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Comment by lr1970 | Hacker News Reader

lr1970

> They'd also know that pretty much the only condition we're treating nowadays is Covid.

This statement might be true for your location but is not true in general. Here in New York City hospitalizations due to covid are not very high and going down quickly. Elective surgeries and procedures go on as scheduled. ICUs are not overrun with covid specific cases. Majority of the patients with positive PCR test are hospitalized for medical reasons other than covid. Recorded deaths do not differentiate between "died from covid" and "died while covid positive" making death statistics hard to interpret. In general, compared to the situation on the ground in March-April 2020 this time the covid load on NYC hospital system is lighter.

The biggest challenge is staffing shortages in the hospitals due to general burn-out, people being on sick leave due to spreading omicron. Noticeable percentage of nurses were laid off because of the vaccine mandate (i am not judging the mandate, just stating the consequence).

SOURCE: several physician relatives and friends working in NYC hospitals (Manhattan, Bronx, Brooklyn).

View on HN

NYTimes has a pretty good source on this.

https://www.nytimes.com/interactive/2020/us/covid-hospitals-...

I'll tell you that here in Chicago, based off data, and anecdotes: really depends on the neighborhood. Vaccinated areas? Doing fine. Undervaccinated areas? Not doing so well.

Gosh, it's like vaccines work and that's the way out of this.

> Gosh, it's like vaccines work and that's the way out of this.

You know, I see snarky little comments like this becoming more and more common on this site, and I'd just like to point out that they are not helpful in any way. Who is it directed towards? Do you think you are convincing anyone, or encouraging a productive discussion? I'd be willing to bet that the overwhelming majority of people on this website are vaccinated. I know I am.

In my opinion, that line is the equivalent of saying "gosh, maybe black people should just stop committing crimes if they don't want to go to jail" or "gosh, maybe gay people should just stop having unprotected sex if they don't want HIV."

I am begging you, and everyone else, PLEASE, if you want to make a point, please do it in a respectful way that doesn't assume anyone who disagrees is stupid. If you need to be snarky, go do it on the-site-that-must-not-be-named.

I actually want to hear good reasons for avoiding vaccinations, because many people care a lot about that.

I can understand immuno-compromised people, an underlying medical condition, for whom a vaccine may not work or may be dangerous. Undergoing chemotherapy treatment for cancer? Got it: vaccines won't help you (or anyone else) until you can get past the cancer.

I don't agree with an argument from stand-my-ground, my-body-my-choice principles. I could agree with such a line of reasoning, if a personal choice did not present an immediate danger to anyone else.

This is a very infectious disease with severe health consequences. No one has control over the outcome, if they choose to infect another person. Maybe it's no big deal for them. Or maybe it wrecks their life, long after the vaccine objector has left the scene.

What are some other reasons for avoiding vaccination?

Just today Sweden's health agency advised against the vaccine for kids

> STOCKHOLM, Jan 27 (Reuters) - Sweden has decided against recommending COVID vaccines for kids aged 5-11, the Health Agency said on Thursday, arguing that the benefits did not outweigh the risks.

https://www.reuters.com/world/europe/sweden-decides-against-...

I'm not super well versed in the science but it seems like reasonable parties advise against vaccination in certain scenarios. Also knowing that government bodies are more likely to prioritize group outcomes over individual outcomes it seems reasonable for individuals to be skeptical.

Having already had an infection before you were able to get vaccinated.

A recent CDC study [0] joins plenty of others from last year in showing that these people were at least as protected from infections and severe outcomes during delta as those who were vaccinated without a prior infection.

Avoiding getting something that offers little benefit and offers even small risks makes sense to me.

You've probably spent the last year being told these people are trying to murder your family though, so it also makes sense to me if you don't agree with this.

[0]: https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e1.htm?s_cid=mm...

> Avoiding getting something that offers little benefit and offers even small risks makes sense to me.

It's not that simple: vaccination is more consistent at producing an immune response and it's stronger. The confound in both cases is that it wanes over time, so comparing someone who was vaccinated a year ago to someone who had COVID last month — or vice versa! — is telling you more about the elapsed time than anything else.

Getting boosted, even after having been infected, is a cheap and easy way to reliably keep your immune response high without unpredictable timing. It's much less risky than getting COVID even if you could organize the equivalent of a “pox party”.

> It's not that simple: vaccination is more consistent at producing an immune response and it's stronger. The confound in both cases is that it wanes over time, so comparing someone who was vaccinated a year ago to someone who had COVID last month — or vice versa! — is telling you more about the elapsed time than anything else.

I encourage you to read the linked study, particularly the parts about the included cohorts. The recovered cohort didn't have any kind of stipulation that their infection was recent. The text does call out waning efficacy in the vaccines, but it does not mention the same for infection.

> It's much less risky than getting COVID even if you could organize the equivalent of a “pox party”.

Does this have something do with what I said?

I did read, when it came out. I’m quoting Dr. Benjamin Silk, one of the authors:

"The evidence in this report does not change our vaccination recommendations. We know that vaccination is still the safest way to protect yourself against COVID-19.”

The reasoning is easy: many more people do not develop as strong a response from infection as they do from vaccination, and vaccination happens on a known schedule. This is especially of interest since the relationship here was reversed with Alpha, and is still unclear with Omicron - the figures I’ve seen have relatively recent infection somewhere between 2 doses and 3 in terms of efficacy, and infected plus vaccinated being the strongest.

Now, if you think from a public health perspective that makes the call very easy: vaccines are cheap and effective, and more reliably produce an immune response. Waiting for people to get infected means that the schedule is unpredictable (overloads happen), and the timing being variable means that you might have people thinking they’re protected but they were part of the group who never mounted a strong response, or who have waned over time. Rather than having people get infected randomly or hoping that they had a strong response, it’s much easier to spend a few seconds vaccinating them so you have a higher confidence that they’re protected.

Maybe you can help me understand this: if what you keep saying about reliability and timing are a thing, why doesn't this data support that?

The study shows a cohort of people who had infections sometime between the advent of testing and march of 2021, and that cohort had better outcomes than the vaccinated but uninfected cohort. How can that be? What does it mean for immunity solely from vaccination to be "stronger" and "more reliable" if the outcomes are worse? What am I missing here?

For the alpha vs delta point, what does it matter if the relationship flipped? They're basically equivalent either way. The important part is that they're both much better than seronaive.

I think you might have lost track of my original response to the question that started this thread (what is a reason to not get vaccinated) where I said:

> Having already had an infection before you were able to get vaccinated.

How are pox parties and "waiting for people to get infected" and "having people get infected randomly" relevant to the scenario that I mentioned, where people don't have the choice of getting vaccinated before they get infected, since its already happened? There's no waiting, there's no parties, there is just dealing with the cards you've been dealt. By now there should be far more of these people than straight up seronaive folks.

Similarly, "We know that vaccination is still the safest way to protect yourself against COVID-19", sounds like the same thing: if you need to gain protection from covid, we recommend getting it via vaccine rather than illness. That doesn't apply in this scenario, since protection has (as it seems to me we see empirically here) already been attained.

> [current medical consensus says] "If you need to gain protection from covid, we recommend getting it via vaccine rather than illness." That doesn't apply in this scenario, since protection has (as it seems to me we see empirically here) already been attained.

Apologies if my edit in quotating you is misrepresenting what you're saying, but it's how I read it.

Okay.

If people have already been infected with COVID, is vaccination going to do them any good?

I think so. I'm not a doctor, nurse, anything. But I expect anyone who hasn't seen COVID for a year, it would help. Probably the same benefit as a booster that follows vaccination for people who [think they] have never been infected.

Vaccination has its own risks. I believe there is very slight risk from the injection itself.

But -- I just got booster dose, my third shot, this week. I had to go to a pharmacy a couple of blocks from my house. I walked. I had to cross a street, with the traffic signal, but there were a couple of cars. They didn't hit me. This time. Then I had to go inside the pharmacy talk to some people, wait about ten minutes. Everyone was wearing masks, but honestly it was the most contact I've had with a random mix of people all week...

If I'd needed to drive miles out of my way to get the vaccination, that's also nonzero risk.

And then... well, it seemed to hit me pretty hard, the vaccine, this time. I felt awful for two days. Then I was fine. But it seemed like a bigger reaction than previous doses. I think that's supposed to happen, actually.

Anyhow, I thought about it, and made my choice. I think it was the right way to go for me.

It's given me some things to think about, thanks.

> Apologies if my edit in quotating you is misrepresenting what you're saying, but it's how I read it.

I think thats a reasonable interpretation of what the original quote (which wasn't mine) was saying.

> If people have already been infected with COVID, is vaccination going to do them any good?

The linked data shows that it did seem to lead to a small improvement for folks during delta. Whether or not that small improvement is worth it is a judgment call.

> Anyhow, I thought about it, and made my choice. I think it was the right way to go for me.

Not that anybody needs this affirmation, but I'm 1000% in support of you making that call.

A lot of people caught the virus and recovered from it. Those people have immunity that is actually stronger than that offered by the vaccines. In those cases getting the vaccine is some (albeit small) risk and almost no reward.

Nobody here is advocating for avoiding vaccinations so your entire point is moot.

I think if we're supposed to treat the position against vaccination being effective as "not stupid", we ought to hear reasons why that is.

My point is that if you insinuate that anyone who holds that position is stupid through sarcasm and snarky comments, you are never going to hear those reasons, because no one will want to engage with you.

I've heard tons of reasons why people aren't getting vaccinated. At least every one I've heard is based on false or poor quality information. I wouldn't go so far as to call those people stupid. But I would say most of their reasons for not getting vaccinated are stupid.

And if your response is to compare it to presumably racist/homophobic statements, I'd say the same of your approach.

Even if it’s stupid, what exactly is saying that going to accomplish other than feigning some superiority over the unvaccinated?

> Nobody here is advocating for avoiding vaccinations so your entire point is moot.

I consistently see anti-vaccination rhetoric on HN.

I'm talking about in this specific comment thread.

> I can understand immuno-compromised people, an underlying medical condition, for whom a vaccine may not work or may be dangerous. Undergoing chemotherapy treatment for cancer? Got it: vaccines won't help you (or anyone else) until you can get past the cancer.

This is exactly backwards from reality. The groups you mentioned are at much higher risk from covid and ergo it is much more important to vaccinate. The risk in absolute terms will remain much higher even with vaccination but this is a poor reason not to vaccinate. The reason you vaccinate is the degree of risk mitigated not the expectation of reducing that risk to zero.

I suggested immune-compromised people as a group who might need to avoid a vaccination because their immune response isn't working.

They won't exhibit an immune response to COVID spike proteins. From the virus, from a conventional vaccine, or from their own cells' production following an mRNA vaccine.

There are certainly degrees of immune system pathology. If you are receiving medical care for such a situation, by all means please follow your doctors instructions and not mine!

I don't wish to be disrespectful but its undesirable to give life alteringly bad medical advice on a public forum. Saying hey don't listen to me listen to your doc after you gave advice that would literally lead to a portion of readers to actually die is in a word insufficient.

>They won't exhibit an immune response to COVID spike proteins. From the virus, from a conventional vaccine, or from their own cells' production following an mRNA vaccine.

This is absolutely untrue. Most people who are immunocompromised have an immune system that works poorly not none. They are worse off than others as far as mortality and morbidity with the vaccine and without it compared to healthier individuals but they are absolutely able to develop antibodies and benefit from vaccination.

The CDC says they are 65-80% less likely to end up in the ER presenting with covid if vaccinated and boosted.

https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e3.htm?s_cid=mm...

Immunocompromised people that took your advice would be 3-5x more likely to die if infected with covid and given prevalence will very likely to be infected in the year ahead of us. Please refrain from giving medical advise without first taking the time to understand the topic you are speaking on. It's more important not to spread health misinformation than chat on business and tech.

How Does an individual choice to get vaccinated or not impact others?

Vaccines do not stop transmission of Covid nor do they stop you from getting Covid.

They merely decrease your chances of getting severe Covid or dying from Covid.

Thus the decision to vax or not is clearly a personal choice.

> Vaccines do not stop transmission of Covid nor do they stop you from getting Covid.

They don't stop it, but they do decrease your chances of acquiring it and they do reduce the viral load you shed.

> They merely decrease your chances of getting severe Covid or dying from Covid.

So they prevent you from taking up a hospital bed, exposing the people who have to care for you to COVID and preventing other non-COVID emergencies from being tended to. That seems to impact others to me.

Should we apply the same standards to the obese? Arguably a greater strain on our health care system.

If avoiding obesity was as easy as a $20 needle prick with minimal side effects... absolutely. Without question, I would require that vaccine for everyone that didn't have a valid medical reason not to.

It is even easier, just dont eat too much. Also free.

If you think that is easier than a needle prick, then you have zero understanding of obesity.

Again, Is it more complicated than: maintain caloric equilibrium?

Or are you about to make a bunch of Socio-economic and cultural justifications for obesity that you will not extend to the unvaccinated?

Yes it is more complicated. Here's two reasons. Glucose only gets converted to fat and harmful proteins at about 1:4 rate, whereas ethanol, fructose, and sucrose get converted to fat and harmful proteins at double or more that rate. So mere "counting calories" is meaningless.

Secondly, and this is the one that people find weird, once you've weighed X pounds, and lost some significant mass, you must eat less calories than simple "calories in is calories out" would suggest, because our physiology reacts as if food is scarce, and will store fat to the detriment of all other functions.

Not sure why I cant reply to the below comment but:

1. Sugar and its substitutes are bad for you, yes thats true (Thank you FDA for recommending 10 servings of grains, and backing the lipid hypothesis which caused low fat (aka High Sugar) products to appear everywhere.

2. Unless the obese somehow violate the law of thermodynamics if you reduce energy in while maintaining energy out mass will decrease.

There's also a difference between difficulty and complexity.

edit : Also, what's the protocol/norm about posting the same reply in multiple threads? I can see some pros and cons to it being within standard behavior, and don't see a clear answer as to which is larger

Just because something is simple, it doesn't make it easy. Dunking a basketball is simple. But it's not easy for most people.

I promise you, if losing weight were "easy" then most people would look like Hollywood action heroes.

I don't know, is there a free two-shot regimen to help deal with obesity? Also, last time I checked, hospitals weren't running out of ICU beds thanks to obesity.

I encourage everyone eligible to protect themselves by getting vaccinated, but hospitals literally are running out of beds thanks to obesity.

https://www.wfae.org/health/2021-09-30/novant-says-9-of-10-c...

> hospitals literally are running out of beds thanks to obesity.

... as a co-morbidity of COVID. Clearly the most effective option for people who are obese (and other people at elevated risk) is to get vaccinated.

Its even easier. Just dont eat too much.

You clearly don't know much about obesity or simply don't care. Either way, if you're truly invested in the public health implications/strategies for obesity, you're welcome to look into it. :)

So its more complicated than: maintain caloric equilibrium?

Or are you about to make a bunch of Socio-economic and cultural justifications for obesity that you will not extend to the unvaccinated?

All these things will just select for more virulent, more severe, more contagious forms of the virus. And extend the lifetime of the pandemic.

You might as well be telling people to take antibiotics 'just in case' because a partially resistant strain of something is going around.

That partially resistant strain won't be "partially" resistant for long.

Because if you're unvaccinated you're much more likely to require hospitalization should you get Covid. The impact to others is the unvaccinated are consuming medical resources and causing burn-out amongst medical practitioners.

We dont make this distinction with the vast majority of personal choices. Obesity causes a ton of strain on our health system. Should we start a class system based on BMI?

I’ve never caught obesity by sitting next to someone. Have you?

Again, vaccines do not stop transmission or contagion

Where are you getting the information for this claim? The vaccines certainly reduce your chance of catching it, and though vaccinated individuals may have similar viral loads to unvaccinated people at peak, the period of time that they're infectious is shorter. [0] One study even suggests less infectiousness. [1]

Where have you seen otherwise?

[0] https://www.thelancet.com/journals/laninf/article/PIIS1473-3...

[1] https://www.jwatch.org/na54386/2021/12/15/transmission-risk-...

Both of those studies predate the omnicron wave. The rate of transmission in fully vaccinated regions is still very high.

This one [0] references omicron specifically, noting that though omicron is better at evading immunity, vaccines still helped.

[0] https://jamanetwork.com/journals/jama/fullarticle/2788485

So you’re in favor of mandates along the lines of “Get the vaccine or you are fired” for marginal benefits? Would you be ok if this precedent was extended to other prevention areas? Eg. Maintain social distancing or you are fired (protests of any kind are typically not socially distanced)

Wasn't this subthread was about your claim that getting vaccinated doesn't influence one's chance of infecting others?

If you want to retreat to "ok, they probably do actually help a little bit with that, but I think the amount to which they help with that is small enough that [thing] isn't worth it.", then ok, but, like, I think you should probably make it explicit.

(earlier, the topic was about like, health insurance, not employment, and so I'm using [thing] to cover both of those things.)

Seatbelts. Helmets. Cigarette taxes. Drinking ages.

Sure but there is a big difference between finding somebody for not wearing a seatbelt in denying them medical care.

If nurses and doctors were quitting and students dropping out of medical school for fear of dealing with the fallout surrounding people not wearing seatbelts... yeah, we'd probably be considering it.

And, of course, the numerous other routine vaccines.

> You know, I see snarky little comments like this becoming more and more common on this site, and I'd just like to point out that they are not helpful in any way.

It just represents a general fatigue that a lot of people have with the anti vaxxers. That we have hard numbers that vaccines actually work seems to be irrelevant to them, so maybe they would be convinced by snark and sarcasm instead?

> In my opinion, that line is the equivalent of saying "gosh, maybe black people should just stop committing crimes if they don't want to go to jail" or "gosh, maybe gay people should just stop having unprotected sex if they don't want HIV."

You are comparing getting a couple of free shots at the pharmacy to much more complicated lifestyle circumstances.

> It just represents a general fatigue that a lot of people have with the anti vaxxers. That we have hard numbers that vaccines actually work seems to be irrelevant to them, so why maybe they would be convinced by snark and sarcasm instead?

and you think this is an experience unique to your viewpoint? do you think the people reading your words who have vaguely opposing views might not also be fatigued when your group flatly denies their concerns as irrelevant?

if you find yourself in an us-vs-them mindset and decide to ditch empathy, all you do is widen the divide.

> do you think the people reading your words who have vaguely opposing views might not also be fatigued when your group flatly denies their concerns as irrelevant?

In the sense that a conspiracy theorist or a crank gets tired of people not believing them, yes, I guess they are annoyed. I just little empathy for them: I want this pandemic to be over, and they are getting in the way of that. Barring that, I hope that they can take responsibility for their choices without forcing the consequences on everyone else.

> I have little empathy for them, however: I want this pandemic to be over, and they are getting in the way of that.

funny, because most everyone i know wants this too, and it’s always “the other side” which prevents the pandemic from “being over”. from a person standing in the middle, it appears that it’s the divide which blocks this, whereas from deep behind lines i guess it looks like everyone past that divide is blocking things.

well good luck winning a battle in the modern world through force of will. there’s a reason the world powers generally don’t conduct large wars openly these days, and that many conflicts are instead resolved via international agreements (especially of trade). if you do discover a way to resolve the social woes in life without leveraging pro-social behaviors (like cooperation/empathy), write me and share your findings so that i in turn can better the state of our society. and if you spot the inherent contradiction of the previous sentence, i’ll buy you a beer.

> funny, because most everyone i know wants this too, and it’s always “the other side” which prevents the pandemic from “being over”.

Yes, that's true. The anti-vaxxers think the vaccines will kill them or make them sterile, or something...it is really hard to keep track of what their current theory is. Again, it's a free shot you can get at the pharmacy, the only rational reason for avoiding it is if you thought it could do harm rather than just being thought ineffective.

But given that unvaccinated are dying 10X more in hospitals due to COVID than unvaccinated cases that come in, maybe this problem will just solve itself the good ole fashioned Darwin way. Mind you, as long as they don't increase unvaccinated deaths, aren't clogging the hospitals or causing my health care costs/premiums to rise (faster than they would otherwise), I believe they should have the liberty to make that decision.

> The anti-vaxxers think the vaccines will kill them or make them sterile, or something...it is really hard to keep track of what their current theory is. Again, it's a free shot you can get at the pharmacy, the only rational reason for avoiding it is [..]

in one sentence, you admit that you don't understand what knowledge some person is operating with. in the next sentence, you claim to know what is rational for that person to do. if you're using "rational" in the literal sense, then you've leapt to premature conclusions.

and i get it. it's exasperating. there's a bunch of people who don't want to take a vaccine. and from the outside it seems that as more information becomes available to this group, their vocalized reason for avoiding the vaccine changes. they're being dishonest, and that's infuriating!

if this is what you're seeing, it doesn't necessarily mean every individual within that group is shifting their story. some certainly are, but many aren't and the group behavior can be explained by things similar to "evaporative cooling": some people leave the group as a result of new information (new people are still getting vaccinated, every day), and the people left behind are the ones for which the previously dominant argument wasn't their primary reason for not getting the vaccine -- and so the dominant argument of the group then changes.

group dynamics encapsulate way more complexity than just that one effect. and i think it's worth considering. you see that your own individual behavior is way more consistent than the other side's behavior -- and it is. but that's comparing an individual (yourself) to a group (anti-vaxxers). it's apples to oranges. the other individuals aren't seeing your individual behavior. they're seeing your group's behavior. they're seeing the exact same type of inconsistent and contradictory behavior that you're so fed up with.

what's the way out? well, we haven't found it, so it's hard to say for sure. but i think it has to involve empathy: seeing beyond the group, and relating to each other as individuals.

> in one sentence, you admit that you don't understand what knowledge some person is operating with. in the next sentence, you claim to know what is rational for that person to do. if you're using "rational" in the literal sense, then you've leapt to premature conclusions.

You are right. I am just assuming that there is a rational explanation in their head for why they don't want to vax, and as you point out, it might not be. Nor are the explanations for vaccine hesitancy consistent.

> but i think it has to involve empathy: seeing beyond the group, and relating to each other as individuals.

I'm not really compassionate enough to see this as an empathy issue: if their choices didn't affect me I wouldn't care one bit what they decided to do. Right now we have a huge society-wide problem that requires some sort of societal cohesion and consensus to defeat, but we lack that, and I don't think any of us have the energy to fight this battle at the individual level.

> Right now we have a huge society-wide problem that requires some sort of societal cohesion and consensus to defeat, but we lack that, and I don't think any of us have the energy to fight this battle at the individual level.

walk me through it: how do we achieve societal cohesion if not by empathy? a society is a network of individuals and entities, and cohesion implies that the individuals want to "stick together". why would i want to be cohesive with the parts of that network that don't acknowledge me? individuals are drawn together by common interests, shared feelings, mutual understanding, ... empathy. it's the basis of every relationship i've ever held onto. how do you build a cohesive society without that? i really don't mean to be obtuse... this is all that i know.

There are limits to empathy. I empathize with those who have been misled by a bunch of loony, grifting parasites who would have been laughed out of polite society 30 years ago. I empathize with those who suffer from mental illness exacerbated by political forces that seek to benefit from the confusion they foment. I empathize with those who are afraid of needles (I am one), and who are overwhelmed with too much information and misinformation.

But at the end of the day, after two years of watching this insanity in our society, where wearing a mask is considered "weak", where taking a vaccine, a vaccine that we're incredibly lucky to have, is considered a sign of Satan, or micro tracking chips, or sterilization or whatever is the latest loony thought of the day, I'm done.

>and you think this is an experience unique to your viewpoint?

Can attest to that. As a flat earther, I am just so sick of the snarkiness of everyone who believes what mainstream science preaches.

We should all equally appreciate ALL differing views because no idea is more or less valid than any other idea. Evolution, creationism, alien seed planted by Xenu, they all deserve our time and attention.

You don't have to give them time nor attention. Being snarky is giving them both, and is done precisely to increase animosity between groups.

> It just represents a general fatigue that a lot of people have with the anti vaxxers. That we have hard numbers that vaccines actually work seems to be irrelevant to them, so maybe they would be convinced by snark and sarcasm instead?

It's far more nuanced than that. I have now had three doses of the vaccine, and I had Covid subsequent to the third dose. Israel is now moving on a fourth dose, and the vaccine manufacturers are making an Omicron-specific variant. If my city continues with prior behavior, and mandates a booster for a virus I've now had, am I an "anti-vaxxer" for not wanting the unnecessary dose?

That you're characterizing the situation in this binary way says a lot to how the entire issue has been treated as a cartoon political issue. But many millions of people are in exactly this situation, today (i.e. those who already had Covid, and are now being required to get a vaccine).

I don't understand why you would be against getting a free booster, or even a shot every 6 months. Is it more harmful in Israel?

Plenty of people said they already had COVID, and they are still in the 10X more likely to die statistics. Either they are had something else (like a flu or a cold, you wouldn't know without a test), or something about natural immunity isn't working. I won't speculate, I believe its the former (easier to confirm that you got the vaccine then if you really got COVID).

> Plenty of people said they already had COVID, and they are still in the 10X more likely to die statistics.

People who have had Covid are at least as well-protected against serious illness as anyone who is vaccinated, and probably more so given the latest variants:

> During October 3–16, compared with hospitalization rates among unvaccinated persons without a previous COVID-19 diagnosis, hospitalization rates were 19.8-fold lower (95% CI = 18.2–21.4) among vaccinated persons without a previous COVID-19 diagnosis, 55.3-fold lower (95% CI = 27.3–83.3) among unvaccinated persons with a previous COVID-19 diagnosis, and 57.5-fold lower (95% CI = 29.2–85.8) among vaccinated persons with a previous COVID-19 diagnosis.

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

Do you have a citation on previously infected unvaccinated people having 10x the mortality rate of vaccinated people?

Or are you saying a lot of people think they've gotten covid but actually got something else?

If it's the latter case, how do you feel about encouraging that the people who don't want to be vaccinated because they've had a prior infection get an antibody test, and get vaccinated if it comes back negative, and if they do indeed have antibodies we treat them the same way we'd treat someone vaccinated?

If you think that natural immunity is comparable to vaccine-generated immunity, but that proposal still sounds unappealing to you, I'd be curious why.

> Who is it directed towards?

I imagine toward the people who behave as if vaccines aren't effective, which are nonzero.

I mean. The latter statement is a thing gay people actually DID say, long before the government told them to. Gay people noticed that it was spread through sex and that condoms work. Not even going to touch the former statement since I don't feel like wading into the criminalization of black people. Suffice to say, not convinced by either of these comparisons.

> I am begging you, and everyone else, PLEASE, if you want to make a point, please do it in a respectful way that doesn't assume anyone who disagrees is stupid. If you need to be snarky, go do it on the-site-that-must-not-be-named.

I'd label your preceding statement to be snarky, fwiw.

It's a commonly accepted fact that vaccines work. We were all vaccinated against multiple viruses as babies for a reason.

The fact that he added the word "Gosh" to his comment doesn't make it insulting or target any specific group of people. You're taking great offense over nothing and distracting from a meaningful discussion.

I think repeating accurate facts is an important thing. Because the random complaints in incorrect and bizarre negative anti-vax claims pass by without someone addressing them often.

What is real and true matters. There's lots of things that are hard to decide, but we know that they're not millions of hidden deaths from getting vaccinated, and we know that there are millions of people protected from dying because they got vaccinated.

I don't think comments like that are meant to convince anyone.

There are vanishingly few circumstances other than legitimate medical conflicts that warrant being unvaccinated. Namely, crippling anxiety of planning/scheduling the appointment, or being misled by trusted advisors (Fox Entertainment or doctors who should have their medical license revoked).

Other than that, I have very little patience or sympathy.

I'm surprised more doctors have not had their license revoked for publicly preaching misinformation. You can have your license revoked for treating a patient when a more specialized expert is available. For example, a dentist can get in trouble for not referring more complex issues to a dental surgeon, periodontist, etc.

And yet we have cardiologists and eye doctors and chiropractors telling the public that the vaccine is dangerous and that we would be better off without it.

I saw someone mentioned that a doctor/professor from Johns Hopkins was raising concerns about college age kids getting vaccinated. I looked him up. He's a surgical oncologist. Guess what the epidemiologists, virologists, and immunologists at Johns Hopkins are recommending?

Oh ya, and the surgical oncologist turned epidemiologist just so happens to have a book about the pandemic that he is pushing right now. I'm sure that has nothing to do with it.

> I'd be willing to bet that the overwhelming majority of people on this website are vaccinated.

I am not so sure. HN is the most "covid is just a flu, masks and respirators dont matter, teachers should teach when sick with covid those lazy bastards" place I regularly visit. I would be surprised if vaccination rates did not followed the same general political alignement.

HN, whatever it's faults is not just one side on this (or many other) political battles.

Encryption is probably the only thing that most people on HN agree with.

What are the demographics of each of your identified cohorts? For example, if the south side is under vaccinated (whatever that means) and doing poorly then it seems a little disingenuous to act like their medical care wasn’t subpar prior to Covid.

> Vaccinated areas? Doing fine. Undervaccinated areas? Not doing so well.

Not accurate AT ALL.

NPR has a better source that also gives COVID patient percentage.

Marin County, CA and Santa Cruz, CA county have 95% vaccination rates and are doing worse in ICU capacity than Escambia county, FL who has 55% vaccination rates.

For most ICUs running at 80 to 90 percent capacity is standard.

https://www.npr.org/sections/health-shots/2020/12/09/9443799...

https://www.beckershospitalreview.com/patient-flow/2-healthc...

> Marin County, CA and Santa Cruz, CA county have 95% vaccination rates and are doing worse in ICU capacity than Escambia county, FL who has 55% vaccination rates.

Marin and SC counties have 13% of beds filled by covid patients. Escambia has 21% filled by covid patients. This appears to directly contradict what you claimed.

We're talking about ICU capacity. That's what flattening the curve is all about.

Marin and Santa Cruz have LESS Covid patients and are closer to overflowing than Escambia.

Also covid patients only make up 13% of the ICU?

Something is odd with your flattening the curve narrative blaming overflow on Covid patients.

Icus in normal times stay at 70% capacity, so covid adding 20-30 percent capacity fills them up. Doing what CA does, flattening the curve and keeping covid induced capacity at 10-15% allows hospitals to continue functioning normally.

Sounds like maybe whats causing the curve to need flattening is the 80% of non-Covid cases in the ICU?

> Marin and Santa Cruz have LESS Covid patients and are closer to overflowing than Escambia.

So I went ahead and checked this, and it's wrong.

Escambia's ICU capacity is 87% full, SC's is 90% full (and SC is a bad choice, as they have a total of 21 ICU beds in the county, they use bay area ICU beds for overflow, which are currently sitting at ~80% capacity), and Marin's is....40%. So I'm not sure what data you're looking at, but it seems to just be wrong.

Secondly, no, covid capacity really is the problem, because for the last year and a half, hospitals were reducing non-critical care. That means you have tons of people who need hip replacements or brain surgery or tumor removal who haven't been able to get it. Many of them will need to recover in the ICU a bit, so you'd want a higher baseline ICU use post-elective surgery freeze, as that implies that the "clog" is being recovered from.

If the hospital is still full due to covid patients, those elective surgeries will never get done, leading people who never caught covid to suffer too. So low covid capacity, but higher overall use temporarily means that we're catching up to all the deferred non-covid care, something we really need to do!

The other possibility is that you mean that the 70-80% that ICUs normally run at is somehow problematic (because well like I just said, we did actually "flatten" it by deferring elective ICU recovery for more than a year in many places). The US already has more ICU beds per capita than most nations, even other developed nations, so I'm not sure what your idea here is other than perhaps, "The us population is too unhealthy or is providing too much healthcare", which are both interesting positions to take for sure.

>Secondly, no, covid capacity really is the problem, because for the last year and a half...<a bunch of non quantitative opinion based unprovable emotional gish gallop stuff I didn't read.>

Bullshit.

Actual data says that Covid patients in ICU take up between 8% to 20ish% of admissions.

COVID is not causing the curve to be need flattening.

The medical system is.

Maybe they shouldn't fire medical professionals who got immunity through COVID infection instead of the vaccine.

> Actual data says that Covid patients in ICU take up between 8% to 20ish% of admissions.

Yes, and actual data says this is a problem, because we don't have the capacity to handle a sustained 15% increase in ICU use. That is simply not a thing we have the capacity to handle.

> Maybe they shouldn't fire medical professionals who got immunity through COVID infection instead of the vaccine.

The less than 1% of people who fall into this category are probably not the issue. 1% more nurses isn't going to address 15% more patients.

> <a bunch of non quantitative opinion based unprovable emotional gish gallop stuff I didn't read.>

You really should have, because none of it was "emotional" and most of it was quantitative, so this makes you look rather silly. Like c'mon, you've lied about how full hospitals are in California, when confronted on that you claim I'm "gish galloping" with emotional nonsense that's just true[0] factual content about how we handle and have handled hospital capacity and why your (completely conjectured!) conclusion was wrong.

[0]: https://revcycleintelligence.com/news/40-hospitals-in-ny-for...

> we don't have the capacity to handle a sustained 15% increase in ICU use.

100 - 15 is 85.

There's 85% left to handle it.

Where is this 85% going and why is it less of a concern in flattening the curve?

why is no one concerned about this 85% of non-covid ICU patients??

Seems to me covid is a small fraction of ICU cases.

Seems to me maybe the ICU should work on handling its caseload..

Seems to me maybe there's systemic problems like the AMA limiting the number of health professionals to keep the salaries up and firing the ones who have natural immunity.

Maybe that's why the curve can't get flattened.

but one thing that is crystal clear from the data is that covid is not the primary cause of hospital overflow.

> Where is this 85% going and why is it less of a concern in flattening the curve?

The short answer would be "aging" and "accidents". And we already do huge amounts of research to lessen the impact of those things, but if you have any ideas, do let me know.

It's less of a concern because it isn't really something we can change. We can't make people age less quickly, or have fewer accidents. And while we can (and did!) treat some of those things less, that has severe downsides in the long term.

> Seems to me covid is a small fraction of ICU cases.

No, it's a 20% bump in what the system is meant to handle. Systems don't generally do well when asked to sustain 20% more of what they were doing, forever.

> Seems to me maybe there's systemic problems like the AMA limiting the number of health professionals to keep the salaries up and firing the ones who have natural immunity.

Can you explain why you keep bringing up nurses when we discuss ICU capacity? Last I checked, we didn't need to vaccinate beds.

how long have aging and accidents been around? since the dawn of the human race?

and they still haven't figured out a way to handle the ICU load?

you would think with all kinds of random unplanned disasters happening all over at any time ..like terrorist attacks or earthquakes or tornadoes... they would be able to increase capacity by 20%

the problem is not covid patients, the problem is either a poorly planned system or news media sensationalism

> ..like terrorist attacks or earthquakes or tornadoes... they would be able to increase capacity by 20%

They can, for brief periods. You start by overflowing to nearby hospitals, you can't do that for covid though, because its global. So you try to drop non-urgent care, but they've already done that. You can't stop treating non-urgent care forever, it's only a temporary approach.

So you're left with, well, reducing serious covid case rates. This can absolutely be done, by the way, with a combination of vaccination and varying masking policies as necessary. Because that's the only tool left after all of the others have been exhausted.

> and they still haven't figured out a way to handle the ICU load?

There is actually a really easy solution, it's just ethically terrible. You refuse (or triage last) unvaccinated covid patients. This solves most of the problems. It is however ethically unconscionable.

> the problem is not covid patients, the problem is either a poorly planned system or news media sensationalism

Yes, we all recognize that the global healthcare system is not able to handle a sustained 10-20% increase in demand. That doesn't make it "poorly planned" (are you willing to pay 20% extra in healthcare costs to cover the increased slack?)

I think you might think your opinions are facts.

You say everything like you have the singular objective answers beyond a shadow of a doubt even if your ideas are just one of many possibilitys.

> Recorded deaths do not differentiate between "died from covid" and "died while covid positive" making death statistics hard to interpret.

This has never been true and remains false.

The UK Government Covid death statistics literally say "deaths with Covid", and are defined as "deaths within 28 days of a positive test".

So it is true, and always has been.

https://coronavirus.data.gov.uk/details/deaths

The next line is "deaths with covid on the death certificate", which is different and is actually a higher number and the more important number, as it deals with people who died of covid induced pneumonia after a multi-week stay in the ICU, but not people who by chance had a heart attack after contracting a mild case.

Now there's where we get into interesting territory. The UK significantly relaxed regulations around March 2020, and basically made it very easy to put "Covid" on death certificates. The requirement for a coroner's report in the case of a novel disease (ie, Covid) was also dropped, as well as the requirement to do a Covid test (or even certify the death in person). [1]

As a result, it will never be possible to know how many died of specifically Covid, and how many died of a viral-induced pneumonia.

https://assets.publishing.service.gov.uk/government/uploads/...

So can you explain something to me:

We know how many people die of non-covid viral induced pneumonia in a normal year (and in a bad year). Most of it is caused by the flu. We also know that covid policies have demonstrably reduced flu rates to some of the lowest ever over the past few years.

So what other cause of viral induced pneumonia do you suppose is the one killing everyone?

I already did. We will never be able to find out how many people specifically died of Covid, and how many died of a viral pneumonia, thanks to the changes in death reporting guidelines that I linked.

I find it absurd to believe that flu "went away" - do you have any evidence for that?

> We will never be able to find out how many people specifically died of Covid, and how many died of a viral pneumonia, thanks to the changes in death reporting guidelines that I linked.

What do you think causes viral pneumonia? If you get in a car crash and bleed out and die, they put both "massive hemorrhage" and "vehicle accident" on your death certificate. If you die of covid-induced viral pneumonia, they put both on your death certificate, because the covid is what caused the pneumonia. You're trying to draw a distinction where there isn't one. Deaths from covid-induced viral pneumonia are deaths from covid, in exactly the same way that deaths from car-crash induced massive bleeding are deaths from a car crash.

> I find it absurd to believe that flu "went away" - do you have any evidence for that?

See https://www.cdc.gov/flu/about/burden/faq.htm#anchor_16336269..., notably the heading "Are there other metrics that can be used to compare the 2020-2021 flu season with past seasons?", which shows a table. That table compares the 2019 and 2020 seasons. Essentially they tested around the same number of specimens and the incidence of influenza was 1000x lower.

This is probably the most accurate datapoint, other things match up (such as reported hospitalizations also being ~100x lower than the year prior) but those are more prone to accidental misclassification of flu-as-covid. You can't really screw up a test in the same way. But generally speaking, they were low enough that the CDC couldn't actually calculate the likely impact, it was too low to make reasonable predictions about. This year it's higher, but still 10x less than a normal year.

(the reason for this is also straightforward: covid-19 variants are generally more contagious than the flu, so mask and social-distancing policies that are somewhat effective at reducing covid transmission are vastly more effective at reducing influenza transmission)

>What do you think causes viral pneumonia?

Clue's in the name. A respiratory virus, of which there are many.

>covid-19 variants are generally more contagious than the flu, so mask and social-distancing policies that are somewhat effective at reducing covid transmission are vastly more effective at reducing influenza transmission

Apparently common colds and the like are even more contagious than Covid-19, as the country where I live has had a mask mandate since September 2020 and I have been ill numerous times with regular sniffles and colds.

I take your point with the data you provided (although there's no information on sampling methods and thus the statistical significance of those numbers. We also don't have a similar data point for the UK), but it's a stretch to attribute it to masks and social control measures. I'm not in the US, but I don't think that policies have changed much over the past year - yet flu is back this winter.

> Clue's in the name. A respiratory virus, of which there are many.

So again, if not covid, what other thing is causing the extreme spike in viral phenomena deaths? Is it some other novel virus that no one noticed or did we suddenly become more susceptible to the common cold?

> Apparently common colds and the like are even more contagious than Covid-19, as the country where I live has had a mask mandate since September 2020 and I have been ill numerous times with regular sniffles and colds.

Anecdotes are not data, but if we're sharing them, your experience would be unusual in my neck of the woods.

> but it's a stretch to attribute it to masks and social control measures

It really isn't.

> but I don't think that policies have changed much over the past year - yet flu is back this winter

Compared to a year ago, social distancing and mask mandates are far weaker. December 2020, gyms were closed and I couldn't go to work and restaurants were at 25% capacity or outdoor/takeout only. Today gyms are open, I can work from my office, and restaurants can run at full capacity.

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