I.e older and more susceptible to illness people like 70 year olds are more likely to be vaxxed than 25 year olds. Had the vaccination rate been constant across ages, the unvaccinated death rate would be far higher and the vaccinated death rate far lower. It’s bad stats to not account for the population differences like that one.
Wish I could edit my comment to add a statement that very sadly has been shown to have been needed. age is but one example out of many different conditions that would cause more frail people to self select. Stop replying to say one can zoom in and see age segments.
And please note that the main point of the article is an ELI5 of why absolute death numbers is misleading, but that eli5 doesn’t mention the sample bias which would be a good “next layer” to mention at least in the conclusion.
So yeah it’s all very fine that as so many people like to reply that a reader can dig around and find age groups assuming they already know about sample bias and thus are trying to control for those things. But oh wait one little problem. This article is explaining why one needs to look at rates not absolute numbers. If someone is aware of sample bias why would they need this article? Are you telling me people who need the first eli5 are going to know sample bias?!?!?
No, the death rate in the ONS data from England is age adjusted. So among the same aged cohorts, the vaccinated are more likely to die than the unvaccinated. Almost twice as likely for the last 6 months straight.
I'm speaking specifically of the age 10 to 59 age group. For the last 6 months that age group, the vaccinated are almost twice as likely to die of any cause than the unvaccinated.
That age group is too wide to make a meaningful comparison without standardising for age. Less than 10% of under-18s and less than 60% in the 18-24 age group have been fully vaccinated, whereas it's more than 80% for the 55-59 group.
The unvaccinated population in that age group is significantly younger than the vaccinated population. As you would expect, older people tend to die more often.
This is also mentioned in a footnote in the ONS data (and this is why they tend to focus on age-standardised figures).
You could say the same for the covid death rate: generally saying that it is a deadly pandemic is misleading, because it disproportionately kills old and sick people, and those tend to die more often
I don't understand your argument. When we're comparing "overall death rate in a world without COVID" to "death rate in a world with COVID", we're looking at the same population. We don't need to adjust for age if we're looking at the same population.
This kind of misconception is so common it even has its own name: Simpson's paradox. It's laughable to think that the vaccinated population, compared to unvaccinated, is dying at the rate suggested by these numbers and no one is ringing the alarm.
Another factor is that if the vaccination rate is very high, this also results in fewer deaths in the unvaccinated group, since it reduces the R factor.
This is actually debatable given that "fully" vaccinated people who get infected - a so-called 'breakthrough infection' - seem to transmit SARS2 at close to the same rate as those unvaccinated [1,2]: fully vaccinated individuals with breakthrough infections have peak viral load similar to unvaccinated cases and can efficiently transmit infection in household settings, including to fully vaccinated contacts
Whether the R-factor is reduced markedly depends on the number of breakthrough infections. In this study the infection rate in household contacts exposed to the delta variant was 25% (95% CI 18–33) for fully vaccinated individuals compared with 38% (24–53) in unvaccinated individuals, i.e. the vaccinated run ⅔ of the risk of getting infected compared to the unvaccinated. Given that the vaccinated were of a younger age than the unvaccinated the actual risk reduction is likely to be even smaller than stated.
Well, as confirmed by your [1], vaccinated people can transmit the virus during a much shorter duration. That's bound to severely decrease R among vaccinated crowds.
This is only one source, there are more with different results.
> That's bound to severely decrease
This does not seem to be the case if the examples of fully vaccinated regions - Gibraltar is an interesting example, the entire population from 12 years up is vaccinated but the infection rate seems to be skyrocketing which has led to the cancellation of Christmas celebrations and new restrictions [1]. Israel is another example of how vaccinations do not seem to curb infections, something which is clearly visible on this graph [2] showing vaccinations (teal line) and daily infections, sliding 7-day window (dark line).
My question to all those who seem to insist on the current crop of vaccines being as effective as they're claimed to be is what you think will be gained by what is clearly a half-truth? Yes, the vaccines seem to have some effect for a limited amount of time but is is clear that they do not provide enough protection to justify the proposed vaccination mandates nor does the difference between transmission rate between vaccinated and unvaccinated justify implementing a 2-tier society as is now being either planned or implemented in several countries. If people are to follow The Science™ they should be allowed to go by actual scientific data, whether those align with the narrative or go against it. Dogma is not science, it is a belief or set of beliefs that is accepted by the members of a group without being questioned or doubted. The insistence on the efficacy of the currently available vaccines against SARS2 has the looks of a dogma in the light of the evidence. Assuming that the goal of everyone partaking in this discussion is to both minimise the impact of as well as the length of the local epidemics and the pandemic it is important for people not to be misled with false promises, something which has happened far too often already.
My belief is that people generally quarantine after they show symptoms, so the dangerous period is the presymptomatic phase, and the length of that phase appears to be similar between the vaccinated and the unvaccinated. So it's possible vaccinations don't majorly lower R.
It’s frustrating how people cherry pick data and don’t think about important findings in their own cited sources. I’ve seen similar comments to that one so many times citing viral load being the same and always ignoring that the duration is much shorter. Their own citations undermine their point…
It is even more frustrating to see the dogmatic approach to the fact that the vaccines are less effective than they were made out to be. The more this becomes clear, the harder it will be to keep up this narrative. I assume that you, just like most others here, wants to see these epidemics and the pandemic end as soon as possible with as little damage as possible? In that case it is adamant to be objective in the search for a way out. Current data shows that the vaccines which are now available don´t provide the level of protection against either infection, hospitalisation or death which they were supposed to do so an alternative strategy is needed. This can include a new vaccine - there are many in the works - but it has to include a way to keep society running without imposing authoritarian mandates or we stand to loose much more than just the people who succumbed to the disease.
Let me see if I understand correctly your thesis (collated from several of your responses).
1. You believe/observe that the current generation of vaccines are useful.
2. You believe/observe that the current generation of vaccines are insufficient.
3. You believe/observe that many people (on HN?) have too much faith in vaccines as a silver bullet.
4. You believe/observe that the government responses (in western countries?) are authoritarian, hence politically dangerous. I imagine you mean lockdowns and the pressure towards vaccination. I am not sure whether you also mean other measures (mandatory masking, classroom shutdowns, remote work, closing down restaurants, etc.)
5. You believe/observe that the government responses (in western countries?) are inefficient or insufficient.
6. You conclude that that the government responses must change.
Is that correct?
I agree with you that it is an important conversation to have. Of course, I disagree with some of your points (in particular 4.), but that's life :)
No, not really. Instead of walking your points I can summarise my position on this issue as it does not really differ from my position on most other issues.
My starting point is objectivity and as such I dislike narrative. When SARS2 became a thing it was woven into a number of narratives, one of which has now become dominant in many western countries. This narrative revolves around a collectivist technocratic approach to tackling what is deemed to be a severe threat against public health. The technocracy gets to dictate how people are to act, when they are to act, with whom they are allowed to interact and when they have to refrain from interacting with anyone. Dissenters are quickly labelled and attempts are made to publicly shame those who oppose. The tools of the technocracy are deemed to be highly effective and, again, dissenters are labelled and shamed. The problems with this approach are manifold:
- SARS2 is not a severe threat for large swaths of the population - this became clear early on in the pandemic and has been clear ever since.
- liberal democracy and technocracy do not mix, the former depends on dissent and discussion to reach a consensus while the latter can not tolerate dissent. Most western countries have liberal democratic traditions in one form or another, most people like it that way and want to keep these traditions alive.
- the tools of the technocracy are not nearly as effective - and in some cases not effective at all, or worse (e.g. forcing people to shelter in place, not allowing them to go outdoors) - as stated but those who point this out are quickly marked as dissenters, labelled and shunned. The same is done to anyone who suggests alternatives to the officially mandated tools.
- authoritarian powers, once gained, are hard to give up.
Once the epidemics and the pandemic are over - in a year or 2 - an overview of the pros and cons of the different strategies should be made based on real data (i.e. raw verified data) by neutral observers (if such can be found). What I expect that overview to show is that the costs of the more authoritarian measures - strict lockdowns, school closures, severe limits to personal contacts - ended up being higher than the benefits. Those costs can be expressed in lives lost to (substance/physical) abuse, loneliness, estrangement and other social impacts leading to an increase in suicides. They can be expressed in the loss of academic achievement due to school closures leading to a lowering of future prospects for the affected. As tends to be the case these impacts are not equally spread over all classes of society, the lower classes are hit much harder than the middle and higher.
With all these things in mind it should be now be clear that for me the issues are not so much related to whether the vaccines are useful or not or whether masking works or not. If the vaccines are shown to work people will take them without the need for a dictate from the authorities to do so. Even if they are shown to only be marginally effective those in the most vulnerable groups will still take them to lower their personal risk. Locking down society has not been proven to be effective in reducing the spread of transmission [1,2] while it has a marked impact on social well-being as well as economic activity. The Swedish example shows that people voluntarily adjust their behaviour to limit the risk of personal exposure without a need for the authorities to intervene. People make risk assessments every day, some of them rational - people tend to not cross busy motorways since they know they probably won't survive - and other irrational. A policy based on informing people of the true risks (which was hard to do in the beginning of the pandemic but a lot easier a few months in), providing means - informational, material, medical and economical - to lower those risks and a limited number of targeted actions to keep essential services running is compatible with a liberal democratic political tradition and does far less damage to society than an authoritarian regime of lockdowns and forced medical procedures.
The authoritarian approach might fit countries with an authoritarian political tradition, China or - earlier - the Soviet Union being prime examples of such. Western countries tend(ed) to pride themselves on not being 'like China' or 'like the Soviet Union'. I'd like to keep it that way, if I want to live in an authoritarian state there are plenty of such to move to. I did not do so, instead I moved from one liberal democracy to another.
So, if I understand correctly, it seems that your disagreement with current policies is, to a large extent, ideological, rather than practical.
Also, if I read correctly what you write, the main disagreement between you and me is that you seem to conflate:
1. technocracy == authoritarianism;
2. taking public health measures == authoritarianism;
3. informed people will take good decisions.
To which I would counter with different definitions and observations:
1. In my book, technocracy means "letting people who actually understand the issue do something about it", by opposition to "count on people whose main skills are diplomacy and politics do something about a problem they don't understand." We still count on the latter to actually defend our democracy and technocrats (just as police officers, judges or teachers) are part of the means of action of a democracy.
2. In my book, the measures that have been taken were imperfect necessary (or at least seemed necessary at the time) based on existing knowledge about epidemics. They have a cost, largely in terms of personal comfort and mental health, but we're so far from authoritarian regimes that I suspect that people who use the word "authoritarian" to describe them have no clue what it means.
3. Experience with the US seems to suggest that many informed people will... do random things?
First, an aside: did you ever watch that interview with Jordan Peterson by Cathy Newman, better known as the "so what you're saying" interview [1]?
Also, no, your understanding of my - fairly straightforward, straight out of liberal democracy 101 - position is lacking. Technocracy can lead to authoritarianism but it does not need to. Taking public health measures also does not equate authoritarianism - where do you get that from? On the subject of well-informed people taking "good" decisions a whole discussion can be had but one thing is clear: well-informed people make better decisions than uninformed or misinformed people, on aggregate.
Now with regard to your positive attitude towards technocracy I'd suggest that this is probably due to the fact that you, just like most people here, are "well-educated" and employed in a knowledge-driven field where knowledge is a currency/equals power. In this environment is is very easy to fall into the trap of ultracrepidarianism [2], the tendency for people to assume that expertise is a universal currency which retains its value outside of the specific field of expertise. Who better to deal with a health "crisis" than healthcare experts, people who are just as likely to fall for this trap? Who better to deal with any crisis than those experts, they are after all the people who know most about whatever field the crisis might relate to?
The answer here is that those experts are non-experts outside of their fields, just like you and I and everyone else around here - we might strive to become Homo Universalis in the style of Leonardo DaVinci but alas, the knowledge available to humanity will no longer fit in a single man's brain. Putting those experts in charge means they will start making decisions outside of their field of expertise, assuming that everything can be described in terms of their own field of expertise [3]. You might try to counter by saying that of course that is not what would happen, decisions related to the economy will be made by experts on economy, those related to social well-being will be made by experts on sociology and psychology, things which impact national security will be relegated to defence experts, etcetera. That is not how it works as was clearly shown in many countries which followed the narrative by putting the experts in charge.
On the subject of "informed people doing random things" another long discussion can be had, but suffice to say that people have the freedom to act as they will within the bounds of the law, even if those actions are deemed inappropriate or foolhardy by others. These rights are set out in the US constitution and made explicit in the Bill of Rights which states that The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people. The perennial struggle between 'rugged individualism' and 'the greater good' will continue no matter how many words we waste on it so as long as the USA keeps its constitution and bill of rights and related laws in place I'd advise those informed people against doing what I consider to be stupid things (which may not coincide with what you or they consider to be stupid things) but I would not try to force them to refrain from doing said things. If they (plan to) do stupid things which harm others they'll quickly find themselves on the wrong side of some law or other and as such can be refrained from doing those things.
Do you agree with a vaccine mandate using the current crop of SARS2 vaccines? If so, can you explain your reasoning around forcing people to take what still are experimental preparations without a safety track record where the efficacy of the preparations is questionable and the disease they are supposed to protect against is not a significant threat for the majority of those who would be forced to undergo vaccination?
Can you defend the imposition of authoritarian lockdown regimes when the disease-related outcome in regions without such regimes are largely similar, knowing that those authoritarian measures come with a large cost of their own?
The reason for which I attempt to summarize your position is very much because I wish to avoid arguing against something that you're not claiming. So far, it's the only technique I have found to discuss online with people with whom I disagree while learning from the conversation and avoiding turning it into a slugfest. Apparently, I'm failing.
I'm going to thank you for your time and wish you a pleasant day.
As a side-note, I'm well aware of the Dunning-Kruger hypothesis. I've seen it in action all across the board since the beginning of the crisis and, frankly, pretty much all the time for as long as I remember paying attention, technocracy or not.
Having answered your questions I can not help but notice that you did not answer my questions on vaccination mandates and lockdown regimes. It would be interesting to know if you support these and, if so, why.
We seem to speak different languages. In my language non strictly enforced mask mandates, mild social distancing, and vaccine mandates for approved vaccines that do actually provide solid protection (while yes not complete protection, this was not promised btw) sounds highly reasonable. You seem to say those measure mean authoritarianism you. Thus we speak different languages. I could talk in my own language, writing pages on my beliefs, but unless I spend a huge amount of research to write it in your language, it’s pointless.
Why, yes, a vaccination mandate using an experimental vaccine for a disease which is not a significant risk for a large part of those who would actually be forced to take those vaccines given that those for whom SARS2 is a risk mostly have been vaccinated by now and where those vaccines do not give significant protection against catching or spreading the disease is not reasonable. I suspect you would have not called this reasonable before the pandemic hit but were scared into accepting a "new normal" for 'the greater good of society".
Calling the vaccines "approved" is playing with words, compare what it normally takes to get approval for a bog-standard vaccine with how this novel mRNA vaccine was "approved" to see what I'm getting at, consider that there is no long-term experience with either mRNA vaccines in humans nor this specific vaccine based around the (known to be harmful [1,2,3,4]) "spike protein". Realise that the method of action for these vaccines (whether mRNA or vector-based) is to induce your body to produce just that harmful spike protein and consider the potential for damage, especially in combination with the untargeted delivery mechanism - nano-lipid particles carrying mRNA fragments, targeting is done by injecting into muscle tissue and as such wholly depends on the accuracy of the injection - my wife could hardly move her arm for a week after an inaccurately (too high) placed first dose of "Moderna SpikeVax".
Do we speak a different language? That is possible, language is malleable and words change their meaning. This tends to be an evolutionary process which takes a significant amount of time. Changing the definition of words and concepts in a mere few months is not evolutionary but revolutionary, this is not a natural process. I'll stick to evolution instead of revolution.
Thankfully, epidemiologists around the world did not wait for mint2 on HN to realize this. All of these all-age rates are age-adjusted according to the country’s population pyramid.
It really seems like it's safe to say that a fully vaccinated person's risk of dying from covid is low enough where based on the pre-2020 accepted societal standards for risk there should be next to no behavior modification expected.
This point 100x times. I am more paranoid about COVID than most people are because I have an autoimmune disease (which is mild and seems to not really affect outcomes). While my autoimmune caveat can be written off, I see most people seeing death as the only bad outcome and framing their risk tolerance and mitigation based on that. What has given me extra concern from the start is the damage done by COVID for patients who survive and even have a mild case. The rates of Long COVID (potentially overdiagnosed because of similarities with pandemic restriction related depression) are sufficiently high that it more concern than is given.
The vast majority of cases for someone who is fully vaccinated are asymptomatic or mild. The risk of having a severe enough case to require any sort of medical attention is quite low, and for those people who do need it the new antivirals seem to be working very well.
The problem is that vaccination protects you from having a bad case of Covid, but it doesn't protect you from getting infected and infecting others. So, if the vaccinated carry on as if it's 2019, the disease will jump from one vaccinated person to the next until it finds an unvaccinated person.
I encourage everyone eligible to get vaccinated, but since the virus is now endemic everyone will eventually be exposed. You can't seriously expect people to tolerate restrictions indefinitely.
>You can't seriously expect people to tolerate restrictions indefinitely.
I honestly think there's a small percentage of society which would, we've all come across people out there with the personality trait of being utterly unable to resist wagging their fingers at their fellow human beings. Whatever your opinion on the restrictions and their effectiveness, nobody with eyes can deny that this social finger-wagging has been a huge part of the zeitgeist of the last two years.
I'm hoping that this attitude starts to die off as covid becomes endemic because aggressive moral authoritarianism rarely ends well for people who have a less black-and-white view of the world.
> You can't seriously expect people to tolerate restrictions indefinitely.
Honest question: Why not?
2019 is not some magical single gold standard Right Amount Of Personal Freedom. Behaviors become subject to restriction all the time (and also some other restrictions become lax or disappear over time). Taboos come and go. Society changes and the set of acceptable behaviors can also change with time.
I remember similar arguments being used back when seat belt laws were introduced. "I'll never wear those things!" "They wrinkle my clothing!" "They're tyranny!" "People will not tolerate making them mandatory!" But... now we do tolerate it. Same with anti-smoking laws. Society is very flexible and capable of changing.
There are a lot of dangerous things that were regularly done in the past, but are now forbidden, or even taboo. I don't see why things like masks, distancing, and limits to indoor occupancy are un-changeable special cases.
Not indefinitely. At this point sensible exit criteria from most restrictions would probably be that enough of the population is vaccinated and boosted that the remainder don't pose a serious threat to the hospital system.
This is completely wrong—being vaccinated does reduce your likelihood of getting infected (and thus reduces likelihood of infecting others).
> In September, unvaccinated persons had a 5.8X risk of testing positive for COVID-19 and a 14X risk of dying from COVID-19 compared to vaccinated persons.
The risk of testing positive for covid is conditioned on the probability of being tested in the first place. The CDC guidance skews towards testing unvaccinated people more aggressively, hence the numbers are predictably skewed towards the unvaccinated. Further confounding the issue, vaccination among kids and teenagers is recent, their VE numbers are going to decline over time.
Medical research indicates VE against infection of about 50% after 6 months, which is 2:1.
* People who have come into close contact with someone with COVID-19 should be tested to check for infection:
* Fully vaccinated people should be tested 5–7 days after their last exposure.
* People who are not fully vaccinated should get tested immediately when they find out they are a close contact. If their test result is negative, they should get tested again 5–7 days after their last exposure or immediately if symptoms develop.
* Unvaccinated people who have taken part in activities that put them at higher risk for COVID-19 because they cannot physically distance as needed to avoid exposure, such as travel, attending large social or mass gatherings, or being in crowded or poorly-ventilated indoor settings.
* People who have been asked or referred to get tested by their healthcare provider, or state, tribal, localexternal icon, or territorial health department.
I believe that the proper response to this is to limit the percentage of hospital wards that can be devoted to COVID 19 cases, as the main effect of low vaccination rates is that the hospitals get too full.
And suddenly, I'm not worried anymore, unlike now where the regional hospitals are massively backed up or closed due to low vaccination rates.
My compassion is completely fatigued. All I can think about now is getting back to the gym when my youngest is fully vaccinated.
> limit the percentage of hospital wards that can be devoted to COVID 19 cases
That's really not going to fly from a political, legal, or medical ethics standpoint. Like, just letting the unvaccinated die and shielding the health system would be an option if societies worked completely differently than they actually do, but given how societies actually are, this is simply not an option.
> Vaccinated people are significantly less likely to contract the virus
Recently vaccinated people are significantly less likely to contract covid than totally naive folks. Efficacy against infection seems to wane pretty heavily over time.
> Breakthrough infections are significantly less contagious than infections in nonimmune persons
This seems to be in dispute (by a study referenced in your linked article). I think it would be fair to say they are at least contagious for a shorter duration though.
It sounds like you agree that "vaccination doesn't protect you from getting infected and infecting others", the statement I was responding to, is wrong.
I think fixating on the limits of vaccination rather then the benefits is misleading. Vaccination works, yet many people think it does not due to this rhetoric.
I think it's not as simple as that. I think a large part of the difficulties we're having around getting everyone on the same page is that people are saying things that they want to be true, and even are true if you squint a little, but can reasonably be read as not true.
"Vaccines work" (or the constantly repeated "these vaccines are safe and (remarkably/fantastically/stupendously) effective) isn't trying to educate you on the vaccines so you can make the right decision on your own, it's meant to get you to take the vaccine. They're stronger statements than are justified, and they make people suspicious as a result.
Some people are going to read " vaccinations work" as "you take this vaccine and you can't get covid, can't spread covid", which is not even close to accurate. We're all better off (IMO) being honest and humble and careful with our language, so we don't get caught overplaying our case and further galvanizing people.
I have friends and family who have had to delay lifesaving medical procedures because hospitals are still swamped and medical personnel are still overworked from dealing with the COVID cases we currently have.
Societal standards for risk still need to take into account far, far more than just "Am I, personally, going to die from exactly this one risk factor?"
I agree, however the obvious answer is that society should then build more hospitals and train more nurses, the same way that China did in 2020. Not plunge the economy into debt and force millions of people to change their behavior because of a broken system.
> however the obvious answer is that society should then build more hospitals and train more nurses
And if you have a time machine, that's a great solution. Just go back about 7 years and tell them "we'll be needing a lot more medical staff around 2020, get training them, please". It's not really a wonderful solution now, though, due to the very long lead times for training staff.
> the same way that China did in 2020
While China did build more hospitals in 2020, it leaned heavily on redeployment of staff from non-impacted regions, because it was always largely able to keep covid a regional problem. It wasn't just producing new doctors and nurses in a week; they were coming from elsewhere. When covid is endemic, this option doesn't work very well.
Oh OK. How many years will that take? You can't just staff these new hospitals with just new nurses, you need doctors and other support staff. We have a vaccine now. If everybody just got it when they could we could start to move on without spending millions or billions building new hospitals and paying people to train to become nurses and doctors in half a decade.
China built a 1000 bed covid hospital in 10 days and staffed it with army nurses.
Compare this to requiring 330 million people to continually agree and coordinate basic pandemic behavior like masks and vaccines.
Costs are largely irrelevant. Perhaps 100 million for such a hospital. This is 0.0001% of the 6+ trillion the government has spent on other covid actions.
There's a reason China hasn't made this their strategy for the rest of the pandemic. It works as a stop-gap, if you accept low quality of care (read: high mortality) and if you're dealing with a regional outbreak where you can ship in resources from surrounding areas.
It's not going to work if the entire country, continent or planet is in the same situation.
> obvious answer is that society should then build more hospitals and train more nurses
The number of hard to get nurses? Or say - funding for building hospitals that operate on profit? System still and likely seems to perpetually be broken.
Nobody could even get society to do basic pandemic stuff like wear masks or take vaccines. How would they ever coordinate "build more hospitals and train more nurses" ?
Also, what is this "society" you speak of? There are very very few hospital facilities in the USA built as public institutions, or even with (much) public funding. That's now how things work in capitalism.
>Nobody could even get society to do basic pandemic stuff like wear masks or take vaccines. How would they ever coordinate "build more hospitals and train more nurses"
The answer is pretty simple. You don't need mass coordination to build more hospitals.
It requires 1 person (the president) to agree to build emergency hospitals, or at worst 51% of 535 people in congress.
Compare this to requiring 330 million people to continually agree and coordinate basic pandemic behavior like masks and vaccines.
There are less than 1000 covid ICU patients in California today and 12,000 in the entire country. China built a 1000 bed covid hospital in 10 days and staffed it with army nurses.
> It requires 1 person (the president) to agree to build emergency hospitals, or at worst 51% of 535 people in congress.
At worst, it takes 60% of the Senate (because cloture), 218/435 in the House, plus the President to pass the law to do it federally, and then someone invokes the judiciary via lawsuits over federal authorities (“building hospitals is not an enumerated power”).
But if we want to be pedantic, you are assuming a filibuster and controversy.
I think that could be done entirely by executive action, using administrative actions, like 900 billion dollars of other covid spending that had no legislative approval.
I suppose states and governors could sue to have federal hospitals treating their residents torn down in the middle of a pandemic, but that would be terrible PR.
> But if we want to be pedantic, you are assuming a filibuster and controversy.
Since we're talking about what it takes to force a preferred solution in the absence of consensus, and you specifically said you were targeting the worst case, yes, I’m doing exactly what you called for.
> I suppose states and governors could sue to have federal hospitals treating their residents torn down in the middle of a pandemic, but that would be terrible PR.
Worse than suing to prevent schools or towns from requiring masks? Worse than suing to prevent "vaccine mandates"?
I'm sure you'll see it differently than I do.
> But if we want to be pedantic, you are assuming a filibuster and controversy.
I don't think you have to assume much to believe that at the present time, not a single Republican senator would vote in favor or such a measure if it was backed by the current president.
> there should be next to no behavior modification expected.
So, there are a few things here.
Purely from an individual point of view, for the average vaccinated (and especially the average boosted person), this is probably largely true.
And indeed if the whole population was vaccinated then this would probably largely be true for everyone.
But the elephant in the room is the hospitals. If rates are high enough that the ICUs are full (typically, in heavily vaccinated countries, mostly of unvaccinated people and severely immunocompromised people) then that is a big, big problem. If you're in a nasty car accident, say, you may, under normal circumstances, end up in ICU. However, if ICU is full of covid patients, you won't, even if you need it. And, less dramatically, overcrowded hospitals mean a lot of routine stuff gets cancelled. Many countries' hospital systems have, in practice, been in a reduced normal capacity for the last two years, and there are significant backlogs; it can't go on forever.
But yes, if you, personally, are vaccinated and boosted (and not immunocompromised), then you, personally, are unlikely to die regardless of how bad your behaviour is. Not of covid, anyway. Perhaps avoid ending up in a situation where you need to go to hospital for something else, indefinitely, though.
Why haven't governments been working hard at increasing capacity in terms of ventilators and hospital beds and other needed equipment, since March 2020? Back then governments actually did that, and set up emergency beds.
I know that there's a shortage of personnel, but it just seems that this would've been something to work towards since the beginning. I don't know what is practically needed from the personnel to nurse <60 year old Covid patients (couldn't less trained staff, 6 month quick course do the bulk of it?), the vast majority of which who go home, while it's the older ones who won't return home, and will likely require constant and/or prolonged care.
Solve the equation for the younger patients and boom, you can increase hospital capacity (or setup new "Covid ICU:s") and just let the wave hit. Seems it would be such a better solution than whatever we're doing now (prolonging the backlogs forever).
> Why haven't governments been working hard at increasing capacity in terms of ventilators and hospital beds and other needed equipment, since March 2020? Back then governments actually did that, and set up emergency beds.
Many of them have. In general, equipment isn't the problem today in rich countries; it's staffing.
> I don't know what is practically needed from the personnel to nurse <60 year old Covid patients (couldn't less trained staff, 6 month quick course do the bulk of it?)
If they're in ICU (which is the main concern), multiple specially trained nurses per bed, plus various doctors and other support staff.
I'm not quite following the distinction you're making here between young and old; the main relevant distinction is ICU (mostly either unvaccinated or immunocompromised) or non-ICU (most vaccinated patients of all ages who require hospitalization land here; also lots of unvaccinated). Many countries are seeing fall-offs in the numbers of elderly people in ICU as the boosters go down the list, but ICU numbers are still growing.
> I'm not quite following the distinction you're making here between young and old
What I was getting at is that the vast majority of people dying in the ICU are 60+. So scaling up ICU's isn't gonna do much for them. Scaling up ICU's to cater for the <60 group (plus non-Covid hospitalizations) on the other hand, which you as well mention are more represented now with boosters, we could simply ease up on restrictions, not worry about the minority of unvaccinated people, and let this run its course much quicker than what the current "plan" allows for.
> multiple specially trained nurses per bed
How much training? Just brainstorming here: Wouldn't a 2-6 month (paid) intensive course be enough? It's not like you'd need to specialize in everything, just common symptoms/issues related to Covid hospitalizations. And after that you'd have a guaranteed well-paid* job for as long as this lasts. Throw in a college education like the military, if we're talking the US, for good measure.
Just seems like there could be more done so much more in this area.
*) this would of course include paying these people properly, which could be done through government subsidies
edit: We thought the vaccine would take care of this whole thing but now after it's apparent it won't, we need to think of better solutions.
Is it? 0.2 percent of American's have already died from this. Or put another way, 99.98% is the current best real live actual number of how survivable Covid-19 is. Not some made up number with a bunch more 9's or 0's, but 99.98%. Three nines would be pathetic for a website's uptime. (I might be biased on that one, I do that professionally.) This puts it 3rd on the list of health reasons Americans die, behind cancer and heart disease and we sure as shit do a ton of things to prevent cancer in a large population (see also: Why we don't have more nuclear power plants. Hey guess what you get when you get exposed to poisonous radiation?).
COVID19 is NOT a personal health emergency. As an American, your chance of dying from COVID are vanishingly small, and even your chance of being seriously ill or suffering from "long COVID" are extremely small.
But ... COVID19 IS a public health emergency. It is contagious enough and causes a need for hospitalization enough that it is fairly easy for it to overwhelm our public health care systems. This means that when you next cut your hand with a turkey carving knife, are involved in an automobile accident, turn out to have cancer, or suffer from any of an almost innumerable number of medical conditions, you (and everyone else) will face personal consequences (including risk of death) from COVID19's impact on health care systems.
This disease is not about you, or me, or individuals in general. It's about a threat to our public health systems because of large numbers (and the numbers don't have to be that large) of people catching COVID19, getting sick and overloading hospitals. It has nothing really to do with risk of death or long term consequences, although the friends and relatives of the hundreds of thousands of dead Americans, and the thousands of people with long covid might also want a word with you.
This has been the #1 (if not the only) concern from the beginning. It baffles me how little focus is being put into it.
Why not pour a ton of resources into hospital capacity, equipment, training staff (quick courses with guaranteed well-paid work), finding solutions that require less staff..? Being to scale up this operation seems imperative for when something like this happens in the future. I.e. spin up new Covid ICU:s when/where needed. We seem to be highly inelastic/incapable in this regard.
Reasonably sure that more people get cancer from things like smoking than their desire to build their own nuclear power plants.
People can still and will keep on buying cigarettes and smoke and give themselves cancer. Governments still permit their sale in a lot of places. I think the ship has sailed on support for the 'give up freedoms such as traveling to see your friends and family and engaging in social activities' preventative measure.
I set our target uptime at 99.95% believing that to be the most reasonable balance of availability and willingness to take risks to increase the pace of developing the product.
> 0.2 percent of American's have already died from this. Or put another way, 99.98% is the current best real live actual number of how survivable Covid-19 is.
Pretty bad comparison. Covid is massively front loaded. Almost every single person in the US has a much higher chance of dying from heart disease or whatever over a legitimate period of time.
Based on CDC data the best number of how survivable COVID-19 is for unvaccinated patients is 99.4%. That's a population average. There is a huge variance between age groups.
You'd think so, but where I'm from there are rural areas where hardly anyone has vaccinated and those who get sick from COVID are filling all of the hospitals in the cities while many other people were actually protesting at hospitals.
It's really disconcerting to think all those amazing life-saving but time-critical techniques and technologies that we have developed in the 20th century don't mean a thing if you're screaming in agony in the back of an ambulance after a car accident while the ambulance is stuck in a protest 200 feet from the ER entrance.
This is an unnecessarily sanctimonious post in my opinion. If you're in favour of fresh restrictions then for how long? To what extent? How much collateral damage in terms of mental health, education, the economy, social cohesion etc are you willing to accept? Implying people are selfish after two years of sacrifice is a rather churlish angle, in my opinion people advocating for continuing restrictions need to put numbers and cost/benefit analyses forward rather than cheap appeals to emotion.
Some people talk about these things as though they're inconsequential but the fact of the matter is that indefinite social distancing means effectively admitting we're going to permanently shutter swathes of the economy along with many cultural institutions that depend on high footfall. Indefinite masks means unprecedented levels of plastic pollution and difficulties for those with various disabilities. It's easy for us on HN who largely work remotely and earn high salaries to claim these measures are inconsequential but to many in other industries they are absolutely devestating.
Sigh, you just don't get it do you? There are other people in the world. Not one more death. Ever. If I could save an elderly grandparent by letting you die or your kids go uneducated or the environment get destroyed by plastic wastes, I would. Because it's not about me or you, it's about everyone else. How many more times do we have to explain this before you people get it???
It's been 2 years now, you're beating a dead horse. Time to look in the mirror.
> Not one more death. Ever.
This is insane. First of all this is an unrealistic/impossible goal. People die all the time. Dying is normal. Especially for elderly people. There's no way to stop people from dying from Covid, even if 100% of people were vaccinated. Get used to it.
1) No, any sanctimony present (and there was none, really) was entirely necessary.
2) I actually made no argument in favor of "fresh restrictions", but that's a nice straw man you are weaving together, there!
3) I didn't "imply people are selfish". I said it, straight out. GP's stated view is ludicrously selfish and ignorant.
4) After two years of sacrifice? That's just it, though: some people still don't get it, as evidenced by the comment I replied to.
5) Nobody argued for "indefinite social distancing", but, again, great straw man. Similarly, I did not say or imply that these measures are "inconsequential".
6) Excuse me, but as a professional classical singer, I am actually part of the industry that is perhaps the most affected out of any industry out there, or at least, tied for that dubious honor. So I don't need any lectures from you. My entire field was wiped out for about 19 months and is only now starting to limp back.
Again, you're just moralising at me rather than answering my points in good faith. You cannot use this forum to deliver a sermon and whinge about getting a lecture back in response. Give me numbers, not platitudes.
Nonsense. The virus is now endemic and will never go away. You can't seriously expect people to continue with masks and social distancing indefinitely. Fortunately vaccines and other treatments reduce the risk to a very low level.
Maximum death rate for all age groups with Moderna, which at least according to these plots provides the lowest death rate, is at 0.8/100_000 in August 2021 for all age groups.
Maximum death rate for the unvaccinated of age 12-17 is at 0.17/100_000, for age 18-29 it is 0.76/100_000, also in August 2021.
So even unvaccinated younger people (age < 30) are better off than the average vaccinated Joe. The thing is, so far I have pretty much never heard of this in my countries media, at least to me it sounds like "vaccinate absolutely everyone or we are all doomed", which according to this data is not the case.
If you are under 30, it appears your risk of death is low regardless of your status, but you will not forever be under 30, and perhaps you know some over-30 for whom the difference in death rate is important? Even if there's no one you care about who is over 30, to the extent that vaccination also reduces your risk of infecting others, it is polite to your society to be vaccinated. Perhaps you get no great benefit, but others do.
Once a vaccinated person has a breakthrough infection they spread similarly but of course the chance to contract it is lower and the time to "virus clearance" is faster.
I was lying in bed for two days until I self-diagnosed with appendicitis and decided to go to the hospital. Turned out I was just in time. What I mean is I won't seek medical help unless absolutely possible (I live in EU countries where medical care is free). Due to this mindset (whether or not you think it's stupid, I don't really care) I'm simply not going to subscribe to having two boosters per year for the rest of my life. I've had two jabs now but as it looks like now I'm probably soon gonna start putting my immune system to work (and travel less as a result I suppose).
There are studies indicating a previous infection provides a stronger and longer lasting response than the vaccine, although this is not definite yet - Israelis and the CDC have made opposing conclusions on this topic.
Yes, one of those two things will happen. The point is that the under 30s aren't likely to make it to a different age bracket where they are more significantly at risk without first achieving immunity in one of those ways.
Sterilizing vaccines inhibit spread. The SARS-CoV-2 vaccines aren't sterilizing to any significant extent. Vaccinated individuals might be contagious for a slightly shorter period but in the long run that doesn't matter because the virus is now endemic and everyone will be exposed eventually. Fortunately the vaccines are still fairly effective at preventing deaths.
Country-level anecdata is basically useless without a multi-factor analysis due to huge differences in restrictions and self-directed prevention by the public.
> at least to me it sounds like "vaccinate absolutely everyone or we are all doomed", which according to this data is not the case.
Sending mass communication about health with a list of "ifs ands or buts" is incredibly challenging especially for a pandemic level response, so if the communication is simply "get the vaccine" then you're going to get a higher uptick.
I understand your nitpick, but also understand the general population doesn't fully grok this stuff.
EDIT: Lemme also add - the data we're viewing is retrospective. We wouldn't know the effect until now, so of course the message has been "Get the vaccine"
> So even unvaccinated younger people (age < 30) are better off than the average vaccinated Joe
Of course you can only say this only for a big 18-29 age group viewed as an aggregate (regarding mortality), but can't say that generally of members the group.
Eg according to https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-... the deaths in 25-29 age group are dramatically more common than among 18-24 year olds, and there are other individual traits that are big factors in death risk. So it's safe to say that lots of <30 year olds have multi-% death risks, not to mention lifelong or long lasting harm from the additional near death cases.
(But of course the most important thing is to reduce infections between people to keep riskier groups alive, so even without personal death risk it would be incredibly immoral to not get vaxed)
I mean it was never the case, since the beginning we all knew it was 95% of deaths among the 50+.
Then the goalposts (sorry for this language but there isn’t any other) shifted to continued transmission and viral mutation, until breakthrough became normalized. Now it’s filling up ICUs and healthcare collapse because of the unvaccinated.
It’s all really sad when the CDC itself needs to cherrypick data until it can proudly say that “vaccines are 5x better than natural immunity” as if it was a competition: man versus nature (never mind the dozens of studies proving otherwise)
You're forgetting the vaccine is also very efficient in preventing hospitalization. By a factor of ≈11 (average, ages 12-17 & 18-59) in the RKI (Germany) data[¹].
So even if you're aged 12 to 29, if you don't get vaccinated you're gambling at taking away someone else's hospital bed. Which will doom the rest of us.
So, can everyone please get fricken vaccinated ffs?
> So even if you're aged 12 to 29, if you don't get vaccinated you're gambling at taking away someone else's hospital bed. Which will doom the rest of us.
According to [1] at no point in time since March this year (when they started recording this data) have there been more than 100 hospitalizations in the age group 0-30 in Germany a country with 80+ million inhabitants. If this means doom to all of us I don't know anymore.
That's a valid argument, I wasn't aware absolute hospitalization numbers <30 were this low.
… which just leaves the other arguments to get vaccinated. Namely, lesser chance of long-term symptoms and lesser chance of getting infected (last I checked, outbound transmission doesn't seem to be reduced much, but inbound is, so it still serves to slow overall spread.)
> That's a valid argument, I wasn't aware absolute hospitalization numbers <30 were this low.
And yet you were more than willing to make the baseless claim in the first place, which is one of the biggest issues with all of this in the first place. The media is doing its best to make covid seem scary as it can and is helped along by misinformation like this, fueling overall distrust.
So in other words all of the non-debunked reasons for <30 to get vaccinated are all about individual health, and have no impact on anyone else's health.
I encourage everyone eligible to get vaccinated, but hyperbole isn't helpful. Occupying a hospital bed won't doom the rest of us. In any given year only a small fraction of the population gets admitted to a hospital for any reason.
"Gesamtzahl gemeldeter Intensivbetten (Betreibbare Betten und Notfallreserve" chart shows the ICU stats over time. Occupied beds are roughly a flatline around 20k, with a small 3k seasonal (covid?) variation. OTOH, the total number of available ICU beds have fallen from ~32k to ~24k, 25%. We are all nervous to see how the medical system will weather the winter covid waves, sadly the covid pandemic is far from over. But I'm confused: the data indicates the system has lost significant ICU capacity, a few times more than the seasonal (covid?) utilization variation. What is going on? Is this something Germans also openly worry about?
1. In the last wave, some hospitals reported more ICU beds than they were actually prepared to staff, because each available bed in the datasheet got them a hefty government subsidy.
2. A non-negligible number of ICU nursing staff were worked into the ground in the Winter 2020/2021 wave and decided to quit (read: move into similar jobs with less horrible working conditions). From what I hear (caution: anecdata), a lot of the remaining staff are now considering to follow them.
That's a curious interpretation of the graphs... in all age groups in the US, the unvaxed line is higher than the vaxed graph (except for 1 data point for ages 12-17).
If you're unvaxed and using "So even unvaccinated younger people (age < 30) are better off than the average vaccinated Joe." as a justification, it's a bit like saying "I know being unvaxed I have worse survival odds than a fully vaxed 65 year old, but I prefer that!"
And please just compare data from close time periods, if we can pick different times for our rates, then I would pick October 2016, the chances of dying from Covid-19 at that time was absolute 0, even for the unvaxed!
The average person (vax or anti-vax) will read this to the end, maybe even understand the numbers but then think "well, but half of COVID deaths are among the vaccinated". 90% of people know that Stats is the hardest math there is and the other 15% don't get it.
Unlikely thing causing no damage is no source of concern
unlikely things which cause tremendous damage are for sure cause of concern because it only needs to happen once and it’s game over for the person/group/entity which find themselves at the receiving end of that
These days you can't rely even on scientists to interpret results correctly. I see interpretation problems almost every other paper I read that has any non trivial research that involves statistics.
Vast majority of people are functional illiterates when it comes to statistics. How you present statistics is more important than what the data actually says.
The Public Health England weekly report, already adjusted for percentage of vaccinated, for the last few weeks clearly shows more deaths of the vaccinated from covid and other causes
The USA having more deaths this year than last, with the Delta that spreads faster but is less deadly
Personally not vaccinated, had covid recently, and have no plans of getting vaccinated. Caught from my Pfizer vaccinated wife, and we both had the same symptoms
Probably because those rates are from 10 to 60 years, which is quite a broad range. People in their fifties/sixties die like A LOT more than young people and these ages happen to be the most vaccinated compared to the youngest ones. https://plato.stanford.edu/entries/paradox-simpson/
Also, when we are seeing far fewer vaccinated people in hospital in most countries (in my country 70% of the admissions in the hospital are from unvaccinated people), it is not only that the number of vaccinated people in hospital is much lower, you have to keep in mind that the number of vaccinated people is much higher (in my country +80%, almost 90%, are vaccinated) so the effect of the vaccine in death rate is even much higher (before measuring the effect of vaccines we even thought that vaccinated people would be the most prevalent in hospital because the number is vastly superior)
There are all kinds of possible explanations for this. If you look at this heatmap of vaccine uptake by age and time (you'll need to select second dose)[1], you'll see that the uptake percentage is fairly uniform across all age groups below 60 e.g. in March, but goes up fast for 55-59 in April, meaning the "10-59 + Second dose" group became older on average during that time. My best guess is that the uniform distribution early on was from healthcare workers; later on, the age-prioritized vaccination rollout changed the distribution.
There's a reverse trend that coincides with an increased uptake in younger groups: The age-specific death rate for "10-59 + Second dose" in June was 2,8 and went down to 2,4 in September.
One thing to keep in mind: When we're talking about the 10-59 age group on their second shot prior to April, that's only a population of 800k with a total of 16 deaths reported between January and April. Confidence intervals for this period are very wide and the upper confidence limit in the ONS data is quite close to what they're reporting e.g. for September.
It does not seem unlikely to me that the group of health workers that made up most of the vaccinated group prior to April generally has a lower death rate than the unvaccinated group, which would have contained most aged 50+ at the time (vaccine uptake was <6% for the 50-59 group at the end of March).
More importantly, COVID also accounted for more than 30% of deaths in the "10-59 + Unvaccinated" group between January and April (2,761 of 8,665), as this was around the time the third wave peaked. As one would expect, this didn't really affect deaths in the vaccinated group.
I don't think anyone should attempt to draw conclusions from such a small group that is not at all representative of the whole population (in general and within the 10-59 age group).
Your link also provides the likely answer when you scroll down to the comments:
> One reason not to draw too much of a conclusion is that 10 to 59 is a really, really broad age group, and the underlying death rate at the top of that group will be much higher than at the bottom.
> If the vaccination is also unevenly distributed in that group (and you would imagine the vaccination rate to be much lower among 10 year-olds than 59 year-olds) that would probably provide a sufficient explanation.
I assume you're saying that this is all due to the respective ages of the populations. If that's the case, then why did the vaccinated group (older) have a lower death rate than the unvaccinated before April?
To answer that question you need to dive into the original data set (if you want to see yourself: Search ONS death by vaccination status, in the .xlsx it's sheet 'Table 4').
There is a reason why the person who made the chart started with 19-Mar-2021: There aren't enough deaths before. Even for the 21-Mar data point it's only 5 deaths!
Luckily ONS does provide confidence intervals (column J, K). There is even a marker in the sheet called 'u' to highlight unreliable data due to small numbers. But whoever made the chart was not interested in either (why?).
While we are already in the full data set, note that the death rate for the unvaccinated group is appr. 4.0 (!) in Jan 2021.
There might also be another reason (hypothetical based on anecdotes): The very first to be vaccinated in the 10-59 group were likely nurses and doctors.
I noticed that they're only evaluating the covid-19 death rate. Not the overall death rate. Based on the latest data from England's ONS, in the 10 to 59 year old category, the vaccinated overall death rate is almost twice as high as the unvaccinated death rate
If your claim is true, the UK’s health authorities are deliberately ignoring this vital fact and have effectively engaged in manslaughter. That seems rather unlikely to me.
Can you be more specific with your claim? The age-standardised mortality rate appears to be significantly higher for the unvaccinated population according to your source.
// edit: Sorry, I missed the part where you were talking about a specific age group. This can be explained by [1].
Your average family physician reads exactly zero published papers per year, and would rely on Googling and reading health authority summary pages or media sources. If the goal is convincing skeptical family members with hard facts, searching the scientific literature oneself is likely much more effective.
Cute response folks. My physician is also my MIL. She is also not sure if boosters are a good idea. Doctors are not all equipped to keep up on the latest research on a rapidly changing topic. If I ask a doctor outside my family I am not likely to get linked to the latest research and an explanation of its quality.
I am absolutely able to read a study and interpret its results. I read the phase 3 trial results for Moderna and was satisfied that it was excellent evidence for getting the vaccine. I’m not yet aware of any booster studies outside of antibody counts post booster. It would be nice to have an idea of how much my risk of Covid drops and for how long, but I’m not sure if we have evidence collected on that yet.
as a person asking this question on the internet, i'm going to assume that you are not a scientist, and probably unqualified to make a scientific decision. you might be able to read some scientific-sounding information, but unless you're a professional in the field your odds of coming to a correct conclusion based on information you read is no better than random, and will almost certainly be biased by your politics.
i'll be getting a booster when my local health authorities say i'm eligible for one, because i know i have no relevant expertise that enables me to make a scientific conclusion on this subject. and neither does HN.
Your countries health care service most likely has public guidelines on this which you should consult.
If you have some kind of medical condition and a booster concerns you I advise you make an appointment with your doctor to discuss your specific concerns and get professional advice.
Hacker News is not the place to ask such a question nor give any response other than "check with your local health care service or doctor" imho.
If you previously received an mRNA vaccine then you might want to consider waiting to get a booster until the Novavax vaccine is approved. It uses different technology and we expect that the combination of two different vaccine types will likely produce a wider spectrum of immunity. But there's little hard data on that so far and you shouldn't take this as medical advice.
Yes; there is minimal disadvantage to doing so, it appears probable that booster shots reduce the chances if getting covid (which, even if not fatal is often quite _unpleasant_), and thus transmitting it, and, while it is very rare for vaccinated under 40s to die of covid, well, no-one wants to be a statistic.
> How many months after my second dose should I get it?
Recommendation normally seems to be 5 or 6 months; some authorities are recommending after 3 months for J&J.
> What are the best resources to answer this question?
Bob Wachter who is the chair of the department of medicine at UCSF says get a booster 6 months after either Pfizer or Moderna. If you got the J&J get a booster after 4 months.
For what it's worth, it would never cross my mind to get a doctor's appointment to just ask if I should get a booster. The health care system does not have enough slack for everyone to do that. I'd read official recommendations.
For what it’s worth, every recommendation I can remember hearing or reading advised to consult with your doctor to “see if the vaccine is right for you”
Upon receiving any sort of medical injection, you’re also typically recommended to follow up with your doctor.
For Covid in Europe at least you get the consultation when getting the jab. So I would (and do) check recommendations, reserve a vaccination slot, and talk with the doctor administering the vaccine if I have any questions.
It's not so much about trusting your doctor. For me, it's more about utter absurdity of the image of every single patient of a GP calling said doctor to ask this question, and thinking that the answer given is going to be any more specific for most of those patients than, say, guidance from the CDC.
Yes, if you have existing medical conditions that your doctor is aware of, they may be in a better position to point out any potential interactions between those conditions, any treatment you already receive, and a booster. But I'm guessing that this isn't a description of most of the population.
I'm also not sure that most doctor's offices really want every single patient calling in to ask "Should I get the booster?", and might simply be unable to deal with such a flood of questions.
There's also the little detail of millions of Americans not actually having "a doctor" in the traditional sense.
This article doesn’t identify any statistical problems. It just points out that it would be possible to get a misleading result if you handle your data incorrectly. It provides no actual evidence that such a mishandling is actually occurring.
The problem isn't only mishandling of data by statistical analysts, it is merely sufficient that government data be improperly recorded (as was famous last year, when people saw Covid statistics miraculously jump down on weekends and back up on Mondays in several countries) or that vaccinated/unvaccinated populations were misclassified (for example, by only defining people as vaccinated 2 weeks after they had their second dose, i.e. 3 months after the first dose, a rather long time). The article shows that artefacts you'd expect to see if data was improperly recorded, is actually visible in the real government figures. Whether due to the issues discussed, or due to other causes would require deeper analysis. But the onus then goes on people doing statistical analyses to understand, and correct for any mistakes in the originally compiled government data, and not blindly put numbers in Excel without deeply understanding the data they're feeding into it. Any good undergrad statistics prof would cringe at that.
The issue is that there is no actual evidence that the data is being recorded improperly. Anyone can come up with a just so story to describe how the data could be corrupted, but writing such a blog post does not in fact put a burden on the people doing actual analysis to refute the claim.
Not how it works. Burdens of proof work in courts of law, but you can't make a statistical analysis without addressing whether the data being used is sound.
You'll see a bunch of first-year undergrad papers rely on mediocre data, and then do all sorts of straight-from-textbook statistical analysis of the data, with p-values computed to 5 digits, and then discuss the data's mediocrity in a "Discussion" section. That's a common trope. But if the data is mediocre, you don't have a paper in the first place! Your p-values are junk, so are the abstract and conclusion, and you can't hand-wave it away by bringing up easily-addressed problems with the data in the Discussion section; should have addressed them in the first place. A great physics prof said: "any figure without an uncertainty is meaningless". So is any statistical analysis that doesn't validate the data it relies on.
But all that's besides the point, since the article I linked gives good reasons to believe the original government data does display issues in the first place.
But still, it is worth noting that the peak US vaccinated death rates on those charts (e.g. ~1.47 / 100k for Pfizer) are higher than the current _unvaccinated_ death rate in Chile. Vaccination contribute an order of magnitude decrease in the death rate, but surges can contribute an order of magnitude difference as well, within a country over time or between countries. Vaccines matter a lot, but all the other public health tools to prevent/combat surges also still matter.
The numbers are small and the risk concentrated in the elderly ailing population such that an outbreak in nursing homes can skew the overall numbers one way or another, depending on lack of PCR tests or over-sensitive PCR tests. These numbers are mostly useful for detecting general trends, e.g. are the cases going up or down, what is the O(death risk)?. Strictly comparing different locales is not going to be very informative
I think your point is valid for e.g. not comparing municipalities.
But comparing countries of tens of millions of people I think is not dominated by noise.
But perhaps a more pointed comparison is the US peak death rate for J&J vaccine recipients was higher than the lowest unvaccinated death rate. That swing happened only from early June to early August. I.e. if you got the J&J shot in early June, you decreased risk by 15 micromorts/wk with that vaccination but in just two months, the surge increased your risk by like 28 micromort/wk.
I don't think that's a statistical fluke; I think the situation really did get materially worse in the US over that period. That proceeded from choices we made as a society.
This winter, our collective choices still have the potential to create impacts which will rival the efficacy of the vaccines.
Example at the beginning shows clear algorithm how to turn ratio between vaccinated and unvaccinated deaths, percentage of vaccinated and population size into actual death rates for vaccinated and unvaccinated.
I wonder why they didn't apply it to real world data later on in the article.
Because Covid seems to be exceptionally efficient at killing those who are already sick. It's somewhat survivorship bias... Now that we have more effective means of protecting the at-risk (and plenty of them already died), the mortality rate is going down since the mix of people getting sick includes more healthy people as a %.
Recently infected people haven't had as much chance to succumb. There are also delays in reporting I believe. I also think your explanation carries much of the effect size, but the timing also matters.
It’s not about recently infected. It’s about deaths per day of unvaccinated. If the amount of death among the unvaccinated is going down daily then it is. It has nothing to do with recently infected because at some point some of those people may die next week or the week after and it will be reported then.
If the data reports the date when someone dies, and it takes a couple of days for the death to trickle through the data processing/reporting pipelines, wouldn't that be a lag?
This confused me as well -- it's not totally obvious with the way that the information is presented.
Per the "Sources" tab:
> Incidence rate estimates: Weekly age-specific incidence rates by vaccination status were calculated as the number of deaths divided by the number of people either fully vaccinated (cumulative) or unvaccinated (obtained by subtracting the cumulative number of fully vaccinated and current number of partially vaccinated people from the 2019 U.S. intercensal population estimates) and multiplied by 100,000. Overall incidence rates were age-standardized using the 2000 U.S. Census standard population. Rates are not adjusted for time since vaccination, underlying conditions, or other demographic factors besides age.
So I believe you're correct in that the data comparing deaths against the entire population, not against people who got covid.
> Wouldn't that cause an increase in the death rate among the unvaccinated?
If the unvaccinated are skewing younger over time, we'd expect the death rate to go down because of that. Younger people are much less likely to die from COVID, even if they're not vaccinated, and this seems to be especially true for school age children.
The denominator of the death rate is not COVID cases, it is total population. If the number of COVID cases drops, even if mortality remains constant, then the death rate will also see a concomitant drop. When compared to a graph of the daily cases, the pattern in the parent post essentially matches.
There has never been enough hospital overrun to significantly impact death rates. In other words, the number of people who died who would have survived if more hospital care was available is extremely small relative to the total death toll.
Moderna seems to be slightly more effective but with slightly worse side effects. Dose is the most likely explanation (30µg for Pfizer/Biontech vs 100µg for Moderna).
An additional reason is that Pfizer/Biontech was available first, so old or otherwise vulnerable people are more likely to have been vaccinated with that.
That is, Moderna is probably more effective, but people vaccinated with it have an even lower death rate because they're less likely to have been in a vulnerable group.
This is also a major factor that can be missed when going over the vaxxed vs unvaxxed death rates. If (eg) 75% of the population is vaxxed, 5% chose not to take it and 20% are too young (and thus very unlikely to die of Covid), then the difference in death rate will be much smaller than you'd expect based on vaccine effectiveness.
Yes, and we are also pretty certain that the mechanism of action is the number of mRNA particles contained: 30 µg for Pfizer/Biontech vs 100 µg for Moderna.
As a result, Germany e.g. uses half-doses for Moderna and vaccinates under 30s exclusively with Biontech.
If you change the age group to the youngest possible, there are times where those dying that are vaccinated actually surpasses those that are unvaccinated. The difference is so low though that I don't understand how it would make sense to vaccinate those under 12. I remember at the onset of COVID-19 that they tried so hard to make everyone scared to death (literally) that they would push videos of people dying in the streets saying it was COVID-19 causing it.
Because they spread to the rest of the population. I don’t understand how, two years into the pandemic people are still evaluating whether we should vaccinate people based only off the risk to themselves.
I don't know the answer to this, but how does the total viral shed of a unvaccinated child compare to a vaccinated 60+? Also the viral shed of children compared by vaccine status.
If it turns out the answer is lower and similar respectively, then it would seem vaccination of children makes little difference in the grand scheme.
Two years in and we still make policy with many unknowns. Why don't we have a better understanding of the effects of policies over the last two years? I suspect (hope) we will have a 9/11 style commission in the US to study covid and policy for many years
Ok,so kids which are more likely to be picked up and held transmit slightly more than other kids.
This sheds no light on my original query which seeks to compare viral loads and transmission rates between unvaccinated kids and vaccinated adults. First, vaccines were not available during the study. Second, it only considered one direction, kids to adults. One would need to do a multi way with more age groups. We know the disease is skewed w.r.t. age.
I don't care about the rest of the population; I care about the health of my children. So yes, I am going to evaluate vaccinating a young child based on the risk to them. The child death rate graph is just noise; you can't tell any difference between vaccinated and not. The side effect rate from vaccines graph is, obviously, 0% in the latter group.
I’m not convinced it matters that much. Regions with high vaccination rates are having corona spikes right now. In my country 92 % of adults are vaccinated and we have the highest number of cases since 2020. Gibraltar with 100 %, Ireland with 95 %, there are more countries/regions…, all having a big rise in cases and are going back into lockdown.
So it doesn’t seem like the lower viral load is making much of a difference.
In Ireland we have, today, rates substantially lower than the peak in January. The variant prevalent in January was far less infectious, and most stuff was closed in January (there was a sort of timid partial reopening of some pubs and restaurants the previous November, which was reversed at the end of December, no events with over 50 people were allowed, everyone was still told to work from home where possible, etc). Now we have a much more infectious variant, almost everything is open (though people were advised to work from home where possible last week), and the rate is still lower.
That actually looks like reasonable evidence that the vaccine _is_ somewhat effective at lowering the R number, to me. At any rate, something is clearly reducing infection; despite a much more infectious variant, and far, far more social mixing, the R number is lower than it was in January.
Exactly this. I am double vaxxed Moderna and got it. I was bad sick, but not as bad as my unvaxxed friends who got it. But I’m sure I spread that sucker all over the place. And by the way, the mask made no difference In my case. I’m convinced it’s a fresh N95 everyday or you’re wasting your time.
How can you possibly know such a thing? The mask is more about reducing your spread to others, do you have reliable data on how many people you would have infected in lieu of masking? No, you don't.
All I know is I wore one and so did all my friends and it cut through all of us like a knife through butter. Nobody was spared. People think masks are going to save them. In my experience, they prevented nothing of consequence to me or the people I interact with.
The vaccine is still good at preventing you from catching it at all. If you don't catch it you don't spread it. It's more like 50% effective than 99%, but it's still going to reduce the chance you give it to anyone substantially.
A friend of mine is concerned about the life long impacts covid may have on his children. He really wants them to be vaccinated to prevent any of the long term effects.
I'm not sure what data there is on children and long term covid impacts?
This observation always really irritates me; making no comment about this particular instance, data jumping around doesn't necessarily mean it's noisy. Some datasets have high variance.
VAERS (an early warning system that allows unverified reports and requires physicians to report all seemingly related deaths) shows 0.0022% (9,810) of vaccinated individuals in the US died after receiving the vaccine.
Generously assuming all those reports can be directly linked to the vaccination (they can't), that figure is already three orders of magnitude lower than the 1.6% (772,000) of people who caught COVID that died. Looking at the linked charts, if we'd had the vaccine at the beginning, we could surmise that roughly 77,000 (87,000 if you want to add the unconfirmed vaccine deaths) of COVID deaths would have been vaccinated, and almost 700,000 would have been unvaccinated. Add in the potential effect of herd immunity, which we never achieved--who knows how well off we'd be if people hadn't wasted so much energy railing against the public good (for an idea, maybe look at how the polio vaccine went over with the public, and how many people in the US now have polio).
Every death is a tragedy. A little bit of elementary school knowledge of how vaccines work, combined with actually using your brain, indicates the degree of tragedy could be reduced at least 10-fold if all the irrationally angry people would just get vaccinated.
> that figure is already three orders of magnitude lower than the 1.6% (772,000)
I think the interesting ethical/moral/etc debate is what to do for people who are at lower or negligible risk of dying from COVID in the first place.
For example, https://www.statista.com/statistics/1191568/reported-deaths-... suggests that <20k people under 40 have died from covid over 2 years. There might be age groups or demographics where the risk of death from the vaccine is higher than from covid. (This is a statistics observation, not a political statement.) For those groups, what should be expected in terms of vaccination? E.g. what if for your demographic, the risk of death from the vaccine in 1 in 50k but the risk of death from covid is 1 in 200k?
It seems like it could be a debate worth having. I'd love to see a similar breakdown of vaccine deaths by age (though I don't think there's an official count of confirmed vaccine deaths yet).
If a healthy under-40 individual had the same or slightly higher risk of dying from the vaccine as from covid, but a lower risk of passing it to their parents and any elderly person they come into contact with, should they prioritize their own small statistical advantage over the lives of those others? Should they also consider infections down the line, generated by the individuals they infected?
If someone were to present a convincing case that such a hypothetical were true, I might be forced to rethink some things. However, since the vaccine isn't mandatory, I don't see much in the way of actionable conclusions (other than posting the stats to the CDC website). Personally, I'd take on at least double the (low) risk to try and protect my family. But I'm also biased by knowing how shitty COVID can be, and preferring a quick death to a COVID death.
There is and never will be a definitive "morally right" answer for all situations. Also death is not the only metric people are scared form side effects that may not cause death. They probably should not be but most people simply cant do the research to "know" the real risks. So most people go by what they are told from someone they trust or they do the opposite of what someone they dont trust says (for example the mainstream media).
In the end the only acceptable "morally right" thing to do it to let people decide. This is how it was before covid and this is how it should be after. Will this lead to more death than enforced vaccination for everyone? Yes, it almost certainly will but that should not be the metric. Its an completely "invalid" argument that would never be used for any other similar topic.
You are doing your math incorrectly. The "0.0022%" number if for all age groups, so if you want to compare appropriately, you use the % for death via covid for all age groups, which is 1.6%. If you want to narrow it to age group, you need to find the death rate in VAERS by age group.
Furthermore, the 0.0022% is undoubtedly a gross exaggeration of death-by-vaccine, as VAERS is designed to capture nearly any result of death after a vaccination, including things like "got hit by a car" because drugs could cause drowsiness, for instance.
In fact, it seems that people that get the vaccine have a reduced chance of dying from non-Covid things.
Based on the link in my comment, 600 deaths from covid in the 17 and under bracket since 2019. ~70m people in that age group, so that's 1 in 200k per year for 2 years, roughly? The vaccine risk (1 in 50k) is based on the .0022% figure in the grandparent comment. Not sure how that varies by age.
I think being generous with these arguments hurts more than helps. The reporting rules are mandatory for COVID-19 vaccines because they were authorized under emergency use.
"Healthcare providers who administer COVID-19 vaccines are required by law to report the following to VAERS" ... "Death" - https://vaers.hhs.gov/reportevent.html
Even someone who dies of a car accident gets recorded as a death. There is no judgement call made as to whether the vaccine caused it at all, it is required by law.
VAERS is a dataset that is meaningless on its own, especially in the case of the COVID-19 vaccine. It is meant to be compared with other datasets to uncover trends which could indicate a problem with the vaccine.
No need to be black and white about this. It's not just a battle between the rabid authoritarians and hysterical Chicken Littles on one side, and the crackpot QAnons and categorical anti-vaxxers on the other. There's a range of reasonable positions in between. So let's stop framing things in the distorted and divisive way that the media has profited enormously from.
I, for one, do not think the COVID vaccine specifically should be mandatory, nor do I think coercive tactics should be used. I think freedom of conscience is important generally and people should not be compelled against their consciences to do things they do not think they should be doing. We should also avoid fixating on COVID as if it was the be-all and end-all of human existence. It is one consideration and also one that does not justifiably admit imposing a blanket burden on everyone. Perhaps this is the result of the law of instrument: some epidemiology-informed considerations could be so hyperfocused on COVID, everything else if forgotten.
Yes and no. Vaccination is absolutely a black and white issue, you either got vaccinated or you didn't. What comes after that is not black and white: the antibody count is variable, from zero to some large number.
What I'm proposing is not black and white but instead two things that give people a range of choices.
Vaccine mandates make sense for the same reason drunk driving bans make sense: externalities.
The role of government is to cover for market failings, and spillover costs are a prime example of an area where markets are essentially guaranteed to fail.
First, I very clearly didn't say that they're the same thing so I'm not sure why that would be relevant. Second, that analogy makes no sense other than as a dog-whistle.
Lastly, even all of that aside, there's no rule that says the government can only mandate actions or prohibit actions. There are plenty of examples of both things in the US legal code.
There are several studies saying that vaccines are beneficial even for people who have natural immunity from an infection. Also, if we have learned anything the last two years it's that at a population level people flatly cannot handle nuance. Anything other than a flat "you must have proof of vaccination" isn't going to work.
One of those studies on the infected-then-vaccinated set (or, at least, an author of the study, being interviewed) claims “superhuman immunity” — effective against a spectrum of SARS viruses. Presumably the reverse (vaccinated-then-infected) is not true.
I will say that I do not particularly trust NPR any more; they have misreported events in direct contradiction of clear video and audio feeds of the events.
This post is very confusing to me. Why would the reverse not be true? Why did you post a source that you don't trust? Why just throw out an accusation like that, but with no specifics for people to follow up on and decide for themselves?
Well, that would be most countries, even in the West. Few places have an NHS-style comprehensive and universal coverage system, and in most of the rest (spanning Germany, the US, etc.) there are various levers of private insurance regulation that governments can employ to this end.
For instance, the coverage of tests and vaccines has been legislated and repeatedly updated through the course of the pandemic in the country where I live.
I would say belief systems versus being specific to either or. Being specific, If the number of deaths from covid or the fact that that vaccines have been proven effective for over 100 years aren't enough to sway an individual to get vaccinated I don't think anything will especially a comment on hatebook.
"the fact that that vaccines have been proven effective for over 100 years"
Even in the case of Covid, where people who are vaccinated are still prone to carrying, suffering from, and spreading the disease? I wonder if your sentiment will change after the vaccines pass FDA approval.
Are you sure that's the right one? Comirnaty.com currently states:
"Comirnaty® has the same formulation as the FDA-authorized Pfizer-BioNTech COVID-19 Vaccine"
Yet a previous version clarified that these two products are legally distinct, and even contain certain undisclosed differences:
"COMIRNATY® (COVID-19 Vaccine, mRNA) is also known as Pfizer-BioNTech COVID-19 Vaccine*
On December 11, 2020, the US Food and Drug Administration (FDA) authorized the emergency use of the Pfizer-BioNTech COVID-19 Vaccine to prevent COVID-19 in individuals 16 of years and older. On August 23, 2021, COMIRNATY® (COVID-19 Vaccine, mRNA)* received FDA approval.
The licensed COMIRNATY® vaccine has the same formulation as the authorized vaccine Pfizer-BioNTech COVID-19 Vaccine, and the products can be used interchangeably to provide the vaccination series without presenting any safety or effectiveness concerns. The products are legally distinct, with certain differences that do not impact safety or effectiveness."
It's not about antivaxers (honestly - personally, I haven't even thought about those folks first), it's about vaccine efficiency. Something I am - as someone who was eagerly vaccinated - is curious about. Surely it's always good to know what are my risks those days.
We can't move on when a substantial part of the population remains unvaccinated. With hospitals in the brink of collapse, there would be no return to normality any time soon.
> when a substantial part of the population remains unvaccinated
It's a vanishing minority of crazies. 99.9% of over 65-year olds have had one jab; 80% of those over 12 [1]. Close to a fifth of the population has had their booster.
This debate is over. The people who are left will either be nudged by mandates or self-isolate from areas of dense population or economic activity, which automatically reduces their risk to the public.
I interpret the link re 99.9% of over 65-year olds having had one jab in the same way as you, but I'm doubtful as to whether the number is correct - see e.g. https://www.cdc.gov/nhsn/covid19/ltc-vaccination-dashboard.h... also from the CDC which claims only about 90% of nursing home residents having had one jab. 0.1% of over 65 not having any vaccination seems very small, given logistical differences / political opposition etc.
In Greece, where I live, one third of people over 60 are unvaccinated. The same goes for various European countries which explains the new wave that is deadlier than ever. The more data we have the better.
Wow, that's amazing. As someone who has followed the covid stuff pretty closely, that's very surprising to me. I would have guessed it would be around 95%.
It's not a vanishing minority. The people over 65 largely have it because they've stared mortality in the face enough times to hedge on the side of caution. On the other side, you've got the under-65 crowd who aren't met monthly or weekly with an obituary of someone they know or used to know who think that they're "healthy" because they haven't had a triple bypass yet.
Brutally (and to your point in a backwards way, because I think your point is valid), history shows humanity moved on before vaccines existed, and we're here to talk about moving on or not.
Well then make it a law. No amount of reasoning will change these people's mind. The only anti-vax people I've seen get vaccinated are the ones who lost a close one, and even that does not always work, let alone some data viz.
I am vehemently pro-vaxx, but I'm against making it law, as that is an attack on bodily autonomy.
I'm fine with jobs requiring vaccination, and I'm fine with government jobs and public schools requiring vaccination, and even businesses (especially ones involving crowds of people, like conference/convention halls and cruise ships) requiring vaccination. It's basically saying, "You don't want to get vaccinated? Fine, then you don't get to participate in our society."
But a law introducing criminal penalties for being unvaxxed? No way.
I know tons of people who have been convinced by talking, and have been very active in matching up experts I personally know to people who have questions. This is a tractable problem in the majority of cases, it just requires empathy and patience.
People are stressed, people are scared, people are exhausted. Righteous anger makes all of that worse.
yesterday I was in line to get my booster and I overheard an unvaccinated person get their first dose because their job offer was about to be rescinded.
So, in addition to losing loved ones I think mandates do work. Putting it into law, like you suggest is harder, but giving companies green light for mandates is easier and does have some noticeable effect.
I've always loved this logic. Luckily lead, asbestos, CFCs, plastic hardners, microplastics, Teflon, fracking pollutants and ICE/diesel fumes have had no presumed medical benefits so we need rigorous evidence to believe they have already killed us.
If you would look at what is going on in Europe right now, antivaxxers can't be ignored. They are causing huge issues at the moment, like parts of Germany and Austria are fucked from a hospital point of view.
The article is not "proving vaccines work", it's explaining how some statistics presented in news or social media might be misleading.
Also: no, we can't stop collecting evidence supporting the efficacy of vaccines, because then the anti-vaxxers will scream blue bloody murder about how "there's no evidence."
I.e older and more susceptible to illness people like 70 year olds are more likely to be vaxxed than 25 year olds. Had the vaccination rate been constant across ages, the unvaccinated death rate would be far higher and the vaccinated death rate far lower. It’s bad stats to not account for the population differences like that one.