The Third Wave, the View from Wisconsin, & Navigating Risk in Covid-19

Рет қаралды 22,476

3 жыл бұрын

In this UCSF Department of Medicine Covid Grand Rounds, we’ll begin with George Rutherford’s review of the state of the pandemic, including the massive surge in the Midwest and its implications. Then we’ll hear from Ann Sheehy and Andrew Braun - a hospitalist and an intensivist at the University of Wisconsin, respectively - who will describe their experience in the hardest hit area of the country. Finally, Julia Marcus, an infectious disease epidemiologist at Harvard and journalist for The Atlantic, will discuss the nuanced issues surrounding estimating and managing risks (schools, flying, visiting family, etc.) in Covid-19. The session is moderated by UCSF Department of Medicine chair Bob Wachter.
Program
Bob Wachter: Introduction
00:02:47 - 00:20:20 - Current State of the Pandemic: George Rutherford, UCSF Professor, Dept. of Epidemiology & Biostatistics; Director of the Prevention and Public Health Group
00:20:20 - 0:36:45 - The View from Wisconsin: Panel Discussion with Ann Sheehy (Assoc. Professor of Medicine and Chief of the Division of Hospital Medicine, University of Wisconsin-Madison), Andrew Braun (Asst. Professor of Medicine and Director of the University of Wisconsin Health Adult Cystic Fibrosis Clinic, University of Wisconsin-Madison), and George Rutherford (UCSF Professor, Dept. of Epidemiology & Biostatistics; Director of the Prevention and Public Health Group)
00:36:45 - 01:10:28 - Navigating Risk: Panel Discussion with Julia Marcus (Assoc. Professor, Dept. of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute; Adjunct Faculty, The Fenway Institute)
Bob Wachter: Closing
See previous Covid-19 Medical Grand Rounds:
• October 6: President Trump’s Covid-19 Diagnosis: Implications for Transmission, Treatment, and Prognosis
• President Trump’s Covi...
• September 24: San Francisco and Covid-19: What Went Right and Lessons Learned
• San Francisco and Covi...
• September 17: In Search of a Vaccine for Covid-19: Science and Politics
• In Search of a Vaccine...
• September 10: Covid-19: Current State, Falling Mortality Rates, and “AeroNabs"
• Covid-19: Current Stat...
See all UCSF Covid-19 grand rounds, which have been viewed over 1.08M times, here: medicine.ucsf.edu/covid-19-ne...

Пікірлер: 95

@maryking6770 3 жыл бұрын

Thank you so much for these brilliant and incredibly informative broadcasts.

@mikefalkowski1146 3 жыл бұрын

Im not a student at UCSF, or a person with any medical background. Just a 62 yr old with several underlying health conditions. With the political undermining of info coming from CDC n FDA its really hard for a person to know if they are getting accurate information. I also watch a teacher from the UK, John Campbell who has explained medical terminology, so I'm able to understand what you experts are saying at times So, I just wanted to let you know that I truly appreciate u sharing/posting these very informative videos, I look forward to watching Friday mornings. Thanks again 😷

@skywalkercowgirl 3 жыл бұрын

I too watch this program on Friday mornings and watch John Campbell ! I am grateful for all of this helpful information! My other channel is from the University of Minnesota, Dr Osterholm. it really was a small joy to find someone else who relies on two of my favorite sources!

@vickyhestad75 3 жыл бұрын

I also follow those two amazing people!

@andymullarx6365 3 жыл бұрын

There's a lot of us in the same boat. We've given up on mainstream media for news on anything that matters. Having the internet has never before been more important than this pandemic period. I do look at both sides even among the scientists and doctors and try to apply logic to what they're stating taking into consideration their own biases and associations which does unfortunately influence their findings and interpretations of published data.

@jamiejones8508 3 жыл бұрын

I work in healthcare and follow John Campbell as well. Not only good information, but he is also teaching people how to read the scientific literature and do critical analysis themselves, which in these current times is particularly important!

@willmpet 3 жыл бұрын

I am a 72 year old and I listen to John Campbell and to Michael Osterholm's updates in order to stay informed.

@alanrcrews 3 жыл бұрын

Its not supposed to be "give me liberty and give me death"

@bhs1test473 3 жыл бұрын

"When is the next time I can hug someone to show support?" Hi, Dr. Robert I'd like to thank you again for your resourceful, neutral grand round series. It truly illustrates the value of collecting more data, organize it and take effective interventions. I was very very sad last week as my project was cancelled and people were losing hope in my org. So I decided to quit and do some exploration on my own. I don't quite have the maths skill here to make informed decision, but I am happy to provide details you need from the field. If you are interested, please reach out to Robert Califf as I left some hint there early on this week. Thank you!

@tomgucwa7319 3 жыл бұрын

Press on comrade...an go badgers

@sleepsmartsmashstress740 3 жыл бұрын

incredibly informative

@buzzpedrotti5401 3 жыл бұрын

Thanks, again!

@jamiejones8508 3 жыл бұрын

Thanks for pushing back on the HIV analogy. Having worked in HIV in the 80s, I agree that it's different. It might be a better analogy to think about smoking in public. I'm old enough to remember when it was perfectly acceptable for smokers to smoke wherever they wanted to - at work, in the pub, on the train - and they felt that they had the right to do so. Sadly the non-smokers were breathing in the secondary smoke and some of them were badly affected by that and even died from it. We've worked out that non smokers have the right to breath safe smoke free air and that that's more important than inconveniencing smokers who want to smoke everywhere. The same applies to COVID, but even more so. The right for all to breathe safer air trumps the perceived right to not wear a mask. If someone has health conditions that mean that they genuinely can't wear a mask, I would suggest that they probably need support by other people to get in their shopping etc, rather than risk going into crowded places maskless and being a superspreader themselves.

@rachellethomas5499 3 жыл бұрын

It speaks *volumes* that this would be called a 'third' or even a 'second' wave.

@ennmac 3 жыл бұрын

How do you get rid of the weekend reduced testing skew to data? Rather than averaging the last seven days each day, you could look at Fridays' average rates. It'd smooth out the dips

@amaryllisyazon5348 3 жыл бұрын

Very balanced Medical update

@dianedoherty3655 3 жыл бұрын

There is no third wave. We’re on the third peak of the first wave, dude !

@christopherrobinson7541 3 жыл бұрын

Perhaps a better description.

@buzzpedrotti5401 3 жыл бұрын

People, certainly Americans, are imperfect at managing radical (unknowable) uncertainty. We don't think about it well. We communicate about it poorly and in different, inconsistent ways. Different people have different vulnerablity. We don't accept it, we deny it. We fight it. Our leaders, people after all like us, face the same limits and have little to add to help. We stumble individually and collectively. Perhaps we can come to accept this and go easier on ourselves and others. Good Luck

@ricknash3055 3 жыл бұрын

Bob Wachter started his discussion suggesting if only the USA would slow it's IFR then India would take first place. Even so that wouldn't be much to boast about, given India's population is 1.3 billion compared to USA'S 330 million. The deaths per 1M are 87 versus 700 respectively. Even if India's numbers were off by the difference of tested per million, about 5x, the USA would still remain firmly in first place.

@toddoneill3941 3 жыл бұрын

So grateful for all of you and your work! Are there any theories or work in identifying how the virus uses super spreaders and what prerequisites, such as blood type, a super spreader must have for them to function as a super spreader?

@MythicbellsPersians 3 жыл бұрын

Your broadcasts are excellent. I never miss one. I’m not a *no* mask person nor, in honesty, a *yes* mask. But I do follow the recommendations at large, however I do tend to wonder how one get the data on mask wearing in a given area or state in order to say “where masks are worn” or “not worn” the graph goes up, down, or remains stable. Does someone look out the window in the area in question and say “yep, looks like more people are wearing masks here” ... or now they aren’t. Just curious how this data is arrived at, and are variables taken into account such as thin gater masks vs 3 layer/filter cloth masks, or masks worn under the nose, or over a beard.

@jansonshine9082 3 жыл бұрын

Excuse me, MPH in Integrative Studies here. How can we have a "third wave" when we never flattened the curve from the first wave? Also FYI, serrapeptase 120,000 units p.d. works better, safer against COVID 19 clotting than the more traditional choices. That with supplemental oxygen & hydrocortisone can do wonders. Stay safe all!

@patriciahoke4722 3 жыл бұрын

Why isn't "warp speed" development of at-home remedies prioritized? Is ANY work being done on that? Are physicians disseminating the message that everyone should have a pulse ox at home?

@Rach1941 3 жыл бұрын

FDA has stringently forbidden the mass production and sale of home antigen kits from the start. As Dr. Mina has repeatedly said, this approach could halve the virus R0 in short order.

@patriciahoke4722 3 жыл бұрын

@@Rach1941 Agree. But I'm (also) talking about at-home therapeutics / medicines. Why are we STILL waiting till the last minute to start treating this? Also - pulse ox. There's no widespread effort that I can discern, attempting to educate Americans. Maybe I've missed it, but I don't think so.

@alphadork1 3 жыл бұрын

@@patriciahoke4722 Have you tried putting a slice of onion in your shoe?

@zhuhui1520 3 жыл бұрын

@@patriciahoke4722 Maybe a little pill to treat HIV could also be very handy.

@Cathy-xi8cb 3 жыл бұрын

I am a therapist, and correctly using a pulse oximeter, reading and interpreting the numbers and assessing how they change with activity or position requires some training and experience. I have trained my friends and family, but they will need to be evaluated more completely if/when they become ill. Same with medications. You need a medical professional to know what to take and when. Your average GP has 6-10 minutes to see you in their office. I can't fully train most people how to get onto a toilet after hip surgery in that amount of time....

@telectronix1368 3 жыл бұрын

It speaks **volumes** that this would be called a 'third' or even a 'second' wave.

@lte23401 3 жыл бұрын

I always like UCSF COVID-19 Grand Round and truly appreciate the great work! How about inviting Dr. Michael Osterholm, University of Minnesota to give some update and his thoughts? His podcast are sincere, insightful and informative. I do not quite understand Julia Marcus talk? She talks a lot but they seem in circles and not much context, confusing.

@MyPerennial 3 жыл бұрын

Loved the last speaker

@Cathy-xi8cb 3 жыл бұрын

Julia Marcus doesn't understand the Hasidim and their thousands of wedding attendees in Brooklyn. At all. The small weddings are about 400. Every. single. night. all. summer. long.

@andymullarx6365 3 жыл бұрын

KZfaq only works as well as it does because of the comments. How dull it would be otherwise.

@ernieshippey4739 3 жыл бұрын

Surprised that George would use IHME predictions. IHME's model doesn't use any population health attributes in its model. The high risk ethnic groups (hispanics and blacks) are at 4x more risk of hospitalization per CDC. El Centro California has 90% hispanic population and 1,850 Deaths per million , while Wisconsin only has 14% high risk ethnic groups in entire state and only 325 deaths per million. Obesity rate in San Francisco is only 10%, while over 3x that in rest of country. Need to look beyond case counts and blaming everything on bars and republicans.

@angelikabertrand4045 3 жыл бұрын

I think 6,000 healt care workers in America have passed. Get rid of Trump. There will be no vaccine. A denemark Biologist says this covid is a mean mutatcious virus. Well have to co excist with it. Whether we like it or not??? God Help Us.

@judyhansel8000 3 жыл бұрын

Still using live animals in research at UCSF?

@MyPerennial 3 жыл бұрын

Give me a break

@buzzpedrotti5401 3 жыл бұрын

It seems worthwhile that visitors not come into California.

@daveninjaneuro7089 3 жыл бұрын

Aren't you in your closet?

@buzzpedrotti5401 3 жыл бұрын

@@daveninjaneuro7089 Fair enough. It's hard to tell from in here...

@patriciahoke4722 3 жыл бұрын

Young people are spreading this, and they likely are chafing at restrictions. Why not let them come up with solutions? Give them the goal (transmission rate of X), give them some parameters and see what they come up with. They would be responsible for enforcement, oversight and communication.

@Cathy-xi8cb 3 жыл бұрын

You are suggesting that a cohort that can't roll out of bed for an early class, or separate whites from colors in a washer, perform adult management behaviors? And one of the outcomes is death?

@patriciahoke4722 3 жыл бұрын

@@Cathy-xi8cb Not all of them are as you say. Many are super responsible, super nice and very intelligent people. I work with such young people.

@notsogreen 3 жыл бұрын

Maybe young people should be told as South Korea has announced, that being asymptomatic does not mean no heart or other organ damage. SK has advised that EVERYONE infected be checked for heart damage for the 6 months following infection. They have even found live virus in heart tissue when persons were considered recovered with negative tests. So live virus can be hiding in organs, etc. Even "dead" viral particles can cause ongoing inflammation in some recovered.

@yossarianmnichols9641 3 жыл бұрын

Forget about CDC until the new president is sworn in. It will have to be re-branded.

@tatonka411 3 жыл бұрын

So many misconceptions here. It's still the first wave. Masks are NOT the most important public health measure - they're not even the easiest. The preferred term is physical distancing, as we should encourage social connections.

@alanrcrews 3 жыл бұрын

A 70% effective vaccine to 70% population vaccinated gets us to Herd Immunity, of 50% protected?

@sleepsmartsmashstress740 3 жыл бұрын

NO 90% protected

@allangibson8494 3 жыл бұрын

Covid control requires a minimum of 60% protection to get anything approaching herd immunity. Cloth masks use requires 95% compliance to get similar protection. With strict enforcement Victoria Australia got the Re to 0.6 using masks. Currently Victoria has had no cases detected in the last four days with a population similar to Los Angeles.

@sleepsmartsmashstress740 3 жыл бұрын

@@allangibson8494 Let us make it 70% to account for absentee votes and for an additional buffer or play room Shall we? And what about 99% mask use?

@biblicalstorm3791 2 жыл бұрын

W O R T H L E S S I N F O R M A T I O N

@davidflavin7516 3 жыл бұрын

Maybe some of the access deaths are due to unnecessary lockdowns

@Savolitutu 3 жыл бұрын

Isn’t it interesting that after all of these measures and lockdowns and masks, people haven’t woke to the fact each individual must make serious health choices like exercise, good healthy food, and meditation or prayer of some choice. Our bodies are spectacularly made but we do conscious or unconciously poor choices towards it. Doctors who haven’t promoted these lifestyle choices should lose their medical license. This guy is disingenuous stating masks help. The studies show of those who died, the ones wearing masks all the time had a 70% greater chance of dying.

@darbykuntz5979 3 жыл бұрын

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@andrewkim2244 3 жыл бұрын

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@kamwolf3960 3 жыл бұрын

In case anybody from UCSF actually reads these comments, which I doubt, I'd like to ask this: WHY would you not have Dr Larry Brilliant in on one of these meetings? He is who should be speaking on this. Also, why not really go in depth into the successes in New Zealand? Not impressed with Julia Marcus. Could she possibly be more non-committal and less clear? Comparing this pandemic to HIV? How absurd! And, yes, there should absolutely be strict enforcement of Public Health mandates. Again, I hope that you will have Dr Brilliant speak. Of anybody I've heard so far, at least in this country, he's the one who knows exactly what must be done in order to squash the pandemic.

@alphadork1 3 жыл бұрын

Although he's a smart guy and a wonderful speaker, Dr. Brilliant is retired and not actively involved in any aspect of the response to the pandemic. As a public service UCSF makes these sessions available to everyone, but these GR videos are produced primarily for UCSF's internal education, for the benefit of its clinicians and researchers. I don't think Dr. Brilliant has much to teach the people who are actively working on and teaching other doctors about the pandemic right now.

@buzzpedrotti5401 3 жыл бұрын

I stay hidden in my closet... It's getting gamey in here.

@daveninjaneuro7089 3 жыл бұрын

Instacart will still deliver to you :)

@crystalmckendrick8576 3 жыл бұрын

How do you get rid of the weekend reduced testing skew to data? Rather than averaging the last seven days each day, you could look at Fridays' average rates. It'd smooth out the dips