Covid vaccination linked to 'substantial reduction' in hospital admissions • Hacker News Board

Re: Covid vaccination linked to 'substantial reduction' in hospital admissions

#211

Post by hntrader » Mon, Feb 22, 2021, 8:57 PM UTC

scrollaway wrote: post #134

dragontamer wrote: post #129

Earlier quoted context omitted.

> Since we're on the topic, shouldn't this (hospital admissions) be the almost singular criterion to influence public policy / restrictive measures? Given the high correlation between COVID# cases (or %Positive) and hospitalizations, why not just use COVID# and "gain" 2 weeks of information? Hospitalizations are weeks delayed from COVID# or %Positive spikes. Its a slow moving disease: taking 5 to 14 days before peopl…

> Given the high correlation between COVID# cases (or %Positive) and hospitalizations, why not just use COVID# and "gain" 2 weeks of information? As we vaccinate the people at the highest risk of hospitalization, the correlation will change: Numbers may stay very similar, but hospitalizations should go way down.

This, and also hospitalizations are a less exploitable metric. Self-selection bias isn't much of a problem, and the number of tests being done doesn't influence the results.

I would look at either hospitalizations or deaths once vaccinations reach a large percentage of the population.

Re: Covid vaccination linked to 'substantial reduction' in hospital admissions

#212

Post by standardUser » Mon, Feb 22, 2021, 8:57 PM UTC

ceejayoz wrote: post #208

standardUser wrote: post #186

Earlier quoted context omitted.

It's an important metric because earlier indicators aren't as useful. The rate of new cases is tricky because we don't really care if someone gets COVID-19 anymore than we care if they get the common cold, assuming they have only mild symptoms and fully recover. Hospitalizations are the first unambiguous metric we have to know there is a serious problem that may require a dramatic response.

> It's an important metric because earlier indicators aren't as useful. Sure they are. They're less precise , but they're more useful , because they're more likely to let you combat the spike before it gets out of control. It's like a smoke alarm. Maybe it's going off because it's over-sensitive and someone just took a shower... but it's a better early warning system than waiting for active flames to appear.

I agree, but once vaccinations are widespread and we are confident that severe illness will be very rare, it would be hard to take drastic measures based only on the rate of new cases. There could be a huge surge of cases but we would expect a low hospitalization rate, so we would likely want to wait.

Re: Covid vaccination linked to 'substantial reduction' in hospital admissions

#213

Post by ceejayoz » Mon, Feb 22, 2021, 8:57 PM UTC

cogman10 wrote: post #195

wcfields wrote: post #179

I may get downvoted for this, but genuinely curious if there's vaccine tourism (not that I'm in a position to get on a jet to get a shot). Eg, if the wait time is long for my group in the US/UK/Wherever, can I book a flight to UAE or Cuba to get a vaccine at the airport?

I don't think so. There's simply not excess vaccines to go around at this point. I imagine this might happen more in the future when a larger percentage of some nations are vaccinated.

> There's simply not excess vaccines to go around at this point.

I'm sure there are creative people out there who'll, say, put you on the staff list at a dentist's office so you're technically a "first responder". For a price, of course.

Re: Covid vaccination linked to 'substantial reduction' in hospital admissions

#214

Post by ceejayoz » Mon, Feb 22, 2021, 8:58 PM UTC

standardUser wrote: post #212

ceejayoz wrote: post #208

Earlier quoted context omitted.

> It's an important metric because earlier indicators aren't as useful. Sure they are. They're less precise , but they're more useful , because they're more likely to let you combat the spike before it gets out of control. It's like a smoke alarm. Maybe it's going off because it's over-sensitive and someone just took a shower... but it's a better early warning system than waiting for active flames to appear.

I agree, but once vaccinations are widespread and we are confident that severe illness will be very rare, it would be hard to take drastic measures based only on the rate of new cases. There could be a huge surge of cases but we would expect a low hospitalization rate, so we would likely want to wait.

Once vaccinations are widespread, yes.

Until then, getting out in front of a spike remains necessary.

Re: Covid vaccination linked to 'substantial reduction' in hospital admissions

#215

Post by Dumblydorr » Mon, Feb 22, 2021, 9:02 PM UTC

wcfields wrote: post #179

I may get downvoted for this, but genuinely curious if there's vaccine tourism (not that I'm in a position to get on a jet to get a shot). Eg, if the wait time is long for my group in the US/UK/Wherever, can I book a flight to UAE or Cuba to get a vaccine at the airport?

It's already the case, look at all the exceptions for the wealthy and powerful getting vaccines early, be that politicians, celebrities, athletes, connected individuals, and the numerous cases we each may know of. I won't say more but I do know a few personally who got the vaccine too early.

Re: Covid vaccination linked to 'substantial reduction' in hospital admissions

#216

Post by timthorn » Mon, Feb 22, 2021, 9:02 PM UTC

ytwySXpMbS wrote: post #92

jedberg wrote: post #87

Earlier quoted context omitted.

The UK's policy of making sure everyone gets their first dose of the two dose vaccines before most everyone gets their second, setting the second dose at 3 months instead of 3-4 weeks.

This isn’t quite right. The UK has delayed second doses to 3 months after the first dose to enable more people to get their first dose quicker. The plan is all adults vaccinated by September, and they certainly aren’t delaying second doses until then.

That's been brought in - all adults are now expected to be offered their first dose by 21 July.

Re: Covid vaccination linked to 'substantial reduction' in hospital admissions

#217

Post by erfgh » Mon, Feb 22, 2021, 9:02 PM UTC

ImaCake wrote: post #196

chrisjs95 wrote: post #187

I'm really worried that will be "locked down" indefinite even when hospitalizations go down. I'm also worried that when an actually deadly virus hits our shores we'll be more hesitate to do lockdowns. So basically governments used their once in a 50 year lockdown on this. It mainly killed people that were fat (why the US had a higher mortality) and old. Except no one every said lose weight, exercise and get fresh air…

When something with ~30-50% mortality starts doing a COVID there won't be room for anti-vaxxers and anti-lockdown people. With COVID you can get sick and live. With something like ebola you get sick and die, or you go through the most traumatic event of your life. It doesn't leave a middle ground of disbelief. So I think there would be the political will for a second lockdown if our next global pandemic looks like eb…

Ebola does not spread as easily as COVID so a lockdown would not be needed.

Re: Covid vaccination linked to 'substantial reduction' in hospital admissions

#218

Post by aantix » Mon, Feb 22, 2021, 9:05 PM UTC

rcpt wrote: post #198

aantix wrote: post #175

Earlier quoted context omitted.

>People (extraordinarily healthy people) are suffering pulmonary embolism What are the numbers?

I've posted elsewhere but Here: https://www.medrxiv.org/content/10.1101/2021.01.16.21249950v...

Where in that study does it show the the numbers for the pre-COVID healthy cohort?

Re: Covid vaccination linked to 'substantial reduction' in hospital admissions

#219

Post by AndrewBissell » Mon, Feb 22, 2021, 9:06 PM UTC

ravenstine wrote: post #210

aclimatt wrote: post #108

Since we're on the topic, shouldn't this (hospital admissions) be the almost singular criterion to influence public policy / restrictive measures? The line I've heard repeatedly is we're waiting for "total" herd immunity, as in ensuring almost all of a population is potentially protected from the virus. Frequently quoting fall / end of 2021, potentially into 2022. Shouldn't the only benchmark be those with medium-to-…

Should we have an "end"? To play devil's advocate, clearly the world can handle a certain amount of locking-down, the social distancing, the mask wearing, etc., so it seems it is better if we just accept these restrictions indefinitely because we can save more people. Maybe we're fine not having mass gatherings, not eating indoors, and not leaving the house without a mask if it means saving the vulnerable. After all,…

Have you actually looked into the numbers regarding what lockdowns have done to mental health, not to mention the economic impacts which are going to feed back into people's well being in all sorts of ways? Just because your subjective experience of being a shut-in for nearly a year has been a tolerable one does not mean that has been the case for large numbers of people.

I want my kids to go to a harvest festival again with a live band and tons of people like the one they did in fall 2019. No, this is not something worth giving up simply to preserve a few years of life for some nonzero number of society's most vulnerable and aged. And no, I'm not any more willing to wait five years to see whether there's some lurking complications from the disease, any more than people have been willing to do that with the vaccines which are being distributed.

Re: Covid vaccination linked to 'substantial reduction' in hospital admissions

#220

Post by woeirua » Mon, Feb 22, 2021, 9:07 PM UTC

foolmeonce wrote: post #97

woeirua wrote: post #74

Earlier quoted context omitted.

Because you look at similar cohorts at the same time. So if group A has received the vaccine, but group B has not, and they're being observed during the same time/geographical area, and the groups are sufficiently randomized otherwise, then you would expect to capture the effect of any other confounding variables. Given the large number of people vaccinated so far, and the magnitude of the effect it's pretty safe to…

Sounds like cherry picking to me. Doctors know if you have been vaccinated when making this decision. I.e. perhaps 90% of people with 1 dose who are admitted are serious enough to need intensive care vs a small percentage of non-vaccinated patients admitted more often as a precaution. I guess everyone here thinks double blind trials are for fools?

I think the clinical guidance is still the same, that is you get admitted when you are showing certain symptoms regardless of vaccination status.