Some New Science on Virus Transmission on Airplanes

[Lateral Hazard]

Originally Posted by Up Helly Aa

Many will not like my opinion. It is refreshing to listen to a little common sense and not all of this panic and political hogwash. It is a virus....it spreads...they have been with us since the beginning of mankind. The human immune system fights of off viruses in 99.999% of all cases. If we are not exposed to new viruses our immune system weakens. Mask at best simply slow the spread. They do not stop it. Viruses vary widely in death rates......especially when those counting have a political agenda. I have had it and got through fine. Two weeks of feeling lousy. They have a very good handle on treating for it early now. I am over 80.

My son and daughter in-law had it. 34 and 35. Both in outstanding health.
We almost lost my son in the ICU 3 times.
"I am 80 and I had it" does not in anyway mean it is not deadly. Everyone needs to be careful and mask, 6 ft. and wash hands.

[Dockhead]

Originally Posted by Singularity

Appeal to . . . . paying particular attention to the observation that "crazy uncle" type misinformation spreaders are far less a problem than eloquent folks.

This is such a mess of confused nonsense -- I think I've spent enough time on it. I've got actual work today, and I think I made my case.


Just one minor point -- Hegel never used the term "cognitive dissonance", which is a term from psychology, invented in 1957 (Hegel having died in 1831). Nor "projection", which is another term from psychology, not philosophy. The "F" on that paper, for the pretentious misuse of references, by one who has never read a page of what is referred to, stands.

[Happ]

Originally Posted by Lateral Hazard

My son and daughter in-law had it. 34 and 35. Both in outstanding health.
We almost lost my son in the ICU 3 times.
"I am 80 and I had it" does not in anyway mean it is not deadly. Everyone needs to be careful and mask, 6 ft. and wash hands.

In my opinion it is irresponsible to minimize this virus in any way, shape or form. You are not on of the 300,000 that have died from this virus. You fortunately have not had to grieve the loss of your son. Do you think you would just shake this off if you had lost your son?

[Capn Jimbo]

Originally Posted by Dockhead

So not just to prevent deaths, but to end isolation of nursing home residents for the sake of their quality of life and psychological health?


I hadn't thought of that. I think that's a VERY good reason to vaccinate them, but I would still not prioritize that, over vaccinating those people likely to be spreading the virus. Surely the first priority has got to be ending the pandemic. What saves some lives in the short term might indeed not be what saves them in the long term.

What a sad, sad attitude. On this basis our health professionals - who protect themselves scrupulously - would also not qualify.

[valhalla360]

Originally Posted by Capn Jimbo

What a sad, sad attitude. On this basis our health professionals - who protect themselves scrupulously - would also not qualify.

How so, medical staff are highly exposed and are in frequent close physical contact with at risk individuals. That would place them as key links in the chain of spread, even if they are scrupulous about contact. Cutting those links would provide a huge benefit to the overall population...including the elderly in nursing homes.

Now if you want to break down different categories of medical staff, you might have an argument as some jobs have far less physical contact and thus much lower risk of infection.

[goboatingnow]

Originally Posted by Dockhead

Again, I have an objection to the logic employed here.

Just because it is not proven that vaccination prevents transmission, does not indeed prove that "following the science suggests giving it to those likely to get sick with severe consequences is the correct first action."

We don't need proof, we just need to know what is most likely. If it is most likely that vaccination does NOT prevent transmission, then I agree with you -- people should be vaccinated in order of their vulnerability. But that should also take into account likelihood of infection as well as likelihood of a bad outcome, so even still maybe not necessarily nursing home residents, but perhaps vulnerable people who circulate in society. This would be right because it would maximize the life saving effect of the vaccine.

BUT if we think that it is most likely that vaccination DOES prevent transmission -- and I think that is what most scientists believe -- then this does not hold. In that case, using the vaccine to suppress transmission may well provide greater life saving effect, than vaccinating nursing home patients. Or at least than exclusively vaccinating nursing home patients -- perhaps some kind of mix would give an optimum result. This could be worked out empirically.

I have some insight as my brother is a microbiologist with Phizer

The vaccine trials did not indicate any real data to to whether it prevents transmission largely because it takes along time to prove that theory. The precautionary principle as my brother points out is that until shown otherwise you plan on the basis that it does not , whatever wishful thinking. scientific or otherwise suggests.

Therefore medical opinion ( and I listened to the deputy chief medical officer today say the same thing ) is that you treat the vaccine as preventing illness until demonstrated conclusively otherwise that it also prevents transmission

The second wave shows that less people have natural immunity ( Tegnell “ herd immunity “ never materialised largely because enough people didn’t get the disease in the first place ) and these unsubstantiated view that significant percentages of untested people have had the disease is just that , unsubstantiated

The next factor is that contract tracing to identify super spreaders etc or to establish a local outbreak origin has largely failed due to either Chaos or work load. The apps have not generally delivered their promises ( largely because Bluetooth detection is nonsense anyway ) I notice in Ireland promotion of the app has completely died away

Hence right now we (a) have no proof it impedes or prevents transmission, (b) we don’t really know who has had Covid and who hasn’t and (c) we don’t really have a handle on the level of immunity conferred by having the disease

Hence , given the main reason for lockdowns is to present “ overrunning the health systems “ rather then simply stopping people getting sick ( or so every public health official claims on the radio ). The key to removing lockdowns and restoring normality is clearly to prevent serious Covid related illness in the first instance

Then it matters less if Covid still is transmitted to the largely non- vulnerable groups. Hence once the vulnerable are immune we can begin to restore normality

Then as we vaccinate more and more it doesn’t really matter if the vaccine does or doesn’t prevent transmission as the virus will die away anyway as the number of suitable hosts diminishes overtime

I do think it will be the onset of summer before full normality or something near it will be established.

I also think it will be hard to get rid of all these public health advisory groups who have clearly liked being in the limelight.

[Dockhead]

Originally Posted by Capn Jimbo

What a sad, sad attitude. On this basis our health professionals - who protect themselves scrupulously - would also not qualify.

You don't read, before posting?

Originally Posted by Dockhead

. . . I think it's absolutely correct, on several different levels, to vaccinate ALL front line health care workers first. First of all, working with infected people daily, they are most exposed. Second, we can least afford to have such people knocked out of action. Third, just morally -- those people who are in the front lines protecting the rest of us, surely deserve to be protected first.. . .

https://www.cruisersforum.com/forums...ml#post3296737



Apology accepted.

[Dockhead]

Originally Posted by goboatingnow

I have some insight as my brother is a microbiologist with Phizer

The vaccine trials did not indicate any real data to to whether it prevents transmission largely because it takes along time to prove that theory. The precautionary principle as my brother points out is that until shown otherwise you plan on the basis that it does not , whatever wishful thinking. scientific or otherwise suggests.

Therefore medical opinion ( and I listened to the deputy chief medical officer today say the same thing ) is that you treat the vaccine as preventing illness until demonstrated conclusively otherwise that it also prevents transmission

The second wave shows that less people have natural immunity ( Tegnell “ herd immunity “ never materialised largely because enough people didn’t get the disease in the first place ) and these unsubstantiated view that significant percentages of untested people have had the disease is just that , unsubstantiated

The next factor is that contract tracing to identify super spreaders etc or to establish a local outbreak origin has largely failed due to either Chaos or work load. The apps have not generally delivered their promises ( largely because Bluetooth detection is nonsense anyway ) I notice in Ireland promotion of the app has completely died away

Hence right now we (a) have no proof it impedes or prevents transmission, (b) we don’t really know who has had Covid and who hasn’t and (c) we don’t really have a handle on the level of immunity conferred by having the disease

Hence , given the main reason for lockdowns is to present “ overrunning the health systems “ rather then simply stopping people getting sick ( or so every public health official claims on the radio ). The key to removing lockdowns and restoring normality is clearly to prevent serious Covid related illness in the first instance

Then it matters less if Covid still is transmitted to the largely non- vulnerable groups. Hence once the vulnerable are immune we can begin to restore normality

Then as we vaccinate more and more it doesn’t really matter if the vaccine does or doesn’t prevent transmission as the virus will die away anyway as the number of suitable hosts diminishes overtime

I do think it will be the onset of summer before full normality or something near it will be established.

I also think it will be hard to get rid of all these public health advisory groups who have clearly liked being in the limelight.

Taken separately, all these propositions are more or less reasonable.

But I'm not sure how they hang together or what point is supposed to be made.

Nothing here contradicts the basic idea that unless we have good reason to believe that vaccination does NOT prevent transmission, we should be concentrating on vaccinating potential spreaders (after front line health care workers of course). It's not a complicated idea.

[valhalla360]

Originally Posted by goboatingnow

Hence right now we (a) have no proof it impedes or prevents transmission, (b) we don’t really know who has had Covid and who hasn’t and (c) we don’t really have a handle on the level of immunity conferred by having the disease

This seems to be a summary of your point...along with if you can't prove it, we must assume the worst case scenario.

a) Just because we don't have definitive proof, doesn't mean it isn't highly likely that it reduces the likelihood of transmission. It may sound like semantics but there is a big difference between "reduces" and "impeding" transmission. Impeding would imply some direct mechanism blocking transmission. But simple logic says someone who is infected and takes a week or two to clear it is likely going to be infectious for longer than someone who is exposed but immune with the virus never proliferating in their body and quickly clearing it from their system. It may not be 100% at blocking transmission but I would argue it's so likely, we should start from that assumption until you could prove otherwise. The vaccine testing shows us nothing pro or con to the idea as it wasn't part of the study...so a lack of evidence from the current studies doesn't prove anything.
b) Incorrect. We don't know 100% of the infected individuals. In the US we know of at least 16.8million confirmed cases for example. Assuming they used even a modest amount of logic, they kept track of who tested positive, that is a large group that could be placed in one of the later groups to be vaccinated. I would have even higher expectations in the medical profession where they are presumably testing more often and making choices about who is allowed to work based on it, so they should have a much better idea of who has previously been infected.
c) Based on the rarity of documented re-infected, it is fair to say that at least in the short term, the immunity is pretty effective and therefore a lower priority relative to those who have no immunity.

The goal would not necessarily be to refuse the vaccine to those previously infected but to move them to one of the later groups to get the vaccine. So they would eventually get the vaccine but the first limited doses would be put to better use maximizing their benefits to get things under control as quickly as possible.

[goboatingnow]

Originally Posted by valhalla360

This seems to be a summary of your point...along with if you can't prove it, we must assume the worst case scenario.

a) Just because we don't have definitive proof, doesn't mean it isn't highly likely that it reduces the likelihood of transmission. It may sound like semantics but there is a big difference between "reduces" and "impeding" transmission. Impeding would imply some direct mechanism blocking transmission. But simple logic says someone who is infected and takes a week or two to clear it is likely going to be infectious for longer than someone who is exposed but immune with the virus never proliferating in their body and quickly clearing it from their system. It may not be 100% at blocking transmission but I would argue it's so likely, we should start from that assumption until you could prove otherwise. The vaccine testing shows us nothing pro or con to the idea as it wasn't part of the study...so a lack of evidence from the current studies doesn't prove anything.
b) Incorrect. We don't know 100% of the infected individuals. In the US we know of at least 16.8million confirmed cases for example. Assuming they used even a modest amount of logic, they kept track of who tested positive, that is a large group that could be placed in one of the later groups to be vaccinated. I would have even higher expectations in the medical profession where they are presumably testing more often and making choices about who is allowed to work based on it, so they should have a much better idea of who has previously been infected.
c) Based on the rarity of documented re-infected, it is fair to say that at least in the short term, the immunity is pretty effective and therefore a lower priority relative to those who have no immunity.

The goal would not necessarily be to refuse the vaccine to those previously infected but to move them to one of the later groups to get the vaccine. So they would eventually get the vaccine but the first limited doses would be put to better use maximizing their benefits to get things under control as quickly as possible.

What is known as a fact , is the vaccine prevents the disease, other assumptions are just that. Hence since deaths are the worst outcome of Covid ( or maybe you disagree ) It makes the decision to vaccinate those most vulnerable to death first. But clearly the intention is to vaccinate everyone as quickly as practical, that’s the summary of my logic and The logic of any public health official I’ve listened too

[Auspicious]

Originally Posted by Dockhead

Nothing here contradicts the basic idea that unless we have good reason to believe that vaccination does NOT prevent transmission, we should be concentrating on vaccinating potential spreaders (after front line health care workers of course). It's not a complicated idea.

I disagree. People who would or might otherwise get sick and as a result change their behaviors instead could themselves become super spreaders. Until we can demonstrate that the vaccine does prevent transmission we must assume it does not.

[Singularity]

Originally Posted by Dockhead

Taken separately, all these propositions are more or less reasonable.

But I'm not sure how they hang together or what point is supposed to be made.

Nothing here contradicts the basic idea that unless we have good reason to believe that vaccination does NOT prevent transmission, we should be concentrating on vaccinating potential spreaders (after front line health care workers of course). It's not a complicated idea.

In my opinion the above observation is not consistent with expert opinion, math modeling that Goboatingnow well described, nor consistent with WHO vaccination modeling/guidance as cited below.

It's otherwise not consistent with tradition best practices in infection disease management where the worst is first assumed, while at least the Oxford vaccine trial found nasal shedding during animal testing (where the animals where quite loaded with inoculum such that the viral load in the animals might have been inordinately high).

Young superspreaders are harder to target such that providing limited vaccine in the younger age group is akin to firing a couple shells of birdshot into a stadium full of people hoping that you hit the right people. <---makes no sense

Model-informed COVID-19 vaccine prioritization strategies by age and serostatus
https://www.medrxiv.org/content/10.1101/2020.09.08.20190629v2.full
""A highly effective transmission-blocking vaccine prioritized to adults ages 20-49 years minimized cumulative incidence, but mortality and years of life lost were minimized in most scenarios when the vaccine was prioritized to adults over 60 years old.""

Doing the Touchy Math on Who Should Get a COVID Vaccine First
Mathematicians model pandemic scenarios by plugging thorny ethical and logistical issues into calculations
https://www.scientificamerican.com/a...vaccine-first/
""The consensus among most modelers is that if the main goal is to slash mortality rates, officials must prioritize vaccinating those who are older, and if they want to slow transmission, they must target younger adults.

“Almost no matter what, you get the same answer,” says Harvard epidemiologist Marc Lipsitch. Vaccinate the elderly first to prevent deaths, he says, and then move on to other, healthier groups or the general population."


WHO SAGE Roadmap for Prioritizing Uses of COVID-19 Vaccines in the Context of Limited Supply.
https://www.who.int/docs/default-sou...rsn=bf227443_2

[Dockhead]

Originally Posted by Auspicious

I disagree. People who would or might otherwise get sick and as a result change their behaviors instead could themselves become super spreaders. Until we can demonstrate that the vaccine does prevent transmission we must assume it does not.

Logically incorrect. You assume what is most likely. Not arbitrarily one thing in the absence of proof to the contrary.

That is how you choose between vaccinating the most likely to die, versus the most likely to spread.

If the vaccine prevents spreading, then vaccinate the most likely to spread.

If the vaccine only prevents dying, then vaccinate the most likely to die.

This is NOT complicated. Virtually all vaccines of other diseases, prevent one from spreading the disease against which one is vaccinated. So the most likely scenario is that the COVID vaccine will prevent spreading.

If that is the case, then vaccinating one grocery store clerk -- as in Valhalla's scenario -- could save hundreds or thousands of lives, versus vaccinating one nursing home resident, which might save one life. If this is the case, obviously vaccinate the grocery store clerk.

People, this is policymaking 101. Save the most lives, do the most good, with what you have. Be logical and rational.

[Dockhead]

Originally Posted by Singularity

In my opinion the above observation is not consistent with expert opinion, math modeling that Goboatingnow well described, nor consistent with WHO vaccination modeling/guidance as cited below.

It's otherwise not consistent with tradition best practices in infection disease management where the worst is first assumed, while at least the Oxford vaccine trial found nasal shedding during animal testing (where the animals where quite loaded with inoculum such that the viral load in the animals might have been inordinately high).

Young superspreaders are harder to target such that providing limited vaccine in the younger age group is akin to firing a couple shells of birdshot into a stadium full of people hoping that you hit the right people. <---makes no sense

Model-informed COVID-19 vaccine prioritization strategies by age and serostatus
https://www.medrxiv.org/content/10.1101/2020.09.08.20190629v2.full
""A highly effective transmission-blocking vaccine prioritized to adults ages 20-49 years minimized cumulative incidence, but mortality and years of life lost were minimized in most scenarios when the vaccine was prioritized to adults over 60 years old.""

Doing the Touchy Math on Who Should Get a COVID Vaccine First
Mathematicians model pandemic scenarios by plugging thorny ethical and logistical issues into calculations
https://www.scientificamerican.com/a...vaccine-first/
""The consensus among most modelers is that if the main goal is to slash mortality rates, officials must prioritize vaccinating those who are older, and if they want to slow transmission, they must target younger adults.

“Almost no matter what, you get the same answer,” says Harvard epidemiologist Marc Lipsitch. Vaccinate the elderly first to prevent deaths, he says, and then move on to other, healthier groups or the general population."


WHO SAGE Roadmap for Prioritizing Uses of COVID-19 Vaccines in the Context of Limited Supply.
https://www.who.int/docs/default-sou...rsn=bf227443_2

It's an empirical question. ""The consensus among most modelers is that if the main goal is to slash mortality rates, officials must prioritize vaccinating those who are older, and if they want to slow transmission, they must target younger adults."

As I wrote.

In the long term, slowing transmission MIGHT reduce death in the long term. It's an empirical question.

[Singularity]

Originally Posted by Dockhead

Logically incorrect. You assume what is most likely. Not arbitrarily one thing in the absence of proof to the contrary.

That is how you choose between vaccinating the most likely to die, versus the most likely to spread.

If the vaccine prevents spreading, then vaccinate the most likely to spread.

If the vaccine only prevents dying, then vaccinate the most likely to die.

This is NOT complicated. Virtually all vaccines of other diseases, prevent one from spreading the disease against which one is vaccinated. So the most likely scenario is that the COVID vaccine will prevent spreading.

If that is the case, then vaccinating one grocery store clerk -- as in Valhalla's scenario -- could save hundreds or thousands of lives, versus vaccinating one nursing home resident, which might save one life. If this is the case, obviously vaccinate the grocery store clerk.

People, this is policymaking 101. Save the most lives, do the most good, with what you have. Be logical and rational.

I agree with the bolded section and I kindly ask that the logic and rationalization schemes that guide expert opinion (cited above) be taken into consideration.