The "Omicron" name means people are going to die thinking of a Futurama joke, and not one of the good Futurama jokes.

I've had a similar thought, except my version is: At some point, the deadliness/danger of covid will cross the threshold of deadliness/dangerousness of things we live with all the time - cars, cancer, corporate pollution. At which point going balls to the wall over covid safety stops making sense.

That's not the right episode of Futurama.

I just now noticed you didn't do the OP, but I would have made the same joke regardless.

I guess I've been going to the gym, including the indoor pool, since this summer. I haven't gone to an indoor restaurant since summer though and honestly, museums are kind of boring regardless.

You just put 'museum' there so you looked like a person driven to maintain a broad intellect in tough times instead of a guy who wanted cheese fries while they were still hot.

Availability of oral antivirals, probably in the early months of 2022, will be the game changer for me. Once we have an effective therapy that can be taken at home, I think I'll be pretty much back to normal life.

Availability of oral antivirals

After the first big trumpeting press releases, didn't we learn that for efficacy these depend on speedier diagnosis than we normally get now?

Presumably, an effective treatment would encourage more people to seek medical care sooner.

I wore a mask in the dive bar yesterday, but pulled it down when I talked to someone. I did not make Ace wear a mask.

After the first big trumpeting press releases, didn't we learn that for efficacy these depend on speedier diagnosis than we normally get now?

That seems like a solvable problem, but a bigger issue is that when the full results came out from the Merck study the efficacy was a lot lower than the interim results suggested, for reasons that are unclear. The FDA advisory committee narrowly recommended approval, but there were a lot of concerns about both that and the potential for side effects, which also seems to be pretty unclear at this point. The Pfizer one works differently and may not have the same issues, but the full results aren't available yet.

That said, having effective antivirals available will be a big deal even if the specific drugs are less miraculous than the initially promised.

Obviously kids don't have enough time in bars that they need to be unrecognized by bartenders.

Jammies' mom was driving me a little crazy over Thanksgiving. She is slightly Fox-indoctrinated, but has gotten her shots and her booster. Her primary motivation as a character is to keep the peace, which has gotten increasingly tense since 2016.

The way she keeps the peace on the topic of Covid is to repeatedly just say that she doesn't understand why the government has to get everyone a shot, when they could just be doing monoclonal antibody treatments. Everyone she knows (in her well-to-do circles) has been able to just go get monoclonal antibodies whenever they've needed them! Why aren't we just focusing on that? She clearly sees it as a way to thread the needle between vaxxers and anti-vaxxers, but it drives me crazy, possibly unfairly. Monoclonal antibody treatments shouldn't be a way to let Fox off the hook for brainwashing its viewers out of getting vaccinated.

Why don't they just put the 5g in the monoclonal antibodies? Much more volume so you could make someone magnetic and infertility with just one treatment.

Sure, let's do the expensive treatment instead of the free shot! I can see a case for the pills being a game changer, maybe, except that it's so politicized that people won't get tested to own the libs or something.

Kids' second dose is tomorrow and if Pebbles does not get superpowers or 5g she is going to kill me because the shot is not worth it to her. "It's just like the flu shot" "I don't like that either."

I really need to schedule my booster, but I still can't be sick voluntarily

My KN95 is way more comfortable than the cloth masks I wore before. I'd really like to get kids 6 months and up vaccinated and much higher levels of adult vaccination before giving up precautions - but I still think we have a duty to slow transmission as long as there's a chunk of people (kids) who are not eligible for protection.

I also want to be able to get diagnosed and treated quickly and easily were I to get it. I'm not confident in my ability to do that now even though I work for a major health system.

I've also come to think that we tolerated way too much death due to the flu and this reflects badly on us as a society. Better flu vaccines and greater immunization would help. But there are also things that would not be felt as individual precautions that could help a lot which I think we should keep doing or start doing. Like public buildings should have better ventilation and air cleaning, including things like disinfection with far UV-C light.

It's been interesting to watch the evolving understanding of airborne transmission and the importance of ventilation as this pandemic has unfolded. It would be a good outcome if COVID forced us to clean up indoor air the way cholera (eventually) forced us to clean up indoor water.

The OP matches my feelings -- I'm still not reducing precautions at this point, but I'm certainly thinking about the question of, "what is the right long-term strategy."

I do think we need another round of discussions about how to prioritize interventions from, "here is what everybody should be doing as much as possible" to, "these are good practices, but there's flexibility, not everybody needs to do them all the time."

From my understanding vaccination is the easiest intervention that should prioritize for everybody, and cloth masks have value but are probably more at, "might as well be flexible about mask wearing because that doesn't alter the overall risk level very much."

But what goes in between those two, what should be more encouraged than it is now -- regular testing? Specific policies to implement planned short-term restrictions when local case counts are high? Easy access to anti-viral medication?

I'm not sure.

18: You aren't allowed to poop in the outdoor water either, usually.

I basically haven't taken any precautions by personal choice (I follow the rules of my county and employer, of course) since July or so. Though this weekend we're hosting a party and decided to have it outside, not really as a personal precaution but so as not to make things too awkward for guests with different levels of comfort. We've had smaller indoor gatherings without masks for up to 8 or so people who are all one friend-group, but this'll probably be more like 20 and some guests won't know each other. Of course lots of general precaution creeps in, like one of the committees I'm on meets by Zoom, and some of my students still prefer Zoom meetings. But I've been dining indoors and going to coffee shops pretty regularly since the summer (slowing down a little at the peak of Delta), I've travelled internationally, we've started going to pub trivia again, etc.

I suppose I am even more careful about avoiding republicans than before, but that's a precaution that I can take for the rest of my life. I'd already stopped setting foot in churches outside of weddings and funerals, but I think now I'd avoid going to an evangelical wedding unless it was immediate family. That's sustainable forever though, and Trump had already got me most of the way there.

16: I'm going tomorrow. Tim had to cancel his because of a work project. Really different attitude from the spring. I almost snagged another for him next Saturday, but we'll have to wait until the 18th.

19: Vaccination (including boosters, probably annually), increased ventilation standards (including windows that actually fucking open), rapid tests when symptomatic (if we had rapid tests), actually taking time off work when sick, and wearing masks when having symptoms or in care facilities. Maybe required masking indoors in public when new cases go over 75/100K? I think that's about it.

cloth masks have value but are probably more at, "might as well be flexible about mask wearing because that doesn't alter the overall risk level very much."

Cloth masks also have value as anti-vaxxer repellent.

24: When you say care facilities, do you mean nursing homes. You still have to wear masks in outpatient hospital practices, and a I know plenty of staff would like to be free of them.

There was some study which showed you were more likely to get the flu if you were seen in your doctor's office within a few days of a patient who had flu. As Teo said, we've been following drip,et precautions for all of these viruses, and it was probably wrong.

Right now, I know of clinics that are seeing COVID potential patients in negative pressure rooms. Others are just cleaning the room between patients. So you could go to the doctor to get tested for strep (taking off your mask in the process) in the same room where a COVID patient was examined and walk out of the encounter infected with COVID. I don't think that's ok.

increased ventilation standards (including windows that actually fucking open)

At work we had great ventilation during the summer when we did open all the windows, but not so much now that the windows are closed.

Right, nursing homes and hospitals for sure. Probably oncology practices? I have no strong opinions beyond that.

There is absolutely no ventilation except through the door in the bathroom at my office. It's really unpleasant even without covid.

Especially if you think cholera is spread by miasma.

My office has windows that open (though not all of them actually function). Not a great time of year to be opening them, though, especially since it's been unseasonably cold off and on for the past few weeks.

cloth masks have value but are probably more at, "might as well be flexible about mask wearing because that doesn't alter the overall risk level very much."

really?!

Cloth masks do some good, but not that much. Booster without masks is obviously better than masks without boosters.

Looking at the numbers at microcovid.org (as good a starting point as any) shows a bigger effect than I would have guessed (the Bangladesh study actually reduced my estimate for the effectiveness of masking -- so take the numbers below as a best case scenario and that real world masking will probably be be less effective.

Wearing a thick cloth mask reduces your risk by 1/3. If the person you're interacting with is wearing a thick cloth mask that reduces your risk by 2/3. So if both of you are wearing good cloth masks the total risk is reduced by 7/9 (~78%). Having a properly sized in-room HEPA filter reduces risk by 75% (again, using the microcovid numbers). So they are actually similar in impact.

But, HEPA filters are passive (from the perspective of the people in the room) and masking requires active participation, so there's some advantage for ventilation.

But, honestly, if you believe the microcovid estimates that's a pretty good argument in favor of masking.

25: so true.

28: Primary care office in the community? They'll drop it at some point unless you're a symptomatic patient.

33: when I wore a cloth mask, it did have filter layers, but I know the rewashabke ones are not as good. I also had pm 2.5 filters and put in a filter sheet. Not just wearing a T-shirt. Though very early on SP sent me some home-made cloth masks. I saved one as a souvenir.

I think those numbers are wildly over optimistic for real world usage.

37 -- I agree, in part because people don't _want_ to put in the effort to wear good masks and wear them correctly.

But, FWIW, here are their sources for those numbers: https://www.microcovid.org/paper/14-research-sources#masks

17, 18, 34, etc.: Unfortunately, while good ventilation is frequently preached, it's hard to do. Mechanical codes require a certain number of air changes per hour (usually 2, more in health settings) and set minimums on the amount of outdoor air. But the way that projects are built fight optimization-- during building construction, the owner usually doesn't know who the tenant will be, and what their demands are. (They often know generically... the space is set up for offices, so install office level ventilation, etc.) It's also something that rarely comes up in negotiations, so it's an easy corner to cut.

When someone is looking to lease a space, it's like pulling teeth to get any concrete information from the leasing agent, beyond gross square footage. If something's new or newly replaced, the owner might choose to brag about it -- but most owners don't want to reveal that they keep repairing units from 1980 instead of modernizing every few decades. Similarly, most leases shove all repair and maintenance costs for the units on the lessee-- in practice, a big spend might be partially compensated by a few months of reduced rent [negotiated on the fly], but you'll always pay more for a unit than you'll get credited in rent. And, of course, at the end of the lease the unit stays with the building, so the lessee has little incentive to overbuy, unless they're in quite a long lease. (After all, make the mechanical unit too good, and the owner will use that as a selling point when it's time to consider rent increases... since it's something they can brag about to the next tenant if you don't work out.)

The solution is probably to get infectious disease experts to testify in mechanical code adoption hearings, to increase the minimum outside air or air turnover rates for various occupancy types. But that's a very long game, with the biggest impact on new construction and little impact on existing homes and businesses.

39: the engineers who study this are saying it's airborne. Infectious disease docs often say it's droplet. I think you could have HEPA filters with UV- c light in doctors' exam rooms, but you would need to mandate them.

There 's an epidemiologist on twitter from Toronto ai follow whose Twitter tag line says : "Air: it's the new poop." I think we need regulation and campaigns to make air quality in schools and other public buildings better. As well as public transit.

"Air: it's the new poop."

She who smelt it, dealt it.

heebie: I sympathize with you. [I'm 3-shots] I was rabidly careful, isolating for most of the time since Mar 2020, not stepping inside a foreign building for vast lengths of time ..... until the 2021 Election. But since that day, I've been going to the gym, taking public transit, and going into grocery stores. I always mask up (N95 gatapack mask) and am always careful, but I'm no longer isolating. B/c "there are more important things at stake, than not getting a covid infection, and we can't wait forever because of that."

I'm not there yet; we're still mostly hanging back. Not that that's really that much of a stretch, is kind of the problem.

We are traveling for the first time soon, for Christmas, and I was rebuffed when I suggested that a multi-family get together on Christmas Eve should have people rapid-testing in advance. I'm kind of angry because I thought it was a totally reasonable accommodation and people in my electronic social bubble mostly seem to agree. Does that seem like crazy talk to the more relaxed folks? The host said "Everyone's vaccinated, mostly boosted, and this is a clean area" ["clean" rubs me all kinds of wrong ways].

We won't do tests, but this year the combination neti pot/gravy boat will not be used.

Nathan: I know someone who went to T-day with their fam; estranged dad shows up from a different Red state, he's antivaxx and covid-positive but doesn't tell anybody till later. So this someone and their spouse are testing, waiting, etc, etc.

100% you should demand that everybody take tests. 100%. And if they don't, you shouldn't go. It's the *least* they can do, the *least*. Anybody who refuses, is by construction a danger to your and your family's health.

I guess I've succumbed to covid fatigue before most of you. Got my 3 shots, but I'm wearing a mask only when I have to, and going/doing whatever I want. Which isn't exactly high risk -- and actually, I did decide not to try to get a ticket to the big football game a couple of weeks ago. Outdoors, but plenty of unvaxxed folks, and masks probably pretty thin on the ground. We're having plenty of cases, but it's the bullheaded unvaxxers that are bearing the brunt of it.

CharleyCarp: From where I sit, this is the morally acceptable position at this point: do what is mandatory, but after that, only if you feel like it. B/c 20% of our population (more, in some areas) is simply not onboard for the win. We can't continue forever trying to make up for their perfidy.

And clearly nobody is going to make the vaxx mandatory. I mean, it's a free country.

that last sentence was supposed to be in sarc font. Ah, well.

Got my 3 shots, but I'm wearing a mask only when I have to, and going/doing whatever I want.

This and I'm somewhat exasperated by the thought of doing more. My friend thinks Omicron will mean another lockdown, but once Steady has his second shot, I'm done. That was the point of getting vaccinated.

Megan: I'm there, too. Though, if vaccines are made mandatory (no religious exemptions, either), I'm 100% ready to accept lockdowns while they go house-to-house to inject the imbeciles. Otherwise, yeah, I'll do what I need to do to protect myself, and that's it.

Someone on Twitter called the (adult) unvaccinated "volunteers" and that seems right to me.

I'm close to Charley and Megan's position. I wear a mask at work, at church, and in shops and when otherwise requested, and I am one of maybe 10% masking. We're not really restricting activities at all - the kids need to learn and it shouldn't be them that bears the cost of adults being too dumb to vaccinate* - but I don't do much besides work, our close friends are all vaccinated and none of us have fragile relatives nearby. It's hard to see the point.

*My dad has not vaccinated and Pebbles has WORDS for "he is not being very smart. It is not a bad shot."

43: I sent Tim to Canada with a lack of BINAX Now for their Thanksgiving, and his brother did not want to put his then unvaccinated kids through it. BIL is a jerk though, because he led us to believe he would do it but then changed his mind after Tim was already at his Mom's.

Ontario is now sending kids home with rapid tests so that they can all test after the Christmas Holiday. I'll bet he'll do it now, but when I said it it didn't appear mainstream.

49: what about the kids under 5 who can't be vaccinated yet?

43: Also "clean" bothers me. It's like, " we're careful and wear masks, so you shoukdnz'tbbe careful. And I'm explicitly talking about a situation where not everybody is vaccinated. Similar to people who want to have sex without wearing condoms without eating tested for STDs first, because only junkies get STDs.

I've been here for a while, as per Charley and others above. I wear a mask in shops, and on public transport. I'm vaccinated and have my booster booked for a couple of weeks from now. I take regular lateral flow tests, and I've had PCRs a couple of times over the past few weeks because I know I've been exposed to people with COVID. I'm not stupid, and i've avoided a couple of very crowded indoor situations, but, generally, I just do whatever I did before. I go to the pub, I eat out, I go to museums and galleries, I've been on one trip abroad (holiday), etc. I've read some of the past threads here in recent weeks about people's covid precautions and they are just way more restrictive than anything I'm personally prepared to do at the moment. I am meeting some work colleagues for a leaving drinks thing tonight, and I'm doing a lateral flow in advance. This was requested by one of the other attendees, and I'm fine with it. I'm doing them regularly anyway.

I live in London. My wife is working at a school in central London, travelling by tube every day, and her school is full of refugee kids and people living in crowded and poorly ventilated accommodation. I have an 8 year old who is at school all day. That school has just had an outbreak severe enough that it was put in special measures by local public health organisations.

Anything I personally do in terms of precautions is like throwing straws against the wind in terms of my overall exposure to the virus. On top of that, I'm about 60% sure I've had it already anyway.

53: kids under five fortunately get overwhelmingly mild cases. It's less serious than the flu, for which we vaccinate, but don't wear masks or expect people to curtail activities or cancel schooling for a year.

The flu vaccine for kids (was?) is pretty openly advertised as being done to protect the olds because the effectiveness of the flu vaccine is not good in the elderly.

Obviously, we're now teaching kids to say "fuck you olds" in the name of freedom and conservatism, so I suppose flu deaths will start to rise in a couple of years.

I guess it could help keep Social Security funded.

57: I'm reasonably confident the same is true of the COVID vaccine for kids. It's on balance better for them to get the vaccine than it is to get Covid but Covid is not such a risk to them that we'd bother with a vaccine if it weren't killing adults.

I would like to relax a bit but Martha is still petrified. Her sense of self-worth is fragile at the best of times and she's convinced that getting sick would descend into long-COVID kinds of symptoms and disability, and would destroy any or all of the things she manages to feel worthwhile about (this is a kind of internalized ableism, as she will be the first to point out).

Death stalks us all, but long term disability is less universal. It's also financially disastrous to most in America.

I did an NFL game maskless with my son on Sunday. In a week I've got a work function at a restaurant that might attract a half-dozen people (where in a normal year it would be more like 15). I'm triple-vaxed. I go to a sparsely populated office twice a week unmasked. But absent a specific reason, I stay out of the world. No restaurants, for instance, and I haven't had a professional haircut yet.

And I'm not maskless around anyone I don't trust (except for the football game, which of course was outdoors). I have the privilege of working with non-assholes, even though the employer won't mandate vaccines. October was really when I started loosening up.

That's how Larry Zonka broke his nose like 15 times.

60: Covid is definitely more dangerous to kids than the flu and per 100000 kids has killed more kids than other things we do vaccinate for already. Of course kids are safer, but the general expectation is that kids 5-11 should not die of vaccine preventable illnesses and 800 plus have plus thousands of hospitalizations.

We also have a duty to protect vulnerable kids - Down's, immunocompromised. But as Moby says, conservatives are saying f- you to all that,

Some are even going anti mandate for routine childhood diseases. Before I go to Florida again, I might look into getting an MMR booster.

I am pretty firmly in the world of "what will be socially polite, mask-wise?" For example, at the Tejano dive bar I would not have worn a mask if I weren't flying to see my mom today. As it was, I pulled it down to talk, which is obviously not the point of masks but was socially expedient.

60: Vaccine researchers and ID docs I know curtailed their activities quite a bit until their kids were vaccinated and they were boosted. One is still being careful until his toddler is vaccinated.

58: It'll take several years because so many of the people at the highest risk of dying of flu already died of covid, so you'd expect flu deaths to be lower for at least several years.

Maybe I'm thinking about this all wrong, but if vaccination means you have like a 5% risk of contracting Covid if you come into contact with it, doesn't masking just cut that down to 1-3% if it's 1/3-7/9 effective?

I'm in a vaccine-mandatory workplace, and masking just feels like security theater to me at this point. I'm still wearing just cloth masks instead of N95s because they fulfill masking requirements more comfortably, and that extra couple of percentage points doesn't matter much to me.

66: And around here it might go the other way. The polite thing to do would be to wear it in public even if you felt fine. Some places have mandates in public buildings - generally the places with high vaccination rates. And in others most choose to. I think it's a good thing to keep up through this winter in pharmacies etc.

Other areas that are less liberal have given up. Our cases and wastewater prevalence are going up A LOT. Hospitalizations have not been this high since February. The majority of the hospitalized are unvaccinated but a good chunk plus percent are not (probably not boosted though). I

Spike - NH is on fire with Covid.

69 is roughly right for Alpha without boosters, or for Delta with boosters. But for Delta without boosters you had nowhere near that level of protection against infection. The big question is whether boosters are enough to give that kind of big protection against Omicron infection, or whether we're back to like 60% protection.

The power law applies to reducing risk, of course. And reasonable people are deciding that the work of getting another 1-2% risk reduction just isn't worth it. Not worth it to them, not worth it for the diffuse benefit it gives society as a whole. You can decide different but given that people here are chiming in with 'nope, I'm doing what I'm gonna', epidemiologists should realistically accept that baseline rather than pleading for more or trying to re-explain the cost-benefit analysis.

It is easy for rude people like me to suspect that the people pleading for more caution just underestimate the costs because they personally experience them differently. I don't like isolation; I don't like a small constant incremental burden (of tracking and carrying and wearing masks) even as I can completely acknowledge that it is small.

I'm cool with saying that for me personally, the costs of losing things like fun and socializing are too high. If you want to cast that as frivolous, that's fine, go ahead. But. Even if the only thing that matters is public health, the costs of extra COVID caution go both ways. As of yesterday, I've lost two men in my life (not terribly close) to death by suicide this year. In the first, COVID isolation was an explicit stated cause. I'm nearly certain of the other as well. And the weight gain from COVID caution?

My kid is sweet and compliant and wears his mask easily. But he wants to take it off and I dearly hope that when his school is 100% vaxxed, they will. (I do not care enough to get involved in the decision.)

So yeah. I'm done. I don't care enough about diffuse risk to other vulnerable people enough to pay any higher personal costs (after 3x vax, masks indoors). Telling me more about them won't change that. Make of that what you will.

Just got boosted with Moderna.

69: SP - I agree with 71. If you're boosted, I think you're at 90 plus protection against symptomatic Delta disease. At this point though we have to think as 2 mRNA as the prime.

65: Look, my kids are vaccinated. We're also cautious around the younger kids in our social circle. I'm not saying 'fuck you' to anyone -- but I don't think it's reasonable to mask or curtail all activities forever. So, not forever. Fine. So the question then is, where's the point where we more or less go back to normal?

My sister's family contracted COVID over Thanksgiving. The adults are vaccinated, the kids aren't yet. Baby probably brought it home from daycare. Everyone, fortunately, is fine (sister's proactive testing kept them all from giving it to unvaxxed grandparents), but the 8yo who didn't contract it somehow or cleared it too quickly for the tests is it going to miss probably a month of school because every day he doesn't get it from his sister counts as a brand new exposure, so his 'clock' starts December 6th for an illness that ran lightly through the family in about 72 hours. If he'd tested positive when his parents did he'd be back at school sooner. I get the reasons for it now, but this is a genuine cost.

74: I would say at an absolute minimum when the a month or so after the 2 and up are vaccinated but would prefer to wait until a month after eligibility opens up for the 6 months and up.

Deaths below 50 a day nationwide. Ideally paired with 80 plus percent vaccinated. But basically a combined process and outcome measure: everybody has had a chance to be vaccinated and deaths are way down. I also want vulnerable people to have easy access to treatment. Like, if my boss the kidney transplant patient could take a quick point if care Covid test and have a script got a pill or an IM monoclonal shot as easily as we can get treated for a UTI now, I would be ok with dropping precautions like masking in public, essential places (pharmacy, grocery, government buildings).

Yeah, I was just going to say that the other turning point for me will be when testing positive for Covid, even if the case is mild or asymptomatic, doesn't cause a ton of avoidable hassle and irritation for immediate family and people around us: having to quarantine, having Elke miss school for arbitrarily long, try to get the positive family member separated from the others to the extent that it even seems worthwhile, etc. Maybe over time I'll become more sanguine about that.

After my second Pfizer dose at the end of April, I routinely wore a kind of useless cloth mask for my (quite limited) trips into the world beyond my house. In cases where I was seriously concerned, I'd wear a "real" mask. But it wasn't at all the same level of concern as the pre-vaccine era. If I had even mild respiratory symptoms I'd get a PCR test. As far as I know, I never got infected, and I think we ate indoors at a restaurant all of one time.

74: I think that's awful and completely support Test to Stay, i.e. daily rapid tests to keep exposed kids in school.

Megan, truly sorry for your losses. Jesus.

Neither were very close. I'm surprised and nostalgic and sad for them. But they aren't acute losses to me now.

Thank you though.

77: Yeah, it's just a mess of the protocol not accounting for the exposure coming from within the house continually. They can get rapid tests, but the rule is 7 since exposure plus negative test with no symptoms, or 10 days post infection plus negative test. So, baby niece gets it (we think, but she didn't test positive till much later but she had the sniffles first), gives it to her parents, who are the first positive cases. 4yo and baby test positive a few days later, so her clock is ten days starting from the Friday after Thanksgiving. Ten days for her is Dec. 6th, but that's then the last date of exposure for the asymptomatic 8yo. Keeping him in his room to avoid exposure for three weeks is inhumane, so of course he's been exposed. Sister is fighting with the district a little over this and I think they're willing to let him back with a negative test and no symptoms on the 6th, but the policy just clearly wasn't designed for unending waves of kid crud.

75: We're not going to get below 50 per day nationwide. Utah alone is a fifth of that. Part of the reason I'm kinda done is that I can't see major vaxx uptake in the 0-4 population here (5-12 is already slow), and rural Utah is basically a Herman Cain Award at this point. I'll wear masks as long as it's prudent (they're not mandated at the university and at least 20% of my class was out with COVID this semester) but if the kindergarten rules change so that vaccinnated kids count as masked for the purposes of exposure/closure, then Pebbles is done. She hasn't seen a teacher's face in nearly two years now, and I'm not at all confident that they're doing much good. (No mandate, so it's sort of up to the 5yos whether they wear it, and so far the masked side has the advantage of peer pressure.)

80: We'll get there one way or another. It just depends on how many people die first. But getting the high vaxx rates may not be possible. I want eligibility for younger kids before we drop precautions here. I'm hoping schools here will mandate the vaccine. Last year for the fall, flu vaccines were mandated for students, so it's not without precedent.

I also think it's really important fir vulnerable folks to have easy access to treatment quickly.

I'd like my local restaurants to have vaccine passports.

For now my church (and our entire diocese) has an indoor mask mandate. They dropped the sign-up requirement. Tat was to allow contact tracing. I suspect that one of their requirements for dropping it will be broader eligibility for vaccines. They've been very clear that they can't check parishioners vaccine cards at the door. Maybe choir members have to be vaccinated? And we still offer ZOOM worship.

Our diocese has a sign on every door reading (from memory) "The bishop asks that all parishioners who are able get a vaccination and that all attendees wear a mask regardless of vaccination status." Despite the whole thing about listening to bishops, only about half are masked.

80: We'll get there one way or another.

Not necessarily. Trevor Bedford had argued* (before Omicron) that continuing mutation could mean a steady state of 50-100K deaths/year (~150-300 per day). Which sounds like a close to a worst case scenario in terms of keeping the argument going between, "continued restrictions" and "I'm done" for a long time.

Sympathies, Megan, that is sad.

It is interesting the way in which the experiences we seen in our circles are anchoring reference points for how we read the data. My partner has a good friend who's had a really rough long-covid experience and, for that reason, is particularly cautious (I'd be fairly cautious anyway, but that is definitely pressure for me to be even more cautious).

* In the end of this talk (video) around the 38 minute mark.

Link to (very interesting) Trevor Bedford presentation on tracking COVID mutation -- here.

People sometime take them off if they are at a lectern. It looks like the choir director does that too. There's one jerk in the choir who has a blue surgical mask but wears it around his chin. He's probably in his 60's or 70's.

They always take them off on the lectern and always wear them when distributing communion.

To the OP, I am conflicted because I get the impulse, but also accepting an endemic COVID as a new row in the annual cause-of-death tables makes things much worse permanently for a lot of immunocompromised people and people with other conditions.

If the better treatments pan out, maybe we avoid social chaos from that decision (e.g. full demasking doesn't overload the hospitals), but the people who do die are not just the unvaccinated.

People take one off one at a time to eat their wafer (no wine except for the priest). I wait to go outside before I take my mask off.

I meant that the priest will mask up for communion, not the parishioners.

SP and Nathan - if either of you are reading, I sent you e-mails.

87: Wait until you find out about the rest of our health care system.

Anyway, there's a political cost associated with federal and state mandates and some political outcomes that are more likely if covid restrictions are tight are probably more deadly for the immunosuppressed.

87: there's zero possibility that that row isn't going to be there. It's just a question of how much continuing efforts there are to keep the numbers in that row say 25% lower.

It's not just covid. Public health has been undermined enough around the world to the point where I think it's a safe bet that overall deathiness will rise, especially for infectious diseases as a class.

what's interesting to me is how much of this general "i'm done" response is attributable to children largely being spared severe disease & the virus pre-omicron not being v good at reinfection. if omicron or another variant causes more severe disease in children and/or is better at reinfecting would people here shift their behavior?

i don't understand the resistance to masking indoors where service workers have spend their working days around the undifferentiated public. just seems like a shitty move.

& i'm fine with continuing what i'm doing now* for quite some time bc not interested in providing a host for the bastard to replicate & potentially evolve into something worse.

*mask when indoors public spaces except for when showering at swim club, heavier duty when traveling by air which have to do for work, otherwise working from home, avoid eating inside at restaurants (unless work requires it, wouldn't do it for colleagues but would for clients), small gatherings (including indoors) with family & friends when all eligible vaxxed & bc anyone with any symptoms excludes themselves & their household proactively & i trust them to do so. would also rapid test before gatherings except they aren't available here in any reasonable way. have had one cold - isolated until got a neg test result.

I once shared an office with a guy from Pakistan. He was explaining to me how he had to bring pornograpgy when he went home because his brother was a high-ish official. No one would believe he could not carry porn through customs or that there was any reason not to do so except fear of arrest. So they'd get mad at him (or his brother) for holding out. More topically, he was explaining how Hep A was just a thing that you got from time to time because they people who cooked your food couldn't avoid it

I do always wear masks when the service people do, but I admit I see it more as reassuring them I'm not going to be an unnecessary pain in their ass as opposed to disease prevention. I'm very glad my work keeps canceling all planned trips even though expensing dinner is one of my favorite things.

They are very much exposed through customers, but I figure my vaccinated, non-social self isn't a meaningful additional risk given what else goes on.

What really annoys me is that no one will publish thresholds for changing cautiousness that businesses and schools can then responsibly hang on to. 10 cases/100K/day triggers mask-wearing, below that you're clear? Great. Whatever. I just want us to have a metric and to be transparent about it.

I was responsible for polling the math department about whether they wanted to keep the mask mandate going next semester. They all do. I do not. When they announced kids could get vaccinated, I stopped harassing my students about wearing their masks over their nose. I still wear mine correctly but it was putting me in this adversarial relationship and it was enough.

87: I don't think there's any way short of time travel that this isn't endemic, unfortunately.

95: when the facts change, I change my mind. We'll know more with omicron (persei 8) in a couple of weeks. But right now, I'm lacking confidence that masking is doing all that much compared to vaccination or just avoiding crowds. We're pretty close to a pre-COVID life except that we don't do anything indoors with the kids other than their gymnastics classes (I am the only one in the facility with a mask, and people are fine bringing their babies -- at what point do I need to keep acting like I'm the likely problem here?) piano (one on one with the instructor, everyone masked) and school (no mask mandate, so not clear on the point...)

I believe, and will say once again with feeling, that the social costs of the lockdowns, restrictions, controversies and mostly right-wing politicization are so much higher than we have been able to assess. It's not limited to extreme cases like suicides. I wonder how much generally liberal people's frustration with the collective action problems of the pandemic is loaded to the breaking point with frustration about every other equally urgent collective action problem. It's hard for me to separate them: there's so much amorphous sense of oppression and fear and pessimism.

To be clear, I wasn't exactly aware of how bad the lighter cloth masks were when I opted to wear them, I have been wearing my better mask lately including right now, and I am a pretty fast grocery shopper. I am also clearly going insane from isolation and it's bad.

how much of this general "i'm done" response is attributable to children largely being spared severe disease

In my case, virtually all. If this were measles or even Zika-like, I'd have been ten thousand times more careful. So long as kids aren't getting bad sick? Eh.

If it mostly killed kids, I'd have gone to my dad's cabin in literally February of 2020, before it arrived.

I agree it's likely to be endemic, but it could be endemic at 5 deaths a day or 500, and I feel like we're going to settle for the latter.

What really annoys me is that no one will publish thresholds for changing cautiousness that businesses and schools can then responsibly hang on to.

The Bay Area public health officers got together to do this! One of the criteria is subjective ("COVID-19 hospitalizations in the jurisdiction are low and stable, in the judgment of the health officer") but the rest are objective.

I feel like 500 deaths a day would be a win.

Our current local mask mandate also has objective criteria for scaling back:

The public health emergency does not end until either (1) crisis standards of care are ended at two of three local hospitals for 14 consecutive days; or (2) there is no longer substantial or high community transmission per the CDC for 14 consecutive days.

99: Serious question. What would you do if one of. Your students was vulnerable or had vulnerable family and came duo to you and told you the poor compliance made them uncomfortable? Would you change how you talked to your class about masks? If not, what would you tell the student who came to talk to you about it?

105: " (2) there is no longer substantial or high community transmission per the CDC for 14 consecutive days." isn't likely to happen anytime soon.

That sounds like a reasonable standard but, for better or worse, the CDC has set a fairly aggressive line for what it takes to not count as "substantial" transmission.

Zika is bad for women who get preganant and their fetuses. Is it bad for kids?

Kids who's parents have died will suffered terrible trauma and lasting problems. Society could have supported other people - done more to help people with substance use issues avoid overdose. Wearing a good mask at a drugstore or grocery store or on a bus is not what led to those suicides or overdoses.

I am also clearly going insane from isolation and it's bad.

I would have predicted I'd be well-suited to isolation, and I haven't been isolating all that much, since there's the kid. But I definitely would have handled isolation a lot better in a bigger living space. Psychological issues aside, it's hard in a practical way to isolate when you're tripping over people and new things.

106: Actually dealt with that last year. Rising cases made student uncomfortable due to immunocompromised mom who was told by her doctor that COVID would kill her in her condition (cancer.) I livestreamed the class so the student could participate virtually, because even with a mask mandate we couldn't ensure safety. This year, with no mandate, I'd probably do the same. Begging students to be considerate when the legislature went out of their way to ensure we couldn't mandate masks simply won't work.

5 deaths a day (in the US I assume?) seems wildly implausible to me. I don't think there's anything at all we could do that will get it to that level. Baseline pneumonia deaths are a little over 100 per day. I expect once everyone unvaccinated has gotten covid we'll end up at something and average of 50 deaths per day, with the pessimistic case being more like 100-150 per day if we get new bad variants annually, and the optimistic case being more like 25 if immunity ends up lasting longer once covid explores most of the variant space. Maybe we could change that from like 50 to 40 by masking forever.

It looks like Omicron isn't really blocked by earlier variants, though I think nobody knows how deadly it is yet.

Spike - NH is on fire with Covid.

It very much is. We had done relatively well with covid up through this summer and then everybody gave up.

We have the lowest vaccination rate in New England, and people are spending time indoors now because its cold. Our local hospital is out of ICU beds and patients are stacking up in the ER.

I guess its not shocking how we got here. There has been very little effort to do vaccinations in schools, vaccine mandates have been banned from public organizations, including municipal governments and the state university system, and at one point the state refused $27 million in federal vaccination assistance. We ended up accepting $22 million a few weeks later, but those few weeks were very costly.

Every city and town is on their own as to whether to have a mask mandate or not. We are trying to pass a mask mandate (again) in our city but its taking some time because we can't shortcut the process or it would face legal challenge. There has been a lot of resistance to the mandate from the Free Staters and also from owners of downtown businesses who don't want to be the ones to have to ask the Free Staters to put on a mask.

I got my Moderna booster today. I don't feel as sick as I did with Pfizer 2nd dose today, but I could get the reaction tomorrow. I do feel light headed when I sit up. I worry ai'd be totally wiped out by COVID itself. Bad colds lay me low too.

106: what Cala said. I'd zoom them in.

Baseline pneumonia deaths are a little over 100 per day. I expect once everyone unvaccinated has gotten covid we'll end up at something and average of 50 deaths per day, with the pessimistic case being more like 100-150 per day if we get new bad variants annually, and the optimistic case being more like 25 if immunity ends up lasting longer once covid explores most of the variant space. Maybe we could change that from like 50 to 40 by masking forever.

If that was the scenario we were facing I'd feel pretty good. But (a) see 83/4 and, (b) with Omicron it doesn't like like we're getting there soon.

My personal behavior / preferences are close to DQ at 95 (except that I'm not working remotely, but don't have work travel or in-person meetings), but I understand why people are hitting their limits.

If the kid is kind of an asshole, use Teams instead of Zoom just to make their life harder.

107: Yeah, we're much more likely to come out of it through the other criterion. Two of the hospitals have recently ended crisis standards of care, so assuming things continue to get better rather than worse for the next couple weeks (big assumption!) we'll probably be done with masking mid-December. The mandate also expires after 60 days without further action by the Assembly, which would also be about mid-December.

I'm still guessing that full mRNA vaccination gives 90% or so protection against hospitalization and death even with Omicron. If there's a big change in that number then that'd change my estimates.

114: Keep me posted. I'm going next weekend for the same booster.

Fwiw my Moderna booster was nothing much, and the second shot flattened me. Much smaller dose.

2nd Pfizer?

I had 1,2 Moderna and 3 Pfizer. 2 was rough, totally knocked me out for a day with a fever and chills. 3 made me tired for half a day but basically fine.

But which day? The day of or after?

Mostly Day after. Two was early afternoon, three was late afternoon. For three the tired time was roughly 20-28 hours after the shot, if I remember right.

Thanks. I'm trying to decide if Thursday will be good.

I was mostly fine, or at least no worse than usual, after all three Moderna shots. Wife and son got Moderna boosters yesterday after Pfizer first and second doses and are moderately under the weather today, but nothing horrible.

In terms of getting past covid, and what stability and an acceptable level of "endemic" might look like, I think "not regularly overwhelming regional medical systems" is something to shoot for.

Two thoughts, after reading this entire thread:
1. it's heartening, isn't it, that so many are strategizing *when* to get their boosters. the idea of refusal is not even within imagining.
2. Fauci said if we get to 100 deaths/day, we can think of the outbreak as suppressed. That's a bad flu year, and that ain't great, but it pencils out to 3 cases/100k/day. But that was before Delta arose, so I don't know if he'd change his mind today.

I haven't gotten a booster yet, but I am planning to soon. I work for the local health department, so I'm pretty sure I can just walk into the clinic downstairs from my office and get the shot whenever. I was knocked out pretty bad by the second shot, so I'm trying to time the booster so it won't be a huge inconvenience if I'm out of commission the next day. I may do it Monday.

"As of yesterday, I've lost two men in my life (not terribly close) to death by suicide this year. In the first, COVID isolation was an explicit stated cause. I'm nearly certain of the other as well."

That is tragic, but it isn't an example of a wider problem - quite the reverse. Suicide rates actually fell slightly during lockdown. See Appleby et al in the Lancet, for example.

"What really annoys me is that no one will publish thresholds for changing cautiousness that businesses and schools can then responsibly hang on to."

Yes. Utterly feckless.

114: I slept a bunch when I got home yesterday afternoon. I had a headache at night and was worried that I was going to get nausea but I didn't. I took some Tylenol in the middle of the night, ate some Graham crackers and (of all things) a prune. I was going to eat an apple but I'd finished them off. I have a bit of a headache but no fever. I even managed to cook dinner last night with some breaks to sit down.

My home inspection is this morning, so I just need to make it through 1 or so. Tim cancelled his, so he is totally lucid. Luckily we grabbed and appt for him on 12/18, because they are booking out here. He"# sticking w/ Moderna because it's easier to get the appt.

Arm still hurts. I've heard that the experience runs the gamut. My co-worker's husband did not have much in the way of symptoms after the 2nd shot, and he was laid low by the third. She said he was hallucinating a bit.

129.2: if we get that level and flu is suppressed, then ok. But we don't need to live with a new normal of double the respiratory disease we had before.

Endemic ertainly seems the most likely outcome, as was the case with flu. But I would expect it to continue to get less lethal even beyond that, since killing your host is a really bad strategy for any parasite. Good news for any descendants who survive climate change.
In theory it should be possible to eliminate it in time, but the political homicidal faction seems determined to prevent that. The only example of an epidemic disease apparently disappearing without intervention that I can think of is the English Sweat, which killed Prince Arthur among many others at the beginning of the 16th and seems to have vanished by the end of it. But nobody knows what that was, so don't get your hopes up.

I had Moderna all three times. The pharmacist opined after asking me "how was the second shot?" that the smaller booster dose and longer spacing seemed to make the booster more tolerable. I'd still planned it for a day when I had nothing the next day.

My second AZ shot laid me out for 72 hours; my Pfizer booster passed without notice. I'm much in charity with Pfizer at the moment. I get the impression different vaccines affect different people differently. Scope for a PhD?

128: But vaccinated people have very very little effect on that. There's nothing we can do that will stop the unvaccinated from overwhelming the health care system. Especially since vaccinated people mostly spend time around other vaccinated people and vice-versa. We just have to wait for all the volunteers to get it.

If we don't want to live with doubling the number of respiratory illnesses what we should be trying to do is largely eliminate *flu*, which is much much easier (though still impossible) than doing the same with covid.

135: covid already has a pretty low death rate and the vast majority of spread happens earlier in infection than serious illness does, so there's just no selective pressure to be less deadly. So far variants have been slightly more deadly. Death rates will go down because of partial immunity not because of evolution.

132, 133: Thanks.

That is tragic, but it isn't an example of a wider problem - quite the reverse. Suicide rates actually fell slightly during lockdown. See Appleby et al in the Lancet, for example

I'm skeptical that it wasn't much higher among select subgroups, like teenagers. Isn't the highest group usually old people, which might not have been exacerbated by lockdown the way high school students were? Anecdotally, our high school had 6 suicides, which is staggering.

142: I don't know if that's the case or not. In our patch we found that demand for child and adolescent mental health services spiked massively once schools reopened after lockdown and then again after summer holidays. That's normal apparently; there's a spike at the start of every term. But that's mostly eating disorders rather than self harm.

I got my Pfizer booster on a Friday evening (first shot was J&J). Saturday afternoon I had that "might be coming down with something" feeling, and was fine by Sunday other than mild arm soreness, which lasted another day.

My experience was Pfizer 1 -- NBD, felt slightly cruddy for a day. Pfizer 2 -- shot on a Friday, wiped out all weekend. Completely flattened for Saturday. Moderna booster -- shot on a Thursday, felt a little cruddy but went to work on Friday. Left work around 1:00 PM, feeling worn-out. Felt really drained that evening, but woke up the next day feeling much better.

137: or different protocols over time. I read that Canada spaces out the doses by eight weeks and I'm wondering if that will be studied as a way of minimizing side effects. I'm boosted but delayed it a month because I couldn't afford to get ill.

Kids' second dose went fine. Pebbles tried to hide under the chair but I caught her and then she didn't notice the actual jab. They're extra noisy this morning but I don't think it's a side effect.

Now the Assembly is considering ending the mask mandate even earlier than the automatic triggers.

I don't know if it's the loneliness or politics but I've been daydreaming about my old hobby of strangling white guys or otherwise contorting their bodies until they yield. Not ready to return, though, as redstate mma fans are probably the most disease-ridden people on earth.

Bostoniangirl: I agree with you 100%, that 100 deaths/day from covid is still unacceptably large. Fauci's point (echoed by other epidemiologists) is that that is a level of death that we as a society have been willing to accept in the past, and hence, that we shouldn't think is outlandish (unlike 1000 deaths/day) or politically-motivated. For myself, like John Cole over at B-J, I think I'll forever more be wearing my N95 mask(s) in all crowded indoor environments. Going ..... now ...... THREE winters without a cold or flu is pretty bloody marvelous, and the price is just wearing a mask? Sign. Me. Up.

Apropos of "sore arm", I got the Shingrix shot yesterday afternoon, and am sitting here with a sore arm, a bit of a temp, a bit feverish. Wondering if I'm gonna get hit with the whammy soon. Glad I got it, and for anybody out there who's over-50 and hasn't got it, go get it! It's a great relief. I have a friend to whom I mentioned this, and he responded by telling me how he got shingles *twice* before age 35. *Twice*. Jesus.

149.1: It's worth remembering that "society" is an abstraction and that the best explanation for the course of the vaccination program is that one side of the political debate decided that a few hundred thousand deaths disproportionately among their followers was a reasonable price to pay to derail the popularity of a narrow Democratic majority. This was successful enough to scare the moderate Congress people into debilitating inaction and they have now learned this is a reasonable action given certain ways of valuing human life.

Moby: I can only vehemently agree. I think that that's why Fauci and other scientists have landed on 100 deaths/day: b/c that's a criterion that preceded all of this madness, and that they know (given the current covid CFR) won't overwhelm our medical system.
It's completely true that the level of death and maiming that some in our society would accept, is wildly greater than that, and that's .... a pretty horrific thing to learn about our countrymen.

What I'm trying to say is: there's some level of death that we as a society *should* accept: there are other things that kill people too, and at some point, covid will be less of a risk than many of those other things. The level we have today is ..... way too high. I'm willing to accept the reasoning behind choosing 100 deaths/day, even though I would continue to practice countermeasures.

I'm not disagreeing with that except in the magnitude. I don't think 1000/deaths a day is outlandish. I think it's where we'd be right now if the vaccines were just a bit less effective and where we still might be depending on evolutionary and political events we can't control. 100/deaths a day would be a huge success.

Covid doesn't care whether you "accept" 100 deaths a day or not. The long term death rate is going to be basically the same no matter what you do. There's some uncertainty in terms of how well it will reinfect and how often, but we have no say in that.

Moby: I took a look at 91-divoc just now, and .... hooboy, looks like (7-day smoothed) deaths are going up like a rocket. A. Rocket.

153: I can't change the whole country, but I would like to work on upgrading indoor air. There's a lot that can be done. Whether there's political will is the question. And there probably isn't nationally, but in my own state, I could work on ventilation and then maybe we could get to a place of minimum indoor air quality standards.

Those kind of things might be able to change 100 to 50 or 200 to 100. But you're not changing 100 to 10 through better ventilation regulations on new construction.

How many people died before we got vaccines was a genuine question we genuinely could do stuff about. How many people die per day during the endemic phase is not something we have much say in. It depends on facts about covid, immunity, and vaccines, but doesn't care much about what we do within the feasible options.

When we start talking about 100/day vs. 20/day, we're talking about very serious restrictions and tradeoffs. 100/day we might get to through vaccination and conscientious masking indoors. And upgrading indoor ventilation would be great!

But 10/day probably requires shutting down schools and air travel and gyms and restaurants and swim clubs, and that also has societal costs. Something like half of Utah students never even logged in when schools went online. "Sorry, kids, we can't educate you because we have to make sure that people with access to a free vaccine who refuse to take it or any other precautions around their vulnerable family aren't at risk of catching it" is not a winner. My kids are mostly fine but they're the sort that would teach themselves to read from a discarded CVS receipt and we have enough outdoor activities that they didn't really notice that we skipped all indoor entertainment for a year and a half. Kids who need special ed or extra help or just don't have a spare philosophy professor lying around the house are in a lot worse shape and I'm already seeing the effects at the college level.

158: I don't think we disagree that much. I think a certain amount of masking in certain settings should remain the norm. I'd also hope that we could get some vaccines that block transmission. With flu, we have crummy vaccines and poor uptake. These are way better. At leas locally - I'm going to push for vaccine mandates. In schools certainly.

I think things that were not done - like rapid tests 2x week for workers in long-term care, coupled with paid sick leave could do a lot to protect the most vulnerable. My hospital helped some of the SNFs with infection control during our surge, and what I've heard is that their standard of care was pretty terrible. Those things would have a cost, to be sure, but nothing that can't be overcome, and it would go along way toward protecting the most vulnerable.

I still want cheap, reliable testing. My sister caught their case of Covid because her husband was willing to wait three hours in line for a rapid test the day before Thanksgiving. Most everyone else probably would have assumed it was the sniffles and then gone ahead with the plans. Kids pick up SO much at school and it's nearly impossible to get quick tests if one doesn't have a job that's flexible enough to wait in line for hours at the rapid test place. Pebbles' school has rapid tests in the office but if we want the Calabat tested we have to drive to the clinic which makes it a harder call since kids always seem to have sniffles.

I hate masks so much

Cowl?

Yes, I don't see indefinite masking/lockdowns as the solution to get deaths down to, say, 100/day. We should have been investing in a lot more stuff than just lockdowns and vaccines. The Biden administration was doing this on paper, but seems to have been stymied by poor governmental capacity.

And the Trumpified federal judiciary, which might kill vaccine mandates.

To clarify, I hate being surrounded by people whose faces are not visible and who do not know ASL

161: Messily, I've seen some masks with clear material over the lips. I've wondered if they would be less hateful to the deaf community if lips were visible. Of course, plenty of people hate the way they feel on the face.

Topically enough, I just had dinner with an old friend who is partially reliant on lip reading. We didn't consider wearing masks, mostly because he's an old enough friend that if I got covid from him, I'd blame generic suburban white people regardless and he'd do the same.

Messily: I've read that face shields are worse than masks (presumably b/c they don't reduce aerosols at all). I wonder if a combination of a face shield with a porous N95 hood that had an elastic ring for the neck, might do the trick? So you would get adequate humidity, resulting in more drops condensing inside the shield, and the N95 material would filter out aerosols ? Maybe with some sort of anti-fog coating on the shield itself.

Just wondering. Certainly this has been a disaster for hearing-disabled folks.

166 typed before 165 was visible.

Endemic means much lower deaths because everyone will be exposed as children, when risk is much lower. Like chickenpox or measles used to be.

Endemic means much lower deaths because everyone will be exposed as children, when risk is much lower. Like chickenpox or measles used to be.

Endemic means much lower deaths because everyone will be exposed as children, when risk is much lower. Like chickenpox or measles used to be.

170-172. Endemic for Covid may mean lower levels of death because of exposure as children, but not all endemic diseases have low rates of death. I thought this was a good Twitter thread on the meaning of endemic. It doesn't mean we don't attempt to control it or conversely that we don't wind up with persistent high levels of death.

https://twitter.com/epiellie/status/1444675356913508357?s=21

Weirdly, I have absolutely no input as to what kind of masks everyone wears.

(Also fyi "deaf and hard of hearing" for the group, obviously go with individual preferences for individual people, but "hearing-disabled" is not what most of us call ourselves)

174: Obviously. But I've wondered whether making hospitals have ones available which show their staff members mouths and requiring staff to use them when treating deaf/hard of hearing could be mandated under the ADA.

Messily: sorry, I was reaching for the right term, but .... that's all I came up with. Senior moment, one might say. I understand what you mean: you can't control what kinds of masks people wear. But I thought perhaps there might be such masks, so that at least, for those people who interact with the deaf regularly, they might be able to choose that mask.

I mean, yes, obviously, and I have a lot of them and have figured out which ones work best and various approaches to heat and fog. I'm deaf and we're about to hit the 2 year anniversary of the First Wave. I'm well aware of what my options are as far as face visibility and masks. "A clear mask! Thanks guys, that's a great idea that I would never have thought of on my own or been exposed to in interactions with the hundreds of deaf people I know!"

I'm in a terrible mood obviously but this is still an infuriating thing to suggest to deaf people and for some reason hearing people LOVE to do it.

WE KNOW ABOUT THE CLEAR MASKS.

176: hospitals won't even bring in interpreters half the the time, there's no way they're going to go out of their way to use more expensive masks.

WE KNOW ABOUT THE CLEAR MASKS.

But have you tried listening harder?

Clear masks and X-Ray Specs.

when my stepson visited my better half in th icu post heart attack i told the staff he was deaf & reliant on lip reading & they were great - just took off their masks when they talked to him & didn't bug us about being unmasked together in better half's (closed door) room. but this was during the summer in sf, so pretty low case rate & hospital numbers of covid patients. a tiny bit of luck in a yuck situation!

one of the regulars at the club is deaf in one ear & hard of hearing in the other. since childhood - don't know if it was one of those endemic childhood diseases or since birth. also english is her either second or third language. also she's pushing 70 and seriously does not look it. she's pretty metal! anyways people's capacity to treat deaf & hard of hearing people like idiots & condescend to them will never cease to amaze me. she's enormously patient with the masks but has also figured out she can get me to repeat things for her. i seriously cannot do this in cantonese although she's made me try.

My office is still remote, but we'll probably be masked in the office when we go back in, and we are ordering clear masks for because we've got a hard of hearing attorney. But of course that only helps her in the office, not dealing with anyone else.

179: Can they steal them from law offices?

The best thing in life is to give a fifteen minute monolog that starts with "Well, actually mansplaining is...."

BendShape masks are by far the best

The stressful part for me isn't that I don't know what people are saying, it's that I can't tell whether they're even talking or not. And people are JACKASSES. I was waiting to check at the doctor the other day and didn't notice the woman telling me there was an open window, so she put her head a foot from my ear and yelled something very loudly in my face.

I hope you were able to slap her.

No but I raised my eyebrows in an extremely cutting manner

187 last is both a completely banal every day occurrence for every deaf & hoh person i know and absolutely fucking enraging.

It's so stressful and so much easier to avoid when you can see faces

The Calabat and Pebbles didn't even get sore arms after the shot, which they are taking as signs that their bodies will DESTROY coronavirus.

So long as kids aren't getting bad sick? Eh.

Neat, I don't care about you either.

My perspective on masks, shots, ventilation, etc is so different than everyone else's that it's one of those times where I wonder if I'm delusional.

But- the larger picturea, the primary goal of all these measures, isn't to protect any individual person from getting covid (of any sort). It's to slow the spread down enough to let the scientists catch up with it. Yes, some people will still catch it even if they're wearing a mask and lots of people won't even if they aren't being careful at all. But population-level, the fewer transmissions and the slower the spread, the fewer mutations, and the more likely we get more vaccines and/or treatments.

I'm not wearing a mask and using an air purifier because I'm worried about myself or my partner or the kids I work with. I'm sure we'd all have mild cases. But reducing the chance of transmission whenever possible is a We Live In A Society behavior, not a Kids Can Get Sick position

194: I don't disagree that the precautions are for others but the question is whether the mask/social isolation measures we're taking, once vaccines are in the picture, move the needle significantly on population-level spread. Especially because the people who are vaccinated and who are much less likely to be the source of spread as a result are also the people likely to be wearing masks and minimizing contacts.

I support 95 (especially w/ regards to protecting public facing service workers who don't know who is vaccinated), 193!, and 194.

To fully discuss this, we need someone to argue the for getting kids sick while protecting adults side.

Its kind of crazy to me that I spend most of my time at home in front of a computer, and I was able to get a booster, but I'm sending my 15-year-old to high school everyday with a whole bunch of unvaxinated people and he can't get boosted.

197: Wasn't that the Swedish model?

198: I know some people were spacing out boys doses to improve durability and strength of immune response. I think there's a concern about myocarditis in teenage boys. J and J isn't approved for the under 18s, cause that or Novavax would probably be better than an mRNA booster for that demographic.

ok so ballet school has declared masks everywhere. my teacher walks into class and takes hers off, and brings a fucking photographer to document how awesome she is. 5 out of 17 students are wearing. photog is not. I am fucking furious. your standards where are they.

195 has anyone done a study on that yet? And I'd be really curious about comparing different cities/areas to each other (do some places have more commingling of Vax/Anti?)

I wear a mask when I go to, like, the grocery store or the library or the doctor or something. Not when I go to someone's house, or in my house.

199: Anyone who can do what they do to cod is capable of anything.

We just had our son do the BINAX test to be safe. He's covidless, but has a disgusting cold.

The tests are right next to the giant Twix bars.

That's also a test.

202: working from anecdote mostly, but COVID-concerned people around here are vaxxed, getting their kids vaxxed, and masking. The COVID-unconcerned are doing none of those things and make up most of those hospitalized. Mask efficacy studies are all over the map but they require everyone to buy in which we really don't have here.

Part of my frustration is that my family and friends are basically doing everything right while quite a lot of the state mainlines essential oils and horse paste and then wonders why our cases spike after every holiday.

206: Should I buy the test or 14 giant Twix bars?

Anyway, Bill Gates put the teaching tracking chips in the horse de-worming medication.

-teaching

I bet its been a banner year for horse worms, with all the horse deworming medication out of stock.

That's the Norwegians, who we expelled from our beloved monarchy in 1905 for exactly this reason.

The vile slanders of Herrn Doktor Hick are insupportable.

193: it would perhaps have been unnecessarily cruel to have replied "as long as kids aren't committing suicide during lockdown? Eh."

207- do the two groups overlap socially there? (Concerned and unconcerned) do they generally socialize in separate spaces, or are there things both go to?

I think we have an outlier situation here because there's so many crossover groups (libertarians and nature-obsessed hippies and unexpectedly vehement antifederalists etc) and other than my actual personal friends, I have no idea who is or isn't vaccinated. (And I can't hang out with people if they're wearing masks)

I'm pretty sure a subset of the "unconcerned" here is actively spreading covid. Or was a few couple ago. The hospitalization rates are through the roof when so many are vaccinated. The unvaccinated are going to all be infected, along with some of the vaccinated.

Younger son's whole year has been focused on violin playing, and he made first chair in his HS orchestra, and the concert is in two days....and he just came down with flu. Posted here instead of check-ins because peripherally "germ-carriers inflict costs" related. There will be other concerts but I think it will be a blow.

Sorry Abe. That sucks.

The fact that idiots have co-opted the I-don't-want-to-change-my-life space makes it difficult to talk about the tradeoffs involved. The Missus and I are both thrice-vaccinated, as is our living-at-college son. Our daughter has two shots.

And the Missus and I were out of town in a rural area on Saturday and stopped in a totally unmasked diner. Just because we wanted to. Is that reasonable? We were distanced -- except from the staff, who seemed unconcerned but mostly also stayed out of our near-air.

I can't imagine what it's like to have small children in this time. I can't imagine what it's like to go out in the world immuno-compromised. I've got a lot of sympathy for everyone, including for people who want to criticize my choices.

215: Somewhat more isolated, I think, because of Utah's weird demographics. Certainly I'm at one extreme end of that -- moved here for a university job, most of my friends are university professors, one kid goes to university lab school, no elderly relatives nearby to infect with kid-enabled COVID even if we caught a breakthrough case -- but Utah can be divided into people who are "from California" (moved here in the last 20 years) and the people who have deep roots here (overwhelmingly Mormon, conservative, and Trumpy af). It's the latter group, especially in rural areas that is resisting vaccination, that are also in support of the leg making it impossible to require masks in schools. So it's a safe bet that the people who are voluntarily masking their kids are also the ones getting the boosters and the littles vaccinated. We're seeing the numbers reflected in the hospitalizations and deaths. While there are more breakthrough cases, it's not even close.

(Fun observation: in the Calabat's school almost no one wears masks except for the kids who are part of the gifted magnet program, where masking is over 90% voluntarily. The Calabat was bringing extra masks for a friend whose mom apparently wasn't providing them -- like an 80s peer pressure tale minus the drugs.)

So part of my thinking on this is that I'm really out of things to ask my kids to do to make COVID go away unless the rest of this state gets its shit together. They're vaxxed. They wear masks. The Calabat hasn't had a birthday party since 2019 -- what's the marginal benefit of canceling another one?

Apparently, all the poops in Boston have covid but nobody is checking the poops here.

Of course there's some risk I can spread covid or have, but it doesn't make sense to think of this as yes/no, it's about probabilities. And now that I'm boosted I think it takes more than 100 of me to equal the added risk of one unvaxxed person. My risk of infection is like 1/10th of someone unvaccinated, plus I'd be contagious for something like a third of the time and likely be less contagious due to lower viral load, and moreover since I mostly am in places with required vaccinations (since it's required for our students and staff) that's another drop by a factor of close to 10. If I were more careful maybe I go from 1/100 of an unvaxxed person to 1/1000 or 1/10000, but that's just not going to change the overall numbers by much at all.

It's frustrating, but there's essentially nothing boosted people can do in order to meaningfully change the dynamics of the pandemic. You've already done roughly all you can do just by getting 3 courses of an mRNA vaccine.

(Of course Omicron could change the situation somewhat. But I fully expect that it means vaccines are relatively better compared to having caught it before, and so although it could raise my risk of spreading it's going to only decrease the number of me needed to equal an unvaxxed person.)

219- I think it's much more of a mixed up unpredictable situation here. We are having small parties, but outside, and invite-only. Some friends go out to bars and shows, wearing masks, and I probably would not do that even if I were hearing. And I'm not having a big crazy party any time in the near future.

220: Not just Boston proper. MWRA covers a bunch of municipalities in the Greater Boston area - though not Cambridge.

Apparently, all the poops in Boston have covid

I think the Boston term for them is "Brahmins," and I'm sure they don't all have it.

221: Right now, we have a backlog on vaccine appointments. Tim had to cancel his Friday appt. we could find nothing at drug stores. We got one for the 18th at the health system of his PCP. I looked for earlier ones, and now there are none there. The city of Boston is opening up appointments. I asked the pharmacist who did not my shot about appointment availability, and he said that they don't have any until after Christmas. I know Baker says he is working on the issue.

Our boosted population is not that high, so I think we really need to keep masking until at least mid January.

I just want the health department to check my poops because it costs me $23 to check my boogers.

My mother-in-law visited this weekend, while I left to go visit my own parents. She tested positive this morning. UGH.

225: contrast -- when I decided I had time to get the booster, I made the appointment at Costco's pharmacy for the next day and had my choice of times. Same thing with the kiddie shots.

And now that I'm boosted I think it takes more than 100 of me to equal the added risk of one unvaxxed person. My risk of infection is like 1/10th of someone unvaccinated, plus I'd be contagious for something like a third of the time and likely be less contagious due to lower viral load, and moreover since I mostly am in places with required vaccinations (since it's required for our students and staff) that's another drop by a factor of close to 10.

I think the basic idea is correct, but your numbers are likely off by a factor of 10 (at least pre-booster; in the short term boosters might reduce your risk an additional five-fold). This is something I've paid attention to because we have one unvaccinated person at the office -- which is a little awkward -- and I've had conversations with my spouse about the question of how much additional risk that poses, and my position is that the difference is probably a factor of 10, not 100.

Our county publishes data (about once a month) showing the case rate per 100K people by vaccination status, and over the last couple of months the ratio has been about 3:1 or 3.5:1 (not 10:1) higher case rate among vaccinated people (and that includes the possibility that vaccinated people are also being less cautious about risk). One likely factor; by this point a significant percentage of unvaccinated people have had covid and have some resistance based on prior infection.

OK. I am blegging.

Official CDC stance (I think) is that you're fully vaccinated at 2 weeks after your 2nd shot. Until then, you have to behave as though you're completely unvaccinated, even though clearly you've got significant protection.

School stance is that unvaccinated kids have to stay home for 10 days after exposure. Clearly my mother-in-law majorly exposed our kids.

I want to do what's ethical, but I am fine with breaking rules. Our kids got their first shot on 11/13 and their second shot on 12/4. Is it ethical to treat them as though they're vaccinated for purposes of assessing quarantining? ack.

In other words, if we need to keep them home in order to be safe for others, goddamnit we will, but I would really really like to be able to send them into school in good conscience.

Clearly Pokey is fine to stay in school - he actually had Covid back in September.

229.2 My numbers were post-booster! I agree that, during the post-Delta pre-booster era the numbers were a bit different. It's still true that you don't have that much impact on the dynamics if you're changing from 1/10 of an unvaxxed person to 1/8th or whatever.

A bigger point is that you're right that I was comparing to an unvaxxed person who hadn't already gotten covid. It's the unvaxxed people who haven't already gotten it which are by far the main driver. (Though this looks like that may change dramatically with omicron.)

(At least according to the logic that fully vaccinated people can continue to go about their life after an exposure, unless they're showing symptoms.)

Heebie -- that sounds awful.

What is the difference in protocol for vaccinated vs unvaccinated at school? I think they should have significant protection, but I'm still not sure what I would advise in that situation.

229.2 My numbers were post-booster!

Okay, then I agree it's closer to 50-100:1. But, we don't know how long that will last for. The booster is supposed to provide longer lasting protection than the original dose but there's still the chance that in 6 months it will be back to a 10:1 or 20:1 difference.

I also think your basic point is correct. Even if it is a 20:1 ratio it means your choices about masking or being in public spaces have less impact on the total population risk profile. But the difference also doesn't mean that the impact is 0! The collective behavior by fully vaccinated people is still a factor in spread.

School stance is that unvaccinated kids have to stay home for 10 days after exposure.

How does the school define "vaccinated." Does the school specify "fully vaccinated"?

What is the difference in protocol for vaccinated vs unvaccinated at school?

When Pokey had covid, Hawaii was allowed to go in as long as she was masked and symptom free. Ace and Rascal had to stay home for 11 days.

How does the school define "vaccinated." Does the school specify "fully vaccinated"?

It's not published and I'm scared to ask.

Actually my dad just sent me a bunch of very promising charts about how protected they are by this point.

Kids showed stronger response to vaccines than adults. I'd think if you did daily rapid tests at home starting Wednesday on one kid each morning until the weekend, it wouldn't be unethical.

Oof, that's tough. Our district doesn't recognize any difference between vaccinated and unvaccinated so I don't have a lot of experience here. Is there good data on the "two weeks after the last dose" guideline?

The tigers at our zoo have covid so you need to stay out of their enclosure.

227: Sorry. But in the long run, that's the kind of thing that you really give you leverage for future in-lawing.

243:. But what will they eat?

They're vegan.

The Democratic Party could solve a lot of this country's problems by adopting a platform of forbidding entry into tiger cages and outlawing plummets from tall buildings. Vaccine and mask requirements aren't getting the job done quickly enough.

Is it ethical to treat them as though they're vaccinated for purposes of assessing quarantining?

Ugh! This is a tough one. They're so close, but probably not yet considered fully vaxxed (unless the school's protocols are less stringent than the CDC guidelines?). At the same time, quarantining children is so extreme, so hard on the kids and the parents. And with the first dose on 11/13, it's likely they already have significant protection.

Honestly, I would be tempted to treat them as vaccinated for the purposes of assessing the need to quarantine.

My 9-year old nephew just finished a 10-day quarantine after a classmate tested positive; his 7-year old brother, who attends a different school, did not have to stay home as he was considered merely a contact of a close contact: so confusing! My sister was afraid to ask the 7-year's school, but then decided that she had to (and luckily got the answer she was hoping for!...) 7-year old nephew got his first jab during his brother's 10-day quarantine period; 9-year old's first dose postponed due to quarantine.

Here's the chart my dad sent me, showing that after roughly Day 14, the first dose offers very good protection, and he added in the email that the second dose is to sustain the protection.

I don't know if he's cherry-picking out of kindness/rosy-colored glasses.

Kids showed stronger response to vaccines than adults.

Coupled with this.

I'd think if you did daily rapid tests at home starting Wednesday on one kid each morning until the weekend, it wouldn't be unethical.

Do you mean if we kept them home and did rapid tests Wednesday-Saturday, or sending them in to school and doing the rapid tests?

Also: heebie, I think you are entitled to feel more than a little bit peeved about your mother-in-law exposing your kids like that.

heebie, what's the actual timeline? From *multiple* close calls this semester, I've learned that 'exposure' locally means 'within 24 hours of someone testing positive' for contact tracing. So, for example, if I have a student who tests positive on a Saturday, the student doesn't count as having exposed my Thursday class two days prior, even though it's likely that the student was germy. So if your mother-in-law visited Saturday, and she tested positive today, the kids wouldn't count as exposed for the purposes of the health department. At which point ethically I'd be fine with testing Hawaii to make sure she didn't pick it up, monitoring her for symptoms, and ensuring she wears a mask.

One of the Calabat's classmates has a brother who tested positive for COVID, prevaxx. She's exposed, but the Calabat didn't count as a contact because she didn't have symptoms and they were both wearing masks. Pebbles was exposed after her first shot (nine days before Thanksgiving), and we didn't find out until the Monday before (very short contact with a teacher but during snack so unmasked), at which point it was pretty clear she hadn't contracted it, but we still ran it by our friendsgiving group before gathering.

She tested negative on Thursday night, flew in on Friday afternoon, flew out on Sunday morning, tested positive on Monday morning. Staying at our house, so not a brief exposure in passing.

We have the same number of hospitalizations right now as we did last year at this time, but deaths are down to 20/day as compared with 40/ day a year ago. Hospitalizations are 1,118 in the State. 34% of those are in people who are classified as "fully vaccinated". I don't know if those folks have been boosted. Obviously, as the percentage of the population vaccinated goes up, the percentage of those hospitalized *and* vaxxed will go up. The super majority of hospitalizations are I. The unvaccinated minority, and, obviously, in a 100% vaxxed population, 100% of the hospitalizations will be vaccinated people. But it's important to remember that These numbers are higher than what our hospitals can manage easily. U Mass (which is admittedly in an area with a lower vaccination rate) is talking about re-opening it's field hospital.

252: I am extremely curious to know how she caught it. Maybe it was random bad luck. But maybe it was that the moment the houseguests left, they went back to hanging out with my brother- and sister-in-law with their kids and no masks. Unless she volunteers, it would be hard to know.

Give her points for getting tested. But I will personally get judgmental about people with Covid right up until I test positive, at which point getting sick will be entirely understandable.

251: So, Hawaii's fully vaxxed, no concern. Pokey had it and has at least one shot, which data seem to show is actually better for immunity than two shots, no concern. So, it's just Ace and Rascal who are borderline. The data show kids get a much stronger antibody response than adults, so probably one shot is nearly enough to qualify them as having immunity like someone vaccinated would. I doubt they'd show a positive Monday or Tuesday (kind of a short window), so starting to test Wednesday seems like the highest probability, then test W-F. If you have a bunch of tests, you could start tomorrow. You could test both, but assuming they all spent time together, if one kid got it, the other probably did, too.

If they showed any symptoms or tested positive, they'd need to stay home, of course.

That seems reasonable to me. Like, if I (again, not a high risk person) were hanging out with your kids, that would seem like a solid plan.

256: They've always resented you for being unwilling to eat gravy that was served neti-pot style.

251: In MA we have "Test to Stay". You do a rapid test every day before school for a certain number of days. As long as the kid is negative that morning, they can go to school, but you don't do just one test. I believe the kids test daily for at least 5 (and maybe 7) days. If you pay $14 for a pack of 2 at Walmart, that will set you back $42. I think that would be ethical, and I'm a stickler.

Thanks, Ydnew. I feel reassured and okay about this plan.

260: I'm comfortable shelling out for home tests.

They're right next to the giant Twix bars, which are disappointingly four bars in one package and not two really long bars.

236: NYTimes has the vaxxed infection rates at around 1/6th of the unvaxxed rate for the country for the whole delta wave (after being around 1/12th pre-Delta). I wonder why the rates in your county would be so different?

re: 264

Timing for vaccinations? A lot of EU countries are having big waves at the moment, and the waves are semi-correlated with the peak of their vaccination programs. Once you are 5 or 6 months post-vaccination the protection has waned quite a lot. If one state had vaccinated earlier, they'd expect to see a higher rate among their vaccinated population than one that vaccinated later.

It seems like Israel is the one to watch, they seem to be somewhat ahead in the vaccination/decline/outbreak/bootser cycle compared to everyone else.

Also, it's where the apocalypse starts.

antisemite

The apocalypse starts within each of us.

I'll allow it.

See who's in charge of it.

Boosted

Hey, how's the new job going? I don't think I've seen you say.

It's amazing. Practically stress free (because asshole free)

I'm also coming back to NY for two weeks on the 17th thought that may be a bad time for a meetup

274 is good to hear!

Yay Barry!

236: NYTimes has the vaxxed infection rates at around 1/6th of the unvaxxed rate for the country for the whole delta wave (after being around 1/12th pre-Delta). I wonder why the rates in your county would be so different?

Did the NYT have data for the whole Delta wave? I remember they had a big article, but all the data stopped in September (and I think early September). The rate of new infections among fully vaccinated people definitely went up (locally) after that.

I think the primary reason is waning protection, but it may also be that people's habits changed over the summer after they got vaccinated and case rates fell (locally the lowest rates were in early July).

On the other hand, maybe our county is not representative. Looking at the WA State report, it looks like breakthrough cases are typically 1/4 of the total cases. If 2/3 of the state population is fully vaccinated that looks like a ratio of ~6:1 (1/3 of people accounting for 75% of cases; 2/3 of people accounting for 25% of cases).

Over the year our rates in the county have been lower than the state average (though not at the moment), perhaps that's resulted in less of a gap between vaccinated and unvaccinated.

One could also speculate that it's differences in asymptomatic testing rates. If there's a lot of asymptomatic breakthrough infections, then you'll get a different ratio if you have more asymptomatic testing. Or maybe once vaccination rates get high enough then you're really comparing vaccinated adults to unvaccinated kids, which is a very different comparison from vaccinated adults and unvaccinated adults.

One could also speculate that it's differences in asymptomatic testing rates.

Maybe, but the Case Fatality Rate gives some insight into the amount of testing (the fewer asymptomatic cases are detected, the higher the CFR) and the local CFR is lower than the state average.

Except that vaccination rates effect CFR dramatically, so I don't think you can use that anymore to compare places with very different vaccination rates.

Yes, that's a factor. A higher percentage of the local cases are post-vaccination. But the local CFR was lower than the state average before vaccination kicked in (despite having a couple of nursing home outbreaks early).

But, thinking about it, if our county is showing more breakthrough infections (in terms of the ratio to non-breakthrough infections) your speculation is that we're just doing a better job of testing for them. Maybe, but I can tell you testing locally is a bit of a pain -- not terrible but I'd be surprised if we were that much better at catching asymptomatic infections than the rest of the state.