Author Topic: How much will non-vaxxing by GOP reduce the population of voting age republicans  (Read 86607 times)

MudPuppy

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I’m moving to an outpatient role. Not even truly patient facing because I’m doing occupational health. The pay cut is significant and I will still be affected by Covid in that we will have employee Covid cases, but I can’t WAIT to go. The wellness courses I’m holding in September are smoking cessation and pre-conception wellness. Doesn’t that sound too good to be true??

ender

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As you should...I'm surprised we haven't seen a mass exodus of healthcare workers in the US.

We're already seeing it. There's an increasing staffing crisis in healthcare workers in Canada. The alarm bells are ringing very, very loudly.

I can't imagine it's better in the US.

There were issues with this before covid...

MudPuppy

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@ender are you implying I that the issues remain unchanged, and that burnout and PTSD are not accelerating this… exponentially?


I want to say for the record, that there had never been a shortage of HCW, there has only been a shortage of fair wages and fair working conditions.

ender

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@ender are you implying I that the issues remain unchanged, and that burnout and PTSD are not accelerating this… exponentially?


I want to say for the record, that there had never been a shortage of HCW, there has only been a shortage of fair wages and fair working conditions.

No, I just mean that areas of the USA were facing shortages of folks in various medical fields even pre-covid and all indicators suggested longer term gaps in the number of folks needed.

Paul der Krake

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A nurse in London makes about one third to one half of what a nurse makes in New York or San Francisco. Roughly equivalent cost of living.

Import the nurses from overseas and flood the market, problem solved.


CodingHare

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A nurse in London makes about one third to one half of what a nurse makes in New York or San Francisco. Roughly equivalent cost of living.

Import the nurses from overseas and flood the market, problem solved.
Lol, if money was the only factor, those London nurses would already be here.  Our crappy medical insurance system, Covidiots, and insane work hours make that a non starter.  Make the US a better country and then maybe they'd consider it.

Metalcat

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As you should...I'm surprised we haven't seen a mass exodus of healthcare workers in the US.

We're already seeing it. There's an increasing staffing crisis in healthcare workers in Canada. The alarm bells are ringing very, very loudly.

I can't imagine it's better in the US.

There were issues with this before covid...

Here in Canada too.

Covid has just turned it up to 11. We went from a staffing shortage to literally not even being able to pay enough to get some positions filled. It's no longer "this is an imminent crisis" it's now "this is a crisis with no solution"

I'm also wondering if post covid there will be a drop in enrolment for some medical professions.

There has already been a steady decline in enrolment in certain programs, especially those that lead to traditionally female, poorly compensated, junior medical roles. Post covid, I can't imagine many parents encouraging their child to pursue these careers.

PDXTabs

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A nurse in London makes about one third to one half of what a nurse makes in New York or San Francisco. Roughly equivalent cost of living.

Import the nurses from overseas and flood the market, problem solved.
Lol, if money was the only factor, those London nurses would already be here.  Our crappy medical insurance system, Covidiots, and insane work hours make that a non starter.  Make the US a better country and then maybe they'd consider it.

London, historically at least, has imported nursing staff from eastern Europe. The USA could do that too (or from the Philippines). But that only solves the problem for the USA. Not Poland and the Philippines.

But yes, the USA could do a much better job importing skilled foreign labour. Eg, why can't a UK licenced physician practice in the USA without redoing all of med-school?

Abe

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A nurse in London makes about one third to one half of what a nurse makes in New York or San Francisco. Roughly equivalent cost of living.

Import the nurses from overseas and flood the market, problem solved.
Lol, if money was the only factor, those London nurses would already be here.  Our crappy medical insurance system, Covidiots, and insane work hours make that a non starter.  Make the US a better country and then maybe they'd consider it.

London, historically at least, has imported nursing staff from eastern Europe. The USA could do that too (or from the Philippines). But that only solves the problem for the USA. Not Poland and the Philippines.

But yes, the USA could do a much better job importing skilled foreign labour. Eg, why can't a UK licenced physician practice in the USA without redoing all of med-school?

They can...most choose not to due to above-mentioned structural issues. One of my colleagues is having an interesting time adjusting to said issues after moving from the UK.

PDXTabs

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They can...most choose not to due to above-mentioned structural issues. One of my colleagues is having an interesting time adjusting to said issues after moving from the UK.

Interesting. Every US MD I've ever talked to said that it was super hard going that direction over the pond. I'd be curious to know what their credentials were in the UK and how they transferred. Keeping in mind that most physicians in the UK have something like five years of college and a MB ChB.

Metalcat

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A nurse in London makes about one third to one half of what a nurse makes in New York or San Francisco. Roughly equivalent cost of living.

Import the nurses from overseas and flood the market, problem solved.
Lol, if money was the only factor, those London nurses would already be here.  Our crappy medical insurance system, Covidiots, and insane work hours make that a non starter.  Make the US a better country and then maybe they'd consider it.

London, historically at least, has imported nursing staff from eastern Europe. The USA could do that too (or from the Philippines). But that only solves the problem for the USA. Not Poland and the Philippines.

But yes, the USA could do a much better job importing skilled foreign labour. Eg, why can't a UK licenced physician practice in the USA without redoing all of med-school?

That's a far more complex question than just immigration policy.

I get what you are saying regarding importing skilled labour, but the issues behind that specific example of MD credentialing and equivalency are an absolute beast.

Suffice to say, it's not a great example for illustrating immigration issues because the licensing bodies that govern who can practice as a doctor are NOT government organizations. Doctors are self governed, especially when it comes to licensing.

Paul der Krake

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A nurse in London makes about one third to one half of what a nurse makes in New York or San Francisco. Roughly equivalent cost of living.

Import the nurses from overseas and flood the market, problem solved.
Lol, if money was the only factor, those London nurses would already be here.  Our crappy medical insurance system, Covidiots, and insane work hours make that a non starter.  Make the US a better country and then maybe they'd consider it.
No, they don't come here because the medical world has a iron lock on occupational licensing and the immigration laws make it very difficult/expensive.

Both of these things are a policy choice.

Mr. Green

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The Herman Cain Award subreddit is just overflowing with publicly declared anti-vaxxers dying, like by the hour it seems. It's just shocking how many people are kicking the bucket right now.

PDXTabs

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That's a far more complex question than just immigration policy.

I get what you are saying regarding importing skilled labour, but the issues behind that specific example of MD credentialing and equivalency are an absolute beast.

Suffice to say, it's not a great example for illustrating immigration issues because the licensing bodies that govern who can practice as a doctor are NOT government organizations. Doctors are self governed, especially when it comes to licensing.

Well, it's both. Because a nurse with a job offer and a sufficiently high salary in the EU can get a blue card. I'm not aware of an equivalent PR track visa in the USA.

Abe

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They can...most choose not to due to above-mentioned structural issues. One of my colleagues is having an interesting time adjusting to said issues after moving from the UK.

Interesting. Every US MD I've ever talked to said that it was super hard going that direction over the pond. I'd be curious to know what their credentials were in the UK and how they transferred. Keeping in mind that most physicians in the UK have something like five years of college and a MB ChB.

this colleague’s training was in the UK. If there is a position, the hospital can sponsor their visa. The accreditation is done post-hoc on the assumption they will pass the medical licensing exams in the US. Its not easy, but is doable if one has a visa. But again, physicians from Europe are not falling over themselves to come join our fiasco of a healthcare system. I am sure our behavior as a society is not encouraging them to reconsider.

former player

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There are a dishearteningly high number of people who have bought into misinformation so heartily that they refuse to even test. Today alone I have had 5 people in my ER who are seeking treatment for raging Covid symptoms but refuse to be tested for Covid at all. In addition to not being counted among the Covid stats, the people are certainly not isolating or taking precautions otherwise. And of course we know they aren’t going to get a vaccine for an illness they won’t even be tested for.
So if you then say "we are going to give you the treatments we give to covid patients" do they refuse those treatments too?  I bet not.
You mean like regeneron and remdesivir? We wouldn’t do that without a positive test

I'm a bit taken aback by this, on both the medical providers and the patients' part.

Do you explain to the patients that you think they've got covid but without a positive test won't give them what you think is the right treatment?  Could you say "this is the right treatment for what you've got" and ask them to consent to it without explaining that it's the treatment for covid?  Or "covid treatment is right for you, do you consent to it?" What does a patient say then?  Do you give any treatment or just turn them away?

And what are the medical ethics?  I would have thought it was pretty common to treat someone, or at least start treating someone, based on diagnosis from symptoms?  And early on tests for covid weren't widely available so treatment in those cases would be based on diagnosis not tests, why would this situation be ethically different?

I mean, I get and entirely sympathise with "no test, no treatment, goodbye" but I'm having trouble with the ethics of it.  And if it's a matter of rationing scarce resources that might be justifiable except that giving someone less than optimal treatment seems likely to use up more resources rather than less, such as making them more likely to need inpatient or ICU care, unless you are going to refuse treatment altogether.

Such a mess, all of it, and so unnecessary.  I entirely understand not wanting to deal with it any more.

Metalcat

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That's a far more complex question than just immigration policy.

I get what you are saying regarding importing skilled labour, but the issues behind that specific example of MD credentialing and equivalency are an absolute beast.

Suffice to say, it's not a great example for illustrating immigration issues because the licensing bodies that govern who can practice as a doctor are NOT government organizations. Doctors are self governed, especially when it comes to licensing.

Well, it's both. Because a nurse with a job offer and a sufficiently high salary in the EU can get a blue card. I'm not aware of an equivalent PR track visa in the USA.

I was specifically just referring to the example of doctors.

MudPuppy

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@former player i think I’m not processing your post correctly, so I apologize if that’s so.

Sure we can (and do, when they don’t literally walk out at the mere suggestion that they might have Covid) give people something for their headache or something for a cough or maybe some fluids if they are dehydrated, but the treatments that are for Covid can’t be given on supposition, regeneron for example is still EUA and not all of Covid patient qualify for it. If case positivity is 20% then that’s 4 out of 5 people who DONT have it. If you’re talking about early on when there were no tests, all we had was supportive care then anyway, so the point was moot.

And yes, of course we try to educate about why we want to test. But it pretty much never helps when they are so deeply bought into the misinformation and conspiracy theories that they are refusing to be tested while actively sick.

No one is refusing anyone care and I never implied that we were.

OtherJen

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There are a dishearteningly high number of people who have bought into misinformation so heartily that they refuse to even test. Today alone I have had 5 people in my ER who are seeking treatment for raging Covid symptoms but refuse to be tested for Covid at all. In addition to not being counted among the Covid stats, the people are certainly not isolating or taking precautions otherwise. And of course we know they aren’t going to get a vaccine for an illness they won’t even be tested for.
So if you then say "we are going to give you the treatments we give to covid patients" do they refuse those treatments too?  I bet not.
You mean like regeneron and remdesivir? We wouldn’t do that without a positive test

I'm a bit taken aback by this, on both the medical providers and the patients' part.

Do you explain to the patients that you think they've got covid but without a positive test won't give them what you think is the right treatment?  Could you say "this is the right treatment for what you've got" and ask them to consent to it without explaining that it's the treatment for covid?  Or "covid treatment is right for you, do you consent to it?" What does a patient say then?  Do you give any treatment or just turn them away?

And what are the medical ethics?  I would have thought it was pretty common to treat someone, or at least start treating someone, based on diagnosis from symptoms?  And early on tests for covid weren't widely available so treatment in those cases would be based on diagnosis not tests, why would this situation be ethically different?

I mean, I get and entirely sympathise with "no test, no treatment, goodbye" but I'm having trouble with the ethics of it.  And if it's a matter of rationing scarce resources that might be justifiable except that giving someone less than optimal treatment seems likely to use up more resources rather than less, such as making them more likely to need inpatient or ICU care, unless you are going to refuse treatment altogether.

Such a mess, all of it, and so unnecessary.  I entirely understand not wanting to deal with it any more.

It seems like it would be a bad idea, from a medical ethics standpoint (and also a clinical standpoint), to give someone a not widely available and not fully approved treatment with very narrow indications for symptoms without a positive test. Lots of things can cause pneumonia, for example, and Regeneron would be useless against all of them except COVID pneumonia.

If someone showed up at the clinic with a lump in their breast, you'd refer them to radiology for imaging tests, perform a biopsy, and run genetic tests before prescribing further treatment. They would be within their rights to refuse any of those tests, and therefore it would not be ethical to prescribe tamoxifen without knowing that you're actually dealing with an estrogen receptor-positive breast cancer and not a benign cyst.

Sibley

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LOL. Illinois just issued an order. There's a lot of people scrambling to get appointments. I'm sure there's also a lot of people screaming, but who will end up getting the vaccine because getting weekly tests is inconvenient/uncomfortable.

Best part is - a bunch of people at my job aren't vaccinated. Mostly inertia/lack of urgency. We audit school districts. The order applies to us. At least one person is now getting vaccinated (haven't heard from the others yet, but I'm guessing a bunch more will be too).

PeteD01

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The Herman Cain Award subreddit is just overflowing with publicly declared anti-vaxxers dying, like by the hour it seems. It's just shocking how many people are kicking the bucket right now.

On my way home from a family gettogether where I heard of deaths and severe illness in distant relatives, I started thinking about what form the transition to endemicity of the virus could take. I live in Jacksonville and things are really bad here in the unvaccinated population. That probably colors my thoughts more negative than the issue deserves. In any case, here is what I wrote down when I got home. I think there is a possibility that the unvaccinated are going to be absolutely screwed as vaccination rates are going up:

I am slowly becoming more and more supicious that Delta is more virulent than previous variants.
Generally, transmissible pathogens do not do well in terms of becoming endemic if their virulence is excessive, but this is not always true, particularly with zoonotic diseases. But now we have a large population of vaccinated people in whom the virus can circulate with minimal mortality.
Maybe this has removed the brake on virulence similar to what is seen in zoonotic diseases like Ebola. In other words, the vaccinated are to the unvaccinated what bats are to humans in areas where Ebola is endemic.
Combine this with the close contact of this population with the susceptible, unvaccinated population and one comes up with the, not at all desirable, situation that ever more lethal variants could freely circulate exterminating over time the unvaccinated adult population. (immunity conveyed via infection in adults doe not appear to be protective in the long run, whereas children are probably more likely to develop robust immunity from infection) 
I now can imagine the entering of the endemic stage to be accompanied by a massive die-off of the unlucky unvaccinated population.
What I am saying here is not more than basic evolutionary biology: The apparent decrease over time in virulence of a successful endemic pathogen is not necessarily mediated by a change of the pathogen but also by a major mortality event in the host population selecting for resistant varieties and resulting in an apparent decrease in virulence.
The depopulation of the Americas by infectious diseases after contact with Europeans comes to mind, but there are many other examples, particularly in plant diseases (Dutch elm disease and others).
Well, food for thought, nothing more.

« Last Edit: August 31, 2021, 08:12:33 AM by PeteD01 »

former player

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@former player i think I’m not processing your post correctly, so I apologize if that’s so.

Sure we can (and do, when they don’t literally walk out at the mere suggestion that they might have Covid) give people something for their headache or something for a cough or maybe some fluids if they are dehydrated, but the treatments that are for Covid can’t be given on supposition, regeneron for example is still EUA and not all of Covid patient qualify for it. If case positivity is 20% then that’s 4 out of 5 people who DONT have it. If you’re talking about early on when there were no tests, all we had was supportive care then anyway, so the point was moot.

And yes, of course we try to educate about why we want to test. But it pretty much never helps when they are so deeply bought into the misinformation and conspiracy theories that they are refusing to be tested while actively sick.

No one is refusing anyone care and I never implied that we were.
So I guess that if a covid-denier (shorthand for "has covid, won't have test") came in needing supportive treatment it would be given but dexamethasone wouldn't?  Meaning that they had less chance of recovery and might also take up more resources in the form of in-patient care?  I've seen reports of people in intensive care and on the way to intubation and death still refusing to believe in covid, but I guess I thought they would still have been getting the full treatment on the basis not necessarily that it was the covid treatment but that it was "the appropriate treatment for your unnamed condition".

The "walking wounded", wanting help but not covid help I can completely understand turning away with symptomatic relief only.  At this point covid denial is pretty much a cult and health care providers can't be expected to do more than state what they think is wrong, they can't possibly be responsible for de-programming the cult members.

OtherJen

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@former player i think I’m not processing your post correctly, so I apologize if that’s so.

Sure we can (and do, when they don’t literally walk out at the mere suggestion that they might have Covid) give people something for their headache or something for a cough or maybe some fluids if they are dehydrated, but the treatments that are for Covid can’t be given on supposition, regeneron for example is still EUA and not all of Covid patient qualify for it. If case positivity is 20% then that’s 4 out of 5 people who DONT have it. If you’re talking about early on when there were no tests, all we had was supportive care then anyway, so the point was moot.

And yes, of course we try to educate about why we want to test. But it pretty much never helps when they are so deeply bought into the misinformation and conspiracy theories that they are refusing to be tested while actively sick.

No one is refusing anyone care and I never implied that we were.
So I guess that if a covid-denier (shorthand for "has covid, won't have test") came in needing supportive treatment it would be given but dexamethasone wouldn't?  Meaning that they had less chance of recovery and might also take up more resources in the form of in-patient care?  I've seen reports of people in intensive care and on the way to intubation and death still refusing to believe in covid, but I guess I thought they would still have been getting the full treatment on the basis not necessarily that it was the covid treatment but that it was "the appropriate treatment for your unnamed condition".

The "walking wounded", wanting help but not covid help I can completely understand turning away with symptomatic relief only.  At this point covid denial is pretty much a cult and health care providers can't be expected to do more than state what they think is wrong, they can't possibly be responsible for de-programming the cult members.

How would you prove that someone has COVID without a positive test? It seems that medical professionals would be opening themselves up for lawsuits for prescribing wrong treatments.

MudPuppy

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@former player if the treatment is the most correct for the patient’s symptoms, sure. But you can’t give drugs willy nilly based on supposition, since it does NOT help everyone with the symptom set. The symptom constellation could be many things.

Think about antibiotics, it is not best practice to give antibiotics unless there is evidence of bacterial infection. Even then, not all antibiotics are created equal and don’t reach certain tissues in the same way, even if the bacteria in a Petri dish might be technically susceptible.

PeteD01

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I've seen reports of people in intensive care and on the way to intubation and death still refusing to believe in covid, but I guess I thought they would still have been getting the full treatment on the basis not necessarily that it was the covid treatment but that it was "the appropriate treatment for your unnamed condition".


Almost certainly would they have received the appropriate treatment.
Administering treatments with the appropriate risk benefit ratio without having a specific diagnosis is called empiric treatment. In the critical care setting this approach is actually the rule not the exception. Unless the patient has refused a particular intervention appropriate treatments will be provided. Depending on the particular intervention refused, admission to the ICU might be denied.

Another rather common situation in the pre-antiretroviral era of HIV was the patient admitted with typical complications of advanced AIDS but without having had an HIV test, either because of refusal to be tested or because of being a new presentation. We treated all of these patients empirically unless specific treatments were refused.

Highly specific therapies for mild disease with nonspecific symptoms in limited supply, such as MAB therapy for the prevention of severe COVID, are an entirely different thing. There a diagnosis would have to be made prior to treatment unless disease prevalence is extremely high (like 95% of patients walking through that door during the last 2 weeks with these symptoms had COVID). The prevalence at which such a treatment would be administered empirically also depends on the characteristics of the specific test. As no test is ideal, there is a disease prevalence above which performing the test is not indicated anymore due to unacceptably high false negative rates.
This situation has not been encountered in any of the MAB treatment centers (AFAIK).

As one can see, patient factors, disease factors, community factors, economic factors, resource limitations, treatment risks and benefits, test characteristics, and informed consent issues have all to be considered.
The decision making is thus somewhat complex in many situations and cannot be satisfactorily discussed in a general way.
« Last Edit: August 31, 2021, 03:02:33 PM by PeteD01 »

Omy

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Jumping back to the thread topic, I just saw this posted by Neil deGrasse Tyson:

"In case anyone is curious…

Right now in the USA, every ten days, more than 8,000 (unvaccinated) Republican voters are dying of COVID-19. That’s 5X the rate for Democrats."

bacchi

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Jumping back to the thread topic, I just saw this posted by Neil deGrasse Tyson:

"In case anyone is curious…

Right now in the USA, every ten days, more than 8,000 (unvaccinated) Republican voters are dying of COVID-19. That’s 5X the rate for Democrats."

Did he explain how he got this number?

Even if true, because of the deaths in Alabama and Missouri and Lousiana, it won't change any future elections there. It might matter in Florida where DeSantis barely won.

Kris

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Jumping back to the thread topic, I just saw this posted by Neil deGrasse Tyson:

"In case anyone is curious…

Right now in the USA, every ten days, more than 8,000 (unvaccinated) Republican voters are dying of COVID-19. That’s 5X the rate for Democrats."

Did he cite a source for that?

Mr. Green

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Jumping back to the thread topic, I just saw this posted by Neil deGrasse Tyson:

"In case anyone is curious…

Right now in the USA, every ten days, more than 8,000 (unvaccinated) Republican voters are dying of COVID-19. That’s 5X the rate for Democrats."

Did he explain how he got this number?

Even if true, because of the deaths in Alabama and Missouri and Lousiana, it won't change any future elections there. It might matter in Florida where DeSantis barely won.
We're in Seattle and I just had an appointment with a surgeon who performs mostly elective surgeries. He said the hospitals here are a nightmare right now and they're not filled with local people, but ones that are being brought in from the rural parts of the state because their small systems don't have the capacity. You can guess how those rural areas vote. This is the story all across the country right now.

CodingHare

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Jumping back to the thread topic, I just saw this posted by Neil deGrasse Tyson:

"In case anyone is curious…

Right now in the USA, every ten days, more than 8,000 (unvaccinated) Republican voters are dying of COVID-19. That’s 5X the rate for Democrats."

Did he explain how he got this number?

Even if true, because of the deaths in Alabama and Missouri and Lousiana, it won't change any future elections there. It might matter in Florida where DeSantis barely won.

I braved the hellsite of Twitter to see if he did--nope.  I would like to see where he is pulling those very specific numbers from if it isn't his derričre.

And I say that as someone whose opinion is that logically R deaths should be outweighing D deaths based on political opposition to public health measures.  But to move from an opinion to a fact, show me the data!

FIPurpose

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Jumping back to the thread topic, I just saw this posted by Neil deGrasse Tyson:

"In case anyone is curious…

Right now in the USA, every ten days, more than 8,000 (unvaccinated) Republican voters are dying of COVID-19. That’s 5X the rate for Democrats."

Did he explain how he got this number?

Even if true, because of the deaths in Alabama and Missouri and Lousiana, it won't change any future elections there. It might matter in Florida where DeSantis barely won.

And in Warnock's re-election in Georgia, and in the 20 or so house seats that were won or lost with by a <2% margin.

It wouldn't make or break any election by itself, but the people dying are mostly in their 50's. Those are people who should've been reliable GOP voters for the next 3 decades. So it doesn't move the needle too much, but it is a permanent loss and any election that comes within a few thousand votes, especially in the South, one will have to wonder if the GOP pushing vaccination more might have changed the outcome.

Mr. Green

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The Herman Cain Award subreddit is just overflowing with publicly declared anti-vaxxers dying, like by the hour it seems. It's just shocking how many people are kicking the bucket right now.

On my way home from a family gettogether where I heard of deaths and severe illness in distant relatives, I started thinking about what form the transition to endemicity of the virus could take. I live in Jacksonville and things are really bad here in the unvaccinated population. That probably colors my thoughts more negative than the issue deserves. In any case, here is what I wrote down when I got home. I think there is a possibility that the unvaccinated are going to be absolutely screwed as vaccination rates are going up:

I am slowly becoming more and more supicious that Delta is more virulent than previous variants.
Generally, transmissible pathogens do not do well in terms of becoming endemic if their virulence is excessive, but this is not always true, particularly with zoonotic diseases. But now we have a large population of vaccinated people in whom the virus can circulate with minimal mortality.
Maybe this has removed the brake on virulence similar to what is seen in zoonotic diseases like Ebola. In other words, the vaccinated are to the unvaccinated what bats are to humans in areas where Ebola is endemic.
Combine this with the close contact of this population with the susceptible, unvaccinated population and one comes up with the, not at all desirable, situation that ever more lethal variants could freely circulate exterminating over time the unvaccinated adult population. (immunity conveyed via infection in adults doe not appear to be protective in the long run, whereas children are probably more likely to develop robust immunity from infection) 
I now can imagine the entering of the endemic stage to be accompanied by a massive die-off of the unlucky unvaccinated population.
What I am saying here is not more than basic evolutionary biology: The apparent decrease over time in virulence of a successful endemic pathogen is not necessarily mediated by a change of the pathogen but also by a major mortality event in the host population selecting for resistant varieties and resulting in an apparent decrease in virulence.
The depopulation of the Americas by infectious diseases after contact with Europeans comes to mind, but there are many other examples, particularly in plant diseases (Dutch elm disease and others).
Well, food for thought, nothing more.
I read an interesting article just a couple days ago that a new variant has been uncovered, one labelled C.1.2 (that would mean something to a virologist). It is the most highly mutated variant yet, and shares many of the same mutations that the Delta variant does. We'll have to see whether it's as transmissible or deadly, etc. with time. Interestingly, this latest variant has evolved to needing only half as many iterations as the original strain to mutate again. So the speed of mutation from that variant forward is doublly fast. How many attempts at mutation does it need to find one that hurts us more? that evades vaccines? We're leaving the door open for a very bad outcome.

HPstache

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Jumping back to the thread topic, I just saw this posted by Neil deGrasse Tyson:

"In case anyone is curious…

Right now in the USA, every ten days, more than 8,000 (unvaccinated) Republican voters are dying of COVID-19. That’s 5X the rate for Democrats."

Did he explain how he got this number?

Even if true, because of the deaths in Alabama and Missouri and Lousiana, it won't change any future elections there. It might matter in Florida where DeSantis barely won.

I braved the hellsite of Twitter to see if he did--nope.  I would like to see where he is pulling those very specific numbers from if it isn't his derričre.

And I say that as someone whose opinion is that logically R deaths should be outweighing D deaths based on political opposition to public health measures.  But to move from an opinion to a fact, show me the data!

I feel like at the same time logically D deaths outweighed the R deaths, pre-vaccine, based on a higher percentage of COVID cases in larger cities (early pandemic NYC, for instance, or COVID "heat maps" looking like population density maps pre vaccine) as well as pointed out multiple times in this thread the discrepancy in case rates and deaths throughout minorities.  What did we lose, 500k of the 650k pre vaccine?  Of course, that's not what this thread is about, which is about the deaths of non-vaxxing individuals, but I say it as a reality check for all the gross political hand wringing in this thread.

FIPurpose

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Jumping back to the thread topic, I just saw this posted by Neil deGrasse Tyson:

"In case anyone is curious…

Right now in the USA, every ten days, more than 8,000 (unvaccinated) Republican voters are dying of COVID-19. That’s 5X the rate for Democrats."

Did he explain how he got this number?

Even if true, because of the deaths in Alabama and Missouri and Lousiana, it won't change any future elections there. It might matter in Florida where DeSantis barely won.

I braved the hellsite of Twitter to see if he did--nope.  I would like to see where he is pulling those very specific numbers from if it isn't his derričre.

And I say that as someone whose opinion is that logically R deaths should be outweighing D deaths based on political opposition to public health measures.  But to move from an opinion to a fact, show me the data!

I feel like at the same time logically D deaths outweighed the R deaths, pre-vaccine, based on a higher percentage of COVID cases in larger cities (early pandemic NYC, for instance, or COVID "heat maps" looking like population density maps pre vaccine) as well as pointed out multiple times in this thread the discrepancy in case rates and deaths throughout minorities.  What did we lose, 500k of the 650k pre vaccine?  Of course, that's not what this thread is about, which is about the deaths of non-vaxxing individuals, but I say it as a reality check for all the gross political hand wringing in this thread.

That may be, but also remember that that initial wild type was far more deadly to people 65+. And even in New York City the Biden-Trump vote was 70-30, but among 65+ it was closer to 50-50. I would agree those waves likely took out more D's than R's, but due to age, it may be more balanced than you expect. Whereas now the deaths are almost exclusively anti-vax / vaxed 80+ which is absolutely going to lean R no matter where you are. I don't know about Tyson's 80/20 ratio, but it wouldn't surprise me if that were close to true.

Cool Friend

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Jumping back to the thread topic, I just saw this posted by Neil deGrasse Tyson:

"In case anyone is curious…

Right now in the USA, every ten days, more than 8,000 (unvaccinated) Republican voters are dying of COVID-19. That’s 5X the rate for Democrats."

Did he explain how he got this number?

Even if true, because of the deaths in Alabama and Missouri and Lousiana, it won't change any future elections there. It might matter in Florida where DeSantis barely won.

I braved the hellsite of Twitter to see if he did--nope.  I would like to see where he is pulling those very specific numbers from if it isn't his derričre.

Neil deGrasse Tyson is famously anti-science so he probably made it up.

GodlessCommie

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That may be, but also remember that that initial wild type was far more deadly to people 65+. And even in New York City the Biden-Trump vote was 70-30, but among 65+ it was closer to 50-50. I would agree those waves likely took out more D's than R's, but due to age, it may be more balanced than you expect. Whereas now the deaths are almost exclusively anti-vax / vaxed 80+ which is absolutely going to lean R no matter where you are. I don't know about Tyson's 80/20 ratio, but it wouldn't surprise me if that were close to true.

Also keep in mind that the initial wave hit Black communities especially hard, and they are still vaccinated at a lower rate (although catching up). In almost all states, Black Americans' share of covid deaths is higher than their share of population. And older Black voters are the most reliable Dem contingent.

https://www.kff.org/coronavirus-covid-19/issue-brief/latest-data-on-covid-19-vaccinations-race-ethnicity/

Latinos fare better, probably due to skewing younger.

bacchi

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That may be, but also remember that that initial wild type was far more deadly to people 65+. And even in New York City the Biden-Trump vote was 70-30, but among 65+ it was closer to 50-50. I would agree those waves likely took out more D's than R's, but due to age, it may be more balanced than you expect. Whereas now the deaths are almost exclusively anti-vax / vaxed 80+ which is absolutely going to lean R no matter where you are. I don't know about Tyson's 80/20 ratio, but it wouldn't surprise me if that were close to true.

Also keep in mind that the initial wave hit Black communities especially hard, and they are still vaccinated at a lower rate (although catching up). In almost all states, Black Americans' share of covid deaths is higher than their share of population. And older Black voters are the most reliable Dem contingent.

https://www.kff.org/coronavirus-covid-19/issue-brief/latest-data-on-covid-19-vaccinations-race-ethnicity/

Latinos fare better, probably due to skewing younger.

Interestingly, not in Texas, where the Lt Gov tried to blame the covid surge on black, urban, Democrats.

Quote from: https://www.washingtonpost.com/nation/2021/08/20/dan-patrick-covid-african-americans/
Black residents in Texas accounted for 16.4 percent of the state’s cases and 10.2 percent of deaths as of Aug. 13. Black people make up about 13 percent of the state’s population, according to census data.

Also, raw numbers count in voting, not percentages. E.g., 5% of 12 is fewer than 2% of 61.

Samuel

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Jumping back to the thread topic, I just saw this posted by Neil deGrasse Tyson:

"In case anyone is curious…

Right now in the USA, every ten days, more than 8,000 (unvaccinated) Republican voters are dying of COVID-19. That’s 5X the rate for Democrats."

Did he explain how he got this number?

Even if true, because of the deaths in Alabama and Missouri and Lousiana, it won't change any future elections there. It might matter in Florida where DeSantis barely won.

I braved the hellsite of Twitter to see if he did--nope.  I would like to see where he is pulling those very specific numbers from if it isn't his derričre.

Neil deGrasse Tyson is famously anti-science so he probably made it up.

Last night I saw somewhere on reddit a response attributed to him on this. It was basically combining the stats that 1) 1000 unvaccinated people a day are dying, and 2) that 25% of Republicans were unvaccinated vs. 5% of Democrats.

FIPurpose

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You can't just look at national demographics because not every state has been hit the same. The major outbreaks early on were in NYC and Louisiana whose black populations are about 25% and 32%.

This doesn't look like it has anything to do with anything except that blacks communities tend to live in city/city urban places at higher rates. When we know that early covid deaths were in very specific localities, it doesn't make any sense to compare that to national demographics or even sometimes to state demographics.

You can look at heat maps of covid in NYC now and the hot spots basically line up with the Trump-Biden voter exit polls.

https://gothamist.com/news/coronavirus-statistics-tracking-epidemic-new-york

https://www.nytimes.com/interactive/2021/upshot/2020-election-map.html

Will this swing any elections? Only if it's really really close. Another difference between then and now: the early deaths were among old voters. Voters that weren't going to be around in 10-15 years anyways. The anti-vaxers dying now could have gone on another 30-40 years. When talking about voter demographics, this killed off a lot of old reliable D voters in NYC, but now it's killing the young (relatively) reliable R voter.

GodlessCommie

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This doesn't look like it has anything to do with anything except that blacks communities tend to live in city/city urban places at higher rates. When we know that early covid deaths were in very specific localities, it doesn't make any sense to compare that to national demographics or even sometimes to state demographics.

That - and also higher level of co-morbidities, more pollution, worse water, worse access to healthcare. There is general mistrust of medical establishment, too, as a result of Tuskegee experiment and J&J talc powder scandal.

In perpetually close states like Wisconsin (20K vote difference in '20, 23K in '16), Covid deaths may very well swing elections. I would expect it to hurt Rs in WI, though, since early deaths are already baked into the 20K D vote advantage, and the state as a whole is pretty white.
« Last Edit: September 01, 2021, 03:39:59 PM by GodlessCommie »

PeteD01

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The Herman Cain Award subreddit is just overflowing with publicly declared anti-vaxxers dying, like by the hour it seems. It's just shocking how many people are kicking the bucket right now.

On my way home from a family gettogether where I heard of deaths and severe illness in distant relatives, I started thinking about what form the transition to endemicity of the virus could take. I live in Jacksonville and things are really bad here in the unvaccinated population. That probably colors my thoughts more negative than the issue deserves. In any case, here is what I wrote down when I got home. I think there is a possibility that the unvaccinated are going to be absolutely screwed as vaccination rates are going up:

I am slowly becoming more and more supicious that Delta is more virulent than previous variants.
Generally, transmissible pathogens do not do well in terms of becoming endemic if their virulence is excessive, but this is not always true, particularly with zoonotic diseases. But now we have a large population of vaccinated people in whom the virus can circulate with minimal mortality.
Maybe this has removed the brake on virulence similar to what is seen in zoonotic diseases like Ebola. In other words, the vaccinated are to the unvaccinated what bats are to humans in areas where Ebola is endemic.
Combine this with the close contact of this population with the susceptible, unvaccinated population and one comes up with the, not at all desirable, situation that ever more lethal variants could freely circulate exterminating over time the unvaccinated adult population. (immunity conveyed via infection in adults doe not appear to be protective in the long run, whereas children are probably more likely to develop robust immunity from infection) 
I now can imagine the entering of the endemic stage to be accompanied by a massive die-off of the unlucky unvaccinated population.
What I am saying here is not more than basic evolutionary biology: The apparent decrease over time in virulence of a successful endemic pathogen is not necessarily mediated by a change of the pathogen but also by a major mortality event in the host population selecting for resistant varieties and resulting in an apparent decrease in virulence.
The depopulation of the Americas by infectious diseases after contact with Europeans comes to mind, but there are many other examples, particularly in plant diseases (Dutch elm disease and others).
Well, food for thought, nothing more.
I read an interesting article just a couple days ago that a new variant has been uncovered, one labelled C.1.2 (that would mean something to a virologist). It is the most highly mutated variant yet, and shares many of the same mutations that the Delta variant does. We'll have to see whether it's as transmissible or deadly, etc. with time. Interestingly, this latest variant has evolved to needing only half as many iterations as the original strain to mutate again. So the speed of mutation from that variant forward is doublly fast. How many attempts at mutation does it need to find one that hurts us more? that evades vaccines? We're leaving the door open for a very bad outcome.

The good news is that natural immunity from infection has now rather convincingly been shown to be at least as good as immunity from vaccination with the Pfizer/Biontech vaccine.

https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v1
« Last Edit: September 01, 2021, 03:05:01 PM by PeteD01 »

Kris

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The Herman Cain Award subreddit is just overflowing with publicly declared anti-vaxxers dying, like by the hour it seems. It's just shocking how many people are kicking the bucket right now.

On my way home from a family gettogether where I heard of deaths and severe illness in distant relatives, I started thinking about what form the transition to endemicity of the virus could take. I live in Jacksonville and things are really bad here in the unvaccinated population. That probably colors my thoughts more negative than the issue deserves. In any case, here is what I wrote down when I got home. I think there is a possibility that the unvaccinated are going to be absolutely screwed as vaccination rates are going up:

I am slowly becoming more and more supicious that Delta is more virulent than previous variants.
Generally, transmissible pathogens do not do well in terms of becoming endemic if their virulence is excessive, but this is not always true, particularly with zoonotic diseases. But now we have a large population of vaccinated people in whom the virus can circulate with minimal mortality.
Maybe this has removed the brake on virulence similar to what is seen in zoonotic diseases like Ebola. In other words, the vaccinated are to the unvaccinated what bats are to humans in areas where Ebola is endemic.
Combine this with the close contact of this population with the susceptible, unvaccinated population and one comes up with the, not at all desirable, situation that ever more lethal variants could freely circulate exterminating over time the unvaccinated adult population. (immunity conveyed via infection in adults doe not appear to be protective in the long run, whereas children are probably more likely to develop robust immunity from infection) 
I now can imagine the entering of the endemic stage to be accompanied by a massive die-off of the unlucky unvaccinated population.
What I am saying here is not more than basic evolutionary biology: The apparent decrease over time in virulence of a successful endemic pathogen is not necessarily mediated by a change of the pathogen but also by a major mortality event in the host population selecting for resistant varieties and resulting in an apparent decrease in virulence.
The depopulation of the Americas by infectious diseases after contact with Europeans comes to mind, but there are many other examples, particularly in plant diseases (Dutch elm disease and others).
Well, food for thought, nothing more.
I read an interesting article just a couple days ago that a new variant has been uncovered, one labelled C.1.2 (that would mean something to a virologist). It is the most highly mutated variant yet, and shares many of the same mutations that the Delta variant does. We'll have to see whether it's as transmissible or deadly, etc. with time. Interestingly, this latest variant has evolved to needing only half as many iterations as the original strain to mutate again. So the speed of mutation from that variant forward is doublly fast. How many attempts at mutation does it need to find one that hurts us more? that evades vaccines? We're leaving the door open for a very bad outcome.

The good news is that natural immunity from infection has now rather convincingly been shown to be at least as good as immunity from vaccination with the Pfizer/Biontech vaccine.

https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v1

First, that article is a preprint that has not yet been peer reviewed. Second, there are a lot of flaws in their methodology from what I can gather. (Read the comments.)

Releasing preprints has been a particularly problematic aspect of this pandemic. Especially as they are so open to misunderstanding, misinterpretation, and even willful misrepresentation by the science illiterate and would-be profiteers.

PeteD01

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The Herman Cain Award subreddit is just overflowing with publicly declared anti-vaxxers dying, like by the hour it seems. It's just shocking how many people are kicking the bucket right now.

On my way home from a family gettogether where I heard of deaths and severe illness in distant relatives, I started thinking about what form the transition to endemicity of the virus could take. I live in Jacksonville and things are really bad here in the unvaccinated population. That probably colors my thoughts more negative than the issue deserves. In any case, here is what I wrote down when I got home. I think there is a possibility that the unvaccinated are going to be absolutely screwed as vaccination rates are going up:

I am slowly becoming more and more supicious that Delta is more virulent than previous variants.
Generally, transmissible pathogens do not do well in terms of becoming endemic if their virulence is excessive, but this is not always true, particularly with zoonotic diseases. But now we have a large population of vaccinated people in whom the virus can circulate with minimal mortality.
Maybe this has removed the brake on virulence similar to what is seen in zoonotic diseases like Ebola. In other words, the vaccinated are to the unvaccinated what bats are to humans in areas where Ebola is endemic.
Combine this with the close contact of this population with the susceptible, unvaccinated population and one comes up with the, not at all desirable, situation that ever more lethal variants could freely circulate exterminating over time the unvaccinated adult population. (immunity conveyed via infection in adults doe not appear to be protective in the long run, whereas children are probably more likely to develop robust immunity from infection) 
I now can imagine the entering of the endemic stage to be accompanied by a massive die-off of the unlucky unvaccinated population.
What I am saying here is not more than basic evolutionary biology: The apparent decrease over time in virulence of a successful endemic pathogen is not necessarily mediated by a change of the pathogen but also by a major mortality event in the host population selecting for resistant varieties and resulting in an apparent decrease in virulence.
The depopulation of the Americas by infectious diseases after contact with Europeans comes to mind, but there are many other examples, particularly in plant diseases (Dutch elm disease and others).
Well, food for thought, nothing more.
I read an interesting article just a couple days ago that a new variant has been uncovered, one labelled C.1.2 (that would mean something to a virologist). It is the most highly mutated variant yet, and shares many of the same mutations that the Delta variant does. We'll have to see whether it's as transmissible or deadly, etc. with time. Interestingly, this latest variant has evolved to needing only half as many iterations as the original strain to mutate again. So the speed of mutation from that variant forward is doublly fast. How many attempts at mutation does it need to find one that hurts us more? that evades vaccines? We're leaving the door open for a very bad outcome.

The good news is that natural immunity from infection has now rather convincingly been shown to be at least as good as immunity from vaccination with the Pfizer/Biontech vaccine.

https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v1

First, that article is a preprint that has not yet been peer reviewed. Second, there are a lot of flaws in their methodology from what I can gather. (Read the comments.)

Releasing preprints has been a particularly problematic aspect of this pandemic. Especially as they are so open to misunderstanding, misinterpretation, and even willful misrepresentation by the science illiterate and would-be profiteers.

I hear you but I can´t help the illiterate and they cannot be protected from this in any reasonable way.
I have reviewed quite a number of papers and I can report, unless outright fabrication is discovered, that this study moves my needle from possible equivalence of prior infection with vaccination from possibly (as there is mechanistic biological plausibility) to most likely equivalence and possibly superiority of prior infection in conveying immunity to symptomatic reinfection (I emphasize symptomatic) when compared to the effects of the Pfizer/Biontech vaccine.
The real meat of the study is found in the very low rates of symptomatic reinfection in all groups (hence the wide CI´s of the OR´s despite the large number of subjects). The finding that the the odds of symptomatic reinfection are in favor of natural immunity is only the icing on the cake as the risk of symptomatic reinfection was less than 0.1% 1%. That translates into less than 10 per 100 in both groups, making the difference between the groups for all practical purposes irrelevant.
The difference between the groups is what the comments are going on about, but this is at this point an interesting but academic discussion.
Of course, observational studies have serious limitations but we will never see RCT´s investigating this issue.
 
« Last Edit: September 02, 2021, 04:46:04 PM by PeteD01 »

geekette

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<snip stuff from above>

I hear you but I can´t help the illiterate and they cannot be protected from this in any reasonable way.
I have reviewed quite a number of papers and I can report, unless outright fabrication is discovered, that this study moves my needle from possible equivalence of prior infection with vaccination from possibly (as there is mechanistic biological plausibility) to most likely equivalence and possibly superiority of prior infection in conveying immunity to symptomatic reinfection (I emphasize symptomatic) when compared to the effects of the Pfizer/Biontech vaccine.
The real meat of the study is found in the very low rates of symptomatic reinfection in all groups (hence the wide CI´s of the OR´s despite the large number of subjects). The finding that the the odds of symptomatic reinfection are in favor of natural immunity is only the icing on the cake as the risk of symptomatic reinfection was less than 0.1%. That translates into less than 10 per 1000 in both groups, making the difference between the groups for all practical purposes irrelevant.
The difference between the groups is what the comments are going on about, but this is at this point an interesting but academic discussion.
Of course, observational studies have serious limitations but we will never see RCT´s investigating this issue.

I appreciate that you know your stuff, but I think we need @nippycrisp in here to translate medical to regular folk english. 

PeteD01

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I appreciate that you know your stuff, but I think we need @nippycrisp in here to translate medical to regular folk english.

OR - odds ratio
CI - confidence intervals
RCT -randomized controlled trial

sorry about that

In plain English: If this paper is not totally fabricated, it shows that the risk of mild to moderate COVID after vaccination with Pfizer/Biontech and/or previous coronavirus infection is somewhere around 0.1 percent.
That means that 10 or less inividuals out of a thousand are going to become ill after having survived any one of these events. Even if one of the three is really much better in terms of relative risk, the absolute risk of catching the disease again is very low for all three.
So for practical purposes, the risk is really low for all of them.
The real issue for the individual is still the relative risk between suffering COVID vs taking the vaccine.
The paper is not about that.
From an epidemiological, or public health, point of view, this is very good news, however.
« Last Edit: September 01, 2021, 05:38:41 PM by PeteD01 »

MudPuppy

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Here’s my concern with natural infection immunity alone: it’s more unpredictable in both strength and duration. People with natural infection still need to get vaccinated. There is a fair amount of data that suggests this the the most robust immunity.

Admittedly, I’ve got a very different sample for anecdata than many people do, but I’ve known more second infections than breakthrough infections. A couple unfortunate bastards have has second infections that are ALSO breakthrough infections. Those people should not play the lottery, as the saying goes.

PeteD01

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Agree, these new data do not change any recommendations.

DadJokes

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Vanderbilt Health decided to start sharing some stats from their hospitals on weekly covid hospitalizations. This is for the seven days ending 8/28:

Total hospitalized
Unvaccinated: 156
Vaccinated: 30

Total in ICU:
Unvaccinated: 33
Vaccinated: 6

Total Ventilated:
Unvaccinated: 9
Vaccinated: 1

They also add that the majority of vaccinated have underlying immune compromise

A guitarist in the church band passed away this week from covid. I hope that the pastor will discuss it and urge people to get vaccinated this Sunday.

fuzzy math

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Maybe this has removed the brake on virulence similar to what is seen in zoonotic diseases like Ebola. In other words, the vaccinated are to the unvaccinated what bats are to humans in areas where Ebola is endemic.


The vaccinated are eating the unvaccinated? You need to read up and reassess your analogy there

https://www.bbc.com/news/health-29604204

fuzzy math

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Large numbers of healthcare workers are retiring or switching to outpatient to avoid covidiots (defined by me as people who don’t believe that covid is a significant health threat to their given demographic, and refuse basic low-risk precautions because of conspiracy theories from Facebook rather than listening to experts). My hospital is partially exempt from taking covid patients and even we’re having problems retaining because many nurses work at other hospitals too and are burnt out. I remember in this forum a certain person said that “well it’s what we signed up for”, but turns out it isn’t a draft and healthcare workers have other options. So have fun laying in that ER gurney for 2 days, courtesy of your local covid deniers.

Even with the partial exemption we have two units with covid patients. Just waiting for the next set of emergency transfers because there’s literally nowhere else to send someone…

Speaking of which, what happened to that one person who was convinced we were being “hysterical” when warning about potential consequences of the pandemic?

Staffing at my hospital was abhorrent BEFORE the pandemic. Nurses on most of the units were taking more patients than what the patient's needs dictated. "oh this patient is a 1:2? well we'll give you 3 of those today". This was by design. The growth of bean counters and the relative lack of growth of care / support roles had already destroyed the profession. Add in COVID, furlough people, subject them to conditions where their PPE was terrible, and combine that with an already simmering staffing crisis and you've got a multi faceted crisis now. Then add in emergency traveling responder pay, where nurses were making $7 - 10k a week doing assignments in NY and CA, and you've created a vacuum where it literally pays to leave. RNs at my hospital make $26 an hour, excluding shift differentials etc. No bonus pay for CCRN. They are hiring travelers at $117 per hour. What incentive is there to stay when your hospital devalues you so much that they'll hire people who have to be trained and babysat and they're paying them 450% of what you're making? Now the hospital pays a $25 / hr bonus for any extra shift you pick up. It still doesn't even come close to what travelers make, but at least its helping staff receive compensation without having to leave their family to travel, and its incentivizing them to work a 4th shift a week, which is helping to cover the staffing shortages.
« Last Edit: September 02, 2021, 07:43:09 AM by fuzzy math »