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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

by 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.
    - rscho 4y ago
      Well, you already reached your own conclusions, but you see the reason why I focused on corporations is a) Pfizer making money is an extremely common critic regarding the COVID situation, at least around here, and b) the objection you were formulating was up to now unclear to me, so I unconsciously focused on the most common one. I never thought you were making a purely political statement, because in my mind, this problem has nothing political in it. I'm not that left wing and most docs are not lefties at all. Honestly, I don't think the academic/medical arm of public health has a political agenda. We just don't care who is in charge, but it's frustrating to see people working against their best interest when you're spending 70+ hours a week attempting to improve a catastrophic situation. Regarding the lying, I fear you're attributing to malice what is in fact just ignorance. Academics were asked for recommendations, sent back their best guess about a very uncertain situation, and got backlash about everything they guessed wrong. I have to say that the american way of extremely polarized political opinions spreading to everything feels really alien to me.

by rscho 4y ago

_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.
  - rscho 4y ago
    Well, you already reached your own conclusions, but you see the reason why I focused on corporations is a) Pfizer making money is an extremely common critic regarding the COVID situation, at least around here, and b) the objection you were formulating was up to now unclear to me, so I unconsciously focused on the most common one. I never thought you were making a purely political statement, because in my mind, this problem has nothing political in it. I'm not that left wing and most docs are not lefties at all. Honestly, I don't think the academic/medical arm of public health has a political agenda. We just don't care who is in charge, but it's frustrating to see people working against their best interest when you're spending 70+ hours a week attempting to improve a catastrophic situation. Regarding the lying, I fear you're attributing to malice what is in fact just ignorance. Academics were asked for recommendations, sent back their best guess about a very uncertain situation, and got backlash about everything they guessed wrong. I have to say that the american way of extremely polarized political opinions spreading to everything feels really alien to me.