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If we’re worried about hospital capacity why are we firing healthcare workers?

_3u10 5y ago
Because it helps reduce capacity which increases the political will for mandates.
loeg 5y ago
We have vaccine mandates because infected healthcare workers spreading COVID reduce capacity even more. We haven't actually fired many workers, because the vast majority just get the vaccine (mostly before the mandates).
- LurkingPenguin 5y ago
  1. You need to account for the fact that some percentage (perhaps large) of healthcare workers already survived COVID and have natural immunity. Since the science is demonstrating that natural immunity is as durable and robust as vaccine immunity (if not more durable and robust), one would have to ask what the rationale is for firing workers who have natural immunity (as verified by a past COVID diagnosis or presence of antibodies) and do not want to be vaccinated. 2. The science is clear that vaccinated individuals can contract and spread the virus. While this doesn't mean that the vaccines aren't useful (they absolutely are), we need to be realistic about this in high-risk settings.
  - zdragnar 5y ago
    Healthcare workers have been on the front line, unvaccinated, for going on two years. To mandate it or risk being fired has absolutely pissed off quite a few that I know of... My wife has gotten it, and even she is offended. The hyperbole around this very serious situation just makes all the policies seem even more like theater. To your second point, there was just a new report I saw yesterday that there is no difference in viral load between asymptomatic vaccinated and unvaccinated individuals.
    - LurkingPenguin 5y ago
      > The hyperbole around this very serious situation just makes all the policies seem even more like theater. One has to conclude that it is theater at this point. Because the science is pretty darn clear. Interesting that nobody downvoting my comment (and yours) has posted a reputable and recent/current scientific source stating that: 1. Natural immunity is inferior to vaccine-based immunity. 2. Millions of Americans (perhaps 100 million according to a model developed by the CDC) haven't already had and recovered from COVID. 3. Vaccinated individuals can't become infected and spread the virus.
      - macintux 5y ago
        I’m definitely in the pro-vaccine, pro-mandate column, but both 1 and 3 from your list strike me as dubious given the information to this point. Certainly there’s been conflicting information on both.
        LurkingPenguin 5y ago
        Re-read my comment. I'm asking if anybody downvoting me can provide scientific evidence that those statements are true. Nobody has, because they're not. Natural immunity is durable and robust, and vaccinated people can get infected and spread the virus. In fact, according to the Israeli data, vaccinated people are magnitudes of order more likely to get a Delta breakthrough infection than a person with natural immunity is to get reinfected with Delta.
  - frostirosti 5y ago
    > do not want to be vaccinated What's the reason for this? The vaccine has been approved fully by the FDA and hundreds of millions of people have received it. > 2. ... Sure, and people who have had covid and get it again as well. But why risk sick days, lost productivity, severe illness when there's an effective, safe alternative. The capital cost of caring people who get sick with covid is far higher on a per capita basis for those who are unvaccinated.
    - LurkingPenguin 5y ago
      > do not want to be vaccinated What's the reason for this? The vaccine has been approved fully by the FDA and hundreds of millions of people have received it. It's none of your business why they don't want to be vaccinated. If science demonstrates that COVID survivors have strong immunity, why should they be forced to be vaccinated as well? We do not force people who can show immunity to measles, mumps, and rubella to get the MMR vaccine. From the CDC: https://www.cdc.gov/vaccines/vpd/mmr/public/index.html https://www.cdc.gov/vaccines/vpd/mmr/public/index.html > You do not need measles, mumps, and rubella (MMR) vaccine if you meet any of these criteria for presumptive evidence of immunity*: > You have laboratory confirmation of past infection or had blood tests that show you are immune to measles, mumps, and rubella. > Sure, and people who have had covid and get it again as well. But why risk sick days, lost productivity, severe illness when there's an effective, safe alternative. The capital cost of caring people who get sick with covid is far higher on a per capita basis for those who are unvaccinated. You are distorting the science by trying to lump people who survived COVID in with the unvaccinated. They are not the same group. From Israel: https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v1 https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v... > SARS-CoV-2-naïve vaccinees had a 13.06-fold (95% CI, 8.08 to 21.11) increased risk for breakthrough infection with the Delta variant compared to those previously infected, when the first event (infection or vaccination) occurred during January and February of 2021. The increased risk was significant (P<0.001) for symptomatic disease as well. When allowing the infection to occur at any time before vaccination (from March 2020 to February 2021), evidence of waning natural immunity was demonstrated, though SARS-CoV-2 naïve vaccinees had a 5.96-fold (95% CI, 4.85 to 7.33) increased risk for breakthrough infection and a 7.13-fold (95% CI, 5.51 to 9.21) increased risk for symptomatic disease. SARS-CoV-2-naïve vaccinees were also at a greater risk for COVID-19-related-hospitalizations compared to those that were previously infected. > This study demonstrated that natural immunity confers longer lasting and stronger protection against infection, symptomatic disease and hospitalization caused by the Delta variant of SARS-CoV-2, compared to the BNT162b2 two-dose vaccine-induced immunity. Individuals who were both previously infected with SARS-CoV-2 and given a single dose of the vaccine gained additional protection against the Delta variant.
- howlong 5y ago
  Why do we have vaccine mandates for people working from home?
- OrvalWintermute 5y ago
  You've made an amazing claim, that infected healthcare workers, who, were caring for Covid patients for almost 2 years now, have been spreading COVID further. This, despite the fact that they are most likely to have caught it early as they were caring for patients prior to vaccines, and hence to have obtained natural immunity. Please provide evidence to support your amazing claim.
mmastrac 5y ago
I'm no policy or health care expert, but maybe because front-line and hospital workers are exposed to extremely large viral loads which seem to be related to the severity of the disease, and taking one HCW off the front-lines and adding them to the sick in the ICUs is worse than one less HCW and the same ICU level? This seems like you are trying to start a flamewar about vaccine mandates, BTW.
- nradov 5y ago
  There's no reliable evidence that healthcare workers wearing proper PPE are exposed to extremely large viral loads. Nor is there evidence that symptom severity depends on initial viral load (beyond some minimum threshold for infection). It's a plausible hypothesis but the human challenge trials necessary to prove or disprove it haven't been done yet.
  - kortex 5y ago
    > Nor is there evidence that symptom severity depends on initial viral load (beyond some minimum threshold for infection). https://www.nature.com/articles/s41467-020-19057-5 https://www.nature.com/articles/s41467-020-19057-5 > It's a plausible hypothesis It's extremely plausible, and been demonstrated before in influenza, poxviruses, and other viruses. The human challenge trials necessary to prove a dose-dependent relationship between fall height and lethality haven't been conducted, either, but we have sufficient evidence from longitudinal and natural experiments to draw firm conclusions.
    - nradov 5y ago
      That study you linked isn't relevant to my point. The question is whether the initial viral dose at the point of infection is correlated with symptom severity later in the disease course. That remains unknown. The study looked at the relation between current viral load and symptoms after infection, which is an entirely separate issue.
- twofornone 5y ago
  Something extremely frustrating about virtually all reporting to date is that I haven't seen any statistics as to infection and reinfection rates among front line workers. The implication is that immunity post exposure/infection doesn't exist, but I suspect that this data is being deliberately withheld because it would suggest that frontline workers don't need vaccines, or at the very least don't need a mandate.
rediguanayum 5y ago
The immediate parent comment is correct. Because Covid precluded elective surgery which is a major money maker for hospitals, the bottom line was hit. Consequently many hospitals cut back, and lot go physicians, PAs, nurses, techs, etc. When you hear hospitals are full, it very often isn't because of lack equipment or beds, but rather insufficient staff, especially nurses due to legal regulations around staffing ratios. (Source wife is a healthcare worker on the frontlines)

Because it helps reduce capacity which increases the political will for mandates.

loeg 5y ago

We have vaccine mandates because infected healthcare workers spreading COVID reduce capacity even more. We haven't actually fired many workers, because the vast majority just get the vaccine (mostly before the mandates).

LurkingPenguin 5y ago
1. You need to account for the fact that some percentage (perhaps large) of healthcare workers already survived COVID and have natural immunity. Since the science is demonstrating that natural immunity is as durable and robust as vaccine immunity (if not more durable and robust), one would have to ask what the rationale is for firing workers who have natural immunity (as verified by a past COVID diagnosis or presence of antibodies) and do not want to be vaccinated. 2. The science is clear that vaccinated individuals can contract and spread the virus. While this doesn't mean that the vaccines aren't useful (they absolutely are), we need to be realistic about this in high-risk settings.
- zdragnar 5y ago
  Healthcare workers have been on the front line, unvaccinated, for going on two years. To mandate it or risk being fired has absolutely pissed off quite a few that I know of... My wife has gotten it, and even she is offended. The hyperbole around this very serious situation just makes all the policies seem even more like theater. To your second point, there was just a new report I saw yesterday that there is no difference in viral load between asymptomatic vaccinated and unvaccinated individuals.
  - LurkingPenguin 5y ago
    > The hyperbole around this very serious situation just makes all the policies seem even more like theater. One has to conclude that it is theater at this point. Because the science is pretty darn clear. Interesting that nobody downvoting my comment (and yours) has posted a reputable and recent/current scientific source stating that: 1. Natural immunity is inferior to vaccine-based immunity. 2. Millions of Americans (perhaps 100 million according to a model developed by the CDC) haven't already had and recovered from COVID. 3. Vaccinated individuals can't become infected and spread the virus.
    - macintux 5y ago
      I’m definitely in the pro-vaccine, pro-mandate column, but both 1 and 3 from your list strike me as dubious given the information to this point. Certainly there’s been conflicting information on both.
      - LurkingPenguin 5y ago
        Re-read my comment. I'm asking if anybody downvoting me can provide scientific evidence that those statements are true. Nobody has, because they're not. Natural immunity is durable and robust, and vaccinated people can get infected and spread the virus. In fact, according to the Israeli data, vaccinated people are magnitudes of order more likely to get a Delta breakthrough infection than a person with natural immunity is to get reinfected with Delta.
- frostirosti 5y ago
  > do not want to be vaccinated What's the reason for this? The vaccine has been approved fully by the FDA and hundreds of millions of people have received it. > 2. ... Sure, and people who have had covid and get it again as well. But why risk sick days, lost productivity, severe illness when there's an effective, safe alternative. The capital cost of caring people who get sick with covid is far higher on a per capita basis for those who are unvaccinated.
  - LurkingPenguin 5y ago
    > do not want to be vaccinated What's the reason for this? The vaccine has been approved fully by the FDA and hundreds of millions of people have received it. It's none of your business why they don't want to be vaccinated. If science demonstrates that COVID survivors have strong immunity, why should they be forced to be vaccinated as well? We do not force people who can show immunity to measles, mumps, and rubella to get the MMR vaccine. From the CDC: https://www.cdc.gov/vaccines/vpd/mmr/public/index.html https://www.cdc.gov/vaccines/vpd/mmr/public/index.html > You do not need measles, mumps, and rubella (MMR) vaccine if you meet any of these criteria for presumptive evidence of immunity*: > You have laboratory confirmation of past infection or had blood tests that show you are immune to measles, mumps, and rubella. > Sure, and people who have had covid and get it again as well. But why risk sick days, lost productivity, severe illness when there's an effective, safe alternative. The capital cost of caring people who get sick with covid is far higher on a per capita basis for those who are unvaccinated. You are distorting the science by trying to lump people who survived COVID in with the unvaccinated. They are not the same group. From Israel: https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v1 https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v... > SARS-CoV-2-naïve vaccinees had a 13.06-fold (95% CI, 8.08 to 21.11) increased risk for breakthrough infection with the Delta variant compared to those previously infected, when the first event (infection or vaccination) occurred during January and February of 2021. The increased risk was significant (P<0.001) for symptomatic disease as well. When allowing the infection to occur at any time before vaccination (from March 2020 to February 2021), evidence of waning natural immunity was demonstrated, though SARS-CoV-2 naïve vaccinees had a 5.96-fold (95% CI, 4.85 to 7.33) increased risk for breakthrough infection and a 7.13-fold (95% CI, 5.51 to 9.21) increased risk for symptomatic disease. SARS-CoV-2-naïve vaccinees were also at a greater risk for COVID-19-related-hospitalizations compared to those that were previously infected. > This study demonstrated that natural immunity confers longer lasting and stronger protection against infection, symptomatic disease and hospitalization caused by the Delta variant of SARS-CoV-2, compared to the BNT162b2 two-dose vaccine-induced immunity. Individuals who were both previously infected with SARS-CoV-2 and given a single dose of the vaccine gained additional protection against the Delta variant.
howlong 5y ago
Why do we have vaccine mandates for people working from home?
OrvalWintermute 5y ago
You've made an amazing claim, that infected healthcare workers, who, were caring for Covid patients for almost 2 years now, have been spreading COVID further. This, despite the fact that they are most likely to have caught it early as they were caring for patients prior to vaccines, and hence to have obtained natural immunity. Please provide evidence to support your amazing claim.

mmastrac 5y ago

I'm no policy or health care expert, but maybe because front-line and hospital workers are exposed to extremely large viral loads which seem to be related to the severity of the disease, and taking one HCW off the front-lines and adding them to the sick in the ICUs is worse than one less HCW and the same ICU level? This seems like you are trying to start a flamewar about vaccine mandates, BTW.

nradov 5y ago
There's no reliable evidence that healthcare workers wearing proper PPE are exposed to extremely large viral loads. Nor is there evidence that symptom severity depends on initial viral load (beyond some minimum threshold for infection). It's a plausible hypothesis but the human challenge trials necessary to prove or disprove it haven't been done yet.
- kortex 5y ago
  > Nor is there evidence that symptom severity depends on initial viral load (beyond some minimum threshold for infection). https://www.nature.com/articles/s41467-020-19057-5 https://www.nature.com/articles/s41467-020-19057-5 > It's a plausible hypothesis It's extremely plausible, and been demonstrated before in influenza, poxviruses, and other viruses. The human challenge trials necessary to prove a dose-dependent relationship between fall height and lethality haven't been conducted, either, but we have sufficient evidence from longitudinal and natural experiments to draw firm conclusions.
  - nradov 5y ago
    That study you linked isn't relevant to my point. The question is whether the initial viral dose at the point of infection is correlated with symptom severity later in the disease course. That remains unknown. The study looked at the relation between current viral load and symptoms after infection, which is an entirely separate issue.
twofornone 5y ago
Something extremely frustrating about virtually all reporting to date is that I haven't seen any statistics as to infection and reinfection rates among front line workers. The implication is that immunity post exposure/infection doesn't exist, but I suspect that this data is being deliberately withheld because it would suggest that frontline workers don't need vaccines, or at the very least don't need a mandate.

rediguanayum 5y ago

The immediate parent comment is correct. Because Covid precluded elective surgery which is a major money maker for hospitals, the bottom line was hit. Consequently many hospitals cut back, and lot go physicians, PAs, nurses, techs, etc. When you hear hospitals are full, it very often isn't because of lack equipment or beds, but rather insufficient staff, especially nurses due to legal regulations around staffing ratios. (Source wife is a healthcare worker on the frontlines)