To Vaccinate or Not---The Rat Flu Odyssey Continues

[SumJongGuy]

My pulse ox was 94% when I was at the doc a few weeks ago. "Normal" for me was always like 98%. Does 4% difference even mean anything really?

I think 4% is pretty significant. Another 4% and you're entering the danger zone.

[old goat]

If he went to clinic for eval, pulse ox is standard of care for admission vitals. If you want to rule out pathology, testing accomplishes that. Shrugging your shoulders and saying "I don't know" accomplishes nothing. Rule out what it isn't, then consider alternative diagnosis. If patient is troubled/suffering from symptoms with poor quality of life, shared decision making on further testing is warranted. All the studies below offer same day results except stress echo. In fact, all offer results in about two hours. Such a simple thing to do versus reading forums and anecdotes.

1. CT chest with contrast. (will rule out pulmonary fibrosis)
2. Stress echo. (identify exercise related cardiac dysfunction)
3. CRP, IL6, ferritin (help rule out persistent inflammatory dysfunction). Rare in men.
4. BNP (classic marker of heart strain in heart failure patients)
5. Troponin HS (after strenuous exercise, can be elevated in normal pathology, more commonly after myocardial infarction/profound illness)


FWIW this is an excellent study summary from Mayo about "long covid", both phenotype, associated labs, etc.

A good history and physical, done in person, is such a simple thing to do and is a good way to avoid ordering a lot of expensive and unnecessary tests that drive up the cost health care with no benefit.
Maybe some or all of the tests you have suggested are necessary; maybe they aren't, but neither you nor I are in a position to know.

[old goat]

My pulse ox was 94% when I was at the doc a few weeks ago. "Normal" for me was always like 98%. Does 4% difference even mean anything really?

4% is significant--if you can't raise it by taking deep breaths and coughing. And your hands have to be warm--if it was checked right after you came in from the cold it may not be meaningful. It's also important if the saturation drops after exercise.

[jono]

Also little evidence that masking in school kids does fuck all. I'll spare you the citations.

The study you cited makes no attempt to address masking in school kids, it's an attempt to address the effectiveness of mask mandates. Those two things are very obviously not the same. You might say it says fuck all about the effectiveness of masking in school kids, in fact, since that's not even its objective (which it also fails at by trying to isolate a single variable by which to assess the effectiveness of a political measure).

In that study, a difference in mask use between the two groups would support the effectiveness of mandates rather than masks, but a difference in masking would support effectiveness of masks. They don't appear to address that or the ancillary effects of a mandate increasing community caution, and the commonality of any such effects across both groups--there are pretty much zero political tools that can be isolated to a single variable. You might say such a study is a fool's errand.

There have been a lot of lessons in stats given in these threads. I'll spare me the citations.

[The AD]

Thanks (and to The AD). Yeah, they did well overall, even if the global reality finally broke through. That, and they spent the bulk of the past two years being able to skip through the glades without anyone (other than at the airport Customs desk) needing to worry too much about Covid.

Yeah, the thing that concerns me is many people will see numbers spiking now in countries that previously locked down and say "See? Locking down was dumb!" when in fact the real numbers still show those countries have faired exponentially better than we have over the last two years. We've got this mindset that whatever the most recent thing is is the most important thing.

[Percy Rideout]

Damn, check out the New Zealand numbers (current average daily case rate 330 per 100K population). NZ spent most of the last two years as the global success story, isolating itself from the pandemic not just due to geography, but incredibly strict testing, quarantine, and contract tracing. And as it turns out, they just ended up keeping themselves ripe and ready for the virus's inevitable incursion. The lesson? I don't know, maybe "flatten the curve" was more the right approach than "dodge the curve".

I said this a year ago and got lambasted by a few for it (suck it, bennymac). That was last spring when many were certain that the Vaccine was a cure all. Annnd here we are.

[bodywhomper]

Also little evidence that masking in school kids does fuck all. I'll spare you the citations.

Discussion about the efficacy of mask mandates, black hole. Do not care to further engage.

Frownie face

My observation is that one of the newest shitty job components for teachers, aids, admin staff, grocery clerks, supervisors, coworkers, etc. has been enforcing/asking people to minimally wear a mask, to at least cover their mouth and nose, let alone have one that fits well enough to not have large gapping gaps. With smaller children, there is the additional challenge of keeping them from putting the mask in their mouth. It’s even more challenging when those that are reading/writing the local policy are not complying with their own rules. One example is the cdc entry about the teacher in Marin Co that infected most of her class from pulling down mask to read to her young students.

[bennymac]

I said this a year ago and got lambasted by a few for it (suck it, bennymac). That was last spring when many were certain that the Vaccine was a cure all. Annnd here we are.

You know the drill. Post up your comment and my reply. I shouldn’t have to tell you that. But no one here is surprised I have to.

[The AD]

I said this a year ago and got lambasted by a few for it

You deserved it then and you deserve it now.

[Truckee Joe]

Can't believe you guys can't see this Fourth Turing happening all over now. The younger generation is going to rise up and say you'll f*€¥ed us with your system and policies for the past 40 years. The next 20-40 years people will find a better, more fair way. And I guarantee a zero covid policy will not be apart of it. Keep protecting yourself boomers because the people younger than you want it to stop. They have literally nothing to lose.


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[bennymac]

You think it’s “young people” that are resistant to covid mitigation measures? And that it was the boomers who were rallying behind restrictions and mandates?

[bodywhomper]

My teen embraces a 0 covid policy. His peers, too. They are not mouth breathers.

How’s it go: ~200k kids in the US are now orphans as a result of Covid? That’s not nothing to lose.

In my neck of the woods, the boomer gen is the most vocal and successful at undermining and derailing attempts to mitigate spread.

[dunfree]

Yeah, the thing that concerns me is many people will see numbers spiking now in countries that previously locked down and say "See? Locking down was dumb!" when in fact the real numbers still show those countries have faired exponentially better than we have over the last two years. We've got this mindset that whatever the most recent thing is is the most important thing.

The real story is comparing New Zealand to Hong Kong; huge rise in cases both places, well vaxxed NZ has far fewer deaths.

[The AD]

Can't believe you guys can't see this Fourth Turing happening all over now.

I guess this was the first Turing?

[Mofro261]

I honestly don't think my doc will do much at this point. This is all so new. Lots of anecdotal evidence out there now though.

I think I posted in this thread a couple weeks ago how exercise felt like it "released" more covid in my body....don't know how else to explain it.

Then I just read this today.

https://www.verywellhealth.com/exerc...hletes-5195661

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Ok, this isn't so much a call out on you in particular, but chock up another "holy fucking load of bullshit interpratation" of a single citation to make an egregious interpretation in that article by Verywellhealth. If that's representative of that site, don't ever click again.

"Very well health" is saying "Sars-2-Cov2 S1 proteins" are causing exercise intolerance assoc w/ long covid.

Some researchers have found a link between exercise intolerance and a specific SARS-CoV-2 S1 protein in long COVID-patients

A recent study showed that exercise intolerance is common among long COVID patients. It is largely a result of the SARS-CoV-2 S1 protein, which is found inside endothelial cells that are mobilized by exercise.1

But really what the cited paper is discribing, is a host cytokine and chemokine profile (these are your own host protein signaling molecules) that is associated with long covid and more severe clinical disease. These host proteins are derived from your own immune cells- T cells, B cells eg; the actual paper lists a few of them that any immunologist would be well aware of, IFN-g, IL-2, IL-6, CCL5. These are what are known as pro-inflammatory (sometimes TH1) molecules, they are tightly regulated in the body, and their over abundance can result in cytokine storm. None of them are unique to COVID.

https://www.frontiersin.org/articles...21.700782/full

Expression of CCR5 and its cognate ligands have been implicated in COVID-19 pathogenesis, consequently therapeutics directed against CCR5 are being investigated. Here, we explored the role of CCR5 and its ligands across the immunologic spectrum of COVID-19. We used a bioinformatics approach to predict and model the immunologic phases of COVID so that effective treatment strategies can be devised and monitored. We investigated 224 individuals including healthy controls and patients spanning the COVID-19 disease continuum. We assessed the plasma and isolated peripheral blood mononuclear cells (PBMCs) from 29 healthy controls, 26 Mild-Moderate COVID-19 individuals, 48 Severe COVID-19 individuals, and 121 individuals with post-acute sequelae of COVID-19 (PASC) symptoms. Immune subset profiling and a 14-plex cytokine panel were run on all patients from each group. B-cells were significantly elevated compared to healthy control individuals (P<0.001) as was the CD14+, CD16+, CCR5+ monocytic subset (P<0.001). CD4 and CD8 positive T-cells expressing PD-1 as well as T-regulatory cells were significantly lower than healthy controls (P<0.001 and P=0.01 respectively). CCL5/RANTES, IL-2, IL-4, CCL3, IL-6, IL-10, IFN-γ, and VEGF were all significantly elevated compared to healthy controls (all P<0.001). Conversely GM-CSF and CCL4 were in significantly lower levels than healthy controls (P=0.01). Data were further analyzed and the classes were balanced using SMOTE. With a balanced working dataset, we constructed 3 random forest classifiers: a multi-class predictor, a Severe disease group binary classifier and a PASC binary classifier. Models were also analyzed for feature importance to identify relevant cytokines to generate a disease score. Multi-class models generated a score specific for the PASC patients and defined as S1 = (IFN-γ + IL-2)/CCL4-MIP-1β. Second, a score for the Severe COVID-19 patients was defined as S2 = (IL-6+sCD40L/1000 + VEGF/10 + 10*IL-10)/(IL-2 + IL-8). Severe COVID-19 patients are characterized by excessive inflammation and dysregulated T cell activation, recruitment, and counteracting activities. While PASC patients are characterized by a profile able to induce the activation of effector T cells with pro-inflammatory properties and the capacity of generating an effective immune response to eliminate the virus but without the proper recruitment signals to attract activated T cells.

Collectively, the papers authors parse basal levels of these cytokines/chemokines into what they called "S1" phenotypes and "S2" phenotypes that they stipulate may help identify who may be succeptible to long covid. Whoever wrote that piece of shite article may not have even read the abstract of the only article they are citing to note that S1 and S2 weren't referring to the S1 or S2 subunits of the Sars2 Spike protein.

Also, in measuring these host signaling molecules, the base line levels varying across populations, but also within an individual across the time of day, during and after exercise, with stress, levels of sleep, temperature, etc.

[Truckee Joe]

You think it’s “young people” that are resistant to covid mitigation measures? And that it was the boomers who were rallying behind restrictions and mandates?

I saw two faces. One that wanted to show they follow the rules, and then when no one was looking, do whatever you want, just like old people. Who made the rules? It wasn't the 20 year olds.

[Percy Rideout]

You know the drill. Post up your comment and my reply. I shouldn’t have to tell you that. But no one here is surprised I have to.

Here is me from 9/24/21 in the Australia lockdown thread in politcal asshattery. To your credit it wasn't you jumping in, but rather the subhuman jizzmonkeys dunfree and Killinik that I group you together at this point. They were trying their best to pile it on, protractors and all because they don't understand big words or discussing ideas. They are here to troll and fight because they are unfulfilled in the real world.

I wish i wasn't right on this one, but here we are.

Appreciate the response from an Aussie. Thanks for the insight we aren't getting in America.

re: lockdowns. Is your population prepared to play this game for another 4-5 years? Pandemics don't just end. They turn endemic. If your population isnt exposed en masse, they will eventually.

I see Australia and NZ accidentally protracting COVID deaths and lockdowns in their countries. (The rationale comes from a pure and "think of the children!" place, but it may not work out as originally intended.)

[bennymac]

If you want to list the gripes 20 year olds have with what 65 year old people have done to society these two years of covid restrictions are not going to be high on that list.

[dunfree]

Here is me from 9/24/21 in the Australia lockdown thread in politcal asshattery. To your credit it wasn't you jumping in, but rather the subhuman jizzmonkeys dunfree and Killinik that I group you together at this point. They were trying their best to pile it on, protractors and all because they don't understand big words or discussing ideas. They are here to troll and fight because they are unfulfilled in the real world.

I wish i wasn't right on this one, but here we are.

You weren’t right dumbfuck, you are just to far gone to tell.

[RoooR]

And yes I'm vax + boost. FWIW the first vax shot in Feb of 2021 destroyed me for 10 days....with many of these same lingering sypmtoms I have now from actually getting covid. After that first shot I was having the chest pains, palpitations etc for weeks. I'm not anti vax at all, but I guess I just have that kind of immune system?

Pretty sad state of affairs that even to discuss the vax side effects you have to preface that you're not anti vax. The myocarditis stuff is real. Especially for teenage boys. Killed some people and ruined the fitness of others. As many as COVID? No. But real shit did happen to real people as a result of the vaccines.

[SumJongGuy]

If you want to list the gripes 20 year olds have with what 65 year old people have done to society these two years of covid restrictions are not going to be high on that list.

But when you look at the basket of deplorables protesting mask and vax measures it's mostly people in their 30s and above..

[The AD]

Pretty sad state of affairs that even to discuss the vax side effects you have to preface that you're not anti vax. The myocarditis stuff is real. Especially for teenage boys. Killed some people and ruined the fitness of others. As many as COVID? No. But real shit did happen to real people as a result of the vaccines.

You realize myocarditis is also associated with viral infections too, right?

Recent data provided by the CDC suggests that among 100,000 vaccinated adolescent males, only about four to seven would be expected to develop post-vaccine myocarditis. If this group was not vaccinated, however, more than 5,500 would be likely to become infected with COVID-19 over a period of three months, with infections resulting in 50 hospitalizations, potential MIS-C, myocarditis and possible death.

https://www.chop.edu/news/health-tip...d-19-get-facts

[old goat]

Can't believe you guys can't see this Fourth Turing happening all over now. The younger generation is going to rise up and say you'll f*€¥ed us with your system and policies for the past 40 years. The next 20-40 years people will find a better, more fair way. And I guarantee a zero covid policy will not be apart of it. Keep protecting yourself boomers because the people younger than you want it to stop. They have literally nothing to lose.


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Every generation since the dawn of history, and probably before, thought they were going to do it better than their predecessors. The boomers certainly thought that. Maybe your generation will be different but my guess is that the people following you will be asking why you fucked up so bad.

[DougW]

One thing that has come up in the anti circles is the pzifer after market vax reactions. Is there anything to this? Of course when you give 10mil a shot just by chance a certain number are going to die the next day which may or may not be related to vax.

[old goat]

Pretty sad state of affairs that even to discuss the vax side effects you have to preface that you're not anti vax. The myocarditis stuff is real. Especially for teenage boys. Killed some people and ruined the fitness of others. As many as COVID? No. But real shit did happen to real people as a result of the vaccines.

How many killed? How many had their fitness ruined?
According to data in VAERS, over an 8 month period there were 1200 cases of post vaccine myocarditis in people under 30, 87% had complete resolution of their symptoms by the time they were discharged. No deaths reported.
https://cdn.jamanetwork.com/ama/cont...5G5CRDK6RD3PGA

I have not kept up with the stuff Mofro is talking about--in my field we see disorders of the inflammatory cascade mainly in the setting of severe infection and trauma. My understanding is that drug or other interventions aimed at altering the bad effects of rampant inflammation have been much tried but not particularly successful. If that has changed I would like to know. This kind of information is still important in understanding things like long covid and hopefully will some day lead to treatments but I don't believe it has any current use as far as treating long covid. Again, correct me if I'm wrong.