That the government is still visibly divided over whether vaccination is a good idea is what really troubles me here and it's pretty much purely America at this point. Canadian liberals don't like the Liberals - Liberals don't like the Conservatives and neither Liberals nor Conservatives like liberals. That all said every represented party in Canada (and almost every individual MP) is either pro-vax or losing a lot of clout right now. In the US the GOP is technically for vaccinations and sane mandates - but if you look at House Reps and Governors you'll see a lot of anti-mask mandate laws and other protests.

The government is of the people - but it should be the best of us not the biggest conspiracy theorists among us (having one or two is fine - but this problem is a lot bigger than just Marjorie Taylor Greene)

> That the government is still visibly divided over whether vaccination is a good idea

Where is that visible?

The article mentions Robert Kennedy Jr. I believe he’s a senator?

In no way is that "the government", and the most I can gather from that article is he's against mandates. Not the vaccines themselves.

I feel one of the biggest sources of divide right now is coming from all of those who try to conflate the two. Agree or not, one can be opposed to mandates to the point of rebellion while still rushing to take the vaccine. They are two completely separate things.

Even if he was one cog actively in "the government", I still would say that nothing here shows "That the government is still visibly divided over whether vaccination is a good idea"

He's not, and never has been. He's just related to JFK. (And the son of Bobby Kennedy, who was a senator.)

> In the US the GOP is technically for vaccinations and sane mandates

Some GOP members support these things. Many do not, as you mention the governors and reps.

I meant specifically the party leadership (since US political parties don't have formal representation) - If you look at McConnell and even Trump (when not hyperbolizing) you'll see they very consistently message that everyone should be vaccinated. One of the things I sort of appreciate about Trump is the fact that, even while getting booed at most of his events over it, he's continued to mention that he was vaccinated and it's perfectly safe. (This isn't meant to devolve into things we think about Trump - I just wanted to call out that single point).

Each and every politician is an individual with his own beliefs and biases.

To expect an entire group to form a single consensus is no different than expecting the entire American populace to form a single consensus, is it?

Politicians need to be smart enough to know when to present a united front - they have a much greater visibility into the damage this pandemic is causing to the country by being completely immersed in dealing with it as their vocation. Yes, some people might still disagree (I've got no illusions or hope for a fully united consensus) but those people should be fewer, harder to see and much more ostracized than what the US political arena looks like today.

Politicians are also quite capable from detaching their personal beliefs from their public beliefs - Dick Cheney notably held to the party line opposing gay marriage while having an openly gay daughter. There are a litany of other examples of failing to practice what you preach - so yea, even if they privately hold these beliefs it's quite reasonable to assume that Mitch McConnell and others would be able to coerce them into falling in line when talking to the public.

Parties are supposed to help with the "forming a consensus" part.

Yeah, give that guy a medal for just once not saying what his lunatic base wants to hear.

We detached this subthread from https://news.ycombinator.com/item?id=28699410.

This is not the same thing as goalpost shifting. This is just the result of changes to best-effort predictions based on information in an evolving situation. These changes often directly contradict each other as new evidence shows them to be false. A goalpost shift is usually by someone who ignores evidence that disproves their theory, and moves on to something else as a tactic for distraction and/or self-delusion. They change the subject but never address the item that they were proved wrong about.

Fauci literally lied because he didn't trust the population with the truth. That's moving the goal posts.

No. That's lying. Moving the goal posts does not require lying, in fact in rarely includes it. It only requires that you change your argument when you're disproved.

The fable "The Dragon In My Garage" by Carl Sagan is a nice demonstration of a similar concept. http://people.whitman.edu/~herbrawt/classes/110/Sagan.pdf

See also, The Invisible Gardener: https://en.wikipedia.org/wiki/Parable_of_the_Invisible_Garde...

We absolutely did not learn that masks work during this pandemic.

At the start of the pandemic there was not much information on the effectiveness of public mask wearing to stop disease. It had been studied a tiny bit based on SE asian mask wearing cultures and the studies from memory were pretty inconclusive. We got much more and much better data when the pandemic began.

I'm not an expert and you should check these facts yourself, but my personal experience was that I investigated this after a trip to Japan many years before the pandemic began. I wondered why western culture did not have a similar mask wearing etiquette and my conclusion on the efficacy was that the evidence for it actually making a difference was sparse and weak.

EDIT: I may have misunderstood your emphasis. I took it to be on the time, as in you were saying that we knew beforehand that masks worked. I see this might not be correct. If you are saying that the evidence is still not good, you may be correct, but I think there is enough early evidence and plausible mechanism of action to assume that the right mask in the right setting is effective. I accept that single layer cloth masks might not do much.

There’s possible a lot of nuance there, that his short comment lacks (and probably leading to downvotes). There were several pre-pandemic studies that suggested masks would be harmful or didn’t show an effect. Then, state-by-state comparisons of laws in the US also show very little correlation. So if the emphasis was on (still) lacking retrospective evidence, that seems a fair complaint. Very recently, there’s a preprint article by a research group that looked back at the existing studies, and showed that many of them were too underpowered to be even capable of demonstrating the expected benefits. It has a great graph of this (https://www.reddit.com/r/COVID19/comments/pxet7q/unmasking_t...)

So—in contrast to the vaccine, where the data was gathered before giving authorization was given last year—it seems that mask mandates may have been just hopeful trials that assumed there wasn’t long-term problems associated with masks, well in advance of actually having relevant data. And, in further comparison, we also have drugs like HCQ, which were pushed ahead of the data—and continue to be advocate despite continued lack of evidence in large trials. So it feels unclear that data ever mattered as much as being seen doing something? I’m saddened by it all.

An optimisitic interpretation is that mask wearing looked to have a plausible mechanism for benefit, and so as the situation ran ahead of the data, the public health officials probably made a best effort guess that mask wearing will probably help and so made the recommendation. Not all public policy can be 100% informed by data 100% of the time. I like to think that this carried more weight in the decision than just wanting to appear to do something, though I am sure that also played some role.

Thankfully most evidence-respecting organizations including governments have taken the position that it is very unlikely that HCL is of any benefit as the data has become better. Its really only fringe groups who are pushing that one hard still and even many of those have moved on to ivermectin.

They work better at containing the spread of the virus than not wearing masks. Social distancing and some indoor restricts along with masks work fairly well. Vaccinations are even better.

Don't forget:

"You can't ban travel from China, that's racist!" --> "You can't ban travel from China, it won't do anything anyway!"

Then the rest of the planet introduced travel bans, which are still in effect a year later -_-.

Suppose that:

1. The China travel ban started when China had very few COVID cases.

2. The China travel ban started when we already had untraceable domestic spread in the US.

3. The EU travel ban started when the EU had a lot of COVID cases.

If those three things happened (#1 and #3 happened without a doubt, jury's still out on #2, because our contact tracing has been crap), it's possible for both of the statements you are quoting to be true. There's literally no point in banning travel from China, if Paris has 10x the prevalence of COVID, and you haven't banned travel from it.

Considering that the first major outbreak in the US was caused by travelers from the EU, it seems pretty clear that banning travel form China, but not from Europe didn't do much to keep COVID out of the US.

Why were European travelers being treated preferentially to Chinese ones, for over a month? I see a lot of people insisting that the travel ban wasn't racist, but I've never seen anyone explain this conundrum.

>>>There's literally no point in banning travel from China, if Paris has 10x the prevalence of COVID, and you haven't banned travel from it.

Was there ever an indication that Paris had 10x the COVID of Wuhan?

If travel bans don't work, why did China implement them domestically, specifically with respect to Wuhan?[1]

>>>Considering that the first major outbreak in the US was caused by travelers from the EU

Citation please? Maybe my Google-Fu is weak, but I'm getting Washington State as the site of the first major US outbreak, and the first US case was a Wuhan traveler in Washington State.[2][3]

>>>Why were European travelers being treated preferentially to Chinese ones, for over a month?

Look at this map regarding the spread of SARS[4]. It reached the world fairly quickly. Yet we didn't implement a global travel shutdown. Travel bans were rather focused on Hong Kong and parts of China[5]. The cost-benefit analysis of implementing strict travel controls on countries other than the origin point are probably based on an assessment of the ability of secondary locations (in your example, Europe) to contain the spread from a small number of imported cases. This would provide the maximum benefit (spread reduction) at the lowest overall cost to quality of life and economic activity. If they had taken sensible measures, as they did with Ebola and SARS, maybe they could have.

[1]https://economictimes.indiatimes.com/blogs/Whathappensif/how... [2]https://www.nytimes.com/2020/03/04/us/coronavirus-in-washing... (PAYWALLED) [3]https://www.nejm.org/doi/full/10.1056/NEJMoa2001191 [4]https://www.nsf.gov/about/history/globalhealth_impacts.jsp [5]https://www.aljazeera.com/news/2003/5/23/who-lifts-sars-trav...

> Was there ever an indication that Paris had 10x the COVID of Wuhan?

This would be a meaningful response if it was a Wuhan travel ban. But it wasn't. It was a China travel ban.

Beijing, for instance, had ~300 total cases at the time the China travel ban was put in place. Paris, at the time that the EU travel ban was put in place had multiple thousands. The prevalence of COVID in the EU was more than an order of magnitude higher when the EU travel ban was put in place.

> If travel bans don't work, why did China implement them domestically, specifically with respect to Wuhan?[1]

Travel bans can work if you ban travel from places with a high case load. We didn't do that, though. We banned travel from places that we politically disliked, and didn't ban travel from places that we liked. Unsurprisingly, the virus didn't care about our political preferences...

> Citation please? Maybe my Google-Fu is weak, but I'm getting Washington State as the site of the first major US outbreak, and the first US case was a Wuhan traveler in Washington State.[2][3]

I live in WA. It was not a major[1] outbreak. New York was the first major outbreak, and very, very quickly overtook WA in case numbers.

> The cost-benefit analysis of implementing strict travel controls on countries other than the origin point are probably based on an assessment of the ability of secondary locations (in your example, Europe) to contain the spread from a small number of imported cases.

By late-February, COVID was completely out of control in Europe. By that point, anyone who thought that the EU had the ability to 'control the spread from a small number of imported cases' was either blind, or crazy, or just woke up from a two-month-long coma. They were way past the point of having to deal with a 'small number of imported cases' - they were at the point where uncontrolled community spread was overwhelming national hospital systems, and national lockdowns were being instituted.

And through all this time, we were welcoming European travelers with open arms.

I understand all of your arguments, and all the disaster mitigation steps you outline make sense - but they were not applied consistently to the two regions. By every metric, China was doing better at the time of the travel ban from it. By every metric, we should have banned travel from Europe in mid-February. We didn't, because we like the EU.

[1] I mean, it was major, if the baseline is compared to zero. It was not major if compared to what NYC went through a week later. NYC went from having one Covid case on March 1st, to 1,000 deaths by March 31st. New York state had more COVID cases than any country in the world by April 10th. [2] Meanwhile, Washington went from one case in January 21st, to one death on Feb 29th, to 247 deaths by March 31st. [4]

[2] https://www.investopedia.com/historical-timeline-of-covid-19...

[3] https://www.kiro7.com/news/local/coronavirus-washington-stat...

[4] Was the Washington outbreak the first one? Yes. Did it become a major one? Yes, by mid-March. Was New York worse off by every metric at that point? Also yes. Was New York a complete disaster zone by mid-April? Also yes. It was seeing a thousand deaths a day.

Ok, I think that's all pretty fair. I would have preferred a China-style lockdown to be implemented no later than February. I think we're closer to agreeing than disagreeing, in that we both feel the severity of the US's response was inadequate. I'm fortunate enough to live in Japan so I'm watching the disaster in my home country from afar.

The travel ban to China in the US mostly came from FAs blatantly refusing to fly to China. Also, yet we got EU flight bans nearly instantaneously. (Go figure)

If you ban travel from China but not Chinese nationals, then what's the point?

Nothing stops people from China from flying to Europe and then the US.

Nothing.

Yes, it was racism. Yes, it was pointless. Do you want to continue this discussion further?

>>>Nothing stops people from China from flying to Europe and then the US.

What portion of the traveling population is willing to take trans-continental detours like that? Some controls are better than NO controls.

>>>Yes, it was racism. Yes, it was pointless.

Are you saying that strict controls on population movements originating from the source geographic region of a virus should never be implemented as an early step to containment?

Obama did it in 2014 in response to Ebola: https://www.theguardian.com/us-news/2014/oct/21/us-limited-e...

and Asia did it to varying degrees in response to SARS in 2003: https://www.nytimes.com/2003/04/12/news/battling-the-spread-...

>>>I'm saying that calling it the "Chinese flu" and combining it with Trump's nationalist rhetoric and other outright racist remarks is racism, yes.

That's moving the goalposts. We were discussing the government act of implementing travel restrictions, as a policy. Rather than debate whether that is sound policy, you've retorted with "well he also said racist stuff...which is racist". This is why we can't make progress. Rather than address individual implementations on their own merits, all too often people are now lumping everything originating from the same decision-maker together and discarding the whole package.

>>>And what is the point of stopping flights from China only? When there were global outbreaks?

Because at the time (31 Jan 2020), ALL 210+ fatalities had travelled to China: https://www.washingtonpost.com/us-policy/2020/01/31/trump-we...

There was no spontaneous, independent outbreak of COVID appearing contemporaneously in Italy or the UK. A complete international travel ban probably WOULD have been the best idea (along with 90 days of Wuhan-style internal lockdowns). Short of that, a ban on the source nation of (again, at that time) 100% of the fatal cases seems like an appropriate compromise to not completely collapse confidence in the steady trajectory of the US & global economy.

>>>"Obama did it too" is not an argument.

It establishes precedent. Both for the policy itself, and that the deafening lack of "Racism!" criticism as proof of the hypocrisy inherent in the accusers today.

That's not moving the goalposts.

It's context. You want to ignore the fact that Trump was blaming China as a whole for coronavirus?

It's racism to blame the coronavirus on Chinese people.

So you want to tell me you are surprised when people see racism by the racist guy who does and says racist things pretty much constantly?

I'm not going sit here and line by line debate you. I lived during it. I know what happened. It was a nonsense policy like basically the whole of the Trump administration's response. It was a complete joke. There was no federal response to the domestic crisis here. We had no supplies. We had no leadership.

It's just a funny thing to point to this as some shining example of Trump doing the right thing when ever other indicator is saying otherwise.

>>>You want to ignore the fact that Trump was blaming China as a whole for coronavirus?

I think it's valid to blame the CCP government for the pandemic going global. Especially when the CCP instituted a strict DOMESTIC travel lockdown without a matching INTERNATIONAL one. Why did they let people continue to fly internationally from Wuhan?

>>So you want to tell me you are surprised when people see racism by the racist guy who does and says racist things pretty much constantly?

I'm saying that people are so wrapped up in their emotional response to Trump the person that it is interfering with their ability to accept sensible government policies. Policy decisions which are not distinctive from previous responses to global pandemic risks over the past 20 years. I see it all the time in my own (black American) community.

>>>I'm not going sit here and line by line debate you.

You asked if I wanted to continue the debate. Every one of my posts links to policy implementations in living memory, with citations. Your posts have no references, and you've doubled down on arguing about racism rather than debate policy, before bowing out of the conversation? So...concession accepted? This is why we can't have nice things...like a functioning government.

>>>There was no federal response to the domestic crisis here. We had no supplies. We had no leadership.

The US has known for a decade that it was unprepared for a pandemic[1]. Lack of supplies cannot be dumped solely on the feet of the most recent shitty Commander-in-Chief, in a long line of turds holding the office. As for leadership, half of the country spent the previous 3 years undermining the Executive Branch's authority because Orange Man Bad, and then was surprised when the massive (yet understaffed of key leadership positions near the top) Federal bureaucracy wasn't able to coalesce and pivot on a dime to tackle an emergent crisis? And you are SURPRISED at this? I'm not.

[1]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1936949/

So, you're not wrong that there have been plenty of shifts. Some of those were laughably optimistic even at the time, some of those are true (masks do work, but cloth masks suck). Some of the people are hypocritical and will get haircuts or whatever that they forbid others from doing.

But you know what basically everyone is doing? Getting vaccinated. Even Trump got vaccinated and told others to do the same. [1][2] If it's some kind of poison, as many are memeing, you'd think we wouldn't want to do that. You can argue that there are long-term unknowns... but that's equally true of the virus. And I've seen literally nothing that the vaccine has caused that isn't known to also be caused by Covid.

So I'd say not to get your science from journalists in general, wear a quality mask (N95 preferably, but at least surgical), and do what you can to lower the replication rate of this stupid virus below 1 so that it goes away. That last part is proving really hard so far.

[1] https://www.deseret.com/2021/4/23/22399234/former-president-...

[2] https://www.nbcnews.com/politics/donald-trump/trump-booed-al...

I encourage everyone to get vaccinated if they can, but the virus will never go away. You can't seriously expect asymptomatic people to continue wearing masks indefinitely.

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

https://www.thetimes.co.uk/article/covid-19-will-just-end-up...

> You can't seriously expect asymptomatic people to continue wearing masks indefinitely.

Millions of people throughout Asia have been for decades though.

No we haven't. We wear masks when we have flu symptoms, not all the time.

It does seem likely that the virus will become endemic, though hopefully reduced to something like a common cold virus. It is possible to get something in between, though, where the virus only exists in certain regions and thereby contain it, though this seems to be getting less likely.

We might get some traction with a booster tailored to delta, but only time will tell.

You seemed to have confused me with someone that is opposed to the vaccination. I have been fully vaccinated for months.

Most people do confuse my positions because I disagree with both sides. I am one of the unorthodox Vaccinated Ant-Vaxxer's that believes people should get vaccinated but I also respect individual liberty to allow them the choose to no inject themselves with a medical treatment if they do not desire it. Since I oppose government mandates then I must be "Anti-Vaxx".....

Crazy I know, to respect peoples body autonomy in 2021 during a pandemic no less......

I also have a high degree bullshit detector, and can not stand hypocrisy which I see ALOT of logical hypocrisy around covid.

>>do what you can to lower the replication rate of this stupid virus below 1 so that it goes away. That last part is proving really hard so far.

it is not "proving hard" it was always impossible and anyone to tell you otherwise is lying. SARS-COVID-V2 is endemic, and will likely settle out with annual deaths being over that of seasonal flu. This idea that we can "beat" COVID like we have beat other things like polio is just wrong.

> it is not "proving hard" it was always impossible

Well there's the Australian method, but I'd prefer things not go that way. I agree that people should have informed consent for vaccinating, that's why I try to inform people so that they consent.

>Well there's the Australian method,

I dont believe that is either practical or sustainable. Nor is it compatible with a society that has any respect for individualism which we in America do.

AU will be unlikely to keep their draconian measures in place forever, either economic reality, or social unrest will force a change

> AU will be unlikely to keep their draconian measures in place forever, either economic reality, or social unrest will force a change

It's worked well for us in Western Australia, and we're effectively a covid-free island with one of the best individual economies in the world right now.

The restrictions will be relaxed as we get 80% vaccinated - which we're very likely to do, this year.

Also the Australian method has given us less COVID deaths in the past two years than America had, yesterday. It is a pity that those 600k Americans that died won't be able to bask in America's superior environment of individual rights.

So you believe that Zero COVID deaths is the singular goal, to cast off all Human Rights, freedoms, and liberties in pursuit of that goal is ethical position?

That safety and security is triumphant over freedom and liberty?

That life is so dear, and safety so sweet, that is to be purchased at the price of chains and Tyranny complete with camps for which you send people?

Yes have pity and sadness for those have died, but I know what course I prefer.. for me give me liberty or give me death for I would rather die free, than a serf in a gilded cage

That's a pretty poetic way to say you're fine with letting 600 000 people have zero freedom. Australia will be opened up and 90% vaccinated with maybe 3k deaths. Unfortunately Little Caesars went bankrupt here, during that time, but I guess that's liberty dying on the altar of public safety. Enjoy the ultimate sacrifice those people made for two years of unlimited Applebees.

It is pretty short sighted if you believe the only businesses and people financially impacted and bankrupted in Australia were Little Caesars, I can assure you that is false

I am sure you likely enjoy a tech sector job which afford you the privilege of sitting on your bum all day having very little impact to your financial life, others are not an privileged.

> It is pretty short sighted if you believe the only businesses and people financially impacted and bankrupted in Australia were Little Caesars, I can assure you that is false

Oh cheers, I didn't know. I will reconsider my position on the 600k dead Americans.

Could you just humor me and do a little back of the envelope calculation of the loss of economy in the US vs AU vs the number of deaths? Hint: Australia's economy is doing fine. Let me know how much each life was worth.

> (N95 preferably, but at least surgical),

I wouldn't even go as low to recommend surgical (at least not without a mask fitter)

KF94, KN95 (reputable), FFP2, or an higher quality N95 NIOSH (shame they won't make those for kids)

well 98% of people vaxxed is nice goal to be aiming for.

But in reality once my kid can get the vaccine (he is 3 years old) I will be one the side of people wanting to remove all COVID restriction.

For now people that refuse to get the vaccine are un-necessarily putting my family in danger.

Goals should be achievable. I encourage everyone to get vaccinated if they can but we'll never reach 98% no matter what we do.

Fortunately CDC data shows minimal risk to children. The estimated infection fatality rate for the 0-17 age group is only 0.001%.

The main benefit of vaccination is reducing the risk of severe symptoms. Vaccinated people can still catch and spread the virus, thereby putting your family at risk. There is probably some reduction in contagiousness but we don't have clear data on that yet.

Forgot to mention if my son get any kind of lungs issue or pneumonia he would likely die. It’s because his lungs are already very week from some other issues.

So while “normal” kid are likely to survive if infected mine will not unless he has 0 symptoms.

Ok, take the vacc. (I would have taken it if had been offered it before I got corona.)

Ok. Then what? What will happen? Corona goes away? Seriously? Corona is here to stay my friend.

You can walk yourself through the reasons why with simple math, really.

Every disease has an estimated R0. The number of people an infected person will infect. You probably have heard of this.

Delta, last I checked, has an estimated R0 of between 5 and 9.5.

Vaccination levels reduce that. And it's a simple equation. All you need to know is the vaccination rate for your population, and an estimated efficacy rate of the vaccine.

And from that, you can figure the new adjusted Rt:

rt = r0 * (1 - (vacRate * eff))

And that's it. And no matter what efficacy rate you pick (infection efficacy estimates for mRNA against Delta vary widely), the resultant rt will be less than the initial r0.

And if it's less, then that effectively means that the disease is less contagious for that population, compared to how contagious it was pre-vaccination.

And less contagious is better than more contagious.

So now I am legitimately curious. What part of the above reasoning do you actually disagree with?

(Incidentally, vaccination also improves your chances of avoiding future infection, even if you've already been infected.)

What is the efficiency against transmission of the latest mutations? AFAIK there is a great efficiency against bad symptoms, but much lower efficiency against transmitting the disease to others, but I don't know the latest numbers.

(Copied from elsewhere in the thread:)

Last I heard, the CDC gave a 95% CI of the mRNA vaccines being 26% - 84% against infection (from Delta), and there's an additional 40% - 60% protection against infecting others (I've seen that estimate in multiple places but I don't know the source). If that's true, it suggests an overall range of 55.6 - 93.6 effectiveness against infecting others.

Over the summer Florida has been in the news because of an ongoing epidemic spike. Using hospitalization rates, the spike started sometime in early July. By late Sept it is almost gone. The fully vaccinated rate increased from 48% to 59% during the same time period. Is the receding fully explainable by the increase in vaccination rate, or can we consider other forces at play, for example forces of outside human control that have been at play in every single epidemic before the vaccines era?

https://coronavirus.jhu.edu/region/us/florida

https://data.democratandchronicle.com/covid-19-vaccine-track...

Edit: I plotted Rt as a function of eff, assuming r0=7 and vacRate=1. Rt goes below 1 only for values of eff > 0.85, which means that given the numbers for eff you gave in a different post "overall range of 55.6 - 93.6 effectiveness against infecting others", there are plenty of scenarios where vaccines by themselves cannot stop an infection wave even if the population is 100% vaccinated.

https://www.wolframalpha.com/input/?i=plot+y+%3D+7+*+%281+-+...

https://www.wolframalpha.com/input/?i=solve+1+%3D+7+*+%281+-...

Edit2. For a 0.59 vacRate, there are some solutions for R0 * (1 - 0.59 * eff) < 1 with eff in [0, 1] and R0 in [0, 9], specifically there are solutions for R0 < 2.x Not going to cut it for 0.59 vaxx rate and delta, no matter how effective the vaccines are.

https://www.wolframalpha.com/input/?i=plot+1+%3E+y+*+%281+-+...

Some combination of death, natural immunity, vaccination, distancing, mask use, etc. What other forces are you suggesting?

Note that the more populous counties probably increased vaccination at a greater rate, like Miami-Dade went from 56% to 72% over the same time range.

Natural immunity as a direct effect of an infection wave is my first guess. In some circles 'natural immunity' has become a dirty word :/

The assumptions between the equation rt = r0 * (1 - (vacRate * eff)) are too simplistic and unable to explain Florida infection wave behavior. There are more variables that we ignore when focusing only on Rt and vaccines.

The silver lining: At some point the whole population would have been exposed to covid, either through vaccines, infection or both. At that point the whole vaccination rate / effectiveness discussion becomes moot. Perhaps I wish the public discourse would keep an eye on 'estimated population fraction exposed to covid' that includes all plausible factors.

Yes, I brought up that equation merely to illustrate how vaccination alone can impact Rt downward - for a while it was unclear to me exactly how "partial vaccination" (before herd immunity) was a benefit; that helped me see that it really just mean it slows down the doubling rate until you get to Rt=1. But overall, Rt is impacted by all forms of mitigation including natural immunity.

The way I actually use that equation in my personal dashboards is to estimate what Rt "would" be, at today's mitigation levels, if no one had gotten vaccinated. So for instance, Portland's Rt is currently 0.92 (according to one model). By plugging in Portland's vaccination rate and efficacy estimates, you can estimate that Portland's Rt would be around 2 today if not for the vaccinations, if all other mitigation were the same.

On the one hand, 2 is a lot better than those estimates of 5 to 9.5, which means that we're impacted a lot by current mitigation practices (masks, distancing) and natural immunity. On the other hand, 2 is huge! Given estimates on infectious periods, that means that currently our cases halve every 90 days or so, but 2 would mean cases would be doubling every week or so. Gargantuan difference. So just an illustration that vaccination has a big impact and matters a lot.

or maybe they're just reporting data creatively

https://www.reddit.com/r/dataisbeautiful/comments/pxizb1/oc_...

and it seems like it works

Alabama, Georgia, Missisipi, South Carolina all show a similar profile:

https://coronavirus.jhu.edu/region/us/alabama

https://coronavirus.jhu.edu/region/us/georgia

https://coronavirus.jhu.edu/region/us/mississippi

https://coronavirus.jhu.edu/region/us/south-carolina

Edit: Also Oregon and Washington, lest we suspect there is a grand RedState conspiracy at foot.

https://coronavirus.jhu.edu/region/us/oregon

https://coronavirus.jhu.edu/region/us/washington

This is missing the last step of calculations as any degree of lower r0 doesn’t necessarily prevent endemic disease. My understanding is that at this point, vaccines are about keeping symptoms mild and ICUs at low capacity through reduced spread and more effective immune responses. This seems compatible with the view that we will have to live with this disease for a long time.

you argumentation is correct but misses a point. the vaccs may encourage new variants due to evolutionary pressure.

That point is incorrect; discussed elsewhere.

I mostly agree with you but "And less contagious is better than more contagious." is a giant hand wave in a logical argument. You should explain what specific outcome in the longer term improved by this and justify that.

The implicit assumption in that statement is that "less contagious" means "less disease" means "less casualty".

Other ideas https://boriquagato.substack.com/p/the-vaccinated-supersprea...

It is all much more opaque than the "get your vacc and your old live comes back" evangelists want you too believe. Corona will stay.

I don't know what pro-vax people are saying "get vaccinated and your old life comes back", that seems a mischaracterization to me. The reason to get vaccinated is to protect yourself and others from the disease.

Once everyone (young kid less than 5 years old) can get the vaccine if they want to, I really doubt Covid restriction will stay in place.

Take the vaccine (Moderna if you can pick), significantly reduce the health risk of covid on you. Also, helps to dampen the overall rate in the county and reduces the risk new mutations that may create more breakthroughs.

If you're complaining about the withdraw of mitigations, that's because people and states have refused to participate in the mitigations as a whole.

If they were compliant, we'd be in a situation like Australia or Taiwan. Masks optional, nearly normal (they have restrictive borders), open concerts, and lockdowns only when a couple of cases pop up.

Australia has been on significant lockdown for long stretches at a time, I am not sure I'd consider that "nearly normal" since they have to keep locking down every time Covid is reintroduced somehow.

They are keeping Covid rather low, though I would not trivialize the cost of doing so.

"and reduces the risk new mutations" likely the opposite is true. It is called evolutionary pressure.

I will get vaccinated next year since I move back to China then. They insist and I am okay with it since I get something in return.

> "and reduces the risk new mutations" likely the opposite is true. It is called evolutionary pressure.

Chicken and egg problem: You can't have evolutionary pressure without an environment to operate in. Vaccines reduce the space in which they can attempt to successfully mutate.

That environment of evolutionary pressure is exactly what is being created. An environment where strains with higher fitness for immune escape are more able to spread, in a compounding manner. Particularly with leaky vaccines as we're using for c19 that do not prevent contraction with high efficacy.

Please read this - even just the 'Prevention' section for a real world example. https://en.wikipedia.org/wiki/Marek%27s_disease#Prevention

or read how antibiotic resistance comes about, which seems to be less contentious / politicly affected... But the same evolutionary mechanism is at work.

That's not how evolutionary pressure works. If fewer people are infected, the virus has fewer opportunities to mutate. Among those people, any surviving mutation has (by definition) a greater ability to escape the vaccine, but that's not the same thing as saying that the vaccine increases the chance of a new mutation.

There's a missing part to this by the way: you need a reservoir for new mutations to replicate in, and they have to be mutations which become dominant in the reservoir.

Since the vaccines reduced R(eff), generally below 1 (so far observed), any chain of infection through vaccinated people tends to terminate - not continue. Which means however vaccine evading that virus is, all of it dies.

This all changes if you have a large group of unvaccinated people presenting no challenge to it. Freely spreading for a whole lot of cycles through that population means more vaccine-resistant copies are now out there, with more opportunity to challenge vaccine resistant individuals they come into contact with (since R(eff) in the unvaccinated is ~8).

This is incorrect. I encourage everyone to get vaccinated if they can, but there is no reliable evidence that this reduces R(eff) below 1.

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

R(eff) lowers the higher the vaccination rate. There are some pretty obvious % targets depending on your R(eff) initial. For the initial population number it's ~90%.[1]

So no, I am in no way wrong.

[1] https://grattan.edu.au/news/race-to-80-how-we-mapped-austral...

"no reliable evidence" - of course vaccination helps bring R(eff) lower. That's just the way the math works. If R(eff) is already low enough due to other mitigation, then additional vaccination helps bring it below 1. We see that all over the nation now, R(eff) rates dipping below 1 as vaccination rates increase.

I have trouble visualizing that, but if that's true it's just more reason to do whatever we can to get local Rt < 1. Vaccines get us partway there, other mitigation efforts like mask use, distancing (and natural immunity) get us partway there as well.

I'm personally vaccinated and not very worried about getting the disease if I have to be out and about. I feel my personal risk is low. But in terms of societal/community risk to others, that's why I have a personal policy of limiting myself socially so I don't contribute to spread.

The local metrics I personally follow are:

1) Is Rt above 1?

2) Are cases/100k above 10?

3) Is test positivity above 5%?

4) Is ICU usage above 85%

If any of those are on the wrong side, I'm limiting my social gatherings.

disagree.

i’m in singapore right now, with one of the highest vaccination rates in the world (82%+) of moderna and pfizer.

restrictions are still in place, and r(eff) is > 1 the last few weeks.

Not sure what the counterpoint is? r(eff) would surely be higher than it is now, if not for that vaccination level.

So you're not getting vaccinated and you've convinced yourself it's for pro-social reasons. Misinformation truly is something to behold.

The poster is confirming that vaccine mandates work as well.

Let's be clear, mitigations were being removed when vaccination rates were increasing and hospital rates were decreasing. It's only because a significant enough portion of the country has decided that not getting vaccinated is more important to them and have caused our medical system to be put back under strain have the mitigations been put back in place.

80% of people 12 and up have received two doses of Pfizer or Moderna in Canada. COVID is still a major factor here (worse than ever in some regions with lower rates ~75%).

[1] https://www.ctvnews.ca/health/coronavirus/more-than-80-per-c...

And how many of the people effected by that are unvaccinated? You are simply re-stating what I said, as vaccines rates went up AND hospitalizations went down, mitigations were removed. Then the Delta variant hit and has been an absolute disaster for those who have refused to get vaccinated and our medical care system. 20% is a significant amount of people, and hospitalizations have gone up and therefore mitigations have been put back in place.

I would love to get back to (semi-)normal, I'm sick of this shit. But I've done, and continue to do the things that are helping make things less worst, I wear a mask, I socially distance, I have my vaccine. If a new version of the vaccine came out that targeted the Delta version of Covid, I would get that too.

And I don't believe that Covid is going to be eradicated by everyone getting vaccinated. In fact, I don't know anyone that believes that. What I and others believe is that if we get very close to 100% vaccination, we can lift many of the mitigations being put in place.

Yes, people will still get Covid, but they will be less likely to get it, less likely to get sick if the do, less likely to have severe symptoms, less likely to go to the hospital, and less likely to die. And our hospitals won't be over run.

The main purpose of my comment was to add some clarity to the discussion with concrete numbers and references. Terms like significant, insignificant, less, more, etc, should be quantified with references in my opinion where possible.

To answer your question, the unvaccinated represent 75% of hospitalizations in one region that publishes raw data (https://bit.ly/3oriNqS).

It's that and that the more spreadable Indian/Delta Variant developed and took hold in April. (Variant name there for news references) Took the US 2 months to announce it was a concern.

So is measles, polio, & chickenpox, but those vaccines have still made a huge difference in general quality of life.

You should still get vaccinated. Post-infection immunity is very heterogeneous, with respect to what level of protection you'll have, and how long it will last. You might have great protection for a bit, or you might get reinfected just like the first time, like many have.

The combined protection of natural with vaccination will be better than just one or the other. I hope you stay safe.

an israli paper claimed my immunity is 13 times better now compared to vaccinated people.

The CDC says[1]

> Yes, you should be vaccinated regardless of whether you already had COVID-19 because:

> Research has not yet shown how long you are protected from getting COVID-19 again after you recover from COVID-19.

> Vaccination helps protect you even if you’ve already had COVID-19.

an Israeli paper[2] (probably the one you're thinking of) also mentions that yes - your immunity from having the disease is better than a vaccine but getting both still provides a much better outcome. Please note that this study is very recent and may be overturned in review.

> This study demonstrated that natural immunity confers longer lasting and stronger protection against infection, symptomatic disease and hospitalization caused by the Delta variant of SARS-CoV-2, compared to the BNT162b2 two-dose vaccine-induced immunity. Individuals who were both previously infected with SARS-CoV-2 and given a single dose of the vaccine gained additional protection against the Delta variant.

So maybe you'll end up super-immune! Congratulations! (now go get vaccinated)

1. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/faq.html

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

What's the paper?

I'd guess it's this one: https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v...

It's been recently published and the warning on it is:

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.

It's not something that can be held up as evidence in any direction at the moment.

FWIW, an anti-vax cousin of mine has had covid three different times. Each time he recovered, but each time he kept spreading it. So don't count having had covid once as a blanket "I don't need the vax" card.