Covid-19

[Maynerd]

Re: Covid-19

I gotta say, I'm disappointed in the Biden administration largely leaving the distribution up to the individual states to manage.

You'd rather have the federal bureaucracy completely screw it up?

[YankeePride1967]

Re: Covid-19

You'd rather have the federal bureaucracy completely screw it up?

You are thinking of the private insurers. Leave it to them and we will be paying $5,000 per shot

And I think what is going on in Texas is yet another example of how the government hating Neo-cons are bad for America

[Texsahara]

I gotta say, I'm disappointed in the Biden administration largely leaving the distribution up to the individual states to manage.

I am fine with states doing this. I do think it would have been better to have had more guidelines initially but now I feel like it would be more disruptive to try and change much. Offer help and guidance where needed. That's about it.

[Maynerd]

Re: Covid-19

I am fine with states doing this. I do think it would have been better to have had more guidelines initially but now I feel like it would be more disruptive to try and change much. Offer help and guidance where needed. That's about it.

Strongly agree.

What works in a densely populated metropolitan area will not necessarily work in a rural, agricultural area. One size does not fit all. And, the more local the responsibility is pushed, the better prepared we will be to address those differences.

[theDurk]

Re: Covid-19

Strongly agree.

What works in a densely populated metropolitan area will not necessarily work in a rural, agricultural area. One size does not fit all. And, the more local the responsibility is pushed, the better prepared we will be to address those differences.

Like the completely dysfunctional Texan locally-based response to the need for reliable electric power generation? Not always, Maynerd. This is another example of a principle without nuance that can have as bad a result as the opposite. Sure, there are frequently dysfunctions associated with 'one size fits all' Federalism. But that does not mean the opposite is without fault. It's never that easy.

Don't forget that most local jurisdictions are firmly in the control of one or the other of one of those partisan political parties you hate so much.

[Tyler Durden]

Re: Covid-19

You'd rather have the federal bureaucracy completely screw it up?

As opposed to this completely-not-screwed-up system of 50 states with 50 different poorly constructed websites which the age group with the least proficiency in using technology must navigate to get vaccinated, or stand in the equivalent of a bread line hoping to get an unused leftover at the end of the day?

Absolutely.

Scroll through this thread and you'll find few if any posts celebrating their state's management of this process. All our current system does is slow the ability to get as many people vaccinated as quickly and efficiently as possible.

[Maynerd]

Re: Covid-19

Scroll through this thread and you'll find few if any posts celebrating their state's management of this process. All our current system does is slow the ability to get as many people vaccinated as quickly and efficiently as possible.

When I think of something being done as quickly and efficiently as possible, I do NOT look to the federal government. YMMV.

[billyhoyle]

Re: Covid-19

Age groupings like this are fine to make histograms, or to show relative categories, but they're a terrible tool for risk prioritization. I'm 64. In five months, I'll turn 65. My risk will not suddenly go from 30X to 90X overnight. But, my prioritization for the vaccine is based on these arbitrary groupings. Someone born six months earlier than I was is seen to be in significantly greater risk. This is obviously not the case.

They’re not a terrible tool for risk prioritization. Somebody could also just reanalyze the cdc data with smaller cutoffs/rolling average, etc. There have to be cutoffs somewhere though. The fact that society views 65 as the cutoff age for a senior just worked against you here. They should open to 55+ next though based on the data rather than stop age prioritization at 65.

[ZYanksRule]

Re: Covid-19

It completely depends on the condition. Many of the co-morbidities have a relatively small increase in risk for death. I'll list some of them below:

Diabetes: 2-4 times increased risk. Smoking: 1-2 fold increased risk Asthma: minimal increased risk Cancer: ~2 fold increase Obesity: ~2 fold increase

By contrast, compared to somebody 18-29, being 50-64 years old increases your risk of death 30X, 65-74 increases your risk 90X, 75-84 increase your risk 220X, 85+ increases it 630X.

I do not know what condition you have, but the majority of conditions that fall into the "at risk" category that states like NJ are prioritizing are relatively small increases in risk compared to even being 50+. If you are between 50 and 64 with diabetes, then your risk becomes 2-4 *30, so you fall more into the risk group of the 65-74 group. But the general point is that age is a significantly more important risk factor than almost any comorbidity, and the most simple and effective way to administer the vaccine is to work your way back in age starting with 75+. If your condition has a risk factor comparable to age, I'd totally support prioritizing it with the elderly-I'm just pissed at the number of conditions that states like NJ have included in their rollout, making those at the most risk (seniors) struggle to find appointments.



I have very elderly family in Bergen. Getting an appointment was impossible. The solution was to just walk into a hospital giving vaccine without an appointment and ask for one of the end of day extra doses. Not sure how reproducible this strategy is-I think many of the nurses administering the vaccine in NJ realize how screwed up their system is and accommodate some of the very elderly walk ins. Or maybe this was just very good luck.



It depends on the specific co-morbidity. A 64 year old will be at significantly greater risk than a 33 year old with almost any co-morbidity (even cancer and diabetes). I'm not saying this is the case for all co-morbidities-I just haven't seen one in the literature that is comparable to age.

Here is the other issue: Vaccines stop symptomatic infection in most groups, if not all groups. 95% -- at least -- of symptomatic infections are stopped. By vaccinating some groups of 18-65 people with risk, is that doing more to slow hospitalizations because those people are more likely to get infected than older people? Older people seem to be more likely to spend the majority of their days at home right now, whereas middle-aged folks are still working and trying to run around, etc, so they are driving much of the spread in the community.



So if you are vaccinating high-risk people in younger age groups, those people will likely not be spreading the virus around, which will lower infection, hospitalization, and death rates more than vaccinating the elderly exclusively.



I don't know if this is all true or part of the calculation, but if the goal is to allow us to go back to normal faster, it does make sense to vaccinate people who can't/aren't just staying home. Obviously the elderly should be prioritized, but by starting to spread it around to people more likely to spread the virus, you might be doing more to slow the spread than by vaccinating the elderly exclusively.

[Maynerd]

Re: Covid-19

I don't know if this is all true or part of the calculation, but if the goal is to allow us to go back to normal faster, it does make sense to vaccinate people who can't/aren't just staying home. Obviously the elderly should be prioritized, but by starting to spread it around to people more likely to spread the virus, you might be doing more to slow the spread than by vaccinating the elderly exclusively.

So, we should punish those who are responsible and reward those who aren't?

You must be a big fan of forgiving student debt.

[billyhoyle]

Re: Covid-19

Here is the other issue: Vaccines stop symptomatic infection in most groups, if not all groups. 95% -- at least -- of symptomatic infections are stopped. By vaccinating some groups of 18-65 people with risk, is that doing more to slow hospitalizations because those people are more likely to get infected than older people? Older people seem to be more likely to spend the majority of their days at home right now, whereas middle-aged folks are still working and trying to run around, etc, so they are driving much of the spread in the community.



So if you are vaccinating high-risk people in younger age groups, those people will likely not be spreading the virus around, which will lower infection, hospitalization, and death rates more than vaccinating the elderly exclusively.



I don't know if this is all true or part of the calculation, but if the goal is to allow us to go back to normal faster, it does make sense to vaccinate people who can't/aren't just staying home. Obviously the elderly should be prioritized, but by starting to spread it around to people more likely to spread the virus, you might be doing more to slow the spread than by vaccinating the elderly exclusively.

Even if you ignore CFR and just look at total mortality, which accounts for how prone people are to get infected, it still is obvious that the elderly should be vaccinated first. A young grocery store worker may be more likely get infected than an old person avoiding crowds, but when that young worker visits an elderly parent and infects that person, that's where the greatest harm happens.

Also, with the variants, asymptomatic spread itself will likely be impossible to stop in the long run. The most important thing is getting the people most at risk vaccinated (and then eventually getting everyone vaccinated once there is sufficient supply).

[YankeePride1967]

Re: Covid-19

So, we should punish those who are responsible and reward those who aren't?

You must be a big fan of forgiving student debt.

Other than very distant outside visits which have ended when the weather got cold I have sacrificed basically my life the last year snd stayed home. Haven’t seen my godkids except for a few very distant visits. No movies, eating out or anything I love. I did it because I don’t want to get sick and I don’t want to be the reason anyone else does. So if someone tells me I should wait longer to give it to someone who sent to bars, ate in restaurants, attended large gatherings I might start an insurrection! (Speaking only of those the poster you replied to who wouldn’t stay home, not couldn’t)

[Yankee Tripper]

Re: Covid-19

Even if you ignore CFR and just look at total mortality, which accounts for how prone people are to get infected, it still is obvious that the elderly should be vaccinated first. A young grocery store worker may be more likely get infected than an old person avoiding crowds, but when that young worker visits an elderly parent and infects that person, that's where the greatest harm happens.

Also, with the variants, asymptomatic spread itself will likely be impossible to stop in the long run. The most important thing is getting the people most at risk vaccinated (and then eventually getting everyone vaccinated once there is sufficient supply).

So you're saying there are no long term effects of COVID-19 that young people have to worry about?


It seems pretty clear that the long term effect are unknown but there seems to be a possibility of long term term heart issue even in mild cases. Reducing the number of super spreader classifications would seem as important as vaccinating the high risk elderly.

[billyhoyle]

Re: Covid-19

So you're saying there are no long term effects of COVID-19 that young people have to worry about?


It seems pretty clear that the long term effect are unknown but there seems to be a possibility of long term term heart issue even in mild cases. Reducing the number of super spreader classifications would seem as important as vaccinating the high risk elderly.

Where did I say there are no long term effects? I said prioritize the people most likely to get seriously ill. Some young people get very sick and have long term effects, but most clear the virus and recover without any issues (near or long term). It's really not complicated-you give priority to those most at risk.

[Yankee Tripper]

Re: Covid-19

Where did I say there are no long term effects? I said prioritize the people most likely to get seriously ill. Some young people get very sick and have long term effects, but most clear the virus and recover without any issues (near or long term). It's really not complicated-you give priority to those most at risk.

So we should be prioritizing African American and Hispanics then well ahead of caucasians.