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Comment by gandalfgeek | Hacker News Reader

The "COVID deniers", as they were labeled, (think people like Jay Bhattacharya, Scott Atlas et al), warned about all of this. They presented the tradeoffs and probabilities on both sides. But they were completely shut down without debate, in the name of "following the science." They were shut down in concerted fashion-- by govt, by social media (under govt coercion, or ideological pull), by legacy media. And now the truth is coming out, and there is still no accountability for the "beat COVID at all costs" proponents.

If we are to prevent this the next time a pandemic rolls through the world (and it will), there needs to be a society-level post-mortem, and not a blameless one.

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My area experienced a hospital overload and that was very debilitating. No emergency services were available and that influenced people’s behaviors way more than the local lockdown order.

This was the worst case scenario that the lockdown orders were made to avoid.

In hindsight, I’m more so annoyed that additional healthcare capacity hasn't occurred, 3 years in. All the time borrowed and none of it used.

To your credit, I do wonder if a month or two of debilitated emergency services in a Darwinian surge would have been better. The purge still happened, just took longer and SOME people got more fine tuned treatments by getting sick later, at the expense of healthier people having missed screenings for longer.

>My area experienced a hospital overload and that was very debilitating.

Are you sure? Are you really sure? As opposed to just hearing dire warnings? My understanding is that all or almost all of the predicted overload of hospitals never actually happened.

In Wales, for example, Millennium Stadium was converted into a temporary field hospital with 300 beds and capacity to expand to 2000 beds. It was such a big deal that a public contest was held to name it Dragon's Heart Hospital <https://en.wikipedia.org/wiki/Dragon%27s_Heart_Hospital>. However, said hospital never had more than 46 patients at one time, and was closed in six weeks for lack of use!

Even in NYC, which really did see overloaded hospitals briefly in March-April 2020, USNS Comfort treated a total of 179 patients. USNS Mercy treated a total of 77 patients in LA.

Regarding "hospitals" then, no, I'm not really sure, you seem to have some data although the time period I'm referring to was Winter 2020-2021.

Regarding lack of availability of emergency services due to some bottleneck of medical resources and personnel? then, yes, I'm really sure.

If the industry is anything like every other industry, than bottlenecks were surely induced BY the lockdown then and not prevented by it.

So the justification for the lockdown was caused by the lockdown

Sure, practically, it would have been more efficient to go Sweden-style scorched earth.

What I want done better next time, is building an "off switch" into the messaging. It should have been made clear from the start that COVID was temporary and would settle down into background flu noise in a few years. The danger has dissipated a lot faster than the hype. My local university just transitioned from "masks required" to "masks recommended", and the vaccine has been available for 1.5 years already.

Sweden? Look at Jamaica. Absolutely no impact from covid.

Jamaica had significantly more deaths from COVID than the global average. 3,476 deaths out of 3 million people is 1.16 deaths per 1000 people.

Global average is 6,713,093 deaths from 8 billion people or 0.84 deaths per 1,000 people. Granted there is likely underreporting in global numbers.

The real difference is simply the age of the population. Jamaica has a median age of 29.4 years old, where Italy which got hit even harder with 3 deaths per 1,000 people has a median age of 46.5. This is also why the developing world got out so easily: https://www.statista.com/statistics/829732/global-population...

Sweden's death totals per capita are still somewhere around 2x to 3x their neighbors.

Is that a success? Certainly not unequivocally.

Misleading. In terms of all cause mortality, Sweden is the clear winner in Europe.

Bhattacharya is also a vaccine skeptic (or, at least, an mRNA vaccine skeptic), so if you're taking him seriously on public policy, flip a coin.

I don't know what you remarks you are referring to here, but Jay's insight on vaccines has been measured, reasonable, and, as evidence goes, accurate. He hasn't been a detractor with regard to mRNA in particular, and encouraged risk-stratified uptake of the vaccines.

He is an authority of impeccable integrity in epidemiology, buttressed by his prescience during this pandemic. He has been a friend since well before GBD, and I'm very proud of the way he has handled the asinine attempts at assassination on his character.

Jay just retweeted something a few hours ago that says:

"Fauci and @CDCDirector et al have actively participated in the greatest public health catastrophe in the last hundred years—and maybe ever."

I can assure you the argument that the person is making is neither measured, reasonable, nor accurate. I think you are giving him more credit than he deserves in terms of his nuanced arguments.

Playing devils advocate, what was a worse public health catastrophe in the last 100 years?

That’s the wrong question to be asking. It pre-supposes that the “participated in” phrasing is accurate, when “actively fought against” would be more accurate.

Well, for one, the US response to the AIDS epidemic.

Also calling it a catastrophe is just begging the question. Maybe every country in the world should have been more prepared to deal with a novel respiratory virus causing a global pandemic, but they weren't, and in retrospect the primarily US-led response of making a vaccine using a new technology in one year and vaccinating a large percentage of the world in the next year is nothing short of astounding.

The issue with arguing that the CDC lost a lot of public trust is much more nuanced, and well, maybe it did, but that has a lot more to do with external factors that have nothing to do with the CDC (such as political leadership) and not much to do with what the CDC itself did. And this isn't to say the CDC did everything right, or even did a "good" job. But they certainly didn't do a catastrophically bad job.

aids

Time is proving him right, and you wrong. And I sincerely hope that I'm wrong about this.

Trying to learn about this conversation. What is it that is being proved true?

That hindsight is at least marginally closer to 20/20 than foresight.

Lotta people just continue on operating from the assumption that we knew the severity of COVID upfront which… we didn’t. It was very severe and it appeared even more so (as is well within the bounds of possibility of a novel pathogen).

It’s so hard to talk about this without being labelled a “vaccine denier”.

We all knew the initially claimed protection rates were overstated, it was acknowledged as a limitation in the initial study protocol but ignored by politicians and media.

For the validation trials, due to the time / resource requirements (we didn’t have PCR capacity) testing for seroconversion/positivity was only done on symptomatic patients and not at a routine time interval. This type of testing is well known to result in overestimating treatment effects (you’re missing all the people who didn’t self declare symptoms and get tested by not having strictly adhered testing intervals) and there’s zero doubt “94% protection” was an overestimate (even by the original Pfizer study authors). By how much, we’re not sure, and we absolutely needed something in a time of uncertainty and it was the right decision at the time given available resources and pandemic pressures.

As evidence has accumulated, we’re realizing the vaccine effects and COVID mortality (particularly post Delta) are vastly overstated.

I have not seen a CT chest with the “cardboard lung” appearance of COVID-19 pneumonia or ECMO patients since December/Jan 2022, and I was reporting inpatient chest imaging in the largest ECMO center in Ontario at multiple points during the pandemic.

The “sniff test”, suggested things were changing (like population drift with a ML model). And the issue with the vaccine rollout is we went back to “science based medicine” rather than the currently accept “evidence based medicine” where lab tests like neutralization assays were being extrapolated into clinical outcomes. Medicine moved away from this type of reasoning for a reason, you really need to look at higher level outcomes to know what’s actually going on. You can rationalize many treatments on a scientific level (as was done for anti malarial drugs at some point) but it usually ends up invalid.

What’s being proven true now, is that we overestimated both COVID mortality due to confounding effects of co-admission (how many inpatients are there BECAUSE of COVID not with it) as well as the effectiveness of vaccines, particularly at later stages in the pandemic. They probably worked well for COVID 1.0 up to Delta at preventing serious illness but that quickly dropped.

I don’t buy the evidence to support current vaccination recommendations with the bivalent (esp. young and healthy), and you can see many institutions have dropped that requirement (only the initial 2 dose series was ever mandatory at my place)

I agree that vaccinating young and healthy people with the bivalent vaccine doesn't have much data supporting it.

The rest of your claims are dubious at best. Yes COVID deaths are going down, but that's because the most vulnerable are already dead and most everybody has a prior infection now. All the vaccine studies up to the bivalent booster used clinical outcomes. Most COVID deaths are "from" COVID, not with COVID, so this distinction is not particularly meaningful... Nobody is arguing that 100% of deaths are attributed perfectly.

Basically the vaccine recommendations up to the bivalent booster (ie 3 shots of the original vaccine for all age groups) were obviously correct and have overwhelmed data supporting them. The bivalent booster is a bit more complicated, but don't pretend that invalidates everything from the past 1.5 years.

Two issues with your argument.

First, what time point are you talking about though? Covid has been Jan 2020 to present and the variants arguably represent different diseases. Certainly they have different morbidity and mortality supported by science and evidence (e.g. at some point around omicron it became an upper airway infection).

Two, what’s the clinical outcome you’re referring to? How is attributable death determined? I’m not aware of any evidence to say the most COVID deaths since July 2022 are due to COVID. Particularly as we are not seeing the same clinical signs/changes with the newer variants as we were before.

What is the overwhelming data? There are a lot of observational studies reporting relative risk reduction. What’s the absolute risk of someone < 40 dying or being hospitalized due to omicron? Medical coding is horrendous and these questions are hard to answer with accuracy. I would be cautious with the strength of your statement, this is an ongoing field of study.

As I stated, the initial vaccination recommendation made sense, but when those recommendations were made they were not supported by strong evidence (largely because you can’t obtain evidence in an active pandemic).

I’m not anti-vax, and I support the initial recommendations, particularly given the context in which they were made. There is probably equal quality evidence on whether the booster was actually effective vs triggering temporary immune response boosting short term outcomes when I last updated myself on the literature in the fall (most of the studies measure out to 3 months, which is what we would expect from temporary immune boosting due to exposure). What are the long term risk reductions and is there lasting immunity to support the booster?

Is it sensible to divert human resources to boosters if the effect only lasts a few month and the ARR is minimal? Keeping in mind that diverting nurses to vaccination resulted in cancellation of elective ORs. These are important questions.

Now is the time to do more careful and objective analyses, not to shame or critique Dr. Fauci and co but to inform future decision making.

The statement that he retweeted, that you seem to be taking as discrediting, strikes me as entirely plausible.

The actors in question have tarnished their otherwise somewhat respectable careers over this, and indeed it has been a public health catastrophe of 100-year proportions.

>somewhat respectable careers

Only somewhat? I was under the impression Fauci et. al. were regarded as extremely competent.

Yeah I think he was regarded as competent as far as institute directors go (which of course isn't saying much). But it's not his competence that is at issue here, so much as his moral compass, and his lacking commitment to continuing education.

The most obvious marks on his record, prior to covid, were the ire he drew from gay men during the AZT fiasco (I imagine you've seen this photo, for example: https://pbs.twimg.com/media/EapU2PGWsAAvxfb?format=jpg&name=...), and his role in supporting rather recklessly thought-out gain-of-function research (from, eg, CambridgeWG and co).

No response that NIAID has ever given provides the appearance that Fauci is personally committed to continuing education sufficient to respond to CambridgeWG's critiques, and frankly, his understanding seems to be closer to the level of amateurs like me (although his purse strings have little in common :-) ).

I think it's fair to say that he has always been a controversial figure, a friend to pharma and defense profiteers, and often a media darling. He has made funding decisions which have led to wonderful discoveries and deserves a great deal of credit for those.

But I don't think he's particularly notable for any groundbreaking epidemiological research or insight. And, although it may still be taboo to say it, he has spent and squandered whatever respect he may have had left with his colleagues. Even those who may have agreed with his bizarre public health policy advocacy seem to agree that he got into a horrific conflict of interest from which he was unable to escape except by resignation.

So it's not necessarily a matter of competence.

There is nothing inaccurate about that statement. If it sounds emotional, it’s because it is.

I invite you to publicly speak out against the narrative and see how it feels. Nothing is more exciting than your own friends and family calling you a horrible, alt-right grandma killer and wishing an agonizing Covid death. All because you had the audacity to look at publicly available data and come to a different conclusion than “The Experts”. If anything this persons tweet is far more measured than it needs to be.

Sounds like as far as the mRNA vaccine, he was skeptical of the need to vaccinate young children given the extremely low COVID mortality rate in kids and concerns about myocarditis. Doesn't sound all that crazy.

It's kind of expected some people will be skeptical about such an unprecedented situation (mass lockdowns, school shutdowns, quick vaccine rollout, mRNA being a relatively new technology at scale etc). Honestly it's a good thing to have scientists who are willing to be skeptics within reason, scientists make mistakes all the time and it's good to have other scientists checking them.

Also important to remember some of what was considered 'crazy' and 'misinformation' and got people banned is now accepted as fact (like vaccines don't stop the spread, myocarditis risk etc)

https://www.salon.com/2022/12/16/why-elon-musk-and-right-win...

> Bhattacharya is expressing tacit agreement with the panel's premise that "the Biden Administration and pharmaceutical corporations continue to push widespread distribution of mRNA vaccines on the public, including children as young as 6 months old, through relentless propaganda while ignoring real-life adverse events." Bhattacharya is also agreeing to work with individuals like Florida Surgeon General Joseph A. Ladapo, who has spread misinformation about mRNA vaccines. Additionally, in May he argued the data on whether COVID-19 vaccines save lives is "surprisingly nuanced" and that it led him to believe "public health authorities should have recommended the cheaper adenovector vaccines over the mRNA vaccines all along for most patients."

https://unherd.com/thepost/study-into-mrna/

Genuinely don't see what he's said wrong here. He's just quoting a legitimate scientific review? Do you feel he misrepresented what's in the study?

From the article you linked:

> A bombshell new study by a distinguished team of Danish researchers led by Prof. Christine Stabell-Benn suggests a surprisingly nuanced answer. In the randomized trials of the covid vaccines, the adenovector-based vaccines, including the AstraZeneca and Johnson & Johnson vaccines, reduced all-cause mortality of study participants relative to people randomly assigned a placebo. Indeed, the reduction in mortality is larger than expected from the Covid effect and may suggest additional beneficial “non-specific effects” from those vaccines against other health threats.

> On the other hand, Stabell-Benn and her colleagues found no statistically meaningful evidence in the trial data that the mRNA vaccines reduced all-cause mortality. The numbers of deaths from other causes including cardiovascular deaths appear to be increased in this group, compensating for the beneficial effect of the vaccines on Covid. Stabell-Benn is keen to stress that the sample is relatively small and is calling for further investigation, and also that the study took place during very low levels of Covid, so the relative advantage of protection against Covid would have been smaller at that time compared to at other points in the pandemic.

> However, these preliminary results stand in sharp contrast to the unambiguous message from public health agencies and governments worldwide, which granted emergency authorization to the vaccines based on evidence from the trials that the vaccines reduce the likelihood of getting symptomatic covid. From a purely scientific perspective, preventing symptomatic covid is an interesting outcome to study. From a public health perspective, prevention of covid symptoms is not as important as prevention of death or disease transmission, which the randomized trials did not study. Dr. Stabell Benn and her colleagues have now looked at overall mortality for the first time.

> At the very least, the plain implication (since both sets of vaccines are available) is that public health authorities should have recommended the cheaper adenovector vaccines over the mRNA vaccines all along for most patients.

> In other words, the international move to de-authorise the AstraZeneca vaccine across Europe and elsewhere looks like it may have been a mistake, and that AZ was actually a better option than the Pfizer or Moderna vaccines.

> It offers a potential contributory explanation for the better overall mortality outcomes in the UK (which overwhelmingly used the AZ vaccine) than much of continental Europe (which phased out the AZ vaccine) after the vaccine programme in the second half of 2021.

From the study: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4072489

> To examine the possible non-specific effects (NSEs) of the novel COVID-19 vaccines, we reviewed the randomised control trials (RCTs) of mRNA and adenovirus-vector COVID-19 vaccines reporting overall mortality, including COVID-19 deaths, accident deaths, cardiovascular deaths and other non-COVID-19 deaths. For overall mortality, with 74,193 participants and 61 deaths (mRNA:31; placebo:30), the relative risk (RR) for the two mRNA vaccines compared with placebo was 1.03 (95% CI=0.63-1.71). In the adenovirus-vector vaccines there were 122,164 participants and 46 deaths (vaccine:16; controls:30). The RR for adenovirus-vector vaccines versus placebo/control vaccine was 0.37 (0.19-0.70). The adenovirus-vector vaccines were associated with protection against COVID-19 deaths (RR=0.11 (0.02-0.87)) and non-accident, non-COVID-19 deaths (RR=0.38 (0.17-0.88)). The two types of vaccines differed significantly with respect to impact on overall mortality (p=0.030) as well as non-accident, non-COVID-19 deaths (p=0.046). The placebo controlled RCTs of COVID-19 vaccines were halted rapidly due to clear effects on COVID-19 infections. However, the data presented here argue for performing RCTs of mRNA and adeno-vectored vaccines head-to-head comparing long-term effects on overall mortality.

I don't see what's so crazy in his article, doesn't seem like a gross misrepresentation of the study.

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