Chuckles of the Day




A woman went to the doctors office. She was seen by one of the new doctors, but after about 4 minutes in the examination room, she burst out and ran down the hall screaming. An older doctor stopped her and asked her what the problem was, and she explained. After listening, he had her sit down and relax in another room.

The older doctor marched back to the first and demanded, “What’s the matter with you? Mrs. Terry is 63 years old, she has four grown children and seven grandchildren, and you told her she was pregnant?”

The new doctor continued to write on his clipboard and said, “Does she still have the hiccups?”

* * * * * * *

Father O’Neal answers the phone.

“Hello, is this Father O’Neal?”

“It tis!”

“This is the IRS. Can you help us?”

“I can!”

“Do you know a Sean Flanders?”

“I do!”

“Is he a member of your congregation?”

“He is!”

“Did he donate $10,000 to the church?”

“He will!”




New Studies Find Evidence Of ‘Superhuman’ Immunity To COVID-19 In Some Individuals

Michaeleen Doucleff wrote . . . . . . . . .

Some scientists have called it “superhuman immunity” or “bulletproof.” But immunologist Shane Crotty prefers “hybrid immunity.”

“Overall, hybrid immunity to SARS-CoV-2 appears to be impressively potent,” Crotty wrote in commentary in Science back in June.

No matter what you call it, this type of immunity offers much-needed good news in what seems like an endless array of bad news regarding COVID-19.

Over the past several months, a series of studies has found that some people mount an extraordinarily powerful immune response against SARS-CoV-2, the coronavirus that causes the disease COVID-19. Their bodies produce very high levels of antibodies, but they also make antibodies with great flexibility — likely capable of fighting off the coronavirus variants circulating in the world but also likely effective against variants that may emerge in the future.

Immunity To COVID-19 Could Last Longer Than You’d Think

“One could reasonably predict that these people will be quite well protected against most — and perhaps all of — the SARS-CoV-2 variants that we are likely to see in the foreseeable future,” says Paul Bieniasz, a virologist at Rockefeller University who helped lead several of the studies.

In a study published online last month, Bieniasz and his colleagues found antibodies in these individuals that can strongly neutralize the six variants of concern tested, including delta and beta, as well as several other viruses related to SARS-CoV-2, including one in bats, two in pangolins and the one that caused the first coronavirus pandemic, SARS-CoV-1.

“This is being a bit more speculative, but I would also suspect that they would have some degree of protection against the SARS-like viruses that have yet to infect humans,” Bieniasz says.

So who is capable of mounting this “superhuman” or “hybrid” immune response?

People who have had a “hybrid” exposure to the virus. Specifically, they were infected with the coronavirus in 2020 and then immunized with mRNA vaccines this year. “Those people have amazing responses to the vaccine,” says virologist Theodora Hatziioannou at Rockefeller University, who also helped lead several of the studies. “I think they are in the best position to fight the virus. The antibodies in these people’s blood can even neutralize SARS-CoV-1, the first coronavirus, which emerged 20 years ago. That virus is very, very different from SARS-CoV-2.”

In fact, these antibodies were even able to deactivate a virus engineered, on purpose, to be highly resistant to neutralization. This virus contained 20 mutations that are known to prevent SARS-CoV-2 antibodies from binding to it. Antibodies from people who were only vaccinated or who only had prior coronavirus infections were essentially useless against this mutant virus. But antibodies in people with the “hybrid immunity” could neutralize it.

These findings show how powerful the mRNA vaccines can be in people with prior exposure to SARS-CoV-2, she says. “There’s a lot of research now focused on finding a pan-coronavirus vaccine that would protect against all future variants. Our findings tell you that we already have it.

“But there’s a catch, right?” she adds: You first need to be sick with COVID-19. “After natural infections, the antibodies seem to evolve and become not only more potent but also broader. They become more resistant to mutations within the [virus].”

Hatziioannou and colleagues don’t know if everyone who has had COVID-19 and then an mRNA vaccine will have such a remarkable immune response. “We’ve only studied the phenomena with a few patients because it’s extremely laborious and difficult research to do,” she says.

But she suspects it’s quite common. “With every single one of the patients we studied, we saw the same thing.” The study reports data on 14 patients.

Several other studies support her hypothesis — and buttress the idea that exposure to both a coronavirus and an mRNA vaccine triggers an exceptionally powerful immune response. In one study, published last month in The New England Journal of Medicine, scientists analyzed antibodies generated by people who had been infected with the original SARS virus — SARS-CoV-1 — back in 2002 or 2003 and who then received an mRNA vaccine this year.

Remarkably, these people also produced high levels of antibodies and — it’s worth reiterating this point from a few paragraphs above — antibodies that could neutralize a whole range of variants and SARS-like viruses.

Now, of course, there are so many remaining questions. For example, what if you catch COVID-19 after you’re vaccinated? Or can a person who hasn’t been infected with the coronavirus mount a “superhuman” response if the person receives a third dose of a vaccine as a booster?

Hatziioannou says she can’t answer either of those questions yet. “I’m pretty certain that a third shot will help a person’s antibodies evolve even further, and perhaps they will acquire some breadth [or flexibility], but whether they will ever manage to get the breadth that you see following natural infection, that’s unclear.”

Immunologist John Wherry, at the University of Pennsylvania, is a bit more hopeful. “In our research, we already see some of this antibody evolution happening in people who are just vaccinated,” he says, “although it probably happens faster in people who have been infected.”

In a recent study, published online in late August, Wherry and his colleagues showed that, over time, people who have had only two doses of the vaccine (and no prior infection) start to make more flexible antibodies — antibodies that can better recognize many of the variants of concern.

So a third dose of the vaccine would presumably give those antibodies a boost and push the evolution of the antibodies further, Wherry says. So a person will be better equipped to fight off whatever variant the virus puts out there next.

“Based on all these findings, it looks like the immune system is eventually going to have the edge over this virus,” says Bieniasz, of Rockefeller University. “And if we’re lucky, SARS-CoV-2 will eventually fall into that category of viruses that gives us only a mild cold.”

Source : NPR

Halloween Donuts of Mister Donut in Japan

Triage Protocols Made Public by Alberta Health Services

Jay Rosove wrote . . . . . . . . .

The term “triage” may be a scary one to hear, but Alberta’s health authorities are preparing its staff and the public for the possibility of that extreme measure.
When triage is declared health officials must decide which critically ill patients are eligible to receive care and which are not.

A 52-page document outlining how life and death decisions will be made if the province’s health-care system is overwhelmed past its breaking point has been posted publicly by Alberta Health Services.

The framework for the critical care triage protocol in Alberta describes the procedure that will be put into place when all available resources and mitigating steps for critical care have been exhausted.

“We’ve started the educational process,” AHS CEO Dr. Verna Yiu told reporters on Thursday.

According to the AHS triage framework, the decision to activate the protocol would be up to Dr. Yiu, “in consultation with the AHS Executive Leadership Team.”

“Basically this week was really sharing with our staff about what it is,” said Dr. Yiu, “and really setting up the infrastructure in place so that we – if we had to use it, again this would be an absolute, absolute last resort – that the staff are ready and trained and prepared.”

According to the AHS document, the critical care triage protocols are designed to “create an objective process to guide health-care professionals in making difficult determination of how to allocate resources to critically ill adult and pediatric patients when there are not enough critical care resources for everyone.”

WHEN TRIAGE MEASURES CAN BE TRIGGERED IN ALBERTA

The framework divides the province-wide triage measures into two possible phases, based on the severity of surging volumes of critical care patients.

When the usual number of critically ill patients is exceeded, and all available critical care surge beds is at 90 per cent or greater, the AHS triage guidelines state that should be considered a “Major Surge” and “Phase 1 Triage may be required.”

According to the AHS framework, Phase 1 triage would mean “eligibility assessment for entry into critical care are based on one year expected mortality of approximately greater than 80 per cent.”

In other words, the greater your likelihood of survival, the better chances you have of receiving care.

Phase 1 triage would not affect pediatric patients, however Phase 2 would.

The triage guidelines state that Phase 2 may be required in the event of a “Large Scale Surge.”

According to the framework, a large scale surge is when “critically ill patient demand exceeds available capacity and human resources,”

“All feasible strategies to maximize staffing resources, staffing functions, supplies and equipment and access to invasive mechanical ventilation will have been used prior to initiation of this triage phase,” the document reads. “Provincial occupancy of available critical care surge beds is 95 per cent or greater.”

In a Phase 2 triage scenario patients would receive eligibility assessments, and current critical care patients would receive a “discontinuation assessment.”

When the triage protocol is active, consent from patients or their families would not be required to withhold or withdraw care.

Vaccination status will not be a consideration on whether a patient is treated.

HOW CLOSE IS ALBERTA TO ACTIVATING TRIAGE?

Dr. Neeja Bakshi, a general internist with primary inpatient practice at Edmonton’s Royal Alexandra Hospital, told CTV News Edmonton on Friday she believes the province’s ICUs could “potentially” be overrun within the next 12 to 14 days.

“Whether or not that’s to be the time we have that means that’s going to be the time we have to enact the protocol is a bit of a moving target,” said Dr. Bakshi. “It depends on resources and how much we can try to do within the current system.”

“This is also why we are starting to educate the folks that might be involved in the triage protocols right now.”

As the fourth wave of COVID-19 surges across Alberta, the province has begun to implement extraordinary measures to make room for the daily average of 20 new patients being admitted into the province’s ICUs.

While Ontario has agreed to accept patients from Alberta, Dr. Yiu said on Thursday that AHS is also in conversation with other provinces about sending patients if needed as well.

‘We need to bend that curve’: Alberta could transfer ICU patients to Ontario as hospitalizations near 900
According to AHS, field hospitals in Edmonton and Calgary have also been prepared.

When asked about triage protocols and ICU care rationing, Dr. Yiu stopped short of making any predictions.

“From our perspective the numbers are changing daily and almost hourly… Things that were projected from last week already (are not) accurate this week,” she said. “It’s related to the fact that we are continuing to find additional capacity.

“But it comes at a cost. And that cost is that when we start reducing the procedures and postponing procedures. That’s how we’re finding a lot of the capacity.”

The AHS CEO stressed the importance of getting every eligible Albertan vaccinated in order to avoid extreme measures like triage.

“I just can’t say enough how important it is for Albertans to go out and get vaccinated,” she said.

On Friday, the province announced 80 per cent, or more than 3.1 million of eligible Albertans, have received at least one dose of a COVID-19 vaccine.

Alberta has 310 ICU beds including 137 surge beds, Dr. Yiu said. Eighty-six per cent of those beds are occupied – largely by COVID-19 patients.

Dr. Yiu said the province currently has over 600 ventilators and an additional 200 “less than optimal ventilators,” which “could be used.”

According to the province, there are 911 hospitalizations due to COVID-19 with 215 of those in ICUs, as of Friday.

Alberta has 19,201 active cases of COVID-19.

The province has seen 2,523 deaths related to COVID-19.

Source : CTV


Read more at Alberta Health Services

Critical Care Triage during Pandemic or Disaster – A Framework for Alberta . . . . .

Vegan Fried Rice Bowl with Baked Tofu

Ingredients

1 package (14-ounce) extra-firm tofu, drained
2 tablespoons tamari
1 tablespoon apple cider vinegar
1 tablespoon olive oil
1 tablespoon maple syrup
1 tablespoon Dijon mustard
1/8 teaspoon salt
1/8 teaspoon pepper
3 tablespoons tamari
1/4 cup hoisin sauce
3 tablespoons rice wine vinegar
3 cloves garlic, minced
2 teaspoons ground ginger
1 teaspoon sriracha
1 tablespoon peanut oil
1 cup chopped cabbage
½ red bell pepper, seeded and diced
1 cup snow peas, halved
3 scallions, diced
1/2 cup peas
4 cups cooked brown rice
1 teaspoon sesame oil and 3 tablespoons white sesame seeds to garnish

Method

  1. For the tofu, press for 20 minutes, then cut into bite-size cubes. In a shallow bowl, place tofu cubes. In a separate medium bowl, whisk together tamari, vinegar, oil, maple syrup, mustard, salt, and pepper. Pour over tofu and toss well to ensure all cubes are covered. Refrigerate for 20 minutes, tossing again after 10 minutes.
  2. Preheat oven to 375 degrees. Line a rimmed baking sheet with parchment paper.
  3. Remove tofu from marinade and place in a single layer on prepared baking sheet. Bake for 25 minutes, flipping every 10 minutes until golden brown, crispy on edges, and chewy in center. Immediately sprinkle with salt and pepper while still hot.
  4. In a small bowl, whisk tamari, hoisin, vinegar, garlic, ginger, and sriracha, and set aside.
  5. In a skillet over medium-high heat, warm oil and add cabbage, bell pepper, and snow peas. Cook for 3 minutes, stirring frequently, until vegetables start to soften.

  6. Add scallions and peas and cook for 1 minute while stirring.
  7. Add sauce to vegetables and stir to coat. Add rice and stir until evenly coated in sauce. Cook for 4 minutes to heat through.
  8. To serve, divide fried rice among 6 bowls. Top with tofu, a few dashes of sriracha, sesame oil, and sesame seeds.

Makes 6 servings.

Source: Veg News magazine


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