Instead of rewarding those who worked these horrible jobs and maybe attract new workers with better conditions (e.g. more holidays), better pay or tax reduction, our politicians did campaigning and ignored the upcoming winter.
Now they blame it on the unvaccinated and want to force high-speed vaccinating as many people as possible. But it won't help now. And it won't work either because they also messed up the whole vaccine supply chain.
I have long lost all hope in politicians. 99% of them are ridiculous creatures without a spine and only interested in their own progress.
The wave started leveling off about 2 weeks after and the rules are still in force.
Not sure where you got your information.
In the end we never were in control of the situation but people cannot accept that.
And there are plenty of countries around the world which have done a much better job than SF of testing, contact tracing, vaccination, etc. We can compare e.g. Sweden to other Nordic countries to see what an abysmal failure the Swedish “herd immunity” strategy turned out to be.
* * *
“We haven’t tried anything and we’re all out of ideas” is easy to sell to grumpy people tired of a really shitty year or two, on the back of an unprecedented wave of anti-public-health propaganda, but it is an absolutely terrible pandemic response.
What do you believe this comparison means? I'm not sure its saying much of anything. Perhaps you could come up with another similar sized city, with same socioeconomic/population-type makeup, with same latitude and seasonality profile to compare against? I'm not familiar with SF data sources on this, but I'm curious if you can provide a source for current IFR? My state here in southeast US's IFR is .012. That includes people who died in car accidents, of poisonings, of falls and other injurious actions while having tested positive for COV in last 28 days. My county is comprised of mostly older folks (median age 44), small at 186K people, and we haven't had a COV death registered in the last 11 months.
>We can compare e.g. Sweden to other Nordic countries to see what an abysmal failure the Swedish “herd immunity” strategy turned out to be.
Can you show some data sources for this? Everything I'm seeing is pointing to Sweden's last 2 flu seasons (encompassing COVID years) showing the same or lower all cause mortality than their previous 15-20 years. With 2018 being the major outlier not just in Sweden but all around the world, for which we still have no explanation.
> IFR is .012
Do you mean CFR (case fatality rate)? IFR (infection fatality rate) is always only speculative, because we don’t ever have complete knowledge of the number of infections.
In total throughout the pandemic SF has had ~670 Covid deaths and ~54,000 confirmed Covid cases for a population of ~880,000.
For the same population, the USA average would be ~2090 deaths and ~110,000 confirmed cases. Except those are both dramatic underestimates of the relative numbers because SF has consistently had a much lower percentage of positive tests, and hasn’t had anywhere near the US gap between confirmed Covid deaths and total excess deaths.
In science you're really meant to use all the data because the problem with this sort of cherry-picking is that it can go both ways. Florida removed all its restrictions and was predicted to become a bloodbath just like they predicted that for Sweden. It didn't happen, results appear to have been unaffected by the changes. Studies that look at all the data find no correlations between lockdowns and COVID mortality (but lots of correlations with other bad problems).
0.012 is the San Francisco CFR. 0.016 is the USA CFR, if we go by confirmed cases/deaths as reported by the New York Times.
The IFR should be substantially lower than either of these; many deaths go uncounted, but a far larger proportion of infections never get a confirmed positive test. I would guess IFR to be in the 0.004–0.008 range. (Which is still scary high!) I’m sure if you do a search of the academic literature you can find more careful analysis and better informed estimates. It obviously varies from place to place and is substantially dependent on demographics and availability of medical care.
* * *
Florida was a bloodbath! It has had among the worst outcomes anywhere in the USA since mid 2021. Tens of thousands of avoidable deaths after the universal free availability of extremely effective vaccines and better understanding of viral transmission. The state government not only stopped any state-level public health action, it actively prevented state/local public health departments and local governments from acting. It is hard to imagine a more complete failure of state leadership.
Florida has had something like 4x more Covid deaths than San Francisco, per capita. And if we only look at deaths after widespread vaccine availability, Florida has had >10x more.
Of course, the virus eventually burned through a large majority of the unvaccinated population, and without enough remaining hosts to infect, flamed out. Fingers crossed that future virus variants don’t have enough immune escape to burn back through the state again.
Yet, despite being significantly "older" than CA, it did significantly better than CA in 2020 with regards to all-cause-mortality. 2021, seems to be a different story at this point and I'm very curious as to the 10% difference between years (certainly seems to imply the virus has not burned through the population, assuming the virus had anything to do with mortality).
The usual credible figures I see for IFR are between 0.1% and 0.3% - higher figures tend to be using bad methodologies like including estimates from the very first days of the pandemic when people were trying to estimate IFRs using random Chinese media reports, etc. If you restrict yourself to more rigorous methodologies and sample sizes, IFR falls a lot.
As for Florida being a "bloodbath", lol. That word doesn't mean what you think it means. Nowhere has been a bloodbath, and if there's one thing that's been consistently true about Covid data it's that you can make anywhere seem worse or better than anywhere else by choosing what to compare against. Use all the data and Florida seems pretty good, especially as Europe is busy proving that vaccines appear to have accomplished nothing at all in terms of total numbers, despite the many claims of efficacy.
If we take 330 million people as an estimated US population, an IFR of 0.012 and 0.44 of everyone infected (CDC estimate from 1 October), that would be 1.74 million deaths. But the number of Covid deaths in the USA is probably only around 1 million (CDC estimate is 920 thousand as of 1 October), putting the US IFR at ~0.006. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...
I’d estimate a US IFR somewhere in the 0.004–0.008 range. We missed counting a significant number of Covid deaths, but we didn’t miss 60% of them. (In US counties with the highest proportion of elderly people, the IFR might locally be closer to 0.012.) But that is still a very high IFR!
Covid is a scary, scary disease. Deadly, highly contagious even before symptoms, and indistinguishable from common respiratory diseases during the part of the infection when most spread happens. Fortunately we have extremely effective vaccines (if only we can convince everyone to take them), and spread takes place almost always between unmasked people indoors making it relatively inexpensive to dramatically reduce the reproductive rate of the virus by avoiding indoor spaces and wearing masks when they are inevitable.
Getting really tired of hearing this. To a HEALTHY human, it’s like a bad cold. Me and my family have had it in the last month and confirmed with tests so I know what we had. It’s gone through a bunch of friends too and the worst they experienced was feeling miserable in bed for a couple of days.
I have no doubt that for some it IS scary, but let’s not chuck around emotive language that isn’t an accurate description in the majority of cases.
Yes, I do live in one of these older counties and specifically in my region of the county. Obviously words such as 'scary' are useless and subjective. Anti-biotic-resistant strep nearly killed me 3 years back, so to me, that was a scary disease. The COVID I had was milder than my yearly flu, and this is effect on the overwhelming majority of the population even considering the obesity rate in the US. Scary is not the word I would use.
> But that is still a very high IFR!
I mean, perspective is everything. What are you comparing this IFR to? I consider this a very low IFR, especially when you realize what we in the US classify a "COVID death". We do not count deaths of any other diseases using the same methodology as we have with COVID as far as I'm aware, and I believe this is the primary reason for our inflated mortality vs. most of the rest of the world.
What expert are you? What are your numbers to determine that corona without measurements would not create a new york or Italy event across Germany?
There is probably a reason why you are not a virologist. Or do you have your own model numbers?
They're so proud that they can answer the question about what happens to the pond that is half-covered by sea lilies the next day but never think about what happens the day after that.
tldr: There is no persistent exponential growth in nature.
https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus...
Index page: https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus...
what would make sense is a steady and controlled Durchseuchung with specific protection of vulnerable people (like old and sick) - b/c the best immunity is gained by infection.
but Durchseuchung never sounded good - that's why that term got so popular. it sounds ugly and brutal. but it's what was happening all the time with many diseases in the past thousands of years.
Source? I think there's plenty of peer-reviewed scientific articles claiming the opposite.
Also probably true without the vaccine first, but the initial survival rate without vaccination is a lot lower.
http://www.hopkinsmedicine.org/health/conditions-and-disease...
Here you can find linked three studies by the CDC that support the idea that natural immunity is harder to get and less effective (besides, as others have said, there's the non trivial chance of side effects or not even surviving the virus)
I don't care about what the "experts" think or say, I care about studies.
Update: https://www.nature.com/articles/d41586-021-02795-x#ref-CR5 reports many studies that claim that we should be vaccinating people after a natural infection to get "super immunity", but that is different from what the OP was claiming (natural immunity > vaccine immunity)
https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v...
That doesn't help if you die of the infection first, and COVID is extremely lethal among the demographics that most need the direct benefits of immunity.
In a nutshell, the German government and every other country on earth is doing what you propose, except that they are vaccinating at the same time and try to keep the curves flat (but your use of "slow" also suggests this, so it's not clear what else you're suggesting).
No, this is only true if the R value is constant in time. Not all functions with a positive first derivative are the exponential function.
Because otherwise the growth is indeed exponential, yeah?
Of course, the epidemic curve described by that function would indeed bounded below by an exponential function on part of its range, but the same is true of any function with positive derivative, and calling for example f(x) = x^2 exponential for that reason makes the term meaningless.
This is presumably what the OP meant by “as long as R>1, the curve is exponential”. But this is literally equivalent to saying “as long as f’(x) > 0, f is exponential” which is just not a useful concept.
The initial spreading will be exponential in the beginning - as every actual curve illustrates - if the disease is left unchecked as OP suggested, until R_t values go down again due to immunity. That's all I meant to say.
[1] https://www.sciencedirect.com/science/article/pii/S002251932...
exponential in the beginning == this part of the function can be approximated by a function ae^xb where a>0 and b>1
vs.
first derivative bounded away from zero in the beginning == any function that increases, including linear functions with constant first derivative and polynomials with linear first derivative
Or do you think all increasing functions are the same..?
It is easy to show that for any function whose derivative is continuous and positive at 0, there is an exponential function (properly translated such that they agree at 0) that has similar properties.
You should be specific about what properties you're talking about. What you're saying is that any function increasing function grows faster than some exponential function on a finite interval.
Still, you can observe f(x) on x ∈ [0, 1] and see that it is growing linearly. And you can observe g(x) on ∈ [0, 1] and see that it is growing exponentially.
I do not see the value in discussing the rate of exponential growth of f. Where as for g, there is a parameter with value ln(2).
If data looks like f, don't try to fit an exponential function to it (whether it's a least-squares fit, or any other objective f > g.
Are you trying to say anything else?
What if we all respected the first confinement? 6 weeks everybody at home, period.
The disease would be gone.
But no, oh no. People just can't be reasonable. So instead of 6 weeks, we've been dealing with this shit for almost two years.
And now you blame those who are unvaccinated, while vaccinated people go partying and spread the disease.
No, you should blame unreasonable people.
If taken literally, how is that supposed to work? People working for the emergency service still need to work, and they certainly can't work from home. Same for most of the medical sector, nursing services etc. and of course the various bits of infrastructure. Some industries cannot be easily shut down (you cannot stop or start a steel works on a whim). Most people involved in food production, too. Maybe you can blame people for not keeping at least two weeks of provisions (although blaming them won't change anything), but expecting them to go six weeks without buying any food or other provisions is certainly unrealistic. Things break, and not all of them can be left for up to six weeks to be fixed. (If your fridge breaks, or the heating breaks or your roof springs a leak, that cannot really wait. Same if things break in any of the critical industries and services that cannot be shutdown and need to keep working). All this residual activity still needs some amount of transportation and all the infrastructure that that entails. Etc.,etc. …
I don't know how many other people this has happened to but I too have my doubts as to whether there was ever any hope of containing this.
Delta. Omicron.
Our technology sucks and is slow, we can't achieve R < 1 this way.
The mRNA technology would let us inject omicron-specific boosters tomorrow, but then there is a lot of other safety hurdles that have to be met before it gets authorized and then distribution hurdles to convince people to take it…
Mathematically, we will get to R=1 this way, some day or another, with some percentage of people getting it via illness and some via vaccination. The choice is still ours on how and when.
At this point I'm less worried about covid and more worried about the global rise in authoritarian trends.
So you say that at some stage there will be vaccines for COVID-19 that are not nMRA (Pfizer, Moderna) or Viral vector (AstraZeneca)
Why? The people who are happy with vaccines are fairly happy with these vaccines and might refine them, but not about to dump them entirely for a different technique. in fact mRNA vaccines are the new hot thing.
And the people who really aren't happy with these vaccines, will never be happy. They'll find a way to object.
So what's the incentive for such a classical vaccine? Who's going to root for it?
Moderna and Pfizer (1) and AstraZeneca (2) are getting ready for the next round, still using their current technologies. They're not planning on going back to "classical vaccines" for COVID-19.
1) https://fortune.com/2021/11/29/covid-19-omicron-vaccine-prot...
2) https://www.independent.co.uk/news/uk/omicron-oxford-covid-a...
Vaccination is of course imperfect and cannot be the sole measure, but we can't achieve R < 1 without a lot of it.
Delta came out of India. Omicron came out of South Africa. How do mandates in the West stop variants elsewhere?
And variants aside, the vaccinated are still getting sick and dying at significant rates [1]. This vaccine is not the slam-dunk our "experts" promised. Until some miracle cure comes along, R < 1 is simply not possible.
If you think full vaccination is a necessary goal despite all this, OK fine. You know what might go a long way in terms of achieving mass vaccination? Open sourcing the vaccine recipe. Not just the RNA sequence. The whole recipe.
This should be a no-brainer.
Governments have no qualms with mandating lockdowns, masks, and vaccines for the masses.. but for some reason they hit the brakes when it comes to mandates for pharma. Not only is this a good idea in terms of improving supply side logistics, but also for the sake of re-building trust.
But no, common sense is too hard and "blame and shame" is too easy.
Being unvaccinated does not harm the vaccinated.
Hospital collapse has been liminal for 2 years now, it's a manufactured crisis. Instead of bolstering our healthcare staff and paying our front line workers more, we have done.. the exact opposite. We funnel tons of money to pharma, while frontline workers have effectively had their pay cut in half.
We're quite literally being force fed lies. But I guess that doesn't matter because at the end of the day the Milgram experiment prevails and all these attempts to question the narrative and hold authority accountable is pointless.
[1] https://assets.publishing.service.gov.uk/government/uploads/...
page 15
This is, on average over large numbers, not correct. Higher rates of disease spread harms everyone, the vaccinated included.
> This vaccine is not the slam-dunk our "experts" promised.
Which expert promised you that?
> it's a manufactured crisis ... We're quite literally being force fed lies ... Milgram experiment ... question the narrative
Cranks write like this. That is a shame as some of your other points are very correct, particularly around the need for Intellectual property waiver, which some have been calling for for some time, to no avail (1). BTW, they don't generally call it "open sourcing" in that field.
Hospitals genuinely are in crisis and doing difficult triaging, anyone working in them can tell you that.
1) https://reliefweb.int/report/world/time-runs-out-break-trips...
https://www.businessinsider.com/who-says-no-evidence-coronav...
> Moderna's chief medical officer, Tal Zaks, said last month that he believed it was likely the vaccine would prevent transmission but warned that there was not yet "sufficient evidence" of it.
https://www.nytimes.com/2021/04/01/health/coronavirus-vaccin...
> The Centers for Disease Control and Prevention on Thursday walked back controversial comments made by its director, Dr. Rochelle P. Walensky, suggesting that people who are vaccinated against the coronavirus never become infected or transmit the virus to others.
> Cranks write like this.
Apologies I'm new to being a social pariah, being under pseudo house arrest, and psychosis in general.
I don't want hospitals to collapse. I'm afraid if we give up this freedom now, we'll never get it back. I'm afraid of the unknown and putting my life in the hands of people (our dear leaders) that really have never cared about my health before.
Even now its not about care for my own health, but for "the greater good".
But there's no easy fix to help us now, because it takes a long time to train doctors, nurses and other staff, or actually build hospitals. Yes, the crisis is entirely predictable but also entirely real. It is possible, even likely for a "liminal" crisis to persist at that level, as the safety valve that keeps it there is that patients without sufficient care just die off. These are the "excess deaths". Yes, I am appalled.
This is BTW one way how "Being unvaccinated could harm the vaccinated": If I (very much vaccinated) need urgent treatment for any reason, and can't get it because all the beds are full of unvaccinated COVID patients, then I am harmed thereby.
If your main concern right now is the "freedom" implications and the "we've been lied to narrative" not the actual deadly pandemic then you have been misdirected, and should reconsider your media diet away from conspiracy-mongers.
Yes, we need to take the good of others into account. Like it or not we live in a society and our actions impact others. This pandemic is making it clear to those who can see, that stubborn selfish refusal, and paranoid anti-mask and anti-vax "freedom" rhetoric harms not just yourself, but also those around you. Rugged individualism is a complete bust in this context. Collective action is what works.
This deadly pandemic is not deadly for everyone.
People over 50 make up 1/3 of the population but 93% of covid deaths. I imagine this number is roughly proportional for hospitalizations by the same age groups. We can do some handwavy math and say if everyone under 50 was unvaccinated, they would only ever take up 7% of ICU beds.
Is 7% the difference between collapse or not? "One size fits all" doesn't make sense.
Further, I'm so confident I will never get sick and be hospitalized with covid that I'm happy to forgo my right to an ICU bed. Thus I'm decoupled from the dilemma. Or at least in an ideal world I would be able to make that choice. This was my assessment the first time I got covid, and now I likely have some level of immunity, so I'm even more confident now.
And as far as your hospital scenarios go, my point is we haven't seen the things you describe materialize. I'm sure there are a handful of cases, which is a tragedy, but if it's marginal then we shouldn't hold it up as a liminal crisis like we have been.
> Yes, we need to take the good of others into account. Like it or not we live in a society and our actions impact others.
Tell me the magic number for risk tolerance. If everyone self-quarantined from driving, and we switched to a delivery only economy, we could drastically reduce the number of motor vehicle fatalities. Do we not owe that to the greater good? What about for climate change? We should continue living like we did in 2020 forever.
> Collective action is what works.
It always works when your leaders are competent and have your best interests in mind. My country doesn't even recognize natural immunity, which I envy the UK for.
But free choice works too. Look at Florida, Sweden, people will still choose the vaccine. You don't need a mandate.
> If your main concern right now is the "freedom" ...
I can't believe the "vaccinated" are completely unconcerned by the trends regarding freedom right now.
You know its not an either/or situation, you can be concerned about both, right?
Look at Howard Springs Australia. Look at the vaccine passports. Look at the thread you're posting in. You probably think you're exempt. But immunity wanes, and variants will continue to emerge.
Governments never relinquish their emergency powers once they're enacted. This is just the latest "WMDs in Iraq". I can't speak for the UK, but in the US we still have the patriot act, and we just recently pulled out of Afghanistan.
20 years later we still live under the boogeyman of terrorism. Imagine if all the money we put into the war on terror went into better healthcare and other social goods?
All of this is to say, I don't have absolute trust in the vaccine or the plan or the people in charge, I don't trust them to make good decision nor to be honest.
If you want me to be onboard with "the plan", governments need to tell me - What's in the vaccine. - Exactly when they'll declare this over. - That they'll undo all of their emergency powers afterwards.
Otherwise, just like the war on terror, this will never be over no matter how much we comply.
The idea that most people "not at risk" is wrong.
The idea that collective action is all about trusting government is wrong, it's primarily abut supporting the other people in your community. it's a very USA'ian line of thinking to jump to "Imma screw over my fellow citizens because the government can't be trusted. Freedom!".
The idea that Florida and Sweden are good examples is wrong.
And as above, the idea that the "freedom" implications and the "we've been lied to narrative" not the actual deadly pandemic is wrong. Do not confuse the one crisis (of democratic ideas) with the other (of infectious molecules) or your responses will not be appropriate. They operate at completely different levels of abstraction.
The idea that "we haven't seen the hospital scenarios you describe materialize" is, in my local area, wrong.
> Look at Howard Springs Australia. Look at the vaccine passports. Look at the thread you're posting in. You probably think you're exempt
I have no idea of the point you're trying to make, and please to make no assumptions at all about me.
I googled "Howard Springs" but I have no idea what crazy talking point I am supposed to be nodding along with now.
> governments need to tell me - Exactly when they'll declare this over
You can't vote on the virus's timeline. The only politicians who have tried to declare "it's over" are charlatans.
> governments need to tell me - What's in the vaccine.
Do I need to go into the reasons why this is paranoid delusional, confused idiocy? Governments don't design or manufacture the vaccines. Without a bio-medical background that you and I both lack it's just not comprehensible. And lastly, can you not google the layman's explainers and research papers? I understand why you didn't post this line alone in a comment - it would be flagged and deleted.
All in all, I feel like someone at a party who has engaged a stranger in conversation, and now regrets it, as they speak a lot but say absolutely nothing worth hearing.
It would help if you explained what is wrong.
As it looks now, you just don't like what the stranger said and declare him not worth listening.
To me it is clear that vaccine passports is clearly not working and all this has become a big failure for politicians who don't know how to exit this failed strategy therefore double down on their plans.
I hope you stay safe, healthy, and have a wonderful holiday this year.
So then what happened summer 2020?
It's technically true that this worked then, but 2020 is gone, not to return. a) new COVID strains were inevitable and b) prolonged strict lockdowns unpalatable and c) mass vaccination has a huge benefit. As part of a multi-pronged strategy, of course. Depending on only one measure, be it lockdown or vaccination, is not going to work.
https://www.alberta.ca/stats/covid-19-alberta-statistics.htm...
Keep in mind the effectiveness is measured in tens/100,000. An there are some very sick people given the vaccine, that die before the 14 days of the second dose.
Well at least people know how much weight to give your opinions.
https://mobile.twitter.com/MartinNeil9/status/14668143477626...
Which countries are you talking about? It's certainly not the case for Germany, and I don't know any other European country for which this would be the case.
Which countries? I find it hard to get data at vaccination prevalence in ICU population specifically, but in Switzerland, the figures I see cited is 60-70% of patients unvaccinated (With 90% of 80%+ year olds in the population being double vaccinated).
For the 80+ group the latest data for hospitalisations is 47% vaccinated, 31% non-vaccinated, 22% unkown.
If you look at the total value, it appears that only 11 % of hospitalized are double vaccinated, though the latest seven day average puts that number at 27 %.
For the broad population is 28% vaccinated vs 57% non-vaccinated. The remaining 15% is "unknown". But Switzerland has a relatively low vaccination rate at 67%.
Edit: looking at deaths instead of hospitalisations in the broad population:
Fully-vaccinated 46%, partially-vaccinated 2%
Non-vaccinated 41%
Unknown 12%Edit: I can't find ICU numbers but the latest death stats for 80+ are 46% vaccinated, 33% non-vaccinated, 21% unknown.
what did they do? nothing because case numbers were low, I did push and push to finally get my grandpa to get is 3rd shot mid november while go to the doctor for something else... by coincident the rush to get the booster started 1 day after that.
I bet this happened a lot.... As far as I know just like for the 1st shot sverybody above 70 got that same letter. Meaning they had more than 2 months head start to get the boostershot.
So at least in Berlin I wont have sympathy anymore for taking away the shot from somebody else (got my appointment in january)
Also consider its their tax dollars being squandered and mismanaged.
The biggest issue is that not enough people got vaccinated.
If you'd please review https://news.ycombinator.com/newsguidelines.html and stick to the rules when posting here, we'd appreciate it.
Reducing the number of severe cases by a factor of 10 is very from from not working.
What "narrative"? What are you even talking about?
No-one, including the person you responded to, has claimed that vaccinated people can't get sick. The claim (backed by statistics) is that the unvaccinated are being hospitalized at a much higher rate and for a much longer duration.
You're arguing a point that no-one is disagreeing with.
However, we are not talking about "the unvaccinated", rather about "a tiny unfortunate fraction of unvaccinated people". There are 4,690 covid patients in ICU beds and 25M unvaccinated people. Assuming all covid ICU patients are unvaccinated, the covid ICU incidence rate within the unvaccinated population is 0.02%.
For an analogy, we could reason that because the prison population skews 90/10 male/female, all males should either undergo a vasectomy, or pay a recurring 10k euro fine. I hope this is obviously unethical.
Yes the point is to make sure that those ICU capacity which is very small and normally enough would and is struggling due to covid and vaccination helps.
What is so hard to understand?
We banned toxic paint, we enforce certain vaccines (polio, measles)
It's only logical to enforce a vaccine on people.
Same as you will get reanimated when you have an accident.
We formed and created rules around our society for a long time and those limitations are here for the good of all of us.
A society can't be forced to have a medical oath and in parallel has to watch when people don't play along.
You expect us to do the best to help you in an emergency and in parallel expect total freedom?
Not how our society works. Srsly get over it.
If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html and taking the intended spirit of the site more to heart, we'd be grateful.
Also consider that a population of 100, and 90 of those people are vaccinated. Uf 15 vaccinated people end up in the hospital, and 5 unvaccinated people also end up in the hospital, vaccination is still clearly better for you. But people will still say "75% of the people in the hospital were vaccinated; clearly the vaccines aren't working!" Yeah, well, out of vaccinated people, only 16% ended up hospitalized, while 50% of unvaccinated people ended up hospitalized. Those are the real numbers that matter. Percent of cohort hospitalized, not percent of total hospitalized.
The analogy is “every house has sprinklers so no need for a fire department any more”.
https://www.moh.gov.sg/covid-19/statistics
Look at "Proportion (%) of cases ever critically ill in ICU or died, by age and vaccination status"
Looking at the high risk group of 80+ year old (43% of all ICU cases and/or deaths), the numbers are: unvaccinated (24%), partially vaccinated (16%) and fully vaccinated (3.2%).
They don't define partially vaccinated (typically 14 days after 2nd dose). So clearly the vaccine reduces the risk of ICU/death, but the "truly" unvaccinated make up only 50% of ICU cases in that age group.
https://mobile.twitter.com/VojtechGibis/status/1463608271378...
NEOČKOVÁN - not vaccinated OČKOVÁN - vaccinated
The last 5 patients are those that have been released from the unit in that week. The first two were move to less severe case ICU. The last three died...
One more: https://mobile.twitter.com/VojtechGibis/status/1465783542982...
Czech ICU occupancy - blue unvaccinated, orange vaccinated. And yes, we had several cases <30 years old and unfortunately even children on ICU.
I think that training people to handle 90% of the issues you see in Covid-related illnesses could be done relatively quickly, if we wanted to do that. The ICU bed shortage really refers to a ICU-staff shortage, and anything we could do to relieve that burden would be a good thing.
Look at the sheer difference in numbers of healthcare professionals between America and Cuba. If they can do it even after decades of cruel and unusual sanctions, we sure as fuck can too.
But it seems strange to realize that people don't want to do a job where you have to watch people die like flies over the course of two to three weeks. No money in the world makes that acceptable for many.
With the availability of the vaccines (at least in the developed world) this has become a pandemic of the uninformed know-it-alls ("Querdenker" = Crooked thinker, as they are call here). If you work on an ICU to rescue people that tell you that this is all a scam by the Pharma-Industrial Complex, you would want to quit.
It is not the media's fault where we are now, nor are the politicians (entirely) to blame. At least half the blame should be frankly put on social media disinformation and the usual tabloid press (Springer/Bild) that fabricate Fox-News style lies.
In the last 20 years the standard "joke" (ha ha, only true) about the universal health system is that you need to be in good health in order to have enough energy to fight for your right to get help. The health care debt was an all time high at the start of the pandemic, and has since sky rocketed.
The faults are many. Poor wages has create many empty seats at the university programs. A lack of available personal has created a demand for labour hire employees, creating a system where many are moving to those in order to get pay rises, furthering increasing the cut that the middle men takes. An sharp increase in populations has increased demand, without any corresponding supply or funding. Employees has had an increase in paper work, with technology solutions that has caused additional work rather than optimized the work flow. Those same technology solutions has also been expensive to the point of corruptions, with some deals being actually corruptions that gone to court.
The situation is so bad that my own health clinic is sending every patient that calls them on non-mondays to the emergency department, as they are by law required to redirect the patient somewhere and all their own doctors are booked for the rest of the week, a pattern that been going on every week for the last year. Vacations has been removed as an emergency decision at many hospitals, and in one case the "compensation" for lost summer vacation was a fruit basket.
The expected time frame to raise the standard and actually train enough workers, as calculated by researchers a few years ago, was (if I remember right) somewhere around 10-20 years into the future. One pre-panedmic solution was to encourage skilled immigration directly from hospitals of nearby countries, a fix that obviously is not going to work now. If Germany is anywhere similar, then the blame isn't disinformation. It is systemic problem that has existed for decades and is now being pushed to over the edge.
It's really a shockingly well kept secret, especially to the outside world. Much like the utterly dysfunctional rail system.
Before the pandemic, I would have said that the country's healthcare system was about a decade away from resource-crisis. Now, it may have already started. I'm terrified of ending up in a hospital, even if there's no covid-wave ongoing. I do not want my life in the hands of the overworked traumatized remnants.
The way this country treats healthcare workers is shameful.
Media and politics are way more responsible than the craziest idiot.
Knowing that the vaccine doesn't prevent the person from getting and spreading covid. Knowing that the point of the vaccine is to prevent serious illness in the person receiving it. I struggle to understand why you would not even question how important they are in that setting unless you are worried they have dropped that extra safety component.
It's part of the reason that bed capacity has been so difficult to keep constant or increase.
Vaccines reduce the risk of spreading the virus. People who are vaccinated are less likely to get seriously ill. This absolutely doesn't mean you won't die if you are vaccinated. Think seat belts in car accidents. It is all about reducing risk. On mass, at population levels, this means ICU have capacity to take in other seriously ill people. If ICUs are full and there is a plane crash or whatever where many people are seriously injured we are screwed.
You could make the point that increasing the spread when everyone is protected is fine but that allows for increased mutations.
Except for all of 2020.
and this?
https://www.kff.org/other/state-indicator/flu-vaccine-requir...
I posit that any sane and intelligent person would choose NOT to go into politics. Because of the system we as society have created around the job.
Absolutely agree with you about hospital/medical resourcing though, we have the same situation in Australia. In the name of efficiency these services get paired to the bone, and we have no capacity to respond to unusual events.
The Neo liberal worldview posits that redundancy is bad. I think Western countries in general are suffering from this Anorexia. It cripples innovation as well.
Did you suddenly switch your job to become a nurse?
How do you think we would have been able to ramp up everything while in a pandemic?
The only people which exhibit antisocial behavior are those that don’t care about protecting themselves and others from infection. Wearing a mask, avoiding meeting others and getting tested is just as valid as getting a vaccine. Perhaps more, because those that do get vaccinated (at least among my acquaintances) seem to wrongly assume that the vaccine is enough and don’t take any other measures except what they must (masks). So they’re meeting in groups, going to restaurants without getting tested, etc.
Take care like what? Be locked up for years and not meeting anyone? Because everything else is much more risky than just taking the damn jab and stfu about it.
Also: those people who still are unvaccinated are mostly conspiracy nutjobs and don't give a damn about the rest of the population around them so it's quite obvious they wouldn't give a damn about "taking care".
How do you know they're nutjobs? Everyone I know that's unvaccinated are normal people. This is just what the media and politicians are saying without providing any proof.
I hope blaming people not at all involved in current miseries becomes a popular sport again.
You're lying and the fact that you seriously think any sane person would believe this is both hilarious and sad as it's a very beautiful example of this covidioten movement we have to deal with.
https://news.ycombinator.com/item?id=25961423 (Jan 2021)
https://news.ycombinator.com/item?id=21161447 (Oct 2019)
https://news.ycombinator.com/item?id=19471378 (March 2019)
https://news.ycombinator.com/item?id=18012949 (Sept 2018)
https://news.ycombinator.com/item?id=17863013 (Aug 2018)
Not only that but it looks like we've had to ban you in the past. All this is seriously not cool, regardless of how right you are or feel you are.
I'm not going to ban you right now because it doesn't look like you've been doing it recently, but please review the rules and stick to them from now on, because if you keep doing it, we're going to end up having to.
It also looks like you've been using HN primarily for ideological battle and that's also a line where we ban accounts. Please review the rules and stick to them from now on: https://news.ycombinator.com/newsguidelines.html.
I WORK IN THE MEDICAL FIELD MYSELF and your ridiculous lies are embarrassing.
https://twitter.com/ZDFbayern/status/1466813138741903365
This is what a covid patient gets in intensive care. Every day!
Diederik Grommers, one member of the Dutch Outbreak Management Team (OMG) states: "it doesn't matter if you're vaccinated or not; 60% of the beds are occupied by vaccinated people; the problems we will encounter in the coming weeks are caused by the fact that we totally hollowed out our health care" [0].
The Netherlands has about 6 ICU beds per 100.000 citizens. Germany has almost 30 ICU beds per 100.000 citizens [1]. Now I know Germany did accept patients from The Netherlands on their ICUs and perhaps Germany is doing the same for other countries, so perhaps that is causing a capacity problem in Germany as well.
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[0]: https://www.youtube.com/watch?v=yFg78PgDgu0
[1]: https://cdn.nos.nl/image/2020/03/30/640384/3840x2160a.jpg
Yeah, Germany has a ton of ICU beds in comparison, and yet, we're struggling exactly the same as any other country. I find it strange, too. In early 2020 I expected we'd see big differences between different countries based on ICU capacity, but we saw the same story everywhere (regional overload around the peak of a wave), with a few minor differences (whether some patients are transferred within the country or to other countries). Perhaps countries have different standards for when they put patients in ICU's, allowing hospitals (and governments) to always operate close to capacity? Would be one explanation, but I really don't know.
High total number notwithstanding though, our ICU capacity actually decreased during the pandemic, see:
https://www.intensivregister.de/#/aktuelle-lage/zeitreihen
The graph under "Gesamtzahl gemeldeter Intensivbetten" shows total capacity (light blue) + emergency reserve (green), dark blue is occupied beds. There was a pretty sharp drop-off in the total capacity a year ago, and a slower decrease all throughout 2021. Apparently, that's mostly due to nurses quitting in droves since the pandemic made their already bad working conditions even worse.
Our politicians didn't lift a finger to prevent or revert this, and now they're blaming a minority for this massive, massive failure. Just makes me really angry, I'll take downvotes for that if I have to :)
There's different standards in different countries for sure. In The Netherlands there's a focus on quality of life. If a patient cannot have a decent quality of life after staying on ICU, there's a preference to provide the patient with palliative care instead. In (e.g.) Italy this approach would not be accepted.
I can't say that I like the Dutch approach to covid in general, but in my first job I was deep into governement budgetting of hospitals (just before the introduction of the current Dutch reimbursement system) and it was a whole lot about 'keeping beds' and keeping patients in them to fulfill the budget. That was not what I'd call a generally efficient system. Even the health outcomes were worse since outpatient treatments usually have fewer side effects. What I've learned in that job is that doctors are like people. They respond to incentives. If that incentive is to have beds filled with people, you get just that. Beds with people.
I know Germany has a mixed system but it seems to me that socialized medicine keeping costs down slowly erodes care. The increase in costs in the US is also unsustainable. There might be a happy medium in there but it might be too early to tell.
You can see this happening in Canada too. We have a hybrid system in healthcare where the majority of critical care is paid for via taxes/government subsidies however secondary/tertiary stuff is either out of pocket or through insurance agencies (prescriptions, out-patient care like physiotherapy, etc).
Over the past 20-30 years, our system has seen the typical government thought process of throwing more money at problems but not actually having someone be accountable for the actions of the government over decades. You end up with a bunch of overpaid, under-worked management at the top while the actual front-line workers suffer with low staffing, not enough beds, budget cuts for the front line but raises for management etc. etc.
Not to mention the number of students coming here for health education (doctor, nurse, specialist) - then immediately saying sayonara for another country like the US or in the case of foreign students, their home country.
I don't understand why we keep cutting healthcare budgets - one possible reason could be because corporations have slowly been taking over every aspect of society as they move faster and make smarter decisions than government officials.
There was a case of a clinic that performed unnecessary surgeries and procedures just to rake in more tax money.
The problem isn't socialised medicine per se, it's trying to mash a socialised medicine system with "market forces", it's the ideology of the Third Way [1] to appease to these neoliberalist policy desires that is crumbling the Swedish healthcare (and welfare) system for the past 2 decades.
A hospital with a good cost based activity system could probably tell you more, although that would require a very high measure of control.
Dutch press just reports the general direction of (internal) prices for IC-days (about € 3k / night). That really is nowhere close to the proper answer to the question "How much would expansion cost?" The sum based on that € 3k would be: €3k * 365 * 65% * 1200 = about € 850 million for the whole of IC-care. That is a low figure for the Netherlands (€ 25 billion total medical specialist care), so I expect a lot of the IC-costs are absorbed by other DRGs or the other way around: that price doesn't include all of the fixed costs and is a marginal price.
Weird move for one of the richest countries in the world, no?
The decline in public healthcare quality has nothing to do with the lack of government oversight but it's due to the lack of funding and personel (which is also funding related). Ask any overworked healthcare worker in the public system.
Even if we were able to handle the load on the healthcare system, that still would be a very large amount of unnecessary suffering and death. And even though there are some fundamental issues with working conditions and pay in this area, fixing them would not be enough to be able to handle the load that an exponentially growing viral disease could cause if it remains unchecked. If you do not stop the exponential spread, even with twice the capacity you'd only gain another 1-2 weeks until you're at capacity anyway.
The vaccines work well and are safe. The problem is that too many people didn't take them. There's plenty of problems with how this was organized in Germany, but in the we simply didn't manage to convince enough people to get vaccinated.
It is nonsense to vaccinate young and very healthy people, especially kids. Their risk from COVID is minimal to non-existent.
Also the spread is not stopped by vaccinating. Vaccinated still spread the virus. If it is reduced is still unclear. There was a study in GB that showed the incidence numbers in vaccinated was just as high or higher than in unvaccinated. The sample sizes of vaccinated and unvaccinated were equal as they should be. Reports in Germany about these numbers forget to mention that vaccinated people are basically not tested.
> The vaccines work well and are safe.
They do not work well enough. First of all people still transmit the virus after only about 2 months after the vaccination. Then the protection goes down extremely between 2-6 months after the vaccination (that is why we need boosters all the time). It is still unclear if we continue to need boosters after the third shot.
While vaccinated people who get infected still spread the virus, they’re less likely to get infected in the first place, which is a necessary precursor to spreading.
But yes, we’ll probably need updated vaccines, similarly to how we update the flu shot every year.
"beds" is a proxy for "health workers", if you put a bad covid case in a "bed" they just die, they need constant attention
Source: https://www.thelancet.com/journals/laninf/article/PIIS1473-3...
* Peak viral load, GIVEN catching it?
* Duration of peak viral load, GIVEN catching it?
* Severe disease, GIVEN catching it?
* Hospital stay, GIVEN catching it?
* Death, GIVEN catching it?
There are many relevant parameters that the vaccines might affect. And the vaccinated people have a few parameters: number of shots, time since last shot, age, etc. People seem to focus on one or two of these questions at a time.
From your link, actually, related to duration:
"Fully vaccinated individuals with delta variant infection had a faster (posterior probability >0·84) mean rate of viral load decline (0·95 log10 copies per mL per day) than did unvaccinated individuals with pre-alpha (0·69), alpha (0·82), or delta (0·79) variant infections."
Clearly it's not going to stop transmission, but it could slow it down. People on both sides of this issue seem to undervalue partial measures and tradeoffs.
I would like to see the source for that if you have the link?
There is a lot to digest and probably it's easy to come to the wrong conclusions from this. I was referring to Figure 2.(a)
Point being, we didn't know what vaccination rate would reduce the R-value below 1, and FAFAIK we still don't know. Not even for the original Sars-cov-2 virus, and not for any of the variants.
> Cases of Covid-19 were less common among household members of vaccinated health care workers during the period beginning 14 days after the first dose than during the unvaccinated period before the first dose (event rate per 100 person-years, 9.40 before the first dose and 5.93 beginning 14 days after the first dose). After the health care worker’s second dose, the rate in household members was lower still (2.98 cases per 100 person-years). These differences persisted after fitting extended Cox models that were adjusted for calendar time, geographic region, age, sex, occupational and socioeconomic factors, and underlying conditions. Relative to the period before each health care worker was vaccinated, the hazard ratio for a household member to become infected was 0.70 (95% confidence interval [CI], 0.63 to 0.78) for the period beginning 14 days after the first dose and 0.46 (95% CI, 0.30 to 0.70) for the period beginning 14 days after the second dose. ... Not all the cases of Covid-19 in the household members were transmitted from the health care worker; therefore, the effect of vaccination may be larger.1 For example, if half the cases in the household members were transmitted from the health care worker, a 60% decrease in cases transmitted from health care workers would need to occur to elicit the association we observed (see the Supplementary Appendix). Vaccination was associated with a reduction in both the number of cases and the number of Covid-19–related hospitalizations in health care workers between the unvaccinated period and the period beginning 14 days after the first dose.
Populations where people are less likely to get infected are less likely to spread. You have to be infected before you can spread.
> Maybe you’re seeing people reading the actual stats?
What kind of reasoning is this? So because Covid-19 isn’t the worst pandemic in history, then it makes sense to believe it’s a hoax or overhyped?
I don’t think this is too far from the survival rate of those admitted to intensive care in general.
But I think the point is that COVID really increases your chances of being admitted there in the first place.
If you're in a certain age range, and have several comorbidities.
That means that somebody has to pay for them. Given that unavoidable but inconvenient fact, basic health care and life support might as well be organized under the auspices of the state and the costs shared among all residents.
Yeah, there are issues with staffing and inadequate payment of the staff, sure, and those problems are long-standing and unresolved, but even if they were solved that wouldn’t be much of a help.
We would then maybe talk about a couple thousand (here in the literal sense) beds in terms of increasing ICU capacity, if that (simply because it’s not as though Germany’s existing ICU capacity is somehow ridiculously small, it’s quite large, actually if you put it in context and adding a couple thousand beds would be a massive increase). That would be helpful but wouldn’t really solve the underlying problem.
And either way: Increasing ICU capacity right now is not a solution. It’s completely misguided. Not least of which because it takes forever to increase capacity. You have to train people for that …
Unvaccinated people are to blame for this, but especially cowardly politicians who were too frightened to start implementing vaccination mandates right away (summer 2021), as soon as it was clear that you cannot reach good enough vaccination numbers just based on pleas alone.
We do have a solution for this and the solution is vaccination. However, in the very short term even that won’t be good enough, we need to break the 4th wave and for that contact reduction is necessary (and already happening).
Think about time frames.
Contact reduction, will show its effects within a couple weeks, vaccination mandates plus a logistical push for booster vaccinations, will show their effects within one month to three months, making healthcare more resilient in general, will show its effects within a couple of years, maybe a decade.
Yes but.. extraordinary times exist, if we were sane we would prepare for crises before they happen, because we always knew that it would hit us eventually, people have been warning about this for ages, this is not some black swan.
More healthcare capacity would help, just like more supply chain capacity would help, or the ability to manufacture some masks, the entire problem is we've been running on the idiotic 80s managerial efficiency mindset for decades and now we're running on fumes on every front.
If we had any appreciation for crisis management, robustness, redundancy and had some shock absorbers in our system many people would not have needed to die. And no it's not just the unvaccinated. Plenty of countries this year, including the US, will lose more people in total to covid in 2021 than in 2020. Vaccines help but they are not pandemic ending, and our systems are deeply screwed up.
this was entirely preventable by providing nurses and those keeping hospitals running with the support they need to do suchs jobs during a time of crisis.
In the netherlands for instance, many nurses have been running 12h shifts during the peaks, and there has been very little practical support in helping those people.
I am not even talking about monetary funds, but mainly practical stuff. (for instance, some volunteers decided to do grocery shopping for nurses during peaks).
If people are busting their ass off to prevent the healthcare systems from collepsing, maybe the goverment should have done far more in its power to prevent those people from quitting.
I really wonder if any of the people here talking about massively scaling up ICU capacity have ever even been in or visited someone in an ICU. It is called an “intensive care” unit for a reason. Extensive resources are required. Putting aside the physical space, equipment and pharmacological needs, the teams of people are specialized and have extensive knowledge and training.
You can't keep the staff and maintain the gear needed to handle 100x "once in a century" event all the time, it just doesn't work. Most health systems are already huge money sinks and on the brink of collapse in normal times... This isn't a "a bomb injured 300 people" event, we can't live 100% prepared to every single potential threats.
And the other thing you can do is, actually have a prepared and tested response plan to a crisis. Our reaction to this was to dust off some plans from the the shelves, every individual state had different systems in place, two years in we don't really have a functioning digital app, but ten different solutions none of which more than a fraction of people have adopted, and so forth. Completely avoidable chaos if anyone was actually in charge of readying the country for these situations.
A strategy that would make sense would include BOTH vaccination and ICU capacity, one of which could have been started in March 2020, and it would have put us in a much better position today. Letting capacity decrease while waiting for vaccines that may or may not end the pandemic is negligent. Not getting vaccinated may be seen by some as negligent also, but different standards apply for governments and citizens.
The pandemic comes in waves, we do not need to plan for endless exponential growth. A few weeks of extra capacity would make the whole thing much easier to handle, given that we might be already at the peak and cases seem to be going down again[0]. The RKI weekly report[1] currently lists 1700 ICU cases, a month ago it was 1100[2]. So the 4000 beds we lost throughout the year[3] could have made a big difference.
[0]https://www.tagesschau.de/inland/rki-infektionen-103.html
[1]https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus...
[2]https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus...
[3]https://www.intensivregister.de/#/aktuelle-lage/zeitreihen
As I point out in my other comment, you cannot interpret that number in any to imply as though we ever actually had those 4,000 beds.
Just as with opposition to seatbelts it’s important for politics to create facts and just decide this issue. Everyone should be vaccinated and that’s just how it is.
Nothing more to say, our worldviews are too far apart.
There are many many reasons why one would or would not get a vaccine. For many, the reason was to go on vacation without too much hassle. Or because of social pressure. Or because they’re caring for someone who’s vulnerable.
If someone gets tested, uses masks properly and avoids groups of people they’re doing just as much as the average vaccinated. Definitely more than the truly antisocial which went into YOLO mode after getting vaccinated.
Why not both?
If this truly is an energy and hospitals truly are at risk, find a way to build more capacity even if it is temporary. Blaming the public for the failure to do this is wrong. And if you aren’t building this capacity… maybe this really isn’t an emergency?
You know that is hard to get people? You know how long it takes to teach someone? Especially while a pandemic is ongoing?
They set up "Nightingale Hospitals" (reference to Florence Nightingale) - basically convention centres were converted into field hospitals with ventilators. One in London had 4000 beds, and there were others elsewhere in the country. It took 9 days to build the London one (I was impressed!)
After all that, the 4000 bed one in London treated 20 patients during the first wave: https://www.bbc.co.uk/news/health-56327214 Most are now shutdown or being used as vaccination centres from what I know.
If the UK can pull this off in 9 days, I am sure other more sophisticated countries can do the same if they need to.
If you end up on a fucking ventilator in an ICU bed, the damage is long done. The goal is not to maximize the number of people we can have on ventilators. That is an absurd idea on the same level of the "natural immunity is better than the vaccine!" insanity we got in 2021.
Lockdowns end when we stop enacting them, there is no reason (except governmental screw up) to insist that people who chose to take the risk must not get sick under any circumstances, or to assume that everyone must be in lockdown until every last soul is jabbed and boostered whether they want to or not.
Vaccine mandates have been a thing for well longer than I've been alive. I wasn't allowed to attend public school as a kid without having been given several vaccines.
Sure, there were anti-vax people and people with religious exemptions then, but the vast majority of the people who are up in arms and crying foul about COVID vaccination mandates didn't blink an eye when told they had to vaccinate their kids against the measles as a condition for sending them to school.
Why the hypocrisy?
> Lockdowns end when we stop enacting them
We have lockdowns because we think they slow the spread of disease and save lives, not "just because". That's like saying "birthday parties end when we stop having them". Well, yeah, but that's a tautology and not a very useful point to make.
> there is no reason [...] to assume that everyone must be in lockdown until every last soul is jabbed and boostered whether they want to or not.
That seems like a straw man, though. Who is saying we have to lock everything down until everyone is vaccinated? What country has even tried to implement something like this? Some areas have certainly tied the relaxation of restrictions in some ways to vaccination rates, but the main concern for restriction levels is mostly other metrics, like new-case rates, hospitalizations, percent of ICU capacity used, death rate, etc.
> there is no reason (except governmental screw up) to insist that people who chose to take the risk must not get sick under any circumstances
Everyone who gets sick is a host for the virus to mutate in. Everyone who gets sick, or is even merely unvaccinated, runs a higher risk of passing on the disease to someone else.
I am really really tired of the "it doesn't hurt anyone else if I don't get vaccinated" argument. Yes. It. Does. Full stop.
The health minister was throttling Biontech/Pfizer deliveries just as demand started to go up for crying out loud!
It could always be worse, but I’m not at all surprised about lack of trust in the government.
You will spend years in lockdowns because that’s the only thing they’re capable of. See Portugal or Denmark for the vaccination happy case. Better than Germany but nowhere near life-as-usual.
Finally, if half the population doesn’t value all those things… Germany is proper fucked. You're exaggerating by a lot, which tells me you don’t value science and rationality.
If the spike protein mutates like it did in Omicron, most of the other antibodies will still continue to work while new spike antibodies are created. In contrast, if the vaccine-induced antibodies are avoided, immunity in vaccinated people drops to zero.
This leads to another consideration. As I understand it, antibody tests only check for the spike protein antibodies. This implies that if there are 10 other antibodies not being tested, then actual protection is 10x higher than the test indicates. Any antibody count falls over time because the body is efficient. If the disease enters the body again, it will just start pumping out the antibodies again as long as it knows how to make them.
The proof of the pudding is in the eating. People with just natural immunity in Israel are 10-15x better off than people who just got the vaccine. As this is the largest such study and encompasses pretty much the entire population, you can eliminate common sample size and selection bias issues that happen when you hand-choose a couple hundred people to look at.
E.g., Guillain-Barre syndrome is ~10 times more common after a COVID infection than a COVID vaccine. Myocarditis is something like 20 times more likely.
In relation to what? An average Covid infection? We don't even know how many go undetected to know what that average even is. Or the average out of hospital cases? Or simply confirmed cases? What are the numbers when comparing young healthy people vs old people with co-morbidities? What about children?
Has this been studied? I have natural anti-bodies and will participate in a study.
Also one that collects high income taxes and high health care contributions (~14% of the income). So one can't really blame it on lack of funds.
"The total number of NHS hospital beds in England has more than halved over the past 30 years, from around 299,000 in 1987/88 to 141,000 in 2019/20, while the number of patients treated has increased significantly." [0]
[0] https://www.kingsfund.org.uk/publications/nhs-hospital-bed-n...
I agree that vaccines are part of the solution. I disagree that stripping citizens of their rights and insulting them on TV is part of literally any solution for anything. If a government feels the urge to do that, it should look for alternatives instead. Maintaining ICU capacity from one year before (decreased by 4000 in 2021, see: https://www.intensivregister.de/#/aktuelle-lage/zeitreihenht... - "Gesamtzahl gemeldeter Intensivbetten"), is the lowest-hanging fruit, I'm sure there are additional alternatives that I'm not qualified to comment on.
Edit: It was pointed out to me that the DIVI numbers have some complexity that I did not account for. So grain of salt on the actual ICU number, but I've not yet seen anyone deny the trend. Here's a fact check that confirms that beds were lost: https://correctiv.org/faktencheck/2021/11/17/divi-praesident...
PCR test units and hospital bureaucracy are past their limits - e.g. regions like Bonn, Essen or Recklinghausen reporting zero cases on multiple consecutive days (Nov 29, Nov 30), which is _very_ unlikely w.r.t. the case numbers of the surrounding regions and those very regions reporting more than one hundred cases today.
The published indicators do not count cases that are reported late [2], which leads to apparently stalling case numbers. Growths may not be exponential forever but given that roughly one quarter of the population is not vaccinated, I would not take bets that the virus runs out of hosts before the health care system collapses.
I agree to the sentiment made that the balance between economic efficiency and damaging austerity for profit margin gains in the German health care system (especially for worker’s loans) has been tipping way too far to the latter in the past decades.
[1] https://www.lzg.nrw.de/covid19/download/laborbest_faelle_sar... (updated each day at 0:00 CET)
[2] https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus...
edit: some formatting.
Meanwhile vaccinating anyone < 60 has a very small benefit and it should be up to choice. Myokarditis side effects from the vaccine are probably bullshit, you can get it from almost all infections, so I expect it to see for every vaccine. We probably have no data since we lack operation of this scale.
But people here are afraid (typical) and even demand harsher policies. They also seem incapable to hold political leaders to account. Politics basically failed to prepare for the next wave, which was known to be happening quite a long while ago. Instead we had an embarrassing slap-fight between different states. One more stupid than the other.
Also you cannot just get a vaccine, you have to actively search for places that administer them. Pretty sure that I won't renew mine again, since this is just not acceptable.
I would advise you to ask a doctor, even if those aren't too keen to get another patient with vaccine trouble, but getting a vaccine in an active wave might not be the best health recommendation.
This isn't exactly true. People under 60 have a smaller risk to get to the Hospital/ICU but it's definitely not 0. There is also still a very real risk for Long-Covid and other complications from it. This gets even worse when said <60 person has obesity, smokes or other underlying health issues.
For your reference, in the Netherlands about 89% of 18+ people have been fully vaccinated. Yet the 11% unvaccinated make up 50% of Hospital beds and more than 70% of ICU beds. Looks at this image from our Minister of Health: https://twitter.com/hugodejonge/status/1466482208995164175
It's in Dutch but you'll get the message.
Furthermore, even if you are somehow not at risk of Covid, and you would magically know this about yourself it is STILL a good idea to get the shot because it reduces your chances of getting it (and passing it on!) and even if you get it your viral load is lower so the chances to spread it are reduced.
Stop making up arguments and get your bloody shot.
Very true, last month for the booster there was only one place in Stuttgart (large city for German standards) offering appointments within the year. It's gotten better again, but it's not like they didn't know that there would be a new wave of vaccinations once the first people are 6 months in (or had J&J).
Wild statement to make without any numbers.
Here is a start:
https://www.statista.com/statistics/1105512/coronavirus-covi...
Covid is a serious disease, but we are talking of mandatory vaccination and I don't think that it can be justified for younger age groups.
Having also less risk from the vaccine itself (which got injected into over 4 billion people) in comparison to COVID?
I disagree.
Lucky for me in this discussion, experts and politics are also now more inclined to have mandatory vaccination.
Mandatory vaccination exists in Germany for other things as well. I totally think it is reasonable.
Of course that will overwhelm the system.
(Also paradoxically, an improved healthcare system should need fewer ICU beds, so the decrease is probably a good thing)
I'm guessing it's the same with ICU beds... And now we have a situation where a high percentage of people have picked up their handsets...
There is no need to insult 3rd world countries like this.
Also curious how one squares the resource constraint issue with the exceptional nature of the events of the past couple years. What I mean is, did anyone think it made sense to massively increase capacity before the pandemic began? I'm not in health care so I don't have any special insight here; i.e. I'm asking, not challenging. From an outsider's perspective it seems like it would've been a tough sell to advocate for what was, in the "before times," an unnecessary increase in capacity.
But another thing that always gets scrambled in the newspapers is the "level" of ICU beds.
The ICU at my town's hospital (and it's not small) has patients that would lie in a normal station at a big university hospital.
ICU bed != ICU bed. In smaller hospitals, ICU means "post-op, needs surveillance" or "gets oxygen".
At a large hospital ICU means "ECMO" or similarly severe conditions.
So when you're reading that there are x thousand ICU beds still available in the country: most are not really up to the task when it comes to a severe covid case, and furthermore, an ICU bed at the other end of the country doesn't help you much.
I’m comparing the numbers from the DIVI registry:
2020-12-02: https://edoc.rki.de/handle/176904/7522 2021-12-02: https://edoc.rki.de/handle/176904/9047
I’m getting 24,949 beds for today, 27,543 as the year ago number (in both cases including a couple thousand ICU beds for kids which were later split out in the more current DIVI reports since ICU beds for kids aren’t helpful for this pandemic).
That’s a difference of 2,594.
Also, as the DIVI themselves explain: “Consequently, several factors play a role in influencing the number of beds that can be operated. A deliberate reduction of beds during the pandemic cannot be assumed. The reduction in available beds can be explained by the various points mentioned above, among others, and is supported by other data collected. The decisive factor for the operability of a bed is the medical staff.”
This is under a FAQ entry where they list five different reasons for the reduction in capacity: https://www.intensivregister.de/#/faq/18af7107-e098-43e7-a9f...
Staff themselves being affected by COVID-19 and becoming unable to work is just one of them.
The others are changes in how much staff is allocated per patient (this was increased), hospitals being more precise in their reporting and only reporting beds that can actually be staffed, changes in the criteria for a bed to be actually countable and the high effort ICU therapy of COVID-19 patients requires.
TBH I would not be surprised if the actually don't know the exact numbers. But even if it's "only" 2594 it's still too many.
You could call it deliberate however if the working conditions for people under such heavy load are not improved.
You don't really wish that kind of thing on anybody. So you try to avoid people going to the ICU in the first place (assuming you have a humane government, which unfortunately isn't always the case).
That said, the pandemic has definitely taught a lot of countries that stripping your health care system is probably a bad idea.
The reason people are even mentioning ICU beds are because they're trying to shift the vaccination argument from "do it for yourself, if you want to" to "you have to do it for others".
If we had enough ICU beds, there would be NO argument to force people to get vaccinated, just like there is no argument to force people to not smoke or not be fat.
The arguments for vaccination go a lot further than just a lack of ICU beds.
Yet isn't it strange that the one crisis we have chosen to pull out all the societal stops for, to radically reorient all of society and put it in stasis for, is COVID-19. Odd coincidence that most of the first list affects young people, COVID-19 primarily affects old people, and the political leadership of the developed world happens to be comprised of old people.
And the subset of old people responsible for handling the pandemic hasn't even managed to do that properly. This is the same category of people who hollowed out unions, induced globalization, and generally kicked out the ladder beneath them in a variety of ways.
I do care about my parents/grandparents, I've been vaccinated, and I'd wear a mask around an old person. That's the absolute maximum I'm willing to do voluntarily and feel fine about that. I'd even venture to suggest that if someone has a problem and demands that all of society radically realign itself to fix/prevent it in a way that's disproportionate to society's other needs, it's not society that's being selfish.
To be frank, I'm in favour of mass cryogenics. Build mausoleums under mountains and fill them with the frozen heads of the dead, to be revived later.
Science fiction has no place in policy determination.
On the other hand, I don't care if you choose to be fat or smoke yourself to death, that won't harm anyone.
That there are a bunch of egoists that would rather have us all fend for ourselves doesn't change that, and usually those are exactly the people demanding we take on their burdens when the situation is reversed. It's called a social contract for a reason: taxes, vaccination against communicable diseases where possible, compulsory education and so on, it's the flipside of the coin, you get a lot of rights, but you also have some (sometimes moral) obligations.
I agree that it would be a much stronger argument. However, I also find it cruel to force people into an injection that they do not want, and would probably still oppose a universal vaccine mandate for that reason. I'd be okay with a mandate that allows people who really don't want the vaccine to opt out. I'd even be okay with that for the COVID vaccines if it wasn't for the 2G stuff and the awful rhetoric against unvaccinated people that preceded it. Enacting the mandate now makes the whole thing feel too much like "we'll get you somehow". Like I said, I find it cruel. It's not my idea of a humane society.
Keep in mind that there is plenty of precedent for mandatory vaccinations, in almost every developed country and in plenty that are not young children are vaccinated against a whole raft of diseases that would otherwise cause serious problems. The only people that are exempt are those that do not want any vaccinations for religious reasons because it apparently interferes with 'gods plan'. If you want to deal with this at the same level of ignorance then that's fine with me but I personally have absolutely no problem with a mandate and I also would not have a problem with rescinding the exemption for religious purposes.
https://www.businessinsider.com/delta-variant-made-herd-immu...
But reducing the amount of active infections does have a beneficial effect because even though everyone will likely be exposed that doesn't necessarily mean that everybody will also get the disease (even the the worst diseases viral do not necessarily spread to 100% of the population), and there some chance that later strains may become milder. And if fewer people are ill at the same time that should increase the level of care available.
But it's a rearguard action at this point.
Illusion of control. The chance was never there. Even countries who are way more suitable for isolation like australia didn't manage to keep the virus out. Attributing that to "those that tried to spare the economy" is just another toxic blame game.
It's like a fire. If your house is the only house in a row of houses that is well prepared against fire then you're going to go down, in spite of all of your preparations.
The fatalism that many people exhibit is a self fulfilling prophesy: we won't be able to do it so we're not even going to try. But you know what? Australia, New Zealand, Singapore and China showed that it is possible.
No, they just moved themselves into a corner that they will be trapped in for the next 10 to 20 years.
I don't see that with this series of vaccines. They do not stop transmission. The ICU issue cannot be addressed fairly without addressing the other causes that put large numbers of people in ICUs.
We pay every year as a society in deaths for the assumption of some risk. We manage it, make laws, or just leave it alone and some people die (for example, we don't ban cars or eating too many calories or swimming pools).
In my estimation we are going a bit overboard demanding everyone take a novel injection, most especially when it appears the health authorities either didn't understand or didn't communicate the effectiveness over time of the injections.
There's a point were everything can't be all about what someone at the top proclaims is for the social good. Otherwise we wind up in corruption and dictatorship.
This was the same with every vaccine in the past, very few vaccines have received as much scrutiny as these, the biggest risk is the long term one and even there we have a fairly good idea of what the possibilities of materializing are.
None of these weigh up against the damage that a COVID-19 infection does.
If you think mandatory vaccination equates corruption and dictatorship then I am not sure we are on the same wavelength regarding the meaning of those terms.
There are a small group of people out there who are scared to death to take this vaccine because they genuinely think it will do harm to them. They are being asked to override their own alarms by people who do not share the fear because they don't have the same alarm bells going off. I know only a few of these people and they all have a ton of prior negative experiences with the medical system that would have left me feeling much the same way if I had shared their experiences personally. There are people that have been put in a 'do as you are told' situations and have received medical interventions that have done them great harm. Now they are being hounded and once again are being told to do as they are told, while fearing for their own health. A lot of people are willing to sweep aside their concerns as if they are asocial, ignorant, stupid, irresponsible and part to blame for the scale of the epidemic. People who feel out of control want to blame others so very badly, concentrating culpability in the hands of a group of bad actors, and it results in completely warped thinking with a tendency to dehumanise. And people can pick this up in others and it only increases their skepticism. They fear people operating in a blinkered, blame-seeking authoritarian way, and they see that as danger.
Though I encourage vaccination and have repeatedly tried to talk people who fear it off the ledge, I totally understand where the dictatorship and corruption logic is coming from. It doesn't take a hard-core cynic to raise an eye-brow when a drug company CEO proclaims that we'll all be needing many repeated doses of their product for years to come, while a leading political figure with immediate ties to the biotech industry wants to encourage countries to mandate the use of their products. If you had told me 2 years ago that society would control, monitor, demonise and divide people on the basis of having or having not received a recent government sanctioned medical treatment, I would have probably called you a hysterical conspiracy nut.
Two things drive me crazy: 1. How easy it is to dehumanize a significant percentage of the population. 2. How willingly politicians embrace that in order to find a scapegoat for their own failures.
As in, we can't just say "We have some social responsibilities so you must XX per the authorities" when XX is self serving, counterproductive, useless or harmful. We have an individual right, and responsibility, to weigh the dictates we are given at some point, perhaps not on all issues, but on some.
Other vaccines were not taken in to market in this manner. It is a novel vaccine.
This is pretty much the norm in any country that is a democracy but that does not have coalition governments. You get a kind of see-sawing effect where one group will enact a bunch of stuff and then when the tables are turned it all gets undone. It's stupendously inefficient.
Democracy is quite flawed but it still is the best mechanism for government that we have that is sustainable over a longer period of time.
This means the virus is busy making copies of itself in their body. Those copies not only have a chance to mutate, but have evolutionary selective pressure to mutate around the vaccine.
If you don't have the vaccine, it has no pressure to mutate around the vaccine.
There maybe more depth in their motives. But this is the surface.
So I'm kind of surprised to see this. I was under the impression Germany was the opposite.
https://tradingeconomics.com/country-list/hospital-beds
Germany is #2 out of those reporting. Crushing Canada by like 300%.
https://tradingeconomics.com/country-list/medical-doctors
Germany #1 for doctors, beating Canada by 100%
https://tradingeconomics.com/country-list/nurses
Germany #2 for nurses, beating Canada by ~75%
I kind of step back, how terrible is Canada doing?
>The staffing problems in hospitals (and nursing homes) have existed much longer than Covid. I heard a lot about them myself when I did my FSJ (volunteer work) back in 2004, and it's only gotten worse since then.
Oh ya big time. I can't remember a time when nurses/psws/doctors weren't in huge demand here in Canada.
Before covid: https://www.blogto.com/city/2019/07/toronto-hospital-fraud/
During covid pre-vax: https://toronto.ctvnews.ca/ontario-hospital-lays-off-97-regi...
Antivaxxers fired: https://www.thestar.com/news/gta/2021/11/28/were-on-the-brin...
You can't be on one side in huge demand for nurses but also be firing them willy nilly.
Firing them for not getting the vaccine isn't true at all. They've been reducing nurses and such for long before.
>Our government is in full CYA mode, and doing everything they can to blame a scapegoat for problems they themselves have willingly created over decades. It's despicable, and nobody should support it.
I propose that Canada and Germany probably have the same problem. That we are on the same page.
I am curious what you think is that problem?
Wow, why is there the wage cap when nursing has long been an issue in Ontario? I wonder who thinks this stuff up and thinks they are somehow saving money by doing this. It just generates inefficiencies and unintended side effects.
Whenever there's problems like this there's always seems to be a long trail of government interference that's counterproductive.
Bill 124 has nothing at all to do with Nurses. The word 'nurse' does not show up even once. This bill is effectively what put doug ford into power. That is to say, he was elected to pass this one. It is more than required.
As you likely know Ontario is the highest debt subnational in the world. The mcguinty government was in power for ~10 years but did so by buying votes. They had so many gigantic scandals and might be one of the worst governments ontario ever had. Hilariously, the PCs approach was to tell ontario he was going to fire 100,000 people. That obviously didn't go well giving Wynne a majority.
However, Hudak was right, 100,000 less people in government. Because we didn't... we are in a far worse situation. Pre-covid ontario was very bankrupt. It was so bankrupt Wynne was forced to sell off highly profitable assets like Hydro1. Now that covid happened? I dont even know what will happen.
>Whenever there's problems like this there's always seems to be a long trail of government interference that's counterproductive.
The consequences of decisions in either way is difficult and rarely properly assessed. As Greece knows, someone eventually ends up holding the garbage bag and has to clean up.
These are the consequences of decisions made.
But I don't know enough about provincial politics to debate the policies. You seem to have a better grasp of that.
I feel people misunderstand these issues so often, everyone just wants bigger government always. What happened during Mcguinty was well forecasted. He upon coming into power increased taxes on manufacturing. The consequence was that manufacturing dropped significantly. Ontario shed somewhere around 800,000 jobs because of that move and mcguinty trying to hide his shame increased the size of government to artificially hide abysmal unemployment. Population of Ontario was roughly 12 million at that time i believe. Labour participation was roughly 60%. Dropping 800,000 is more than 10% increase to unemployment. 10% unemployment is pitchforks at the capital.
The consequence? You converted tax paying people to tax deficit. It broke the balance by alot and it was all to hide the bad idea of raising taxes and harming ontarians.
Flipside, while this is an obvious failure, it shouldn't detract from a big government. Healthcare was obvious context above. What exactly is OHIP? It's a crappy basic health insurance provided by the government that has much less coverage today compared to years ago. It's not that we shouldn't do that, we simply don't cover everything. We know it's a good thing to cover the basics. It's just a definition of 'what are the basics'. Should diabetes meds be included? Type 1 vs Type 2? On top of that, it being single payer means most of society receives their healthcare from the rich.
>It's a strong hammer aimed at a few well deserved targets but hits broadly across a wide group where it doesn't always make sense. It's like a one size fits all approach.
It does make sense. What comes in bankruptcy? If we don't control those costs we are forced into austerity measures. Greece's Syriza is a communist party and they chose austerity out of their options. If we go into that, it will mean way more than 100,000 jobs fired abruptly. Which wasn't Hudak's plan. He was going to allow anyone who wants to keep working to keep working. Retirements, job hopping, etc being the plan.
The reason why you dont hear much of a chirp from the ultra strong unions is that they know the alternative is far worse.
>But I don't know enough about provincial politics to debate the policies. You seem to have a better grasp of that.
When Wynne got a majority. She took this power as her winning and not hudak losing. I called exactly what was about to happen. Wynne who was at the feet of all the scandals was going to be even worse because she would be under much more scrutiny. Not much of a prediction obviously, no future sight needed.
She actually was not bad besides the obvious corruption, she very nearly balanced the budget. Yet she made history books. She's the lowest approval rating for ontario premiers ever, and she provided the worst election result for the ontario liberals.
When doug ford got into power, I predicted exactly the same. doug ford didnt win, wynne lost. He's going to make decisions to fix the disaster of the liberals and take the blame. Flipside, he seems to be highly approved of because of covid and his response being objectively good. So I might be wrong on that front but he didnt fix the liberal corruption.
The staffing problems in hospitals (and nursing homes) have existed much longer than Covid. I heard a lot about them myself when I did my FSJ (volunteer work) back in 2004, and it's only gotten worse since then. Our government is in full CYA mode, and doing everything they can to blame a scapegoat for problems they themselves have willingly created over decades. It's despicable, and nobody should support it.
FSJ is a year-long volunteer program for young people typically organized and funded by NGOs like the Red Cross and similar. I worked with small children, plenty of the other volunteers I met regularly worked in hospitals and nursing homes. They all talked at length about how atrocious the working conditions were and how they were asked to do things they weren't legally allowed to (e.g. taking blood, handing out medication) because the staff shortages were severe enough that people didn't have enough time to adhere to very reasonable safety rules anymore. That was 17 years ago.
This is a well known, widely publicized[0] and not at all new problem, and the unvaccinated are not to blame for it. Let me repeat, we're talking about one of the wealthiest countries in the world with a population of 83M people crumbling over a few thousand ICU patients.
[0]Some random articles from 2018/19 (German):
https://gesundheit-soziales.verdi.de/themen/mehr-personal/++...
https://www.tagesspiegel.de/politik/wenn-aus-notstand-panik-...
https://www.zeit.de/politik/deutschland/2018-05/pflegenotsta...
https://www.rbb-online.de/kontraste/ueber_den_tag_hinaus/bil...