4 ms·

You can't delete public health and expect unchanged levels of care individually. Health at the individual level very much depends on public health policies. Do

by rscho 4y ago

You can't delete public health and expect unchanged levels of care individually. Health at the individual level very much depends on public health policies. Don't believe me? Have fun watching your newborn die from whooping cough!

fidgewidge 4y ago
Yes, it would have effects on people's health but those effects would be both positive and negative. They'd both have to be summed together, but even then, health isn't everything. A healthy society run by totalitarians is still a deeply unpleasant society to live in. Whooping cough vaccines and vaccines in general would still exist without public health. The difference is that it would be an individual decision to buy them, based on whether they believe it helps themselves and others, or not. It wouldn't be a government decision.
- rscho 4y ago
  There are very few public health interventions that are deleterious to even a fraction of the population, because the prime directive is "first, do no harm" and that's a very much entrenched principle of public health. Regarding vaccines, I chose the whooping cough example on purpose. This vaccine is only 60% efficient. The risk of newborns being killed or gravely ill would be highly increased if used only at the individual level, including for a particular person choosing to vaccinate. Your view of risks and benefits involved is very much skewed by your overconfidence in individual medicine. It is widely known that poulation-level interventions aka public health are the most effective (e.g. the Cuban system).
  - _heimdall 4y ago
    > the prime directive is "first, do no harm" and that's a very much entrenched principle of public health. Covid response made it clear that this directive went out the window. Practitioners in the medical industry may whole-heartedly believe and follow this goal, but public health is now much too political for it. Plenty of examples in the US. To name a few: Faucci's masking debacle New York City's handling of elderly patients during the peak of their outbreak approval of vaccines under the age of 5 after a study with only 30 participants Biden's holiday speech from the Oval Office attacking anyone who didn't get vaccinated Initial vaccine trials data bastardized by public health officials, claiming vaccines stop the spread when that was never tested. The list goes on, but public health has been made a political game driven by few who they know what's best and are willing to saw what they think will get compliance rather than sharing what is and isn't known and doing no harm by fostering another core principle of informed consent.
  - deleted 4y ago
    [deleted]
  - fidgewidge 4y ago
    "This vaccine is only 60% efficient." How do you know? Because you were told by the same system that claimed Comirnaty was 95% effective? For those of us who generalize from public health in the COVID years to public health in general, why is that generalization wrong, in your view?
    - rscho 4y ago
      > How do you know? It's been known for decades, and knowing that is part of my job. I'm in Europe, where this vaccine is part of the basic plan for all children. > For those of us who generalize from public health in the COVID years to public health in general, why is that generalization wrong, in your view? Most public health interventions do not make money for corporations or in fact, for anybody. They mostly spare taxpayer money by increasing efficiency across the healthcare system. COVID is a very particular case where a new technology became our best guess, and made money for powerful people. So COVID can't be generalized to other interventions at all.
      - fidgewidge 4y ago
        "It's been known for decades, and knowing that is part of my job" Mmm yeah not surprised, was already thinking your posts sounded just like the sort of things public health people say. But that didn't answer the question. How do you know? "Most public health interventions do not make money [ - ] so COVID can't be generalized to other interventions at all" That's a non-sequitur. Nobody mentioned money or corporations in this thread. You're answering an imaginary objection instead of the one we're actually raising, which says a lot. My prior that public health [-adjacent] people are all so left wing that they don't even realize how ideologically biased they are just got incremented again. The problem here is not corporations or money or some people getting rich. The observation we are generalizing beyond COVID is that people who work in public health seem to lie a lot. Specifically, they lie any time they think a lie will make people act in ways that please them, and what pleases them is anything where everyone is forced to act in exactly the same way all at the same time. By "public health" we mean here government officials, academics, researchers and the people who speak for them. Hey we don't trust Pfizer either but if it weren't for the public health sector forcing us to buy and consume their products, we could just ignore them, or make case-by-case decisions, so the root problem is not them.
wmorgan 4y ago
Whooping cough is a funny example, since most adults are in fact not vaccinated for it -- in the US anyway, the vaccination rate for pertussis is under 30%. The reason newborns aren't dying from whooping cough is not that we vaccinate everyone. Instead, we make the vaccine widely available for people who want it (I got my booster at one of my wife's ultrasounds), and we tell parents not to expose their newborns to anyone who isn't vaccinated, until the baby can get their own. So for whooping cough specifically, it really is up to the parents, and I would say more of an individual responsibility thing.

by rscho 4y ago

fidgewidge 4y ago

Yes, it would have effects on people's health but those effects would be both positive and negative. They'd both have to be summed together, but even then, health isn't everything. A healthy society run by totalitarians is still a deeply unpleasant society to live in. Whooping cough vaccines and vaccines in general would still exist without public health. The difference is that it would be an individual decision to buy them, based on whether they believe it helps themselves and others, or not. It wouldn't be a government decision.

rscho 4y ago
There are very few public health interventions that are deleterious to even a fraction of the population, because the prime directive is "first, do no harm" and that's a very much entrenched principle of public health. Regarding vaccines, I chose the whooping cough example on purpose. This vaccine is only 60% efficient. The risk of newborns being killed or gravely ill would be highly increased if used only at the individual level, including for a particular person choosing to vaccinate. Your view of risks and benefits involved is very much skewed by your overconfidence in individual medicine. It is widely known that poulation-level interventions aka public health are the most effective (e.g. the Cuban system).
- _heimdall 4y ago
  > the prime directive is "first, do no harm" and that's a very much entrenched principle of public health. Covid response made it clear that this directive went out the window. Practitioners in the medical industry may whole-heartedly believe and follow this goal, but public health is now much too political for it. Plenty of examples in the US. To name a few: Faucci's masking debacle New York City's handling of elderly patients during the peak of their outbreak approval of vaccines under the age of 5 after a study with only 30 participants Biden's holiday speech from the Oval Office attacking anyone who didn't get vaccinated Initial vaccine trials data bastardized by public health officials, claiming vaccines stop the spread when that was never tested. The list goes on, but public health has been made a political game driven by few who they know what's best and are willing to saw what they think will get compliance rather than sharing what is and isn't known and doing no harm by fostering another core principle of informed consent.
- deleted 4y ago
  [deleted]
- fidgewidge 4y ago
  "This vaccine is only 60% efficient." How do you know? Because you were told by the same system that claimed Comirnaty was 95% effective? For those of us who generalize from public health in the COVID years to public health in general, why is that generalization wrong, in your view?
  - rscho 4y ago
    > How do you know? It's been known for decades, and knowing that is part of my job. I'm in Europe, where this vaccine is part of the basic plan for all children. > For those of us who generalize from public health in the COVID years to public health in general, why is that generalization wrong, in your view? Most public health interventions do not make money for corporations or in fact, for anybody. They mostly spare taxpayer money by increasing efficiency across the healthcare system. COVID is a very particular case where a new technology became our best guess, and made money for powerful people. So COVID can't be generalized to other interventions at all.
    - fidgewidge 4y ago
      "It's been known for decades, and knowing that is part of my job" Mmm yeah not surprised, was already thinking your posts sounded just like the sort of things public health people say. But that didn't answer the question. How do you know? "Most public health interventions do not make money [ - ] so COVID can't be generalized to other interventions at all" That's a non-sequitur. Nobody mentioned money or corporations in this thread. You're answering an imaginary objection instead of the one we're actually raising, which says a lot. My prior that public health [-adjacent] people are all so left wing that they don't even realize how ideologically biased they are just got incremented again. The problem here is not corporations or money or some people getting rich. The observation we are generalizing beyond COVID is that people who work in public health seem to lie a lot. Specifically, they lie any time they think a lie will make people act in ways that please them, and what pleases them is anything where everyone is forced to act in exactly the same way all at the same time. By "public health" we mean here government officials, academics, researchers and the people who speak for them. Hey we don't trust Pfizer either but if it weren't for the public health sector forcing us to buy and consume their products, we could just ignore them, or make case-by-case decisions, so the root problem is not them.

wmorgan 4y ago

Whooping cough is a funny example, since most adults are in fact not vaccinated for it -- in the US anyway, the vaccination rate for pertussis is under 30%. The reason newborns aren't dying from whooping cough is not that we vaccinate everyone. Instead, we make the vaccine widely available for people who want it (I got my booster at one of my wife's ultrasounds), and we tell parents not to expose their newborns to anyone who isn't vaccinated, until the baby can get their own. So for whooping cough specifically, it really is up to the parents, and I would say more of an individual responsibility thing.