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Comment by vmception | Hacker News Reader

Alright, now you lost me.

As someone that complied initially, holed up in an apartment solo for many months while the city descended into chaos, and began testing every 7 days when that became available and staggering interactions between people, I feel like I’ve shown that I’m willing to help mitigation efforts.

Boosters for last year’s virus makes less sense. Boosters at all make less sense, especially for a non vulnerable population, and the fairly predictable solution of stacking them every 6 months should come under much more scrutiny. Especially with the unnecessary myocarditis element.

The same for cloth masks, if they are less effective against the newer prevalent variant.

I’m not sold on this one, and I’ll totally begin bolstering anti-establishment sentiment if they are the only ones willing to disagree.

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> Boosters for last year’s virus makes less sense.

The antibodies elicited in response to the booster, 6 months later, are different and more diverse in their neutralization capabilities than the ones elicited in response to the first shots.

Although it is likely an omicron-tuned booster would be more effective, time is of the essence and there is both evidence and a reasonable explanation as to why the original booster works. Specifically, the immune system is not static and also changes over time.

Here is a presentation by a virologist on the research his team performed that leads to this conclusion (amongst other lines of research) https://www.youtube.com/watch?v=LIcaSqQFrX0

Correct me if I'm wrong, but we didn't have a delta-specific boosters yet, what makes you think we will have those for omicron? With insensitives like that, why big pharma even think about doing anything beyond press-releases?

As far as I’m aware, the boosters are not specific to any variant. Aren’t they the same formula as the initial mRNA doses?

Me neither. I was replying to a comment with "omicron-tuned booster" catched my eye.

did you read the rest of my comment? or were you just keyword scanning? your question doesn't really follow from anything I said

I did, but then I saw a link to YouTube instead of PubMed or arXiv.

cool, cool. it's from HHMI and is a talk on multiple published works but okay. thanks for taking the time to process literally any of the information I am trying to communicate rather than just surface level cues from random words. it shows in the deep discussion you've provided us so far.

And yet you participate in the topic on "hacker news".

Which means they're specific to the original, pre-variant virus.

Okay, but why demand boosters from those younger than 40?? Considering new myocarditis studies and how low the risk is for someone already vaccinated and how negligible it is with Omicron (even for non-vaccinated)? This blind boosterization is only demonstrating how the governments are still shitless scared of their medical system collapses with vulnerable groups, so that they want to boost anyone in sight, just to be on a safer side.

Because if protection from symptomatic infection increases at a population level, then overall transmission becomes less likely.

Look, the risks are pretty low for younger people, but from a population level every extra bit of immunity helps to reduce the likelihood of health care system collapse (which has been the goal throughout the pandemic).

> Because if protection from symptomatic infection increases at a population level, then overall transmission becomes less likely.

Protection from Omikron quickly wanes. At what point does that "extra bit of immunity" justify heart injury? We're talking about roughly 1 in 10000 doses administered causing Myocarditis in a young male. We don't know if the risk increases after each dose, but preliminary data suggests that it may:

https://www.medrxiv.org/content/10.1101/2021.12.23.21268276v...

We're talking about ~1:10000 odds for one specific vaccine when vaccinating young males, which is why many countries are no longer using that vaccine for this demographic. Other vaccines are closer to 1:100000, which isn't far from the myocarditis risk of an infection with COVID-19.

The study also shows that there was practically no increase in risk for the third shot (though with a fairly wide CI), so it's possible the risk may just depend on whether someone is immunonaive or not.

> Other vaccines are closer to 1:100000, which isn't far from the myocarditis risk of an infection with COVID-19

The risk is given by the FDA as up to 1:14285 (males aged 12-17) for the second dose:

https://www.fda.gov/media/154869/download

However, a study from Hong Kong found an incidence of up to 1:2700 in the second dose (males aged 12-17):

https://pubmed.ncbi.nlm.nih.gov/34849657/

What we don't know is whether a vaccination would actually prevent Myocarditis in a breakthrough infection. These risks may well not be mutually exclusive. In any case, the risks are not directly comparable unless you assume 100% PCR-confirmed infection risk over six months, which is of course unrealistic.

1:100000 was in reference to the "males < 40" age bucket in the UK study linked by OP. The myocarditis risk from infection for the 12-17 age group appears to be significantly higher according to this study[1] (1:1141), which gets us quite close to the Hong Kong study incidence if we assume two shots after the first dose.

> In any case, the risks are not directly comparable unless you assume 100% PCR-confirmed infection risk over six months, which is of course unrealistic.

I do wonder how unrealistic it is with Omicron, but maybe we'll get lucky and Omicron's less likely to cause myocarditis.

[1]: https://www.medrxiv.org/content/10.1101/2021.07.23.21260998v...

Maybe if the health care system had lots of staff, meaning lots of doctors, not just the trickle that comes from the tiny amount of medical schools, the system wouldn't collapse?

Has America tried addressing COVID that way, increasing the number of doctors?

Has America considered doubling the number of doctors, nurses, hospitals, and all other medical support, building and bootstrapping many more medical schools, and graduating an enormous cadre of recruits from a seven year program, all at a cost probably over a trillion dollars a year, so that we can care for a massive influx of Covid patients in preference to advocating booster shots?

We need to do that anyway, but then the doctors that make those decisions wouldn’t get paid nearly as much. There is absolutely an artificial scarcity of MDs in the medical field that needs to be discussed.

You're getting a massive influx even if the booster shots have 100% uptake, so let's just stop restricting the number of residencies and let the doctors we already train... work as doctors!

That's not the real cost. They could double the number of doctors by cutting the amount of education required by half, and get better results. And they wouldn't need to expand medical school capacity at all.

The amount of education doctors get is harmful. It actually makes them worse at their job. It's effectively a form of hazing by AMA.

There's a combinatorial explosion of effects and side effects in the human body. It's important to learn and memorize, and memorization is undervalued, but not to that extent. It's like memorizing optimal solutions to traveling salesman instances. Other times it's like memorizing a times table of the three-digit numbers. That is a waste of time and will make you a much worse mathematician.

That's one of the dumbest things I heard in a long time

Then all you need is bullet-proof evidence that transmission is significantly impacted by the vaccines. It ain't a guessing game, do the measurement. Do it all over the world and compare and contrast.

This seems to suggest viral loads are the same for everybody - vaxxed, unvaxxed, symptomatic or asymptotic.

https://www.ucdavis.edu/health/covid-19/news/viral-loads-sim...

Vaccinated individuals hit the same peak mRNA loads for the same symptom severity on average. Their time to recover is faster though, and at peak you recover less viable virus indicating they are producing more viral debris.

And that's after fewer people who are vaccinated catch the virus, and there's more aborted infections and asymptomatic infections after vaccination.

All of those studies use PCR Ct values as proxies for viruses and compare vaccinated and unvaccinated individuals with similar symptom severity, and it turns out that correlates at peak because symptoms are on average due to antigen loading. Those studies aren't very good at showing how effective vaccination is at preventing transmission. They just show that its nonzero.

Shouldn’t we be distinguishing between unvaxxed who had Covid, and unvaxxed who didn’t?

None of those old studies apply now that omicron is around. Omicron spread all throughout the world at record breaking pace via vaccinated people, so it doesn't seem like vaccines are doing much at all to prevent spread of omicron.

You may be correct, but it's too early to tell.

As I have stated elsewhere in this thread, the rate of vaccine escape has gone up by about 5x, (from 6% to 30%), but that's still much better than one would get from no vaccination.

But it spreads so fast that it doesn't seem like that matters. It spreads basically as fast as people are interacting, if it gets into the student body then everyone will be infected in a matter of days even if they are all vaccinated.

I can't see how it could spread any faster than it already does through vaccinated people. A few people there being unvaccinated wont make a difference.

> And that's after fewer people who are vaccinated catch the virus, and there's more aborted infections and asymptomatic infections after vaccination.

This is the big one. Conditional on symptoms the viral load may be similar betwee vax/no vax, but if the vax have much less probability of getting symptoms then all is good.

I haven't read the full paper, and it's pretty small data (maybe n=120 in total) but this would seem to suggest that there's about a 40% reduction in transmission associated with vaccination: https://www.thelancet.com/journals/laninf/article/PIIS1473-3...

I honestly don't understand how there wouldn't be protection from the vaccine. It's not a sterilising vaccine, but it does offer protection.

"SAR among household contacts exposed to fully vaccinated index cases was similar to household contacts exposed to unvaccinated index cases (25% [95% CI 15–35] for vaccinated vs 23% [15–31] for unvaccinated)."

In other words, once infected, there is no reduction. How effective are these boosters against Omikron infection, weeks and months down the line?

All the above applies for the flu as well, so why do we insist on inventing a new set of rules for Corona ?

With vaccine and booster shots, both require a similar amount of hospital resources.

The current way is simply not sustainable.

"every extra bit of immunity helps" - Agree. But this shouldn't be mandated. Rewarded, yes. But not mandated.

> those younger than 40

I think your concern is based on the heightened risk of myocarditis, right?

My understanding (mostly from [0], made by a UK cardiologist) is that the danger of myocarditis from the vaccine is higher than the danger of myocarditis from COVID only for males under the age of 30 who receive a Moderna shot. For every other case, the vaccine is an improvement (so males under 30 should get Pfizer/BioNTech, which is the government recommendation at the moment in my country).

[0]: https://youtu.be/5iABaxRWGxk

I think you missed the point, people under 40 are not very likely to be hospitalized so why should they get the boosters.

People should be free to choose booster shots, those who are worried can continue to get booster shots.

In essence the same system we have with the flu is what we should have with Corona.

And then we can focus on some of the bigger problems such as Global Warming.

> And then we can focus on some of the bigger problems such as Global Warming

Funny how that got dropped from the spotlight, I didn’t even notice.

> I think you missed the point, people under 40 are not very likely to be hospitalized so why should they get the boosters.

I don't see the point written anywhere so I suppose I did.

In my opinion, people should get the vaccine as long as the harm of not having it is greater than the harm of having it. Adverse reactions are very uncommon and unvaccinated people are at heightened risk of hospitalisation (even under 40s) so the balance tips in favour of the vaccine. The booster seems like a good idea due to Omicron.

> People should be free to choose booster shots, those who are worried can continue to get booster shots.

I do agree that people should have a choice to take it or not.

However just as I believe the right to free speech doesn't mean I'm obliged to listen, I believe the right to choose not to be vaccinated (or receive a booster) doesn't mean I'm obliged to be around you. That is, I think it's fine for participation to be refused to people based on their vaccination status (though I support say testing as an alternative).

> That is, I think it's fine for participation to be refused to people based on their vaccination status

This doesn’t make sense either. You are already free not to participate. You can’t demand non-participation. Especially as it is not proven that vaccination prevents transmission.

Myocarditis is not the same as death. Boosters are required because the efficacy of the vaccine has been observed to wane with time.

Too bad the health systems couldn't come up with one tiny sugar pill that would confer 100% protection against all variants for the next 100 years. The are asking us to take 3 shots, the horror!

> This blind boosterization is only demonstrating how the governments are still shitless scared of their medical system collapses with vulnerable groups, so that they want to boost anyone in sight, just to be on a safer side.

I mean yes, that's still sort of the point.

There's still probably about 10% of the population which is unvaccinated and unexposed. If they all wind up catching Omicron in the next 2-3 months (due to its ability to reinfect and ignore neutralizing antibodies to travel through the population to find those still-vulnerable hosts) then the fraction of them winding up in the hospital will be sufficient to knock over the hospital system again. We didn't have any excess capacity in our medical system when this started, and we have less now.

The population's tolerance for any sort of behavioral changes is low, and the unvaccinated aren't listening to anyone, so the real only remaining lever to pull is recommending boosters to try to provide some level of protection against disease and transmission over the next couple of months in order to flatten the curve yet again.

The modelling estimates that I've read though are that we're at about 90% of the population being exposed (depends somewhat widely on vaccination status and how hard the area was hit by Delta though), so we're just about done with the pandemic. Omicron should mostly finish the job that Delta started of finding all the holdouts and burning through all the dry wood in the population. In the meantime though that last 10% is enough to put the medical system under too much stress again.

When 100% of the population was dry tinder hospitals were under strain X.

Now we have 1/10th that by your estimate. Why wouldn't we be under significantly less strain?

Current variants are significantly more infectious (R0 used to be around 2.5-3.0 for the ancestral strain, Delta was 5+, Omicron estimates go up to 10). Vaccine efficacy is also reduced for these variants. We've also scaled back non-pharmaceutical interventions in many places.

You've neglected to account for the substantial difference in average hospital stay period between Delta and Omicron.

Do we know how large this effect is for the unvaccinated? I'm still not sure if the numbers we're seeing from countries with relatively high seroprevalence through either vaccination, infection, or both can easily be applied to other countries.

This UK report[1] does show a corrected Hazard Ratio of 0.76 relative to Delta, but more than half of this group seems to have had a previous infection. Not sure what it would look like if you exclude them.

[1]: https://www.imperial.ac.uk/media/imperial-college/medicine/m...

Because it has never taken more than a small fraction of the immune-naive population getting coronavirus to have the severe cases overload the hospitals and Delta made that worse.

And Omicron is able to reinfect through the recovered/vaccinated population and we're not taking any precautions at all now so the rate of infections is through the roof.

The Omicron curve in South Africa looks like a Bell curve and is in the process of dropping as fast as it rose. Without vaccines or boosters.

Sir John Bell, regius professor of medicine at Oxford University:

https://www.theguardian.com/world/2021/dec/28/omicron-is-not...

"Omicron is “not the same disease we were seeing a year ago” and high Covid death rates in the UK are “now history”, a leading immunologist has said."

There should be special scalable government covid wards to handle overflow at this point. This is no longer a collective problem, considering that the remaining unvaccinated are mostly by choice. The externalities are far worse than the disease now.

There aren’t any excess medical professionals to staff a scalable COVID ward.

Are we really that unimaginative as a society so as to walk the decision tree all the way down to "not enough doctors and nurses" as the intractable problem behind all this suffering and strife? I used the word "scalable" with intention. There has been more than enough time to design a protocol and train less experienced staff that could be utilized in most cases. Highly trained medical professionals would be reserved for unique situations, which surely are not the bulk of covid hospitalizations. Hundreds of billions could have been invested into a scalable protocol that doesn't require drafting of existing medical professionals, and the cost would have still just been a drop in a bucket compared to how much has been spent on relief and how much has been lost by society as a whole. Other than R&D in pills and shots, the response to covid has been lethargic and hopeless. They didn't use this excuse of lack of medical professionals during the polio epidemic - for those that got left behind by the vaccine, they used ingenuity and created the iron lung.

Actually there’s a UK report saying that protection against symptomatic disease wanes significantly after only 10 weeks: https://assets.publishing.service.gov.uk/government/uploads/...

Effectiveness against severe disease is unknown.

And there’s also https://www.medrxiv.org/content/10.1101/2021.12.23.21268276v... claiming that for males younger than 40, risk of myocarditis from the vaccine and disease is similar.

Under these circumstances, mandating boosters for students is not justified.

That UK report suggests that protection from symptomatic infection reduces (at the 10 week mark) for Pfizer, but not for Moderna.

It reduces for both, but Moderna's still high at that "9+" week mark because of the larger dose. It's only reasonable to assume that it will plummet fast as more weeks pass. Notice also how the AstraZeneca vaccinated are disadvantaged yet again: they both have less protection in the first place and lose protection no matter what booster they get.

The conclusion is that the current boosters are essentially obsolete for infection control. When considering also the risk of myocarditis, vaccine mandates in colleges don't make sense.

>for males younger than 40, risk of myocarditis from the vaccine and disease is similar.

When a person has COVID-19, is myocarditis the only symptom that can kill them?

Total risk of death and injury from COVID-19 is far greater than the total risk of death and injury from vaccine-induced symptoms.

Mandating boosters is very easily justified.

It’s may not be justified, because the subjects are already vaccinated and protected, but there is an increase in myocarditis risk for them.

Protection from the vaccine wanes over time. For the entire population, boosters reduce COVID-19 death/injury more than they increase vaccine death/injury.

Many European countries are segmenting the population by age and making different recommendations for different segments.

Creating policies "for the entire population" is irresponsible given that we know that these vaccines have side-effects which are more frequent at specific age spans, so I expect that the appropriate institutions are verifying the latest data and are adjusting their recommendations. This is generally happening e.g. in the UK or Germany.

Slide 15 of this current CDC document for boosters with what they share as the relevant measured data on how effective the two dose vaccine is over time. Look at the severe disease vs. time. Without stating my opinion, Draw your own conclusion.

https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-...

Welcome to the resistance... its not glamorous, but it is overwhelmingly obviously the right time to be a skeptic.

I've increasingly come to the idea that everyone is cosplaying outbreak, and somehow I didn't get the memo that this was fun.

Indeed. As a C

The skeptics have felt overwhelmingly in the right for the past 21 months, but throughout that time period, reality has not been particularly compliant to their wishes.

What reality has shown, time and again, is that medical systems across the entire world are incapable of dealing with COVID while providing the same standard of care that people generally expect. (For both non-COVID and COVID cases.)

I personally feel there are reasons to be optimistic over the next few months, but that its too early to say - and claiming otherwise is engaging in very speculative, very wishful magical thinking.

> What reality has shown, time and again, is that medical systems across the entire world are incapable of dealing with COVID while providing the same standard of care that people generally expect. (For both non-COVID and COVID cases.)

Speak for your country. Numerous countries did not blink an eye, and did not panic either.

I think people forget that it all started by "lets flatten the curve" before it turned into a pandemic of fear for absolutely no reason.

> Numerous countries did not blink an eye, and did not panic either.

'Panic' can mean anything you personally want it to, so of course there will be countries that match your criteria.

Is wearing masks at the theatre panic? If you hate masks, yes! If you don't, no? Is requiring that foreign travelers have a negative test before admission at the border panic? Depends on where you stand. Is discouraging travel before vaccines were available panic? Well, that depends on whether or not you own a hotel! Is requiring that employers provide COVID sick days panic? Depends on your political view on labour relations. Eviction moratorium? Depends on whether you are a landlord!

The population of skeptics might have changed during the last six months. You could be debating right now with someone who was strongly in favor of quarantine measures in 2020.

Exactly. The self-professed "skeptics" have only seemed to doubt one narrative (the mainstream one) but have seemed singularly credulous when it comes to alternative theories, treatments, etc. All in an effort to stand out, not to help. Many have even supported multiple mutually exclusive beliefs at different times, pointing to the few hits as evidence of their perspicacity, quietly hoping everyone will forget the misses.

The world would be better off with some real skepticism, not just Oppositional Defiant Disorder disguised as skepticism. Real skepticism notes the absence or weakness of evidence behind a claim, but can be overcome as the evidence becomes stronger. True skepticism also does not require assertion of an alternate or opposite theory as Absolute Truth with no more evidence than the theory one is being "skeptical" about. People should ask for - even demand - evidence, but not misportray disagreement (or disagreeableness) as skepticism.

They're using "argument in the alternative" [1], which is logically sound. The goal isn't to show that any particular alternative theory is true, just to show that the mainstream one is false.

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

It's "logically sound" in the sense that it's sound by disjunctive introduction. For most people, that's not an interesting sense of "soundness" (you haven't told me anything interesting by saying "it's either cloudy or not cloudy" when I've asked you for the weather.)

No they're not.

> with the goal of showing that regardless of interpretation there is no reasonable conclusion other than the advocate's

For that part of the definition to apply, there must be some particular conclusion that the advocate supports. It's multiple arguments for a single conclusion, whereas what I was observing is multiple separate conclusions. That's pure contrarianism, neither skepticism nor argument in the alternative.

Isn't "the media and government have been intentionally exaggerating the danger of COVID, and most of the mitigation strategies being mandated shouldn't be" the conclusion?

Not really. The second part alone ("most of ... shouldn't be") might qualify as skepticism, particularly if the reason given is lack of sufficient evidence, but few stop there. Most go on to express one or more other reasons and/or conclusions, such as "intentionally exaggerating" which is its own claim requiring its own proof. Also, if that's the only reason given then it can't be argument in the alternative because there are no alternative routes given to the desired conclusion. Just one route to one conclusion, contrary to the original proposition but itself lacking proof.

Plenty of the COVID skeptic types I know, and myself included, have expressed exactly the sentiment the GP described. In a way, it's nice to be vindicated after all this. I don't think it really makes a difference whether that sentiment fits into the exact Wikipedia definition you're arguing about, but it's obvious to me it's been a common one for the entirety of the pandemic.

How are skeptics vindicated by the second part? I have always agreed with both of those skeptic things however I come from a different pov than most, most likely.

Only the first has been closer to being true. We don’t have a decently sized population that did very little if anything wrt mitigating like the rest of the world. Just because the mitigation mandates have been too much doesn’t make the average skeptics correct. Considering a large amount of skeptics want little if any mitigation efforts. It’s hard to say the world would be in a better place if the skeptics decided everything. I don’t see how it wouldn’t be a shit show if that was the case.

My real skepticism, having been vaccinated and boosted, is that institutions like the CDC, FDA, and Pfizer are just being lazy foot-draggers about bringing out vaccines updated for specific variants.

And whatever happened to the project of vaccines that provide full, sterilizing immunity? Last publication I can find is for a study in freaking mice[1]. Is there no imperative to actually provide sterilizing immunity at "warp speed", because society can just shove non-sterilizing vaccines into people and save on ICU beds?

[1] -- https://www.cell.com/iscience/fulltext/S2589-0042(21)01005-1

I too desperately want a sterilizing vaccine. Given the existence of influenza and the common cold (a bunch of rhino and corona viruses), this seems unlikely unfortunately.

If it seems unlikely, then someone should explain why it works in a mouse model but not in the real world. If the virus mutates too quickly for a full sterilizing vaccine, then nonetheless, any vaccine that reduces transmission is helpful. If the virus mutates too quickly period, all the more reason for variant-specific boosters, targeted to the strains circulating, just like the yearly flu shot.

> someone should explain why it works in a mouse model but not in the real world.

As the saying goes, 'mice lie and monkeys exaggerate'.

The current vaccines do, in fact, reduce transmission. This efficacy drops over time, but it definitely exists.

> is that medical systems across the entire world are incapable of dealing with COVID while providing the same standard of care that people generally expect. (For both non-COVID and COVID cases.)

That's despite billions in fundings and ever-growing budgets.

Time for a re-structuring and a culture change.

Restructuring to what? Socialized, privatized, mixed-market, none of them have had the ability to handle this pandemic in a business as usual world.

You risk the institution effectively having to shut down if too many students/faculty are sick at any given time.

Students live in dorms with other students. If one gets sick they have to isolate away from other students. This is effectively impossible in a traditional dorm so they have to be moved to quarantine. There is likely a limit to quarantine space available. If quarantine is filled the University will have to shut down because they cannot follow CDC guidance.

It is not about the immediate health risk to the students as that is relatively low, but the University being able to continue operations.

Or they could not? Among college-aged folks, Corona has mild symptoms - maybe approaching a bad flu.

When I was at school, we had flu outbreaks. People got sick, their roommates got sick…and no one was tested or quarantined or had to wear masks. Life continued.

What if we just stopped? We could treat Corona outbreaks at schools like cold or flu outbreaks. Would anyone even notice Omicron ripping through the student body if we weren’t obsessively looking? I doubt it.

There are a lot of older (and otherwise susceptible) people on campus. Regardless, no they can’t do that because if something did happen, they’d get blasted.

It’s the same with anything safety-related, really. Driving a car is super unsafe, but rather than banning cars, you wear a seatbelt.

Older people should WFH and be careful. They shouldn’t burden younger generation for their disproportionate susceptibility to this disease.

I know what the next counter argument is: But they will get COVID from their children. Then I guess we should discourage older people from hanging out with anyone without testing and precautions.

Why aren’t we placing burden on older generation to protect themselves?

I am sympathetic to this point, but many of the older people are the professors, ostensibly the reason for students being there in the first place.

Yes, and the professors are also part of the government and financial success of a research-based school. Undergraduate students are perhaps only 50% of the school’s priorities.

> Older people should WFH and be careful.

Do we have or are you pushing for policies requiring WFH accommodations for them? What about people without jobs that can be done remotely, which yes does include a lot of the elderly population.

And careful how? Like for example frequent testing of those around them? Or policies requiring employers to not allow people back to work until they are confirmed non-contagious?

> Older people should WFH and be careful.

Absent any of those policies existing, this line like so so many others in here just reads as "it seems pretty safe for me now so good luck everyone."

I too was in college during a major flu outbreak. I got very sick. It actually changed a lot of operating procedures at my school and was the start of hand sanitizer being everywhere. It also kicked off the increased recommendation of the flu vaccine for everyone.

The CDC has guidance for colleges and universities on how to handle any number of outbreaks. Colleges are following guidance on how to handle Covid-19. Will that guidance change in the future? Probably. But it hasn’t changed yet.

That guidance needs to change now, there is little difference to flu and Corona outbreaks due to the vaccines.

Thus spake someone who has never actually had influenza.

How can you be so sure ?

Because people who've had a bad dose of influenza never call it a bit flu.

I'm not sure what the definition of a bad dose is, but i have never taken any flu shots and have managed just fine.

So with three vaccine shots for Corona, I'd say that the chances of getting seriously ill with the flu is much higher than Corona.

Thus my original point stands, we should start treating Corona the same way we treat the flu, starting now.

There are at least two reasons not to treat Corona outbreaks at schools like cold or flu outbreaks, and TBH even during a flu outbreak, it's reasonable to expect people to get vaccinated, even if it's not required like other vaccines. In some cultures, it's even expected that if you're at all sick, even with the common cold, you'll wear a mask to protect others as well, but I get that that's not the norm in the US or around Stanford.

First, there's not just healthy "college-aged" students on campus. With that in mind, there's a risk that area hospitals could get overloaded with patients. You don't want the hospital to be full when there's a car accident or someone needs their stomach pumped, someone suspects they might have an STD, or whatever. Requiring a booster mitigates that risk as it lessens the symptoms to the point where hospitalization is shorter/unlikely.

Second, there's a chance for a mutation each time the virus spreads from one person to another. For that reason, you don't want it ripping through everyone.

I encourage everyone eligible to get vaccinated, but vaccination won't prevent the virus from ripping through everyone. The primary benefit is reducing severe symptoms.

https://www.medpagetoday.com/opinion/vinay-prasad/94646

The current thinking is that mutations are most likely to occur in immunocompromised patients who experience prolonged infections. Vaccines aren't very effective for them.

https://www.scientificamerican.com/article/covid-variants-ma...

> oo many students/faculty are sick at any given time.

Whats the rate of hospitalization for COVID among students right now? If you dont have that kind of actual data in hand, you can't make a proper decision.

because of the demographics that number should be close to zero, except for students that have multiple comorbidities.

The CDC has guidance for how colleges should handle students who test positive for Covid. You cannot have a student who has tested positive living in the dorms with other students.

You do not need to be in the hospital to be sick, no?

Colleges and schools in general are also very unforgiving of sick time, compared to work.

If you miss a week or two of a difficult class, you may not be able to make up for that lost time in order to pass. With some classes only being offered at specific quarters/semesters and many being impacted, a single failed or dropped class can put you a year behind graduation, assuming you can pay for it. If a professor or teaching assistants gets sick, it would have pretty significant impacts for a larger number of students.

The vaccine doesn’t prevent infection; it mainly prevents death. The other way to interpret this is that they do not want to be responsible for deaths, but are fine with low-risk infections.

I anecdotally know people who had a booster and were still subsequently infected. Packing 200 people in a room over 100 days and these rare cases will happen.

So, will you refuse tetanus boosters as well? Flu shots? Malaria, et.al.?

This reluctance to accept medications that have proven to minimize the impact of deadly infections doesn't make a lot of sense to me.

I may not refuse tetanus and flu shots but I will 100% retain my RIGHT to refuse those shots. It's 100% the responsibility of the government to prove both the utmost necessity and the spread-prevention efficacy of any medical procedure the government forces upon its citizens.

Stanford is a private school. Do they not have the right to self determination and to choose how to build their own community? If they want people whos response to a booster are either "yes please" or "no skin off my back, I have better things to worry about" or "I personally dont agree with this but not a hill worth falling on" then I think that is their prerogative and within their power.

And society has an equal right to quarantine people who could spread a deadly, infectious disease to protect the vulnerable.

As George Washington himself did.

Whose rights are greater?

> Whose rights are greater?

No one's "rights are greater." This is a false dichotomy. Does the government have a right to force people to take the flu shot? No. If a flu came along that was so deadly that the government wanted to force people to get the flu shot, then the government would need to prove the necessity and the spread-prevention efficacy of that medical procedure.

>Does the government have a right to force people to take the flu shot? No.

If you're talking about the United States, this question has been settled at the federal level by the Supreme Court for over a century. At the state level, the first vaccine mandate was in 1809. Most states have vaccine mandates for children, many of them with only medical exemptions. It's legal. It's not some great infringement on your rights.

> this question has been settled at the federal level by the Supreme Court for over a century.

Right, the Federal government does not have the right to force the public to take a shot, while states may. It may appear that public health is being run at the national level, but really the CDC issues recommendations and many states ignore these recommendations and replace them with their own. Public health is run by the states, but that doesn't mean the state can do whatever it wants. Each state has its own constitution, and its own state supreme court that verifies whether any mandate is lawful, so this is going to depend on the state constitution and local public health laws.

> It's not some great infringement on your rights.

The fact that the treatment varies state by state shows that people do consider this to be a right worth retaining, and in high enough populations to hold sway over local Government up to the state level.

>The fact that the treatment varies state by state shows that people do consider this to be a right worth retaining

Yes, we live in an age of mass-indoctrination. If Fox News runs Anti-Food Safety segments 24/7 for months, we're probably going to have a few states that remove punishment/fines/laws for people who prepare food with shit on their hands. That doesn't mean that serving food with shit in it is an inalienable right.

More likely you end up with farmers who can sell milk according to the buyers desires.

Ironic

* George Washington was dealing with smallpox which kills 20—30 % of those infected.

* Quarantines have been used since the middle ages and they were used against people showing symptoms or groups of people likely to have the disease. We haven't had quarantines with covid. We've shut down society as a whole.

Omicron spread all throughout the world via vaccinated people at historical record speed. Vaccination is evidently not a good way to prevent spread right now, mandating vaccines to prevent spread therefore doesn't make sense. If you want to prevent spread you mandate a lockdown or similar, not vaccine. Vaccine might help lessen severity, in which case you need to mandate it for populations at risk. But it doesn't make sense to mandate it to prevent spread, since it doesn't.

You cannot conclude your 2nd sentence from your first. The relative rates of serious disease AND the transmission rate have both been demonstrated to be lower for vaccinated and boosted people - even with the Omicron variant.

Vaccines, even when not fully effective, greatly reduce the amount of virus you shed, and thus significantly reduce transmission.

Anecdotes are near-worthless, but I will share that my neighbor got covid. He was vaccinated and boosted. His wife and him felt sick, as did their infant (obviously not vaccinated), for two days. TWO DAYS ONLY. ...and their other two children never contracted it at all - tested negative twice each.

Getting vaccinated reduces disease severity AND transmission.

A disease that kills 20-30% of the population halted in its path by the smallpox vaccine which gives IMMUNITY for decades!

The Covid vaccines are fraudulent and more and more people are realising this. The CDC changing the definition of a vaccine from "providing immunity" to "increasing protection" just after Covid-vaccinated people started getting infected shows arm-in-arm corruption with big pharma.

Your 10th booster shot will kill you not save you.

George Washington by all accounts was a rebel traitor (in the best way possible). Should we see whatever words of wisdom he had? What would he see in our government today?

We have been over this so many times here: Tetanus and Malaria also affect younger people, median COVID-19 fatality age is over 80. No one criticizes an 80 year old for getting vaccinated. Herd immunity is elusive, as we see in regions with 95% vaxxed.

The Delta and Omicron variants are sufficiently contagious that there will be no significant herd immunity effect. Everyone will eventually be exposed.

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

The vaccines help protect you from long COVID and from very serious complications that can form (or even death).

It is very misleading to imply that only old people suffer from that as there are countless stories of “I have a 35 yold friend with no pre-existing conditions who’s fighting for their lives”. If it were only old people the hospital situations would look drastically different and we wouldn’t have capacity issues. We maybe are now better at saving those people than at the start of the pandemic but we’re not perfect yet.

Hopefully the COVID pills coming out to treat it are going to meaningfully reduce the outsized burden anti-vaxx people are putting on the health care system (overwhelmingly, if not even exclusively, the people ending up in hospital due to COVID are unvaccinated)

> It is very misleading to imply that only old people suffer from that as there are countless stories of “I have a 35 yold friend with no pre-existing conditions who’s fighting for their lives”

Those stories are breathlessly reported on because they are rare, 2.4% of Covid Deaths in the US are people under the age of 40[1] which is 50% of the US population, it's harder to find data but most of them had whom had other issues or were not direct covid deaths. Covid Risk goes up orders of magnitude by age [2].

[11 https://www.statista.com/statistics/1191568/reported-deaths-... [2] https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investi...

Nowhere am I saying that failure to get a vaccine puts you at risk of death. I'm saying they get hospitalized [1].

60-69 yolds had ~2k hospitalizations last week

50-59 yolds had 1.5k hospitalizations last week

40-49 yolds had 1k hospitalizations last week

30-39 yolds had ~1k hospitalizations last week

Thus we see each age range has roughly the same number of hospitalizations. Not sure how this correlates on a per capita basis although in this case it doesn't really matter since the healthcare system is a shared resource.

Why are hospitalizations important? At this point, you dying or having complications from a failure to vaccinate is thankfully mostly your own problem since vaccinations are supremely effective at preventing this regardless of the COVID strain from the looks of it. Overwhelming the medical system and placing an undue burden on it because of refusal to vaccinate is why we're still facing lockdowns due to spikes of variants. Hopefully with the new treatment pill and evolutionary direction Omicron is taking means we're on our way out of the pandemic.

Again, focusing on the mortality when a massive problem is overwhelming our shortstaffed medical system is myopic. 25% of hospitalizations result in an ICU visit [2].

> Patients who were hospitalized more recently with COVID-19 (April to June 2021) were younger (median age of 59 compared with 68) and experienced lower in-hospital death rates (10% compared with 18%) than those who were hospitalized between January 2020 and March 2021.

This indicates the old people are smartly getting vaccinated or dying off. But again, deaths is not the primary problem the unvaccinated have at this point. Primarily they form a reservoir for the virus to mutate and put burden the health care system.

[1] https://covid.cdc.gov/covid-data-tracker/#new-hospital-admis... [2] https://www.cihi.ca/en/covid-19-hospitalization-and-emergenc...

The fact is that young people are at very low-risk for covid. If you want to bring vaccine status into it, you get way more ROI vaccinating older groups. We've seen Hospitalizations per capita have go from 5 per 100k/day in Jan 2021 to 3 per 100k a day in December 2021[1] because of lower hospitalization rate's in older groups, not from lower rates in younger groups. Hospitalization is also not that clean of a comparison, since a 35yr old who is discharged after a day is taxing the system way less than someone there for a month.

32% of people 25-39 [2] aren't fully vaccinated, sure it would help some if they were but if you really wanted to solve the problem you'd address the large % of older groups that aren't vaccinated and are contributing to the majority of deaths & strain on the health system.

28% of people 40-49

21% of people 50-64

10% of people 65-74

15% of people 75+

[1] https://covid.cdc.gov/covid-data-tracker/#new-hospital-admis... [2] https://www.mayoclinic.org/coronavirus-covid-19/vaccine-trac...

Furthermore, that 2.4% is composed nearly entirely of unvaccinated individuals (~99%). Chance of death or hospitalization from covid is exceedingly small for vaccinated individuals <40.

https://covid.cdc.gov/covid-data-tracker/#rates-by-vaccine-s...

> there are countless stories of “I have a 35 yold friend with no pre-existing conditions who’s fighting for their lives”

You can't say this about rare serious COVID cases but also point out that the plural of anecdote is not data when other people say similar things about rare serious vaccine side effects.

> have proven to minimize the impact of deadly infections

if Omicron is as mild as shown by the current data, you won't be able to show any kind of baseline difference between boosted and unboosted.

> if Omicron is as mild as shown by the current data, you won't be able to show any kind of baseline difference between boosted and unboosted.

That's a massive if to base a health care system on.

Like, look at the incentives. If they over-react and Omicron is much less severe, people will be upset but they'll get over it.

If they under-react, and it turns out to be Delta-level with much more vaccine escape, that will be much, much worse.

And this is one of those un-reversable decisions beloved (or hated, I guess) by Jeff Bezos.

I think the Covid vaccines have proven to be utterly ineffective compared to other shots. No one talks about "Covid immunity" via vaccine but the 'immunity' word is overwhelmingly used for other vaccines. Looks like Pfizer/BioNTech made bank and laughing their way while rising in the top billionaires list.

https://www.nih.gov/news-events/nih-research-matters/malaria...

Dec: "The co-founder of BioNTech SE on Thursday joined the world's 500 richest people after the U.K. this week approved use of a Covid-19 vaccine that the German firm created with Pfizer Inc."

This is a good question I've been also trying to get an answer to, and I've never had a reason to ask before now: with the seasonal flu drive are we often reusing a prior season's flu vaccine? I always assumed they developed new ones all the time, is the answer "it depends"?

Seasonal flu vaccines are reformulated every year based on the circulating virus strains. Leftover doses from the previous season are discarded, not reused.

https://www.cdc.gov/flu/prevent/flushot.htm

Tetanus booster is once every 10 years or so, isn't it? Flu shots aren't a requirement, are they?

The time frame for a booster is based on the longevity of its protection.

The flu shot (and many others) are required for some professions. Protection for the vulnerable they interact with.

Opinion: if you don’t want to protect the vulnerable in society, you should refrain from participating in it.

Aren't the vulnerable already protected with boosters? Where is the logic?

My vulnerability is that I take immunosuppresants, which makes the vaccines significantly less effective (last I heard a few months ago, fully half of the breakthrough infections of the vaccinated were in the small population of immunosuppressed people).

OK, I get your point. It's an ideological dilemma then - you'd prefer as many people around you to be vaccinated and boosted to lessen your chance of getting infected (although, even those boosted could transmit). On the other hand, those younger cohorts getting vaccines mostly to protect the others are subjecting themselves to low, but still tangible risk of getting vaccine complications. So there is some altruism at play and this is something which shouldn't definitely be mandated by the governments. (PS: It's good that very effective pills are now coming to help immunosuppressed).

Like the flu shots, there are people who legitimately (shorthand for “have a medical reason”) can’t get vaccinated.

vaccines are more effective the more people have them.

The tetanus vaccine has been used for over a century, it really is not comparable to a rushed vaccine like those against COVID.

What doesn't make a lot of sense is comparing vaccines that have been around for ages (tetanus, flu) to ones that were developed like yesterday (COVID, malaria).

I have the COVID vaccine but that doesn't mean I am not concerned about potential long-term effects that we know nothing about. That, and the possibility of original antigenic sin [0] permanently screwing over our ability to mount an effective immune response to novel strains.

What justification is there for pushing a non-sterilizing vaccine, that doesn't prevent spread, on non-vulnerable populations?

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

Even if it's not sterilizing, it does reduce the spread. Lower viral loads means less virus transmission.

Let's say antigenic sin fears became a reality. Then the short term solution is mass production of a next gen regeneron regencov? Or a different enough vaccine that causes a response?

What leads you to believe long-term effects are possible?

It’s not proven how good this booster is. A (preliminary?) study was showing recently that the protection against infection fades away after merely 10 weeks.

Again, this 10 week (the most data they had) suggested that this was only true for Pfizer, but not Moderna.

It's far too early to be sure though.

But apparently not too early to force others to be the test group.

Sorry, can you clarify what you mean here?

It sounds to me like "since we don't have the data yet, by mandating it now anyway, we're forcing people to test it".

Sure, but that's not a global thing. I chose to get a booster, and there have been no mandates in my country (and given rates of vaccination, it's unlikely that there will be).

Sorry, how is that relevant as a comment on an article about a school requiring booster shots for all students?

And? Thats >10 weeks of protection at no monetary cost to you.

Its not some different product, its the same vaccine.

> Thats >10 weeks of protection at no monetary cost to you.

monetary costs are not the only costs you pay

When I took the vaccine I was sick for a few days. I don't have any risk factors. I have multiple double vaxxed and non-vaxxed family members for whom covid was a minor cold and none for whom it was serious. I assume that as I am genetically closest to my family members they are a good predictor for how I will fare, if I haven't already had it without knowing it.

Why would I sicken myself for a few days with the next vaccine shot to marginally decrease the odds I will be sick for a few days from covid?

The benefits are always balanced against the potential harm.

For young males, the risk of myocarditis from the vaccine may be comparable to that from the disease according to a UK study - until that’s clarified, booster mandates have no place in colleges.

Myocarditis is only one COVID-19 symptom. The total risk of injury and death is far higher from COVID-19 than the vaccine.

We’re talking about already vaccinated individuals which are protected against harm and now should get a booster that’s associated in a study with increased risk of myocarditis. This connection must be studied more before anybody thinks about mandating boosters.

The cost is potential health risks associated with taking the vaccine/booster. We don't know exactly why myocarditis rates are elevated and some people would rather wait for more information.

Do you have a place I can read about myocarditis rates?

The WHO acknowledges there may be a link between myocarditis and the vaccine.[1]

Sudden cardiac arrest incidents increased in 2020 (vaccine was not officially realeased until Dec. 2020).[2]

I added the second link to show there may be a rise of cardiovascular disease not due to the vaccine. I'm interested in seeing data for 2021.

[1] https://www.who.int/news/item/26-05-2021-gacvs-myocarditis-r...

[2] https://www.heartrhythmjournal.com/article/S1547-5271(21)007...

> I’m not sold on this one, and I’ll totally begin bolstering anti-establishment sentiment if they are the only ones willing to disagree.

I’m a compliant, conformist Asian, and they’re beginning to lose even me. My nine year old’s private school required everyone to get vaccinated (and we’re in a county where vaccination rates are high) but for some reason she is still wearing masks and eating lunch outside in the winter. My three year old—who is a hyperactive little boy to begin with—suffering developmental delays because he can’t understand instructions from masked teachers. For example, we do a gym class on Saturdays and he can’t tell which of the instructors he should be listening to, against the background noise. I cheat and take off my mask to give him instructions. I’ve noticed—that in a class where I suspect everyone is a democrat (blue state, almost entirely non-white or interracial)—about half the other parents are doing the same thing.

Masks inhibit the most fundamental communication API we have. Faces. Our occipital lobes and the vision system is trained to identify faces for a number of things from gauging emotions to assessing symmetry for mating. It is so deeply ingrained in us. It makes me think that cutting off half of the face is going to lead to developmental issues in people, I am not qualified to predict. Not directly relevant but there was a cool neurology experiment where they flipped faces upside down and people couldn't even recognize President Obama [1].

I also understand that Masks prevent people spitting large droplets. But no one seems to be raising concerns that we've starved kids from one of the most evolutionarily significant aspects of humans - facial communication. Would be great if academics/scientists who are far greater qualified in this matter try to understand what impact masks will have on kids - something tells me they are going to face opposition.

[1] I learned about this experiment from the Introduction to Human Brain course at MIT. I watched the entire thing a couple of years ago, it was truly eye opening and I believe the professor had an AMA on HN at time. Check it out: https://ocw.mit.edu/courses/brain-and-cognitive-sciences/9-1...

Non-white != democratic / blue

There are guaranteed to be healthy 18 years who've been double-vaxxed and fought off a COVID infection, possibly as recently as right now during the massive Omicron wave. Their near-term risk of winding up dead/in ICU from a potential new COVID infection is effectively zero.

The idea of a blanket mandate that these young people must be immediately boosted regardless of how many times and how recently their immune system has fought off SARS-CoV-2 or what their current antibody levels are is totally unsupportable as science or public policy. We're moving from cloth mask theater to potentially screwing up your immune system and endangering yourself with unnecessary-to-harmful booster theater. Enough.

Stanford is also remaining willfully ignorant of prior infection-conferred immunity, easily measured by IgG assay. This is all becoming very embarrassing.

Infection-conferred immunity is inferior to vaccine-conferred immunity.

That isn't so, and both controlled studies and population-level statistics make that clear.

Inferior in what way? There are several measures of effectiveness. When it comes to consistency of immune response, the vaccines are superior. When it comes to broad spectrum immunity to variants, infection-conferred immunity is superior. When it comes to how long immunity lasts, infection-conferred immunity is vastly superior.

Just because a percentage of the population is "non vulnerable" doesn't mean getting Covid is harmless. There are measurable impacts on cognitive ability: https://www.thelancet.com/journals/eclinm/article/PIIS2589-5...

This is self-reported data. Self-reported data is garbage. There's simply too much risk of bias.

To illustrate the point, a large study out of France found that the only "long covid" symptom that actually correlates with confirmed illness was loss of smell. But there were multiple "long covid" symptoms that correlated with self-reported illness.

https://jamanetwork.com/journals/jamainternalmedicine/fullar...

We have to be careful to separate populations by severity of disease, hospitalization, etc., but "long covid" is at least partly psychosomatic.

The data was from a cognitive assessment, not self-reported. There were some self-reported components, like do you have depression, anxiety, etc. But the measurement of cognition was not self reported.

The question of whether or not the respondent actually had Covid-19 was self-reported:

> People who indicated that they had suspected having COVID-19 were presented further questions including whether they had breathing difficulties, what happened as a consequence of their breathing difficulties, and whether there had been positive confirmation via a biological test (Table S1).

Also, this was a web-based test, conducted at home, where the participants self-selected into the survey. There is no universe in which this should be considered unbiased data.

> Also, this was a web-based test, conducted at home, where the participants self-selected into the survey. There is no universe in which this should be considered unbiased data.

You know, I was kinda in agreement with you until you said this. Please read the paper (which had absolutely no information about the Covid stuff in the docs or signup forms.)

Like, one could argue that the major selection factor was whether or not the subject watched TV, which would be fair but not germane to this particular argument.

In fact, the Covid stuff was added after the study had started, and they did a follow-up survey in December 2020 and of the people who reported later Covid, they were indistinguishable from the overall population.

Like, I agree that this would have been much much better if they'd had access to the NHS data and could have joined with the cognitive test data and I personally am not convinced of their modelling approaches, but there's a tradeoff between enough data to estimate important effects, and the accuracy of said data, especially when it comes to medical conditions.

Is your argument that people would preferentially report Covid-19 and throw the intelligence test? Or something else?

Like, this paper has a bunch of problems, but the main effect is not that surprising. The real question is how generalisable the findings are to other viral infections. That's something that hopefully will get investigated more over time.

> In fact, the Covid stuff was added after the study had started,

Not relevant to my point. They didn't verify infection. The people being surveyed knew that they were being surveyed about Covid-related things. Also, even if you separate the intelligence-test part from the covid-results part by time, now you have two problems: self selection bias for the intelligence part (i.e. people who are more likely to be worried about cognitive decline take the time to participate in tests of cognitive skills), and for the covid test part (i.e. people who are worried about Covid will be more likely to respond to the Covid test part).

There are so many sources of bias here, it's impossible to de-combobulate them all. It's simply a mess.

> and they did a follow-up survey in December 2020 and of the people who reported later Covid, they were indistinguishable from the overall population.

You can attempt to control for bias by doing this sort of thing, but it's not enough. Just because the sample population looked like the control population on summary parameters B, C and Z doesn't mean that they weren't biased on the primary endpoint of the study -- and remember. the participants knew they were being surveyed related to Covid (because again, they were being asked).

Also, the procedure they used also leaves open the possibility that (for example) study participants could have self-selected by finding the survey from "long covid" forums, and the like. We can't rule it out.

> Is your argument that people would preferentially report Covid-19 and throw the intelligence test? Or something else?

I have a number of problems with this study (and I've enumerated a few) but most of them fall under the category of "self-reported data is garbage", which is why I led with that. As the French CONSTANCES study (a much better study) I linked showed: when people are allowed to self-report even just their covid status, they mess up the results.

A better (but still not good) study of this sort would at least take the intelligence test and cross-check it against testing results to get an objective result on one of the parameters of interest. But there would still be too many sources of bias to enumerate -- open-ended, web-based surveys like "The Great British Intelligence Test" are simply garbage, and should not be taken seriously by anyone, anywhere.

OK thank you for expressing your issues with the paper in a much more useful fashion that your first take, it's greatly appreciated.

I would note, however, that your strong point that self-reported data is garbage would lead you to disbelieve in the existence of pain, which seems like an unlikely interpretation.

That French study is interesting, I need to dig into it a little more.

That being said, do you think that people lied about being in hospital/on ventilator. That seems unlikely to me, and the cognitive outcomes seem to respond in a dose-dependent fashion to each step of Covid infection, which is not something that I would have expected to see if there were response biases going on.

Like, the only real explanation I can come up with here is that maybe a bunch of people were still sick, and this correlation drives the observed responses with cognitive function.

Looking at the methods, the Covid stuff comes after the cognitive test, so could not have impacted the cognitive test results. Additionally the actual webform (linked from the paper) shows nothing about Covid. Again, I think the biggest bias in this sample is likely to be their TV-watching status.

That being said, they did a complete cases analysis, which can often throw away lots of useful data, but it doesn't appear that many people quit halfway through (which is weird, given my experience of doing survey research).

> As the French CONSTANCES study (a much better study) I linked showed: when people are allowed to self-report even just their covid status, they mess up the results.

This comes under the headings of different disciplines are different I guess. If this study had been done under the aegis of a medical department, then we'd have laboratory confirmed Covid but they'd have messed up the cognitive test part. Science is difficult, and messy and often not satisfying to anyone, and personally I think we can learn things from this paper.

You disagree, I guess we'll find out when the systematic reviews/meta-analyses happen ;)

> That being said, do you think that people lied about being in hospital/on ventilator. That seems unlikely to me, and the cognitive outcomes seem to respond in a dose-dependent fashion to each step of Covid infection, which is not something that I would have expected to see if there were response biases going on.

I said in my original comment that we need to be more careful about separating the degrees of severity of illness from reports of "long covid". Post-hospitalization syndrome is a thing -- people who were on ventilators have lingering after effects. It isn't "long covid", and confusing that with reports of "I had asymptomatic illness and now I am tired" is just bad science.

Unfortunately, most of these "long covid" studies do exactly that. They take all levels of severity, mix them together, correlate with self-reports of symptoms, and don't anchor anything to objectively observable criteria (like test results). Most of this stuff wouldn't pass muster at an 8th grade science fair.

> Looking at the methods, the Covid stuff comes after the cognitive test, so could not have impacted the cognitive test results.

You have no evidence that they had covid at the time of the cognitive test (or before). It's self-reported. Even if it's true that the two questions were strictly separated in time, and it wasn't possible to take the cognitive test later, after the covid questions were added (this is not clear from the methods, btw), the results are hopelessly confounded.

> Again, I think the biggest bias in this sample is likely to be their TV-watching status.

They recruited across the web as well. It's right there in the methods.

Sure, the data isn't perfect, but data rarely is. You're also assuming that, because the data isn't perfect, that the effect measured would go away with better data. I actually think the opposite would happen. There is a correlation between the severity of self-reported sickness and cognitive decline. Those who ended up in a hospital show the most severe signs of cognitive decline. If they were actually in a hospital, they likely know for sure whether or not they were positive, compared to those who recovered at home and only suspected they had covid. There have also been visible changes to the brain when looking at MRIs before / after a person has covid.

> There are measurable impacts on cognitive ability: https://www.thelancet.com/journals/eclinm/article/PIIS2589-5...

Good luck driving anything with this garbage paper. Not all published literature is reliable. (Remember the Lancet last year?)

What's your justification for not rating this paper?

Having just read the Methods and Results sections, I see a reasonably well conducted study, which does suffer from some of the characteristic flaws of quantitative social sciences (an over-reliance on normality assumptions, a fetish for normality and sphericity tests and a somewhat credulous notion of analysing the residuals, and a hatred for visual displays) but the work itself is pretty solid (speaking as someone with actual domain experience in this field).

But I'd love to hear more about your problems with the paper, in the hope that I will learn something.

Do you have a specific criticism of this study?

The sole rationale for mandatory health measures, is to prevent healthcare systems from being overwhelmed.

Other than that, when Covid becomes endemic, vaccinations should be offered to those who wants them, as has always been the case with winter flu.

Is that really the sole rationale? What about polio vaccination? I believe that vaccine is mandated in schools to protect children, not to keep healthcare systems from becoming overwhelmed.

I would clarify the sole rationale for the Covid situation.

Covid is not particularly dangerous to the young and healthy.

The danger is that the small percentage of people who become seriously ill is still enough to overwhelm a health system, as it is so contageous.

You’re assuming that it’s the only rationale for the Covid situation, but whether or not that is true is exactly what we’re discussing :)

I'm referring to the situation in the UK.

The sole rationale for restrictions and vaccinations has been to stop our healthcare system from being overwhelmed.

That's the way it was presented by the government to the public. It wasn't the rationale, for example, to wait for a vaccine to reduce the chances of some individuals from getting longer term symptoms of the disease, given there are any proven.

If our healthcare system was somehow able to handle every case, there would have been no rationale for restrictions.

All major markets are completely open, the boosters lack the same veracity as initial vaccination and infection. We are going to learn to live with that.

The goal is to keep ICUs available for general emergencies.

Stanford, of course, is just a private institution, but is foreshadowing the predilections of influential policy makers.

>The goal is to keep ICUs available for general emergencies.

Can anybody back this up with actual data? Looking at my own state's dashboard doesn't seem to suggest that there has ever been even a remote risk of ICUs being overwhelmed.

It also doesn't really stand up to basic scrutiny: hospitals were recently firing medical staff who refused vaccines. That doesn't seem like the behavior of a system which is on the brink of being overwhelmed.

I have family members who work in a hospital in the US and they said that their hospital is overwhelmed with asymptomatic individuals saying "I think I might have COVID!" and panicking. The correct response to that is to refer these people to their primary care physician. But yeah ICUs have never been close to being overwhelmed by COVID at this hospital.

Are you looking at the numbers as a whole or county by county? If 800/1000 beds are available in the state and 19/20 in your county that’s a problem. That’s ignoring that few systems are designed to operate at capacity for any extended period of time.

Maybe the analysis should be above the level of basic scrutiny.

The data I've seen about this has shown that the antibody numbers will slowly dip over time after the initial vaccine shots, but skyrocket after the booster.

I'm not sure what your argument against the booster is beyond the mention of myocarditis (which the CDC addresses here: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/my...) and "it's a lot of work."

At this point, those of us who can do the maximum amount possible to avoid catching the virus and/or making sure that we mitigate its effects should do so. The most likely risk at this point isn't death, it's ending up in the hospital for enough time that someone else can't get admitted or has to put off an important procedure.

> who can do the maximum amount possible to avoid catching the virus

Hear me out - but, I suggest doing the opposite. Get vaccinated, then deliberately expose yourself to the virus every month. If you do that, you'll never get sick, and your immune response will remain high.

> .. I’ll totally begin bolstering anti-establishment sentiment if they are the only ones willing to disagree.

What does this mean? It’s not enough to be against vaccine mandates?

It means I have to listen to wildly absurd theories and hang out in Orange County, just because I didn't get the 3rd++ booster

Also lost me and I'm not even a Stanford student.

But the wording is exactly the same as used by companies. "Strongly encouraged" is now the preferred wording to express: "You MUST comply with this."

But since everyone who is worried have gotten the vaccine and will continue to get booster shots ad infinitum, there is zero reason to force this on everyone else.

It's time to stop this nonsense.

I came to the same conclusion. Fully vaxxed, but pressured by family into getting booster. Couldn't get out of bed for a day, and my heart still feels weird a week later. Going to the doctor to get that checked out.

I had a rash cover half my body that started at the vaccination site. My GP, who is the head of internal medicine at a famous hospital, call me directly during the holidays as it's not that common apparently.

Did this get entered in reporting database VAERS? How would you know?

It helps everyone to accurately report adverse reactions.

> Did this get entered in reporting database VAERS?

Yes

> How would you know?

Like I said, my doctor, who spent some time digging into this, mentioned it was not a common occurance.

God speed.

I had a friend. 75. Health nut. Swam every day. Organic vegetarian. Regular checkup. Never a blip.

2 months after the second shot, dead of sudden heart attack.

Post-hoc, ergo propter hoc. 75 year olds have a tendency to die, a plurality from cardiovascular failure (pre-covid).

I had the similar friend, swam everyday 10 laps at least. Never a blip during regular checkups. Organic Vegan

2 months after the second shot, hes perfectly fine

The writing was on the wall as soon as governments started normalizing vaccination passports. Governments and businesses can now take that same mentality forward for whatever type of shot they want. Meanwhile they continue to antagonize those who choose not to take these shots, employing the classic citizen vs citizen tactic from the playbook.

Another weird take on a government's rights to dictate who is allowed to enter and exit their own country.

Countries have always been able to impose vaccine requirements for smallpox polio, yellow fever, meningitis and now covid.

Businesses didn't need to validate that people coming into their stores had these vaccines because the government already would have validated it for them.

Businesses have the right to ensure the health of their employees and customers.

> Another weird take

It's not the "take" that's weird, it's the situation. I said nothing about whether the government or businesses have the right or not. Just that since it has now started it is likely to be used further. That's not a weird take, it's just a fact proven by the current situation that previous poster was describing.

I've been entering businesses my entire life and until now I've never had to show private medical information about vaccinations in order to enter. Similarly, I've traveled through multiple countries in my life and until now I've never had to show private medical information about vaccinations in order to enter. What's weird is that now I can't go to a funeral without telling someone at the door about what shots I have.

It's also interesting that pointing out this very unusual state of affairs and its likely continuance results in a response suggesting that it's "weird" to even point it out, suggesting that it should not be pointed out, because who wants to be "weird" or say "weird" things. That's a type of antagonization.

The immune response to the booster isn't linear relative to the response to the earlier shots.

The every six months thing doesn't apply until there's actually a government recommendation to get a 4th shot. I think there is enough chance that there will be, but there's also a pretty good chance that there won't be (because we are actually getting to the point where ~everyone has been infected or vaccinated).

The government has already determined the expiration of booster shot certificates. What am I supposed to do afterwards, never come out anymore?

Which government, what determination?

EU, 9 months

So https://ec.europa.eu/commission/presscorner/detail/en/ip_21_... ?

That requires the booster to be treated as proof of vaccinated status for 9 months, it doesn't predict that proof of additional shots will be required in the future. Which makes sense, as we don't have the information to make that determination!

If my vaccination pass expires then I can't go eat, get on a plane, go to work. So it's a requirement to get another shot, the politicians/government just didn't say it out loud - typical.

Last time I got the vaccine for covid I was promised 5 years. It was reduced to 5 months post-facto. Do you seriously expect me to believe it will be at least the advertised 9 months this time - or that it's going to increase?

So "get more shots of the vaccine we don't have enough information about"?

I'm drawing the line at two.

There's good data about the booster being an effective booster. There's not much data about whether another one will be beneficial (neither in terms of whether it will help immunity or whether there will be a lot of virus in circulation...).

> Boosters for last year’s virus

You're announcing confidently to the world that you don't know anything about immunology, and haven't seen the studies that show that boosters produce broad neutralization against Omicron even though they haven't been updated (and you probably lack the ability to theorize as to how that could be possible).

> the fairly predictable solution of stacking them every 6 months

Outside of Israel nobody is suggesting boosters every 6 months. We'll see how that goes for them. Lots of experts are actually very suspicious of the idea that we'll be boosting constantly (outside of the 3% of the vulnerable population that is immunosuppressed).

>Outside of Israel nobody is suggesting boosters every 6 months.

Why would any other country stop with 1 booster? I think rather that they are just slow rolling their mandates. The data suggests that the immune boost is temporary so I don't see how the situation will be any different for shot 4.

Perhaps the only difference will be increasing fatigue with compliance.

A 4th shot is unlikely to produce substantially better immunity than a 3rd shot.

The realistic goal is also not to prevent transmission but to prevent severe disease and death, and a 4th shot won't help much with that at all.

Once everyone has T-cells the pandemic phase is over and it really does just become a cold or the flu and we're getting close. Estimates are that around >90% of the population is exposed or vaccinated. Once we get there then the reaction to the virus should look more like a cold or flu virus. We don't recommend anything for colds. For the flu we mandate it for health care workers and highly recommend it for vulnerable people and offer it to everyone. We're going to wind up there soon.

There's also going to be a narrower number of people who have been vaccinated and never caught the virus who think that the goal is zero covid, sooner or later nearly everyone catches it. Once they've been vaccinated and caught mild disease they're going to stop treating it as an existential threat. Once that happens their appetite for supporting mandates will disappear.

My guess is that Omicron is the last gasp of the pandemic phase of the virus. And I can't see mandates for 4+ shots being anything other than political suicide in the US outside of health care.

>There's also going to be a narrower number of people who have been vaccinated and never caught the virus who think that the goal is zero covid, sooner or later nearly everyone catches it.

Right, see, the issue is that these people who want Zero COVID but are just slightly bothered by that never having been the stated goal are planning to go down fighting.

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