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Germany locks down unvaccinated people, as leaders plan to make shots compulsory (cnn.com)
435 points by Tomte 57 days ago | hide | past | favorite | 1623 comments



What we're seeing here is one of the wealthiest countries in the world with a population of > 80M people crumbling over a few thousand ICU patients because of long-standing issues that were never addressed.

The staffing problems in hospitals (and nursing homes) have existed much longer than Covid. I heard a lot about them myself when I did my FSJ (volunteer work) back in 2004, and it's only gotten worse since then. Our government is in full CYA mode, and doing everything they can to blame a scapegoat for problems they themselves have willingly created over decades. It's despicable, and nobody should support it.

FSJ is a year-long volunteer program for young people typically organized and funded by NGOs like the Red Cross and similar. I worked with small children, plenty of the other volunteers I met regularly worked in hospitals and nursing homes. They all talked at length about how atrocious the working conditions were and how they were asked to do things they weren't legally allowed to (e.g. taking blood, handing out medication) because the staff shortages were severe enough that people didn't have enough time to adhere to very reasonable safety rules anymore. That was 17 years ago.

This is a well known, widely publicized[0] and not at all new problem, and the unvaccinated are not to blame for it. Let me repeat, we're talking about one of the wealthiest countries in the world with a population of 83M people crumbling over a few thousand ICU patients.

[0]Some random articles from 2018/19 (German):

https://gesundheit-soziales.verdi.de/themen/mehr-personal/++...

https://www.tagesspiegel.de/politik/wenn-aus-notstand-panik-...

https://www.zeit.de/politik/deutschland/2018-05/pflegenotsta...

https://www.rbb-online.de/kontraste/ueber_den_tag_hinaus/bil...


So true and not mentioned enough by the media. The fact that we lost more than 4000 ICU beds over last year (during the Corona pandemic!!) because of personnel shortage is mind-boggling.

Instead of rewarding those who worked these horrible jobs and maybe attract new workers with better conditions (e.g. more holidays), better pay or tax reduction, our politicians did campaigning and ignored the upcoming winter.

Now they blame it on the unvaccinated and want to force high-speed vaccinating as many people as possible. But it won't help now. And it won't work either because they also messed up the whole vaccine supply chain.

I have long lost all hope in politicians. 99% of them are ridiculous creatures without a spine and only interested in their own progress.


With exponential spread, the actual number of ICU beds really doesn't matter, because whatever you've got will be overwhelmed across a similar timeframe anyway. The only way to actually fix the problem is to get the R-value below 1, which requires mass vaccinations.


The spectre of exponential spread is summoned way too often. Yes, an epidemic spreads exponentially when it starts, but also it's self limiting after a while. The 4th wave is wearing of already. Every wave so far has worn off in every country, with our without measures. As a recent example, compare Latvia and Estonia in the past few months. The former imposed strict measures, while the latter didn't, and yet the two curves match very closely.


Estonia re-imposed strict measures as well because the ICU was becoming overwhelmed. This means mandatory masks everywhere, no public activities without proof of vaccination (restaurants, gyms etc) and limits on opening hours and strong police enforcement of these rules.

The wave started leveling off about 2 weeks after and the rules are still in force.

Not sure where you got your information.


Mankind has a tendency to not accept what it cannot control. Our politicians and virologists often said something along the lines: "we need to do X to keep control of the situation".

In the end we never were in control of the situation but people cannot accept that.


Most of the measures we took were nothing more than modern day rain dances. Feeble attempts by humans arrogant enough to think they could defeat or control a natural phenomenon that is well beyond ours to control.


San Francisco has had less than 1/3 as many deaths per capita as the US national average, and somewhere between a third and half of the deaths SF did have can be attributed to one terrible policy mistake – re-opening indoor bars and restaurants in fall 2020 – which immediately kicked off 2–3 months of fast exponential growth. If the rest of the USA had been even as fast acting and careful as SF, more than half a million dead Americans would still be alive.

And there are plenty of countries around the world which have done a much better job than SF of testing, contact tracing, vaccination, etc. We can compare e.g. Sweden to other Nordic countries to see what an abysmal failure the Swedish “herd immunity” strategy turned out to be.

* * *

“We haven’t tried anything and we’re all out of ideas” is easy to sell to grumpy people tired of a really shitty year or two, on the back of an unprecedented wave of anti-public-health propaganda, but it is an absolutely terrible pandemic response.


> San Francisco has had less than 1/3 as many deaths per capita as the US national average...

What do you believe this comparison means? I'm not sure its saying much of anything. Perhaps you could come up with another similar sized city, with same socioeconomic/population-type makeup, with same latitude and seasonality profile to compare against? I'm not familiar with SF data sources on this, but I'm curious if you can provide a source for current IFR? My state here in southeast US's IFR is .012. That includes people who died in car accidents, of poisonings, of falls and other injurious actions while having tested positive for COV in last 28 days. My county is comprised of mostly older folks (median age 44), small at 186K people, and we haven't had a COV death registered in the last 11 months.

>We can compare e.g. Sweden to other Nordic countries to see what an abysmal failure the Swedish “herd immunity” strategy turned out to be.

Can you show some data sources for this? Everything I'm seeing is pointing to Sweden's last 2 flu seasons (encompassing COVID years) showing the same or lower all cause mortality than their previous 15-20 years. With 2018 being the major outlier not just in Sweden but all around the world, for which we still have no explanation.


San Francisco has done significantly better than any other city in the continental USA, despite being one of the most internationally connected, transit dependent, and densely populated. Honolulu is the only similarly successful large US city.

> IFR is .012

Do you mean CFR (case fatality rate)? IFR (infection fatality rate) is always only speculative, because we don’t ever have complete knowledge of the number of infections.

In total throughout the pandemic SF has had ~670 Covid deaths and ~54,000 confirmed Covid cases for a population of ~880,000.

For the same population, the USA average would be ~2090 deaths and ~110,000 confirmed cases. Except those are both dramatic underestimates of the relative numbers because SF has consistently had a much lower percentage of positive tests, and hasn’t had anywhere near the US gap between confirmed Covid deaths and total excess deaths.


0.012 would be too low to be a CFR. That roughly the right number for COVID IFR (maybe a bit too low), which can be calculated in ways that make it less speculative e.g. sero-surveys. Even so CFR is also speculative because so many cases aren't reported: that's the reason IFR exists as a separate concept.

In science you're really meant to use all the data because the problem with this sort of cherry-picking is that it can go both ways. Florida removed all its restrictions and was predicted to become a bloodbath just like they predicted that for Sweden. It didn't happen, results appear to have been unaffected by the changes. Studies that look at all the data find no correlations between lockdowns and COVID mortality (but lots of correlations with other bad problems).


This is the correct take. At this point, since we've already vaccinated the only control groups we had in the trials, we no longer can draw valuable conclusions. The only statistic that we should now rely on, in order to account for all positives and negatives from government's COVID response (vaccinations, lockdowns, hysterics and tantrums) is year-over-year (preferably flu season) all cause mortality, in a specific location, for a specific population.


> 0.012 would be too low to be a CFR.

0.012 is the San Francisco CFR. 0.016 is the USA CFR, if we go by confirmed cases/deaths as reported by the New York Times.

The IFR should be substantially lower than either of these; many deaths go uncounted, but a far larger proportion of infections never get a confirmed positive test. I would guess IFR to be in the 0.004–0.008 range. (Which is still scary high!) I’m sure if you do a search of the academic literature you can find more careful analysis and better informed estimates. It obviously varies from place to place and is substantially dependent on demographics and availability of medical care.

* * *

Florida was a bloodbath! It has had among the worst outcomes anywhere in the USA since mid 2021. Tens of thousands of avoidable deaths after the universal free availability of extremely effective vaccines and better understanding of viral transmission. The state government not only stopped any state-level public health action, it actively prevented state/local public health departments and local governments from acting. It is hard to imagine a more complete failure of state leadership.

Florida has had something like 4x more Covid deaths than San Francisco, per capita. And if we only look at deaths after widespread vaccine availability, Florida has had >10x more.

Of course, the virus eventually burned through a large majority of the unvaccinated population, and without enough remaining hosts to infect, flamed out. Fingers crossed that future virus variants don’t have enough immune escape to burn back through the state again.


>Florida was a bloodbath! It has had among the worst outcomes anywhere in the USA since mid 2021.

Yet, despite being significantly "older" than CA, it did significantly better than CA in 2020 with regards to all-cause-mortality. 2021, seems to be a different story at this point and I'm very curious as to the 10% difference between years (certainly seems to imply the virus has not burned through the population, assuming the virus had anything to do with mortality).


You're right. I dropped a zero by mistake, I was seeing 0.0012 (0.12%) but that's not what was being written.

The usual credible figures I see for IFR are between 0.1% and 0.3% - higher figures tend to be using bad methodologies like including estimates from the very first days of the pandemic when people were trying to estimate IFRs using random Chinese media reports, etc. If you restrict yourself to more rigorous methodologies and sample sizes, IFR falls a lot.

As for Florida being a "bloodbath", lol. That word doesn't mean what you think it means. Nowhere has been a bloodbath, and if there's one thing that's been consistently true about Covid data it's that you can make anywhere seem worse or better than anywhere else by choosing what to compare against. Use all the data and Florida seems pretty good, especially as Europe is busy proving that vaccines appear to have accomplished nothing at all in terms of total numbers, despite the many claims of efficacy.


I do mean IFR. I hope you understand that the CFR numbers you're quoting, are also speculative estimates. :-) Almost certainly the number of infections is vastly undercounted as recognized by CDC's footnotes on their Data Tracker. As of middle of last year, the CDC estimates that 45-55% of all Americans had been infected with COVID.


> CDC estimates that 45-55% of all Americans had been infected with COVID.

If we take 330 million people as an estimated US population, an IFR of 0.012 and 0.44 of everyone infected (CDC estimate from 1 October), that would be 1.74 million deaths. But the number of Covid deaths in the USA is probably only around 1 million (CDC estimate is 920 thousand as of 1 October), putting the US IFR at ~0.006. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...

I’d estimate a US IFR somewhere in the 0.004–0.008 range. We missed counting a significant number of Covid deaths, but we didn’t miss 60% of them. (In US counties with the highest proportion of elderly people, the IFR might locally be closer to 0.012.) But that is still a very high IFR!

Covid is a scary, scary disease. Deadly, highly contagious even before symptoms, and indistinguishable from common respiratory diseases during the part of the infection when most spread happens. Fortunately we have extremely effective vaccines (if only we can convince everyone to take them), and spread takes place almost always between unmasked people indoors making it relatively inexpensive to dramatically reduce the reproductive rate of the virus by avoiding indoor spaces and wearing masks when they are inevitable.


“Covid is a scary, scary disease. Deadly, highly contagious even before symptoms…”

Getting really tired of hearing this. To a HEALTHY human, it’s like a bad cold. Me and my family have had it in the last month and confirmed with tests so I know what we had. It’s gone through a bunch of friends too and the worst they experienced was feeling miserable in bed for a couple of days.

I have no doubt that for some it IS scary, but let’s not chuck around emotive language that isn’t an accurate description in the majority of cases.


Thats just wrong. There are more than enough healthy humans for which it is much more than just a bad cold, which end up in the ICU eventually. To my understanding it is not possible to know upfront who is such a human and who is not, even perfectly healthy people have bad outcomes. And yes, I am aware its just a small percentage of people in certain age groups.


Is unknowingly transmitting a disease that could kill someone you love (or even that you don't) without your knowledge not scary to you? Great, you have a healthy family and friends. What happens when one of those friends or family members isn't as healthy as they were the last time they caught covid? Still seems pretty scary to me.


What you may be missing is just how high of a percentage of the population of most western countries are not classed as healthy by any metric. Overweight, unfit, damaged through nicotine or alcohol abuse or even simple naturally occurring diseases where our health systems are able to keep them alive but not make them healthy again.


> In US counties with the highest proportion of elderly people, the IFR might locally be closer to 0.012.)

Yes, I do live in one of these older counties and specifically in my region of the county. Obviously words such as 'scary' are useless and subjective. Anti-biotic-resistant strep nearly killed me 3 years back, so to me, that was a scary disease. The COVID I had was milder than my yearly flu, and this is effect on the overwhelming majority of the population even considering the obesity rate in the US. Scary is not the word I would use.

> But that is still a very high IFR!

I mean, perspective is everything. What are you comparing this IFR to? I consider this a very low IFR, especially when you realize what we in the US classify a "COVID death". We do not count deaths of any other diseases using the same methodology as we have with COVID as far as I'm aware, and I believe this is the primary reason for our inflated mortality vs. most of the rest of the world.


I think it's wrong to describe this as saving people's lives. You have only reduced one particular kind of risk for a short period of time, while other similar risks continue to arise and affect the same people.


Yep… “There’s nothing we can do” is just flatly unacceptable to the majority of the population. That’s when religion gets invented to create rituals to ward away evil.


Yeah, and a major function of the church is to help people deal with death.


It's called "illusion of control", most prominent example being rain dances.


During the complete pandemic I never heared a so good fiting wise word like this.


Why are you so certain that the fourth wave is leveling off?


There is some self-limiting, but this limit is way above 1x/2x/3x ICU capacity currently.


self-limiting by death?


It's getting down because you are hearing those numbers in the news every day.

What expert are you? What are your numbers to determine that corona without measurements would not create a new york or Italy event across Germany?

There is probably a reason why you are not a virologist. Or do you have your own model numbers?


People who claim that "people don't understand exponential growth" don't understand it themselves, most of the time.

They're so proud that they can answer the question about what happens to the pond that is half-covered by sea lilies the next day but never think about what happens the day after that.

tldr: There is no persistent exponential growth in nature.


"If something cannot go on forever, it will stop." —Herbert Stein, economist, 1986


As of 12/02/2012, Robert Koch Institute, roughly the German CDC, estimates 7-day R-value at 0.92

https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus...

Index page: https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus...


not true - infection rate grows sigmoidal and not exponential. that's why at the moment you can observe a stabilization despite few changes in regulation as of now compared to the summer. infection spread saturates periodically after suceptible clusters are depleted.

what would make sense is a steady and controlled Durchseuchung with specific protection of vulnerable people (like old and sick) - b/c the best immunity is gained by infection.

but Durchseuchung never sounded good - that's why that term got so popular. it sounds ugly and brutal. but it's what was happening all the time with many diseases in the past thousands of years.


> the best immunity is gained by infection.

Source? I think there's plenty of peer-reviewed scientific articles claiming the opposite.


Even if it was, it still means risking death or permanent organ damage + good chance of passing the infection to others. Not the best value proposition & definitely not webscale.


I think it could be technically accurate, if you include that vaccination before getting infected gives better immunity than most other options. (It is almost like a booster shot, but worse in almost every possibly way)

Also probably true without the vaccine first, but the initial survival rate without vaccination is a lot lower.


So do not think, and go and look. Turns out that's exactly what scientists have been saying for a few months already.


I think the first person doing the claim should provide evidence, but anyway:

http://www.hopkinsmedicine.org/health/conditions-and-disease...

Here you can find linked three studies by the CDC that support the idea that natural immunity is harder to get and less effective (besides, as others have said, there's the non trivial chance of side effects or not even surviving the virus)

I don't care about what the "experts" think or say, I care about studies.

Update: https://www.nature.com/articles/d41586-021-02795-x#ref-CR5 reports many studies that claim that we should be vaccinating people after a natural infection to get "super immunity", but that is different from what the OP was claiming (natural immunity > vaccine immunity)


There are studies that say otherwise too.

https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v...


> This article is a preprint and has not been peer-reviewed [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.


> b/c the best immunity is gained by infection

That doesn't help if you die of the infection first, and COVID is extremely lethal among the demographics that most need the direct benefits of immunity.


That's not what they're saying. They're saying we should have protected those demographics and let the rest get infected.


That's a bit misleading. As long as the R value is above 1 the spreading is exponential. That follows directly from how the R-value is defined. What you mean is that the curve will take a sigmoidal shape for a while once the number of immune people has reached a certain threshold. In that case, the R-value is slowly approaching 1 again, and finally will go below 1 (which finally results in a curve that is not sigmoidal, of course). Other measures like lockdowns do the same to the curve, as is easy to observe by overlaying the measures over the curve, just not with an initial increase of cases that leads to hundreds of thousands of deaths. Estimated Infection Fatality Rates during the first Covid wave - where there was full hospital care available - ranged from 0.5% to 2%. So for Germany's 80M people that would be in the ballpark of 400,000 to 1.6M deaths - under medical care. Even if you take the original estimates of around 0.3% the results wouldn't have been flattering.

In a nutshell, the German government and every other country on earth is doing what you propose, except that they are vaccinating at the same time and try to keep the curves flat (but your use of "slow" also suggests this, so it's not clear what else you're suggesting).


> As long as the R value is above 1 the spreading is exponential

No, this is only true if the R value is constant in time. Not all functions with a positive first derivative are the exponential function.


Are you talking about a situation where the R value approaches 1 from above? e.g. R(t) = 1 + 1/t?

Because otherwise the growth is indeed exponential, yeah?


That’s one possibility, but there’s no reason it has to converge to 1 (i.e. linear). R(t) = 100/t is also not exponential.

Of course, the epidemic curve described by that function would indeed bounded below by an exponential function on part of its range, but the same is true of any function with positive derivative, and calling for example f(x) = x^2 exponential for that reason makes the term meaningless.

This is presumably what the OP meant by “as long as R>1, the curve is exponential”. But this is literally equivalent to saying “as long as f’(x) > 0, f is exponential” which is just not a useful concept.


You're nitpicking out of context, I didn't give a definition of an exponential function, I was talking about the spreading of the Covid 19 disease. For example, the R0 value of SARS-CoV-2 was estimated 5.8 in the US and "...between 3.6 and 6.1 in the eight European countries"[1] Obviously, it depends on many factors like population density and contacts of persons/day, but generally the disease will start spreading exponentially with R_t values approaching this number or staying constant.

The initial spreading will be exponential in the beginning - as every actual curve illustrates - if the disease is left unchecked as OP suggested, until R_t values go down again due to immunity. That's all I meant to say.

[1] https://www.sciencedirect.com/science/article/pii/S002251932...


Can you explain the difference between a function being "exponential in the beginning" and "having first derivative bounded away from zero at the beginning" ?


How about this:

exponential in the beginning == this part of the function can be approximated by a function ae^xb where a>0 and b>1

vs.

first derivative bounded away from zero in the beginning == any function that increases, including linear functions with constant first derivative and polynomials with linear first derivative

Or do you think all increasing functions are the same..?


Consider for example the functions f(x) = x + 1 and g(x) = e^{ln(2) * x}. Then f(0) = g(0), f(1) = g(1), and f(x) > g(x) whenever 0 < x < 1.

It is easy to show that for any function whose derivative is continuous and positive at 0, there is an exponential function (properly translated such that they agree at 0) that has similar properties.


> that has similar properties.

You should be specific about what properties you're talking about. What you're saying is that any function increasing function grows faster than some exponential function on a finite interval.

Still, you can observe f(x) on x ∈ [0, 1] and see that it is growing linearly. And you can observe g(x) on ∈ [0, 1] and see that it is growing exponentially.

I do not see the value in discussing the rate of exponential growth of f. Where as for g, there is a parameter with value ln(2).

If data looks like f, don't try to fit an exponential function to it (whether it's a least-squares fit, or any other objective f > g.

Are you trying to say anything else?


Exponential implies a doubling of R value. Starting with an R value of 1.1 the length of time required for doubling of the infected population is longer than other factors which will lower the R value to under 1.


wrong - many countries kept everything opened and the curve subsided after a while. It doesn't go to the infinite.


It doesn't requires mass vaccination. It requires people to be a little smart.

What if we all respected the first confinement? 6 weeks everybody at home, period.

The disease would be gone.

But no, oh no. People just can't be reasonable. So instead of 6 weeks, we've been dealing with this shit for almost two years.

And now you blame those who are unvaccinated, while vaccinated people go partying and spread the disease.

No, you should blame unreasonable people.


> 6 weeks everybody at home, period.

If taken literally, how is that supposed to work? People working for the emergency service still need to work, and they certainly can't work from home. Same for most of the medical sector, nursing services etc. and of course the various bits of infrastructure. Some industries cannot be easily shut down (you cannot stop or start a steel works on a whim). Most people involved in food production, too. Maybe you can blame people for not keeping at least two weeks of provisions (although blaming them won't change anything), but expecting them to go six weeks without buying any food or other provisions is certainly unrealistic. Things break, and not all of them can be left for up to six weeks to be fixed. (If your fridge breaks, or the heating breaks or your roof springs a leak, that cannot really wait. Same if things break in any of the critical industries and services that cannot be shutdown and need to keep working). All this residual activity still needs some amount of transportation and all the infrastructure that that entails. Etc.,etc. …


Why doesn't the same argument apply to other corono-viruses like influenza and the common cold? And why ignore the role of asymptomatic people (who can transmit) and those with symptoms so mild they can't be distinguished from the normal ups and downs of bodily functions. How then can one be 'smart'? These diseases wouldn't be and won't be gone. We are going to have to live with them as we've lived and thrived with untold thousands of viruses throughout our evolutionary journey.


There is also a small subset of the population who doesn't build an immunity to the disease. A friend's mom caught Covid last December before a vaccine existed. Her body isn't creating antibodies so -- as of the last time I texted that friend -- she's had it for at least 8 months. She was an incredibly friendly and social woman who has basically been turned into a Typhoid Mary that does experience Covid symptoms (and has intensely self-quarantined).

I don't know how many other people this has happened to but I too have my doubts as to whether there was ever any hope of containing this.


this disease is also spreading through animals and wildlife. Locking down humans would have most surely not put an end to it


There have never been a real shortage of ICU beds even in the worst days of Covid. Check stats, now situation is even better.


I can't believe people still think herd immunity is possible.

Delta. Omicron.

Our technology sucks and is slow, we can't achieve R < 1 this way.


It can’t be all that bleak.

The mRNA technology would let us inject omicron-specific boosters tomorrow, but then there is a lot of other safety hurdles that have to be met before it gets authorized and then distribution hurdles to convince people to take it…

Mathematically, we will get to R=1 this way, some day or another, with some percentage of people getting it via illness and some via vaccination. The choice is still ours on how and when.


Take a look at history to see how bleak it can get.

At this point I'm less worried about covid and more worried about the global rise in authoritarian trends.


At some point the classical ones are available that are not vector or mRNA vaccinations. Although there is still skepticism regarding duration of the protection.


> At some point the classical ones are available that are not vector or mRNA vaccinations.

So you say that at some stage there will be vaccines for COVID-19 that are not nMRA (Pfizer, Moderna) or Viral vector (AstraZeneca)

Why? The people who are happy with vaccines are fairly happy with these vaccines and might refine them, but not about to dump them entirely for a different technique. in fact mRNA vaccines are the new hot thing.

And the people who really aren't happy with these vaccines, will never be happy. They'll find a way to object.

So what's the incentive for such a classical vaccine? Who's going to root for it?


What do you mean? We need better vaccines for any long term strategy.


And those will likely also not be "classical vaccines".

Moderna and Pfizer (1) and AstraZeneca (2) are getting ready for the next round, still using their current technologies. They're not planning on going back to "classical vaccines" for COVID-19.

1) https://fortune.com/2021/11/29/covid-19-omicron-vaccine-prot...

2) https://www.independent.co.uk/news/uk/omicron-oxford-covid-a...


I can't believe people still think that mass vaccinations is not part of the solution

Vaccination is of course imperfect and cannot be the sole measure, but we can't achieve R < 1 without a lot of it.


I can't believe people still think after 2 years we're at a point technologically and logistically that we can control nature and just make this "go away".

Delta came out of India. Omicron came out of South Africa. How do mandates in the West stop variants elsewhere?

And variants aside, the vaccinated are still getting sick and dying at significant rates [1]. This vaccine is not the slam-dunk our "experts" promised. Until some miracle cure comes along, R < 1 is simply not possible.

If you think full vaccination is a necessary goal despite all this, OK fine. You know what might go a long way in terms of achieving mass vaccination? Open sourcing the vaccine recipe. Not just the RNA sequence. The whole recipe.

This should be a no-brainer.

Governments have no qualms with mandating lockdowns, masks, and vaccines for the masses.. but for some reason they hit the brakes when it comes to mandates for pharma. Not only is this a good idea in terms of improving supply side logistics, but also for the sake of re-building trust.

But no, common sense is too hard and "blame and shame" is too easy.

Being unvaccinated does not harm the vaccinated.

Hospital collapse has been liminal for 2 years now, it's a manufactured crisis. Instead of bolstering our healthcare staff and paying our front line workers more, we have done.. the exact opposite. We funnel tons of money to pharma, while frontline workers have effectively had their pay cut in half.

We're quite literally being force fed lies. But I guess that doesn't matter because at the end of the day the Milgram experiment prevails and all these attempts to question the narrative and hold authority accountable is pointless.

[1] https://assets.publishing.service.gov.uk/government/uploads/...

page 15


> Being unvaccinated does not harm the vaccinated.

This is, on average over large numbers, not correct. Higher rates of disease spread harms everyone, the vaccinated included.

> This vaccine is not the slam-dunk our "experts" promised.

Which expert promised you that?

> it's a manufactured crisis ... We're quite literally being force fed lies ... Milgram experiment ... question the narrative

Cranks write like this. That is a shame as some of your other points are very correct, particularly around the need for Intellectual property waiver, which some have been calling for for some time, to no avail (1). BTW, they don't generally call it "open sourcing" in that field.

Hospitals genuinely are in crisis and doing difficult triaging, anyone working in them can tell you that.

1) https://reliefweb.int/report/world/time-runs-out-break-trips...


>> Which expert promised you that?

https://www.businessinsider.com/who-says-no-evidence-coronav...

> Moderna's chief medical officer, Tal Zaks, said last month that he believed it was likely the vaccine would prevent transmission but warned that there was not yet "sufficient evidence" of it.

https://www.nytimes.com/2021/04/01/health/coronavirus-vaccin...

> The Centers for Disease Control and Prevention on Thursday walked back controversial comments made by its director, Dr. Rochelle P. Walensky, suggesting that people who are vaccinated against the coronavirus never become infected or transmit the virus to others.

> Cranks write like this.

Apologies I'm new to being a social pariah, being under pseudo house arrest, and psychosis in general.

I don't want hospitals to collapse. I'm afraid if we give up this freedom now, we'll never get it back. I'm afraid of the unknown and putting my life in the hands of people (our dear leaders) that really have never cared about my health before.

Even now its not about care for my own health, but for "the greater good".


I can only speak about where I am (UK) but the health care crisis is a complex topic, but there's no mystery at all to why it came about: decades of under-investment are 100% predictable given the party that has been power for a while now. It's what they always do. People should not be surprised that their votes have this obvious consequence.

But there's no easy fix to help us now, because it takes a long time to train doctors, nurses and other staff, or actually build hospitals. Yes, the crisis is entirely predictable but also entirely real. It is possible, even likely for a "liminal" crisis to persist at that level, as the safety valve that keeps it there is that patients without sufficient care just die off. These are the "excess deaths". Yes, I am appalled.

This is BTW one way how "Being unvaccinated could harm the vaccinated": If I (very much vaccinated) need urgent treatment for any reason, and can't get it because all the beds are full of unvaccinated COVID patients, then I am harmed thereby.

If your main concern right now is the "freedom" implications and the "we've been lied to narrative" not the actual deadly pandemic then you have been misdirected, and should reconsider your media diet away from conspiracy-mongers.

Yes, we need to take the good of others into account. Like it or not we live in a society and our actions impact others. This pandemic is making it clear to those who can see, that stubborn selfish refusal, and paranoid anti-mask and anti-vax "freedom" rhetoric harms not just yourself, but also those around you. Rugged individualism is a complete bust in this context. Collective action is what works.


Sure, this is a general problem with finite limited resources that are collectively owned. The more you have, the less I get. When demand exceeds the supply, harm is unavoidable. And yes we should do what we can to drive down the demand, but I don't see what that has to do with forcing restrictions on people that are not at risk?

This deadly pandemic is not deadly for everyone.

People over 50 make up 1/3 of the population but 93% of covid deaths. I imagine this number is roughly proportional for hospitalizations by the same age groups. We can do some handwavy math and say if everyone under 50 was unvaccinated, they would only ever take up 7% of ICU beds.

Is 7% the difference between collapse or not? "One size fits all" doesn't make sense.

Further, I'm so confident I will never get sick and be hospitalized with covid that I'm happy to forgo my right to an ICU bed. Thus I'm decoupled from the dilemma. Or at least in an ideal world I would be able to make that choice. This was my assessment the first time I got covid, and now I likely have some level of immunity, so I'm even more confident now.

And as far as your hospital scenarios go, my point is we haven't seen the things you describe materialize. I'm sure there are a handful of cases, which is a tragedy, but if it's marginal then we shouldn't hold it up as a liminal crisis like we have been.

> Yes, we need to take the good of others into account. Like it or not we live in a society and our actions impact others.

Tell me the magic number for risk tolerance. If everyone self-quarantined from driving, and we switched to a delivery only economy, we could drastically reduce the number of motor vehicle fatalities. Do we not owe that to the greater good? What about for climate change? We should continue living like we did in 2020 forever.

> Collective action is what works.

It always works when your leaders are competent and have your best interests in mind. My country doesn't even recognize natural immunity, which I envy the UK for.

But free choice works too. Look at Florida, Sweden, people will still choose the vaccine. You don't need a mandate.

> If your main concern right now is the "freedom" ...

I can't believe the "vaccinated" are completely unconcerned by the trends regarding freedom right now.

You know its not an either/or situation, you can be concerned about both, right?

Look at Howard Springs Australia. Look at the vaccine passports. Look at the thread you're posting in. You probably think you're exempt. But immunity wanes, and variants will continue to emerge.

Governments never relinquish their emergency powers once they're enacted. This is just the latest "WMDs in Iraq". I can't speak for the UK, but in the US we still have the patriot act, and we just recently pulled out of Afghanistan.

20 years later we still live under the boogeyman of terrorism. Imagine if all the money we put into the war on terror went into better healthcare and other social goods?

All of this is to say, I don't have absolute trust in the vaccine or the plan or the people in charge, I don't trust them to make good decision nor to be honest.

If you want me to be onboard with "the plan", governments need to tell me - What's in the vaccine. - Exactly when they'll declare this over. - That they'll undo all of their emergency powers afterwards.

Otherwise, just like the war on terror, this will never be over no matter how much we comply.


There are so many questionable things in this rambling waffle that it's hard to know where to start.

The idea that most people "not at risk" is wrong.

The idea that collective action is all about trusting government is wrong, it's primarily abut supporting the other people in your community. it's a very USA'ian line of thinking to jump to "Imma screw over my fellow citizens because the government can't be trusted. Freedom!".

The idea that Florida and Sweden are good examples is wrong.

And as above, the idea that the "freedom" implications and the "we've been lied to narrative" not the actual deadly pandemic is wrong. Do not confuse the one crisis (of democratic ideas) with the other (of infectious molecules) or your responses will not be appropriate. They operate at completely different levels of abstraction.

The idea that "we haven't seen the hospital scenarios you describe materialize" is, in my local area, wrong.

> Look at Howard Springs Australia. Look at the vaccine passports. Look at the thread you're posting in. You probably think you're exempt

I have no idea of the point you're trying to make, and please to make no assumptions at all about me.

I googled "Howard Springs" but I have no idea what crazy talking point I am supposed to be nodding along with now.

> governments need to tell me - Exactly when they'll declare this over

You can't vote on the virus's timeline. The only politicians who have tried to declare "it's over" are charlatans.

> governments need to tell me - What's in the vaccine.

Do I need to go into the reasons why this is paranoid delusional, confused idiocy? Governments don't design or manufacture the vaccines. Without a bio-medical background that you and I both lack it's just not comprehensible. And lastly, can you not google the layman's explainers and research papers? I understand why you didn't post this line alone in a comment - it would be flagged and deleted.

All in all, I feel like someone at a party who has engaged a stranger in conversation, and now regrets it, as they speak a lot but say absolutely nothing worth hearing.


Most people are "not at risk" in a sense that their risk is clearly much less than for others. There is no zero risk of anything, so we should not aim for that.

It would help if you explained what is wrong.

As it looks now, you just don't like what the stranger said and declare him not worth listening.

To me it is clear that vaccine passports is clearly not working and all this has become a big failure for politicians who don't know how to exit this failed strategy therefore double down on their plans.


It's been an honor and a privilege having a difficult dialogue with an enlightened stranger.

I hope you stay safe, healthy, and have a wonderful holiday this year.


> we can't achieve R < 1 without them.

So then what happened summer 2020?


Are you saying that we shouldn't vaccinate, because strict lockdowns worked, against the COVID-19 original strain, for a while?

It's technically true that this worked then, but 2020 is gone, not to return. a) new COVID strains were inevitable and b) prolonged strict lockdowns unpalatable and c) mass vaccination has a huge benefit. As part of a multi-pronged strategy, of course. Depending on only one measure, be it lockdown or vaccination, is not going to work.


Not the only way. What is with the north korean way? Just shot anyone that has covid?


I might be working from old info here but my understanding is that vaccination reduces the ICU burden. Assuming that's still good info, is it totally unreasonable to blame the unvaccinated for ICU overload?


Vaccination does reduce the proportion of people that need ICU beds, but there are pretty rapid diminishing returns on just vaccinating more; countries have reached the point where the majority of Covid patients in their ICUs are vaccinated at well below 100% vaccination. Also, vaccinating younger lower-risk people doesn't help because they're at substantially lower risk of needing the ICU even unvaccinated than someone older or higher-risk who is vaccinated and because the vaccines aren't really useful to stop the spread of the disease either. Countries have generally had significantly higher vaccine acceptance amongst older people who need it more. (Though I think one of the big problems Germany has is their vaccine uptake amongst the elderly is somewhat low compared to other countries.)


Right now in my province, unvaccinated individuals make up 11.2% of 12+ population but more than 66% of hospitalizations. I don't expect the ICU rates to be more favourable to the unvaccianted than total hospitalization rates. If there is a point of rapid diminishing returns, it is not at ~90% yet.

https://www.alberta.ca/stats/covid-19-alberta-statistics.htm...


Your missing the vaccine injured in those stats because they define unvaccinated as anyone less than two weeks after vaccinated.


What do you mean? The immunity doesn't kick in the second the vaccine is injected into your arm. How else should they count vaccinated vs unvaccinated? (Also note that there is a category of partially vaccinated in the stats that is people who have only received the first dose of a two-dose vaccine).


These stats do not show the difference between taking a shot but still being infected within two weeks after it, and not taking any shots at all and being infected. If you're going to blame the second group for filling up ICUs, you cannot lump them together.


It means the stats aren't as useful.


Its probably just time delayed. Give it a few months. The vaccine protection seems to wear off rather quickly, based on data from UK and Israel.


Protection from hospitalization and death, particularly in under-65 or so, does not wear off. Neutralizing antibody levels naturally wane and can allow infection, T-cell and B-cell populations don't (unless you get infected with measles or have some other conditions, and assuming you form a robust T-cell response to begin with and aren't immunocompromised or just quite old).


I think the vaccine is probably as effective as two doses of a laxative. Any 75+ year olds that survived the two doses of the laxative, will now have better outcomes against covid.

Keep in mind the effectiveness is measured in tens/100,000. An there are some very sick people given the vaccine, that die before the 14 days of the second dose.


> I think the vaccine is probably as effective as two doses of a laxative.

Well at least people know how much weight to give your opinions.



Are they hospitalized for Covid or all reasons?


These are only COVID stats.


Correlation does not imply causation.


> countries have reached the point where the majority of Covid patients in their ICUs are vaccinated at well below 100% vaccination.

Which countries are you talking about? It's certainly not the case for Germany, and I don't know any other European country for which this would be the case.


You make a good point re vaccinating lower risk patients. In the UK, not only the population has a high vaccination rate, but the rate is particularly high among the population at risk (~95% for the >70yo [1]). As a result, hospital cases and deaths are a fraction of the Jan 2021 peak, even though infection levels are high.

[1] https://www.bbc.co.uk/news/health-55274833


> countries have reached the point where the majority of Covid patients in their ICUs are vaccinated at well below 100% vaccination

Which countries? I find it hard to get data at vaccination prevalence in ICU population specifically, but in Switzerland, the figures I see cited is 60-70% of patients unvaccinated (With 90% of 80%+ year olds in the population being double vaccinated).


> in Switzerland, the figures I see cited is 60-70% of patients unvaccinated (With 90% of 80%+ year olds in the population being double vaccinated)

For the 80+ group the latest data for hospitalisations is 47% vaccinated, 31% non-vaccinated, 22% unkown.

https://www.covid19.admin.ch/en/vaccination/status


Well yeah, for 80+ with a vaccination rate of 92 %.

If you look at the total value, it appears that only 11 % of hospitalized are double vaccinated, though the latest seven day average puts that number at 27 %.


I was just giving a number consistent with the 80+ vaccination rate quoted.

For the broad population is 28% vaccinated vs 57% non-vaccinated. The remaining 15% is "unknown". But Switzerland has a relatively low vaccination rate at 67%.

Edit: looking at deaths instead of hospitalisations in the broad population:

  Fully-vaccinated 46%, partially-vaccinated 2%
  Non-vaccinated 41%
  Unknown 12%


Yes, those are the numbers for _hospitalizations_ in general, but the higher percentages I've been seeing (and for which I've been unsuccessful finding official documentation) are for _ICU_ patients specifically.


But they were not for 80+ patients specifically, or were they?

Edit: I can't find ICU numbers but the latest death stats for 80+ are 46% vaccinated, 33% non-vaccinated, 21% unknown.


Right now, young people take the "booster shots" that should be given to the elderly, first. Politicians will be very proud that "XY percent of the population are already boostered". The dying will continue.


I dropped in to a local clinic this week to get my booster (no appointment, even) and was given the shot in about 15 minutes. Most of the other people there waiting looked relatively young. Seems that we're doing a terrible job of reaching out to the elderly to get them their boosters. Or they just don't want it.


Yes, and this is another example of the really bad management skills of our government. If you announce the wrong KPIs (XY percent vaccination regardless of personal risks) you might be performing great according to them and still fail miserably on your actual goals.


Which country is that ? Here in Czech Republic there is clear priority for 60+ years for the third doses. Also a big vaccination drive based on volunteers to vaccinate ideally up to a milion eligible people with the third dose till Christmas.


Here in Berlin for example, in the first week of september my 85 year old grandparents received a booster shot invite letter from the Berlin senate. It said something like starting 20th september you can get the 3rd shot from any doctor or you can go without an appointment to a vaccination centre across the city.

what did they do? nothing because case numbers were low, I did push and push to finally get my grandpa to get is 3rd shot mid november while go to the doctor for something else... by coincident the rush to get the booster started 1 day after that.

I bet this happened a lot.... As far as I know just like for the 1st shot sverybody above 70 got that same letter. Meaning they had more than 2 months head start to get the boostershot.

So at least in Berlin I wont have sympathy anymore for taking away the shot from somebody else (got my appointment in january)


Its never unreasonable to blame the victim, just bad taste.

Also consider its their tax dollars being squandered and mismanaged.


It is not totally unreasonable but there is a component of blind blame to it. It will become a discussion after the pandemic and I don't think this will be too beneficial for our public health care system and health insurance.


Yes because no effort was made to increase ICU capacity which was continues to be the biggest issue


No, that isn't the biggest issue. The ICU is the last resort, it's the point where we throw incredible amounts of effort and hardware at the problem to gain a chance of still saving them. And even then 50% still die, and others likely will have permanent damage from the severe course of the disease.

The biggest issue is that not enough people got vaccinated.


ICU itself causes massive damage too. Side effect like died of hands and feet are not uncommon.


Vaccinated are still being hospitalized. How much longer will you buy into the narrative that they are not when so many countries are showing evidence to the contrary.


Would you please stop posting flamewar comments to HN? You've unfortunately been doing it repeatedly, and we ban that sort of account.

If you'd please review https://news.ycombinator.com/newsguidelines.html and stick to the rules when posting here, we'd appreciate it.


Vaccines reduce severe courses of the disease by about 90%. The number vary depending on what you look at exactly, and for elderly people boosters are really mandatory to keep the vaccine effective.

Reducing the number of severe cases by a factor of 10 is very from from not working.


>Vaccinated are still being hospitalized. How much longer will you buy into the narrative that they are not when so many countries are showing evidence to the contrary.

What "narrative"? What are you even talking about?

No-one, including the person you responded to, has claimed that vaccinated people can't get sick. The claim (backed by statistics) is that the unvaccinated are being hospitalized at a much higher rate and for a much longer duration.

You're arguing a point that no-one is disagreeing with.


Please do not take HN threads further into flamewar, regardless of how wrong someone is or you feel they are. It just makes everything worse.

https://news.ycombinator.com/newsguidelines.html


True, unvaccinated people are being hospitalized at a higher rate and for a longer duration.

However, we are not talking about "the unvaccinated", rather about "a tiny unfortunate fraction of unvaccinated people". There are 4,690 covid patients in ICU beds and 25M unvaccinated people. Assuming all covid ICU patients are unvaccinated, the covid ICU incidence rate within the unvaccinated population is 0.02%.

For an analogy, we could reason that because the prison population skews 90/10 male/female, all males should either undergo a vasectomy, or pay a recurring 10k euro fine. I hope this is obviously unethical.


Your prison thing is widely weird and not sure at all how you relate those two.things.

Yes the point is to make sure that those ICU capacity which is very small and normally enough would and is struggling due to covid and vaccination helps.

What is so hard to understand?


Vaccine mandates enforced by heavy fines and/or prison are criminalizing being unvaccinated with the number of "boosters" the authorities deem necessary. Justified by group "crime" statistic differentials. We may argue that it is done in service of a good cause, but it is still criminalizing. Our weird reality.


We are allowed to enforce a lot of things as a society.

We banned toxic paint, we enforce certain vaccines (polio, measles)

It's only logical to enforce a vaccine on people.

Same as you will get reanimated when you have an accident.

We formed and created rules around our society for a long time and those limitations are here for the good of all of us.

A society can't be forced to have a medical oath and in parallel has to watch when people don't play along.

You expect us to do the best to help you in an emergency and in parallel expect total freedom?

Not how our society works. Srsly get over it.


Could you please not post flamewar comments to HN? I'm afraid you've already broken the site guidelines more than once with this account.

If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html and taking the intended spirit of the site more to heart, we'd be grateful.


Sure, but how many vaccinated people are ending up in the ICU, compared to unvaccinated? How many are dying?

Also consider that a population of 100, and 90 of those people are vaccinated. Uf 15 vaccinated people end up in the hospital, and 5 unvaccinated people also end up in the hospital, vaccination is still clearly better for you. But people will still say "75% of the people in the hospital were vaccinated; clearly the vaccines aren't working!" Yeah, well, out of vaccinated people, only 16% ended up hospitalized, while 50% of unvaccinated people ended up hospitalized. Those are the real numbers that matter. Percent of cohort hospitalized, not percent of total hospitalized.


That's like saying, people are still hospitalized after car crashes so seatbelts and airbags are useless.


The safety of modern cars has been shown to lead to more aggressive driving, so this metaphor may track on more levels than you realize.


When all houses have sprinklers only sprinkler equipped houses will burn down. Still in absolute numbers there should be much less fires.


Right, but the point is you still need more ICU capacity.

The analogy is “every house has sprinklers so no need for a fire department any more”.


Do you, though? I see lots of numbers around hospitalizations, but how many (vaccinated) people hospitalized end up in the ICU?


Singapore does a great job of testing and the vaccination rate is >95% for the eligible population. Despite that, they have introduced restrictions due to ICU overload.

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

Look at "Proportion (%) of cases ever critically ill in ICU or died, by age and vaccination status"

Looking at the high risk group of 80+ year old (43% of all ICU cases and/or deaths), the numbers are: unvaccinated (24%), partially vaccinated (16%) and fully vaccinated (3.2%).

They don't define partially vaccinated (typically 14 days after 2nd dose). So clearly the vaccine reduces the risk of ICU/death, but the "truly" unvaccinated make up only 50% of ICU cases in that age group.


From all the local reporting the overwhelming majority of people in Czech ICU are not vaccinated. A few examples - listing from a hard-case ICU in Ostrava for a week in November:

https://mobile.twitter.com/VojtechGibis/status/1463608271378...

NEOČKOVÁN - not vaccinated OČKOVÁN - vaccinated

The last 5 patients are those that have been released from the unit in that week. The first two were move to less severe case ICU. The last three died...

One more: https://mobile.twitter.com/VojtechGibis/status/1465783542982...

Czech ICU occupancy - blue unvaccinated, orange vaccinated. And yes, we had several cases <30 years old and unfortunately even children on ICU.


People wearing seatbelts still die in car crashes. When will you stop buying into the narrative that seatbelts saves lives?


Training an ICU nurse takes about 5 years. The only realistic option during the pandemic would be to encourage immigration of ICU nurses from poorer countries, but that just moves the problem elsewhere.


How long does it take the army to train a field medic? (Serious question, I don't know if there's some extended training involved, I just assume it's far less than, say, a nursing degree.)

I think that training people to handle 90% of the issues you see in Covid-related illnesses could be done relatively quickly, if we wanted to do that. The ICU bed shortage really refers to a ICU-staff shortage, and anything we could do to relieve that burden would be a good thing.


The US Army takes 16 weeks to train a field medic. However most of that training isn't applicable to treating COVID-19 patients.


So does developing a vaccine usually. We should be taking extraordinary measure not saying "oh that will take too long don't even start"


Assigning ten teachers to a student won't make the student learn ten times as fast.


Modifying the procedures and allowing people to work before they're through arbitrary redtape does. The EUA the vaccine received is the same concept. The reason the vaccine was developed faster wasn't just the number of scientists working on it, but the amount of funding directed towards it. Increasing money to education programs would increase the amount of people they can train, allow for further optimizations to be developed etc.


Thousands of ICU nurses quit on the past few years. They are still trained and would just have to be convinced to return.


I have a suspicion that ICU training for a COVID specific nurse could be much shorter - if there were any will or basic common fucking sense among policy makers, and if there were fewer people making excuses for those who ghoulishly and cynically privatized healthcare for profit across the Western world.


A "COVID specific nurse" still needs the entire slate of training that goes with respiratory disease, inflammatory disease, etc, and all the secondary complications that come from those.


Then train 3 nurses in respiratory disease, inflammatory disease, and secondary complications separately. Put them under an experienced nurse, and incentivize them to add to their skills when they're not working.

Look at the sheer difference in numbers of healthcare professionals between America and Cuba. If they can do it even after decades of cruel and unusual sanctions, we sure as fuck can too.


Well, mistakes by ICU personnel can easily kill - and that's on top of a significant, often >50% death chance for covid ICU patients. Better make sure the people don't get as far as getting intensive care in the first place.


It is mentioned enough by the media. Thank you.

But it seems strange to realize that people don't want to do a job where you have to watch people die like flies over the course of two to three weeks. No money in the world makes that acceptable for many.

With the availability of the vaccines (at least in the developed world) this has become a pandemic of the uninformed know-it-alls ("Querdenker" = Crooked thinker, as they are call here). If you work on an ICU to rescue people that tell you that this is all a scam by the Pharma-Industrial Complex, you would want to quit.

It is not the media's fault where we are now, nor are the politicians (entirely) to blame. At least half the blame should be frankly put on social media disinformation and the usual tabloid press (Springer/Bild) that fabricate Fox-News style lies.


If the problem in Germany is anything like in Sweden, then the issue is not that "people don't want to do a job where you have to watch people die". It is 100% a lack of funding and poor management.

In the last 20 years the standard "joke" (ha ha, only true) about the universal health system is that you need to be in good health in order to have enough energy to fight for your right to get help. The health care debt was an all time high at the start of the pandemic, and has since sky rocketed.

The faults are many. Poor wages has create many empty seats at the university programs. A lack of available personal has created a demand for labour hire employees, creating a system where many are moving to those in order to get pay rises, furthering increasing the cut that the middle men takes. An sharp increase in populations has increased demand, without any corresponding supply or funding. Employees has had an increase in paper work, with technology solutions that has caused additional work rather than optimized the work flow. Those same technology solutions has also been expensive to the point of corruptions, with some deals being actually corruptions that gone to court.

The situation is so bad that my own health clinic is sending every patient that calls them on non-mondays to the emergency department, as they are by law required to redirect the patient somewhere and all their own doctors are booked for the rest of the week, a pattern that been going on every week for the last year. Vacations has been removed as an emergency decision at many hospitals, and in one case the "compensation" for lost summer vacation was a fruit basket.

The expected time frame to raise the standard and actually train enough workers, as calculated by researchers a few years ago, was (if I remember right) somewhere around 10-20 years into the future. One pre-panedmic solution was to encourage skilled immigration directly from hospitals of nearby countries, a fix that obviously is not going to work now. If Germany is anywhere similar, then the blame isn't disinformation. It is systemic problem that has existed for decades and is now being pushed to over the edge.


I'm in a Berlin medtech company closely related to GPs and have multiple other connections to area hospitals. From this perspective I would say everything you've said is entirely accurate for at least this part of Germany, if not the whole country.

It's really a shockingly well kept secret, especially to the outside world. Much like the utterly dysfunctional rail system.

Before the pandemic, I would have said that the country's healthcare system was about a decade away from resource-crisis. Now, it may have already started. I'm terrified of ending up in a hospital, even if there's no covid-wave ongoing. I do not want my life in the hands of the overworked traumatized remnants.

The way this country treats healthcare workers is shameful.


Fortunately there is now COVID, so the ruined health care system can be framed afterwards as having been caused by the unvaccinated.


No the unvaccinated just gave the health care system a few good kicks in the ribs after it was already down.


This is seeking someone to blame honestly, those "Querdenker" didn't influence anything else but themselves. The truth is we always had a form of triage in emergency admission rooms even before the pandemic.

Media and politics are way more responsible than the craziest idiot.


It's quite interesting that the main tabloid here in Czech Republic is doing very solid covid reporting - still kinda in the personal stories people can relate tabloids do - just this time telling stories of people severely ill with covid, mostly unvaccinated or interviews with medical personnel about what their hell looks like. Frankly I did not expect that from them and I'm sincerely hoping it helps at least someone to stop believing in bullshit.


More money and better shifts and not firing unvaccinated would fill the gap.


You can't have people who are not vaccinated working at a hospital. This has been known for years and has been practiced for years. Vaccinations prevent the spread of disease. Surely you aren't questioning this.


Before the vaccine (less than a year ago) they prevented the spread by using n95 masks and ppe.

Knowing that the vaccine doesn't prevent the person from getting and spreading covid. Knowing that the point of the vaccine is to prevent serious illness in the person receiving it. I struggle to understand why you would not even question how important they are in that setting unless you are worried they have dropped that extra safety component.


No, they really didn't. Healthcare workers got COVID in large numbers, causing severe absenteeism, a number of deaths, and many with ongoing Long Covid conditions.

It's part of the reason that bed capacity has been so difficult to keep constant or increase.


>Knowing that the vaccine doesn't prevent the person from getting and spreading covid.

Vaccines reduce the risk of spreading the virus. People who are vaccinated are less likely to get seriously ill. This absolutely doesn't mean you won't die if you are vaccinated. Think seat belts in car accidents. It is all about reducing risk. On mass, at population levels, this means ICU have capacity to take in other seriously ill people. If ICUs are full and there is a plane crash or whatever where many people are seriously injured we are screwed.


People who get vaccinated are less likely to get seriously ill. Seriously ill people withdraw from society. Those with mild illness continue to go out into society and increasing the spread.

You could make the point that increasing the spread when everyone is protected is fine but that allows for increased mutations.


> You can't have people who are not vaccinated working at a hospital.

Except for all of 2020.

and this?

https://www.kff.org/other/state-indicator/flu-vaccine-requir...


At some point there are diminishing returns. Eg if you fire everyone then more people will die because there is no hospital.


> I have long lost all hope in politicians. 99% of them are ridiculous creatures without a spine and only interested in their own progress.

I posit that any sane and intelligent person would choose NOT to go into politics. Because of the system we as society have created around the job.


In Germany, the majority of the cases are from unvaccinated people getting sick and infecting other people

https://rocs.hu-berlin.de/publication/maier-2021-germany/


That is one paper from a couple of postdocs.


As are pretty much all papers ever written


Never trust a model whose parameters you did not pull out of your own ass.


I'm sure what you are saying is true but it doesn't really address the problem at hand. The bird has flown the coup and now action needs to be taken to save lives.

Absolutely agree with you about hospital/medical resourcing though, we have the same situation in Australia. In the name of efficiency these services get paired to the bone, and we have no capacity to respond to unusual events.

The Neo liberal worldview posits that redundancy is bad. I think Western countries in general are suffering from this Anorexia. It cripples innovation as well.


What would save lives would be a lockdown again.


And what did you to help out?

Did you suddenly switch your job to become a nurse?

How do you think we would have been able to ramp up everything while in a pandemic?


I don't know why you are voted down. This is very much true for The Netherlands as well. Ever since the year 2000, possibly before, ICU beds have been scaled down.

Diederik Grommers, one member of the Dutch Outbreak Management Team (OMG) states: "it doesn't matter if you're vaccinated or not; 60% of the beds are occupied by vaccinated people; the problems we will encounter in the coming weeks are caused by the fact that we totally hollowed out our health care" [0].

The Netherlands has about 6 ICU beds per 100.000 citizens. Germany has almost 30 ICU beds per 100.000 citizens [1]. Now I know Germany did accept patients from The Netherlands on their ICUs and perhaps Germany is doing the same for other countries, so perhaps that is causing a capacity problem in Germany as well.

---

[0]: https://www.youtube.com/watch?v=yFg78PgDgu0

[1]: https://cdn.nos.nl/image/2020/03/30/640384/3840x2160a.jpg


Thanks, that was an interesting video. I had to rely on auto-translated subtitles but from the little Dutch I can understand, it seems like they got the gist across.

Yeah, Germany has a ton of ICU beds in comparison, and yet, we're struggling exactly the same as any other country. I find it strange, too. In early 2020 I expected we'd see big differences between different countries based on ICU capacity, but we saw the same story everywhere (regional overload around the peak of a wave), with a few minor differences (whether some patients are transferred within the country or to other countries). Perhaps countries have different standards for when they put patients in ICU's, allowing hospitals (and governments) to always operate close to capacity? Would be one explanation, but I really don't know.

High total number notwithstanding though, our ICU capacity actually decreased during the pandemic, see:

https://www.intensivregister.de/#/aktuelle-lage/zeitreihen

The graph under "Gesamtzahl gemeldeter Intensivbetten" shows total capacity (light blue) + emergency reserve (green), dark blue is occupied beds. There was a pretty sharp drop-off in the total capacity a year ago, and a slower decrease all throughout 2021. Apparently, that's mostly due to nurses quitting in droves since the pandemic made their already bad working conditions even worse.

Our politicians didn't lift a finger to prevent or revert this, and now they're blaming a minority for this massive, massive failure. Just makes me really angry, I'll take downvotes for that if I have to :)


> Perhaps countries have different standards for when they put patients in ICU's, allowing hospitals (and governments) to always operate close to capacity? Would be one explanation, but I really don't know.

There's different standards in different countries for sure. In The Netherlands there's a focus on quality of life. If a patient cannot have a decent quality of life after staying on ICU, there's a preference to provide the patient with palliative care instead. In (e.g.) Italy this approach would not be accepted.


The number of ICU beds may have been inflated. At the start of the pandemic, hospitals had to report available ICU beds, and they received money for the number of beds they reported. I know of two hospitals that reported all of their beds (the physical objects) when the intention of the law / regulation was to have only those beds reported that could be operated / staffed.


Counter argument: Medical personel is hard to find and expensive, as is IC infrastructure. Why would we've needed to keep spare IC capacity for decades only to find out we need it in case of a pandemic? The German argument could be re-constructed into an argument that any country will run into IC shortages regardless of the level of IC availability. In an exponential curve it's only three or four cycles (8-12 days?) away, regardless of capacity. Hence, keep your IC capacity at regular efficient rates and use vaccination to get out of the hot seat. IC's save some but lose many. Vaccinations save many.

I can't say that I like the Dutch approach to covid in general, but in my first job I was deep into governement budgetting of hospitals (just before the introduction of the current Dutch reimbursement system) and it was a whole lot about 'keeping beds' and keeping patients in them to fulfill the budget. That was not what I'd call a generally efficient system. Even the health outcomes were worse since outpatient treatments usually have fewer side effects. What I've learned in that job is that doctors are like people. They respond to incentives. If that incentive is to have beds filled with people, you get just that. Beds with people.


You can’t throw a stone without hitting a nurse in the US, but I’m guessing they’re paid far better here as well just as doctors are.

I know Germany has a mixed system but it seems to me that socialized medicine keeping costs down slowly erodes care. The increase in costs in the US is also unsustainable. There might be a happy medium in there but it might be too early to tell.


> I know Germany has a mixed system but it seems to me that socialized medicine keeping costs down slowly erodes care.

You can see this happening in Canada too. We have a hybrid system in healthcare where the majority of critical care is paid for via taxes/government subsidies however secondary/tertiary stuff is either out of pocket or through insurance agencies (prescriptions, out-patient care like physiotherapy, etc).

Over the past 20-30 years, our system has seen the typical government thought process of throwing more money at problems but not actually having someone be accountable for the actions of the government over decades. You end up with a bunch of overpaid, under-worked management at the top while the actual front-line workers suffer with low staffing, not enough beds, budget cuts for the front line but raises for management etc. etc.

Not to mention the number of students coming here for health education (doctor, nurse, specialist) - then immediately saying sayonara for another country like the US or in the case of foreign students, their home country.

I don't understand why we keep cutting healthcare budgets - one possible reason could be because corporations have slowly been taking over every aspect of society as they move faster and make smarter decisions than government officials.


This is accurate. The socialized health care system in Germany worked fine for multiple decades, until a few years ago our government decided to reimburse hospitals not based on days a patient spends there (which created perverse incentives, agreed) but rather based on diagnosis. So, a hospital earns X euros for every patient with condition X, creating other perverse incentives, and resulting in less money for the hospitals, which of course trickled down to nurses.


The same happens here in Sweden. Since the implementation of more neoliberalist policies on healthcare, allowing more private clinics and paying clinics based on diagnosis created a perverse incentive to overdiagnose patients.

There was a case of a clinic that performed unnecessary surgeries and procedures just to rake in more tax money.

The problem isn't socialised medicine per se, it's trying to mash a socialised medicine system with "market forces", it's the ideology of the Third Way [1] to appease to these neoliberalist policy desires that is crumbling the Swedish healthcare (and welfare) system for the past 2 decades.

[1] https://en.wikipedia.org/wiki/Third_Way


How expensive is it as a percentage of overall healhcare spending?


There is no easy answer to that question to my knowledge. All of what hospitals do is translated into the Dutch equivalent of diagnosis-related groups. Those DRGs are standardized across the hospitals doing procedures. Insurers bargain with hospitals (usually on a higher level) for price-setting. So while there are DRGs that probably have a large IC-component, most have only a little. So the costs of IC are reimbursed via all treatments that have an average IC-component.

A hospital with a good cost based activity system could probably tell you more, although that would require a very high measure of control.

Dutch press just reports the general direction of (internal) prices for IC-days (about € 3k / night). That really is nowhere close to the proper answer to the question "How much would expansion cost?" The sum based on that € 3k would be: €3k * 365 * 65% * 1200 = about € 850 million for the whole of IC-care. That is a low figure for the Netherlands (€ 25 billion total medical specialist care), so I expect a lot of the IC-costs are absorbed by other DRGs or the other way around: that price doesn't include all of the fixed costs and is a marginal price.


>"[...] we totally hollowed out our health care"

Weird move for one of the richest countries in the world, no?


Privatization of infrastructure in Germany has always led to a, at least perceived, decline in quality. This has been true for postal service, railway, telcos and now health care.


Health care in Germany is a not-for-profit endeavour and is strictly controlled by the law, with ministry of health oversight.


It sounds like you read that off the government shill brochure.

The decline in public healthcare quality has nothing to do with the lack of government oversight but it's due to the lack of funding and personel (which is also funding related). Ask any overworked healthcare worker in the public system.


It’s a lack of personnel because the population pyramid is going from a triangle to a rectangle. This is what that transition does to the labor force.


People are dying friendo, please wise up.


Except he was talking about the Netherlands.


When was healthcare in Germany not private?


More than 10 years ago


From what I've read, it has always been a heavily regulated private system (which is mostly non-profit in practice).


Something like 50% of the people in intensive care for COVID still die.

Even if we were able to handle the load on the healthcare system, that still would be a very large amount of unnecessary suffering and death. And even though there are some fundamental issues with working conditions and pay in this area, fixing them would not be enough to be able to handle the load that an exponentially growing viral disease could cause if it remains unchecked. If you do not stop the exponential spread, even with twice the capacity you'd only gain another 1-2 weeks until you're at capacity anyway.

The vaccines work well and are safe. The problem is that too many people didn't take them. There's plenty of problems with how this was organized in Germany, but in the we simply didn't manage to convince enough people to get vaccinated.


The argument always is that there are not enough beds for non-corona patients. More beds would certainly help.

It is nonsense to vaccinate young and very healthy people, especially kids. Their risk from COVID is minimal to non-existent.

Also the spread is not stopped by vaccinating. Vaccinated still spread the virus. If it is reduced is still unclear. There was a study in GB that showed the incidence numbers in vaccinated was just as high or higher than in unvaccinated. The sample sizes of vaccinated and unvaccinated were equal as they should be. Reports in Germany about these numbers forget to mention that vaccinated people are basically not tested.

> The vaccines work well and are safe.

They do not work well enough. First of all people still transmit the virus after only about 2 months after the vaccination. Then the protection goes down extremely between 2-6 months after the vaccination (that is why we need boosters all the time). It is still unclear if we continue to need boosters after the third shot.


Vaccines do reduce spread.

While vaccinated people who get infected still spread the virus, they’re less likely to get infected in the first place, which is a necessary precursor to spreading.


Not necessarily true with the new variants, and it won’t be true for future variants either. The virus jumped to wild animals so it’s freely mutating in unvaccinated hosts outside of the human population.


IIRC the effectiveness is reduced for delta, certainly, but not to zero.

But yes, we’ll probably need updated vaccines, similarly to how we update the flu shot every year.


> The argument always is that there are not enough beds for non-corona patients. More beds would certainly help.

"beds" is a proxy for "health workers", if you put a bad covid case in a "bed" they just die, they need constant attention


>...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. Host–virus interactions early in infection may shape the entire viral trajectory.

Source: https://www.thelancet.com/journals/laninf/article/PIIS1473-3...


Vaccinated people don’t transmit as much, nor are they as likely to contract the virus. Current estimates are 85-90% of transmission in Germany involves someone unvaccinated

https://rocs.hu-berlin.de/publication/maier-2021-germany/


* Chance of catching it?

* Peak viral load, GIVEN catching it?

* Duration of peak viral load, GIVEN catching it?

* Severe disease, GIVEN catching it?

* Hospital stay, GIVEN catching it?

* Death, GIVEN catching it?

There are many relevant parameters that the vaccines might affect. And the vaccinated people have a few parameters: number of shots, time since last shot, age, etc. People seem to focus on one or two of these questions at a time.

From your link, actually, related to duration:

"Fully vaccinated individuals with delta variant infection had a faster (posterior probability >0·84) mean rate of viral load decline (0·95 log10 copies per mL per day) than did unvaccinated individuals with pre-alpha (0·69), alpha (0·82), or delta (0·79) variant infections."

Clearly it's not going to stop transmission, but it could slow it down. People on both sides of this issue seem to undervalue partial measures and tradeoffs.


> There was a study in GB that showed the incidence numbers in vaccinated was just as high or higher than in unvaccinated

I would like to see the source for that if you have the link?


A bit late reply but I was asleep. You can find the report here: https://assets.publishing.service.gov.uk/government/uploads/...

There is a lot to digest and probably it's easy to come to the wrong conclusions from this. I was referring to Figure 2.(a)


The problem isn’t simple and certainly not a matter of just vaccinating. A big part of the problem is that govt was confident that two jabs in the summer would be sufficient because of two faulty assumptions: that immunity would last and that fully vaccinated people would not spread covid.


Also, more broadly, that people would actually be willing to get vaccinated at a rate high enough to reduce the R-value below 1.


The vaccines were never proven to reduce virus spread, were they? I mean, the clinical trials were about reducing susceptibility, not infectivity. I don't think there were any numbers available on the vaccine's effect on virus transmissibility. It was implicitly assumed that fewer symptoms would translate to fewer transmissions, but was this ever proven?

Point being, we didn't know what vaccination rate would reduce the R-value below 1, and FAFAIK we still don't know. Not even for the original Sars-cov-2 virus, and not for any of the variants.


Vaccination reduces transmission: https://www.nejm.org/doi/full/10.1056/NEJMc2106757

> Cases of Covid-19 were less common among household members of vaccinated health care workers during the period beginning 14 days after the first dose than during the unvaccinated period before the first dose (event rate per 100 person-years, 9.40 before the first dose and 5.93 beginning 14 days after the first dose). After the health care worker’s second dose, the rate in household members was lower still (2.98 cases per 100 person-years). These differences persisted after fitting extended Cox models that were adjusted for calendar time, geographic region, age, sex, occupational and socioeconomic factors, and underlying conditions. Relative to the period before each health care worker was vaccinated, the hazard ratio for a household member to become infected was 0.70 (95% confidence interval [CI], 0.63 to 0.78) for the period beginning 14 days after the first dose and 0.46 (95% CI, 0.30 to 0.70) for the period beginning 14 days after the second dose. ... Not all the cases of Covid-19 in the household members were transmitted from the health care worker; therefore, the effect of vaccination may be larger.1 For example, if half the cases in the household members were transmitted from the health care worker, a 60% decrease in cases transmitted from health care workers would need to occur to elicit the association we observed (see the Supplementary Appendix). Vaccination was associated with a reduction in both the number of cases and the number of Covid-19–related hospitalizations in health care workers between the unvaccinated period and the period beginning 14 days after the first dose.


Given that vaccination reduces asymptomatic infection with SARS-CoV-2,2,3 it is plausible that vaccination reduces transmission; however, data from clinical trials and observational studies are lacking.


> The vaccines were never proven to reduce virus spread, were they? I mean, the clinical trials were about reducing susceptibility, not infectivity.

Populations where people are less likely to get infected are less likely to spread. You have to be infected before you can spread.


The psychology of the vaxxed asymptomatic COVID carrier cannot be left out of the equation. Whether this psychology leads one to engage in risky disease-spreading behaviour, this is for the experts to elucidate.


Maybe. On the other hand, a lot of anti vaxxers seems to think Covid-19 is a hoax, and that undoubtedly influences behavior.


Do you have a source for that? This is the first time Ive heard someone call it a hoax that was an antivaxxer. Most antivaxxers are hesitant due to the speed at which the vaccines were made, the new technology used to make them, and the fact that the companies making them can’t get sued if they kill people.


There are those type too, yes, but there are also people who think Covid is a hoax, or at least that its danger has been drastically exaggerated. There tends to be a lot of overlap between beliefs here.


So no source. Interestingly if you look up the list of global epidemics however COVID is #6 of 20, and if you sort by total global population list, COVID is #11. So it seems we have actually had worse pandemics. Maybe you’re seeing people reading the actual stats?


I haven’t seen any studies diving into anti vaxxer beliefs that deeply, no.

> Maybe you’re seeing people reading the actual stats?

What kind of reasoning is this? So because Covid-19 isn’t the worst pandemic in history, then it makes sense to believe it’s a hoax or overhyped?


I was under the same impression that vaccine would not reduce the spread or carrying of the virus. It would just greatly reduce the change you landing on the IC.


What would be the rate in question for Delta? My understanding is that it was feasible for earlier variants, but Delta has R too high to begin with.


If your focus is on R value for transmission, then you will also need to eradicate it from every single cat and deer on the planet. Good luck with that.


Also, the government knowingly ignored warnings by the RKI (german institute for public health) saying that numbers and hospital admissions will go up rapidly in autumn.


> Something like 50% of the people in intensive care for COVID still die.

I don’t think this is too far from the survival rate of those admitted to intensive care in general.

But I think the point is that COVID really increases your chances of being admitted there in the first place.


So far I know 4 that have contracted COVID and all explained it felt like a bad flu but no where near enough to go to the hospital. But mileage will vary here for sure.


>But I think the point is that COVID really increases your chances of being admitted there in the first place.

If you're in a certain age range, and have several comorbidities.


ICU survival rate is highly dependent on the cause, diagnosis, and/or disease that the patient is admitted for. It can range from 70-10%.


The smallpox and polio vaccines worked well. The corona shots have people still getting sick and transmitting live virus. That was not success even a couple years ago.


You forget one, the people that are dying have taken the risk for ther own and didn't want to get vaccinated. It's ok when they die, it's their decision that's gone wrong. Other people didn't got vaccinated and will never get covid anywhere. This is a decision that not the government has to make for the people.


Those people don't refuse to go to hospital and they don't refuse the ICU bed.


Would you support a comprehensive healthcare opt-out, where an unvaccinated person would forego right to treatment, and also not have to pay taxes for public healthcare?


No, because at the end of the day, we're not going to literally let them die on the sidewalk outside the hospital just because they can't pay.

That means that somebody has to pay for them. Given that unavoidable but inconvenient fact, basic health care and life support might as well be organized under the auspices of the state and the costs shared among all residents.


If you aren't willing to do your part to protect yourself and your community, why should your community protect you, when doing so would endanger others' lives?


The same can be said if many STDs though, drug use, and obesity.


That reflects a deep socialist mentality.


those people still paid their taxes, health plan care and they should be treated. Stuff like this https://www.aerzteblatt.de/nachrichten/sw/Intensivmedizin?s=... should be better investigated. I thought as German, something that we learned from our past was not "oben buckeln und nach unten treten" or something like "to crawl to the bigwigs and bully the underlings". Winter 2021, and we still don't have a plan, the schools still offline and the numbers are much worse now than winter 2020 when the numbers of unvaccinated were almost 90% of the population.


No country in the world has the capacity to take care of more than “a couple thousand” ICU patients (well, it’s more like a couple of ten thousand ICU patients for the best equipped and richest large countries in the world, like Germany). Simply because “a couple thousand” is all that’s needed during ordinary times.

Yeah, there are issues with staffing and inadequate payment of the staff, sure, and those problems are long-standing and unresolved, but even if they were solved that wouldn’t be much of a help.

We would then maybe talk about a couple thousand (here in the literal sense) beds in terms of increasing ICU capacity, if that (simply because it’s not as though Germany’s existing ICU capacity is somehow ridiculously small, it’s quite large, actually if you put it in context and adding a couple thousand beds would be a massive increase). That would be helpful but wouldn’t really solve the underlying problem.

And either way: Increasing ICU capacity right now is not a solution. It’s completely misguided. Not least of which because it takes forever to increase capacity. You have to train people for that …

Unvaccinated people are to blame for this, but especially cowardly politicians who were too frightened to start implementing vaccination mandates right away (summer 2021), as soon as it was clear that you cannot reach good enough vaccination numbers just based on pleas alone.

We do have a solution for this and the solution is vaccination. However, in the very short term even that won’t be good enough, we need to break the 4th wave and for that contact reduction is necessary (and already happening).

Think about time frames.

Contact reduction, will show its effects within a couple weeks, vaccination mandates plus a logistical push for booster vaccinations, will show their effects within one month to three months, making healthcare more resilient in general, will show its effects within a couple of years, maybe a decade.


>Simply because “a couple thousand” is all that’s needed during ordinary times.

Yes but.. extraordinary times exist, if we were sane we would prepare for crises before they happen, because we always knew that it would hit us eventually, people have been warning about this for ages, this is not some black swan.

More healthcare capacity would help, just like more supply chain capacity would help, or the ability to manufacture some masks, the entire problem is we've been running on the idiotic 80s managerial efficiency mindset for decades and now we're running on fumes on every front.

If we had any appreciation for crisis management, robustness, redundancy and had some shock absorbers in our system many people would not have needed to die. And no it's not just the unvaccinated. Plenty of countries this year, including the US, will lose more people in total to covid in 2021 than in 2020. Vaccines help but they are not pandemic ending, and our systems are deeply screwed up.


This is also about appreciation. The main bottleneck for increasing capacity is not machines, rooms or beds, those are available. It's hospital staff that's lacking. ICU beds are the most staff intensive beds in a hospital. It's a job that requires years of training, so you can't just scale it up. Also, the willingness to be a nurse has decreased during the last couple months. A lot of hospital staff has burned out during the first few waves and either reduced their contracts to part time, or quit entirely. The remaining staff has to work hard, until exhaustion and beyond, in order to fight for the patient's lives. Covid stations require proper hygiene which puts extra stress on the hospital staff. And they put in all of this work because some people couldn't be bothered to seek out vaccination, often even the patients themselves. This is the main difference to the first few waves where vaccination has not been available to everyone.


> Also, the willingness to be a nurse has decreased during the last couple months

this was entirely preventable by providing nurses and those keeping hospitals running with the support they need to do suchs jobs during a time of crisis.

In the netherlands for instance, many nurses have been running 12h shifts during the peaks, and there has been very little practical support in helping those people.

I am not even talking about monetary funds, but mainly practical stuff. (for instance, some volunteers decided to do grocery shopping for nurses during peaks).

If people are busting their ass off to prevent the healthcare systems from collepsing, maybe the goverment should have done far more in its power to prevent those people from quitting.


Buying groceries for a nurse is a nice thought but it is not going to erase the misery of working in a COVID ward for months or years.

I really wonder if any of the people here talking about massively scaling up ICU capacity have ever even been in or visited someone in an ICU. It is called an “intensive care” unit for a reason. Extensive resources are required. Putting aside the physical space, equipment and pharmacological needs, the teams of people are specialized and have extensive knowledge and training.


> Yes but.. extraordinary times exist, if we were sane we would prepare for crises before they happen

You can't keep the staff and maintain the gear needed to handle 100x "once in a century" event all the time, it just doesn't work. Most health systems are already huge money sinks and on the brink of collapse in normal times... This isn't a "a bomb injured 300 people" event, we can't live 100% prepared to every single potential threats.


you don't need to 100x it, but you can keep 20-30% of slack in the system, instead of literally cutting or not even keeping up funding for one of the most important sectors of the country. Nurses and healthcare workers have been overworked for ages in Germany, and not just here. With the NHS in England it's the exact same situation. Most of the countries had higher capacity ten or twenty years ago then we have now. What's the point of getting richer and growing if your public infrastructure decays?

And the other thing you can do is, actually have a prepared and tested response plan to a crisis. Our reaction to this was to dust off some plans from the the shelves, every individual state had different systems in place, two years in we don't really have a functioning digital app, but ten different solutions none of which more than a fraction of people have adopted, and so forth. Completely avoidable chaos if anyone was actually in charge of readying the country for these situations.


In three months, the booster efficiency might start waning again, we don't know that yet. These vaccines so far aren't looking like they are the solution to the pandemic either, better vaccines or better treatment might be. I'm not saying it doesn't make sense to get vaccinated if you want to help with the situation, but I do find the way our politicians deflect blame and openly insult a not so small segment of the population completely distasteful. They shouldn't be surprised if the people they're insulting are not willing to help anymore, now or in the future.

A strategy that would make sense would include BOTH vaccination and ICU capacity, one of which could have been started in March 2020, and it would have put us in a much better position today. Letting capacity decrease while waiting for vaccines that may or may not end the pandemic is negligent. Not getting vaccinated may be seen by some as negligent also, but different standards apply for governments and citizens.

The pandemic comes in waves, we do not need to plan for endless exponential growth. A few weeks of extra capacity would make the whole thing much easier to handle, given that we might be already at the peak and cases seem to be going down again[0]. The RKI weekly report[1] currently lists 1700 ICU cases, a month ago it was 1100[2]. So the 4000 beds we lost throughout the year[3] could have made a big difference.

[0]https://www.tagesschau.de/inland/rki-infektionen-103.html

[1]https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus...

[2]https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus...

[3]https://www.intensivregister.de/#/aktuelle-lage/zeitreihen


Please source the 4,000 number properly: https://news.ycombinator.com/item?id=29422105

As I point out in my other comment, you cannot interpret that number in any to imply as though we ever actually had those 4,000 beds.


Fair enough, thanks for the info, I'll check it out. But let it be 2594 then, that is still too many given that we should have increased it by any means possible before starting to publically insult 20% of the population. I'm not assuming a deliberate reduction, I am assuming negligence.


20% of the population is, however, behaving stupidly and irrationally and in a very antisocial way. Insulting them is perfectly fine.

Just as with opposition to seatbelts it’s important for politics to create facts and just decide this issue. Everyone should be vaccinated and that’s just how it is.


... yeah, okay, I disagree with everything. I don't think it's acceptable for a government to insult its citizens, and I do think boundaries should be respected.

Nothing more to say, our worldviews are too far apart.


Vaccination is not a signal of intelligence or rationality :-)

There are many many reasons why one would or would not get a vaccine. For many, the reason was to go on vacation without too much hassle. Or because of social pressure. Or because they’re caring for someone who’s vulnerable.

If someone gets tested, uses masks properly and avoids groups of people they’re doing just as much as the average vaccinated. Definitely more than the truly antisocial which went into YOLO mode after getting vaccinated.


This is such a bizarre take. If the ICUs are filling up, the solution should be to prevent people from getting sick, not to make the ICUs bigger. There are undoubtedly many problems in the German healthcare system, but the current surge is clearly due to the very large number of unvaccinated people.


> the solution should be to prevent people from getting sick, not to make the ICUs bigger.

Why not both?


the two weeks were to build up health care capacity. We erected field hospitals to manage the sick and then closed them because they weren’t being used.

If this truly is an energy and hospitals truly are at risk, find a way to build more capacity even if it is temporary. Blaming the public for the failure to do this is wrong. And if you aren’t building this capacity… maybe this really isn’t an emergency?


You understand what exponential growth is? Yes? No?

You know that is hard to get people? You know how long it takes to teach someone? Especially while a pandemic is ongoing?


But if we do that then the media doesn't have a scare tactic


For what it is worth, in the UK there were similar concerns.

They set up "Nightingale Hospitals" (reference to Florence Nightingale) - basically convention centres were converted into field hospitals with ventilators. One in London had 4000 beds, and there were others elsewhere in the country. It took 9 days to build the London one (I was impressed!)

After all that, the 4000 bed one in London treated 20 patients during the first wave: https://www.bbc.co.uk/news/health-56327214 Most are now shutdown or being used as vaccination centres from what I know.

If the UK can pull this off in 9 days, I am sure other more sophisticated countries can do the same if they need to.


Those hospitals were a joke. Ask anybody who worked in the NHS and they would have told you no way in hell could they have found sufficient numbers of staff to actually run them. A publicity stunt. The country went crazy thinking people were dying in the street and we needed emergency hospitals/morgues


Same thing happened here in Italy especially during the first wave. They started building these temporary hospitals that hosted very few patients and some of them even finished during the end of the wave when there was no need for extra beds anymore.


We had similar ones here in Czech Republic and it was the same - if we had to use them, there would really not be enough people to run them. :P


Is this the ventilator fallacy? You know, it's march 2020, and everyone is rushing to make more of those damn ventilators?

If you end up on a fucking ventilator in an ICU bed, the damage is long done. The goal is not to maximize the number of people we can have on ventilators. That is an absurd idea on the same level of the "natural immunity is better than the vaccine!" insanity we got in 2021.


No, it's not the goal. The goal is also not to split society in two and create a group that'll hate everyone forever, just because our leaders can't own up to their mistakes. The goal is to get through the pandemic best we can, and keeping societal values and principals intact should be an important part of that.


what values? half the population doesn't value science, rationality, wisdom, progress etc. I don't wanna be governed by science deniers. I also don't wanna spend years in lockdown because people are refusing to get pricked by a needle


Values such as politicians not insulting a group of people on television, not taking their rights away because they might potentially get sick eventually, generally not judging before proven guilty, not forcing someone to put something in their body that they absolutely do not want, not punishing one person for another person's crime. Last one is what they're doing to you if you feel like unvaccinated people are holding you hostage.

Lockdowns end when we stop enacting them, there is no reason (except governmental screw up) to insist that people who chose to take the risk must not get sick under any circumstances, or to assume that everyone must be in lockdown until every last soul is jabbed and boostered whether they want to or not.


> Values such as politicians [...] not taking their rights away, [...] not forcing someone to put something in their body that they absolutely do not want

Vaccine mandates have been a thing for well longer than I've been alive. I wasn't allowed to attend public school as a kid without having been given several vaccines.

Sure, there were anti-vax people and people with religious exemptions then, but the vast majority of the people who are up in arms and crying foul about COVID vaccination mandates didn't blink an eye when told they had to vaccinate their kids against the measles as a condition for sending them to school.

Why the hypocrisy?

> Lockdowns end when we stop enacting them

We have lockdowns because we think they slow the spread of disease and save lives, not "just because". That's like saying "birthday parties end when we stop having them". Well, yeah, but that's a tautology and not a very useful point to make.

> there is no reason [...] to assume that everyone must be in lockdown until every last soul is jabbed and boostered whether they want to or not.

That seems like a straw man, though. Who is saying we have to lock everything down until everyone is vaccinated? What country has even tried to implement something like this? Some areas have certainly tied the relaxation of restrictions in some ways to vaccination rates, but the main concern for restriction levels is mostly other metrics, like new-case rates, hospitalizations, percent of ICU capacity used, death rate, etc.

> there is no reason (except governmental screw up) to insist that people who chose to take the risk must not get sick under any circumstances

Everyone who gets sick is a host for the virus to mutate in. Everyone who gets sick, or is even merely unvaccinated, runs a higher risk of passing on the disease to someone else.

I am really really tired of the "it doesn't hurt anyone else if I don't get vaccinated" argument. Yes. It. Does. Full stop.


Assuming you’re in Germany, you’re governed by people which managed to screw up every single aspect of handling this pandemic. From masks don’t work, to masks availability in healthcare, vaccine availability, to booster availability to making tests fee-based and much much more.

The health minister was throttling Biontech/Pfizer deliveries just as demand started to go up for crying out loud!

It could always be worse, but I’m not at all surprised about lack of trust in the government.

You will spend years in lockdowns because that’s the only thing they’re capable of. See Portugal or Denmark for the vaccination happy case. Better than Germany but nowhere near life-as-usual.

Finally, if half the population doesn’t value all those things… Germany is proper fucked. You're exaggerating by a lot, which tells me you don’t value science and rationality.


im not from germany. in my country the vaccine uptake is less than 50%. at this point everyone who wanted the jab could have gotten it. so im not exaggerating at all actually


You’ve replied to a guy who is in Germany on a topic about Germany and then made some claims without specifying you’re from somewhere else though. That was very confusing…


They value all those things just as much as you do, they call some of them different names. And they don't believe that 'the other side' actuals exemplifies or actually values those things. Every lie they see coming from people in power (masks don't work, two weeks to stop the spread, the vaccine will fix this all) makes them less trustworthy.


Did you know that the immune system reacts to more than just the spike protein? It will create a dozen or so antibodies against all the different parts of the virus.

If the spike protein mutates like it did in Omicron, most of the other antibodies will still continue to work while new spike antibodies are created. In contrast, if the vaccine-induced antibodies are avoided, immunity in vaccinated people drops to zero.

This leads to another consideration. As I understand it, antibody tests only check for the spike protein antibodies. This implies that if there are 10 other antibodies not being tested, then actual protection is 10x higher than the test indicates. Any antibody count falls over time because the body is efficient. If the disease enters the body again, it will just start pumping out the antibodies again as long as it knows how to make them.

The proof of the pudding is in the eating. People with just natural immunity in Israel are 10-15x better off than people who just got the vaccine. As this is the largest such study and encompasses pretty much the entire population, you can eliminate common sample size and selection bias issues that happen when you hand-choose a couple hundred people to look at.


It's such a dumb take because natural immunity requires you to contract real Covid. I wish this was obvious, but it seems required to state it outright? I feel you should take this revelation straight to the vaccine makers and tell them they wasted all their effort and should have hosted infection parties instead.


On this topic, it's worth noting that most vaccine side effects -- which are largely "your immune system kicked into high gear and exploded" type problems -- are an order of magnitude worse when fighting an actual infection than when responding to a vaccine.

E.g., Guillain-Barre syndrome is ~10 times more common after a COVID infection than a COVID vaccine. Myocarditis is something like 20 times more likely.


> E.g., Guillain-Barre syndrome is ~10 times more common after a COVID infection than a COVID vaccine. Myocarditis is something like 20 times more likely.

In relation to what? An average Covid infection? We don't even know how many go undetected to know what that average even is. Or the average out of hospital cases? Or simply confirmed cases? What are the numbers when comparing young healthy people vs old people with co-morbidities? What about children?


"natural immunity is better than the vaccine"

Has this been studied? I have natural anti-bodies and will participate in a study.


this!! It's unbelievable that these wealthy western countries find "cheaper" to stop their economy than to build few more hospitals, beds and employ / pay more these guys running this. It's hundreds, maybe thousands, of billions wasted in Germany alone, versus. no idea but definitely not hundreds of billions to increase the ICU capacity to keep the economy open no matter what.


> What we're seeing here is one of the wealthiest countries in the world with a population of > 80M people crumbling over a few thousand ICU patients because of long-standing issues that were never addressed.

Also one that collects high income taxes and high health care contributions (~14% of the income). So one can't really blame it on lack of funds.


Same story in UK (and about bed numbers in general).

"The total number of NHS hospital beds in England has more than halved over the past 30 years, from around 299,000 in 1987/88 to 141,000 in 2019/20, while the number of patients treated has increased significantly." [0]

[0] https://www.kingsfund.org.uk/publications/nhs-hospital-bed-n...


The same is said in the Netherlands, but if you double the number of available IC beds, with associated staff (good luck with that), all you've bought yourself is two weeks before those are full as well – because of exponential growth.


Growth isn't exponential forever, cases appear to be going down again in Germany already. Delta waves seem to be only about 8 weeks long (check data from different countries, or here: https://www.nytimes.com/2021/09/01/briefing/delta-peak-covid...), so two extra weeks would help a lot.

I agree that vaccines are part of the solution. I disagree that stripping citizens of their rights and insulting them on TV is part of literally any solution for anything. If a government feels the urge to do that, it should look for alternatives instead. Maintaining ICU capacity from one year before (decreased by 4000 in 2021, see: https://www.intensivregister.de/#/aktuelle-lage/zeitreihenht... - "Gesamtzahl gemeldeter Intensivbetten"), is the lowest-hanging fruit, I'm sure there are additional alternatives that I'm not qualified to comment on.

Edit: It was pointed out to me that the DIVI numbers have some complexity that I did not account for. So grain of salt on the actual ICU number, but I've not yet seen anyone deny the trend. Here's a fact check that confirms that beds were lost: https://correctiv.org/faktencheck/2021/11/17/divi-praesident...


I’ll not take a stance on the correct number of free ICU beds as I do not feel qualified to judge these numbers without more insight on the intricacies of what would qualify fully operational beds, but regarding the stalling case numbers I feel confident enough (after looking at some raw numbers from the municipalities themselves [1]) to dismiss the apparent trend as a statistic artifact.

PCR test units and hospital bureaucracy are past their limits - e.g. regions like Bonn, Essen or Recklinghausen reporting zero cases on multiple consecutive days (Nov 29, Nov 30), which is _very_ unlikely w.r.t. the case numbers of the surrounding regions and those very regions reporting more than one hundred cases today.

The published indicators do not count cases that are reported late [2], which leads to apparently stalling case numbers. Growths may not be exponential forever but given that roughly one quarter of the population is not vaccinated, I would not take bets that the virus runs out of hosts before the health care system collapses.

I agree to the sentiment made that the balance between economic efficiency and damaging austerity for profit margin gains in the German health care system (especially for worker’s loans) has been tipping way too far to the latter in the past decades.

[1] https://www.lzg.nrw.de/covid19/download/laborbest_faelle_sar... (updated each day at 0:00 CET)

[2] https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus...

edit: some formatting.


Yeah, it's possible. I tried to word it carefully. There seems to be a trend in Bavaria though, Saxony maybe, but it's too soon to tell. Those two were the first to be hit by the current wave, and some areas of Bavaria had the highest incidence for a decent while I believe, so that might be an indicator of having reached the peak at least in some parts of the country. But you are correct, it's absolutely not clear yet, and could be due to lack of testing capacity.


The egregious part is that they reduced ICU beds last summer, they even had monetary incentives to reduce them.

Meanwhile vaccinating anyone < 60 has a very small benefit and it should be up to choice. Myokarditis side effects from the vaccine are probably bullshit, you can get it from almost all infections, so I expect it to see for every vaccine. We probably have no data since we lack operation of this scale.

But people here are afraid (typical) and even demand harsher policies. They also seem incapable to hold political leaders to account. Politics basically failed to prepare for the next wave, which was known to be happening quite a long while ago. Instead we had an embarrassing slap-fight between different states. One more stupid than the other.

Also you cannot just get a vaccine, you have to actively search for places that administer them. Pretty sure that I won't renew mine again, since this is just not acceptable.

I would advise you to ask a doctor, even if those aren't too keen to get another patient with vaccine trouble, but getting a vaccine in an active wave might not be the best health recommendation.


Meanwhile vaccinating anyone < 60 has a very small benefit and it should be up to choice. Myokarditis side effects from the vaccine are probably bullshit, you can get it from almost all infections, so I expect it to see for every vaccine. We probably have no data since we lack operation of this scale.

This isn't exactly true. People under 60 have a smaller risk to get to the Hospital/ICU but it's definitely not 0. There is also still a very real risk for Long-Covid and other complications from it. This gets even worse when said <60 person has obesity, smokes or other underlying health issues.

For your reference, in the Netherlands about 89% of 18+ people have been fully vaccinated. Yet the 11% unvaccinated make up 50% of Hospital beds and more than 70% of ICU beds. Looks at this image from our Minister of Health: https://twitter.com/hugodejonge/status/1466482208995164175

It's in Dutch but you'll get the message.

Furthermore, even if you are somehow not at risk of Covid, and you would magically know this about yourself it is STILL a good idea to get the shot because it reduces your chances of getting it (and passing it on!) and even if you get it your viral load is lower so the chances to spread it are reduced.

Stop making up arguments and get your bloody shot.


>Also you cannot just get a vaccine, you have to actively search for places that administer them. Pretty sure that I won't renew mine again, since this is just not acceptable.

Very true, last month for the booster there was only one place in Stuttgart (large city for German standards) offering appointments within the year. It's gotten better again, but it's not like they didn't know that there would be a new wave of vaccinations once the first people are 6 months in (or had J&J).


Sooo any proof for your thoughts on the missing benefits of a vaccinated person u der 60?

Wild statement to make without any numbers.


The numbers of people dying from Covid. Germany has 100,000 dead people and ~5000 are under the age of 65. But you cannot stop there, you need to incrementally look at age correlated data to see a picture.

Here is a start:

https://www.statista.com/statistics/1105512/coronavirus-covi...

Covid is a serious disease, but we are talking of mandatory vaccination and I don't think that it can be justified for younger age groups.


So you don't think it's critical for younger people to be less infections?

Having also less risk from the vaccine itself (which got injected into over 4 billion people) in comparison to COVID?

I disagree.

Lucky for me in this discussion, experts and politics are also now more inclined to have mandatory vaccination.

Mandatory vaccination exists in Germany for other things as well. I totally think it is reasonable.


Germany has "only a few thousand" ICU beds (and while this nber has trended downward over time, it was never more than 10,000). It's misleading to not phrase this as a percentage, which is something like a sudden 50%+ spike in need for ICU capacity.

Of course that will overwhelm the system.

(Also paradoxically, an improved healthcare system should need fewer ICU beds, so the decrease is probably a good thing)


Analog phone networks break down (you get no dialtone) if everyone in the service area picked up their handset and want to dial-out, they have much fewer lines than handsets, because they calculated what capacity they might need (how many calls would be ongoing at one time) and just have that many lines, plus maybe a safety margin.

I'm guessing it's the same with ICU beds... And now we have a situation where a high percentage of people have picked up their handsets...


Yes, but do you really think we should manage our health system like a windy cell phone network provider? By the way, the cell phone networks and internet connections in Germany are on the level of some 3rd world countries.


> By the way, the cell phone networks and internet connections in Germany are on the level of some 3rd world countries.

There is no need to insult 3rd world countries like this.


Germany was long criticised for its overcapacity of intensive care wards. Just up until the pandemic hit.


Thanks for the insight. I'm curious; is the problem staffing, "beds" (which I assume means actual physical beds, or is this a term of art?), or a combination?

Also curious how one squares the resource constraint issue with the exceptional nature of the events of the past couple years. What I mean is, did anyone think it made sense to massively increase capacity before the pandemic began? I'm not in health care so I don't have any special insight here; i.e. I'm asking, not challenging. From an outsider's perspective it seems like it would've been a tough sell to advocate for what was, in the "before times," an unnecessary increase in capacity.


Staffing, mostly. There are a lot of "beds" still available, just nobody to tend to them.

But another thing that always gets scrambled in the newspapers is the "level" of ICU beds.

The ICU at my town's hospital (and it's not small) has patients that would lie in a normal station at a big university hospital.

ICU bed != ICU bed. In smaller hospitals, ICU means "post-op, needs surveillance" or "gets oxygen".

At a large hospital ICU means "ECMO" or similarly severe conditions.

So when you're reading that there are x thousand ICU beds still available in the country: most are not really up to the task when it comes to a severe covid case, and furthermore, an ICU bed at the other end of the country doesn't help you much.


"Beds" means "staffed beds", not just physical places to put patients. It's a combination of facilities and staffing.


Thanks for the clarification. (I'm a little surprised I haven't seen this spelled out before, considering how much ink has been spilled over this issue, but I digress.)


It's staffing. See my other comment. Germany lost > 4000 ICU beds during the past year.


Could you source that claim?

I’m comparing the numbers from the DIVI registry:

2020-12-02: https://edoc.rki.de/handle/176904/7522 2021-12-02: https://edoc.rki.de/handle/176904/9047

I’m getting 24,949 beds for today, 27,543 as the year ago number (in both cases including a couple thousand ICU beds for kids which were later split out in the more current DIVI reports since ICU beds for kids aren’t helpful for this pandemic).

That’s a difference of 2,594.

Also, as the DIVI themselves explain: “Consequently, several factors play a role in influencing the number of beds that can be operated. A deliberate reduction of beds during the pandemic cannot be assumed. The reduction in available beds can be explained by the various points mentioned above, among others, and is supported by other data collected. The decisive factor for the operability of a bed is the medical staff.”

This is under a FAQ entry where they list five different reasons for the reduction in capacity: https://www.intensivregister.de/#/faq/18af7107-e098-43e7-a9f...

Staff themselves being affected by COVID-19 and becoming unable to work is just one of them.

The others are changes in how much staff is allocated per patient (this was increased), hospitals being more precise in their reporting and only reporting beds that can actually be staffed, changes in the criteria for a bed to be actually countable and the high effort ICU therapy of COVID-19 patients requires.


So I had this number from the (reputable) news but I googled it and found e.g. the Ärzteblatt as a source: https://www.aerzteblatt.de/nachrichten/128476/Intensivmedizi... (German)

TBH I would not be surprised if the actually don't know the exact numbers. But even if it's "only" 2594 it's still too many.

You could call it deliberate however if the working conditions for people under such heavy load are not improved.


That's not really the problem though. See, no matter how many ICU beds you have, the people going to the ICU are about 40% or so likely to die from COVID and the remainder will recover but will take a very long time to do so and have a significant chance of having long term residual effects and/or complications.

You don't really wish that kind of thing on anybody. So you try to avoid people going to the ICU in the first place (assuming you have a humane government, which unfortunately isn't always the case).

That said, the pandemic has definitely taught a lot of countries that stripping your health care system is probably a bad idea.


You're missing the point.

The reason people are even mentioning ICU beds are because they're trying to shift the vaccination argument from "do it for yourself, if you want to" to "you have to do it for others".

If we had enough ICU beds, there would be NO argument to force people to get vaccinated, just like there is no argument to force people to not smoke or not be fat.


If we had enough ICU beds there would still be an argument because it will cause a bunch of people to die. If you don't care about that then that's your problem, but personally I'd like those old people to stick around for a bit longer, and keep in mind that one day you too will be old.

The arguments for vaccination go a lot further than just a lack of ICU beds.


The old people should get vaccinated and self-isolate.


Right, maybe we should stick them on an island somewhere so they don't have contact with the rest of society then. Really, the degree of selfishness here is incredible. Don't you have parents or grandparents? Would you want them to be isolated from you and the rest of your family, their friends and neighbors for the foreseeable future just so you can pretend that there is no problem?


So, we have a climate crisis, uncontrolled health care and college costs, decades of pointless war, mass incarceration, and a variety of other crises that cause a lot of death and suffering.

Yet isn't it strange that the one crisis we have chosen to pull out all the societal stops for, to radically reorient all of society and put it in stasis for, is COVID-19. Odd coincidence that most of the first list affects young people, COVID-19 primarily affects old people, and the political leadership of the developed world happens to be comprised of old people.

And the subset of old people responsible for handling the pandemic hasn't even managed to do that properly. This is the same category of people who hollowed out unions, induced globalization, and generally kicked out the ladder beneath them in a variety of ways.

I do care about my parents/grandparents, I've been vaccinated, and I'd wear a mask around an old person. That's the absolute maximum I'm willing to do voluntarily and feel fine about that. I'd even venture to suggest that if someone has a problem and demands that all of society radically realign itself to fix/prevent it in a way that's disproportionate to society's other needs, it's not society that's being selfish.


There is a problem. The problem is that they're old and frail, and the world is out to kill them.

To be frank, I'm in favour of mass cryogenics. Build mausoleums under mountains and fill them with the frozen heads of the dead, to be revived later.


> To be frank, I'm in favour of mass cryogenics. Build mausoleums under mountains and fill them with the frozen heads of the dead, to be revived later.

Science fiction has no place in policy determination.


By not getting vaccinated aren't you a danger to others who are not vaccinated?

On the other hand, I don't care if you choose to be fat or smoke yourself to death, that won't harm anyone.


second hand smoke is a thing.


Yeah, but then the unvaccinated would only be risking their own lives. The most prominent argument for compulsory vaccination right now is that they're taking away scarce ICU beds.


It's a factor, but not the whole story. A lot of people are immunocompromised and for them just getting infected immediately raises the risks to unacceptable levels. We all owe the weaker people in our societies (from a health perspective) to take care of them, and if that requires us to get vaccinated to create a cordon of safety then so be it.

That there are a bunch of egoists that would rather have us all fend for ourselves doesn't change that, and usually those are exactly the people demanding we take on their burdens when the situation is reversed. It's called a social contract for a reason: taxes, vaccination against communicable diseases where possible, compulsory education and so on, it's the flipside of the coin, you get a lot of rights, but you also have some (sometimes moral) obligations.


The dead comment is unfortunately correct, there will probably be no herd immunity with these vaccines. That's what I hear from every virologist/epidemiologist lately anyways, and the real world data with highly vaccinated countries having record surges appears to confirm it.

I agree that it would be a much stronger argument. However, I also find it cruel to force people into an injection that they do not want, and would probably still oppose a universal vaccine mandate for that reason. I'd be okay with a mandate that allows people who really don't want the vaccine to opt out. I'd even be okay with that for the COVID vaccines if it wasn't for the 2G stuff and the awful rhetoric against unvaccinated people that preceded it. Enacting the mandate now makes the whole thing feel too much like "we'll get you somehow". Like I said, I find it cruel. It's not my idea of a humane society.


Vaccines by themselves won't do miracles. But vaccines combined with some reasonable level of restrictions can get us through this to the point where we've caught up with the virus to a degree that we have other means to reduce the number of serious cases.

Keep in mind that there is plenty of precedent for mandatory vaccinations, in almost every developed country and in plenty that are not young children are vaccinated against a whole raft of diseases that would otherwise cause serious problems. The only people that are exempt are those that do not want any vaccinations for religious reasons because it apparently interferes with 'gods plan'. If you want to deal with this at the same level of ignorance then that's fine with me but I personally have absolutely no problem with a mandate and I also would not have a problem with rescinding the exemption for religious purposes.


I encourage everyone eligible to get vaccinated, however in the long run that won't protect the immunocompromised. The virus is so contagious that there will be no significant herd immunity effect. Everyone will be exposed eventually.

https://www.businessinsider.com/delta-variant-made-herd-immu...


That's true. We missed our chance to contain it early on, thanks to those that tried to spare the economy at the cost of 'a few lives' which has now harmed our economy for a much longer period than an initial effort at containment would have caused, not to mention that at that time we didn't know exactly how bad it would get (it could have been a lot worse than it was).

But reducing the amount of active infections does have a beneficial effect because even though everyone will likely be exposed that doesn't necessarily mean that everybody will also get the disease (even the the worst diseases viral do not necessarily spread to 100% of the population), and there some chance that later strains may become milder. And if fewer people are ill at the same time that should increase the level of care available.

But it's a rearguard action at this point.


> We missed our chance to contain it early on, thanks to those that tried to spare the economy at the cost of 'a few lives'

Illusion of control. The chance was never there. Even countries who are way more suitable for isolation like australia didn't manage to keep the virus out. Attributing that to "those that tried to spare the economy" is just another toxic blame game.


They didn't manage because the rest of us fucked up.

It's like a fire. If your house is the only house in a row of houses that is well prepared against fire then you're going to go down, in spite of all of your preparations.

The fatalism that many people exhibit is a self fulfilling prophesy: we won't be able to do it so we're not even going to try. But you know what? Australia, New Zealand, Singapore and China showed that it is possible.


> Australia, New Zealand, Singapore and China showed that it is possible.

No, they just moved themselves into a corner that they will be trapped in for the next 10 to 20 years.


While I don't disagree with what you are saying in the abstract, there are limits and the demands really should be rational.

I don't see that with this series of vaccines. They do not stop transmission. The ICU issue cannot be addressed fairly without addressing the other causes that put large numbers of people in ICUs.

We pay every year as a society in deaths for the assumption of some risk. We manage it, make laws, or just leave it alone and some people die (for example, we don't ban cars or eating too many calories or swimming pools).

In my estimation we are going a bit overboard demanding everyone take a novel injection, most especially when it appears the health authorities either didn't understand or didn't communicate the effectiveness over time of the injections.

There's a point were everything can't be all about what someone at the top proclaims is for the social good. Otherwise we wind up in corruption and dictatorship.


> In my estimation we are going a bit overboard demanding everyone take a novel injection

This was the same with every vaccine in the past, very few vaccines have received as much scrutiny as these, the biggest risk is the long term one and even there we have a fairly good idea of what the possibilities of materializing are.

None of these weigh up against the damage that a COVID-19 infection does.

If you think mandatory vaccination equates corruption and dictatorship then I am not sure we are on the same wavelength regarding the meaning of those terms.


I don't understand why this batch of vaccines is being compared to vaccines for other diseases as if they are the same thing. Other vaccines are generally mandated for children with extremely high efficacy, have an extremely low chance of adverse events, prevent community spread perfectly or almost perfectly, have an exactly known quantity of doses required and are deployed as prevention (not in the midst of a pandemic). Importantly, they treat diseases that cause extremely bad outcomes in children at very high rates. This current generation of covid vaccines is more like a drug that works well for some and not so for others, doesn't prevent transmission, aims at moving target, requires an unknown amount of doses, only modestly discourages continued spread and represents one of many ways for society to treat, tackle and prevent the disease. This is a disease that is trending downwards in its mortality rate, while being of fairly low risk for the majority of the population, with the lowest risk found for young people. The diseases we mandate children to get vaccinated for are not declining in their disastrous health effects as far as I know. The risk of adverse events from the current set of covid vaccines is lowish but not particularly low. All that doesn't make the vaccines we have for covid any less important, but the comparison really does not wash and is a highly dubious way of engaging around the topic of body sovereignty.

There are a small group of people out there who are scared to death to take this vaccine because they genuinely think it will do harm to them. They are being asked to override their own alarms by people who do not share the fear because they don't have the same alarm bells going off. I know only a few of these people and they all have a ton of prior negative experiences with the medical system that would have left me feeling much the same way if I had shared their experiences personally. There are people that have been put in a 'do as you are told' situations and have received medical interventions that have done them great harm. Now they are being hounded and once again are being told to do as they are told, while fearing for their own health. A lot of people are willing to sweep aside their concerns as if they are asocial, ignorant, stupid, irresponsible and part to blame for the scale of the epidemic. People who feel out of control want to blame others so very badly, concentrating culpability in the hands of a group of bad actors, and it results in completely warped thinking with a tendency to dehumanise. And people can pick this up in others and it only increases their skepticism. They fear people operating in a blinkered, blame-seeking authoritarian way, and they see that as danger.

Though I encourage vaccination and have repeatedly tried to talk people who fear it off the ledge, I totally understand where the dictatorship and corruption logic is coming from. It doesn't take a hard-core cynic to raise an eye-brow when a drug company CEO proclaims that we'll all be needing many repeated doses of their product for years to come, while a leading political figure with immediate ties to the biotech industry wants to encourage countries to mandate the use of their products. If you had told me 2 years ago that society would control, monitor, demonise and divide people on the basis of having or having not received a recent government sanctioned medical treatment, I would have probably called you a hysterical conspiracy nut.


Thank you! Every crazy axe murderer receives more empathy then the people who simply stopped trusting the system after being lied to one time too often.

Two things drive me crazy: 1. How easy it is to dehumanize a significant percentage of the population. 2. How willingly politicians embrace that in order to find a scapegoat for their own failures.


I think, (or hope rather) that the mandates are well meaning, no I don't think this is dictatorship, rather I'm addressing your more "meta" point about social responsibility and the perils of one group being able to dictate to others without input.

As in, we can't just say "We have some social responsibilities so you must XX per the authorities" when XX is self serving, counterproductive, useless or harmful. We have an individual right, and responsibility, to weigh the dictates we are given at some point, perhaps not on all issues, but on some.

Other vaccines were not taken in to market in this manner. It is a novel vaccine.


> the perils of one group being able to dictate to others without input

This is pretty much the norm in any country that is a democracy but that does not have coalition governments. You get a kind of see-sawing effect where one group will enact a bunch of stuff and then when the tables are turned it all gets undone. It's stupendously inefficient.

Democracy is quite flawed but it still is the best mechanism for government that we have that is sustainable over a longer period of time.


Democracy in itself is nothing more then the dictatorship of the majority. It certainly doesn't constitute a just society, alone. In addition, you need at least fundamental, untouchable civil rights, protection of minorities and the rule of the law.


I'm terrified by the fact that there are so many antivaxxers in Germany that they're showing up here too, as supposedly educated and intelligent peers. It is absolutely the fault of unvaccinated that they're unvaccinated and putting society at risk. It doesn't matter how many ICU beds and staff you have, an unvaccinated population would quickly overwhelm it simply by virtue of how incredibly long it takes to recover and how quickly new strains would develop.


Vaccinated people get the disease and transmit it about as well as unvaccinated people.

This means the virus is busy making copies of itself in their body. Those copies not only have a chance to mutate, but have evolutionary selective pressure to mutate around the vaccine.

If you don't have the vaccine, it has no pressure to mutate around the vaccine.


It is exactly the same in Greece. They transition from public to private, they try to hide it and make profit over the deaths with the vaxxes.

There maybe more depth in their motives. But this is the surface.


>What we're seeing here is one of the wealthiest countries in the world with a population of > 80M people crumbling over a few thousand ICU patients because of long-standing issues that were never addressed.

So I'm kind of surprised to see this. I was under the impression Germany was the opposite.

https://tradingeconomics.com/country-list/hospital-beds

Germany is #2 out of those reporting. Crushing Canada by like 300%.

https://tradingeconomics.com/country-list/medical-doctors

Germany #1 for doctors, beating Canada by 100%

https://tradingeconomics.com/country-list/nurses

Germany #2 for nurses, beating Canada by ~75%

I kind of step back, how terrible is Canada doing?

>The staffing problems in hospitals (and nursing homes) have existed much longer than Covid. I heard a lot about them myself when I did my FSJ (volunteer work) back in 2004, and it's only gotten worse since then.

Oh ya big time. I can't remember a time when nurses/psws/doctors weren't in huge demand here in Canada.

Before covid: https://www.blogto.com/city/2019/07/toronto-hospital-fraud/

During covid pre-vax: https://toronto.ctvnews.ca/ontario-hospital-lays-off-97-regi...

Antivaxxers fired: https://www.thestar.com/news/gta/2021/11/28/were-on-the-brin...

You can't be on one side in huge demand for nurses but also be firing them willy nilly.

Firing them for not getting the vaccine isn't true at all. They've been reducing nurses and such for long before.

>Our government is in full CYA mode, and doing everything they can to blame a scapegoat for problems they themselves have willingly created over decades. It's despicable, and nobody should support it.

I propose that Canada and Germany probably have the same problem. That we are on the same page.

I am curious what you think is that problem?


> Furthermore Bill 124, introduced in 2019, disincentivizes nurses by limiting wage increases. Many nurses have said repealing the bill would go a long way in retaining nurses. Others say removing barriers for internationally educated nurses would help fill in gaps.

Wow, why is there the wage cap when nursing has long been an issue in Ontario? I wonder who thinks this stuff up and thinks they are somehow saving money by doing this. It just generates inefficiencies and unintended side effects.

Whenever there's problems like this there's always seems to be a long trail of government interference that's counterproductive.


>Wow, why is there the wage cap when nursing has long been an issue in Ontario? I wonder who thinks this stuff up and thinks they are somehow saving money by doing this. It just generates inefficiencies and unintended side effects.

Bill 124 has nothing at all to do with Nurses. The word 'nurse' does not show up even once. This bill is effectively what put doug ford into power. That is to say, he was elected to pass this one. It is more than required.

As you likely know Ontario is the highest debt subnational in the world. The mcguinty government was in power for ~10 years but did so by buying votes. They had so many gigantic scandals and might be one of the worst governments ontario ever had. Hilariously, the PCs approach was to tell ontario he was going to fire 100,000 people. That obviously didn't go well giving Wynne a majority.

However, Hudak was right, 100,000 less people in government. Because we didn't... we are in a far worse situation. Pre-covid ontario was very bankrupt. It was so bankrupt Wynne was forced to sell off highly profitable assets like Hydro1. Now that covid happened? I dont even know what will happen.

>Whenever there's problems like this there's always seems to be a long trail of government interference that's counterproductive.

The consequences of decisions in either way is difficult and rarely properly assessed. As Greece knows, someone eventually ends up holding the garbage bag and has to clean up.

These are the consequences of decisions made.


I'm all for reduction in the size of bureaucracies and addressing financial issues realistically. I just strongly dislike when they create inflexibility with things like wage increase caps. It's a strong hammer aimed at a few well deserved targets but hits broadly across a wide group where it doesn't always make sense. It's like a one size fits all approach.

But I don't know enough about provincial politics to debate the policies. You seem to have a better grasp of that.


>I'm all for reduction in the size of bureaucracies and addressing financial issues realistically.

I feel people misunderstand these issues so often, everyone just wants bigger government always. What happened during Mcguinty was well forecasted. He upon coming into power increased taxes on manufacturing. The consequence was that manufacturing dropped significantly. Ontario shed somewhere around 800,000 jobs because of that move and mcguinty trying to hide his shame increased the size of government to artificially hide abysmal unemployment. Population of Ontario was roughly 12 million at that time i believe. Labour participation was roughly 60%. Dropping 800,000 is more than 10% increase to unemployment. 10% unemployment is pitchforks at the capital.

The consequence? You converted tax paying people to tax deficit. It broke the balance by alot and it was all to hide the bad idea of raising taxes and harming ontarians.

Flipside, while this is an obvious failure, it shouldn't detract from a big government. Healthcare was obvious context above. What exactly is OHIP? It's a crappy basic health insurance provided by the government that has much less coverage today compared to years ago. It's not that we shouldn't do that, we simply don't cover everything. We know it's a good thing to cover the basics. It's just a definition of 'what are the basics'. Should diabetes meds be included? Type 1 vs Type 2? On top of that, it being single payer means most of society receives their healthcare from the rich.

>It's a strong hammer aimed at a few well deserved targets but hits broadly across a wide group where it doesn't always make sense. It's like a one size fits all approach.

It does make sense. What comes in bankruptcy? If we don't control those costs we are forced into austerity measures. Greece's Syriza is a communist party and they chose austerity out of their options. If we go into that, it will mean way more than 100,000 jobs fired abruptly. Which wasn't Hudak's plan. He was going to allow anyone who wants to keep working to keep working. Retirements, job hopping, etc being the plan.

The reason why you dont hear much of a chirp from the ultra strong unions is that they know the alternative is far worse.

>But I don't know enough about provincial politics to debate the policies. You seem to have a better grasp of that.

When Wynne got a majority. She took this power as her winning and not hudak losing. I called exactly what was about to happen. Wynne who was at the feet of all the scandals was going to be even worse because she would be under much more scrutiny. Not much of a prediction obviously, no future sight needed.

She actually was not bad besides the obvious corruption, she very nearly balanced the budget. Yet she made history books. She's the lowest approval rating for ontario premiers ever, and she provided the worst election result for the ontario liberals.

When doug ford got into power, I predicted exactly the same. doug ford didnt win, wynne lost. He's going to make decisions to fix the disaster of the liberals and take the blame. Flipside, he seems to be highly approved of because of covid and his response being objectively good. So I might be wrong on that front but he didnt fix the liberal corruption.


This is imo not true. Ofcourse there could be more ICU beds, but the real problem is something called exponential growth. Doubling your ICU capacity only will give you a week or two until you need to have restrictions again. Failing to include the concept of exponential growth is cherrypicking facts.


Still, get the vaccine


USA is probably the country with the highest cost for an hospital visit. I am sure the hospital are able to afford hiring more staff :)


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