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Comment by LurkingPenguin | Hacker News Reader

> A study estimated that nearly two-thirds of COVID-19 hospitalizations in the U.S. could be attributed to obesity, diabetes, hypertension, and heart failure.

> This research further highlights the burden of heart and metabolic diseases in the U.S. Almost 3 in 4 U.S. adults is overweight or obese. Nearly half of people have prediabetes or diabetes.

> “Medical providers should educate patients who may be at risk for severe COVID-19 and consider promoting preventive lifestyle measures, such as improved dietary quality and physical activity, to improve overall cardiometabolic health,” says O’Hearn.

I'm sure I'll get downvoted for saying this but I find it interesting how we can go so far as to terminate large numbers of people from their jobs if they refuse to get vaccinated, even if they have natural immunity, but it's basically blasphemy to talk about how fat and metabolically and cardiovascularly unhealthy large numbers of people in countries like the US are[1].

Incidentally, it's becoming more and more evident that the people who are more likely to have bad outcomes in breakthrough cases are...the same people who are more likely to have bad outcomes when unvaccinated[2]. And there's even some evidence that men with high BMIs have poorer immune responses to the vaccines to begin with[3]. Which isn't surprising either.

[1] https://www.cnbc.com/2021/09/01/sweetgreen-ceos-linkedin-pos...

[2] https://www.cnn.com/2021/09/08/health/severe-breakthrough-ca...

[3] https://www.news-medical.net/news/20210907/COVID-19-vaccine-...

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Your proposal is to fire fat people from their jobs because they pose a risk to.... others?

In seriousness, the whole point of vaccination is public health, which means you're not doing it just for yourself but also for the person who's working next to you. That's why people are getting terminated.

Overweight people put a huge strain on the healthcare system, maybe 30% of the entire health expenditure in the USA can be attributed to obesity. Which creates shortages and drives up costs for others who need it.

So yes, overweight people should be banned from civil society (and certainly restaurants) because the risk of them catching covid and causing even more strain on the healthcare system would be very bad even if they are vaccinated. Not until they get low risk and effective gastric bypass surgery at least. It's for the greater good.

That is to say, I don't believe such a horrific, dystopian, nasty, bullying attitude as this, but I can see how people who believe the unvaccinated should be given the same treatment for the alleged greater good would also think this about overweight people if they were to be logically consistent in their positions.

It would make more sense at least then saying people who have had covid and had no issues overcoming it are an unacceptable amount of risk to allow at offices and in restaurants, but those who haven’t had covid but have gotten the vaccine are an acceptable amount of risk.

I personally don’t think we should ban, overweight people, people who have had covid or haven’t had covid, who have been vaccinated or haven’t been vaccinated like we did before covid. But since our risk tolerance has gone down as a society at least be logical about it. Getting on a plane, covid test regardless of the fact you don’t appear sick at all, ok fair enough you’re crammed in a tin can. For restaurants, and offices, I think “have no symptoms of covid” is an acceptable amount of risk.

Those saying vaccinated but never got covid are acceptable, but unvaccinated recovered from covid unacceptable, would be more logical to say fat people are banned.

That is the frustration with it. It is just one group trying to say to another group, submit to us, we are your masters, or else we will punish you.

I wonder what people who have endured that kind of attitude in their history think of that attitude?

Unless there's an obesity spike that takes up all the ICU beds in a region (doughnut sale or something) your argument makes no sense.

It makes perfect sense. That is not required for my argument to make sense, 30% of healthcare costs is staggering, and absolutely could result in higher costs or worse outcomes for others.

And a spike from one particular cause does not necessarily lead to a shortage. If a few extra patients start getting covid and then there is a bed shortage, then fewer overweight people in there might also have prevented the shortage.

Look, it's for the greater good. No use arguing against it unless you hate grandma and Science™.

His point is that being fat and being unvaccinated both increase the risk society bears that you will a) give someone else covid and/or b) use hospital resources.

I understand TP's point. It's nonsensical because he's comparing twinkies to eclairs. They're superficially similar but are in reality vastly different things.

Yes, obese people are vastly worse for society than the unvaccinated in terms of financial costs. The solution is even simpler than getting a vaccine because they don't have to go anywhere. They simply have to eat less.

Cost of obesity was $1.4T in 2014, covid costs in excess of $16T. Just googling. I can't comment on methodology, etc. Obesity is ongoing, pandemic will eventually subside, etc. Thoughts?

For argument's sake let's say those numbers are right.

Then what is the argument for the covid response that could not also justify a similarly harsh response to obesity? Is it the exact amount of money that's at issue? The exact number of people who might die or suffer or be squeezed out of adequate healthcare due to load on the system caused by obesity?

I've never seen it. None of the experts or legislators or corporate news talking heads have ever explained it. If we got the cost of covid below $10T would that be sufficient to lift mandates and restrictions and other measures?

Or deaths? Deaths attributable to obesity is what, about 300,000 per year in the US? If covid deaths per year were brought down just a little bit and dipped under the 300k mark would that end the need for those measures?

You just don't get it. People aren't trying to optimize cost of healthcare at the system level, they are optimizing for themselves not dying and not getting sick. The perception (which I think it true, but you don't) is that the unvaccinated are putting them at risk. I want mandates to protect myself. I don't want to be in office with someone who is unvaccinated, or refuses to wear a mask. It's all about me, me, me.

No I do get it. People are trying to optimize the cost of healthcare system at the system level, and they absolutely cut it down as much as they can and people go without treatment for it.

You have vaccines to protect yourself, and if you're an anti vaxer or are still irrationally terrified of the virus you always have the option to shut yourself in your home.

If I'm understanding you, you don't personally believe in "banning overweight people from civil society" but you want to propose it to make a point about how much of a "horrific, dystopian, nasty, bullying attitude" you think the belief in vaccine mandates are, and how if one believes the anti-vaccinated should be restricted then it's effectively equivalent? Seems like an reductio ad absurdum fallacy to me, if so, since you're trying to characterize the belief in vaccine mandates as inevitably leading such a ridiculous, absurd conclusion. In this case banning overweight people.

> If I'm understanding you, you don't personally believe in "banning overweight people from civil society"

Correct.

> but you want to propose it to make a point about how much of a "horrific, dystopian, nasty, bullying attitude" you think the belief in vaccine mandates are, and how if one believes the anti-vaccinated should be restricted then it's effectively equivalent?

Much the same arguments made for bullying and coercing people to getting unwanted medical procedures can be used for either, yes.

> Seems like an reductio ad absurdum fallacy to me,

Why? What is any more absurd about it? 30% of health expenditure is a staggering cost to society. This is not just meh no big deal like the common cold, it's a real cost borne by everyone. And as we see, when they do get covid they get much more complications from it, which makes covid spikes more problematic too. Why can obesity be so easily brushed aside but not people who choose not to be vaccinated from covid?

Because that's just how I understand reductio ad adsurdum to mean, there's a valid chain of reasoning that leads from the initial premise to an unacceptable conclusion. In this case you believe that being "banned from civil society" (your characterization) for being unvaccinated is ok, you must accept the same for being overweight.

"Reductio ad absurdum is a mode of argumentation that seeks to establish a contention by deriving an absurdity from its denial, thus arguing that a thesis must be accepted because its rejection would be untenable"

You said _fallacy_ though. Because reductio ad absurdum can be a fallacy, and just taking any old "logical extreme" doesn't necessarily give you a sound argument.

I am not taking anything to extremes as far as I can see. The situations are not 100% identical to be sure, but as I said, most of the arguments I have heard about unvaccinated could also be applied to the overweight.

And as a disclaimer I'm sorry to have to use overweight as my example, if there was another equally good one I would use that instead because I worry it would cause pain to people even though I hope it's clear that I don't actually feel this way. But similarly I know people who don't want the vaccination and especially don't want to vaccinate their young boys, and they feel horribly bullied and coerced by it so I speak out.

You felt compelled to speak out in their defense, but your choice of comparisons and rhetoric is precisely why I felt compelled to clarify as well and what made me raise an eyebrow on the logic in it. That is to say I think you chose your example, and to make it in a intentionally hyperbolic way with things like "banned from civil society" and "horrific, dystopian, nasty, bullying" because you saw that it would make the most emotional impact to compare to your acquaintances' situation, but that's precisely where I felt it was becoming absurd.

Having just now re-confirmed that levels of nasal virus drop faster in vaccinated people to make sure I'm not being illogical, the creation of laws that allow businesses, schools, and others to legally stop you from entering isn't "horrific, dystopian, nasty, bullying" the way you characterize it at all, like banning obese people due to their burden on healthcare costs would be.

To me, it really does come off as a trying to point out the issues with mandates by drawing it to the absurd conclusion of excluding overweight people from society. So hopefully that clears up why I saw it that way, but maybe I'm incorrect definitionally.

There are always going to be mandates or policies that conflict with what parents, or people in general want to do. To me that doesn't make it nasty or bullying, though they may feel horribly bullied if it affects them. If anything I'd say those feelings (and most examples of nasty bullying I've seen) extend from the acts of anti-science politicization of masks and vaccines, which in my opinion is a great disservice to the public. We now people who now feel like nasty bullies are creating new mandates in a nasty dystopian nightmare world, which I think is extremely unfortunate.

I don't believe it does, and I think it's a fine analogy. I don't see why confirming levels of nasal virus dropping faster in vaccinated people would have anything to do with it. The actual question is the wide scale, end to end cost benefit analysis of all this and whether it justifies medical coercion.

I've never seen anywhere that case has been made, certainly not made in a comprehensive and compelling way that you couldn't reasonably disagree with.

I imagine the case would be different for different interests, but "a few hundred to a few thousand people die of covid every day" would be my go to if I were the one making it.

Compared with what? What exact measures would you propose, what benefit will they have and to whom, and what will they cost?

Is coercing people into getting vaccinated by preventing them from travel, jobs, etc. going to save thousands of the willingly vaccinated who otherwise would have died? Where are the numbers? Do you understand the gravity of coercing people to get unwanted medical treatments, or at least if you don't think it's a big deal at least accept that many people actually do extremely strongly believe notions like the government staying out of their bodies and medical issues?

And then can you logically make all these arguments and numbers in a way that they can not with similar arguments be applied to automobiles and related deaths, obesity and related issues and medical system load, etc etc?

None of this has been thoroughly examined, litigated, justified and sold to the public on its merits as far as I can see. Still. It still has not been. There has been propaganda relentlessly pushed out there in the form of fear and urgency and appeals to authority rather than facts or evidence. There has been no room to question things or present different opinions -- people who dared to do have been attacked, bullied, fired, deplatformed, and censored.

> Compared with what?

I really don't get what is the glitch here? You seem fixated on finding logical parallels to an ongoing response to a global pandemic, which is honestly getting quite repetitive to discuss.

It's compared with the current level of deaths to vaccination rate given it's not going away.. The logical conclusion of unsurprising policies as a response to the novel coronavirus, or any highly transmissible zoonotic virus.

Are we even on the same page here that less deaths is better from the perspective of public policy?

Honestly your rhetoric, message after message gets so tiresome to engage with, by virtue of hyperbolic it is. "Relentless propaganda", "daring to have different opinions gets you attacked bullied fired etc etc".

It's a national healthcare apparatus' response to a virus, nothing more or less.

After reading it all, repeating it every which way, it's just not compelling to me. This doesn't need to be some hyper-emotional, hyper-politicized topic, where parents of young boys need to fearfully victimize themselves as patriot-martyr enemies of the fascist state. I'm getting to the point of having a kind of second-hand embarrassment at the characterization.

> I really don't get what is the glitch here?

The glitch? The glitch is getting you to complete your ideas and form a coherent response.

> You seem fixated on finding logical parallels to an ongoing response to a global pandemic, which is honestly getting quite repetitive to discuss.

I'm fixated because I posted some questions in a covid thread that doesn't mindlessly toe the line, and that's exhausting you? I rather think you would be less upset in the end if you just conceded you don't have good answers. Sometimes it's okay to admit you don't know everything.

This flustered incoherent rambling is what's embarrassing and exposes you as incapable of addressing what I wrote just as surely as a simple admission would have. With the additional benefit of the latter being retaining some dignity. The entire thread is here plain as day for anybody to read, and the point is still floating around happily well above your head:

> Are we even on the same page here that less deaths is better from the perspective of public policy?

So what to do about the overweight person question. I know you're getting flustered and angry because you can't answer it, so you're just pretending it's not relevant or it's somehow "absurd", without actually being able to articulate why.

Why not just stop participating in the conversation if it's upsetting you so much? You're clearly not getting any benefit from considering different perspectives.

I'm not sure why my replies got deleted, pretty wack

I encourage everyone to get vaccinated if they can, but over the long run it does very little to protect the person who's working next to you.

https://www.nature.com/articles/d41586-021-02689-y

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

Great link. I read it. The body of work is not conclusive. Yes we need boosters, according to the CDC so I guess that makes sense.

But, have you heard of herd immunity?

The research is quite conclusive. You might want to read it again.

I have heard of herd immunity. Unfortunately because the vaccines aren't really sterilizing and the Delta variant is so contagious there will be no significant herd immunity effect to protect those who lack immunity. Over the long run we'll all be exposed to the virus multiple times no matter what we do. That's why I recommend that everyone eligible get vaccinated to protect themselves against severe symptoms.

The paper was conclusive but the BODY of work does not in the majority agree, given the link. There is no consensus, yet. Also, "The study has not yet been peer reviewed" so maybe take it with a grain of salt.

Is your latter conclusion re herd immunity being impossible supported by the literature, or at least a mathematical model? If R0 goes below zero the community is protected. The vaccinated fraction might have to be large in order for this to happen, but that's also the case for the measles. You're stating that it doesn't matter what this fraction is, even if one person isn't vaccinated they're eventually going to get infected.

> There is no consensus, yet

There is no reasonable hypothesis for how humeral vaccines could induce antibodies in the mucosae, therefore stop viral replication there, and therefore reduce shedding and hence infection of others. Nasal vaccines perhaps, which are an exciting development and may be what actually ends the outbreak, but not the current lot.

To be able to claim the current vaccines reduce spread you either have to propose how humeral vaccines delivered to the blood could induce T cells in the mucous membranes of the nose and throat, or suggest another mechanism by which the virus can spread.

So you're saying case rates are only dropping because of masks?

I didn't mention masks nor the effect or lack of effect of the current vaccines on case rates, I only added a supporting statement to the previous comment that they are doing very little to stop spread.

> Your proposal is to fire fat people from their jobs because they pose a risk to.... others?

Responses like this are sadly typical. What is your aim? To shoot down a legitimate discussion of risk factors like obesity and poor cardiovascular health, which are disturbingly common in the US?

Calling into question the sanity of firing large numbers of unvaccinated people, many of whom will have natural immunity, is not a proposal to fire fat people. What is your purpose for trying to suggest that it is?

> In seriousness, the whole point of vaccination is public health, which means you're not doing it just for yourself but also for the person who's working next to you.

I recognize the value of vaccines and traveled halfway around the world to get vaccinated thank you very much.

But the COVID vaccines are not sterilizing. The data shows that they can reduce transmission of the virus, which is great, but this effect has very real limits that it is dishonest to overlook given what we know today.

Case in point: a new UK study found that, per the BBC, "individuals who have had two vaccine doses can be just as infectious as those who have not been jabbed"[1]. In the study, a vaccinated index case transmitted the virus to unvaccinated household members 38% of the time to vaccinated household members 25% of the time.

That's a meaningful reduction but not anywhere near enough reduction to pretend that vaccination is a panacea for stopping transmission.

Finally, your comment totally ignores the part of my comment that mentioned natural immunity, which the science increasingly says is robust, strong and lasting[2].

[1] https://www.bbc.com/news/health-59077036

[2] https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v...

My aim is to point out the absurdity of comparing obesity vaccination and viral transmission.

Herd immunity? One of my responders says that's impossible and the only way to be safe is get vaccinated. You are essentially saying "hey just let it happen no vaccination needed".

What is a HN reader to make of these contrasting viewpoints?

How about this given current public health guidelines? Get vaccinated, or stop complaining when us vaccinated want to deny you entry. Wear a mask, or also be denied access. The difference between obesity and a deadly virus is that the deadly virus is directly and immediately affecting me by your choices. I can pay higher health insurance premiums, but I don't want to die.

> You are essentially saying "hey just let it happen no vaccination needed".

I neither stated nor implied this. Please don't lie about or distort what other people have posted.

This post is about a study which found most COVID hospitalizations are in people with four specific comorbidities that are major public health issues that are often pooh-poohed when raised.

> Get vaccinated, or stop complaining when us vaccinated want to deny you entry.

Thanks for your preaching. I don't know if you're making demands of me specifically or speaking generally, but as I mentioned, I traveled halfway around the world to get vaccinated.

The vaccines do not provide sterilizing immunity and the science is increasingly clear that the vaccines do not stop transmission to the extent everyone had hoped for. If you are in a high-risk group to begin with, you are still at higher risk of a bad outcome if you get a breakthrough infection.

Finally, once again, your "get vaccinated or else!" comment totally ignores the fact that authorities are trying to compel people who have natural immunity to get vaccinated, even when the science is already fairly clear that their immunity is robust, strong and lasting.

> Wear a mask, or also be denied access

Messaging has been a constant problem throughout the pandemic. A lot of people got vaccinated primarily because they were told vaccines offered the only and quickest path back to normalcy.

As it has become clear that the vaccines don't stop people from catching and transmitting SARS-CoV-2, inconsistent guidance around masking, and flip-flops on masking rules, have only caused people to lose trust in public health authorities.

It doesn't help that the people now telling everyone they need to mask up even when vaccinated are frequently caught breaking their own rules.

> The difference between obesity and a deadly virus is that the deadly virus is directly and immediately affecting me by your choices.

If you are in not in a high-risk group, your odds of dying from COVID are minimal. If you are vaccinated and not in a high-risk group, your odds of dying are miniscule.

Once again, the vaccines do not provide sterilizing immunity and do not prevent you from getting and transmitting the virus.

People with comorbidities frequently associated with poor lifestyle choices affect everyone as they make up the majority of the people being hospitalized. Overwhelmed hospitals have resulted in individuals being unable to access non-emergency healthcare and they are one of the primary reasons we're told we can't just "live with the virus" even in places where vaccination rates are high.

> I can pay higher health insurance premiums, but I don't want to die.

Huh? Under the ACA, individuals cannot be denied coverage or charged higher premiums for being obese, diabetic, etc. And once again, if you're not in a high-risk group, your odds of dying in a car accident are probably higher than your odds of dying from COVID.

Don't tell me my odds when you don't know anything about me, my lifestyle, my age, etc. https://link.springer.com/article/10.1007/s10654-020-00698-1...

Yes, I pay higher premiums because the risk pool is large and includes high risk high cost individuals even though I'm low risk. I can afford it. Me. I can't afford dying (got dependents?), or long covid, which IMO worse than death in severe cases. The messaging for vaccination has been straightforward enough for me: I get it to protect me, you get it to protect me if only for herd immunity. Yes vaccine effectiveness fades over time, but you can get a booster. And, I think in places where the vaccination rate fraction is over 90% (arbitrary high threshold) things will get back to normal.

> I can't afford dying (got dependents?), or long covid, which IMO worse than death in severe cases.

Good news. There's early evidence that the vaccines don't provide nearly as much protection against long COVID:

https://www.medrxiv.org/content/10.1101/2021.10.26.21265508v...

> On the other hand, previous vaccination does not appear to be protective against several previously documented outcomes of COVID-19 such as long-COVID features, arrhythmia, joint pain, type 2 diabetes, liver disease, sleep disorders, and mood and anxiety disorders. The narrow confidence intervals (related to the high incidence of these outcomes post-COVID) rules out the possibility that these negative findings are merely a result of lack of statistical power. The inclusion of death in a composite endpoint with these outcomes rules out survivorship bias as an explanation.

With all due respect, your comments suggest that you really don't understand the limitations of the vaccines. It seems you think they provide a lot more protection than they do and your mention of herd immunity is especially ill-informed. Discussion of herd immunity has all but died because the vaccines are non-sterilizing and do not prevent transmission of the virus. SARS-CoV-2 is well on its way to becoming an endemic virus.

> And, I think in places where the vaccination rate fraction is over 90% (arbitrary high threshold) things will get back to normal.

You should consider moving then because this certainly isn't going to happen in the US. And every 3-6 months when VE wanes in large numbers of vaccinated cohorts, you'll see spikes in breakthrough infections (where testing is being done to even catch them) and pushes for people to keep getting boosted. Most likely, the number of people willing to boost indefinitely will decrease as time goes on.

Things are going to get back to normal in places where people accept living with the virus.

You keep citing unreviewed papers. This last one was done by a psychiatrist, apparently. I'm not convinced that herd immunity is not going to happen given the evidence you've presented.

Getting vaccinated and wearing masks every 6 months and wearing masks indoors in public is living with the virus.

I don't know what their proposal was, but replace "fat" with "unvaccinated" in your response and you'll see what they (likely) were getting at. The logic of "you must get vaccinated to protect the vaccinated" eludes me, since I thought the vaccinated are already protected from severe disease (though crucially not from infection or transmission) irrespective of anyone else's vaccination status.

Full disclosure: I'm overweight. 14kg down from where I was a year ago, with another 10kg or so to go. I'm baffled that NIH/CDC said literally nothing about this issue as it relates to COVID since the beginning of the pandemic. One would think 18+ months is a sufficient amount of time to lose at least some weight, and thereby reduce the risk.

> In seriousness, the whole point of vaccination is public health, which means you're not doing it just for yourself but the person who's working next to you.

9/23/2021: 99.7% of Waterford adults fully vaccinated against Covid-19 https://www.irishexaminer.com/news/arid-40704104.html

10/11/2021: Waterford Now Has Highest Incidence of Covid in Ireland https://waterford-news.ie/2021/10/11/waterford-now-has-highe...

Increases in COVID-19 are unrelated to levels of vaccination across 68 countries and 2947 counties in the United States https://link.springer.com/article/10.1007/s10654-021-00808-7

Covid cases hit records in South Korea and Singapore despite widespread vaccinations https://www.nytimes.com/2021/10/01/world/covid-cases-hit-rec...

Chile sees Covid surge despite vaccination success https://www.bbc.com/news/world-latin-america-56731801

World's Most Vaccinated Nation Is Spooked by Covid Spike https://www.nytimes.com/2021/05/12/business/economy/covid-se...

Vermont sees the biggest surge in COVID cases despite having the country's highest vaccination rate https://fortune.com/2021/08/12/vermont-covid-cases-vaccinati...

Iceland has been a vaccination success. Why is it seeing a coronavirus surge? https://www.washingtonpost.com/world/europe/iceland-covid-su...

Nearly 60% of hospitalized COVID-19 patients in Israel fully vaccinated, data shows https://www.beckershospitalreview.com/public-health/nearly-6...

Virus surge hits New England despite high vaccination rates https://apnews.com/article/coronavirus-pandemic-health-pande...

A few more:

Vaccinated and unvaccinated individuals have similar viral loads in communities with a high prevalence of the SARS-CoV-2 delta variant https://www.medrxiv.org/content/10.1101/2021.07.31.21261387v...

Covid-19: Fully vaccinated people can carry as much delta virus as unvaccinated people, data indicate https://www.bmj.com/content/374/bmj.n2074

No Significant Difference in Viral Load Between Vaccinated and Unvaccinated, Asymptomatic and Symptomatic Groups Infected with SARS-CoV-2 Delta Variant https://www.medrxiv.org/content/10.1101/2021.09.28.21264262v...

>Nearly 60% of hospitalized COVID-19 patients in Israel fully vaccinated, data shows https://www.beckershospitalreview.com/public-health/nearly-6...

But almost everyone in Israel fully vaccinated, so a per capita number would be needed instead, and would tell a very different story. This is a pretty miss-leading title.

I haven't read the rest of the articles you posted, and likely won't given you included this one.

The title is not misleading. It's a statement of fact inferred from data presented in the first paragraph. Calculating per capita hospitalisation would be a measurement of a different metric and require a different title too.

It's not that it's not true, it's that it that you can't make the conclusion that vaccines are ineffective at stopping the spread of covid from it. And if you don't understand that, you are either (a) deliberately trying to misrepresent the evidence or (b) just exercising confirmation bias. Given your response to the parent post, it seems more like the former.

High vaccination rate (meeting state targets) leads to revoking mask mandates and reopening schools and social venues. This increased social contact leads to a spike is cases. Nothing surprising here once you think about it.

Your list of articles fails to illustrate a point once you read beyond the click-bait headlines. Most articles say that even though there are spikes the cases are mild due to vaccine (Iceland, for example, has not hospitalized a single Covid case during their “surge”)

> High vaccination rate (meeting state targets) leads to revoking mask mandates and reopening schools and social venues. This increased social contact leads to a spike is cases. Nothing surprising here once you think about it.

What then was lockdown and mass vaccination for, if not to reduce spread? That's certainly what we were told where I live. If spread spikes when vaccinated people are again in close contact then wasn't the whole thing just a giant waste of time and money given the motivation?

>What then was lockdown and mass vaccination for, if not to reduce spread?

To reduce death and serious illness.

...in which case, restrictions should never have been mandated, and those who looked at their personal risk and decided that going about their lives as normal was acceptable should have been allowed to do so.

And besides, in the UK the continuing lockdowns were very much sold on the hypothesis that they prevent transmission.

And before anyone replies that mandates stop hospitals being overwhelmed, read the other comments here on the load obesity, smoking, alcoholism etc. places on the health services - mandates for COVID-19 are inconsistent with our past behaviours regarding causes of hospitalisation.

>in which case, restrictions should never have been mandated

Which would have resulted in more death and serious illness.

You either didn't read or understand my comment, or you're intentionally choosing not to address my points, so I won't reply to you any more.

I did read and understand your comment. I just chose to pick on the most obvious falsehood at the start.

It’s very interesting seeing doctors around me start to adopt the opinion that vaccines are effectively useless. I’ve talked to numerous doctors working in hospitals here who say that media publicity about the unvaccinated prevalence in their icus is bullshit.

It's hard to imagine doctors around you adopting the opinion that vaccines are useless. Because they're not.

Sadly, it's a moving target. After a number of months VE against infection falls off a cliff. VE against severe infection has decreased some 10%, but has not fell off a cliff. I don't know what the future will bring, I'm keeping a nervous eye on the situation. That Israel and FDA/CDC are clearly pushing for boosters is definitely not helping increase the confidence. They are in a much better position to glimpse at the future, and have decided for reasons they are not candidly sharing with the public that the vaccines as-is are not sufficient.

Vaccines and COVID prevalence are statistically uncorrelated. Does that seem like the mark of an effective vaccine?

> but it's basically blasphemy to talk about how fat and metabolically and cardiovascularly unhealthy large numbers of people in countries like the US are

Not really that interesting. People don’t like to feel bad.

Tell someone they have an unhealthy lifestyle and may die sooner (fat shaming), and they’ll feel bad.

And if people feel bad, they won’t vote for you in the next election, or worse, they won’t buy your company’s product.

and we know the virus is fat shaming the whole population from day one, everyone knows now

there is no use worrying about how blasphemous it is to point that out because its already working - “at risk people” (of obvious risk we shall not name) are sheltering in place as if it was March 2020 - at least in my part of the US

you can just talk to people online and tell there is a wide gulf of what reality is. there are people that have no idea that the worlds been opened up for most of the year and that gigantic hundred thousand+ music festivals are occurring

have you been to a big event? its all lean young people

it doesnt have to be said, its working on its own as people always had a choice to shelter without government instruction, government has helped lessened the consequence of that choice with subsidies

at this point there is only a marginal utility in public policy adjusting to say “yeah only fat people and diabetics and hypertensioned should or should have followed these lockdown procedures while the rest of society never needed to”. Theres no point now. There would have been some theoretically optimal way for the economy to not disrupt but thats a moot point now. No official is ever going to say “oh whoops”, there is just maybe going to be some obscure paper modeling an optimal mitigation measure that never was.

I think you're confused about why some unvaccinated people are being fired. It's not to be mean to them, it's to get them away from customers and employees so they don't pass it on and cause another shutdown. We've had fat people in the US for hundreds of years, and they still haven't caused a national shutdown.

> I think you're confused about why some unvaccinated people are being fired. It's not to be mean to them, it's to get them away from customers and employees so they don't pass it on and cause another shutdown.

The greatest confusion here is found in comments like yours, which imply that the vaccines provide sterilizing immunity and stop transmission of the virus, which they do not.

The latest on this: https://www.bbc.com/news/health-59077036

As for "shutdowns", the rationale du jour in places where vaccination rates are high but restrictions are still in place, and where people are often unable to access non-emergency healthcare services, is that the hospitals are overwhelmed.

The issue of obesity, diabetes, etc. is very pertinent to that, as the majority of the people being hospitalized have four comorbidities frequently associated with poor lifestyle choices.

As for deaths, https://www.bmj.com/content/372/bmj.n623 paints a very stark picture:

> Taking data from over 160 countries, the report found linear correlations between a country’s covid-19 mortality and the proportion of adults that are overweight. There is not a single example of a country with less than 40% of the population overweight that has high death rates (over 10 per 100 000), the report said. Similarly, no country with a death rate over 100 per 100 000 had less than 50% of their population overweight.

So maybe you should consider that "fat people" (as you call them) are a bigger pandemic problem than you argue. If "fat people" weren't clogging up the ICUs and dying, maybe it would be easier to start "living with the virus".

> The greatest confusion here is found in comments like yours, which imply that the vaccines provide sterilizing immunity and stop transmission of the virus, which they do not.

My comment does not imply that. It implies that a vaccinated person is less likely to spread it than an unvaccinated person, which is obviously true, given that the vaccine significantly lessens the chances of having it (if you don't have it, you won't spread it), and even for those who do get sick, it lessens the severity of the symptoms (a person coughing mucus and spit everywhere is more likely to spread it than someone who just has a fever).

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