This is the thing that drives me the most nuts about so many people's reactions to this disease who treat infection as a binary: You die or you don't die and the latter is just as good as not getting it, ignoring the (a) social/medical/emotional costs of a person being sick and (2) the fact that we have just been learning about the long-term effects of infection. From the beginning I've been worried that we're going to see a generations-long impact on overall health just from people who were infected and then "got better." There's so much unknown about this disease but we've let a bunch of politicians and cable TV/internet/podcast hacks claim that it's not serious so that a significant fraction of the population ends up actively spreading the disease and providing reservoirs for it to mutate.
The thing is, I’m not sure preventing the spread is realistic. Unless you move to the country or to outer space, and never receive any mail or goods, you will always be in contact with, or in the vicinity of, something that has been in contact with, or in the vicinity of, someone else.
It wasn't always the case. Time and time again the US government in particular chose the economy over people's lives. Or even people's live over having to do something.
Counties like S. Korea, had bold actions like contact tracing and lockdowns. Many many countries covered pay for folks to stay home. The US initially had a lock down then just quit acting really.
Sure, preventing ANYONE from getting COVID was unrealistically, but preventing most people from getting it was always possible.
> Counties like S. Korea, had bold actions like contact tracing and lockdown
I was in South Korea from March-June 2020, there was no lockdown in South Korea. The only serious restriction was the 2 week quarantine required to enter the country. Businesses and everything were open just as usual - I was eating out at restaurants and working out of coffee shops everyday. Hell I even went to an amusement park one day (ok that did end up shutting down a week or two later when it was discovered that someone who had tested positive had been there).
Meanwhile my family in the U.S were under lockdown not allowed to leave the house without an excuse deemed acceptable by the government, shocked that South Korea was life as usual despite having such a low case count.
I do recall reading that South Korea does not kid around with it's contact tracing, which was the reason why it went from flareups with the night club patrons, to having things under control.
In comparison, countries like Canada (which I'm in) and US, does a half-hearted job in contact tracing.
We rolled out the COVID Alert app, which is supposed to balance privacy concerns with the need for contact tracing, but now with Omicron burning through all the provinces, most have shifted to only PCR testing people in high-risk groups. And having a PCR testing from public health is the only way to get the one time key to fire off the alerts.
North America could barely get masks going, paid lip service to contact tracing...
South Korea released propaganda, which you bought, and are still buying years after seeing empirically that it makes no sense.
Australia implemented absolutely dystopian contact tracing decisions, countrywide lockdowns, left its citizens abroad, and it's still clear that every single person in that country is going to get COVID. It will be endemic, just like it is everywhere else. Even worse, the country has by-and-large taken a vaccine which gives them resistance to a spike protein that is not the most common in today's COVID cases. Recent (simian) experimentation has shown that the Omicron booster is not effective for previously vaccinated individuals.
You will not see long term differences in outcomes between Canada, the US, and countries like South Korea or Australia. Our measures did not work, do not work, and are exclusively security theater. Countries which 'have things under control' are either extremely ruthless in their lockdown and travel approach, and have deferred pain, or are lying on the numbers.
I don't think it's fair to dismiss South Korea's results as propaganda. They do indeed have serious contact tracing. I'm not sure how it is now, but when I was in Korea in March-June 2020, there was a website where anyone could see literally every positive COVID case (anonymized), and everywhere they'd been over the last 2 weeks. They obtain this information via credit card transactions and such because they know that that is more reliable than personal testimony's.
Although this would be a non-starter in the U.S due to privacy concerns, I don't deny that this was probably effective. At the same time I imagine cases were drastically underreported because testing positive would result in your whole office shutting down, potentially getting one fired. So there's no incentive to get tested unless you have no choice.
There's barely any uptake in Canada.
Not that it matters, the only way you'd get a one-time key to trigger alerts for others is through a PCR test, which public health, as of this moment, will not do PCR test for symptomatic people unless they're in a high risk group.
Went and donate blood mid Dec 2021, it's one of the things that I kept up, because people still need that stuff. 10 days later, I get a email from them saying that I may have been exposed. While it's nice that they notify me, it's not from public health's contact tracing.
I don't want to live in a country where the government enforced wide-reaching shutdowns of businesses and quarantined people forcibly in their homes like China and Taiwan do. I think it's a violation of my civil liberties.
If a lockdown and travel restrictions, with limited duration, could have contained the spread of COVID or some other disease, I don't think it's an unreasonable impingement on civil liberties. Practically speaking a few weeks of restrictions every few decades shouldn't be problematic, or at least much less problematic than something like wartime restrictions.
Of course the value of any lockdown policy is contingent on the practical ability to correctly assess the threat of a new disease early enough that such short-duration, non-pharmaceutical interventions could work. But I don't think temporary restrictions are incompatible with basic civil liberties.
EDIT: Removed amateur-hour epidemiology, restated "philosophical" argument contingent on NPIs being effective.
As an immunocompromised person, and considering the ADA, I'm of the opinion that some mitigation strategies, like required masking in the grocery store, help preserve my civil liberties and should be considered reasonable accommodations.
Given our civil liberties conflict, you wind up in a tough to resolve scenario.
Your 'civil liberties' are arguing for positive rights, which are fundamentally different than advocating for existing negative rights.
Positive rights are your assertion that you have the right to action from another group. In general, medicine is one area where positive and negative rights conflict regularly. For example, imagine abortion, assisted suicide, or emergency care during a pandemic. Some of these are solved by employment contracts -- as an ER doctor you are accepting to be bound by people's positive right to emergency medical care.
However, your assertion is that society et large should be bound by your positive right.
You should have a very strong case for this. Do you?
This is neither an employer-employee relationship nor an accessibility requirement.
You know this because you did not have an established mask mandate or legal requirements for facilities to validate that patrons were not ill. Either of these would infringe on the rights of other groups. Like it or not, there are established groups of people who are unable to wear masks. The other route of validating that customers are not sick would paradoxically infringe on the rights of the immunosuppressed.
> You know this because you did not have an established mask mandate or legal requirements for facilities to validate that patrons were not ill.
A COVID test before entering every facility would probably not be a reasonable accommodation. I'm of the opinion that a Federal mask mandate in public spaces could probably have been justified under the ADA - anywhere that can be forced to have an accessible bathroom, access ramps, etc.
> Like it or not, there are established groups of people who are unable to wear masks.
Balancing that would similarly be an ADA question. A lot of people claimed to be in this category, but attempts to use the ADA to bypass state-level mask mandates tended to flop.
Frankly the risk to the immunocompromised does not appear to have been that high. Countries like South Africa, which have nearly a thirty percent HIV positive rate, did not see substantially different outcomes.
Beyond that, we had pre-existing data that masks don't do much. Post hoc analysis and wishful thinking have contributed to a modern round of pseudoscience claiming that masks are effective. When the dust settles, I think we'll see that well-fitted N95s are just about the only effective prevention measure. But, as I'm suspecting you know, this would not constitute a reasonable accommodation. In industries that require it, mask fitting and regular testing are commonplace. Further, fitted N95s can only be worn safely for a short duration.
On the other hand, I think that what the ADA should mandate is proper ventilation systems in these heavily trafficked areas. I do think that this is similar to what we've seen for accessibility requirements for businesses, and frankly a bizarre untackled problem for public health.
> But, as I'm suspecting you know, this would not constitute a reasonable accommodation.
I disagree. We agree on many of the same facts - better masks are important, as is ventilation - but not, apparently, the approaches those facts inform. The "as I'm suspecting you know" shit is rude; in this case, for example, some other countries (correctly) don't count cloth masks as legit. We should've done that, too, way back in 2020.
Re: South Africa, it's a young population, and being HIV+ alone doesn't make you inherently immunosuppressed if treated effectively - which SA is quite good at.
I mean purely as reasonable accommodation is defined by the ADA. Sorry, it looks like my 'as I'm suspecting you know' landed differently than I intended. I meant that you seem to be aware of ADA requirements.
For example, requiring a workplace to provide an employee who requires it an N95 mask very clearly falls under the 'reasonable accommodation' category.
However, requiring all employees or patrons to wear N95 masks does not track with other examples of reasonable accommodations.
Your 'civil liberties' demand that I not shoot my gun at you is a violation of my right to bear arms. How dare you demand action from me to protect your rights? After all, my rights are right there in the constitution.
Your civil liberties don't give you a right to get other people sick. My son's a type 1 diabetic (this isn't a matter of diet, exercise - that's type 2 diabetes.) Diabetics are at higher risk for complications from COVID. It pisses me off that people like you (and there are a lot of you) think it's your right to do what you please because it's inconvenient to wear masks, quarantine, social distance, etc. There are a lot of people at risk. Don't be a selfish prick.
IMHO, there's two ways to look at that problem : protect the fragile, or restrain the non-fragile. And I'm in the same boat as your son.
The current policies in the west have done nothing to proactively protect the fragile, and everything to restrain the non-fragile.
As an example of what I mean : I spent a couple of lockdowns in a relatively poor country (Serbia) which for example allowed the 60+, fragile and immunocompromised exclusive access to shops, malls and other commerce until 9, a 30 minute pause to ventilate with nobody inside, and then normal access for the rest of the population. Subsidised delivery services were organised, etc. 16 hospitals with 900 ICU bed each (pop 6 million) were built chinese-style in 6 months, so the local healthcare system could go back to normal.
Also, health insurance has a basic public option, with price-controlled drugs, generally 10-15x smaller than the US retail price, even for US-made drugs, new or old.
Watching the US figuratively struggle for air for two years has been quite demoralizing.
My civil liberties give me the right to leave my house and for people to have businesses and for me to visit those businesses. Perpetual lockdowns are a losing battle.
There are no absurd levels of death.
Average COVID death per day since the outbreak is likely lower than the average death from cigarette smoking. And people die from cigarette smoking since years and years. Million in the last decade in the US alone. And there is no doubt that cigarette smoking also increased COVID death.
Another way to look it it is birth rate versus death rate.
Globally speaking COVID death would need to be at lest one order of magnitude higher to stagnant growth. The 2 year pandemic made the global world population lag by about a week. So in a week we have the same number of people as we would have today if there were no COVID. Its that insignificant.
On a population chart over 100 years COVID will be p much invisible, a tiny tiny slow down of the growth. There are no absurd levels of death there are just many many humans and thus the death number feel subjectively high.
According to the CDC 1,027 people / 1000k died in 2020 compared to 870 people /100k in 2019. +157/100k (18%) is definitely more, but not an absurd amount more. I believe our response was appropriate.
We're not going to do perpetual lockdowns for the rest of eternity and not every country in the world is capable of enforcing a lockdown like China and the rest of East Asia anyway. It was always going to spread.
Easy for the laptop class of this website to call not wanting lockdowns selfish when it disproportionally harms the poorest and most vulnerable of our society.
> it disproportionally harms the poorest and most vulnerable of our society.
So does dying from Covid, or getting sick numerous times and missing work. Or not being able to afford missing work so you go in anyway and spread the disease, leading to your work being shutdown for weeks.
No matter what is done, the poorest and most vulnerable will be disproportionally affected. While I agree we can't perpetually mandate stay-at-home orders and expect everyone to live off savings, we _can_ expect the gov't to make that possible beyond the pathetic payments that folks received.
I’m with you: I much prefer the USA’s response to China’s. However, if COVID turned out to be worse and I felt my and my family’s life were in danger, I would expect (and demand) that level of lockdown here at least.
You may wish to review the numbers you are stating comparisons about. The rate for COVID per day in the US is about 1300 (911k / 700 days). The total is about 9000 per day, which is 3x 9/11 every day
Yes, and our response was pretty strong. How does my comment run counter to that? If it were even worse than it was, a Chinese-level lockdown response would have been necessary, but it wasn't, at least here in the USA.
Protecting people from financial misery in order to isolate is the path we took and completely half assed it. There was never a moment when police were instructed to harass people for being outside, or not wearing a mask.
Now if you have something against government mandating that businesses operate within certain safety parameters then I’ve got news for you….
Contact tracing at the very least. It controls spread while allow places to stay open. Seems like the US just threw up their hands and decided that it was too difficult logistically and alternating between partial lockdowns and letting people who whatever.
> I’m not sure preventing the spread is realistic.
South Korea has a total confirmed case rate 10x lower than the USA, and a death rate 20x lower. It's absolutely realistic. It just requires serious effort on the part of everyone to follow straightforward rules about testing/tracing/mitigation. Korea hasn't been shut down for two years. They've just been smarter about it.
Care to compare the average BMI of citizens of both countries, a known major factor in someone getting sick. Having a lower BMI protects more against this disease than being vaccinated.
Its know fact that Europeans were immune to some of the diseases they brought to America that nearly wiped out Native Americans. Therefore its not unreasonable to think that different populations will have different levels of response to a disease. Perhaps South Koreans were more likely to be exposed to similar enough corona viruses in the past to garner them enough protection this time.
This fallacy is distressingly common. That's not the way logic works. The contention above was that it was impossible to mitigate the spread of covid. I provided an existence proof that it was not. It's not on me to refute every contradicting hypothesis. It's clear that Korea did something right, and people interested in techniques to fight the virus would do best to study those actions instead of make excuses for why it must have been something else.
As far as natural population immunity though: that's just wrong. It's a novel virus (c.f. the initial outbreak in a nearby east asian nation), everyone gets it. Korea has absolutely had rapid outbreaks too (the church group got a ton of press early) that show that covid can spread rapidly there. They just handled it better.
Even that Antarctic research station that's the next best thing to the moon, staffed 100% by scientists and professionals who take it seriously and did everything better than any of us do, evereyone got it.
I suspect there's at least one thing that Antarctica does worse than everyone else: air supply. I suspect they recycle their air really heavily, to minimize the energy cost of heating up outside air. But that matters for the spread of something like Covid.
I'm guessing. I don't know. If anyone has actual information, feel free to jump in...
Well that's generally how heat exchangers work, for that reason, even in temperate climates.
I know there are some standards for recycling air in public buildings such as schools, and air born sickness seems like something they would have to worry about normally, so I would imagine they were pretty prepared for that aspect
Studies aren’t the best but it looks like vaccination significantly reduces the risk of these issues. Just hold off infections till the population can get vaccinated.
Bigger issue is getting people to vaccinate especially since long Covid will cost billions in increased insurance premiums and Medicare costs.
It's not that hard. The risk is highest when we have these waves from new variants. There are forecasts that predict them with weeks lead time. And then the wave comes and goes over a few weeks. You just have to up your defenses during those weeks.
This is basically standard practice now for some time in medicine, at least in the United States. Every time I or my partner have ever been to the doctor for any kind of concern, they always focus exclusively on life threatening conditions. The moment that cancer or such is ruled out (even when I've insisted I didn't think that was a likely possibility), care basically stops, any further inquiry is like pulling teeth. We joke that this is like the "Not Hotdog" app from the Silicon Valley series, "Not Cancer".
My cynical view is that it's more profitable to treat life threatening issues than trying to keep you healthy which would only result in less profits for hospitals. The whole incentive structure of health care leads to very bad outcomes.
" we've let a bunch of politicians and cable TV/internet/podcast hacks claim that it's not serious so that a significant fraction of the population ends up actively spreading the disease and providing reservoirs for it to mutate."
This is sort of a half truth. You can still spread it if vaccinated.
Yes, and you can still die with a seatbelt on. But a vaccine makes it less likely that you get it (can't spread it if you didn't get it), less likely to spread it (fewer days sick, smaller viral load, ability to self isolate because still functioning, not requiring outside assistance to not die).
You’re blatantly ignoring logic here just to make yourself feel better. Vaccinated people catch the disease 90% less with 90% less viral load and somehow you’re equating that to an unvaccinated person’s ability to catch and spread the disease. Ridiculous. Vaccinating saves lives and reduces the spread.
That is debunked lie repeated like mantra in mass media. Omicron is spreading same for vaccinated or not. Gibraltar, Ireland, Portugal data proofs that... Inform yourself, please and do not repeat fantasies. Vaccines are designed to help with reducing death risk for mutations that are not here anymore.
You seem to be ignoring the various permutations of the situation. How about people with natural immunity, which some studies suggest is as food or better? It seems you are ignoring scenarios to avoid cognitive dissonance. 90% is not 100%, it's not logical to assign 100% of the blame.
Are they though? I agree that there is not symmetry.
There are many groups, doing many different activities. There are plenty of vaccinated people who are done with masking, done with isolation, and going out in public or traveling. While there are also people who caught covid while doing a necessary job before a vaccine was required.
It's false to create only two groups. This completely ignores symmetry, undermining your entire argument of saying I'm ignoring it.
Would you like to expand on that? There clearly are numerous different groups providing a variety of permutations of risk taking or risk avoiding actions.
">This completely ignores symmetry
... and this would not follow even if it were."
Would you like to explain this too? It appears to me that two artificial groups were formed and then used in a false dichotomy.
I'm not being pedantic. Attacking a large number of people in a heterogeneous, artificial group is disingenuous when a moderate to large number of the people in that group may not even exhibit the risks claimed, while wholly ignoring the risks posed by the "good" group.
I see there was a data race in my editing, so I will move my update here:
Beyond that, it is consistent with every factual claim you have made to say that the population lies on a broad spectrum of how thoroughly they are contributing to ameliorating the impact of this epidemic on the population as a whole. Your own argument is predicated on this spectrum being divisible into two populations. My point is that, wherever you make that divide, one group is helping more than the other.
With regard to your specific questions here:
1) Putting aside the abstruse issue around the axiom of choice (which is not relevant here) one can always create two groups, and in my expanded reply, I made a relevant, non-pedantic case for that.
2) There are more symmetries than dichotomous ones.
Also:
> while wholly ignoring the risks posed by the "good" group.
With words like 'wholly' and 'false', you are making straw man arguments. It is factually accurate and completely reasonable to say that some people are net contributors to public health, while others have the opposite effect.
"Your own argument is predicated on this spectrum being divisible into two populations. My point is that, wherever you make that divide, one group is helping more than the other."
My argument is that the person who made the division into two groups did so using the wrong line, and even then blamed one group for the damage while absolving the other. This two group divide was poorly defined and should not have been made in the first place.
"With words like 'wholly' and 'false', you are making straw man arguments."
Not at all. 'False' is a perfectly acceptable way to identify a factually incorrect statement. If the person making the argument supports their argument with facts as well as non-subjectively, unambiguously defined definition of the groups, then one could address the individual points. As it stands, they made a blanket statement which is not supported by facts but rather by opinion. Perhaps they could rephrase it to be accurate or add facts to support their claim.
"It is factually accurate and completely reasonable to say that some people are net contributors to public health, while others have the opposite effect."
But it is not factually accurate based on the division made by the original person. Nor was that the claim (net contributors to public health). Nor have I seen facts to support the claim that one group is a net positive and the other is a net negative. If both groups are capable of catching and spreading the virus, then there is no net positive in that context - merely one group is less of a net negative - to what degree would again require better definition of the groups.
> My argument is that the person who made the division into two groups did so using the wrong line... This two group divide was poorly defined and should not have been made in the first place.
At that time, you called it a half-truth. You wrote "You can still spread it if vaccinated", dividing the population into the vaccinated and the rest. You were not arguing then that this particular line is poorly defined, and you have not done so since, even though you have frequently made that claim.
>...and even then blamed one group for the damage while absolving the other. [my emphasis.]
This is straw-manning again: Dhosek did not go that far. This is not as pedantic as it might seem, as any claim that this was implied would depend on the commonsense notions of net benefit that you are trying to argue against.
> Not at all. 'False' is a perfectly acceptable way to identify a factually incorrect statement.
But that is not what you were doing when you introduced 'false' into the discussion.
> But it is not factually accurate based on the division made by the original person.
Suddenly you seem to know exactly what Dhosek meant! Your argument seems to be "I don't know what you mean, but you are wrong."
>If both groups are capable of catching and spreading the virus, then there is no net positive in that context.
This is the crux of your argument, and its downfall. Unless you can show that vaccination, contact tracing, social distancing and mask-wearing have no causal and beneficial effects over the 'null hypothesis' of doing nothing, then it does not follow that they have no net benefit to society, except (or even) if practiced to the maximum and with vaccination providing complete protection. That's what 'net' means in this context (and others)! You would have to put an unjustifiably high weight on any deviation from the ideal situation in order to turn it negative.
I don't even think "covid burden" was the topic, depending on how you define that it could mean the demographics most at risk hospitalization (as overwhelming hospitals seems to have been the concern, and justification for lockdowns). It was only defined as people acting as reservoirs and vectors. This is essentially the entire population given that experts believe catching covid is inevitable, and that the virus can persist after exposure, including in the gut. So the only distinction I can see being made in this context of inevitable infection, reservoirs, and vectors, is vaccine status. Which is not a great dividing line. Basically, my whole point is that in the context of reservoirs and vectors, there's not a reasonable basis for a division into two groups.
If by introducing demographics, you are referring to age: one can - and should, for various purposes - partition the population by age. Doing so is somewhat more arbitrary than, say, by vaccination status, but both can be clearly well-defined. The difference is that no-one chooses to get older, and so there are no ethical issues with it.
As for the argument that everyone will get it eventually: For one thing, the pace matters, the recent shortage of ICU beds is a negative public-health outcome, and the statistics clearly show the benefit of vaccination in this regard (few health issues have better statistical evidence.) This alone shows that there is a reasonable basis for so dividing the population.
> This is the thing that drives me the most nuts about so many people's reactions to this disease who treat infection as a binary: You die or you don't die and the latter is just as good as not getting it
When I hear folks say that, I always ask them, "Herpes has a 100% survival rate, does that mean you'd shrug it off as no big deal if someone gave you herpes?".
Ok but herpes never shut down the world. We never shut down or severely restricted capacity in restaurants, gyms, stores, hotels, etc. over herpes, or required a herpes test to leave the house or get on an airplane. There is no herpes vaccine, but I imagine that even if there were, you'd never be required to show your proof of recent herpes vaccination to go to a restaurant or even ride public transportation or stay at a hotel (the situation in Italy).
Nobody is denying that COVID causes problems for some people, the argument is that it doesn't justify forcing everyone to wear masks everywhere, get vaccinated multiple times to do anything in society, get COVID tested anytime one needs to travel (for countries that haven't shut down borders), and force remote learning on children. Maybe it's possible that the side effects from these authoritarian policies don't outweigh the benefits, and disproportionately harm the youth for the benefit of the elderly since COVID is only statistically dangerous for those close to the median age of life expectancy. Perhaps people should be able to vote with their feet.
This is the thing that drives me the most nuts about many policy makers: they ignored natural immunity. They ignored that cloth masks (and likely surgical) would do nothing against an aerosol born disease. They ignored the impact of lockdown of society to everyone. The US masking 2 year old kids when the rest of the world masked starting at 6 year old or older.
EDIT: just to add: from what we can see, vaccines help cut down on adverse outcomes due to a covid infection, which is why I'm still pro-vaccine. But many other policies out there are just nonsense.
FYI Natural immunity provides a fraction of the immune response that being vaccinated does. People were getting reinfected with Covid after six months during the initial wave before any mutations cropped up.
Do you have any studies which you can point to that actually that demonstrate that "natural immunity provides a fraction of the immune response that being vaccinated does"?
From what I can tell even the CDCs latest online review, as of Oct 2021, doesn't have any evidence that one is better than the other in terms of antibodi titers [1] In fact the most recent CDC published studies, from this year, have shown naturally induced immunity to be superior to vaccine induced immunity in terms of both illness and death [2]
This is one of the reasons the "we don't know the long-term effects of the vaccines" argument was always silly. We don't know the long-term effects of COVID, either. They're likely to be bigger than a small dose of mRNA that breaks down in a matter of minutes/hours.
It'll be interesting to see what we think of the "let it rip" strategy for Omicron a lot of areas used a decade from now.
>It'll be interesting to see what we think of the "let it rip" strategy for Omicron a lot of areas used a decade from now.
1. Omnicron is so infectious no public health measures can prevent it.
2. Omnicron infects the upper air ways NOT the lungs like previous strains, this prevents it from easily spreading to other organs.
Omnicron should really be thought of as a different but adjacent virus because of how differently it attacks our bodies.
Thankfully "let it rip" is paying off with infections plummeting around the world after an 8 week~ wave of it.
> Thankfully "let it rip" is paying off with infections plummeting around the world after an 8 week~ wave of it.
Our reported cases here in Canada are only plummeting since restrictions have been placed on who can actually have a PCR test scheduled, and these are the only results that are reported.
The emphasis has been put on handing out rapid tests, which aren't tracked. As expected, cases started dropping immediately alongside the number of PCR tests performed. We're not past the spike, we're just ignoring it.
While lack of testing under-reports cases, it does show trends. There's also the covid symptom tracker which can be used to infer the true infection rate.
You can dive into it, but by all metrics cases are going in countries that started their omnicron wave mid to late December
If you look to Nova Scotia, you can also see hospitalization peaking and arguably decreasing, aprox 1-2 weeks after reported cases peaked. (Nova Scotia is a good case because it started the Omnicron wave 2-3 weeks before the rest of Canada)
Further the new BA.2 strain (which is causing a slight re-uptick of cases in the UK) is reported as 1.5x more infectious as well. So this is literally the most infectious disease ever recorded, and possibly the most infectious ever full stop.
My interpretation of this is health measures can slow it a bit, but 100% of the population will be exposed, so given the less pathogenic nature of it, getting it over with faster would likely be a net benefit.
I guess that globally isolating potential hosts (including animal hosts, such as rodents in the wild) from each other for a prolonged period would technically work.
It'll be interesting to see what we think of the "let's destroy the livelihoods of a huge fraction of the population for unproven benefits" strategy a lot of areas used a decade from now.
Agreed - lockdowns are the novel strategy being used for COVID, whereas "let er' rip" which is just protecting the most vulnerable population while minimizing disruptions for everyone else has been the status quo.
We didn't shut down society for polio before the vaccine. That was an exponentially more fucked up disease.
They're saying if we'd just "let 'er rip" from the beginning that the economic impact would have been lower and that this would have been preferable.
Ignoring, of course, the fact that if we'd done so then the death toll would have been pretty horrendous and that if everyone's sick or afraid of getting sick the economy is still going to to get screwed.
Tons of businesses still can't hire enough staff to stay open. Maybe unemployment numbers have recovered, but many people have decided they just don't want to work anymore.
Plenty of people will remember it this way. Many small businesses went bankrupt and an entire generation of kids had massive educational and social setbacks.
It's absurd to even suggest that everything is back to normal and everyone is A-OK with how things worked out.
1. The US is not the only country in the world. There are already plenty of studies of devastating downstream effects of lockdowns in poorer countries. Of course, a lot of that is out of sight for people in the US.
2. The demographics of the people who died with/of covid skew what, 70% over the age of 65? More? How many of those people do you think were actively looking for a job?
3. I'd say that "and we've zero information on how they might make up ground" is _exactly_ why it's unconscientious to inflict this kind of damage on them.
> The demographics of the people who died with/of covid skew what, 70% over the age of 65? More? How many of those people do you think were actively looking for a job?
Pre-covid the labor participation rate for people 65+ was 26% and the 65-75 bracket was projected to climb to 30% by 2030 as the last of the baby boomers entered that range. The idea that everyone retires at 65 is not particularly accurate.
70% of deaths are over 65 but what percentage of that was folks way over 65? (Late 70s+) - Quite a bit. 70% of that 70% in the US.
How many folks in their late 70s are still working that late in life? - Approximately 5% in the US.
Not sure that the math supports that US deaths were the decrease in the participating labor force. I don’t recall too many octogenarians waiting tables and being retail cashiers pre-pandemic. They seem to be concentrated primarily in roles where they are public health experts with piss poor communication skills (in my opinion).
The US has poor access to preschool education, so most of those millions born in the last couple of years are not yet qualified to enter the labor force.
The long-term impact of either one cannot be conclusively determined in the short-term, barring the invention of time travel.
"I will not take the vaccine because there are no long-term studies" is silly because it's inconsistent. "I will not take the vaccine and I will not get COVID" isn't a reliable option, so it's largely a choice between two unknowns.
That leaves us having to make educated guesses. Based on the history of vaccination, the safety thus far of nearly 10 billion doses of vaccine administered, and stuff like the biology and half-life of mRNA, the choice seems fairly clear.
The infection fatality rate (not to be confused with case fatality rate) is about 0.2%, and only statistically significant for old people >60 and those with comorbidities. Anecdotally no one I know including myself who doesn't fall in these buckets experienced worse than a week of flu symptoms. The vaccines are only shown to last about 6 months, and even then aren't even effective with the latest variants.
I don't think it's unreasonable for a healthy person under 60 years of age with no comorbidities to opt out of the vaccine (or the flu vaccine, which actually is deadlier than people think, yet nobody cares about your flu vaccination).
That's a false dichotomy. You can be vaccinated and get covid since the vaccine only prevents serious illness (and as this study says, you don't need to be serious ill to have these elevated risks). So it's not an either/or. With the soon to be endemic status, it's most probably 1) catch covid while unvaccinated 2) catch covid while vaccinated 3) very unlikely but not catch covid with either vaccination status.
You're making a false dichotomy, ignoring the existence of other treatments, the fact that 50-80% of infections are asymptomatic, and the fact that cross-immunity from previous coronaviruses means many people may never develop COVID, even if they are exposed.
No, it's really not so clear if you take a more objective look. First off, the history of vaccination is irrelevant, because this is a novel technology.
Second, the short half life of mRNA does not guarantee that there are no long term effects.
Third, you are ignoring that in this choice between "two unknowns", the probability of getting symptomatic covid (presumably asymptomatic/mild covid is unlikely to cause heart issues) is less than 1. The probability of exposure to the vaccine for a vaccinated person is 1.
Fourth, unlike exposure to covid in young, healthy people, the vaccine guarantees that your tissues are exposed to a rapid megadose of an inflammatory protein, manufactured in isolation, as opposed to an infection where the protein is attached to the rest of the virus and exposure ramps up gradually. That's my personal concern and I feel like its being swept under the rug. There is a nonzero risk of autoimmune disorders which will be difficult to detect, especially if past preprints regarding expression of the spike protein in human tissues post vaccination prove to be true.
Finally:
>The long-term impact of either one cannot be conclusively determined in the short-term, barring the invention of time travel
Right, which is why vaccine trials normally take 5-10 years and "safe and effective" has been a campaign of transparent propaganda. Numerous past vaccines have been pulled from the market for fewer side effects. Combine that with the stigma against reporting side effects/speaking against the vaccines, the fact that the actual safety trial data is a secret known only to pfizer/moderna and the FDA, the rumors that adverse event collection during clinical trials was (deliberately?) inadequate, the history of big pharma deliberately harming consumers in pursuit of profits, the full protection of pfizer et al from liability, and the assertion that covid is less of a problem than it has been made out to be (especially with recent data on omicron), no, the choice is not clear at all if you have not been taken in by the propaganda.
Edit: let's also remember that the claims of both safety and effectiveness have been repeatedly revised, and multiple points of "misinformation" have been proven correct. So on top of all this it should be clear that our institutions are not deserving of the amount of trust that people like you are placing in them. The executive branch wanted a vaccine yesterday, the FDA suspended typical testing protocols for what amounts to a rubber stamp, and now we are the safety trials. Not even getting into our sudden collective amnesia regarding regulatory capture.
Genuinely curious about these. Can you cite sources?
> There is a nonzero risk of autoimmune disorders which will be difficult to detect, especially if past preprints regarding expression of the spike protein in human tissues post vaccination prove to be true.
Which preprints? Why do you say autoimmune disorders have a nonzero risk and will be difficult to detect?
> actual safety trial data is a secret known only to pfizer/moderna and the FDA
Do you have a source?
> multiple points of "misinformation" have been proven correct.
So if I dont know the long-term effect of COVID and I dont know the long-term effect of the vaccine the logical thing is to intentionally get the vaccine and deal with whatever may be the long-term effects later?
You didn't notice but your argument is actually one against being the first to take the vaccine. Since it is perfectly reasonable to assume that one can avoid getting COVID for a long time long enough to make a decision on actual numbers later on.
> So if I dont know the long-term effect of COVID and I dont know the long-term effect of the vaccine the logical thing is to intentionally get the vaccine and deal with whatever may be the long-term effects later?
Yes, considering the vaccine's mechanism - causing your body to produce a SARS-CoV-2 viral protein that an active infection would also cause you to produce. Worrying about the vaccine while getting infected with SARS-CoV-2 is like worrying about getting wet in a swimming pool; you're already wet.
> Since it is perfectly reasonable to assume that one can avoid getting COVID for a long time long enough to make a decision on actual numbers later on.
I do not think that's perfectly reasonable to assume in the days of Omicron.
>...is like worrying about getting wet in a swimming pool; you're already wet.
No, that exactly not what it is. I never had COVID so I was never in that swimming pool in the first place. My personal situation allowed me to stay far away form any swimming pools so the risk of falling in one was very small.
Intentionally getting the vaccine gives me 100% of the unknown risk associated with it while not getting the vaccine gives me a unknown but lower than 100% risk of getting COVID and then once I have it 100% of the unknown risk associated with COVID but that happens ONLY when I get it.
This kind of risk assessment is done for every medical procedure.
Lets just make a though experiment and assume the risk of COVID and the vaccine would be exactly the same. Now its obvious that taking the vaccine is more risk than trying to avoid getting COVID instead.
Of course the risk is not the same but back in the days we did not know the risk of either so it was perfectly reasonable to try to avoid COVID for as long as possible until the actual risk for both is better known.
>I do not think that's perfectly reasonable to assume in the days of Omicron.
Pretty much everyone already did try to avoid getting COVID for over a year when the vaccines came out. Most of us succeed and did not get COVID in that time but somehow it should not be reasonable to think one can do it longer? Omicronw wasn't a thing then, its irrelevant, no one could include it in their personal risk assessment back then.
No one knew that Omicron would come and between the vaccine roll out and the first Omicron case many month passed.
Sure, things have changed now, Omicron seems to be way harder to avoid but on the other hand the risk is also way lower so the risk assessment is completely different now. Funny enough many people regret getting pushed to take the vaccine and would not do it again and even reject the booster(s).
Also the risk assessment for kids always suggested that vaccines are not needed for them and now with Omicorn less then ever. But the same people who declared everyone stupid/selfish or whatever who didn't take the vaccine, are the people who now push and promote that kids also get vaccinated and parent who dont want that are declared monsters. In other words thous people never cared about risk assessment and logical decision anyway they just want everyone to do what they want.
Everyone else is declared an anti-vaxxer and a horrible human for no reason.
Risk assessment for medical stuff is a personal decision. And People will decide differently which is perfectly fine. Not acceptable is to not respect it and treat people differently based on their decision.
Except there are too many cases of healthy young people having myocarditis related reactions soon after the vaccine, and that's not documented for covid. Is why discussion about vaccine related myocarditis centers on lipid nano particles having a strong uptake effect by heart and other tissues. Yes, yes nothing is "settled" because everything is so new. Just can't ignore that my family knows more people who died or went to hospital related to second dose/booster than covid itself.
> During March 2020–January 2021, patients with COVID-19 had nearly 16 times the risk for myocarditis compared with patients who did not have COVID-19, and risk varied by sex and age.
> During March 2020–January 2021, the risk for myocarditis was 0.146% among patients with COVID-19 and 0.009% among patients without COVID-19. Among patients with COVID-19, the risk for myocarditis was higher among males (0.187%) than among females (0.109%) and was highest among adults aged ≥75 years (0.238%), 65–74 years (0.186%), and 50–64 years (0.155%) and among children aged <16 years (0.133%).
> While we often associate cardiovascular conditions with elderly populations, myocarditis can affect anyone, including young adults, children and infants. In fact, it most often affects otherwise healthy, young, athletic types with the high-risk population being those of ages from puberty through their early 30’s, affecting males twice as often as females. Myocarditis is the 3rd leading cause of Sudden Death in children and young adults.
Forgive me, but that sounds like a strawman. I don't think I've ever heard someone say they'll "just not get it", although ironically many of those more enthusiastic about taking the vaccines sure seemed to act like they won't get it... until they got it anyway. But perhaps it's a failing of mine that the only people I meet who were skeptical of the mass vaccine deployment strategy usually had the exact opposite view you are suggesting they have.
4. Unknown long-term risks of Covid enhanced by vaccine + unknown long-term risks of vaccine.
Vaccine-enhanced disease is a very real thing, it's happened before (e.g. dengue). But it doesn't matter. Now we are talking about higher order nonlinear terms which are almost impossible to predict.
I am not claiming that I know for sure getting the vaccine is a negative risk/reward, although I do believe it is a possibility. I am just claiming that, given the present situation and present uncertainty, the vaccine mandate laws are evil, and the people who advertised this as a great vaccine with 90% efficacy ("pandemic of the unvaccinated") are liars since it's actually the least effective vaccine ever made.
>One look at hospitalization and death stats should confirm this as obvious
Not in my country, not obvious at all. And my country has better data than yours I bet.
I feel like I should weigh in on this because I seem to be one of the unlucky ones with heart impact.
I'm 40 years old and prior to catching covid on Jan 1st I was in the best shape of my life. I ran 9 ultramarathons last year, including a 40 mile run on my birthday. I was double vaccinated and boosted on December 7th, all Moderna. I do 100 pushups and 100 squats a day and was regularly running 30 miles per week. (50km)
Covid took me out for 3 full weeks and my fitness wasn't enough to power through it. The first symptoms were extreme fatigue but what is hanging on is chest pain. I have had to significantly cut back my training.
Only in the last week do I feel like I can get back to a more normal pace and that's with a measured concern to not overdo it. I always feel great at the time, but afterwards I'm paying the price.
I plan to continue training at a reduced effort to try and bring back my fitness. I've never had something that holds on for so long before.
I was 28 when I got it (alpha flavor). Resting heart rate rose by ~20 bpm, blood pressure went from <120/<80 to stage 2 hypertension (>140/>90). High enough that it gave me dizzy spells and chest pains. Two years later I've got my blood pressure mostly under control (2L+ water daily, low sodium, high fiber, no NSAIDs) but my pulse is still elevated.
Lungs also took a serious beating, but mostly recovered. I had a bronchoscopy and was the youngest patient they had seen in years. Bronchoscopy showed an absurdly high number of white blood cells in my lungs ~18 months post-covid- evidence of inflammation and extremely reactive tissue.
It likes to make sure you remember it, that's for sure.
No embellishment here. Today is 879 days in a row and I've tracked them all in an app I wrote.
The last 6 months, minus a week has been with 25 of them in burpee form.
I break them up throughout the day, it's not a lot of exercise at all. It feels like the bare minimum to stay in overall functional fitness shape. It's nice to have the strength to do whatever I'd like to do on tap anytime.
9 ultramarathons in a year may have been over-training however. (Towards the end it was getting to be one every other weekend just for kicks.)
Is it? You don't need 100 pushups to build muscle. At a certain point you are well overdoing it, and definitely not doing your joints any favors. So why do it?
Overtraining is a real thing, and this person is doing it. Either that or they're embellishing to make a point.
Does this control for the long-term effects of closing gyms and rec centers and having people live more sedentary lives to avoid COVID (which they got anyway)?
I'm surprised that exercise is mentioned all the time for heart health - but the word doesn't appear even once in the article.
I'm not them, but I think they probably are referring to the fact that sitting on your ass eating cheetos for a year also takes a serious toll on heart health.
Sedentary life styles causes heart health to degenerate over long spans of time (>5 years). Covid on the other hand directly causes heart damage. Which one do you think has a greater impact?
I didn't see it in this article but I wonder if they took into account vaccinated people who had breakthrough infections? Or vaccinated people who were exposed but didn't get sick (although I don't know how you find those people). Does the vaccine and your primed immune system negate the effects of "long COVID"?
There was a study out of Israel[1] and another out of the UK[2] that both showed some effectiveness against long COVID for those who are vaccinated. (Reddit links provided because those often have useful summaries of the studies.)
First COVID-19-positive
test (T,) between 1 March 2020
and 15 January 2021
n = 162.690
VA vaccination began in late December 2020, hence some of the veterans may have received at least one injection, but would not have been considered vaccinated until 14 days after their second injection, https://blogs.va.gov/VAntage/82728/va-begin-covid-19-vaccina...
Hmm, you're right. I mistakenly thought the study ended on 15 Jan 2021, but that's when it started.
By July 2021, about 50% of veterans had been vaccinated, so it's possible a sizable percentage of these studied veterans were in fact vaccinated (and there are known issues with cardiovascular side effects of vaccines),
https://www.usatoday.com/story/news/nation/2021/07/26/va-man...
After reading this article this was my question as well, it seems like a very relevant point considering a majority of the population (in my country at least) is vaccinated twice, and getting up on their booster too now.
> the veteran population skews older, white, and male: In all three groups, about 90% of patients were men and 71% to 76% were white. Patients were in their early 60s
How many patients received early treatment? It is well understood that outcomes are worse, and treatment more difficult, the further Covid progressed before treatment begins.
I was waiting in line yesterday at Costco to return something. The return line was packed and clerk came by and ordered people to wait outside. There was a guy that took issue with this because it was cold outside. The clerk called the manager. The manager came over and he said, "Look I got 2 shoots and a booster. Why do you want to make me wait outside when it's cold" The manager smoothed things over, and let the guy wait inside. But over the entire commotion I ended up talking to a guy behind me. This was a man in his 70s. He was returning a chrome book. He bought it to stream TV and the thing couldn't play back smoothly, and he didn't like the quality of the speakers. He started complaining about whats going in the world. How he feels sorry for the new generation. Seeing kids masked up and not able to communicate and play freely. How expensive things are, especially housing. How expensive organic food is now, and how it was the common food back before. And he concluded that what we are seeing is Bill Gates and tech companies take over the world. For his age, he looked very fit and healthy. Maybe this was just a rant, but I can't help that this is a pretty common sentiment now.
People got the shots, and things still didn't change. People feel lied to. The tolerance for mandates is eroding quick. Willingness to take more booster shots is not there, people are dropping out. And its questionable if more booster shots will even work.
Mental health, and well being of society needs to be the much bigger consideration.
Also you can't look at covid in isolation. Look at the overall mortality rate.
And those numbers are up. Deaths unrelated to covid are up too.
I saw a cardiologist 11 months after my infection (Jan 2021 prior to vaccine availability to public). I had a small heart scare at the end of Thanksgiving break where I went to the ER out of precaution and discharged immediately as nothing was wrong, but to me felt like I was going to die.
They were not concerned that COVID had any play in heart health after that many months. Of course, more and more articles and studies are coming out regarding the actual short term & longer term effects accompanied with the unknowns. My story related very closely to these young people who woke up feeling like they are in their 50s/60s and scared they will croak any given moment.
After going through a year of hell, I'm quite optimistic and more aware of my heart health than ever.
This is another article I found last year that really resonated with my story and gave me lots of hope for answers. No doctor was able to give me one, so I had to experiment and try lots of stuff over the last year.
My casual (non-expert) observation is that covid disproportionately affects the heart more than other viruses we're familiar with.
We know its related to the spike protein, but do we know why? What makes it harmful (is it basically protein-sized shrapnel?) and why does it prefer the heart? (maybe there is no preference and effects on the heart are just easier to observe)
Further, if the spike is whats dangerous, what are the effects on people who have had 2 shots, a booster, AND then got covid anyway? This makes up the majority of my friends and family.
Thankfully the new omicron variant isn’t very good at infecting the lungs and stats in the upper respiratory tract. This means it doesn’t enter the blood and doesn’t have a chance to wreak havoc on the rest of the body. Since vaccinated people are primarily getting omicron and the booster is able to drastically improve the immune response I wouldn’t be overly worried.
I get that part, what I'm wondering now is that in light of those findings, are we concerned that there is a similar risk to younger folks who got COVID?
In lieu of a study that answers this exactly, we could extrapolate the general risk of covid to get a sense of how different age brackets are affected.
That is, given people over 50 make up 93% of severe outcomes, I wouldn't expect young people to exhibit significant levels of heart damage or other types of "long covid".
> are we concerned that there is a similar risk to younger folks who got COVID
Children's ACE2 receptors are more resilient to damage, which is likely why they have only ~50% the risk of long covid as compared with a fully vaccinated adult. So yes, it's definitely a risk, but a smaller one.
That said, as an adult you can likely mitigate any cardiovascular damage at least somewhat by taking an ACE inhibitor to up-regulate your ACE2 receptors, whereas without medical training that probably wouldn't be especially safe or ethical to do on your kids.
Oh wait, there is nothing about vaccines? So suddenly there is increased risk of heart failure, myocarditis and so on, but it has nothing to do with vaccines.
Isn't that same study that referred to reduced effectiveness of vaccines among veterans?
> Our analyses censoring participants at time of vaccination and controlling for vaccination as a time-varying covariate show that the increased risk of myocarditis and pericarditis reported in this study is significant in people who were not vaccinated and is evident regardless of vaccination status.
It absolutely means they "have a control group of people infected but unvaccinated".
As it's not a clinical trial, that means they have the vaccination status as a value in the data being analyzed, and are able to account for its effects in their analysis, and did so.
If you read their footnotes, they say:
"In total, 95,223 (61.93%) participants in COVID-19 group received COVID-19 vaccine (42,065 (44.18%), 45,450 (47.73%) and 7708 (8.09%) received BNT162b2, mRNA-1273 and Ad26.COV2.S, respectively) and 3,173,169 (56.29%) participants in contemporary group received COVID-19 vaccine (1,349,844 (42.54%), 1,609,399 (50.72%) and 213,926 (6.74%) received BNT162b2, mRNA-1273 and Ad26.COV2.S, respectively) before end of follow up."
So it looks like both the COVID-19 group and contemporary group had received the covid vaccine.
What part of "61.93% [of] participants ... received COVID-19 vaccine" is confusing to you?
Both the "got COVID" and the "didn't get COVID" ("contemporary control") group had some people vaccinated and some not. They can slice and dice the data based on vaccination status; they clearly have the info.
