Coronavirus and You - Page 517

On November 23 2021 01:33 RKC wrote:
There's still a high amount of vaccinated people being infected and hospitalised due vaccine effects waning off. Question is, to what extent should the government introduce soft mandates or restrictions on people in need or ready for boosters? Maybe above a certain age?

On November 23 2021 01:31 Liquid`Drone wrote:


This is basically BJ's point, though. If we wanted to live 2020-2021 style, we could basically eliminate the flu. But we don't - we accept some deaths (900 per year in Norway), we accept some hospitalizations, we accept some illness, because we - as society- consider this preferable to having to socially distance. (There's no question that social distancing works - but it's also incredibly costly).

Then, now that Covid - for the vaccinated - is basically down to flu-level in terms of how dangerous contracting it is, can you really justify having the harsh measures that were largely considered acceptable one year ago, pre-vaccine? I was totally fine with social distancing last year - because I saw how bad Covid could be in other countries, and I didn't want Norway to be like those countries. Pre-vaccine, we had like 650 deaths in one year (fewer than the flu - but because of restrictions that were massively impacting people's quality of life). Post vaccine, I guess we're likely to hit similar numbers - but with people living their lives fairly normally. I'm not willing to impose or live with harsh measures to make that 650 number drop to 100 instead - I was, however, willing to impose and live with harsh measures to turn a potential 10000 into 650.

I don't really care about stuff like vaccine passports or mask mandates, those don't impact my life. I care a lot about social distancing, because that massively influences the quality of my life (it also really works).

The point with the comparison isn't some type of 'let's try to measure which disease is worse' - it's trying to establish 'how dangerous does a disease have to be before we implement harsh measures that work to combat it'. Using the regular seasonal flu as a sort of cutoff for that imo makes a lot of sense precisely because we could have used the same measure we've used to fight covid to fight the flu, but we don't, because it's considered 'not sufficiently devastating to warrant it' - while pre-vaccine, covid was 'sufficiently devastating to warrant it', so we went for it. Bloated health care / 'flatten the curve' style arguments have some validity for sure (depending on region) - but there, I think 'spend more money on increasing health care capacity' is something that should've been done a long time ago anyway.

On November 23 2021 01:33 RKC wrote:
There's still a high amount of vaccinated people being infected and hospitalised due vaccine effects waning off. Question is, to what extent should the government introduce soft mandates or restrictions on people in need or ready for boosters? Maybe above a certain age?

On November 23 2021 01:31 Liquid`Drone wrote:


This is basically BJ's point, though. If we wanted to live 2020-2021 style, we could basically eliminate the flu. But we don't - we accept some deaths (900 per year in Norway), we accept some hospitalizations, we accept some illness, because we - as society- consider this preferable to having to socially distance. (There's no question that social distancing works - but it's also incredibly costly).

Then, now that Covid - for the vaccinated - is basically down to flu-level in terms of how dangerous contracting it is, can you really justify having the harsh measures that were largely considered acceptable one year ago, pre-vaccine? I was totally fine with social distancing last year - because I saw how bad Covid could be in other countries, and I didn't want Norway to be like those countries. Pre-vaccine, we had like 650 deaths in one year (fewer than the flu - but because of restrictions that were massively impacting people's quality of life). Post vaccine, I guess we're likely to hit similar numbers - but with people living their lives fairly normally. I'm not willing to impose or live with harsh measures to make that 650 number drop to 100 instead - I was, however, willing to impose and live with harsh measures to turn a potential 10000 into 650.

I don't really care about stuff like vaccine passports or mask mandates, those don't impact my life. I care a lot about social distancing, because that massively influences the quality of my life (it also really works).

The point with the comparison isn't some type of 'let's try to measure which disease is worse' - it's trying to establish 'how dangerous does a disease have to be before we implement harsh measures that work to combat it'. Using the regular seasonal flu as a sort of cutoff for that imo makes a lot of sense precisely because we could have used the same measure we've used to fight covid to fight the flu, but we don't, because it's considered 'not sufficiently devastating to warrant it' - while pre-vaccine, covid was 'sufficiently devastating to warrant it', so we went for it. Bloated health care / 'flatten the curve' style arguments have some validity for sure (depending on region) - but there, I think 'spend more money on increasing health care capacity' is something that should've been done a long time ago anyway.

On November 23 2021 01:52 Liquid`Drone wrote:


Ya, this is becoming an increasingly relevant question. I will have to see more data on 'how dangerous is it for people at x period of time after second vaccine dose' before I really make up my mind on this. Like, even if people are still getting sick and even hospitalized, for how long are they hospitalized, to what degree is it dependent on comorbidities, etc.. If the effect of being fully vaccinated is essentially 0 effect 1 year after the last vaccine shot, then the same arguments that apply to 'vaccine mandates' will also apply to 'booster mandates' - but if it has moved to 20% protection against the 'weak' effects (so it still spreads like wildfire) and 70% protection against the most adverse effects (so deaths and long term intensive care stay low) then it'll be different.

I'm also generally of the opinion that we should focus on giving poorer regions of the world full vaccination before we start boostering up, but I don't fully know to what degree this not happening is a consequence of lacking vaccine doses or lacking infrastructure in handing them out / lacking willingness. (And, fortunately, poorer countries of the world are less troubled by a) high average age and b) obesity, two of the main determiners for Covid being really bad.

On November 23 2021 01:44 Gorsameth wrote:
So what is the argument/discussion here?

'If Covid is at a level the flu is usually at, we're happy to accept it' is, imo, probably not a controversial statement. I'd be fine with that. But is that where countries that are looking at more measures, and limiting the freedom of the unvaccinated are at?

Since this was all sparked by Austria, is everything 'fine' in Austria? Considering they are looking at a general vaccine mandate I would hazard a guess its not fine at all.

On November 23 2021 02:10 Artisreal wrote:

That makes a lot more sense to me, thanks for providing the context I had missed / was missing. Rather than to compare apples and oranges, I'd much rather have a forthright discussion what level of measures are acceptable.
With that on the forefront, the context in which we compare different scenarios with different illnesses to answer that question is less loaded in my book. It speaks less of denialism than poses a chance to look forward and gives the context that this, according to current knowledge, is not going away.

On November 23 2021 02:39 WombaT wrote:

It’s an important question, and one that doesn’t really crop up enough.

How high is the bar for acceptable infection and death rates, that once exceeded, would justify a continuation or re-imposition of restrictions, and what restrictions.

Discussion of this is complicated greatly because we all live in different countries, with vastly different cultural norms and facilities. Speaking of apples and oranges.

I could see in some places some of the softer distancing measures, mask-wearing etc being considerably more effective due to cultural buy-in, where that’s lacking well perhaps mandates of certain things become appropriate.

Within my own locale, the health service is getting its arse kicked, and we’re not even having a notably bad Covid wave, it was basically stretched to the struggle point even prior to the pandemic.

A properly bad wave of Covid between people who haven’t vaccinated + the waning of efficacy in those who got vaccines a long time ago, I would be rather worried at the specific overloading of the health service scenario.

For all I think the general healthcare structures suck, if nothing else (some areas of) the US have a pretty good ability to scale as there’s excess ICU/hospital capacity, as Blackjack mentioned. Of course it’s the US, which is giant so this isn’t going to universally apply there, but from memory it’s generally true.

Also as Drone alludes to, the health service shouldn’t have been left to wither on the vine to the extent that it only has to take a few knocks to be overloaded, and I don’t think in perpetuity you can justify Covid restrictions on the rationale of overloading health services, if you’re not working to make them more resilient to fluctuations. Early on with a novel virus(es), yes absolutely, you may have to put the breaks on to spare health services, but if you don’t subsequently adjust said services to have the ability to cope after having bought them time, I don’t think that’s sustainable, or desirable.

I don’t know the state of affairs in all of your various countries, that is a particular factor and worry where I’d live anyway, and it does influence my own particular views re Covid

Emergency department–based boarding of the critically ill patient is common, but no nationally representative frequency estimates has been reported. Boarding literature is limited by variation in the definitions used for boarding and variation in the facilities studied (boarding ranges from 2% to 88% of ICU admissions). Prolonged boarding in the emergency department has been associated with longer duration of mechanical ventilation, longer ICU and hospital length of stay, and higher mortality.

On November 23 2021 04:44 maybenexttime wrote:

I think you're misreading the data. Vaccines drastically reduce the net transmission even with the delta variant. First, you are much less likely to catch the infection in the first place (here's a video commenting on a study on this). Secondly, while the viral load in vaccinated people is roughly the same as in the unvaccinated, it drops more rapidly. IIRC, unvaccinated people are infectious for about twice as long as the vaccinated.

What this means in practice is that the higher the vaccination rate, the milder the measures necessary to drop the R factor below 1.

On November 23 2021 04:49 JimmiC wrote:

I'm in agreement with Joe.

On November 23 2021 06:26 JimmiC wrote:

Well hello Stewart!

Individual insurance is calculated with some basic health and demographic questions and then depending on those questions answers they will often ask for lab work or other medicals. So a 25 male 6tf tall, 175 pounds, non smoker with a clean medical history would pay a certain amount and the same but 55 would pay a lot more. A smoker would pay more, someone with a family history of cancer or heart disease would pay more and so on.

On the group side (insurance you get from where you work), it depends on the size of the business, the business would pay either based on their companies past performance or by some metrics the insurance company would have from all similar businesses while taking into account the basics like age of the workers.

Group insurance dollar for dollar is more expensive than individual if someone is healthy because they all pay the same and it has to account for those who are not (nd cheaper for the unhealthy). The big advantage is that it is guaranteed, individual insurance will deem some people "uninsurable" where as group policies cover all employees. If your health is not great when you leave a business you usually have the option to convert the policy to individual which if you are not in good health you should do and if you are you should not, as the premiums are again higher because of negative self selection.

There are people in the insurance companies called actuaries and all they do is go through all the numbers and try to calculate what is the probability of whatever pays the insurance out, so in the case the chances of catching covid, the chances of hospitalization, and then death.



Conversely you could give people a tax refund if they did get vaccinated but for some reason with human psychology rewards do not affect behavior nearly to the degree as negative outcomes like extra cost do. This is why grocery stores charge a nickel or whatever for bags instead of give a discount when you don't take them.