OT- article about nursing shortage/challenges in MS and the many

[paindonthurt]

I stopped at these 2

1. County owned
2. Nurses quitting at refusals to get vaccines. ********. They might be quitting Bc it’s stressful. They might be quitting Bc they were forced to get a vaccine they didn’t want. They might be quitting Bc others won’t get the vaccine but I’ll bet everything I own 1 in 5 aren’t quitting but everyone won’t get the vaccine.

 

[johnson86-1]

That's the kicker, they didn't want the state to get saddled with the bill later on. It's valid, but I'm guessing we'd have stayed on the federal payroll somehow, that's usually how it works. I have no idea what the answer is for that, both sides have merit.

It's really not. Medicaid takes up a good chunk of state funds even though the federal government pays for most of medicaid for Mississippi (I think ~75%). There might be dynamic effects that reduces the net hit to the government pretty low though with the share only being 10%.

 

[paindonthurt]

For every complex problem, there is also an answer that is clear, simple and right.

All complex problems are solved by breaking them down into simple solutions.

 

[paindonthurt]

Fake news. The most fake.

Straight up lying.

 

[ckDOG]

That's right.

These are the things that happen when chaos strikes. I wish most people would just 'accept' and understand that COVID happened, it's here, and in general, hospitals just have to treat people like numbers. It isn't personal. I've had family members die during this, as many others have. I saw a person today complaining on facebook about not being able to see her newborn babies after she gave birth (which is awful), but she also was unvaccinated, and around her other daughter last Friday who tested positive. What is a hospital to do?? It's just chaos.

I wish people would just get this. There's no one to blame. The medical field is in turmoil. Of course, if it were me, I think I'd have viewed this as an opportunity to work as much OT as I ever wanted and get a bunch of raises. Instead, so many have just gotten angry about having to work so much, blamed others, told people to stay at home and virtue signaled about it (L4 Shankass), refused vaccination, etc. So I understand why people are mad at the healthcare system. Holy hell what a mess.

The posturing and heel digging has been eye opening on human nature. You get one group of people that expect life to completely pause and be bubble wrapped and another that can't read a damn chart and be bothered to take a safe vaccine bc of a list of bogus reasons. Then you have the group of people that expect perfection from the beginning as if this wasn't a novel virus and completely ignore that the entirety of society has no experience in responding to airborne pandemics in the last century.

Good news is I think most people do actually get it. It's a ****** situation that we've never had to deal with. You take the little steps you can to protect yourself and family, live life with some mild inconvenience, and hope for the best. Nothing else a person can do. But reasonable people have no voice in a world of squeaky wheels and a click bait media that loves to hand a microphone to the village idiot.

 

[johnson86-1]

While I disagree with some of what you wrote, you are correct that there is an issue, a knowledge gap I guess, around how to treat those with prior infections in regards to a vaccine.

It's not a knowledge gap. It's letting politics and dislike/hatred for "out groups" dictate what should be decisions based on science. It's not like people like Fauci haven't heard of natural immunity and don't have access to studies on how long natural immunity typically lasts. They are not requiring people who have recovered from infection to get vaccinated because they have data showing natural immunity lasts a shorter period of time than vaccine induced immunity. They are doing it because some of those recovered people would be part of the out group, and they don't want them to avoid their control just because they have already recovered from infection.

 

[paindonthurt]

I think he is finding humor in illogical mandates and procedures.
I find them humorous.

Now if we just had a national campaign for cheap logical solitons to health!

Like eating healthy
Exercising
Getting the correct amount of vitamins
Etc

 

[BiscuitEater]

I feel like you just reinforced that Tate's refusal to expand Medicare is idiotic. I concur.

Expanding Medicare is IDIOTIC. Currently, 22% expenses are fraud! The gov't can't even do mail right, or run a train BUT you want it to do more medical? jUST LOOK AT THE va SYSTEM!

 

[paindonthurt]

I agree with this but something tells me you aren’t consistent on the subject self assess and realize you are at fault.

 

[johnson86-1]

3) Hospital admins are breathtakingly incompetent in Mississippi Healthcare Institutions.

We have a lot of county owned hospitals in Mississippi that have a lot of politics infecting them. Of course, when there's not competition (and very little of Mississippi has enough population to have competitive hospitals), the for-profit hospitals likely aren't going to provide a better service. Non-profit, non-government hospitals can be good or can just be essentially "for-profit" with profits going to executives and doctors rather than owners.

The article doesn't mention the fact that Singing River just didn't fund it's pension for like a decade under a prior executive team. That was probably as harmful as the COVID hit as far as finances.

 

[ckDOG]

Sure

I think he is finding humor in illogical mandates and procedures.
I find them humorous.

Now if we just had a national campaign for cheap logical solitons to health!

Like eating healthy
Exercising
Getting the correct amount of vitamins
Etc

All that + vaccine. All are important, but you won't find a stronger correlation to bad Covid outcomes than vaccination status. Israel is neurotic about cases and has gone overboard on their vaccination approach, but you still can't argue that being vaccinated or not isn't the biggest influence of hospitalization/death. You're being stubborn arguing otherwise. And no, I don't want to force you to get one if you have chosen not to - please no bogey man here. You're an adult that should be able to see the forest for the trees by this point.

 

[Maroon Eagle]

If you can solve healthcare in a logical - and not philosophical - fashion, you have my vote for Governor.

 

[paindonthurt]

I don’t know enough abt healthcare to be able to solve it, but there are plenty of people who know a lot and are smart, but politics.

 

[paindonthurt]

What if you have natural antibodies?
Been proven that they are equally or more effective than vaccines.

 

[Faustdog]

Expanding Medicare is IDIOTIC. Currently, 22% expenses are fraud! The gov't can't even do mail right, or run a train BUT you want it to do more medical? jUST LOOK AT THE va SYSTEM!

I was on the fence here, but the all-caps and exclamation points really pushed me over to your side.

 

[mstateglfr]

What if you have natural antibodies?
Been proven that they are equally or more effective than vaccines.

Jeffrey Townsend, the study’s lead author and Yale professor of biostatistics, explained that it can take several years to collect enough data to determine the rate of reinfection of an infectious disease. This creates a problem for researchers, as COVID-19 has only been actively circulating for about a year and a half. In the absence of sufficient empirical data, a team of Yale researchers and colleagues at other institutions sought to determine the rate of reinfection by analyzing immunological data from SARS-CoV-1, Middle East respiratory syndrome and human coronaviruses. With an understanding of how these viruses evolve and how they are related to each other, the team was able to model the likelihood of reinfection for SARS-CoV-2, the virus that causes COVID-19.
...
The study showed that the duration of immunity is relatively short. According to Hassler, the risk of reinfection is about five percent at three months after the initial infection. After 17 months, that number increases to 50 percent.
https://yaledailynews.com/blog/2021/10/07/covid-19-reinfection-is-likely-among-unvaccinated-individuals-yale-study-finds/

This study says that at 3 months after infection, immunity is about the same as initial vaccination numbers. I think it also importantly addresses the reality that there hasnt been a ton of time to fully study reinfection rates.

[FONT=noto_sansregular]Johns Hopkins has conducted a [/FONT]large study[FONT=noto_sansregular] on natural immunity that shows antibody levels against COVID-19 coronavirus stay higher for a longer time in people who were infected by the virus and then were fully vaccinated with mRNA COVID-19 vaccines compared with those who only got immunized. (The results of the study were published in a [/FONT]letter[FONT=noto_sansregular] to the Journal of the American Medical Association on Nov. 1, 2021.)
[/FONT][FONT=noto_sansregular]The data show that one month after they got their second shot, participants who had had COVID-19 more than 90 days before their first shot had adjusted antibody levels higher than those who had been exposed to the coronavirus more recently than 90 days. Three months after the second coronavirus vaccine, the antibody levels were even higher: 13% higher than those who were exposed to the virus less than or equal to the 90-day mark.
[/FONT]https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/covid-natural-immunity-what-you-need-to-know

This study says natural immunity combined with vaccination is most effective.

The data is clear: Natural immunity is not better. The COVID-19 vaccines create more effective and longer-lasting immunity than natural immunity from infection.

• More than a third of COVID-19 infections result in zero protective antibodies
• Natural immunity fades faster than vaccine immunity
• Natural immunity alone is less than half as effective than natural immunity plus vaccination

The takeaway: Get vaccinated, even if you've had COVID-19. Vaccine immunity is stronger than natural immunity.
https://www.nebraskamed.com/COVID/covid-19-studies-natural-immunity-versus-vaccination

This article just flat out says vaccination is better than natural immunity.




- I intentionally stayed away from the CDC since some here think that is the devil, though Johns Hopkins mentions CDC data.
- It really sucks that this thread seems to have turned into yet another covid thread. That is just one of many discussion points in the detailed article.

 

[Smoked Toag]

What if you have natural antibodies?
Been proven that they are equally or more effective than vaccines.

They are only effective if you actually have them. Once you catch the Vid and don't die, you're likely alright going forward, at least as far as death. But if you're one of the people who haven't caught it yet, and unvaxxed, you're playing with fire.

The best way to get rid of it, is to get vaxxed, then catch it. You won't get it bad but will have natural antibodies as well. That's why most things opened once vaccines were available.

The goal is herd immunity (i.e. wiping the virus out). The vaccine gives you a shield until we get there. If everybody was vaxxed, this happens a lot faster. If they don't, we have to wait for everyone to get antibodies, which likely takes a few years (as we're seeing now). And we all get to argue about it until we get to that point.

 

[grimedawg1]

Medicaid Match

It's really not. Medicaid takes up a good chunk of state funds even though the federal government pays for most of medicaid for Mississippi (I think ~75%). There might be dynamic effects that reduces the net hit to the government pretty low though with the share only being 10%.

In MS, hospitals pay about $250 million in taxes to fund matching programs for the state - depending on the FMAP (matching rate calculated by feds). The "state" pays by taxing hospitals.

To expand Medicaid, hospitals have put forward a plan to cover the match.

Regardless, there are several studies that show economic growth from expanding covered lives will result in enough new tax revenue to cover the match. If someone offers me $900 million dollars if I come up with $100 million, I try my best to come up with that. If you get just the $1 billion in the state with no multiplier at a tax rate of 5%, that is $50 million. Also, these things run thru private companies for Medicaid now (a boondoggle) and the insurance premium tax is 3%.

 

[horshack.sixpack]

I know a brand new nursing grad who got her "dream job" at UMMC and then quit as soon as they mandated vaccines. Seems unbelievable that you'd go through all that trouble to be an RN and then quit because you don't believe in healthcare, but it sure happened once that I know of; perhaps the only one, but I suspect not. Back in the day I saw more doctors than I would've guessed, who were nearing retirement age, accelerate retirement rather than start using EMR systems.

 

[grimedawg1]

I generally agree wholeheartedly with your point - except that it is not just confined to coaches. Good administrators are rare. The issue is that many just have no idea how to manage people. They let personal grievances and turf battles and likes and dislikes interfere in managing. Many don't have a real ability to manage people. Their experience is that they got a master's of some sort and are put in line because someone in county office thinks they might be good.

 

[ckDOG]

It's a coronavirus

What if you have natural antibodies?
Been proven that they are equally or more effective than vaccines.

Natural and vaccinated immunity will wane relatively quickly for a coronavirus. This one was just novel - so many humans had a rough time reacting. It'll settle down just like the handful of other coronaviruses that circulate (common cold). Our bodies just handle the existing versions better. They'll handle this new one just fine in the future after a few rounds of exposure and mutations. I've had my vaccines and just cleared out omicron. Not much to it. I'm sure I'm ironclad for a few months now, but like the flu, I'm sure I'll need an annual shot going forward. If for nothing else to avoid feeling like complete *** when I do get Covid again in the future.

Speaking of flu, saw the same thing with the Spanish flu. It was the OG H1N1 and it wrecked us. Other variants of H1N1 are still around, but our bodies and health care approach adapted and we live with it just fine. So... virus gonna virus, but some folks just can't wrap their minds around that our best defense right now by a long shot is a vaccine. It's not perfect but just look at who gets hospitalized vs who doesn't.

 

[Cousin Jeffrey]

All that + vaccine. All are important, but you won't find a stronger correlation to bad Covid outcomes than vaccination status.

...or previous infection.

The CDC is even admitting this.
https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e1.htm

See the Figure in the paper. The vaccinated (with or without previous infection) and unvaccinated with previous infection all have similar risks for hospitalization. In fact, after July of last year (Delta?), the risk was slightly higher for vaccinated without previous infection. The lines for those with previous infection (with or without vaccination) are basically the same.

 

[Big Sheep81]

The biggest issue with increased pay from the hospital manage point of view is that these payroll costs are not sustainable in the long run if reimbursement rates do not increase with them. Most businesses raise prices to cover increased wages. Hospitals are under constant pressure to reduce costs to lower the cost of health care. When this Covid mess subsides (and it will at some point) you simply cannot cut wages back far enough to offset the increases. Every hospital is trying to retain folks and spending money in the form of hazard pay and bonuses to retain staff. But there is going to be a day of reckoning (like Doc Holiday said). Lots of businesses will continue to keep prices high to offset the cost of $15 an hour cashiers. I'm on the board of a rural hospital and during pre-covd times we were lucky to have a 3% margin at the end of a year. There's tons of covid money that has rolled in but that faucet is about cut off.

Health care is a cast iron ***** to manage. And the biggest factor in Mississippi is burnout. Our folks are simply exhausted. And offering more money isn't working like you think. It's time off that they need the most.

 

[ckDOG]

Okay that's fine

...or previous infection.

The CDC is even admitting this.
https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e1.htm

See the Figure in the paper. The vaccinated (with or without previous infection) and unvaccinated with previous infection all have similar risks for hospitalization. In fact, after July of last year (Delta?), the risk was slightly higher for vaccinated without previous infection. The lines for those with previous infection (with or without vaccination) are basically the same.

You could replace "+ vaccine" with "+ recently acquired antibodies" or similar and the point still stands. The problem with the immunity through infection part is the fact you have to get infected. That's great with the benefit of hindsight, but it's an unnecessary risk when there is an effective and easily obtained vaccine available. Plus, immunity (any type) wanes with coronavirus. Control what you can control without the incremental risk seems like the obvious play to me assuming you don't have something unique that makes vaccines a non option.

 

[Cousin Jeffrey]

You could replace "+ vaccine" with "+ recently acquired antibodies" or similar and the point still stands. The problem with the immunity through infection part is the fact you have to get infected. That's great with the benefit of hindsight, but it's an unnecessary risk when there is an effective and easily obtained vaccine available. Plus, immunity (any type) wanes with coronavirus. Control what you can control without the incremental risk seems like the obvious play to me assuming you don't have something unique that makes vaccines a non option.

Not that you're accusing me of saying it, but I wanted to clarify. I'm not advocating anyone go out and get infected intentionally (although with omicron, the risks seem even lower than they already were).

There are also incremental risks with the vaccine (even though we're not allowed to talk about that). And for someone who has already recovered from an infection, they might view the vaccine as a risk they're not willing to take. Especially considering how the number of shots needed to remain "up to date" continues to increase every few months.

General statement not directed at you...
Not everyone who chooses not to get the shot is an uninformed conspiracy theorist rube.

 

[paindonthurt]

I’ve got it twice.

I got it right now.

I’ve tested for antibodies a couple of times.

 

[paindonthurt]

So you are gonna keep getting the jan every 3 or 4 months?

Do you get multiple flu shots a year or even every year?

 

[paindonthurt]

3 months after the vaccine the same thing happens.

60% plus of the country isn’t going to keep getting jabbed every 4 to 6 months.

You are dumber than I thought if you think that’s going to happen long term.

 

[johnson86-1]

Natural and vaccinated immunity will wane relatively quickly for a coronavirus. This one was just novel - so many humans had a rough time reacting. It'll settle down just like the handful of other coronaviruses that circulate (common cold). Our bodies just handle the existing versions better. They'll handle this new one just fine in the future after a few rounds of exposure and mutations. I've had my vaccines and just cleared out omicron. Not much to it. I'm sure I'm ironclad for a few months now, but like the flu, I'm sure I'll need an annual shot going forward. If for nothing else to avoid feeling like complete *** when I do get Covid again in the future.

Speaking of flu, saw the same thing with the Spanish flu. It was the OG H1N1 and it wrecked us. Other variants of H1N1 are still around, but our bodies and health care approach adapted and we live with it just fine. So... virus gonna virus, but some folks just can't wrap their minds around that our best defense right now by a long shot is a vaccine. It's not perfect but just look at who gets hospitalized vs who doesn't.

The only two hospital systems I have any contacts its inpatients are disproportionately vaccinated in comparison to the population. Not sure if that's abnormal or not. Of course, you would hope people with a lot of comorbidities would be much more likely to get vaccinated, so that doesn't mean the vaccines aren't working at all even if that's typical, but I think people need to be realistic about how effective it is at this point.

 

[horshack.sixpack]

I'm amazed at both the number of rural hospitals in MS and the amount of MS that won't have a nearby hospital if those don't persist. I can't imagine what it takes to keep them running, compliant with all requirements and staffed with decent employees.

 

[horshack.sixpack]

My booster was 8 months after my 2nd. Who is saying every 3 -4 months. I'll certainly continue getting boosted to not be concerned about potential bad outcomes from COVID. I do get a flu shot most years. I've certainly gotten busy and forgotten before.

 

[Maroon Eagle]

Eh. Why not? These shots are nothing-- I took them and felt well enough to work the next day.

If you really want to experience painful shots though, wait until you're 50 or so and get the Shingrix vaccine.

No fun.

But also much better than getting Shingles.

 

[Maroon Eagle]

Yep.

When you work in the public and see loads of people, it's pretty much common sense to get a flu shot.

 

[horshack.sixpack]

Given that current data is that you are 29X more likely to be hospitalized if you aren't vaccinated and get COVID vs being vaccinated, I'd say you stumbled into an anomaly.

 

[HailStout]

This will be my only comment on this thread because I really am tired of fighting about COVID

Watching my ICU nurses go through COVID and specifically the delta variant was beyond awful. It has sucked for me but not like it has for them. Day after day for 12 hours at a time they put everything into taking care of patients only to watch every effort they made be ultimately futile. They got to know the patient’s families. They updated them everyday. At least I was able to move on to the next patient after I rounded on each one of them. I frequently would encounter a nurse outside in tears. They would collect themselves and go back in and keep being the true heroes they all were. For so many of them they could not take it anymore. They decided life was too short to be this miserable and quit after the delta wave was over. I don’t blame any of them. I’m impressed they held out as long as they did.

Please don’t let the politics and distrust that seems to permeate every damn thing that happens now let anyone forget what those nurses who truly were on the front line went through.

And be nice to each other. We all should be on the same side no matter where our opinions fall.

 

[BoomBoom.sixpack]

It's not a knowledge gap. It's letting politics and dislike/hatred for "out groups" dictate what should be decisions based on science. It's not like people like Fauci haven't heard of natural immunity and don't have access to studies on how long natural immunity typically lasts. They are not requiring people who have recovered from infection to get vaccinated because they have data showing natural immunity lasts a shorter period of time than vaccine induced immunity. They are doing it because some of those recovered people would be part of the out group, and they don't want them to avoid their control just because they have already recovered from infection.

There's plenty of plausible reasons, so just assuming it's done out of hate and a desire to control is a horse paste take. As I've said, conservatism is horse paste and drinking bleach all the way through, and you just went a long way towards proving it. Easiest explanation is that in general the risk from vaxxing too soon after infection is negligible compared to covid risk (that was my conclusion after deep research, the risk of severe covid after previous delta infection was on par with severe reaction to the vax for my cohort) while increased vax rates cut down on transmission and thus was a met social good. Combine that with general doctor/politician resistance to changing stances as the situation changes, and it makes perfect sense. Don't need a ridiculous narrative to explain that.

 

[BoomBoom.sixpack]

I know a brand new nursing grad who got her "dream job" at UMMC and then quit as soon as they mandated vaccines. Seems unbelievable that you'd go through all that trouble to be an RN and then quit because you don't believe in healthcare, but it sure happened once that I know of; perhaps the only one, but I suspect not. Back in the day I saw more doctors than I would've guessed, who were nearing retirement age, accelerate retirement rather than start using EMR systems.

I'm not surprised. Conservatism has become a cult, and giving up a job is low on the list of crazy things cultists will do. Hell, we're very close to a national kool-aid moment, the ivermectin hcq stuff is only a half step away.

It's going to get worse before it gets better.

 

[mstateglfr]

3 months after the vaccine the same thing happens.

60% plus of the country isn’t going to keep getting jabbed every 4 to 6 months.

You are dumber than I thought if you think that’s going to happen long term.

I provided 3 links that address your claim. I did not search for anything to prove a preconceived bias. I looked for articles that are clear and cite/recap research.
One article even supports your claim.

My post withheld commentary on your claim.

What if you have natural antibodies?
Been proven that they are equally or more effective than vaccines

How proven is it? Li KS to actual good research would help.
Again, I provided info that supports your claim so don't think I am against the claim or whatever.