Stopping Elective Cases

[vector2]

I am awaiting the data, but consider for a moment that vaccination usually reduces the severity of the disease to either mildly symptomatic or asymptomatic. It’s a virus that’s spread airborne and/or through respiratory droplets, so I would conjecture that transmissibility would be decreased if a carrier has less sneezing, nasal drip, and coughing due to being vaccinated.

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[Ezekiel2517]

Is it uniformly accepted that vaccinated individuals carry virus and can infect others? Is it also accepted that vaccination lessens or eliminates symptoms?

If both are true, the argument of getting the vaccine to protect OTHERS seems invalid.

Furthermore, the asymptomatic carrier would be MORE likely to infect others, like giving your sick kid Tylenol and sending them to school.

So far as the at-risk population getting the shot to protect themSELVES, that seems like a reasonable risk benefit to consider.

Yes, it has been shown that ppl infected w/ Delta can at first build up comparable levels of virus in their nose regardless of vaccination status.

However, studies have shown these viral loads fall much more quickly in vaccinated ppl. And this actually follows common sense since those who are vaccinated have the immune defenses to prevent the virus from replicating uncontrollably in the airway, lungs, etc.. Which is why those who are vaccinated are still protected against severe disease/hospitalization/death, unlike the unvaccinated. And, since vaccinated ppl are therefore much less likely to get infected and have symptomatic disease, they are also much less likely to transmit Delta. Unfortunately, the "media" most ppl get their info from, isn't doing a good enough job of getting this across.

Virological and serological kinetics of SARS-CoV-2 Delta variant vaccine-breakthrough infections: a multi-center cohort study

Objectives Highly effective vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been developed but variants of concerns (VOCs) with mutations in the spike protein are worrisome, especially B.1.617.2 (Delta) which has rapidly spread across the world. We aim to study...

www.medrxiv.org

 

[gasdoc77]

I am awaiting the data, but consider for a moment that vaccination usually reduces the severity of the disease to either mildly symptomatic or asymptomatic. It’s a virus that’s spread airborne and/or through respiratory droplets, so I would conjecture that transmissibility would be decreased if a carrier has less sneezing, nasal drip, and coughing due to being vaccinated.

So if vaccination makes the disease asymptomatic, would the vaccinated asymptomatic carrier be more likely to go to churches, grocery, schools, and nursing homes than a young healthy unvaccinated person who is aware they aren't feeling well?

 

[vector2]

So if vaccination makes the disease asymptomatic, would the vaccinated asymptomatic carrier be more likely to go to churches, grocery, schools, and nursing homes than a young healthy unvaccinated person who is aware they aren't feeling well?

1. The transmissibilty from the asymptomatic vaccinated does not last as long and its peak is probably shorter lived.

2. Your hypothetical operates under the false assumption that the infected-unvaccinated don't also have a decently long period where they are asymptomatic but contagious. Which they do. In fact, there's a possibility that delta infected may be contagious within 2 to 3 days of exposure, which would likely be before the onset of sxs severe enough to make them consider staying home, assuming those symptoms even appear while they spend days to weeks being contagious.

 

[Southpaw]

So if vaccination makes the disease asymptomatic, would the vaccinated asymptomatic carrier be more likely to go to churches, grocery, schools, and nursing homes than a young healthy unvaccinated person who is aware they aren't feeling well?

that you Tucker?

 

[Blockit]

1. The transmissibilty from the asymptomatic vaccinated does not last as long and its peak is probably shorter lived.

2. Your hypothetical operates under the false assumption that the infected-unvaccinated don't also have a decently long period where they are asymptomatic but contagious. Which they do. In fact, there's a possibility that delta infected may be contagious within 2 to 3 days of exposure, which would likely be before the onset of sxs severe enough to make them consider staying home, assuming those symptoms even appear while they spend days to weeks being contagious.

How many “asymptomatic vaccinated” have you seen? Every single vaccinated person that has gotten delta that I know of had *some* symptoms.

 

[vector2]

How many “asymptomatic vaccinated” have you seen? Every single vaccinated person that has gotten delta that I know of had *some* symptoms.

Personally I've seen none. However we don't really have widespread PCR surveillance data yet of the asymptomatic vaccinated for the CDC to share with us, so obviously when you hear about a breakthrough case it's because the affected person was sick enough to seek a test and/or treatment, which thus leads to selection bias.


E: take a look at the 27 vaccinated positives on that Carnival ship recently. They reported "mild to no symptoms"

 

[Mman]

How many “asymptomatic vaccinated” have you seen? Every single vaccinated person that has gotten delta that I know of had *some* symptoms.

I assume that is because vaccinated people are only getting tested if they are symptomatic. By definition they had symptoms to even seek out a test.

 

[Stank811]

How do vaccinated people spread Delta? What the science says

Emerging data suggest that Delta could spread more readily than other coronavirus variants among people vaccinated against COVID-19. But key questions remain.

www.nature.com

wouldn’t say it is wide spread PCR data but it small sample size suggest even the asymptomatic vaccinated have high levels

 

[nimbus]

So if vaccination makes the disease asymptomatic, would the vaccinated asymptomatic carrier be more likely to go to churches, grocery, schools, and nursing homes than a young healthy unvaccinated person who is aware they aren't feeling well?

That’s a good reason to keep masking even if you’re vaccinated. I still mask at Target.

 

[nimbus]

How many “asymptomatic vaccinated” have you seen? Every single vaccinated person that has gotten delta that I know of had *some* symptoms.

The problem is that we don’t know the true denominator. How would we know how many “asymptomatic vaccinated” we have unless we surveillance test the entire population. In Wuhan they actually did this when they detected 3 local cases of delta.

China's Wuhan to test all 12 million residents as Delta variant spreads

China's Wuhan city will test its 12 million residents for the coronavirus after confirming its first domestic cases of the highly transmissible Delta variant.

www.reuters.com

 

[nimbus]

Welp I just got a text that my scheduled AVR/CABG tomorrow morning is cancelled because we don’t have an icu bed to put them postop. Boo…..it’s starting again.

 

[wholeheartedly]

Personally I've seen none. However we don't really have widespread PCR surveillance data yet of the asymptomatic vaccinated for the CDC to share with us, so obviously when you hear about a breakthrough case it's because the affected person was sick enough to seek a test and/or treatment, which thus leads to selection bias.


E: take a look at the 27 vaccinated positives on that Carnival ship recently. They reported "mild to no symptoms"

This data does exist, more at the local level. Nursing homes are still doing regular testing of staff and residents, frequency contingent on community prevalence and facility positives.

We had a few vaccinated staff test positive and they were asymptomatic. Per discussion with our health department after second samples were submitted, what they were generally seeing was with breakthrough cases was people with high Ct values or Ct values that suggest viral load dropped quickly. There’s also a preprint I saw that says yes vaccinated people do have high viral loads at onset, as approximated by Ct value, but drop quickly. Which makes perfect sense and duration of transmissibility would be shorter.

It’s tricky though because Ct values are only a loose approximation of viral load, don’t account for virus viability, are not linear on the assay, can’t be compared across platforms, change location and viral load during infection, and can have larger imprecision than people expect. So this is all just fairly loose approximations.

 

[Mman]

That’s a good reason to keep masking even if you’re vaccinated. I still mask at Target.

Target feels like a safer environment than Walmart.

 

[DrZzZz]

Welp I just got a text that my scheduled AVR/CABG tomorrow morning is cancelled because we don’t have an icu bed to put them postop. Boo…..it’s starting again.

We've got a limit on our cardiac volume due to lack of perfusionists. They're all marooned in the ICU managing the Covid patients on ecmo.

 

[GassYous]

We've got a limit on our cardiac volume due to lack of perfusionists. They're all marooned in the ICU managing the Covid patients on ecmo.

The fact that we are placing these jokers on ecmo says it all about our society

 

[circleK]

Getting back on track to the original thread subject I’m curious what areas you all are in that are seeing OR cases halted?

 

[coffeebythelake]

Getting back on track to the original thread subject I’m curious what areas you all are in that are seeing OR cases halted?

Our hospital is lucky to be largely spared by covid. We have a covid icu but it isn't overflowing, still the patient demographics getting intubated are the same as what others have described: largely unvaxxed. We briefly had to halt elective cases in 2020 during the initial crisis but has since been full steam ahead with cases. In fact we have been busier than ever.

 

[OneFellSwoop]

I also agree vaccination helps reduce morbidity and mortality.

I agree recommendations for vaccination should be made based on risk assessment but even then I have a hard time with mandates which is a different discussion

This. In the rural areas I’m at, many well educated people with advanced degrees, including physicians, teachers etc simply won’t get the vaccine because they feel they are being forced. Nevermind the science which when I’ve explained they all understand and agree, but would rather take covid’s risk than be ‘coerced’ into a vaccine.

Like it or not, you may think they are stupid or not, but this is the world we live in and we have to find a better way than mandates. What that way is, I have no idea. It might be just to let it run rampant via a viral-aided social Darwinism. Not a good plan, but like the saying goes: you can lead a horse to water…

 

[dpmd]

No but by being vaccinated doesn’t prevent you from spreading COViD either

It makes you less likely to get it and spread it (and if you do get it then you are also infectious for less time)

 

[Zekchar]

Like it or not, you may think they are stupid or not, but this is the world we live in and we have to find a better way than mandates. What that way is, I have no idea. It might be just to let it run rampant via a viral-aided social Darwinism. Not a good plan, but like the saying goes: you can lead a horse to water…

This might be it right here. Two things needs to happen:
1) Insurance companies must decline reimbursement for COVID related complications or hospitalizations to previously unvaccinated
2) Those that are unvaccinated have to be declined care at hospitals. If those struggling with this concept due to Hippocratic oath guilt then those same patients are to be given 2 days on the vent then mandatory trial of extubation.

There needs to be legit consequences for not getting the vaccine. Everything is a bailout that needs to end.

 

[coffeebythelake]

This might be it right here. Two things needs to happen:
1) Insurance companies must decline reimbursement for COVID related complications or hospitalizations to previously unvaccinated
2) Those that are unvaccinated have to be declined care at hospitals. If those struggling with this concept due to Hippocratic oath guilt then those same patients are to be given 2 days on the vent then mandatory trial of extubation.

There needs to be legit consequences for not getting the vaccine. Everything is a bailout that needs to end.

the 1st one might be fairly easy to do since insurance companies are evil
the 2nd one might only occur if there was an actual critical shortage and care rationing situation

 

[dpmd]

the 1st one might be fairly easy to do since insurance companies are evil
the 2nd one might only occur if there was an actual critical shortage and care rationing situation

The more likely thing is that it would be decided by lottery or chances of survival, not by who was taking precautions or not.

 

[Stank811]

It makes you less likely to get it and spread it (and if you do get it then you are also infectious for less time)

Not sure if we can say your less likely to get it….on the random samples using PCR looks as if your chance of testing positive is not significantly different and all the recent data suggest the viral load is the same which suggest if you are vaccinated you are not less likely to spread it. I agree the current days that I have read suggest vaccinated individuals are infectious for a couple days less.

 

[Stank811]

This might be it right here. Two things needs to happen:
1) Insurance companies must decline reimbursement for COVID related complications or hospitalizations to previously unvaccinated
2) Those that are unvaccinated have to be declined care at hospitals. If those struggling with this concept due to Hippocratic oath guilt then those same patients are to be given 2 days on the vent then mandatory trial of extubation.

There needs to be legit consequences for not getting the vaccine. Everything is a bailout that needs to end.

Not sure what to say…scary thoughts

 

[vector2]

the 1st one might be fairly easy to do since insurance companies are evil
the 2nd one might only occur if there was an actual critical shortage and care rationing situation

Yeah, the denying care from your insurer idea sounds good on its face, but upon deeper examination it's terrible in that it reinforces the notion that healthcare is only a consumer commodity (as opposed to a necessity that literally everyone uses at some point in their lives), and it takes us back to the notion that the insurer should be the one deciding what's a preexisting condition, deciding what tier health plan you fit in and whether there's a qualified pre-auth, and ultimately deciding who pays for what- instead of leaving it up to the person who should really be calling the shots: the physician.

I much prefer that employers, shopping malls, grocery stores, restaurants, banks and pretty much every public place one could think of make vaccination a condition of being employed or present. It's not ideal but it's better than messing with people's health coverage.

 

[dpmd]

Not sure if we can say your less likely to get it….on the random samples using PCR looks as if your chance of testing positive is not significantly different and all the recent data suggest the viral load is the same which suggest if you are vaccinated you are not less likely to spread it. I agree the current days that I have read suggest vaccinated individuals are infectious for a couple days less.

The Israel data based on surveillance including looking for asymptomatic infection showed reduced but not zero effectiveness for preventing infection.

 

[vector2]

Not sure what to say…scary thoughts

Nah, her sentiment isn't scary. It's actually a perfectly rational piece of reasoning that just happens to have negative unintended consequences vis a vis the power that insurance companies would hold.

What's absolutely scary is that 20% of the population would die out of spite (and infect others along the way) due to a misguided notion of "freedom" and another 20% would sacrifice themselves based on a Facebook misinformation post shared by a trollbot.

 

[Stank811]

Nah, her sentiment isn't scary. It's actually a perfectly rational piece of reasoning that just happens to have negative unintended consequences vis a vis the power that insurance companies would hold.

What's absolutely scary is that 20% of the population would die out of spite (and infect others along the way) due to a misguided notion of "freedom" and another 20% would sacrifice themselves based on a Facebook misinformation post shared by a trollbot.

To suggest any population of people should be declined care is scary

 

[vector2]

To suggest any population of people should be declined care is scary

We literally do it all the time. Or before covid were you crusading for the IVDU on his 2nd tricuspid valve to get a 3rd? Or that the cirrhotic who can't or won't put down the Jack is just as entitled to a liver as the other cirrhotic who went through hell on earth to stay off the sauce? Or how bout all the uninsured LVEF 20%'ers at my charity hospital who don't get to go across town to the large hospital system where one pretty much has to have BCBS to get an LVAD? Will you take up their mantle? And surely you agree that we should go single-payer tomorrow so everyone has healthcare, right?

Spare me the sob story you're trying to sell me about "denying care," my dude. You're only dying on that hill now because you got wrong-headed ideas about covid. At least substance abuse and heart failure are real conditions. Being anti-covid vaccination (and then thinking you don't have to pay the consequences) is just sheer ignorance and selfishness.

 

[Stank811]

We literally do it all the time. Or before covid were you crusading for the IVDU on his 2nd tricuspid valve to get a 3rd? Or that the cirrhotic who can't or won't put down the Jack is just as entitled to a liver as the other cirrhotic who went through hell on earth to stay off the sauce? Or how bout all the uninsured LVEF 20%'ers at my charity hospital who don't get to go across town to the large hospital system where one pretty much has to have BCBS to get an LVAD? Will you take up their mantle? And surely you agree that we should go single-payer tomorrow so everyone has healthcare, right?

Spare me the sob story you're trying to sell me about "denying care," my dude. You're only dying on that hill now because you got wrong-headed ideas about covid. At least substance abuse and heart failure are real conditions. Being anti-covid vaccination (and then thinking you don't have to pay the consequences) is just sheer ignorance and selfishness.

I do not think any of the patients you described should be denied the same care as any one else in the same position. I have in the past questioned futility. But to deny a patient care who would likely benefit Is a thought process I strongly oppose no matter the circumstance.

I am not anti COViD vaccine. With the current evidence, I have a hard time supporting mandates and strongly feel if a patient decided not to get vaccinated for any reason and presents with COViD requiring hospital care they should receive the same care as the patient who was vaccinated. I am also concerned with such ideas and thoughts being written and supported in this forum.

 

[Airway]

prior to delta I read through the CDC that vaccination reduced viral load and transmissibility. Delta may have changed that, though some studies out there are showing that delta may not live as long in the vaccinated relative to the not. I think it’s irresponsible for the medical community to be divided on the message it sends to the public, which is that vaccination is imperative and is our best chance at keeping people at home and healthy.

it’s also hard to argue against masking though there isn’t great evidence outside of the anecdotal. Like @nimbus I haven’t had so much as a cold since the start of covid. I wear my mask. I wash my hands all the time. I don’t shake hands anymore.

I feel like when the medical community starts the ‘you can still get and spread covid while vaccinated’ or ‘hey natural immunity is better than vaccination’ we are sending the public a very dangerous, mixed message and we are no different than Tucker Carlson (who is almost surely vaccinated and probably was before anyone here). The mixed message leads to ambiguity and mistrust and adds fuel to the fire of the anti-vaxxers growing across social media.

While rcts have failed to show amazing effect as have lots of observational data/papers showing masks work (saying masks work is only based on anecdotal suggests your personal experience which I think undervalues masks).

I do not think any of the patients you described should be denied the same care as any one else in the same position. I have in the past questioned futility. But to deny a patient care who would likely benefit Is a thought process I strongly oppose no matter the circumstance.

I am not anti COViD vaccine. With the current evidence, I have a hard time supporting mandates and strongly feel if a patient decided not to get vaccinated for any reason and presents with COViD requiring hospital care they should receive the same care as the patient who was vaccinated. I am also concerned with such ideas and thoughts being written and supported in this forum.

What's the lack of evidence? The evidence is overwhelming that vaccines work inexpensive and are safe (incredibly safe compared to covid).

 

[vector2]

I do not think any of the patients you described should be denied the same care as any one else in the same position.

Well, I think you do. Because it sounds like you're just being flippant and contrarian for the sake of being flippant and contrarian, as surely you're not so naive or misinformed as to not know that ethical organ selection takes into consideration numerous psychosocial factors in addition to the medical indications. And that discussion has nothing to do with the "futility" you mentioned. We don't deny livers to ongoing alcohol drinkers because it's medically futile. On the contrary- that new liver is gonna work great for a long time even in the face of some ongoing drinking. But it's not going to last as long as it would in someone who follows the rules and recommendations. We deny livers to ongoing alcohol (ab)users because livers are a *limited precious resource* and thus someone is going to get indicated medical care denied when demand inevitably exceeds supply.

And do you know what else is a limited precious resource? ICU beds in the middle of a pandemic. Again, I was arguing against the idea of insurance denying care for the unvaccinated, but you are a fool if you don’t understand where that impulse comes from. Maybe you just haven't seen enough STEMIs and TBIs boarding in the ED and PACU because the ICUs are filled with proned, intubated unvaccinated people.

 

[anonperson]

I do not think any of the patients you described should be denied the same care as any one else in the same position. I have in the past questioned futility. But to deny a patient care who would likely benefit Is a thought process I strongly oppose no matter the circumstance.

I am not anti COViD vaccine. With the current evidence, I have a hard time supporting mandates and strongly feel if a patient decided not to get vaccinated for any reason and presents with COViD requiring hospital care they should receive the same care as the patient who was vaccinated. I am also concerned with such ideas and thoughts being written and supported in this forum.

The vaccine works. We can see it in real time that it is doing what it is supposed to. It blows my mind that there is even a debate on this.

If there was more widespread vaccination, the disease burden in this country would be significantly less.

 

[Stank811]

Where have I said the vaccine doesn’t work? You people are crazy. I have repeatedly said the vaccine clearly reduces morbidity and mortality.

 

[Stank811]

Well, I think you do. Because it sounds like you're just being flippant and contrarian for the sake of being flippant and contrarian, as surely you're not so naive or misinformed as to not know that ethical organ selection takes into consideration numerous psychosocial factors in addition to the medical indications. And that discussion has nothing to do with the "futility" you mentioned. We don't deny livers to ongoing alcohol drinkers because it's medically futile. On the contrary- that new liver is gonna work great for a long time even in the face of some ongoing drinking. But it's not going to last as long as it would in someone who follows the rules and recommendations. We deny livers to ongoing alcohol (ab)users because livers are a *limited precious resource* and thus someone is going to get indicated medical care denied when demand inevitably exceeds supply.

And do you know what else is a limited precious resource? ICU beds in the middle of a pandemic. Again, I was arguing against the idea of insurance denying care for the unvaccinated, but you are a fool if you don’t understand where that impulse comes from. Maybe you just haven't seen enough STEMIs and TBIs boarding in the ED and PACU because the ICUs are filled with proned, intubated unvaccinated people.

I am glad you known me so well. All I am saying is if a patient comes to the hospital requiring care because of sever COViD vaccinated or unvaccinated they should be provided care and their care should not be rationed based on their vaccination status and to suggest otherwise in my opinion is scary and the thought process should not be supported in this forum

 

[vector2]

. All I am saying is if a patient comes to the hospital requiring care because of sever COViD vaccinated or unvaccinated they should be provided care

Actually that wasn't all you were saying. Initially you said "To suggest any population of people should be declined care is scary" ..... and then I pointed out to you in detail why that notion is absurd on its face, since both medical resources and money are not infinite when it comes to a variety of conditions, and thus sometimes must be rationed based (in part) on value judgments.

If you want to narrow your claim now specifically to covid patients, fine. To make a generalized blanket statement that all covid pts should get full court press hospital care is an easy line to throw out there. The real moral dilemma comes when resources start getting critically low like they have this past week and one has to actually start choosing who gets that last ICU bed.

 

[vector2]

Where have I said the vaccine doesn’t work? You people are crazy. I have repeatedly said the vaccine clearly reduces morbidity and mortality.

You've begrudgingly admitted a couple of times that the vaccine reduces morbidity and mortality.

What you've repeatedly done is concern troll every tiny gap or question relating to vaccine efficacy during a time when 90-97% of hospitalizations are in the unvaccinated.

But I'm sure you're "just asking questions"

 

[Stank811]

You've begrudgingly admitted a couple of times that the vaccine reduces morbidity and mortality.

What you've repeatedly done is concern troll every tiny gap or question relating to vaccine efficacy during a time when 90-97% of hospitalizations are in the unvaccinated.

But I'm sure you're "just asking questions"

I find it odd how you took a normal conversation and have started to suggest my thoughts and infer my feelings. Why? Asking fair questions is now considered concern trolling?

Don’t you have the same questions and concerns? The world is talking about a booster vaccine…is that the right answer or are we just throwing out what we think is the best answer? I think we are just suggesting booster hoping that it helps bc I assume it would be a monumental task to role out a new vaccine every 6 months designed specifically for the variant of the day. Is the way I phrased my above question less concern trolling?

 

[deleted126335]

I find it odd how you took a normal conversation and have started to suggest my thoughts and infer my feelings. Why? Asking fair questions is now considered concern trolling?

Don’t you have the same questions and concerns? The world is talking about a booster vaccine…is that the right answer or are we just throwing out what we think is the best answer? My guess best answer bc I assume it would be a monumental task to role out a new vaccine every 6 months designed specifically for the variant of the day. Is the way I phrased my above question less concern trolling?

We may very well be rolling out a new vaccine every 6-12 months just like we do with the flu.

“When my information changes, I alter my conclusions. What do you do, sir?”

-John Maynard Keynes.

 

[Stank811]

We may very well be rolling out a new vaccine every 6-12 months just like we do with the flu.

“When my information changes, I alter my conclusions. What do you do, sir?”

-John Maynard Keynes.

I agree that a vaccine that is specific to the delta variant would seem like the best choice but don’t anticipate the world being able to pivot that quickly…maybe some day once the process for the vaccine is scaled etc.

 

[POW16]

Perhaps not in developing countries but I would argue that most of the developed world could easily roll out yearly Covid vaccines. I flew through SF yesterday and you can even get vaccinated at the airport.

 

[Zekchar]

I am glad you known me so well. All I am saying is if a patient comes to the hospital requiring care because of sever COViD vaccinated or unvaccinated they should be provided care and their care should not be rationed based on their vaccination status and to suggest otherwise in my opinion is scary and the thought process should not be supported in this forum

I disagree.

I disagree on behalf of the stroke patient who now has to hang out in the ER because there is no ICU bed.
I disagree on behalf of the vaccinated septic nursing home patient who is being diverted to a distant hospital since the ICU is full.
I disagree on behalf of the heart attack patient whose ICU bed is being occupied by the 30 year old anti-vax tic-tok watching dingus. I disagree on everybody who took the personal and social responsibility to do the right thing, but are now being pushed aside and their lives are being constrained by selfish assholees.

There has been ample time. Those that do not get the vaccine electively should not be given care at the expense of those who got vaccinated and require care. Most are simply to shy to say this. It's time to advocate on behalf of those that did the right thing, and to hell with the personal liberties of those opting out of the vaccinations. They now have the personal liberty of being de-prioritized when it comes to receiving hospital care.

 

[vector2]

I find it odd how you took a normal conversation and have started to suggest my thoughts and infer my feelings. Why? Asking fair questions is now considered concern trolling?

Don’t you have the same questions and concerns? The world is talking about a booster vaccine…is that the right answer or are we just throwing out what we think is the best answer? I think we are just suggesting booster hoping that it helps bc I assume it would be a monumental task to role out a new vaccine every 6 months designed specifically for the variant of the day. Is the way I phrased my above question less concern trolling?

The questions that you (and LeonsMom, to an extent) have been asking throughout the thread aren't unique to you all. There is a phenotype throughout the internet and IRL for those who are vehemently anti-mandate and who, in the service of being anti-mandate, go on and on with "just questions" about the efficacy of masks or whether vaccinated people spread the virus as much as the unvaccinated. Maybe a small percentage are actual scientists doing research or people with legitimate epidemiologic curiosity.

But the other 99.9% are anti-vax, anti-mask concern trolls. And no offense, if we're playing the probabilities here, I wouldn't bet that an enthusiastic trumper fits into the former category.

 

[anonperson]

I agree that a vaccine that is specific to the delta variant would seem like the best choice but don’t anticipate the world being able to pivot that quickly…maybe some day once the process for the vaccine is scaled etc.

I thought the process was scaled. Companies developed a safe and effective vaccine for a novel coronavirus in about a year yet there is a decent number of anti vaccination people who don't trust the new vaccine because they came out too quickly.

With the current evidence, I have a hard time supporting mandates

The current evidence shows a significant risk of hospitalization in unvaccinated people. The side effect profile of the vaccines is low.

Hospitals are getting overwhelmed.

Not sure how the current evidence doesn't support more aggressive vaccine administration?

This is a pandemic that we have not seen the likes of ever in my lifetime. I know this stands in the face pro individual freedom people but it's not a normal situation.

And I say this as a right leaning/conservative voter (yes, including voting for Trump).

A vaccine mandate is fine and needed.

 

[Stank811]

I disagree.

I disagree on behalf of the stroke patient who now has to hang out in the ER because there is no ICU bed.
I disagree on behalf of the vaccinated septic nursing home patient who is being diverted to a distant hospital since the ICU is full.
I disagree on behalf of the heart attack patient whose ICU bed is being occupied by the 30 year old anti-vax tic-tok watching dingus. I disagree on everybody who took the personal and social responsibility to do the right thing, but are now being pushed aside and their lives are being constrained by selfish assholees.

There has been ample time. Those that do not get the vaccine electively should not be given care at the expense of those who got vaccinated and require care. Most are simply to shy to say this. It's time to advocate on behalf of those that did the right thing, and to hell with the personal liberties of those opting out of the vaccinations. They now have the personal liberty of being de-prioritized when it comes to receiving hospital care.

Your position is a slippery dangerous slope. Was your stroke patient a smoker or an uncontrolled HTN who was non compliant with meds etc….the scenarios are endless in which the ICU and medical resources are used on patients who haven’t behaved in what is in the best interest of their health.

 

[VA Hopeful Dr]

Your position is a slippery dangerous slope. Was your stroke patient a smoker or an uncontrolled HTN who was non compliant with meds etc….the scenarios are endless in which the ICU and medical resources are used on patients who haven’t behaved in what is in the best interest of their health.

Not even close to the same thing.

Managing HTN is a life long issue that requires frequent doctor visits, labs, life style changes. It requires daily medication (often multiple). And all of that doesn't guarantee you won't have complications. Quitting smoking is exceptionally difficult to do (especially with the current Chantix recall).

COVID requires you to go to a pharmacy and get a shot. That's the extent of it.

 

[Stank811]

The questions that you (and LeonsMom, to an extent) have been asking throughout the thread aren't unique to you all. There is a phenotype throughout the internet and IRL for those who are vehemently anti-mandate and who, in the service of being anti-mandate, go on and on with "just questions" about the efficacy of masks or whether vaccinated people spread the virus as much as the unvaccinated. Maybe a small percentage are actual scientists doing research or people with legitimate epidemiologic curiosity.

But the other 99.9% are anti-vax, anti-mask concern trolls. And no offense, if we're playing the probabilities here, I wouldn't bet that an enthusiastic trumper fits into the former category.

In my opinion we need to do our best to remove ourselves (medical community) from the political discourse associated with the pandemic. I reluctantly mentioned mandate in a previous thread bc I suspected it would quickly create 2 camps which refuse to give up their positions which has turned out to be true. You are correct that I am pro Trump but before Trump I voted for Obama twice and before that voted for Bush….so clearly very confused politically and still maintain my position they all have an impossible task.
The political discourse amongst physicians just reduces the critical thinking and flexibility of thought in my opinion and people get so rigid in their opinions we loose the ability to even suggest we might be wrong and agree with the “other side”.

 

[Mman]

I keep it simple for myself. Almost every person in the US would be better off if they received the vaccine. The odds of complication from the vaccine are so significantly outweighed by the potential odds of complication from the disease in unvaccinated. Furthermore, the rest of the population is better off if people are vaccinated. So it is a benefit both to the person and to society. I have a very low opinion of the morality of people choosing not to be vaccinated.


(yes there are a miniscule number of people that have legitimate medical reasons for not being able to be vaccinated and there outrage should outweigh mine by 10x)

 

[dpmd]

Not even close to the same thing.

Managing HTN is a life long issue that requires frequent doctor visits, labs, life style changes. It requires daily medication (often multiple). And all of that doesn't guarantee you won't have complications. Quitting smoking is exceptionally difficult to do (especially with the current Chantix recall).

COVID requires you to go to a pharmacy and get a shot. That's the extent of it.

In some places they will even come to you to give it.