angelzen

I wonder what the exit condition for the pandemic mode is, or even how we define "out of the pandemic". Vaccines have delivered a great success in blunting the sharp edge. Compare cases vs. deaths. I picked 4 countries with varied vaccination levels: Singapore (>85%), Austria (>60%), Israel (>60%) and Romania (>35%). Case spikes occur regardless of vaccination levels, death spikes are near extinct in areas with high vaccination. Yet there are still broad restrictions: mask mandates, social distancing, wfh, vaccine passports, partial lockdowns.

Caveat: there is a lot more to this data than meets the eye, but public health policies appear to be driven by broad numbers, so for the purpose of the "how does the pandemic mode end" conversation these curves are a reasonable starting point.

https://ourworldindata.org/explorers/coronavirus-data-explor...

That is lazy. Indeed, there is no point in refuting a random 90 page paper. However, a good professional should be able to quickly summarize the state of the area touched by the paper and provide a short list of key citations and publications. A good professional should also be able to say "this is outside of my area of expertise" and point to the general direction of where expert feedback can be sought.

"The vaccine was never touted as being 100% effective."

We have overloaded the very term "vaccine" in a fairly misleading manner. One one hand we have vaccines that are highly effective in the longterm and can virtually eradicate dangerous diseases. On the other hand we have flu & covid vaccines, which can help control the severity of the disease, but are incapable of preventing regular widespread outbreaks.

Childhood vaccines are from the first category. Let's enumerate: polio, smallpox, tetanus, hepatitis b, hepatitis a, rubella, hib, measles, pertussis, pneumococcal strep, rotavirus, varicella, diphtheria, mumps. Some of these had no cases for decades, for others very rare localized outbreaks make the news. From the second category, flu and covid have regular outbreaks in highly vaccinated communities and there is no hope for herd immunity.

Perhaps it's time to clear up the semantic overload and create a new term to delineate the important difference between the two classes of vaccines. For example, use "vaccines" for the first category and "immunity stimulants" for the second.

https://www.healthgrades.com/right-care/vaccines/14-diseases...

This is an orthogonal point. I don't see any provision mandating wages or promotions for periods when people are on leave, abled or disabled.

The argument assumes that all people receive the same pay and promotions for the same work. Wage differentials between people from the same age cohort appear because gap years, which are the human approach for infant care, lead to small but measurable delays in the mother's careers.

BTW, this is not an argument that all wage differentials that are observed in the real world are, or should be, explainable this way. It is simply a pushback against rigid Procrustean axioms that risk doing more harm that good.

https://www.eeoc.gov/laws/guidance/your-employment-rights-in...

We seem to disagree with a very specific point about breastfeeding. One perspective is supported by reasonable authoritative sources (AAP). What is your recommendation for the care and feeding for an infant in their first year of life?

"The American Academy of Pediatrics recommends that infants be exclusively breastfed for about the first 6 months with continued breastfeeding along with introducing appropriate complementary foods for 1 year or longer." https://www.cdc.gov/breastfeeding/faq/index.htm

Pumping is challenging, if not downright degrading. Ask a working mother. It also doesn't work as well as you might think, both the baby and the mother need breastfeeding 2-3 hours apart, or else the lactation may stop. Formula is suboptimal, according to AAP and common sense.

This is exactly how the singleminded focus on one metric (equal wages or bust) goes awry. Both mothers and infants suffer the pressure on mothers to compete on equal footing with males at all times. Is it really that hard to give mothers the space (and financial support) to chose the well being of their infants and of themselves, and accept that course of action will inevitably lead to a small decrease in lifetime wages?

Even the ancients were well aware of the dangers of attempting to equalize everyone to the exact same standard. See the story of the Procrustes bed, https://en.wikipedia.org/wiki/Procrustes

A third of severe influenza cases develop bacterial pneumonia. Which, left untreated, is deadly. I know, because a few years back I developed pneumonia in the wake of a flu, collapsed a lung and almost died. They saved my life in an ICU with antibiotics. If the only metric of relevance is saving lives via medical intervention, prescribing an antibiotic course to everyone that develops cold symptoms is a no brainer. Statistically, such a public health measure will definitely save lives. Taking it a notch further, why don't we just mandate an antibiotic course twice a year for each person, sick or healthy. We'll never lose another life to bacterial pneumonia.

Yet we are very careful to not overuse antibiotics. Why?

https://www.pulmonologyadvisor.com/home/topics/pneumonia/bac...

Let's recap:

1. The proposal is to offer mothers a 12 months leave, at the very least as a social expectation, even better paid by a state run insurance, see e.g. unemployment, to take care of their infant children.

2. Mothers rather than fathers because mammals feed their infants with milk, and milk is produced only by mothers. Human mothers need to feed their infants every 2-3 hours. As long as breastfeeding takes place, simultaneously working a career is pretty much out of the question.

"The American Academy of Pediatrics recommends that infants be exclusively breastfed for about the first 6 months with continued breastfeeding along with introducing appropriate complementary foods for 1 year or longer." https://www.cdc.gov/breastfeeding/faq/index.htm

3. This arrangement will create gap years and have a measurable effect on mothers careers. Specifically their wages will be smaller compared to same age fathers.

Working the chain of reasoning backwards, anyone that axiomatically insists no wage gap should ever be measured between men and women, sadly a very popular stance, is (willfully?) ignoring the motherhood aspect. Men and women are not fully interchangeable.

I don't see where the catastrophizing charge "excluding half of the human kind from the social sphere" comes from. As stated above, there is at least one critical area in life, specifically infant care, where men and women are not perfectly equal. Not being perfectly equal does not imply men and women must be maximally different to the point of "exclusion from the social sphere".

Until we drop the pretense that men and women are perfectly equal, we are going to produce inhuman outcomes. This is not even a new observation, the ancients had the story of Procustes holding people equal by the standard of his iron bed and fixing any deviation from his equal norm via blunt force.

https://en.wikipedia.org/wiki/Procrustes

Agreed, the situation is a mess. Lest we remember that even particle physics, the canonical example for the success of the scientific method, can be subject to systematic bias due to social pressure.

"Decades ago, physicists including Richard Feynman noticed something worrying. New estimates of basic physical constants were often closer to published values than would be expected given standard errors of measurement. They realized that researchers were more likely to 'confirm' past results than refute them — results that did not conform to their expectation were more often systematically discarded or revised."

https://www.nature.com/articles/526187a

Your question: "Why should mothers take care of infants?" A passing familiarity with mammal biology is required. FYI, babies do not subsist on hamburgers and fries.

Admittedly, it is very difficult to have this conversation when some people hold axiomatically that men and women are biologically interchangeable. Unless we can agree to a minimally reasonable set of differences between men and women in the reproductive realm, before and after birth, we won't get very far.

PS. There is nothing "penalizing" in taking care of an infant. It is a fundamental part of life. Some even see it as rewarding.

Perhaps this is a case of metrics getting ahead of reality. Some circles have taken as an axiomatic truth that any disparity in wages between males and females is an intrinsic scandal. Perhaps there are some reasons for that, for example the tradeoff between forcing mothers back into the workforce vs. giving them ample time (order of 12 months) to recover and take care of the new born. For the not parents out there, a new born requires feeding every 2-3 hours. Expecting a mother to feed on that schedule and perform as an employee is inhuman.

FWIW, the vaccine efficacy story is very muddled.

* UK shows negative VE

* US and Germany show 90-95% VE

* Medical literature shows 50% VE at six months and waning

Sadly, there is no longterm RCT in place to perform this basic, but extremely valuable measure. We have to rely on epi data, and epi data is very easy to mess up. I wonder how much of this is due to different testing regimens. Like CDC telling vaccinated people to not test unless symptoms, or UK school guidance instructing, on contact with known covid case, vaccinated people to do a PCR, but unvaccinated people to self isolate for two weeks. Plus copious doses of Simpson, as different age groups have vastly different covid outcomes and vastly different vaccination rates.

Perhaps you mean "90% of covid hospitalizations", which is different than "90% of hospitalizations". I've been checking the jhu pages for various US states, never seen covid hospitalization rates above 10-20% and covid ICU utilization rate above 30%.

Right now, using the Rt map from https://covidestim.org, looks like Indiana & Ohio are in the middle of a wave. Covid hospital bed utilization: IN 10%, OH 15%. Covid ICU utilization: IN 20%, OH 20%.

https://coronavirus.jhu.edu/region/us/indiana

https://coronavirus.jhu.edu/region/us/ohio

Sorry, does not compute. Feel free to do whatever triage you want for the scarce ICU resource. Banning large numbers healthy people form society, of which the vast majority (>99%) will never need an ICU, is something else entirely.

Like many things in life, absolute universal healthcare is impossible. At limit it implies life without death and youth without aging. The utopian ideal must contend with the reality that resources are finite and accept tradeoffs.

ICUs are a scarce bonus, not an entitlement. We are talking denying basic human rights to a large segment of healthy people on the off chance that a tiny percent of them will end up populating the tiny number of ICUs available in the country at some point in the future. What's next: obese people, people engaging in sexual promiscuity, smokers, babies with congenital malformations or simply old people? All of these populations have a higher statistical chance to occupy an ICU bed, so we should just ban them from society? WTaF?

I like NestedText, it's less verbose than anything else for nested data.

"Do you shrug off flu vaccines because they're only effective for a year" Yes, indeed, I don't go out of my way to get a flu vaccine. Flu vaccine effectiveness is underwhelming, 30-40% on average, see https://www.cdc.gov/flu/vaccines-work/past-seasons-estimates....

CDC definition I just quoted: "Immunity: Protection from an infectious disease. If you are immune to a disease, you can be exposed to it without becoming infected."

There is more (and less) to similarity than the shape of the flag. Taking in account economic, geographic and cultural factors, a fair comparison would also consider Germany and Netherlands, possibly also Austria, Belgium, Switzerland and UK. The 'rich germanic protestant NW Europe countries' block. For the nitpickers, Finnish is not germanic and Austria is Catholic, but the point stands.

https://old.reddit.com/r/MapPorn/comments/9jyxqt/gdp_per_cap...

https://en.wikipedia.org/wiki/Germanic_languages#/media/File...

Both: "Immunity: Protection from an infectious disease. If you are immune to a disease, you can be exposed to it without becoming infected."

Before: "Vaccine: A product that stimulates a person’s immune system to produce immunity to a specific disease, protecting the person from that disease. Vaccines are usually administered through needle injections, but can also be administered by mouth or sprayed into the nose."

After: "Vaccine: A preparation that is used to stimulate the body’s immune response against diseases. Vaccines are usually administered through needle injections, but some can be administered by mouth or sprayed into the nose."

http://web.archive.org/web/20210826113846/https://www.cdc.go...

https://www.cdc.gov/vaccines/vac-gen/imz-basics.htm

"For young children, Covid looks like a normal flu, if not a mild one: <US hospitalization rate for 0-4 yo olds chart, covid lower than flu for 9 out of 10 past years>". This is new data. Hopefully in a year or two our media will finally muster the inquisitive spirit to research such data for other age groups. Who knows, maybe we'll learn that covid is like a (mild) flu for most age groups, except past retirement age...

Generally speaking, under 50 populations survive covid fairly well. Under 18 survive almost perfectly, with a higher survivability rate than drowning. Therein lies the problem: we expose the young(er) populations to a black swan event.

Please spend a few minutes to refresh on the data. Some nice dashboards from Singapore (ongoing delta wave), but also e.g. King County, WA (Seattle) shows similar data, though you have to drill down a bit (Demographics tab, then Deaths metric). For example in the past 30 days a total 12 deaths in the under 50 population, for a total of 10% of total covid deaths. Or, since the pandemic started, a death rate of 22/100k or less in all age groups <50, going as low as 0-3/100k for under 30s.

This is not to say that people, especially the elderly, should not get vaccinated if they choose so. It is only a reminder that there is a perception problem around covid and that the long term risk calculus is more complicated.

https://www.moh.gov.sg/covid-19/statistics

https://kingcounty.gov/depts/health/covid-19/data/daily-summ...

Ha. I stopped at the gif with rotating robots.

1. Where do you pick your transmission data from? Are there credible studies? VE is the closest proxy for infecting other persons. Beyond that it is difficult to guess transmissibility, in particular because asymptomatic infections and differences in behavior.

2. I expect a vaccine to significantly (VE >90%) reduce infection probability for at least 10 years. These vaccines ain't that. While I'm vaccinated, I have not signed up for an endless stream of "boosters" every 6 months or so. Probably I'll be declared "unvaccinated" with a straight face and excluded from society in the not-so-far future.

no clear benefit on short term metrics != probably harmful

There is a growing body of research indicating that VE declines over time. After 6 months the vaccines reduce the risk of getting covid by 2x, VEaI = 50%. Not sure where you picked the 10x number.

(OA) US, veterans, 3 months VEaI = 78%, 6 months VEaI = 50%, https://www.science.org/doi/10.1126/science.abm0620

US, 5 months VEaI = 47%, https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

UK, 3 months VEaI = 75%. https://www.nature.com/articles/s41591-021-01548-7

Qatar, 3 months VEaI = 70%, 6 months VEaI = 12.8%, https://www.nejm.org/doi/full/10.1056/NEJMoa2114114

(preprint) Sweden, <50yo, 2-4 months VEaI = 83%, 4-6 months VEaI = 50%, https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3949410

Conspicuously missing the persecution of Kulaks and Christians, among others, in the Soviet Union. Side note aside, some of those historical blights hinge on the choice of religion / ideology. You'd think that choosing the correct gods to worship is a fairly easy choice. Freedom of thought, freedom of religion? Pshaw, the State knows better what the population must think. For the common good, social harmony, the luminous future, etc, etc, etc...

They had to build a fleet of robots to study emergent behavior?! Have they heard of this amazing tool that can simulate pretty much any physical behavior for pennies on the dollars called "computer"?

Delta has been suppressed over the summer in NW Europe. Seasonality played a major role. Winter season is upon us, the dam is bursting.

There is little hope to control the spread in the longterm, especially after delta. Eventually covid will burn through the population one way or another. Vaccines help dull the sharp edge, hopefully this holds moving forward. The other hope is that a population no longer immunologically naive to the virus will be more resilient, that is waves will be rarer and smaller. Sweden may have a head start, for the rest we have to wait for fall 2022.