[werm82]

> some research has shown that they don't do very well at stopping spread, so why all the fuss to force people to get vaccinated?

Do you have a link/links to where you read that vaccines don't do well at stopping the spread? Everything I've read is that vaccines, while not 100% effective at stopping the vaccinated person from infecting someone else, significantly lower the risk of spreading the virus[0]. That risk drops dramatically when both parties involved are vaccinated.

[0] https://www.cdc.gov/coronavirus/2019-ncov/vaccines/keythings..., see Effectiveness --> What we know

[jjoonathan]

Yeah, GP has a couple of interesting ideas mixed in there (NY lockdown policy and building hospital capacity) but the rest are bog standard anti-mask, anti-vax talking points. Masks help, vaccines help -- it's all about pushing R below 1, and a measure doesn't have to be 100% effective (or anywhere near that) to push.

Lockdowns do flatten the curve, and while we might have built new hospitals in a parallel universe, in this one we really don't want to saturate the beds (again). I was pleasantly surprised by the "flatten the curve" narrative -- usually the telephone game ensures that this kind of nuance gets buried under simpler, incorrect versions like "if we just lock down for two weeks, this will be over," but this time around I was pleased to see "flatten the curve" start strong and keep its legs.

CDC's initial mask take was wrong, but evidence changed their minds, and that's a good sign. GP, if you want to harp on this, tell me: if I were to dig through your post history would I find a bunch of poorly aged posts about a silent first wave?

[disgruntledphd2]

> while we might have built new hospitals in a parallel universe, in this one we really don't want to saturate the beds (again).

Unfortunately, while hospitals can be built, you can't train enough medical professionals to staff the hospital in two years.

More generally, rather like nobody expects the Spanish inquisition, no health care system can cope with a global pandemic. We'd need to 10x health care capacity, most of which would sit unused for most of the time.

[autokad]

I am not anti vax, I am vaccinated and I recommend to everyone to do the same. However, relying on this vaccine as a long term solution is a very bad idea.

Also you are stating I am anti mask when I stated how I recommended mask usage. Do you not read or do you just force your expectations on people?

Sure, go ahead and dig through my history. not sure what you mean by 'a silent first wave'.

[criticaltinker]

GP's statement contradicts the scientific literature - vaccination does reduce viral load of subsequent infection, and consequently reduces transmission [1].

However folks should be aware that immunity acquired through natural infection is robust and durable, and also has the same effect of reducing viral load and transmission [2].

It has been documented that people with asymptomatic infection will clear the virus quickly compared to those who are symptomatic [3]. Recent meta-analyses [4] and large population serological studies [5] have estimated the asymptomatic proportion lower bound to be at least ~33%, and the upper bound to be ~65% (even higher for young adults). Considering recent evidence that cases may be massively under-reported, the true asymptomatic proportion could be even higher than suggested [6].

Taken together, these results imply that a majority of the population has been already exposed to the virus, and either through natural infection or vaccination has acquired some degree of immunity that reduces the transmission of the virus.

Analogous to antibiotic resistance, vaccine resistance can evolve if vaccines are used indiscriminately [7][8][9][10]. So the benefits of compulsory mass vaccination may not outweigh the risks of such a policy, given the current state of affairs.

> so why all the fuss to force people to get vaccinated?

It is an important question with tremendously complex factors that go beyond the expertise of most lay people.

[1] Initial report of decreased SARS-CoV-2 viral load after inoculation with the BNT162b2 vaccine https://www.nature.com/articles/s41591-021-01316-7?origin=ap...

[2] Longitudinal analysis shows durable and broad immune memory after SARS-CoV-2 infection with persisting antibody responses and memory B and T cells https://www.cell.com/cell-reports-medicine/fulltext/S2666-37...

[3] The Natural History and Transmission Potential of Asymptomatic Severe Acute Respiratory Syndrome Coronavirus 2 Infection https://www.sciencedirect.com/science/article/pii/S266652472...

[4] The Proportion of SARS-CoV-2 Infections That Are Asymptomatic https://www.acpjournals.org/doi/full/10.7326/M20-6976

[5] Estimating the asymptomatic proportion of SARS-CoV-2 infection in the general population: Analysis of nationwide serosurvey data in the Netherlands https://link.springer.com/article/10.1007/s10654-021-00768-y

[6] Evaluating the massive underreporting and undertesting of COVID-19 cases in multiple global epicenters https://www.sciencedirect.com/science/article/pii/S253104372...

[7] Risk of rapid evolutionary escape from biomedical interventions targeting SARS-CoV-2 spike protein https://pubmed.ncbi.nlm.nih.gov/33909660/

[8] Can we predict the limits of SARS-CoV-2 variants and their phenotypic consequences? https://www.gov.uk/government/publications/long-term-evoluti...

[9] Why does drug resistance readily evolve but vaccine resistance does not? https://royalsocietypublishing.org/doi/pdf/10.1098/rspb.2016...

[10] The adaptive evolution of virulence: a review of theoretical predictions and empirical tests https://pubmed.ncbi.nlm.nih.gov/26302775/

[makomk]

Covid-19 vaccination used to reduce viral load of subsequent infections. Unfortunately, this doesn't seem to work with the current Delta variant - both the CDC in the US and PHE in the UK have released studies finding that the viral load of vaccinated and unvaccinated people is basically the same. They're also not so effective at stopping people from catching the Delta variant, and when you combine that with its higher infectivity it's basically impossible to get herd immunity using them.

[rossriley]

No this is extremely misleading, the misquote you are using applies only to breakthrough infections, but the vaccines themselves are highly effective at preventing infection and thus breakthrough infections are very rare in vaccinated individuals.

Should you happen to not mount a robust immune response despite being vaccinated then at that point you will have a viral load similar to an unvaccinated person, but the good news is even if this is the case you will still have much less severe disease outcomes than an unvaccinated person.

The vaccines are incredibly effective against all current variants.

[logicchains]

>breakthrough infections are very rare in vaccinated individuals.

This is simply not true. In countries with accurate tracing like Singapore and Israel, it's apparent that the vaccinated aren't significantly less likely to get infected than the unvaccinated. Check figure 10 on https://www.moh.gov.sg/news-highlights/details/update-on-loc... ; the unvaccinated only make up around 10-20% of cases. They also only make up 10-20% of the population; if the unvaccinated were more likely to be infected, we'd expect them to constitute a larger proportion of infections.

[Amezarak]

There have been > 111k breakthrough infections in the US alone through the end of July. The CDC stopped tracking them unless they resulted in hospitalization or death, but we can still look at the data from the 35 states still tracking it.

It is fair to say that vaccination reduces the chance of infection. "Very rare", however, is not how I would characterize it.

https://www.bloomberg.com/news/articles/2021-07-30/cdc-scale...

Data from Israel suggests that efficacy may be much lower than initially believed, but still much better than nothing.

https://www.sciencemag.org/news/2021/08/grim-warning-israel-...

[ummwhat]

They are effective. The vaccine stops delta between 70 and 90% of the time (depending on which vaccine and which study you look at). The "impossible to get herd immunity" scenario is within the error bars, but I wouldn't state that as a fact. On the contrary, it looks like NYC just reached it's Delta peak 2 or 3 days ago. This strongly implies herd immunity is still possible, but we need to wait and see if the trend holds.

[dubyah]

Round 13 of the Imperial College REACT-1 study did still indicate an average lower viral load(higher Ct values) in vaccinated individuals.

[autoexec]

Even in the case of the delta variant vaccinated people who get infected are more likely to have reduced symptoms (if they have any noticeable symptoms at all). That means a lot less coughing up huge plumes of virus over great distances. Nothing is perfect, but in the end the vaccines increase your odds of not being infected while decreasing your odds of spreading the virus. Herd immunity may not be reached but we can drastically reduce deaths and serious illness. That's already a win for vaccines.