So true and not mentioned enough by the media. The fact that we lost more than 4000 ICU beds over last year (during the Corona pandemic!!) because of personnel shortage is mind-boggling.
Instead of rewarding those who worked these horrible jobs and maybe attract new workers with better conditions (e.g. more holidays), better pay or tax reduction, our politicians did campaigning and ignored the upcoming winter.
Now they blame it on the unvaccinated and want to force high-speed vaccinating as many people as possible. But it won't help now. And it won't work either because they also messed up the whole vaccine supply chain.
I have long lost all hope in politicians. 99% of them are ridiculous creatures without a spine and only interested in their own progress.
With exponential spread, the actual number of ICU beds really doesn't matter, because whatever you've got will be overwhelmed across a similar timeframe anyway. The only way to actually fix the problem is to get the R-value below 1, which requires mass vaccinations.
The spectre of exponential spread is summoned way too often. Yes, an epidemic spreads exponentially when it starts, but also it's self limiting after a while. The 4th wave is wearing of already. Every wave so far has worn off in every country, with our without measures. As a recent example, compare Latvia and Estonia in the past few months. The former imposed strict measures, while the latter didn't, and yet the two curves match very closely.
Estonia re-imposed strict measures as well because the ICU was becoming overwhelmed. This means mandatory masks everywhere, no public activities without proof of vaccination (restaurants, gyms etc) and limits on opening hours and strong police enforcement of these rules.
The wave started leveling off about 2 weeks after and the rules are still in force.
Mankind has a tendency to not accept what it cannot control. Our politicians and virologists often said something along the lines: "we need to do X to keep control of the situation".
In the end we never were in control of the situation but people cannot accept that.
Most of the measures we took were nothing more than modern day rain dances. Feeble attempts by humans arrogant enough to think they could defeat or control a natural phenomenon that is well beyond ours to control.
San Francisco has had less than 1/3 as many deaths per capita as the US national average, and somewhere between a third and half of the deaths SF did have can be attributed to one terrible policy mistake – re-opening indoor bars and restaurants in fall 2020 – which immediately kicked off 2–3 months of fast exponential growth. If the rest of the USA had been even as fast acting and careful as SF, more than half a million dead Americans would still be alive.
And there are plenty of countries around the world which have done a much better job than SF of testing, contact tracing, vaccination, etc. We can compare e.g. Sweden to other Nordic countries to see what an abysmal failure the Swedish “herd immunity” strategy turned out to be.
* * *
“We haven’t tried anything and we’re all out of ideas” is easy to sell to grumpy people tired of a really shitty year or two, on the back of an unprecedented wave of anti-public-health propaganda, but it is an absolutely terrible pandemic response.
> San Francisco has had less than 1/3 as many deaths per capita as the US national average...
What do you believe this comparison means? I'm not sure its saying much of anything. Perhaps you could come up with another similar sized city, with same socioeconomic/population-type makeup, with same latitude and seasonality profile to compare against?
I'm not familiar with SF data sources on this, but I'm curious if you can provide a source for current IFR? My state here in southeast US's IFR is .012. That includes people who died in car accidents, of poisonings, of falls and other injurious actions while having tested positive for COV in last 28 days. My county is comprised of mostly older folks (median age 44), small at 186K people, and we haven't had a COV death registered in the last 11 months.
>We can compare e.g. Sweden to other Nordic countries to see what an abysmal failure the Swedish “herd immunity” strategy turned out to be.
Can you show some data sources for this? Everything I'm seeing is pointing to Sweden's last 2 flu seasons (encompassing COVID years) showing the same or lower all cause mortality than their previous 15-20 years. With 2018 being the major outlier not just in Sweden but all around the world, for which we still have no explanation.
San Francisco has done significantly better than any other city in the continental USA, despite being one of the most internationally connected, transit dependent, and densely populated. Honolulu is the only similarly successful large US city.
> IFR is .012
Do you mean CFR (case fatality rate)? IFR (infection fatality rate) is always only speculative, because we don’t ever have complete knowledge of the number of infections.
In total throughout the pandemic SF has had ~670 Covid deaths and ~54,000 confirmed Covid cases for a population of ~880,000.
For the same population, the USA average would be ~2090 deaths and ~110,000 confirmed cases. Except those are both dramatic underestimates of the relative numbers because SF has consistently had a much lower percentage of positive tests, and hasn’t had anywhere near the US gap between confirmed Covid deaths and total excess deaths.
0.012 would be too low to be a CFR. That roughly the right number for COVID IFR (maybe a bit too low), which can be calculated in ways that make it less speculative e.g. sero-surveys. Even so CFR is also speculative because so many cases aren't reported: that's the reason IFR exists as a separate concept.
In science you're really meant to use all the data because the problem with this sort of cherry-picking is that it can go both ways. Florida removed all its restrictions and was predicted to become a bloodbath just like they predicted that for Sweden. It didn't happen, results appear to have been unaffected by the changes. Studies that look at all the data find no correlations between lockdowns and COVID mortality (but lots of correlations with other bad problems).
This is the correct take. At this point, since we've already vaccinated the only control groups we had in the trials, we no longer can draw valuable conclusions. The only statistic that we should now rely on, in order to account for all positives and negatives from government's COVID response (vaccinations, lockdowns, hysterics and tantrums) is year-over-year (preferably flu season) all cause mortality, in a specific location, for a specific population.
0.012 is the San Francisco CFR. 0.016 is the USA CFR, if we go by confirmed cases/deaths as reported by the New York Times.
The IFR should be substantially lower than either of these; many deaths go uncounted, but a far larger proportion of infections never get a confirmed positive test. I would guess IFR to be in the 0.004–0.008 range. (Which is still scary high!) I’m sure if you do a search of the academic literature you can find more careful analysis and better informed estimates. It obviously varies from place to place and is substantially dependent on demographics and availability of medical care.
* * *
Florida was a bloodbath! It has had among the worst outcomes anywhere in the USA since mid 2021. Tens of thousands of avoidable deaths after the universal free availability of extremely effective vaccines and better understanding of viral transmission. The state government not only stopped any state-level public health action, it actively prevented state/local public health departments and local governments from acting. It is hard to imagine a more complete failure of state leadership.
Florida has had something like 4x more Covid deaths than San Francisco, per capita. And if we only look at deaths after widespread vaccine availability, Florida has had >10x more.
Of course, the virus eventually burned through a large majority of the unvaccinated population, and without enough remaining hosts to infect, flamed out. Fingers crossed that future virus variants don’t have enough immune escape to burn back through the state again.
>Florida was a bloodbath! It has had among the worst outcomes anywhere in the USA since mid 2021.
Yet, despite being significantly "older" than CA, it did significantly better than CA in 2020 with regards to all-cause-mortality. 2021, seems to be a different story at this point and I'm very curious as to the 10% difference between years (certainly seems to imply the virus has not burned through the population, assuming the virus had anything to do with mortality).
You're right. I dropped a zero by mistake, I was seeing 0.0012 (0.12%) but that's not what was being written.
The usual credible figures I see for IFR are between 0.1% and 0.3% - higher figures tend to be using bad methodologies like including estimates from the very first days of the pandemic when people were trying to estimate IFRs using random Chinese media reports, etc. If you restrict yourself to more rigorous methodologies and sample sizes, IFR falls a lot.
As for Florida being a "bloodbath", lol. That word doesn't mean what you think it means. Nowhere has been a bloodbath, and if there's one thing that's been consistently true about Covid data it's that you can make anywhere seem worse or better than anywhere else by choosing what to compare against. Use all the data and Florida seems pretty good, especially as Europe is busy proving that vaccines appear to have accomplished nothing at all in terms of total numbers, despite the many claims of efficacy.
I do mean IFR. I hope you understand that the CFR numbers you're quoting, are also speculative estimates. :-) Almost certainly the number of infections is vastly undercounted as recognized by CDC's footnotes on their Data Tracker. As of middle of last year, the CDC estimates that 45-55% of all Americans had been infected with COVID.
> CDC estimates that 45-55% of all Americans had been infected with COVID.
If we take 330 million people as an estimated US population, an IFR of 0.012 and 0.44 of everyone infected (CDC estimate from 1 October), that would be 1.74 million deaths. But the number of Covid deaths in the USA is probably only around 1 million (CDC estimate is 920 thousand as of 1 October), putting the US IFR at ~0.006. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...
I’d estimate a US IFR somewhere in the 0.004–0.008 range. We missed counting a significant number of Covid deaths, but we didn’t miss 60% of them. (In US counties with the highest proportion of elderly people, the IFR might locally be closer to 0.012.) But that is still a very high IFR!
Covid is a scary, scary disease. Deadly, highly contagious even before symptoms, and indistinguishable from common respiratory diseases during the part of the infection when most spread happens. Fortunately we have extremely effective vaccines (if only we can convince everyone to take them), and spread takes place almost always between unmasked people indoors making it relatively inexpensive to dramatically reduce the reproductive rate of the virus by avoiding indoor spaces and wearing masks when they are inevitable.
“Covid is a scary, scary disease. Deadly, highly contagious even before symptoms…”
Getting really tired of hearing this. To a HEALTHY human, it’s like a bad cold. Me and my family have had it in the last month and confirmed with tests so I know what we had. It’s gone through a bunch of friends too and the worst they experienced was feeling miserable in bed for a couple of days.
I have no doubt that for some it IS scary, but let’s not chuck around emotive language that isn’t an accurate description in the majority of cases.
Thats just wrong. There are more than enough healthy humans for which it is much more than just a bad cold, which end up in the ICU eventually.
To my understanding it is not possible to know upfront who is such a human and who is not, even perfectly healthy people have bad outcomes.
And yes, I am aware its just a small percentage of people in certain age groups.
Is unknowingly transmitting a disease that could kill someone you love (or even that you don't) without your knowledge not scary to you? Great, you have a healthy family and friends. What happens when one of those friends or family members isn't as healthy as they were the last time they caught covid? Still seems pretty scary to me.
What you may be missing is just how high of a percentage of the population of most western countries are not classed as healthy by any metric. Overweight, unfit, damaged through nicotine or alcohol abuse or even simple naturally occurring diseases where our health systems are able to keep them alive but not make them healthy again.
> In US counties with the highest proportion of elderly people, the IFR might locally be closer to 0.012.)
Yes, I do live in one of these older counties and specifically in my region of the county. Obviously words such as 'scary' are useless and subjective. Anti-biotic-resistant strep nearly killed me 3 years back, so to me, that was a scary disease. The COVID I had was milder than my yearly flu, and this is effect on the overwhelming majority of the population even considering the obesity rate in the US. Scary is not the word I would use.
> But that is still a very high IFR!
I mean, perspective is everything. What are you comparing this IFR to? I consider this a very low IFR, especially when you realize what we in the US classify a "COVID death". We do not count deaths of any other diseases using the same methodology as we have with COVID as far as I'm aware, and I believe this is the primary reason for our inflated mortality vs. most of the rest of the world.
I think it's wrong to describe this as saving people's lives. You have only reduced one particular kind of risk for a short period of time, while other similar risks continue to arise and affect the same people.
Yep… “There’s nothing we can do” is just flatly unacceptable to the majority of the population. That’s when religion gets invented to create rituals to ward away evil.
People who claim that "people don't understand exponential growth" don't understand it themselves, most of the time.
They're so proud that they can answer the question about what happens to the pond that is half-covered by sea lilies the next day but never think about what happens the day after that.
tldr: There is no persistent exponential growth in nature.
not true - infection rate grows sigmoidal and not exponential. that's why at the moment you can observe a stabilization despite few changes in regulation as of now compared to the summer. infection spread saturates periodically after suceptible clusters are depleted.
what would make sense is a steady and controlled Durchseuchung with specific protection of vulnerable people (like old and sick) - b/c the best immunity is gained by infection.
but Durchseuchung never sounded good - that's why that term got so popular. it sounds ugly and brutal. but it's what was happening all the time with many diseases in the past thousands of years.
Even if it was, it still means risking death or permanent organ damage + good chance of passing the infection to others. Not the best value proposition & definitely not webscale.
I think it could be technically accurate, if you include that vaccination before getting infected gives better immunity than most other options. (It is almost like a booster shot, but worse in almost every possibly way)
Also probably true without the vaccine first, but the initial survival rate without vaccination is a lot lower.
Here you can find linked three studies by the CDC that support the idea that natural immunity is harder to get and less effective (besides, as others have said, there's the non trivial chance of side effects or not even surviving the virus)
I don't care about what the "experts" think or say, I care about studies.
Update: https://www.nature.com/articles/d41586-021-02795-x#ref-CR5 reports many studies that claim that we should be vaccinating people after a natural infection to get "super immunity", but that is different from what the OP was claiming (natural immunity > vaccine immunity)
> This article is a preprint and has not been peer-reviewed [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.
That doesn't help if you die of the infection first, and COVID is extremely lethal among the demographics that most need the direct benefits of immunity.
That's a bit misleading. As long as the R value is above 1 the spreading is exponential. That follows directly from how the R-value is defined. What you mean is that the curve will take a sigmoidal shape for a while once the number of immune people has reached a certain threshold. In that case, the R-value is slowly approaching 1 again, and finally will go below 1 (which finally results in a curve that is not sigmoidal, of course). Other measures like lockdowns do the same to the curve, as is easy to observe by overlaying the measures over the curve, just not with an initial increase of cases that leads to hundreds of thousands of deaths. Estimated Infection Fatality Rates during the first Covid wave - where there was full hospital care available - ranged from 0.5% to 2%. So for Germany's 80M people that would be in the ballpark of 400,000 to 1.6M deaths - under medical care. Even if you take the original estimates of around 0.3% the results wouldn't have been flattering.
In a nutshell, the German government and every other country on earth is doing what you propose, except that they are vaccinating at the same time and try to keep the curves flat (but your use of "slow" also suggests this, so it's not clear what else you're suggesting).
That’s one possibility, but there’s no reason it has to converge to 1 (i.e. linear). R(t) = 100/t is also not exponential.
Of course, the epidemic curve described by that function would indeed bounded below by an exponential function on part of its range, but the same is true of any function with positive derivative, and calling for example f(x) = x^2 exponential for that reason makes the term meaningless.
This is presumably what the OP meant by “as long as R>1, the curve is exponential”. But this is literally equivalent to saying “as long as f’(x) > 0, f is exponential” which is just not a useful concept.
You're nitpicking out of context, I didn't give a definition of an exponential function, I was talking about the spreading of the Covid 19 disease. For example, the R0 value of SARS-CoV-2 was estimated 5.8 in the US and "...between 3.6 and 6.1 in the eight European countries"[1] Obviously, it depends on many factors like population density and contacts of persons/day, but generally the disease will start spreading exponentially with R_t values approaching this number or staying constant.
The initial spreading will be exponential in the beginning - as every actual curve illustrates - if the disease is left unchecked as OP suggested, until R_t values go down again due to immunity. That's all I meant to say.
Can you explain the difference between a function being "exponential in the beginning" and "having first derivative bounded away from zero at the beginning" ?
exponential in the beginning == this part of the function can be approximated by a function ae^xb where a>0 and b>1
vs.
first derivative bounded away from zero in the beginning == any function that increases, including linear functions with constant first derivative and polynomials with linear first derivative
Or do you think all increasing functions are the same..?
Consider for example the functions f(x) = x + 1 and g(x) = e^{ln(2) * x}. Then f(0) = g(0), f(1) = g(1), and f(x) > g(x) whenever 0 < x < 1.
It is easy to show that for any function whose derivative is continuous and positive at 0, there is an exponential function (properly translated such that they agree at 0) that has similar properties.
You should be specific about what properties you're talking about. What you're saying is that any function increasing function grows faster than some exponential function on a finite interval.
Still, you can observe f(x) on x ∈ [0, 1] and see that it is growing linearly.
And you can observe g(x) on ∈ [0, 1] and see that it is growing exponentially.
I do not see the value in discussing the rate of exponential growth of f. Where as for g, there is a parameter with value ln(2).
If data looks like f, don't try to fit an exponential function to it (whether it's a least-squares fit, or any other objective f > g.
Exponential implies a doubling of R value. Starting with an R value of 1.1 the length of time required for doubling of the infected population is longer than other factors which will lower the R value to under 1.
If taken literally, how is that supposed to work? People working for the emergency service still need to work, and they certainly can't work from home. Same for most of the medical sector, nursing services etc. and of course the various bits of infrastructure. Some industries cannot be easily shut down (you cannot stop or start a steel works on a whim). Most people involved in food production, too. Maybe you can blame people for not keeping at least two weeks of provisions (although blaming them won't change anything), but expecting them to go six weeks without buying any food or other provisions is certainly unrealistic. Things break, and not all of them can be left for up to six weeks to be fixed. (If your fridge breaks, or the heating breaks or your roof springs a leak, that cannot really wait. Same if things break in any of the critical industries and services that cannot be shutdown and need to keep working). All this residual activity still needs some amount of transportation and all the infrastructure that that entails. Etc.,etc. …
Why doesn't the same argument apply to other corono-viruses like influenza and the common cold? And why ignore the role of asymptomatic people (who can transmit) and those with symptoms so mild they can't be distinguished from the normal ups and downs of bodily functions. How then can one be 'smart'? These diseases wouldn't be and won't be gone. We are going to have to live with them as we've lived and thrived with untold thousands of viruses throughout our evolutionary journey.
There is also a small subset of the population who doesn't build an immunity to the disease. A friend's mom caught Covid last December before a vaccine existed. Her body isn't creating antibodies so -- as of the last time I texted that friend -- she's had it for at least 8 months. She was an incredibly friendly and social woman who has basically been turned into a Typhoid Mary that does experience Covid symptoms (and has intensely self-quarantined).
I don't know how many other people this has happened to but I too have my doubts as to whether there was ever any hope of containing this.
The mRNA technology would let us inject omicron-specific boosters tomorrow, but then there is a lot of other safety hurdles that have to be met before it gets authorized and then distribution hurdles to convince people to take it…
Mathematically, we will get to R=1 this way, some day or another, with some percentage of people getting it via illness and some via vaccination. The choice is still ours on how and when.
At some point the classical ones are available that are not vector or mRNA vaccinations. Although there is still skepticism regarding duration of the protection.
> At some point the classical ones are available that are not vector or mRNA vaccinations.
So you say that at some stage there will be vaccines for COVID-19 that are not nMRA (Pfizer, Moderna) or Viral vector (AstraZeneca)
Why? The people who are happy with vaccines are fairly happy with these vaccines and might refine them, but not about to dump them entirely for a different technique. in fact mRNA vaccines are the new hot thing.
And the people who really aren't happy with these vaccines, will never be happy. They'll find a way to object.
So what's the incentive for such a classical vaccine? Who's going to root for it?
And those will likely also not be "classical vaccines".
Moderna and Pfizer (1) and AstraZeneca (2) are getting ready for the next round, still using their current technologies. They're not planning on going back to "classical vaccines" for COVID-19.
I can't believe people still think after 2 years we're at a point technologically and logistically that we can control nature and just make this "go away".
Delta came out of India. Omicron came out of South Africa. How do mandates in the West stop variants elsewhere?
And variants aside, the vaccinated are still getting sick and dying at significant rates [1]. This vaccine is not the slam-dunk our "experts" promised. Until some miracle cure comes along, R < 1 is simply not possible.
If you think full vaccination is a necessary goal despite all this, OK fine. You know what might go a long way in terms of achieving mass vaccination? Open sourcing the vaccine recipe. Not just the RNA sequence. The whole recipe.
This should be a no-brainer.
Governments have no qualms with mandating lockdowns, masks, and vaccines for the masses.. but for some reason they hit the brakes when it comes to mandates for pharma. Not only is this a good idea in terms of improving supply side logistics, but also for the sake of re-building trust.
But no, common sense is too hard and "blame and shame" is too easy.
Being unvaccinated does not harm the vaccinated.
Hospital collapse has been liminal for 2 years now, it's a manufactured crisis. Instead of bolstering our healthcare staff and paying our front line workers more, we have done.. the exact opposite. We funnel tons of money to pharma, while frontline workers have effectively had their pay cut in half.
We're quite literally being force fed lies. But I guess that doesn't matter because at the end of the day the Milgram experiment prevails and all these attempts to question the narrative and hold authority accountable is pointless.
> Being unvaccinated does not harm the vaccinated.
This is, on average over large numbers, not correct. Higher rates of disease spread harms everyone, the vaccinated included.
> This vaccine is not the slam-dunk our "experts" promised.
Which expert promised you that?
> it's a manufactured crisis ... We're quite literally being force fed lies ... Milgram experiment ... question the narrative
Cranks write like this. That is a shame as some of your other points are very correct, particularly around the need for Intellectual property waiver, which some have been calling for for some time, to no avail (1). BTW, they don't generally call it "open sourcing" in that field.
Hospitals genuinely are in crisis and doing difficult triaging, anyone working in them can tell you that.
> Moderna's chief medical officer, Tal Zaks, said last month that he believed it was likely the vaccine would prevent transmission but warned that there was not yet "sufficient evidence" of it.
> The Centers for Disease Control and Prevention on Thursday walked back controversial comments made by its director, Dr. Rochelle P. Walensky, suggesting that people who are vaccinated against the coronavirus never become infected or transmit the virus to others.
> Cranks write like this.
Apologies I'm new to being a social pariah, being under pseudo house arrest, and psychosis in general.
I don't want hospitals to collapse. I'm afraid if we give up this freedom now, we'll never get it back. I'm afraid of the unknown and putting my life in the hands of people (our dear leaders) that really have never cared about my health before.
Even now its not about care for my own health, but for "the greater good".
I can only speak about where I am (UK) but the health care crisis is a complex topic, but there's no mystery at all to why it came about: decades of under-investment are 100% predictable given the party that has been power for a while now. It's what they always do. People should not be surprised that their votes have this obvious consequence.
But there's no easy fix to help us now, because it takes a long time to train doctors, nurses and other staff, or actually build hospitals. Yes, the crisis is entirely predictable but also entirely real. It is possible, even likely for a "liminal" crisis to persist at that level, as the safety valve that keeps it there is that patients without sufficient care just die off. These are the "excess deaths". Yes, I am appalled.
This is BTW one way how "Being unvaccinated could harm the vaccinated": If I (very much vaccinated) need urgent treatment for any reason, and can't get it because all the beds are full of unvaccinated COVID patients, then I am harmed thereby.
If your main concern right now is the "freedom" implications and the "we've been lied to narrative" not the actual deadly pandemic then you have been misdirected, and should reconsider your media diet away from conspiracy-mongers.
Yes, we need to take the good of others into account. Like it or not we live in a society and our actions impact others. This pandemic is making it clear to those who can see, that stubborn selfish refusal, and paranoid anti-mask and anti-vax "freedom" rhetoric harms not just yourself, but also those around you. Rugged individualism is a complete bust in this context. Collective action is what works.
Sure, this is a general problem with finite limited resources that are collectively owned. The more you have, the less I get. When demand exceeds the supply, harm is unavoidable. And yes we should do what we can to drive down the demand, but I don't see what that has to do with forcing restrictions on people that are not at risk?
This deadly pandemic is not deadly for everyone.
People over 50 make up 1/3 of the population but 93% of covid deaths. I imagine this number is roughly proportional for hospitalizations by the same age groups. We can do some handwavy math and say if everyone under 50 was unvaccinated, they would only ever take up 7% of ICU beds.
Is 7% the difference between collapse or not? "One size fits all" doesn't make sense.
Further, I'm so confident I will never get sick and be hospitalized with covid that I'm happy to forgo my right to an ICU bed. Thus I'm decoupled from the dilemma. Or at least in an ideal world I would be able to make that choice. This was my assessment the first time I got covid, and now I likely have some level of immunity, so I'm even more confident now.
And as far as your hospital scenarios go, my point is we haven't seen the things you describe materialize. I'm sure there are a handful of cases, which is a tragedy, but if it's marginal then we shouldn't hold it up as a liminal crisis like we have been.
> Yes, we need to take the good of others into account. Like it or not we live in a society and our actions impact others.
Tell me the magic number for risk tolerance. If everyone self-quarantined from driving, and we switched to a delivery only economy, we could drastically reduce the number of motor vehicle fatalities. Do we not owe that to the greater good? What about for climate change? We should continue living like we did in 2020 forever.
> Collective action is what works.
It always works when your leaders are competent and have your best interests in mind. My country doesn't even recognize natural immunity, which I envy the UK for.
But free choice works too. Look at Florida, Sweden, people will still choose the vaccine. You don't need a mandate.
> If your main concern right now is the "freedom" ...
I can't believe the "vaccinated" are completely unconcerned by the trends regarding freedom right now.
You know its not an either/or situation, you can be concerned about both, right?
Look at Howard Springs Australia. Look at the vaccine passports. Look at the thread you're posting in. You probably think you're exempt. But immunity wanes, and variants will continue to emerge.
Governments never relinquish their emergency powers once they're enacted. This is just the latest "WMDs in Iraq". I can't speak for the UK, but in the US we still have the patriot act, and we just recently pulled out of Afghanistan.
20 years later we still live under the boogeyman of terrorism. Imagine if all the money we put into the war on terror went into better healthcare and other social goods?
All of this is to say, I don't have absolute trust in the vaccine or the plan or the people in charge, I don't trust them to make good decision nor to be honest.
If you want me to be onboard with "the plan", governments need to tell me
- What's in the vaccine.
- Exactly when they'll declare this over.
- That they'll undo all of their emergency powers afterwards.
Otherwise, just like the war on terror, this will never be over no matter how much we comply.
There are so many questionable things in this rambling waffle that it's hard to know where to start.
The idea that most people "not at risk" is wrong.
The idea that collective action is all about trusting government is wrong, it's primarily abut supporting the other people in your community. it's a very USA'ian line of thinking to jump to "Imma screw over my fellow citizens because the government can't be trusted. Freedom!".
The idea that Florida and Sweden are good examples is wrong.
And as above, the idea that the "freedom" implications and the "we've been lied to narrative" not the actual deadly pandemic is wrong. Do not confuse the one crisis (of democratic ideas) with the other (of infectious molecules) or your responses will not be appropriate. They operate at completely different levels of abstraction.
The idea that "we haven't seen the hospital scenarios you describe materialize" is, in my local area, wrong.
> Look at Howard Springs Australia. Look at the vaccine passports. Look at the thread you're posting in. You probably think you're exempt
I have no idea of the point you're trying to make, and please to make no assumptions at all about me.
I googled "Howard Springs" but I have no idea what crazy talking point I am supposed to be nodding along with now.
> governments need to tell me - Exactly when they'll declare this over
You can't vote on the virus's timeline. The only politicians who have tried to declare "it's over" are charlatans.
> governments need to tell me - What's in the vaccine.
Do I need to go into the reasons why this is paranoid delusional, confused idiocy? Governments don't design or manufacture the vaccines. Without a bio-medical background that you and I both lack it's just not comprehensible. And lastly, can you not google the layman's explainers and research papers? I understand why you didn't post this line alone in a comment - it would be flagged and deleted.
All in all, I feel like someone at a party who has engaged a stranger in conversation, and now regrets it, as they speak a lot but say absolutely nothing worth hearing.
Most people are "not at risk" in a sense that their risk is clearly much less than for others. There is no zero risk of anything, so we should not aim for that.
It would help if you explained what is wrong.
As it looks now, you just don't like what the stranger said and declare him not worth listening.
To me it is clear that vaccine passports is clearly not working and all this has become a big failure for politicians who don't know how to exit this failed strategy therefore double down on their plans.
Are you saying that we shouldn't vaccinate, because strict lockdowns worked, against the COVID-19 original strain, for a while?
It's technically true that this worked then, but 2020 is gone, not to return. a) new COVID strains were inevitable and b) prolonged strict lockdowns unpalatable and c) mass vaccination has a huge benefit. As part of a multi-pronged strategy, of course. Depending on only one measure, be it lockdown or vaccination, is not going to work.
I might be working from old info here but my understanding is that vaccination reduces the ICU burden. Assuming that's still good info, is it totally unreasonable to blame the unvaccinated for ICU overload?
Vaccination does reduce the proportion of people that need ICU beds, but there are pretty rapid diminishing returns on just vaccinating more; countries have reached the point where the majority of Covid patients in their ICUs are vaccinated at well below 100% vaccination. Also, vaccinating younger lower-risk people doesn't help because they're at substantially lower risk of needing the ICU even unvaccinated than someone older or higher-risk who is vaccinated and because the vaccines aren't really useful to stop the spread of the disease either. Countries have generally had significantly higher vaccine acceptance amongst older people who need it more. (Though I think one of the big problems Germany has is their vaccine uptake amongst the elderly is somewhat low compared to other countries.)
Right now in my province, unvaccinated individuals make up 11.2% of 12+ population but more than 66% of hospitalizations. I don't expect the ICU rates to be more favourable to the unvaccianted than total hospitalization rates. If there is a point of rapid diminishing returns, it is not at ~90% yet.
What do you mean? The immunity doesn't kick in the second the vaccine is injected into your arm. How else should they count vaccinated vs unvaccinated? (Also note that there is a category of partially vaccinated in the stats that is people who have only received the first dose of a two-dose vaccine).
These stats do not show the difference between taking a shot but still being infected within two weeks after it, and not taking any shots at all and being infected. If you're going to blame the second group for filling up ICUs, you cannot lump them together.
Protection from hospitalization and death, particularly in under-65 or so, does not wear off. Neutralizing antibody levels naturally wane and can allow infection, T-cell and B-cell populations don't (unless you get infected with measles or have some other conditions, and assuming you form a robust T-cell response to begin with and aren't immunocompromised or just quite old).
I think the vaccine is probably as effective as two doses of a laxative.
Any 75+ year olds that survived the two doses of the laxative, will now have better outcomes against covid.
Keep in mind the effectiveness is measured in tens/100,000. An there are some very sick people given the vaccine, that die before the 14 days of the second dose.
> countries have reached the point where the majority of Covid patients in their ICUs are vaccinated at well below 100% vaccination.
Which countries are you talking about? It's certainly not the case for Germany, and I don't know any other European country for which this would be the case.
You make a good point re vaccinating lower risk patients. In the UK, not only the population has a high vaccination rate, but the rate is particularly high among the population at risk (~95% for the >70yo [1]). As a result, hospital cases and deaths are a fraction of the Jan 2021 peak, even though infection levels are high.
> countries have reached the point where the majority of Covid patients in their ICUs are vaccinated at well below 100% vaccination
Which countries? I find it hard to get data at vaccination prevalence in ICU population specifically, but in Switzerland, the figures I see cited is 60-70% of patients unvaccinated (With 90% of 80%+ year olds in the population being double vaccinated).
Well yeah, for 80+ with a vaccination rate of 92 %.
If you look at the total value, it appears that only 11 % of hospitalized are double vaccinated, though the latest seven day average puts that number at 27 %.
I was just giving a number consistent with the 80+ vaccination rate quoted.
For the broad population is 28% vaccinated vs 57% non-vaccinated. The remaining 15% is "unknown". But Switzerland has a relatively low vaccination rate at 67%.
Edit: looking at deaths instead of hospitalisations in the broad population:
Yes, those are the numbers for _hospitalizations_ in general, but the higher percentages I've been seeing (and for which I've been unsuccessful finding official documentation) are for _ICU_ patients specifically.
Right now, young people take the "booster shots" that should be given to the elderly, first. Politicians will be very proud that "XY percent of the population are already boostered". The dying will continue.
I dropped in to a local clinic this week to get my booster (no appointment, even) and was given the shot in about 15 minutes. Most of the other people there waiting looked relatively young. Seems that we're doing a terrible job of reaching out to the elderly to get them their boosters. Or they just don't want it.
Yes, and this is another example of the really bad management skills of our government. If you announce the wrong KPIs (XY percent vaccination regardless of personal risks) you might be performing great according to them and still fail miserably on your actual goals.
Which country is that ? Here in Czech Republic there is clear priority for 60+ years for the third doses. Also a big vaccination drive based on volunteers to vaccinate ideally up to a milion eligible people with the third dose till Christmas.
Here in Berlin for example, in the first week of september my 85 year old grandparents received a booster shot invite letter from the Berlin senate. It said something like starting 20th september you can get the 3rd shot from any doctor or you can go without an appointment to a vaccination centre across the city.
what did they do? nothing because case numbers were low, I did push and push to finally get my grandpa to get is 3rd shot mid november while go to the doctor for something else... by coincident the rush to get the booster started 1 day after that.
I bet this happened a lot....
As far as I know just like for the 1st shot sverybody above 70 got that same letter. Meaning they had more than 2 months head start to get the boostershot.
So at least in Berlin I wont have sympathy anymore for taking away the shot from somebody else (got my appointment in january)
It is not totally unreasonable but there is a component of blind blame to it. It will become a discussion after the pandemic and I don't think this will be too beneficial for our public health care system and health insurance.
No, that isn't the biggest issue. The ICU is the last resort, it's the point where we throw incredible amounts of effort and hardware at the problem to gain a chance of still saving them. And even then 50% still die, and others likely will have permanent damage from the severe course of the disease.
The biggest issue is that not enough people got vaccinated.
Vaccinated are still being hospitalized. How much longer will you buy into the narrative that they are not when so many countries are showing evidence to the contrary.
Vaccines reduce severe courses of the disease by about 90%. The number vary depending on what you look at exactly, and for elderly people boosters are really mandatory to keep the vaccine effective.
Reducing the number of severe cases by a factor of 10 is very from from not working.
>Vaccinated are still being hospitalized. How much longer will you buy into the narrative that they are not when so many countries are showing evidence to the contrary.
What "narrative"? What are you even talking about?
No-one, including the person you responded to, has claimed that vaccinated people can't get sick. The claim (backed by statistics) is that the unvaccinated are being hospitalized at a much higher rate and for a much longer duration.
You're arguing a point that no-one is disagreeing with.
True, unvaccinated people are being hospitalized at a higher rate and for a longer duration.
However, we are not talking about "the unvaccinated", rather about "a tiny unfortunate fraction of unvaccinated people". There are 4,690 covid patients in ICU beds and 25M unvaccinated people. Assuming all covid ICU patients are unvaccinated, the covid ICU incidence rate within the unvaccinated population is 0.02%.
For an analogy, we could reason that because the prison population skews 90/10 male/female, all males should either undergo a vasectomy, or pay a recurring 10k euro fine. I hope this is obviously unethical.
Your prison thing is widely weird and not sure at all how you relate those two.things.
Yes the point is to make sure that those ICU capacity which is very small and normally enough would and is struggling due to covid and vaccination helps.
Vaccine mandates enforced by heavy fines and/or prison are criminalizing being unvaccinated with the number of "boosters" the authorities deem necessary. Justified by group "crime" statistic differentials. We may argue that it is done in service of a good cause, but it is still criminalizing. Our weird reality.
Sure, but how many vaccinated people are ending up in the ICU, compared to unvaccinated? How many are dying?
Also consider that a population of 100, and 90 of those people are vaccinated. Uf 15 vaccinated people end up in the hospital, and 5 unvaccinated people also end up in the hospital, vaccination is still clearly better for you. But people will still say "75% of the people in the hospital were vaccinated; clearly the vaccines aren't working!" Yeah, well, out of vaccinated people, only 16% ended up hospitalized, while 50% of unvaccinated people ended up hospitalized. Those are the real numbers that matter. Percent of cohort hospitalized, not percent of total hospitalized.
Singapore does a great job of testing and the vaccination rate is >95% for the eligible population. Despite that, they have introduced restrictions due to ICU overload.
Look at "Proportion (%) of cases ever critically ill in ICU or died, by age and vaccination status"
Looking at the high risk group of 80+ year old (43% of all ICU cases and/or deaths), the numbers are: unvaccinated (24%), partially vaccinated (16%) and fully vaccinated (3.2%).
They don't define partially vaccinated (typically 14 days after 2nd dose). So clearly the vaccine reduces the risk of ICU/death, but the "truly" unvaccinated make up only 50% of ICU cases in that age group.
From all the local reporting the overwhelming majority of people in Czech ICU are not vaccinated. A few examples - listing from a hard-case ICU in Ostrava for a week in November:
The last 5 patients are those that have been released from the unit in that week.
The first two were move to less severe case ICU. The last three died...
Training an ICU nurse takes about 5 years. The only realistic option during the pandemic would be to encourage immigration of ICU nurses from poorer countries, but that just moves the problem elsewhere.
How long does it take the army to train a field medic? (Serious question, I don't know if there's some extended training involved, I just assume it's far less than, say, a nursing degree.)
I think that training people to handle 90% of the issues you see in Covid-related illnesses could be done relatively quickly, if we wanted to do that. The ICU bed shortage really refers to a ICU-staff shortage, and anything we could do to relieve that burden would be a good thing.
Modifying the procedures and allowing people to work before they're through arbitrary redtape does. The EUA the vaccine received is the same concept. The reason the vaccine was developed faster wasn't just the number of scientists working on it, but the amount of funding directed towards it. Increasing money to education programs would increase the amount of people they can train, allow for further optimizations to be developed etc.
I have a suspicion that ICU training for a COVID specific nurse could be much shorter - if there were any will or basic common fucking sense among policy makers, and if there were fewer people making excuses for those who ghoulishly and cynically privatized healthcare for profit across the Western world.
A "COVID specific nurse" still needs the entire slate of training that goes with respiratory disease, inflammatory disease, etc, and all the secondary complications that come from those.
Then train 3 nurses in respiratory disease, inflammatory disease, and secondary complications separately. Put them under an experienced nurse, and incentivize them to add to their skills when they're not working.
Look at the sheer difference in numbers of healthcare professionals between America and Cuba. If they can do it even after decades of cruel and unusual sanctions, we sure as fuck can too.
Well, mistakes by ICU personnel can easily kill - and that's on top of a significant, often >50% death chance for covid ICU patients. Better make sure the people don't get as far as getting intensive care in the first place.
But it seems strange to realize that people don't want to do a job where you have to watch people die like flies over the course of two to three weeks. No money in the world makes that acceptable for many.
With the availability of the vaccines (at least in the developed world) this has become a pandemic of the uninformed know-it-alls ("Querdenker" = Crooked thinker, as they are call here). If you work on an ICU to rescue people that tell you that this is all a scam by the Pharma-Industrial Complex, you would want to quit.
It is not the media's fault where we are now, nor are the politicians (entirely) to blame. At least half the blame should be frankly put on social media disinformation and the usual tabloid press (Springer/Bild) that fabricate Fox-News style lies.
If the problem in Germany is anything like in Sweden, then the issue is not that "people don't want to do a job where you have to watch people die". It is 100% a lack of funding and poor management.
In the last 20 years the standard "joke" (ha ha, only true) about the universal health system is that you need to be in good health in order to have enough energy to fight for your right to get help. The health care debt was an all time high at the start of the pandemic, and has since sky rocketed.
The faults are many. Poor wages has create many empty seats at the university programs. A lack of available personal has created a demand for labour hire employees, creating a system where many are moving to those in order to get pay rises, furthering increasing the cut that the middle men takes. An sharp increase in populations has increased demand, without any corresponding supply or funding. Employees has had an increase in paper work, with technology solutions that has caused additional work rather than optimized the work flow. Those same technology solutions has also been expensive to the point of corruptions, with some deals being actually corruptions that gone to court.
The situation is so bad that my own health clinic is sending every patient that calls them on non-mondays to the emergency department, as they are by law required to redirect the patient somewhere and all their own doctors are booked for the rest of the week, a pattern that been going on every week for the last year. Vacations has been removed as an emergency decision at many hospitals, and in one case the "compensation" for lost summer vacation was a fruit basket.
The expected time frame to raise the standard and actually train enough workers, as calculated by researchers a few years ago, was (if I remember right) somewhere around 10-20 years into the future. One pre-panedmic solution was to encourage skilled immigration directly from hospitals of nearby countries, a fix that obviously is not going to work now. If Germany is anywhere similar, then the blame isn't disinformation. It is systemic problem that has existed for decades and is now being pushed to over the edge.
I'm in a Berlin medtech company closely related to GPs and have multiple other connections to area hospitals. From this perspective I would say everything you've said is entirely accurate for at least this part of Germany, if not the whole country.
It's really a shockingly well kept secret, especially to the outside world. Much like the utterly dysfunctional rail system.
Before the pandemic, I would have said that the country's healthcare system was about a decade away from resource-crisis. Now, it may have already started. I'm terrified of ending up in a hospital, even if there's no covid-wave ongoing. I do not want my life in the hands of the overworked traumatized remnants.
The way this country treats healthcare workers is shameful.
This is seeking someone to blame honestly, those "Querdenker" didn't influence anything else but themselves. The truth is we always had a form of triage in emergency admission rooms even before the pandemic.
Media and politics are way more responsible than the craziest idiot.
It's quite interesting that the main tabloid here in Czech Republic is doing very solid covid reporting - still kinda in the personal stories people can relate tabloids do - just this time telling stories of people severely ill with covid, mostly unvaccinated or interviews with medical personnel about what their hell looks like. Frankly I did not expect that from them and I'm sincerely hoping it helps at least someone to stop believing in bullshit.
You can't have people who are not vaccinated working at a hospital. This has been known for years and has been practiced for years. Vaccinations prevent the spread of disease. Surely you aren't questioning this.
Before the vaccine (less than a year ago) they prevented the spread by using n95 masks and ppe.
Knowing that the vaccine doesn't prevent the person from getting and spreading covid. Knowing that the point of the vaccine is to prevent serious illness in the person receiving it. I struggle to understand why you would not even question how important they are in that setting unless you are worried they have dropped that extra safety component.
No, they really didn't. Healthcare workers got COVID in large numbers, causing severe absenteeism, a number of deaths, and many with ongoing Long Covid conditions.
It's part of the reason that bed capacity has been so difficult to keep constant or increase.
>Knowing that the vaccine doesn't prevent the person from getting and spreading covid.
Vaccines reduce the risk of spreading the virus. People who are vaccinated are less likely to get seriously ill. This absolutely doesn't mean you won't die if you are vaccinated. Think seat belts in car accidents. It is all about reducing risk. On mass, at population levels, this means ICU have capacity to take in other seriously ill people. If ICUs are full and there is a plane crash or whatever where many people are seriously injured we are screwed.
People who get vaccinated are less likely to get seriously ill. Seriously ill people withdraw from society. Those with mild illness continue to go out into society and increasing the spread.
You could make the point that increasing the spread when everyone is protected is fine but that allows for increased mutations.
I'm sure what you are saying is true but it doesn't really address the problem at hand. The bird has flown the coup and now action needs to be taken to save lives.
Absolutely agree with you about hospital/medical resourcing though, we have the same situation in Australia. In the name of efficiency these services get paired to the bone, and we have no capacity to respond to unusual events.
The Neo liberal worldview posits that redundancy is bad. I think Western countries in general are suffering from this Anorexia. It cripples innovation as well.
Not getting vaccinated is not antisocial, assuming that those people take care otherwise.
The only people which exhibit antisocial behavior are those that don’t care about protecting themselves and others from infection. Wearing a mask, avoiding meeting others and getting tested is just as valid as getting a vaccine. Perhaps more, because those that do get vaccinated (at least among my acquaintances) seem to wrongly assume that the vaccine is enough and don’t take any other measures except what they must (masks). So they’re meeting in groups, going to restaurants without getting tested, etc.
> Not getting vaccinated is not antisocial, assuming that those people take care otherwise.
Take care like what? Be locked up for years and not meeting anyone? Because everything else is much more risky than just taking the damn jab and stfu about it.
Also: those people who still are unvaccinated are mostly conspiracy nutjobs and don't give a damn about the rest of the population around them so it's quite obvious they wouldn't give a damn about "taking care".
For someone that's unvaccinated, on the young side that works from home and doesn't (actually can't) go to bars/restaurants/etc the risk is already low. They can only get infected outside or while meeting friends.
How do you know they're nutjobs? Everyone I know that's unvaccinated are normal people. This is just what the media and politicians are saying without providing any proof.
This is sadly very typical behavior at this point. You don't have to fear unvaccinated people, the protection you get is from the vaccine alone. What you might want to fear is a triage for which healthcare funding is solely responsible. Perhaps unvaccinated take up more beds, I am not really sure we can trust the data though because there will be insane political pressure to keep that on the message.
I hope blaming people not at all involved in current miseries becomes a popular sport again.
Not locked up. My wife, and most of our friends are either RNs, MDs, PAs, etc.
We've had COVID. Now my wife is dealing directly with people who are dealing with adverse reactions to the vaccines they took (many of them nurses and doctors themselves experiencing neurological symptoms continuing for months and months at a time, and not allowed to speak about it for fear of losing their licensure).
I only ask because it seems unreasonable to me to fear a virus that only meaningfully impacts .3% to .5% of your population. So, why not answer? Why are you afraid of the unvaccinated?
This is utter conspiracy bullshit. Neither would anyone lose their license about reporting side effects nor are those in any way so prevalent that your wife would be dealing with multiple amounts of them nor are they in any way close to as severe as the effects of COVID and long COVID.
You're lying and the fact that you seriously think any sane person would believe this is both hilarious and sad as it's a very beautiful example of this covidioten movement we have to deal with.
You broke the site guidelines egregiously in this thread and crossed well over the line where we would ban an account. Not only that but you have a long history of doing this.
Not only that but it looks like we've had to ban you in the past. All this is seriously not cool, regardless of how right you are or feel you are.
I'm not going to ban you right now because it doesn't look like you've been doing it recently, but please review the rules and stick to them from now on, because if you keep doing it, we're going to end up having to.
You also broke the site guidelines egregiously. We ban accounts that do this sort of flamewar on HN, especially when it's the tit-for-tat nasty sort of flamewar like this.
It also looks like you've been using HN primarily for ideological battle and that's also a line where we ban accounts. Please review the rules and stick to them from now on: https://news.ycombinator.com/newsguidelines.html.
Fair enough. How do you/HN define "ideological battle" so I can have some frame of reference? I'm largely reporting on things I'm either seeing, experiencing, or that friends and family are seeing or experiencing. Often, it is in response to some ridiculous (in my opinion) mass-hysteria from other posters. I feel it's imperative to show experiences other than the 'common' one. I'm also curious why you would be willing to provide ammunition in these so-called "ideological battles" by banning accounts? By all means, this is your house, so your rules...ban if you must.
Instead of rewarding those who worked these horrible jobs and maybe attract new workers with better conditions (e.g. more holidays), better pay or tax reduction, our politicians did campaigning and ignored the upcoming winter.
Now they blame it on the unvaccinated and want to force high-speed vaccinating as many people as possible. But it won't help now. And it won't work either because they also messed up the whole vaccine supply chain.
I have long lost all hope in politicians. 99% of them are ridiculous creatures without a spine and only interested in their own progress.