COVID Vaccine (2)

Discussion in 'Flight Following' started by X3 Skier, Nov 18, 2020.

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  1. chemgeek

    chemgeek En-Route

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    The Pfizer vaccine, which requires dry ice temps, will probably not be distributed beyond hospitals and research centers that have access to ultralow freezers. You local PCP clinic in unlikely to have the necessary freezer equipment. The Moderna vaccine is a little easier to handle, as it can be stored a typical freezer temperatures. High volume locations should be able to handle it. IIRC, once you thaw it out, you have a limited time to use up the doses. The AstraZeneca and Johnson & Johnson viral vector vaccines can be stored at regular refrigerator temps, and I'll bet these (for which the US has contracted for 400 million doses, enough for 250 million individuals) will be the ones the might make it into the local drug stores, etc. I would not expect the AstraZeneca or J&J vaccines to get a U.S. EUA prior to late January based on the starts of their Phase 3 trials. The AstraZeneca vaccine has already been approved in the UK, but is still in a U.S. Phase 3 trial.
     
  2. weilke

    weilke Touchdown! Greaser! PoA Supporter

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    You don't need a ultracold freezer for Pfizer. You do need access to dry ice to replenish the box and you have to go through enough doses per day to use up 1000-5000 doses over the course of 35 days. So that's not your regular GPs office, but any health department drive-through site should be able to use enough of it to work directly from the Pfizer container.
     
  3. Lindberg

    Lindberg En-Route

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    Are you actually treating asymptomatic cases? My in laws and my wife all have it, and are all symptomatic (mild, thankfully), but no one's offered any treatment. Not the ER where they were tested nor their personal physicians. No calls from county or state health authorities for surveillance or contact tracing either. So at least anecdotally, around here it doesn't seem like there's any "treatment" unless you're in the hospital. Hopefully someone objective writes the history of this pandemic.
     
  4. chemgeek

    chemgeek En-Route

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    True, as long as your facility is confident of using up all those doses quickly, as it is difficult to store in dry ice indefinitely.
     
  5. Lindberg

    Lindberg En-Route

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    Circular reasoning. You presume there must be "a half dozen tiers of people." The single most-reliable predictor of serious consequences from the disease is age. If you must prioritize, prioritize by that. That's as easy as looking at someone's driver's license.
     
  6. Matthew Rogers

    Matthew Rogers Ejection Handle Pulled

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    The real question is how many of those that got the saline injection are walking around with dangerous “asymptomatic” cases that will turn symptomatic in the future. ;)
     
    Last edited: Dec 30, 2020
  7. Matthew Rogers

    Matthew Rogers Ejection Handle Pulled

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    Because she is responsible for keeping everyone alive and healthy, including those of us who are following the rules and regulations and staying away from COVID but still have the usual serious health issues from time to time. If the medical professionals get sick, the entire system breaks down, even if it is not the infectious disease side of care.
     
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  8. weilke

    weilke Touchdown! Greaser! PoA Supporter

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    Because someone had to make a decision on how to set the broad priorities. As all of those rules apply to larger groups with internal inhomogeneities, when looked in a granular way at individuals, it is easy to find 'this vs. that pairs' that don't make sense. I had access to the vaccine from two separate sources in group 1b yet my direct exposure to covid patients in both groups is fairly modest. I would rather have the guy who drives the forklift to stack the bodies into the refrigerated trailers at the loading dock get one of my doses, but he wouldn't fall into any of the little pigeon-holes the higher ups have come up with.

    At the end of the day, I may not agree with how those priorities were set, but if we want to blame the leadership on how this all is getting screwed up, we at least have to stick to the rules they laid out.
     
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  9. Cap'n Jack

    Cap'n Jack Final Approach

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    Pfizer's distribution isn't as difficult it may appear.
    This was discussed at length earlier in the thread.
    From Pfizer: https://www.pfizer.com/news/hot-topics/covid_19_vaccine_u_s_distribution_fact_sheet
    • We have specially designed,temperature-controlled thermal shippers utilizing dry ice to maintain recommended storage temperature conditions of -70°C±10°C for up to 10 days unopened.
    • The Pfizer thermal shippers, in which doses will arrive, that can be used as temporary storage units by refilling with dry ice every five days for up to 30 days of storage.
    • Refrigeration units that are commonly available in hospitals. The vaccine can be stored for five days at refrigerated 2-8°C conditions.
    There's no reason the vaccine can't be delivered in dry ice to a local facility, and used within the 5 day period listed for a regular refrigerator.
    Sending anything by Fedex or UPS ground takes 5 days across the country- I managed a project that replenished lab consumables that were shipped via ground. Pfizer has faster shipping options, but worst casing it, they have another 5 days to get it to a local clinic, who have another 5 days to inject it.
    You isn't that difficult, either. Just get a delivery from your local welding supply store, or go there yourself for a new supply. In Nebraska, one of the local supermarket stocks it. However, as discussed earlier, that assumes the liquid carbon dioxide used to make the dry ice. Anecdotally, I've heard of price increases, and my order from before the Christmas break hadn't arrived suggesting spot shortages- take this comment with salt.
     
  10. kyleb

    kyleb Final Approach

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    The buckets (tiers) have to be big and easy to understand. It makes sense to vaccinate groups of people (healthcare, first responders, etc.) early, just as it makes sense to vaccinate the elderly early. That's being done. Trying to carve out for individual circumstances makes that infinitely more difficult and probably involves some bureaucratic panel that decides who gets it and who doesn't. I want no part of that because it would turn into a cluster.
     
  11. weilke

    weilke Touchdown! Greaser! PoA Supporter

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    30 days.
     
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  12. David Megginson

    David Megginson Pattern Altitude

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    Everything I've read says that it's OK for a few days after coming out of the freezer. You can ship it in dry ice, and then it's good for the day, at least, once warmed up. So you're correct that the hospitals and research centres will probably have to continue to be the distribution hubs, but they don't have to be the actual vaccination sites (or even in the same city as the vaccination sites).
     
  13. X3 Skier

    X3 Skier En-Route PoA Supporter

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    IMHO, before this thread goes further, might I suggest a thread be started elsewhere about how various people would allocate the Vaccines be distributed to the 330,000,000 or so people in the USA?

    I’m more interested in the Vaccines themselves and their effects, experiences, etc, which is why I started this thread rather than have to weed thru definitions or who should get the shots (or not) and other peripheral items. But if I have to do the weeding, it’s part of the “curse” of Internet forums:)

    Thanks for all the great info to date.

    Cheers
     
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  14. RyanB

    RyanB Super Administrator Management Council Member PoA Supporter

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    I just got the Moderna vaccine. Had to wait in line for about an hour and a half, but none the less, I was able to get it. The second dose is scheduled for January 27th.
     
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  15. Lindberg

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    Should have been age. Easy to carve, easy to verify, easy to dispense. The categories they created are actually much harder to understand or verify. Now in my state, you're eligible for the shot if you are over 16 and have one or more risk factors, "including, but not limited to [list of diseases including obesity]." So the tech at Walgreens is going to verify whether I have coronary artery disease, sickle cell, or diabetes? Is she going to calculate my BMI? Nah. So effectively, it's just everyone over 16 who's willing to check a box.
     
  16. Lindberg

    Lindberg En-Route

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    She's responsible for fixing athletes' broken bones and torn ACLs.
    Grocery-store clerks, same. Health-care professionals who have direct contact with COVID patients are at much higher risk to get it. That's common sense, but also backed up by Science (yea Science!). And since all the 1A doses to health-care workers were distributed by their employers, it would certainly have been possible to make that distinction. No one wanted to bother though, just like no one will bother to test folks for antibodies before giving the shots. But those same people will talk about how few doses we have because of someone else's alleged incompetence.
     
  17. kyleb

    kyleb Final Approach

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    It isn't that simple. If we only go by age, an isolated 65 year old gets the vaccine sooner than the young doc in the ICU who handles 20 cases a day.

    None of it is easy. The CDC guidelines are reasonable. But if individual states are mucking it up, well, that's on the voters to fix.
     
  18. wsuffa

    wsuffa Touchdown! Greaser!

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    Not a problem. We can just invoke the defense production act and there will be plenty of ultra low freezers in not time at all. :rolleyes:
     
  19. X3 Skier

    X3 Skier En-Route PoA Supporter

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    Just received another email from the Principal Investigators at my Trial Site.

    They will start Clinic visits Monday, Jan 4 to unblind the results and offer the Moderna Vaccine to those who received the Placebo and desire to get it.

    I intend to continue to be tracked for the duration of the Trial.

    Cheers.
     
    Last edited: Dec 30, 2020
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  20. Lindberg

    Lindberg En-Route

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    Oh, I didn't realize the current system is simple. Wait, no it clearly isn't.
    And if we do it this way, the L&D orderly gets it before the 65 year old grocery clerk. The scheme you endorse is equally flawed and more complex.
     
    Last edited: Dec 30, 2020
  21. SoonerAviator

    SoonerAviator Final Approach

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    Ford Motor Co. will probably be able to build them out of spare parts like they did with the ventilators, lol.
     
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  22. PlasticCigar

    PlasticCigar Pre-Flight

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    Completely asymptomatic patients don’t get any specific “treatment” other than contact tracing and close monitoring. That being said, many are actually “presymptomatic” and will eventually go on to develop symptoms, just not yet (these are the people who show up at the tent and say “my son has COVID, can I get swabbed?”)

    High-risk outpatients can get “bam” depending on the facility (I find most monoclonal antibody drug names unpronounceable):
    https://jamanetwork.com/journals/jama/fullarticle/2774326

    Decadron is indicated for patients with hypoxemia. Most of these are admitted but as hospitals became more saturated they may be treated as outpatients with home oxygen and close monitoring.

    Remdesivir is being used for inpatients

    If your family has COVID it would be good to let their doctor know and to monitor their oxygen saturation with a pulse ox (both at rest and with ambulation). There is a phenomenon associated with COVID that some call “happy hypoxia” but is more accurately “silent hypoxia” in which COVID patients become severely hypoxemic with relatively few symptoms.

    Prior to this outbreak I almost never saw someone checking into the ER by private vehicle with an O2 sat in the 60’s. Now it happens not infrequently.

    I hope everyone recovers quickly and I’m sorry to hear about their illness.

     
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  23. Lindberg

    Lindberg En-Route

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    Thanks for that. So far everyone's only had mild symptoms, and my wife is trying to stay isolated so the rest of us don't get it. Monitoring temp, ox, etc. My in-laws are in their 70's, so high risk, but weren't offered anything by their physicians. And it seems that our county has all but given up on tracing. They admitted at the very beginning that they weren't surveilling active cases, and as a result are the only large county in the state not reporting recoveries.

    Just my lay perspective, but I don't understand why none of the EUA approved treatments are being offered on a wider basis. Every urgent-care clinic and street-corner ER around here is making fat bank doing non-stop testing, but if you're positive, none have anything more to offer than a packet of information and recommendations from the CDC. Maybe that's just because the vast majority recover without any treatment, but that's also true of flu, and they rx Tamiflu to just about everyone who comes through the door during flu season. And people don't or can't follow the recommendation to self-isolate for 10 days, so it seems that anything that would shorten the normal course or period of contagiousness might reduce spread....
     
  24. David Megginson

    David Megginson Pattern Altitude

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    It's very convenient being a pilot and having a pulse oximeter in my flight bag. We've been using it together with the thermometer whenever a family member feels a bit under the weather.
     
  25. denverpilot

    denverpilot Tied Down PoA Supporter

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    Y’all probably saw my little tiny county has the first two confirmed cases of the UK’s “more contagious” strain now. (Technically one confirmed, second suspected and the testing is probably done by the time I type this...)

    Couple of National Guard young gents who didn’t travel anywhere, but both volunteered at a nursing home in Simla, CO... which means it’s been in Simla, of all places, for at least a little while.

    “More contagious” — depending on what those words actually are mathematically — speeds up the logistics vs natural spread foot race.

    Version 1.0 was already pretty contagious when masks and such don’t even put a dent in it but eliminated the flu. Ha. (Take that statement with however many pounds of salt you like. Haha... garbage numbers in, bad math out... it’s still Schroedinger’s virus after all!)
     
  26. Everskyward

    Everskyward Experimenter

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    I don't think the actual county made the national news, but I was curious enough to look. People wouldn't know where it was anyway, even many people who live in Colorado. ;)

    I usually get blank stares when people ask me where I used to live....
     
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  27. denverpilot

    denverpilot Tied Down PoA Supporter

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    Lol yup.

    I joked with another resident...

    “We’re number one! We’re number one!”



    Rah... rah.

    My boss telling the data center guy where I live today just said “Way out East kinda near Elizabeth.” Ha.
     
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  28. FormerHangie

    FormerHangie En-Route

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    My wife, who is an RN, got her first injection of the Pfizer vaccine last Wednesday. On Thursday, she had some muscle pain at the injection site and a mild headache. That lasted one day. Saturday she had the sniffles, but so did I, I think it was the change of weather.

    My sister, who is also an RN, got her first dose yesterday. So far, no side effects.
     
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  29. Palmpilot

    Palmpilot Touchdown! Greaser! PoA Supporter

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    Have you found a model of oximeter that's bright enough to use outdoors? I bought one years ago, and didn't actually try it out until this year when I read about the incredibly low sats that people were showing up with while having no symptoms. Then I tried it while flying, and discovered that it's too dim to read in daylight, even in the shade! Which is weird, considering the fact that I bought it from an aviation supplier. :(
     
    Last edited: Dec 31, 2020
  30. Lindberg

    Lindberg En-Route

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    A friend who's a hospital administrator (high up in admin, in charge of real estate) posted that be got the shot. Not over 65. Even assuming he got it in group 1b (individuals with underlying conditions) he still wouldn't have had access except because he works for a hospital system. The hospitals got thousands of doses and are using them, just not on the general public. At least not around here.
     
  31. kyleb

    kyleb Final Approach

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    You get some of that when you set up "classes" that are large. There are individual circumstances you'd rather see handled differently, but do you really want to create/adjudicate a petition process for every Tom, Dick, and Harry who is "different"?
     
  32. David Megginson

    David Megginson Pattern Altitude

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    The U.S. and Canada have limited healthcare capacity. If the ICUs fill up, we're toast. If the healthcare workers get sick, we're double toast (we won't have enough people to care for the sick or to administer the vaccine). If the people who support the healthcare workers to let them do their job get sick, we're in trouble. So it make sense to start by protecting our emergency-response capacity, which includes both the healthcare facilities and the healthcare professionals.

    Your life will be probably be exactly the same after you get the vaccine — public health measures like physical distancing, wearing masks indoors, travel restrictions, and limits on gatherings will to stay in place until either the disease dies down on its own or a large majority of the population has been vaccinated, and most jurisdictions don't plan on exemptions for people who have had the vaccine. It's not about individual vaccinations (they won't be a get out of jail free card), but about doing your share to make sure the whole population becomes resistant to the disease. Then, and only then, can life return to normal-ish.
     
  33. David Megginson

    David Megginson Pattern Altitude

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    During the 2014–15 West Africa Ebola outbreak, infection prevention and control training (IPC) initially focused on just doctors and nurses, and the infection rate among healthcare workers was terrible. By 2015, they realised that to keep the system working, IPC has to involve everyone in the health system, including not just doctors and nurses, but porters, drivers, cleaners, etc. etc., because any weak link can snap the chain. The same lesson will apply to the C19 vaccine — we'll need to get vaccines early not just to the frontline doctors and nurses, but to everyone who keeps the health system running. The doctors and nurses have the riskiest (and most-exhausting) jobs, but they're the tiny tip of a pyramid of support that makes it possible for them to do those jobs.
     
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  34. denverpilot

    denverpilot Tied Down PoA Supporter

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    Wife was Thursday, soreness Friday. No other effects other than she grew a second head. LOL. Kiddin’.
    [​IMG]
     
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  35. denverpilot

    denverpilot Tied Down PoA Supporter

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    That’s a bummer.

    Locally we ended up with a good rule... use it within 72 hours or lose it to someone who’ll administer.

    Kinda motivated orgs to have a (written) plan. Go figure.

    Some on the ball school districts have already started/done their nurses even.
     
  36. MacFly

    MacFly Line Up and Wait

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    I confess to a certain amount of ambivalence about the vaccination and skipped signing up for the first round at any of the hospitals where I'm on staff. No one in the first group seems to have dropped dead, so I went ahead in the second round. As a surgeon, I don't take care of COVID patients unless they have a surgical emergency or by accident, but COVID, however I contract it, taking me out of the game does put a burden on my colleagues and my Fellow, as well as impairing the two hospitals' ability to address trauma and other surgical emergencies. And it imposes significant inconvenience for my patients. We're extraordinarily busy with elective surgery and 10 days off would be a real problem for many of them. Those were the things that ultimately drove my decision to go ahead.
     
  37. Juliet Hotel

    Juliet Hotel En-Route

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    There are those who look at stories like this and without knowing the rest of the story just assume its a case of hospitals are just doing whatever they want or hospitals are playing favorites and allowing those they like to jump the line.

    I believe most people are fundamentally good and want to do the right thing so until more information is known, I'm going to bet it was likely a case of thawed doses for medical staff who were in line and had one or more people opt out unexpectedly and thus they start going down the list to find someone who is on site now that will take the dose before it expires.
     
  38. Lindberg

    Lindberg En-Route

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    No, I don't; that's what the current system is. Based on individual circumstances. I've advocated for a simple age-based system. Easy to implement and medically justifiable.
     
  39. kyleb

    kyleb Final Approach

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    I think you have to create priority buckets that include healthcare and first responders. You need those systems to continue functioning. What if the pharmacy in the hospital "goes down" due to COVID? Can't let that happen. So you get those behind the scenes people the vaccine. Same with the janitors cooking staff, administrators, etc. The healthcare system is a system that depends on much more than *just* the doctors and nurses.
     
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  40. Lindberg

    Lindberg En-Route

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    That's why we flattened the curve. And they did precisely nothing. Trained no new ICU nurses, equipped no new beds. Didn't increase emergency response capability. The hospital systems around here providing the most data actually expose much of the BS that we were fed early on. They have plenty of capacity, surge capacity, and emergency surge capacity. They have PPE on hand to last at least six months, and more in the pipeline. During the last spike, emergency hospitals were set up in the largest cities here, and they saw zero patients. Elected officials wanting to appear to be doing something are sounding alarms that don't seem to be based on reality.

    A lot of folks are wanting to blame and shame uncooperative citizens unwilling to have sacrifices. I chose to blame the people whose responsibility it was to be prepared for this who weren't. Someday, the media will move on from shame and fear and tell us what really happened.
     
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