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Discussion in 'Environmental Discussion' started by tochatihu, Jan 26, 2020.
it's hard to think of positive or negative providing relief. it's just more of the same
Have a question for Prius Chat members-
Does wearing a mask in public while shopping give a behind the curtain glimpse of a person's character?
In our State the Governor and our State Head Doctor have asked all citizens to wear masks when shopping - not to protect themselves (we all know it doesn't) but to protect others in case you are symptomatic.
I went grocery shopping today which is my routine every Monday at around 8 am - at our local Krogers it was about 70% masks to 30% no mask with all Kroger employees wearing masks.
When then drove to the big city to do our meat shopping at Whole Foods it was now about 9:30 am in this large Metro city - All shoppers wore mask and all Whole Foods employees wore mask.
I think Whole Foods probably has a different clientele than Krogers but the difference was stark!
( My family wore a mask in both stores)
My opinion is- yes- wearing a mask does give you a behind the curtain peak at a persons character
My wifes' opinion - I need to mind my own business!
Please don't get the idea I am setting myself up as a character judge - I would rate myself as a C- compared to other people, struggling to improve myself to a C.
From The Conversation
Experts often cite factors like poverty, poor diet and stress for the fact that Black Americans are dying from COVID-19 at disproportionately high rates. Yet the U.S. health care system itself shares the blame, write IUPUI scholars Tamika Zapolski and Ukamaka Oruche.
African Americans face bias from providers, experience longer wait times for appointments than white people and tend to lack clinics in their own neighborhoods, which results in missed or canceled sessions. The root cause, they explain, is racism in the distribution of health care.
My daughter had to have COVID PCR test at Mass General before she could get needed MRI. The cost of COVID test alone was $405. The same PCR test at my PCP cost $125. Yeah, they were both covered by insurance, but if you don't have a good health insurance, or maybe no health insurance, many simply can't afford to have tested, let alone treated for COVID-19.
And corporate/city rules and regulations:
Whole Foods has face masks at the door and a signs.
Costco has face masks and you must have one to enter.
Some airlines will kick a passenger off if they don't wear a mask.
The infection rates have shown that public action CAN reduce COVID-19 rates. Public inaction has the opposite effect. So the choice is clear:
Do nothing and live in sh*thole county of your own making.
Do the right thing and enjoy working, shopping, and other activities that don't spread COVID-19.
is that the amount they charge, or the agreed amount between the insurer or provider?
That's amount they charge. Different insurance has different agreements with providers for discount amount. My daughters bill was discounted $188 to final plan payment of $217 for Mass General test while my PCP's bill was discounted $15 to final plan payment of $110. Anyone without health insurance will get the full amount billed.
right. shame on mg, but sometimes, it's made up in other ways.
In general large medical centers like Mass General will cost far more than smaller regional hospital charge for the same service and/or procedure. Yeah, they have better state of art equipment and world renowned expert doctors, but still, the disparity is substantial. Too substantial to create inequality in health care between those who have and have not. And I think COVID-19 is exacerbating the imbalance even farther very quickly.
This list of mask policies of US airlines may not be current. Does anyone have a fresher link?
US airlines mandate face masks, including American, Delta, United, Southwest - CNET
Recently, Elon Musk claimed, "There are a ridiculous number of false positive C19 tests, in some cases ~50%. ..." Given how many tests were given an emergency exception for use, I can easily believe some tests are a coin toss.
So looking around, I found what appears to be fact-based introduction: Coronavirus (COVID-19) tests: Methods, availability, and accuracy
The FDA is reporting:
EUA Authorized Serology Test Performance | FDA
The issue is what separates "a test" from "a case?" If a test comes back "positive" but no symptoms, isolation and contact tracing makes sense. But would that be treated as "a case?"
I assumed "a case" means COVID-19 symptoms. But we also know there are asymptomatic people who can spread the SAR-CoV-2 virus. Are they "a case?"
A hard "case" definition would be someone with COVID-19 symptoms diagnosed by a medical professional. But how are asymptomatic, tested individuals counted? A second test by a different method would seem to be the minimum.
As far as I know, one person can be tested more than once, and if one person is positive more times it's still one case.
I heard of a problems when a person is positive on a test for more than a month, even though all the symptoms are already gone.
Most states define the "Case" as shown below. I did not check every state CDC site for it's definition used, but a few I checked are using the same or very similar definition adopted from US-CDC 2020 Interim Case Definition by the Council of State and Territorial Epidemiologists (CSTE) referenced below. So, all positive PCR test results will be counted as confirmed case regardless of presence or absence of any symptoms. On the other hand, antibody test positive result alone will not be counted as a case automatically without confirmed epidemiological link or presence of typical COVID-19 symptoms.
Here is documentation for the US-CDC criteria to define the case:
Coronavirus Disease 2019 (COVID-19) | 2020 Interim Case Definition, Approved April 5, 2020
What are Confirmed Cases? This represents the number of persons tested with a SARS CoV-2 PCR test result from any approved lab.
What are Probable Cases? There are two instances in which someone can meet the probable case definition:
A close contact identified through an epidemiological investigation of a confirmed case becomes symptomatic OR
An individual has a positive SARS-CoV-2 serology test AND
Is a close contact of a confirmed case (as identified through an epidemiological investigation) OR
Is symptomatic with:
A cough and/or shortness of breath or difficulty breathing OR
At least two of the following symptoms:
Repeated shaking with chills
New loss of taste or smell
As for the specificity and sensitivity of the approved PCR testing, it is very robust that false positive is very rare. Under controlled laboratory setting false positive rate is probably close to 0%, that is specificity of the PCR testing is near 100%. See the "Clinical Evaluation" below from FDA documentation on approved COVID-19 PCR test being used in the US. I have never heard of high false positive associated with PCR testing for COVID-19. And most of the false negative results of PCR test are not due to the PCR testing sensitivity problem but due to sampling error and other human errors associated with the testing. OTOH, the antibody tests are still being refined, and some may represent more false positives.
LabCorp COVID-19 RT-PCR test EUA Summary - FDA
every state may be different. in massachusetts, you only get tested if you come to the hospital with symptoms.
so if you're positive, you're a 'case'.
there is some random inner city pop up testing for anyone who wants it, so that may through a few asymptomatic cases into the mix.
then there's antibody testing, positives of which are tracked seperately
Not necessarily true now. That might have been the case earlier when the demands for the tests are high and resources are scarce, but now, they are testing asymptomatic individuals. My daughter had no COVID-19 symptom, she was asked by the Mass General to be tested in order to go in for MRI which was for a test unrelated to COVID-19.
sorry, i meant anyone who needs to go in the hospital. you are right, and there are more people going in now for elective stuff, so more testing.
which will probably bring the percent of positive down.
i don't think there is a breakdown of asymptomatic vs symptomatic cases on the mdph website, is there?
Don't think so. I don't even know if such data exist. Testing site did not ask any medical question, so it is up to an ordering physician to enter such data, but I doubt it is entered. Hospitalization and death are the only ways to track COVID-19 positive case outcome?
COVID-19 Dashboard - June 29, 2020
Reading about the testing really makes me appreciate a company in our state - Kroger.
We are a poor state with not a lot of means. Krogers said they would sponsor free testing across the state for residents at Krogers expense manned by their people. They turn the samples over to labs who also volunteered their services to process the tests.
I personally have not gotten a test as we stay a home and wear masks when we infrequently go out- if I was positive with the test unless I was dying I would assume they would tell me to stay home which we are doing anyway!
Some companies in our country are truly amazing
A new study on 149 COVID-19 recovered individuals showed that most produced neutralizing antibody against SARS-CoV-2. However, 99 percent of the study’s participants did not make high enough titres of neutralizing antibodies to mount an ideal immune response. Of 1 percent of study subjects with high titres above 1:5,000 COVID-19 neutralizing antibodies, researchers were able to identify three antibodies that were extremely effective at neutralizing SARS-CoV-2.
Implication is that designing a vaccine to elicit such strong neutralizing antibody can be very effective. Also, even though individual's immune responses may not be strong enough to ward off the SARS-CoV-2 infection, exogenously administered monoclonal antibodies maybe used for treatments or prevention of COVID-19.
Boy if there's anything I hate, it's having to pore over some boring graph trying to spot elusive differences.
Kind of striking that not only the initial swoosh, but each subsequent little artifact that's seen in both traces, plays in the US on what looks like a more than one, not quite two week delay after being seen in the EU, and how well the US has made use of that advance-notice advantage.