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.
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.
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.
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 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.
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...
https://noahcarl.substack.com/p/why-have-there-been-so-few-c...
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.
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".
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.
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.
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.
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.
If they start spreading exponentially via aerosols, sure.
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.
But covering the nose and mouth, when around others, is beyond the pale?
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.
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.
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.
> 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?
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?
The burden of proof is on those who claim things are different than the norm.
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.
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.
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.
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.
Because it's up to 10x more deadly than influenza, particularly for vulnerable populations.
https://www.hopkinsmedicine.org/health/conditions-and-diseas...
But my point wasn't about op, it was about the population as a whole, hence the "especially in vulnerable population" part.
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.
In most populations, today, COVID is significantly more dangerous and deadly than influenza.
Because you don't live in an isolated tribe, some percentage of your population remains at risk of contracting covid and perpetuating its spread.
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.
https://hms.harvard.edu/news/how-covid-19-causes-loss-smell
The risk to younger children is minimal.
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?
Not quite. The worst bouts of flu are the ones that kill people. Some of the influenza A strains are no joke.
Also, "Think of the children". those that can't get vaccinated but are now dying from the delta strain?
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.
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.
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.
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-...
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.
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 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.
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.
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 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.
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.
I appreciate your posting that, but it isnt helpful for my situation.
[1] https://msdh.ms.gov/msdhsite/_static/14,21994,420,873.html
Which point are you having trouble with?
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.
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.
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.
[1] https://www.tn.gov/health/cedep/ncov/data/hospitalization-da...
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...
Not news articles but the actual data you're using?
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.