> This is a really good article on the immune system.
I still don't particularly like it that much.
None of this should be all that new.
There were plenty of knowledgeable people saying all along that sterilizing nutralizing immunity in the mucosa was unlikely to be achievable for a vaccine against a respiratory virus that most commonly had no viremic phase, particularly as a shot given in the arm.
They were also saying that T-cells were the important thing to prevent disease and death and we shouldn't be focusing on preventing infection.
Some other people who debated or disagreed with that perspective are now suddenly learning novel new things about the immune system. There's a good chunk of experts out there that were saying this all along though (if you were listening to them and not the headlines and blogs and twitter).
> There were plenty of knowledgeable people saying all along that sterilizing nutralizing immunity in the mucosa was unlikely to be achievable for a vaccine against a respiratory virus that most commonly had no viremic phase, particularly as a shot given in the arm.
You are absolutely right, this has been my experience too. Pointing out what you did about (lack of) sterilising and (importance of) mucosal immunity usually got you downvoted here up until recently. It doesn't matter what your political persuasion is (I am, or at least I was, going into the pandemic, a left liberal), the idea that the vaccines would end the pandemic if only enough people got 1, 2, 3 or more doses was gaslighting from the beginning, probably arising from flippant remarks from politicians when asked for target dates to lift lockdown restrictions - "when X% are vaccinated!". And the idea that this was never what was being said about them this time last year is also gaslighting that's happening right now.
The problem is that this is a very nuanced subject. Everyone thinks they know what's going on, because they've been told it's simple: get vaccinated/boosted, work from home and do as we say and this will all be over. Much of the data being used to justify this was one or more of badly collected, badly analysed or badly interpreted by dishonest politicians, journalists, scientists and members of the public pushing their own (or their bosses') agendas. Instead of opponents' arguments being heard and countered in public ("sunlight is the best disinfectant"), they have been deplatformed under the auspices of "public safety". Scientists have lost their jobs for saying something to counter the narrative - it has become illegal to disagree with the scientists the politicians listen to, under punishment of losing your livelihood. It has been a total shitshow that has exposed how corrupt the whole system is. It has made me quite depressed at how little we've apparently learned since the last century. I thought we were living in the age of science, but what we have right now is far, far from it; maybe we should call it the age of misinformation - driven by humans' psychological maladaptation to their own incredible invention, the internet.
Couldn't have said it better. When I had multiple smart people I knew in real life yelling what amounts to word salad at me about how I'm so misguided and horrible for asking basic questions about the data... ...that is when I knew this whole thing was gonna last a long time and devolve into a complete shitshow. If people were allowed to express critical opinions and the general public was made aware of the actual numbers regarding covid risk we would have never done any of the things we did over the last two years.
These anointed "experts" still have not told people to chill the fuck out about covid and children. We have two years of publicly available data saying they are at virtually no risk. Yet the CDC and Fauci both act like covid is some kind of grave danger to children.
Dig deep enough into most of the pro-"what we've done"'s arguments and they are nothing more than thinly disguised appeals to authority.
I find peoples' reactions to this to not be a new phenomenon, but I do have the pandemic to thank for making me far better at identifying such personalities and not letting myself judge the person having them. In my experience it's pretty rare to find someone capable of removing emotion from an argument. Perhaps 5% of people I know are capable of this. The other 95%, given enough debate, put you in their idiot or "basically Hitler" box and cease to listen to or respect anything you say. This makes me very sad, because we've got other huge challenges needing faced as a species and I can see the same crazy nonsense we've seen with COVID happening for all of those too. Before we can begin to fix real issues facing civilisation, we're going to have to fix our ability to tolerate and debate arguments we disagree with.
One thought I had recently is how up and downvotes on sites like HN must contribute to tunnel vision in debates. I know I have self-censored in the past knowing that something I would say would get downvoted into oblivion, and I've posted stuff that hasn't been very constructive but that I've known would be a crowd pleaser. This surely creates echo chambres resembling the opinions of the loudest in the community. Old vBulletin-style forums before likes and up/downvotes were a thing, where all you could do was quote-reply (and one-word "+1" and "disagree" replies were brutally deleted by zealous moderators), were perhaps in hindsight the closest to optimal we ever reached in the realm of textual online debates. What a sorry state of affairs.
Thanks for sharing your thoughts and also how it makes you feel. In Jan 2021 I had become “intellectually lonely”. That was my feeling when I realized there’s almost no one left to have a productive conversation about COVID with. Also I realized how lazy most people are in just putting in even 1 hour of research that could change their situation dramatically (e.g. around supplementing vitamin D).
At the same time I started listening to many interviews with Daniel Schmachtenberger. Mindblowing, but also quite abstract. Rebel Wisdom does some work on the meta-level, i.e. how we can become better at sensemaking. Whether it’s around COVID or the next thing. And that for me is really the main takeaway from this pandemic. We suck at collectively making sense of complex threats and enacting good policies. Even simpler issues like statistical deaths due to air pollution most people don’t quite take for what they are.
I’d be happy to get in contact, I’m trying to figure out what ways there are to connect people and create a community that does high efficiency-collective sensemaking. Something that gives a good and balanced picture of status quo truth quickly. But also something that allows to progressively dig deeper into details.
If this resonates with you → gubikmic@gmail.com
Oh, and I totally agree about the message board presentation making a big difference. I posted a crucial comment providing the context to the JRE thing yesterday and it didn’t get any attention. But even on Twitter most people missed the context, so it’s no wonder our sensemaking is so inefficient. Imagine talking for an hour only to later realize the point of contention became 90% mute in the presence of a bit of new information. That’s how I saw this, but multiplied by thousands of people. What a waste of smart people’s time.
I'm glad I found this thread and thank you for not self censoring this time. I've very often done the same. And yes, the vBulletin style forums is something I really miss.
I'm curious what do you think should have been done differently?
my un-educated thinking is
(1) kids catch covid like everyone else, they don't get bad symptoms, but they bring it home and give it to their parents, grandparents, etc. I know 3 families where this happened. Kids got it first, passed it on to everyone else.
(2) lockdowns and/or similar measures, have been needed to keep hospitalization numbers at or below capacity. Some people claim lockdowns are about power but I see zero political upsides to lockdowns so it's hard to see how proposing them is a power grab.
(3) vaccinations, same as above, needed to keep hospitalization numbers at or below capacity
Note: My personal anecdata, my unvacced 79yr old father died from covid 2 weeks ago. His wife has had a harsh case as well but at the moment it looks like she'll pull through.
I don’t get it, there was some hope that vaccines could end the pandemic. They didn’t. But they still help, at least by making people much less likely to die. Is there something to be mad at? Hell, even if they ended up not helping much, I wouldn’t be mad at governments for trying. I must be missing something.
If the virus hadn’t mutated from alpha to delta, and then to omega — each of those could have achieved essentially hersd immunity. Unfortunately it mutated before we could tamp it down everywhere. That doesn’t make the people who said vaccines could end the mess wrong, just means we all got unlucky.
Even given (for the sake of argument) that there was cause for hope at some point, that's not an excuse to cling to that hope indefinitely, especially when it demands the violation of other people's bodily autonomy. That hope is dead, and people must let it rest.
More Americans died in the last month from Covid than died in the Vietnam war… to me, that’s an unacceptable toll. I get that people differ in that opinion but it can’t be too surprising that people really aren’t okay with that level of sustained death as the “end game” of this.
It won't keep up like this. It is inevitable that sooner or later everybody will have been infected at least once. Covid-19 will have become just another seasonal respiratory infection that everyone catches for the first time when they're young and the few bad cases will almost all be successfully handled with medicine. Some people may keep getting yearly vaccinations, like so many do with influenza. Most probably won't. Life will largely return to what it was, except for what our experiences during this time has done to our outlook in life.
This is the conclusion I have come to for myself. I got the initial COVID vaccine but the flu vaccine doesn't seem worth it for me and I won't be getting any boosters or further vaccines.
> but the flu vaccine doesn't seem worth it for me
Such a confusing, yet common stance. The flu vaccine is free, risk is essentially nil, and it reduces your chance of death across the board[1]:
> At a median follow‐up duration of 19.5 months, influenza vaccine was associated with a lower risk of all‐cause mortality (RR, 0.75; 95% CI, 0.60–0.93 [P=0.01]), cardiovascular mortality (RR, 0.82; 95% CI, 0.80–0.84 [P<0.001]), and major adverse cardiovascular events (RR, 0.87; 95% CI, 0.80–0.94 [P<0.001]) compared with control. The use of the influenza vaccine was not associated with a statistically significant reduction of myocardial infarction (RR, 0.73; 95% CI, 0.49–1.09 [P=0.12]) compared with control.
Let’s just leave it to health insurance providers to raise your premiums, then. If you believe in personal responsibility, that’s how the consequences of your decision will play out should you need hospitalization for your future immune-escaping variant infection.
Consider if your first impulse is to deny the possibility of that last point. You’re probably not an evolutionary virologist, so the truth is you have no idea which mutations are next. Perhaps you think T-cell immunity will save you, but omicron already escapes >50% of T-cell antibody types in 21% of vaccinated or infected people. Will we develop better cross-neutralizing antibodies from omicron or will antigen imprinting doom us to suffering wave after wave of new variants, due to maintaining variant-specific immunity only?
I bet that feeling of self-righteousness is satisfying, isn’t it? Perhaps that’s because blaming other humans subconsciously lets you continue the illusion that humans were ever in control of the pandemic in the first place or that a real risk ever existed for you. Anger is a lot more comfortable than existential anxiety.
But the truth is, it’s not “the man” who’s keeping you down at all — the pandemic limitations you feel right now are the libertarian equivalent to your fist being restrained from meeting your neighbor’s nose.
Due to the Affordable Care Act (Obamacare), medical insurers aren't legally allowed to set premiums based on vaccination status. But I would still encourage everyone eligible to protect themselves by getting vaccinated regardless of insurance issues.
>Cellular immunity is highly durable and effective.
The question is not how long the immunity lasts (based on original SARS patients, probably multiple decades to a lifetime), but whether affinity-matured T-cells can sufficiently cover the antigen-space of future ACE2-binding spike proteins.
Somatic hypermutation might still be too complex to model computationally to answer that question outright.
Do you know whether this question is answerable in another way?
It’s just very difficult to make people care about the flu. It’s something they might experience a couple times in their lives and no one really expects to die from it.
It’s impressive annual vaccination rates are as high as they are.
The fact that the group of participants in the study was of a certain age range means that the study says nothing about the result for people outside of that age range.
Much more and better explanation about flu shots here:
That's exactly what I'm saying. The study tells me something about that age range, and nothing about anyone else. So it tells me that it's a good idea to get a flu shot when you reach that age range. What exactly are you trying to say???
> So it tells me that it's a good idea to get a flu shot when you reach that age range.
No, that's not what it tells you. Really, I can't help you if an article that spells this stuff out in great detail results in a response that indicates that you have not understood it, they spent a lot more time on this than I will be able to do in this context.
... The study subjects were in that age range, were they not? I truly don't understand how you could draw conclusions about how a young person should approach flu shots from this study, and I'm not approaching this from a malicious place. If you're not going to converse in good faith, this is probably not the place for you.
Not anti vax, not that it should matter for this argument.
The one part you left out is that there is a genetic component, so the first few ways were a form of selection against people who couldn't handle covid. It seems likely the the remaining population is much less susceptible to dying in future waves.
Flu would have looked like this the first time around, except when it arose, people didn't fly around the world or even really move a few miles from their home most of the time, which acted as a natural way to reduce outbreaks.
What months? Months after omicron appearance? It has been here just about 2 months and boosters are still important because even though omicron is very fairly different from each previous variant we know, vaccine induced immunity still can recognize it after being boosted (it is related to antibody affinity if you want to know more).
Most importantly, vaccine induced immunity still protects against severe disease that requires hospitalization.
More importantly, if the herd immunity is the question - omicron and vaccination might provide very robust immune protection.
Another thing to keep in mind - because omicron was so successful, it may have blocked the appearance of a new variant that is a derivative of it and the next similar variant that might appear that is neither some pre-omicron derivative nor close to omicron.
Vaccination with the original variant is not a bad bet because it is most likely just in the middle of every possible derivation from it.
What's more, before omicron it was a pretty reasonable position to conclude vaccinations were ending the pandemic. By that I mean... That is a very reasonable position to hold only 3 months ago.
And I still think the vaccines are substantially accelerating the end. So I'm not even sure what the complaint is. That it isn't the only factor? Sure, but it's a huge one, and one of few that we can control.
It wasn't a reasonable position since we've known cats and dogs (and everything else) could catch it. (Among other reasons, but this is the most obvious for anyone even slightly familiar with previous vaccination efforts.)
For a virus that supposedly just jumped from wild animals to humans, it'd be irresponsible to simultaneously think it couldn't happen again from any of the number of species potentially acting as reservoirs.
Unless there's been new information in the past few weeks I haven't seen, one of the strongest theories about Omicron is that it's a hop back from rats that had been infected with Alpha.
Vaccines are still going to end the pandemic earlier with an enormous amount of lives saved.
But, you need to stop equating ending the pandemic with eliminating the virus.
After the pandemic ends the virus will be with the human race for the rest of our natural lives most likely.
We live with HCoV-229E and HCoV-OC43 and all of us catch that and nobody considers the pandemics that started transmission of those viruses in the human race to still be pandemics.
When the disease burden drops sufficiently then the pandemic is over. Vaccines reduce the disease burden dramatically.
> What's more, before omicron it was a pretty reasonable position to conclude vaccinations were ending the pandemic.
I've not seen a convincing argument against simply looking at excess deaths. This avoids all of the problems around classifcations of deaths with/from COVID, vaccination statuses, etc. It's much harder to disguise deaths or lack of deaths. EuroMOMO [1; scroll 60% down to the z-scores] shows excess deaths in Europe basically went back to normal in most countries after the European wave in spring 2020, long before vaccines were available. This was the case despite widely varying levels of lockdown stringency - with at least one country, Sweden, not doing any significant locking down at all. And many countries' peaks at this time were, if you scroll back in time, comparable in magnitude to excess deaths during previous winters. If you draw a line in your mind down the various countries' graphs at early 2021 when significant fractions of the populations of these countries were starting to get vaccinated, you will probably struggle to determine that they've had any real positive effect at all. Once you do that, consider an alternative hypothesis could better describe the data, for example that the virus is highly seasonal and we have very little control over it. Now, a bonus: change the age group from "all ages" to younger cohorts and observe that in many countries excess deaths did not shift from resembling noise during the entirely of the past 2 years. There are even some countries, not known for being paragons of good health such as Scotland, that barely saw any out of the ordinary excess deaths in the young during the whole period. I think people seem to think things are far worse than they actually are in most countries because of the panic created by media and politicians. This is why I am very unconvinced by the argument that vaccines have been helping to end the pandemic, at very least amongst most of those who have been locked down. It seems much more reasonable to me that other factors are at play here.
After you’ve had a bunch of excess deaths (of the oldest and most vulnerable) wouldn’t you expect it to go below normal after that? Isn’t staying above normal still indicative that lots of excess people are dying?
No country was even close to what you could call significantly vaccinated until mid-2021. The winter 20-21 wave is almost entirely unvaccinated populations.
The winter 21-22 is now mostly vaccinated and, surprise, it’s much lower (and unvaccinated are still the majority of deaths).
> I've not seen a convincing argument against simply looking at excess deaths.
The upset from lockdowns and delayed or canceled treatments/surgeries is why. I don't think we have final numbers for 2021 yet, but the numbers from the US in 2020 showed a jump in non-covid deaths about half as big as covid deaths.
Cancer didn't have a big jump that year, but it is one of the things that got postponed diagnoses and treatments, because it doesn't kill immediately so it's not an emergency, so one expectation I've seen is for it to spike in 2021.
And there will be a long tail of death and shortened lives that haunt the entire generation of young people these public health policies fucked over. And the worse part is the spite, hatred, and bullying anybody who expressed any concern got. Especially when the evidence is increasingly showing virtually all of our panicked reactions didn’t really do a god damn bit of good against Covid.
This outcome was obvious to anybody paying attention in the beginning.
> I've not seen a convincing argument against simply looking at excess deaths.
You do not see it? I see a long fat tail there.
There were 131500 excess deaths during weeks 1-8 and 230000 after that. Does it sound normal to you?
And for every age group below 65, 2021 has been worse than 2020 and worse than previous years except 2019 for 0-14 that was even worse than all pandemic years.
Are you intentionally blind to this?
You appear to think that we can somehow take each age group and somehow handle them much differently. Practice has showed that we all are connected.
Why are we getting such runover by omicron - kids in the schools and kindergartens. I do not blame them, it just is like it is.
when you say "it's seasonal" what do you mean? It certainly is not a "winter" thing given that until omicron, Japan's highest numbers were in the middle of hot and humid summer.
You are missing the fact that the government and the media has been consistently dishonest and/or wrong at virtually every stage of the pandemic but they still act as what they say is sacrosanct and anyone that questions their edicts is committing some terrible sacrilege. People are also tired of the burdensome restrictions that are entirely performative (like masking in general) and harmful (masking in schools, especially among young children. Anyone who has eaten dinner in a packed restaurant with 200 other unmasked people but is then required to put on their mask for the 10 foot walk to the bathroom knows exactly how ridiculous and useless these restrictions are.
Wrong? of course, it's hard get things right when hit by a new virus, with lot of unknowns. We still don't fully understand how it transmits, why it's so harmful compared to common cold, etc. Dishonest? I'm not so sure.
You say "they still act as what they say is sacrosanct and anyone that questions their edicts is committing some terrible sacrilege". I'm sorry I don't get what you're trying to say here. You can say this about any law. You're saying they act as if laws were important and needed to be unforced.
Finally, of course laws are "dumb", they are binary, you can ridicule any law by pushing it to its limit. Driving on this road at 100 km/h is legal, but suddenly at 100.001 it's illegal?? so yeah, when you're exactly in between a place where you must wear a mask and a place where you don't, it's as ridiculous as... any law really.
People in general can’t look at things as systems or have any understanding of probability or nuance. So trying to communicate a clear message to get people to voluntarily perform a pro-social action that doesn’t have 100% certainty turns out to be incredibly difficult. Mix in that most Western countries are highly individualistic, the existence of anti-vaxxers, the spread of things like QAnon and it’s an up hill battle.
I’ve heard engineers complain saying things like “I got the vaccine, how come I haven’t gotten all my freedoms back yet? Why did I bother?” in the middle of an out break. The people whose job it is to look at complex systems fall short. Maximising their chances of getting severely ill is seen as an inconvenience.
Nobodies pissed at the government for making vaccines available, they are pissed that they are having their livelihoods threatened based on false premises.
Doesn't matter if the pandemic ended or not. Society (or at least the politicians) chose to regress. The virus is a virus. It doesn't tell us how to react to it. We do.
Many states didn't regress during delta. They kept calm and carried on with normal. Only some states decided to regress. And the outcomes are almost identical--in the same ballpark at least.
Mask mandates say “vaccines dont work” and “stay scared”.
They are dehumanizing.
Besides it doesn’t matter what you think about masks. The fact that many people resent wearing them is reason enough to rethink forcing people to wear them. We do live in society and not everybody considers Covid the only problem in existence. Especially post vaccine.
Maybe people want to move on? Mayne those people have incredibly valid reasons for they wish? Maybe the government should respect that?
It's a piece of cloth worn over your nose and mouth. How fragile is your sense of humanity?
> Besides it doesn’t matter what you think about masks. The fact that many people resent wearing them is reason enough to rethink forcing people to wear them.
I don't like wearing shoes, but that doesn't make shoe mandates (which are totally a thing, but only private businesses, not by government order) dehumanizing.
> We do live in society and not everybody considers Covid the only problem in existence.
Is that straw man dead yet?
> Especially post vaccine.
On this point, I actually agree. Would vaccine mandates be acceptable instead? It would be much more effective than mask mandates (which, while I have no real problem with them in principle, don't actually work that well because so many people don't wear them correctly).
What about a mandate against wearing shoes, when many are more comfortable wearing them? I think the argument here is that any mandate beyond the bare minimum is harmful to freedom. Just because you don't mind wearing a mask doesn't mean others can't.
I say this as someone who doesn't mind masks and wears them often.
If not wearing shoes was potentially helping health services to keep being functional, then yes it would make sense to mandate it. Harmful to freedom? What about the freedom of having functional health services? I keep hearing about freedom but freedom isn't about doing whatever we want, we also have to consider the freedom of others not to suffer from our actions. I consider my suffering of wearing a mask laughable compared to the suffering of people unable to get health care when their life depends on it. I'm happy to wear it even if in the future it turns out they weren't helping significantly.
> I'm happy to wear it even if in the future it turns out they weren't helping significantly.
I guess that's where we differ. I believe we should make our best decisions based on what science predicts. If there's unlikely to be a significant benefit, some are not happy to wear it. You are, but that's a personal choice.
There are lots of sacrifices we could make that would have an immediate and more tangible impact on health outcomes. Outlaw motor vehicles, mandatory vegetables, end alcohol sales. We don't do that because it would piss people off.
Edit: since we already asked you twice not to do this, and you've continued, I've banned the account. If you don't want to be banned, you're welcome to email hn@ycombinator.com and give us reason to believe that you'll follow the rules in the future.
Just curious, but would you feel comfortable elaborating on how? I haven’t found them all that bad personally, but maybe there’s something I’m not as attuned to.
Not everybody considers Covid the only problem in existence? Sure you can consider whatever you want, but hospitals being overrun and barely able to provide not-covid-related health services is the reality some people keep ignoring. Maybe people want to move on? Sure we all do, but... you know... health services can't just "move on"...
and your argument amounts to bullying. It doesn’t matter why I dislike masks. I don’t want to wear one. They are a medical device that I’d rather subject myself to no matter the risk it puts me in. And you have no right to force me or bully me or call me names.
Masks turned a swath of a particular political party into some seriously sanctimonious assholes.
> And you have no right to force me or bully me or call me names.
Sure we do. The word "quarantine" comes from the fact that during large stretches of human history we'd isolate people before entering new cities for the objectively true concern that they're bring in new pests. My grandparents traveled to the Americas from Europe and had the vaccination cards, had thorough medical examinations, and had to quarantine after coming from a ship full of sick people.
The entire history of human civilization is one big narrative of hygiene management. Sewage, water management, waste management, disease control.
I like my civilization more than I care for the whining of people ignorant of the unthinkable amounts of pain that diseases have caused. So, yeah, no problem calling you names, some people need to be reminded of their own ignorance every now and then.
At this point there's no valid scientific or medical reason to continue with mask mandates. I recommend listening to UCSF infectious disease expert Dr. Monica Gandhi who provides a clear explanation of the current situation.
Because masks never really made any statistical impact on the virus spread, so requiring them at this point means you’re not following the data you’re following something else. (I was pro-mask for a while before we had data)
Yes, compliance and knowing how to wear a mask has been an issue. That's not the same thing as "masks don't work."
This is a random place to put this, but I just want to point out that I think for the most part even mask wearing is not required anymore (unless you are sick, but why are you going anywhere sick?)
Part of the reason I put it here is that I want to make sure it's understood that despite the fact I'm pretty pro-vax, pro-mask and generally supported the lockdowns at the time -- we're past all that for now with Omicron. Things are still a mess, and the facts on the ground could change, but I think it's important that everybody gets on the same page that we're moving on.
The surgeons already know. Since the 1990s, there has been a general movement away from using surgical masks in the OR, due to accumulating evidence that they have no effect. (For example, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480558/)
That link doesn’t indicate “accumulating evidence that they have no effect”, and the link explicitly states “it would be imprudent to recommend the removal of facemasks from surgery”.
It is a literature review that didn’t find strong evidence for surgical mask effectiveness more because it hasn’t been researched deeply. And it notes that the absence of evidence does not indicate ineffectiveness of surgical masks, and rather a more significant research trial would have to be performed (and there were caveats to the feasibility of doing that as well).
Specific quotes from that article:
“What literature that is available on the subject tends to be dated with poorly explained methodology. There is also uncertainty over whether the results of such studies can be extrapolated to current surgical practice given the advent of new antiseptic techniques since they were completed.”
“It is clear that more studies are required before any absolute conclusions can be drawn regarding the effectiveness or, indeed, ineffectiveness of surgical masks. The published literature does suggest that it may be reasonable to further examine the need for masks in contemporary surgical practice given the interests of comfort, budget constraints and potential ease of communication, although any such study would undoubtedly have to be large and well controlled to prove causality given the low event frequency of surgical site infections.”
“It is important not to construe an absence of evidence for effectiveness with evidence for the absence of effectiveness. While there is a lack of evidence supporting the effectiveness of facemasks, there is similarly a lack of evidence supporting their ineffectiveness. With the information currently available, it would be imprudent to recommend the removal of facemasks from surgery. Instead, in the medical field where common practice can so easily become dogma, it is necessary to recognise the constant need to maintain a healthy scepticism towards established beliefs and to periodically re-evaluate and critically assess their scientific merit.”
The selected quotes misrepresent the thrust of the article. From the abstract, "...overall there is a lack of substantial evidence to support claims that facemasks protect either patient or surgeon from infectious contamination."
At the end, they take the stance that while evidence doesn't support any benefit, it doesn't indicate harm either, so might as well continue using masks.
The most frequent complaint is that most research on the subject is not high quality, but what about those studies that are good? The most thorough clinical study is Tunevall (https://pubmed.ncbi.nlm.nih.gov/1853618/), which clearly supports no benefit. There are apparently no high quality studies that support benefit.
Not really. I'm saying masks work and mandates are necessary public health policy.
Regardless of a mandate, people will do what they do even if it's not in their best interests, or in the interests of their loved ones, or the interests of their neighbors. They will smoke in public places, they will goto work sick, they will drive drunk. Frankly put, people can be jerks. So you put a mandate out there, and you do your best.
Masks work. In areas where mask utilization is high, there is good air filtration and people follow distancing rules, the spread is slowed.
As somebody who works with immuno-compromised patients, where wearing masks was already common before the pandemic; This reminds me a whole lot about original resistance against hand washing [0]
Some measures are simply common sense practices and don't need an overwhelming amount of scientific studies to justify them. Particularly when the drawbacks to them are so minor, while the potential advantages are huge.
> Particularly when the drawbacks to them are so minor, while the potential advantages are huge.
Does it justify mandatory wearing of religious symbols and tattoos? After all, there are almost no drawbacks, and "potential" advantage is even bigger. It was considered "common sense" for millennia.
Before COVID-19, we had extensive analysis of previous pandemics, with the consistent judgment that public mask-wearing had no noticeable effect. For example, the DoD commissioned a study of the 1918-1920 pandemic. (https://news.ycombinator.com/item?id=30179067)
What data do you have that show that masks don't have a statistical impact on spread, mortality, or both? Has this data been corrected for confounding factors and made widely available in replicated, peer-reviewed studies, or did you have to spend a half hour cherry-picking Google results to find it?
The latter question sounds insulting and dismissive, but it's actually posed in good faith. It highlights a genuine epistemological problem about the nature, limits, and validity of our knowledge about the pandemic. I can find studies on PubMed and elsewhere that back up virtually any belief, prejudice, policy, or therapy that I like. So can you. Where does that leave us, except with the obvious solution of trusting our local, state, and national health authorities?
> What data do you have that show that masks don't have a statistical impact on spread, mortality, or both?
From the 1918-1920 Spanish influenza pandemic onward, public health agencies have evaluated the effects of mask mandates and other non-pharmaceutical interventions. The consistent result of these epidemiological studies has been failure to detect a positive effect. A typical review article, which was I think the most quoted up until 2020 is Cowling (https://pubmed.ncbi.nlm.nih.gov/20092668/).
From the discussion:
In conclusion there remains a substantial gap in the scientific literature on the effectiveness of face masks to reduce transmission of influenza virus infection. While there is some experimental evidence that masks should be able to reduce infectiousness under controlled conditions, there is less evidence on whether this translates to effectiveness in natural settings. There is little evidence to support the effectiveness of face masks to reduce the risk of infection.
It’s not my job to prove masks don’t work. That isn’t how science works. It’s your job to prove masks are worth their costs to society. It’s your job to prove that I need to be forced to wear one for two years now.
I see virtually no evidence that suggests masks do anything meaningful to the spread of Covid—especially enough to justify forcing service workers to wear them 8 hours a day, 5 days a week for two years straight. Especially now that anybody can get a vaccine. Why should service workers be required to wear them? To protect fully vaccinated people who are still afraid of Covid? Seems pretty selfish to ask that if people. Especially when service workers get bullied and gaslight by rich tech workers who think “masks are virtually costles” while their only time masking is their 1 hour weekly trip to the grocery store…
These Covid measures are nothing more than forcing the lower class to protect the upper class (or at least pretends to. It’s all theater and we all know it). It is incredibly privileged to support any of the nonsense we’ve mandated the last two years.
I don’t care if they work or not. Public health officials get to communicate health information. They don’t get to force the population to wear masks for 2 years. That isn’t their job even if you or they think it is.
You might love masks but not everybody feels the same way. Leave people the hell alone.
Your perspective is valid, but it exists on a continuum. It's clearly possible for the "I have the right to be the next Typhoid Mary" perspective to be carried too far. That's the whole dilemma in a nutshell... how far is too far? I'm not qualified to say, and it looks like you aren't either, given the lack of actionable guidance you're offering.
"Leave people the hell alone" isn't an option, because you live in a populated, civilized nation rather than on a deserted private island. (I will note, however, that they won't shoot you at the border for trying to leave.)
I’ve never taken the argument to be that children are at grave risk. I think Fauci even said that the risk is minimal in particular with vaccines. “The with vaccines” will rub some folks the wrong way but the point remains: it’s about potential transmissions, asymptomatic transmissions at that. They so rarely even show symptoms that some are convinced that kids aren’t infectious but that’s the same nonsense we have today where people think they aren’t infectious because they got the vaccine. Add in tight conditions at schools and parents willing to send their kids to school sick, and it’s not ideal.
So what if kids transmit? Everybody age five and up can walk in and get a vaccine. Who are we protecting? Transmission doesn’t matter in a post vaccine world.
Besides, asking kids to sacrifice their one and only childhood to protect fully vaccinated adults who are still afraid is a horrific public policy. Kids should never be asked to sacrifice for adults. That just isn’t how things work.
No, it’s the forced isolation and fear that’s sacrificing childhoods.
All over DFW superintendents are resigning. They see the damage they’ve done and are jumping ship as the chickens come home to roost. I suspect all over the nation school and county health leadership are getting out before the full scope of the damage they’ve caused is realized.
> they've been told it's simple: get vaccinated/boosted
It is that simple.
90% of the people in the hospitals are unvaccinated still.
Cut the unvaccinated fraction of the population down by 1/3 and you cut the hospitalization rate for the next wave by roughly 1/3.
Instead people are doing T-cells/B-cells and affinity maturation the hard slow way.
If we had a 100% vaccination rate we'd be done.
Don't know why everyone so desperately needs to look for counterintuitive ways to approach the very simple problem that when there's a global pandemic you mitigate it with vaccination. Any other result is intellectuals thinking too hard to try to impress themselves and probably missing basic facts in the process.
Even during the height of a COVID surge, the total hospitalizations is maybe 20% higher than normal. Also note that as COVID hospitalizations increase, regular hospitalizations decrease. This is a consequence of the dishonest reporting criteria encouraged by the CDC; people are hospitalized for unrelated reasons but happen to test positive for COVID so are counted as a COVID patients instead of regular patients. See, for instance: https://www.dailywire.com/news/massachusetts-now-differentia....
You can also web search for hospitals being overwhelmed by the flu. In a few minutes I found this happening in two different years: 2018 and 2000. The reality is that hospitals get overwhelmed very easily for a number of reasons. Even if you vaccinated everyone in the U.S., they would still get overwhelmed during surges. In other countries with higher vaccination rates, hospitals still get overwhelmed and primarily with vaccinated people: https://www.npr.org/sections/goatsandsoda/2021/08/20/1029628...
The reality is that this pandemic is over as soon as we make it over. My family has been living a normal life since October 2020.
Thanks, glad to know that the wait times my family has spent with my grandparents this past couple years when they needed to go to the hospital was all in our heads.
Not to belabor the point, but it seems like you're talking past me, not against me. I said the hospitals would be overwhelmed even if everyone got vaccinated, not that they weren't overwhelmed.
There are some good arguments that current hospitalization metrics are misleading and underestimate the healthcare workload. Delayed treatments or patients who cannot access treatment may be a more useful metric to measure how overwhelmed a healthcare system is.
I noticed the hospitalizations graph on my favorite source for Texas (Texas tribune) now reads “Total current patients with COVID-19 in hospitals”. That’s deceitful in my eyes because that includes anyone in the hospital for any reason who tests positive and not people only hospitalized because of Covid-19 which is what you’re expecting.
Also, the whole ICU capacity percentage numbers inducing so much fear and panic are very misleading. ICU capacity isn’t static it can be adjusted up and down. So saying ICU is at 98% capacity utilization is meaningless because it could be very well possible that ICU beds can be added and now ICU capacity is 75% utilization.
Vaccines are shown to reduce cases of serious symptoms and hospitalization. Yes, even if everyone is vaccinated is possible for hospitals to still be overwhelmed if infections spread too quickly (hence things like distancing still being important), but even in that case, you’d have less people needing hospital attention that are unable to get it.
The overall goal of our societies, as I see it, is returning to living our lives as normal and killing the fewest people in the process. Reducing hospitalization rates means that more exposure can safely happen before hospitals are at risk. When they come close to being overwhelmed, additional restrictions on gathering will probably need to be reemployed until the risk subsides again.
These risks are also very local (more local than state) and personal. So it’s perfectly reasonable for the pandemic to “be over” for some where the risk is low, yet not for some where the risk remains high.
No, the current status is that we'll be done if and only if we reach acceptance of a situation that is not going to go away anytime soon. The only thing stopping us from being done is in people's heads.
My government has spent hundreds of billions to prevent "the health care system from being overburdened". Not a single cent of that money went into the healthcare system. In fact, the systematic reduction of "healthcare overcapacity" was continued throughout. Our politicians are either remorseless criminals or fantastical dunces. Either way the world would be a better place if they were removed from power, one and all.
>The only thing stopping us from being done is in people's heads.
Of course. The actual political debate in the US is whether society should accept and normalize daily mass death. If we applied today’s standards, 9/11 would have been a non-issue. It’s only about a days worth of covid deaths, after all.
No amount of vaccination will avoid everyone getting infected sooner or later. The vaccinated who die will have died with vaccination mandates or without them. The unvaccinated who die fall into two groups. Those who would also have died vaccinated and those who do so as a consequence of their own choice. That's neither my business nor yours, it's theirs alone. We may argue with them, but we can't force them and claim to be more moral for it, quite the opposite in fact.
> Those who would also have died vaccinated and those who do so as a consequence of their own choice.
Their choice has a direct effect on society and causes harm to other people. So no it's not as a simple as.
I guess we could deny the unvaccinated medical care in hospitals. Because they take up ressources that would be spent on people with other medical issues. We have an about 70% vaccination rate and 80-90% of hospitalized covid patients are unvaccinated. Meanwhile I know of people that can't get standard procedures done because of covid patients (this wasn't a problem before the pandemic).
Due to EMTALA, hospitals are legally required to care for any patient who arrives in unstable condition regardless of vaccination status. But I would encourage everyone eligible to get vaccinated as it reduces the risk of hospitalization.
An overworked ER Nurse who just can't take it anymore may decide to not update a patient's medical record when a patient is in decline and instead will simply discharge the patient. If the Patient dies at home, the medical records will not indicate a decline, therefore no EMTALA violation. That is how my Mother was basically manslaughtered by West Hills, CA ER back in March of 2018, right in front of my own eyes. I still have PTSD from the incident. After Mom died at home in my arms without ever having been treated for her pre-pnemonia, NOBODY would investigate. How cruel and complicit is that?
Your comment implicitly assumes that vaccination is the only possible way to reduce death, but we have many other interventions that we can choose to prioritize as a society:
* Mandate a minimum # of nurses and pay them fairly. Patient survival depends on nurses being able to do their jobs, but hospitals seem to prefer saving money by cutting staff.
* Improve society’s overall health by reducing inequality. Lives have intrinsic value that transcends any economic or profit-based calculus. We consider mass death unacceptable because we recognize this basic truth.
* Make paid sick days and short-term disability more accessible. It can take weeks to months to properly recover, depending on severity.
* New building regulations in public spaces to lower the viral inoculum (correlated with severity) using tactics such as improved ventilation and 222nm UV lamps.
* Ensure access to the basic necessities: healthy food, housing, healthcare. You can’t survive a covid infection if you’re dying of exposure on the street.
>Your comment implicitly assumes that vaccination is the only possible way to reduce death
No, this was a discussion about 1. the claim by others that vaccination would be the key to "end" all of this and 2. my complaint that not a single cent of many 100s of billions my government spent on all of this went into health care.
I would very much have liked if we had spent more money on nurses, and into making their work as easy as possible by allowing them to concentrate on their core competencies and offload the easier parts of the jobs onto more nursing assistants, which can be trained relatively quickly. Alas, we didn't, and here we are!
There's no real argument for continued restrictions beyond hospital capacity (and even that one is a stretch). Why not spend money on that and open up the economy again?
In France, between January 1st and 16th, vaccinated people accounted for 60% of the new hospitalizations. We, like most of Europe, have 90+% of adult population fully vaccinated, and are nowhere near "being done".
90% sounded high; I found an article saying as of today 79% of people in France have had both of the initial shots (not sure how they figure single-dose vaccines like J&J and Oxford), and 80% had 1. [1]
Let's say it's 80%. 80/20. Primary vax status probably hasn't changed too dramatically in 1 month.
p (hospitalized | unvaxxed) = p (unvaxxed | hospitalized) * p(hospitalized) / p(unvaxxed)
= 0.4 * p(hospitalized) / 0.2
= 2 * p(hospitalized)
Vaccination gives a 2.67x reduction in hospitalizations (against omicron which all the anti-vaxxers are saying the vaccines don't do anything against).
With your 90% figure, it becomes 2/3 instead of 3/4 and 4 instead of 2, which is 6x, confirming what the other replier got.
In the most relevant age group 60+ the reduction in hospitalizations is 83% for double vaxxed and 95% for boostered in Germany according to latest figures:
Unless we can get stats for who's eligible or not eligible for the vaccine when they're hospitalized for COVID-19, what can be done with that extra distinction?
Same with age and risk-factor cohorts. We could repeat the probability calculation for each cohort if we could collect those data, but it would probably make the vaccine even more effective: Presumably, more higher-risk people are double/triple/quad vaxxed at this point, so whatever rate they show up to the hospital is higher than what the average healthier person could expect.
We know that for a long time. I'm just saying that despite having 93% of the adult population vaccinated (-18 yo do not need the vaccine pass to go anywhere) , and our ICU beds occupation rate being only 70% at the highest omicron peak, our politicians still refuse to call it an end.
"Being done" with covid is only a political decision, and no percentage appears to be high enough for them.
This is true but slightly misleading : if 100% of the population was vaccinated, 100% of hospitalizations would be amongst vaccinated people.
They would be a much smaller and manageable number, and on average much older/vulnerable than they are now (vaccination basically lowers your risk to that of someone 20-30 years younger)
More figures from France : the unvaccinated 8% account for 39% of hospitalizations, 54% of intensive care admissions, 46% of Covid deaths.
This is a hugely outsized effect, so there's still enormous potential for drastically improving the situation in hospitals with just a few more percentage points of vaccinated people.
Current numbers are already manageable. At the Omicron wave peak, total ICU beds are 70% full. And recent (official) data shown that 30% of all COVID positive hospitalizations were actually unrelated to COVID, that number being as high as 50% for 0-49 age group. Yet our politicians refuse to drop restrictions, they even doubled down by making vaccination mandatory to go anywhere, when a negative test used to be enough.
I said "if we had 100% of the population vaccinated we'd be done" and I meant it.
I didn't mean 90%.
If 5% of the population is susceptible that's enough to overload the hospital system during a wave. It really doesn't take much with this virus.
And Delta's transmissibility really destroyed the destroyed the notion of herd immunity. The correct number should be 100% vaccinated.
And its still 90% unvaccinated people filling up the hospitals, even though you're highly vaccinated.
Once you hit the hospital percentages matching the population percentages then the "natural immunity" enthusiasts will have finally all basically caught it sufficiently to gain immunity the hard way and it'll be done.
This sounds like Simpson paradox again. It happened in Israel.
People with weakened immune systems and other health issues are more likely to be vaccinated. But they're less likely to have a robust immune response to the vaccine.
For a vaccine that doesn’t confer sterilizing immunity and whose effectiveness wanes rather quickly? To say nothing of variants or the fact that this virus has animal reservoirs. Or the impossibility of vaccinating 100% of a population in the first place, nevermind in perpetuity.
in my country the official figure is that "90% of hospitalized are unvaccinated or vaccinated without a booster". this certainly sounds like a doctored phrase and it dilutes trust to the medical system.
It's simply accurate, and reflects the dramatic difference in vaccine efficacy between 2 and 3 doses (or rather, between a recent or more distant dose)
The problem with that narrative is that it absolves responsibility for further action by pretending that the vaccines are the best we can do about this pandemic. It becomes a show and that's not good
Because of the sheer numbers the amount of vaccinated still are the majority in the hospital. You rate of going to the hospitalization is lower, but the raw numbers show more people in the hospital that are vaccinated.
The people are are unvaccinated in some cases have medical reason not to be and therefore be more likely to be hospitalized for anything. You'd need to stratify the numbers by age, vaccine status, and comorbidity status to get the full picture.
Early on when the 99% are unvaccinated line was going around all the data used was usually from before the vaccines were available.
The epidemic will be over when COVID-19 IFR will drop below acceptable level, even when SARS-CoV-2 will continue to circulate. I.e. when covid will be like regular fly, nobody will worry about it anymore.
Is it wrong?
There are two main strategies to achieve low death rate:
1) Natural — let weak people die. Cheap.
2) Semi-natural — let weak people to be infected, then try to rescue them. Costly.
3) Supportive — support weak people with vaccines, to help them survive. Costly, but cheaper than (2).
I havnt watched TV since the 2017 elections. Ive missed on everything including bushfires, natural disasters, pandemics, and capitalism.
I can see clearly how the system works. I said i wouldnt watch a single news report (including Covid) until it was a "highlight reel" and man o man has mainstream society lost its glammer. its a machine, where the capitalists and poilticans jockie for your money using the power you can give them against you while smiling into the camera and saying they love you.
FAANG you up the ass at every chance they get. Even the celebs are pawns, reliant on the ad companies for there bread and butter.
ive never been free-er. I had my covid (health issues) 15yrs ago and realised that day that life was precious and u should not take it for granted. I quite everything, travelled the world, and experienced modern society in all its wonder. I met people everyday who wished they could quit and travel like me and i told them, you can.
Unfortunately humans are not capable of infinite growth in a world where nature is being processed into profit in a constant grasp of more and more. Nature imposes its own limits. Virus are part of the moderisation game. They are a cost of buisness. Like our parents generation where the WW1/2 and The depression scared and and shaped them (and created this system), our children will be scared by the unresolved trauma their parents experienced during Covid.
It certainly undermines the "Check out how rational I am" veneer this person is peddling. I also don't understand the overall argument - is the anger that someone out there thinks they're more protected via vaccine than they are? The message that I think most lay people that are pro-vaccine have in their heads, at least those in my social circle, is merely that they help. They reduce the risk of infection and if you get infected they reduce the chance of hospitalization/death. Those things are true. But the gp commenter seems to want to frame the pro-vaccine as being duped idiots. That's not accurate. Their comments have the energy of "Vaccines work, but not the way you think, so vaccination efforts are unnecessary" without saying it outright.
You are quite right, but the media, the government, and many public health agencies have been ignoring this, focusing solely on antibody levels, and trying to keep them constantly high through ever more panicky calls for more and more boosters. For everyone, regardless of prior infection.
One, measuring antibodies is MUCH easier than measuring T or B cell response. This is especially true early on in the pandemic, if you want to measure representative numbers of people, and you don't know when/whether they will be exposed or catch COVID (due to masking/lockdowns etc).
Two, when your problem is that the hospitals are filling up and you're facing a labor shortage for some essential workers for a a few months... then boosting antibodies for 4-6 months to reduce retransmission rates and minimizing symptomatic cases makes a lot of sense.
The process of hypermutation and affinity maturation takes months to finish. The initial immune response to a pathogen is poor and takes ng/ml of antibodies to neutralize the threat. The immune system essentially has a "budget" for antibodies and the early antibodies are poor and take up too much of that. Affinity maturation produces higher affinity antibodies that are effective at pg/ml but it takes months. But you can now "fit" many more kinds of antibodies into the bloodstream.
Hitting the mature immune response with a booster releases those high potency antibodies from germinal centers.
This is why nearly every single vaccine we give kids comes in a series of 2 or 3 shots spaced out over 6+ months.
The initial mRNA shots were way too close together and were done that way out of expediency since the second shot gave a lot better protection very quickly. It also allowed the trials to complete faster and probably saved 100,000s of lives. It was basically a "wartime" decision to slam shots into arms way too fast.
The increased affinity against Omicron after a booster is also something that shouldn't have been a surprise.
The utility of 4th shot boosters in non-elderly non-immunocompromised and chasing after the idea of reducing spread through infection is on a lot less firm footing. Even the booster-obsessed Israelis are finding in studies that it doesn't do much good. This coronavirus also is currently mutating too rapidly and infection too many people in each wave to be able to logistically update the vaccines for new variants, so it doesn't look very useful to be thinking of it analogously to the yearly influenza shots.
I agree with most all of that, and that it was largely unsurprising. When the mRNA shots were developed there was a tradeoff to be made (and BNT/Mod chose slightly different paths) on both amount of RNA and dosing schedule to minimize side effects while rapidly providing strong immunity (we're also lucky JJ and they all chose a stabilized prefusion Spike unlike ChAdOx etc). Boosters for T and B response in particular are common, but orders of magnitude higher antibodies are quite likely to help minimize Omicron effects (especially for first responders who received early Pfizer doses) and do appear to cause significant reductions in infection/symptomatic cases.[1] I would not have slowed down the testing or EUA, although manufacture was an issue early on. We didn't know when/if a significantly immune evading variant would arrive, and I feel fairly lucky with when Omicron arrived (after many of the most susceptible could be vaccinated). If it had arrived 8 months earlier, it would have been catastrophic.
I also feel that the WHO choices have not been very good. From down playing human transmission early in the pandemic to demanding that there not be boosters in order to speed up the multi-year process of vaccinating 4billion people by 40million doses, when Omicron was already spreading quickly. Honestly, prioritization in the developing world is more important. They seem more political than other sources.
I don't understand who your "they" is. In my opinion there were valid reasons for both decisions on antibodies and boosters. Since I know one of the people in your linked podcast, I will not comment on it.
No that's simply wrong. Antibodies are relatively unimportant and levels decline quickly. What actually matters far more is cellular immunity. Fortunately the vaccines and recovery from infection have both been shown to produce a significant level of durable cellular immunity in the vast majority of patients.
Who do you personally know in the linked podcast? What are your medical qualifications?
Israel was one of the first place to boost (the first?) and I think the rationale there was not just about antibody levels. There were multiple factors. The emergence of Delta which to some extent bypassed the previous two vaccine doses. The decline in protection against severe disease over time (and specifically against delta). And yes, even temporary control of the community spread (which is maybe the more questionable aspect) to allow the country to remain more or less open while keeping hospital load and deaths under control.
In Israel I also believe there is different policy for people that have been infected. This varies from place to place. Determining whether someone was or wasn't previous infected isn't that simple. You can do it if you have good contract tracing, testing, and more centralized health services like Israel does. Also many places didn't have a large enough portion of the population get infected in the first place so maybe not worth worrying too much about.
I don't see how it is so hard. Every positive PCR gets reported to the local health department which reports it to the state DPH. If the state can use this data to send me a letter asking me to donate convalescent plasma surely they could add this information to their digital covid passport.
I think if the data is available it is perfectly reasonable, and even expected, to consider it. Like they do in Israel. I can't really comment on the US in this regard but I'd agree with you that if they can they should... Right now where I am (Canada) they don't even bother testing you unless you're at risk, so nobody knows...
Because some times you have to make a call. Some studies are now revealing that booster shots might be less effective in those who recovered (watched a guy present his unpublished data the other day). But it’s not that obvious.
It's new to me. Sometimes it's nice to have an article rehash old knowledge and bring it into the current context. If for nothing other than to educate the ignorant like me.
But the way it is written sounds like nobody on Planet Earth could have possibly predicted this and that the way B-cells and T-cells work is completely novel discoveries in 2022.
There were people saying this is roughly would happen in mid-2020.
Tony Fauci was saying he'd be happy if the VE against disease was only 50% in Fall 2020. He was trying to set expectations to about where we are right now.
It gives the wrong impression to people who don't know anything about it and it undermines the vaccine messaging strategy. There's a stronger message that virologists and epidemiologists who were specialists in this kind of thing were grounded mostly in reality all along and THIS WAS THE PLAN AND THE PLAN IS WORKING. By claiming that we're radically learning new things it sounds like the whole thing was a clusterfuck. Getting a vaccine with around 50% efficacy against disease and 90% efficacy against hospitalization was always the winning strategy. We were just supposed to hit 80%-90% vaccination rates at least and the low vaccination rates are meaning that the Omicron wave was more of a burden on hospitals than it ever needed to be.
What went wrong is that the vaccine trials were cut short. People who complain about that usually try to argue we cut short the "long term safety" outcome, which is nonsense because vaccine side effects are autoimmune conditions that either start turning up in a population 3 months after dosing or they don't. What we actually cut short was the _durability_ outcomes of the trials since that was the thing that would have taken 2 years and we didn't have the time. Turns out the headline 90% VE against infection numbers weren't durable but the damage was done once they made the initial headline splash and everyone entirely forgot that Fauci was setting expectations down around 50% beforehand. Then they felt they were lied to. Now they feel like the vaccine program was a failure.
We're now back on track to the original plan, and its viewed as being a failure because the phase III results jacked the expectations up to the mRNA vaccines being magicsauce that would instantly end the whole pandemic. This article is still selling it like this is sort of Plan B in response to information that we could never have anticipated. Instead we're back on what was Plan A all along after the hypecycle got blown away by waning immunity and Delta and Omicron.
I think the lesson here is that one shouldn't listen either to antivax grifters or to greedy pharma execs who oversell their products because of the enormous incentive to do so, whether it be vaccines or Alzheimers treatments. The best approach is to listen to what real scientists who actually understand the subject say, but that does take patience and a willingness to invest time.
> By claiming that we're radically learning new things it sounds like the whole thing was a clusterfuck
Dr. Fauci and all the other anointed "experts" were constantly saying "there is so much to still learn about this virus". They still do when asked questions they don't want to really answer.
They've been acting like COVID was some mysterious brand new virus that required us to abandon every single thing we knew about epidemiology. They are somewhat responsible for this insanity.
> we shouldn't be focusing on preventing infection.
I'm confused by what you mean. I have read headlines that say mRNA vaccines reduce the risk of infection by 91%, but it seems like you have more nuanced information from knowledgeable people. So, who should I look to to get the "real" information about what to expect from vaccines and public health?
I think these were measured shortly after reaching full vaccination status (>=14 days after second shot). That seems to be a different thing than, say, six months after vaccination.
It was just common sense. Flu vaccines have never been much more than 50% effective. The idea that you can just vaccinate against such a hugely virulent virus like COVID, and expect it to stop spreading with such ineffectual vaccines just made no mathematical sense what so ever.
If people didn't understand that it is because they didn't want to.
> If people didn't understand that it is because they didn't want to.
"Listen to the experts". The experts never said any of that. Nor did the media. Critical thinking has been shunned the last two years. I mean you can think critically but lord help you if you say what you think online or in person. It's the in person bullying that is the worst, by the way.
Interestingly I think all conversations that I have had in-person, with someone or a group of people I know, have been civil. In fact the only times where I was able to have healthy discussions were in-person.
Healthy online discussions with people I know in the real world? Nope.
Healthy online discussions with people I don't know in the real world? Doubly nope.
I still don't particularly like it that much.
None of this should be all that new.
There were plenty of knowledgeable people saying all along that sterilizing nutralizing immunity in the mucosa was unlikely to be achievable for a vaccine against a respiratory virus that most commonly had no viremic phase, particularly as a shot given in the arm.
They were also saying that T-cells were the important thing to prevent disease and death and we shouldn't be focusing on preventing infection.
Some other people who debated or disagreed with that perspective are now suddenly learning novel new things about the immune system. There's a good chunk of experts out there that were saying this all along though (if you were listening to them and not the headlines and blogs and twitter).