IMHO we should just return to normal, consider this a new kind of flu and deal with the fact it's more deadly. I always knew there is a chance a flu can kill me one day. I'm Ok with the fact the chance is higher now.
My personal (apparently risky, I don't recommend it to others) strategy is living an active social life to be in regular contact with the virus (while testing every now and then to make sure I don't spread it) so my immune system keeps on producing the natural antibodies (I also test for every couple of months).
You might be willing to accept the risk of getting sick on your behalf, but by advocating a return to 'normal' before we have the capabilities to deal with this virus, you are advocating for putting even more stress on healthcare systems across the globe already on the verge of failure. There are patients in heavily-impacted areas who cannot access healthcare for other life-or-death concerns because hospitals are crumbling under the workload of COVID cases.
The article even states this; COVID is likely to reach endemic status eventually, but we are still nowhere near that. Ignoring it will have enormous costs on vulnerable populations -- even more than it already has.
This keeps being repeated but most hospitals operate at about 80% capacity as-is. Places in Tennessee and Florida are currently, with COVID-19, operating at about 80%. [0]
If we look at Israel, which has a very high vaccination rate, we see that they're supposedly running out of hospital space. [1] But the article linked doesn't say _anything about their actual numbers atm_ and points to a fiscal problem rather than a manpower problem.
There was a recent Science Magazine article that states that 13% of the hospitalized-and-vaccinated group are under 60. That amounts to 39 people in a country of 9 million. [2]
I've asked this before both here and elsewhere: If these vaccines aren't "good enough," what is? At what point does this become "zero COVID" in that "nobody can ever die from this disease again?"
[0]: this may have changed -- things are changing quickly -- so I'd be curious if you have any recent (<1 week old) information on this.
[1]: https://www.haaretz.com/israel-news/israel-s-public-hospital...
[2]: https://www.sciencemag.org/news/2021/08/grim-warning-israel-... -- and I took this from Louis Rossmann's video https://www.youtube.com/watch?v=mYtfT7HsJq0
Yes.
> This keeps being repeated but most hospitals operate at about 80% capacity as-is.
They aren't overwhelming total hospital capacity, they are overwhelming specialized resource capacity, particularly ICU capacity.
> Places in Tennessee and Florida are currently, with COVID-19, operating at about 80%
In Florida and numerous other states (not Tennessee), there are significant areas over 95% ICU capacity. [0]
[0] https://www.nytimes.com/interactive/2021/08/17/us/covid-delt...
https://www.tennessean.com/story/news/health/2021/08/19/tenn...
It's not like there is any large ICU capacity anywhere anyway.
In the country? No. In large areas? Yes.
> I keep seeing reports of staff getting fired or quitting because of vaccine requirement. Maybe I’m getting fake news?
There are vaccine requirements being adopted some places, and there are departures related to it. But if you are seeing news suggesting that that is the major source of capacity strain (or even the major source of COVID-related causes of people departing healthcare jobs), it is, at least, distorted news.
This is precisely because there is high demand for registered nurses and other medical staff at the moment.
Ok. At least somebody can exercise reason when necessary.
By the way (I believe that's is nonsensical but I also believe I am probably wrong - I am far from an expert), what's the point of force-vaccinating people who have obviously contacted the infection on many occasions and still are Okay? To me this indicates their immune systems are doing a great job and we should rather avoid teaching them (their perfectly competent immune systems) how they should do it. And I don't know about any evidence of vaccinated people being less contagious than those naturally immune.
I don't know but, fwiw, Europe is considering prior infection proven by an antibody test as equivalent to being vaccinated.
This makes no sense from an immunological perspective, and sounds like one of those pseudoscientific ideas that "natural" immunity is somehow stronger than "vaccination" immunity.
A vaccine is nothing more than exposing the immune system to the antigens. If their immune systems are already geared up to fight Covid, they will simply respond to the vaccine as another Covid infection and fight it accordingly.
As for whether there is any benefit, there absolutely is. Multiple exposure events greatly increase the storage of the antibodies in the memory cells of the immune system. This is why most vaccines require at least two shots, and why the CDC is now recommending a third booster shot for some people.
Plenty of studies show that the immunity of people who are vaccinated is stronger than those who were infected naturally (e.g. [1]), and that the immunity of people who have had Covid is significantly more robust after subsequent vaccination (e.g. [2], [3]).
1. https://www.biorxiv.org/content/10.1101/2021.04.15.440089v2....
2. https://apnews.com/article/science-health-coronavirus-pandem... ("The survivors who never got vaccinated had a significantly higher risk of reinfection than those who were fully vaccinated, even though most had their first bout of COVID-19 just six to nine months ago.")
3. https://www.medrxiv.org/content/10.1101/2021.04.25.21256049v...
>This makes no sense from an immunological perspective, and sounds like one of those pseudoscientific ideas that "natural" immunity is somehow stronger than "vaccination" immunity.
There's nothing unscientific about it; it's been known for a while now that some vaccines like the flu vaccine are inferior to natural immunity: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2870374/
Ok, well I've cited two studies that say the opposite, and one of those studies looked at antibody responses over time from matched individuals. The "on the ground" results in Israel are completely confounded by who is an isn't vaccinated, with at risk people (including healthcare workers) being significantly more likely to be vaccinated.
> it's been known for a while now that ...
Oh my. Did you read that study? It shows nothing of the sort. It is a mathematical Markov simulation of what happens assuming natural infection is stronger than vaccines.
The kicker is in the discussion:
> Under the plausible assumption that protection against influenza infection lasts longer after naturally acquired infection than after vaccination, we show that ...
This is literally begging the question. The authors make the assumption that naturally-acquired immunity is stronger. Then they write a model that repeatedly exposes people given that assumption. Then they "show" that, surprise surprise..... people with naturally-acquired immunity catch the flu less frequently.
In Israel, as almost everywhere else (other than early in the pandemic with nursing homes in many places), implementation of and compliance with vaccination and other COVID countermeasures had been strongest among the elderly and immunocompromised; at the same time, COVID infection has been more likely to lead to death in the elderly. So, the population most likely to be infected if exposed has a higher baseline vaccination rate and a smaller rate of prior COVID infection, both due to countermeasures and inverse survivorship effects. Without controlling for that, which bare population numbers like this don’t do, you have no idea what the relative immunity effect of prior infection vs. vaccination is.
The UK: in local areas, patients had to be diverted sometimes hundreds of miles to a hospital with space. all non emergency hospital care was stopped, and some emergency routine care was delayed.
Belgium was overwhelmed.
The issue is this, we can't just not admit the over 60s. even if we did, that would only free up 50% capacity (ie you could go one more cycle of exponential growth, doubling every n weeks/days)[source https://coronavirus.data.gov.uk/details/healthcare?areaType=...]
filling hospitals means that the resources used to treat both sudden hospitalizations and long term are diverted. so car accident/drinking/heavy sports/DIY injuries have worse outcomes, and cancer outcomes drop off a cliff.
if the UK manages to keep the total number of patients in hospital with covid to less than 7-10k that would be a brilliant outcome for winter. we are currently at ~6k, and its still summer.
The issue is there are not enough trained doctors and nurses. They take at least 8 years to train. that's the main constraint. Suitable beds can be made up in a number of weeks (see china and the "nightinggale hospitals") but if there is no staff, they are pointless
I'm not sure a big percent- of people is prone to hard covid. I tend to believe the majority of people has already went through it asymptomatically/easily and so will the majority of those who still hasn't.
Exponential growth in positive tests doesn't imply infinite (limited only by the size of the population itself) exponential growth of severe cases or deaths.
Correct!
but when in the growth phase we can't know when it will stop. We have a fixed[1] upper bound on the number of people we can deal with at one go. so when we see we are getting close, we have to take drastic action.
We know that testing in the uk is a proxy for actual infection, it tends to favour symptomatic as its "self selecting". The ONS survey is more accurate but has a significant lag.
I really hope that you are correct about asymptomatic. but we can't be sure, yet.
In New Zealand, it already has. Every time there is a single case or two, the entire locale (Auckland in this case) fully locks down. This is the 5th time it locked down. https://www.nytimes.com/2021/08/17/world/australia/new-zeala...
It's ironic that Covid has been arguably more disruptive in NZ than in US, which has a ton of cases.
> short and regional
Downplay it all you want. Auckland is a pretty big place. Alert Level 4 means that 1/3 of New Zealand population is locked down.
https://www.texastribune.org/2021/08/10/coronavirus-texas-ho...
As the pandemic started, ~70% of ICU bed use was normal, since then its been around 80~90% and now approaching 100%.
https://covid-texas.csullender.com/
So yes it is overwhelming hospitals. Even if you're vaccinated, this should scare you.
It may not be universal, but it certainly appears to be the case that many hospitals are being pushed over the limit due to covid patients.
Part of the issue, though, appears to be the fact that hospital admins are unwilling to raise salaries on essential employees like nurses.
Note: last April (2020), they said it had exploded due to COVID-19.
Florida has the second-oldest population in the U.S., but it's death rate per 100,000 is average among the states. NYC and NJ are two states with the highest death rate per 100,000.
Both have very high hospitalization rates. Both also have very high vaccination rates.
In the worst case, it may just been that the vaccine effectiveness wanes over time.
Positive covid tests require a hell of a lot more hospital overhead to deal with, even if they don’t have symptoms and are in for something else. It could very well be the case that this is a self made problem. We very well could be artificially overloading hospitals because we dictate that every positive test, regardless of symptoms, invokes massive overhead.
And again, every article I read never clarifies this. In fact many conflate “people with covid but there for something else” and “people sick with covid”.
I am fully inclined to believe that this hospital shortage is a self inflicted problem. If this was literally a hospital full of people choking on their own ooze, the media would be all over it like moths to a flame.
The stories on the reddits I suggested are all pretty much the same. Patient comes in struggling to breath, tests positive for covid, ends up with blood clots or pneumonia which pushes them into the ICU.
Here's just one of many stories of burnout [1]
[1] https://www.reddit.com/r/nursing/comments/p9ps06/the_burn_ou...
> So, the anecdotal evidence would be...
I'm not trying to represent it as anything other than that.
Here are a few different articles from around the gulf coast states that speak to this:
https://www.khou.com/article/news/health/coronavirus/houston...
https://www.npr.org/2021/08/19/1029260134/alabama-hospitals-...
Something that may be a little confusing as well is what does "full" mean. Both morally and legally, it is very difficult for a hospital to turn someone away. Rather than turn someone away, the hospital will have new people wait, attempt to make more room, and provide less care to more people. This leads to the question: Is a hospital full if they're stashing patients in hallways and providing hallway care? Within an ICU, typical care is either one nurse to two patients or one to one depending on the reason for the ICU stay. At the moment, the ratios are 3-4 to 1, which is not the standard of care, but the best they can do. Does this count as a hospital being full?
On a more personal note, my wife is an ICU physician. At the moment, I'm writing this from a hotel room because I started traveling with her to help alleviate the stress from her work. On this trip, she will do seven days of twelve hour shifts in a row. The hospital has asked us to stay for longer, but we're exhausted and have work elsewhere. This sort of thing does not happen during flu season, so I will assert strongly that we are still not close to the realm of normal.
In a direct answer to your manpower question, this hospital does not have enough staff. They don't have enough physicians and they don't have enough nurses. Recently, this particular hospital acquired multiple new ECMO units, which do absolutely help with care. They can't use them. They don't have the nurses.
As one more anecdote, a friend of my wife who is also an ICU physician called the other day with a story from her unit. She just admitted a patient who spent six days waiting in the ER with COVID. They had no available, staffed beds until then.
Now, to be sure, I am just another voice on the internet. You can choose to believe me or not and that's fine. I will say that getting news from what actually occurs in the hospital is difficult. Reporters are people too and they're not necessarily trained to understand the nuance of hospital reality. That doesn't mean what they report isn't useful, but it may be frustratingly incomplete.
Some questions that may help with any personal investigation:
1. What are the number of staffed bed available in the hospital? Beds are different than staffed beds, but they are sometimes used synonymously. Right now, with the lack of staff, it may not be.
2. Are the ICUs in the Level 1, 2, or 3 trauma centers full? Trauma center designation gives information about the number and type of staff that a hospital is required to keep available 24-hours a day. Generally speaking, the large trauma centers have better staff and better equipment. Even if there is an ICU bed available in a regional medical center, it doesn't mean it can provide the care required. Simply, they may not have the equipment or specialists required for care. As long as the large hospitals in the cities are full then transfer is not possible and overall medical care in that region is reduced.
Are these difficulties because there are fewer nurses on the market, the existing staff are burned out, there are better opportunities to work locums, or some other factor? Not sure. Mostly, it's to say that there was never a conversation between us on the lack of nurses prior to COVID.
As far as physicians, also not sure. I will say that demand was consistent prior to COVID, but now demand for both temporary and permanent positions is extremely high. They won't stop calling. Something to understand here is that the supply of new critical care physicians takes a very long time to ramp up, four years of medical school, four years of residency, and two years of fellowship. They're not easy to replace.
As a final side note, whether they do or not, they would all like to quit. They're burned out. This has gone on too long. The families dealing with end of life care are often abusive. Virtually all of their patients are unvaccinated, which means that this is preventable. They're frustrated that their professional opinion has very little impact on the public discussion of COVID, especially when they deal with the issue so intimately and they spent a good portion of their life dedicated to understanding and treating the issues behind illness.
[0]: https://www.beckershospitalreview.com/finance/20-hospitals-l...
Isolation from other patients means that they need other rooms and other nurses. It is not safe to have a nurse go from a clean room to a COVID room repeatedly if they don't have enough PPE to fully gown between rooms. Otherwise, there is cross contamination. Currently, there is not enough PPE. If a hospital has the staff, they will also isolate the physicians to either COVID or non-COVID wards to prevent cross contamination. Often, they do not have the physicians, so there is a time cost to constantly changing PPE. Time spent changing PPE means time not taking care of patients.
When a patient dies in a COVID room, the room must be cleaned. This takes time and staff. Failure to do so can also lead to increased infections.
To be clear, infections that spread in the hospital are very well studied. It's the reason why hospitals have very strict rules about things like hand hygiene. It's one of those inspections that can cost a hospital a lot of money.
That's a long way to say, it's not a self made problem. A patient that comes in for something like a heart stent who is also COVID positive is far more work than one who does not have COVID. I do not know if these news articles are referring to these cases as COVID hospitalizations. In some sense, it doesn't impact the broader issue: In a good number of states, hospitals are effectively full. The reason behind this issue is unvaccinated people catching COVID.
We need to accept that vaccines exist and work. It shouldn’t matter if the dude in the hospital has a positive covid test because everybody in that room can be vaccinated if they want to.
This mass testing created a bunch more problems than it solved.
The difference between COVID and something like cancer is that cancer is not highly contagious. COVID is. Further, it's contagious and deadly. That's why it requires special care. COVID is also not the only disease where these kind of precautions are taken. Another one is TB. Now, there are other diseases that are contagious, but not right now. For example, syphilis is both contagious and deadly. However, you're not going to catch syphilis when you're sitting next to someone who is positive. With COVID, you potentially will. That's why they have to test for it in the hospital.
Now, I will agree that vaccines exist and work. In the sense that there are people who choose to refuse vaccination, I will also agree it is a self made problem. However, this affects everyone to a high degree and not just the vaccinated.
Case in point, my wife and I are vaccinated. If she gets COVID, she most assuredly won't die, but she can't work in the ICU. She would risk getting her patients infected even though she is vaccinated. That means the hospital loses a physician in short supply. They're going to test you in the hospital because they can't afford you getting their staff sick.
This also affects you. You're vaccinated. However, say you're appendix bursts, you may or may not be able to get into the ER before you become septic. Yes, the ER will triage based on need. However, if there's no beds there's no beds and you will not be seen.
However, to reiterate, the hospital will always test you for diseases that they believe will affect their staff. You come in with respiratory symptoms. You're getting a COVID test. Having surgery? They'll test you for HIV. It's a protection issue. COVID is a pain because airborne infections are hard to contain.
https://www.tennessean.com/story/news/health/2021/08/19/tenn...
The bottlenecks here aren't total capacity, they are (in order of importance) 1. the number of vents, 2. the number of nurses with ICU level training, and 3. the number of ICU beds. The total number of hospital beds doesn't even factor in.
Source: I am a physician.
This is a blip in the ocean of hospitalizations in LA county.
"Tallia says his hospital is 'managing, but just barely,' at keeping up with the increased number of sick patients in the last three weeks. The hospital’s urgent-care centers have also been inundated, and its outpatient clinics have no appointments available.”
"Dr. Bernard Camins, associate professor of infectious diseases at the University of Alabama at Birmingham, says that UAB Hospital cancelled elective surgeries scheduled for Thursday and Friday of last week to make more beds available"
“We had to treat patients in places where we normally wouldn’t, like in recovery rooms,” says Camins. “The emergency room was very crowded, both with sick patients who needed to be admitted”
"In CA… several hospitals have set up large 'surge tents' outside their emergency departments to accommodate and treat … patients. Even then, the LA Times reported this week, emergency departments had standing-room only, and some patients had to be treated in hallways.”
“Hospitals across the state are sending away ambulances, flying in nurses from out of state and not letting children visit their loved ones for fear they’ll spread… Others are canceling surgeries and erecting tents in their parking lots to triage the hordes of… patients.”
“We’ve never had so many patients,” said Adrian Cotton, chief of medical operations at Loma Linda University Health in San Bernardino County.”
...but then again, maybe not. These are all quotes from 2018, flu season.
Why are healthcare systems unable to scale (horizontally or vertically) to meet demand unlike every other industry in the world? That should be a red flag that you don't have a robust system when it is unable to scale. We've had nearly 2 years since the start of covid to make healthcare systems more robust. Why haven't we? Maybe we should focus on that instead of telling people to mask up from cradle to grave.
Imagine if the computer industry were the same and we asked people to limit their internet time for 2+ years because the servers and routers that make up the internet were always on the brink of collapse? Like... wouldn't we just build more servers and routers until demand could be met?
Extraordinary claims…
If you're saying we should fill that labor requirement with low-skill medical technicians, you're misunderstanding the needs of the hospital. If you are ending up in the ER or ICU with covid, or any other cause, you are beyond the help of an at-home med tech, which is why you're at the hospital in the first place.
The problem is that the incentives aren't aligned with health care primarily due to third party payer system and onerous regulations.
You ever wonder why there is a line of people outside of urgent care every day to get tested for covid? Presumably, there are cheap tests that be administered at home without having to see a nurse or doctor. Or if you really can't do that you can train someone how to administer tests in a few hours and have that as a service. But in the US at least, it's nearly impossible to do these things. It took until April 2021 for the FDA to approve at home covid tests, and they're still not popular or available (at least I haven't seen them)
https://www.npr.org/sections/coronavirus-live-updates/2021/0...
But a lot can be done. In Italy during the height of the pandemic, they "emergency graduated" 5th (or maybe 6th ... near the end) year medical students. I really wonder if there's any data whether they provided worse care after some on-the-job training than "fully educated" practitioners.
If I have a private pilots license and the pilot of my commercial aircraft is incapacitated, sure I'm technically more qualified than the others on the aircraft to try to perform an emergency landing. But that doesn't mean American Airlines should be expanding their routes because I could land a plane.
If the ICU patient can't breathe on a vent and are able to secure ECMO, the ECMO specialist ratio is ideally 1:1. Under a crush of patients maybe 1:2 patients. A 1:3 ratio is risking all the patients under that specialist's care because the patients are all too tenuous. Let me reiterate and restate: 3 ECMO patients are too much for a single ES to support.
The ECMO specialist isn't the only person caring for the patient. There is the ICU nursing staff, the pulmonary therapist, plus the actual pulmonary doctors, the renal doctors, plus plus plus. You are talking decades if not a hundred+ years of study just to take care of a single ICU patient.
Labor and not beds is the bottleneck.
The only way to deal with this pandemic is to vaccinate as many people as possible. It's the best way that we know of to reduce spread of, and the effects of catching covid-19.
This has always been a systemic problem of how hard medical education and license are to get. I'm pretty sure medical personnel can be trained to reasonable (mediocre but better than nothing) skill level much faster and for much cheaper than it normally is.
This approach might sound like some completely out of the box, untested and extreme approach, yet it’s completely standard in industries that are not as heavily regulated as medicine is. Alas, healthcare has its Rules and Procedures and Best Practices, and as a result, everyone else must adjust and implement novel approaches, so that the healthcare industrial and regulatory complex doesn’t have to.
I guess I'm bias because my spouse is an ICU RN, but the ignorance of HN comments boggles my mind. Do all the hackers try to solve domain problems they have absolutely 0 experience in? I don't pretend to have solutions for the healthcare system because I don't work in the healthcare domain. I can assure you, the red tape that exists is there for very good reasons, because we've tried "unregulated" systems and they were a disaster. We've learned from our mistakes, and that means rigor that can't be replaced by some keyboard jockey writing webdev or embedded systems for unrelated fields.
How did this understaffing happen?
> More than 260 hospitals and health systems furloughed workers in the last year, and many others implemented layoffs.
[0]: https://www.beckershospitalreview.com/finance/20-hospitals-l...
The big issues are: the job sucks, the patients suck, the insurance companies suck, the hospital administration sucks. It's a hard, thankless job, where you get shit on all day by everyone, figuratively and literally, and for not much pay. Pre-COVID, pay was maybe $30-35/hr for most floor jobs. Or you could get an hospital office job, making more than that working a basic 9-5, no shit, no working holidays, no lawsuits (due to bone-headed coworkers fucking up), no feeling like a waiter, or being groped by patients.
Nursing is a terrible career anymore.
What you're describing is either an MD, a NP, or a traditional nurse/specialist.
ICU nurses have been worked to the bone for 18 months now, and often already at higher patient/nurse ratios that customary.
The coming problem won’t be one one of insufficient beds but insufficient people to care for them.
I understand this is much easier said than done but we hardly have a choice if we actually want to do something useful.
https://www.cdc.gov/nchs/covid19/nhcs/intubation-ventilator-...
The answer to this is not to say 'we can't fix the underlying issues right now, so we're not going to do anything'. The answer is to take measures that we _can_ implement until those longer-term solutions can come into play.
It's like the whole chip shortage thing. Most people ask why aren't we building more chip-building plants? The answer is we are doing that, but it takes billions of dollars and a lot of trained manpower to set up such a factory, and all of that takes a lot of time.
These are what are called in economics as highly inelastic supplies, which it seems is unknown to many commentators, who BTW have a habit of quoting Econ 101 in every discussion.
Social distancing and masking work. They reduce the possibilities for spread between people -- not perfectly, but enough to reduce it to a manageable level for our current healthcare resources.
Saying that our current measures to combat the virus don't work is disingenuous at best, and a blatant disregard for everything we've learned from the past year and a half at worst.
I have always been a vaccine enthusiast but now I see infection surging even in the most vaccinated areas.
> masking work
I have always been saying this, even when officials denied. Yes, mandatory masks in public transport and grocery stores are the only of all the deployed measures I recognize as actually working.
> blatant disregard for everything we've learned from the past year and a half at worst.
I actually don't think we have learnt much.
Despite the decline in vaccine effectiveness (I've seen conflicting studies of how much this has changed), they're still incredibly effective compared to any other protection we have at the moment.
None of this changes the fact that people are going to continue to die until a higher proportion of the population receives a COVID vaccine -- and that we _can_ mitigate this through other measures. None of these things lead me to the conclusion that we should return to normal and accept an increased healthcare system burden and death rate.
[0] https://www.cdc.gov/mmwr/volumes/70/wr/mm7034e1.htm?s_cid=mm...
https://www.kff.org/policy-watch/covid-19-vaccine-breakthrou...
The reported share of COVID-19 cases among those not fully vaccinated ranged from 94.1% in Arizona to 99.85% Connecticut.
The share of hospitalizations among those with COVID-19 who are not fully vaccinated ranged from in 95.02% in Alaska to 99.93% in New Jersey. (Note: Hospitalization may or may not have been due to COVID-19.)
The share of deaths among people with COVID-19 who are not fully vaccinated ranged from to 96.91% in Montana to 99.91% in New Jersey. (Note: Deaths may or may not have been due to COVID-19.)How is this data useful what so ever? I don't particularly care if someone in a car accident was or was not vaccinated unless Pfizer has came up with an MRNA based seat belt recently. If anything this data just muddies up the waters further.
Over 94% of patients are unvaccinated... It's pretty clear in my mind what's happening here.
This line made me both laugh and cry a little.
edit: your comment did make me laugh though. So perhaps you were just going for humor, in which case you succeeded and I apologize for being a wet blanket.
Might be better than having nothing, in the case of ICUs being overwhelmed and overcapacitied.
This seems to be the fundamental disagreement between the ‘anti’ side (anti-mask, anti-vaxx etc) and the ‘pro’ side. The reality is that different people can have vastly different risk tolerances. Some people are ok knowing they could die from a circulating respiratory illness and some simply are not. Some people believe vaccines are risky, others do not.
The challenge is it’s very hard (maybe impossible) to change someone’s personal risk tolerance. Imagine trying to convince someone with a fear of heights to go skydiving. You can state the facts, cite safety figures for parachutes etc but you are still unlikely to get them on a plane.
There are many articles (I’ve seen two just in passing) where nurses talk about COVID patients going on a ventilator, and begging for the vaccine, only to be told it’s too late.
I feel that most people that are taking risks with COVID (e.g. healthy people not getting vaccinated) either don’t have enough foresight to realize they actually don’t want to be hospitalized/die from this, or they don’t believe the risks are real.
Risk assessment is something many aren’t great at — that is striking a reasonable balance between no fear and too much fear. This is made worse by conflicting opinions and studies, and not being able to discern truth from fiction/sensationalism.
You read about it, I have heard from the witnesses. Some beg, some show fatalist. In fact,
> until they’re bitten
some do not quite realize that it is death involving slow asphyxia we are talking about... Days of drowning, not minutes.
> Risk assessment [...] is made worse by conflicting opinions and studies, and not being able to discern truth from fiction/sensationalism
Which is one of the biggest mess behind e.g. vaccine hesitancy, not to mention not convincing narratives about correct behaviour to prevent spreading.
Anyway, the communicational mess is a disaster, while this reference "fiction" is more problematic. It is not, at this level, something you discriminate easily. When Derek Lowe writes some find him credible, when Robert Malone speaks some find him credible - keys for discrimination are not easily at hand.
That is your opinion. One person’s neurotic is another person’s normal. It’s very hard, maybe impossible, to force-change someone’s perception of risk. Both sides will remain at loggerheads until they accept this.
Second, about "getting antibodies the natural way": what about a 7 points IQ drop as a risk? What about a first-level-paretian-20-per-cent risk of long consequences, "the fifth wins four fifths of the jackpot"? A few made that reasoning and could tell you it was not a good idea, some still feel damaged. I invite you: do not focus on death as a risk.
How can you be almost sure ? Are you an immunologist or a contagious disease expert ? Do you have data to back this up ?
Maybe on the next mutation I'll have cause to agree with you. For now, herd immunity is still an endgame worth pursuing.
In the US through May 2021, so it might not be a good representation for delta, here were the infections, hospitalizations, and deaths per 100k for various age groups:
Age Inf Hosp Deaths
0-17 37k 287 0.5
18-49 44k 1100 25
50-64 32k 2600 85
65+ 22k 5200 1140
If the numbers for delta are at all similar for kids, then there is a good chance that there is not much difference between a population where everybody gets vaccinated and population where all the adults get vaccinated but the kids do not, suggesting vaccinating adults should be the priority.
The long term endgame is probably a population where it is endemic, everyone gets it as a child when they are young enough that it doesn't cause serious illness, and then keeps getting it every year or so for the rest of their lives. Those subsequent cases don't cause serious illness because they still have protection from the last time.
That's what happened with the four other coronaviruses that are in wide circulations in humans. They are thought to have caused terrible pandemics when they first got to humans which were deadly in adults but not bad in children. Nowadays they are still around, everyone gets them frequently, and we don't even bother to have a separate name for the illness they cause. We just lump it in with the illnesses from a bunch of other viruses and call it the common cold. Around 20% of common colds are from those coronaviruses.
The relevant argument with kids and Delta is not about whether it happens to some people, it's whether the risk rates high enough to mobilize large scale, disruptive countermeasures.
I can only find data on deaths, not hospitalizations [1], but assuming the numbers are roughly proportional here are things that are more dangerous to kids than Delta:
- Drug ODs
- Car accidents
- Cancer
- Heart disease
- Drowning
- Suffocation
The posted numbers seem to imply that if 37k out of 100k kids had covid, 287 of them end up in the hospital. Does it not follow that if 100k out of 100k had covid that 775 kids would have been hospitalized?
> Granted we're probably way under counting infections in that age group
People get tested when they feel sick enough to be worried, there are many very minor and/or asymptomatic cases for which we won't have data. By using the positive case counts as the denominator you are using the most serious slice of cases to argue that coronavirus infections are serious.
It's definitely not exact to use the infection as the denominator, but I'd argue it's much closer than using the 100k as the denominator. I think I stand by my original post.
Like you, I can't wait until the vaccines are approved for under 12 children.
Yes, this is now thought to be the case for the 1889-1890 pandemic.
[0]: https://www.childtrends.org/indicators/infant-child-and-teen...
Hospitalisation rates have been pretty much flat vs previous waves (there was no wave last summer).
Do you have some numbers?
As far as I know, it indeed supresses the virus from circulating, it just doesn't stop it completely.
Here in my area, which started early with broad vaccinations - the numbers are way down.
https://ourworldindata.org/explorers/coronavirus-data-explor...
For fun, add India, which has comparatively low vaccinations, where Delta began:
https://ourworldindata.org/explorers/coronavirus-data-explor...
But while I was looking into that, last at the beginning of the year - the quality was horrible. Even here in developed germany, it was hard to get meaningful numbers from different districts. I mean, there were lots and lots of data flying around, but most of it not solid or directly comparable in my understanding.
And here india looks interesting, if true. That would speak for a sort of herd immunity?
I think most data is not really comparable across countries, only across time (and even then: discard data early on), because of different levels of data collection. So best only to compare the same country vs its own prev spikes. But this is esp true with India vs smaller countries, you may be able to compare Euro nations to each other more accurately, but would caution against interpreting small differences as meaningful.
UK for instance: https://coronavirus.data.gov.uk/details/cases
Both those factors would result in a softer curve without any vaccination.
Nope, it does not. Check your facts again with the Delta variant.
This fact really bothers me. I feel like once adults got vaccinated we all spiked the football and said "F--k the kids, I got mine".
Death rate for kids with new variant please?
https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19...
That said, my kids are wearing made in the USA masks.
Until there is data that shows conclusively that Delta affects kids more than previous variants, you should not parrot lines like "that appears to be changing quickly". Substantiate your claim with data or at least say it's anecdotal. Alternatively, if you have data, please share it.
We can send the kids back to school with no vaccines, no masks, no precautions, and say "We don't have any data that this thing is dangerous for children". The obvious problem there is that we don't have a ton of data in general with this variant. So, if we're wrong about the danger, we risk harming a lot of children while we dutifully wait for the data to roll in.
This is the same reason that most women (and many men for that matter) will cross the street late at night if they are on an empty street and see a large man approaching them. They have zero evidence suggesting that the person is a threat, but the cost of being wrong in such cases is very high. So, having limited data, they tend to take a very cautious and conservative approach and cross the street. In our case, just change, "Cross the street" to "Wear a mask".
This comparison is far from perfect, but you get the idea.
In other words, whoever makes a claim that things have changed better provide a reason why it is reasonable to think things have changed. Typically that comes in data.
No arguing on Hacker News is going to change the policy response anyway.
Also remember that herd immunity works best when those who are antibodies are evenly distributed. Schools will become major places where it's spread because of how many people without immunity are in one place.
For me, the mood in London is "we've had enough, it's endemic, let's live with it".
Hospitalization rates are also back up to significantly higher than they were this time last year.
And that's with the restrictions you're referring to. So, no, I don't think that it would make sense for the UK to just go right back to normal just yet, at least until the vaccinations rates are high enough that you see the case rate go back down and stay down.