4 ms·

There appears to be complete lack of clarity in what we're aiming to achieve. As in asking ourselves "what are the next steps?" as my OH is wont to say. At s

There appears to be complete lack of clarity in what we're aiming to achieve. As in asking ourselves "what are the next steps?" as my OH is wont to say. At several points in 2020 it seemed fairly clear that health services were at risk of being overwhelmed. That's a pretty big deal, drastic measures to try and prevent that seemed the appropriate and necessary response. Now that a majority of adults are vaccinated - and hopefully almost all of the most vulnerable - are we still at risk of health services being overwhelmed? If the vaccines are keeping a majority from serious illness from a Covid19 infection, where are the patients coming from to overwhelm the hospitals? It's also become completely clear that the delta variant can (and will) both a) infect and b) spread in the vaccinated population. Happily the vaccine does a good job preventing serious illness, so these people aren't likely to end up in hospital. In Münster, Germany 380 vaccinated people attended a party in a nightclub on 3 September, the latest data show 81 confirmed Covid19 infections from this event.[0] This event is being reported as if it were somehow a failure or a scandal, but isn't this how mass vaccination is supposed to work? The cases are all mild. Nothing to see here, move along... At some point we're going to have to stop testing, stop contact tracing, but keep offering vaccines(!), although stop stressing about who choses to take them, and head back to how we dealt with viruses before 2019. Oh, and maybe we all need to take another look at the CDC's 'Leading causes of death' chart. Plenty of ways to die other than Covid19: https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm The idea of reaching 'zero Covid' is dead (if it was ever much of a proposition anyway). [0]https://www.spiegel.de/panorama/corona-mindestens-26-neuinfektionen-in-muenster-nach-party-unter-2g-bedingungen-a-27f0c70c-4244-4cec-b62c-67bb2b891626 https://www.spiegel.de/panorama/corona-mindestens-26-neuinfe...

bsaul 5y ago
I’ve been waiting for governments to reach that conclusion for months now. Alas, it seems that today’s political speech are voluntarily simplified to the extreme, probably as a mean to maximize the expected result (aka: getting the max number of people vaccinated). The risk being to antagonize educated citizen that may completely loose respect for public policies as a consequence.
morsch 5y ago
Now that a majority of adults are vaccinated - and hopefully almost all of the most vulnerable - are we still at risk of health services being overwhelmed? Maybe? The official model for the UK projects (it stresses that it's not a prediction, they're not very confident) 2000 daily hospitalisations in a likely, optimistic scenario. I don't know how many hospitalisations it takes to overwhelm the system in the UK. The numbers per capita are bound to be worse in Germany and parts the USA, which have lower overall vaccination rates. An astonishing 15% of the population over 60 in Germany is still not vaccinated. Younger people end up in critical care in much lower numbers, but those that do, tend to stay there for a longer time. https://www.gov.uk/government/publications/spi-m-o-consensus-statement-on-covid-19-8-september-2021 https://www.gov.uk/government/publications/spi-m-o-consensus...
- logifail 5y ago
  > The numbers per capita are bound to be worse in Germany and parts the USA, which have lower overall vaccination rates Germany and the USA have way more critical care beds available per capita than almost anywhere else in the developed world, by some margin, at least based on the figures in this article (the US more than 5x as many as the UK, Germany almost 4.5x) To a dreadful first-order approximation, shouldn't it be around 5x harder to overwhelm a system which has 5x more capacity? https://www.forbes.com/sites/niallmccarthy/2020/03/12/the-countries-with-the-most-critical-care-beds-per-capita-infographic/ https://www.forbes.com/sites/niallmccarthy/2020/03/12/the-co...
  - loup-vaillant 5y ago
    > To a dreadful first-order approximation, shouldn't it be around 5x harder to overwhelm a system which has 5x more capacity? Not with an exponentially spreading disease. Remember the lake that double its size each day, and becomes full in 50 days: it takes 49 days to make it half-full, and if you doubled its capacity, it'd fill in 51 days instead. In the end, it mainly depends on the (serious) morbidity rate and the transmission rate. The latter more than the former, generally: if it is any higher than one, you'll have a doubling period just like the lake (longer than a day, though) until you approach saturation (a sizeable portion of the population is infected or immune). Doubling hospital capacity will only give you a doubling period's worth of time before you have to resort to other measures that push the transmission rate below 1. Now if the (serious) morbidity rate is so low that hospitals don't become saturated even as most of the population got infected, that's another story.
1shooner 5y ago
>If the vaccines are keeping a majority from serious illness from a Covid19 infection, where are the patients coming from to overwhelm the hospitals? In my part of the world (US south), they are coming from the half of the population that refuses to be vaccinated. They are still overwhelming the ICUs and EDs. Non-essential procedures for the rest of us have been rescheduled etc. It's just another wave, who knows how many more we'll have? So from where we're at, any decrease in immunity still presents enough of a threat to the healthcare infrastructure. Lung cancer and heart disease aren't shutting down other units of our hospitals so they can move nursing staff to ICU.
smaryjerry 5y ago
The question of whether hospitals are overwhelmed is actually multi-factor. Are some hospitals overwhelmed? Yes, but is the cause due to COVID or unvaccinated patients? The fact is there is a labor shortage right now, many people are struggling to hire and find people and at my local hospital the rooms are there, built, empty but they cannot be maintained or used because the nurses have all quit because of the ease to find another job, high stress, risk of catching COVID, mask requirements all day, dealing with people who won’t wear masks and more issues that are all directly related to the disease but not caused by the disease itself. Now they can find a less stressful job, maybe working remotely from home, move to a cheaper cost of living area, or simply work in an environment without masking all day long. When Delta hit nurses quit because they didn’t want to deal with it any more.
- logifail 5y ago
  > Yes, but is the cause due to COVID or unvaccinated patients? Given hospitals routinely test for Covid on admission, isn't there a third option? Patients admitted to hospital with non-Covid19 medical issues who then happen to test positive and subsequently get put in the statistics in a total which the media then report as "Covid19 patients in hospital" See: "23% of Covid infections in hospital [in the UK] - or nearly one in four - were patients admitted for other reasons"[0] "More than half of Covid patients in hospital [in the UK] 'tested positive after admission'"[1] [0] https://www.bbc.co.uk/news/uk-58030125 https://www.bbc.co.uk/news/uk-58030125 [1] https://www.mirror.co.uk/news/uk-news/more-half-covid-patients-hospital-24623148 https://www.mirror.co.uk/news/uk-news/more-half-covid-patien...
lamontcg 5y ago
> It's also become completely clear that the delta variant can (and will) both a) infect and b) spread in the vaccinated population. It isn't clear at all that delta breakthrough infections result in superspreading. There are documented cases of transmission chains of breakthrough infections, but I haven't seen any instances of single individuals with breakthrough infections creating superspreading events. By preventing the worst symptoms and reducing the amount of viable virus and duration of breakthrough infections, transmission is almost certainly reduced by some amount. It may be a substantial amount. Literally nobody knows. People are assuming that since transmission isn't reduced to zero that we have to assume it isn't reduced at all, which is almost certainly false.
- logifail 5y ago
  > It isn't clear at all that delta breakthrough infections result in superspreading. The party in Münster that's making headlines over here is being called a superspreading event.[0] The number of confirmed infections has now risen to 83. > transmission is almost certainly reduced by some amount. It may be a substantial amount. Literally nobody knows If no-one knows, is the phrase "almost certain" appropriate? [0] https://www.wa.de/nordrhein-westfalen/muenster-2g-party-corona-infektionen-cuba-club-nrw-gaeste-mitarbeiter-symptome-90980919.html https://www.wa.de/nordrhein-westfalen/muenster-2g-party-coro...
  - lamontcg 5y ago
    We know for certain that the disease course in breakthrough infections is shorter and milder. Yes, it is almost certain that transmission would be reduced. And the Münster party doesn't have adequate contact tracing at all. That could be one unvaccinated person with forged or lacking credentials that infected everyone else. They don't know who the index case or index cases were. At least 28 of the affected people haven't submitted proof of vaccination, and if the person who caused the outbreak knew they were breaking rules and got sick they may have avoided getting tested and might not even be in the 83 known cases.

bsaul 5y ago

I’ve been waiting for governments to reach that conclusion for months now. Alas, it seems that today’s political speech are voluntarily simplified to the extreme, probably as a mean to maximize the expected result (aka: getting the max number of people vaccinated). The risk being to antagonize educated citizen that may completely loose respect for public policies as a consequence.

morsch 5y ago

Now that a majority of adults are vaccinated - and hopefully almost all of the most vulnerable - are we still at risk of health services being overwhelmed? Maybe? The official model for the UK projects (it stresses that it's not a prediction, they're not very confident) 2000 daily hospitalisations in a likely, optimistic scenario. I don't know how many hospitalisations it takes to overwhelm the system in the UK. The numbers per capita are bound to be worse in Germany and parts the USA, which have lower overall vaccination rates. An astonishing 15% of the population over 60 in Germany is still not vaccinated. Younger people end up in critical care in much lower numbers, but those that do, tend to stay there for a longer time. https://www.gov.uk/government/publications/spi-m-o-consensus-statement-on-covid-19-8-september-2021 https://www.gov.uk/government/publications/spi-m-o-consensus...

logifail 5y ago
> The numbers per capita are bound to be worse in Germany and parts the USA, which have lower overall vaccination rates Germany and the USA have way more critical care beds available per capita than almost anywhere else in the developed world, by some margin, at least based on the figures in this article (the US more than 5x as many as the UK, Germany almost 4.5x) To a dreadful first-order approximation, shouldn't it be around 5x harder to overwhelm a system which has 5x more capacity? https://www.forbes.com/sites/niallmccarthy/2020/03/12/the-countries-with-the-most-critical-care-beds-per-capita-infographic/ https://www.forbes.com/sites/niallmccarthy/2020/03/12/the-co...
- loup-vaillant 5y ago
  > To a dreadful first-order approximation, shouldn't it be around 5x harder to overwhelm a system which has 5x more capacity? Not with an exponentially spreading disease. Remember the lake that double its size each day, and becomes full in 50 days: it takes 49 days to make it half-full, and if you doubled its capacity, it'd fill in 51 days instead. In the end, it mainly depends on the (serious) morbidity rate and the transmission rate. The latter more than the former, generally: if it is any higher than one, you'll have a doubling period just like the lake (longer than a day, though) until you approach saturation (a sizeable portion of the population is infected or immune). Doubling hospital capacity will only give you a doubling period's worth of time before you have to resort to other measures that push the transmission rate below 1. Now if the (serious) morbidity rate is so low that hospitals don't become saturated even as most of the population got infected, that's another story.

1shooner 5y ago

>If the vaccines are keeping a majority from serious illness from a Covid19 infection, where are the patients coming from to overwhelm the hospitals? In my part of the world (US south), they are coming from the half of the population that refuses to be vaccinated. They are still overwhelming the ICUs and EDs. Non-essential procedures for the rest of us have been rescheduled etc. It's just another wave, who knows how many more we'll have? So from where we're at, any decrease in immunity still presents enough of a threat to the healthcare infrastructure. Lung cancer and heart disease aren't shutting down other units of our hospitals so they can move nursing staff to ICU.

smaryjerry 5y ago

The question of whether hospitals are overwhelmed is actually multi-factor. Are some hospitals overwhelmed? Yes, but is the cause due to COVID or unvaccinated patients? The fact is there is a labor shortage right now, many people are struggling to hire and find people and at my local hospital the rooms are there, built, empty but they cannot be maintained or used because the nurses have all quit because of the ease to find another job, high stress, risk of catching COVID, mask requirements all day, dealing with people who won’t wear masks and more issues that are all directly related to the disease but not caused by the disease itself. Now they can find a less stressful job, maybe working remotely from home, move to a cheaper cost of living area, or simply work in an environment without masking all day long. When Delta hit nurses quit because they didn’t want to deal with it any more.

logifail 5y ago
> Yes, but is the cause due to COVID or unvaccinated patients? Given hospitals routinely test for Covid on admission, isn't there a third option? Patients admitted to hospital with non-Covid19 medical issues who then happen to test positive and subsequently get put in the statistics in a total which the media then report as "Covid19 patients in hospital" See: "23% of Covid infections in hospital [in the UK] - or nearly one in four - were patients admitted for other reasons"[0] "More than half of Covid patients in hospital [in the UK] 'tested positive after admission'"[1] [0] https://www.bbc.co.uk/news/uk-58030125 https://www.bbc.co.uk/news/uk-58030125 [1] https://www.mirror.co.uk/news/uk-news/more-half-covid-patients-hospital-24623148 https://www.mirror.co.uk/news/uk-news/more-half-covid-patien...

lamontcg 5y ago

> It's also become completely clear that the delta variant can (and will) both a) infect and b) spread in the vaccinated population. It isn't clear at all that delta breakthrough infections result in superspreading. There are documented cases of transmission chains of breakthrough infections, but I haven't seen any instances of single individuals with breakthrough infections creating superspreading events. By preventing the worst symptoms and reducing the amount of viable virus and duration of breakthrough infections, transmission is almost certainly reduced by some amount. It may be a substantial amount. Literally nobody knows. People are assuming that since transmission isn't reduced to zero that we have to assume it isn't reduced at all, which is almost certainly false.

logifail 5y ago
> It isn't clear at all that delta breakthrough infections result in superspreading. The party in Münster that's making headlines over here is being called a superspreading event.[0] The number of confirmed infections has now risen to 83. > transmission is almost certainly reduced by some amount. It may be a substantial amount. Literally nobody knows If no-one knows, is the phrase "almost certain" appropriate? [0] https://www.wa.de/nordrhein-westfalen/muenster-2g-party-corona-infektionen-cuba-club-nrw-gaeste-mitarbeiter-symptome-90980919.html https://www.wa.de/nordrhein-westfalen/muenster-2g-party-coro...
- lamontcg 5y ago
  We know for certain that the disease course in breakthrough infections is shorter and milder. Yes, it is almost certain that transmission would be reduced. And the Münster party doesn't have adequate contact tracing at all. That could be one unvaccinated person with forged or lacking credentials that infected everyone else. They don't know who the index case or index cases were. At least 28 of the affected people haven't submitted proof of vaccination, and if the person who caused the outbreak knew they were breaking rules and got sick they may have avoided getting tested and might not even be in the 83 known cases.