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This measure can't be a way to create "zero covid spaces" because people who are vaccinated can still transmit the virus (even though less than unvaccinated people, but it doesnt seem to be a 90% reduction either). So the goal here is to increase the vaccination rate.

It seems pretty weird to ask the indoor business owners to be the ones who are in charge of controlling that the vaccination rate is increasing and to be the one who are punished because the vaccination rate is not high enough.

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> "zero covid spaces"

As a tangent, I wish we would get rid of this "zero covid spaces" mania, makes having a reasonable discussion between those who want to continue our lives as normal as possible given the circumstances (I am one of them) and those who want to get back to an illusory "pre-covid normal" basically impossible.

One of my grand-mothers died of tuberculosis about 10 years ago. Imo it's as nasty a death as death by covid is. A quick web search tells me 1.4 million people die of TB each year, I suppose an average of 1.4 million (give or take a few hundred-thousands) have died of TB each year for the last half-century at least. Nobody ever talked about us disrupting our daily lives in order to bring TB cases to zero.

The U.S. only has around 600 deaths from TB per year. Covid was 100x more deaths with lockdowns and other restrictions factored in.

Not even remotely the same thing.

Sorry that I wasn't clear, I'm not from the US, I know this is an US-article but I see that push to get to zero covid cases in many places, no matter the continent.

Probably covid deaths will trickle down to 500-600 per year in places like the US in a few years, a combination of higher access to vaccines and better health facilities, and the number will remain high in places like India/SE Asia, just like it now happens with TB.

The US numbers still show that TB can be mitigated without intrusive widespread restrictions.

The majority of deaths occur in sub-Saharan Africa and SE Asia. That leads me to believe that the differentiator is access to medical care, primarily access to life saving drugs.

>The U.S. only has around 600 deaths from TB per year. Covid was 100x more deaths with lockdowns and other restrictions factored in.

Actually, COVID has been 1000x more deaths, not 100x.

Your covid numbers are 100x skewed and essentially fake.

> It seems pretty weird to ask the indoor business owners to be the ones who are in charge of controlling that the vaccination rate is increasing and to be the one who are punished because the vaccination rate is not high enough.

If their businesses are spreading the disease then it seems entirely reasonable.

With vaccinated people acting as asymptomatic spreaders - this is impossible to know.

Pretty much this. Businesses that are known to be problematic, like restaurants and bars, should expect that their choice to stay open and continue serving people comes with responsibilities. They don't operate free of consequences, and they shouldn't expect to externalize those consequences.

However, it really sucks that the people who mostly end up trying to enforce the mandate are the staff who already have, in most countries, jobs that most of us would not consider fun. The people most likely to insist on going out to eat and entertain are, generally, the sorts of unpleasant folk that already treat waitstaff poorly.

Are restaurants and bars known to be problematic?

They might be in the space of restauruncles.

So far the data coming out of the EU has indicated that when passports and certificates were introduced, there was an uptick in vaccination the day the measure was introduced. Estonia, for instance, has seen this happen.

The Netherlands has seen willingness to vaccinate rise from around 60% at the start of the crisis to 87% right now, and part of this success is attributed to the fact that the government always made it clear that vaccination was not going to be mandatory, and testing would be an alternative.

Alternatively, I'd be much more comfortable going out if I knew everyone around me would be vaccinated.

But a lot of them can still be positive (i think 30% with AZ vaccine), and somehow noone tests the vaccinated ones, so you'd never know, and most of them are asymptomatic, so they don't even know it.

I got my vaccine early on, and haven't been tested since.

Still a lot of unknowns, but seems pretty clear that vaccinated people are less likely to contract and spread. So I like my odds better among a vaccinated crowd.

User timr was presenting a study upthread that the odds of contagion are , as of right now, basically equal between vax and no vax.

This was based on the fact the same level of virus load was found in both populations that were infected.

> that were infected

These are the key words. But the odds of being infected in the first place are lower if you are vaccinated. So given a choice to spend time with a vaccinated stranger or an unvaccinated one, you should prefer the former if you want to avoid getting sick.

why?

> the goal here is to increase the vaccination rate

The goal is to avoid overloading the hospital system. Vaccinated people spreading the Delta variant amongst each other is not going to do that. Unvaccinated people getting sick will.

Is there evidence NYC's hospital system could be overloaded?

UK just peaked (https://coronavirus.data.gov.uk/); Does NYC have significantly worse vaccine coverage in vulnerable populations or worse capacity?

> Is there evidence NYC's hospital system could be overloaded?

Yes, because exactly that happened in March and April of 2020, leading to tens of thousands of deaths. Here's your evidence[1][2][3].

[1] https://abc7ny.com/nyc-hospital-queens-coronavirus-news/6070...

[2] https://www.cnn.com/2020/03/30/us/brooklyn-hospital-coronavi...

[3] https://www.foxnews.com/health/nyc-hospitals-overwhelmed-by-...

That's before a considerable amount of population gained some level of immunity. UK experienced relatively low hospitalization in their last wave.

Hospitalizations in the US have increased 400% since the beginning of July, and in NYC specifically[1], they have doubled with steep positive rate-of-change.

[1] https://www1.nyc.gov/site/doh/covid/covid-19-data-trends.pag...

That's not answering though about capacity. UK's went up 8x, but they were nowhere close to hitting capacity.

NYC's hospitalizations dipped to ~18 admitted/day citywide in June and are up to ~50 now. But that's a long way from 350 over winter and far away from hitting 1700 in the initial surge.

The UK government realized that even with their high case spike (to winter level) that vaccination ensured that hospitalizations would not come close, so they ended restrictions at what in retrospect was their peak cases. Their admission rate hit maybe a quarter of their winter rate even though case rate peak was similar. (vaccine cut hospitalization rate per case by 75%).

To my point, unless we're substantially different from the UK, it doesn't look like hospitalization capacity should be a concern with this wave.

> Is there evidence NYC's hospital system could be overloaded?

My friend, a plastic surgeon, was drafted to tend to an entire floor of folks on ventilators. No other doctors. Occasionally, an exhausted nurse. He spent the last twenty years doing face lifts. I think some patients were in doctor’s offices.

We also halted surgeries and cancer patients’ visits and hosts of other stuff to keep the strained system from going New Delhi.

Not if they are 20 or already had covid.

> Not if they are 20 or already had covid

We have inconclusive data on the protection past infection affords with respect to the Delta variant. We have decent data showing the mRNA vaccines work. We also have inconclusive but pointed data about the Delta variant being more problematic for younger people [1].

[1] https://www.nytimes.com/2021/08/03/health/covid-young-adults...

At this point when I see "comprehensive data is lacking" in some NYT article hyping the Covid threat I just close the tab. About a week ago they were trying to say children were dying in droves from the Delta wave in Indonesia based entirely on the testimony of one doctor who was probably confusing TB for Covid. Two weeks ago they were saying the J&J vaccine was useless against Delta based on a dodgy study that contradicted all sorts of real-world observations, like J&J's effectiveness against the South African variant.

We have data from Israel that with respect to Delta, "Israelis who were vaccinated were 6.72 times more likely to get infected after the shot than after natural infection": https://www.israelnationalnews.com/News/News.aspx/309762

> The goal is to avoid overloading the hospital system.

This is clearly not the goal -- there have been no additions to hospital capacity since the pandemic started in earnest 17 months ago.

This is definitely not the case where I live. Existing units were shifted, capacity was reserved, some makeshift isolation units built on containers were purchased. At any rate, that is a substantial cost to build out and maintain.

> The goal is to avoid overloading the hospital system

If that's the goal we need to decide what things are ok to go to the hospital for and what aren't. A lot of hospital visits could be prevented if we took the obesity epidemic seriously - I imagine the CFR of covid would be way down if America was not so obese.

And if we're ok with mandating vaccines, we should definitely be ok with mandating a healthy bodyfat %. The health gains from the latter would dwarf that of the former.

"A lot of hospital visits could be prevented if we took the obesity epidemic seriously:"

That's a lovely multi-generational idea and we should work towards it in the coming decades. Meanwhile, as 400 Americans die of a preventable illness every single day, we should prioritize reducing the hospitalization rate. Florida became the most recent state to halt surgeries at some hospitals... again.

You're missing the key distinction which is that obesity is primarily self-destruction but the virus is largely a negative externality (passing it to others, giving evolution a chance to evolve another strain). If someone has the virus and coughs in my face, that's no better than punching me in the face, which is illegal for good reason. If they eat themselves to death instead, it's no skin off my back (aside from taxes)

> If they eat themselves to death instead, it's no skin off my back

They make themselves more vulnerable to a number of viruses - not just covid. Healthier immune systems reduce transmission.

But we're okay requiring masks, and we're okay putting the onus on businesses to enforce that.

I'd much rather enforce vaccinations than masks.

It more or less made sense to require masks when people where unvaccinated. But now there is no reason to be OK to require masks either unless you are for mask wearing mandate for everything, everywhere, all the time

"It more or less made sense to require masks when people where unvaccinated. But now there is no reason to be OK to require masks either unless you are for mask wearing mandate for everything, everywhere, all the time"

Well, CDC is saying even vaccinated people should be masking. So it seems we are moving to a public-space mask everywhere all the time.

I think CDC is saying vaccinated people should be masking, because they may still transmit the virus to all the unvacinated out there that have a much higher likelihood of ending up at the hospital should they get infected. If all were vaccinated, transmission would be much less of a problem (since risk of acute symptoms would be way lowered) and I'm not sure the CDC would mandate masks.

If that's true though, then the argument frequently given about requiring vaccinations to prevent mutation is not very strong if vaccinated people are still infectious hosts. So it seems the need to masks even with vaccination exists.

The CDC doesn't care about cases, they care about hospitalizations, and 99% of hospitalizations are unvaccinated people. If everyone is vaccinated and the virus is passing freely, the CDC couldn't care less because very few people would be going to the hospital. Just like how we don't mandate masks for the common cold, since that doesn't overload our hospital system like COVID has.

"If everyone is vaccinated and the virus is passing freely, the CDC couldn't care less because very few people would be going to the hospital."

The CDC does worry about infections due to the risk of escaped mutants.

https://www.msn.com/en-us/health/medical/cdc-covid-19-only-a...

Or you could...require neither at this point in time.

If you're worried about covid then get the vaccination. For people who want to take a risk, let them do it.

I have the vaccine so why do I care if Im around people that have covid? We believe in science right?

You believe in science? Great!

What does the science tell you about the risks to vaccinated individuals when exposed to other vaccinated individuals or to non vaccinated individuals?

...that they’re really darn low either way! Not zero, and with very bad consequences if you win the lottery, but if you’re vaccinated (or younger than 12) you should be more concerned about the flu!

"...people who are vaccinated can still transmit the virus "

Well, yes, In the same way an infant may fight Muhammad Ali. Futurama references aside, the vast majority of data shows that vaccinated people are far less likely to spread the virus.

> people who are vaccinated can still transmit the virus

Just FYI, a vaccinated person, like anyone else, can only transmit the virus if they have a symptomatic breakthrough case.

So you're saying there's no such thing as asymptomatic spread of COVID-19? Isn't asymptomatic spread a primary reason for the unprecedented restrictions and mass testing?

Edit: Down voters, I would appreciate an explanation for the down votes. Am I missing something simple or is OP mistaken?

You are (mostly) correct. It is pre-symptomatic transmission that has driven most of the spread. By comparison, asymptomatic carriers have been shown in studies to spread the virus much less effectively. People can still get infected after being vaccinated (or having recovered naturally), but they are far more likely to have a truly asymptomatic case and therefore less likely to spread the virus.

That's an interesting distinction I will look into more. Thank you for the reply.

If this is the case, I stand by my questioning of OP's statement: "a vaccinated person, like anyone else, can only transmit the virus if they have a symptomatic breakthrough case."

This seems an oversimplification.

Would you have a reference? I have been speculating the same for a while, but by now I wish we had some proof rather than speculation.

Here is one... https://wwwnc.cdc.gov/eid/article/27/4/20-4576_article

This one is great because it really brings to light the issue with deciphering the data...

"Since asymptomatic infections represent a large fraction of the infected population, they contribute substantially to community transmission in the aggregate together with presymptomatic cases, even when they individually transmit at a low per capita rate."

https://www.pnas.org/content/118/9/e2019716118

You know, I'd almost forgotten about asymptomatic spread, and I'm glad you asked. My assertion about vaccinated was based on a non-scientific interpretation of something I read. I'm afraid I lack the expertise to really answer in depth. So the best I can do is point to the sources that address it. "The viral load in these breakthrough cases was about three to four times lower than the viral load among infected people who were unvaccinated" https://www.scientificamerican.com/article/the-crucial-vacci...

So as best I understand it, the vaccinated are orders of a magnitude less likely to be asymptomatic spreaders, compared to the unvaccinated. As with pretty much everything relating to disease and epidemiology, there are very few absolutes.

This is good context for your comment. Thank you.

Vaccinated people produce a much lower viral load. The lower the viral load that your body takes in, when you get infected, the less serious your symptoms/the lower your risk of hospitalization and death.

Researchers found that vaccinated people can produce the same viral load as one exhibiting symptoms (and unvaccinated).

Can, or do? How frequently? How much lower is their viral load, on average, than an unvaccinated person's?

You are either making a truly extraordinary claim, or are supporting my point. If vaccination significantly reduces viral load in 95% of cases, it's true that it might not reduce it for everyone. But it makes a huge difference, in terms of public health. Both epidemics, and viral infections are a numbers game. Reduce the denominator in an exponent, or a constant multiplier, and you get the difference between life and death.

"do"

[1] https://www.news-medical.net/news/20210803/Unvaccinated-and-... [2] https://www.medrxiv.org/content/10.1101/2021.07.31.21261387v...

Can.

They sampled people who were getting tested for COVID, and divided the samples into vaccinated-with-breakthrough-cases-who-got-tested and unvaccinated-and-sick-who-got-tested.

This completely fails to account for people who are vaccinated, and don't have breakthrough cases, which is the overwhelming majority of vaccinated individuals.

Because of the incredible sampling bias in the study [1], the conclusions that it makes are significantly less extraordinary than your claims.

Just because someone somewhere runs a study that compares 50 dead-in-car-crash people who were wearing seat belts, and 50 dead people who weren't wearing seat belts, you can't conclude that wearing a seatbelt does not reduce your risk of death or injury.

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