I don't understand why we continue with anything other than vaccination at this point outside of particularly sensitive places (hospitals, nursing homes, etc.). Masks and social distancing make sense when there is nothing else but we're way passed that. I can't be the only person that thinks its farcical to walk into a restaurant masked, remove it at the table for an hour while talking and eating, then put it back on to leave. I mean, does the virus call a truce while we sip our beers? Was it fooled by wearing a mask at the hostess stand?
If we were a more mature people socially and politically we would drop the silly theater, mitigate as best we can with our (really quite amazing) vaccine technology, and then go about our lives.
What about ventilation? We should be improving ventilation in public spaces to prevent asthma alone, but I think it could also be good for preventing COVID spread in some cases.
First off, I want to say I can see why Matt hired you - you are a good writer and you managed to condense a lot of information into a something that was not a chore to read, so well done.
Here are a few thoughts:
In many ways I think it's useful to think of this as three pandemics and not one pandemic. That's because the three major variants have not been affected by our interventions in the same way, particularly vaccine and masking effectiveness.
Secondly, with regard to mandates, process and legitimacy matter a great deal. Austria's parliament passing a mandate into law is not the same thing as the Biden administration trolling through regulations looking for something to shoehorn into a mandate. Personally, I have no problem with mandates, but there needs to be democratic accountability and support. Two years into this we should not be relying on emergency powers and gimmicks like the OSHA ETS rule.
And since the government has done such a bad job at building credibility, any hope for a democratically-legitimate mandate is pretty much gone. And two years in, it's quite depressing to see that the same mistakes are being made that contribute to a lack of public confidence.
Given these realities, I'm basically where you are. Vaccination is the best option and that ought to be encouraged, but at the end of the day, it's a choice and if people want to roll the dice, then they can do that.
If you buy "Covid Zero" doesn't make sense, and I do, then it doesn't really matter that much how good masks work. They're only a delay tactic, which is only useful in a few circumstances that mostly no longer apply (like the hospitals are full or vaccines are around the corner).
This is why the "I support mask mandates because I CARE and people are DYING" people are so incredibly frustrating. Because you're doing this "until COVID is gone" but COVID is only gone after some combination of everyone is vaccinated, exposed, or both. So all you're doing is taking the same outcome and stretching it out slightly, all the while tut-tutting at the monsters who have taken a moment to think this through. I am truly, deeply confused at why this can't be explained to so many people.
Both the Republicans and Democrats show their specific malfunctions with the Covid policies they adopted, or not adopted.
Republicans choose idiocy for the sake of idiocy. To adopt competent policies would be a breach of faith with the base.
Democrats choose to enact strict policies against Covid, some of dubious value, but then not bother to enforce them. Enforcing rules on people means punishing them for violating them.
Any summary of COVID's risks that doesn't include the wildly different outcomes by age is incomplete at best, and misleading at worst.
An unvaxxed person under 30 is less likely to die from COVID than a fully vaxxed 55 year old. Policies should have adjusted to reflect this reality. But the battlefield lines had been drawn around visual signs of compliance like masking.
We'd have been much better off if the federal government would have said: "We are focused on getting those over 50 vaccinated and boosted. This disease is particularly harmful to that group. The vaccine is available for the rest of you, but our focus is on those over 50." And then respond to any policy proposal or question - masks, schools, OSHA, travel mandates, anything - with a version of that response.
One nitpick, the section on social distancing (which is a phrase I hope to soon banish from existence), references aerosol droplets as the transmission path.
Aerosols would be the better choice, to eliminate the confusion the CDC/WHO introduced to the world when they anchored themselves to droplets and surface-based transmission.
Your data on masking is all pre-omicron. And since Omicron is the prevalent variant, you ar argument for masking policies is outdated.
You also left out border closures which I think have are the most affective. Whenever I asked my question above about mask mandates, someone inevitably points to New Zealand or South Korea or one of these other island nations that has the ability to lock their borders. They make Trump look pro open borders.
I can show you charge after chart after chart that shows the Omicron Spike is exactly the same in every country regardless of masking policy. Argentina was so successful with their precautions that they did not have a delta wave at all. They were powerless against Omicron.
Look at South Korea now with their cases and Omicron. Yes there cases per capital are lower than other places, but that spike is heading in one direction right now. Up up up. Their mask and policies are not working. And news stories say they’re about to enter into all sorts of other severe lockdowns. So yes locking people in their houses or apartments was probably an effective measure, masks… I’m not seeing it.
Feb 5, 2022·edited Feb 5, 2022Liked by Milan Singh
Found another study about case incidence.
"As of January 8, 2022, age-adjusted 14-day cumulative incidence and hospitalization rates remained highest among unvaccinated persons (6,743.5 and 187.8 per 100,000, respectively), and lowest among fully vaccinated persons with a booster (1,889.0 and 8.2, respectively) and fully vaccinated persons without a booster (3,355.5 and 35.4, respectively)."
What about ventillation? Seems like an oversight to leave that out. No good evidence on this? I feel like this could be a good one politically for an exit strategy from all the masking debates since it requires nothing other than money and no behavior change.
"Covid-19 primarily spreads through aerosol droplets and the further away one gets from the source of the aerosols, the lower the concentration of viral particles.
...And it so happens that respiratory aerosol droplets don’t spread beyond six feet, hence the “stay six feet apart” guideline."
As I understand it, this is just plain wrong, at least based on what Zeynep Tufekci has been wring about aerosol transmission for almost 2 years.
The presentation of the vaccines' efficacy against infection in this piece is horribly misleading.
The outdated 90% plus efficacy against infection figure is highlighted in both text and in charts while the more relevant, and much lower efficacy against infection for Omicron is not presented as a similar percentage figure. As I understand it, vaccine efficacy against Omicron is roughtly 70% at best and degrades to somewhere near 30-40% after just a couple months after a booster. Those lower percentages should have been cited in the article.
I get it that the vaccines do a great job protecting against hospitalization and death and it's fine to highlight that or even lead with that. But if you're going to highlight efficacy against infection, do it honestly and reliably.
What really bothers me about some of the NPIs is that there’s no clear roadmap for return to normal. Take Washington DC, which for months has had one of the strictest mask mandates in the country. It made at least some sense to keep it through the holidays, and consequently through the Omicron spike. But with cases falling precipitously, there doesn’t seem to be a lot of clear communication about why it’s going all the way to the end of February. Especially since we just implemented a super-based vaccine mandate for dining!
I’d like to see more in here about which groups are at high risk and why. Over 55 for sure but also which comorbidities increase risk the most? Immunocompromised, too. Many times the discussion about NPIs and vaccines turns to protecting these populations.
I don't understand why we continue with anything other than vaccination at this point outside of particularly sensitive places (hospitals, nursing homes, etc.). Masks and social distancing make sense when there is nothing else but we're way passed that. I can't be the only person that thinks its farcical to walk into a restaurant masked, remove it at the table for an hour while talking and eating, then put it back on to leave. I mean, does the virus call a truce while we sip our beers? Was it fooled by wearing a mask at the hostess stand?
If we were a more mature people socially and politically we would drop the silly theater, mitigate as best we can with our (really quite amazing) vaccine technology, and then go about our lives.
What about ventilation? We should be improving ventilation in public spaces to prevent asthma alone, but I think it could also be good for preventing COVID spread in some cases.
So, uh, I shouldn’t be sterilizing my groceries anymore?
First off, I want to say I can see why Matt hired you - you are a good writer and you managed to condense a lot of information into a something that was not a chore to read, so well done.
Here are a few thoughts:
In many ways I think it's useful to think of this as three pandemics and not one pandemic. That's because the three major variants have not been affected by our interventions in the same way, particularly vaccine and masking effectiveness.
Secondly, with regard to mandates, process and legitimacy matter a great deal. Austria's parliament passing a mandate into law is not the same thing as the Biden administration trolling through regulations looking for something to shoehorn into a mandate. Personally, I have no problem with mandates, but there needs to be democratic accountability and support. Two years into this we should not be relying on emergency powers and gimmicks like the OSHA ETS rule.
And since the government has done such a bad job at building credibility, any hope for a democratically-legitimate mandate is pretty much gone. And two years in, it's quite depressing to see that the same mistakes are being made that contribute to a lack of public confidence.
Given these realities, I'm basically where you are. Vaccination is the best option and that ought to be encouraged, but at the end of the day, it's a choice and if people want to roll the dice, then they can do that.
If you buy "Covid Zero" doesn't make sense, and I do, then it doesn't really matter that much how good masks work. They're only a delay tactic, which is only useful in a few circumstances that mostly no longer apply (like the hospitals are full or vaccines are around the corner).
This is why the "I support mask mandates because I CARE and people are DYING" people are so incredibly frustrating. Because you're doing this "until COVID is gone" but COVID is only gone after some combination of everyone is vaccinated, exposed, or both. So all you're doing is taking the same outcome and stretching it out slightly, all the while tut-tutting at the monsters who have taken a moment to think this through. I am truly, deeply confused at why this can't be explained to so many people.
Both the Republicans and Democrats show their specific malfunctions with the Covid policies they adopted, or not adopted.
Republicans choose idiocy for the sake of idiocy. To adopt competent policies would be a breach of faith with the base.
Democrats choose to enact strict policies against Covid, some of dubious value, but then not bother to enforce them. Enforcing rules on people means punishing them for violating them.
Any summary of COVID's risks that doesn't include the wildly different outcomes by age is incomplete at best, and misleading at worst.
An unvaxxed person under 30 is less likely to die from COVID than a fully vaxxed 55 year old. Policies should have adjusted to reflect this reality. But the battlefield lines had been drawn around visual signs of compliance like masking.
We'd have been much better off if the federal government would have said: "We are focused on getting those over 50 vaccinated and boosted. This disease is particularly harmful to that group. The vaccine is available for the rest of you, but our focus is on those over 50." And then respond to any policy proposal or question - masks, schools, OSHA, travel mandates, anything - with a version of that response.
One nitpick, the section on social distancing (which is a phrase I hope to soon banish from existence), references aerosol droplets as the transmission path.
Aerosols would be the better choice, to eliminate the confusion the CDC/WHO introduced to the world when they anchored themselves to droplets and surface-based transmission.
https://www.bmj.com/content/373/bmj.n913
Spot on, Milan. Well done.
Your data on masking is all pre-omicron. And since Omicron is the prevalent variant, you ar argument for masking policies is outdated.
You also left out border closures which I think have are the most affective. Whenever I asked my question above about mask mandates, someone inevitably points to New Zealand or South Korea or one of these other island nations that has the ability to lock their borders. They make Trump look pro open borders.
I can show you charge after chart after chart that shows the Omicron Spike is exactly the same in every country regardless of masking policy. Argentina was so successful with their precautions that they did not have a delta wave at all. They were powerless against Omicron.
Look at South Korea now with their cases and Omicron. Yes there cases per capital are lower than other places, but that spike is heading in one direction right now. Up up up. Their mask and policies are not working. And news stories say they’re about to enter into all sorts of other severe lockdowns. So yes locking people in their houses or apartments was probably an effective measure, masks… I’m not seeing it.
https://ourworldindata.org/explorers/coronavirus-data-explorer?zoomToSelection=true&time=2020-03-01..latest&facet=none&pickerSort=desc&pickerMetric=total_cases&hideControls=true&Metric=Confirmed+cases&Interval=7-day+rolling+average&Relative+to+Population=false&Color+by+test+positivity=false&country=~KOR
Found another study about case incidence.
"As of January 8, 2022, age-adjusted 14-day cumulative incidence and hospitalization rates remained highest among unvaccinated persons (6,743.5 and 187.8 per 100,000, respectively), and lowest among fully vaccinated persons with a booster (1,889.0 and 8.2, respectively) and fully vaccinated persons without a booster (3,355.5 and 35.4, respectively)."
So there remains an effect on infection rates.
https://www.cdc.gov/mmwr/volumes/71/wr/mm7105e1.htm#T1_down
What about ventillation? Seems like an oversight to leave that out. No good evidence on this? I feel like this could be a good one politically for an exit strategy from all the masking debates since it requires nothing other than money and no behavior change.
"Covid-19 primarily spreads through aerosol droplets and the further away one gets from the source of the aerosols, the lower the concentration of viral particles.
...And it so happens that respiratory aerosol droplets don’t spread beyond six feet, hence the “stay six feet apart” guideline."
As I understand it, this is just plain wrong, at least based on what Zeynep Tufekci has been wring about aerosol transmission for almost 2 years.
The presentation of the vaccines' efficacy against infection in this piece is horribly misleading.
The outdated 90% plus efficacy against infection figure is highlighted in both text and in charts while the more relevant, and much lower efficacy against infection for Omicron is not presented as a similar percentage figure. As I understand it, vaccine efficacy against Omicron is roughtly 70% at best and degrades to somewhere near 30-40% after just a couple months after a booster. Those lower percentages should have been cited in the article.
I get it that the vaccines do a great job protecting against hospitalization and death and it's fine to highlight that or even lead with that. But if you're going to highlight efficacy against infection, do it honestly and reliably.
What really bothers me about some of the NPIs is that there’s no clear roadmap for return to normal. Take Washington DC, which for months has had one of the strictest mask mandates in the country. It made at least some sense to keep it through the holidays, and consequently through the Omicron spike. But with cases falling precipitously, there doesn’t seem to be a lot of clear communication about why it’s going all the way to the end of February. Especially since we just implemented a super-based vaccine mandate for dining!
I’d like to see more in here about which groups are at high risk and why. Over 55 for sure but also which comorbidities increase risk the most? Immunocompromised, too. Many times the discussion about NPIs and vaccines turns to protecting these populations.