@freemo On a national level, you *do* need to know how many health workers per hospital have *not* been vaccinated, so you know where to send the sharply limited supply of vaccines.

You don't need to know *who* they are.

The national registry is a very lazy solution to the first of these. (There are other solutions; some of which don't spill over into the second of these).

...so yeah, I think we're broadly in agreement with regards to what is or is not truly necessary.

@ccc Well sort of... as I said you need to know who is in the queue. You obviously have no need to know what hospital workers arent vaccinated when those workers dont intend to get vaccinated. You would only need to know how many hospital workers there are that intend to get vaccinated and who have not.

Thus all you need to know is who is in the queue (people who want to get vaccinated and havent), not who is unvaccinated.

@freemo

....wait wait wait wait up right there.

Hospital workers who don't *intend* to get vaccinated? Is that a thing that happens?

@ccc for normal vaccines, no. But when its a vaccine that skipped several years of safety tests, has a real risk of life threatening ADE long-term, has emergency authorization to be distributed without the normal safety vetting, and has an exemption so if you die when you take it (or get injured) you cant sue for compensation... when all that happens to be the case for a vaccine, then yes, a great many hospital workers do not wish to be vaccinated.

@freemo ...oh, dear.

Now I'm suddenly seeing a second use for a national registry of people who have been vaccinated. It would prevent a prospective patient from needing to check with each doctor who might treat him, individually, who might have been COVID vaccinated. Which - from a patient's point of view - might very well otherwise become a necessary precaution in a few months' time.

@ccc I dont think a patient should have a right to demand that a doctor put their life at risk in order to vet them. What a patient would have a right to is a doctor that isnt actively sick, a doctor that is regularly checked for presence of the disease, a doctor that washes their hands, wears a mask, and takes all the precautions... but tahts as far as it goes.

The scenario your depicting is a very dangerous slope where doctors and nurses would be required to put their lives at risk, take drugs that have not been properly vetted for safety if they wish to keep their jobs. I dont think we have any right to demand a nurse or doctor both be on the front line and risk their lives AND take experimental drugs before the rest of us that could kill them if they wish to keep their jobs.

@freemo You are right - a doctor should not put his own life at risk in order to vet a patient. But, as a patient, I also should not be expected to put my life at risk when going to the doctor.

And the way this virus spreads, *any* interaction with another human being carries a small but potential risk of picking up said virus. It doesn't *have* symptoms for the first several days - for some people, particularly if they are healthy people, it might never have symptoms at *all*. So, if I need to interact with someone, there is a small-but-finite chance of picking up the virus. (This is *especially* the case if I need to interact with someone who needs to look into my mouth, because I need to remove my own mask to permit that).

So, in order to reduce the risk to my own life, I should be able to select to visit a doctor who *has* received the vaccination. I shouldn't have the right to force a doctor to receive the vaccination; but I should have the right to select a different doctor if I find that the doctor I would have visited has not received said vaccination.

@ccc while I can understand that perspective,and I might even agree with you if we were talking about a vaccine with proven safety... it just doesn't make sense that a patient should have the right to pick doctors who put their lives at risk for your safety, or to allow doctors to have an advantage (draw in more patients) if they put their life at risk through taken an unproven vaccine.

Moreover if a doctor is taking the proper precations then even if they have the virus and they dont know you wont be at risk.. if they are disinfecting regularly, wearing a face mask and shield, and using fresh gloves, then there shouldnt be much of a risk to you.

If that doesnt satisfy you then you have the right to get the vaccine yourself, or do a televisit.

Doctors literally enter rooms and treat patients who are immunocompromised where even a little bacteria from a wall or a cold could easily kill them and yet they do so with a great track record of safety. So any such fears, presuming a doctor takes the right precations are moot in my eyes.

@freemo As I understand it, the currently available vaccines have gone through some basic trials. Not as much as the full understand-it-all type safety trials - there hasn't been enough time for those, yet - but enough to be fairly certain that having the vaccine is a good deal less lethal than *not* having the vaccine and risking the virus.

But let's consider an unvaccinated doctor who takes good precautions. What are my chances of dying if I visit that doctor, in person?

First of all, if I get the virus, I've got a straight-out 3% chance of dying from it (source: https://www.worldometers.info/coronavirus/ ) That's the average odds across all age groups, all countries, worldwide - the elderly or immunocompromised have lower odds, the young and healthy have better odds, and so on. But let's run with 3% chance of death if I have the virus and do a bit of a Fermi estimate.

Now, in consulting with a doctor, I'll need to spend some time in the doctor's room, with my symptoms being investigated. (Let's assume, for the sake of argument, that I'm facing a problem that requires the doctor to see my symptoms in-person). That's a small room, and I may have to remove my mask and say 'ah' while he pushes my tongue down... since this virus is so terribly eager to spread, the odds are that if the doctor has the virus then I will get the virus. But what are the odds that the doctor has the virus?

Face masks and shields and so forth will help. They're imperfect defenses, but they are defenses; they help to prevent the doctor from contracting the virus himself. But let's consider the doctor having regular self-tests (and temporarily closing down his own practice if he finds he has the virus) Now, how often does the doctor self-test?

The test may take a day or so of analysis in a very overworked lab to get a result; and the materials used in the test also have a cost. So self-testing once a week feels about right. There are 52 weeks in a year - this is a Fermi estimate so I'm rounding that to 50. Let's assume that a non-vaccinated doctor gets the virus once in any given year, on average.

Then my Fermi estimate suggests that I have a 2% chance (roughly) of getting the virus in any single visit to an unvaccinated doctor. If I get it, I get a 3% chance of death. So, merely by visiting an unvaccinated doctor, I get a six in a thousand chance of dying as a direct result of the visit.

Therefore, if I can't tell whether a doctor has taken the vaccination or not, I should not visit the doctor unless either (a) I have been vaccinated (this will take a while, I am not a health worker and the vaccines can only be produced so fast) or (b) I believe that I have at least a six in a thousand chance of dying if I *don't* visit the doctor.

@ccc they have went through some very basic safety trials, yea.. typically 5 - 10 years worth hof safety trials down to a few months.

Basically they got through enough trials to know if you take it you probably wont die or get ill in the first few months. But they have absolutely no data regarding the likely hood of 6 month or more concerns.

ADE is the biggest concern that is only detected in longterm trials. This is where a vaccine will usually provide immunity and show normal healthy responses in the short period after taking a vaccine but after 9 months, a year, or more into the future (when long-term immunity sets in rather than short-term) if an immunized person gets the disease they will have a more severe reaction tot he disease than an unimunized person.

If ADE becomes an issue with the COVID vaccine, and we have absolutely no data to provide safety against this, it means people who take it could potentially be in for a death sentance in a a year or more. Health workers who will likely be exposed to covid long after the virus is rampant would be particularly vulnerable to such a situation.

Your assessment of masks seems off... can you explain to me how immunocompromised individuals who would trivially die from even exposure to a cold manage to generally be safe for years on end when treated by doctors even thought they have to be in a clean room? If full protection (face shield, mask, gloves, fresh cloth body suit) were so ineffective wouldnt these people be dropping like flys every time a doctor visited them?

@freemo This virus has been out for a year, and one-point-seven million people have died. Waiting another four years would mean the deaths of approximately another seven million people - which, as I understand, is the reason why this vaccine got fast-tracked.

> Your assessment of masks seems off...

Yeah, it's a Fermi estimate. About half of my assessments are almost certainly off, one way or the other - I'm kind of hoping that they approximately cancel out, but I wouldn't be at all surprised to find out that the actual odds of dying as a result of visiting an unvaccinated doctor are off from my estimate by an order of magnitude or more. And yes, that includes my assessment of the effectiveness of masks.

@ccc While ADE is far from certain it is a real risk. Yes over a million have died, its very serious. But on the chance ADE, a very real chance, ADE is a side effect of this vaccine, then what happens whe the covid death rate all of a udden doubles?

Taking risks where there is a complete unknown but very reasonable possiblity that the end result is that the death toll fromt he virus goes up and not down long term, thats not an acceptable risk.

Its a shame people are dying, but acting and doing anything, no matter how unsafe, just because of the bias that doing something feels like it is better than nothing, is not good reasoning.

We have enough historic examples of how lack of proper safety measures causes a cure to become worse than the disease. We shouldnt let that be the case here.

I am not suggesting the vaccine not be released at all. I am suggesting that given the very real threat that it can put you at a greater risk of death than the virus, it should be u to the the individual if they want to take it and we should make every effort to ensure no one is strong armed into taking it against their better judgement for their own safety.

@freemo Hmmm. Not being a medical professional myself, I know absolutely nothing about ADE. How probable would you guess it is, and how much effect does it have? Is a doubling of the death rate typical?

@ccc There is really no way to know. The risk could be anywhere from 0 to 100% thats the problem. We cant even estimate it until we have long term data, its a complete unknown.

What I can say is this, doctors have been repeatedly warning of the ADE risk of a premature COVID vaccine int he scientific journals. I have seen no such journals that are capable of saying how high the risk is, but they do continually point out that ADE is observed in most varians of Coronavirus we know of and as such presents a very real risk here.

In the discussion from yesterday ont his topic one such journal I quoted said the following (though lacks specific numbers for aforementioned reasons):

ADE has been observed in SARS, MERS and other human respiratory virus infections including RSV and measles, which suggests a real risk of ADE for SARS-CoV-2 vaccines and antibody-based interventions. However, clinical data has not yet fully established a role for ADE in human COVID-19 pathology.

When so many doctors are continually warning us about COVID vaccines being premature, and there have been efforts to block the early approval of COVID by many in the medical community, it should raise red flags in its own right.

@freemo Did a bit of poking around (i.e. briefly googled) and found a paper on the subject: https://pubmed.ncbi.nlm.nih.gov/32785649/

The abstract (which is all I've read) suggests that ADE in COVID vaccines is "unlikely" and gives a few reasons why - including that people who have previously had COVID (and thus whose immune systems already know to fight it off) are *not* where most of the fatalities are.

So.

Let's assume that the odds of an ADE-type effect are *no greater* than one in three. (From the looks of that paper, it seems that the actual odds are a good deal smaller than that). And let's assume that an ADE-type effect flat-out doubles the lethality of the virus. Then it is still *very* sensible to have the vaccine, as I will now show.

Let's assume that without the vaccine, everyone will eventually get COVID at some point in their lives. Similarly, if the vaccine has an ADE effect, everyone will get the virus after getting the vaccine.

Anyone who gets the virus has, on average, a 3% chance of death (as implied by current statistics). Therefore, anyone who doesn't get the vaccine has a 3% chance of death.

If there is an ADE effect, that doubles - goes up to six percent. But as the paper above suggests, there is a less than one in three chance of and ADE effect turning up. So the odds of dying of COVID is you get the vaccine are less than one-third of 6% - i.e. less than 2%.

Therefore, there is less risk of dying of COVID if you take the vaccine than if you do not.

--------------

So. How to handle this in a practical sense? I do agree with you that people should not be *forced* to take the vaccine. But, by the same token, if I am visiting a doctor then I want to know that (a) it is safe for me to do so, and (b) that the doctor understands how to find the treatment route with the highest probability of success. For both reasons (a) and (b), I would heavily prefer that the doctor that I visit is one who does not refuse the vaccination.

@ccc There is a big difference between making estimates for ourselves as to whether the risk reward is viable or not. I think its fine if you want to look at the risks and determine the vaccine is a safer bet, even with the unknowns, than not getting it.

The issue here is if you have a right to force others, directly or otherwise, to get the vaccine.

I dont care if you choose to get it, I do care if you choose to force medical professionals to get it or create a situation where a medical professional who doesnt get it can no longer find a job.

Thats the key here, we can speculate till the cows come home about whats likely or not and create any sort of guess numbers we want, doesnt really change the issue that when we are dealing with an undeniably higher danger from this vaccine than typical that we have no right to exert pressure on anyone to get it.

@freemo I certainly wouldn't want to force anyone to get the vaccine in the face of their own estimate as to the safety thereof.

But, by the same token, when I visit the doctor I wish to choose a doctor such that I minimise my own personal chances of dying as a result of visiting the doctor.

For the reasons I have given in my previous posts, I have concluded that my best chance of surviving the doctor's visit is to visit a doctor who has taken the vaccination (at least, until such a time as I myself am vaccinated).

So, then comes the question: should I be able to know, before visiting the doctor, whether or not the doctor has been vaccinated?

I would *want* to know, so that I can select a doctor who has been vaccinated. But merely knowing that therefore does exert an indirect pressure on doctors to not only get the vaccination, but moreover to advertise that they have got the vaccination. Is this indirect pressure on doctors more or less important than my desire to improve my odds of survival by avoiding the unvaccinated doctors?

@ccc by that same ogic do you also have a right to know what doctors have HIV so you can avoid them out of fear of accidentally contracting HIV.. A persons medical data id protected for a reason.