5 ms·

> There's too much uncertainty and I don't know how to quantify and otherwise address risk from stranger You know what would help with this? A randomized cont

by timr 5y ago

> There's too much uncertainty and I don't know how to quantify and otherwise address risk from stranger You know what would help with this? A randomized controlled trial. This isn't tricky at all, except that we can't do the science because it has become political, because people insist that they know the answer already! And if the study shows what they don't want to see, then they censor it, bury it, downvote it into oblivion, or...write missives about how they're going to ignore it. Also, are you vaccinated? Yes? Then the answer is almost certainly no risk at all. This much we know from ~all of the data regarding vaccines and serious illness, worldwide.

vishho 5y ago
We cannot do the science, because such a randomized test would be deeply unethical. Compare to having pregnant women smoke cigarettes to study effect on the fetus. You do this only afterwards with observational data. Next to politization there is also public health, which is more of a management science than an emperical science. And economic concerns. From all the data worldwide, you only reduce risk of hospitalization and death, not for spreading to your grandmother or catching it from a bypasser sneezing in your face. To act like there is no risk for the leaky vaccinated, is to actually increase your risk. Data shows that asymptomatic breakthrough infections are able to cause long-COVID. Now you did not even feel sick and gave your body and immune system rest to clear the virus. Very risky!
- timr 5y ago
  > We cannot do the science, because such a randomized test would be deeply unethical. Thank you for perfectly illustrating the problem. I was actually sort of worried that people wouldn't take me seriously when I said that science has become so political that we actually can't do any. It sounds conspiratorial, doesn't it? But, alas: 1) I post results of RCTs showing that masks do little, if anything. 2) Someone replies that the evidence is insufficient for reasons X, Y, Z. 3) I say "great, let's gather more evidence to resolve those uncertainties". 4) Someone replies "we can't, it's unethical". Quite a fine castle you've built on that cloud, good sir. Very safe indeed.
  - cedilla 5y ago
    It is unethical. All your accusations of narrow-mindedness, but you can't see the obvious, glaring ethical problems with such a trial. Not the least because it would be completely infeasible. You may pretend that we can "simply" do a "controlled experiment" but you ignore how impossible it is to tell any sizeable group of people to behave in a certain way and report honestly about it. "Randomised control trials" are the platonic ideal but in the real world, you can't endanger people for your curiosity, and you will have greatest problems to actually enforce your test protocol. It's more than "tricky". Unless you have access to some spherical people in a vacuum.
  - cthalupa 5y ago
    It isn't a political issue to not do studies that require doing things that actively and intentionally put people at things we know are highly likely to put them at risk of physical harm. The world decided this was unethical long before the current political climate.
    - GekkePrutser 5y ago
      But what if those people volunteer?
    - angelzen 5y ago
      In masks + covid context it feels like "unethical" is used as a thought terminating cliche. * The pandemic is affecting 8,000,000,000 people all around the world. A large size RCT enrolls X0,000 participants. For example, the Pfizer covid mRNA vaccine clinical trial had 21,728 placebo participants. For every RCT participant, the RCT results are going to inform the course of action for hundreds of thousands of people. This is to say that such RCTs are extremely valuable given the high infectiousness of the virus. * The risk to the participants is at worst a moderate increase in the chance of being infected with covid. The covid fatality risk to a healthy adult is small. In the US there have been about 50,000 deaths with covid in <50yo age group. An RCT with 20,000 <50yo people on the placebo arm may see about 3 covid deaths assuming all the placebo participants are going to be infected. Realistically, only a fraction of participants are going to actually be infected with covid, thus there is a good chance every single one of the RCT participants will continue their lives just fine, especially if the study designers are careful to not include people with serious comorbidities. * Vaccines are available to reduce the death risk by another order of magnitude if deemed necessary. Alas, while the vaccines have strong effects in preventing serious covid, they only have a middling effect on preventing infections [edit: after a few months]. The mask/no mask infection effect remains measurable. * Covid is endemic. Everyone is at risk to to be infected with covid sooner or later. Wearing a mask may decrease the daily risk by a moderate margin, unfortunately integrated over many days the infection probability approaches 1. The RCT is merely speeding the risk by a moderate margin for the placebo arm participants. * There is a large pool of potential volunteers that don't (want to) wear masks anyways. Adults have the right to volunteer for risky activities, including activities that may result in death.
- deleted 5y ago
  [deleted]
NikolaNovak 5y ago
>>"Also, are you vaccinated? Yes? Then the answer is almost certainly no risk at all" That is not my lay person interpretation of the currently best available data. A vaccinated person can get infected, can get seriously ill, and can spread out to others more vulnerable. It helps, drastically, and I sure as heck got mine, but my understanding is that it does not confer individual invulnerability.
- gladinovax 5y ago
  [flagged]
- NikolaNovak 5y ago
  replying to "Gladinovax": >>"I'm doing great without one. No need to worry about longterm risks from a rushed vaccine. 1 year does not equal 10. Ever." There are categories of knowledge where I'm profoundly uninterested in any individual's experience (best friend or stranger on the internet alike:). Simply put - a person surviving Russian Roulette does not make playing Russian Roulette a good idea, no matter how convinced they are and loudly proclaimed that it worked out great for them :). I do not know your situation - maybe you've gone hermit; maybe you're in an area of low risk; maybe you're being careful; maybe you're the one asshole around and everybody else is vaccinated/wearing mask/implementing lockdown while you're taking credit for not getting your sorry ass sick; or (most likely but I have no way of judging), you're just lucky - see the Russian roulette above. But in risk evaluation of this sort, again, I'm far far more interested in verifiable statistics than individual's lived experience.Don't get me wrong - we can have a nice round of drinks and talk about how last year's been to us and approaches we've taken and it'll be interesting and we can share; but it's not a policy-guiding thing.
- timr 5y ago
  > A vaccinated person can get infected, can get seriously ill, and can spread out to others more vulnerable. I can get hit by a car when I walk down the street, but I've been doing it my entire life and I'm still here. I can die in a horrible plane crash when I fly, but I still do it. I can have a heart attack when I go to the gym, but it's still a net positive for my life. Do you have a grasp on the actual risks involved here? You do realize that, even unvaccinated, unless you're elderly or obese or severely immunocompromised, the risk from this virus is measured in fractions of a percent, right? And if you've had even a single dose of an approved vaccine, you can take that number and divide it by 10? At some point, you have to let the terror go. > my understanding is that it does not confer individual invulnerability. Who promised you invulnerability?
PaulDavisThe1st 5y ago
> Also, are you vaccinated? Yes? Then the answer is almost certainly no risk at all. As of the week before last, 28% of all hospitalizations in my state (NM) related to COVID19 involved fully vaccinated people.
- headmelted 5y ago
  Isn’t this statistic in itself a little misleading though? Given that so many people are vaccinated now, the proportion of hospitalizations would be expected to trend higher in that group as the pool of unvaccinated people is shrinking at the same time. Also, the eldest people (largely those most at risk of hospitalisation) are substantially more likely to have been vaccinated already, no?
  - PaulDavisThe1st 5y ago
    In the context of the claim that, once vaccinated, you are in "no risk at all" for symptomatic COVID19, I don't think it's misleading: significant numbers of fully vaccinated individuals can and do become sick with the disease. Ergo, even when fully vaccinated, you still face some risk. None of this is an argument against vaccination, of course.

by timr 5y ago

vishho 5y ago

We cannot do the science, because such a randomized test would be deeply unethical. Compare to having pregnant women smoke cigarettes to study effect on the fetus. You do this only afterwards with observational data. Next to politization there is also public health, which is more of a management science than an emperical science. And economic concerns. From all the data worldwide, you only reduce risk of hospitalization and death, not for spreading to your grandmother or catching it from a bypasser sneezing in your face. To act like there is no risk for the leaky vaccinated, is to actually increase your risk. Data shows that asymptomatic breakthrough infections are able to cause long-COVID. Now you did not even feel sick and gave your body and immune system rest to clear the virus. Very risky!

timr 5y ago
> We cannot do the science, because such a randomized test would be deeply unethical. Thank you for perfectly illustrating the problem. I was actually sort of worried that people wouldn't take me seriously when I said that science has become so political that we actually can't do any. It sounds conspiratorial, doesn't it? But, alas: 1) I post results of RCTs showing that masks do little, if anything. 2) Someone replies that the evidence is insufficient for reasons X, Y, Z. 3) I say "great, let's gather more evidence to resolve those uncertainties". 4) Someone replies "we can't, it's unethical". Quite a fine castle you've built on that cloud, good sir. Very safe indeed.
- cedilla 5y ago
  It is unethical. All your accusations of narrow-mindedness, but you can't see the obvious, glaring ethical problems with such a trial. Not the least because it would be completely infeasible. You may pretend that we can "simply" do a "controlled experiment" but you ignore how impossible it is to tell any sizeable group of people to behave in a certain way and report honestly about it. "Randomised control trials" are the platonic ideal but in the real world, you can't endanger people for your curiosity, and you will have greatest problems to actually enforce your test protocol. It's more than "tricky". Unless you have access to some spherical people in a vacuum.
- cthalupa 5y ago
  It isn't a political issue to not do studies that require doing things that actively and intentionally put people at things we know are highly likely to put them at risk of physical harm. The world decided this was unethical long before the current political climate.
  - GekkePrutser 5y ago
    But what if those people volunteer?
  - angelzen 5y ago
    In masks + covid context it feels like "unethical" is used as a thought terminating cliche. * The pandemic is affecting 8,000,000,000 people all around the world. A large size RCT enrolls X0,000 participants. For example, the Pfizer covid mRNA vaccine clinical trial had 21,728 placebo participants. For every RCT participant, the RCT results are going to inform the course of action for hundreds of thousands of people. This is to say that such RCTs are extremely valuable given the high infectiousness of the virus. * The risk to the participants is at worst a moderate increase in the chance of being infected with covid. The covid fatality risk to a healthy adult is small. In the US there have been about 50,000 deaths with covid in <50yo age group. An RCT with 20,000 <50yo people on the placebo arm may see about 3 covid deaths assuming all the placebo participants are going to be infected. Realistically, only a fraction of participants are going to actually be infected with covid, thus there is a good chance every single one of the RCT participants will continue their lives just fine, especially if the study designers are careful to not include people with serious comorbidities. * Vaccines are available to reduce the death risk by another order of magnitude if deemed necessary. Alas, while the vaccines have strong effects in preventing serious covid, they only have a middling effect on preventing infections [edit: after a few months]. The mask/no mask infection effect remains measurable. * Covid is endemic. Everyone is at risk to to be infected with covid sooner or later. Wearing a mask may decrease the daily risk by a moderate margin, unfortunately integrated over many days the infection probability approaches 1. The RCT is merely speeding the risk by a moderate margin for the placebo arm participants. * There is a large pool of potential volunteers that don't (want to) wear masks anyways. Adults have the right to volunteer for risky activities, including activities that may result in death.
deleted 5y ago
[deleted]

NikolaNovak 5y ago

>>"Also, are you vaccinated? Yes? Then the answer is almost certainly no risk at all" That is not my lay person interpretation of the currently best available data. A vaccinated person can get infected, can get seriously ill, and can spread out to others more vulnerable. It helps, drastically, and I sure as heck got mine, but my understanding is that it does not confer individual invulnerability.

gladinovax 5y ago
[flagged]
NikolaNovak 5y ago
replying to "Gladinovax": >>"I'm doing great without one. No need to worry about longterm risks from a rushed vaccine. 1 year does not equal 10. Ever." There are categories of knowledge where I'm profoundly uninterested in any individual's experience (best friend or stranger on the internet alike:). Simply put - a person surviving Russian Roulette does not make playing Russian Roulette a good idea, no matter how convinced they are and loudly proclaimed that it worked out great for them :). I do not know your situation - maybe you've gone hermit; maybe you're in an area of low risk; maybe you're being careful; maybe you're the one asshole around and everybody else is vaccinated/wearing mask/implementing lockdown while you're taking credit for not getting your sorry ass sick; or (most likely but I have no way of judging), you're just lucky - see the Russian roulette above. But in risk evaluation of this sort, again, I'm far far more interested in verifiable statistics than individual's lived experience.Don't get me wrong - we can have a nice round of drinks and talk about how last year's been to us and approaches we've taken and it'll be interesting and we can share; but it's not a policy-guiding thing.
timr 5y ago
> A vaccinated person can get infected, can get seriously ill, and can spread out to others more vulnerable. I can get hit by a car when I walk down the street, but I've been doing it my entire life and I'm still here. I can die in a horrible plane crash when I fly, but I still do it. I can have a heart attack when I go to the gym, but it's still a net positive for my life. Do you have a grasp on the actual risks involved here? You do realize that, even unvaccinated, unless you're elderly or obese or severely immunocompromised, the risk from this virus is measured in fractions of a percent, right? And if you've had even a single dose of an approved vaccine, you can take that number and divide it by 10? At some point, you have to let the terror go. > my understanding is that it does not confer individual invulnerability. Who promised you invulnerability?

PaulDavisThe1st 5y ago

> Also, are you vaccinated? Yes? Then the answer is almost certainly no risk at all. As of the week before last, 28% of all hospitalizations in my state (NM) related to COVID19 involved fully vaccinated people.

headmelted 5y ago
Isn’t this statistic in itself a little misleading though? Given that so many people are vaccinated now, the proportion of hospitalizations would be expected to trend higher in that group as the pool of unvaccinated people is shrinking at the same time. Also, the eldest people (largely those most at risk of hospitalisation) are substantially more likely to have been vaccinated already, no?
- PaulDavisThe1st 5y ago
  In the context of the claim that, once vaccinated, you are in "no risk at all" for symptomatic COVID19, I don't think it's misleading: significant numbers of fully vaccinated individuals can and do become sick with the disease. Ergo, even when fully vaccinated, you still face some risk. None of this is an argument against vaccination, of course.