ICU providers, how are your units looking? Total COVID & Vaccinated vs Unvaccinated.

In most cases the key is downgrading ICU patients into regular beds asap. However, COVID patients LOS in the icu is extremely prolonged and causing floor beds to be more critical.

DanM wrote:

Jeff Wigand wrote:

You think it’s an incredible coincidence that almost all the covid patients in the hospital didn’t get vaccinated.

You think it’s an incredible coincidence that hospitals have the option of using observation status to distort admission statistics ?

https://health.usnews.com/health-care/patient-advice/articles/2018-10-18/have-you-really-been-admitted-as-an-inpatient-to-the-hospital

Have You Really Been Admitted – as an Inpatient – to the Hospital?

It isn’t just a clerical distinction. Your status can significantly impact coverage and what you pay.

You're in a hospital bed, and there you remain overnight – perhaps longer. Whatever adversity you're facing, one thing you may never consider is whether or not you've been admitted to the hospital: that is, specifically, if you're an inpatient.

The article you posted was 3 years old, and Medicare have changed a little since then. (Mainly to make it more obvious).

If you’re in the hospital for “one midnight” AND 23 hours or less, you’re considered an “observation”. The hospital gets paid less, since it’s covered as “outpatient” services. The patients also have to pay more out of pocket (deductibles) since it’s not covered under their inpatient insurance. (The patients have to sign consent for this by the way. A fact that was actually mentioned in the last 2 paragraphs of your link). It’s a way Medicare came up with to save money. (By paying hospitals less).

You really think all these patients are paying cash deductibles and NOT causing an uproar?

And that hospitals are volunteering for less reimbursement rather than admitting patients??

I live in Illinois. Earlier in this pandemic we had a 2000 bed portable hospital built inside McCormick Place to handle overflow patients from the hospitals. It was taken down after serving roughly 20 patients. Where is this pop up hospital now? Why isn’t it being reassembled in an area that needs it? Is there any outreach to the thousands of health care workers, especially nurses who lost their jobs because they were unvaxxed? Now we have this new guidance coming from the government that cloth masks are little more than facial decorations. From where I sit, this has been a cluster for a long time. The entire country of India has fewer cases than nearly half of the states in the USA. Shouldn’t we be examining what they are doing right, especially considering they have 4 times the population of the US?

If you are going to try this argument you have to recognize the testing disparities and general financial disparities between the 2 countries. Of course less cases are reported in India- what % of their population actually has access to regular testing? Covid cases are similar everywhere- aside from places with strict lockdowns. It is what it is. We are lucky enough to live in a country where we have access to vaccines and testing, high quality care if we need it. I am a physician, some people are very sick, others not. There isn’t a great solution besides giving yourself the best shot possible at not getting very ill (vaccines, not being obese, etc). Modern medicine is a miracle. Point blank. It’s amazing what we can do and prevent (despite what the media says).

Jiminycricket wrote:

The entire country of India has fewer cases than nearly half of the states in the USA. Shouldn’t we be examining what they are doing right, especially considering they have 4 times the population of the US?

Testing in India is sparse so case counts are much lower, the median age is about 10 years lower than the USA so expected death rate should be lower, and excess deaths approach 5x the verified covid death count suggesting covid death attributions are a gross under count.

Doctor, its not an argument. Since when did medicine shun all debate? You were taught in Medical school to approach things with skepticism. All science advances with challenges. If not, we would still fear sailing off the edge of the earth. India has done some unique things, not the least of which is access to Ivermectin. Read the studies. Your point on testing falls flat when you consider Indias death rate. Look it up. 348 cases yesterday. No test test needed for death! America is failing miserably. High infection rates, world leader in deaths. Therapeutics are the answer yet very little emphasis or use if monoclonal antibodies. I see no urgency, and no outcry from the medical establishment on increasing production and access. Wash your hands message and wear a mask are not working. Have we ever seen Fauci debate anyone like Marty Mikary or Jay Bhattacharia? As Americans have been denied healthy scientific debate and been force fed everything from filtered media and public health “experts” like Fauci who has not treated a single patient since 1968. In closing, I ask simply, what positive data can you cite for how we as a country are handling the pandemic? We are process driven, not results driven. That is shameful and proving catastrophic.

146-187K Vaccine deaths between just February-August 2021.

When are we going to stop this madness?

https://www.researchgate.net/publication/355581860_COVID_vaccination_and_age-stratified_all-cause_mortality_risk

I find it odd that people don't think drs "read the studies". Since the pandemic started (basically March 2020 for us), we've 2 weekly sessions on Microsoft Teams with the entire division of critical care reading the studies together. Both so we learn on the fly, and so we can review the studies to find what's useful and what's not.

Medical journals have made 2 decisions regarding publishing in the pandemic; first, everything related to COVID is open to the public (no subscription or membership needed), and second, they made it easier to get things published (they don't want editorial review to get in the way of information dissemination).

The intention was good, but the effect is that poor quality studies are published and given the aura of "science", and the public has access to all of them, and everyone who know how to use google is suddenly an expert in epidemiology, virology and public health.

There were dozens or early, small scale studies on ivermectin (because in lab studies on petri dishes, it looked promising at stopping the virus from replicating). Most of them were in a single center, with small sample sizes, and not blinded or placebo controlled. Some were positive, some negative. All (correctly) reach the same conclusion; "looks promising, but we need large multi-center, randomized, placebo-controlled trials to see if this works".

Here are the RCTs done afterwards. ALL OF THEM SHOWED NO BENEFIT.

BMC Infect Dis. 2021 Jul 2;21(1):635.

JAMA. 2021 Apr 13;325(14):1426-1435.

J Infect Chemother. 2021 Dec;27(12):1743-1749.

J Med Virol. 2021 Oct;93(10):5833-5838.

J Pharm Pharm Sci. 2021;24:343-350.

Where have we had results in the USA that come close to these?

https://www.thedesertreview.com/opinion/columnists/indias-ivermectin-blackout---part-v-the-secret-revealed/article_9a37d9a8-1fb2-11ec-a94b-47343582647b.html

Jiminycricket wrote:

Where have we had results in the USA that come close to these?

https://www.thedesertreview.com/opinion/columnists/indias-ivermectin-blackout---part-v-the-secret-revealed/article_9a37d9a8-1fb2-11ec-a94b-47343582647b.html

This is a long winded response... bear with me.

We studied the Delta waves in India state-by-state, both because we knew it was coming here, and because a large number of our drs are originally from India and were desperate to see if we could find out a way to help. I read through that article you linked, and it's not as impressive as you might think. An author can cherry pick numbers based on what message they're trying to convey, or choose to only talk about a few weeks rather than a longer period. He chose to include the numbers from Uttar Pradesh and Kerala in one 4-7 week period that fits the narrative of the story.

Think about how a foreign reporter could come to the US to report on the difference in cases between Florida and Washington State... if they came in February of 2020, they could say "Florida's amazing, Washington's response is terrible!" Or they could come in August 2021 and say "Florida's terrible! Why don't they do what those brilliant people in Washington State did!" Wouldn't be that informative, would it? Kerala is the farthest south, and Utter Pradash is the farthest north. There are a lot of differences, even if you just look at the weather.

On the vaccinations, what always gets lost is that India at the time was only using 3 vaccines: Covishield, Covaxin and Sputnik V. I'm not that confident in any of them.

Uttar Pradesh's response was an embarrassment at the beginning. And their health system was drastically under reporting deaths (by a factor of about 20 times). Here's an older report from Foreign Policy comparing the two states.

(Kerala has a more modernized health system, so their numbers are more consistent with what you would see from the Delta surge).

They were averaging 3 deaths AN HOUR in Utter Pradash, and eventually the Indian gov't and WHO basically overruled the local state government. They imposed a strict lockdown, and as the article you linked to mentioned, sent 10s of thousands of workers going door-to-door in a MASSIVE testing campaign. THAT brought the cases down, not the Ivermectin. (Australia did the same, without giving out ivermectin, and had the same result). I'll copy-and-paste it for you from your article (emphasis is mine):

The activity involved an aggressive house-to-house test and treat program with medicine kits.

The WHO explained, "Each monitoring team has two members who visit homes in villages and remote hamlets to test everyone with symptoms of COVID-19 using Rapid Antigen Test kits. Those who test positive are quickly isolated and given a medicine kit with advice on disease management."

There is no way Americans would allow that kind of a policy.. the success has nothing to do with Ivermectin or any other drug. They locked people at home and tested everyone.

Jiminycricket, I like your articulate thoughts. Why can’t these things be discussed.

Notice they are really pushing the “more test” narrative right now. Test test test. Just an observation. Follow the…

Also, I just read a tweet that India has halted testing. Halted testing.

@ PCRF guy. What was in the kits they distributed in India? They said ivermectin was included. I ask again. What have we done in the USA that has any positive and significant results? It has gone from bad to worse. In all of this, Fauci takes his eye off the ball and fails to see that our current flu vax doesn’t address this years flu variant. The company I work for is based in India. In the first major surge in India they saw north of 400k/ cases per day. They are now seeing 7-8k per day. Our manufacturing plants were crippled earlier in the pandemic and have been remarkably consistent in their staffing and productivity since. Your assertions of ivermectin being ineffective are in direct contrast to my India based colleagues real world in person observations. You can cite all the studies you want critical of it, but offer little solutions as our cases and deaths far exceed India with 1/4 the population. Nurses can dance at the behest of Jill Biden, but our mobile hospitals already built then disassembled are sitting in a warehouse somewhere. That stunt by those nurses was eerily similar to the hermit kingdom propaganda of Kim Jong Il

Antivaxxers' narcissism and lack of consideration for others continues. Freedumbz!

Thanks PCRF guy and EPIRunner

The research is complicated and I know how much time it takes to read it and provide a thorough interpretation.

The SSC guy, who is generally extremely open-minded, bordering on contrarian, did a breakdown of EVERY IVM study and came to the conclusion that no RCTs showed benefit, except in regions with endemic worm infections (i.e. the IVM was curing the worms not the COVID).

IVM moaners keep saying "run the studies." We did. It doesnt work.

https://astralcodexten.substack.com/p/ivermectin-much-more-than-you-wanted

prsresident wrote: Perhaps the best way to deal with all this noise is genuine discussion without snark or the need to assert one's superiority over another. I bet that would increase vaccination rates more than anything.

Condescension is the liberal’s Achilles Heel. They just can’t help themselves, and it undermines all of their efforts.

carmine9 wrote:

But then why so much more death and negative outcomes reported to VAERs in connection with the Jab than were reported in the last 30 years with all other vaccines combined?

Seems you don't care about this.

Wonder why?

Because there are people who want to believe that X issue is due to the vaccine and not something else. There are also people exaggerating side effects. Aches and cold chills becomes "severe pain and convulsions", etc. You are acting like prior to the vaccine being released everything was all rosy and few people were against the covid vaccine, then wham widespread side effects and that is where the backlash is from. There were a lot of people saying things along the lines of "I ain't getting no d*mn vaccine" when all of the vaccines were still in clinical trials.

[quote]Jiminycricket wrote:

@ PCRF guy. What was in the kits they distributed in India? They said ivermectin was included. I ask again. What have we done in the USA that has any positive and significant results? It has gone from bad to worse. In all of this, Fauci takes his eye off the ball and fails to see that our current flu vax doesn’t address this years flu variant. The company I work for is based in India. In the first major surge in India they saw north of 400k/ cases per day. They are now seeing 7-8k per day. Our manufacturing plants were crippled earlier in the pandemic and have been remarkably consistent in their staffing and productivity since. Your assertions of ivermectin being ineffective are in direct contrast to my India based colleagues real world in person observations. You can cite all the studies you want critical of it, but offer little solutions as our cases and deaths far exceed India with 1/4 the population. Nurses can dance at the behest of Jill Biden, but our mobile hospitals already built then disassembled are sitting in a warehouse somewhere. That stunt by those nurses was eerily similar to the hermit kingdom propaganda of Kim Jong Il[/quote]

The point I was making is that the state imposed a very strict lockdown, for weeks, while workers went door to door testing everyone, and isolating those who tested positive. That’s what controlled the outbreak, not the kits.

This isn’t meant to be condescending, so I apologize in advance if it sounds snarky. I’m going to try to demonstrate a logical fallacy.

“They gave every household a medicine kit containing paracetamol. Since the medication worked, this proves that paracetamol is a cure for COVID. You know it by its name in the US. Tylenol. But acetaminophen is cheap and generic, and big pharma only wants you taking expensive patented drugs, so there’s a media blackout on this data”.

Now replace Tylenol with IVM and you see why I said it’s a logical fallacy.

Your first post said that drs should “read the studies”. So I mentioned the studies to you, and your response was the above. “Cite all the studies you want, people I talked to say otherwise”. 99% of people with COVID survive. So if someone knows someone who took a medicine and it “worked”, the only way to prove that is with RCTs. (Some of the ones I posted were done in India during that wave).

Several countries had better responses than India. We can and should look at what they did, since we clearly aren’t doing well.

Here would be my plan:

Expanding access to rapid point of care tests (especially in schools and college campuses), vaccinations, streamlining getting early therapeutics to those who test positive (monoclonals, the new oral antivirals..), setting up treatment centers at or near nursing homes so they get these drugs earlier, increasing hospital capacity, activating the national guard to set up field hospitals where needed, using the defense production act to scale up manufacturing of therapeutics.

I definitely agree that drs and nurses dancing and singing on TikTok is ridiculous. Even more so when they’re doing it at the White House. (I think it’s more virtue signaling though). Most people don’t spend time with healthcare workers, and these stunts make us look silly.

But imagine if Joe Biden declared we are going do what they did in that report from India. “I’m going to force all of you to stay home, and send govt agents to you door-to-door to test you and give you medicines to take”. That would be more alarming than the silly singing and dancing to most people (and why it won’t work and would most certainly backfire).