I Got a 'Mild' Breakthrough Case | Hacker News Reader

I Got a 'Mild' Breakthrough Case

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155 pointsdsr12505 comments

I’m getting a little tired of articles or chats with people where you get the impression that people think the vaccines will create some sort of covid-proof bubble around them. This is the only explanation I can find for people acting surprised that vaccinated people get sick. The whole point was to prime the immune system so that when exposed, the likelihood of extreme effects would be drastically reduced. That’s it.

(E: I don’t get why people downvote this - all of the benefits of vaccination are precisely due to what I describe. Lower likelihood of individual bad outcomes, which reduces burdens on healthcare, and ideally, reduces community spread by reducing the amount of virus that replicates in an individual and can be passed on. This is why I was one of the first in line when I could get the vaccine. Perhaps daring to critique people with unrealistic vaccine expectations is unacceptable?)

Right. It’s like a hardware update for an immune system.

But all the regulations around us create this covid-proof impression.

Eg. where I live, hospitals consider introducing vaccination requirements for visitors. But that somehow defies logic. The vaccine only reduces symptoms (and might thus save yourself, or others, when extended with the hospital-bed-limit-thought), but it wouldn't stop you from transmitting the disease if you are infected (and vaccinated) but you aren't aware.

So I don't even blame the public, but rather the regulators. They ought to know better.

Edit: I might need to support this claim.

The most trustworthy source I found was this article by the JHU [1] (2021-08-02). While there are many that claim different numbers (ranging from stopping roughly 60% to 0%), for transmission, no one claimed that virus infection is influenced.

[1]: https://publichealth.jhu.edu/2021/new-data-on-covid-19-trans...

No. Vaccine reduces viral load and transmissibility, but in close contact situations you're still going to transmit it.

> The vaccine only reduces symptoms (and might thus save yourself, or others, when extended with the hospital-bed-limit-thought), but it wouldn't stop you from transmitting the disease if you are infected (and vaccinated) but you aren't aware

Are you sure about that? Even this article refers to a study which says that vaccinated people are 5 times less likely to test positive than non-vaccinated. _Some_ asymptotic transmission will still occur in the vaccinated but it's reasonable to expect that it happens to a lesser degree. I'd be very curious to see studies that claim that there's no difference in asymptomatic transmission between the vaccinated and unvaccinated.

Correct. Whenever people talk about the vaccine not slowing spread they forget that vaccinated people are 5x less likely to catch covid to start with. They only seem to focus on viral loads of break through infections.

Those stats are all point-in-time and the result of very brittle analysis. Not surprisingly, you can therefore find stats that state the opposite.

In the UK this weekend there was a little blowup on Twitter because a TV journalist had his own breakthrough case, which caused him to do some journalism and download the data tables from Public Health England. He was surprised to discover that in the UK the proportion of vaccinated people getting infected is now higher than the proportion of unvaccinated people, i.e. the UK is experiencing the exact opposite of what your stat claims. Actually he was so surprised by this he posted it on Twitter and openly wondered why there was no debate about it, at which point he found out why not: he was mobbed, shouted down and ended up posting a grovelling apology.

https://dailysceptic.org/2021/09/12/robert-peston-shocked-by...

Part of the problem was that his Twitter followers are innumerate. They assumed that this stat was overall percentage of people getting infected, but it's not. It's proportions of both groups. Therefore, the fact that more people are vaccinated than not in the UK is irrelevant. The vaccinated are - at this point in time - getting it more often than the rest. And journalists are afraid to report on it because they get attacked so you just don't know about it.

Reasons? Unclear. Scientists also seem to mostly refuse to do studies that might undermine vaccine messaging. Most likely the vaccine protection wanes so fast that it simply split the delta wave in two, with the unvaccinated getting it first, leading to lots of headlines about "pandemics of the unvaccinated" etc, and then the vaccinated wave coming second, leading to stats like this one which are simply ignored.

If everyone wears seatbelts then 100% of the vehicle crash victims in hospitals will be seatbelt users. But seatbelts are still highly effective at reducing injuries and deaths.

That's not what the stat is saying. You seem to be mis-interpreting it in the same way some of the other people were.

Take 1000 people who are vaccinated. Measure how many get infected in a time span T. Calculate the ratio.

Take 1000 people who are not vaccinated. Measure how many get infected in a time span T. Calculate the ratio.

In the UK the infected:non-infected ratio is higher for the first group than the second. That should be impossible as it implies effectiveness is now negative. Possible root cause - the (relatively small) group of people who refuse to take the vaccine are refusing because they know they already got it, and thus have natural immunity, but the vaccine doesn't build immunity that lasts, so as time goes on the vaccinated group ends up getting infected anyway and having to fall back on building their own natural immunity. That's just speculation but otherwise it's hard to explain what is going on here.

But those numbers don't account for severe disease, hospitalization, and death which are the whole point of the vaccines. You're latching onto this dramatic exchange because of some stupid idea that vaccines are this magic shield against any infection, and while they do reduce risk of infection they are mostly meant to prevent severe disease, hospitalization, and death.

Also you don't account for possible explanations for the UK data. For example, maybe unvaccinated people in the UK are more likely to have previously contracted COVID. More likely I think, the vaccinated are taking much more risk than the unvaccinated, leading to their higher case counts. Many unvaccinated are immunocompromised (or know that they are at higher risk for severe complications from COVID because they are unvaccinated) so I assume many of them are taking higher precautions than the vaccinated, i.e. wearing N-95's, not leaving their houses while many vaccinated people I know in the UK are going to 50k person festivals.

OK, a few points here. Firstly, reducing hospitalizations was not the point of the vaccines. That's this week's narrative that was retrofitted onto events when the vaccines failed at their actual goal. We know this because:

• The vaccine trials didn't use "severe disease" or hospitalizations/deaths as their target metric. They used PCR positives.

• The original protocols don't include boosters.

• The pre-2021 definition of vaccine is something that makes you immune.

What's happening now is grotesque: dictionaries are actually changing their definition of vaccine to try and cover up that the COVID vaccines have failed on their own terms. Compare Merriam-Webster before [1] and after [2]. The definition at the start of 2021 is short and to the point, a vaccine is administered to "produce or artificially increase immunity". The definition today is that a vaccine merely has to "stimulate the body's immune response". No actual immunity needs to be created under the new definition, which has been rewritten because the COVID vaccines fail to meet the normal definition of vaccine. We already have a word for what the COVID "vaccines" are doing, the word is prophylactic. And there's nothing wrong with those! They're just different to vaccines.

"some stupid idea that vaccines are this magic shield against any infection"

This idea is not stupid. It is the conventional expectation for vaccines up until this point. Vaccinations against diseases like smallpox, measles, mumps and so on do provide you a magic shield, which is why vaccines were taken so seriously and seen as so important previously. That's also why pre-2021 discussion of vaccines were dominated by discussions of herd immunity thresholds and whether vaccination could achieve zero COVID, a topic that's now vanished. Once again, this new narrative is made up in the last few months as it becomes clear the COVID vaccines aren't working properly.

"Also you don't account for possible explanations for the UK data. For example, maybe unvaccinated people in the UK are more likely to have previously contracted COVID"

I provided a possible explanation in the final paragraph. The one you're proposing is literally the exact same alternative explanation I posted in reply to nradov. I think this is quite possible.

[1] https://web.archive.org/web/20210108224740/https://www.merri...

[2] https://www.merriam-webster.com/dictionary/vaccine

This is NOT true. https://www.nytimes.com/article/breakthrough-infections-covi...

"after an outbreak among vaccinated and vaccinated workers at the Singapore airport, tracking studies suggested that most of the spread by vaccinated people happened when they had symptoms"

The vaccines substantially help to reduce spread. Doesn't eliminate it, but obviously something a hospital would want to require.

"most of the spread by vaccinated people happened when they had symptoms"

Sounds like there is still a cultural / communication issue where people are not getting tested or self-isolating when sick.

The vaccine does a reasonable job at reducing transmission in the aggregate. It lessens the average viral load, shortens the average time a person is infectious, etc.

Treating transmission as a boolean ignores the large-but-not-100-percent improvement. Better to treat it as a distribution.

I don’t see what you are blaming regulators for.

"Evidence demonstrates that the authorized COVID-19 vaccines are both efficacious and effective against symptomatic, laboratory-confirmed COVID-19, including severe forms of the disease. In addition, a growing body of evidence suggests that mRNA COVID-19 vaccines also reduce asymptomatic infection and transmission. Substantial reductions in SARS-CoV-2 infections (both symptomatic and asymptomatic) will reduce overall levels of disease, and therefore, viral transmission in the United States. ... Data from multiple studies in different countries suggest that people vaccinated with Pfizer-BioNTech COVID-19 vaccine who develop COVID-19 have a lower viral load than unvaccinated people.(41-44) This observation may indicate reduced transmissibility, as viral load has been identified as a key driver of transmission.(45) Two studies from the United Kingdom found significantly reduced likelihood of transmission to household contacts from people infected with SARS-CoV-2 who were previously vaccinated for COVID-19.(25, 46)"

https://www.cdc.gov/coronavirus/2019-ncov/science/science-br...

"Two studies1,2 from Israel, posted as preprints on 16 July, find that two doses of the vaccine made by pharmaceutical company Pfizer, based in New York City, and biotechnology company BioNTech, based in Mainz, Germany, are 81% effective at preventing SARS-CoV-2 infections. And vaccinated people who do get infected are up to 78% less likely to spread the virus to household members than are unvaccinated people. Overall, this adds up to very high protection against transmission, say researchers."

https://www.nature.com/articles/d41586-021-02054-z

"COVID-19 vaccines appear to help prevent transmission between household contacts, with secondary attack rates dropping from 31% to 11% if the index patient was fully vaccinated, according to a Eurosurveillance study yesterday. The population-based data looked at the Netherlands from February to May, when the Alpha variant (B117) was dominant and the available vaccines were by Pfizer/BioNTech, AstraZeneca/Oxford, Moderna, and Johnson & Johnson."

https://www.cidrap.umn.edu/news-perspective/2021/08/study-ti...

"There has been good news, too, on the subject of viral load in breakthrough cases. Researchers in Israel studied vaccinated people who became infected. The viral load in these breakthrough cases was about three to four times lower than the viral load among infected people who were unvaccinated. Researchers in the U.K. reported a similar result. They also found that vaccinated people who became infected tested positive for about one week less than unvaccinated people."

https://www.scientificamerican.com/article/the-crucial-vacci...

I don't think that's true. The vaccine still reduces the likelihood that you'll be infected so only allowing vaccinated visitors reduces the risk that COVID enters a hospital through visitors. I think the vaccine also reduces the likelihood that people with breakthrough infections infect other people

Ditto. My family and I are all fully 2 dose vaccinated, and I didn't go out from my house for nearly a month. I caught COVID(via my mother) last thursday. The facilities are long overrun since a few months ago, so my symptoms which are: blood coughing, nausea, chest pain, ~93%SpO2 are considered "quite mild" and "home quarantine only".

In the wake of other variants like Delta, I doubt that people who didn't/can't get the vaccine can be protected by herd immunity alone.

A few of my friends are getting breakthroughs too, which seems like a lot in comparison to the global statistics, so it might be just anomalies.

Best of luck for your recovery. It sounds like it's "Mild" only in the "You're not about to die just yet" sense.

Delta is a cruel variant. I hope all of your family recovers also.

To the contrary, I don't think that's plausible. In the whole COVID-19 decision the question of the initial load has not been discussed well enough, IMO.

If you think about the virus passing your various layers of protection it is clearly a numbers game, IMO. A mask, even if imperfect, might reduce your initial viral load below a threshold that allows your immune system to kill all infected cells very quickly so you don't develop strong symptoms. The same goes for distance.

So I don't see any reason to not expect a certain "sterile" immunity after a vaccination. The way I see it, the vaccination should prevent some of the low-load infections completely, regardless of the virus variant.

Any discussion of viral load seems too subtle for a general audience, but that's sound.

It's kind of like Vaccine + mask + low exposure (social distance, short times, good ventilation) is your "armor class" against the virus.

If your armor is good enough, the chance of becoming infected IS very low.

> I’m getting a little tired of articles or chats with people where you get the impression that people think the vaccines will create some sort of covid-proof bubble around them. This is the only explanation I can find for people acting surprised that vaccinated people get sick.

No, it’s because until the Delta variant became the most common variant, the vaccines essentially did create a covid-proof bubble around the recipient. The trials for Comirnaty and the Moderna vaccine both showed >90% effectiveness against PCR positive infections, not just against hospitalization and death.

> The trials for Comirnaty and the Moderna vaccine both showed >90% effectiveness against PCR positive infections

I don't believe the official trials for Moderna and Pfizer measured PCR positive infections at all. (They involved thousands of people, it was a time when PCR test were difficult to obtain; they remain expensive at that scale).

I have not heard of Comirnaty, not sure about that.

There may have been pre-delta studies that showed PCR infection effectiveness (Cite?), I don't think they were the official trials.

Comirnaty is the brand name of the Pfizer vaccine.

According to this article, all of the major vaccine trials studied PCR positivity, not deaths/hospitalizations. https://www.bmj.com/content/bmj/371/bmj.m4058.full.pdf

> The first question is whether the right endpoints are being studied. Contrary to prevailing assumptions (including those of a former Food and Drug Administration commissioner8), none of the vaccine trials are designed to detect a significant reduction in hospital admissions, admission to intensive care, or death.9 Rather than studying severe disease, these mega-trials all set a primary endpoint of symptomatic covid-19 of essentially any severity: a laboratory positive result plus mild symptoms such as cough and fever count as outcome events (table 1).

Ah, thanks for the correction.

"a laboratory positive result plus mild symptoms" was the thing being measured, ok.

“ To sum it up, I'd put my breakthrough case of COVID-19 right up there with my worst bouts of flu.”

Exactly. I see no reason why I’d take strong measures to avoid getting exposed to it (now that I and 90% of adults around me are fully vaccinated) when I never did the same for the flu. Somewhere along the way we seem to have lost sight of what constitutes a normal disease burden.

Perhaps we were too lackadaisical about flu.

I've certainly enjoyed not getting the usual bouts of cold and flu my kids would bring home from school every winter.

I hope at least one lesson we take from COVID is "people should be able to take sick days rather than coming to work/school sick".

It’s perfectly fine for that to be ones risk tolerance and to take mitigation steps. It’s not to mandate them by government fiat.

We've been quite comfortable with vaccine mandates for decades. My kids needed proof of MMR, DTaP, and several others to be able to attend school. Colleges have similar requirements. Hand washing is mandated "by government fiat" in many scenarios, as are quite a few other OHSA or public health scenarios - try working on a construction site without a hard hat, for example.

In 2019 or earlier, when have you had to show an ID and proof of vaccination to enter any building other than your own house? And for schools, didn't you used to have private schools or homeschooling as an option to avoid these kind of mandates? And hard hats aren't really comparable, since you can take them back off at the end of the workday.

> In 2019 or earlier, when have you had to show an ID and proof of vaccination to enter any building other than your own house?

I live in upstate New York - one of the more aggressive states for COVID measures - and have not yet had to do this, a year and a half into the pandemic.

(I did, however, have to prove my vaccination status and present ID when I became a naturalized US citizen quite a few years ago. https://www.uscis.gov/policy-manual/volume-8-part-b-chapter-...)

> And for schools, didn't you used to have private schools or homeschooling as an option to avoid these kind of mandates?

These still exist.

> These still exist.

But they don't get you out of the mandates anymore. Adults who already finished school used to never have to tell anyone their vaccination status to participate in society.

Again, I literally had to prove my vaccination status to be allowed to stay in the US. In 2009… and I’ve yet to present my COVID card anywhere in upstate NY.

Non-citizens do not have the right of citizens, you might have known already, but one can be denied the green card and/or not allowed into the country for having a communicable disease like AIDS or TB. If I follow your logic, it's okay to have AIDS, TB, leprosy, etc. passports too?

> If I follow your logic, it's okay to have AIDS, TB, leprosy, etc. passports too?

If they start spreading exponentially via aerosols, sure.

But people with AIDS are not allowed into the country already, why you add conditions? Does the Constitution say anything about aerosols? Besides, TB spreads with the aerosols so we should have the BCG vaccine mandates, right?

It's fairly obvious that TB is not spreading like COVID does in the United States. If it were, restrictions would be sensible. (I would note that if you have TB, you may wind up subject to a quarantine order. https://www.cbsnews.com/news/tb-patient-quarantine-condition...)

Constitutionally, SCOTUS has ruled on the point in the past. https://en.wikipedia.org/wiki/Jacobson_v._Massachusetts

> Jacobson v. Massachusetts, 197 U.S. 11 (1905), was a United States Supreme Court case in which the Court upheld the authority of states to enforce compulsory vaccination laws. The Court's decision articulated the view that individual liberty is not absolute and is subject to the police power of the state.

You argued that the rules applied to foreigners should be applied to the citizens. Right now foreigners with TB, AIDS and many other diseases are not allowed in the country. The question for you: is it okay to deport citizens with the same diseases? If the same rules apply then we should be doing this but as we obviously don't do this, this means the rules for foreigners are different. I am sure you can find the court cases confirming that.

Not entirely true. Certain classes of jobs, like working in health care, have always mandated vaccination. Additionally, when most vaccines are given in childhood, making sure everyone is vaccinated in grade school has the effect of ensuring that most adults are vaccinated. No need to keep re-checking throughout life.

I’m referring to masks. Mandating vaccines is fine and good.

So you are ok with injecting things into peoples bodies, by force.

But covering the nose and mouth, when around others, is beyond the pale?

Yes, because I’ve gotten vaccinated and I shouldn’t be continued to be punished with restrictions.

People can do that, stay home when sick. Then they just have fewer vacation days. At least, that's how it works for me. I suppose we could think of it as an incentive to remain healthy.

Sick time should be separate from vacation time for that reason. Otherwise, people have an incentive to come into work while sick so that they can use their paid time off for holidays and vacation when they aren’t ill.

On the other hand, I guess there are some people who when given a separate bank of sick time feel it’s ok to use it as a 2nd pool of PTO. My workplace gives a separate set of sick time though and it’s always seemed a better way of handling things to me.

For office workers, the whole remote experiment of the last year seems to be the equilibrium. You can still "come to work" even if you feel like death, you're just allowed to do it from home until you're not contagious.

That's quite a privileged perspective. Many low wage, non-union workers don't have that flexibility.

> People can do that, stay home when sick. Then they just have fewer vacation days.

I experienced that too, when I lived in the US.

In Denmark I have separate sick leave. Staying home sick doesn't count as PTO. For more than a few days I'll need a note from the doctor.

I think it's around 6 months before sick leave is grounds for termination.

In any case, in the US people don't take sick days unless it's really bad. Obviously, this must cause more infections.

> have lost sight of what constitutes a normal disease burden.

I don't think so. This is only "mild flu" for vaccinated people. We still have kept sight that people who can't be vaxed can die, and people who ignorantly chose not to vax are killing people because they clog the ICUs and prevent people from getting non-covid life-saving care.

So we haven't lost sight, people just choose not to see. You just can't teach some people to be unselfish and considerate.

The people who can’t be vaxxed have extremely low death rates. It’s possible RSV is actually a bigger danger to them than covid (and increases in youth suicides due to lockdowns appear to be higher than the number of lives saved from covid).

As to ignorant people filling ICUs, that’s not a risk where I live in SF that has near universal vaccination and relatively low hospitalization rates. The UK and Denmark have demonstrated you can love on with life after high vaccination rates are achieved.

> and people who ignorantly chose not to vax are killing people because they clog the ICUs and prevent people from getting non-covid life-saving care.

Honest question - would you provide information for that please? The two articles I've seen on that were both completely retracted within a few days of publication. I know unvaxxed people, and I want to have all available information before conversing with them.

The hospitals are clogged because the basic in person care is crippled by covid prevention practices. So instead of going to your pcp to deal with an ear infection or bladder infection the only place you can go is hospital as now any time you have covid like symptoms you have to get a covid test to get access to care.

Similarly you can’t get care if you have a slow growing cancer or need minor surgery. All these people are going to have negative outcomes

They don't put people simply pending a COVID test in the ICU.

Mississippi was recently down to six ICU beds in the entire state: https://www.wlbt.com/2021/08/04/just-6-icu-beds-available-en...

Arkansas got to zero: https://apnews.com/article/health-arkansas-coronavirus-pande...

This isn't explicable with your hypothesis.

You can absolutely go to your PCP for a COVID test, and get your ear infection treated while you're there.

Not here you can’t. They specifically ban anyone with covid like symptoms from entering which is like everything.

Besides what are the outcomes for using ICUs for covid. I bet long term outcomes are pretty dismal, that might be a good time to say unless you are healthy and under 55 if you need icu it might just be your time. Rationing care is a ethical and practical thing to do.

> The hospitals are clogged because the basic in person care is crippled by covid prevention practices.

They also seem to be suffering from the labor shortage. Only secondhand anecdata from friends in the medical field, but nurses seem to be getting harder to hire and retain right now.

Thank you, but I was asking for actual verifiable information that hospitals are getting clogged due to non-vaccinated people. I asked for two reasons. 1) That is not at all the case with the hospitals near me. 2) The recent articles I've seen make this assertion were immediately retracted due to the people they relied upon not telling the truth.

So, before I speak with some of my unvaxxed friends, I wanted actual information to support, otherwise they could (correctly) say not to bring them unfounded assertions.

For example: https://eu.usatoday.com/story/news/health/2021/09/10/cullman...

Thank you, but that isn't an example of ICUs filled with non-vaxxed. It might be an example of filled ICUs. When I look at reported ICU information for Mississippi, the data doesn't support that. [1]

I appreciate your posting that, but it isnt helpful for my situation.

[1] https://msdh.ms.gov/msdhsite/_static/14,21994,420,873.html

Given that vaccination significantly decreases an individual's risk of hospitalization and that only about 40% of Missippippians are fully vaccinated, it seems like we would be justified in inferring that the people filling the ICUs are generally unvaccinated, no?

Filling the icus might only mean adding 4-8 heads over existing load though if you only have 20-30 beds and you are running 70-80% as a baseline

The ICUs are full of people with suspected covid. Vaccinated people are less likely to have covid. 40% of Mississippi is vaccinated.

Which point are you having trouble with?

I don't know that there are documented non-COVID deaths due to it, but various parts of the southern US (where vaccination rates are low) have reported ICUs at or near capacity. E.g.

https://www.tennessean.com/story/news/health/2021/08/19/tenn...

One has to assume that at a certain level there is a finite quantity of medical care available at a given facility, and a spike in COVID cases would deplete it. Whether or not that threshold has been crossed, and if not how close such places are to crossing it, is an interesting question.

Thank you, but that news article seems incorrect. When I look at the hospital capacity for TN, according to the TN Dept. of Health, I see available floor beds, some available ICU beds, 62% available adult ventilators, and 1/3 available airborn infection isolation rooms. [1]

[1] https://www.tn.gov/health/cedep/ncov/data/hospitalization-da...

The article says that there are no ICU beds in "every major Tennessee metro area." The TDH dashboard you linked to says (today) that 4% of ICU beds are available statewide. Given that ICU bed use is almost certainly not entirely uniform statewide, and that it might be expected to be highest in metro areas, it seems entirely plausible in light of the TDH data that there are no available beds in metro areas--or at least close enough to literally zero that Tennesseans should be very worried.

It is somewhat worthless to pile assumptions on top of assumptions to come to conclusions. If you look at the map of Share of I.C.U. beds occupied, you can make a better, more finely grained decision. [1]

The question I asked has nothing to do with whether ICU beds are occupied. However, I also will point out that you are replying to a reply to a reply to my question, none of which actually addressed what I asked.

[1] https://www.nytimes.com/interactive/2021/us/davidson-tenness...

Incorrect how? Individual hospitals themselves are reporting they are at capacity. The TN rollup statistics aren't going to tell you very much about whether your local hospital is actually full at a given time, which is going to be the most relevant thing to know if you're seeking urgent care.

Can you show the data you use to make this claim about ICU's being clogged to prevent people from getting life saving care?

Not news articles but the actual data you're using?

> Exactly. I see no reason why I’d take strong measures to avoid getting exposed to it (now that I and 90% of adults around me are fully vaccinated) when I never did the same for the flu.

Because it's up to 10x more deadly than influenza, particularly for vulnerable populations.

https://www.hopkinsmedicine.org/health/conditions-and-diseas...

The flu is equally if not more deadly in populations without preexisting immunity (e.g. isolated tribes). Once people acquire immunity (preferable through multiple doses of vaccination), it’s really not any different than the flu.

Do you live in an isolated tribe? Otherwise, I don't see how that's particularly relevant to your comment.

In most populations, today, COVID is significantly more dangerous and deadly than influenza.

I now have antibodies and memory cells against covid (because I’m fully vaccinated), so covid is not deadlier than the flu for me.

Yes, for you. The point I've been stressing is that it's (mask wearing, social distancing) not just about you.

Because you don't live in an isolated tribe, some percentage of your population remains at risk of contracting covid and perpetuating its spread.

Your link does not seem to support that Covid-19 is 10x more deadly than influenza in a vaccinated person, like the poster you are replying to. It’s 10x more deadly if you haven’t been vaccinated but the vaccines are showing 10-20x decrease in hospitalization and death, bringing the risk more into flu range.

> Your link does not seem to support that Covid-19 is 10x more deadly than influenza in a vaccinated person, like the poster you are replying to.

But my point wasn't about op, it was about the population as a whole, hence the "especially in vulnerable population" part.

Parent however qualified that they were considering the risk to themselves and their own contacts, who are also vaccinated. For them and their associates, treating this like the flu seems more reasonable. Assuming they’re in the USA, everyone who is unvaccinated at this point (except children, who have low risk of death) is doing so by choice. We can’t be expected to put our lives on hold for conspiracy theorists forever.

That statement seems to be very obsolete. It claims "doctors and scientists are working to estimate the mortality rate". Well, that work has been done and the results were that you can find IFRs of anywhere between 0% and 1.6%, with a median of about 0.2%:

https://www.who.int/bulletin/online_first/BLT.20.265892.pdf

There's a letter here in the BMJ that states it's comparable to flu:

https://www.bmj.com/content/371/bmj.m4509/rr

The nature of IFR calculations means there will likely always be very wide uncertainty intervals, however.

> Somewhere along the way we seem to have lost sight of what constitutes a normal disease burden.

Alternatively this pandemic may have permanently shifted what we consider to be a normal disease burden. Maybe we shouldn't accept tens of thousands of Flu deaths every year if there are some relatively simple changes we can make to reduce them.

If simple means forcing everybody, including toddlers, to wear masks… I’ll hard pass.

You are conflating two things. This guy's illness was about the same as worst bout of flu -- that doesn't mean that's necessarily typical, but let's say it is.

Currently, in most of the USA, your chances of getting covid are probably a LOT higher than that of getting the flu. Way more people are getting covid than getting a bad case of the flu.

So it's not quite the same.

If the chances of getting the flu were always this high, including the chances of really severe disease or death for some (say, those with organ transplants)... we probably would have been doing something different.

But I agree with you we shoudln't have to, don't need to, and can't sustainably simply shut down life forever.

I find the experts advice reassuring. IF you are vaccinated:

> Even with delta, the goal is not to go back to a lockdown mindset, though, says Malani. "My hope is that people who are fully vaccinated should really feel like this risk is manageable."

> "Feel good about spending time with your friends, or having a small dinner party, but make sure everyone is vaccinated," she says.

For now I am wearing a mask at the store (not that big a deal), and avoiding large public unmasked gatherings. In part because I want to try to help get community transmission rates a lot lower so we can then do more.

But I agree I'm not gonna do it forever.

>Somewhere along the way we seem to have lost sight of what constitutes a normal disease burden.

Having relatives in the healthcare sector and hearing stories during bad flu waves (2020 was not the first year in recent memory where people needed to be treated in makeshift tents[1]) we do indeed have lost sight of the disease burden, but probably not in the way you imagine.

I was lucky to spent the first few months of the covid-19 pandemic in Japan, and I can tell you I did not see overrun hospitals at any point because people by and large take hygiene and avoiding the spread of infectious disease seriously.

[1]https://time.com/5107984/hospitals-handling-burden-flu-patie...

I am skeptical whether you have drawn the correct conclusion from your experience in Japan. There seems to be something else going on beyond just taking hygiene seriously.

https://noahcarl.substack.com/p/why-have-there-been-so-few-c...

I think the article leaves a lot of space for the possibility that the Japanese have kept infections low because it is a low physical contact culture, and that there have been fewer deaths due to the lack of obesity.

Those are possible hypotheses but remain unproven.

Early in the pandemic they also understood the issue of poor airflow and took that seriously. For example, on the trains (even in winter) they keep a number of the windows open to ensure airflow. Schools were required to keep the classroom windows open and breaks were required at set intervals to ensure people were moving in and out of the classrooms. Restaurants were requested to keep their windows and doors open.

To be honest, I don't think hygiene is taken seriously here. Most people don't wash their hands after using the bathroom, especially at home. That said, they also don't shake hands, and they do use hand sanitizer and wipe their hands with towelettes before meals.

I think what OP really means here is the universal mask usage, which is common during flu (and allergy) season, which definitely had an impact.

Of course, Japanese people rarely take off work when they're sick. They're actively discouraged from doing so, as almost no companies offer sick leave. You're required to take your sick leave from your vacation time, and most companies offer less than 10 days of vacation time. I think the most impactful thing during covid is that the government actively pushed companies to allow work from home, which is a major shift in how people work here. I, for instance, have never gone into the office (I started during covid) and my company is allowing work from home as the default, forever.

The government response as a whole is pretty comical, and they can't really be given much credit. They started a "travel around the country" program called GoTo Travel, which definitely resulted in covid being spread from Tokyo around the country, during one of their larger waves. Their vaccine roll out has been one blunder after another.

Overall, I think the way the culture works here, and their past experiences with SARS, and their normal handling of the flu, is why the country hasn't been overrun, even though it's mostly stayed open the entire time.

> now that I and 90% of adults around me are fully vaccinated

I'm curious, where did that 90% figure come from?

Around here, of the eligible population, about 1 of every 3 has no shot at all, one 1 out of 4 with just a single shot. If you look at the full population, including minors and other ineligible groups, the numbers are even worse.

That means if I go to the grocery store, I'm absolutely gonna be in proximity to someone unvaccinated at some point along the way.

Assume he’s in a EU country/US state with high vaccination rate.

In Santa Clara county (Silicon Valley), 87.6% residents over 12 have has one dose, 82.4% are fully vaccinated. I have no idea if people eager for boosters are getting double counted.

Minors aren't at serious risk, and 99% of the remaining unvaccinated population has made a conscious choice to live dangerously.

No, some large percentage of the remaining unvaccinated population have decided to put people like my immunocompromised mother-in-law at risk through their actions.

I'm genuinely sick of this "I got mine jack" attitude toward vaccination. Getting vaccinated isn't just about you. Unfortunately we apparently have a good solid 20-30% of the population who care only about themselves. But, who should be surprised. This is just American radical individualism coming home to roost.

And that's ignoring the fact that with Delta there's early indications that it's leading to an increase in the number of younger folks hospitalized or worse.

I encourage everyone to get vaccinated if they can, but the Delta variant is so contagious that your immunocompromised mother-in-law is likely to be exposed eventually no matter how many people are vaccinated. There will be no significant herd immunity effect.

https://www.businessinsider.com/delta-variant-made-herd-immu...

The Delta variant causes more younger people to be hospitalized just because there are more infections total. There is no reliable evidence that Delta causes more severe symptoms.

> There will be no significant herd immunity effect.

This is a statement that lacks critical nuance.

Will there be herd immunity that eliminates the virus from the population?

I agree, the answer is probably "no".

But vaccines significantly reduce the chance of acquiring covid upon exposure, and they reduce the period in which you're infectious if you experience a breakthrough case.

https://www.nature.com/articles/d41586-021-02187-1

The result is that R is significantly reduced in a highly vaccinated population. This reduces the rate of spread and the chance any one person will be exposed, thereby protecting the vulnerable.

I know everyone is throwing around the example of Israel's experience, but no one seems to be considering just how much worse things would be for them if they didn't have a high rate of vaccination. The answer: a lot worse. Especially when you consider that, even with Delta, vaccines are highly protective against hospitalization and death:

https://www.covid-datascience.com/post/israeli-data-how-can-...

Unfortunately that's not how it works in the real world. Since the virus is now endemic, the chance that vulnerable people will be exposed over the next several years approaches 100%. Reducing R0 only slows down the spread a little. We don't have a practical way to reduce it below 1.

> Reducing R0 only slows down the spread a little.

Reproduction is an exponential function. A small change in R has a large effect in rate of spread.

> We don't have a practical way to reduce it below 1.

First, this is just not true. Even the (likely pessimistic) Israeli data indicates that vaccinations reduce chance of infection by over 60%. This cuts R in half from 5-7 to 2-3, and probably less when you consider the window of infection is shorter for breakthrough cases.

Combined with other measures--contact tracing, masks, social distancing, improved ventilation, etc--the measures that got Alpha transmission below 1 without a vaccine would be effective with Delta in vaccinated populations. This could allow moving to a model of managing hotspots rather than dealing with unsourced community spread.

Second, you presume that there will never be a vaccine effective against Delta. I'd rather we do what we can now--which means driving of vaccination rates as high as possible as quickly as possible--to slow spread and buy time for targeted boosters to come out than to throw up my hands and just assume that everyone is gonna get COVID so we might as well just give up and stop trying.

Nope. Not wearing masks forever. Vaccines were the end. If they don’t work, nothing will. Either way the only ethical thing to do is learn to live with it and go back to normal.

Life is way to short and we can’t just piss it away being myopically focused on slowing exactly one very specific illness. Sorry.

I don't know what policy around flu should be, but I'd like to share my data points about flu, for those who think flu is no big deal.

The last two times I had flu (first age 36, then a few years later), I was unable to work for an entire month each time.

For most of that time I struggled to get out of bed, and couldn't think much. I was too weak and tired, so I slept most of the time or did low energy activities, and relied on other people to bring me food. The first one meant I missed Christmas: My partner went to an all-day get together with our mutual friends, and I stayed home in bed, too ill to go.

My other flu story would be, a good friend and former employer got flu one day when he was visiting his wife and children (he normally worked in another country to them). Few days into it, he lay down on a sofa and died. I don't know the rest of the story, but I miss him. I think my life would be different if he were still around.

These experiences certainly gave me more respect for flu as a killer.

The last two times you had flu with severity great enough to alert you that you had flu.

Those two experiences you want to avoid in the future, and which define you behaviour (modelled on the impact of the bullets you may get, not on the non-impact of the bullets you may miss).

About a third of influenza infections are asymptomatic.

https://pubmed.ncbi.nlm.nih.gov/18230677/

> My partner went to an all-day get together with our mutual friends, and I stayed home in bed, too ill to go.

So your partner did not quarantine? Avoid non-essential trips? Wear a mask?

I don't think you'd disagree that our COVID precautions at _this_ point are incongruous with the past, but highlighting it for others reading.

Covid isn't flu. It doesn't spread, behave, or affect people like flu. It's not a type of flu. There are some similarities and many differences. Do we really have to keep pointing it out?

I don't think current precautions are incongruous with the past. Because they are significantly different situations.

(Edit: Removed "inappropriately" from "incongruous", as it was intended to clarify but it proved unhelpful. Keeping this note because it gives context to the reply.)

I didn't say "inappropriately". And I'm responding to your flu comparison.

I didn't compare flu with Covid. I responded about the experience described as "worst bouts of flu" to give perspective to that experience by itself. Many people have never had a flu that lasted like that. Hearing that it happens is interesting. In particular, someone thinks it's just a few days off work, and I know some people in the US don't have enough permitted sick days to be sick for a month.

I think comparing two situations and calling the different responses to them "incongruous" implies the comparison is intended to be about something you think is appropriate. (And I think it's an inappropriate comparison, because Covid and flu are sufficiently different.) Otherwise the comparison is pointless. Perhaps I should have written "appropriately incongruous" instead of "inappropriately", though; the multiple negatives seem to get confusing around that sort of language, especially across continents.

in what country are yoy that 90% of the adults are fully vaccinated?

Also, "Think of the children". those that can't get vaccinated but are now dying from the delta strain?

Ireland, almost. (I think we're at 92% with one dose, and 89% with two).

thats astounding. well done you lot :-)

It's not quite as good as it seems, because we have a lot of kids in Ireland, but it's still massively reassuring.

> Exactly. I see no reason why I’d take strong measures to avoid getting exposed to it (now that I and 90% of adults around me are fully vaccinated) when I never did the same for the flu.

It should really go without saying COVID-19 is much more transmissible than any recent version of the Flu. Comparisons of symptoms and severity in healthy adults has never been the sticking issue.

I'm disheartened to see people on HN of all places thinking solely as an individuals and not about the management of health care resources at a population level. Health care resources are finite and viruses like COVID can still spread exponentially even with current vaccination rates.

From the beginning, the goal has been to lower transmission, lower cases, and therefore lower the burden on the _world_ health care system to a tenable degree. Yes, there may be _more_ effective measures we can take at this point, such as ramping up vaccination, but at the end of the day, if you don't transmit the disease to others or end up in the hospital yourself, you are helping the cause.

tldr; Whether or not it poses a risk to _you_ is besides the point, in so far as the risk of overburdening the health care system remains.

The healthcare system also had more than a year and a half to build capacity to deal with this stuff? Why should society be required to bail out hospitals by adhering to arbitrary restrictions on their life?

I don't disagree with you, but your tone does smack of biting the hand that feeds.

I mean all this “protect the hospital” crap is bailing them out. Might as well be honest about it. People should be pissed that hospitals didn’t build capacity… why they aren’t, beats me.

I completely disagree with them. They seem to think hospitals operate like spinning up extra VMs when extra load is generated.

And, in particular areas where there is an outbreak it can work like that. Much like you can spin up another VM when you still have underlying resources to do, you can setup an emergency hospital when you can borrow resources from elsewhere.

When everywhere is busy, let's say a major pandemic outbreak, there is no extra capacity, and you tend to lose capacity by attrition of a worn out workforce.

I think it's fair to say that in the past year and a half, we had time to build capacity slowly and intelligently. OTOH, that's not any individual hospital's job. In our capitalistic society, if OP wanted to go build their own hospital, nobody was stopping them.

Change the config file for the hospital from 100 doctors to 200 doctors, and reload the config. You can spin up a new doctor in what 30 seconds? Totally how the world works from the armchair.

Not like it takes 6-7 years to get the basics down, weed out the ones who really are not as into it as they thought or just wont make it, or cant keep up. Not to mention the ones that want to go off and do tit jobs for a living rather than feeding experimental medcine to people who are about to die because they excercised their rights to refuse to take tested medcines.

> I think it's fair to say that in the past year and a half, we had time to build capacity slowly and intelligently

> Change the config file for the hospital from 100 doctors to 200 doctors, and reload the config. You can spin up a new doctor in what 30 seconds?

...wtf?

tbh i am not shocked you cant figure it out.

They totally did though. Did you see all of the new stadiums and ships and warehouses and tents that were erected at the start of the pandemic ready to take the overflow?

None were utilized.

Can you point me to some ICU data that shows them filling up in the past year and a half?

NOT fear mongering media articles, but the actual data you're using?

Why not converse. Show the data that you're using.

You're claiming you can fly and asking me to prove that you can't fly? That's not how science works.

The burden of proof is on those who claim things are different than the norm.

I mean my local hospitals have been publishing icu bed usage since near the beginning of the pandemic and during every surge they run low on icu beds with the majority of the beds used by covid patients.

Would love to see that posting

An odd analogy, given that hospital workers don't feed anyone - it's the rest of society that feeds them.

By point-blank refusing to even consider increasing capacity, despite being written blank cheques by military engineers and ventilator designers, and insisting instead on lockdowns, it is rather the other way around: society fed the healthcare managers who then turned around and bit that hand. Supermarket staff, truckers, farm workers, meat factory operators and so on cannot lock down or work from home, so they had to keep working throughout. Yet health managers just looked blankly at their shiny new emergency hospitals and acted baffled that they were expected to do things differently to normal. Nobody increased capacity to help ensure care for the essential workers. Eventually the quasi-religious approach to the health system will go away and people will start to wonder why exactly all those newly built beds had to be dismantled instead of being paired with an emergency training programme.

> I'm disheartened to see people on HN of all places thinking solely as an individuals and not about the management of health care resources at a population level.

Individualism vs Collectivism is a debate that goes back a long time.

Your 'flattening the curve' argument is fear based.

I haven't seen any actual DATA besides media fear mongering that ICUs are 'almost' full for years now.

> Exactly.

Not quite. The worst bouts of flu are the ones that kill people. Some of the influenza A strains are no joke.

Most seasonal upper respiratory illnesses don't routinely cause loss of smell or taste, which should be a clue to something more nefarious potentially going on. If I were the author I'd worry about subtle frontal brain injury.

For me, boosters and nasal vaccines can't come fast enough (nor can the ability to administer them to younger children).

At some point I think this virus will become like the flu in terms of public health implications, but I don't think it's quite there yet.

Loss of smell in COVID-19 isn't caused by frontal brain injury.

https://hms.harvard.edu/news/how-covid-19-causes-loss-smell

The risk to younger children is minimal.

https://www.nature.com/articles/d41586-021-02423-8

I think the jury's still out about frontal damage:

https://www.science.org/doi/10.1126/scitranslmed.abf8396 https://www.medpagetoday.com/opinion/second-opinions/94301

As for children, yes, the risk is much smaller than for adults, but it's a moving target due to viral evolution, and why not reduce it as much as possible?

Here’s an interesting calculator from Oxford using Britain’s data from COVID:

https://www.qcovid.org/Calculation

My wife is a nurse and doesn’t follow up the data and she was in disbelief that her “risk” of serious/death was around 0.00005% or somewhere near that.

As a nurse, what's her risk of spreading it to someone with a much, much greater risk of death?

If we're going to run society this way, we're going to need much more difficult driving tests.

Unless bad driving is an infectious airborne pathogen, I'm not following this analogy.

Sure seems to be in the mid Atlantic region of the US. Also, I’m sure you get the point they were making, why be unreasonable about it?

Is there a better name for the "playing dumb" style of argument?

Come on - obviously bad driving is not primarily an infectious airborne pathogen. Bad driving is something you can unilaterally inflict on other people to permanently ruin their lives, as is an infectious airborne pathogen.

Well I certainly do think people should consider others when they get behind the wheel.

Similarly I think people should consider the risk to others if they get this pathogen rather than just the risk to themselves.

The problem is, 73% of drivers think they're above-average drivers[1]. So just as you can't know whether you're the one spreading COVID, you can't know if you're the bad driver.

The solution is to get rid of cars as a primary mode of transport, and I really do think we should do that!

1: https://www.businessinsider.com/americans-are-overconfident-...

> So just as you can't know whether you're the one spreading COVID, you can't know if you're the bad the driver.

This really isn't remotely analogous, particularly since you absolutely can know you're at risk of spreading COVID.

You added the "at risk" part, not me! :)

Your version applies to cars too! By driving a car, you are at risk of causing a car crash!

You said "you can't know"

With COVID, you can. Pretty easily.

Sorry, I might not be understanding where you're going with this. I initially thought you meant "you can know you're at risk of spreading COVID, because everyone is at risk of spreading COVID."

Certainly, anyone who receives a positive PCR test for COVID should quarantine ASAP. But if you're incubating COVID, but not infectious yet, the tests will return negative. A test only tells you whether you were infectious at the time of the test, so by the time you've seen the results, the information is already outdated.

> I initially thought you meant "you can know you're at risk of spreading COVID, because everyone is at risk of spreading COVID."

No. That wouldn't be a particularly useful statement.

Dismissing the aggregate risks solely based on your own is short sighted.

Indeed, driving lorries and buses requires an advanced license, with far more stringent testing, presumably because, like in the analogy, you could kill a lot more people behind the wheel of those?

Bad driving begets bad driving. Some jackass cuts you up dangerously, your adrenaline is pumping and you then follow too close behind a third driver repeat ad nauseam

I understand the point you meant to make, but to be honest I've always found it horrifying whenever I have to sit in the DMV and see who all they allow to pilot steel missiles around. Our "licensing" for drivers in the US is abhorrent.

> we're going to need much more difficult driving tests.

Sounds good to me. Let's require regular re-testing while we're at it.

While we are at it, mandatory breathalyzers in all cars, and all cell phones should be locked while traveling over 10 MPH. Let’s do this!

Your analogy doesn't really make sense to me.

It's not like we are aware that there are certain drivers that are 100x more likely to kill certain members of the population.

And if we were aware that certain ways of driving made you 100x more likely to kill someone, people would AT LEAST be talking about banning them.

Like, if teenagers could drive around drunk just find and not kill themselves or other teenagers somehow - they probably wouldn't care if only old, sick people ended up dead from their driving. People would probably make rules or at least talk about making rules to prevent this.

But that's not how driving really works.

Sounds sensible to me.

The US in general has super lax driving tests. Here in Denmark it's about 3 months of theoretical classes side-by-side with driving with a certified driving instructor. We also learn the basics of cars on a closed track, and later learn to drive in slippery conditions on the same closed tracks. The closed-track tests include being able to catch the car after pulling the handbrake in a turn while going 80 km/h (50 mph).

Oh, and to actually get your license you also have to drive 45 minutes with a police official checking your every move.

My friend living in Denmark, with a driver’s license from a corrupt country where literally anyone can get it, would render your whole 3-months intensive system useless. He is in fact driving, and could cause quite a crash, with all this amazing procedure you describe.

We are a somewhat globalized civilization and the same as this security theatre about keeping airports open with countries with 2% vaccination rate can be said about driving.

But Mum, Kevin does drugs and he is fine, why cant I?

Why would you want to pull the handbrake in a turn while going 50 mph? And what is going to happen if you pull the handbrake at 50 mph other than the handbrake burning out? I have not had a car with a handbrake at all but I drove a few rentals with one and they drove normally even when I forgot to take them off the handbrake, the thing is just a lever with a wire, it cannot stop the car even on idle. Or do they use a rally car with a hydraulic handbrake that does something at that speed?

The point of pulling the handbrake is to artificially trigger a slide in a controlled environment in order to verify that the student driver has the vehicle control skills necessary to recover. It's similar to what can happen driving on ice.

So the car is supposed to slide when you pull the handbrake? This will be hard to pull off in the US where most cars have an electronic parking brake and the ones that have the actual lever have it connected to a weak drum brake that cannot lock wheels when the engine is running.

Also, the whole test seems to be set up like a gold rush for lawyers - if you actually managed to slide the car and roll over at 50 mph you are almost certain to have some injuries not to mention the damage to the car. Who is liable for those, the government that ordered the driver to execute a dangerous maneuver in order to obtain a driving license? What if the driver dies from the injuries?

> So the car is supposed to slide when you pull the handbrake?

Yes, that's what will happen if you brake the rear wheels (what the handbrake does) in a turn.

The point isn't that you'd ever do that, of course, but to simulate the rear end of the car sliding which can happen if you hit ice, oil or even uneven water patches. Can you control that slide? It's really awesome if Denmark is including car control in the test. The US should do the same.

I strongly encourage you (everyone) to find a car control clinic in your area and participate. Even a single weekend will raise your car control skills significantly if you've never had any instruction before.

Newer cars have a lot of traction control magic that try to save you and often do, but there's still no substitute for the driver having skills as well.

Sure the DMV manual will tell you to steer into the skid, but there's no way to learn this muscle memory without practice and the most productive practice is with a good instructor.

(I used to instruct the BMW club car control clinics (open to all cars) before life got too busy, hopefully will take it up again in the future.)

> Also, the whole test seems to be set up like a gold rush for lawyers

OP said this was in Denmark, so presumably every little thing isn't a "gold rush for lawyers" unlike in the USA.

Handbrakes do not always break rear wheels for one, some cars have front parking breaks. I am pretty sure you will be off the road if you locked your front wheels in a turn no matter how much muscle memory you have, you cannot steer with locked wheels.

And I have not seen a car where a handbrake could lock wheels even on idle, least on driving in gear at 50 mph. I don't doubt such breaks exist, rally cars supposed to have them, but on my car, for instance, all that is going to happen if I pull the handbrake flap in gear is nothing and if I hold it for 5 seconds it will do an emergency stop using its ESC,ABS and all kinds of smart technology (I think it's also supposed to move to the shoulder and turn on hazards but I never really tried it). It won't slide for sure. How am I supposed to pass a test like that? Rent a 500K rally car?

>OP said this was in Denmark, so presumably every little thing isn't a "gold rush for lawyers" unlike in the USA

People can just kill themselves on orders from government in Denmark? Sounds like the country not to take as an example to me.

> Handbrakes do not always break rear wheels for one, some cars have front parking breaks.

Which one specifically? I've never encountered one and a brief web search didn't find any. I'm sure it can exist, but seems exceedingly rare at best.

I mean this in the most encouraging way possible: your comments (this and previous) suggest you have zero experience with car control. I greatly encourage you to find and participate in a few car control clinics to see how cars actually behave on the edge of adhesion and beyond. It's a great learning experience and also just fun. Most importantly, if you ever do hit ice/oil/etc, it might just save you from a crash.

> People can just kill themselves on orders from government in Denmark?

No need to be silly. Surely these tests are done in a suitable location, and there's zero risk from a bit of a slide or spin. Again, something you could experience and learn in a car control class so it stops becoming scary.

Wiki article on the handbrake points at the brands, also ZF makes this https://press.zf.com/press/en/media/media_15682.html not for the parts collectors I imagine. It is hard to check parking brake locations on the cars via internet though.

And thanks for your concern about my car control, you don't seem to be talking about the things I mentioned though: the lack of parking brakes on many cars and the lack of parking brake capable to lock wheels on many more. I am not going to go to your clinic anyways so if you don't want to talk on the topic I will bow out.

Besides, you just informed me that spinning out is completely safe and won't harm me so why again I need to train for that?

So there's about 4 cars with front parking brake based on wikipedia, all of them very old and esoteric. They are so rare they can be ignored as outliers. If you show up at the driving test in one of those I guess you'll have to rent another car.

> Besides, you just informed me that spinning out is completely safe and won't harm me so why again I need to train for that?

You're not discussing in good faith so I won't continue.

Spinning out in a training facility (generally a large parking lot) is perfectly safe, it's a training area. Spinning out in traffic on a windy road, not so much. That's why you should train first in a safe space with instructors, before driving on public roads.

4 car brands, each brand makes multiple car models, Citoën is by no means a rare make. I've seen them even in the US and in Europe (where Denmark is with its test) it's one of the popular brands

Spinning out at 50 mph is not safe anywhere as you can easily rollover, I pity people who go into your clinic as you don't seem to have a slightest clue.

Coming back in late here.

> No need to be silly. Surely these tests are done in a suitable location

My tests were done in the middle of a former cold war airstrip. This link should show the complex in a satellite view: https://www.google.com/maps/place/K%C3%B8reteknisk+Anl%C3%A6...

Notice the darker patch of tarmac. That is extra-slippery when wet and has a sprinkler system on the grass next to it.

Even if you could not lock the rear wheels on a regular manual car with the handbrake, these cars are always modified for instructive use. Think additional mirrors/pedals for the passenger.

An upgraded handbrake doesn't seem far-fetched.

> Even if you could not lock the rear wheels on a regular manual car with the handbrake

Mind you, you don't need to lock the rear wheels to induce oversteer (rear sliding out).

All you need to do is to make the rear wheel braking force be higher than the front wheel braking force while turning. Which in this case, since there is zero braking force on the front wheels, doesn't take much at all. A very quick pull on the handbrake will do it.

If you ever drive a race car with an adjustable brake bias control (changes percentage of braking force front/rear) it's easy to experience it doesn't take much rear bias to induce a spin if braking in a turn, even though none of the wheels ever lock.

So every time I drove off with the engaged parking brake I had my car sliding in the turns? Great news: I appear to have so much muscle memory that I was able to drive without even noticing that.

So you use an instructor car's to pass the driving test in Denmark? It's not how the things in the US work. People cry bloody murder if a state requires to show ID to vote because of unmanageable costs of getting a 20ish dollar/5ish years ID, imagine you had to rent a specially modified car to get a DL or not being able to get a job/buy food?

The website doesn't have that info.

also tiny, since they have rigorous procedures and properly-deployed ppe for all sorts of transmissible infections, not just covid (and where masks can actually help, unlike most mask usage).

the treatment risk calculation is also entirely different, since "someone with a much, much greater risk of death" is already flirting with death in other material ways.

You’re making uninformed assumptions and obviously don’t work at a Covid center in the USA. Personnel are now careless, many are fatigued and/or disillusioned, protocolsuu are not universal or enforced, many buy into the political drama and don’t mask when outside the facility and patients have become argumentative about masking. The moment I have another career option is the moment I quit. PPE use / enforcement and availability is also spotty. People are tired of arguing with their coworkers about it, too.

buddhism suggests we focus on the things we can control, like perception and attitude in the face of otherwise uncontrollable circumstances. i've no doubt the situation for many medical professionals is quite frustrating, even infuriating, but it would have been so in any of the myriad of realistic scenarios. the virus is, and was always going to be, endemic, which means hospitalization and death rates are pretty well bounded no matter what we realistically did. the frustration comes from believing that this isn't true, that there was something that could be done to significantly reduce these rates, but that's mediopolitical messaging, not realistic possibility. accepting this could possibly relieve some of your frustration.

also, no assumption was involved, just the simple logic of multiplying two tiny numbers resulting in another tiny number.

What's a parents' risk of having children that eventually die? What's your risk of driving and having a seizure at the same time and wiping out kids on the sidewalk? What's your risk that while leaving Home Depot you dropped a few nails on the ground and someone's car tire picked them up and now they'll have a blowout on the highway?

We can take this stupid premise to its logical end and never do anything out of fear that we might eventually harm someone else, but that's not how life has gone on for millennia. We have the vaccine which is the solution, by and large the data supports that the sustained overreaction is now disproportionate to the actual risks, time to let the science we supposedly all believe in aka natural selection run its course.

No way, the 6th booster will definitely do it! Or maybe the 7th!

We can take a realistic look at the increased risks involved with particular behaviors and the relative gains.

There are people who don't have kids of their own because of the high risk of passing potentially fatal genetic defects to their children. If you are an at risk epileptic, driving regularly is something you should avoid.

If an you are contemplating an activity that has a significant risk of causing harm to others, you have a moral obligation to consider if the benefits are big enough to be worth that risk.

If you have a higher than average level of contact with vulnerable populations, you should take higher than normal precautions to reduce your chances of infection. This is just basic moral common sense.

I don't understand the point you're trying to make. Should we stop having nurses treat covid patients so they don't spread it to people who are more likely to have severe reactions? Should we stop having nurses treat people with compromised immune systems and other health issues so they can treat covid patients?

Absolutely useless: the calculator doesn't even ask if you have been vaccinated! And the risks are calculated for someone in the UK - completely irrelevant if you are not (no NHS etcetera).

Was the calculator developed before Delta? Does it already include a factor for your chances of catching it, or is it the risk after you have caught Covid? So many glaring issues - it isn't designed to be informative to the general public.

The associated paper was published in October 2020, so yes this was developed well before delta (at least well before delta's arrival in the UK), most likely in the period between the first and second major peaks in the UK. Given the way academia works I doubt it has been updated significantly since then.

The “risk” is misleading because it’s the risk that you will catch it within a 90 day period based on the community spread in the UK at some point in the past (before Delta) times the risk that you will die if you catch it.

Since your wife is a nurse, she’s much more likely to be exposed than the average UK resident. I also think even in her case you likely added an extra zero or 2 based on what I’m seeing while playing around with it.

I think what most people want is what’s my risk of death assuming I get it, not that multiplied times the risk of being infected within only the next 90 days.

Those are two different measurements.

You have: 1. Chance of getting a disease 2. Chance of dying from said disease once acquired

Both have numerous factors that affect the result.

For someone who works in health care, they're likely subjected to multiple variants at one time.

What's the metrics look like when someone is hit with 2+ variants at once?

HIV is similar, where someone can be positive for 1 or more different strains. And their viral loads are cumulative.

At this point the Delta variant has effectively out completed everything. The chance of exposure to any other variant is low.

>an absolute failure to understand Bayes theorem.

>a totally asinine comment

Why not multiply by the probability that you don't die within the next 90 days from some other event, or the probability that the earth doesn't explode within 90 days.

The likelihood that you're infected is both too hard to calculate for a given individual to be useful and, based on current epidemiological models, close enough to 1 over the long term for unvaccinated people that it doesn't make much difference.

The probability used in the model presented is the probability that a random person in the UK will be infected given the same conditions seen in March of 2020 over a 90 day period. It's a useless number. Multiplying the IFR just destroys whatever useful information you could extract from the IFR in the first place.

NPR article honestly just sounds like fear-mongering. I am fine with showing how worse it can get, but nothing in the NPR article talks about the likelyhood of getting a bad case of COVID after vaccination. Objectively informing the public, it is not.

The section "How high are my chances of getting a breakthrough case these days?" goes into that. If you're looking for a hard number, I don't think anyone can give you that because it's highly community specific.

I have no idea how you got fear-mongering from that article, though. My impress was that it's a reality check on what the vaccine is capable of and what one individual's breakthrough looks like.

> I have no idea how you got fear-mongering from that article

This is a single first-hand account, was subject to publication bias, and a relatively bad breakthrough case.

> how you got fear-mongering from that article

Title of the article: "I got 'Mild' Breakthrough Case".

By definition, it is not a mild case. Any reasonable definition of mildness would not include the terms "My eyeballs ache" and "103 degree fever".

The article implies that even the mild case of COVID has horrifying symptomps which it goes into great detail to painfully exemplify. This is misleading. Absolutely despicable journalism, if you ask me.

It didn't imply, it defined the term 'mild' as hospitalization or use of oxygen. What are you mad about? The point was to give an anecdote to keep people aware of what a breakthrough is like.

> "NPR article honestly just sounds like fear-mongering."

that's nearly all of npr (and nyt) now, especially the covid-related news that's 50+% of npr stories. i can no longer stomach more than their 10-minute hourly news summary on the radio these days.

I’m personally way more worried about long-term cognitive symptoms than about dying. Obviously the jury’s still out on long term symptoms, but something like a quarter of people with symptomatic COVID seem to have some kind of cognitive symptom (mainly “brain fog” and/or short-term memory loss) 8 months later. https://www.medrxiv.org/content/10.1101/2021.03.18.21253633v...

It's also unclear if those long COVID symptoms will resolve after a few years.

Even a few weeks of "brain fog" would be pretty devastating to my mental health, ability to earn a living, and ability to be an effective parent.

I was double vaxxed with moderna and caught a breakthrough case.

The weird thing is that while the extent of my infection was that I had a bad sinus infection without fever for about 3 days. It greatly effected my cognition, besides temporarily (<1 day) losing my sense of smell I also experienced a loss of spatial/body awareness and was knocking things over which I never do even when sick, I was easily cognitively overwhelmed for about 10-15 days after my positive test, 11 days after my symptoms subsided.

I am a software engineer that a couple times of year may get halo migraines, the worst untreated migraines I've had caused a small decrease in cognition and working memory for almost a week, most migraines have little to no cognitiove effect.

This "mild" covid was by far the most systemic and far reaching cognitive impairment I've had, worse even then post surgery recovery involving deep general anesthesia. It effected working memory, ability to follow conversational threads & profoundly limited my available vocabulary, I was missing words, not simply fumbling for them, for several weeks.

It's an interesting virus to be sure, my generally unflappable fiancee was uncharacteristically worried by my erratic mental state, she was relieved I tested positive with covid as she had been worrying about a stroke or something.

Anecdotally... I would not recommend getting this virus if you are a knowledge worker.

Sorry you had a rough experience but unfortunately that's not really actionable advice. Since the virus is now endemic all of us can expect to be exposed multiple times in our lives regardless of what protective measures we take.

What treatments did your doctor prescribe during the infection? Unfortunately many physicians still aren't treating it aggressively enough with monoclonal antibodies and other therapies.

https://www.covid19treatmentguidelines.nih.gov/therapies/ant...

I would not say that it was a rough experience, just that it had a stronger cognitive component than I had expected as a vaccinated individual. Was I supposed to give actionable advice? I clearly said my experience was an anecdote.

I was out of town when I became infected so I was not able to procure monoclonal antibodies during the recommended period, the healthcare logistics were a pain (as they often are in the states). I of course took high bioavailability zinc, magnesium, vitamin d, vitamin c, etc, etc.

If you're asking that I provide actionable advice I would suggest these things in so far as I'm qualified to make any suggestions.

1. get vaccinated

2. keep an oxygen meter on hand or use the one on your phone

3. keep a home antigen test on hand

4. if you test positive throw whatever your doctor recommends at it

5. When traveling wear a comfortable silicon respirator with a good fit.

6. It would be nice to have a nasal spray vaccine, it was very clear during my infection that covid was not able to find purchase outside of my heads mucosal... zone? region? it seems like a nasal spray booster that targets strengthening the immune response of that part of your body might be of enormous benefit to prevent these cognitive effects in mild cases.

I lost $1000 due to post COVID brain fog just today. I’m a photographer and had my first shoot since having it, and I set up a light in a way where the first gust of wind toppled it over in to a lake.

With around than 1% getting long COVID, which used to be called "viral fatigue" pre 2020, I'm not certain its something to worry about.

I think "long COVID" is too vague to really provide a specific incidence rate - it's more meaningful to look at the incidence rates of particular symptoms long after infection.

The study I linked finds 27.9% incidence of "confusion/brain fog/trouble focusing attention" and 20.7% incidence of short-term memory loss 8 months after symptomatic COVID infection (confirmed with antibody testing), compared to 14.7% and 5.6% respectively in the control group (who tested negative for COVID antibodies).

I don't know or really care if "long COVID" is the right term for what those folks are experiencing, but that result has real practical significance and the rates are way higher than 1%. The same study also finds significant incidence rates for lots of other symptoms that could reasonably fit under the "long COVID" umbrella.

I (40 yo non overweight, non smoker, non diabetic) got COVID back in March last year. I was healthy before that and got a 'mild' case by medical standards. And yet, I developed a nasty pneumonia in one of my lungs at that time.

After more than a year, I still haven't recovered my full lung function. As soon as I get in a room with AC I start to cough, and my lungs are sensitive to cold weather .

It may be 'just' 1 percent... But darn it sucks to win that lottery.

A better measure would be similar to Expected Utility: 1% multiplied by the 'loss' value of living the rest of your life fucked up.

Take a look at this book. Many patients with similar symptoms caused by other diseases have been able to improve just with breathing exercises. There has been significant research in this area, not just pseudoscience woo.

https://www.mrjamesnestor.com/breath

As others have pointed out, that site generates a risk that isn't what most people think of as the risk of death, that is it gives the risk of catching and then dying of Covid during a 90 day period when Delta wasn't around.

For a more expected assessment of "risk of dying if I have covid", you can use this:

https://www.economist.com/graphic-detail/covid-pandemic-mort...

Although it only shows "<0.1%" for anyone under 40s, so it doesn't break things down that fine (better for hospitalizations).

Looks like actual cases will make up a material portion of herd immunity. Columbia reports that up to 1/3 of Americans already had contracted COVID by the end of 2020:

https://www.publichealth.columbia.edu/public-health-now/news...

Five reasons why COVID herd immunity is probably impossible https://www.nature.com/articles/d41586-021-00728-2

Here’s why herd immunity from Covid is ‘mythical’ with the delta variant https://www.cnbc.com/2021/08/12/herd-immunity-is-mythical-wi...

The developer of the AstraZeneca shot says the Delta variant has made herd immunity impossible because vaccinated people can still transmit the virus https://www.businessinsider.com/delta-variant-made-herd-immu...

That’s talking about herd immunity from vaccines. OP is talking about herd immunity from natural infection. So your links don’t invalidate the point, considering Israel research just proved that natural immunity is 13x more effective against Delta than Pfizer mRNA

......? Herd immunity is herd immunity. It doesn't matter what caused it.

Natural immunity is great, but most people clearly don't have and won't get natural immunity. Having had COVID-19 already also does not make you later immune, to any variant. You can get it again and spread it again. https://health.clevelandclinic.org/can-you-get-covid-19-more...

Have a link handy about the 13x research? Not doubting, just want to read more about it as I hadn't seen that one yet!

Text-only version:

https://text.npr.org/1036356773

Thanks. NPR used to have a pop-up asking if one wants to be tracked or go to the text-only version. Now they only offer getting tracked or some convoluted guide on “other options”.

So did I a few weeks ago. I was vaxxed in April. And then caught it in early August. Three days of sweating and chills, a week of coughing and loopy-head. Positive PCR test. 3 weeks later and I still have a chest-cough I can't shake.

Of course, if I didn't have the vaccine, I probably would be in an overflowing hospital close to death.

Assuming that you're between 18-49 years old, the CDC puts the infection fatality rate for that age group at 0.15%. So, unvaccinated, you would have a 99.85% chance of not dying. Being vaccinated, of course, further improves your odds.

https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...

The younger you are within that bracket, your odds improve even more. If you have no comorbidities, even better.

Basically, I wouldn't be worrying about death as any given young individual, but at a population scale, COVID is quite deadly. I'm personally much more worried about the other reported effects and lasting tissue damage.

> Assuming that you're between 18-49 years old

That is a huge range of ages and varying risk levels - in effect, you are over-averaging.

****************

For a 45 year old caucasian male with no comorbidities non-smoker

0.16 (95% CI: 0.14 - 0.17 ) times the risk of dying from COVID-19 compared to the average risk for the US population

absolute rate of mortality of 1.3 (95% CI: 0.6 - 2.8 ) per 100000 individuals in subgroups of the population with a similar risk profile to yours during the period of 09/11/2021 - 10/01/2021. This estimate is calculated based on the CDC's Ensemble mortality forecast data..

95% CI: Error bounds with 95% confidence.

****************

For an 18 year old caucasian male with no comorbidities non-smoker

0.02 (95% CI: 0.02 - 0.02 ) times the risk of dying from COVID-19 compared to the average risk for the US population.

95% CI: Error bounds with 95% confidence.

****************

Calculated using JHU's COVID-19 Mortality Risk Calculation https://covid19risktools.com:8443/riskcalculator

You've copy pasted something wrong

Your numbers are way off. The CDC estimate of fatality rate in the 18-49 age group is 0.06%. And that's highly dependent on co-morbid conditions.

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...

Mid-50's with an existing disease. Which is why I got my shot early. I have good reason to worry.

Which vaccine? Collecting anecdata …

Pfizer.

Very similar to you. Had double Pfizer. Felt like crap on a Sunday, felt worse on Monday so skipped work and took a lateral flow test which came back negative. Same symptoms but for maybe 5 days. Lost my sense of taste on day 3 which was also the day I tested positive (I didn't take a test on day 2). I stopped testing positive a few days later, but taste was lost for maybe a week.

I had a cough for maybe 10 days, which has just subsided. I can't tell if I have brain fog, as my cough was really preventing me from sleeping well.

One interesting observation: I was pretty ravenous the entire time. I had a fever and was sweating like a pregnant nun in church, but I never lost my appetite. If anything, it turbocharged.

> taste was lost for maybe a week

All comforting data, as I have second degree acquaintances who have not recovered taste and smell 17 months after infection. I think it would be quite desirable to have stats with comparisons of these details (duration of adverse events) in all relevant different cases.

(Your «sweating like a pregnant nun in church» will remain with me and I must thank you.)

> In my case, it was worse than expected, but, in the parlance of public health, it was "mild," meaning I didn't end up in the hospital or require oxygen.

> ...

> It was a miserable five days. My legs and arms ached, my fever crept up to 103 and every few hours of sleep would leave my sheets drenched in sweat. I'd drop into bed exhausted after a quick trip down to the kitchen. To sum it up, I'd put my breakthrough case of COVID-19 right up there with my worst bouts of flu. Even after my fever cleared up, I spent the next few weeks feeling low.

"Mild" can mean different things to different people. I doubt this description of "mild" fits most people's concept of the word, as it sounds like a severe case of the flu. The fact that these infections are happening against a backdrop of normalization efforts should give anyone who thinks we're out of the woods pause.

As the rate of infection increases, so does the risk to the vaccinated. It's another demonstration, once again, of how our public health system (and the CDC in particular) has failed us:

> ... "quantifying that [chance of symptomatic case in an unvaccinated person] in the U.S. is very challenging" because our "data is so shoddy."

Some time ago, the CDC stopped counting/sequencing "mild" breakthrough cases, so we're flying blind mostly. Maybe it's delta the reporter caught. Maybe something else. Who knows?

https://www.newsweek.com/why-did-cdc-stop-counting-mild-asym...

What's clear is that COVID-19 isn't going away any time soon. What's also clear is that it shares the tendency that all RNA viruses have to mutate at an extremely rapid rate. It has shown that it can change much faster than we can adapt.

> What's clear is that COVID-19 isn't going away any time soon.

This isn’t new information. It was obvious all the way back in March of 2020 that covid was here forever.

Life must go on. We cannot live with this myopic fixation on exactly one specific form of illnesses. These “experts” have already asked enough out if people. We’ve been asked to put our lives on hold for more than 1.7 years now.

Dragging any of this on after the first vaccines came out was unethical as hell. Vaccines were it. There is nothing else we can do besides attempt to build some myopic hellscape where our entire existence is centered around stopping the spread of covid.

Well we can get everyone vaccinated so we quit filling the hospitals with unvaxxed patients.

Hospitals have had more than enough time to prepare for this. If they fill up, that’s on them and the government. Society shouldn’t be punished for that.

I hate being blunt on HN, but this is a stupid take.

If everyone that could take the vaccine did take the vaccine then the hospitals wouldn't have filled up. Instead the vaccine has become a political IQ test that is ravaging particular demographics based on the amount of disinformation they consume.

"Society" isn't being punished, anti-vaxxers are, mostly. Hospitals aren't going to double/triple the size of their ICUs and number of vents/ecmo machines, they are going to triage. Even if did double the beds, you don't double the number of people trained well for these complex procedures in a year.

If they fill up—I mean, when they fill up, that's on my mom, who has to wait for a follow-up surgery because the hospital doesn't have the capacity to take care of her.

I agree that there are better ways to run our healthcare system, but we also have to contend with the facts right now as they are. Perhaps the people being punished most right now are the ones who are in pain, at home, and who can't get medical care because the hospitals don't have capacity to deal with it because they're filled up with COVID-19 cases.

> I doubt this description of "mild" fits most people's concept of the word

Hence the ' around mild in the title. But honestly sure they were sick but they did not seriously fear for their lives or require medical attention. Obviously being asymptomatic would have been more mild but in general this seems like a win.

People need to accept some level unpleasantness and risk in their lives.

This is what post pandemic looks like.

Covid is endemic, and just like you probably don't know anyone who has never had the flu or the cold, it will be the same with this.

Get your vax! It'll likely keep you out of the hospital when you do get it.

Mask up all you want. Avoid crowds. Shun and shame people. You're still going to get it, just like everyone else.

Sherman should have continued marching through the south for several years completely displacing all of the traitors who have become the Republican Party today. Then we could have public health.

> Recent research from the U.K. suggests that vaccinated people are about 50% less likely to develop long COVID than those who are unvaccinated.

To me that doesn't sound like that great of a risk reduction.

That's on top of the reduced risk of catching it in the first place. Estimates of that vary widely, let's use 1/6. So 1/12 risk of long COVID.

Have you factored in the reduced chance of symptomatic disease? That comes before long COVID.

With (two months after) vs without = ~0.2 vs 0.05×0.5×0.2 = ~20% vs ~0.5%

(Explanation: chance of symptomatic disease 2 months after reported as 5% vs "control"; chance of long COVID after symptomatic infection reported as 2.3% as bare minimum, 13% to other research and 40% to a large interpretation.)

Edit: to the three British studies of 2.3%, 13% and 40%, after this thread I can add 25% from a post from user tfehring, including link to article: «something like a quarter of people with symptomatic COVID seem to have some kind of cognitive symptom (mainly “brain fog” and/or short-term memory loss) 8 months later». I will update the tentative value for the chance of long COVID, but the ratio, half of one twentieth, does not change.

People get sick. It happens. I am well-aware that by resuming my pre-pandemic lifestyle, and only wearing a mask in the spaces where they're mandatory, I am increasing my risk of getting ill.

But I'm not going to change my behavior, because I'd rather be sick for a week than sit at home 24/7 for the next year, or wear a mask every time I step outside, and constantly monitor my physical distance from other people. My life is passing me by right now, and I want to enjoy it while I can.

- sit at home 24/7

- wear a mask

These 2 things seem rather different in magnitude.

Especially because a lot of outside doesn’t need a mask. If you live in a dense urban core, it might. If you live in light urban, or suburban/rural, you can mask when stepping into the store or whatever.

Don’t forget that masks are to protect others at least as much as yourself.

And wearing a mask is not just direct individual risk reduction either. Preventing spread reduces opportunities for the virus to mutate, which reduces the larger systemic risk that a new mutation is created that is even more adapted to bypassing vaccines and masks.

> Don’t forget that masks are to protect others at least as much as yourself.

That seems to depend on the mask itself, some masks explicitly state that they offer no protection to the wearer and only serve to provide protection to others _from_ the wearer.

This article, for me, highlights one of the major problems of this entire response. Various establishments keep trying to present a rather black-and-white binary view on these subjects.

They're doing a particularly poor job of explaining the spectrum of risks and protections that are available and how to apply that knowledge to your own individual circumstances.

> masks are to protect others at least as much as

I had a different underestanding: I thought masks are to protect others, overwhelmingly, and there might also be some protecting power for yourself, in a much lesser amount.

The concept is consistent with "since you can, limit dispersing the droplets".

I unfortunately do not have bookmarked articles about this though. Do you have any good source (e.g. to state that masks have a protecting power for the wearer comparable to that for the others)?

You're correct, that is our understanding in NZ, mask wearing is almost entirely about protecting others by limiting the projection range of droplets. It works if everyone wears a mask.

Yes, 99.5% counts as “mostly”, I was just emphasizing that “I don’t want to wear a mask” is “I don’t care to protect you” not “I don’t care enough about the risk to myself too wear a mask”.

I've been seeing this a lot amongst anti-mask arguments. Antimaskers unironically equate wearing a mask to some type of life-altering, oppressive action. It's absurd.

Amongst all of our social responsibilities as human being, wearing a mask is probably the easiest, most bare-minimum thing imaginable, right up there with "don't litter". And just like I don't respect people who litter, I don't at all respect people who don't wear masks in crowded places.

edit: wowfunhappy deleted their comment, but previously it said that the reason they don't wear a mask is because "it fogs up my glasses and is hot and sweaty", and went on to say that such hardships "affect [them] psychologically". This is exactly what I'm referring to in the first sentence of my comment. Absurdity.

I can accept that there may be a continuum of taste in terms of how onerous wearing a mask is. But I don't really know how it can be that bad when my six year old managed it all year last year for school.

The damn thing fogs up my classes when it's cold, and is hot and sweaty when it's warm. When I speak, I frequently have to repeat myself, and I can't casually take a sip of water or eat a snack.

And while this part pertains more to other people wearing masks—I honestly feel like universal masking affects me psychologically. I have a huge amount of trouble recognizing people's faces when their masks are on—I didn't even recognize my sister when I ran into her on the subway—and I'm not able to read anyone's expressions.

I'm not an anti-masker, and I wore one diligently throughout 2020 and early 2021, but I'm just not willing to do it forever! Wearing a mask is by no means torturous, but I really do think it is life-altering. Similar to social distancing, masks change every single interaction I have with others.

I'm aware that masks protect others in addition to myself, but where does my responsibility end? I wear a mask on public transit, and I'll wear a mask any time someone asks me to put one on. But I'm not going to wear one otherwise, and I'm significantly less likely to go into a store if there's a sign on the front that masks are required. I think I should be able to make that choice, and other people can make the opposite choice.

---

Edit: Re your edit, sorry about that, I actually deleted the above comment from downthread in order to post it here instead, and our actions seem to have crossed.

> The damn thing fogs up my glasses when it's cold

Check the nose clip of your mask. Fogging your glasses might mean it's not sealing correctly around the nose, so that the hot humid air from your breath is being directed upwards towards the interior of your glasses, and also allowing unfiltered outside air inside the mask when you inhale.

Yeah, believe me I've tried this. :(

Last winter, I even bought a mask from https://zerofogmask.com/?v=7516fd43adaa, which you heat up with a hair drier before wearing for the first time so it molds to the shape of your face. It admittedly worked better than a normal mask, but only partially and only for a few uses, which wasn't economical at $20 each. Plus, it was particularly uncomfortable.

When I was at Mayo Clinic, one of the eye doctors put tape at the top of my mask to seal it. He did the same to his because he wore glasses. This prevents fogging up glasses (or eye exam equipment).

I'd suggest using paper tape for this because the skin around the eyes is very delicate and regular medical tape is a bitch to get off. They used medical tape, and I felt like it was ripping my lower eyelids off when I removed it!

I wear safety glasses and a mask at work. I pull my mask up a little so that I can catch the edge of it between my nose and the glasses. I haven't had any issues with fogging.

I did some research on this last winter, when I was literally struggling to go outside—I walked straight into a lamp post at one point! I'm not going to be able to find the article now, but what I read it's largely dependent on the shape of your nose and face. I seem to have lost the lottery.

The mask is to protect others as much as it is to protect yourself. You can be contagious and spread it for up to two weeks without symptoms. It's unfortunate that wearing a mask is such a hardship for you.

But how exactly paper ill-fitted masks protect against aerosol-spread virus?

In an ill fitted mask? Not well. The suspension of the virus in aerosol is precisely why masks have any efficacy in the first place, since the viruses themselves could easily permeate without it.

By reducing the number of aerosol particles that escape the mask and thus reducing your chances of infecting someone else.

If the standard is zero transmission, then they are useless. But that isn't had has never been the claim. N95 is better than simple masks, but they are more expensive, initially were in short supply, and uncomfortable.

But this is all about statistics. Simple masks reduce the chance of catching it by some small amount (say 15%) and reduce the emission of virus particles by something like 50% (it all depends on the mask). This doesn't mean the odds are cut in half; it means the exponent of the spread of the virus is cut in half.

Here you go chief: https://www.ucsf.edu/news/2020/06/417906/still-confused-abou...

The disease is significantly (primarily?) spread via aerosol. Against which officially sanctioned masks are a pretty marginal intervention.

https://uwaterloo.ca/news/media/study-supports-widespread-us...

It's a simple and easy way to reduce chances of spreading it to another person. It diverts airflow from directly forward, changing the distance outward that aerosols from your mouth go. Since, as you point out, this virus is spread via aerosols, this impacts the chances of spreading it, by reducing the contagion radius around you.

Simple and easy and, given the miniscule risks to all but the unvaccinated, completely unreasonable to impose on others.

This has to be the biggest mistake of the whole pandemic. Exhalation valves dramatically improve the comfort of masks. A cloth mask might give 50% protection, and a surgical mask about 75%, but even after you double the effects to account for filtering both on exhalation and inhalation, that's still only 75% (1-(1-.5)^2) and 94% (1-(1-.75)^2), which is worse than the 95% you could expect from a correctly fitted N95 mask with exhalation valve.

If you protect yourself then you also protect others, because you can't infect others unless you are infected yourself. This focus on filtering exhaled breath just results in people wearing masks incorrectly to avoid the problems of valveless masks, making the numbers even worse than the previous calculation. It's also much easier to motivate people with self-protection than altruism, especially when the people they're helping often don't reciprocate. We've had more than long enough to solve the production problems by now, so N95 should be the minimum standard.

As former military ( I assume that background is the reason for this), I just cannot understand what the deal is over masks. I can literally forget that I'm wearing a fitted surgical mask. They feel like nothing. What is so damn hard about wearing them? I hear so many grown adults whine and complain and dramatize having to put one on, and it just blows my mind.

Maybe I am, unknown to myself, a superhero, and my power is not having a hard time wearing a mask. Or maybe I'm not a spoiled entitled brat. Not sure anymore.

Anecdata. I was 15kg heavier last summer than this summer. I had a lot harder time wearing a mask last year than this.

My understanding is that masks at least cloth or surgical are vastly more about others than yourself.

Protect who though? Who do masks protect at this point? People who are vaccinated? They have no need to worry. People who are unvaccinated? They made that choice.

There is literally no reason for a vaccinated individual to wear a mask. Vaccines work. They are the ticket out of this. Not masks.

I can't stand this intimation that you're an asshole for not wearing a mask. If other people want to be precautious, they can get vaccinated and wear a mask and do the social distancing. It's not my problem.

I hear this quite often on the internet, yet I can count on one hand the number of times I have seen a person wearing a mask in public pre-COVID. I’m in the US so it is extremely uncommon.

Where has all of the concern for the immunocompromised been before this? The flu is quite deadly, you know.

Nice attitude. Time flies whether you like it or not.

Our perception of time seems to be related to the number of new experiences we have.

If every day is exactly like ever other, you quite literally are losing a portion of your life.

Again another false dichotomy. Wearing a mask and social distancing doesn’t preclude you from new experiences. One could argue living to have more masked experiences is more experiences. Having more people living to share those experiences with, is more experiences.

I don't understand how some of you seem perfectly content to want to wear a mask everywhere for the rest of your existence.

It’s completely insane. I suspect a lot of people that share this view live their entire lives through a computer/phone/TV screen.

I go outdoors and hike beautiful coasts and mountains, enjoy properly socially distanced dining outdoors, and follow the guidelines given by CDC. I go out a lot but I manage the risk accordingly. There are lots of people that don’t want to take a single precaution. It’s like saying “I don’t want to wear a condom having casual sex”, eventually that person is going to get herpes or hpv. I guess I realize now why those diseases are so common is because many people fail to take precautions so they can have “more experiences”.

It’s just until the big waves of infection and death stop. That will happen when people take the threat seriously and take precautions. Maybe it will take another mutation that causes a great disturbance in public health to get Floridamen on board, but we will have to wait for them before we can call this over because the virus isn’t going to burn out on its own.

> Wearing a mask and social distancing doesn’t preclude you from new experiences.

You really can't think of any activity that is diminished by wearing a mask ?

210 Million people (64%) have already been vaccinated in the US, and children aren't even eligible. At some point there is an acceptable level of risk. When do these 'temporary safety precautions' stop?

We are patiently waiting for Floridamen to start participating in public health. Until then we will continue the precautions. Eventually enough people will die and they will come around.

Seems like you buy into the media narratives more than data... For most of Covid Florida's performance has been middle of the pack in the US despite having a large elderly population. They've slipped recently but still are only the 12th highest state deaths per population [1].

Plenty of other red or blue states that have done worse.

[1] https://www.statista.com/statistics/1109011/coronavirus-covi...

It’s just a symbol, it doesn’t need to be taken literally. After all the reason Floridamen exist as a meme is because of public disclosures of crimes by the state police.

Limiting the amount of new experiences people are able to have reduces their quality of life, period.

Everyone can make their own choices, but I don't mind wearing a mask in optional scenarios if it gives me a good chance of avoiding a difficult and feverish few days with above average risk of hospitalization compared to flu. I can definitely picture wearing masks on an ongoing basis e.g. on mass transit even once the pandemic is done. On the other hand, we are still taking measured risks like eating indoors in not too crowded restaurants. My tolerance will likely increase once my children are both vaxxed but at the rate we're going that won't be for a while.

It's worth considering the continuum between taking the minimum possible measures and the maximum. There is space between those two.

> eating indoors in not too crowded restaurants.

This is one of the potentially higher risk activities that I see commonly accepted. If your area has high rates of community spread and/or the restraunt has poor ventilation, this is probably a risk that should be avoided. Choosing restraunts with outdoor seating or getting takeout to eat in a park is a very minor sacrifice to cut out one of the hishest risk activities that people commonly engage in

> [Indoor dining] is probably a risk that should be avoided

Eh. I have seen conflicting data on this. For example, some studies attributed only 1% of COVID spread to indoor dining (sorry in advance, I don't have a citation). My area is very highly vaccinated and requires all people to show a vaccine card to eat indoors, and while we do have some cases, the per capita rate right now is about 1/10000 and level.

Also, point of order, you can tell me I "should" do something according to your values, or according to some mutually agreed standard (which in this case does not exist), but you cannot tell me what I should do according to my values. I feel like this is a point of communication disconnect between those of us who favor increased or decreased COVID restrictions.

> Eh. I have seen conflicting data on this. For example, some studies attributed only 1% of COVID spread to indoor dining (sorry in advance, I don't have a citation)

This is pretty useless without details on the study conditions. If the study includes a population for which indoor dining is allowed 10% (on a per capita per day basis) but masks are mandated in other venues at a 0% rate, then the proportional amount of spread drom indoor dining should much lower that if the data is collected where indoor dining is allowed 100% and mask mandate coverage is 100%.

Similarly, if you don't bother to wear a mask in other indoor settings, indoor dining won't be as high among your risks. If you work from home, always mask everywhere and are very careful with social distancing, and have a similarly cautious bubble, indoor dining will probably be among your highest risk.

I mean "should" as in "if managing your covid risks is something you care about, this is a low impact way to reduce those risks when your local situation makes that important." Since I am not advocating any externally imposed restrictions, I think you are reading things into my comment that aren't there.

Or you know you can adjust your lifestyle and still enjoy it without it needing to be the same as pre-pandemic. Have some more imagination.

do you have kids, or know anyone who has kids that are unable to get vaccinated?

I'd rather be sick for a week

this is a completely absurd assumption, and not appropriate for the standard of serious discourse this site aims for.

you could have no symptoms at all. you could die. you could suffer serious cognitive effects which eliminate your ability to work, read books, or even watch TV. you could get sick and stay sick for the rest of your life. we don't know the exact duration of long covid, but there are plenty of people who got sick in early 2020 and haven't gotten better yet.

there's a huge range of symptoms. in the dreamworld you posit here, where getting sick for a week would be the worst-case scenario, your reasoning would make sense, but nobody lives there, because that place doesn't exist.

But doesn't this apply to everything?

When you crash your car, you could walk away unscathed. You could die. You could suffer serious cognitive effects which eliminates your ability to work, read books, or even watch TV. Should people be afraid to drive?†

My question for you would be, when does this end? I'm vaccinated, and the vaccines are very effective. Should we all be practicing social distancing for the rest of our lives?

---

† Actually, maybe yeah, I think the number of people who die in car crashes is reason enough to move away from them as a primary mode of transport, even putting aside environmental concerns. But the point is, we have decided to accept this risk.

I think a better analogy is drunk driving because we are talking about risk to yourself and the risk you present to others. What about those people who really want to experience driving while high or drunk? What sort of freedom do we have where we prevent those activities?

Should you be allowed to drive drunk on a private road? Well, as long as I'm not paying your health bills, you fully recycle your trashed vehicle, and there's no other externality - go for it...

Is asking people not to drive drunk too much? Apparently it is because there are lots of people who do it.

EDIT: You do make a good point re: what's the exit strategy. My personal thoughts are we take some reasonable measures, especially during times when the virus is very active, but we should resume a more normal life. The people who don't get to resume a normal life should be those that have made the choice not to get a vaccine. To continue on my analogy, you choose to get drunk at the party, driving home is not an option as much as you'd really like to do that.

Why do you bring up being drunk? The analogy is much more accurate if you question why we're allowed to drive at all, even when sober.

It has to do with your probability of causing serious harm to other people. ~40k deaths/year from driving (presumably some significant portion from drunk driving, texting, drugs etc.). (EDIT: this number is in the USA)

The point I am making is that you are not free to do whatever you feel like you want to do. You wanna drive? Get a license. You wanna drive drunk? Not allowed. You wanna speed? Not allowed. There are people coming to this discussion from the perspective that their freedom to do whatever they want is absolute regardless of impact to others, but it's not.

It's a balance. For sure the measures/restrictions on freedom need to be proportional to the risks but this is not about individual risks. If you drive a tank and there's zero risk to you you still can't drive drunk.

It only applies if you completely ignore the magnitude of the situation. Most US adults are exposed to cars on a daily basis. It doesn't overrun the hospital system like covid. Cars are dangerous but covid seems much more so.

The hospital system is overrun by people who refuse to get vaccinated. If you're vaccinated, the risk is significantly lower than a car crash. And if you're not vaccinated, you should get vaccinated.

> you could have no symptoms at all. you could die. you could suffer serious cognitive effects which eliminate your ability to work, read books, or even watch TV. you could get sick and stay sick for the rest of your life. we don't know the exact duration of long covid, but there are plenty of people who got sick in early 2020 and haven't gotten better yet.

Why just apply this to covid? 45,000 people a year in the US die when they get behind of a wheel of a car every year. Does that number need to be zero to be an acceptable level of risk.

at our current covid death rate, that 45K people happens about every 10 to 15 days. call it two weeks for simplicity's sake.

that 45K is also the most popular argument in favor of self-driving cars.

but none of this has ANYTHING TO DO with the argument I made, which is that the grandparent's estimate of a worst-case scenario was just wildly inaccurate.

> at our current covid death rate, that 45K people happens about every 10 to 15 days. call it two weeks for simplicity's sake.

Your math is wrong, 45 /1.5 = 30

But so what? 8,000 people tragically die a day in the US under accepted normal conditions and we move on.

> none of this has ANYTHING TO DO with the argument I made, which is that the grandparent's estimate of a worst-case scenario was just wildly inaccurate

Realistically if you are young, healthy, and vaccinated that is the worst case scenario.

> at our current covid death rate, that 45K people happens about every 10 to 15 days. call it two weeks for simplicity's sake.

I think your numbers may be a tad off in general, but regardless, I'm pretty sure you're including unvaccinated adults. While I absolutely don't want anyone to die, I don't feel a responsibility to protect people who aren't willing to take the most basic of steps to protect themselves.

So, the expert in the article agreess you shouldn't sit at home 24/7 for the next year:

> Even with delta, the goal is not to go back to a lockdown mindset, though, says Malani. "My hope is that people who are fully vaccinated should really feel like this risk is manageable."

> "Feel good about spending time with your friends, or having a small dinner party, but make sure everyone is vaccinated," she says

But you probably should still be wearing masks in crowded indoor locations and avoiding/reducing large gatherings.

Since it's all statistical, it's not all of nothing, going to an occasional large gathering isn't the same as might as well go to one every day, you can prioritize ones important to you.

But it's up to you. The important thing is if you do get sick or know you're sick, please quarantine to avoid infecting others.

The annoying thing is, all the risks are proportional to how much covid there is in the community. If we could get rates down, then we wouldn't have to worry so much. So it's not just about what we are willing to risk personally, it's about trying to change social behavior to get risks much further down, so everyone in the community can do more stuff safer!

And I want to be able to climb a mountain, drink alcohol, taste pizza, and live past age 70. All of those things can go out the window with a severe case of COVID-19, and potentially even with an asymptomatic case, due to the long-term effects of scarring on multiple organs, and unknown long-term neurological effects.

I know humans always prioritize short-term goals over long-term. But personally, I am fine with wearing a mask or staying in for a year, to ensure my health for the next 70 years.

I also wear condoms when having sex with strangers. Crazy, I know, but somehow getting a lifelong disease just doesn't seem worth the momentary pleasure.

All you have to do is listen to the stories of young people who are now on a breathing machine for life. If that doesn't scare the fucking bejesus out of you, I don't know what will.

All respiratory viruses can have long term effects. I’ve had super annoying colds that refused to go away for like 6 months. Covid is no different.

So many people are so absolutely petrified over covid. It’s like they suddenly woke up and realized that respiratory viruses can suck and people die of horrible illness. None of this is unique to covid.

It’s life. There are no guarantees. What we are doing now is not living. Vaccines were it. Time to return to actual normal.

> Covid is no different.

Covid-19 is literally a neurological disease. It causes the body to attack itself, like an autoimmune disease, which is what is leading to the incredibly high number of severe cases leading to death. And all of the long-term, quality-of-life-impacting side-effects that have nothing to do with respiratory viruses.

This has been reported for over a year.

> It’s life. There are no guarantees.

There's no guarantee you will get AIDS Or HepC if you have unprotected sex. Time to throw away the rubbers, we can't stop living life now can we?

Oh, wait. You can still fuck with rubbers. I guess you don't have to choose between not fucking or getting AIDS.

Just like you don't have to choose between being a hermit and making out with a dozen strangers at a bar. These things called "masks" are there to reduce risk without forcing us to stop living life.

> This has been reported for over a year.

If we covered the flu the same way we cover covid, people would be saying the same things…

> These things called "masks" are there to reduce risk without forcing us to stop living life.

Sorry I’m fully vaccinated. I’m not wearing a mask ever again. Masks are not normal. In fact they are quite the opposite.

Vaccines were supposed to be the end. Not some kind of dystopia where everybody wears masks and treats each other like disease vectors… forever. Because some people are frightened.

First, it's not forever. Over time, when we know more about the virus and it changes more, there will probably be less-severe variants where we can mostly rely on vaccination.

Second, there are plenty of ways you can mitigate the need for masks and social distancing with people that you know. Just like you don't need to use condoms with a monogamous partner that you trust, you don't need to wear masks around vaccinated people that use masks and social distance around people they don't know.

Third, you're not sorry. You're going to get people killed and continue to hurt the economy (and people who depend on it) because you can't stand to put a piece of cloth on your face for 5 minutes, stand back a bit from someone, or eat outside. You're freaking out and being childish because you personally don't care about the consequences, while ignoring the consequences for everyone else. It's the same as people who refused to wear condoms during the AIDS crisis because "they're not normal".

> Over time, when we know more about the virus and it changes more, there will probably be less-severe variants where we can mostly rely on vaccination.

With all due respect, this is a crazy take. Calling me childish and telling me that I’m “freaking out” is bullying and textbook gaslighting.

Covid is not novel at this point. It’s been a thing since very early 2020. What more are we possibly gonna know about it? It’s a respiratory virus. Not unlike many of its kind.

We have a vaccine for it. Anybody who is at risk can walk in and get it free.

I’m fully vaccinated. There is absolutely no reason for me to wear a mask. I’ve done my part. My obligations to society are over. I now can return to actual normal, no matter what people convince themselves of.

Pushing this dystopian “new normal” crap is, quite frankly, insane. There will be no new normal. People pushing for it need to be rigorously called out for the insanity they are preaching. Party is over.

> It’s a respiratory virus. Not unlike many of its kind.

It's very much unlike others of its kind. And it is novel. It is literally called a "novel coronavirus". Just to give you an idea how deadly and different this virus is:

- An outbreak of Ebola from 2014 to 2016 killed 11,310 people in West Africa.

- In 2009, the H1N1 pandemic killed approximately 12,469 people in the US.

- In 2014, during the MERS-CoV pandemic, 2 people in the US tested positive.

- As of today, COVID-19 has killed 661,000 people in the US.

COVID-19 is 53 times more deadly than the last major coronavirus pandemic in the US. Fifty. Three. Times.

> We have a vaccine for it.

We have a vaccine developed for the first variant of it, alpha. The vaccine was not developed against the delta variant. There is a drastic difference in its effectiveness against delta. Hence why there are now new mask mandates - for vaccinated people - where delta is rampaging. Are you telling me you didn't know this at all?

> I’ve done my part. My obligations to society are over.

Actually, no, society literally requires you by law to continue to wear masks in places where Delta is surging. But whatever; you want to kill people, you're gonna kill people.

I get it. You're petrified. But life will get better, and it does indeed change. "Normal" does shift. People didn't used to wear condoms, now they do (except for you). People didn't used to brush their teeth, now they do (except for you). People didn't used to wash their hands, now they do (except for you). You apparently live in 1750, where medical science and overall culture hasn't changed for hundreds of years, where everything is totally normal and will never ever ever ever Ever EVER change. Because everyone else is just insane, and you're normal.

Denial is a nicer place to live than reality.

> sit at home 24/7 for the next year, or wear a mask every time I step outside

These are extremely extremely extremely different things.

Living in a dense, student-heavy neighborhood of the Boston area, I really hope that this isn't the thinking of many students who just arrived, from all over.

The thinking is understandable, but a pandemic like Covid-19 seems like one scenario in which a billion small individual sacrifices together could've (and possibly still can) be a dramatically positive net benefit to the world.

One way to think about the significance of minor individual sacrifice like voluntarily masking (where it's not absolutely required by law/rules) is that every infection will tend to spread exponentially. Passing it on to even only one person seems like that would likely result in at least one tragedy for someone else's family. IIUC, masking reduces that significantly, so masking when I believe there's a significant risk of spread seems an easy decision to me.

My question for you is, what is the end point?

I am willing to wear a mask and practice social distancing for a period of time—in the aim of some goal. I'm not willing to do it forever. Which is why I wore a mask until this summer when vaccines were widely available.

Give me an end date, and explain why things will be different then, and I'll do it! Honestly! But right now, I'm looking around and I'm not seeing a timeline.

It's a pandemic. Why would you expect a firm end date?

I know we're living in strange and difficult times, but I feel like a lot of people haven't accepted that just because you're tired of it, doesn't mean the pandemic is over, doesn't mean it's a good idea to stop taking measures to reduce illness and death.

Because we think the powers that be might not ever let it be "over". Remember that after it became apparent that "two weeks" was a lie, the next lie where the goalposts were moved to was "once a vaccine is widely available".

^ Just to be clear, I personally don't think there's some conspiracy. I just think a lot of people aren't reasoning about the level of risk in a rational way. They absolutely were in 2020, but now we have widely-available vaccines.

It doesn't have to be a conspiracy, there just has to be incentives to keep the fear up.

> Remember that after it became apparent that "two weeks" was a lie...

It wasn't a lie.

First off, significant portions of the population refused to take the measures advised.

Second, it's on you if you took "two weeks to slow the spread" (and yes, it was slow, not stop; https://www.cnbc.com/2020/03/16/trumps-coronavirus-guideline...) as "two weeks to slow the spread and then we're done". That's an absurd misunderstanding of the point of it.

> It's a pandemic. Why would you expect a firm end date?

Or an event, and a plausible way the world will get there. Please tell me what the goal is.

I don't think COVID is ever going to go away, just as the flu has never gone away, and every number I've seen indicates that if you're vaccinated (!), the risk of either virus putting you in the hospital is similar.

That seems to me like it's as good as it's gonna get.

> Please tell me what the goal is.

I think a reasonable goal is "get the vaccine approved for children", and I think the FDA's dragging heels on this has been a significant mistake.

I think a major reason the FDA is dragging their heels is because children under 12 are not at serious risk from COVID in the first place, so the risk vs reward calculous is very different.

Which is subsequently why I'm not particularly worried. Yes, the stories of the children who are in the hospital are heartbreaking, but they're the outliers.

Edit: Actually, I just realized something... now that the Pfizer vaccine is fully FDA approved, parents should be able to find a pediatrician who will administer the vaccine off-label, if they want their kids to have it badly enough...

If kids truly needed a vaccine, they’d be approved by now. The fact is kids are not at all even close to being at risk of covid. This is something that all these public health “experts” should be cheering about but I good news hasn’t been allowed since March of 2020. Good news around covid has always been met with outrage and mockery.

I don't know when this will end, nor what the end will look like.

To consult recent history, my layperson's vague impression is, if early on we'd had better leadership and precautions compliance, we would've already incurred vastly fewer family tragedies, and the pandemic might've even been all but over by now.

So, personally (and I know my situation is easier than many people's), I can hold out longer with precautions, and I'm not yet willing to just give in to the same mistakes that seemed to contribute to us getting into the current challenging situation.

The recognition that the medical establishment is still unsure of many things regarding a still developing situation is a good first step. The next is to realize that the misinterpretations of their knowledge and understanding are the direct result of misrepresentation of events and facts by media outlets.

At the beginning of the pandemic, health agencies started misrepresenting and overstating the certainty of science, in order to attempt to get more buy-in from the public.

It started with masks. The studies that we had about masks really were not great, but they did a risk-reward calculation behind closed doors: worst case scenario, the surgical masks don't impact the spread and it changes nothing; best case scenario, we reduce community spread. The problem with this is that if they told the public that this was how they were thinking about the problem, they wouldn't get people wearing the masks, so they overstated their confidence in it when speaking to the public. A good amount of people truly believe that the science was clear. But it wasn't.

It continued with tests. It's much better to have a high rate of false positives than to have any rate of false negatives, so they pumped up the cycle count to accomplish this. They later toned it down. To the public, the tests aren't even questioned, most people believe they're pretty accurate, and most people are unaware that they have changed the criteria throughout the last year and a half. They sold it to the public like this because they knew that people would avoid getting tested and staying quarantined if they didn't trust the tests.

Lately, it's about the vaccines. There is no serious scientist that believed that the vaccines would prevent COVID from becoming endemic. It was obvious that this was going to be with us for the rest of our lives back all the way in April of last year (or earlier). There are no serious scientists that believe that 2 shots and a booster is going to be the end of it, and yet they're happy to tell us that we "might" need boosters. Do any serious scientists actually believe that? These aren't "breakthrough" cases, because it's not truly a vaccine in the sense that the Polio vaccine was a vaccine. It's a prophylactic. We always knew it was a prophylactic, but they sold it to the public as something else, because people wouldn't get it if they didn't lie.

We need to decide if we're okay with science agencies lying to us. Is their purpose to exact change on society, or is their purpose to do good science and tell us honest results? All of the confusion in this article stems from the misrepresentations they sell us.

Your assumption is that everyone is just as rational as you. Scientific agencies should just give out the exact probability numbers and let people decide for themselves. That's not how the world works. Our brains just cannot intuitively grasp probabilities (https://www.scientificamerican.com/article/why-our-brains-do...). Presenting the precise and most accurate information to the public without any embellishment sounds great in theory, but it doesn't work in practice.

What alternative do you suggest? Lying to the public? Or the government making every decision for them like they're all children? Both of those sound much, much worse.

Yeah, lie to the public for the greater good. If lying gets more people to wear masks and get vaccinated, and can prevent thousands of deaths, so be it. What's wrong with lying?

Because invariably the truth eventually comes out and then people trust their government even less? Then when the next crisis comes along it doesn't matter if you lie or tell the truth, the public won't listen anyway.

> What's wrong with lying

Where to start.

First of all, dignity.

Mental pollution.

Problematic instancing of what is «greater good».

Retribution.

Precendents and possibility of abuse.

Alienating all those who immediately cease trust [against the matter] in front of what smells of a lie.

Cessation of trust [against the agent].

...There must be more.

The problem with it is that you lose trust.

If I know you lied about the efficacy of the vaccine then how do I know you didn't lie about the chance of bad side effects too?

Because democracy is much better than some kind of authoritarian system where the common people are considered stupid and ignorant and undeserving of having a say in how their society is ran.

The big problem here is that many people don’t think democracy is worth preserving, and they’re fine being lied to as long as they’re comfortable and have competent leaders. Except…. when the democratic checks and balances that keep the powers that be in check fail everything goes to shit. First slowly, then quickly.

I don’t want to turn this into an overly political rant, but if you look at recent history it’s not hard to see how bad things happen when politicians and other authority figures can lie with impunity.

No, don't lie to the public. That's what happened in the first place. "Pfft... you don't need masks." The government said that because masks were hard to get and they wanted to control public behavior. This turned out to be a lie, everyone found out, then regardless of whether the authorities were giving good, accurate advice or not, the trust had been breached.

Politicians saw this as an opportunity to gain ground. In the absence of any trusted authority it became an us vs. them thing for too many people.

Don't lie to the public. Tell them the truth, tell them what they ought to do, and why you think so. Earn trust. It'll be easier to get people to do the right thing.

""Pfft... you don't need masks." The government said that because masks were hard to get and they wanted to control public behavior. This turned out to be a lie,..."

This is false.

https://news.ycombinator.com/item?id=28201328

Lying works the first time. After you've lost people's trust, they are less likely to listen the second time, even if you're telling the truth the second time.

The position you seem to be defending (not «presenting the precise and most accurate information to the public») is dis-educative for its target (the not «as rational as you») and alienates the rest (the «as rational as you»).

Lying to the public doesn't work either, because once they're established as a known liar, why should we believe anything they say?

>We need to decide if we're okay with science agencies lying to us.

This is the "Science is a Liar sometimes"[1] defense, and it can be used to discredit any sort of scientific research. You are basically asking that our agencies be 100% correct the first time and be perfect predictors of the future.

Secondly I don't understand how you were mislead about vaccines. The efficiency rates were always described in preventing you from going to the hospital. With COVID, the main issue has always been overstressing the health system - thats where the breakdown happens and thats why everyone needs to take the vaccine. Even now, ICU beds are not majority unvaccinated COVID cases, which overworks nurses and prevents people with other diseases from getting proper treatment.

[1] https://www.youtube.com/watch?v=U3Ak-SmyHHQ

I think they're asking for science not to misrepresent the facts.

They're not asking for science to be perfect.

It's easy to say the facts were misrepresented in hindsight. The original consensus is that there was no need for widespread mask wearing, and a supply shock would have been dangerous. We only know now (or rather a couple months later), that advice was wrong.

> everyone needs to take the vaccine

This is simply not true, anyone who claims this is ignoring a vast body of scientific evidence supporting the fact that individuals who’ve recovered from previous infection will be at least as well protected as vaccinated individuals against reinfection.

If you were to say “most people who don’t already have natural immunity ought to be vaccinated” that would be a much more sensible recommendation, in-line with general scientific consensus (and public health policies in other countries).

>If you were to say “most people who don’t already have natural immunity ought to be vaccinated” that would be a much more sensible recommendation, in-line with general scientific consensus (and public health policies in other countries).

It might be scientific consensus, but I do not consider this good public policy. There are several problems:

1. How do you verify if someone has gotten COVID already? The PCR test can report negative for as short as 2 weeks after symptoms go away.

2. Do you then parallel documentation where people have vaccine documents or positive test requirements?

3. How should businesses/schools treat positive testing individuals who did not get vaccinated?

4. Should the government just wait for the unvaccinated to get COVID and just roll the dice if they survive or not?

I'm not sure how you can seriously argue that point versus the massively simpler to execute policy plan of just getting everyone vaccinated.

We are not cattle no matter what you public policy wonks have been led to believe. It is possible to test to differentiate between those currently shedding the virus and those who are recovered with natural immunity. Those with natural immunity actually do themselves harm by taking a double vaccine dose according to some immunologists.

> 1. How do you verify if someone has gotten COVID already? The PCR test can report negative for as short as 2 weeks after symptoms go away.

Antibody tests?

"Among Kentucky residents infected with SARS-CoV-2 in 2020, vaccination status of those reinfected during May–June 2021 was compared with that of residents who were not reinfected. In this case-control study, being unvaccinated was associated with 2.34 times the odds of reinfection compared with being fully vaccinated."

https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e1.htm?s_cid=mm...

"Effectiveness of two doses remains at least as great as protection afforded by prior natural infection. The dynamics of immunity following second doses differed significantly between BNT162b2 and ChAdOx1, with greater initial effectiveness against new PCR-positives but faster declines in protection against high viral burden and symptomatic infection with BNT162b2. There was no evidence that effectiveness varied by dosing interval, but protection was higher among those vaccinated following a prior infection and younger adults."

https://www.medrxiv.org/content/10.1101/2021.08.18.21262237v...

"We examined whether sera from recovered and naïve donors, collected before and after immunizations with existing messenger RNA (mRNA) vaccines, could neutralize the Wuhan-Hu-1 and B.1.351 variants. Prevaccination sera from recovered donors neutralized Wuhan-Hu-1 and sporadically neutralized B.1.351, but a single immunization boosted neutralizing titers against all variants and SARS-CoV-1 by up to 1000-fold. Neutralization was a result of antibodies targeting the receptor binding domain and was not boosted by a second immunization. Immunization of naïve donors also elicited cross-neutralizing responses but at lower titers. Our study highlights the importance of vaccinating both uninfected and previously infected persons to elicit cross-variant neutralizing antibodies."

https://www.science.org/doi/full/10.1126/science.abg9175

1) That CDC study has a relatively small sample size (N=738) and uses data from a single state during a 2-month period. The confidence interval on the "2.34" odds ratio is large (95% CI = 1.58–3.47). Most importantly, a tremendous amount of literature contradicts those findings. Nearly every large scale and long term serological study has demonstrated that immunity acquired through previous infection is at least equally effective as vaccination in preventing reinfection.

- A previous history of SARS-CoV-2 infection was associated with an 84% lower risk of infection, with median protective effect observed 7 months following primary infection. This time period is the minimum probable effect because seroconversions were not included. This study shows that previous infection with SARS-CoV-2 induces effective immunity to future infections in most individuals. [1] (N=25,661)

- In conclusion, documented SARS-CoV-2 reinfections were exceedingly rare, with an incidence of 0.3 infections for every 1000 persons-week, and none were severe. Seroconversion after symptomatic or asymptomatic SARS-CoV-2 infection seems to be associated with a 10-fold reduction in risk of successive viral infection contamination, lasting at least 8 months. [2] (N=1,494)

- The study results suggest that reinfections are rare events and patients who have recovered from COVID-19 have a lower risk of reinfection. Natural immunity to SARS-CoV-2 appears to confer a protective effect for at least a year, which is similar to the protection reported in recent vaccine studies. [3] (N=15,075)

- Reinfection is rare in the young and international population of Qatar. Natural infection appears to elicit strong protection against reinfection with an efficacy ~95% for at least seven months. [4] (N=192,967)

- The degree of protection (10-fold) associated with seropositivity appears to be comparable to that observed in the initial reports of the efficacy of mRNA vaccines in large clinical trials.* [5] (N=3,257,478)

2) The preprint you cite is a "large community-based survey". I'll trade you pre-prints, this one is a retrospective observational study with data out of Israel [6]:

"This study demonstrated that natural immunity confers longer lasting and stronger protection against infection, symptomatic disease and hospitalization caused by the Delta variant of SARS-CoV-2, compared to the BNT162b2 two-dose vaccine-induced immunity. Individuals who were both previously infected with SARS-CoV-2 and given a single dose of the vaccine gained additional protection against the Delta variant."

3) Natural infection elicits antibodies that vaccination alone does not (for example nucelocapsid protein antibodies) [7]. The paper you cited does not provide evidence that vaccination on top of existing immunity confers any significant benefit to health outcomes in the face of viral mutation and variants of concern.

[1] SARS-CoV-2 infection rates of antibody-positive compared with antibody-negative health-care workers in England: a large, multicentre, prospective cohort study (SIREN) https://pubmed.ncbi.nlm.nih.gov/33844963/

[2] Risk of Reinfection After Seroconversion to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Population-based Propensity-score Matched Cohort Study https://academic.oup.com/cid/advance-article/doi/10.1093/cid...

[3] Assessment of SARS-CoV-2 Reinfection 1 Year After Primary Infection in a Population in Lombardy, Italy https://jamanetwork.com/journals/jamainternalmedicine/fullar...

[4] SARS-CoV-2 antibody-positivity protects against reinfection for at least seven months with 95% efficacy https://www.sciencedirect.com/science/article/pii/S258953702...

[5] Association of SARS-CoV-2 Seropositive Antibody Test With Risk of Future Infection https://jamanetwork.com/journals/jamainternalmedicine/fullar...

[6] Comparing SARS-CoV-2 natural immunity to vaccine-induced immunity: reinfections versus breakthrough infections https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v...

[7] Immunogenicity and crossreactivity of antibodies to the nucleocapsid protein of SARS-CoV-2: utility and limitations in seroprevalence and immunity studies https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879156/

> This is the "Science is a Liar sometimes"[1] defense

No, this is not "Science is a liar sometimes" defense.

When we were misled about mask efficacy with a number of circular lies (you don't need masks, you do need masks, double mask!, cloth masks are as effective as N9ts, N95 is overkill, it is not aerosolized, etc) a good number of those were well-known lies of varying proportion, and not the scientific method in progress.

The truth was that people were lying to us consciously to preserve N95 mask supply for frontline workers, but that truth would have gone much further than the mistruths and half truths we were told.

At the same time as the hyperbole was spreading about covid taking over ERs and News coverage was emphasizing this fact, my surgeon wife was telling me how empty all of the hospitals were, and the on-call cases dropped to nothingness because people were isolating and not going outside. But still, the drumbeat of 24/7 news cycle kept putting out bogus info about saturation of ERs and ICUs chock full of intubated covid patients.

If there has been any damage done to science by our authorities during this crisis, it is completely self-inflicted.

>When we were misled about mask efficacy with a number of circular lies (you don't need masks, you do need masks, double mask!, cloth masks are as effective as N9ts, N95 is overkill, it is not aerosolized, etc) a good number of those were well-known lies of varying proportion, and not the scientific method in progress.

The original consensus is that there was no need for widespread mask wearing, and a supply shock would have been dangerous. We only know now (or rather a couple months later), that advice was wrong. Again, I'm not sure how you can feel misled about the advice with regards to a novel virus. It just sounds like you are frustrated because the data wasn't 100% accurate on day one.

>At the same time as the hyperbole was spreading about covid taking over ERs and News coverage was emphasizing this fact, my surgeon wife was telling me how empty all of the hospitals were, and the on-call cases dropped to nothingness because people were isolating and not going outside. But still, the drumbeat of 24/7 news cycle kept putting out bogus info about saturation of ERs and ICUs chock full of intubated covid patients.

Your anecdote is not a good replacement data. Maybe your wife's hospital or experience was different but that may not reflect the hundreds of thousands of other hospitals. If you don't believe ICU reports, it could help to look at how salaries for traveling nurses have grown in the same time period. If hospitals are empty why are their salaries rising? Did hospital administrators suddenly get charitable?

[1] https://www.beckershospitalreview.com/nursing/going-back-to-...

> The original consensus is that there was no need for widespread mask wearing, and a supply shock would have been dangerous. We only know now (or rather a couple months later), that advice was wrong. Again, I'm not sure how you can feel misled about the advice with regards to a novel virus. It just sounds like you are frustrated because the data wasn't 100% accurate on day one.

Please do not project anger or frustration. It was clearly respiratory in nature from day one, and I always thought it was bad advice intentionally given out to control supply, rather than the painful truth of "we don't have enough and we need to save it for medical workers".

> Your anecdote is not a good replacement data. Maybe your wife's hospital or experience was different but that may not reflect the hundreds of thousands of other hospitals. If you don't believe ICU reports, it could help to look at how salaries for traveling nurses have grown in the same time period. If hospitals are empty why are their salaries rising? Did hospital administrators suddenly get charitable?

This wasn't anecdotal, as the 4 hospital systems she supports are circulating daily covid lists, and the numbers were quite low. Because I have an interest, this data was shared with me. The CDC's own numbers for covid patients also reflect this fact [1].

A travel nurse is a poor proxy for a Covid staffing problem, since what you are probably pointing out is instead common staffing issues from school closings, and nurses prioritizing their own family over work. More recently, many nurses are resigning from covid vaccine mandates [2].

Many nurses go through advanced training in order to be able to treat specialized patients, also known as Critical Care [3]. Most travel nurses are not Critical Care / ICU / ID qualified [4] , nor experienced to work an infectious disease unit either, nor are they respiratory therapists, or Infectious Disease docs, the two medical pros most likely to be impacted by a covid outbreak.

Saying a travel nurse is like a Critical Care / ICU / ID nurse, is like going to an Orthopedic surgeon to have your heart surgery, or visiting an interventional radiologist to get your ACL repaired. While both an Orthopedic surgeon and an interventional radiologist are medical doctors, they have specific residencies, fellowships, and advanced medical education that equates to thousands of hours. In this type of education for nurses, that likewise translates to a specific number of hours working in the field, learning the equipment, practices for Standard of Care.

The more mid-level Critical Care certifications can be found at [5] and the graduate-level / advanced certifications at [6]

Here is a useful reference I found on the transition of nursing into advanced specialties focused on Critical Care / ICU / disciplines [7]

If you wanted to provide accurate data around travel nurses, you would need to pull out the small subset of travel nurses trained in Critical Care, ICU/ID, or advanced educated like Nurse Practicioners, and then expand on it. But you haven't done that, and are just conjecturing.

The medical establishment has a rapidly growing body of knowledge and a huge number of specializations, to treat all the injuries, pathologies, and maladies that plague us.

[1] https://gis.cdc.gov/grasp/COVIDNet/COVID19_3.html

[2] https://www.thedailybeast.com/lewis-county-hospital-halts-ba...

[3] https://www.purdueglobal.edu/blog/nursing/list-nursing-speci...

[4] https://www.gmercyu.edu/academics/learn/types-of-nurses

[5] https://www.aacn.org/certification/get-certified

[6] https://www.aacn.org/certification/advanced-practice

[7] https://www.americannursinghistory.org/nursingspecialty-crit...

"*When we were misled about mask efficacy with a number of circular lies..."

This is false.

https://news.ycombinator.com/item?id=28201328

> You are basically asking that our agencies be 100% correct the first time and be perfect predictors of the future.

That isn't how I read this comment at all :/.

First off, the person isn't even saying not to trust scientists at all, much less because they are wrong: in each case the idea was that they are acting in their best understanding of what the effect of a certain kind of intervention will be; the comment isn't blaming scientists for getting something wrong or failing to predict the future: it explicitly even seems to agree with each intervention as being a sensible thing to do given the information at the time and the risk/benefit analysis.

And then secondly, the issue of someone overstating their confidence on purpose and knowingly is very different from someone misunderstanding something and later realizing they were wrong. "I think this is our best course of action to mitigate the impact" is an honest thing to say. But people seem to want to hear "this will solve the problem fully". People seem to not want to deal with "I realize this might not help much, but it certainly won't hurt: let's try it and see how effective it is" (another honest thing to say), but instead want to hear "trust me: you need to do this as I know it is going to work".

I was--and am!--fully willing to do things that are only going to mitigate the impact, whether to myself or to others, and I am willing to do it even on reasoning as flimsy as "it is unlikely to hurt". But I feel like I am in a vast minority, and so everyone instead is motivated to overstate their confidence and overstate their intended result in the hope of getting more compliance, which is why we have people who don't just feel "scientists and doctors are trying their best to work in our best interests, and this is our best hope as of today" but help get on the bandwagon of "if you disagree with how effective this is going to be you are an idiot who is anti-science and you are part of the problem in our attempts to get compliance".

I truly do not understand what distinction you are trying to make and your interoperation seems to be way less charitable than I gave.

Your problem is, as I understand it, is you understand that they can be wrong, but they didn't use your preferred language? Are you asking the USG to personally message to 300MM Americans?

Do you get mad at your doctor for being wrong sometimes for the same reason?

The problem there is that the experts did say, "I think this is our best course of action to mitigate the impact," but people heard "this will solve the problem fully" and then decided that all science is a lie.

No, he is asking to not be knowingly lied to. You might be fine with this if you are from Far East or India https://en.wikipedia.org/wiki/Face_(sociological_concept)#Ch.... Lying to save face, or even for greater good is not tolerated in the West.

>No, he is asking to not be knowingly lied to.

My problem is the implication what they lied. That's why I posted the "Science is a liar sometimes clip". You can't call someone a liar for giving you bad advice on imperfect information. Was Aristotle lying when he said the sun revolves around the earth or was he just wrong?

Not all health agencies, for instance in New Zealand they have been very honest about the science and what is known.

Regarding the article, I think many people wanted to know that there was an "end" in sight to COVID. This narrative was attached to Vaccines as "the end" by much of the press that I watch in the states.

Here in NZ the press is putting pressure on the Govt. to ease lock-down restrictions as the vaccination rate goes up. But we're still reluctant to allow covid in "and just live with it" even as levels of vaccination rise.

I think the only realistic "end" is when the multiplicative effect of masks, caution (social distancing for eg) and the vaccine reduces R below 1 in each individual country long enough to achieve elimination over time.

It would be a pity if in some communities Covid is never eliminated.

I feel bad for the population of New Zealand.

The amount of lockdowns and Covid restrictions was one of most restrictive in the world.

And after all of that, you all recently had one of the highest rates of infection since the pandemic started.

What a tough situation there.

It like all being locked down for years and having the borders closed for years didn't change a thing.

All of New Zealand's lockdowns saved a heck of a lot of lives over the course of 2020 and early 2021, and now vaccines are available! It wasn't for nothing!

This is a good point.

Hopefully the vaccine works against the variants.

The protection seems to be waning already in Israel.

https://www.npr.org/sections/goatsandsoda/2021/08/20/1029628...

Thanks for your concern.

Our lockdowns might be the most restrictive, but that makes them the most effective. So I'm not too worried about that. I'd prefer a short sharp lockdown and then total freedom (within the borders) over the lingering fear that appears to be happening overseas.

Personally I'm happy to be winning another few months or a year free of Delta by staying at home for a while. If there was no official lockdown I would still want to stay at home.

I'm not sure how long these tactics will work, though. Australia tried, but once covid got a foothold, it's in, and they're past the point of lockdowns stopping it. There also comes a point where New Zealand will either have to accept the risk of covid or continue with a North Korea level of border isolation. The political endgame is pretty messy because opening the borders will introduce covid and people will die--not a lot, but probably more than the entire pandemic for the country.

Australia tried, but not as hard as New Zealand.

"past the point of lockdowns stopping it"

You are never past the point of lockdowns stopping it. It just takes 14 days of strict lockdowns and all the people who are currently infected without knowing it have progressed to either known or recovered.

Then you just do some testing and contact tracing (while remaining in lockdown) to mop up the rest of your infected population.

This applies to any infected population. Note that most lockdowns define "essential" too widely - beyond just supermarkets, doctors & hospitals.

> It just takes 14 days of strict lockdowns...

The problem is you need to keep utilities running and hospitals open. Then there are slightly less strict lockdowns where people can get limited exercise outdoors, buy groceries, and food production continues. NSW tried this, and it's failing. I suspect it's a combination of delta is too contagious for lockdowns to work in practice, too many people will violate them, 14 days doesn't account for asymptomatic household spread, and 14 days is more like p95 than p999.

That's why you can't come out of lockdowns after just 14 days. At this point you can really start mopping up with contact tracing and so forth.

A further 14 days and any regions with no cases are safe to exit lockdown, as long as you have good border controls.

But I imagine that if your hospitals are flooded with patients and Covid is rocking your area, you need those initial 14 days just to reduce the caseload to the point where you can test and contact trace again. That's all it takes to get back from "impossible to eliminate" to "we just need to stamp this out now"

> And after all of that, you all recently had one of the highest rates of infection since the pandemic started.

I think you need to check the stats again, NZ is finding about 20 covid cases per day. They have had fewer than 4,000 cases of covid since March 2020. It’s one of the lowest rates of infection in the world and appear on track to eliminate the delta variant from their country for now. (I suspect it’s only a matter of time till it escapes their quarantine system though, but they’re successfully buying time to finish a vaccination campaign.)

Source: https://ourworldindata.org/explorers/coronavirus-data-explor...

Indeed! And most of those more recent cases are the families of known contacts. Unfortunately Delta is very good at spreading within the household.

People enter lockdown, realise they are a case and are moved to quarantine almost immediately. Unfortunately those few days between infection and quarantine are enough now to spread Delta.

Right, but you were only having 20 cases per day in march 2020 at the very start of the pandemic as well before any restrictions were in place.

So doesn't look like anything has changed.

I feel bad for you all. All of that for an endemic virus that's never going away.

https://ourworldindata.org/covid-cases

NZ has had way, way less lockdowns than pretty much anywhere else in the world.

This is because they are an island, and they eliminated Covid once and are aiming to do so again.

They delayed Covid once. And are going to delay Covid again.

The only way to eliminate it to a basic endemic state, is via the immune system.

And the fact that vaccines just reduce the symptoms and don't stop it's spread....means it's never going away.

The word "Eliminate" has an epidemiological meaning and it is not up to you to interpret it into some other word.

Eliminate revolves around the strategy of stopping viral spread in a given population until there are no new cases. That population in this case is NZ, not the world.

For more info on "Keep it out, Prepare for it, Stamp it out," read https://www.health.govt.nz/our-work/diseases-and-conditions/...

> the strategy of stopping viral spread in a given population until there are no new case

Will never happen happen except temporarily. That's just fundamental epidemiology.

Well, naturally we won't eliminate Covid globally until we globally pursue an elimination strategy.

It's a pity that more nations aren't doing so.

Has there ever been an airborne disease that's been elimated globally?

Any nation could do the same. It's less to do with "being an island" so much as "having strong borders"

I feel like "only NZ could have done this, since they are an island" is a cop-out.

Any nation could adopt other pillars of our system also, such as free testing, free healthcare, free vaccinations. Or Contact tracing, quarantine of infected people. Clear scientific communication by those in charge.

It's not magic, it has been well documented what to do in pandemic situations for 20 years. Only the specific tools (the test, the vaccine itself) are specific to Covid-19.

> I feel bad for you all. All of that for an endemic virus that's never going away.

I’m not from NZ. I’m from USA, a country that took the opposite approach and allowed the virus to spread before vaccines were available. Over 600,000 of my fellow citizens died as a result. The NZ approach may not have been effective in the USA for various reasons, but we can’t dispute it was very effective in NZ at preventing the death of their citizens.

Now, even if they reopen to the world without any controls and allow the virus to become endemic in a few months, they’ll have saved many of their citizens’ lives. Vaccination reduces the death rate from Covid-19 by around 10-20x so 90% or 95% of Covid-19 deaths are preventable if you vaccinate before letting the virus become endemic.

Okay, so we had a couple of cases. Then we went into level 4 lockdown (essentials only, leave house to exercise or supermarket). That happened in 2020.

The spread stopped, though we detected cases for the next two weeks (as normal for Covid) which had been infected pre-lockdown.

Then we spent a whole year with no restrictions, no masks, normal gatherings, no covid. There were a couple of minor lockdowns lasting a few weeks in there from small border breaches.

This time, we did the same thing. Same lockdown, same cases afterwards. The only difference is that Delta spreads now within families post lockdown, otherwise everything is the same.

In a month from now, we'll be back to open with no restrictions or deaths.

Our total deaths so far since Covid began in 2019? 27.

We currently have 4 people in critical condition at hospital.

How do the totals look where you live?

No need for that, we're doing fine. Most of the country is already on it's way back to normality. The most populous city is still locked down but it's better to be locked down for 2 months than to have the hospitals clogged with Covid patients and have everyone you know getting sick. Looking forward to enjoying another long stretch without restrictions after this!

i don't think New Zealand has actually had intense lockdown for the entire last 18 months? I think they had short periods, but over the whole pandemic period I think they've had much less interruption to daily life than here in the USA, with much of that time having few restrictions, no?

> you all recently had one of the highest rates of infection since the pandemic started.

I don't think so?

Here's a nice graph of NZ restrictiveness compared to UK and US. You'll see we peak up higher than either but then drop down to very low restrictions.

https://ourworldindata.org/grapher/covid-stringency-index?ta...

That graph definitely makes it look like NZ has had a lot less restrictions cummulatively than USA.

It certianly felt that way from here in NZ.

I think part of our successful economic recovery is because it wasn't only OPEN but SAFE. In the US and UK there are families living in fear of infection, leading to less consumer behavior.

Don't feel too bad for New Zealand, we're doing alright. We're currently in week 4 of our fourth lockdown (in one city of about 1.5 million people, the rest of the country has much lesser restrictions currently).

Before this we had a seven week nationwide lockdown from March 23 to May 13 2020, and a lockdown in one city for two weeks, August 14 to 30 2020, and a lockdown of three days and then one week in one city in February 2021. Other than this, we've spent a few weeks in alert level 2 (large gatherings banned) and most of the last year and a half in alert level 1 (no meaningful restrictions aside from border controls and masks required on public transport). Over this time, 27 people have died of COVID-19.

Yes our lockdowns have been harsh, but they worked, and thanks to that, we've spent most of our time with less restrictions than the rest of the world and relatively few deaths.

Full details can be found here, (alert levels 3 and 4 are lockdown, level 2 is gathering restrictions and level 1 is no day-to-day restrictions): https://covid19.govt.nz/alert-levels-and-updates/history-of-...

Wild animals can spread COVID, so I don't see how it can ever be eliminated. We may be able to reduce R temporarily in humans via social distancing measures, but it's going to tick back up as soon as the restrictions are lifted.

One more reason not to let it breed in the human population - That's the easiest way to avoid creating new variants and spreading it to the local ecosystem.

> It started with masks. The studies that we had about masks really were not great, but they did a risk-reward calculation behind closed doors: worst case scenario, the surgical masks don't impact the spread and it changes nothing; best case scenario, we reduce community spread. The problem with this is that if they told the public that this was how they were thinking about the problem, they wouldn't get people wearing the masks, so they overstated their confidence in it when speaking to the public. A good amount of people truly believe that the science was clear. But it wasn't.

Inaccurate and dangerously wrong conjecture. Research published long before COVID-19 proved the efficacy of masking in blocking particulate matter. That's why terms like N95 even exist.

https://www.nature.com/articles/s41598-020-72798-7

That study came out last year, but there are similar studies published many years ago. I don't have time to google for them all right now, but they are out there for those who want to find them.

The science on masking was clear and your statement is irresponsible.

If you wouldn't trust a cloth mask to protect you from asbestos dust or second hand smoke, you shouldn't trust it to protect you from a disease that spreads as an aerosol.

OSHA doesn't, and you shouldn't either.

Not all cloth masks function the same way. If you read the studies, it depends on the weaving and the material. Cotton vs. denim, for example, is studied.

None are as effective as a non-woven material. But they are still more effective than no mask.

Edit: > asbestos dust or second hand smoke

You have to know what size of particulate matter that you're looking to filter is in order to determine whether that mask material works for the given application. What you're saying is too broad to be useful and isn't very insightful.

Aerosol viral loads are (if I heard correctly) 50x smaller than asbestos particles. OSHA doesn't allow cloth masks to be used around asbestos.

If this were a flu that spread primarily as droplets, cloth masks would have their place. As it is, we have known since early on that wasn't the case, and that cloth masks are about as useful as a cloth bonnet would be useful as a motorcycle helmet.

https://pubs.acs.org/doi/10.1021/acsnano.0c05025

"Materials were microimaged and tested against size selected NaCl aerosol with particle mobility diameters between 50 and 825 nm. Three of the top five best performing samples were woven 100% cotton with high to moderate yarn counts, and the other two were woven synthetics of moderate yarn counts"

This image in particular: https://pubs.acs.org/na101/home/literatum/publisher/achs/jou...

You can see N95 non-woven performs the best, but cotton twill does provide protection.

Cool analogy tho.

50-850nm is way off; coronavirus are 20-500 tops.

I guess we should call OSHA and tell them that it is okay to consider cloth masks as safety equipment around asbestos.

>Inaccurate and dangerously wrong conjecture. Research published long before COVID-19 proved the efficacy of masking in blocking particulate matter.

Sure, but what wasn't certain was things like: Was covid transmitted in the air by particles (yes)? Was it transmitted via aerosols (no)? Was it transmitted by touch (no)? How many particles are needed to infect someone (unsure)? Do masks protect me or someone else? What type of masks are needed to protect? How many masks do I need to wear?

From my exposure, I saw non experts being very emphatic about answers that actually took a long time to get answers to. These emphatic non experts alienated people that continued continued be unsure. In some cases, the experts were emphatic - and then wrong - which further alienated people.

You're missing my point. Do you remember last year, very early in the pandemic, when Fauci went on TV and urged people not to go out and horde N95s, claiming that they didn't work, when in reality he just wanted to ensure that they were available for healthcare workers? And then he flipped around weeks later and recommended surgical masks for everyone?

I'm not claiming that masks do or don't work. I'm just claiming that they lied about it (twice) to suit their interests.

> Research published long before COVID-19 proved the efficacy of masking in blocking particulate matter. That's why terms like N95 even exist.

Sure, but what about for aerosols? If you want to see what the self-proclaimed rational community thought of masks and research available at the time in March of 2020 as it pertained to COVID, see this article: https://slatestarcodex.com/2020/03/23/face-masks-much-more-t...

I agree with you on that point. Fauci told a noble lie about the N95 masks and it really harmed credibility. Perhaps I did miss your point.

My intention was to say that, outside of Fauci, the science around mask efficacy was well-known because you said that it wasn't.

once you start accepting the existence of "noble lies" told by authority figures, why do you continue to trust them?

Your anecdote is false.

https://news.ycombinator.com/item?id=28201328

you use the word "lie" here with loose abandon and with astounding confidence in your ability to infer motivations of every single member of a massive and complex system of public health and medical professionals.

frankly, this is conspiracy talk and it's pathetic to see it upvoted.

There is a strong trend of anti-intellectualism in modern culture that extends to HN. If someone says something that later turns out to be false, then they are considered to be lying, and their supposed lie is used to justify disbelief in anything any other expert says.

It's a violation of basic reasoning skills as well as the HN rules, but it will always will get upvoted because it satisfies a certain kind of hubris: "If I don't know something then no one could possibly know it and therefore the idea I came up with after 10 seconds of thought is just as valid as anyone else's."

yes. isn't this place supposed to be strongly moderated to prevent this kind of garbage?

> It's much better to have a high rate of false positives than to have any rate of false negatives, so they pumped up the cycle count to accomplish this. They later toned it down.

I not aware of any evidence that increased cycle counts have a significant effect on false positives. To the best of my knowledge, the false positive rates of of PCR tests are extremely low. My understanding is that cycle counts were changed to balance false negatives against testing time/lab loads. If you have evidence that contradicts this, I would love to see it.

> These aren't "breakthrough" cases, because it's not truly a vaccine in the sense that the Polio vaccine was a vaccine.

The polio vaccine is also not 100% effective. Both polio vaccines and covid vaccines reduce but do not eliminate your chance of being infected. In what sense is the covid vaccine not a "true vaccine"?

Edit: We have other vaccines that have even lower level of preventative efficacy than the covid vaccines do against delta and we still administer them.

Counting down to the moment when mainstream media changes its tune to something like "Big Pharma! Rushed (Trump's) (non)-vaccines! $$$! etc."

> At the beginning of the pandemic, health agencies started misrepresenting and overstating the certainty of science, in order to attempt to get more buy-in from the public.

Sure, the mainstream media oversimplified what the scientists were saying. But much of the actual early data was available in open archives, sci-hub, and library genesis. How much of the real science did you read, or did you use the MSM as a placeholder for scientists?

It's simple to understand masks when you look at another tech : HVAC filters.

The better the filter (keeping surface area =), the harder it is to breathe. The less filtering the filter, the easier to breathe.

N95's and better were stupidly hard to get hold of early on. But they have a toll on breathing. Again, it's not "maskless" and "heavy filtration". It's a gradient of filtration... And most materials don't have rated filter properties. That's not to say they can't filter - they do. They're just not as good as an N95.

And even surgical masks are there primarily to prevent talking, breathing, coughing, and sniffling from being as impactful to other people.

Anybody in IT would know there's no one solution, and no perfect solution. Everything's a tradeoff, and early on, cloth masks were leaps and bounds better than none at all.

> It continued with tests. It's much better to have a high rate of false positives than to have any rate of false negatives, so they pumped up the cycle count to accomplish this. They later toned it down. To the public, the tests aren't even questioned, most people believe they're pretty accurate, and most people are unaware that they have changed the criteria throughout the last year and a half. They sold it to the public like this because they knew that people would avoid getting tested and staying quarantined if they didn't trust the tests.

A good reason why our testing was so terrible and laggard was because of trump. Elections matter, and his brand of "inject bleach", "take hydroxyclorquine", and continual fall of fake news got a whole hell of a lot of people killed. And he retarded federal government's access to tests, and also severely impacted democratically led states in testing. (citation: https://www.nbcnews.com/think/opinion/did-trump-kushner-igno... )

"Trump has made no secret of his ambivalence about testing. "When you do testing to that extent, you're going to find more people," Trump said in June at an ill-timed rally in Tulsa, Oklahoma. "You're going to find more cases. So I said to my people, 'Slow the testing down, please.'""

"Most troubling of all, perhaps, was a sentiment the expert said a member of Kushner's team expressed: that because the virus had hit blue states hardest, a national plan was unnecessary and would not make sense politically. "The political folks believed that because it was going to be relegated to Democratic states, that they could blame those governors, and that would be an effective political strategy," said the expert."

I believe those speak for themselves.

> Lately, it's about the vaccines. There is no serious scientist that believed that the vaccines would prevent COVID from becoming endemic. It was obvious that this was going to be with us for the rest of our lives back all the way in April of last year (or earlier). There are no serious scientists that believe that 2 shots and a booster is going to be the end of it, and yet they're happy to tell us that we "might" need boosters. Do any serious scientists actually believe that? These aren't "breakthrough" cases, because it's not truly a vaccine in the sense that the Polio vaccine was a vaccine. It's a prophylactic. We always knew it was a prophylactic, but they sold it to the public as something else, because people wouldn't get it if they didn't lie.

You only need to study your history about the Kansas Military Base Flu... Errr, the "Spanish Flu". Lasted 2.5 years. Had anti-vaxxers. Had anti-maskers. Had nearly the same groups on both sides saying the same stuff. Cats, dogs, and other mammals could also get and spread it (they even masked their cats and dogs).

And regular Covid is pretty much gone. Now, it's delta and newer greek char variants. That's because people won't limit the spread using reasonable and working methodologies (vaccine, masking, social distancing, limiting group sizes). And those mutations migrate away from the original vaccine's work on the initial Sars-CoV-n19. I'd be reasonably sure my vacc would protect against the original.

> We need to decide if we're okay with science agencies lying to us. Is their purpose to exact change on society, or is their purpose to do good science and tell us honest results? All of the confusion in this article stems from the misrepresentations they sell us.

Scientists aren't lying - you're just listening to the wrong research (protip: main stream media are the usual culprits of lying/oversimplifying/lies of omission).

The vaccines work in varying degrees, primarily keeping people who do happen to get a variant out of the hospital.

People need to let go of their pride, so that even if they don't want to listen to authority, they can accept that they should.

This might not seem like a big difference but it is. The former creates arbitrary roadblocks: people refusing the vaccines no matter the incentives. It causes people to form junk "science" to justify why 2 + 2 actually equals 5. The latter allows people to compromise: I'm not intrinsically opposed to X, I'm just opposed because of Y, and if you can solve Y than I no longer care about X.

People need to accept cognitive dissonance more. And accepting cognitive dissonance means accepting that sometimes you're the dumb guy or the bad guy. But everyone is the dumb guy or bad guy at some point, whether or not they accept it. Accepting means that you can correct your mistakes and be the dumb/bad guy less often.

Unfortunately it's against human nature to accept cognitive dissonance: it literally causes stress. I don't even think I can fully accept cognitive dissonances. But I believe we can teach people how to resolve cognitive dissonance better, so that people can accept that they have flaws and make mistakes, without accepting that they're a failure.

You are making an amazingly important point. If one accepts "all models are wrong, some are useful" then it fairly directly follows that cognitive dissonance is essential and irreducible and when one encounters it maybe examine one's models? Aka how and why one thinks and feels?

Zen shout-out: This is non-dualism in another guise, and a key Zen practice is to confront irreducible dissonance and batter yourself against it until you are forced to develop and internalize higher-order cognitive and emotional models that can represent contradictions and reason/feel over them to produce useful results.

>It continued with tests. It's much better to have a high rate of false positives than to have any rate of false negatives, so they pumped up the cycle count to accomplish this. They later toned it down. To the public, the tests aren't even questioned, most people believe they're pretty accurate, and most people are unaware that they have changed the criteria throughout the last year and a half. They sold it to the public like this because they knew that people would avoid getting tested and staying quarantined if they didn't trust the tests.

Extraordinary claims require extraordinary evidence. Do you have a source for this?

That's not how I remember it. IIRC, the CDC dragged their feet on recommending masking because of the same lack of explicit studies you cite and supply chain worries. Then once they did recommend masks, you have a much of people citing their "flip flop" as a reason not to trust them.

> It was obvious that this was going to be with us for the rest of our lives back all the way in April of last year (or earlier).

IIRC, no one knew shit in April 2020. Your statement feels like its heavily influenced by hindsight bias.

I think you're confused. I'm not sure exactly who you're counting as "science agencies," but if it's the kind of agencies I'm thinking of, I wouldn't say their purpose is either to "exact change on society" or to "do good science and tell us honest results." Their purpose it to come up with public policy to solve actual problems in the face of rather severe uncertainty. Hopefully that based on good science (which may be psychology/sociology), but that's often not possible.

It's not "lying" to not share your exact level of pessimism/cynicism or to be unable to make statements about the future with the benefit of hindsight.

Current CDC data on breakthrough cases: .04%. 99.6% of vaccinated people are not contracting COVID.

100% minus .04% does not equal 99.6%, and a link to the source of the data would make your comment more credible.

I have no ‘claims’ to make; this is public, easily accessible, free information.

CDC running vaccination dashboard: https://covid.cdc.gov/covid-data-tracker/#vaccinations_vacc-...

CDC Breakthrough Case Investigation and Reporting https://www.cdc.gov/vaccines/covid-19/health-departments/bre...

As of 9.7.2021, of approximately 178M Americans fully vaccinated, there have been 14,115 breakthrough cases requiring hospitalization or who died. I’ll leave it to you to calculate that percentage.

For those familiar with the usual limitations of data collection, it’s clear there is no ‘perfect’ count of breakthrough cases, so hospitalization/mortality are the most concrete data available.

However, there is reporting beyond just those two categories, so the CDC estimates .04% of those fully vaccinated develop breakthrough cases.

"Next, a headache clamped down on the back of my skull. Then my eyeballs started to ache. "

Why do I feel like this was written in an alarmist tone with some kind of an agenda?

Probably because anyone who got a solid case of COVID will raise the alarm for others and have an agenda of preventing it. The 24 hours of reaction I got from shot #2 convinced me that I really wanted to avoid a full case.

The agenda of reducing the spread of covid? Yes that's the agenda... It's a good one!

You snark, but the agenda of a new source such as NPR should be to objectively inform the public.

That means, highlighting the risks of a breakthrough case such as the one in the article with the addition of probability of getting such a case, using data as a means of supporting their arguments about risks post-vaccination, etc.

The entire article is written in a spooky manner, indirectly extrapolating a single anecdotal experience written in alarmist tone.

Have you had COVID? It fucking sucks. This vivid description is pretty accurate to my experience.

Is it an alarmist tone or an accurate expression of symptoms? Why do you immediately take it for an agenda?

Sometimes, if you feel scared while reading something, it doesn't mean that the author is trying to make you scared for no reason; it might mean that they are just describing something that is a little scary.

Totally understood. There is nothing wrong in reporting how bad COVID can get.

The reason for immediately taking it for agenda starts with the headline "I got 'Mild' case of COVID", then proceeds to explain how a 'Mild' case of COVID can make your eyeballs ache and make your skull explode in 103 degree fever. This is gross mischaracterization of medically agreed upon common symptoms of COVID.

The next conclusion is become cynical and try to understand what is the purpose of this article and who is its audience? I hope I can call out the publication without anyone accussing that I have an agenda.

Half of the article was about how the author is surprised by how bad a quote-unquote "mild" case of COVID can actually be. They're making the point that even if you aren't hospitalized, this shit is pretty rough for some people. Not deadly, and not even necessarily long-lasting (as the author was careful to specify); just shitty.

I think that is a very fair presentation of a story. I call you out for the agenda thing only because I think purported fear of an agenda is kind of an argument-red-flag; it just means you don't like the conclusions that are suggested by the data available.

We talk a lot about agenda, bias, narrative -- sometimes, a lot of people see the same set of facts and come to the same conclusion, not because they're Sheep and being controlled by the Thought Police, but because one conclusion is fairly correct.

This is coming off more antagonistic towards you, in particular; I don't mean that, and I don't mean to suggest you're a conspiracy theorist or whatever. I just mean that sometimes, a clear conclusion from an article isn't an agenda so much as it is reasonably logical fact-presentation and basic analysis.

There’s a lot of conflicting data about the vaccine effectiveness against reducing symptoms of breakthrough infections.

It’s interesting though, that the author’s symptoms sound about average for someone of their age group if unvaccinated, which is around the same or slightly worse than what all of the people under 50 I know who got Covid reported, whether vaccinated or not.

I know quite a few people 35-55 who went to hospital with severe symptoms and a few with breakthroughs this fall. None of the breakthrough cases required more than perhaps a day or two of rest.

> The vaccines aren't a forcefield that ward off all things COVID. They were given the greenlight because they greatly lower your chance of getting seriously ill or dying.

> ... there were reassuring findings earlier this year that the vaccine was remarkably good at stopping any infection, even mild ones. This was a kind of bonus, we were told.

Isnt this false? If I recall, there was not enough data in early clinical trials to tell how effective the vaccines were at preventing severe illness and death, and the vaccines were largely approved based on reducing the risk ratio of infection

EDIT: pretty sure I'm right. See data below.

Willful ignorance, confirmation bias, etc. Unthinking people are the bedrock of this world and they will twist themselves into knots to assuage their guilt.

It is true/correct. It's much easier to measure hospitalizations rather than infection, and the #s in the real world confirmed the advertised effectiveness from the trial, for Alpha.

I think you're wrong. For instance, this website about the emergency use authorization for the Moderna vaccine says, for equal sized vaccinated and control groups, that

> Vaccine efficacy against hospitalization due to COVID-19 was 89% (95% CI: 13%, 89%). Deaths were also uncommon, 6 in the vaccine group and 7 in the placebo group.

https://www.cdc.gov/vaccines/acip/recs/grade/covid-19-modern...

In other words, there was not nearly enough data to tell whether it was effective at reducing deaths, and only weak data on hospitalizations.

Do you have a cite that describes it otherwise? If not, please edit your comment.

> Where did I get it? Who knows. Like so many Americans, I had loosened up with wearing masks and social distancing, after getting fully vaccinated

I’m not a fan of this vaguely hamartiological style of reasoning. The narrative structure is like a biblical cautionary tale. The author had something bad happen to him, and so he’s searching for a transgression he committed that he can use to construct a punishment narrative.

Never heard the word hamartiological before but it's perfect here and describes exactly how I've felt too.

risk analysis != hamartiology

I don't see any punishment narrative. I think you a reading into the article to support your own narrative. Indeed, the entire article is about adjusting how one sees the related risks given the information that has emerged around the vaccines and the delta varriant.

This article is not risk analysis. It’s just a bunch of narrative stories.

It’s depressing how all these stories just reinforce the idea that the US could never suffer another lockdown.

We have exploding cases and even a brief lockdown would greatly decrease them, but the political will to try and stop it has completely dried up, likely from business interests.

I don't have a business and I don't want to be shut in home. If you want to then lock yourself down, thanks.

No one wants to do chemotherapy or have tumor excisions, but you need to or you suffer a worse fate.

Chemotherapy is actually an excellent analogy. We don't give chemotherapy to everyone just because a few people might have undetected cancer.

Cancer does not spread rapidly through air. Also, chemotherapy is done after you get cancer. It is not a preventative measure.

It is preventative though, it prevents the cancer from progressing and metastasizing.

It is not preventative in the sense that you can't ask millions of people to get chemotherapy just in case.

It’s a reductio ad absurdism, I’m not saying everyone has potential cancer, I’m saying that sometimes protecting your health isn’t convenient or fun. The idea is that it is temporary.

Not a good analogy. Many doctors chose to bypass chemotherapy and tumor excisions. Chances are the gain is a handful of years of utmost misery. If that.

https://www.fredhutch.org/en/news/center-news/2014/05/How-do...

> “dying patients continue to be hospitalized and subjected to ineffective therapies that erode their quality of life and their personal dignity” while doctors “have a striking personal preference to forego high-intensity care for themselves at the end-of-life and prefer to die gently and naturally.”

I’m not good at analogies I guess. I’ll come up with a new one.

Lockdowns cause obesity, suicide both in short-term and long term, and we don’t have figures on whether the lack of exercise and sadness causes more cancer but it could. I personally have lost all of my friends due to anger issues, I only have my workmates left, if I ever lose my keys. There has also been visibly more attacks in France since the lockdowns started (bethroatings, I mean). Pro-lockdown people never seem to include the human aspect of it.

A 2 week lockdown caused this? I'm not advocated for a year long one again, but having 100k+ cases a day might be more harmful.

Is the hospitalization rate and death rate among vaccinated people really that high? Or is it at or below flu rates? I think that's what should be driving lockdown decisions.

If the rates of hospitalization and death are still high for unvaccinated people, I don't see why we should suffer more restrictions for people who refuse to protect themselves.

I searched for "monoclonal" and "respirator" in the article and found nothing. If you want go avoid getting infected, wear a correctly fitted respirator, preferably NIOSH P100 elastomeric with replaceable cartridges. If you can convince your doctor, they can prescribe monoclonal antibodies right after you get exposed, with no symptoms or testing needed.

I've seen nobody wear respirator or anyone recommend wearing that to avoid infection until this comment.

I wear a EN 149 P3 elastomeric half mask respirator (99.97% effectiveness) and face shield whenever I go into shops or other indoor spaces other than my own home. It's a lot more comfortable than a surgical mask. If everybody did the same then the pandemic would probably be over by now.

Cost is "£1000-£2000 per treatment" https://www.bbc.co.uk/news/health-58281332

In the US the federal government buys it, though I'm not sure they are going to continue doing so. In the tristate area and Florida it's apparently pretty easy to get.

If you think you're getting sick, the number one action you should take is to begin treatment early. You need to take action before symptoms get worse. The author had a high grade fever for a week but never mentioned seeking any treatment.

Things you should do yourself: take vitamins and nutritional supplements, drink plenty of water, get your body moving, isolate yourself from others, wear a mask.

Things your doctor should do for you: prescribe antivirals, also corticosteriods & antithrombotics if symptoms continue to worsen. The goal is to avoid the hospital and severe outcomes - many clinics will prescribe these safe & widely available over the counter medicines with little to no consultation.

Whether you're vaccinated or not, this should be the standard of care for everyone - it's no different than most other viral infections. For some reason very few people seem to be aware of this advice, and all the scientific evidence supporting it (in the context of SARS-CoV-2 and in general).

Most things on your list are fine and prob won't hurt, but you didn't explicitly mention one thing that has studied benefit which is monoclonal antibodies. Also needs to be done early.

Nonsense, get monoclonal antibodies as soon as possible. The earlier the better.

All you said was available during 2020, and people have been taking vitamins minerals, etc. and dying anyway.

> For some reason very few people seem to be aware of this advice, and all the scientific evidence supporting it (in the context of SARS-CoV-2 and in general).

It’s because most of it is not backed by scientific evidence, there aren’t proved to be any general “antiviral” drugs you can effectively take to fight colds or other viruses. Tamiflu does exist for flu and maybe takes a day off your disease course, but even that is disputed. Zinc has as many negative studies as positive, high doses of vitamin C (e.g. “Emergen-C”) have flamed out in trials in the past. Some of them may have a small effect but don’t think it’s going to be a game changer in the fight against COVID-19. Only monoclonal antibodies and the vaccine are.

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