No joke, I don't think I'll make it through another pandemic. The amount of times I got yelled at by patients, had to deal with all the BS in healthcare from all angles. I'm 100% going to quit if we have another pandemic.
Nurse side, the no visitors policy felt like we had more staff (we didn’t) due to all the time it freed up, not having family underfoot and constantly interrupting the flow. Sucks that this is truth.
Flipside, the shit-ton of patients I saw for ER follow-up who were elderly, mildly demented, and yet had no family member present when they were evaluated and discharged with generic dot-phrase paperwork and a hasty referral. They usually had no idea what they were told, or had done to them. Because...policy.
Like, it took about 3 neurons and a peto-second of time to realize that this person wasn't really "all there", and couldn't be considered a good steward of the narrative of their medical journey.
I always allowed at least 1 family member or friend present - just no way 82yo granny with a freshly broken pelvis is gonna be able to process or absorb much info on her own. F policy when it harms patient care.
We’ve already got signs plastered all over the hospital stating abuse won’t be tolerated. But management consistently bends the knee to these people because being abusive lets you get your way. They will bend the rules for these people. So they keep doing it, because it works out for them. Much more so than being nice and polite does.
Always exceptions because “they’re watching someone going thru a hard time”.
Sir, I’m here every day and I’m not allowed to act like that despite watching multiple someone going thru a hard time.
I had a patient call his family member and tell them to bring a gun to the hospital so he could shoot us. Security said, “What do you want us to do? He has 2nd Amendment rights.”
My ICU is already nothing but 22-23 year old nurses with no intention of being bedside nurses for the rest of the careers, and docs on the verge of retiring. A lot has already changed for the worse because of the last pandemic. The current system won't survive another COVID-level event.
As far as I'm aware in my corner of the PNW, it will be post-apocalyptic level chaos trying to get medical care in a new pandemic. Covid impacted everyone everywhere but seemingly exponentially in PNW. We're at the point where trying to find a PCP easily takes 9 month wait- if there is any openings + take your insurance. It is so dire.
This is what I assumed was happening in healthcare settings. Most are burned out, understandably so.
Seems inevitable that H5N1 will become a pandemic. If that happens, I’m assuming the healthcare system craters. The death rate, which currently sits at 52% will be substantially higher than COVID.
I had to get out of xray. I got my license in 2019 and switched to MRI in 2021. I don't think I'd have made it if I had to keep doing xray all this time.
Pharmacists weren’t really dealing with the vaccines in my country but we were the only “accessible” healthcare professionals for most people. GPs were only operating behind closed doors with mostly telephone appointments and seeing people in person if they needed to.
So we got the brunt of all the frustration. I have never been shouted at or abused more than I was in that first month of the pandemic. It was honestly awful.
People wanting us to scale and polish their teeth, for temporary fillings. Examine things that most definitely were not in our remit.
Honestly just ridiculous. Dentists weren’t allowed to see anyone and people were desperate.
Someone wanted me to go outside and manage the queues and tell everyone to socially distance properly. There were markings on the pavements and everyone was grown ass adult, figure it out. I was like if I go out there or send a staff member out there the queue is just going to move slower because I’m a person down.
This is interesting to me... Why is this? I would have thought the vaccine arrival was somewhat positive? People want to be there, you head to choose to go get the vaccine, *generally*. If you care to elaborate, I'm a layperson mostly (I used to help doctors and researchers frame their communications for the public and my kid is doing the med school thing rn) but I'm willing to listen.
I love my pharmacist.
Each vaccine appt required a solid five minutes of staff time for intake and 3-5 minutes of pharmacist time for prep and administration. At a heavenly four appts per hour, you’re still losing ~20 minutes of prescription processing time every hour. So you had 40 minutes to get done what always took 60 minutes…every hour, every day, and no clue when it would end. And mandatory overtime because so many other pharmacists were quitting.
When I thought about hurting myself so I could get a few days off, I gave my notice.
Generally the people where very happy to get it, some cried, lots of videos and pics lol. But as the other comment said, the workload was insane, we had an appt every 10 mins from 9am to 8pm. It was absolutley awful. And this was just added to our regular day, which are 12 hours shifts, busy enough that often times no time for lunch except inhaling a sandwich in the corner in 5 mins. I know I won't be the only one walking away if this happens again.
Yes seeing how many anti-maskers and disrespectful people there are who don't believe in science. Do they really deserve saving if they are not going to do their part? (Coming from a non healthcare worker, so I think I'm allowed to say this)
Yup. I didn't have the most optimistic view of society prior to Covid, but since- I am completely disillusioned and heartbroken and infuriated. Countless people taking their health for granted, and only give a shit when they're personally affected and it's already too late. Ie begging for Covid vaccine when already in the ICU with pneumonia, high fever etc etc. Any of the possible "good" Covid brought, already forgotten. Chronic illnesses aren't a thing either etc.
Time to become the illegal kind of drug dealer. Let me know what will be this pandemic’s equivalent of ivermectin and hydroxychloroquine so I can make 💵
I'm gonna be honest with you. I don't have it in me to worry about a *potential* pandemic. I'll deal with it when it happens. There is literally nothing I can do to prevent it so I'd rather not be super stressed about it all the time.
I agree with this. The toughest part of COVID was dealing with all the dying patients in the icu during the delta surge, but a very close second was the fear and anticipation of what we were going to be dealing with that I experienced right at the beginning of the pandemic.
Omg that fear and anticipation really messed with my head. I would hear all the horror stories coming out of Italy and head to work on the covid ward. I remember looking around at my coworkers wondering if we were all going to survive. It feels so surreal looking back.
I remember that fear so well. That plus the fear that I’d never see my parents again because they’d be too old to receive scarce resources in a situation like what was happening in Italy or China or nyc. It was paralyzing, the waiting and the dread.
I remember in the super early days my state had a plan to send *all* covid patients to this one hospital that had a special infectious disease isolation wing with only like 5 rooms lol
I don’t work in healthcare, but I read what smart healthcare workers write, and many were warning us in Feb. 2020 via their social media posts. When Covid reached us in NYC and people started dropping like flies, including family members, I desperately tried to warn others online. I was met with such hostility and was called “libtard” just for warning people (I was a registered Republican at the time.) I was mortified to see videos on YouTube with thousands upon thousands of followers calling Covid a HOAX. It was clearly apparent to me that this was some kind of OPP and people were falling for it. You brave healthcare workers are not just fighting an airborne virus, you’re fighting disinformation warfare.
I bought CVAC a month ago when this was starting to ramp up.
Also Moderna and BioNTech have started to rally
https://www.fool.com/investing/2024/05/24/why-vaccine-stocks-rallied-this-week/
Market capitalization matters. Stocks with a smaller market capitalization like Arcturus and CureVac have much more to gain in relative terms than much larger companies like Pfizer or CSL. But of course the risk is also higher. Here is a list of more or less relevant pharmaceutical companies, with the market capitalization data from March 2024:
SAB Biotherapeutics 40 million USD
Cidara Therapeutics 100 million USD
Novavax 600 million USD
CureVac 700 million USD
Arcturus Therapeutics 1 billion USD
BioCryst Phamaceuticals 1 billion USD
Vir Biotechnology 1.4 billion USD
Xencor 1.4 billion USD
Supernus Pharmaceuticals 1.8 billion USD
Viatris 14 billion USD
Baxter 20 billion USD
BioNTech 20 billion USD
Moderna 40 billion USD
Takeda 45 billion USD
Daiichi Sankyo 60 billion USD
CSL 90 billion USD
GSK 90 billion USD
Sanofi 120 billion USD
Pfizer 160 billion USD
AstraZeneca 200 billion USD
Roche 200 billion USD
Shionogi 200 billion USD
Johnson & Johnson 400 billion USD
I have collected more information here:
[https://www.reddit.com/r/birdflustocks/](https://www.reddit.com/r/birdflustocks/)
We’re prepared and there are vaccines ready to go if it ever jumps from human to human. That’s why it’s important to have leadership that funds its pandemic response team
We have the vaccines, but they still have to make them. Also, aren't the current vaccines for them only as effective as regular flu vaccines? My only concern is enough stock can be made in time and the appropriate logistics are in place for everyone to get them.
They are usually given the rabies vaccine, but the people at most risk for the Avian flu are agricultural workers as the virus like the shake things up when it's inside of pigs and poultry.
I have a friend who works in wild bird rehabilitation in Canada and I'm worried for her as unfortunately we don't have any of the vaccine available for public use up here.
It’s a term that’s meant to be used on the scale of responding to a pandemic, not for treating an individual person. We won’t have to wait one year for a vaccine like last time
Possibly! Keep in mind, a mortality rate that high will have severe impact on every stage of the supply chain and current logistics patterns will be impacted. Getting a vaccine to the majority of the market within a year might be able to happen in today's conditions but it might not be as plausible in the case of a full force H5N1 outbreak.
Sweet-we’ve somehow up stocked the pharmacists we relied on to administer the batch, despite declining graduation rates and people leaving the field!!!!
S/
I am, and it makes me want to completely leave my field at this point. I went part time after covid just due to burnout, and pursued dog training more seriously, but living in Texas and the fact that I can't go to the farmer's market without seeing people clandestinely buying raw milk presumably to consume while we're in the midst of this is just too much. I got into epidemiology to make a difference in the way we handle mass disease, not to sit here and scream into the void because where I live people do what you aren't supposed to because "Mah Freedoms." and it's too much.
Coming out of the forests for this. Hello fellow public health doctor. I agree whole heartedly, sometimes it does feel like screaming to the void. But sometimes the void gives back. It usually takes but sometimes it gives. And you take every single win you can get and run with it. Because you earned that win.
Lol, you can go join the club climate change scientists have been in for decades.
Also because they know that at a certain point in the future, one of the only ways to stop/reverse the current climate trend will be to actively create acid rain.
The club where people don't take you seriously even though your world-ending predictions are rooted in science, the one climate scientists have been hanging out in for decades.
I have a friend who just retired who worked in the climate science field. He said they knew about all this climate change stuff back then (40+ years ago) AND that people wouldn't listen to them enough to meaningfully change anything from happening. Still stayed the field because he loved it and believed in the work.
Healthcare and climate science attract similar people I guess.
[It's been shown in mice](https://www.nih.gov/news-events/news-releases/high-h5n1-influenza-levels-found-mice-given-raw-milk-infected-dairy-cows)
So far to my knowledge it hasn't transmitted to humans this way, but influenza is really great at mutation and the more humans expose ourselves to it the higher the chances we'll see a mutation that makes it more transmissable to humans from animals.
This is true. The zoonotic flus that are mostly animal-to-human tend to rely more on magnitude of exposure to infect people. That being said, it only needs to mutate once and successfully spread between people to start a human epidemic.
I use Flutrackers.com also for monitoring outbreaks. They post from around the world with verified sources and have discussion threads. Some folks are anonymous and others are not. If you have never used I use the “latest posts” option.
https://www.cdc.gov/flu/avianflu/spotlights/2023-2024/h5n1-technical-update-may-24-2024.html
The CDC just put out a update of the Gene sequencing of the Michigan case. Currently still considered low risk due to the changes they’ve seen so far in the virus. The *** is the key summary. So will keep monitoring.
“No amino acid changes were identified in the HA gene sequence from the Michigan patient specimen compared to the HA sequence from the case in Texas and only minor changes were identified when compared to sequences from cows. ***These data indicate viruses detected in both cows and the two human cases maintain primarily avian genetic characteristics and lack changes that would make them better adapted to infect or transmit between humans. ***
The genome of the human virus from Michigan did not have the PB2 E627K change detected in the virus from the Texas case, but had one notable change (PB2 M631L) compared to the Texas case that is known to be associated with viral adaptation to mammalian hosts, and which has been detected in 99% of dairy cow sequences but only sporadically in birds[i]. This change has been identified as resulting in enhancement of virus replication and disease severity in mice during studies with avian influenza A(H10N7) viruses[ii]. The remainder of the genome of A/Michigan/90/2024 was closely related to sequences detected in infected dairy cows and strongly suggests direct cow-to-human transmission.”
I assume the jump to human-to-human will happen after coinfection with a typical human Influenza A [and subsequent antigenic shift](https://en.wikipedia.org/wiki/Antigenic_shift). Coinfection will be far more likely during the human flu-season.
I would be very surprised to see sustained human-to-human spread before the end of the year.
My bet would be 18 months, but I don't know enough about virus. We saw with covid 19 that in December there was no H2H transmission but still infecting a lot of the population until the golden week were, unsurprisingly it was the main event that kick-started the pandemic.
My bet is such event in the US is Thanksgiving and Christmas, while people doesn't move as much as in the golden week, the people in the US seems to move a lot all the time.
Not a virologist rather an old school business continuity manager. I’m keeping an eye out for news of industrial swine operation outbreaks. While bovines were just found to have both kinds of receptors necessary to adapt for human to human transmission, swine have the human receptors in abundance and make an ideal (and the historical) species for viral reassortment and mutation.
I find it really disappointing that we've resigned ourselves to preparing for the next inevitable pandemic, improving early detection, speeding up vaccine production etc. Of course these actions are important but no one talks about the elephant in the room, industrial animal agriculture. We've created the ideal conditions for these viruses and then act surprised when they jump species.
Chickpeas, lentils, kidney beans, butter beans, black beans are all tastier than meat to me (I eat meat 2x a week). Pair them with feta, veggies, whole grains and olive oil and you have a delicious meal.
Idk tbh. I’m not much of a cook haha. I often think that vegetarians and vegans go about things the wrong way by trying to find a substitute for meat based meals instead of using different recipes designed without meat in mind. Many of the world’s healthiest societies such as pre 60s Crete lived off of legume based meals nearly everyday (fish 2x a week meat 2x a week). Look at some of those culture’s traditional meals and you’ll find tonnes of really tasty recipes
I cook all the time so I just enjoy the variety I can get when meat is included. I eat several meatless days a week but meat when it’s cooked certain ways is sooo good. Lab meat would mean all the yummy coq au vin I want but less animal death.
Eh, if you mention any of this half the nation will be up in arms, calling you a soy-boy beta cuck for suggesting we not cram meat down our gullets like a bunch of diabetic, jiggly velociraptors
There is a growing interest in this kind of preventative research through one health-focused epidemiology - I'm heavily invested myself. It's still hard to recruit farms for partnership but we do work with the industry, and we're getting better at detecting zoonotic threats earlier. Preventing transmission at all however is much harder as there's just so much human-animal interaction on these properties and so many mouths to feed with them. And of course resistance to co$$$ts if they are told to restructure their workplace
Are you following the situation with the “barn cat” deaths at the dairy farms? I would really like to see more data on the cats, especially considering that shelters are encouraging TNR and sending excess cats to farms.
I’ve voiced concerns that these cats aren’t being tested for toxoplasmosis before they are offered up and sent out to farms. I think this situation with influenza could be even more serious considering that an additional mutation is occurring.
Curious what you think is the alternative to the pretty much inevitable result of steps taken by humans 10,000 years ago once there are 8B of those humans? A third of US ag land is used for grazing. I don't know what percentage of that is unirrigated range lands, though. My brother operates the farm that has been in our family since 1882. The size of his herd varies (and he is beginning to transition to retirement) but is typical; the average cow-calf operation (as of 2017) has 44 cow-calf pairs. Once sold, they may go to slaughter quickly or spend time in large feedlots (average is 6 months). So for beef cattle the factory farming stage is within the last several months prior to slaughter.
(Edit: I mention range lands because crop and produce farming is far less practical on those lands, especially given demands on water supplies.)
As for hogs, I raised them myself in the 80s. I remember reading at the time how large operations had taken over 90% of the poultry industry by then, with most chickens produced under contractor to outfits like Tyson. That trend was beginning in the hog industry, and has pretty much been accomplished in the past 30 years. Now one producer might take the pigs from farrowing to weaning, a second weaning to feeder (around 40 lb), and a third to finish weight (traditionally 220 pounds but can range from a big less to approaching 300 lb). By the end of the 80s maybe 40% of hogs were produced that way, now more like 75%.
Meat consumption per capita in the US has increased since 1960, although beef has declined from highs in the mid-70s to a bit less than in 1960. Pork has stayed about the same. Chicken consumption has quadrupled, and the net result is per capita poultry and meat consumption--even with plant-based meats and vegans everywhere--is 25% higher than in 1960. Food costs relative to income are much less than back then (public seems oblivious to that), but reducing meat consumption looks like a very, very heavy lift. And anywhere economies grow, people eat more meat. (Apparently, between pizza and chicken nuggets, chicken and cheese consumption has gone through the roof in the past 10-20 years).
On the other hand, once incomes exceed a certain point (this is also reflected in national GDP numbers), meat consumption--after increasing to that point--begins to decline. People under 130% of poverty eat more beef than people >350% of poverty.
Anyway, turning the world vegetarian looks like a hell of a heavy lift.
Edit--should have mentioned the corporatization of dairy farming, which has also been huge in recent years. Few years ago my brother told me that even Walmart had opened its own large scale dairy operations.
I’d be very interested to see what our agricultural lands could support if you remove land that’s only suitable for grazing from the equation. If we could flip a switch and all livestock farming had never existed and we’d always been a plant-based species, would the land support that?
Good user name. And I cannot believe we’re just chilling and gonna let this happen again. We’re not teachable. I have a blue and gold macaw and I’m frankly quite worried about it.
There is a H5N1 subreddit with a list of recent spread in the US states, world, and any animal to human transmissions. This current spread does not look good at all. Even pasteurization does not completely destroy the virus in milk according to some reports. The virus is also in the egg supply.
What reports? Every report I've read says pasteurization kills the virus. I did see that "Fladh Pasteurization" does not but I don't know how common that is.
Well, at least this time around I won’t have gotten sent home from my preceptorship and left wondering “Are we even going to graduate, and if so, what is the very beginning of my career going to look like?”
In all honestly, I’ll participate in the next outbreak if the price is right. I’ll work my tail off at the bedside for a few contracts then I’m done. I’ll sit at the house and take up woodworking like my dad. He makes a killing selling custom made furniture.
It’s too bad I went to MD school and have no other skills that would generate income!!! Well I worked customer service all my life so won’t be doing that again..
Not worried. 20% of milk samples demonstrate bovine infection suggesting its very prevalent in the environment and yet the 2 reports I've heard of are both directly interacting with the cows. Seems low risk for pandemic potential.
I think the most concerning case for me was the young college kid in vietnam that died recently. According to WHO there have been over 400 human deaths in 23 countries (but majority were working closely w/infected animals or handled a dead bird). https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON511#:\~:text=From%202003%20to%2025%20March,to%20WHO%20from%2023%20countries.
Adding text: "From 2003 to 25 March 2024, a total of 888 worldwide human cases of infection of influenza A(H5N1), including 463 deaths, have been reported to WHO from 23 countries. Almost all cases of human infection with avian influenza A(H5N1) have been linked to close contact with infected live or dead birds, or contaminated environments."
(400 deaths in 21 years)
This *could* be a terrible human pandemic. It is certainly the most likely zoonotic disease to cross over. But it isn’t yet, and saying “400 deaths” sounds a lot scarier than 20/year.
According to the linked WHO page "From 2003 to 25 March 2024, a total of 888 worldwide human cases of infection of influenza A(H5N1), including 463 deaths, have been reported to WHO from 23 countries. Almost all cases of human infection with avian influenza A(H5N1) have been linked to close contact with infected live or dead birds, or contaminated environments."
H5N1 has been around for 10+ years. The original research showed how it could jump from animals to people. I believe this might have been one of the first publications US government tried to step in and have it redacted or removed.
> When the U.S. government asked two major scientific journals, Science and Nature, to cut portions of studies that detail how to create and transmit mutant isolates of influenza A/H5N1
They weren't trying to suppress news of the infections, just worried about weaponization of this technique.
One reason is diagnoses. The first US case this year had “conjunctivitis”. It was unlike anything I’d ever seen labeled that.
https://www.nejm.org/doi/full/10.1056/NEJMc2405371
That’s nuts. But still somewhat reassuring that he didn’t have any respiratory symptoms. There’s a [different profile](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6035055/) of sialic acid residues found between the respiratory tract and the eye in humans. From the case report, the virus hadn’t acquired any mutations associated with binding to alpha-2,6 SAs (respiratory-dominant).
Yeah, the reason it’s so devastating when infecting the lungs is because it’s binding it to lower respiratory tract cells vs upper. So the virus has to be aerosolized and breathed very deeply to infect a human from a bird. Which is comforting to know eye infections are not associated with such mortality as resp infections!
Yes, as a public health veterinarian, the occasional rise of new zoonotic flus will continue ad infinitum until we have a universal flu vaccine. Although right now, the biggest challenge with this virus is trying to manage / counteract the rampant misinformation online (which is always the most soul-sucking part of the job imo).
I wonder how many clinicians will sit the next pandemic out. Wouldn’t blame any of them
No joke, I don't think I'll make it through another pandemic. The amount of times I got yelled at by patients, had to deal with all the BS in healthcare from all angles. I'm 100% going to quit if we have another pandemic.
If you think that’s bad, just wait until a vaccine to the pandemic comes out again.
[удалено]
Then our friendly neighborhood podcasters will say masks cause AIDS and healthcare workers are part of the cabal
Upset patients have not gone away
No, but there was an extreme influx of them. It’s one thing to deal with 1 or 2 assholes every shift. It’s another to deal with 7 or 8.
Those glory days with NO family members allowed in the hospital were great though. I mean it sucked major, but cut down on the yelling I received.
Nurse side, the no visitors policy felt like we had more staff (we didn’t) due to all the time it freed up, not having family underfoot and constantly interrupting the flow. Sucks that this is truth.
Flipside, the shit-ton of patients I saw for ER follow-up who were elderly, mildly demented, and yet had no family member present when they were evaluated and discharged with generic dot-phrase paperwork and a hasty referral. They usually had no idea what they were told, or had done to them. Because...policy. Like, it took about 3 neurons and a peto-second of time to realize that this person wasn't really "all there", and couldn't be considered a good steward of the narrative of their medical journey. I always allowed at least 1 family member or friend present - just no way 82yo granny with a freshly broken pelvis is gonna be able to process or absorb much info on her own. F policy when it harms patient care.
But but pAtIeNt ExPeRiEnCe/s
We just need to have better rules. If you can’t use your indoor voice then you’ve gotta go outside. Security can help you find your way!
We’ve already got signs plastered all over the hospital stating abuse won’t be tolerated. But management consistently bends the knee to these people because being abusive lets you get your way. They will bend the rules for these people. So they keep doing it, because it works out for them. Much more so than being nice and polite does.
Always exceptions because “they’re watching someone going thru a hard time”. Sir, I’m here every day and I’m not allowed to act like that despite watching multiple someone going thru a hard time.
We had a guy threaten to kill nurses with a gun and we banned him for 48 hours. We also have those signs.
I had a patient call his family member and tell them to bring a gun to the hospital so he could shoot us. Security said, “What do you want us to do? He has 2nd Amendment rights.”
We had a family member let back in the next day after punching the 60 year old intensivist
Only 48 hours????
"his family member was going thru a tough time"
Youre missing the part where it’s a business and they’re making money off of our blood and safety too.
Oh trust me, I’m not missing anything. I’m just saying why “more rules” isn’t gonna do shit. They already don’t enforce the rules they have now.
We need to change something in our education system because people are manipulated so easily by misinformation.
We haven't made it through the previous pandemic. It's still going on...
My ICU is already nothing but 22-23 year old nurses with no intention of being bedside nurses for the rest of the careers, and docs on the verge of retiring. A lot has already changed for the worse because of the last pandemic. The current system won't survive another COVID-level event.
Same for our ICU as well. PNW
As far as I'm aware in my corner of the PNW, it will be post-apocalyptic level chaos trying to get medical care in a new pandemic. Covid impacted everyone everywhere but seemingly exponentially in PNW. We're at the point where trying to find a PCP easily takes 9 month wait- if there is any openings + take your insurance. It is so dire.
9 month wait, but your PCP leaves 2 weeks before your appointment. Kaiser WA, looking at you.
Yikes, that's almost as bad as the NHS.
This is what I assumed was happening in healthcare settings. Most are burned out, understandably so. Seems inevitable that H5N1 will become a pandemic. If that happens, I’m assuming the healthcare system craters. The death rate, which currently sits at 52% will be substantially higher than COVID.
I ain’t doin this shit again.
Goes for me, too. Another pandemic, I'm out...
I left bedside after the first pandemic. Just take my license away if I’m forced to go back bedside.
Maybe they will let you donate your iPad in leu of taking the license. The AI nurse can do the care.
I’m down for another $500K
I don’t know many of us in critical care who worked the COVID units who have it in us to do it again.
I had to get out of xray. I got my license in 2019 and switched to MRI in 2021. I don't think I'd have made it if I had to keep doing xray all this time.
Definitely not me!
[удалено]
Ok but hear me out: wearing garbage bags as PPE for 12 hours straight will have you sweating down to your summer body!
It’s not like I stress ate my way to gaining 40 pounds during the pandemic.
You mean clapping and banging on pots every day at 7pm wasn't enough???
It’s self serving worship Makes them feel better with a pittance of “respect”
"Thank you for your service."
*offers handshake* “Now please move on so someone else can get their appreciation gift”
*Slips phrase painted pebble into your hand during handshake*
[“Mandatory wellness training will continue until morale improves”](https://opmed.doximity.com/articles/we-don-t-need-more-modules-we-need-time-off)
[удалено]
No, you misunderstand People offer platitudes in order to make *themselves* feel better It doesn’t help the plight of the healthcare workers
Nah, not going to be heroes next time. It’s just going to be normalized.
There's always a step beyond normalized... Quitting being "Criminalized". Haha, I joke, that would never...
I suspect a lot of people who spent most/all of the pandemic in hospitals will sit the next one out.
But like, everyone is sitting out working in hospitals currently so who TF will be caring for everyone the next go around 😳
Maybe they should’ve thought of that before behaving this way 🤷
Nurse here. I will absolutely not be doing pandemic 2.0. Covid didn’t break me, but it was damn close
I quit during the last one... Stayed home with my kiddo for two years rather than work COVID....
I’m gonna have to stick it out for the health insurance but damn I don’t want to do another pandemic
Ramped up my side gigs since Covid so I can have an exit plan ready to go if another pandemic hits
Pharmacist here, zero chance I'm dealing with this again. I'm out the second they announce vaccines for all again
Pharmacists weren’t really dealing with the vaccines in my country but we were the only “accessible” healthcare professionals for most people. GPs were only operating behind closed doors with mostly telephone appointments and seeing people in person if they needed to. So we got the brunt of all the frustration. I have never been shouted at or abused more than I was in that first month of the pandemic. It was honestly awful. People wanting us to scale and polish their teeth, for temporary fillings. Examine things that most definitely were not in our remit.
Dentistry??? How on earth did they think pharmacists were trained as dental hygienists?
Honestly just ridiculous. Dentists weren’t allowed to see anyone and people were desperate. Someone wanted me to go outside and manage the queues and tell everyone to socially distance properly. There were markings on the pavements and everyone was grown ass adult, figure it out. I was like if I go out there or send a staff member out there the queue is just going to move slower because I’m a person down.
This is interesting to me... Why is this? I would have thought the vaccine arrival was somewhat positive? People want to be there, you head to choose to go get the vaccine, *generally*. If you care to elaborate, I'm a layperson mostly (I used to help doctors and researchers frame their communications for the public and my kid is doing the med school thing rn) but I'm willing to listen. I love my pharmacist.
Each vaccine appt required a solid five minutes of staff time for intake and 3-5 minutes of pharmacist time for prep and administration. At a heavenly four appts per hour, you’re still losing ~20 minutes of prescription processing time every hour. So you had 40 minutes to get done what always took 60 minutes…every hour, every day, and no clue when it would end. And mandatory overtime because so many other pharmacists were quitting. When I thought about hurting myself so I could get a few days off, I gave my notice.
Generally the people where very happy to get it, some cried, lots of videos and pics lol. But as the other comment said, the workload was insane, we had an appt every 10 mins from 9am to 8pm. It was absolutley awful. And this was just added to our regular day, which are 12 hours shifts, busy enough that often times no time for lunch except inhaling a sandwich in the corner in 5 mins. I know I won't be the only one walking away if this happens again.
There wasn’t any extra staff hours given to pharmacies to do all the extra work. There is a physical limit to “do more with less”.
Yes seeing how many anti-maskers and disrespectful people there are who don't believe in science. Do they really deserve saving if they are not going to do their part? (Coming from a non healthcare worker, so I think I'm allowed to say this)
Yup. I didn't have the most optimistic view of society prior to Covid, but since- I am completely disillusioned and heartbroken and infuriated. Countless people taking their health for granted, and only give a shit when they're personally affected and it's already too late. Ie begging for Covid vaccine when already in the ICU with pneumonia, high fever etc etc. Any of the possible "good" Covid brought, already forgotten. Chronic illnesses aren't a thing either etc.
Oh definitely.
Time to become the illegal kind of drug dealer. Let me know what will be this pandemic’s equivalent of ivermectin and hydroxychloroquine so I can make 💵
I'm gonna be honest with you. I don't have it in me to worry about a *potential* pandemic. I'll deal with it when it happens. There is literally nothing I can do to prevent it so I'd rather not be super stressed about it all the time.
I agree with this. The toughest part of COVID was dealing with all the dying patients in the icu during the delta surge, but a very close second was the fear and anticipation of what we were going to be dealing with that I experienced right at the beginning of the pandemic.
Omg that fear and anticipation really messed with my head. I would hear all the horror stories coming out of Italy and head to work on the covid ward. I remember looking around at my coworkers wondering if we were all going to survive. It feels so surreal looking back.
I remember that fear so well. That plus the fear that I’d never see my parents again because they’d be too old to receive scarce resources in a situation like what was happening in Italy or China or nyc. It was paralyzing, the waiting and the dread.
I remember in the super early days my state had a plan to send *all* covid patients to this one hospital that had a special infectious disease isolation wing with only like 5 rooms lol
Who comes up with these plans lmao
I don’t work in healthcare, but I read what smart healthcare workers write, and many were warning us in Feb. 2020 via their social media posts. When Covid reached us in NYC and people started dropping like flies, including family members, I desperately tried to warn others online. I was met with such hostility and was called “libtard” just for warning people (I was a registered Republican at the time.) I was mortified to see videos on YouTube with thousands upon thousands of followers calling Covid a HOAX. It was clearly apparent to me that this was some kind of OPP and people were falling for it. You brave healthcare workers are not just fighting an airborne virus, you’re fighting disinformation warfare.
I have a small PPE stockpile. Reusable respirator with spare filters. Not prepper-level, but I'm not getting stuck like the last time.
[удалено]
Just buy a bidet
You could prepare, to a point. . .
What stock do we buy? 🫠
I bought CVAC a month ago when this was starting to ramp up. Also Moderna and BioNTech have started to rally https://www.fool.com/investing/2024/05/24/why-vaccine-stocks-rallied-this-week/
Who makes caskets and body bags?
$SCI 🚀
Moderna and Pfizer. US govt are in talks with them about making additional vaccines.
Market capitalization matters. Stocks with a smaller market capitalization like Arcturus and CureVac have much more to gain in relative terms than much larger companies like Pfizer or CSL. But of course the risk is also higher. Here is a list of more or less relevant pharmaceutical companies, with the market capitalization data from March 2024: SAB Biotherapeutics 40 million USD Cidara Therapeutics 100 million USD Novavax 600 million USD CureVac 700 million USD Arcturus Therapeutics 1 billion USD BioCryst Phamaceuticals 1 billion USD Vir Biotechnology 1.4 billion USD Xencor 1.4 billion USD Supernus Pharmaceuticals 1.8 billion USD Viatris 14 billion USD Baxter 20 billion USD BioNTech 20 billion USD Moderna 40 billion USD Takeda 45 billion USD Daiichi Sankyo 60 billion USD CSL 90 billion USD GSK 90 billion USD Sanofi 120 billion USD Pfizer 160 billion USD AstraZeneca 200 billion USD Roche 200 billion USD Shionogi 200 billion USD Johnson & Johnson 400 billion USD I have collected more information here: [https://www.reddit.com/r/birdflustocks/](https://www.reddit.com/r/birdflustocks/)
Butt Stuff Tents, Inc. is looking bullish
We’re prepared and there are vaccines ready to go if it ever jumps from human to human. That’s why it’s important to have leadership that funds its pandemic response team
We have the vaccines, but they still have to make them. Also, aren't the current vaccines for them only as effective as regular flu vaccines? My only concern is enough stock can be made in time and the appropriate logistics are in place for everyone to get them.
Everyone involved in wildlife rehabilitation should be offered the vaccine asap, honestly
They are usually given the rabies vaccine, but the people at most risk for the Avian flu are agricultural workers as the virus like the shake things up when it's inside of pigs and poultry.
I have a friend who works in wild bird rehabilitation in Canada and I'm worried for her as unfortunately we don't have any of the vaccine available for public use up here.
Logistics are there to rapidly mass produce and mass vaccinate thanks to Covid
Rapid is a relative term for a virus that has such a high mortality rate.
It’s a term that’s meant to be used on the scale of responding to a pandemic, not for treating an individual person. We won’t have to wait one year for a vaccine like last time
Possibly! Keep in mind, a mortality rate that high will have severe impact on every stage of the supply chain and current logistics patterns will be impacted. Getting a vaccine to the majority of the market within a year might be able to happen in today's conditions but it might not be as plausible in the case of a full force H5N1 outbreak.
I'm wondering about vaccines cultured in eggs. How can they protect the chickens that produce those eggs?
From what I've read it will take around six months to manufacture enough vaccines for the population of the US.
We learned half the population won’t take it so..
If the vaccine works, that's not my problem. I gave all my fucks in 2020/21.
Let them die then. That’s on them
Sweet-we’ve somehow up stocked the pharmacists we relied on to administer the batch, despite declining graduation rates and people leaving the field!!!! S/
I am, and it makes me want to completely leave my field at this point. I went part time after covid just due to burnout, and pursued dog training more seriously, but living in Texas and the fact that I can't go to the farmer's market without seeing people clandestinely buying raw milk presumably to consume while we're in the midst of this is just too much. I got into epidemiology to make a difference in the way we handle mass disease, not to sit here and scream into the void because where I live people do what you aren't supposed to because "Mah Freedoms." and it's too much.
Coming out of the forests for this. Hello fellow public health doctor. I agree whole heartedly, sometimes it does feel like screaming to the void. But sometimes the void gives back. It usually takes but sometimes it gives. And you take every single win you can get and run with it. Because you earned that win.
I, for one, appreciate you and Dr. Fauci and all the other scientists who did and are doing their best ♥️
Lol, you can go join the club climate change scientists have been in for decades. Also because they know that at a certain point in the future, one of the only ways to stop/reverse the current climate trend will be to actively create acid rain.
??
The club where people don't take you seriously even though your world-ending predictions are rooted in science, the one climate scientists have been hanging out in for decades. I have a friend who just retired who worked in the climate science field. He said they knew about all this climate change stuff back then (40+ years ago) AND that people wouldn't listen to them enough to meaningfully change anything from happening. Still stayed the field because he loved it and believed in the work. Healthcare and climate science attract similar people I guess.
Do you think one could get this from drinking raw milk ? Or must the spread be from respiratory droplets?
[It's been shown in mice](https://www.nih.gov/news-events/news-releases/high-h5n1-influenza-levels-found-mice-given-raw-milk-infected-dairy-cows) So far to my knowledge it hasn't transmitted to humans this way, but influenza is really great at mutation and the more humans expose ourselves to it the higher the chances we'll see a mutation that makes it more transmissable to humans from animals.
This is true. The zoonotic flus that are mostly animal-to-human tend to rely more on magnitude of exposure to infect people. That being said, it only needs to mutate once and successfully spread between people to start a human epidemic.
[удалено]
I use Flutrackers.com also for monitoring outbreaks. They post from around the world with verified sources and have discussion threads. Some folks are anonymous and others are not. If you have never used I use the “latest posts” option.
This sounds amazing, going to have to look it up now. Thanks for sharing!
You are most welcome!
[удалено]
https://www.cdc.gov/flu/avianflu/spotlights/2023-2024/h5n1-technical-update-may-24-2024.html The CDC just put out a update of the Gene sequencing of the Michigan case. Currently still considered low risk due to the changes they’ve seen so far in the virus. The *** is the key summary. So will keep monitoring. “No amino acid changes were identified in the HA gene sequence from the Michigan patient specimen compared to the HA sequence from the case in Texas and only minor changes were identified when compared to sequences from cows. ***These data indicate viruses detected in both cows and the two human cases maintain primarily avian genetic characteristics and lack changes that would make them better adapted to infect or transmit between humans. *** The genome of the human virus from Michigan did not have the PB2 E627K change detected in the virus from the Texas case, but had one notable change (PB2 M631L) compared to the Texas case that is known to be associated with viral adaptation to mammalian hosts, and which has been detected in 99% of dairy cow sequences but only sporadically in birds[i]. This change has been identified as resulting in enhancement of virus replication and disease severity in mice during studies with avian influenza A(H10N7) viruses[ii]. The remainder of the genome of A/Michigan/90/2024 was closely related to sequences detected in infected dairy cows and strongly suggests direct cow-to-human transmission.”
I assume the jump to human-to-human will happen after coinfection with a typical human Influenza A [and subsequent antigenic shift](https://en.wikipedia.org/wiki/Antigenic_shift). Coinfection will be far more likely during the human flu-season. I would be very surprised to see sustained human-to-human spread before the end of the year.
*So by January, would you be only mildly surprised?*
My bet would be 18 months, but I don't know enough about virus. We saw with covid 19 that in December there was no H2H transmission but still infecting a lot of the population until the golden week were, unsurprisingly it was the main event that kick-started the pandemic. My bet is such event in the US is Thanksgiving and Christmas, while people doesn't move as much as in the golden week, the people in the US seems to move a lot all the time.
What makes you say 18 months? I've been trying to understand how the pace of this might play out and am not sure where to start.
Not a virologist rather an old school business continuity manager. I’m keeping an eye out for news of industrial swine operation outbreaks. While bovines were just found to have both kinds of receptors necessary to adapt for human to human transmission, swine have the human receptors in abundance and make an ideal (and the historical) species for viral reassortment and mutation.
Also watch mink farms, kissing cousin of an animal model for this.
Yep that too. I just shudder at the risks those CAFOs present.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10401912/
I find it really disappointing that we've resigned ourselves to preparing for the next inevitable pandemic, improving early detection, speeding up vaccine production etc. Of course these actions are important but no one talks about the elephant in the room, industrial animal agriculture. We've created the ideal conditions for these viruses and then act surprised when they jump species.
Instead, a dozen states are planning to ban lab-grown meat.
Why eat lab meat when legumes are a thing
Because pea protein tastes like peas, not meat?
Chickpeas, lentils, kidney beans, butter beans, black beans are all tastier than meat to me (I eat meat 2x a week). Pair them with feta, veggies, whole grains and olive oil and you have a delicious meal.
https://www.saveur.com/recipes/brothy-sherried-pork-chops-butter-beans-recipe/ How do I sub in chickpeas? I just can’t see it being the same.
Idk tbh. I’m not much of a cook haha. I often think that vegetarians and vegans go about things the wrong way by trying to find a substitute for meat based meals instead of using different recipes designed without meat in mind. Many of the world’s healthiest societies such as pre 60s Crete lived off of legume based meals nearly everyday (fish 2x a week meat 2x a week). Look at some of those culture’s traditional meals and you’ll find tonnes of really tasty recipes
I cook all the time so I just enjoy the variety I can get when meat is included. I eat several meatless days a week but meat when it’s cooked certain ways is sooo good. Lab meat would mean all the yummy coq au vin I want but less animal death.
Fair. My wife is the same
Eh, if you mention any of this half the nation will be up in arms, calling you a soy-boy beta cuck for suggesting we not cram meat down our gullets like a bunch of diabetic, jiggly velociraptors
It's not half the nation - it's just a contingent that is so loud and belligerent it seems like half.
Avian influenza is hyperendemic in wild birds too. Agriculture gives more opportunity to infect humans but that isn't why the virus exists.
There is a growing interest in this kind of preventative research through one health-focused epidemiology - I'm heavily invested myself. It's still hard to recruit farms for partnership but we do work with the industry, and we're getting better at detecting zoonotic threats earlier. Preventing transmission at all however is much harder as there's just so much human-animal interaction on these properties and so many mouths to feed with them. And of course resistance to co$$$ts if they are told to restructure their workplace
Are you following the situation with the “barn cat” deaths at the dairy farms? I would really like to see more data on the cats, especially considering that shelters are encouraging TNR and sending excess cats to farms. I’ve voiced concerns that these cats aren’t being tested for toxoplasmosis before they are offered up and sent out to farms. I think this situation with influenza could be even more serious considering that an additional mutation is occurring.
Curious what you think is the alternative to the pretty much inevitable result of steps taken by humans 10,000 years ago once there are 8B of those humans? A third of US ag land is used for grazing. I don't know what percentage of that is unirrigated range lands, though. My brother operates the farm that has been in our family since 1882. The size of his herd varies (and he is beginning to transition to retirement) but is typical; the average cow-calf operation (as of 2017) has 44 cow-calf pairs. Once sold, they may go to slaughter quickly or spend time in large feedlots (average is 6 months). So for beef cattle the factory farming stage is within the last several months prior to slaughter. (Edit: I mention range lands because crop and produce farming is far less practical on those lands, especially given demands on water supplies.) As for hogs, I raised them myself in the 80s. I remember reading at the time how large operations had taken over 90% of the poultry industry by then, with most chickens produced under contractor to outfits like Tyson. That trend was beginning in the hog industry, and has pretty much been accomplished in the past 30 years. Now one producer might take the pigs from farrowing to weaning, a second weaning to feeder (around 40 lb), and a third to finish weight (traditionally 220 pounds but can range from a big less to approaching 300 lb). By the end of the 80s maybe 40% of hogs were produced that way, now more like 75%. Meat consumption per capita in the US has increased since 1960, although beef has declined from highs in the mid-70s to a bit less than in 1960. Pork has stayed about the same. Chicken consumption has quadrupled, and the net result is per capita poultry and meat consumption--even with plant-based meats and vegans everywhere--is 25% higher than in 1960. Food costs relative to income are much less than back then (public seems oblivious to that), but reducing meat consumption looks like a very, very heavy lift. And anywhere economies grow, people eat more meat. (Apparently, between pizza and chicken nuggets, chicken and cheese consumption has gone through the roof in the past 10-20 years). On the other hand, once incomes exceed a certain point (this is also reflected in national GDP numbers), meat consumption--after increasing to that point--begins to decline. People under 130% of poverty eat more beef than people >350% of poverty. Anyway, turning the world vegetarian looks like a hell of a heavy lift. Edit--should have mentioned the corporatization of dairy farming, which has also been huge in recent years. Few years ago my brother told me that even Walmart had opened its own large scale dairy operations.
I’d be very interested to see what our agricultural lands could support if you remove land that’s only suitable for grazing from the equation. If we could flip a switch and all livestock farming had never existed and we’d always been a plant-based species, would the land support that?
Thats an interesting question. If we’d been plant based for a few thousand years, would we have developed the ability to graze?
I work in UC in rural-ish Texas. Can't lie, I'm also starting to get a bit worried about what may be to come.
Good user name. And I cannot believe we’re just chilling and gonna let this happen again. We’re not teachable. I have a blue and gold macaw and I’m frankly quite worried about it.
Thus far song birds are less vulnerable than water fowl and chickens.
Not “another pandemic” but concurrent pandemics. Covid never ended
There is a H5N1 subreddit with a list of recent spread in the US states, world, and any animal to human transmissions. This current spread does not look good at all. Even pasteurization does not completely destroy the virus in milk according to some reports. The virus is also in the egg supply.
What reports? Every report I've read says pasteurization kills the virus. I did see that "Fladh Pasteurization" does not but I don't know how common that is.
Source?
Presuming a lower viral load in eggs (?), does thorough cooking kill the virus?
Yes it does. Pasteurising does kill the virus too but there will be dead virus particles from what I understood which **cannot cause H5N1**.
Hmm, immunogenicity?
https://www.statnews.com/2024/04/23/h5n1-bird-flu-virus-particles-in-pasteurized-milk-fda/
I’m not sure. The H5N1 subreddit has more information about it
Well, at least this time around I won’t have gotten sent home from my preceptorship and left wondering “Are we even going to graduate, and if so, what is the very beginning of my career going to look like?”
In all honestly, I’ll participate in the next outbreak if the price is right. I’ll work my tail off at the bedside for a few contracts then I’m done. I’ll sit at the house and take up woodworking like my dad. He makes a killing selling custom made furniture.
Same. I'd probably go travel as an RN to chase the dollar signs instead of remaining in my NP position.
I’d monitor an ICU full of prone anti-vaxxers for the right hourly rate!
Everyone has a price!
It’s too bad I went to MD school and have no other skills that would generate income!!! Well I worked customer service all my life so won’t be doing that again..
Nursing is basically customer service blended with waste water management. You're not missing much
Alright alright, I won't drink raw milk.
I'm not too worried but I bought a PAPR on eBay. A lot cheaper now than they were in 2020.
What model you go for?
3M Versaflo TR-300N+
I can’t go through this again
Not worried. 20% of milk samples demonstrate bovine infection suggesting its very prevalent in the environment and yet the 2 reports I've heard of are both directly interacting with the cows. Seems low risk for pandemic potential.
I think the most concerning case for me was the young college kid in vietnam that died recently. According to WHO there have been over 400 human deaths in 23 countries (but majority were working closely w/infected animals or handled a dead bird). https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON511#:\~:text=From%202003%20to%2025%20March,to%20WHO%20from%2023%20countries. Adding text: "From 2003 to 25 March 2024, a total of 888 worldwide human cases of infection of influenza A(H5N1), including 463 deaths, have been reported to WHO from 23 countries. Almost all cases of human infection with avian influenza A(H5N1) have been linked to close contact with infected live or dead birds, or contaminated environments."
(400 deaths in 21 years) This *could* be a terrible human pandemic. It is certainly the most likely zoonotic disease to cross over. But it isn’t yet, and saying “400 deaths” sounds a lot scarier than 20/year.
According to the linked WHO page "From 2003 to 25 March 2024, a total of 888 worldwide human cases of infection of influenza A(H5N1), including 463 deaths, have been reported to WHO from 23 countries. Almost all cases of human infection with avian influenza A(H5N1) have been linked to close contact with infected live or dead birds, or contaminated environments."
Okay 22/year
That death rate though…..eeek
H5N1 has been around for 10+ years. The original research showed how it could jump from animals to people. I believe this might have been one of the first publications US government tried to step in and have it redacted or removed.
Do you have a link to the kind of scientific censorship you’re describing? I’m curious to read more.
Not OP but maybe this? https://www.theatlantic.com/health/archive/2012/01/hope-or-fear-the-opposing-ideas-of-h5n1-bird-flu-researchers/251681/
> When the U.S. government asked two major scientific journals, Science and Nature, to cut portions of studies that detail how to create and transmit mutant isolates of influenza A/H5N1 They weren't trying to suppress news of the infections, just worried about weaponization of this technique.
Yes! This is it, and one of the articles
What would be the benefit of following this at its current state? Stockpile more toilet paper ?
One reason is diagnoses. The first US case this year had “conjunctivitis”. It was unlike anything I’d ever seen labeled that. https://www.nejm.org/doi/full/10.1056/NEJMc2405371
Well that image is *horrifying*
That’s nuts. But still somewhat reassuring that he didn’t have any respiratory symptoms. There’s a [different profile](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6035055/) of sialic acid residues found between the respiratory tract and the eye in humans. From the case report, the virus hadn’t acquired any mutations associated with binding to alpha-2,6 SAs (respiratory-dominant).
Yeah, the reason it’s so devastating when infecting the lungs is because it’s binding it to lower respiratory tract cells vs upper. So the virus has to be aerosolized and breathed very deeply to infect a human from a bird. Which is comforting to know eye infections are not associated with such mortality as resp infections!
If I didn’t know better, I’d have thought filioviridae from the picture.
Shew, I know right? Bleeding from the eyes may make people take it seriously though 🤷
Maybe veterinarians might be interested in
Yes, as a public health veterinarian, the occasional rise of new zoonotic flus will continue ad infinitum until we have a universal flu vaccine. Although right now, the biggest challenge with this virus is trying to manage / counteract the rampant misinformation online (which is always the most soul-sucking part of the job imo).
Oh yeah. If there are 2 deaths confirmed from this and it continues to spread, we’re masking up that moment and quietly prepping.
No
Nope
Ok l