The Politics of Covid 19, mask wearing and the vaccination process

[Smoove_B]

Also on H1N1 the book essentially says that the CDC and the government didn't respond well to that pandemic, but rather we essentially just got lucky because the virus turned out not to be all that lethal.

Yes. It's been an open secret in public health that we were lucky. However, when we've tried to warn politicians and the general public after the fact, all they remember is that it wasn't a big deal and that we all over-react to things.

And re: state and local responses, this is where it ties into the ongoing breakdown in American political institutions. Because the GOP has eroded democratic accountability in so many states via gerrymandering and voter suppression and the like that a lot of state governments are mainly accountable to the Fox News base and minimally to the general electorate, which skews the disease responses. I think no matter what your political institutions are it's going to be almost impossible to avoid having some crazy and/or corrupt people in positions of influence when a pandemic hits, but the decline in our institutions makes that sort of thing way more widespread.

It's an intersection I never really pondered until COVID-19 - just how much politics have influenced everything from top to bottom. You're going to make me read this book sooner than later, aren't you?

[malchior]

It does suggest change is needed, but I don't know how - public health is a state issue. Where things are getting weird is looking at what's happening in TX and FL right now. Their decisions are impacting everyone in America and I don't know how anyone could argue otherwise. At what point do their actions become a national security issue? The argument that the federal government should have a more powerful role in domestic public health has been made stronger based on what's happened over the last ~18 months. I just don't know how it could happen in a practical sense.

This is interesting to me because Trump and his goons in the inverse way made it a national security issue last year when they were intercepting and re-selling medical supplies to the highest bidder. After they lit a bomb under the supply chain to begin with. Another "crime" that I still don't think has been adequately explained or investigated.

[Smoove_B]

Should that ratio be writ large (which doesn't seem to be the case so far), it'd be hugely concerning.

I'd need to see more information about the vaccinated people that died, because yes, it does suggest a problem. However, it's a very small sample size and if there are special considerations they need to be detailed.

There was something similar in data reported in NJ yesterday - not with deaths, but breakthrough cases. I think for one cluster of ~700 cases the state was saying around 28% of them were breakthrough. What I've yet to see clarification on is whether or not they're using breakthrough in the way it is intended - vaccinated people being hospitalized vs people that are vaccinated and experiencing symptoms. I suspect it's the later as I would not expect 28% of vaccinated people to be hospitalized.

Regardless, all this reinforces the reasons masking is so important right now - along with avoiding large crowds and promoting well-ventilated areas indoors. When the virus is rampaging through the U.S. we need to "raise the shields" and start adding in layers of risk mitigation. Yes, as an individual that is vaccinated your individual chances of survival are dramatically increased; you're also way less likely to even have symptoms if you're exposed and infected. However, with higher levels of circulating virus, the chances of you coming into contact with a situation where you're being exposed have also gone up.

It's the different between running across a field while someone is shooting a revolver at you vs running across the same field while someone is shooting am M-60.

There's only so many times you can roll the dice before they come up snake eyes.

[El Guapo]

Also on H1N1 the book essentially says that the CDC and the government didn't respond well to that pandemic, but rather we essentially just got lucky because the virus turned out not to be all that lethal.

Yes. It's been an open secret in public health that we were lucky. However, when we've tried to warn politicians and the general public after the fact, all they remember is that it wasn't a big deal and that we all over-react to things.

And re: state and local responses, this is where it ties into the ongoing breakdown in American political institutions. Because the GOP has eroded democratic accountability in so many states via gerrymandering and voter suppression and the like that a lot of state governments are mainly accountable to the Fox News base and minimally to the general electorate, which skews the disease responses. I think no matter what your political institutions are it's going to be almost impossible to avoid having some crazy and/or corrupt people in positions of influence when a pandemic hits, but the decline in our institutions makes that sort of thing way more widespread.

It's an intersection I never really pondered until COVID-19 - just how much politics have influenced everything from top to bottom. You're going to make me read this book sooner than later, aren't you?

FWIW the book doesn't really get into the "decline of American political institutions" angle, beyond the parts ragging on the CDC that we've already discussed (and the inherent political issue of having to get politicians to act at a point when the problem is essentially invisible).

As an aside the Lewis book has prompted me to now read the John Barry book on the 1918 pandemic, which features prominently in Lewis's book. Reading about the federal response to the 1918 pandemic has made me feel a little bit better about our COVID response, at least.

[Smoove_B]

As an aside the Lewis book has prompted me to now read the John Barry book on the 1918 pandemic, which features prominently in Lewis's book. Reading about the federal response to the 1918 pandemic has made me feel a little bit better about our COVID response, at least.

I haven't read that book in years; I'm kinda wondering how it would be now with my current lens now completely changed.

If you're looking to really expand your view of things (and impress people with the thickness of a book), I would recommend Betrayal of Trust - the Collapse of Global Public Health from 2000.

It came out a few years after I'd graduated and was working in the field and I was amazed at how much information it contained about the history of public health that I never learned - both here in the U.S. and worldwide. Everything that's come to pass she's predicted, though I'm not sure about the deeper connections to politics. But in terms of preparedness and response? Absolutely.

[El Guapo]

As an aside the Lewis book has prompted me to now read the John Barry book on the 1918 pandemic, which features prominently in Lewis's book. Reading about the federal response to the 1918 pandemic has made me feel a little bit better about our COVID response, at least.

I haven't read that book in years; I'm kinda wondering how it would be now with my current lens now completely changed.

If you're looking to really expand your view of things (and impress people with the thickness of a book), I would recommend Betrayal of Trust - the Collapse of Global Public Health from 2000.

It came out a few years after I'd graduated and was working in the field and I was amazed at how much information it contained about the history of public health that I never learned - both here in the U.S. and worldwide. Everything that's come to pass she's predicted, though I'm not sure about the deeper connections to politics. But in terms of preparedness and response? Absolutely.

Amazon says that book is for grades 8 - 17, so unfortunately I'm out of that range.

[Smoove_B]

Amazon says that book is for grades 8 - 17, so unfortunately I'm out of that range.

Such a weird rating system.

In other news, the State of Arkansas has 8 ICU hospital beds left. That's...not good.

Arkansas ranks third in the country for new virus cases per capita, according to numbers compiled by Johns Hopkins University researchers. The state’s cases have been skyrocketing in recent weeks, fueled by the delta variant of the virus and the state’s low vaccination rate.

Only about 37% of the state’s population is fully vaccinated against the virus.

[LawBeefaroni]

Only about 37% of the state’s population is fully vaccinated against the virus.

They got the placebo.

Not to make light of it. That's a surprisingly low number but not a surprising result. Wonder how anti-vax will brush it off.

[Zaxxon]

The coronavirus is more dangerous for everyone right now. Children are no exception.

Preaching to the choir, I know. But...

[Daehawk]

With the spottiness and lack of vaccinations I have started wondering if this virus will mutate into something thats just annoying or go the other way and flat out kill you in two days.

[disarm]

With the spottiness and lack of vaccinations I have started wondering if this virus will mutate into something thats just annoying or go the other way and flat out kill you in two days.

That's exactly what some (including Fauci) are warning about if we don't get the spread under control.

[Kurth]

With the spottiness and lack of vaccinations I have started wondering if this virus will mutate into something thats just annoying or go the other way and flat out kill you in two days.

That's exactly what some (including Fauci) are warning about if we don't get the spread under control.

Probably a stupid question, but isn't a virus that flat out kills you in two days a fundamentally bad virus (meaning, poor performing and destined to die off itself relatively quickly)?

I would think that a virus that is that deadly can't really pass itself on to new hosts before it kills off its carrier, so from an evolutionary perspective, it wouldn't be all that long-lived. Is that off-base?

[malchior]

Cue the whining about tech overreach.

https://twitter.com/donie/status/1425344460263763971

[LawBeefaroni]

A seven day suspension is just handing him meat for the base. They should give him a 7 .month suspension.

[raydude]

With the spottiness and lack of vaccinations I have started wondering if this virus will mutate into something thats just annoying or go the other way and flat out kill you in two days.

That's exactly what some (including Fauci) are warning about if we don't get the spread under control.

Probably a stupid question, but isn't a virus that flat out kills you in two days a fundamentally bad virus (meaning, poor performing and destined to die off itself relatively quickly)?

I would think that a virus that is that deadly can't really pass itself on to new hosts before it kills off its carrier, so from an evolutionary perspective, it wouldn't be all that long-lived. Is that off-base?

Isn't one of the insidious things about Covid-19 the fact that you can be shedding it for days before you start developing symptoms (if ever)? Looking at it from the virus' viewpoint - it just wants to multiply and spread as much as possible. If it's possible for it to spread for days before you develop symptoms and die two days later that would be ideal for it. Bad for us.

[El Guapo]

Apparently the American Academy of Pediatrics has urged the FDA to grant emergency approval for ages 5 - 12 based on available data. Not sure whether that changes anything or not. Also some indication that the FDA may expand the approved age to 8+ in September.

[Smoove_B]

I'm all in support of getting kids vaccinated sooner, but remember - even if we could vaccinate every single kid tomorrow, there's still 5+ weeks of time that must pass before they're fully protected.

Don't put all your eggs in the vaccine basket. We still need to be universally masking indoors, increasing ventilation in the schools, doing out best ot minimizing crowding, etc... Don't let a school say kids can be vaccinated now so we're removing all other protections.

The vaccines will help, but they don't mean we should stop all the NPI efforts (contrary to what the CDC said back in May).

[Zaxxon]

I'm all in support of getting kids vaccinated sooner, but remember - even if we could vaccinate every single kid tomorrow, there's still 5+ weeks of time that must pass before they're fully protected.

Don't put all your eggs in the vaccine basket. We still need to be universally masking indoors, increasing ventilation in the schools, doing out best ot minimizing crowding, etc... Don't let a school say kids can be vaccinated now so we're removing all other protections.

The vaccines will help, but they don't mean we should stop all the NPI efforts (contrary to what the CDC said back in May).

Now do schools that are removing all other protections and also include kids who can't get the vaccine.

I don't think anyone here is looking to put all eggs in the vaccine basket, but rather lots of us have kids whose districts have decided that baskets are out of fashion--we don't need eggs anymore, anyway.

[stessier]

Don't put all your eggs in the vaccine basket.

When the State actively takes and hides all the other baskets, you put the eggs in whatever is left.

[El Guapo]

I'm all in support of getting kids vaccinated sooner, but remember - even if we could vaccinate every single kid tomorrow, there's still 5+ weeks of time that must pass before they're fully protected.

Don't put all your eggs in the vaccine basket. We still need to be universally masking indoors, increasing ventilation in the schools, doing out best ot minimizing crowding, etc... Don't let a school say kids can be vaccinated now so we're removing all other protections.

The vaccines will help, but they don't mean we should stop all the NPI efforts (contrary to what the CDC said back in May).

Oh I know. But you know, the sooner I can get my son vaccinated the better. And it seems like 80% of the NPI decisions are effectively being made independent of vaccination status anyway - in particular, the insane red YOLO states aren't going to be any more cautious during the unvaccinated period, so we might as well allow the non-insane families living there to get their kids vaccinated as soon as we can.

[Smoove_B]

I don't think anyone here is looking to put all eggs in the vaccine basket, but rather lots of us have kids whose districts have decided that baskets are out of fashion--we don't need eggs anymore, anyway.

I'm sorry, I'm in information officer mode - not necessarily directed at anyone here. But there's been a real strong push in various locations nationwide to argue that kids in 8th-12th grade environments don't need masks because they're old enough to have been vaccinated, so no other protections are now needed.

It's spillover from the general belief that masks (and other NPIs) aren't needed anymore because of the vaccine. The binary thinking behind what the CDC communicated has snowballed into an unintended consequence.

The other observation I noticed over the last 24 hours by people way smarter than I am, is that the 2020 message for schooling where "parents have to make the best decisions for themselves" is now morphed into a reason for not wearing a mask. At its core, that message undermines the idea of public health and sets the tone that individuals should be in charge of their own health and their own health only during a communicable disease outbreak - no worries about the community or others.

Careers are going to be made on analyzing the communication blunders that have been made.

[LawBeefaroni]

With the spottiness and lack of vaccinations I have started wondering if this virus will mutate into something thats just annoying or go the other way and flat out kill you in two days.

That's exactly what some (including Fauci) are warning about if we don't get the spread under control.

Probably a stupid question, but isn't a virus that flat out kills you in two days a fundamentally bad virus (meaning, poor performing and destined to die off itself relatively quickly)?

I would think that a virus that is that deadly can't really pass itself on to new hosts before it kills off its carrier, so from an evolutionary perspective, it wouldn't be all that long-lived. Is that off-base?

Isn't one of the insidious things about Covid-19 the fact that you can be shedding it for days before you start developing symptoms (if ever)? Looking at it from the virus' viewpoint - it just wants to multiply and spread as much as possible. If it's possible for it to spread for days before you develop symptoms and die two days later that would be ideal for it. Bad for us.

It wouldn't really be ideal for it. Things like the cold or the flu do much better than something like ebola. Survival pressures, not virility, drives their evolution.

The perfect COVID, from COVIDs point of view, would be one that produces mild symptoms and is largely ignored by the immune system. Severe symptoms and/or mortality reduce its survivability.

[El Guapo]

I don't think anyone here is looking to put all eggs in the vaccine basket, but rather lots of us have kids whose districts have decided that baskets are out of fashion--we don't need eggs anymore, anyway.

I'm sorry, I'm in information officer mode - not necessarily directed at anyone here. But there's been a real strong push in various locations nationwide to argue that kids in 8th-12th grade environments don't need masks because they're old enough to have been vaccinated, so no other protections are now needed.

It's spillover from the general belief that masks (and other NPIs) aren't needed anymore because of the vaccine. The binary thinking behind what the CDC communicated has snowballed into an unintended consequence.

The other observation I noticed over the last 24 hours by people way smarter than I am, is that the 2020 message for schooling where "parents have to make the best decisions for themselves" is now morphed into a reason for not wearing a mask. At its core, that message undermines the idea of public health and sets the tone that individuals should be in charge of their own health and their own health only during a communicable disease outbreak - no worries about the community or others.

Careers are going to be made on analyzing the communication blunders that have been made.

It seems like one of the core challenges with public health communication (speaking as a budding public health communication expert) is how much do you just tell people what they should do as best you understand it at the time, vs. how much do you factor in how idiots are going to misinterpret what you are saying? Seems like the challenge with the former is that idiots are inevitably going to misinterpret, and the problem with the latter is that if you constantly pitch the message to the idiots, then the non-idiots can't rely on you totally for understanding what's actually safe and what's not.

[Smoove_B]

It seems like one of the core challenges with public health communication (speaking as a budding public health communication expert) is how much do you just tell people what they should do as best you understand it at the time, vs. how much do you factor in how idiots are going to misinterpret what you are saying? Seems like the challenge with the former is that idiots are inevitably going to misinterpret, and the problem with the latter is that if you constantly pitch the message to the idiots, then the non-idiots can't rely on you totally for understanding what's actually safe and what's not.

Yes, this goes back to the link AB posted elsewhere regarding the "white lies" public health professionals tell.

The core message I was taught is that we need to present the public with the same information we've been provided in the hopes that they reach the same conclusions we have.

That's the theory; in practice I can't say it typically works out that way. Part of the reason isn't just understanding the information, but what individuals and communities value. This is a whole separate topic, but in short, communities don't value public health (that's my theory and I'm sticking to it).

Regardless, health communication is without question a skill and we're failing at it (and have been, arguably for the last 30+ years). Classic public health is the no-it-alls communicating high from the mountain - do this, don't do that. More modern public health (1980/1990) starts with trying to educate and inform communities as to why they should conclude, don't do that, do this instead - making them partners.

Unrelated, but here's a scene from after a school board meeting in TN:

https://twitter.com/natalie_allison/sta ... 8202548224

The parking lot after a school board meeting last night in Franklin, the wealthiest place in Tennessee. Parents harassed medical professionals who had spoken in favor of masks in schools. “We know who you are. You can leave freely, but we will find you.”

We're not going to fix this easily and I'm afraid it's going to likely take a generation of people that suffered death and loss from COVID-19 to reset priorities. I am more and more feeling like we're not going to change much of anything anymore; the die has been cast.

[LawBeefaroni]

It's spillover from the general belief that masks (and other NPIs) aren't needed anymore because of the vaccine. The binary thinking behind what the CDC communicated has snowballed into an unintended consequence.

Didn't we establish that here the day the CDC made that call?





Honestly the mixed messaging from every quarter eventually wears most people down. I'm seeing so many just grab onto the one that suits them best. Kind of like how people love cafeteria style religion.

[malchior]

It's spillover from the general belief that masks (and other NPIs) aren't needed anymore because of the vaccine. The binary thinking behind what the CDC communicated has snowballed into an unintended consequence.

I've seen that in my local community threads on the social medias where a few folks equating wearing masks to the vaccines being pointless (with lots of likes). Because Americans are generally overgrown spoiled children.

Careers are going to be made on analyzing the communication blunders that have been made.

I wouldn't be too hard on anyone at this point. We're the problem. The messaging could have been perfect and we'd still probably have much or all this chaos and selfishness.

[Smoove_B]

Didn't we establish that here the day the CDC made that call?

Well...yeah. But I apparently the world isn't listening to OO.

Honestly the mixed messaging from every quarter eventually wears most people down. I'm seeing so many just grab onto the one that suits them best. Kind of like how people love cafeteria style religion.

Yes, also true. This is where my cynicism creeps in and suggests that the message was crafted to juice the economy - just like every other decision we've made for this entire pandemic.

I've seen that in my local community threads on the social medias where a few folks equating wearing masks to the vaccines being pointless (with lots of likes). Because Americans are generally overgrown spoiled children.

Yup.

I wouldn't be too hard on anyone at this point. We're the problem. The messaging could have been perfect and we'd still probably have much or all this chaos and selfishness.

That will be in the analysis for sure - how did we get to this point? It's going to be a combination of education, politics and attitudes.

[Smoove_B]

One for Pete Rock. I hope wherever you are my dude, you're doing well.

https://twitter.com/brikeilarcnn/status ... 4446464008

"Don't Florida my Fauci!" says Skid Row ex-singer (also of Gilmore Girls fame) Sebastian Bach. He contracted covid but credits the vaccine for his mild case.

"Get the vaccine," Bach says. "Like, you don't want polio, right, so you get the vaccine for that. You don't want covid."

[LawBeefaroni]

I've seen that in my local community threads on the social medias where a few folks equating wearing masks to the vaccines being pointless (with lots of likes). Because Americans are generally overgrown spoiled children.

Yup.

I wouldn't be too hard on anyone at this point. We're the problem. The messaging could have been perfect and we'd still probably have much or all this chaos and selfishness.

That will be in the analysis for sure - how did we get to this point? It's going to be a combination of education, politics and attitudes.

In times of crisis you need to take decisive action first and message later. At least if you are an effective leader. From the beginning, inaction and status quo were the preferred mode. Let someone else take the wheel because there is too much potential political damage attached. At some point I'm going to review these threads from the beginning to remember where we have been along the way.

But I know that at very few points did we have decisive leadership at the federal level. Even at the state level, where I'll admit our governor did a decent job, there was hesitation in deference to politics. Or complete capitulation to politics as we see on the South.

It says something that Gov. Cuomo, an egotistical turd, was who the half the nation was looking to for several weeks.

[LordMortis]

...

The parking lot after a school board meeting last night in Franklin, the wealthiest place in Tennessee. Parents harassed medical professionals who had spoken in favor of masks in schools. “We know who you are. You can leave freely, but we will find you.”

We're not going to fix this easily and I'm afraid it's going to likely take a generation of people that suffered death and loss from COVID-19 to reset priorities. I am more and more feeling like we're not going to change much of anything anymore; the die has been cast.

How do you not move out of TN? Take their federal funding toys away. Let them govern locally. Give assistance to those who want to GtFO. Quarantine the area. Let them burn their backyard to the ground. Another reason why I don't run things, I guess.

[LawBeefaroni]

By the way, that leaked CDC report? This is why you do peer review.

In a leaked report, the Centers for Disease Control and Prevention made a surprising claim about the delta variant of the coronavirus: It "is as transmissible as: - Chicken Pox," the agency wrote in a slideshow presentation leaked to The Washington Post on July 26.

Chickenpox is one of the most contagious viruses known. Each individual can spread the virus to as many as "90% of the people close to that person," the CDC reports.

Is the delta variant that contagious as well?

The short answer is no, says evolutionary biologist and biostatistician Tom Wenseleers at the University of Leuven in Belgium.

...


For one, the leaked document underestimated the R0 for chickenpox and overestimated the R0 for the delta variant. "The R0 values for delta were preliminary and calculated from data taken from a rather small sample size," a federal official told NPR. The value for the chickenpox (and other R0s in the slideshow) came from a graphic from The New York Times, which wasn't completely accurate.

This is just more ammo for FUD. The message real message will be lost to many:

"At the end of the day, this delta variant is much more transmissible than the alpha variant," the official added. "That's the message people need to take from this." The official requested anonymity because they were not authorized to speak to the media on this topic.

[malchior]

Here is the slide (bottom) - I might have used the following language: "Delta variant may be as transmissible as:" for the Chickenpox line since they only have a wide range but some of the criticism about this today seems like nitpicking to me. I can't help but wonder if the top picture is *too specific*. I'd leave that to Smoove_B but I've heard the R0 talked about in ranges because well it's ongoing and we are still gathering data. Also, once again I can't help but say...STFU Nate.

https://twitter.com/dznyc/status/142546 ... 13/photo/1

[LawBeefaroni]

...

The parking lot after a school board meeting last night in Franklin, the wealthiest place in Tennessee. Parents harassed medical professionals who had spoken in favor of masks in schools. “We know who you are. You can leave freely, but we will find you.”

We're not going to fix this easily and I'm afraid it's going to likely take a generation of people that suffered death and loss from COVID-19 to reset priorities. I am more and more feeling like we're not going to change much of anything anymore; the die has been cast.

How do you not move out of TN? Take their federal funding toys away. Let them govern locally. Give assistance to those who want to GtFO. Quarantine the area. Let them burn their backyard to the ground. Another reason why I don't run things, I guess.

My parents just moved out. Sold a great little horse farm in the foothills of the Smokies and temporarily relocating to my sister's basement because it's a fucked up state.

[Zaxxon]

Apparently the American Academy of Pediatrics has urged the FDA to grant emergency approval for ages 5 - 12 based on available data. Not sure whether that changes anything or not. Also some indication that the FDA may expand the approved age to 8+ in September.

The source, a letter from the AAP to the FDA dated 8/5/21.

[LordMortis]

My parents just moved out. Sold a great little horse farm in the foothills of the Smokies and temporarily relocating to my sister's basement because it's a fucked up state.

My parents would likely like to move in. They're good people but I have no idea how to reach them. Heck, I fear my mom is literally going kill herself by both not getting vaccinated and by running herself into the ground with stress and exhaustion feeding the homeless because her fellow church membership keeping making commitments and then never delivering on them while she won't back down on a promise or let people go hungry. (I personally can't stomach feeding the homeless. My soul is never so crushed as it is when exposed so such things and I don't bounce back for a long long time. I'm an embarrassment.)

[Smoove_B]

I believe school started today in FL. Sending strength to parents and public health advocates pushing back against DeSantis right now.

https://twitter.com/malar0ne/status/1425478257164525575

(can't copy text; images from Tweets)

[Blackhawk]

"Leaked" sends up a lot of red flags that it shouldn't be taken at face value. It isn't a published study. In fact, I can't find any context about it at all. All I have seen was that it was a PowerPoint presentation and that 'an official' said it was why they changed their guidance (was 'an official' in that discussion, or is it just hearsay?) Was it an official presentation? Was it a pitch someone was making internally? Was it a final form document, or a work-in-progress?

It isn't a source.

[Defiant]

There's a just released preprint study that found that Moderna and Pfizer are less effective against infection (just infection - the study has no data about things like hospitalizations or deaths). That seems to be in line with the Israeli study which had looked like an outlier.

And experts cautioned against rushing to conclusions.
“This is the kind of surprising finding that needs confirmation before we should accept its validity," said Cornell virologist John Moore.

https://www.axios.com/coronavirus-vacci ... 57070.html

[LawBeefaroni]

Why are they releasing a pre-print, non-peer reviewed study? No one is going to take action before it is reviewed.

Hey, here's some unverified scary stuff. Policy cant be made until we verify, but enjoy!

[Daehawk]

I think even with a booster we're going to need a full new vaccine within a year.

I dont mind. Long as something helps Ill go get it.