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ShiftNurse 1 point ago +2 / -1

If you want a visual and great explanation on the concept of herd immunity look up the chain of infection and read a little bit about it.

Basically for a comment reply, the gist is that there are 6 main components that are necessary for disease to spread. If you break any of the links in that chain then you prevent the spread of infection. The more links you break the harder the spread for infection.

Each infection is different and acts in different ways and our own man made preventions and such all have different levels of effectiveness.

As an example, dysentery is severe diarrhea caused by pathogens in contaminated food and water. As long as you prevent the contamination of food and water this essentially goes away. This is something we essentially "cured" through improved hygiene hundreds of years ago.

For something like influenza which has VERY hit or miss immunization coverage and that is spread easily by respiratory droplets that are coughed or sneezed up it is better to have a combination of approaches which is why they recommend the influenza vaccine for those at risk of coming into contact or those who are at risk of serious complications if they get influenza. They also recommend people covering coughs and sneezes, not touching your face, social distancing, and washing hands frequently.

Herd immunity is something you want when the spread of something is not easily controlled by breaking other links in that chain. Measles is an airborne virus. It has super small particles that travel easily and the infection can be EXTREMELY dangerous and even deadly. You can't exactly just cover your cough (mode of transmission) and not touch your face (portal of entry) because you can literally just breath that virus in from the air. This is where the idea of herd immunity comes in. If enough people are vaccinated and able to effectively fight the virus and prevent it's spread it no longer has a host (reservoir) to hang out in. If you make enough people immune to being reservoirs, then people who are unable to get vaccines for whatever reason are at a much lower risk of becoming infected.

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ShiftNurse 1 point ago +2 / -1

The virus has nothing to do with DNA. DNA is like your cells brain, it's wrapped up neatly in the middle of the cell and is extremely difficult to get into and change. Typically cancer is the result of DNA changes.

Viruses latch onto certain types of receptors on cell walls which allows them to a variety of things, the biggest being able to enter a cell to turn the protein creating portions of your cells into virus producing factories. This process causes your immune system to react and try to kill those infected cells to prevent the spread, this is what generally causes actual symptoms of being sick like fever, body aches, cough, etc. The body can go into overdrive with this which is called a cytokine storm which is the big issue early on with covid. This reaction causes severe inflammation and a bunch of other issues.

In regards to the cell marker the virus targets, it's different for every virus and they all work in different ways. Covid is thought to like the ACE2 receptor which is found largely in the lungs, heart, blood vessels, kidneys, and the GI system which explains the slew of symptoms.

In terms of treatments, the treatments that have been used all work in very different ways. Ivermectin and HCQ are both anti parasitic drugs with HCQ also being an immunosuppressant. The thought behind these ones helping was that it prevented the body from going into the cytokine storm that is essentially the kickstart for the whole illness cascade. Based on what the docs around here are talking about they basically think these drugs have to essentially be timed perfectly for it to be truly effective. Being a preventative treatment means it isn't guaranteed to prevent illness and people will still get sick regardless.

Take all this with a grain of salt. I obviously don't have all the answers to everything, but this is based on what I have seen personally with covid ICU patients over the past year as well as what the infectious disease and pulmonology docs are using in their treatments.

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ShiftNurse 2 points ago +2 / -0

Of course. That still doesn't change the fact that this is still something that is difficult to treat.

I guess what I'm basically trying to get at here is even if tomorrow, every world leader came out and said this is an engineered influenza virus created by China, it doesn't change the fact that even our best treatment options are hit or miss. What difference does it make whether it's labeled an influenza strain, or it's man made, or whatever else. It doesn't change the medical problems that come with this.

Some patients get remdezivir, or ivermectin, or whatever and some steroids and are on their way in 5 days despite having diabetes, heart failure, and are overweight. Others get remdezivir, or ivermectin, or whatever and literally nothing happens and they end up in the ICU for 46 days.

The people who have these stays are the ones having crazy other issues like heart and kidney failure, blood clots, etc. They're generally stable from a respiratory standpoint for weeks before the rest of the problems clear up.

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ShiftNurse 6 points ago +6 / -0

ICU nurse here. I don't have an answer and won't try to pretend to know the truth any which way about whether it's flu or not etc, I don't care about any of that. What most of us in healthcare, have experienced and seen and is why we're concerned, is that patients who are critically ill with this thing are unlike anything we've previously dealt with before and treatments are hit or miss. Hospital I work at has like 18 different clinical trials happening including ivermectin and it literally seems like it comes down to a coin toss on whether any of them will work. Even in patients with comorbidities, the traditional flu is a respiratory thing and presents as a respiratory thing. Very, very rarely did we ever have flu patients coming in with the massively vast range of issues that the patients are experiencing with this thing now. Weird types of heart failure, kidney failure, clotting issues in people who should not have clotting issues as well as clotting even when on hard core anticoagulation, neurologic problems, the list goes on. Basically my point is, even if this does end up being confirmed as a weird flu strain, it doesn't change the fact that this is still stupid difficult to treat.

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ShiftNurse 1 point ago +1 / -0

Oh I know, it's just real obnoxious to me that there's just such a huge lack of basic understanding. I'm not out here tryna change anyone's mind or anything, just sorta pointing out the obvious.

In my opinion, if you're gonna bash something you should at least have a basic understanding of what you're bashing and why, just makes you (the collective, not you specifically) look goofy and discredits your movement when you clearly aren't even understanding the most basic concepts.

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ShiftNurse 1 point ago +2 / -1

I'm lumping your title in with my original statement because people testing positive for a virus despite being vaccinated shouldn't be a surprise to literally anyone who has a concept or understanding of how vaccines work.

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ShiftNurse -1 points ago +1 / -2

Regardless of any other argument, the number of people who have literally no concept of how a vaccine even works, which includes the way it was originally designed to work, is absolutely astounding to me.

For the record, I'm NOT making any argument for or against any specific vaccine.

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ShiftNurse 2 points ago +2 / -0

It can't give you herpes, but any stress or immune response, in this case the intended reaction to getting a vaccine is an immune response, can cause a herpes flare up if you already have herpes.

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ShiftNurse 2 points ago +3 / -1

Venting someone as a literal last resort was one of the biggest changes made from the first round of this thing but so far nothing has prevented people from reaching that point. First everyone was on HCQ/Zithro with zinc/vit c/vit d supps. Then it was remdezivir. Now it's ivermectin or one of a slew of other meds or combinations.

So far nothing has prevented people from hitting the ICU and requiring intubation. I know y'all like to make it a black and white subject around here like there's a choice between pills and some iv medicine or a ventilator as treatment, but that's not how it goes lol.

I got nothing on the visitation though. I work ICU and we already had visitor limitations before the whole thing. Never anything that prevented end of life visitation etc though.

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ShiftNurse 1 point ago +1 / -0

Someone can be immunocompromised for a whole slew of reasons, from not playing in nature enough (current research suggests this is why allergic and autoimmune diseases have been exploding in recent years), cancer treatments, medications or other illness, age, etc.

Like I said, I personally don't want the covid vaccine because 1) it has only been a few months and I'd like to see more long term testing which leads me to 2) I'm young and healthy and personally am classifying this into the flu vaccine group in terms of necessity for me. I'm young and healthy and take relatively good care of myself. Even in the event that I do get either influenza or covid, I'll probably be fine.

However, if my hospitals start requiring it, it's not a big enough deal to me that I would give up my job and be outraged over all this because the vaccine itself is not that big of a deal.

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ShiftNurse 1 point ago +1 / -0

If you are seeking exemptions, yes, which is why it is illegal to discriminate against those people and why I said in my comment that those protected individuals are the obvious exception here.

"Annual influenza immunization is required for all employees, including, but limited to, physicians, fellows, volunteers, students, contracted personnel, and professional staff, unless medical contraindication or religious prohibition exists."

Literally right from the top of the policy.

Not everywhere requires them, I shouldn't have been so all inclusive when I said every single one. A large majority of healthcare orgs require it, unless exempt etc.

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ShiftNurse 1 point ago +1 / -0

I 110% agree with this, to a certain degree.

Healthcare is both an individual and community focused field. For some things there needs to be much more focus on the others. For other things there needs to be a bigger focus on community. Unfortunately certain disease spreads from person to person which makes that a community problem. When you participate in society, you either agree to certain rules (vaccines for MMR, polio, etc to go to public schools or as an agreement for certain jobs) or you make the decision to live a life without those societal niceties and some extra hurdles to jump over.

Healthcare in this country is absolutely atrocious and health literacy is even worse. Healthy diet, exercise, vitamins, etc are all excellent and all your body really needs to fight something off, as a normal healthy individual. However, there are many people who are not able to do that or are immunocompromised and unable to do that naturally which is why vaccines are a thing and are important and (other than the covid vaccine) have very little to no real major risk.

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ShiftNurse 1 point ago +1 / -0

Based on your comment and complete and total lack of absolutely any understanding of how vaccines work ("does not kill any virus, people still get the flu after the flu shot") I'm not going to be able to change your mind on the science so I won't even address it.

In terms of everything else, like I've told you nobody can hold you down and force you to get a vaccine. I have never once tried to say anything of that nature. FOR CONDITION OF EMPLOYMENT, because we live in a free country, your employer can require you to get a flu or covid vaccine, get a drug screen, a criminal background check, a credit check yada yada. You are not required to accept those terms and you do not have to get that vaccine or authorize a background check if you don't want too.

Like I said, I don't agree with requiring the flu vaccine etc as condition of employment. But I also knew that would be a requirement for my career and had to make a choice on whether a flu vaccine was a big enough deal or not to prevent me from doing something I love.

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ShiftNurse 1 point ago +1 / -0

Uh, as condition of employment, they can require you to be vaccinated. There's nothing illegal about that. They cannot hold you down and vaccinate you, but they don't have to continue employing you if you refuse and you don't have to get the vaccine or continue working for them if you disagree with that practice. It's no different than requiring a drug screen, or to be tobacco free, or whatever else as a condition of employment.

There is a massive difference between forcing you to be vaccinated and requiring vaccination as terms of employment.

I don't agree with requiring you to be vaccinated as condition of employment, but we live in a free country and you're more than welcome to quit and get a job somewhere that doesn't require it or even quit and start your own business that doesn't require you or your employees to be vaccinated.

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ShiftNurse 1 point ago +1 / -0

Shooooot, any way you can add how frequently the patient pushes the call light and the proportion of time spent in room because of that to patient billing. Can you also add one that times how long I spend charting all the dumb ass required charting, that would be glorious.

How much does implementation of this type of thing cost? It sounds super useful but at the same time sounds expensive upfront as well as to install.

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ShiftNurse 1 point ago +1 / -0

It doesn't impact your job performance, but it does impact the health and safety of employees which employers are concerned about.

You're completely missing the point I'm making as well as misreading what I wrote. Every major health system and major health organization in the country requires the flu shot as condition of employment. Pre employment physical also requires all immunization records, tuberculosis screen, drug screen, tobacco screen, and some other things.

I literally have to get my flu shot at both hospitals I currently work at (both are part of the two largest health systems in the country) or I am removed from the schedule and face corrective action, up to and including termination if I don't get it.

They have the right to require those as terms of employment. I don't know anything about the rest of jobs and stuff because I've only ever worked healthcare, but employers can require those. If they require a drug screen, and you take a prescription medication that would.makr you test positive, they have every right to ask you about it and terms of employment. Again, if it's that big of a deal to you you have every right to refuse and not seek employment where they are asking.

I definitely don't agree with it and believe I should have the option to choose whether I want the flu vaccine every year, but I also know I chose this career and knew it would be terms of my employment. I could have gone into something else that didn't require it if it was that huge of a deal to me.

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ShiftNurse 1 point ago +1 / -0

Uhh where did I say they were asking you to reveal protected health information, that we literally have laws specifically to protect those pieces of information, like HIV status or whether you've had an abortion? Especially when those pieces of information don't impact you or the job in any way shape or form. As long as they aren't discriminating against protected persons of course.

Your employer can 100% require you to get a covid swab, get the vaccine, take a drug test or any other slew of things as condition for employment. If it's such an egregious wrong for them to ask that of you then don't seem employment there. You have that right. Literally every major healthcare system and organization in this country requires you to get the flu vaccine yearly as s condition of employment, unless you have special circumstances of course.

For people who are so gung go about freedoms and choices and shit, sure is weird those freedoms and choices should only matter when it's convenient for you or something you believe in.

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ShiftNurse 1 point ago +1 / -0

That sounds like the same rfid system they had for us. What's different/new about the one you're working on? I'd assume if they can differentiate between me standing outside the doorway of the patients room or being inside the door of the patients room that's the same thing as what you just described.

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ShiftNurse 1 point ago +1 / -0

Your employer can require you to swab as condition of employment, just like they can require you to get vaccinated or take a drug test as condition of employment.

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ShiftNurse 1 point ago +1 / -0

If they shared that info with anybody without your consent it's a violation*

Can't even share information with family members if permission to do so hasn't been obtained.

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ShiftNurse 1 point ago +1 / -0

Basically they had the rfid system that was set up to recognize zones and there were four major zones; patient rooms, hallways and supply, nursing stations, and then the break room. There were a few misc other ones like conference rooms and such but I was never in those so they never showed up on my report.

The system's main function was to allow other staff to locate you if needed and to judge staffing needs but was also used to fire some people for being lazy or lying about where they were. We had a board that showed the location of each badge tracker. Sensitivity and zoning was literally set up so that if you were sitting at a computer between two rooms it would literally say "ShiftLeader Pod 23/24." If you were in a patient room it would say the same "ShiftLeader Patient Room 23."

The report gave a pie graph of percentage of total time spent in each major type of zone and then the breakdown looked like an itemized report for each day. "1900-1904 Patient Room 23" 1905-1912 Patient Room 24." Then have the total cumulative time for each major zone at the bottom.

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ShiftNurse 2 points ago +2 / -0

You're a little late, those rfid tags have been around for years. Still have mine from my first job almost 10 years ago. Management was running reports quarterly and they were part of your yearly eval.

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ShiftNurse 1 point ago +1 / -0

Assuming you live in the US, hospice is a service, not a place. You can literally sign up for hospice to have a visiting doctor, nurse, aide, chaplain and a whole slew of other things come to your home to provide a whole slew of services that you and your family can pick based on what is best for everyone involved.

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ShiftNurse 2 points ago +2 / -0

I mean if the goal is eliminating the entire human population that would make sense. But if we're talking population control (which is the frequent conversation around here with sterilization etc) why would you eliminate a producing and critical infrastructure like healthcare..?

You get rid of the people who take care of the sick and then what? Just mass deaths in the streets? Otherwise healthy and productive children/adults dying of a ruptured appendix? Who produces? Who's left to rule?

See what I'm trying to get at? Like I said, not getting it myself and one of the main reasons is I'm low risk, everyone in my life is low risk, and I'm not taking the risks of a vaccine with such a short research cycle. I just really don't understand this whole jump right to "vaccines have literally been designed to murder you."

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ShiftNurse 2 points ago +2 / -0

I'm an ICU nurse working covid, not getting the vaccine because of a few different reasons, just to preface my question.

Vaccines obviously have potential complications, but if the goal really was to kill people and reduce the population why would you start with the entirety of the medical community of the entire country..?

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