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Comment by tptacek | Hacker News Reader

Sure you do, if they're relatively low-skilled and straightforwardly replaceable, and they're endangering the rest of the staff by refusing to comply with health and safety requirements.

This is 1.8% of their workforce. Their normal annual turnover is 8%.

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>if they're relatively low-skilled and straightforwardly replaceable

narrator: "they aren't".

What qualifies you to speak on the subject?

What makes you more qualified than the people who actually have professional education, training, and experience in running a hospital?

I took the time to look up the employee turnover rate at a regional health care provider in order to write my comment. Can I ask that you expend at least that much effort (it's not much!) to support your claim with evidence?

My argument might be more subtle than my comment makes it seem; if so, that's my fault, because I wrote downthread as well and probably assumed people read both comments. A very large cohort of the workers in a regional health chain are not medical professionals, but rather support staff. Those are the employees that I'm saying are relatively low-skilled and replaceable. What's more, our current economic conditions make it straightforward for them to hop to other jobs right now.

What you're saying seems pretty unlikely, given the demographics of vaccination.

Health officials have spent nearly two years claiming that all of society has to shut down because they cannot increase staffing capacity at all. That's why so many of the emergency hospitals that were built ended up shutting down having never seen a single patient.

This claim was always implausible on its face, but having so adamantly claimed this, public health does not now get to claim that huge numbers of workers can be trivially hired and trained within a few weeks. If that actually is the case then the justification for lockdowns evaporates.

You are right, I did not understand that you were speaking about support staff and not those in nursing. Obviously nurses and doctors are not trivial to train and replace.

Our local hospitals have lost on average over half their nursing staff in the last year, and hasn't been able to replace near enough of them. This was before vaccine mandates.

Which is only putting more stress on the ones who stayed, and it's getting to where they are getting burnt out, having gone through a year and a half of COVID and now taking to the slack due to the shortages.

No telling what's going to happen when the vaccine mandate kicks in next month for most of the nurses.

The normal overnight staffing where my wife works is usually one doctor, 3-mid levels and 6 nurses.

They've been down to one doctor and 1-2 nurses for most of the last month.

Amusingly enough, 1.8% is close to the IFR of Covid.

CFR, not IFR.

Ok so the percent of staff they’re firing is higher than the IFR?

> endangering the rest of the staff

Where did this idea come from that we vaccinated people need to be protected from the unvaccinated? That’s what the vaccine is _for_, protecting us from the unvaccinated. And it’s good at its job!

Please educate yourself on herd immunity.

Delta is so transmissible that herd immunity is no longer achievable even with 100% vaccinated.

it's not black & white

Which edition of herd immunity, the early 2020 or 2021 definition? It's a moving target you see...

https://web.archive.org/web/20201101161006/https:/www.who.in...

https://www.who.int/news-room/q-a-detail/coronavirus-disease...

It is a moving target because yes - we don't (as a society) have a ton of practice with worldwide pandemics. Information evolves and our expert's interpretation evolves with it. If you reject opinions from everyone who has ever changed their mind after receiving more information you'll be left with one or two ridiculously lucky people and a who bunch of stubborn morons who simply reject the notion that their past selves might have been incorrect.

It's not that I reject it it's that Id like to see something like git logs. Public health officials should drop the aura of infallibility and adopt some dev community style humility.

I am in disagreement with most of my family on this point (taking the least popular point of view). I understand the idea that transparency always allows better information around personal decisions - but I'm not certain if more transparency that might include speculation during a pandemic would actually lead to a greater sense of public safety. I feel like generally being transparent does increase public stability by increasing faith in the government - but I also feel like a pandemic is a good time to burn some of that public good will to keep a unified message to the public.

The current US federal government has no public good will left to burn. You have to be deluded to think they do.

Society has been experiencing pandemics for as long as society has existed. There is literally nothing humanity has more experience with than disease.

Herd immunity is a moving target because people like Fauci change their assessment of it depending on opinion polls. That's by his own words, not anyone else's. The guy admitted it to the New York Times. The "science" is not evolving and people who keep claiming it is, are just hurting the credibility of actual science even more than it's already been hurt. After all, a "science" that is constantly asserting things with 100% confidence and then next week asserts something totally different, also with 100% confidence (which they do), is actually pretty worthless to society.

Am I looking at the wrong parts of those pages? In the first I see "The threshold for establishing herd immunity for COVID-19 is not yet clear." and in the second I see "The proportion of the population that must be vaccinated against COVID-19 to begin inducing herd immunity is not known."

Also, the threshold for herd immunity is based partially on how well the virus spreads, and Delta changed that, which means that the threshold for herd immunity probably changed. When facts change, the messaging needs to change to stay accurate.

...? The vaccine isn't a panacea that eradicates the virus. Vaccine means your viral load is going to be lower than the alternative and less likely to spread. You can be vaccinated and still spread the virus, but getting the hogs to stop running around so we can try and achieve herd immunity for those that aren't able to get the vaccine is a pretty obvious goal.

It reduces your risk of serious illness to the point of irrelevance. If you’re vaccinated, you’re not quite at zero risk, but you’re close enough that the pandemic is over for you.

And delta is so transmissible that herd immunity is no longer achievable even with 100% vaccinated.

> And delta is so transmissible that herd immunity is no longer achievable even with 100% vaccinated.

There is ample evidence that suggests the exact opposite[1].

[1]: https://www.nejm.org/doi/full/10.1056/NEJMc2106757

That article isn’t about herd immunity.

It doesn't reduce risk to irrelevance - there can still be some serious consequences - and the more unvaccinated people we've got around the more likely we're going to see even more variants which may bypass the efficacy of the vaccine and force us back into full lock downs.

> It reduces your risk of serious illness to the point of irrelevance.

For the most part, and if you're healthy. Unfortunately in a hospital you're working with people that are vulnerable.

Why is this such a controversial thing anyways? In the past we've made vaccines mandatory.

The vaccine isn’t without side effects, and there is still a debate about whether natural immunity is sufficient.

The he side effects are trivial. Just get the vaccine and stop deluding yourself.

No. You’re just assuming that it’s by choice.

Because you're still allowing people who can transmit the disease around these "vulnerable" patients.

And the line drawn isn't even an arbitrary number, but an arbitrary policy with an assumed improvement.

An improvement that we know isn't good enough to prevent spread in populations with near 100% vaccination rates.

It's a free, safe vaccine that significantly reduces the spread of the virus that has caused a global pandemic over the last 18 months or so. If you're a health care worker and you won't get vaccinated, you probably should find a new line of work.

It doesn't need to be 100% effective at stopping spread to be an excellent idea.

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