Coronavirus (Covid-19) informational thread

[pshufd]

The fact that ivermectin is generic does not mean that it would not be “indicated” for COVID-19 if it was indeed effective. Dexamethasone is generic and dirt cheap, yet is a standard of treatment in severe cases. Drugs are used off-label all the time and it’s approval status, so long as it’s FDA approved to begin with, is irrelevant.

It’s true that pharmaceutical companies have an incentive to come out with shiny new expensive treatments. But there are also incentives among hospitals as well as governments who fund any amount of public healthcare to find effective treatments at the lowest cost. Most reimbursement these days is capitation rather than fee-for-service, meaning the hospital gets paid a X amount of money to treat Y condition rather than paying an itemized invoice for each service provided.

I’m throwing out costs and oversimplifying for the sake of example here: let’s say an insurer pays $30,000 for 2 weeks of inpatient psych treatment to treat a patient’s bipolar mania. The hospital could spend $3000 on meds using the newest brand name drugs or $50 using generics that have been around for decades. Why throw away $3000 when you could get the same outcome for $50 and keep the extra $2950?

If healthcare can get the same outcome for less, they will take that opportunity- and seek out ways to do so. Sometimes it’s almost hard to laugh when drug reps come in trying to sell some new $2000/month drug that really has no meaningful benefit over an older drug that costs $2/month. Or some new combination of two existing drugs that cost $300/month while the two drugs independently cost $15 each. Or levothyroxine (normally $5/month, $40 for brand name Synthroid) that costs $250 because it comes in a capsule instead of a tablet. The best might have been this a $7,000 naloxone (Narcan) auto-injector called Evzio. Alternatively a vial of naloxone and a syringe is probably $11. (Not surprisingly, Evzio no longer is on the market).

You should also understand that if you take an existing generic drug, change the dose or dosage form, do expensive clinical trials, go through the approval process, you can patent it and sell it as a brand name drug. For example, in 1992 finasteride aka Proscar was approved. It comes in a single dose (5mg) and is used to treat enlarged prostates. In 1997, finasteride 1mg was approved for male pattern baldness, aka Propecia, which got its own patent. And while Propecia cost $100/month and wasn’t covered by insurance, generic finasteride 5mg cost several dollars per month.

Another example, ~10 years ago some of the manufacturers of albuterol inhalers and lobbied the government to ban CFC’s in inhalers, which was the propellant everyone used. This was done under the guise of environmentalism despite the amount CFCs being very small. This way a few companies could corner the market getting non-CFC inhalers approved while others opted not to make such a large investment. Because they used a new propellant, a new approval process was necessary despite it being the exact same drug. This allowed them to charge $40/inhaler instead of $5

If a drug is truly effective, pharmaceutical companies will find a way to patent it and make money.

There have been a number of meta analyses done on ivermectin and COVID-19. Many studies are small, of poor quality, and or flawed in procedure or calculations. Additionally, investigating the raw data, a number of studies are believed to be fraudulent / have manufactured results.

At the end of the day do I care if people want to take it? Not really, it’s quite benign in terms of risks, provided the correct dose is taken. Do I recommend it, no. What I do care about is people buying up the world supply of it preventing people who legitimately need it from being able to get it. In reality, millions of people take homeopathic treatments everyday that have zero clinical evidence of working. So it’s really nothing new and just part of the wild we live in.

I haven’t thoroughly read many of the ivermectin studies, but I did the hydroxychloroquine research. The HQC studies were so poorly designed and absurd I was astonished anyone, especially in healthcare, would find the results in any way meaningful. HCQ while a generally safe drug does have some significant risks if not doses and monitored appropriately. But me, my wife, and some of my colleagues all endured tantrums and threats (death threats if your my wife) from patients and family members who demanded HQC. Talk about insanity.

https://www.reddit.com/r/QAnonCasualties/comments/rakxun

I take a number of supplements myself and my oncologist was familiar with all of them. I wouldn't take them if they didn't help. Though I'd have to say that running 20 miles a week helps a lot too.

I had a number of oddball things happen with chemo in terms of generics, brand names, and drug dispensing that have me doubting that doctors or hospitals try to save money on drugs.

 

[A.Goldberg]

https://www.reddit.com/r/QAnonCasualties/comments/rakxun

I take a number of supplements myself and my oncologist was familiar with all of them. I wouldn't take them if they didn't help. Though I'd have to say that running 20 miles a week helps a lot too.

I had a number of oddball things happen with chemo in terms of generics, brand names, and drug dispensing that have me doubting that doctors or hospitals try to save money on drugs.

There is a difference between homeopathy and taking natural supplements. Homeopathy by definition is pseudoscience. Like eating 10ths of grapes a day isn’t going to cure one’s stage IV cancer. Many supplements have clinical value, like taking VitaminD for VitaminD deficiencies or magnesium and/or potassium to treat muscle spasms. Alcoholics often require VitaminA, folate, and thiamine supplementation. Methylfolate supplementation appears to help treat depression. Research suggests SAM-E (S-adenosylmethionine) is at least as effective as NSAID painkillers, etc.

Then there’s natural/herbal products. Some of them do have evidence to support their use. Chamomile, Tumeric, St. John’s Wort for example. Often these treatments are less practical and carry more side effects that conventional drugs.

That said, there are also supplements that demonstrate no clinical value and are marketed to misleadingly imply misleading or unproven effects. Same with natural medications. For example, some supplements are broken down by stomach acid or cannot physically be absorbed through your intestines, therefore cannot enter systemic circulation have produce effects. Many natural/herbal products health claims are based on thousands year old lore and not supported by science.

Regarding drug costs, as a clinical pharmacologist 30% of my job is finding ways to cut drug costs. It’s called MTM, medication therapy management. I review patient charts to weed out redundant therapy, unnecessarily expensive medications that can be switched to something cheaper, discontinuing non longer needed medications. For every $1 they pay me for MTM I save the hospital $3.

To be clear the capitation reimbursement system is usually also performed in the context of value based care- meaning we get paid more the less we have to treat you. So we’re not going to give you the cheapest drug if it’s not effective. It’s about striking a balance between the most effective treatment at the lowest cost, not simply the lowest cost. But if the choice is between a $2000 brand name drug and others that cost $20, $30 and $50 but there is no evidence the $2000 drug is more effective, you’re going to go through all the cheaper options first. If the evidence shows the best course of action is using a $40,000 drug versus a $1,000 drug, that happens too… because ultimately failed treatment requires more hospitalizations and in the end costs more.

In the context of chemotherapy, finding the right treatment is literally the difference between life and death. So cost is generally less of a concern as it is in less dire and time sensitive situations. That said, there are also back door deals where brand name drugs can be cheaper than generics, but I don’t want to go down that rabbit hole of drug pricing smoke and mirrors.

Every hospital has rough guidelines of how conditions are to be treated and cost is a big factor. You’re not going to start treatment for moderate IBS with a $12,000 drug when far less expensive drugs are likely to work just fine. In the outpatient setting insurance/PBM’s have tons of guardrails- that’s why prior authorizations exist and so called “step therapy” (requiring you to try the cheapest drugs first).

From a business perspective it would be foolish not to consider your expenses when you’re effectively given a flat rate reimbursement but if you fail to treat them the first time and their disease returns, you’ll get paid less.

 

[Richard8655]

https://www.reddit.com/r/QAnonCasualties/comments/rakxun

I take a number of supplements myself and my oncologist was familiar with all of them. I wouldn't take them if they didn't help. Though I'd have to say that running 20 miles a week helps a lot too.

I had a number of oddball things happen with chemo in terms of generics, brand names, and drug dispensing that have me doubting that doctors or hospitals try to save money on drugs.

This physician's experience report really hit home. It's horrific. I want to share it with my anti-vax conspiracy friends, but fear it will end any semblance of friendship. Perhaps so be it.

 

[BoxerGT2.5]

https://www.reddit.com/r/QAnonCasualties/comments/rakxun

I take a number of supplements myself and my oncologist was familiar with all of them. I wouldn't take them if they didn't help. Though I'd have to say that running 20 miles a week helps a lot too.

I had a number of oddball things happen with chemo in terms of generics, brand names, and drug dispensing that have me doubting that doctors or hospitals try to save money on drugs.

It has been a problem from the start, how political COVID is. This is true on both sides, the Q folks are the ones who are seeking off label treatments they saw online. If you want Ivermectin, get it from your general doctor if he/she will prescribe it to you. When you're hospitalized, your care is going to follow what is considered best practices. Which likely won't involve the thing you read online.

 

[BoxerGT2.5]

This physician's experience report really hit home. It's horrific. I want to share it with my anti-vax conspiracy friends, but fear it will end any semblance of friendship. Perhaps so be it.

Honest question, at this point who cares if they're refusing the vaccine. If they catch it and die, so be it. At this point I liken it to a smoker. You smoke and get lung cancer, you made your bed. God bless, I hope you enjoyed your one life. It doesn't affect me.

 

[metapunk2077fail]

American media is pretty terrible. They always downplay everything just to pump stonks. It's very greed and money driven.

US media is trying really hard this week to downplay Omicron. Europe and UK media are more cautious and there is breaking news of a second variant of Omicron which is very hard to detect.

It always seems the US prefers to clean up a mess after a tragedy rather than prevent one in the first place. This can be seen in many cases throughout the last 20-30 years, from domestic extremists to 9-11 and from school shootings to covid and from housing and dot com bubbles to the latest crypto and qanon scams. Always late action and no prevention.

 

[Mainsail]

Honest question, at this point who cares if they're refusing the vaccine. If they catch it and die, so be it. At this point I liken it to a smoker. You smoke and get lung cancer, you made your bed. God bless, I hope you enjoyed your one life. It doesn't affect me.

I understand what you are saying, and part of me agrees with you. But, COVID is somewhat different than smoking. While we can have laws that reduce the possibility of second hand smoke (e.g. no smoking in public places), COVID is a contagious disease that can infect others and there is really no way to prevent people from breathing in public. We can have mask mandates to try to reduce contagion, but anti-vaxers tend to resists and circumvent these requirements. Also, a rapidly spreading virus can mutate, putting even the vaccinated population at risk. While vaccination reduces the possibility of spread and the severity of the illness, no vaccine is 100% effective. In addition, the unvaccinated overcrowd hospitals and diverts resources. Although, I suppose smokers use a disproportionate share of health care resources as well, in most states, an insurer can charge as much as 50% more for a person who uses tobacco products. Perhaps, we should have a health care premium differential for the unvaccinated.

I think the big difference is that when you smoke (and observe restrictions in public), you basically put yourself at risk. When you spread a contagious disease, you put others at risk.

 

[44267547]

Honest question, at this point who cares if they're refusing the vaccine. If they catch it and die, so be it. At this point I liken it to a smoker. You smoke and get lung cancer, you made your bed. God bless, I hope you enjoyed your one life. It doesn't affect me.

Brutal, but true. What could possibly anyone say to somebody at this point who is still ‘unsure’ or doubtful, given you can’t even use your smart phone or leave your home without hearing about the vaccine through your employer, friends/family, marketing, etc. And we already know the unfortunate aftermath for those who have challenged the vaccine and where they end up. My thoughts are very similar to yours, there’s no convincing these stragglers or ‘my body, my choice’ crowd , and the consequences should follow, and be used as an example of what not to do.

I look at it like these ignorant-defiant people serve a purposeful example who choose to ignore the vaccine and seemingly don’t want to understand the consequences, but I have no sympathy in the slightest. We’re all adults, and we have to make decisions for our future, not just today.

 

[BoxerGT2.5]

I understand what you are saying, and part of me agrees with you. But, COVID is somewhat different than smoking. While we can have laws that reduce the possibility of second hand smoke (e.g. no smoking in public places), COVID is a contagious disease that can infect others and there is really no way to prevent people from breathing in public. We can have mask mandates to try to reduce contagion, but anti-vaxers tend to resists and circumvent these requirements. Also, a rapidly spreading virus can mutate, putting even the vaccinated population at risk. While vaccination reduces the possibility of spread and the severity of the illness, no vaccine is 100% effective. In addition, the unvaccinated overcrowd hospitals and diverts resources. Although, I suppose smokers use a disproportionate share of health care resources as well, in most states, an insurer can charge as much as 50% more for a person who uses tobacco products. Perhaps, we should have a health care premium differential for the unvaccinated.

I think the big difference is that when you smoke (and observe restrictions in public), you basically put yourself at risk. When you spread a contagious disease, you put others at risk.

Ok, but we know the vaccines don't prevent transmission. A vaccinated person can still give you COVID. So while your laying in bed sick as a dog or worse, will you find comfort knowing that you contracted it from a vaccinated person over an unvaccinated person?

Listen, I think they're nuts. But I'm at the point where I just want people to let people live their lives. I don't have to like or agree with someone's decision.

 

[A.Goldberg]

Honest question, at this point who cares if they're refusing the vaccine. If they catch it and die, so be it. At this point I liken it to a smoker. You smoke and get lung cancer, you made your bed. God bless, I hope you enjoyed your one life. It doesn't affect me.

Well, when you have significant portion of the population and another portion vaccinated, it becomes the ideal breeding ground for viruses to replicate, mutate, and for variants to pop up, potentially including those that are resistant to the existing immunity. That’s basically the situation in Africa. Ideally 1. everyone eligible for vaccination would cut the crappy and get their vaccination and 2. The global community would make a better effort to ensure underprivileged countries get the vaccines they need.

I am curious to know what percentage of country has immunity (natural via infection, vaccine acquired, or both). In June the WSJ claimed of the 55% totally unvaccinated at the time, about half have natural immunity- though I’m sure that’s a very rough estimate and I suspect the percentage varies significantly depending on where you are (ie cities vs rural areas). So our 70% vaccination rate may not fully represent actual immunity. That said, getting the vaccine on top of natural immunity presumably would be best.

It amazes me people are still “hesitant” (at this point resistant is technically more appropriate) to get the vaccine despite 7.8 BILLION doses now administered globally. I have yet to hear of people turning into pumpkins from it.

While I obviously think everyone eligible should be vaccinated, I’m afraid even the government even flirting with the idea of mandates makes the hesitant/resistant people even more so. There are definitely lessons to be learned on how to manage a pandemic so as not to create this insane polarity in society.

 

[Mainsail]

Ok, but we know the vaccines don't prevent transmission. A vaccinated person can still give you COVID. So while your laying in bed sick as a dog or worse, will you find comfort knowing that you contracted it from a vaccinated person over an unvaccinated person?

Listen, I think they're nuts. But I'm at the point where I just want people to let people live their lives. I don't have to like or agree with someone's decision.

However, you are much less likely to get COVID from a vaccinated person than an unvaccinated person primarily because a vaccinated person is much less likely to get infected in the first place.

People keep forgetting this fact because the CDC stepped all over their message about the effectiveness of vaccines in preventing transmission when they went back to mask mandates for the vaccinated. I am not so much criticizing the policy as the messaging when they did the about-face.

BTW - Your notion of treating the unvaccinated like smokers has some appeal to me. You can't smoke in a restaurant. You can't smoke on a plane. You can't smoke on the job if you are in a public building. You can be required to pay higher HC insurance premiums if you smoke. There is a strong argument for treating the unvaccinated the same as smokers. It's a choice that you are free to make, but that choice comes with limitations and restrictions.

 

[BoxerGT2.5]

However, you are much less likely to get COVID from a vaccinated person than an unvaccinated person primarily because a vaccinated person is much less likely to get infected in the first place.

People keep forgetting this fact because the CDC stepped all over their message about the effectiveness of vaccines in preventing transmission when they went back to mask mandates for the vaccinated. I am not so much criticizing the policy as the messaging when they did the about-face.

BTW - Your notion of treating the unvaccinated like smokers has some appeal to me. You can't smoke in a restaurant. You can't smoke on a plane. You can't smoke on the job if you are in a public building. You can be required to pay higher HC insurance premiums if you smoke. There is a strong argument for treating the unvaccinated the same as smokers. It's a choice that you are free to make, but that choice comes with limitations and restrictions.

Except the transmission rate isn't 0. British studies confirmed breakthrough cases have a similar peak viral load as unvaccinated people, it's just that it decreased faster in the vaccinated segment. Moreover, the efficacy of the vaccines decreases rapidly with time. At best what we can say is the vaccines are a therapeutic that prevents a person from developing serious complications/death more so than confirms an immunity.

I would say our federal government has made a number of mistakes over the span of the past two administrations that has caused those resistant to dig their heels in.

 

[BoxerGT2.5]

Well, when you have significant portion of the population and another portion vaccinated, it becomes the ideal breeding ground for viruses to replicate, mutate, and for variants to pop up, potentially including those that are resistant to the existing immunity. That’s basically the situation in Africa. Ideally 1. everyone eligible for vaccination would cut the crappy and get their vaccination and 2. The global community would make a better effort to ensure underprivileged countries get the vaccines they need.

I am curious to know what percentage of country has immunity (natural via infection, vaccine acquired, or both). In June the WSJ claimed of the 55% totally unvaccinated at the time, about half have natural immunity- though I’m sure that’s a very rough estimate and I suspect the percentage varies significantly depending on where you are (ie cities vs rural areas). So our 70% vaccination rate may not fully represent actual immunity. That said, getting the vaccine on top of natural immunity presumably would be best.

It amazes me people are still “hesitant” (at this point resistant is technically more appropriate) to get the vaccine despite 7.8 BILLION doses now administered globally. I have yet to hear of people turning into pumpkins from it.

While I obviously think everyone eligible should be vaccinated, I’m afraid even the government even flirting with the idea of mandates makes the hesitant/resistant people even more so. There are definitely lessons to be learned on how to manage a pandemic so as not to create this insane polarity in society.

We still don't know a thing about the virus because we still can't have a serious conversation about where it came from. People are trying to cover their own ass first and foremost.

As to your point about getting the vaccine in the hands of poor countries. These vaccines were developed with the use of public tax dollars, their formula's should be public. The vaccines should be considered a public good. The fact that profit or patent rights enter the conversation during a global pandemic is asinine. Does anyone have the guts to stand up to Pharma CEO's? It doesn't appear there is.

 

[Madhatter32]

I should also mention Merck’s new COVID-19 oral antiviral therapeutic drug was reviewed by the FDA’s Drug Advisory Committee and just squeaked by 13 approved, 10 opposed. Ultimately though the FDA decides to approve or deny, not the advisory committee.

Apparently despite Merck’s interim report stating their drug offered a 50% reduction in hospitalizations and death, apparently in the final analysis the number was actually 30%. While 30% is significant, the 70% failure rate opens a big door for promotion of mutation, which was also observed in studies. That of course is problematic and could easily lead to a strain that’s entirely resistant to Molnupiravir. It was also found to be highly teratogenic (toxic to fetuses) which is a problem. Therefore it’s also likely not going to be approved for children. Many other highly teratogenic drugs (ie accutane) are highly controlled with all sorts of measures, including things like pregnancy tests and mandatory birth control. It could make prescribing and dispensing difficult if similar precautions are taken.

In the case of a lot of viruses (ie HIV), using a single antiviral even in the best cases is bound for eventual failure and resistant mutation for one of a number of reasons. That’s why most HIV regimens are at least 2 or 3 drugs in combination. The chance of resistance formation is greatly reduced (though HIV mutates far faster than SARS-CoV-2.

Pfizers upcoming COVID-19 antiviral allegedly has 90%+ efficacy. Not sure if that will turn out to be the case in the real world (such studies tend to be designed to optimize positive outcomes and minimize negative ones), but it does use two antivirals which will potentially lead to less risk of treatment failure and viral mutation and resistance. It does contain rotonivir which interacts with almost every other drug under the sun which is a problem, but that can usually be managed. Especially considering the short course of treatment.

Both drugs are seeking EUAs and not studies have been published so we’ll see what happens.

Eli Lilly's therapy appears to be better than Merck's. It uses bamlanivimab in combination with etesevimab and it already has FDA EUA -- even recently for kids. It appears to reduce the risk of COVID-19 up to 80% in certain groups. It's one drawback is in it's administration -- IV versus a pill.

FDA authorizes bamlanivimab and etesevimab for COVID-19

Post-exposure prophylaxis with bamlanivimab and etesevimab, administered together, is not a substitute for vaccination against COVID-19

www.fda.gov

 

[A.Goldberg]

Eli Lilly's therapy appears to be better than Merck's. It uses bamlanivimab in combination with etesevimab and it already has FDA EUA -- even recently for kids. It appears to reduce the risk of COVID-19 up to 80% in certain groups. It's one drawback is in it's administration -- IV versus a pill.

FDA authorizes bamlanivimab and etesevimab for COVID-19

Post-exposure prophylaxis with bamlanivimab and etesevimab, administered together, is not a substitute for vaccination against COVID-19

www.fda.gov

The new Merck and Pfizer antivirals currently under EUA review are not comparable to bamlanivimab/etesevimab, which are monoclonal antibodies. They’re two entirely different types of drugs… and can be used in combination.

Monoclonal antibodies function a lot like natural antibodies, they target specific proteins on the virus (in this case, parts of the viral spike protein) and adhere themselves to physically inhibit the virus from being able to infect the host.

The antivirals on the other hand are for treatment of the infection itself- both outside and inside of the hospital, including severe cases. These work in various specific ways, but ultimately they all inhibit the replication of the virus by interfering with the genetic code being copied.

B/E, like other monoclonal antibodies, can be used to treat mild-moderate infections and like the others, is prohibited for use in hospitalized COVID patients and those requiring oxygen.

B/E is also authorized for post-exposure prophylaxis in very select populations. It is administered to high-risk individuals who may have been exposed to the virus or those in an environment where it could be acquired (ie living in a nursing home). To be eligible for prophylaxis, one must either not fully vaccinated or fully vaccinated but suffering a condition that would impede the immune response (ie immune improvised people). It’s use is restricted in areas with certain viral variants prevalence. above a certain threshold.

Antivirals can be used in any severity of COVID-19, while that’s not the case with mAb’s. These two drug types can also be used in combination to fight the infection using two different mechanisms of action.

It’s not uncommon to have people get infected, put off medical treatment as their condition deteriorates, and then come to hospital in a state where it’s too late to use mAb’s. But if we have antivirals we can still provide a targeted treatment.

Another consideration is that mAb’s require infusions, which is impractical. It usually takes 30-60 minutes and ideally requires monitoring for adverse effects for another hour. REGEN-CoV mAb’s have the option of administering 4 subcutaneous injections instead, but this is not the preferred way. To give infusions you really need a hospital setting or have special clinics setup. Then you need nurses to setup and administer the infusions. This is the big reason why mAb’s have been so underutilized.

COVID antivirals, if they can successfully get authorization, have the benefit of being tablets that could easily be picked up at a pharmacy and self administered like any other prescription oral medication. And taking a tablet is far less uncomfortable then having a needle stuck in your vein for an hour and then having to wait another hour for monitoring for anaphylaxis.

Having multiple drug types to treat COVID in a target manner however will likely lead to even better outcomes.

 

[eatrains]

Except the transmission rate isn't 0. British studies confirmed breakthrough cases have a similar peak viral load as unvaccinated people, it's just that it decreased faster in the vaccinated segment. Moreover, the efficacy of the vaccines decreases rapidly with time. At best what we can say is the vaccines are a therapeutic that prevents a person from developing serious complications/death more so than confirms an immunity.

I would say our federal government has made a number of mistakes over the span of the past two administrations that has caused those resistant to dig their heels in.

Nothing is zero. But vaccines reduce the chance of infection, of transmission, and of serious illness, hospitalization, and death. Just like masks and distancing reduce risk. And reducing risk ultimately reduces the burden on hospitals and staff, keeping them sane and available to treat normal needs.

And "the efficacy decreases rapidly with time" is dangerously vague. The ability to wholesale prevent infection wanes, but the prevention of severity and death largely does not.

 

[400]

Uk govpresser expecting some rather worrying increases, doubling cases every few days with the new strain.

 

[dannyyankou]

It seems like Delta may be starting to peak in parts of upstate New York. Daily hospitalizations are starting to decline in Finger Lakes and Western New York regions.

 

[dannyyankou]

Uk govpresser expecting some rather worrying increases, doubling cases every few days with the new strain.

If it's true that it's a milder virus more akin to the common cold, the faster the spread the better. If it stomps out Delta, that could save lives.

 

[400]

If it's true that it's a milder virus more akin to the common cold, the faster the spread the better. If it stomps out Delta, that could save lives.

Problem for me seeing it as just a cold is I read that they picked up on this due to a spike in people presenting at hospital. Perhaps more time required to see the long game wit this one but if this rips through the un protected (and protected where it will happen) then hospitals are hammered again. ITU's are hard pressed again and they have not had much time off. UK already has long waits at A+E. Some area's double digit ambulances cannot unload patients.

 

[44267547]

At this point, there is a need of mutual aid from FEMA with the staff shortages with hospitals in Detroit. It’s not a good situation and it’s only going to become more problematic with the holidays. What I don’t understand, is that the governor is aware of of the current situation and has had ample time to prepare for this, given nothing is progressing at this point.

Secondly, I’m really bewildered at the amount of people who don’t understand the booster and what it is supposed to do. The people I’ve talked to, are under the illusion that it’s a ‘full dose’, and that they don’t need it. That’s because they’re uneducated, and they don’t want the booster, because their employer will ‘not require it’, as long as their other two vaccinations are completed. Back to the point, I think we need more education on the booster, [not just from a media standpoint], but employers should be encouraging and providing literature on what the booster does, and even if it’s not required, at least provoke the thought.

 

[poorcody]

Secondly, I’m really bewildered at the amount of people who don’t understand the booster and what it is supposed to do. The people I’ve talked to, are under the illusion that it’s a ‘full dose’, and that they don’t need it. That’s because they’re uneducated, and they don’t want the booster, because their employer will ‘not require it’, as long as their other two vaccinations are completed. Back to the point, I think we need more education on the booster, [not just from a media standpoint], but employers should be encouraging and providing literature on what the booster does, and even if it’s not required, at least provoke the thought.

Totally agree with you on this. Unfortunately it goes back to September when boosters were first seen as not necessary since hospitalization and death hadn't waned like infection. Since then we have seen vaccinated hospitalizations go up (20-30% in most states now) -- showing that waning immunity is only increasing. I think it was encouraging yesterday that Fauci said the definition of full vaccination will change to 3-doses "is inevitable".

Only about a quarter of the US population is boosted at this point: which to me means only a quarter of population is fully vaccinated.

 

[BoxerGT2.5]

Nothing is zero. But vaccines reduce the chance of infection, of transmission, and of serious illness, hospitalization, and death. Just like masks and distancing reduce risk. And reducing risk ultimately reduces the burden on hospitals and staff, keeping them sane and available to treat normal needs.

And "the efficacy decreases rapidly with time" is dangerously vague. The ability to wholesale prevent infection wanes, but the prevention of severity and death largely does not.

Less than 6 mos is "dangerously vague"?

Among persons 60 years of age or older, the rate of infection in the July 11–31 period was higher among persons who became fully vaccinated in January 2021 (when they were first eligible) than among those fully vaccinated 2 months later, in March

 

[dannyyankou]

Data from New York. Science is amazing-

 

[iOS Geek]

Totally agree with you on this. Unfortunately it goes back to September when boosters were first seen as not necessary since hospitalization and death hadn't waned like infection. Since then we have seen vaccinated hospitalizations go up (20-30% in most states now) -- showing that waning immunity is only increasing. I think it was encouraging yesterday that Fauci said the definition of full vaccination will change to 3-doses "is inevitable".

Only about a quarter of the US population is boosted at this point: which to me means only a quarter of population is fully vaccinated.

The thing to consider though, is that to the average person who reacts instead of reading into the data explaining WHY the change is happening (which lets be honest, is probably a shockingly large percentage of people), as the definition of "fully vaccinated" changes...I think we're going to see less and less uptake. Take the booster for example. Uptake is not impressive. At all. Even in areas with high vaccination rates. And that's just with 3. If it ends up going to 4 (which I've heard mumblings of, but at the moment I'd say nothing credible), I think it'll be even less. And then there's me. I'm two weeks after my third, and I STILL don't feel quite right. My reaction to each dose has been far worse than the one before it. Based on that, I think the third is going to be my last.

Now off the topic of vaccinations, Marin County, California is going to be an area to keep an eye on. If I read correctly, they are no longer using case rates to drive their response (and this includes NOT reinstating their mask mandate even though cases are rising). They are instead shifting to hospitalization rates, and I believe the threshold they are using is 13 per 100,000. If it works for them, I wouldn't be surprised to see this method spread, especially in areas with higher vaccination rates.