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Old Jan 27, 2020, 9:09 am
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Old Sep 29, 2021, 8:05 am
  #9556  
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Originally Posted by Diplomatico
Unfortunately, too many people (including - and especially - the media) still obsess over "cases" as the most important determining factor in calculating risk/trends re: COVID.

By now, we should be less concerned about raw case numbers and should be focusing more on hospitalizations and deaths as indicators.
Yes, that's right but a couple of points on that:
- case numbers drive hospitalisation. We are using that within the NHS to predict quite accurate how many beds will be needed in 2 weeks, and also to plan mortuary space.
- the above works in combination with vaccination levels per age group and case numbers per age group.
So the death rate in the UK is 131.4, per day per rolling 7 day average. It would be below 100 if we get from 83% double vaccinated to 99% double vaccinated (96.2 to be precise). Based on first vaccination doses, we will get to 91% in next month or so. If the case rate goes up by 10,000 per day then that will kill another 25 or so people per day / 250 people hospitalised per day. But the critical thing is that happens in 2 weeks time, hence tracking case numbers is pretty useful.
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Old Sep 29, 2021, 8:30 am
  #9557  
 
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Originally Posted by invisible
Let me try to rephrase what you are asking:

Question is following - at what point are we going to remove masks and other restrictions and what are KPIs for that?

The honest answer on that question in the US is - ‘no idea’.

However you will hear different answer- ‘when science will allow it’. When you ask about what is the specific ‘science’ you will hear about r0 plus bunch other lingo not really helping you with the answer, so see the above.

At the end if you want to live without masks other things from clown world - well you need to be in a place where they are not. Sorry for being straightforward here…
Thank you. No need to apologize. I was just curious if any sort of "past experience" had resulted in some sort of science-driven policy. It seems though that this may not be the case (at least here in the US). I'll try to find the news report (it was on TV, so I don't know if they have an actual clip) as yet another example of "zero covid" approach (IMO).

Local high school has an 80% vaccination rate of students and staff/faculty. They have chosen to continue the mask mandate because "we have had zero covid cases so far".

I'm not keen on having weekly nasal swab tests and masked all the time (granted, just my opinion which is obviously different from those who crafted such policy at a certain local university) when that "population" is 99% vaccinated. That tells me that we will never be free of masks/testing. If at 80 and 99% fully vaccinated, you can't get rid of those things, then we'll never be rid of them.

And if one takes the logical steps like: Well, those college kids interact with non-population folks who aren't vaccinated, then you expand that to the City (city folks interract with non -vaccinated residents outside of said city), and then the county, and then the state, and then the country, basically until the entire world is at 99% vaccination, we'll have masks/testing (and personally we'll still have COVID cases as I believe this is going to be endemic and vaccines won't prevent the spread, just the majority of really bad effects of COVID).

And thanks for the folks with the Singapore info. I didn't realize Singapore was at like 80% vaccination rate (good for them!) Granted, it's an island (vs. the US) and there's obvious social differences with the population (vs. here). But good knowledge, nonetheless.
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Old Sep 29, 2021, 9:59 am
  #9558  
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Originally Posted by hurnik
I'm not keen on having weekly nasal swab tests and masked all the time (granted, just my opinion which is obviously different from those who crafted such policy at a certain local university) when that "population" is 99% vaccinated. That tells me that we will never be free of masks/testing. If at 80 and 99% fully vaccinated, you can't get rid of those things, then we'll never be rid of them.
My experience is that colleges and high schools are extra cautious in this space, so even though I have to work in a mask all day long, given I'm in a healthcare setting, I'd be very happy to see them being rolled back from society generally. And this is because you are studying indoors, socialising a lot, large groups of people, some will have undiscovered vulnerabilities to respiratory diseases.

The thing that is holding us back is the unvaccinated. In theory we say to them "over to you, good luck with Darwin", but if the unvaccinated is too high a number then to protect healthcare we need to bear down on infection cases. Otherwise healthcare will run out of resources for things other than COVID, as we saw in the USA and some parts of the UK system too. We're on a bit of an experiment here in the UK, there are now relatively few restrictions left, particularly for those vaccinated (many travel restrictions get lifted on Monday), and yes the hospital cases are stretched by the unvaccinated, but the evidence is pointing to life post COVID. People and organisations and parts of the community go at different paces. So a college is going to stick with masks for a little while longer, a rural area with low case numbers and high vaccination levels is probably already post-COVID now.
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Old Sep 29, 2021, 10:48 am
  #9559  
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Originally Posted by shorthauldad
What's the point in quarantining Covid-positive but apparently healthy students on a campus where everyone is vaccinated?

.
They should be quarantined because they are still transmitting Covid, and a breakthrough case can also create another breakthrough case. There is also likely a small number of fake vaccination cards among all the vaccinated, plus people with preexisting conditions, people with limited vaccine protection for various reasons, so there are holes in the prevention system. Asking positive cases to quarantine, even if asymptomatic, is minimal and common sense.
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Old Sep 29, 2021, 10:57 am
  #9560  
 
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Originally Posted by freed0m
today, if someone got flu, it is advised to isolate and mask if going somewhere and talking with people.
At one level, I think we probably agree. Not infecting other people with your illness seems, well, just basic manners and common sense.

We have three kids here, and over the years I've seen too many parents attempt to deliver obviously sick children to kindergartens and/or schools, and guess what, other kids (and their parents, and grandparents) end up getting sick too. Too many times to count I've had the phone call from a kindergarten saying "your child just vomited everywhere" / "your child now has a fever of XX°C" and ending with "come and get them NOW!"

On another level, it seems the data say many (the majority of?) people who get seasonal flu don't get sick.

https://www.cdc.gov/flu/about/keyfacts.htm:
How Many People Get Sick with Flu Every Year?
A 2018 CDC study published in Clinical Infectious Diseasesexternal icon looked at the percentage of the U.S. population who were sickened by flu using two different methods and compared the findings. Both methods had similar findings, which suggested that on average, about 8% of the U.S. population gets sick from flu each season, with a range of between 3% and 11%, depending on the season.

Why is the 3% to 11% estimate different from the previously cited 5% to 20% range?
The commonly cited 5% to 20% estimate was based on a study that examined both symptomatic and asymptomatic influenza illness, which means it also looked at people who may have had the flu but never knew it because they didn’t have any symptoms. The 3% to 11% range is an estimate of the proportion of people who have symptomatic flu illness.
UK flu study: Many are infected, few are sick
https://www.cidrap.umn.edu/news-pers...d-few-are-sick

British researchers who tested people for influenza antibodies before and after each flu season for 5 years found that an average of 18% of them appeared to have contracted a flu infection each season, but only 23% of that group got sick, according to a report in The Lancet Respiratory Medicine.

As for the possible role of asymptomatic carriers in spreading flu, Bresee commented that symptoms correlate with the amount of virus shed. "So my presumption is that asymptomatic infected people will shed less virus than people who are symptomatic, and therefore will contribute less to community spread," he said. "But I'm not sure how much data there are for that."


Isn't it the case that fighting a disease which can spread asymptomatically is, to be blunt, a real PITA? If Covid is in that category then, well...
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Old Sep 29, 2021, 11:01 am
  #9561  
 
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Originally Posted by nk15
Asking positive cases to quarantine, even if asymptomatic, is minimal and common sense.
In that case presumably we should all support widespread, regular testing of the vaccinated (as well as the unvaccinated), just to make sure we pick up breakthrough cases who might be unknowingly putting others at risk?

Oddly that doesn't seem to be part of government policy (at least on this side of the Atlantic). It's almost like "not needing to be tested" is somehow the reward for getting vaccinated.

"Follow the science", they said ...
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Old Sep 29, 2021, 11:30 am
  #9562  
 
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I think you are overthinking this. The vaccine offers very good (but not 100%) protection from serious illness, meaning we can start to consider covid as an illness with less severe consequences - comparing it to flu has a bit of a bad history but I think might be reasonable now. BUT hundreds of thousands of grandparents die each year of flu, many times caught from children or grandchildren unfortunately.
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Old Sep 29, 2021, 11:31 am
  #9563  
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Originally Posted by shorthauldad
In that case presumably we should all support widespread, regular testing of the vaccinated (as well as the unvaccinated), just to make sure we pick up breakthrough cases who might be unknowingly putting others at risk?

Oddly that doesn't seem to be part of government policy (at least on this side of the Atlantic). It's almost like "not needing to be tested" is somehow the reward for getting vaccinated.

"Follow the science", they said ...
If everyone is vaccinated and masked, and there is some kind of air filtration/ventilation system (i.e., three layers of protection, with vaccination being the most important), there is no need for regular testing, unless someone becomes symptomatic. This is the protocol we use in my workplace, and it is stricter than the CDC guidelines.

Despite these layers, we had one person infected, which triggered testing in 3-5 days post exposure or 10-day quarantine for those immediately exposed (same room), per our protocol. No further cases detected.
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Old Sep 29, 2021, 1:25 pm
  #9564  
 
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Originally Posted by 8420PR
The vaccine offers very good (but not 100%) protection from serious illness (...)
One can't help but note that "being young" and "being healthy" also offer very good (but not 100%) protection from serious illness caused by Covid.

I've quoted Spiegelhalter before, he's obviously off-message for some here, but here goes:

( https://www.theguardian.com/world/20...es-are-failing )
So why will the majority of those in hospital with Covid be double jabbed? There are several factors at work. First of all, who has and has not been vaccinated matters. Across the UK about 30% of adults are not fully vaccinated. While some are vulnerable people who for some reason have not been jabbed, the majority are young, and healthy enough not to be considered at particular risk: these are people who would very rarely get sick enough with Covid-19 to need hospital care
(..)
The total number of Covid hospitalisations will be dramatically lower than in a world without vaccines, but those who are admitted are increasingly likely to have had both shots
(..)
“If fully vaccinated, the risk of being hospitalised falls by about 90%,” said Prof David Spiegelhalter, chair of the Winton Centre for Risk and Evidence Communication, at Cambridge University. “But it doesn’t disappear, and as a large proportion of the highest risk people are now vaccinated it’s inevitable they will start to form the majority of the people with Covid in hospital, particularly as most of the unvaccinated people are young and therefore at low risk. Indeed, being young reduces the risk even more than being vaccinated.”


I slightly resent having been tagged with 'whataboutism' for raising this before, but look at the recent CDC data ( https://data.cdc.gov/NCHS/Provisiona...-Age/9bhg-hcku ) and the historical CDC data for causes of death by age cohort ( https://www.cdc.gov/injury/images/lc..._1100w850h.jpg )

How many 10-34 year olds in your town / county / country took their own life this week? How many homicides?

Then take a deep breath and look at how many died from Covid?

How many died from non-Covid pneumonia?

You might well be happy that your employer exceeds the CDC guidelines for Covid and insists on masks and vaccines and ventilation, but why not worry at least that much about mental health and violent crime?
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Old Sep 29, 2021, 1:27 pm
  #9565  
 
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Originally Posted by shorthauldad
In that case presumably we should all support widespread, regular testing of the vaccinated (as well as the unvaccinated), just to make sure we pick up breakthrough cases who might be unknowingly putting others at risk?
Welcome to Singapore. Ask how this exact policy works hire. Hint - it doesn’t.
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Old Sep 29, 2021, 1:38 pm
  #9566  
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Originally Posted by shorthauldad
I slightly resent having been tagged with 'whataboutism' for raising this before, but look at the recent CDC data ( https://data.cdc.gov/NCHS/Provisiona...-Age/9bhg-hcku ) and the historical CDC data for causes of death by age cohort ( https://www.cdc.gov/injury/images/lc..._1100w850h.jpg )

How many 10-34 year olds in your town / county / country took their own life this week? How many homicides?

Then take a deep breath and look at how many died from Covid?

How many died from non-Covid pneumonia?

You might well be happy that your employer exceeds the CDC guidelines for Covid and insists on masks and vaccines and ventilation, but why not worry at least that much about mental health and violent crime?
This is all very well but it is whataboutery. Pure and simple whataboutery. You cannot do public health on whataboutery - whataboutery doesn't give you a policy. It's about improving on all of the above. My goodness the amount time we have spent in recent months on trying to get both non Covid and Covid pneumonia down is extraordinary, I spend a minimum of 2 hours a week on public health protection measures in this space - identifying related trigger cases, contacting the directors of public health, using the Contact-Trace system (the old one) - and it's not my primary job to do this, there are probably 200 people working on this fulltime, and but for them pneumonia would be far higher. Suicides same. We don't have many homicides, but for the first time in February we were using the police morgues to store COVID bodies because the hosptials and private undertakers had run out of space. Whatabout trying to keep all of this down, getting people jabbed, sensible but proportionate health measures to stop / avoid people dying unnecessarily? Once we get everyone jabbed - and in the UK we are getting probably close enough - we can remove the very few other restrictions that remain. Whatabout a bit of common sense?

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Old Sep 29, 2021, 2:16 pm
  #9567  
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Are there any studies pending about Covid-19 infections in children resulting in increased autism, even for exposure only well after birth?

Association between Viral Infections and Risk of Autistic Disorder: An Overview

Abstract: Autism spectrum disorder (ASD) is a neurodevelopmental condition of the central nervous system (CNS) that presents with severe communication problems, impairment of social interactions, and stereotypic behaviours. Emerging studies indicate possible associations between viral infections and neurodegenerative and neurobehavioural conditions including autism. Viral infection during critical periods of early in utero neurodevelopment may lead to increased risk of autism in the offspring. This review is aimed at highlighting the association between viral infections, including viruses similar to COVID-19, and the aetiology of autism. A literature search was conducted using Pubmed, Ovid/Medline, and Google Scholar database. Relevant search terms included “rubella and autism”, “cytomegalovirus and autism”, “influenza virus and autism”, “Zika virus and autism”,
“COVID-19 and autism”. Based on the search terms, a total of 141 articles were obtained and studies on infants or children with congenital or perinatal viral infection and autistic behaviour were evaluated. The possible mechanisms by which viral infections could lead to autism include direct teratogenic effects and indirect effects of inflammation or maternal immune activation on the developing brain. Brain imaging studies have shown that the ensuing immune response from these viral infections could lead to disruption of the development of brain regions and structures. Hence, long-term follow up is necessary for infants whose mothers report an inflammatory event due to viral infection at any time during pregnancy to monitor for signs of autism. Research into the role of viral infection in the development of ASD may be one avenue of improving ASD outcomes in the future. Early screening and diagnosis to detect, and maybe even prevent ASD are essential to reduce the burden of this condition.
https://mdpi-res.com/d_attachment/ij...8-02817-v3.pdf
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Old Sep 29, 2021, 3:23 pm
  #9568  
 
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Originally Posted by corporate-wage-slave
This is all very well but it is whataboutery. Pure and simple whataboutery. You cannot do public health on whataboutery - whataboutery doesn't give you a policy. It's about improving on all of the above. My goodness the amount time we have spent in recent months on trying to get both non Covid and Covid pneumonia down is extraordinary, I spend a minimum of 2 hours a week on public health protection measures in this space - identifying related trigger cases, contacting the directors of public health, using the Contact-Trace system (the old one) - and it's not my primary job to do this, there are probably 200 people working on this fulltime, and but for them pneumonia would be far higher. Suicides same. We don't have many homicides, but for the first time in February we were using the police morgues to store COVID bodies because the hosptials and private undertakers had run out of space. Whatabout trying to keep all of this down, getting people jabbed, sensible but proportionate health measures to stop / avoid people dying unnecessarily? Once we get everyone jabbed - and in the UK we are getting probably close enough - we can remove the very few other restrictions that remain. Whatabout a bit of common sense?
What do you consider 'close enough' in terms of %? I think it's currently about 72% (about 45 million fully vaccinated) and about 100k vaccinations/day, (yes I know that not everyone can get it, like those under 16 or whatever the current age range is). If you mean the 16 and over, I think it's already around 90% with BBC reporting 9 in 10 over the age of 16 having had a single jab)?

If total population, at 100k per day, the remaining 17 million might take a while.
If the current "eligible" population, and the fact that Delta can and does infect vaccinated folks, will you ever be "close enough"? (Not saying this in a disparaging way).

Personally I think you guys are doing great to get to such a high number very quickly.
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Old Sep 29, 2021, 3:37 pm
  #9569  
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Originally Posted by hurnik
What do you consider 'close enough' in terms of %? I think it's currently about 72% (about 45 million fully vaccinated) and about 100k vaccinations/day, (yes I know that not everyone can get it, like those under 16 or whatever the current age range is). If you mean the 16 and over, I think it's already around 90% with BBC reporting 9 in 10 over the age of 16 having had a single jab)?
I mean 16 and over, so that is 89.8% of those 16+ have had one dose as of yesterday, and 82.5% have had both jabs. So in a few days we should hit 90%, and the final figure is going to be about 92%, we think, though the tail effect will make the final 2% seem hard work. I see ages 12 to 15 as being a bonus. And in reality from Monday there will be very few COVID restrictions left, at least for those vaccinated. Some colleges are being slow to return to large class teaching, but that's about all I can think of for those vaccinated. Unvaccinated people have a few more restrictions, mainly when travelling, or if they work in care homes, but it's not a lot. Mask wearing has clearly reduced but is to some extent visible in some locales.
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Old Sep 29, 2021, 4:06 pm
  #9570  
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Originally Posted by shorthauldad

You might well be happy that your employer exceeds the CDC guidelines for Covid and insists on masks and vaccines and ventilation, but why not worry at least that much about mental health and violent crime?
I also forgot the 4th and 5th layers of protection we use, such as a blend of WFH and in person (both within and between people), and limiting congestion relevant to space, plus good sanitizing, etc. These measures have increased everybody's comfort in the workplace. We will be possibly transitioning to lessen some of social distancing and other restrictions and move more towards fuller in person work in 2022, but this is dependent on community spread and community vaccination levels. We have very high morale mostly due to a very responsible employer. We are really a role model regarding how we handled this from the start of the pandemic.

Last edited by nk15; Sep 29, 2021 at 4:34 pm
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