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Re:New York's largest healthcare provider fires 1,400 unvacc... by tptacek on Monday October 04, 2021 @06:28PM (#28752987)
Sure you do, if they're relatively low-skilled and straightforwardly replaceable, and they're endangering the rest of the staff by refusing to comply with health and safety requirements.

This is 1.8% of their workforce. Their normal annual turnover is 8%.

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Re:New York's largest healthcare provider fires 1,400 unvacc... by woodruffw on Monday October 04, 2021 @06:32PM (#28753065)
We have ample evidence that the current vaccines reduce COVID's spread[1].

[1]: https://www.nature.com/articles/d41586-021-02054-z

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Re:New York's largest healthcare provider fires 1,400 unvacc... by woodruffw on Monday October 04, 2021 @06:43PM (#28753227)
I don't know what the Provincetown study is, but see above for up-to-date evidence that vaccines continue to be effective at reducing transmission.
Re:New York's largest healthcare provider fires 1,400 unvacc... by ipaddr on Monday October 04, 2021 @07:03PM (#28753471)
https://www.washingtonpost.com/health/2021/07/30/provincetow...

Whatever you do, please understand that if you had the vaccine it doesn't mean that you cannot transmit covid.

Re:New York's largest healthcare provider fires 1,400 unvacc... by woodruffw on Monday October 04, 2021 @07:14PM (#28753581)
Who said “cannot”? It’s about reduction.
Re:New York's largest healthcare provider fires 1,400 unvacc... by munk-a on Monday October 04, 2021 @07:01PM (#28753454)
Please link your sources and highlight the relevant information.
Re:New York's largest healthcare provider fires 1,400 unvacc... by iammisc on Monday October 04, 2021 @06:35PM (#28753097)
Hold on hold on... this article makes the claim you're trying to show, but then immediately backtracks on the currently most-spreading strain.
Re:New York's largest healthcare provider fires 1,400 unvacc... by woodruffw on Monday October 04, 2021 @06:38PM (#28753150)
They don't "backtrack." Nature is a scientific publication, so they don't make claims before the evidence supports them. The article is from July, before we had strong evidence of the vaccine's effectiveness at reducing transmission agains the Delta strain.

Here's a research summary from last month[1] that shows that vaccines continue to perform strongly at transmission reduction.

Edit: A direct link to the NEJM study (9/8/21) showing reduced transmission[2].

[1]: https://www.cidrap.umn.edu/news-perspective/2021/09/covid-va...

[2]: https://www.nejm.org/doi/full/10.1056/NEJMc2106757

Re:New York's largest healthcare provider fires 1,400 unvacc... by iammisc on Monday October 04, 2021 @06:49PM (#28753304)
Yes, they did backtrack. They said the vax prevents COVID spread. Then in the next phrase said.. but we don't know about Delta yet. At the time of publication, delta was the most commonly spreading variant. That means they made a claim 'the vax prevents COVID spread' that had an unknown truth value at the time, especially in the context of contemporaneous events.

The second link you provided is actually relevant. Thanks.

Re:New York's largest healthcare provider fires 1,400 unvacc... by woodruffw on Monday October 04, 2021 @06:56PM (#28753388)
I think it's a remarkable stretch to frame responsible editing ("the current evidence suggests reduced transmission with vaccination, but there's a confounding unknown") as "backtracking."
Re:New York's largest healthcare provider fires 1,400 unvacc... by iammisc on Monday October 04, 2021 @07:12PM (#28753563)
Except, this is like saying the current flu vaccine provides 100% resistance to the 1918 spanish flu, while leaving out that it doesn't work for this year's virus. All perhaps statements that could be considered true, but not useful if it's dealing with current events.
Re:New York's largest healthcare provider fires 1,400 unvacc... by woodruffw on Monday October 04, 2021 @09:02PM (#28754353)
Nobody uses language like “100% resistance” when talking about diseases. That’s not what the Nature article claims, and not what any reputable source would claim.
Re:New York's largest healthcare provider fires 1,400 unvacc... by david38 on Monday October 04, 2021 @07:15PM (#28753590)
Just because Delta was spreading doesn’t mean they had time to do a study on it. You have to look at the paper’s submission date.
Re:New York's largest healthcare provider fires 1,400 unvacc... by beerandt on Monday October 04, 2021 @07:46PM (#28753854)
Which is fine- but that also means it isn't applicable to the current variant.

If you say it's too old to study the current virus, it's also too old to justify any treatments or policy with the current virus.

Re:New York's largest healthcare provider fires 1,400 unvacc... by woodruffw on Monday October 04, 2021 @09:07PM (#28754382)
Viral changes are incremental; research needs to be updated as changes occur, but it would be extraordinary for it to be invalidated outright. Thus far, the research has mostly shown incremental changes to transmissibility &c., changes that do not warrant significant policy shifts. Getting vaccinated continues to be an excellent public health policy and goal.
Re:New York's largest healthcare provider fires 1,400 unvacc... by beerandt on Monday October 04, 2021 @09:32PM (#28754521)
That's not what I'm saying- people are picking and choosing when to apply marginal changes to questionably applicable research and when not to.

The same people saying "close enough" with vaccine transmissibility trials based on the original virus applying to delta, are the same ones saying natural immunity transmissibility studies done on the original virus don't apply to delta.

And now that we've got real numbers on natural immunity that beat vaccination (alone) numbers, that number is no longer "good enough"?

BS. It's not just moving goal posts, it's completely different moving goalposts for each side.

ETA:

>extraordinary for it to be invalidated outright.

Actually, if the whole "vaccinated cases are usually so mild you don't have symptoms" is true, and the Israeli research about viral loads for break through cases being as high as unvaccinated cases is also true...

Then vaccinated workers at a hospital could very well be worse, because they'd be transmitting the virus and infecting patients, while being less likely to have symptoms making them aware that they're likely infected and causing harm.

That's not exactly far fetched, based on current claims.

Re:New York's largest healthcare provider fires 1,400 unvacc... by jjwiseman on Monday October 04, 2021 @11:20PM (#28755156)
> And now that we've got real numbers on natural immunity that beat vaccination (alone) numbers

You know what gives far superior protection than natural immunity gained via infection? Getting vaccinated after having been infected. You're more than twice as likely to be re-infected if you've had COVID once and don't get vaccinated vs. having COVID and then getting vaccinated[1]. So even if you've had COVID, if you take the free, extremely safe vaccine you are now less than half as likely to be re-infected, which likely means you're much less likely to spread it to someone else.

> Then vaccinated workers at a hospital could very well be worse, because they'd be transmitting the virus and infecting patients, while being less likely to have symptoms making them aware that they're likely infected and causing harm.

This is something that anti-vax people seem to like to bring up as a possibility with no data to back it up. The data we actually do have[2], by directly measuring the secondary attack rate ("chance that an infected person infects another person") actually shows that vaccinated people are less likely to infect others.

1. https://www.cdc.gov/media/releases/2021/s0806-vaccination-pr... 2. https://www.eurosurveillance.org/content/10.2807/1560-7917.E...

Re:New York's largest healthcare provider fires 1,400 unvacc... by AndrewBissell on Tuesday October 05, 2021 @09:00AM (#28758783)
How do you know the vaccine is safe to take after having recovered from infection? That has never been studied in a rigorous way, recovered individuals were excluded from the trials.

People keep bringing up these studies and links to research that was conducted before the Delta variant became dominant. Are you all simply unaware that it's not relevant anymore?

Re:New York's largest healthcare provider fires 1,400 unvacc... by lamontcg on Monday October 04, 2021 @08:22PM (#28754092)
No, Vaccinated People Are Not ‘Just as Likely’ to Spread the Coronavirus as Unvaccinated People

https://www.theatlantic.com/ideas/archive/2021/09/the-vaccin...

The impact of SARS-CoV-2 vaccination on Alpha & Delta variant transmission

https://www.medrxiv.org/content/10.1101/2021.09.28.21264260v...

Re:New York's largest healthcare provider fires 1,400 unvacc... by tomrod on Monday October 04, 2021 @06:34PM (#28753087)
Usually I would respond with a scientific source to correct your claim. However, since that has already been added to comments, I am really curious. How did you arrive at your current conclusion?
Re:New York's largest healthcare provider fires 1,400 unvacc... by AndrewBissell on Monday October 04, 2021 @06:44PM (#28753239)
A CDC prison study of a Delta variant outbreak showing an attack rate of 93% on unvaccinated inmates & staff versus 89% for those vaccinated more than 4 months prior: https://www.cdc.gov/mmwr/volumes/70/wr/mm7038e3.htm

Another example of a major outbreak in a 96% vaccinated and high PPE setting: https://www.eurosurveillance.org/content/10.2807/1560-7917.E...

No relationship between case rates and vaccination across 68 countries: https://link.springer.com/article/10.1007/s10654-021-00808-7

Re:New York's largest healthcare provider fires 1,400 unvacc... by jjwiseman on Monday October 04, 2021 @07:02PM (#28753464)
I feel like you've posted evidence that vaccines are effective at reducing spread (in addition, of course, to being extremely effective at reducing deaths).

The CDC prison study says "The attack rate was higher among unvaccinated versus fully vaccinated persons (39 of 42, 93% versus 129 of 185, 70%; p = 0.002)."

The Eurosurveillance article you posted says "The calculated attack rate among all exposed patients and staff was 10.6% (16/151) for staff and 23.7% (23/97) for patients, in a population with 96.2% vaccination rate (238 vaccinated/248 exposed individuals)." Do you think that indicates that vaccines don't reduce spread? What do you think the attack rate would be in an unvaccinated population?

The European Journal of Epidemiology article isn't actually trying to look at vaccine effectiveness in reducing spread. It has some interesting information, but that's not what it's about.

Re:New York's largest healthcare provider fires 1,400 unvacc... by lamontcg on Monday October 04, 2021 @08:35PM (#28754166)
So the prison study is of tightly packed inmates and shows a high attack rate and bears on infectivity during an oubreak. There is literally nothing in there on onwards transmission from the vaccinated or in contact tracing because it was most likely quite impossible to do.

That study cannot be used to disprove the idea that the unvaccinated inmates all gave the virus to the vaccinated ones. That is almost certainly wrong and there should have been some onwards transmission from the vaccinated, but that sentence is quite literally correct. The study says nothing about it.

Meanwhile I've posted elsewhere:

The impact of SARS-CoV-2 vaccination on Alpha & Delta variant transmission

https://www.medrxiv.org/content/10.1101/2021.09.28.21264260v...

That study is real world contact tracing.

Re:New York's largest healthcare provider fires 1,400 unvacc... by tomlockwood on Monday October 04, 2021 @06:46PM (#28753276)
Re:New York's largest healthcare provider fires 1,400 unvacc... by AndrewBissell on Monday October 04, 2021 @06:52PM (#28753338)
I don't dispute that the vaccines may be effective in reducing hospitalizations & deaths from Covid but that's a separate question from whether and how much they reduce transmission.
Re:New York's largest healthcare provider fires 1,400 unvacc... by prawn on Monday October 04, 2021 @07:04PM (#28753474)
I know your entry to the conversation was about transmission, but the broader context here seems to be about hospital staffing, which would make hospitalisation vs cases the more useful question.
Re:New York's largest healthcare provider fires 1,400 unvacc... by AndrewBissell on Tuesday October 05, 2021 @09:25AM (#28759090)
Not sure I understand your point? Are you saying that the capacity gains from preventing the marginal addition to ICU occupancy of unvaccinated nurses who become sick and need hospitalization will outweigh the capacity impacts of firing them all?
Re:New York's largest healthcare provider fires 1,400 unvacc... by beerandt on Monday October 04, 2021 @07:55PM (#28753907)
No- it's about whether a 4% reduction (or 40%, or whatever marginal rate) in transmission is cause for termination, when we know that "compliant” employees, in a near 100% vaccinated population will still transmit the virus.

More so if the argument is that the hospital patient population is especially vulnerable.

We don't even know if the likelihood of transmission is reduced enough to affect over number of transmissions.

Re:New York's largest healthcare provider fires 1,400 unvacc... by tomlockwood on Monday October 04, 2021 @06:56PM (#28753382)
Re:New York's largest healthcare provider fires 1,400 unvacc... by AndrewBissell on Tuesday October 05, 2021 @09:24AM (#28759067)
The vaccinated and unvaccinated are tested at very different rates, this is comparing apples and oranges.
Re:New York's largest healthcare provider fires 1,400 unvacc... by TrevorJ on Monday October 04, 2021 @06:30PM (#28753020)
>if they're relatively low-skilled and straightforwardly replaceable

narrator: "they aren't".

Re:New York's largest healthcare provider fires 1,400 unvacc... by tptacek on Monday October 04, 2021 @06:54PM (#28753369)
I took the time to look up the employee turnover rate at a regional health care provider in order to write my comment. Can I ask that you expend at least that much effort (it's not much!) to support your claim with evidence?

My argument might be more subtle than my comment makes it seem; if so, that's my fault, because I wrote downthread as well and probably assumed people read both comments. A very large cohort of the workers in a regional health chain are not medical professionals, but rather support staff. Those are the employees that I'm saying are relatively low-skilled and replaceable. What's more, our current economic conditions make it straightforward for them to hop to other jobs right now.

What you're saying seems pretty unlikely, given the demographics of vaccination.

Re:New York's largest healthcare provider fires 1,400 unvacc... by native_samples on Tuesday October 05, 2021 @04:25AM (#28756744)
Health officials have spent nearly two years claiming that all of society has to shut down because they cannot increase staffing capacity at all. That's why so many of the emergency hospitals that were built ended up shutting down having never seen a single patient.

This claim was always implausible on its face, but having so adamantly claimed this, public health does not now get to claim that huge numbers of workers can be trivially hired and trained within a few weeks. If that actually is the case then the justification for lockdowns evaporates.

Re:New York's largest healthcare provider fires 1,400 unvacc... by TrevorJ on Tuesday October 05, 2021 @05:07PM (#28765650)
You are right, I did not understand that you were speaking about support staff and not those in nursing. Obviously nurses and doctors are not trivial to train and replace.
Re:New York's largest healthcare provider fires 1,400 unvacc... by beerandt on Monday October 04, 2021 @09:08PM (#28754387)
Our local hospitals have lost on average over half their nursing staff in the last year, and hasn't been able to replace near enough of them. This was before vaccine mandates.

Which is only putting more stress on the ones who stayed, and it's getting to where they are getting burnt out, having gone through a year and a half of COVID and now taking to the slack due to the shortages.

No telling what's going to happen when the vaccine mandate kicks in next month for most of the nurses.

The normal overnight staffing where my wife works is usually one doctor, 3-mid levels and 6 nurses.

They've been down to one doctor and 1-2 nurses for most of the last month.

Re:New York's largest healthcare provider fires 1,400 unvacc... by AdamHominem on Monday October 04, 2021 @06:48PM (#28753297)
What qualifies you to speak on the subject?

What makes you more qualified than the people who actually have professional education, training, and experience in running a hospital?

Re:New York's largest healthcare provider fires 1,400 unvacc... by TechBro8615 on Monday October 04, 2021 @07:02PM (#28753461)
Amusingly enough, 1.8% is close to the IFR of Covid.
Re:New York's largest healthcare provider fires 1,400 unvacc... by votepaunchy on Monday October 04, 2021 @07:30PM (#28753727)
CFR, not IFR.
Re:New York's largest healthcare provider fires 1,400 unvacc... by TechBro8615 on Tuesday October 05, 2021 @12:35AM (#28755533)
Ok so the percent of staff they’re firing is higher than the IFR?
Re:New York's largest healthcare provider fires 1,400 unvacc... by beervirus on Monday October 04, 2021 @06:40PM (#28753183)
> endangering the rest of the staff

Where did this idea come from that we vaccinated people need to be protected from the unvaccinated? That’s what the vaccine is _for_, protecting us from the unvaccinated. And it’s good at its job!

Re:New York's largest healthcare provider fires 1,400 unvacc... by lloydgrossman on Monday October 04, 2021 @06:44PM (#28753237)
...? The vaccine isn't a panacea that eradicates the virus. Vaccine means your viral load is going to be lower than the alternative and less likely to spread. You can be vaccinated and still spread the virus, but getting the hogs to stop running around so we can try and achieve herd immunity for those that aren't able to get the vaccine is a pretty obvious goal.
Re:New York's largest healthcare provider fires 1,400 unvacc... by beervirus on Monday October 04, 2021 @06:51PM (#28753331)
It reduces your risk of serious illness to the point of irrelevance. If you’re vaccinated, you’re not quite at zero risk, but you’re close enough that the pandemic is over for you.

And delta is so transmissible that herd immunity is no longer achievable even with 100% vaccinated.

Re:New York's largest healthcare provider fires 1,400 unvacc... by hanniabu on Monday October 04, 2021 @06:58PM (#28753423)
> It reduces your risk of serious illness to the point of irrelevance.

For the most part, and if you're healthy. Unfortunately in a hospital you're working with people that are vulnerable.

Why is this such a controversial thing anyways? In the past we've made vaccines mandatory.

Re:New York's largest healthcare provider fires 1,400 unvacc... by beerandt on Monday October 04, 2021 @07:58PM (#28753936)
Because you're still allowing people who can transmit the disease around these "vulnerable" patients.

And the line drawn isn't even an arbitrary number, but an arbitrary policy with an assumed improvement.

An improvement that we know isn't good enough to prevent spread in populations with near 100% vaccination rates.

Re:New York's largest healthcare provider fires 1,400 unvacc... by jjwiseman on Monday October 04, 2021 @09:02PM (#28754357)
It's a free, safe vaccine that significantly reduces the spread of the virus that has caused a global pandemic over the last 18 months or so. If you're a health care worker and you won't get vaccinated, you probably should find a new line of work.

It doesn't need to be 100% effective at stopping spread to be an excellent idea.

Re:New York's largest healthcare provider fires 1,400 unvacc... by dkdk8283 on Monday October 04, 2021 @07:15PM (#28753587)
The vaccine isn’t without side effects, and there is still a debate about whether natural immunity is sufficient.
Re:New York's largest healthcare provider fires 1,400 unvacc... by beervirus on Monday October 04, 2021 @09:27PM (#28754484)
The he side effects are trivial. Just get the vaccine and stop deluding yourself.
Re:New York's largest healthcare provider fires 1,400 unvacc... by dkdk8283 on Thursday October 07, 2021 @04:32PM (#28791676)
No. You’re just assuming that it’s by choice.
Re:New York's largest healthcare provider fires 1,400 unvacc... by woodruffw on Monday October 04, 2021 @06:58PM (#28753408)
> And delta is so transmissible that herd immunity is no longer achievable even with 100% vaccinated.

There is ample evidence that suggests the exact opposite[1].

[1]: https://www.nejm.org/doi/full/10.1056/NEJMc2106757

Re:New York's largest healthcare provider fires 1,400 unvacc... by beervirus on Monday October 04, 2021 @07:01PM (#28753446)
That article isn’t about herd immunity.
Re:New York's largest healthcare provider fires 1,400 unvacc... by munk-a on Monday October 04, 2021 @06:58PM (#28753411)
It doesn't reduce risk to irrelevance - there can still be some serious consequences - and the more unvaccinated people we've got around the more likely we're going to see even more variants which may bypass the efficacy of the vaccine and force us back into full lock downs.
Re:New York's largest healthcare provider fires 1,400 unvacc... by AdamHominem on Monday October 04, 2021 @06:43PM (#28753233)
Please educate yourself on herd immunity.
Re:New York's largest healthcare provider fires 1,400 unvacc... by neither_color on Monday October 04, 2021 @06:56PM (#28753392)
Which edition of herd immunity, the early 2020 or 2021 definition? It's a moving target you see...

https://web.archive.org/web/20201101161006/https:/www.who.in...

https://www.who.int/news-room/q-a-detail/coronavirus-disease...

Re:New York's largest healthcare provider fires 1,400 unvacc... by jjwiseman on Monday October 04, 2021 @07:06PM (#28753501)
Am I looking at the wrong parts of those pages? In the first I see "The threshold for establishing herd immunity for COVID-19 is not yet clear." and in the second I see "The proportion of the population that must be vaccinated against COVID-19 to begin inducing herd immunity is not known."

Also, the threshold for herd immunity is based partially on how well the virus spreads, and Delta changed that, which means that the threshold for herd immunity probably changed. When facts change, the messaging needs to change to stay accurate.

Re:New York's largest healthcare provider fires 1,400 unvacc... by munk-a on Monday October 04, 2021 @07:00PM (#28753436)
It is a moving target because yes - we don't (as a society) have a ton of practice with worldwide pandemics. Information evolves and our expert's interpretation evolves with it. If you reject opinions from everyone who has ever changed their mind after receiving more information you'll be left with one or two ridiculously lucky people and a who bunch of stubborn morons who simply reject the notion that their past selves might have been incorrect.
Re:New York's largest healthcare provider fires 1,400 unvacc... by native_samples on Tuesday October 05, 2021 @04:23AM (#28756729)
Society has been experiencing pandemics for as long as society has existed. There is literally nothing humanity has more experience with than disease.

Herd immunity is a moving target because people like Fauci change their assessment of it depending on opinion polls. That's by his own words, not anyone else's. The guy admitted it to the New York Times. The "science" is not evolving and people who keep claiming it is, are just hurting the credibility of actual science even more than it's already been hurt. After all, a "science" that is constantly asserting things with 100% confidence and then next week asserts something totally different, also with 100% confidence (which they do), is actually pretty worthless to society.

Re:New York's largest healthcare provider fires 1,400 unvacc... by neither_color on Monday October 04, 2021 @07:29PM (#28753715)
It's not that I reject it it's that Id like to see something like git logs. Public health officials should drop the aura of infallibility and adopt some dev community style humility.
Re:New York's largest healthcare provider fires 1,400 unvacc... by munk-a on Monday October 04, 2021 @07:33PM (#28753747)
I am in disagreement with most of my family on this point (taking the least popular point of view). I understand the idea that transparency always allows better information around personal decisions - but I'm not certain if more transparency that might include speculation during a pandemic would actually lead to a greater sense of public safety. I feel like generally being transparent does increase public stability by increasing faith in the government - but I also feel like a pandemic is a good time to burn some of that public good will to keep a unified message to the public.
Re:New York's largest healthcare provider fires 1,400 unvacc... by iammisc on Monday October 04, 2021 @07:46PM (#28753848)
The current US federal government has no public good will left to burn. You have to be deluded to think they do.
Re:New York's largest healthcare provider fires 1,400 unvacc... by beervirus on Monday October 04, 2021 @06:53PM (#28753346)
Delta is so transmissible that herd immunity is no longer achievable even with 100% vaccinated.
Re:New York's largest healthcare provider fires 1,400 unvacc... by kitkat_new on Monday October 04, 2021 @06:55PM (#28753377)
it's not black & white