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Comment by standardUser | Hacker News Reader

"First, anyone coming to work on our campuses will need to be vaccinated. We’re rolling this policy out in the U.S. in the coming weeks and will expand to other regions in the coming months."

This is the trend in the last couple weeks among many companies and governments. It's just a shame the need for this wasn't realized 2-3 months ago. We could be far ahead of where we are today if more entities had been more aggressive about vaccine mandates. It almost feels like we're feigning collective surprise that a big chunk of Americans decided to take a staunchly anti-science, anti-medicine, anti-rationality stance. In reality, I think most of us saw this coming a mile away.

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It almost feels like we're feigning collective surprise that a big chunk of Americans decided to take a staunchly skeptical stance against big government and big media hysteria and fear-pumping and make their own decisions based on their personal risk tolerance and waiting to see how things actually play out. I don't know about most of us, but I saw this coming a mile away.

Around 99% of hospitalizations are among the unvaccinated, which means we are now seeing hundreds of deaths everyday from a preventable illness.

There are hundreds of deaths everyday from many preventable causes, we generally don't force people to take medications or change their lifestyle to reduce them.

"Preventable causes" are very different form "preventable illnesses". Avoiding a heart attack requires decades of actions and decisions. Avoiding polio requires one shot once.

In the developed world, not many people die from diseases that are preventable by vaccine. Well, until now.

One argument that got thrown around a lot was that people in the hospital with COVID are taking medical resources away from others. You could make the same argument for people who choose to drink, smoke, remain obese, sedentary, have untreated diabetes or other chronic conditions that will eventually put them in the hospital needing a lot of very expensive care.

Those conditions don't overwhelm hospital capacity because they don't produce exponential growth of illness, so I don't think you could make the same argument.

I can name dozens of lifestyle choices you're forbidden from doing due to risk to yourself and others.

Sadly my favorite past-time - driving tanks into office buildings - was outlawed by "big government". /s

Yes because those causes usually dont affect others. With COVID, those unvaccinated people create a breeding ground for new even stronger variants of COVID that could kill millions more. Or force us to go back to quarantine even longer. If you are hell bent on risking your own life, fine, but your liberty ends where mine begins.

These kind of hyper libertarian arguments always just conveniently ignore everyone except the person making them. We allow smoking because it's your choice but not in public places because that hurts others. We have speed limits because your liberty to drive at 120 ends when it endangers other drivers. We have no restrictions on how much fast food you can eat because it does not impact anyone else.

Huh I didn't know the obese were no longer a heavy weight on the cost, availability and quality of healthcare. Good to know! Looking forward to my insurance premiums coming down once you pass that info to the insurance companies and socialized gov medicine!

Wait so now you ARE in favor of restricting the liberty of those who eat fast food because it costs you???? Which is it liberty for all or just liberty as long it doesn't cost you a cent?

Letting a contagious pandemic rage in your country is not exactly good for national security reasons.

It's actually 97% [1] and from anecdata from a friend there is at least one hospital where unvaccinated COVID hospitalizations is as low as 90% (and I want emphasize the obvious that it means 10% of hospitalized COVID patients are vaccinated).

[1] https://www.npr.org/2021/07/16/1017012853/97-of-people-enter...

Why is that surprising? If 100% of the population were vaccinated, 100% of the hospitalized would be vaccinated too.

More plausibly, suppose the vaccine is 90% effective against severe disease and 60% of the population is vaccinated. Then you'd have 6/46ths of the hospitalizations (15% roughly) coming from the vaccinated.

Effectiveness against severe symptoms is what matters the most (and effectiveness against transmission comes second). As long as the maths confirm the effectiveness of the vaccination, having a number of vaccinated people in hospitals is expected. A 90% effectiveness corresponds to having your ICU beds magically multiplied by 10, which is nothing to sneeze about.

That figure seems questionable.

1) high cycle PCR tests tend to produce false positives. [0]

2) recently (maybe now?) the CDC was recommending that the cycle count be lowered for vaccinated individuals (break through cases). [1]

If unvaccinated individuals are being tested to a different standard, that would seem to muddy the waters, wouldn't it?

[0] https://medicine.yale.edu/labmed/sections/virology/COVID-19%...

[1] https://web.archive.org/web/20210623005911/https://www.cdc.g...

I posted this comment in good faith. I would appreciate feedback rather than downvotes.

I'm not the downvoters but:

I followed your link [1] and read the entire page multiple times and I can find no content which supports "recommending that the cycle count be lowered for vaccinated individuals".

It says that samples submitted for sequencing should be positive when CT<=28 or are detected as positive by another modality.

I wish I could find a "slam dunk" source that stated what the current threshold recommended by the CDC, but I can't quite find it. I've personally read many sources that talked about using cycle counts above 30 over the past year.

Some more discussion on this topic was on HN yesterday [0]

also, from last August:

  One solution would be to adjust the cycle threshold used now to decide that a patient is infected. Most tests set the limit at 40, a few at 37. This means that you are positive for the coronavirus if the test process required up to 40 cycles, or 37, to detect the virus. [1]

[0] https://news.ycombinator.com/item?id=27972195

[1] https://www.nytimes.com/2020/08/29/health/coronavirus-testin...

And? Why aren't people allowed to take risks anymore?

If the vaccine is available and I choose not to get it and then die... Well, that's my own prerogative.

We are quickly moving into a corporate and government nanny state where citizens and users can't be trusted with their own agency so their agency is removed.

> Well, that's my own prerogative.

Does this also imply that you will be responsible for the cost of your own choices, and that you will not infect anyone else and not interact with the public?

If I infect another unvaccinated person... so what? They made their choice as well. The vaccine is widely available enough now that anyone that doesn't have it chose not to get it (or they have an exceedingly rare medical reason)

The vast majority of the world does not have effective mRNA-type vaccines, and have outbreaks following mass vaccination of ineffective ones (and in some cases, fraudulent locals use saline). Kids cannot receive it yet, as much as they want to, and there are numerous parents explicitly refusing their kids the consent to be vaccinated. The more spread, the more dice get rolled on creating further deficiencies in vaccination success.

Honestly, my opinion - if everyone could be vaccinated and the vaccine was always 100% effective 100% of the time without exception, I would not care at all about "individual choice" or "I don't want to take it", I would not care about the extra mutations being created, I would not care about being next to an unvaccinated individual at all.

> Kids cannot receive it yet, as much as they want to

Do kids even need it? I was under the impression that child covid deaths (or even just severe reactions to the disease) were incredibly rare.

They were relatively rare, until Delta. Kids are also germ factories that will wipe it on everything and anything.

I'll point out that when we talk about how "oh it'll only be bad if you have comorbidities too", I'm pretty sure more than 75% of the US qualifies as having those. I'm not paranoid by any means, and I don't want vaccine apps or centralised databases to exist (anonymously signed timestamped attestations maybe), but the vaccines are not 100%, and my risk model dislikes being stuck next to someone dumping out virions for over 8 hours a day with recirculating air.

[side note: I've also worked retail in the past and that taught me to never trust the general public, and that some idiot parent absolutely will bring a kid in with measles, norovirus, and smallpox in at the same time while lying about how they're healthy so they don't get charged a $10 cancellation fee.]

"Disease experts say kids don't seem to be developing more severe COVID-19 cases as a result of the Delta variant "

https://www.businessinsider.com/delta-variant-covid-risk-to-...

Your risk (really, your blast radius) is coupled with your broader society's risk. This has always been the case; I suspect that with increasing population density, this is unavoidable.

ETA: not all unvaccinated are by choice. This is not now and never has been purely an issue of choice.

> And? Why aren't people allowed to take risks anymore?

Because they are taking risks with other people's lives, if they spread it. I'm not sure why this is so hard to factor in - if you get Covid, you are more likely to give it to someone else.

If people take the risk, they should also be responsible (collectively, since we apparently can't do tracing very well) for the results. That means they cover the financial costs, and (in my more extreme moments), I think they should face charges of negligence where we can directly attribute to a source.

It isn't though.

Sure if you got sick and crawled into a ditch and died then more power to you.

Instead you would end up going to a hospital and wasting a bunch of peoples time, and in the event your dumbass dies from it - some poor man/woman has to hold your hand while you gurgle out your deathrattle.

Being selfish with your own life in a society never just affects you. That's why it's a society. Someone will always have to clean up your shit when you make poor decisions with your life.

So are we going to outlaw being selfish? People waste hospital time and resources all the time with a plethora of things other than covid. Should we take away their agency so they can't do that anymore?

There are not many comparable cases, where the selfish behavior gives a very measurable reinvigoration to a global pandemic for which the longer it persists the greater the risk that it will spawn a variant that puts us back to step 1 - or worse.

You can't put the genie back into the bottle no matter how hard you crack the authoritarian whip.

No we will not. But if you get close to my family that is fragile and may dire if they catch the virus then I will respond with the same selfish force as you.

That is physically harm you to make sure you die in a safe place, not in my yard

Sounds fair.

("you" of course means "the unvaccinated who use their freedom to hurt others")

Would you do the same if someone accidentally killed your family members in a DUI? (i.e. kill the person who was DWI)?

Someone driving under influence who has an accident is committing an attempt of a murder, or a murder if there are victims.

There are all kind of possible accidents, DUI is the kind where someone decides that they take the risk of other lives. Similar to the recent accident in Italy where a ski lift was purposely not maintained to avoid stopping it. They knew that they are risking someone's life.

With this said there are two cases:

- the one when someone drives under DUI and I have to kill him to avoid a possible direct accident towards me or my family (by pushing his car from a cliff or something). I would nit hesitate.

- after the accident. I am for a death sentence for specific cases where it is a matter of getting rid of human trash (rapes, murders with premeditation, paedophilia, ...). In that case it is a matter of social hygiene. In the case of DUI I am at the edge, with the possibility of someone to spend years helping the society to try to redeem

on average if you move forward your death you end up saving society money so they are actually be selfless not selfish.

OTOH, if the person has bitcoin and dies it is considered a donation to other users.

> Why aren't people allowed to take risks anymore?

What do you mean "anymore"? Collective rule to fight contagious disease is literally as old as civilization. There are rules for it in the Old Testament.

Because your risk becomes everyones risk. The vaccine is becoming less and less effective against variants and people talk as if dying or hospitalizations is the only bad outcome. Long term health problems from even 'mild' COVID infections is a thing and the efficacy of vaccines at preventing that is not clear.

So getting a vaccine does not make the vaccinated isolated from the risks the unvaccinated choose. Your choices affect what I can do and the risks to my health.

Exactly. This is the only way to retain a free society. This will never end. The variants are spreading now faster in the vaccinated than the unvaccinated. This is not surprising. Virologists have warned us about this. However, they have been censored.

> Why aren't people allowed to take risks anymore?

Because we're going to run out of room in the hospitals and we all carry the cost of treating the problem. And the doctors and nurses that we have are going to be pushed to the breaking point.

In other words because "we live in a society".

Your right to do whatever the hell you want with your life, no matter how stupid, ends once the health care system starts to fall over (again).

You aren't going to run out of room in hospitals, for goodness sake. That was debunked last year. Countries that didn't panic, don't have dysfunctional healthcare systems, and didn't make lots of healthcare workers stay away from work, were fine.

That didn't happen last year because we changed our behavior.

It wasn't "debunked", it was avoided.

And our current status:

"As COVID surge escalates in Louisiana, hospitals shut down elective surgeries"

https://www.nola.com/news/coronavirus/article_bb29717a-ee58-...

"How Louisiana's 4th COVID wave has hospitals 'past burnout': not enough equipment, staff or time"

https://www.theadvocate.com/baton_rouge/news/article_d53b6fc...

"13 hospitals in Mississippi have no ICU beds available due to COVID-19 Delta variant spike"

https://www.fox13memphis.com/news/local/13-hospitals-mississ...

"Florida Hospital Admissions Break Covid Record Set in January"

https://www.bloomberg.com/news/articles/2021-07-28/florida-h...

You get headlines like that in many years, newspapers love "hospital at brink of collapse" stories. Look at the archives of the last 10 years and you'll find it's a common theme. There are several tricks that can be used to generate them, for example in most hospitals ICU is a flexible designation and ICU capacity can be increased or lowered. It's inefficient to have empty ICU beds, so those units are very often "full" but it doesn't mean much.

Look at places like Sweden (fewest ICU beds in the EU, not overloaded), or Switzerland (one of the best staffed systems, also not overloaded). There are problems when bad management makes problems, as in any enterprise, which newspapers love to find, and sometimes they invent problems that don't really exist (finding a doctor who will say they're tired/burnt out/need money is the easiest thing in the world).

That's why it's better to look at the stats and dig into the system level causes of load issues, as you would with any IT system.

As for avoided: no, none of the measures implemented have had any impact. You can find proof of this in many forms, but the simplest is to look at places like the UK. They just removed a whole boatload of restrictions in the form of "freedom day" and cases fell off a cliff. Experts were left baffled because they had all been predicting a huge surge, although people who were actually looking at the data weren't baffled at all: the fall was predictable given the shape of the same wave in other countries + the assumption that restrictions were having no effect.

> That's why it's better to look at the stats and dig into the system level causes of load issues, as you would with any IT system.

Since you're making an argument from statistics, it would be helpful to provide some numbers for your claims and their provenance.

Take a look at the Swiss hospital stats. Many countries don't provide hospitalization stats regularly, keep them secret, or corrupt them in various ways, for example in the UK there was a blowup just a few days ago because it turned out over half of all COVID hospitalizations appeared to be catching COVID in the hospital itself meaning those stats were giving an inflated impression of hospital load. These numbers were leaked despite their importance to understanding the severity of the epidemic. But the Swiss stats are open and public.

https://www.covid19.admin.ch/en/hosp-capacity/total

As you can see, it never got above ~80% utilization, even though Switzerland's second wave peaked many weeks before restrictions were re-imposed. The Swiss system is well funded, but it's not an alien planet. If they can do it any developed country can. Also remember that lots of places built emergency hospitals. They were invariably never used.

Or look at Swedish data.

https://www.folkhalsomyndigheten.se/contentassets/4b4dd8c7e1...

Sweden started the pandemic with the lowest ICU capacity in the EU yet their age adjusted mortality only reached the same level as in 2012 - not even a "once in a decade" level problem.

https://softwaredevelopmentperestroika.wordpress.com/2021/01...

> "over half of all COVID hospitalizations appeared to be catching COVID in the hospital itself"

That isn't factual.

Half of COVID hospitalizations were diagnosed with COVID after admission.

The shitty newspaper article then spread the impression that people were going into the hospital for a broken leg and contracting COVID and counted as COVID hospitalizations with exactly zero proof.

The alternative explanation is that people show up at the hospital with strokes and heart attacks and are tested and show COVID positive and probably really are COVID hospital admissions due to COVID-caused thrombosis Particularly since thrombosis affects more younger people who are now making up the majority of unvaccinated hospital admissions. 40 year olds who get the sniffles and think its just a cold, then throw a clot and get admitted or just die has been happening from the very start of this.

Not even going to waste my time on your WhatAboutTheSwissHospitalDataism, I have work to do and don't have hours to spend today to figure out why you're wrong.

People are tested before admission and then tested after admission. The figures are to do with the latter. People who turn up at hospital because they're dying of COVID don't get counted in the latter. Regardless, your alternative explanation is no more factually based than the obvious, simple explanation.

Regardless, I can see you already have your conclusion and will stick to it. So be it.

We don't let people drive without a seatbelt or ride a motorcycle without a helmet. Oh no, what a case of government overreach!

That is an excellent example of government overreach.

Motorcycle helmet rules are set at a state level in the US and many states do allow it.

You use up shared resources while you're dying.

If you do it at home sure, but if you all get together and clog up hospitals, now it's my problem.

Except in this case it's not just you. You can pass it on to people who can't take the vaccine for medical reasons. Also, COVID has led to large parts of the economy as well as education system shutting down. Letting the virus romp around increases the chance of the disruption continuing indefinitely.

This is basic social contract stuff. It's disappointing to see so many people unwilling to undergo minimal sacrifices to help safeguard the health and welfare of others.

Are you aware of how that number is generated? Why is it exactly the opposite in other countries?

> Around 99% of hospitalizations are among the unvaccinated

"unvaccinated" includes people who have had one dose or people who had the second dose less than two weeks ago[1]:

>> a vaccine breakthrough infection is defined as the detection of SARS-CoV-2 RNA or antigen in a respiratory specimen collected from a person ≥14 days after receipt of all recommended doses of an FDA-authorized COVID-19 vaccine.[1]

>> ... A total of 10,262 SARS-CoV-2 vaccine breakthrough infections had been reported from 46 U.S. states and territories as of April 30, 2021. Among these cases, 6,446 (63%) occurred in females, and the median patient age was 58 years (interquartile range = 40–74 years). Based on preliminary data, 2,725 (27%) vaccine breakthrough infections were asymptomatic, 995 (10%) patients were known to be hospitalized, and 160 (2%) patients died.[1]

>> ... As of April 30, 2021, approximately 101 million persons in the United States had been fully vaccinated against COVID-19. [1]

Now, let's look at a more recent report[2]:

>>> As of July 19, 2021, more than 161 million people in the United States had been fully vaccinated against COVID-19.

>>> Hospitalizations* 5,601 (95%)

>>> Deaths† 1,141 (19%)

So, "fully vaccinated" increased by 60% over that period, but deaths among the fully vaccinated increased by 613%.

That's curious.

[1]: https://www.cdc.gov/mmwr/volumes/70/wr/mm7021e3.htm

[2]: https://www.cdc.gov/vaccines/covid-19/health-departments/bre...

Two minor adjustments:

> Beginning May 1, 2021, CDC transitioned from monitoring all reported COVID-19 vaccine breakthrough infections to investigating only those among patients who are hospitalized or die, thereby focusing on the cases of highest clinical and public health significance.

This is just to keep in mind the % of cases that result in death will be higher based on the different focus of the monitoring.

> 292 (26%) of 1,141 fatal cases reported as asymptomatic or not related to COVID-19.

So you're saying 1,141 - 292 = 849 or 430% increase over 160 deaths recorded before.

Still significant. This is at the same time that Delta is increasingly dominant[0][1]. So it does seem like this Delta variant may be more deadly, even to the vaccinated, though still massively less deadly when compared directly to the unvaccinated. From April 30th through about yesterday, there were about 35,000 total deaths in the U.S. from COVID-19[2]. That number dwarfs the total 850 or so that have died while vaccinated since the beginning of vaccination availability.

[0] https://www.nytimes.com/interactive/2021/07/17/us/delta-vari...

[1] https://static01.nyt.com/images/2021/07/15/us/delta-variant-...

[2] https://www.worldometers.info/coronavirus/country/us/

>> > 292 (26%) of 1,141 fatal cases reported as asymptomatic or not related to COVID-19.

> So you're saying 1,141 - 292 = 849 or 430% increase over 160 deaths recorded before.

No, I was comparing apples to apples. If you want to do it this way, you need to also note:

> 28 (18%) decedents were asymptomatic or died from a cause unrelated to COVID-19.[1]

Therefore, (1,141 - 292)/(160 - 28) corresponding to 543% increase.

Either way, the baseline went from 100 million fully vaccinated to 160 million fully vaccinated meaning a 60% increase in the population in question resulted in either 543% or 713% more deaths after breakthrough infections.

Further,

>> Beginning May 1, 2021, CDC transitioned from monitoring all reported COVID-19 vaccine breakthrough infections

this is only relevant insofar as we now have no measure of how many fully vaccinated individuals get infected, don't feel sick, and walk around with high viral loads.

[1]: https://www.cdc.gov/mmwr/volumes/70/wr/mm7021e3.htm

> Either way, the baseline went from 100 million fully vaccinated to 160 million fully vaccinated meaning a 60% increase in the population in question resulted in either 543% or 713% more deaths after breakthrough infections.

Right - the only logical variable to account for the increase would be Delta. Unless you're implying some other cause for the increase?

> Unless you're implying some other cause for the increase?

I am not particularly interested in the cause ... but, the Bayesian in me combines the fact that CDC stopped reporting number of breakthrough infections combined with the facts that chances of dying from Covid19 are low to being with and supposedly lowered by the vaccine gives me the gut feeling that breakthrough infection rates are now probably around 2-3% which means there are a whole lot of typhoid Marys walking around with high viral loads.

And suddenly the CDC's reversal on masks makes sense. We should all still be wearing them, as they are better at preventing spread from the person wearing then anything else.

And, now, this[1]:

> Among 1497 fully vaccinated health care workers for whom RT-PCR data were available, 39 SARS-CoV-2 breakthrough infections were documented. Neutralizing antibody titers in case patients during the peri-infection period were lower than those in matched uninfected controls ...

For the record, that's 2.6% breakthrough infection among fully vaccinated people who are healthier and more careful than the general population.

[1]: https://www.nejm.org/doi/full/10.1056/NEJMoa2109072

There are three things put forth in the declaration of independence: Life, Liberty and the Pursuit of Happiness - for some reason America has decided that #2 trumps 1 & 3 to an extreme degree - but in the rest of the world 1 & 3 are also viewed as fundamentally necessary freedoms.

Err, I don't think we could have had vaccine mandates much earlier than now. At most a month or so.

In the spring there were fewer doses than people who wanted them - people were flying to other states to get vaccines. Mandating vaccination wouldn't have sped it up much, while making workers' lives even harder.

You could mandate it at the office. As more people get vaccinated, more are eligible to return. Eventually you could add in mandatory attendance as the vaccine is more available.

To be honest, it is rather surprising, don't you think so?

At the beginning of the vaccination campaigns it was natural for people to be skeptic of vaccines that had been developed so quickly, but you'd really expect these feelings to go away after so many millions have been vaccinated without problems. What's strange about it is that some colleagues of my girlfriend apparently continue to peddle vaccination conspiracies after they've got their second Pfizer shot. What's going on?

You simply cannot be certain there are no long term side effects until "long term" (at least a few years) has passed. For the vaccine holdouts, some may be more easily pursuaded next year or the year after, assuming COVID is still a problem then. Historically, flu pandemics naturally burn out after a year or two.

You can't be certain until you die (hopefully many, many decades from now) that there were no side effects. But we can be "reasonably certain" based on the sum of knowledge and data we have regarding vaccines in particular and medicine in general. Waiting 3 years, from a scientific perspective, is completely arbitrary. The length of clinical trials is not arbitrary.

Yes, I'm just saying that the more time passes, and the more people see that their friends and neighbors are suffering no side effects, that this particular concern/objection will decline.

It was very naive to think that 100% of the population would enthusiastically be on board with getting this vaccine. That never happens. I am too young to remember but I would guess there were holdouts on the first polio vaccines as well (though maybe not as many, as it affected mostly children and the diesease had much worse outcomes).

100% would be naive, but you'd think 80% or more to be a realistic expectation...

Is there something specific that comes to mind when you speak of this knowledge and data on vaccines that makes you so assertive or are you just paraphrasing something you may have heard elsewhere?

Apparently, the lengths of _these_ clinical trials were arbitrary though. See https://news.ycombinator.com/item?id=27987904

Not sure why my comment got deleted, even with people agreeing with it. Seems you have to be very careful if you don't agree with the above statement. Just a note for everyone else.

It probably hasn't been (or has barely been) a couple of months since someone not in a higher risk group could have easily been fully vaccinated (2 weeks after second shot).

Everyone I know reached "fully vaccinated" status before the end of May, so about two months ago. I suppose availability varied by state/region for a while though. But the bigger point is, we should have been implementing more incentives back then such as the ones we are seeing implemented now.

>It almost feels like we're feigning collective surprise that a big chunk of Americans decided to take a staunchly anti-science, anti-medicine, anti-rationality stance.

This is the natural result of 40+ years of sustained attack on the idea of government, on the effectiveness of public institutions, on the concepts of authority and expertise:

>Anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that "my ignorance is just as good as your knowledge"

I'm pro science, pro medicine and vaccinated, but as far as "the sustained attack on the idea of government" and "the concept of authority"; you don't think the fairly obvious and rampant corruption in the government, itself has something to do with that? Political donations have become a "buy your senator" campaign for corporate influence without the need for subtlety or subterfuge, and we've been at a state of declared war for 30 years, with expanded governmental control, with no end in sight. This doesn't seem like an attack on the idea of government, but an attack on the idea of a corrupted governing body.

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