.

[Smoove_B]

Isn't the history of public health pretty much defined as too little, too late?

Well, for some things, sure. I'm struggling to think of a situation where a new disease emerges and then ~12 months later a vaccination is available to help address it. And at the same time we know masking stops spread but we refuse to enact mandates despite knowing kids can't be vaccinated yet.

The speed at which all this is happening makes it hard to explain why we're not doing these things (in a vacuum, I know it's political). I feel like I'm that meme with the giant cat person sitting on box, confused as to what's happening.

[Blackhawk]

We got new guidance from the school today. My impression is that it comes down to, "Our bad plan was too inconvenient, so we are tweaking it to a worse plan." But things have been so convoluted lately that I really can't tell the good ideas from the sketchy bad ideas anymore.

[RMC]

We got new guidance from the school today. My impression is that it comes down to, "Our bad plan was too inconvenient, so we are tweaking it to a worse plan." But things have been so convoluted lately that I really can't tell the good ideas from the sketchy bad ideas anymore.

Nah, last year our schools were in person all year long. My daughter was at a lunch table with someone that tested positive. By the time the school admitted she was positive, it was two weeks later. We had my daughter tested and isolated her until we got the negative result. Which was fun in itself, as the testing site "lost" her results and it took almost a week to get them anyway...

So it's about what is to be expected of public schools.

[Smoove_B]

So...the current guidelines say that even if both parties are masked, if one of the people involved tests positive for COVID-19, the other person is considered a "close contact" if they meet that definition (exclusive of the mask).

If you're a close contact and you're wearing a mask and not vaccinated? You should be quarantined.

If you're a close contact and you're wearing a mask and vaccinated? Current recommendation is to only quarantine if you're symptomatic, but you should continuing masking and get tested to confirm negative status.

If you want the details, check here.

If there's no school masking policy in place, I can only assume it's distilled chaos.

[El Guapo]

I assume that this is effectively a way to make quarantining optional. "Listen, you'll have to quarantine if you tell me that you weren't wearing a mask at the time. With that in mind, were you wearing a mask?"

[Freyland]

In a video, an exhausted-looking Rogan said that over the weekend he tested positive after having felt run down and feverish. "We immediately threw the kitchen sink at it," he said. "Monoclonal antibodies, ivermectin, Z-Pak, prednisone." Three days of treatment, he claimed, had him feeling like a new man.

Or hear me out - maybe just get vaccinated? Nah. Too easy.

Prednisone is a miracle drug. I don't think it's an antiviral though... Coming down might just be a bitch. He better hope the "Monoclonal antibodies" do the trick.

Prednisone suppresses the immune system. He had better hope the monoclonal antibodies work!
At least his worms won't get out of control.

Steroids are immunosuppressive but they also reduce inflammation which can cause many of the issues associated with Covid.

As a doc, pretty aware of that. Not recommended for use in Covid unless the patient has some level of respiratory failure.

Makes sense not to resort to the immunosuppressive anti inflammatory as the first line of treatment.
My sister received it in the hospital but probably due to her asthma and other indicators as she progressed which may have called for it. This was earlier in the year so no monoclonal antibody for her (and she might have been too far along)

Forgot you are a doc! What's your specialty if I may ask?

Heya.
Internal Medicine and Pediatrics.
Totally agree that steroids would have been on the menu if she had asthma, and even now used if the patient has oxygenation problems.
Going down to your next post, you are correct that Zithromax is not indicated for Covid treatment.
Total aside here, they are now using Zithromax as a pre-op med for reasons I'm not entirely clear on, so I suspect that will be a much greater cause of antibiotic resistance than the occasional rich dude demanding the kitchen sink (unfortunately).

[Blackhawk]

FWIW, they implemented a mask policy three days ago with the express purpose of not having to contact trace masked students. The policy came out today. I can only assume that they were given advance notice.

My personal feeling is that they were having so many cases and having to send so many kids home that they put this into place as a way to eliminate quarantining.

[RMC]

So...the current guidelines say that even if both parties are masked, if one of the people involved tests positive for COVID-19, the other person is considered a "close contact" if they meet that definition (exclusive of the mask).

If you're a close contact and you're wearing a mask and not vaccinated? You should be quarantined.

If you're a close contact and you're wearing a mask and vaccinated? Current recommendation is to only quarantine if you're symptomatic, but you should continuing masking and get tested to confirm negative status.

If you want the details, check here.

If there's no school masking policy in place, I can only assume it's distilled chaos.

Last year, masks 100% all the time. This year, and school has not started yet, no masks required, but suggested. My daughters(I have three in school all vaccinated) are in sports and no masks there either, except on the bus. And they social distance on the bus. Luckily, they do outdoor individual sports, Cross Country and Track and Field, and they are vaccinated, so they should be fine.... I hope...

[Blackhawk]

Prednisone suppresses the immune system. He had better hope the monoclonal antibodies work!
At least his worms won't get out of control.

*aside*

Thanks for posting this, by the way. My son was just prescribed prednisone, and was supposed to start them today. After seeing your post I did some research and called the doctor for clarification on why (they spoke with Michelle when they initially prescribed them after seeing his CT scans, and she was in the middle of a shift change and didn't have time to get all the details.) It turns out that they were just trying to give him an option to reduce some nasal swelling until he could see his ENT next week about a deviated septum. The thing is that he isn't having any more trouble breathing than normal, so it isn't necessary at all.

I don't have experience with it, and didn't realize that it was an immunosuppressant. I can't see having him on that in his school, of all places, during a surge unless there is some meaningful medical need.

He is now off of them after only one pill.

/add - Funny (not really) story. He should have had three more during school today. I gave them to the nurse with instructions this morning. She was called out, and her assistant took over. The assistant forgot. It worked out well, although the nurse was embarrassed and pissed when she found out after we called her. I wouldn't want to be that assistant right now.

[Kurth]

Oh, why the heck is Rogan getting a Z-pack? Does he have a secondary bacterial infection going on?

Because it sounds cool. "Kitchen sink" man.

With a dude like Rogan, I wonder if they actually also literally threw a sink at him.

I was watching that and so ready to see it edited to add a sink flying in and hitting him in the face. #disappointed

[Zaxxon]

I'll try to do better in the future.

[Freyland]

Prednisone suppresses the immune system. He had better hope the monoclonal antibodies work!
At least his worms won't get out of control.

*aside*

Thanks for posting this, by the way. My son was just prescribed prednisone, and was supposed to start them today. After seeing your post I did some research and called the doctor for clarification on why (they spoke with Michelle when they initially prescribed them after seeing his CT scans, and she was in the middle of a shift change and didn't have time to get all the details.) It turns out that they were just trying to give him an option to reduce some nasal swelling until he could see his ENT next week about a deviated septum. The thing is that he isn't having any more trouble breathing than normal, so it isn't necessary at all.

I don't have experience with it, and didn't realize that it was an immunosuppressant. I can't see having him on that in his school, of all places, during a surge unless there is some meaningful medical need.

He is now off of them after only one pill.

/add - Funny (not really) story. He should have had three more during school today. I gave them to the nurse with instructions this morning. She was called out, and her assistant took over. The assistant forgot. It worked out well, although the nurse was embarrassed and pissed when she found out after we called her. I wouldn't want to be that assistant right now.

It makes me happy to contribute, since at best I usually just post snarky one-liners.
*If* it's necessary he reduce some swelling in the nasal passages, a *nasal* steroid spray would provide a benefit without systemic suppression. That being said, given your description of the school situation, I'm not sure I would encourage immune reduction of our body's first line of defense against respiratory pathogens (nasal mucosa and its "soldiers").

[Alefroth]

Oh, why the heck is Rogan getting a Z-pack? Does he have a secondary bacterial infection going on?

Because it sounds cool. "Kitchen sink" man.

With a dude like Rogan, I wonder if they actually also literally threw a sink at him.

With a dude like Rogan, I wonder if they actually just gave him placebos.