Where do you stand on "living with Covid", "getting back to normal"

[trollwithamustache]

If you don't know anyone who has died of covid, or had serious complications of covid, it's possibly because the risk factors for that are closely related to poverty and race and you don't know enough people in that demographic.

Or they don't hang out with old people.  Every COVID death I am aware of in my extended network was over the age of 80 and/or in an assisted living facility.  Every COVID story I've heard  was basically "it was horrible, you don't want it" and they were fine 3-4 days later with no hospitalization.

So no, I don't want to get COVID, but it is not like there are bodies in the street a la the bubonic plague. 

[GodlessCommie]

Or they don't hang out with old people.  Every COVID death I am aware of in my extended network was over the age of 80 and/or in an assisted living facility.  Every COVID story I've heard  was basically "it was horrible, you don't want it" and they were fine 3-4 days later with no hospitalization.

So no, I don't want to get COVID, but it is not like there are bodies in the street a la the bubonic plague.

800,000 is a lot of bodies. We have states smaller than that. It's like entire North Dakota gone, or one and a half Wyoming. That they are not in the streets speaks more to our ability to handle dead bodies, not to the size of the pile of bodies.

Also, younger people absolutely do die. My friend's sister died in her 50s.

[BlueMR2]

Somewhat related, I'm shocked that no one I know well has had a serious case or required hospitalization. We have a large family, spread out over the US, most with risk factors of age and comorbidities. Add a large and extended network of friends from the military and I'm amazed that no one has died due to COVID. Several mild cases but nothing serious.

Same here.  I hear about people dying from it (sometimes even whole families) on the news, but the personal experience is totally different.  Nobody I know or am related to has had symptoms worse than a cold, when they had any at all (and I'm in a largely older, anti-vax, and anti-mask family that likes to travel).  I'm really curious as to what the difference might be.  We know that age is a risk factor, but there must be something else that's much stronger.  Is it nutritional since lower income people seem to have a worse time?  Maybe genetic as to the thing with whole families?  Probably some combination of course, but there may be one strong factor that hasn't been positively identified yet.

[Chris22]

If you don't know anyone who has died of covid, or had serious complications of covid, it's possibly because the risk factors for that are closely related to poverty and race and you don't know enough people in that demographic.

The only person in my direct social circle that died was a former teacher of mine I kept in touch with who was morbidly obese and in assisted living recovering from a stroke. I think he was +/- 60.

My FIL went to the hospital with it but was on mononucleal antibodies pretty quickly and recovered fast.

Everyone else I personally know who had it it was a non-event.

[LongtimeLurker]

I'm proposing that we use the golden rule here.  Do what you reasonably can to lower the risk you will help turn your community into a covid cesspool with overwhelmed hospitals.  For me, that means:

Get vaccinated. 
Get boosted.
When case levels are high and hospitalizations are increasing in your community, follow indoor masking and other cdc recommendations.

First, who is arguing against vaccination in this thread?

Second, you clearly did not read/understand the information I posted, and the available information on vaccination. Vaccination adds a layer of protection against serious illness and death, but it wanes as people get older, offering the best protection for people who are already at low risk. IE: Getting the vaccine is more of a boon for you than for the public, especially given a vaccinated person can still spread the virus without even realizing they are sick.

Third, indoor masking has been shown, in the aggregate, to not offer much protection. In schools, for example, it reduces transmission by ~5%, with the overwhelming vast majority of children at lower risk of serious illness/death from COVID than from many other common diseases like RSV. Yet, people lose their minds trying to make schools adopt mask mandates. Even though the same mandates make teaching, already something very difficult, even more challenging. This is in regards to cloth masks, and I would imagine its because people, even people trying to follow the rules/be safe, often take them off for various reasons. "What? I cant hear you, let me take my mask off and lean forward".

Finally, do you propose these mitigation measures to go in perpetuity? We are at 2 years and counting, with a heavy psychological and economical toll. I'm just putting the suggestion out there that we might need different strategies than currently adopted, especially given the adopted strategies appear to have failed.

[LongtimeLurker]

Somewhat related, I'm shocked that no one I know well has had a serious case or required hospitalization. We have a large family, spread out over the US, most with risk factors of age and comorbidities. Add a large and extended network of friends from the military and I'm amazed that no one has died due to COVID. Several mild cases but nothing serious.

Same here.  I hear about people dying from it (sometimes even whole families) on the news, but the personal experience is totally different.  Nobody I know or am related to has had symptoms worse than a cold, when they had any at all (and I'm in a largely older, anti-vax, and anti-mask family that likes to travel).  I'm really curious as to what the difference might be.  We know that age is a risk factor, but there must be something else that's much stronger.  Is it nutritional since lower income people seem to have a worse time?  Maybe genetic as to the thing with whole families?  Probably some combination of course, but there may be one strong factor that hasn't been positively identified yet.

I think this speaks to the overestimation of how deadly COVID is. Again, if you are under 50, the chance of serious illness from COVID is extremely low. While, even someone who is 80 years old has only an ~8.5% chance of dying if infected. Its just the fact that it is completely new and thus spreading like wildfire that is the problem, because then COVID being slightly more deadly than H1N1, for example, causes big problems for society.

The original worst case estimates for COVID, at least the reasonable ones, had about 1.8 million people dying in the US. (350,000,000 people in the US. Everyone gets it, 0.5% die = 1,750,000). We are about halfway there.

[Zikoris]

If you don't know anyone who has died of covid, or had serious complications of covid, it's possibly because the risk factors for that are closely related to poverty and race and you don't know enough people in that demographic.

I think in my case it's mostly because 1. I know relatively few old people, period, and 2. Most of my social circle live similar-ish lifestyles to me (outdoor activities, mostly/entirely plant-based diet with minimal/no fast food, preference for walking/biking over cars, etc), which means the overall healthiness is pretty good. I think in my entire social circle, including family, there are like two obese people (both of whom are white and not in poverty).

[GodlessCommie]

Finally, do you propose these mitigation measures to go in perpetuity? We are at 2 years and counting, with a heavy psychological and economical toll. I'm just putting the suggestion out there that we might need different strategies than currently adopted, especially given the adopted strategies appear to have failed.

United States lost 802,000 out of the population of ~335 million. That comes to approximately 1 of 417 Americans dying.
Our friends to the North lost ~30,000 out of the population of 38 million. Or approximately 1 out of 1266 Canadians.

We are doing 3 times worse. Canadians kept each other alive 3 times better with no draconian measures, no loss of freedom, and only marginally worse economic performance. They had no tools that we didn't have. In fact, they were at a disadvantage - we got vaccines and cutting edge treatments well before them, and we had more intensive care units per capita.

How can we look at this and decide that nothing can be done better?

[trollwithamustache]

Or they don't hang out with old people.  Every COVID death I am aware of in my extended network was over the age of 80 and/or in an assisted living facility.  Every COVID story I've heard  was basically "it was horrible, you don't want it" and they were fine 3-4 days later with no hospitalization.

So no, I don't want to get COVID, but it is not like there are bodies in the street a la the bubonic plague.

800,000 is a lot of bodies. We have states smaller than that. It's like entire North Dakota gone, or one and a half Wyoming. That they are not in the streets speaks more to our ability to handle dead bodies, not to the size of the pile of bodies.

Also, younger people absolutely do die. My friend's sister died in her 50s.

Sure, this isn't to deny COVID isn't real or that younger people haven't died from it. 

As others have posted, there are what, a good 330 million Americans? First number on google is ~2.6 million Americans die every year. With an average life expectancy of 78.8 years. There is a lot of overlap on Comorbitiies.

And this is actually my now not secret COVID pet peeve. Why isn't public health hammering us to exercise more and diet? If everyone walked more, lost 5 lbs and ate more salad their risk profile would go down. And if I am totally wrong and being fat and out of shape does not affect your COVID risk?

The major side effect of this program would be a reduced risk of heart disease and high blood pressure.

[mathlete]

Finally, do you propose these mitigation measures to go in perpetuity? We are at 2 years and counting, with a heavy psychological and economical toll. I'm just putting the suggestion out there that we might need different strategies than currently adopted, especially given the adopted strategies appear to have failed.

United States lost 802,000 out of the population of ~335 million. That comes to approximately 1 of 417 Americans dying.
Our friends to the North lost ~30,000 out of the population of 38 million. Or approximately 1 out of 1266 Canadians.

We are doing 3 times worse. Canadians kept each other alive 3 times better with no draconian measures, no loss of freedom, and only marginally worse economic performance. They had no tools that we didn't have. In fact, they were at a disadvantage - we got vaccines and cutting edge treatments well before them, and we had more intensive care units per capita.

How can we look at this and decide that nothing can be done better?

At least part of Canada's edge on us comes from the fact that we have around 30 million people with almost no relationship with the healthcare system here. Huge failing on our part, but one that existed pre-pandemic.

Not to say that we did a good job, because we didn't (except on vaccines, I think we largely did a good job there).

[Chris22]

How can we look at this and decide that nothing can be done better?

I don’t think that’s the message. I think the message is that the two things that are most focused on as “we must do this to defeat the virus!” to the point of hysteria are shown to be relatively middling in effectiveness. Doubling down on things that aren’t doing a great job isn’t better just because it’s “doing something”. 

[HPstache]

Finally, do you propose these mitigation measures to go in perpetuity? We are at 2 years and counting, with a heavy psychological and economical toll. I'm just putting the suggestion out there that we might need different strategies than currently adopted, especially given the adopted strategies appear to have failed.

United States lost 802,000 out of the population of ~335 million. That comes to approximately 1 of 417 Americans dying.
Our friends to the North lost ~30,000 out of the population of 38 million. Or approximately 1 out of 1266 Canadians.

We are doing 3 times worse. Canadians kept each other alive 3 times better with no draconian measures, no loss of freedom, and only marginally worse economic performance. They had no tools that we didn't have. In fact, they were at a disadvantage - we got vaccines and cutting edge treatments well before them, and we had more intensive care units per capita.

How can we look at this and decide that nothing can be done better?

Healthier population, less population density & the timing of the waves are big factors here.  Yes, Canada is "doing better" but the United states had massive outbreaks brewing (New York / New Jersey) by the time most in the world knew Covid was going to be a huge problem.

[GodlessCommie]

...but why stop there. Right this moment, we lose ~1,200 friends and neighbors a day. Canadians lose 19. Nineteen. Nineteen, one-nine.

Adjusted for population, we are 7.5 times shittier to each other than Canadians.

[GodlessCommie]

I don’t think that’s the message. I think the message is that the two things that are most focused on as “we must do this to defeat the virus!” to the point of hysteria are shown to be relatively middling in effectiveness. Doubling down on things that aren’t doing a great job isn’t better just because it’s “doing something”.

Once you remove the emotional and unsubstantiated dig at the imaginary hysteria, what's left in your argument?

[Chris22]

I don’t think that’s the message. I think the message is that the two things that are most focused on as “we must do this to defeat the virus!” to the point of hysteria are shown to be relatively middling in effectiveness. Doubling down on things that aren’t doing a great job isn’t better just because it’s “doing something”.

Once you remove the emotional and unsubstantiated dig at the imaginary hysteria, what's left in your argument?

That no one’s saying we can’t do better, they’re (or at least Lurker who I agree with) is saying what we’re doing isn’t all that effective.  If you ask most people who want a better response to Covid what to do, they’ll say more masks and more vaxx. Those aren’t really effective.

[GodlessCommie]

Healthier population, less population density & the timing of the waves are big factors here.  Yes, Canada is "doing better" but the United states had massive outbreaks brewing (New York / New Jersey) by the time most in the world knew Covid was going to be a huge problem.

Does the timing explain the 3x difference? Especially the 7.5x difference now?

As for the population density - the overall population density doesn't matter. And the density in population centers is comparable.

[mathlete]

Sure, this isn't to deny COVID isn't real or that younger people haven't died from it. 

As others have posted, there are what, a good 330 million Americans? First number on google is ~2.6 million Americans die every year. With an average life expectancy of 78.8 years. There is a lot of overlap on Comorbitiies.

Couple of things. Weekly excess mortality of 10%-40% for two years straight is a huge deal. Not just in terms of the loss of human life, but in that our society is not built around handling that much sickness in death. There's the stuff I've already hammered like hospital capacity and healthcare worker burnout, but there's also stuff like freezers and the national guard having to be shipped into handle bodies.

And comorbidity <> on death's door. Almost half of American adults have high blood pressure, for example. Massive amounts of life years are being lost. You can tell because insurance companies are making less money. If the people dying in 2020 would have died in 2021 anyway, it would be no big deal for them.

And this is actually my now not secret COVID pet peeve. Why isn't public health hammering us to exercise more and diet? If everyone walked more, lost 5 lbs and ate more salad their risk profile would go down. And if I am totally wrong and being fat and out of shape does not affect your COVID risk?

The major side effect of this program would be a reduced risk of heart disease and high blood pressure.

This deals with the difference between acute and chronic issues. COVID is acute. Obesity is chronic. Eating salads and walking more doesn't fix COVID in the immediate. It doesn't provide any relief for hospitals.

And public health does hammer diet and exercise. The AMA has guidelines that your physician is almost certainly going to inform you of if you're overweight. Michelle Obama made it her pet project. The CDC/WHO/etc. spend a lot of time thinking about this.

But these are hard, generational problems to tackle. Like cigarettes before them, our food and our phones are engineered to be addictive. There's optimism to be found there because we've managed to make major progress on smoking, but it's still the leading preventable cause of death in the US. And we can regulate the hell out of it and make it prohibitively expensive because no one needs to smoke. But people gotta eat. And technology is ubiquitous.

I think we can and will solve diet/exercise/phone use. But it's gonna be generational. The "eat a salad" thing does nothing for COVID.

[mathlete]

Personally, I think everyone should do as much as they're comfortable doing to slow the spread of COVID and lessen the burden on our healthcare infrastructure.

For me, that's distancing, masking, and getting every vaccine the CDC and FDA says I can get.

That said, I'm often the only mask-wearer in the grocery store. I don't judge people who don't wear it. I understand. And if the ability to take off the mask is what pushes someone to get vaccinated, I  am TEN THOUSAND percent supportive of that.

The only thing that annoys me is the, "Heh, look at all these hysterical people. I, the smart one, recognize that I'm 38 and unlikely to die form COVID." Cool. Congratulations. But maybe consider that public health guidance and policy might need to take more things into account.

[GodlessCommie]

That no one’s saying we can’t do better, they’re (or at least Lurker who I agree with) is saying what we’re doing isn’t all that effective.  If you ask most people who want a better response to Covid what to do, they’ll say more masks and more vaxx. Those aren’t really effective.

On the contrary - it is a common theme in this thread that nothing can be done. That action, beyond vax, is pointless.

And if I missed it, what is it that people who gone back to normal suggest we can and should do better?

As for the effectiveness of masks, NIH seems to disagree.

wearing mask in public is essential as its effectiveness has already been well established by the current studies

[mm1970]

If you don't know anyone who has died of covid, or had serious complications of covid, it's possibly because the risk factors for that are closely related to poverty and race and you don't know enough people in that demographic.

Or they don't hang out with old people.  Every COVID death I am aware of in my extended network was over the age of 80 and/or in an assisted living facility.  Every COVID story I've heard  was basically "it was horrible, you don't want it" and they were fine 3-4 days later with no hospitalization.

So no, I don't want to get COVID, but it is not like there are bodies in the street a la the bubonic plague.

https://www.businessinsider.com/florida-hospitals-refrigerated-coolers-stories-bodies-morgues-are-full-2021-8

[mathlete]

Spoiler: show

Pfizer Booster showing good news against both Omicron and Delta. Note the wide confidence interval on Omicron though. Moderna is a similar story.

More vaccination does help.

graph spoiled for size

[Jon Bon]

That said, I'm often the only mask-wearer in the grocery store. I don't judge people who don't wear it. I understand. And if the ability to take off the mask is what pushes someone to get vaccinated, I  am TEN THOUSAND percent supportive of that.

I kind of feel the same way, in the beginning when we had an unapproved vaccine we were encouraging people to get a new product using new tech was a bit of a hard sell. However there was a huge carrot of well if you are vaccinated you don't have to wear a mask anymore.

Now its all the stick, just cancel everything and wear a mask basically forever?

The goal posts/safety margin has constantly moved which is extremely frustrating. I think that pretty much everyone has a "aw screw it" moment you know?

First it was hard lockdown that scared the shit out of everyone. Then flatten the curve, then cancel everything and mask up. Then it was encourage the vaccine and we are gonna beat this! Now everyone has gotten a vaccine that wants one, and I kind of feel we are in the same place. Not really trying to make points to anyone here just how I think a fair amount of people feel about the situation.

"Well if nothing is every going to get better with covid I am going to live my life and damn the torpedo's!" So to speak....

I would just like to see more collaborative efforts from our institutions rather than directive.

[LongtimeLurker]

Finally, do you propose these mitigation measures to go in perpetuity? We are at 2 years and counting, with a heavy psychological and economical toll. I'm just putting the suggestion out there that we might need different strategies than currently adopted, especially given the adopted strategies appear to have failed.

United States lost 802,000 out of the population of ~335 million. That comes to approximately 1 of 417 Americans dying.
Our friends to the North lost ~30,000 out of the population of 38 million. Or approximately 1 out of 1266 Canadians.

We are doing 3 times worse. Canadians kept each other alive 3 times better with no draconian measures, no loss of freedom, and only marginally worse economic performance. They had no tools that we didn't have. In fact, they were at a disadvantage - we got vaccines and cutting edge treatments well before them, and we had more intensive care units per capita.

How can we look at this and decide that nothing can be done better?

We can't. Its obvious the mitigation strategies we have used have not worked. So why continue them given the cost? 

However, check out the bolded part. Look at Canada and ask what they did different. Mandatory quarantine for people entering the country. Closed border for all but essential travel. Vaccination mandate for mass transit(including air travel). Ban or limitations on social gatherings nationwide. That certainly sounds to me like loss of freedom and draconian measures.

Is that loss of freedom worth ~600,000 lives? Would those measures have made that big of a difference? Would they have been feasible and legal? My initial instinct would be no, they would not be feasible or legal in the US.

[LongtimeLurker]

wearing mask in public is essential as its effectiveness has already been well established by the current studies

Then why hasn't it worked in someplace like... Los Angeles where mask mandates are back in effect?

https://www.webmd.com/lung/news/20210907/masks-limit-covid-spread-study

I was mistaken, it was 9% less, not 5%.

Compared to villages that didn't mask, those where masks of any type were worn had about 9% fewer symptomatic cases of COVID-19. The finding was statistically significant and was unlikely to have occurred by chance alone.

[mathlete]

wearing mask in public is essential as its effectiveness has already been well established by the current studies

Then why hasn't it worked in someplace like... Los Angeles where mask mandates are back in effect?

https://www.webmd.com/lung/news/20210907/masks-limit-covid-spread-study

I was mistaken, it was 9% less, not 5%.

Compared to villages that didn't mask, those where masks of any type were worn had about 9% fewer symptomatic cases of COVID-19. The finding was statistically significant and was unlikely to have occurred by chance alone.

There was some research done on this last year. Re: why cities with mandates didn't seem to out perform on balance. The conclusion was that mandate <> adoption. You can tell people to do something, but who is going to enforce it? Citizens? The guy scanning groceries making $10/hr?

There's good news and bad news here. The bad news is that the mandates aren't enforceable en masse outside of say, government buildings. The good news is that people decide to wear masks on their own when the virus gets worse in their area.

[mathlete]

I kind of feel the same way, in the beginning when we had an unapproved vaccine we were encouraging people to get a new product using new tech was a bit of a hard sell. However there was a huge carrot of well if you are vaccinated you don't have to wear a mask anymore.

Now its all the stick, just cancel everything and wear a mask basically forever?

Really though, to be fair, the non-mask wearers are largely winning at this point. Through the combination of either the carrot, or fatigue. Only 51% of Democrats say they wear a mask at the store "every time" now, and they're the most likely group among political affiliation. Enforcement is better at sports arenas and government buildings and stuff, because of liability, but the idea that there is this mask secret police beating everyone with a stick is largely overplayed.

Most people aren't wearing masks anymore and they largely do so without incident. I'm aware of high profile stuff that goes viral, but this is the exception and not the rule.

The goal posts/safety margin has constantly moved which is extremely frustrating. I think that pretty much everyone has a "aw screw it" moment you know?

First it was hard lockdown that scared the shit out of everyone. Then flatten the curve, then cancel everything and mask up. Then it was encourage the vaccine and we are gonna beat this! Now everyone has gotten a vaccine that wants one, and I kind of feel we are in the same place. Not really trying to make points to anyone here just how I think a fair amount of people feel about the situation.

"Well if nothing is every going to get better with covid I am going to live my life and damn the torpedo's!" So to speak....

I would just like to see more collaborative efforts from our institutions rather than directive.

I get that. Apparent goal-post shifting is tough. And it's hard when the CDC says one thing and the WHO says another and the WH says a third. It can be fatiguing.

People want a simple and direct answer. But what I keep falling back on, is that this is largely an unrealistic expectation. This is a novel virus killing millions of people. It's a hard problem to address and the science is evolving all the time.

I know people want a simple answer. I know they want their freedom. I know they want healthcare services to be available to them with no disruption. I know they don't want to get sick and die from COVID. I know they want the labor market to be more settle and have less burnout.

But we quite simply can't have all of these. We're working out the balance in real time. And the stakes are very very high.

I wasn't alive obviously, but it seems that we were more unified during WWII. And American involvement there lasted four years. I thought it was a good idea when Trump started calling the virus "the invisible enemy". Maybe a war metaphor would get people on board more. Sadly, it didn't seem to do much.

[PDXTabs]

wearing mask in public is essential as its effectiveness has already been well established by the current studies

Then why hasn't it worked in someplace like... Los Angeles where mask mandates are back in effect?

https://www.webmd.com/lung/news/20210907/masks-limit-covid-spread-study

I was mistaken, it was 9% less, not 5%.

Compared to villages that didn't mask, those where masks of any type were worn had about 9% fewer symptomatic cases of COVID-19. The finding was statistically significant and was unlikely to have occurred by chance alone.

There was some research done on this last year. Re: why cities with mandates didn't seem to out perform on balance. The conclusion was that mandate <> adoption. You can tell people to do something, but who is going to enforce it? Citizens? The guy scanning groceries making $10/hr?

That's one of my big complaints about he US response. Rules that aren't enforced aren't really rules (have you seen our drivers?). In Italy police enforce mandates. I've seen zero police enforcement of anything pandemic policies in Oregon or Washington. Grocery store enforcement is also very spotty, presumably because they don't get a big ass fine from the OLCC like they do for alcohol sales. Also, the OLCC stings for alcohol sales but not masks.

So, mask rules are like those pesky rules about indicating before changing lanes or not driving 1mph over the speed-limit or not turning into the wrong lane. They are a technicality that does not stop you from doing whatever the fuck you want, because rules that are not enforced are not really rules.

But then we might need actual rules for exempting people who shouldn't be wearing them.

[mathlete]

Following up more on "simple and direct answers". People have tried at many points during the pandemic to give comforting and uncomplicated answers. Just off the top of my head:

-Dr. Drew came on TV early on and said it was no big deal
-Lt. Gov of Texas said that since the virus largely affects old people, young people should live their lives and let a willing group of old people carry the burden of all the risk
-Dr. John Ioannidis made waves by bucking the trend of scientists saying that this pandemic could kill hundreds of thousands of Americans, and declared what we were doing to be an overreaction
-Mr. Money Mustache said we should be eating more salads
-Joe Rogan said we should avoid the vaccine if we're young, and just take ivermectin if/when we get sick.

These answers are all nicer and more appealing than what we get from the CDC. But we would be completely and totally fucked if any of these people were in charge of the process.

Part of being in charge of big and important things means informing people of when things change, giving bad news, and then just letting them be mad at you.

[OtherJen]

If you don't know anyone who has died of covid, or had serious complications of covid, it's possibly because the risk factors for that are closely related to poverty and race and you don't know enough people in that demographic.

Or they don't hang out with old people.  Every COVID death I am aware of in my extended network was over the age of 80 and/or in an assisted living facility.  Every COVID story I've heard  was basically "it was horrible, you don't want it" and they were fine 3-4 days later with no hospitalization.

So no, I don't want to get COVID, but it is not like there are bodies in the street a la the bubonic plague.

The people I knew who died of COVID were between the ages of 40 and 70, and none were in a nursing home. One was a former classmate, one was a school friend's mother, one was a former fellow choir singer, and one was my city's mayor.

[Chris22]

wearing mask in public is essential as its effectiveness has already been well established by the current studies

Then why hasn't it worked in someplace like... Los Angeles where mask mandates are back in effect?

https://www.webmd.com/lung/news/20210907/masks-limit-covid-spread-study

I was mistaken, it was 9% less, not 5%.

Compared to villages that didn't mask, those where masks of any type were worn had about 9% fewer symptomatic cases of COVID-19. The finding was statistically significant and was unlikely to have occurred by chance alone.

There was some research done on this last year. Re: why cities with mandates didn't seem to out perform on balance. The conclusion was that mandate <> adoption. You can tell people to do something, but who is going to enforce it? Citizens? The guy scanning groceries making $10/hr?

There's good news and bad news here. The bad news is that the mandates aren't enforceable en masse outside of say, government buildings. The good news is that people decide to wear masks on their own when the virus gets worse in their area.

I will tell you anecdotally in my little area of Chicagoland, masking is 95%+ indoors. We have a mandate and almost everyone follows it. And I don’t think we’re any better or worse than anywhere else.

There’s also the extremely silly theater. You’d be getting daggers everywhere around here for walking into a restaurant without a mask. However, once at your table, you’re more than welcome to sit there unmasked for hours and hours eating and drinking and laughing and talking and no one thinks anything of it. It’s silly. Hell, I was at an important meeting at work this week (first time in my office in almost a year) and we all masked up like the good responsible people we are for a 6-hour meeting. Except for the hour they brought in lunch, where we all de-masked and sat at the same table and ate and talked for an hour. Then lunch was over and we all put our masks back on. Why?  I dunno.  It was dumb.

[OtherJen]

wearing mask in public is essential as its effectiveness has already been well established by the current studies

Then why hasn't it worked in someplace like... Los Angeles where mask mandates are back in effect?

https://www.webmd.com/lung/news/20210907/masks-limit-covid-spread-study

I was mistaken, it was 9% less, not 5%.

Compared to villages that didn't mask, those where masks of any type were worn had about 9% fewer symptomatic cases of COVID-19. The finding was statistically significant and was unlikely to have occurred by chance alone.

There was some research done on this last year. Re: why cities with mandates didn't seem to out perform on balance. The conclusion was that mandate <> adoption. You can tell people to do something, but who is going to enforce it? Citizens? The guy scanning groceries making $10/hr?

There's good news and bad news here. The bad news is that the mandates aren't enforceable en masse outside of say, government buildings. The good news is that people decide to wear masks on their own when the virus gets worse in their area.

I will tell you anecdotally in my little area of Chicagoland, masking is 95%+ indoors. We have a mandate and almost everyone follows it. And I don’t think we’re any better or worse than anywhere else.

There’s also the extremely silly theater. You’d be getting daggers everywhere around here for walking into a restaurant without a mask. However, once at your table, you’re more than welcome to sit there unmasked for hours and hours eating and drinking and laughing and talking and no one thinks anything of it. It’s silly. Hell, I was at an important meeting at work this week (first time in my office in almost a year) and we all masked up like the good responsible people we are for a 6-hour meeting. Except for the hour they brought in lunch, where we all de-masked and sat at the same table and ate and talked for an hour. Then lunch was over and we all put our masks back on. Why?  I dunno.  It was dumb.

I agree with you. If you're making the decision to uncover your face to eat in a restaurant, there's little point in masking between the door and your table.

Grocery stores are different: even people who choose to skip restaurant dining need to buy food. Hopefully people who are immunocompromised are shopping at off times or using curbside services, but I'm happy to wear a mask in places like that (or medical offices, etc.). It seems a small price to pay to make someone else more comfortable.

[HPstache]

wearing mask in public is essential as its effectiveness has already been well established by the current studies

Then why hasn't it worked in someplace like... Los Angeles where mask mandates are back in effect?

https://www.webmd.com/lung/news/20210907/masks-limit-covid-spread-study

I was mistaken, it was 9% less, not 5%.

Compared to villages that didn't mask, those where masks of any type were worn had about 9% fewer symptomatic cases of COVID-19. The finding was statistically significant and was unlikely to have occurred by chance alone.

There was some research done on this last year. Re: why cities with mandates didn't seem to out perform on balance. The conclusion was that mandate <> adoption. You can tell people to do something, but who is going to enforce it? Citizens? The guy scanning groceries making $10/hr?

There's good news and bad news here. The bad news is that the mandates aren't enforceable en masse outside of say, government buildings. The good news is that people decide to wear masks on their own when the virus gets worse in their area.

I will tell you anecdotally in my little area of Chicagoland, masking is 95%+ indoors. We have a mandate and almost everyone follows it. And I don’t think we’re any better or worse than anywhere else.

There’s also the extremely silly theater. You’d be getting daggers everywhere around here for walking into a restaurant without a mask. However, once at your table, you’re more than welcome to sit there unmasked for hours and hours eating and drinking and laughing and talking and no one thinks anything of it. It’s silly. Hell, I was at an important meeting at work this week (first time in my office in almost a year) and we all masked up like the good responsible people we are for a 6-hour meeting. Except for the hour they brought in lunch, where we all de-masked and sat at the same table and ate and talked for an hour. Then lunch was over and we all put our masks back on. Why?  I dunno.  It was dumb.

Same with airplanes, it's laughable.  Everyone's super careful throughout the airport and on the plane... and then, snack time!

[nereo]

That's one of my big complaints about he US response. Rules that aren't enforced aren't really rules (have you seen our drivers?). In Italy police enforce mandates. I've seen zero police enforcement of anything pandemic policies in Oregon or Washington. Grocery store enforcement is also very spotty, presumably because they don't get a big ass fine from the OLCC like they do for alcohol sales. Also, the OLCC stings for alcohol sales but not masks.

So, mask rules are like those pesky rules about indicating before changing lanes or not driving 1mph over the speed-limit or not turning into the wrong lane. They are a technicality that does not stop you from doing whatever the fuck you want, because rules that are not enforced are not really rules.

But then we might need actual rules for exempting people who shouldn't be wearing them.

It's interesting you bring up the topic of rules, enforcement and compliance, because I've been thinking a lot about that lately.
We seem to have a large group of people who say they will follow the rules outside their homes, but are resistant to following the guidelines - often because they disagree with their effectiveness or find the recommendation to be a burden.

Then we've got a very loud minority that resist any attempt to make the guidelines into rules, (because freedom...?).

So we are left in a position where rules (often called "mandates") are deeply unpopular and frequently only enacted as a last resort, and instead presented as guidelines, which are widely ignored because they aren't rules, and a pandemic that won't subside for a combination of reactors.

It's the proverbial 'damned if you do, damned if you don't' situation, and we all wind up worse off.

[GodlessCommie]

We can't. Its obvious the mitigation strategies we have used have not worked. So why continue them given the cost? 

No, it is not obvious. We know that we haven't beaten Covid, but we don't know what the toll would be if we didn't use the measures that we have. 

However, check out the bolded part. Look at Canada and ask what they did different. Mandatory quarantine for people entering the country. Closed border for all but essential travel. Vaccination mandate for mass transit(including air travel). Ban or limitations on social gatherings nationwide. That certainly sounds to me like loss of freedom and draconian measures.

On the contrary - these are moderate, reasonable measures. And, since they are done with consent of the governed (as confirmed by a mid-Covid election), they do not constitute a loss of freedom.

Is that loss of freedom worth ~600,000 lives? Would those measures have made that big of a difference? Would they have been feasible and legal? My initial instinct would be no, they would not be feasible or legal in the US.

Why wouldn't they make a difference, given they made a difference elsewhere?

What loss of life would make you agree to reasonable and moderate measures implemented by our neighbor with a higher Freedom Index?

[Nick_Miller]

The Millers are as vaxed as we can be and we mask up wherever ordered/requested. Other than that, we're living our lives. I struggle to know where to draw lines. We took vacations this summer, including one to NYC, so it's not like I can slam anyone for going out and doing things.

[GuitarStv]

Finally, do you propose these mitigation measures to go in perpetuity? We are at 2 years and counting, with a heavy psychological and economical toll. I'm just putting the suggestion out there that we might need different strategies than currently adopted, especially given the adopted strategies appear to have failed.

United States lost 802,000 out of the population of ~335 million. That comes to approximately 1 of 417 Americans dying.
Our friends to the North lost ~30,000 out of the population of 38 million. Or approximately 1 out of 1266 Canadians.

We are doing 3 times worse. Canadians kept each other alive 3 times better with no draconian measures, no loss of freedom, and only marginally worse economic performance. They had no tools that we didn't have. In fact, they were at a disadvantage - we got vaccines and cutting edge treatments well before them, and we had more intensive care units per capita.

How can we look at this and decide that nothing can be done better?

There aren't even any cultural differences to point at - as Canadians we get all our culture from American TV.  :P

[GodlessCommie]

Then why hasn't it worked in someplace like... Los Angeles where mask mandates are back in effect?

https://www.webmd.com/lung/news/20210907/masks-limit-covid-spread-study

I was mistaken, it was 9% less, not 5%.

a) mask mandate is not the same as mask wearing.
b) did not work as measured how? LA not beating Covid to zero cases? You have to measure LA with people wearing masks against LA with people not wearing masks on number of deaths/hospitalizations to say "it didn't work"
c) 9% in the study isn't efficacy of masks. It's efficacy of telling people in a village to wear a mask.

But let's run with this number for a second. 9% of 800,000 is 72,000 people. I know, it's way back of the envelope, and 800K is with some of us wearing masks.

But still, is 72,000 fellow Americans staying alive not enough incentive for you to wear a mask indoors? What size pile of bodies do you need to wear one?

[seattlecyclone]

That no one’s saying we can’t do better, they’re (or at least Lurker who I agree with) is saying what we’re doing isn’t all that effective.  If you ask most people who want a better response to Covid what to do, they’ll say more masks and more vaxx. Those aren’t really effective.

On the contrary - it is a common theme in this thread that nothing can be done. That action, beyond vax, is pointless.

There's a difference between "pointless" and "unlikely to be effective enough to be worth the effort." Vaccination is a no-brainer. Everyone should do it. If everyone had done it, our hospitals wouldn't be facing a capacity crunch right now, and the overall infection numbers would likely be a lot lower. I also have no real objection to mask wearing in public settings where practical (eating and strenuous exercise and public speaking being obvious exceptions). I think we should definitely settle into a social norm of wearing masks when we have respiratory symptoms, but for asymptomatic people the benefit seems much less.

Pretty much every other possible mitigation effort requires people to abstain from activities that would otherwise bring positive value to their lives, and for what? So that if people happen to be infected without knowing it they'll have less opportunity to pass it along to someone else who—if they do get infected—will probably turn out fine unless they didn't get their vaccine? That's where I start to say I'm not interested in playing along anymore.

I'm operating on the assumption that COVID will be around forever. For it to be otherwise it seems we'd need to do some sort of coordinated worldwide lockdown where nobody can leave the house at all for 2-4 weeks except in cases of dire emergency. Sufficient food would need to be provided to everyone in advance of this so nobody would need to go to a grocery store or get take-out from a restaurant. Rent and mortgages would need to be forgiven for the duration, plus additional stimulus payments. Even if you get all the world's governments to play along with this, you'd need near-universal compliance among the general population. I see no chance of any of this happening, hence my assumption that the virus will be present for the rest of our lives.

So, let me throw it back to you. If COVID will be around forever, what things should we not have anymore because they're just too risky? Should nobody ever eat at a restaurant again? Sing in a choir? Play in an orchestra? Go to a basketball game? Where's your line between acceptable and unacceptable risks given the ever-present virus?

[mizzourah2006]

wearing mask in public is essential as its effectiveness has already been well established by the current studies

Then why hasn't it worked in someplace like... Los Angeles where mask mandates are back in effect?

https://www.webmd.com/lung/news/20210907/masks-limit-covid-spread-study

I was mistaken, it was 9% less, not 5%.

Compared to villages that didn't mask, those where masks of any type were worn had about 9% fewer symptomatic cases of COVID-19. The finding was statistically significant and was unlikely to have occurred by chance alone.

Also keep in mind that study found the 9% reduction was for surgical masks. They found no statistically significant difference between the unmasked villages and the villages that used cloth masks.

[GodlessCommie]

I agree with you. If you're making the decision to uncover your face to eat in a restaurant, there's little point in masking between the door and your table.

I agree. It's dumb, and it's one of the counterproductive, 100% performative things.

[Cranky]

Or they don't hang out with old people.  Every COVID death I am aware of in my extended network was over the age of 80 and/or in an assisted living facility.  Every COVID story I've heard  was basically "it was horrible, you don't want it" and they were fine 3-4 days later with no hospitalization.

So no, I don't want to get COVID, but it is not like there are bodies in the street a la the bubonic plague.

800,000 is a lot of bodies. We have states smaller than that. It's like entire North Dakota gone, or one and a half Wyoming. That they are not in the streets speaks more to our ability to handle dead bodies, not to the size of the pile of bodies.

Also, younger people absolutely do die. My friend's sister died in her 50s.

My DD’s friend in her 30s died from Covid. She seemed pretty healthy before that. Which is why I think we’ve been so careful.

[mathlete]

Maybe it's worth level setting here. This is the current topline guidance form the CDC.

If you’ve been fully vaccinated: You can resume activities that you did prior to the pandemic. To reduce the risk of being infected with the Delta variant and possibly spreading it to others, wear a mask indoors in public if you are in an area of substantial or high transmission.

That doesn't sound unreasonable to me. Some jurisdictions are trying to "overachieve". Whether this is due to safety theater, or because the admins of 6 hospitals called the mayor and said, "we're fucked if the numbers keep trending this way" is a case by case basis.

Other jurisdictions are giving the finger to the Feds and suing.

But on balance, that's the guidance. That's the countrywide attitude. Nobody is talking about a total cessation of living our lives.

[GodlessCommie]

I think we should definitely settle into a social norm of wearing masks when we have respiratory symptoms, but for asymptomatic people the benefit seems much less.

I'm glad we are in agreement on the usefulness of masks.

Pretty much every other possible mitigation effort requires people to abstain from activities that would otherwise bring positive value to their lives, and for what? So that if people happen to be infected without knowing it they'll have less opportunity to pass it along to someone else who—if they do get infected—will probably turn out fine unless they didn't get their vaccine? That's where I start to say I'm not interested in playing along anymore.

...or have a weakened immune system. People receiving an organ transplant, cancer survivors, autoimmune disorders - these things are not rare by any stretch, and these people had enough trouble staying alive even before Covid. Do you want to re-think you answer with this in mind?

I'm operating on the assumption that COVID will be around forever. For it to be otherwise it seems we'd need to do some sort of coordinated worldwide lockdown <skipped>

So, let me throw it back to you. If COVID will be around forever, what things should we not have anymore because they're just too risky? Should nobody ever eat at a restaurant again? Sing in a choir? Play in an orchestra? Go to a basketball game? Where's your line between acceptable and unacceptable risks given the ever-present virus?

I'm also operating on the assumption that COVID will be around forever. However, I do not accept that the only reaction to a permanent change is to accept all negative consequences.

There are mitigation measures that can (and should) be taken. Improved ventilation is the most obvious one. Others can require vaccination and/or frequent testing, which orchestras are doing already. Mask mandates should stay, for all - it's too unreliable to trust the goodwill, and people respond better to simple rules that don't change. WFH rules may need to be strengthened, possibly through legislation. Paid sick live is a must - it's a travesty that we didn't have it before, it's 10x worse that we don't have it now. Internet must reach 100% of households.

In general, I don't have all the answers (and that's an understatement), but I invite you to approach it from the angle of "if there's the will, there's the way". What this topic tells me is that we lost the will, not that there's no way (again, look North).

[trollwithamustache]

And this is actually my now not secret COVID pet peeve. Why isn't public health hammering us to exercise more and diet?

This deals with the difference between acute and chronic issues. COVID is acute. Obesity is chronic. Eating salads and walking more doesn't fix COVID in the immediate. It doesn't provide any relief for hospitals.

We are almost two years in, it is feeling pretty chronic. Note getting the Vaccine doesn't reduce loads on hospitals right now either. It reduces the loads some time in the future after you have done your sequence.

[GuitarStv]

And this is actually my now not secret COVID pet peeve. Why isn't public health hammering us to exercise more and diet?

This deals with the difference between acute and chronic issues. COVID is acute. Obesity is chronic. Eating salads and walking more doesn't fix COVID in the immediate. It doesn't provide any relief for hospitals.

We are almost two years in, it is feeling pretty chronic. Note getting the Vaccine doesn't reduce loads on hospitals right now either. It reduces the loads some time in the future after you have done your sequence.

That's not quite right.  Getting the vaccine does reduce loads on hospitals a lot for covid classic and delta flavour.  It's much less effective at reducing hospital load for the extra spicy omicrons unless you've had a booster as well.

[LongtimeLurker]

Then why hasn't it worked in someplace like... Los Angeles where mask mandates are back in effect?

https://www.webmd.com/lung/news/20210907/masks-limit-covid-spread-study

I was mistaken, it was 9% less, not 5%.

a) mask mandate is not the same as mask wearing.
b) did not work as measured how? LA not beating Covid to zero cases? You have to measure LA with people wearing masks against LA with people not wearing masks on number of deaths/hospitalizations to say "it didn't work"
c) 9% in the study isn't efficacy of masks. It's efficacy of telling people in a village to wear a mask.

But let's run with this number for a second. 9% of 800,000 is 72,000 people. I know, it's way back of the envelope, and 800K is with some of us wearing masks.

But still, is 72,000 fellow Americans staying alive not enough incentive for you to wear a mask indoors? What size pile of bodies do you need to wear one?

a) Agreed. But I'm not willing to put in the kind of enforcement at this point to make them the same. And yes, because freedom.
b) Case loads rising, hospitalizations rising.
c) That's not how it works. All 72,000 would not die. 72,000 would get infected and then 0.5%, at most, would die = 360 people.

It sounds callous to say "let 360 people die so I don't have to walk around wearing a surgical mask", but its the truth that many people would be willing take that risk.

In the US, there have been ~50,000,000 cases. Reduce that by 9% = 4,500,000 * 0.5% = 22,500 fewer deaths over 2 years, if we all started wearing surgical masks on March 1, 2020 (when the CDC lied and advised us not to in order to protect mask supply for healthcare workers) and continued to this day. Assuming 100% use by people in the US.

That also assumes we either 1) never stop wearing them or 2) eventually COVID-19 disappears or becomes a statistically insignificant disease. Both are very unlikely, so there is a chance you simply delay rather than prevent death, which still has value.

[mm1970]

get that. Apparent goal-post shifting is tough. And it's hard when the CDC says one thing and the WHO says another and the WH says a third. It can be fatiguing.

People want a simple and direct answer. But what I keep falling back on, is that this is largely an unrealistic expectation. This is a novel virus killing millions of people. It's a hard problem to address and the science is evolving all the time.

I know people want a simple answer. I know they want their freedom. I know they want healthcare services to be available to them with no disruption. I know they don't want to get sick and die from COVID. I know they want the labor market to be more settle and have less burnout.

But we quite simply can't have all of these. We're working out the balance in real time. And the stakes are very very high.

Yep.  It's not goal shifting.  People want easy and simple.  We tried that with "please don't wear masks" in early 2020, when it should have been "save the N95's for hospital workers until we get enough for everyone else, but in the mean time, cover your face."

It SEEMS like the vaccines mean "hey, no  more masks!"  And that is just FINE when you are dealing with alpha.  It's less fine when Delta is 2-3x more contagious than Alpha and Omicron is AGAIN 2x more contagious than delta.  The virus is changing, thus we need to also.

[PDXTabs]

That's one of my big complaints about he US response. Rules that aren't enforced aren't really rules (have you seen our drivers?). In Italy police enforce mandates. I've seen zero police enforcement of anything pandemic policies in Oregon or Washington. Grocery store enforcement is also very spotty, presumably because they don't get a big ass fine from the OLCC like they do for alcohol sales. Also, the OLCC stings for alcohol sales but not masks.

So, mask rules are like those pesky rules about indicating before changing lanes or not driving 1mph over the speed-limit or not turning into the wrong lane. They are a technicality that does not stop you from doing whatever the fuck you want, because rules that are not enforced are not really rules.

But then we might need actual rules for exempting people who shouldn't be wearing them.

It's interesting you bring up the topic of rules, enforcement and compliance, because I've been thinking a lot about that lately.
We seem to have a large group of people who say they will follow the rules outside their homes, but are resistant to following the guidelines - often because they disagree with their effectiveness or find the recommendation to be a burden.

Then we've got a very loud minority that resist any attempt to make the guidelines into rules, (because freedom...?).

So we are left in a position where rules (often called "mandates") are deeply unpopular and frequently only enacted as a last resort, and instead presented as guidelines, which are widely ignored because they aren't rules, and a pandemic that won't subside for a combination of reactors.

It's the proverbial 'damned if you do, damned if you don't' situation, and we all wind up worse off.

Well, in Oregon we had actual rules to wear a mask outdoors that were lifted last month. But they were ambiguous and entirely unenforced. I would bet that the average Oregonian didn't even know that they existed. I don't know what kind of political theatre that is, but it's bad, and its only going to hurt the Democrats in the midterms. Basically no one supported it. Just to reiterate, it wasn't just unenforced, it was unenforced to the point that no one knew it was a rule.

As to restaurant theatre, I can go to my local bar and saddle up between two strangers and drink for the night, but I better put on my mask to walk to the door.

[mm1970]

Finally, do you propose these mitigation measures to go in perpetuity? We are at 2 years and counting, with a heavy psychological and economical toll. I'm just putting the suggestion out there that we might need different strategies than currently adopted, especially given the adopted strategies appear to have failed.

United States lost 802,000 out of the population of ~335 million. That comes to approximately 1 of 417 Americans dying.
Our friends to the North lost ~30,000 out of the population of 38 million. Or approximately 1 out of 1266 Canadians.

We are doing 3 times worse. Canadians kept each other alive 3 times better with no draconian measures, no loss of freedom, and only marginally worse economic performance. They had no tools that we didn't have. In fact, they were at a disadvantage - we got vaccines and cutting edge treatments well before them, and we had more intensive care units per capita.

How can we look at this and decide that nothing can be done better?

There aren't even any cultural differences to point at - as Canadians we get all our culture from American TV.  :P

Weird, 'cuz I like Canadian TV.

[Chris22]

get that. Apparent goal-post shifting is tough. And it's hard when the CDC says one thing and the WHO says another and the WH says a third. It can be fatiguing.

People want a simple and direct answer. But what I keep falling back on, is that this is largely an unrealistic expectation. This is a novel virus killing millions of people. It's a hard problem to address and the science is evolving all the time.

I know people want a simple answer. I know they want their freedom. I know they want healthcare services to be available to them with no disruption. I know they don't want to get sick and die from COVID. I know they want the labor market to be more settle and have less burnout.

But we quite simply can't have all of these. We're working out the balance in real time. And the stakes are very very high.

Yep.  It's not goal shifting.  People want easy and simple.  We tried that with "please don't wear masks" in early 2020, when it should have been "save the N95's for hospital workers until we get enough for everyone else, but in the mean time, cover your face."

It SEEMS like the vaccines mean "hey, no  more masks!"  And that is just FINE when you are dealing with alpha.  It's less fine when Delta is 2-3x more contagious than Alpha and Omicron is AGAIN 2x more contagious than delta.  The virus is changing, thus we need to also.

More contagious but not more deadly.  And possibly less so.