outbreak! (ebola, sars, coronavirus, etc)

one one level, https://www.amazon.com/American-Sickness-Healthcare-Became-Business/dp/1594206759 is a great book that identifies the problems and incremental solutions (and how to navigate it in the meantime). recommended for anyone using the US health system! on another level, i read it and was like "you all must be out of your fucking minds".

I think we all just want and need a strong guarantee that more and more corporations will be there to take larger cuts from our inevitable health problems as we age. it isn't much to ask for some security - for those companies.

Come on, don't be so selfish, you pay that $650,000 so that others only have to pay half that.

I can see why they want to bam abortion at those prices

You should see how much *keeping* kids cost.

hey, be nice to those kids. someday they'll be paying the $1.4M bill to keep your old ass alive for a couple more years

i want to be clear that i think everyone's ass here is old, especially my own

I guess it's good that this is the time that dad is being moved out of skilled nursing again because lord do I not want him there when Omicron really takes off.

(he's boosted, and not really immunocompromised per se, but 73 and not in perfect health, so y'know).

in other news, hey i guess I'll be wearing my KN95 in the house again for a lil bit. might be overcautious and gonna be uncomfortable but idk. he's not home yet so I have time to decide.

when covid first popped off I aws wearing a fucking balaclava in the house so this is better than that

FWIW, last year we wound up paying a total of around $470 for four PCR tests (two each for myself and my wife) that were supposed to be free. We went to a drive-up at a hospital, but you had to do an "intake call" first. They bill the intake call as "telemedicine." On top of that, we couldn't straighten anything out because we have separate medical and hospital plans and the hospital couldn't figure out which one to bill, billed the wrong one, and then it was too late by the time they realized they were wrong because the plan they billed had sent us like $10 "reimbursement" (out of network, hey hey) and therefore the claim was already considered processed. I actually wasted some hours trying to get this resolved and couldn't.

My wife also had an insane and sort of related experience trying to get a booster at CVS, spent 6 hours on phone/in person (two separate trips) because of our overcomplicated insurance (this time they couldn't figure out whether it was our health plan or our prescription plan, and we got stuck in a byzantine nightmare going back and forth between CVS and the two different plans).

This is all relatively quid/ag for us, we're fine, but just to confirm that, yes, the US healthcare and health insurance system is a nightmare and can't possibly be helping things here.

i didn't have a quarter of a million dollars btw

― 𝔠𝔞𝔢𝔨 (caek), Friday, December 17, 2021 3:05 PM (one hour ago) bookmarkflaglink

well not after you foolishly blew your pile on luxury intensive care for your newborn infant you didn't, what ever happened to personal responsibility in this country

love too be free to contract with healthcare providers

did not expect Dr Jha to be uhh this bold. I suspect he's about to take a beating from his peers (idk if he's wrong per se but wow brave)

For nearly 2 years, I've closely tracked infections

Because infections invariably led to hospitalizations and deaths

But I expect that in this upcoming wave

That link will finally break

Cases will spike

But among vaccinated/boosted people, it won't lead to serious illness

— Ashish K. Jha, MD, MPH (@ashishkjha) December 17, 2021

what does he mean by "that link will break"?

"among vaccinated/boosted people, it won't lead to serious illness" is true but a significant fraction (perhaps even most) americans are going to get omicron in the next 4-8 weeks, and the vast, vast majority of over 65s are not boosted.

I don't see how that doesn't lead to a lot of hospitalizations unless he thinks it's intrinsically *very* mild.

weird tweet.

Even hospitalizations is a little squishy and ICU is probably a better measure of severity.

Seems like a weird thing to say but he might be trying to counter the AJ Leonardis of the world and overcorrecting

The Omicron wave is already here and is sure to be staggering large. But there has been some good news, too—at least relatively speaking. A thread (1/x) https://t.co/julic17Fym

— David Wallace-Wells (@dwallacewells) December 17, 2021

i haven't read the full article (and DWW is a climate writer not an epidimiologist, and he's had some dodgy covid takes before) but this thread is very reasonable IMO. there's a lot of reasons to be optimistic, including the possibility that omicron might in some sense end the pandemic?!

but he's also right that the US is very poorly prepared relative to other developed countries for what's about to happen. if you get it, you'll probably be fine, but try very hard not to give it to anyone else!

a superficial sheeb of intelligence (jon /via/ chi 2.0) at 4:19 17 Dec 21

The pre-insurance bill for my son's C-section birth was definitely north of a quarter mil

we used to joke that we hadn't paid off our baby until year 2 haha

Hmm

Important🧵by Ravi and his team
Omicron-> Lung cell infectivity reduced, consistent with Hong Kong findings:https://t.co/4PO3uPERLC
Which, added to immunity wall of vaccination, would help reduce potential of Covid pneumonia 👍 https://t.co/r2SeXXxIoV pic.twitter.com/EvvPgO8I2s

— Eric Topol (@EricTopol) December 17, 2021

Xxpost yea I'm picking up tests tonight and testing mom and i

Breaking: Illinois hospitals are being flooded with patients more than at any other time of the pandemic, a Tribune analysis of state data has found. https://t.co/QOSI49Vxgp

— Chicago Tribune (@chicagotribune) December 17, 2021

I love how it looks like eazy broke in there

i've been going insane thinking about how omicron is going to be bad based on every sensible thing i've read about it and it's been infuriating to watch the CDC and media continually go, 'well... the cases are mild,' based on basically nothing. the infectivity supersedes the diminished symptoms, if the diminished symptoms are in fact an element of this variant which can't be confirmed. but it's okay because The Economy is churning along folks

The total bill for keeping me alive in 2019 was about 1.5 million. About 3/4 of that was covered by insurance, and I essentially showed the huge teaching hospital (U Penn) that I had no money to pay the rest, and they ate the rest of the bill. Very lucky in this regard.

This thread makes an interesting case for being extra cautious if you have symptoms and test negative

IMPORTANT:

RAPID TESTS DO WORK WITH OMICRON

"But why are some people staying negative in the first days they have symptoms??"

This is expected. Symptoms don't = contagious virus
This is literally a reflection of the fact that vaccines are doing their job!

PLEASE READ pic.twitter.com/YBJvNovQXL

— Michael Mina (@michaelmina_lab) December 18, 2021

lol literally just read that thread

I don't even know what symptoms to look out for these days. The sniffles?

bootyflakes

One person I know who got it recently said it was a lot like a bad stomach flu, for her and for her kids.

mom told me she had massive diarrhea.

just tested her, she's negative

tested her nose, not her diarrhea, to be clear

i'm negative too. same time tomorrow Binax? yay!

great thread

This is one of the most confusing times of the pandemic, w/ a firehose of new Omicron data (lots of fab work on #medtwitter putting it into context). In this (long) 🧵, I'll offer my take on how the new information is changing my thinking & behavior.(1/25)

— Bob Wachter (@Bob_Wachter) December 17, 2021

also Ashish expanded on his thread from earlier, but....it's kind of a thin explanation.

Lets talk about why we'll soon see an uncoupling of infections and hospitalizations

No, its not because Omicron is "mild"

I'm not sure it is

Its because Omicron has so much immune evasion

That we'll see a change in who gets infected

Thread https://t.co/rJlO4HczCw

— Ashish K. Jha, MD, MPH (@ashishkjha) December 18, 2021

International travel hasn't been a good idea since March of last year and remains not a good idea.

Lucky if you can work in your home country and don’t have to look for a job somewhere else. But screw those people right?

https://www.theguardian.com/world/2021/dec/17/hundreds-off-work-ill-at-leading-london-hospital-as-omicron-cases-surge

i’m sure this will be fine

Netherlands not fucking around:

Lockdown in the Netherlands:

- From tomorrow until January 14
- All non-essential stores, restaurants, cinemas, and schools are closed
- Events are banned, including Christmas markets
- Only 2 people can be outside together, unless they live at the same address. 4 on holidays

— BNO Newsroom (@BNODesk) December 18, 2021

Good article if you have any free ones left

https://nymag.com/intelligencer/2021/12/the-south-africa-omicron-wave-is-already-peaking-why.html

Excellent piece on the end of the pandemic.

https://www.bmj.com/content/375/bmj-2021-068094

. Far from a dramatic “end,” pandemics gradually fade as society adjusts to living with the new disease agent and social life returns to normal.

I agree, and it's what I thought in April.

Deactivating or disconnecting ourselves from the dashboards may be the single most powerful action towards ending the pandemic.

I did this last summer - and rates were really low. Perhaps there was some sort of correlation between my actions and how highly the pandemic was raging?

This is good to see.

Actually, more recent data from Denmark looks more encouraging. Based on a far larger sample size, Omicron hospitalisations are at ~0.6% vs. ~1.5% for Delta (~60% down).
(Thanks @RufusSG for spotting the report)
8/https://t.co/ALkZLAXDvv pic.twitter.com/zKJfTohuT2

— Prof Francois Balloux (@BallouxFrancois) December 19, 2021

Some more reporting on what could be coming in terms of variants.

https://www.theatlantic.com/health/archive/2021/12/america-omicron-variant-surge-booster/621027/

lots of sobering pulls from that article, but this is one that hits hardest right now and gives me such little hope:

Like the variants that preceded it, Omicron requires individuals to think and act for the collective good—which is to say, it poses a heightened version of the same challenge that the U.S. has failed for two straight years, in bipartisan fashion.

(thanks for sharing though)

There's no public policy that will contain a virus this contagious, only thing that is effective is vaccinating as many people as possible and hopefully eventually an effective antiviral, which does admittedly seem like a real likelihood now, something I didn't expect.

the hope of public policy containing covid in the US went down the toilet before April 2020. US policy rn is mainly aimed at slowing it down and causing the fewest hospitalizations and deaths, except in states like Texas, where the policy is to let the virus do whatever it wants.

don't forget the Floridas!

There's no public policy that will contain a virus this contagious

How many people have died in your state from the virus?

pandemic response is a state of mind

now this is a thread:

I've talked about my Tuberculosis story. Here's what the Gov't told me when I was diagnosed:
-Go home.
-Don't leave your house.
-Tomorrow we will begin treating you.
-A gov't worker will come to your house to treat you for 6-9 months
-If you refuse treatment, you will go to jail

— Magdi Semrau (@magi_jay) December 20, 2021