I don't know what policy around flu should be, but I'd like to share my data points about flu, for those who think flu is no big deal.

The last two times I had flu (first age 36, then a few years later), I was unable to work for an entire month each time.

For most of that time I struggled to get out of bed, and couldn't think much. I was too weak and tired, so I slept most of the time or did low energy activities, and relied on other people to bring me food. The first one meant I missed Christmas: My partner went to an all-day get together with our mutual friends, and I stayed home in bed, too ill to go.

My other flu story would be, a good friend and former employer got flu one day when he was visiting his wife and children (he normally worked in another country to them). Few days into it, he lay down on a sofa and died. I don't know the rest of the story, but I miss him. I think my life would be different if he were still around.

These experiences certainly gave me more respect for flu as a killer.

> My partner went to an all-day get together with our mutual friends, and I stayed home in bed, too ill to go.

So your partner did not quarantine? Avoid non-essential trips? Wear a mask?

I don't think you'd disagree that our COVID precautions at _this_ point are incongruous with the past, but highlighting it for others reading.

Covid isn't flu. It doesn't spread, behave, or affect people like flu. It's not a type of flu. There are some similarities and many differences. Do we really have to keep pointing it out?

I don't think current precautions are incongruous with the past. Because they are significantly different situations.

(Edit: Removed "inappropriately" from "incongruous", as it was intended to clarify but it proved unhelpful. Keeping this note because it gives context to the reply.)

I didn't say "inappropriately". And I'm responding to your flu comparison.

I didn't compare flu with Covid. I responded about the experience described as "worst bouts of flu" to give perspective to that experience by itself. Many people have never had a flu that lasted like that. Hearing that it happens is interesting. In particular, someone thinks it's just a few days off work, and I know some people in the US don't have enough permitted sick days to be sick for a month.

I think comparing two situations and calling the different responses to them "incongruous" implies the comparison is intended to be about something you think is appropriate. (And I think it's an inappropriate comparison, because Covid and flu are sufficiently different.) Otherwise the comparison is pointless. Perhaps I should have written "appropriately incongruous" instead of "inappropriately", though; the multiple negatives seem to get confusing around that sort of language, especially across continents.

The last two times you had flu with severity great enough to alert you that you had flu.

Those two experiences you want to avoid in the future, and which define you behaviour (modelled on the impact of the bullets you may get, not on the non-impact of the bullets you may miss).

About a third of influenza infections are asymptomatic.

https://pubmed.ncbi.nlm.nih.gov/18230677/

>Somewhere along the way we seem to have lost sight of what constitutes a normal disease burden.

Having relatives in the healthcare sector and hearing stories during bad flu waves (2020 was not the first year in recent memory where people needed to be treated in makeshift tents[1]) we do indeed have lost sight of the disease burden, but probably not in the way you imagine.

I was lucky to spent the first few months of the covid-19 pandemic in Japan, and I can tell you I did not see overrun hospitals at any point because people by and large take hygiene and avoiding the spread of infectious disease seriously.

[1]https://time.com/5107984/hospitals-handling-burden-flu-patie...

I am skeptical whether you have drawn the correct conclusion from your experience in Japan. There seems to be something else going on beyond just taking hygiene seriously.

https://noahcarl.substack.com/p/why-have-there-been-so-few-c...

Early in the pandemic they also understood the issue of poor airflow and took that seriously. For example, on the trains (even in winter) they keep a number of the windows open to ensure airflow. Schools were required to keep the classroom windows open and breaks were required at set intervals to ensure people were moving in and out of the classrooms. Restaurants were requested to keep their windows and doors open.

To be honest, I don't think hygiene is taken seriously here. Most people don't wash their hands after using the bathroom, especially at home. That said, they also don't shake hands, and they do use hand sanitizer and wipe their hands with towelettes before meals.

I think what OP really means here is the universal mask usage, which is common during flu (and allergy) season, which definitely had an impact.

Of course, Japanese people rarely take off work when they're sick. They're actively discouraged from doing so, as almost no companies offer sick leave. You're required to take your sick leave from your vacation time, and most companies offer less than 10 days of vacation time. I think the most impactful thing during covid is that the government actively pushed companies to allow work from home, which is a major shift in how people work here. I, for instance, have never gone into the office (I started during covid) and my company is allowing work from home as the default, forever.

The government response as a whole is pretty comical, and they can't really be given much credit. They started a "travel around the country" program called GoTo Travel, which definitely resulted in covid being spread from Tokyo around the country, during one of their larger waves. Their vaccine roll out has been one blunder after another.

Overall, I think the way the culture works here, and their past experiences with SARS, and their normal handling of the flu, is why the country hasn't been overrun, even though it's mostly stayed open the entire time.

I think the article leaves a lot of space for the possibility that the Japanese have kept infections low because it is a low physical contact culture, and that there have been fewer deaths due to the lack of obesity.

Those are possible hypotheses but remain unproven.

Perhaps we were too lackadaisical about flu.

I've certainly enjoyed not getting the usual bouts of cold and flu my kids would bring home from school every winter.

I hope at least one lesson we take from COVID is "people should be able to take sick days rather than coming to work/school sick".

People can do that, stay home when sick. Then they just have fewer vacation days. At least, that's how it works for me. I suppose we could think of it as an incentive to remain healthy.

Sick time should be separate from vacation time for that reason. Otherwise, people have an incentive to come into work while sick so that they can use their paid time off for holidays and vacation when they aren’t ill.

On the other hand, I guess there are some people who when given a separate bank of sick time feel it’s ok to use it as a 2nd pool of PTO. My workplace gives a separate set of sick time though and it’s always seemed a better way of handling things to me.

For office workers, the whole remote experiment of the last year seems to be the equilibrium. You can still "come to work" even if you feel like death, you're just allowed to do it from home until you're not contagious.

That's quite a privileged perspective. Many low wage, non-union workers don't have that flexibility.

> People can do that, stay home when sick. Then they just have fewer vacation days.

I experienced that too, when I lived in the US.

In Denmark I have separate sick leave. Staying home sick doesn't count as PTO. For more than a few days I'll need a note from the doctor.

I think it's around 6 months before sick leave is grounds for termination.

In any case, in the US people don't take sick days unless it's really bad. Obviously, this must cause more infections.

It’s perfectly fine for that to be ones risk tolerance and to take mitigation steps. It’s not to mandate them by government fiat.

We've been quite comfortable with vaccine mandates for decades. My kids needed proof of MMR, DTaP, and several others to be able to attend school. Colleges have similar requirements. Hand washing is mandated "by government fiat" in many scenarios, as are quite a few other OHSA or public health scenarios - try working on a construction site without a hard hat, for example.

In 2019 or earlier, when have you had to show an ID and proof of vaccination to enter any building other than your own house? And for schools, didn't you used to have private schools or homeschooling as an option to avoid these kind of mandates? And hard hats aren't really comparable, since you can take them back off at the end of the workday.

> In 2019 or earlier, when have you had to show an ID and proof of vaccination to enter any building other than your own house?

I live in upstate New York - one of the more aggressive states for COVID measures - and have not yet had to do this, a year and a half into the pandemic.

(I did, however, have to prove my vaccination status and present ID when I became a naturalized US citizen quite a few years ago. https://www.uscis.gov/policy-manual/volume-8-part-b-chapter-...)

> And for schools, didn't you used to have private schools or homeschooling as an option to avoid these kind of mandates?

These still exist.

> These still exist.

But they don't get you out of the mandates anymore. Adults who already finished school used to never have to tell anyone their vaccination status to participate in society.

Again, I literally had to prove my vaccination status to be allowed to stay in the US. In 2009… and I’ve yet to present my COVID card anywhere in upstate NY.

Non-citizens do not have the right of citizens, you might have known already, but one can be denied the green card and/or not allowed into the country for having a communicable disease like AIDS or TB. If I follow your logic, it's okay to have AIDS, TB, leprosy, etc. passports too?

> If I follow your logic, it's okay to have AIDS, TB, leprosy, etc. passports too?

If they start spreading exponentially via aerosols, sure.

But people with AIDS are not allowed into the country already, why you add conditions? Does the Constitution say anything about aerosols? Besides, TB spreads with the aerosols so we should have the BCG vaccine mandates, right?

It's fairly obvious that TB is not spreading like COVID does in the United States. If it were, restrictions would be sensible. (I would note that if you have TB, you may wind up subject to a quarantine order. https://www.cbsnews.com/news/tb-patient-quarantine-condition...)

Constitutionally, SCOTUS has ruled on the point in the past. https://en.wikipedia.org/wiki/Jacobson_v._Massachusetts

> Jacobson v. Massachusetts, 197 U.S. 11 (1905), was a United States Supreme Court case in which the Court upheld the authority of states to enforce compulsory vaccination laws. The Court's decision articulated the view that individual liberty is not absolute and is subject to the police power of the state.

You argued that the rules applied to foreigners should be applied to the citizens. Right now foreigners with TB, AIDS and many other diseases are not allowed in the country. The question for you: is it okay to deport citizens with the same diseases? If the same rules apply then we should be doing this but as we obviously don't do this, this means the rules for foreigners are different. I am sure you can find the court cases confirming that.

Not entirely true. Certain classes of jobs, like working in health care, have always mandated vaccination. Additionally, when most vaccines are given in childhood, making sure everyone is vaccinated in grade school has the effect of ensuring that most adults are vaccinated. No need to keep re-checking throughout life.

I’m referring to masks. Mandating vaccines is fine and good.

So you are ok with injecting things into peoples bodies, by force.

But covering the nose and mouth, when around others, is beyond the pale?

Yes, because I’ve gotten vaccinated and I shouldn’t be continued to be punished with restrictions.

> Exactly. I see no reason why I’d take strong measures to avoid getting exposed to it (now that I and 90% of adults around me are fully vaccinated) when I never did the same for the flu.

It should really go without saying COVID-19 is much more transmissible than any recent version of the Flu. Comparisons of symptoms and severity in healthy adults has never been the sticking issue.

I'm disheartened to see people on HN of all places thinking solely as an individuals and not about the management of health care resources at a population level. Health care resources are finite and viruses like COVID can still spread exponentially even with current vaccination rates.

From the beginning, the goal has been to lower transmission, lower cases, and therefore lower the burden on the _world_ health care system to a tenable degree. Yes, there may be _more_ effective measures we can take at this point, such as ramping up vaccination, but at the end of the day, if you don't transmit the disease to others or end up in the hospital yourself, you are helping the cause.

tldr; Whether or not it poses a risk to _you_ is besides the point, in so far as the risk of overburdening the health care system remains.

The healthcare system also had more than a year and a half to build capacity to deal with this stuff? Why should society be required to bail out hospitals by adhering to arbitrary restrictions on their life?

I don't disagree with you, but your tone does smack of biting the hand that feeds.

I completely disagree with them. They seem to think hospitals operate like spinning up extra VMs when extra load is generated.

And, in particular areas where there is an outbreak it can work like that. Much like you can spin up another VM when you still have underlying resources to do, you can setup an emergency hospital when you can borrow resources from elsewhere.

When everywhere is busy, let's say a major pandemic outbreak, there is no extra capacity, and you tend to lose capacity by attrition of a worn out workforce.

I think it's fair to say that in the past year and a half, we had time to build capacity slowly and intelligently. OTOH, that's not any individual hospital's job. In our capitalistic society, if OP wanted to go build their own hospital, nobody was stopping them.

Change the config file for the hospital from 100 doctors to 200 doctors, and reload the config. You can spin up a new doctor in what 30 seconds? Totally how the world works from the armchair.

Not like it takes 6-7 years to get the basics down, weed out the ones who really are not as into it as they thought or just wont make it, or cant keep up. Not to mention the ones that want to go off and do tit jobs for a living rather than feeding experimental medcine to people who are about to die because they excercised their rights to refuse to take tested medcines.

> I think it's fair to say that in the past year and a half, we had time to build capacity slowly and intelligently

> Change the config file for the hospital from 100 doctors to 200 doctors, and reload the config. You can spin up a new doctor in what 30 seconds?

...wtf?

tbh i am not shocked you cant figure it out.

They totally did though. Did you see all of the new stadiums and ships and warehouses and tents that were erected at the start of the pandemic ready to take the overflow?

None were utilized.

Can you point me to some ICU data that shows them filling up in the past year and a half?

NOT fear mongering media articles, but the actual data you're using?

Why not converse. Show the data that you're using.

You're claiming you can fly and asking me to prove that you can't fly? That's not how science works.

The burden of proof is on those who claim things are different than the norm.

I mean my local hospitals have been publishing icu bed usage since near the beginning of the pandemic and during every surge they run low on icu beds with the majority of the beds used by covid patients.

Would love to see that posting

An odd analogy, given that hospital workers don't feed anyone - it's the rest of society that feeds them.

By point-blank refusing to even consider increasing capacity, despite being written blank cheques by military engineers and ventilator designers, and insisting instead on lockdowns, it is rather the other way around: society fed the healthcare managers who then turned around and bit that hand. Supermarket staff, truckers, farm workers, meat factory operators and so on cannot lock down or work from home, so they had to keep working throughout. Yet health managers just looked blankly at their shiny new emergency hospitals and acted baffled that they were expected to do things differently to normal. Nobody increased capacity to help ensure care for the essential workers. Eventually the quasi-religious approach to the health system will go away and people will start to wonder why exactly all those newly built beds had to be dismantled instead of being paired with an emergency training programme.

I mean all this “protect the hospital” crap is bailing them out. Might as well be honest about it. People should be pissed that hospitals didn’t build capacity… why they aren’t, beats me.

> I'm disheartened to see people on HN of all places thinking solely as an individuals and not about the management of health care resources at a population level.

Individualism vs Collectivism is a debate that goes back a long time.

Your 'flattening the curve' argument is fear based.

I haven't seen any actual DATA besides media fear mongering that ICUs are 'almost' full for years now.

You are conflating two things. This guy's illness was about the same as worst bout of flu -- that doesn't mean that's necessarily typical, but let's say it is.

Currently, in most of the USA, your chances of getting covid are probably a LOT higher than that of getting the flu. Way more people are getting covid than getting a bad case of the flu.

So it's not quite the same.

If the chances of getting the flu were always this high, including the chances of really severe disease or death for some (say, those with organ transplants)... we probably would have been doing something different.

But I agree with you we shoudln't have to, don't need to, and can't sustainably simply shut down life forever.

I find the experts advice reassuring. IF you are vaccinated:

> Even with delta, the goal is not to go back to a lockdown mindset, though, says Malani. "My hope is that people who are fully vaccinated should really feel like this risk is manageable."

> "Feel good about spending time with your friends, or having a small dinner party, but make sure everyone is vaccinated," she says.

For now I am wearing a mask at the store (not that big a deal), and avoiding large public unmasked gatherings. In part because I want to try to help get community transmission rates a lot lower so we can then do more.

But I agree I'm not gonna do it forever.

> Somewhere along the way we seem to have lost sight of what constitutes a normal disease burden.

Alternatively this pandemic may have permanently shifted what we consider to be a normal disease burden. Maybe we shouldn't accept tens of thousands of Flu deaths every year if there are some relatively simple changes we can make to reduce them.

If simple means forcing everybody, including toddlers, to wear masks… I’ll hard pass.

> Exactly. I see no reason why I’d take strong measures to avoid getting exposed to it (now that I and 90% of adults around me are fully vaccinated) when I never did the same for the flu.

Because it's up to 10x more deadly than influenza, particularly for vulnerable populations.

https://www.hopkinsmedicine.org/health/conditions-and-diseas...

Your link does not seem to support that Covid-19 is 10x more deadly than influenza in a vaccinated person, like the poster you are replying to. It’s 10x more deadly if you haven’t been vaccinated but the vaccines are showing 10-20x decrease in hospitalization and death, bringing the risk more into flu range.

> Your link does not seem to support that Covid-19 is 10x more deadly than influenza in a vaccinated person, like the poster you are replying to.

But my point wasn't about op, it was about the population as a whole, hence the "especially in vulnerable population" part.

Parent however qualified that they were considering the risk to themselves and their own contacts, who are also vaccinated. For them and their associates, treating this like the flu seems more reasonable. Assuming they’re in the USA, everyone who is unvaccinated at this point (except children, who have low risk of death) is doing so by choice. We can’t be expected to put our lives on hold for conspiracy theorists forever.

That statement seems to be very obsolete. It claims "doctors and scientists are working to estimate the mortality rate". Well, that work has been done and the results were that you can find IFRs of anywhere between 0% and 1.6%, with a median of about 0.2%:

https://www.who.int/bulletin/online_first/BLT.20.265892.pdf

There's a letter here in the BMJ that states it's comparable to flu:

https://www.bmj.com/content/371/bmj.m4509/rr

The nature of IFR calculations means there will likely always be very wide uncertainty intervals, however.

The flu is equally if not more deadly in populations without preexisting immunity (e.g. isolated tribes). Once people acquire immunity (preferable through multiple doses of vaccination), it’s really not any different than the flu.

Do you live in an isolated tribe? Otherwise, I don't see how that's particularly relevant to your comment.

In most populations, today, COVID is significantly more dangerous and deadly than influenza.

I now have antibodies and memory cells against covid (because I’m fully vaccinated), so covid is not deadlier than the flu for me.

Yes, for you. The point I've been stressing is that it's (mask wearing, social distancing) not just about you.

Because you don't live in an isolated tribe, some percentage of your population remains at risk of contracting covid and perpetuating its spread.

Most seasonal upper respiratory illnesses don't routinely cause loss of smell or taste, which should be a clue to something more nefarious potentially going on. If I were the author I'd worry about subtle frontal brain injury.

For me, boosters and nasal vaccines can't come fast enough (nor can the ability to administer them to younger children).

At some point I think this virus will become like the flu in terms of public health implications, but I don't think it's quite there yet.

Loss of smell in COVID-19 isn't caused by frontal brain injury.

https://hms.harvard.edu/news/how-covid-19-causes-loss-smell

The risk to younger children is minimal.

https://www.nature.com/articles/d41586-021-02423-8

I think the jury's still out about frontal damage:

https://www.science.org/doi/10.1126/scitranslmed.abf8396 https://www.medpagetoday.com/opinion/second-opinions/94301

As for children, yes, the risk is much smaller than for adults, but it's a moving target due to viral evolution, and why not reduce it as much as possible?

> Exactly.

Not quite. The worst bouts of flu are the ones that kill people. Some of the influenza A strains are no joke.

> Somewhere along the line we went from “flatten the curve” to “no one can ever get sick again”.

Oh please, no public health official has ever said that, and you know it.

The problem is the curve isn't flat, thanks to 1) Delta, and 2) vaccine hesitancy. There's a reason ICUs in the American south are at or over capacity.

Well, then you should be able to find some excellent examples of public officials (I'll welcome comments from the CDC, WHO, state level health authorities, or similar expert organizations) making the claim that "no one can ever get sick again"! I look forward to the voluminous citations supporting your claims.

As an aside, I find it amusing yet entirely unsurprising that you're of the persuasion to believe the term "woke" is somehow a pejorative. But nice work throwing around what you believe to be insults.

Nowhere in that quote does Fauci say "no one can get sick again". He's literally talking about flattening the curve and the reason for doing so.

Either your reading comprehension is lacking or you need to try harder.

Oh the implication! Well, you got me there. Obviously we can't just read what he said and take it at face value...

It’s complete gaslighting. There was even animated charts plastered over everybody’s Facebook posts.

“Two weeks to flatten the curve and build up hospital capacity”.

Right down the memory hole and people calling you crazy. Gaslighting.

> to the point where you sort of start feeling like the experts don't really know what they’re talking about either

Speak plainly. Waffling language like this is commonly used by conspiracy theorists who don't want to come out and say anything clearly and plainly, because it could quickly be shot down by the actual facts. Instead they use speech patterns like this to create a hazy word cloud that breeds uncertainty.

Do you really think the experts don't know what they are talking about? Say so then. Enough with the snarky insinuation.

What about last year when they were talking about natural immunity passports before vaccines were available, now they pretend natural immunity does not exist!

Immunity is a right wing talking point. We’ve politicized the immune system.

> Somewhere along the line we went from “flatten the curve” to “no one can ever get sick again”.

You’re right — I haven’t heard “flatten the curve” rhetoric since the earlier days of the pandemic. Taking the vaccine helps prevent healthcare systems from crashing. In highly vaccinated areas, is it accurate to now say, “Mission accomplished”? I don’t think so, given that children under 12 can’t be vaccinated. And yet we are sending them back to in-person learning in droves….

+1 about the inconsistent messaging and logic.

Children aren’t at risk of covid. Flu and pool drowning is greater risks…

In my opinion these public health “experts” have a moral obligation to tell people to stop worrying about kids. I honestly don’t understand why they haven’t cheered the fact kids aren’t at risk. It’s good news!

The cynical side of me thinks they want to let people remain scared so they gobble up kids vaccines when released. Which is pretty ethically challenged but par for course with these “experts”.

My kids get flu shots every year.

What data are you using that shows hospital systems crashing?

Not media articles but where is the actual data you're using to make this claim?

> were told prevents us from getting sick

I never heard this. I belive many people jumped to this conclusion on their own. Because they associate vaccination with immunization.

People believe this because most vaccines are sterilizing. If you get the measles vaccine you can't get measles again ever. The Covid and flu vaccines don't work that way.

Re: measles, this isn’t necessarily the case. Breakthrough infections have been known and discussed before.[0] The measles vaccine efficacy is estimated at 97% implying 3% chance of a breakthrough.

However, Covid-19 vaccine efficacy against infection was originally 93-95% but has dropped to 60% or less against the Delta variant. A lot of discussion seems to ignore this. To get back to the 90% plus efficacy we’ll need the vaccine to be re-tuned against delta, which no one seems in a rush to do for some reason…

[0] https://pubmed.ncbi.nlm.nih.gov/31039835/ “In an outbreak of measles in Gothenburg, Sweden, breakthrough infections (i.e. infections in individuals with a history of vaccination) were common. [. . .] Sixteen of 28 confirmed cases of measles in this outbreak were breakthrough infections.”

Can I interest you in

Katherine J. Wu (The Atlantic) - We’re Asking the Impossible of Vaccines // Complete protection against infection has long been hailed as the holy grail of vaccination. It might simply be unachievable.

https://www.theatlantic.com/science/archive/2021/09/steriliz...

> So we all took a vaccine that we were told prevents us from getting sick

At no point have I ever seen anyone claim the vaccine is 100% effective.

Should have used “protects” instead of “prevents” - bad word choice on my end.

> claim the vaccine is 100% effective.

They were very clear in the press releases that it was 95% effective.

in what country are yoy that 90% of the adults are fully vaccinated?

Also, "Think of the children". those that can't get vaccinated but are now dying from the delta strain?

Ireland, almost. (I think we're at 92% with one dose, and 89% with two).

thats astounding. well done you lot :-)

It's not quite as good as it seems, because we have a lot of kids in Ireland, but it's still massively reassuring.

> now that I and 90% of adults around me are fully vaccinated

I'm curious, where did that 90% figure come from?

Around here, of the eligible population, about 1 of every 3 has no shot at all, one 1 out of 4 with just a single shot. If you look at the full population, including minors and other ineligible groups, the numbers are even worse.

That means if I go to the grocery store, I'm absolutely gonna be in proximity to someone unvaccinated at some point along the way.

Assume he’s in a EU country/US state with high vaccination rate.

In Santa Clara county (Silicon Valley), 87.6% residents over 12 have has one dose, 82.4% are fully vaccinated. I have no idea if people eager for boosters are getting double counted.

Minors aren't at serious risk, and 99% of the remaining unvaccinated population has made a conscious choice to live dangerously.

No, some large percentage of the remaining unvaccinated population have decided to put people like my immunocompromised mother-in-law at risk through their actions.

I'm genuinely sick of this "I got mine jack" attitude toward vaccination. Getting vaccinated isn't just about you. Unfortunately we apparently have a good solid 20-30% of the population who care only about themselves. But, who should be surprised. This is just American radical individualism coming home to roost.

And that's ignoring the fact that with Delta there's early indications that it's leading to an increase in the number of younger folks hospitalized or worse.

I encourage everyone to get vaccinated if they can, but the Delta variant is so contagious that your immunocompromised mother-in-law is likely to be exposed eventually no matter how many people are vaccinated. There will be no significant herd immunity effect.

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

The Delta variant causes more younger people to be hospitalized just because there are more infections total. There is no reliable evidence that Delta causes more severe symptoms.

> There will be no significant herd immunity effect.

This is a statement that lacks critical nuance.

Will there be herd immunity that eliminates the virus from the population?

I agree, the answer is probably "no".

But vaccines significantly reduce the chance of acquiring covid upon exposure, and they reduce the period in which you're infectious if you experience a breakthrough case.

https://www.nature.com/articles/d41586-021-02187-1

The result is that R is significantly reduced in a highly vaccinated population. This reduces the rate of spread and the chance any one person will be exposed, thereby protecting the vulnerable.

I know everyone is throwing around the example of Israel's experience, but no one seems to be considering just how much worse things would be for them if they didn't have a high rate of vaccination. The answer: a lot worse. Especially when you consider that, even with Delta, vaccines are highly protective against hospitalization and death:

https://www.covid-datascience.com/post/israeli-data-how-can-...

Unfortunately that's not how it works in the real world. Since the virus is now endemic, the chance that vulnerable people will be exposed over the next several years approaches 100%. Reducing R0 only slows down the spread a little. We don't have a practical way to reduce it below 1.

> Reducing R0 only slows down the spread a little.

Reproduction is an exponential function. A small change in R has a large effect in rate of spread.

> We don't have a practical way to reduce it below 1.

First, this is just not true. Even the (likely pessimistic) Israeli data indicates that vaccinations reduce chance of infection by over 60%. This cuts R in half from 5-7 to 2-3, and probably less when you consider the window of infection is shorter for breakthrough cases.

Combined with other measures--contact tracing, masks, social distancing, improved ventilation, etc--the measures that got Alpha transmission below 1 without a vaccine would be effective with Delta in vaccinated populations. This could allow moving to a model of managing hotspots rather than dealing with unsourced community spread.

Second, you presume that there will never be a vaccine effective against Delta. I'd rather we do what we can now--which means driving of vaccination rates as high as possible as quickly as possible--to slow spread and buy time for targeted boosters to come out than to throw up my hands and just assume that everyone is gonna get COVID so we might as well just give up and stop trying.

Nope. Not wearing masks forever. Vaccines were the end. If they don’t work, nothing will. Either way the only ethical thing to do is learn to live with it and go back to normal.

Life is way to short and we can’t just piss it away being myopically focused on slowing exactly one very specific illness. Sorry.

> have lost sight of what constitutes a normal disease burden.

I don't think so. This is only "mild flu" for vaccinated people. We still have kept sight that people who can't be vaxed can die, and people who ignorantly chose not to vax are killing people because they clog the ICUs and prevent people from getting non-covid life-saving care.

So we haven't lost sight, people just choose not to see. You just can't teach some people to be unselfish and considerate.

> and people who ignorantly chose not to vax are killing people because they clog the ICUs and prevent people from getting non-covid life-saving care.

Honest question - would you provide information for that please? The two articles I've seen on that were both completely retracted within a few days of publication. I know unvaxxed people, and I want to have all available information before conversing with them.

The hospitals are clogged because the basic in person care is crippled by covid prevention practices. So instead of going to your pcp to deal with an ear infection or bladder infection the only place you can go is hospital as now any time you have covid like symptoms you have to get a covid test to get access to care.

Similarly you can’t get care if you have a slow growing cancer or need minor surgery. All these people are going to have negative outcomes

> The hospitals are clogged because the basic in person care is crippled by covid prevention practices.

They also seem to be suffering from the labor shortage. Only secondhand anecdata from friends in the medical field, but nurses seem to be getting harder to hire and retain right now.

Thank you, but I was asking for actual verifiable information that hospitals are getting clogged due to non-vaccinated people. I asked for two reasons. 1) That is not at all the case with the hospitals near me. 2) The recent articles I've seen make this assertion were immediately retracted due to the people they relied upon not telling the truth.

So, before I speak with some of my unvaxxed friends, I wanted actual information to support, otherwise they could (correctly) say not to bring them unfounded assertions.

For example: https://eu.usatoday.com/story/news/health/2021/09/10/cullman...

Thank you, but that isn't an example of ICUs filled with non-vaxxed. It might be an example of filled ICUs. When I look at reported ICU information for Mississippi, the data doesn't support that. [1]

I appreciate your posting that, but it isnt helpful for my situation.

[1] https://msdh.ms.gov/msdhsite/_static/14,21994,420,873.html

Given that vaccination significantly decreases an individual's risk of hospitalization and that only about 40% of Missippippians are fully vaccinated, it seems like we would be justified in inferring that the people filling the ICUs are generally unvaccinated, no?

Filling the icus might only mean adding 4-8 heads over existing load though if you only have 20-30 beds and you are running 70-80% as a baseline

The ICUs are full of people with suspected covid. Vaccinated people are less likely to have covid. 40% of Mississippi is vaccinated.

Which point are you having trouble with?

They don't put people simply pending a COVID test in the ICU.

Mississippi was recently down to six ICU beds in the entire state: https://www.wlbt.com/2021/08/04/just-6-icu-beds-available-en...

Arkansas got to zero: https://apnews.com/article/health-arkansas-coronavirus-pande...

This isn't explicable with your hypothesis.

You can absolutely go to your PCP for a COVID test, and get your ear infection treated while you're there.

Not here you can’t. They specifically ban anyone with covid like symptoms from entering which is like everything.

Besides what are the outcomes for using ICUs for covid. I bet long term outcomes are pretty dismal, that might be a good time to say unless you are healthy and under 55 if you need icu it might just be your time. Rationing care is a ethical and practical thing to do.

I don't know that there are documented non-COVID deaths due to it, but various parts of the southern US (where vaccination rates are low) have reported ICUs at or near capacity. E.g.

https://www.tennessean.com/story/news/health/2021/08/19/tenn...

One has to assume that at a certain level there is a finite quantity of medical care available at a given facility, and a spike in COVID cases would deplete it. Whether or not that threshold has been crossed, and if not how close such places are to crossing it, is an interesting question.

Thank you, but that news article seems incorrect. When I look at the hospital capacity for TN, according to the TN Dept. of Health, I see available floor beds, some available ICU beds, 62% available adult ventilators, and 1/3 available airborn infection isolation rooms. [1]

[1] https://www.tn.gov/health/cedep/ncov/data/hospitalization-da...

The article says that there are no ICU beds in "every major Tennessee metro area." The TDH dashboard you linked to says (today) that 4% of ICU beds are available statewide. Given that ICU bed use is almost certainly not entirely uniform statewide, and that it might be expected to be highest in metro areas, it seems entirely plausible in light of the TDH data that there are no available beds in metro areas--or at least close enough to literally zero that Tennesseans should be very worried.

It is somewhat worthless to pile assumptions on top of assumptions to come to conclusions. If you look at the map of Share of I.C.U. beds occupied, you can make a better, more finely grained decision. [1]

The question I asked has nothing to do with whether ICU beds are occupied. However, I also will point out that you are replying to a reply to a reply to my question, none of which actually addressed what I asked.

[1] https://www.nytimes.com/interactive/2021/us/davidson-tenness...

Incorrect how? Individual hospitals themselves are reporting they are at capacity. The TN rollup statistics aren't going to tell you very much about whether your local hospital is actually full at a given time, which is going to be the most relevant thing to know if you're seeking urgent care.

Can you show the data you use to make this claim about ICU's being clogged to prevent people from getting life saving care?

Not news articles but the actual data you're using?

The people who can’t be vaxxed have extremely low death rates. It’s possible RSV is actually a bigger danger to them than covid (and increases in youth suicides due to lockdowns appear to be higher than the number of lives saved from covid).

As to ignorant people filling ICUs, that’s not a risk where I live in SF that has near universal vaccination and relatively low hospitalization rates. The UK and Denmark have demonstrated you can love on with life after high vaccination rates are achieved.