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Jan 17, 2022Liked by Tomas Pueyo

I would like for you to be right... I am so tired of the pandemic. But I fear it's premature to declare game over, for several reasons. 1. As you say, heath workers are still in a crisis stage of the omicron surge. We need to maintain precautions until hospitalizations come down. The trauma hospital here in Seattle is at 120% bed capacity, with cots in hall ways and the ER. Keep masking for at least another few weeks. Many hospitals are on edge of failing. 2. We may be done with the virus, but it's not done with us. We are lucky that even though antibodies from vaxx or infection are less effective against omicron, this variant doesn't do well in the lungs and so doesn't cause the severe respiratory symptoms that cause most fatalities. There is no guarantee that the next variant won't evade antibodies like omi AND cause severe illness like delta. 3. Speaking of variants, as long as 25% of Americans are unvaxxed, and larger proportions in other countries, the virus will continue to find many hosts to infect and generate new variants in. Some of those variants will share omi's ability to evade antibodies and cause breakthrough infections. Until most of the world is vaxxed and regularly boosted, I fear that we will have periodic outbreaks like the past month, regularly disrupting society. 4. Speaking of the unvaxxed, I wish we could write them off as exercising a choice to suffer the consequences of their bad decision. But omi has showed us that their bad choices impact us too. They make up most of the patients in critical care in hospitals and are pushing hospitals to postpone non-covid procedures like cancer, heart, diabetes and elective surgery. People who need treatment are dying because of the feckless of the unvaxxed. Also, a big pool of unvaxxed hosts allows the virus to transmit throughout the entire population, including kids, the elderly, and the immunocompromised. Like it or not, we're all in it together. So as long as a significant part of the population remains unvaxxed, I think it's too early to declare an end to pandemic life and move to a "covid is just another endemic seasonal bug" way of life. Sorry, I really do want to get this over with.

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author

Agreed! By point:

1. I mention it’s not over today, but based on the info we have, it will be probably over in a bit more than a month or so. I’m preparing for then.

2. You’re right, which is why I say based on what we know today and what will probably happen, with a big caveat that things might turn out different. We should always adapt to the info we have.

3. Natural immunity will be huge after omicron. We need to account it for it.

4. This is the hardest debate.

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Agreed. Your point 3 reminds me of something I forgot to include in my post. Natural immunity is transient. Data show that antibodies from infection start to decline as soon as 3 months after infection, and may be at baseline by 6-12 months. Also, immunity from one variant may not translate to other variants. Having delta did not protect people from omicron since it has novel mutations that Delta antibodies don't recognize. No reason to think this won't be true for future variants. Natural immunity to one variant isn't like natural immunity to measles because CoV2 mutates much more rapidly than measles virus. The only way off the covid treadmill is by near universal vaccination and boosting. You could write an entire other article about the odds of that happening, given the current state of the world.

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Jan 17, 2022·edited Jan 17, 2022

Natural immunity is wide and stong. Look at what's happening in India with their Omicron wave: not as many death as during the Delta surge. It's not only because Omicron it's different: they have a high level of natural immunity. Natural immunity is very strong in kids, but works fine for most folks. When antibodies decline, cellular immunity stays strong and T cells are ready to fight a new variant (many epitopes: they'll recognize it!) & B cells are ready to produce new antibodies. Folks will get sick, they'll probably contaminate their friends, but it'll be fine for most people. There won't be a need for booster for the general public: regular infections will do this role to the perfection.

Covid-19 was a problem because our immune systems were naive against it. We do live with many hCoVs, and we do fine because we encountered these coronaviruses in childhood. From my - limited - understanding, there is no reason to believe that this is going to be totally different with SarS-CoV-2. Read for example the last interview of Christian Drosten. Many wise people who studied this stuff extensively share similar views. They might be too optimistic, and not totally right; but it's highly unlikely that we'll have to keep boosting everybody for years or get the hospital under huge pressure...

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I hope you're right about lasting immunity from B and T cells. Here is a link to a good study of post-infection immunity. https://www.nih.gov/news-events/nih-research-matters/lasting-immunity-found-after-recovery-covid-19 However, this doesn't change the observation that there are lots of people who had delta covid and then were re-infected by omicron. The antibodies and T/B cell memories generated by exposure to delta were not comprehensive enough to ward off omicron due to the large number of novel mutations and the resultant antigens. "Natural" immunity (all immunity is natural, whether induced by infection or vaccination) only looks reassuring because omicron causes less severe symptoms by not surviving well in the lower respiratory system. If this variant were more like delta which thrives in the bronchi and lungs, we might have more severe illness even in the vaxxed and boosted, and even more hospitalization. While we can count on new variants arising as long as so much of the world is unvaxxed, no one knows whether they will be more or less virulent than earlier variants. The India data are intriguing, but one grim explanation might be that earlier surges, especially delta, killed off devastating numbers of the most vulnerable, leaving behind the younger and healthier who generally do better with omicron. The broader point here is that we are not done with the pandemic yet, and should not let down our guard completely.

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I doubt. Research shows that immunity from coronavirus goes down in 3-4 months. I have had common cold as many as 6 times in a given year (probably different strains).

It is true, that there are many layers of immunity.

But we will continue to see many future COVID waves.

The question is: how will we as a society, handle those.

I, for one, am in the market for getting an annual booster, especially if those become variant-indepenedent.

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“Natural immunity is transient.” is absolutely spot-on.

And now even natural immunity to Omicron is transient! There’s emerging anecdotal data from multiple South African doctors of Omicron reinfections following previous Omicron infection.

See Dr Eric Feigl-Ding’s tweet from 16 Jan 2022 👇🏻

https://twitter.com/drericding/status/1482219593351450627?s=21

And we aren’t even THREE months into Omicron initial infections yet.

Do NOT count on natural immunity even if you’ve recovered from Omicron. There’s no guarantee you won’t get reinfected.

Also, we know that reinfection risk from natural immunity is 2-9x higher for Delta & older variants, compared with vaccine-derived immunity.

See Dr Eric Feigl-Ding tweet thread 30 Sept 2021 👇🏻

⚠️NATURAL IMMUNITY versus VACCINES—Which is stronger? Let’s compare reinfection breakthroughs vs vaccine breakthroughs: ➡️Natural immunity is **MUCH weaker than vaccine** protection. By how much? HUGE—Vaccine is 📌9x stronger in May, 📌2x stronger during #DeltaVariant.🧵 #COVID19

https://twitter.com/drericding/status/1443411199920594956?s=21

Which is exactly why you still need to get vaccinated/boosted, even AFTER getting infected with Delta or Omicron.

• Just like my father-in-law did (got his booster/3rd dose), after catching Delta variant in October, despite being Pfizer 2-dose vaccinated at the time of infection. He is a GP/family physician, ie high-risk healthcare worker.

So you get MORE protection against reinfection, plus REDUCE risk of Long COVID.

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Jan 18, 2022Liked by Tomas Pueyo

TP has enough credibility at this point that your dismissive and militant tone is inappropriate. Existing immunity was not "Just obliterated". That's hyperbole. TP's essay was optimistic, thing is, this virus probably has a few tricks up it's sleeve yet.

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No you don't, you desperately want it to last forever.

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Yes. A not much noticed aspect of the Corona Panic is that millions of people absolutely LOVE it. It's the best thing that ever happened to them. They will be miserable and depressed when it's finally done, and they can't virtue signal anymore with their double-masks and endless Twitter posts about how the unvaxxed are killing our children! Of course here in reality it was over before it started, but it won't be "done" for EB and that ilk until the media relentlessly tells them it's safe now.

What's EB gonna do when nobody wants to listen to his/her moral grandstanding anymore?

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this could not be farther from the truth.

i don't know a single person who "absolute loves it".

Also, speaking on behalf of other people is rude.

If you *THINK* they absolutely love it, you should at least ASK THEM.

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> There is no guarantee that the next variant won't evade antibodies like omi AND cause severe illness like delta.

There isn't a guarantee, but each time it mutates it becomes less likely to do so again - because there's only so many changes it can make. If it returns to an old state we'll have immunity to that and it won't be able to spread.

(The pharma people gave a similar reason for not wanting to do omicron boosters; the original vaccine might cover a wider range.)

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Jan 17, 2022Liked by Tomas Pueyo

Few support the resumption of anything like “the hammer”. But I am astounded that you appear to have given up on sensible protections like FFP2/N95 masks, restrictions on mixing in confined venues, and proper precautions in schools. Even if omicron is the last significant variant, these will still save thousands of lives, prevent hundreds of thousands of cases of disability, and protect us against the uncertainty of a blood and brain disease they is not yet well understood.

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Under what conditions would you lift all measures?

I agree with what you say on masks and the like, but these are true today, they will be true in 2 years, and they were true 5 years ago. And yet not everybody was walking around with N95. Do you argue that was a mistake? That would be a reasonable position.

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While it’s difficult to answer that question *yet*, I would suggest that there may be a permanent shift in our attitude to clean air, with resulting permanent behaviour changes. This is perhaps analogous to the nineteenth century change in attitude towards cleaner water, or indeed the restrictions on cigarette smoking in enclosed spaces introduced just a decade and a half ago. Before the Pandemic, East Asian countries already saw public mask wearing in some circumstances as normal and considerate, and to me it seems very likely that we shall adopt some of this in the West.

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WE'VE ALWAYS BEEN AT WAR WITH EASTASIA!

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There you go, again, trebuchet. All or Nothing. Muted permanently.

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Reasonable to wear an N95 whenever the possibility of transmitting or inhaling a respiratory virus is arbitrarily high, in perpetuity? Why not go full hazmat?

Is it a reasonable position to cap the speed limit at 20mph everywhere? Clearly it would save lives and limbs. Even better -- 10mph! Maybe start with 20 so people can get adjusted.

While we're at it, alcohol should be totally illegal and harshly penalized.

Think of what these two small changes would do for public health.

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Jan 17, 2022Liked by Tomas Pueyo

I don't disagree with you Neil. However, I don't think Tomas is really saying that we should give up on sensible protections until the omicron wave is over. And, even then, precautions should remain for many. I'm not in a high-risk group, but I'll be wearing a good quality mask for the forseeable future! Maybe it's taken a pandemic to realize how many vulnerable people are out there and how little all of us do to protect them. For example, I probably should have been wearing a mask every time I visited my mother in her supportive housing home. But it never even occurred to me before.

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author

That is indeed what I say.

I will also use masks in the future. But not everywhere.

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Jan 17, 2022Liked by Tomas Pueyo

You're right. In a month or two, why not let our guard down, if the situation keeps getting better. Right now? Too early!

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The article mentions that.

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I think that Tomas is advocating for an option somewhere near the middle of a continuum between "Always wear a mask everywhere forever" and "Stop wearing a mask now and never wear one again". Something like "It will soon be possible to wear masks in decreasingly fewer circumstances, and eventually we will almost never wear a mask."

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Your straw-man sophistry is unworthy of you, trebuchet.

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This is a matter of sensible public health measures, Trebuchet, not an “all or nothing” polarised argument. In practice we can only “live with” covid the way we “live with” measles, or plague. The way we have done this with other diseases is through a combination of increased permanent basic steps to minimise community spread of *any* virus/bacteria, and targeted measures to contain and suppress specific outbreaks.

There will be changes in everyday life. For example, over the coming decade I expect proper ventilation to be mandated in enclosed public spaces such as pubs and schools. And I also expect the continuation of greater protections – such as masks – in specific localised outbreaks. Wearing a FFP2/N95 mask in some situations is hardly onerous if it is going to save even just one person from lifetime disability or death, is it? (Particularly if that person is you).

I do think you need to take a historical view here. For example, in England there was no drink-driving limit until 1967 and drink driving was mostly socially acceptable. A quote from insurancefactory “The introduction of the breathalyser led to many protests, particularly by publicans who said it was an infringement on personal liberty and would lead to bankruptcy.” Another example: up until 2007 in England you could freely smoke in an enclosed public space. Against many vocal objections on the grounds that it was an extreme measure, it was banned. Few could now imagine that ban ever being lifted. In both cases, changes once criticised as immoderate and draconian became accepted practice within a matter of years.

So on the basis of historical precedent, I think you are probably going to be disappointed. While many current protections will be removed, there will be at least some permanent changes compared with how we were before 2020.

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There you go, again, trebuchet. All or Nothing. Muted permanently.

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Respect your opinion, but I'm at the other end of the spectrum. I don't find it a bother. I barely remember that I have it on when I'm back in the condo. Cheap as borscht as Tomas pointed out very early in the pandemic and therefore high bang to buck factor. But I guess they bother some more than others.

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I'll sit in the middle, as I think a lot of people do. I hate masks, really do, but I'd hate being intubated even more, so I'll wear them when the risk justifies it. And that risk is a combination of the prevalance of the virus, its danger to me, and the specifics of the location (crowded / low ventilation), and any risk I might have to others. This is nuanced, so not easily definable in regulations, but its also something that is hard for individuals to decide on (especially the kind of individuals who have also decided not to get vaccinated).

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deletedJan 19, 2022·edited Jan 19, 2022
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Barf (in your mask, please).

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Jan 17, 2022·edited Jan 17, 2022Liked by Tomas Pueyo

I think you make a great case for most to return to normal life especially perhaps once this wave subsides, but why little mention/discussion of LongCOVID, which will be a lingering/ongoing cost and perhaps the biggest impact from Omicron? Also, what's your take on emerging research that t-cells (at least in some) are put out of action by COVID-19, especially with multiple exposures/infections (Anthony J Leonardi from Johns Hopkins is someone who makes these points which some label as extreme/off-the-mark while some embrace)? Yet other more mainstream and less strident/controversial researchers (Akiko Iwasaki) are finding COVID is having other nonlung-related effects on the brain and other organs, again showing that perhaps we should be much more worried about long-term effects? ... I raise these questions as someone who continues to experience Long COVID-like symptoms (sporadic lung soreness/chest pressure/heart palpitations) from a March 2020 mild COVID-like illness (tests weren't available). On the good side, I am currently largely functional in my life, but I'm not same (I used to be able to run marathons) and my ability to exercise has been diminished and I worry about my longterm health as well as anyone unlucky enough to be battling long covid now and into the future. In my mind, those worried about the vaccines are ironically missing the perhaps the greatest long-term dangers in addition to the higher mortality rates (even with Omicron). Similarly, as we look at the pandemic as a whole, it's the long tail that we can't ignore and a big reason, I think, that justifies not fully embracing a pre-2020 lifestyle even at this point.

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Hi t4rmc, I'm with you. Did you read this?

https://unchartedterritories.tomaspueyo.com/p/long-covid-chronic-fatigue-syndrome

Also, apparently, vaccines reduce the effects of Long COVID to baseline.

And Omicron is unstoppable.

So although I have lots of sympathy for ME/CFS patients, and truly care about them, this care is not actionable after Omicron in terms of stopping COVID, I believe.

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Jan 17, 2022Liked by Tomas Pueyo

Thanks taking the time to respond. Hadn't seen the your deeper dive on Long COVID and in reading it it echoes a lot of what I have read elsewhere regarding how it can be similar to ME/CFS. ... On vaccines, I hope that is true ... FWIW, my symptoms waned following vaccination, unfortunately returning as I tried to resume previous levels of activity/exercise AND/OR when encountered cold-like symptoms. ....It's been sort of like the pandemic itself, I think I'm finally done and then I'm not. (Not giving up, tho!) .... Omicron may be "unstoppable" by societies now but that doesn't mean we should stop trying to do reasonable mitigations both short and longterm (improving ventilation is something that could move the needle on COVID and all airborne viruses). Omicron is probably fitter because of its ability to infect those who have been vaccinated/previously infected, also largely driven by our own behavior and lack of protections, not because it's *more* transmissible. If not already aware, here are some fairly even keel experts who also agree that once vaccinated the best course for all is to worry much less and resume a lot of normal activity. They also discuss a paper that brings a lot of new insight on infectiousness: https://www.microbe.tv/twiv/twiv-854/ ... Thanks again for your insights during the pandemic, as I've been mostly following you throughout.

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>Also, apparently, vaccines reduce the effects of Long COVID to baseline.

No, they don't.

A reduction of half just means that statistically you need one more reinfection to get LongCOVID.

A reduction of 75% means you need two reinfections.

Etc.

The reduction was around half for breakthroughs before Omicron, and we have no data for Omicron yet, we just decided to let several billion be infected with it without any data on that whatsoever.

Currently the plan is for us to be getting an annual "natural booster", and you just advocated for that plan too in your astoundingly stupid post.

So vaccines make close to zero difference with respect to the outcome of current policies, which is everyone being afflicted with some level of disability in the long term.

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You know, GM, you can argue everything you are arguing without being rude.

Your insults just wipe away any validity that readers might find in your posts.

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Some people will suffer from long covid, either from past infection of because of future ones. Some will get long covid even though they are vaccinated. This is likely going to be a problem for society. That being said, those who had several covid infections (with or without vaccine) probably won't have long covid at all, even though they'll have more covid infections in the future (as covid will keep circulating). Their body had good reactions in the past, once there is local immunity in the nose and strong cellular immunity, the risk of getting long covid appears pretty low. Of course there is still lot of unknowns, and we might discover some post covid diseases in a not so distant future, but we also might enter an endemic phase, where the situation is fine *for most people* even though it's still dramatic - and will keep going that way - for others, in a more limited number.

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Jan 17, 2022Liked by Tomas Pueyo

Here in Manitoba, Canada, hospitals are pretty close to being overwhelmed. Granted this is due to successive governments of all stripes under-funding healthcare such that surges are difficult to deal with. I feel very strongly that we all have a duty to our fellow humans to do what we can to avoid worst case scenarios. I think that whole "this is what to expect in a month" should be bolded :). Because people see what they want to see (yay, it's over!!). No...it will be LARGELY over SOON. And we need to keep up our fight for just a bit longer to help our overwhelmed healthcare workers. But, in any case, thank you Tomas for (1) providing such insightful thoughts throughout the pandemic, and (2) providing a respectful forum for discussions.

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author

Thank you for contributing to it.

I hear you and I was struggling with this.

The reason why I posted this now instead of in a month is because (1) most people who agree with you will do what you say, and (2) people take some time to adjust. It's important to start discussing this now.

I might have been mistaken.

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Jan 19, 2022Liked by Tomas Pueyo

I’m very grateful to you for article and for the heads up now about preparing to adjust in the future. It’s extremely valuable information. And I don’t think you were mistaken. Right under the title of your article it says, “This Omicron wave is likely to be the last we should be cautious around. As a result, we should officially end the pandemic soon, probably in a month or so, unless some new, pretty unlikely new information appears.” You said it is LIKELY to be the end, PROBABLY so. You didn’t say it’s the end. You said it’s likely UNLESS new info shows up. You were very clear that there’s a possibility things won’t go as we hope. You said the pandemic is likely to end IN ABOUT A MONTH. You didn’t say stop taking precautions now. All of this is very clearly stated. It’s not your fault if people don’t read and/or don’t comprehend what you wrote. Thank you for continuing to provide well written, well researched, timely info on a variety of really important subjects.

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Jan 18, 2022Liked by Tomas Pueyo

Tomas. Please don’t let this be the first time since the pandemic you’ve been fundamentally wrong!!!! 🤣🥰👊🏼🙏🏼

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Jan 17, 2022Liked by Tomas Pueyo

Wow. Unsubscribing now. I've followed your writing since before The Hammer and the Dance and you've been awesome. But your total disdain for anyone who doesn't want to get vaccinated is gross. "It’s anti-vaxxers’ prerogative to die from COVID if they want to [Maybe social healthcare systems shouldn’t treat their COVID or their Long COVID though.]" is a disgusting sentiment (maybe we should apply that same logic to smokers, drinkers and the obese? No, we shouldn't. That's not what a civil society does. We should be promoting health and educating people about the impact of their choices.).

What the world needs now is for people to come together and this isn't how you do it. You have an audience and a platform to do that but you're just pushing people further apart if they don't agree with the idea of getting a vaccine, despite (still) no long-term data. I'm not against vaccines (I think they're amazing) but I am FOR choice and FOR freedom and FOR respect. I wish you'd do the same.

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author

I agree with you. Thanks for your thoughts.

The wording might be provocative, but I agree with you that we should be for choice and respect. This is what I share.

The problem of freedom, obviously, is when choices that somebody makes have an impact on others. In which circumstance are these consequence ok? When are they not?

This is a very hard problem. As a society, we decided that in most cases we’re ok with speech, even if it hurts others (as long as it doesn’t hurt them physically, Eg inciting violence). But we decided we’re not ok with physical violence.

Now as a society we are not in agreement in things like. In fact, there are special taxes on alcohol and tobacco, and I think sugar should be added to the list, because they’re a way to account for the higher societal cost of individual behavior.

Again, this is a very interesting and hard problem to solve, and I’m glad we can discuss topics like this one in this forum.

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Also, I appreciate you taking the time to reply. Thank you for that. 👍

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The wording isn't "provocative" it's divisive. If you really wanted to "solve hard problems" and "have an open discourse" you wouldn't start by vilifying people and invalidating their opinion before you've even begun the discussion.

If you actually want to have an open discussion on a hard and (already) divisive topic, start by being open, inquisitive and curious of another perspective *as a valid perspective*. Don't try to BS people by pretending to be open when you've already made up your mind. It's inauthentic and unbecoming of you.

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Jan 18, 2022Liked by Tomas Pueyo

Is not the cigarette and alcohol analogy not near perfect?

People will have the choice to vaccinate or not. It shouldn’t present a existential risk to society in the way it could have done from this point forward.

So they’re just killing themselves mostly. Like smokers. It is their choice. A higher financial premium may be allocated to them, like taxes on cigarettes, because of their higher cost burden to society. But they will still get treated in hospital just like smokers or alcoholics do. A tolerable nuisance if you like

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I'm much more sympathetic to smokers as there are addictive properties in tobacco. Nothing addictive about the behavior of the world's Kyrie Irvings-- unless stupidity is no considered an addiction.

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I tend to agree being something of an aficionado of addiction and I can tell first hand it is not a choice.

However, to avoid a complex conversation about the nature of addiction, the analogy works.

Equally, smokers cannot smoke inside as they risk damaging others. This also may apply to the unvaccinated- altho given the scale of ‘breakthrough’ With Omicron I’m not sure how steady that parallel holds

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Their "opinion" adversely affects the health of others. Their "opinion" doesn't deserve respect as it's anti empirical. I don't respect bad ideas that harm others. Do you?

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Adam, I'm with you here.

I too enjoyed Tomas' writing for a while, but the "othering" on display here is gross. Maybe someone's "anti-vaxx" because there are treatments that are very effective (as even you mentioned in this very article) or maybe someone's "anti-vaxx" because they already had and recovered from Covid and believe in the logic and history of natural immunity or maybe someone's "anti-vaxx" because they are demeaned, ridiculed and wished dead just for hesitating on using a brand new product... one that you can't "unuse", so it's a pretty important decision wouldn't you say?

Regardless, you've lost my respect, Tomas.

BTW, "why would kids, who can not make decisions, be at the mercy of their parents' decisions on their life and death?"... that swings both ways. https://globalcovidsummit.org/news/thousands-of-physicians-and-scientists-reach-consensus-on-vaccinating-children-and-natural-immunity

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Thank you. It sounds like the declaration was in October? There was much less data then.

Also, it’s kind of hard to follow the declaration when it’s a series of links. I painstakingly analyzed this in December and reached a different conclusion. 15k physicians can surely put together something better than I did.

For the rest, I think we disagree on labels. I agree with you that a person with previous immunity should be considered as vaccinated.

I also agree that if they can just take paxlovid for treatment, that is cheap and should be done.

I’m thinking here about freedom. You should be free to not get vaxxed, but the rest of people should be free to not pay for it if it has an outsized cost. There is a true tradeoff here that is hard to process but is important to discuss.

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Sorry for just a bunch of links, there. I think the point was that there are plenty of scientists on both sides (vaxx the kids, don't vaxx the kids) and the most painful thing to me is the denigrating of the other side (sadly done by both sides, although it "feels" like it's more unidirectional, but that could just be my bias). Science used to be about open inquiry and questioning things... the pursuit of something after all.

Also, I appreciate you writing: "a person with previous immunity should be considered vaccinated." I've personally struggled with this for a year now because there are people who see me as dirty, mean, selfish for being unvaxxed when, as you said, I _am_ vaccinated... just naturally.

I had my 3-week stint battling Covid last year, following a 3 month battle with cancer. Beat them both. Now I'm healthy, protected with natural immunity, and just want to be done with this whole thing.

And yet my status is persona-non-grata in so may places... in so many ways.

Sigh...

Anyway, thank you again for taking the time to respond. That helps.

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author

Shit, that is awful. I'm sorry. Nobody should go through this...

Places who treat you as unvaxxed are not being reasonable. You have built immunity in another way. It should be acceptable. In a few countries in Europe, a previous infection counts as full vaccination. That is reasonable.

I hear you on the kids. That's why I did the research myself, which I summarized in this article (thought I had linked it)

https://unchartedterritories.tomaspueyo.com/p/should-you-vaccinate-your-child

Best,

Tomas

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I am sorry to hear about your medical problems. Very difficult. But as a cancer survivor you very well may be immunocompromised, and this is all the more reason for you to be vaccinated. I don't understand, and really don't want to know, what your reasons are for rejecting a vaccine that is safer than both cancer and covid, but I urge you to reconsider and at least speak with a physician. Your unfortunate medical experience doesn't justify promulgating disinformation like saying "there are plenty of scientists on both sides..." This absolutely isn't true. The VAST majority of scientists (of whom I am one) and physicians unequivocally support vaccination for kids and the rest of the population. The number opposing vaccination is exponentially smaller. It is just wrong to convey the impression that there is ongoing controversy among scientists and medical personnel about the risks vs. benefits of vaccination. We have a global data set now that shows without question that the benefits are far greater than any rare risks. Take heart inflammation in adolescent males, one of the few documented risks. A recent study reported that out of 5.1 million people who received a second dose of Pfizer vaccine, 136 people experienced this inflammation; 95% of those cases were mild and disappeared after mild treatment (link below). That's a risk of 0.000000003%, and this is for one of the more common side effects. The risk of unvaccinated people getting covid was estimated to be anywhere from 33-50% with Delta and is surely higher for the more contagious omicron (link below). People with a history of medical complication are at higher risk of getting moderate to severe symptoms requiring hospitalization. I really encourage you to reconsider both your stance on personal vaccination and promulgating misleading information to justify your own choice.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8747813/

https://medium.com/david-grace-columns-organized-by-topic/the-risk-from-not-being-vaccinated-vs-the-risk-from-getting-the-vaccine-5-000-to-1-e2b97598d3c7

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EB, I appreciate your concern, and I'm open to having my mind changed. But I really am not open to having my choice made for me. I just can't get past that. I'm not saying that communal concerns never out-weigh personal choice, but I just don't believe that applies here, especially to me: I've recovered from Covid (tested at the start, positive test), even had antibody tests shortly after to confirm that my body had generated antibodies... and based on that, and based on what _should_ be common knowledge about natural immunity, I just don't see the sense in me getting the vaccines.

Ultimately we could probably argue ad-nauseum about lots of things here, but being shut out of a part of society because I have "natural vaccine" versus "manufactured vaccine" in my body is frustrating and demoralizing.

I truly truly hope that Tomas' predictions here come to pass. I truly hope that Covid-19 becomes much more like the flu... namely that we have widely available solutions and informational campaigns, but little to no mandates. I guess if we can't even agree on that, then perhaps we just have to agree to disagree.

All the best to you.

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And to you.

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Ridiculous. Classic false equivalency argumentation. No Dan, both sides don't have valid and equal points. This is the same garbage rhetoric climate change deniers utilize.

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Thank you for your response, Tomas.

I agree wholeheartedly about freedom. The problem is, in my mind, that "rest of people should be free not to pay for it" is a really, really dangerous and slippery slope, ESPECIALLY in the hands of governing people. Maybe the problem is that the tradeoff calculus is just way different in my mind.

"Let the doctor tell me I shall die unless I do so-and-so; but whether life is worth having on those terms is no more a question for him than for any other man." ~ C.S. Lewis (1958).

In the end, though, I celebrate with you the hopeful end to this pandemic and the hopeful resumption of "normalcy" (whatever that looks like). At the very least, I hope it means a LOT less fear.

That, above all else, seems to be the real "virus" of the past 2 years.

I don't want to live in fear (prudence, sure; caution, yes)... nor do I want my fellow humans to live in fear.

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Tomas is being polite. Dan is purveying the type of mis/disinformation that is sickening and killing thousands of people. I'll meet his "15,000 doctors agree..." with the millions of pediatricians who support vaccination fo children because of the mass of data showing that it is safe and effective. Treatments are NOT a substitute for vaccination. First, you have to be infected before you can receive treatment, and the infected can transmit virus to others for days before symptoms appear, or worse may be asymptomatic and not take precautions. Those who are unknowingly exposed to infected unvaccinated people have no choice about their exposure, so the unvaxxed's freedom deprives others of their freedom to be safe. Also, treatments are difficult to obtain at this point; Pfizer's anti-viral is in very short supply, it will only be available to those who test positive, and is most effective when taken within three days of infection onset; good luck getting a test result and a prescription from a physician within three days. The Regeneron antibodies are not effective against omicron, and the GSK antibodies which are effective are out of stock now. I won't waste space on quack treatments like ivermectin. The upshot is that treatment is not an alternative to vaccination. As for "othering," being unvaxxed is not an inherent condition over which one has no choice. Those who continue to be unvaxxed at this time, despite the record of safety in literally hundreds of millions of people, and who insist on continuing to enjoy all the same access to societal opportunities like air travel, restaurants, and entertainment and sports events, are choosing to keep the pandemic going. These people do indeed have the right to reject vaccine, but I don't think they have the right to infect others or enjoy access to open society where they pose a risk to the vaccinated majority. There are laws against exposing others to risk by driving while intoxicated, carrying flammable substances on to a plane, disposing of toxic material inappropriately, and I think that going into society if unvaxxed falls in this same category.

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There's a critical difference between hurting other and hurting yourself. You can get as drunk at home but driving when significantly impaired by alcohol is out in my book. How about you?

Not getting vaxed is not like getting drunk at home, it's like drunk driving. You are risking serious harm to others. (And costs to everyone.)

These things are always trade-offs. There's always some inconsistency due to the irrationality of cultural norms we can more-or-less add up the costs and benefits. We end up with mandates against running red lights but not on obesity. I can't see a case that not vaxing is somehow ok. Given the potential downside to others, it's in the drunk driving category.

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I wonder if Tomas has any idea how damaging his early COVID articles were to the world. He thinks he helped, instead he hurt. His 'hammer' cure ended up being far far worse than the disease itself. So Thank You for that Tomas. I'm glad you're saying we can move on now, but your proposed lockdowns caused more havoc and damage than can ever be measured. It might take decades to undo the damage. The hammer was never a good idea, and its too late to backtrack from that. Your ideas caused so much harm, and were never routed in any kind of reality.

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The true crime was a lack or coordinated effort or solution narrative. The havoc was caused by the Trump administration to ignore sound advice, leaving a gaping hole for disinformation to rear its ugly head. New Zealand practiced "the hammer" and had a total of 52 deaths. Now they're dealing with quacks arguing the vaccine is more deadly than COVID, but the hammer worked like gangbusters. Larry Brilliant (and others) have said a coordinated masking effort could have ended the spread of COVID in 3 months. Imagine how much pain and suffering we could have avoided if we could have all been on the same page from day one. I applaud Tomas's early efforts in identifying a clear path — it's just too bad no one with any authority (outside New Zealand) adopted it.

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You make good points, and I think you're right on the benefit of a coordinated solution. And also on your troll comment below, as I am probably being overly critical of Tomas. I believe the solution he proposed was very dangerous in opening pandora's box of authoritarian measures. But his intentions were good, and to be fair to him, he didn't expect governments to embrace these authoritarian measures and never let go of them. My point is mostly two-fold: a) that the road to authoritarianism is a slippery slope & paved with good intentions; b) that we can't be so myopic on trying to eradicate COVID. we have to consider all kinds of health (ie. mental health, social division, health of livelihoods, etc) and the impact our measures will have on them. Where i live (Canada) we took more of a New Zealand approach, and our deaths are lower than the US. However, the social price we've paid to achieve it, IMO is not worth it. We're still in lockdown, today as we speak. Kids haven't been in school, mental health issues are skyrocketing, and we've completely removed people who have chosen not to take a vaccine from society. We've thrown the very ethics that made our country special, out the window in pursuit of an unrealistic and unachievable ambition of eradicating COVID. The ambition isn't worth the toll, if we lose our compassion and ethics along the way.

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China went into lockdown almost 3 months before Tomas made his article.

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If we're aiming to embrace their authoritarian ways, then i guess that's a valid point. To be fair to Tomas, we didn't know enough about the virus at that point, so mistakes are understandable. But trading liberty for safety was always a dreadful idea.

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The trolls come out at night.

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Way to live in the "what might have been." Go yell at a tree... or politician.

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> Taking a few more weeks to vaccinate them will give us time to lower their risks of hospitalization, death, and ME/CFS by 90%.

Might be more than a few weeks for kids under 5, unfortunately.

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Jan 17, 2022Liked by Tomas Pueyo

Thanks. You are right about the PCSD. I feel like I've been living in a grotto for 2 years. :)

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Jan 18, 2022Liked by Tomas Pueyo

Hi Thomas! Thanks for this analysis and also thank you so much for all your work and very useful articles since the begining of the pandemic and your availability for exchanging data and ideas. Talking about people who can not relax : we don't know yet how dangerous Omicron remains for vulnerable people such as those with heart disease or diabet and this is an important part of the western countries population which might be still at very high risk with Omicron as it escapes partly from vaccination and as the immunity vanish after few months. Do we have new data on this? Also you don't mention at all the long Covid wich can follow almost 30% of the contaminations with the previous variants. This is an important issue. Do we know wether Omicron will cause big nomber of long Covid or not? The other point is that I have the impressionn that the gouvernements are not well prepared for the phase when the Virus will get endemic. May be the first thing we should do is to ask our governements to prepare better "the living with the virus", to ask them to recognize officialy that Covid is airbone and to act accordingly, to invest (and communicate) much more on meausres such as indoors ventilation, wearing face mask during winters in public transport or busy shops, to up date the list of vulnerable people with and apply or recommand some specific measures for them. I'm living in Switzerland and unfortunately, I have the impression this is not the direction we are taking. Our gouvernement and media don't talk anymore about long Covid, they do not communicate on public buillding ventilation systems. While hospitals are full and the daily deaths are increasing, all the concernes are about when the virus gets endemic to remouve all the measures to live as before. We hear all the time that Omicron is mild but very little information or discussion about who is still at risk wih Omicron, what proportion of the population they constitute, how they should behave during this huge wave and what we can do as a society to continue to protect them without excluding them from the active life, when Omicron will be endemic. Looking forward to reading you again. Cheers.

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author

Good to see you from Facebook!

Long COVID here:

https://unchartedterritories.tomaspueyo.com/p/long-covid-chronic-fatigue-syndrome?r=36xnz&utm_campaign=post&utm_medium=web&utm_source=direct

Odds are Omicron won’t be worse. But we can’t stop it anyways. So the ppl who want to be safe should wait 1-2 months and open up, or never open up. There won’t be a massive transition between what happens in 2 months ha 2 years.

I agree that govs are the worrying ones

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Jan 17, 2022Liked by Tomas Pueyo

Hi Thomas. Thank you for providiing unique analysis to us throughout the pandemic. One small point to think about in terms of those who still need to be extremely careful...If you take the 7 million immune compromised persons in the USA, you must add to them the families that they live with. So the real number may be double or triple that. Likewise, if the very elderly (say above 85), 7 million, must be protected, you need to add their families or caregivers to that number. So, you may be looking at 30+ million Americans who cannot really get on with life. I live in such a household where we have persons from both categories, all vaxed and boosted, but I have to very careful not to bring the virus home. No indoor groups or dining at all, etc., etc.

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True. But that is also true of any other disease. Which existed before the pandemic. So if we’re going to change our behavior va pre-pandemic, we need a very very good reason, and we need to accept its forever.

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You're the only non scientist I follow and respect on this subject. You know data and stay in your lane. Thanks.

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Jan 17, 2022Liked by Tomas Pueyo

Requesting that you do a thorough examination of the Long-Haul Covid situation and the potential for massive numbers of citizens who become so disabled that they cannot work. The disability support and health systems will suffer tremendous stress.

I feel that you so far have maintained blinders to this possibility. But I enjoy your analyses, so hope you will respond to the challenge.

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Thank you. I do recall seeing this but did not comment at the time.

We are a family w/ young adult child who has suffered 10 years of disabling post-viral syndrome.

mRNA vaccine was hope for improvement + safety. Instead, 2 doses pushed this individual further into ME/CFS downward spiral for the last 8 months.

We continue to pursue health nonetheless, but cannot take any chances of exposure while living in a 50% "denial" area. It's difficult to describe the horror this has been for the immunocompromised/ chronically ill.

We are using Bob Wachter's approach to let the surrounding area complete this surge.

But it is disheartening that your suggestion to "start living again" gives only a single line to those "Who Can’t Relax Yet." Once again, a disability community must bear the burden of poor responsibility on the part of their neighbors.

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Another commenter is correct to describe your article as "total trash". Case in point:

"it’s anti-vaxxers’ prerogative to die from COVID if they want to"

I would remind you now of your own flippant analysis of virulence, esp. in terms of IFR. It's been 1% or less, and everyone understands that the old and the fat are at increased risk. So much for "anti-vaxxers' prerogative". They will need to seek more likely causes of death if they are in a hurry.

You might also do some growing up about what constitutes an antivaxxer. Such a person rejects any and all vaccines, but many people who reject your new sacrament don't qualify. Rather, these people object to

• the cultish climate of hysteria,

• the obvious lying about causes of death (remember the confession of Dr. Ngozi Ezike of lllinois in April 2020),

• rushed development of the potions,

• conflicts of interest in hospitals and the pharmaceutical industry;

• reflexive pandemicist hostily to the mere idea of therapeutic treatment (which is ironic),

• suppressed manufacturer liability,

• no long term testing,

• pandemicist malice and bullying,

• strange and bizarre side effects and injuries,

and other problems. Now that awareness of these problems is growing, many people who took the jabs initially are now rejecting boosters. They, too, aren't [gasp!] anti-vaxxers, yet. Rather, they are awakened to the fact that the Covid-19 affair is a hustle with religious overtones.

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Jan 18, 2022Liked by Tomas Pueyo

Tomas,

Just a quick comment.

You have forgotten to include pregnant women in the group (or families with newborns) in the group of people who cannot relax. We live in the northwest of England; our due date is in just 6 weeks, and we are crossing our fingers to be able to go to the hospital and receive adequate care.

I hope that all you say here becomes true soon.

Thanks as always.

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author

Apparently vaccines work well for pregnant women.

Hopefully in 6 weeks hospitalizations will be going down. You will probably be able to make a reasonable prediction on hospital occupancy by comparing New England cases vs hospitalizations to what happened in South Africa

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Jan 18, 2022·edited Jan 18, 2022

Yes, you are right. The issue is that many pregnant women are not jabbed (difficult to understand).

And yes, I am using South Africa data to try to predict England's situation, which -at least on paper- shoud be ok by end of Feb.

This that I am pasting below is still important for anyone with small kids:

https://www.ft.com/content/28be9d3f-0b12-4c33-bda9-fbff375c0b7e

"Data from Europe and the US show more child admissions in recent days than at any time during the pandemic, but severe cases are rare in the youngest age groups and Omicron infections generally looked similar to other common respiratory illnesses.

Paediatric admissions in France are nearly six times greater than the previous high of August 2021, while case rates among English under-5s are more than three times higher than last winter’s peak. About 80 under-5s are being admitted daily to hospital in England, up from the previous record of 24 last summer. The US under-5s hospitalisation rate has jumped to more than four in 100,000, from 2.5 per 100,000 in December, and is by far the highest rate during the pandemic."

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It's difficult to understand that many pregnant women (none included in vax trials) would decline a rapidly developed emergency vaccine by known liars and war profiteers who assure them it's perfectly safe while they cannot possibly know this in the long term?

What is difficult to understand exactly?

Even if they're "wrong" the rationale is perfectly understandable.

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Jan 19, 2022·edited Jan 19, 2022

A few questions about your reply as you use many arguments from the anti-vax community:

- You say 'none included in vax trials'. Can you explain to me how testing works in pregnant women?

- You say 'rapidly developed emergency vaccine'. Tomas has written about this extensively in the past. One year after the side effects are well documented and very low. Do you have any data that shows otherwise?

- You say 'know liars and war profiteers'. Can you be more specific? I am just thankful to the scientists that have saved -literally- millions of lives. By the way, have you had to pay any money for your jab?

- You say 'They cannot possibly know this in the long term?'. Is over one year not enough time for you, especially when comparing the data to the effects of long Covid that many other readers mention here? Again, Tomas has written extensively about this.

Finally, I am writing this from a place where just before Omicron most people were not bothered to wear a mask when going into the supermarket or travelling on public transport. Again, difficult to understand.

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You've previously advocated for flattening the curve, which has happened - vertically. Also your data arguing on virulence is in direct conflation with WHO data, which puts virulence at 25% less than Delta, not 25% less than original.

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It depends on the definition of virulence. I believe they look at odds of going to the hospital. I'm looking at deaths.

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Yes, I've heard conflicting reports on this too. It's hard to find anything solid. I did hear a virologist asserting Omicron is less virulent than Delta but more virulent than earlier generation Covid.

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Hi Tomas, how are you, just 2 or 3 point: here in Chile, people getting into the Hospital are those with 2 dosis of cvac, maybe who are not having covid, unvaccinated people and children. Therefore, at least here is still happening. My opinion is that resources must be oriented to those ones who are not vaccinated, the ones with no third occidental vaccine dosis and take care of children. For sure we will have a 5th wave (maybe Sigma), which will be more contagious and hopefully lest agressive especially with children. Thus, again, the ones who fulling the Hospitals are people that I mentioned before. I am not sure about a 4th dosis, the efforts of the goverments mus be oriented to those antivaccines and childrens (and those only vaccinated with cvac maybe). Lots of regards. Fredy

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That's hard. I don't know cvac at all

But I think Omicron will swipe the world vaccinated or not. So it sounds like what we do after this matters much less than what we've done up to this point wrt vaccines

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>But I think Omicron will swipe the world vaccinated or not

There is no need for that, public health measures work no matter how contagious the virus is, if they are properly implemented.

Omicron spreading fast is just an excuse not to bother with containment.

I don't see Omicron sweeping through China.

It is just that we in the West have completely given up.

Something that could not be possible with the support of the sycophantic experts, like what you have now become too....

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GM, here's an interesting anecdote, I live in a part of Asia devastated by a Cat 5 cyclone about a month ago. We'd done a good job to that point with distancing and generally containing the outbreak. But now, the electrical grid is down and island wide we're experiencing scarcity of water, food, fuel, and supplies. The economy is cash only now. Long lines for all necessities. It's bad. People are still masking but distancing and hygiene are no longer possible. Guess what's breaking out now? Yep, Covid. So I'm not sure lockdowns and many other measures remain viable. The holes are showing. But we've got weapons now. WMD's actually. We'll keep doing what we can with distancing and masking, but let's face fuck Covid with mRNA and other hardware. Nature had a good article on Covid recently, the long game these nasty particles play is evolving breakthrough capability. Oh really? We can play that.

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Omicron certainly seems to be slowly sweeping through China; it's also exploding in places like Australia that took successful harsh measures before, and Japan which successfully, uh, didn't seem to do much but nevertheless got away with it until now.

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Yeah. Fourth dose would likely be unneeded for most people, but might be useful for some specific categories (folks with several comorbidites, immunocompromised, etc). But it's likely that rich countries will mandate these to try to keep transmission lower and the economy going, as it'll appear cheaper for them than any restriction they *might* have to put into practice if there's a new wave. Probably a mistake but likely. It would be wiser, as you say, to vaccinate the unvaccinated!

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