I saw a video on the expected failure of hospital systems in the Southeast states - as a mathematical certainty. I think that this is what NYC experienced Spring 2020. Vaccinations are increasing but it takes six weeks for people to be fully vaccinated. I do not know if this will be a problem in the rest of the country but it could certainly happen in my area given our vaccination numbers.
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Coronavirus (Covid-19) informational thread
- Thread starter yaxomoxay
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I find your post bizarre. How would you know only 20% people masked at your grocery store, did you like keep a tally of the occupancy or something of people entering and leaving? Secondly, how would you know your numbers will likely ‘double’ in the next two weeks? Is that based off the lack-there-of people masking in a grocery store at 20%?
Eyeball estimate.
We were 155 three weeks ago. We're over 1,100 as of Friday.
True, stupidity can be found everywhere. But looking at a US map showing states with the highest cases of COVID and lowest vaccine rates, it can easily be identified geographically and politically.
The problem is that the average person isn't looking at the growing numbers, and, despite two waves, doesn't have an innate grasp of exponential growth.
One of the videos that I linked had the interviewed guy clarify that hospital systems in some states are going to fail. Just simple mathematics. Other states can take on mitigation but how many are doing that right now? Numbers are low at an absolute level so people are complacent.
And college and school are right around the corner.
My niece can't get the vaccine sadly. She had issues with her legs when she was 17 or 18 missed a whole month or two of school. She could not even walk. Took them forever to figure out what was wrong. Sorry I forgot the name of the issue. Seriously I did.
In the UK, two broad groups of children (defined as 12 to 18) have received vaccines. Those who have close contacts who are susceptible - typically immuno-compromised or old and not healthy relatives, especially when living together with the children. And those who have a relevant condition themselves.
So far, I don't think there have been many, if any, significant issues.
Although not designed to be full trial of vaccinating children, it has produced substantial data that is still accumulating and should help identify any issues.
This is a pretty common practice (and often issue) with clinical trials. Ethically it’s questionable to test a pharmaceutical on children before first testing it on adults. Second, drug companies don’t want the liability or negative optics of testing novel drugs/vaccines on children and having severe adverse events occur. Third, parents are less likely to enroll their kids in researching an experimental substance, unless it’s a potentially lifesaving treatment. Fourth, considering the risks of COVID to children up until recently have been minimal, no ones going to take unnecessary risks with children.
With conventional (small molecule) pharmaceuticals, there are often major differences between adults and children as children can metabolize drugs very differently and can have varying neurotransmitter receptor populations. Vaccines however are a totally different ball game and I would not expect to see any significant differences between adults and children.
That said, COVID is more likely to induce multi-system inflammatory syndrome in children, which presumably could also occur with the vaccine. That said, this is not particularly common.
While it seems the delta variant is more likely to affect children, I think we still need a lot more data on this. When we hear about pediatric hospitals becoming “overwhelmed”, keep in mind they aren’t setup to deal with an influx of COVID cases. Historically, the most likely children with COVID to be hospitalized had significant underlying conditions like asthma, obesity, neurological conditions, immune suppression, etc.
Pfizer didn’t start trials in children under 12 until June, which is a bit insane in my opinion. Apparently a decision is going to be made for this population “within the coming school year”.
We of course will have to deal with vaccine hesitancy among parents though. If you think vaccine hesitancy is bad in adults, just wait until it involves getting people’s children vaccinated. I expect it will be worse.
There are two patient populations I least enjoy working with- #2, old people because they often have no idea what’s going on and have low healthcare literacy and #1, children, but only because of their parents.
In the UK, 16/17 year olds are able to make the decision for themselves. (Given they understand.) Which could result in some, umm, interesting discussions within familes - let alone outside.
Vaccination seems to have largely broken Delta, the question is what (if anything) comes next. Some have floated the idea Delta is about as infectious as this virus is able to get while still being an effective Human pathogen, if that is true we won't be looking at such explosive outbreaks in the future (though even pre-named-variant infectivity is more than enough to be a big problem).
If the above proves true the next wave is likely to be whatever variant is best able to thrive in vaccinated and part vaccinated populations... it's possibly already extant, but Delta is helping to suppress it by being more infectious. As Delta recedes and other variants are given more room to breathe, my worry is we will get the MERS scenario - a variant which is less easy to catch (still more transmissible than MERS itself) but more deadly if you do.
This is probably getting too far ahead and into speculative territory, but at least here the prevailing attitude seems to be 'its all over' and I'm not yet convinced that's wise, highly vaccinated population or not...
If the above proves true the next wave is likely to be whatever variant is best able to thrive in vaccinated and part vaccinated populations... it's possibly already extant, but Delta is helping to suppress it by being more infectious. As Delta recedes and other variants are given more room to breathe, my worry is we will get the MERS scenario - a variant which is less easy to catch (still more transmissible than MERS itself) but more deadly if you do.
This is probably getting too far ahead and into speculative territory, but at least here the prevailing attitude seems to be 'its all over' and I'm not yet convinced that's wise, highly vaccinated population or not...
The US has a handful of states or municipalities that allow vaccinations without parental consent as young as 11 years old (but generally 14-16). There are also some states where providers can decide whether or not minors are mature enough to get the vaccine.
Generally I don’t like the idea of minors making healthcare decisions without the consent of their parents. That said, I also believe parents aren’t always the best qualified to make medical decisions for their children. Taking decisions out of parents hands does create a slippery slope though.
I wouldn’t be surprised to see more states adopt more flexible policies in regards to vaccines in an effort to overcome anti-vaxx parents.
16-17 seems perfectly reasonable to me, if you’re considered mature enough at that age to make your own decisions about your sexual heath, then you’re also mature enough to make your own decisions about the risks of vaccination. Under 16 is a little more contentious, though if the advice/ evidence strongly favours vaccination and the child wishes to receive it I think there should be some mechanism, possibly through schools or GPs, which gives them access to do so discretely.
There are forum threads in various areas where teenagers ask how to get vaccinations without their parents' consent or knowledge. So there are teenagers interested in getting vaccinated despite what their parents want.
We're accelerating with active cases in my state and, last night, our infectious disease head gave a 30-minute interview where he was more worried than the interview he gave on Friday. I went to the gym this morning and it was packed (I got a late start). Adult swim class, kids all over the place, parking lot packed. I skipped my workout and will workout at home and maybe go in later when there are fewer people there.
I didn't see anyone else there wearing a mask.
New daily cases have fallen back somewhat here (though the drop now seems to have slowed) but the hospitalisation rate has stayed quite low. Certainly a lot lower than for previous waves. That makes me think that the Delta outbreak is manageable, even if we get a second peak in this wave over the next month or two. My worry is that Delta seems to be neutralised quite effectively by the vaccines, but what happens if we get caught short by a variant that isn't...
When I've gone into town since all remaining restrictions were lifted on the 19th July it seems most people are still wearing masks, most supermarkets are still requiring them to be worn, and people still seem to be giving each other as wide a berth as is practical. With the legislation in place it's no longer legally enforceable (it's now back to being a civil not a police matter) but so far people seem to be being sensible. OTOH large gatherings are now being permitted and even encouraged, and in those sorts of packed situations I don't think masks will help either way, you're in too close a proximity to other people for too long.
I agree, especially considering the risks of getting approved vaccines are infinitesimally small and aside from exceeding rare adverse events, there are no potential longterm health consequences. And certainly if you’re old enough to consent to an abortion or drive a car, you’re should old enough to consent to a vaccine. Apparently in Nebraska you have to be 19+ to independently consent to vacations. Crazy.
Specific to vaccines, this is what I think is reasonable:
- Competent minors 16+ can walk into a pharmacy or clinic and get the vaccine, no questions asked.
- Those under 16 must be counseled by a prescriber and deemed mature enough to have informed consent (Realistically this covers most 12/13 to 15 YO).
I have ethical issues with minors who are not capable of informed consent and the medical industry forcing care upon children and their otherwise competent parents when it’s not a life-saving, emergency intervention. At worst such a policy would make skeptical parents avoid healthcare for their children altogether.
I think the best tactic for those opposed or hesitant to the vaccine is either use incentives and/or make life more difficult without it (ie mandating the vaccine for schools, camps, etc). There are some states, much like with the case with abortion, if the parents do not consent to vaccinations the court can intervene. It seems like an atrocious waste of the court system and time for something as minor as vaccines though.
Having spent some of my clinical rotations in a children’s hospital, I’ve seen first hand the consequences of anti-vaxx ideology in kids i.e. infections preventable with vaccines causing encephalitis leading to death or permanent, lifelong cognitive and/or motor impairment. So believe me when I say the anti-vaxx movement bothers me deeply. This is why I’m not necessarily opposed to consequences for the parents of unvaccinated children who get severely ill or die.
I think the best tactic in the meantime for those opposed or hesitant to the vaccine is either use incentives and/or make life more difficult without it (ie mandating the vaccine for schools, camps, etc). There are some states, much like with the case with abortion, if the parents do not consent to vaccinations the court can intervene. It seems like an atrocious waste of the court system and time for something as minor as vaccines though.
That said not all 16-17 year olds have autonomy regarding reproductive health. Whether it’s right or wrong, there are still states that mandate parental consent for abortion for those under 18 (with or without the ability for courts to overrule the parents), while others require parental notification, and others no parental involvement at all. For consequential decisions like abortion, I think one can make valid arguments for each.
Regardless of the state, most of these minor consent laws (which independently address abortion, to prenatal care, to STD’s, to mental health, to addiction, etc) don’t make a ton of sense when written next to other minor consent regulations in the same jurisdiction (ie you can get an abortion at 15 but not mental health counseling). And many of these “confidential” treatments aren’t really confidential if the minor uses insurance or abuse is suspected.
The laws around consent of minors is a messy and often poorly considered system.
A university in the UK seems to be going down the incentive path - all students will be entered in a draw. The first ten who are fully vaccinated (or officially exempted) will "win" £5000.
I dislike that because we already have far too many forms of gambling being heavily promoted. And it seems to trivialise the issue.
The Welsh government has spoken to the public in a level-headed, clear way, at least when contrasted with England. (It doesn't help that much of the time you don't even know whether the UK government is talking for the UK or just England.) So far, Wales is ahead of England and Scotland. (Only to provide context - it really isn't a competition and should be seen as one.)
Well, I can’t speak for NH but in Massachusetts the last DPH report I saw from several days ago said there were roughly 7,700 breakthrough cases out of 4.33m fully vaccinated residents, which is a breakthrough rate of 0.18% (and even less if you consider the partially vaccinated). 0.009% of fully vaccinated people required hospitalization and 0.002 died. The median breakthrough age was 82.5 and 75% had significant underlying disease. Overall deaths are down and hospitalizations are way down since July.
I think there’s questions to be answered about the prevalence of asymptomatic breakthrough and the ability for the virus to spread in such cases. And along those lines how much utility masks have in the vaccinated when we consider surgical and cloth masks don’t protect the individual wearing it. There’s some preliminary evidence surgical and cloth masks may not be particularly effective at preventing delta spread.
That’s not to say masking isn’t a good precaution in the meantime, especially for high risk individuals (who should probably use N95. I have my suspicion masking vaccinated people, especially those who are younger and healthy, won’t be terribly effective. It’s detrimental to enact mask mandates that enable and embolden people refusing to get the vaccine. At the same time, the more the virus spreads, the greater chance of resistance and more pathogenic strains. So I think it’s absolutely vital we get hesitant people to change their mind and children under 12 authorized ASAP.
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What? No masks in the pool?!
Masks in the pool is the one idea my pool hasn’t come up with. As someone who swims laps 4-5x a week (under normal circumstances ~2miles per day) I have become quite frustrated with my pools ongoing COVID restrictions. Restrictions that don’t exist in any other pools at this point, including:
1) Required scheduling of lane for a 45 min slot (about 1/2 my desired timeframe), 1x per day, maximum 5 swims per week (up until recently max 3/week)
2) One person per lane, even if it’s a member of your hou
3) Each lane is required to start/rest at alternating ends of the pool and you get yelled at by the lifeguard if you screw this up, unless you’re old.
4) If you use a kick board or pull bouy it must be put in a bin to be decontaminated (as if a giant pool of chlorinated water won’t decontaminate any pathogens)
There’s an awful lot of restrictions considering chlorinated water has been found to kill the virus and the CDC has found zero cases of COVID spreading in pools. Many pools also have ozone generators and UV filters (or are outside and get plenty of UV), also associated with killing the virus.
I think it’s a bigger risk having everyone wait inside the foyer of the building (without masks at this point) for the previous block of swimmers to leave the changing room, so the your block can all enter the changing room at the same time, then be herded out of the pool back into the changing room at the same time.
Our state infectious disease guy kept hammering on vaccines. He was asked on masks and social distancing and he said those were fine but our focus should be on vaccinations. It feels like we have no state or local leadership on vaccinations though. It's like they declared victory and went on vacation.
I was at a club last week and there were a ton of kids and moms at the pool. In lounge chairs around the pool and in the pool. It looks like they were having a lot of fun.
There are no restrictions on the pool at my club right now. There was an aqua-aerobics class in the open section and people swimming lanes this morning.
One thing about the Boston area is that you have much higher population density and far higher demand for recreation. So the pandemic has resulted in some level of rationing.
When you consider the cost of inpatient treatment of COVID (especially in the US), shelling out 50,000£ nationally is small beans. I suppose it’s more of a raffle than it is gambling, especially considering the vaccine is free (I assume in your country). That said I would agree there a well known danger of people winning large sums of money, often leasing to economic ruin
Here in Massachusetts they did a $1m raffle. Frankly I think 100 x $10,000 prizes or some combination of larger and smaller amounts would have been better as the chances of winning seem less remote. But we have a decently high vaccination rate as it is.
Here in the US we have the data on who is not getting vaccinated, the majority can pretty much be summarized into two groups. These groups could be be directly targeted in their own ways, but of course that’s not happening- that would make too much sense. The blanket approach of calling those opposed stupid, ignorant, and evil only goes so far. Speaking from my experience as a healthcare provider, condemnation and condescension in usually the least effective persuasion tactic.
Though much of our public doesn’t understand scientific knowledge evolves, the CDC has clearly not mastered the art of healthcare communication, leading to doubt and mistrust. But I think the most detrimental to society has been the sensationalism and politicization by our dysfunctional national media.
Yeah, the pool I use is indoors so no sunbathers and it typically doesn’t have many small children as it’s designated for lap swimming. They do have a pool for kids and a diving well but those been shut down for COVID and converted to really bad pools for swimming laps. There is an outdoor pool nearby so typically kids are a rarity here in the summer.
I’d love to use the outdoor pool but they don’t have designated lap swim times and when the pool is open to the public, they remove all the lane lines. So I imagine I’ll be dodging small children when trying to swim.
I put up with the nonsense (including an power hungry lifeguard) because it’s near my home and dirt cheap, despite being a gorgeous pool.
We've been in this for over 15mos, we have 3 vaccines available at no cost to anyone over the age of 12. How much state and local leadership on vaccinations do you need? At this point it is a personal choice, no amount of brow beating is going to change someone's mind. Seeing a loved one die, generally will do it. Which is the same phenomenon every smoker clings to, lung cancer isn't real until it hits close to home. Of the patients I've seen get diagnosed with lung cancer it has always been, "it will never happen to me", followed by years/decades of telling the patient they really should quit, to eventually the blank white look on their face when they're told they have a spot on their lungs, off to PET scan.
The same people who believe the earth is flat and that the vaccine causes metal to stick to you are the people you will never turn, so why bother.
I agree with everything you said succinctly. The reality is, it will take a personal loss of a friend/family member for the unvaccinated that was healthy that didn’t have the vaccination to provoke someone else to finally consider the vaccination. There’s likely no amount of truth, backed-factual science that will convince anyone waiting this long, it’s probably down to something that really ‘hits hard’ where they know someone that was ‘reasonably healthy, with no underlying conditions and young’ that lost their life, which makes an unvaccinated person think, ‘Gee, what could happen to me if this happened to that person.’
That’s what we’re seeing in Louisiana, the death rate was spiking, and now you have lines of people who negated the vaccine, now want to get vaccinated.
Belmont, MA reinstituting mask mandate. That would be a start.
Managing a state hospital crisis or potential state hospital crisis.
Figuring out what to do in case of school outbreaks.
You know, all the stuff that we did last year.
100%. With that said I do not agree with singling anyone out or excluding them from society based on their vaccination status. You're not changing anyone's mind by calling them stupid or whatnot. If you're vaccinated then the risk to you is infinitesimally small. They're putting themselves at risk for serious complications/hospitalization.