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The Official MacNN COVID-19 Thread (Page 26)
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OreoCookie
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Sep 16, 2021, 07:11 PM
 
Originally Posted by Spheric Harlot View Post
From what I gather at this point, it unfortunately looks like herd immunity against Delta simply isn't possible, even with 100% vaccinated. […] Someone correct me if I'm wrong.
That’s not correct, it is just that the threshold for herd immunity is higher.

That is because herd immunity is not just achieved through vaccination. And because vaccines protect strongly against severe cases of Covid even with the delta variant, a high vaccination rate will effectively protect the population. In fact, it seems that vaccinated people who contract e. g. the delta variant will be protected against the delta variant much better.

SarS-CoV-2 will remain endemic like the flu. In fact, the common flu is AFAIK a descendent of the “Spanish” flu, and it is much less lethal for the same reasons. So that is what scientists expect to happen to Covid as well: most people will be protected by the combination of a vaccine and repeated exposure since childhood. There will be rare, severe cases — just the like flu. But it won’t bring the medical systems to its knees or cause mass casualties.
Originally Posted by Spheric Harlot View Post
I still think that it's a bit callous to refer to a concert off-handedly as a "superspreader event" when talking about having attended it — because there's still a long way to go.
Here is the thing: if everyone attending the concert is vaccinated, then this is not the same as super spreader events for several reasons: on average
- vaccinated people are less likely to contract Covid,
- vaccinated people do not transmit the disease at the same rate, and
- vaccinated people who are infected are much less likely to develop severe cases of Covid.

In fact, AFAIK the combination of vaccination plus infection (with most likely a mild case) offers not only the best protection, but is ultimately the fate of society.
Originally Posted by MacNNFamous View Post
Wrong. Ban all large events and lock the fuck down everywhere. Close all restaurants indoors, delivery only. Force all businesses to do curbside pickup. Masks required, even in buttfuck tiny-dicked patriotland freedomville, fine anyone who argues, or throw them in jail, or just shoot them in the fucking head for all I care. We could be done with this in a couple months, and covid would be GONE, forever.
No, Covid will remain endemic in the entire world.
Shutdowns and/or lockdowns are measures to control the spread, to slow the spread down, but you cannot eliminate it, it’s way, way too late for that. At this stage the focus should lie with vaccinations, and when certain thresholds are reached it is acceptable to re-open parts of society again.

So the problem is that in most countries a large share of the population doesn’t (want to) get vaccinated. There are few countries (like Portugal or Denmark) where vaccination rates are very high (of the order of 85 %). This is the problem at this stage.

We can argue whether it makes sense to hold concerts at this point, yes, but it isn’t as easy as you claim.
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ghporter
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Sep 17, 2021, 05:32 PM
 
The last estimate I saw for a US herd threshold was 85-95% vaccinated.

I’m disappointed that having some of the most anti-survival public figures actually getting COVID hasn’t seemed to change the rhetoric against individuals taking self-protective (as well as community-protective) steps. Of course these very public figures get extremely aggressive treatments that most folks don’t have access to, so they don’t wind up (visibly) being extremely ill. For example, Governor Abbott, who was vaccinated, got some really advanced treatments, including monoclonal antibody therapy, and tested negative a few days later.

Regeneron is freely available - if your doctor or hospital can get it. But if you aren’t a big wig, you may have to wait for the drug to be ordered and arrive, instead of having somebody physically go get it “so the boss won’t have to wait”. Oh, I’m sorry. Did my disdain short circuit my anti-sarcasm filter? Again? Darn.

Glenn -----OTR/L, MOT, Tx
     
Spheric Harlot
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Sep 17, 2021, 07:35 PM
 
Originally Posted by OreoCookie View Post
In fact, AFAIK the combination of vaccination plus infection (with most likely a mild case) offers not only the best protection, but is ultimately the fate of society.
Thank you; this is the bit I was missing.
     
OreoCookie
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Sep 17, 2021, 08:49 PM
 
Originally Posted by ghporter View Post
The last estimate I saw for a US herd threshold was 85-95% vaccinated.
Yes, the delta variant seems to be twice as contagious than the other variants and lies in between SARS and chicken pox.
Originally Posted by ghporter View Post
I’m disappointed that having some of the most anti-survival public figures actually getting COVID hasn’t seemed to change the rhetoric against individuals taking self-protective (as well as community-protective) steps.
Not just public figures, at this stage pretty much everyone should know someone personally who has contracted Covid and died. In my case I know of two people who died just before vaccines became available (December 2020/January 2021). The number increases if I include people who have recovered or if we include people that are one step removed (I know someone who knows someone …).
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subego
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Sep 17, 2021, 10:52 PM
 
So far I don’t know anyone who’s died (knock on wood), but I have a small network.

I know one long hauler.
     
MacNNFamous
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Sep 18, 2021, 12:34 PM
 
I would say we've lost 10-15 people at work, but we have 5000+ employees so... yeah. Last one to die was a lead engineer.
     
ghporter
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Sep 19, 2021, 11:28 AM
 
Nationwide, 1 of every 500 Americans has died from COVID. State by state varies, but that’s still a huge number.

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MacNNFamous
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Sep 19, 2021, 04:48 PM
 
You guys should go to some more concerts, maybe we can get it 1 out of every 250 by christmas.
     
Brien
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Sep 19, 2021, 10:04 PM
 
Sadly may happen. Esp. if this thing escapes vaccination.
     
Brien
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Sep 19, 2021, 10:07 PM
 
Originally Posted by andi*pandi View Post
Rob, you are not wrong... that's what I was saying a year ago... It wasn't fair at the beginning when we in WA/MA/NY were struck hard and locked down and not leaving the house, to see other areas ignoring it, belittling it, and living their lives, and thumbing their noses at us. And now the shoe is on the other foot with delta, in some regards.

I think what we're seeing is how long people can hold out in isolation, and the toll it takes. Getting vaccinated was like a breath of fresh air, mental relief. I willingly wear a mask if it's the small price to pay to leave the house.

What is the new normal?
I don’t think any of us know but we can’t continue with half measures either… I don’t think our economy can survive further lockdowns and/or printing money indefinitely.
     
ghporter
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Sep 20, 2021, 10:57 AM
 
Having a ton of consumers die won’t help the economy either. The costs associated with increased mortality rates are spread across the entire economy. Fewer consumers, less spendable income because of medical debts, less available childcare taking parents out of the workforce, “final expenses” for people who would never have thought of getting insurance to cover “old people costs”. Who’s going to benefit from all this death? Not even the funeral industry, since they’re over stretched and understaffed too.

Opening up, but enforcing solid, proven mitigation steps like masks and distancing will help both people and businesses. Banning those mitigations, and encouraging idiots to spread whatever is growing in their noses hurts everybody.

Glenn -----OTR/L, MOT, Tx
     
OreoCookie
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Sep 20, 2021, 09:44 PM
 
The other thing are costs that we will only see in decades, e. g. the cost that school children are missing out on school. They (and the parents of those children) have sacrificed to buy society time until a vaccine was widely available. (And of course, many others including health care workers have sacrificed, too.) Now it is, and a significant portion of the population is so egotistic to not take it.
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MacNNFamous
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Sep 21, 2021, 11:06 AM
 
Could not imagine being a teenager during this. All I did was chase skirts....
     
reader50
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Sep 22, 2021, 12:34 AM
 
If you live in Charlotte, North Carolina, you may have seen the black truck driving around near the football stadium. Telling people "Don't get vaccinated". Apparently by the Wilmore Funeral Home.

Story here (also lots of other places)

Turns out the "Wilmore Funeral Home" does not exist. It's an ad agency trying to get more people protected. North Carolina is below 50% fully vaccinated, so someone got creative. Reports are the truck drew a lot of attention.
     
andi*pandi
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Sep 22, 2021, 01:55 PM
 
Huh, saw the truck posted lots on facebook but no one pointed out the advertising company angle. Still clever.
     
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Sep 22, 2021, 02:58 PM
 
Police in the Canadian province of Quebec are searching for a man they suspect of punching a nurse in the face for giving his wife a Covid-19 vaccine without his consent, a police spokesman said on Wednesday.
Well whoop-de-doo. Wives are property - they can't get a vaccine unless husband OKs it.

It's not even clear if he punched the correct nurse. Most pharmacies employ more than one nurse. And have more than one branch store. Hope they catch the guy, on felony assault.
     
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Sep 22, 2021, 03:02 PM
 
And hope his wife gets to a safe space!
     
reader50
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Sep 23, 2021, 03:10 PM
 
Further details on the nurse punching.
"Right at the beginning, the suspect was very angry, very aggressive, he asked the nurse why she vaccinated his wife without approval, without his consent," Carrier said. "And he punched her right in the face multiple times so the nurse didn't have the time to defend or explain herself ... and she fell to the ground and the suspect left running out of the drugstore.
...
The nurse was taken to a nearby hospital by ambulance where she was treated for the "multiple injuries to the face" he said.
There is no security footage, only multiple witness descriptions. Police are asking for tips. Oh, and that pharmacy has suspended vaccinations. The bad guy is ahead, for now.
     
ghporter
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Sep 24, 2021, 05:39 PM
 
This sounds like an abuse issue, that’s for sure. I hope the Quebec authorities find the sack of “stuff” and he gets convicted. Some places in the US have special rules about assaulting health care workers, as in “it’s a felony, no matter what.”

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Sep 30, 2021, 03:37 PM
 
     
Spheric Harlot
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Oct 1, 2021, 08:00 AM
 
The fact that this should be necessary, forty years after generations of kids grew up with Carl Sagan's "Cosmos", really, really does not fit into my head.

I just cannot.
     
Thorzdad  (op)
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Oct 8, 2021, 06:44 PM
 
     
Waragainstsleep
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Oct 10, 2021, 01:20 PM
 
Good. I'm over these anti-vax idiots. If it weren't for their innocent kids I'd be happy to see a virus that could take them out of the population and the gene pool. No great loss at all.
I have plenty of more important things to do, if only I could bring myself to do them....
     
subego
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Oct 10, 2021, 02:45 PM
 
In one example, IIUC, either the patient or the donor is refusing the vaccine because they’ve had COVID.

Is that a legit reason to block the transplant?

The other party in this case has a religious objection to the vaccine. Isn’t blocking that a First Amendment violation?
     
Spheric Harlot
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Oct 10, 2021, 03:43 PM
 
I miss the days when medicine was not about FREEDUMS but about BASIC FUCKING COMMON SENSE.
     
Thorzdad  (op)
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Oct 10, 2021, 05:37 PM
 
Originally Posted by subego View Post
In one example, IIUC, either the patient or the donor is refusing the vaccine because they’ve had COVID.

Is that a legit reason to block the transplant?
Having had COVID does not give you the level, or reliability, of protection that the vaccines do.

Originally Posted by subego View Post
The other party in this case has a religious objection to the vaccine. Isn’t blocking that a First Amendment violation?
Setting aside for a moment the blatant bullshittery that claiming to have a religious objection to this one vaccine is, no, there is no 1A issue. They are freely expressing their supposed religious objection. And, in turn, they are experiencing the consequences of their expression.
     
subego
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Oct 10, 2021, 06:57 PM
 
My knee-jerk response is the consequence of death is rather extreme, and if I’m going to impose that consequence, I can’t claim the person I’m imposing it on is being allowed free expression.

I’m disinclined to call bullshit on religious objections in this type of scenario because the objector is personally adopting a bunch of extra risk. They’re “putting their money where their mouth is” to a much greater extent than a generic religious objector.

Good article about vaccines!
     
Laminar
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Oct 11, 2021, 10:12 AM
 
Originally Posted by subego View Post
I’m disinclined to call bullshit on religious objections in this type of scenario because the objector is personally adopting a bunch of extra risk. They’re “putting their money where their mouth is” to a much greater extent than a generic religious objector:
Does that really count if they don't believe it's what they're doing? What if they believe that people are dropping dead left and right from the vaccine? If they believe that the vaccine is ineffective? If they believe the side effects of the vaccine are worse than actually having COVID?

In the vast majority of cases, these people are not saying, "I understand that the vaccine is the best and safest decision I can make for myself and my community, but I have to hold true to my long-held religious values and forego the vaccine."

They're saying, "I've been duped by politicians, the media, and other bad actors and I'm terrified of this shot, and lying is my best chance at avoiding it."

Anyone vaccinated against chickenpox, MMR, Hep A, or rabies has vaccines developed from cells cloned from fetal cells collected in the '60s. The vast majority of people had no objection to receiving those vaccines because those vaccines weren't widely politicized by morons. If you've gotten every other shot, but just not THIS shot due to religious exemption, well then I hope your religion doesn't have any rules against lying.
     
subego
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Oct 11, 2021, 11:09 AM
 
Maybe I’m misunderstanding, but the scenario you’re describing sounds like what I called a “generic religious objector”, not an organ transplant donor/recipient.

Even if the donor/recipient is full of shit, they’re objectively playing a far more serious version of the “fuck around and find out” game, no?
     
ghporter
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Oct 11, 2021, 12:11 PM
 
Being an active smoker, having uncontrolled diabetes, and being a chronic alcohol abuser are all valid reasons for being rejected for a transplant. People are booted from lists for falling off the wagon, for discovery of other medical issues - including genetics or environmental exposures - and for a number of other reasons.

The rationale is that you should be a good candidate to thrive after the transplant. Refusing to take steps to avoid COVID is not compatible with this. That organ should go to someone who won’t “waste” it by getting sick and possibly dying from a completely avoidable disease.

There are thousands of people waiting for the next available organ. Should it go to someone who needs it because of something beyond their control and who will make the best use of it for the longest time, or someone who might die soon because they don’t want a couple of shots?

Glenn -----OTR/L, MOT, Tx
     
subego
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Oct 11, 2021, 12:15 PM
 
I can see kicking people off the waiting list, but that doesn’t apply here. It’s a friend/family member making the donation directly to the recipient.
     
ghporter
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Oct 11, 2021, 12:21 PM
 
You still need to be a realistic, viable candidate. They’re not going to go to the trouble of doing any surgery when there are potential major problems involved.

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Laminar
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Oct 11, 2021, 01:36 PM
 
Originally Posted by subego View Post
Maybe I’m misunderstanding, but the scenario you’re describing sounds like what I called a “generic religious objector”, not an organ transplant donor/recipient.
Oh, I missed your delineation between the two types.

Even if the donor/recipient is full of shit, they’re objectively playing a far more serious version of the “fuck around and find out” game, no?
Yes they are, but they don't think that, so nothing they've done should be considered noble or impressive.
     
subego
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Oct 11, 2021, 02:04 PM
 
Originally Posted by ghporter View Post
You still need to be a realistic, viable candidate. They’re not going to go to the trouble of doing any surgery when there are potential major problems involved.
In trying to determine a rough estimate of the likelihood the transplant recipient would catch COVID, I discovered a mistaken assumption on my part.

I thought transplant recipients were on immunosuppressants only during recovery. Apparently that’s for life. In other words, there’s pretty much a 100% chance they’ll get infected in an immunocompromised state. It makes sense to refuse that procedure. I was assuming a much lower probability. Mea culpa.
     
subego
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Oct 11, 2021, 02:49 PM
 
Originally Posted by Laminar View Post
Yes they are, but they don't think that, so nothing they've done should be considered noble or impressive.
I guess I consider it “less passive-aggressive than the usual”.
     
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Oct 11, 2021, 07:32 PM
 
Originally Posted by subego View Post
I thought transplant recipients were on immunosuppressants only during recovery. Apparently that’s for life. In other words, there’s pretty much a 100% chance they’ll get infected in an immunocompromised state. It makes sense to refuse that procedure. I was assuming a much lower probability. Mea culpa.
Yes, that’s the thing: the chance that people will get Covid in their lifetimes is nigh 100 % — unless they are dying of something else in the meantime. People are afforded the highest protection is when they have been vaccinated and have contracted the disease: among the normal population the vaccination protects (with very high probability) against a severe case of Covid, so vaccination first, Covid second is preferable. The case is different for immunocompromised people: they are much more likely to develop a severe case of Covid.

Once you understand all this, the medical community’s decision makes sense. People who decide against vaccinations aren’t being punished, these are the consequences of their actions. Although I think a lot of them don’t see it that way.
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subego
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Oct 11, 2021, 09:37 PM
 
Now I’m flopping back.

I wanted to see if any news source was mentioning the lifetime problem, and I came across this article about the policy of a hospital network in Toronto.

https://www.ctvnews.ca/health/corona...d-19-1.5617447

The article gives stats. “[U]nvaccinated patients face a 12-per-cent higher risk of organ rejection and a 30 per cent greater chance of dying from COVID-19”.

While this is likely enough added risk to kick someone off a list, I don’t know if it’s enough to make to make someone unambiguously unfit, which what matters with a direct donor.
     
OreoCookie
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Oct 11, 2021, 10:43 PM
 
Originally Posted by subego View Post
The article gives stats. “[U]nvaccinated patients face a 12-per-cent higher risk of organ rejection and a 30 per cent greater chance of dying from COVID-19”.

While this is likely enough added risk to kick someone off a list, I don’t know if it’s enough to make to make someone unambiguously unfit, which what matters with a direct donor.
You are just accounting for the risk for individuals.
But you have to consider also the risk to other patients: when my mom was doing chemo, she was tested for Covid twice before entering. (My mom was partially vaccinated half-way through her treatment, and it didn’t make sense to vaccinate her two, three weeks before her death.) If one of the patients brought Covid onto the oncology floor, you can imagine what would happen. The municipal government consolidated all cancer patients to one single hospital, too.

I reckon the risk calculus of recent transplants is comparable to cancer patients (obviously I don’t know the numbers, but since both groups are immunocompromised, I think this is a safe assumption), so I think precautions and considerations are similar.

Lastly, the question is whether a potential transplant who refuses vaccinations will ever get to be on top. People lose their spots on the transplant list for e. g. drinking alcohol and other unnecessary risky behavior. Since organ donors are so rare, I think it is entirely justified to exclude people who refuse vaccinations.
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subego
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Oct 11, 2021, 11:18 PM
 
Just so I’m clear, the scenario you’re talking about is someone brings COVID into the hospital, the organ recipient catches it, and then the organ recipient spreads it to other patients? The organ recipient wouldn’t give it to anyone otherwise because they’d be tested.

Also, just in case, I want to reiterate this particular organ is being directly donated by a friend or family member (I forget which). There’s no list involved. Like I said, it’s probably enough added risk to get someone kicked off a list.

Since there’s no list, the question is whether the added risks from COVID tip them into the “unfit” category.
( Last edited by subego; Oct 11, 2021 at 11:34 PM. )
     
OreoCookie
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Oct 12, 2021, 04:38 AM
 
Originally Posted by subego View Post
Just so I’m clear, the scenario you’re talking about is someone brings COVID into the hospital, the organ recipient catches it, and then the organ recipient spreads it to other patients?
Yes, that's one of the scenarios. My larger point is that you were just focussing on personal risk and personal reward rather including the impact on the community, the health care system and society at large.
Originally Posted by subego View Post
The organ recipient wouldn’t give it to anyone otherwise because they’d be tested.
The infection is not caught by a PCR test from day 0, you need sufficient levels of virus proteins for them to be detected. So yes, there is a risk that the infection spreads. It might be small, but the impact of a cluster infection in a hospital, especially one that caters to immunocompromised patients, would be massively damaging.
Originally Posted by subego View Post
Also, just in case, I want to reiterate this particular organ is being directly donated by a friend or family member (I forget which). There’s no list involved. Like I said, it’s probably enough added risk to get someone kicked off a list.
Sure, but there is still the added risk of spreading Covid amongst immunocompromised patients on the wing. There is also the issue of limited resources, there are some localities where Covid pushes the health care system to its limit.

What matters to me is the fact that we are still in the middle of the pandemic, and there are lots of restrictions in place such as travel restrictions. In case not having been vaccinated is their choice, I think it is ok to deprioritize voluntarily unvaccinated patients. (Of course, different rules should apply for people who cannot be vaccinated at the moment, e. g. young children.) Once the pandemic subsides and Covid turns into a version of the seasonal flu, I think we can talk about relaxing some of the standards. That time hasn't come yet, because no big nation is close to herd immunity as far as I know.*

Note that it is not enough to look at national Covid trends, if you look at the map you see that there are Covid hot spots, and most of them are in regions with lower-than-average vaccination rates. So the risks of carrying infections into other hospital wings is higher and likewise, the probability that patients are not vaccinated is higher, too.

People who refuse to get vaccinated just need to accept that the pandemic is not over and that decisions have consequences. Personal choice is fine, but then you need to accept the consequences for your actions.
Originally Posted by subego View Post
Since there’s no list, the question is whether the added risks from COVID tip them into the “unfit” category.
If you are just talking about things like bone marrow transplants where e. g. you get the donation from typically a relative, I don't think the added personal risk is the deciding factor, although it does enter into the risk calculus for a hospital. But it makes sense to me to require a vaccination that has proven completely safe so far (as evidenced by the fact that literally several billion people have been vaccinated and we have not seen a large number of complications.

* I think the fact that vaccines are ubiquitous now in most developed nations is another important factor, I don't think it'd be fair to impose these restrictions when it was hard to get vaccinated.
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subego
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Oct 12, 2021, 08:27 AM
 
This is a specific, real-world case. It’s for a kidney.

If there is absolutely no reasonable way for the recipient to be admitted without an acceptable margin of safety, then I can accept denying the procedure. I’m skeptical this is the situation.

If the hospital is willing to perform the transplant with vaccinated individuals, I am likewise skeptical their resources are too strained.
     
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Oct 12, 2021, 12:56 PM
 
Originally Posted by subego View Post
If the hospital is willing to perform the transplant with vaccinated individuals, I am likewise skeptical their resources are too strained.
You're discounting the risk to the hospital staff (including the surgical team), and especially risk to other patients in the hospital.

Doing a procedure on a vaccinated individual who tests negative carries minimal risks to everyone. But organ surgery on someone who might be infected ...

Besides the other patients who may be exposed during recovery, there is the surgical team. They will do surgeries on others after Johnny Freedumb. Should one doctor or nurse catch it, they can pass it to the next patients while they're open, and on immunosuppressants right after. This risk to dozens or hundreds can be almost completely avoided, by not doing Johnny Freedumb.

The problem with an unlimited freedom is it runs over the freedoms of others. Usually a different freedom. Johnny considers the risks minimal to himself (true) but doesn't ask the other patients for permission to risk their lives. He's asking the surgical team to risk their lives, and not even asking the other hospital staff.
     
subego
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Oct 12, 2021, 01:40 PM
 
I think this got tangled.

I said if there’s no reasonable way to admit the recipient without an acceptable margin of safety, then it makes sense to deny the procedure. So, I’m not discounting the risk, I’m just skeptical there’s no reasonable way to safely admit the patient. Can’t they be quarantined beforehand?

What was quoted was a comment about available resources.
     
subego
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Oct 12, 2021, 03:34 PM
 
Originally Posted by reader50 View Post
Johnny Freedumb
Unfortunately, the way civil liberties work, you have to go to the mat all the time to defend utter morons, because if you don’t, the liberty isn’t there anymore when someone needs to make legitimate use of it.

I agree though, liberty is not unlimited, and comes with qualifiers. So far, that list is:

1) Direct donor (i.e., no waiting lists)
2) Must still be a fit candidate with the added risk
3) Must be able to be admitted COVID-free
4) Does not overstrain resources

If these qualifications are met, on what grounds do we deny the transplant?
     
reader50
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Oct 12, 2021, 05:11 PM
 
If the hospital and surgical team are OK with the risks, the above scenario is fine with me. However, this sounds like an elective surgery (even if Johnny dies without it) and I think the hospital and/or staff have the right to refuse. If they cannot refuse -- then Johnny would have the freedom to asses risk in his choice, and the staff are denied their right to asses risk and choose.
     
subego
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Oct 12, 2021, 05:48 PM
 
Wouldn’t refusing under these conditions be “doing harm”?
     
reader50
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Oct 12, 2021, 06:04 PM
 
Not acting can often be shown to do harm. ie - when you do not respond to those offers to "feed starving children in Africa" you are doing harm. Based on typical junk mail loads, I imagine you have starved hundreds of children in Africa by now. Maybe more.

What you're speaking of is compelled action. Where the doctors & staff in this case, are denied the choice to say no. Even if they believe the risks to others to be unacceptably high. Risking the lives of the many, to save the life of one - who could remove the special risk at any time. But chooses not to do so, because people he's never met told him space aliens are behind the vaccines. Or maybe Bill Gates, with those mind-control chips too small to see in the serums.
( Last edited by reader50; Oct 12, 2021 at 10:01 PM. Reason: missing letter)
     
subego
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Oct 12, 2021, 06:40 PM
 
If they believe the risks to others to be unacceptably high, then the recipient hasn’t fulfilled qualification 3 in the list.
     
OreoCookie
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Oct 12, 2021, 09:42 PM
 
Originally Posted by subego View Post
This is a specific, real-world case. It’s for a kidney.

If there is absolutely no reasonable way for the recipient to be admitted without an acceptable margin of safety, then I can accept denying the procedure. I’m skeptical this is the situation.

If the hospital is willing to perform the transplant with vaccinated individuals, I am likewise skeptical their resources are too strained.
Again, I think you are focussing too much on the personal situation. Let me give you an analog from the story. Japan has had pandemic measures in place before Covid-19. Their policy was that every single patient will be hospitalized. The policy was designed chiefly by medical doctors (who focus more on the individual patient) and less by epidemiologists (who view pandemics on the societal scale). This worked extremely well for small-scale pandemics: the spread was suppressed and the outcomes of individual patients better. But I don’t need to explain to you why this policy failed spectacularly during Covid: hospitals were full of asymptomatic people and patients with a mild case since that is the vast majority.

The same is true here: on an individual level, can you squeeze in and accommodate unvaccinated patients? Yes. But the knock-on effects on the system might be full of unintended consequences. Health care workers have been pushed to their limits and are perhaps close to burnout. You have very little slack in the system to accommodate additional, unnecessary stress. Even small increases in effort needed to accommodate unvaccinated patients (say, 5 %) or disruptions (2 ICU nurses contract mild cases of Covid and are out of order for 2 weeks) will have a significant impact when you are running close to capacity or even above it.
Originally Posted by subego View Post
Unfortunately, the way civil liberties work, you have to go to the mat all the time to defend utter morons, because if you don’t, the liberty isn’t there anymore when someone needs to make legitimate use of it.

I agree though, liberty is not unlimited, and comes with qualifiers. So far, that list is:

1) Direct donor (i.e., no waiting lists)
2) Must still be a fit candidate with the added risk
3) Must be able to be admitted COVID-free
4) Does not overstrain resources

If these qualifications are met, on what grounds do we deny the transplant?
I think the reasoning is quite simple: we are still in the middle of a pandemic with a medical system that is strained. If either of the patients (donor and recipient) are denying the recommended course of treatment (i. e. a Covid vaccination), given the circumstances, I think it is ok to refuse treatment for the reasons outlined above.

Once Covid has turned from pandemic to endemic disease the situation changes and experts should revisit these questions. I nevertheless think that it is still entirely ok to effectively exclude people who chose not to get vaccinated from getting a transplant by bumping them so far down that there is little hope of getting a transplant — provided that is what the best available evidence says. Of course, this would be different for cases where patients are not put on a donor list.
Originally Posted by subego View Post
Wouldn’t refusing under these conditions be “doing harm”?
Are you talking about doing harm/minimizing harm for the individual or for society? I sounds like you are thinking of the former, i. e. from the vantage point of the patient. Minimizing harm for the individual can be at odds with minimizing harm for society.

Just to give you an illustration: prior to Covid Japan had a policy in place how to deal with outbreaks of new diseases: all infected were to be hospitalized. Not only does this curb the spread of the disease, it maximizes the chances of survival for the individual patient. The policy was chiefly designed by physicians (who tend to think of individual patients) and less by epidemiologists (who think of outbreaks on a larger scale). You can imagine why this policy was extremely successful with smaller outbreaks and why it failed with Covid: in the early phase of the Covid pandemic hospitals were full of asymptomatic patients and people with mild cases of Covid. The health care system was quickly overwhelmed. For individual patients, is it better to spend two weeks in hospital under scrutiny of doctors or at home? The answer is clear. Yet minimizing harm to the individual leads to a situation where society is massively worse off.
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subego
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Oct 13, 2021, 03:18 AM
 
So, we’re having one of those disconnects we have.

For example, an explicit premise of my question is the procedure isn’t a strain on resources.

You offer strain on resources as a reason to deny the procedure. This is a good and correct answer, which I agree with… but it’s an answer to a different question than the one I’m asking. If there’s a strain on resources (i.e., damage to the common good) then the procedure absolutely should be denied, but strain on resources is explicitly not a variable in my question.
     
 
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