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Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by mc32 on Friday October 01, 2021 @01:13PM (#28721057)
Will this affect mandate requirements, if as effective as it’s claimed? If so we don't need to reach hard to achieve 95% vaccination rates and we can get closer to a normal life.
Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by mmastrac on Friday October 01, 2021 @01:14PM (#28721080)
If it halves hospitalizations, it'll have a pretty drastic effect on overwhelmed ICUs but there's probably still a ways to go before ICU levels return to normal and we can skip mandates.
Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by smnrchrds on Friday October 01, 2021 @01:33PM (#28721311)
Alberta has 173 normal ICU beds. As of this Monday, there were 312 Albertans in ICUs, 265 of whom for COVID [1]. The extra 139 beds were surge capacity, created by shutting down other services, postponing surgeries, and diverting resources to COVID ICU treatments.

Even if the number of COVID patients in ICUs halved, we would have 132 people in the ICU with COVID, or 179 patients in total for all causes. It would still be over capacity and need surge beds, but it would still be much better than the current state. What this tells me is that whether we can skip mandates depends a lot on healthcare capacity in your region. Maybe the US with its higher population-adjusted ICU beds can get back to normal sooner than Canada.

[1] https://www.cbc.ca/news/canada/edmonton/alberta-health-care-...

Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by shrubble on Friday October 01, 2021 @02:51PM (#28722117)
Alberta has 4.4 mln or so people.

Colorado, with 5.8 mln people, has over 1700 ICU beds.

Alberta's been 'running on fumes' re: ICU beds and they got caught out...

Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by smnrchrds on Friday October 01, 2021 @03:48PM (#28722633)
I don't think the two jurisdictions count ICU beds the same. Alberta (and Canada in general) have about half as many ICU beds per capita as the US, not 1/10th. If I had to guess, I would say the number for Colorado includes other types of ICU (neonatal, cardiac, etc.) that the Albertan number doesn't. Alberta has 8,513 acute care beds. How many of those would be counted as ICU beds per the Colorado definition, I don't know.

https://www.albertahealthservices.ca/about/about.aspx

Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by PaulDavisThe1st on Friday October 01, 2021 @04:04PM (#28722803)
Arguably, most of the world's industrial economies have been running on fumes increasingly over the last 30-40 years, as "fat has been trimmed", JIT supply chains have taken over, and "efficiency via merger-then-closure" have been common themes in national economies.
Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by KaiserPro on Friday October 01, 2021 @01:50PM (#28721501)
remember that in exponential growth, halving the people going to hospital buys you one extra doubling time. (ie, if numbers increase every two weeks, halving the growth buys you two extra weeks.) You need to make sure that the growth has stopped, not just halved.
Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by _3u10 on Friday October 01, 2021 @05:05PM (#28723375)
Yup, and with an R value for delta between 5 and 8 on a two week infection cycle... well thats about 3 days... even with 100% of people vaccinated it will buy about a month, assuming the vaccine numbers hold and 1/35th of the vaxxed vs unvaxxed get hospitalized.
Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by logicalmonster on Friday October 01, 2021 @01:34PM (#28721315)
What are normal ICU levels and is this a goalpost that can ever be achieved?

Long before Covid, it was well-known that hospital ICUs were designed to run fairly close to 100% capacity because it wasn't profitable to pay for staff that weren't truly needed at any given time. Is there any hospital that is going to pay for far more staff than they need and somehow manufacture many ICU beds out of nowhere? I feel like this is a goalpost intentionally designed to never be achievable.

As further evidence, if the situation was actually so dire, would unvaccinated people (many of whom already had Covid) be on the chopping block in so many locations?

Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by crooked-v on Friday October 01, 2021 @01:41PM (#28721394)
> and is this a goalpost that can ever be achieved?

It could absolutely be achieved. Literally the only thing keeping things from going back to more-or-less normal conditions right now is that there are many unvaccinated people getting extremely ill from COVID and filling up ICUs.

Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by logicalmonster on Friday October 01, 2021 @02:38PM (#28721996)
Again, what are normal ICU levels?

As far as I'm aware, ICU staffing is modified to achieve close to 100% capacity at all times with minimal spare beds, whether pre-Covid or post-Covid. If this is the case, then there's no scenario possible, regardless of what happens with Covid, where hospitals report anything but "few ICU beds are available".

Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by crooked-v on Saturday October 02, 2021 @06:50PM (#28732812)
Normal ICU levels are levels lower than "every available nurse and doctor is busy with ICU patients".

It's really not that complicated. Under normal conditions capacity can usually scale to meet the needs of the local community. Under COVID conditions, all theoretical capacity is already taken by COVID patients.

Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by logicalmonster on Tuesday October 05, 2021 @07:16PM (#28766961)
Yet, healthcare systems are currently rushing to axe many thousands of unvaccinated healthcare workers. Don’t you think it sends mixed messages to be claiming that there’s such a dire shortage of ICU capacity on one hand, but to be letting so many fully capable healthcare workers go? (many of whom have already been exposed to Covid and have natural immunity anyway)
Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by PaulDavisThe1st on Friday October 01, 2021 @04:06PM (#28722847)
The data collected in the US by the Department of Health has routinely shown ICU availability in my county (Santa Fe, NM). That data has generally indicated that roughly half the available ICU beds are filled, with 1 or 2 patients there due to COVID.

p.s. according to our local newspaper, this data is incorrect.

Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by easytiger on Friday October 01, 2021 @01:39PM (#28721371)
Not to mention standardised admission criteria and ICU eligibility criteria were chucked out the window in many countries when covid became a thing

Edit downvotes and no discussion. This place is getting worse

Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by mrfusion on Friday October 01, 2021 @01:18PM (#28721130)
If we’re worried about hospital capacity why are we firing healthcare workers?
Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by mmastrac on Friday October 01, 2021 @01:22PM (#28721176)
I'm no policy or health care expert, but maybe because front-line and hospital workers are exposed to extremely large viral loads which seem to be related to the severity of the disease, and taking one HCW off the front-lines and adding them to the sick in the ICUs is worse than one less HCW and the same ICU level?

This seems like you are trying to start a flamewar about vaccine mandates, BTW.

Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by twofornone on Friday October 01, 2021 @01:43PM (#28721406)
Something extremely frustrating about virtually all reporting to date is that I haven't seen any statistics as to infection and reinfection rates among front line workers. The implication is that immunity post exposure/infection doesn't exist, but I suspect that this data is being deliberately withheld because it would suggest that frontline workers don't need vaccines, or at the very least don't need a mandate.
Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by pcwalton on Friday October 01, 2021 @07:20PM (#28724505)
> I suspect that this data is being deliberately withheld because it would suggest that frontline workers don't need vaccines, or at the very least don't need a mandate.

Of all the possible reasons you couldn't find this data, a vast conspiracy is the most likely cause? Come on.

Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by twofornone on Saturday October 02, 2021 @03:24AM (#28726716)
Don't you think it would be a public service for news to report such information? Have it listed somewhere conveniently?

It would literally be the most accurate look at worse case constant exposure.

I'm not implying any sort of conspiracy, just an emergent combination of social pressure and implicit taboo. Lots of powerful and not so powerful reputations are riding on the "danger" of this virus and the "safety and efficacy" of the vaccines. And if that's not enough for you, don't forget that fear gets clicks.

Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by nradov on Friday October 01, 2021 @01:35PM (#28721326)
There's no reliable evidence that healthcare workers wearing proper PPE are exposed to extremely large viral loads. Nor is there evidence that symptom severity depends on initial viral load (beyond some minimum threshold for infection). It's a plausible hypothesis but the human challenge trials necessary to prove or disprove it haven't been done yet.
Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by kortex on Friday October 01, 2021 @04:03PM (#28722792)
> Nor is there evidence that symptom severity depends on initial viral load (beyond some minimum threshold for infection).

https://www.nature.com/articles/s41467-020-19057-5

> It's a plausible hypothesis

It's extremely plausible, and been demonstrated before in influenza, poxviruses, and other viruses. The human challenge trials necessary to prove a dose-dependent relationship between fall height and lethality haven't been conducted, either, but we have sufficient evidence from longitudinal and natural experiments to draw firm conclusions.

Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by nradov on Friday October 01, 2021 @05:17PM (#28723476)
That study you linked isn't relevant to my point. The question is whether the initial viral dose at the point of infection is correlated with symptom severity later in the disease course. That remains unknown. The study looked at the relation between current viral load and symptoms after infection, which is an entirely separate issue.
Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by loeg on Friday October 01, 2021 @01:21PM (#28721169)
We have vaccine mandates because infected healthcare workers spreading COVID reduce capacity even more. We haven't actually fired many workers, because the vast majority just get the vaccine (mostly before the mandates).
Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by howlong on Friday October 01, 2021 @01:28PM (#28721260)
Why do we have vaccine mandates for people working from home?
Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by LurkingPenguin on Friday October 01, 2021 @01:27PM (#28721244)
1. You need to account for the fact that some percentage (perhaps large) of healthcare workers already survived COVID and have natural immunity. Since the science is demonstrating that natural immunity is as durable and robust as vaccine immunity (if not more durable and robust), one would have to ask what the rationale is for firing workers who have natural immunity (as verified by a past COVID diagnosis or presence of antibodies) and do not want to be vaccinated.

2. The science is clear that vaccinated individuals can contract and spread the virus. While this doesn't mean that the vaccines aren't useful (they absolutely are), we need to be realistic about this in high-risk settings.

Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by frostirosti on Friday October 01, 2021 @01:47PM (#28721455)
> do not want to be vaccinated What's the reason for this? The vaccine has been approved fully by the FDA and hundreds of millions of people have received it.

> 2. ... Sure, and people who have had covid and get it again as well. But why risk sick days, lost productivity, severe illness when there's an effective, safe alternative. The capital cost of caring people who get sick with covid is far higher on a per capita basis for those who are unvaccinated.

Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by LurkingPenguin on Friday October 01, 2021 @02:07PM (#28721692)
> do not want to be vaccinated What's the reason for this? The vaccine has been approved fully by the FDA and hundreds of millions of people have received it.

It's none of your business why they don't want to be vaccinated. If science demonstrates that COVID survivors have strong immunity, why should they be forced to be vaccinated as well? We do not force people who can show immunity to measles, mumps, and rubella to get the MMR vaccine.

From the CDC: https://www.cdc.gov/vaccines/vpd/mmr/public/index.html

> You do not need measles, mumps, and rubella (MMR) vaccine if you meet any of these criteria for presumptive evidence of immunity*:

> You have laboratory confirmation of past infection or had blood tests that show you are immune to measles, mumps, and rubella.

> Sure, and people who have had covid and get it again as well. But why risk sick days, lost productivity, severe illness when there's an effective, safe alternative. The capital cost of caring people who get sick with covid is far higher on a per capita basis for those who are unvaccinated.

You are distorting the science by trying to lump people who survived COVID in with the unvaccinated. They are not the same group.

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

> SARS-CoV-2-naïve vaccinees had a 13.06-fold (95% CI, 8.08 to 21.11) increased risk for breakthrough infection with the Delta variant compared to those previously infected, when the first event (infection or vaccination) occurred during January and February of 2021. The increased risk was significant (P<0.001) for symptomatic disease as well. When allowing the infection to occur at any time before vaccination (from March 2020 to February 2021), evidence of waning natural immunity was demonstrated, though SARS-CoV-2 naïve vaccinees had a 5.96-fold (95% CI, 4.85 to 7.33) increased risk for breakthrough infection and a 7.13-fold (95% CI, 5.51 to 9.21) increased risk for symptomatic disease. SARS-CoV-2-naïve vaccinees were also at a greater risk for COVID-19-related-hospitalizations compared to those that were previously infected.

> 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.

Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by frostirosti on Friday October 01, 2021 @04:03PM (#28722800)
I wonder if the answer to all of this changes if insurance companies decide that covering the cost of laboratory confirmation of covid 19 antibodies or the cost covering the expenses related to hospitalization exceed the cost of vaccination people who may not need it.

If Aetna decided to not cover hospitalization if you are not vaccinated (or I'll give you laboratory confirmed immune), then it would be an entirely different calculus for people.

The argument of "Oh well I'll just find a different insurance provider" doesn't track in the United States either because most people do not have that option. The mandate and the exchange has been almost entirely gutted, so you're left with the option your employer provides.

That's another good point too. The government really doesn't have a lot of say in terms of whether or not you're vaccinated, it's entirely your employer. At the end of the day it's not Aetna/Kaiser/Blue Cross/et al. covering your health care costs, it's your employer. They certainly do not want to cover any unnecessary expense. So requiring employees to be vaccinated is the simplest, scalable, and cost effective solution.

If we're going to point to organizations that have no tolerance for the unvaccinated for diseases other than covid, we need look no futher than the US military: https://www.hhs.gov/immunization/who-and-when/military-membe...

Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by LurkingPenguin on Friday October 01, 2021 @08:38PM (#28724909)
I find it interesting that you're talking about ways to coerce people to vaccinate when the discussion here is how you deal with people who are known to have survived a COVID infection and thus have natural immunity. You seem to be conflating the immunologically naive with vaccine naive. Why? What is your intention?

Over 43 million Americans have already tested positive for COVID. I don't believe there's an official count of the number of people who have tested positive for antibodies, but speaking to your comment about cost, an antibody test is under $50.

https://www.labcorp.com/coronavirus-disease-covid-19/individ...

> Labcorp will bill the cost of the COVID-19 antibody test directly to your health plan if you are insured, or if you are uninsured, Labcorp will bill the appropriate government program. The cost of the test is $42.13 and is based on rates established by the Centers for Medicare & Medicaid Services (CMS). In the event that your health plan, or applicable government program does not cover the cost of the test, you may receive an invoice from Labcorp for up to $42.13.

Nothing you wrote addresses the scientific evidence, which is that people with natural immunity have protection that is not inferior to that provided by vaccines. In fact, the evidence increasingly shows that their protection is far superior.

Why can't you just leave the tens of millions of Americans who already have a confirmed history of COVID recovery alone? Why do you feel they need to be coerced by the government and their employers to receive a vaccine when the science shows they have higher levels of protection?

Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by howlong on Friday October 01, 2021 @03:09PM (#28722279)
The vaccine has been approved fully by the FDA and hundreds of millions of people have received it.

Not unlike Red Bull and Cap'n Crunch.

Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by zdragnar on Friday October 01, 2021 @01:39PM (#28721375)
Healthcare workers have been on the front line, unvaccinated, for going on two years. To mandate it or risk being fired has absolutely pissed off quite a few that I know of... My wife has gotten it, and even she is offended.

The hyperbole around this very serious situation just makes all the policies seem even more like theater.

To your second point, there was just a new report I saw yesterday that there is no difference in viral load between asymptomatic vaccinated and unvaccinated individuals.

[dead]
Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by macintux on Friday October 01, 2021 @03:06PM (#28722246)
I’m definitely in the pro-vaccine, pro-mandate column, but both 1 and 3 from your list strike me as dubious given the information to this point. Certainly there’s been conflicting information on both.
Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by LurkingPenguin on Friday October 01, 2021 @03:31PM (#28722490)
Re-read my comment. I'm asking if anybody downvoting me can provide scientific evidence that those statements are true. Nobody has, because they're not.

Natural immunity is durable and robust, and vaccinated people can get infected and spread the virus. In fact, according to the Israeli data, vaccinated people are magnitudes of order more likely to get a Delta breakthrough infection than a person with natural immunity is to get reinfected with Delta.

Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by OrvalWintermute on Friday October 01, 2021 @01:38PM (#28721365)
You've made an amazing claim, that infected healthcare workers, who, were caring for Covid patients for almost 2 years now, have been spreading COVID further. This, despite the fact that they are most likely to have caught it early as they were caring for patients prior to vaccines, and hence to have obtained natural immunity.

Please provide evidence to support your amazing claim.

Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by rediguanayum on Friday October 01, 2021 @01:33PM (#28721306)
The immediate parent comment is correct. Because Covid precluded elective surgery which is a major money maker for hospitals, the bottom line was hit. Consequently many hospitals cut back, and lot go physicians, PAs, nurses, techs, etc. When you hear hospitals are full, it very often isn't because of lack equipment or beds, but rather insufficient staff, especially nurses due to legal regulations around staffing ratios. (Source wife is a healthcare worker on the frontlines)
Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by _3u10 on Friday October 01, 2021 @01:20PM (#28721149)
Because it helps reduce capacity which increases the political will for mandates.
Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by _3u10 on Friday October 01, 2021 @01:17PM (#28721108)
Norway, Sweden, and the UK no longer have mandates, it's a political question not a medical question.
Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by kwhitefoot on Friday October 01, 2021 @01:26PM (#28721236)
> it's a political question not a medical question.

Not as much here in Norway as it is in the UK. Our death rate per unit population is one tenth of the UK and local authorities remain prepared to reinstate restrictions. Here we have been living pretty much normally for months already anyway.

And while the government has occasionally overreacted both the government and population have mostly followed the Norwegian Public Health Institute (FHI) advice.

Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by dham on Friday October 01, 2021 @04:01PM (#28722776)
> it's a political question not a medical question.

>> Our death rate per unit population is one tenth of the UK and local authorities

It's a fat question at the end of the day. Norway doesn't have many fat people.

Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by kwhitefoot on Saturday October 02, 2021 @03:06AM (#28726624)
It has a lot more now than it did when I arrived here in 1986. Dramatically more so.
Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by jeltz on Friday October 01, 2021 @01:21PM (#28721167)
We, Sweden, lifted the mandate 2 days ago and after a clear trend of the small fourth wave not increasing.
Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by _3u10 on Friday October 01, 2021 @01:26PM (#28721230)
Precisely. Also congrats on having sane politicians. Sweden has 10x the hospitalization rates of many countries that still have mandates, thus it is a political question, not a medical one.
Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by jeltz on Friday October 01, 2021 @02:38PM (#28721999)
What countries? Show me the data.

Edit: Deleting most of my post since Sweden does not track hospitalizations, only ICU admissions so I compared incorrectly. Here is the graph for ICU, judge for yoruselves if there are any with a 1/10 of Sweden's numbers.

https://ourworldindata.org/grapher/weekly-icu-admissions-cov...

Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by _3u10 on Friday October 01, 2021 @05:01PM (#28723347)
I misspoke, it was deaths, not hospitalizations. Norway has 1/10th the deaths per capita of Sweden. Canada has 1/2 of what Sweden has, and we are still have mandates and restrictions.
Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by KaiserPro on Friday October 01, 2021 @01:51PM (#28721507)
given the UK's death rate, I wouldn't use it as a data point for success.
Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by gizmo686 on Friday October 01, 2021 @01:50PM (#28721494)
No. You will never be able to get this to enough of the people who need it when they need it. By the time most people seek treatment it is too late for antivirals to be effective.

Even if that wasn't the case, there us too much political momentum behind mandates in the US for this to change the course.

Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by opinionbanned on Friday October 01, 2021 @06:36PM (#28724104)
Hopefully not. mandates are great and we need more forced Medical procedures. Maybe forced sterilization or lobotomies will finally return.
Re:Antiviral Molnupiravir Reduces Risk of Hospitalization/De... by wyager on Friday October 01, 2021 @01:14PM (#28721082)
If it’s patented and they can make real money off it, maybe