Coronavirus thread

[bhodges]

OK, folks, please continue discussion, bearing the following things in mind:

1. The pandemic is plagued (pun intended) by lots of misinformation, everywhere.
2. It is also plagued by lots of miscommunication, everywhere.
3. It is an extremely stressful issue for all of us. Many of us know people who are either very sick or have died.
4. The holiday season is also quite stressful for many, only adding to the mix.

Please consider these points, and remember, if you think a post is likely not appropriate -- you're probably right. Thank you.

--Bruce

[Karl Henning]

Yes, I have been lucky to have that option, even if sometimes unpopular. But I think we ourselves have the obligation in the health sector to observe the advices we give the patients.

That can be a challenge for the care-givers, indeed.

[Mandryka]

More good news about omicron, this time from Edinburgh University

These early national data suggest that Omicron is associated with a two-thirds reduction in the risk of COVID-19 hospitalisation when compared to Delta.

https://www.pure.ed.ac.uk/ws/portalfiles/portal/245818096/Severity_of_Omicron_variant_of_concern_and_vaccine_effectiveness_against_symptomatic_disease.pdf

[Karl Henning]

No surprise: Driven by omicron, U.S. cases surpass summer delta peak

[Karl Henning]

It's just our unvaccinated neighbors' way of wishing us all a very merry Christmas—

In highly vaccinated New England, hospitals are under unprecedented strain as coronavirus surges

By Joanna Slater
Today at 8:00 a.m. EST

On a recent morning, Neil Meehan opened a spreadsheet he has come to dread.

It showed the number of intensive-care beds available in an area of New Hampshire that is home to 350,000 people: two.

A day earlier, there was just one. Very often there are none.

Meehan, the chief physician executive at Exeter Hospital, has worked in emergency medicine for nearly three decades. He has lost track of the number of unprecedented things he has witnessed during this second pandemic winter as virus cases and hospitalizations in the state hit record highs.

His hospital has canceled elective surgeries and placed adult patients in pediatric wards. There are members of the National Guard carrying out support tasks. One seriously ill patient had to wait a week for a transfer to a larger hospital that could treat his condition, a move that normally would have taken hours.

"You have duress in the system that I have never seen before," said Meehan, 56.

Across New England and the northeastern United States, hospitals are struggling with an overwhelming burden of patients amid a covid-19 surge that has struck harder and faster than experts expected, even in some of the most highly vaccinated states in the country.

The infections — nearly all driven by the delta variant, not its new cousin omicron — have led to record covid hospitalizations in Vermont, New Hampshire and Maine. All three states have experienced their biggest surges in cases since the pandemic began and asked for federal help, another first. President Biden announced Tuesday that the government will send emergency medical teams to Vermont and New Hampshire and ambulance crews to Maine.

In Massachusetts, Rhode Island and Connecticut, covid hospitalizations have soared in recent weeks, although they remain below previous peaks. Yet the winter surge comes at a time when hospitals were already grappling with a staffing shortage combined with an influx of people who had delayed care and an increase in patients battling mental illness. Doctors fear that a large wave of omicron cases could increase the burden even further.

"It's definitely as bad as it's ever been," said Eric Dickson, chief executive of UMass Memorial Health in Worcester. "I can use a New England analogy. Snowstorms, right? You get a bad snowstorm and oh, you deal with it. But you get one on top of that, and now you've got all that snow from before that you have to manage. And that's really what it's feeling like now — it's just piling up."

Interviews with 10 hospital leaders across the region revealed a grave picture. Executives at smaller and midsized hospitals said that it has become exceedingly difficult to secure care at higher-level facilities in the region and they worry that delays in transferring patients could have life-threatening consequences. Several said they were discussing whether they might need to implement standards for rationing care.

In Rhode Island, the president of an association of emergency doctors warned in a letter to the governor last week that the situation had become "acutely untenable" and "any added strain right now will lead to the collapse of the healthcare system."

The emergence of the omicron variant represents a major unknown. The variant is already present across New England and doctors said they expected it to become the dominant strain shortly. They oscillated between optimism that the variant appears to cause milder illness and pessimism that the sheer number of infections could overwhelm hospitals.

Doctors in the region all said that a substantial majority of the patients currently hospitalized with covid — between 60 percent and 80 percent — were unvaccinated. The breakthrough cases that end up in the hospital tend to be milder and are concentrated among older patients and people with other health conditions, they said.

Most state leaders in New England have been reluctant to reimpose mask mandates, but several have announced plans to distribute millions of free tests. On Tuesday, Massachusetts Gov. Charlie Baker (R) said he was activating up to 500 members of the National Guard to assist stretched hospitals.

The recent experience of states in New England is especially dispiriting given their vaccination rates. In Vermont, long lauded for its handling of the pandemic, 77 percent of the population is fully vaccinated, compared with nearly 62 percent nationwide. In Maine, the same figure is 75 percent. In Massachusetts, it's 74 percent.

This fall, as colder weather pushed people indoors and children returned to school, transmission began to accelerate. In places such as Vermont, New Hampshire and Maine, which were relatively unscathed by previous surges, there was also a lower level of prior exposure to the virus. Meanwhile, vaccine-induced immunity was waning in those who had flocked to get their shots early in 2021.

Matthew Fox, an epidemiologist at Boston University, emphasized that vaccines are "still very effective" at preventing serious illness and death. But when it comes to vaccines preventing infections, "we thought it would be a greater benefit than we're observing."

Fox said that difference could be due to waning immunity, or to the delta variant itself, which emerged after vaccines were developed. "If you put it all together, it's just more transmission than we would have liked," he said. The highly contagious omicron variant, meanwhile, can spread among people who are fully vaccinated and boosted.

The high vaccination rates in places such as Vermont and Maine masked considerable variations at the county level, experts said. "People say, 'Oh, Maine's doing really well,' but when you peel the onion layers, what you see is two states," said Dora Anne Mills, chief health improvement officer at MaineHealth. While 83 percent of the population in Cumberland county — home to the city of Portland — is fully vaccinated, that same figure slides to below or near 60 percent in several predominantly rural counties.

Mills said her group of hospitals had scrambled to find more space — canceling elective surgeries, treating patients in recovery rooms for the first time — but she was anxious about the coming weeks because "we could very well be finding out what the limit of that capacity is."

Nirav Shah, director of the Maine Center for Disease Control and Prevention, echoed that sentiment. "It is not out of the realm of possibility that we will approach a time where ICU beds will not be available," Shah recently told the Portland Press Herald. "Not just for covid patients but for any patient." He said the state is making plans to avoid that situation, which he likened to a "big pileup on the highway."

In neighboring New Hampshire, where vaccination rates are lower, hospitals have been flooded with covid patients. Jocelyn Caple is chief medical officer of Valley Regional Hospital, a 21-bed facility in Claremont. She said that 50 percent or more of her beds on any given day are now taken up by patients with covid. Her greatest concern is finding spots for critically ill patients of all kinds at higher-level hospitals. "The sense that the entire system is frozen with an inability to transfer patients around is the most worrisome aspect," Caple said.

In New Hampshire, Maine and Vermont, covid hospitalizations have touched their highest point in the pandemic in December. For New Hampshire, they peaked at 478 according to state figures. In Vermont, they hit 94. That figure may not sound large to other parts of the country, said Trey Dobson, chief medical officer at Southwestern Vermont Medical Center. But in a low-population state like Vermont — home to just 600,000 people in total — it is considerable, he said.

"What we have going right now is what I would call a triple whammy," Dobson said. There is an influx of patients coming into hospitals, both with covid and other ailments; hospitals are having difficulty discharging patients to rehabilitation facilities and nursing homes, which are also strapped for staff; and hospitals can't find beds for patients at larger, more specialized facilities.

Dobson said his hospital has called as far away as Philadelphia to find appropriate beds, and there have been days "where we've made 20 calls and not found someone who could take a patient."

In Massachusetts, the number of patients hospitalized with covid has swelled over the past month, to more than 1,600 as of Monday, compared with 700 a month earlier. Hospitals are struggling to cope with the added burden. Ron Walls, chief operating officer of Mass General Brigham, the state's largest hospital system, said that starting in the late summer, hospitals saw patients returning "in absolutely unprecedented numbers" as the pandemic appeared to recede. The surge in covid cases is "stressing an already stressed system," Walls said.

Mark Keroack, the chief executive of Baystate Health, the main hospital system in the western part of Massachusetts, said his facilities are licensed to treat 998 patients at a time. During the past month, however, the number of patients admitted jumped to as high as 1,200. The hospitals are now 10 percentage points over capacity on a regular basis — something he has never seen before.

Baystate is the only health-care provider in its part of the state that offers the highest level of trauma services. "By God, if we get jammed up to the point where we can't take any more, it's serious," said Keroack. "Where can people go? All the big systems in Massachusetts are fighting the same battle we are." Keroack said that one patient elsewhere in the state who required an advanced life support treatment — pumping and oxygenating a patient's blood outside the body — had been transferred from Massachusetts to Virginia this month.

Meanwhile, Keroack's hospital has begun reviewing its policies on how to ration medical care in an ethical way, also known as crisis standards of care, should that become necessary. "I'm sitting here, staring at the barrel of this gun," he said, referring to the rationing policy. He worries that his hospital might "actually be putting it into use before January is out."

Under such standards, doctors make decisions about how to prioritize resources, including whether to treat someone based on age and severity of illness. No one wants to take that step, said Dickson, the hospital executive in Worcester. But "effectively that's what happens when you run out of space," he said.

His hospital has stopped taking patient transfers except for the most serious trauma cases — people suffering from strokes, heart attacks and brain hemorrhages — and it's become "really hard even to take those," said Dickson. That leaves smaller community hospitals trying to care for patients with other potentially life-threatening surgical emergencies, he said.

Doctors say they feel like they're shouting into a void, delivering news that a pandemic-weary population no longer wants to hear. "You come into work and say, 'This is the worst it's ever been,' " said Dickson. "And then you come in the next day and it's even worse."

[Karl Henning]

It's just our unvaccinated neighbors' way of wishing us all a very merry Christmas—

In highly vaccinated New England, hospitals are under unprecedented strain as coronavirus surges

By Joanna Slater
Today at 8:00 a.m. EST

On a recent morning, Neil Meehan opened a spreadsheet he has come to dread.

It showed the number of intensive-care beds available in an area of New Hampshire that is home to 350,000 people: two.

A day earlier, there was just one. Very often there are none.

Meehan, the chief physician executive at Exeter Hospital, has worked in emergency medicine for nearly three decades. He has lost track of the number of unprecedented things he has witnessed during this second pandemic winter as virus cases and hospitalizations in the state hit record highs.

His hospital has canceled elective surgeries and placed adult patients in pediatric wards. There are members of the National Guard carrying out support tasks. One seriously ill patient had to wait a week for a transfer to a larger hospital that could treat his condition, a move that normally would have taken hours.

"You have duress in the system that I have never seen before," said Meehan, 56.

Across New England and the northeastern United States, hospitals are struggling with an overwhelming burden of patients amid a covid-19 surge that has struck harder and faster than experts expected, even in some of the most highly vaccinated states in the country.

The infections — nearly all driven by the delta variant, not its new cousin omicron — have led to record covid hospitalizations in Vermont, New Hampshire and Maine. All three states have experienced their biggest surges in cases since the pandemic began and asked for federal help, another first. President Biden announced Tuesday that the government will send emergency medical teams to Vermont and New Hampshire and ambulance crews to Maine.

In Massachusetts, Rhode Island and Connecticut, covid hospitalizations have soared in recent weeks, although they remain below previous peaks. Yet the winter surge comes at a time when hospitals were already grappling with a staffing shortage combined with an influx of people who had delayed care and an increase in patients battling mental illness. Doctors fear that a large wave of omicron cases could increase the burden even further.

"It's definitely as bad as it's ever been," said Eric Dickson, chief executive of UMass Memorial Health in Worcester. "I can use a New England analogy. Snowstorms, right? You get a bad snowstorm and oh, you deal with it. But you get one on top of that, and now you've got all that snow from before that you have to manage. And that's really what it's feeling like now — it's just piling up."

Interviews with 10 hospital leaders across the region revealed a grave picture. Executives at smaller and midsized hospitals said that it has become exceedingly difficult to secure care at higher-level facilities in the region and they worry that delays in transferring patients could have life-threatening consequences. Several said they were discussing whether they might need to implement standards for rationing care.

In Rhode Island, the president of an association of emergency doctors warned in a letter to the governor last week that the situation had become "acutely untenable" and "any added strain right now will lead to the collapse of the healthcare system."

The emergence of the omicron variant represents a major unknown. The variant is already present across New England and doctors said they expected it to become the dominant strain shortly. They oscillated between optimism that the variant appears to cause milder illness and pessimism that the sheer number of infections could overwhelm hospitals.

Doctors in the region all said that a substantial majority of the patients currently hospitalized with covid — between 60 percent and 80 percent — were unvaccinated. The breakthrough cases that end up in the hospital tend to be milder and are concentrated among older patients and people with other health conditions, they said.

Most state leaders in New England have been reluctant to reimpose mask mandates, but several have announced plans to distribute millions of free tests. On Tuesday, Massachusetts Gov. Charlie Baker (R) said he was activating up to 500 members of the National Guard to assist stretched hospitals.

The recent experience of states in New England is especially dispiriting given their vaccination rates. In Vermont, long lauded for its handling of the pandemic, 77 percent of the population is fully vaccinated, compared with nearly 62 percent nationwide. In Maine, the same figure is 75 percent. In Massachusetts, it's 74 percent.

This fall, as colder weather pushed people indoors and children returned to school, transmission began to accelerate. In places such as Vermont, New Hampshire and Maine, which were relatively unscathed by previous surges, there was also a lower level of prior exposure to the virus. Meanwhile, vaccine-induced immunity was waning in those who had flocked to get their shots early in 2021.

Matthew Fox, an epidemiologist at Boston University, emphasized that vaccines are "still very effective" at preventing serious illness and death. But when it comes to vaccines preventing infections, "we thought it would be a greater benefit than we're observing."

Fox said that difference could be due to waning immunity, or to the delta variant itself, which emerged after vaccines were developed. "If you put it all together, it's just more transmission than we would have liked," he said. The highly contagious omicron variant, meanwhile, can spread among people who are fully vaccinated and boosted.

The high vaccination rates in places such as Vermont and Maine masked considerable variations at the county level, experts said. "People say, 'Oh, Maine's doing really well,' but when you peel the onion layers, what you see is two states," said Dora Anne Mills, chief health improvement officer at MaineHealth. While 83 percent of the population in Cumberland county — home to the city of Portland — is fully vaccinated, that same figure slides to below or near 60 percent in several predominantly rural counties.

Mills said her group of hospitals had scrambled to find more space — canceling elective surgeries, treating patients in recovery rooms for the first time — but she was anxious about the coming weeks because "we could very well be finding out what the limit of that capacity is."

Nirav Shah, director of the Maine Center for Disease Control and Prevention, echoed that sentiment. "It is not out of the realm of possibility that we will approach a time where ICU beds will not be available," Shah recently told the Portland Press Herald. "Not just for covid patients but for any patient." He said the state is making plans to avoid that situation, which he likened to a "big pileup on the highway."

In neighboring New Hampshire, where vaccination rates are lower, hospitals have been flooded with covid patients. Jocelyn Caple is chief medical officer of Valley Regional Hospital, a 21-bed facility in Claremont. She said that 50 percent or more of her beds on any given day are now taken up by patients with covid. Her greatest concern is finding spots for critically ill patients of all kinds at higher-level hospitals. "The sense that the entire system is frozen with an inability to transfer patients around is the most worrisome aspect," Caple said.

In New Hampshire, Maine and Vermont, covid hospitalizations have touched their highest point in the pandemic in December. For New Hampshire, they peaked at 478 according to state figures. In Vermont, they hit 94. That figure may not sound large to other parts of the country, said Trey Dobson, chief medical officer at Southwestern Vermont Medical Center. But in a low-population state like Vermont — home to just 600,000 people in total — it is considerable, he said.

"What we have going right now is what I would call a triple whammy," Dobson said. There is an influx of patients coming into hospitals, both with covid and other ailments; hospitals are having difficulty discharging patients to rehabilitation facilities and nursing homes, which are also strapped for staff; and hospitals can't find beds for patients at larger, more specialized facilities.

Dobson said his hospital has called as far away as Philadelphia to find appropriate beds, and there have been days "where we've made 20 calls and not found someone who could take a patient."

In Massachusetts, the number of patients hospitalized with covid has swelled over the past month, to more than 1,600 as of Monday, compared with 700 a month earlier. Hospitals are struggling to cope with the added burden. Ron Walls, chief operating officer of Mass General Brigham, the state's largest hospital system, said that starting in the late summer, hospitals saw patients returning "in absolutely unprecedented numbers" as the pandemic appeared to recede. The surge in covid cases is "stressing an already stressed system," Walls said.

Mark Keroack, the chief executive of Baystate Health, the main hospital system in the western part of Massachusetts, said his facilities are licensed to treat 998 patients at a time. During the past month, however, the number of patients admitted jumped to as high as 1,200. The hospitals are now 10 percentage points over capacity on a regular basis — something he has never seen before.

Baystate is the only health-care provider in its part of the state that offers the highest level of trauma services. "By God, if we get jammed up to the point where we can't take any more, it's serious," said Keroack. "Where can people go? All the big systems in Massachusetts are fighting the same battle we are." Keroack said that one patient elsewhere in the state who required an advanced life support treatment — pumping and oxygenating a patient's blood outside the body — had been transferred from Massachusetts to Virginia this month.

Meanwhile, Keroack's hospital has begun reviewing its policies on how to ration medical care in an ethical way, also known as crisis standards of care, should that become necessary. "I'm sitting here, staring at the barrel of this gun," he said, referring to the rationing policy. He worries that his hospital might "actually be putting it into use before January is out."

Under such standards, doctors make decisions about how to prioritize resources, including whether to treat someone based on age and severity of illness. No one wants to take that step, said Dickson, the hospital executive in Worcester. But "effectively that's what happens when you run out of space," he said.

His hospital has stopped taking patient transfers except for the most serious trauma cases — people suffering from strokes, heart attacks and brain hemorrhages — and it's become "really hard even to take those," said Dickson. That leaves smaller community hospitals trying to care for patients with other potentially life-threatening surgical emergencies, he said.

Doctors say they feel like they're shouting into a void, delivering news that a pandemic-weary population no longer wants to hear. "You come into work and say, 'This is the worst it's ever been,' " said Dickson. "And then you come in the next day and it's even worse."

I'll go ahead and say it: if it's that bad in New England, what are Florida and Texas going to be like?

[Karl Henning]

Helaine Olen: Covid or no covid, hefty deductibles will continue to discourage individuals from seeking care when ill. And that's the case among many who have insurance. Others have less help. Nearly a quarter of private industry workers in the United States lack paid sick leave, and many workers who have contracted covid have been denied the paid sick leave that was mandated in one of the early coronavirus protection packages. Some employers insist that workers report in until a diagnosis is confirmed — something that can take days, putting other employees at risk.

[fbjim]

There's something much more interesting than that going on. Somehow, I don't understand how exactly, the left have adopted a rigid authoritarian stance in this pandemic, they talk down or even ignore the costs of NPIs and stress the benefits, maybe to the point of exaggerating the benefits. So people's positions have become all mixed up with where they see themselves on the political spectrum.


There's another thing too.  Some people are scared and they want to see actions like vaccine mandates in the face of what they see as a personal threat, because, rightly or wrongly, the feel they would be safer.

In all honesty, I have effectively seen the opposite, where some left wingers have effectively become libertarians in the face of both this, and with climate change. An effective denial of the concept of societal responsibility, and a belief that any safety regulations are a conspiracy of the elites against the honest worker are straight out of the libertarian playbook.


It is far more disturbing for me to see this with climate change debates, but that is beyond the scope of this thread. Suffice it to say that many have taken a hard line stance that nothing should affect the convenience or lifestyles of the average middle class Westerner.

[Karl Henning]

The statement, signed by top officials from nine Massachusetts hospitals and health systems ...

Oh, yeah? Well, what do they know?

'We have the tools to turn the tide': While COVID cases soar in Massachusetts, new Omicron data offers promise

By Nick Stoico and Danny McDonald Globe Correspondent and Globe Staff, Updated December 22, 2021, 9:13 p.m.

On a day when Massachusetts reported a single-day record for new COVID-19 cases, two teams of British researchers offered a glimmer of hope that the fast-moving Omicron variant may cause less severe illness than earlier variants, and US regulators authorized the first pill to treat the coronavirus.

Also on Wednesday, researchers in South Africa reported that cases there dropped by 20 percent in the past week, suggesting the country's Omicron-fueled surge of infections may have peaked after about a month.

Still, federal, state, and local officials continue to urge caution ahead of Christmas and are pleading with unvaccinated individuals to get their shots and vaccinated people to get a booster.

While Omicron may lead to less severe symptoms, doctors in Massachusetts say the current surge has pushed health systems to a "crisis point" and hospitals are "nearing full capacity."

"The good news is that we have the tools to turn the tide, but it will take a team effort. It will take a renewed sense of diligence and responsibility from everyone who calls Massachusetts home," the Massachusetts Health & Hospital Association said in a statement Wednesday.

The statement, signed by top officials from nine Massachusetts hospitals and health systems, outlined five crucial steps residents must take to ease the strain on hospitals, including getting vaccinated for both COVID-19 and the flu, plus receiving a COVID-19 booster shot when eligible, wearing a mask in public at all times, and testing for COVID-19 after exposure or developing symptoms.

It remains unclear how long this surge will last. The United States has seen cases rise by about 23 percent in the past 14 days, according to the Centers for Disease Control and Prevention. Omicron, which early data show to be two to three times more transmissible than the Delta variant, now accounts for more than 70 percent of US infections.

Massachusetts on Wednesday reported 7,817 new confirmed COVID cases — up from 5,133 new cases a week earlier — and 33 new deaths.

The state also reported 56,716 vaccinations, including booster shots, had been administered, the Department of Public Health said. The state also reported that 1,621 patients with COVID-19 were in the hospital. On Wednesday, the seven-day positivity was 7.02 percent.

The state's report came a day after Governor Charlie Baker stopped short of requiring residents to wear masks and instead issued an advisory for people to wear face coverings in public spaces. Baker also announced that he's activated the National Guard to assist overwhelmed hospitals.

On Wednesday, Baker defended his decision to issue the advisory rather than a hard mandate requiring masks. He cited the state's high vaccination numbers as part of his reasoning.

"Now that we have 5 million people in Massachusetts who are vaccinated and almost 2 million people who are boosted, and we have rapid tests, [we should] recognize and understand that our strategy at this point is sort of layered and multidimensional," Baker told GBH during his regular appearance on Boston Public Radio.

State and federal leaders, including Senate President Karen Spilka and US Representative Ayanna Pressley and Senator Edward J. Markey, have called for reimposing a mask mandate.

The absence of a statewide mandate has left local communities scrambling to craft their own rules. Mask mandates so far have been enacted in Boston, Medford, and Watertown.

The five-member Salem Board of Health voted unanimously Wednesday to adopt a mask mandate at least until March, and a vaccine requirement for public spaces and most businesses starting Jan. 15.

"To me it'd be irresponsible to not do something," said Dr. Jeremy Schiller, the board chair, during an emergency meeting held via Zoom. "The things we know work in lieu of shutting down businesses is vaccines and masks. They work."

Boston Mayor Michelle Wu's office on Wednesday said the city, which is averaging 369 new cases per day, has seen an 89 percent increase in positive cases compared to two weeks ago.

Earlier this week, Wu announced a new vaccine mandate for city workers, while eliminating the option to show a weekly negative COVID test in lieu of a vaccine. Wu's mandate also sets a requirement for people to show proof of vaccination for some indoor spaces, including restaurants, gyms, and entertainment centers.

In a radio appearance Wednesday on GBH, Wu said the mandate is necessary to keep patrons at ease and prevent businesses from being forced to shut down as cases continue to climb.

"It's something meant to keep our businesses open," she said.

Wu said she has received racist messages in the wake of the announcement and noted that many come from beyond the borders of the city and state.

"Every time I open my phone, it's another dozen hateful messages, again from folks outside the city and all across the country who feel enraged at Boston taking a leadership role here," Wu said during the interview on GBH's Greater Boston. [emphasis mine—kh]

Wu, the daughter of Taiwanese immigrants, who last month became the first woman and first person of color elected to the mayor's office in Boston's history, said such opposition represented that there is "a clear message that there is still a part of our society, even in this state, even in this city, that really feels like something is being taken away from them . . . that is based in misinformation, it's based in, I think at some level, hatred, and fear, and confusion."

Dr. Anthony Fauci, the nation's top infectious disease expert, reaffirmed his concern for unvaccinated people, who he said are "very vulnerable" to becoming infected, during an interview on MSNBC on Tuesday.

"That's why I worry about the people who refuse to get vaccinated. When you're dealing with any SARS-CoV-2 or COVID-19 virus, it's a problem," he said. "When you're dealing with one that spreads so rapidly and you are unvaccinated, the virus is going to find you."


In the mix of positive and grim news surrounding the coronavirus this week, the FDA on Wednesday authorized Pfizer's new drug, Paxlovid, the nation's first pill against COVID-19, which individuals will be able to take at home. Though supply for the drug is expected to be limited initially, it may provide an affordable and fast option for treating early COVID-19 infections.

The drug is reportedly highly effective with a nearly 90 percent reduction in hospitalizations and death among patients most likely to suffer severe symptoms.

"The efficacy is high, the side effects are low, and it's oral. It checks all the boxes," Dr. Gregory Poland of the Mayo Clinic told the Associated Press. "You're looking at a 90 percent decreased risk of hospitalization and death in a high-risk group — that's stunning."

Still, the new studies released Wednesday in Britain seem to bolster earlier research that suggests Omicron may not be as harmful as the Delta variant, said Manuel Ascano Jr., a Vanderbilt University biochemist who studies viruses.

"Cautious optimism is perhaps the best way to look at this," he said.

An analysis from the Imperial College London COVID-19 response team estimated hospitalization risks for Omicron cases in England, finding people infected with the variant are around 20 percent less likely to go to the hospital at all than those infected with the Delta variant, and 40 percent less likely to be hospitalized for a night or more.

That analysis included all cases of COVID-19 confirmed by PCR tests in England in the first half of December in which the variant could be identified: 56,000 cases of Omicron and 269,000 cases of Delta.

A separate study out of Scotland, by scientists at the University of Edinburgh and other experts, suggested the risk of hospitalization was two-thirds less with Omicron than Delta.

So, Fauci says the unvaccinated are vulnerable? Who believes him, anyway?

[fbjim]

The opinion pieces out of the "mainstream" center-liberal outlets such as the Atlantic and Politico are very much trending in the direction of a lack of appetite for further measures as we saw in the initial waves, beyond light measures such as indoor dining restrictions, et al. Those publications are generally a good way to see where the wind is blowing- and I think most, including the administration, see it shifting more towards a vaccination-testing-based strategy as there is little appetite for total shutdowns of any industry anymore.

[Karl Henning]

There's another thing too.  Some people are scared and they want to see actions like vaccine mandates in the face of what they see as a personal threat, because, rightly or wrongly, the feel they would be safer.


Your errors include the imputation of personal fear as the necessary driver and your reducing a worldwide public health crisis to a personal threat. Don't feel bad, Andrei makes these errors all the time.

[Karl Henning]

The opinion pieces out of the "mainstream" center-liberal outlets such as the Atlantic and Politico are very much trending in the direction of a lack of appetite for further measures as we saw in the initial waves, beyond light measures such as indoor dining restrictions, et al. Those publications are generally a good way to see where the wind is blowing- and I think most, including the administration, see it shifting more towards a vaccination-testing-based strategy as there is little appetite for total shutdowns of any industry anymore.

Indeed. I do not see a renewed lockdown in Mass.

[Mandryka]

There's another thing too.  Some people are scared and they want to see actions like vaccine mandates in the face of what they see as a personal threat, because, rightly or wrongly, the feel they would be safer.


Your errors include the imputation of personal fear as the necessary driver and your reducing a worldwide public health crisis to a personal threat. Don't feel bad, Andrei makes these errors all the time.

This is a Trump style argument. Did I say "necessary driver"? If so, where?

[Mandryka]

In all honesty, I have effectively seen the opposite, where some left wingers have effectively become libertarians in the face of both this, and with climate change. An effective denial of the concept of societal responsibility, and a belief that any safety regulations are a conspiracy of the elites against the honest worker are straight out of the libertarian playbook.


It is far more disturbing for me to see this with climate change debates, but that is beyond the scope of this thread. Suffice it to say that many have taken a hard line stance that nothing should affect the convenience or lifestyles of the average middle class Westerner.

That's interesting. Just focussing on health, what I haven't come across  is the denial of social responsibility from the left. Maybe you could give me an example online.

[Karl Henning]

Speculative, but interesting

Booster shots crushed Israel's delta wave. It's betting a fourth dose will do the same to omicron.

By Shira Rubin
Today at 7:17 a.m. EST

TEL AVIV — Israel's decision this week to become the first country to recommend a fourth vaccine dose to combat the highly contagious omicron variant came after health officials concluded that an initial booster had turned the tide this fall against the delta variant.

While they acknowledged that their decision was not based on new scientific data about the omicron variant, officials said they thought it would be prudent to recommend an additional shot because they believe that the ability of the initial booster to prevent infection has been waning over time.

The decision, announced by Israeli officials Tuesday, will make a fourth dose — or second booster — of the Pfizer-BioNTech vaccine available to people over 60, those with compromised immune systems and employees in the health-care sector. All eligible recipients would need to have had their third dose more than four months prior.

The decision is still awaiting confirmation by Health Ministry Director Nachman Ash before becoming national policy. But facilities across the country are preparing to begin administering the vaccine, with many saying they are ready to start as early as Sunday.

Israel's national coronavirus advisory committee made its recommendation for the fourth dose Tuesday while still gathering data on the omicron variant, saying it does not have the luxury of time. Omicron is believed to be three times more transmissible than previous variants, and while it may be milder — it has not caused massive increases in hospitalizations in the United Kingdom, and infections have plummeted after a surge in South Africa — many Israeli health officials warn that an increase in even moderate cases could overwhelm the country's hospitals.

According to Health Ministry data, 1,400 people tested positive for the coronavirus on Wednesday, 45 percent of of whom were fully vaccinated. In Israel, that means they were at least 12 years old and had received a booster shot at least one week prior, or were within six months of having received a second vaccination shot.

"It's a risk-management issue," said Arnon Afek, deputy director of Sheba Medical Center in central Israel, who is a member of the policy section of the national coronavirus advisory committee.

"The committee looked at the incredibly fast spread of omicron, in the U.K. and other countries, and decided that we do not have the time. They decided that we should work in parallel: First give the recommendation to immunize, and then run the studies," he said.

When Israel last summer launched a campaign for booster shots in response to the delta variant, it based the decision on studies from Israel and abroad showing that vaccine efficacy significantly waned in at-risk people at least five months after they received the second dose.

Experts mostly agree that the boosters — first offered to people over 60 and vulnerable groups in July, then to most of the general population in August — helped crush the delta wave in Israel, allowing the economy and schools to remain open. They credited the vaccine — more than social distancing enforcement, closing the borders or other measures that helped only to delay infection — with making the strategy successful.

In the weeks that followed, Clalit, Israel's largest health provider, found that a third shot of the Pfizer-BioNTech vaccine was 92 percent effective in preventing serious illness and 93 percent effective in preventing hospitalization, compared with decreased protection from only two doses, according to a large-scale study published in the Lancet medical journal in October.

Yasmin Maor, director of the infectious-disease unit at Wolfson Hospital and a member of the advisory committee, said in a news conference Wednesday night that it was "unfortunate" that the booster seems to provide insufficient protection against omicron during Israel's "fifth wave."

"We would have been happy to have a perfect product, but we have to note how many lives were saved because we administered a third vaccine dose," she said.

"When the booster was new, there was little spread of infection. The farther we move away from it, we are seeing double the rate of infection," Boaz Lev, who heads the advisory committee, told reporters. "The price will be higher if we don't vaccinate."

Israel has confirmed at least 341 omicron cases, most of which were traced to travelers who returned to Israel from abroad.

On Monday, Israel added 10 countries, including the United States and Canada, to its "red list" of banned destinations, which also include several European countries and almost all of Africa. The entry of noncitizens has been banned since last month.

Amnon Lahad, chairman of family medicine at Hebrew University, said Israel's fourth-dose campaign was based on "panic," rather than science.

Instead of going forward with the next round of vaccines, he said, Israel should dedicate resources to inoculating the country's estimated 1 million unvaccinated people, many of whom are members of the country's underserved populations and lack easy access to a vaccination facility. [emphasis mine—kh]

Out of a population of 9.3 million, 6.4 million have received their first shot, 5.8 million their second and 4.1 million their third, according to the Health Ministry.

The towns with the lowest rates are ultra-Orthodox, Arab and lower-income communities.

Israel has recorded more than 8,200 coronavirus-related deaths. It has not confirmed any deaths from the omicron variant.

On Wednesday, the Health Ministry said that a 65-year-old man who died the day before had contracted the delta variant, not omicron as originally reported.

Lahad criticized Israel's policy of classifying documentation from cabinet meetings and other government discussions about coronavirus policy, saying that the "secrecy" was contributing to vaccine hesitancy across the country.

"Israel is behaving like it's in a war," he said.

[fbjim]

That's interesting. Just focussing on health, what I haven't come across  is the denial of social responsibility from the left. Maybe you could give me an example online.

What I see is a mutation of the idea of structural problems and oppression where a) individuals are powerless in the face of structural problems, and b) since the problems are structural and individuals are powerless, it is useless to coerce any individual to do anything at all when the real problem is a conspiracy of the Elites.

I first noticed this in climate change when I saw more and more people take the line that frankly common-sense measures to reduce energy use are portrayed as useless when you hear the common refrain that x companies do y percent of emissions- the implication being that no person should have to do anything or have any change in their middle-class lifestyles and that things like fuel taxes are an elite conspiracy to reduce the quality-of-life of the average person.

Unfortunately, the idea that no person should endure even the slightest inconvenience for the benefit of society at large is foundational to how society actually functions. If nobody is willing to make the slightest sacrifice, you don't have a society, you have a group of individuals- which is the modern libertarian-conservative view of society expressed in the post-Reagan years.

[Mandryka]

Unfortunately, the idea that no person should endure even the slightest inconvenience for the benefit of society at large is foundational to how society actually functions. If nobody is willing to make the slightest sacrifice, you don't have a society, you have a group of individuals- which is the modern libertarian-conservative view of society expressed in the post-Reagan years.

Not among younger people. I don't know where you are but in the UK younger cohorts, who are relatively safe in the pandemic, suffered all sorts of serious impositions without flinching in 2020 and 2021 to protect older folks.

[Karl Henning]

Pregnancy apps have become a battleground of vaccine misinformation

[Mandryka]

I first noticed this in climate change when I saw more and more people take the line that frankly common-sense measures to reduce energy use are portrayed as useless when you hear the common refrain that x companies do y percent of emissions- the implication being that no person should have to do anything or have any change in their middle-class lifestyles and that things like fuel taxes are an elite conspiracy to reduce the quality-of-life of the average person.

I think it's maybe the idea that there's no way you (morally] ought to do something something if it only makes a very small difference. This is what we used to call a mistake in moral mathematics - Derek Parfit discusses it brilliantly, and demonstrates fallaciousness, in his Reasons and Persons.

[fbjim]

I think it's maybe the idea that there's no way you (morally] ought to do something something if it only makes a very small difference. This is what we used to call a mistake in moral mathematics - Derek Parfit discusses it brilliantly, and demonstrates fallaciousness, in his Reasons and Persons.

One of my favorite things I've read recently was Hirschman, who coined the tropes of reaction to social change as perversity (i.e. we shouldn't do anything because we might make the problem worse), futility (we shouldn't do anything because the problem is too large for social change to solve), and jeopardy (we shouldn't do anything because it may put previous social gains at risk). More and more I'm seeing this sort of thing pop up in these kinds of debates, though I think this is more common to centrist reaction (centrists love to argue that we shouldn't do anything because we might accidentally make the problem worse) than left/right reaction.


In terms of left-reaction, though, the relevant trope is that any attempt to compel or coerce changes in societal behavior will necessarily result in state and elite violence against poor and minorities, because our enforcement systems are too entrenched in capitalist and racist hierarchies of power.