Covid: the shape of things to come

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Michi

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BTW, I've heard that many epidemiologists predict that, eventually, every single person in Australia will get Covid. It's just a matter of when.
 

LostHighway

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It sounds like vaccine approval for ages 5 to 11 is only weeks away in the US.

I'm scheduled to go in for the booster on Wednesday along with this year's formulation of the flu vaccine. I'm cautiously optimistic as the Delta wave seems to be receding here but low vaccination rates coupled with on going data collection issues remain concerning. The most vaccinated US states (New England) are doing quite well but we still have states where only about 40% of the population is fully vaccinated. I am also concerned that politicians will prematurely relax masking and other precautionary steps. The lack of public health infrastructure and very low vaccination rates in poorer countries still have the potential to conjure up new mutations in the covid virus.

Edit: Polling on vaccine decisions in the USA
 
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MarcelNL

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BTW, I've heard that many epidemiologists predict that, eventually, every single person in Australia will get Covid. It's just a matter of when.
that is pretty much my thought and what I hear reputable virologists say from the very start of this journey.

Autumn and or the Summer holiday season is making cases go up here, still the non vaccinated make up the majority of cases in ICU by FAR.
 

gregfisk

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Here in the US, 91 to 99 percent “depending on the source” of people in the hospital with Covid are the unvaccinated. That makes it pretty clear, to me anyway that the number one goal for every country in the world should be to get people vaccinated. This may seem obvious but here in the states we have so much disinformation being pushed by certain media and Facebook that something has to be done. I have several friends who are either Drs., Nurses or Pharmacists and they are at the end of their ropes. They cannot continue down this road and hope to come out on the other side intact. This is all much too difficult for them after this much time in the trenches. And with the constant threats they’re getting from loved ones who hire lawyers because they won’t give the critically ill horse dewormer is beyond insane.
 

Barmoley

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Here in the US, 91 to 99 percent “depending on the source” of people in the hospital with Covid are the unvaccinated. That makes it pretty clear, to me anyway that the number one goal for every country in the world should be to get people vaccinated. This may seem obvious but here in the states we have so much disinformation being pushed by certain media and Facebook that something has to be done. I have several friends who are either Drs., Nurses or Pharmacists and they are at the end of their ropes. They cannot continue down this road and hope to come out on the other side intact. This is all much too difficult for them after this much time in the trenches. And with the constant threats they’re getting from loved ones who hire lawyers because they won’t give the critically ill horse dewormer is beyond insane.
Can we stop “horse dewormer” nonsense. Ivermectin is approved by FDA for human use. I am not suggesting it should be used to treat COVID, but calling it horse dewormer makes it very hard to take seriously anything else people spilling this nonsense say.
 

Michi

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Barmoley

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Right.

Like I said not suggesting it should be taken for COVID. Doesn’t change the fact that it is a drug approved for human consumption and has been taken by millions or more people through out the world. Like most other drugs it can be dangerous when used inappropriately.
 

gregfisk

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Here in the States there are Very few Drs., if any who will prescribe Ivermectin to people who are trying to use it for Covid. So, the people who are using it to treat Covid are buying horse dewormer. That is a fact.
 

MarcelNL

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as with almost anything, the devil is in the detail and it's the dose that folks should be concerned about especially when buying veterinarian formulations of drugs .for off label use. Nobody knows how their individual case of Covid will turn out nor do they know the proper dose of Ivermectin for Covid so I'd strongly suggest that wait and see how Covid develops is safer approach (SHOULD there be any positive outcome of a future risk benefit asessment, which -as usual- will be also be dose dependent).
 

Barmoley

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Here in the States there are Very few Drs., if any who will prescribe Ivermectin to people who are trying to use it for Covid. So, the people who are using it to treat Covid are buying horse dewormer. That is a fact.
Doesn’t change the fact that calling it horse dewormer is misleading. The drug has been used for 40 years, scientists who discovered it received a Nobel prize. When used appropriately for its intended purpose and with a correct dosage it is safe and side effects are well understood. It’s like saying we should stop taking amoxicillin because it is fish antibiotic.
 

MarcelNL

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Doesn’t change the fact that calling it horse dewormer is misleading. The drug has been used for 40 years, scientists who discovered it received a Nobel prize. When used appropriately for its intended purpose and with a correct dosage it is safe and side effects are well understood. It’s like saying we should stop taking amoxicillin because it is fish antibiotic.
I beg to differ....it's not the same...the labeled use is quite different, it would be similar if Ivermectin would have been approved for Covid treatment, or any other antiviral effect...it is not..
 

Luftmensch

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I've heard reports from a number of epidemiologists who fear that this might turn into a disease for children, seeing that no-one under the age of 12 can receive a vaccine yet.
Yeah 😕

I also worry about indigenous and remote communities. @Nemo probably knows a thing or two about rural health networks. It would have been nice to take advantage of the increased vaccination rates in NSW and remain locked down just a wee bit longer to:
  • allow regional/rural NSW to get more vaccines out there
  • alleviate pressure on the health system even further before taking our foot off the breaks
I think the politicians and media have been using a broad-brush and are too keen assume the average is good enough. Sydney is not the same as Walgett by a long stretch...


I've heard that many epidemiologists predict that, eventually, every single person in Australia will get Covid. It's just a matter of when.
In the long run I expect that will be the case. If there was ever a chance to eradicate the virus.... it was very near the beginning. I suppose its future is probably going to look something like seasonal flu??

I guess the goal for now is to vaccinate as many people as we can. Interestingly that will change the selection pressure placed on SARS-CoV-2. Delta seems geared towards maximum transmission. A large population of vaccinated people will provide resistance to that. I guess that new selection pressure will favour mutations that are better adapted to withstanding an immune response. Again... maybe like seasonal flu, we will need to update the vaccines every few years... I hope not!! It would be much better if the virulence of SARS-CoV-2 diminished and it just became a minor background, inconvenience.



Yowzer... hard not to interpret those results through a political lens 😖
 

ian

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I think @Barmoley is just saying that “horse dewormer” is needlessly inflammatory, which is probably true. Maybe we can just agree to say “a drug to treat parasitic infections” or something? It indicates just as well the inapplicability of the drug to covid, and isn’t as inflammatory or misleading. Horse dewormer seems to suggest it hasn’t even been declared safe for humans under any circumstances.
 
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tcmx3

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I have a bit of a difficult time with the fact that the conversation so often steers back to protecting the feelings of people who are 1. not helping and 2. by and large the least affected demographic rather than say doing something about this:

1634654086625.png
 

ian

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Not employing hyperbolic or inflammatory language is going to help, if anything. Idk that anything said in the covid discussion thread is going to effect significant change elsewhere, but ridiculing people isn't helpful when you're trying to convince them of something. And with so much disinformation coming from those who are promoting things like Ivermectin, doesn't it seem like a good idea not to be misleading when you talk about it? Hard to take the high ground when you're not being completely straightforward and transparent, even if calling Ivermectin a horse dewormer isn't on the same scale of disinformation* as saying that it'll cure covid.



*Yes, literally it's true, but it's also misleading.
 

rocketman

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Guys there are many, many medications which are used for "off the label" issues, and have been for years... Just because a med is a vet med now, does not mean that there might not be a human use for that same med... And vice versa.. Many human meds are used for vet. uses... Same applies to human meds, which are constantly being used for off the label uses effectively... The results is what counts, not the label... Unless it is tried, you do not know the result. Then a study.
The problem in the US is that unless the company making and selling the med is willing to spend another 100 million to do a study of the new use, there will not be a formal evaluation... No one is willing to do such a study on a med with the patent expired.
 

tcmx3

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Not employing hyperbolic or inflammatory language is going to help, if anything. Idk that anything said in the covid discussion thread is going to effect significant change elsewhere, but ridiculing people isn't helpful when you're trying to convince them of something. And with so much disinformation coming from those who are promoting things like Ivermectin, doesn't it seem like a good idea not to be misleading when you talk about it? Hard to take the high ground when you're not being completely straightforward and transparent, even if calling Ivermectin a horse dewormer isn't on the same scale of disinformation as saying that it'll cure covid.
there are no marginal cases of I think I'll go down to the feed supply store and buy some horse branded ivermectin paste. I legitimately dont understand how so many folks are convinced that the primary thing driving this behavior is how the "other side" talks about it.

again this conversation steers again and again towards making sure we're really nice to people who share facebook disinfo or who really dont want to get vaccinated for some reason instead of discussing why the tax credits have stopped.
 

ian

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there are no marginal cases of I think I'll go down to the feed supply store and buy some horse branded ivermectin paste. I legitimately dont understand how so many folks are convinced that the primary thing driving this behavior is how the "other side" talks about it.
Of course it's not the primary thing, but that doesn't make it a bad idea to use precise language. The only reason I started piling on here is that Barmoley was getting all this flack for a perfectly reasonable comment that didn't need to dominate the thread. If you want to talk about tax credits, no one's stopping you from starting up a conversation.
 

LostHighway

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Yowzer... hard not to interpret those results through a political lens 😖
There is unquestionably a political component to who is or is not vaccinated in the US, but the correlation that I find more interesting is that poorer people, especially those without health insurance have low vaccination rates. Despite the fact that the vaccines are widely available without cost in the US I think some people don't trust "free" as a reflection of how health insurance works in the USA with a surprise bill often appearing months after the procedure. Poorer people are also more likely to face transportation or scheduling issues.

Looking at another data set wastewater tracking provides an interesting window into the number of active infections. Since not everyone with the virus gets tested and not all testing is aggregated into a central data set wastewater is, at least arguably, a more comprehensive indicator. We thank the Boston area KKF members (shoutout to @ian) for their contributions to this data. Massachusetts has one of the higher fully vaccinated rates (around 68%? - the Boston area may be higher) but the numbers are notably higher than the summer lulls of 2020 or 2021 although not near the height of the 12/20 - 2/21 rate.
 

ian

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Looking at another data set wastewater tracking provides an interesting window into the number of active infections. Since not everyone with the virus gets tested and not all testing is aggregated into a central data set wastewater is, at least arguably, a more comprehensive indicator. We thank the Boston area KKF members (shoutout to @ian) for their contributions to this data. Massachusetts has one of the higher fully vaccinated rates (around 68%? - the Boston area may be higher) but the numbers are notably higher than the summer lulls of 2020 or 2021 although not near the height of the 12/20 - 2/21 rate.
Wow, I had no idea they were doing that. Really cool.
 

MarcelNL

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of course off label use is not seldom, but rarely there has been such widespread advocacy of it for really very unscientific reasons in an attempt to avoid a proper cure...
 

spaceconvoy

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I legitimately dont understand how so many folks are convinced that the primary thing driving this behavior is how the "other side" talks about it.
Thank you for admitting your ignorance. Does anyone remember last year pre-election when vaccine hesitancy went up among Democrats? There was a fear that Trump was fast-tracking something potentially dangerous for political reasons. And then a year later these same people were calling for the FDA to ignore its protocol and fast-track full approval under Biden. My intent isn't to be overtly political beyond offering an counter-example for how everyone changes their behavior based on what the 'other side' is saying.

We're suggesting that following the available scientific evidence will help achieve a better public health outcome, ie, engaging in less needlessly inflammatory rhetoric on a public forum will ever so slightly reduce vaccine resistance. But you see this as 'protecting their feelings.' I think that's an interesting tell, nearly an admission that your goal is primarily to hurt the feelings of your opponents despite the (admittedly marginal) cost to public health. So whose feelings is this really about?
 

ian

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Thank you for admitting your ignorance. Does anyone remember last year pre-election when vaccine hesitancy went up among Democrats? There was a fear that Trump was fast-tracking something potentially dangerous for political reasons. And then a year later these same people were calling for the FDA to ignore its protocol and fast-track full approval under Biden. My intent isn't to be overtly political beyond offering an counter-example for how everyone changes their behavior based on what the 'other side' is saying.

We're suggesting that following the available scientific evidence will help achieve a better public health outcome, ie, engaging in less needlessly inflammatory rhetoric on a public forum will ever so slightly reduce vaccine resistance. But you see this as 'protecting their feelings.' I think that's an interesting tell, nearly an admission that your goal is primarily to hurt the feelings of your opponents despite the (admittedly marginal) cost to public health. So whose feelings is this really about?
Generally +1, although I think the example in the first paragraph has a few qualifications. E.g.

1) it's natural to be hesitant at first, and then to feel impatient about getting vaccines approved once the pandemic has been going on for ****ing ever,
2) in the intervening time there had been lots of scientists reassuring everyone that they were safe, and that the approvals were generally following regular protocol, and that the holdup was not so much about their safety or effectiveness,
3) one of those presidents has a habit of doing whatever it takes to inflate his bank account or election numbers, so it's more plausible (at least to me) that he'd try to push something through that was unsafe.

Anyway, how bout those tax credits?
 

gregfisk

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Anyone who changes their stance depending on what the other side says isn’t a very deep thinker and probably isn’t able to make good decisions on there own. The reason the message was questioned at the beginning was because of the messenger, nothing more. I find it humorous that so much is being made of me pointing out the ignorance of people who are willing to eat a dewormer drug for a deadly virus that has a life saving vaccine available to them for free. Whether ivermectin is approved for human consumption is irrelevant since it’s certainly not approved for Covid. My point I was trying to make wasn’t that stupid people eat horse paste, it was that the smart people in the medical industry have had enough of these people and their Facebook medical degrees. I have friends who are tired and if we don’t continue to get people vaccinated at a very high rate something is going to break.
 

Barmoley

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Anyone who changes their stance depending on what the other side says isn’t a very deep thinker and probably isn’t able to make good decisions on there own. The reason the message was questioned at the beginning was because of the messenger, nothing more. I find it humorous that so much is being made of me pointing out the ignorance of people who are willing to eat a dewormer drug for a deadly virus that has a life saving vaccine available to them for free. Whether ivermectin is approved for human consumption is irrelevant since it’s certainly not approved for Covid. My point I was trying to make wasn’t that stupid people eat horse paste, it was that the smart people in the medical industry have had enough of these people and their Facebook medical degrees. I have friends who are tired and if we don’t continue to get people vaccinated at a very high rate something is going to break.
Your point is lost due to bad presentation and incorrect message. Your tired friends would not prescribe people horse paste, at least I hope they wouldn't. They would prescribe human approved medicine which is safe for human consumption when taken as prescribed. They should not prescribe it for covid since it hasn't been approved to treat covid. If you want to get people vaccinated, you need to know why they choose not to. Just assuming that they are dumb won't help you resolve the issue. I have many friends who are doctors and pharmacists who refuse to vaccinate, I disagree with them and don't understand their reasons, but I definitely don't think they are morons.
 

tcmx3

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Thank you for admitting your ignorance. Does anyone remember last year pre-election when vaccine hesitancy went up among Democrats? There was a fear that Trump was fast-tracking something potentially dangerous for political reasons. And then a year later these same people were calling for the FDA to ignore its protocol and fast-track full approval under Biden. My intent isn't to be overtly political beyond offering an counter-example for how everyone changes their behavior based on what the 'other side' is saying.

We're suggesting that following the available scientific evidence will help achieve a better public health outcome, ie, engaging in less needlessly inflammatory rhetoric on a public forum will ever so slightly reduce vaccine resistance. But you see this as 'protecting their feelings.' I think that's an interesting tell, nearly an admission that your goal is primarily to hurt the feelings of your opponents despite the (admittedly marginal) cost to public health. So whose feelings is this really about?
provide some actual empirical evidence for your claim or get off that soap box.

frankly from your posts I straight up dont belive you're even capable of reading a scientific paper and understanding the statistics within.

also love the internet psychologist game tell me more about myself Dr. Freud.
 

Nemo

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I also worry about indigenous and remote communities. @Nemo probably knows a thing or two about rural health networks. It would have been nice to take advantage of the increased vaccination rates in NSW and remain locked down just a wee bit longer to:
  • allow regional/rural NSW to get more vaccines out there
  • alleviate pressure on the health system even further before taking our foot off the breaks
I think the politicians and media have been using a broad-brush and are too keen assume the average is good enough. Sydney is not the same as Walgett by a long stretch...

In the long run I expect that will be the case. If there was ever a chance to eradicate the virus.... it was very near the beginning. I suppose its future is probably going to look something like seasonal flu??

I guess the goal for now is to vaccinate as many people as we can. Interestingly that will change the selection pressure placed on SARS-CoV-2. Delta seems geared towards maximum transmission. A large population of vaccinated people will provide resistance to that. I guess that new selection pressure will favour mutations that are better adapted to withstanding an immune response. Again... maybe like seasonal flu, we will need to update the vaccines every few years... I hope not!! It would be much better if the virulence of SARS-CoV-2 diminished and it just became a minor background, inconvenience.
We were a fair bit behind Sydney here. You may remember the former premier "thanking" regional NSW for our patience while she took our vaccine allocation to Sydney. It would have been nice to have an extra couple of weeks at the other end to catch up from that. No dice.

We are in the beginning of a major outbreak started at a couple of local nightclubs. Multiple local schools are affected and this is necessitating isolation of hospital staff with kids at those schools. Elective surgery has been cancelled. I saw them loading covid hoods (devices which cocoon the bed in plastic and turn it into a mini negative pressure room) into ICU yesterday.

Fortunately, we have managed to catch up with 1st doses (95%) and are getting there with second doses (75%). I'm not sure if this vaccine rate is widespread throughout regional NSW (a lot of our vaccine supply comes from Vic).

I really worry about the indigenous communities. I have heard from multiple sources that there is a significant amount of vaccine hesitancy in many communities. Many people in those communities are very vulnerable. So much irreplaceable knowledge of country bound up in those very vulnerable elders.

The virus is here to stay. I guess that the evolutionary pressures in the unvaccinated (still a lot of the world) will remain for transmissiblility. In the vaccinated it will be both transmissibility and immunity evasion. Interestingly enough, SARS-COV-2 is already a pretty good immune evader. One of it's genes is an antagonist for interferon, one of the immune system's important messengers for defence against viruses. This may be one reason that it makes some people so sick. Another interesting fact is that Measles (significantly more transmissible than even delta) has not managed to mutate to avoid the immunity provided by vaccination. I have no idea whether this has any relevance for covid.
 
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