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mchusma

The whole booster conversation seems like a political game.

If you have a vaccine, then your risk of death is far below that of the flu (statistically).

If you don't have a vaccine by now, you want covid instead and this booster conversation is irrelevant.

Kids are banned from taking anything.

So I expect booster or no booster, frankly it just won't matter much at the population scale.

I also don't understand the mask/booster thing now.

Is it to protect kids? If so, then all that effort is better directed at the FDA who has banned them from getting the vaccine. I think this is the area where people should have the most anger and Biden should frankly push legislation to replace or reform the FDA. Their behavior has been atrocious.

Is it to protect the unvaccinated? COVID is not going away, so IMO here we just want everyone in this population to get the disease as fast as possible to get it over with. Spreading is basically "good" for this group.

Is it to protect the vaccinated? This makes no sense, as the risk to the vaccinated well below the range we have accepted for decades.

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> If you have a vaccine, then your risk of death is far below that of the flu (statistically).

That seems worth checking.

US flu deaths per year over the last 10 years ranged from 12000 to 61000, averaging 35900 [1]. That's 3.7 to 18.6 per 100k, averaging 10.9 per 100k.

Weekly COVID deaths among vaccinated people is 0.1 per 100k [2].

The flu season is typically about 8 months. A weekly death rate of 0.1 per 100k over 8 months would be 3.5 per 100k.

So...about 1/3 the risk of dying from from flu in an average flu year which arguably is indeed "far below".

[1] https://en.wikipedia.org/wiki/United_States_influenza_statis...

[2] https://www.cdc.gov/mmwr/volumes/70/wr/mm7037e1.htm

> The flu season is typically about 8 months. A weekly death rate of 0.1 per 100k over 8 months would be 3.5 per 100k.

That's still depressingly high, and the 0.1 rate doesn't is before July 17th, so wouldn't really account for the Delta variant? COVID is no joke.

How is 1/3 of a number that the vast majority of people don't even blink at "depressingly high"?

Delta was the dominant variant only by end of July so the data set for the 0.1 number could have been based mostly on a virus which is 2.5x less deadly.

We're now facing an endemic virus which, even with vaccination, approaches (or could get as bad as) the deadliness of the flu.

Doesn't seem quite right to compare historical flu rates of the general population to mask mandated covid rates among vaccinated.

As it is today, it seems like flu deaths are far less frequent than covid deaths. Cherry picked link but it _is_ the cdc.

https://www.cdc.gov/flu/weekly/index.htm

>Among the 3,388 PIC deaths reported for this week, 2,785 had COVID-19 listed as an underlying or contributing cause of death on the death certificate, and three listed influenza, indicating that current PIC mortality is due primarily to COVID-19 and not influenza.

You just said it's not fair to compare mask mandated rates, but then compare against the flu, which obviously is affected by the mask mandates (also mask mandates right now in the US are a bit of a joke, have you seen a sports game recently?).

The point is that comparing un-masked flu rates to masked-covid rates isn't valid.

Comparing masked-flu to masked-covid is valid.

Of course, if you're doing that comparison, it may also be worth mentioning that the flu also has a vaccine and if you're vaccinated against the flu too, its less dangerous than covid.

both comparisons are useful to me. masked covid vs. masked flu shows how dangerous covid is in relative terms, masked covid vs. unmasked flu shows how dangerous covid is compared to the risks I used to take.

Flu is under-diagnosed compared to covid because it kills a lot of old people and their cause of death is frequently not listed as flu. With covid, every death that might be attributable to it is counted. So it’s probably actually a more extreme difference under a fair comparison.

Any kind of equivalence statement to the flu is a well-known conservative "dog whistle"

And therein lies the problem: to politicize a perfectly testable statement and put intent into it.

That is not true at all. I'm fairly progressive and I found the analysis done there credible and welcome the information.

that's exactly why you should rethink the concept of a 'dog whistle'.

1 ) painting an individual politically by extrapolating a single opinion across their entire persona is irresponsible and over-simple.

2 ) 'conservative' is over-generalized to the point of uselessness and ambiguity.

it's a concept (dog whistle) that is used strictly for generating rage and calling other individuals to arms so that the crowd picks up torches and pitchforks and follows your lede in attacking an individual's opinion with as little prompting or individual thought as possible.

the classification and announcement of a 'dog whistle' makes civil conversation near impossible afterwards, even if those who announce it are dead-wrong or working in poor faith against an individual.

In my experience the people who announce 'dog whistles' are rarely arguing in good faith.

>it's a concept (dog whistle) that is used strictly for generating rage and calling other individuals to arms so that the crowd picks up torches and pitchforks and follows your lede in attacking an individual's opinion with as little prompting or individual thought as possible.

It is not used strictly for that, indeed would be ineffective for that purpose were it not also a useful word. It means "warning, this seemingly innocent reference/argument/line of argument has historically been used by people with questionable motives, and warrants extra scrutiny".

Isn't the dog whistle comparing COVID without vaccination/masking/distancing/etc to the flu, to downplay the severity of the pandemic and hence the need to take any action against it?

A comparison of COVID risk in vaccinated people showing that vaccination apparently reduces the risk to less than that of the average seasonal flu is the opposite of what the usually dog whistling people are trying to convey.

Not only that, but it is part of the concerted campaign by the right to downplay Covid. They would very much prefer the poors to suffer and die quietly - without stopping work of course.

I get so frustrated by this stuff.

Here’s where you went wrong.

Your number is not based on efficacy last week. It’s cumulative!

The vaccine efficacy wanes. For those who get a vaccine 8 months ago, it’s almost worthless now.

The worst part of you logic, you lump all risk groups together! A 90 year old is not a 20 year old. Argh! People have been doing this, even public health people, since the beginning of the pandemic. Teenagers and children have never been at risk really. It’s not about you, it’s about high risk groups. Old people, obese people with diabetes over a certain age.

I get so very frustrated.

> For those who get a vaccine 8 months ago, it’s almost worthless now.

You need to back this claim up with data please.

Good point - another data point that is actually not one, but many. There are 13 different COVID-19 vaccines around the globe, which work in different ways.

"The overall age-adjusted vaccine effectiveness against infection for all New York adults declined from 91.7% to 79.8%." - https://www.cdc.gov/mmwr/volumes/70/wr/mm7034e1.htm?s_cid=mm...

"Two doses of mRNA vaccines were 74.7% effective against infection among nursing home residents early in the vaccination program (March–May 2021). During June–July 2021, when B.1.617.2 (Delta) variant circulation predominated, effectiveness declined significantly to 53.1%." - https://www.cdc.gov/mmwr/volumes/70/wr/mm7034e3.htm?s_cid=mm...

"The efficacy figure, which is based on an unspecified number of people between June 20 and July 17, is down from an earlier estimate of 64% two weeks ago and conflicts with data out of the U.K. that found the shot was 88% effective against symptomatic disease caused by the variant." - https://www.cnbc.com/2021/07/23/delta-variant-pfizer-covid-v...

"“As seen in real world data released from the Israel Ministry of Health, vaccine efficacy in preventing both infection and symptomatic disease has declined six months post-vaccination, although efficacy in preventing serious illnesses remains high,” the companies said in a written statement. “These findings are consistent with an ongoing analysis from the Companies’ Phase 3 study,” they said. “That is why we have said, and we continue to believe that it is likely, based on the totality of the data we have to date, that a third dose may be needed within 6 to 12 months after full vaccination.” ...... Executives from Pfizer and BioNtech have repeatedly said people will likely need a booster shot, or third dose, within 12 months of getting fully vaccinated because they expect vaccine-induced immunity to wane over time. They also said it’s likely people will need to get additional shots each year." - https://www.cnbc.com/2021/07/08/pfizer-says-it-is-developing...

So, while it's true that the effectiveness wanes, the same articles also point out that it is still effective at preventing severe hospitalization. If you're vaccinated, you're more likely after 6 months to get COVID anyway, but you are much less likely to be sent to the hospital or die.

It was a horrible marketing mistake to ever imply that a vaccine would eliminate COVID by reducing transmission / infection. In fact, it'll turn COVID into a manageable disease by eliminating the most severe symptoms.

https://www.cdc.gov/mmwr/volumes/70/wr/mm7037e2.htm

77% efficacy against infection for Pfizer, 92% efficacy against infection for Moderna in the US.

Really wish people would stop saying vaccines have waned to uselessness. That just isn't even true for VE against infection. All the studies that I see at the lower level of ~50% VE against infection are highly problematic (there was a study of healthcare workers in San Diego where their unvaccinated control was only monitored via PCR for infection and only had a 3x increase of infections during the delta spike in Jul which suggests their unvaccinated controls had a significant amount of natural resistance or were taking many more precautions).

Pretty sure he thinks antibody count is the same as being protected. And since antibodies fade over time, he thinks the protection fades. But the immune system is immensely more complicated with memory cells and such.

We don’t have it past early midsummer yet but this[1] goes to the beginning of summer. You can extrapolate out from the trend lines. I prefer to take a conservative ie. maximally pessimistic view because of the potential for human suffering. Ymmv

[1] https://www.bmj.com/content/374/bmj.n2113

““In my opinion, a reasonable worst case scenario could see protection below 50% for elderly people and healthcare workers by winter,” he said. “If there are high levels of infection in the UK, driven by loosened social restrictions and a highly transmissible variant, this scenario could mean increased hospitalisations and deaths. We urgently need to make plans for vaccine boosters and decide if a strategy to vaccinate children is sensible.””

Nothing past 6 months or so yet, but again the original British report which is discussed in the bmj article shows trend lines and it’s easy to extrapolate if you are good with charts/data.

How are you going to get frustrated and then make wild claims with 0 evidence?

Er, so can you show any numbers to the effect that Covid is deadlier than the flu among some Covid-vaccinated subpopulation? Even if it's true that Covid "scales" (becomes deadlier) as a function of age more steeply than influenza does, it's not clear to me that Covid is deadlier in any single age group.

Good news: it may actually last several years not months: "A series of new studies, including two led by Ellebedy, suggests that mRNA vaccines like those from Pfizer-BioNTech and Moderna trigger the immune system to establish long-term protection against severe COVID-19 — protection that likely will last several years or even longer, Ellebedy says." https://www.npr.org/sections/goatsandsoda/2021/08/30/1032520...

Vaccine efficacy against infection wanes, but not severe disease and death. This is likely due to the difference in speed in which the B cells (faster) and T cells (slower) wane from the vaccine.

Your claim is frustrating because it is inaccurate and misleading.

As this thread seems to be confusing two concepts, maybe worthwhile to post again:

"Vaccine efficacy, effectiveness and protection"

https://www.who.int/news-room/feature-stories/detail/vaccine...

Vaccine efficacy is found in trials, vaccine effectiveness is dynamic depending WHEN you calculate it and its found after 'deployment in the field'

"A vaccine’s efficacy is measured in a controlled clinical trial and is based on how many people who got vaccinated developed the ‘outcome of interest’ (usually disease) compared with how many people who got the placebo (dummy vaccine) developed the same outcome. Once the study is complete, the numbers of sick people in each group are compared, in order to calculate the relative risk of getting sick depending on whether or not the subjects received the vaccine. From this we get the efficacy – a measure of how much the vaccine lowered the risk of getting sick. If a vaccine has high efficacy, a lot fewer people in the group who received the vaccine got sick than the people in the group who received the placebo."

"Vaccine effectiveness is a measure of how well vaccines work in the real world. Clinical trials include a wide range of people – a broad age range, both sexes, different ethnicities and those with known medical conditions – but they cannot be a perfect representation of the whole population. The efficacy seen in clinical trials applies to specific outcomes in a clinical trial . Effectiveness is measured by observing how well the vaccines work to protect communities as a whole. Effectiveness in the real world can differ from the efficacy measured in a trial, because we can’t predict exactly how effective vaccination will be for a much bigger and more variable population getting vaccinated in more real life conditions."

Your frustration could be lessened by being less wrong.

This very article is titled “experts say booster shots not needed”. Less frustrated people are statistically more likely to get that this means the essential benefits of vaccination have not (or not yet) deteriorated significantly.

As to with data from all age groups, they do so for both the value and the comparison. If you feel the need to split each population into subgroups, you would need continue doing so once you find, for example, what differs from the 20-year old that died vs the one that didn’t. In the end, each person would have their own group, because they all differ. But try doing any comparisons, then.

The table from the CDC is split into two parts, one covering April 4 - June 19 and one covering June 20 - July 17. I used the death rate from the latter.

As far as age groups go, isn't there a pretty high correlation between high risk age groups for flu and high risk age groups for COVID?

As far as vaccine efficacy goes, the comment I decided to try to check the data on was comparing deaths, not infections. The mRNA vaccines in the US have had only a slight drop in the effectiveness at preventing death.

You can’t discount COVID deaths by using yearly flu deaths, but then only extrapolating to 8 months. Think of the other four months as “low-activity flu-months” and should be obvious why. You are intuitively mixing an attempt to estimate risk per year and risk per infection, I believe.

I’m also not entirely sure how good surveillance is for the flu? I could imagine it being recorded as “pneumonia” or “respiratory arrest”, especially when it affects poorer people, or those not admitted to hospitals.

(please not that the two issues above would pull any conclusion into opposite directions, then reflect on the relative amounts of hate and love, respectively, before deciding that I must be wrong because disagree)

There’s a serious disconnect between public health experts and the general public, and the experts have continued to not learn that lesson over the last year plus. It’s mind-boggling.

Earlier in the summer, we lifted mask mandates “because the vaccines were preventing disease”, and regardless of the technical facts behind that decision, the perception was reality for the general public. Now they are trying to walk that back to “vaccines prevent serious disease” in the face of delta breakthroughs but the baseline had already been set.

Not to mention the fact that experts continue to pedantically stick to their definition of serious disease as “needed oxygen in the hospital”, once again out of touch with the layperson’s opinion that a week of debilitating sickness at home followed by a month of weakness until full recovery seems pretty “serious” and something people do not want. Boosters are appealing because laypeople don’t want any serious-by-their-definition disease and experts seemingly are incapable of acknowledging or understanding that, let alone their part in creating confusing messaging (partly to appease a 3rd set of people who ironically don’t really want to hear from them at all).

Public health officials need to understand that their primary job is managing public perception of a situation first and foremost. They can go push their glasses up and pedantically spout off technical corrections behind closed doors as much as they want, but in public they have to connect and empathize with normal humans.

Part of this probably comes from medicine’s continued promulgation of their air of expertise (read: superiority) that they’ve affected for a long while, but things like compassion and bedside-manner at lower importance. I worked in medicine and studied public health, and this status-over-all-else attitude was one of the reasons I left.

> Public health officials need to understand that their primary job is managing public perception of a situation first and foremost. They can go push their glasses up and pedantically spout off technical corrections behind closed doors as much as they want, but in public they have to connect and empathize with normal humans.

So what should they have said in the beginning? If they don't give technical reasons, they will be accused of talking down from their ivory tower, dictating policy with a 'just trust us' attitude, or of being biased/political.

But if they give technical reasons, people will nitpick those, especially if the data is incomplete or evolving.

There were lots of people being correct and nuanced, but they were drowned out (partly for political reasons I suspect).

> So what should they have said in the beginning?

Probably something like “Masks aren’t proven to help yet, but unless covid is unlike any other respiratory disease they probably won’t hurt.” Yes, this could’ve caused a rush on them (though maybe that would’ve alleviated some of the need in hospitals?) and we would’ve had to deal with that, but lying to people in the name “for their own good” is not empathizing with them.

Getting too deep into technical reasons in the middle of such an event is not understanding the definition of teachable moment. Most people aren’t open to learning deep knowledge when their fear or other emotions are up, but it can take real skill to avoid diving into details as an expert. And I have some sympathy for people getting metaphorical microphones shoved in their face, but that just goes back to my point about public health (and medical people in general) needing to know that their job is as much soft skill as hard.

you're somehow making a dissonant "people are too stupid for their own good" argument couched in a "don't talk down to the people" argument. but this dichotomy is wholly unnecessary.

the simpler reframing is to tell people the truth, and do it so it's not overwhelming to folks ("having empathy") who have many competing attention-grabbing issues in their lives (i.e., they're busy, not stupid).

and regarding masks, the simple truth is, they don't help in most common situations (i.e., out in public, where distancing does all the work), and it's extremely hard to get folks to use them in the one common situation where they can be effective: social/family gatherings. masks were never going to be an effective mitigation for this one reason alone, but because of their visible, performative value, became immediately politicized.

Agree 100% with your comment, there has been a breakdown when it comes to technical definitions. The medical professional's definition of "airborne spread" for example. By their textbook definition, "airborne spread" was impossible and it got into the definition of what a droplet is.

The CDC seems dangerously close to a no-win scenario.

Present truth and facts backing policy: Not managing public perception correctly.

Tell public what needs to be done but omit details: Conserve N95's with "masks don't work" all over again.

This. Even here in Germany it's a "damned if you do, damned if you don't" scenario. It's entirely polarized.

You cant tell the truth because it will just be 'fuel for the anti-vaxers'. Not telling the truth being also fuel for the anti-vaxers.

vaccines are and always were effective, its just 90+ % of people would need to take them to kill covid once and for all. but people are dumb so its not happening

> Public health officials need to understand that their primary job is managing public perception of a situation first and foremost.

Actually, public health officials need to maintain the trust of the public, or no one will listen.

And you won't be trusted if everything coming out of your mouth is a lie, no matter what your intentions.

Actually, it's both. Parent is arguing a consequentialist ethical framework - public health experts have a primary duty of care to the population, and their actions should promote this goal.

Your position of "you won't be trusted if everything coming out of your mouth is a lie" is fully compatible with this framework.

Considering the other person's mental model and incorporating their terminology when communicating with them, even when they're a bit wrong, isn't "lying" - it's basic empathy.

>Is it to protect kids? If so, then all that effort is better directed at the FDA who has banned them from getting the vaccine. I think this is the area where people should have the most anger and Biden should frankly push legislation to replace or reform the FDA. Their behavior has been atrocious.

What specifically has been atrocious? The FDA has ALWAYS been extremely cautious in approving vaccinations for children. The vaccine was just officially approved for adults, they don't feel they have the data to do so for kids yet as far as I can tell.

The FDA initially wanted 2 months of data for under 12, just like adults. Then they changed their minds and wanted 6 months instead. I'm sure they had a reason, but in 70 years of vaccines, we've never had a side effect after 2 months. If they changed their minds once, they can damn well do it again and get this thing out there.

Then there's the objections (and resignations) to the booster. The specific reasons being:

> current vaccine supplies could save more lives if used in previously unvaccinated populations than if used as boosters in vaccinated populations

We all know this, but it's not the FDA's job to factor in global supply and distribution. Are boosters safe and effective? That's the FDA's job. Will denying boosters in the US increase first shots in other countries? That sure seems debatable to me. But regardless, it's not the concern of the FDA. I don't know what the hell they have been doing, but they've been going far beyond their scope lately.

How are they going to model efficacy if child mortality is very low already?

I think the first efficacy data is going to be about preventing infections. Data about preventing deaths will take longer to obtain.

Infections in a world where asymptotic spread is possible seems tough to measure. Are infections measured by symptoms such as cough, fever, etc, or by enough virus replication to shed or expel viral enough material to infect others?

Depends on the study design. Infections are detected by doing a PCR covid test. However, different studies might have different criteria for exactly who gets tested.

PCR doesn’t differentiate between live and dead virus molecules, which makes it less than diagnostic for active infection without symptoms, right?

That distinction isn't as important for evaluating vaccine efficacy. It wants to measure if the person was infected, not if the person is infectious.

If a trial subject is exposed to virus and the vaccine works to trigger an effective immune response, how does PCR know the difference between virus molecules neutralized by vaccine response and those neutralized otherwise?

In those cases the virus particles don't replicate enough to be detected.

How is a difference be determined between between vaccine enhanced immune response, normal immune response and not exposed?

The basic structure of a phase 3 vaccine efficacy trial is that you give the vaccine to half of the volunteers and placebo to the other half. Then you you wait for them to naturally be exposed to COVID. When a pre-determined number of infections is reached, the data is unblinded and they compare how many infections happened in the vaccine group vs the placebo group. If less people are infected in the vaccinated group then it shows that the vaccine is effective.

The initial comment wrote:

If child mortality and clinically significant infection are low, then would it not potentially take longer to see a statistically difference in a difference between vaccine and placebo subjects?

> I'm sure they had a reason, but in 70 years of vaccines, we've never had a side effect after 2 months.

Have we ever had mRNA vaccines?

no, but nothing about the mechanism of mRNA vaccines suggests they'd be an exception in that regard, since mRNA is very short-lived and thus if you'd get long-term effects, you'd have them from other delivery methods too.

As Vinay Prasad would say, It is often our mechanistic understanding that misaligns with study results. All we can do is test.

I believe part of the difficulty was the lull in infections before delta, plus the effectiveness of school closures. If nobody is getting sick, you cannot say anything about effectiveness.

I don’t know if they want proof of effectiveness again, or are specifically looking at risk (which would not be impacted by the above).

If guess the risk of death is so low among children, you need far more data to exclude a risk from vaccination at that (small) magnitude. Think of helmets, and how they are exactly as comfortable to wear in a car as they are on a motorcycle.

> Is it to protect the unvaccinated? COVID is not going away, so IMO here we just want everyone in this population to get the disease as fast as possible to get it over with.

No we definitely do not want that. There are large deaths of the country where vaccinated people are dying of unrelated conditions simply because hospitals are too full of dying unvaccinated COVID patients. The only way this works is if hospitals deny admittance to unvaccinated patients entirely, to reserve capacity for all the normal reasons that people need hospitals. No one is seriously suggesting this level of care rationing though.

it's really simple: you ration care according to the urgency of need. it's no different than any other event that would bring more people to the hospital than usual.

i've heard stories like what you're talking about. they don't make much sense. hospitals running out of oxygen? get more oxygen. that's why we have roads and trucks. not enough beds in the icu? build more. i think often about the start of the pandemic, before it got over here. i saw a story on the news that china had put up several hospitals practically overnight to handle the influx of patients. but here there's nothing but lame excuses. when i hear that kind of stuff it feels like i'm talking to someone that owes me money but doesn't have it.

Serious questions:

1. Where do you get the extra oxygen? There are places asking residents to reduce water usage because they are running out of liquid oxygen (used for water treatment in those places) do to medical uses. Do we have an enough manufacturing capabilities to produce enough oxygen to satisfy demand? Can this easily be increased?

2. "Beds" is not accurate. Often hospitals at 100%+ capacity still have physical space (i.e. "beds"), but who staffs the beds? You need doctors, nurses, and custodial staff. Where do those come from? Traveling nurses are a thing and places like Florida and Texas are hiring hundreds (thousands?). What is they supply of these nurses? What about doctors?

3. Where do the dead go and how do you deal with it? At the beginning of the pandemic NYC has to use refrigerated trucks. Now Texas and Florida (and presumably other out of control places) are also using refrigerated trucks to store the dead. This is probably one of the easier logistical issues because presumably we could just freeze the thousands of dead people every day until morgues and other resources could catch up.

I don't think this is so simple as "get more oxygen" and "add beds".

> i've heard stories like what you're talking about. they don't make much sense. hospitals running out of oxygen? get more oxygen. that's why we have roads and trucks. not enough beds in the icu? build more.

Poor? Just get more money! If only every problem had such a facile answer!

None of this is remotely as easy as you seem to think it is. If it were that easy, they'd already be doing it. They're not morons. And as someone else pointed out, "not enough beds" is shorthand for "not enough doctors and nurses". It'll take years to increase the supply there.

Where are people dying because the hospitals are too full of unvaccinated patients dying of COVID-19?

On the twitter!

In Southern Oregon, people with cancer or who are at risk of heart attack or stroke are being made to wait for care, because the hospitals are filled with unvaccinated COVID-19 patients:

https://www.oregonlive.com/coronavirus/2021/09/absolutely-he...

In another rural region (Idaho, maybe?) there was just that, someone who had some treatable condition who was unable to be seen for all the unvaccinated COVID patients, and who died from the condition. I couldn't find the article, but it was just published on some authoritative news service a few days ago, in case you'd like to look for it.

I mean the government and these private hospitals had a year and a half to build capacity. Last I checked building capacity was supposed to be the rationale for the whole “flatten the curve” thing back in March of 2020.

Why are hospitals “full” when they had all this time? Why is society supposed to be punished for a failure of leadership to do what they said?

Doctors and nurses don't get built in a year.

That seems like such an excuse. A year and a half is plenty of time to get creative. Pull people out of retirement. Let nursing students do more. Pay truckloads of money to all of them. I dunno. Figure it out. These folks are supposed to be the “experts”… what have they been doing this whole time?

Saying “no it cannot be done” is just not a valid excuse.

> Pull people out of retirement, Pay truckloads of money

So take the most vulnerable age group (old people) - and stick them on the front lines, looking after fat lazy middle aged people who are too lazy to get a 50cc jab.

They are retired doctors, they are not retards.

> what have they been doing this whole time?

Working on the most cost-effective, life-saving way to manage the pandemic: encouraging everyone who is able to to get vaccinated. Unfortunately, they had to work against an absurd scenario where an equal-opportunity virus has been politicized.

I am not a doctor so I cannot judge if “no it cannot be done” is valid or not.

But I think experts are allowed and expected to say “no it cannot be done” when something truly cannot be done. Experts are not superheroes and unlike superhero movies (just as example) there are matters that we cannot solve in a timely matter no matter how many experts we throw in the ring.

Alabama, for one: https://www.cnn.com/2021/09/13/us/alabama-heart-patient-icu-...

There is a finite healthcare capacity (largely based on the number of doctors and nurses). Once it's exceeded, people start dying who otherwise could've been saved had the full amount of healthcare resources been available.

> Is it to protect the vaccinated? This makes no sense, as the risk to the vaccinated well below the range we have accepted for decades.

What is the acceptable range? Older people are still dying from Covid even after 2 shots. If a third shot can improve someone's protection from death due to Covid, say from 70% to 90% [1], that sounds like a good reason to take that shot.

The comparison between someone in Israel taking a booster shot and someone in a 3rd world country without access to vaccines is irrelevant - at least until there's a serious global initiative to provide vaccines to everyone around the world.

[1] Original stats talked about 90% protection, but that has gone down since then. One of the possible reasons is the need for a booster shot. But we still don't know what level of protection the booster shot will provide.

As long as they don't impose to me (40 y.o.) to catch a plane... fine with me

I am getting very wary of the whole situation.

"As soon as we get a vaccine we are good". Now we have the bloody thing, I got injected with it hoping to get back to normal: "We need a booster shot"

I was always pretty rational about it, but this is becoming a farce

There is a good chunk of society that absolutely refuses to move on.

Yea, They can easily end this by just getting the jab, but choose not to. I'm starting to think the anti-mask, anti-vax crowd actually loves COVID and stay-at-home and all these restrictions. With COVID, these people imagine themselves as powerful freedom fighters, knowers of The Truth, battling the authoritarian government, standing lone against evil, occasionally martyrs for the cause--just like Braveheart! Without this imagined COVID tyranny, they're just normal schmucks like the rest of us.

mhh you might be right

some people need a villain to justify the evil in the world

I believe a serious issue with your “protect the unvaccinated” statement is it overlooks the amount of pressure they exert on our shared medical system. If your hospital beds are overrun with unvaccinated Covid patients, there is less room for others.

We could address the hospitalization issue by doing a better job of deciding when to hospitalize. It seems that more than half of the cases of those who are taking spaces in hospitals are asymptomstic, mild, or incidental.

https://news.yahoo.com/57-percent-vaccinated-covid-19-203448...

They're in the hospital for other reasons.

That study is based on VA data and not reflective of the general population. It seems very problematic to talk as if that's true for all hospitals.

> hospital beds are overrun with unvaccinated Covid patients, there is less room for others

Was in Jackson Hole for Labor Day weekend. They border Idaho, whose voluntarily unvaccinated have filled its hospitals. In four days I met as many nurses and one doctor who quit out of frustration. They could no longer empathise with their patients, each describing a visceral anger at tending to ICUs of COVID patients, all unvaccinated.

I was there too. I was also in Boise, and Twin Falls, ID.

I went to no less than 20 doctors or nurses in the space of 2 weeks

Not one doctor mentioned anything about quitting or being short-staffed.

20 doctors/nurses in 2 weeks? I hope you were taking a survey or selling medical equipment, and you were not ill.

It did seem crazy at the time.

But not ill. Thanks for your concern.

One of the doctors was an ophthalmologist. Did the full vision test while at it. I was not driving - mostly doing uber to get around.

Made the mistake accepting the eye drops they often do for vision testing.

My phone was a complete blur after the drops.

Yes...I had a few more appts that day.

Trying to get around or even something as basic as calling was hard. Now imagine having to fill out online forms on mobile. Nightmare

In quiet desperation, i tried to turn on the accessibility settings on my android.

The phone suddenly started parroting loudly YOU ARE NOW USING ACCESSIBILITY SETTINGS PLEASE CONFIRM in the middle of a quiet waiting room.

The 3 hours that followed where the most vulnerable and humbling of my life.

> Not one doctor mentioned anything about quitting or being short-staffed

This likely comes down to self selection. You were in Idaho, I in Jackson. Also, relatively-rural Driggs versus denser Boise having different rates of spare hospital capacity as well as vaccination. (Or seeing a doctor at their office versus off duty.) Given Idaho was flirting with crisis standards of care, I think it’s objective to say they have a problem.

This is definitely one of the reasons I bailed after Medical school. Unvaccinated COVID patients are new, but that kind of decision making is not. Once I realized medicine was as much begging people to make good decisions as it was actually helping people, I just didn't think I could spend a lifetime doing that. Anecdotally, the few physician contacts I've kept are regularly posting about how much they are working. Which is impressive, because to them working 60+ hours a week is not considered too much.

>They could no longer empathise with their patients, each describing a visceral anger at tending to ICUs of COVID patients, all unvaccinated.

Did you ask them if they treat obese people the same way?

If obesity could be prevented with a simple shot, and was otherwise overwhelming our healthcare system, that might be a useful question.

I mean you could get Osha to start banning foods or do whatever with the jurisdiction they have now. Tax sugar out of existence. Then government subsidize all healthier foods. I mean the amount of money we spent no Covid we could have done all this....

But wait are you saying people should be able to make their on decisions? Obesity effects only a single person. Nope obesity is transmissible. I've seen too many couples where 1 is skinny and the other is obese or overweight. They both become overweight.

No one in the history of the world has died from obesity two weeks after simply spending time with another obese person.

Yes but if we sent everyone a Peloton in March 2020 and required use of it how many people would we have saved by now? Just pay people to use it which seems more ethical than paying people to take the vaccine.

Pandemics come and go. We might as well use fear to pass policies now like we did after 9/11

It IS overwhelming our health system. The 1,3, and 9th causes of death can all be attributed to in whole or at least in part to obesity. And guess what it has a super simple treatment called exercise and healthy diet. You can add it to reasons for dying from COVID as well.

https://www.who.int/news-room/fact-sheets/detail/the-top-10-...

While we're at it since you seem to be really into some weird sort of eugenics mindset why don't you let us all know whether drug addicts should get treated? You might wanna tread carefully on this authoritarian attitude you've got going. You're treading a very fine line deciding who's worthy of treatment and who's not.

I do not want a medical system that gets to pass judgement on who they're going to administer treatment to. That's absolutely horrifying. These nurses can vent all they want but the moment they suggest they're not going to do everything they can to save people they should be relieved of their jobs.

> While we're at it since you seem to be really into some weird sort of eugenics mindset

I’m morbidly curious what leads you to say that.

I don't understand their frustration.

There's not much they can do for a patient once that patient is admitted to the ICU.

Hospitals should have been setting up Covid wards, or tents. The hospital had enough time. Other than intubation there's not much. I guess if you are important enough you get those coveted antibodies that were donated, or blood thinning drugs if you have blood clots in your lungs.

I've never met a doctor who quit over ethics. I've seen many who quit over ego disutes, or pay.

In medicine there's something called Professional Deniability. American doctors gave it in spades.

I'm all for getting the idiots vaccinated, but don't buy the caring doctor quitting because he/she has a moral dilemma.

(I think American doctors are good, but caring no. Ethical just enough to keep them out of a Malpractise suit.)

> Hospitals should have been setting up Covid wards, or tents.

They have, at least where I am. As demand goes up, they've even shut down whole clinics to reserve them for COVID patients.

> The hospital had enough time.

They definitely did not have enough time to train and hire new nurses and doctors.

They are not quitting out of ethics, ego or pay. They are quitting because they are overworked (more patients per doctor), and putting their own lives at risk because people made a choice not to get vaccinated.

> Hospitals should have been setting up Covid wards, or tents.

didn't this happen basically everywhere already, and most if not all of ended up being unneeded at the time? our local civic center converted into a temporary emergency covid care facility months ago and it was never used, so they shut it down. now the local healthcare corporation CEO is claiming the ICUs are full again. well if that's truly the case, we could easily set up the emergency care facility again, our mayor and governor have shown they're more than willing to help when the situation arises. so, at least here in my neck of the woods, something doesn't add up.

Percentage of 65+ people in Idaho with at least one covid vaccine dose: 93.2%

Percentage of 65+ people in Wyoming with at least one covid vaccine dose: 89.2%.

https://www.mayoclinic.org/coronavirus-covid-19/vaccine-trac...

As I mentioned on another thread, I just spent a few days in the hospital with an appendicitis. The hospital was swamped with COVID patients. It took 16 hours for me to be admitted to the hospital, which I was told was quite long for this hospital. My hospital roommate waited nearly 30 hours. The non-covid floor that I was on was severely understaffed, with nurses caring for 2.5x as many patients as normal. The nursing staff was run ragged.

I'm not sure exactly what we should do. We can't just refuse to treat the unvaccinated (I half suggested this before, which I regret), but we need to maintain our ability to care for other people. I didn't make a conscious decision that landed me in the hospital. My roommate didn't decide to let a spider bite his foot. The stage 4 cancer patient whose "elective" surgery was postponed didn't decide to get cancer. The heart patient who can't get an ICU bed didn't decide to have a heart attack.

I could imagine having regional FEMA/national guard run COVID hospitals. But where would the staff come from? There are a limited supply of trained medical staff.

I'm just not sure what we can do that's humane and fair to everyone besides just provide incentives to get vaccinated. We probably need WWII level propaganda to convince the unvaccinated.

So your assumption is that all the covid patients were unvaccinated?

Not an assumption. Just the data showing this to be true almost universally across the US. Statistically, breakthrough cases also skew older. Locally where I live >95% of patients in the hospital with COVID are unvaccinated.

It's a safe assumption that MOST are unvaccinated based on all available data. But of course not ALL (statistically speaking).

> If you don't have a vaccine by now, you want covid instead and this booster conversation is irrelevant

Friend’s mother visiting from Jamaica. People in her country are dying while they wait for first shots. The voluntarily unvaccinated in America are idiots. The author’s point is there are billions of unvoluntarily unvaccinated around the world to whom these doses could go.

Yikes. Idiots? All this condescension all the time.

Maybe some people won’t get the vaccine because they already had Covid. Israeli study showed that people who had Covid are more protected than the vaccinated.

Doesn’t hurt to get vaccinated anyway. In fact that should offer the most protection overall.

And that’s besides the point as the recovered may as well be vaccinated in the context of this discussion.

somebody's gotta be the control group in all of this, I'll take one for the team, in the name of Science

Not with the delta variant.

It's highly ignorant to call unvaccinated Americans idiots. Over 100 million Americans have already caught and recovered from Covid. I imagine many in that group don't see any value in getting the vaccine (rightfully so).

Most of those people don't actually know they had COVID. They make up stories that "they've already had it". Remember that vaccinated still get COVID, those numbers include them.

What evidence do you have for your claim? An anecdote or two from your own life? How is that any more scientific than what you claim to be decrying?

In the U.S. at least, there is a mass testing regime that many must submit to for work, school, etc. Are you suggesting those who have tested positive in these situations are "making up stories"?

Anecdotally, there are people who say it only based upon symptoms. I'd even argue that they are probably right, but its fair to say that they have any way of validating or proving that knowledge.

I agree that if someone is doing this, they do not have definitive proof.

The comment I was responding to claimed "most" people are making claims without proof. Despite the hundreds of millions (billions?) of covid tests that have been administered throughout the pandemic in the U.S.

There were a few stories that called into question the effectiveness of these tests ranging from PCR, antibody, antigen, etc.

Overwhelmingly people did not have to test for COVID, and never did. They had a few "symptoms" and claimed they got COVID and it "was no big deal". When in reality they have no proof of it. Humans overwhelmingly make up stories so reinforce their opinions. And no, most work did not require testing, even government work. Even federal government work.

"Humans overwhelmingly make up stories so reinforce their opinions."

At least we can agree on that. You're doing it right now.

Funny that you put "a few symptoms" in scare quotes, given that loss of taste and smell is highly indicative of covid and not any other widely circulating illness.

There is some value in fitting in with society and showing those who are skeptical that there's nothing to be afraid of with a vaccine. And with more mandates going into place it's easier to just get vaccinated.

I've said from the beginning of this year that I'll get vaccinated as soon as the government gets out of it. At this point, the mandates are specifically why I refuse to get vaccinated. I caught covid in August so I'm immune for the next year at least. So there's no reason for me to get vaccinated and every reason not to.

> I've said from the beginning of this year that I'll get vaccinated as soon as the government gets out of it. At this point, the mandates are specifically why I refuse to get vaccinated.

Do you find any irony in your decision being controlled by the government's policy?

I agree with arcbyte, and I got my second shot in March. The amount of government interference as it relates to COVID and vaccines is complete bullshit. I hope we look back on this in 20 years and feel a deep sense of embarrassment for how COVID and the vaccine has been managed and used to emotionally manipulate and divide people.

When 9/11 happened it united the country. COVID should have done the same thing, but it has been used as a political tool instead, bringing out the worst in people. It makes me quite depressed when I think about it for too long.

> When 9/11 happened it united the country. COVID should have done the same thing, but it has been used as a political tool instead, bringing out the worst in people. It makes me quite depressed when I think about it for too long.

I've felt this way too. People have made this so incredibly, incredibly divisive. I'm not sure what blend of fear and tribalism is driving this either. When you talk to some people about covid, what comes out of their mouth is almost word salad--they are so incredibly fearful and panicked that almost none of what they say makes sense. The idea that society should completely alter everything for this one specific illness (aka "new normal") is pretty absurd, yet people will stop just short of spitting on your face when you express any skepticism at all.

Societies reaction to this is all just so freaking bizarre. None of what we are doing adds up or makes much sense when you really start asking questions.

After 9/11 a significant portion of the US was staunchly anti-war, organized some of the largest protests in US history, and yet they were ignored by the media and demonized as anti-patriotic. On top of that, muslim americans have had to endure years of racist attacks, not only from individuals but also from the state, in borders and airports, ongoing to this day.

If you think it "united the country" then you either have rose-tinted glasses on, or you had your opinion validated by the pro-war media and never looked elsewhere. The difference is that now the media disagrees with you.

That isn't accurate. The media doesn't disagree with me, the country is ripped in two over COVID and vaccines, there is no denying that.

Why do you say they disagree?

Edit: capitalization

Second edit: I didn't say the WAR united the country. You're twisting my comment.

The war was a direct response to 9/11, they're directly related, just like vaccines and mandates are a direct response to COVID. The country was ripped in two back then two, you just didn't hear about it as much.

I was wrong when I said the media disagrees with you though. Maybe the difference is that the anti-vax side has managed to organize through the internet and has gotten a lot more coverage, so they look bigger than they actually are?

> The war was a direct response to 9/11, they're directly related, just like vaccines and mandates are a direct response to COVID. The country was ripped in two back then two, you just didn't hear about it as much.

I understand the point you’re trying to make, but I still disagree. I was in high school when 9/11 happened, I remember it well. There was a period of time, I will admit it was on the order of 48-96 hours, where this country was as united as I’ve ever experienced. COVID could have had that same effect, us as country(wo)men against the world. It didn’t. From the jump it was politics. I’m sure you remember Harris and Biden saying they wouldn’t get a vaccine when Trump was president. It’s political all the way down.

You talk about an event that occurred over 12 hours uniting the country for a business week, and wonder why a disease that had been politicized and downplayed in contradiction to the science and what we were seeing in other countries for months before we saw significant numbers of infections in the US did not generate the same effect?

Of course it didn't. I don't understand why you think it ever had the chance to.

>I’m sure you remember Harris and Biden saying they wouldn’t get a vaccine when Trump was president. It’s political all the way down.

I remember their comments. I also remember the rest of the statements they made and the context around them. And neither of them said they wouldn't get a vaccine while Trump was president - they said that they wouldn't get a vaccine if Trump was the only one saying to get it, and experts like Fauci weren't.

https://www.politifact.com/factchecks/2021/jul/23/tiktok-pos...

> I remember their comments. I also remember the rest of the statements they made and the context around them. And neither of them said they wouldn't get a vaccine while Trump was president - they said that they wouldn't get a vaccine if Trump was the only one saying to get it, and experts like Fauci weren't.

that is another shining example of how COVID and the vaccine were used for political manipulation. Biden and Harris should have not made the vaccine about donald fucking trump.

Their stance was bullshit and you know it. In what world are global pharma companies going to develop a brand new vaccine using relatively new technology to try and stop a global pandemic, and the only fucking person to talk about them is Trump? Nobody else will say anything until Trump does? Trump would be the first and only authority on these vaccines? That's such a crock of shit.

> I caught covid in August so I'm immune for the next year at least.

Yeah and if you got vaccinated you probably wouldn't have caught it in August. Great hill to (hopefully metaphorically) die on.

Choosing to risk catching a disease with a 1-2% case fatality rate, while refusing an overwhelmingly safe and effective vaccine is the definition of idiocy.

IFR is a better metric than CFR:

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s...

The overall IFR is misleading, given how age-stratified the risk is:

https://www.nature.com/articles/s41586-020-2918-0

I absolutely adore when publicly available data sourced from government agencies gets downvoted.

Since March of 2020 any kind of statement suggesting covid isn’t as bad as some make it out to be is met with fierce vitriol. The number of times I’ve been called “dangerous” for posting well sourced data that clearly shows the IFR of covid is not 1-2%…

It’s as if people believe that any good news will result in others “not taking this serious”. They must feel that everybody needs to be scared stiff of this thing all the time… the result is the average person thinks if they catch covid they have a 10% chance of dying, which for most age groups is like 1000x off[0].

It’s super evil, really. If people were better informed about the risk profiles of covid, how many would have sacrificed a year and a half of their short life? Wouldn’t that imply that forcing this “new normal” crap by scaring the daylights out of people is a tad misguided and perhaps very unethical and immoral? If the only way you can get people to comply with your draconian interventions is lying to society about the risks of covid… well that is pretty fucked up.

Worse, by the way, is peoples risk assessment for covid is so completely wrong it makes debating public policy impossible. If the average adult thinks they have a 10% of dying if they got covid, of course they will want to mask little kids at school, of course they’ll cheer vaccine passports, of course they’ll rat each other out for sitting on a park bench. If they knew kids were at almost zero risk of covid, and their age bracket had minimal risks, would they have agreed to any of that?

[0] a fascinating data set: https://covid19pulse.usc.edu/

I remember when I first saw that USC dataset, it was mind blowing. Any public health official worth their salt should be absolutely horror struck that the public's perception of the risk profile of a disease is off by multiple orders of magnitude. Their entire job is to accurately inform the public about public health risks, and that dataset is proof that they've failed more spectacularly than I would have thought possible. They should be working around the clock to try to amend their failure, and earn back the trust they've thrown away.

Strangely, despite all the pearl clutching about "misinformation", this data-backed and quantifiable instance of covid misinformation never gets brought up. As a result, I now consider government / public health institution claims to be politically calculated fearmongering or propaganda until proven otherwise, and likely not worth my time to pay attention to. I'll update my opinion about them if their stance toward "correcting misinformation" starts to include misinformation like the above as well.

I'm not holding my breath.

You expressed my exact thoughts better than I ever could hope to. Thanks!

Mmmm - I thought the problem was that the risk profile is it's not linear? So like, if enough people have it, they swamp emergency rooms, and suddenly, a lot more people are dying than would be dying at a lower incidence rate. So from a public health perspective, you're not really looking at 'how likely is this to kill people' but rather, 'how likely is this to crash an already fragile medical system' and thereby cause a lot of people to die.

I think the point about COVID is that if everybody just ignored it, this is absolutely what would happen, and case fatality rates could get pretty high.

If they've already had and recovered from Covid, as in the case of this 100 MM, their case fatality rate is nothing near that, and may well be lower than that for vaccinated-but-never-infected people.

Their choice is this, if they are otherwise healthy and young: With protection as good or better than the vaccinated, should I get a shot that might lower my already minuscule chance of dying or serious disease by a further tiny amount.

I could see rational people coming down on both sides of that.

Let us assume person x already got covid? The rationale for refusing the vaccine is either (a) they believe they do not need it or (b) they do so on ideological belief.

If it is (a), evidence shows that covid + vaccine is better than either alone and hence no reason to refuse the vaccine.

If it is (b), there is perfect justification for calling that stancy as an idiotic stance.

It is true that evidence suggests past infection + vaccine is best. But the evidence also shows that antibodies from past infection are superior to two shots of Pfizer which the majority of people were rolling with maskless just fine.

So regarding option a, it’s moreso the case that there’s no legitimate reason TO bother with the vaccine if you have those antibodies already. A marginal improvement at best over what is already better than two shots of Pfizer, is not worth the long-term unknowns to me.

Source:

https://www.science.org/content/article/having-sars-cov-2-on...

There is also new evidence that it may be safer for boys to just get covid rather than vaccination.

Source:

https://www.theguardian.com/world/2021/sep/10/boys-more-at-r...

Knowing this, will you still say there’s no reason to refuse it? Why would you elevate yourself into a position where you believe yourself to be an arbiter of this? The evidence is clear that the antibodies tens of millions already have from past infection are excellent. So stop coming up with false dilemmas.

> It's highly ignorant to call unvaccinated Americans idiots.

Agreed. The correct term for them is "immoral". The only world in which it makes sense to forgo the vaccine is one in which your life is only one that matters. So a healthy unvaccinated person is making a perfectly rational decision, just a morally bankrupt one.

How is it morally bankrupt to care about yourself more than people you don't know?

How does getting a vaccine affect a young healthy person negatively?

It is immoral for the same reason as refusing to help others survive at zero cost to you.

> How does getting a vaccine affect a young healthy person negatively?

Isn't that a reason people don't want the shot? Because they're not sure of the answer to that question.

I got my 2 shots. Had to drive 1.5 hours each way both times, find someone to watch my kids and burn up 2 Saturdays that I could have spent doing something I wanted to do that wasn't getting a shot.

To claim there is zero cost is insincere at best.

I am not sure which country you are in because I can walk into pharmacies and grocery stores and get a shot while shopping. Vaccine appointments were booked out early in the year in the United states. You could have just waited. The US government/pharma companies cant produce 600 million doses in a couple of weeks.

For me both shots were zero cost, as for every other person I know.

I was flying all over the country for the entire lockdown period. I didn’t want to wait to get the shot.

You had a peculiar outlier situation that simply isn't true for 99% of Americans. Glad to see that you judged that the vaccine was worth spending 2 entire days on.

If you answer my question I'll answer yours.

The vaccine does not come with 0 cost.

What was the cost to you? Sore arm? Feverish for a day?

It sucks to be surrounded by people who won't give a shit about senior Citizens, immunocompromised neighbors or older folks in their own families. It is indeed a lack of morality.

It would be very useful to know what percent of the unvaccinated population are not getting vaccinated because they already had COVID. What are their demographics, compared to the larger demographics of the unvaccinated population? And is it worth spending any effort (or White House budget paying TikTok influencers) trying to convince them to get a vaccine for an illness they have already had?

Anecdote to support your statement: A close friend that tested positive for COVID last year works at a hospital. They saw no value in getting vaccinated since they had already been infected and recovered. They were given an ultimatum last month of "get vaccinated or find a new job".

Reason has left the building.

How it would have hurt to get a vaccine?

Well for one it could go to desperate people in 3rd world countries? If you already provably had covid letting your now useless shot go to the ones in need is arguably the moral choice?

The doses in the countries they're at now aren't likely to go to a different country, and are more likely to expire before they could be shipped elsewhere, so people in those countries may as well get them. For other places, the problem is manufacturing and distribution, and lifting patent restrictions would help too.

>How it would have hurt to get a vaccine?

Notice how easy it is to conveniently jettison the science + data and just demand that people "tow the line or else.."

It's not only ignorant of the science, as you point out regarding prior immunity, but highly ignorant of history and social dynamics. Creating an underclass that is considered diseased and "dangerous to us" ends badly, to say the least.

https://en.wikipedia.org/wiki/Ten_stages_of_genocide

https://en.wikipedia.org/wiki/Dehumanization

In addition, minorities have reason to distrust the medical establishment.[0] For all the noise made about "voter ID is racist", almost no one has said that "vaccine passports are racist". Do we really want to create another two tiered system where minorities are the outgroup again?

[0] https://en.wikipedia.org/wiki/Tuskegee_Syphilis_Study

Calling the unvaccinated idiots is about as effective as calling the obese, alcoholics, people who don’t take their medication, etc, idiots.

Apparently we have sympathy for people who fail to make good health choices except for the unvaccinated.

Not effective at all.

> obese

Requires lifestyle change

> alcoholics

Requires lifestyle change

> people who don’t take their medication

Requires lifestyle change

> Vaccine

Requires a choice and a half day off.

There is a BIG difference there.

What you call lifestyle changes I call “need to make a decision”. Patients make terrible healthcare choices all the time. If we’re going to hammer them on vaccines let’s go all in, huh?

Obesity causes massive costs and burden on our healthcare system yet I don’t see people calling them idiots.

A lifestyle change is something that you need to actively pursue forever. It's not just a one time decision and action. I can't tell if you're being intentionally obtuse, or you actually can't see the difference.

And yes, all the issues listed are ones that can (usually) be corrected by action of the person involved. But the _level_ of action is on a totally different scale.

>I can't tell if you're being intentionally obtuse

Given this guy's attitudes towards vaccines, I doubt it's intentional.

Then we agree - these are are healthcare choices where people fail to make the right one?

> What you call lifestyle changes I call “need to make a decision”.

Well I'd suggest not downplaying it that way. Going from a junk-food-and-soda diet to a healthy one is a huge shift in lifestyle. You don't just make a decision one day and that's that. You have to make that decision several times a day, every day, for the rest of your life.

Not getting enough exercise? You don't just sign up for a gym membership and consider it done. No, that's just the first step. Now you need to show up at the gym several times a week, and put the work in over and over again.

An alcoholic doesn't just decide to stop drinking one day, then poof they're cured. That decision is just the beginning. What follows is some mix of white knuckling in the beginning and an ever-present vigilance to maintain sobriety. It's not just "I don't drink anymore", but also "I need to come to terms with this issue or that relationship", and "I can't hang out at the bar every night anymore". It's a long-term project, not just a decision.

Getting a vaccination is not like that at all. It really is a single decision, once made, and never thought about again.

Obesity is also way more complex than taking a shot. Its not as simple as "eat as much as your neighbor". Minor systemic differences in metabolism can have huge long-term weight implications.

There's a little bit of an unfair comparison here. You say the vaccine is a single choice, but what I see, continued boosters, masks, social distancing forever, "I'm willing to make a small change in my life to end this." And you might say "I'm not arguing for those things though" but if you stop at one shot, a year from now someone is going to be calling you an anti vaxxer or covid denier for not wanting to turn this one shot into a lifestyle change. And that's what is expected of us if we are being honest, not one quick shot, but a permanent lifestyle change. Some people don't even want to start down that road.

The lifestyle change is a choice that we make. For those people that HAVE made these choices, should also have a choice into taking a vaccine when they don't need it, just to satisfy those that have not taken the choice to do the same. Those who are obese, alcoholics or whatever can then take the choice to get vaccinated to better protect themselves

The problem is that, by not getting vaccinated, they're not _just_ impacting themselves. They're more likely to get, to pass it to others, to introduce a variant, etc. We're all much safer if everyone gets immunized. Or, at least, so the prevailing scientific theory and minds indicate... and you can either believe them or chose not to with no actual facts to back up your position... and be called an idiot ./shrug.

The unvaccinated are putting others at risk, including kids. I can't say the same about the obese or people who don't take their medication.

There is no significant risk to healthy kids.

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

Obese people take up health care resources that could go to keeping kids healthier at lower cost or making those resources more available to kids in an emergency.

asides from obese people / poor lifestyle choice people taking up health care resources, not only from Covid but they're also taking up resources from all other ailments that comes up BECAUSE they're obese. As well the culture today encourages plus size, like it's asking to overwhelm the healthcare system

obesity spreads too https://www.nejm.org/doi/full/10.1056/NEJMsa066082 just not the way you think they do as a virus

If someone were struggling with alcoholism, and I offered them an FDA approved shot to remove their addiction to alcohol, I would consider them fairly stupid if they refused it. Handling diseases and addictions is a long term struggle, not similar to a one time choice at all. It is orders of magnitude easier to get a covid shot than to rid yourself of an addiction.

There are FDA approved medications which are effective in treating alcoholism.

https://www.webmd.com/mental-health/addiction/features/fight...

Those are all drugs which try to make curing addiction easier, but it's still hard and you're going to suffer withdrawal symptoms and take these drugs for months. Very different from this magical hypothetical. Probably taking something like one of these is, however, advisable if trying to get off alcohol?

I’m glad your not a doctor then?

First off, the vaccine does not eliminate the risk of Covid. If you went to an alcoholic and said “this shot has a 90% chance of curing you of alcoholism but had side effects and you might end up quitting anyways” would you still call them an idiot for hesitating?

Type 2 diabetics can prevent most of the complications if they adhere to a strict diet and medication regimen. When they end up getting a limb amputated do you call them idiots as well?

> If you went to an alcoholic and said “this shot has a 90% chance of curing you of alcoholism but had side effects and you might end up quitting anyways” would you still call them an idiot for hesitating?

Depends on the side effects obviously. If clinical trials revealed nothing but rare allergic reactions to shots themselves and priors based on established medical knowledge predicted a very low chance of anything unusual happening over the very very long term, it'd be a no brainer. Nobody just quits alcoholism. It's by definition a difficult process.

> Type 2 diabetics can prevent most of the complications if they adhere to a strict diet and medication regimen. When they end up getting a limb amputated do you call them idiots as well?

I would call them idiots if they were presented a single shot to cure them of type 2 diabetes and they decided not to, then lost their limbs.

It's not really fair to compare a healthy person to someone "struggling with alcoholism".

If you run into a bar shouting about the dangers of consuming alcohol while promising an injection that makes a person never want to drink again, I would consider you fairly stupid.

That's my point. Falling victim to alcoholism is not an apt analogy to getting a covid shot. People don't generally choose to become alcoholics. If you really want to make your contrived example fit, it would be something like a shot that prevents organ damage from alcohol, not desire to drink.

If such a thing were available, and people refused, and then got alcohol poisoning, then it is arguable that, on some level, their stupidity is to blame here.

Ok, but would you call them an idiot? That’s my point. Do you think calling them idiots makes them more or less likely to make the right choice?

>Calling the unvaccinated idiots is about as effective as calling the obese, alcoholics, people who don’t take their medication, etc, idiots.

I mean, we should. And I say that as someone who is overweight and drinks more than I should. (Hm. Are they connected?!)

I'm fully aware that one of the most significant changes I can make to reduce my risk profile for all cause mortality is dropping weight, and have at times done so, and at times slipped back into poor eating and exercise habits. I'm in the middle one of the trends to improve it, but who knows if it will stick this time.

And yep, I'm stupid for not sticking to it. Or lacking in willpower. Or some combination of things that you would be fully justified in ascribing some sort of negative label to.

But if I could take a shot that makes me significantly less likely to die from my love of craft beer and cooking delicious, delicious, high calorie meals full of carbs and fat and not enough veggies, I sure would. If I could take a shot that made my body recover from doing strength training now in my 30s like it did back when I was in my early 20s, and less likely to have minor injuries, or even more likely to get me to return to the habit after recuperating from those injuries instead of staring wistfully at my garage door and thinking "man I really should get back to lifting weights", I would definitely do that.

I know I'm an idiot for not taking enough control over my own life to take care of some of the single largest health concerns. But I'd be an even bigger idiot if there was something as simple as a two or three dose vaccine regimen available to take care of those risks that I ignored.

Anecdotally, I decided not to get the vaccine. Three weeks ago, my friend who had gotten the vaccine got Covid, and then gave it to me. (He also beat me in golf that day which says a lot more about my golf than his ability to play while sick). But anyway, we both lost our sense of taste and smell, had fevers, were achy, him up until about a week ago, me up until a couple of days ago. So, perhaps he would have had an even tougher go at it had he not been vaccinated, but to me it seems we both suffered just about identical outcomes.

I roll a six sided die. You roll a 20 sided die. We both get a 4. I guess they're the same.

Except the 6 and 20 numbers are ones you just made up to support your position and make yourself feel warm inside but this fact just makes your entire statement meaningless and at the center of your grin at your own wit is an empty, hollow nothing.

His point was that two processes can result in the same outcome when dependent on more factors than just the quality of the process. That doesn't mean that you shouldn't use the better process, just that it does not guarantee a better outcome. Only a better chance of a better outcome.

Though, based on the actual data we have, his numbers aren't bad for cases, and would need to be shifted to a dice with a lot more sides than a d20 for hospitalizations and deaths.

https://www.fastcompany.com/90675524/delta-variant-vaccinate...

Anecdotally, the CEO of my company just died of Covid.

Anecdotally, my uncle who was otherwise healthy died months after getting the jab. And my sister's husband came down with some major fatigue/fever issues recently after the jab. So again, I took my chances based on the facts I had, yet I will get downvoted because they aren't in lock step with most of HN.

Apparently my comment was also not in lock step as you say. I'm not questioning your decision but if we're providing anecdotal data points then we should provide as many as possible.

So, at first you claimed you didn't want to get the vaccine because a friend got it and still got sick. Now you claimed your uncle died from it and your sister's husband got serious sick from it. I wonder why you didn't mention that at first to make your point, instead of using the much less serious case about your friend. Make me skeptical about everything you said.

No, it wasn't that I didn't want to get the vaccine because my friend got sick. The fact was he had the vaccine, and got me sick and we both had as close to the exact same experience during the sickness. The second parts about my uncle and my sister's husband I can't really prove they are related to the vaccine, but were just in response to the previous commenters. Sorry if that wasn't clear.

Given the R0-value of Covid, the likelihood is fairly high that you spread the virus to other people. Your amazingly impressive immune system would have absolutely crushed the virus with the help of a vaccine, and perhaps you would have had 0 symptoms and been totally non-contagious. Someone could be in a hospital bed because of your decision. Food for thought.

Last I checked, it's unknown how much (if at all) the vaccine reduces spread.

please give '''my''' shot to a high risk person in jamaica or iran or brazil. i don't need it, they do.

Thankfully, the most high risk people in Brazil have gotten two shots by now; we're moving towards giving a first shot to every adult, and starting second shots for everyone. The vaccination campaign was botched by negligence and corruption from the Bolsonaro government, but by now the doses are finally arriving.

We're also having the same discussions about third dose... Currently, the order is to give a third dose for the elderly (70+) and immunocompromised.

> i don't need it

Yes. You do. Even if you're asymptomatic, the virus will still mutate with a small chance of becoming another variant, and if you're unvaccinated in such a case, that means you'll spread it to others.

By not being vaccinated, you run the risk of spreading a variant around that is a "breakthrough variant" - a mutation of the disease that is hardened against a particular vaccine brand.

Thus, you will be contributing to healthy people getting sick despite being properly vaccinated.

While I agree that the rational course for anybody who is able to get vaccinated is to get vaccinated, people may still have reasons—however irrational—that are not idiotic.

Lets say you are a person who has had substandard health care all your life. And justly see the medical system as something not catered for people like you. You know the history of inhumane medical experiments being conducted on your ancestors as early as a generation ago. You also know that the medical profession has had severely wrong and racist theories about health care for your ethnicity.

Now the medical profession asks you to trust them and accept the vaccine.

Now I am not that person, and where I’m from the health care system has proven it self to be extremely valuable for me personally and those who I love (and coincidentally has one of the highest vaccination rate in the world). But if I put my self in other’s shoes I can easily understand how vaccine hesitancy is only natural.

Now what to do about it: Respect peoples concerns, e.g. don’t call them idiots for these concerns. Try to understand and educate. If people still don’t want the vaccine, don’t panic. Keep giving vaccines out for free to those who want it (and please include poorer countries). Perhaps if enough people are vaccinated worldwide it will slow the spread and mutation rate of the virus enough that we won’t have more of the mass waves of new variants and the vaccination status of each individual becomes irrelevant.

Why are all your suggestions about protecting people? Don't you realise there is a huge profit opportunity?

If big pharma can get billions of people signed up for regular booster shots and new vaccines, they will become enormously powerful.

The reason for masks always has been to flatten the curve. The hospitals are too full for everyone just to get it and get it over with, so people without COVID can't get medical help. Right now, the CDC recommends everyone older than 2 years old should wear a mask indoors. This is not just to protect kids but prevent them spreading it.

Source: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-si....

Accept the CDCs own study of 169 K–5 schools failed to find that masks for children in schools prevent the spread. Adult masks and ventilation were supported.

"The 21% lower incidence in schools that required mask use among students was not statistically significant compared with schools where mask use was optional."

https://www.cdc.gov/mmwr/volumes/70/wr/mm7021e1.htm

Are there real statistics on just how many people are being turned away? Hasn't it always been the case that people sometimes have to be turned to another hospital? Wouldn't reform of the horrible mix of public/private hospitals make more sense? It seems to me the risk to the general population isn't really that high, it just makes news because it's a sad story when someone who had a heart attack can't get admitted because some anti-vax moron is taking up space.

There are tons of people coming into the hospitals in my part of the US who are completely asymptomatic but panicking. The solution to this isn't for everyone to wear masks, the solution is for the hospitals to redirect those people to their primary care physicians.

> I also don't understand the mask/booster thing now.

It’s to reduce strain on hospitals and healthcare in general, but ICU beds in particular. It’s one thing for someone to get severe covid when the healthcare system knows how to treat it and has the capacity. It’s another thing to get severe covid (or have a heart attack, or be in an auto accident) when hospitals are at full capacity. The goal of the US government has always been to flatten the curve and never to eradicate the disease.

It's to flatten the curve. Approx 10% of vaccinated still require oxygen and other medical measures. And with hospitals currently at full capacity, boosters are a short-term way to keep the hospitalization numbers low until kids can get vaccinated and every one else has had their chance before we fully open everything up once and for all.

We’ve been flattening the curve for a year and a half. They had ample time to build capacity. Why is it not built?

>Biden should frankly push legislation to replace or reform the FDA

That's a very American-centric view. I'm not aware of any regulatory bodies (WHO included) which allow vaccination for kids under 12.

Regarding kids I think the approach to be more careful is granted: kids immune system does not work the same as in adults.

Also overall their health/body works different than adults thus lot of medication available for adults cannot be used for kids as it is dangerous.

Thus what is beneficial for adults might not be for children.

> Is it to protect the vaccinated?

Unfortunately, yes. The unvaccinated are a fertile ground for strains to develop. Protecting the unvaccinated is in your own best interest. We're going to need new vaccines when the the virus evolves in the unvaccinated, but the vaccinated can delay that eventuality.

Do you know about ADE?

People with a vaccine that doesn’t stop infection may have a higher chance and time to help develop mutations in order for it to survive.

It was extremely dangerous to push an imperfect vaccine, and because we know the current ones do not stop infection, transmission, or lower the viral load, that might be what has happened. IDK, not an epidemiologist.

https://www.chop.edu/centers-programs/vaccine-education-cent...

Your own link says that there is zero evidence of ADE being an issue with CV19 and our vaccines.

Luc Montagnier, a Nobel Prize winner, is quite concerned about ADE and these vaccines creating mutations. He’s also unvaccinated.

So what? There are many more Nobel Prize winners who are vaccinated. Brilliance doesn't make you immune to stupidity.

The risk to the vaccinated increases over time, as the protection wears off.

Not to mention, the original version of the virus is gone, it has been outcompeted by the variants. The booster should be updated to work against the latest dominant variants. Think of it as a software update.

> Not to mention, the original version of the virus is gone, it has been outcompeted by the variants.

No, that is not true. Also, for note, there are ZERO tests for variants so you know. It must be genetically sequenced. All the data we have is from sampling. Last report I saw put delta at 20% of Covid cases in the UK based on sampling sewage water which seems like it could have a high margin of error. But I’m open minded if you have a different source.

fwiw, the US has been increasing its vaxxed % by about 3-4 points per month. Not great, but still improving.

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