thinking of you wintertell!! i hope all is well!
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ā Thus, in two large cohorts, Black patients had nearly three times the frequency of occult hypoxemia that was not detected by pulse oximetry as White patients. ā This is substantially important to how we approach medical treatment of covid in people of color. Holy crap.
(Less medicalized language interpretation: because the devices we use to approximately measure how well someone is circulating oxygen around their body are calibrated to white skin, we frequently miss hidden (no symptoms) low oxygen states in black patients. At three times the rate of white patients.)
Eta also- Another issue- weāre telling black patients to come in if their lips or nail beds turn blue. Black skin doesnāt turn noticeably blue when deoxygenated. 
dangerous discharge/triage instructions.
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My aunt (lives with me) is on the list to get the COVID vaccine in Feb! Rest of house has to wait til June, but she at least can experience more freedom and peace of mind soon 
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The whole family is getting tested tomorrow on. Day 5 of exposure. Really not looking forward to it. But regardless, you have to quarantine the whole time because you could be the unlucky one with a longer time before it presents itself outside of that 5-7 window.
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Hnnnnngh. Racism fucking sucks.
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The worst part is how HARD it is as a medical worker to learn about this stuff, relative to other continuing education. I literally have to follow random Instagram accounts for this sort of thing. Iām not learning this through medscape and so on, generally. Thatā¦ is not okay.
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It is definitely not okay.
Also, thank you for randomly following IG accounts and for sharing with us here.
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Oh. But beyond complaining. An ask. If anyone has medical worker friends or relatives, please pass relevant education on to them if your relationship allows? Iām not seeing this through mainstream CE channels yet. And beyond that, keep the knowledge in your back pocket in case youāre in a position to advise anyone on seeking treatment. Triage nurses may not know best in this case 
the racial gap in covid outcomes is insane.
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+1 Knowedge is power!
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Another ask, can anyone help me find resources in detecting particularly occult (hidden) deoxygenation in POC? I need to improve my education on this, and also have a couple receptive nurses I would like to pass resources onto as well if I can find them. Ty.
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Oooof. Iām not in the medical field but have good searchfu (literally my job), and Iām doing some Google searches and not doing well. The best Iām finding so far in a quick set of searching is some discussion around pulse oximetry in sickle cell patients (like this or like this).
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Yeah this is all Iāve found so far:
(CW: sexual assault care)
This is a depressing research process. This should not be THIS hard to find.
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Yeah, so much research is based on whites, or even just white men, and that really affects results for other people!
Quality of care is a big driver of differences in medical outcomes between various groups.
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From a friend who got the shot yesterday:
āUpdate: woke up with a headache (though this is common for me) and my arm is sore today (like a tetanus shot). Feel fine otherwise!ā
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CDC recently added an option for shortening quarantine to 7 days, if you test negative on day 5 or after, and remain asymptomatic: https://www.cdc.gov/coronavirus/2019-ncov/more/scientific-brief-options-to-reduce-quarantine.html
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More personal experience updates from getting the shot. I donāt know if these help anyone, but I find it interesting and somewhat comforting 
I can stop sharing them if people would like though!
From a mom group friend:
So after 24 hours my only side effects have been arm tenderness at the injection site and muscle pain. It was bad enough to take Tylenol throughout the day. Other than that I feel good.
From a sister of a friend:
I had mild-moderate arm pain for 36 hours, since resolved. The only other serious #SideEffect is feeling a little more protected against a deadly virus. 5/5 stars, would recommend.
Eta donāt remember if I shared my nurse friend/former coworkers update:
woke up with a headache (though this is common for me) and my arm is sore today (like a tetanus shot). Feel fine otherwise!
Eta2: another nurse friends update.
Ahem: I received the covid vaccine on Wednesday. Had a sore injection site yesterday.
No soreness today! Absolutely no symptoms 
#ibelieveinscience
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So I have covid. The details are in my journal, but I came here to add a note about tests.
My rapid test was positive. My husbandās PCR test the same day was negative. We have the same symptoms so this seemed fishy and I started reading about false negative rates. I had been told during my October hospital stay that the rapid antigen tests were reliable for positives but had up to a 30% false negative rate.
But apparently even PCR tests, which are more reliable, can have false negative rates (up to 20%) depending on quality of execution: https://www.health.harvard.edu/blog/which-test-is-best-for-covid-19-2020081020734
Hypothesis
That means a negative test is not a guaranteed all-clear. It is one part of the overall strategy. I suspect many accidental transmissions have happened when someone gets a negative test result and assumes itās foolproof. Especially with infection rates at such peaks in the US, even 5-30% of a big number is still a really freaking big number.
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Iām really sorry this is happening.
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There have also been false positives with the rapid antigen tests:
If testing is easily available where you are, especially if the community incidence is low (which it is NOT almost everywhere in the USA right now), the FDA suggests a confirmatory PCR within 48h.
BUT, with so much covid in the community, plus symptoms, even if a PCR is negative, thereās STILL a good chance you have covid because of the false negative rates with PCR, as you said, and it might be impossible to know for sure.
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This is really alarming, since you canāt necessarily rely on clinical indicators like work of breathing or shortness of breath in covid. There are all these patients who look and feel completely fine, and itās only when you throw the pulse ox on, you see theyāre hypoxic. And pulse ox is less reliable in black & brown people.
I donāt know what to do about this. Except to fix our medical equipment, which obviously canāt be done overnight.
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