Medical Discussion of Coronavirus

[CordMcNally]

What about withholding tax refunds for the unvaccinated? That was how the individual mandate was enforced.

there is some evidence that the vaccination lotteries are effective.

Refusing to give the taxpayer their own money back (realizing that some people get out more than they pay in) seems like a bad way to go about it.

[Tim]

I was asked not to be political when I pointed out the varying vaccination rates by political beliefs and state vote in the presidential election, now you're on a witch hunt for Fauci. Let's keep this medical. We're mostly doctors here, Fauci is one of us and as such imperfect and most of us do not treat him as a god.

In the meantime, about 97-98% of Covid cases are occurring among unvaccinated people:

https://www.seattletimes.com/seattle-news/health/the-two-societies-97-of-new-covid-cases-are-among-people-who-havent-gotten-the-shots/

and vaccination rates continue to vary widely by red state/blue state:

Top ten:
1. Vermont Number of people fully vaccinated: 354,287
Percentage of population fully vaccinated: 56.78

2. Maine
Number of people fully vaccinated: 742,131
Percentage of population fully vaccinated: 55.21

3. Massachusetts
Number of people fully vaccinated: 3,740,479
Percentage of population fully vaccinated: 54.27

4. Connecticut
Number of people fully vaccinated: 1,922,629
Percentage of population fully vaccinated: 53.93

5. Rhode Island
Number of people fully vaccinated: 552,367
Percentage of population fully vaccinated: 52.14

6. New Hampshire
Number of people fully vaccinated: 675,168
Percentage of population fully vaccinated: 49.66

7. New Jersey
Number of people fully vaccinated: 4,389,480
Percentage of population fully vaccinated: 49.42

8. Maryland
Number of people fully vaccinated: 2,931,258
Percentage of population fully vaccinated: 48.49

9. New Mexico
Number of people fully vaccinated: 1,009,421
Percentage of population fully vaccinated: 48.14

10. Hawaii
Number of people fully vaccinated: 677,530
Percentage of population fully vaccinated: 47.85


bottom ten:

41. South Carolina
Number of people fully vaccinated: 1,750,335
Percentage of population fully vaccinated: 34.

42. Oklahoma
Number of people fully vaccinated: 1,340,489
Percentage of population fully vaccinated: 33.88

43. Idaho
Number of people fully vaccinated: 589,073
Percentage of population fully vaccinated: 32.96

44. Utah
Number of people fully vaccinated: 1,042,991
Percentage of population fully vaccinated: 32.53

45. Georgia
Number of people fully vaccinated: 3,409,346
Percentage of population fully vaccinated: 32.11

46. Wyoming
Number of people fully vaccinated: 185,170
Percentage of population fully vaccinated: 31.99

47. Tennessee
Number of people fully vaccinated: 2,182,063
Percentage of population fully vaccinated: 31.95

48. Louisiana
Number of people fully vaccinated: 1,462,006
Percentage of population fully vaccinated: 31.45

49. Arkansas
Number of people fully vaccinated: 946,639
Percentage of population fully vaccinated: 31.37

50. Alabama
Number of people fully vaccinated: 1,435,719
Percentage of population fully vaccinated: 29.28

51. Mississippi
Number of people fully vaccinated: 817,730
Percentage of population fully vaccinated: 27.48
What are we going to do about this? How are we going to encourage those unvaccinated majorities to vax up?

Quoting Seattle Times analysis of one county, linking that to state vaccination rates proves what? I am not after Fauci. I want to see that his actions were in good faith. Most of the emails are actually “old news” that there seems to have been an effort that was not motivated by best efforts or science.
One serious one is the lack of transparency on masks.
The masks available to the public data shows are effective in preventing spread. Very ineffective in preventing infection. It seems they considered mask quality and decided the prevention was not worth it. Why? Maybe yes, maybe no. Then all of the sudden crappy masks are protective. What is up with that? Less than candid responses were inexcusable. I don’t care his motivations. It’s his actions that count and NIH as well. This isn’t political, it’s personal. We isolated a MIL for over a year including her attending a mass for my BIL that passed from Covid. His musings about two masks are insulting. If he would have communicated facts, maybe things would be different. That was his responsibility. Judge Fauci by his actions in context. He clearly knows better on masks.

And you want to say “In the mean time” to accomplish what? No be political.
We could also take a look at “hard to reach” populations and slice and dice. I am sure we can find traits like socioeconomic and race factors. My answer to that is target resources to reach them.
“One of us” makes no difference. Not all physicians did flip flops and messaging that intentionally was misleading. Face it, he did admit he lied about masks. I doubt he will admit to anything else. That makes no difference either.

[Lithium]

Refusing to give the taxpayer their own money back (realizing that some people get out more than they pay in) seems like a bad way to go about it.

I think the state governments are getting about as much mileage as they can out of the carrots. It will be interesting to see whether any of them are bold enough to utilize any sticks. Just about any of them are going to be toxic politically. Withholding refunds may be philosophically repugnant, but I can’t think of an alternative that is really all that practical. Can you?

[CordMcNally]

I think the state governments are getting about as much mileage as they can out of the carrots. It will be interesting to see whether any of them are bold enough to utilize any sticks. Just about any of them are going to be toxic politically. Withholding refunds may be philosophically repugnant, but I can’t think of an alternative that is really all that practical. Can you?

Why do we need an alternative? I don't have any numbers on those vaccinated but I'd bet that overall a majority of the high risk individuals are vaccinated. There are no areas of the country that are overwhelmed. Some states have been open with large gathering and crowds for months. Everyone who wants to be vaccinated (and meets the age criteria) has likely already had their chance to be vaccinated. It's well past time for everywhere to open up and go on like normal. People who still want to wear masks are more than welcome to.

[bovie]

I think the state governments are getting about as much mileage as they can out of the carrots. It will be interesting to see whether any of them are bold enough to utilize any sticks. Just about any of them are going to be toxic politically. Withholding refunds may be philosophically repugnant, but I can’t think of an alternative that is really all that practical. Can you?

What is your goal here? 100% vaccination rate? Don't be silly.

Those that get sick can be treated--that's why we have hospitals. And of course the majority who get infected don't get sick at all, or probably even know they were infected. We also know much more now than we did last year, and have the capacity to treat if necessary.

Those that are scared/at-risk--and for whatever reason still unvaccinated--can continue to stay home or wear masks or shields or pappers or whatever helps them sleep at night. But I'd hazard a guess that most unvaccinated people, at this point, are sleeping just fine...

It's way past time to get on with gettin' on. The only thing that should be shut down right now is the hysteria.

[Rando]

Withholding refunds may be philosophically repugnant, but I can’t think of an alternative that is really all that practical. Can you?

I think there would be a serious constitutional problem and it would not be practical.even if the vaccines were not still on emergency authorization. The individual mandate was either a fee or a tax depending which way the wind was blowing, either way it's a monetary responsibility you could reasonably ask the IRS to manage.

[Lithium]

What is your goal here? 100% vaccination rate? Don't be silly.

Those that get sick can be treated--that's why we have hospitals. And of course the majority who get infected don't get sick at all, or probably even know they were infected. We also know much more now than we did last year, and have the capacity to treat if necessary.

Those that are scared/at-risk--and for whatever reason still unvaccinated--can continue to stay home or wear masks or shields or pappers or whatever helps them sleep at night. But I'd hazard a guess that most unvaccinated people, at this point, are sleeping just fine...

It's way past time to get on with gettin' on. The only thing that should be shut down right now is the hysteria.

Not 100% vaccination rate. Just prevention of more mask mandates, business shutdowns, school closures next winter if cases go up again. If that happens, we ALL bear the costs, but the responsibility is far from evenly distributed.

[Lithium]

I think there would be a serious constitutional problem and it would not be practical.even if the vaccines were not still on emergency authorization. The individual mandate was either a fee or a tax depending which way the wind was blowing, either way it's a monetary responsibility you could reasonably ask the IRS to manage.

I agree it’s not politically feasible in this Supreme Court, which has changed a lot in the last ten years. But I would never have thought at the time they would have upheld the individual mandate as a tax.

[CordMcNally]

Not 100% vaccination rate. Just prevention of more mask mandates, business shutdowns, school closures next winter if cases go up again. If that happens, we ALL bear the costs, but the responsibility is far from evenly distributed.

Then don't produce mask mandates or force business and schools to close. Given the number of people vaccinated and those who have already had COVID, I think we'll be in good shape.

[Lithium]

Then don't produce mask mandates or force business and schools to close. Given the number of people vaccinated and those who have already had COVID, I think we'll be in good shape.

I think time will tell whether the vaccine numbers are high enough already or not. Obviously the federal authorities don’t think so. It would be nice to get the numbers higher so that it’s less likely that those hard decisions end up on the governors’ desks.

I guess this discussion just indicates that there probably isn’t anything else they can do to get the numbers higher.

[bovie]

I think time will tell whether the vaccine numbers are high enough already or not. Obviously the federal authorities don’t think so. It would be nice to get the numbers higher so that it’s less likely that those hard decisions end up on the governors’ desks.

I guess this discussion just indicates that there probably isn’t anything else they can do to get the numbers higher.

Given the track record of federal authorities on this, I'm not sure their opinion is all that persuasive.

Also, a key point that I think is missed in all of this--the point is not to prevent all infections. That was never the point, and it will never happen. The cat is out of the bag on that one, and COVID is here to stay.

The point of this whole thing is to be able to maintain the capacity of hospitals, both in terms of capacity to admit, and capacity to treat. That's the whole reason they're there. And where we are now with vaccination and natural infection, that goal has probably been accomplished already.

Trying to prevent every last infection by mandating masks, shutting down businesses, telling people that they can't see their parents/grandparents/children, is just such a ridiculously low risk tolerance that it's almost laughable. I simply fail to understand how this became tolerable to a country like ours. Nothing in life is completely free of risk.

In the parlance of this forum, it's the equivalent of telling someone to go 100% bonds in retirement when they've just barely hit 25x spending. You're just exchanging one risk for another, even worse one.

[FIREshrink]

Why do we need an alternative? I don't have any numbers on those vaccinated but I'd bet that overall a majority of the high risk individuals are vaccinated. There are no areas of the country that are overwhelmed. Some states have been open with large gathering and crowds for months. Everyone who wants to be vaccinated (and meets the age criteria) has likely already had their chance to be vaccinated. It's well past time for everywhere to open up and go on like normal. People who still want to wear masks are more than welcome to.

The least objectionable and most practical policy is essentially what the CDC has done: if you're vaccinated, live life normally, if you're not, mask in public spaces. If everyone actually followed this policy and the unvaccinated number shrank to ~20% by winter this is officially over IMO. But I'm pretty sure many of those walking around without masks are unvaccinated, which is propagating spread and placing at risk those who can't be vaccinated for medical reasons, children, and those with a poor immune response to the vaccines.

[bovie]

Not 100% vaccination rate. Just prevention of more mask mandates, business shutdowns, school closures next winter if cases go up again. If that happens, we ALL bear the costs, but the responsibility is far from evenly distributed.

If cases go up again next winter and someone looks back at the way this has been handled this past year regarding mask mandates, business shutdowns, school closures, and the like, and says, "yes, that worked well let's do that again," there's a certain inpatient unit they should be escorted to for an indefinite stay.

[CordMcNally]

The least objectionable and most practical policy is essentially what the CDC has done: if you're vaccinated, live life normally, if you're not, mask in public spaces. If everyone actually followed this policy and the unvaccinated number shrank to ~20% by winter this is officially over IMO. But I'm pretty sure many of those walking around without masks are unvaccinated, which is propagating spread and placing at risk those who can't be vaccinated for medical reasons, children, and those with a poor immune response to the vaccines.

I think propagate is probably not the correct term since cases have been going down as everything has been opening up more and more. I have no doubt that not everyone walking around unmasked is vaccinated the same way I have no doubt that not everyone wearing a mask is unvaccinated. Different people have different risk tolerances. We can't take all risks out of everyday life for everyone. If you deem yourself high risk then wear all the masks you want or don't go out in public. The US is opening back up and this time politics can't stop it.

[Lithium]

If cases go up again next winter and someone looks back at the way this has been handled this past year regarding mask mandates, business shutdowns, school closures, and the like, and says, "yes, that worked well let's do that again," there's a certain inpatient unit they should be escorted to for an indefinite stay.

I think you’re proving my point. Why let it get to the point where that is even on the table? Mask mandates and business closures may not be good policy but we can’t rely on our politicians to execute good policy.