Sadly, we leave this crisis in worse shape, with worse public health literacy, and with a wider gap between haves and have nots. Thanks for offering the strongest information as it unfolded. As a healthcare provider, I will never forget the aggression toward providers. I will never look at a patient or their family the same way again. Innocence lost. Completely.
Problem is persons resistant to useful info about COVID-19, listened to Anti-Vaxxers false info, & COVID-19 isn't "visual" like Rabies, Smallpox, Moneypox, Sexually Transmitted Diseases, Measles, etc.
i don’t trust any of you high paid turds, killing people for money is a crime! big pharma big medicine is the major threat to citizens in this country nothing else except the federal government is even close! shame on you all
@@grider421 During the pandemic, hospitals got _PAID_ for each patient who died from/with/of COVID. It's the most incriminating policy in the history of the United States.
@@Lp78Ch Um, every patient who is admitted to a hospital has their stay paid for by Medicare, Medicaid or health insurance whether they live or die. This is a meaningless accusation of malfeasance by the medical system. I would rather have a socialized medicine system.
Thank you for this entire series. It was our most important source of information during the pandemic. Our only disappointment would be that George Rutherford is not part of this final episode. During the first 18 months of the pandemic he was the contributor who was capable of talking us all down from the ledge on a weekly/monthly basis. For this we are truly grateful.
@@gferraro8353 ua-cam.com/play/PLp2l8GCZXFqSgUfwaResQ7rGwKbGIUi_m.html This link includes many Covid episodes mixed in with other topics. Sadly it seems as if they have removed many of the Covid Grand Rounds from UA-cam.
Thank you . I have been following this program since back in 2020 along with TWIV and JAMA and MedCram. As a nurse, I educated myself and initiated discussions with my husband even before New Year 2020. Working for University hospital really helped too and we got vaccinated early on. We kept working. This year, My father in law finally got infected with SARS COVID 2 this past May , he is in his 70s , he refused the vaccines in the past years, didn’t really believe all about this, and so everyone around him in the family is vaccinated and tried to protect him and he got really sick but was able to overcome it because of Paxlovid. The MD who first saw him even scolded him because he was trying to take hydroxychloroquine….
You are the epitome of medical incompetence. These shots were never intended to protect other people. They are akin to bad cancer drugs. They work, but the side effects are tremendous.
well ivermectin sure worked for me! and i used the horse wormer, my son was sicker than me we both took it and he was better the next day, i never really got sick i took it when the symptoms first started. good stuff
One cannot underestimate how valuable the Covid Grand Rounds have been in the public health response. The timely, accurate, and thoughtful information saved lives and reduced misery.
Just when I thought it was “over” I just found out my 29 year old colleague tested positive doe COVID and was getting better, started to feel bad quickly and she DIED of meningitis within days. We are all stunned. How could this happen?
So sorry. This happened because people develop viral meningitis and die. And it will happen to other people going forward, crushing their families, as it has been for decades. It is a very dangerous illness and can develop after any virus. Again, so very, very sorry.
Cannot thank you enough for this final round-up, and for all these grand rounds have offered throughout the pandemic. If you'd asked me, before the pandemic began, whether I would ever watch something like grand rounds, I would have looked at you as if you were from outer space. That you, Dr. Wachter, offered these out on UA-cam, has been an enormous gift. Thank you so much.
I appreciated being able to watch UCSF Grand Rounds as a retired double boarded MD, in Internal Medicine and Anesthesiology, Thank you. I wonder how to ask Dr Bob Wachter what he would think about doing a Grand rounds on Near Death Experience? There is on Netflix a limited series, "Surviving Death" and i would ask Dr. Wachter to watch the first 10 minutes of the Doctor explaining her Death experience. I would wonder, what a thoughtful , group like UCSF might be able to do with the Science and known information in this area? I would also wonder, why not try and explore, How many of these experiences , can be recorded and explored in 1 year say, at UCSF? How many codes are there and how many survive and of those, are there Near Death Experiences?
A heartful thank you for your years of valuable public service during the acute phase of this historic pandemic. A special shout-out of appreciation to Dr. George Rutherford, UCSF Professor of Epidemiology, whose gruff and clear-headed thinking provided key, insightful guidance during the early years.
Thank you Dr Wachter for such an incredible series on COVID-19. I was curious. I know you all take an oath to "first do no harm". Is there anyway we can get our elected politicians to take a similar oath? It seems to me it would solve a lot of problems.
Our US elected officials/politicians take an oath of office in public ceremony on Bible or Koran. It shouldn't be difficult for elected politicians to keep faithful to their oath of office.
And how many doctors violated that "do no harm" oath during the pandemic? Millions???? I've never seen a bigger group of sorry-@ss losers in my entire life.
Very happy for those of you who feel Covid is no longer a big deal. You forget those of us who have had a seemingly permanent adverse reaction to the vaccines who CANNOT get boosted. For us, caution remains our watchword....along with other at-risk people.
Agreed. Those of us (plus those close to us who know about the life threatening side effects) who are considered, "collateral damage," of the vaccine still value our lives. We need a better vaccine with less collateral damage.
I have appreciated these Grand Rounds for several years and thank Dr Wachter, his guests and the team who put these videos together, especially during that first year, when personal and professional stresses must have been difficult. I am especially grateful for Dr Jetelina and her contributions, particularly regarding pediatric info about Covid when nobody else was talking about the data on kids - she has been a definite high point of these GRs. M Ghandi, on the other hand, with her libertarian views and hostile attitude to vaccination was the low point in the first year of these posts. I was relieved when she stopped appearing on GR and hope to never see her again.
I love seeing leftists devouring each other, like how they threw Monica Gandhi under the bus. Please continue to cancel each other until there is no one left.
@@svm3224 Yes, you are correct. At the very beginning; and when the vaccines came out she even stated that the vaccines were extremely effective. And by the way, Dr Ghandi is/has done tremendous work on HIV-AIDS and for the patient community here in SF. She is to be lauded for that work. I take issue with how she added to public confusion - at a national level - with her statements. I have felt frustrated with her attitude toward mandates and her eventual dismissal of the mRNA vaccines (in her Jan 24, 2022 enewsletter). Wachter gave her huge credibility by including her on GR, perhaps as a collegial gesture to include “many voices” into the discussion-but that only worked in the beginning. It became evident very quickly that Ghandi was creating uncertainty at key points where she disagreed with (UCSF, local, national) public health policy. She tried to apply the way she runs her clinic to a national public health emergency, and it didn’t work. She has sent mixed messages since the beginning of the pandemic, and she has not helped, in my opinion.
VP can't be invited because he'd challenge the covidians religion. MY GOD still masking and think it stops ILLNESS? I haven't masked and don't get sick.
I'm struck by how so many folks - including Kaitlyn right here in this zoom -- when they talk about their choices for themselves emphasize what is right for them - as individuals - versus as members of an interdependent family/kinship group/community where love and/or care is part of the experience. So long as a lot of people - including the people who are the deciders of policy and the leaders of research -- take that view, public health on focused on ANY CHALLENGE - will never truly succeed -- because it is not grounded in an heartfelt sense that we are a group species - interconnected for good and not just bad. I say "heartfelt" because an intellectual understanding is not enough. Knowing you can catch something from the other members of your group might make you pull away from the group and focus on your own individual health - buy more masks, work remotely in the Sierra foothills, buy top quality air filters, all the things I've seen people do through this pandemic -- versus buying masks for others, helping others, making corsi-boxes for others, wearing a mask because it protects others - not just yourself. Knowing you can catch something and pass it on to people you love and/or care about - that's a whole different thing. I have always appreciated Bob's perspective because he talked about his family --- his parent/s, wife, kids, etc - in a way that told me he cares about them, loves them, and makes choices that are grounded in wanting to protect them. Until we want to protect others as much as we want to protect ourselves as individuals, we'll never get that far in so many areas - public health, climate change mitigation, reducing income inequality, etc.
Also, a big thank you to Carlos for talking about the current state of the healthcare system. Over and over and over, I've seen the impact on my friends and family. Long waits and poor care in ERs, hospitals, incredibly difficult to get appointments with docs, etc. I accompanied many people thru health issues during the pandemic -- going with them to the ER or spending time in hospitals for problems other than COVID. I did that prior to the pandemic - and I see a huge difference in level of care pre and post pandemic/2020. And yes, big thank you on discussion of conspiracy crap - and the way it intersects with anti Semitism, misogyny, racism, etc. It's horrendous. And given the the way that isms already work in health care - combine the isms - racism, misogyny, etc. - with existing problems such as poor maternal outcome for Black women - and now add in healthcare worker shortage --- what happens there? It's bad. Really bad.
@@cynthiaeagleton4873 Ugh, you do realize that none of the so-called COVID vaccines are sterilizing???? You can literally go around spreading it to other people even after you got vaccinated. How many people have you killed?
@@cynthiaeagleton4873 I'm recovering from getting COVID for the 1st time. I thought I was prepared, using People's CDC advice section of website "What do do if you Get COVID". However since tested positive Independence Day weekend was unable to go to my doctor. Then thought I did not qualify for Paxlovid since I'm on statins and under 65 without major health problems.Then was able to get telehealth appointment with my PMD who berated me for not getting tested at their clinic or coming in to see her in person. She did not believe I had COVID and after 5 days she can't treat me. I then went and got a PCR test which of course was positive. The testing company included telehealth visit with nurse who was so much more helpful than my own MD.
... and thank you, Dr. Smith, for thanking Dr. Wachter on behalf of those of us lay people who successfully navigated the worst of Covid using the valuable minute-by-minute data and thoughts presented in these Grand Rounds.
Thank you for mentioning the refrigerator trucks, they are embedded in my mind forever and unfortunately forgotten by many. People who deny this was serious I can’t believe they would say that after seeing the refrigerator trucks!
@@christopherrobinson7541 It's mostly medical malpractice, and the _deliberate_ withholding of drugs that actually worked. Early treatment could have saved millions of lives.
@@Lp78Ch Paxlovid needs to be taken within the first couple days. But the mantra you're spewing is for drugs that have zero impact on Covid (ivermectin and hydroxychloroquine). I thought the alt medicine people were supposedly against faked medical studies ... but apparently not.
I have watched each COVID-19 discussion since March 2020. Thank you for your education. This was an amazing final Grand Rounds - great discussion and insights from everyone. 💛
Thank you for bringing up long oovid (LC). Overall, it's a good time to get closer to a sense of "back to normal"; however, LC still needs to be taken into consideration. Also, some people had bad reactions to the vaccine and can't get additional boosters, even if they're eligible and would like to get them.
Trust as an issue: It would help if, for example, my US Representative would answer my emails on COVID-19 related issues (after the auto-reply promises an answer).
a special injections love-in not even one mention of all the people who refused the injections and are now perfectly fine there was one at about 50 mins and it was about how to get them to still now take the injections that they have proven they didn't need thanks, buh-bye
@@ccrider4516 You do realize that "social distancing" was completely made up without any scientific basis????? And, of course, the jabs are non-sterilizing, which means you can have the disease and go around spreading it madly.
Most of the dead and disabled from Covid were unvaccinated. I doubt you listened to a minute of this (or any other) medical presentation, you're just reacting based on your iatrophobia.
@@markrobinowitz8473 WRONG. The latest V-safe data revealed that there were over 10 million SAE's within 10 days of the second COVID shot. You need to stop spewing disinformation.
Bravo! Concerning Public Health (PH) & the CDC... wouldn't it be good to recognize that the CDC (and much of Public Health) did a less than stellar job in many respects and that some reform & improvements are needed? I have really enjoyed this forum (Grand Rounds) for the past 3 years largely because there's a discussion about what we know, what we think & what we don't know. Yes, the problem they (PH) faced was big, but was the power wielded used judiciously? Was the communication done great/ok/poorly? Were changes to policy made promptly as new information came in? Academic study vs PH expeditious response? Sadly, I am of the opinion that PH & particularly the CDC did not rise to these challenges so it's understandable why people don't believe and are not at all interested in continuing to follow. Some examples: ventilation regulatory response? Mask off/on/off... and masks are not a yes/no, but a continuum of goodness. Did we close schools quickly enough or open them up fast enough when different data came in? Prioritizing PCR over antigen tests (Dr Mina made a great case for antigen tests)? Does the CDC even now clearly indicate what they know vs what they think vs what they don't know in language that's usable? I hear you when you say that politically it is difficult to even conceive of a good discussion. Nevertheless, the discussion is needed. Will our political (and PH & CDC) leadership rise to this challenge? Finally, hurray for Mark's positive & hopeful insights!
I agree with your overall assessment of what the CDC could have done better - there we’re certainly some blind spots. Don’t overlook the fact that they were politicized under Trump, which lead to a lot of the administrative sclerosis and incompetence you mention. Things have improved only a little, almost as if the CDC is suffering from PTSD.
Problem for CDC to know how to better explain to the public about why to get a vaccine, how vaccines work, & more information about COVID-19 & how its spread.
Hello everyone I'm Jeff from Taiwan me UCSF medical Grand rounds has provided me with all kinds of important issues and resources during the pandemic due to the pandemic we have the the videos of the grand rounds on UA-cam I would like to know whether we will still post videos of the grounds on youtube when we go back on September thank you
Working from home was great and showing how not everyone can is highly useful, but at the same time, I believe we had pre-vaccine NPIs which would have (and maybe did) help the butcher - distancing and masking. Oh, and of course ventilation. Regarding those with pre-existing conditions, and Dr Mark asking why no one brought it up previously, OMG - WE HAVE BEEN!!!!!!!!!!! Excuse my frustration. And his point that he wants to make sure it was public-facing careers and no pre-existing conditions that harmed people from Covid is a good one, and I'm sure (or I hope) studies have been done.
Equity for all students regardless of background and race is critical, as is the equitable care of patients that occurs more often when practitioners are of all races and backgrounds.
I’m a retired nurse. Have had 5 shots and one mild case of Covid. I could get another booster now but my doctor recommended waiting until the Fall at the earliest. Right now the incidence of Covid is very low.
In Canada, the vaccination rate has been much healthier than in the US for a long time. Most of the "protests" up here were funded and organized by US crazies, not Canadian ones. It would be interesting to study scientifically the differences between the two countries in secondary negative results (to education and economy) from our more adult approach to dealing with COVID.
@@Lp78Ch I'm not sure what you mean. Our death rate per 100,000 is 39% of the rate in the United States. COVID patients in the US are the ones dropping like flies, compared to Canada's. Our vaccination rates have been far better than those in the US for a long time. For the most part, COVID's a health issue in Canada, rather than a political one like it is in the US.
@@bunnyfamcal Please continue to believe your evil government. You live in tyranny and you don't even realize it. You're the frog in a pot of boiling water. By the time you realize it, you're all cooked.
What can I say. I appreciate your input and opinion. Sadly with all resect to your education, these opinions by large I can get from a cleaner in a shopping senter. I think it admirable that you want to analyse and see if something was mishandled and done in a wrong way. My mother taught me to listen to people smarter than I am. You will recognize those by the results. Consequently, please take yourseves out of "public health" discussions as you failed to comperhand it. Do not, I repeat please do not look around because you could find who did something right, and if you have to do that please, please do not try to replicate their methods and achieve their results becuse it might be determental to the spread of the virus. I think it is marvellous that you consider economy and politics and liberty, Multi level aproach is essential for not achieving any meaningful outcome. Looking forward for next episode of brain massage. Excellent use of words" marvellous, incredibe and other superlatives, but if I may you should have inserted few "we know" or "we all know". Follow the numbers.....you know numbers?
The discussion begins by noting the Supreme Court's decision to ban affirmative action for college admissions. And as I watch, a few days later, another similar court prohibits government agencies such as the CDC, NAIAD, the Surgeon General, from communicating with social media platforms about misinformation appearing on them. 🙁
I thought I dodged the virus after all this time. Took all vaccines that were possible for someone my age. Now on Day 10 and struggling with fatigue and horrible brain fog. Ho hum(not). What about the people with long COVID? Glad people aren't dying as much but those with long COVID are the casualties in the zeal to get back to normality.
I think you mean sewage waste. That gets monitored in different communities which have sewers. Many things are monitored in addition to COVID, for example, polio.
Did we know at what tissue temperature did SARS COV2 better replicate? Did that matter? Because If TWiV 659 at min29 virologist Christian Drosten suggest that SARS COV2 better replicate at very low tissue temperature. Did high body temperature protect against Covid19? Did that explain why elderly have high rysk?
I have so much I’d like to say as a physician who took care of COVID pts since March 2020. I have points of agreement and disagreement. 1- I enjoyed watching the grand rounds the last 3 years. Thank you for that. 2 - I’m glad that there’s an admittance that school closures for a very prolonged time is deemed to be a mistake by most of the panelists. We had rapid testing available to us prior to vaccines but we didn’t take Dr Michael Mina’s advice to use them until much later. That’s one thing we could do better in future. 3 - the over politicization of the pandemic on BOTH sides destroyed the trust of the American people in physicians and health organizations. We had conspiracy theorists/misinformation on the right (eg, Plandemic) and had the left (misleading public on post-infection immunity, inflated efficacy of vaccines on transmissibility, mandating LOW risk students to vaccinate /boost when their risk is so low, etc). Both the right and left need to let go of their egos and admit both screwed up big time and made it political. 4- YLE Katelin (sorry if misspelled) posts on her blog were amazing. Love her work. It’s terrible she has to endure attacks on herself. Truly disgusting. I hope she and others like her are safe. 5- I’m not sure why it’s necessary to comment on how “bad” the SCOTUS decision is on affirmative action. It’s like having them (judges/lawyers) comment on efficacy and safety of COVID vaccines. This type of commentary is what makes things divisive and political in our academic institutions. Secondly, SCOTUS still said applicants may write about their experiences (race, socioeconomic etc) in their essays. 6- I agree with the notion that our public health system is extremely fragmented and we need a better system that communicates better. Having different EMRs, little federal authority etc is a big problem. Thankfully we had Israel and other countries to rely on early on. But we need to lead the way next time! Again, thank you for introducing me to your grand rounds. Even though I may disagree with some issues/opinions you have made I still find many aspects educational, informative and enjoyable. Kind regards
How is saying no more affirmative action is “structural racism” and “moving back”. Affirmative action by definition is structural racism. To be clear, I think structural racism exists in other ways (eg, companies hiring interns who worked for free and who probably came from well off whites families in large part). But saying that we should hire, in part, based on race is not racism? What am I missing?
Wake up. The far left has captured all academia, including the liberals at UCSF. My comment is not meant to be politically divisive. It's the truth. ALL the problems came from the left.
Wastewater is the classic "canary in the coal mine", in an inverse response manner. Manage the reservoir, manage the viral vector pathways, manage the disease.
This is the first time I've seen this series. It is interesting and discouraging to see that the doctors are mostly living their lives with the assumption that they will not be among the 10% who get long COVID or another bad outcome, even as they see the outcome of infection among patients. There is little public awareness of Long COVID and how to prevent it (by not getting infected) and that is a huge public health failure. The fact that doctors are relying on waste water and what their circle tells them to give them the heads up on rising levels of infection when that is what public health should be doing is another failure. Do they expect the public to be doing this research? Many think "COVID is over" because media/public health isn't talking about it. Many don't even know how to avoid infection. They are sanitizing their hands instead of wearing N95 masks to avoid an airborne pathogen. They don't know about ventilation and filtration. Some places (public/private) have learned and implemented better ventilation and filtration but I doubt this is as widespread as it needs to be - especially in restaurants. The pandemic continues, people continue to die, there are disparities as to who can get paxlovid to help them, and we are in a "mass disabling event". How many of the heroic healthcare workers have died or were disabled?
What I've read every where on social media - humans don't want to have any more to do with COVID-19, they looked for persons to blame, wanting to assault who were trying to help them. Do we allow human beings to fail when they seem to be making wrong decision about public health?
yeah I read today Dr. Wachter announced on Twitter he came down with COVID! He got dehydrated and fell in the shower and had to go to hospital overnight. Glad I was able to keep hydrated during my current bout.
Heck, even these "scientists" are not aligned with the real science. We've been bombarded with disinformation from day one. "Social distancing" was completely made up--there is not one piece of research demonstrating that it works!!!
Sorry, this is a group-think party that is amazingly non-diverse in perspective. I am not from the right, so please don't dismiss this as feedback from "them." The CDC did a terrible job of directing research where it was needed and left many important questions unanswered and potentially unanswerable. I have had Covid and four Pfizer shots. Each one has gotten me sick for 3 - 4 days. Where is the study showing the current comparison of symptoms from the vaccine vs. symptoms from the illness? What concerns exist related to unknown long term effects of vaccination? Where are the ongoing studies showing emerging excess or reduced mortality? Yes, we are concerned about "long Covid" but what about lack study of long-term outcomes of vaccine recipients. There were so many things that were left undiscussed because of your lack of diverse thinking!
If there is one source for patient communication on this issue it would be Katelyn... Saves the pediatrician, primary care doctor so much time, should have had CME credit for her newsletter.
Dr. Wachter: I hope you're feeling better after your COVID infection and fall! Stay hydrated. I wish my doctor told me that. NP from COVID testing company was the only one to say drink a lot of fluids, rest and take vitamins and zinc since it was too late for me take Paxlovid.
@@addiecoelman1996 Do I know you? I hang around with a bunch of morons at work and half of my clients are clinically retarded. Are you one of those cases?
Our healthcare system is totally incapable of adequate response to infectious diseases, in large part because the people who don't have healthcare will always be a ready reservoir for disease. If you strive to eliminate a ready reservoir you greatly reduce the impact of infectious diseases.
Yes, it amazes me. Not a single legitimate study that says masks have any use, in fact a Cochrane Analysis that says they don't, yet they stick with the same old interventions. This is why nobody trusts public health, because they do not follow the science.
Well it's 2 months later (9/1). Dr Klotman, from Baylor, says over 50% of recent waste water samples have doubled.
Sadly, we leave this crisis in worse shape, with worse public health literacy, and with a wider gap between haves and have nots. Thanks for offering the strongest information as it unfolded. As a healthcare provider, I will never forget the aggression toward providers. I will never look at a patient or their family the same way again. Innocence lost. Completely.
Perhaps this loss of trust was EARNED????? You think???
Problem is persons resistant to useful info about COVID-19, listened to Anti-Vaxxers false info, & COVID-19 isn't "visual" like Rabies, Smallpox, Moneypox, Sexually Transmitted Diseases, Measles, etc.
i don’t trust any of you high paid turds, killing people for money is a crime! big pharma big medicine is the major threat to citizens in this country nothing else except the federal government is even close! shame on you all
@@grider421 During the pandemic, hospitals got _PAID_ for each patient who died from/with/of COVID. It's the most incriminating policy in the history of the United States.
@@Lp78Ch Um, every patient who is admitted to a hospital has their stay paid for by Medicare, Medicaid or health insurance whether they live or die. This is a meaningless accusation of malfeasance by the medical system. I would rather have a socialized medicine system.
Thank you for this entire series. It was our most important source of information during the pandemic. Our only disappointment would be that George Rutherford is not part of this final episode. During the first 18 months of the pandemic he was the contributor who was capable of talking us all down from the ledge on a weekly/monthly basis. For this we are truly grateful.
@@gferraro8353 ua-cam.com/play/PLp2l8GCZXFqSgUfwaResQ7rGwKbGIUi_m.html This link includes many Covid episodes mixed in with other topics. Sadly it seems as if they have removed many of the Covid Grand Rounds from UA-cam.
Thank you .
I have been following this program since back in 2020 along with TWIV and JAMA and MedCram. As a nurse, I educated myself and initiated discussions with my husband even before New Year 2020. Working for University hospital really helped too and we got vaccinated early on. We kept working.
This year, My father in law finally got infected with SARS COVID 2 this past May , he is in his 70s , he refused the vaccines in the past years, didn’t really believe all about this, and so everyone around him in the family is vaccinated and tried to protect him and he got really sick but was able to overcome it because of Paxlovid. The MD who first saw him even scolded him because he was trying to take hydroxychloroquine….
You are the epitome of medical incompetence. These shots were never intended to protect other people. They are akin to bad cancer drugs. They work, but the side effects are tremendous.
well ivermectin sure worked for me! and i used the horse wormer, my son was sicker than me we both took it and he was better the next day, i never really got sick i took it when the symptoms first started. good stuff
One cannot underestimate how valuable the Covid Grand Rounds have been in the public health response. The timely, accurate, and thoughtful information saved lives and reduced misery.
Yuck. UCSF is a joke.
@@Lp78Ch
@@terjeoseberg990 Your mom should have considered abortion.
I agree with you.
Thank you so very much for all you did in such uncertain and bewildering times.
Just when I thought it was “over” I just found out my 29 year old colleague tested positive doe COVID and was getting better, started to feel bad quickly and she DIED of meningitis within days. We are all stunned. How could this happen?
So sorry. This happened because people develop viral meningitis and die. And it will happen to other people going forward, crushing their families, as it has been for decades. It is a very dangerous illness and can develop after any virus. Again, so very, very sorry.
@@Cathy-xi8cb, Is it an immune response problem? Does the immune system malfunction and attack the brain or something?
@@terjeoseberg990 Viral meningitis is from a virus, and bacterial meningitis (more rare) is bacterial. Meningitis is not Long Covid.
I am so sorry to hear this. So young!
@@ccrider4516 What a compassionate question! Really? Is that all you care about?
Glad to hear you feel you can drop back on the Covid Ground round. However, your timing! I just came down with Covid for the 1st time this week!!
Cannot thank you enough for this final round-up, and for all these grand rounds have offered throughout the pandemic. If you'd asked me, before the pandemic began, whether I would ever watch something like grand rounds, I would have looked at you as if you were from outer space. That you, Dr. Wachter, offered these out on UA-cam, has been an enormous gift. Thank you so much.
Thanks so much for every Grand rounds, Dr. They were incredibly helpful throughout the pandemic.
Final?
Final in the planned series, special editions may become available, stay tunned.
I appreciated being able to watch UCSF Grand Rounds as a retired double boarded MD, in Internal Medicine and Anesthesiology, Thank you. I wonder how to ask Dr Bob Wachter what he would think about doing a Grand rounds on Near Death Experience? There is on Netflix a limited series, "Surviving Death" and i would ask Dr. Wachter to watch the first 10 minutes of the Doctor explaining her Death experience. I would wonder, what a thoughtful , group like UCSF might be able to do with the Science and known information in this area? I would also wonder, why not try and explore, How many of these experiences , can be recorded and explored in 1 year say, at UCSF? How many codes are there and how many survive and of those, are there Near Death Experiences?
No audience challenges allowed. Not really a Grand Rounds.
Right after Bob said "it's over", he caught covid, fell in shower, and made it to the headline on CNN.
Karma.
A heartful thank you for your years of valuable public service during the acute phase of this historic pandemic. A special shout-out of appreciation to Dr. George Rutherford, UCSF Professor of Epidemiology, whose gruff and clear-headed thinking provided key, insightful guidance during the early years.
Thank you for these sessions. They have been very helpful. Very appreciated.
Thank you Dr Wachter for such an incredible series on COVID-19. I was curious. I know you all take an oath to "first do no harm". Is there anyway we can get our elected politicians to take a similar oath? It seems to me it would solve a lot of problems.
Our US elected officials/politicians take an oath of office in public ceremony on Bible or Koran. It shouldn't be difficult for elected politicians to keep faithful to their oath of office.
And how many doctors violated that "do no harm" oath during the pandemic? Millions???? I've never seen a bigger group of sorry-@ss losers in my entire life.
Very happy for those of you who feel Covid is no longer a big deal. You forget those of us who have had a seemingly permanent adverse reaction to the vaccines who CANNOT get boosted. For us, caution remains our watchword....along with other at-risk people.
Agreed. Those of us (plus those close to us who know about the life threatening side effects) who are considered, "collateral damage," of the vaccine still value our lives. We need a better vaccine with less collateral damage.
I have been taking a prophylactic approach: Quercetin, zinc, Vitamins C and D, melatonin, NAC, and Xlear nasal spray. Hope that helps!
The vax is the problem not COVID
No one said it wasn’t a big deal or over-start listening at perhaps 6 minutes in.
I have appreciated these Grand Rounds for several years and thank Dr Wachter, his guests and the team who put these videos together, especially during that first year, when personal and professional stresses must have been difficult. I am especially grateful for Dr Jetelina and her contributions, particularly regarding pediatric info about Covid when nobody else was talking about the data on kids - she has been a definite high point of these GRs. M Ghandi, on the other hand, with her libertarian views and hostile attitude to vaccination was the low point in the first year of these posts. I was relieved when she stopped appearing on GR and hope to never see her again.
I love seeing leftists devouring each other, like how they threw Monica Gandhi under the bus. Please continue to cancel each other until there is no one left.
Strange..when I first saw Dr. M Gandhi address Covid issues, she was arguing for vaccine mandates.
@@svm3224 Yes, you are correct. At the very beginning; and when the vaccines came out she even stated that the vaccines were extremely effective.
And by the way, Dr Ghandi is/has done tremendous work on HIV-AIDS and for the patient community here in SF. She is to be lauded for that work. I take issue with how she added to public confusion - at a national level - with her statements.
I have felt frustrated with her attitude toward mandates and her eventual dismissal of the mRNA vaccines (in her Jan 24, 2022 enewsletter). Wachter gave her huge credibility by including her on GR, perhaps as a collegial gesture to include “many voices” into the discussion-but that only worked in the beginning.
It became evident very quickly that Ghandi was creating uncertainty at key points where she disagreed with (UCSF, local, national) public health policy. She tried to apply the way she runs her clinic to a national public health emergency, and it didn’t work. She has sent mixed messages since the beginning of the pandemic, and she has not helped, in my opinion.
Why is this still remote? And where is the balance? Dr Vinay Prasad should have been invited.
VP can't be invited because he'd challenge the covidians religion. MY GOD still masking and think it stops ILLNESS? I haven't masked and don't get sick.
Prasad is not a credible source.
I'm struck by how so many folks - including Kaitlyn right here in this zoom -- when they talk about their choices for themselves emphasize what is right for them - as individuals - versus as members of an interdependent family/kinship group/community where love and/or care is part of the experience. So long as a lot of people - including the people who are the deciders of policy and the leaders of research -- take that view, public health on focused on ANY CHALLENGE - will never truly succeed -- because it is not grounded in an heartfelt sense that we are a group species - interconnected for good and not just bad. I say "heartfelt" because an intellectual understanding is not enough. Knowing you can catch something from the other members of your group might make you pull away from the group and focus on your own individual health - buy more masks, work remotely in the Sierra foothills, buy top quality air filters, all the things I've seen people do through this pandemic -- versus buying masks for others, helping others, making corsi-boxes for others, wearing a mask because it protects others - not just yourself. Knowing you can catch something and pass it on to people you love and/or care about - that's a whole different thing. I have always appreciated Bob's perspective because he talked about his family --- his parent/s, wife, kids, etc - in a way that told me he cares about them, loves them, and makes choices that are grounded in wanting to protect them. Until we want to protect others as much as we want to protect ourselves as individuals, we'll never get that far in so many areas - public health, climate change mitigation, reducing income inequality, etc.
Also, a big thank you to Carlos for talking about the current state of the healthcare system. Over and over and over, I've seen the impact on my friends and family. Long waits and poor care in ERs, hospitals, incredibly difficult to get appointments with docs, etc. I accompanied many people thru health issues during the pandemic -- going with them to the ER or spending time in hospitals for problems other than COVID. I did that prior to the pandemic - and I see a huge difference in level of care pre and post pandemic/2020. And yes, big thank you on discussion of conspiracy crap - and the way it intersects with anti Semitism, misogyny, racism, etc. It's horrendous. And given the the way that isms already work in health care - combine the isms - racism, misogyny, etc. - with existing problems such as poor maternal outcome for Black women - and now add in healthcare worker shortage --- what happens there? It's bad. Really bad.
@@cynthiaeagleton4873 Ugh, you do realize that none of the so-called COVID vaccines are sterilizing???? You can literally go around spreading it to other people even after you got vaccinated. How many people have you killed?
I like the way you put this. The hyper-individualism of the US has really undermined social solidarity and thus the COVID response as well.
@@cynthiaeagleton4873 I'm recovering from getting COVID for the 1st time. I thought I was prepared, using People's CDC advice section of website "What do do if you Get COVID". However since tested positive Independence Day weekend was unable to go to my doctor. Then thought I did not qualify for Paxlovid since I'm on statins and under 65 without major health problems.Then was able to get telehealth appointment with my PMD who berated me for not getting tested at their clinic or coming in to see her in person. She did not believe I had COVID and after 5 days she can't treat me. I then went and got a PCR test which of course was positive. The testing company included telehealth visit with nurse who was so much more helpful than my own MD.
What Have We Learned? Support public health and science !
Yes, they need our support, because all the talking-heads are completely incompetent. They need help, badly.
Viruses don't care about anyone's opinions!
... and thank you, Dr. Smith, for thanking Dr. Wachter on behalf of those of us lay people who successfully navigated the worst of Covid using the valuable minute-by-minute data and thoughts presented in these Grand Rounds.
I really appreciate the continued discussion of the risk of long-COVID.
Thank you for mentioning the refrigerator trucks, they are embedded in my mind forever and unfortunately forgotten by many. People who deny this was serious I can’t believe they would say that after seeing the refrigerator trucks!
It's medical malpractice that killed all those victims. Doctors should be locked up.
Yes, and it was horrible to know you had a relative in one because the funeral business was overwhelmed as well as the county morgues.
@@Lp78Ch It was and is the SARS-CoV-2 virus.
@@christopherrobinson7541 It's mostly medical malpractice, and the _deliberate_ withholding of drugs that actually worked. Early treatment could have saved millions of lives.
@@Lp78Ch Paxlovid needs to be taken within the first couple days. But the mantra you're spewing is for drugs that have zero impact on Covid (ivermectin and hydroxychloroquine). I thought the alt medicine people were supposedly against faked medical studies ... but apparently not.
I have watched each COVID-19 discussion since March 2020. Thank you for your education. This was an amazing final Grand Rounds - great discussion and insights from everyone. 💛
Excellent ideas ...thank you all!
Curious why we're not seeing the usual cast who gave us UCSF updates?
They all took the shots. What do you think happened to them???
Thank you for bringing up long oovid (LC). Overall, it's a good time to get closer to a sense of "back to normal"; however, LC still needs to be taken into consideration. Also, some people had bad reactions to the vaccine and can't get additional boosters, even if they're eligible and would like to get them.
The relative lack of comorbidities in children was a saving grace, which we understood better a year or two into the pandemic.
Trust as an issue: It would help if, for example, my US Representative would answer my emails on COVID-19 related issues (after the auto-reply promises an answer).
Best summary I have seen.
a special injections love-in
not even one mention of all the people who refused the injections and are now perfectly fine
there was one at about 50 mins and it was about how to get them to still now take the injections that they have proven they didn't need
thanks, buh-bye
Awesome!
Bye!
@@ccrider4516 You do realize that "social distancing" was completely made up without any scientific basis????? And, of course, the jabs are non-sterilizing, which means you can have the disease and go around spreading it madly.
Most of the dead and disabled from Covid were unvaccinated. I doubt you listened to a minute of this (or any other) medical presentation, you're just reacting based on your iatrophobia.
@@markrobinowitz8473 WRONG. The latest V-safe data revealed that there were over 10 million SAE's within 10 days of the second COVID shot. You need to stop spewing disinformation.
Bravo!
Concerning Public Health (PH) & the CDC... wouldn't it be good to recognize that the CDC (and much of Public Health) did a less than stellar job in many respects and that some reform & improvements are needed? I have really enjoyed this forum (Grand Rounds) for the past 3 years largely because there's a discussion about what we know, what we think & what we don't know. Yes, the problem they (PH) faced was big, but was the power wielded used judiciously? Was the communication done great/ok/poorly? Were changes to policy made promptly as new information came in? Academic study vs PH expeditious response? Sadly, I am of the opinion that PH & particularly the CDC did not rise to these challenges so it's understandable why people don't believe and are not at all interested in continuing to follow.
Some examples: ventilation regulatory response? Mask off/on/off... and masks are not a yes/no, but a continuum of goodness. Did we close schools quickly enough or open them up fast enough when different data came in? Prioritizing PCR over antigen tests (Dr Mina made a great case for antigen tests)? Does the CDC even now clearly indicate what they know vs what they think vs what they don't know in language that's usable?
I hear you when you say that politically it is difficult to even conceive of a good discussion. Nevertheless, the discussion is needed. Will our political (and PH & CDC) leadership rise to this challenge?
Finally, hurray for Mark's positive & hopeful insights!
I agree with your overall assessment of what the CDC could have done better - there we’re certainly some blind spots. Don’t overlook the fact that they were politicized under Trump, which lead to a lot of the administrative sclerosis and incompetence you mention. Things have improved only a little, almost as if the CDC is suffering from PTSD.
Problem for CDC to know how to better explain to the public about why to get a vaccine, how vaccines work, & more information about COVID-19 & how its spread.
the cdc who etc. are just as corrupt as you! how pathetic you are@@montrealtendencies
@@kathrynsmith3417 The CDC has been completely captured by Big Pharma. Why are you not seeing this? It's really obvious.
Thank you!!
Hello everyone I'm Jeff from Taiwan me UCSF medical Grand rounds has provided me with all kinds of important issues and resources during the pandemic due to the pandemic we have the the videos of the grand rounds on UA-cam I would like to know whether we will still post videos of the grounds on youtube when we go back on September thank you
You've been lied to. All these people do is lie, lie, lie.
Thank you all, but especially Dr. Mark Smith for his insightful non-revisionist comments
Working from home was great and showing how not everyone can is highly useful, but at the same time, I believe we had pre-vaccine NPIs which would have (and maybe did) help the butcher - distancing and masking. Oh, and of course ventilation.
Regarding those with pre-existing conditions, and Dr Mark asking why no one brought it up previously, OMG - WE HAVE BEEN!!!!!!!!!!! Excuse my frustration. And his point that he wants to make sure it was public-facing careers and no pre-existing conditions that harmed people from Covid is a good one, and I'm sure (or I hope) studies have been done.
Equity for all students regardless of background and race is critical, as is the equitable care of patients that occurs more often when practitioners are of all races and backgrounds.
Do you pick your doctor by race, or by ability????
The Eric Topol quote " we need to get smarter, faster" is a better life plan than "ignorance is bliss"?!
I’m a retired nurse. Have had 5 shots and one mild case of Covid. I could get another booster now but my doctor recommended waiting until the Fall at the earliest. Right now the incidence of Covid is very low.
In Canada, the vaccination rate has been much healthier than in the US for a long time. Most of the "protests" up here were funded and organized by US crazies, not Canadian ones. It would be interesting to study scientifically the differences between the two countries in secondary negative results (to education and economy) from our more adult approach to dealing with COVID.
Gee, the "adults" in the room are dropping like flies. I wonder why.
@@Lp78Ch I'm not sure what you mean. Our death rate per 100,000 is 39% of the rate in the United States.
COVID patients in the US are the ones dropping like flies, compared to Canada's. Our vaccination rates have been far better than those in the US for a long time. For the most part, COVID's a health issue in Canada, rather than a political one like it is in the US.
@@bunnyfamcal Please continue to believe your evil government. You live in tyranny and you don't even realize it. You're the frog in a pot of boiling water. By the time you realize it, you're all cooked.
@@bunnyfamcal The worst province death rate in Canada is comparable to the best death rate for any US state.
@@markrobinowitz8473 Comparing made-up data by incompetent scientists is what "science" is all about.
What can I say. I appreciate your input and opinion. Sadly with all resect to your education, these opinions by large I can get from a cleaner in a shopping senter. I think it admirable that you want to analyse and see if something was mishandled and done in a wrong way. My mother taught me to listen to people smarter than I am. You will recognize those by the results. Consequently, please take yourseves out of "public health" discussions as you failed to comperhand it. Do not, I repeat please do not look around because you could find who did something right, and if you have to do that please, please do not try to replicate their methods and achieve their results becuse it might be determental to the spread of the virus. I think it is marvellous that you consider economy and politics and liberty, Multi level aproach is essential for not achieving any meaningful outcome. Looking forward for next episode of brain massage. Excellent use of words" marvellous, incredibe and other superlatives, but if I may you should have inserted few "we know" or "we all know". Follow the numbers.....you know numbers?
That was quite the alcohol fueled rant!
@@Patrick_Ross
The discussion begins by noting the Supreme Court's decision to ban affirmative action for college admissions. And as I watch, a few days later, another similar court prohibits government agencies such as the CDC, NAIAD, the Surgeon General, from communicating with social media platforms about misinformation appearing on them. 🙁
So?
I thought I dodged the virus after all this time. Took all vaccines that were possible for someone my age. Now on Day 10 and struggling with fatigue and horrible brain fog. Ho hum(not). What about the people with long COVID? Glad people aren't dying as much but those with long COVID are the casualties in the zeal to get back to normality.
Seek help from the good folks at FLCCC.
@@Lp78Ch
@@noellegillies2874 Or not. Continue to suffer for as long as possible.
@@Lp78Ch have a nice day
Without local data on current infection rates, where can we get the groundwater information? We were told "we have the tools". We need this tool.
I think you mean sewage waste. That gets monitored in different communities which have sewers. Many things are monitored in addition to COVID, for example, polio.
BE WISE...WEAR N95....PREVENT INFECTIONS. GOOD LUCK. FALL AND WINTER WILL BE THE NEXT TEST. GODBLESS.
Texas making the right call to leave schools open was likely not due to any real thought on the matter, but just dumb luck.
Did we know at what tissue temperature did SARS COV2 better replicate?
Did that matter?
Because If TWiV 659 at min29 virologist Christian Drosten suggest that SARS COV2 better replicate at very low tissue temperature.
Did high body temperature protect against Covid19?
Did that explain why elderly have high rysk?
I have so much I’d like to say as a physician who took care of COVID pts since March 2020. I have points of agreement and disagreement.
1- I enjoyed watching the grand rounds the last 3 years. Thank you for that.
2 - I’m glad that there’s an admittance that school closures for a very prolonged time is deemed to be a mistake by most of the panelists. We had rapid testing available to us prior to vaccines but we didn’t take Dr Michael Mina’s advice to use them until much later. That’s one thing we could do better in future.
3 - the over politicization of the pandemic on BOTH sides destroyed the trust of the American people in physicians and health organizations. We had conspiracy theorists/misinformation on the right (eg, Plandemic) and had the left (misleading public on post-infection immunity, inflated efficacy of vaccines on transmissibility, mandating LOW risk students to vaccinate /boost when their risk is so low, etc). Both the right and left need to let go of their egos and admit both screwed up big time and made it political.
4- YLE Katelin (sorry if misspelled) posts on her blog were amazing. Love her work. It’s terrible she has to endure attacks on herself. Truly disgusting. I hope she and others like her are safe.
5- I’m not sure why it’s necessary to comment on how “bad” the SCOTUS decision is on affirmative action. It’s like having them (judges/lawyers) comment on efficacy and safety of COVID vaccines. This type of commentary is what makes things divisive and political in our academic institutions. Secondly, SCOTUS still said applicants may write about their experiences (race, socioeconomic etc) in their essays.
6- I agree with the notion that our public health system is extremely fragmented and we need a better system that communicates better. Having different EMRs, little federal authority etc is a big problem. Thankfully we had Israel and other countries to rely on early on. But we need to lead the way next time!
Again, thank you for introducing me to your grand rounds. Even though I may disagree with some issues/opinions you have made I still find many aspects educational, informative and enjoyable.
Kind regards
How is saying no more affirmative action is “structural racism” and “moving back”. Affirmative action by definition is structural racism.
To be clear, I think structural racism exists in other ways (eg, companies hiring interns who worked for free and who probably came from well off whites families in large part). But saying that we should hire, in part, based on race is not racism? What am I missing?
Wake up. The far left has captured all academia, including the liberals at UCSF. My comment is not meant to be politically divisive. It's the truth. ALL the problems came from the left.
Wastewater is the classic "canary in the coal mine", in an inverse response manner. Manage the reservoir, manage the viral vector pathways, manage the disease.
This is the first time I've seen this series. It is interesting and discouraging to see that the doctors are mostly living their lives with the assumption that they will not be among the 10% who get long COVID or another bad outcome, even as they see the outcome of infection among patients. There is little public awareness of Long COVID and how to prevent it (by not getting infected) and that is a huge public health failure. The fact that doctors are relying on waste water and what their circle tells them to give them the heads up on rising levels of infection when that is what public health should be doing is another failure. Do they expect the public to be doing this research? Many think "COVID is over" because media/public health isn't talking about it. Many don't even know how to avoid infection. They are sanitizing their hands instead of wearing N95 masks to avoid an airborne pathogen. They don't know about ventilation and filtration. Some places (public/private) have learned and implemented better ventilation and filtration but I doubt this is as widespread as it needs to be - especially in restaurants.
The pandemic continues, people continue to die, there are disparities as to who can get paxlovid to help them, and we are in a "mass disabling event". How many of the heroic healthcare workers have died or were disabled?
What I've read every where on social media - humans don't want to have any more to do with COVID-19, they looked for persons to blame, wanting to assault who were trying to help them. Do we allow human beings to fail when they seem to be making wrong decision about public health?
You do realize most of the damage was caused by the mRNA shots.
yeah I read today Dr. Wachter announced on Twitter he came down with COVID! He got dehydrated and fell in the shower and had to go to hospital overnight. Glad I was able to keep hydrated during my current bout.
It's not so much that people are anti-science, but rather that the government narrative doesn't always align with the science.
Heck, even these "scientists" are not aligned with the real science. We've been bombarded with disinformation from day one. "Social distancing" was completely made up--there is not one piece of research demonstrating that it works!!!
Sorry, this is a group-think party that is amazingly non-diverse in perspective. I am not from the right, so please don't dismiss this as feedback from "them." The CDC did a terrible job of directing research where it was needed and left many important questions unanswered and potentially unanswerable. I have had Covid and four Pfizer shots. Each one has gotten me sick for 3 - 4 days. Where is the study showing the current comparison of symptoms from the vaccine vs. symptoms from the illness? What concerns exist related to unknown long term effects of vaccination? Where are the ongoing studies showing emerging excess or reduced mortality? Yes, we are concerned about "long Covid" but what about lack study of long-term outcomes of vaccine recipients. There were so many things that were left undiscussed because of your lack of diverse thinking!
If there is one source for patient communication on this issue it would be Katelyn... Saves the pediatrician, primary care doctor so much time, should have had CME credit for her newsletter.
“At humility, I’m the greatest!” Bullwinkle J. Moose
Are they part of the problem? We are being lied t
We learned that a lot of Americans are incredibly stew pid.
Especially those who _willingly_ took the injections without doing their own research! So many morons with "jabber's remorse."
Dr. Wachter: I hope you're feeling better after your COVID infection and fall! Stay hydrated. I wish my doctor told me that. NP from COVID testing company was the only one to say drink a lot of fluids, rest and take vitamins and zinc since it was too late for me take Paxlovid.
Wachter lied all through the "pandemic" and caused endless suffering. Perhaps this is karma's way of getting even with him.
The only thing to fear is fear itself....this fear is useless
It seems like these "experts" got their Ph.D. in fearmongering!!
@@Lp78Ch says the troll who routinely spreads fear and gossip
@@addiecoelman1996 Do I know you? I hang around with a bunch of morons at work and half of my clients are clinically retarded. Are you one of those cases?
Our healthcare system is totally incapable of adequate response to infectious diseases, in large part because the people who don't have healthcare will always be a ready reservoir for disease. If you strive to eliminate a ready reservoir you greatly reduce the impact of infectious diseases.
This is really funny. Nothing more one can say.
ArtemiC Rescue and Support helped make my Long dissapear after 9 days.
Wear your mask. Forever.
Yes, it amazes me. Not a single legitimate study that says masks have any use, in fact a Cochrane Analysis that says they don't, yet they stick with the same old interventions. This is why nobody trusts public health, because they do not follow the science.
Its really hard getting peo back to work when they've been off working/school for so long...that was our mistake...
No, it's hard to find workers because they are dead or badly injured by the medical countermeasures.
Thank you very much!