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Comment by nemothekid | Hacker News Reader

>We need to decide if we're okay with science agencies lying to us.

This is the "Science is a Liar sometimes"[1] defense, and it can be used to discredit any sort of scientific research. You are basically asking that our agencies be 100% correct the first time and be perfect predictors of the future.

Secondly I don't understand how you were mislead about vaccines. The efficiency rates were always described in preventing you from going to the hospital. With COVID, the main issue has always been overstressing the health system - thats where the breakdown happens and thats why everyone needs to take the vaccine. Even now, ICU beds are not majority unvaccinated COVID cases, which overworks nurses and prevents people with other diseases from getting proper treatment.

[1] https://www.youtube.com/watch?v=U3Ak-SmyHHQ

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> You are basically asking that our agencies be 100% correct the first time and be perfect predictors of the future.

That isn't how I read this comment at all :/.

First off, the person isn't even saying not to trust scientists at all, much less because they are wrong: in each case the idea was that they are acting in their best understanding of what the effect of a certain kind of intervention will be; the comment isn't blaming scientists for getting something wrong or failing to predict the future: it explicitly even seems to agree with each intervention as being a sensible thing to do given the information at the time and the risk/benefit analysis.

And then secondly, the issue of someone overstating their confidence on purpose and knowingly is very different from someone misunderstanding something and later realizing they were wrong. "I think this is our best course of action to mitigate the impact" is an honest thing to say. But people seem to want to hear "this will solve the problem fully". People seem to not want to deal with "I realize this might not help much, but it certainly won't hurt: let's try it and see how effective it is" (another honest thing to say), but instead want to hear "trust me: you need to do this as I know it is going to work".

I was--and am!--fully willing to do things that are only going to mitigate the impact, whether to myself or to others, and I am willing to do it even on reasoning as flimsy as "it is unlikely to hurt". But I feel like I am in a vast minority, and so everyone instead is motivated to overstate their confidence and overstate their intended result in the hope of getting more compliance, which is why we have people who don't just feel "scientists and doctors are trying their best to work in our best interests, and this is our best hope as of today" but help get on the bandwagon of "if you disagree with how effective this is going to be you are an idiot who is anti-science and you are part of the problem in our attempts to get compliance".

I truly do not understand what distinction you are trying to make and your interoperation seems to be way less charitable than I gave.

Your problem is, as I understand it, is you understand that they can be wrong, but they didn't use your preferred language? Are you asking the USG to personally message to 300MM Americans?

Do you get mad at your doctor for being wrong sometimes for the same reason?

The problem there is that the experts did say, "I think this is our best course of action to mitigate the impact," but people heard "this will solve the problem fully" and then decided that all science is a lie.

> This is the "Science is a Liar sometimes"[1] defense

No, this is not "Science is a liar sometimes" defense.

When we were misled about mask efficacy with a number of circular lies (you don't need masks, you do need masks, double mask!, cloth masks are as effective as N9ts, N95 is overkill, it is not aerosolized, etc) a good number of those were well-known lies of varying proportion, and not the scientific method in progress.

The truth was that people were lying to us consciously to preserve N95 mask supply for frontline workers, but that truth would have gone much further than the mistruths and half truths we were told.

At the same time as the hyperbole was spreading about covid taking over ERs and News coverage was emphasizing this fact, my surgeon wife was telling me how empty all of the hospitals were, and the on-call cases dropped to nothingness because people were isolating and not going outside. But still, the drumbeat of 24/7 news cycle kept putting out bogus info about saturation of ERs and ICUs chock full of intubated covid patients.

If there has been any damage done to science by our authorities during this crisis, it is completely self-inflicted.

>When we were misled about mask efficacy with a number of circular lies (you don't need masks, you do need masks, double mask!, cloth masks are as effective as N9ts, N95 is overkill, it is not aerosolized, etc) a good number of those were well-known lies of varying proportion, and not the scientific method in progress.

The original consensus is that there was no need for widespread mask wearing, and a supply shock would have been dangerous. We only know now (or rather a couple months later), that advice was wrong. Again, I'm not sure how you can feel misled about the advice with regards to a novel virus. It just sounds like you are frustrated because the data wasn't 100% accurate on day one.

>At the same time as the hyperbole was spreading about covid taking over ERs and News coverage was emphasizing this fact, my surgeon wife was telling me how empty all of the hospitals were, and the on-call cases dropped to nothingness because people were isolating and not going outside. But still, the drumbeat of 24/7 news cycle kept putting out bogus info about saturation of ERs and ICUs chock full of intubated covid patients.

Your anecdote is not a good replacement data. Maybe your wife's hospital or experience was different but that may not reflect the hundreds of thousands of other hospitals. If you don't believe ICU reports, it could help to look at how salaries for traveling nurses have grown in the same time period. If hospitals are empty why are their salaries rising? Did hospital administrators suddenly get charitable?

[1] https://www.beckershospitalreview.com/nursing/going-back-to-...

> The original consensus is that there was no need for widespread mask wearing, and a supply shock would have been dangerous. We only know now (or rather a couple months later), that advice was wrong. Again, I'm not sure how you can feel misled about the advice with regards to a novel virus. It just sounds like you are frustrated because the data wasn't 100% accurate on day one.

Please do not project anger or frustration. It was clearly respiratory in nature from day one, and I always thought it was bad advice intentionally given out to control supply, rather than the painful truth of "we don't have enough and we need to save it for medical workers".

> Your anecdote is not a good replacement data. Maybe your wife's hospital or experience was different but that may not reflect the hundreds of thousands of other hospitals. If you don't believe ICU reports, it could help to look at how salaries for traveling nurses have grown in the same time period. If hospitals are empty why are their salaries rising? Did hospital administrators suddenly get charitable?

This wasn't anecdotal, as the 4 hospital systems she supports are circulating daily covid lists, and the numbers were quite low. Because I have an interest, this data was shared with me. The CDC's own numbers for covid patients also reflect this fact [1].

A travel nurse is a poor proxy for a Covid staffing problem, since what you are probably pointing out is instead common staffing issues from school closings, and nurses prioritizing their own family over work. More recently, many nurses are resigning from covid vaccine mandates [2].

Many nurses go through advanced training in order to be able to treat specialized patients, also known as Critical Care [3]. Most travel nurses are not Critical Care / ICU / ID qualified [4] , nor experienced to work an infectious disease unit either, nor are they respiratory therapists, or Infectious Disease docs, the two medical pros most likely to be impacted by a covid outbreak.

Saying a travel nurse is like a Critical Care / ICU / ID nurse, is like going to an Orthopedic surgeon to have your heart surgery, or visiting an interventional radiologist to get your ACL repaired. While both an Orthopedic surgeon and an interventional radiologist are medical doctors, they have specific residencies, fellowships, and advanced medical education that equates to thousands of hours. In this type of education for nurses, that likewise translates to a specific number of hours working in the field, learning the equipment, practices for Standard of Care.

The more mid-level Critical Care certifications can be found at [5] and the graduate-level / advanced certifications at [6]

Here is a useful reference I found on the transition of nursing into advanced specialties focused on Critical Care / ICU / disciplines [7]

If you wanted to provide accurate data around travel nurses, you would need to pull out the small subset of travel nurses trained in Critical Care, ICU/ID, or advanced educated like Nurse Practicioners, and then expand on it. But you haven't done that, and are just conjecturing.

The medical establishment has a rapidly growing body of knowledge and a huge number of specializations, to treat all the injuries, pathologies, and maladies that plague us.

[1] https://gis.cdc.gov/grasp/COVIDNet/COVID19_3.html

[2] https://www.thedailybeast.com/lewis-county-hospital-halts-ba...

[3] https://www.purdueglobal.edu/blog/nursing/list-nursing-speci...

[4] https://www.gmercyu.edu/academics/learn/types-of-nurses

[5] https://www.aacn.org/certification/get-certified

[6] https://www.aacn.org/certification/advanced-practice

[7] https://www.americannursinghistory.org/nursingspecialty-crit...

"*When we were misled about mask efficacy with a number of circular lies..."

This is false.

https://news.ycombinator.com/item?id=28201328

No, he is asking to not be knowingly lied to. You might be fine with this if you are from Far East or India https://en.wikipedia.org/wiki/Face_(sociological_concept)#Ch.... Lying to save face, or even for greater good is not tolerated in the West.

>No, he is asking to not be knowingly lied to.

My problem is the implication what they lied. That's why I posted the "Science is a liar sometimes clip". You can't call someone a liar for giving you bad advice on imperfect information. Was Aristotle lying when he said the sun revolves around the earth or was he just wrong?

I think they're asking for science not to misrepresent the facts.

They're not asking for science to be perfect.

It's easy to say the facts were misrepresented in hindsight. The original consensus is that there was no need for widespread mask wearing, and a supply shock would have been dangerous. We only know now (or rather a couple months later), that advice was wrong.

> everyone needs to take the vaccine

This is simply not true, anyone who claims this is ignoring a vast body of scientific evidence supporting the fact that individuals who’ve recovered from previous infection will be at least as well protected as vaccinated individuals against reinfection.

If you were to say “most people who don’t already have natural immunity ought to be vaccinated” that would be a much more sensible recommendation, in-line with general scientific consensus (and public health policies in other countries).

>If you were to say “most people who don’t already have natural immunity ought to be vaccinated” that would be a much more sensible recommendation, in-line with general scientific consensus (and public health policies in other countries).

It might be scientific consensus, but I do not consider this good public policy. There are several problems:

1. How do you verify if someone has gotten COVID already? The PCR test can report negative for as short as 2 weeks after symptoms go away.

2. Do you then parallel documentation where people have vaccine documents or positive test requirements?

3. How should businesses/schools treat positive testing individuals who did not get vaccinated?

4. Should the government just wait for the unvaccinated to get COVID and just roll the dice if they survive or not?

I'm not sure how you can seriously argue that point versus the massively simpler to execute policy plan of just getting everyone vaccinated.

We are not cattle no matter what you public policy wonks have been led to believe. It is possible to test to differentiate between those currently shedding the virus and those who are recovered with natural immunity. Those with natural immunity actually do themselves harm by taking a double vaccine dose according to some immunologists.

> 1. How do you verify if someone has gotten COVID already? The PCR test can report negative for as short as 2 weeks after symptoms go away.

Antibody tests?

"Among Kentucky residents infected with SARS-CoV-2 in 2020, vaccination status of those reinfected during May–June 2021 was compared with that of residents who were not reinfected. In this case-control study, being unvaccinated was associated with 2.34 times the odds of reinfection compared with being fully vaccinated."

https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e1.htm?s_cid=mm...

"Effectiveness of two doses remains at least as great as protection afforded by prior natural infection. The dynamics of immunity following second doses differed significantly between BNT162b2 and ChAdOx1, with greater initial effectiveness against new PCR-positives but faster declines in protection against high viral burden and symptomatic infection with BNT162b2. There was no evidence that effectiveness varied by dosing interval, but protection was higher among those vaccinated following a prior infection and younger adults."

https://www.medrxiv.org/content/10.1101/2021.08.18.21262237v...

"We examined whether sera from recovered and naïve donors, collected before and after immunizations with existing messenger RNA (mRNA) vaccines, could neutralize the Wuhan-Hu-1 and B.1.351 variants. Prevaccination sera from recovered donors neutralized Wuhan-Hu-1 and sporadically neutralized B.1.351, but a single immunization boosted neutralizing titers against all variants and SARS-CoV-1 by up to 1000-fold. Neutralization was a result of antibodies targeting the receptor binding domain and was not boosted by a second immunization. Immunization of naïve donors also elicited cross-neutralizing responses but at lower titers. Our study highlights the importance of vaccinating both uninfected and previously infected persons to elicit cross-variant neutralizing antibodies."

https://www.science.org/doi/full/10.1126/science.abg9175

1) That CDC study has a relatively small sample size (N=738) and uses data from a single state during a 2-month period. The confidence interval on the "2.34" odds ratio is large (95% CI = 1.58–3.47). Most importantly, a tremendous amount of literature contradicts those findings. Nearly every large scale and long term serological study has demonstrated that immunity acquired through previous infection is at least equally effective as vaccination in preventing reinfection.

- A previous history of SARS-CoV-2 infection was associated with an 84% lower risk of infection, with median protective effect observed 7 months following primary infection. This time period is the minimum probable effect because seroconversions were not included. This study shows that previous infection with SARS-CoV-2 induces effective immunity to future infections in most individuals. [1] (N=25,661)

- In conclusion, documented SARS-CoV-2 reinfections were exceedingly rare, with an incidence of 0.3 infections for every 1000 persons-week, and none were severe. Seroconversion after symptomatic or asymptomatic SARS-CoV-2 infection seems to be associated with a 10-fold reduction in risk of successive viral infection contamination, lasting at least 8 months. [2] (N=1,494)

- The study results suggest that reinfections are rare events and patients who have recovered from COVID-19 have a lower risk of reinfection. Natural immunity to SARS-CoV-2 appears to confer a protective effect for at least a year, which is similar to the protection reported in recent vaccine studies. [3] (N=15,075)

- Reinfection is rare in the young and international population of Qatar. Natural infection appears to elicit strong protection against reinfection with an efficacy ~95% for at least seven months. [4] (N=192,967)

- The degree of protection (10-fold) associated with seropositivity appears to be comparable to that observed in the initial reports of the efficacy of mRNA vaccines in large clinical trials.* [5] (N=3,257,478)

2) The preprint you cite is a "large community-based survey". I'll trade you pre-prints, this one is a retrospective observational study with data out of Israel [6]:

"This study demonstrated that natural immunity confers longer lasting and stronger protection against infection, symptomatic disease and hospitalization caused by the Delta variant of SARS-CoV-2, compared to the BNT162b2 two-dose vaccine-induced immunity. Individuals who were both previously infected with SARS-CoV-2 and given a single dose of the vaccine gained additional protection against the Delta variant."

3) Natural infection elicits antibodies that vaccination alone does not (for example nucelocapsid protein antibodies) [7]. The paper you cited does not provide evidence that vaccination on top of existing immunity confers any significant benefit to health outcomes in the face of viral mutation and variants of concern.

[1] SARS-CoV-2 infection rates of antibody-positive compared with antibody-negative health-care workers in England: a large, multicentre, prospective cohort study (SIREN) https://pubmed.ncbi.nlm.nih.gov/33844963/

[2] Risk of Reinfection After Seroconversion to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Population-based Propensity-score Matched Cohort Study https://academic.oup.com/cid/advance-article/doi/10.1093/cid...

[3] Assessment of SARS-CoV-2 Reinfection 1 Year After Primary Infection in a Population in Lombardy, Italy https://jamanetwork.com/journals/jamainternalmedicine/fullar...

[4] SARS-CoV-2 antibody-positivity protects against reinfection for at least seven months with 95% efficacy https://www.sciencedirect.com/science/article/pii/S258953702...

[5] Association of SARS-CoV-2 Seropositive Antibody Test With Risk of Future Infection https://jamanetwork.com/journals/jamainternalmedicine/fullar...

[6] Comparing SARS-CoV-2 natural immunity to vaccine-induced immunity: reinfections versus breakthrough infections https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v...

[7] Immunogenicity and crossreactivity of antibodies to the nucleocapsid protein of SARS-CoV-2: utility and limitations in seroprevalence and immunity studies https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879156/

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