Officially, the CDC says the definition of “fully vaccinated” is not changing. Here’s a source that is unlikely to go away — the CDC likes to “keep its website up to date” and get rid of what it said previously. But here’s what they say about post-exposure quarantine for health care workers (note that I’m adding an image from their site because it will someday “be updated” and disappear):
I have bent over backwards to both follow what the CDC says, do what they say, and not speak ill of them. My patience wears thin.
Reminder: Omicron may not make you as sick, but it is very easy to transmit. There are millions of new cases; between lack of hospital beds and sick hospital staff that can’t take care of patients, it’s a mess. Keep your hands clean and your mask up over your nose where it belongs. Stay safe out there.
And so we drag over the two year mark with COVID. More variants, more sickness, more cases. And things will “likely get worse” according to experts. I have seem greater numbers in my facility, and “surprise” cases (we test on admit, thankfully). Objectively, we have more cases now than when we tried to lock down! Notice I said tried, because obviously it didn’t work out as planned.
Nevertheless, the CDC has changed guidelines to make it easier for people to get back to work. Or if you’re more cynical, to make it easier for companies to force people to get back to work. Nurses — both union and not — came out against. Other unions, including flight attendants, came out against. Will that change anything? Not known.
For the record, my company has a policy saying don’t come to work of you have a fever, productive cough, vomiting, diarrhea, generalized rash, conjunctivitis, or have been instructed to quarantine. People who are sick should stay home, period. Don’t try to soldier through, because you’ll both do a halfway job and potentially make other sick. I encourage everyone to follow this sane advice even outside a pandemic.
There is good news, however. The influenza rate is sharply down over the pre-panda era. In my area, we’ve had less than two dozen hospitalizations and (so far, knock on wood) no deaths. In fact, one line of influenza may be extinct!
Keep your hands clean and your masks on, folks. The mask goes over the nose, by the way.
A lot of you have New Years Resolutions. I think it’s wonderful that you want to do something to improve yourself and/or your life. However, I will point out that if it were really important to you, you would not have waited for an arbitrary calendar date. You’d have started working on it right away (or at minimum, started making plans).
There’s been a lot of talk over the last couple decades about SMART goals: a goal that is Specific, Measurable, Achievable, Relevant, and Time constrained. That R (often mislabeled as “reasonable,” and how is that different from achievable?) can also be seen as your Reason for the goal. It’s the “why it’s important,” and arguably the most important part. Why do you want to have a million dollars or lose 30 pounds or earn your degree? That why is what will get you up in the morning to work your goal.
Picture taken by me at Mandalay Bay. I needed a cool picture to start you guys off. I’m going to try and post more regularly this year.
The mandate is broken into three big pieces, which will be addressed individually: government employees, health care workers, and employees of large employers.
Government Employees:
The Federal Government is acting as an employer, not as the government. The courts have long held that it’s ok for an employer to say “no smoking” or “we don’t cover birth control pills.” The courts have also said it’s ok to have requirements for a job. Schools — a specialized “employer” — have required certain vaccines since before I was a small child. That ship has sailed.
Health Care Workers:
The Feds are using their authority under the Centers for Medicare/Medicaid Services Conditions of Participation. They are in essence saying “If you want our money, you must do these things.” Since at least 99% of hospitals receive money from Medicare, Medicaid, or both, effectively all hospitals will be finding ways to comply with this rule once the actual rules are finalized (it’s already a done deal in some states like California). This is another case where the courts spoke years ago and the ship has long since sailed.
There are a few places that think they can legislate or make executive orders to make this go away. Florida’s governor appears to be backing down about a half step, only vowing to fight the mandate for businesses. Texas’s governor not so much. There are teams of hospital lawyers girding up for battle, because hospitals want to get paid and federal regulations overrule states.
The one aspect of this I find interesting is that the mandate as announced (no word on implementation yet) does not appear to have a loophole to regularly test employees that have legitimate medical contraindications to the vaccine. I do have a horse in this race. My building could lose employees if there’s not a loophole. However I’m the sucker who is going to be running a lot of COVID tests if there is.
Large Employers:
Here’s where stuff gets interesting. The rule would require employers with 100 or more employers to mandate vaccines. And there’s a testing loophole. This falls under OSHA. Fun thing about the law creating OSHA, the OSH Act. There’s a part of it called Section 18 that allows states to have their own OSHA rules. There’s your Tenth Amendment compliance right there. Done. However, those rules have to be at least as strong as the federal rules. You can have your state rules, but only if those state rules also include stuff like the vaccine mandate.
The Vaccine Mandate doesn’t violate the Tenth Amendment, stop saying it does.
There’s been a great deal of scare talk about the “far left” and how they’ll create chaos and turn everything evil in this country. I thought I’d share what I believe the actual left stands for. I think you’ll find it not so terrifying. Heck, you might even agree with some of these points.
Police departments don’t need tanks. They don’t need rubber bullets. Defunding means no tank and rubber bullet money. They need to knock and announce themselves before trying to bust your door down. And they should refrain from shooting black people and dogs under the pretext of being scared.
Speaking of What Would Jesus Do: don’t want an abortion or a gay marriage? Don’t have one. Want to prevent abortions? Advocate for better access to birth control, birth defect prevention, and rape prevention.
Almost nobody actually seriously wants to take guns away from law abiding citizens! Yeah, there’s a few crackpots among the left (and among the right too). We do want responsible gun ownership by people who follow and respect both the law and safety rules. That specifically excludes most of the nuts out there showing off or even aiming their weapons in public.
The rule of law is important. Lawmakers who actually work for their constituents are important.
Nobody wants anarchy. Trust me on this. I hope you find this guide helpful.
Yesterday, I received notification that COVID-19 data would be reported to the Department of Health and Human Services instead of the CDC. That change is effective today. This abrupt change was sent to me from the Association for Professionals in Infection Prevention, then confirmed about a half hour later by email from the CDC itself. As an Infection Preventionist, my duties include reporting regularly to the CDC’s National Healthcare Safety Network. Until today, this was the single largest and most accurate repository of infection information in the United States.
Some hours later, the various news services got wind of the change.
Sometimes professionals use words in very specific ways that aren’t obvious. Just the other day I realized that is what happened with those two words. My Facebook friends have seen me very carefully point out articles like these, which suggest than COVID-19 is airborne, rather than droplet. I did this carefully because before yesterday, the WHO and CDC staunchly denied any such thing and today the WHO merely confirms that there is “emerging evidence.” Today I want to explain why it’s different, and a really big deal, in fairly simple terms.
Standard precautions are what we do to protect everybody at all times. This includes keeping your hands clean, using disposable gloves, and changing those gloves between patients. Hand washing is still the most important thing you can do to keep from getting or transmitting any disease. It’s so important the CDC has an entire section on it.
When we know a person has certain infections that could spread, we use Contact precautions. This is for fairly heavy organisms that can survive for a while on surfaces, and that we can inadvertently transport to a new victim on our hands or clothing. One such organism you may have heard of is MRSA, Methicillin Resistant Staphlycoccus Aureus. We also use Contact for more mundane bugs like head lice. For Contact, we make sure to use gloves, treatment gowns to cover our clothing, and we are extra sure to wash our hands after taking our gear off.
Now for the meat of this discussion. Droplet precautions are for organisms that can move in droplets we create when we talk, cough, or sneeze. These droplets can go maybe 6 feet or so (that’s where the 6 feet apart for social distancing comes from) before they go SPLUT! onto a surface. Droplet precautions always includes Contact precautions. That surface can be somebody else’s face, which is why the protective gear for Droplet precautions includes a facemask and ideally eye protection, in addition to gloves and gown. The most common organism for which we use Droplet is the Flu. Remember, up until yesterday, the WHO insisted this was all we needed to protect ourselves from COVID-19. And as of this moment — subject to change without notice — the CDC still does.
By contrast, Airborne precautions are for organisms that can float in the air a long ways and a long time. Much farther than 6 feet. And to do this, they are very small and very lightweight. Examples include Measles, Tuberculosis, and Ebola. These bugs are small enough to get through and around normal surgical masks. These patients should be cared for in a special “negative pressure” hospital room — the HVAC system is designed to create lower air pressure than in surrounding areas while still having fresh air move in and out, so germs aren’t likely to go into the rest of the hospital. To care for these patients, you need special masks, such as N95 or a powered respirator, and they need to fit correctly to prevent germs getting around the edges. That’s over any above gloves, gown, shoe covers, hair covers, and eye/face protection.
As you can see, there’s actually a huge difference between droplet and airborne transmission. And although many experts have privately held that COVID-19 is airborne, its a huge step for the WHO to admit that. I hope the CDC joins them shortly.
