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Comment by enkid | Hacker News Reader

Except there are multiple states out if ICU beds because they tried this. Every person in the hospital with COVID is another person who can't use that bed to get medical treatment.

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That’s what I meant in my last sentence. Unvaccinated Covid patients should have a lower priority. I haven’t heard of any hospitals trying that.

Deleted incorrect information, the decision was reversed.

That sounds like a good start. I hope more hospitals will follow this example.

In general, I think it’s very unhealthy to attempt to take away people’s agency and treat them as children. Don’t want to get vaccinated? Your choice. But there are consequences of this choice and we should make this consequences clear. Other than that - let people do what they want to do.

Looks like they reversed the decision: https://www.dallasnews.com/news/watchdog/2021/08/19/if-north...

Now do obesity.

What about water rationing?

https://www.google.com/amp/s/pledgetimes.com/orlando-declare...

You're healthy. What about immunocompromised people for whom the vaccines have only had a partial effect?

https://www.google.com/amp/s/theconversation.com/amp/immunoc...

Like it or not, we live in a society. Our decisions affect everyone else and we can't fully account for externalities. Solving these sorts of tragedies of the commons is exactly what public policy is meant to do.

Personally, I think vaccine mandates need to happen yesterday. People who don't believe in the vaccines can suck it up. Facts don't care about their feelings.

Sorry do you live in the US? Do you really think a vaccine mandate is possible here? People will literally fight that with assault rifles. This situation is already tearing our society apart, there is no way any large scale mandatory vaccination project would succeed.

Vaccine mandates are constitutional in the USA. We just forget our history from time to time. People also misunderstand the meaning of freedom as well.

https://www.scientificamerican.com/article/vaccine-mandates-...

Doesn’t matter. The best way to guarantee that the final 28% probably won’t get vaccinated is to mandate it. The best way to get the final 28% vaccinated is to fully FDA approve it, get Fauci and Biden to ease up on the vax shaming and then simply expect that 10-15% still won’t do it. You write them off and let the chips fall.

It’s remarkable to me that our government hasn’t figured out that you don’t get people who are already distrustful of the government to magically become trustful of the government by doing the same shit over and over that caused the distrust.

That's fine, they should get shut out of public life then. That's what fully internalizing the externalities looks like.

Ya know…I seem to recall a bunch of people once thought that same exact thing about some other people about 60+ years ago. They thought they were better than the others, that the others were inferior, dirty, diseased, and less intelligent. Those powerful folks did all they could to keep the others out of stores, restaurants, front seats of buses, off water fountains, etc. and just kind of hoped those folks they hated and didn’t want in their society would just go away too.

The difference is that discrimination based on race is unjust, while discrimination based on vaccination status is just. I'll let you work out why.

Have you worked out the formula to correctly balance personal and collective risk, computationally? I would not dismiss the matter as trivial - I see it more as Nobel prize worth.

Plenty of gray areas, of course, where the decision is legitimately hard. The Vietnam draft was clearly immoral but was the World War 2 draft just? I'm really not sure.

Vaccine mandates are nowhere close to that, though—the individual risk is virtually nonexistent while the collective risk is massive. The general problem does not need to be solved fully for us to move forward with public policy in clear-cut cases.

In the specific case, you write about a «virtually nonexistent individual risk» while many¹ are yet to find such reassurance. If that statement were evidently true, one would agree with your conclusion save some details.

¹(including the brightest people I know - statement disincorporated from the above since anecdotal)

Those people are much less bright than you think they are.

There are zero people in my own social circles who didn't get vaccinated the moment they could (some live in countries where they still don't have access to vaccines). The difference might be that my social circle is mostly queer people like myself, and we know how bad pandemics can be.

Again, I have very little sympathy for anti-vax people. The correct thing to do for society as a whole is to follow New York's and San Francisco's lead and exclude them from public life until they get vaccinated. Public policy can't be based on fringe pseudoscience.

I believe may still be a good idea for me to disambiguate and rephrase:

the set of population I mentioned would not agree with your statement «virtually nonexistent individual risk». They may have taken the vaccine, but e.g. would consider it a non-easy choice to decide whether their infant children should be vaccinated (with Pfz/Mod/OAZ/JnJ) - whether the health risk for a child is higher (and how much) after infection vs after vaccine. (I insist: there's no limit towards the top, but they are the smartest I know.)

In fact, by the way, to help solving these theoretical doubts, the source of the damages should be properly defined. I am not informed of a clear, reliable, strong theory about the cause of damages in either (vaccine vs infection) - I have seen different ideas.

I do not know the NY and SF measures, but in general yes, if the unvaccinated represent a somehow higher risk of contagion they should remain proportionally isolated. But not even this proportion of risk seems to me well defined. Recently I found an article stating "The transmission rate for the vaccinated is 30% the normal". That value was the n-th of many other found in these months (and of course, that very statement is sketchy). But only yesterday I met an article that complicated the matter (and the numbers) for a(/the) dominant strain.

Surely, I find it perverse that ideas are spread like: "Health care is part of the social package, so you do as we impose". At this stage, it makes more sense to go along the lines "If you want to drink soda, you will not be treated for diabetes" (example is stretched) - one's freedom of judgement is respected, and there is no weird blackmailing based on terms and conditions imposed. I much prefer the other idea of "Non-vaccinated shall compensate the proportional part (95%?) of the cost of the treatments".

You give the idea of mixing different sets, with «anti-vax people» and «fringe pseudoscience»: you seem to be focussing on the unreasonable positions, disregarding reasonable doubts. Again: you wrote of «virtually nonexistent individual risk», and it that were evident, the set of the reasonable doubts would not exist. Especially as people receive information of adverse events post-vaccine, they have all right to demand clarity on the scope and measure, what and how much - the opposite would be irrational. And this has nothing to do with pseudoscience - on the contrary.

> Those people are much less bright than you think they are

You should very probably note you used a dismissive unsubstantiated statement.

Yes, perhaps today. People who discriminate are always confident in the moral justifications behind their prejudices.

All I see is just another group of folk devils that people feel the need to create to separate out people they don’t like.

I'm really not interested in meta-level arguments. In general I find them to be tiring and unenlightening.

And I’m not interested in people who advocate discrimination as a solution to anything.

So there, our positions are set.

Not doing any discrimination at all is a genuinely absurd position to hold. Discrimination is a necessary part of life without which society would collapse.

The question always is on which bases discrimination is good and on which bases it is bad. Discrimination based on race, ethnicity, gender, nationality, and other inherent characteristics of people is generally bad. Discrimination based on things like vaccination status is good.

Like I said, people who choose to discriminate against other people always have some subjectively moral justification for why they do it.

And it is our job as human beings to ascertain which justifications are valid and which aren't.

You can't run away from object-level moral arguments. You just can't.

I am very much a moral realist. There are correct and incorrect moral stances.

Any human response that can be considered evil by simply who it is applied to…is an evil response all the time. People may justify that evil by their feeling they have the “correct” moral stance, but it’s still evil and shitty to the target group. Personally, I am not willing to participate in an intentional evil to any group even if I disagree with them r are different from them. If that makes me immoral, so be it.

It's pretty simple yeah, you start withdrawing funds and federal services from people that don't get vaccinated. If there's one thing you can get from US history it's that money rules, and this approach does work historically.

Now I don't know that they should be implemented, and there would be some unrest, but it would end up working.

Yes, I live in the US. The way I think vaccine mandates can be done here is for every workplace, business and school to require them. Hopefully the upcoming approval of the Pfizer vaccine should unblock more of this.

OK, let’s explore that.

At what level do you think this would be enforced? Federal? Completely unenforceable unless you want to involve the military domestically. State level? Obviously half of the States are not going to do that. City level? Again, completely pointless.

Also, many business owners are antivaxx, why would they participate in this?

Federal funds should be withheld from states and cities until they impose mandates (this is the traditional way the feds have exercised control over states and cities). Businesses which refuse to implement them should have their lines of credit frozen or their permits revoked. Owning a business open to the public is a privilege, not a right.

There needs to be an all-out effort. The US did far more during WW2.

So, for example, all federal funds should be withheld from Florida until they introduce and enforce statewide vaccination? And we are going to do that with booster shots as well?

This sounds like tyranny to me.

Yes. all federal funds should be withheld from Florida until they introduce and enforce a vaccine mandate.

To the extent that this is tyranny, so be it. As I said, the US did far more during WW2.

Some states are out of ICU beds due to onerous restrictions on nursing supply, like vax mandates (my own state of Oregon for example)

Can you find any source which suggests that vaccine mandates are the reason for the shortage of nurses in Oregon? The first 5 results on Google for “Oregon Nurse shortage”, which are mostly from April-May, list workplace stresses and at-risk family members as reasons for the exodus.

Some articles are as old as December, which is before the vaccine was even available, let alone mandated

This is a new policy brown is enacting against the wishes of the Nurses union. There is no data yet, I'm just extrapolating based on the fact that these new requirements will cause some nurses to quit rather than be vaccinated, which will directly reduce the number of ICU beds while not contributing meaningfully to the % vaccinated.

If we are only to rely on already collected empirical data to make decisions or form opinions we would never be able to hold an opinion when it matters most... before

Without vaccination mandates you run the risk of an epidemic amongst nurses which can knock out 40% of your ICU beds at once. That's why nurses have to be vaccinated against dozens of illnesses.

These nurses have been unvaccinated for more than a year while in proximity with those with COVID-19. Exactly when are 40% of the nurses going to be knocked out in this model?

Nurses up until now practiced exceptionally higher restrictions to avoid this. But safety fatigue sets in and it won't work forever.

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