I Got a 'Mild' Breakthrough Case

https://www.npr.org/sections/health-shots/2021/09/12/1036356773/i-got-a-mild-breakthrough-case-heres-what-i-wish-id-known

by dsr12 • 5 years ago

155 431 5 years ago

npr.org

Wowfunhappy17• 5 years ago

People get sick. It happens. I am well-aware that by resuming my pre-pandemic lifestyle, and only wearing a mask in the spaces where they're mandatory, I am increasing my risk of getting ill.

But I'm not going to change my behavior, because I'd rather be sick for a week than sit at home 24/7 for the next year, or wear a mask every time I step outside, and constantly monitor my physical distance from other people. My life is passing me by right now, and I want to enjoy it while I can.

Jabbles4• 5 years ago

- sit at home 24/7

- wear a mask

These 2 things seem rather different in magnitude.

quantified3• 5 years ago

Especially because a lot of outside doesn’t need a mask. If you live in a dense urban core, it might. If you live in light urban, or suburban/rural, you can mask when stepping into the store or whatever.

Don’t forget that masks are to protect others at least as much as yourself.

awsthro00945• 5 years ago

I've been seeing this a lot amongst anti-mask arguments. Antimaskers unironically equate wearing a mask to some type of life-altering, oppressive action. It's absurd.

Amongst all of our social responsibilities as human being, wearing a mask is probably the easiest, most bare-minimum thing imaginable, right up there with "don't litter". And just like I don't respect people who litter, I don't at all respect people who don't wear masks in crowded places.

edit: wowfunhappy deleted their comment, but previously it said that the reason they don't wear a mask is because "it fogs up my glasses and is hot and sweaty", and went on to say that such hardships "affect [them] psychologically". This is exactly what I'm referring to in the first sentence of my comment. Absurdity.

snupples• 5 years ago

The mask is to protect others as much as it is to protect yourself. You can be contagious and spread it for up to two weeks without symptoms. It's unfortunate that wearing a mask is such a hardship for you.

vl• 5 years ago

But how exactly paper ill-fitted masks protect against aerosol-spread virus?

mrob3• 5 years ago

This has to be the biggest mistake of the whole pandemic. Exhalation valves dramatically improve the comfort of masks. A cloth mask might give 50% protection, and a surgical mask about 75%, but even after you double the effects to account for filtering both on exhalation and inhalation, that's still only 75% (1-(1-.5)^2) and 94% (1-(1-.75)^2), which is worse than the 95% you could expect from a correctly fitted N95 mask with exhalation valve.

If you protect yourself then you also protect others, because you can't infect others unless you are infected yourself. This focus on filtering exhaled breath just results in people wearing masks incorrectly to avoid the problems of valveless masks, making the numbers even worse than the previous calculation. It's also much easier to motivate people with self-protection than altruism, especially when the people they're helping often don't reciprocate. We've had more than long enough to solve the production problems by now, so N95 should be the minimum standard.

Ekaros• 5 years ago

My understanding is that masks at least cloth or surgical are vastly more about others than yourself.

spookthesunset11• 5 years ago

Protect who though? Who do masks protect at this point? People who are vaccinated? They have no need to worry. People who are unvaccinated? They made that choice.

There is literally no reason for a vaccinated individual to wear a mask. Vaccines work. They are the ticket out of this. Not masks.

Invictus0• 5 years ago

I can't stand this intimation that you're an asshole for not wearing a mask. If other people want to be precautious, they can get vaccinated and wear a mask and do the social distancing. It's not my problem.

jasonladuke03113• 5 years ago

I hear this quite often on the internet, yet I can count on one hand the number of times I have seen a person wearing a mask in public pre-COVID. I’m in the US so it is extremely uncommon.

Where has all of the concern for the immunocompromised been before this? The flu is quite deadly, you know.

5faulker• 5 years ago

Nice attitude. Time flies whether you like it or not.

bequanna2• 5 years ago

Our perception of time seems to be related to the number of new experiences we have.

If every day is exactly like ever other, you quite literally are losing a portion of your life.

asdfasgasdgasdg3• 5 years ago

Everyone can make their own choices, but I don't mind wearing a mask in optional scenarios if it gives me a good chance of avoiding a difficult and feverish few days with above average risk of hospitalization compared to flu. I can definitely picture wearing masks on an ongoing basis e.g. on mass transit even once the pandemic is done. On the other hand, we are still taking measured risks like eating indoors in not too crowded restaurants. My tolerance will likely increase once my children are both vaxxed but at the rate we're going that won't be for a while.

It's worth considering the continuum between taking the minimum possible measures and the maximum. There is space between those two.

shkkmo6• 5 years ago

eating indoors in not too crowded restaurants.

This is one of the potentially higher risk activities that I see commonly accepted. If your area has high rates of community spread and/or the restraunt has poor ventilation, this is probably a risk that should be avoided. Choosing restraunts with outdoor seating or getting takeout to eat in a park is a very minor sacrifice to cut out one of the hishest risk activities that people commonly engage in

birdyrooster12• 5 years ago

Or you know you can adjust your lifestyle and still enjoy it without it needing to be the same as pre-pandemic. Have some more imagination.

crixlet• 5 years ago

do you have kids, or know anyone who has kids that are unable to get vaccinated?

tessierashpool2• 5 years ago

I'd rather be sick for a week

this is a completely absurd assumption, and not appropriate for the standard of serious discourse this site aims for.

you could have no symptoms at all. you could die. you could suffer serious cognitive effects which eliminate your ability to work, read books, or even watch TV. you could get sick and stay sick for the rest of your life. we don't know the exact duration of long covid, but there are plenty of people who got sick in early 2020 and haven't gotten better yet.

there's a huge range of symptoms. in the dreamworld you posit here, where getting sick for a week would be the worst-case scenario, your reasoning would make sense, but nobody lives there, because that place doesn't exist.

Wowfunhappy17• 5 years ago

But doesn't this apply to everything?

When you crash your car, you could walk away unscathed. You could die. You could suffer serious cognitive effects which eliminates your ability to work, read books, or even watch TV. Should people be afraid to drive?†

My question for you would be, when does this end? I'm vaccinated, and the vaccines are very effective. Should we all be practicing social distancing for the rest of our lives?

---

† Actually, maybe yeah, I think the number of people who die in car crashes is reason enough to move away from them as a primary mode of transport, even putting aside environmental concerns. But the point is, we have decided to accept this risk.

rkk36• 5 years ago

you could have no symptoms at all. you could die. you could suffer serious cognitive effects which eliminate your ability to work, read books, or even watch TV. you could get sick and stay sick for the rest of your life. we don't know the exact duration of long covid, but there are plenty of people who got sick in early 2020 and haven't gotten better yet.

Why just apply this to covid? 45,000 people a year in the US die when they get behind of a wheel of a car every year. Does that number need to be zero to be an acceptable level of risk.

jrochkind16• 5 years ago

So, the expert in the article agreess you shouldn't sit at home 24/7 for the next year:

Even with delta, the goal is not to go back to a lockdown mindset, though, says Malani. "My hope is that people who are fully vaccinated should really feel like this risk is manageable."
"Feel good about spending time with your friends, or having a small dinner party, but make sure everyone is vaccinated," she says

But you probably should still be wearing masks in crowded indoor locations and avoiding/reducing large gatherings.

Since it's all statistical, it's not all of nothing, going to an occasional large gathering isn't the same as might as well go to one every day, you can prioritize ones important to you.

But it's up to you. The important thing is if you do get sick or know you're sick, please quarantine to avoid infecting others.

The annoying thing is, all the risks are proportional to how much covid there is in the community. If we could get rates down, then we wouldn't have to worry so much. So it's not just about what we are willing to risk personally, it's about trying to change social behavior to get risks much further down, so everyone in the community can do more stuff safer!

throwaway203716• 5 years ago

And I want to be able to climb a mountain, drink alcohol, taste pizza, and live past age 70. All of those things can go out the window with a severe case of COVID-19, and potentially even with an asymptomatic case, due to the long-term effects of scarring on multiple organs, and unknown long-term neurological effects.

I know humans always prioritize short-term goals over long-term. But personally, I am fine with wearing a mask or staying in for a year, to ensure my health for the next 70 years.

I also wear condoms when having sex with strangers. Crazy, I know, but somehow getting a lifelong disease just doesn't seem worth the momentary pleasure.

All you have to do is listen to the stories of young people who are now on a breathing machine for life. If that doesn't scare the fucking bejesus out of you, I don't know what will.

spookthesunset11• 5 years ago

All respiratory viruses can have long term effects. I’ve had super annoying colds that refused to go away for like 6 months. Covid is no different.

So many people are so absolutely petrified over covid. It’s like they suddenly woke up and realized that respiratory viruses can suck and people die of horrible illness. None of this is unique to covid.

It’s life. There are no guarantees. What we are doing now is not living. Vaccines were it. Time to return to actual normal.

UncleMeat• 5 years ago

sit at home 24/7 for the next year, or wear a mask every time I step outside

These are extremely extremely extremely different things.

neilv2• 5 years ago

Living in a dense, student-heavy neighborhood of the Boston area, I really hope that this isn't the thinking of many students who just arrived, from all over.

The thinking is understandable, but a pandemic like Covid-19 seems like one scenario in which a billion small individual sacrifices together could've (and possibly still can) be a dramatically positive net benefit to the world.

One way to think about the significance of minor individual sacrifice like voluntarily masking (where it's not absolutely required by law/rules) is that every infection will tend to spread exponentially. Passing it on to even only one person seems like that would likely result in at least one tragedy for someone else's family. IIUC, masking reduces that significantly, so masking when I believe there's a significant risk of spread seems an easy decision to me.

Wowfunhappy17• 5 years ago

My question for you is, what is the end point?

I am willing to wear a mask and practice social distancing for a period of time—in the aim of some goal. I'm not willing to do it forever. Which is why I wore a mask until this summer when vaccines were widely available.

Give me an end date, and explain why things will be different then, and I'll do it! Honestly! But right now, I'm looking around and I'm not seeing a timeline.

ColinWright• 5 years ago

Text-only version:

https://text.npr.org/1036356773

blub• 5 years ago

Thanks. NPR used to have a pop-up asking if one wants to be tracked or go to the text-only version. Now they only offer getting tracked or some convoluted guide on “other options”.

wyager2• 5 years ago

Where did I get it? Who knows. Like so many Americans, I had loosened up with wearing masks and social distancing, after getting fully vaccinated

I’m not a fan of this vaguely hamartiological style of reasoning. The narrative structure is like a biblical cautionary tale. The author had something bad happen to him, and so he’s searching for a transgression he committed that he can use to construct a punishment narrative.

jimmaswell• 5 years ago

Never heard the word hamartiological before but it's perfect here and describes exactly how I've felt too.

shkkmo6• 5 years ago

risk analysis != hamartiology

I don't see any punishment narrative. I think you a reading into the article to support your own narrative. Indeed, the entire article is about adjusting how one sees the related risks given the information that has emerged around the vaccines and the delta varriant.

wyager2• 5 years ago

This article is not risk analysis. It’s just a bunch of narrative stories.

systemvoltage5• 5 years ago

"Next, a headache clamped down on the back of my skull. Then my eyeballs started to ache. "

Why do I feel like this was written in an alarmist tone with some kind of an agenda?

quantified3• 5 years ago

Probably because anyone who got a solid case of COVID will raise the alarm for others and have an agenda of preventing it. The 24 hours of reaction I got from shot #2 convinced me that I really wanted to avoid a full case.

nvr2194• 5 years ago

The agenda of reducing the spread of covid? Yes that's the agenda... It's a good one!

systemvoltage5• 5 years ago

You snark, but the agenda of a new source such as NPR should be to objectively inform the public.

That means, highlighting the risks of a breakthrough case such as the one in the article with the addition of probability of getting such a case, using data as a means of supporting their arguments about risks post-vaccination, etc.

The entire article is written in a spooky manner, indirectly extrapolating a single anecdotal experience written in alarmist tone.

ketzo2• 5 years ago

Have you had COVID? It fucking sucks. This vivid description is pretty accurate to my experience.

Is it an alarmist tone or an accurate expression of symptoms? Why do you immediately take it for an agenda?

Sometimes, if you feel scared while reading something, it doesn't mean that the author is trying to make you scared for no reason; it might mean that they are just describing something that is a little scary.

systemvoltage5• 5 years ago

Totally understood. There is nothing wrong in reporting how bad COVID can get.

The reason for immediately taking it for agenda starts with the headline "I got 'Mild' case of COVID", then proceeds to explain how a 'Mild' case of COVID can make your eyeballs ache and make your skull explode in 103 degree fever. This is gross mischaracterization of medically agreed upon common symptoms of COVID.

The next conclusion is become cynical and try to understand what is the purpose of this article and who is its audience? I hope I can call out the publication without anyone accussing that I have an agenda.

whiddershins• 5 years ago

There’s a lot of conflicting data about the vaccine effectiveness against reducing symptoms of breakthrough infections.

It’s interesting though, that the author’s symptoms sound about average for someone of their age group if unvaccinated, which is around the same or slightly worse than what all of the people under 50 I know who got Covid reported, whether vaccinated or not.

TravelPiglet• 5 years ago

I know quite a few people 35-55 who went to hospital with severe symptoms and a few with breakthroughs this fall. None of the breakthrough cases required more than perhaps a day or two of rest.

marricks2• 5 years ago

It’s depressing how all these stories just reinforce the idea that the US could never suffer another lockdown.

We have exploding cases and even a brief lockdown would greatly decrease them, but the political will to try and stop it has completely dried up, likely from business interests.

hrfbi• 5 years ago

I don't have a business and I don't want to be shut in home. If you want to then lock yourself down, thanks.

birdyrooster12• 5 years ago

No one wants to do chemotherapy or have tumor excisions, but you need to or you suffer a worse fate.

laurent92• 5 years ago

Lockdowns cause obesity, suicide both in short-term and long term, and we don’t have figures on whether the lack of exercise and sadness causes more cancer but it could. I personally have lost all of my friends due to anger issues, I only have my workmates left, if I ever lose my keys. There has also been visibly more attacks in France since the lockdowns started (bethroatings, I mean). Pro-lockdown people never seem to include the human aspect of it.

marricks2• 5 years ago

A 2 week lockdown caused this? I'm not advocated for a year long one again, but having 100k+ cases a day might be more harmful.

kelnos• 5 years ago

Is the hospitalization rate and death rate among vaccinated people really that high? Or is it at or below flu rates? I think that's what should be driving lockdown decisions.

If the rates of hospitalization and death are still high for unvaccinated people, I don't see why we should suffer more restrictions for people who refuse to protect themselves.

jessriedel2• 5 years ago

The vaccines aren't a forcefield that ward off all things COVID. They were given the greenlight because they greatly lower your chance of getting seriously ill or dying.
... there were reassuring findings earlier this year that the vaccine was remarkably good at stopping any infection, even mild ones. This was a kind of bonus, we were told.

Isnt this false? If I recall, there was not enough data in early clinical trials to tell how effective the vaccines were at preventing severe illness and death, and the vaccines were largely approved based on reducing the risk ratio of infection

EDIT: pretty sure I'm right. See data below.

birdyrooster12• 5 years ago

Willful ignorance, confirmation bias, etc. Unthinking people are the bedrock of this world and they will twist themselves into knots to assuage their guilt.

alexpw• 5 years ago

It is true/correct. It's much easier to measure hospitalizations rather than infection, and the #s in the real world confirmed the advertised effectiveness from the trial, for Alpha.

jessriedel2• 5 years ago

I think you're wrong. For instance, this website about the emergency use authorization for the Moderna vaccine says, for equal sized vaccinated and control groups, that

Vaccine efficacy against hospitalization due to COVID-19 was 89% (95% CI: 13%, 89%). Deaths were also uncommon, 6 in the vaccine group and 7 in the placebo group.

https://www.cdc.gov/vaccines/acip/recs/grade/covid-19-modern...

In other words, there was not nearly enough data to tell whether it was effective at reducing deaths, and only weak data on hospitalizations.

Do you have a cite that describes it otherwise? If not, please edit your comment.

ummonk4• 5 years ago

“ To sum it up, I'd put my breakthrough case of COVID-19 right up there with my worst bouts of flu.”

Exactly. I see no reason why I’d take strong measures to avoid getting exposed to it (now that I and 90% of adults around me are fully vaccinated) when I never did the same for the flu. Somewhere along the way we seem to have lost sight of what constitutes a normal disease burden.

ceejayoz9• 5 years ago

Perhaps we were too lackadaisical about flu.

I've certainly enjoyed not getting the usual bouts of cold and flu my kids would bring home from school every winter.

I hope at least one lesson we take from COVID is "people should be able to take sick days rather than coming to work/school sick".

rejectedandsad3• 5 years ago

It’s perfectly fine for that to be ones risk tolerance and to take mitigation steps. It’s not to mandate them by government fiat.

GeorgeTirebiter• 5 years ago

People can do that, stay home when sick. Then they just have fewer vacation days. At least, that's how it works for me. I suppose we could think of it as an incentive to remain healthy.

SavantIdiot4• 5 years ago

have lost sight of what constitutes a normal disease burden.

I don't think so. This is only "mild flu" for vaccinated people. We still have kept sight that people who can't be vaxed can die, and people who ignorantly chose not to vax are killing people because they clog the ICUs and prevent people from getting non-covid life-saving care.

So we haven't lost sight, people just choose not to see. You just can't teach some people to be unselfish and considerate.

ummonk4• 5 years ago

The people who can’t be vaxxed have extremely low death rates. It’s possible RSV is actually a bigger danger to them than covid (and increases in youth suicides due to lockdowns appear to be higher than the number of lives saved from covid).

As to ignorant people filling ICUs, that’s not a risk where I live in SF that has near universal vaccination and relatively low hospitalization rates. The UK and Denmark have demonstrated you can love on with life after high vaccination rates are achieved.

IncRnd5• 5 years ago

and people who ignorantly chose not to vax are killing people because they clog the ICUs and prevent people from getting non-covid life-saving care.

Honest question - would you provide information for that please? The two articles I've seen on that were both completely retracted within a few days of publication. I know unvaxxed people, and I want to have all available information before conversing with them.

nickthemagicman13• 5 years ago

Can you show the data you use to make this claim about ICU's being clogged to prevent people from getting life saving care?

Not news articles but the actual data you're using?

nkozyra11• 5 years ago

Exactly. I see no reason why I’d take strong measures to avoid getting exposed to it (now that I and 90% of adults around me are fully vaccinated) when I never did the same for the flu.

Because it's up to 10x more deadly than influenza, particularly for vulnerable populations.

https://www.hopkinsmedicine.org/health/conditions-and-diseas...

ummonk4• 5 years ago

The flu is equally if not more deadly in populations without preexisting immunity (e.g. isolated tribes). Once people acquire immunity (preferable through multiple doses of vaccination), it’s really not any different than the flu.

javagram8• 5 years ago

Your link does not seem to support that Covid-19 is 10x more deadly than influenza in a vaccinated person, like the poster you are replying to. It’s 10x more deadly if you haven’t been vaccinated but the vaccines are showing 10-20x decrease in hospitalization and death, bringing the risk more into flu range.

native_samples5• 5 years ago

That statement seems to be very obsolete. It claims "doctors and scientists are working to estimate the mortality rate". Well, that work has been done and the results were that you can find IFRs of anywhere between 0% and 1.6%, with a median of about 0.2%:

https://www.who.int/bulletin/online_first/BLT.20.265892.pdf

There's a letter here in the BMJ that states it's comparable to flu:

https://www.bmj.com/content/371/bmj.m4509/rr

The nature of IFR calculations means there will likely always be very wide uncertainty intervals, however.

ASinclair• 5 years ago

Somewhere along the way we seem to have lost sight of what constitutes a normal disease burden.

Alternatively this pandemic may have permanently shifted what we consider to be a normal disease burden. Maybe we shouldn't accept tens of thousands of Flu deaths every year if there are some relatively simple changes we can make to reduce them.

spookthesunset11• 5 years ago

If simple means forcing everybody, including toddlers, to wear masks… I’ll hard pass.

jrochkind16• 5 years ago

You are conflating two things. This guy's illness was about the same as worst bout of flu -- that doesn't mean that's necessarily typical, but let's say it is.

Currently, in most of the USA, your chances of getting covid are probably a LOT higher than that of getting the flu. Way more people are getting covid than getting a bad case of the flu.

So it's not quite the same.

If the chances of getting the flu were always this high, including the chances of really severe disease or death for some (say, those with organ transplants)... we probably would have been doing something different.

But I agree with you we shoudln't have to, don't need to, and can't sustainably simply shut down life forever.

I find the experts advice reassuring. IF you are vaccinated:

Even with delta, the goal is not to go back to a lockdown mindset, though, says Malani. "My hope is that people who are fully vaccinated should really feel like this risk is manageable."
"Feel good about spending time with your friends, or having a small dinner party, but make sure everyone is vaccinated," she says.

For now I am wearing a mask at the store (not that big a deal), and avoiding large public unmasked gatherings. In part because I want to try to help get community transmission rates a lot lower so we can then do more.

But I agree I'm not gonna do it forever.

Barrin92• 5 years ago

Somewhere along the way we seem to have lost sight of what constitutes a normal disease burden.

Having relatives in the healthcare sector and hearing stories during bad flu waves (2020 was not the first year in recent memory where people needed to be treated in makeshift tents[1]) we do indeed have lost sight of the disease burden, but probably not in the way you imagine.

I was lucky to spent the first few months of the covid-19 pandemic in Japan, and I can tell you I did not see overrun hospitals at any point because people by and large take hygiene and avoiding the spread of infectious disease seriously.

[1]https://time.com/5107984/hospitals-handling-burden-flu-patie...

nradov13• 5 years ago

I am skeptical whether you have drawn the correct conclusion from your experience in Japan. There seems to be something else going on beyond just taking hygiene seriously.

https://noahcarl.substack.com/p/why-have-there-been-so-few-c...

CarelessExpert4• 5 years ago

now that I and 90% of adults around me are fully vaccinated

I'm curious, where did that 90% figure come from?

Around here, of the eligible population, about 1 of every 3 has no shot at all, one 1 out of 4 with just a single shot. If you look at the full population, including minors and other ineligible groups, the numbers are even worse.

That means if I go to the grocery store, I'm absolutely gonna be in proximity to someone unvaccinated at some point along the way.

sprafa• 5 years ago

Assume he’s in a EU country/US state with high vaccination rate.

Wowfunhappy17• 5 years ago

Minors aren't at serious risk, and 99% of the remaining unvaccinated population has made a conscious choice to live dangerously.

jlokier3• 5 years ago

I don't know what policy around flu should be, but I'd like to share my data points about flu, for those who think flu is no big deal.

The last two times I had flu (first age 36, then a few years later), I was unable to work for an entire month each time.

For most of that time I struggled to get out of bed, and couldn't think much. I was too weak and tired, so I slept most of the time or did low energy activities, and relied on other people to bring me food. The first one meant I missed Christmas: My partner went to an all-day get together with our mutual friends, and I stayed home in bed, too ill to go.

My other flu story would be, a good friend and former employer got flu one day when he was visiting his wife and children (he normally worked in another country to them). Few days into it, he lay down on a sofa and died. I don't know the rest of the story, but I miss him. I think my life would be different if he were still around.

These experiences certainly gave me more respect for flu as a killer.

istorical• 5 years ago

The last two times you had flu with severity great enough to alert you that you had flu.

darkerside6• 5 years ago

My partner went to an all-day get together with our mutual friends, and I stayed home in bed, too ill to go.

So your partner did not quarantine? Avoid non-essential trips? Wear a mask?

I don't think you'd disagree that our COVID precautions at _this_ point are incongruous with the past, but highlighting it for others reading.

senectus12• 5 years ago

in what country are yoy that 90% of the adults are fully vaccinated?

Also, "Think of the children". those that can't get vaccinated but are now dying from the delta strain?

disgruntledphd23• 5 years ago

Ireland, almost. (I think we're at 92% with one dose, and 89% with two).

zumu• 5 years ago

Exactly. I see no reason why I’d take strong measures to avoid getting exposed to it (now that I and 90% of adults around me are fully vaccinated) when I never did the same for the flu.

It should really go without saying COVID-19 is much more transmissible than any recent version of the Flu. Comparisons of symptoms and severity in healthy adults has never been the sticking issue.

I'm disheartened to see people on HN of all places thinking solely as an individuals and not about the management of health care resources at a population level. Health care resources are finite and viruses like COVID can still spread exponentially even with current vaccination rates.

From the beginning, the goal has been to lower transmission, lower cases, and therefore lower the burden on the _world_ health care system to a tenable degree. Yes, there may be _more_ effective measures we can take at this point, such as ramping up vaccination, but at the end of the day, if you don't transmit the disease to others or end up in the hospital yourself, you are helping the cause.

tldr; Whether or not it poses a risk to _you_ is besides the point, in so far as the risk of overburdening the health care system remains.

spookthesunset11• 5 years ago

The healthcare system also had more than a year and a half to build capacity to deal with this stuff? Why should society be required to bail out hospitals by adhering to arbitrary restrictions on their life?

nickthemagicman13• 5 years ago

I'm disheartened to see people on HN of all places thinking solely as an individuals and not about the management of health care resources at a population level.

Individualism vs Collectivism is a debate that goes back a long time.

Your 'flattening the curve' argument is fear based.

I haven't seen any actual DATA besides media fear mongering that ICUs are 'almost' full for years now.

justin66• 5 years ago

Exactly.

Not quite. The worst bouts of flu are the ones that kill people. Some of the influenza A strains are no joke.

derbOac2• 5 years ago

Most seasonal upper respiratory illnesses don't routinely cause loss of smell or taste, which should be a clue to something more nefarious potentially going on. If I were the author I'd worry about subtle frontal brain injury.

For me, boosters and nasal vaccines can't come fast enough (nor can the ability to administer them to younger children).

At some point I think this virus will become like the flu in terms of public health implications, but I don't think it's quite there yet.

nradov13• 5 years ago

Loss of smell in COVID-19 isn't caused by frontal brain injury.

https://hms.harvard.edu/news/how-covid-19-causes-loss-smell

The risk to younger children is minimal.

https://www.nature.com/articles/d41586-021-02423-8

andrewclunn• 5 years ago

The recognition that the medical establishment is still unsure of many things regarding a still developing situation is a good first step. The next is to realize that the misinterpretations of their knowledge and understanding are the direct result of misrepresentation of events and facts by media outlets.

SavantIdiot4• 5 years ago

So did I a few weeks ago. I was vaxxed in April. And then caught it in early August. Three days of sweating and chills, a week of coughing and loopy-head. Positive PCR test. 3 weeks later and I still have a chest-cough I can't shake.

Of course, if I didn't have the vaccine, I probably would be in an overflowing hospital close to death.

ralusek• 5 years ago

Assuming that you're between 18-49 years old, the CDC puts the infection fatality rate for that age group at 0.15%. So, unvaccinated, you would have a 99.85% chance of not dying. Being vaccinated, of course, further improves your odds.

https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...

The younger you are within that bracket, your odds improve even more. If you have no comorbidities, even better.

Basically, I wouldn't be worrying about death as any given young individual, but at a population scale, COVID is quite deadly. I'm personally much more worried about the other reported effects and lasting tissue damage.

OrvalWintermute3• 5 years ago

Assuming that you're between 18-49 years old

That is a huge range of ages and varying risk levels - in effect, you are over-averaging.

****************

For a 45 year old caucasian male with no comorbidities non-smoker

0.16 (95% CI: 0.14 - 0.17 ) times the risk of dying from COVID-19 compared to the average risk for the US population

absolute rate of mortality of 1.3 (95% CI: 0.6 - 2.8 ) per 100000 individuals in subgroups of the population with a similar risk profile to yours during the period of 09/11/2021 - 10/01/2021. This estimate is calculated based on the CDC's Ensemble mortality forecast data..

95% CI: Error bounds with 95% confidence.

****************

For an 18 year old caucasian male with no comorbidities non-smoker

0.02 (95% CI: 0.02 - 0.02 ) times the risk of dying from COVID-19 compared to the average risk for the US population.

95% CI: Error bounds with 95% confidence.

****************

Calculated using JHU's COVID-19 Mortality Risk Calculation https://covid19risktools.com:8443/riskcalculator

nradov13• 5 years ago

Your numbers are way off. The CDC estimate of fatality rate in the 18-49 age group is 0.06%. And that's highly dependent on co-morbid conditions.

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...

SavantIdiot4• 5 years ago

Mid-50's with an existing disease. Which is why I got my shot early. I have good reason to worry.

everybodyknows• 5 years ago

Which vaccine? Collecting anecdata …

SavantIdiot4• 5 years ago

Pfizer.

qeternity• 5 years ago

Very similar to you. Had double Pfizer. Felt like crap on a Sunday, felt worse on Monday so skipped work and took a lateral flow test which came back negative. Same symptoms but for maybe 5 days. Lost my sense of taste on day 3 which was also the day I tested positive (I didn't take a test on day 2). I stopped testing positive a few days later, but taste was lost for maybe a week.

I had a cough for maybe 10 days, which has just subsided. I can't tell if I have brain fog, as my cough was really preventing me from sleeping well.

One interesting observation: I was pretty ravenous the entire time. I had a fever and was sweating like a pregnant nun in church, but I never lost my appetite. If anything, it turbocharged.

mdp20216• 5 years ago

taste was lost for maybe a week

All comforting data, as I have second degree acquaintances who have not recovered taste and smell 17 months after infection. I think it would be quite desirable to have stats with comparisons of these details (duration of adverse events) in all relevant different cases.

(Your «sweating like a pregnant nun in church» will remain with me and I must thank you.)

hvocode• 5 years ago

I’m getting a little tired of articles or chats with people where you get the impression that people think the vaccines will create some sort of covid-proof bubble around them. This is the only explanation I can find for people acting surprised that vaccinated people get sick. The whole point was to prime the immune system so that when exposed, the likelihood of extreme effects would be drastically reduced. That’s it.

(E: I don’t get why people downvote this - all of the benefits of vaccination are precisely due to what I describe. Lower likelihood of individual bad outcomes, which reduces burdens on healthcare, and ideally, reduces community spread by reducing the amount of virus that replicates in an individual and can be passed on. This is why I was one of the first in line when I could get the vaccine. Perhaps daring to critique people with unrealistic vaccine expectations is unacceptable?)

ianai• 5 years ago

Right. It’s like a hardware update for an immune system.

TobTobXX• 5 years ago

But all the regulations around us create this covid-proof impression.

Eg. where I live, hospitals consider introducing vaccination requirements for visitors. But that somehow defies logic. The vaccine only reduces symptoms (and might thus save yourself, or others, when extended with the hospital-bed-limit-thought), but it wouldn't stop you from transmitting the disease if you are infected (and vaccinated) but you aren't aware.

So I don't even blame the public, but rather the regulators. They ought to know better.

Edit: I might need to support this claim.

The most trustworthy source I found was this article by the JHU [1] (2021-08-02). While there are many that claim different numbers (ranging from stopping roughly 60% to 0%), for transmission, no one claimed that virus infection is influenced.

[1] https://publichealth.jhu.edu/2021/new-data-on-covid-19-trans...

R0b0t1• 5 years ago

No. Vaccine reduces viral load and transmissibility, but in close contact situations you're still going to transmit it.

uh_uh• 5 years ago

The vaccine only reduces symptoms (and might thus save yourself, or others, when extended with the hospital-bed-limit-thought), but it wouldn't stop you from transmitting the disease if you are infected (and vaccinated) but you aren't aware

Are you sure about that? Even this article refers to a study which says that vaccinated people are 5 times less likely to test positive than non-vaccinated. _Some_ asymptotic transmission will still occur in the vaccinated but it's reasonable to expect that it happens to a lesser degree. I'd be very curious to see studies that claim that there's no difference in asymptomatic transmission between the vaccinated and unvaccinated.

nwvg_7257• 5 years ago

This is NOT true. https://www.nytimes.com/article/breakthrough-infections-covi...

"after an outbreak among vaccinated and vaccinated workers at the Singapore airport, tracking studies suggested that most of the spread by vaccinated people happened when they had symptoms"

The vaccines substantially help to reduce spread. Doesn't eliminate it, but obviously something a hospital would want to require.

thephyber• 5 years ago

The vaccine does a reasonable job at reducing transmission in the aggregate. It lessens the average viral load, shortens the average time a person is infectious, etc.

Treating transmission as a boolean ignores the large-but-not-100-percent improvement. Better to treat it as a distribution.

I don’t see what you are blaming regulators for.

mcguire7• 5 years ago

"Evidence demonstrates that the authorized COVID-19 vaccines are both efficacious and effective against symptomatic, laboratory-confirmed COVID-19, including severe forms of the disease. In addition, a growing body of evidence suggests that mRNA COVID-19 vaccines also reduce asymptomatic infection and transmission. Substantial reductions in SARS-CoV-2 infections (both symptomatic and asymptomatic) will reduce overall levels of disease, and therefore, viral transmission in the United States. ... Data from multiple studies in different countries suggest that people vaccinated with Pfizer-BioNTech COVID-19 vaccine who develop COVID-19 have a lower viral load than unvaccinated people.(41-44) This observation may indicate reduced transmissibility, as viral load has been identified as a key driver of transmission.(45) Two studies from the United Kingdom found significantly reduced likelihood of transmission to household contacts from people infected with SARS-CoV-2 who were previously vaccinated for COVID-19.(25, 46)"

https://www.cdc.gov/coronavirus/2019-ncov/science/science-br...

"Two studies1,2 from Israel, posted as preprints on 16 July, find that two doses of the vaccine made by pharmaceutical company Pfizer, based in New York City, and biotechnology company BioNTech, based in Mainz, Germany, are 81% effective at preventing SARS-CoV-2 infections. And vaccinated people who do get infected are up to 78% less likely to spread the virus to household members than are unvaccinated people. Overall, this adds up to very high protection against transmission, say researchers."

https://www.nature.com/articles/d41586-021-02054-z

"COVID-19 vaccines appear to help prevent transmission between household contacts, with secondary attack rates dropping from 31% to 11% if the index patient was fully vaccinated, according to a Eurosurveillance study yesterday. The population-based data looked at the Netherlands from February to May, when the Alpha variant (B117) was dominant and the available vaccines were by Pfizer/BioNTech, AstraZeneca/Oxford, Moderna, and Johnson & Johnson."

https://www.cidrap.umn.edu/news-perspective/2021/08/study-ti...

"There has been good news, too, on the subject of viral load in breakthrough cases. Researchers in Israel studied vaccinated people who became infected. The viral load in these breakthrough cases was about three to four times lower than the viral load among infected people who were unvaccinated. Researchers in the U.K. reported a similar result. They also found that vaccinated people who became infected tested positive for about one week less than unvaccinated people."

https://www.scientificamerican.com/article/the-crucial-vacci...

poopypoopington2• 5 years ago

I don't think that's true. The vaccine still reduces the likelihood that you'll be infected so only allowing vaccinated visitors reduces the risk that COVID enters a hospital through visitors. I think the vaccine also reduces the likelihood that people with breakthrough infections infect other people

ProtoAES256• 5 years ago

Ditto. My family and I are all fully 2 dose vaccinated, and I didn't go out from my house for nearly a month. I caught COVID(via my mother) last thursday. The facilities are long overrun since a few months ago, so my symptoms which are: blood coughing, nausea, chest pain, ~93%SpO2 are considered "quite mild" and "home quarantine only".

In the wake of other variants like Delta, I doubt that people who didn't/can't get the vaccine can be protected by herd immunity alone.

A few of my friends are getting breakthroughs too, which seems like a lot in comparison to the global statistics, so it might be just anomalies.

choeger• 5 years ago

To the contrary, I don't think that's plausible. In the whole COVID-19 decision the question of the initial load has not been discussed well enough, IMO.

If you think about the virus passing your various layers of protection it is clearly a numbers game, IMO. A mask, even if imperfect, might reduce your initial viral load below a threshold that allows your immune system to kill all infected cells very quickly so you don't develop strong symptoms. The same goes for distance.

So I don't see any reason to not expect a certain "sterile" immunity after a vaccination. The way I see it, the vaccination should prevent some of the low-load infections completely, regardless of the virus variant.

gridspy15• 5 years ago

Any discussion of viral load seems too subtle for a general audience, but that's sound.

It's kind of like Vaccine + mask + low exposure (social distance, short times, good ventilation) is your "armor class" against the virus.

If your armor is good enough, the chance of becoming infected IS very low.

javagram8• 5 years ago

I’m getting a little tired of articles or chats with people where you get the impression that people think the vaccines will create some sort of covid-proof bubble around them. This is the only explanation I can find for people acting surprised that vaccinated people get sick.

No, it’s because until the Delta variant became the most common variant, the vaccines essentially did create a covid-proof bubble around the recipient. The trials for Comirnaty and the Moderna vaccine both showed >90% effectiveness against PCR positive infections, not just against hospitalization and death.

jrochkind16• 5 years ago

The trials for Comirnaty and the Moderna vaccine both showed >90% effectiveness against PCR positive infections

I don't believe the official trials for Moderna and Pfizer measured PCR positive infections at all. (They involved thousands of people, it was a time when PCR test were difficult to obtain; they remain expensive at that scale).

I have not heard of Comirnaty, not sure about that.

There may have been pre-delta studies that showed PCR infection effectiveness (Cite?), I don't think they were the official trials.

whb07• 5 years ago

Here’s an interesting calculator from Oxford using Britain’s data from COVID:

https://www.qcovid.org/Calculation

My wife is a nurse and doesn’t follow up the data and she was in disbelief that her “risk” of serious/death was around 0.00005% or somewhere near that.

nkozyra11• 5 years ago

As a nurse, what's her risk of spreading it to someone with a much, much greater risk of death?

rogerkirkness• 5 years ago

If we're going to run society this way, we're going to need much more difficult driving tests.

nvr2194• 5 years ago

The website doesn't have that info.

clairity3• 5 years ago

also tiny, since they have rigorous procedures and properly-deployed ppe for all sorts of transmissible infections, not just covid (and where masks can actually help, unlike most mask usage).

the treatment risk calculation is also entirely different, since "someone with a much, much greater risk of death" is already flirting with death in other material ways.

dQw4w9WgXcQ• 5 years ago

What's a parents' risk of having children that eventually die? What's your risk of driving and having a seizure at the same time and wiping out kids on the sidewalk? What's your risk that while leaving Home Depot you dropped a few nails on the ground and someone's car tire picked them up and now they'll have a blowout on the highway?

We can take this stupid premise to its logical end and never do anything out of fear that we might eventually harm someone else, but that's not how life has gone on for millennia. We have the vaccine which is the solution, by and large the data supports that the sustained overreaction is now disproportionate to the actual risks, time to let the science we supposedly all believe in aka natural selection run its course.

fredophile• 5 years ago

I don't understand the point you're trying to make. Should we stop having nurses treat covid patients so they don't spread it to people who are more likely to have severe reactions? Should we stop having nurses treat people with compromised immune systems and other health issues so they can treat covid patients?

robocat• 5 years ago

Absolutely useless: the calculator doesn't even ask if you have been vaccinated! And the risks are calculated for someone in the UK - completely irrelevant if you are not (no NHS etcetera).

Was the calculator developed before Delta? Does it already include a factor for your chances of catching it, or is it the risk after you have caught Covid? So many glaring issues - it isn't designed to be informative to the general public.

azornathogron• 5 years ago

The associated paper was published in October 2020, so yes this was developed well before delta (at least well before delta's arrival in the UK), most likely in the period between the first and second major peaks in the UK. Given the way academia works I doubt it has been updated significantly since then.

learc832• 5 years ago

The “risk” is misleading because it’s the risk that you will catch it within a 90 day period based on the community spread in the UK at some point in the past (before Delta) times the risk that you will die if you catch it.

Since your wife is a nurse, she’s much more likely to be exposed than the average UK resident. I also think even in her case you likely added an extra zero or 2 based on what I’m seeing while playing around with it.

I think what most people want is what’s my risk of death assuming I get it, not that multiplied times the risk of being infected within only the next 90 days.

nickthemagicman13• 5 years ago

Those are two different measurements.

You have: 1. Chance of getting a disease 2. Chance of dying from said disease once acquired

Both have numerous factors that affect the result.

swiley• 5 years ago

an absolute failure to understand Bayes theorem.

systemvoltage5• 5 years ago

NPR article honestly just sounds like fear-mongering. I am fine with showing how worse it can get, but nothing in the NPR article talks about the likelyhood of getting a bad case of COVID after vaccination. Objectively informing the public, it is not.

dimator• 5 years ago

The section "How high are my chances of getting a breakthrough case these days?" goes into that. If you're looking for a hard number, I don't think anyone can give you that because it's highly community specific.

I have no idea how you got fear-mongering from that article, though. My impress was that it's a reality check on what the vaccine is capable of and what one individual's breakthrough looks like.

clairity3• 5 years ago

"NPR article honestly just sounds like fear-mongering."

that's nearly all of npr (and nyt) now, especially the covid-related news that's 50+% of npr stories. i can no longer stomach more than their 10-minute hourly news summary on the radio these days.

tfehring2• 5 years ago

I’m personally way more worried about long-term cognitive symptoms than about dying. Obviously the jury’s still out on long term symptoms, but something like a quarter of people with symptomatic COVID seem to have some kind of cognitive symptom (mainly “brain fog” and/or short-term memory loss) 8 months later. https://www.medrxiv.org/content/10.1101/2021.03.18.21253633v...

xupybd• 5 years ago

It's also unclear if those long COVID symptoms will resolve after a few years.

b3nji• 5 years ago

With around than 1% getting long COVID, which used to be called "viral fatigue" pre 2020, I'm not certain its something to worry about.

gilbetron2• 5 years ago

As others have pointed out, that site generates a risk that isn't what most people think of as the risk of death, that is it gives the risk of catching and then dying of Covid during a 90 day period when Delta wasn't around.

For a more expected assessment of "risk of dying if I have covid", you can use this:

https://www.economist.com/graphic-detail/covid-pandemic-mort...

Although it only shows "<0.1%" for anyone under 40s, so it doesn't break things down that fine (better for hospitalizations).

Vecr2• 5 years ago

I searched for "monoclonal" and "respirator" in the article and found nothing. If you want go avoid getting infected, wear a correctly fitted respirator, preferably NIOSH P100 elastomeric with replaceable cartridges. If you can convince your doctor, they can prescribe monoclonal antibodies right after you get exposed, with no symptoms or testing needed.

nvr2194• 5 years ago

I've seen nobody wear respirator or anyone recommend wearing that to avoid infection until this comment.

mrob3• 5 years ago

I wear a EN 149 P3 elastomeric half mask respirator (99.97% effectiveness) and face shield whenever I go into shops or other indoor spaces other than my own home. It's a lot more comfortable than a surgical mask. If everybody did the same then the pandemic would probably be over by now.

murkle• 5 years ago

Cost is "£1000-£2000 per treatment" https://www.bbc.co.uk/news/health-58281332

Vecr2• 5 years ago

In the US the federal government buys it, though I'm not sure they are going to continue doing so. In the tristate area and Florida it's apparently pretty easy to get.

criticaltinker3• 5 years ago

If you think you're getting sick, the number one action you should take is to begin treatment early. You need to take action before symptoms get worse. The author had a high grade fever for a week but never mentioned seeking any treatment.

Things you should do yourself: take vitamins and nutritional supplements, drink plenty of water, get your body moving, isolate yourself from others, wear a mask.

Things your doctor should do for you: prescribe antivirals, also corticosteriods & antithrombotics if symptoms continue to worsen. The goal is to avoid the hospital and severe outcomes - many clinics will prescribe these safe & widely available over the counter medicines with little to no consultation.

Whether you're vaccinated or not, this should be the standard of care for everyone - it's no different than most other viral infections. For some reason very few people seem to be aware of this advice, and all the scientific evidence supporting it (in the context of SARS-CoV-2 and in general).

arn• 5 years ago

Most things on your list are fine and prob won't hurt, but you didn't explicitly mention one thing that has studied benefit which is monoclonal antibodies. Also needs to be done early.

sonicggg• 5 years ago

Nonsense, get monoclonal antibodies as soon as possible. The earlier the better.

All you said was available during 2020, and people have been taking vitamins minerals, etc. and dying anyway.

javagram8• 5 years ago

For some reason very few people seem to be aware of this advice, and all the scientific evidence supporting it (in the context of SARS-CoV-2 and in general).

It’s because most of it is not backed by scientific evidence, there aren’t proved to be any general “antiviral” drugs you can effectively take to fight colds or other viruses. Tamiflu does exist for flu and maybe takes a day off your disease course, but even that is disputed. Zinc has as many negative studies as positive, high doses of vitamin C (e.g. “Emergen-C”) have flamed out in trials in the past. Some of them may have a small effect but don’t think it’s going to be a game changer in the fight against COVID-19. Only monoclonal antibodies and the vaccine are.

11thEarlOfMar• 5 years ago

Looks like actual cases will make up a material portion of herd immunity. Columbia reports that up to 1/3 of Americans already had contracted COVID by the end of 2020:

https://www.publichealth.columbia.edu/public-health-now/news...

throwaway203716• 5 years ago

Five reasons why COVID herd immunity is probably impossible https://www.nature.com/articles/d41586-021-00728-2

Here’s why herd immunity from Covid is ‘mythical’ with the delta variant https://www.cnbc.com/2021/08/12/herd-immunity-is-mythical-wi...

The developer of the AstraZeneca shot says the Delta variant has made herd immunity impossible because vaccinated people can still transmit the virus https://www.businessinsider.com/delta-variant-made-herd-immu...

nomoreplease• 5 years ago

That’s talking about herd immunity from vaccines. OP is talking about herd immunity from natural infection. So your links don’t invalidate the point, considering Israel research just proved that natural immunity is 13x more effective against Delta than Pfizer mRNA

nickysielicki2• 5 years ago

At the beginning of the pandemic, health agencies started misrepresenting and overstating the certainty of science, in order to attempt to get more buy-in from the public.

It started with masks. The studies that we had about masks really were not great, but they did a risk-reward calculation behind closed doors: worst case scenario, the surgical masks don't impact the spread and it changes nothing; best case scenario, we reduce community spread. The problem with this is that if they told the public that this was how they were thinking about the problem, they wouldn't get people wearing the masks, so they overstated their confidence in it when speaking to the public. A good amount of people truly believe that the science was clear. But it wasn't.

It continued with tests. It's much better to have a high rate of false positives than to have any rate of false negatives, so they pumped up the cycle count to accomplish this. They later toned it down. To the public, the tests aren't even questioned, most people believe they're pretty accurate, and most people are unaware that they have changed the criteria throughout the last year and a half. They sold it to the public like this because they knew that people would avoid getting tested and staying quarantined if they didn't trust the tests.

Lately, it's about the vaccines. There is no serious scientist that believed that the vaccines would prevent COVID from becoming endemic. It was obvious that this was going to be with us for the rest of our lives back all the way in April of last year (or earlier). There are no serious scientists that believe that 2 shots and a booster is going to be the end of it, and yet they're happy to tell us that we "might" need boosters. Do any serious scientists actually believe that? These aren't "breakthrough" cases, because it's not truly a vaccine in the sense that the Polio vaccine was a vaccine. It's a prophylactic. We always knew it was a prophylactic, but they sold it to the public as something else, because people wouldn't get it if they didn't lie.

We need to decide if we're okay with science agencies lying to us. Is their purpose to exact change on society, or is their purpose to do good science and tell us honest results? All of the confusion in this article stems from the misrepresentations they sell us.

1helloworld12• 5 years ago

Your assumption is that everyone is just as rational as you. Scientific agencies should just give out the exact probability numbers and let people decide for themselves. That's not how the world works. Our brains just cannot intuitively grasp probabilities (https://www.scientificamerican.com/article/why-our-brains-do...). Presenting the precise and most accurate information to the public without any embellishment sounds great in theory, but it doesn't work in practice.

josephcsible7• 5 years ago

What alternative do you suggest? Lying to the public? Or the government making every decision for them like they're all children? Both of those sound much, much worse.

mdp20216• 5 years ago

The position you seem to be defending (not «presenting the precise and most accurate information to the public») is dis-educative for its target (the not «as rational as you») and alienates the rest (the «as rational as you»).

mrob3• 5 years ago

Lying to the public doesn't work either, because once they're established as a known liar, why should we believe anything they say?

nemothekid6• 5 years ago

We need to decide if we're okay with science agencies lying to us.

This is the "Science is a Liar sometimes"[1] defense, and it can be used to discredit any sort of scientific research. You are basically asking that our agencies be 100% correct the first time and be perfect predictors of the future.

Secondly I don't understand how you were mislead about vaccines. The efficiency rates were always described in preventing you from going to the hospital. With COVID, the main issue has always been overstressing the health system - thats where the breakdown happens and thats why everyone needs to take the vaccine. Even now, ICU beds are not majority unvaccinated COVID cases, which overworks nurses and prevents people with other diseases from getting proper treatment.

[1] https://www.youtube.com/watch?v=U3Ak-SmyHHQ

nickthemagicman13• 5 years ago

I think they're asking for science not to misrepresent the facts.

They're not asking for science to be perfect.

criticaltinker3• 5 years ago

everyone needs to take the vaccine

This is simply not true, anyone who claims this is ignoring a vast body of scientific evidence supporting the fact that individuals who’ve recovered from previous infection will be at least as well protected as vaccinated individuals against reinfection.

If you were to say “most people who don’t already have natural immunity ought to be vaccinated” that would be a much more sensible recommendation, in-line with general scientific consensus (and public health policies in other countries).

OrvalWintermute3• 5 years ago

This is the "Science is a Liar sometimes"[1] defense

No, this is not "Science is a liar sometimes" defense.

When we were misled about mask efficacy with a number of circular lies (you don't need masks, you do need masks, double mask!, cloth masks are as effective as N9ts, N95 is overkill, it is not aerosolized, etc) a good number of those were well-known lies of varying proportion, and not the scientific method in progress.

The truth was that people were lying to us consciously to preserve N95 mask supply for frontline workers, but that truth would have gone much further than the mistruths and half truths we were told.

At the same time as the hyperbole was spreading about covid taking over ERs and News coverage was emphasizing this fact, my surgeon wife was telling me how empty all of the hospitals were, and the on-call cases dropped to nothingness because people were isolating and not going outside. But still, the drumbeat of 24/7 news cycle kept putting out bogus info about saturation of ERs and ICUs chock full of intubated covid patients.

If there has been any damage done to science by our authorities during this crisis, it is completely self-inflicted.

saurik• 5 years ago

You are basically asking that our agencies be 100% correct the first time and be perfect predictors of the future.

That isn't how I read this comment at all :/.

First off, the person isn't even saying not to trust scientists at all, much less because they are wrong: in each case the idea was that they are acting in their best understanding of what the effect of a certain kind of intervention will be; the comment isn't blaming scientists for getting something wrong or failing to predict the future: it explicitly even seems to agree with each intervention as being a sensible thing to do given the information at the time and the risk/benefit analysis.

And then secondly, the issue of someone overstating their confidence on purpose and knowingly is very different from someone misunderstanding something and later realizing they were wrong. "I think this is our best course of action to mitigate the impact" is an honest thing to say. But people seem to want to hear "this will solve the problem fully". People seem to not want to deal with "I realize this might not help much, but it certainly won't hurt: let's try it and see how effective it is" (another honest thing to say), but instead want to hear "trust me: you need to do this as I know it is going to work".

I was--and am!--fully willing to do things that are only going to mitigate the impact, whether to myself or to others, and I am willing to do it even on reasoning as flimsy as "it is unlikely to hurt". But I feel like I am in a vast minority, and so everyone instead is motivated to overstate their confidence and overstate their intended result in the hope of getting more compliance, which is why we have people who don't just feel "scientists and doctors are trying their best to work in our best interests, and this is our best hope as of today" but help get on the bandwagon of "if you disagree with how effective this is going to be you are an idiot who is anti-science and you are part of the problem in our attempts to get compliance".

rasz2• 5 years ago

No, he is asking to not be knowingly lied to. You might be fine with this if you are from Far East or India https://en.wikipedia.org/wiki/Face_(sociological_concept)#Ch.... Lying to save face, or even for greater good is not tolerated in the West.

gridspy15• 5 years ago

Not all health agencies, for instance in New Zealand they have been very honest about the science and what is known.

Regarding the article, I think many people wanted to know that there was an "end" in sight to COVID. This narrative was attached to Vaccines as "the end" by much of the press that I watch in the states.

Here in NZ the press is putting pressure on the Govt. to ease lock-down restrictions as the vaccination rate goes up. But we're still reluctant to allow covid in "and just live with it" even as levels of vaccination rise.

I think the only realistic "end" is when the multiplicative effect of masks, caution (social distancing for eg) and the vaccine reduces R below 1 in each individual country long enough to achieve elimination over time.

It would be a pity if in some communities Covid is never eliminated.

nickthemagicman13• 5 years ago

I feel bad for the population of New Zealand.

The amount of lockdowns and Covid restrictions was one of most restrictive in the world.

And after all of that, you all recently had one of the highest rates of infection since the pandemic started.

What a tough situation there.

It like all being locked down for years and having the borders closed for years didn't change a thing.

Wowfunhappy17• 5 years ago

Wild animals can spread COVID, so I don't see how it can ever be eliminated. We may be able to reduce R temporarily in humans via social distancing measures, but it's going to tick back up as soon as the restrictions are lifted.

davmar4• 5 years ago

It started with masks. The studies that we had about masks really were not great, but they did a risk-reward calculation behind closed doors: worst case scenario, the surgical masks don't impact the spread and it changes nothing; best case scenario, we reduce community spread. The problem with this is that if they told the public that this was how they were thinking about the problem, they wouldn't get people wearing the masks, so they overstated their confidence in it when speaking to the public. A good amount of people truly believe that the science was clear. But it wasn't.

Inaccurate and dangerously wrong conjecture. Research published long before COVID-19 proved the efficacy of masking in blocking particulate matter. That's why terms like N95 even exist.

https://www.nature.com/articles/s41598-020-72798-7

That study came out last year, but there are similar studies published many years ago. I don't have time to google for them all right now, but they are out there for those who want to find them.

The science on masking was clear and your statement is irresponsible.

zdragnar3• 5 years ago

If you wouldn't trust a cloth mask to protect you from asbestos dust or second hand smoke, you shouldn't trust it to protect you from a disease that spreads as an aerosol.

OSHA doesn't, and you shouldn't either.

geoduck14• 5 years ago

Inaccurate and dangerously wrong conjecture. Research published long before COVID-19 proved the efficacy of masking in blocking particulate matter.

Sure, but what wasn't certain was things like: Was covid transmitted in the air by particles (yes)? Was it transmitted via aerosols (no)? Was it transmitted by touch (no)? How many particles are needed to infect someone (unsure)? Do masks protect me or someone else? What type of masks are needed to protect? How many masks do I need to wear?

From my exposure, I saw non experts being very emphatic about answers that actually took a long time to get answers to. These emphatic non experts alienated people that continued continued be unsure. In some cases, the experts were emphatic - and then wrong - which further alienated people.

nickysielicki2• 5 years ago

You're missing my point. Do you remember last year, very early in the pandemic, when Fauci went on TV and urged people not to go out and horde N95s, claiming that they didn't work, when in reality he just wanted to ensure that they were available for healthcare workers? And then he flipped around weeks later and recommended surgical masks for everyone?

I'm not claiming that masks do or don't work. I'm just claiming that they lied about it (twice) to suit their interests.

Research published long before COVID-19 proved the efficacy of masking in blocking particulate matter. That's why terms like N95 even exist.

Sure, but what about for aerosols? If you want to see what the self-proclaimed rational community thought of masks and research available at the time in March of 2020 as it pertained to COVID, see this article: https://slatestarcodex.com/2020/03/23/face-masks-much-more-t...

lucretian2• 5 years ago

you use the word "lie" here with loose abandon and with astounding confidence in your ability to infer motivations of every single member of a massive and complex system of public health and medical professionals.

frankly, this is conspiracy talk and it's pathetic to see it upvoted.

mcguire7• 5 years ago

There is a strong trend of anti-intellectualism in modern culture that extends to HN. If someone says something that later turns out to be false, then they are considered to be lying, and their supposed lie is used to justify disbelief in anything any other expert says.

It's a violation of basic reasoning skills as well as the HN rules, but it will always will get upvoted because it satisfies a certain kind of hubris: "If I don't know something then no one could possibly know it and therefore the idea I came up with after 10 seconds of thought is just as valid as anyone else's."

shkkmo6• 5 years ago

It's much better to have a high rate of false positives than to have any rate of false negatives, so they pumped up the cycle count to accomplish this. They later toned it down.

I not aware of any evidence that increased cycle counts have a significant effect on false positives. To the best of my knowledge, the false positive rates of of PCR tests are extremely low. My understanding is that cycle counts were changed to balance false negatives against testing time/lab loads. If you have evidence that contradicts this, I would love to see it.

These aren't "breakthrough" cases, because it's not truly a vaccine in the sense that the Polio vaccine was a vaccine.

The polio vaccine is also not 100% effective. Both polio vaccines and covid vaccines reduce but do not eliminate your chance of being infected. In what sense is the covid vaccine not a "true vaccine"?

Edit: We have other vaccines that have even lower level of preventative efficacy than the covid vaccines do against delta and we still administer them.

resource0x• 5 years ago

Counting down to the moment when mainstream media changes its tune to something like "Big Pharma! Rushed (Trump's) (non)-vaccines! $$$! etc."

noasaservice2• 5 years ago

At the beginning of the pandemic, health agencies started misrepresenting and overstating the certainty of science, in order to attempt to get more buy-in from the public.

Sure, the mainstream media oversimplified what the scientists were saying. But much of the actual early data was available in open archives, sci-hub, and library genesis. How much of the real science did you read, or did you use the MSM as a placeholder for scientists?

It started with masks. The studies that we had about masks really were not great, but they did a risk-reward calculation behind closed doors: worst case scenario, the surgical masks don't impact the spread and it changes nothing; best case scenario, we reduce community spread. The problem with this is that if they told the public that this was how they were thinking about the problem, they wouldn't get people wearing the masks, so they overstated their confidence in it when speaking to the public. A good amount of people truly believe that the science was clear. But it wasn't.

It's simple to understand masks when you look at another tech : HVAC filters.

The better the filter (keeping surface area =), the harder it is to breathe. The less filtering the filter, the easier to breathe.

N95's and better were stupidly hard to get hold of early on. But they have a toll on breathing. Again, it's not "maskless" and "heavy filtration". It's a gradient of filtration... And most materials don't have rated filter properties. That's not to say they can't filter - they do. They're just not as good as an N95.

And even surgical masks are there primarily to prevent talking, breathing, coughing, and sniffling from being as impactful to other people.

Anybody in IT would know there's no one solution, and no perfect solution. Everything's a tradeoff, and early on, cloth masks were leaps and bounds better than none at all.

It continued with tests. It's much better to have a high rate of false positives than to have any rate of false negatives, so they pumped up the cycle count to accomplish this. They later toned it down. To the public, the tests aren't even questioned, most people believe they're pretty accurate, and most people are unaware that they have changed the criteria throughout the last year and a half. They sold it to the public like this because they knew that people would avoid getting tested and staying quarantined if they didn't trust the tests.

A good reason why our testing was so terrible and laggard was because of trump. Elections matter, and his brand of "inject bleach", "take hydroxyclorquine", and continual fall of fake news got a whole hell of a lot of people killed. And he retarded federal government's access to tests, and also severely impacted democratically led states in testing. (citation: https://www.nbcnews.com/think/opinion/did-trump-kushner-igno... )

"Trump has made no secret of his ambivalence about testing. "When you do testing to that extent, you're going to find more people," Trump said in June at an ill-timed rally in Tulsa, Oklahoma. "You're going to find more cases. So I said to my people, 'Slow the testing down, please.'""

"Most troubling of all, perhaps, was a sentiment the expert said a member of Kushner's team expressed: that because the virus had hit blue states hardest, a national plan was unnecessary and would not make sense politically. "The political folks believed that because it was going to be relegated to Democratic states, that they could blame those governors, and that would be an effective political strategy," said the expert."

I believe those speak for themselves.

Lately, it's about the vaccines. There is no serious scientist that believed that the vaccines would prevent COVID from becoming endemic. It was obvious that this was going to be with us for the rest of our lives back all the way in April of last year (or earlier). There are no serious scientists that believe that 2 shots and a booster is going to be the end of it, and yet they're happy to tell us that we "might" need boosters. Do any serious scientists actually believe that? These aren't "breakthrough" cases, because it's not truly a vaccine in the sense that the Polio vaccine was a vaccine. It's a prophylactic. We always knew it was a prophylactic, but they sold it to the public as something else, because people wouldn't get it if they didn't lie.

You only need to study your history about the Kansas Military Base Flu... Errr, the "Spanish Flu". Lasted 2.5 years. Had anti-vaxxers. Had anti-maskers. Had nearly the same groups on both sides saying the same stuff. Cats, dogs, and other mammals could also get and spread it (they even masked their cats and dogs).

And regular Covid is pretty much gone. Now, it's delta and newer greek char variants. That's because people won't limit the spread using reasonable and working methodologies (vaccine, masking, social distancing, limiting group sizes). And those mutations migrate away from the original vaccine's work on the initial Sars-CoV-n19. I'd be reasonably sure my vacc would protect against the original.

We need to decide if we're okay with science agencies lying to us. Is their purpose to exact change on society, or is their purpose to do good science and tell us honest results? All of the confusion in this article stems from the misrepresentations they sell us.

Scientists aren't lying - you're just listening to the wrong research (protip: main stream media are the usual culprits of lying/oversimplifying/lies of omission).

The vaccines work in varying degrees, primarily keeping people who do happen to get a variant out of the hospital.

armchairhacker• 5 years ago

People need to let go of their pride, so that even if they don't want to listen to authority, they can accept that they should.

This might not seem like a big difference but it is. The former creates arbitrary roadblocks: people refusing the vaccines no matter the incentives. It causes people to form junk "science" to justify why 2 + 2 actually equals 5. The latter allows people to compromise: I'm not intrinsically opposed to X, I'm just opposed because of Y, and if you can solve Y than I no longer care about X.

People need to accept cognitive dissonance more. And accepting cognitive dissonance means accepting that sometimes you're the dumb guy or the bad guy. But everyone is the dumb guy or bad guy at some point, whether or not they accept it. Accepting means that you can correct your mistakes and be the dumb/bad guy less often.

Unfortunately it's against human nature to accept cognitive dissonance: it literally causes stress. I don't even think I can fully accept cognitive dissonances. But I believe we can teach people how to resolve cognitive dissonance better, so that people can accept that they have flaws and make mistakes, without accepting that they're a failure.

rtikulit• 5 years ago

You are making an amazingly important point. If one accepts "all models are wrong, some are useful" then it fairly directly follows that cognitive dissonance is essential and irreducible and when one encounters it maybe examine one's models? Aka how and why one thinks and feels?

Zen shout-out: This is non-dualism in another guise, and a key Zen practice is to confront irreducible dissonance and batter yourself against it until you are forced to develop and internalize higher-order cognitive and emotional models that can represent contradictions and reason/feel over them to produce useful results.

ZoomerCretin• 5 years ago

It continued with tests. It's much better to have a high rate of false positives than to have any rate of false negatives, so they pumped up the cycle count to accomplish this. They later toned it down. To the public, the tests aren't even questioned, most people believe they're pretty accurate, and most people are unaware that they have changed the criteria throughout the last year and a half. They sold it to the public like this because they knew that people would avoid getting tested and staying quarantined if they didn't trust the tests.

Extraordinary claims require extraordinary evidence. Do you have a source for this?

tablespoon• 5 years ago

It started with masks. The studies that we had about masks really were not great, but they did a risk-reward calculation behind closed doors: worst case scenario, the surgical masks don't impact the spread and it changes nothing; best case scenario, we reduce community spread. The problem with this is that if they told the public that this was how they were thinking about the problem, they wouldn't get people wearing the masks, so they overstated their confidence in it when speaking to the public. A good amount of people truly believe that the science was clear. But it wasn't.

That's not how I remember it. IIRC, the CDC dragged their feet on recommending masking because of the same lack of explicit studies you cite and supply chain worries. Then once they did recommend masks, you have a much of people citing their "flip flop" as a reason not to trust them.

It was obvious that this was going to be with us for the rest of our lives back all the way in April of last year (or earlier).

IIRC, no one knew shit in April 2020. Your statement feels like its heavily influenced by hindsight bias.

We need to decide if we're okay with science agencies lying to us. Is their purpose to exact change on society, or is their purpose to do good science and tell us honest results? All of the confusion in this article stems from the misrepresentations they sell us.

I think you're confused. I'm not sure exactly who you're counting as "science agencies," but if it's the kind of agencies I'm thinking of, I wouldn't say their purpose is either to "exact change on society" or to "do good science and tell us honest results." Their purpose it to come up with public policy to solve actual problems in the face of rather severe uncertainty. Hopefully that based on good science (which may be psychology/sociology), but that's often not possible.

It's not "lying" to not share your exact level of pessimism/cynicism or to be unable to make statements about the future with the benefit of hindsight.

y7• 5 years ago

Recent research from the U.K. suggests that vaccinated people are about 50% less likely to develop long COVID than those who are unvaccinated.

To me that doesn't sound like that great of a risk reduction.

bryanlarsen• 5 years ago

That's on top of the reduced risk of catching it in the first place. Estimates of that vary widely, let's use 1/6. So 1/12 risk of long COVID.

mdp20216• 5 years ago

Have you factored in the reduced chance of symptomatic disease? That comes before long COVID.

With (two months after) vs without = ~0.2 vs 0.05×0.5×0.2 = ~20% vs ~0.5%

(Explanation: chance of symptomatic disease 2 months after reported as 5% vs "control"; chance of long COVID after symptomatic infection reported as 2.3% as bare minimum, 13% to other research and 40% to a large interpretation.)

Edit: to the three British studies of 2.3%, 13% and 40%, after this thread I can add 25% from a post from user tfehring, including link to article: «something like a quarter of people with symptomatic COVID seem to have some kind of cognitive symptom (mainly “brain fog” and/or short-term memory loss) 8 months later». I will update the tentative value for the chance of long COVID, but the ratio, half of one twentieth, does not change.

tomohawk• 5 years ago

This is what post pandemic looks like.

Covid is endemic, and just like you probably don't know anyone who has never had the flu or the cold, it will be the same with this.

Get your vax! It'll likely keep you out of the hospital when you do get it.

Mask up all you want. Avoid crowds. Shun and shame people. You're still going to get it, just like everyone else.

aazaa• 5 years ago

In my case, it was worse than expected, but, in the parlance of public health, it was "mild," meaning I didn't end up in the hospital or require oxygen.
...
It was a miserable five days. My legs and arms ached, my fever crept up to 103 and every few hours of sleep would leave my sheets drenched in sweat. I'd drop into bed exhausted after a quick trip down to the kitchen. To sum it up, I'd put my breakthrough case of COVID-19 right up there with my worst bouts of flu. Even after my fever cleared up, I spent the next few weeks feeling low.

"Mild" can mean different things to different people. I doubt this description of "mild" fits most people's concept of the word, as it sounds like a severe case of the flu. The fact that these infections are happening against a backdrop of normalization efforts should give anyone who thinks we're out of the woods pause.

As the rate of infection increases, so does the risk to the vaccinated. It's another demonstration, once again, of how our public health system (and the CDC in particular) has failed us:

... "quantifying that [chance of symptomatic case in an unvaccinated person] in the U.S. is very challenging" because our "data is so shoddy."

Some time ago, the CDC stopped counting/sequencing "mild" breakthrough cases, so we're flying blind mostly. Maybe it's delta the reporter caught. Maybe something else. Who knows?

https://www.newsweek.com/why-did-cdc-stop-counting-mild-asym...

What's clear is that COVID-19 isn't going away any time soon. What's also clear is that it shares the tendency that all RNA viruses have to mutate at an extremely rapid rate. It has shown that it can change much faster than we can adapt.

spookthesunset11• 5 years ago

What's clear is that COVID-19 isn't going away any time soon.

This isn’t new information. It was obvious all the way back in March of 2020 that covid was here forever.

Life must go on. We cannot live with this myopic fixation on exactly one specific form of illnesses. These “experts” have already asked enough out if people. We’ve been asked to put our lives on hold for more than 1.7 years now.

Dragging any of this on after the first vaccines came out was unethical as hell. Vaccines were it. There is nothing else we can do besides attempt to build some myopic hellscape where our entire existence is centered around stopping the spread of covid.

pixl975• 5 years ago

Well we can get everyone vaccinated so we quit filling the hospitals with unvaxxed patients.

rkk36• 5 years ago

I doubt this description of "mild" fits most people's concept of the word

Hence the ' around mild in the title. But honestly sure they were sick but they did not seriously fear for their lives or require medical attention. Obviously being asymptomatic would have been more mild but in general this seems like a win.

People need to accept some level unpleasantness and risk in their lives.

stakkur2• 5 years ago

Current CDC data on breakthrough cases: .04%. 99.6% of vaccinated people are not contracting COVID.

hoppyhoppy2• 5 years ago

100% minus .04% does not equal 99.6%, and a link to the source of the data would make your comment more credible.

stakkur2• 5 years ago

I have no ‘claims’ to make; this is public, easily accessible, free information.

CDC running vaccination dashboard: https://covid.cdc.gov/covid-data-tracker/#vaccinations_vacc-...

CDC Breakthrough Case Investigation and Reporting https://www.cdc.gov/vaccines/covid-19/health-departments/bre...

As of 9.7.2021, of approximately 178M Americans fully vaccinated, there have been 14,115 breakthrough cases requiring hospitalization or who died. I’ll leave it to you to calculate that percentage.

For those familiar with the usual limitations of data collection, it’s clear there is no ‘perfect’ count of breakthrough cases, so hospitalization/mortality are the most concrete data available.

However, there is reporting beyond just those two categories, so the CDC estimates .04% of those fully vaccinated develop breakthrough cases.

birdyrooster12• 5 years ago

Sherman should have continued marching through the south for several years completely displacing all of the traitors who have become the Republican Party today. Then we could have public health.

I Got a 'Mild' Breakthrough Case

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