CR: COVID-19 --Political Talk

[Immaculate Vibes 114]

6 minutes ago, PenelopeWitherspoon said:

It is like you do not read things that do not support your idiotic views.  Long covid and complications after recovery.  Have you not been paying attention?!?

How about you stop posting bad info.

Do you have any valid long Covid rates? I must be missing all the kids with chronic fatigue walking around with nasal cannulas?

[Skipper 6406]

42 minutes ago, PenelopeWitherspoon said:

I don't like kids.  I purposefully avoid places where kids are going to be, but sometimes, parents don't practice common courtesy and allow their snot nosed kids to act like complete shits in places where they honestly shouldn't be (think movie theaters, Broadway theaters, Museums, the ballet, and nice restaurants).  And don't get me started on kids on flights (I have long complained about that, so much so that I would be happy to pay a premium to be on a kid free flight because they have also shown up in both business and first with too much regularity).  So if some of those entitled parents aren't able to bring their precious with them because they refuse to get them vaccinated, then that is no fucking skin off my nose.  

And actually, I do not think there should be middle ground. If you choose to remain unvaccinated, you are a fucking asshole.  You should be shunned.  

LOL.   This explains so much.  

[Anastasis 23699]

kIDs sHoUld nOt Be iN mUsEUms oR MoVie tHeAteRs!

Jesus Christ this thread has gone off the rails. 

[Nivek 17330]

5 hours ago, Skipper said:

What's funny is one of the guys on the last Attia podcast (recorded end of December) 100% predicted this phrasing.   The CDC is kind of becoming a joke.  Starting with the whole "masks don't work" statement at the beginning of the pandemic (in an effort to keep demand low for high quality mask due to shortage), and now treating a booster like it has the same benefit in a 15 year old as it does in a 75 year old.    Businesses, schools, etc. all make policy based on CDC recs and they continue to enact policy based on absolutely zero nuance because they think American's are too dumb.  

I have yet to see any data reflecting a material benefit for a "booster" in a fully vaccinated kid, teenager, 20 year old etc.  I saw the CDC distributed data over weekend that did reflect the benefit of the booster on hospitilazations but it wasn't broken down by age tiers.  And you know damn well the CDC has that data.  Just pure intellectual dishonesty if that data isn't released.   The only study i've seen to date looking at booster benefit against sever disease by age showed the benefit at 70+.  If someone has found more recent data please link.

Your stupidity is on full fucking display.  Have you ever been to the CDC?  Have you walked their campus, taken a tour and met with some of their scientists?  Have you asked them questions or discussed with them their research that they can discuss?  I know it is difficult to gain access, but the scientists working there is pretty fucking far from a joke you incompetent fuckhead.

Just because you misunderstood the message, just because you saw a political appointee try to rat fuck the organization doesn't reflect on the men and women working there and their reputation.  If you wanted to argue the basis for using the Vero cells as a proxy for human infection then go ahead, but arguing that the organization is a joke because you have limited understanding speaks more about you than it does them.  

Do you think the CDC has power to compel states, counties, and private hospitals to provide data? 

Also why would the CDC have stats on boosters for kids who just got access to boosters a month ago?   

I am sorry that is the only study you have seen, but try searching more.  The last study I read about was on the different vaccine boosters protection improvements for those who received the J&J vaccine.   They didn't have time to break down that study by weight, age, diet, hair color, ethnic origin, height, BMI, activity level, drug use, medical history, prevalence of pets in the home, exposure to known toxins, or cigarette use.     But I suppose since they didn't break it down by, if the people who did smoke smoked newports instead or virginia slims, well, the study was invalid.  I mean, it is not like there is a pressing concern here for expedience.   

 

 

[Heme Doc 417]

3 hours ago, Neonmoon said:

 

 

Okay, so let's discuss the Peter Attia article since both of you are relying on that as your basis for being anti-mandate. 

First let's start out with Attia's points, if I am wrong summing it up, let me know

He agrees that the relative risk reduction (RRR) of death is between 84% and 88%, regardless of age, and overall, the risk of death among people who were vaccinated was infinitesimal. So that's good. Vaccines are good. 

So his argument against is

1. Vaccines do not provide complete protection to the vaccinated. They are not 100% effective at preventing infection, hospitalization, and death. In fact, although vaccines significantly reduce risk of detectable infection in the few months after vaccination, this protection drops precipitously once circulating antibodies decline, though protection against severe infections and death persists. Now, we have Novel therapeutics, fluvoxamine, and sophisticated critical care. 

2. Omnicron is less virulent. 

3. Natural Immunity. The null hypothesis around this point, at the outset, should be that natural immunity is indeed as good as vaccine immunity, pending data to prove that assumption false.

4. Vaccines don't prevent transmission. It seems that they only slightly reduce the risk of transmission, and that vaccinated and unvaccinated persons with detectable infection have the same viral loads, despite the reduction in disease severity for the former group. Using a metric called the secondary attack rate (SAR), it’s possible to look at infection rates in household contacts stratified by contact vaccination status and index case vaccination status, and based on such analysis, it seems that vaccination only slightly prevents transmission. Vaccination does not reduce the peak viral load in the infected (though it does appear to reduce the duration of viral shedding, which may translate to the reduction in SAR).

He sums his position up like this

We have a virus that is far less lethal than the one that started the pandemic two years ago.
We have very effective vaccines that reduce the severity of illness and death by about 90%.
We have ample treatments to further reduce severity of illness in death (in vaccinated and unvaccinated alike) by another 90% or so.
We have better methods of providing in-hospital care to the infected.
For all their benefits, vaccines are not very effective at preventing transmission.

The impact of vaccine mandates

An unvaccinated person cannot board a plane or a train, let alone go into a restaurant, gym, or skating rink. A Canadian friend of mine, this week, was prohibited from seeing a medical doctor for a corneal abrasion because the doctor refused to see unvaccinated patients. What they are not, however, is a monolithic tool to be used as a sword against our citizens, rather than a shield against a virus.

What is the scientific evidence to support vaccine mandates today?  If this were really about science, why would we not allow previous infection, which confers all the benefits of vaccination, if not more, the same rights?

 

My rebuttal

1. Vaccines do not provide complete protection to the vaccinated

      - Vaccines significantly protect against sever infection, hospitalization and death. Seat belts don't protect you 100% but we mandate those. 

2. Omnicron is less virulent

        - Delta is very deadly. We can't make decisions based on best case scenario variants. What if another variant develops that is deadlier than Delta? 850,000 people have died in the US. We mandate vaccinations against Rubella. 1,000 pregnant women lost their babies, 2,100 newborns died, and 20,000 babies were born with congenital rubella syndrome. Yet we still require it even though most people won't be affected. We have a long history of taking harmless vaccines so other people don't die. Just because you don't give a shit about X number of people dying, doesn't mean it's okay. 

3. Natural Immunity.

         Vaccines work better than natural immunity because there is no risk associated with dying to obtain a vaccine as opposed to natural immunity. Just because you want to take your chances with the virus doesn't mean that's a good idea, especially when it will negatively impact others. The more people that are vaccinated, the less chance the virus has to spread and infect others. 

4. Vaccines don't prevent transmission.

         No shit. But as he says, they do "slightly reduce the risk of transmission. Vaccination does not reduce the peak viral load in the infected (though it does appear to reduce the duration of viral shedding, which may translate to the reduction in SAR)." They reduce transmission

5. I will add Legal

      - Vaccine mandates are legal. See Jacobson v Massachusetts, 197 U.S. 11 (1905)

6. Impact of Mandates

     - There is no impact other than learning how selfish people are. It is a choice. People are choosing to lose their job, lose access to sports, theatre, etc. People are choosing to lose access to the public because they are too fucking selfish to take a harmless vaccine to protect the public. Fuck them. 

7. What is the scientific evidence to support vaccine mandates today?

      - He already listed all the scientific evidence to support that getting vaccinated is better than not being vaccinated. He ignores all the data on previous deaths. He makes the assumption that only less virulent variants will remain. He admits vaccines reduce transmission.

8. If this were really about science, why would we not allow previous infection, which confers all the benefits of vaccination, if not more, the same rights?

    - This one is bit more complicated as the science backs previous infection providing good immunity. So I would agree they should be given the same rights as vaccinated. The problem with this is two-fold. Logistics and Policy. Logistically, we would require everyone have a vaccine pass (which still seems to be a bugaboo with the same people advocating for anit-mandates), and the vaccine pass would have to be updated with a confirmed infection test, and then given a time period of how long that immunity lasts. Of course vaccinated immunity has scientifically been proved to last longer than natural immunity. So we would need to update each vaccines pass with the require timelines. Policy, it would send the wrong message. If you want to take your chances with the virus, then go for it. 

 

 

 

 

Thank you for the thoughtful reply.  I wasn’t relying on the article for my feelings on usefulness of mandates.  I just used it as a jumping off point for discussion around certain aspects of vaccine mandates.  

I stand by my previous post that mandates of current vaccine formulations against the current circulating variant (and likely future variants) have little value. 

To me, the ethical case for vaccine mandates requires that vaccines significantly reduce harm to others.   I think we both agree that current vaccines do a relatively poor job at stopping transmission to others with Omicron and also with waning immunity.  I agree that vaccines do slow transmission some (especially if boosted), but not enough to mandate them (in my opinion).  Preventing indirect harm to others is another way mandates might be beneficial, by improving hospital capacity.  I have previously laid out some problems with this reasoning. 

I think we would both agree that the main benefits of vaccination are primarily protection for the individual, particularly against severe outcomes.  We do compel other activities for individual safety (seatbelts being an example you mentioned).  But there are important differences between seatbelts and vaccinations.  Further, we do not compel other interventions which would be of benefit to the individual or society (weight loss, restrictions on food/alcohol, or yearly flu vaccines to name a few).  The primary goal of a mandate with current circumstances, to me, is to compel as many people as possible to get vaccinated.  I fear we have reached the end of that usefulness.  If you ain’t been vaxxed yet, you’re probably not going to.  

I can’t speak as much to the legalities of mandates.  I know there’s been stuff in the Supreme Court, but I’m no lawyer.  

In an unrelated note — on the topic of the power of these vaccines…my wife went in today for her very last cycle of pretty potent immune suppressive adjuvant chemo.  She has been on chemo since late Sep and got her COVID booster just before starting chemo.  SARS Ab level is STILL off the charts > 2500 as of last week.  Still not had COVID throughout the surge and being on chemo the whole time.  

[Nivek 17330]

24 minutes ago, PenelopeWitherspoon said:

It is.  But I do not have a lot of patience, and kids are not something that were ever anything I wanted.  I have dogs, and while I will sometimes take the dog or dogs if we are going for drinks outside where they are welcome, for the most part, I leave them at home for the same reason that I believe most people should leave their kids at home.  I don't want to impose my life choices on others when out in public.

I get it.  My buddy and his wife are dog owners that like to take them out into nature and subsequently their car smelled like a wet dog and looked like a pomeranian exploded inside of it.   They were really into dogs, and loved chatting it up with other dog owners.  I found it funny, because you wouldn't see parents coming up to random other parents telling them how cute their kid was or their breeding.   But this mindless chatter does happen at kid events.  

We also do need to teach kids how to behave in public.  I wonder if one of my kids will ever learn, but I mostly suspect he will when he gives a shit but for now is just going to see how far he can drive me crazy. 

---Jr. Get off the floor.  2 cheeks down.  Jr. don't lick the salt shaker.  (Later)  NO goddamnit don't touch the urinal cake! Now don't touch anything and come here.  Oh fuck, don't push your hair out of your face NOW! (dad washes hands, face, hair of kid) UGHHH go see Mommy.   

[Captainant 28386]

13 minutes ago, Heme Doc said:

To me, the ethical case for vaccine mandates requires that vaccines significantly reduce harm to others.   I think we both agree that current vaccines do a relatively poor job at stopping transmission to others with Omicron and also with waning immunity.

Someone who is unvaccinated and needlessly consuming and constraining our extremely limited medical resources is absolutely harming other people. It's not a direct matter of transmissibility, but we're all on the same boat. Care providers shouldn't be forced to choose between unvaxxed Joe MAGA or someone who is fully vaxxed but facing a health issue they have no control over. 

Edited January 24, 2022 by Captainant
Missed a contraction there. Shouldn't instead of should

[wildcat09 29556]

So what's funny is I generally agree with the criticism of the CDC that they've damaged themselves by trying to mix politics and science. From their early white lies about the effectiveness of masking (to protect the mask supply for docs and nurses) to initially opposing boosters (because they thought those doses should go to countries that had shitty vaccine supply), the CDC has significantly damaged its reputation. You can understand and sympathize with their reasons and still recognize that. They're scientists and should stick to talking about only the science and leave the policy shit to the politicians. 

But all these twitter docs the anti-mandate posters are posting here are...doing the exact same thing, just in the other direction. Their opposition to testing asymptomatic people is based on their non-scientific determination that testing asymptomatic people generates anxiety:

 

And of course, the opposition to mandates is based to a significant degree on the oppositional defiance they bring out in some people:

 

And from Attia's article earlier, some of his opposition was based on what he clearly felt was unfair treatment of people who refused to get vaccinated, including a Canadian friend and another person who had previously been a guest on his podcast. 

None of this has much to do with the hard science of covid. They're also mixing their own politics with the science. And they and others like them are to a not insignificant degree responsible for creating the anxiety and defiance that they're saying justifies their preferred policies. 

[PenelopeWitherspoon 19279]

53 minutes ago, longhornmatt said:

Now, the service / emotional support animals going everywhere with anyone who isn’t blind is bullshit.  On that I can agree.  

Wait, I think I have an idea that might strike a compromise with Penelope.  Maybe we could allow some kids to come to movie theaters and restaurants, or get on airplanes, provided they’re service children.  You know, not just whiny freeloaders, but plucky kids just trying to make an honest buck carrying your bags or following you with a fainting couch. They would be well behaved, too, because, come on kid, do you want to sew clothes for Nike in an Indonesian sweat shop or see the world? 

If the kids are well behaved, I do not have an issue.  But more often than not, the kids are not.  My dislike of chidren is probably more so here in the city where the stay at home moms allow their precious little kids to ride their bikes or scooters on the fucking sidewalks or in building lobbies with impunity.  My personal favorite is the 5 year old kid that lives in our building who has a temper tantrum in the lobby on the regular.  

[Willfully Horn 8204]

1 hour ago, smoky said:

Moral of the story is there are no absolutes, don't try to spike the covid football, and check the dates on story that show up as "new"

We’ll spike the football together, or not at all. I didn’t see the Omicron update, but there’ll be another variant. In two months between the JH publication and the CDC release five days ago, we learned that Delta provided better immunity than its predecessor for survivors. It’s too early to know how long that lasts, and Omicrin’s immunity benefit is two months and counting. Way too soon to know definitively how long the immunity lasts for it or Delta.

Which is the point. The folks who set policy were correct, until a new variant. Wear masks and get vaxxed. Even if you’ve had CV. That’s the consensus and that’s best practices. All other talk is a distraction from the surest way to spiking the ball.

1 hour ago, Skipper said:

No.   You don't have that right. He speaks convincingly about why "mandating" folks get the vaccine is wrong. 

Agree that I should have said mandate. I’m thinking in terms of societal expectations. Which anti mandate talk (your business cannot mandate vaccinations) dilutes.

[Immaculate Vibes 114]

26 minutes ago, wildcat09 said:

So what's funny is I generally agree with the criticism of the CDC that they've damaged themselves by trying to mix politics and science. From their early white lies about the effectiveness of masking (to protect the mask supply for docs and nurses) to initially opposing boosters (because they thought those doses should go to countries that had shitty vaccine supply), the CDC has significantly damaged its reputation. You can understand and sympathize with their reasons and still recognize that. They're scientists and should stick to talking about only the science and leave the policy shit to the politicians. 

 

Don’t forget their school recs. I’d like to see the science behind recommending universal indoor masking of 2 year olds. Spoiler alert-there isn’t any. 
 

https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/k-12-guidance.html

 
CDC recommends universal indoor masking by all* students (ages 2 years and older), staff, teachers, and visitors to K-12 schools, regardless of vaccination status.

[Captainant 28386]

2 minutes ago, Immaculate Vibes said:

Don’t forget their school recs. I’d like to see the science behind recommending universal indoor masking of 2 year olds. Spoiler alert-there isn’t any. 
 

https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/k-12-guidance.html

 
CDC recommends universal indoor masking by all* students (ages 2 years and older), staff, teachers, and visitors to K-12 schools, regardless of vaccination status.

You're right, there's a flaw in the policy so we should throw the baby out with the bathwater and lick doorknobs to get herd immunity faster. How foolish of us!

[Immaculate Vibes 114]

1 minute ago, Captainant said:

You're right, there's a flaw in the policy so we should throw the baby out with the bathwater and lick doorknobs to get herd immunity faster. How foolish of us!

Flaw in the policy? How about a wrong policy. We’re the only country in the whole recommending something so ridiculous. Stupid. Anyone with kids reads that and immediately knows that fucking stupid. I’m sure there’s Penelope’s of the world that say, “It’s about fucking time”.  Gotta keep those kids masked so there’s an infinitesimally smaller chancr she gets Covid after being triple vaxxed 

[Dahobbs 18185]

45 minutes ago, wildcat09 said:

So what's funny is I generally agree with the criticism of the CDC that they've damaged themselves by trying to mix politics and science. From their early white lies about the effectiveness of masking (to protect the mask supply for docs and nurses) to initially opposing boosters (because they thought those doses should go to countries that had shitty vaccine supply), the CDC has significantly damaged its reputation. You can understand and sympathize with their reasons and still recognize that. They're scientists and should stick to talking about only the science and leave the policy shit to the politicians. 

But all these twitter docs the anti-mandate posters are posting here are...doing the exact same thing, just in the other direction. Their opposition to testing asymptomatic people is based on their non-scientific determination that testing asymptomatic people generates anxiety:

 

And of course, the opposition to mandates is based to a significant degree on the oppositional defiance they bring out in some people:

 

And from Attia's article earlier, some of his opposition was based on what he clearly felt was unfair treatment of people who refused to get vaccinated, including a Canadian friend and another person who had previously been a guest on his podcast. 

None of this has much to do with the hard science of covid. They're also mixing their own politics with the science. And they and others like them are to a not insignificant degree responsible for creating the anxiety and defiance that they're saying justifies their preferred policies. 

Yeah, this is what I've been saying over and over in this thread. People are conflating the scientific analysis and the policy analysis. They aren't the same thing. Science can inform policy decisions, but generally isn't going to decide them. Other factors have to be considered too. Unfortunately everyone gets too caught up in the phrase "follow the science" without realizing that the science only takes us so far. Science tells us vaccines work and are very low risk. But that isn't going to tell you anything about the economics of issuing mandates, the potential downstream consequences of giving government the power to determine individual health choices, or the possibility that such policies will inflame divisions in a society. Unfortunately, people will often cloak arguments under the veil of science and say that whoever disagrees, whether it be for or against a certain policy (e.g., vaccine mandates), is failing to follow the science. But science can't make these decisions for us. They are inherently political question that must go through a political analysis, which yes, includes the science as one input among many.   

Edited January 24, 2022 by Dahobbs

[Willfully Horn 8204]

12 minutes ago, Immaculate Vibes said:

Gotta keep those kids masked so there’s an infinitesimally smaller chancr she gets Covid after being triple vaxxed 

Sixty percent difference isn’t infinitesimal.

At least, it was that much of a difference. Still looking for Omicron data. The POV you support was wrong for two years, it is smart to wait and learn more before giving you any benefit of the doubt.

[JimmyJames 12271]

12 minutes ago, Immaculate Vibes said:

Flaw in the policy? How about a wrong policy. We’re the only country in the whole recommending something so ridiculous. Stupid. Anyone with kids reads that and immediately knows that fucking stupid. I’m sure there’s Penelope’s of the world that say, “It’s about fucking time”.  Gotta keep those kids masked so there’s an infinitesimally smaller chancr she gets Covid after being triple vaxxed 

Just because you’ve rebranded yourself and changed your handle doesn’t change the fact that in the past you were a complete anti vaxxer spreading around all sorts of bullshit propaganda that helped kill thousands. You don’t get to reset yourself as some sort of reasonable purveyor of information now. 

[workswithseed 2201]

 

 Lot of stupid here.

[Anastasis 23699]

1 hour ago, Heme Doc said:

I stand by my previous post that mandates of current vaccine formulations against the current circulating variant (and likely future variants) have little value. 

If we had a vaccine that conferred sterilizing immunity would that change your assessment?

 

It is kinda wild to me that vax development and testing seems to have fallen off.  Where are we with nasal administration and variant updates?  The mRNA tech's primary advantage is that once you are comfortable with the tech, we should be able to rapidly deploy updates.  We need the same amount of urgency to get to vaccine 2.0 as we had to get the first roll out. 

[Skipper 6406]

43 minutes ago, Nivek said:

Your stupidity is on full fucking display.  Have you ever been to the CDC?  Have you walked their campus, taken a tour and met with some of their scientists?  Have you asked them questions or discussed with them their research that they can discuss?  I know it is difficult to gain access, but the scientists working there is pretty fucking far from a joke you incompetent fuckhead.

 

Also why would the CDC have stats on boosters for kids who just got access to boosters a month ago?   

 

 

 

Wildcat elaborated on what I meant by saying the CDC is "becoming a joke". Their inconsistent messaging and mixing of politics/science and making policy recs without an accurate representation of the risks and benefits.  I don't actually think the serious scientists that work there are a joke.  It's a message board dude.   

Also, I don't expect the CDC would have stats on kids with boosters yet.  I would expect them to have stats on kids vaxed 2X sufficient to show there is a BENEFIT to a fully vaccinated 14 year old getting a booster (i.e., are there actually healthy fully vaccinated 14 year olds that are getting severe disease such that a Booster would provide a benefit.) They discussed that there is myocarditis risk but it is extremely low.  But I think you have a duty to show the benefit exceeds that risk if you are going to recommend kids "should" (not may) get boosted.  At least the "benefits" should be part of the discussion/equation.

[Heme Doc 417]

19 minutes ago, Captainant said:

Someone who is unvaccinated and needlessly consuming and constraining our extremely limited medical resources is absolutely harming other people. It's not a direct matter of transmissibility, but we're all on the same boat. Care providers shouldn't be forced to choose between unvaxxed Joe MAGA or someone who is fully vaxxed but facing a health issue they have no control over. 

I agree with you that the unvaccinated disproportionately utilize resources and this results in indirect harm to others.  But I disagree that mandates are an ethical solution to the problem.  We do not mandate other behaviors which disproportionately utilize healthcare resources (weight loss for obesity, smoking/alcohol cessation, flu vaccinations, etc).  

[Heme Doc 417]

13 minutes ago, Dahobbs said:

Yeah, this is what I've been saying over and over in this thread. People are conflating the scientific analysis and the policy analysis. They aren't the same thing. Science can inform policy decisions, but generally isn't going to decide them. Other factors have to be considered too. Unfortunately everyone gets too caught up in the phrase "follow the science" without realizing that the science only takes us so far. Science tells us vaccines work and are very low risk. But that isn't going to tell you anything about the economics of issuing mandates, the potential downstream consequences of giving government the power to determine individual health choices, or the possibility that such policies will inflame divisions in a society. Unfortunately, people will often cloak arguments under the veil of science and say that whoever disagrees, whether it be for or against a certain policy (e.g., vaccine mandates), is failing to follow the science. But science can't make these decisions for us. They are inherently political question that must go through a political analysis, which yes, includes the science as one input among many.   

VERY well said.  Full agreement here

[Sawbonz 28081]

I think the problem many docs and other healthcare professionals have with mandates goes back to our medical ethics training and the concepts of autonomy vs paternalism and beneficence vs non maleficence I’m kind of done with this thread but y’all should read up on those concepts if you are unfamiliar 

[Heme Doc 417]

5 minutes ago, Anastasis said:

If we had a vaccine that conferred sterilizing immunity would that change your assessment?

 

It is kinda wild to me that vax development and testing seems to have fallen off.  Where are we with nasal administration and variant updates?  The mRNA tech's primary advantage is that once you are comfortable with the tech, we should be able to rapidly deploy updates.  We need the same amount of urgency to get to vaccine 2.0 as we had to get the first roll out. 

Yes, it probably would.  In a case where vaccine confers sterilizing immunity, much less risk of transmitting to others and harming them.  
 

GREAT question about new vaccine development.  I don’t know what the deal is.  

[Heme Doc 417]

2 minutes ago, Sawbonz said:

I think the problem many docs and other healthcare professionals have with mandates goes back to our medical ethics training and the concepts of autonomy vs paternalism and beneficence vs non maleficence I’m kind of done with this thread but y’all should read up on those concepts if you are unfamiliar 

Physicians are good at taking multiple choice standardized tests.  It’s how many of us think.  “Here’s a problem.  Pick the one best solution”.  COVID, unfortunately, is not like that.  COVID reminds me of a test question in medical school…

After the test, friends and classmates all gathered to discuss how we thought we did.  “What did you answer on question 7?”  Everyone had a different answer.  Each person convinced their answer was correct…

But it turns out they screwed up the test and left off the correct answer choice.  We ALL answered wrong but were convinced we were right.  There’s some deeper meaning there, probably.

[Anastasis 23699]

2 minutes ago, Sawbonz said:

I think the problem many docs and other healthcare professionals have with mandates goes back to our medical ethics training and the concepts of autonomy vs paternalism and beneficence vs non maleficence I’m kind of done with this thread but y’all should read up on those concepts if you are unfamiliar 

It's actually pretty telling some of the exchanges on this board in the past where some posters come from a perspective of training in biomedical ethics vs. posters with other perspectives.  Whoa to the poster who applies conflict of interest overlay to that framework.  

[Skipper 6406]

43 minutes ago, PenelopeWitherspoon said:

 My personal favorite is the 5 year old kid that lives in our building who has a temper tantrum in the lobby on the regular.  

It's funny to me you think parents can control the emotions of a 5 year old.  And honestly I'm not criticizing that harshly as I probably wasn't much different before I had kids.

I'll say this that the COVID experience hasn't exactly helped your cause of expecting kids to act like small adults in public. 

 The biggest public meltdown I can recall from our kids was when we made our recently turned 5 year old leave a church Halloween carnival this past year.  It was a massive carnival, tons of bounce houses, games, petting zoo, candy you name it.  Basically 5 year old nirvana.   And we didn't set expectations and it was a total shitshow when it was time to leave.  And it set us all off and we were shitty parents threatening to 'never do it again if this is how you are going to act', etc. etc..  Then we sat down after getting kids to bed, had a glass of wine, and realized that was the first large scale event like that he had experienced since before COVID (which started when he was 3).  It was a pretty stark reminder of how much our kids have missed out on.  And frankly a good example of why I'm absolutely against policies that limit experiences of our kids (continued lockdowns, vax passports, etc.) when they don't seem absolutely necessary.

 

[Immaculate Vibes 114]

19 minutes ago, Willfully Horn said:

Sixty percent difference isn’t infinitesimal.

At least, it was that much of a difference. Still looking for Omicron data. The POV you support was wrong for two years, it is smart to wait and learn more before giving you any benefit of the doubt.

Where do you get 60%?

[NameAlreadyInUse 5164]

11 minutes ago, Heme Doc said:

I agree with you that the unvaccinated disproportionately utilize resources and this results in indirect harm to others.  But I disagree that mandates are an ethical solution to the problem.  We do not mandate other behaviors which disproportionately utilize healthcare resources (weight loss for obesity, smoking/alcohol cessation, flu vaccinations, etc).  

Except we do put those mandates on smoking and alcohol in government by prohibiting those not of a certain age from partaking, and private companies also provide both carrots and sticks for weight loss and smoking/alcohol cessation.  This doesn't feel like a completely black/white issue to me and it's frustrating to see so many people try to argue black/white so emotionally, when the answer lies in the gray.  We are never going to be able to properly define the gray if the people yelling for black and the people yelling for white can't quit publicly tantruming long enough for the conversation to even happen.  

[Willfully Horn 8204]

7 minutes ago, Immaculate Vibes said:

Where do you get 60%?

https://www.google.com/amp/s/www.abc12.com/coronavirus/university-of-michigan-study-shows-mask-mandates-at-schools-show-lower-covid-transmission-rates/article_9dfcd525-94d5-50cb-9b00-ac1c2171d7fe.amp.html

Sending a link, like a civilized person.

Edited January 25, 2022 by Willfully Horn
Rebuke

[Immaculate Vibes 114]

Just now, Willfully Horn said:

https://www.google.com/amp/s/www.abc12.com/coronavirus/university-of-michigan-study-shows-mask-mandates-at-schools-show-lower-covid-transmission-rates/article_9dfcd525-94d5-50cb-9b00-ac1c2171d7fe.amp.html

Thanks for helping prove my point. This study amplifies the importance of relative risk reduction vs absolute risk reduction, which is also relevant to vaccines.

60% more!

Reality 

went from 45 cases/100,000 to 73 cases/100,000

[Anastasis 23699]

3 minutes ago, Willfully Horn said:

https://www.google.com/amp/s/www.abc12.com/coronavirus/university-of-michigan-study-shows-mask-mandates-at-schools-show-lower-covid-transmission-rates/article_9dfcd525-94d5-50cb-9b00-ac1c2171d7fe.amp.html

Sendinf a link, like a civilized person.

Link to the actual study?

[Anastasis 23699]

1 minute ago, Immaculate Vibes said:

Thanks for helping prove my point. This study amplifies the importance of relative risk reduction vs absolute risk reduction, which is also relevant to vaccines.

60% more!

Reality 

went from 45 cases/100,000 to 73 cases/100,000

Going to take a shot here and guess that they didn’t control for rates if community transmission in that analysis. 
 

 

[Heme Doc 417]

3 minutes ago, NameAlreadyInUse said:

Except we do put those mandates on smoking and alcohol in government by prohibiting those not of a certain age from partaking, and private companies also provide both carrots and sticks for weight loss and smoking/alcohol cessation.  This doesn't feel like a completely black/white issue to me and it's frustrating to see so many people try to argue black/white so emotionally, when the answer lies in the gray.  We are never going to be able to properly define the gray if the people yelling for black and the people yelling for white can't quit publicly tantruming long enough for the conversation to even happen.  

I agree about it being a gray area.  I don’t pretend to have all the right answers.  I hope you don’t feel like I’m throwing a tantrum.  Just trying to have respectful dialogue.  I’d lean more towards the carrot/stick approach above.  Companies can give reduced insurance rates or other perks for employees to get vaccinated.  I’m fine with healthcare workers being mandated to get the vaccine.  I do wish there were carve outs for exceptions for those previously infected (although I’d still advise them to get vaccinated).  

[PenelopeWitherspoon 19279]

27 minutes ago, Anastasis said:

It's actually pretty telling some of the exchanges on this board in the past where some posters come from a perspective of training in biomedical ethics vs. posters with other perspectives.  Whoa to the poster who applies conflict of interest overlay to that framework.  

You mean the conflict of interest you tried to convince us all was right for lawyers but it wasn't?  You mean that conflict of interest discussion?

[Doc Sam Beckett 5854]

2 hours ago, PenelopeWitherspoon said:

I don't like kids.  I purposefully avoid places where kids are going to be

 

They're worse than old people, which is pretty hard to accomplish

[Anastasis 23699]

3 minutes ago, PenelopeWitherspoon said:

You mean the conflict of interest you tried to convince us all was right for lawyers but it wasn't?  You mean that conflict of interest discussion?

The one where we learned that everyone acknowledges that contingency fee structures are incompatible with the principle of justice, but somehow a segment of the profession has carved out a lice little Thomas J Henry niche for themselves. 

[PenelopeWitherspoon 19279]

31 minutes ago, Skipper said:

It's funny to me you think parents can control the emotions of a 5 year old.  And honestly I'm not criticizing that harshly as I probably wasn't much different before I had kids.

I'll say this that the COVID experience hasn't exactly helped your cause of expecting kids to act like small adults in public. 

 The biggest public meltdown I can recall from our kids was when we made our recently turned 5 year old leave a church Halloween carnival this past year.  It was a massive carnival, tons of bounce houses, games, petting zoo, candy you name it.  Basically 5 year old nirvana.   And we didn't set expectations and it was a total shitshow when it was time to leave.  And it set us all off and we were shitty parents threatening to 'never do it again if this is how you are going to act', etc. etc..  Then we sat down after getting kids to bed, had a glass of wine, and realized that was the first large scale event like that he had experienced since before COVID (which started when he was 3).  It was a pretty stark reminder of how much our kids have missed out on.  And frankly a good example of why I'm absolutely against policies that limit experiences of our kids (continued lockdowns, vax passports, etc.) when they don't seem absolutely necessary.

 

And if it were once in a while, I would be a little more understanding.  But it isn't.  It is like clockwork every fucking week.

[Willfully Horn 8204]

19 minutes ago, Anastasis said:

Link to the actual study?

My search skills are too poor. Maybe it hasn’t been released, though @smoky found an update, he says, which I also haven’t been able to find. But, the story is all over media in Michigan, and I have no reason to doubt it.

Sixty percent isn’t infinitesimal. There may be other factors than masks, and any of those variables which we can control ought be put in place. Within reason, and cost. Masks fall into both categories.

Edited January 25, 2022 by Willfully Horn
Mention and poor writing

[PenelopeWitherspoon 19279]

4 minutes ago, Anastasis said:

The one where we learned that everyone acknowledges that contingency fee structures are incompatible with the principle of justice, but somehow a segment of the profession has carved out a lice little Thomas J Henry niche for themselves. 

Consultants get contingencies as well.  If you are a SALT consultant, you get more $$$$ if you save someone more money.  Contingency structures are absolutely allowed, but there are requirements depending on the kind of engagement.  

Sometimes, it makes sense to align the compensation with the outcome.

[DaysOff 8157]

I agree with you that the unvaccinated disproportionately utilize resources and this results in indirect harm to others.  But I disagree that mandates are an ethical solution to the problem.  We do not mandate other behaviors which disproportionately utilize healthcare resources (weight loss for obesity, smoking/alcohol cessation, flu vaccinations, etc).  

Just a data point, but United was averaging one employee death per week. Ten weeks now since their mandate and no deaths. You ask nicely for a year then you mandate the stupids so we can have a civilized society.

[Anastasis 23699]

Just now, PenelopeWitherspoon said:

Consultants get contingencies as well.  If you are a SALT consultant, you get more $$$$ if you save someone more money.  Contingency structures are absolutely allowed, but there are requirements depending on the kind of engagement.  

Sometimes, it makes sense to align the compensation with the outcome.

[JimmyJames 12271]

10 minutes ago, Anastasis said:

The one where we learned that everyone acknowledges that contingency fee structures are incompatible with the principle of justice, but somehow a segment of the profession has carved out a lice little Thomas J Henry niche for themselves. 

Nobody learned that. You expressed that dumbass opinion and everyone on here disagreed with you because it’s asinine. Then we moved on. Now you’ve brought it back again for some reason.

[Anastasis 23699]

9 minutes ago, Willfully Horn said:

But, the story is all over media in Michigan, and I have no reason to doubt it.

Because it supports your priors?

 

Would love to see the data. I bet that they did not control for the obvious confounders. 

[Captainant 28386]

4 minutes ago, Anastasis said:

Tell me more about the ethics of denying care, since that's what enables the record profits of you and your employers. It's always a hoot to hear someone on the take from insurance companies twist themselves up justifying their shit.

[Anastasis 23699]

Just now, Captainant said:

Tell me more about the ethics of denying care, since that's what enables the record profits of you and your employers. It's always a hoot to hear someone on the take from insurance companies twist themselves up justifying their shit.

You mean like a CMS NCD?

https://www.cms.gov/newsroom/press-releases/cms-proposes-medicare-coverage-policy-monoclonal-antibodies-directed-against-amyloid-treatment

 

[Anastasis 23699]

Or a NICE one?

https://www.nice.org.uk/guidance/indevelopment/gid-ta10739

[Willfully Horn 8204]

Nmnm

Edited January 25, 2022 by Willfully Horn

[Captainant 28386]

3 minutes ago, Anastasis said:

Or a NICE one?

https://www.nice.org.uk/guidance/indevelopment/gid-ta10739

Nice. My dad, rest in peace, was put into the hospital by an experimental trial of Nuplazid encouraged by the insurance company because it was cheaper. Tip of the cap to you and yours for that. 

Destroyed years of progress in his physical therapy and regressed him to the point where my mom could no longer care for him, and resulted in his entering skilled nursing care 24/7 for the remainder of his life. So yeah. NICE. 

[Anastasis 23699]

1 minute ago, Willfully Horn said:

Alzheimer’s treatment?

Is there something you would like to share?

Sure.  Alzheimer's disease is about to wreck our healthcare system. 

[Anastasis 23699]

1 minute ago, Captainant said:

Nice. My dad, rest in peace, was put into the hospital by an experimental trial of Nuplazid encouraged by the insurance company because it was cheaper. Tip of the cap to you and yours for that. 

Destroyed years of progress in his physical therapy and regressed him to the point where my mom could no longer care for him, and resulted in his entering skilled nursing care 24/7 for the remainder of his life. So yeah. NICE. 

Would love to hear more. That doesn't make any sense at face value.  Nuplazid is the only AAP with an indication in PDP, but it is far from the lowest cost alternative.