The US ***

[D_W]

So, I read posts quoting statistics as flawed

Who? As for the rest of the folks, if people jabbed can move freely, it's not an excuse for someone else to imitate them. That "it's not fair" crap without regard to outcomes needs to be stamped out. I'm fairly sure all of the mask rules here for people who have already had covid or jabs are just to try to get uniformity - and that the risk of those with some immunity would be too low to affect outcomes. )

but "we have to be fair" rather than teaching people how things work.

Like the masks at the outset. We were to wash our hands all the time. I told my spouse that it was stupid, we'll watch the mailman and bulk warehouse workers. They'll have no choice but to touch thousands of items. What a surprise, they didn't sick. Anyone who went in a room did, but we were advised early on that nobody needed masks and you should be admonished if you wore your own N95 masks because only health care workers should have them.

(wait, we don't really need masks, so what's the big emergency there? It was pretty transparent - the outcomes from locations with high hospitalization rates were from indoor areas with much breathing of "other peoples' stuff" ) Not from touching, but we're still getting nonstop crap about washing hands to make a difference. Garbage.

As long as we're afraid of actually describing what works and why and with whom, we're destined for this groupist crap.

I'm sure that the initial false information about not needing masks led to a lot of deaths, and that was intentional. Not the deaths for entertainment or some evil purpose, but hoarding supplies was put above the lives of people being misled.

quotes of low infection rates from oppressive countries with minimal international travel are pointless, though. Many of the least desirable places in the world fared *really really well* for a long time at the outset of this thing. Wonder why.

 

[mikej460]

Handwashing guidance, like all other guidance is scientifically based, but your counter to this is based on some sort of warped logic that everything we touch has been touched by someone else so why bother? My wife and I wipe all hard surface stuff we receive (including mail) with diluted bleach on a cloth then wash our hands, we also gel our hands whenever we go into a store etc. and when we leave, because we want to do all we can not to get or spread the virus. That's the responsible thing to do, what isn't responsible is to challenge and counter the scientifically led recommendations. The rules are there for a reason.

 

[D_W]

No, it's not scientifically based unless you say you can measure virus on a surface, but the question of viability and outcome isn't asked. If the letter carrier doesn't get sick, and neither do people stocking shelves with 100 times more exposure, then you know that touch transmission is very unlikely. As in immaterial. We measure outcome when it's available and not interim logic or quasilogic. If it seems logical that found virus on the surfaces could lead to transmission, but we find out that it doesn't and there's no evidence of it, then concluding that reasoning overrides outcome is anti scientific.

If you propose one thing, and observe another, then the next time your observations become your proposal. If you cling to the former through many iterations despite the same observation, that's just ego getting in the way of truth. Or in some cases, worse.

I'd be willing to bet that more people died washing their hands and not wearing a mask in the first several weeks than died from touching things in the entire year.

Time and again when more information is provided about covid virus on surfaces, the footnote says none of the samples could be cultured. They're not viable and won't cause illness. Enclosed spaces and breathing droplets has been shown clearly to cause very poor outcomes with severity correlated with viral load floating in droplets and time exposure.

This virus doesn't spread the same as a flu or whatever else. It has been very easy to observe the environments where it spreads quickly and situations where it doesn't.

 

[D_W]

Handwashing guidance, like all other guidance is scientifically based, but your counter to this is based on some sort of warped logic that everything we touch has been touched by someone else so why bother? My wife and I wipe all hard surface stuff we receive (including mail) with diluted bleach on a cloth then wash our hands, we also gel our hands whenever we go into a store etc. and when we leave, because we want to do all we can not to get or spread the virus. That's the responsible thing to do, what isn't responsible is to challenge and counter the scientifically led recommendations. The rules are there for a reason.

https://www.nytimes.com/2020/05/22/health/cdc-coronavirus-touching-surfaces.html
So, I did wash my mail for about two weeks - but I have to be honest, I really don't recall for sure. My wife probably had me wash groceries a couple of times. I have a spray bottle with lysol in it - I could show you the bottle and you'd see how little was sprayed from it.

I said to her at the outset, you have to get virus on your fingers and stick it in your eyes or nose at an appreciable viral load in order to transmit the virus, I don't believe it. I'm watching the mailmen and the staffers at sams and we're going to see what's up. If the sams staffers are touching your boxes all day and people are in the store coughing on them and touching them and they don't get sick - I think the handwashing stuff is just busy busy, and the 6 foot rule indoors is bunk - it's going to get people in smaller spaces killed.

The wife wasn't entertained. By april, I wasn't washing anything - no mailmen here got sick, and nobody at sams or really any store seemed to get the virus at an accelerated rate. The parcel delivery folks also didn't. They were canaries for us.

The hand washing thing was and is just a way to keep people busy and mentally engaged - I'm interested in the outcome. Not getting sick, not in busy work.

Note that in Nov. last year, the CDC started saying publicly that touch transmission was very unlikely. At one point, one of the officials said they didn't have a confirmed case of it. Now, I'd bet someone somewhere got sick touching things, but would also bet that it's a tiny fraction of 1%. Maybe a fraction of that fraction.

My motivation was probably the same as yours - early on, they said that asthma was a risk factor. I have asthma that is nonexistent most of the time, but it's excited by coughing. A cold turns to bronchitis, what would covid do? From the outset, telling people early on that no mask was needed and that they should wash their hands was two wrong answers. The latter is fine, it's harmless. Prioritizing it over controlling what you breathe is deadly.

The CDC had decided within months that touch transmission was unlikely, but they didn't publicly say much. That's too bad. Once they and others did, they tried to cover their tracks by claiming that hand washing was to prevent other types of sickness so that you wouldn't be a burden on the health systems (which at the same time here, were foundering because they had no patients - even while the ICUs did become more occupied later, the arm of the health care system that would address cold and flu ,etc, was laying off workers).

 

[Jameshow]

I wash hands whenever I get home, also gel hands when I get back into the car from a shop etc.

Cheers James

 

[D_W]

I wash hands whenever I get home, also gel hands when I get back into the car from a shop etc.

Cheers James

I still do that, too (minus the gel). But that was good practice before Covid. It's still good practice to avoid the little non-covid goblins that do get passed hand to face more easily. Providing the guidance along with covid as a means to stop covid while having fairly relaxed ideas about what a mask is is odd.

 

[John Brown]

I know you guys think we can't do public health in the US, but we can - we just end up doing some of it through public providers, and some private.

Class 1A here has been opened up not just to the elderly and really fat, but also to the moderately fat (like me). What's that? BMI 30. I just barely skid over the line at 205 and 5'9". I remember the says of getting to 160 pounds and thinking it was impossibly fat and I must get back to 145. Now, I'd like to get back to 160.

But, anyway, I'm the last adult in my entire extended family who isn't vaccinated - until Friday.

Class 1A BMI dropped from 40 to 30 to the lower cutoff and I at 30.something got in. All other relatives have either had covid, work in health care, are older, etc, have child care, dental licenses, etc. IT's bizarre -every single adult that is a first degree relative or in law has functional immunity and before the threshold was lowered, I was a huge potential fly in the ointment.

Here's how it went down - my health system is gigantic. They blew their vaccine wad on their employees, contractors, subcontractors, etc, with nothing left for anyone other than their nursing home patients. So they have been bombarding me with emails after I signed up for the class 1A to wait for them to get more allocation. Too bad, one of their competitors got it and is dosing shots at the baseball stadium in some figure like 4,000 a day.

I went, it was super orderly with a long moving line, took ten minutes, I sat in a large open area to confirm no shock and that was that. The lady flatly said to me "you're getting pfizer today, your second appointment is already scheduled exact same place and same time in 3 weeks, see you then. The scheduling is automatic and we cannot change it".

Perfect, I don't want a million options, just get the job done.

Everyone was pleasant, professional, the health system employees were all over the place outside on the road and in the parking lot helping to direct everyone - it was like white glove service. All you needed was a form of ID at the door and you were in and out with your card reminding where to go.

We are to get 150MM more doses or something before the end of March here. Covid cases are at 1/5th the level that they were 2 months ago and both vaccines seem to have no issues with any variant. Things are looking up.

(no symptoms from the first ***, either, aside from very mild shoulder soreness yesterday. I've dropped ice cubes on toes before and had more pain than that).

The reason for not having a gaggle of options here (as in right in my locale - normally for flu shots you get bombarded with options, spam, etc, to get your flu shot in various places) in the first place (counties around here and rural where my parents live were vaccinated long ago) is that our large health systems have HQs here with their contractors being here. In our county, the allotment was used quickly in nursing home and health system staffs. I wouldn't be surprised if out of the 1.2 million people in my county, that at least 50k were health care (as one of the systems itself has more than that in total staff - just not all in our county).

The anti-vaccine sentiment that the news drums up along with all of the other scare rubbish? It's not here on the ground.

I actually saw a news story today that said that the decline in tests (40% decline in covid tests to go along with the 80% decline in cases) may punish us by not finding all of the new covid cases as the government turns from testing to vaccinating. It totally glossed over the fact that there are three times as many tests being given now per positive case - the tests are down 40% because there isn't anyone to administer them to. I'm surprised they're even that high.

Deaths are a trailing indicator, so we still have relatively high deaths occurring from the longer term cases, but even those are down off of the peak and continue to trend down. It's almost as if such good news isn't worth talking about because it's not profitable.

Over here, a BMI of 30 puts one in the obese category, not just moderately fat. I guess it's just another difference like gallons or shoe sizes.

 

[D_W]

It's called "obese" here, too.

25-30 is called overweight, 40+ is severely obese.

I have been informed by a couple of scottish friends who visit often that there are not obese or overweight people in the UK, though.

 

[D_W]

I just worked through the BMI calculator. Interesting. At 5'9", even at 150 lbs, i would be only a couple of points from overweight. at 165, I'd be on the bubble.

I was at the lower end of both of those until getting married (below both for a large amount of that) - i guess that's a unisex chart. To be at the top end of normal weight range at, say, 155 pounds at 5'9" for a male is dippy. My immersion body fat at 150 pounds was 10. how much lower can you go without wasting off lean mass?

 

[John Brown]

That's totally correct. It's actually illegal to have a BMI over 25.
Punishment consists of being stretched on a rack until one's BMI falls below that figure.

 

[John Brown]

Sorry, looks like you responded to your own post while I was typing...

 

[D_W]

Sorry, looks like you responded to your own post while I was typing...

No worries. I respond by pretending to accidentally refer to my scottish friends as English... "all of you English people think you're much better than americans, eh, just because you're skinny and you sound like Shrek?"

Of course, I don't really know how that's received except that it elicits a pause every time!!

My best friend here, or one of three, I'd say, is English. I call him British, which elicits an immediate response. "ENGLISH...I'M ENGLISH....BRITISH COULD MEAN ANYTHING!!! IT'S NOT THE SAME."

He lives in the US by choice. I won't repeat what he says (he's of means, though. It's easy to live here when money isn't an issue).

Fair opportunity to do the same in the States, though - go to the south and refer to all Americans as Yankees. I'd give a tenner to see a recording of the response.

(I like your stretcher solution - instant results. Many promise instant results re: weight, but the stretcher would deliver).

 

[D_W]

Shot 2 yesterday here in the US (we still do the 3 week interval with pfizer, even though we know that you're pretty much 92-93% protected 2 weeks after the first shot).

same place, same routine, and strangely, in a room with 100 desks or so giving the shots with shotees assigned a desk at random when one became available - literally same desk.

Total time involved - less than 10 minutes (plus a 15 minute wait on the end to confirm on reaction, and then out).

I still see some faff on youtube from time to time in recommended videos about the US doing poorly administering vaccines - just goofy. 2 million shots a day now in the US, and all of the drummed up crap about "Trump supporters" who wouldn't get vaccinated.... it didn't materialize. That was predictable.

 

[RobinBHM]

Sorry to hear this, Canada is often a poster child or doing things well. I'm involved in the vaccine R&D programme, and my guess is that global production will ramp quite quickly and you will be flooded with material earlier than that. Most large economies including UK US, EU, and Canada, had to place early bets on a number of candidates as they could not tell which would work. India is a powerhouse of vaccine manufacture and the command economies also have production. The result is the west will have 4x more than it needs and will start to give it away. The giant factories in India will start to come on stream. Canada has a lot of good will due to its good general diplomacy, so will likely find a channel before long.
On the public vs private debate, Vaccine work is a good example where public private partnerships work well. Vaccine development is very high risk, the money is made on the childhood staples, epidemic vaccines are usually big loss makers and done for good will - Ebola, Sars etc as they need to be prepared in advance and no-one buys without a pandemic, which only happens once is a generation. Note that the Pfizer *** was developed by a German small co. Moderna, AZ was a publicly funded venture by Oxford and UK government with industry muscle in manufacturing. There are lessons to be learned by the West, where complacency over Sars and Swine flue left us short. In my company case we had a Pandemic scale up centre bid to government turned down 3 years ago despite £50m of industry co-funding, it just didn't seem a priority back then and without the long term public money, industry just cant sustain something that is only used in an emergency. Industry is great as scaling up manufacturing and relativity quickly - after a development lead time - in 6 months, PPE, ventilators, vaccine production has gone from tick over to global scale. The public investment is about having the starting infrastructure available to shorten the lead times, this is something that can be done through co-operation between public and private entities and amongst neighboring states, its an insurance policy. Lots of lessons to learn. We will probably overreact to the pandemic and we will end up with a surplus of laboratories sitting around waiting for the next epidemic.....

very interesting -a vaccine perspective from somebody on the inside.

I know EU is very concerned at the moment, especially as there is a 3rd wave coming over there (Ironically the UK variant). My understanding though is that Europe has at least 3 vaccine manufacturers currently setting up to produce in France: CDMO Recipharm -in Monts, Delpharm - Saint Remy, Fareva.

So despite the EU being behind now, it seems likely they will get plenty of vaccine availability fairly soon.



In regards to the public / private development of vaccines -It seems like the rapid turn around of the covid vaccine was enable by wealthy governments throwing money at pharmaceutical companies to set up and manufacture concurrently with the testing phase -and so the private companies had no risk if it failed, which is the usual difficulty of vaccine and drug development.

 

[Amateur]

....just to add,
my daughter is a Paramedic trainee....in a v/large health service just outside London...
front line staff I would have thought........she's in the thick of it......
I asked when she would get her ***......she just laughed.......not enough to go around......
I'm still self isolating, she can have mine.......

please take care out there.....

You sure about that?
Doesnt sound right to me when they have been putting calls out to anyone that hasn't had it.
Plus all she needs to do it what you say is correct is to go online and book one.
So why hasnt she done that?

 

[Amateur]

We've done worse here than USA in terms of deaths per million, if that's any consolation!
USA 1,582 UK 1,803
Don't know if Trump deserves any credit, but Johnson certainly can be blamed for our pathetic scenario.

Look at the Geographics of America and the UK. Wide open spaces and from what I gather each state taking responsibility. Here we are all packed in like sardines.
Boris got off to a bad start I agree but thats in the past he has made up for it.
As for deaths we have a very old aged unfit population which fits into those numbers whereas younger age populations coped much better.
Besides this is a non political forum so why he was commented on in the fir.st place is beyond me?

 

[TominDales]

Reply to D_W - Shot 2 today.
Great to hear. We have just had our first shot this week. Did you get any cold like side effects? In the UK, we are noticing some very strong flue like reaction in some people to the first AZ vaccine and to a lesser extent the second Pfizer. The first Pfizer and second AZ seem to have little side effects.

Most of the world is sticking to the 3 weeks interval, as that was what the companies trialed in the early stages, they did it to speed up the trails and get rapid approval in a crisis - a very laudable thing to do. The UK is an outlier on this, they have relied on the prevailing scientific consensus, based on vaccine data of the past 50 years, that in most cases, immunity builds up over several months (up to a year) and a booster is most effective in the 3 to 6 month time period for viruses with a short memory effect and 1 year interval for stable ones like measles, so 3 months seems an optimum for this virus.

The UK vaccine strategy at this early stage in the pandemic, is to reduce deaths and serous medical complications in the short term, so aiming at high coverage and not so worried about high % effectiveness of the first dose . There has been little data to substantiate this scientific hunch until now. This is a very pragmatic approach and works in the UK where there is high confidence in the NHS and anti-vax not a big issue.

In other parts of the world governments are sticking to the company recommendations on 3 weeks. as politician and regulators are weary of the anti vaxers so taking a more cautious approach. In the US the FDA has more rigid rules than most countries as well as anti-vaxer concerns. The FDA rigidity is partly a historical legacy from the original FDA success in avoiding Thalidomide. In that case, as single minded lady official (Francis Kelsey) obstinacy against health professional pressure and industry pressure proved right, it was a world changing victory for the FDA, and that has been a principle ever since, but has tended to make the FDA a bit rigid in its approach compared to EU and other compatible regulators.
This is still a fast changing picture with new evidence emerging so we will have to keep adapting to new information. I'd be interested in your experience. My wife and I both suffered for a couple of days with AZ 2st dose this week, My wife was physically sick and had high temperature for 2 days and very poorly ached all over, but we would do it again. See what happens in 3 months time.

 

[TominDales]

very interesting -a vaccine perspective from somebody on the inside.

I know EU is very concerned at the moment, especially as there is a 3rd wave coming over there (Ironically the UK variant). My understanding though is that Europe has at least 3 vaccine manufacturers currently setting up to produce in France: CDMO Recipharm -in Monts, Delpharm - Saint Remy, Fareva.

So despite the EU being behind now, it seems likely they will get plenty of vaccine availability fairly soon.

In my view the EU is making a number of mistakes on vaccines. As you say it's only a matter of time before they will have enough. But what they do have in stock from AZ is being held up by ill considered policy changes. Having managed the early stages of lockdown really quite well, they are in my view being a bit reckless and in this respect the UK has been exemplary. The key thing is to keep confidence in the vaccines high, otherwise you can get poor uptake which is self defeating.
There are a few paradoxes:
The EU has huge vaccine production capacity, it is a net exporter of vaccines, the UK has very little and has relied on EU production even for UK designed vaccines by companies like GSK, manufacture and distribute their vaccines from Belgium - this has been a major Brexit headache for AZ and GSK as finishing lines have had to be moved over the boarder to get EU approval etc. It seems this massive capacity has lead to complacency in the EU. The UK on the other hand had very little home production and has spent a huge some of money (£13bn) on advanced contracts and building some quite modest local production as a preoccupation. The UK is now worried the EU may interrupt these commercial contacts with Pfizer etc, like the US is doing with its war-powers acts etc. The German government is concerned because once the EU overrides commercial contracts, importers like the UK and developing countries will lose confidence in the EU post pandemic and insist on domestic supply - just like they did when the US flexed is muscles a few years ago. That will damage the EU business model for decades to come.
The EU's vaccilation on approving the AZ vaccine is very worrying, and one suspects a bit of nationalism as well as caution with anti vaxers, as Sanophi and the German majors didn't get their vaccines through in time. And bizarrely there was delay in Brussels on the Pfizer Biontech contact because some EU states suspected Germany favour its Biotech business.
Having had a relatively good first wave and dodging the British variant in wave 2 - which probably added 50k deaths to our tally - they are at risk on letting a 3rd wave happen and even allowing new variants to emerge.

 

[Spectric]

The issue that makes it worse is that we are a little island, think of it as a castle with a moat around it, so we had the means to prevent this virus getting amongst the population by locking down the few to protect the majority. Just like the kings of old, the enemy approaches so you pull up the drawbridge. If all ports and airports had been closed until quarantine centres had been established and then EVERYONE coming into the uk was quarantined for two weeks before actually entering then we would be in a much better position than we are now. What this country needs is an emergency response team that are not political and with the power to use any means to prevent another pandemic even if it means upsetting people and their human rights, and we need to think about ID cards of some sort, it would be a good starting point for any future track and trace systems and could also be a vacination record to allow travel. The issue is we have three fronts that all need to be addressed, the vacine is helping deal with one of them, the current virus but we cannot ever just ignore it because it is with us for at least the foreseeable future and then what is coming next, it is not a case of it finding us but as we encroach into unknown places we will find it.

 

[D_W]

Look at the Geographics of America and the UK. Wide open spaces and from what I gather each state taking responsibility. Here we are all packed in like sardines.
Boris got off to a bad start I agree but thats in the past he has made up for it.
As for deaths we have a very old aged unfit population which fits into those numbers whereas younger age populations coped much better.
Besides this is a non political forum so why he was commented on in the fir.st place is beyond me?

we probably have more rural population, but more than half of our population is hugely social and densely packed in urban and suburban. The hardford, NY, NJ corridor probably has 25 million of population and is a magnet for tourists - thus, the early results were predictable (plus, their mayor in NYC was slow to shut things down).

I don't think the EU is getting as much criticism as they deserve given how much crap we hear in the US about how far behind our public health initiatives are (those kinds of comments tend to ignore the fact that we have enormous social medicine systems that are funded publicly and only provided mostly privately at the point of service).

That's compounded by the fact that the typical means in the US is high enough that there's not a lot of elderly care in home (Which means the nursing homes are just packed with vulnerable in arrangements that are similar to hotels -in many cases here, the nursing homes are converted hotels since the setup is ideal for room by room access and double occupancy).

There was profit incentive to get vaccines made and distributed here, and as you mention, much state pressure on politicians to create additional pressure at the federal level from governors, and the governors are under pressure from the county and city locations.

The holier than thou start from the EU and other parts of the world and discussion of how fast and how much they'd vaccinate is schadenfreude (which is a bit unhealthy to partake in). Despite our news sources here, we had a million shots a day before trump ever left office. The news is an interesting thing - it's so politically biased (keeping in mind, I am registered independent and behave accordingly) that the news aggregation services here are showing me a clip of biden tripping three times in a row on steps (which is a bit concerning).....

.....but every single news outlet providing that is from the UK. I expect if I go look now, some of the US outlets may have a story about it out of embarrassment of being accused of not reporting it due to political bias.

And that's with the background also that I think the biden presidency is going quite well. It's the bias in the news that I'm not a fan of.