So I got Covid 😒

[SuperMatt]

Did I miss the money train somewhere. Never gotten kickbacks for prescribing anything. Maybe I'm doing something wrong...

It’s those opioids…

Opioid Manufacturer Purdue Pharma Pleads Guilty to Fraud and Kickback Conspiracies

Opioid manufacturer Purdue Pharma LP (Purdue) pleaded guilty today in federal court in Newark, New Jersey, to conspiracies to defraud the United States and violate the anti-kickback statute.

www.justice.gov

Purdue also admitted it conspired to violate the federal Anti-Kickback Statute. Between June 2009 and March 2017, Purdue made payments to two doctors through Purdue’s doctor speaker program to induce those doctors to write more prescriptions of Purdue’s opioid products. Also, from April 2016 through December 2016, Purdue made payments to Practice Fusion Inc., an electronic health records company, in exchange for referring, recommending, and arranging for the ordering of Purdue’s extended release opioid products – OxyContin, Butrans, and Hysingla.

And if you believe the admitted kickbacks are the only ones they paid out, well I’ve got some land in Florida to sell you…

 

[User.45]

Apparently so. I mean you could be some Turkish guy who makes truckloads of money selling "cures" on Oprah and so prominent that you might be running for US Senate in a state that you have only ever visited.

But here you are, hanging out with – ugh – people. Gotta do something about your ethics, man. They are holding you back.

Ah! And I thought I did "Telemedicine" right..

It’s those opioids…

Opioid Manufacturer Purdue Pharma Pleads Guilty to Fraud and Kickback Conspiracies

Opioid manufacturer Purdue Pharma LP (Purdue) pleaded guilty today in federal court in Newark, New Jersey, to conspiracies to defraud the United States and violate the anti-kickback statute.

www.justice.gov

And if you believe the admitted kickbacks are the only ones they paid out, well I’ve got some land in Florida to sell you…

Valid point. Though the vast majority of physicians who prescribed opiates didn't get kickbacks. The prime population was pain clinics.
In the mid 2010s the easiest way to get a rating of 1/5 on Vitals.com, or collect formal hospital complaints is not prescribing narcs.

I'll add that I prescribed maybe one or two opioid prescription in the past 4 years.***

***Outside the hospice setting.

 

[Huntn]

I would say for adults currently it’s largely the right wing making up most of the unvaccinated. But prior to COVID the natural medicine people were much more prevalent with vaccines, but many of them have since changed their minds- at least for themselves with COVID. That’s why we were seeing outbreaks of things like Whooping cough in affluent blue neighborhoods among children. Not long ago children’s vaccination rates in wealthy LA neighborhoods were worse than South Sudan. There has always been the anti-vax right wing religious folks, but they’re usually a small faction. The natural medicine movement has really exploded in the past decade or so. Weirdly though, things have been turned upside down with COVID.

It will be interesting to see what happens with children’s COVID vaccinations. Right now the rates aren’t so great. In the 5-11 age group, vaccines have been available for 2 months. Nationally only 17% are fully vaccinated, but varies widely- only 5% in Mississippi and 19% in California, but 48% in Vermont. In Canada, the rate is 2%.

I find the whole natural medicine movement very annoying. It’s far often untrained people taking treatment into their own hands based on blog posts without any professional oversight. They don’t effectively treat their condition which then deteriorates putting them in a precarious position that could have likely been entirely avoided had they used evidence based medicine- as well as the massive hospital bill.

I wonder if it is really trust only natural ingredients which is a bit of a joke as they in many cases have the same basis, finding a chemical compound that that cures something, but the thing about vaccines is they prevent something. In some cases it strikes me as laziness, or ignorance, not being able to afford the doctor visit, distrust of doctors or gullibility.

The Trump Effect: Why do I need a vaccination when I can take a horse worm medication bought at the farm supply store, or maybe drink a little bleach?

With a substantial number of the Trump crew, instead of putting their trust into real medical authorities, they vested themselves in a big fat manipulator who felt that because COVID might hurt his Presidency, because of it’s effect on our economy, kneejerked himself into accusations and denial, an ego so huge and maladjusted that he thought he could actually talk everyone in to just ignoring it.

 

[Huntn]

Here’s a good summary of it:

Spreading Pseudoscience: 5 Reasons Why Some Liberals Are as Bad as Conservatives

The first step to solving problems is to identify and understand them. With that in mind, here is a list of five reasons why some liberals are just as bad, or at least almost, as creationism-believing conservatives when it comes to spreading pseudoscience.

www.huffpost.com

And let’s not forget the Green Party endorsed homeopathy in 2016. Homeopathy by definition is pseudoscience.

California had such dwindling vaccination rates by ~2014 they had to put laws in place to mandate vaccinations. After that vaccinations rebounded, but following that there was a huge increase in exemptions.

That said, not all natural products are snake oils, but very few have evidence to support their use. Those that do work usually either require many doses per day, have more side effects, interact with other drugs or health conditions, and/or are not as effective.

That’s not to say every liberal believes in this stuff. Just like not every religious conservative believes solely depends on faith healing. The majority of Americans left and right believe in conventional, evidence based medicine. But you do have these factions on both ends of the spectrum that don’t.

But there are unfortunately a lot of people who oppose pharmaceuticals in favor of natural products. Anyone who works in healthcare has to deal with these people.

There are some on the left, but you have to admit that it’s not a they're both just as bad argument. You’ve already said there are or you suspect there are a lot more on the Right, or those under Trump’s orbit.

 

[Renzatic]

There are some on the left, but you have to admit that it’s not a they're both just as bad argument. You’ve already said there are or you suspect there are a lot more on the Right, or those under Trump’s orbit.

It used to be something you'd see more of among suburban soccer moms in affluent neighborhoods. That's changed quite a bit since the pandemic arrived, and vaccines became yet another bullshit political battleground for the culture war.

 

[Huntn]

Homeopathy has absolutely no relationship to "natural medicine". The former is utter nonsense. The latter is poorly grounded but still has infinitely more merit than homeopathy, which has none — you might as well just pray.

I do have some issues with pharma, though. It seems to take the position that this or that compound will fix anything, and doctors seem to be all too quick to prescribe the pill that pays them the most to promote it.

This is a topic which I am ignorant, but have an impression though popular culture that at some point in human history there were sources of knowledge regarding plants and their ability to cure certain ailments such as natural antibiotics. I have no idea who I would trust today to have such knowledge, but COVID-19 seems to have brought the quacks out of the woodwork.

 

[Renzatic]

This is a topic which I am ignorant, but have an impression though popular culture that at some point in human history there were sources of knowledge regarding plants and their ability to cure certain ailments such as natural antibiotics. I have no idea who I would trust today to have such knowledge, but COVID-19 seems to have brought the quacks out of the woodwork.

Just think of the homeopathy/anti-vax movement as what it is: 21st century snake oil marketing.

 

[AG_PhamD]

There are some on the left, but you have to admit that it’s not a they're both just as bad argument. You’ve already said there are or you suspect there are a lot more on the Right, or those under Trump’s orbit.

Yes, I’ve said multiple times currently in terms of COVID, the right wing is the bigger problem… and not just the typical radical religious right wingers. I think the majority of the right wing refusing vaccines are doing it for non-religious reasons- it’s like some hill to die on (quite literally) about personal freedom that makes little sense.

I’m not trying to make a political slight against the left or make some competition of who is more antivax. I’m just saying anti-vax people do actually exist and there’s a significant number of them out there. I’m not sure why I even have to prove this considering intuitively I’m sure you know they do. Going “all natural” has been incredibly trendy.

If you want to go back pre-pandemic though, before all this crazy partisanship around vaccines, I’d say the liberal crowd may have had an edge. For example:

LA's Richest Neighborhoods Have Vaccination Rates Lower Than the Poorest Parts of Africa

Hollywood parents say not vaccinating makes "instinctive" sense. Now their kids have whooping cough.

www.theatlantic.com

After a Debacle, How California Became a Role Model on Measles (Published 2018)

Changing minds on vaccination is very difficult, but it isn’t so important when a law can change behavior.

www.nytimes.com

Until California banned personal belief exemptions for vaccines, 36% of children were in a school below herd immunity. Some schools were 80% and below. The ban largely rectified the problem, however medical exemptions magically spiked 400%, most commonly in the schools that had high rates personal belief exemptions. That prompted CA to pass another law in 2019 scrutinizing medical exemptions by doctors.

Clark County, WA 2019- Only 81% of kids age 1 to 5 are MMR vaccinated.

A Measles Outbreak Is Hitting the Pacific Northwest. Now There's a Surge in People Getting Vaccinated

“There’s no reason we should be having this outbreak”

time.com

On the topic of alternative medicine:
https://jezebel.com/experts-say-those-who-dont-vaccinate-their-kids-tend-to-1832157679 (1/29/2019)

Daniel Salmon, the director of the Institute of Vaccine Safety at Johns Hopkins University, told ABC news that existing research suggests parents who tend vaccinate their kids, “tend to be better educated. They tend to be white, and they tend to be higher income. They tend to have larger families and they tend to use complementary and alternative medicine like chiropractors and naturopaths.”

Why Holistic Medicine Is Marketed to Rich White Women

And how this leaves behind those who need it most

medium.com

United States such treatments have become staples at upscale spas and clinics in trendy New York and Los Angeles neighborhoods. As a result, those utilizing holistic medicine are actually more likely to be educated, wealthy, and insured. It’s a vicious cycle in which holistic treatments are glamorized, sold to the wealthy, and thus hyperconcentrated for moneymaking purposes.

Millennials Embrace Alternative Medicine, a $32 Billion Business

Many in their 20s and 30s are embracing alternative medicine, which includes everything from massage, meditation, acupuncture and yoga to herbal, nutritional and plant-based supplements and homeopathic remedies.

www.thefiscaltimes.com

I suspect a lot of these all natural people have since sensibly changed their minds, at least when it comes to the COVID vaccine and their own body. What they decide in terms of vaccinating their children is yet to be seen. Right now children’s COVID vaccine rates are very low in most states, regardless of politics/culture.

 

[SuperMatt]

Yes, I’ve said multiple times currently in terms of COVID, the right wing is the bigger problem… and not just the typical radical religious right wingers. I think the majority of the right wing refusing vaccines are doing it for non-religious reasons.

I’m not trying to make a political slight against the left or make some competition of who is more antivax. I’m just saying these people do actually exist and there’s a significant number of them out there. I’m not sure why I even have to prove this considering intuitively I’m sure you know they do. Going “all natural” has been incredibly trendy.

If you want to go back pre-pandemic though, before all this crazy partisanship around vaccines, I’d say the liberal crowd may have had an edge. For example:

LA's Richest Neighborhoods Have Vaccination Rates Lower Than the Poorest Parts of Africa

Hollywood parents say not vaccinating makes "instinctive" sense. Now their kids have whooping cough.

www.theatlantic.com

After a Debacle, How California Became a Role Model on Measles (Published 2018)

Changing minds on vaccination is very difficult, but it isn’t so important when a law can change behavior.

www.nytimes.com

Until California banned personal belief exemptions for vaccines, 36% of children were in a school below herd immunity. Some schools were 80% and below. The ban largely rectified the problem, however medical exemptions magically spiked 400%, most commonly in the schools that had high rates personal belief exemptions. That prompted CA to pass another law in 2019 scrutinizing medical exemptions by doctors.

Clark County, WA 2019- Only 81% of kids age 1 to 5 are MMR vaccinated.

A Measles Outbreak Is Hitting the Pacific Northwest. Now There's a Surge in People Getting Vaccinated

“There’s no reason we should be having this outbreak”

time.com

On the topic of alternative medicine:
https://jezebel.com/experts-say-those-who-dont-vaccinate-their-kids-tend-to-1832157679 (1/29/2019)

Why Holistic Medicine Is Marketed to Rich White Women

And how this leaves behind those who need it most

medium.com

Millennials Embrace Alternative Medicine, a $32 Billion Business

Many in their 20s and 30s are embracing alternative medicine, which includes everything from massage, meditation, acupuncture and yoga to herbal, nutritional and plant-based supplements and homeopathic remedies.

www.thefiscaltimes.com

I suspect many of these all natural people have since changed their minds, at least when it comes to the COVID vaccine and their body. What they decide in terms of vaccinating their children is yet to be seen. Right now children’s COVID vaccine rates are very low in most states, regardless of politics/culture.

I would submit that these anti-vax movements have little to do with each other.

The refusal to get the measles vaccine was not about politics. It was a sizable, but not huge group of parents who bought into the anti-vaccine hysteria following a flawed study (falsely) claiming that vaccines caused autism. This pushed many into the arms of snake-oil salesmen pushing homeopathic nonsense.

The current anti-vaccine movement is only about the COVID-19 vaccine, and its roots are clearly traced to Donald Trump. It is FAR larger, and is purely political.

It’s not an apples-to-apples comparison.

 

[Huntn]

Just think of the homeopathy/anti-vax movement as what it is: 21st century snake oil marketing.

And I would seperate this from actual “natural medicine“ as practiced by… gosh, I can’t say who, oh yeah Strider who told Sam to find Athelas to help slow the poison in Frodo’s wound. Seriously, my impression is that native cultures have/had some level of knowledge regarding plant healing properties.

 

[User.45]

Yes, I’ve said multiple times currently in terms of COVID, the right wing is the bigger problem… and not just the typical radical religious right wingers. I think the majority of the right wing refusing vaccines are doing it for non-religious reasons- it’s like some hill to die on (quite literally) about personal freedom that makes little sense.

I’m not trying to make a political slight against the left or make some competition of who is more antivax. I’m just saying anti-vax people do actually exist and there’s a significant number of them out there. I’m not sure why I even have to prove this considering intuitively I’m sure you know they do. Going “all natural” has been incredibly trendy.

If you want to go back pre-pandemic though, before all this crazy partisanship around vaccines, I’d say the liberal crowd may have had an edge. For example:

LA's Richest Neighborhoods Have Vaccination Rates Lower Than the Poorest Parts of Africa

Hollywood parents say not vaccinating makes "instinctive" sense. Now their kids have whooping cough.

www.theatlantic.com

After a Debacle, How California Became a Role Model on Measles (Published 2018)

Changing minds on vaccination is very difficult, but it isn’t so important when a law can change behavior.

www.nytimes.com

Until California banned personal belief exemptions for vaccines, 36% of children were in a school below herd immunity. Some schools were 80% and below. The ban largely rectified the problem, however medical exemptions magically spiked 400%, most commonly in the schools that had high rates personal belief exemptions. That prompted CA to pass another law in 2019 scrutinizing medical exemptions by doctors.

Clark County, WA 2019- Only 81% of kids age 1 to 5 are MMR vaccinated.

A Measles Outbreak Is Hitting the Pacific Northwest. Now There's a Surge in People Getting Vaccinated

“There’s no reason we should be having this outbreak”

time.com

On the topic of alternative medicine:
https://jezebel.com/experts-say-those-who-dont-vaccinate-their-kids-tend-to-1832157679 (1/29/2019)

Why Holistic Medicine Is Marketed to Rich White Women

And how this leaves behind those who need it most

medium.com

Millennials Embrace Alternative Medicine, a $32 Billion Business

Many in their 20s and 30s are embracing alternative medicine, which includes everything from massage, meditation, acupuncture and yoga to herbal, nutritional and plant-based supplements and homeopathic remedies.

www.thefiscaltimes.com

I suspect a lot of these all natural people have since sensibly changed their minds, at least when it comes to the COVID vaccine and their own body. What they decide in terms of vaccinating their children is yet to be seen. Right now children’s COVID vaccine rates are very low in most states, regardless of politics/culture.

Invalid points in a COVID discussion, when the death differential is a net +200K for GOP voters despite being fewer than Democrats.

 

[AG_PhamD]

Invalid points in a COVID discussion, when the death differential is a net +200K for GOP voters despite being fewer than Democrats.

AG_PhamD said:
Yes, I’ve said multiple times currently in terms of COVID, the right wing is the bigger problem… and not just the typical radical religious right wingers. I think the majority of the right wing refusing vaccines are doing it for non-religious reasons- it’s like some hill to die on (quite literally) about personal freedom that makes little sense.

This is exhausting.

 

[Yoused]

I wonder if it is really trust only natural ingredients which is a bit of a joke …

Spoiler: 100% NATURAL cure!

(except, not quite sure about how natural warfarin or Prussian Blue are)

 

[Renzatic]

And I would seperate this from actual “natural medicine“ as practiced by… gosh, I can’t say who, oh yeah Strider who told Sam to find Athelas to help slow the poison in Frodo’s wound. Seriously, my impression is that native cultures have/had some level of knowledge regarding plant healing properties.

There is some truth to these natural remedies. Like willow bark being a good substitute for aspirin, and other little bits and bobs. It's when you start getting into the whole ZINC CURES EVERYTHING, I READ ABOUT IT ON THE INTERNET crowd, who tend to take marginal evidence as proof positive of massive effects that things start getting screwy.

 

[User.45]

This is exhausting.

Thanks for agreeing

 

[AG_PhamD]

So it turns out my 96 year old grandfather caught COVID. He woke up with chest congestion this morning and by this afternoon had fainted, prompting an ambulance ride to the hospital.

He lives at home with a full time caregiver who is truly amazing. He’s not particularly mobile so he doesn’t get out much. His caregiver tested negative, so we’re not exactly sure how he caught this. Sneaking out at night to hangout with his girlfriends? Haha.

He received his booster a couple weeks before Thanksgiving so presumably he should have antibodies … but he’s also 96 so his immune system is not going to be the best. Given his age, underlying mild-moderate respiratory issues, and propensity for pneumonia, his illness is obviously quite concerning.

All I know is he’s on fluids and supplemental O2. And that he had a chest x-ray but nothing more.

 

[Huntn]

So it turns out my 96 year old grandfather caught COVID. He woke up with chest congestion this morning and by this afternoon had fainted, prompting an ambulance ride to the hospital.

He lives at home with a full time caregiver who is truly amazing. He’s not particularly mobile so he doesn’t get out much. His caregiver tested negative, so we’re not exactly sure how he caught this. Sneaking out at night to hangout with his girlfriends? Haha.

He received his booster a couple weeks before Thanksgiving so presumably he should have antibodies … but he’s also 96 so his immune system is not going to be the best. Given his age, underlying mild-moderate respiratory issues, and propensity for pneumonia, his illness is obviously quite concerning.

All I know is he’s on fluids and supplemental O2. And that he had a chest x-ray but nothing more.

Best wishes to your Grandfather. Does anyone have a clue how he was exposed?.

 

[Alli]

My sister-in-law’s mother made fun of us for going on a cruise during a pandemic. Right before we left she tested positive. She caught Covid at a wedding.

 

[User.45]

So it turns out my 96 year old grandfather caught COVID. He woke up with chest congestion this morning and by this afternoon had fainted, prompting an ambulance ride to the hospital.

He lives at home with a full time caregiver who is truly amazing. He’s not particularly mobile so he doesn’t get out much. His caregiver tested negative, so we’re not exactly sure how he caught this. Sneaking out at night to hangout with his girlfriends? Haha.

He received his booster a couple weeks before Thanksgiving so presumably he should have antibodies … but he’s also 96 so his immune system is not going to be the best. Given his age, underlying mild-moderate respiratory issues, and propensity for pneumonia, his illness is obviously quite concerning.

All I know is he’s on fluids and supplemental O2. And that he had a chest x-ray but nothing more.

I hope he's well. We've been testing a set of patients' antibodies and there are people who produce virtully none even after 2x2 full doses of Pfizer and Moderna. Now I don't yet know about their cellular immunity because we'll test that later, in bulk. But this is why in an ideal, data driven world we would rely on biomarker data about immunity. The other perk of such would be that it would be much better to individualize recommendations on quarantine duration (immunosuppressed patients shed the viral particles longer).

Also, it was a caregiver, who probably had a false negative antigen test. Unless there are other contacts within the past 2-4 weeks.

 

[AG_PhamD]

Best wishes to your Grandfather. Does anyone have a clue how he was exposed?.

Thanks! We’re still working out where he’s been and who he had been in contact with.

I hope he's well. We've been testing a set of patients' antibodies and there are people who produce virtully none even after 2x2 full doses of Pfizer and Moderna. Now I don't yet know about their cellular immunity because we'll test that later, in bulk. But this is why in an ideal, data driven world we would rely on biomarker data about immunity. The other perk of such would be that it would be much better to individualize recommendations on quarantine duration (immunosuppressed patients shed the viral particles longer).

Also, it was a caregiver, who probably had a false negative antigen test. Unless there are other contacts within the past 2-4 weeks.

Interesting. I would be curious to know what you find out.

I would agree the caregiver is probably the most likely culprit. She got a PCR test but yes, a false negative is entirely possible. I did give them a bunch of rapid tests, so she could that a shot if she hasn’t already. She does live with him 24/7 but does go out to run errands.

He also has an RN and PT that come in. Not sure when the last time they were around. But that’s another likely possibility if they were around last week.

There’s also a couple people from the senior center who come by to visit and do activities with him. This has been greatly reduced since COVID, but I think one of the women still stops by on occasion.

There’s also some people from the synagogue that visit him, but I’m not sure how often that happens either.

My mom and uncle had visited him ~18hrs before his symptoms began. While my Uncle has been known to be rather lax with COVID reccomendations, I think it’s unlikely it came from either him or my mom as that would be an absurdly fast incubation period. My mom is a physician and is tested twice a week- plus takes rapid tests before visiting him.

Ultimately I suppose the source doesn’t really matter. I don’t think someone would intentionally be around him if they knew they were infected. I’m not looking for someone to blame.

The rather nonspecific treatment info I have been told he is on Remdesivir, IV antibiotics, a steroid, and a blood thinner.

Anyways, reportedly he is feeling better this morning. He ate this morning and apparently was joking with nurses, so that’s a good sign.