Medical Discussion of Coronavirus

[FIREshrink]

You are reading causation where I am just documenting association. The association is a serious public health threat and requires a public health response. This isn't a political statement.

[Tim]

You are reading causation where I am just documenting association. The association is a serious public health threat and requires a public health response. This isn't a political statement.

Guilt by association? Why is this a serious public health threat? There were many things with this pandemic that were not science. They were opinions based upon inferences and extrapolations. Since when is a public health response based on speculation necessary or required? Is it a fact? Close quarters with a lack of ventilation seems to be the only fact. Even the 6 foot social distancing turns out to be based upon other data. It is a political statement. Pure and simple. Even if it were true, there is zero public health response that is required. Required by who?

Actually you would need to look at a state by zip code and precinct. Unfortunately the demographics seem to indicate the vaccination rate is clustered in heavily leaning populations that might not align with the red/blue broad brush. I really hope the efforts are made to vaccinate in those population areas. Regardless of race or political affiliation or mail in votes. State is not an indicator of the vaccine distribution. I would prefer they use the vaccine data to target the zip codes that are identified as being low vaccination rates.

[Panscan]

You are reading causation where I am just documenting association. The association is a serious public health threat and requires a public health response. This isn't a political statement.

sure seems like one to me. A non-political statement would be " a public health response is needed in states with relatively low rates of vaccination"

when you tie in the political correlation, it becomes political.

We can play this game with associations of data such as crime in various cities and their voting associations and all kinds of other demographics to suit our arguments.

[PedsCCM]

If you have 90% of the staff vaccinated, the other 10 % refusing is pretty much a non-factor in my opinion.

This is also a bad precedent for future events from a health perspective as well as employee/employer power struggle.

I very much appreciate the libertarian basis for this but I think you might be missing some important employer (and patient) interests. Let's take a simple example. 5-10% of my hospital's inpatient population is immunosuppressed from cancer, etc. 20%+ percent of the ICU is immunosuppressed (probably a lot more). These people have to be in the hospital to get needed treatment. Are you really ok with 10% of workers being unimmunized? What happens if a patient gets exposed by a healthcare provider? Is the hospital at all responsible morally, ethically or financially? If you are undergoing chemo, would this policy influence your choice in healthcare systems? What about choosing a SNF for your parents or grandparents?

Again, I'm 100% on board with libertarian values especially where the government is concerned. I just find it hard to believe that individual autonomy can unilaterally dominate ALL other interests. Because of that I'm also completely ok with allowing private businesses to create policies that their employees need to abide by. In my system, we have to get the flu shot yearly, show MMR and varicella vaccinations or titers, etc. This is disclosed during the hiring process. COVID will undoubtedly be added at some point in the next 5 years. The hospital system where I did fellowship wouldn't hire you if you used tobacco and their orientation UDS screened for nicotine byproducts. If you don't like the policy, you don't have to work at those places.

[FIREshrink]

Guilt by association? Why is this a serious public health threat? There were many things with this pandemic that were not science. They were opinions based upon inferences and extrapolations. Since when is a public health response based on speculation necessary or required? Is it a fact? Close quarters with a lack of ventilation seems to be the only fact. Even the 6 foot social distancing turns out to be based upon other data. It is a political statement. Pure and simple. Even if it were true, there is zero public health response that is required. Required by who?

Actually you would need to look at a state by zip code and precinct. Unfortunately the demographics seem to indicate the vaccination rate is clustered in heavily leaning populations that might not align with the red/blue broad brush. I really hope the efforts are made to vaccinate in those population areas. Regardless of race or political affiliation or mail in votes. State is not an indicator of the vaccine distribution. I would prefer they use the vaccine data to target the zip codes that are identified as being low vaccination rates.

What other demographic factor is more associated with vaccine hesitancy?

[Tim]

What other demographic factor is more associated with vaccine hesitancy?

Overlay however you wish. One can slice and dice by age, gender, socioeconomics, heritage race or as you choose colors that symbolize legal boundaries and associate them with politics. CDC provides data by all of those. Political signaling was probably the most harmful and least effective impact in fighting this pandemic.

[Panscan]

I very much appreciate the libertarian basis for this but I think you might be missing some important employer (and patient) interests. Let's take a simple example. 5-10% of my hospital's inpatient population is immunosuppressed from cancer, etc. 20%+ percent of the ICU is immunosuppressed (probably a lot more). These people have to be in the hospital to get needed treatment. Are you really ok with 10% of workers being unimmunized? What happens if a patient gets exposed by a healthcare provider? Is the hospital at all responsible morally, ethically or financially? If you are undergoing chemo, would this policy influence your choice in healthcare systems? What about choosing a SNF for your parents or grandparents?

Again, I'm 100% on board with libertarian values especially where the government is concerned. I just find it hard to believe that individual autonomy can unilaterally dominate ALL other interests. Because of that I'm also completely ok with allowing private businesses to create policies that their employees need to abide by. In my system, we have to get the flu shot yearly, show MMR and varicella vaccinations or titers, etc. This is disclosed during the hiring process. COVID will undoubtedly be added at some point in the next 5 years. The hospital system where I did fellowship wouldn't hire you if you used tobacco and their orientation UDS screened for nicotine byproducts. If you don't like the policy, you don't have to work at those places.

Flu shot has opt outs. How is someone going to prove that a patient got covid from their unvaccinated health care employee experience ?

this is a bad argument about “ if you don’t like it you don’t have to work there “ bc these entities basically form monopolies in most areas and collude with each other. If they required their employees to have a certain BMI is that ok ? I mean you can take it or leave it right ? We are just debating about where the line is.

the health effects of nicotine and tobacco are quite clear and we have studied it for decades. I’m just a little hesitant for employers to be able to have something come out and in months be able to unilaterally say it’s mandatory when there is little long term data. I got my shots but that doesn’t mean I think it’s appropriate for it to be mandated by employers.

the fact we have seen vaccine pauses in multiple different countries with multiple different vaccines should tell you all you need to know. These things are experimental and that’s fine and clearly for the benefit of society but I’m not sure how you have no opt out policy in a situation like this.

[jfoxcpacfp]

https://covid.cdc.gov/covid-data-tracker/#vaccinations

I was pleasantly surprised with the progress made on the covid vaccinations. A 7day average of 3.2m is a good thing. The question is when will the drop off in demand occur. The 18-65 seems to be the challenge now.

Hmmm - I’m 64 and tomorrow w/b 2 wks since my 2nd shot (Moderna). I have a picture of my card on my iPhone for travel. I’d say at least 50% at WM are masked, which i was happy to see. Will keep my mask on in public places for awhile longer, at least till “Masks Required” signs come down.

[jfoxcpacfp]

Facts are not political. The politicization of this virus and the response occurred more than a year ago and the end *result* of the politicization is vaccine hesitancy by nearly half of all Republicans, with the top ten states for vaccine hesitancy being states that voted Republican in the 2020 presidential election.

https://www.wsj.com/articles/amid-expanded-covid-19-vaccine-eligibility-signs-emerge-of-slowing-demand-11619256602?mod=mhp

Please, ppl. Let’s not bring political parties into this as both sides have questioned the vaccine process. This thread has gone on too long and been too helpful to have to shut it down at this point. Let’s keep politics out of it.

[CordMcNally]

The hospital system where I did fellowship wouldn't hire you if you used tobacco and their orientation UDS screened for nicotine byproducts. If you don't like the policy, you don't have to work at those places.

Even those who enjoy a cigar every now and then can’t work there? I wonder why they stopped there and didn’t include caffeine?

[PedsCCM]

Flu shot has opt outs. How is someone going to prove that a patient got covid from their unvaccinated health care employee experience ?

this is a bad argument about “ if you don’t like it you don’t have to work there “ bc these entities basically form monopolies in most areas and collude with each other. If they required their employees to have a certain BMI is that ok ? I mean you can take it or leave it right ? We are just debating about where the line is.

the health effects of nicotine and tobacco are quite clear and we have studied it for decades. I’m just a little hesitant for employers to be able to have something come out and in months be able to unilaterally say it’s mandatory when there is little long term data. I got my shots but that doesn’t mean I think it’s appropriate for it to be mandated by employers.

the fact we have seen vaccine pauses in multiple different countries with multiple different vaccines should tell you all you need to know. These things are experimental and that’s fine and clearly for the benefit of society but I’m not sure how you have no opt out policy in a situation like this.

You're right. We are debating where the line is. My argument over the last several pages is that vaccines under EUA should not be required but I expect and agree with the rights of private companies to mandate the vaccine once an EUA is approved. That policy would be most similar to influenza, MMR and varicella. BTW the possibilities for opt outs vary widely based on state law and hospital system policy. At a minimum they all must adhere to EEOC (religious) and ADA (allergic) compliant exemptions. I would argue that banning smoking and obesity are more similar to each other than they are to any of the vaccine policies and I disagreed with the practice of testing for tobacco.

[PedsCCM]

Even those who enjoy a cigar every now and then can’t work there? I wonder why they stopped there and didn’t include caffeine?

Yep and I do like a cigar every now and then

[Panscan]

You're right. We are debating where the line is. My argument over the last several pages is that vaccines under EUA should not be required but I expect and agree with the rights of private companies to mandate the vaccine once an EUA is approved. That policy would be most similar to influenza, MMR and varicella. BTW the possibilities for opt outs vary widely based on state law and hospital system policy. At a minimum they all must adhere to EEOC (religious) and ADA (allergic) compliant exemptions. I would argue that banning smoking and obesity are more similar to each other than they are to any of the vaccine policies and I disagreed with the practice of testing for tobacco.

Would be curious as to any systems that make obesity centered metrics for employment but honestly they might not be able to find staff, it feels like medical employees(doctors, nurses, techs) (especially older ones) tend to be as obese as general population.

It probably hasn't happened yet but I wonder if it will in near future.

[FIREshrink]

Overlay however you wish. One can slice and dice by age, gender, socioeconomics, heritage race or as you choose colors that symbolize legal boundaries and associate them with politics. CDC provides data by all of those. Political signaling was probably the most harmful and least effective impact in fighting this pandemic.

You originally asked when the drop off in demand would occur. I wrote that it already had. The dropoff is not universal. It occurred first in areas whose common characteristic is their political identification.

Most assuredly I wish this was not the most important "overlay." I am not making this up. I want to reach herd immunity or whatever maximal level of vaccination we can/need to move on. So how to craft the public health effort to achieve? If we've learned anything in the last year about public health it's that messaging, and the messenger, matter. Example: a recent focus group conducted by Republican pollster Frank Lutz with Republican vaccine hesitant or refusers showed they uniformly reject Fauci as an expert. Knowing this is important. So we need to put someone else out there to drive up vaccine acceptance in this group - the group with the highest rate of vaccine refusal.

[Tim]

You originally asked when the drop off in demand would occur. I wrote that it already had. The dropoff is not universal. It occurred first in areas whose common characteristic is their political identification.

Most assuredly I wish this was not the most important "overlay." I am not making this up. I want to reach herd immunity or whatever maximal level of vaccination we can/need to move on. So how to craft the public health effort to achieve? If we've learned anything in the last year about public health it's that messaging, and the messenger, matter. Example: a recent focus group conducted by Republican pollster Frank Lutz with Republican vaccine hesitant or refusers showed they uniformly reject Fauci as an expert. Knowing this is important. So we need to put someone else out there to drive up vaccine acceptance in this group - the group with the highest rate of vaccine refusal.

Choose your measurement, you chose politics. Upon replay of the specific locations facts can support a different conclusion for herd immunity. The lines drawn are following the electoral college. Non-political statement. If every major urban area was vaccinated, we would not have a political discussion, it would be demographic.
I attempted to refer to statistics. No more sense inferring conclusions.