Vaccine passports

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WFJ
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Re: Vaccine passports

Post by WFJ » Sat Jan 01, 2022 12:09 pm

lpm wrote:
Fri Dec 31, 2021 6:25 pm
There's no longer any justification for vaccine passports. People with a vaccine are getting infected from other people with a vaccine. Excluding an unvaccinated person from a restaurant is just punishment now, it does nothing to improve the safety of others.
There's no longer any justification for speed limits. People driving under the speed limit are crashing into other people driving under the speed limit. Prosecuting people for speeding is just a punishment now, it does nothing to improve the safety of others.

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Re: Vaccine passports

Post by Millennie Al » Sun Jan 02, 2022 12:43 am

WFJ wrote:
Sat Jan 01, 2022 12:09 pm
lpm wrote:
Fri Dec 31, 2021 6:25 pm
There's no longer any justification for vaccine passports. People with a vaccine are getting infected from other people with a vaccine. Excluding an unvaccinated person from a restaurant is just punishment now, it does nothing to improve the safety of others.
There's no longer any justification for speed limits. People driving under the speed limit are crashing into other people driving under the speed limit. Prosecuting people for speeding is just a punishment now, it does nothing to improve the safety of others.
You can speed up very easily, but you can't unvaccinate yourself.
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Re: Vaccine passports

Post by WFJ » Mon Jan 03, 2022 11:52 am

Millennie Al wrote:
Sun Jan 02, 2022 12:43 am
WFJ wrote:
Sat Jan 01, 2022 12:09 pm
lpm wrote:
Fri Dec 31, 2021 6:25 pm
There's no longer any justification for vaccine passports. People with a vaccine are getting infected from other people with a vaccine. Excluding an unvaccinated person from a restaurant is just punishment now, it does nothing to improve the safety of others.
There's no longer any justification for speed limits. People driving under the speed limit are crashing into other people driving under the speed limit. Prosecuting people for speeding is just a punishment now, it does nothing to improve the safety of others.
You can speed up very easily, but you can't unvaccinate yourself.
I don't understand your point. The fact that vaccinated people can also catch and spread the disease does not invalidate the justification for vaccine passports (if such a justification exists) any more than the fact car accidents occur at low speeds invalidates the justifications for speed limits.

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Re: Vaccine passports

Post by lpm » Mon Jan 03, 2022 12:33 pm

What a dumb analogy.
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Re: Vaccine passports

Post by shpalman » Mon Jan 03, 2022 1:13 pm

"There's no longer any justification for driving licences. People with a driving licence are crashing their cars into the cars of other people with driving licences. Excluding people without driving licences from driving on the roads is just punishment now, it does nothing to improve the safety of other drivers."
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Woodchopper
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Re: Vaccine passports

Post by Woodchopper » Mon Jan 03, 2022 1:33 pm

lpm wrote:
Fri Dec 31, 2021 6:25 pm
There's no longer any justification for vaccine passports. People with a vaccine are getting infected from other people with a vaccine. Excluding an unvaccinated person from a restaurant is just punishment now, it does nothing to improve the safety of others.
I think that the driving analogies aren't very good. But vaccination still gives some protection against infection, with three doses providing the most. Passports also provide an incentive to get vaccinated (though one which could be viewed as having crossed the line into coercion).

Whether vaccine passports are worth placing restrictions on society is a difficult question to answer.

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Re: Vaccine passports

Post by shpalman » Mon Jan 03, 2022 1:39 pm

Woodchopper wrote:
Mon Jan 03, 2022 1:33 pm
lpm wrote:
Fri Dec 31, 2021 6:25 pm
There's no longer any justification for vaccine passports. People with a vaccine are getting infected from other people with a vaccine. Excluding an unvaccinated person from a restaurant is just punishment now, it does nothing to improve the safety of others.
I think that the driving analogies aren't very good. But vaccination still gives some protection against infection, with three doses providing the most. Passports also provide an incentive to get vaccinated (though one which could be viewed as having crossed the line into coercion).

Whether vaccine passports are worth placing restrictions on society is a difficult question to answer.
Analogies are always sh.t, but the fact that vaccination provides imperfect protection against getting infected is why I want unvaccinated people (who are more likely to get infected and more likely to still be infectious) kept away from me for my sake, and the fact that vaccination doesn't provide sterilizing immunity is why unvaccinated people need to be kept away from me for their own sake.

Unvaccinated people also need to be kept away from each other, for their own safety, which they've demonstrated that they are unable to look after on their own.

This is not the only example of the state trying to stop people doing stupid things to themselves because of humans being sh.t at risk analysis.
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Re: Vaccine passports

Post by WFJ » Mon Jan 03, 2022 2:06 pm

lpm wrote:
Mon Jan 03, 2022 12:33 pm
What a dumb analogy.
Whether the analogy is perfect or not, the reasoning in the analogy equally as faulty as in your original statement. Vaccine passports may or may not be a good idea, but the imperfectness of vaccines does nothing to invalidate any justification for them that might exist. Unless the argument is that vaccines are completely useless at lowering transmission.

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Re: Vaccine passports

Post by lpm » Mon Jan 03, 2022 2:50 pm

shpalman wrote:
Mon Jan 03, 2022 1:39 pm
Woodchopper wrote:
Mon Jan 03, 2022 1:33 pm
lpm wrote:
Fri Dec 31, 2021 6:25 pm
There's no longer any justification for vaccine passports. People with a vaccine are getting infected from other people with a vaccine. Excluding an unvaccinated person from a restaurant is just punishment now, it does nothing to improve the safety of others.
I think that the driving analogies aren't very good. But vaccination still gives some protection against infection, with three doses providing the most. Passports also provide an incentive to get vaccinated (though one which could be viewed as having crossed the line into coercion).

Whether vaccine passports are worth placing restrictions on society is a difficult question to answer.
Analogies are always sh.t, but the fact that vaccination provides imperfect protection against getting infected is why I want unvaccinated people (who are more likely to get infected and more likely to still be infectious) kept away from me for my sake, and the fact that vaccination doesn't provide sterilizing immunity is why unvaccinated people need to be kept away from me for their own sake.

Unvaccinated people also need to be kept away from each other, for their own safety, which they've demonstrated that they are unable to look after on their own.

This is not the only example of the state trying to stop people doing stupid things to themselves because of humans being sh.t at risk analysis.
A paternalistic state, restricting people for their own sake, is fundamentally unattractive. There needs to be a high bar. Either the cost to those individuals needs to be very small ("you must wear a seat belt") or the extra protection very high ("you must wear a motorcycle helmet").

The protection from vaccines against infection is no longer very high, while protection against serious disease/death isn't particularly significant for under 50s. Forcing unvaccinated 30 year olds to stay away from each other is a huge overreach of state power, for pretty trivial benefits. The freedom to go nightclubbing is an important one and can't be thrown away for trivial advantage.

"For their own sake" just doesn't work. I don't think it even works for over 80s in care homes.

Which leaves "for my sake". Which doesn't work either. We live in a world of infectious diseases and get ill several times each year as a result. These routine illnesses often kill the very old and vulnerable. There's been a global pandemic and we all have to accept the new norm of an additional nasty illness in our lives.

We live in society, not as individuals. Why pick this specific risk and not all the others? I would like to restrict the freedoms of other people for my own sake in loads of ways. I want alcohol banned for others because there's a risk drunks will be violent to me. I want people banned from driving polluting cars that damage my lungs. I want everyone to take cold, flu and norovirus tests before they share public transport and office space with me. But obviously I can't restrict the freedoms of others in society just for my own sake.

Restricting the unvaccinated from sharing a restaurant or nightclub with me fails to give me extra protection of any significance, particularly compared to the huge protection already given to me by the state in the form of three vaccines.

There's been a global pandemic. We don't get to demand measures that take our risk back down to the world of 2019. We have to accept the likelihood of additional illness without losing all sense of proportion with restrictions on others.
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Re: Vaccine passports

Post by shpalman » Mon Jan 03, 2022 3:02 pm

There are restrictions on alcohol sale and consumption, and controls on pollution from vehicles.
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Re: Vaccine passports

Post by lpm » Mon Jan 03, 2022 3:07 pm

But not prohibitions. With vaccine passports the intent is to prohibit the unvaccinated, not restrict them.
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Re: Vaccine passports

Post by Woodchopper » Mon Jan 03, 2022 3:10 pm

And as well as what lpm wrote, the benefit of vaccination isn't one of partial protection versus no protection. In the UK circa 95% of people have antibodies so the chances are that someone in a nightclub who hasn't been vaccinated has antibodies from natural immunity (even if they haven't been tested). Other European states will probably have similar ratios.

I wouldn't go as far as lpm. But its not obvious to me that the benefits of vaccine passports outweigh the costs, especially as those costs appear to include an erosion of public trust in public health authorities.

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Re: Vaccine passports

Post by shpalman » Wed Jan 05, 2022 7:52 am

Macron declares his Covid strategy is to ‘piss off’ the unvaccinated
“In a democracy, the worst enemies are lies and stupidity”
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Re: Vaccine passports

Post by Bird on a Fire » Wed Jan 05, 2022 10:45 am

Seems fair enough. We can't risk having healthcare collapse every winter just to treat a bunch of stubborn wrong people for a disease many of them don't even believe in.

The options are mass vaccination, seasonal lockdowns or radical changes to how healthcare works.
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Re: Vaccine passports

Post by Woodchopper » Wed Jan 05, 2022 1:53 pm

Bird on a Fire wrote:
Wed Jan 05, 2022 10:45 am
Seems fair enough. We can't risk having healthcare collapse every winter just to treat a bunch of stubborn wrong people for a disease many of them don't even believe in.
That isn't what's happening. As of 29 December only 25% of people in hospital due to Omicron were unvaccinated (and another 6% only had one dose).
https://assets.publishing.service.gov.u ... update.pdf

Even if everyone were fully vaccinated there would still be serious pressure on the healthcare system if everyone lived like it was 2019.
Bird on a Fire wrote:
Wed Jan 05, 2022 10:45 am
The options are mass vaccination, seasonal lockdowns or radical changes to how healthcare works.
IMHO we will need a combination of vaccination, lower social contacts especially during winter, and changes to healthcare. At least in Western Europe we know how to vaccinate and over the last two years we've learnt how to keep going with much reduced social contact.

But radical changes to healthcare will be more difficult. For example, if the government were to decide today to double the number of doctors being trained in the UK, I guess that most of the extra numbers probably wouldn't graduate until about 2030-2035. It takes seven years to train a doctor and before that I guess it would take years to build up the capacity to train twice as many. Before 2020 the British government might have been able to assume it could rely upon migrant doctors and nurses, but they are in demand everywhere.

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Re: Vaccine passports

Post by Bird on a Fire » Wed Jan 05, 2022 2:07 pm

Woodchopper wrote:
Wed Jan 05, 2022 1:53 pm
Bird on a Fire wrote:
Wed Jan 05, 2022 10:45 am
Seems fair enough. We can't risk having healthcare collapse every winter just to treat a bunch of stubborn wrong people for a disease many of them don't even believe in.
That isn't what's happening. As of 29 December only 25% of people in hospital due to Omicron were unvaccinated (and another 6% only had one dose).
https://assets.publishing.service.gov.u ... update.pdf

Even if everyone were fully vaccinated there would still be serious pressure on the healthcare system if everyone lived like it was 2019.
Interesting - it's over 60% of critical care patients, who I assume are the hardest to treat.
https://www.mirror.co.uk/news/uk-news/u ... 0-25827977
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Re: Vaccine passports

Post by Bird on a Fire » Wed Jan 05, 2022 2:15 pm

Of course, what actually matters is the relative risk for vaxed vs unvaxxed.

The % of hospitalisation data is skewed by the fact that the UK never finished its vaccine rollout before unlocking.
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Re: Vaccine passports

Post by shpalman » Wed Jan 05, 2022 2:31 pm

table4.png
table4.png (98.98 KiB) Viewed 187 times
I think what matters in this context is to understand what's the best we could hope for even if everyone were recently vaccinated (and boosted, if applicable), and if it's still an R well above 1 and a substantial hospital influx then some sorts of NPIs will always be necessary.
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Re: Vaccine passports

Post by Sciolus » Wed Jan 05, 2022 2:59 pm

Bird on a Fire wrote:
Wed Jan 05, 2022 2:07 pm
Woodchopper wrote:
Wed Jan 05, 2022 1:53 pm
Bird on a Fire wrote:
Wed Jan 05, 2022 10:45 am
Seems fair enough. We can't risk having healthcare collapse every winter just to treat a bunch of stubborn wrong people for a disease many of them don't even believe in.
That isn't what's happening. As of 29 December only 25% of people in hospital due to Omicron were unvaccinated (and another 6% only had one dose).
https://assets.publishing.service.gov.u ... update.pdf

Even if everyone were fully vaccinated there would still be serious pressure on the healthcare system if everyone lived like it was 2019.
Interesting - it's over 60% of critical care patients, who I assume are the hardest to treat.
https://www.mirror.co.uk/news/uk-news/u ... 0-25827977
Roughly a third of hospital patients who test positive are being treated for something else, and I think (but am not sure) they are included in the denominator of Woodchopper's 25%. If we hypothesise that they are nearly all vaccinated, it suggests that it's more like 35-40% of people being treated for covid in hospital are unvaccinated. (Of course, "with not of" patients are still a problem because of isolation requirements etc.)

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Re: Vaccine passports

Post by Woodchopper » Wed Jan 05, 2022 3:16 pm

Sciolus wrote:
Wed Jan 05, 2022 2:59 pm
Bird on a Fire wrote:
Wed Jan 05, 2022 2:07 pm
Woodchopper wrote:
Wed Jan 05, 2022 1:53 pm


That isn't what's happening. As of 29 December only 25% of people in hospital due to Omicron were unvaccinated (and another 6% only had one dose).
https://assets.publishing.service.gov.u ... update.pdf

Even if everyone were fully vaccinated there would still be serious pressure on the healthcare system if everyone lived like it was 2019.
Interesting - it's over 60% of critical care patients, who I assume are the hardest to treat.
https://www.mirror.co.uk/news/uk-news/u ... 0-25827977
Roughly a third of hospital patients who test positive are being treated for something else, and I think (but am not sure) they are included in the denominator of Woodchopper's 25%. If we hypothesise that they are nearly all vaccinated, it suggests that it's more like 35-40% of people being treated for covid in hospital are unvaccinated. (Of course, "with not of" patients are still a problem because of isolation requirements etc.)
I'm not sure why we should assume that almost all the people admitted to hospital for another reason would be vaccinated. Perhaps they might if they are older. Alternatively, people who are in hospital may be those who in general aren't disposed to look after their health. Or maybe they just resemble the population in general.

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Re: Vaccine passports

Post by Bird on a Fire » Wed Jan 05, 2022 3:32 pm

shpalman wrote:
Wed Jan 05, 2022 2:31 pm
table4.png

I think what matters in this context is to understand what's the best we could hope for even if everyone were recently vaccinated (and boosted, if applicable), and if it's still an R well above 1 and a substantial hospital influx then some sorts of NPIs will always be necessary.
I'm not sure R really matters that much, compared with hospital occupancy. We know that vaccinated people are less likely to be hospitalised and stay less time in hospital, so increasing % vaxed would reduce the peak by "quite a lot".

Omicron is new and we don't really know what's going to happen this winter, but it'll be interesting to model alternative scenarios based on everyone being vaccinated. If it turns out to be a difference between NHS collapsing or not, that suggests that pushing uptake to ~100% and/or just keeping the unvaxed out of the NHS would be useful.

Maybe I'm being unimaginative but I find it hard to imagine a future with adequate NPIs every winter. Folk never bothered in the past, they just accepted a higher death toll.

We've lost most of the old diseases, and now we're making some new ones.
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Re: Vaccine passports

Post by Bird on a Fire » Wed Jan 05, 2022 3:45 pm

Perhaps worth noting that in Portugal, where ~90% of the population is vaccinated (compared with ~70% in UK), unvaccinated people make up 75% of hospital admissions.

The calculations there suggest that unvaxxed are 21x likelier to end up in hospital.

https://observador.pt/opiniao/a-vacinac ... ernamento/
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Re: Vaccine passports

Post by Bird on a Fire » Wed Jan 05, 2022 3:48 pm

Mind you, they've only got 1203 people in hospital (147 in intensive care), out of a population of 10m.

https://covid19.min-saude.pt/ponto-de-s ... -portugal/

I reckon the vaccine passports in Portugal probably helped to (a) encourage uptake (especially amongst the young at the back of the queue), and (b) reduce the spread of omicron. (Though I also reckon it helps that people have a vague sense of social responsibility and the government aren't all totally horrible fuckwits.)
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Re: Vaccine passports

Post by shpalman » Wed Jan 05, 2022 4:11 pm

I originally started reading your final sentence as

"We've lost most of the old people..."

I suppose we're interested to know if getting the last few unvaccinated people vaccinated would be of anyone's benefit except to themselves, and the debate at the moment is whether it's the small remaining proportion of unvaccinated who are disproportionately the reason why
hospitalizations are increasing.

Of course, fewer vaccinated people would be catching covid (both in and out of hospital) if there weren't any unvaccinated people. But the UK is fairly close* to everyone being vaccinated or having antibodies from infection, and you're still in the situation you're in.

The reason I mention R is that if we're dealing with something with a fast doubling time then you have an unstable situation in which suddenly everyone needs hospital at once and you don't have much time to react; this isn't like seasonal 'flu or whatever, which is much more spread out in time, so I don't realistically think we can expect to be able to live with Omicron-covid in the same way. Not during the winter anyway: summer Delta-covid in the UK seemed to be self-limiting for reasons we still don't understand.

I do note, however, that occupancy in mechanical ventilation beds in the UK isn't going up (yet).** In Italy, the numbers in intensive care are increasing in parallel with the numbers in non-critical care, but they're only slowly increasing and don't yet reflect the more recent acceleration in cases. It has been enough to trip more and more regions into Yellow status and at least one (Liguria I think) risks Orange status.

Seeing that BOAF posted about Portugal while I was writing this, I've already posted graphs from https://lab24.ilsole24ore.com/coronavirus/ which show that the vaccinated are about 3.6x less likely to catch it, 4 or 5 times less likely to need to go to hospital, 9x less likely to need to go to intensive care, about 3.7x less likely to die. Apart from the case data, though, these estimates are a bit old.

In Lombardy (population 10m) we have 2546 in hospital (of which 234 in intensive care), although we had numbers similar to Portugal a few weeks ago (1202 and 136 on the 8th of December, 1340 and 147 on the 17th). Just over 80% of the population of Lombardy have received at least one vaccine dose. Or, to put it another way, we have double the unvaccinated population than Portugal has. So "* - fairly close" isn't precise enough, because it's one minus the vaccinated fraction which matters, so the UK having three times the unvaccinated population compared to Portugal makes a big difference, and the Delta wave during the summer wasn't useful because those antibodies weren't the right ones and anyway they've worn off.

** - maybe I should wait until today's update before posting...
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Re: Vaccine passports

Post by shpalman » Wed Jan 05, 2022 4:23 pm

Italy's council of ministers is discussing, for example, making vaccination obligatory for the over-60's and making a Super Green Pass (vaccination or recovery) necessary for going to work.
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