Ian Welsh

The horizon is not so far as we can see, but as far as we can imagine

Category: health care Page 4 of 35

No The Solution To Ending Mandatory Masking Isn’t “Well YOU can still mask”

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On September 27, 2022

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Few things make more more tired or contemptuous of someone than, when a masking mandate is removed, someone saying “well, you still have the choice to wear a mask, we’re not effecting you” or some variation.

Masking is not primarily about protecting yourself. Only a respirator and a well-fitted N95 offer good protection from Covid if other people aren’t masking.

 

Now that chart may be making you feel safe if you go quickly in and out of businesses, but realize that there are multiple people in those buildings and that in an enclosed space the virus builds up, so even if there’s only one person who is infectious, if they’ve been there for a while, you can walk in and get a huge dose. And if you have multiple exposures in different places, the viral load can build.

Oh, and if you think anything short of a respirator is likely to protect you on a long flight where people don’t have to mask…

Masking is not primarily about protecting yourself, though it helps, it’s about protecting other people, especially since Covid can be asymptomatic and since Covid tests, especially the rapid antigen tests, often give false negatives.

It’s not, thus, just about you. It’s about the people around you.

And hysterics aside and rare conditions, no, masking may be uncomfortable but it doesn’t hurt adults or children. What hurts them is getting Covid, especially repeated exposure leading to organ damage, including brain damage, and to serious long-Covid.

Now I know that most countries have given up and just declared Covid over. Happening where I live, even as emergency departments have to be closed because of not enough nurses and doctors. It’s “over”.

But this marker is still worth placing. Masking is far more effective when it is a communal action. Some things, to work properly, we must do together.

The end result of not doing these things (which go far beyond masking) is going to be a double digit percentage of the population disabled and I doubt, combined with climate change, that our societies can handle that.

Welcome to the future. Deliberately un-handled plague, ecological collapse and climate change, combined with a cyberpunk dystopia without the cool parts of cyberpunk.

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Ontario’s Mass Murdering “Top Doctor”

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On August 31, 2022

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I don’t consider this hyperbole:

Remember that ever since school openings, school infection rates have spiked before general community rates. Schools, as anyone who is a parent or was a child should know, are cesspools of infection even in good times. Kids get sick, pass it along, their families then get sick and in turn pass it along to co-workers and so on.

And letting people who are still infectious go to work is obviously insane. Note that 10 days was the original guideline, then it was dropped to 5, which was absolutely not enough. As for masks, they only partially protect other people, unless you have a respirator or properly fitted n95 and never take it off for the duration of the school or work day. If you’re with other people for hours in a surgical or cloth mask, forget it, you’re exposing them and almost no one wears a properly fitted N95 mask and also never takes it off or breaks the seal.

BA.5 is arguably the most infectious disease we know about, beating measles. It’s certainly in the top 5. If it doesn’t kill someone, it has a good chance of doing permanent damage, and that damage can add up to Long Covid, and be disabling. Every time you get Covid, more damage can be done, until symptoms appear that don’t go away after the infection. People who have had Covid are at more risk for heart disease, diabetes and brain conditions.

Now, some data from the US on Covid:

  • Around 16 million working-age Americans (those aged 18 to 65) have long Covid today. 
  • Of those, 2 to 4 million are out of work due to long Covid. 
  • The annual cost of those lost wages alone is around $170 billion a year (and potentially as high as $230 billion). 

The pandemic isn’t over. Covid keeps mutating into more infectious forms. Our society cannot survive this going on for years and years. Lost wages is the least of it, the economic impact and human cost go far beyond that.

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Sweden’s Relative Performance In Covid

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On August 30, 2022

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Sweden famously chose a herd immunity policy during Covid and deliberately withheld life-saving support from seniors, giving them morphine instead of oxygen when they had plenty of oxygen. It wasn’t triage, it was murder. There are many claims that they did well due to their policy. Did they?

Let’s take per-capita deaths as our proxy. Sweden(196.15) did do better than the US (316.83) and the UK ( 302.59) in deaths per 100,000 population. However, they did worse than all their sister-Scandinavian states: Norway (
72.92) Denmark (118.93) and Finland (100.65).

Their death toll was almost 3x Norway’s, the best performer, and somewhat over half again as much as Denmark’s, the worst performer among the other Scandinavian countries. They did worse than Germany (176.90) but slightly better than France (237.39).

All of these countries are, however, pathetic compared to good performers. Japan (30.87), South Korea (51.92), Vietnam (44.29) and China (1.06).

All of these numbers come from the John Hopkins chart. I have to say that I don’t believe some of the statistics. Russia and India had much higher mortality than the chart indicates, for example. Some will suspect that China falls into the same camp, but the people I know in China support the idea that China’s zero Covid has largely worked. The rare exceptions, Hong Kong and Shanghai, did not follow the same policies as other cities. But even if one were to assume that fatalities were 10X as large as stated, China would still have massively outperformed.

The truth is that most countries completely cocked up Covid. They shutdown way too late in each wave, they didn’t quarantine properly, they didn’t put filtration into buildings and they didn’t massively limit international travelers and make quarantine for those travelers who remain mandatory, supervised and supported.

If we had just properly shut down early (and stayed shut down a bit longer), tracked and traced and quarantined we could possibly have ended Covid early. If we had not been told Covid vaccines were a silver bullet, rather than like weaker flu vaccines (have to take them multiple times, they aren’t that effective) and used proper public health policy, a hell of a lot less people would have died.

As for Sweden. Solidly middle of the pack, worse than their peer Scandinavian countries and deliberately murdered old people. Sweden’s GDP growth was nothing spectacular in 2021: middle of the pack. Inflation was solidly middle of the pack, though better than their peer Scandinavian countries.

It’s fair to say that Sweden’s Covid performance wansn’t terrible among developed nations and not as disastrous as many (including myself) thought it would be. But Sweden is nowhere near best in class, or among its Scandinavian peers. The sad truth is that virtually all Western countries blew it and Sweden is among that group.

It’s not that shutdowns don’t work, contra the propaganda, it’s that for them to work you have to do them early, keep them on long enough (though by doing them early virtually all of China’s shutdowns have lasted less time than Western ones) and support people at home with food deliveries and so on so they can actually stay at home. Paid sick days of essential workers were needed, and people going out to grocery shop and so on probably did a great deal of danger. Once schools were opened up, Covid numbers surged first in schools, then to the general population.

Sweden’s no great victory, but it does show that most of what the West did was ineffective. Effective public health measures, where they were done, reduced mortality and cases significantly, but in the West we did everything half-assed, and that’s what our numbers show. Sweden had the grace to mostly not even bother.

People don’t support shutdowns and other public health measures because they didn’t work well because they were done badly. If they had worked they would have wide support.

So the lesson of Sweden (minus their deliberate murder of seniors) is simply do it properly.

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BA.5 Covid Is Incredibly Virulent and MonkeyPox Is in Exponential Growth

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On July 28, 2022

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Yeah…

Remember that even a mild case of Covid can cause organ damage without you knowing, or can give you Long Covid with symptoms, sometimes extremely severe symptoms and that damage can accumulate each time you get Covid.

Meanwhile, two days ago, from WHO:

 

Don’t assume that because you aren’t gay or don’t have a lot of partners you won’t get monkeypox; plenty of people who aren’t having anal sex are getting it. Most of the guidance I’ve read says “direct contact,” but…

While experts believe monkeypox spreads primarily in close contact through skin lesions, evidence suggests the virus can also be airborne, at least over short distances. For example, during Nigeria’s monkeypox outbreak in 2017, scientists recorded cases of airborne transmission within a prison and in health care workers who did not have direct contact with patients. However, it is not clear how much airborne transmission contributes to the overall spread of the virus.

What I suspect is that monkeypox can spread through droplets, which is not the same as Covid, which is fully airborne. Droplets is how most scientists originally thought Covid spread, which is why “social distancing” was emphasized so much at the start of the pandemic.

Generally vaccines are not available unless you’re queer and have multiple partners, but check locally. I suspect the directions at the start of Covid should be relatively effective vs. monkeypox: distance, use 70 percent ethanol or dettold, and wear a mask. (Soap alone will not do it – correction.)

This stuff is nasty, takes a month to clear, and can leave permanent disfiguring scars. So keep an eye on it and take it seriously if it’s spreading where you are.

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How Standard Media Skews Public Understanding

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On July 12, 2022

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I recently had a long conversation with a fellow Canadian about current events, especially Covid and the economy. He read a lot of newspapers: he’s well informed by normal standards.

But over the course of the conversation I realized he was terribly informed.

For Covid, he was convinced both that China had only controlled Covid thru very long lockdowns and that they were lying about results. In particular, he remembered Shanghai well, but didn’t realize Shanghai was an exception. Most Chinese cities have locked down much less over the course of Covid than we have.

When I mentioned that other countries had much lower rates than us, he dismissed that as well. He thought travel bans and quarantines were completely pointless, when they have worked very well for those countries which implemented them. Western Australia’s travel ban kept Covid low there for ages, and New Zealand had a wave almost immediately after as they released restrictions.

He believed that not doing zero-Covid style policies was better for the economy and that China’s economy was in free fall. It has issues, to be sure, but it also has a 2% inflation rate, among other advantages.

He was convinced governments could not just find money to support people in lockdowns, believing money comes from taxes (it doesn’t, most money is created of thin air, this is something the MMT people are right about.)

He believed that vaccines are the most effective anti-Covid measure. They aren’t: China has worse vaccines than us and much better performance, and Covid variants have optimized for vaccine and natural immunity evasion. BA.5 in particular laughs at immunity, whether natural or vaccine.

In general he felt that the economy must be prioritized, and that is done best by keeping it open at all times. There was no acknowledgment of long Covid as a factor, or of the fact that each infection increases the odds of long term health damage to victims.

There was a sense of hopelessness about Covid being international, and that it would just keep going forever as a result, without knowledge of us restricting vaccines for much of the world, not doing travel bans or quarantine properly and not supporting other countries to do the right things (not that we are ourselves.)

He wouldn’t acknowledge that if shutdowns are to be done, they should be done at the point where numbers start going into exponential growth, even though there aren’t a lot of cases then, instead of waiting for hospital ICUs to be overwhelmed, and that by doing so we’d actually have shorter lockdowns and a lot less deaths and disabled and sick people.

This isn’t a badly read guy; he knew about the things the media has covered at length.

And this is the problem with propaganda; it creates a world view among its victims that is simply incorrect, and if you don’t actually know what’s going on  you can’t make good decisions or support good decision at the political level.

What I see is that the West, in most cases, is creating circumstances where 15-20%, or more, of our population will wind up disabled in some way. Repeated Covid infections are going to gut us: our society cannot run with that many people with long term health damage.

But the media’s coverage has been of the “what we’re doing is the best way and everyone else is doing it badly.” It’s not that there aren’t exceptions, but that’s the general tone and message, along with a huge push for vaccines at the cost of other measures like masking, quarantines, travel bans, and proper indoor ventilation which actually, in some combination, work better.

One could call this “learned helplessness.” My conversation partner was convinced that everything reasonable had been tried, that zero-Covid policies hadn’t worked where tried and that doing them was tyrannical, bad for the economy and worse than what we had done.

Nothing could be done, so Covid would remain chronic, with wave after wave.

In a sense he’s right, except that so far we have refused to do what works, so Covid will keep going.

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The Next Covid Wave Is Onrushing

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On June 28, 2022

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Covid continues to evolve and it continues to do so in response to whatever is holding it back most.

In the case of Omicron BA.4 and BA.5, this is immunity: either from vaccines or previous infection.

Nature:

Increasingly, scientists think that variants including Omicron and Alpha probably originated from months-long chronic SARS-CoV-2 infections, in which sets of immune-evading and transmissibility-boosting mutations can build up

Whatever holds back a species most is what it will gain the greatest advantage from mutating to defeat. Since most of the world outside of China is no longer bothering with even the most basic non-vaccine measures to stop the spread of Covid, this means vaccines and natural immunity.

By now readers should be familiar with how exponential growth works, and these charts should make you twitchy.

Now, since nearly the beginning of the pandemic this blog has warned about how waves of reinfections would cause spiraling Long Covid numbers. It was obvious this would be the case, both because it appears possible to get it each time you’re infected and because even when there are not obvious symptoms, Covid often does some permanent organ damage, including brain damage, which shows up when people are tested.

Here’s the current known damage in the US, just for cases with actual symptoms.

And here’s the math of reinfection:

You don’t want to get infected and you don’t want to get reinfected, especially now that BA.4 and BA.5 are immune escape variants.

Where I live, in Ontario Canada, all mask mandates have been removed. For a while people kept wearing them anyway, but what I’m seeing now is that even in something like the subway or in streetcars, which are tailor made for infection, more than half of people aren’t wearing masks.

And unless you’re wearing a properly fitted N95 mask or a respirator, masks don’t protect you that well: masks primarily protect other people if you’re infected, and remember that it’s very easy to be infected and infectious and not even now it, plus in places with inadequate sick leave, of which Ontario is one, most people who know they’re infected still have to go to work if they can: they can’t take two weeks off, they need the money, and their bosses don’t have to let them have the time off.

So continue to take this seriously. I wear n95 masks when I’m inside buildings or in a large crowd outside. The pandemic isn’t over, and our response to it is essentially to rely on luck that eventually a variant will be produced which is even more infectious but much milder.

That may happen, but we don’t if it will or when. Till then, I advise taking reasonable precautions, and don’t believe it when a new variant happens and people say “oh, it’s milder.” It might be slightly milder in the sense of not very likely to kill you, without being milder in the sense of less likely to cause Long Covid.

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Civilization Ending Long Covid Pt. 2 — 320K Long Term Sick In UK Labor Force

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On May 18, 2022

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Starting in 2020, an increase of 320K long term sick people. We tend to do percentages off the population, but the UK Labor Force is 34.7 million people. That means, in 2 years, what is probably most Long Covid, caused about a .92% decrease in the labor force just due to long Covid. Another .38% of the population left the UK Labor force for other reasons.

Where’d I get this from? The Bank of England!

Since end of 2019- we’ve seen a fall of 450,000 (1.3% of labour force- a very large decrease in labour force … The persistence & scale in this drop has been a surprise to us. We’ve seen an increase in long-term sickness in that number – around 320,000 people…

…Falling participation in the labour market is not a lack of job opportunities, but a rise in long term sickness linked to the pandemic. The issue of Long Covid is very serious.

Last week I wrote that a big part of rising labor costs was a tight labor market and…

much of why the labor market is tight is because they let a million people die and probably millions be disabled by not handling Covid

I’ve been emphasizing for a long time that Long Covid was going to be the real problem. .92% may not seem like much, but remember:

  • You can get Covid over and over again;
  • There is no long lasting or complete immunity from Covid either from vaccines or natural immunity;
  • New variants are being born all the time and the ones which survive and thirve are generally optimized against whatever is the biggest barrier to current spread;
  • Each time you get Covid you can get long term damage. It may not be sympomatic, but it’s there.
  • So the next time you get Covid, you’re more likely to get symptomatic Long Covid.

Let us assume, for the sake of argument, that UK and US reductions in the labor force are about the same, in percentage terms. (Death rates in the UK are slightly lower than the US, but I don’t trust either country’s stats all that much.)

The US Labor force in 2021 was about 161.2 million. Multiply that by .0092 and we have a reduction of approximately 1 million, four hundred and eight-three thousand people (1.483 million). Now, imagine the US loses that number of people from the workforce every two years?

Doesn’t take long from those numbers to be catastrophic, does it?

Understand that marginal rates control the capitalist market.

The good side of this is that taking so many people out of the workforce absolutely will increase wages without wage controls. And it will keep doing so for as long as we refuse to control Long Covid and have no effective AND widely deployed cure. Problem is, while we do way too much bullshit labor and could get by with less workers, I doubt it’s going to be Wall Street parasites whose jobs we don’t fill, it’ll be people who actually make, grow, mine or distribute goods that matter, and people like nurses and orderlies and teachers and so on who are actually productive, rather than parasites at best.

Meanwhile, China, who supposedly wrecked their economy with Zero-Covid, will not be suffering under this reduction. (The Shanghai outbreak is now almost completely under control, much to the dismay of pro-death and disabling neoliberals.)

And this is before the fact that we will need to take care of all those sick people, though I suppose the American solution will be to let them use up all their savings, get thrown off any private healthcare, perhaps manage to get on Medicaid and eventually wind up on the street and die.

Blah, blah, blah.

The point is that our civilization CANNOT survive this sort of disabling if it just keeps going on and on. Multiply by all the problems we’re going to have with climate change, and stir in a mix of nuclear-armed Great Power competition and the results are catastrophic.

It’s Long Covid or a real cure or a miracle where Covid dies out by itself (not seeing how that happens when natural immunity is limited), or we are in for a world of hurt.

Take precautions. It’s not death you should worry about, it’s disabling. I don’t know what happens after death, but I do know that a lot of very bad things can happen to you while you’re still alive.

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Does Zero Covid In China Work?

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On May 9, 2022

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So, we hear a lot of stories about Shanghai, where rolling lockdowns and administrative failures have lead to videos of people w/o enough food in lockdown, etc…

Shanghai is an interesting case, because Shanghai did not follow the normal Chinese zero-covid protocol. It didn’t shut down right away, but tried to do just do small shutdowns, and let the number of cases increase. This is not what other cities do.

I follow a maker account in Shenzen (the primary electronics manufacturing city in China and the world.) Since Covid they’ve occasionally written or done videos about the covid response in Shenzen, which has over 17 million people, plenty of trade, and lots of visitors from Hong Kong.

Wu says it better than I could.

I feel I’ve spent too much time on Covid recently, and do intend to move onto more interesting (if not always more important topics), but it’s IMPORTANT that people understand there were other options to dealing with Covid other than let’er’rip, whether or not most of the rest of the world’s actions were motivated by greed, psychopathy or incompetence, and regardless of how much 40+ years of neoliberalism have gutted our administrative capacity (it has been two years, we could have rebuilt a lot in those 2 years and we didn’t.)

Thatcher’s mantra was TINA (There Is No Alternative.) It has bred apathy and resignation. But if even the goddamn Chinese Communist Party can do better, then it’s obvious that there There Is An Alternative (TIAA?)

There are NO problems of any significance in the world today which are not a result of having a really, really bad elite and populations which are OK enough with them to let them keep doing what they do. There are also no problems we do not know how to deal with far better than we are right now.

As long as this is true, as a friend said just after Bush v. Gore, we’re going to ride this bucket all the way down to hell.

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