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growlers

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Everything posted by growlers

  1. Cancer only kills about 1200 or so kids a year 0-15 years old. Childhood cancer is almost never preventable, we spend enormous resources on it every year in both research and treatment, isn't something that is spreadable to others, and isn't easily preventable with a vaccine (except HPV and hep B, but those are given to prevent getting cancer as an adult). I wish the media would quit telling me cancer kills kids.
  2. I quit posting and only lurk a little now. I had to quit because of the covid deniers . I've taken care of >2000 covid patients and just can't deal with the trump posters spreading misinformation and dismissing my experience /expert knowledge for their own bizarre agenda. They don't even attempt to learn anything and just post variations of the same arguments over and over. I realized it's a waste of my time.
  3. anecdotal = someone who has taken care of a couple thousand covid patients. And it's been the focus of my career for over a year. I am gonna bow out of this. I regret jumping back into this cesspool. I look forward to posting nonsense uninformed opinions in your rocket science thread.
  4. didn't say anything close to that - i said that 99% of the covid science deniers and antivaccination crowd are trump supporters. I'll actually walk that back - it's probably only 90%.
  5. this is a good example of what I am irritated about in this thread (and life). I personally had 3 of my patients in their 30s with minimal preexisting conditions die. I've admitted many many patients in their 30s/40s/50s who had extended hospital stays with resulting massive physical and financial hardships as a result only of covid. It killed three of my healthcare coworkers that I knew well and I personally cared for several dozen more. HERD immunity, you don't even know how to spell the word but you think you are an "expert"
  6. I know nothing about rocket science and if there was a thread discussing the subject I wouldn't post my uninformed opinions about it as some sort of arrogant master-of-all-subjects. I also wouldn't denigrate and post that international experts in the field and other posters that were in the rocket science field were idiots. And i certainly wouldn't inform my opinion solely or primarily based on what my favored politicians thought about rocket science. As to your question: my opinion on masks has evolved, you know, LIKE SCIENCE DOES. I have read and absorbed evidence put out by experts and formed an opinion, like science does. It has slowly become clear that vaccinated people are very unlikely to spread the virus. That scientific opinion took time and evidence to evolve. At this point, now that the scientific community has this evidence, the only reason to for vaccinated people to wear masks is so that unvaccinated people might be forced to wear masks to both protect themselves and to encourage them to get vaccinated. I personally don't feel that it is reasonable at this point to mandate masks for these reasons - my "unmasking date" is based on two weeks after the date that anyone who wanted to get vaccinated could get vaccinated. I think that it is reasonable for a public health expert to look at the situation and determine that we need to protect the anti-vaccers and perhaps the people that haven't had the opportunity to get vaccinated so we need to keep masking for a bit longer. I don't agree with that personally, partly because I'm incredibly annoyed by the anti-vaccination crowd, but I'm willing to keep wearing masks if the public health experts determine that we need to do it. But that is partly because I don't see wearing a mask walking into a restaurant as some sort of leftwing constitutional affront to my USA#1 liberties - and I see it as just a minor annoyance, and I trust the experts to make these decision with far more information than I have. Just like I would trust the contractor to determine how much rebar i need in my skyscraper instead of some guy on twitter. But whatever- you do you.
  7. it's amazing how the CDC was internationally renowned until Trump told 40% of you to not like them.
  8. I've been making this point for over a year and these posters don't care. Quit wasting your time.
  9. If Joe and the moderators want to wonder why this forum is going to crap, just look at the last 48 hours of this thread for your answer. The anti-science and anti-expert posters have destroyed it. Experts - meaning doctors actually caring for these patients in the hospital - who also read the literature on a daily basis - are denigrated when they post - and are also told that experts like Fauci are clowns for some sort of perceived political points. All it is one big gotcha thread for whatever error they perceive or whatever talking point Tucker Carlson said on Fox last night. I don't get the anti-expert angle. I had a plumber out today to fix something. I don't know #### about plumbing. I don't stand there and argue with him and argue about plumbing "facts" I read on twitter. Yet in this forum, and in real life, there are constantly anti-science MAGA-hats telling me I have no idea what I am talking about. Even at work. It's bizarre.
  10. from the latest issue of the New England Journal of Medicine, thought this was interesting. Perspective Australian Firearm Regulation at 25 — Successes, Ongoing Challenges, and Lessons for the World List of authors. Joel Negin, Ph.D., Philip Alpers, Natasha Nassar, Ph.D., and David Hemenway, Ph.D. Twenty-five years ago, on Sunday, April 28, 1996, a 28-year-old man used a Colt AR-15 semiautomatic rifle to kill 35 people in the quiet tourist town of Port Arthur, tucked away in the southeast corner of Tasmania, a small island off mainland Australia. The events of that day launched one of the world’s most powerful natural experiments in firearm-injury prevention. Victoria (Australia’s second-most populous state) had previously tightened its firearm law after mass shootings in the region. But in most of the country, firearm policies had been changed very little in the decades before 1996. Within 2 weeks after the Port Arthur shooting, however, state and territory governments and the federal government had all agreed to a new firearm-regulation standard that involved implementing or strengthening gun-owner licensing, firearm registration, safe-storage policies, and suicide-prevention programs. As part of the policy changes, the government also announced a mandatory buyback program for newly prohibited firearms. Over the next 18 months, 659,940 semiautomatic rifles and shotguns were purchased from residents and destroyed. The total cost of the program — AU$500 million (U.S.$361 million at the 1997 exchange rate)1 — was paid for by a one-time levy that cost taxpayers an average of $15 each. Tens of thousands of gun owners also voluntarily turned in nonprohibited firearms with no compensation. Rate of Gun Deaths in Australia, 1993 to 2019. These policy changes have had a substantial and positive effect on gun violence in Australia. In the 20 years leading up to and including the 1996 Port Arthur massacre, there were 11 mass shootings (defined as shootings in which five or more people, not including the perpetrator, were killed) in the country. In the 22 years that followed, there were no such incidents. Between 1979 and 1996, average annual firearm-related mortality was 3.6 per 100,000 people; after the policy intervention, it dropped to 1.2 per 100,000 people between 1997 and 2013 (see graph).1Firearm-related mortality had already been falling in Australia, but changes in the rate of firearm-related death accelerated from an average decrease of 3% per year before gun laws were upgraded to an average decrease of 4.9% per year afterward. There were sizable reductions in firearm-related suicides and homicides. The most noticeable drop was for firearm-related suicides (which account for about 70% of gun deaths), with no evidence of substitution in methods of suicide.2 Globally, Australia was reported to have one of the largest annual rates of change in the number of firearm-related deaths between 1990 and 2016.3 Given potential confounding, it’s difficult to establish a direct link between the 1996 legislation and changes in firearm-related mortality. The number of nonfirearm suicides and homicides has also fallen during the past quarter-century in Australia. Reductions in gun deaths, however, have been much more substantial: between 1997 and 2013, there was a 55% reduction in the firearm-related suicide rate, as compared with a 16% reduction in the nonfirearm suicide rate, and a 62% reduction in the firearm-related homicide rate, as compared with a 44% reduction in the nonfirearm homicide rate. Moreover, the drop in firearm-related deaths was largest in states where the most guns were surrendered and smaller than average in Victoria, which had already restricted access to semiautomatic long guns. A rare-events model provided strong evidence that the absence of mass shootings in Australia between 1997 and 2017 wasn’t merely a continuation of a preexisting pattern.4No other policy has been suggested to explain the large reduction in firearm-related mortality after the national revision of gun legislation. As compared with the United States, Australia has fewer guns per capita, stronger gun regulations, and far lower firearm-related mortality. Studies have found that a country’s estimated rate of firearm ownership is associated with its rates of firearm-related suicide and homicide.3 The effect of gun availability on violent death is substantial. For example, an international meta-analysis of intimate partner violence perpetrated by men found that having access to a gun was linked to an increase by more than a factor of 10 in the likelihood of killing a partner (as opposed to committing nonfatal violence).5 Although the scale of the challenge is clearly different in the United States than in Australia, the Australian experience provides important lessons for the United States and other jurisdictions with high rates of gun violence. This example demonstrates that taking a public health approach to firearm-injury prevention by reducing access, strengthening regulation, and engaging the community can reduce gun deaths. It also shows that after mass-shooting incidents, countries have an opportunity to improve policies. Australia’s policy change used a substantial amount of the relatively new — and right-leaning — Prime Minister John Howard’s political capital. The support of many conservatives was crucial and was secured by opinion polls showing overwhelming support for firearm regulation and by media pressure. Gun-policy reforms were supported by all major political parties, whereas conservative parties in many other countries staunchly oppose such reforms. The success of firearm regulation became a source of pride for many Australians. Mass shootings account for a small proportion of firearm-related deaths, but they tend to receive a substantial amount of media coverage and can focus the attention of the public and politicians on gun violence more broadly. The legislation’s primary goal was to reduce access to the semiautomatic firearms that were responsible for the majority of mass killings, but it also introduced and tightened public-safety policies, licensing requirements, and other regulations aimed at preventing more common forms of firearm-related injury and death. Although preventing gun deaths is essential, focusing on deaths obscures another tragic reality of firearm violence. In addition to the people killed by firearms, a larger number are injured and have life-changing pain, disability, and psychological distress resulting from the use of firearms, which leads to substantial expenses related to medical care, mental health care, and rehabilitation.5Australian firearm policy now focuses, more than it did in the mid-1990s, on domestic and family violence, which often involves additional victims besides intimate partners, including children. The Australian experience shows that efforts to reduce gun violence benefit from the use of multipronged interventions, including gun registration, gun-owner licensing, safe-storage policies, and suicide-prevention programs. Despite Australia’s success, its gun laws are vulnerable to pressure. Although the government destroyed a substantial proportion of privately owned firearms after the implementation of updated gun legislation, many single-shot rifles and shotguns have been imported to replace banned semiautomatic weapons. There are now more than 3 million registered firearms — a figure that is increasing — in a country of 25 million people. The rate of gun ownership is lower than it was in 1996, but Australia’s sport-shooting community remains vibrant, and certain groups such as farmers use firearms in much the same way as they did before the new laws were enacted. A wealthy lobbying group with a national membership of 200,000 gun owners, which has grown over the past two decades, funds politicians who promise to chip away at firearm regulation. Such ongoing challenges serve as a reminder of the fragility of Australia’s achievements and the need to avoid policy complacency, not just in Australia but around the world. On the 25th anniversary of the Port Arthur mass shooting, we believe that Australian policymakers should recommit to maintaining and strengthening firearm regulation in recognition of the horror of that day and of the bold strides taken by legislators in the weeks and months that followed. Disclosure forms provided by the authors are available at NEJM.org. This article was published on April 24, 2021, at NEJM.org.
  11. Just want to stress very very strenuously that my calculation would be very different if we didn't have the mRNA vaccines to use. Also it's potentially not just blood clot issues - the thrombocytopenia associated with it means it almost certainly is an autoimmune process - a form of TTP - which we don't know yet if it could turn into a lifelong problem.
  12. yes, I agree that every american has the right to make a calculated decision about their personal risk of cerebral venous sinus thrombosis from a novel vaccine based upon their own extensive knowledge of the science involved and that the FDA should have no input
  13. FYI I live in vegas, am very familiar with this issue and this proposed law, and it doesn't affect anyone's private lawn. It is dealing with "ornamental" turf, which is in road medians, along public sidewalks, etc. So the right wingers derailed this thread for nothing. As usual.
  14. I assume Fauci has been interviewed about this? Does anyone know what he said about the sinus thrombosis issue?
  15. I think the FDA is doing the right thing here. They aren't pausing it for run of the mill blood clots like DVT/PE, this is a very specific and very rare type of clot - cerebral venous sinus thrombosis with thrombocytopenia. I've never seen a case of this in my whole career. I've seen cerebral sinus thrombosis a few times, but never with thrombocytopenia, and the two conditions are treated completely differently. If you treat it with heparin you can kill the patient. We need to get the knowledge out there to the doctors of this being a risk and make sure we are looking for this - it is very difficult to diagnose this as headache is an extremely common reason to go to an ER or urgent care and this requires advanced imaging to diagnose and likely not seen on a standard non contrast head CT. I would guess that more people than what has been reported have had this complication, as either it improved without seeking medical attention or the diagnosis was missed. If we didn't have the other vaccines to fall back on then I would say the risk of not vaccinating people far outweighs the risk of this complication, but that isn't the case. We should pivot to 100% mRNA vaccines, which seem to be more effective anyway
  16. This is all one long argument agreeing I should be able to get the box of grenades I want. I’m not planning on killing people with them but even if I do, I would have just used something else. Like an airplane. I WANT MY GRENADES To the “average” person, like me, who is fine with licensed trained background checked gun ownership, who maybe owns a shotgun but isn’t into worshipping it, but is horrified that someone can get powerful enough weapons to shoot hundreds of people at a concert from the 32nd floor of a building - this is what you sound like
  17. At least you need a license, registration, insurance and take a test to drive a car
  18. I don’t know what aspect of that article you are referring to as being ridiculous. This seems like news to report.
  19. This is the crux of why so many of us get apoplectic with the pro AR-15 argument. nobody with a knife kills 58 people across the street. Nonsense illogical opinion. Likely straight from some NRA talking point guide. If these criminals/terrorists in England had access to AR-15s those incidents would be a lot worse and many more shot and killed on average. Just like ........wait for it........USA#1
  20. Did you read the article that you responded with this to? it really was quite devoid of “emotion “, most of it described a physicians experience with the difference between high and low velocity bullet injuries. Actually the narrative at the end spot on describes my opinions on the subject. It’s a really good article. It’s impossible to discuss the topic with you guys. I bring up the October 1 shooter, and told it’s somehow not relevant to the discussion. It was the largest mass shooting in United States history and it was done from the 32nd floor of a hotel across a street with AR-15s and I’m told that the shooter would have killed the same number of people with a handgun or a knife. Someone posts this article which gives the experience of a physician and it’s “emotional”. You guys just regurgitate NRA taking points about mental illness over and over. Then it turns out the October 1 shooter was never diagnosed as being mentally ill. Background checks are favored by what, 85% of Americans, yet the NRA and the republicans they pay off fight against them. And then we are told we are told WE are the ones being disingenuous.
  21. I am basically a lurker here but I believe there was pages of assertion from some in the pro- gun crowd that cars are also deadly weapons and equating banning ar-15s to banning cars. I think that idea is way more loony than my argument that if it reasonable for me to buy an ar-15 that it is reasonable for me to buy a grenade.
  22. I would genuinely like to go throw some grenades in the desert. That would be awesome. Why can’t I do that? I don’t see the difference. I can throw rocks in the desert but that is not as fun. But some have established that rock = ar-15 and since I’m not throwing the rock or the grenade at a person my rights are being infringed because I can’t buy them at a store.
  23. https://www.lvmpd.com/en-us/Documents/1-October-FIT-Criminal-Investigative-Report-FINAL_080318.pdf Of course I am taking the most horrific example, it is a thread about mass shootings. Should we leave this one out for some reason? The link above answers all your "unknowable" questions about the type of guns he used. He didn't use a turkey gun. You can even masturbate to the pictures of the guns if you would like. If he didn't have access to these guns he couldn't have killed so many people. It is as simple as that. If we allowed rocket launchers to be sold I have no doubt he would have successfully used those to blow up the jet fuel tankers instead of unsuccessfully shooting them with his AR-15 to cause more carnage.
  24. So the Vegas October 1 shooter would have done more damage with a handgun? He killed 58 people and shot another 411. He had a revolver and I'm not sure why he didn't use that instead of his fourteen AR-15s.. You live in a fantasy land.
  25. it sounds crazy to say this now, but i never wore a mask when seeing influenza patients. A lot of it is just that I always get vaccinated at work well before the first cases come in. Some of it is that it's more difficult to make a "connection" quickly with patients when you are wearing a mask. Staff who either couldn't or wouldn't get vaccinated are required to wear a mask for the winter months- they give you a sticker to put on your badge to prove you got the shot, or they had to wear a mask at all times. I'm sure masks are here to stay in the hospital, at least for the next year regardless of covid numbers. The patients expect it now too
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