The Fourth Wave, and “Is it Safe to…?”
ฝัง
- เผยแพร่เมื่อ 11 ก.ค. 2024
- In this UCSF Department of Medicine Covid-19 Grand Rounds, we begin with an update from George Rutherford on the current state of the pandemic, including the emerging but highly regional fourth wave. Next, we will present various scenarios (gatherings, travel, schools, sports, and more) to Monica Gandhi and Peter Chin-Hong, who will opine on whether the scenario is safe or risky - both to those who are vaccinated and those who are not. The session is moderated by UCSF Department of Medicine Chair Bob Wachter.
Program
Bob Wachter: Introduction
00:03:37-00:16:57 - The State of the Pandemic with George Rutherford (Professor, Dept. of Epidemiology & Biostatistics; Director of the Prevention and Public Health Group)
00:16:57-00:27:19 - Q&A
00:27:22-01:01:26 - Q&A and Conversation with Monica Gandhi (Professor of Medicine; Associate Chief of Division of HIV, Infectious Diseases, and Global Medicine at ZSFG; Director of the UCSF-Gladstone Center for AIDS Research; and Medical Director of the HIV Clinic, Ward 86, ZSFG)
and Peter Chin-Hong (Professor of Medicine, Division of Infectious Diseases at UCSF Health)
Bob Wachter: Closing
See previous Covid-19 Medical Grand Rounds:
• March 25: The State of the Pandemic, Therapeutics, and Emerging Data on Variants • The State of the Pande...
• March 11: Covid at One Year: Looking Back and Looking Ahead • Covid at One Year: Loo...
• February 18: The 23rd Annual Reza Gandjei Memorial Lecture: A Conversation with Atul Gawande • The 23rd Annual Reza G...
• February 11: The New Vaccines, Attitudes Toward Vaccination, and the Biden Covid-19 Task Force • The New Vaccines, Atti...
See all UCSF Covid-19 grand rounds, which have been viewed over 1.76M times, here: medicine.ucsf.edu/covid-19-ne...
75yr old lay person here. I've listened twice, as I do with most of these. Thank you so much for sharing them.
I found Dr Rutherford's presentation reassuring. Mixed response to Dr. Gandhi's 'what it's safe to do' message. Thumbs up for noting the common courtesy of masking up and distancing when around people we don't know. Disturbing to have her say she would eat in an enclosed commercial space. Generalizes the message to "it's ok to be periodically unmasked in an enclosed space with people you don't know to be fully immunized." Additional risk for people without eye shields. Don't real world reports concern people who are likely paying attention to masking, distance, ventilation? I'm with Dr. Chin-Hong re risk and also concern for the young people I see on the sports field and traveling in unmasked groups, albeit outside.
An another note, I've heard worrisome reports of insufficient testing facilities. Can you address that in the future?
In King County, WA.. we're at 6.0% hospitalization rate of positive cases and 1.6% Covid death rate, presently. Fully vaccinated here but still too aware of viral genetics to let my guard down. Can't believe we're still having non-essential travel at this time. Such a crucial moment to make good decisions.
@@gferraro8353 Oh no. I worry about long-term consequences of the young ones getting it. And flights.. on January 20, 2020, I wrote to WHO, CDC, and NIAID to please ask for all non-essential flights to be grounded worldwide and track/trace anyone who came out of China. Anyone who was watching the science coming out of there knew we were in big trouble. All of this was avoidable.. 😓
@@circa1890 😔😢 yes..started tracking it in early January -this wasn’t good.
You don't sound confident they work. Your actions speak loudly. It is not for you to decide what should be essential. Your opinion is non-essential
Forget about travel, not a single person in your country has been in compulsory quarantine. Unless you had an incredible population stopping non essential travel has the same outcome as now because no quarantine. Look to Western Pacific WHO region countries, can't have either open travel or voluntary quarantine and needs to be 14 days (unlike the 10 days voluntary).
Just look at Israel to see how well the vaccines are working against the virus, incl variants. Being vaccinated is empowering because it's real, and the data supports it!
We traveled internationally several times a year pre-pandemic. NOTHING could get us on a plane. The highly touted airflow in interrupted by rising body heat,seat & tray table position,psgrs & FA walling by. You can't have the discussion w/out the danger of the restroom and what's escaping from it. And we only travel Business Class (FF upgrades). In coach, even if middle seat not filled, they're only 18 inches wide.
Additionally you must get to the airport, navigate security & TSA, airport itself, restrooms, waiting area, arrival w/signifant aerosolization as people get luggage out of overhead bins, breathing rates increase, jetway, airport, baggage carousel, shuttle to rental car/hotel.
Wouldn't stay in hotel or rent a car. Just unacceptable risk. Again this from listening to hrs of virology podcasts 7 days a week for the last 15 months. Plus journal articles. Children getting sick at higher rates & numbers. We're staying home so we can live to travel another year. And we spent @ 6 months a year out of the country.
Then just get the vaccine.
Next year is not promised.
Great program, I look forward to viewing it every week, thank you.
It may not be appropriate (or politically correct) to bring this up. All the positive reports of protection mentioned by Monica were based on Pfizer vaccine. But not everyone is vaccinated with Pfizer. It may be reasonable to assume those had Moderna had similar protection. But what about J&J? Can we assume there is no significant difference between efficacy 70% and 95% in the various scenarios mentioned? .
I was going to say something similar but I chickened out
I really appreciate the information you are providing to us. I have been following your videos for a year. It helps balance out the confusion of conflicting information from the news media and some government officials.
37:46 "And yet, the vaccine effectiveness was even better than the efficacy in the clinical trials..." Thank you, Dr. Monica, for sharing this wonderful news!
I wish celebratory news would be more prominently reverberated on the news, which skews negative globally.
I wish they had discussed prior health concerns as a component of risk assessment. An obese 70 year-old man with CHF has a different risk level in all but a super-low prevalence situation.
I lost my grand dad to this pandemic and also lost my job. still haven't gotten my stimulus cheque yet. so sad!
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@@luciabarbosa1801 Yea, so many news on bitcoin these days, please how do I get started? @Lewis, please take heart dear!
I encourage everyone to get the vaccine. Let's keep our country safe!
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you can reach out to him on WhatsApp 👆🏻
Really appreciated this, thank you.
I have a neurological condition, F.N.D, Fibromaligia, Ashtma, and Arthritis, I am 61, my gut feeling is to say no.
Same stay away from the S P piggybacked onto a C R. Like rogue T cells in MS it can pass through the blood brain barrier.
Great info...thanks so much !!
I am surprised at the personal assessments by some that travel, public exposure and child exposure are becoming acceptable. Many risk averse will instead remain cautious, isolated and protected for months after the last cases disappear.
The cases will remain. The risk averse are pathetic cowards
What about the P1 variant? Major outbreak in Vancouver, BC including half of the Canuck hockey team.
Which vaccine is Chile using? Sinovac it's turning out to not be very effective and China exported huge amounts of that two countries that were struggling. Notably Chili's in its fall moving into its winter and they're probably battling a seasonal surge
If we are aiming for 0%"risk we are all in serious trouble. Are we going to become a " 0 % risk" culture for all diseases? What does this look like?
Good discussion. Thank you
If it works it works - you would only keep protecting yourself if it doesn’t work isn’t that the case?
Does it work on. variants?
If it was made last year is it like taking last years flu shot ?
will work with new strain variant
...Lot of opinions here and making statements
So disappointed with much of what these people are putting out here. Dr Gandi, I predict you will be eating your words .
Ivermectin works on all variants.
@@kamwolf3960 I'm betting on Ghandi. She's not alone in this interpretation, also supported by The Data. I'll double down in a month if Israel and UK continues to look as beautiful as it does now.
We need to learn more about the T-cell response and its durability, here. Initial signs are encouraging...
I think that George made a very good point about varinants, in that the California variant (20C etc) B.1.427/B.429 appears to be out performing the UK B.1.1.7 variant, due to fitness.
In the absence of the B.1.427/B.429, when the B.1.1.7 variant gets to 10% the cases increase rapidly (Michigan), where B.1.427/B.429 has a high prevalence, the impact of B.1.1.7 is less (New York) .
To understand what is going on we need to consider the drivers and development, from the viruses point of view, not ours.
It would be useful if people are careful of giving a realistic description of covid situations.
Eg. Using the word 'low' referring to outbreaks... what is low? 20 new cases/deaths a week?, 100 or 1000 new cases/deaths per week? In what context, is 'low' applied to? Can health system still care for everyone equally?
So far, hospitals in 1st world countries are 'prioritising' care. Would you still described as low transmission?
Let's face it, health care systems world wide weren't able to equitably offer care to populations, before the onset of covid .
2ndly, Every new case, is an opportunity for spread and a new variant... I don't feel it's ethical, to risk people's lives with 'soft information'.
We need to understand, that the vaccines (to date) only prevent severe outcomes for disease, they do not prevent infection.
That the status is ever changing.
3rdly, I'm guessing, it is harder to contact trace 'a symptomatic ' cases... and therefore, harder to contain the virus.
Every life matters. Shouldn't we strive to help and save everyone?
Wishing everyone, to keep well, stay safe and look out for others' well being.
It's California, so I'm assuming first names are ok: thank you George, Bob, and Monica, as always.
What is the status of AeroNabs? It seemed so promising a year ago and now we hear nothing about it.
Recall early in pandemic UCSF had expert had served FAA and said wouldn't fly because of the horizontal airflow within planes - vent above with body heat plumes. Don't take off N95 and faceshields. Plenty of other germs.
The changing rooms at indoor venues for hockey may be the spread point.
Actually it’s the ice on the rink
Indoor hockey in Michigan and Minnesota?!
Re passports. It depends...
1.In private settings, house rules
2. In public settings with real, present danger, passports are justified.
3. In public settings where fear guides perceptions rather than clear, present danger, free people manage their own fear and personal action. They do not impose their fear on others. Therefore, most organizations will shy away from passports in most low danger settings.
Individual risk assessment by Monica Ghandi? I will take it.
Wouldn't even consider going to an indoor OR outdoor restaurant, any building, traveling, someone's house. From listening to several hours of variety of university virology podcasts daily for over a year plus reading science & medical journal papers.
Yet this charlatan , Dr Gandhi, smiles and promotes loosening up.
You should have been studying immunology and researching pubmed because you've learned nothing. Ivermectin, HCQ, and budisomide are great treatments against covid.
Gee it's warmer in TX and FL.
Love the nuanced conversation and humor throughout. Would love to see Dr. Wachter wrestling in a mosh pit!🤘🙃😷💗
A bunch of well educated reasonable people having a robust discussion. May have varying opinions but able to have a fair discourse. Hmmm
At first, I was going to simply listen to this and weigh the arguments. Yet, I cannot stop from thinking that Monica Gandhi whose background is exceptional would communicate to the public that her family, which is undeniably a tiny sample group, is Monica's safety measuring stick. Sigh. Maybe, there will be a follow-up UCSF School of Medicine blurb where Monica recants her numerous questionable statements and questionable assurednesses. Placing people in harm's way is something that I hope is not on the table and which can be used as a tool for debating an opponent. Forgive my reacting to something which I think is disconcerting.
TIny addendum: Vaccines are our best means to increase the probability of keeping our species safe from the virus and from its variants. That I wholeheartedly support and agree with. It is too early to state that the one or that the two recommended vaccine doses will be enough to keep us safe as there are discussions that the virus and its variants may be with us for the long haul. That booster shots over the course of our lives may be necessary. There are far too many unknowns. We may need to be humble at what we do not know of.🌸
Johnson and Johnson. Recently bought Monsanto, makers of glycosphate--earth and consequently human poisoning
Dr. Wachter: you, wrestling in a mosh pit might be a good side-topic for one of your institution's updates.
I see three highly educated individuals, extremely highly educated in medicine & infectious disease, doing a near “George Rutherford” risk analysis multiple times a day! The need to articulate your reasoning in conversation is where the common person isn’t going to listen, unless you lead with it, and they will run off and do what they want and mistakenly spread and blame you... people are what they want to be?
Refer to Dr. Sucharit Bhakdi
Really?? We are ok with Covid passports? Who wants the government to decide what we can and can't do. Concentration camps are next. Where does the totalitarianism end? I want to live until I die. You are begging us to merely exist until the heart stops. I can't do this forever.
@Kicapu Not really. Just asking fair questions. I don't want everyone to know my health information. That's personal information. If we compromise here, where does it stop?
@Kicapu What if I feel scared now? Are you willing to give me all your health records so I can feel safer?
@Kicapu Just asked a fair question. If you won't give me your medical records, why should you force me to give you mine? Fair question.
@Kicapu Just asked a fair question. If you won't give me your medical records, why should you force me to give you mine? Fair question.
Testing. Tracing. Supported isolating. AND vaccinating. You know this, yet you continue to refuse to promote or even speak of it. Why ???? Get Dr Larry Brilliant to participate in these Grand Rounds. If ANYONE is to be listened to, it would be him.
Natural Immunity Rocks! The right Tools is key.
So many of the vaccination sites require a car to get to. We have to do better in SF about access without cars.
Can you orders an Uber or Lyft to take you there and back?
The effects seen in the NE and Chile can be seasonal effects linked to UV level and weather patterns that keep people indoors. As for herd immunity the UK has one several herds depending on population density, demographics and ethnicity herd whereas the US has many many more so it is unlikely a uniform result will be achieved on a particular date.
34:30
LOL
What about unvaccinated people hanging out with vaccinated people? Like if I’m unvaccinated, is it ok to hang out indoors unmasked with vaccinated friends?
If you keep your 10 foot pole distance, that's my fav distance. OR if I know the win to be at my back, friends in front of me.
Vaccinated people still get the virus and still spreads it. If you wouldnt be in a ro ok m with someone with out being vaccinated then I would follow the same rule
70% where I live in the UK according to a taxi driver, and witnessed myself, no masks, no social distancing, numbers are still dropping here,
Sorry but that is just misleading information . In the Uk we still have masks, social distancing, and restrictions. Non essential shops don’t open until Monday. Pubs and restaurants only open for outdoor service on Monday. Perhaps that has something to do with declining case numbers, which indeed they are doing. Must be that well known virologist/ statistician taxi driver.
How does illegal immigration affect the outbreaks?
Holy monotone Batman. I’ve listened to a lot of lectures on this subject and been mentally engaged by them but this guy is putting me to sleep
No one knows yet wether the vaccines work with variants.
It seems like if it vaccines don't work ...well blame it on the variants
Not in the state I am in
It is a violation of our rights. Passports are discriminator. My state uses the EHR system to cover up malpractice. It as well has more medical information on it then you realize.. so just more facsism.
No they should not
Ha ha ha! I’m not afraid of the cold or flu. If anyone tries to vaccinate my kid against this cold and flu I will be very angry! Leave the kids alone. I heard this doctor say “I think” a lot. Good for him. So do I for my own loved ones. God bless and continue to open everyone’s eyes.
Rose coloured glasses Monica.
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Crypto is the new gold
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