[Pestilence] https://youhavetoliveyour.life/

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Nocturtle: Mar 17, 2007

My kids are starting school again tomorrow and it seems worth checking on official guidance regarding the role of masks for in-person education:
CDC: Updated May 11, 2023

quote:

...
Masking
Wearing a well-fitting mask or respirator consistently and correctly reduces the risk of spreading the virus that causes COVID-19. At a high COVID-19 hospital admission level, universal indoor masking in schools and ECE programs is recommended, as it is in the community at-large.
...
Anyone who chooses to wear a mask or respirator should be supported in their decision to do so at any COVID-19 hospital admission level, including low. At a medium and high COVID-19 hospital admission level, people who are immunocompromised or at risk for getting very sick with COVID-19 should wear a mask or respirator that provides greater protection. Since wearing masks or respirators can prevent spread of COVID-19, people who have a household or social contact with someone at risk for getting very sick with COVID-19 (for example, a student with a sibling who is at risk) may also choose to wear a mask at any COVID-19 hospital admission level. Schools and ECE programs should consider flexible, non-punitive policies and practices to support individuals who choose to wear masks regardless of the COVID-19 hospital admission level.
...

NYC schools health guidance: seems to be current advice

quote:

Consider wearing a mask, especially in a crowded indoor setting particularly if your child has a medical condition that puts them at risk for severe COVID-19, or if they are around others who are at increased risk for COVID-19, such as grandparents or other older adults.

American Academy of Pediatrics: no update for 2023-2024 school year
NYS public health: defers to CDC guidance
NYC public health: no update for 2023-2024 school year

A number of public-health focused organizations haven't updated guidance for the current school year. At least semi-current CDC guidance clearly recommends that student mask usage should be supported, and NYC public school health guidance doesn't contradict it.

We'll continue to send our kids to school in masks although I am ambivalent about it. Why send kids into an environment where masks might be required? If air is potentially hazardous enough to require permanent masks it's too hazardous for children. The reality is we don't have a choice. We can't afford to have a parent quit their job and try to homeschool while waiting for clearer reinfection research or improved vaccines/treatments to become available.

Pingui posted:

Interesting development and good news for Nocturtle and anyone else in NY.

That is interesting, thanks for pointing it out. My kids' public NYC school at least was fairly good at providing masks if requested all through last year and teachers would often mask at the door etc.

# ¿ Sep 7, 2023 02:26

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# ¿ May 11, 2024 10:21

Nocturtle: Mar 17, 2007

Zugzwang posted:

Is there any reasonable argument at all why everyone can get flu boosters yearly but the covid booster might get gatekept?

Offit has made that argument at several FDA VRPAC meetings and is probably the closest to a valid reason. Paraphrasing, it's that there's no evidence that COVID boosters are likely to reduce community severe disease rates due to contemporary variants while there's a lot of evidence that flu shots do.

One part of their explanation is that the flu shot reduces severe disease by protecting the most vulnerable because it both protects against severe disease and also crucially reduces transmission probability. The latter will reduce community spread and help protect high-risk people for whom boosters are less effective. In contrast contemporary COVID variants are both so contagious and have so thoroughly evaded vaccine induced immunity that boosters likely don't significantly reduce transmission probability and so won't reduce community spread. The most vulnerable people in society are likely at equal risk of infection whether everyone gets the booster or not. They're essentially saying COVID evolved around vaccine-induced infection protection and everyone already has hybrid immunity so additional boosters don't provide additional public health benefit. It's similar to arguments that COVID boosters are not cost effective in healthy populations, which is likely true in terms of costs due to acute disease burden.

The other part of the explanation is that in healthy people there's little evidence that COVID boosters reduce community severe disease rates as most healthy people already have hybrid (T-cell!) immunity. In comparison there's a lot of evidence that properly selected flu shots do reduce severe disease rates even in healthy people because often the contemporary flu strain will be somewhat novel to at least a portion of the public. This is what Offit means when they say a "a miss is a mile" in flu shot strain selection.

To be clear I don't agree with these arguments but IMO this is the pro-gatekeeping rationale.

The Oldest Man posted:

The real question you should be asking is how long will it be before flu shots are gatekept like in the UK

Now you've jinxed it. THANKS.

# ¿ Sep 11, 2023 20:18

Nocturtle: Mar 17, 2007

Today's ACIP meeting is in progress and the presentation slides have been uploaded here. There is a lot of information, looks like it will be a long meeting. Especially interesting are the "Economic Analysis of Vaccination" and "Evidence to Recommendations Framework" presentations. One interesting result from the economic analysis finds that COVID boosters in the 65+ age range likely save society money overall, while in the 18-49 year age range the estimated tradeoff is $115,588 per QALY. I think that's worth it! Overall it appears likely everyone in the US >6 months will be eligible for the updated shots.

Nocturtle has issued a correction as of 16:57 on Sep 12, 2023

# ¿ Sep 12, 2023 16:48

Nocturtle: Mar 17, 2007

lol just noticed that the economic analysis presented at ACIP evaluating the benefit of boosters in terms of cost per QALY is assuming the boosters cost the private market price-gouging $120 amount instead of the previous $30 / dose. So the tradeoff for another round of boosters in the 18-49 year old age range should be something more like $28750 / QALY. That would be a bargain for society but less profit for pharma so instead the price per dose was set high enough that the cost-effectiveness is questionable.

# ¿ Sep 12, 2023 17:07

Nocturtle: Mar 17, 2007

Recently finished reading "The Viral Underclass: The Human Toll When Inequality and Disease Collide". It examines from an America-centric view how lower classes in contemporary capitalist society are disproportionately impacted by infectious disease epidemics and public health burdens generally. A central point is that individuals in the "viral underclass" are made vulnerable to disease and other health risks by society but critically are blamed for their own precariousness and diminished health. The book is organized so that each chapter discusses a factor perpetuating the viral underclass such as capitalism, ableism, the US prison system etc. It also follows in particular the story of Michael Johnson, a member of the poor black gay viral underclass, and their highly publicized criminal prosecution for transmitting HIV.

Overall the book is fairly fine. There's a lot of good information, but nothing very novel or controversial. It's a little unfocused and preachy in places, but not too much. It's worth reading as a recap of the intersection of class and public health, though not essential. IMO reading Necropolis is more relevant towards understanding the trajectory of the COVID pandemic + how and why the profit motive will always trump public health, despite it describing a society 150-200 years in the past.

# ¿ Sep 14, 2023 04:34

Nocturtle: Mar 17, 2007

toggle posted:

if someone goes to work ill with covid, infects a coworker and that person is either maimed or dies, is the infector a bio terrorist?

It is misguided to blame the last individual in a long chain of infections for the consequences of a disease that has been designated normal by political authorities. There is a whole slew of public health failures behind every infection and that gets obscured when you focus the blame on individuals.

For comparison would you label someone that transmits HIV a bio-terrorist or criminal and prosecute them accordingly? That makes sense if your goal is to punish people, but it's a terrible idea when trying to reduce the spread of HIV. Practically it would provide a huge disincentive for anyone to ever get tested. It would also disproportionately impact society's underclass as they're made more vulnerable to disease generally. It's the same for all infectious disease.

That said going to work or a public place while sick when you didn't have to and getting other people sick makes you a jerk and the large majority of people are clear on this. But even then workers are usually expected to show up to work even if they're sick, the individual sick people aren't the problem.

# ¿ Sep 23, 2023 14:27

Nocturtle: Mar 17, 2007

Maed posted:

if they knew about having hiv and did it on purpose, yes

Reactionary conservatives agree with you and happily pass laws criminalizing transmission while defunding health services. People that actually want to mitigate community spread of infectious disease oppose such laws because they are counter productive. They make the problem worse.

# ¿ Sep 23, 2023 15:06

Nocturtle: Mar 17, 2007

For reference even the CDC considers criminalizing HIV transmission to be ineffective, unscientific and outdated:

quote:

HIV Criminalization and Ending the HIV Epidemic in the U.S.
Print
Updated January 19, 2023

Ending the HIV Epidemic in the U.S. requires addressing structural barriers to HIV prevention and care. Current scientific and medical evidence should inform state laws and practices that criminalize actions taken by people with HIV. States should consider updating or repealing outdated laws and practices.

After more than 40 years of HIV research and significant biomedical advancements to treat and prevent HIV, most HIV criminalization laws do not reflect current scientific and medical evidence.

Many of these laws were passed at a time when very little was known about HIV, including how HIV was transmitted and should be treated.
These laws have not increased disclosure and may discourage HIV testing, increase stigma against people with HIV, and exacerbate disparities.
...

Public health organizations are very clear in their opposition to these laws, just one example out of many from the American Academy of HIV Medicine:

quote:

The American Academy of HIV Medicine (AAHIVM) and its members are opposed to laws that distinguish HIV disease from other comparable diseases or that create disproportionate penalties for disclosure, exposure or transmission of HIV disease beyond normal public health ordinances. We support non-punitive prevention approaches to HIV centered on current scientific understanding and evidence-based research.

The opinions of people concerned with solving public health problems oppose criminalizing infectious disease transmission. It's a social systemic problem, not a criminal matter. They also don't work and in practice are used as a bludgeon against members of social underclasses that are made most vulnerable by society to the diseases in the first place. There's no valid reason to support criminalizing or labeling transmission "terrorism" or whatever aside from the desire to punish. That's the real reason conservatives love these types of laws.

Insanite posted:

wasn't part of the open biden rush about beating OSHA to issuing some sort of covid guidance that might've opened employers up to liability?

i might be half-remembering it, but i recall that being the word at the time.

You are absolutely correct and IMO it was one of the key events in the American COVID response. IIRC there were even some leaked draft OSHA guidelines that labeled COVID an "airborne workplace hazard" but I can't find them. Does anyone else recall this?

# ¿ Sep 23, 2023 15:56

Nocturtle: Mar 17, 2007

Strep Vote posted:

Did I say criminalize? Yes you are a bioterrorist and you will not be punished. That's what this comes down to. Yes, it is immoral and a sin to knowingly spread disease, and you are also free to kill as many people as you like in this society as long as they are peons and you have plausible deniability.

Labeling someone a terrorist will be read as implying criminality in the western context. I disagree with framing a massively systemic social problem in terms of individual morality but obviously sick people shouldn't go around knowingly putting others at risk of infection. This isn't controversial and the large majority of Americans also agree when asked (from a May 2023 Ipsos poll):

Of course what the public prefers doesn't translate into govt policies supporting sick people being able to stay home and quarantine or get health care reducing the chances of infection and transmission in the first place. This gets back to the futility of discussing chains of infection in terms of moral culpability when the core problem is public health being subordinated to capitalism.

# ¿ Sep 23, 2023 18:22

Nocturtle: Mar 17, 2007

My kids were able to get Moderna COVID boosters recently, including my under 5 year old. Pediatric booster availability has apparently been improving, at least in the NYC area. We went to the CVS minute clinic but Walgreens purported to have open slots for kids too.

Not happy about the current pandemic situation but am grateful that at least my family could get the updated vaccines, even if they are already somewhat out-of-date. It's terrible that the boosters aren't an option for most people internationally.

# ¿ Oct 18, 2023 03:28

Nocturtle: Mar 17, 2007

Strep Vote posted:

https://wellbefore.com/products/3d-kf94-style-kn95-pro-mask-with-adjustable-ear-loops

Trip report: with head straps, it fits like an aura but is more breathable, and fits my spouse's tall mug with a huge lower pocket under the chin. Awesome, comes in a very handsome denim as well as black, for those who are looking for an aura that doesn't stand out.

This was a good recommendation, thanks. Definitely lower profile than the Aura which can be useful going into the fifth year of the pandemic.

# ¿ Oct 22, 2023 01:11

Nocturtle: Mar 17, 2007

One thing I noticed while spending a lot of time in a US hospital ICU recently were all the informational displays constantly emphasizing that a full fit-test was required in order for an employee to wear an N95. I'm sure a number of healthcare workers don't think masks in healthcare settings are necessary at this point (in part because that's effectively what public health authorities say) but I get the feeling that even workers who'd like to wear N95s have to run an administrative or bureaucratic gauntlet to be allowed to do so. Doesn't seem ideal.

# ¿ Oct 23, 2023 18:16

Nocturtle: Mar 17, 2007

There's been a type of news reporting accompanying this fall's vaccine rollout in the US that describes all the problems caused by the American private insurance model but can't seriously discuss fixes, instead only offering suggestions for how individuals can try to navigate the private insurance Rube Goldberg machine to get their shots. STAT's Helen Branswell recently posted just such an article, though they do a good job summarizing all the problems with current vaccine distribution in the US. A few key points:

quote:

�We�re absolutely making it too hard�: The complexity of adult immunization delivery hinders vaccine uptake
By Helen Branswell Oct. 25, 2023

Alison Buttenheim was floored by a sign she saw in her doctor�s office when she went to get the first jab of the two-dose shingles vaccine to protect her against painful flare-ups of varicella zoster.

�Medicare patients cannot receive Tdap or zoster vaccines here. They need to obtain [them] at their pharmacy. If they receive it here, they need to pay out of pocket,� the notice read.
...
Then there are issues around payment.

The payment piece should be simple because U.S. health insurers are required to pay for vaccines that have been recommended by the Advisory Committee on Immunization Practices, which guides the CDC on vaccine use. The vaccines we�re talking about here have all been recommended by the ACIP. But when a vaccine is newly added to the recommended list, insurers have up to a year to start to cover the cost. Some take their time, as a number of people who tried to get an RSV shot this fall found out to their dismay.

Even insurers that add a new vaccine quickly may have restrictions on where the people they cover can get immunized. Limaye�s insurance pays for her vaccines if she gets them at a Hopkins pharmacy or at a Walgreens. If she books an appointment at a CVS, however, she�d end up having to pay for her shot.

There�s a simple fix for this, Omer said. The Vaccines.gov website that people can search to find appointments for Covid or flu shots could be programmed to ask users for health insurance details, and incorporate that information into the search results they are shown. Even better would be if the site linked individuals to their vaccine records to help remind them of the immunizations they are missing. �That would be the version 4.0,� he said. �There seems to be some limitation of our imagination, even within the existing resources. It�s not easy, but it�s not nearly impossible.�
...
�Honestly, if we really care about the health of the American people, all pharmacies should be able to offer all adult vaccines. Bottom line,� she said, adding there should be no in-network/out-of-network deals between insurers and pharmacy chains.
...
Even if the issues around insurance reimbursement could be clarified, that wouldn�t solve the problem of under-vaccinated adults, however. That�s because a big chunk of American adults, an estimated 25 million, are not covered by private insurance, Medicaid, or Medicare.
...

The article does include a quote from the public health Dean suggesting a band-aid fix that private insurers shouldn't be allowed to place network restrictions on vaccine administration, similar to US Federal law regarding emergency care. However the larger picture painted by the article is American public health being failed by private insurance providers in even fairly simple preventative care, yet very little discussion about adapting the private insurance model or presenting realistic proposals to do so. Instead you get experts suggesting that maybe making the vaccines.gov website better could help increase vaccine uptake, which is just so futile. Most charitably the ACA experience destroyed all interest in US healthcare reform for the foreseeable future, though this type of reporting might also be an example of how modern western media can't seriously discuss reforming problems caused by the capitalist system manufacturing consent-style.

STAT also semi-recently posted a good article pointing out that people should in fact get the updated vaccine protecting against the infectious disease causing the largest number of hospitalizations and deaths. It's a little silly that this kind of article needs to be written at all but the recent estimate that only ~3% of Americans have received the booster shows there's a need. One key quote summarizing an analysis presented to the CDC ACIP of the projected benefit of the updated shot in the American population:

quote:

https://www.statnews.com/2023/10/13/updated-covid-vaccine-for-everyone/
Yes, everyone should get an updated Covid-19 vaccine
By Jennifer Beam DowdOct. 13, 2023
...
But cost-benefit scenarios presented to ACIP showed that universal vaccination was worth the cost under most scenarios. Compared with only vaccinating those older than 65, universal vaccine recommendations were projected to prevent about 200,000 more hospitalizations and 15,000 more deaths over the next two years. These modeling exercises don�t even typically account for things like potential long Covid and lost productivity of parents staying home with sick kids. So, if anything the collective benefits are likely underestimated.
...

Preventing ~15000 deaths and hundreds of thousands of hospitalizations seems a worthwhile goal in and of itself, even leaving aside that the updated shots likely have an overall positive cost-benefit.

# ¿ Oct 26, 2023 16:22

Nocturtle: Mar 17, 2007

NYC wastewater data updated today and fortunately it appears community spread is trending down after a relatively small Aug-Sept wave:

The NYC variant breakdown suggests the recent wave was driven by some combo of EG.5, FL.1 and HV.1 (don't take this variant contribution plot too seriously):

Can't really compare absolute concentrations over widely-separated time periods but it does suggest the current situation is better than last fall.

Less happy despite COVID cases and mortality being down it is still much more lethal than the flu this season:

Tzen posted:

got my kids vaxxed up with moderna today. with the updated juice, how have kids reactions been? they've been normal now but who knows what tomorrow will bring.

My kids got the updated Moderna and flu shots at the same time recently and they had no reactions beyond a slightly sore arm. Not even a day of relative quiet or lower energy.

Nocturtle has issued a correction as of 04:39 on Nov 11, 2023

# ¿ Nov 11, 2023 04:36

Nocturtle: Mar 17, 2007

Pingui posted:

No one could have etc. etc. (unfortunately the graphics are hosed up, so I'll just note what the highlighted line is above each graphic)

Archived link: https://archive.li/lcqEK

From a little bit back but IMO the US Bureau of Labor Statistics CPS data on disability is probably the best way to understand the real-world pandemic chronic health impact on the public over time and it's been interesting to see it get more media attention and analysis such as this NY Times article. Looking at the data it's hard to escape the conclusion that the pandemic has caused ~1% of the working age population to develop significant cognitive problems so far, and it appears most reasonable analyses arrive at this conclusion. The increase in disability rate with time doesn't appear to be slowing either, which is not a comfortable observation. It shouldn't be too surprising though as a lot of PASC-specific medical studies looking at verified infections suggested something roughly like 5-10% weird long-term symptoms, with ~1-2% badly impacted. More general population-level data seems to be showing something similar over time. Where this goes longer-term isn't clear, but it would be nice to see the observed trend at least slow down.

edit: worth emphasizing this is roughly 1% of the working age public reporting just cognitive disability attributable to the pandemic and doesn't directly include significant cardiovascular or immunological post-infection issues. So the proportion of working age people "badly" impacted by the pandemic is firmly above 1%.

UnfortunateSexFart posted:

Surgery update, I'm being transferred to a private hospital because apparently the alternative was to send me home after I got bumped for the transplant recipient. Pretty shocking and disappointing.

I have a very complex immigration and private health insurance situation and literally no one can give me a 100% sure answer on private surgery costs, or even the same answer as anyone else. I suspect I won't find out until a bill shows up after.

Canada where I'm from (or at least BC) doesn't even really have private options as far as I know, so this insurance poo poo is all new to me and the exact opposite thing someone recovering from a heart attack should be dealing with.

So glad I have the "freedom to choose" as American politicians like to say.

Still no firm date for surgery. But apparently it's locked in at the new place once I get it.

Very sorry to read about your recent health issues and insurance shenanigans. Also moved from Canada to a non-UHC country (America) and it's definitely jarring having to suddenly navigate private health insurance. The health insurance model of "when you get sick just go to whatever hospital for treatment" is very good IMO but apparently not available in much of the world.

Nocturtle has issued a correction as of 20:19 on Nov 24, 2023

# ¿ Nov 24, 2023 17:18

Nocturtle: Mar 17, 2007

Regarding the potential of COVID to induce or accelerate cancer, IMO Al-Aly's study on postacute impacts at two years is relevant. In this study they use the US VA medical records database to demonstrate measurably higher rates for a wide range of medical conditions at two years after COVID infection compared to controls, but significantly not cancers. It's possible they weren't specifically considering cancer in their study, but given the number of other conditions included that would be a strange choice. They don't really specify in the article but you'd think they'd check. Al-Aly's results should be taken seriously as evidence of COVID's potential to induce cardiovascular and neurological disease + other long term impacts but in the same way might also suggest cancer is less of a concern. Not claiming it's the last word and two years might not be enough time for these kinds of impacts to become apparent.

# ¿ Nov 27, 2023 15:53

Nocturtle: Mar 17, 2007

Hilda Bastian put together another excellent update on next-generation vaccine development on their blog. These are always worth reading to get a sense for whether improved vaccine protection might eventually become available and the associated timeline. The main news this update is that three US Project Nextgen candidates will enter phase 2B trials in 2024, two of which are intranasal vaccines. From the update:

quote:

https://absolutelymaybe.plos.org/20...-vax-update-12/
Advancing Past Early Trials � Plus Shooting for Lifelong Immunity (Next Generation Covid Vax Update 12)
...
The 3 vaccines from the USA chosen for Project NextGen are:

Gritstone Bio�s self-amplifying mRNA vaccine aiming to be �variant-proof�;
Covi-Vac/CoviLiv: A live virus intranasal vaccine from Codagenix; and
Castlevax viral vector intranasal vaccine, from a Mount Sinai Hospital spin-off.
...

The "Gritstone" vaccine is interesting because it allegedly leads to a more durable immune response. However the claims of it being "variant-proof" appear flimsy, also from the update:

quote:

...
The numbers are too small to assess efficacy, especially against moderate or severe Covid. However, for 2 of the trials they report that mild Covid was common. In the UK trial, when Omicron emerged, 8 of the 17 participants got mild Covid. In the US trial, 23 of 48 people got mild Covid. No one became so ill that they needed hospitalization. The rate for the third trial wasn�t reported.
...

None of the vaccines proceeding to phase 2b seem designed to address the fact that the SAR-COV-2 virus continues to evolve around immunity much much faster than vaccines can be updated. It is not even clear whether mucosal vaccines provide any significant additional protection against infectin without addressing this more fundamental issue, and there are already some clinical trials suggesting they don't (see the Pneucolin trial result). As a result it doesn't seem a given that any of these candidates will be able to demonstrate superiority over existing vaccine options. In the event that one of these vaccines work out it appears the relevant timescale to become available to the public would be at least 3+ years away, given they need to progress through the phase 2B trial, subsequent phase 3 trial, then the approval + distribution process. Presumably double that for when next-generation pediatric vaccines might become available, but fortunately children do not get COVID.

The so-called "pancoronavirus" vaccines that might address COVID's rapid evolution are much more theoretical at this point and apparently all still only at the phase 1 stages. Probably not worth paying attention to at present.

# ¿ Dec 1, 2023 16:23

Nocturtle: Mar 17, 2007

The Oldest Man posted:

I found the "children can't spread it" cope extra funny since all three of the earliest confirmed outbreaks in Washington state, which I think confirmed outbreaks before anywhere else did thanks to the Seattle Flu Project, were in schools.

TBH I prefer the current "COVID is over deal with it" consensus to the early pandemic double-think with people seriously arguing that kids don't get or spread COVID and that 3ft spacing in classrooms was sufficient to stop an airborne virus etc etc. It's more honest now, no-one cares if some kids get unlucky and are badly impacted by the virus and that's that.
edit: I mean lots of people care obviously but this doesn't translate into policy

Nocturtle has issued a correction as of 22:04 on Dec 22, 2023

# ¿ Dec 22, 2023 22:00

Nocturtle: Mar 17, 2007

Silent Linguist posted:

How are those of you with young kids coping with all this? I�ve been getting more and more worried and depressed thinking about my 3-year-old at daycare. There�s no way to get him to wear a mask all day, especially since no one else is. He�s been in daycare for over 2 years now and fortunately has so far avoided the insane infections that some kids have gotten (in fact he was barely sick this past year). But I feel like that could change in an instant. Just feeling kind of hopeless and almost regretting having a kid.

We still take COVID about as seriously as anyone with young kids attending in-person schools, including sending them to school in masks, keeping them up to date on their shots, wearing masks in indoor public places generally etc. It's not lost on me that all these precautions likely aren't any more effective than taking no precautions at all, for example the kids can wear masks to school but need to take them off in the crowded cafeteria to eat. We can only do the best we can. Fortunately we're all still healthy and the whole situation has helped motivate a renewed focus on staying healthy that has been very positive.

The clock is definitely ticking on wearing masks in school though. Probably at most another year or so before the kids decide to stop wearing them or the schools stop indulging the practice entirely.

As to your larger point, I don't regret having our kids who are great but certainly am not happy about the world we're making for young people.

# ¿ Mar 7, 2024 23:44

Nocturtle: Mar 17, 2007

That FRED data is apparentl just normalizing the BLS CPS self-attested disability rates. The absolute numbers even looking at the total (not just employed) working-age population show the same hockey-stick graph shape starting around early-2021:

Essentially ~1.5 million additional working age people self-reporting significant disability, about ~0.5-0.75% of the total working age population. Working age women in the labor force with disability alone increased by roughly ~1 million.

I check this dataset every once in a while to see any sign of a plateau instead of a steadily increasing rate, nothing obvious yet. That excess retirement data is new and unwelcome though.

# ¿ Mar 9, 2024 23:28

Nocturtle: Mar 17, 2007

Andre Picard is one of the main health issues reporter for the Globe and Mail, Canada's equivalent to the New York Times. Given he's Canadian he's ultimately small potatoes and his views are not important ( :canada:

), but it's as if a top New York Times columnist published an article questioning whether we need to worry so much about cancer. Typing that sentence out I realize that may have already happened.

It is wild to see the same type of media consent manufacturing processes used to minimize the impacts of high inflation or arguing that it's the immigrants causing Canada's high housing prices (another current local "issue") being used to question the utility of cancer screening and treatments. At least the CDC director isn't outright declaring that we need to learn to live with rising cancer rates.

The Oldest Man posted:

also you don't necessarily need to have an actual conspiracy for this when you can instead build an entire grant and trust system that can be selectively deployed toward think tanks and academics who will reliably come to the right conclusion about whatever topic on their own, that's the american way

Yes exactly. One of the key strengths in the model of the media consent manufacturing system is that no-one needs to be in control, but instead pro-capitalist views naturally get amplified and reinforce each other through consolidated for-profit media organizations. Maybe some politically and economically powerful individuals/group are aware of what they're doing and purposefully try to shape public opinion, but everyone in charge could be completely clueless and disorganized and the general opinions that get widely distributed would be largely the same.

# ¿ Mar 28, 2024 16:27

Nocturtle: Mar 17, 2007

Mola Yam posted:

ehhh people are really flexible on their "unshakeable" beliefs when material conditions change

this works both ways - like how 70%+ of australians (towards the end of our lockdowns) said that we shouldn't go back to normal if it meant 5,000 people would die over the next year. then we went back to normal and 15,000-20,000 died in the next year, and no one really gave a poo poo.

Glad other people still remember that survey. It's not news that the state prioritizes economic interests over the public, but it was an esp clear case where the public can clearly and before-the-fact indicate that they wanted to avert a certain level death and the state went ahead and allowed an order of magnitude more death.

Ultimately what do you want people to do? They have to adapt their beliefs to the new normal because they didn't get a choice in the matter, as the Australian case demonstrates so well. It's the same situation with any of the other problems that have been deemed insoluble by the status quo, like climate change or chronic homelessness etc. Insisting that more should be done when we all know nothing will be done is futile and will just get you labeled a tedious shrill.

# ¿ Mar 30, 2024 13:31

Nocturtle: Mar 17, 2007

Zantie posted:

Yeah, moth-shot = best-shot

I disagree with this, there is some evidence that the self-amplifying mRNA vaccines are better than any other option. Unfortunately you have to be in Japan to get it right now.

On the subject of vaccines Hilda Bastian posted another summary of next generation COVID vaccine development yesterday. It's always a good rundown of current research. Stuff is happening, but can't help but notice that the amounts being spent on next-generation vaccine research of all types are a small fraction of the amount shoveled into the Ukraine bonfire just last week.

Why do researchers in the UK love challenge trials so much:

quote:

Human challenge program: Mucosal Immunity in human Coronavirus Challenge (MusiCC)

This is a new 5-year program led by Imperial College London to speed development and access to mucosal coronavirus vaccines by running placebo-controlled human challenge trials. That involves trying to infect volunteers under controlled conditions, which means trials that can establish whether infection is blocked can be completed quickly, with fewer volunteers than a standard trial.
...
The first step is deciding on which variant of SARS-CoV-2 will be used, and then developing a version that can be used in the trials. Imperial College London has done this before. Their team published the results of a Covid human challenge trial with 36 people to test the process. They were able to infect just over half the participants with a version of the original virus (wild type).

There was a similar-sounding UK COVID challenge trial where IIRC they unsurprisingly gave the expected fraction of participants longer term post-infection impacts.

# ¿ Mar 30, 2024 14:01

Nocturtle: Mar 17, 2007

U-DO Burger posted:

I recently finished reading The Viral Underclass: The Human Toll When Inequality and Disease Collide, and I cannot recommend it enough to this thread. The author is Dr. Steven Thrasher, a journalist and scholar who had been covering the policing and criminalization of HIV for years and years prior to the start of the COVID pandemic. He does a fantastic job explaining how society structures itself to foist the disease burden onto the downtrodden, and the book is a much easier and accessible read than Necropolis or Health Communism.
...

I read this a while ago and thought it was worthwhile but didn't like it enough to recommend it to others. It certainly has a lot of good content and effectively argues that criminalizing disease transmission is just another stick with which to beat the underclasses, same as the drug war. I think this point might be controversial even here. I didn't particularly enjoy their writing style and found the author took too long to make points, in part due to the very personal nature of the writing. For this reason I found Necropolis a much more interesting read.

"Pandemics: a very short introduction" is IMO also very good in part because it provides a broad and to the point overview of pandemics throughout history. Sometimes people talk about how we used to prioritize public health and that's wrong, public health has always been subservient to economic concerns and ruling class interests. The author points out that public health measures past and present tend to be dominated by technical interventions ie vaccines/antibiotics/killing insects, and the underlying social arrangements that lead to underclasses being most vulnerable to pandemics are rarely/never addressed. Also interesting to read people from over a century ago essentially arguing that cholera is mild and doesn't require any sort of mitigation.

edit: definitely agree these books are very helpful towards understanding the COVID pandemic and other perennial public health issues. Haven't read Health Communism but will look into it.

Nocturtle has issued a correction as of 22:08 on Apr 6, 2024

# ¿ Apr 6, 2024 22:06

Nocturtle: Mar 17, 2007

icantfindaname posted:

Paxlovid was nice while it lasted

https://x.com/zeynep/status/1775851011489370337?s=46&t=XyUS8LjqSBeKD9e9B1aSGg

Without discussing the merits of this recent Pfizer study, I thought there were in fact a few reasonable studies that suggested Paxlovid lead to a significant reduction in post-infection impact. For example Al-Aly's medical record study using the VA database for example suggested a 0.7 RR for any post-COVID condition including things like stroke, embolisms etc. Of course that wasn't a double-blinded placebo control study, but that doesn't seem to be totally disqualifying. The two studies are of course measuring different things. Personally think the post-COVID infection stroke rate is more relevant than the time until you stop feeling sick, which raises the question why Pfizer didn't bother measuring it in their own study.

This reminded me that one of the strongest pieces of evidence that both post-COVID impacts exist and the incidence can be reduced via medical intervention was this placebo controlled study with Metformin. This result seemed kind of wild and unexpected and you'd think it would catalyze some treatment guidelines or even be replicated since it came out. As far as I can tell it has not.

# ¿ Apr 7, 2024 01:40

Nocturtle: Mar 17, 2007

The confidence intervals in that Economist article on COVID death toll estimates are way too large for China at least. China's overall disease burden was likely very similar to Australia's/New Zealand's, given they largely eliminated community spread until the large majority of the population was vaccinated (then stopped for surprisingly similar reasons):

The main estimates are in fact close but the confidence intervals suggest China's death toll could have been double Australia's which is not realistic IMO.

# ¿ Apr 8, 2024 16:45

Nocturtle: Mar 17, 2007

Yesterday Katelyn Jenner of "Your Friendly Local Epidemiologist" posted a summary of next-generation vaccine research, though they appear to use Bastian's reviews as a primary reference. The overall picture is still that relatively small potential improvements like mucosal vaccines should not be expected in the west for at least the next couple of years, and "variant proof" vaccines still appear to be a pipe-dream.

I check Jenner's blog occasionally because they often have useful summaries about the pandemic compiled from various data sources. However they also showcase the viewpoint of one category of mainstream post-pandemic public health experts along the lines of Osterholm and Wachter. These are people who recognize and will acknowledge the significant ongoing COVID public health burden but who's takeaway from the pandemic is that public health measures were too restrictive and more "liberal" approaches might be better in future. It's a weird balancing act compared to the more straightforward viewpoint that COVID was never a big deal, esp once the first-generation vaccines were available, and that virtually all mitigations were misguided. These are the two viewpoint options going forward though, absolutely no-one with any relevance in the public sphere is arguing that next time we should lock down harder and nip things in the bud.

harrygomm posted:

dunno if yall have seen this or talked about it, but i don't know if it's legit good news or https://news.ucr.edu/articles/2024/04/15/vaccine-breakthrough-means-no-more-chasing-strains

the paper they cite inline leads to a dead link and i can't find the paper on the pnas site directly either. which probably says enough as it is. it also seems to be in animal trials stage still. idk maybe there's hope

Being in animal trials means even if it works out it's likely over 5 years away, given the recent very slow rate of development.

A bigger issue is that even producing current generation COVID vaccines let alone developing new next-generation versions might in fact be economically infeasible, as Novavax sliding towards bankruptcy and Pfizer's recent vaccine division losses suggest.

# ¿ Apr 17, 2024 18:53

Nocturtle: Mar 17, 2007

Vesi posted:

wow the lockdowns really did a number on britain

https://twitter.com/JimBethell/status/1780230698885898259

It's been before but these kinds of labor market numbers are likely the best way to get a sense of the population level COVID disease burden going forward. They don't have the significant uncertainties of PASC-specific research, esp as it's essentially impossible going-forward to identify a no-COVID-ever control group. These surveys are also relatively less likely to be gamed like hospitalization rates etc. For English-language sources the US BLS CPS survey data and the UK ONS seem to be the best or most easily available.

Correcting for the change in UK working age (16-64) population between 2020 and 2024, the rate of economic inactivity due to "long-term sickness" increased from 4.8% of the working age population to 6.6%. Attributing this to the pandemic suggests that ~1.8% of the UK working age population was impacted enough to have difficulty working.

I've posted these plots before, but for comparison BLS CPS data suggests the pandemic led to an additional 0.5-0.75% of the total American working age population self-reporting some kind of disability:

The two labor surveys ask about different things which might explain why the absolute value of the changes are different. However the pandemic-era trends look very similar. It would be nice if they stop going up, forget about returning to the pre-pandemic baseline.

While I consider these plots to be fairly dire it occurs to me that policy-makers and the politically powerful would probably see them as a big win, to the extent they think about COVID at all which is doubtful. They ended pandemic mitigations and returned to business as usual, and the cost was only ~1-2% of the working age population getting hit with significant long-term impacts + the few million vulnerable people that died. I suspect even the Chinese state administrators would see these numbers as justification for ending the zero-COVID policy.

# ¿ Apr 19, 2024 19:44

Nocturtle: Mar 17, 2007

Shady Amish Terror posted:

It is a step above nothing, and even that's tremendous in our lovely propagandized hell.

I admit I still can't fully wrap my head around it though; if you're going to bother wearing a mask at all, why does such a massive plurality insist on wearing them in the wrongest, most uncomfortable ways possible?

This was figured out in a previous version of this thread. People are wearing masks like this in case they meet an obviously sick person, in which case they think RED ALERT and pull up the mask to cover their nose. Otherwise wearing a surgical or cloth mask all day is uncomfortable so if no-one around is sick why not breathe comfortably? It's not irrational.

The failure to accurately communicate what "airborne virus" means or to provide high quality comfortable N95s to everyone that wants them is the underlying problem.

# ¿ Apr 30, 2024 20:50

Nocturtle: Mar 17, 2007

Raskolnikov2089 posted:

Welp, good news/bad news.

Bad news: my formerly COVID-doomer primary care doc has been successfully pod-peopled. He had no problem wearing a mask for me, nor admitting that long COVID was a thing, but he now thinks COVID has mutated to be much less harmful, and is no longer masking at large.

Good news: my fear of long COVID and the religiously adhered to exercise program that fear spawned has me no longer pre-hypertensive! 110/78 baby!

I fully recognize that COVID may append an ironic, "lol thought you'd escaped blood pressure meds?" coda after my next infection, but for now I'll take the win it gave me and take a victory lap with a salty bacon cheeseburger.

Very nice! Not so much the burger part though, too many sad pigs and cows involved.

Regardless of COVID's perceived severity one takeaway from the pandemic is the critical importance of getting healthy and fit. The pandemic really accelerated a number of existing problems in healthcare provision, not even considering potential long-term COVID impacts. Minimizing the chance of developing any kind of chronic health issue has always been worthwhile, but it esp prudent given the current state of healthcare throughout the western world.

Still not as fit as before getting COVID, but TBH that has more to do with the work commute going from very good to terrible, disastrous. Couldn't get a cushy WFH in your pajamas job, what a dream.

# ¿ May 1, 2024 18:22

Nocturtle: Mar 17, 2007

Soap Scum posted:

oh also, a friend of mine who's very involved in some good political causes but like still eats out constantly and is generally very bad about masking/mitigation/testing/etc. posted this on their ig story today:

like .... yes, correct, but also do you not realize that this is a post about yourself and your behavior re: covid???

it's just shocking how a pile of like 20 - 40M dead people, 100M+ disabled, and an entire directly affected planet legitimately does not even register in people's brains when they say poo poo like this

no real point in posting here just felt like i needed to share that with some fellow sickos

The COVID pandemic is notable in that it's a significant and new public health issue that was thoroughly normalized within 2 years, to the extent that it's now just another problem in the long list of problems that society can't or won't address. Even people still paying attention to the pandemic that acknowledge it's a large ongoing additional disease burden will often conclude nothing more can be done. A lot of the mainstream public health experts who want to remain relevant appear to have landed on this view. For most people like your friend COVID as an issue is irrelevant or forgotten entirely.

There might be an interesting discussion about why someone can be legitimately and in good faith outraged at indifference to the suffering in Gaza or local social problems while not being aware of COVID's ongoing impact. Maybe it's very obvious as the carnage in Gaza is just so monstrous as to be unignorable, while COVID's impact tends to be more subtle and diffuse. Both issues were the subject of consent manufacturing, often explicitly directed by political leaders. That helped push COVID entirely into the background and frankly was also working well in the west for Palestine until the Oct 7 attacks. However the state never felt it needed to quash COVID-awareness protests with over-the-top police violence.

# ¿ May 3, 2024 02:22

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# ¿ May 11, 2024 10:21

Nocturtle: Mar 17, 2007

Didn't see it posted but Hilda Bastian posted another monthly update on next-generation COVID vaccine development at the end of April. As far as I can tell not much to see, and there appear to be very few vaccines (mucosal or otherwise) in late-phase clinical trials that presumably could eventually become available in western countries anytime soon. Really the main recent development was the self-amplifying mRNA vaccine approved in Japan at the end of 2023, so time to figure out how to import and distribute in the US. Not sure which version of the spike protein it uses though.

In US vaccine news there is a VRBPAC meeting scheduled May 16 where they plan to approve this fall's version of the COVID vaccine. My main interest in the meeting is to see whether they continue to approve an updated version for young children, and given last year's terrible uptake it doesn't seem like this should be a given. I'm not happy at how the pandemic was normalized but do really appreciate that at the very least my kids could get updated shots and hope that continues. I realize this is an extremely lucky position, as the large majority of people in the world never received anything beyond the initial vaccine series if they got anything at all.

edit:
lol nvm just read Zantie's last post

Nocturtle has issued a correction as of 15:16 on May 3, 2024

# ¿ May 3, 2024 15:08

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