Thursday, December 30, 2021

The social benefits of not getting COVID tested

Beneath one of the posts below, I commented that I recently got myself tested for COVID.   It wasn't as easy a decision as it seems: it struck me that I'd be making life easier for myself and everyone around me by keeping the cloak of ignorance of COVID infection wrapped cozily around us.

I had been feeling a bit run down recently, and wasn't sure whether or not that was normal life / job / ministry / holiday burn-out or a sign that I might be infected with COVID (or something else).  As I mentioned in the comment, I also was aware that my sense of smell and taste seemed to have diminished recently.  I'm fully vaccinated and "boostered", but I understand that breakthrough cases aren't uncommon with the Omicron variant.  So I thought it was possible I was experiencing COVID symptoms.

So I decided to get tested.  In the Chicago area, the do-it-yourself rapid tests are completely out of stock in all the stores, so getting rapid results didn't seem to be an option.  But my wife mentioned to me that our daughter the school teacher had to get herself tested at the beginning of the school year*, and our doctor's office had given her a rapid-result test.  She suggested I call the doctor to see if he would do it for me.  As I reported in the comment, I managed to finagle both a rapid-result and a PCR test from the doctor.

The only other test options I knew of were to go to (a) one of the state-administered test stations or (b) one of the community hospital-administered test sites.  Demand for tests is very high right now in this area, and I understand the community hospital sites aren't taking walk-up patients now; one has to make an appointment, and the bookings are several days out.  That didn't do me much good, as I had a number of engagements upcoming in the next few days, and felt I needed to know right away whether or not I'm infected.  The state-administered site near me is a same-day site (drive-up, not walk-up) but the lines of cars reportedly are very long, and I'd lose a big chunk of the day.  And our state only is administering PCR tests, and results may not be available for 2-3 days.  I didn't think I could wait that long to find out. 

Thanks to the magic of texting, word spread quickly among my kids that Dad was going to get himself tested.  Naturally, that elicited expressions of concern.  But I also detected a thread of grumpiness running through their comments: they've all spent a good deal of time with me this holiday season, so if it turned out that I was infected, then all of them would have been exposed to someone who was COVID positive.  (That one of them may have been the agent of my infection hasn't appeared in their commentary so far :-)).  The grumpiness is because my testing positive would disrupt their lives.  They are young adults, and all of them have social lives, including plans to see friends during the holiday season.  In addition, being exposed to a COVID positive person would mean that a couple of them wouldn't be able to go into work for a few days.   

In addition: my brother had brought his family into Chicago for a week, and we were supposed to have dinner with them this week.  And we're supposed to get together with my parents this weekend.  If I was to test positive, all of that would have to be called off.

In addition to all that: I've had a pretty full ministry schedule recently.  I took part in three of the Christmas liturgies and a Sunday mass the day after Christmas, thus exposing our only priest, our music director, various musicians and other ministers, and anyone who received communion from me or spoke with me before or after any of those masses.  Really, anyone in the worship space over those three days would have breathed in the air I had exhaled, even though we're all masked. 

And if it turns out I need to quarantine for a few days, that would knock me out of commission for this coming weekend's liturgies.  As this coming Saturday is a holy day, this weekend is nearly as liturgy-intensive for me as last weekend was.  Mass can proceed without a deacon, but it does cause a bit of disruption of the deacon doesn't show up - if for no other reason than someone needs to take my communion station. 

As these conversations and thoughts transpired over the last few days, nobody actually said to me, "Don't get tested - everyone's lives will be easier."  But I'd be lying if I said the thought didn't cross my mind.  

Just thinking about it, there are three possible "cases":

  • Case 1: I get tested and the test result is, I'm COVID positive.  Life result: grumpiness ensues.  My life is disrupted, and the lives of various others also are disrupted
  • Case 2: I get tested and the test result is, I'm COVID negative.  Life result: everyone happily carries on with whatever constitutes normal life these days
  • Case 3: Whether or not I am infected, I don't get myself tested.  Life result: the same as Case 2
I trust it's tolerably clear that there can be some social pressure - or individuals like me who tend to be sensitive to social pressure can put pressure on ourselves - not to get tested.  Everyone is happier if they think the people with whom they are interacting aren't COVID positive.  People are happier if they're ignorant, even if the thing about which they're ignorant is that they're sick and probably are sickening others. 

* My daughter the teacher also needs to get tested periodically throughout the school year, even though she is fully vaxxed and boostered, and her pupils also get tested weekly.  The school passes out do-it-yourself kits to the kids so their parents can test them at home.  The school district apparently has no shortage of the do-it-yourself kits.  I think one of the reasons the kits are so unavailable to the general public is that, at least around here, the supply has been prioritized for schools.  Is that the best prioritizing?  I am not sure.  Nobody wants children to be sick, and the percentage of young children who have been vaccinated still is quite low.  And schools seem like ideal settings for the virus to get passed from person to person and family to family.  But children seem more resistant to COVID than adults.  I think there are more vulnerable demographics than schoolchildren.  It strikes me as a difficult ethical puzzle. 

25 comments:

  1. Priorities and policies about testing, masking, and treatment are being made in real time as the virus mutates and new ways to fight it emerge. All these decisions vary from region to region because our public health system is highly decentralized. There are obviously pros and cons to this decentralized approach.

    I'm not going to second guess the efforts of knowledgeable people on the ground as they try to keep people from being buried in this mudslide. They are dealing with one grim constant: Nobody has enough knowledge or stuff to deal with whatever is going on at any given time.

    I'm pretty sure epidemiologists and ethicists are busy compiling lessons learned for the next pandemic. But if the info and recommendations get mired down in politics as they have with covid, all that just becomes an academic exercise.

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  2. Jim, since I have been living with a Covid patient (now two Covid patients) since at least Christmas Day (contagious for at least two days prior), I think that you would be irresponsible not to be tested if you suspect Covid. You don't just interact with a few healthy young adults, you interact with older, more vulnerable people like my husband - he was fully vaxxed and boostered, but his symptoms have not been loss of taste or smell but extreme lethargy, cough so bad that it has caused such a sore throat that he only ate a small carton of yoghurt for two days, and borderline oximeter readings - 88-90 when first waking up, then maybe 91-92 - go to the ER if below 90. He did get the antibody infusion - the only one that seems to actually work against omicron (Sotrovimab) and he was very lucky that the infusion center had some - it's out of supply in many areas of the country. The more commonly used monoclonal antibody treatments (Regeneron etc) aren't effective against omicron, removing one line of defense for the high risk patients. He felt better last night, the oximeter was up to 95 and he ate solid food. Not every area is as fortunate as yours - home test kits are not only sold out in all the stores around here, most are sold out on Amazon, Walmart etc or unavailable until January something. Some school children and teachers are immunocompromised as well, so the school system is being responsible. My son's symptoms so far seem to be extreme fatigue, but not the cough and low oxygen saturation levels that my husband has experienced. This has also resulted in me being unable to begin radiation when scheduled, and I still have to avoid getting Covid between now and the second week of January or it will be postponed again. The longer it's pushed out, the less effective it might be in preventing a repeat of the cancer.

    There are some disruptions that are more serious than missing a New Year's Eve party.

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  3. The value of some social institutions, such as policies for vaccination and testing, is precisely that they relieve individuals from having to take responsibility for complex and difficult decisions that might disturb some individuals in our lives. They provide a standard for our behavior. For some reason we are currently undergoing a libertarian moment in which we are giving too much priority to individual freedom, sometimes even disguised as freedom of conscience.

    When it comes to vaccination and testing, dioceses need to be taking much stronger stances with regard to their employees and volunteer ministers. I am sure that they like schools could get preferential treatment with regard to vaccination and testing. This is especially true of the Catholic Church since we have large congregations in comparison to many other churches.

    While I can understand parishes not wanting to REQUIRE vaccination and testing for all people who attend Mass, I cannot understand their reluctance to making vaccination and testing an ideal. First by mandating it for their employees and volunteer ministers, and secondly be advertising that its ministers are vaccinated and tested, and thirdly encouraging people in the pews to advertise their own vaccination status and testing status when they come to Mass, e.g. by tags.

    In my opinion parishes have really failed at being safe places. They have left all the safety up to individuals on their own. That is certainly not a community model, it is a business model. Each person makes their own choices without regard to what other people need.

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    1. The Pope urged people to get vaxxed and was himself vaccinated. https://www.vaticannews.va/en/pope/news/2021-08/pope-francis-appeal-covid-19-vaccines-act-of-love.html

      However, Dave says his Catholic FB "friends" from the local parish are saying that the vaccines were made with fetal stem cells, and they are not going to inject themselves or their kids "with little dead babies."

      Hope that gives them comfort when they are watching their loved ones gasp for breath.

      Whatever I get out of Mass does not offset this kind of bullsh*t virtue signaling.

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  4. Now they are saying that family members of someone who has Covid don't have to quarantine. Don't know if that is evidence based, probably not.
    We still haven't heard results from my husband's test, but I'm doubting if it is Covid. His main symptoms are a sore throat and hoarseness. He just ate half a pizza for lunch, so his appetite doesn't seem to be affected. What we both are is tired. The cold is enough reason to take it a little easy. I hate it that we cancelled the family gift exchange, but I was really not looking forward to cleaning house and cooking a holiday dinner. It was heavenly to sleep in until 7:00 this morning, which is two hours longer than a work morning.

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  5. Meanwhile here is an interesting bit of news, Japanese scientists are working on a vaccine that provides lifetime immunity, no boosters needed: https://www.japantimes.co.jp/news/2021/12/29/national/science-health/one-shot-lifetime-covid-vaccine/

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  6. Guidance on breakthrough infections ( until it changes anyway)

    https://www.theatlantic.com/health/archive/2021/12/omicron-breakthrough-vaccine-testing/621014/?utm_source=newsletter&utm_medium=email&utm_campaign=atlantic-daily-newsletter&utm_content=20211229&utm_term=The%20Atlantic%20Daily

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  7. Well my husband heard back from his test, and he doesn't have Covid. Just a nasty cold. Very thankful for that (the negative Covid result, not the cold). He has pretty much lost his voice, so good thing he's not on to preach this weekend.

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  8. My husband made a dramatic turnaround yesterday- I think probably due to the infusion of monoclonal antibodies. By yesterday evening he was eating normal food, watching a football game, reading the news on his computer. He still has symptoms of getting over a bad cold, but no more borderline oxygen readings.

    So if any of the high risk people, like Jean, Raber , and Betty do get infected and have low oxygen saturation readings, I would recommend getting the infusion. It’s best done as early in the illness as possible, preferably within 3 days. My husband got it on day 4. Our son’s symptoms were gone within 48 hours and were very mild.

    Glad your husband just has a cold, Katherine.

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    1. Great to hear good news from everybody. I just home tested myself and it was negative. So I'll be going to the dinner dance tonight. We made sure to get a table of the vaccinated. Affair is done by ten so most of the drunks should still be busy getting drunk while I'm on the road.

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    2. Glad to hear good news, Anne.

      Stanley, enjoy the dancing, and drive defensively.

      We will be home eating spaghetti and power-watching the awfulness of "Succession" on our free 7 days of HBO.

      I am glad to see the end of this godawful year, but it has taught me to keep my expectations low, my hopes modest, my prayers unceasing, and not to make long-term plans.

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    3. We have learned not to have ANY procedures done without asking how much it costs. (Going rate for emergency intervention for a myocardial infarction with post-stent rehab and monitoring is about $60,000 plus ongoing $150 per month in meds, some of which are not available as generics.)

      Monoclonal antibody infusion cost info here: https://www.phe.gov/emergency/events/COVID19/therapeutics/Pages/outpatient-mAb-cost-coverage-faqs.aspx

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    4. We have medicare and a supplemental medigap policy. Although it was a private infusion center rather than the county run center, there was no cost to us. We were fortunate to have the coverage.

      I hope your husband is old enough for Medicare, Jean! But even if you have it, and don't have supplemental, the out of pocket with deductible and copays will add up. My husband's medical costs in recent years have been high and the medigap premiums more than paid for. Mine were not - until this year when I got cancer. But I was afraid to drop my medigap coverage for fear of getting something dire, and also for the price of the premium if I tried to get it later - in my mid-70s instead of late 60s. All together we pay a lot in premiums these days. My husband also has some very expensive heart medications, not available as generics. He gets adequate coverage for the first half of the year with reasonable co-pays but then falls into the "gap" around June and pays $hundreds/month for the rest of the year. On top of paying the $100+/month (roughly)Part D prescription plan insurance. So out of pocket prescription costs for him add up to several thousand $/year including the premiums and the full cost of the expensive drugs for half the year.

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    5. Cost of covid vax, testing, and treatment is govt subsidized, but not always free. I had to pay some kind of "admin fee" for my second test, but then Medicare picked that up. The Boy said his pharmacy was going to charge him for his booster, so he went to a different joint and got it free.

      Hope you will avoid infection.

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    6. Medicare and supplemental paid for all of my knee surgery, and associated costs. At least I think it did. It was four months ago, and I assume any uncovered costs would have shown up by now. One thing everyone warned us about was, don't sign up for Medicare Advantage. Since neither the area providers or the local hospital accept Advantage plans, it was never an option for us.

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    7. We never signed up for the Advantage plans because we travel so much. It’s too limited. Many people here have Kaiser, which is very reasonable but very limited locally as far as hospitals and doc choices and also only in a few areas of the country. If you go out of network with either an advantage plan or with Kaiser you just revert to normal Medicare co- pays and deductibles.

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    8. Must be nice to have choices.

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    9. Yes - we are fortunate. I wish you had the same choices - medigap has come in very handy for my husband in recent years and for me this year. You might want to do a cost-benefit analysis for next year to see if premiums are less than the co-pays and deductibles.

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    10. We have done all kinds of analysis. Most poor people have to get quite good at it. Otherwise they die.

      Despite the dire warnings of Katherine and the AARP, we are going with an advantage plan that will at least pick up some dental and vision costs. Pharmacy remains to be seen bc all supp and advantage plans change their formularies constantly.

      Our labs, rads, docs, specialists, oral surgeons, dentists, hospitals, etc. participate, and we can't afford to move or travel out of the coverage area. Hopefully we will get screwed less often than we do now on straight Medicare with a really crappy high-deductible rx plan.

      Hoping for the best with your radiation and husband's full recovery in the new year.

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    11. I think an Advantage plan might work well for you. We travel way more than most people so it’s medigap for us. This year my husband ended up in the ER at Stanford because of Covid. In August 2019 he spent two days at Stanford hospital because of heart failure. He had to go to the ER in Florida a few years ago - kidney stones. There are quite a few visits to ERs over the years while we traveled, including the stroke when we were in France, still on company insurance. We have no dental or vision coverage. The most expensive full out of pocket costs we have are my hearing aids $5000 for the current pair. Medicare doesn’t pay a dime of it. He has the most expensive prescription plan ( most don’t cover his heart meds at all so we have to buy the most expensive plan) and still pay thousands out of pocket on top of more than $1200 annual premium. Just for him. My plan is separate of course. I would vote for any candidates who would have a real plan to fix our disaster of a healthcare system - starting with getting rid of the profit motive distortions in the current system - the most expensive system in the world by far, yet millions still don’t have coverage and millions more can barely afford it.

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    12. I have no faith left in government's ability to solve health care.

      Fwiw, Costco has excellent discounts on hearing and vision. We get our glasses there. The Boy saved thousands on his hearing aid.

      Indian companies have made excellent profits on manufacturing very cheap generic drugs that they supply to American pharmacies. I have never understood why American companies want to hold their patents for so long when there is obviously a huge market for generics. Get their friends in Congress to give American generics some kind of edge, and they could be making lots of $$.

      Until the pandemic, there was a nice little grey market that helped people in Michigan make border runs for drugs. My uncle regularly went on that "cruise."

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    13. Oh, I don’t have much faith that our healthcare system, the very worst in the rich countries club will ever be fixed. There is too much money given to the politicians to head off any meaningful change. Both parties. Before my hearing got as bad as it is now, I bought my hearing aids at Costco. They are the best place for most people. But once my hearing loss went to severe- profound, I really needed a skilled PhD audiologist to program them. Now my hearing is so bad I know that even they can’t fix what is wrong, so I might be back at Costco again because their technicians can deal with the part of the spectrum of sounds I can hear, even though they can’t help in the range of frequencies that I can’t hear at all, no matter how well educated and experienced the audiologist .

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    14. When I was first retired, I had an advantage plan provided by my former employer, now we get to choose between advantage plans and regular Medicare.

      One of the many disadvantages of advantage plans is that the insurance company not only decides what doctors you see by also what treatments they will pay for.

      For example, it was difficult to get more than six sessions of physical therapy per year no matter what the physical therapist recommended. Tt took me about three years to get the physical therapy that I needed for my balance problem. The first year the therapist gave a rapid overview of the various things I could do to improve things. Not really very helpful. The second year I learned to how to use a treadmill with my balance problem. The third year I was able to master the elevated treadmill with my balance problem. When I had mastered all that, a lot of the problems caused by my balance problem resolved themselves. In other words, all I really needed was to restore my exercise ability to what it was before my balance problem. However, it meant that they spent many, many times the cost of physical therapy in vain attempts to resolve those other problems. Very pennywise but pound foolish!

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    15. I imagine that the pandemic has made things much more difficult for people with a hearing loss. If others are wearing masks, lip reading would be impossible. Not to mention masks muffle one's voice to a degree.

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  9. Another optimistic video from Dr. Campbell. Although a Delta infection doesn't provide much antibody immunity to Omicron (although vaccines provide some T-cell protection), Omicron may protect against Delta. It appears Delta wanes when Omicron waxes. It is great that we have all this science and technology to track and understand the virus, as opposed to 1918.

    https://youtu.be/PYLbJ0H8zdc

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