Tag: COVID

Diet, Health

Yum, Fermented Milk

I had a follow up meeting this week with my gastroenterologist to discuss strategies to fix my gut issues. Two things jumped out at me from the discussion. The first was weight loss. The doc is a very fit guy who’s into brazilin jiu-jitsu. We’d been talking about diet, and he laughed and said, “these days I have to be careful about who I say this to, but losing just ten pounds would make a huge difference in how your gut feels”.

What struck me is not that I could lose some weight (I already know that), but that in today’s day and age he has to be careful about telling someone that. It’s sad that we no longer want to hear the truth. We want to be told to take this one pill and it will fix everything. In reality, we’d all be better off if doctors felt like they could freely tell their patients that they’re a disgusting fat-body and it’s time to do something about it. Unfortunately, that would offend our delicate sensibilities and someone would probably sue for damaging their self-esteem.

The second thing he said is that people don’t understand how long it takes to repair the gut microbiome when things go haywire. He felt it was going to take six months to a year to get back to normal. He said he laughs when people say they can remove a particular food or try a diet for a week or two and think it will do anything. Several months is the minimum to see real change. He said the gut is incredibly complex and we still don’t understand much about why it gets out of whack.

My official diagnosis is post-disease IBS. I contracted something at some point, and it threw my gut into a downward spiral. When we originally talked, I’d said Covid was the last time I’d been sick. He didn’t initially think that was the cause. When we met this time, he said he followed up with some research and studies are starting to show that Covid is having an impact on gut health. Interesting.

Anyway, as a part of repairing things we talked about foods and supplements I should be taking. Big amounts of protein, wheat dextrin fiber, yogurt with live cultures, and fermented foods like Kefir. I had to Google kefir. I’d seen it in the store but didn’t know what it actually was. It’s fermented milk. Uhhhh… I don’t know if I can do that.

When I was in my early twenties I worked at a restaurant. During my break I was in the habit of chugging one of those mini cartons of milk. One fateful evening, I grabbed a carton and started drinking it down like I was shot gunning a beer. The carton as almost empty before I realized the milk was… chunky. I ran to a garbage can and vomited up all that spoiled and curdled milk. I haven’t drunk milk since.

So you can see why I’d be a little hesitant to drink fermented milk on purpose. I think I’ll put that on the back burner for now. Besides, it turns out sauerkraut has the same benefits. I like sauerkraut. I like hot dogs. I could do a sauerkraut dog a day. What could go wrong with that?

Daily Life

It Was Time To Leave Healthcare

My last day was very surreal. With each task, I’d think “Oh, this is the last time I’ll ever do this”. I’ll never start an IV again. I’ll never pull out another Hemovac drain. This is the last time I’ll hang antibiotics. It’s the very last time I’ll dispense medications. It was an odd feeling.

It was time to leave healthcare for a lot of reasons. Healthcare has changed, and not for the better. Healthcare workers have been leaving the profession for a while, but Covid turned that exodus into a stampede. Hospitals are facing a crushing shortage of workers. That lack of staff is making working on the hospital floor unsafe. The patients are sicker, more demanding, ruder, and more violent. At the same time the near-daily onslaught of new rules, regulations, and charting/documenting requirements leave little time to actually connect with your patient. It’s sad, and I don’t see it getting better.

As an RN, I’ve been hit, kicked, spit on, yelled at, threatened, peed on, vomited on, and cleaned up more poop than you can possibly imagine. All while working a 14-hour day, sometimes without enough time to take a lunch break. We worked the Covid floors without enough supplies, being forced to wear the same dirty mask for two and three days because there was such a shortage. It’s been interesting times the last few years.

At the same time, it’s been an amazing experience. I saw and did things I never thought I’d be doing. I was able to connect with people at a level you can’t do at a cocktail party. I’ve held the hands of people as they drew their last breath. I spent time consoling people who just received devastating news about a tumor prognosis or were newly paralyzed. I sat quietly with people whose loved one was going to pass away soon. I also got to hear some fantastic stories from old folks about growing up in the depression, war experiences, and traveling across the country before there were interstate highways. I made some good calls that probably resulted in people living vs dying. I responded to codes and performed CPR on folks. I’ve had several people stop me in a store and tell me that, “you won’t remember me, but you took care of my father. He was so grateful for your care.” I have enough stories of crazy, wacky patients, gruesome injuries, and blood and gore to last a lifetime. In my pre-healthcare life, I never would have imagined that one day I’d be chasing a crazy, naked old lady with dementia as she ran down the stairs towards the parking lot. They definitely skipped over that part in nursing school.

I’m grateful I got to experience all of it. The good and the bad. (ok, maybe not the poop) It’s made me more appreciative of the blessings I have in my life. It’s also made me realize how important it is to try and be a good human. At the end of the day, that’s all you have. When you exit this world, how do you want people to remember you? Healthcare reminded me on a daily basis that you don’t know when your time is up. Slow down a bit and enjoy life. Make sure you take the time to see and do things. Because you never know what’s around the corner.

So, it’s time for the next chapter. I’m not entirely sure what that is yet, but I’m looking forward to it.

Government, Health, Solving the wrong problem

It’s Time To Fear The Toilet

I like learning new things. Most of the time it’s useless information like, on average 100 people a year choke on ballpoint pens. Or Al Capones business card said he was a used furniture dealer. And that licking a stamp is one-tenth of a calorie. But once in a while I stumble upon something that’s interesting and useful. Like Covid is spread through the toilet. What?

If you have time, this article is an excellent read. It’s long and complicated. I confess, I’ve read it three times now and still don’t understand at least a third of it. It’s about the origins of Covid. But one section about transmission routes of Covid caught my eye. It turns out that the initial, and most probable, sources of infection were from fecal aerosols and Class B Biosolids. Fecal aerosols? That sounds horrible!

Toilet aerosols are, well… produced by the forceful evacuation of fecal material, followed by flushing (not sure how else to put it?). Large amounts of virus are shed in fecal matter. Part of the longstanding methodology of tracing virus spread is from testing wastewater. (I didn’t know that) So, you’ve produced a plume of virus containing aerosol that now wafts through the plumbing and hovers in air. Household member number two comes along to conduct their daily constitutional and, boom, transmission. The bulk of transmission, especially early on, came from intra-family and group living settings. Hmmm.

Next up is the Class B Biosolids. I’d never heard of that. I wish I hadn’t. It turns out that the “sludge” that comes from wastewater treatment facilities is repackaged as fertilizer. Yes, you read that right. Human feces, now branded as a “Biosolid”, is given/sold to farmers as fertilizer. Class B means it has NOT been treated to remove pathogens. So, we’re happily spreading Covid virus packed human feces fertilizer on our food source. This chart blew me away. It shows the top 500 US counties with Covid case increases early in the pandemic (Nov 2020). Next to it is the US counties with the highest level of corn production. The two are a near mirror image. Nah, that’s not frightening at all.

A few minutes of searching time and you’ll realize that none of this is new or novel information. It was well known science long before Covid, with plenty of papers in the various journals. Our various health departments and agencies clearly know about this. Yet, they spent over a year pushing respiratory droplets and fomites as the primary vector of transmission. We’ve been forced to wear useless masks in the hopes that they might stop the larger mucus particles and to panic buy sani-wipes to clean every conceivable surface before we sit down. Meanwhile the virus has been happily aerosolized and is wafting along in plumes, and slowly drifting down to be inhaled hours or days later in any room that doesn’t have adequate ventilation.

With pro sports back in swing, how many “super spreader” events have there been from stadiums of 70,000+ fans? None. They’re outdoors or in facilities with fantastic air circulation. There’s clearly been some limited spread at events like Sturgis. While most of the Sturgis rally is outdoors, what other component does it have? In the evening everyone heads to the bars and clubs with little to no real HVAC capability. Why haven’t there been any large spread events documented with the airlines? If primary transmission was direct respiratory droplet spread, you’d think we’d constantly hear of entire planeloads of passengers that tested positive. We don’t. Airlines have some of the most effective air circulation you’ll find.

This is not to imply that you cannot get Covid via respiratory droplets. Of course you can. But that’s going to happen in an environment of close contact for extended periods of time. Bars, clubs, friends sitting around the kitchen table for hours. Coughing, laughing, touching their face, sharing drinks, smokes, and physical contact (what do you think the young kids are doing at the clubs, silly rabbit?)

You are not going to get Covid walking through the grocery store, strolling through the restaurant to your table, or passing people on the hiking trail. If you do, you most likely passed through an aerosolized plume that’s been wafting in the air for hours already. Unless you’re wearing a properly fit tested N-95 mask… nothing is going to prevent that. Sorry.

There’s much more to unpack in this article, this was just the first part that jumped out at me. How much further I go with it depends upon the current state of my ADHD attention span, the weather, and my natural inclination to throw up my hands and decide never to write again at any given moment (happens multiple times a week).

The image I’m left with after reading this is that poor fellow who you spot walking along by themselves, outdoors, alone, wearing a mask. Fearful and paralyzed with the idea that the ‘Rona is just waiting for them around every corner. Can you even imagine them finding out there’s Corona virus in fertilizer and fecal aerosols? Being unable to eat or ever poop again would be a sad ending.

Daily Life, Government, Politics

What To Do With All My Daylight Savings?
  • This morning we returned to standard time. Back in the days when we had actual clocks, that meant a week of discovering time pieces that you’d forgotten to set back. Now the only devices we have in our home to manually reset are the oven clock and my analog watch. Meanwhile, the twitters blow up every year declaring a national emergency and the congress needs to stop it’s important work to abolish the DST practice. Personally, I like it. We live in the northern latitudes so during the summer when the days are already longer, tacking on the extra hour DST gives you means it’s light until almost 10pm. I love having the extra time to do outdoor stuff. During the winter, the days are short anyway so why not have it light a bit earlier? Are you a pro or con DST person?

Hard times create strong men. Strong men create good times. Good times create weak men. And, weak men create hard times.

G. Michael Hopf
  • President Biden claimed the other day, in an incomprehensible babble, that the supply chain problem is because Covid shut down factories and if you asked people in restaurants they wouldn’t understand it because reporters aren’t explaining very well and “When your editor says, “Explain the supply chain.”  Okay?  “Lots of luck in your senior year,” as my coach used to say.” WTF? Meanwhile our Vice President, who happens to be the chair of the national space council (whatever that is?) interrupted a NASA presentation to ask if we can track the population of trees against race. WTAF? Because, you know, space activity is climate action. I want me some environmental justice, brother. Word! As Tucker Carlson says all the time, these are not serious people. From the quote above, I’d postulate that we’re currently in the transition from weak men to hard times. And don’t get your panties all in a bunch, “men” is a colloquialism for “the population” today. Relax people.
  • A 77 year old man was confronted by an armed robber and instead of handing his things over, the elderly man pulled out a gun and shot the robber in the head and chest, police said. He was pronounced dead at the scene. “Officer, where’s the victim? Oh, he’s DRT. DRT? He’s dead right there.” I love me a good DRT story.
  • Remember special council Durham? Turns out he’s still out there and released another indictment. Even if you’re a rabid anti-Trump person, you have to admit that your Russia collusion theory is getting pretty hard to defend. Whether you agree or disagree, in a normal world it would at least be considered newsworthy right? You’d think that CNN and MSNBC who devoted 90% of their time for several years on the story would at least be attempting to debunk his indictment right? Not a single mention of the story on either web site yet. Hmmm. The bad orange man was right – the media is the greatest enemy this country faces.
  • Speaking of the media and radio silence, the FBI raided Project Veritas offices and homes of a number of employees the other day. Why? They’re looking for Ashley Biden’s diary. Why? That’s very unclear. Why would the FBI suddenly be interested in a missing diary? We don’t know. What we do know is that in that diary she alleges that it probably wasn’t appropriate for her to take showers with her father as a child. The diary was stolen and the contents came out just before Biden’s first debate with Trump. Just the like the Hunter Biden laptop, the media collectively killed the story. Move along people, nothing to see here.
  • I’m most of the way through Molly Hemingway’s book “Rigged” about the 2020 election. I’d highly recommend it – even if you’re a massive lefty. Why? Even if you disagree with her assertions, she lays out how our election process really works. I had no idea how corrupt it really is. Us common people don’t have much to do with who actually gets elected, on either side of the aisle.
  • At a football game a dog scored the longest frisbee catch record – end zone to end zone. Dogs rule. Meanwhile, I’m headed out on a motorcycle ride with a friend who is a new rider and just got his first motorcycle. I think he’s a little nervous. Been there, done that. My job is to help build confidence, while pushing the envelop just enough to improve skills. It’s sort of a blind leading the blind scenario. What could possibly go wrong?

Song of the day: Lo Fidelity Allstars – Battleflag

Cool, Daily Life, Health, Travel

I Like Pickles
  • This week Mrs Troutdog and I celebrated our 29th wedding anniversary. It’s still a mystery how she’s managed to put up with me for that long. An even greater mystery is how I managed to hide my love of pickles for this many years. As part of our anniversary celebration we flew down to Palm Springs to play some golf and see the in-laws. On day one of our visit I discovered a giant Costco tub of pickles in her mom’s fridge. I spent the next few days diligently working my way through the giant vat of pickles. At one point Mrs Troutdog declared, “all these years and I had no idea you liked pickles so much?”. My secret is out. I guess I have to confess. I’ve been hiding pickles to eat when she’s not there. I’ve been sneaking out of bed to visit late night pickle stores. If we can get through the shock and shame of my pickle secret, I’m pretty sure we can make it through another 29 years of marriage.
  • While looking stuff up for my pickle story, I discovered that there are a ton of pickle of the month clubs. Who knew? I never would have guessed that the pickle community was large enough to support monthly deliveries of pickles. So, if any of you are looking to buy me a gift… now you know.
  • If I ever become super-woke and feel compelled to list my pronouns, I’m going with… rib/eye. Stole that from twitter. Not sure why that amused me so much.
  • Speaking of Palm Springs, we played a couple of days of golf at some high-end courses. I tend to be a local muni-course type of player. I bring my own water, walk the course whenever possible, and expect to see the condition of the fairways and greens as… “variable”. These Palm Springs courses are not that. You pull up to the clubhouse and dudes run out and put your clubs in the cart. They supply tees, wet towels, water, and divot repair tools. The greens and fairways are perfectly manicured. You truly feel bad taking a divot on the fairway. It’s honestly intimidating if you’re not much of a golfer. I was a bit worried leading up to the trip. Spent a bunch of money on travel bags for the clubs, dealing with checking them in at the airline, and the super expensive green fees – last thing in the world I wanted to then play horribly. It got in my head leading up to the trip. This is why I could never turn pro. Well, that and that whole lack of coordination thing. But, I played really well (for me). It was a fun experience and I look forward to our taking more golf trips. Except how do I now go back to regular people courses where you have to load and unload your own clubs from the car?
  • There was a political bloodbath last night. Shockingly, it turns out that when the economy is tanking and crime is through the roof people stop caring about frivolous topics. First and foremost people want safety, security, jobs, and a working economy. In times of scarcity, climate change, race, race, race, race, race, race, and socialist spending are not high on peoples list of concerns. It will be interesting to see what the democrats do in response. At the moment the progressive wing is claiming the problem was that they didn’t go hard enough on progressive demands. We’ll see how that works out.
  • COP26 has wrapped up and the end result was… nothing. Zip. Zero. Nada. Not a single accomplishment. Oh, how will the climate survive? The two biggest greenhouse gas emitters chose not to attend. Too busy building out coal fired electrical power plants I suppose. The African countries did make it clear that they’re pissed though. Why? We’ve reneged again on the 2009 pledge to pay them 100 billion a year to “cope with climate change”. Clearly John Kerry wasn’t on top of his game this year. But hey, at least he got to take his private plane out for a spin again. Along with 400 others carbon spewing planes, 85 car caravans, and massive gala dinners (where I’m sure they at least used paper straws).
  • This trip we took was the first time I’ve traveled out of state since the pandemic started. My state is mostly anti-mask and I haven’t had to wear a mask anywhere (other than work) for a long time. Traveling to California is different… mask mandates everywhere, vaccine cards required to eat inside restaurants. Masks in the airport and on the plane. And all of it is just theater. Wearing a mask to walk twenty feet into a restaurant only to take it off at the table is absurd. Sigh… and the plane – both Mrs Troutdog and I were scolded by flight attendants several times for letting our masks drop. Until food and drink service arrived – then yay! Everyone can eat, drink, talk and cough. The ‘rona is smart enough not to spread while you’re eating and drinking. I still cannot grasp that our public officials continue to push this nonsense. If you had told me two years ago that the entire country would soon think it was normal to walk around outside with a mask on your face, I would have sworn you were smoking something.
  • Speaking of smoking something, California is one of the states who has legalized the ‘herb. It was odd to see marijuana dispensaries on every corner. I could care less. I do wish there was a test or definition for what “under the influence” was, but otherwise each to their own. It may or may not be true that the bottle of vitamin gummies that came back no longer contains “vitamins”. The challenge at our age is remembering to grab the right bottle when taking the morning vitamin regime.

Song of the day: Macka B Legalize the herb

Daily Life, Health

Dodged A Bullet

One of the unique aspects of hospital work is the concept of being “floated”. I have my home floor where I was hired. But the hospital has the right to send me to any floor they choose in order to cover staff shortages. I guess the theory is that an RN is generic and doing nursing shit is the same on every type of floor right? Doesn’t matter that I have no idea who the providers are and many of the medications on that floor are something I’ve never seen. I have no idea what the policies are for that specialty or even how to find the supply room. Imagine being in marketing and working day after day on a particular product launch. You show up to work and your boss tells you to have to go work on a different product team today. After all, marketing is marketing, right?

Anyway, I showed up the other day and checked the schedule. The dreaded words… float to the covid floor. Sigh. Naturally nobody wants to work the covid floor, so everyone has to take a turn. Unfortunately due to the spike in cases in my area, coupled with huge staffing shortages, getting floated to the covid floor is becoming pretty common. So off I went to the hot zone.

Twelve hours of putting on a heavy plastic gown, gloves, N95, surgical mask, and face shield, going in the room to take care of business, then stripping it all off. Then doing the same in the next room. Then going back to the first room. Then the next room. Over and over and over again. These folks are sick. For the most part not much bothers me medically – but watching people struggling to breathe when there’s little I can do, is just hard. It makes for a long day.

Fast forward a few days and I woke up and just felt… off. I did a bunch of errands and then some yardwork. By early afternoon I had zero energy and a splitting headache had set in. The next morning, no change. No energy, fatigue, brain fog, and a dull headache. Classic covid symptoms. Crap! The China virus finally got me. How ironic that I’ve been writing about breakthrough cases in vaccinated people and now I’m going to be one of those statistics. In my mind I replayed all my patient encounters. Did I get sloppy with my PPE? Did I forget to wash my hands and then touched my face? I was adjusting my mask when that guy coughed on me, maybe that was it?

We have some people coming to visit and an upcoming trip, so I figured I better get tested just to confirm. Insurance will pay if you’re willing to wait 2-3 days for your results. If you need immediate results it’s out of pocket. So I plunked down my $142 and got the swab via a drive through testing center. I went home and started making a list of who I may have come in contact with so I can tell them they might have been exposed.

Negative. Negative for covid and influenza. Whew. And this morning I woke up and felt fine. I don’t know what it was. Maybe it was a cold? Too many days of poor sleep? Didn’t drink enough water? Too many nachos in one sitting? Weird.

Our world has certainly changed. I never used to think twice about feeling off for a few days. Now, the slightest sniffle and we all worry that the dreaded virus finally got us. We’ve been brainwashed into becoming a society that fears normal human interaction. Half the population endorses authoritarian/totalitarian measures of control. The other half is ready riot in protest.

I live in a weird dichotomy. I live my life as normal as possible, without fear. My odds of grave injury in a motor vehicle accident are higher than being struck down by covid. I’m going to eat in restaurants, enjoy time with friends, and see family. Yet, in the back of my mind are images that not everyone sees. A few days ago I watched a man be wheeled into his wife’s room for a few minutes to say goodbye – before we pulled her off oxygen support. Another covid statistic. That’s real. It’s not a meme on Facebook.

I miss normal.

Government, Health

Crossing The Minefield

Because I have some time on my hands, and I’ve got my tinfoil hat shaped just right, I’m going to add an update to my previous (poorly worded) post on leaky vaccines. This one is about risk assessment. I think we’d all agree that each individual should be able to make an informed decision about the risks of getting or not getting the vaccine or booster. In a perfect world we’d see all the pros/cons and decide what’s right for your particular scenario. But what if you weren’t told all the info?

(adjusts hat) Ok, here we go. It’s starting to look like after your first dose of the mRNA vaccine you go through a roughly two week window of a highly immune suppressed state. The reasons why are not clear yet. The most likely cause seems to be that the mRNA vaccine has to turn off the toll-like receptors so the vaccine can enter the cells without being attacked by the immune system. Other options are a fall in lymphocytes and neutrophils that are seen three days post vaccine. Regardless of cause, it appears likely that you are in a highly immune compromised state for several weeks after your first dose. This does not happen after the second dose.

The impact of this is a significantly increased death rate post first dose. This was seen clearly in the Israel data and now in the Palestinian data since they are just now getting their first doses. Going back to Israel, we see the same corresponding rise in death rate following the booster.

Just to be clear, people are NOT dying from the vaccine. They appear to be briefly in a highly immune compromised state and then get covid or a cancer spreads, etc…

So to steal a brilliant analogy – we have some percentage risk by not taking the vaccine, based upon our age, comorbidities, fitness, etc… We can mitigate some of that risk by taking the vaccine, but in order to do that we have to first cross a minefield. You’d probably want to know what are the odds of stepping on a mine, right? Well, the first study on this shows a 46% increase in suspected covid during that two week period. Even the Pfizer data itself shows a 40% increase.

Don’t you think it would have been good to know that you’d briefly have a nearly 50% increased chance of getting covid and massively increased odds of being hospitalized for several weeks after getting your vaccine? The tradeoff for running across the minefield is a vaccine that is eventually 56% effective (not the 95% we were sold).

Again, I’m not arguing that you shouldn’t get the vax. I think most folks 50 and older, or folks with comorbidities should. BUT, don’t you think folks should have been advised that for 2-3 weeks post first dose you need to self isolate as much as possible to reduce the risk of getting covid? I blissfully went back to work after my first dose, including working the covid floor! And why in gods name would we be pushing the vaccines during peaking cases? From a big picture, public health standpoint, you’d want to be vaccinating during lulls in case rates.

Which brings me back to the previous post. What if we’ve created a bunch of vaccinated asymptomatic superspreaders who are inadvertently causing a spike in case rates? And then in response we push/mandate vaccinations and start boosters. We just potentially put millions of people into that two week risk window with covid on the increase and superspreaders walking around… The hospitalization and death rates will be interesting follow this winter.

Come to think of it, my tinfoil hat is feeling a little snug. Time to take it off and go do something productive outside.

Government, Health

Did We Screw Up?

Sit back and relax for a minute. I have a short tale that might worry you a bit. One that, if true, would prove to be one of the greatest public health blunders in history. It’s about a vaccine. Wait, wait, don’t go… this isn’t an anti-vax tirade or a rant about mandates. It’s a story about what happens when people rush to make a decision without waiting for all the data.

A question – what happens if we created a “leaky vaccine” and pushed it out to billions of people?

Here’s the background. I follow a number of statisticians. Yes, I know I’m a geek. But I like data and charts and graphs. I admit much of the stats are above my head, but I took just enough statistics to semi-sorta understand what I’m reading. Anyway, I first heard about the idea of leaky vaccines from something that Joe Rogan said on his podcast. He, of course, was immediately blasted for pushing tinfoil hat conspiracy stuff. Which, of course, made me want to read more about it. Enter the statisticians who plot and analyze the data and ignore the politicians and media wisdom.

What you want is a sterilizing vaccine. One that creates an immune response powerful enough that it instantly attacks and wipes out the virus in the host before it can replicate and spread. What you don’t want is a “leaky vaccine” that produces an immune response sufficient to protect the host, but isn’t able to prevent a buildup of viral load or transmission. Every day it’s looking more likely that we’ve produced a pretty leaky covid vaccine. This is generally ok for you, the vaccinated individual. Your immune response protects you from getting really sick. But the population as a whole…

Here’s the worrisome part. The data is showing that when a vaccinated person is hit with covid, their viral load and shedding of virus is equal to that of unvaccinated people and lasts for days. And the best part? Because they have an immune response that starts working to protect them, they are generally asymptomatic. Are the lightbulbs starting to go off? In our mad rush to push the vaccine without sufficient testing, we may have just created a bunch of vaccinated asymptomatic superspreaders, happily walking around and infecting the unvaccinated and those unhealthy folks (vaccinated or not) who managed to dodge the bullet during the first covid wave.

Israel, one of the most vaccinated nations on the planet, got hammered with a second wave. Similarly the UK and many highly vaccinated cities in the US. The hospitals are being overrun in many cities, including my own. In many places it’s far worse than the first covid wave. We’re seeing tons of “breakthrough” cases – vaccinated folks who get covid. Unfortunately many of those folks have multiple comorbidities, which is why they got the vaccine in the first place. Their outcomes aren’t great (but still better than without the vaccine). Get vaccinated so you can safely visit your immunocompromised family and friends! We need a vaccine passport so we can safely shop and go to restaurants! The potential irony would be humorous if it wasn’t so tragic.

It’s a catch-22. The vaccine we rushed into the population is clearly good for the individual, but may be bad for society as a whole. Politicians and public health officials panicked and pushed out something without knowing the potential long term impacts. And now that we’re facing skyrocketing case and fatality rates again, the panicked response is boosters! We need boosters in every arm ASAP!

Never mind that the FDA advisory panel voted 16-2 AGAINST authorizing the booster for everyone. The CDC ignored that and did it anyway. The two top virologists at the FDA resigned over the politicization and handling of all this. Yay! Trust the science bitches.

It’s easy to be an armchair quarterback, I get that. But what makes science all sciency, is a willingness to continually examine the data, re-evaluating, questioning, and rethinking your hypothesis if results weren’t what you expected. Unfortunately politics and fear forced us to throw all that out the window. Politics and vanity will keep anyone from saying out loud, “uh guys, we might have screwed up?” Maybe this is a big nothingburger. Maybe in a couple years this will be a minor, annual flu-like annoyance. Or maybe we’ll be on booster #8 and wondering why we keep getting so many mutating variants? My tinfoil hat fits me just fine, thank you.

Daily Life, Government, Health

Ivermectin Killed The Dinosaurs

The virus which shall not be named for fear of offending someone presented the United States with a unique inflection point. We were thrust into a position in which we could have fundamentally altered the health of this country. And rather than doing the right thing, the combined government and public health officials collectively shit the bed. Let me explain.

The US population is not generally healthy. We’re fat. We don’t exercise. We eat like crap and massively overconsume the crap that we do eat. Here’s a fun statistic – the United States ranks 46th in life expectancy. 46. Cuba ranks higher than the US. The number one cause of death in the US is heart disease – an almost completely self-induced problem that can be somewhat reversed with diet and exercise when discovered. 700,000 people died of heart disease in 2020. More than any other cause, including covid and cancer.

And what puts you at risk for dying of covid? Age, heart disease, obesity, diabetes, and smoking. Way back at the beginnings of this pandemic it seems that the thing to do would be to scream from the rooftops that if you’re fat, out of shape, smoke, or have diabetes this disease is going to kill you. As Dean Vernon Wormer said, “Fat, drunk, and stupid is no way to go through life, son”. Wage an all out campaign to inform the population that changing your lifestyle is no longer optional if you want to survive long term. But we didn’t.

Oh sure, there were a few passing mentions of comorbidities putting you at higher risk but we certainly didn’t make a huge deal of it. Instead we opted for punishing everyone. What we should have done was quickly isolate the elderly, keep schools open and keep the economy running. We should have made the central message, broadcast daily, that if you are fat, have the diabetes, hypertension, or smoke you should isolate as much as possible if you want to survive this. Hammer home that folks who are overweight and hypertensive, should they wish to mingle with the public, need to be wearing a properly fitted N95 mask. Not the useless paper ones or that nasty bandana you’ve been wearing for a month without washing. No N95, no vaccination and you will get covid and will probably die. Why are we afraid to tell the truth?

But that’s not what we did. We cratered the economy. We isolated everyone including the young and healthy, prolonging herd immunity. Rather than keeping gyms open and telling people that you need to get outside, exercise, and improve your health if you want to survive… we kept everyone isolated inside. The result? 42% of adults reported gaining weight. How much? An average of 29 pounds.

We gambled on the holy grail of vaccination to magically protect everyone, including those most at risk. There’s no doubt its made a huge difference in moving us more quickly towards herd immunity (since we never let the young and healthy develop natural immunity). But mayors and governors had to start opening up to have any chance of saving their economies. And the vaccine has given those who have risk factors a false sense of security. And sure enough, a more virulent version of covid appeared and now even those who’ve been vaccinated are getting sick. The vaccine isn’t a magic shield. It’s doing what it’s supposed to do. It will dramatically lessen the chances of the infection turning worse. This is why everyone should get the shot, even if you’re “healthy”. It gives you a fighting chance of keeping any symptoms mild and not ending up hospitalized. But if you’re overweight and in poor health… it may not be enough. And that’s exactly what the data shows. The overwhelming majority of people hospitalized and/or dying of covid right now have the classic comorbidities, vaccinated or unvaccinated.

So why are our public health officials not screaming at the top of their lungs about this? Are we afraid of offending people? Are we more worried about “fat shaming” than we are of people dying? For those of us who have the risk factors (and I count myself as one of them), we know what we look like the mirror. I’d rather my self esteem take a hit if it’ll force me to go for a run, than die because someone was afraid of telling me I need to drop a few pounds.

It’s time for health care providers and public health officials to be brutally honest. Stop with the silly mask charade. Form a modern equivalent of the old Presidents Council on Physical Fitness. Since we’re already printing money, how about a tax write-off for gym memberships and exercise equipment? Government subsidies to insurance companies that offer deep discounts on health insurance premiums if you can keep your BMI, blood pressure, and A1C at or below healthy limits?

Crazy talk, I know. But sadly we’d rather pit citizens against each other and ostracize folks from participating in society if you don’t take the jab. We’re scolded like little children, being told that “patience is wearing thin” and “this isn’t about freedom”. Officials are afraid to talk about natural immunity from covid because it might detract from their only message – 100% of citizens must have the vaccine, no exceptions.

Covid is going to turn endemic at some point. I think you’re foolish not to get the vaccine, but that’s your personal choice to make. We are all going to get Covid eventually, that’s a certainty. The only question will be how many factors do you have going in your favor when you do get it? Personally, I want to have had the vaccine and I want my weight, blood pressure, and A1C to be the best I can get ’em given my age. I’m just as guilty as the next person of being lazy about that. Not anymore. I’m enjoying life too much right now to lose it because I couldn’t put down the nachos.

Clearly the government isn’t going to do the right thing for its citizens. It’s up to you. So as Inspector Harry Callahan famously said, “You’ve got to ask yourself one question: ‘Do I feel lucky?’ Well, do you, punk?”

P.S. The title has nothing to do with anything. I saw it on the internet and loved it, but couldn’t think of anything to relate it to.

Health

No Vax, No Treatment?

Social media is an interesting place. There is no doubt its driven a giant wedge in society. Everyone has been forced into one camp or another. There is no longer respectful debate or differing opinions… on anything. People are constantly outraged at something. Outraged and extreme. There are no shades of gray, just black and white. The latest outrage seems to be a massive amount of self-righteous indignation over people choosing not to get the vaccination for the virus we shall not name.

Post after post on Twitter and Facebook of people calling folks who haven’t been vaccinated uncaring monsters, selfish, and worse. What I’m seeing a lot of lately are people saying that if an unvax’d person gets Covid they should be denied a hospital bed, relegated to tents in the parking lot, or “go to the back of the line”.

Not only does that opinion lack any compassion, it also shows a complete lack of understanding of our healthcare system. I’ll estimate that at least 50% of my hospital (probably more) is full of people being treated for something self-induced. Obese, smoker, throws a clot and has a stroke. Uncontrolled diabetic who has non-healing necrotic foot ulcers. Alcohol detoxing. Drug overdoses. Alcohol induced cirrhosis. Suicide attempts. Intravenous drug users with massive septic abscesses. The list goes on and on.

All these folks get treated. We don’t withhold care because they are responsible for their illness. We don’t judge your poor life choices. Oh, and by the way – the vast majority of these folks are unfunded. They do not have insurance. They still get the same care as everyone else. The hospital has to eat that cost, and so it gets passed on to you.

Are hospitals starting to see a lack of beds? Yep. But it’s for a variety of reasons. Prior to Covid we were starting to see a decline in the number of rehab, skilled nursing, and assisted living facilities. We have patients in the hospital that are medically cleared, but have been there for weeks (months sometimes) because we can’t find a facility that will accept them. Covid made that problem 10x worse. I’d guess that at any given time close to a quarter of the beds on my floor are occupied by patients who have been cleared to go but we can’t find placement for them.

The other issue is one of staffing. Many, many hospitals were starting to see staffing shortages pre-covid. With the pandemic, the bottom simply fell out from a staffing perspective. We often have physical beds available… just no staff to be able to accept more patients. I receive text messages from management nearly daily, begging for folks to come in and work additional shifts. Overtime pay, premium pay, covid bonuses, and we still can’t cover all the staff shortages.

So now we have a new variant that’s hitting the world pretty hard and that’s making everything worse again. Is this new wave impacting care for non-covid things? Absolutely. We’re now limiting elective surgeries again and postponing non-urgent procedures. That sucks. The trickle down effect of people postponing care will hit us hard later. All in all, this is a mess. Covid will be with us forever and the impact on our nation’s overall health will be a generational one. The point is that hospitals being “overwhelmed” is a multi-factorial problem, not just due to Covid. Surges in Covid cases simply exacerbate what was already an issue in healthcare.

So back to my original point. If you think that we should start rationing care based upon a personal choice about a vaccine… be careful what you wish for. We go down that road and you better not show up to the hospital slightly overweight with hypertension and a smoker, and complaining of chest pain. You may get put to the back of the line so we can treat someone with cancer first. So sorry you’re having a heart attack, I guess you should have taken better care of yourself. Bottom line, this pandemic sucks for everyone. Stop with the indignant, self righteous outrage. We’re divided enough already as it is. No need to add to it so you can feel morally superior over someone who makes different choices than you.