4 ms·

> public health officials should be telling individuals some basic things that they can do to really reduce harm: people with symptoms of a respiratory infectio

by retrac 5y ago

> public health officials should be telling individuals some basic things that they can do to really reduce harm: people with symptoms of a respiratory infection, vaccinated or unvaccinated, should stay the hell away. They shouldn’t visit vulnerable friends or relatives. They should cancel social plans. They should call in sick for work. They should get tested and stay home until recovered. Employers should insist that sick employees stay home. Not only telling people. We should work to enable this. Missing a week of work can be expensive and many are broke. There is a perverse incentive here. I'm not sure the best way to address it.

toomuchtodo 5y ago
In the US, employers are legally permitted to mandate vaccinations. Countries can mandate them for border crossings (air, sea, and land). Mandate them. Those who opt out (without legitimate medical reason) are the ones who can face the costs of their choice, instead of society collectively carrying the burden. Like Cato says, "embrace harm reduction."
- errantmind 5y ago
  Sure, as long as we also ban fast food, tobacco, alcohol, and raise the minimum standard for food at the grocery store to USDA Organic. I'm tired of carrying these unhealthy peoples' burdens. Might as well target the actual big causes of death, like heart, lung, and liver disease.
  - toomuchtodo 5y ago
    No, we don’t have to do those at the same time as a public health crisis, and ICU beds are not overflowing due to the maladies you enumerated. They are overflowing because of the unvaccinated.
    - errantmind 5y ago
      Most of the unvaccinated in the ICU are either overweight, have preexisting conditions, or are old. I don't see any reason not to attack other root causes to clear out the ICUs while we are at it, right?
      - edmundsauto 5y ago
        Long term health should absolutely be prioritized. However, given resources are limited (especially people's attention span), we should prioritize the highest impact, lowest cost opportunities to return back to our previous normal. It's easier to move the needle with vaccinations and masks, compared to obesity and smoking - both of which have been in the crosshairs of public health officials for decades. They're just harder to move in the short term.
        galdosdi 5y ago
        Well, actually, you can safely lose 2 lbs per week of body weight. The pandemic has been going on long enough that that works out to 150 lbs for someone who started slowly losing weight as soon as the pandemic began (the obesity connection was obvious and well publicized early on) Almost all obese people are less than 150 lbs overweight. So yeah, at both an individual and societal level, we should have responded (and should respond today) by treating obesity as a public health emergency (or at an individual level a personal medical emergency) similar to early stage cancer, severe hypertension, or serious nutrient deficiency, etc. The medical evidence even before covid was clear: obesity kills. I'm going to cross over into controversial territory when I say that in the total absence of modern processed foods and modern sedentism, becoming or staying obese is difficult for most people. (If this were not true, how to explain that obesity was and is rare in places with neither of the above? Why do my size L clothes get labelled as size XL in France and Asia? Why do obesity levels keep rising in America as sedentism and processed food keep marching on? WHY was obesity unknown in my family until immigrated from a traditional agricultural society where every family had deep culinary knowledge and walked or rode horses everywhere to a modern industrialized car dependent one where food comes from freezers and microwaves, and then immediately became very common? Why is Asia thinner than Europe, Europe thinner than NYC and other walkable northeastern cities with a lot of food choice, and those places thinner than flyover country america?) This is an easy problem to solve. It hasn't been solved for decades because bathing the population in processed food and sedentism can't be offset by a few public service ads imploring people to spend all their energies fighting their artificially unhealthy environment. Instead, just give people a healthy environment and watch the problem melt away. Sell healthy food as ubiquitously as fast food and make it easy to get around without a car. Problem solved or at least severely improved. Lots of data obviously showing this. This is a problem we can solve, or at least make enough headway on to save millions of lives. We should have been on it before, but covid should have been a watershed moment on this. Instead we got pandemic stress baking and in some places, even outdoor exercise bans.
    - didjathinkmess 5y ago
      >They are overflowing because of the unvaccinated. Source for this claim? Asking because I see stats being thrown around constantly: unvaccinated are 97% of ICU patients, etc. The only problem is, there's no data to back it up. I've followed sources to the very end to try and locate this data but it doesn't exist. Most lazily point at the CDC but even they openly admit the data isn't reliable because they aren't tracking breakthrough cases correctly. Maybe your source is legit.
      - simonh 5y ago
        Associated Press did an analysis of the data. The CDC won't give numbers because the figures we have are patchy, good for some states and poor or non existent from others, so they can't calculate population wide figures. The AP just looked at the most comprehensive figures we have for those areas that do have strong reporting. https://apnews.com/article/coronavirus-pandemic-health-941fcf43d9731c76c16e7354f5d5e187 https://apnews.com/article/coronavirus-pandemic-health-941fc... This is also consistent with figures from the UK that keeps much more comprehensive and consistent records, because it has a unified national health infrastructure, as well as much higher vaccination rates.
      - maxerickson 5y ago
        The data for vaccination status of people that are hospitalized should not be impacted by the way people that are not hospitalized are tracked...the proportion of vaccinated people in the ICU is independent from the overall number of breakthrough infections (because their vaccination status can be recorded by the hospital directly).
deleted 5y ago
[deleted]
TrevorJ 5y ago
The data also indicate that it's likely that: 1. Reducing weight to a healthy level 2. Getting enough vitamin D are very likely to contribute to better outcomes for the disease, and we've known this for quite some time. Not only have I not seen any public health messaging around this, but the policies that have been in place have trended towards reducing the sorts of activities that would result in better outcomes based on these factors.
bradknowles 5y ago
Problem is that, with COVID, you can be completely asymptomatic and yet still highly infectious. If the problem was as simple as telling all the sick people they had to stay home, that would be easy.

by retrac 5y ago

toomuchtodo 5y ago

In the US, employers are legally permitted to mandate vaccinations. Countries can mandate them for border crossings (air, sea, and land). Mandate them. Those who opt out (without legitimate medical reason) are the ones who can face the costs of their choice, instead of society collectively carrying the burden. Like Cato says, "embrace harm reduction."

errantmind 5y ago
Sure, as long as we also ban fast food, tobacco, alcohol, and raise the minimum standard for food at the grocery store to USDA Organic. I'm tired of carrying these unhealthy peoples' burdens. Might as well target the actual big causes of death, like heart, lung, and liver disease.
- toomuchtodo 5y ago
  No, we don’t have to do those at the same time as a public health crisis, and ICU beds are not overflowing due to the maladies you enumerated. They are overflowing because of the unvaccinated.
  - errantmind 5y ago
    Most of the unvaccinated in the ICU are either overweight, have preexisting conditions, or are old. I don't see any reason not to attack other root causes to clear out the ICUs while we are at it, right?
    - edmundsauto 5y ago
      Long term health should absolutely be prioritized. However, given resources are limited (especially people's attention span), we should prioritize the highest impact, lowest cost opportunities to return back to our previous normal. It's easier to move the needle with vaccinations and masks, compared to obesity and smoking - both of which have been in the crosshairs of public health officials for decades. They're just harder to move in the short term.
      - galdosdi 5y ago
        Well, actually, you can safely lose 2 lbs per week of body weight. The pandemic has been going on long enough that that works out to 150 lbs for someone who started slowly losing weight as soon as the pandemic began (the obesity connection was obvious and well publicized early on) Almost all obese people are less than 150 lbs overweight. So yeah, at both an individual and societal level, we should have responded (and should respond today) by treating obesity as a public health emergency (or at an individual level a personal medical emergency) similar to early stage cancer, severe hypertension, or serious nutrient deficiency, etc. The medical evidence even before covid was clear: obesity kills. I'm going to cross over into controversial territory when I say that in the total absence of modern processed foods and modern sedentism, becoming or staying obese is difficult for most people. (If this were not true, how to explain that obesity was and is rare in places with neither of the above? Why do my size L clothes get labelled as size XL in France and Asia? Why do obesity levels keep rising in America as sedentism and processed food keep marching on? WHY was obesity unknown in my family until immigrated from a traditional agricultural society where every family had deep culinary knowledge and walked or rode horses everywhere to a modern industrialized car dependent one where food comes from freezers and microwaves, and then immediately became very common? Why is Asia thinner than Europe, Europe thinner than NYC and other walkable northeastern cities with a lot of food choice, and those places thinner than flyover country america?) This is an easy problem to solve. It hasn't been solved for decades because bathing the population in processed food and sedentism can't be offset by a few public service ads imploring people to spend all their energies fighting their artificially unhealthy environment. Instead, just give people a healthy environment and watch the problem melt away. Sell healthy food as ubiquitously as fast food and make it easy to get around without a car. Problem solved or at least severely improved. Lots of data obviously showing this. This is a problem we can solve, or at least make enough headway on to save millions of lives. We should have been on it before, but covid should have been a watershed moment on this. Instead we got pandemic stress baking and in some places, even outdoor exercise bans.
  - didjathinkmess 5y ago
    >They are overflowing because of the unvaccinated. Source for this claim? Asking because I see stats being thrown around constantly: unvaccinated are 97% of ICU patients, etc. The only problem is, there's no data to back it up. I've followed sources to the very end to try and locate this data but it doesn't exist. Most lazily point at the CDC but even they openly admit the data isn't reliable because they aren't tracking breakthrough cases correctly. Maybe your source is legit.
    - simonh 5y ago
      Associated Press did an analysis of the data. The CDC won't give numbers because the figures we have are patchy, good for some states and poor or non existent from others, so they can't calculate population wide figures. The AP just looked at the most comprehensive figures we have for those areas that do have strong reporting. https://apnews.com/article/coronavirus-pandemic-health-941fcf43d9731c76c16e7354f5d5e187 https://apnews.com/article/coronavirus-pandemic-health-941fc... This is also consistent with figures from the UK that keeps much more comprehensive and consistent records, because it has a unified national health infrastructure, as well as much higher vaccination rates.
    - maxerickson 5y ago
      The data for vaccination status of people that are hospitalized should not be impacted by the way people that are not hospitalized are tracked...the proportion of vaccinated people in the ICU is independent from the overall number of breakthrough infections (because their vaccination status can be recorded by the hospital directly).

deleted 5y ago

[deleted]

TrevorJ 5y ago

The data also indicate that it's likely that: 1. Reducing weight to a healthy level 2. Getting enough vitamin D are very likely to contribute to better outcomes for the disease, and we've known this for quite some time. Not only have I not seen any public health messaging around this, but the policies that have been in place have trended towards reducing the sorts of activities that would result in better outcomes based on these factors.

bradknowles 5y ago

Problem is that, with COVID, you can be completely asymptomatic and yet still highly infectious. If the problem was as simple as telling all the sick people they had to stay home, that would be easy.