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Comment by lamontcg | Hacker News Reader

> they've been told it's simple: get vaccinated/boosted

It is that simple.

90% of the people in the hospitals are unvaccinated still.

Cut the unvaccinated fraction of the population down by 1/3 and you cut the hospitalization rate for the next wave by roughly 1/3.

Instead people are doing T-cells/B-cells and affinity maturation the hard slow way.

If we had a 100% vaccination rate we'd be done.

Don't know why everyone so desperately needs to look for counterintuitive ways to approach the very simple problem that when there's a global pandemic you mitigate it with vaccination. Any other result is intellectuals thinking too hard to try to impress themselves and probably missing basic facts in the process.

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You've been duped by the mostly deceitful narrative about overwhelmed hospitals. Look at this data for your state: https://coronavirus.jhu.edu/data/hospitalization-7-day-trend....

Even during the height of a COVID surge, the total hospitalizations is maybe 20% higher than normal. Also note that as COVID hospitalizations increase, regular hospitalizations decrease. This is a consequence of the dishonest reporting criteria encouraged by the CDC; people are hospitalized for unrelated reasons but happen to test positive for COVID so are counted as a COVID patients instead of regular patients. See, for instance: https://www.dailywire.com/news/massachusetts-now-differentia....

You can also web search for hospitals being overwhelmed by the flu. In a few minutes I found this happening in two different years: 2018 and 2000. The reality is that hospitals get overwhelmed very easily for a number of reasons. Even if you vaccinated everyone in the U.S., they would still get overwhelmed during surges. In other countries with higher vaccination rates, hospitals still get overwhelmed and primarily with vaccinated people: https://www.npr.org/sections/goatsandsoda/2021/08/20/1029628...

The reality is that this pandemic is over as soon as we make it over. My family has been living a normal life since October 2020.

Thanks, glad to know that the wait times my family has spent with my grandparents this past couple years when they needed to go to the hospital was all in our heads.

Edit: /s because apparently that is necessary.

Not to belabor the point, but it seems like you're talking past me, not against me. I said the hospitals would be overwhelmed even if everyone got vaccinated, not that they weren't overwhelmed.

Is this sarcasm? Because if not, glad you figure it out.

There are some good arguments that current hospitalization metrics are misleading and underestimate the healthcare workload. Delayed treatments or patients who cannot access treatment may be a more useful metric to measure how overwhelmed a healthcare system is.

See https://twitter.com/DellAnnaLuca/status/1486208081142947840/...

I noticed the hospitalizations graph on my favorite source for Texas (Texas tribune) now reads “Total current patients with COVID-19 in hospitals”. That’s deceitful in my eyes because that includes anyone in the hospital for any reason who tests positive and not people only hospitalized because of Covid-19 which is what you’re expecting.

Also, the whole ICU capacity percentage numbers inducing so much fear and panic are very misleading. ICU capacity isn’t static it can be adjusted up and down. So saying ICU is at 98% capacity utilization is meaningless because it could be very well possible that ICU beds can be added and now ICU capacity is 75% utilization.

Overwhelmed hospitals is not a binary risk.

Vaccines are shown to reduce cases of serious symptoms and hospitalization. Yes, even if everyone is vaccinated is possible for hospitals to still be overwhelmed if infections spread too quickly (hence things like distancing still being important), but even in that case, you’d have less people needing hospital attention that are unable to get it.

The overall goal of our societies, as I see it, is returning to living our lives as normal and killing the fewest people in the process. Reducing hospitalization rates means that more exposure can safely happen before hospitals are at risk. When they come close to being overwhelmed, additional restrictions on gathering will probably need to be reemployed until the risk subsides again.

These risks are also very local (more local than state) and personal. So it’s perfectly reasonable for the pandemic to “be over” for some where the risk is low, yet not for some where the risk remains high.

>we'd be done

No, the current status is that we'll be done if and only if we reach acceptance of a situation that is not going to go away anytime soon. The only thing stopping us from being done is in people's heads.

My government has spent hundreds of billions to prevent "the health care system from being overburdened". Not a single cent of that money went into the healthcare system. In fact, the systematic reduction of "healthcare overcapacity" was continued throughout. Our politicians are either remorseless criminals or fantastical dunces. Either way the world would be a better place if they were removed from power, one and all.

>The only thing stopping us from being done is in people's heads.

Of course. The actual political debate in the US is whether society should accept and normalize daily mass death. If we applied today’s standards, 9/11 would have been a non-issue. It’s only about a days worth of covid deaths, after all.

No amount of vaccination will avoid everyone getting infected sooner or later. The vaccinated who die will have died with vaccination mandates or without them. The unvaccinated who die fall into two groups. Those who would also have died vaccinated and those who do so as a consequence of their own choice. That's neither my business nor yours, it's theirs alone. We may argue with them, but we can't force them and claim to be more moral for it, quite the opposite in fact.

> Those who would also have died vaccinated and those who do so as a consequence of their own choice.

Their choice has a direct effect on society and causes harm to other people. So no it's not as a simple as.

I guess we could deny the unvaccinated medical care in hospitals. Because they take up ressources that would be spent on people with other medical issues. We have an about 70% vaccination rate and 80-90% of hospitalized covid patients are unvaccinated. Meanwhile I know of people that can't get standard procedures done because of covid patients (this wasn't a problem before the pandemic).

Due to EMTALA, hospitals are legally required to care for any patient who arrives in unstable condition regardless of vaccination status. But I would encourage everyone eligible to get vaccinated as it reduces the risk of hospitalization.

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

An overworked ER Nurse who just can't take it anymore may decide to not update a patient's medical record when a patient is in decline and instead will simply discharge the patient. If the Patient dies at home, the medical records will not indicate a decline, therefore no EMTALA violation. That is how my Mother was basically manslaughtered by West Hills, CA ER back in March of 2018, right in front of my own eyes. I still have PTSD from the incident. After Mom died at home in my arms without ever having been treated for her pre-pnemonia, NOBODY would investigate. How cruel and complicit is that?

Your comment implicitly assumes that vaccination is the only possible way to reduce death, but we have many other interventions that we can choose to prioritize as a society:

* Mandate a minimum # of nurses and pay them fairly. Patient survival depends on nurses being able to do their jobs, but hospitals seem to prefer saving money by cutting staff.

* Improve society’s overall health by reducing inequality. Lives have intrinsic value that transcends any economic or profit-based calculus. We consider mass death unacceptable because we recognize this basic truth.

* Make paid sick days and short-term disability more accessible. It can take weeks to months to properly recover, depending on severity.

* New building regulations in public spaces to lower the viral inoculum (correlated with severity) using tactics such as improved ventilation and 222nm UV lamps.

* Ensure access to the basic necessities: healthy food, housing, healthcare. You can’t survive a covid infection if you’re dying of exposure on the street.

>Your comment implicitly assumes that vaccination is the only possible way to reduce death

No, this was a discussion about 1. the claim by others that vaccination would be the key to "end" all of this and 2. my complaint that not a single cent of many 100s of billions my government spent on all of this went into health care.

I would very much have liked if we had spent more money on nurses, and into making their work as easy as possible by allowing them to concentrate on their core competencies and offload the easier parts of the jobs onto more nursing assistants, which can be trained relatively quickly. Alas, we didn't, and here we are!

> Not a single cent of that money went into the healthcare system.

If everyone was vaccinated the healthcare system wouldn't be overburdened without spending a dime on the healthcare system.

Preventative medicine is always the cheapest option.

If my grandmother had wheels, she'd be a bicycle.

There's no real argument for continued restrictions beyond hospital capacity (and even that one is a stretch). Why not spend money on that and open up the economy again?

In France, between January 1st and 16th, vaccinated people accounted for 60% of the new hospitalizations. We, like most of Europe, have 90+% of adult population fully vaccinated, and are nowhere near "being done".

90% sounded high; I found an article saying as of today 79% of people in France have had both of the initial shots (not sure how they figure single-dose vaccines like J&J and Oxford), and 80% had 1. [1]

Let's say it's 80%. 80/20. Primary vax status probably hasn't changed too dramatically in 1 month.

p(hospitalized | vaxxed) = p(vaxxed | hospitalized) * p(hospitalized) / p(vaxxed)

= 0.6 * p(hospitalized) / 0.80

= 0.75 * p(hospitalized)

---

p (hospitalized | unvaxxed) = p (unvaxxed | hospitalized) * p(hospitalized) / p(unvaxxed)

= 0.4 * p(hospitalized) / 0.2

= 2 * p(hospitalized)

Vaccination gives a 2.67x reduction in hospitalizations (against omicron which all the anti-vaxxers are saying the vaccines don't do anything against).

With your 90% figure, it becomes 2/3 instead of 3/4 and 4 instead of 2, which is 6x, confirming what the other replier got.

[1] https://www.sortiraparis.com/news/coronavirus/articles/23973...

In the most relevant age group 60+ the reduction in hospitalizations is 83% for double vaxxed and 95% for boostered in Germany according to latest figures:

Page 28 on vaccine efficacy.

https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus...

93% of the eligible have had two doses in France, or 78% of the population : https://covidtracker.fr/vaccintracker/

Unless we can get stats for who's eligible or not eligible for the vaccine when they're hospitalized for COVID-19, what can be done with that extra distinction?

Same with age and risk-factor cohorts. We could repeat the probability calculation for each cohort if we could collect those data, but it would probably make the vaccine even more effective: Presumably, more higher-risk people are double/triple/quad vaxxed at this point, so whatever rate they show up to the hospital is higher than what the average healthier person could expect.

We know that for a long time. I'm just saying that despite having 93% of the adult population vaccinated (-18 yo do not need the vaccine pass to go anywhere) , and our ICU beds occupation rate being only 70% at the highest omicron peak, our politicians still refuse to call it an end.

"Being done" with covid is only a political decision, and no percentage appears to be high enough for them.

This is true but slightly misleading : if 100% of the population was vaccinated, 100% of hospitalizations would be amongst vaccinated people.

They would be a much smaller and manageable number, and on average much older/vulnerable than they are now (vaccination basically lowers your risk to that of someone 20-30 years younger)

More figures from France : the unvaccinated 8% account for 39% of hospitalizations, 54% of intensive care admissions, 46% of Covid deaths.

This is a hugely outsized effect, so there's still enormous potential for drastically improving the situation in hospitals with just a few more percentage points of vaccinated people.

Current numbers are already manageable. At the Omicron wave peak, total ICU beds are 70% full. And recent (official) data shown that 30% of all COVID positive hospitalizations were actually unrelated to COVID, that number being as high as 50% for 0-49 age group. Yet our politicians refuse to drop restrictions, they even doubled down by making vaccination mandatory to go anywhere, when a negative test used to be enough.

Unless my math is wrong, by your own numbers, unvaccinated French adults are 6x more likely to be hospitalised than unvaccinated adults.

Doh! meant to say "vaccinated adults" at the end. (saw this too late to edit).

Absolutely, but this is in no way related to whether we decide this is "the end" or not.

I said "if we had 100% of the population vaccinated we'd be done" and I meant it.

I didn't mean 90%.

If 5% of the population is susceptible that's enough to overload the hospital system during a wave. It really doesn't take much with this virus.

And Delta's transmissibility really destroyed the destroyed the notion of herd immunity. The correct number should be 100% vaccinated.

And its still 90% unvaccinated people filling up the hospitals, even though you're highly vaccinated.

Once you hit the hospital percentages matching the population percentages then the "natural immunity" enthusiasts will have finally all basically caught it sufficiently to gain immunity the hard way and it'll be done.

This sounds like Simpson paradox again. It happened in Israel.

People with weakened immune systems and other health issues are more likely to be vaccinated. But they're less likely to have a robust immune response to the vaccine.

> If we had a 100% vaccination rate we'd be done.

For a vaccine that doesn’t confer sterilizing immunity and whose effectiveness wanes rather quickly? To say nothing of variants or the fact that this virus has animal reservoirs. Or the impossibility of vaccinating 100% of a population in the first place, nevermind in perpetuity.

“Ending it” was always a pipe dream.

in my country the official figure is that "90% of hospitalized are unvaccinated or vaccinated without a booster". this certainly sounds like a doctored phrase and it dilutes trust to the medical system.

It's simply accurate, and reflects the dramatic difference in vaccine efficacy between 2 and 3 doses (or rather, between a recent or more distant dose)

The problem with that narrative is that it absolves responsibility for further action by pretending that the vaccines are the best we can do about this pandemic. It becomes a show and that's not good

Because of the sheer numbers the amount of vaccinated still are the majority in the hospital. You rate of going to the hospitalization is lower, but the raw numbers show more people in the hospital that are vaccinated.

The people are are unvaccinated in some cases have medical reason not to be and therefore be more likely to be hospitalized for anything. You'd need to stratify the numbers by age, vaccine status, and comorbidity status to get the full picture.

Early on when the 99% are unvaccinated line was going around all the data used was usually from before the vaccines were available.

> 90% of the people in the hospitals are unvaccinated still.

Where is this true?

New York City:

https://twitter.com/DougHenwood/status/1486807706954567685

Pennsylvania:

https://www.msn.com/en-us/health/medical/about-90percent-of-...

Kansas City:

https://www.newspressnow.com/news/national_news/coronavirus/...

Missouri:

https://www.newspressnow.com/news/regional_news/central_miss...

Arizona over 80%:

https://ktar.com/story/4856002/banner-health-leader-over-80-...

Boosters 90% effective against hospitalization with Omicron:

https://fox8.com/news/coronavirus/cdc-boosters-90-effective-...

There are a whole lot of nonsense claims in this post without anything backing it up

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