Covid: the shape of things to come

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Luftmensch

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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.
😍

Thanks for the thoughtful reply. I knew you would have something interesting to say. Yeah... I am 100% with you. Good to hear vaccinations are catching up... but totally frustrating the political class is not being patient. The marginal cost of holding back for a few weeks is so low compared to the potential benefit.

Like I say... discussion about NSW... is really often a discussion around Sydney (to the detriment of the rest of NSW).


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.
Oh wow... I didnt know that. I hope it fizzles. It must be pretty stressful seeing the hospital prepare for the worst!



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.
Yeah :(. Totally forgivable. 'The system' has been a failure for indigenous communities at its most benign. At its worst... weaponised and racist. I have a lot of empathy for hesitancy there. The government should be working triple time with community leaders to ensure access and coverage.



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 intereng 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.
You are likely to be more informed than me.

Delta was a smack in the face partially because SARS-COV-2 is so new. While Delta is more transmissible than other variants (and ultimately outcompeted them), it isnt fundamentally different - though, I dont mean to minimise its significance! The silver lining is that we have never been so fast at responding from an immunology perspective. With the help of vaccines we can acquire a pretty decent immune response even to Delta. Although SARS-COV-2 may continue to duck and weave (e.g. seasonal flu analogy)... its novelty is wearing off.

From that perspective, while not quite measles, my hunch is that the scope for SARS-COV-2 mutation is limited. A large change/event would likely require some antigenic shift. Again... probably through some zoonotic transmission originating from pigs or birds... but at that point we'd be talking about SARS-COV-3.

But hey... I am just a guy ;)

Interesting what you said about interferon!
 
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big_adventure

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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.
Nobody here is claiming that human dose Ivermectin being taken under prescription for an approved, recognized malady is a problem. Thing is, nobody is prescribing the human version to humans for COVID care. Thus, people are going to livestock feed stores to buy the no-scrip-required horse version and self-medicating on the stuff.

Therefore, calling it "horse dewormer" is ABSOLUTELY appropriate, since it's actually what idiots are taking, completely ineffectually against COVID and carrying a measurable risk to their health in the process.
 

ian

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Thus, people are going to livestock feed stores to buy the no-scrip-required horse version and self-medicating on the stuff.
Ah, well, I guess for those people that's a decent point. Seems like some people are actually getting prescriptions, though. 🤦‍♂️


 

big_adventure

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Ah, well, I guess for those people that's a decent point. Seems like some people are actually getting prescriptions, though. 🤦‍♂️


The issue there, of course, is that there are like 7 asshat doctors prescribing this stuff for a condition it does nothing for, and for which the manufacturer says straight out "do not prescribe it for this." That's already bad, but then there are the literally tens of thousands of people who are buying this stuff in horse format and self dosing. I stand by that calling it horse dewormer doesn't reduce the validity of the discussion at all. It got to the point that feed stores around the states are having to turn away customers for their own good.
 

MarcelNL

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I'm not amazed by the existance of weirdo's in medicine, yet I DO really wonder what the addition of 'Republican' and 'congressman' has to do with the information someone is prescribing a drug for off label use other than that it is likely adding to polarization?

Meanwhile, a variant of the delta variant seems to have appeared...10% more infectious than the delta variant.
 

Barmoley

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Nobody here is claiming that human dose Ivermectin being taken under prescription for an approved, recognized malady is a problem. Thing is, nobody is prescribing the human version to humans for COVID care. Thus, people are going to livestock feed stores to buy the no-scrip-required horse version and self-medicating on the stuff.

Therefore, calling it "horse dewormer" is ABSOLUTELY appropriate, since it's actually what idiots are taking, completely ineffectually against COVID and carrying a measurable risk to their health in the process.
On the contrary, my reply was specifically to the poster claiming that his friends in medical field are tired of prescribing "horse dewormer" to people. That they are overwhelmed by threats from their loved ones whom hire lawyers because these medical professionals are refusing to prescribe horse dewormer to them. So I'll repeat my suggestion. If you want people to take you seriously, stop repeating this nonsense.

Ivermectin has a name and approved use in humans, calling it horse dewormer only serves to mislead and antagonize and I don't think we need any more of this crap in COVID discussions there is plenty already. You of course can call it whatever you want.
 

ian

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I'm not amazed by the existance of weirdo's in medicine, yet I DO really wonder what the addition of 'Republican' and 'congressman' has to do with the information someone is prescribing a drug for off label use other than that it is likely adding to polarization?
You accusing Fox News of liberal bias? :)

But yea, polarization is part of their business model.
 

ian

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The issue there, of course, is that there are like 7 asshat doctors prescribing this stuff for a condition it does nothing for, and for which the manufacturer says straight out "do not prescribe it for this." That's already bad, but then there are the literally tens of thousands of people who are buying this stuff in horse format and self dosing. I stand by that calling it horse dewormer doesn't reduce the validity of the discussion at all. It got to the point that feed stores around the states are having to turn away customers for their own good.
Where's this data coming from, btw? I was trying to figure out how many people are getting prescriptions vs getting the veterinary version, and found stuff like this, where there are like 88,000 prescriptions per week vs 3,600/week prepandemic. Those 7 doctors must be getting hand cramps! Guess there are a fair number of people trying to get the veterinary version, too, but I don't think we can say that the amount of people using the human version is insignificant.

 
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gregfisk

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On the contrary, my reply was specifically to the poster claiming that his friends in medical field are tired of prescribing "horse dewormer" to people. That they are overwhelmed by threats from their loved ones whom hire lawyers because these medical professionals are refusing to prescribe horse dewormer to them. So I'll repeat my suggestion. If you want people to take you seriously, stop repeating this nonsense.

Ivermectin has a name and approved use in humans, calling it horse dewormer only serves to mislead and antagonize and I don't think we need any more of this crap in COVID discussions there is plenty already. You of course can call it whatever you want.
I suggest you read what I wrote again. I said no such thing.
 

Barmoley

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I suggest you read what I wrote again. I said no such thing.
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.
🤷‍♂️
 

Luftmensch

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This is becoming absurd. Do we really want to die on the hills of style rather than substance?

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
If we all agree Ivermectin is an approved human antiparasitic that should not be used to treat COVID... then surely if you removed the word 'horse' you agree with 100% of @gregfisk's original post?

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.
Is that 0.65789% 'style' really worth aggressively disengaging over?

makes it very hard to take seriously anything else people spilling this nonsense say
Your point is lost due to bad presentation and incorrect message.
That is not particularly adult. You could neutrally state your objections once and try to seek common ground... which... on face value looks something like 99.34% of what @gregfisk originally said.


Here is my common ground. I 100% agree Ivermectin is approved for human use. I 100% agree there is currently no evidence that supports it being an effective COVID treatment. In the purest sense, I 100% agree, calling Ivermectin a 'horse dewormer' is unproductive. In practice, I only largely agree that has to have a material impact on the conversation.

Back to substance...

How do you feel about medical professionals being pressured by the public to prescribe a human approved drug. A drug for which there is currently no evidence of efficacy for the intended prescription request? And this being done in an environment where the medical system has been under strain for almost two years?



I was chomping at the bit to get involved... despite pulling in the reins, I clearly fell off my high horse...
 
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WildBoar

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it is not unheard of for medical professionals to prescribe drugs of dubious benefit. Drug manufacturers send models to Doctors office to sweet talk them into prescribing many meds. I would not say the medical professions are pressured into doing it, but they can receive financial rewards. So not a stretch some might allow public pressure to convince them to write a prescription or two. They gotta get paid, amIright?

I am not condemning doctors, but there is no doubt prescriptions are frequently written that will have very little benefit for the patient.

(speaking from the US, it's possible in some parts of the world doctors will only prescribe medicines they 100% know will be helpful/ beneficial for their patients. it's possible a place like this may exist somewhere on Earth)
 

spaceconvoy

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I see this as a very practical issue in the context of "How can we shorten the pandemic?" In order of impact:
1. Get vaccinated
2. Encourage others to get vaccinated
3. Avoid risky behavior and continue to wear masks indoors
4. Encourage others to avoid risky behavior and continue to wear masks indoors

After we've taken care of the things under our own control, how can we best accomplish the second goal? In order of most-productive to least-productive:
1. Use effective methods of persuasion
2. If you're not an effective communicator, you can remain silent
3. Use counter-productive methods of persuasion, such as calling the vaccine-hesitant "idiots" and implying they're animals.

Let's be honest about why people engage in the third solution and for whose sake. If insulting people makes you feel better, just own up to it instead of pretending you're saving the world.
 

icanhaschzbrgr

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3. Use counter-productive methods of persuasion, such as calling the vaccine-hesitant "idiots" and implying they're animals.

Let's be honest about why people engage in the third solution and for whose sake. If insulting people makes you feel better, just own up to it instead of pretending you're saving the world.
If I'm calling antivaxers idiots it's not because they make it harder for me to save the world. It's because they make it hard for me to save my family.

With crowds of unvaccinated people around it's only a question of time when you'll get covid. No matter have many doses of vaccines you already have. Covid quickly mutates when given "food" of unvaccinated crowds.

Here in Russia we had an effective vaccine available to public starting last February or March. Yet the majority of people are still unvaccinated. And I can't distance from all of them. I have to deal with them on a daily basis. And it makes me really angry and agressive towards them. I can't stand when my family is in risk because of those who are too lazy or ignorant to take a shot.
 

Barmoley

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This is becoming absurd. Do we really want to die on the hills of style rather than substance?



If we all agree Ivermectin is an approved human antiparasitic that should not be used to treat COVID... then surely if you removed the word 'horse' you agree with 100% of @gregfisk's original post?



Is that 0.65789% 'style' really worth aggressively disengaging over?




That is not particularly adult. You could neutrally state your objections once and try to seek common ground... which... on face value looks something like 99.34% of what @gregfisk originally said.


Here is my common ground. I 100% agree Ivermectin is approved for human use. I 100% agree there is currently no evidence that supports it being an effective COVID treatment. In the purest sense, I 100% agree, calling Ivermectin a 'horse dewormer' is unproductive. In practice, I only largely agree that has to have a material impact on the conversation.

Back to substance...

How do you feel about medical professionals being pressured by the public to prescribe a human approved drug. A drug for which there is currently no evidence of efficacy for the intended prescription request? And this being done in an environment where the medical system has been under strain for almost two years?



I was chomping at the bit to get involved... despite pulling in the reins, I clearly fell off my high horse...
I’m not sure why being adult is defined by you as being neutral and not pointing out nonsense and bad arguments. This not withstanding, I’ll try to explain what I already wrote in my original comment.

It is nonsense to say that medical professionals are tired from being pressured to prescribe horse dewormer. It is factually not true, since they obviously can’t. The only purpose for this is to insult and antagonize people that don’t believe what the person saying this believes. As such the rest of the argument is lost because it is clear that the person saying this has an agenda and does not respect people with opposite opinions.

Now, you keep on saying that it is function vs style but it really isn’t. If your goal is to convince people with opposite views then insulting them is the least effective method of doing so. On the other hand if your goal is to feel superior then sure continue in the same manner, but you won’t reach your stated goals.

Medical professionals shouldn’t prescribe Ivermectin for COVID since it hasn‘t been approved for COVID. I am only talking about the US, since it is available over the counter in some other countries. Ivermectin is very well known and understood and it is harmless to most people in correct dosages, so even if some doctors prescribe it for COVID they are not really hurting anyone. Regardless, as I stated originally I don’t think they should. I have a hard time believing that the pressure is overwhelming since they basically have all the power they can just say no. OP said they are being sued over it, and maybe it is true, but I have a hard time believing it since there is no way any lawyer would take this case since clearly they are not breaking any rules.
 

icanhaschzbrgr

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It is nonsense to say that medical professionals are tired from being pressured to prescribe horse dewormer. It is factually not true, since they obviously can’t.
You insist on things original author hasn't said. Actually author told you that you misunderstood his point. Yet you insist on things that you read somewhere between the lines and come up with your own explanation. So who's factually wrong here?
 

Luftmensch

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Look... going in circles is going to lead to moderation.

I dont have much more to contribute. For now, the last I will say is: finding common ground is a useful strategy for generating productive conversation. Sometime that means giving others the benefit of the doubt. Sometimes that means letting go of a little bit of ground go. Nobody is obliged to change their mind if they don't find the discussion convincing.
 

spaceconvoy

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If I'm calling antivaxers idiots it's not because they make it harder for me to save the world. It's because they make it hard for me to save my family.

With crowds of unvaccinated people around it's only a question of time when you'll get covid. No matter have many doses of vaccines you already have. Covid quickly mutates when given "food" of unvaccinated crowds.

Here in Russia we had an effective vaccine available to public starting last February or March. Yet the majority of people are still unvaccinated. And I can't distance from all of them. I have to deal with them on a daily basis. And it makes me really angry and agressive towards them. I can't stand when my family is in risk because of those who are too lazy or ignorant to take a shot.
I feel the same way, angry to be surrounded by so many people who put me in danger. I feel similarly whenever I drive on the highway, but most people have become desensitized to that form of collective risk. The question is what behavior should I respond with?

My mother-in-law is also Russian and lives in Moscow. She is educated, very liberal, and politically conscious. She has a somewhat high-profile job in the media, and is neither stupid nor crazy. But she's unvaccinated.

She's hoping to travel to Europe soon to get a Western vaccine, but she absolutely refuses to take Sputnik. It's because of how well informed she is, her understanding of how deeply the state controls the media, and her long memory of government incompetence, that she distrusts the Russian vaccine.

The more people who tell her to get the vaccine, the less she's convinced. It just reinforces her view that the propaganda machine is working in overdrive. Why should she think otherwise? These people are friends and acquaintances parroting messages in a highly controlled media environment, not vaccine researchers.

Even if she could talk to a scientist with direct involvement in the vaccine development, how could she ever truly trust them, given the omnipresent threat of 'falling' out of a fifth floor window if they say anything out of line. There is a very deep paranoia held by many highly intelligent people who grew up in the Soviet Union, and it's not without reason.

All that is to say, not all vaccine-hesitant people are idiots. Of course that's easier to illustrate when talking about the specifically Sputnik-hesitant, but I try to imagine how her experience could mirror others who have been lied to and mistreated by our own medical system.
 

Luftmensch

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I try to imagine how her experience could mirror others who have been lied to and mistreated by our own medical system
For sure! I feel the same way about our indigenous communities. They have been lied to (and much worse) many times by the government. On the American side of thing, I dont find it hard to imagine how a broken medical system would make poor people skeptical/anxious about incurring unforseen costs.
 

icanhaschzbrgr

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My mother-in-law is also Russian and lives in Moscow. She is educated, very liberal, and politically conscious. She has a somewhat high-profile job in the media, and is neither stupid nor crazy. But she's unvaccinated.
Too bad for her. Even more so if she's well educated and still can't filter information.

I have zero trust in our mass media. They have been lied so much that even if they speak crystal truth now, they have lost all the credibility.

Yet there are scientific publications in curated medical journals. Sure they aren't an easy read, but that's our best source of vaccine information. And Sputnik does works. And it works more or less as effective vaccines from China/US/India/Europe.

But most ignorant people doesn't care to spend their time reading those articles. And if they do read they often manages to interpret results in the way that would prove their views.

BTW Sputnik is used in other countries as well and there's statistics about it's effectiveness. I can share links if anyone here cares.

On a personal thing 3 of my relatives are doctors. My mother, my uncle and his daughter. Only 2 of them are vaccinated. My uncle is quite antivaxer. I have no idea how that's possible. He has been working as a doctor for 30 years. How could he see all the deaths from Covid and still believe in antivaxers noncenxe. My mother can't understand him. Even his daughter can't understand his reasoning. Frustrating.
 

AT5760

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OP said they are being sued over it, and maybe it is true, but I have a hard time believing it since there is no way any lawyer would take this case since clearly they are not breaking any rules.
These lawsuits are occurring. Here's an article that sums up some of them: https://www.cbc.ca/news/world/ivermectin-lawsuits-covid-us-1.6214131

Few statements are ever outright wrong, but saying "there is no way any lawyer would take this case" is close. Not poking at you, just my chosen profession...
 
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