Coronavirus

[bkp_duke]

@NikolaACDC - instead of hitting the "disagree" button, why don't you actually bring some HARD DATA to the argument?

I've got a randomized controlled study, and CDC commentary on that study above. What do you have?

 

[NikolaACDC]

Are you sure it's not the price rather than the actual availability? (e.g. We won't purchase if the cost is more than X per mask)

Sure, it's possible they didn't want to or couldn't afford to pay for supplies.
End result is still that many health care workers worked for much of last year with limits on the amount of PPE they could use.
Survey: PPE shortages continue for many nurses
Which explains the high rate of infection and death among them.

 

[AlanSubie4Life]

unvaccinated, which in the USA have made their choice. If there are no negative consequences to that choice,

But there are negative consequences to that choice (other than to themselves).

if the government tells that group that they MUST wear a mask, that's a blatant over-reach that is not supported by the data at hand.

I agree that wearing masks for vaccinated individuals is not strongly supported by the data (it reduces risk, but the overall risk of hospitalization & death after vaccination is low unless you are immunocompromised or some other special case). But I see no solution to the issue that enforcement of masking of the unvaccinated is necessary to keep infection pressure down (and protect children and others without access to the vaccine (or who are unable to be vaccinated safely for whatever reason)). What would you propose?

Clearly risk for the vaccinated has increased over the past few weeks (in San Diego cases are 10x what they were a few weeks ago, for example).

People get vaccinated in order to avoid getting the disease (and that's a very reasonable expectation if a sufficient proportion of the population is vaccinated - at that point vaccines are ~100% effective). So I think it's reasonable for the government to provide an environment where that is actually a possibility - it's a public health issue.

The reason the CDC is recommending universal masking is because there's no other way (currently) to get only unvaccinated individuals to mask up. The sooner we have vaccine requirements and vaccine passports the better. We need to make it as inconvenient as possible for unvaccinated individuals. There's no mandate or requirement that they get vaccinated of course - it's a free country - they just might have to live their life differently, work somewhere else, not be able to eat at restaurants or visit bars, etc. It's fine. Maximize freedom for all.

 

[bkp_duke]

But there are negative consequences to that choice (other than to themselves).

With the vaccine, that "risk to others" is VERY small now. There is always some risk in everything we do. We can't babysit everyone in society.

Furthermore, FORCING universal mask wearing is just incentivizing these people further not to get vaccinated and creating a positive feedback loop to their anti government mindset. If anyone in government had a brain, they would incentivize these people, not find a way to reinforce their beliefs of Gov=bad.

How many conversations have you had with vaccine hesitant people where they have said "well, if the vaccine is so effective, why does the government want us to keep wearing a mask?" Seriously, like it or not, it is a valid argument, especially for the "simple minded" that constitute so much of our population.


I've got ZERO worries about the 17 and under population. Both the hospitalization rate and death rates from COVID-19 for these groups are lower than even with seasonal influenza (and that is in a partially vaccinated population when considering influenza). I say that as someone with two children in this age group (who will be vaccinated when it is available for them).

And blanket statements like "clearly risk for the vaccinated has increased" are too vague. What are those numbers, exactly? The ones I have seen are so low that they do not justify mask mandates for vaccinated individuals, without exception.


And then we get to the practicality - with the current anti-police environment, who's going to enforce a mask mandate? I 100% guarantee you that cops won't be writing tickets for not wearing masks, so any mandate, aside from things like flying on a plane, is going to be un-enforceable.


And the CDC did NOT recommend universal masking - go check your facts, that's completely wrong:

COVID-19 Vaccination

COVID-19 vaccines protect against COVID-19. Get safety info and more.

www.cdc.gov

 

[jerry33]

Sure, it's possible they didn't want to or couldn't afford to pay for supplies.
End result is still that many health care workers worked for much of last year with limits on the amount of PPE they could use.
Survey: PPE shortages continue for many nurses
Which explains the high rate of infection and death among them.

I was really only responding to the current shortage. Last year they were either hard to get or horrendously expensive. They are still more expensive than they should be by about 3X but they are not unaffordable.

 

[NikolaACDC]

I was really only responding to the current shortage. Last year they were either hard to get or horrendously expensive. They are still more expensive than they should be by about 3X but they are not unaffordable.

Not sure, maybe you missed it - the articles were from last year, 2020.

 

[madodel]

With the vaccine, that "risk to others" is VERY small now. There is always some risk in everything we do. We can't babysit everyone in society.

Furthermore, FORCING universal mask wearing is just incentivizing these people further not to get vaccinated and creating a positive feedback loop to their anti government mindset. If anyone in government had a brain, they would incentivize these people, not find a way to reinforce their beliefs of Gov=bad.

How many conversations have you had with vaccine hesitant people where they have said "well, if the vaccine is so effective, why does the government want us to keep wearing a mask?" Seriously, like it or not, it is a valid argument, especially for the "simple minded" that constitute so much of our population.


I've got ZERO worries about the 17 and under population. Both the hospitalization rate and death rates from COVID-19 for these groups are lower than even with seasonal influenza (and that is in a partially vaccinated population when considering influenza). I say that as someone with two children in this age group (who will be vaccinated when it is available for them).

And blanket statements like "clearly risk for the vaccinated has increased" are too vague. What are those numbers, exactly? The ones I have seen are so low that they do not justify mask mandates for vaccinated individuals, without exception.


And then we get to the practicality - with the current anti-police environment, who's going to enforce a mask mandate? I 100% guarantee you that cops won't be writing tickets for not wearing masks, so any mandate, aside from things like flying on a plane, is going to be un-enforceable.


And the CDC did NOT recommend universal masking - go check your facts, that's completely wrong:

COVID-19 Vaccination

COVID-19 vaccines protect against COVID-19. Get safety info and more.

www.cdc.gov

Maybe not the CDC yet, but Fauci said it 2 days ago.

Fauci says vaccinated Americans could be forced to wear masks again amid Delta spike

 

[AlanSubie4Life]

Both the hospitalization rate and death rates from COVID-19 for these groups are lower than even with seasonal influenza (and that is in a partially vaccinated population when considering influenza).

Obviously data is limited, but it's fairly likely that COVID-19 is more dangerous to children than typical seasonal influenza, particularly those under 5 and over 12 (over 12 less relevant here since they can be vaccinated). At best we can say the danger is similar. Yes, it's true that these influenza IFRs do include the impact of vaccination (otherwise they would be worse). But we do vaccinate for influenza for a reason, and right now 0-5 (and 6-12 but they seem lower risk) can't be vaccinated so it's relevant to compare risk of influenza with vaccination to COVID-19 without.

It's kind of a big deal for a child to die of a transmissible disease, when they are infected by someone who should have been vaccinated. Are we really going to let 100 more kids die needlessly?

What are those numbers, exactly? The ones I have seen are so low that they do not justify mask mandates for vaccinated individuals, without exception.

I'd estimate the increase in risk is proportional to the increase in community transmission. The baseline risks are pretty unclear I agree and I definitely want as much data as possible. Public Health England has the best summary I am aware of so far (but this is just an efficacy measurement, it doesn't establish the actual baseline risk which presumably would depend on transmission levels and infection pressure): https://www.nejm.org/doi/full/10.1056/NEJMoa2108891

And the CDC did NOT recommend universal masking - go check your facts, that's completely wrong:

That was my shorthand for what they actually recommended - obviously their recent recommendations depend on community transmission levels and it was for indoor areas only (this is obvious from the context of this discussion). My point was "universal" in the sense that it doesn't differentiate between vaccinated and unvaccinated individuals when it comes to public indoor settings (which I believe is the whole point of this recommendation).

 

[madodel]

These anti-vaxxers are flat out stupid and insane. I run a local Facebook group for the community for announcements, events and business postings. I just posted a local news article that our county cases have more than doubled in the past week and our state is up 86% and people should get vaccinated to stop this. That triggered a bunch of troll messages and arguments with me despite warnings they'd be banned for spreading misinformation. They wouldn't stop so I banned them. They can't help themselves. This is not going to end well if ever.

 

[AlanSubie4Life]

I 100% guarantee you that cops won't be writing tickets for not wearing masks, so any mandate, aside from things like flying on a plane, is going to be un-enforceable.

FORCING universal mask wearing is just incentivizing these people further not to get vaccinated and creating a positive feedback loop to their anti government mindset. If anyone in government had a brain, they would incentivize these people, not find a way to reinforce their beliefs of Gov=bad.

Yeah, that's fine, and I'm actually ok with just a strong recommendation, not a mandate, on masking, which is clearly communicated to the public (especially to the vaccinated, being honest about their risk level to the best of our current knowledge, and trying to communicate how this risk level depends on exposure to the virus - which seems like it has been a big challenge). Regarding incentives to get vaccinated: I'm fine with proof of vaccination being required for as many workplaces as possible, to attend sporting events, concerts, fly on planes, etc. As many ways to incentivize vaccination as possible. These seem like great incentives for vaccination! Then we can get away from masking.

 

[bkp_duke]

Obviously data is limited, but it's fairly likely that COVID-19 is more dangerous to children than typical seasonal influenza, particularly those under 5 and over 12 (over 12 less relevant here since they can be vaccinated). At best we can say the danger is similar. Yes, it's true that these influenza IFRs do include the impact of vaccination (otherwise they would be worse). But we do vaccinate for influenza for a reason, and right now 0-5 (and 6-12 but they seem lower risk) can't be vaccinated so it's relevant to compare risk of influenza with vaccination to COVID-19 without.

It's kind of a big deal for a child to die of a transmissible disease, when they are infected by someone who should have been vaccinated. Are we really going to let 100 more kids die needlessly?

Nope, completely wrong. Here's the hard data:

Estimated Flu-Related Illnesses, Medical visits, Hospitalizations, and Deaths in the United States — 2018–2019 Flu Season | CDC

CDC calculates estimates of disease burden in the United States using surveillance data and modeling to adjust for sources of under-detection. Burden estimates for the 2018-2019 season found here.

www.cdc.gov

477 influenza deaths in 2019 (the last year we have data for a non-pandemic seasonal influenza season) in the 0-17 age group. And if you go through data for other years, that was a pretty "typical" influenza year.

COVID-19 in 2020 was FAR more prevalent than the typical seasonal influenza. Which, btw, we have some degree of immunity to because of childhood influenza vaccination. There was presumed minimal to zero immunity for kids to COVID-19.

337 deaths in the 0-17 age group for COVID-19 (and this is for 18 months, not 12 months like influenza above):

COVID-19 deaths by age U.S. 2023 | Statista

Between the beginning of January 2020 and June 14, 2023, of the 1,134,641 deaths caused by COVID-19 in the United States, around 307,169 had occurred among those aged 85 years and older.

www.statista.com

Basically, this is a VERY different infection in the 0-17 age group than adults. It's essentially a cold (and coronaviruses are typical cold viruses).

The push to vaccinate the 0-17 age group is because we PRESUME that they are vectors to other, more susceptible populations, although that evidence is not well-founded at this time.

 

[AlanSubie4Life]

337 deaths in the 0-17 age group for COVID-19 (and this is for 18 months, not 12 months like influenza above):

The actual number is 519 in the 0-17 age group (and this assumes we actually counted them all).

COVID Data Tracker

CDC’s home for COVID-19 data. Visualizations, graphs, and data in one easy-to-use website.

covid.cdc.gov

COVID-19 in 2020 was FAR more prevalent than the typical seasonal influenza.

"Obviously the data is limited" I said.

That's definitely the key question. Evidence needed here for your claim.

600k recorded cases in the 0-4 group, with 173 deaths, CFR 0.029%. (Probably 2 million infections or so? So maybe an IFR of 0.01%?) Do you really think that is more prevalent than a typical influenza season where we take no precautions? It's also not really fair to look at documented cases of influenza - have to look at CDC estimates for that as well.

I'd be interested in what the estimates of infection counts of COVID in the 0-4 group are, and compare to influenza estimated cumulative incidence. To me this is an open question (and the whole point of the plot posted above).

In my view we've taken substantial steps to reduce transmission to children. The question is how effective has that been (we don't take any such steps for influenza, really). Obviously this question all comes down to the denominators, as usual for public health. I'm very curious what is the answer here.

Frankly, the question also comes down to NUMERATORS. We didn't catch all the COVID deaths in children, for sure, nor do we catch all the influenza deaths in children. All four numbers are in question for both influenza (2) and COVID (2); need some estimates with a methodology which results in good accuracy.

COVID Data Tracker

CDC’s home for COVID-19 data. Visualizations, graphs, and data in one easy-to-use website.

covid.cdc.gov

It's essentially a cold (and coronaviruses are typical cold viruses).

It really isn't. If rhinoviruses, RSV, etc., were typically as dangerous as influenza, we'd be doing something about them.

The novel part of SARS-CoV-2 (lack of prior immunity) is a super important part of this - most teenagers have already seen most of these other viruses by the time they are teens, so these viruses are generally well dealt with and are thus not too dangerous You can't say "if we had prior immunity it would be just like these viruses" - because we don't have prior immunity until after vaccination.

(Again, to be clear: it's legitimate to compare lethality of influenza with prior immunity to COVID with no immunity - I'm definitely not trying to argue that influenza is less lethal than COVID in the imaginary world where influenza was completely novel.)

I'm actually not making an argument about the relative lethality at all, to be honest - I'm saying I don't know. The very limited evidence I see suggests that COVID may well be more dangerous in certain age groups, particularly 0-4, and 12-17, than influenza with prior immunity taken into account, and I think that's fairly likely (if I had to bet that is how I would bet), but I don't have a position on it beyond that, and the picture is definitely not clear.

 

[bkp_duke]

Thank you for making my point for me. 337 or 519, with numbers that small compared to the number of cases, the exact number doesn't matter. Over an 18 month period, it's a TINY number compared to the prevalence of the disease. Literally you are arguing over MICROSCOPIC levels of death (not diminishing the death of anyone's child - that is always tragic - but speaking from a pure statistics standpoint).

Again, VERY different disease/infection in the 17 and under population than it is in the 18 and older population. And that death rate will only go DOWN, not up, as the 0-17 population hits higher and higher levels of immunity.

At BEST the fatality rate of COVID-19 in an UNVACCINATED 0-17 population is comparable to the fatality rate of Influenza in a VACCINATED (partially - the take rate on influenza vaccines in this group is ~60-63% - see graph below). As this age group is vaccinated for SARS-CoV-2, that fatality rate is going to drop even further, below what the rate is for influenza.

Flu Vaccination Coverage, United States, 2019–20 Influenza Season | FluVaxView | Seasonal Influenza (Flu) | CDC

Estimates of Flu Vaccination Coverage among Children — United States, 2017–18 Flu Season

www.cdc.gov

Here is another way to look at it:
It is EXACTLY BECAUSE the COVID-19 death rate is SO LOW in this age group that the FDA is being super, extra cautious about approving the vaccine for this age group. If there are side effects, the rate of those could easily grow to as high as the fatality rate in this group, and that would make for a very VERY bad scenario about public trust in children's vaccines in the future. We are already seeing some of this: because of the incidence of myocarditis in 18-25 yo males, the FDA has required both Moderna and Pfizer to expand their trials to get more statistical data for the younger group.

 

[AlanSubie4Life]

As this age group is vaccinated for SARS-CoV-2, that fatality rate is going to drop even further, below what the rate is for influenza.

As I said, before vaccination is available, that's the comparison we're making here - unvaccinated COVID (since that is what is relevant for kids since they can't get vaccinated!) to influenza with pre-existing immunity. I don't think anyone thinks that vaccinated children with normally functioning immune systems are at any significant risk at all.

Over an 18 month period, it's a TINY number compared to the prevalence of the disease.

Again, what's the denominator? And what's the denominator for influenza? I personally have no idea. I'd guess it's about 2-2.5 million for the 0-4 year group for COVID, but maybe it's as high as 4-5 million?

 

[bkp_duke]

As I said, before vaccination is available, that's the comparison we're making here - unvaccinated COVID (since that is what is relevant for kids since they can't get vaccinated!) to influenza with pre-existing immunity. I don't think anyone thinks that vaccinated children with normally functioning immune systems are at any significant risk at all.



Again, what's the denominator? And what's the denominator for influenza? I personally have no idea. I'd guess it's about 2-2.5 million for the 0-4 year group for COVID, but maybe it's as high as 4-5 million?

Influenza 0-17 was 11 million "symptomatic cases" in 2019. If someone's not symptomatic, we don't test for influenza. Similar clinical criteria to COVID-19 - most of the time we don't test (except for travel).

Best estimate, comparable denominators, or COVID-19 is higher.

 

[AlanSubie4Life]

FDA is being super, extra cautious about approving the vaccine for this age group. If there are side effects, the rate of those could easily grow to as high as the fatality rate in this group, and that would make for a very VERY bad scenario about public trust in children's vaccines in the future.

Actually I think they've been really terrible. They only recently demanded that the trial be expanded to do just this...as though it was something that wasn't knowable a year ago when the vaccine trials started... https://www.washingtonpost.com/heal...hildren-under-12-help-rule-out-safety-issues/

I'm all for caution but if you're looking for rare side effects (a worthy goal!) you need a massive trial group.

 

[AlanSubie4Life]

Best estimate, comparable denominators, or COVID-19 is higher.

Influenza 0-17 was 11 million "symptomatic cases" in 2019. If someone's not symptomatic, we don't test for influenza.

So by that metric, to be clear, the denominator for COVID is 3.5 million symptomatic diagnosed cases (0-17) according to the CDC website linked above vs. 11 million symptomatic for influenza in 2019.

I actually don't think this is a legitimate comparison for various reasons already described above, but just pointing it out.

So that would be 519 deaths with 3.5 million cases (COVID) vs. 477 with 11 million cases (influenza 2019).

Again, I think there are a number of issues with this comparison.

 

[bkp_duke]

So by that metric, to be clear, the denominator for COVID is 3.5 million according to the CDC website linked above vs. 11 million symptomatic for influenza.

I actually don't think this is a legitimate comparison for various reasons already described above, but just pointing it out.

So that would be 500 deaths with 3.5 million cases (COVID) vs. 477 with 11 million cases (influenza).

Again, I think there are a number of issues with this comparison.

Again, I think any way you "split it", this is statistically a TINY number of deaths. The CDC has been clear that their reasoning for wanting to vaccinate that age group is not for death prevention in that age group, it's b/c they presume that they can be vectors to more susceptible populations.

 

[AlanSubie4Life]

Again, I think any way you "split it", this is statistically a TINY number of deaths. The CDC has been clear that their reasoning for wanting to vaccinate that age group is not for death prevention in that age group, it's b/c they presume that they can be vectors to more susceptible populations.

Sure, it's relatively small numbers, but this is what initiated this entire conversation:

I've got ZERO worries about the 17 and under population. Both the hospitalization rate and death rates from COVID-19 for these groups are lower than even with seasonal influenza

So I think the actual data on that comparison is actually still unknown, but please see the statistics we've arrived at above: 519 deaths with 3.5 million cases (COVID), directly from CDC data, vs. 477 deaths with 11 million cases (influenza 2019, your data).

More digging and analysis would be required to determine whether COVID was lower death rate - and based on the data I've seen I think COVID has a higher death rate than typical influenza. But I don't know and am not making that claim - it's just how I would bet if I had to based on what I've seen.

 

[Dave EV]

Wife and I are vaccinated, and except for when required by a business, we are not wearing masks any longer. We understand, and accept, that there is a VERY limited chance that we could become infected, and a much smaller chance we could have symptoms. We are both fine with that.

With the vaccine, that "risk to others" is VERY small now. There is always some risk in everything we do. We can't babysit everyone in society.

I personally know of two people who managed to avoid getting COVID until recently. Both are fully vaccinated (Pfizer) and picked it up indoors maskless after letting their guard down.

One of those two managed to give it to a half-vaccinated relative before realizing they had COVID. Fortunately, the other relatives did not get it.

The prevalence of "long COVID" or where symptoms persist beyond 6 weeks, appear to be around 20% for people who are vaccinated that get COVID (sorry, don't have the reference handy). Both of those above reasons seem like good reasons to either strongly recommend or require masks indoors again, whether you care about the unvaccinated or not.

I understand the resistance to going back to masking, but honestly, the cat is out of the bag - again.

Here in San Diego County the case rate is almost 10x higher than it was a month ago and there are 3-4x as many people in the hospital. Given that the vaccination rate has not changed significantly in the last month, I would not be surprised to see hospitals filling up again in the next 2-6 weeks, unless we can reduce the rate of COVID infections.