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Post by dmo on Jan 30, 2022 12:26:46 GMT -6
To make a long story short, I'm of the opinion that as soon as it was apparent that vaccines don't stop transmission then all the mandates should have been over. Think about it, when you go to a concert, restaurant, job, etc... where it's either vaccine card or a negative test, then the only people there that can have covid and spread it are vaccinated people. It makes no sense to carry on this way. Josh, Promised myself I'd stay out of this one, but your statement re: vaccine versus testing leading to only vaccinated people having covid to spread at a given event is factually inaccurate hence incorrect. No test is existence is 100%, and the rapid (home) antigen tests now widely used aren't as accurate as PCR - the "gold standard". PCR was estimated to have a 90% plus sensitivity initially based on benchtop lab data showing close to 100% sensitivity in the lab - in clinical practice it has turned out to be about 80% sensitive (but 98% specific). Antigen testing is much worse - about 65% in symptomatic people with 98% specificity but only 44% sensitive in asymptomatic people. If you test 100 people who are asymptomatic (temporarily assuming anyone feeling ill isn't going out) - with PCR we'd have up to 20 possible positive Covid folks attending, with antigen testing up to 56 (over half) potentially positive.
I think big gov't has missed the point on emphasizing testing because the public equates a negative test with having no disease - and that's just not accurate. I personally think we should only test those admitted (for cohort isolation from other patients) and symptomatic high risk outpatients as well as those <5 years. Once flu is endemic each year I don't test everyone with flu like symptoms - I diagnose them with ILI (Influenza-like Illness) and send them on there way. Omicron is endemic at this point - so if you have URI symptoms - you probably have Covid and just stay home for 5 days.
As to getting rid of all mandates - I think we all want a return to "normalcy". Our understanding of covid continues to evolve (like recent evidence that highest risk of spread is 2 days prior/3 days after symptom onset) - but until we can effectively decrease total numbers requiring hospitalization we have to balance risk/benefit of restrictions on activities and overwhelming the health care system. I think a lot of the restrictions fail to meet the intent (as in testing before large events) and agree we should focus on strategies that can actually minimize risk. Stay safe out there.
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Post by seawell on Jan 30, 2022 12:50:50 GMT -6
To make a long story short, I'm of the opinion that as soon as it was apparent that vaccines don't stop transmission then all the mandates should have been over. Think about it, when you go to a concert, restaurant, job, etc... where it's either vaccine card or a negative test, then the only people there that can have covid and spread it are vaccinated people. It makes no sense to carry on this way. Josh, Promised myself I'd stay out of this one, but your statement re: vaccine versus testing leading to only vaccinated people having covid to spread at a given event is factually inaccurate hence incorrect. No test is existence is 100%, and the rapid (home) antigen tests now widely used aren't as accurate as PCR - the "gold standard". PCR was estimated to have a 90% plus sensitivity initially based on benchtop lab data showing close to 100% sensitivity in the lab - in clinical practice it has turned out to be about 80% sensitive (but 98% specific). Antigen testing is much worse - about 65% in symptomatic people with 98% specificity but only 44% sensitive in asymptomatic people. If you test 100 people who are asymptomatic (temporarily assuming anyone feeling ill isn't going out) - with PCR we'd have up to 20 possible positive Covid folks attending, with antigen testing up to 56 (over half) potentially positive.
I think big gov't has missed the point on emphasizing testing because the public equates a negative test with having no disease - and that's just not accurate. I personally think we should only test those admitted (for cohort isolation from other patients) and symptomatic high risk outpatients as well as those <5 years. Once flu is endemic each year I don't test everyone with flu like symptoms - I diagnose them with ILI (Influenza-like Illness) and send them on there way. Omicron is endemic at this point - so if you have URI symptoms - you probably have Covid and just stay home for 5 days.
As to getting rid of all mandates - I think we all want a return to "normalcy". Our understanding of covid continues to evolve (like recent evidence that highest risk of spread is 2 days prior/3 days after symptom onset) - but until we can effectively decrease total numbers requiring hospitalization we have to balance risk/benefit of restrictions on activities and overwhelming the health care system. I think a lot of the restrictions fail to meet the intent (as in testing before large events) and agree we should focus on strategies that can actually minimize risk. Stay safe out there.
Thanks for the info! I knew testing had its flaws but that's even worse than I thought. In light of that information, doesn't it still seem reasonable that a group of tested people would be less likely to have covid than a group of untested people? I guess the most pertinent example would be an unvaxxed but negative tested healthcare worker(that is probably fired by now) vs a vaxxed, positive tested(but asymptomatic or mild symptoms) healthcare worker that doesn't have to miss any time. I'm sorry but I just don't understand that. Mandates at this point seem like nothing more than coercion to me.
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Post by bgrotto on Jan 30, 2022 12:52:26 GMT -6
To make a long story short, I'm of the opinion that as soon as it was apparent that vaccines don't stop transmission then all the mandates should have been over. Think about it, when you go to a concert, restaurant, job, etc... where it's either vaccine card or a negative test, then the only people there that can have covid and spread it are vaccinated people. It makes no sense to carry on this way. That would mean ignoring the needs of our already-overwhelmed hospitals and medical professionals, and the needs of all of their patients -- both those seeking medical care for covid and those seeking care for everything else. Until serious illness from covid is a relative rarity (an outcome for which vaccines are unequivocally effective, and highly so), vax cards and/or negative tests remain a social necessity.
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Post by seawell on Jan 30, 2022 12:53:58 GMT -6
That would mean ignoring the needs of our already-overwhelmed hospitals and medical professionals, and the needs of all of their patients -- both those seeking medical care for covid and those seeking care for everything else. Until serious illness from covid is a relative rarity (an outcome for which vaccines are unequivocally effective, and highly so), vax cards and/or negative tests remain a social necessity. Then maybe hire back the people you fired would seem like a reasonable option as well?
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Post by bgrotto on Jan 30, 2022 13:05:04 GMT -6
That would mean ignoring the needs of our already-overwhelmed hospitals and medical professionals, and the needs of all of their patients -- both those seeking medical care for covid and those seeking care for everything else. Until serious illness from covid is a relative rarity (an outcome for which vaccines are unequivocally effective, and highly so), vax cards and/or negative tests remain a social necessity. Then maybe hire back the people you fired would seem like a reasonable option as well? From what I've read, the folks fired (or who quit) due to vaccination requirements amounts to about 1% of the medical workforce, so if that's accurate no, I don't think it'd really help much to hire them back. ETA: on second thought, the bigger issue here is beds. More beds with covid patients means fewer beds for everyone else. Hiring more nurses or doctors doesn't fix that problem in any way. You can't (re-)hire your way out of a facilities issue. So even if that 1% figure above is way, way off, I'm still of the same mind.
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Post by seawell on Jan 30, 2022 13:24:44 GMT -6
Then maybe hire back the people you fired would seem like a reasonable option as well? From what I've read, the folks fired (or who quit) due to vaccination requirements amounts to about 1% of the medical workforce, so if that's accurate no, I don't think it'd really help much to hire them back. ETA: on second thought, the bigger issue here is beds. More beds with covid patients means fewer beds for everyone else. Hiring more nurses or doctors doesn't fix that problem in any way. You can't (re-)hire your way out of a facilities issue. So even if that 1% figure above is way, way off, I'm still of the same mind. But surely it wouldn't hurt? You have to understand the hypocrisy that comes across when you fire a worker for not being vaxxed then you allow a worker who tests positive to continue to work without missing time. Not to mention, they tested positive for the very thing that you're trying to prevent from spreading...how does this make any sense?
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Post by dmo on Jan 30, 2022 14:11:51 GMT -6
Josh, Re: tested versus untested: in theoretical statistical terms yes you'd have a lower odds ratio in the tested versus untested group since the tested group would identify a certain percentage of asymptomatic positives - call it 50% for antigen - that would then be excluded.. The problem is in the real world any given group does not necessarily follow the same distribution prevalence of disease that the "ideal" population statistics predict. So you could have (in theory) a group who are all positive but test negative (unlikely but possible). The reality is testing (antigen/rapid) doesn't really provide enough accuracy to effectively predict risk.
Don't want to go through the vax versus not vaxxed discussion again - but your asymptomatic not vaccinated HCW tested by antigen (since minimum PCR turn around is 24h) has a 54% chance of actually being infectious/contagious and may not think they're infected so more lax with PPE and not wear an N95. An asymptomatic vaccinated HCW who is tested positive knows they are infected and would then (in theory) be in an N95 all day to minimize risk of transmission to others. Is one actually a higher risk than the other? - not sure we truly know.
Re: staff/bed shortages. Short answer - it's almost always staff. Outside of the ER (which does actually have finite bed capacity) - hospitals usually have beds, just not the staff to use them. Inpatient services can be curtailed (no elective surgeries, close wards, etc) but the ER is required to try and see everyone presenting for care - hence seeing patients in hallways, waiting room, etc when patients can't move from the ER to the floor/ICU/etc. Hospitals (and medicine) have serious issues as private equity has gotten more involved and made profit vice patient care the priority. Like "just in time" supply chain models - great in theory and decrease waste when run properly but not designed to cope with large volume surges, supply chain disruptions, etc. Hopefully the health care system will take some serious lessons learned from this event - but we'll see.
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Post by bgrotto on Jan 30, 2022 14:14:59 GMT -6
From what I've read, the folks fired (or who quit) due to vaccination requirements amounts to about 1% of the medical workforce, so if that's accurate no, I don't think it'd really help much to hire them back. ETA: on second thought, the bigger issue here is beds. More beds with covid patients means fewer beds for everyone else. Hiring more nurses or doctors doesn't fix that problem in any way. You can't (re-)hire your way out of a facilities issue. So even if that 1% figure above is way, way off, I'm still of the same mind. But surely it wouldn't hurt? You have to understand the hypocrisy that comes across when you fire a worker for not being vaxxed then you allow a worker who tests positive to continue to work without missing time. Not to mention, they tested positive for the very thing that you're trying to prevent from spreading...how does this make any sense? If a nurse or doctor can test positive and still come to a hospital to work, then I agree that is stupid policy. Are you sure that's something that is actually happening? In any event, that's a separate issue from vaccination mandates. I am fully behind a vaccine requirement for medical staff, no ifs and or buts.
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Post by dmo on Jan 30, 2022 14:22:06 GMT -6
Given the staffing strain, it was proposed that positive HCWs could work in N95s if minimal symptoms but few (if any) places had that actually happen. The biggest thing was reducing "quarantine" from 10 to 5 days - but that;s supported by current evidence that max transmissible period is 2 days prior and 3 days post symptom onset. Nobody's really clear on what testing positive and being asymptomatic but vaccinated means re: risk stratification but usually assumed lower risk.
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Post by seawell on Jan 30, 2022 14:39:32 GMT -6
But surely it wouldn't hurt? You have to understand the hypocrisy that comes across when you fire a worker for not being vaxxed then you allow a worker who tests positive to continue to work without missing time. Not to mention, they tested positive for the very thing that you're trying to prevent from spreading...how does this make any sense? If a nurse or doctor can test positive and still come to a hospital to work, then I agree that is stupid policy. Are you sure that's something that is actually happening? In any event, that's a separate issue from vaccination mandates. I am fully behind a vaccine requirement for medical staff, no ifs and or buts. Yes, it's a real thing at some places that have had staffing shortages: www.msn.com/en-us/health/medical/health-care-workers-can-return-to-work-even-with-positive-covid-diagnosis/ar-AASE9FpIt has to do with mandates because even if only 1%(it's a good bit higher in some places) of staff have been fired over the mandate then that seems counterproductive to me.
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Post by seawell on Jan 30, 2022 15:07:55 GMT -6
A response from Spotify: newsroom.spotify.com/2022-01-30/spotifys-platform-rules-and-approach-to-covid-19/"A decade ago, we created Spotify to enable the work of creators around the world to be heard and enjoyed by listeners around the world. To our very core, we believe that listening is everything. Pick almost any issue and you will find people and opinions on either side of it. Personally, there are plenty of individuals and views on Spotify that I disagree with strongly. We know we have a critical role to play in supporting creator expression while balancing it with the safety of our users. In that role, it is important to me that we don’t take on the position of being content censor while also making sure that there are rules in place and consequences for those who violate them. You’ve had a lot of questions over the last few days about our platform policies and the lines we have drawn between what is acceptable and what is not. We have had rules in place for many years but admittedly, we haven’t been transparent around the policies that guide our content more broadly. This, in turn, led to questions around their application to serious issues including COVID-19. Based on the feedback over the last several weeks, it’s become clear to me that we have an obligation to do more to provide balance and access to widely-accepted information from the medical and scientific communities guiding us through this unprecedented time. These issues are incredibly complex. We’ve heard you – especially those from the medical and scientific communities – and are taking the following steps: Today we are publishing our long-standing Platform Rules. These policies were developed by our internal team in concert with a number of outside experts and are updated regularly to reflect the changing safety landscape. These are rules of the road to guide all of our creators—from those we work with exclusively to those whose work is shared across multiple platforms. You can now find them on our newsroom, and they’ll live permanently on the main Spotify website. They are being localized into various languages to help our users understand how Spotify assesses all content on our platform. We are working to add a content advisory to any podcast episode that includes a discussion about COVID-19. This advisory will direct listeners to our dedicated COVID-19 Hub, a resource that provides easy access to data-driven facts, up-to-date information as shared by scientists, physicians, academics and public health authorities around the world, as well as links to trusted sources. This new effort to combat misinformation will roll out to countries around the world in the coming days. To our knowledge, this content advisory is the first of its kind by a major podcast platform. We will also begin testing ways to highlight our Platform Rules in our creator and publisher tools to raise awareness around what’s acceptable and help creators understand their accountability for the content they post on our platform. This is in addition to the terms that creators and publishers agree to governing their use of our services. I want you to know that from the very first days of the pandemic, Spotify has been biased toward action. We launched a variety of educational resources and campaigns to raise awareness and we developed and promoted a global COVID-19 Information Hub. We donated ad inventory to various organizations for vaccine awareness, funds to the World Health Organization and COVID-19 Vaccines Global Access (COVAX) to increase vaccine equity and supported the Go Give One fundraising campaign. And we established a music relief project to support the creative community. While this is not a complete list, I hope it gives you a sense of how seriously we’ve approached the pandemic as a company. I trust our policies, the research and expertise that inform their development, and our aspiration to apply them in a way that allows for broad debate and discussion, within the lines. We take this seriously and will continue to partner with experts and invest heavily in our platform functionality and product capabilities for the benefit of creators and listeners alike. That doesn’t mean that we always get it right, but we are committed to learning, growing and evolving. Daniel"
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kcatthedog
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Post by kcatthedog on Jan 30, 2022 15:18:41 GMT -6
Personally, super proud of Neil and Joni for having principles.
Spotify and Joe care about one thing, money, not people’s health.
Every freedom also contains a responsibility, neither Joe or Spot are standing on any moral mountain on this issue.
Anyway, speaking implicitly of music, let’s go !
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Post by dmo on Jan 30, 2022 15:19:51 GMT -6
Josh, As a HCW I have to comply with many infectious disease vaccinations, but I do think that after we all spent the first year dealing with this without a vaccine it wasn't the right approach to fire people who expressed reservations. So frustrated by how poorly we've handled much of the pandemic - we really are better/more capable than this.
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Post by kcatthedog on Jan 30, 2022 15:28:13 GMT -6
Lots of lessons to be learned, like, hey maybe disbanding the national pandemic analysis and planning office, wasn’t such a good cost savings idea ? Who knew ?
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Post by seawell on Jan 30, 2022 16:17:18 GMT -6
Personally, super proud of Neil and Joni for having principles. Spotify and Joe care about one thing, money, not people’s health. Every freedom also contains a responsibility, neither Joe or Spot are standing on any moral mountain on this issue. Anyway, speaking implicitly of music, let’s go ! I think you can support NY and Joni without making a claim like that against Joe. Having listened to him for years, you couldn’t be more wrong. He cares very much about health in general and about getting more people healthy. Please listen to some episodes if you haven’t, I think you’ll be surprised.
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Post by seawell on Jan 30, 2022 16:34:15 GMT -6
Lots of lessons to be learned, like, hey maybe disbanding the national pandemic analysis and planning office, wasn’t such a good cost savings idea ? Who knew ? Agreed, as previously stated I don’t think 45 did a good job in regards to the pandemic at all. Plenty of blame to go around. On a side note, any idea where your prime minister is at the moment? 😉
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Post by seawell on Jan 30, 2022 16:39:31 GMT -6
Josh, As a HCW I have to comply with many infectious disease vaccinations, but I do think that after we all spent the first year dealing with this without a vaccine it wasn't the right approach to fire people who expressed reservations. So frustrated by how poorly we've handled much of the pandemic - we really are better/more capable than this.
I know you don’t post for any kind of recognition but I feel compelled to say once again that we’ll absolutely never be able to repay or thank you guys enough. My sincere gratitude. I certainly hope one day soon we’ll be far enough removed to stop pointing fingers and come up with real solutions moving forward to not put you guys in that position ever again 🙏🏼
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Post by Johnkenn on Jan 30, 2022 16:47:07 GMT -6
Went and listened to a large portion of the podcast with Malone. I thought it was excellent. Why in the world would you censor that like the Chinese?
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Post by kcatthedog on Jan 30, 2022 17:10:14 GMT -6
Fair enough, Josh, ok, so, to what ever extent either the reality or the perception that COVID misinformation was being provided on the podcasts ( and that seems well documented ), hopefully, everyone’s considers what lessons can be learned and applied from this.
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Post by bgrotto on Jan 30, 2022 17:14:27 GMT -6
Went and listened to a large portion of the podcast with Malone. I thought it was excellent. Why in the world would you censor that like the Chinese? "Caving to communists" 🙄 This sort of rhetoric is so pathetic.
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Post by seawell on Jan 30, 2022 17:17:09 GMT -6
What some of us are trying to point out is that you can't just call things you disagree with "misinformation." Or, I guess you can, but millions of people are tuning you out. The doctors putting forth the ideas on Joe's podcast, even if you disagree with them, at least deserve a seat at the table so there can be an open discussion. Honestly, listening to the episodes with Dr. Malone and Dr. McCullough on JRE should be required listening for this particular thread. Otherwise, how do we even know what we're arguing about here? I wonder if any reporters have bothered to ask Neil Young if he listened to those episodes?
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Post by bgrotto on Jan 30, 2022 17:31:23 GMT -6
What some of us are trying to point out is that you can't just call things you disagree with "misinformation." Peter McCullough was on like a month ago claiming the pandemic was planned, that previously-infected people are immune permanently, and doing the same tired BS routine claiming VAERS is proof of thousands of vaccine deaths. That's not a disagreement. That is good ol' fashioned misinformation.
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Post by seawell on Jan 30, 2022 17:47:03 GMT -6
What some of us are trying to point out is that you can't just call things you disagree with "misinformation." Peter McCullough was on like a month ago claiming the pandemic was planned, that previously-infected people are immune permanently, and doing the same tired BS routine claiming VAERS is proof of thousands of vaccine deaths. That's not a disagreement. That is good ol' fashioned misinformation. If you had listened to both episodes you'd know that Dr. McCullough had Dr. Malone pass on the info that he had changed his stance on permanent immunity once omicron entered the picture. Dr. McCullough has treated thousands of Covid patients, he's earned a seat at the table. Disagree with him...fine...but silence him, or Dr. Malone, or Joe...no...not gonna happen. I think it's important to note that JRE used to be on Apple Podcasts, Youtube, Spotify, etc all at the same time... He went exclusive with Spotify in 2020. So, his show isn't nearly as available as it used to be, yet his listeners have gone through the roof. You don't have to like it, I'm just telling you every time you say "misinformation" it becomes less and less meaningful. People are flocking to these episodes for a reason and this may be shocking to you but the idea that the pandemic was not of natural origin and at least to some extent intentional and used for political gain is not such an unbelievable idea to A LOT of people. I'm not touching VAERS again haha..but if you look at it and still see NOTHING then once again that is a level of faith and trust I'll never understand.
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Post by drbill on Jan 30, 2022 18:32:48 GMT -6
Just an observation.....
Out in the REAL world - where musicians are the rarity, NY (and musicians by association) is/are taking a pretty bad beating over this. Sad to see from a musicians perspective.
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Post by drbill on Jan 30, 2022 18:34:26 GMT -6
you can't just call things you disagree with "misinformation." I think if you had to boil all the debates down to ONE sentence....this would be it. Thanks Josh.
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