Do you have a dumb question that you're kind of embarrassed to ask in the main thread? Is there something you're just not sure about?
This is your opportunity to ask questions. No question too simple or too silly.
Culture war topics are accepted, and proposals for a better intro post are appreciated.
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Notes -
I think you can use this sort of pseudo-science to justify vaccines post hoc. You can also use the same pseudo-science to justify not taking them at all.
I know quite a few people who got lasting side effects from the Covid vax, and it’s nearly heretical to talk about it. (These are people I know IRL, not internet reports) That alone makes me extremely skeptical about anyone saying how there are ~zero risks from any and all vaccines. Why is there a giant propaganda campaign to cover up the risks? Am I just some crazy statistical outlier who knows 3+ people very closely who’ve been vaccine maimed, even though it “hardly ever occurs” in the general population? I wouldn’t bet on that
I would, I guess.
Adverse reactions are going to cluster for one reason or another.
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People win the lottery despite the odds not being in their favor.
If you've bought a ticket, and then you find a million pounds in your bank account, then congratulations, knowing that the odds were stacked against you doesn't mean you've not won.
I know literally zero people who have been "vaccine maimed". I used to be responsible for a COVID ICU before vaccines too, and I can definitely tell you that I saw plenty die of it.
It is far more likely that you are either:
Lying. On the internet, anyone can be a dog, or claim to be one.
Mistaken.
Surrounded by people who are mistaken or lying.
Assuming 150 people you could "closely know" (Dunbar's number as a first approximation), then someone, somewhere, out there in the world will find 3 people who were harmed by vaccines. Because vaccines are not perfectly safe, and I've never claimed that. If you consider people who are mistaken about their illness being caused by a vaccine, then the number skyrockets.
I think the immense propaganda to get vaccinated and stfu should tell you something, and a curious rationalist should wonder why there is this pressure for vaccines and no other medical intervention or medicine?
If I say “I don’t believe in antibiotics, I won’t be giving my kids any” generally people are like “lol weird but ok”. “I don’t believe in braces, teeth with straighten themselves out over time” … “haha ok good luck”
Why is it totally different about vaccines? I believe it’s because there are way more side effects than stated, and pharmaceutical companies make more money than god by mandating they go into everyone’s arm starting from birth. Therefore requiring heavy propaganda and narrative control campaigns.
Last thing I’ll say: clearly you are the type of person who strongly enforces the “right” point of view and socially polices other people’s takes on vaccines. If I had a vaccine side effect and you were my friend, I’d probably be mum about it
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I don't know one single person who had lasting adverse effects from the vaccine. This includes professionally. I do know many with acute effects (including myself).
I've also met a few people who have made claims of adverse effects but they've all been clearly mistaken (typically it involves active mental illness, or sometimes other clear medical causes of the problem which they attribute to COVID).
I'll be real with you, I find the fact that you're being downvoted so heavily rather frustrating.
We're both doctors, and we're not perfect. Most doctors aren't perfect either, but I would expect you'd agree with me when I say the majority of our colleagues are smart, conscientious people who genuinely want to do right by the people who see them.
We've conceded that vaccines have risks. We've pointed out scenarios where vaccination might be technically net positive, but of such minuscule effect that people shouldn't run around screaming because they've missed a shot. We've pointed out circumstances where the calculations change, and that vaccination schedules are made for the whole population, and not just for conscientious upper middle class nerds who take care of their health.
If I was being paid at US rates, you'd bet I'd walk any neurotic person through an entire questionnaire that ticks off boxes and adds up net QALYs for any given vaccine. This isn't really feasible at scale, and mass media is necessarily something that must scale and reach the LCD.
Yet I see more FUD than I want to here. Somehow the whole profession is discredited by covid, even though quite a few doctors would happily tell you that the way the pandemic was handled was far from perfect.
It all strikes me as a gross over-correction. The public should trust the medical field and the US government less because of our errors, but some people are throwing out the unvaccinated baby with the bath water.
I know we've got more than our fair share of contrarians, the Motte encourages their presence, but damn.
We agree mistakes were made.
What follows? And then what?
One option is that people just straight-up stop trusting experts. You don't like that option, for what seems to me to be a number of fairly solid reasons. What's your proposed alternative, and where do you see it being implemented?
Doctors go through lengthy training, but while you can't just walk into a hospital and ask to become an intern, the textbooks are free, and so is most of the research and literature (if you know how to use libgen).
If you can't parse the literature and weigh up the risks and benefits with confidence, then I'm afraid the only solution is to look at people you think are trustworthy and do as they suggest.
There's a reason that doctors tend to be highly paid professionals in almost every country, and it isn't all regulatory capture. (British doctors make above median wages, but nowhere near a free-ish market would settle as we're victims of regulatory capture).
This is because medicine is difficult. It's also the easiest it's ever been, now that so much knowledge and resources are available to anyone with an internet connection. If you've taken high school biology and have an LLM, there's practically nothing you can't theoretically learn given the time and will. This is often impractical, hence why you want to pay someone who doesn't need to do this.
I think a sensible reaction to covid pandemic measures would be to demand governments provide far more evidence to justify a lockdown longer than a month. If it's not abundantly clear that you're dealing with a disease that kills upwards of several % of the population, by the time that period is over, then demand the lockdowns end or violate them in public protest.
You should trust doctors very slightly less, trust governments and government medical bodies quite a bit less, but IMO, if you're at the point where vaccines seem net-negative to you, you've over-shot the mark.
If you really want to, there's always the option of litigation against government officials if you can prove they willfully lied. If they encouraged lockdowns when it became clear it wouldn't help, or overstated the benefits of vaccination (without the benefit of hindsight), then they should be accountable for the harm.
the sensible reaction is Governments don't get to lockdown anymore.
You had the power, you abused it, you don't get the power anymore.
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My concern at this point is not justifying a lockdown more than a month. I believe there is now sufficient backlash on that particular subject.
My concern at this point is what other thing that might be demanded next time.
If I have a pilot who forgot to put the landing gear down, went through remedial training on the subject, and was reinstated, my concern is not so much the pilot forgetting to put the landing gear down a second time. That particular item has been well-established. My concern is moreso "what other things might the pilot have forgotten that weren't covered in the remedial training?" Same idea.
(This is why remedial training often covers far more than just the specific incident.)
Government officials often have immunity.
The burden of proof lies the wrong way for this to help in practice, as all of these are nigh-unfalsifiable.
Of course, if your intent is for this to be a bureaucratic tarpit then your job is done here. I sincerely hope that is not your goal.
Do you have better alternatives? At the end of the day, if you're unhappy with the government, then you need to elect a better government. I presume that it wouldn't be impossible to strip bureaucrats of their immunity if the laws was changed to reflect that. What else could I really advise, that someone shoot Fauci?
In a way, the new Republican government reflects the deep unrest with previous medical policy. RFK isn't a fan of vaccines.
The reason I advocate for governments having the ability to impose lockdowns and quarantines is because pandemics can be highly dangerous. Covid was initially believed to have a ~1-10%% CFR for the first few weeks, and on the higher end, the serious possibility of several hundred million people dying justifies some action be taken. I think a month is enough to narrow the CFR down, leaving aside the primary benefit of reducing spread.
Sure. So can lockdowns.
(How many routine medical procedures & tests were cancelled due to COVID lockdowns & overreactions? How many of those were the same ones that the Medical Consensus(TM) said were hugely important for health? Oh, the Medical Consensus(TM) has since suddenly shifted to saying no, those weren't helpful actually? Oh, the Medical Consensus(TM) has decided to classify all deaths with detectable levels of COVID as solely due to COVID, and now there is no evidence for increased death rates due to diseases that could have been caught via said procedures? How... convenient.)
(Hopefully not overly snippy. I had to go back and tone it down; hopefully I toned it down enough. Still sarcastic; hopefully not snippy.)
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Sidenote: if you've given me a 3sat problem and purported solution, expecting me to solve said 3sat problem just in order to point out that your purported solution does not actually satisfy all of the equations is inane.
Agreed.
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I feel that.
Not sure what to do about it, though.
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The impression I've gotten in my time here is that most people are pretty much just smart enough, with a side helping of tech-bro-ism.
Medicine seems easy/simple from the outside in a large part because most people here are young and healthy and don't interact with the complicated parts of the field. Most people here also don't exist in fields where a lit review is a thing (in a large part because most of the people who do that are far left at this point). A half assed opinion piece is considered an authority and their's no need to read primary source material or contra narrative information critically.
We (docs) also get used to hardcore digging in because of skin in the game. If I pick the wrong medicine my patient fucking dies. That means I'm naturally going to have much more "informed" commitment to my medical views (even when they turn out to be a wrong) than somebody arguing on the internet without significant consequence.
Add in the political climate - nothing I say when defending medicine is going to do anything to separate me seeming like one of "those" COVID people to skeptics.
All those types of things together and more and you get my downvotes and the vitriol.
You should use this as a Gell-Mann Amnesia moment however. As my media diet continues to improve I get access to more and more better primary source material and you see things like rampant factual inaccuracy here on other topics outside of medicine that I've just happened to have been informed about.
We are still pretty good here! But outside of a few reliable posters you'll see a lot of very confidently stated low information stuff being promulgated.
Ultimately most of the people still complaining about COVID are having a tantrum. I get why they are having a tantrum, I was not happy about some of the policy decisions - but it's still a throwing the baby out with the bathwater moment.
Fortunately for my sanity, I've filtered my Twitter feed to the extent that the most profound cases of retardation miss me haha.
This is what irks me the most. Short of going full Dr. Phil and taking up full-blown vaccine denialism, what can I say to people with that mindset and convince them? It's an utter mode collapse, there are certainly people in this thread who have views more nuanced than "all vaccines are amazing and harmless" and "vaccines are designed to turn you into a gay frog", but it confuses me.
I'm rather fortunate that medicine was never this politicized either in India or the UK. There isn't the same degree of digging in of heels and treating arguments as soldiers rather than an attempt to establish empirical fact.
COVID lockdowns were a bust, but even if they'd curbed the disease, I'm unsure if it was worth it if it pissed off tens of millions of people in the States to the point that even basic medical knowledge became untrustworthy.
Do these people not note that there are >180 other countries out there? If vaccines were a scam or net harmful, then you'd find at least a few countries that rejected them wholesale. The only ones without state vaccination programs are absolute basket-cases, and even they have the sense to accept foreign medical aid.
...which was repeatedly stated at the start of the pandemic by people who were later denounced as COVID deniers and largely memory-holed since then.
(I'd love to give references, but for the obvious problem with this.)
I don't necessarily disbelieve you. But the level of justification for lockdowns at Day Zero, 30, 90 and 365 varied significantly.
Remember that in the very early days, we genuinely weren't sure of COVID's CFR, if there's a disease that's spreading like wildfire and you aren't sure it won't kill tens or hundreds of millions, then I think an initial lockdown is sensible. Once it becomes clear that it's nowhere as bad as it was thought, and the primary risk was for old and sick people, then lockdowns should have been lifted. I don't think that this was obvious until several months in, and I was doing my best to stay abreast. There was genuine terror that I and other doctors could catch it, and that it had a very real chance of killing us. I think around 3 months in, I was personally feeling safer, but still worried about spreading it to the elderly members of my family, and still was right up till vaccines became available.
We knew very early from cases like the Diamond Princess what we were likely looking at. Possibly you could argue it was until May 2020, when we had CFR data out of New York that showed kids how severe the age stratification of impact was.
In addition, there was functionally speaking zero support for the kind of lockdowns we saw in Medical Literature. The famous pandemic influenza response paper (written by Donald Henderson - who led parts of the smallpox eradication effort) mentioned how important it was to try to keep life functioning as normally as possible. I still don't understand where the policy came from - it seems like we saw China do it, saw a bunch of people die in NY due to doctors over-ventilating (I think that was a well-intentioned mistake) and Cuomo shoving people back into Nursing homes (honestly, might also have been a well-intentioned mistake), and everybody panicked.
Less charitably, bureaucrats got high on their own supply of people listening to them/convinced themselves they could stop all disease spread (Fauci quite obviously embraced his narcissistic side).
I personally remember my first visit to a new PCP post COVID. Within 10 minutes he was recommending I get a COVID booster, he did not ask if I'd had COVID recently, how my reaction to previous shots had been (heavy acute symptoms after my 2nd shot), or whether the elevated risk as a young male was worth it, it was just "here's the recommendation I will now parrot to you unthinkingly".
I have not been back.
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The problem there is that old people (and the sick as a subset of old) are an extremely powerful constituency in the West. They proceeded to [ab]use that power to carve out a bunch of advantages for themselves at everyone else's expense; hence the hysteria continuing until it was clear the people paying for it had had enough of their bullshit.
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Sidenote: this comes across as patronizing.
If this is not your intent, I suggest attempting to rephrase to better communicate in future.
If this is indeed your intent, I may as well stop the conversation now, as there can be no additional learnings.
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I think an initial plea of "this is looking like it could be a pandemic: please restrict social contact", along with the governmental support to allow people to do so*, would have been a very good idea and would have been sensible in such a case. This is not the same as a government-enforced lockdown, especially one as hamfistedly done as COVID was.
In some ways this is less effective than an outright lockdown; this is far less likely to cause widespread backlash.
Of course, it's now in many ways a moot point. That credibility was burnt; this is close enough that it was caught in the backlash and also wouldn't be feasible now.
[* e.g. government-financed no-questions-asked refunds for travel, decrees that workers must be able to take sick days, vacation, or leave without retaliation for the next X days, that sort of thing. I am overall very much against Big Government, but as long as we're already taking the downsides...]
I think the primary place our calculations here differ is mine includes the time lost in lockdown in the downside. If you lock people up for a hundred man-years to save one person, you haven't actually gained much of anything.
This pushes the tipping point earlier (assuming lockdowns in the first place).
My bigger issue here is that I've heard a growing amount of attempted retroactive changes of the narrative, of the same people who were proclaiming on day 90 that LOCKDOWNS MUST CONTINUE who are now backing off and attempting to say they were saying otherwise on day 90.
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If it makes you feel better you can usually have a healthy conversation about this in real life if you are sufficiently skilled, I've converted anti-vaxxers before, but it's nearly impossible to do online for all the reasons most things with any amount of heat are nearly impossible to do online.
Additionally most people have some things they are absolutely retired about, with many people feeling hopelessly abused by social justice and modern leftist politics they are likely going to be retarded about anything that touches that stuff at all.
I do wonder if some of your surprise comes from being in India during COVID - the way things felt in the UK or US vs India may make for some difference in experience or expectation?
I've never met an anti-vaxxer in person, though I'm not usually in the business of handling vaccinations! I agree that if you establish a good therapeutic relationship, it's possible to make people come around.
India was far more sane about lockdowns. I think ours lasted 4 to 6 months, and eventually the government realized it was economically untenable if nothing else.
We never had an anti-vax movement of note, everyone and their dog was fighting for a shot when they became available.
I actually don't know what it was like in the UK at the time, it wasn't on my radar nearly as much as the US was. All I remember is reading about scandals where Dominic Cummings was caught partying during the same time the government was demanding everyone stay home.
Yeah I think you may have missed the "moment" and therefore would struggle to get into the headspace of some of the angry people. Probably ultimately good haha but people were pissssseedddd.
The people who still are still pissed are going to be hard to convince.
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