Pfizer board member suggests end to mask, vaccine mandates | Hacker News Reader

Pfizer board member suggests end to mask, vaccine mandates

ntdca.com

400 pointsalexrustic1,209 comments

Something from the NYT mailing list yesterday:

> The Covid vaccines are remarkably effective at preventing serious illness. If you’re vaccinated, your chances of getting severely sick are extremely low. Even among people 65 and older, the combination of the vaccines’ effectiveness and the Omicron variant’s relative mildness means that Covid now appears to present less danger than a normal flu.

> For the unvaccinated, however, Covid is worse than any other common virus. It has killed more than 865,000 Americans, the vast majority unvaccinated. In the weeks before vaccines became widely available, Covid was the country’s No. 1 cause of death, above even cancer and heart disease.

At this point if an adult in the US is unvaccinated it is (1) almost certainly by choice (there are some people who cannot get it for medical reasons but they make up only a very tiny fraction of the unvaccinated), and (2) it is very unlikely that any evidence or logical arguments will chance their minds.

With COVID becoming endemic everyone is going to get antibodies, with the only choice being whether you get your first antibodies by vaccination or by getting COVID.

The only question really then is how fast do we want the unvaccinated to do the getting antibodies by getting COVID thing. The faster they get it, the faster we can be as done with COVID as we are ever going to be.

I'd say the answer to that should be determined by the hospital capacity. If a region has sufficient hospital capacity that it would not be overwhelmed by the increase in COVID cases among the unvaccinated go ahead and lift most restrictions.

> The faster they get it, the faster we can be as done with COVID as we are ever going to be.

This reminds me of the arguments that unvaccinated were the cause of COVID-19 and were endangering those who are vaccinated. Vaccinated people get and spread COVID still. In fact, recent studies show natural immunity or vaxxed plus COVID causes much more antibodies than simply getting vaccinated, especially with a vaccine that targets an old mutation that has proven much less effective against Omicron and the likes. The vaccinated people will prob continue to get vaccinated a few times a year until they get a less dangerous variant.

>It has killed more than 865,000 Americans

It looks like that's more Americans than have been killed in combat in all of the wars of the 20th century combined [1]

Granted it's less than the UK lost in WW1 alone, so it's perhaps more a testament to how few the US managed to loose in the world wars (compared to Europe), but it's still wild to realize.

[1] https://www.statista.com/statistics/1009819/total-us-militar...

These numbers can be further separated by "with Covid" and "from Covid" causality, as well as co-morbidities and expected lifetime. E.g. if someone was soon to die from illness A, but died 3 months earlier from complications induced by Covid, and the hospital received a financial payment for classifying this as Covid-related treatment, that should be broken out into a separate reporting category. Such deaths would not much change all-cause mortality for the year.

Excess mortality is higher than reported COVID deaths. Australia contained the virus in 2020 and saw negative excess mortality. Official COVID deaths understate the true toll.

...of lockdowns?

COVID denialists often attribute excess deaths to lockdowns as opposed to undercounting of deaths from COVID. I was just preempting that line by pointing out Australia had severe lockdowns but negative excess deaths.

COVID what-ists? You mean all manner of people who have all manner of opinions and reasons for them that just so happen to differ from the views presented as scientific consensus by government, media and celebrities?

Here is a summary of over 400 studies demonstrating lockdowns are ineffective or harmful:

https://brownstone.org/articles/more-than-400-studies-on-the...

Prepare a sufficiently convincing argument against each and every one of them, and against the credentials of each and every author, before using the term "denialist" in application to anyone other than yourself.

Ok. I don’t care what the purported “studies” say. China, Taiwan, Australia had hard lockdowns. Taiwan and Australia have accurate statistics — they had virtually no COVID deaths and no excess deaths.

Sweden is 62nd on a list of 180 countries on deaths per capita. We can argue back and forth like this but why bother? If you don't care what the studies say, your mind is made up, making discussion with you valueless - for you.

I’m not saying there’s a huge difference between light and lighter lockdowns (ie, Denmark/Norway/Germany vs Sweden). I’m saying lockdowns themselves don’t produce excess deaths vs baseline (as evidenced by Australia and Taiwan). Therefore, the excess deaths that occurred in the US, which are greater than official COVID deaths, indicate COVID deaths are being under counted, not over counted

Doesn't basing your conclusion on the two countries that support it, out of a pool of ~200 that exist, seem a bit tentative?

It's at about the same level as the counter argument regarding Sweden (which is one reason I made it).

Have a look through the studies I linked, you'll find several that perform rigorous analysis on a large number of countries, including in some cases specifically regarding excess mortality.

For example, have a look at Figures 2A and 2B from the following study. 38 countries compared by length of initial lockdown measures, versus per capita excess mortality for the period, and then the same measure compared across all states of the US:

https://www.nber.org/system/files/working_papers/w28930/w289...

This doesn't support the hypothesis that lockdowns reduce excess deaths.

As I recall the basis of the argument against lockdowns (which yes was made by legitimate epidemeologists before covid made everything so politicized and tribal) is that the disease eventually comes right back and infects everyone once the lockdown ends. I do think there is a good argument about allowing vaccines to be developed and delivered though. But benefits like preventing hospitals from being overwhelmed were believed to already be achievable with social distancing alone. So one must be careful to not give to much credit to the lockdowns alone.

As for excess deaths, it presumably depends on how well the country can endure the self-inflicted downsides (such as a recession) that comes with it. Countries where it causes severe problems probably are the very ones who didn't have the political will to maintain the lockdowns, leading to some biased conclusions. We also have lots of other issues caused by covid response such as shortages and spiking prices all over. Being outright dodged by pointing blame at some indermediate actor like "corporate supply chains" or "hoarders" or whatever.

The point is there are arguments that can be made on all sides. No need to insult and dismiss people.

Leading cause of death in the US, 2015-2020: https://jamanetwork.com/journals/jama/fullarticle/2778234 (see table a few paragraphs down)

Heart disease, unintentional injuries, Alzheimer disease, and diabetes all jumped more than the expected trend.

2021 numbers I don't think will be finalized for another month or so.

Yes so it seems if anything COVID deaths are being misclassified as Alzheimer’s, diabetes, etc

One thing I've heard multiple doctors comment on is that they are seeing more patients who were successfully managing a condition have significant declines after a bout of COVID, even a mild one. That's definitely a bit of a philosophical question trying to assign fractional responsibility but you can also side-step this to some extent by looking at it as years of life lost — e.g. if someone with a manageable heart disease where patients tend to die 10 years older dies after having COVID, that's something like a decade where they could have been around their friends and family.

In places with good nationwide data like the UK and national level lockdowns, the excess mortality spikes also line up very well with the case outbreaks (especially pre vaccination), and considerably less well with other plausible causes of excess mortality (lockdown and unemployment induced stress, [long term effects of] reductions in access to treatment for chronic conditions)

> the hospital received a financial payment for classifying this as Covid-related treatment

Can you explain this more? Surely a hospital doesn't just get money for simply classifying it. How does a hospital benefit from classifying someone's treatment as Covid related other than being paid for the necessary treatment?

There are probably better sources, https://www.washingtonexaminer.com/news/cdc-director-acknowl... (Aug 2020)

> U.S. Centers for Disease Control and Prevention Director Robert Redfield agreed that some hospitals have a monetary incentive to overcount coronavirus deaths as they do deaths for other diseases. “I think you’re correct in that we’ve seen this in other disease processes, too. Really, in the HIV epidemic, somebody may have a heart attack but also have HIV — the hospital would prefer the [classification] for HIV because there’s greater reimbursement,” Redfield said during a House panel hearing Friday when asked by Rep. Blaine Luetkemeyer about potential “perverse incentives.”

For families, Covid classification for a death enabled up to $9000 for funeral expenses, https://www.cnet.com/personal-finance/covid-funeral-reimburs...

There is very little substance on that page plus it's 18 months old and the other fact you posted isn't an incentive for hospitals. I really wonder if that's actually a thing.

U.S. Congressional testimony by a CDC Director is not substantive?

The 2nd point offers a financial incentive for families to agree with hospital (mis)classification, i.e. it aligns the financial incentives of family and hospital towards Covid attribution.

Hospitals do receive extra payments for treating COVID-19 patients.

https://www.usatoday.com/story/news/factcheck/2020/04/24/fac...

I know this is going to sound conspiratorial but I think you’d have to be pretty naive to accept the reported deaths in the US due to Covid to be that accurate. Hospitals(which in the US are for profit mind you) were quite literally given more money for reporting a death as a Covid death for a period of time. https://www.usatoday.com/story/news/factcheck/2020/04/24/fac...

Actually you could say it’s difficult to trust the numbers coming from any country for a variety of reasons, whether it be under or overreported.

> difficult to trust the numbers coming from any country for a variety of reasons

This must be a golden age for those doing a dissertation on media studies. So many quant-driven narratives, so little time. Hopefully cross-country data and narratives are being archived and aggregated into an open-data academic repository that can be studied in coming years.

Given that raw data of vaccine trials aren't even being made public I doubt that any reliable data is being collected, let alone analysed

Progress is slowly being made on transparency. For the Omicron-specific Pfizer vaccine, the clinical trial in humans must be completed before approval and clinical trial data must be submitted at the same time (no 75-year delays).

https://www.reuters.com/business/healthcare-pharmaceuticals/...

> recent study from Israel showed that while a fourth dose of an mRNA vaccine boosted antibodies, the level was not high enough to prevent infection by the Omicron variant ... the debate appears to have shifted with the European Medicines Agency (EMA) saying on Friday that international regulators now preferred clinical studies to be carried out before approval of a new vaccine ... it may not be possible to realise a current plan to launch an Omicron-targeting vaccine by the end of March ... Inclusion of clinical trial data in the regulatory filings may have an impact on the delivery of initial batches.

At this point, given that the quantity and quality of the public data of vaccine rollouts dwarfs the data of vaccine trials in both scope and usefulness, anyone still grousing about vaccine trial data is just playing political football, for the sake of FUD.

It's like arguing about the raw data of the Wright brothers flight, when millions of people are flying around the world on 747s. Was it relevant in the past? Yes. Is it relevant today? No.

You want to know about vaccine safety? Look at excess mortality, hospital admissions, and long-term health problems of the vaccinated and unvaccinated populations, today. Ten billion COVID vaccines have been administered around the world in the past year. Any of the data we've gathered from that is about a thousand times more relevant to literally anything we could be doing, than raw study data on a few thousand people.

If a policeman breaks into your house without a warrant it's illegal even if he is right and you are a criminal. Procedures have to be followed.

Most legal systems do not agree with you. Fruit of the poisoned tree is a peculiarly American legal abberation, and even in the United States, it is not applicable in many cases.

Most ethical and legal systems around the world, in fact, would use that evidence to both convict the criminal, and then independently recommend separate sanctions for breaking procedures.

But we're not even talking about ethics or legality, here. We are talking about knowledge. People claim that we don't know about the safety of vaccines because we don't have data on trials conducted on thousands of people.

... Yet we have data about vaccines administered to billions of people. Why don't those critics look at that data, instead?

It's because knowledge and fact-finding isn't the point of that complaint. The people asking about this don't actually care about having a data-driven argument about the safety or efficacy of vaccines, they just found a procedural problem, that they can play a political game with. The politics is the entire point.

You can use excess deaths then, those numbers are even higher. And even if official Covid numbers are inflated, even tenfold, it's still a disease that resulted in a lot of death.

A non trivial portion of excess deaths can be laid at the feet of the response to the virus, not necessarily the virus itself.

This would include the things like firing healthcare workers, leading to other problems being undiagnosed, and worsening instead of being treated. I would also include lockdowns and mask mandates as being responsible for increased amounts of depression, which has a known poor impact on survival over time, and that's not just counting suicide.

we maybe fired less than a tenth of a percent of health care workers. and most were not even nurses they were janitors and the like. a few thousands in a field of hundreds of thousands.

if your going to make shit up at least make up believable bullshit.

No need for the attitude.

And it doesn't have to be widespread - given the thin staffing margins that hospitals already run on, losing a small amount of people in a large facility can have outsized effects.

there is no need for you to spread completely unfounded conspiracy theories without evidence to back it up either but here we are.

You yourself said we're talking about a few thousand people. The idea that losing that many people all at once (within the space of a month or two), especially during a time of increased hospital usage, has no impact on outcomes (which is what you appear to be arguing), is asinine.

I'd thank you to engage with the argument in good faith per the site guidelines, or don't bother responding.

tl;dr; when you start having the discussion in good faith I will.

once you actually have a position that can be discussed. show me evidence of your position and I'll stop calling it a bat shit insane conspiracy theory.

right now all you've done is assert complete bullshit. I can link to articles with hospitals stating how many of their staff they've fired due to anti-vax behaviors. I doubt you can find a single instance of a hospital shortage due directly to the few thousand works in the entire country who were fired for their anti-vax beliefs.

even if you did find a hospital in that position, the issue certainly isn't wide spread enough to even merit a footnote when it comes to health policy.

Actual people dying because of Covid is probably even higher than what the official data reports, see: https://twitter.com/MaxCRoser/status/1486075272638119936?s=2...

You're right that does sound conspiratorial

This is just one reason for doubting the accuracy of the reported number of COVID-related deaths. Fauci, Chicago's Department of Public Health, and others have admitted that they've counted deaths as COVID deaths if the person tested positive for COVID while in the hospital. Dying from COVID and dying with COVID are two different things, but both have been lumped together in the CDC's death tally.

Some doctors are reporting adverse/fatal effects associated with the use of Remdesivir (which hospitals are using to treat COVID patients). These issues include acute kidney injury, bradycardia, and death. The CDC has counted these deaths as COVID deaths as well.

There are also other aspects of COVID that seem difficult to suss out. For example, how many people have died from the vaccines? VAERS is reporting 22,193 vaccine-related deaths and over 1 million adverse reactions. There are also deaths and suicides caused by our response to COVID; e.g., the lockdowns, depression, job loss, fear of going to the doctor/hospital due to COVID, etc. Those aren't being counted as COVID-related deaths by the CDC, but perhaps they should be.

Even if you removed all the politicization/propaganda of both COVID and the vaccines, it still seems like we've made a lot of mistakes during the past two years that would make producing an accurate death count virtually impossible.

That's true, but not if you make the deaths per capita. WWII was per-capita deadlier in the US than covid (so far).

>> It has killed more than 865,000 Americans

> It looks like that's more Americans than have been killed in combat in all of the wars of the 20th century combined [1]

Like all deaths tragic, but let's not pretend young men, effectively kids, dying in war is the same as elderly & chronically sick populations dying of disease.

I would personally agree (though you will find people who won't), but I found it to be an interesting comparison just to get an idea of the scale.

> Like all deaths tragic, but let's not pretend young men, effectively kids, dying in war is the same as elderly & chronically sick populations dying of disease.

Where elderly means > 40 and chronically sick includes "has a bit of high blood pressure".

> chronically sick includes "has a bit of high blood pressure".

The CDC says > 40% of US adults are obese (> 100 Million people!) and 13% of US adults have diabetes. If that's not a chronically sick population I don't know what is.

[1] https://www.cdc.gov/obesity/data/adult.html [2] https://www.cdc.gov/diabetes/pdfs/data/statistics/national-d...

This is the elephant in the room I was trying to talk to people about at the very start of this pandemic. People are endlessly willing to talk about how divided we are about all kinds of issues and yet the fact that we cannot at minimum rally behind the fact we need to deal with the obesity epidemic is a bad sign.

My big problem with the initial lockdowns was not really about the larger lockdown at all - we just (obviously in hindsight) went too far with locking down larger, wide open places where people exercise.

Spring break in Miami with people crammed onto a beach? Probably a bad idea. A few surfers going in the water a hundred feet from one another and some other people doing a morning run? Likely a net benefit to Covid outcomes.

Elderly doesn't mean > 40. More than 81% of COVID-19 deaths occur in people over age 65.

https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precaut...

Fortunately the vaccines and other treatments are still very effective in preventing deaths among the elderly population.

I wanted to comment a little on the "choice" thing. I'm not sure that every person who is unvaccinated chose that. I had to try very hard to get my three doses. For the first series, I had to go to a faraway FEMA-run site. For the booster, I scheduled three appointments with CVS; the first two times, they canceled my appointment on the walk over (I made the first like 3 weeks in advance, and they canceled with 10 minutes notice -- "sorry, we ran out".) I did eventually get that third dose; but each signup took me about 15 minutes of typing in all of my medical information (`insert into form_responses (email, json_blob_that_is_passed_to_the_final_appointment_making_system) ...`?). I imagine some people just gave up after their first appointment was canceled.

I never saw anyone talking about this; the government websites are like "go to CVS, you can just walk in!" but in reality no CVS locations were accepting walk-ins if you asked. And even appointments were tenuous.

I feel like it's fair to place 90% of the blame on individuals, but I also think big companies are misrepresenting themselves to the government, or the government isn't asking if they actually have vaccines or not.

Access is also a larger issue in under-served populations. I'm fortunate enough, as probably are many on this site, to be able to just swing by CVS during some downtime while WFH. A person who is paid hourly for an in-person job and reliant on public transportation will have a much harder time.

I wish there were stats on "want to vaccinate, but haven't been able to."

Very true. I'm the best possible case, right? I get my full salary and benefits to wander over to CVS only to be told they're out of vaccine. I get my full salary and benefits while filling out all the paperwork. And if I do get COVID, guess what -- full salary and benefits while I recover.

Most people are not that lucky, and unfortunately have to choose to roll the dice on COVID to avoid the certainty of being fired for missing work.

I would love it if there was data on "want a vaccine but couldn't get it". The vaccine finder website could have you indicate "I'm interested" and then email you every month and ask you to confirm that you got a vaccine or that you gave up or that you're still looking. I fear that people don't ask questions they don't want to know the answer to; "300 million people are looking for a vaccine but only 200 million got it" would not look good. Sigh!!

How long ago was that? I have to think the situation today is quite different from when the major vaccines were approved months ago, but I could be wrong.

fwiw, I put myself on the King County (seattle, wa area) booster waiting list months ago and only got an email the other day that my turn was up. They wanted me to drive ~30 minutes out of town for a booster, and I don't have a car.

The situation is not great. I have no idea how a poor person would navigate this system.

I got my first dose early April, which was pretty late looking at the numbers. I found this vaccination site because a friend of mine from Nebraska found some New York representative talking about this particular site on Twitter. Guess it got a lot of reshares and trended or something. I signed up and got a slot many weeks in the future. (At the time, the major pharmacies didn't have any sort of working sign-up system. I thought about writing an elaborate scraper to immediately notify me of a slot, but decided that was unethical and didn't. Also, very boring.)

For my third dose, that was last month. I think I signed up for my ultimately-canceled appointment early December targeting a date before Christmas. I ended up getting the shot in the first week of January.

I felt like I had to devote a lot of mental energy to getting the vaccine much later than everyone else, looking at statistics. I totally believe that other people said "I like the vaccine, but fuck this shit" and that's why they're not vaccinated.

The vaxxed and unvaxxed populations both rely on the same medical infrastructure. So when the unvaxxed fill hospitals to recover or die, they are consuming scarce resources that are required by the population at large for other things like birth, cancer, surgery, etc. Sadly, we don't have an ethical way to let all the unvaxxed get covid without impacting the medical system negatively for the rest of us.

The same reasoning can be applied to obesity.

I highly recommend reading this series if you think obesity is a personal failure: https://slimemoldtimemold.com/2021/07/07/a-chemical-hunger-p...

Obviously, yes, medical conditions do place burdens on health systems. That's why we tax cigarettes highly. However, in spite of considerable public health initiatives, the obesity rate continues to rise...

Not really. Various groups may disproportionately take up health resources, but the risk we're talking about is acutely overwhelming health systems.

This is definitely the most pressing issue, but shouldn't we also, as a society, build the ability to e.g. double ICU capacity when needed? We're not talking about 100x here.

As much as I support vaccination, it feels like gaps in vaccination are also used as an excuse to blow off repairing an extremely fragile public health system. We've had two years at this point.

Two years doesn't seem like very long to double ICU capacity. How are you going to staff them? Nursing degrees take 3 years. Medical degrees much longer. And capacity to train doctors and nurses is also stretched by the pandemic and non-trivial to expand.

I do agree that this is something governments ought to be looking into over the long term though.

If the short-term problem is specific to Covid, you just need to bring/train people for that.

Training people to assist Covid cases, run PCR tests, should be a matter of weeks, not years. Germany did it, I have 4 (four!) test centers on within a block of distance, all of them are filled with students and otherwise-unemployed people who got some minimal training.

I don't think test centres are the problem. I live and the UK and the only time tests were scarce was a few days around Christmas when there was very high demand.

A standard nursing degree in Europe takes three years. That's not a scientific law, it's not like it takes 365 * 3 * 2/3 = 17520 hours to learn how to be useful in an ICU. An LPN can be done in a year. We trained mechanical engineers in as little time during WWII.

If we're to treat this like an emergency, why aren't we treating it like an emergency?

> If we're to treat this like an emergency, why aren't we treating it like an emergency?

Because in truth it probably never was. We assembled fully staffed field hospitals that went completely unused.

...only if (and if only!) obesity were a problem that could be solved by a couple of quick, free shots at the local pharmacy.

It'd be interesting to see what big pharma could come up with in a year.

"free shots"... hah those shots cost Tens of billions of dollars if not more. It was a totally worthwhile investment to make (we probably should have invested more in it) - but lets not pretend like there is nothing we could do about obesity if threw 100 Billion at the problem.

Obesity isn't contagious and doesn't have spiky behavior in hospitalizations. We also know a reliable cure even if its very difficult to put into practice (impossible for some).

Obesity is one of the big contributors to Covid infections that require complex hospital care. The two are linked.

That's why I think vaccination schemes that offered free food were undermining the "following the science" bit.

As was the banning of the popular "Parkrun" in the UK, which is a collective outdoor exercise event, during the lockdown.

So many policies have undermined the "follow the science" bit in my mind.

one run and one meal is not gonna make or break someones weight. one vaccine might save their life

You edited your comment.

> one run and one meal is not gonna make or break someones weight

On the contrary, we have had two years of this pandemic. Government messaging could have been a lot stronger on the benefits of exercise. That's 2 years for people to become healthier.

And "one vaccine" has turned into one vaccine plus boosters. Everyone is going to get Covid at some point. General fitness will remain one of the best long term ways of combating the virus.

The Parkrun is a weekly occurrence, and is popular even for those who do not have an interest in exercise as a hobby, as it is informal. As such, it acts as an important gateway to a healthier lifestyle.

I'm by no means alone in seeing banning it as counterproductive, and not "following the science".

https://www.bbc.co.uk/news/uk-wales-59816344

If the government wants to serverely curtail individual liberties, then I expect good reasons for doing so. It's not good to encourage blind adherance to illogical policies.

Junk food has consumption tax

Also, assuming their obesity is a life style choice instead of type 1 diabetes, I suspect many obese people would be willing to take a easy vaccine if it exists considering how big the lose-weight-quick industry is

Obesity isn't exogenous, infectious or subject to exponential growth. Even a superficial consideration of the facts shows that analogies between obesity and covid are unsound.

Next time I have to postpone an elective surgery for 3 months because obesity cases have filled the ICU, then you can apply the same reasoning.

Cigarette use kills 480000 people every year in the US alone. 300 billion dollars estimated to be spent per year with treatment of smoking-related illness.

I don't want even to look at the numbers of the more critical epidemic on the US: obesity and metabolic diseases.

By arguing that "the unvaxxed" are a burden and that they deserve discrimination, you are opening the gates for those arguing that smokers should be forced to stop smoking, or that obese people need to be forced to stricter diets.

Smokers, obese people and metabolic diseases are not filling up hospitales at the unsustainable rate unvaxxed people are; and none of those can be quickly fixed with a pinch in the arm, not even nicotine addiction.

Yeah, at this time of the year they are being filled by all types of seasonal respiratory diseases, like it happened for most years in recent times, even before Covid. The flu shot is widely available and recommended for most over-55 (I think?), but you don't hear anyone claiming that it should become mandatory.

So let me get this straight, what you are asking is why not add one more huge problem to an already near-collapse system because there are already huge similar issues that caused it to be in that state?

What I am saying is that we have for two years already heard that the restrictions and mandates were to avoid overloading a then-unprepared-and-taken-by-surprise health system, but the US still can't even have large-scale availability of rapid tests.

I am also saying that if problem of the health system is lack of personnel, then firing healthcare workers who refuse the vaccine (even after being infected) is counter-productive and can only be seen as a bone-headed political move.

But most of all what I am saying is that we should not accept the policy theater. Making this about vaxxed vs unvaxxed is just yet-another way for governments (worldwide) to hide their ineptitude.

It's been two years already. Countries in Europe with comparable levels of vaccination to the US are already treating Covid as "just a endemic, seasonal respiratory disease". Yet the US still wants to pretend that things just don't get solved because of rednecks and "problematic people" that need to submit to the will of the elite.

So vaccines are "the will of the elite"? I can't wait until this guy finds out most vaccines are mandatory to enter the public education system and has been that way in most countries for decades, even in red states like Texas.

Don't be stupid.

It is not the vaccination, per se[*]. It is the political maneuvering and using the unvaxxed as a cover for their failures, this perpetual "if only they did what we are asking of them", etc. The will of the elite is that we accept this perpetual terror until we give them carte blanche for them to do whatever "Big Reset" they want.

In Germany we are testing our kids twice a week at a minimum, and everyday when/if a positive test is found in the school. Case numbers are high, measures are in place, but people are mostly living their lives without waiting for Mary from Bumfuck Alabama to get her shot. Why is it so hard for the US to drop the empty pointless rhetoric and get their shit together?

[*]If it helps you, I am not against the vaccines. I got mine, boosters and all. What I am against is the policy theater. What I am against is schools being closed and causing a lot more long-term harm to kids than the potential risks of them getting covid. What I am against is firing health care workers for political reasons while claiming that the system will collapse unless everyone complies.

I actually think children are much better off with what you call "long-term damage", this generation will now be way more likely to be ready for the next pandemic which is _not_ a question of if but _when_, with this first-hand experience hopefully they will avoid many of those failures you complain about (when many of the reach political positions in their adulthood); and is not like they are getting anywhere near serious long-term damage like during the black plague when most children saw half of their family die and there was no internet, or electricity or any of the niceties they now enjoy.

You are kidding, right?

Granted, a very cynical view of the educational system is most Western countries is that it is a glorified time-waster for kids to be busy while parents work. But even that was lost during the pandemic. Most schools basically have given up on getting students to learn anything this past year. Lockdowns have acted as prolonged stunt on children's socialization opportunities. Anxiety levels for teenagers are through the roof.

The effects of these two years on younger kids will be profound and long-lasting. They are paying a lot more than their share of risk. And saying "they are not dying" is not a consolation because - unlike with the Plague - kids are basically zero-risk compared with other age groups.

> At least they had internet and other niceties

Are you serious? The last thing you should want for kids is for them to become dependent on something like the Internet. Such a comment is almost offensive to a parent that does not want to see their kids turning into mindless, socially-inept drones like the average HN-commenter.

Actually, that's not true.

We have some hypotheses that children are the flu reservoir and that if we required them to get an annual shot it would tamp down flu seasons.

The primary difference is that the flu vaccine is predictive and can miss. It's kind of hard to demand that people take something that may not work.

If we got something genuinely terrible like Spanish Flu, yes, everybody would be demanding that people get a flu shot.

Actually, they do. It's not the young unvaxxed athletes who end up in ICUs, it's those people with obesity and other comorbidities who fill up hospitals.

You are being pedantic, in this context I obviously meant vaxxed smokers, vaxxed obese people, et al.

And most of the people (vaxxed or not) who need critical care with COVID have those pre-existing conditions.

Well that is not true actually - they likely are filling up hospitals quite a bit. The big difference is that smoking, metabolic diseases, car accidents, etc etc are all relatively PREDICTABLE diseases year to year. Our medical system then sizes to be able to deal with these predictable rates of disease.

Unvaxxed are not filling up the hospitals at a higher rate than vaxed now. The two doses you got in the summer doesn't work anymore.

We already have discrimination in medical care its called 'triage', unfortunately it doesn't involved removing care once granted.

We also charge smokers more for health care due to the burden they put on the system, yet another form of discrimination.

You're also making the naive mistake of relating a stable system (smokers with health issues) with an unstable system (covid patients). These two types of systems have VERY different impacts on the medical infrastructure.

QED: no one is opening any flood gates. we've had this shit in place for over a century. we use to let you just die at home when you caught the plague.

Then go charge more for those who are at risk and reject the recommendation for vaccine. I'd argue that would be a lot more effective (and fair) to get people to vaccinate then any of the current sociopolitical pressure and ostracization.

I’ve wondered why increased healthcare premiums for unvaccinated persons isn’t a tool we’re using.

I’m assuming it’s a bad idea for reasons that I haven’t thought through; I’d love to hear them from anyone who has spent time on the issue.

They're illegal because of Obamacare, I believe. My understanding is that smoking is the only pre-existing medical condition that can be used to discriminate.

But we could already charge more for certain things like being overweight and cover this issue anyway. IMO if your BMI is over a certain amount you should probably be required to take a Covid vaccine, but not everyone.

>We already have discrimination in medical care its called 'triage', unfortunately it doesn't involved removing care once granted.

Based on seriousness of the case, not really on whether it was preventable in the first place. For extremely limited resources like organs there is consideration of future risks, but that isn't really the same thing.

>We also charge smokers more for health care due to the burden they put on the system, yet another form of discrimination.

So let insurance adjusters charge different rates for vax/unvac'd people covered by insurance like they do for smokers.

> Based on seriousness of the case,....

incorrect its based on likely hood of survival. no point in wasting resources on a soon to be dead individual when you can save someone who actually has a chance.

The Affordable Care Act (Obamacare) doesn't allow medical insurers to set premiums based on vaccination status.

I mean, that's a pretty decent comparison. Society has spent the last few decades encouraging people not to smoke, using everything from campaigns to actual laws that make it harder to smoke. This has caused smoking to go down a lot.

So in that sense, the response to COVID is similar - though on an accelerated time scale, because the epidemic is much worse.

> So in that sense, the response to COVID is similar - though on an accelerated time scale, because the epidemic is much worse.

Tobacco still causes 480K+ deaths a year in the US so saying covid is worse is a very strong claim.

https://www.cdc.gov/tobacco/data_statistics/fact_sheets/heal...

Thanks for bringing those numbers. Kind of crazy to me that tobacco still causes so many deaths - I had no idea.

I think the epidemic is worse in a few particular ways (though obviously not as bad in other ways as smoking, since I doubt COVID will keep causing 480k deaths a year). Ways in which it is worse:

1. It causes a spike of hospitalizations - this causes much less healthcare to be available in general. Smoking is already (regretably) factored in, I imagine, and doesn't cause sudden spikes.

2. COVID is generally not something you can protect yourself from - unlike smoking, which is to a much greater extent a personal choice.

3. Efforts to contain COVID are having a drastic effect on the economy in a way that smoking doesn't (both government-mandated and personal actions.)

1, Sure it does stress the hospital system in a different way.

2, Whole heartedly disagree with. Covid has specific health risk factors (Obesity, Diabetes etc) that long term people have a similar level of control over as smoking. People also have direct control over how much risk they want to take; there are vaccines, there are therapies, there are N95 Masks & no one is forcing you to go to a bar/club/sporting-event.

3. I'm not going to attribute to Covid the panic and over-reaction because of its novelty. Just like we don't attribute to the 9/11 terrorists the destabilization of the middle east and hundreds of thousands of deaths.

2. that's partially true.

But people don't always control having diabetes. People don't control having cancer. People don't control other forms of immunocompromisation. People don't control being older.

3. I don't think it's an overreaction. You said in 2 that there are vaccines, therapies, masks. These things took a year to get to. If not for the actions in the first year, there'd be many more dead.

Tobacco has killed millions in the US and will keep killing millions in the US for the foreseeable future... I don't know how you can objectively even begin to justify saying Covid-19is worse... Especially in a world world with multiple highly effective therapies and vaccines

> you are opening the gates for those arguing that smokers should be forced to stop smoking, or that obese people need to be forced to stricter diets.

Honestly, then good, we should open that can of worms.

> 300 billion dollars estimated to be spent per year with treatment of smoking-related illness.

AFAIK this treatment doesn't include "clogging an ICU because these people are on ventilators". I could be wrong though.

I'd be interested to see a poll of pro-vaccine-mandate individuals asking these questions:

1. Should smoking be banned? (by smoker status)

2. Should obese people be forced by the government to restrict calories? (by obesity status)

I honestly have no idea how it would go. Most people are more coy about those opinions.

Some countries are starting to ban smoking - look at New Zealand. Personally I am not against it specifically - if you are going to do some kind of extra harmful drug it might as well at least be one that is not so damn boring like Nicotine.

Obese people is a more complicated issue and I would argue that (at a societal level) it is an indicator of a larger social problem that is then causing the issue downstream just like other issues of addiction. I think we would be better off targeting that issue upstream.

That being said I do really like that in some countries (Japan, from what I hear) your general doctor can prescribe you basic things like "exercise". It must be painfully obvious to so many doctors out there that the best solution to some problems is to get the person actually moving more but instead they have to beat around the bush with after the fact duct tape type medical fixes.

> I think we would be better off targeting that issue upstream.

I'm not sure I understand. You mean like banning certain foods?

To be consistent, we probably shouldn't be covering people who ride or drive vehicles. https://www.cdc.gov/media/releases/2014/p1007-crash-injuries...

This is one of the reasons for motorcycle helmet laws and maybe seat belts

The numbers are equal now with the new variant.

Given the topic of the post, it's funny you didn't mention one measure that does convince holdouts to get vaccinated: mandates.

https://www.economist.com/graphic-detail/2022/01/22/do-vacci... (https://archive.fo/g2vHF)

Mandates work up to a point. Eventually you will be left with a portion of the population that cannot be convinced and will not obey mandates.

Once you've reached that point, what purpose does the mandate serve? Nobody else is going to get the vaccines, so there is no public health justification for keeping the mandate around. However, what remains is the continual need to provide your vaccine status to your employer and in various other aspects of your daily life, which is a burden for vaccinated people too.

The United States has probably already reached that point, or will soon.

I saw that email. David Leonhart I believe, who is one of my preferred NYT journalists.

Something that was conspicuously absent from the paragraph regarding the unvaccinated vs. the vaccinated paragraph preceding it:

Risk stratification by age. When talking about the vaccinated, he calls out the "even in people over age 65".

There is zero question that vaccines reduce the relative risk for people under 65, however, it should be noted that the absolute risk for healthy people in this category is orders of magnitude lower purely by virtue of their age. Unhealthy people in this category should be vaccinated, of course.

Just an example of narrative bias creeping in, even from the relatively top-flight Leonhart.

Anyway, not disagreeing with you, just calling out a specific example of why the journalism on COVID has been, primarily unintentionally, misleading.

This totally discounts reinfections and long covid. A lot of people are going to die and get disabled.

Antibodies seem to not last very long at levels that prevent infection. This is a very severe crisis that doesn't end because people get tired. It's like being tired of a war and laying down your weapons and then getting surprised when you get overrun.

I agree - I am worried about taking hospital capacity claims at face value though.

From what I've seen, it was common for hospitals to report being overwhelmed even during flu seasons pre-covid. I wouldn't classify that level of 'overwhelmed' worthy of mandates upon society.

I don't doubt that during these periods of time hospital resources are strained in some way, but there's a difference between this routine level of being overwhelmed and a level where freedoms should be restricted from the general public.

I don't have a good model for where the line should be drawn, but I lean towards not imposing restrictions unless massive benefit can be shown beyond a reasonable doubt.

There are operations research PhD's who use decades of aggregate demand data in dynamic pricing algorithms for the purpose of revenue and queue management in perishable services, e.g. software for pricing of airline seats, rental cars and hotel rooms.

In countries with universal healthcare, price cannot be used for queue management, but the US isn't one of those countries. Did any hospital use queue management software to adjust pricing as a mechanism for demand throttling, due to limited capacity in 2020-2021?

In any case, if supply-vs-demand is both a policy driver and metric of intervention performance, we need public, detailed hospital capacity data for analysis and optimization of net societal costs vs benefits. Utilization of space and skills is eminently quantifiable and software already exists for demand mgmt.

> Did any hospital use queue management software to adjust pricing as a mechanism for demand throttling, due to limited capacity in 2020-2021

No one shops for healthcare in the US based on price, for three reasons. First, prices are unknowable in advance. Second, if you have insurance the insurance will fulfill their end of the bargain if you need to be admitted (i.e. they will pay as agreed upon in the insurance contract). Third, emergency rooms in the US are required by law to stabilize any emergent patient that walks in the door, which means anyone can go to any ER anywhere and get treatment.

Isn't there a new law, partially rolled out, that requires US hospitals to disclose the cost for a procedure or treatment in advance?

Hospitals don't comply with it. What is the government going to do, shut them down or fine them into closing during a pandemic?

Private companies have coopted the power over our government during this pandemic, and we have gladly given it to them in fear.

They're required to publish their prices, which results in giant PDF documents with thousands of different charge codes and prices. Its almost incomprehensible to analyze unless you're in healthcare billing. Plus, you'd need to know what services/medications/equipment you'll need before you even get to the hospital, which is pretty dang tricky unless you're a doctor yourself.

I was recently in the hospital for abdominal issues. How would I know what drugs they would give me? How would I know if they were going to give me some kind of scan? If they were going to give me a scan, are they going to use a portable machine or use a stationary machine? Are they going to need to use some kind of endoscopic scope? Will I need other things to assist with those scans (sedatives, contrast materials, etc)? Which blood work tests is the doctor going to order? Which urine tests is the doctor going to order? Are they going to order stool samples? How many samples are they going to need, how many times are they going to need to re-run tests? What if I get there and determine I need surgery? How should I have known I needed that ahead of time? What kind of surgery is it going to be? What drugs are involved in that?

Its not like you can walk up and see a board that says "INTESTIONAL DISTRESS -- $175"

> Its almost incomprehensible to analyze unless you're in healthcare billing.

Considering that hospitals seem (anecdotal evidence only) to fuck up their own billing codes like 20% of the time, I'm not even sure that's enough.

I briefly tried using the results of that, they're totally unnormalized, so even lining up identical line item charges is difficult. We have a deep learning language model that normalizes the language and lines up potential matches. But even if that works, it still doesn't get you the bill, because a single encounter includes a big batch of billing codes, depending on what the doctor tries to give you. And to get normal baskets, you probably want claims data. And the claims data providers we spoke to wanted 6-7 figures for a small dataset.

It's an incredibly parasitic industry, I've never seen anything quite like it. It's a pretty stark contrast to the largely altruistic motives of many of the healthcare professionals themselves.

Pricing is mostly fixed for at least a year at a time by contracts with payers (insurance companies), or by Medicare fee schedules. Hospitals have almost no legal flexibility to dynamically adjust prices based on demand.

A few of my friends are doctors. When it hits, it's hell. Here in Poland 300h of work during the month the infections are at their peak is not unheard of.

Dude go to a hospital in a populated area during this surge. My wife sat in the waiting room for 3 hours with SEVERE abdominal pain, DURING A PREGNANCY and was unable to be seen. We went home. If she’d had an ectopic pregnancy, she would probably not be here anymore.

My mom had to wait for ~ 5 hrs in ER waiting room in relatively severe pain. Was another 8-9 hours 'inside' just to be sent home. Years ago she'd had been admitted and stayed overnight to be on the safe side (older adult, known health issues, etc) but ... no room, over capacity, stretched way too thin.

To be fair I had exactly that same experience at the UCSF Emergency Room in 2017. Four hours in the waiting room, and then the only bed they could give me was against one wall of a busy hallway.

Yes its very common even in richest places. Case point #2 - Geneva, Switzerland has the biggest public hospital in whole country (HUG). They employ around 10k personnel overall, and Geneva is relatively small city (they call it the smallest metropole for a reason). There is no shortage of money or high tech equipment.

But if you came pre-covid during say weekend night and you were not clearly about to die, 10+h waiting time in emergency was not unheard of (wife was serving there for some time as doctor, those folks deserve some proper respect). Simply overwhelmed, not enough staff comprised mostly by junior doctors. Now they are properly good in diagnosing whether your excruciating pain is life-threatening or not, but it must suck big time to be on patient's side.

This is by far the biggest emergency in whole canton. Any private clinic or smaller medical centre will send serious cases straight there.

Its not something discussed frequently but that's just how things are, in one of the richest and well-organized countries in whole world. Don't expect much better experience if you have bad luck with timing.

Well, here in germany it is quite similar.

That means, I had to wait only a short time once, but that was after a dog bite to my face and it just looked horrible with blood all over it.

But the next time, with an deep open wound in my leg, which was actually way more dangerous, I had to wait quite some time, before they even checked.

I think I’d read your biography.

2012 checking in.

this describes many ER visits I've had, ones with my kids and ones I had myself. ERs are the worst possible places to go for medical care, except for near-immediate death. Over time, especially in the US, more and more people use the ER as first-line care (especially on the weekend).

Last week, my son had COVID (tested positive) but mild symptoms. At some point he says "I have a blue tongue, I don't remember having that before". Doctor and wife want to rush him to the ER and I say no. My daughter and I debugged it a day later (he had just taken a blue gummy pill, and somehow didn't think to mention that). What would have happened if we went to the ER? Shrugs from the doctor after sitting around the ER at midnight-5AM ("yeah I guess it's not cyanosis and it's gone now"), my wife and I have increased exposure to COVID in the ER, and a $3K bill for looking at a tongue.

I'm sorry about your experience. I do wish your wife would have received better care, but I'm not sure we can jump to the conclusion that the experience you had implies mandates and restrictions upon society are worthwhile.

Do you know that it would have been a shorter wait time during a period where the hospital wasn't overwhelmed? If so, how much shorter? Perhaps the medical staff were able to tell the signs of ectopic pregnancy in a way that allowed them put your wife lower on the triage priority list than you thought she should have been.

Does your area have any sort of restrictions? If not, how would the amount of time you had to wait be changed in a world where your area did have restrictions?

Even if you can show some benefit from the restrictions, are the benefits great enough to be worthwhile given the costs?

Restrictions would likely achieve essentially nothing right now. Reducing R from insane to merely very high might slightly flatten the curve, but not likely enough to make much difference. Restrictions on a level like China are a different story, but that’s not about to happen here.

Vaccines are entirely different story. They seem to have little effect on transmission (maybe enough to be useful after three doses but maybe not), but they seem to substantially reduce the number of people who end up hospitalized. So more vaccines would lower the curve, not flatten it.

(Take this with a grain of salt. Great data on vaccine efficacy in the US is a bit hard to come by, and I haven’t run the numbers.)

I had an extremely traumatic accident a week ago and came into a major city hospital as a level one trauma patient.

I came in with absolutely no wait..ambulance directly to a trauma bay, no waiting, no clothing, no nothing.

After about six hours they figure out I was not going to die and was relatively okay. Okay here means two broken legs not “walking around”. Half of the patients at this hospital had covid and I have a five month old at home who isn’t vaccinated (obviously).

Once I got admitted to the trauma floor for a couples days it was like I didn’t exist. The staff seemed totally overwhelmed and it took hours to get some simple things like water. Without visitors, a bag of belongings got delivered by being isolated in a chair well out of my limited reach. Took me eight hours to get my laptop from that bag. I was okay with that because I wanted to interact with as few potential covid vectors as possible but wow.

I think, from my experience there are a couple of things happening:

1) staff are overwhelmed to day with the ratio of patients to staff. I can’t comment why but the nurses I saw weren’t sitting they were constantly moving.

2) staff are demoralized and frustrated. You could hear it in their voices and tone and body language. They were trying but grumpy.

3) shit rolls down hill. Drs. (Save one angel who talked with me for 30 minutes about life) where in and out for brief profunctory conversations that had no communicative value about what was

They need more nurses. And like everywhere else it seems no one is willing to pay them more or treat them better. We can pay execs millions with no qualms and no evidence it works. But as a patient having the worst day of my fucking life, I interact with front line staff and they are out there getting run into the ground and being treated like shit for it.

I’m so sorry for your wife, I was so lucky I had a different experience. But the shared thing, I think, is that the American medical system is going through a full and complete collapse and no one with the power to change things is willing to do anything.

I’m terrified.

Is the explanation simply that so many nurses are being forced to isolate with Omicron? Since even vaccinated staff can still spread it, so they still take the tests often, and isolate for 2 weeks if positive.

This has been relaxed greatly in 2022 at many hospitals. Most are isolating only for 5 days now under the new CDC guidelines, and some only if the person is symptomatic.

"Is the explanation simply that so many nurses are being forced to isolate with Omicron?"

A explanation why people are frustrated, who work hard and intense, take all the risk - but only get low pay?

Exactly, "you've been a nurse for 30 years, you're 60yrs old, you tested positive for COVID and you still have symptoms, but if you don't come back into work after 5 days (without pay) you'll also face punishment when you return". Of course, if a patient get's COVID while under your care (and symptomatic) and chooses to sue you, "you're on your own babe!". Also, "it is mandatory that you get vaccinated/boosted, but also come into work the next day or you won't be paid and it will count as one of 4 unscheduled days off per year before termination".

And people wonder why nurses are pissed off?

We focus on human causes because we connect to them better. And because for many many people these are the concrete things that can understand when I’m a stressful situation. Abstract problems like decades of “capacity management” “workflow improvements” and “right sizing” are so abstract they don’t resonate with someone who is standing in an er in pain. They aren’t dumb they are stressed out. Stress is basically fight or flight…it makes us stupid.

Stress is why I made the firefighters put in safety glasses and got angry at them that I couldn’t find my glasses. Both while trapped under a literal oak tree

I would suggest the explanation is similar to the supply chain.

In the interest of profits we have wrung every ounce of every part of the system that runs healthcare. And at the end of all of those elements are human beings. Such systems are unstable. They work but are not fault tolerant at scale because no one ever really looks at the whole system they just look at a part of the system they control. I’m okay if healthcare is more like an a320 as opposed to an F22 because the F22 needs 50 man hours of maintenance to fly and the a320 does it’s thing in a much more germane fashion. Jwst can have 184 single point of failure actuators because it’s the bleeding edge, healthcare needs to have -184.

The problem is we see humans as humans. A machine breaks, it is not perceived as having agency, autonomy, or humanity we don’t blame it. When people die waiting in an er or healthcare personnel are short with patients or quit in droves there is a person whose actions and motives we can question and blame. We understand that experience slightly more and can find ways to question it.

It isolates the problems from view. When no one’s looking at the whole system (and being listened to) no one can shift course. It was not efficient to build capacity for truly abnormal events, so it didn’t make financial sense For anyone to do so. And now nurses are testing and isolating…and. Not just. And.

Meanwhile my friend who is a nurse in the UCLA hospital complex says they’re so understaffed because they let so many people go/nurses retired or quit that all nurses are allowed to come to work if they’ve tested positive but their symptoms are improving

This is a perfect sign of what I’m talking about.

They fucked around with these people for so long that when they need them, actually need them, they aren’t there. They rolled the dice in an assumption that they held sufficient economic power to control them. Now they are left exposing patients to covid as a necessity to prevent their operations from completely ceasing.

That is failure by any other name.

I wouldn’t blame the hospital too much — they were responding to the economic incentive of lockdowns and lack of actual patient pressure by closing entire wings of the hospital and laying people off. I.e there wouldn’t be this nurse shortage at the hospital if the lockdowns never happened.

Coming from the UK and Italy - 3 hours is nothing. If you're about to die they'll send you to emergency, otherwise you'll have to wait hours. If you're unhappy, pay for a private insurance and get decent service.

Actually I had to go to the hospital (not covid) and it was almost deserted with reception coming to check the desk they were supposed to be attending half an hour after we were supposed to be there. People generally went less to the hospital because of the pandemic (which causes other problems).

IDK if it's gotten worse, but circa 2004->2006, my experiences with the NHS were nothing but pleasant. I mostly dealt with northern hospitals and GPs, but it was pretty much in and out. Appointments didn't take long, we were in and out in almost all cases.

Where can you find a private A&E in the UK?

Ugh, I'm so sorry you had to go through that. For other folks reading this: yes, three hours doesn't sound like that long a wait. But I'm willing to be those felt like the three longest, most stressful hours of your life when your mind is racing with possibilities and fears about the future of your wife and/or baby.

If it's anything like my Dad's recent trip (I went with him—kids who haven't had to deal with hospitals, always make sure someone else is with you to watch out for you if you have to go in, there is a good chance you'll have a bad time if you don't) the waits are super-long even for people who are obviously in a lot of distress, and they also don't communicate at all about where you are in the triage pool, so you're looking at people who you overheard saying they've already been there three hours when you got there, and they do seem like they need help, and you're like... how fucking long am I going to have to wait? And there's no answer, which I get, but if they could at least tell the ones who definitely aren't getting in "you're low-priority and we have no hope of seeing you today, we're just waiting until you get frustrated and leave" (this was the end result for like 50% of the people in the ER that day, from what I could tell, some of whom really did seem like they needed to get in) exactly that, it'd relieve some stress to know you're not in that group. The lack of communication bordered on abusive, for that reason, and I get they can't give an exact wait time, but at least saying "yes we do actually intend to get you in at some point" would be nice.

Similar experience in my family, father-in-law spent 18 hours waiting in a ER. Needs a biopsy and imaging which are taking weeks to get done because, as several doctors have admitted, the hospital is both overwhelmed with Covid patients and short-staffed due to infections among doctors and nurses.

I know a lot of nurses and have been following what's happening in hospitals. It's complicated. Here are a couple things I've learned...

1. Many hospitals are under staffed. Schools that produce nurses have stayed steady state while demand has increased. This was before the pandemic. During the pandemic many nurses left due to mandates, being treated poorly (by hospital mgmt and people in the hospital), being overworked during shortages, and more. This has all made staffing a huge problem.

When hospitals don't have the staff they close beds down and can't operate at full capacity.

Hospitals that used to only hire RNs with bachelor degrees and wouldn't consider an associates (it's the same amount of schooling in the nursing portion) are now trying to hire LPNs.

2. Some emergency rooms are seeing a crazy number of people. More than usual. This is for a variety of reasons. COVID is one but also people putting off having things treated so they are now emergencies is another. Couple this with the staffing shortage and it's even worse.

Hospital capacity is a technical problem and can be solved by building more hospitals, hiring more workers or changing the roles to allow nurses to handle more issues. The hospitals are meant to serve people, not the other way around. Covid didn't arrive overnight. If there are capacity issues they should be addressed independent of everything else.

3 hours? In the best of times it's an 8 hour wait before covid.

Where has this happened to you? I've been to the ER 6 times in the US and never waited more than 2 hours (pre-covid) in New Orleans, San Francisco, and New York.

The time I had to wait 2 hours in SF, with a kidney stone was not pleasant, but it was at 3 AM at a hospital that does charity for the homeless, so that was a bit exceptional.

Busy ERs are not unique to covid. I've had many experiences with multi-hour ER waits pre-2020

The thing they don't always mention is that hospital capacity is always close to being overwhelmed, by design, because otherwise you're sitting around with a large amount of extraordinarily expensive idle hospital capacity. A small change is enough to go from "almost full" to "over capacity."

The seemingly obvious thing to do would be to build some temporary capacity specifically for COVID patients. We've had quite a long time to do this now so I'm not sure what's preventing it. Maybe it's caught up in that thing where captured regulators are gatekeeping medical certifications to maintain labor scarcity or some such thing?

This is a hard problem, because you do not only need beds, but also humans tending to the patients.

And while you can just build another hospital if you have the cash - you cannot just build another doctor, if you need one.

> you cannot just build another doctor, if you need one.

So take your pool of existing NPs and give them a temporary promotion.

Or anything like that. It's an emergency, right? So what about people in medical school who have yet to be licensed? Grab them and have them do stuff. Retired doctors? Go get them. Whatever. It's an emergency. Get creative. You don't need things perfect. You need things to work. It's an emergency. Every second you aren't focused on solving overwhelmed healthcare is a second you are stealing from people through lockdowns.

I really don't understand why people are completely incapable of using their imagination to solve "hospitals over capacity". The only thing I can think of is perhaps hospitals have never actually been overwhelmed because if they were... we'd have fixed the problem already.

"So what about people in medical school who have yet to be licensed? Grab them and have them do stuff. Retired doctors? Go get them. Whatever. It's an emergency. Get creative"

Would you prefer a student, or a seasoned doctor to decide on you - if you are in a critical condition in the hospital?

But sure, I would take any advanced med student over being ignored while in need of care. And since this is not rocket science, here in germany all the retired doctors, trained military medic, ... have been registered and contacted in the beginning - to be ready if needed, but as far as I know, it was not made use of (much?).

And YES. It should have been invested massivly in healthcare in the beginning of the crisis and it was. But mainly just in infrastructure it seems. Or high level corruption.

Because today there are de facto fewer hospital beds avaiable, than in the beginning - because apparently it was not invested enough in the people. The ordinary health workers. They are leaving burned out.

For a short amount of time, you can enlist lots of reserve stuff so to say. But not for years.

It’s an emergency, remember?. It doesn’t need to be perfect. It’s an emergency, remember?

Find ways to make it work. Fire the naysayers. Figure it out.

Or alternately accept there never was a problem with healthcare capacity because if there was, we’d have demanded it to be fixed already. Because any reasonable person can state it can and should be fixable. Problem is too many people lost their mind and forgot what it meant to be reasonable.

"Or alternately accept there never was a problem with healthcare capacity because if there was, we’d have demanded it to be fixed already"

Strange, that I head many demands of fixing the broken healthcare system way before covid, though.

When it would have been working right - it would have been possible to scale it up to the needed size.

> The thing they don't always mention is that hospital capacity is always close to being overwhelmed, by design, because otherwise you're sitting around with a large amount of extraordinarily expensive idle hospital capacity. A small change is enough to go from "almost full" to "over capacity."

If that was true, it would not be okay. There needs to be enough capacity to handle unpredictable spikes in load. This can be described using the same sort of queueing theory that anyone legitimately operating at scale needs to worry about: you don't just track average latency, but also track tail latency.

Luckily, emergency hospital buildings are not "always close to be overwhelmed." Their staff is always close to being overwhelmed, but the buildings are not. Instead, they maintain a reserve capacity of temp nurses, who get called during brushfire season and New Year's Midnight to handle the unusually high load. They are paid well by the hourly wage, but don't get any benefits, and either have a second job or a retirement plan to carry them over the rest of the year.

Only this time, they were never sent home. And, since some of them are being forced to quit their jobs, they're demanding the benefits package, which is getting expensive.

Edit: and, of course, this all goes to crap once a brushfire happens on top of the pandemic

> The seemingly obvious thing to do would be to build some temporary capacity specifically for COVID patients.

Many states did exactly that back in march of 2020. Most of these temporary facilities were closed virtually unused.

> I'm not sure what's preventing it

It takes time to to train doctors and nurses, they don't grow on trees. Opening immigration for these professions could be a short term solution but getting a US license is complicated too (maybe rightfully so).

Can you give me an example of a scenario where you would be in favor of restriction like the ones that have been implemented?

2018: "Hospitals Overwhelmed by Flu Patients Are Treating Them in Tents"

https://time.com/5107984/hospitals-handling-burden-flu-patie...

This pandemic has been extremely hard on many healthcare providers. But hospitals in many areas were routinely overwhelmed during winter respiratory virus season in previous years. They dealt with it as best they could, and we didn't impose mandates or restrictions on the rest of society.

https://peterattiamd.com/covid-19-current-state-omicron/

Covid has been something like ten times as deadly as the flu. I imagine those hospital beds put way more strain on the system as a whole than a bad flu season (see: ventilator sharing). I think any human with a shred of empathy for their tribe would agree, that this level of misery warranted collective action on the level of our response to measles, mumps, rubella, tuberculosis, diphtheria, pertussis...

And though I really hope it's the case, I've heard no news yet that Omicron will be the last significant variant.

Did you actually listen to that panel discussion I linked where several leading physicians explain what's been happening and the mistakes that have been made?

Given the amount of time between when you posted and when I replied, it's safe to say I hadn't listened to the three-hour conversation between two physicians and a professor. Initially I scrolled down, was put off by the stack of text and images/embeds with no clear organization, skimmed the Cliff's notes, and failed to understand how it correlated with "we didn't impose mandates or restrictions on the rest of society."

They make several good points about policy moving forward and vaccinating children, but they were disregarding Omicron before we even knew much about it. Their general position aged like milk, now that there are more people in the hospital with Covid than at any point in the pandemic. They complain about Fauci holding rigid positions, while my science-illiterate family complain that the rules keep changing/are confusing. None of this addresses the fact that masks and vaccines are consistent with past policy in America and have been more effective than nothing, at least as far as people complied, or that comparisons to the flu are a bit of a stretch.

Actually, their general position has aged very well and has been proven largely correct. They consistently recommended vaccination for the majority of people with perhaps a few very limited exceptions. You should listen to the follow up panel discussion in which noted infectious disease expert Dr. Monica Gandhi explains why mask mandates are bad policy.

https://peterattiamd.com/covid-part2/

https://profiles.ucsf.edu/monica.gandhi

I work with a lot of clinicians.

Normal flu seasons don't leave them with 1000 yard stares.

New variants are now emerging every 30 days. Good luck with that plan. Why is the concept that life finds a way so hard to accept? We're getting our asses kicked by this thing.

But I would agree with you if the variants would just stop creating themselves. But it doesn't seem like any immunity really lasts. So this leads to repeatedly infecting yourself with variants as they emerge (1 in 6 chance of a bad outcome of long covid or worse), become a bit of a test rat for the latest vaccine, or some combination therein.

I'm hoping we eventually get a vaccine that transcends the evolutionary range of this thing. And then we could do exactly what you're suggesting. But that's a science project and you never know how those will go.

The main concern I have is will we be a nation crippled with PTSD and long-term healthcare concerns when this is finally over with?

> I'd say the answer to that should be determined by the hospital capacity. If a region has sufficient hospital capacity that it would not be overwhelmed by the increase in COVID cases among the unvaccinated go ahead and lift most restrictions.

Having anyone's freedoms dependent on available hospital capacity is a terrible way to run a society. Note that these freedoms were debated and won in an era where medicine was terrible.

I’d like to know that if I have a heart attack or get hit by a bus then I’ll have access to top quality healthcare —- not burnt out understaffed hospitals.

Sharing limited resources is a major role of the government, and managing hospital capacity seems to fall under “promote general welfare” to me.

My $0.02

It definitely is, but they’re addressing it from the wrong end.

If the pandemic could be fixed by the government managing individual behavior we’d be done with it by now.

Instead the government should be focused on expanding highly covid specific care capacity. That is by far a better way to spend the covid relief money than distributing it to sustain a nebulous lockdown.

As far as I understand from talking with doctors, at no time within the last year have hospitals been at maximum emergency covid capacity, as in hospital beds in the hall ways, cafeteria, etc. This tells me that we are close to the amount of beds we need, and it would be feasible to build out additional capacity quickly, relieve the strain, and get back to normal.

> Instead the government should be focused on expanding highly covid specific care capacity. That is by far a better way to spend the covid relief money than distributing it to sustain a nebulous lockdown.

This is not something the government can do. It's not something anyone can do. What you're asking for (though you may not know it) is for their to suddenly be more nurses and medical practitioners. That's not a thing that can just suddenly happen, or even happen with 2-3 years of prep. You need a decade to actually functionally increase the supply of nurses and specialists.

Now there are lots of short term fixes the government has done, such as activating the national guard in locations (to reduce non-medical load on nurses) and hospitals can pause elective services to free up space and time, but that has huge downsides since it means people get life saving nonemergency surgeries like cancer removal.

> You need a decade to actually functionally increase the supply of nurses and specialists.

Similar things were said for the vaccine.

There is so much gatekeeping in the medical community that is not totally necessary. A doctor or nurse that immigrates to the US from a different country which has better health care than we do cannot practice were without jumping through tons of hoops. That is a pretty straightforward way the government – in a state of national emergency mind you! – could instantly and functionally increase the supply of nurses and specialists.

Are you suggesting that people rely on unprecedented medical advancements as a policy solution?

:lol_sob: Why can't we have nice things mrcrumb1?? Hahaha.

But yes. Yes, I'm advocating that people be just a little bit more open minded and flexible about this issue and, ideally, the so many others like it. Sometimes it's quite depressing to consider the giant gap between how society functions today and how it could function if it operated by different rules.

Isn’t the shortage of healthcare workers world wide? How does reducing the friction of moving into the US do anything but shift the problem around?

Consider the already immigrated medical professionals living in the United States right now that are unable to practice because of the above described licensing issues.

To give a couple examples. If a nurse moves to the US and learns he can't practice without going back to medical school, he may opt instead to work a different job and defer his medical career. If a doctor moves to the US and is in the same position, she may choose to remain a stay-at-home mom and let her husband be the primary breadwinner.

There's also the arbitrage aspect here: globally we may have a healthcare worker shortage, but it may be more severe in one place than another. Reducing the friction involved in moving the workforce could allow workers that are in relative over-supply to move to an area with relative under-supply, improving the overall efficiency of the system.

> Consider the already immigrated medical professionals living in the United States right now that are unable to practice because of the above described licensing issues.

New York and New Jersey did this. In early 2020 (so two years ago). Despite this, they ran into extreme shortages. So now that we've done that, what next?

> If a doctor moves to the US and is in the same position, she may choose to remain a stay-at-home mom and let her husband be the primary breadwinner.

And is she just going to suddenly start working if the licensure requirement goes away? Some might, but a lot won't because they are already parenting. This is what I mean by these policies require years to have an impact.

From what I’ve seen the current shortages are primarily due to lack of sufficient pay and firing nurses who don’t want to get vaccinated. Additionally it seems like current nurses are over qualified for covid care.

How long would it take to train someone from a nursing adjacent field to treat 95% of what they are likely to see when treating a covid patient? Is anyone even asking that question? If not, why not?

It seems like we’re willing to take drastic action when it comes to mandate public behavior, but not when it comes to reforming bureaucracies, processes, and regulations.

> firing nurses who don’t want to get vaccinated.

I would love to see stats on that. From what I can tell, the actual percentage of medical practitioners quitting due to vaccine mandates is very small. My family work in the medical field in a red state and the set of people actually quitting over the vaccine requirement (as opposed to making a lot of noise and then deciding unemployment is unattractive) is tiny, but this may not be representative.

> Sharing limited resources is a major role of the government, and managing hospital capacity seems to fall under “promote general welfare” to me.

Sure. It's a pretty delicate balance between individual liberties and preventing bad collective outcomes, though.

If you lock down 340 million people for a week-- maybe the net effect is stealing 3.5 days of life's "enjoyment" or "quality" from each. That's 3.3 million years of quality life taken.

You need to save 20 years of quality life for 165,000 people to break even. In the first wave we probably exceeded that benefit, but it's highly doubtful any subsequent time passes that bar.

And, IMO, if there's ever anything close to a "tie", you need to favor individual liberty.

Maybe making people mask "costs" 0.2 days per week-- much smaller cost, but also a smaller effect. I think it's still justified, but only barely... It won't be soon.

Okay, then instead of punishing the general public, how about they go build more capacity? They've had 2 years at this point and they are still freaking out about "overflowing hospitals". It's not fair, ethical or moral to push mandates on citizens at this point.

It takes a long time to train doctors and nurses and other relevant staff. Worse, the hard working conditions those people have been enduring since 2020 has led to a lot of burnout and attrition.

That sounds like excuses. This thing is an emergency, right? Well, fix it!

Punishing the public with these awful mandates because “it’s too hard” is a huge failure of our government.

Are you opposed to laws mandating seatbelts or criminalizing heroine?

Not OP, but I am. I don't mind laws mandating that cars HAVE seatbelts. But I think it's your choice if you want to wear them.

With Heroin, I'm not sure criminalization really had much affect at all on the percentage of heroin addicts. And I'd bet that it had less effect than the rate of prescriptions for synthetic opiates did.

what about laws mandating cloth triangles on your face^H^H^H^H chest at the beach?

what about laws banning second-hand smoke indoors?

Yes to both of those things. The government shouldn't get to take money from me because I endangered myself.

You think not wearing a seatbelt only endangers you?

Especially since hospital capacity is induced scarcity due to government regulation and the AMA.

Or firing doctors and nurses who recovered from Covid and declined vaccination.

We'd be having the same shortages right now even in a completely unregulated free market hospital system. A free market isn't going to build and maintain a bunch of extra capacity that goes unused except during once in a hundred year outliers like major pandemics.

All that an unregulated free market would change is how we decide who gets treated when there isn't enough capacity to treat everyone.

Having anyone's freedoms dependent on available hospital capacity is a terrible way to run a society.

So is letting people die from otherwise treatable injuries and infections so someone else can enjoy their "freedom" to ... you know what I'm driving at.

Yes, exactly. The world is dangerous and full of risks.

Freedom is literally worth sacrificing lives for. This is a fundamental founding idea of the US.

Other people's lives, you mean.

Yes exactly. When the lock down and mask mandates resulted in neuroplastic infants and toddlers not seeing as much lip and face movement during critical speech and socialization age (and in many case, daycares and schools being shut down resulting in less critical socialization), you sacrifice younger children in the hopes some others will be saved.

So we sacrifice other lives (young children) so our own adult lives can perhaps be saved.

Also consider that young children are the demographic least affected (symptoms and death) by COVID. It was obvious a few months in, but these debilitating policies continued.

So we sacrifice other lives (young children) so our own adult lives can perhaps be saved.

The lives of their grandparents (and of older folks not related to us), you mean. You know, the ones actually the most vulnerable to this epidemic.

I agree that the choices are difficult, no matter what we do. But there's no need to distort the basic equation, and make this particular choice appear to be something plainly selfish (young and mid-life adults snubbing the kids to cover their own asses) when it plainly is not.

No I don't mean just our grandparents. I benefit way more from any reduction in exposure to covid than my kid does. The difference between a 2 year old and a mid 30s person is significant.

The point is it's misleading to say "so our own adult lives can be saved" when that's not the main motivation for these policies.

If the health system becomes incapacitated, and we have to push people out of ICUs to make way for the "freedom fighter" who won't vaccinate (which is already happening in some areas), then everyone suffers -- not just "mid 30s adults".

So you want "freedom fighter" (whatever you consider that to be) to sign their death warrant? How are you going to keep them out of the hospital? I'd happily sign a death warrant today if it means the end of this tired argument of people complaining that people seek healthcare when they are ill.

>If the health system becomes incapacitated

If the health care system isn't working, then we need to look at expanding healthcare; perhaps by eliminating a lot of the regulations that drag it down. You don't have the right to force someone to make sure there are beds at a hospital. I don't think the answer is compelling non-consensual activity in private business such as masks.

------------------

>It's not that they "seek healthcare". But that they expect to have critical resources like ICU beds available to them (and therefore, denied to others) so they can enjoy their "freedom" (to ignore common sense) -- that folks take issue with.

You're seriously complaining that when someone seeks healthcare they are using a bed? You know how many people using beds are there for non-essential activities (motorcycling, roofing a non-essential shed, snake bite because they went hiking, whatever). Should we outlaw any non-essential activity that could send you to the ED?

It's 'common sense' to me that my (almost) 2 year old's speech development will be harmed if she can't see me speak (and at least one initial study suggests that is correct), so I don't wear a mask anywhere when she's with me nor do I enter establishments that require me to. Maybe that makes me a 'freedom fighter' for my kid's development.

we need to look at expanding healthcare;

Not happening in the short term.

complaining that people seek healthcare when they are ill.

It's not that they "seek healthcare". But that they expect to have critical resources like ICU beds available to them (and therefore, denied to others) so they can enjoy their "freedom" (to ignore common sense) -- that folks take issue with.

> Not happening in the short term.

Why not? It's an emergency. It's completely possible to fix this short term in a way that lets us move on without all these socially toxic and corrosive restrictions. Probably would cost an order of magnitude less, even.

It's completely possible to fix this short term

That's not what people in healthcare say. But hey, you can say whatever you want.

Because the front-line people in health care don't have the legislative or fiscal power to change the system they're working in. We need systematic update to healthcare system, not to blame the "people in healthcare" which are the least of all the problems.

Naw. This is an emergency, right? You don't need any of that. You just need people that are trainable enough to handle covid surges. Medical students, nurses, hell maybe even veterinarians... use your creativity.

If hospital capacity was an issue caused by covid surges, we'd have fixed it already.

Letting people not normally licensed to expand their scope and authority to practice on humans is a regulatory and legislative challenge. Healthcare workers badly need cooperation of regulators, legislators, and fiscal stakeholders of the industry to un-fuck the industry. Also capital can be better directed towards results rather than bloated administrators in a less regulatory burdened market.

And lockdowns, forced masking and vaccine passports aren’t a “regulatory and legislative challenge”? Really?

This is supposed to be an emergency, right? Give me a break. Covid specific healthcare capacity can easily be scaled up with the amount of resources we are pouring in this dumpster fire. Figure it out.

Agree on all points.

I wasn't, by even the remotest possible interpretation, "blaming people in healthcare".

So I find that a very, very weird implication for you to make.

Apologies, blame is probably too strong of a word.

I interpreted you were holding them accountable to answer the question of expanding/fixing health care in the short term. Clearly their answers are going to be in the context of their limited power to change the whole system without the cooperation of others. They need the cooperation of both the capital holders / owners of the health care industry as well as regulators and legislators. I think when you answering this question, they are answering it within the context of working within their current constraints, which can be quite tight.

To say they are the one to answer the question, in my opinion, is to shift the onus on them to answer it. In fact we need the feedback of these workers, and they're critical in us solving current problems. They need our cooperation. But I think framing the question as something they're supposed to answer, as you have done, narrows the focus on people not to be blamed for the constraints that hold them back and thus force an otherwise unreasonable answer.

No, just that they definitely would not agree with your view that the current system limitations are "completely possible to fix in the short term". For the simple reason that the most critical resource it depends on (trained people) is finite and highly inelastic. And is already contracting (i.e. they're are already starting to burn out and leave the profession).

Along with the second most critical resource that we expect them to have for us: empathy. Especially for those who won't vax.

This is an emergency. Find a way. It isn’t fair to blame the public and then force them into some dystopian “new normal” for years because a bunch of highly paid people can’t figure out how to fix emergency Covid hospitalization capacity.

If somebody says it isn’t possible, fire them and find somebody who can figure it out. It’s a fucking emergency, remember? It’s completely possible. Saying otherwise is an excuse. Figure it the fuck out.

Zero excuses.

(Or the more simple answer is there actually isn’t a problem with hospital capacity because otherwise we’d have fixed it. You know… because it is something that could be fixed… with money alone)

You're seriously complaining that when someone seeks healthcare they are using a bed?

No, not when they "seek healthcare". But when they go out and inevitably get themselves covid because they think they're making bold, individualist statement (as many of these people apparently do think) by not masking and not getting vaccinated.

I think you are making an important point here that I would love somebody to answer. Why is covid different than riding a motorcycle? Nobody is required to ride a motorcycle. We know for a fact, it's more dangerous than driving a car as a mode of transport. It's a person needlessly putting themselves in danger purely for their own reasons. Why is there no talk of denying a hospital bed to them? The same applies to obesity and a 1000 other things.

Why is covid different than riding a motorcycle?

Would you agree with this analogy:

"Going out into crowded public spaces unmasked and unvaccinated ... is not unlike riding a motorcycle without a helmet. And with a busted taillight and bad brakes too, because you're also putting other people at risk."

The mask is like having disc brakes. No mask is like having drum breaks. Walking up to someone and coughing in their face is no brakes. You may be more likely to save a life with the disc brakes, but I admit I occasionally ride bikes with drum brakes instead.

Being vaccinated is a strong tail light (having already had COVID before may be a strong tail light too). Being unvaccinated but never caught COVID is a legal but moderate tail light. Being deathly ill but sneezing on the produce is no tail light.

Wonderful, so I take it you are advocating that anybody who drives a motorcycle with no tail light and drum brakes should be left to die outside the hospital if something happens? Would that be an accurate assessment of your position?

Not at all.

I would not agree with that analogy regarding masks. Nor, I suspect, would noted expert on infectious diseases Dr. Monica Gandhi. I recommend you listen to her recent statements on the subject.

https://peterattiamd.com/covid-part2/

https://profiles.ucsf.edu/monica.gandhi

I'm not sure what you're driving at, because she clearly doesn't think that "masks" as such are ineffective - just the cloth/surgical masks -- she advocates N95/KN95. Which of course are what everyone should be wearing now (in close public settings), by this point.

Also, the discussion in that podcast is a bit strange (for a bunch of reasons). For one thing, it seems to reduce the "mask question" to one of individual (or close family) risk -- "If I'm comfortable with the risk level (as affects me and my family), I should be able to decide whether to wear a mask or not (paraphrasing)" -- and completely sidesteps the community risk issue (especially in crowded public settings). Which is very different, and is of course what mask mandates (whether you agree with them or not) are designed to address.

For another, it dwells a lot on the "shame" and (what they think of) as quasi-religious aspects of mask wearing - this idea that people expect others to wear masks because those who do not are "unclean". Which may be what some people think, but to suggest that this is what most people think or that this should be part of the policy debate is just ... werid.

You choose to leave your house. Isn't that your choice?

Ahh yes because everyone knows heart attacks, strokes, aneurisms and burst appendixes never happen in your own home.

And many people, given the choice between money or freedom, choose freedom, even if it can make them poor. Heck, Snowden chose to relinquish wealth to defend everyone’s liberty.

I think it's less about freedoms and more about rights

Is it a person's right to fly on an airplane without wearing a mask? I'd don't think so

Is it a person's right to decide what medicines they take? I'd say yes, definitely

You can take away freedoms in the interest of others, but not rights, in my opinion. The policies I've seen are pretty fuzzy on this distinction

Is it a person's right to decide what medicines they take? I'd say yes, definitely.

Note that the mandates in question (those in Quebec) don't force you to get the vaccine.

They just say that if you don't, you no longer have an inalienable "right" to shop at Walmart.

I hate this casting of the issue as "freedom". It's absurd.

My "freedom" to live because I have a medical issue but cannot get treatment will be severely impacted if hospitals are overrun with patients and worn out workers.

See, we can both play the "freedom" game.

We don’t owe you the right to live with a deadly disease. You cannot mandate others to perform actions just so you can live, if you wouldn’t live naturally.

We do it all the time. You are mandated to get a license to drive a car so that you don't have a higher chance of killing people.

Not on private property you don't need a license. Similarly, a business on private property should be able to dictate a mask or vaccination isn't required. You shouldn't have a right to dictate what kind of consensual conduct happens on private property.

In Texas, I can get hammered, drive a car drunk without a license behind a fence 10 feet next to the highway (property-side). And there's not a damn thing you can legally do about it, despite any fears I may plow through that fence. The suggested (stricken) OSHA mandates were basically forcing non-consensual penetration, or lose your job.

---------

>That's not totally true. This Texas-based DWI defense attorney says:

You conveniently skipped the top of the page where it explicitly says DWI in Texas must occur in public (a fenced in private property is almost never considered public). Sure a cop can probably find a reason to arrest you no matter what you're doing, if they want to.

>Obviously you should be able to be unvaccinated only on private property then...

Most businesses are on private property. Given that the fourth amendment protects us from handing over documents except on subpeona/court order or probable cause of crime (a few states do compel revealing your identity, although you don't have to reveal your age if the crime is age-related such as alcohol violation), and you can't tell by looking at someone if they're vaccinated, it would essentially be meaningless to make it a crime to be unvaccinated while walking to work for instance. Controlling vaccination is far easier on private property, where you have no freedom to travel and can thus be stopped and checked before entering.

That's not totally true. This Texas-based DWI defense attorney says:

> The police can arrest you if they have probable cause to do so for driving under the influence. Even if you are operating your motor vehicle on what you believe is your own property, the police still may have probable cause to believe your conduct is a threat to yourself or others. Therefore, you should not assume that you are completely safe from arrest or conviction if you are driving drunk on your own property. - http://jackpettit.com/blog/dwis-and-drunk-driving-on-private...

> The suggested (stricken) OSHA mandates were basically forcing non-consensual penetration, or lose your job.

Is that really so different? If you need to drive for your job and try to do so without a licence you'll lose your job too. Conversely, if you're in your own home then nobody is going to make you wear a mask (well certainly not the government anyway).

Obviously you should be able to be unvaccinated only on private property then...

Driving is a bad example. Almost any other public safety regulation is a better example; most of them apply to private property. Almost never do private companies get to "choose" to follow safety regulations. McDonalds must follow food safety regulations, construction companies must follow building codes, industrial companies must follow occupational health and safety standards, aircraft operators must follow FAA regulations, etc.

Being forced to wear a mask or vaccinate could be a public health risk:

  - Infants/Toddlers (mask): linguistic development health risk
  - Adults (vaccine): risk of anaphylaxis, TTS, GBS, Myocarditis, Pericarditis

Individuals should weigh these risks and determine whether it makes sense in their particular scenario. None of McDonalds food safety regulations I'm aware of involve penetrating a human with a needle.

Also the driving thing was somebody else, I just responded to it. If you didn't like it, it would have made more sense to have told them it was a bad example instead of me. It wasn't my example.

Hahaha, in a worldview that has little much more to aspire to than the acquisition of wealth and material things, I guess it's not a shock that people start looking at each other in a legalistic mentality as small, poor, not so well protected corporate entities such that we are fashioned in the image of a company. All of the microbes that live in our guts are our employees, our mind is the CEO sitting in the brain as its office, the other organs hosting other managers.

You give Texas as an example; but important for your example, its government disincentivized and removed the rights from companies, private property, and small local governments to require masks, vaccines, or reduction in capacities.

Can you point to me where it was made illegal to require a mask on private property in Texas (other than perhaps for certain disabled persons per ADA)?

My understanding is masks mandates were only banned in places like public schools, where the owner is the public thus the individual public student has the decision to wear a mask or not. I would certainly disagree with this sort of control on private school, although I might add it could be a public health risk to mandate masks in school as it could harm the linguistic health of some young children developing language skills.

I believe you're correct on masks, only applying to smaller local government and not private property.

Employers were banned from vaccine mandates (even on their private property).

Court rulings were that these were abuse of the state government on smaller local governments and private entities.

There's often more than one statute that prohibits a certain proscribed activity. You might not be liable under the Texas Vehicle Code for DWI for drinking and driving on a non-public highway; but depending on the circumstances, you could be liable for under the Penal Code for reckless endangerment (section 22.05(a)).

Can you cite a case where someone has been convicted under 22.05(a) for driving drunk on private property without actually having hit anyone? You can charge whatever you like, a prosecutor/grand jury can "indict a ham sandwich." Texas still has a sodomy law on the books too (although enforcing it has been stricken by supreme court).

Reckless endangerment does not require you actually hit anyone. Where did you get that from?

Texas Penal Code 6.03(c): "A person acts recklessly, or is reckless, with respect to circumstances surrounding his conduct or the result of his conduct when he is aware of but consciously disregards a substantial and unjustifiable risk that the circumstances exist or the result will occur. The risk must be of such a nature and degree that its disregard constitutes a gross deviation from the standard of care that an ordinary person would exercise under all the circumstances as viewed from the actor's standpoint."

And what does the now-void sodomy law have to do with anything?

You're also mixing up indictment with conviction.

At any rate, you don't have to have a fact pattern that precisely matches a previously-recorded case to think "gee, maybe this is a bad idea and puts me at risk of violating some law." Most cases involve fact patterns that are at least somewhat different from previous case law. A prosecutor's job is to make their case based on the facts, the law, and the ability to draw parallels from other cases.

I'm gonna ask the question again, since you completely dodged it: Can you cite a case where someone has been convicted under 22.05(a) for driving drunk on private property without actually having hit anyone?

I know what the difference is between indictment and conviction, stop trying to act like this holier than thou. The 'fact pattern' of drunk driving on private property isn't a rare pattern, it shouldn't be difficult to dig up a conviction under that statute if it has been succesful.

>Reckless endangerment does not require you actually hit anyone. Where did you get that from?

No shit. I got it from my example, where the driver didn't hit anyone. That's what we were both talking about, a drunk driver on their own private property behind a fence. When did I ever say they hit someone? In my example they didn't, which is why I asked for a case where they didn't.

The sodomy law is an example of how overzealous prosecutors can prosecute "a ham sandwich" on whatever they want but it means jack in terms of whether they can actually convict someone, even if the exact letter of the law suggests they can.

>A prosecutor's job is to make their case based on the facts, the law, and the ability to draw parallels from other cases.

Sadly many prosecutors care more about convictions (or just dragging someone through the system, conviction or not) than any of those. And some care more about convictions than even justice, to the point they will imprison people for victimless crimes. A bad prosecutor is one of the most dangerous and despised members of society.

The fact is that nobody knows right now with certainty whether driving drunk on private property would result in a reckless endangerment conviction. I cited an alternate legal theory that a prosecutor could use. If there’s no case law that is directly on point, we have to go with what the statute says and other case law about the statute in other cases, and make our best guess based on what a prosecutor might argue and how a judge might find. That’s what lawyers do. I’m not being “holier than thou;” I’m using my formal legal training to contribute to the conversation and dispel myths about the law. I don’t want anyone taking unnecessary risks, influenced by false suggestions or claims made here, and ending up in potentially serious trouble as a result. Many criminal cases involve multiple counts of violations of different criminal laws for the same conduct in order to improve the chances of a conviction on at least one of them. That’s just par for the course, and is the basis for the phrase “throw the book at them.”

As for the sodomy law, before it was ruled unconstitutional (and therefore void), it was enforceable and people were convicted of it. See, e.g., https://www.glapn.org/sodomylaws/sensibilities/texas.htm

The fact that it has been voided since is something every prosecutor knows, and so they won’t even try to indict anyone for it. Getting the law off the books is a formality at this point.

>As for the sodomy law, you are still wrong. Before it was ruled unconstitutional (and therefore void), it was enforceable and people were convicted of it.

Except I never said that no one had ever been convicted. I'm saying even though the law still is on paper, it doesn't mean someone can be successfully convicted of performing a 'fact pattern' that looks like it might violate the letter of the law. For someone formally trained in law you have a shockingly poor attention to detail or even accurately recalling facts.

You need to stop making personal attacks or you risk being removed from HN.

If saying you haven't recalled facts correctly or paid attention to detail is a 'personal attack', then you calling me 'wrong' and insinuating I was dumb enough to mix up indictment and conviction (despite that I hadn't) is also a personal attack. Stop playing the victim, it's a sad pathetic look.

> or you risk being removed from HN.

Is this some kind of threat? You have a power play fetish too eh? What would I _ever_ do without non-practicing lawyers arguing with me about the risk of me going to jail for some Texas penal code offense they can't even find a conviction for under one of the most common socially frowned upon 'fact patterns' known to man (Texan drunk at the wheel on his fenced-in property). But hey man, however you keep your razor sharp I guess.

--------------------

Other snips from Otterley's attacks on my character:

'Worse, you are a hypocrite: You gladly take full advantage of the protections the law affords you, while expressing disdain for the protections and fairness-guiding that the law affords others.'

'I think we've reached the end of this conversation with a clear understanding of the type of person you are. This is a garden-variety description of egotistical selfishness'

'Good for you. I bet you have a Black friend, too.'

Mr. Otterley: YOU are the hypocrite.

---------------------

Oh and another one for my friend Otterley from our old conversation, in case we don't meet each other under this username again:

'But I really thank you for the laughs. Maybe the next time I spark up a blunt, I'll stop and think to myself "lawless egotistical selfishness" and think back about dear Otterley'

I admit I did do that in a prior conversation. I apologize. I should not have done that. I disagree with you on many things, but it should not stoop to a personal level.

Thank you. I also apologize for the times I've overstepped the bounds of politeness, inclusive of my statement regarding 'someone formally trained in law.' I hope from here on out we can focus more attention on making any interactions with each other more focused on learning from each others' different perspectives in a positive and constructive way. I will try channel these experiences into become a better communicator.

Of course you can. You're just making this up.

> See, we can both play the "freedom" game.

The doctors and nurses you're asking treatment from are people who deserve freedom and work-life balance, too. Many have been fed up and are quitting. Would you support the government forcing them to continue working? Would you force young people to be doctors and nurses?

Your example is a transaction between people (the doctor and you). You don't have a right to that transaction. The other party can withdraw for whatever reason (including not having time).

The freedom to roam is freedom. I understand the point you're trying to make, but the parent comment is correct in the usage of the world freedom, whether you like it or not.

no its not, you can't roam into another's house. another's place of business. or a government building without following the rules of said environment.

nor do mask or vax mandates limit this concept of 'roaming' in any way.

>You don't have a right to that transaction. The other party can withdraw for whatever reason

This is not always the case, even with hospitals in the US. Few markets are 100% laissez-faire in the US, and definitely not regulated industries like healthcare.

For example, if you are a hospital in the US that participates in Medicare, you must provide basic treatment to stabilize a patient with an emergency medical condition, or transfer the patient to another facility that can.

https://www.cms.gov/Regulations-and-Guidance/Legislation/EMT...

Freedoms aren’t considered in isolation. Maintaining freedom for some means removing freedom for others some times. In this case the “freedom” to get timely treatment for those that need it.

> In this case the “freedom” to get timely treatment for those that need it.

That's not freedom, that's an entitlement.

> In this case the “freedom” to get timely treatment for those that need it

So why not build more capacity instead of forcing the public to adhere to a bunch of toxic and socially corrosive mandates?

Are you not getting timely treatment? Is this your reality?

> the “freedom” to get timely treatment for those that need it.

That's not freedom. Freedom is not putting up barriers.

Interesting. In this take, what are the limits to freedom? Your right to swing your fist and all that. If your actions are limiting what I can do, is that not curtailing my freedoms?

Edit: to be clear on where I stand. I think you can do whatever you want, as long as it doesn't affect me. If it affects me, maybe you should still be able to do it, but then we need some thought and discussion and isn't an automatic right because "freedom".

> Note that these freedoms were debated and won in an era where medicine was terrible.

That was also an era when the US was subject to numerous epidemics and pandemics of diseases such as cholera, typhus, yellow fever, bubonic plague, smallpox, and influenza, and it was debated and found that placing restrictions to try to limit the harm from those epidemics was a legitimate exercise of the state's police power and not an infringement of civil rights.

Having anyone's freedoms dependent on available hospital capacity is a terrible way to run a society.

You should note that government regulations are designed to keep hospitals running nearer capacity. See "certificates of need", which are (in most places) required to get authorization to build a new hospital. You've got to prove to the gov't that a new hospital really is necessary. And thanks to regulatory capture, the tendency is for existing providers to try to sink such applications.

What freedoms are you talking about here?

I recommend you do some basic research on the history of quarantine and the united states as well as colonial america. You'll quickly see your assertion stands on shaky ground. https://www.ushistory.org/laz/history/index.htm

> The only question really then is how fast do we want the unvaccinated to do the getting antibodies by getting COVID thing. The faster they get it, the faster we can be as done with COVID as we are ever going to be.

No, there's one other question - how much of our limited health resources do we want to allocate to people still refusing to get vaccinated.

In all fairness, I think they should be allocated proportionately. If 20% of a region's population is unvaccinated, and there's a bed shortage, they should get ~20% of hospital beds.

> If a region has sufficient hospital capacity that it would not be overwhelmed by the increase in COVID cases among the unvaccinated go ahead and lift most restrictions.

This is basically the reasoning used in Ireland; the hospitals weren't overwhelmed as Omicron peaked in the first week or so of January, so overnight we went from really quite restricted to all restrictions except mask requirements gone. Over 95% of Irish adults are vaccinated, so this isn't a trick that will work everywhere, but... for now it seems to be going okay.

This seems to be the near consensus opinion of reasonable people I know. People are really downplaying how effective the vaccines have been. My one unvaccinated friend has stated several times that they would rather sign a waver denying themselves access to an ICU bed than get vaccinated. I don't know what we are waiting on as a society to reopen other than enough people to get it.

>” At this point if an adult in the US is unvaccinated it is (1) almost certainly by choice (there are some people who cannot get it for medical reasons but they make up only a very tiny fraction of the unvaccinated), and (2) it is very unlikely that any evidence or logical arguments will chance their minds.”

This typical line of thought ignores a huge issue. Vaccine mandates don’t help per se, but it’s an issue that is pretty bad to just gloss over.

Articles like this really need to describe some sort of policy or plan for the 7 million or so immunocompromised people in America.

Like at least mention them and advocate something. Don’t just gloss over 7 million people. Propose something like Priority access to the new Pfizer pills and additional assistance with other things to avoid high risk activities.

> Articles like this really need to describe some sort of policy or plan for the 7 million or so immunocompromised people in America.

Wear good masks, social distance, etc. Basically do everything that's recommended to prevent the spread of covid, besides getting a vaccine. As a bonus, doing these things will help keep them safe from a large number of other airborne illnesses that put them at risk.

Plus, there has been an increased awareness about preventing the spread of airborne diseases in general. Lots of stores and businesses have installed filtration systems that help keep everyone safer. Contactless delivery / checkout is much more mainstream, and it's now socially acceptable & legal to wear a mask, which is something certain people are going to continue to do. So while it has certainly been a nightmare for immunocompromised people, some positive changes have also resulted.

There always have been, and always will be, vulnerable immunocompromised people. We didn't reorganize society around that fact before the pandemic, and we shouldn't do so now.

Sorry if that sounds harsh, but we can't keep using things that will never change as reasons to persist with a state of emergency -- otherwise that state of emergency will never end.

You may want to reread my comment and think about what I’m saying, you didn’t need to come out and advocate abandoning immunocompromised people to Covid.

“ It has killed more than 865,000 Americans, the vast majority unvaccinated.”

Could someone please put a number on “vast majority”? I keep hearing this adage but a majority is 51% and there’s a big range between 51 and 100% that a word like “vast” doesn’t precisely capture..

You'd have to adjust for the period of time where vaccination wasn't available but currently the difference is best characterized as vast — the weekly rate is 10 per 100k versus 0.71 for fully vaccinated without a booster and 0.10 for boosted individuals:

https://ourworldindata.org/grapher/united-states-rates-of-co...

I would guess something like 5-25%, but it's a subjective term, so who knows.

Table 1 on page 3 has unvaccinated covid deaths at ~20% of the total.

https://www.cdc.gov/mmwr/volumes/71/wr/pdfs/mm7104e2-h.pdf

You forget the second order effect here: the more unvaccinated people hospitals have to treat, the more likely their nurses and doctors are to quit, even if "the hospital is not overloaded". The more likely they are to quit, the more likely people are to die of other preventable causes in the future (because once they're burned and quit, they're not coming back).

The exact operation of this effect isn't clear, I think.

If we could wave a magic wand and make it all immediately end, that would be preferable. But that's not going to happen.

That leaves us with two choices. We can let it drag on and on, or we can tear off the bandaid quicker. It's not clear to me which of those two is worse for the healthcare professionals you're talking about.

"... has killed more than 865,000 Americans, ..."

Can we start holding people and publications to differentiating for past variant vs. Omicron, etc? It deserves and necessitates such nuance.

I don't see how we could ask that of either people or publications - the data simply doesn't exist. Only a tiny fraction of Covid cases get genetically sequenced.

So perhaps we should add huge qualifiers to all these scary sounding numbers, eh? Because the lack of context throughout this pandemic has created vast amounts of ungrounded, unchecked fear and hysteria.

> With COVID becoming endemic everyone is going to get antibodies

Vaccines provide better protection than infection, just to be clear. It's not true that you're safe because of a previous infection.

See: https://www.cdc.gov/media/releases/2021/s0806-vaccination-pr...

I see your Aug. '21 CDC paper, and raise you 1 more recent Jan. '22 CDC paper: https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e1.htm

"By the week beginning October 3, compared with COVID-19 cases rates among unvaccinated persons without a previous COVID-19 diagnosis, case rates among vaccinated persons without a previous COVID-19 diagnosis were 6.2-fold (California) and 4.5-fold (New York) lower; rates were substantially lower among both groups with previous COVID-19 diagnoses, including 29.0-fold (California) and 14.7-fold lower (New York) among unvaccinated persons with a previous diagnosis, and 32.5-fold (California) and 19.8-fold lower (New York) among vaccinated persons with a previous diagnosis of COVID-19. During the same period, compared with hospitalization rates among unvaccinated persons without a previous COVID-19 diagnosis, hospitalization rates in California followed a similar pattern. These results demonstrate that vaccination protects against COVID-19 and related hospitalization, and that surviving a previous infection protects against a reinfection and related hospitalization. Importantly, infection-derived protection was higher after the Delta variant became predominant, a time when vaccine-induced immunity for many persons declined because of immune evasion and immunologic waning (2,5,6)."

TL;DR only vaccine did not provide better protection than only previous infection

Not necessarily: https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v...

No they don't, indisputably now. See the massive 15 million people study from CDC Jan'2022 paper and here is an article that summarizes it: https://thepulse.one/2022/01/24/cdc-admits-the-obvious-natur...

Actual paper published on Jan 19, 2022: https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e1.htm?s_cid=mm...

Done with Covid?

Are you aware that vaccines are failing spectacularly with regards to Omicron infection?

Hospitalizations are another story, but this notion of the vaccines ending Covid is just not holding up with new variants.

What? I thought it has been pretty clear that even with Omicron, the vaccine dramatically reduces risk. In WA, the unvaccinated are 2-4x more likely to get covid and 5-11x more likely to be hospitalized.

https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/...

I certainly hope so, but the numbers (how great the benefit is) keep getting lower. And your stats are just per population. Maybe the people who refuse to get vaccinated are also 2-3x as likely to refuse to wear masks or avoid crowds. We need real stats somehow by randomly testing populations then seeing how they fare.

Data from Australia, Israel, Denmark, all highly vaccinated countries, show a very different picture, and yes, even on a per Capita basis

I think the hospital capacity is a key argument indeed. But there is another aspect to consider. Each viral replication is a potential event where a new variant can arise, thus the fewer viral replications the better since each new variant has unknown risks. An unvaccinated person will on average be host to many more viral replications after exposure to the virus than a vaccinated person after exposure. Thus, if a large part of the population remains unvaccinated, the virus has more room room to evolve than necessary given we have easy access to effective and safe vaccines. Therefore, this should also factor into a debate around vaccination policies and personal choice vs societal risk.

> Thus, if a large part of the population remains unvaccinated, the virus has more room room to evolve than necessary given we have easy access to effective and safe vaccines.

Word was that Omicron diverged from an earlier version of covid in mice, over the course of about a year, then jumped into humans [0].

I think this detracts quite a bit from the point you were trying to make above, since we are not vaccinating mice, nor all the other animals that harbor covid such as bats, cats, dogs, primates, and deer [1].

Since we can't vaccinate or destroy all of the non-human hosts for this coronavirus, and the virus already has evolved in animals and made the jump to humans a couple of times, I don't agree that the point you made above is relevant.

[0] https://www.medicalnewstoday.com/articles/covid-19-did-omicr...

[1] https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/...

Interesting. Indeed animal hosts could be problem. I would counter two points:

1) Assuming animals were a major source of variants, it quantitatively but not qualitatively changes the problem. Until we know the quantities, I do not see how you can assert relevance.

2) The references you provide say Omicron came most likely from a human with prolonged infection. The paper proposing a intermediate variant in mice is interesting, but considered unlikely (your reference: "Evolutionary biologist Mike Worobey, Ph.D., of the University of Arizona in Tucson, said the most plausible theory remained that Omicron evolved in an immune-compromised patient with a protracted [SARS-CoV-2] infection.")

Viral replications are the only scenario where variants can emerge naturally. Duration of disease and severity of disease are correlated with load and total viral replications. Vaccination reduces both at the population level. A vaccinated person therefore will on average be a less likely source of a variant. How much this weighs against other factors when deciding on policy is impossible for me say, but I would insist it is not irrelevant based upon current knowledge.

I would agree that it is not irrelevant. My language there may have been too strong.

I was probably thinking that the other factors (personal protection, hospital capacity, and the political question of mandates) seem so much more significant to me. There's lots of lesser factors (side effects, the immuno-compromised, social cohesion, etc).

I guess I kind of looked at variants as a wash, given they are so much out of our control and there are many unknowns. It's in the realm of possibility that the current vaccines could leave us more susceptible to future variants (a la original antigenetic sin). Hard to make a decision on less significant unknowns.

I encourage everyone eligible to protect themselves by getting vaccinated but this is unlikely to prevent new variants from evolving. The current thinking is that new variants are most likely to evolve in immunocompromised patients who experience prolonged infections. Vaccines are less effective for them.

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

I agree with this, and I do not think it contradicts my original statement. You cannot prevent new variants, but you can reduce the rate of their emergence.

The paper you cite supports this: in a case study of a single immunocompromised patient who---because of that---had a prolonged infection, many replications of the virus were observed. This patient represents a "hot spot" of variant emergence in this furthermore antibody treated patients. From the article "the remaining samples [sic: most] are consistent with arising from a consistent viral population".

What I take from this is: we ought to prevent prolonged infections where it is possible. Again, from the article "The effects of convalescent plasma on virus evolution found here are unlikely to apply in immunocompetent hosts in whom viral diversity is likely to be lower owing to better immune control." And a vaccinated individual will on average have the best immune control.

We don't do anything to reduce the rate of emergence of new variants of HCoV-OC43, another betacoronavirus very similar to SARS-CoV-2 in terms of genetics and clinical effects. So far that hasn't been a problem.

https://www.sciencedirect.com/science/article/pii/S026240792...

That virus has also not caused a global, multi-year long pandemic. In this context, your reference seems tangential to me. Vaccinations ought to reduce SARS-CoV-2 variant emergence rates by virtue of reducing viral replications.

What are you talking about? As far as we can determine, HCoV-OC43 did cause a global, multi-year long pandemic starting in 1889.

Lol, right---I did not recognize this as the agent of one of the "deadliest pandemics" starting in 1889 (Wikipedia) in history. But what is your point? Are you of the opinion that vaccines cannot reduce variant emergence rates?

My opinion on the matter is irrelevant. There is no reliable, quantitative scientific evidence that vaccination actually reduces variant emergence rates. It's an interesting hypothesis but hasn't been proven or disproven.

It is pretty obviously so, and it's also not controversial really.

e.g. https://www.channelnewsasia.com/commentary/covid-omicron-var...

>Do the unvaccinated populations fuel the emergence of SARS-CoV-2 variants?

> The consensus among the scientific community is yes, they likely do. Unvaccinated people have less protection from the SARS-CoV-2 virus and thus would allow more of the virus to multiply within them.

> The higher rate of virus multiplication in the unvaccinated is likely to result in more possible mutations of the virus, resulting in the emergence of a larger number of variants in unvaccinated than vaccinated people.

I think at this point there is not much more to say here, at least from my end. Have a great day.

I agree.

My sense is the government has silently taken this stance and that hospitals aren't at risk of collapse like they were a year or more ago. I also get the feeling the vaccinated have given up on the unvaccinated too just based on how rarely I now see posts on social media. It's like a tacit acceptance that if people are going to choose to die, so be it.

I actually wonder if this not caring is what will actually defuse this particular anti-vaxx movement. Or it'll just be the next vaccine and the Covid vaccine issues will be completely forgotten. I mean when was the last time you heard about vaccines causing autism?

what's interesting here is the underlying psychology that makes people susceptible to manipulation by thinking they're in the know on some Big Lie. This seems to be nothing new however and I can't help but think of this quote from Goebbels of all people [1]:

> “If you tell a lie big enough and keep repeating it, people will eventually come to believe it. The lie can be maintained only for such time as the State can shield the people from the political, economic and/or military consequences of the lie. It thus becomes vitally important for the State to use all of its powers to repress dissent, for the truth is the mortal enemy of the lie, and thus by extension, the truth is the greatest enemy of the State.”

[1]: https://www.jewishvirtuallibrary.org/joseph-goebbels-on-the-...

I've never heard a convincing argument about why the COVID restrictions weren't literal violations of human rights. Often I got a variant of "I'm scared we're just going to do it". Most (all?) of the arguments for it turned out to be wrong - eg, vaccination has not slowed the spread, even marginally, according to the experience in Australia where COVID tore through a highly vaccinated population. In my state (~95% adults 12+ vaccinated) we have had more than a million cases (population 8 million) in 1.5 months. And the testing systems collapsed, probably quite a bit more in reality.

This is now taking it one step further - this argument is as an assumption - suggesting people have to give up their freedoms because people paying for their own hospital capacity is unacceptable to you. I say that because the sort of person who is pro-freedom to the point of not wanting a vaccine might well overlap with the population of people pro-freedom enough that they want individuals to pay for their own healthcare.

This is not a sustainable position against 2019 business-as-usual. I agree with the headline.

I’m Australian. Vaccination and restrictions were why we never saw refrigerated containers of dead people on street corners, like NYC did in the first wave. Many people would have died or needed to be hospitalized.

You are proportionately about as bad as the United States is in deaths right now.

Cite your data.

Start here: https://91-divoc.com/pages/covid-visualization/

Showing new deaths per day with 1 week averaging normalized by population, the US is about 2-3x Australia right now.

As for new confirmed cases per day normalized by population, everybody is about the same because Omicron is so infectious. I suspect the US number is a bit undercounted because the number of cases spiked so fast that confirmed cases simply couldn't keep up.

False. The US has had 2,687 deaths per million population since coronavirus began. Australia has had 128.

In the last 7 days the US has had 46 deaths per million population. Australia has had 17.

See for yourself: https://www.worldometers.info/coronavirus/

(Australia is starting from near-zero natural immunity, too.)

Manhattan (not to mention Staten Island, as well as Queens and Brooklyn which are geographically on Long Island) is also an island, just like Australia (and Tasmania.) Clearly they should have isolated themselves before covid took hold. ;-)

Apologies in advance for getting on my soapbox, but this has been on my mind for a while.

The way in which the media has gotten everyone to say "the unvaccinated" is a 'disease' against basic science (not even getting into the divisive nature of this). I would go as far as saying if you read any paper, study, or other that refers to the "unvaccinated" as a single cohort, you are reading vaccine propaganda, not science, or certainly not good science.

This must stop. Prior infection immunity is basic science that we've known for eons, and ignoring it is so blatantly glaring an omission, it should make the most staunch pro-vaccine person pause and say: "why are they so adamant to vaccinate those with prior infection?". One would expect prior infection to be robust, and multiple studies, including even the CDC's most recent shows it to be easily as good if not better and longer lasting than the vaccine. This should not come as a surprise to anyone.

If you think any of the above is "anti-vax" then I would suggest the media has won and science is dead. I'm not suggesting the vaccine doesn't work. I'm not suggesting it doesn't provide protection against severe disease and death. I'm not suggesting anyone go out and intentionally try to get COVID, but a HUGE # of people have already had it and ignoring them is downright unscientific. If you are a rational person who wants to see good science and are unemotional and detached from outcomes, then you will want to see proper study cohorts, and combining prior infection in with the "unvaccinated" cohort, is just bad science. This bad science fuels the anti-vaxx movement even more, and honestly, it is hard blame them.

Because the vaccine protects so much better than just a previous infection. We've been over this, over, and over. But you just won't accept the numbers now will you?

I hope this is sarcasm

If you were infected with the original strain, you'd have had less immunity to Delta than if you were vaccinated. The exact same thing for Delta vs Omicron.

The mRNA vaccines give a broader immunization that covers more. That's not even up for debate, you're only pretending it is.

I hope your comment is sarcasm.

This is wrong according to the CDC. Prior infection is better than the vaccine by itself but vaccine + prior infection is best. https://www.forbes.com/sites/joewalsh/2022/01/19/cdc-prior-c...

It's been awhile since I read about that study but didn't it determine that previous infection provided better resistance to infection than vaccination without a booster, but that vaccination provided better resistance to serious illness and death?

Either way I find it weird that the study clearly shows vaccination + infection provides the best protection yet people are using this to argue that they don't need a vaccination at all.

It is also the combo most likely to give you side effects.

Source? Because the CDC disagrees https://www.forbes.com/sites/joewalsh/2022/01/19/cdc-prior-c...

What do you mean by "broader"? The mRNA vaccines present the original spike protein to your immune system. A viral infection exposes you to the spike protein as well as every other piece of the virus.

Until the CDC changed the definition of vaccine in Sept 2021, most vaccines were understood to provide sterilizing immunity against infection, not only "protection" against illness/death.

Intramuscular/serum vaccines cannot stop respiratory infections, by definition. They are non-sterilizing. Only a nasal/mucosal vaccine or nasal infection can provide sterilizing immunity against a respiratory virus.

You rewriting history? The vaccine was never said to be 100% effective. Stop trying to twist reality to face your own political views.

A collection of headlines on vaccine efficacy, https://youtube.com/watch?v=TSZMtSPX3iE

pretty much all those quotes are "very effective", which is not really quantitative enough to say that fauci and the media were "wrong".

Is it super important that they are technically wrong on something, anyway? Like, do you think Fauci is going to be cancelled because he said something wrong? I doubt that's going to occur based on his prior messaging.

delusion is a funny thing.

This is simply a lie and you know it.

"If you're vaccinated, you won't get COVID" - Joe Biden

Joe Biden, well known epidemiologist.

From the beginning, there has not been a COVID-19 vaccine that purported to be 100% effective. There are vanishingly few vaccines that provide 100% immunity, if for no other reason than the immune system is not perfect.

In human history, we have only completely removed 1 virus from humanity: smallpox. That is literally the only 100% effective vaccine ever produced. And even then, it is only 100% effective after the fact.

This didn't happen all of a sudden in Sept 2021. The flu vaccine has always been about harm reduction and began seeing widespread civilian use in 2007-2008.

Maybe it's just where I live, but I've never heard the "flu shot" called a vaccine.

The CDC calls them "Seasonal Flu Vaccines":

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

So does the Mayo Clinic:

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

I won't go on, but by definition, a medicine that you take that's intended to build up your immune response to a disease is a vaccine. I saw someone upstream write "Intramuscular/serum vaccines cannot stop respiratory infections, by definition," and as far as I can tell this is just point-blank wrong. Whooping Cough -- pertussis -- is a respiratory bacterial infection we've been vaccinating against with intramuscular shots since the 1940s.

Immunoglobulin A versus Immunoglobulin G, we still don't know how to stimulate a response (outside of exposure to a virus) to create Immunoglobulin A, which protects our upper respiratory tract.

This is the technological limits of what vaccines are capable of. Vaccination limits the damage, ensuring a much lower likelihood of catching a 1 to 3 day cold affecting only my upper respiratory tracts rather than risking the lungs and the rest of my body on a potentially multi-week infection.

The longer the infection, the more likely pneumonia or another co-infection will injure or kill you.

“Most” vaccines. The reason why they didn’t have to invent “non-sterilizing” as a term just for COVID vaccines, is because some existing vaccines had this same property. The acellular pertussis vaccine (the aP in TDaP) is non-sterilizing for example, yet I bet you never took any issue with it.

Does measles count as a respiratory infection? It causes coughing, is airborne, and infection happens via nasal passages. The intramuscular measles vaccine seems to work pretty well.

Not disagreeing with this (although my understanding is that there have been studies that show vaccination has been more effective), but how would you seperate the unvaccinated / previously-infected-and-recovered cohorts?

Even by reconciling PCR testing data (which I imagine is incredibly patchy at best), you still would only know historically how many people tested positive (ignoring what is in all likelihood a majority of the cases that never got tested) and be able to reconcile it against numbers of vaccinated, which tells you nothing useful without being able to intersect the two sets (which you can’t do without uniquely identifying every PCR test and matching it to an individual universally).

i.e. the better data you would need doesn’t exist.

There's a recent (January 19, 2022) CDC publications with numbers on exactly that. Forbes provides a brief overview: "CDC: Prior Covid Infection Offered More Protection Against Delta Than Vaccines — But Both Together Did Best"

https://www.forbes.com/sites/joewalsh/2022/01/19/cdc-prior-c...

Currently, people who only got one shot or got their second one less than two weeks ago are being counted as “unvaccinated” which seems disingenuous at best.

If that data doesn't exist then that's just because it isn't tracked. Here in Germany if you test positive on a PCR test you have to quarantine for 14 days, then you get a proof of recovery which for 6 months you can use like a proof of vaccination (which you need for non-essential shops, gyms, etc when the 7-day incidence is too high, like right now). As a result, tracking numbers for the "recovered" cohort isn't a problem. Obviously the "unvaccinated" group will always contains some unknown number of recovered people we don't know about, but at large enough effect sizes that isn't a problem.

simple numbers show that unvaccinated get covid at higher rates and the number of hospitalizations is higher which puts strain on the hospitals. If something happens to me I dont want an unvaccinated taking a spot I need.

Your comment could not illustrate my point better if you had tried

It doesn't illustrate your point. You, on your soapbox pretend you have it all figured out. You, on the side of science. But as some of the responses have shown, you haven't really thought it through. I agree however, that the media hasn't either. But when was that ever true?

First, apologies for slight snugness of that that reply - probably not needed, and I've received some probably well deserved downvotes for that.

Second, it does prove my point in that the poster referred to the "unvaccinated" as a single group, a position that I'm suggesting results in a very inaccurate set of conclusions (which other responders have commented on) because of skewed cohorts.

Third, I most definitely do NOT have it all figured out - I'm as confused as anybody else on most of this stuff, which is why my post was on a single focused point, and not on issues where I have an opinion, but much less research and data supporting my position.

Lastly, I've read all the replies and thought it was good discussion. I didn't see anything to suggest I hadn't thought it through or disprove my position, just disagreements on how useful it would or wouldn't be, which is fair.

That's a reasonable answer. I appreciate that. I agree on your main point.

How many times do you typically get hospitalized per year?

What about smokers? What about the obese? What about people who took risks and acquired HIV?

When obesity, HIV and smoking related illnesses are easily transmitted by breathing and (largely) easily avoided by getting vaccinated I'll have a problem with them too

The probability density function (PDF) for being hospitalized due to smoking or obesity is very wide but not tall. The PDF for being hospitalized due to COVID is not wide but is tall.

It is things with not wide but tall PDFs that cause problems with hospital capacity because it generally takes a fairly long time to increase hospital capacity.

Things with very wide but not tall PDFs are much easier to deal with because you've got years to build up capacity for them and that increased capacity will be needed for decades. The latter is important because it means a young person can look at that increased long term need and choose a career in healthcare knowing that the demand will still be there 10-14 years later when they've finished school and residency and will still be their long enough to see them through their entire career.

Our hospital capacity is already built out to deal with public health issue that it already deals with. This is a special case (if you somehow did not notice - how often have you heard about hospital overcrowding in the US before?).

Are you worried you won't have care at a hospital because of someone is unvaccinated? Has that ever happened? Are hospitals full where you live? Where did you get a fear like that?

Sorry what? Yes, this has happened many times in many regions during this pandemic. If anything, as governments lean more and more into "let's just call it endemic and give into anti-vaxxers," it's happening more.

And to make it concrete: where I live we're into emergency (as in, stretching the system past its limits) ICU capacity and elective procedures (which, please note, does not mean optional) have been cancelled or delayed en masse for a couple months now as we've been going through our 4th and 5th waves.

People are absolutely regularly having diminished quality of health care due to unvaccinated people catching, as well as spreading, covid.

I don't know where you live but they cancelled those things here as well. Not because of the unvaxed but because 30% of nurses who are triple vaxxed were down with covid.

I mean, I dunno what to tell you but when they start opening up emergency ICU capacity being down 30% of nurses (accepting your premise for the sake of argument) doesn't help but it's not the core problem. The problem is people getting sick with severe illness due to covid, and that is largely unvaccinated people.

Severe outcomes stretch the system more, and unvaccinated people have more severe outcomes.

At any rate, if those nurses weren't vaccinated it's likely more than 30% would be out and a significant portion of them would be dead, so if you want to go down the "vaccines make people sick/more likely to be sick" path then you've just fallen off the rails. The path you have in mind would be a mass death event our medical systems are completely unequipped to handle.

There are 100s of new articles around the country about hospitals near or at capacity and patient care being affected, due to omicron surge. Here is just one:

https://www.latimes.com/california/story/2022-01-20/hospital...

> why are they so adamant to vaccinate those with prior infection

Because the data shows they don't matter.

This is the same thing as deaths due to covid vs. deaths while positive to covid. Sure some people might have been miscounted as covid deaths but actually died due to cancer/car accident/whatever. Despite this the excess deaths over the past two years is much higher than the number of covid deaths; thus showing that miscounts must be a small minority which, in any case, is absolutely dwarfed by excess deaths not counted as covid deaths. It might even grow a little as testing improves but it still remains mostly irrelevant.

Likewise it may be that some people do not need a vaccination. However, we have a 30/70 split in number of covid hospitalizations, with 30 being vaccinated people, in countries where the split in the normal population is 90/10. This means that despite some unvaccinated people having had prior infection the vaccine reduces hospitalizations by 20x. Given this data the most effective strategy is to just vaccinate everyone without what is effectively a pointless distinction.

As the number of unvaccinated but protected people will grow (through a combination of more infections, more vaccinations and more deaths), the proportion above will revert to 90/10 and unvaccinated people will not be an issue anymore. For now however analyzing the proportion of naturally immune people among the unvaccinated is, again, mostly irrelevant.

My point is that it is NOT a pointless distinction, and there is a huge discrepancy between "unvaccinated - prior infection" and "unvaccinated - no infection" cohorts. Countries that track prior infection (there are a few) show this in their data, and if you separate them you will see the "unvaxxed - no infection" get worse and the other much better. If the subject matter were something less politically polarizing I'm suggesting this would be a split group in everyone's data.

The only people who make getting vaccinated a political matter are those who refuse to get vaccinated. If you look at the data (and not just the convenient headlines) “unvaccinated, prior infection” have a lot higher chance of reinfection and a lot higher chance of a severe outcome than vaccinated. Sure it is still better to be “unvaccinated, prior infection” vs “unvaccinated, no prior infection” but not the same order of magnitude as “vaccinated and boosted”.

Roughly speaking this is the difference between your risk of driving with no seat belt and no air bags (unvaccinated), no seat belt and no air bags but with a bicycle helmet (prior infection), seatbelt (vaccinated), and seatbelt and airbags (vaccinated and boosted).

> Roughly speaking this is the difference between your risk of driving with no seat belt and no air bags (unvaccinated), no seat belt and no air bags but with a bicycle helmet (prior infection), seatbelt (vaccinated), and seatbelt and airbags (vaccinated and boosted).

It's absolutely not the same delta there. Not even close. The relative risk and absolute risk are completely different in magnitude, and unvaccinated cohorts are concentrated in younger, healthier populations with a minimal level of risk.

The most distinguishing characteristic of COVID is it's age-risk gradient. There is LITERALLY a 1000X delta in IFR between the youngest and oldest demographics. The fact that the vaccine policies don't take this into account has resulted in the greatest erosion in trust of public health authorities in history. Your analogy doesn't even take this into account, which further demonstrates the shallow aspect of it.

> There is LITERALLY a 1000X delta in IFR between the youngest and oldest demographics.

This is the point that I can’t seem to express eloquently enough to overcome the nonstop torrent of poorly calibrated advice from the authorities. I don’t have time to pore over the data, but last time I checked the annualized death totals for children (17 and under) were approximately equal to the 2019 deaths from influenza for that age group. When the marginal benefit of vaccination gets that low, you do have to start asking whether the side effects are worth it—trading a 0.01% risk of myocarditis for a 2% risk of death is clearly worth it, but can you say the same when the risk of death is on the same order of magnitude as the side effects?

(edit: numbers are hand-wavy, not trying to make an authoritative point)

Vaccine side effects are less frequent and less severe that. Unvaccinated COVID side effects in all age cohorts. By a significant margin.

Myocarditis in particular is 8x more likely to occur with COVID vs the vaccine.

So, while an argument could be made that the risk of adverse reaction or death from COVID is too small to matter one way or the other in young people, it is not correct to say that the vaccine is more risky.

There is one exception I have seen in some data that myocarditis risk was roughly equal or slightly higher for young men of a specific age group who received the second dose of the moderna vaccine. But one could of course avoid that particular vaccine and still be better of vaccinated because that of course is only for myocarditis and the absolute risk is very tiny.

This article breaks it down, and references a newer, larger N Oxford study using data from the British NHS. Agreed on it being certain age cohorts. My dad would be a lunatic to not be vaxxed. But a 20 year old who is healthy?

https://ravarora.substack.com/p/the-truth-about-vaccine-indu...

I have not gone through that study or article in depth yet, but the thing that jumps out at me initially is that it is using seroprevelance data from Battacharia and I am yet to understand how he is so confident in his numbers. All of his surveys from my understanding rely on data gathered from people who came in looking to be tested. Which would obviously taint the randomness as people who think they might have had COVID are much more likely to take the time to come in and be tested.

Also, if his data is to be believed, then the protection offered by having had COVID in the past has been far overstated.

> Because the data shows they don't matter.

Source? Because the CDC says otherwise.

> In the first full week of October, vaccinated New Yorkers with a prior Covid-19 case were 19.8 times less likely to catch the virus than their unvaccinated and uninfected peers, whereas people who were unvaccinated but previously infected were 14.7 times less likely, and vaccinated but uninfected New Yorkers were just 4.5 times less likely.

In other words, natural immunity alone can be up to 5X more protective than the vaccine alone, according to the CDC.

https://www.forbes.com/sites/joewalsh/2022/01/19/cdc-prior-c...

There is a behavioral component.

Is that because people who have caught it are more likely to take precautions against catching it again?

Those who were vaccinated but previously uninfected may have had a “it can’t happen to me and if it does, I’m vaccinated” attitude.

I’d expect unvaccinated people to be in the bucket with covid deniers and anti-maskers, which would have the highest base rate of COVID.

I doubt it. I caught it in Aug/September during the delta wave and am way less careful now than I was before. Not saying this is true or advocating a position here, but I feel like the pandemic is over for me, I don't have to worry about any current variants, etc. The people I talk to who have also developed natural immunity have the same sort of feeling.

Meanwhile… my sister and her daughter had a Covid sandwich: caught it in summer 2020, got vaccinated as soon as feasible, then caught it again a few days ago.

Anecdotally, my sister is one of those people who “catches everything” so I can’t say I’m surprised, but clearly there is no such thing as absolute sterilizing immunity (natural or vaccine-induced) for this particular coronavirus.

It's not specific to this one, it's true of all coronaviruses.

This article explains why it's so hard to make a vaccine for coronaviruses:

https://www.abc.net.au/news/health/2020-04-17/coronavirus-va...

Of course, this was written a few weeks before "Project Warp Speed" when everyone and their dog announced that had found a vaccine for this brand new coronavirus.

I think what they are suggesting is that natural immunity + vaccine is also more protective than just natural immunity

But natural immunity doesn't work if you die or end up having severe loss of health, so vaccine + natural immunity would be best way.

CDC said last October that 146 million people (~40%) in the US have already recovered from Covid.

There are also interventions other than vaccines, e.g. early treatment, https://c19early.com

yes, vaccine + natural immunity gives you super immunity by a large factor, they also found that it doesn't matter if you get the virus, then get vaccinated, or get vaccinated then get the virus, you'll end up with super immunity.

Super immunity is not a scientific concept, it would be nice to have some numbers or studies to show the difference.

Natural immunity as a personal choice should have been possible. But that has not been an option, for someone who wants to be part of society.

You are confusing the effect on individual people with the effect on the whole community. I do not debate the effect of natural immunity on individuals who have had COVID in the past, but it is not widespread enough to cause a dent in the infection or to alleviate the stress on the healthcare system.

The effect exists but the data shows it does not matter.

> The effect exists but the data shows it does not matter.

You may have been right at a time where almost nobody had a previous infection. However, estimates by reputable sources https://covidestim.org/us show that a large percentage of people have been infected by covid at least once. The data are by state, I see ~75% for MA, 80% for CA and NY, and you can pick your favorite state.

At this point it is more correct to say that the vaccine does not matter, and immunity by prior infection is the dominant effect. Either that, or the Yale school of public health, the Harvard school of public health, and the Stanford Medicine institutes who run the covidestim.org site are full of shit.

If the vaccine does not matter, why do we still see such a prevalence of unvaccinated people among patients Who required hospitalization?

Because many of these are older individuals with contraindication. The elderly with unknown vaccine status. The homeless. People in nursing homes trying to live out the last years of their life without the discomfort of vaccine side effects.

Not age adjusting the vaccinated and unvaccinated cohort is disingenuous. Not breaking out ‘unknown’ vaccine status — which only becomes relevant for the stats after death - is disingenuous.

You are reading propaganda, and reading it uncritically.

The elderly (more susceptible) are overwhelmingly more vaccinated than the younger, not less.

Medical records are not well distributed. In most of these statistics, unknown vaccine status is considered to be the same bucket as unvaccinated. My hypothesis is that most of this group is either elderly or homeless.

Similarly, there is a selection problem for the elderly who choose to remain unvaccinated. You're saying that they think vaccines are ineffective -- and this is definitely a cohort of people! But there is a separate cohort of people, who are more likely to be hospitalized, who know they have severe existing health problems.

I don't think your math is correct there and that data is pre-Omicron.

https://www.imperial.ac.uk/news/232698/omicron-largely-evade... estimates that prior infection offered 85% protection against Delta but only 19% against Omicron.

The vaccines also offer very little protection against infection by Omicron, and less with the B.2 variant.

Definitely not saying vaccines aren't important - they keep you out of hospital! But they don't prevent infection post Delta.

I don’t know why you think this. Covid cases — people merely testing positive — are overwhelmingly among the unvaccinated in every state. Vaccine cuts your risk by 3x to 5x depending where you look.

Look at this chart: https://covid.cdc.gov/covid-data-tracker/#rates-by-vaccine-s...

If you read to the bottom of the previous study I posted they addressed vaccine effectiveness too based on UK data. They work! Just make sure to get your booster.

> It cuts your risk by 3x to 5x depending where you look.

In other words, it's 70-80% effective, which is pretty poor performance for a vaccine. So, can we please get an update that encodes the Omicron spike instead of trying to boost antibodies for a virus that's now extinct?

They’re working on it. But the original target effectiveness during vaccine development was 75%. We got lucky it was so much better against earlier strains. It’s still pretty good — about the same as an average year’s flu shot.

It’s a far cry from the apparently very popular myth that the vaccines no longer work at all.

The flu shots are some of the least effective vaccines out there.

The original target effectiveness was set low because anything to nudge the R value down was better than nothing.

We now know that we can do much better.

Flu shots are about 40% effective.

What would be interesting, would be to see flu shot efficiency and COVID shot efficiency over time.

Preferably including Omicron data as well.

Pfizer is planning to release an "Omicron + previous variants" version of their vaccine in March. I guess even with the accelerated approval scheme it takes some time. Then we will wait for the manufacturing.

There is also the "what will happen to the previous batches" question as no one will be willing to get the old vaccine.

Quick question, if I forced you to stand in a groin-kicking machine that will:

A) Once in every.. I dunno, 200 times (0.5%) it kicks you so hard that, without protection you're 100% going to die

B) Once every 10 times (10%) it kicks you so hard you're sent to the hospital

C) Just to spitball, let's say 3 out of 10 times it will kick you hard enough that you're out of commission for a couple days but able to recover without hospitalization

D) 3 out of 10 times it will lightly kick you where you hurt a bit but it's just a minor inconvenience

E) The rest of the time it will let you leave without being kicked.

Ok, so you're strapped into this machine. Now, before I turn it on, I offer you a cup (protection). 70%-80% of the time this cup will offer you complete protection against whatever the machine throws at you. But remember that it's still 100% effective when the machine does nothing, so we only need to look at the 70.5% of the time the machine will actually kick you.

So with 70%-80% protection call it 75% effective, we drop our percentages for each scenario:

A) 0.5% -> 0.125% B) 10% -> 2.5% C) 30% -> 7.5% D) 30% -> 7.5%

This is just doing the simple math. The vaccines drastically lower the chance of severe COVID compared to no vaccine at a higher rate than their overall effectiveness.

So again, you going in there wearing the cup or no? Because that's the choice you have when it comes to getting vaccinated.

The person you are replying to is talking about hospitalizations for severe ilness. The study you are quoting is talking about covid infections in general. These two are not the same and the vaccine protects from the former (severe illness and death).

No, he's also talking about severe illness and death. He's saying that prior infection is a good substitute for the vaccine in preventing severe illness and death. The corollary being that we should consider "vaxed or prior infection" and "immunologically naive" as the two relevant groups (for mandates etc), not "vaxed" and "unvaxed".

Prior infection is a good substitute for the vaccine because the ones that die from that "prior infection" aren't going to be in the statistic that shows how effective a prior infection is compared to a vaccine for a subsequent covid infections

You're responding to the wrong comment. I'm clarifying what the other commenter said, not championing his point.

That being said, your comment still doesn't make any sense. The people who would be substituting prior infection for a vaxpass would not be the dead ones, because dead people are not known for going to comedy shows, bars, or restaurants.

Ie, the claim is that "conditioned on being infected [and alive], a vaccine is superfluous". The [and alive] that you clarified is about as helpful as "and non-fictional"

Here is the actual study: https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e1.htm?s_cid=mm...

Importantly it doesn’t account for the effect of boosters and looks at pre-omicron data.

That noted the best protection seems to be had by a combination of vaccination and prior infection, which is perhaps unsurprising.

Also other CDC studies suggest that natural immunity declines quicker than vaccine induced immunity (https://www.cdc.gov/mmwr/volumes/70/wr/mm7044e1.htm?s_cid=mm...).

Given these results it would seem like generally a good idea to get vaccinated, even if you have had prior infection.

> Importantly it doesn’t account for the effect of boosters and looks at pre-omicron data.

Don't just read the summary. Look at figure 1:

https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e1.htm#F1_down

There are unvaccinated, uninfected people...and then there is everyone else. Once you have been infected or vaccinated, the difference between is so small as to be academic. And as the authors note, the importance of natural infection increased over time, as the virus escaped the vaccines:

"Importantly, infection-derived protection was higher after the Delta variant became predominant, a time when vaccine-induced immunity for many persons declined because of immune evasion and immunologic waning."

To your other claim:

> other CDC studies suggest that natural immunity declines quicker than vaccine induced immunity

No. That's not what that study said. First, it followed symptomatic infection, not severe illness. As we're seeing now, Omicron pretty handily bypasses vaccine-induced immunity to cause minor illness.

Also, methodologically, the study you're citing was bad. It only gave credit for natural immunity to those people with confirmed infections, which was/is an underestimate, and made vaccines look more effective than they are. A substantial fraction of the "only vaccinated" group almost certainly had undiagnosed covid infection.

> There are unvaccinated, uninfected people...and then there is everyone else.

This is shifting the goal. The disclaimers I cited come directly from the study and are highly relevant when comparing the effect of natural immunity vs vaccination.

> No. That's not what that study said. First, it followed symptomatic infection, not severe illness.

This doesn’t contradict what I said. The study gives evidence that natural immunity (to symptomatic infection) declines more quickly than vaccine induced immunity.

> Also, methodologically, the study you're citing was bad. It only gave credit for natural immunity to those people with confirmed infections, which was/is an underestimate, and made vaccines look more effective than they are.

One, the same effect would also have been present in the natural immunity group, as people may have been reinfected since their initial confirmed infection.

Two, this is largely irrelevant to the point I was making.

The statistical evidence suggests that even if you have had a previous confirmed infection, you’re still better off getting vaccinated.

>The statistical evidence suggests that even if you have had a previous confirmed infection, you’re still better off getting vaccinated.

Sure. And you'll continue to be better protected every time you get a booster, every 6 months, for the rest of your life. But all of us are going to stop getting boosters at some point. We're going to decide we're "immune enough", and go on with our lives, even though there will be some minute chance of getting Covid, from whichever variant is then around.

Many people with prior infection may feel they are "immune enough", and you can argue over the significance of the remaining risk, but ultimately that's a decision they make for themselves, just as all of us do in every facet of our lives every day.

Regardless of the minutia of the numbers, the recommendation to get vaccinated regardless of whether you have had COVID in the past or not is based on the fact that a very high number of people in the US and worldwide "think" they probably had covid but aren't entirely sure because they never got tested. The vaccine for everyone is easier and cheaper from a public health standpoint than to have people taking serology tests that may or may not be accurate and then waiting for the results in order to find out if you should get the vaccine or not. When the fact is, even if you were previously infected, you will be even better off getting vaccinated.

Apparently a lot of people without prior infection or the vaccine feel they are immune enough. And they are the ones clogging the ICU beds and otherwise taxing our health care system. I think "immune enough" in some cases, like a pandemic or potential pandemic, has to be decided from a public health standpoint and not on an individual basis.

> This is shifting the goal. The disclaimers I cited come directly from the study and are highly relevant when comparing the effect of natural immunity vs vaccination.

No, it isn't. It's clarifying that there's a great big forest here, lest we get lost in the details of the spots on the bark beetles in one particular tree. The immunity granted by prior infection is at least on par with that of vaccination.

Moreover, I quoted directly from the study to explain why short-term squiggles in the lines at the bottom of the graph aren't worth dwelling upon: the vaccines are getting worse over time (against symptomatic infection), and the effect of natural immunity is gaining importance. This is exactly as you would expect for a virus that has evolved to partially escape the vaccine.

Regardless, these are minor differences. You can't reasonably argue that vaccination has a definitive advantage over natural infection. We should be counting both.

From a recent editorial from a Johns Hopkins professor addressing the CDC trying to whitewash their own failings in the study:

https://www.wsj.com/articles/the-high-cost-of-disparaging-na...

"Yet the CDC spun the report to fit its narrative, bannering the conclusion “vaccination remains the safest strategy.” It based this conclusion on the finding that hybrid immunity—the combination of prior infection and vaccination—was associated with a slightly lower risk of testing positive for Covid. But those with hybrid immunity had a similar low rate of hospitalization (3 per 10,000) to those with natural immunity alone. In other words, vaccinating people who had already had Covid didn’t significantly reduce the risk of hospitalization."

"Similarly, the National Institutes of Health repeatedly has dismissed natural immunity by arguing that its duration is unknown—then failing to conduct studies to answer the question. Because of the NIH’s inaction, my Johns Hopkins colleagues and I conducted the study. We found that among 295 unvaccinated people who previously had Covid, antibodies were present in 99% of them up to nearly two years after infection. We also found that natural immunity developed from prior variants reduced the risk of infection with the Omicron variant."

Classic NIH: Say there isn't enough data when challenged on a policy, then deliberately not study it. They did this for DECADES with cannabis.

Some anecdotes:

I got COVID before there were vaccines and I've received all three shots. While all of my friends caught Omicron, I have not - and I'm the only one among them who got sick beforehand. On the other hand, I have an unvaccinated coworker who has now gotten Delta and Omicron. I know that doesn't prove anything, but it also doesn't make these studies I see any more illuminating either.

As an aside, I'm not even sure I want things to go back to "normal" other than lifted travel restrictions and the anger/frustration/callout culture to go away. Restaurants taking over the streets, working from home, less cars, etc have all been a boon for the way I live my life.

Data has been showing 80/20 vaxed/non vaxed hospitalizations for this new variant. How does that change your worldview?

Source? That might mean we’re approaching herd immunity and critical mass for vaccinated people in the population, which would be fantastic.

https://covid-19.ontario.ca/data#casesByVaccinationStatus

The same source gives roughly 60/40 for hospitalizations and 50/50 for ICU, so the more severe the symptoms the more vaccinations help.

The ICU stat is tricky. They classify anyone who they don't know their vax status as non-vaxxed. Many people who come into the ICU can't speak, fill out paperwork. They are classified as non-vaxxed. By the time they recover enough to share their status they get transferred out of the ICU.

Probably the most misleading stat of them all.

If somebody comes in the ICU with COVID symptoms, it's extremely likely that they were hospitalized earlier and thus their vaccination status is known.

If somebody comes in the ICU without non-COVID symptoms, they aren't in the statistic, in other words you need to make the probability of "unknown status" conditional on being in the ICU for COVID.

8% of the population in the paper are not vaccinated.

27% of hospitalizations are not vaccinated.

~50% of ICU cases are not vaccinated.

The conclusion is that people are bad at understanding statistics.

The labeling for the data is tricky. If you don't actually dive in you will miss it.

8% are not vaccinated at all.

27% are not vaccinated, partially vaccinated or unknown status

50% of the ICU cases are not vaccinated, partially vaccinated or unknown status.

It is good to understand that 1/2 of the people who come into the ICU are reported as unknown vaccine status by default because they can't speak or fill out paperwork.

I use to produce these reports for this government and the ones before for years . Presenting facts a certain way is what happens and reports get rescoped when the data doesn't agree with the intended outcome.

8% of the population has had no vaccination at all and 27% of hospitalized have had no vaccination at all. The unvaccinated and hospitalized population is THREE TIMES higher than it should be. That is the story in this report.

> I use to produce these reports for this government and the ones before for years . Presenting facts a certain way is what happens and reports get rescoped when the data doesn't agree with the intended outcome.

Are you saying the numbers presented in this report are not accurate or were fudged in some way?

I don't think you should lump unknown and unvaxxed. It creates a false impression. ICU numbers would look different. Most people in the ICU are unknown.

I could go on about hospital visits for non covid reasons being lumped with covid hospital visits.

I have issues with how data is collected in the field. I have issues with the reclassifications that go back and claim covid killed this patients after dying of other reasons.

I have issues with what they decide to collect and what information they ignore.

I would like a source, but still: no need to even ask me, as it's exactly the case I mention in the last paragraph.

Isn't that highly subjective, however? Two people show up to the hospital feeling equally lousy, both test positive for Omicron. First guy says he's vaxxed and boosted, doc suggests he's fully protected, this is the worst of it, go home and rest up (which is exactly what a doctor told my father). Second guy says nope, I'm unvaxxed. Doc is probably going to admit this guy overnight for observation.

Multiply by tens of thousands, and you can project the effects on hospitalization stats, which aren't necessarily tied to the degree of illness.

Except that with your second example the hospital isn't going to admit the patient for simply "feeling lousy". So, no, the assertion that this is how that stat has become inflated is not the actual cause.

I think you are purposely attempting to divert from the main point. Consider "lousy" to be, say, a 102 fever, persistent cough, and inability to taste anything. And then both test positive, as I stated. The unvaxxed guy is likely to be admitted, at least for observation.

If that was the case the doctors would see that the vaxed getting admited would have a higher death rate than the unvaxed as they would only admit those most likely to die from that group. If they did have a higher death rate then the stats and the doctors experience would reflect that and so the doctors would not heavily select for the unvaxxed. Though there is the possibility in your hypothetical that even the vaxxed with worse symptoms on average than the admitted unvaxed have a better chance of survival than a less symptomatic (when admitted) unvaxxed but if that's the case it pretty much shows the doctor are behaving correctly in a 'bias' of admitting unvaxxed.

The fact that "lousy" is subjective in the examples given, and is being leveraged to make your point however you see fit, at least to me, discredits the point you're attempting to make.

You're still not making any sense. The symptoms you describe wouldn't meet hospital admission criteria unless the patient had serious risk factors other than being unvaccinated. Hospital admission is primarily based on respiratory distress or blood oxygen saturation under 94%. A mild fever and cough can be managed on an outpatient basis. Ageusia is clinically irrelevant.

Perhaps, although that's assuming every doctor in every ER at every hospital in the country has the same minimum criteria. Somehow, I doubt that is the case.

What's your point? You might be able to find a few doctors who fail to follow the protocol but that has no measurable impact on the healthcare system.

It seems like you don't have any actual knowledge of how healthcare works in the real world and are just making things up.

Point is doctors are not robots, they enjoy a significant amount of autonomy, and I still believe that all other things being equal, many doctors are more likely to admit an unvaxxed Covid-positive patient than a vaxxed Covid-positive, because they believe that the unvaxxed patient has a higher risk of more serious symptoms.

So you have a belief, but no actual data or even anecdotes to back it up.

Nearly half of Omicron admissions released a day later. Did they magically recover overnight, or were they admitted with mild symptoms in the first place, just as a precautionary measure?

Early data from France suggests omicron patients leave hospital far more quickly - including 43 per cent in less than a day

https://www.telegraph.co.uk/global-health/science-and-diseas...

(at Kaiser Permanente Southern California) Among 154 Omicron variant-infected patients who completed hospitalization by January 1, 2022, 129 (83.8%) were discharged in ≤2 days

https://www.medrxiv.org/content/10.1101/2022.01.11.22269045v...

> However, we have a 30/70 split in number of covid hospitalizations, with 30 being vaccinated people, in countries where the split in the normal population is 90/10. This means that despite some unvaccinated people having had prior infection the vaccine reduces hospitalizations by 20x. Given this data the most effective strategy is to just vaccinate everyone without what is effectively a pointless distinction

No. This is wrong. As the parent noted, the CDC's own data shows that prior infection provides robust protection against severe disease. Both without vaccination:

https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e1.htm#F1_down

https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e1.htm

As well as a substantial additional benefit after vaccination:

https://www.cdc.gov/mmwr/volumes/71/wr/mm7101a4.htm

> Previous COVID-19 illness was associated with reduced odds of severe outcomes (aOR = 0.27; 95% CI = 0.09–0.84).

Moreover, the CDC estimates that over 150M people in the US (out of a country of 330M) have had Covid:

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...

That's 45% of the US population (before Omicron). There's no rational way to characterize this as insignificant.

I did not say that prior infection does not reduce severe outcome. It does but _it does not change the fact_ that the severe outcomes are much more rare among vaccinated people. This means that there are still too few people with prior infection, for this to be an important factor in policy making. It will be once the proportion of unvaccinated people in hospitals starts to resemble the proportion in the general population.

The severe outcomes are even more rare amongst prior-infected, unvaccinated people.

I suggest you look up seroprevalence surveys. The bulk of COVID infections (barring mandatory and regular testing being extant in a given locality) go undetected, due to the mild symptoms in the vast majority of the population. The seroprevalence surveys have shown this since May 2020.

And again I do not debate that. But they are too few to have an impact on the overall statistics of unvaccinated people. It they were not such a small minority, you would not be seeing so many more severe outcomes among the unvaccinated.

See https://covidestim.org/us for an update to your "too few" statement. The number of previously infected people is at least 70% in all US states I have looked at (80% in NY and CA).

While not directly comparable, an official report from the UK [1, Figure 3] estimated that effectively 100% of blood donors were either vaccinated, previously infected, or both. This was in September. Blood donors are not a representative sample of the population, but it's not hard to believe that by now effectively everybody (in the UK) has some kind of immunity.

[1] https://assets.publishing.service.gov.uk/government/uploads/...

It 70-80% has been infected, then most of the vaccinated population will be vaccinated and infected, which provides still stronger protection than just infections.

The end result is the same: higher proportion of severe illness among the unvaccinated, which is most easily fixed by vaccinating them.

> higher proportion of severe illness among the unvaccinated

No, among the unvaccinated and uninfected, which, as the data others have been giving shows, is nowhere near even a majority of the unvaccinated any more, let alone enough of a majority to treat it as if it represented all unvaccinated people. So your claim that the unvaccinated but infected are too few to matter and should not affect vaccine recommendations, let alone vaccine mandates, is egregiously wrong.

Again, a category error:

You are failing to differentiate between the two subgroups of unvaccinated people, the previously infected/unvaccinated, and the purely unvaccinated. Additionally, you are not doing any further subdivision on these two groups by age. The blanket "one size fits all" strategy you are advocating is assuming that all of these groups are at zero risk for adverse events from the vaccine. Young, healthy males have a statistically zero risk of severe COVID complications, and a statistically small but non-zero risk of myocarditis. The risk of myocarditis from the vaccine falls to practically zero as you progress upwards up the age distribution, which is the exact group of people who have the highest benefit from the vaccine. You are talking about a gradient which impacts both the cost and the benefit, with a diminishing cost and an increasing benefit going up in age. Not taking this into account is so illogical, that in my opinion, people who hold this view are clearly blinded by bias.

If I'm going to get smeared as an "anti-vaxxer", I'm going to go ahead and use a label to describe humans who hold the rigid, data-resistant view that you possess:

Immunity deniers

> Immunity deniers

Let's not do this. When this mess is over we'll all want to work and break bread together again, and that's much more important than whatever any of us happened to believe or say in the fog of war.

You're right, labeling people is a terrible thing to do.

I'm just at a breaking point now, after 2 years of having the most anxiety and risk-averse among us gleefully demonize, censor, and shame those of us with heterodox opinions. When you add to that the enthusiastic endorsement of forcing people like me to get a shot despite already having immunity solely to appease their paranoia, the bitterness has put me over the edge. Considering that it's the same crowd who has spent decades chanting "my body, my choice" and insisting that the government "never come between a person and their doctor", the hypocrisy adds to the outrage. I've been called a conspiracy theorist for pointing out the highly improbable chain of coincidences that made me doubt the narrative around the virus' origins, then had to watch as they all change their minds without an ounce of self-reflection or a single apology. On top of this, the national media has been completely, un-flinchingly on board with all of it, which is a distinguishing characteristic from the harassment and government intrusion upon LGBT folks championed by the political far right until the 2010s. They gave these anxiety driven tyrants full moral authority to violate my rights. I hope you can understand my bitterness.

The last thing I want to do is dehumanize others. For the crime of not wanting to get NEEDLESSLY injected with a rushed, experimental genetic technology whose trials were entirely run by pharmaceutical companies who have a long history of overstating benefits and hiding risks for their products, I've been ostracized, condemned, and coerced by the same people who insist on not eating GMO produce.

Enjoyed your posts and keep it coming.

Just finished a few trips to Latin America. Kissed the ground when I got back here to Florida, where kids goto school, don't wear masks, and don't have to be vaccinated. Here, we respect individual liberties. We respect the right to go out and earn a living and put food on the table and if we lock everything down, at least uncle sam sends out checks to hold us over for a while.

People are starving and dying in places like Venezuela, Cuba, and other countries in LA. Small business has been devastated by the un-ending lock downs.

Unemployment is rampant. People cannot put food on the table. Its crazy. The lack of empathy that local governments have in LA for a persons right to earn a living is unconscionable. Maybe its because the virus has hit hard the wealthy elite ruling class since they tend to be rich, fat, white, and old. I dunno. But they are all wanting to break in to America and would if they could.

That's really awful to hear regarding Latin America. How is Columbia doing? Do you have any insights there?

Lots of columbians here in miami trying to make ends meat. I've met one famous soap actress who cleans houses here ( in Fl) and also a successful psycologist who is waiting on tables because of the economic malaise caused by forced business closures.

Politics is a contact sport.

> Young, healthy males have a statistically zero risk of severe COVID complications, and a statistically small but non-zero risk of myocarditis.

Now imagine having a healthy 7-year old son, and having an excruciatingly difficult conversation with your spouse about why he shouldn’t get vaccinated. Or having to cut off ties with your mother-in-law, preventing your children from seeing their grandmother, because she thinks you are actively harming your own young children by not getting vaccinated despite having natural immunity.

These people are destroying the very bonds of society.

Regardless of how small the absolute risk, the risks of COVID are far higher than the risks of the vaccine, even for 7 year olds. So why are you choosing to die on that hill?

Regarding 7 year olds, you are grossly misinformed, but that's not your fault. The US Federal government is continuing in it's grand tradition of doubling down on bad science to save face of bureaucrats who made bad policy decisions. For previous examples, see the thousands of studies by NIH to justify cannabis prohibition, USDA food pyramid, dragging feet on leaded gasoline for decades, etc.

The rationale for vaccinating kids was to prevent them from spreading it. The vaccine did that effectively before Delta. With omicron, it's worthless for preventing spread. Kids are the one age group at higher risk from flu than covid.

My two kids (8 and 15) aren't vaxxed. They caught omicron, and now they are in the ICU... Oh wait,no they are fine, had almost zero symptoms, and were playing outside the day they tested positive. Which is, statistically, a virtual certainty. They aren't morbidly obese or immunocompromised, so they shrugged it off.

Nobody is dying on a hill. We're just better at statistics and aren't gullible enough to believe these panicked fools.

Put an experimental product from Big Pharma in your kid for no reason. That's your call. But ask yourself why you suddenly trust the FDA, an organization that labeled oxycontin non addictive, approved Vioxx, approved remdesivir for covid despite it being useless, and that's just the past 15 years. Fear is the mind killer indeed.

At this point, the vaccine is as experimental as getting COVID.

We have lots of data on both. Said data shows that 7 year olds are much more likely to have serious affects from COVID than from the vaccine. That's not to say serious outcomes from covid are at all likely. Just that the relative risk is lower with the vaccine.

To reiterate, the absolute risk is tiny, so it's really not a big deal. But if you truly understand statistics, then you will also see that everyone will be exposed to COVID and you are better off with the vaccine than without no matter the age cohort.

And the vaccine reduces transmission (less so than we had hoped, but a reduction, nonetheless), no one ever said it would 100% stop transmission.

I suppose taking an experimental vaccine seems unnecessary if you consider a wild virus to be natural, maybe even artisinal, and you ignore the fact that while the vaccine is quality controlled and the same as what billions of people have now received, and the virus is constantly mutating, well then I guess the virus sounds safer.

My wife is from a family of fiercely independent Filipino immigrants. She's always been super levelheaded. I lucked out with her. Her late father was a chemist, and her uncles are all practicing physicians. They were all universally shocked when the push to vaccinate kids started. They know it's not dangerous to kids. They can't even talk about it without lapsing into angry rapid Tagalog. She was right there with them.

Here's a new editorial from a prof at Johns Hopkins:

https://www.wsj.com/articles/the-high-cost-of-disparaging-na...

Might be useful in those conversations on previous infection. And I agree regarding the social fabric being destroyed by these bureaucrats. They are going to slowly try to find a way to ease out of this in a manner that minimizes the damage to their reputations. That's what political elites have always done when their narratives crumble after they have dug in. See the utter absence of contrition or self reflection after the Iraq wmd fiasco for an example. Or Vietnam. They don't care how much damage they do in the process.

You said:

> Given this data the most effective strategy is to just vaccinate everyone without what is effectively a pointless distinction

The data clearly shows that protection from natural infection is at least as substantial as from vaccination, and that ~half (if not more) of the US population has had it. This fairly obviously impacts the most effective strategy. Mandating vaccines (and now boosters) in young, healthy people who were already at small risk, including those who have already had the virus, is so absurd that I can't even characterize it as science. It is simply punitive behavior.

Most countries recognize prior infection. We're in a small, small club of scientifically illiterate nations here, and it's rather embarrassing.

> It will be once the proportion of unvaccinated people in hospitals starts to resemble the proportion in the general population.

If the total number of hospitalizations is a manageable number, the percentage that are vaccinated is irrelevant. It's a metric of punishment, not a realistic policy goal. I have no idea what the future will bring with regard to the ratio of unvaccinated hospitalizations, but I know that hospitalizations in general will fall as the population achieves broad immunity -- and natural infection certainly counts toward that goal.

Your ~half estimate is more like 70-80% these days. See https://covidestim.org/us

(This makes your case stronger, of course.)

Absolutely. I'm being intentionally conservative here.

> Mandating vaccines (and now boosters) in young, healthy people who were already at small risk, including those who have already had the virus, is so absurd that I can't even characterize it as science. It is simply punitive behavior.

The idea that a vaccine is a punishment is disturbing. I'm glad to have been able to get it.

I said the mandate is punitive, not the vaccine.

If you feel more comfortable getting an unnecessary vaccination, nobody is stopping you. Other people should not be coerced into doing the same against their will.

College kids are currently being expelled for refusing boosters. Children are being refused classroom education. Prior infection is not taken into account, and risk/benefit is not a factor. There's no other way to frame this than as coercive behavior.

College kids were already required to get multiple vaccines to attend and I remember being lined up to take the swine flu nasal spray with no say in the matter if I was going to continue education.

> There's no other way to frame this than as coercive behavior

We coerce people constantly when they have bad behavior that affects society and others. I don’t know why people keep trotting out mandates as having aspects of coercion/authoritarianism is a mic drop moment explaining why they are bad. How is this worse than all the other health based coercion we’ve had?

I think their point is that the data shows that previous infection provides good protection. If the goal is protection, then this should count for something, and should be factored in to the risk-benefit ratio. The risk-benefit ratio is not negligible for young, which is why the vaccine still hasn't been approved for the very young (and there's certainly not a step function in the risk-benefit ratio, by age). But, the risk-benefit ratio calculations being used don't seem to be including previous infection. This is not necessarily scientific.

For the other-than-COVID vaccines that are required for enrollment, there isn't existing protection in the majority of the population. Nobody has natural, effective, protection against measles.

I think the practical problem/reason is that there's infrastructure set up to track and share vaccination/booster status. There's no infrastructure set up to track, or even test, immunity status, which is the real metric of risk. So, for practical reasons, proof of vaccination status will always be favored and, almost certainly, held above the true, yet difficult to measure, immunity status, to drive policies. This is an easy out, that might cause harm, relative to an "ideal" policies that were based on immunity.

> College kids were already required to get multiple vaccines to attend and I remember being lined up to take the swine flu nasal spray with no say in the matter if I was going to continue education.

Saying it's happened in the past isn't an argument that it should continue in the future. I doubt your swine flu nasal spray had as intense of negative side effects as the COVID second shot and booster tend to in the young and healthy. Now that we're in booster territory and Delta is being phased out the shots are almost certainly more painful than the disease for some portion of the population.

> How is this worse than all the other health based coercion we’ve had?

I can't recall any other health based requirement for attending an event or restaurant. I also don't understand why people continue to harp on how a personal COVID vaccination decision "affects society and others" at this point. The vaccine only marginally prevents infection at this stage, and the primary benefit of reduced severity should stop everyone who's vaccinated from worrying about what others around them may be doing. I get the flu shot so I don't get the flu, and I'm not sitting around telling others who haven't that they're putting me in danger.

Marginal reduction in transmission can mean the difference in ending a pandemic or dragging it out for another year or two. There is a big difference in an R value of R1 and R0.9

And you probably don't remember ever being required to show vaccination status to get into a stadium or restaurant in your lifetime because you hadn't previously lived through a pandemic.

> Marginal reduction in transmission can mean the difference in ending a pandemic or dragging it out for another year or two.

Sure, it’s great that we have the vaccines to do so. We should be focusing on making them available to everyone on earth rather than forcing them down the throats of those who don’t want them to get to the fastest “end.”

> And you probably don't remember ever being required to show vaccination status to get into a stadium or restaurant in your lifetime because you hadn't previously lived through a pandemic.

Fair enough. My reply was in response to a status quo argument, but indeed this pandemic hasn’t been just that. In which case I think you have to assess the dangers to those who have been vaccinated, which is not much. Indeed with omicron the risk isn’t very high for a large portion of the population vaccinated or not. And the vaccines are available to anyone who wants to reduce their risk, thus the mandates make little sense.

When I worked in DoD intel in the past, I had to travel to multiple nations with extremely high rates of dangerous tropical disease. I took multiple vaccines for this purpose. At no point do I ever recall worrying about whether the local populations I was dealing with were vaccinated at all. Because that's how vaccines work. They make it so you don't have to worry about others not being vaccinated or giving you the disease. With diseases that are highly dangerous to children, this is a different case, because you can't vaccinate children when they're extremely young and therefore a person not being vaccinated can transmit the virus to them. With COVID it is the absolute opposite. Small children are at minuscule risk and are actually far more at risk from influenza due to the dynamics of the virus. This risk age gradient is actually unprecedented and a unique feature of COVID.

What's really happening here is people who have considered themselves progressive and tolerant their entire lives have decided that they want to impose policies that are tyrannical, but they have to desperately backfill this logic to make it feel okay. They aren't willing to let any form of data disrupt this because if they did, they would have to admit to themselves that they had a tyrannical impulse in the first place.

Notice how when he got the swine flu nasal spray he wasn't demanding that everyone else in every public place he went to also get it. Nothing about this makes sense unless you view it as people trying to psychologically justify tyrannical impulses.

> When I worked in DoD intel in the past, I had to travel to multiple nations with extremely high rates of dangerous tropical disease. I took multiple vaccines for this purpose. At no point do I ever recall worrying about whether the local populations I was dealing with were vaccinated at all.

Yeah the tropical diseases are an interesting parallel for me too. In a place where malaria or dengue are prevalent I don’t blame others for being vectors of the disease, I assess my own risk and behave accordingly. And the mere fact that they’re spread via mosquitoes instead of air/surfaces doesn’t change the necessity of congregating people to spread. But these diseases are not universally dangerous, so people should not be universally pressured to take any measure to avoid them.

I’m not sure I fully agree with the tyrannical impulse premise, but I’d subscribe more readily to a tribal “badge of honor” premise, which in this (and indeed most cases) happens to be tyrannical. I think generally the masses don’t intend tyranny, rather they virtue signal to coerce and thus become tyrannical as a result.

There is a pre—existing vaccination mandate for enrollment at colleges in the US.

All the vaccines mandated by colleges have been around for decades. It’s not “just another vaccine” to add to the list; there is a difference.

Which brings it all back to a lack of trust in the vaccine/science. The current science is that the vaccines are safe and provide a greater degree of protection than prior infection alone. Outside of some very rare conditions that would make someone unfit for a vaccine, there's no reason not to get vaccinated. Refusing to get one only increases your chances of ending up in a hospital and for what? There's no advantage to giving yourself a disadvantage no matter how small you think the benefit a free vaccine would give you over the protection a natural infection has already given you.

Your logic here is flawed. Even if you've already had covid, the vaccine will give you more protection. That's good. We can't do the reverse (give deliberate natural immunity to those who are already infected), but that's no reason to say that natural immunity is "good enough." That goes for the individual as well as society. Would you decline airbags because seatbelts as effective?

I think you're hitting a strawman here.

Are any number of vaccine shots "good enough"? Or, should we be getting one every month to get as much protection as possible?

There's a line to be drawn somewhere, and I think what's argued here is that natural immunity should count for something, instead of being lumped into the same group as those "unvaccinated and no prior infection".

> Even if you've already had covid, the vaccine will give you more protection.

And more risk. Which is greater?

I completely agree with your comment and to help summarize why you are having to explain all of these things to these people, I suggest everyone on this thread read the following link to understand their error.

Dividing groups of people up without going deep enough into categorization creates contradictory conclusions.

https://en.m.wikipedia.org/wiki/Simpson%27s_paradox

The assumption that excess deaths can be attributed to any single cause is simply not based on data and/or science.

What is the age breakdown of these excess deaths? If the distribution doesn't mirror the age distribution of known COVID deaths, that's an immediate indicator that it's factoring in multiple sources.

Drug overdoses, attempted suicides and actual suicides are way up, for example. Drug abuse is way up. Child abuse is way up.

I'm not saying you are wrong. I'm simply saying that you can't know that you are right without a careful analysis of the data. It should be noted that the "excess deaths are way up" is also used as a tool of people claiming that the vaccines are killing people as well.

Again, I want to emphasize, I don't know the detailed data behind the excess deaths. COVID is certainly one factor, but what percentage does it constitute? I'm not claiming I know, but you are. That's the difference.

You are also ignoring the studies out of Israel (sample size of 2.5 million people), Qatar (sample size of 400K people), the recent CDC study in other replies to your comment, etc. It's a long list of studies that show that prior infection is a superior, more durable form of immunity to Delta than vaccine-only populations.

Additionally, it's rather absurd to use hospitalizations as a metric for the general population. I'm sure you are extremely aware that the bulk of unvaccinated people getting hospitalized are not young or healthy. "Some unvaccinated people" is also a statement ignoring the shocking prevalence of prior infection in seroprevalence studies, which isn't really shocking when considering a respiratory virus that has an R0 that has been at minimum 3 in the beginning with the original variant, and is now 6-7 with omicron.

The data has changed, but many people's opinions have remained fixed. I don't understand what motivates this, but it's become tiresome as it continues to drive policies that are intuitively foolish and violate centuries of immunological knowledge.

In case you haven't seen it before, https://euromomo.eu/graphs-and-maps has graphs of excess data for most of Europe (plus Israel) by age groups.

I find it a great resource to cross-check the misinformation of the mainstream media. For example, I challenge anybody to look at the 0-14 and 14-44 graphs and tell me when covid actually occurred.

Note that excess is not defined as a deviation from a typical year, but as a deviation from a typical year when no diseases are circulating. The goal of the euromomo website is to detect things like flu outbreaks, so the number of excess deaths is usually greater than 0, capturing the flu, heat waves, and presumably other disasters.

I am talking about the raw "deaths in 2020 - average deaths in 2015-2019" number. It is much higher than just the COVID deaths.

> Note that excess is not defined as a deviation from a typical year, but as a deviation from a typical year when no diseases are circulating.

Data is deseasonalized, which does not mean what you wrote.

> Data is deseasonalized, which does not mean what you wrote.

You are correct that I oversimplified a complex situation. https://euromomo.eu/how-it-works/methods/ describes their method, especially section "Hypothesis".

Their model includes a sinusoidal seasonal component, as you noted. However, what I said is also true. From the Hypothesis section, third bullet:

"Parts of Spring and Autumn are less likely to be influenced by additional processes leading to excess deaths and the main pattern of mortality can therefore be modelling using only those periods, resulting in a baseline being the number of deaths expected when no particular process increases mortality."

As is clear from the bullet that precedes the text that I quoted, "processes leading to excess deaths" means winter infections and summer heat waves. So my description, while incomplete, is hopefully not too misleading. For completeness, I should mention that they also adjust for population growth. (You can't just do 2020-avg(2015-2019) because the total population is different.)

But winter excess deaths will not be zero _in the absence_ of winter infections. Because they add that sinusoidal component, they will be zero in an average-strong flu year for example, and less than zero in weaker flu years.

Your claim is empirically false. The total number of excess deaths was 81K in 2017, 158K in 2018, 101K in 2019. (You need to click a few buttons to enable data from past years.) The reason is that the sinusoidal amplitude is fairly small and is explicitly calibrated not to capture the flu. Look for example at the 2019-2020 winter graph: the empirical data matches the model until covid kicks in. For some reason, people die more in winter irrespective of the flu, and the sinusoidal component attempts to capture this effect.

Stepping back from the details for a minute: this is a 15-year long joint effort of public health authorities in Europe, with the explicit goal "to design a routine public health mortality monitoring system aimed at detecting and measuring, on a real-time basis, excess number of deaths related to influenza and other possible public health threats across participating European Countries." In terms of data analysis, their model is very simple, comprising a constant, a linear trend term for population growth, and a sine-wave term for non-flu seasonality. Do you really think that they would be so incompetent as to use a model that explicitly removes the flu, which is the very effect that they are trying to capture? Give them some credit, they know what they are doing.

> Drug overdoses, attempted suicides and actual suicides are way up, for example. Drug abuse is way up. Child abuse is way up.

Just to be clear, you're saying that the reason we've seen hundreds of thousands of excess deaths last year is because of drugs, suicides, and child abuse.

https://injuryfacts.nsc.org/motor-vehicle/historical-fatalit... https://www.cdc.gov/nchs/nvss/vsrr/mortality-dashboard.htm#

If people want to explore some "crude" (CDC's word) data by age group. Cherry-picking some data, there were 10-15 times more drug overdoses then covid deaths in 2020 (Q2-3) for 25-34. Similar ratios for 15-24. And I'm sure it'll be the exact opposite for higher age groups or if you focused on people with comorbidities. Yet these demographics are grouped together without any nuance when it comes to mandates. Note this is pre-vaccine and pre-delta so not really representative of current state of things.

There are 10-15 times more drug overdoses than COVID, but there arent significantly more overdoses than previous years. Some increase, but it looks like a steady increase.

In other words, excess death counts would account for overdose deaths because they are expected. They wouldn't be considered "excess" deaths.

The numbers I have seen for excess deaths pretty closely match COVID death numbers as counted from death certificates. So you have two unconnected sources matching up pretty closely. I'd say there is a good chance the near million COVID deaths number we are looking at is pretty close.

>died due to cancer/car accident

The WHO definition of a covid death means that they can only be counted as covid deaths if there's a clinical link between cause of death and covid.

Ergo, cancer and car accident victims with covid wouldn't be counted.

I suppose it depends on how your country defines it and if it follows WHO guidelines

Correct, that's why I characterized them as miscounts.

There are popular theories about thousands of such miscounts happening to get more money from the government, but it makes no sense for them to be more than a small minority of mistakes.

>There are popular theories about thousands of such miscounts happening to get more money from the government, but it makes no sense for them to be more than a small minority of mistakes.

Show me profit motive, and I'll show you an audit worth doing. If you've not parsed and checked that data, I'd recommend not passing judgement on it. The market can stay irrational longer than you can remain solvent.

Earlier in the pandemic many public health agencies over counted COVID-19 deaths by including everyone who had tested positive regardless of the actual cause of death. Most agencies have now corrected those numbers to better align with WHO and CDC guidelines so current metrics are generally more accurate. For example Santa Clara County had to adjust the death count down by 22%.

https://www.nbcbayarea.com/news/local/santa-clara-countys-co...

Saying that some people might have been miscounted is pushing an agenda that is not pro science I'd say.

In London this number has been as high as 40%, so it's highly relevant to present accurate numbers.

But the only place science has won is in producing a good vaccine, the rest has been a shit show of crazy decisions and a hunt for those who didn't want to get vaccinated right away.

I sincerely hope sanity returns.

> However, we have a 30/70 split in number of covid hospitalizations, with 30 being vaccinated people, in countries where the split in

Is that vaccinated? Fully-vaccinated? Or "up to date" (i.e., whatever round of boosters are being pushed)?

The point is, the narrative has pushed the importance of "the science". Yet so much is actually not consistent with science / scientific method at all. Ffs, they can't even get the definitions and language right.

These aren't occasional lapses. They're non-stop. I hear what you're saying. However, it still doesn't address the negligence. After two yrs it's not incompotence, is it? Still?

". Given this data the most effective strategy is to just vaccinate everyone without what is effectively a pointless distinction."

So...we don't need science. Just everyone bend over and do what the authorities say, when they say, and how they say it? That's it? Kids? New borns? And everyone else on the low side of risk? Just because?

You can't have your science and dismiss it too.

Zeynep Turfekci talks about this in this thread, and about why she thinks prior infection offers less protection than the vaccines, to the point that she supports vaccinations for those who have already caught COVID.

https://twitter.com/zeynep/status/1484930583214100481?t=UDTW...

Lost a lot of respect for Zeynep after reading that. The argument boils down to unvaxxed have more hospitalization, some unvaxxed also have prior infection, therefore prior infection isn't effective. There is no data in her post that those with prior infection are the ones being hospitalized. Meanwhile, there is real data elsewhere on this topic.

> to the point that she supports vaccinations for those who have already caught COVID

It's so ridiculous now they're requiring vaccination for the vaccinated too.

I've also noticed this. I have covid right now. I'm double vaccinated. I was planning to get my booster shot, but now that I've had covid what's the point. It's not likely to increase my immunity and it comes with risks.

At some point the government will probably change the definition of fully vaccinated to three shots and then I'll be in that unvaccinated group I usually make fun of.

Somebody I know lost their job because they wouldn't get vaccinated (but they'd already had confirmed covid). That seems very unfair.

I'm very angry at the dumbasses who haven't been infected and refuse to get vaccinated, including family of mine who died because of that. But no distinction is being made of those who have natural immunity. Which, as you say, is unscientific.

I feel like partly that's because many people think they had it, but didn't, and partly because it's easier for the government to just tell everyone to get vaccinated.

>I'm very angry at the dumbasses who haven't been infected and refuse to get vaccinated, including family of mine who died because of that.

You use your dead relative as proof for your case in the same breath as calling them a dumbass.

This goes to prove a point. Does it matter if everyone is vaccinated & "safe", at the expense of our dignity and respect as a species?

Getting vaccinated doesn't hurt our "dignity as a species". It's the smart and socially responsible thing to do, so it would make one more worthy of respect.

I know name calling is pretty low, but I stand by it. The data is so good right now, there are so many people who have been vaccinated, so many who've had covid with and without being vaccinated, that yes, you're a dumbass if you think it's smart not to get the vaccine. You've listened to the wrong information and built a bad argument in your mind.

My family member who died was a lovely person, but always bad at critical thinking and always fell for conspiracy theories. Mostly it was harmless. Sometimes it just cost him a lot of money. This time it cost him his life.

> It's not likely to increase my immunity and it comes with risks.

Can you explain what risks you're referring to here?

There have been side effects from the vaccine, including documented cases of really bad reactions [1],[2]. I’m double vaxxed, boosted, and got covid. But to say the shot is without risks is disingenuous.

That said, the risk of dying unvaccinated from COVID is much greater than the risks of vaccine. And it’s unclear if side effects from the shot are correlated to worse outcomes from COVID (e.g. It’s unknown if these people who were paralyzed definitely would have died when they contracted covid, so paralysis is a potentially better outcome).

[1] https://www.wpxi.com/news/top-stories/every-day-that-i-work-...

[2] https://www.wkrn.com/news/nashville-woman-partially-paralyze...

The relevant risk for your situation is vaccine risk, versus risk of reinfection (not just hospitalization, but also long term effects).

The math may still work out for your preferred choice, but i wanted to point out that it’s fallacious to dismiss the (rare) risks from reinfection, especially when focusing on the (rare) risks from the vaccine.

You may have said this and I just missed it, but both those risks are small and honestly boils down to a preference IMO. I may just have missed in your comment where you made the right comparison, in which case I’m being a bit pedantic without cause and I apologize.

You really went out of your way, there, to cover any potential misinterpretation. Thanks for being a considerate part of the community!

I don't think you'll get any more functional immunity from an extra shot of vaccine compared to two and an infection. So the benefit side of the calculation is lacking.

While the vaccine risks are very small, they're also highest for those who have had the actual infection. There will be little bits of virus lingering in my body for a long time. If I get that vaccine, my immune system is going to go ape attacking them, and maybe do some collateral damage in the process.

To be clear, I still think the risk is small, but so is is the benefit. I don't think it's worth it.

Thanks for writing a detailed comment of your thinking, I think we both are evaluating it the same way, I just wasn't very clear with my initial wording.

> I don't think you'll get any more functional immunity from an extra shot of vaccine compared to two and an infection.

The evidence disagrees with your opinion.

Inflammation, memory loss, swollen lymph, chest pains, feeling sicks for months, no energy, trouble breathing.

You thought the vaccines were risk free?

The ability for humans to focus on a vanishingly small risk of side-effects to justify taking a much larger risk by refusing to vaccinate is mind-boggling to me.

It's the same argument that people use to justify not wearing a seat belt. "There's types of wrecks where being unbelted is actually safer!" Well, sure, but those are an extremely tiny portion of wrecks, and you're vastly safer in the vast, vast majority of wrecks wearing a seat belt.

Get the damned vaccine. If you experience side effects, then that sucks, you lost the lottery. The CDC reports:

* Anaphylaxis happens to 5 people per million vaccinated. (0.0005% rate)

* Thrombosis with TTS after J&J vaccine. 57 confirmed in more than 18 million doses (0.0003% rate)

* GBS after J&J vaccine. 302 cases in more than 18 million doses (0.0017% rate)

* Myocarditis. 1233 reports in total.

* Death. 11,657 deaths among vaccinated. Note that this is death for any reason. A vaccinated person mauled to death by a bear is counted here. (0.0022% rate)

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/ad...

* edit for formatting

For young males, the risk of myocarditis strikes me as underappreciated. To quote the NYT (https://www.nytimes.com/2021/10/09/health/researchers-find-a...):

"Males between 16 and 29 years of age have an increased risk of developing heart problems after receiving a second dose of coronavirus vaccines made by Pfizer-BioNtech or Moderna, according to a large new analysis published on Wednesday in the New England Journal of Medicine.

The study, conducted in Israel, estimated that nearly 11 of every 100,000 males in that age group developed myocarditis, inflammation of the heart, a few days after having been fully vaccinated."

Isn't myocarditis something you can get when you have a virus (even non-Covid). I wonder what the myocarditis rates are for covid patients in that age range

OH NO! 11 out of 100,000 males!!! GOD FORBID!! That's 0.011%!! The risk is so high!!!!

Why don't we just quote the part you conveniently left out: "For every million vaccinated boys ages 12 to 17, the shots might cause a maximum of 70 myocarditis cases, but would prevent 5,700 infections, 215 hospitalizations and two deaths, the agency has estimated... One of the new studies looked at data from 2.5 million vaccinated members of Israel’s largest health care network who were aged 16 years or above. The researchers identified 54 cases of myocarditis, and deemed 41 of them to be mild."

So 54 cases out of 2.5 million people vaccinated. And it likely prevented over 10,000 infections, 500 hospitalizations, and 5 deaths. It really, really sucks for those folks. But the benefits VASTLY (orders of magnitude) outweigh the risks.

The risk isn't "underappreciated." The risk is statistically insignificant compared to the protection offered by vaccination.

Those are the major reported prizes. There are many more high tension, depressed, generally unwell, joints swelling winners with brain fog.

It's gamble, the next booster might be the one that gets you. And you'll need a booster because it only lasts a few months anyhow.

This isn't a "gamble." No one would gamble if the house offered these odds. The gamble is NOT getting the vaccine. You're gambling with your life, possibly. And you're much more likely to get a "prize" like death, hospitalization, long COVID, etc if you refuse to get vaccinated. Like tens or even hundreds of thousands of times more likely.

my first 2 shots were fine, but my booster f'ed me up. I was in lots of body pain for 36 hours. 5 weeks later I caught omicron. I imagine by some point this year Ill be considered not fully vaccinated, but right now my desire to get another booster is very small.

right now we know that even the booster provides little ability to stop you from getting omicron. likely by the next mandated booster the variant of the time will also easily surpass the booster.

> right now we know that even the booster provides little ability to stop you from getting omicron

This is true, but the data is showing that being boosted means that catching Omicron when boosted means you are much, much more likely to have a very minor illness. Refusing future boosters comes at the risk of your own health, as well as the health of the people around you.

I'm fully boosted, sat directly across from a friend in a bar booth for over an hour last weekend (figure about 2.5 feet/80cm). She tested positive the next days. I tested negative with PCR twice in the last week however. If was unboosted, much less unvaccinated, I'm 100% sure I'd be positive.

well congratulations, I'm boosted and it didnt mean shit, you were probably just lucky

Actually, you were unlucky.

Also, did you end up in the hospital? Did you die?

Because by being vaxxed and boosted you greatly increased your chances of having the chance to post ill-informed comments on Hacker News post-recovery.

Omicron rarely sends people to the hospital. check that, so does all other variants of covid19; however, omicron does so at about the same levels as the flu - with or without vaccination. However, stop trying to change the narrative. the comment was that they think they didnt get covid was because they were vaccinated - the idea that we must mandate vaccines because that stops the spread. it doesnt.

No I was not unlucky. get your head out of the sand, omicron breaks through the vaccine easily.

<pajama caste playbook> Because by being vaxxed and boosted you greatly increased your chances of having the chance to post ill-informed comments on Hacker News post-recovery.

hinting at censorship already are you, boy, you just follow the playbook dont you?

<pajama caste playbook> we need to mandate vaccinations and masks to stop the spread of covid

<data> that's not working

<understanding of how the vaccines work> this is not how the vaccines work

<non pajama caste> you are violating my cival rights

<pajama caste playbook> well it prevents severe disease. you need to be censored for misinformation. you need to be prevented from going outside so I can feel safe because vaccination prevents the spread of covid.

<pajama caste playbook> you hate science, science works by censoring those who disagree with the proposed opinion. I worship science so I am the superior caste. I am science, I am good

Who hurt you?

Listen, if you're hell bent on willfully increasing your risk of death/hospitalization, that's on you. The simple fact is being vaccinated drastically reduces the risk of that.

Does the current vaccine work as well against Omicron as it did against prior variants? No. But does it work better than literally doing nothing? Yes.

And yes, you were unlucky. The vaccines are still 70+% effective at preventing breakthrough infections based on the data we currently have.

The vaccine is not ineffective. And it reduces the severity of the infection even in the case of a breakthrough.

And as far as OP is concerned, there is a high likelihood that their boosted status did protect them from infection.

> Who hurt you?

Every time I have to show my vaccination card to be in public.

> Listen, if you're hell bent on willfully increasing your risk of death/hospitalization, that's on you.

I am vaccinated and boosted. I MAY not want to get boosted AGAIN because it was extremely painful and made me sick for more than a day. I MAY not want to go through that again while taking into account what is happening in the FUTURE with the variants. but I may not have the right to make my own decision due to mandate fanatics

> And yes, you were unlucky. The vaccines are still 70+% effective at preventing breakthrough infections based on the data we currently have.

do you even know what that means? what does it mean to be '70% effective'? How long does this effectiveness last? effective against what (covid19, delta, omicron)? Are you talking about vaccinated 1, 2, or booster? I know personally 20 people who have gotten it. 15 vaccinated 5 Unvaccinated. We have been having more than 600k cases per day since the beginning of January. I'm guessing there is A LOT of break through cases in that.

> And as far as OP is concerned, there is a high likelihood that their boosted status did protect them from infection.

If they were sitting across from me when I was feverish from omi, they would have gotten it. keep in mind, I was infected by someone who was vaccinated.

> Refusing future boosters comes at the risk of your own health, as well as the health of the people around you.

And some scientists think that repeated boosters will backfire and lead to waning immunity or at least immunity better centered around the exact strain the vaccine is made (so could be mitigated by different boosters). Plus downsides of repeatedly have to make time to get boosters, taking doses from people who haven't even had the opportunity to get a single dose. Differences in risk between a healthy under 30 and an unhealthy over 65.

It's possible that your statement is correct for some demographics and incorrect for others. But that nuance is not in the current discussion or the current mandates; and that nuance could save lives in less-developed countries.

> And some scientists think that repeated boosters will backfire and lead to waning immunity

* citation needed *

> or at least immunity better centered around the exact strain the vaccine is made

Given how mRNA vaccines work, there's nothing stopping the producers from putting as many different "instructions" as they wish in a single dose. But anyways, again * citation needed *

> Plus downsides of repeatedly have to make time to get boosters

Boo frickin' hoo. Even if we have to get quarterly boosters, that's four times a year. You're on Hacker News, you obviously have spare time on your hands.

> taking doses from people who haven't even had the opportunity to get a single dose

At this point, in the developed world, there's no one left who hasn't had "the opportunity to get a single dose." In fact, we have vaccines going bad due to anti-vaxers refusing to get vaccinated. And realize that a vial of vaccine sitting in the WalMart or CVS down the street isn't going to magically get repositioned to Africa due to Americans refusing it.

> Differences in risk between a healthy under 30 and an unhealthy over 65.

You know what drastically lowers the risks of COVID infection, both in terms of getting infected in the first place and the chance of bad outcomes if you do contract it? GETTING VACCINATED.

> throw_nbvc1234 1 hour ago | parent | context | flag | on: Pfizer board member suggests end to mask, vaccine ...

> Refusing future boosters comes at the risk of your own health, as well as the health of the people around you. And some scientists think that repeated boosters will backfire and lead to waning immunity or at least immunity better centered around the exact strain the vaccine is made (so could be mitigated by different boosters). Plus downsides of repeatedly have to make time to get boosters, taking doses from people who haven't even had the opportunity to get a single dose. Differences in risk between a healthy under 30 and an unhealthy over 65.

Based on your comment history, you're American, so you're not helping anyone in "less-developed" countries by refusing a vaccine. You're just exposing yourself and your community to a higher level of risk.

I'm curious what you think of situations like mine:

I have MS, and I'm not sure that frequently boosting my immune system when I have an autoimmune disease is the best idea. In addition, I'm in a single-income WFH household and we easily isolated when we got omicron. My sister and I literally caught Omicron together and just quarantined for 14 days. We had our mother drop off stuff on the doorstep so we didn't have to go out/expose anyone. It was boring, but I'm damn sure we didn't infect anyone.

I'm a software developer, not a medical professional, so my opinion doesn't really matter for your situation. What I will say is that it took three seconds to google "covid vaccine multiple sclerosis" and I came to the National Multiple Sclerosis Society's COVID-19 page which says, "People with MS should be vaccinated against COVID-19...None of the available vaccines contain live virus and the vaccines will not cause COVID-19. The vaccines are not likely to trigger an MS relapse or have any impact on long-term disease progression. The risk of getting COVID-19 far outweighs any risk of having an MS relapse from the vaccine."

I'm double-vaccinated, I'm just not boosted. (I'm similar to someone else in this thread in that I was waiting for more information before getting boosted and caught Omicron first). I think boosters are a good idea for the general population, I just think that there might be a difference between 2 doses once and repeated activation of the immune system. Also there's a difference between the risk posed by the original variant or Delta vs. Omicron.

Plus to be completely blunt, "not likely to trigger an MS relapse or have any impact on long-term disease progression" isn't language to inspire confidence. To be fair, I think we understand the vaccines pretty damn well, it's MS that I think we might not understand well enough here.

> as well as the health of the people around you

'the science' says you are wrong. the vaccines do not prevent spread. that is very very very clear in the data now, so stop spreading that nonsense

> as well as the health of the people around you

'the science' says you are wrong. the vaccines do not prevent spread. that is very very very clear in the data now, so stop spreading that nonsense

that assumption relied on at least 3 things being true: #1 ) having lower symptoms from the vaccine would not encourage those shedding the virus but not being observably sick to go out and spread the disease (*hint this is probably a pretty bad assumption) #2 ) the vaccine would reduce viral load #3 ) a reduction of viral load would prevent you from spreading it to others

It turns out the vaccine does not lower viral load. and even though this has been shown to be medically true, you can see that in places like Isreal and Germany where the virus spreads pretty easily. hell, even in the US, you dont get nearly 1m cases a day without vaccinated people spreading it.

> partly because it's easier for the government to just tell everyone to get vaccinated.

Do you make no allocation in your mind for the potential that the government is corrupted and the motivations have nothing really to do with public health?

Sorry, but in my opinion that is a silly thing to believe. I'm assuming you're from a liberal democracy, what if I told you you could have _your_ name on the (local) ballot next time a $LOCAL vote comes around?

The government, for the most part, is not an evil cabal of deep state cultists (in most countries that describe themselves as liberal today). People like you or me can join a party, and then get elected within a year or two.

What I absolutely do believe is that people elected, through what is essentially a harmless popularity contest in peace time, are the worst type of people you want to have taking decisions in a crisis. People worried about their next re-election are _not_ going to make the right decisions, apart from the fact that in peace time the electorate optimizes for populism and extremism, and the candidates are sometimes more like actors than leaders. In short: they are incompetent, heavy handed and not even remotely equipped to deal withe massive leverage attached to the levers they control.

Sure, I could end up voted in as the mayor of a small town. That's nothing like making it into congress.

A small town mayor has none of the power a member of congress would.

In democracy the larger the seat, the larger the infrastructure required to get there.

The funding of this infrastructure brings the necessity of corruption.

> A small town mayor has none of the power a member of congress would.

Assuming the mayor is in an executive mayor system (not a council-manager) system, they often have far more practical power than a member of Congress over any issue, but their power is over smaller issues. Even in a council-manager system, the mayor (who is a primus inter pares council member) is more likely than member of Congress to have decisive power over any issue within their ambit.

(Also, being a small town mayor, or similar local officer, is not an uncommon way to build the infrastructure for becoming, say a state legislator. And that's a way to build the infrastructure for Congress, and that for Senate/Governorship, and that for the Presidency.)

We are discussing a conspiracy that requires the cooporation of hundreds of worldwide governments. The process to gain the power of your "congress" is fairly insignificant within this discussion. There are many governments with varying paths to power.

So every government, the world over, even those at war with each other, all decided to push a "get vaccinated" message for reasons other than health?

I mean, governments want to ensure their income stream (tax payers) are alive to pay taxes, but that's hardly "corrupt" and is still to do, indirectly, with public health

> So every government, the world over, even those at war with each other, all decided

Yes, it's quite a possibility. Please read into the growing concentration of world power via corporations and un-elected organization like the WEF and WHO. Further, please read into puplic-private partnerships.

Our world is a global one these days and nearly every government is corrupted by a form of corporatism.

> Our world is a global one these days and nearly every government is corrupted by a form of corporatism.

So communist Cuba is corrupted by a form of corporatism? Big pharma got to the ayatollahs in Iran? Maduro in Venezuela is goose stepping to the beat of the pharmaceutical conspiracy?

> So communist Cuba is corrupted by a form of corporatism?

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

> Authorities of the Ministry of Public Health (MINSAP) and the Biotechnological and Pharmaceutical Industries of Cuba (BioCubaFarma) met with representatives of European embassies, Cuban-based partner agencies and PAHO/WHO country office to continue promoting collaboration in the health sector.

https://www.farsnews.ir/en/news/13990121000392/Ayallah-Khame...

> The World Health Organization has considered priorities in combating coronavirus and Islamic Republic of Iran obeys and follows up priorities as defined by WHO.

Admittedly Iran banned US made vaccines, but then just put out their own in cooperation with the WHO, COVAX and Gavi.

https://www.hrw.org/news/2021/01/12/iran-khameneis-reckless-...

> Iran has said that the country is participating in the COVAX Facility, which is an effort by the World Health Organization, Gavi (the Vaccine Alliance), and the Coalition for Epidemic Preparedness Innovations (CEPI) to help low- and middle-income countries get access to vaccines. Iran started the first phase of the human trial for a domestically produced vaccine in December 2020.

See https://www.weforum.org/agenda/2020/04/who-funds-world-healt... for who the WHO is funded by. At the point when the US pulled funding, the largest donor was the Bill and Melinda Gates Foundation and the third was Gavi. Bill Gates owns a lot of pharma stock. The foundation is a way to garner influence in a tax free and humanitarian looking way.

Who funds Gavi?

It's a rabbit hole, but the world is complicated and conflicts of interest (corruption) abound. Please do follow a few of these research threads and try to be open minded to those suspicious of wealthy people claiming to operate in our interest.

You're nuts. Cuba and Iran meet with the WHO and suddenly they discard decades of antagonism to get on board some crazy covid conspiracy? These are not research threads, but wild inferences from innocuous happenings.

You're not even proposing anything specific. This is Glenn Beck level 'just asking questions'.

But orgs like WHO don't have any real power - they make recommendations and (western) countries, in the main, either accept or reject them.

I think it's a stretch to suggest all the countries are in on this together as some sort of 'control' method.

Public/Private partnerships are a modern necessity in countries that choose to keep their citizens happy through low-tax policies. There's room for corruption there sure, but that doesn't lend itself to all countries agreeing to go with this wild covid idea as an exercise in exerting greater control over their populaces

We're not talking about the government here, we're probably talking about over a hundred governments worldwide. They're all corrupt in the same way? That's ridiculous.

Also what's the end game here. Why would a corrupt government gain by mandating masks and encouraging vaccination. Even the potential motive is lacking.

Around half of my immediate family members had pretty bad reactions to the booster (fever/chills, aches for several days). And all of them got omicron anyway and had the same symptoms as family members who hadn't gotten the booster. I'm debating getting the booster but part of me thinks "why punish myself with high probability of fever/chills if in all likelihood I'm just going to get omicron anyway and suffer the same symptoms as everyone else"

The data so far suggests that the booster grants substantial protection against severe disease with omicron. If anecdotally there doesn't appear much difference in your circle, that's much weaker evidence. I would still recommend it. Also my parents got the booster with no side effects of note, so not everybody reacts that way.

> If anecdotally there doesn't appear much difference in your circle, that's much weaker evidence

You can't compare studies looking at the population average with someone's specific social circle. Young people have a near-zero chance of getting severe disease anyway.

"substantial protection against severe disease with omicron" is irrelevant when the chance of severe disease is so low.

COVID was the #1 cause of death in the USA in 2020. Not just for morbidly obese 70+ year olds etc. Anyone saying that something which has killed near 1 million people just in the USA in the last two years is a minor risk are just flat wrong.

Does it really? Across age demographics and other risk factors when compared with those with 2 shots (who from data I’ve seen aren’t getting severe disease because of the protection from the vaccination)? That would surprise me and isn’t what I’ve seen. Would love to see what you’re referring to.

But they're still alive...The entire point of getting vaccinated is to keep you out of the hospital from severe symptoms or dying. A small chance of a slight cold for a few days is worth the tradeoff vs. suffocating to death from a preventable airborne disease.

"why give my body more tools to fight off infection?" This is a strange question to me.

The mRNA vaccines were developed in February 2020. The virus has had ample opportunity to change since then so it's not surprising that you still got sick.

I don't think it makes sense to extrapolate this to a hypothetical new shot which is developed for the new virus.

> now that I've had covid what's the point.

Because the booster increases future immunity and decreases the chance that you'll pass future infection to others.

> It's not likely to increase my immunity

Yes it is. I don't know why people are so certain it won't.

https://www.latimes.com/science/story/2021-11-27/protection-... for instance.

It's not true that no distinction is made for natural immunity. The CDC guidelines consider natural immunity from confirmed covid cases as valid for 90 days. That may not match the science, but policy has to trail the science as well as balance the science with public policy strategy.

90 days is just silly. Also anywhere there's a vaccine mandate, except in parts of Europe, that doesn't count for anything - when a confirmed recovery should be equal to vaccinated status.

Isn’t it just simpler to vaccinate everyone and be done with it? Instead of tracking who already had an infection etc. Just like we do for all the other vaccines we get.

I don’t understand why it’s so controversial. The upside is huge and there is literally no downside.

"literally no downside"

Adverse reactions to vaccinations exist. Some are severe / fatal.

Ignoring this feeds into vaccine skepticism.

There is no downside to force vaccinating a population with something new that doesn't expect the first long term study to be in until 2024? How could that be controversial?

A woman has a right to say my body my choice. You think removing that choice is without controversy?

>A woman has a right to say my body my choice. You think removing that choice is without controversy?

Choosing to terminate a pregnancy is not comparable to choosing to spread a highly contagious disease.

Allowing a government to control those rights means they can and someone will take advantage of this in the future.

Let's say America's birthrate is too low because of the vaccine, the government could use that reasoning to suspend the right to choose.

LOL

But we don't do it with every other vaccine. There are vaccines targeted at specific groups and vaccines that are optional regardless of group.

And there are zero mandatory vaccines that require 6-month boosters for life.

And zero mandatory vaccines that have efficacy rates under 90+% (probably more like 99%).

I think it's ok to acknowledge we're in totally novel territory with covid.

What we need are tests that indicate immunity levels and give a good predictor of risk.

I'd like to make sure I understand your underlying position before proceeding.

I think what you're trying to say is that you believe there is an adequate enough case for people who had prior infection to avoid what they believe is an unnecessary medical procedure which may have some risk. And, scientifically, you believe it's absolutely certain that in this specific situation, prior infection immunity provides very good protection, enough to override any benefits we might see that happen at very high vaccination rates.

Hope that's a good summary....

Are you a scientist?

You made a number of statements about what is good and bad science, but some of the reasoning you make doesn't completely add up. In science nobody has epistemic certainty, but scientists and public health people act as if they do. In reality public health decisions are made using imperfect information and balance utilitarian and emotional concerns, as well as prior knowledge of patient compliance. Sometimes it may be necessary to not change a message, even if it's somewhat wrong, too quickly.

The calculus is very simple at this point. I believe CDC and others are saying that the additional risk from taking the vaccine is very very small, and the marginal benefit of having even people with prior infection get vaccinated presents a greater (overall) health outcome (presumably in the form of people who had infection immunity but still were re-infected, and then infected others).

Beyond that I don't think anybody has enough scientific data that is certain enough to say that you're right in your statements, and I think it's pretty poor taste to just keep attacking people who disagree with you as doing "bad science". Science is a subtle art, and anyway, public health is an entirely different field that has to concern itself with effective communication and people-emotions and ethics, so sometimes what CDC announcements may not be identical to what the state of the art of science is saying.

I think making a simpler and weaker point would work better. I'd criticize the media for unnecessarily creating additional fear, uncertainty, and doubt, around COVID (there was a lot of early reporting about how omicron was going to destroy the world, that was entirely baseless speculation). And too many people, both media and generally, are quick to criticize people who don't "follow the CDC to the letter", especially around vaccines. I think that kind of cropped up politically in the US after the unnecessary autism/vaccine scare and ended up representing a dividing line.

BTW, I'm an ex-scientist, worked in medical biology for decades, and I don't think many vaccines (flu, covid) are nearly as effective as the medical establishment suggests (look at the numbers of people who died of flu even in years with very high vaccination rates). And people do have significant side effects from getting vaccinated, but very rarely are the side effects more dangerous than the value of being vaccinated (in cases of flu and covid), which is why I support them. Finally, I think that herd immunity doesn't actually work in diseases like flu or covid. So I have some sympathy to your message but ultimately, just get vaccinated and boosted unless you can truly articulate some huge risk to your personal biology.

If you skipped this wall of text, stop and read it. Well said.

Adding on, immunity declines over time, so to maintain it would either mean reinfection or booster…

Cellular immunity is quite durable over a lifetime. It's really only antibodies that substantially decline over time.

https://peterattiamd.com/covid-part2/

when you say "wall of text" do you mean I could have rewritten my points to be more effective (all my writing is propaganda and my goal is to convince more people, the proxy for which is upvotes)"? The reason it's structured the way it is is that I only spent a little time editing it after I banged out the essential points. "I have made this longer than usual because I have not had time to make it shorter."

Not at all. I mean it is a lot of text for a comment and my tendency is to skim or skip the long ones.

It was worth reading.

I think you hit the nail on the head when you said the vaccines are less efficacious than initially reported (~94% decrease in the probability of disease incidence). I just don't understand how you square that with your conclusion, just keep getting boosted some indeterminate number of times by vaccines we know are 1) not as good as advertised, and 2) seem to be providing less and less protection over time as new variants emerge.

The best protection based on my knowledge of biochemistry would be natural immunity to the current variant in circulation.

I give that recommendation for the same reason I floss my teeth when asking my children do so; it's modelling good behavior to establish life-long health habits. It's not that I think flossing is particularly effective at countering gum disease (compared to just brushing alone), but it's the mainstream position and I think it's better to model "follow mainstream science" than "repeatedly question the medical establishment without data". I watch the news and literature for occasional reviews of flossing and I would update my parenting if warranted.

The clear public health trend seems to be that we're going to see 2-3 revs of the vaccine booster per year, not that we're going to depend on natural immunity. I think it is almost certain that most COVID deaths were front-loaded and this will look almost exactly like flu vaccines in 3 years.

If I had kids I think I would encourage the exact opposite behavior. As a scientist by training I have been trained to be skeptical, question everything, and do my own research. I would hope to pass that along to my children.

I also think you've set up a straw man to knockdown when you equate being skeptical to "question[ing] the medical establishment without data". There's no shortage of data out there on and around this topic. You can search on PubMed and literally read for weeks.

I'm a skeptic, but it gets in the way of pedagogy, for example we often don't teach high school students how friction really works (according to the most up to date theories). Instead they get a few basic equations that describe a much simpler model (and which fall down if you try to make some predictions). Certainly I teach my children to be mildly skeptical, but I see no value in them questioning flossing until they're about 16 and can start to read and argue for themselves. And even then, I don't think most people are capable to read primary literature or review articles.

As to searching on pubmed and reading for weeks: that's the problem! The vast majority of people are not qualified to read the scientific literature. You need extensive training to learn how to read literature and evaluate it properly. This is especially true for medical/biology research. Learning to be proficient in that world (medical biology/public health literature) is the price of entry for being effective at changing policies. The Skeptics don't always win.

Skeptics shouldn’t always win, but at least they have convinced themselves one way or the other.

Agree to disagree but I’m all for people reading and researching on their own. Nobody understands the literature the first go, that happens with time.

I get the sense that those within scientific circles tend to get a bit triggered when others attack them doing "bad science".

I suppose it's a loaded term has a wide range of connotations, perhaps the point about not giving more fuel to "anti-science" groups like flat-earthers and hard line antivaxxers is justified.

But then I couldn't shake the feeling that the criticism of "bad science" is justified -- what you described is basically scientists making political and policy decisions, and dispensing not-exactly-true statements to the public. That may not be "bad science" for the reason that it's not science at all -- the scientist is tasked with being a politician, and we all know what politicians do.

The problem is that to outsiders (like me), there's really no way we can tell which hat the "Scientist" is wearing. I personally think that scientists trying to pretend to be politicians is going to backfire badly in the long run, no amount of policing against non-scientists bad mouthing "science" is going to fix that.

The fundamental problem is, without a full-blown censorship system to silence skeptics (whether justified or not), there's really no a good way to prop up the authority of the scientific establishment unless they stop telling white lies and establish authority based on a track record of speaking objective truths.

> but a HUGE # of people have already had it and ignoring them is downright unscientific.

Unless they went to the hospital or had a positive test, then they just think they had it right?

We get data like this:

All we know are things like:

   Unvaccinated 12-34 year-olds in Washington are
   • 2 times more likely to get COVID-19 compared with fully vaccinated 12-34 year-olds.
   • 5 times more likely to be hospitalized with COVID-19 compared with fully vaccinated 12-34 yearolds.
   Unvaccinated 35-64 year-olds are
   • 3 times more likely to get COVID-19 compared with fully vaccinated 35-64 year-olds.
   • 7 times more likely to be hospitalized with COVID-19 compared with fully vaccinated 35-64 yearolds.
   Unvaccinated 65+ year-olds are
   • 4 times more likely to get COVID-19 compared with fully vaccinated 65+ year-olds.
   • 7 times more likely to be hospitalized with COVID-19 compared with fully vaccinated 65+ year-olds.
   • 11 times more likely to die of COVID-19 compared with fully vaccinated 65+ year-olds.

(from https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/..., so local to where I live).

But it unfortunately doesn't break down things like "had a confirmed prior infection" or "thought they might have had a prior infection". It would be interesting to see how the data works, but right now unvaccinated people are on average in a very bad spot. For all we know, the unvaccinated are just more likely to have comorbidities (e.g. obesity) that lead to their higher fatality rates. But for now, getting vaccinated is so easy, I wouldn't take the risk.

> If you are a rational person who wants to see good science and are unemotional and detached from outcomes, then you will want to see proper study cohorts, and combining prior infection in with the "unvaccinated" cohort, is just bad science.

Not sure what you mean. Science detached from outcomes is bad science. Science is trying to suss out cause and effect, not to avoid reality.

> This bad science fuels the anti-vaxx movement even more, and honestly, it is hard blame them.

Ah. There it is. Nope. It's still easy to blame them. It's not a sufficient criticism to cede moral superiority. "You didn't adjust your tone to distinguish 'unvaccinated' from 'immune-because-infected' from 'vaccinated'." does not suggest that antivaxxers are any less morally bankrupt for promoting the course of action which results in serious illness and death.

> One would expect prior infection to be robust, and multiple studies, including even the CDC's most recent shows it to be easily as good if not better and longer lasting than the vaccine.

I got COVID back in March of 2020. I got two vaccines and a booster, and then in late December I caught COVID again (probably Omicron based upon symptoms and the prevalence).

>If you think any of the above is "anti-vax" then I would suggest the media has won and science is dead.

[edited to remove antagonistic comment] - I think your comment about science being dead is less-than-useful hyperbole.

Why focus on the "get vaccinated" message? Because the vaccine is free. It's widely available. There is absolutely low, low risk to taking it - less risk by far than getting COVID or long COVID. Because prior to Omicron, the goal wasn't "let everyone get sick and be done with it", it was "prevent anyone from getting sick". I just thought of one as I type this: To say "we accept natural immunity as a viable strategy" could have encouraged thousands upon thousands of ignorant or otherwise actively anti-authority citizens to get sick on purpose to stick it to the man, then end up in the hospital.

I don't want lies to win, and I don't want to ignore the science. Natural immunity should be acknowledged for its benefits. I think a government could do that, and still say "tough shit, get vaxxed" just to make sure people don't commit bio-warfare on communities by trying to get ill.

Yes, this is a prime example of bad data being worse than no data.

In the UK, for months now, the rate of infection has been higher among the vaccinated cohort than among the unvaccinated cohort, for most age groups. [1]

The antivaxxers are of course pointing to this data and claiming it's evidence that the vaccines make you more likely to get infected, and therefore the tinfoil hats were right all along.

But what's actually happening is that the unvaccinated cohort contains a lot of people with natural immunity, who are dragging the numbers down, while the vaccinated cohort doesn't have as many people in it who have had a prior infection.

I strongly suspect that if you were you properly separate people by vaccination status and prior infection, you would see that the group of unvaccinated+no prior have a much higher case ratio than any other group. But since we don't have this good data, the antivaxxers are running hog wild with the bad data, drawing the wrong conclusions.

[1] https://public.tableau.com/app/profile/t.coddington/viz/UKRe...

Either way, there is no point in vaccinating the unvaccinated cohort that you mentioned.

If you are right, most of them have natural immunity and the data proves that this is already better than the vaccine, so what's the point? They are already doing ok, and vaccination would then move them to the vaccinated column and count their immunity as a success for the vaccine, which is unscientific and dishonest.

I agree.

Many places around the world have vaccine passes that don't care about natural immunity, which is incredibly unscientific and dishonest. If the case rate is higher among the vaccinated, you're statistically less protected at a venue that checks the vaccine pass. It's counterproductive and ought to be abolished immediately.

Vaccine mandates that ignore natural immunity are equally wrong. Many hospitals in the US fired un-vaccinated healthcare personnel without regarding natural immunity, which led to staff shortages, which combined with this Omicron surge means hospitals are so desperate for staff, that many are allowing people to work with an active corona infection, as long as they are vaccinated. We're preferring actually infected people over un-infected, but un-vaccinated people. In a healthcare setting.

And the people responsible for this is claiming to "follow science".

It's absurd.

The only measurement that should matter is your immunity level, regardless of how you acquired it.

Thanks for saying this. Science is dead.

In a prior probability sense, that makes sense, right? The adaptive immune system has to be working or the vaccines wouldn't work, and adapting against the actual threat has to be effective or you'd never have fought it off in the first place.

Of course, the general problem here is one of measurability and working in an adverse environment. So in a medical sense, prior infection determines response. But in a public health sense, if you believe that prior infection claims are easier to fake than vaccine records, and if you believe the spread risk is worse, then it makes sense to proxy spread risk with vaccine records. Personally, I get what you mean, and perhaps I'm not fighting too hard for the truth here because I don't really care that much.

But I just wanted to say I'm with you on the facts since every other response is operating (in my opinion) in the fallacious "there's a paper that says" mode. It's just not Bayesian.

It's a lot harder to accurately determine if someone has convalescent immunity than it is to just give them a couple shots.

And then immunity is not a binary or linear response. Vaccination can still boost immunity in the case that someone has recovered from infection.

Unvaccinated people have caused other people to suffer worse health outcomes because unvaccinated people are disproportionately filling hospital and ICU beds (and wearing out doctors and nurses).

Developing antibodies the old fashioned way is great! Doing it with vaccines saves other people's lives. That is the problem with people who refuse the vaccine and why they deserve to be vilified.

Vilifying people for making unhealthy choices is never an effective public health measure. It didn't work for the HIV/AIDS epidemic and it won't work now. Try education and harm reduction instead.

I think it was clear I was not offering a public policy idea. I was explaining the common emotional response most of us have when they see people make decisions that they know will cause physical harm others. Like poisoning a river or driving drunk.

Some unvaccinated are immunocompromised.

I know someone who could not get vaccinated for medical reasons (legitimately), and caught it, and died.

It just really sucks to know that the person I know would more likely be alive if not for the choices of others.

Vaccination does not prevent one from being contagious. On the contrary, vaccination could lead to more risky behavior.

Which of these two people are more likely to spread COVID:

1. An unvaccinated person who rarely leaves their house and avoids contact with people as much as possible.

2. A vaccinated individual with an asymptomatic infection who regularly engages in social activity, confident that their triple-boosted immunity will protect them from serious illness.

So yes, the choices of others have an impact, but I don't think it's clear that getting a vaccine is the thing that universally improves the outcome for others. It's individual behaviors more than vaccination status that impact the health of others. The choice to get vaccinated (or not) has little impact on one's chance of shedding the virus. But the change in behavior thanks to vaccine-induced confidence leading to more risky behavior could actually have a negative impact on the health of others.

Your comment is a potpourri of the kind of fractured logic that has become all too common in this debate.

> Vaccination does not prevent one from being contagious.

I never said it did, that's not even a counterpoint. Seat belts do not prevent car accident injuries, helmets do not prevent concussions. But they all are effective in reducing the probability.

> On the contrary,

Note the common form of the straw man.

> Vaccination could lead to more risky behavior.

"could", an imagining of some sort of scenario that works for whatever reality you're trying to believe in

> Which of these two people are more likely to spread COVID:

Apparently you think those two options are exhaustive?? Eliding right past the public behavior of the non-immunocompromised unvaccinated? Ignoring the point that if more unvaccinated people were vaccinated and boosted, it would be less likely that vaccinated people engaged in social activity would spread COVID? So, no thank you, I will not ignore a reality that hit me viscerally in favor of your theories of what "could" be true.

It's also sociopathic. We've stopped caring about the people around us and created a group to hate that we refer to in a dehumanizing way. You may not agree with their choices, but they are still people and it should be beneath us to dehumanize "them" - actually our neighbors. It's actually horrifying from a human perspective

Ignoring those who are unvaccinated but had a prior infection seems like it can only make the data look better for the unvaccinated than it actually is, no? Because the "true" death rate among the unvaccinated-and-not-yet-infected will be higher than among the unvaccinated-and-previously-recovered group that already has that immunity you talk about.

So if anything, breaking that out just makes not getting vaccinated for those without prior infection look even stupider.

I'd have no problem with treating proof of immune response as similar to vaccinated, but I also haven't seen most of the outraged argue for that - versus just arguing for "freedom" - so... don't wait for me to make that case for them.

Do we apply this same thinking to the flu? If I have had the flu before I shouldn’t be encouraged to get a flu shot? Seems easier for everyone to just get the flu shot than figure out if I have had the flu before and then maybe get a flu shot. What am I missing?

well said, the "unvaccinated" term is way to dehumanize real people.

Ethically I think it’s the people who cannot get vaccinated through no choice of their own that need to guide policy. If we can protect these people, and there was a fair amount of hospital capacity, I’d be all in on letting the anti-vaxxers just get it. I live in a country with health care. So I’d even be in favour of charging the anti-vaxxers the cost of care. Give the nurses the extra money.

By the same logic, just leave the thief and murderer as is because it is very unlikely any education will change their mind.

Antibodies are only one aspect of immunity and they tend to decline over time. Over the long run cellular immunity is more important.

https://peterattiamd.com/covid-part2/

Hospitals are overwhelmed by people who are vaccinated, have mild or even asymptomatic covid, and are certain they are going to die.

https://www.wcax.com/2021/12/22/covid-positive-vermonters-wi...

I'm sure there's plenty of actual sick people too. But we need a serious change to our messaging.

CDC's new paper throws a wrench in all of these arguments from NYT: https://thepulse.one/2022/01/24/cdc-admits-the-obvious-natur...

> it is very unlikely that any evidence or logical arguments will chance their minds

Disagree. Anecdotally a relative dying of Covid traumatizes some (not all) just enough to start questioning their beliefs and get the jab.

> With COVID becoming endemic everyone is going to get antibodies, with the only choice being whether you get your first antibodies by vaccination or by getting COVID.

That's not what endemic means.

You're not going to get COVID antibodies via the vaccines. You would with other vaccines (e.g., polio, measles, etc.), where they inject the actual disease into your body in order to trigger your body's natural immune response, but the mRNA vaccines don't work that way. The only way to get COVID-19 antibodies currently is to get the disease.

I'm not vaccinated and it is by choice because I've already had COVID. Getting a vaccine for a disease you've already had is like wearing two pairs of pants. Sure, you can do it, but why?

I don't think you're breaking any new ground here. In the two regions where I've lived since the outbreak, hospital capacity was already a factor in what precautions were mandated.

But the spread of disease is a lot more complicated than sick/not sick. It has an affect on society much farther and wider than hospital capacity, and that should not be the sold yardstick by which we measure our reaction.

Except, the hospital capacity per 1000 population has been steadily declining in the West for ages [0] and is at half the capacity in China for comparison. So rather than blaming the unvaccinated, we should maybe review the policies that lead to it.

[0] https://data.worldbank.org/indicator/SH.MED.BEDS.ZS?location...

My guess is you don't have children under 5 who can't be vaccinated right now. Yes, there is a low chance of complications, but it's still the most deadly infectious disease for that age group [1] and I'd rather have my kids obtain antibodies through vaccination than disease.

[1] https://twitter.com/GYamey/status/1455708642297188354

> The only question really then is how fast do we want the unvaccinated to do the getting antibodies by getting COVID thing.

I think the question that so many people forget is how fast the unvaccinated themselves want to get antibodies, not how fast someone else wants to get them antibodies.

Im my country, Germany, that currently is debating mandatory vaccinations for everyone, the maximum average share of Covid patients was 5% at the top of the most deadly Covid wave. 95% of patients were in for other reasons.

https://www.bundesgesundheitsministerium.de/fileadmin/Dateie...

> Gemessen an der vorhandenen Bettenkapazität ergibt sich eine durchschnittliche Belegungsquote von 1,3% durch COVID-19. Die höchsten tagesbezogenen Belegungsquoten gab es in der zweiten Dezemberhälfte mit knapp 5% aller Betten.

I don't want to have to undergo medical procedures, just for optimizing a statistic by a very small percentage (for two weeks in a year) that could have been optimized in other ways. Some pointless covid intervations at national level have burned so much money that nations could have built thousands of new hospitals instead.

> (2) it is very unlikely that any evidence or logical arguments will chance their minds.

While this is true, we've seen that employer mandates actually do change their minds. Yes, something like 1-2% of people don't get vaccinated even in that case, but that's far less than the 20% that claim they will lose their jobs to not get vaccinated.

Nice fairytale but you should see more television. People who decided to not get the jab have been hunted like animals. And people that got the jab got really sick or died and infected others.

Also there were effective medications for covid but people were misled to believe that they did not work, people died and were terrorized to get vaccinated.

This is a crime. Unless you enjoy it.

The media's binary separation of populations into vax and unvax is a false dichotomy. More causal factors would be represented by:

  1. Covid-recovered 
  2. Vaccinated
  3. Partly-vaccinated (< 14 days after 2nd shot)
  4. Covid-naive + Unvaccinated

CDC reporting bundles #3 and #4. UK reports all 4 categories separately.

#1 was already a high percentage in 2021 and is now higher due to Omicron.

Edit: CDC estimated pre-Omicron #1 as 146 million people (as of Oct 2021), https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...

It is so amazing to me how many people don't seem to recognize this.

My (somewhat baseless) speculation on this is that a lot of the people in forums like HN are early adopter types who mostly work from home, and so were able to avoid exposure and got the vaccine relatively early. From this standpoint, I could see it being harder to empathize with folks who were exposed in everyday life (it's just a simple jab, I did it, why can't everyone else? Or maybe even those folks must be bad/lesser people if they didn't stop themselves from being infected).

Combine that with the constant onslaught of media time that pointedly ignores the categories that you breakdown above, and maybe it's no wonder that people have the opinions on this that they do.

Not to mention all of the vaccine injuries that do exist but are rarely reported on.

It's almost like there's a narrative here.

> Not to mention all of the vaccine injuries that do exist but are rarely reported on.

Source?

Consider for a moment that the "antivaxxers" are correct, that there is enormous bias in our medical, pharmaceutical, and media establishments in favor of vaccine safety. Could you really expect a reliable source on the subject if this were the case? What proportion of people are willing to speak out and risk career and social suicide for being labeled an "antivaxxer"? It is a self reinforcing chilling effect - few people speak out, data does not surface, fewer people look for evidence of adverse events, and over time it becomes riskier and more difficult to convince people that something is amiss.

Meanwhile the internet is awash with anecdote of severe symptoms following vaccination, and particularly concerning are frequent reports of doctors who are dismissive and/or refuse to submit reports on adverse effects. And then there are occasional claims of specialists in various neurological or heart related disciplines who claim to be seeing an unprecedented spike in certain normally rare symptoms among vaccinated patients.

Yeah, they could all be lying or this could be the nocebo effect or it's an army of bots spreading antivaxx propaganda...or maybe you can't magically accelerate a 5+ year testing and evaluation schedule for a novel technology merely because the president says he wants a vaccine yesterday? Note that the clinical data from pfizer and moderna is not available to the public - we are essentially relying on the manufacturers good faith with respect to the safety data that lead to approval by the FDA (moderna still isn't approved, by the way).

https://www.bmj.com/content/375/bmj.n2635

https://www.bmj.com/content/376/bmj.o102

You've presented an unfalsifiable story. There's no way to prove it wrong, that's just more evidence of the conspiracy.

A massive global coverup of the vaccine being bad, or conspiracy theorists using facebook to spread their narrative.

https://en.wikipedia.org/wiki/Occam%27s_razor

> Consider for a moment that the "antivaxxers" are correct, that there is enormous bias in our medical, pharmaceutical, and media establishments in favor of vaccine safety. Could you really expect a reliable source on the subject if this were the case?

I'm sorry, but this is just classic conspiracy theory thinking. "The very absence of evidence that I'm right is proof that I'm right."

The point is that it is borderline disingenuous to ask for a source when the allegation is that the sources are deeply biased in favor of their own consistent and pervasive "safe and effective" propaganda. I'm not alleging that this proof of anything.

Even if you spell it out for them, something tells me this person will keep calling you names, and finding every excuse not to question how they got to "believing" what they do.

I'm the one who originally asked for a source - there was no name calling, nor should there be.

If someone is going to make a bold claim about something generally considered to be safe, actually causing a significant number of injuries, it's irresponsible not to provide a source.

The name-calling wasn't referring to you. I'm pretty clearly referring to the person who threw out "conspiracy theory thinking" as if that was helping anything.

For what it's worth: Sometimes there isn't a source. It will behoove you to entertain an idea without demanding that someone provide a source that you approve of.

You can check VAERS yourself. Asking for sources on something that is so publicly available is... weird.

Antivaxxers rail against all vaccines. Your "less than five years testing" straw man is problematic when they have issues with polio and smallpox vaccines, MMR, etc., some of which have been around nearly half a century.

Being honest, NO amount of testing would be an acceptable amount/duration for a significant portion of that group.

> they could all be lying or this could be the nocebo effect or it's an army of bots spreading antivaxx propaganda

or a more prevalent pop-social affliction: "nonsense amplification syndrome"

Myocarditis and "long covid-like" side effects have both been widely reported...

Just search in this page for "vaccin":

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

Full disclosure: I'm vaccinated, am pro-vaxx, but every choice has risks.

And myocarditis is caused by the COVID virus. Search for that on the same page.

I would imagine that it's highly likely that people who get myocarditis from the vaccine would have gotten myocarditis from the virus. Certainly more than the general population.

Sure, but there are people who believe they can avoid catching covid-19, and they might be capable of that. Especially if you're living like a hermit or in an otherwise isolated and/or sparse community, you may be well positioned to just ignore this whole mess.

Somewhat orthogonally, I never caught chickenpox, at least nothing symptomatic...

Edit: I think it's also worth noting the history of mRNA vaccines is fraught with toxicity issues [0], and even to this day the stuff I read is pretty damn handwavy surrounding the "modified" pseudouridine toxicity fix which took 7 years to find. One just can't make the argument that the real virus and this synthetic soup of poorly understood nanoparticles are analogous.

[0] https://www.nature.com/articles/d41586-021-02483-w

Oct 2021, https://www.reuters.com/legal/government/covid-vaccine-injur...

> More than 1,300 COVID vaccine-related injury claims are now pending before an obscure government tribunal ... Lawyers tell me the vaccine is so new that there’s virtually no definitive research on injury causation to cite ... In the meantime, people like McFadden face a strict one-year deadline from the date of vaccination to file a claim with the CICP.

Unproven causality, but here's a database of 2021-2022 news reports on heart issues in athletes (missing baseline numbers for prior years): https://airtable.com/shrbaT4x8LG8EbvVG/tbl7xKsSUIOPAa7Mx

Vaccine injuries are reported from official sources just the same as covid-related injuries. There’s not a big media buzz around it because the numbers are so small, and everyone knew going in that there would be a small number of adverse reactions.

Were you used to seeing myocarditis and pericarditis in the news regularly before 2019...?

Are those more likely to be a) a side effect/risk of the vaccine, or b) a known result of the disease, which is present in people who have had COVID, even unvaccinated?

I'm not sure what you're trying to imply, but it certainly seems like you're saying it's newsworthy due to the vaccine.

>Are those more likely to be a) a side effect/risk of the vaccine, or b) a known result of the disease

I have a more pressing question for you:

Do you expect the medical establishment to accurately and honestly attribute the increase in myocarditis and pericarditis as side effects of the vaccine, or purely a result of the disease? I sure as shit don't. I expect the medical establishment to do and say whatever it takes to protect their profits.

No, and after seeing the rates of cases related to both the vaccine and COVID, it probably should have stayed that way.

These days you have to add ‘eligible for booster and chose not to get it’, ‘got booster shot’ and ‘not eligible yet for booster shot’.

In the Netherlands we started the booster campaign on November 18, but we get graphs claiming ‘hardly any people with boosters in hospital!’ with the data including hospitalizations from November 19 onwards.

Encouraging natural immunity is asking for hospitals to get filled up by people giving themselves covid on purpose. This affects non covid patients too.

I suspect that's why the media doesn't do it.

That's also why many governments do not accept proof of recovery in lieu of proof of vaccination. Those who do have vaccine-skeptic people catching the virus intentionally and risking death.

https://globalnews.ca/news/8524409/hana-horka-czech-singer-c...

Let's remember that the best case for vaccinated people is Covid recovery. Wilful ignorance of the best case would be unwise.

https://cbs12.com/news/local/new-covid-variant-detected-in-a...

> "Omicron is acting like a super booster," Unnasch said. "People who have gotten omicron are going to be really well protected against infection, not just disease moving forward, which is a really good sign."

The best case is never catching COVID again. Even vaccinated people put themselves at risk (albeit less than non-vaccinated people) if they catch COVID intentionally. No one recommends just going out there and catching COVID. But when proof of vaccination systems allow for it, some people do it anyway and some of them die instead.

Relevant xkcd: https://xkcd.com/2557/

Not going to happen with a coronavirus, even with self-isolation forever.

Yes, yet another way the government is dishonestly manipulating people into a single course of action even when it is of little benefit to anyone other than those who mistake metrics for what the metrics were designed to manage. There appears to be no bottom to the depths of credibility destruction that the government will plunge in order to put compliance above all else.

So there playing the I am ignoring it or lying about it for your benefit card like Fauci about masks early on?

It was a while ago that the CDC estimated recovered COVID numbers to bre around 146 million. It is more like over 200 million at this point with overlap of vaccinated people.

I am sick of being ignored of having recovered, and people making the excuse that if they let us know how good natural immunity is, or even talk about it, the idiots will go out and get COVID. I don't want a nanny state, or police state for that matter. The WHO and a lot of the world are at odds with the CDC especially on masking and boosting of under 12 year-olds.

Besides boosting one after the other may be weakening the immune system [1]. It makes sense. It raises antibodies, but wanes quickly. Natural immunity lives in B- and T-cell long-term memory of the immune system. SARS-COV1 recovered are still testing strong for immunity for over 18 years now.

I am getting repetitive, but let's address obesity, diabetes, poor lifestyle choices, and their kind before mandating anyone's personal health choices or shaming them for their decisions. If I call out obesity it is fat shaming..., but go ahead and lump the recovered in with the unvaccinated and try and shame and steer the course of our lives with mandates and policing.

[1] https://newsrescue.com/covid-boosters-could-weaken-immune-sy...

The difference is that I can't catch diabetes or obesity from others.

No, those are self-inflicted, and you can take action to rid yourself of them or minimize their effects. Self empowerment.

And since I first posted the CDC released a study that shows natural immunity is better than vaccination. Not surprised since vaccination went from 95% efficacy, and you will not catch or transmit COVID (very early on); to well, it's like 78% effective after a few months, and you can catch a mild case of COVID; to it drops below 50% after 3 to 5 months (vaccines cannot be FDA approved if they show less than 50% effectiveness), and you will need a booster, and you can be infected and infect others.

And we can debate mask-wearing, but there are no substantive studies on the issue, and if naturally immune and the vaccinated are protected (probably greater than 90% of the population by now), why masks? Not to even drag in having all of our children masked 8 hours/day, while the rest of us are able to limit our mask-wearing even though 12 and under are the least at risk for anything serious from COVID.

Recognizing that naturally acquired immunity exists for tens of millions isn't the same thing as encouraging people to intentionally catch covid to gain natural immunity. Failure to differentiate between the two is just another way the injection maximalists look out of touch or unempathetic.

This response is actually an example of what I'm talking about.

The comment that I replied to was explaining how the segment of the population that is a candidate for giving themselves covid while being high risk is (and has been) shrinking out of existence.

Meanwhile, there is a much larger (and growing) cohort that continues to be harrased if they (fairly) decide they don't need these vaccines, and the harrasment is justified by claims like yours.

Even the CDC has finally come around and published data along these lines (despite numerous studies suggesting the same starting from early last year). But after bullshitting people for so long, I guess we just have to expect there will be a ton of inertia behind the idea that every human needs these vaccines, no matter what.

Why doesn't someone make the point that 95%+ (or 98%+ etc) of Americans are protected via natural immunity or vaccines and back it up with data?

Once that point is made, the discouraging natural immunity argument can stop because hospitals can't overfill anymore.

However until that point can be made[0] I think the "don't encourage natural immunity" position will prevent the most deaths.

By the way, I also don't condone harassment of unvaccinated people or vaccination as a requirement for employment etc either. Those are separate issues to me.

[0]: I tried looking for it but CDC data is only sept 2021 and estimated only 146M infections https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...

I attempted to make an argument like that 2 weeks ago.

I was using an estimate of 120m instead of the 146 that you quoted. And I'm just a dummy on the internet, so I'm probably at least a little wrong. But the gist was that if you could jab everyone tomorrow (which you can't), you might get a little bit of a benefit in the stats, but politically you'd be dead

https://news.ycombinator.com/item?id=29914681

There's no reason hospitals can't still fill up anyway if you have enough volume.

EDIT: I should mention that I really appreciate what you said above:

> By the way, I also don't condone harassment of unvaccinated people or vaccination as a requirement for employment etc either. Those are separate issues to me.

I'm in Canada where the mandates are quite extensive but also change frequently.

I'd like to think the govt is hoping that each time restrictions are loosed, some type of immunity has developed and restrictionz can be loosed more. When things seem to get worse and worse again, the restrictions are added to ensure hospitals can work.

At the end of the day, a large decrease in severity will be the deciding factor. We can try to model when that will happen, but it will have to actually happen regardless of what the models say.

https://covidestim.org/us has estimates on the percentage of people ever infected by state. I looked at MA, NY, and CA, and they all hover around 80% (with error bars). I can't find a cumulative US estimate.

I have no idea how they came up with the estimate, but the site is maintained by reputable institutions, so I am inclined to believe these numbers unless proven otherwise.

How about we do this. For people that can and “should be” vaccinated but don’t by choice due to their own risk assessment, if they catch Covid and need hospital treatment they don’t get it.

That way they have their freedom and hospital capacity isn’t put at risk. If the people refusing to get vaccinated are willing to shoulder the risk themselves I have no problems with it.

I agree. This is really the critical point: If you are in a low risk group, but get covid you have no way of knowing whether you will consume hospital resources or not. In that case it's best to get vaccinated if you can to protect others who made need the hospital.

> If the people refusing to get vaccinated are willing to shoulder the risk themselves I have no problems with it.

This is the point: the people who are refusing to be vaccinated that have recovered from a prior infection are not at a higher risk of severe outcomes than the folks who got vaccinated and didn't have a previous infection [0].

So maybe if your definition of "should be vaccinated" is narrow enough, then maybe you can justify some kind of priority order for treatment. That's not a topic I'm going anywhere near though.

[0] https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e1.htm?s_cid=mm...

There are going to be gray areas. Some individuals should not or cannot get the vaccine. What qualifies for that exactly is a bit muddy as well. So I agree what is "should" isn't very clear.

As an individual, it's really the numbers around the ratio of unvaccinated individuals in hospital / ICU consuming resources unnecessarily and therefore depleting them for the rest of us unnecessarily that's maddening. That plus the regrettable stories about people that are vocally anti-vax that end up dying from covid.

So for me it's like fine, freedom is important and you can choose to go against whatever recommendation you want. But at the same time you have to shoulder the consequences for it too. You can't have it both ways. Have the freedom to do whatever you want but also not bear the consequences of those actions.

> As an individual, it's really the numbers around the ratio of unvaccinated individuals in hospital / ICU consuming resources unnecessarily and therefore depleting them for the rest of us unnecessarily that's maddening.

I think I'm failing to make this clear enough. I'll try again.

The set of unvaccinated people is made up of those with a prior infection (call them R for recovered) and without (call them N for naive). And for simplicity, we'll keep the vaccinated variable to a binary, yes or no. So you have vaccinated with a prior infection (VR) and vaccinated without (VN).

When you say unvaccinated you are talking about R + N. We have data from the CDC that says R and VN were at roughly equivalent risk of hospitalizatiom during delta, and VR was a little bit better. N was by far the worst, and is who you actually mean when you talk about the people disproportionately filling up the hospitals. Because that's what the CDC is saying, that members of R, VR, and VN were all showing up in the hospitals at a similar much lower rate, and N was in a different universe.

You wouldn't know this unless you specifically asked yourself the question and went looking for the answer, because so far it has gotten very little air time. So it's not surprising that you and lots of other people are not aware. I'm only aware because I happen to be a member of R, and so this is important to me. It sucks living in a world where lots of people think its fine to lump me in with N, and advocate for taking away my livelihood and freedom of movement.

Saying "the unvaccinated are clogging up the hospitals" is like saying "I don't like Mexican food" when really you just don't like spicy peppers. You may avoid some burn that way, but now you're missing out on the rest of the cuisine, and you've failed to equip yourself with the knowledge to avoid the Indian or Thai dishes that will destroy you (because you think it's just the Mexican part that matters, not the spicy ingredients).

Does that make sense?

I think we're in agreement, and I wasn't being clear enough as well. I do mean the N set. This is what I mean by the "should" being fuzzy.

Unfortunately some of the R set ("some" is also fuzzy, I don't know how much but by this point I'm guessing high proportion), were in the N set and just didn't need to go to the hospital. So the mentality and risk factor prior to move from N to R is the same. There is no deterministic way (except moving to VN first) to mitigate that risk ahead of time.

It depends on what strain you had and timing — this paper had a previous infection lower than a 3 dose vaccination:

https://www.medrxiv.org/content/10.1101/2022.01.03.21268111v...

The big question, of course, is timing — if you had a mild case in 2020, you're unlikely to do as well as someone who got their second dose a couple months ago.

Until the people hoarding ICU beds and grinding medical staff into the ground are no longer disproportionately unvaccinated COVID patients, I don't see anyone caring too much about the distinction.

> ... I don't see anyone caring too much about the distinction.

I think you're absolutely right, which is why I'm here banging this drum. People should care about the distinction, because it matters if you want to actually understand the situation.

Certain groups are overrepresented in the prison system in the US. Some people think this means that all members of those groups are bad people. The people who think this are poorly informed, and can only get in the way of solving the actual problems.

And no, I'm not equating the treatment of unvaccinated people to that of minorities in the US. I am equating the structure of the misunderstanding involved (disadvantaged minority + other problems describes a lot of prisoners, but its the other problems that dominate the equation. Just like unvaccinated + seronaive can describe a hospitalized patient, but the seronaive part is what matters).

I tried to explain this better in another comment: https://news.ycombinator.com/item?id=30096072

If the distinction is vaccinated people vs people with natural immunity, I don't think that's a scientifically sound distinction. Do you mean people who recovered 20 months ago from a long gone variant? Or people who recovered with no symptoms last week from Omicron? Do we know what it means if a person has antibodies from a recovery a year ago, given the advent of brand new strains that have spread like wildfire and are only just now being studied in depth?

What we do know, thanks to a mountain of unambiguous data, is that people who have had vaccine shots go to the hospital way, way, way less often than those who have not. Which means vaccines prevent other people from suffering bad health outcomes due to lack of healthcare resources. It is a win for everyone.

I'm not aware of any evidence of immunity after recovery waning over time. Omicron seems to infect more people with a previous infection than delta did, but protection from hospitalization is still strong. I'm interested to see otherwise if you have links.

The CDC looked at how people fared with delta with a previous diagnosis by March 2021, so presumably anywhere from when pcr and antigen tests started up until March. There is no breakdown of previous variants in this study, its just if you had a previous infection, you were protected.

I know, this doesn't sound like anything you've heard yet. They still manage to slip in a recommendation that "all eligible persons should be up to date with COVID-19 vaccination", but the data doesn't support that.

> Four cohorts of persons aged ≥18 years were assembled via linkages of records from electronic laboratory reporting databases and state-specific immunization information systems.† Persons were classified based on whether they had had a laboratory-confirmed SARS-CoV-2 infection by March 1, 2021 (i.e., previous COVID-19 diagnosis)§; had received at least the primary COVID-19 vaccination series¶ by May 16, 2021; had a previous COVID-19 diagnosis and were fully vaccinated*; or had neither received a previous COVID-19 diagnosis by March 1 nor received a first COVID-19 vaccine dose by the end of the analysis period.

> By the week beginning October 3, compared with COVID-19 cases rates among unvaccinated persons without a previous COVID-19 diagnosis, case rates among vaccinated persons without a previous COVID-19 diagnosis were 6.2-fold (California) and 4.5-fold (New York) lower; rates were substantially lower among both groups with previous COVID-19 diagnoses, including 29.0-fold (California) and 14.7-fold lower (New York) among unvaccinated persons with a previous diagnosis, and 32.5-fold (California) and 19.8-fold lower (New York) among vaccinated persons with a previous diagnosis of COVID-19. During the same period, compared with hospitalization rates among unvaccinated persons without a previous COVID-19 diagnosis, hospitalization rates in California followed a similar pattern. These results demonstrate that vaccination protects against COVID-19 and related hospitalization, and that surviving a previous infection protects against a reinfection and related hospitalization. Importantly, infection-derived protection was higher after the Delta variant became predominant, a time when vaccine-induced immunity for many persons declined because of immune evasion and immunologic waning (2,5,6).

Yeah all those Oklahoma gunshot victims can't be seen by the ER.

https://taibbi.substack.com/p/moral-majority-media-strikes-a...

> Encouraging natural immunity is asking for hospitals to get filled up by people giving themselves covid on purpose. This affects non covid patients too.

So uh, what is that.... 0.01% of the entire population? Less? Yes, some people will cheat the system but people cheat all systems all the time. That's just life.

Most people will do the right thing. We cannot build a society around 0.01% of us who cheat.

>Encouraging natural immunity is asking for hospitals to get filled up by people giving themselves covid on purpose.

there's no interest in talking about actual treatments or a $1 early treatment remedy [1], like every other disease. There's nothing that's patentable and profitable, so the focus is on vaccinations, which increasingly show more infections

The US DoD maintains detailed military personnel data to protect national security. Their health care surveillance data shows everything from neurological issues impacting US airforce pilots to 300% increase in miscarriages and cancer. The data is being scrubbed and military whistleblowers are trying to fight to bring it to public attention.

It's like Snowden, but from the healthcare department of the US military. [2]

1 - https://c19early.com -- w/ peer reviewed data sources

2-https://twitter.com/TheChiefNerd/status/1485695818996854788

Thank you for posting.

> From this standpoint, I could see [..]

there are so many different standpoints you could take from the HN population.

- "HN focuses on tech; novel tech tends to be anti-regulation => HN must be anti-mandate."

- "HN focuses on engineering; engineering is often an optimization game that involves balancing tradeoffs => HN must believe COVID response relative to all the other risks we face is an over-reaction."

- and of course the one you presented.

my theory is that opinions within any group are just more divergent than people realize. some groups do a better job than others in (a) understanding that and (b) working with that. it's almost all cultural: do people in your culture publicly voice their non-conforming views, and to what degree do people in your culture update their beliefs when they hear new information?

At this point, “3” represents a tiny fraction of the population so isn’t even really worth breaking out

To the contrary, #3 includes everyone receiving a booster, because immune system suppression/DoS immediately after a vaccine makes it the period of highest risk for both infection (from Covid or anything else) and vaccine injury. If we don't have separate reporting for #3, those negative effects will be attributed to #4. How many people know they should minimize physical exertion and crowds for 14 days post-vax?

Ok, that’s different from the definition you just provided but in any event it’s still a very small proportion of the population

> it’s still a very small proportion of the population

At present yes, but this was 100% of the now-vax population at a prior point in time (everyone passes through #3 to enter #2), so it should be separated in the historical record.

Everyone “passes through” the 10 second duration during which the vaccine is actually being collected, but we don’t collect statistics on those people

If you're comparing the duration of an injection with the medically and legally mandated 14-day period of exclusion, look into the scientific reasons for the 14-day period.

The 10 second and 14 day period both have approximately the same effect on aggregate statistics, which is zero

> How many people know they should minimize physical exertion and crowds for 14 days post-vax?

I didn't know that. What's the source for that medical advice?

Jul 2021 in the context of myocarditis risk for men, https://www.leisureopportunities.co.uk/news/Should-people-av...

> The government of Singapore has become the first to recommend that people who've received the Pfizer or Moderna vaccine should avoid strenuous physical activity after getting their shots, something of urgent importance to gym operators as vaccine programmes continue to roll out around the world.

Transient blood clots, lymphocytopenia, similar to a Covid infection: https://news.ycombinator.com/item?id=29216083

It's actually larger than you'd think, because OP didn't also include "only one of the first two shots" in the "partially vaccinated" category.

That’s a fair point. Between shot one and two weeks after shot two is meaningful

How do you know that?

There's also a further separation that is veeery relevant: age groups. There are sometimes graphs that split them out if you go digging far enough, but the graphs that make headlines are usually along the lines of "death rate, fully vaccinated versus unvaccinated" (which as you point out has its own issues). Not splitting it out into age groups gives casual readers the impression that mortality is evenly distributed along all age groups, which it most definitely is not.

Good breakdown. I'd propose further breaking out of each category based on whether the person is immunosuppressed (for example from medication given to organ transplant recipients) or otherwise immunocompromised.

Yes, someone else mentioned 7M people in the US. This group is usually prioritized, e.g. for boosters.

You may even split up (1) into omicron-recovered and other-variants-recovered, since recovering from omicron strain seems to give a stronger resistance against reinfection for both omicron and delta, whereas recovering from delta offers little reinfection resistance to omicron[1].

[1] https://www.nytimes.com/2021/12/28/health/covid-omicron-anti...

Good point, thanks.

This, along with a large number of other trends related to COVID (including vaccine effectiveness), can be simply explained by immunity just not being very long lasting (4-6 months?). The Delta wave predates Omicron by around that much time.

I think when all the dust settles around COVID, we're going to learn that both vaccines and "natural immunity" last 3-6 months, and that explains almost all of the noise and confusion about what "works" and what doesn't. And that also suggests that "herd immunity" was never a realistic goal, whether by vaccines or infection. Maybe some future vaccine can be developed which targets a different signal and can last longer.

I feel that you need to include the people for masks and those against it. Unlike vaccines, masks do not lose efficacy over time or due to new variants. Both anti-vax and pro-vaccine supporters can fall into the anti-mask category. I don’t understand why people in the West are so anti-mask. It's been two years since I've gotten sick with anything.

1. Covid-recovered and Vaccinated + pro-mask

2. Covid-recovered and Partly-vaccinated + pro-mask

3. Covid-recovered + pro-mask

4. Vaccinated + pro-mask

5. Partly-vaccinated (< 14 days after 2nd shot) + pro-mask

6. Covid-recovered and Vaccinated + anti-mask

7. Covid-recovered and Partly-vaccinated + anti-mask

8. Covid-recovered + anti-mask

9. Vaccinated + anti-mask

10. Partly-vaccinated (< 14 days after 2nd shot) + anti-mask

11. Covid-naive + Unvaccinated + anti-mask

> I don’t understand why people in the West are so anti-mask.

"anti-mask" has an implicit spin where it sounds like you're claiming a person is against the idea of anyone wearing a mask, but then often apply the label to a person who is perfectly fine with masks so long as the person wearing the mask is doing so of their own volition.

so i say split that category, and then the major categories might be more like "pro-universal-masking", "anti-universal-masking" (i.e. "individual choice"), and "anti-mask-wearing-in-public" (not only doesn't want to wear a mask, but doesn't want the people around them to be wearing a mask).

> in the West are so anti-mask. It's been two years since I've gotten sick with anything.

For one data point, I'm vaccinated, had Omicron, and am now "anti-mask", as in, I think they are more harmful to me than not wearing a mask. The vaccines/boosters only target one protein, of 28. I want periodic exposure to all the proteins, to keep my immunity up and minimize my risk for now and future variants.

Of course, I wear a mask as a courtesy for others. But, if nobody around me has a mask, I will remove mine.

> I want periodic exposure to all the proteins, to keep my immunity up and minimize my risk for now and future variants.

I think this makes sense to say now that the new variants are becoming less and less lethal. At the same time, this sounds similar to anti-vaccine arguments.

> At the same time, this sounds similar to anti-vaccine arguments.

I don't see how, since I didn't mention vaccination. Vaccination for initial immunity reduces the risk incredibly, with boosters reducing it even more. Also, it would be very unlikely that all all anti-vaccine arguments are wrong, since that would require the vaccines to be risk free and perfect. We know they aren't, since people have died directly from vaccination, and it's failing in trials for young children. But, the relative risk is mostly negligible compared to the the actual disease, for almost all.

You don't have to mention vaccination. That is pretty much anti-vax rationale for not getting vaccinated. You just applied it to masking.

The other thing that needs bringing into the discussion is vulnerability.

The average of death with Covid in the US is 80.

If every healthy 30 year old and under in the US declined the vaccine, this would barely move the needle. They personally are not vulnerable and are not likely to end up in hospital.

Reading this discussion, you would think that vaccinated = safe, unvaccinated = certain doom. Age is a much stronger predicter than vaccine status.

Age and also just health status in general, people with diabetes or heart issues are vulnerable; but to your point most of those vulnerable are now vaccinated.

My point was that triple jabbing the worlds healthy 5-30 year olds will not move the needle on hospital demand. They are simply not vulnerable to the disease in a significant way.

So sure, let’s discuss unvaxxed/1 shot/2 shot/boosted splits, but in the relevant population. To focus on 20 year olds is a red herring.

COVID vaccines reduce the incidence of long COVID symptoms, which most definitely affect young people.

Do you have a reference? It seems "long COVID" isn't completely understood, especially in the young: https://www.medicalnewstoday.com/articles/young-people-less-...

“In theory, every citizen makes up his mind on public questions and matters of private conduct. In practice, if all men had to study for themselves the abstruse economic, political, and ethical data involved in every question, they would find it impossible to come to a conclusion about anything. We have voluntarily agreed to let an invisible government sift the data and high-spot the outstanding issues so that our field of choice shall be narrowed to practical proportions.”

- Edward Bernays, “Propaganda”

> The media's binary separation of populations into vax and unvax is a false dichotomy. More causal factors would be represented by:

> 1. Covid-recovered

> 2. Vaccinated

> 3. Partly-vaccinated (< 14 days after 2nd shot)

> 4. Covid-naive + Unvaccinated

And my group:

   5. Vaccinated and Covid-recovered

I consider this as the gold standard of SARS-CoV-2 immunization.

I'm vaccinated and boostered by my own choice. My problem with mandates is where does it end? Why this mandate and not other mandates? Who gets to decide that?

It ends with covid vaccines because that is the only pandemic that is currently raging across the globe.

The politicians we elect democratically makes the decisions.

Could the global obesity epidemic not also be handled through mandates?

True, I imagine that would be quite frightening and have a lot of data to support a number of initiatives that the population would vehemently disagree with.

Even in grade school, I remembered dreading when they would have us run a mile as fast as we could and record the times.

Obesity is a complicated disease that manifests through a variety of biological, behavioral, and environmental factors. These factors differ widely between individuals. I think there are mandates that could help make the disease less prevalent, but it is very much ingrained in our daily life, so I'm cynical as to the efficacy of such measures. It's very difficult to mandate behavioral (look at how many people don't even want to put a mask on) or environmental (think what foods are available in a region based on scarcity, culture etc - and yes this is a real factor in obesity) changes. A concise video on the topic: https://www.youtube.com/watch?v=-ZC4rfSMq8c

>Obesity is a complicated disease that manifests through a variety of biological, behavioral, and environmental factors.

Obesity is not a disease. It is a condition defined as a Body Mass Index (BMI) of >30[0].

Yes, there are a variety of factors that contribute to a BMI >30, but like "tobacco use disorder," it's emphatically not a disease. Some obesity may be related to actual diseases, but obesity in itself isn't a disease.

[0] https://www.cdc.gov/obesity/adult/defining.html

FYI, clicking on another page from your link states obesity is a ”serious chronic disease”. https://www.cdc.gov/obesity/about-obesity/index.html

It wasn't my goal to argue nomenclature, but a disease is: "a disorder of structure or function in a human, animal, or plant, especially one that produces specific signs or symptoms or that affects a specific location and is not simply a direct result of physical injury." or "a particular quality, habit, or disposition regarded as adversely affecting a person or group of people." (Oxford Languages) By this definition it makes sense to me to call obesity a disease. For what it's worth, I was trying to convey that obesity is far more complicated than many consider - the official definition may imply that you can just "lower BMI" and solve the problem. I also see immense value in understanding obesity as a disease in order to de-stigmatize it - you wouldn't tell someone with high blood pressure to "just relax", or imply they aren't trying hard enough to cure it - which is what a lot of the public stigma around weight related disease is effectively doing. Also, BMI when combined with waist circumference can help to correct issues with BMI to better understand your individual risk: https://www.mayoclinic.org/diseases-conditions/obesity/in-de... https://www.barbellmedicine.com/blog/how-to-measure-your-wai...

You don't get fat, because your neighbour coughs on you.

You becoming obese doesn’t affect me the way you catching Covid does. Yes obesity eats up healthcare resources as well but not to the degree and certainly not as quickly as Covid cases do.

Obesity is the #1 reason covid is a problem though. And metabolic syndrome, nearly the same thing.

True but my colleague become obese doesn’t make me obese by working next to him. (Unless he insists on sharing all his snacks lol. Even then I have a choice)

Fat taxes are a form of this. I think the primary difference is that they have strong economic incentives aligned against them. I don't see this as the case with vaccine and mask mandates.

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

You can't catch obesity from someone coughing in the same room as you.

But to extrapolate further: Sugar taxes have been tried in countries - Mexico for one. I think there was massive backlash from CocaCola/Pepsi etc, for infringing on their freedom to make obscene profits. I seem to recall discussions here about some of the lawmakers finding Israeli spykits on their phones (the ones pushing for the sugar tax). edit: https://www.nytimes.com/2017/02/11/technology/hack-mexico-so...

Quoting the NYT for anything related to Israel is likely biased.

No matter what one's stance is on Israel, or the Palestine question, it's hard to blame the actions of one company on the Israeli government.

I should have clarified NSO group. They are an Israeli company with many ex members of Israeli NSA (whatever it's called).

No, but on a higher meta-level it is contagious. Obesity is more prevalent in societies where high-caloric foods are more readily available. Now I'm more libertarian leaning myself so I wouldn't actually advocate for this, but if we mandated a cap on calorie-per-serving for "foods", you'd see a drastic drop in the availability of high carbohydrate foods (particularly sugar) which would essentially cause forced sugar-withdrawal in most of the population.

A couple months later? Everyone's sugar-thermostats are reset, the lower-calorie food tastes nearly as good – if not better – and obesity rates would plummet.

However, since we don't/can't coordinate such a thing on a national level, everyone gets exposed to constantly increasing carb content in their food, and maintaining a lower calorie diet requires significantly more effort. I can speak from personal experience, I simulated this on a personal level when I moved to South Korea for 2 years where sugar is nearly non-existent. As a modestly thin person I lost an additional 15-20 pounds while I was there without having to work hard or suffer with worse-tasting food (well, I did experience sugar withdrawal for the first couple months).

If you could avoid getting obese with two shots in the arm and wearing a piece of cloth every time you leave the house for a couple years.

I'm not so sure about this. Call me a cynic, or even a Libertarian (gasp!) but it is generally not in the nature of government to wind down an apparatus that they paid so much for once "the threat" has passed. Now that governments have the infrastructure for requiring and/or showing proof of vaccination, it really isn't a stretch to think they will want to keep that system and have it be readily available for the next pandemic, whatever it may be.

Also, a lot of government employees' jobs now depend on keeping these systems in place in one form or another...

Indeed, and I also sense a lot of Department of Healths at the state level will seek to track the yearly flu-shoot with this system as well. Not necessarily mandating it for public participation, but as a public health measure. The amount of productivity lost due to the seasonal flu is substantial, and the amount of data that can be gleaned from such a database is too tantalizing to ignore.

FYI, departments of health have already been tracking vaccinations in a database for years before COVID. https://www.cdc.gov/vaccines/programs/iis/resources-refs/faq...

Not really

I mean, it probably depends on where you are, but at least here (Ireland) this isn't true. The contact tracing and vaccination apparatus was run largely with people borrowed from other civil service departments, or hired as contractors. When the mass vaccination capability was stood down last year, they went back to their normal work and it took a while to start it back up again for boosters.

Did your local government actually hire large numbers of new permanent employees to administer this? This is (a) rather unlikely and (b) very much something you can check.

Who is better situated to respond to a pandemic than the state? What is the alternative?

I wasn't proposing an alternative, just chiming in that I don't believe the GP's assertion that "It ends with covid vaccines". Mainly because the government now has a powerful tool at its disposal for fighting pandemics and it will not want to stop using it once the threat is finally past us because it has so much utility and expandability for future health crises.

In Germany there were at least half a dozen members of parliament caught with their hands in the cookie jar for the money meant to buy masks alone. It would be interesting to see how many more used it to enrich themselves but the decisions enabling them where so hilariously badly written that nearly all the money spend on the masks was wasted.

You can write entire lists of how fucked up the governments response was. Government money for tests done under supervision of a professional? The same Dr. listed as on site contact in half the country. Repeated calls to get vaccinated? Government repeatedly blamed Doctors and population but never bought enough vaccines.

The government response around here can be summed up as corrupt incompetents fucking up the economy while playing the blame game. I could not think of a group objectively less qualified to respond.

>The government response around here can be summed up as corrupt incompetents fucking up the economy while playing the blame game. I could not think of a group objectively less qualified to respond.

Assuming you live in a country with democratic (small 'd') institutions, you elected those folks. If they're corrupt and/or incompetent, that's on you and your fellow countrymen, no?

It is mostly the same parties sitting in government as back in Weimar when they helped Hitler ban the biggest competition. I am quite sure some of them even date back to our last Kaiser (not the soccer one). What is a single person to do against political parties that historically should be considered complicit in starting and losing two World Wars and survived without having their ideologies purged?

>"If they're corrupt and/or incompetent, that's on you and your fellow countrymen, no?"

To an extent, yes, but I believe real-life has shown that removing incumbents is very difficult. I sense that the makeup of the district and the composition of party strength is the major factor in determining whether or not a politician is reelected or replaced, rather than popularity or approval rating.

There is lots of precedent for winding down wartime laws. Libertarians think governments want to be authoritarian for the sake of being authoritarian, but that is not how democracy works.

Let me know when the USA PATRIOT act finally expires (without pieces being made into permanent laws).

Many parts of the USA PATRIOT Act have expired. https://www.npr.org/sections/thetwo-way/2015/05/31/411044789...

Other parts have been modified. https://en.wikipedia.org/wiki/USA_Freedom_Act

It would be more democratic if the people were making the decision themselves by directly voting the laws. With the elective system we delegate decision making to people we choose from a very limited pool of candidates which aren't selected democratically. In a way "elect democratically" is a bit of an oxymoron.

I thought this last spring. Then, way too many people decided to refused to get vaccinated.

I'm honestly jealous of your lack of cynicism.

That's literally the case with every government-imposed rule in existence. You're asking a question that has been asked and answered 100 times.

"Why seatbelts? Where does it end?"

"Why can't I shoot someone? Where does it end?"

etc etc

Answered how? Each one of those were debated and we have agreed on some of these rules. I don’t think the debate for vaccine mandates has been settled though, much as some would like to see any discussion of it quelled.

I don't understand why people keep asking this like some kind of magic bullet.

Obviously there is a governmental body that has the authority to do this wherever you are from. And in a democracy that governmental body will be acting based on the will of the people. Even if you disagree that the executive has that authority, the courts have the authority to interpret if they do. And the legislature ultimately has the authority to override it.

In the United States if we all voted for it we could have mandates for every single vaccine ever created. But there is barely enough political will for this one. And that's only because COVID is much more of a threat than anything else at the moment.

Is it that hard to understand that many people are uncomfortable or unclear where the the line is drawn between civil liberties and state powers/majority rule. You might say that covid mandates are clearly inside the lines, but that isn't a declaration of where the line is.

Well we just had a once in a century global pandemic that killed one million Americans and vaccines that work extremely well and there is no mandate - so I think the better question is what would it take for there to be a mandate?

What's aggravating is all the "feel good" policies that fly in the face of the current state of the pandemic. We have gotten to the point where numerous officials have said something along the lines of "vaccines won't protect you against getting Omicron, masks don't really do anything either".

So you think. Ok, we have gotten to the point where these measures are ineffective, so lets do away with the measures. And that is precisely where you bump up against these "feel good" policies.

We know masks don't really work, but lets keep mandating them because they give us the sense of security that they are doing something. We know vaccines don't prevent you from getting or spreading Covid but we feel like it does something, so mandate it anyways.

I'm afraid that we are moving from "we need mandates to keep people safe" to "we need mandates to keep people feeling safe". In 20 years we're all still going to be wearing masks at the airport because "it makes people feel safer".

The good news is if you pay the $100 for TSA Pre-Check, you won't have to take your mask off to clear the checkpoint.

They've been making me take my mask off for precheck still at SFO and LAX.

That is not true. They require you to remove your mask to verify your face for a few seconds, other than that you put it back on.

That was my attempt at a joke, apparently unsuccessful.

Any more details on the "masks don't work thing"? It's news to me, and i don't see how that could have changed - masks, even cloth ones, but even more so for surgical and N95 types, drastically limit how much virus you spread when you're contagious; and especially N95 also offer some protection against catching it. Especially for crowded places, masks seem like a no brainer.

Not OP. They work, but much more marginally and situationally than most people think. They're best thought of as a delaying factor in exposure, with cloth masks adding no or a few minutes and surgical masks adding somewhat more time. In many situations, this is irrelevant, because you're stuck with the group and the air for far longer than the mask differential affords. I'd say the optimal places for wearing masks are probably supermarkets, and maybe also communter transit. Can't find the damn paper now, and all information is false anyway.

If I'm not mistaken, these claims stem from studies modelling droplet diffusion, obviously no experiment could pass ethics for an actual infection exposure. I guess to each their own, but I am highly skeptical of the value of these kind of studies, also covid is aerosolized so why are we worrying about droplets again?

> covid is aerosolized so why are we worrying about droplets again?

Becasue we don't want sick people spitting all over the place when they talk, even when we aren't inhaling their breath.

Around a month ago Rochelle Walensky, director of the CDC, said in an interview (paraphrased) "cloth masks are ineffective against the transmissibility of omicron".

(Edit: wrong person, here's video of what I'm remembering: https://mobile.twitter.com/townhallcom/status/14733056927149... ) (Anyway that was just intended as context for below, what I think may have been the starting point for a larger shift)

Thing is, the virus didn't change size, so right after this it's as if people started to realize the droplets-vs-aerosols mistake from 2020 that a minority have kept on since then, and what they've been saying for over a year is slowly becoming accepted:

Masks and social distancing were mandated under the assumption SARS-CoV-2 spread primarily through heavy droplets that would quickly fall to the ground, which were also large and heavy enough to easily be caught by masks. However, it turns out the primary spread vector is aerosol - too small for cloth masks to catch, light enough to quickly diffuse through a room, and light enough to easily slip around the sides of an unsealed mask.

A well-sealed N95 might work, but considering how bad even pro-mask people are at wearing cloth masks correctly, I don't think very many would manage to wear the N95 right.

> said in an interview (paraphrased) "cloth masks are ineffective against the transmissibility of omicron".

That's a reallty dangerous thing to try and paraphrase - what did they actually say? Less effective? Have limited effectiveness? There's no evidence of any effect whatsoever? You have to be precise.

Masks are effective against influenza. Swine flu + SARS-CoV2 can increase IFR up to 50x, i.e. we will have a "Spanish flu" level of epidemic again.

No she didn't. She said cloth masks were the least effective type of mask. Here's the CDC guidance: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-si...

And here's a quote not a "paraphrase": "What I will say is the best mask that you can wear is the one that you will wear and the one you can keep on all day long that you can tolerate in public indoor settings and tolerate where you need to wear it," Dr. Rochelle Walensky, the CDC director, told reporters this week. from https://abcnews.go.com/Politics/cdc-warns-loosely-woven-clot...

Ah yeah I got two interviews mixed up - here's video of what I'm remembering: https://mobile.twitter.com/townhallcom/status/14733056927149...

I'm no longer sure what point you're trying to make. She didn't say "masks don't work" either.

Masks absolutely work to prevent covid infection. Higher quality masks are much better than cloth ones, but any mask is better than no mask.

I added a note to my first comment, basically I think this triggered a realization in a lot of people how assumptions have been wrong from the start.

The CDC has repeatedly changed their standpoint on multiple measures in response to political influence. I put more trust in the WHO, who still recommend using masks. https://www.who.int/emergencies/diseases/novel-coronavirus-2...

Also N95 have a limited effectiveness over time (e.g. you need to change it regularly).

This typically applies to surgical masks as well. The reason is that the fibers of the mask have an electrostatic charge. This charge helps the mask filter particles much better, but the charge will wane over time.

The official guidance on my P100 3M 2297 filters is to replace them when breathing becomes hard or the nuisance organic vapor protection isn't working as well as you'd like. Everything I've found concurs that the particulate filtration does not diminish with time/use.

AFAIK some filters are mechanical and others require the electrosatic charge to reach their stated performance. Half-masks or full face masks are typically of the former kind, while smaller masks of the latter kind.

The 2297 and 2097 filters (at least) are made with electrostatic media. The 2297 touts "Advanced Electret Media" for easier breathing.

From the only randomised controlled study of masks... https://bmjopen.bmj.com/content/5/4/e006577.long

  "The rates of all infection outcomes were highest in the cloth mask arm, with the rate of ILI statistically significantly higher in the cloth mask arm (relative risk (RR)=13.00, 95% CI 1.69 to 100.07) compared with the medical mask arm. Cloth masks also had significantly higher rates of ILI compared with the control arm. An analysis by mask use showed ILI (RR=6.64, 95% CI 1.45 to 28.65) and laboratory-confirmed virus (RR=1.72, 95% CI 1.01 to 2.94) were significantly higher in the cloth masks group compared with the medical masks group. Penetration of cloth masks by particles was almost 97% and medical masks 44%

What type of masks do you see ~98‰ of people using? Here it is the cloth/fashion mask. The ones which, at the a beginning, had warnings about not being effective protection against covid.

> numerous officials have said something along the lines of vaccines won't protect you against getting Omicron, masks don't really do anything either"

No they haven't. There's a pervasive anti-vax myth that Fauci "admitted" the vaccines don't work. Not true and didn't happen.

The data are very clear that vaccines reduce your chances of getting infected (not just seriously ill or dying, but getting infected in the first place). https://www.cdc.gov/coronavirus/2019-ncov/vaccines/effective...

Masks are also effective at preventing infection. Even "bad" masks are measurably better than nothing: https://www.pnas.org/content/118/4/e2014564118

Vaccines and masks absolutely work to reduce your chance of getting infected with covid. Further, if you do get breakthrough covid, vaccines greatly reduce the chances you will end up hospitalized or dead.

Your links do not mention the omicron variant. The CDC estimates that an unboostered vaccine (2 doses) is only 38% effective against omicron. Boosting brings the effectiveness up to 82%.[1]

So to be more precise - vaccines work against Omicron, but not as well as the original strains and only if you keep up with boosting every few months. Vaccines are less effective against omicron in general, and the effectiveness wains very quickly.

[1] https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e3.htm?s_cid=mm...

I think we're saying the same thing: vaccines protect you from getting covid, but you should get a booster and even then you obviously can't expect 100% protection. (Just the one booster is fine.)

You ignored the part about masks. Leana Wen referred to cloth masks as "little more than facial decoration". Unless there are mask mandates that require better masks, the mandates are effectively useless.

I'm not sure I'd read too much into off-the-cuff remarks from CNN guest experts.

Mask mandates aren't worthless, but I agree they'd be a lot better if they required better masks. I believe that's already the case in other countries and I wouldn't be surprised if it eventually comes to the US.

Leana Wen isn't just some talking head. She was the head of Planned Parenthood and is a nationally-known medical figure. She is especially respected on the political left. That makes her statement especially surprising because the left has been the side pushing the mask mandates.

FWIW "the political left" in the United States is not so much a team and more a loose coalition of folks who have some range of views that don't agree with the more uniform political right. It's not that useful to call this out as a group as if surely 80% of folks in the political left care what Leana Wen has to say unless it happens to be particularly insightful. Most folks don't actually know this woman's name, nor do they particularly care.

It might be healthier for you to see things less as "there are two sides" and reconsider how you analyze individual topics. When you say "this is the view of side L and this is the view of side R" you are in danger of missing nuance and views that cut across. If you identify with say, side R, you will bias yourself toward those specific viewpoints.

The point is that she is a well-known and respected person on the left. She is not loved on the right. If she had made this remark 6 or 12 months ago she would have alienated the people who love her. That would have ruined her reputation.

Don't assume I have a manichean approach to everything. This was just one example where her popularity is very polarized along political lines.

Maybe this person's popularity only looks polar to you because you're making things out to have a team L and a team R, whereas it's more like team R is real and hallucinating a bogeyman team L where surely folks worship named figureheads as much as team R.

You think Planned Parenthood is not polarized? I guarantee you that Wen's favorables/unfavorables break down purely along partisan lines. Plenty of people don't know her. But prior to this statement, all of her favorables were Ds and all of her unfavorables were R's.

Not everything is partisan. But abortion surely is.

My point is simply that it seems odd to describe an individual as "polarizing" when the people who know them are generally either the large number of haters (thanks to R media demonizing individuals) or their small group of personal supporters (because there isn't this huge group worshipping her as you might imagine).

My other point is that Planned Parenthood and abortion are of course polarizing topics but pro-choice folks are not as monolithic in ideology as the core republican base, so it's weird to see statements like this which you made:

> She is especially respected on the political left. That makes her statement especially surprising because the left has been the side pushing the mask mandates.

This rings untrue, and like someone's been watching too much angry news. And characterizing mask mandates as some nonexistent "left-wing agenda" is also really unfair to folks who may not have progressive politics but support masking. My parents for example are Christian capital-R Republicans but think it's bonkers that we can't get folks to do what is best for the common good, in the name of "freedom." At least they understand, very minimally, the difference between fascism and emergency measures.

There are not two sides to this issue until one angry group of people decide "you're either with us or against us" and generate those two sides out of thin air. It's really stupid to do that. Abortion and masking are not related. That are you surprised an individual has a unique opinion different from "their team" is very telling.

You seem to know a lot about an anonymous person on the internet!

If you can't see that abortion is polarized along partisan lines, we live on different planets.

"Abortion care" is less than 8% of what people go to Planned Parenthood for ... Abortion may be polarizing but to take a minority focus of Planned Parenthood and claim Planned Parenthood is polarizing because of it is silly.

That's one way to frame it! The alternative: Planned Parenthood provides the majority of abortions in the US.

The Washington Post has a good explainer on this. [1]

1: https://www.washingtonpost.com/news/fact-checker/wp/2015/08/...

Yeah yeah we get it, republicans hate planned parenthood. What everyone in these replies is trying to tell you, is that this DOESN'T mean democrats/the left/however you want to group {everyone else}, gives a crap about the details of that specific organization / who runs it, even if they are pro-choice in ideology. And your constant choice of saying "but the left!" is problematic at its core.

How is that your takeaway from the balanced fact check article? It says both sides are wrong. As an enlightened liberal, you clearly know better! Good day, friend.

> You seem to know a lot about an anonymous person on the internet!

Yeah I'm going off of the ~20 sentences I've spent time reading from this anonymous person on the internet. You're not doing much in these responses to demonstrate comprehension of my points so maybe it's gg.

> If you can't see that abortion is polarized along partisan lines, we live on different planets.

I didn't dispute this very basic fact. But again, this wasn't what my comments were about.

I'm confused why you think I'm supposed to defend or explain what a CNN guest said.

The comment I was responding to said "masks don't really work," which isn't true. Even cloth masks provide some benefit. Whether that benefit justifies a mask mandate is something reasonable people can disagree about.

You don't have to defend or explain. But you didn't respond to the point about masks. You said that you and GP were on the same page. It didn't seem like that to me since you appear to disagree about masks.

> Just the one booster is fine.

Its fine for right now. You will need another booster in a few months to remain protected (original estimate was every 6 months, CDC lowered that to 5 months already). Israel is already rolling out a fourth shot, and the CDC now recommends 4 doses for immune compromised people.

Israel put that plan on hold actually. Just one booster is fine for now. It's possible that could change. I'm hoping we'll soon get a variant-specific booster that will provide much stronger and more lasting protection from omicron.

I never understood the preoccupation with the number of shots. Is it the hassle and discomfort of the shot itself?

Personally, it makes me feel like we don't really have a handle on the situation. The vaccine was supposed to be a "virtually 100% effective" silver bullet; now we need constant doses just to maintain some level of protection. It does not inspire confidence.

Is there any other vaccine that needs boosters every 5 months?

Several vaccines have 3 doses. Flu vaccines get new variants every 6 months.

Every disease is different. Every vaccine is different. What would it prove?

Kids have vaccines at 2 months, 6 months, 1 year and 5 years.

Considering that the initial schedule of 2 doses in a month was kinda rushed, and that Israel is not proceeding with a fourth dose because the current wave has been manageable despite the very high number of cases, it seems very unlikely that COVID will need periodic boosters in the general population.

My understanding is that is because they are children, so the doses are much lower.

DTAP, for example, is one of the vaccines that kids need. It has a 5 dose schedule. But, an adult that was never vaccinated can get one shot of Tdap instead.

Notably, the DTAP vaccine is 71% effective after 5 years[1]. Compare to the covid vaccine being 38% after 6 months[2].

[1]https://www.cdc.gov/vaccines/vpd/dtap-tdap-td/hcp/about-vacc...

[2] https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e3.htm?s_cid=mm...

I don't think you understand how many assumptions are baked into the current conclusions that vaccines and masks are effective. This relies on accurate reporting of vaccination status and accurate reporting of breakthrough cases. Meanwhile in the real world covid is spreading unabated, record case counts, regardless of vaccination rate or mask compliance.

Clearly something isn't adding up. Meanwhile the rosy estimates of safety and effectiveness have been repeatedly and consistently walked back. I think it's time to recognize that our institutions have had their analyses and recommendations tainted by strong and pervasive political and social biases, from the laypeople who have no incentive to report breakthrough cases, all the way up through the chain past academics and policymakers who have their careers riding on the validity of 2 years of covid research and policy that cannot be contradicted without trashing credibility. That's not to mention the career and social stigma associated with speaking out or publishing negatively against the vaccines.

It doesn't help that dozens of hours of testimony on behalf of researches and clinicians before congresspeople is simply being ignored[0]. Add media to the rabidly biased groups and you're getting closer to reconciling what is being published and communicated about the vaccines and virus with what is happening in the real world.

0. https://www.youtube.com/watch?v=9jMONZMuS2U&t=1s

The vaccines are extremely safe and the real world data from shows they protect you from getting covid in the first place (and are much more effective at preventing severe covid).

Here's the data from Sen Johnson's state: https://www.dhs.wisconsin.gov/covid-19/vaccine-status.htm#ca...

Again, this is based on the assumption that adverse effects are being sufficiently reported and/or attributed to the vaccines.

And once again, the real world data shows that the virus is spreading across the globe at record pace regardless of vaccination rate.

I know it sounds like dangerous conspiracy talk, but sometimes we need to think outside of our official sources. Ultimately it is up to the people to hold our institutions to account. The real world data does not line up with the official claims.

You seem to be alleging a massive global conspiracy that must involve tens if not hundreds of thousands of health officials, academics, and scientists all working together to hide the truth for some unstated reason.

You think Wisconsin health officials are cooking the books? Along with every single other state? C'mon

No. This is the danger of blithely dismissing everything as a "conspiracy theory".

None of this requires a conspiracy. None of this requires explicit communication or collusion. That's not how bias works. Bias works as subtle (sometimes not so subtle) pressure. Pressure against asking certain questions, against publishing certain results (this is hardly unique to covid), massaging data and models (often unconsciously) in favor of certain conclusions.

And then there is the very real stigma - also something which does not depend on an overt conspiracy, just an army of true believers who will publicly castigate those who speak out, putting the livelihoods of dissenters at risk.

Can you explain specifically what bias leads to Wisconsin reporting most covid cases are among the unvaccinated?

There should be stigma for people who spread misinformation during a deadly pandemic, in my opinion.

And yes, what you're implying heavily in your posts would require some sort of conspiracy to be plausible. You're going against dozens of countries' thousands of experts and numerous studies, then choosing to believe quacks on panels on youtube whose wikipedia articles have giant "covid-19 misinformation" sections in them with ample citations.

>And yes, what you're implying heavily in your posts would require some sort of conspiracy to be plausible

Look, regardless of whether what I'm saying is true, your primary argument is that it is implausible because of the logistics of organizing such a vast conspiracy. This is false. All it takes is an emergent culture to instill an implicit bias under threat of ostracization/unemployment/unpersoning and then without any overt conspiracy you will see discourse, studies, and policy all align in a single direction regardless of that direction's validity.

This is the mechanism by which authoritarian governments flourish while simultaneously oppressing their peoples. Life in the Soviet Union was miserable, but the average person would not publicly speak against their leaders. Note that I don't mean to imply that anything about the covid response is "socialist" or anything to that effect, only that emergent consensus, especially when bolstered by propaganda, can influence individuals and society to together behave in an irrational manner in an emergent, implicit fashion.

Let's try to materialize an example. Suppose that you indeed have a society which is irrationally biased in favor of the safety and efficacy of the vaccine, and you are trying to study adverse effects. Moving up the chain

1. Patients are less likely to connect adverse effects to their vaccines (e.g. it only recently came out that monthly cycles were disrupted, originally a "conspiracy theory")

2. Doctors are less likely to acknowledge that strange symptoms are related to vaccines (remember, I'm alleging that they're biased)

3. Researchers are less likely to look into adverse events, especially when from the bottom they now have substantially less data to review

4. Policymakers see this lack of evidence of adverse events as proof of safety when it is only bias which has an emergent muting effect on cataloging of adverse events. They continue to distribute "safe and effective" propaganda in good faith (no conspiracy).

5. The cycle continues.

You may not agree that this bias exists, but my point again is that none of this requires a conspiracy, only a pervasive bias.

Now remember, the phrase "safe and effective" was repeated across media from day one, long before there was ample time to gather evidence of harm. The seed of bias was planted early. I hope you'll at least acknowledge that this is far more plausible than some cooky "conspiracy theory".

Those series of events could potentially happen, but I just don't think it's the case with so many disparate countries at play. I don't really want to get into an extended debate about this, but I appreciate your detailed response and civility here nonetheless.

> I know it sounds like dangerous conspiracy talk, but sometimes we need to think outside of our official sources.

... to Dr. McCullough, this guy? https://en.wikipedia.org/wiki/Peter_A._McCullough#COVID-19

Literally one of the main guys on the panel you cited yourself a post or two ago. Sounds like the definition of a conspiracy theorist / quack to me.

That's hours of "testimony" from conspiracy theorists who all have long records of making flagrantly incorrect statements on COVID. Johnson's big leadoff panelist was a Texas cardiologist who is far from a respected authority in epidemiology and seems to be courting attention by disputing every best practice that ER doctors and the scientific community have agreed works best with acute COVID patients and hyping up silver bullet drugs that have shown limited effectiveness in the best studies. I recommend everyone look up "Dr. Peter Mcullough" and getting a whiff of his reputation before investing any of their time in that panel.

> We know masks don't really work

"Don't really work" - they do work, just with varying degrees of effectiveness.

> We know vaccines don't prevent you from getting or spreading Covid

Again, it looks like the vaccinations with booster do still provide some, limited protection against infection and may also reduce viral load reducing infection risks https://jamanetwork.com/journals/jama/fullarticle/2788105

I rather think of vaccination as a responsibility toward your fellow citizens, rather than a "choice".

This belief might be to blame for many of society's crises. https://trendguardian.medium.com/free-will-a-rich-fairy-tale...

But it looks like the vaccines don't stop the spread of covid: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8481107/

They stop the hospitals from filling up though.

Tobacco kills 8 million of its users, annually. Why is their presence in ICU beds not a topic of concern?

I will think because it is not contagious and does not affect the global economy as such

Probably because that number is fairly stable over time. Beds exist for that load. A new load is a problem, because staffed hospital beds take time to create. It takes years to make a new nurse or doctor, for instance.

Why can’t we just group antivaxxers with smokers then?

We’ve ignored the obesity problem for a long time and are taking 0 steps to correct after we’ve seen our health systems buckle in no small part due to it. If you’re in favor of mandates but not forced weight loss you’re just playing politics.

Yes, one is easier than the other, but the magnitude of good done by reducing obesity dwarfs the good done by vaccines. If the US had ignored Covid and focused solely on obesity we would likely have been better off in terms of all cause mortality.

Nobody knows what is causing the obesity epidemic, unfortunately. There are a lot of theories but no smoking gun.

I'm not buying that. Sure there might be some unknown metabolic factors at play, but it seems disingenuous to overlook the ratio of calories consumed to calories expended.

you can't smoke inside anymore (honestly, nowadays you can only smoke outside and at your own place, and even then, some rentals prohibit smoking) -- that's was a "mandate" to decrease smoking related diseases.

It's a significant topic of concern, and governments have been restricting the tobacco industry more and more since the 80s. Most developed countries now ban indoor smoking and the advertisement of tobacco; some are getting ready to ban tobacco outright.

The point is to reduce critical cases that cause hospital visits. Our system is overwhelmed as is.

The fact that this still needs to be explained 2 years into this is ridiculous.

Was that really the point?

When people anxiously awaited their chance to get the vaccine in January 2021, were they thinking "ooh I can't wait to free up hospital beds"? Or was it "great now I can be immune and be done with COVID"?

I mean, both? I think the vast majority of people I knew (UK, in my 20s) knew that the main reason we were locked down was to minimize the risk of the NHS being so overrun it couldn't perform basic healthcare.

Of course personally we all just wanted to not be locked down any more but I don't actually think that many of us were staying in for our own sakes - we knew the long term risk to our own health if we were to catch it was fairly low. Very biased sample, of course.

If the system is overwhelmed, then hospitals shouldn't have fired workers who didn't want to get vaccinated.

> Our system is overwhelmed as is.

I have yet to see proof that most of the system is "overwhelmed". Sure there are hotspots here and there but this idea that the system is on the brink of collapse is hyperbole. And even if it is true, these dudes had 2 years of our time to figure out how to deal with it. 2 years of our short lives we've given so they could fix this capacity issue. Where is the results? Why is it the general public's fault at this point?

Do you realize how fucking stupid you sound?

Is there a time limit on a pandemic? Do you think these are trivial problems we're dealing with here? Like what world do you live in, bud?

I don't have any patience with people like you anymore. How did you get your head so far up your fucking ass? Fucking christ man.

> I don't have any patience with people like you anymore. How did you get your head so far up your fucking ass? Fucking christ man.

My greatest clue that the last 2 years has been more about hysteria, politics and unchecked, ungrounded fear than an actual severe disease has been reactions like yours. Seriously? I'd ask you what world you live in where you think any of this makes a lick of sense at all? What world do you live in where it is okay to say what you just said? How is it not possible that people can have alternate, equally valid opinions as yours?

2 years is a long time to figure out how to deal with covid patients in a hospital. Long time. We have virtually unlimited resources to do whatever we want to fix it. We could have built a new story on every nurse and doctors house for far less than the costs of these lockdowns and other non-pharmaceutical interventions.

2 years of creating a corrosive, toxic environment where so many people think it is impossible to question any of this. Like, how is it impossible that smart, well meaning people disagree with "the narrative"? Are we all expected to fall in line with a relative handful of anointed "experts"--many who will feel almost no effects from any of their prognostications over the last two years?

Why is it so hard to believe we could have fixed the "overwhelmed hospital" problem in under two years? Like, it takes barely any imagination to come up with ways to deal with it. All kinds of ways to get people to care for sick covid patients. Train people in adjacent fields, shovel money at doctors and nurses thinking about quitting, etc. It really isn't so hard to come up with ideas.

Why is the default answer for all this to blame the public, shame them, shame people who question anything, and force people to sacrifice what little short life they have on this planet? I mean how toxic and corrosive have these health "experts" made us? These "experts" are ripping apart the social fabric that binds us together. It's horrific.

Move on.

Quebec: https://news.ycombinator.com/item?id=30090689

Respectfully, would you mind explaining how getting vaccinated against Covid helps fellow citizens? If it is only to reduce hospital loads then can't the same responsibility be applied to those who choose to engage in unhealthy behaviors?

You are protecting not only yourself, but others as well.

Example: Culture difference (individualistic vs collectivist). In Japan, masks are used even for common flus, as they are seen as a polite gesture toward others

Some people really just don’t want an experimental vaccine which sidestepped the usual regulatory approval.

That talking point no longer works. The vaccine has been taken by billions of people by now and has a larger sample size proving its safety than any other medicine in the history of humanity.

Remains to be seen based on the outcome of longitudinal studies.

I have not seen a comprehensive general population safety study. I believe the last large scale safety studies are the ones used for EUA.

Would love to be proven wrong though. I’m assuming that if there was new good safety data it would be blasted from the roof tops, just like the ~95% effective number was after the phase 3 studies.

Should get BioNTech/Pfizer then, which got the usual regulatory approval.

Cominarty is not available in the United States. [1]

[1]: https://dossier.substack.com/p/bait-and-switch-there-remains...

> I rather think of vaccination as a responsibility toward your fellow citizens

We also have data and prudence and we are long past the point where framing this in that manner is highly morally questionable to put it mildly.

Your idea of responsibility to society is mandating that young healthy people take an injection(s) ostensibly to protect them from a disease they are at no great risk from, negative side effects of the injection be damned?

Do it for grandma? It actually does nothing for grandma, that’s always been a lie, the original study could make no claims about transmission. And now, just look around.

Even if it did something for grandma and grandpa, mandating young healthy people undertake a medical intervention having value trade-off for their own health which is murky, for the supposed benefit of the superannuated or people who have eaten into a state of morbid obesity and premature aging is a horrendous inversion of social order and what is good.

The young sacrificing for the old? What??

> I rather think of vaccination as a responsibility toward your fellow citizens, rather than a "choice".

I don't understand this argument. Maybe I'm being ignorant or childish but since when do we live in a world that as a person you have to be responsible for "fellow citizens".

Don't get me wrong I don't mean we shouldn't be nice or care about other people but no one owe me anything and I don't owe anybody anything. Don't we all learn that in life at some point?

I get the COVID is dangerous and vaccines help but don't put me responsible for you.

> I rather think of vaccination as a responsibility toward your fellow citizens, rather than a "choice".

We make decisions every day of our lives that impact our fellow citizens negatively. Your point is what?

The vaccine mandates are also getting a bit awkward because the justification was always that they protect others, but with omicron, that's a lot less true.

This sort of vague "slippery slope" argument can be applied to argue against almost anything.

It is common and logical to regulate activities that could harm those around you. What cars are allowed on the road and who's allowed to drive them is carefully regulated because cars can kill or injure people. You can drive around your property with an unsafe vehicle but if you want to bring it on a public road, it needs to have working brakes and so on. Vaccine are similar because unvaccinated people are more likely to injure those around them.

Who decides? My city recently created a vaccine mandate to dine indoors at a restaurant. It was decided by the city council and the mayor, same as any other law. I think most citizens support it, but if they didn't they have all the usual ways to make that known or overturn it.

  I'm vaccinated and boostered by my own choice

Great! The problem is that vaccines don't protect society unless a critical-mass of people are vaccinated. The estimate for COVID-19 is that roughly 70% to 85% of the population will need to be vaccinated to reach the herd immunity threshold. USA is at about 63% fully vaccinated (76% had at least one dose).

  where does it end?

It ends when the the threat subsides.

  Why this mandate and not other mandates?

This mandate related to COVID-19 which has killed (at least) 870,837 people in America, and 5,614,744 people worldwide.

  Who gets to decide that?

The people you elect to represent you (for those of us with a democracy-like government)

Sources:

https://health.clevelandclinic.org/how-much-of-the-populatio...

https://www.nytimes.com/interactive/2021/us/covid-cases.html

>Great! The problem is that vaccines don't protect society unless a critical-mass of people are vaccinated.

They don't protect society at all. The herd immunity goal flew out the window with Delta and left the galaxy with Omicron. We will not ever eradicate Covid-19 with vaccination.

>It ends when the the threat subsides.

It should end right now, then. The threat has subsided. We have vaccines and other treatment programs.

Eradication is not the goal. Making sure hospitals aren't overwhelmed with COVID patients is the goal. Catching COVID is potentially dangerous and often times results in long recovery window. Vaccination is harmless and works. The thread will never subside; this is a new virus we will have to live with for the rest of our lives - especially considering we can't seem to get everyone to do the right thing, even with government mandates.

This!

I should have said this, but they mail it.

> Vaccination is harmless

Oh please, if you want to say it's low-risk, or lower-risk than catching covid, go ahead. But don't just assert outright falsities.

It's a lot safer than other things we consider harmless.

The thing is, hospitals aren't overwhelmed. Sure, maybe a handful in the most metropolitan of areas, but should the whole country pay for that? I don't think so. Of course, the news makes it seem like hospitals around the country are overwhelmed, but that's just agenda-based sensationalism, and should be taken with a grain of salt.

As a critical care paramedic in a semi-rural area, most non-metropolitan hospitals are ill equipped to care for acute respiratory patients, and ship them to metropolitan hospitals.

To quote you: "Should the whole country pay for that", too?

Or maybe those metropolitan hospitals should say "sucks to be you", and let's just see how quickly those rural hospitals collapse under the weight.

My local ER, which is certainly not "in the most metropolitan of areas", which used to _never_ have a bed unavailable, has got to the point where ambulance crews _routinely_ (as in dozens of times, every single day) spend 2 to 6 HOURS with a patient in a hallway, "holding up a wall" (and unable to respond to calls in their community), until the ER can free a bed for them.

Anecdotal, I'm sure you'll scream. But "agenda-based sensationalism" is also entirely your opinion, too.

>Vaccination is harmless

Tell that to the increasing number of footballers facing cardiac arrest.

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

As far as I’m aware, you’re spreading a rumor by claiming there’s a link.

https://www.reuters.com/article/idUSL1N2SL1NJ

> FIFA is not aware of a rise in episodes of cardiac arrests… and no cases have been flagged in relation to individuals receiving a COVID vaccine.

"The report recorded worldwide deaths attributed to sudden cardiac arrest or other unexplained sudden death while playing (or shortly after playing) football between 2014 and 2018. There were 614 cases during the four-year period."

Is there any evidence the deaths you're posting about were caused by the mRNA vaccines?

> Making sure hospitals aren't overwhelmed with COVID patients is the goal.

So fix the capacity issue and your problem is solved without toxic, corrosive and highly controversial government mandates with dubious efficacy. I mean, thus far they've had 2 years to fix the "overwhelmed with COVID patients" problem so we wouldn't have to do all this. At this point it's all just excuses. What gives?

> So fix the capacity issue

even if a government build 100 new hospitals in a state do you think they can get enough healthcare workers? at least in Chicago reagion, they are having hard time finding healthcare workers. it's not like hospitals can go to a Med school and ask for 1000 new doctors, respiratory therapists and nurses.

Most doctors and nurses do not work in emergency wards. So if it were truly desperate, it seems almost trivial to get more support. There are 200,000 dentists in the US. 115,000 veterinarians.

Everybody on this forum likes to say “there is no IT shortage. People just aren’t paying enough”. Right?

So… …seems like one solution, eh?

No, that was explicitly not the goal. That is after the goal has massively shifted when new realities surfaced. Our hospitals are optimized to work at 100% load in normal operation. If any external even increases that load it is expected that there will be problems.

> The thread will never subside

Threat from diseases? No, probably not. But the threat from this virus will be manageable without us changing much.

Hospitals are full here. It’s impacting everyone who gets sick or needs emergency care. Not over yet.

I’d say it’s over when Paxlovid is available widely whenever folks catch it, which should be in a couple months.

Pazlovid reduces risk of death or hospitalization by 90%. Basically turns an unvaccinated into a vaccinated person in terms of outcomes.

Question: does it have such a dramatic effect in vaccinated persons too? I just read a few headlines about the tests for this treatment, but haven't really had the time to read in detail.

"We will not ever eradicate Covid-19 with vaccination" is the most small minded statement possible to make. We have eradicated so many diseases with vaccination.

I think what you mean to say is "We cannot eradicate COVID-19 with the current vaccines," but to swear off vaccines as if they can't do the work is frankly, dumb.

> We have eradicated so many diseases with vaccination.

I know that we eradicated smallpox, but only because there are no animal hosts.

Covid has many animal hosts [0]. You'd have to vaccinate them all to eliminate covid, that includes bats, cats, dogs, primates, deer, etc.

Otherwise covid will keep evolving in animals, and jumping back into the human population, as it appears happened with omicron over the course of about a year in mice [1].

I believe that the parent you replied to is correct, we will not eradicate covid with vaccines.

[0] https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/...

[1] https://www.medicalnewstoday.com/articles/covid-19-did-omicr...

>but to swear off vaccines as if they can't do the work is frankly, dumb.

Come now. I said no such thing. This is straw man.

>"We will not ever eradicate Covid-19 with vaccination" is the most small minded statement possible to make. We have eradicated so many diseases with vaccination

I suppose with a long enough time horizon we may invent some vaccine to eradicate Covid-19, the common cold, and Influenza.

>We have eradicated so many diseases with vaccination.

We have eradicated exactly one human disease with vaccination.

> The people you elect to represent you (for those of us with a democracy-like government)

The problem is that so many elected officials don't abide by the rules that they push. Joe Biden, Gavin Newsom, Nancy Pelosi, London Breed, etc. When the powerful can ignore their own rules, they're more likely to enact sweeping mandates.

> When the powerful can ignore their own rules, they're more likely to enact sweeping mandates.

The sweeping mandates are for our public health. These folks aren't asking us to mask up or vaccinate for their own benefit. And they can only sorta ignore their own rules, because aren't they being roasted in the media when they mess up? The fourth estate at work. It will affect their re-election chances.

> The problem is that so many elected officials don't abide by the rules that they push.

Hypocrisy sucks, everyone agrees. Gavin Newsom having maskless restaurant meals when asking the rest of us to stay home is wrong. But it's wrong mainly because _masking is good for public health_ and he didn't listen to the advice of the medical professionals that he was parroting, nor did he conduct himself in the way a public servant held to a higher standard should. It doesn't change that masking and staying at home _does_ help everyone, by keeping hospitals from exceeding capacity and minimizing needless death.

There will always be virtue signalers and hypocrites but let's not allow them to stand in the way of sane public health policy.

> nor did he conduct himself in the way a public servant held to a higher standard should

No one is asking for a higher standard.

> aren't they being roasted in the media when they mess up? The fourth estate at work

Was there any coverage in NYT/CNN/WaPo of Biden shopping maskless? I only heard about it because I happened to read some news from a right-leaning site.

> It will affect their re-election chances.

I'm pretty sure Nancy Pelosi is safe. This only affects politicians in purple districts.

> Was there any coverage in NYT/CNN/WaPo of Biden shopping maskless?

I have a difficult time believing Biden does any shopping on his own.

LMGTFY. [1]

https://nypost.com/2021/11/28/biden-seen-flouting-mask-weari...

>No one is asking for a higher standard.

I am.

Yes because only democratic politicians ignore the rules.

It's particularly egregious because they ignore the rules that they themselves created.

Surely not. But I couldn't think of a single republican politician who has either created or advocated for a rule that he/she then broke. Can you help with examples?

Republicans have faced fewer accusations because they have not implemented as many of the restrictions that public health experts have called for.

It's hard to break rules that don't exist.

> Yes because only democratic politicians ignore the rules.

> It's hard to break rules that don't exist.

Wait, what's your argument again?

That I should stop trying to reason with people who are so biased by their political leanings that they ignore common sense.

> The problem is that so many elected officials don't abide by the rules that they push

Not a single "expert" or government official who pushed these mandates lost their income or livelihood. Many live in big houses and have the financial means to enjoy themselves regardless of their own restrictions.

In my opinion every "expert" and politician should have lost their paycheck the day they enacted this stuff. All these "work from home" people too--none of what most HN readers do is "essential" so they should have been shut down even if they could work from home. If the playing field was level, perhaps more people in positions of power would have questioned things. It takes an incredible amount of privilege to do virtually any of what we did over the last two years.

>> The problem is that vaccines don't protect society unless a critical-mass of people are vaccinated.

I'm having a harder and harder time believing this (that herd immunity is actually possible) considering that the vaccine does nothing to stop it from spreading.

(Am vaxed and caught it, fwiw)

Define nothing, there's definitely some effect from vaccination. It's just much less than the protection from sickness, which is in turn less than the protection from death.

> considering that the vaccine does nothing to stop it from spreading.

Completely untrue. https://www.nature.com/articles/s41591-021-01575-4

"Stop" and "slow" are very different things and cannot be used interchangeable, if you want to keep your point clear.

And, Omicron is not Delta. Omicron is the current pandemic. Vaccines slows the spread, but keeps its R0 well into the "everyone on earth will probably get it" range.

> It ends when the the threat subsides.

> The people you elect to represent you (for those of us with a democracy-like government)

The answers are not as simple as you have suggested. Problem is that there are unelected officials and scientists that are deciding these things, many of which have perverse relationships and incentives that may bias their decisions. I guess these things aren't obvious if you have blind trust in the politicians and media in power.

Herd immunity is for the herd.

The US is where it is because we have individuals willing to fight for individual rights. If casualty of individuals is the cost to keep individuality in this country then I say let it be.

The vaccinated are protected and therefore you are safe (assuming you are vaccinated). So why do you need to proselytize your doctrine on those around you? You're allowed your own opinions, chant your religious beliefs, but don't turn it into law.

You might believe a mandate might be the logical solution, and maybe by some computer models it will save the greatest number of people, but its still a breach of individual rights.

I personally believe what makes the US great isn't the number of people but the quality of people. And I'd rather give up the quantity than the quality. Sure we may end up having a higher proportion of herd people if we dont mandate and many of the individuals end up dying, but we won't have a government that can control those individuals as easily, and that's what matters most.

The vaccine doesn't fully protect the receiver. In other words, they are still put in danger by the actions of unvaccinated people.

My point is that you have to be reasonable and draw a line somewhere between respecting people's liberties, and holding them responsible / preventing them from harming other people.

For instance, if someone wakes up with a sore throat and dry cough but does not postpone a visit to their grandparents in an old-folks home, shouldn't that person be held accountable for the danger they are putting other people in?

> The vaccine doesn't fully protect the receiver.

Not going to disagree here as that's the information I've heard as well. As someone who sees the situation from the outside however, let me tell you that you are the frog in the boiling pot. The goalpost of the claimed efficacy of the vaccine has moved almost to a point where they are barely acceptable. Again, you are the frog in the pot so it's seems okay because it was only yesterday that you were told the vaccine

> holding them responsible / preventing them from harming other people.

But you also have to draw a line between putting people who aren't sick at threat of blood related health issues including myocarditis for young men (who are not at high risk of death), and period irregularities for young women (who again are not at a high risk of death).

> if someone wakes up with a sore throat and dry cough but does not postpone a visit to their grandparents in an old-folks home, shouldn't that person be held accountable for the danger they are putting other people in?

Absolutely! The old-folks better do their due diligence to tell people they think could make them sick to stay away from them. They'd better hold other people around them accountable or else they could die!

They can also take the vaccine if they believe Dr. Fauci.

Or if they believe Joe Rogan they can acquire Ivermectin and take it along with the other drugs quick and early.

Or if they don't believe Joe Rogan but believe the doctors he talks to, they can take what the specific doctors he interviews recommends. For example, sunlight, vitamin d, and exercise, as an example.

Or if they believe Donald Trump they can take monoclonal antibodies.

Or if they believe Gwyneth Paltrow they can buy a mystical egg from goop.com.

Or if they believe Kenneth Copeland ministries they can bow down to let Jesus to exercise judgement on Covid 19.

But that's all going back to individual responsibility. You can't get the state to impose that unto the individual, because no one can guarantee who is at power in the state. To you Joe Biden might be the second coming of Christ, the protector from covid, the abolisher of student loans. To someone else he could be an lying, cheating(on his first wife), geriatric, people pleasing, pedophilic (or at least very creepy towards young girls) career politician. What if he chooses to keep in power the people who lined his pockets and I happen to disagree that their mandated drug which they profit from is the best solution to the problem? What if I don't believe Dr Fauci represents the way, the science, and the light?

Since I can guess your political leanings, and I can guess your biases, and we're coming up with theoretical possibilities, what if Joe Rogan becomes president, then mandates a treatment of "horse dewormer" based on evidence he hears from a doctor who has friends who hold patents on said horse dewormer?

Will you now be hold yourself responsible and prevent yourself from harming others by shoving a vial of horse dewormer into your good self? Then would you impose your friends and everyone they know shove a horse dewormer vial up into their good selves?

To be honest I don't know what you would do, whether you're a "submit to all authority" type, or if you're a "other side is a bad guy" type, or a "we have to fight this together type". But I know what I would say, because I'd say the exact thing I'm saying now: the state should not have that kind of power, and the individual needs to take responsibility.

What I'm getting at is that this isn't a question of health. This is an issue of state power. The health implications have no regards because the mandating of anything at that level is, by the standards upon which this country was founded upon, unconstitutional.

> The estimate for COVID-19 is that roughly 70% to 85% of the population will need to be vaccinated to reach the herd immunity threshold.

That used to be the estimate, however with current vaccines' limited effect on new variants and the extreme infectivity of omicron it seems likely to me that herd immunity is unachievable. At the very least 85% vaccination isn't enough.

Vaccines and booster vaccines seem to be very effective against reducing the severity of an infection though. It's not ideal but it's the best we can do for now. Well, I say 'can' but perhaps it's more accurate to say 'could'.

> The estimate for COVID-19 is that roughly 70% to 85% of the population will need to be vaccinated to reach the herd immunity threshold.

The vaccines aren't completely effective against transmission, so those numbers were already underestimated for the original virus. With the low efficacy against the omicron (and higher transmission rates), I don't believe any amount of vaccination alone would be enough to stop it (but AFAIK, nobody actually knows it yet).

Still, any amount of vaccination will reduce the transmission rate. What is not clear if it's enough to get it lower than 1.

> It ends when the the threat subsides.

You just skipped past their entire point, after helping build it (mandates to protect "society" indeed). Society will never be completely safe. Government has a tendency to hang on forever to powers gained during emergencies.

> The estimate for COVID-19 is that roughly 70% to 85% of the population will need to be vaccinated to reach the herd immunity threshold. USA is at about 63% fully vaccinated (76% had at least one dose).

In Australia we're over 93% double dosed. We're also in our worst outbreak with the most deaths. What is this "heard immunity threshold" meant to do?

>Why this mandate and not other mandates?

i don't know about the US, but where i live there are actual vaccination mandates for diseases like polio and measles. you cannot go to school if you don't have the mandatory vaccines.

covid vaccines are just another one that you need to take.

"I'm not swinging my battleaxe around in crowded places by my own choice. My problem with prohibiting people from swinging battleaxes around in crowded places is, where does it end?"

It doesn't matter.

Covid vaccine mandate -> good.

You can end the thought there. No need to come up with a slippery slope doomsday scenario.

You are already under hundreds of health regulations or "mandates". Pasteurized milk, refrigerated meat, measles vaccine required at admision get to school is standard in a lot of places.

(USA point of view)

I feel like given that vaccines do an acceptable job at reducing risk of hospitalization and death, there is only really a few things worth discussing, in relevant order:

- Are hospitals actually being overloaded by covid cases to the point of being an issue (according to many, yes. but according to [1] Johns Hopkins, no, or only in some cases?).

- Are the unvaccinated actually the majority of the covid related cases (as far as I'm aware, yes).

- Is this localized (state or city specific), or is this a federal issue.

- Are unvaccinated hospitalizations significantly worse compared to other personal decisions (diet, exercise, risky hobbies).

- Finally, what actions, if any, should be taken to correct the hospital load? (nothing, vaccine mandates, accelerated hospital expansion, turning people away, etc)

- If the answer to the previous is nothing, then what are we even doing?

The focus on just asking "vaccine mandate, yes or no" feels like it's missing most of the discussion.

[1] https://coronavirus.jhu.edu/data/hospitalization-7-day-trend

Remember when the US invaded Iraq to "find weapons of mass destruction"? Then a year or two later that shifted to "fighting the terrorist there so we don't have to fight them here", then "winning hearts and minds" or something.

Once you get a mandate for a large-scale, politically charged activity it will never stop; the goal posts will be moved again and again, as many times as it takes and as often as necessary to put the "other side" on the defensive.

We're many weeks past "three weeks to flatten the curve", every week we hear more excuses. My friends pick them up and start parroting them in near perfect unison. I don't actually have any Republican friends, but if I did I'm sure I'd hear something similar from them too. This is no longer about fighting a disease, if it ever was (I also remember the response to AIDS being somewhat less dramatic than to COVID), this is about securing access to resources and power for one group over another. If it means thousands of your followers are discouraged from taking potentially life saving vaccinations (that you yourself have taken) and die as a result, so be it. If it means subjecting billions of people to years of unnecessary and demonstrably ineffective pandemic theater, crushing the financial future of the next generations, and destroying vast swaths of small businesses people have spent their lives building while realizing unprecedented returns on your own portfolio, so be it. The people running this do not care about any of this in the slightest, it's just an excuse to enrich themselves, and for a certain segment of the upper middle class to feel morally superior to others while they take Zoom calls from home and order dinners from Seamless. I guess this is getting boring for them now, so we're starting to be allowed to hear a trickle of stories like this.

These restrictions are so classist and so harmful to the underprivileged and working class it amazes me that the party that is championing them is the one who claims to represent said classes. Almost all of what I thought was true about my political allegiance fell completely apart over the last two years.

> This is no longer about fighting a disease, if it ever was, this is about securing access to resources and power for one group over another.

yeah it's all a big conspiracy to put the bars and restaurants out of business for sinister reasons that are beyond imagination.

People stop patronizing bars, restaurants, shops, etc, instead spend their leisure time/money/etc on infinitely more scalable digital services. Beyond imagination?

Don't be daft. This is exactly the kind of parroted narrative I'm talking about.

It's obvious to any objective observer how this has played out. Initially, three weeks of shutdown, combined with a stimulus program, was going to be painful but bearable. We laid off a bunch of people, cancelled raises, and prepared for a recession. When the "elite" saw how well their stocks, companies, and real estate holdings were doing, well suddenly this didn't seem so bad--for some folks like me and probably you as well. Then, very quickly, it got politicized and ritualized.

I can absolutely guarantee you if home values had cratered, if large businesses were getting their lunch eaten by small businesses, if stocks were on a two year decline and continued to fall, if WFH was only possible for low wage hourly workers, things would look very different and these restrictions would have been lifted a long time ago.

Now wearing a mask for 20 seconds while I walk 2 or 3 meters from the door of a restaurant to the table, only to immediately take it off for an hour to eat dinner isn't a practical mater, its symbolic--the mask is the new flag pin. The staff still needs to wear masks for their whole shift of course--all these COVID measures are falling disproportionately on service workers, I am going through life mostly free from any inconvenience while all the hourly worker I interact with wear masks, "sanitize" any surface I come into contact with, and perform all sorts of extra, mostly meaningless precautions to "keep me safe". I've never worked a job like this, but I can't imagine spending 8 hours sweating in a kitchen with a mask on is much fun.

You haven't really explained how the rich elites are benefiting from mask mandates and restaurant capacity limits. It's actually really annoying to rich people.

If you're suggesting that this was all a big opportunity to lay people off, well, the problem with this theory is that the economy has rebounded and (at least in Canada) we're back at full economic capacity and have re-hired everyone.

> “Employment is now 102.1% above pre-pandemic levels and is among the highest in Canada. This means 56,000 more people are employed in B.C. today compared to before the pandemic. https://news.gov.bc.ca/releases/2022JERI0001-000017

Dealing with the pandemic cost the government a fortune in new debt, which elites generally don't like.

If the pandemic was some scheme by the ultra rich elites to enrich themselves they probably would have done nothing and let the poors die.

You're arguing that I'm claiming this was a premeditated attempt to crush small businesses, but that's clearly not the case. The pandemic response is likely a net loss, trillions has been spent, the opportunity costs are incalculable, the handful of upsides would have a lot to do to make up for this, but there are winners and losers and some of the winners are winning big.

A large contingent of big winners from the pandemic are highly educated upper middle class social elite who tend to have a lot of assets that have dramatically appreciated in value, jobs that they are able to work from home, and work in industries that have benefited from shifts in spending resulting from the pandemic. This was not enough though, and they have now crafted a moral narrative around the necessity and efficacy of these measures that intentionally lack nuance or any consideration of the needs of people who aren't part of their cohort.

> Are unvaccinated hospitalizations significantly worse compared to other personal decisions (diet, exercise, risky hobbies).

I mean, clearly, yes. Those, in themselves, never (or at least virtually never) cause sudden exhaustion of hospital capacity. Now, many covid cases, particularly unvaccinated cases, have some sort of lifestyle problem as a comorbidity, but that's not really the point.

It's not obvious to me.

As an example, lets say hospitals have a capacity of 100, 40 of the capacity is generally taken up by non-lifestyle factors, 40 is taken up by various lifestyle factors (things that could have reasonably been avoided from a better diet, exercise, or otherwise), and the remainder is left as buffer. Now, lets say covid takes up 25 capacity, which now overflows hospitals by demanding 105 capacity. Why is this new lifestyle factor (not getting a vaccine) obviously worse than the previously accepted and accounted for lifestyle factors?

Is it the ease of avoidance? 3 jabs and you're done? If so, what about the injuries we accept that could be avoided entirely through inaction (sports, motorcycles, whatever)?

Is it the magnitude? Looking at covid as a single factor, it could be argued that it has far greater impact than any other individual lifestyle factor. but that information sure hasn't come up in any discussion I've seen. It's always left as an exercise for the reader.

Is it the suddenness? Covid sure has been a shock to the system that it was unprepared for, but that's only true through the lens of comparing pre-pandemic to current moment. Looking at the current state, it's no longer sudden. The existence of covid is now known, and so is hospitalization needs. Now it's just a question of capacity, not suddenness.

I'm not saying the point can't be argued, but it's certainly not obvious to me. And if every discussion is left as "it's obvious, why can't you see it", the discussion won't go anywhere.

It’s a question and a calculation of the CFOs of health care organizations whether or not they want to make major investments and if those investment will provide a high rate of return 5-10 years from now. This is no different than energy companies avoiding build new power plants by giving people rebates and credits for reducing power. Instead, in the short term they are “asking” you to spend more time waiting in the ER or for surgery and asking health care workers to work harder. They were and are really hoping that Covid goes away so they can continue to make astronomical amount of profit and keep there NPS and Glint surveys somewhat above the gutter.

Suddenness still applies if it continues to come in waves like Omicron. If the waves are spaced far enough apart, the extra capacity is hard/expensive to plan for. Omicron came very suddenly after a long period of little activity (and is already leaving almost as fast in much of the US).

Importantly, COVID can make hospital staff sick, which is one way it takes up capacity. I'd read that in the hospitals that hit capacity issues during Omicron, they wouldn't have had any capacity problems if staff weren't sick from Omicron. So, the capacity challenge is having enough personnel slack to cover the suddenness, which seems harder than handling equipment/room capacity issues.

That said, I agree with your points and we need clear answers to those questions.

> - Are the unvaccinated actually the majority of the covid related cases (as far as I'm aware, yes).

They needn't be a majority. The mandate acts to reduce strain on the hospital, so ask whether it achieves that (I think the answer is yes)

> - Are unvaccinated hospitalizations significantly worse compared to other personal decisions (diet, exercise, risky hobbies).

It is harder to fix these than getting a jab.

> - Finally, what actions, if any, should be taken to correct the hospital load? (nothing, vaccine mandates, accelerated hospital expansion, turning people away, etc)

An alternative would be to charge unvaccinated people a premium on hospital costs, as I'm sure health insurance providers would be keen to do.

I mean fixing this stuff now will help us "flatten the curve" in the next pandemic.

> > - Are the unvaccinated actually the majority of the covid related cases (as far as I'm aware, yes).

> They needn't be a majority. The mandate acts to reduce strain on the hospital, so ask whether it achieves that (I think the answer is yes)

Majority is very important here. If vaccinated and non-vaccinated people were hospitalized at equal rate (or even at a rate where more vaccinated were hospitalized) a vaccine mandate isn't exactly going to do anything.

But I now realize that I gave "vaccine works" as a prerequisite, so this bullet point is redundant.

---

> > - Are unvaccinated hospitalizations significantly worse compared to other personal decisions (diet, exercise, risky hobbies).

> It is harder to fix these than getting a jab.

Likely, but hard to say definitively without data, and I know I don't have such data on hand. I talk about it a bit more in another reply better, but many things are even easier than getting 3 jabs. They only require inaction.

My ultimate question on this point is, why do we accept certain lifestyle injuries but not this? Ease of avoidance is a good reason, but I would like to see it compared to other lifestyle injuries.

---

> > - Finally, what actions, if any, should be taken to correct the hospital load? (nothing, vaccine mandates, accelerated hospital expansion, turning people away, etc)

> An alternative would be to charge unvaccinated people a premium on hospital costs, as I'm sure health insurance providers would be keen to do.

I'm not against such an idea at all if it would solve the problem. The high-level issue is that the unvaccinated are costing the system more money / capacity than the vaccinated, so they should pay for it.

However, there is a lack of capacity, not necessarily a lack of funding. If the unvaccinated are charged more, will they actually have a lesser impact on capacity, or will capacity still be reached just with them paying more money? Which then circles back to needing more capacity. Who pays for the extra capacity is almost a separate discussion in itself.

Some people are saying that this is notable because Pfizer has a financial incentive to keep vaccine mandates.

That is not true. Pfizer is going to be making a lot more money from their COVID treatments than from the vaccine.

I think so too, but do you know? I mean, only a few per cent of infectees require much medicine, and Pfizer's market share won't be 100% of that. It's not obvious that x>y.

Anyway, he may also well be thinking that the best policy is to have a history of assessments that turn out to be correct in hindsight. "Drop restrictions when the number of infections declines" is at least plausible.

Paxlovid is interesting in that it is only really effective if you take it as soon as you show any symptoms. Once production is scaled up, hundreds of millions of courses of treatment will be sold. Each around 100x more expensive than a vaccine dose.

It will soon be Pfizer's financial benefit to have as many infections as possible.

I doubt that. Consider no one was vaccinated and 1% of humans would need medication because of a "serious" case. Then the medicine would need to be 100x more expensive than the vaccine considering the alternative is everyone was vaccinated. Now consider many people got 3 or even 4 shots. It's 300x-400x now.

Also you can give the medicine to already vaccinated people that also have serious cases. So you still can sell it in a lower capacity. Also you can sell both vaccines and medicine to states in large batches which is great.

It's a big golden goose for the pharma industry.. let's never forget that.

Fortunately we can trust that they aren't using any of those billions they have made to manipulate public opinion on the issue, because that would be immoral and therefore off limits.

Thank god!

It’s literally a miracle drug for a virus that is killing thousands of people a day, that likely will work for all variants.

Can you stop complaining for one second about the price and acknowledge that it is amazing that they invented it?

Oddest part about it is that they invented it in 2018.

What's your source on that little nugget

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

It was invented for a cat coronavirus in 2018.

Pavloxid works best if you use it at symptom onset, so it should be used on all symptomatic infections, not just serious cases.

The medicine is not indicated to be given to serious cases. It is indicated for use as soon as possible, when you have your first symptom.

Right now this isn't the case because there aren't enough to go around, but this is the premise of the trials, so this is how they will be sold.

People also get COVID more than once.

So basically they're expecting everyone to have a pack in their medicine cabinet, next to the aspirin and bandages?

Well, given they're selling it for thousands of dollars, I think not.

Wait, if it costs thousand of dollars, isn't it basically automatically going to be going only for the serious cases?

No, because it's priced so that the expected cost of untreated illness is still going to be higher. Hospitalization is very very expensive! Also, they will probably be bought in bulk by the government and negotiated down by insurance companies to less than a thousand dollars per treatment,

But doesn't it still rely on a person getting early symptoms of COVID-19 seeking medical aid? I can't really imagine someone developing a cough and then immediately heading to their physician to get their antiviral pills.

It doesn't have to a prescription, they could distribute them after a telehealth meeting, or on the same basis as vaccines, or at any pharmacy after a talk with the pharmacian, etc...

... Wait, can you not? That's basically how tamiflu works. And one relic of the pandemic will be that at-home covid testing will be cheap, easy and available in a way that at-home flu testing is not (antigen tests are already cheap and easily available in Europe, and soon will be worldwide).

Now, I can imagine that not _all_ cases will be given the antiviral automatically. If you're a vaccinated 18 year old with no comorbidities, say, that is probably not going to be cost-effective (though, well, we'll see what happens with long covid); the chances of you landing in hospital are just very low. But if you're an overweight unvaccinated 60 year old, there's quite a good chance of you turning into a hideously expensive ICU case, and it probably makes sense to provide the treatment.

My guess would be to expand the current vaccine initiatives to include this medicine. Have the sniffles? Stop by CVS and get dosed. I can envision a cost model where this approach works out better for them over time.

The vast majority of people isn't going to get a specific, probably expensive medicine for what amounts to a cold for most people. I certainly won't. If anything they'll take some aspirin/paracetamol and rock on.

The medicine will almost certainly be heavily subsidized. Plenty of people take Acyclovir for cold sores and things like Buckley for colds.

> Then the medicine would need to be 100x [300x-400x] more expensive than the vaccine

I'm not suggesting this is true, but it would need to be 100x-400x more profitable, and that includes cost to make and store as well as the price is charged.

Maybe making mRNA vaccines costs much more than a simpler molecule like Paxlovid [0], and hospitals generally seem to charge much more than the over the counter price for everything. You've seen horror stories about $25 aspirin [1] which is easily 400x more expensive than the penny per pill cost of 500 tablets in a $5 bottle [2].

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

[1] https://www.healthcarefinancenews.com/blog/why-aspirin-taken...

[2] https://amazon.com/Basic-Care-Aspirin-Regular-Strength/dp/B0...

This is what i meant (profitable). Sorry bad translation. However their vaccine research was highly funded by states (at least here in Germany and I suspect everywhere else too) so.. not sure how easy it would be to calculate all of that.

That's another subtlety. They've already been funded to make the mRNA vaccine, so maybe that has been milked dry and it's time to move on to the next profitable cow. Obviously I'm just speculating that it's possible.

I cannot recall another example in my lifetime of a global populous all agreeing to purchase a pharmaceutical company's medical product - not just once, but 2-3x per person - in under two years' time.

The implications of this phenomenon on Pfizer's business model are enormous. Pfizer & others would be foolish to not pay close attention to this and figure out a way to exploit it for further gains.

On the flip side, we're also going to witness a very large portion of the population that rejects most all pharmaceutical treatments due to lack of trust. Anyone that has had any vaccine injury, even if minor. Reproductive issues are in a weird classification as being "minor" in that they aren't life threatening, but they certainly are major for young women that are planning on having children. Another group that will have their trust shattered are the people that got vaxxed and boosted, and still caught covid in a very bad way. And finally, the group that has been turned off by the haphazard communication (at best) and downright creepy coercion to get vaccinated.

My trust in the system has been thoroughly shattered, I've gone from looking down at anti-vaxxers with disdain from before the pandemic- to now being labelled as part of that crowd because I am anti mandates. The whole timing of that terminology in and of itself is interesting as well- but that's probably going too deep down the rabbit hole.

> I cannot recall another example in my lifetime of a global populous all agreeing to purchase a pharmaceutical company's medical product - not just once, but 2-3x per person - in under two years' time.

Well this is the first major global pandemic in a century, so that would stand to reason, no? Most of the world received the polio vaccine within a few years of its discovery btw

The rollout of COVID-19 vaccines was far faster than Salk's polio vaccine. It was not used in lower income countries for quite a while, really until OPV came along to really get going. The vaccine was made by multiple manufacturers in the US, including what is now Pfizer.

Pfizer probably got an extra $50 for you this particular year, in addition to the hundreds or thousands of dollars it gets from you every year. If you want to attack drug pricing, drug patents and pharma profits, the time to do that is every year, not just special ones.

The big question for this vaccine is why we rewarded this fully taxpayer-funded development and testing with a patent monopoly.

Why not promote both though?

At this point, the majority of people who would take a yearly booster are going to get it regardless of a mandate.

But if it's a mandate, that's tens (hundreds?) of millions of more vaccines sold every year.

My point is that if we are going to act like everything they say is solely profit motivated, they should still support mandates.

> Pfizer is going to be making a lot more money from their COVID treatments than from the vaccine

If you're saying it's false you should please post a source or at least some kind of napkin calculation. It's not intuitive at all. Otherwise it just sounds like you're beating the already dead "pharma companies sole motivation is money" horse.

That is a trivial conclusion. Much has been written about it. Pfizer themselves have written they estimate 67 billion dollars in revenue each year from Paxlovid, which is way more than their vaccine revenues and it's not even close. If you want my back-of-the-napkin calculation, here it is.

The cost of a generic Paxlovid course of treatment is around 40$. The cost of treatment, negotiated down by the government (and thus higher for other parties) is around 600$. So the marginal profit from a course of treatment of Paxlovid is around 540$.

On the other hand, a vaccine dose costs 20$, and it is very difficult to manufacture. A reasonable estimate of profit is 10$ per dose. This is an overestimate, because Pfizer has to share a sizeable portion of the Profit with BioNTech and other companies.

Paxlovid is indicated to be taken as early as possible - and priced so that it makes financial sense for insurance companies to pay for it to avoid the cost of hospitalization. Therefore we can expect a sizeable proportion of people with COVID symptoms to take it.

Paxlovid reduces the symptomatic illness period, so there is also a very strong incentive for individuals to take it as it allows them to be less sick. For the less fortunate, it also means less sick days to take, which may be crucial to make ends meet.

If we're expecting everyone to take a vaccine dose every six months (which we all know will never happen), that's 20$/person.year from the vaccine.

If we expect everyone to have COVID symptoms every year (which is almost certainly an underestimate), at 540$/person.year, we only need to have a 3.7% take rate for Paxlovid in order for it to generate more profit than everyone taking two doses every year (which, again, will never even come close to happening).

So as long as 3.7% of the population takes one Paxlovid course of treatment every year, Pfizer will make more profit from Paxlovid than the vaccine.

So it is trivially true that widespread COVID infection (and low vaccination numbers) is going to be Pfizer's financial incentive.

> Pfizer themselves have written they estimate 67 billion dollars in revenue each year from Paxlovid

Source? I'm seeing estimates closer to 20-35B when I google "Paxlovid revenue"

You are right and I misread. I will edit my comment. That being said 20-35 billion are estimates for the current year, which are already close to projected revenue estimates for Pfizer (not BioNTech) from the vaccine.

Paxlovid is (1) authorized for

> the treatment of mild-to-moderate coronavirus disease (COVID-19) in adults and pediatric patients with positive results of direct SARS-CoV-2 testing, and who are at high risk for progression to severe COVID-19, including hospitalization or death

It's not that everyone with a Covid infection will get the drug. That number should be far lower than 3.7% of the population, most of which will either be asymptomatic or likely won't require hospitalization due to low risk. I wonder what that means for your calculation.

(1) https://www.fda.gov/news-events/press-announcements/coronavi...

They don't have enough supply yet for this incentive to be in effect. Once they reach the tipping point, look forward to them changing their tune. The good news is that it might actually align with the public's best interest.

Pfizer is going to be making 5.7 billion dollars in revenue from Paxlovid at the bare minimum in the next 6 months, in the US. That's around as much revenue as 300 million vaccine doses. We are already past the tipping point, as of around 20 days ago.

And after mandates are over and with that the official crisis done, they will probably start charging for vaccines and boosters.

They have always been charging for vaccines and boosters, but the bill has been picked up by the taxpayers.

In both cases Pfizer makes money.

> That is not true. Pfizer is going to be making a lot more money from their COVID treatments than from the vaccine.

Not if the vaccines don't work!

> “The only way to get compliance from people and get accommodation [is] if we demonstrate the ability to withdraw these [mandates] in the same manner in which we put them in,” Gottlieb added.

Nope. That line was crossed a long time ago. I can't imagine people suddenly regaining trust in pharma companies and health care agencies now because they backed off at this point.

Do you really think Republicans are not getting vaccinated because they “don’t trust” pharma companies?

Speaking as a Republican who has not gotten vaccinated, yes.

Before COVID vaccines, Republicans on average trusted pharma way more than Democrats. In general, distrust in pharma is the effect, not the cause, of anti-vax sentiment.

I don’t know what’s going on in your specific case. I suspect you are comparing the health risk of vax to not vax, instead of the risk of vax to COVID, which is the comparison you should be making since everyone is going to get omicron eventually, but whatever.

I already got Covid. If you spent a little less time assuming other people's positions (and their motivations), you might find the space to hear them instead.

So it sounds like you didn’t get vaccinated not because you don’t trust pharma but because you already were infected and don’t need the vaccine?

In any event, the risks of the vaccine are still probably much lower than the risks of a second infection, especially if you were infected more than a year ago

Same boat as Andrew. I've already had Omicron. I'm also at a healthy weight, take all recommended supplements and exercise. According to mainstream sources natural immunity is basically the same as the vaccine if not better. The war is over, people just haven't realized it yet.

> On the whole, studies found that the efficacy of infection-induced immunity was about the same as what you’d get from a two-dose mRNA vaccine, and sometimes higher.

https://fivethirtyeight.com/features/how-omicron-upended-wha...

Who hasn’t realized it? The country is fully open and other than mask requirements in schools and public transit, there are essentially no restrictions for vaccinated individuals

> no restrictions for vaccinated individuals

We're talking about natural immunity

> The country is fully open and other than mask requirements in schools and public transit, there are essentially no restrictions for vaccinated individuals

Then it isn't open. Until masks and mass testing are gone, the motor that powers the panic is still running hot and this never ends.

As someone who struggled as well to put myself in the mindset and having just finished reading Empire of Pain which documents the Sackler Family and Purdue's responsibility in the opioid epidemic.

It might be worth reading through it to view a mindset that has developed around pharmaceutical companies and doctors in places that were hit the hardest by the opioid epidemic such as mining towns, old industry towns and other rural areas that are predominately Republican.

They may vote Republican, but I think its fair to say that its likely not the image that first comes to your mind when talking about pro-business, well off Republicans.

Horseshoe theory

Far right and far left reach the same behaviors for different reasons

Correct, with the key word being "suddenly". Nothing happens suddenly; but its a necessary step toward longer-term healing of trust.

I do trust pharma companies now, more than ever. They offered us a way out of this mess, after all.

On the other hand, I do trust the politicians much less.

They made tens of billions of dollars with zero liability and a rubber stamp from the fda...these are still the same toxic companies that have been sued for billions of dollars and benefitted from decades of lobbying and regulatory capture. They have an army of lawyers on standby on the off chance that someone does find a loophole through which to sue them over adverse effects if they prove to be substantial. Meanwhile the pandemic rages on a year after introducing these vaccines, which have gradually been proven less and less effective than these faceless megacorps repeatedly claimed.

Why on earth would you suddenly trust them "more than ever"?

I don't trust big pharma but it's not true they got a rubber stamp. Most vaccine projects were called off because they wouldn't get approved or rejected.

> They offered us a way out of this mess, after all.

An unending series of shots, mandates, and other restrictions is “a way out”? What are you smoking?

It's amazing to me that every post that has anybody arguing against the restrictions or similar gets flagged, no matter the source or rationale.

It's really the most divisive issue I've ever seen in my life.

Or there are financial incentives, which may justify paid interventions online to create the appearance of divisiveness. There are PR agencies which specialize in "grassroots PR".

Users can email hn@ycombinator.com to ask for human review of flagged articles. If the article still remains flagged, only then is the flag sanctioned by HN moderators. Otherwise, flags could be anywhere on the spectrum between organic users, troll botnets and paid interventions.

Is there an API to HN data which could report granular data on article flags, e.g. timestamps or user IDs doing the flagging?

If you've been playing pandemic longer than necessary, you'd clutch your pearls too.

> no matter the source or rationale

In all fairness, it doesn't get much less credible than the Epoch Times.

> It's really the most divisive issue I've ever seen in my life.

I've been yelled at and called very awful things by people I know in real life. Biggest clue that this is 90% hysteria and 10% real.... What ever happened to keep calm and carry on.

Pfizer sells a coronavirus treatment.[1] So more cases are good for their bottom line.

"Cures are nice, but the money is in chronic conditions."

[1] https://www.cnbc.com/2021/12/22/fda-authorizes-pfizers-covid...

This was from 1999.

Language Warning.

https://www.youtube.com/watch?v=RRN3d5S_MTk

I think everyone should get vaccinated, but at this point if you aren't...you aren't going to. So, it's a waste. I think it's time to move on from this. It is understandable that people are afraid of getting sick, dying etc., but 2-3 years is a long part of your life. It's ruining lives in more ways than just people getting sick.

I feel bad for people that live in a constant state of fear in states/countries that have been incredibly strict. My state has been more or less the same now, nothing in my life has really changed aside from the price increases and shortages in both goods and labor. I can't travel to many places I want to though because of fear I'll get there, and everything will be locked down. When this first started I was upset with people going out, etc. but as time has marched on, we know enough about the virus in terms of prevention, treatment, and the low chance of serious infection.

I think my opinion is pretty popular among the populace, but it's astounding how it has not been treated as such in the media and government.

Good article here about "endemic" and the still large problems that portend: https://www.nature.com/articles/d41586-022-00155-x

> The word ‘endemic’ has become one of the most misused of the pandemic. And many of the errant assumptions made encourage a misplaced complacency. It doesn’t mean that COVID-19 will come to a natural end.

> In other words, a disease can be endemic and both widespread and deadly. Malaria killed more than 600,000 people in 2020. Ten million fell ill with tuberculosis that same year and 1.5 million died. Endemic certainly does not mean that evolution has somehow tamed a pathogen so that life simply returns to ‘normal’.

> Stating that an infection will become endemic says nothing about how long it might take to reach stasis, what the case rates, morbidity levels or death rates will be or, crucially, how much of a population — and which sectors — will be susceptible. Nor does it suggest guaranteed stability: there can still be disruptive waves from endemic infections, as seen with the US measles outbreak in 2019. Health policies and individual behaviour will determine what form — out of many possibilities — endemic COVID-19 takes.

Something can be endemic and deadly and still something we accept the consequences of without government imposed restrictions.

For example: HIV is something that is now endemic and (still) deadly. And yet we don't go around forcibly shutting down gay bathhouses, bars, and Grindr and implementing condom and prep mandates, even though they would be effective at reducing its spread. And for good reason: it'd be a massive (and homophobic) violation of civil liberties.

But because mask and vaccine resistance is red tribe coded, a lot of people who would usually be level-headed about epidemiology and cost-benefit analyses end up in a stance driven more by moralizing than sound science.

But we do strongly encourage condom usage and tests. There are education resources and awareness campaigns. Knowingly infecting someone or non disclosure of positive infection status during possible transmission activities is a jailable offense. It's not like HIV is something we simply ignore. There are still strong public health measures and laws protecting the public health.

Most of the anti-mandate people (I'm not one, to be clear) would be quite happy with a world where the interventions around COVID were awareness campaigns. And just as some people insist on not wearing condoms despite the risks, the same will be true of mask wearing and vaccines.

smoking, and indoor second hand smoking laws ... we know the principles here

Would they be happy with "Knowingly infecting someone or non disclosure of positive infection status during possible transmission activities is a jailable offense" for COVID?

Ultimately these interventions, mandates and other public health measures, which wind up as a mix of education, awareness and mandates or laws become a balancing act between personal inconvenience and public good; so the work done for HIV is different from the intervention for covid-19 for that and other reasons.

The standard for criminal HIV transmission (in California, at least; it varies by state) is not "accidentally infecting someone while not knowing your status." It's not even "infecting someone without disclosing that you're HIV-positive while knowing you're HIV-positive." It's "intentionally infecting someone with HIV." And, explicitly, your knowledge of your positive status is not sufficient to establish intent.

>But we do strongly encourage condom usage and tests. There are education resources and awareness campaigns.

Nobody is saying we shouldn't strongly encourage vaccines. But there is a difference between education/awareness campaigns and a mandates.

The same people trying to prevent unvaccinated people from being a part of society would have flipped out if you had to show PrEP status at gay bars in 2019.

>Knowingly infecting someone or non disclosure of positive infection status during possible transmission activities is a jailable offense.

But you aren't charged just because you don't wear a condom or take PrEP while you don't know you have HIV.

So we did do that, and there is a bit of irony there. Back in the 80s AIDS was used to push homophobia and lots of states passed laws making promoting homosexuality illegal. At the time Dr.Fauci went on national television to tell the public you could get AIDS simply by touching or being in proximity to someone who had the virus. So if you want to talk about moralizing science, well actually…

"states passed laws making promoting homosexuality illegal."

Did they? Seems laws have only gone one way, decriminalizing since the late 70s

I mostly agree, but I think the core difference with HIV is how it's transmitted. You're more in control of your transmission risk.

That's less true with Covid given its contagiousness through the air.

I'm of the opinion that private companies have every right to require restrictions they see fit. I'm more mixed about government restrictions now that we're post vaccine (with the exception that requiring vaccine mandates for healthcare workers seems reasonable).

What gets to me about this whole thing is it's not binary but people often talk like it is (probably just political tribalism).

Vaccinated people who are infected spread the disease like the unvaccinated, that's true - but since vaccinated people are much less likely to get infected on exposure things like the vaccine mandates for restaurant entry do have an affect and are not just theater. They reduce the overall probability of positive people in the restaurant.

I think people like Bret Weinstein have done a lot of harm and I'm often surprised by the extent to which intelligence is independent from accuracy.

It's really interesting in the context of this book review: https://slatestarcodex.com/2019/06/04/book-review-the-secret...

Basically, the argument in that is a little reason (incompletely applied or understood) can be a dangerous thing and blindly following consensus is sometimes the adaptive behavior. It's a little misapplied to vaccines since in that case someone did actually know the details and understand the mechanism, but it's possible for a cultural understanding to be entirely selected by natural selection and the reason for it was never understood by anyone!

When we see animals do complex behavior we don't usually assume it's because they understand fully why that mechanism is adaptive, but we often misapply this understanding to ourselves.

Mostly getting off topic, but I thought this was an interesting thing to think about.

vaccinated people are much less likely to get infected on exposure?

With Omicron, vaccinated people are MORE likely to get infected, 90 days post-vaccine.

Source: https://www.medrxiv.org/content/10.1101/2021.12.20.21267966v...

Yeah, more likely to get infected on exposure than an unvaccinated person that has not previously had the disease.

The source link supports that claim as far as I can tell from what's on that page and doesn't say anything about vaccinated people being more likely to get infected vs. unvaccinated (both without natural immunity).

The study excluded previously PCR-positive individuals in both vaccinated and unvaccinated groups. So it's vaccinated and no prior exposure and unvaccinated and no prior exposure.

The infection rate 60 days post-vaccination were higher in the vaccine group.

"The negative estimates in the final period arguably suggest different behaviour and/or exposure patterns in the vaccinated and unvaccinated cohorts causing underestimation of the VE. This was likely the result of Omicron spreading rapidly initially through single (super-spreading) events causing many infections among young, vaccinated individuals."

Yeah, I think it's more likely that this is the explanation. At least I'd need to be persuaded that the more unlikely explanation is the correct one.

yah, difficult to control for that for sure. But most polling indicates unvaccinated folks are far less concerned about COVID in general and less likely to modify their behavior.

Source: https://www.kff.org/coronavirus-covid-19/poll-finding/kff-co...

I don't have to worry about getting HIV every time I go out in public just because some jerk decided he has a god-given right to breathe viral particles into my lungs even though a simple and safe vaccine is readily available.

This makes no sense. It's incredibly clear at this point that vaccinated people with covid spread it just the same as an unvaccinated person with covid.

> just the same

AFAIK that's not true.

IIRC vaccinated people spread smaller quantities of the virus, and the viral droplets they do spread tend to include antigens since their body is actively fighting the infection while they spread it... you know, because their system was primed for the fight thanks to the vaccine.

I think this Fridman podcast interview explored such things, either way it was quite informative on the subject:

https://www.youtube.com/watch?v=G433fa01oMU

Yeah, and a car crash does the same damage regardless of Blood Alcohol Concentration. We should still punish a drunk driver for irresponsible behavior.

My understanding, from a study that may be outdated by now, is the window to spread covid is slightly bigger in the unvaccinated, but not by much.

1-3 days of additional self-quarantine solves this issue.

This is perilously close to "people who get COVID are innocent victims so forcible interventions are justified, while people who got HIV chose to do it so those same nterventions are less justified."

I agree that, for the average person, COVID is easier to contract than HIV. But by the same token, COVID is much less severe than HIV, even with modern treatment plans. It's not at core about some abstract principle about how preventing disease spread trumps all other concerns but is instead a cost benefit analysis. Keeping the country shut down perpetually is an extreme cost that we are continually incurring.

> But by the same token, COVID is much less severe than HIV, even with modern treatment plans.

Do you have a source for this? This wouldn't surprise me for the Omicron variant, but I'm surprised that (for example) someone getting the Delta variant in 2021 was "much less severe" than someone getting HIV in 2021.

COVID19 has, since the beginning, had a 0.6% IFR. The odds of someone under 40 without comorbodities dying of it were and are more or less zero.

HIV was and is invariably fatal. Yes, current drug regimens are remarkably effective. They are also very complex, required for the rest of your life, and do not affect the odds of you infecting someone else by unprotected sex.

*No one*, not even the most ill centenarian, would choose HIV over COVID19 if required to be infected by one.

Minor point of correction: someone who is HIV positive but has an undetectable viral load is very unlikely to give someone else HIV. It's riskier to have sex with a random at a bar of unknown status than it is to have sex with someone with an undetectable viral load. (If you trust that they do indeed have an undetectable viral load and strictly adhere to their medication protocol.)

Thank you for the correction.

I'm still amazed that the person I responded to thought that HIV would be preferable to COVID19! What does that say about the effectiveness, so to speak, of media campaigns about COVID19's dangers?

You've misquoted me twice in a short period of time, I didn't say that HIV would be preferable to the Delta variant. You're right, I would "prefer" COVID over HIV, but my personal preference is not a good metric of the overall severity.

In abstract, given the choice between something that had a (say) 30% chance to kill me but was mostly harmless in the long-run and HIV, I would "prefer" the former over the latter. But I also think that the former is more severe. In my view you're equating two things which are not the same.

For some context, I lost 6 family members in a short period of time to the Delta variant of COVID. My experience with COVID is not "media campaigns" but funerals.

>You've misquoted me twice in a short period of time, I didn't say that HIV would be preferable to the Delta variant.

You wrote

>I'm surprised that (for example) someone getting the Delta variant in 2021 was "much less severe" than someone getting HIV in 2021.

I do not think that my

>No one, not even the most ill centenarian, would choose HIV over COVID19 if required to be infected by one.

and

>I'm still amazed that the person I responded to thought that HIV would be preferable to COVID19!

are so far off.

>In abstract, given the choice between something that had a (say) 30% chance to kill me but was mostly harmless in the long-run and HIV, I would "prefer" the former over the latter.

If the only two choices were infection by something that had a 30% chance to kill me, or HIV (presumably followed by the appropriate drug regimen to control it), I think I'd probably take HIV!

But that's not a choice between COVID19 and HIV. Let me repeat: COVID19 has a 0.6% IFR. Yes, IFR increases by age, but even 85-year olds' IFR is 15%; not great, but (as I understand it) pretty comparable to the flu for the cohort.

>But I also think that the former is more severe.

This is more support for the accuracy of my paraphrasing of you.

>For some context, I lost 6 family members in a short period of time to the Delta variant of COVID. My experience with COVID is not "media campaigns" but funerals.

I am sorry to hear that about your family. But (thankfully for society, if not so much for you or your loved ones) your experience is very atypical. Unless all had multiple comorbidities (immune suppression + obesity + something else), what happened to your family members was very, very, very rare.

> But (thankfully for society, if not so much for you or your loved ones) your experience is very atypical. Unless all had multiple comorbidities (immune suppression + obesity + something else), what happened to your family members was very, very, very rare.

Agreed, I wasn't attempting to extrapolate it over the general population. But you may consider your "media campaigns" comment from my POV.

The point I was attempting to make is that (as a relatively young man) I would risk many illnesses over a long-term debilitating illness that affected my sexual health, even if the former were objectively worse for my overall health. That's why I don't think severity and preference are necessarily correlated. Anyway, the "8 replies deep semantics argument" is not a good use of time for either of us, especially since I don't think our viewpoints are that far off.

If nothing else, I have learned more about HIV from this subthread than I expected, so there is that.

> This is perilously close to "people who get COVID are innocent victims so forcible interventions are justified, while people who got HIV chose to do it so those same nterventions are less justified."

Nope. The existence of simple, effective countermeasures and ease of accessing them set the level of moral culpability for refusing and then infecting someone else as a result.

I'd agree that the cost-benefit is nearing the point of "fuck it, let the selfish jerks have what they want."

Now disease is a matter of "moral culpability"?

It's far easier to accidentally infect someone with COVID than it is to infect someone with HIV, and the harm of the former is less than the harm of the latter. The latter per incident is significantly more costly to society as well.

Should the government require Grindr and gay bars to require customers to show an up-to-date negative status and proof of being on PreP in order to be allowed to participate? With poz people banned from participating at the venue/platform?

> Keeping the country shut down perpetually is an extreme cost that we are continually incurring.

Which country is this that is perpetually shut down? Even the most mask and vaccine forward (ergo "shut down perpetually") parts of the US are pretty operational. Offices are open as are restaurants and schools Disneyland is packed.

We've learned how to keep society running during the pandemic: vaccines, masks, testing, and occasionally heightened indoor occupancy restrictions during large waves to keep hospitals from being overwhelmed.

That's nothing at all like a "perpetual shutdown".

If you are so worried about covid... don't go outside. Or if you do, triple mask and wear a face shield. I don't care. Just don't force me into taking measures to make you less fearful--that's pretty selfish.

It's not the fact that it's red tribe coded, it's the fact that the arguments against these things started from very stupid places.

Mask and vaccine resistance is stupid tribe coded, even if now there might be some valid reasons for talking about it. Stupid tribe and red tribe do happen to overlap, but it's the stupid part that upsets people so universally, not the red part.

Also, HIV is not even remotely as contagious as SARS-CoV-2, so it's not really a fair comparison. We absolutely would have shut down whatever we needed to if HIV were airborne.

I really don’t see how you could reasonably talk with someone that isn’t vaccinated and convince them to get vaccinated by calling them stupid. It’s demeaning and completely dismissive of their apprehensions, fears, or any other reason they haven’t been vaccinated.

I would likely find myself much more reluctant to get vaccinated if the person attempting to convince me is calling me an idiot and just shouting that i’m wrong instead of providing me data on the subject, and being honest enough to openly discuss the subject.

A small amount of humility and respect go a very long way.

Who said anything about convincing people? I'm explaining why it's a challenge to consider a position that may be more valid now, but wasn't valid or was substantially less valid in the past.

It was an abjectly stupid position, held by stupid people. Now, it's possible that the situation has changed and it's marginally less stupid of a position, or even not a stupid position at all, given new information.

It's hard for people to make that switch.

This seems entirely non-sequitur. We don't have condom mandates because there is no practical way to enforce them. We don't have mandates that you need to wear a mask in your bedroom, either. If we allowed sex in stores and restaurants and didn't have condom mandates for people having sex in stores and restaurants, you'd have a point, but we don't allow sex in public. Porn performers don't have condom mandates, but they do have a mandate requiring them to show proof of a recent negative test before they're allowed to perform. I suspect many people you think are level-headed would be entirely supportive of legally mandated condom usage for non-cohabitating partners if there was any remotely realistic way to do it.

And, of course, we do have an absolute shit ton of mandated vaccines, so mandating one for Covid is not at all novel. It's even already a condition of federal employment in a lot of cases. If you're serving in the state department or military or something where you need to go overseas to places where anthrax or malaria are risks, you need to get vaccinated, and that's been normal and in-bounds for half a century.

> And yet we don't go around forcibly shutting down gay bathhouses, bars, and Grindr and implementing condom and prep mandates, even though they would be effective at reducing its spread. And for good reason: it'd be a massive (and homophobic) violation of civil liberties

Actually, following some FUD by a now famous doctor, this had a lot of political and popular support back then: https://www.congress.gov/98/crecb/1983/07/14/GPO-CRECB-1983-...

Check page 28, July 14 1983.

All of this is true, and none of it contradicts anything in the grandparent post.

The Omicron variant has so far shown itself to be milder and overall less dangerous to the vaccinated and unvaccinated. So far it appears to leave patients with good immunity after recovery.

This trend is playing out in the US and western Europe. Ireland has dropped its restrictions .. Denmark also just announced dropping restrictions.

The board member is correct here, despite anyones personal thoughts on covid vaccinations, vaccine requirements etc.. at least for now this latest variant seems to be forcing a change in narrative.

Scott Gottlieb is also a former FDA commissioner and an MD, not just a Pfizer board member.

He’s also been a prolific public commenter during the pandemic and one of the few who has been able to navigate the politics of explaining the situation accurately but still being accepted by many conservatives.

In terms of the headline, being a Pfizer board member is a lot less important than knowing the comment is from Scott Gottlieb.

If everyone is unmasked and the Omicron variant seems to burn through the vaccines in terms of infection but not serious illness, does that mean that it can lead to more mutations and more _bad_ mutations if so many people get it? What's the "mutation rate" in a person who has mild or no symptoms and how infectious are they?

It just seems if one sick person creates a bad variant that is more infectious or even more deadly (and burn through the vaccines like Omicron) and everyone is unmasked/etc at the same time then such a variant could spread wide without immediate detection. I have no idea if any of this is true so take it with a grain of salt...

I could not care less, but then it seems these guys --through lots of lobby and special interest groups-- basically dictate governmental policy the world over.

Am I the only one who finds it heinous that “Pfizer board member” is supposed to give this position more credence as opposed to what should just be clearly obvious to any level headed civic minded individual in the American/western tradition?

“Okay y’all, weve profited at your expense quite enough, let’s dial it back a little before causing too much societal damage writ large” -“Pfizer board member

I think this is kind of a big "duh" statement. Mandates were issued in the face or surging numbers and we now have waning numbers. I'm very hesitant to declare victory too soon but the day is seemingly coming soon. Of course, we'll have to reverse course yet again if there's a new wave which very well might happen. The next stage should shipping billions of doses to the poor nations that haven't gotten any yet.

Millions of people died, there's no victory.

Out of 8 billion that's not very impressive. Millions die in years without "pandemic". (quoted because in the past that mend >1% infection-deaths, this was <1%, yet still a pandemic).

Yeah and I don't call those victories either. We lost and need to do better when it happens again.

Maybe we should outlaw tobacco, limit people's sugar intake via daily glucose testing, and ban alcohol while we're at it?

I think people should be able to choose their vices. Suicide (slow or fast) is by it self not immoral to me.

Tobacco and sugar aren't contagious. If you want to continue down this path of false equivalence, many places have essentially outlawed second-hand smoke.

And vaccines are supposed to protect you, so if people aren't allowed to make their own choices then might as well force them to make whatever groupthink thinks is the best for them.

Vaccines are also a public health measure, like smoking restrictions. You can't choose to keep a petri dish of ebola around either.

You are subject to "groupthink" unless you self-sustain in the woods somewhere. We call it "society." Many things you do every day are a result of "groupthink." The pipes that deliver the water, the social contracts that say you need to wear pants.

Smoking restrictions are not permanent like forcing someone to get an experimental shot. The groupthink you are supporting also caused racism, wars, poverty and has created a mental health crisis. Youth suicide is at an all time high.

The vaccine isn't permanent, as we've very quickly discovered. Death is.

How would you have done things differently to avoid racism, wars, poverty, and mental health crises? Do you think the suicide rate would have been half as high if twice as many people died from the virus?

These are not easy questions to answer. I certainly don't know, and I don't expect you to. It's very easy to act like you know better in hindsight.

The only non "groupthink" way to approach this pandemic would have been to do nothing. There's not a datapoint on the planet that supports doing nothing. Everything else requires some societal "groupthink" effort.

Well for starters rather than force mandate/isolate everyone... people could have been given the option to isolate if they wanted to. Instead we had governors closing down beaches and hiking trails while getting caught fine dining in large groups in Napa. We've also determined that obesity and other contributing factors regarding health have a significant impact on the effects of COVID-19. If anything, the hypocrites have made things worse at times by preventing access to activities that would improve health and rewarding people getting vaccinated from an old variant with free beer, donuts and fast food.

vaccines do protect you from the virus, they don't protect you from an overloaded health care system because others decided they didn't want to get vaxed.

The health care system is overloaded due to shortages of employees wanting to work in healthcare while being mandated to take an experimental vaccine, shortages of labor due to inflation and people re-evaluating whether they want to be wage slaves, and shortages of health care professionals who are taking time off of work due to being sick and many claiming COVID-19 despite being triple vaccinated. Hospitals are also incentivized to inflate the issue of shortages to get more funding.

The vaccines are hardly experimental at this point — Pfizer has full approval and all of them have far more data than usual showing high safety and efficacy — and very few employees chose to leave. You don't get the kind of overload hospitals are reporting from 1% of your workforce choosing not to follow safety guidelines.

> Hospitals are also incentivized to inflate the issue of shortages to get more funding.

That's a conspiracy theory which has no supporting evidence — which is highly unlikely given how many thousands of people would have to be keeping it perfectly secret — and it doesn't fit with how the American medical system works. Hospitals have been reporting significant financial stress because they make most of their money from the elective procedures and other higher-profit treatments which are being canceled due to COVID-19 overload.

It's mostly overloaded because there are more patients than usual though. Ask anyone that works in a hospital. Some literally ran out of physical space to put people, despite staffing. Do you think hospitals are faking their physical dimensions in order to get larger budgets?

Do you think more people are going to hospitals because of the fear porn being broadcast nonstop by the media?

I dont have a problem with a natural cause "shaking out some dead branches". That's how things go. Someone else notes tobacco. And that's it, if we are so serious about extending human life, why not focus on lifestyle diseases? And even with that focus I think people should be able to choose their own vices (as long as it does not harm others).

We (the US, but also others) knew this virus was coming, and completely bungled the response on multiple occasions. Lots of people died that didn't have to die.

We spend a lot of time and money avoiding lifestyle diseases. A virus isn't a lifestyle disease.

> A virus isn't a lifestyle disease.

No it but it seems to kill those that have 'm LS diseases underlying.

> We spend a lot of time and money avoiding lifestyle diseases.

I never saw lockdowns on McD and Dunkin'Dos :)

And I'm no in favor of spending to stop diseases. I feel better about heavy taxes on unhealthy stuff, and tax breaks for healthy stuff. (While the other way around happens all over the glove with life stock and feed subsidies).

I mean, we declared victory at the end of WWII. No one comes out from a battle unscathed.

A year before becoming involved in WWII, Neville Chamberlain, the PM of the UK said: "In war, whichever side may call itself the victor, there are no winners, but all are losers."

Call it a victory if you must, but looking back at the past 2 years there were very few winners.

The B.A2 variant has emerged and is spreading. I’m not sure we’re rounding the corner just yet.

There will always be new variants.

Irrelevant. If the new variants keep killing people in huge numbers, we'll keep seeing restrictions (assuming our governments are doing their jobs). If this happens for the next 100 years, we'll have to keep living with restrictions for the next 100 years; horrible as it is, it's better than the alternatives.

> It's better than the alternatives.

That's an opinion. You will find people who would rather face the chance of becoming sick than live under quasi-lockdown for their entire lives.

We are all dead in the end.

If those people's choices only affected themselves, that'd be fine. But they don't. Typhoid Mary was locked away for a reason.

Why are people so afraid of something that has less than 0.01% of killing them? I am living my life as normally as I can, yet I am unvaccinated and rarely ever wear a mask. I feel mankind has handled this poorly, and has created many more unnecessary problems. I wish more people would join me, living life to its fullest. This thing will only be over when WE decide it is.

I am with you. I have looked at age distribution of covid deaths multiple times and it seems to me that the risk is roughly the same as the background probability of dying from any cause within a year as presented here: https://www.ssa.gov/oact/STATS/table4c6.html.

The number corresponding to my age from that table is around 1/300. Doubling that doesn't bother me in the slightest. I'd probably start being slightly concerned once the background probability reaches 1%, i.e. at the age of about 60. Now, as someone obese with hypertension and pre-diabetes, I am sure my covid risk is somewhat higher, but still immaterial in light of my background risk, which is much, much, much higher. It is the latter that I should be working on, and what I'm trying to do when suicide ideation and the madness of mask and vax mandates momentarily loses it's grip on me. I am absolutely livid that those who set up these rules to combat the minuscule probability all but ensure that real big probabilities for many people will grow even bigger. Talk about penny-wise and pound-foolish. For some reason they do not even acknowledge that concerns other than covid exist, that are absolutely dwarfing their fearmongering despite all their trying.

The message I am hearing from covid-enthusiasts is: "You're rubbish, crazy, mental nutjob. Your problems are imaginary, and if you die tomorrow from your own hand, good riddance! Our fully vaxed percentage will go higher, for the common good."

Actually seems like a very level headed guy.

His record at the FDA is better than I would have expected from someone with such deep industry ties but it looks like he took the job to heart and did it well.

At this point with the rate Omicron has been spreading here in Australia I don't think masks are making much/any difference anymore - seems like this variant is just off the charts w.r.t transmissibility.

Vaccine mandates though I think make sense for the same reason we have mandated immunization in Australia for many other diseases. Unlike somewhere like the US you can't attend a school (any school, not just public schools) without the appropriate vaccines or a medical diagnosis exempting you. So a vaccine mandate for Covid-19 isn't really anything new here. Despite that there is now some political debate about it because we seem to have imported a lot of US hysteria the last decade or two.

Vaccine mandate will help keep herd immunity maintained which reduces deaths among those that actually can't get the vaccine rather than just anti-vax nonsense.

Why is this comment being downvoted? What part isn't true?

This statement seems very specific to the US cultural context:

“The only way to get compliance from people and get accommodation [is] if we demonstrate the ability to withdraw these [mandates] in the same manner in which we put them in,” Gottlieb added.

In Canada, there have been experiments with slowly increasing the number of areas where you are required to have a vaccine in order to enter. They put it on Beer/Liquor stores recently and it saw a huge jump in the number of vaccine appoints.

https://montreal.ctvnews.ca/first-dose-vaccinations-quadrupl...

They are putting the requirement on big box stores (e.g. Home Depot/Lowes/Walmart, excluding the pharmacy areas) now and probably will see another jump.

https://www.cbc.ca/player/play/1995579971859

That said, it does appear that this current wave is mostly over, but deaths are primarily among the unvaccinated, so it is probably still a good idea to aim for near full vaccination:

https://twitter.com/OurWorldInData/status/148607668061993779...

Covid vaccines should be treated similarly to other public health vaccines, like Polio. Although we really need more effective Gen2 vaccines that do not require constant boosters and they need to outright prevent infection rather than just reducing the death rate. These Gen1 vaccines and their semi-effectiveness have been incredibly confusing to the general public.

Why you care if others get the vaccine if it does not stop the spread and new mutations as we saw with the recent variants

I’m fully boosted etc. I don’t think it’s fair to compare it to Polio

It doesn't stop the spread, but it slows it and reduces the severity of the disease. Both of which help our health services to cope. You might care because you want healthcare to be available for yourself or your loved ones should they need it.

> slows it

Not necessarily. Because vaccines suppress symptoms, people who would otherwise isolate in the presence of symptoms could be unaware they are infected and transmitting to others.

I think you should look at Canada and compare it to the US. In Canada there were lockdowns and aggressive vaccination campaigns with high compliance. Death and infection rates are 3x lower than the US per capita.

It isn't a perfect test but the general populations and habits between Canada and US are somewhat comparable otherwise.

I think it is fair to argue that maybe it wasn't worth it, as most of the deaths were primarily among the old and frail. But it does seem that the policy and cultural differences did have an effect.

Cross-country or even cross-state comparisons are highly problematic for many reasons. Many narratives can and have been constructed, which are a far cry from a structured scientific study. Three macro differences between US and Canada: universal healthcare, obesity rates and 90% difference in population size.

None of which changes the fact that vaccinated people can transmit unknowingly.

My understanding is that people with suppressed symptoms are also less likely to transmit it. This makes sense given that we know coughing and sneezing is a primary transmission vector. So if you're not coughing and sneezing you're much less likely to transmit it. Of course you still can transmit it just by breathing, but it's just less likely.

I would also add that I'm speaking in the context of the UK. Here we have freely and widely available lateral flow tests (you can order packs of tests online or pick them up from local chemists, and there is no charge in either case), and people are encouraged to test regularly, especially if attending a social event and even if you have no symptoms. And a lot of people are required to test regularly as part of their jobs, or in order to attend to school. In this context, it's quite likely that asymptomatic cases get picked up anyway.

Ok, so if suppressed symptoms means less likely to spread it- then restrictions based on vaccination status mean nothing. Restrictions based on symptoms are the only restrictions that make sense. I'm not arguing with you, but just pointing out one of the most ridiculous things that I'm currently going through here in Chicago. I am not allowed to workout at a gym, sit down and eat at a restaurant, but if I'm vaccinated, even if I'm sick, I can live my life unrestricted. I am now driving an extra 20 miles daily to workout as my partner was kicked from her gym for not being vaccinated. Great for the environment. Meanwhile- she caught covid a few weeks ago, and despite being pregnant, was recovered within 2 days. We isolated for a week, and I never had symptoms whatsoever. Natural immunity. Meanwhile, and this is anecdotal, but everyone we know that has has had a really bad time with covid during the past month, has also been vaccinated and boosted. And if they had mild cases, they didn't isolate like we did- they just assumed that they were fine because they are vaccinated. But we are the selfish ones.

You wrote: "Meanwhile, and this is anecdotal, but everyone we know that has has had a really bad time with covid during the past month, has also been vaccinated and boosted"

Death is 10x more likely if you are not vaccinated, your anecdote aside:

https://twitter.com/OurWorldInData/status/148607668061993779...

Without controlling for age and comorbidities, this doesn't mean much. You can break down by age, but the categories are ridiculously broad, 18-49, then narrower age bands afterwards.

Another breakdown that we will never see is the data broken down by death within two weeks of any shot(lumped in with unvaccinated) and death after full vaccination lapses. Which is an ever shortening window.

Finally, how are the denominators being calculated? For the United States, we are basically guessing at this point, given that we only have an insanely large range of estimated undocumented people in the country alone.

It greatly reduces deaths, which is the point of a vaccine:

https://twitter.com/OurWorldInData/status/148607668061993779...

Eating five cheeseburgers a day increase the rush of death too. We don’t have laws against it.

Heart disease isn't contagious.

The argument you are pushing is valid against all vaccination mandates for the point of public health. That's pretty hard core anti-vax.

Covid amongst vaccinated is still contagious

I can not find studies about Omicron right now, but Nature reports that vaccination provably reduces the spread of Delta variant, but requires boosters in the 3 month range to maintain effectiveness:

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

The effects of eating five cheeseburgers a day are spread out over decades. The result of a group of people choosing to each five cheeseburgers a day is a tiny increase in the average load on the health care system over many many years.

The effect of COVID on the health care system is a large short term spike in load.

It is almost always in almost all systems much easier to deal with a long term small steady increase in load than to deal with a short term massive spike.

Yeah this whole thing is extremely frustrating to me, it's simply ignoring reality. I would love to not care about other peoples choices, but I can't do that when I have family members who had surgery delayed because of COVID cases taking over hospitals.

> result of a group of people choosing to each five cheeseburgers a day is a tiny increase in the average load on the health care system over many many years.

You are exaggerating and minimizing all at the same time. It doesn't take five cheeseburgers a day to wreck your body. The healthcare system is overloaded, and has been for years precisely because of how many health issues come from our poor diets.

> The American Diabetes Association (ADA) released new research on March 22, 2018 estimating the total costs of diagnosed diabetes have risen to $327 billion in 2017 from $245 billion in 2012, when the cost was last examined.

> This figure represents a 26% increase over a five-year period.

https://www.diabetes.org/resources/statistics/cost-diabetes

These numbers have only gone up.

We have entire government agencies dedicated to food safety and health (FDA and USDA). We also have laws governing trans fat and nutritional facts/disclosure.

It's a point of a vaccine, but they usually do a really good job of reducing transmission too.

We’re seeing mutations because of incubators who weren’t vaccinated.

But anymore, I’m beyond caring. Anti-vax stance is a self correcting problem.

I mourn for the young being indoctrinated, and for the immunocompromised, but those who could help them have made their choices.

> We’re seeing mutations because of incubators who weren’t vaccinated.

I’ve been tracking this closely and all research thus far appears to indicate that statement is inaccurate.

Links? Mutations occur in infected hosts, which vaccines were limiting.

Even with Omicron, a report that hit HN a day or two ago indicated a 5x difference in infection rates created by vaccines.

I think parent post is implying that the situation with Omicron is much more complicated.

Alpha, Delta variants, sure, we can see them evolving pretty much site by site to become the things that they are. There are enough uploaded sequences you can basically watch it happening.

I suppose you can blame the unvaxxed for increasing the probability of such variants.

But Omicron turns up with a freakishly weird number of synonymous vs non-synonymous mutations in the spike, lots of adaptions for immune evasion and... it's rooted in the phylogenetic tree back in 2020? So it just evolved in secret for 18 months, becoming incredibly transmissible while managing not to infect a single person who got sequenced? Bear in mind that is conservatively 100 generations, usually. It's super weird. Whatever process produced Omicron, it was radically different than regular infection and transmission.

This is not something we could reasonably have expected from say, increased infections due to some people not being vaccinated.

In fact all the variants from "regular" transmission over the course of this pandemic - the result of hundreds of millions of infections - are being out-competed by this bolt from the blue.

> Anti-vax stance is a self correcting problem.

Natural immunity is long and strong baby. You'll be waiting a while.

"... researchers looking at SARS-CoV-2 antibodies in people who had recovered found that the difference between the highest and lowest levels varied by a factor of over 1,000. The researchers saw even more variability when they looked at neutralizing antibodies—those known to bind to the virus and prevent it from infecting cells. Neutralizing antibody levels in recovered people varied over a range of 40,000-fold, and up to 20 percent of people didn't have any detectable level of neutralizing antibody."

https://arstechnica.com/science/2020/06/antibody-testing-sug...

But hey, don't let mere science stand in the way of a good catchphrase.

EDIT: I'm quite aware I won't change anybody's opinions. I'm also aware that providing opposing evidence will even strengthen beliefs. So, yeah, I shouldn't have risen to the bait. Regardless, good luck!

Serology studies are you kidding me right now? We can and have measured the clinical outcomes.

edit: It's pretty rich to hear that you've taken my bait, "self-correcting problem" was masterful baiting.

This would be a lot more constructive if you included a link. Or at least explained more.

Not everyone reading will have the same background you do, especially when the issue is something technical like discounting a serology study because you know of more convincing ones.

https://www.reuters.com/business/healthcare-pharmaceuticals/...

There's a lot of talk of antibodies because researchers studying vaccine effectiveness prior to everyone being exposed need something to measure.

It's hard to measure the overall effectiveness of a person's immune response, so they measure antibodies, which are not the whole story. It might not even be the important part. I think this is why GP is derisive of serology.

The immune system is quite complicated.

Personally I suspect that advising people who had breakthrough infections to keep getting boosters will turn out to be bad advice. We'll see I guess.

Your article is from June 2020. Believe it or not, we have more data now!

The beatings will continue until morale improves.

Pfizer would be smart to not push for mandates -- as would anyone else wanting to see more vaccinations, period. More people would probably get their vaccine by choice if it were not forced on them. WE have known this for a long time. Glad they are catching wind of how this all works, psychologically.

> demonstrate the ability to withdraw these [mandates] in the same manner in which we put them in

Just as people commonly rush out of a burning building, then swiftly right back into it. Because they’re safe from the fire now, and being outside the burning building is a life threatening emergency.

Lets forget about everything divisive before omicron:

Cloth masks and omicron are pointless right guys?

It is less effective to the point of irrelevance for a virus that is less dangerous to the point of irrelevance

And we cant get N95s still so this is all theater to have said mandate.

Why/why not?

> “The only way to get compliance from people and get accommodation [is] if we demonstrate the ability to withdraw these [mandates] in the same manner in which we put them in,” Gottlieb added.

The only way to get people to wear masks and get vaccinated is to not make them wear masks or get vaccinated.

Also, didn't we just do this 9 months ago where cases were decreasing, everyone got vaccinated and the CDC said we could burn our masks since vaccines meant we couldn't spread the virus? Looking forward to our yearly "covid is over" every spring for the rest of my life.

I am not sure why we have vaccine mandates that businesses are expected to audit for entry. That to me is absurd. I do not need to provide proof of MMR to enter a McDonalds. I am vaccinated and boosted, but the invasiveness in these requests is a little over the top. Regarding masks, well businesses do often require shirt and shoes for service. I fail to see where masks differ at all in that regard.

Good, now try to convince the French. The vaccine passport is such a bad idea.

https://www.usnews.com/news/best-countries/articles/2022-01-...

So he was referring to the "east coast".

In New York State where I live, we have 95% first-dose vaccination status for adults and 73% for complete vaccine series (https://twitter.com/GovKathyHochul/status/148608338468219289...) .

so here, continued vaccine mandates won't have much additional effect. However, I would venture to say a whole lot of that 95% has been vaccinated *because* of the mandates that were temporarily in effect at the national level as well as the mandates that continue to be in effect (health care workers, federal contractors, large employers that mandate vaccination in any case). My general sense is that the vaccine mandates, despite their being in the process of being torn down by a very broken supreme court, most certainly helped a whole lot in states where state-level leadership was on board with the general idea.

in conservative states where vaccination rates are low, state governments are in varying degrees of defiance towards the federal government, vaccine mandates are not as effective because of the very great resistance to them in these states. you could argue that continued vaccine mandates will continue to not be very effective, and for that reason they should also be rescinded. I'd guess some replies here will make this kind of argument.

I would disagree with that argument, and it's my opinion that vaccine mandates should stay in place to the degree that it's the right thing to do, as well as the completely normal and traditional thing to do from a public health standpoint. The fierce political interference with traditional public health measures is unfortunate but that should not be a rationale for sensible policies to just be switched off.

The policies are sensible in your opinion, you will find that is where you are in disagreement with myself at least. The policies might be sensible with rose colored glasses and a pint of hope, but its not like what we imagined it would be way back a year ago. Ultimately vaccines should be used for those who benefit but forcing it on those who don't need it is just checking a box. Quit pretending like we don't know that most Americans have had Covid by now and that this imparts significant immunity.

A large percentage of urban NY populations were infected and recovered in 2020, gaining immunity to 2020 and Delta variants. Those who recovered from the recent wave of Omicron infections will also have immunity to more-dangerous Delta.

Interestingly enough, there doesn't seem to be any correlation between states like New York and Florida and their polar opposite approaches to mandates. In the end, the data says it made no difference. Why?

I await the results, ten years int he future, where we integrate a wide range of data in less ambiguous ways to determine what the actual effects of vaccination, post-infection resistance, masking, etc were, and understand the underlying causes. I do agree that interventions (except for full shutdown like china) don't seem to have a huge variation in results.

Well we already know there has been a huge increase in the deaths of black children [1]

[1] https://www.detroitnews.com/story/news/nation/2022/01/25/chi...

I am only interested in serious results from quantitative medical biology researchers related specifically to viral infection, not secondary causes.

Also quotes from the newspaper article already point out some of the effects predate covid and thus couldn't have been caused by it.

>related specifically to viral infection, not secondary causes.

You can't separate the two. The governments response to the pandemic needs to be analyzed, and the huge increase in deaths among black children as a direct result of their policies in regards to the virus, and not due to the virus itself, means those deaths were preventable with a less authoritarian response.

Florida have had way more deaths after vaccinations were widely available. Also don’t compare to NY… New York is such a unique state due to how it was hit so hard right away.

Compare Florida and California. Florida has 50% more deaths per capita. That’s a lot!

I don't understand how you can say this in good faith. The state by state death rates were and are all over the map. Death rates seem to have far more to do with the prevalence of underlying conditions and some key decisions made regarding vulnerable sub groups early on. In light of this your comment basically boils down to "don't pick a state that has policy I like that's on the high end, pick one on the low end"

Adjust for median age and your argument is moot

No. The vaccine prevents death. More people are dying in Florida because they are unvaccinated, not because Florida trends older.

I'm not sure if you're being sarcastic, but although the vaccine does greatly reduce probability of death, it's still very clear the substantially larger elderly population of Florida has a larger effect on their death rate than the 3.7% lower vaccination rate.

> ...it's still very clear...

3-4% of the people having a risk of death would explain entirely the ~50% more per capita deaths in Florida.

Maybe if California was 93% vaccinated, not 68.5%. That's mathematically nonsense.

Risk of death from Delta was ~200x higher for the elderly. Obesity added another ~4x. It doesn't matter if vaccines lower that by ~90% because the baseline risk is still there. Florida skewing much, much older has a massive impact in absolute numbers! You can't naively compare Florida stats to CA stats just like you can't compare Utah stats (a very young red state) to CA stats. A more fair comparison is the percentage of the elderly who died in Florida vs CA - the last time I tried to do the math, Florida came out slightly ahead, but you'd probably need a few days for a semi-rigorous comparison.

In truth, I don't think you can actually just multiply all of these numbers because they are correlated (and possibly non-linear). Also, the vaccines are less effective in the elderly population.

> It doesn't matter if vaccines lower that by ~90%...

1. Vaccines reduce the risk of death by more than 90%.

2. Given how effective vaccines are at preventing death, the extreme difference in per capita deaths between Florida and California is entirely attributable to the difference in vaccination rates.

Florida is 25% old people, CA is not.

All the more reason for Floridians to get vaccinated.

The % of the population over 65 is around 50% higher in Florida too. It's complicated!

Keep in mind that NYC is a massive tourist destination -- I'm happy to keep vaccine mandates around if it keeps unvaccinated tourists from hopping in an uber, into a long airport line, eating food in a cramped indoor airport cafeteria, hopping on a plane, into another uber... and then to the table right next to me. At least get a vaccine before you do that.

Unscientific mask and vaccine mandates should be dropped regardless of the opinion of someone on Pfizer's board.

It’s notable because the board member will lose financially with this statement.

It’s in their interest to keep quiet or push more vaccine mandates; especially as they have the “best” one as of now.

I think OP is right.. since you can also make the claim the member is promoting unhealthy habits to sell a cure.

That's not true. Every treatment of Paxlovid the company will sell is going to make a lot more profit that vaccines.

You never know, maybe he invests heavily in hospitals and respirators.

Science seems to be a rather stretchable concept lately.

What about "unconstitutional"? No people want to know your medical status, that used to be protected privacy. Also how can we block people from going outside or gathering?

Maybe for 10% deaths that's a reasonable thing to ask, but for <1% this is waaaay out of proportion for my taste.

Unconstitutional seems to be a rather stretchable concept lately. Here are all the vaccine mandates in the US today: https://www.immunize.org/laws/

Those are states laws. Generally when someone says Unconstitutional without a state qualification they mean Federal Government.

That's what I meant, the basic ones like.. right to privacy, freedom of assembly, bodily autonomy.

That's a rather pointless quibble. State laws that violate the constitution are challenged as unconstitutional, and overturned on that basis. There were antivaxers when the Smallpox virus was rampant. Smallpox is gone, because of vaccine mandates. Public schools require a whole panel of vaccines, both of their employees and students. Until now, that hasn't been seen to violate the constitution. But now, there's a supermajority in the Supreme Court, so really, who knows what the constitution says?

Not quite. Often the reason that a law is unconstitutional is that the federal government lacks the authority to regulate this, but the same law would be constitutional if created by a state government.

USA states make their own laws. Sometimes those laws are challenged as "unconstitional" and then the Supreme Court evaluates and maybe tells them to stop. Most of the time not though. They prefer to "leave it up to the states". The recent OSHA ruling (attempt at broad vaccine mandates for Americans) for instance. The Supreme Court said they can't do that.

I've always found this to be much ado about nothing.

This guy said amid declining cases. What decline??

The decline seen when looking at case counts in the US. https://www.worldometers.info/coronavirus/country/us

7 day average is in decline, from a high of 800k daily cases to the current 600k cases.

Technically that is a decline, but we are still at more cases per day than at any point during the previous waves.

We need some good 'ol FOMO to encourage vaccination:

First month, it's free, second month, it costs $10, third month, it costs $100, fourth mount, $1000.

Not a single person mentioning this is sourced from The Epoch Times?

giveback

I am done. I did my part, wore masks (sometimes double masks,) three shots of vaccines and took all reasonable precautions that a sane person could do. But there are still unmasked people and unvaccinated people (sure, blame me for putting everyone in this binary category) and I am done caring about this class of people. I could not see my family for two years due to one or the other international travel restrictions. I am done being a respectful citizen who does their duty towards society. There are "experts" on all sides providing conflicting science mixed with opinions and research keeps changing every few weeks. Call it an endemic and do away with all the mandates they are yet another source for causing division by the political class.

Sorry about this fatalist and flippant tone.

What’s your perspective on small kids too young to be vaccinated?

zero risk of death from covid

Not zero, but so incredibly low as not to be matter for concern in terms of risk assessment. One of the few upsides of this pandemic is that young children are the least affected, and with vaccines available for ages 5 and up this risk is well mitigated for older children (teens in particular).

> and I am done caring about this class of people.

And their response will be "Finally! This is all we've wanted this entire time!"

I don't think most here understand just how much "this class of people" value freedom over safety.

You say that like it’s a bad thing

I don’t think they value freedom. I think it’s mostly a cult following.

People made their decision then looked for reasons to support it.

This type of thinking is the core of the problem. Both sides ascribe the worst to the other. "They're just too stupid to realize why I'm right!"

Get off your high horse.

Why do you think I’m on a high horse?

People complaining about masks taking away freedom don’t seem to be rioting about freedom of drinking and driving as an example.

I’m all for freedom. Heck I donate to EFF and ACLU annually. I’m also for personal responsibility when it affects others as we live in a society.

> I don't think most here understand just how much "this class of people" value freedom over safety.

No, the problem is that we do, and also see the selfishness of the position with regards to highly communicable diseases. "My body, my choice" is a fantastic principle when the outcome of the choice has negligible impact on people breathing the same air. Many of these same folks would raise a stir if their neighbor started throwing their trash over the fence. In my mind there is no distinction. Their choice to not be vaccinated or wear masks results in people we love dying. It's not their individual freedom that is the risk. Their choice threatens our collective freedoms to life and liberty which we individually enjoy.

> Their choice to not be vaccinated or wear masks results in people we love dying.

It's hard to see how vaccines stop the spread when places like NYC or Israel (some of the most vaccinated places in the world) had record setting numbers in the recent wave.

If vaccines work, shouldn't the "people you love" be vaccinated and thus not impacted by unvaccinated people?

I understand masks can be effective in some cases, but is it really reasonable to demand people wear surgical or N95 masks all the time to prevent "people you love" from getting an illness with a 99.99% survival rate?

> 99.99%

This is an extraordinary claim that runs counter to all available evidence and should be backed up by extraordinary evidence.

https://www.medrxiv.org/content/10.1101/2022.01.11.22269045v... indicates that death rate is less than 0.1 per 1000 for omicron. Sample size is high:

Our analyses included 52,297 cases with SGTF (Omicron) and 16,982 cases with non-SGTF (Delta [B.1.617.2]) infections, respectively

My mistake, I didn't realize you were referring to Omicron specifically (which makes sense). Even so, that is much better than I thought. Thanks for providing the link.

> Even so, that is much better than I thought

I forget the source but survey's suggest the average american thinks if they catch covid they have like a 10% chance of dying. This is in some cases 1000x wrong. People are badly, badly mis-informed on how survivable covid is.

If people knew the actual statistics around covid severity, I don't think we'd be doing any of this at all.

These numbers don't add up for the U.S. as a whole. 0.1 out of 1000 of the entire U.S. population has died of COVID just in the past 19 days.

Of Covid or with covid? With omnicron being so widespread my sense is it's almost impossible not to catch it in a hospital.

You tell me. Cite primary sources.

You’re the guy arguing with a specific scientific study by using some random general statistic. You tell us.

The statistics I'm using are the standard CDC statistics. The question of what proportion of people were dying with or from covid have not been discussed in this thread.

This is the relevant portion of your post:

0.1 out of 1000 of the entire U.S. population has died of COVID just in the past 19 days.

You are the first person to assert “of” COVID. Substantiate it. Cite primary sources.

What does it mean to you for one thing to cause another?

> Their choice to not be vaccinated or wear masks results in people we love dying.

If they are one of the 146 million Americans who recovered from Covid, they are at low risk of reinfection and thus transmission.

The same cannot be said for Covid-naive, vaccinated people who can be infected and silently infect others due to symptoms being suppressed by the vaccine.

That's not at all how immunity or the vaccines work.

UK data showed a ~1% chance of reinfection with Delta. Omicron is higher, https://assets.publishing.service.gov.uk/government/uploads/...

> To the end of week 43 in 2021 (to 31 October 2021) 72,264 possible reinfections have been identified ... 7.9 million first positives

For Delta transmission from vaccinated individuals, a study of Vietnamese healthcare workers found that 70% of infections were pre-symptomatic, https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3897733

> 69 healthcare workers were tested positive for SARS-CoV-2. 62 participated in the clinical study. 49 were (pre)symptomatic ... Breakthrough Delta variant infections are associated with high viral loads, prolonged PCR positivity, and low levels of vaccine-induced neutralizing antibodies, explaining the transmission between the vaccinated people. Physical distancing measures remain critical to reduce SARS-CoV-2 Delta variant transmission.

This isn't a classification problem of COVID-naive+vaxxed versus COVID-exposed versus COVID-naive+unvaxxed, and hasn't been since Delta.

The issue is not vaccine denial by itself, its resistance to any public health measures, including vaccines, masking and other non-pharmaceutical interventions, and so forth. In short, these folks actively pursue a course of not behaving rationally because (usually) of misguided politics.

It's ill-informed. If you have a prior COVID infection, you should still maintain active vaccination status, including boosters. If you get COVID, you should get tested and try to not get others sicks.

Instead, the pantheon of behaviors we observe from anti-vaxxers is spiteful and irrational. Which supports my initial point that this is a self behavior.

Is early treatment considered a public health intervention, https://c19early.com/?

Rejoinder:

Effective treatment is considered a public health intervention if it prevents the spread. Otherwise its medical treatment. This is why vaccination is far superior to post-infection treatment.

Assessment:

I'm deeply suspicious of this website. It uses pooled effects across several studies, which is an improper approach for this type of meta-analysis. For example, it lists hydroxychloroquine as effective. Some initial underpowered studies showed potential, but further research showed it was not effective.[0]

Items:

[1] By forcing a random effects design, you may give inappropriate weighting to under-powered studies showing an effect (low power results in higher effect sizes). 10 studies of 10 people each, with effect averaged via pooled regression, may well show a pooled effect significantly larger than one study with 100 people.

[2] People not deeply familiar with the treatment literature (such as you, me) cannot confirm that the meta-analysis is appropriately comprehensive (they claim to scrape paper sources, but not the inclusion criteria). Since this is a random website presented without context, without bonafides, and so forth, even if the information presented is real it may be cherry picked. Here is the documentation of some of their exclusion protocol -- note if they were intending to be persuasive instead of objective, exclusion of negative meta-analyses would be intentionally phrased objectively: https://hcqmeta.com/#exc

[3] Differing definitions can impact results. "Early treatment" is prophylaxis typically, but why the individual ends ups in a treatment or control group (and what the term means) may be systemically biased depending on the treatment standard of care adopted locally. The differences may not be random, resulting in selection bias (and other forms of bias, but simply put not an apples-to-apples comparison). And because we're dealing with people with will, the uncertainty compounds. By way of example, prophylaxis "treatment" group might be fully self-selected people who are just scared they may have been exposed, and a "control" group (from a matched pair example selected on few if any demographics) that was known to have the disease -- causing immediate positive bias. RCT designs can help with this approach, but again showing solely the pooled effects instead of reporting fixed effects assessments and other regression output is in err.

Conclusion:

So, for these reasons and because the source actually matters in an era of mis-/dis-information, I remain highly suspicious.

Notes [0] Economics is facing its own replication issues, and the paper is an important read for why statistical power matters: https://onlinelibrary.wiley.com/doi/full/10.1111/ecoj.12461

Until they get seriously ill and then they start crying.

My dad's physician, of all people, was anti vax until he ended up in the ER. Then he started telling all of his patients to get vaxxed.

The best part is though that whenever an anti-vax person gets sick, survives and tells people to get the vax, they're treated like they are spreading a disease lol

If you want safety, go to prison

Considering the number of videos I've seen with people yelling at masked people, I'd say that they don't care about freedom at all (since apparently people shouldn't be free to wear masks whenever they want).

You don't think that happens the other way around as well? There's obnoxious morons on both sides of this debate.

I don't think the other side is masquerading their point as some sort of exercise in freedom.

> But there are still unmasked people and unvaccinated people

I'm not sure how you're convinced it's only the unmasked or unvaccinated people that are responsible for the spread of the virus at this point. In many countries they are not allowed to go anywhere.

How is the virus crossing oceans so quickly if the unvaccinated are unable to cross borders?

> if the unvaccinated are unable to cross borders?

Unless regulations across the world have changed drastically in the last couple of weeks, this is just false.

If you're Canadian, you're not allowed to leave the country if you're not vaccinated.

https://travel.gc.ca/travel-covid/travel-restrictions/domest... - the part specifically about "You need to be vaccinated to travel in and out of Canada"

They've made it a requirement to be vaccinated to use any form of federally regulated transportation - plane, train, boat - personal vehicles are the last option, but good luck trying to drive on the pacific ocean since you're not allowed to enter the US unvaccinated either AFAIK.

Thanks for the info, but nothing in the thread I was responding to gave me the impression the GP was referring exclusively to Canada when they said:

“How is the virus crossing oceans so quickly if the unvaccinated are unable to cross borders?”

> but good luck trying to drive on the pacific ocean since you're not allowed to enter the US unvaccinated either AFAIK

Until 5 days ago you could: https://www.forbes.com/sites/sandramacgregor/2022/01/24/cana...

Does "in many countries" not include the country of Canada?

How do you feel about people who are vaccinated but will still likely have permanent serious consequences or shortened life span due to a "mild" infection?

I'm in this category and it doesn't seem particularly rare. Rarely accounted for in these "I am done" type posts though.

Ok but what do you propose though? The vaccinated still spread COVID granted at a lesser rate. A permanent mask mandate? COVID is not going away.

The idea of cooking food stayed. Sanitation stayed. The practice of washing hands stayed. Refrigeration of food stayed. Why the heck shouldn't the use masks stay?

Last I checked, people generally enjoy cooked food more, there isn't a washing hands mandate (outside of certain workplace), no fridge mandate (and it comes with strict benefits of longer lasting food).

I don't understand this position. Are you honestly proposing that we permanently require masks in all public, indoor environments? For the rest of our lives?

I don't see how you can flippantly propose this as an option. How can you be ok with wearing masks for the rest of your life—if it can at all be avoided?

Then we should adapt to it in ways that preserve life? Cholera didn't go away either we just have sewers and wash our hands a lot now.

I'm not a medical or public health expert, it's not up to me to figure it out.

But to start with, the idea that you can be "done" because you've already done "enough" and experienced inconvenience and made sacrifices needs to go. People need more from each other still, sorry!

> I'm not a medical or public health expert, it's not up to me to figure it out.

Those people don't have the right to tell you what to do. They are not politicians and they aren't elected. They can tell me to wear a mask for the rest of my life, but it is my right to say "nope".

If we're doing masks permanently I am going to invest in some bespoke Darth Vader style of head dress or a space suit, because I am completely done with masks.

I've made and used home sewn masks using one of the recommended sewing patterns for the past two years, and I've managed to get a good fit that only fogged up my glasses partly, but since last week these masks have been banned here in the Netherlands. Not because they are proven to be worse than the type II surgical masks that are recommended now, but because the government wants to standardize. So now I wear disposable masks that mean my glasses fog up every damn time I enter a building. Great.

Then there is that constant feeling of not getting enough oxygen, all while being confronted with the 5% who simply refuse to wear a mask in the shops, and shop staff refusing to remark on it for fear of getting into an altercation. I'm thoroughly through with masks. I'll wear them where and when mandatory, but certainly not indefinitely.

Motorcyclists have a great trick to eliminate fogging- after cleaning, rub a little shaving cream onto the lens. It's simple, cheap, and effective. Add a proper-fitting KN95 mask and the difference will be like night and day. There's no need to dress up like Darth Vader (though that might be fun, regardless).

Masks can be uncomfortable. My biggest gripe is actually the awkwardness that sometimes accompanies taking them off and putting them on again. Especially when also wearing glasses, a hat, and/or a helmet. But given my girlfriend wears full PPE for her 12-hour shifts treating COVID patients without ever complaining about getting enough oxygen, I hope the rest of us will bear masking up while we're in the AH or on public transport. Compared to the shit she deals with, it's a minor inconvenience, at best.

Also, maybe I'm wrong but my feeling is the fear of altercation over mask wearing is overblown. I live in a semi-rural part of the United States where masks are a very political and contentious issue (probably more so than in NL). I regularly interact with people strongly opposed to them, and am often in crowds where few if any other people are wearing one, but in the past two years have never experienced any kind of confrontation. Perhaps I'm lucky and my size and physical appearance is intimidating to those who would otherwise pick a fight.

Trust me; I've tried all of the remedies and solutions. Only a really good fit seems to help a little bit, but not completely. Better fitting N95 or FFP2 masks may bring some relieve, but they're relatively expensive and barely available in supermarkets as it is. There is also the feeling that it seems statistically pointless to wear these as long as the majority of people use surgical masks; many not even bothering to cover their noses.

I don't know why, but while I can wear a mask for up to half an hour, anything beyond that becomes torture (doubly so when you are travelling with a toddler who needs you as a parent, which means talking through a mask increasing the out-of-breath feeling). This has made travelling longer distances fairly impossible for me, which again adds to the 'so fucking done' feeling that is gaining the upper hand.

I'd appreciate if you point me to a study showing that vaccinated spread COVID at a lesser rate. As far as i know, currently the findings are inconclusive at best. Lower risk of serious infection and death is more or less established though.

Well hope you don't need to be hospitalized for any other reason then because the beds might be full, there probably won't be enough providers because of burn out, and costs will be going up. We are nearing a collapse of our medical system in a way that people don't seem to be recognizing or doing anything about.

Nearing collapse, are we?

Predict the time of collapse and define “collapse”. I will take a 1:1 $10k bet for the other side if it’s soon enough and reasonable enough. Soon enough and reasonable enough and I’ll raise it to $100k.

$10k is enough for you to medical tourism to the third world. $100k is enough for you to medical tourism to many parts of the first world. So I think this is fair.

> But there are still unmasked people and unvaccinated people and I am done caring about this class of people.

Humm, I wish it was that clear. I'm from Portugal, one of the countries with higher vax rate (anti-vax movement here is negligible) and a few days ago we were on world top 5 for new infections.

Disclaimer: I'm fully vaccinated. However I respect who isn't.

New infections is not a very relevant metric at this point.

Agreed, and we just lost my wife's grandma to Covid. She could have been fine but that part of the family swallowed the anti-vax lie. My wife's aunt almost died from Covid. They should have known better too, having lost a brother in Vietnam to Covid, but the Trumpian lies had a stronger hold on them.

We do still need to think about the people who can't get vaxxed for medical reasons. My sister has MS and has been on immunosuppressants which prevented her from getting it. Thankfully she took a break and got vaxxed because now she has covid.

If we get to, say, April without a serious spike in the death rate, I think the protocols will be rolled back. That assumes we don't see a new variant but it looks like the variants are getting less serious, not more.

"Trumpian lies"?

Trump is actively promoting vaccination.

> Trumpian lies

Trump supports the vaccines that he helped fund and create.

https://www.cnn.com/2021/12/24/politics/trump-covid-vaccine-...

Why is the opinion of a Pfizer board member relevant to legal policy? In other news, McDonald's board members are quite fond of wafer-thin beef patties.

He's a former FDA commissioner, so his opinion is arguably relevant. I'm not sure why they called him "Pfizer board member."

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

"One hand washes the other"

Is it because he's a board member?

I remember a time when people thought it worrying when regulators moved to highly paid positions of the companies they were in charge of regulating.

I mean the description is correct, just not the most relevant identifier. If Ronald Blaylock (investment banker and another board member) made a statement like this, I doubt anyone would care.

But yeah, having our required health treatments controlled by a group of Goldman Sachs et al executives and former regulators collecting large payouts from a company they previously regulated isn't ideal.

I didn't realize there were so many eccentrics on HN, or is there a campaign?

I wonder the people who are questioning vaccine mandates (which evidently brings down the hospital admission rates, thereby saving the health system) also question no public nudity mandates?

They probably scream at everyone around them when they need to get a driver's license or can't smoke in a restaurant. They shriek, "My body, my choice", when they get behind the wheel drunk. And so on and so forth. :D

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