Back to masks for us

[LimpSpatula]

Just lol at what SDN has become.

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Members don't see this ad.

 

[Mass Effect]

Thus proving my point. You have no regard for other's experiences.

That's not how it works. You don't get to just make some baseless claim and then not be questioned on it when you're on a medical forum telling people masks are bad during a global pandemic that's killed over half a million people. That's not how any of this works. You make a claim, back it up. Give examples of degradation of quality of life. Kids not wanting to participate in sports is not it, hate to tell you. That isn't me downplaying your experience. That's me being real with you.

I gave real-world examples but yet you categorize them as people simply finding masks annoying?

Yes, you're using words and phrases that have real meaning on a medical forum to describe kids wanting to quit a sport because he's annoyed by the mask? When the rest of us are caring for patients on ventilators?? You bet I'm going to call you on it. Had you expanded, gave more information, the convo may have gone differently.

Who the heck are you to judge what one considers as merely annoying vs. so annoying that they no longer find ANY joy in activities to the degree that don't participate any longer?

I mean, I'm a human being and a doctor. I get to have an opinion about what you post. It's like if someone posts in here "I experienced a tragedy; I can't find the right shade of nail polish", I get to tell them they're being hyperbolic and if they want a real tragedy, read the obits and stop using words to mean something less than what they actually mean. Language is important.

Who the heck are you to tell me my own kid, who suffered from depression as a result, has not actually suffered? Did they have to get covid to get your sympathy?

Well no, and depression is a different beast. I'd say that depression actually IS diminished quality of life and suffering. You'd get no argument from me there. But your kid didn't suffer from the mask. Your kid suffered from depression that may have been triggered by the choices that resulted from having to wear a mask. You can't just skip all those intermediates and conclude your kid's depression came from wearing a mask. And for what it's worth, I'm sincerely sorry that your kid has depression. Depression sucks. I hope you and his/her pediatrician can get on-board with whatever treatment to help him/her.

This is silly. So nothing degrades life unless it's bad as having covid? Please. My usage of the term should have been clear. I was in no way comparing "annoying" mask wearing with people who "suffer" from covid. Please quit using these strawmen arguments

It's not a strawman argument. Words matter. In this day of social media misinformation and nonsense, using words that have clinical meaning (like quality of life) should have explanation behind it, not just illustrating an inconvenience.

This is your opinion which is contrary to my own experience. Even if I'm n=1, it's still doesn't make it not true. Your dismissive attitude is not becoming of someone in humanity much less medicine. It's this controlling, almost authoritarian, attitude contributes to why many people care questioning your ilk's real motivations

My ilk? Hahaha. Nothing about what I said to you is controlling, but it most certainly is giving you a dose of reality. No apologies for that. It's time doctors who actually follow the science (and common sense) call out those who don't, on all of social media. The bold is really not kosher on SDN. I think there's a specific name for that kind of argument though I can't think of it right now.

 

[WheezyBaby]

Wow, this went much worse than even my cynical self would have thought.

Let's review:

1. No, the vaccines are not 100% protective against COVID in general and the Delta variant specifically.
2. They do, however, decrease the risk of infection and transmission compared to being unvaccinated.
3. They also do still appear very effective and preventing hospitalization and death.
4. We can't just say "screw the unvaccinated" because they are the ones filling up our hospitals in hard hit areas. This means the MI/CVA/Trauma patients are also getting screwed.
5. Its just a freaking mask. I don't like wearing it either, but if I (and my then 4 year old kids) can wear them at Disney World outside in September everyone can wear them indoors. The risk/benefit math skews heavily toward benefit because the risk or wearing a mask is utterly insignificant for 99% of people.

^^^yes

Also I like masks because the top half of my head is objectively more attractive than the bottom half.

 

[SurfingDoctor]

Wow, this went much worse than even my cynical self would have thought.

Let's review:

1. No, the vaccines are not 100% protective against COVID in general and the Delta variant specifically.
2. They do, however, decrease the risk of infection and transmission compared to being unvaccinated.
3. They also do still appear very effective and preventing hospitalization and death.
4. We can't just say "screw the unvaccinated" because they are the ones filling up our hospitals in hard hit areas. This means the MI/CVA/Trauma patients are also getting screwed.
5. Its just a freaking mask. I don't like wearing it either, but if I (and my then 4 year old kids) can wear them at Disney World outside in September everyone can wear them indoors. The risk/benefit math skews heavily toward benefit because the risk or wearing a mask is utterly insignificant for 99% of people.

 

[Neopolymath]

The bold is really not kosher on SDN. I think there's a specific name for that kind of argument though I can't think of it right now.

Burnett's Law

 

[NotAProgDirector]

If the vaccines don’t prevent transmission and infection, the only endgame that makes sense is that CoV-2 infects everyone eventually.

UNfortunately, I don't think that's the end game. If the variants mutate enough such that they evade vaccines, they will also evade natural immunity. So we'll be looking at recurrent infections -- much like flu.

Just lol at what SDN has become.

Actually, I think this discussion adds quite a bit of value. Here we are -- presumably highly intelligent, educated folks. And we can see that there is some disagreement. The question is: should there be a blanket across-the-board mask mandate?

Scientifically, if we assume that masks have some protective value (without which, there's no value to a mask mandate):
1. If the vaccine completely stops infection (or more importantly transmission), then masks for those vaccinated add no value.
2. If those vaccinated can transmit the infection (esp variants), but don't get sick themselves, then a mandate should decrease transmission to unvaxxed -- hence benefit is purely to others.
3. If those vaccinated can get the infection and get seriously ill, then a mask mandate helps decrease infection for everyone.
4. The downsides of a mask mandate are subjective. Some would say they are miniscule compared with COVID infection. But being subjective, others might disagree.
5. No matter what, the vast majority of people who get either the vaccine or COVID infection will have no long term issue. For all of them, masks add no personal benefit, although help decrease infections to others. But no one can tell up front if they will get a minor infection or a major problem from COVID.

Realistically, I worry that we will never get ahead of ongoing mutations. Even with the speed that new RNA Vaccines can be generated, it's going to be difficult to roll out repeated vaccines fast enough. Hopefully we reach an equilibrium where everyone has been vaxxed or infected, and then there's continued transmission with low risk of bad outcome. Ultimately we'll need to choose a time to stop masking, and that will increase those who are higher risk to increase chance of badness.

Personally, I favor universal masking at present. But I hate it. When we were univ masking, I felt like it was no big deal and I could keep doing it forwever. In fact, I didn't get sick at all last winter and told myself that I might wear a mask all winter at work even if not required. Then when the CDC shifted, I stopped wearing a mask outside of work -- and honestly it was wonderful. Then my wife got sick, and gave it to me (not COVID). I'm still coughing weeks later (always happens to me). So now I'm back at equipoise. Wearing a mask everywhere is really annoying. But I'll do it to help everyone else. And perhaps I'll get something out of it also.

I can totally understand how someone would choose not to wear a mask. It doesn't make them evil, or a bad doctor. The fact that we're having this discussion and reaching conclusions like that demonstrates why it's even more difficult for the lay public to do so.

 

[LimpSpatula]

UNfortunately, I don't think that's the end game. If the variants mutate enough such that they evade vaccines, they will also evade natural immunity. So we'll be looking at recurrent infections -- much like flu.


Actually, I think this discussion adds quite a bit of value. Here we are -- presumably highly intelligent, educated folks. And we can see that there is some disagreement. The question is: should there be a blanket across-the-board mask mandate?

Scientifically, if we assume that masks have some protective value (without which, there's no value to a mask mandate):
1. If the vaccine completely stops infection (or more importantly transmission), then masks for those vaccinated add no value.
2. If those vaccinated can transmit the infection (esp variants), but don't get sick themselves, then a mandate should decrease transmission to unvaxxed -- hence benefit is purely to others.
3. If those vaccinated can get the infection and get seriously ill, then a mask mandate helps decrease infection for everyone.
4. The downsides of a mask mandate are subjective. Some would say they are miniscule compared with COVID infection. But being subjective, others might disagree.
5. No matter what, the vast majority of people who get either the vaccine or COVID infection will have no long term issue. For all of them, masks add no personal benefit, although help decrease infections to others. But no one can tell up front if they will get a minor infection or a major problem from COVID.

Realistically, I worry that we will never get ahead of ongoing mutations. Even with the speed that new RNA Vaccines can be generated, it's going to be difficult to roll out repeated vaccines fast enough. Hopefully we reach an equilibrium where everyone has been vaxxed or infected, and then there's continued transmission with low risk of bad outcome. Ultimately we'll need to choose a time to stop masking, and that will increase those who are higher risk to increase chance of badness.

Personally, I favor universal masking at present. But I hate it. When we were univ masking, I felt like it was no big deal and I could keep doing it forwever. In fact, I didn't get sick at all last winter and told myself that I might wear a mask all winter at work even if not required. Then when the CDC shifted, I stopped wearing a mask outside of work -- and honestly it was wonderful. Then my wife got sick, and gave it to me (not COVID). I'm still coughing weeks later (always happens to me). So now I'm back at equipoise. Wearing a mask everywhere is really annoying. But I'll do it to help everyone else. And perhaps I'll get something out of it also.

I can totally understand how someone would choose not to wear a mask. It doesn't make them evil, or a bad doctor. The fact that we're having this discussion and reaching conclusions like that demonstrates why it's even more difficult for the lay public to do so.

Yea sorry real discussion got siderailed about 3 pages ago.

 

[viralhiker]

UNfortunately, I don't think that's the end game. If the variants mutate enough such that they evade vaccines, they will also evade natural immunity. So we'll be looking at recurrent infections -- much like flu.

That is exactly the point I was trying to raise yesterday before tempers started flaring.

At what point does this turn into essentially a "bad flu?" e.g., get your yearly shot if you want, it will be variably protective against severe illness, if you don't want it, c'est la vie.

I can totally understand how someone would choose not to wear a mask. It doesn't make them evil, or a bad doctor. The fact that we're having this discussion and reaching conclusions like that demonstrates why it's even more difficult for the lay public to do so.

I couldn't agree more with everything you're saying. I don't have much more to add to this discussion, as I think you've pooled together the most logical and balanced points everyone is this thread deep down is trying to get at.

Before the name-calling started, of course.

 

[SurfingDoctor]

The problem is people use hospitalizations as the metric of sick. But ya know, being out from work is a problem too. Same with having kids having fever and being out of school. All of that is lost productivity that has to be made up. Say you get vaccinated, but choose not to wear a mask, get infected and have symptoms for a couple of days that preclude you from work. You then transmit that to close contacts. You’re not hospitalized, which is good, but you are also useless for several days (all the while your colleagues have to cover for you) who you may have also infected), when instead you could have worn a damn mask and reduced the chance of that occurring. But no… no masks because selfish feels and reasons. Whoop…

 

[Lawpy]

The problem is people use hospitalizations as the metric of sick. But ya know, being out from work is a problem too. Same with having kids having fever and being out of school. All of that is lost productivity that has to be made up. Say you get vaccinated, but choose not to wear a mask, get infected and have symptoms for a couple of days that preclude you from work. You then transmit that to close contacts. You’re not hospitalized, which is good, but you are also useless for several days (all the while your colleagues have to cover for you) who you may have also infected), when instead you could have worn a damn mask and reduced the chance of that occurring. But no… no masks because selfish feels and reasons. Whoop…

What fraction of vaccinated Americans who got infected are symptomatic? What if most infections we see are asymptomatic?

 

[Mass Effect]

Burnett's Law

That's it. Thanks.

I can totally understand how someone would choose not to wear a mask. It doesn't make them evil, or a bad doctor

Just so we're clear, are you talking about in a healthcare setting or are you talking people choosing not to mask on the street? Because a doctor choosing not to mask in a healthcare setting I'd argue makes them a bad doctor, 100%.

 

[Mass Effect]

That is exactly the point I was trying to raise yesterday before tempers started flaring

No, it really wasn't. What he's saying is that with the mutations, we get recurrent infections the way we do with flu, not that the outcome is like a "bad flu". May be a nuanced difference between those statements, but there's definitely a difference.

Tempers did flare, but I must have missed the name calling.

 

[SurfingDoctor]

What fraction of vaccinated Americans who got infected are symptomatic? What if most infections we see are asymptomatic?

What if… wear the mask, and be a team player... Or choose the opposite.

 

[Lawpy]

What if… wear the mask, and be a team player... Or choose the opposite.

The primary obligation should be on the unvaccinated to be vaccinated though. Because it's looking like the vaccinated people have to mask up simply because the unvaccinated are refusing to be vaccinated (i definitely do not think people who want to be vaccinated but can't make up a large fraction of unvaccinated crowd... it's largely vaccine hesitancy folks)

 

[SurfingDoctor]

The primary obligation should be on the unvaccinated to be vaccinated though. Because it's looking like the vaccinated people have to mask up simply because the unvaccinated are refusing to be vaccinated (i definitely do not think people who want to be vaccinated but can't make up a large fraction of unvaccinated crowd... it's largely vaccine hesitancy folks)

Well, vaccine mandates are fine with me. The biggest problem with masks/vaccines/whatever COVID related is that people seem to have lost their damn minds. I don’t know how you fix that… but mandates might get around it for now.

 

[NotAProgDirector]

Just so we're clear, are you talking about in a healthcare setting or are you talking people choosing not to mask on the street? Because a doctor choosing not to mask in a healthcare setting I'd argue makes them a bad doctor, 100%.

Yes, in public. Masking in healthcare settings seems prudent until we have this under control -- and even then, perhaps it's something we should do forever.

 

[viralhiker]

No, it really wasn't. What he's saying is that with the mutations, we get recurrent infections the way we do with flu, not that the outcome is like a "bad flu". May be a nuanced difference between those statements, but there's definitely a difference.

Tempers did flare, but I must have missed the name calling.

Oh brother give me a break. I didn’t mean the outcome of a specific case is equivalent to catching a bad case of the flu. I meant (and stated quite clearly if you read my comments on that page and others) that the epidemiology of SARS-CoV-2 may end up sharing qualities with influenza, but with more severe infectivity and mortality. the end result being the virus becoming endemic in the human population, with recurrent infections and a yearly vaccine cocktail that individuals can decide whether or not to get, as it may provide some increased protection against hospitalization. Just as the flu vaccine does.

Which is a sentiment that I have not seen shared widely in either lay or professional circles.

Sure, I guess I could’ve been clearer, but it was a quick comment that I didn’t think needed more explaining.

I really don’t get why you are going out of your way to correct a post that didn’t need correcting, except to try and further inflame a discussion that has already gone off the rails.

 

[RespectTheChemistry]

^^^yes

Also I like masks because the top half of my head is objectively more attractive than the bottom half.

That's so funny.

 

[viralhiker]

Tempers did flare, but I must have missed the name calling.

And just because you insist on being corrected yourself:

He was just making the point that you’re a hyperbolic drama queen

 

[FutureInternist]

Seatbelts AND airbags !!!

 

[deleted1103055]

I really don’t get why you are going out of your way to correct a post that didn’t need correcting, except to try and further inflame a discussion that has already gone off the rails.

this might help

Trolls just want to have fun

In two online studies (total N=1215), respondents completed personality inventories and a survey of their Internet commenting styles. Overall, strong …

www.sciencedirect.com

Abstract: In two online studies (total N = 1215), respondents completed personality inventories and a survey of their Internet commenting styles. Overall, strong positive associations emerged among online comment- ing frequency, trolling enjoyment, and troll identity, pointing to a common construct underlying the measures. Both studies revealed similar patterns of relations between trolling and the Dark Tetrad of personality: trolling correlated positively with sadism, psychopathy, and Machiavellianism, using both enjoyment ratings and identity scores. Of all personality measures, sadism showed the most robust associations with trolling and, importantly, the relationship was specific to trolling behavior. Enjoyment of other online activities, such as chatting and debating, was unrelated to sadism. Thus cyber-trolling appears to be an Internet manifestation of everyday sadism.​

​

 

[GoSpursGo]

This thread is beginning to border on overtly political, which is a pity because there are some interesting underlying discussions going on beyond simply reaffirming that masks and vaccines work.

Please steer clear of overtly political posts. If the thread continues to trend in that direction we're going to have to close it.

 

[deleted1103055]

UNfortunately, I don't think that's the end game. If the variants mutate enough such that they evade vaccines, they will also evade natural immunity.

Take a look at this study. The authors make excellent points about T cells, nucleocapsid vs spike specificity.

Cohen et al., 2021, Cell Reports Medicine 2, 100354 July 20, 2021

Longitudinal analysis shows durable and broad immune memory after SARS-CoV-2 infection with persisting antibody responses and memory B and T cells​

In contrast to spike memory B cell kinetics, SARS-CoV-2-specific CD4+ and CD8+ memory T cells each peak early, within the first month, but then slowly decline over the next 6–7 months. Central memory Th1-type CD4+ T cells dominate throughout the early infection and recovery period. However, the CD8+ T cells exhibit a predominant effector memory phenotype early that transitions to those effector memory cells re-expressing CD45RA, maintaining expression of antiviral cytokines and effector functions that have been shown to provide protective immunity against other viral pathogens. We also provide clear evidence that the CD4+ T cells mount a broader antigen-specific response across the structural and accessory gene products, whereas the CD8+ T cells are predominantly nucleocapsid specific and spike-specific responses are substantially lower in frequency…..

Our findings show that most COVID-19 patients induce a wide-ranging immune defense against SARS-CoV-2 infection, encompassing antibodies and memory B cells recognizing both the RBD and other regions of the spike, broadly-specific and polyfunctional CD4+ T cells, and polyfunctional CD8+ T cells. The immune response to natural infection is likely to provide some degree of protective immunity even against SARS-CoV-2 variants because the CD4+ and CD8+ T cell epitopes will likely be conserved. Thus, vaccine induction of CD8+ T cells to more conserved antigens such as the nucleocapsid, rather than just to SARS-CoV-2 spike antigens, may add benefit to more rapid containment of infection as SARS-CoV-2 variants overtake the prevailing strains.

 

[Mass Effect]

Oh brother give me a break. I didn’t mean the outcome of a specific case is equivalent to catching a bad case of the flu. I meant (and stated quite clearly if you read my comments on that page and others) that the epidemiology of SARS-CoV-2 may end up sharing qualities with influenza, but with more severe infectivity and mortality. the end result being the virus becoming endemic in the human population, with recurrent infections and a yearly vaccine cocktail that individuals can decide whether or not to get, as it may provide some increased protection against hospitalization. Just as the flu vaccine does.

Which is a sentiment that I have not seen shared widely in either lay or professional circles.

Sure, I guess I could’ve been clearer, but it was a quick comment that I didn’t think needed more explaining.

I really don’t get why you are going out of your way to correct a post that didn’t need correcting, except to try and further inflame a discussion that has already gone off the rails.

How many times do I have to say because language is important? You can't count on people knowing what you mean when you don't explain it. So yea, it needed correcting.

And I have no idea what you're talking about that you haven't seen this sentiment shared widely in lay or professional circles.

Experts say Covid could become endemic — here's what that means for you

Most experts say that Covid will become endemic after the pandemic ends. Here's how that affects daily life, vaccines and infections.

www.cnbc.com

COVID-19 will probably become endemic – here’s what that means

Even if some places reach herd immunity, the virus is unlikely to disappear.

theconversation.com

As Covid-19 Vaccines Raise Hope, Cold Reality Dawns That Illness Is Likely Here to Stay

Governments and businesses are starting to accept that the coronavirus isn’t a temporary problem and instead will lead to long-term changes enabling society to co-exist with Covid-19, as it does with flu, measles and HIV.

www.wsj.com

Covid likely to stick around as 'endemic' virus

It’s not a ‘one-and-done’ event, infectious disease physician says

www.nhbr.com

WHO warns Covid-19 pandemic is 'not necessarily the big one'

Experts tell end of year media briefing that virus is likely to become endemic and the world will have to learn to live with it

www.theguardian.com

Scientists say COVID-19 could become endemic but pose less of societal threat over time

A majority of infectious-disease researchers surveyed said they expect SARS-CoV-2 to become endemic, meaning it could continue to circulate for years like the flu or common cold.

www.fox10phoenix.com

 

[Lawpy]

We need to enforce vaccine mandates everywhere now

 

[Mass Effect]

Mask mandates = government enforced

Failing to follow mandate = legal penalties

What legal penalties? Cite your source.

 

[Lawpy]

What legal penalties? Cite your source.

Here's an example with schools

How will Pritzker's mask mandate be enforced? State, educators say they've got it covered

School district mask mandate scofflaws will be on the hook for lawsuits or lose funding, state education officials say. But what about kids or staff members who flout mask rules? Suburban educators explain how they'd address it.

www.google.com

One reality that's hard to ignore for districts, Pritzker said, is that if they disregard the mask mandate, they would be liable for any lawsuits that occur if a child contracts COVID-19 in a school setting, for example.

As a last resort, the Illinois State Board of Education can also remove a school's "recognition status," he said. That could mean a loss of state funding, said Jackie Matthews, executive director of communications for the board.

 

[SurfingDoctor]

Seatbelts AND airbags !!!

:: Brittney has entered the chat ::

 

[FutureInternist]

Doofuses everywhere…

My state put out a bulletin today that showed approx 85% of admitted and > 95% of deaths in past month were unvaxxed

 

[SurfingDoctor]

Data out of Israel suggests that vaccines are only 50% effective in preventing delta. Hopefully they still work to reduce the severity of symptoms.

Just to follow up on this, we had a recent hospital-system wide ground rounds. While the Israel data was concerning, apparently our own internal data was that nearly all current hospitalizations were in unvaccinated, and delta is by far the predominate strain.

Vaccination with the current mRNA vaccines (well, the Pfizer one) was 95-100% effective of preventing hospitalization/death, including delta variants, in some data from the UK and Canada.

EDIT: I would post the slide from the grand rounds, but I’m not gonna for copyright reasons. But here is one of the studies:

SARS-CoV-2 Delta VOC in Scotland: demographics, risk of hospital admission, and vaccine effectiveness

www.sciencedirect.com

Overall, a strong vaccine effect did not clearly manifest until at least 28 days after the first vaccine dose (HR 0·32, 95% CI 0·22–0·46; appendix p 3). Among S gene-negative cases, the effect of vaccination (at least 28 days after first or second dose) was to reduce the risk of hospital admission (HR 0·28, 95% CI 0·18–0·43) compared to unvaccinated. The corresponding hazard ratio for risk of hospital admission for Sgene-positive cases was 0·38 (95% CI 0·24–0·58), with an interaction test p value of 0·19, suggesting that there was no evidence of a differential vaccine effect on hospital admissions among those first testing positive

ie, the risk reduction of hospitalization for fully vaccinated people was the same between alpha and delta COVID variants, though there was a slight, but non significant trend of more delta-related admissions in this cohort.

 

[Lawpy]

View attachment 341819

Doofuses everywhere…

My state put out a bulletin today that showed approx 85% of admitted and > 95% of deaths in past month were unvaxxed

Enforce vaccine mandates everywhere. This should be the primary focus

 

[FutureInternist]

View attachment 341819

Doofuses everywhere…

My state put out a bulletin today that showed approx 85% of admitted and > 95% of deaths in past month were unvaxxed

Enforce vaccine mandates everywhere. This should be the primary focus

Agree… even if hard to enforce it should still be the rule for now.

 

[Lawpy]

View attachment 341819

Doofuses everywhere…

My state put out a bulletin today that showed approx 85% of admitted and > 95% of deaths in past month were unvaxxed


Agree… even if hard to enforce it should still be the rule for now.

My controversial proposal is to have a sort of vaccine verification system on a phone or something that readily shows proof of vaccination in every public setting. It's hugely controversial because of massive privacy violations but unfortunately, with covid likely being endemic and the unvaccinated keep driving the covid surges and likely weakening the vaccines by making variants stronger, such mandates are necessary.

I mean we tried giving them money or run lotteries or gifts etc. None of them really worked

What convinced vaccine hesitant people to vaccinate? By seeing people close to them die

‘I should have gotten the damn vaccine,’ woman says fiancé texted before he died of COVID-19

Jessica DuPreez and Micheal Freedy were waiting a year to get the COVID-19 vaccine. DuPreez said they weren't skeptical, just cautious. Now, having lost her fiancé to the virus, DuPreez quickly got the shot and is urging others to do...

www.google.com

Rightwing radio host and anti-vaxxer dies of Covid

Dick Farrel was a vociferous critic of Dr Anthony Fauci and urged people not to get vaccinated

www.google.com

 

[FutureInternist]

My controversial proposal is to have a sort of vaccine verification system on a phone or something that readily shows proof of vaccination in every public setting. It's hugely controversial because of massive privacy violations but unfortunately, with covid likely being endemic and the unvaccinated keep driving the covid surges and likely weakening the vaccines by making variants stronger, such mandates are necessary.

I mean we tried giving them money or run lotteries or gifts etc. None of them really worked

What convinced vaccine hesitant people to vaccinate? By seeing people close to them die

‘I should have gotten the damn vaccine,’ woman says fiancé texted before he died of COVID-19

Jessica DuPreez and Micheal Freedy were waiting a year to get the COVID-19 vaccine. DuPreez said they weren't skeptical, just cautious. Now, having lost her fiancé to the virus, DuPreez quickly got the shot and is urging others to do...

www.google.com

Rightwing radio host and anti-vaxxer dies of Covid

Dick Farrel was a vociferous critic of Dr Anthony Fauci and urged people not to get vaccinated

www.google.com

Although it will NEVER happen, declining to treat non-vaxxed who get COVID is the only way to go, ‘cos these people have shown that they do not care until it affects them.

And then, all of a sudden, these anti-gov, small gov, anti-“Socialism” people, rush to get the treatment that others paid taxes for 🙄

 

[VA Hopeful Dr]

The primary obligation should be on the unvaccinated to be vaccinated though. Because it's looking like the vaccinated people have to mask up simply because the unvaccinated are refusing to be vaccinated (i definitely do not think people who want to be vaccinated but can't make up a large fraction of unvaccinated crowd... it's largely vaccine hesitancy folks)

Obviously that should be the case, but this goes back to my point #4: We can't just say "screw the unvaccinated" because they are the ones filling up our hospitals in hard hit areas. This means the MI/CVA/Trauma patients are also getting screwed.

 

[Mass Effect]

Here's an example with schools

How will Pritzker's mask mandate be enforced? State, educators say they've got it covered

School district mask mandate scofflaws will be on the hook for lawsuits or lose funding, state education officials say. But what about kids or staff members who flout mask rules? Suburban educators explain how they'd address it.

www.google.com

One reality that's hard to ignore for districts, Pritzker said, is that if they disregard the mask mandate, they would be liable for any lawsuits that occur if a child contracts COVID-19 in a school setting, for example.

As a last resort, the Illinois State Board of Education can also remove a school's "recognition status," he said. That could mean a loss of state funding, said Jackie Matthews, executive director of communications for the board.

And? That isn't what I consider legal penalties, especially as it applies to a district/board and not individuals. But even if it left individuals open to lawsuits, so what? People literally sue over everything and never dismiss the very real possibility that people will sue regardless of a mask mandate or not. No mask mandate has been written into law. You won't get a ticket or a jail sentence for not masking. The only real consequences for individuals ignoring a mask mandate is that you can't do things that require a mask - grocery shopping, going to the mall, eating at a restaurant, you know all the things you can't do if you're not wearing a shirt and shoes too.

 

[Lawpy]

Although it will NEVER happen, declining to treat non-vaxxed who get COVID is the only way to go, ‘cos these people have shown that they do not care until it affects them.

And then, all of a sudden, these anti-gov, small gov, anti-“Socialism” people, rush to get the treatment that others paid taxes for 🙄

Obviously that should be the case, but this goes back to my point #4: We can't just say "screw the unvaccinated" because they are the ones filling up our hospitals in hard hit areas. This means the MI/CVA/Trauma patients are also getting screwed.

Well a controversial strategy is to follow something like what FutureInternist suggested or prioritizing MI/CVA/Trauma patients over unvaxxed covid patients.

But i think enforcing vaccine mandates everywhere will cause unvaxxed % to significantly decline and thus not overwhelming hospitals

And? That isn't what I consider legal penalties, especially as it applies to a district/board and not individuals. But even if it left individuals open to lawsuits, so what? People literally sue over everything and never dismiss the very real possibility that people will sue regardless of a mask mandate or not. No mask mandate has been written into law. You won't get a ticket or a jail sentence for not masking. The only real consequences for individuals ignoring a mask mandate is that you can't do things that require a mask - grocery shopping, going to the mall, eating at a restaurant, you know all the things you can't do if you're not wearing a shirt and shoes too.

It trickles down though especially since school funding is threatened. Teachers can be fired for not wearing masks and being fired from schools is by extension being punished by governments for not following the mandate

Edited for clarity

 

[VA Hopeful Dr]

Well a controversial strategy is to follow something like what FutureInternist suggested or prioritizing MI/CVA/Trauma patients over unvaxxed covid patients.

But i think enforcing mask mandates everywhere will cause unvaxxed % to significantly decline and thus not overwhelming hospitals

It trickles down though especially since school funding is threatened. Teachers can be fired for not wearing masks and being fired from schools is by extension being punished by governments for not following the mandate

You literally said yesterday that you're against mask mandates.

The issue is with the mask mandates, not volunteering to wear a mask. I'm willing to wear a mask too but i'm against most mask mandates. The unvaccinated problem is a consequence of policy failure. Mask mandates arose from CDC's inconsistent messaging and guidelines (why would they get rid of masks prematurely in May if delta was on the rise? There would be little to no issue if they never changed their guidelines in the first place.)

 

[hallowmann]

I question this. My state is close to 50/50 vaccinated and unvaccinated. None of the larger hospitals in the state are seeing what you're seeing. My hospital system is running at 95% of inpatient COVID patients unvaccinated.

All the data we've been seeing in a relatively higher vaccinated area compared to the surrounding areas that have generally low vaccination rates is that vaccines are about 90-95% effective at preventing severe illness/hospitalizations but we've seen a hell of a lot of vaccinated people that get very mild or practically asymptomatic cases due to routine screening. We've also seen plenty of vaccinated people who get it with exposures only to other vaccinated people.

I don't see why they shouldn't. It's the same virus after all, albeit with slight variations in the spike glycoprotein, which is only really used for viral entry.

In my opinion, vaccinated and most people previously infected with covid (and thus have developed active immunity), will most likely be fine. We're still only talking about <.01% of the population who actually die from covid. Slow the inevitable spread with masks to help hospitals deal with surges, tell your family/friends to get their shots, and we'll be over this mess before we know it.

Previous infection with COVID seems to confer pretty minimal protection against reinfection and immunity actually seems to wane faster than with vaccines (kind of like shingles and many other virus/vaccine pairs). I've personally seen multiple unvaccinated people that have been reinfected 2-3 times over the last 9-10 month period (we're talking symptomatic each time, months apart, negative tests in between). There are some antibody studies out there that show similar data, but I'm too lazy to look at the moment.

This is what we are seeing too. Probably closer to 99%.

90-95% for hospitalizations/severe infections for us, but I think prevention of covid infection with vaccination is closer to 70-80%.

...
Everyone needs to stop just thinking about mortality. Yes mortality matters, but the truth is that even though a small percentage will die, it's the morbidity that going to change your life. I've seen perfectly healthy young adults go from working as attorneys, bartenders, retail, and even doctors to being on disability one year after infection. I have a post-Covid clinic. That's right, an entire clinic populated by only people who've recovered from the initial Covid infection, now dealing with neurologic and psychiatric symptoms - memory problems, irritability, brain "fog", significant fatigue, sleep problems, not to mention gait problems, pain, SOB, arthritis. Look at the literature online...

I've been seeing a ton of this as well. They're getting these even if they didn't have severe infection necessitating hospitalization. The ones that were hospitalized are in worse shape.

No the danger is directly from unvaccinated people unless you're arguing vaccinated people can transmit the virus

Read that post again. If masks are mandated to prevent outbreaks even in areas with near 100% vaccination rate, it means masks are better than vaccines in preventing the spread of infections.

There are no areas with near 100% vaccination. The fact that kids can't get vaccinated makes this impossible. Saying that masks are helpful at preventing spread is not saying that vaccinations are not. Nothing is 100%. We often tell people that they wear seatbelts and have cars with airbags because both of them can prevent death in an accident. We're not saying airbags do a better job at saving lives than seatbelts, we're just saying they both help at preventing death.

...
Clearly as per your own statement, vaccinated people can transmit the virus, and masks are there to prevent outbreaks. Which means masks are doing a better job preventing outbreaks than vaccines.

100%, vaccinated people can absolutely transmit the virus. We've seen many examples of this in my community. Lots of people who are sick with only vaccinated contacts. Masks don't necessarily do a "better job" at preventing outbreaks than vaccines (they might, we honestly don't have the data, but probably not). The argument is more like this:
Masks prevent infections by x degree.
Vaccines prevent infections by y degree.
Masks + Vaccines prevent infections by z degree.
z = x + y
x < z
y < z
x and y are > 0

I think some SDNers have a hard time grasping with the possibility that covid is very likely endemic and is here to stay forever. Mask mandates being indefinite forever is an unrealistic expectation. There will be covid variants and people will still be hospitalized and die from covid even several years from now. This is difficult to accept but it's inevitable.

What we instead need is regular covid vaccinations that are taken at least annually

No one is saying otherwise. We will need that. But guess what, we don't have it yet. Most of the world doesn't even have the first vaccine yet. We've got tons of communities with <50% vaccination amongst those who can be vaccinated, let alone the whole population.

Also, I actually don't think mask mandates in public indoor places being indefinite is unreasonable. Plenty of countries already do this. I don't think it'll happen in America, because generally speaking we care more about our own comfort than protecting even a small percentage of the population from greater harm. We spent almost a year proving that to be the case when we didn't have vaccines.

If vaccines don't prevent transmission, it severely hurts vaccine confidence and strengthens hesitancy. The people who aren't vaccinated yet will be even less willing to be vaccinated by thinking vaccines won't work and the current problems would worsen. Unvaccinated people are also already significantly unwilling to mask up anyways. It's a lose lose situation all around.

Like i said before, it's the policy failure that's directly causing the problem. The governments failed to persuade enough people to be vaccinated. Vaccine mandates should've been enforced months ago. The CDC should not have gotten rid of mask guidelines for vaccinated in May when delta variant was starting to rise. If it's true vaccines no longer prevent the transmission, it's those 3 factors that should be blamed. The vaccines in meantime should be upgraded.

Dude, the CDC was playing a game. The game was called, convince people to get vaccinated, the same game that you are reportedly advocating. Vaccination rates were waning, supply of vaccines was outpacing demand, and they made the call that now if you are vaccinated, you can do things again without a mask. Do you have any idea how many of my patients that didn't want to get vaccinated prior to that cited that as the only reason they wanted to get vaccinated. It was a boon. A ton of the "on the fence"/"I'll wait until we know more" people were lining up in droves to get the shot. It was actually very effective. It was way more effective then me talking to them about the risks and dangers of infection until my face turned blue. It's probably a major reason as many people are vaccinated now.

Are mask mandates going to hurt vaccination efforts, sure, but it's a risk/benefit analysis. Most of the unvaccinated patients I see are either waiting for some arbitrary amount of time for the vaccine to be out before they get it or they're the never-vaxxers that think "it's too political" and they won't get it until "we know more" about covid/the vaccines, but also can't tell me what they want to know about it. Those people weren't convinced by the removal of mask mandates for months and they won't change their opinion by mask mandates being in place, but at least spread will be decreased.

Wow, this went much worse than even my cynical self would have thought.

Let's review:

1. No, the vaccines are not 100% protective against COVID in general and the Delta variant specifically.
2. They do, however, decrease the risk of infection and transmission compared to being unvaccinated.
3. They also do still appear very effective and preventing hospitalization and death.
4. We can't just say "screw the unvaccinated" because they are the ones filling up our hospitals in hard hit areas. This means the MI/CVA/Trauma patients are also getting screwed.
5. Its just a freaking mask. I don't like wearing it either, but if I (and my then 4 year old kids) can wear them at Disney World outside in September everyone can wear them indoors. The risk/benefit math skews heavily toward benefit because the risk or wearing a mask is utterly insignificant for 99% of people.

Awesome summary. I swear, most of the people posting here must not have firsthand clinical experience with this virus.

^^^yes

Also I like masks because the top half of my head is objectively more attractive than the bottom half.

Not gonna lie, the benefit of not having to shave/trim or "clean up" my facial hair because it's hidden under a mask all day was wonderful.

The primary obligation should be on the unvaccinated to be vaccinated though. Because it's looking like the vaccinated people have to mask up simply because the unvaccinated are refusing to be vaccinated (i definitely do not think people who want to be vaccinated but can't make up a large fraction of unvaccinated crowd... it's largely vaccine hesitancy folks)

Nope. Masking helps prevent spread, and as covered above, there's still spread among the vaccinated, less but still some. Also as mentioned by another poster, even mild infections (like the ones most vaccinated people get) can have a big economic impact from a loss in productivity standpoint.

 

[Mass Effect]

It trickles down though especially since school funding is threatened. Teachers can be fired for not wearing masks and being fired from schools is by extension being punished by governments for not following the mandate

This is not "legal penalties". It just isn't. It doesn't "trickle down", teachers getting fired for not maxing is not "legal penalties". For what feels like the millionth time, language is important and when you're hyperbolic, no one takes anything you say seriously.

 

[Lawpy]

You literally said yesterday that you're against mask mandates.

I meant vaccine mandates.

 

[Lawpy]

This is not "legal penalties". It just isn't. It doesn't "trickle down", teachers getting fired for not maxing is not "legal penalties". For what feels like the millionth time, language is important and when you're hyperbolic, no one takes anything you say seriously.

There is this from few months ago

https://www.google.com/amp/s/www.washingtonpost.com/transportation/2021/02/05/tsa-mask-fines/%3foutputType=amp

Travelers who refuse to wear masks could face fines of more than $1,000, TSA says​

The Transportation Security Administration is beefing up its enforcement of a federal mask mandate, announcing Friday that people who refuse to comply could face fines of more than $1,000.

The agency said that it is recommending fines ranging from $250 for a first offense and up to $1,500 for repeat offenders. However, “aggravating” or “mitigating” factors could result in varying penalties, the TSA said.

 

[SurfingDoctor]

Went to the grocery store after my weekend call and actually saw a good number of people wearing masks. I would say like 70%.

This was impressive to me considering 1) it’s voluntary 2) I live in the south with low vaccination rates and higher community spread because freedomz n stuff. It was actually nice to see.

 

[Lawpy]

All the data we've been seeing in a relatively higher vaccinated area compared to the surrounding areas that have generally low vaccination rates is that vaccines are about 90-95% effective at preventing severe illness/hospitalizations but we've seen a hell of a lot of vaccinated people that get very mild or practically asymptomatic cases due to routine screening. We've also seen plenty of vaccinated people who get it with exposures only to other vaccinated people.



Previous infection with COVID seems to confer pretty minimal protection against reinfection and immunity actually seems to wane faster than with vaccines (kind of like shingles and many other virus/vaccine pairs). I've personally seen multiple unvaccinated people that have been reinfected 2-3 times over the last 9-10 month period (we're talking symptomatic each time, months apart, negative tests in between). There are some antibody studies out there that show similar data, but I'm too lazy to look at the moment.



90-95% for hospitalizations/severe infections for us, but I think prevention of covid infection with vaccination is closer to 70-80%.



I've been seeing a ton of this as well. They're getting these even if they didn't have severe infection necessitating hospitalization. The ones that were hospitalized are in worse shape.



There are no areas with near 100% vaccination. The fact that kids can't get vaccinated makes this impossible. Saying that masks are helpful at preventing spread is not saying that vaccinations are not. Nothing is 100%. We often tell people that they wear seatbelts and have cars with airbags because both of them can prevent death in an accident. We're not saying airbags do a better job at saving lives than seatbelts, we're just saying they both help at preventing death.



100%, vaccinated people can absolutely transmit the virus. We've seen many examples of this in my community. Lots of people who are sick with only vaccinated contacts. Masks don't necessarily do a "better job" at preventing outbreaks than vaccines (they might, we honestly don't have the data, but probably not). The argument is more like this:
Masks prevent infections by x degree.
Vaccines prevent infections by y degree.
Masks + Vaccines prevent infections by z degree.
z = x + y
x < z
y < z
x and y are > 0



No one is saying otherwise. We will need that. But guess what, we don't have it yet. Most of the world doesn't even have the first vaccine yet. We've got tons of communities with <50% vaccination amongst those who can be vaccinated, let alone the whole population.

Also, I actually don't think mask mandates in public indoor places being indefinite is unreasonable. Plenty of countries already do this. I don't think it'll happen in America, because generally speaking we care more about our own comfort than protecting even a small percentage of the population from greater harm. We spent almost a year proving that to be the case when we didn't have vaccines.



Dude, the CDC was playing a game. The game was called, convince people to get vaccinated, the same game that you are reportedly advocating. Vaccination rates were waning, supply of vaccines was outpacing demand, and they made the call that now if you are vaccinated, you can do things again without a mask. Do you have any idea how many of my patients that didn't want to get vaccinated prior to that cited that as the only reason they wanted to get vaccinated. It was a boon. A ton of the "on the fence"/"I'll wait until we know more" people were lining up in droves to get the shot. It was actually very effective. It was way more effective then me talking to them about the risks and dangers of infection until my face turned blue. It's probably a major reason as many people are vaccinated now.

Are mask mandates going to hurt vaccination efforts, sure, but it's a risk/benefit analysis. Most of the unvaccinated patients I see are either waiting for some arbitrary amount of time for the vaccine to be out before they get it or they're the never-vaxxers that think "it's too political" and they won't get it until "we know more" about covid/the vaccines, but also can't tell me what they want to know about it. Those people weren't convinced by the removal of mask mandates for months and they won't change their opinion by mask mandates being in place, but at least spread will be decreased.



Awesome summary. I swear, most of the people posting here must not have firsthand clinical experience with this virus.



Not gonna lie, the benefit of not having to shave/trim or "clean up" my facial hair because it's hidden under a mask all day was wonderful.


Nope. Masking helps prevent spread, and as covered above, there's still spread among the vaccinated, less but still some. Also as mentioned by another poster, even mild infections (like the ones most vaccinated people get) can have a big economic impact from a loss in productivity standpoint.

Kids are going to be vaccinated in near future. In a population with mostly kids, wearing masks is reasonable. There's already major pressure on fda to authorize vaccines for kids

There comes a point where wearing masks on top of being vaccinated becomes redundant though. Enforcing vaccine mandates everywhere will ensure close to full vaccination, even if it isn't 100%

Yes i'm seeing how in general vaccines + masks can be better than masks or vaccines alone in a partially vaccinated population

I find it really surprising a lot of vaccine hesitant people are getting vaccinated because of cdc because i'm seeing the opposite: the people who dropped the masks mostly did not get vaccinated in the first place

The first step now should be to enforce vaccine mandates everywhere

 

[xffan624]

Went to the grocery store after my weekend call and actually saw a good number of people wearing masks. I would say like 70%.

This was impressive to me considering 1) it’s voluntary 2) I live in the south with low vaccination rates and higher community spread because freedomz n stuff. It was actually nice to see.

The reality is Delta is scaring people. In the good news department, daily vaccination rates are up from about 500K a day to 700K a day. I suspect fear is driving more of those than vaccine mandates, but it's probably a combination. In the bad news department daily COVID positive rates are up to 110K+ in the US.

 

[Lawpy]

Went to the grocery store after my weekend call and actually saw a good number of people wearing masks. I would say like 70%.

This was impressive to me considering 1) it’s voluntary 2) I live in the south with low vaccination rates and higher community spread because freedomz n stuff. It was actually nice to see.

I've seen close to zero. The mask mandate discussion is mostly an sdn discussion for me

 

[Lawpy]

The reality is Delta is scaring people. In the good news department, daily vaccination rates are up from about 500K a day to 700K a day. I suspect fear is driving more of those than vaccine mandates, but it's probably a combination. In the bad news department daily COVID positive rates are up to 110K+ in the US.

It's a shame this didn't happen months ago when delta first went on a deadly rampage

 

[xffan624]

It's a shame this didn't happen months ago when delta first went on a deadly rampage

Well, it follows the long American tradition of closing the barn door after the horses have gotten out. Or of Americans only caring about something until it personally affects them.

 

[Mass Effect]

There is this from few months ago

https://www.google.com/amp/s/www.washingtonpost.com/transportation/2021/02/05/tsa-mask-fines/%3foutputType=amp

Travelers who refuse to wear masks could face fines of more than $1,000, TSA says​

The Transportation Security Administration is beefing up its enforcement of a federal mask mandate, announcing Friday that people who refuse to comply could face fines of more than $1,000.

The agency said that it is recommending fines ranging from $250 for a first offense and up to $1,500 for repeat offenders. However, “aggravating” or “mitigating” factors could result in varying penalties, the TSA said.

So you're scouring the Internet to see something to back up this claim basically. Yes, the TSA is allowed to fine people for things. Not wearing a mask on a plane is lunacy. Frankly, I'm in favor of a second offense resulting in being on the no-fly list. Flying is not a right. If you don't want to wear a mask on a plane, don't fly.

 

[Lawpy]

So you're scouring the Internet to see something to back up this claim basically. Yes, the TSA is allowed to fine people for things. Not wearing a mask on a plane is lunacy. Frankly, I'm in favor of a second offense resulting in being on the no-fly list. Flying is not a right. If you don't want to wear a mask on a plane, don't fly.

I mean you were asking for examples and citing sources. And the TSA example is a clear legal penalty

Statewide mask orders usually affect businesses and school districts at large by either fining them, cutting funding or shutting private businesses down. Individual penalties involve being denied entry to places. These actions are fought with lawsuits many of which are ongoing