Vaccines that have a large impact on transmission and infection are there not just for you but for your community.
The covid shots were good against hospitalization and death in older folks, but they were not great at preventing infection or transmission (despite what you may have gleaned from the speakers blaring ads in every public setting for all that time).
You can fall back to the "flooding the hospitals" argument, that works a little better here.
You're misinterpreting data here. You are conflating the fact that the clinical trials didn't measure infection/transmission (which is very hard to do in a clinical trial) with the distinct claim that they didn't reduce transmission in reality.
The vaccines were extremely effective at reducing transmission during the first waves of COVID, where such an intervention was most valuable. And due to viral growth dynamics, even small reductions in transmission yield big net outcomes.
Later waves made the vaccine much less effective at reducing transmission, but still highly effective at reducing hospital utilization which is (despite your snarky aside), extremely valuable. Fatality rates doubled when ERs hit full capacity.
All I'm saying is if you sum up the time (between vaccine release and today) that a person was strongly protected from covid infection and transmission, it's a relatively small portion of that time.
Thats my pushback against gp's argument that you have to give this thing to your young kids to protect me.
I suspect that you and GP and GGP are talking about different time scales.
Vaccinating your children for COVID during peak COVID was the right thing to do both for them and for the adults they interact with.
Vaccinating your children for COVID today is much lower ROI for them and anyone around them.
Vaccinating your children in general is very much the right thing to do, both for them and for anyone around them.
I struggle to think of a decision or conversation where the relevant metric is "what % of time from vaccination until today were you protected" and I doubt that's what GP was discussing either.
> Vaccinating your children in general is very much the right thing to do, both for them and for anyone around them.
Isn't this kinda like saying medicating your children in general is very much the right thing to do?
Like it's obviously one of those things that everyone expects you to just agree with directionally, but the actually correct answer is no, there is no in general. All drugs have a context where they make sense. E.g. you're probably not vaccinating your kids for rabies, unless you live in an animal sanctuary or something. MMR, sure.
It actually seems pretty questionable to me that it was ever a net benefit to your average young kid to get the covid shots.
No there actually is in general and it's the same exact way in which there's generally good guidance for medicating your children: they're called evidence-backed guidelines.
The contexts in which drugs make sense is captured by the clinical guidelines.
And sure, it is arguably questionable whether there was ever a net benefit to an average young kid to get a COVID vaccine. However that is a distinct claim from "it never made sense to give kids COVID vaccines." There was certainly a point in time in which a logical interpretation of the information available at the time indicated that kids should get vaccinated. The risks were (correctly) understood to be near-zero and the benefits were (arguably incorrectly) understood to be significant.
Someone who, in early 2021, decided against vaccinating their children was making a decision that was not indicated by the best-available information at that time.
Someone who bets on Red doesn't get to claim they were "correct" in betting on Red even if Red comes up, and certainly not if Green comes up (arguably neutral outcome).
This is the "nobody got fired for buying IBM" argument. It works in a world where you have trustworthy institutions and its safe to just outsource your decision-making to the authorities.
Your interpretation of events might be that a collective of all well meaning people just got it wrong, and that's your right. A lot of people ended up with different conclusions, like the machine did what it does and made a lot of money, the truth be damned.
Not really. It's the "making decisions based on best-available evidence is good, even if every once in a while it leads you astray."
You're more than welcome to read the evidence they use to create their policies. If you have evidence that is of higher quality than that which "the authorities" are using, then you should depend on that!
But... you almost certainly don't have higher quality evidence than they do. That's the fundamental problem.
If you think that you do, then you too could actually make a fuckton of money with that information. But again: you don't have superior information.
I don't think people even got it wrong. They got it correct with the information available, and they for the most part got it right even in retrospect.
I did read a lot of evidence available at the time. It's why I opted to skip the vaccine for myself given that I had already recovered shortly before the shots were available. That decision was very at odds with authoritative guidance at the time. You'd think I was a damn leper, yet that decision seems to have held up pretty well.
I also frequently tested before any gatherings, and avoided contact when I had any kinds of symptoms, test or not. I saw plenty of people figure they had gotten the shots so why not go out with the sniffles?
"Best information" and what was blasted out of the TV or considered "common sense" at the time I think have quite a bit of daylight between them.
What gives you the idea that a low-risk person opting not to get the vaccine is "at odds with authoritative guidance?" Yes, I would bet that it made you feel like a leper, but that's because people (correctly) think that it signals something about your attitude toward the rest of society. Not sure that can be pinned on public health authorities. People who hold open the door to the cold are assholes and frequently treated as such.
Answer: no. Go get tested, and if positive, don't gather.
Yes, agreed that people were listening primarily to a game of telephone and vibes and not actually reading any of the linked PDFs or listening to the actual words spoken by actual public health officials firsthand, and then they (like you are now) were confused about what the actual guidance said.
I misspoke, right at rollout when supplies were short, they did say you could wait. Once they had enough to sell, everyone who didn't jump in line was a grandma killer.
> Yes, I would bet that it made you feel like a leper, but that's because people (correctly) think that it signals something about your attitude toward the rest of society. ... People who hold open the door to the cold are assholes and frequently treated as such.
This is asinine. There was never any indication in the data that a previously recovered person posed any kind of heightened threat to anyone else, and by testing and isolating like I was, I was doing likely the best you could possibly do for the folks around me.
Also, I made the choice with my doctor's agreement.
> by testing and isolating like I was, I was doing likely the best you could possibly do for the folks around me.
Short of vaccination yes, you were. But also people have no way to actually trust anything you say, whereas even saying that you aren't vaccinated (again, correctly) indicates quite a lot about some combination of your information, selfishness, or care for others.
For example, if you had gone around thinking or saying "I'm not vaccinated because prior infection protections me (and therefore you)" you would have been wrong. That's why people's alarm bells go off when you go around saying that you're not vaccinated.
This entire conversation is a validation of their heuristics. You're acting like public health authorities said X and then they didn't, or acting like there's no evidence of Y when there is, and then saying "see I didn't get vaccinated!" is exactly what everyone was cuing into: this is almost certainly either a confused or selfish person, or both.
You might consider reading the actual Kentucky study (as I did at the time) and looking at the limitations. This and the one in October are exactly the kind of shit that would get published and then reports like your link would way overstate what they were actually capable of showing.
Eventually things calmed down enough that studies could actually be published showing the efficacy of a prior infection without risking careers.
You're misunderstanding btw, I didn't go around telling anyone but my closest friends and family. I wasnt about to out myself as a heretic when the likely biggest propaganda campaign in history was going on (pandemic of the unvaccinated, etc). It was mostly in hn threads on studies like the ones you posted where I would say anything about it.
And yes, all studies have limitations, especially observational studies done in the middle of an emergency.
Here's your claim: "There was never any indication in the data that a previously recovered person posed any kind of heightened threat to anyone else"
That is quite obviously false.
If you believe there was superior data available at the time, please share it. Otherwise, yes that is exactly what the data showed (imperfect as all data is).
> Eventually things calmed down enough that studies could actually be published showing the efficacy of a prior infection without risking careers.
Like which studies? (Not that more recent studies could've possibly time-traveled to inform your decision-making in the past, of course).
A reasonable prior (which my doctor ascribed to) was that immunity after recovery from an infection with a coronavirus would be pretty durable and effective, and you can find plenty of reporting to support the effectiveness early on.
To believe otherwise would take some solid evidence, and maybe the Kentucky study is enough to convince you, but it was not enough to convince me (or apparently my doctor, though we didn't talk about that).
It even said this: Finally, this is a retrospective study design using data from a single state during a 2-month period; therefore, these findings cannot be used to infer causation.
So maybe "any indication" was too strong. How about any convincing indication?
There were others as well, I was following this very closely because it seemed pretty important to not be wrong, and all of the messaging was very insistent.
The study you linked is evidence that prior infection reduces the rate of reinfection. Yes, this would be surprising if it were not true.
Your prior claim was that prior infection is equivalent to or superior to vaccination (i.e. relying on prior infection was not "heightened risk"). That was, and remains, completely false.
"Conclusions: Naturally acquired immunity confers stronger protection against infection and symptomatic disease caused by the Delta variant of SARS-CoV-2, compared to the BNT162b2 2-dose vaccine-indued immunity."
During May–November 2021, case and hospitalization rates were highest among persons who were unvaccinated without a previous diagnosis. Before Delta became the predominant variant in June, case rates were higher among persons who survived a previous infection than persons who were vaccinated alone. By early October, persons who survived a previous infection had lower case rates than persons who were vaccinated alone."
"That was, and remains, completely false."
Would you like to amend your claim? You might have an argument if you stick to "could have been false for short periods of time after people were freshly vaccinated", but otherwise that's pretty indefensible.
You are again misunderstanding the data and its relevance to what we're talking about.
The vaccine protection was not superior for a short period after vaccination. It was superior for the initial variant. We've already established the vaccines became much less effective at reducing transmission in subsequent waves. You've just shared an article that says the Delta wave evaded vaccines for transmission. Yes, that's correct.
How on earth could the Delta variant's evasion have informed your decision not to get vaccinated?
By my "that was and remains false", I am saying it was not only apparently false at the time, but it has been confirmed to be actually false retrospectively as well.
OK, so I think I understand your position now: I made a single decision early on in the pandemic that I wasn't going to get vaccinated, and somehow your links from late 2021 (ie weak evidence that didn't even exist when I was deciding) were sufficient evidence that my one decision was obviously and completely wrong.
In reality, it was a continuous decision: does the totality of evidence coming out suggest I should go get the shots today? And it never definitvely got to that point, and over time the decision became better supported, not less.
You seem to understand the evidence differently. I'll grant you that maybe at some point early on I could have bought a couple months where I would have had a marginally lower chance of infection. This would have had no appreciable effect on the people around me in the grocery store. We'll have to agree to disagree otherwise.
I don’t disagree with your assessment of your individual contribution to overall risk.
The problem is that if everyone decided the same way, then it absolutely would have produced a gigantic difference.
So we’re back to the fundamental point of this being a (true) indicator of someone’s selfishness or attitude toward their neighbors.
Me individually choosing to dump my trash into the local drinking reservoir doesn’t have any appreciable effect on others. There’s a reason, nonetheless, that it’s frowned upon.
Ah, one of those "everybody knows" argument that is on the level of "everybody knows that Napoleon was short".
It's not completely wrong but it ignores important context. The part you are leaving unsaid is that the vaccine reduced transmission even if it didn't prevent it completely. 80% reduction is a significant amount.
Wearing masks on top of that was the sensible thing to do.
More groundbreaking research funded by the NIH. It's sad to think about how much the US is going to lose with the arbitrary slashing and burning and purging.
Most research that is pointed towards important things does get funding from NIH. Most research fails. NIH has a bucket of money for every major issue facing the population. Just takes a few PhD's and a hypothesis to write a proposal.
So long as the research has a conclusion, it's not a failure. We learned something. There may be something to be said for whether or not the research is a worthy topic, but that's a different conversation.
Without some research the current President would probably not be healthy enough to be in office, clearly we have to reduce the risk of that happening again.
Failure in big companies is very common too. They lead to reorganisation, retries and new ways of working.
Why is it accepted in the private sector, but not in the public sector?
The most frustrating thing is they all get away with endless daily lies and just move onto the next subject, NIH might never recover, certainly not this decade.
> Hours after Musk asserted that USAID had restored its Ebola prevention efforts, the agency informed several organizations working with the U.S. government to prevent the spread of the virus overseas that their contracts had been terminated
> organizations — which included UNICEF, which had been working with USAID on Ebola prevention in Uganda and other countries — were among thousands of organizations affected by the Trump administration’s move to cancel foreign-assistance contracts
The American consumer gets a treatment that didn't exist yesterday and whose IP will be free in ~15 years for their tax dollars. A pretty reasonable give and take on the face of it.
(Not that polices to reduce the cost to Americans, especially relative to foreign markets, ought to be unpopular)
> Other countries also get access at 1/3 the price.
1) Many other countries don't have the ass backwards healthcare system that we have
2) Then there are the poorer countries. It turns out that things like providing them cheap food & medicine manages to a) provide a source of soft power & influence in the world, and b) helps us by helping them by limiting the spread of various diseases and maladies
It's all well and good to suggest that each program receiving funding gets a thorough review. Of course, that review needs to be by experts, to ensure it gets a fair shake. Who are the experts in the field? The odds that you can be an expert in the field (by publication count, let's say) without having already been funded by the NIH is pretty slim. So now your experts are also insiders.
That's going to be a big problem as very few insiders are going to be willing to rock the boat. Even if it's necessary.
Maybe you've got a good idea of how to solve this "good review requires experts, experts are very likely insiders, insiders are unlikely to rock the boat" problem. It would be wonderful if there was some solution, even if it was hard.
> Maybe you've got a good idea of how to solve this "good review requires experts, experts are very likely insiders, insiders are unlikely to rock the boat" problem.
You're the one who has identified this as a problem, shouldn't you be the one to suggest an alternative?
The alternative being implemented is that insiders could not police themselves, so outsiders are doing it for them with far less precision.
It’s like a hoarders show where everyone is shocked (SHOCKED!) that things had gotten as bad as it is, the hoarder has lost the capability to determine what is valuable or necessary, so a third party with no attachment or sentiment comes in to clean house and throws out the good with the bad.
Couldn't at least part of the reviewing be done by foreign experts?
Having said that, this smells witch-hunty to me. The US can boast decades of excellence in medical and biological sciences, which in turn generates a massive windfall. Completely upending the architecture behind this dominance on the suspicion that a few hundred million bucks are less-than-optimally spent is a hell of a gambit, and even ignores all the higher-order effects that even that "spare change" bring about.
You've made at least 2-3 personal attacks against me while seemingly not even trying to address the problem that I highlighted. If that's your goal, OK. It definitely goes against the spirit of the rules here if not the letter.
Delaying the flu vaccine? Ok that's bad, sure.
It's also a real goalpost move and also doesn't address the technical problem "insiders going to inside" I raised in answer to the parent's paraphrased "I can't understand this, why is this necessary?"
I don't know that doing things this way is strictly necessary. But I also don't think it's reasonable to just hand-wave away or worse completely fail to even acknowledge much less actually address the insiders problem.
Q> Can you explain why the sledge hammer approach, removing funding for things wholesale and causing large amounts of destruction (both economic and health) is reasonable?
And your answer was
A> It looks like there is a problem with the current system, and changing something would be beneficial.
And, while I agree that the sentiment ("changing something would be beneficial") is fair... as an answer it falls squarely into "We should do something, this is something, so we should do this", which is categorically ridiculous. The way to approach these types of issues, where changing things can (and does) have real, significant impact on lots of people, is to come up with a plan and discuss what the impacts/tradeoffs are. It is _not_ to just do the first thing that comes to mind and then ignore the people who's lives your destroying.
We spend a large portion of the federal budget on human death prevention. It sounds like hyperbole, but anyone dying from administrative changes is literally “world ending” for them.
If a plan to cut bureaucracy was somehow analyzed to find that we could save 5% of the US budget in exchange for 10,000 lives, reasonable people might consider otherwise. To take these changes against life-saving organizations without first analysis of consequences is pretty reckless.
> But I also don't think it's reasonable to just hand-wave away or worse completely fail to even acknowledge much less actually address the insiders problem.
ok but burning down a house with a family in it because of a hypothetical burglar usually isn't a good solution.
It's simple, really. Make it so the experts have 0 leverage. Maybe have "the workers" make all the decisions! ??? Profit? :-) They tried this in Soviet Union...
I'm sure you have direct economic interests. Odds are good someone in your circle is type 1 diabetic, and helping that person will indirectly help you.
I was referring to the election of Trump and the people he's appointed. Everything was rotting from the inside out and infested, and like with everything that is rotted/rusting, you will have to carve it all out to clean it, and sometimes you unfortunately take out legitimate and healthy things.
Again, back to my original point. We've been "trying" this "surgical" approach for decades, and a lot of people believe that it wasn't working with things getting objectively and subjectively worse. Why? I'd argue it's because people's concerns and sincere requests for debate or voicing of their concerns has been met with derision, dismissal, gaslighting and downright cancellation. I'm not trying to debate it here, but my overall point is that people's concerns, criticisms and request for genuine debate have not been listened to, and now the pendulum has arguably swung way too far in response. Perhaps next time around we won't be so dismissive and hostile, and actually meet in the middle.
As a personal aside, the scientific/medical community (overlapping heavily with NIH) has not been able to 'surgically' prevent the advent of crazy child-mutilation and sterilization in the supposedly-enlightened West, so how do you expect average people that disagree with it to try approach it with civility? We've reached absolute peak madness, so of course debate and "surgical" type approaches are out of the window at this point. We must do better next time around.
Ah yes. Trying to have a civil and productive conversation with people who insist we're at "absolute peak madness" of "crazy child-mutilation".
Those aren't sincere people; they're living in an alternate reality warped by propaganda.
Of course I realize this is a deliberately created wedge issue precisely so those folks can claim the burden is on the rest of us to engage properly. And when we're exhausted by debunking bullshit they can claim we're being elitist and dismissive. Brilliant strategy that's taken our country to an illustrious and proud moment...
I could just as well argue that your explanation of this is also a "brilliant strategy" to dismiss any potentially valid concerns the other side may have.
If we can't even get this dynamic right, and both sides have convoluted and elaborate ways to dismiss the other, then surely we can all agree that there will absolutely never be any reconciliation or meeting of the minds of the two groups? Leaving only forced indoctrination, silencing of opinions and plain separation of the two groups into physically different governments/countries.
The important thing is that these things get funded. It doesn't matter what institute funds them. If an institute becomes stultified and corrupt, there's no reason to champion it over creating another.
That's true, but I have lots of experience with the NIH, and haven't found it stultified nor corrupted. In fact, did you hear they recently funded a project that reversed type 1 diabetes?
Besides what others have said, the government is immune from many of the multi-agent coordination problems that trap other types of entities. It's basically the essential reason we have government at all.
So no, not all things government does can be replaced by the private sector, for reasons of game theory.
Slashing is not permanent. It is important to slash in order to determine a middle ground. If a company fires 100 employees and certain operations stop functioning, they may hire back 10 employees and reassess. If operations are still not functional enough, they will hire 10 more. This process continues until everything is operational again. The result is a company that functions just as effectively as before but with fewer employees. This is an optimization of resources and efficiency.
>It is important to slash in order to determine a middle ground
That's not true.
> If a company fires 100 employees and certain operations stop functioning, they may hire back 10 employees and reassess
How likely is it that 10 employees come back? How likely is it that critical institutional knowledge is lost forever?
> The result is a company that functions just as effectively as before but with fewer employees
Does it? Have you ever been through a reorg or restructuring at work? Do things ever get back to just as effective as before any time soon?
> This is an optimization of resources and efficiency
It's squandering human capitol, knowledge and reduced efficiency both in the short term and long term. It's the most expensive way to reduce your overhead. A far cry from optimization.
> How likely is it that critical institutional knowledge is lost forever?
In the digital age, almost impossible. Documentation, process automation, and knowledge transfer mitigate this risk.
> Does it? Have you ever been through a reorg or restructuring at work? Do things ever get back to just as effective as before any time soon?
Yes, I've been through many re-orgs at AWS. If done right, things get better fairly quickly (3-6 months).
> It's squandering human capital, knowledge, and reduced efficiency both in the short term and long term. It's the most expensive way to reduce your overhead. A far cry from optimization.
Not necessarily. The short-term pain of restructuring can lead to long-term efficiency gains. Organizations that fail to optimize end up bloated and sluggish, which is far more costly in the long run. Smart cuts, when combined with proper reallocation of resources, create a more effective organization.
> In the digital age, almost impossible. Documentation, process automation, and knowledge transfer mitigate this risk.
Nobody is so thorough at documenting that their job is 100% documented and the documentation is fully up to date.
You think Jim, who's been training the new hires on the factory floor for a decade, who knows all the tricks to making this fit together at wiget factory even when the process instructions are vague, has documented everything?
Could document everything?
Just be cause digital records are present doesn't mean they're complete, up to date or accurate.
Institutional knowledge is a thing, and it's very valuable. You can't wave it away and say we're in a digital age.
> You think Jim, who's been training the new hires on the factory floor for a decade, who knows all the tricks to making this fit together at wiget factory even when the process instructions are vague, has documented everything?
No, I don't think so. That's why the lay-offs predominantly target probationary employees.
Correct. The majority are not promoted. If they are in the first year of their current level/role and have previous experience, they still haven't accumulated much institutional knowledge to make them indispensable. While experience helps, their impact in a new role is still developing, and their departure is less likely to disrupt operations significantly.
Your last sentence undermines the point in this case. What Musk and Trump are doing are hardly "smart cuts". They couldn't possibly be, with how quickly executed. They are a sledgehammer.
It hasn't been limited to probationary employees. Here's one example: https://www.science.org/content/article/nih-ban-renewing-sen...
Agencies have also been directed to make plans for "significant reductions". For example, EPA plans to cut 65%. Fish and Wildlife and the Bureau of Indian Affairs are preparing for up to 40%. These latter cuts haven't happened yet, but they're very likely.
That's correct. It hasn't been limited to probationary employees only, but many are. Those who are not either aren't needed or will be rehired if operations cannot continue without them.
It's not just about the literal employee contracts. Telling all USAID workers to cease operations and come home within 30 days is still a "cut" even if they are still employed. Not hiring seasonal workers for national parks is a cut. Removing info from the CDC website is a cut. Cancelling the meeting on flu vaccines is a cut.
It's a very hamfisted deliberate disruption of all operations and services. Which, again, can hardly be called "targeted" by any metric.
> In the digital age, almost impossible. Documentation, process automation, and knowledge transfer mitigate this risk.
Are you sure you really work at AWS? Dude, how often do you realize the documentation is not sufficient and you have to dig through people's brain to actually get the nuances, that is, lucky enough they are still around? lolll
How the heck do you apply this process to fundamental research? It's pretty much always the case that with basic research you could have cut 95% of studies after the fact and it wouldn't have made much difference in the end.
The problem is you don't know which 95% of studies beforehand.
Neither companies nor governments fire 100% of their personnel unless a division is no longer needed. Governments, especially, have safeguards to ensure essential functions continue, so they don't simply stop functioning all of a sudden. From a bird's-eye view, a government is not much different from a company. They both allocate resources, manage personnel and strive for efficiency.
