[ub99]

Speaking for myself (as I am pretty healthy). My concern is not about dying as much as it is about developing long Covid and other not fully confirmed potential complications. Saying that, I think at this point in the US we should completely reopen and stop arguing about the measures. I am maximizing my chances of survival and staying healthy by getting vaccinated and wearing a mask. Many people don’t - and that’s their choice that is at this point we should not try to fight. The only thing we should accept is that unvaccinated Covid patients should have a lower priority in hospitals than patients with other conditions.

[dTal]

When you're operating at the level of a government setting policy for an entire country, you're no longer in position to view the world in terms of "personal responsibility". People, as a mass, are a fairly deterministic blob. "Reopening" sends the message that the pandemic is over. If you want to reopen, you need to accept that this will - directly, as a result of your decision - lead to avoidable deaths.

As for the other half of your proposition, I can see why it might seem appealingly logical - why should people who refused vaccination be entitled to medical care? - but I think it's ultimately inhumane. You don't know why they're not vaccinated. Maybe they weren't even offered it. Maybe they were in a disadvantaged life situation - there's a suspicious correlation between economic class and vaccination rate. Maybe they were prevented from getting it by oppressive relatives or partners. Maybe they were just being honestly cautious, and badly misjudged the relative risks. It's not fair to condemn people to death for those things.

[ub99]

I do believe there is away to send a more complete and nuanced message. We can reopen and keep communicating the fact that the disease is still here, people should be careful. I am not sure we really have an alternative. Covid might stay with us forever.

As to your humanitarian point - this can also be addressed with more nuance. A patient can explain that they are coming from a situation where they couldn’t get vaccinated. I don’t think it’s fair to prioritize the treatment of intentionally unvaccinated Covid patients who believe doctors are a part of a worldwide conspiracy. It’s a difficult ethical question - but we have to answer it nonetheless.

[unearth3d]

Wise response. I wouldn't be surprised if ~20% of any society/state/country is immune compromised in some way, most of those people work across their societies; letting covid run would force them to separate, and eventually end in poverty, this would weaken any society.

[ub99]

What do you expect to happen? 20% of the population will not get vaccinated and will wait for Covid to go away? This is also highly unlikely. Keeping the country closed and divided is adding a lot of stress to the stress we are already under due to the pandemic.

[unearth3d]

Just a case in point, some regions only have one vaccine type avy e.g. Australia with Astra, my wife would have serious problems with Astra, fortunately we have Pfizer in NZ, there are many many examples like this.

[SantalBlush]

Sure, if they're unvaccinated but still taking precautions to mitigate the spread to others and reduce the hospital workload, I'll certainly have more sympathy for them. How many unvaccinated people do you believe really do this?

[mdp2021]

?! Most, surely, if they are rational. You seem to be implying the unvaccinated may tend to be careless.

If people delay vaccination in fear of health consequences, of course they will also be extra careful about avoiding contagion.

If people delay vaccination for other sensible, defensible reasons - I cannot guess them. And I do not want to get inside the pit of the "it's all fake" minds. Even today I had to listen to a mate stating that "only the already compromised got killed" - many of "my" dead were very healthy.

[SantalBlush]

There were plenty of people who spoke out against simple precautions at the beginning of the pandemic, before vaccines were available to anyone. So I don't even need to speculate that at least some people do not take precautions while being unvaccinated; I've already seen a lot of it.

[mdp2021]

Of course in the population you will see the whole range, the bell has two tails:

do not assume there is one tail only.

Remember that one side is louder than the other: do not be fooled scouting by noise. (Nor do commit fallacies of generalization at rights - responsibility is on the individual.)

Anecdote: you tell me? The day before posting that - which already contained other anecdotes - this nice guy went for a takeaway and an unknown fool, the wrong tail of cheeky, started smiling and fake-coughing - owner reported he did that whenever he saw anyone wearing a mask. Is that the end of the pandemic? Because the nice guy saw the same at the early beginning: fake-coughers at the supermarket, mocking those who seemed to want to stay at a distance. She, almost twenty, kept herself coughing smiling and almost adhesive (well, it's nice guy involved, what else can you do) at the counter. The boyfriend went along but while leaving went "Well, on the other hand, when it's full of people...", in a sudden strike of reason. And nice guy looking and the sky thinking, the are so foolish they do not remotely guess that I kept at a distance especially because I had to attend to business, hours before, in the biggest epicenter city of the epidemic. Now: if society thinks that combating and preventing foolery is not a priority...

[SantalBlush]

Yes, probability distributions have two tails, but you can't just assume they're the same size. If you know what the probability distribrution of unvaccinated people is w.r.t. precautionary measures they take, then I'd love to see it. But my bet is that you don't have any actual data on it, and you're just making assumptions.

edit: To be clear, I don't know what the distribution looks like either, but I'm not assuming the average unvaccinated person takes other precautions. I don't think we can confidently say that.

[_red]

>punitive hospital policies

Why not also put fat people + diabetics at lower priority? Why is someone killing themselves by being 350lbs and having high-fructose corn syrup blood somehow more forgivable than someone waiting for FDA approval?

[ub99]

Are hospitals overwhelmed because of fat people in ICUs?

[nradov]

Yes hospitals in some areas are overwhelmed because of obese people in ICUs. The data clearly shows that obesity is a critical risk factor for ICU admission.

https://www.cdc.gov/mmwr/volumes/70/wr/mm7010e4.htm

[ub99]

Well, I was responding to the comment about fat people in general, not obese Covid patients. I don’t think the obesity factor should be taken into account at all.

Re your response: ICUs are overwhelmed because of Covid patients, not because of fat people with non-Covid conditions.

[paulddraper]

Is that...a serious question?

[enkid]

Except there are multiple states out if ICU beds because they tried this. Every person in the hospital with COVID is another person who can't use that bed to get medical treatment.

[ub99]

That’s what I meant in my last sentence. Unvaccinated Covid patients should have a lower priority. I haven’t heard of any hospitals trying that.

[eightysixfour]

Deleted incorrect information, the decision was reversed.

[ub99]

That sounds like a good start. I hope more hospitals will follow this example.

In general, I think it’s very unhealthy to attempt to take away people’s agency and treat them as children. Don’t want to get vaccinated? Your choice. But there are consequences of this choice and we should make this consequences clear. Other than that - let people do what they want to do.

[eightysixfour]

Looks like they reversed the decision: https://www.dallasnews.com/news/watchdog/2021/08/19/if-north...

[paulddraper]

Now do obesity.

[howinteresting]

What about water rationing?

https://www.google.com/amp/s/pledgetimes.com/orlando-declare...

You're healthy. What about immunocompromised people for whom the vaccines have only had a partial effect?

https://www.google.com/amp/s/theconversation.com/amp/immunoc...

Like it or not, we live in a society. Our decisions affect everyone else and we can't fully account for externalities. Solving these sorts of tragedies of the commons is exactly what public policy is meant to do.

Personally, I think vaccine mandates need to happen yesterday. People who don't believe in the vaccines can suck it up. Facts don't care about their feelings.

[ub99]

Sorry do you live in the US? Do you really think a vaccine mandate is possible here? People will literally fight that with assault rifles. This situation is already tearing our society apart, there is no way any large scale mandatory vaccination project would succeed.

[sjg007]

Vaccine mandates are constitutional in the USA. We just forget our history from time to time. People also misunderstand the meaning of freedom as well.

https://www.scientificamerican.com/article/vaccine-mandates-...

[kcplate]

Doesn’t matter. The best way to guarantee that the final 28% probably won’t get vaccinated is to mandate it. The best way to get the final 28% vaccinated is to fully FDA approve it, get Fauci and Biden to ease up on the vax shaming and then simply expect that 10-15% still won’t do it. You write them off and let the chips fall.

It’s remarkable to me that our government hasn’t figured out that you don’t get people who are already distrustful of the government to magically become trustful of the government by doing the same shit over and over that caused the distrust.

[sudosysgen]

It's pretty simple yeah, you start withdrawing funds and federal services from people that don't get vaccinated. If there's one thing you can get from US history it's that money rules, and this approach does work historically.

Now I don't know that they should be implemented, and there would be some unrest, but it would end up working.

[howinteresting]

Yes, I live in the US. The way I think vaccine mandates can be done here is for every workplace, business and school to require them. Hopefully the upcoming approval of the Pfizer vaccine should unblock more of this.

[ub99]

OK, let’s explore that.

At what level do you think this would be enforced? Federal? Completely unenforceable unless you want to involve the military domestically. State level? Obviously half of the States are not going to do that. City level? Again, completely pointless.

Also, many business owners are antivaxx, why would they participate in this?

[iammisc]

Some states are out of ICU beds due to onerous restrictions on nursing supply, like vax mandates (my own state of Oregon for example)

[legobmw99]

Can you find any source which suggests that vaccine mandates are the reason for the shortage of nurses in Oregon? The first 5 results on Google for “Oregon Nurse shortage”, which are mostly from April-May, list workplace stresses and at-risk family members as reasons for the exodus.

Some articles are as old as December, which is before the vaccine was even available, let alone mandated

[iammisc]

This is a new policy brown is enacting against the wishes of the Nurses union. There is no data yet, I'm just extrapolating based on the fact that these new requirements will cause some nurses to quit rather than be vaccinated, which will directly reduce the number of ICU beds while not contributing meaningfully to the % vaccinated.

If we are only to rely on already collected empirical data to make decisions or form opinions we would never be able to hold an opinion when it matters most... before

[sudosysgen]

Without vaccination mandates you run the risk of an epidemic amongst nurses which can knock out 40% of your ICU beds at once. That's why nurses have to be vaccinated against dozens of illnesses.

[iammisc]

These nurses have been unvaccinated for more than a year while in proximity with those with COVID-19. Exactly when are 40% of the nurses going to be knocked out in this model?

[sudosysgen]

Nurses up until now practiced exceptionally higher restrictions to avoid this. But safety fatigue sets in and it won't work forever.

[pessimizer]

And IMO it would be better the faster they all give it to each other. The longer it circulates between the non-vaccinated, who are interacting with the vaccinated, the likelier a variant arises that isn't affected by the vaccinations.

We don't want vaccinated people constantly catching covid, even if right now the symptoms are mild or nil 99.9% of the time.

[kodyo]

"My concern is not about dying as much as it is about developing long Covid and other not fully confirmed potential complications."

You and most people who are skeptical about the coronavirus vaccines share the exact same concern. But it sounds like you want them to be institutionally deprioritized because of theirs.

[ub99]

That’s not directly comparable. Antivaxx concern is not rooted in science or statistics. It’s rooted in conspiracy theories and anti-science.

In a similar way you could argue that questioning the last election is the same as worrying about the destructive rise of far-right rhetoric because both are rooted in the concern for our society. And therefore we should not institutionally ignore those who doubt the legitimacy of the election.

“Both sides” argument is not valid just because there are many people on both sides.

[mdp2021]

With «antivaxx concern.... rooted in» are you talking about Pfizer/Moderna/OAZ/JnJ or are you talking in general?

Because if you mean current concerns, and you have the «science and statistics» that debunk such concern, do provide it. Because a lot of hesitants are there, following anecdotal evidence in their close circle and more of post-vaccine damage¹, and data that does not allow for proper computation of risks², and, to say it all, a public rhetoric that does not help owing to oversimplification.

Statistically, I only found data about passive monitoring - it may partially somehow set the minimum expected, but they are easily underestimations. Active monitoring, I have not found anything (I also had raised a thread here for the hunt, at https://news.ycombinator.com/item?id=28034269).

But if you have the credible data, share it - do not assume it is out in the billboards.

¹(what the, in the past 24 hours alone I read on the papers of a local athlete hit with miocarditis, then in a phone call with a friend was told of an acquaintance of his with odd dire damages, and again I read on the papers of a second athlete with miocarditis. This is not aproblematic: this goes rightfully on the table of notions to be dealt with. And beyond the close circle and the credible sources, there are people who wrote around about having been hit by a meteorite a little after the inoculation - less reliable, but more consolidating the presence of the issue than not.)

²Not too many hours ago a divulgative article appeared here on the probability of long covid as "post 12 weeks symptoms": it mentioned three studies, publishing a conservative 2.3% chance, a well-considered 14%, and a broadly encompassing 40%. And one can compute risks reliably with this? And these generic "adverse events" did not even discriminate "nuisance vs impactive vs impairing"!

[howinteresting]

Yes, because one thing is true as shown by scientific evidence and the other is not.

It is really really important that public policy is based on scientific and other sorts of evidence. This is why the initial refusal of the CDC to back masks was so bad—it wasn't based on the evidence.

[iammisc]

Do you worry about Lyme disease, Epstein Barr virus or lone star ticks too? How much time do you spend?

Most Americans should be more worried about obesity and heart disease than long covid.