Re: London

It’s amazing to me that the UK won’t be fully open until late June, when over 40% of the adult population is now vaccinated (and rising fast) and infections and deaths have dropped precipitously.

According to NHS England (as reported by the BBC), between December 31 and March 5 there were only 6 deaths from Covid of people without known underlying health conditions. There were a total of 185 deaths of people who tested positive for Covid, but that can mean a terminal cancer patient with some viral RNA fragments in their system.

This is over and they should open up by the end of March.

Recently vaccinated, I felt brave enough to take a long, freezing bike ride around the island of Manhattan today. Some observations: Areas such as the East Village, and those popular with younger people, looked like they are coming back to life. There were tons of people out and about (in masks), even on a frigid and windy early March Saturday. Other parts of the city, such as the theater district, still feel depressing and dead but that's to be expected with the theaters closed. Even with in-person arts allowed to reopen at 25% capacity on April 1, few producers will reopen their shows since operating at 25% will not cover the costs involved with a Broadway show. I do feel hopeful, though, as I saw more life in the city than I've seen in a while during the pandemic. I believe that by June or July we will begin to see and feel a more familiar NYC.

I'm not sure what about this amazes you. 70-85% of the population needs to be vaccinated before you reach herd immunity and you can still pass on the virus if you get the vaccine. This isn't hard to understand.

If you vaccinate the old then it doesn’t matter who catches the virus. It makes no sense to lock down so that people don’t get a bad flu. Plus about 20% of the population has had the virus which is effectively the same thing. And that 40% will be 70% long before June anyway.

Last estimate I heard (today) was 1/3 had already had the virus and some dense places are around 50%.

Yep. And enough with the "if you had Covid you can still get it again!"

Yes, but your chances of getting it and needing to be hospitalized is incredibly small. Also, if you had it and were asymptomatic and then get it again, you won't notice you even have it, once again.

We don't need 75% of the population vaccinated, that is fear-mongering. We need the old (who make up something like 15-20% of the US) and people with underlying conditions vaccinated (I don't know this number, but its probably way higher than the old in the country). That is all. Everyone else getting vaccinated after those two groups will just help kill this off, it won't make huge dents in daily deaths.

Those over the age of 70 are pretty much at herd immunity now in Louisiana when factoring both vaccinated and previously infected. 65% of the 70+ population has been vaccinated. The 60-69 age group is also getting closer with a third of that population vaccinated. Hospitalizations are at their lowest point since the beginning of the pandemic in early April 2020.

https://bloximages.newyork1.vip.town...03b3.image.jpg
courtesy nola.com

FYI:

https://www.wsj.com/articles/russian...d=hp_lead_pos1

In as much as the older population is not in contact only with others in the same age range, you shouldn't think of the fact that so many of them have been vaccinated as comparable to "herd immunity". Yes, they are protected by their own vaccination from the worst effects of the virus--and the medical system is protected from being overwhelmed by the high rates of serious illness and hospitalization in this age group. But the concept of "heard immunity" means that even the unvaccinated are protected because viral transmission rates have been driven to the negligible. To do that, the entire population needs to become unavailable as viral hosts, not just one segment which is not isolated.

Well, we certainly didn’t shut down the planet until everybody got their Measles vaccine. Or Smallpox, for that matter.

Covid is a case study in mass fear and hysteria, even with the full acknowledgement that it’s a pandemic that’s far worse than the Flu.

No point in griping about it, though, folks. The cat is way out of the bag, we went a bit nuts during this pandemic and handled it miserably....the creation of the vaccines being the one bright spot.

Being that I:

Never

Ever

Ever

Ever with cherries on top.....

Want to go though this again in my lifetime, my recommendation for the the next pandemic: QUARANTINE! Put those early cases in a building for 20 days, feed them....entertain them....but don’t let them spread it!

First of all, keep in mind that in the US, and presumably in the UK, 40% of the population have "known underlying health conditions". So to say that most deaths are in that group isn't saying much.

Anyway, this may have something to do with Boris's cautious attitude:

https://apnews.com/article/europe-en...94884a4b8049e4

Clearly the US--and most of the world--needs a more robust public health system controlled at the federal level (so that "Neanderthal" state governments can't thwart the whole thing). We need the ability to quarantine but also stop travel including Americans returning from abroad unless they are willing to be quarantined also for the necessary period. And especially we need a much more robust ability to contact trace. It doesn't do much good to quarantine identified cases if they've already infected people during the disease's incubation period and we don't have the manpower to run down those contacts and their contacts.

I’m not a big Government guy, but even I favor Congress passing a pandemic emergency powers law. This law both empowers (and limits) the President to enforce quarantine on US residents in the event of a declared pandemic. I envision travelers from abroad and known cases being subject to such quarantine.

The law would need to be specific about what rights quarantined subjects have during said quarantine. I imagine that this same law should also define limitations as well. For example, what Governors can and can’t do during a pandemic, etc.

I’m sure it would be a pain to draft such legislation and get it approved, but we need some sort of path forward in the event that something like this happens again

Yes but I'm suggesting something like a "National Public Health Guard"--a LARGE cohort of trained contact tracers who could be mobilized quickly to find the contacts of identified cases in a pandemic situation (probably even before it's labeled a "pandemic" because remember that took until March with COVID when we know it got started in December or January if not before) so that they too can be quarantined.

Unless I'm mistaken, we have pretty good quarantine laws, many remaining from the era when tuberculosis was the national scourge, but there's been a reluctance in the modern era to use them. We may need to get over that.

But one caveat: My complaint all through this--voiced any number of times in these threads--has been the attempted (and I say "attempted" because I don't think it's ever worked in the US) quarantine, aka "lockdown", of uninfected and uninfectious persons. Historically and by law, the ability to quarantine has previously been used only against people who were or might be infectious to others, not the "others" to whom they might be infectious.

Our local areas are at about 21-25% vaccinated (for first dose). Statewide at 18%. Cases are plummeting.

We should be on track for fans in attendance for opening day at Oracle Park!

^^Here's the situation today for the leading states by # of shots given:

https://uniim1.shutterfly.com/ng/ser...186822/enhance
https://www.bloomberg.com/graphics/c...-distribution/

The US as a whole is doing very well:

https://uniim1.shutterfly.com/ng/ser...187056/enhance
https://www.bloomberg.com/graphics/c...-distribution/

Keep in mind that these are percentages of the TOTAL population but only the ADULT population is eligible for the current vaccines. Roughly 74% pf the US population is over 18 and the vaccine can only go to those over 16 (call that 80% of the population) so maybe 22% of the US population (and maybe 23% of the CA population) that's eligible has gotten at least 1 shot.

For those tracking our progress toward "herd immunity", a rough guess is that 20% of the US population has COVID antibodies from past infection (it was measured at 15% last November). Assuming the same percentage of those people as of the whole population is getting the vaccine (maybe not true--people who know they had COVID may feel less urgency to get the vaccine), you can probably add about 15% to the 22% who've had a shot and say that about 37% of the US adult population now has some immunity to the virus. That's not "herd immunity" levels but it's pretty darned good.

You can be sure I won't be among them. Just sayin'. Some risks are worth it to me and others aren't.

So how do we feel about this? Comments (in keeping with the ban on politics in this thread, please address the policy not in terms of political parties or specific politicians)?

https://www.sfchronicle.com/local/ar...a-16004460.php

I agree with you 100% on this, tup. Response to a nationwide/worldwide panemic needs to be a FEDERAL, not a STATE responisibility. Enough of 50 different responses to one pandemic. We needed a unified response, unified action, and unfortunately that never happened.

We all see where that got us, now. :(

Aaron (Glowrock)

I think it makes sense to prioritize vaccinations for the populations that are more vulnerable, like front line workers, elderly, those with chronic conditions, as well as the lower income folks that never had the option to work from home. These are probably the folks that also have multiple generations living within the same household. It's hard not to bring COVID home to the grandparents when they're in the same house.

Where is Canada in terms of reopening? The US has 3 states now set to go to 100% capacity with day-to-day businesses, but I haven't heard of anything about plans in Canada.

I'm not sure about reopening but they're about 3 months behind the US in terms of vaccine rollout. We've already begun vaccinating educators and essential workers in the food industry. Canada isn't expected to reach that category until end of June/early July.

Also, last I checked the US is averaging more vaccinations per day than Canada has vaccinated in total thus far.

Edit: Yes, in fact, the US just vaccinated 2.9 million today. Canada is currently at 2.4 million doses total. On a per population basis, they are at 6 doses per 100 people. The US is at 27.

Canada has had a horribly slow vaccine rollout. None of my in-laws over the age of 60 in the greater Toronto area have been vaccinated yet. It's really disheartening, and we hope they are vaccinated soon.

On the flip side, metro New Orleans is now at 11.2% fully vaccinated (ldh.la.gov/coronavirus). The mass vaccination sites set up have been working very well. It's all done by appointment, so there are no long lines.

^^That’s pretty much the way it’s being done everywhere in the US. I got mine at a drive-through site in Tucson (again, I first made an appointment online).

Did this story get much press at home (in Canada):

https://www.wsj.com/articles/canada-...4347392?page=1

Rich, powerful guy flew on a private plane to the UAE to get his shot because he couldn’t get one at home. What’s wierd about this is that Canada famously contracted for something like enough vaccine to vaccinate every Canadian 3 times over, the most per capita of any country in the world.

As homebucket said, vaccinations have been slow in ramping up in Canada, due in large part to not having any domestic vaccine production capacity.

Our vaccines are coming from Europe as the US has an Americans-first policy and hasn't been exporting them to us.

It varies from province to province but we're in the range of about 5% of the total population having had a first shot only. The fully vaccinated (two shots) proportion is way lower even.

In terms of reopenings it varies a lot from province to province and even from region to region within provinces.

But nowhere in Canada is as wide open as Texas or Florida are, for example.

Masking in stores, etc. is mandatory everywhere, and school is still disrupted to some degree often with a mix of online vs. onsite. But no schools are closed in Canada AFAIK.

Office workers are still very predominantly working from home if they can so CBD office districts are still extremely quiet and in some cases deserted.

Restaurants are open for sit-down with some restrictions in most places, but not quite everywhere.

Gyms are reopened in most places with restrictions again, as are movie theatres with reduced capacity.

I think in some areas bars have reopened but I don't think you can mill around too much and need to wear a mask if you get up to go the bathroom.

Nowhere has nightclubs, festivals, raves or large-scale concerts or sporting events with large crowds.

Coming from the person that relocated across the Atlantic because they lacked the mental strength to abide by a simple lockdown; that is rather funny.

Discarding your unquantifiable anecdotal evidence, they’d be losing on average nearly three years of their life and paying in the order of 2.3x more for the privilege.

Approximately 18% of the NHS Estate dates from before 1948, although building age doesn’t relate to interior and amenity age which have probably been refreshed several times over. It would be impractical to provide modern medical healthcare if the interiors and amenities didn’t align.

I think you'd have trouble finding a hospital building in active use in the US that dates from before the 1950s. And as I said, due to the legal requirement to make them seismically safe, California will soon be chock-a-block with brand new hospitals.

As it happens, I trained in a hospital building that dated from the 1930s but if it's still in use today it must have been gutted and totally redone inside. It had large open wards holding 30 patients or so, the only privacy being curtains between beds. That would be totally unacceptable in American medicine today and so would the nurse's station that couldn't directly visualize and electronically monitor every bed.

Newness isn't just about having modern equipment although that's important. Modern hospital design also makes certain things much easier or even possible like isolation of large numbers of infectious patients (i.e. COVID) and monitoring of more patients with fewer staff. In a competitive environment, it also allows hospitals to make being a patient in them a bit more pleasant with gourmet food and the ability to allow family members to stay in the room with the sick person in some cases (this is especially common in childrens' hospitals).

As I've said, the lower US average lifespan numbers are complicated to interpret, involving things like remoteness from medical facilities, payment issues for chronic care (not acute serious illness--the kind that gets you hospitalized--where there is a right to care regardless of ability to pay) and a lack of medical sophistication, especially among generally uneducated, immigrant and minority groups. Recently high rates of opiate addiction in some US communities are also thought to play a role.

But none of this really effects a direct comparison of middle class urban dwellers. It's hard to find direct comparisons of the health and mortality figures for urban-dwelling members of the middle class only, country to country, but I think they'd be fairly comparable on either shore of the Atlantic, with the British having, perhaps, the edge on chronic care and the US having the edge when it comes to acute hospital care.

We haven't asked my in-laws specifically how the rollout is being handled in Canada, but is the actual vaccine distribution being done at the regional level or the provincial level. Most of our family is in the Durham Region (Whitby and Oshawa), but we have one brother-in-law that lives in the Halton Region (Oakville). They are all in their 60s except for an aunt who is in her 80s.

Weill-Cornell's original building dates from the early 1930's, and I think Columbia-Presbyterian's original building is a couple years older, even. Mass General's original building is prewar too. I suspect a lot of big, urban medical centers are similar. But your point is likely correct; U.S. hospitals tend to be much newer/better resourced than in Europe. And the older buildings have been so extensively gutted they basically function the same as their newer buildings. Cornell and Columbia have recently built hospital towers too, and they're pretty seamless with the older structures.

And, yeah, I don't understand the lifespan argument. The U.S. has better healthcare and a lower lifespan. The availability of the best healthcare doesn't mean some people won't engage in risky, harmful activities.

The responsibility cascades down from the feds who receive and distribute the vaccine (all from abroad) to the provinces, who then distribute to local health authorities who do the shots.

Older hospital buildings do exist, but I doubt many are acute care facilities, and any that remain must be on the way out.

"Acute" is a technical term regarding both hospital services and facility requirements. I'm sure you can technically convert an old building, but it would be extremely expensive. And the final product probably wouldn't be lean.

Examples of what lean means: Departments are located to optimize healthcare and staff workflows, like imaging is convenient to orthopedic exam rooms. HVAC systems can be maintained without closing the spaces below or any key services. Rooms are sized optimally. Stuff like this can be much harder if not entirely unworkable in a renovation.

You left out the most important factor that effects US lifespan (and also contributes heavily to covid deaths): Obesity, though obesity generally goes hand in hand with "a lack of medical sophistication, especially among generally uneducated, immigrant and minority groups"

I had to get a medicated skin cream while I was in London a couple years ago for a skin issue I had at the time. I was actually just looking for an OTC substitute to use until I could get back to the U.S. But in the U.K. you apparently speak directly to the pharmacist when you go to buy any sort of medication. I described the issue and the guy hands me the prescription strength medication... and charged me £2 for it. It took about 5 minutes and blew my fucking mind.

Getting the same thing in the U.S. would've required waiting a week to go to a dermatologist, a $40 co-pay for the doctor visit, a $40 co-pay for the prescription, and then a trip to Rite-Aid/Walgreens/CVS etc., to wait several hours for them to "fill it". It really put into perspective how many hoops we have to jump through over here to get even the most basic medical care.

I think the UK and Europe are rapidly catching up on the issue of obesity. And in any case, it's a chronic disease and I gave the Brits the edge on management of chronic diseases. The fact is that the US doesn't have enough primary care doctors and the cost of seeing one combined with the time restrictions on appointments mean a lot of people don't get much primary care, at least from a physician. If they get it, it's often from a nurse practitioner these days.

MANAGEMENT of obesity, however, is another matter. I haven't got numbers but I'd bet the US medical system is much more aggressive in management of morbid obesity with such things as bariatric surgery.

Unless you went to the in-store "minute clinic" which you will increasingly find in US pharmacies (or sometimes down the row in a strip center), usually staffed by a nurse practitioner.

But the experience you described is more a matter of what drugs are approved for dispensing without a prescription by which category of provider than anything else. Where I am presently in Arizona, I can go to Mexico 40 miles away and buy all sorts of drugs, some of which are considered "mind altering" and strictly controlled as well as antibiotics and others over the counter in a pharmacia. Is this a better system? That's a matter of opinion.

As we all noticed when the UK was the first to approve COVID vaccines, they are a little more relaxed about who can prescribe and dispense what types of meds than we are.

Also, the co-pays you described depend completely on the type of insurance you have. In my case, if I got it from Walgreen's or a supermarket pharmacy it might have cost me nothing. If I got it from CVS I would have paid full price because my insurance doesn't have a contract with CVS. The doctor visit would likely have been free in any case, whether I saw a dermatologist or an NP at the "minute clinic".

I saw the graphic and thought it was interesting... And since it didn't give the breakdown of which LA County ZIP codes were being prioritized for COVID vaccinations, I looked it up, and found this, in case anyone is interested: https://www.kcra.com/article/califor...list/35770433#

I'm happy to know that my parents will be getting their COVID vaccines soon, through their HMO (Kaiser Permanente); they are in their late 70s. My sister got vaccinated some weeks ago because she is a middle school teacher. My partner and I can't wait to get vaccinated, we plan on doing it as soon as we are allowed to---we're both 50 years old.

I haven't really been going through this thread, so this question might've been asked before, but who here knows anyone, or knows OF anyone, who's had COVID?

Two of my co-workers had it; one of them went through very severe symptoms, with the headache, nausea/vomiting/diarrhea; the other one said he just felt really fatigued for 3 or 4 days, and headache-ey for a day or two; his wife had it too and went through worse symptoms. A few other co-workers were exposed to it but tested negative, and quarantined for 14 days.

Another co-worker of mine, her brother died of complications due to COVID. He died about a month ago, and the funeral was only last week, or something. Very sad. A friend of my parents, her brother also died due to COVID complications.

At this point, are there still people who don't at least know someone who has had it? I've lost count of how many people I know, or know of, who've had it. I also know of a few people who died too. A friend just recently buried two grandparents within a month that died from it.

That annoys me beyond anything. People in their 70s are 55x more likely to be hospitalized from getting Covid than a 5-17-year-old. Yet these governors are succumbing to teacher unions.

Uhhh... what are you talking about?

Yeah... another co-worker of mine had an uncle who died with COVID.

My partner has a few co-workers who also had it, and he also has a co-worker whose son's fiance's brother died from it.

Other than patients, in my own personal circle I only know that my 2 little nephews had it

I know about a half-dozen people in my widest possible entourage who got COVID-19. No reasonably close family members and no deaths.

Teachers themselves are at risk. They are also older than 17. I know three who are 50+

I only knew one person that had it until November, and I only came in contact in person with someone who had previously had it in December (I think). I now know 8 or 9 people that had it, and 5 of them were kids who were asymptomatic. The holiday season rise in cases was pretty big, although it also wasn't as crazy as the first wave because people knew how to work around people that tested positive.

Thanks for the info! I read that there are plans to onshore production, but it won't be ready until late Summer at the earliest. All of the federal govt. in Canada regardless of party should be raked over the coals for that. Hopefully, we will get to see that part of the family at some point this year.

My niece and one of her two teenaged children had it but both had minimal symptoms. What was curious was that her husband and her other son didn’t get it.

These are private companies who developed and are producing the vaccine and they have their plants where they’ve been for years. They built no new ones just to produce this vaccine. As it happens, Pfizer has a plant in the US and one in Belgium making their vaccine. Moderna, I believe, only has a US plant. Pfizer is supplying the US from its US plant and pretty much the rest of the world from the Belgian plant.

What has happened recently is that a couple of companies that have no COVID vaccine of their own have agreed to help produce one or the other of the vaccines from competitors, Merck and Sanofi most notably. What they mainly seem to be doing is diluting and bottling the bulk vaccines, a time-consuming step that takes specialized machinery most drug companies, but only drug companies, have.

If Canada is going to be producing vaccine within its borders, it would likely be having an existing drug plant help to produce one of the vaccines but I haven’t heard of this, More likely is that if Pres. Biden is correct that the US will have enough vaccine for all Americans by the end of May, then US production (which is in the upper midwest not far from Canada) would be available for shipment to Canada.

I saw an interview with PM Trudeau in which he said all Canadians will be vaccinated by July. If Canada is getting a large portion of the output from Pfizer and Moderna’s US plants in June and July, that’s doable.

As Pedestrian alluded to, you can't just rent an empty building and start producing vaccines in it the following morning.

This type of capacity is something Canada does not have and has not had for a while.

It is not the fault of the current Canadian government as these decisions (based on "why should we have the ability to produce our own vaccines when other countries will do it for us and we can just buy?") were made by governments of different stripes some years ago.

I do have some criticisms of Canada's COVID response - especially when it comes to lax border controls - but overall I am reasonably satisfied with how they have handled this.