Coronavirus/COVID-19, Thread 3 (Omicron & Delta Variants)

[Captain_Caveman]

Her's my thing. Everyone in the US has already made up their mind on whether to get vaccinated or not. Practically no one is going to change their mind at this point. If you don't want to get vaccinated, fine. Just say it. It's your right in a free country.

No, it isn't a "free" country. You are not free to walk around naked. You are not free to drive on the wrong side of the road. And you are not free to cut the heads off parking meters like Cool Hand Luke.

So if you want to be "free" and remain unvaccinated, please do it by yourself. Go home, shut the door, order everything from Amazon, watch TV, surf the web, get high, whatever.

But do not get near me or mine. I do not wish to risk death or serious illness from unvaccinated and unmasked people like you who think they have all the answers because some clown on Facebook told them what to think.

Exactly, a person has the right to decide for themselves, but they don't have the right to decide for others, which is what these freaking uneducated, brainwashed, ignorant, (use whatever adjective you want) don't understand.

I wish everyone who can would get vaxxed, and think that schools and some employers have a right to mandate it. And if insurance companies want to jump in on this, by all means.

But these analogies are not equivalent. Making a personal decision about your health care is not the same as reckless driving or being nude in a public place, or vandalizing public property. We cannot compel everyone getting vaccinated.

People can opt out of it if they choose. I just don't want to hear these nonsensical arguments supporting BS science as their justification for why.

[Andrew McCeltic]

Right, like I said to ddb, let me at least explain the basic point so your choice is informed.

I've mellowed a lot, though, since more data's come out about delta. If you're vaxed and masked your odds are good. I worry about my parents getting older, but.. I don't love the idea of mandates, if you want people to get it, PERSUADE them, don't try to make them eat sh*t for being stupid. We could do a mandate, it's very very likely constitutional, SCOTUS has ruled on vaccine mandates at the state level. But I don't want to. And a lot of people are "on the fence" who basically already admit if their boss makes them get vaccinated, they'll grumble and do it..

[La Flame]

You can post statistics of how safe the vaccine is all you want, at the end of the day it comes down to whether you want it or not. It's that simple. Giving government such power to decide over your bodily autonomy sets a dangerous precedent. Once you give up your rights you're never getting them back. Dismissing the downright disgusting and criminal past of the companies that made these vaccines and allowing them to keep operating without increased regulations atleast, is a spit to the face of the millions of families that have suffered from their crimes and keep suffering.

If you can't see that side effects are being suppressed, you're being dismissive on purpose. How can you say this vaccine is so safe and effective if there haven't even been proper studies done on the effects for menstrual cycles. It's only recently that a study is being launched. Many women have been complaining about it for months. Doesn't add up as safe and researched to me. The thing is, don't say it's super safe and nothing is gonna happen if you don't know it, because that is super dismissive and offensive to people who've been maimed for life by these companies and we are seeing this with covid vaccines too.

Why are people not tested for allergies when going to get the shot?
Or if you already currently have covid, a person might not feel they have it and go get a shot simple as that. But it's definitely not officially recommended to get the shot if you have it.
That's not medicine. That's not caring for people. That's checking a name on a list.
Why is it that if you have genuine concerns which can also be backed up by data, a person like Ex calls you subhuman. Why is any and every discussion different from the official narrative being censored on the internet? If you can't see that the media is driving a huge divide between people, you're blind and just as inhuman as you claim the people to be who are just living their lives. You are being fear mongered into it being the end of the world. I'm sympathetic to everyone who has lost close ones to the virus. But if the vaccines is not effective enough to protect the person wholly regardless of other people, its not effective. You can literally get a positive out of testing grapes and oranges with the PCR test.
https://www.theguardian.com/world/2021/jul/02/uk-pupils-orange-juice-fake-positive-covid-test-results


Oh and ex can you link the countless publications that dismiss the link between fda and big pharma? Im actually interested

[Bad-Thoma]

I don't remember a single person in this thread arguing for a government mandate for covid vaccinations. Maybe I missed it? There have been countless arguments as to why people should choose to get vaccinated and endless refutations of junk science and misinformation, but unless I missed it there was never an argument that the government should "make" you take it.

Not being vaccinated is kind of like smoking, it's not illegal and it doesn't need to be (despite the unnecessary burden to the health care system) but no one should have to be put at risk (or discomfort) in a school, arena, store, or business because of your poor choices either. Education and societal pressure won't get everyone to get vaccinated just like it hasn't eliminated smoking but fortunately the wave of antivaxxers isn't anywhere near as large as the wave of smokers in the 50's and 60's when it was vogue and encouraged.

Unfortunately anti-vaxxers are more dangerous to public health than smokers as you can't spot them and second hand smoke isn't going to give you a health issue on one exposure that you can then pass on to others.

For La Flame - here is an article about the menstruation issues. Short summary - it shouldn't be dismissed out of hand as it creates a distrust of the vaccine, it's not being dismissed out of hand but studying the menstrual cycle is always problematic as it so different from woman to woman and even month to month. So far the reported side effects seem to be rare, mild, and short lived and if there were life threatening or severe side effects that data would be there as it would require hospital or doctor visits.

https://www.npr.org/sections/health-shots/2021/08/09/1024190379/covid-vaccine-period-menstrual-cycle-research

[bobbutts]

The projection from anti-vaxxers that people encouraging the vaccine are failing to take the available information into account is pretty incredible. Hint: There's a very large body of rock solid information about the effects of covid in the form of deaths and severe illnesses.

[exculpatory]

I don't remember a single person in this thread arguing for a government mandate for covid vaccinations. Maybe I missed it? There have been countless arguments as to why people should choose to get vaccinated and endless refutations of junk science and misinformation, but unless I missed it there was never an argument that the government should "make" you take it.

Not being vaccinated is kind of like smoking, it's not illegal and it doesn't need to be (despite the unnecessary burden to the health care system) but no one should have to be put at risk (or discomfort) in a school, arena, store, or business because of your poor choices either. Education and societal pressure won't get everyone to get vaccinated just like it hasn't eliminated smoking but fortunately the wave of antivaxxers isn't anywhere near as large as the wave of smokers in the 50's and 60's when it was vogue and encouraged.

Unfortunately anti-vaxxers are more dangerous to public health than smokers as you can't spot them and second hand smoke isn't going to give you a health issue on one exposure that you can then pass on to others.

For La Flame - here is an article about the menstruation issues. Short summary - it shouldn't be dismissed out of hand as it creates a distrust of the vaccine, it's not being dismissed out of hand but studying the menstrual cycle is always problematic as it so different from woman to woman and even month to month. So far the reported side effects seem to be rare, mild, and short lived and if there were life threatening or severe side effects that data would be there as it would require hospital or doctor visits.

https://www.npr.org/sections/health-shots/2021/08/09/1024190379/covid-vaccine-period-menstrual-cycle-research

Thanks for your usual accurate & eloquent post, BT.

I do not have the time for this any longer.
I have too much else to deal with in my personal life.
Everything I have written & every outstanding citation I have posted is based on pure, unadulterated, excellent science.
I have posted all that I have posted out of the kindness of my heart because I know a large group of our guys appreciate it & because I have dedicated my life to excellence in the practice & teaching of medicine.
I am not influenced even a micro-scintilla by the media & I am not on the payroll of Pfizer, Moderna or J&J.
I am smarter than **** & massively well informed. If some of you dick wads think I am somehow blowing smoke or brainwashed, you are sadly mistaken. And I DNGAFF.

No vaccine is perfect & Covid (and especially the evil delta) presents many evolving challenges.
That said, & as I summarized for the 100th time in my most recent lengthy submission yesterday, the Covid vaccines have saved & are saving tens of thousands of lives &, on the whole, the true adverse effects occur in a tiny fraction of those vaccinated. And all potential ‘safety signals’ have been & continue to be thoroughly investigated. The ‘risk-benefit’ ratio OVERWHELMINGLY & INDISPUTABLY favors vaccination.

PS I did indeed post multiple papers demonstrating the indisputable additional protection resulting from vaccination of previously infected individuals. And the CDC has indeed ‘OFFICIALLY’ recommended this.

I am fatigued & disgusted reading continued junk science posted by our small crew of uninformed & willfully ignorant idiots with the medical sophistication of an ameba, meticulously pointing out why the disinformation is fallacious, & getting no where. I always knew there was a significant number of abject morons in the USA - but I did not realize that there were so many. People are still dying by the bucket load & new even more lethal variants are evolving because of these **** idiots.

[SuperDeluxe]

The virus would like to send a heartfelt thank-you to the people who don't do anything to stop it. Special tip of the hat to those who also spread misinformation. It wants to stick around, morph, and kill more and more of us, so it appreciates your help.

I'm going to confess that in 2003, when the SARS-CoV-1 hit, I was an anti-vaxxer. I didn't know anyone who knew anyone who had gotten infected, let alone anyone who had died.

But this time I understood that covid is everywhere and deadly, and that we're all expected to make sacrifices for it to go away. It's not enough if others do it, I have to do my part too.

It's all about choices.

This is what we know that works:

To stop the spread:
- Social distance (with extreme lockdowns being the ideal but impossible scenario)
- Masks
- Washing hands often

To curb hospitalization/death:
- Vaccines

If your reason for rejecting the vaccine is that it doesn't stop the spread, then why the **** do you not do the things that do stop it?

[Andrew McCeltic]

I just think calling people dim witted abject morons isn’t going to change any one’s mind. And dismissing people as unreachable by persuasion or education is a self-fulfilling prophecy. It doesn’t mean any of you have to do it, but, like, to a lot of people experts are basically speaking Latin.

[exculpatory]

I just think calling people dim witted abject morons isn’t going to change any one’s mind. And dismissing people as unreachable by persuasion or education is a self-fulfilling prophecy. It doesn’t mean any of you have to do it, but, like, to a lot of people experts are basically speaking Latin.

Did not insult originally for a long time.

Now totally fed up as many many many of my colleagues are **** fed up.

And And And these abject morons have ALSO dismissed the multiple eloquent & persuasive posts written in plain **** English by non-medical very smart people - in particular by BT, SD & Fencer.

[Andrew McCeltic]

Yeah I know. Idk I guess it’s bc I was a teacher for awhile, sometimes it helps to talk with people and not at them. You can make it more or less safe for people to ask questions and expose their reasoning.

Not asking YOU to do it, and COMPLETELY empathizing with your frustration and exhaustion. And ddb hasn’t responded to me again. Just saying big picture, like, I could imagine outreach being better. Black people are hard to bring off the fence sometimes too but they don’t get as much flack because people understand the history and dynamic.

[Andrew McCeltic]

Anyway ddb here’s why your friend’s thing isn’t obvious and we need science/data:

Imagine I go “Vishnu Krishna hummina hummina applesauce **** heart attack open sesame” and then flip a coin and it comes up heads. I didn’t discover the magic word to make a coin come up heads, and if I do it again and it comes up tails I don’t think I must’ve not pronounced it right.

That’s what “correlation isn’t causation” means. If one thing happens before another it doesn’t mean it caused what happened next.

[Andrew McCeltic]

Doc can correct but I think FDA lists EVERY reported side effect even when it might be coincidence or “placebo”? And why the side effects happen isn’t always explained but it absolutely matters that they’re rare. I’ll give you another example:

[Andrew McCeltic]

You’re forced to play Russian roulette, or do it for fun, or bet money on it. You have two guns to pick from:

One gun has five bullets out of one million chambers, another gun has one bullet out of two million chambers. If you think about it for a second you know which gun to pick, right?

Both guns could kill or hurt you, yeah. We might not understand why - we don’t understand Covid effects perfectly. But the gun with five bullets is Covid, not getting the vax, and the gun with one bullet is the vaccine and having immunity in advance.

I would pick the vaccine gun? And in this scenario you have to pick one up and shoot either way.

[Tatumfor2]

You’re forced to play Russian roulette, or do it for fun, or bet money on it. You have two guns to pick from:

One gun has five bullets out of one million chambers, another gun has one bullet out of two million chambers. If you think about it for a second you know which gun to pick, right?

Both guns could kill or hurt you, yeah. We might not understand why - we don’t understand Covid effects perfectly. But the gun with five bullets is Covid, not getting the vax, and the gun with one bullet is the vaccine and having immunity in advance.

I would pick the vaccine gun? And in this scenario you have to pick one up and shoot either way.

You could take this a step further and say the gun needs to be aimed at your friends and family. Add a bullet for each of the following you refuse to do:

Wear a mask
Social Distance
Regularly sanatize your hands

[Andrew McCeltic]

Ha I thought about that it’s more, the Covid/no vax gun is bigger and if you get the bad luck bullet there’s a good chance it - sorry, gruesome - rips through you and hits three other people too

[Andrew McCeltic]

Read on Twitter

[exculpatory]

Doc can correct but I think FDA lists EVERY reported side effect even when it might be coincidence or “placebo”? And why the side effects happen isn’t always explained but it absolutely matters that they’re rare. I’ll give you another example:

The FDA does indeed pay attention to every single adverse effect reported.

[exculpatory]

Andy, SD, BT, Fencer & the thoughtful, insightful & responsible amongst us:
Wanna see something that blew MY mind which links pulmonology & endocrinology in an attempt to explain often lethal Covid-induced lung disease.
I have read this article 10 times during the last 6 months & still am having a problem grasping all of it.

From the 3/2021 issue of my primary journal - the JCEM (The Journal of Clinical Endocrinology & Metabolism):
https://academic.oup.com/jcem/article/106/3/622/6009077

ME: ‘Excessive mineralocorticoid receptor activation by cortisol’ in the lungs may be a critical component of a pathophysiologic cascade which results in COVID-related ARDS & thrombotic coagulopathy. It lays the groundwork for evaluating a new & UNiQUE therapeutic intervention (dexamethasone PLUS an aldosterone receptor antagonist).

EXCERPTED FROM THE PUBLICATION:
“The loss of the angiotensin-converting enzyme 2 (ACE2) receptor, which is used by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus to get into endothelial and type II alveolar cells, plays a major role in the development of the complications of the infection, acute respiratory distress syndrome (ARDS) and clotting abnormalities.
The loss of the ACE2 receptor results in high levels of angiotensin II, which stimulate nicotinamide adenine dinucleotide phosphate (NADP) oxidase to produce reactive oxygen species (ROS). This removes a key protective mechanism for the pulmonary mineralocorticoid receptor (MR), which now can be activated by cortisol and is no longer aldosterone selective.
Activation of the MR releases adenosine 5′-triphosphate (ATP) from the cells. This then has a paracrine effect on purinergic receptors resulting in calcium entry into the cells.
Increased intracellular calcium results in exocytosis of Weibel-Palade bodies (WPBs) from the cells. These contain the von Willebrand factor (VWF), which spreads like a spiderweb, attracts platelets, and results in microthrombi. The bodies also contain angiopoietin-2, which markedly increases capillary permeability and hence pulmonary edema.
MR blockade with spironolactone has been shown in vitro to block exocytosis of WPBs.
This paper suggests that, on the basis of these hypotheses, there should be trials of dexamethasone to suppress cortisol secretion together with an MR antagonist such as spironolactone or eplerenone.”

ME: FYI, there is precedence for cortisol ‘taking over’ the MR from aldosterone. There is an unusual hereditary syndrome called SAME (syndrome of apparent mineralocorticoid excess) (consequent to the genetic absence of the 11 beta hydroxysteroid dehydrogenase [HSD] type 2 enzyme - which normally deactivates/converts cortisol to cortisone in the kidney) wherein excessive renal cortisol excessively stimulates the MR resulting in hypertension & hypokalemia (mimicking primary hyperaldosteronism).

The intricacy & nuance literally blows my mind. LOL.

[Bad-Thoma]

Andy, SD, BT, Fencer & the thoughtful, insightful & responsible amongst us:
Wanna see something that blew MY mind which links pulmonology & endocrinology in an attempt to explain often lethal Covid-induced lung disease.
I have read this article 10 times during the last 6 months & still am having a problem grasping all of it.

From the 3/2021 issue of my primary journal - the JCEM (The Journal of Clinical Endocrinology & Metabolism):
https://academic.oup.com/jcem/article/106/3/622/6009077

ME: ‘Excessive mineralocorticoid receptor activation by cortisol’ in the lungs may be a critical component of a pathophysiologic cascade which results in COVID-related ARDS & thrombotic coagulopathy. It lays the groundwork for evaluating a new & UNiQUE therapeutic intervention (dexamethasone PLUS an aldosterone receptor antagonist).

EXCERPTED FROM THE PUBLICATION:
“The loss of the angiotensin-converting enzyme 2 (ACE2) receptor, which is used by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus to get into endothelial and type II alveolar cells, plays a major role in the development of the complications of the infection, acute respiratory distress syndrome (ARDS) and clotting abnormalities.
The loss of the ACE2 receptor results in high levels of angiotensin II, which stimulate nicotinamide adenine dinucleotide phosphate (NADP) oxidase to produce reactive oxygen species (ROS). This removes a key protective mechanism for the pulmonary mineralocorticoid receptor (MR), which now can be activated by cortisol and is no longer aldosterone selective.
Activation of the MR releases adenosine 5′-triphosphate (ATP) from the cells. This then has a paracrine effect on purinergic receptors resulting in calcium entry into the cells.
Increased intracellular calcium results in exocytosis of Weibel-Palade bodies (WPBs) from the cells. These contain the von Willebrand factor (VWF), which spreads like a spiderweb, attracts platelets, and results in microthrombi. The bodies also contain angiopoietin-2, which markedly increases capillary permeability and hence pulmonary edema.
MR blockade with spironolactone has been shown in vitro to block exocytosis of WPBs.
This paper suggests that, on the basis of these hypotheses, there should be trials of dexamethasone to suppress cortisol secretion together with an MR antagonist such as spironolactone or eplerenone.”

ME: FYI, there is precedence for cortisol ‘taking over’ the MR from aldosterone. There is an unusual hereditary syndrome called SAME (syndrome of apparent mineralocorticoid excess) (consequent to the genetic absence of the 11 beta hydroxysteroid dehydrogenase [HSD] type 2 enzyme - which normally deactivates/converts cortisol to cortisone in the kidney) wherein excessive renal cortisol excessively stimulates the MR resulting in hypertension & hypokalemia (mimicking primary hyperaldosteronism).

The intricacy & nuance literally blows my mind. LOL.

I'm sticking with the excerpt and not even attempting the full article as I just don't have the lexicon to get anything more than a basic understanding. Covid - potential cascading failure - understanding the cascade - new intervention to stop the cascade possible is what I am getting, and all I can say is I'm grateful these people exist and are doing this work.

[exculpatory]

Andy, SD, BT, Fencer & the thoughtful, insightful & responsible amongst us:
Wanna see something that blew MY mind which links pulmonology & endocrinology in an attempt to explain often lethal Covid-induced lung disease.
I have read this article 10 times during the last 6 months & still am having a problem grasping all of it.

From the 3/2021 issue of my primary journal - the JCEM (The Journal of Clinical Endocrinology & Metabolism):
https://academic.oup.com/jcem/article/106/3/622/6009077

ME: ‘Excessive mineralocorticoid receptor activation by cortisol’ in the lungs may be a critical component of a pathophysiologic cascade which results in COVID-related ARDS & thrombotic coagulopathy. It lays the groundwork for evaluating a new & UNiQUE therapeutic intervention (dexamethasone PLUS an aldosterone receptor antagonist).

EXCERPTED FROM THE PUBLICATION:
“The loss of the angiotensin-converting enzyme 2 (ACE2) receptor, which is used by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus to get into endothelial and type II alveolar cells, plays a major role in the development of the complications of the infection, acute respiratory distress syndrome (ARDS) and clotting abnormalities.
The loss of the ACE2 receptor results in high levels of angiotensin II, which stimulate nicotinamide adenine dinucleotide phosphate (NADP) oxidase to produce reactive oxygen species (ROS). This removes a key protective mechanism for the pulmonary mineralocorticoid receptor (MR), which now can be activated by cortisol and is no longer aldosterone selective.
Activation of the MR releases adenosine 5′-triphosphate (ATP) from the cells. This then has a paracrine effect on purinergic receptors resulting in calcium entry into the cells.
Increased intracellular calcium results in exocytosis of Weibel-Palade bodies (WPBs) from the cells. These contain the von Willebrand factor (VWF), which spreads like a spiderweb, attracts platelets, and results in microthrombi. The bodies also contain angiopoietin-2, which markedly increases capillary permeability and hence pulmonary edema.
MR blockade with spironolactone has been shown in vitro to block exocytosis of WPBs.
This paper suggests that, on the basis of these hypotheses, there should be trials of dexamethasone to suppress cortisol secretion together with an MR antagonist such as spironolactone or eplerenone.”

ME: FYI, there is precedence for cortisol ‘taking over’ the MR from aldosterone. There is an unusual hereditary syndrome called SAME (syndrome of apparent mineralocorticoid excess) (consequent to the genetic absence of the 11 beta hydroxysteroid dehydrogenase [HSD] type 2 enzyme - which normally deactivates/converts cortisol to cortisone in the kidney) wherein excessive renal cortisol excessively stimulates the MR resulting in hypertension & hypokalemia (mimicking primary hyperaldosteronism).

The intricacy & nuance literally blows my mind. LOL.

I'm sticking with the excerpt and not even attempting the full article as I just don't have the lexicon to get anything more than a basic understanding. Covid - potential cascading failure - understanding the cascade - new intervention to stop the cascade possible is what I am getting, and all I can say is I'm grateful these people exist and are doing this work.

Thank you for reading what you read.

You got the gist of it.

There is a very complex bad ass cascade of events which leads to Covid respiratory failure & kills many people.

If you can block 1 or more components of the cascade, maybe you can block the entire cascade & the awful end result.

The part that obviously intrigues me the most is the endocrine components of the cascade - if you can decrease the excess cortisol with decadron and simultaneously interfere with the binding of cortisol to a receptor it does not typically utilize (the mineralocorticoid receptor - which is normally predominantly used by a different adrenal gland hormone called aldosterone), maybe you can prevent the entire cascade from happening - so that the lungs do not fill up with fluid & clotted blood vessels.