Coronavirus

[Cyberyeti]

To be honest Ken, I am not with you on this. The stats are pretty clear that age is by far the biggest factor in covid mortality, significantly above any of the underlying conditions. So it seems absolutely correct to prioritise the elderly in any vaccine rollout. I would definitely place the over 80s in the first wave along with health workers.

 

This is an interesting one. If you're over 80 but live in near isolation, are you at more risk than say a teacher ? Clearly you're at more risk if you catch it, but you're much less likely to get it AND much less likely to pass it on. If you're in a care home situation, you have more contacts, so here it's old care home residents that are at the front of the queue with NHS workers. My dad and stepmum are in their 80s with preexisting conditions so are in the next group down.

[y66]

y66, on 2020-December-03, 16:53, said:NYT has a calculator that U.S. residents can use to determine their place in line for a covid vaccine.

 

 

 

I tried this. It says:

"If the line in Maryland was represented by about 100 people, this is where you'd be standing:"

It then gives a line and I am 25th

They need to rethink this, I am ahead of teachers. I am not trying for an award in being self-sacrificing. It's simple. I live in this country and we have a serious problem.

 

I understand that my being just shy of 82 means that the virus poses a major risk. But it is also much easier, and with much less consequence, for me than it is for some others to avoid or at least minimize contact.

I can wait a few months for the vaccine. We need to get kids back to school and their parents back to work. And it needs to be done with care.

I am looking forward to taking the vaccine, then I will be able to sit in Starbucks and chat with others who come by. But really, I can wait for a while longer while we deal with more important problems.

 

This is pretty obvious, is it not?

Oregon governor Kate Brown hears you. She announced on Tuesday that Oregon’s educators and school staff members will be prioritized in the next round of coronavirus vaccines. She hopes to get kids back in school in February.

 

One argument for prioritizing on age is that it's the fastest path to getting hospitalizations and deaths down which is the key to minimizing business restrictions. Another argument is that prioritizing on age is reasonable, straightforward and less subject to politics and gaming.

 

Source: CDC

[kenberg]

Oregon governor Kate Brown hears you. She announced on Tuesday that Oregon's educators and school staff members will be prioritized in the next round of coronavirus vaccines. She hopes to get kids back in school in February.

 

One argument for prioritizing on age is that it's the fastest path to getting hospitalizations and deaths down which is the key to minimizing business restrictions. Another argument is that prioritizing on age is reasonable, straightforward and less subject to politics and gaming.

 

Source: CDC

 

The numbers are dramatic. But care is needed. I'll be 82 on Jan 1. But that doesn't, by itself, define me. They need to break down the numbers some, such as 75-84 and living independently and 75-84 and living in a situation that requires frequent close contact with many others. I am in favor of high priority for those in nursing homes.

I'm no expert on this, I'm no expert on a lot of things, but one of my frequent complaints with data is that it is far too quick. Here are some numbers, that's that. It is seldom that simple.

 

Anyway, my plan is to take the vaccine as soon as it is offered to me, but if they wanted to put teachers ahead of me I would not cry foul.

 

 

[Winstonm]

The numbers are dramatic. But care is needed. I'll be 82 on Jan 1. But that doesn't, by itself, define me. They need to break down the numbers some, such as 75-84 and living independently and 75-84 and living in a situation that requires frequent close contact with many others. I am in favor of high priority for those in nursing homes.

I'm no expert on this, I'm no expert on a lot of things, but one of my frequent complaints with data is that it is far too quick. Here are some numbers, that's that. It is seldom that simple.

 

Anyway, my plan is to take the vaccine as soon as it is offered to me, but if they wanted to put teachers ahead of me I would not cry foul.

 

 

I'm kind of with you, Ken. I think the emphasis on morbidity is misguided. To stop the pandemic is to halt contagion. It seems reasonable to me then to first inoculate those who are at the highest risk of exposure to the virus. I admit it is difficult to overcome the bile of agreeing that those who refuse to wear masks or who think covid is fake should get vaccinated before me, but I'm thinking if that is the best way to halt the spread then let's do it.

[kenberg]

I'm kind of with you, Ken. I think the emphasis on morbidity is misguided. To stop the pandemic is to halt contagion. It seems reasonable to me then to first inoculate those who are at the highest risk of exposure to the virus. I admit it is difficult to overcome the bile of agreeing that those who refuse to wear masks or who think covid is fake should get vaccinated before me, but I'm thinking if that is the best way to halt the spread then let's do it.

 

I was thinking of teachers. And of others. I was not thinking abut the deniers. I have no idea what to do about them. You didn't mention those who don't want to take the vaccine. . That one is easy for me. You say "Ok, next in line step up". We don't yet have enough to go around so we should not waste time trying to convince those who prefer to not take it.

[hrothgar]

I expect to see a simple solution for folks who don't want to take the vaccine:

 

No vaccine, no insurance coverage for expenses related to COVID (and that goes for Medicaid / Medicare as well)

[johnu]

I expect to see a simple solution for folks who don't want to take the vaccine:

 

No vaccine, no insurance coverage for expenses related to COVID (and that goes for Medicaid / Medicare as well)

They can be covered by Red State Insurance Company, cheapest insurance you can get. Premiums are $0.00, but the only benefits that are paid out are emails and texts begging for donations sent by the Manchurian President.

[kenberg]

I expect to see a simple solution for folks who don't want to take the vaccine:

 

No vaccine, no insurance coverage for expenses related to COVID (and that goes for Medicaid / Medicare as well)

 

I understand and somewhat share the thinking behind this, but no, I don't recommend it. A more modest version would be to require that someone who refuses the vaccine and then needs treatment be first required to publicly announce that he now realizes he was an idiot.

 

For the time being, someone who refuses the vaccine simply makes the shot available to someone else and so we can just go along with that. As supplies become more available this could change.

 

And yes, I didn't take your suggestion literally, I figure it's an expression of frustration and, as noted, I share it.

 

There is perhaps a problem along these lines that warrants some thought. I have seen more than one article from a Black author about the distrust the Black community has for a vaccine when many/most of the advocates for it are White. There are historical reasons for this distrust as you, and everyone, know. What to do? I think the same idea of saying "Ok, I understand" and then going on to the next person is the right idea but with an additional feature or two. You provide information, and you explain the shot will still be available if the refuser should later change his mind. This seems like the best way to build some trust. Don't try a hard sell. Accept the person's concerns and accept his decision. But allow for a change of mind later. Actually we can forget race and use this same approach for all refusers.

 

As I have aged I have seen far more doctors than before. Probably 80% or more of all my medical interactions have been in the last ten years. It has become clear that absolute faith in doctors is very naive. I have always known this but these last ten years have made it very clear. So I understand caution. But here the decision is easy. Well, easy for me. I take the vaccine when it is offered. But we can accept that others will be more cautious.

[Winstonm]

I understand and somewhat share the thinking behind this, but no, I don't recommend it. A more modest version would be to require that someone who refuses the vaccine and then needs treatment be first required to publicly announce that he now realizes he was an idiot.

 

For the time being, someone who refuses the vaccine simply makes the shot available to someone else and so we can just go along with that. As supplies become more available this could change.

 

And yes, I didn't take your suggestion literally, I figure it's an expression of frustration and, as noted, I share it.

 

There is perhaps a problem along these lines that warrants some thought. I have seen more than one article from a Black author about the distrust the Black community has for a vaccine when many/most of the advocates for it are White. There are historical reasons for this distrust as you, and everyone, know. What to do? I think the same idea of saying "Ok, I understand" and then going on to the next person is the right idea but with an additional feature or two. You provide information, and you explain the shot will still be available if the refuser should later change his mind. This seems like the best way to build some trust. Don't try a hard sell. Accept the person's concerns and accept his decision. But allow for a change of mind later. Actually we can forget race and use this same approach for all refusers.

 

As I have aged I have seen far more doctors than before. Probably 80% or more of all my medical interactions have been in the last ten years. It has become clear that absolute faith in doctors is very naive. I have always known this but these last ten years have made it very clear. So I understand caution. But here the decision is easy. Well, easy for me. I take the vaccine when it is offered. But we can accept that others will be more cautious.

 

Something I tend to forget amidst the chaos is that news organizations like to report about combatants - remember Wolf Blitzer in Bagdad? The noise is being made by a minority of the population - but when the noise is reported incessantly it seems like more. I have to kick myself to remember there are more normal or at least semi-normal people in the U.S. than there are noisy nutcases.

 

Perhaps we should turn off those networks who continue to showcase crazy only.

 

 

[hrothgar]

I understand and somewhat share the thinking behind this, but no, I don't recommend it. A more modest version would be to require that someone who refuses the vaccine and then needs treatment be first required to publicly announce that he now realizes he was an idiot.

 

On of the problems that we face as a society is that we have a bunch of idiots out there who are shielded from the consequences of their actions.

 

The one that I am actually most upset about is when you have armed groups of citizens storming capital building in Oregon and Michigan. With all seriousness, I think that the country would be a lot better off if the local police fired some warning shots and, if the crowd didn't disperse started shooting to kill.

 

And, I am perfectly comfortable seeing a bunch of anti vaxxer's have their lives ruined.

 

Please note: I lost a couple close friends to COVID this week.

 

I expect that another is going to die in the next few days (he had a liver transplant a few years back, is on immuno suppressents and and the virus is devastating him)

 

He was forced to travel from Mexico to the US in late November to get his drugs re-filled and appears to have caught the bug while in an airport. He's gone to die because some idiots wanted to see their family.

[kenberg]

Friends and family have had it, pretty much anyone can say that, but so far no one close to me has died from it. I am sorry to hear about your loss. And sorry indeed that this applies to so many.

[Winstonm]

To be honest Ken, I am not with you on this. The stats are pretty clear that age is by far the biggest factor in covid mortality, significantly above any of the underlying conditions. So it seems absolutely correct to prioritise the elderly in any vaccine rollout. I would definitely place the over 80s in the first wave along with health workers.

 

Maybe the first wave. After that, it has been shown that most who have Covid infect only 1 or 2 others. But there is a smaller group of super-spreaders who infect 20-30 or more. The best way to safety for all is to eliminate the super-spreaders, and the best way to do that is to vaccinate those who have the most contact with others in indoor settings, whoever they might be.

[Winstonm]

On of the problems that we face as a society is that we have a bunch of idiots out there who are shielded from the consequences of their actions.

 

The one that I am actually most upset about is when you have armed groups of citizens storming capital building in Oregon and Michigan. With all seriousness, I think that the country would be a lot better off if the local police fired some warning shots and, if the crowd didn't disperse started shooting to kill.

 

And, I am perfectly comfortable seeing a bunch of anti vaxxer's have their lives ruined.

 

Please note: I lost a couple close friends to COVID this week.

 

I expect that another is going to die in the next few days (he had a liver transplant a few years back, is on immuno suppressents and and the virus is devastating him)

 

He was forced to travel from Mexico to the US in late November to get his drugs re-filled and appears to have caught the bug while in an airport. He's gone to die because some idiots wanted to see their family.

 

I am sorry you have to deal with so much death.

 

The problem I think is what you nailed it with your first sentence - which to my thinking spells immaturity. We used to called these kids spoiled - now these kids are in their 30s, 40s, and 50s. No longer kids but still with the mindset that they should not be responsible for others.

 

This is a cultural problem that will take decades to alter.

[barmar]

I expect to see a simple solution for folks who don't want to take the vaccine:

 

No vaccine, no insurance coverage for expenses related to COVID (and that goes for Medicaid / Medicare as well)

If we had such a policy, it should probably apply to all diseases that we regularly vaccinate for. If a parent objects to MMR vaccine for their child on religious grounds, and their child gets one of these diseass, they should have to pray to God for them to get better, they can't go to the doctor/hospital (hmm, isn't this actually what Christian Scientists do?).

 

I heard that since the vaccine distribution started, demand is actually higher than was anticipated from earlier polls, so we may not have as much of a problem getting most people vaccinated. It's easy to say no about a hypothetical vaccine to a pollster, when you don't know much about the efficacy and safety. Now that it's real, and you see people like Pence and Faucci (depending on who you trust) getting it, there's less apprehension.

[kenberg]

If we had such a policy, it should probably apply to all diseases that we regularly vaccinate for. If a parent objects to MMR vaccine for their child on religious grounds, and their child gets one of these diseass, they should have to pray to God for them to get better, they can't go to the doctor/hospital (hmm, isn't this actually what Christian Scientists do?).

 

I heard that since the vaccine distribution started, demand is actually higher than was anticipated from earlier polls, so we may not have as much of a problem getting most people vaccinated. It's easy to say no about a hypothetical vaccine to a pollster, when you don't know much about the efficacy and safety. Now that it's real, and you see people like Pence and Faucci (depending on who you trust) getting it, there's less apprehension.

 

Your second paragraph matches well with the way I see many polls. Often the true answer to what will I do is that I will watch and see. in fact it makes sense. Of course we want to be safe from the virus. So we wait until there is a vaccine and then we see who says what about it. in this pricular case yes, I have made up my mind barring some unexpected development. I take the vaccine when it is offered to me. But there are many many things where the only honest answer to a question about wht I will do is that I will think about it but have not yet done so.

[pilowsky]

Happy new year everyone. Let's hope that 2021 sees the back of all this madness.

 

If we triple the price of fuel so that no-one can afford to drive anywhere and use the money to pay for health education and welfare (and Bridge) will we simultaneously solve COVID, climate change and poverty?

[thepossum]

Happy new year everyone. Let's hope that 2021 sees the back of all this madness.

 

If we triple the price of fuel so that no-one can afford to drive anywhere and use the money to pay for health education and welfare (and Bridge) will we simultaneously solve COVID, climate change and poverty?

 

Its a classic elitist approach to trying to solve a problem, massively increasing the power and privilege of the wealthy elites. Sums up most approaches (recently) to the big problems you raise. I think if you want a fair approach everyone should look at their footrpint (more generically their contribution) to all those problems and reduce it accordingly

 

I actually have a thought on how to imporve poverty. Maybe look at some of the unnecessary studies being conducted all over the world under the guise of a pandemic and put them into more productive areas of the economy where people can actually work and earn and pay their bills rather than being grateful for lousy handouts

 

I know I risk disrepesct even daring to comment, but I do actually (like everyone) have a right and in my case also a responsibility to comment when I see problems in this world

 

But Happy New Year to everyone and I'm hoping the trend to global techno-fascism is not beyond the point of no return. But when I see so many people in the world, even those of a more political bent being so taken in by some propaganda I am very concerned

[pilowsky]

Its a classic elitist approach to trying to solve a problem, massively increasing the power and privilege of the wealthy elites. Sums up most approaches (recently) to the big problems you raise. I think if you want a fair approach everyone should look at their footrpint (more generically their contribution) to all those problems and reduce it accordingly

 

I actually have a thought on how to imporve poverty. Maybe look at some of the unnecessary studies being conducted all over the world under the guise of a pandemic and put them into more productive areas of the economy where people can actually work and earn and pay their bills rather than being grateful for lousy handouts

 

I know I risk disrepesct even daring to comment, but I do actually (like everyone) have a right and in my case also a responsibility to comment when I see problems in this world

 

But Happy New Year to everyone and I'm hoping the trend to global techno-fascism is not beyond the point of no return. But when I see so many people in the world, even those of a more political bent being so taken in by some propaganda I am very concerned

 

It was a joke, my friend. Let's hope 2021 is an improvement on last year :)

[cherdano]

In the other thread, I wished Sunetra Gupta, Carl Henaghan and Rishi Sunak a wonderful retirement in their special place in hell. I would like to apologize to Michael Yeadon for excluding him.

 

Why care about the opinions of such nutjobs as Yeadon? Because unfortunately they've been way too influential in the UK debate, garnering media appearances and influence among conservative backbenchers, making it politically harder for the UK government to respond appropriately and quickly.

[cherdano]

But to switch to a more pressing issue than places in hell, at the moment I feel as if I live in an alternate reality where the huge majority has not realised the consequences of "B 1.1.7 is 50%-70% more transmissible".

• There is now big and reliable data behind this claim. (E.g. you can compare the growth rate of the new strain with the previous variants in all English regions, and get a similar figure for each of them).
  
• This means that just to keep R at 1, we have to do measures that would have moved R to 0.6-0.66 for the old variant; I know of no Western country that has achieved this.
  
• The UK sequences a much bigger proportion of its positive cases than almost any other country - about 10%. One exception is Denmark, which has sequenced a similar proportion of its cases in December. They found that B 1.1.7 accounted for 0.2% of all cases in week 49, 0.5% in week 50, 0.9% in week 51, and 2.3% in week 52.
  At that pace, it'll take 6 weeks for the new strain to dominate in Denmark, and I am not sure there is any reason to believe that any country with a decent amount of travel from the UK is in a very different position.
  

 

E.g. I have seen calls to close schools in the UK for two more weeks after the break, and I just think "You really think schools will reopen as normal before Easter?"

 

It's now a race, we will reach herd immunity after all and the only question is what proportion of the needed 80% or thereabouts comes from vaccinations, and what from natural infections. And how many will die because there is no capacity to treat them. (See here for pictures of ambulances queuing in front of a London hospital. Now imagine numbers doubling once more, and then once more. And I'll stop there just to be kind.)

[hrothgar]

Here's what I find completely incomprensible

 

Here in the US, we apparently have a case where a pharmacist deliberately spoiled 500 doses of the vaccine

 

https://www.theguardian.com/world/2020/dec/31/wisconsin-health-worker-deliberately-spoiled-500-covid-vaccine-doses

 

The numb nut needs to get tried for some combination of terrorism or multiple counts of attempted murder

[Cyberyeti]

But to switch to a more pressing issue than places in hell, at the moment I feel as if I live in an alternate reality where the huge majority has not realised the consequences of "B 1.1.7 is 50%-70% more transmissible".

• There is now big and reliable data behind this claim. (E.g. you can compare the growth rate of the new strain with the previous variants in all English regions, and get a similar figure for each of them).
  
• This means that just to keep R at 1, we have to do measures that would have moved R to 0.6-0.66 for the old variant; I know of no Western country that has achieved this.
  
• The UK sequences a much bigger proportion of its positive cases than almost any other country - about 10%. One exception is Denmark, which has sequenced a similar proportion of its cases in December. They found that B 1.1.7 accounted for 0.2% of all cases in week 49, 0.5% in week 50, 0.9% in week 51, and 2.3% in week 52.
  At that pace, it'll take 6 weeks for the new strain to dominate in Denmark, and I am not sure there is any reason to believe that any country with a decent amount of travel from the UK is in a very different position.
  

 

E.g. I have seen calls to close schools in the UK for two more weeks after the break, and I just think "You really think schools will reopen as normal before Easter?"

 

It's now a race, we will reach herd immunity after all and the only question is what proportion of the needed 80% or thereabouts comes from vaccinations, and what from natural infections. And how many will die because there is no capacity to treat them. (See here for pictures of ambulances queuing in front of a London hospital. Now imagine numbers doubling once more, and then once more. And I'll stop there just to be kind.)

 

Good post, but one quibble. Reopening schools is a political decision at least as much as it's a healthcare decision. I don't think even if it's the right thing to do from a healthcare point of view, the schools will be allowed to stay closed till Easter. Our figures in Norwich (and Norfolk) have risen alarmingly over the last few weeks, more than 1/4 of all the deaths from the pandemic in my local hospital were in December (61 out of a little over 200).

 

Will be interesting to see how fast they can get the vaccinations out and whether they change the targeting a bit. It surely makes sense to get the people at most risk of getting infected and passing it on jabbed ahead of some people at slightly higher risk of serious damage if they catch it, but much lower risk of catching it. As it stands on the gov site 14M people have to be vaccinated before I get my jab as a 55 year old diabetic. I've been in personal T4 or equivalent since March (barring Christmas day, but that was done sensibly), my only risk is at the supermarket. I would much rather all teachers were done before me and possibly people like customer facing supermarket staff as well.

[shyams]

The sequencing/prioritising of population for a vaccine is never a simple solution. It will include political (fraught with risk of backlash) and economic factors. I think these are unwinnable decisions as far as the health authorities are concerned.

 

What is, however, controllable is the speed with which the vaccinations are administered to the eligible population. Here I'm afraid the Govt will insist on sticking to protocols and procedures. For example, a typical vaccine injection should take under 15 seconds to administer. Yet I suspect the NHS centres will take between 5 and 10 minutes per dose.

 

Recently I was told by my GP to take a (seasonal) flu jab and that the receptionist will call to arrange an appointment. During this call, the receptionist offered me a few time slots that were 10 minutes apart. I asked her whether it will really take 10 minutes to get my jab done and was told that sometimes there is a wait. The actual jab took under 5 seconds; the total time at the GP premises was approx. 12 minutes. And the next person to get a jab did not get called in for at least 4-5 minutes after I exited.

 

If the Govt. cannot expedite the administering of COVID jabs, we might easily see an unnecessary delay being introduced into the entire programme. The newly approved vaccine doesn't even need ultra-cold storage --- it should be so much easier to manage the logistics. The Health authorities should focus more on simplifying these logistical matters.

 

Edit: BBC link that describes the bureaucracy linked to vaccine administration :) As expected, the NHS senior management is all in favour of such important ( :) ) bureaucratic hurdles.

Edited January 2, 2021 by shyams

[cherdano]

Good post, but one quibble. Reopening schools is a political decision at least as much as it's a healthcare decision.

You know, you've made three posts in the year 2021, and in two of them you say you disagree with something I said, except I did not say it.

Of course reopening schools is a political decisions. But even a government that has to rely on nutty Brexit backbenchers won't reopen schools while cases are rising and ambulances are queueing in front of hospitals.

 

Yes schools will reopen before Easter, but not without major changes - either hybrid (e.g. cutting effective attendance in half), or with a thorough highly frequent testing system in place.

 

In the week before Christmas, ONS estimated that 3% of all secondary school children in England were PCR positive.

[Cyberyeti]

You know, you've made three posts in the year 2021, and in two of them you say you disagree with something I said, except I did not say it.

Of course reopening schools is a political decisions. But even a government that has to rely on nutty Brexit backbenchers won't reopen schools while cases are rising and ambulances are queueing in front of hospitals.

 

Yes schools will reopen before Easter, but not without major changes - either hybrid (e.g. cutting effective attendance in half), or with a thorough highly frequent testing system in place.

 

In the week before Christmas, ONS estimated that 3% of all secondary school children in England were PCR positive.

 

You have more belief in the government's handling than I have. I think they will get the schools open come hell or high water. It is sadly absolutely normal for ambulances to be queuing outside hospitals this time of year although it's going to be worse this year. I thought highly frequent testing in schools was already announced so that was a given, how thorough it will be is anybody's guess.