COVID - a post-mortem

[RadOncDoc21]

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Once my referring docs stop wearing masks, I will! The only problem is I have to take it off fast when I see other referring docs on the other end of the spectrum. The worst part is when I see them together and I pretend I’m drinking water.

 

[elementaryschooleconomics]

Gotta at least do it for a pic in clinic, otherwise they'd get cancelled by the "OMG YOU'RE GOING TO KILL YOUR PTS WITH COVID THROUGH THE COMPUTER SCREEN AND LEAD WALLS" crowd that seems to still be going strong (see earlier in this thread about the brave person still wearing an N95 wherever she goes)

Once my referring docs stop wearing masks, I will! The only problem is I have to take it off fast when I see other referring docs on the other end of the spectrum. The worst part is when I see them together and I pretend I’m drinking water.

I carry a printed copy of the Cochrane Review on mask efficacy at all times with me, just in case. Like my driver's license.

Oh...wait. I'm a rural doc.

The masks are only in the OR. Like in the before time. The long, long ago.

 

[Ray D. Ayshun]

I'd mask up, too, if I were whoring myself on X.

 

[elementaryschooleconomics]

SDN does not as a matter of policy allow mask and vaccine denial discussions. While this is above my head and not my policy, I am fine to enforce it as I do not disagree.

This is still the policy?

I legit can't keep any of this straight anymore.

Which is exactly...what they want me to think...

 

[Chartreuse Wombat]

This is still the policy?

I legit can't keep any of this straight anymore.

Which is exactly...what they want me to think...

OK lets see how long this post lasts.

1) COVID vaccine doesn't prevent COVID infection (it does protect against severe illness in the unvaccinated)
2) On a population level masks provide no benefit

To make either of these claims (after evidence accumulated) was verboten.

Please let's learn from our mistakes.

The Prophets: D.A. Henderson

Years before Covid, the scientist credited with eradicating smallpox warned against shutting down the world to combat an epidemic.

www.thefp.com

 

[TheWallnerus]

OK lets see how long this post lasts.

1) COVID vaccine doesn't prevent COVID infection (it does protect against severe illness in the unvaccinated)
2) On a population level masks provide no benefit

To make either of these claims (after evidence accumulated) was verboten.

Please let's learn from our mistakes.

The Prophets: D.A. Henderson

Years before Covid, the scientist credited with eradicating smallpox warned against shutting down the world to combat an epidemic.

www.thefp.com

It’s true

 

[elementaryschooleconomics]

OK lets see how long this post lasts.

1) COVID vaccine doesn't prevent COVID infection (it does protect against severe illness in the unvaccinated)
2) On a population level masks provide no benefit

To make either of these claims (after evidence accumulated) was verboten.

Please let's learn from our mistakes.

The Prophets: D.A. Henderson

Years before Covid, the scientist credited with eradicating smallpox warned against shutting down the world to combat an epidemic.

www.thefp.com

Yeah I mean - SDN is a private entity, I support a private entity creating and enforcing its own policies at all times.

Simultaneously, your two statements are indeed now evidence-based and you posted them without editorializing.

But - SDN could very well have zero desire for controversy of that particular nature so it wouldn't be crazy to me if it were still the policy.

As the kids say: maybe SDN don't want that smoke.

 

[deleted1180461]

OK lets see how long this post lasts.

1) COVID vaccine doesn't prevent COVID infection (it does protect against severe illness in the unvaccinated)
2) On a population level masks provide no benefit

To make either of these claims (after evidence accumulated) was verboten.

Please let's learn from our mistakes.

The Prophets: D.A. Henderson

Years before Covid, the scientist credited with eradicating smallpox warned against shutting down the world to combat an epidemic.

www.thefp.com

I was hopeful we were at the point past overt shameless censorship of any criticism or even noticing the Covid hysterics and just at mocking (galaxy braining as hard as i can!) those who still care about it (hint: the 6 trillion didn’t come from your taxes in 2020), but apparently not. If the Iraq war was any clue, these things take at least a decade.

That said, I’m not super interested in getting doxxed at work (again). Appreciate the efforts by mods on the rad onc forum specifically to try and stay neutral politically. Especially seeing a mod lightly jab at the mask silliness. I will hold out hope for our future still!

 

[evilbooyaa]

This is still the policy?

I legit can't keep any of this straight anymore.

Which is exactly...what they want me to think...

I mean it was more of an issue during the time when COVID was more concerningly a 'thing' which is not the case (for most, including myself) now.

The warning that MWRO received from me (once he was unbanned), was more for 'political ranting' than anything else.

Just keep your politics in your pants. It's OK to state you have a lean to to your politics, but to take it out of your pants, flash it around and shove it in people's faces is not what we're going for and will be frowned upon. And when mods/admins both in RO and not in RO frown, warnings and bans happen, because we don't like frowning. If you want to discuss politics, there's a whole forum for that, called 'sociopolitical forum'.

Although be careful, that's where sirspamsalot got in trouble and he ended up being banned because of his actions in SPF (on top of all his nonsense in the SDN RO forum)

But as I hope you (and other conservative leaning SDN members) can see, we try to avoid simply being a 'liberal' hot-spot... see the ongoing existence of the 'Dare you to reply' thread.

 

[elementaryschooleconomics]

I mean it was more of an issue during the time when COVID was more concerningly a 'thing' which is not the case (for most, including myself) now.

The warning that MWRO received from me (once he was unbanned), was more for 'political ranting' than anything else.

Just keep your politics in your pants. It's OK to state you have a lean to to your politics, but to take it out of your pants, flash it around and shove it in people's faces is not what we're going for and will be frowned upon. And when mods/admins both in RO and not in RO frown, warnings and bans happen, because we don't like frowning. If you want to discuss politics, there's a whole forum for that, called 'sociopolitical forum'.

Although be careful, that's where sirspamsalot got in trouble and he ended up being banned because of his actions in SPF (on top of all his nonsense in the SDN RO forum)

But as I hope you (and other conservative leaning SDN members) can see, we try to avoid simply being a 'liberal' hot-spot... see the ongoing existence of the 'Dare you to reply' thread.

The "Dare you to Reply" thread remains the most bold thing I've seen these forums do! As is evidenced by the fact that I have it on "Mute" and if there was a way to easily tabulate it, I believe we'd find I've posted in there like...4 times since it was started years ago.

I identify these days more as a "Frustrated Libertarian", or something. Maybe. I guess. I don't know.

This IS NOT SDN's problem, and not even directed at SDN, or really anyone or anything other than "the zeitgeist", but I'm increasingly alarmed that there continues to be no separation of the pandemic from politics. Obviously I get why and how it became this way but...

Inside my head, in my imagination, exists a place where I can talk about the pandemic and the virus completely devoid of politics. Same with climate change. Both those areas - the science and policy within those areas - are extremely worthy of exploration in a vacuum. And that's not happening now. And I don't see it happening in the future.

Alas.

 

[Ray D. Ayshun]

OK lets see how long this post lasts.

1) COVID vaccine doesn't prevent COVID infection (it does protect against severe illness in the unvaccinated)
2) On a population level masks provide no benefit

To make either of these claims (after evidence accumulated) was verboten.

Please let's learn from our mistakes.

The Prophets: D.A. Henderson

Years before Covid, the scientist credited with eradicating smallpox warned against shutting down the world to combat an epidemic.

www.thefp.com

Well, if we're allowed to talk about, I may have a semantical issue with statement 1. While it never "prevented" entirely, I thought there was good evidence that at least in the early days, vaccination reduced infection rate and transmission rate.

 

[evilbooyaa]

OK lets see how long this post lasts.

1) COVID vaccine doesn't prevent COVID infection (it does protect against severe illness in the unvaccinated)
2) On a population level masks provide no benefit

To make either of these claims (after evidence accumulated) was verboten.

Please let's learn from our mistakes.

The Prophets: D.A. Henderson

Years before Covid, the scientist credited with eradicating smallpox warned against shutting down the world to combat an epidemic.

www.thefp.com

1) Sure, don't disagree. COVID vaccine being taken to prevent COVID infection was a means to an end (not saying I agree with that or not) to get people to take the damn Vaccine, because what it really did is it reduced hospitalizations and deaths, and prior to it, those hospitalizations and deaths were overwhelming hospitals and increasing likelihood of dying from OTHER treatable conditions because a hospital was overwhelmed.

And if you feel the need to refute this and did not live in the hotbeds of COVID pre vaccine availability (New York area, Pacific Northwest I believe, etc.) then I encourage you to keep any uninformed thoughts to yourself.

2) Sure. But to question the utility of masks to prevent an airborne virus, while hospitals were actively being overwhelmed routinely, was the public health issue that SDN wanted to be on the conservative side of. No harm to wearing the mask. Potential significant harm to saying no masks is fine (at that time).

To suggest that we 'learn from our mistakes', means that you think that next time there is a worldwide pandemic that spreads by airborne transmission that we shouldn't get vaccinated and we shouldn't wear masks (I presume not wearing masks anywhere, including hospitals?).

Anyways, don't want RO Twitter thread to continue to devolve into this. CW if you're interested in discussing further, PM me.

 

[elementaryschooleconomics]

Well, if we're allowed to talk about, I may have a semantical issue with statement 1. While it never "prevented" entirely, I thought there was good evidence that at least in the early days, vaccination reduced infection rate and transmission rate.

If you mean the initial clinical trial, I agree - except the endpoints guaranteed a positive trial.

The primary endpoint was:

"Number of Participants With a First Occurrence of COVID-19 Starting 14 Days After Second Dose [ Time Frame: From Day 43 (14 days after second dose) up to approximately 7 months after the second dose ]"

So...from time to enrollment to time to assess primary endpoint was...43 days. 6 weeks. Asymptomatically infected individuals would meet inclusion criteria and the illness would be resolved by that endpoint. Heck, you could get sick after the first dose and have it totally resolved by the second dose!

Anyways, don't want RO Twitter thread to continue to devolve into this. CW if you're interested in discussing further, PM me.

Excellent point, I'm walking away from this topic too, I just wanted to highlight that there's a way to look at these trials just like we rip apart the proton trials...

 

[Ray D. Ayshun]

If you mean the initial clinical trial, I agree - except the endpoints guaranteed a positive trial.

The primary endpoint was:

"Number of Participants With a First Occurrence of COVID-19 Starting 14 Days After Second Dose [ Time Frame: From Day 43 (14 days after second dose) up to approximately 7 months after the second dose ]"

So...from time to enrollment to time to assess primary endpoint was...43 days. 6 weeks. Asymptomatically infected individuals would meet inclusion criteria and the illness would be resolved by that endpoint. Heck, you could get sick after the first dose and have it totally resolved by the second dose!


Excellent point, I'm walking away from this topic too, I just wanted to highlight that there's a way to look at these trials just like we rip apart the proton trials...

Everything I see suggests that getting a vaccine reduces your risk of getting infected for some amount of time. There's a semantical argument from one side that some ID doc somewhere said it prevents it entirely, but that's a separate issue.

 

[elementaryschooleconomics]

Everything I see suggests that getting a vaccine reduces your risk of getting infected for some amount of time. There's a semantical argument from one side that some ID doc somewhere said it prevents it entirely, but that's a separate issue.

I generally agree with you on this, too.

The semantical argument is actually one of Health Policy - in the beginning, that's what we were told by the government and...everyone. It was not true.

In an abstract sense, you can spawn entire PhD dissertations on Health Policy and Scientific Communication and Political Science on that alone.

WHICH IS WHAT I WANT TO SEE! So deeply.

Just...make it a requirement for those PhD dissertations that you must invoke an imaginary world and aren't allowed to actually use the names of any person, political party, or organization from the real world.

I jumped at the chance to get the initial vaccines, knowing the data. I wore masks, knowing the data. I social distanced, knowing the data.

I did so assuming that, when years had gone by and the "E" in the "PHE" was over, we would conduct a post-mortem on everything we did or didn't do, and craft better action plans for the future.

I held up my end of the deal as a citizen, doctor, and scientist. I'm still waiting for the favor to be returned.

I'M TRYING TO WALK AWAY GAAAH

 

[elementaryschooleconomics]

@evilbooyaa - how would an extraordinarily, aggressively moderated pandemic-data thread be received on SDN?

These handful of posts are the most reasonable discussion on this topic I've seen on the internet.

Maybe nerdy RadOncs who have been trained to dissect the most obscure trials are the ones to have a real exploration of this topic...and create world peace?

 

[Ray D. Ayshun]

@evilbooyaa - how would an extraordinarily, aggressively moderated pandemic-data thread be received on SDN?

These handful of posts are the most reasonable discussion on this topic I've seen on the internet.

Maybe nerdy RadOncs who have been trained to dissect the most obscure trials are the ones to have a real exploration of this topic...and create world peace?

a radonc specific comparison is, is a covid vaccine more or less likely to prevent infection than ldrt is to relieve OA pain?

 

[elementaryschooleconomics]

a radonc specific comparison is, is a covid vaccine more or less likely to prevent infection than ldrt is to relieve OA pain?

Oh very interesting.

I haven't dissected the most recent booster data - the last number I remember seeing was 54%? Am I wrong? I'll go look.

If it's less than 80% effective, it's significantly less likely.

But.

That's an amazing thought experiment that I will continue to consider.

 

[Ray D. Ayshun]

Oh very interesting.

I haven't dissected the most recent booster data - the last number I remember seeing was 54%? Am I wrong? I'll go look.

If it's less than 80% effective, it's significantly less likely.

But.

That's an amazing thought experiment that I will continue to consider.

Even more interesting, what will the answer change?

 

[deleted1180461]

To suggest that we 'learn from our mistakes', means that you think that next time there is a worldwide pandemic that spreads by airborne transmission that we shouldn't get vaccinated and we shouldn't wear masks (I presume not wearing masks anywhere, including hospitals?).

100%. Not even a question. Allow me one gentle rant, not intending to debate anything but just to state my opinion and some facts, and I will shut up about this topic, I promise. I believe (especially as a physician) mandating any intervention for medical purposes is failure on a basic moral level, and I will die on this hill (you may have guessed with the mockery over this being my #1 issue). The vaccine was experimental by definition (no long term data) and from the very beginning a narrative was created to allow only it and the awful (but profitable) therapeutic remdesivir in conjunction with obviously unscientific lockdown (shutting down gyms and churches but not liquor/weed stores and political protests) and masking theatrics (wearing bandanas to restaurants) as solutions to this disease and to attack any other proposed solutions as dangerous conspiracy theories. The public was lied to with a nonsensical narrative that lockdowns and forced vaccinations were necessary to prevent others from catching it from healthy appearing people, which with the biology of this virus (extremely high R0) could only have been possible with total isolation indefinitely (China tried and failed) or true vaccine that had near 100% effectiveness in preventing asymptomatic transmission (which the public was told it was but ended up nowhere near this goal). The public was deliberately misled about who was at risk of death or severe disease (the very old, and the very obese) and emotionally manipulated with death counters on CNN that ticked up second by second (as if such real time data could ever exist). Studies showed that public perceptions of risk were off by orders of magnitude (From a Gallup poll, 41% of democrats and even 21% of republicans believed that unvaccinated people across the board had a >50% risk of hospitalization when the true odds were <1%).

The complete failure of all of the above is evidenced by simply looking at outcomes in Sweden, a liberal progressive country that did none of the above and simply isolated those at the highest risk, which they were honest about. They did not do measurably worse than the US or other countries. And if you really want to get into the weeds, you can look at the data from Africa and wonder why that continent was so disproportionately unaffected by this.

What did all this get us?
- Out of control inflation and a rapidly growing wealth divide between those who owned stocks and real estate pre-pandemic vs. those who did not.
- No improved outcomes
- A burgenoning debt crisis
- Massive increase in overdose deaths, drug and alcohol abuse, and mental health issues and suicide of our young healthy people (Swedens excess death rate was the lowest in all of Europe). Lockdowns and social isolation have severe collateral consequences no one had the political fortitude to consider.
- A distrust in the health system leading to poor health outcomes from avoiding preventative care.
- An educationally and socially stunted group of children and adolescents who were not at serious risk but kept out of school for over a year in many cases anyway.
- Vaccine injuries and even deaths in otherwise young healthy people, who again were not at serious risk (in Europe the vaccine is not recommended for these groups, but it was mandated for many here).
- Breaking apart of families and friendships from people who agree with literally anything I wrote above as evil selfish murderers who don't care about killing grandma.

This is why it's my #1 issue. I will never forget what they did. Bobby Kennedy may have a few wacky ideas, but he's a smart man, not the flat-earther he is demonized to be. He is not motivated to seek office for personal gain like virtually everyone else (when your family has a track record of being literally assassinated for trying to do the right thing). Read his book and listen to him speak. (unclear if just mentioning his name is what got me in the dog house or not, guess we will find out). Lots of people are politically homeless like ESE alluded to above these days as the left has adopted the most fringe ideas in tiny corners of universities 20 years ago as their current mainstream positions and the right has factioned off into circus-like performative feuds. Also, if you haven't listened to his VP pick yet, give her a chance. I'm baffled at how anyone could look at the other 2 options and say yeah, Bobby K is definitely the crazy one here.

Thank you.

 

[elementaryschooleconomics]

Even more interesting, what will the answer change?

No! Don't succumb to the nihilism!

My answer to your question about the answer's effect is my entire theory of why I'm on SDN:

The point of writing here is NOT to talk to each other. I mean it is, of course. But not really.

Barring crazy infrastructure changes to the entire internet, these posts will be here forever. They are indexed by search engines.

Who knows how long these servers stay up. They've been here for >20 years at this point so let's just go with 20 more years.

How many people will read our conversations in those 20 years? How will our thoughts influence their thoughts? What effect does that have in the world?

Debate is good. It's currently a lost art form. It still exists here, to a degree (as always: thanks to the strong moderating by @Neuronix and @evilbooyaa).

While I know it's never going to happen, I still lament the absence of a meritocracy in science, medicine, and government.

As such, I don't care if any of us are "right" or "wrong". Maybe having a discussion about something, some undergrad thinking about med school will read my post, disagree with whatever I'm saying, and it's added to the background library of their mind, and in some way down the road they have a career that proves me "wrong" but brings us closer to "truth"...whatever that means.

Probably stupid on my part but hey - I can dream.

 

[Chartreuse Wombat]

Even more interesting, what will the answer change?

I hope that the Public Health Establishment will manifest some humility during the next crisis (and there will be one).

I encourage all to read the article on D.A. Henderson.

Money quote from Dr Henderson

‘You have to be practical, and you have to be humble, about what public health can actually do, especially over sustained periods. Society is complicated, and you don’t get to control it.’

The brave few who tried to provide an argument that closing down society would have negative consequences were pilloried.

The consequences of school closing will be felt for decades to come

 

[elementaryschooleconomics]

Lots of people are politically homeless like ESE alluded to above these days

Good Lord, I'm stealing this forever.

 

[Chartreuse Wombat]

One more quote (article attached)

Experience has shown that communities faced with epidemics or other adverse events respond best and with the least anxiety when the normal social functioning of the community is least disrupted.

 

[elementaryschooleconomics]

Everyone being normal humans on this topic in this thread gives me a half percent more optimism for our future.

 

[Ray D. Ayshun]

I hope that the Public Health Establishment will manifest some humility during the next crisis (and there will be one).

I encourage all to read the article on D.A. Henderson.

Money quote from Dr Henderson

‘You have to be practical, and you have to be humble, about what public health can actually do, especially over sustained periods. Society is complicated, and you don’t get to control it.’

The brave few who tried to provide an argument that closing down society would have negative consequences were pilloried.

The consequences of school closing will be felt for decades to come

There's a chicken/egg question here. When's the last time the public wanted the truth from politicians? Nuance emigrated a long time ago.

 

[Chartreuse Wombat]

There's a chicken/egg question here. When's the last time the public wanted the truth from politicians? Nuance emigrated a long time ago.

I am not blaming the politicians. I am blaming the scientists (some of whom are politicians but their primary loyalty should be science). If they don't know or are unsure most adults will accept that.

 

[deleted1180461]

Everyone being normal humans on this topic in this thread gives me a half percent more optimism for our future.

50/50 chance the normalcy gets scrubbed. I will be thrilled with just mockery though because PROGRESS! I'm saving what I wrote, maybe send to doximity when I get bored enough to feel like doxxing myself.

 

[Mandelin Rain]

Did y'all like 2020 so much that you want to re-live it over and over again?

It sucked. Mistakes were made. Mistakes well beyond COVID. Mistakes not limited to any political party.

Hopefully we've all learned things from that terrible ****ing year.

As far as I'm concerned January 7th, 2021 wiped the slate clean. If you're still making the same mistakes now, that's on you. But, re-litigating the nonsense will make no difference now, nor will it prevent future or current nonsense.

 

[RadOncDoc21]

Can we at least agree that viruses could care less about politics?

 

[TheWallnerus]

Can we at least agree that viruses could care less about politics?

On a scale of 0 to 100, if 100 is "cares maximally" and 0 is "cares none," viruses care zero about politics.
Thus, I do not agree that viruses could care less about politics.
They could not care less.
So, see, we can agree on nothing!!!!

 

[Ray D. Ayshun]

From my own experience teaching mid-level college genetics and having someone ask how I get from 1/4 to 0.25, I don't get too up-in-arms about polls where people completely misunderstand stats or risks. I am frustrated in retrospect by the focus of some public health docs on RRR with respect to infection. That wasn't the point.

 

[evilbooyaa]

These posts have been moved into their own thread, and this thread will now be locked.