non vaccinated job applicants

[Mass Effect]

Screening for TB is similar to screening for covid (either by questionnaire or laboratory tests), and is an entirely different type of liberty restriction, and an entirely different concept, than forced vaccinations

That's fair, but that's not what I said. I'm referring to forced TB treatment. Are you against that?

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[VA Hopeful Dr]

The vaccines definitely have risks.... I had a month of inflammatory arthritis in my feet and ankles after my Pfizer booster. I was limping for a while. Fortunately I recovered

Of course the vaccine has risks, I don't believe anyone is saying otherwise.

But, everything I've been reading for the last year is saying that the risks of covid are significantly higher.

For example, we all remember the blood clot issue around the Johnson & Johnson vaccine back in the spring. It turns out that having covid puts you at approximately 20 times greater risk of that specific kind of blood clot than the vaccine does.

 

[Dr G Oogle]

I'd be happy if it did start and end there, full stop.

Or really, anyone who wants to call themselves "doctor of something meant to treat people" (so many doctors of basketweaving get a pass on basketweaving here) can be held to the same malpractice standards and being sued. It's been shown when people become financially responsible for their bad advice, their advice tends to improve, lol. This is why contractors are responsible for their work, engineers, attorneys, and on and on.

If there was good evidence for the covid vaccine significantly reducing transmission, I would be ok with states (who constitutionally regulate public health/infectious disease) requiring it for certain people, especially doctors

There is great evidence that covid vaccines are great at decreasing Illness severity, hospitalizations and death. People who are vaccinated or who have previously been exposed to an infectious disease can still be carriers and transmitters.

No one is forcing you to get the vaccine, there is plenty of work at places that don’t require or enforce mandates. There are also places in the world which do not have vaccine mandates. Italy has passes for the vaccinated and people who test negative, if you are found without a pass you’re fined a nominal fee. Singapore is sticking the unvaccinated with the hospital bill.

Illinois has proposed doing the same as Singapore. Frankly, I’d be quite surprised (but not really) that people who are opposed vaccine mandates should be all about the public not footing the bill for other people’s personal choices. Many unvaccinated go to ICU this causes high insurance payouts, insurance then raises premiums for everyone including the vaccinated, increased ICU and hospital bed utilization by the unvaccinated leads to staff and resource utilization which means fewer beds, staff and resources for others with serious illnesses. Since denying care by vaccination status is unethical, there has to be some equity, after all the vaccinated are taking a risk with the vaccine since it’s “unknown” and many cite the reason for doing this as protecting others and hoping to minimize the impact of the pandemic, thus making a sacrifice, there must be some sacrifice on the unvaccinated part. And the only fair thing to do is To make sure that the unvaccinated do not cause an undue burden on society, I.e. they can pay for the resources which they use due to issues resulting directly from them not being vaccinated.

 

[VA Hopeful Dr]

There is great evidence that covid vaccines are great at decreasing Illness severity, hospitalizations and death. People who are vaccinated or who have previously been exposed to an infectious disease can still be carriers and transmitters.

No one is forcing you to get the vaccine, there is plenty of work at places that don’t require or enforce mandates. There are also places in the world which do not have vaccine mandates. Italy has passes for the vaccinated and people who test negative, if you are found without a pass you’re fined a nominal fee. Singapore is sticking the unvaccinated with the hospital bill.

Illinois has proposed doing the same as Singapore. Frankly, I’d be quite surprised (but not really) that people who are opposed vaccine mandates should be all about the public not footing the bill for other people’s personal choices. Many unvaccinated go to ICU this causes high insurance payouts, insurance then raises premiums for everyone including the vaccinated, increased ICU and hospital bed utilization by the unvaccinated leads to staff and resource utilization which means fewer beds, staff and resources for others with serious illnesses. Since denying care by vaccination status is unethical, there has to be some equity, after all the vaccinated are taking a risk with the vaccine since it’s “unknown” and many cite the reason for doing this as protecting others and hoping to minimize the impact of the pandemic, thus making a sacrifice, there must be some sacrifice on the unvaccinated part. And the only fair thing to do is To make sure that the unvaccinated do not cause an undue burden on society, I.e. they can pay for the resources which they use due to issues resulting directly from them not being vaccinated.

The problem with this is that no one can afford ICU-level bills, so the hospital will end up eating that cost. That's not an ideal fix. Maybe just a higher hospital co-pay/deductible. That way they feel the pain more but are still likely to pay it.

 

[Dr G Oogle]

Agree. I don’t know how Singapore does, it was a newspaper article and didn’t have time to look into further, but imagine Singapore has more affordable care. Maybe they can just get charged for the cost of care (what insurance would pay out rather than what is charged) and just get put on a payment plan. But I definitely think there
should be actions to deal with consequence of nonvaccination. Certainly don’t think it’s no more a burden than the burden the unvaccinated are putting on the hospital systems.

 

[Stagg737]

There are many reasons. The most obvious being that in order to implement that kind of thing, then every patient would have to know the vaccination status of their treating doc and I don't see hospitals doing that. I also don't know where you work, but where I work, you get the attending/team you get. If a team has 10 patients (and we're always full), then a patient requesting only a vaccinated attending would mean someone else on the other team then needs to be changed to the un-vaccinated attending which would lead to ethical issues, not to mention the hassle and extra work it causes everyone. And if the other two teams then have to take on anyone not wanting to be treated by an un-vaccinated attending, the two other teams' census could swell and that by itself would be reason enough the other attendings don't want to work with this individual.

All this could be circumvented by literally having a question on admit "Are you okay with being treated by non-vaccinated healthcare workers?" I realize that's a gross simplification, but would address most cases.

No, just sounds like more work for everyone else. In terms of current employees, I might agree. But why go through the trouble of hiring someone new just so you can put this policy in place with the goal of firing them if they can't carry an adequate patient load.

I was only speaking about current employees. There are cases of rural hospitals losing nearly half their staff d/t the mandates. Both our hospitals are Level I or II tertiary hospitals, and the drop in rural staffing has caused problems with both hospitals being able to accept patients.

That also isn't true. The deadline has occurred in many places and people have been terminated or placed on leave.


Yes, they are. There are many people flat-out protesting a vaccine.

There are still many places where the deadline was just implemented or has not yet been implemented, your point here isn't what I was saying at all. I was referring to people on this forum in regards to flat-out protesting the vaccine. Seems like everyone "against" it is (mostly) just pointed out potential arguments against it. I'd be pretty surprised if any of us weren't actually vaccinated or were actively protesting against them being utilized.

When does it stop being new? Can you give a deadline? Because we also don't have long-term data on Covid, but what we do know is that the vaccine is safer.

People will have different views on this. I was not ready to be vaccinated when initial testing was being done, but a few months after completion of Phase 3 when data was actually out I was fine with it. I absolutely would not have vaccinated my toddler before the emergence of Delta, but would still have advocated for anyone working in a hospital to be vaccinated.

That's fine. No one is saying they have to take the vaccine. But choices have consequences. Doctors who don't want to get the vaccine should find a private practice (or open their own) that respects that decision until you're satisfied with the data. But this trend of trying to force others to accept your (ill-informed) decisions and claiming it's your "right" to do this or that despite not following the rules is hogwash.

Agree, people have a right to do what they want with their bodies, but that doesn't mean society should bend to their individual decisions. Idk that I would ethically support a blanket mandate or law that would make non-vaccination for COVID illegal, but I certainly think healthcare employers or those who work with very high-risk populations (nursing homes, etc) should be able to mandate their employees be vaccinated to protect those at greatest risk.

Just as a side note, most of those arguments from my original post are NOT my views. I'm Pro-vaccination for pretty much all vaccines, I just don't think the dismissive or condescending attitude that many people (not you) display are more harmful than helpful.

 

[VA Hopeful Dr]

All this could be circumvented by literally having a question on admit "Are you okay with being treated by non-vaccinated healthcare workers?" I realize that's a gross simplification, but would address most cases.

OK, but what if all of the patients say no? Your vaccinated staff will be overwhelmed while the unvaccinated sit on their hands.

 

[ridethecliche]

Re: vaccine hesitancy, anti-vaxxers, anti-maskers etc.

With the huge amount of pushback by some over mask wearing by reframing it as an affront to freedom and liberty, are we actually surprised that most in that group are staunchly anti-EBM as well? At the end of the day, I can understand some of this with vaccination, but not with masks. If you look at it through that lens, it becomes obviously that 'liberty and freedom' are just used as placeholders for 'I wont do what you tell me because I dont feel like it and I dont care'.

IMHO, if it was actually about the vaccines, then those people would be more than willing to wear a mask, especially in lieu of vaccination.

 

[Stagg737]

The known risk of COVID-19 vs the unknown risk of the vaccine? How is the risk of COVID-19 really more known? You say phase 3 trials of the vaccine started 7/2020 -- how much earlier did similar quality trials start on COVID-19? In terms of long term effects, the virus and the vaccine are similarly new.

The facts in that situation don't matter, the perception does. Symptoms of COVID and the major effects are well advertised almost universally by pretty much any entity that provides information to the public. While the info on vaccines is readily available, that info is not nearly as prevalent to the general public nor is it sensationalized like the virus.

The argument they'll make is that trials aren't needed to know what COVID can do, because it's well documented and we saw hundreds and thousands of "case reports" since it became relevant. Meanwhile, more meaningful data for vaccines wasn't available until the end of 2020. Seeing as COVID became a story at the end of 2019, and available vaccine data wasn't available until a year later when we're only 2 years out from COVID starting, they won't be considered "similarly new" at all.

There's also the action vs. inaction side of the argument. Getting a vaccine means putting something into your body and acknowledging those risks. NOT being vaccinated allows the sense of denial and false security that a person won't get COVID and therefore won't experience the symptoms.

I'm not saying any other this is particularly accurate or logically sound, but these are the core of the arguments and thought processes I've seen in people who aren't pro-vaccine.

 

[Stagg737]

Well, the fact the flu shot is yearly hasn't stopped hospitals from requiring it of employees. And I believe the CDC has now come out saying that anyone with 2 shots not 3 now can be considered not fully vaccinated. I may be wrong on this, but apparently this is exactly where discussion is going.

As far as long term data, there is the fact that these vaccines have been used in livestock for at least 10 years (it might be 15). I get that it's only animal studies and so that's limited, but I think we also have to consider what information we have beyond just human studies in describing how "new" and unknown a treatment is. Because even for new treatments, the amount of data available will vary.

As for how people feel, it's also possible that the people doing hiring are talking to employees, and they don't have to say "Candidate B isn't vaccinated", they can just say "How do you feel about us hiring and working with an unvaxxed employee?" And that could not only lead to finding out it's unpopular, but it could lead to grumbling and more questioning of vax status amongst everyone if it becomes clear to people or suspected that the employer doesn't have a policy and so then there might be more scrutiny and speculation for anyone hired at this point, or hell, even amongst existing employees.

Hell, one of the bars/sex clubs around here instituted an "everyone must show proof of vax" policy they didn't have to, just so they wouldn't have to deal with the speculation and bitching. Of course they then deal with a different type of bitching, but that bitching and speculation isn't occurring amongst the bar patrons any given night.

I would hope it would be handled in a manner like this where opinions were obtained anonymously and that it would provide information regarding future hires (which is really was OP was talking about). The concern would be for those already employed and their privacy and revealing their information. Openly asking those questions could create a poor work environment depending on people's views and practices. For example, someone who does not get the vaccine d/t allergies or immunodeficiency should not be forced to reveal the medical reason they can't get the vaccine, but if they didn't they'd likely be heavily chastised by others.

I haven't seen any CDC statements or statements by other medical groups considering 2 vaccinations to not be fully vaccinated but would be interested if this info/policy exists.

OK, but what if all of the patients say no? Your vaccinated staff will be overwhelmed while the unvaccinated sit on their hands.

Then you now have justification for firing non-vaccinated staff as they are not providing essential services and the vaccinated staff require more resources to take care of their patient load. That was the point/endgame idea I was making.

 

[ridethecliche]

The other thing I want to point out is that there's a lot of distrust in the FDA at this point and that distrust is warranted. The approval of aducanumab should call a lot of things into question and IMHO should really make people wonder about some of the mechanisms at play.

It creates distrust in the same agency that fast tracks and approves a lot of COVID related things and I think it couldn't have come at a worse time.

I'm not saying this to be a contrarian... but we have to trust institutions to do the right thing and their misbehavior creates shockwaves and ripples even if the people responsible are different. It just makes things look shady and trust in public institutions is paramount at times like this. This kind of stupid crap erodes it.

 

[sloop]

Re: vaccine hesitancy, anti-vaxxers, anti-maskers etc.

With the huge amount of pushback by some over mask wearing by reframing it as an affront to freedom and liberty, are we actually surprised that most in that group are staunchly anti-EBM as well? At the end of the day, I can understand some of this with vaccination, but not with masks. If you look at it through that lens, it becomes obviously that 'liberty and freedom' are just used as placeholders for 'I wont do what you tell me because I dont feel like it and I dont care'.

IMHO, if it was actually about the vaccines, then those people would be more than willing to wear a mask, especially in lieu of vaccination.

I don’t know that people who question masking are anti-EBM. I don’t dispute that masking reduces transmissibility, but what exactly is the evidence for masking as a policy for an uncontainable virus that now has effective vaccines and treatments? Once we established that it reduced transmissibility, I think we had obvious arguments for masking policies when we still thought it might be possible to contain the virus, and when we were waiting to develop vaccines and therapeutics. We now have vaccines and therapeutics. What exactly is the end game here? It’s increasingly obvious that herd immunity is simply not going to happen, at least not in this country, especially with strains like delta. I think people are insane if they think that we’re all going to just tolerate masking all the time for eternity when there’s no obvious answer to when we might be able to stop.

I think that, if you’re going to advocate a policy like masking as a response to an emergency situation, you have to also have some clear criteria as to when you’re going to suspend that policy. Is it some magic number in terms of hospitalizations? Is it some magic level of vaccination? I think that part of the problem people have with the masking thing is that it’s not actually clear that it’s a means to a realistic end. To a lot of people, it just feels like this pandemic is being used to justify some sort of “new normal” where we all just mask all the time indefinitely. I don’t think that it’s unreasonable to want to be able to eventually go somewhere without a mask, not have one’s glasses fog up, not have a soggy mask full of condensation, etc.

I say this as someone who actually happens to mask whenever I’m indoors and not in my apartment, car, or office. I do it because it’s required in most places around here and people seem to freak out if you don’t. Doesn’t mean it’s not a dumb policy.

 

[birchswing]

I don’t know that people who question masking are anti-EBM. I don’t dispute that masking reduces transmissibility, but what exactly is the evidence for masking as a policy for an uncontainable virus that now has effective vaccines and treatments? Once we established that it reduced transmissibility, I think we had obvious arguments for masking policies when we still thought it might be possible to contain the virus, and when we were waiting to develop vaccines and therapeutics. We now have vaccines and therapeutics. What exactly is the end game here? It’s increasingly obvious that herd immunity is simply not going to happen, at least not in this country, especially with strains like delta. I think people are insane if they think that we’re all going to just tolerate masking all the time for eternity when there’s no obvious answer to when we might be able to stop.

I think that, if you’re going to advocate a policy like masking as a response to an emergency situation, you have to also have some clear criteria as to when you’re going to suspend that policy. Is it some magic number in terms of hospitalizations? Is it some magic level of vaccination? I think that part of the problem people have with the masking thing is that it’s not actually clear that it’s a means to a realistic end. To a lot of people, it just feels like this pandemic is being used to justify some sort of “new normal” where we all just mask all the time indefinitely. I don’t think that it’s unreasonable to want to be able to eventually go somewhere without a mask, not have one’s glasses fog up, not have a soggy mask full of condensation, etc.

I say this as someone who actually happens to mask whenever I’m indoors and not in my apartment, car, or office. I do it because it’s required in most places around here and people seem to freak out if you don’t. Doesn’t mean it’s not a dumb policy.

This is just one anecdote, but I haven't heard of breakouts at Apple Stores in general and this one happened to take place in Texas where masking is not required (I guess it is in other Apple stores?):

'I was symptomatic': Apple employees say store's Covid outbreak goes beyond managers

The store in Southlake has had 22 positive cases since Nov. 26, Black Friday.

www.nbcnews.com

22 employees are now sick--who were vaccinated. Some have lost smell—the cause of which is unknown but it certainly could be neurologically based. I don't know wants to take a chance with long Covid.

If you look at cultures where masking existed before the pandemic, it was always going to be for eternity for those cultures (or more practically speaking until you die). It's just like putting on a pair of glasses. A new way of life. Now it can be our culture--or maybe not, as a lot aren't taking hold of the idea. Frankly I don't see the big fuss about a mask. I mean having to wear an N95 for long periods, yes, I see the fuss. But some of the nicer "N95 equivalent" masks with the ear loops? I don't even notice it. I did masks every flu season before the pandemic. I wear eyeglasses. There are all sorts of annoyances in life we get used to. Well, again, some people get used to. I'd rather wear eyeglasses than risk having permanent eye pain from Lasik. Just like I'd rather wear a mask than deal with long Covid. I mean nothing about that is certain. The preventative effect is probably modest. But it's something.

 

[sloop]

This is just one anecdote, but I haven't heard of breakouts at Apple Stores in general and this one happened to take place in Texas where masking is not required (I guess it is in other Apple stores?):

'I was symptomatic': Apple employees say store's Covid outbreak goes beyond managers

The store in Southlake has had 22 positive cases since Nov. 26, Black Friday.

www.nbcnews.com

22 employees are now sick--who were vaccinated. Some have lost smell—the cause of which is unknown but it certainly could be neurologically based. I don't know wants to take a chance with long Covid.

If you look at cultures where masking existed before the pandemic, it was always going to be for eternity for those cultures (or more practically speaking until you die). It's just like putting on a pair of glasses. A new way of life. Now it can be our culture--or maybe not, as a lot aren't taking hold of the idea. Frankly I don't see the big fuss about a mask. I mean having to wear an N95 for long periods, yes, I see the fuss. But some of the nicer "N95 equivalent" masks with the ear loops? I don't even notice it. I did masks every flu season before the pandemic. I wear eyeglasses. There are all sorts of annoyances in life we get used to. Well, again, some people get used to. I'd rather wear eyeglasses than risk having permanent eye pain from Lasik. Just like I'd rather wear a mask than deal with long Covid. I mean nothing about that is certain. The preventative effect is probably modest. But it's something.

Of course there will always be people who get sick, even while vaccinated. As I said, this virus is not going away and that’s always going to happen. That’s not really the question. The question is when do you just let people make that decision for themselves? I don’t particularly like wearing a mask. I’m an American, not a Korean. I didn’t grow up with people around me wearing masks. I like being able to see people’s faces when I talk to them. I find masks uncomfortable. I don’t like that they fog up my glasses. I’d prefer not to wear one. I am willing to wear one as a temporary emergency measure, but I fundamentally reject the prospect of wearing one indefinitely. Other people may feel differently and voluntarily wear masks all the time even after this pandemic. That’s fine, but I’m not one of those people.

 

[VA Hopeful Dr]

Of course there will always be people who get sick, even while vaccinated. As I said, this virus is not going away and that’s always going to happen. That’s not really the question. The question is when do you just let people make that decision for themselves? I don’t particularly like wearing a mask. I’m an American, not a Korean. I didn’t grow up with people around me wearing masks. I like being able to see people’s faces when I talk to them. I find masks uncomfortable. I don’t like that they fog up my glasses. I’d prefer not to wear one. I am willing to wear one as a temporary emergency measure, but I fundamentally reject the prospect of wearing one indefinitely. Other people may feel differently and voluntarily wear masks all the time even after this pandemic. That’s fine, but I’m not one of those people.

When cases and hospitalizations are low.

 

[Crayola227]

When cases and hospitalizations are low.

Agreed. We cannot have the health system limping as it has been.

 

[birchswing]

Of course there will always be people who get sick, even while vaccinated. As I said, this virus is not going away and that’s always going to happen. That’s not really the question. The question is when do you just let people make that decision for themselves? I don’t particularly like wearing a mask. I’m an American, not a Korean. I didn’t grow up with people around me wearing masks. I like being able to see people’s faces when I talk to them. I find masks uncomfortable. I don’t like that they fog up my glasses. I’d prefer not to wear one. I am willing to wear one as a temporary emergency measure, but I fundamentally reject the prospect of wearing one indefinitely. Other people may feel differently and voluntarily wear masks all the time even after this pandemic. That’s fine, but I’m not one of those people.

I can understand that.

At any point time, we're all potentially exhaling this miasma. And while wearing a mask can protect you to some extent, obviously the people around you wearing a mask would protect you more. So in that way, I see it a bit like the second hand smoke situation—except that we're not choosing to be potential carriers of this or any other respiratory virus. The circumstances just worked out that way. With HIV, it worked out such that we didn't really have to be so interdependent. Generally speaking with HIV, people's choices only directly affected themselves. That's why I think more about smoking as analogous to this virus.

I know in my lifetime the cultural norms on smoking changed drastically, from segregating smokers in restaurants to banning them altogether.

But I doubt you'll have to worry about masking in perpetuity. It sounds like you are in an area where people take it seriously and you're following the rules. I live where no one ever really followed the rules to begin with, and the rules are now mostly gone. The majority across many countries and parties seems to be just tired and want to move on with life.

The way the winds are turning, if anything we're probably more likely to go back to smoking in restaurants than we are to ever having universal masking.

I saw a strange (to me) conversation earlier on in the pandemic on a Swedish forum I go to sometimes. I used to live in Sweden so I check in from time to time to see the goings ons. There was a person asking if others thought it would be OK if they wore a mask on the bus. They were worried about worrying others into thinking they were sick and wondering if they should just go along with what others were doing (not wearing masks), even though this person in particular thought it might be a good idea. That's kind of the Swedish way, to try to be the same as others no matter what it is. But the French on the other hand . . . they'll protest just about anything. And they are, with the restrictions. A lot of Europe is.

 

[ridethecliche]

Agreed. We cannot have the health system limping as it has been.

My issue with this is that it feels like it's almost by design. Like... Lean supply theory has been applied to a situation where it has no business being.

At the beginning of the pandemic, I was hopeful that this would change the Healthcare system for the better.

Yeah... Right.

 

[Old&InTheWay]

When cases and hospitalizations are low.

Case numbers matter less and less as severe illness becomes less common among the vaccinated. I think we should consider setting up COVID convalescent tents outside of hospitals where the voluntarily unvaccinated can ride out their illness while being tended by voluntarily unvaccinated volunteers (maybe the applicant OP is referencing would like a job there?). Would save hospital resources and perhaps nudge people toward vaccination.

 

[sloop]

When cases and hospitalizations are low.

And what is the number of hospitalizations that you deem low enough to end the mask mandates? What is the evidence base for why you picked that number?

 

[VA Hopeful Dr]

And what is the number of hospitalizations that you deem low enough to end the mask mandates? What is the evidence base for why you picked that number?

If only we had a large national group, something full of lots of epidemiologists who have spent years studying infectious diseases. Something whose mission involves controlling diseases.

Maybe they could work that out.

 

[birchswing]

I wrote out a long post that I am concerned would derail the thread on another topic I am more familiar with and consider myself to have some expertise in that relates to the CDC.

So I'll instead just raise the question: Does the CDC have epistemic validity?

(My answer based on the subject matter I am more familiar with is that on any particular subject, unless their claims are investigated, they don't have epistemic validity. For me to say they do would be to suffer Gell-Mann amnesia.)

It might also be of interest for people to know the CDC receives very substantial non-governmental funding from Bloomberg, the Bill and Melinda Gates Foundation, and the CDC Foundation which is an umbrella fundraising organization. One of those organizations in particular has had a large, undue influence on the CDC.

It is not strictly a governmental organization, which is unfortunate. Many other countries, like the UK, can point to an organization like NHS as both a purely public good.

I am less academically knowledgable about COVID than this other subject, but just based on reading the news:

With COVID, they discouraged masking later claiming it was better to lie to the public than use complicated messaging regarding the scarcity of resources. But they also failed to acknowledge the airborne nature of COVID when that was much better understood in Asian countries early on.

Then they told Americans not to mask if they were vaccinated.

Then they came out with some convoluted plan about which counties needed to mask based on infectivity rates that basically meant virtually all of the country *should* be using masks, but which left wiggle room for people to give up on it. To this day, they only advise masking if you are in an area of "high or substantial risk." Are people supposed to check a map each day to know? Does the CDC even know which areas of the country are at high or substantial risk? Their main efforts to far have been retrospective, not at assessing future risk, which is important because right now you really don't know wha the local risk is until the numbers go upward. So their advice is to look at a map of what has happened rather than what is happening because they just don't know. All the data by definition is old. I'm not expecting them to have an oracle, but they could have just scrapped the advice and told everyone to wear a mask because their advice applied to practically everyone anyway.

I do think people should continue to wear masks indoors, but I don't think appealing to the CDC is the best, especially when it comes to masks, where their advice has been terrible.

Edit: Not sure if anyone remembers, but there was a graph from their forecasts web-page going around when Delta was first ramping up where they took every forecast available and they combined all the forecasts and it was just all over the place, and it was sort of being lambasted and looked at quizzically by a lot of epidemiologists—mainly because the CDC wasn't even attempting to do any forecasting of their own. From cases going lower to apocalyptic levels. I just checked their site and their forecasts are still based on other sources (they don't do their own estimates) and are still basically useless with a variation of 500k cases, and they concede:

"Ensemble forecasts combine diverse independent team forecasts into one forecast. They have been among the most reliable forecasts in performance over time, but even the ensemble forecasts do not reliably predict rapid changes in the trends of reported cases, hospitalizations, and deaths. They should not be relied upon for making decisions about the possibility or timing of rapid changes in trends.
More reported cases than expected have fallen outside the forecast prediction intervals for 3- and 4-week ahead case forecasts. Case forecasts at those horizons and assessments of likely increases or decreases will not be shown until sustained improvements in performance are observed.
This week’s national ensemble predicts 540,000 to 1,070,000 new cases are likely to be reported in the week ending December 18, 2021."

And remember their mask guidance is contingent on infectivity rates by county—yet their own estimates vary by 500k cases.

Coronavirus Disease 2019 (COVID-19)

CDC provides credible COVID-19 health information to the U.S.

www.cdc.gov

How can they tell people to wear masks based on the risk in their area when they can't predict the risk?

It's such a stupid position, especially given that their advice (at least at the time they first gave it) applied to virtually every county in the US. They should have just made a blanket policy.

 

[VA Hopeful Dr]

I wrote out a long post that I am concerned would derail the thread on another topic I am more familiar with and consider myself to have some expertise in that relates to the CDC.

So I'll instead just raise the question: Does the CDC have epistemic validity?

(My answer based on the subject matter I am more familiar with is that on any particular subject, unless their claims are investigated, they don't have epistemic validity. For me to say they do would be to suffer Gell-Mann amnesia.)

It might also be of interest for people to know the CDC receives very substantial non-governmental funding from Bloomberg, the Bill and Melinda Gates Foundation, and the CDC Foundation which is an umbrella fundraising organization. One of those organizations in particular has had a large, undue influence on the CDC.

It is not strictly a governmental organization, which is unfortunate. Many other countries, like the UK, can point to an organization like NHS as both a purely public good.

I am less academically knowledgable about COVID than this other subject, but just based on reading the news:

With COVID, they discouraged masking later claiming it was better to lie to the public than use complicated messaging regarding the scarcity of resources. But they also failed to acknowledge the airborne nature of COVID when that was much better understood in Asian countries early on.

Then they told Americans not to mask if they were vaccinated.

Then they came out with some convoluted plan about which counties needed to mask based on infectivity rates that basically meant virtually all of the country *should* be using masks, but which left wiggle room for people to give up on it. To this day, they only advise masking if you are in an area of "high or substantial risk." Are people supposed to check a map each day to know? Does the CDC even know which areas of the country are at high or substantial risk? Their main efforts to far have been retrospective, not at assessing future risk, which is important because right now you really don't know wha the local risk is until the numbers go upward. So their advice is to look at a map of what has happened rather than what is happening because they just don't know. All the data by definition is old. I'm not expecting them to have an oracle, but they could have just scrapped the advice and told everyone to wear a mask because their advice applied to practically everyone anyway.

I do think people should continue to wear masks indoors, but I don't think appealing to the CDC is the best, especially when it comes to masks, where their advice has been terrible.

Seems pretty straight forward to me: COVID-19 and Your Health

And yes, you should check the map routinely. Or if you're feeling lazy, basically if the rolling 7-day percent positive is less than 5% that's considered not high or substantial risk.

Or if you don't trust the CDC, you can look up the NHS guidelines if you'd rather: Face coverings: when to wear one, exemptions, and how to make your own

 

[sloop]

If only we had a large national group, something full of lots of epidemiologists who have spent years studying infectious diseases. Something whose mission involves controlling diseases.

Maybe they could work that out.

Have they given guidance stating the number of hospitalizations at which we should discontinue mask mandates? And what is that threshold based on?

The point is that even the experts here don't have a solid justification for why they make many of the decisions they make, and that has been a major problem throughout this pandemic. Initially, the CDC would not even acknowledge that masking reduced transmission when the evidence for that was already fairly convincing. At one point, they said that vaccinated people didn't need to mask in public. They then walked this back as soon as cases started to rise. There is disagreement among experts about this question. Some are saying that we should consider relaxing mask restrictions after the holidays. Some are saying that we should do it when more children are vaccinated, but can't give percentages of child vaccination that would prompt this move.

My point is that there is really no strong evidence base when it comes to this policy decision. There is an evidence base for masking reducing transmission, yes, but that is different than an evidence base for a decision to end mask mandates. At the end of the day, the "expert opinion" is still just a gestalt assessment or hunch. Which is fine, but you can't take a hard line position on being "team EBM" and not acknowledge that, at the end of the day, these decisions are just based on somewhat arbitrary judgments of public officials. Given that, I think that it's pretty understandable that many Americans see these policies as arbitrary decisions of overreaching governments, rather than practical public health decisions based on "The Science."

 

[VA Hopeful Dr]

Have they given guidance stating the number of hospitalizations at which we should discontinue mask mandates? And what is that threshold based on?

The point is that even the experts here don't have a solid justification for why they make many of the decisions they make, and that has been a major problem throughout this pandemic. Initially, the CDC would not even acknowledge that masking reduced transmission when the evidence for that was already fairly convincing. At one point, they said that vaccinated people didn't need to mask in public. They then walked this back as soon as cases started to rise. There is disagreement among experts about this question. Some are saying that we should consider relaxing mask restrictions after the holidays. Some are saying that we should do it when more children are vaccinated, but can't give percentages of child vaccination that would prompt this move.

My point is that there is really no strong evidence base when it comes to this policy decision. There is an evidence base for masking reducing transmission, yes, but that is different than an evidence base for a decision to end mask mandates. At the end of the day, the "expert opinion" is still just a gestalt assessment or hunch. Which is fine, but you can't take a hard line position on being "team EBM" and not acknowledge that, at the end of the day, these decisions are just based on somewhat arbitrary judgments of public officials. Given that, I think that it's pretty understandable that many Americans see these policies as arbitrary decisions of overreaching governments, rather than practical public health decisions based on "The Science."

Actually "team EBM" would have us mask in indoor public places for the rest of time if the goal is to prevent infectious disease spread. Masks work at preventing respiratory infections and have essentially no risks so the risk/benefit leans heavily towards benefit.

You're right that the data for ending masks just isn't there so you use what data you do have and make a guess that seeks to balance risks of not wearing masks. I'd personally be fine trusting expert opinion on this is the alternative is endless masking.

 

[sloop]

Actually "team EBM" would have us mask in indoor public places for the rest of time if the goal is to prevent infectious disease spread. Masks work at preventing respiratory infections and have essentially no risks so the risk/benefit leans heavily towards benefit.

That's not actually what the evidence shows, though. This is a political value judgment. Many people don't like wearing masks, therefore there actually is detriment. Your dismissal of that detriment and summary judgment that the calculus leans heavily toward benefit is based on your a priori moral assumptions and your political lens. It is not actually based on science or medicine.

You're right that the data for ending masks just isn't there so you use what data you do have and make a guess that seeks to balance risks of not wearing masks. I'd personally be fine trusting expert opinion on this is the alternative is endless masking.

The alternative is not endless masking. Endless masking would almost certainly fail a serious First Amendment challenge. This temporary emergency situation is different, but the more this becomes about routine prevention of pervasive respiratory viruses, the less likely that it would be able to survive a strict scrutiny standard. This is also why we don't solely base policy on science. Science cannot answer the types of interest-balancing questions that are needed for policy.

Legally and socially, we have certain baseline assumptions that include the principle that people generally are entitled to be free from restrictions on their individual autonomy. This is especially true when you get to issues of dress and expression. If you're going impose something in this domain, you generally have to narrowly tailor the restriction to achieve a compelling state interest. In the context of this pandemic, I think that this has to involve some non-arbitrary criteria for when the public health circumstances no longer constitute a "compelling governmental interest" in relation to these restrictions. I don't consider "we're not sure how long we will need these restrictions, but we'll know it when we see it," to be narrowly tailored enough to justify these types of restrictions for much longer.

 

[birchswing]

Seems pretty straight forward to me: COVID-19 and Your Health

And yes, you should check the map routinely. Or if you're feeling lazy, basically if the rolling 7-day percent positive is less than 5% that's considered not high or substantial risk.

Or if you don't trust the CDC, you can look up the NHS guidelines if you'd rather: Face coverings: when to wear one, exemptions, and how to make your own

The point is by their own standards virtually everyone in the country should be doing indoor masking, and by their own admission even in the areas where there is currently an arbitrary cut-off at which vaccinated people don't need to mask they can't predict the future. Right now most of Florida doesn't meet the threshold for indoor masking if you're vaccinated. But that could very rapidly change, and when it changes the map will show what happened—it won't have shown anyone it was going to happen.

All of this has given more cover for people to abdicate masking. Where I live we have no mask mandates for public schools, and yet in my city we've had positivity rates up to 20% at times with business as usual at the local schools.

I'm not saying the CDC could have stopped that, but the policy on whether to use a mask or not based on the percentages (which seems fairly arbitrary and which most of the time applied to almost the entire country) just gave more cover for not masking. They picked a complicated solution that does not seem based on anything particularly concrete at a time when many people were ignoring masking anyway. I think this was cover for them to send out a malleable message that could be in alignment with whatever the political message of the day was.

 

[Bartelby]

Honestly I agree that masking (for those without symptoms) needs to come to an end at some point, and for areas with relatively low transmission that time might be now. Most anti-mask people though have fought it all along, even when it was clearly important to save lives (no or low vaccination rates, overwhelmed health systems, etc). It's not something that has just become an issue.

Also I have noticed some people in this thread framing it as "half the country" being opposed to the vaccine. Currently 82 percent of people 12 and up have had at least one shot, and over 99 percent of people over 65 have had at least one shot according to the NYT. The over 65 are especially vulnerable and have a very good reason to get the shot, much like many of us who work with vulnerable people and thus should have a strong motivation to get the shot. Refusing the vaccine, especially as a healthcare provider, puts you into a pretty small minority.

 

[VA Hopeful Dr]

That's not actually what the evidence shows, though. This is a political value judgment. Many people don't like wearing masks, therefore there actually is detriment. Your dismissal of that detriment and summary judgment that the calculus leans heavily toward benefit is based on your a priori moral assumptions and your political lens. It is not actually based on science or medicine.

The alternative is not endless masking. Endless masking would almost certainly fail a serious First Amendment challenge. This temporary emergency situation is different, but the more this becomes about routine prevention of pervasive respiratory viruses, the less likely that it would be able to survive a strict scrutiny standard. This is also why we don't solely base policy on science. Science cannot answer the types of interest-balancing questions that are needed for policy.

Legally and socially, we have certain baseline assumptions that include the principle that people generally are entitled to be free from restrictions on their individual autonomy. This is especially true when you get to issues of dress and expression. If you're going impose something in this domain, you generally have to narrowly tailor the restriction to achieve a compelling state interest. In the context of this pandemic, I think that this has to involve some non-arbitrary criteria for when the public health circumstances no longer constitute a "compelling governmental interest" in relation to these restrictions. I don't consider "we're not sure how long we will need these restrictions, but we'll know it when we see it," to be narrowly tailored enough to justify these types of restrictions for much longer.

Actually that's exactly what the evidence shows. Indoor masking reduces transmission of respiratory pathogens. Hard stop.

"Not liking wearing masks" isn't a risk. I don't "like" taking my cholesterol medication but that doesn't factor into the risk/benefit equation. I don't "like" using hand sanitizer 60+ times per day either but my dislike doesn't factor into it.

Believe it or not I'm actually fairly conservative so not sure my political lens really factors in here.

Not sure what masking has to do with the first amendment, especially as I didn't mention anything about government in all of this. But since you brought it up its no different than the existing laws about having to wear clothes in public unless you believe those also violate the first amendment somehow.

 

[VA Hopeful Dr]

Honestly I agree that masking (for those without symptoms) needs to come to an end at some point, and for areas with relatively low transmission that time might be now. Most anti-mask people though have fought it all along, even when it was clearly important to save lives (no or low vaccination rates, overwhelmed health systems, etc). It's not something that has just become an issue.

Also I have noticed some people in this thread framing it as "half the country" being opposed to the vaccine. Currently 82 percent of people 12 and up have had at least one shot, and over 99 percent of people over 65 have had at least one shot according to the NYT. The over 65 are especially vulnerable and have a very good reason to get the shot, much like many of us who work with vulnerable people and thus should have a strong motivation to get the shot. Refusing the vaccine, especially as a healthcare provider, puts you into a pretty small minority.

I will say that while that's the country as a whole there is HUGE variability. My county is under 50% of eligible people have received 1 dose.

 

[Dr G Oogle]

don’t know that people who question masking are anti-EBM. I don’t dispute that masking reduces transmissibility, but what exactly is the evidence for masking as a policy for an uncontainable virus that now has effective vaccines and treatments? Once we established that it reduced transmissibility, I think we had obvious arguments for masking policies when we still thought it might be possible to contain the virus, and when we were waiting to develop vaccines and therapeutics. We now have vaccines and therapeutics. What exactly is the end game here? It’s increasingly obvious that herd immunity is simply not going to happen, at least not in this country, especially with strains like delta. I think people are insane if they think that we’re all going to just tolerate masking all the time for eternity when there’s no obvious answer to when we might be able to stop

This is only a valid point of people get vaccinated; just the existence of vaccines without actually being utilized does not help. We do this in the hospitals in flu season. Can opt out of vaccine but still have to wear a mask. Same should be true for COVID. Personally, I’d wear a mask, during the whole pandemic hadn’t had a single flu, cold or sinus infection when I usually get at least one or two bad ones per year.

 

[Dr G Oogle]

The alternative is not endless masking. Endless masking would almost certainly fail a serious First Amendment challenge. This temporary emergency situation is different, but the more this becomes about routine prevention of pervasive respiratory viruses, the less likely that it would be able to survive a strict scrutiny standard. This is also why we don't solely base policy on science. Science cannot answer the types of interest-balancing questions that are needed for policy.

Maybe I missed this in my AP poli sci class but I am unaware of how mask wearing is an infringement on free speech and freedom of expression. Would love to understand that argument though

 

[sloop]

Maybe I missed this in my AP poli sci class but I am unaware of how mask wearing is an infringement on free speech and freedom of expression. Would love to understand that argument though

Mandatory mask-wearing involves compelling a certain type of presentation in many important public spaces and banning other types of presentation. Whether you agree with them or not, many people who are against mask mandates on grounds of the importance of individual liberty choose not to wear masks at least in part, if not primarily, as a political statement or an expression of their autonomy. This is almost certainly a form of symbolic speech under the First Amendment. It is also arguably political speech, which the Supreme Court has considered the “core” of protected speech.

The First Amendment is not immune to restriction, but, as with many constitutional rights, courts have generally subjected such restrictions to a strict scrutiny standard. What this means is that restrictions on speech generally have to be narrowly tailored and serve a significant governmental interest. A temporary restriction during a public health emergency likely passes strict scrutiny (notice that I said this in my initial post). An indefinite one, however, probably does not.

It probably fails on strict scrutiny for several reasons. First, the longer that this pandemic goes on, the less compelling the governmental interest becomes. Reducing transmission to prevent overwhelming hospitals and enable us to develop a vaccine is almost certainly a significant governmental interest. Reducing transmission when most people are vaccinated, vaccines are readily available, there are available therapeutics, and there’s no longer an imminent risk of ventilator shortage, PPE shortage, etc. is much less compelling. I don’t think that the mere claim that the restriction will reduce deaths via reduced transmission is enough to constitute a compelling state interest for restricting political speech in perpetuity. This goes both ways. I don’t think that this would be a good enough reason to indefinitely mandate masks, and I also don’t think it would be a good enough reason to ban attending some sort of crowded BLM protest.

Second, it is not narrowly tailored. These mandates typically affect a person’s ability to go maskless in any public or private indoor space. This might be different if you just said something like everyone has to mask in doctor’s offices and hospitals, but that’s not the case.

 

[sloop]

Actually that's exactly what the evidence shows. Indoor masking reduces transmission of respiratory pathogens. Hard stop.

"Not liking wearing masks" isn't a risk. I don't "like" taking my cholesterol medication but that doesn't factor into the risk/benefit equation. I don't "like" using hand sanitizer 60+ times per day either but my dislike doesn't factor into it.

Believe it or not I'm actually fairly conservative so not sure my political lens really factors in here.

Not sure what masking has to do with the first amendment, especially as I didn't mention anything about government in all of this. But since you brought it up its no different than the existing laws about having to wear clothes in public unless you believe those also violate the first amendment somehow.

Medical risks and benefits are not the only types of considerations when doing the utilitarian calculus of policy evaluation. Surely you know this, because you likely do all sorts of things during the day that are medically risky and confer no medical benefit. Do you drive? You could get into an accident, or get a DVT. The act of driving a car does nothing significant for your health. The reason you do it is that you obtain various non-medical benefits from it, and you “like” the things that come with the mobility of a car.

The fact that you’re denying that people’s preferences matter when considering policy really just shows that you’re coming to conclusions based on prior beliefs and assumptions rather than actually running the calculation that you’re claiming to run. You can either come at this from a utilitarian cost-benefit perspective or make some global deontological determination about what people should do. You can’t do both at the same time. If you’re going to take the utilitarian angle, you actually need to consider the costs and benefits to other people from their perspectives, not yours. Wearing masks genuinely makes some people unhappy. To determine the magnitude of that effect, you have to ask them. Instead, what you’re doing is just saying that those effects don’t matter and not including them in your utilitarian calculus. That’s not a reasonable take. That’s cooking the books to obtain an outcome that supports your prior beliefs and assumptions.

 

[VA Hopeful Dr]

Medical risks and benefits are not the only types of considerations when doing the utilitarian calculus of policy evaluation. Surely you know this, because you likely do all sorts of things during the day that are medically risky and confer no medical benefit. Do you drive? You could get into an accident, or get a DVT. The act of driving a car does nothing significant for your health. The reason you do it is that you obtain various non-medical benefits from it, and you “like” the things that come with the mobility of a car.

The fact that you’re denying that people’s preferences matter when considering policy really just shows that you’re coming to conclusions based on prior beliefs and assumptions rather than actually running the calculation that you’re claiming to run. You can either come at this from a utilitarian cost-benefit perspective or make some global deontological determination about what people should do. You can’t do both at the same time. If you’re going to take the utilitarian angle, you actually need to consider the costs and benefits to other people from their perspectives, not yours. Wearing masks genuinely makes some people unhappy. To determine the magnitude of that effect, you have to ask them. Instead, what you’re doing is just saying that those effects don’t matter and not including them in your utilitarian calculus. That’s not a reasonable take. That’s cooking the books to obtain an outcome that supports your prior beliefs and assumptions.

Actually you don't. We have plenty of public health type laws that don't take that into account at all. You're acting like this is some new idea. It is not.

 

[Crayola227]

This is only a valid point of people get vaccinated; just the existence of vaccines without actually being utilized does not help. We do this in the hospitals in flu season. Can opt out of vaccine but still have to wear a mask. Same should be true for COVID. Personally, I’d wear a mask, during the whole pandemic hadn’t had a single flu, cold or sinus infection when I usually get at least one or two bad ones per year.

Flu isn't as contagious and to my knowledge isn't aerosolized to the same degree, and the mortality and morbidity isn't as high. So I'm not sure the option of masking in lieu of vaccination makes as much sense for healthcare workers in a healthcare setting. Now, if you have every person vaccinated just about and only provide very few exemptions, it might be a viable alternative for like 1% of the healthcare workforce in a given setting.

 

[Crayola227]

Mandatory mask-wearing involves compelling a certain type of presentation in many important public spaces and banning other types of presentation. Whether you agree with them or not, many people who are against mask mandates on grounds of the importance of individual liberty choose not to wear masks at least in part, if not primarily, as a political statement or an expression of their autonomy. This is almost certainly a form of symbolic speech under the First Amendment. It is also arguably political speech, which the Supreme Court has considered the “core” of protected speech.

The First Amendment is not immune to restriction, but, as with many constitutional rights, courts have generally subjected such restrictions to a strict scrutiny standard. What this means is that restrictions on speech generally have to be narrowly tailored and serve a significant governmental interest. A temporary restriction during a public health emergency likely passes strict scrutiny (notice that I said this in my initial post). An indefinite one, however, probably does not.

It probably fails on strict scrutiny for several reasons. First, the longer that this pandemic goes on, the less compelling the governmental interest becomes. Reducing transmission to prevent overwhelming hospitals and enable us to develop a vaccine is almost certainly a significant governmental interest. Reducing transmission when most people are vaccinated, vaccines are readily available, there are available therapeutics, and there’s no longer an imminent risk of ventilator shortage, PPE shortage, etc. is much less compelling. I don’t think that the mere claim that the restriction will reduce deaths via reduced transmission is enough to constitute a compelling state interest for restricting political speech in perpetuity. This goes both ways. I don’t think that this would be a good enough reason to indefinitely mandate masks, and I also don’t think it would be a good enough reason to ban attending some sort of crowded BLM protest.

Second, it is not narrowly tailored. These mandates typically affect a person’s ability to go maskless in any public or private indoor space. This might be different if you just said something like everyone has to mask in doctor’s offices and hospitals, but that’s not the case.

Eh, if people wake up some day and en masse decide to treat wearing pants is core political speech, (my point being it isn't inherently political speech unlike some things) I doubt that would fly.

The reat of your points are fine, except compelling governmental interest probably applies where you have surges and you run out of the very things you mentions. This is still happening where people have decided they want to let the virus run loose similar to the good ol early days of the pandemic, only working with slightly higher natural/vaccine immunity and less masking.

 

[Crayola227]

Medical risks and benefits are not the only types of considerations when doing the utilitarian calculus of policy evaluation. Surely you know this, because you likely do all sorts of things during the day that are medically risky and confer no medical benefit. Do you drive? You could get into an accident, or get a DVT. The act of driving a car does nothing significant for your health. The reason you do it is that you obtain various non-medical benefits from it, and you “like” the things that come with the mobility of a car.

The fact that you’re denying that people’s preferences matter when considering policy really just shows that you’re coming to conclusions based on prior beliefs and assumptions rather than actually running the calculation that you’re claiming to run. You can either come at this from a utilitarian cost-benefit perspective or make some global deontological determination about what people should do. You can’t do both at the same time. If you’re going to take the utilitarian angle, you actually need to consider the costs and benefits to other people from their perspectives, not yours. Wearing masks genuinely makes some people unhappy. To determine the magnitude of that effect, you have to ask them. Instead, what you’re doing is just saying that those effects don’t matter and not including them in your utilitarian calculus. That’s not a reasonable take. That’s cooking the books to obtain an outcome that supports your prior beliefs and assumptions.

You're making a silly argument about driving here.

Cars for many people are NECESSARY. Now, does that then mean the majority of trips taken by people who need cars, are necessary? Not necessarily, but one issue is that it becomes difficult to police driving to the level of the individual and the individual car trip.

 

[sloop]

Actually you don't. We have plenty of public health type laws that don't take that into account at all. You're acting like this is some new idea. It is not.

You’re the one who brought up the risk-benefit issue. Also, I don’t know how you come to the conclusion that these laws don’t consider the detriments to citizens from their perspectives. Presumably these people have representatives, and some of their concerns were considered during the legislative sessions. I’m not saying that you have to let their interests command your determination, only that you should consider them.

I think that if you bring up a medical risk-benefit discussion, you’re obviously in a utilitarian mode of analysis. If, from there, you refuse to consider any non-medical costs and benefits, you’re being arbitrary and disingenuous. That type of thinking leads to all sorts of stupid conclusions that would make people miserable and rob them of any reasonable choices. If you truly believe this, I expect that you’re lobbying for us to ban McDonalds, red meat, cured meats, smoked foods, soda, fast cars that the actuarial data suggests are more dangerous, etc.

I’m sorry, but people don’t actually want to live like that, and our policy makers don’t actually make decisions in a vacuum like that.

 

[sloop]

You're making a silly argument about driving here.

Cars for many people are NECESSARY. Now, does that then mean the majority of trips taken by people who need cars, are necessary? Not necessarily, but one issue is that it becomes difficult to police driving to the level of the individual and the individual car trip.

Okay. Are red meat, cured meat, soda, McDonalds, etc. also necessary for people? If not, I expect you to be lobbying your representative to ban those things.

 

[Crayola227]

Okay. Are red meat, cured meat, soda, McDonalds, etc. also necessary for people? If not, I expect you to be lobbying your representative to ban those things.

I never said something had to be necessary to be permitted. I said that saying cars are just a matter of "liking" to drive to ridiculous as an analogy.

 

[VA Hopeful Dr]

You’re the one who brought up the risk-benefit issue. Also, I don’t know how you come to the conclusion that these laws don’t consider the detriments to citizens from their perspectives. Presumably these people have representatives, and some of their concerns were considered during the legislative sessions. I’m not saying that you have to let their interests command your determination, only that you should consider them.

I think that if you bring up a medical risk-benefit discussion, you’re obviously in a utilitarian mode of analysis. If, from there, you refuse to consider any non-medical costs and benefits, you’re being arbitrary and disingenuous. That type of thinking leads to all sorts of stupid conclusions that would make people miserable and rob them of any reasonable choices. If you truly believe this, I expect that you’re lobbying for us to ban McDonalds, red meat, cured meats, smoked foods, soda, fast cars that the actuarial data suggests are more dangerous, etc.

I’m sorry, but people don’t actually want to live like that, and our policy makers don’t actually make decisions in a vacuum like that.

If you're my age or younger we're too young to remember the backlash when seatbelt laws became a thing, but thanks to the Internet we can see videos/articles from that time. The rhetoric was shockingly similar to the anti-mask stuff we're hearing now.

There's also a pretty big difference between requiring masks in certain settings and banning foods/activities.

But to turn this around, I assume you're against those terrible laws that force me to wear pants when I leave my house. My bare backside is way less likely to cause harm than me breathing on people at the grocery store.

 

[meow1985]

Would you hire a person who says they don't believe in any medication whatsoever for major depressive disorder? There's probably more of an actual argument to be made from that standpoint than against the COVID vaccine but I'd have a hard time seeing any mainstream psychiatric clinic hiring that person.

LOL. Slightly offtopic, but that's my psychiatrist. He loves to quote the book "The Emperor's New Drugs" and how SSRI's just potentiate depression and anxiety and we should all just do therapy. He used to practice in a mainstream clinic, but left to do private practice.

 

[meow1985]

On topic, I am by no means defending an unvaccinated job applicant, but I feel the need to point out that it is hard to practice evidence based medicine on one's self or on one's loved ones because you *can't* be objective. Risks that you talk to your patients about as incredibly rare and reassure them about may seem huge when it's your own life you're thinking about. That is, by the way, why we aren't supposed to treat our own selves or our family members.

The vaccination issue, of course, is one that spans the personal and the professional, so it's a reasonable expectation to bracket our own concerns about our health and make a sacrifice for the greater good. We give up so much for our job - mental health, circadian rhythms, diet, time and energy that could be spent on exercise and self-care. It all can take years off our lives. Marginally increasing our risk of whatever negative outcome is no different.

I would be curious to see what the applicant would say if asked how they would reconcile their choice with evidence based medicine. Or would that be an inappropriate interview question?

How do you know about the COVID vaccine status of this applicant, anyway? Unless there's a vaccine mandate, isn't that between HR and the employee (or potential employee)?

 

[ridethecliche]

Didn't Cleveland clinic just go back on their vaccine mandate for employees?

UH, Cleveland Clinic halt vaccine policy for caregivers after judge blocks vaccine mandate

Cleveland’s University Hospitals said unless there is a further legal action, caregivers may continue to provide patient care services regardless of their vaccination status. Cleveland Clinic said they are also pausing their vaccine policy.

www.news5cleveland.com

 

[nexus73]

Religious vaccine exemptions are looking like they will be extremely liberally granted at my job. Extremely liberally.

 

[VA Hopeful Dr]

Religious vaccine exemptions are looking like they will be extremely liberally granted at my job. Extremely liberally.

That's how it was with us. Basically rubber stamping all of them.

 

[Dr G Oogle]

Religious vaccine exemptions are looking like they will be extremely liberally granted at my job. Extremely liberally.

Send out the list of other drugs that they shouldn’t take if they follow the religious exemption

 

[calvnandhobbs68]

Religious vaccine exemptions are looking like they will be extremely liberally granted at my job. Extremely liberally.

That's how it was with us. Basically rubber stamping all of them.

Which is why it’s so ridiculous when people try to defend this. It’s basically making a mockery of the true concept behind “freedom of religion” which was initially established because people would be, you know, MURDERED for being a part of a minority religious group (and still happens in many countries around the world today).

But hey yeah getting a vaccine that billions of other people in the world have safely received is pretty much the same thing. Wonder how many of these people would be so stoic in their “religious beliefs” if the government came door to door asking who’s in their religious sect so they could line them up over a mass grave or actually ship them off to “re-education camps”.

 

[sloop]

If you're my age or younger we're too young to remember the backlash when seatbelt laws became a thing, but thanks to the Internet we can see videos/articles from that time. The rhetoric was shockingly similar to the anti-mask stuff we're hearing now.

There's also a pretty big difference between requiring masks in certain settings and banning foods/activities.

But to turn this around, I assume you're against those terrible laws that force me to wear pants when I leave my house. My bare backside is way less likely to cause harm than me breathing on people at the grocery store.

The difference is that driving is not generally a right in America. Driving has been subjected to licensure and all sorts of implied contracts with the government. While you’re not always required to identify yourself to police, you are when you’re driving because that is part of what you have to do to have the privilege of driving. You’re not generally required to submit to a breathalyzer, but you are when you’re driving for the same reasons. Driving has never really been considered a right.

Subject to very few limits, you’re generally allowed to dress however you want in public. Yes there are a indecent exposure laws. I tend to disagree with those laws, but that’s a separate discussion. There are very few restrictions on your personal expression in public, and your expression is generally subject to the strongest first amendment protections if it is a form of political expression.

That is the difference between seatbelt laws and mask mandates.