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Nov 23, 2021
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It’s a useful protest for people like me who have almost zero risk from covid.

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How would you feel if you caught it and passed it on to a relative whose risk is not almost-zero?

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To be fair, Fitzgerald could have near-zero risk of catching COVID in the first place, via isolation from society.

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I guess the same as people who had the flu in the past, and didn't fully self-quarantined. Not even vaguely guilty. I agree with them, because guilt over this kind of indirect effect can not be general if you hope to live a normal life. So what should and what should not make you feel guilty, of what is acceptable in term of indirect-risky behavior, is mostly cultural/political/religious/choose your naming, the indirect risk is mostly an a posteriori justification for trying to change mass behavior, by the party that want to change it. It's not something based on a objective attempt at ranking behaviors per indirect bad effects, at least when those indirect bad effects are small...Yes, I am not really convinced by utilitarianism, mostly because of that.

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I'm not a fan of it either, but how are other systems of ethics different? In the end, they too want "the greatest good for the greatest number", except try to achieve it with various rules of thumb and shortcuts, which of course are mostly cultural/political/religious/choose your naming.

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I'm not sure it's true, even theoretically. Most systems have "the greater good for the greater number" as a goal, but certainly not as the only goal (or even the most important one). For example, Justice is often also a goal (often more important than the greater good) (I define the justice as each societal actor get a proportion of the total pie (variously defined) depending on his worthiness (variously defined). This is not a primary goal for utilitarianism, it's at best secondary (in the form of incentive so that net producer of global good are encouraged to produce as much as they can).

But that's not the main point of your comment: I believe there is an advantage of the usual (but suboptimal) rules of thumb utilitarinaism vs classic utilitarianism: The former is not a totalitarism, the second is. Totalitarism is not a problem in general (for physics for example, it is a driving force that I admire), but for government it is, especially when you have a central arbiter much more powerful than any individual or allowed grouping of individuals. It's the recipe for hard dictatorship, regardless of how worthy or altruistic the initial goal seems. The arbiter define the goal, measure it and the total aspect let very little place for unorganised discussion or disagreement. Rules of thumps are maybe less efficient, but they are not total so let unruled liberty spaces from which the system can be reformed....Well, I think I use overly complicated explanantion for something that is quite simple: I do not trust a human (or group of human) that say let us rule, we have the greater good of the greater number as objective. A group of actors, mainly selfish but with some altruistic component, that self-organise in multiple intersecting groups each implementing some reward-punishment system is suboptimal maybe, but do not need any crazy trust in the ruler.

Utilitarianism as a political system is, fo me, synonymous with a benevolent strong (well above human-level cognition) IA.

Utilitarianism as a personal philosophy is not the same. I have admiration for it, coupled with some distrust like for all altruists (are they really sincere?)...I also do not think it make the practitioner especially happy, so as a selfish bastard, I continue to care about myself first, my close ones next, and humanity as a very distant third. At the individual level, this system is maybe less admirable, but it is more actionable and, as you are more able to directly observe happiness of close ones (and, by definition, the most able to observe your own happiness), it's also far less hackable than utilitarianism :-)

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Well, the point about altruism always confused me, long before I knew any relevant definitions. So, probably at about 10 years old, I decided that, since I care about myself the most, and about people close to me much more than everyone else, I must be evil. And further, revelaed preferences showed that pretty much everybody else was the same in practice, regardless of whatever high-minded ideals they might've gone about professing and not acting on. A few decades later, and having learned those definitions, my opinions haven't changed much.

The most important thing that I've understood about why people resist to openly accept and universalize this natural attitude, is that its ultimate logical conclusion is fascism. Which doesn't exactly boast a track record of successful implementations.

Of course, the obvious alternative of trying to universalize some ostensibly egalitarian set of ideals also leads to a totalitarianism of slightly different kind, like you mention, which also earned its share of PR problems, even though it isn't quite excluded from polite society unlike the former.

Is there a principled third way? It doesn't seem that there's even a broad undestanding of these issues, much less a significant informed effort to resolve them.

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Nov 23, 2021
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No. There were some people who joked about it and some of those jokes memed and people turned into reality, but I don't believe any of the currently under investigation drugs are ivermectin alternatives.

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Thank you. I think Pierre Kory mentioned this on some podcast but unless I can hunt that down my assumption is that this is untrue.

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In case your interested:

Theoretical antiviral mechanisms of ivermectin: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8203399/

Theoretical antiviral mechanism of molnupiravir: https://www.nature.com/articles/s41594-021-00651-0

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Yes, molnupiravir, this was it, thank you. I guess the conclusion is that the mechanisms are different?

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Quite different. Ivermectin is theorized to bind to viral proteins at locations which make them non-functional.

Molnupiravir acts as a pseudo-nucleotide, it gets incorporated into viral RNA in place of either citidine or uridine which causes the resulting codons to code for the incorrect amino acid leading to mutated and non-functional proteins.

It's actually super awesome.

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I was reading about this yesterday and it sounds pretty cool, but the thing I don't understand is: how does this not also screw up my own DNA?

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I feel like the rate of posts on ACX has dramatically increased these last 10 minutes.

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But not from ivmmeta. They criticize Scott but never link to his criticism so their reader can decide for themselves.

Which is because the site is built to be cut-and-pasted responses to Internet arguments.

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"To mandate vaccines is to state that humans are all born defective, and only become non-defective after jumping through state-approved hoops. It is philosophically corrosive to everything I believe in."

This feels like an isolated demand for rigor. I am constantly choosing to better my existence in many ways because of my 'defects':

* I take ibuprofen (which is government-approved) because my defective body creates headaches

* I upgrade my phone (which is government-approved in various ways) because I need a better camera because my defective eyes don't permanently store images of what they see

* I take the Moderna vaccine because my defective body is incapable of manufacturing the antibodies against a recently-common virulent disease that risks my wellbeing and that of those around me.

All human life is defined by improving our condition, sometimes under the supervision of a government. Regardless of whether those measures are mandated, it is strange to think of some of those actions as perfectly ordinary and some of them as accepting that you're defective.

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There's a pretty big difference between "government-approved" and "government-mandated". My body was defective, and produced more teeth than I needed. I am happy that I had the option of getting my wisdom teeth extracted to fix that defect. I would not be happy if I was legally required, or even strongly pressured, to get my wisdom teeth extracted -- despite the fact that it was a real defect in my body.

The difference with vaccine mandates is the argument that, by getting a vaccine, you substantially reduce the burden of the disease on other people, and that reduced burden is worth the cost of imposing the state-mandated hoops. But you have to actually make the case that the cost is worthwhile (well, you don't have to but people are going to be a lot less convinced if you don't).

I say this as someone who got vaccinated at the first available opportunity. "Allowed" and "mandatory" should not be conflated.

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I don't disagree. My point is that if you choose to label all of these things as evidence that you are defective, you shouldn't care if the government also labels you defective. The emotional impact of being "defective" loses its meaning when it is applied to every aspect of our daily lives.

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That's disregarding the very important point of individual agency. If I decide I need more exercise and choose to do pushups, that's one thing. If the government sends a drill sergeant to yell at me to do pushups, that's a very different thing.

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If you have TB and you don't comply with treatment someone from the government will come to your house everyday and watch you take your pills. Do you think that's wrong? Should people be free to walk around with active TB?

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I wasn't born with active TB. Nor were most other people.

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Nov 23, 2021
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Huh? You’ve lost me.

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BronxZooCobra did not mention congenital TB, I think he was referring to community acquired TB. After two to five days of treatment you are not contagious anymore.

However, it is important that TB patients take their medication full course (6 months). It is the non-compliance that caused the MDRTB (multi drug resistant) and the EXDRTB (extremely drug resistant) strains. And although most are reminded in a friendly way by community health care workers, I have no objection if -when needed, in case of refusal- it is done at 'gun point' or locking them up.

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It's worth bearing in mind that individual agency is not a fact of natural law. It is, more or less, a privilege a governing majority grants to the polity over which it exerts sovereignty. Like any privilege, if abused it gets revoked. One of the reasons we enjoy as much individual agency in the US as we do is that people by and large don't take it to extremes -- they rein it in a bit voluntarily when it starts to become clear that it pisses off too many people. If that stops happening, there isn't a God Emperor that will stop the majority from circumscribing the amount of individual agency it tolerates.

That may not be pleasant news, and it may not even be the way the world *ought* to operate, if ethics were as as ineluctable as the Second Law of Thermodynamics. But it's the way the world actually does work, and wise men don't argue with forces of nature.

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You have it exactly backwards. Individual agency is the fact of natural law. We trade some of that agency for government to take some of the rough edges off of living around other people. Governments can go farther and use force to make people do things, just like any group of the strong can do to the weak, but the default is individual agency. The fact that it is usual in history for the strong/large group to violate the rights of the weak/small group does not make agency a "privilege."

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Natural law in the sense of what ought to be, sure. In the sense of what actually happens, no. The ugly truth is that groups of humans outside of tiny and fortunate and often transitory alliances, will *always* end up with the group imposing limits on individual agency, because it can. I don't take individual agency by my kids as a bedrock principle of my family, and no responsible parent would. My firm doesn't take individual agency by employees as a bedrock principle, and no successful firm would. If I sufficiently piss off the majority in the State of California, it can and will hound me, lock me up, even kill me, notwithstanding any written law or ethical principle, simply because it can.

The fact that I have a substantial degree of agency in my community, on my street, in my town and state, is a lucky thing, something not unnatural (and indeed which generations of our forefathers have sacrificed and struggled to achieve). It's not the natural state of humans. The natural state is that if I had a loud party, or failed to maintain my home nice 'n' neat, or just didn't say hello respectively enough to the local honcho, my neighbors would beat the shit out of me and enforce compliance with the local tribal values. That is indeed the record of most of human existence, from 40,000 BC to ~1600 or so.

The fact that this *doesn't* happen in modern American society -- that I can thumb my nose at my local community and they're reduced to merely verbal protest, or writing angry letters, is a fact of extraordinarily good luck (and some hard work by our predecessors). It's not a state of nature. It's perfectly possible for it to be undermined, and ultimately destroyed, by insufficient attention and effort to maintaining it, both on the part of the majority *and* on the part of any minority.

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Game theory shows that altruism is selected against because altruism advantages parasitism.

The only ESS is RECIPROCAL Altruism - where people are required to behave in an altruistic manner, on pain of getting the altruism granted by others revoked (historically, this would result in you being killed or cast out of the tribe or whatever).

We require people to pay taxes and to vaccinate themselves for the good of the group so that we can all enjoy the benefits of living in an altruistic society. But this is only enforceable if failure to meet our minimum standards of altruism actually results in real consequences.

It is, in fact, "natural law" that groups showing reciprocal altruism will require that it be reciprocated, as it is how "altruism" is selected for to begin with.

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A tough truth nicely said.

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You mean PE?

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The thing is: wisdom teeth don't affect anyone but yourself. Not being vaccinated hurts society big time. I'm against vaccine mandates as well, in principle. But since we apparently need 90+% of people to decide to get the vaccine, this principle probably can't be upheld everywhere.

The part where I can't wrap my head around is that the very people who like to talk about "serving your country", "patriotism", etc. etc. refuse to act when for the first time their country actually needs them to do something for society. And this something is as insignificant as a small injection thrice with almost no side effects with a medication so well studied, it trumps all other medication we have ever head in terms of statistics we gathered.

For me, everyone who refuses the vaccine lost their right to talk positively about patriotism, duty or the legitimacy of things like the draft. Because that one time they could have proven they actually meant what they were saying, they refused ...

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I think this is an overly binary way of looking at things. There are plenty of people who are willing to do certain things for their country but not other things, and "literally allow people to modify your body" is, I think, high on many people's lists of Thing That Should Be My Decision And My Decision Only.

*Regardless of how insignificant we believe it is*, the idea of a legally mandated injection just grates at my soul. It's one of those things that I think is probably a net benefit in the short term and leads us down a really uncomfortable path in the long term; uncomfortable enough that I don't think we should have it at all.

I'm not the only one who's made the awkward-but-not-entirely-invalid connection between pro-choice bodily autonomy and anti-vaccine-mandate bodily autonomy, y'know?

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How is: "If you are not willing to do this minuscule sacrifice, you have no right to vote on me sacrificing the life of my son!" a binary way of looking at things? I think its a very nuanced position, where you have to do the small things you can do yourself first, before earning the right to be asking someone else to sacrifice big time.

I don't see any potential sane way of reasoning where "putting a safe and well tested vaccine into your body" is a bigger burden to ask for than "take that gun and shoot at those people who I tell you are baddies and potentially get yourself killed in the process" ...

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Because they disagree on whether bodily modification is a miniscule sacrifice; a lot of people are on the Body Is Sacrosanct train, and you're not going to convince them otherwise by saying that you disagree. I think many people would say that a military draft is actually more acceptable than forcing people to undertake medical procedures, regardless of how harmless we currently think those medical procedures are.

And we're largely not OK with a military draft either, US wars have been fought with volunteers for quite a long time.

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I'd consider this a ridiculous position though. Military draft takes away your autonomy and freedoms for the length of the draft and potentially kills you.

Also: I'm not talking about forcing anyone here. I'm of course expecting them to volunteer for their country, if they consider themselves patriots (which they are very obviously not).

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Well, that's only because we haven't had a serious war in quite a long time. If there *were* an extended war at an existential level, e.g. a war with China or something that doesn't get resolved with nukes immediately, the draft remains on the books and would come back into force tout suite.

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But up until two years ago, this viewpoint was a tiny fringe! It's true that a lot of people tried to slow-walk the recommended vaccine schedule for children, but it was only a few percent who ever tried to avoid getting the mandatory childhood vaccinations that have been required for school in every US state.

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"I am.not able to take part in this war , because my doctor has advised me at not ones to allow a bullet to enter my body". -- Woody Allen.

The central example of service to ones country is military service, and that can involve some pretty serious body.modofication. also jabs.

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The notion that any individual not taking a vaccine harms society is utter and complete conjecture. If not, what study are you citing? How was it conducted? Who took part? What analysis was used?

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> If not, what study are you citing?

Studies that report lowered severity and interactivity of vaccinated people.

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The "common sense" study, where right now in my country hospitals have to close entire sections to redirect forces to care for the unvaccinated.

You want numbers? https://www.kbv.de/media/sp/2021-11-19_Corona_Report.pdf

That's actual "boots on the ground" data ...

Nobody needs a study to see that being vaccinated reduces the risk to take up valuable space in the ICU by roughly 90% (numbers vary by age group, but essentially this applies to everyone old enough to vote).

Even with the current Covid prevalence Germany could easily sustain the load on the hospitals if vaccination rates where in the high 90% range ... (but the prevalence wouldn't be the same either)

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Your English is far better than my German. Are we talking a comparison between Germany and some similarly situated country with a vaccination rate in the high 90's?

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No, we are comparing hospitalization of vaccinated and unvaccinated in Germany here. The data in the report is drawn from hospitals all over Germany.

Vaccination status and Covid infection status is noted in all hospitals in Germany, regardless what you are admissioned for. We also know which patients in the ICU are there for Covid related symptoms.

Since we know the vaccination rates in the population by state, a lot of statistics can be calculated from there ...

There are also comparisions with various other Europeen countries being made, but not in the Report I linked above, except for the last page, where they put the data into international context.

Let me translate some of the interesting data for you:

Vaccination rates:

Total: 65.8%, 12-17 38.6%, 18-59 71.8%, 60+ 84.8%

All following numbers are in the format per 100k "unvaccinated/vaccinated/reduction of risk through vaccination"

Symptomatic: total: 817.6 | 212.8 | 74 % , 12-17 968.1/90.8/91%, 18-59 867.3/257.3/70% , 60+ 524.7/150.8/71%

Hospitalized: total: 37.1/7.6/80% , 12-17 4.6/0.3/92% , 18-59 24.5/3.0/88% , 60+ 107.4/15.7/85%

ICU: total 5.8/0.9/85% , 12-17 0/0/- , 18-59 3.5/0.2/94% , 60+ 18.5/2.0/89%

Death: total 3.9/1.0/75% , 12-17 0/0/- , 18-59 0.4/<0.1/88% , 60+ 19.6/2.6/87%

Mind you, that's the data for 18th of October through 14th of November. We experienced a huge influx of patients during that period and since. Those numbers are gonna change pretty soon, since in 2-3 weeks all reserves of hospitals might be depleted and the standard of care will probably drop considerably.

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There is a huge difference in the two reason to try to convince unvaccinated to take the shot, in fact two big differences:

Get vaccinated because it will eradicate covid : once we reach 70% of adults - correction, 70% of popularion, 80%...no it's 90% now, R will be below 1 and covid will go the way of the dodo... I am very reluctant to mandatory health measures justified by population benefits, but it's me and I get plenty of people would agree on this... But it's not true and I think no epidemiologist will day anything about group immunity and covid eradication anymore. Vaccine efficiency for transmission is not enough for it since delta, and there are likely animal reservoirs anyway... So this reason may be acceptable for some diseases, not for covid.

the other reason is that unvaccinated are more at risk of ending in ICU, thus in case of saturation, taking a place needed by a more civic or careful vaccinated that just had the bad luck of accident, other disease or covid despite vaccine.... This is true, but also very similar to smokers and over eater taking valuable medical resources that could benefit more prudent /civic people. I do not want to go this way, not at all and will resist any small step this way (not necessarily because i am impacted by all, i don't smoke for example and this is clearly the immediate next step in this direction, one that is already partially implemented as higher insurance fee for smokers) but because i see it growing and growing constantly and the end state is both clear and awful. I don't want covid to be a new step in this awful ladder...

BTW 90% vaccination for at risk groups is achieved in quite a few European countries... That still impose various restrictions and blame the unvaccinated for this...this looks more like scapegoating that objective analysis

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Smokers and over eaters aren't contagious. They don't all show up in the ICU at once. That's a fine but important difference. If this pandemic had an R of exactly 1, I couldn't care less if people get vaccinated. It's their life and I totally support them being able to chose whether they want to reduce their risk or take their chances.

Hell, I'd even let everyone decide for themselves, if all of them would sign voluntarily a paper claiming to refuse any ICU care, if this implied other people not getting cared for at the best available standards or if it implied that staff has to make overtime.

But this isn't those normal times where we just let everyone live their own lives and nobody gets overly affected by this. This is a moment in time where individual choices with very little effect accumulate in a way that it affects society pretty heavily.

In a way this is like the climate issue. Me driving my car isn't a big deal. A billion people driving their cars is ...

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> Nobody needs a study to see that being vaccinated reduces the risk to take up valuable space in the ICU by roughly 90% (numbers vary by age group, but essentially this applies to everyone old enough to vote).

So, by this token violations of bodily autonomy are justified if they reduce the amount of medical care you personally consume? Because saying that "unvaccinated people take more hospital resources and therefore we are justified in imposing treatments on them against their will" is acceptable also implies "obese people take more hospital resources and therefore we are justified in imposing treatments on them against their will" is acceptable.

If the argument is specifically that the difference is that COVID is contagious and obesity isn't, you would have to make the argument that a marginal person getting vaccinated reduces the total number of people infected with COVID by significantly more than one, which I don't think is supported by the evidence at this point.

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> Because saying that "unvaccinated people take more hospital resources and therefore we are justified in imposing treatments on them against their will" is acceptable also implies "obese people take more hospital resources and therefore we are justified in imposing treatments on them against their will" is acceptable.

It does, at least to the modern left; see NYC sugar-taxes!

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Your logic about the marginal patient is interesting. It's a lot like the marginal voter.

Unfortunately, public health has to deal with biology and human behavior. It IS actually true vaccination reduces both case counts as well as case severity. But you're right, one person getting or not getting the vaccine will not tip the scale. Even so, it really does matter that we get a large percentage of the public vaccinated.

In general I support libertarianism, but some things really do have negative externalities. The argument you present here makes me sigh.

Last year I heard the libertarian candidate for president in an interview say that the thinks different communities should be able to have different requirements for vaccination, and people could move if they don't like it. This kind of thinking is impractical, and terrible from a public health perspective. That one statement cost her my marginal (worthless) vote.

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> by significantly more than one

why?

If people who could vaccinate and refused would be refused hospital care in case of ICU shortage then I would be fully accepting that.

But the problem is that in some places at least people die because people who refuse to vaccinate overloaded hospitals.

Or because to avoid overloading hospitals operations and treatment was cancelled.

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The fact you demand someone links you a study that vaccination reduces contagion makes me inclined to believe you are being facetious at best.

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I should have been more specific. Borrowing from another context:

The only people who regularly get flu shots are people who regularly get the flu. People who never get the flu usually don't get flu shots. The claim that people who never get the flu not getting flu shots is the reason why people who got flu shots are getting the flu is a perfectly reasonable thing to ask for evidence for.

I admit I may be misunderstanding the general claim.

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I’m in an admittedly liberal area in the USA in a liberal bubble, but all of my friends and family get the flu shot each year. They rarely get the flu. Lots of people I know have never had the flu but still get the shot each year. My town and the local university both run flu drives where they encourage everyone of every age to get a flu shot. They all do this because it decreases the spread of influenza, especially protecting people who are immunocompromised.

Certainly there are people who both don’t get a flu shot and don’t get it so they then don’t spread it, but there are also many people who would otherwise have gotten the flu but don’t because they had a flu shot. And those people would certainly have spread it to the people around them (both breakthrough cases and to unvaccinated people). That second group is who need to get the flu shot. Unfortunately, it’s impossible to know who will be in which group beforehand. We can make reasonable guesses (perhaps doctors and nurses are most likely, then teachers and students, then retail workers), but anyone is still a possibility unless they’re in a self-imposed lockdown.

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This has been widely established at least since the days of Pasteur, if not Jenner. There's a reason that every developed society has had some form of vaccine mandates for most of the past century and a half (even though many of these "mandates" are actually just conditional mandates if you choose to enroll in school or the military or something else not technically required).

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Many of them make homeschooling either illegal or highly inconvenient, therefore making mandates essntially unconditional.

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What do you expect 90% vaccinated will achieve that the current 70-80% won't? The reduction in virus transmission of the current vaccines is not great, maybe 1/4 at best but probably more like 1/2...so the reduction of trasmission would be 1/4*%vaccinated + %unvaccinated. We would go from 0.8/4+0.2 = 0.4 to 0.9/4+0.1=0.325...will this magically make R go below 1? More vaccinated people is a good thing... At least among the people more at risk of covid than vaccine (not clear if its all, or people above a certain age)... But hoping that at a certain threshold, vaccination will eradicate covid is untenable, since we had R well above one in countries with 70% vaccinated, in fact since the 80%+ vaccine efficiency against trasmission was reported false. At this point, group immunity by vaccination serve only one clear purpose: stigmatising unvaccinated as the group responsible for the covid problems. I guess for other groups that may have to assume this responsability (like gouvernements), it's very useful

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> But hoping that at a certain threshold, vaccination will eradicate covid is untenable, since we had R well above one in countries with 70% vaccinated

This effect is not necessarily linear. https://en.wikipedia.org/wiki/Herd_immunity

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So, concretely: do you expect that the number of COVID cases will approach zero, and there will be no further outbreaks, in populations that hit 90% vaccine uptake?

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No idea, I would need to research specific numbers.

Even if such data is available it would likely take week or two of work to get model that likely is so simplified that it would be worthless.

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While the vaccines is very effective in reducing severity. it is not effective enough in reducing transmission. So I think Greg's thinking is correct. The Herd Immunity article you link says that enough people have to become "immune to infection" -- that's not what we're presently getting with the vaccine.

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I am well aware of the group immunity equation... It's non linear but it's trivial... Using wikipedia notation, if R0 of covid (delta variant} is 5, you need p>0.8. If do you get more than 80% of people immune (Wikipedia speak, in full it means non transmitting, that's what count, not symptom severity) when between half and a quarter of people vaccinated still can transmit. You can't, getting 100% vaccination will not get you here immunity, it will at most reduce the charge of the hospitals... One clear outcome of the covid is that simple épidemiological models are mostly useless (something i didn't expect, they are simple and their hypothesis seems reasonable), but epidemiologist speak about herd immunity anymore... In fact, scientific theories mostly seems cherry picked to justify measures... The prédictions were wrong, countries have varying issues and problems but it's not the good students in term of vaccinating that necessarily are in better shape. Sweden is not a graveyard, India who got hit by the delta is not in the news anymore... So it's very difficult to dee what is happening and even harder to predict what will happen, but one thing is sure : lent supposed democratic gouvernement turned out to be lying not so democratic entities hostile to individuel freedom and responsibility... Given that, i consider their lack of efficiency a blessing...

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How much does not being vaccinated hurt society, exactly? Vaccination does not stop the virus from being hosted or spread by humans. COVID also has reservoirs in animal populations, so there is no way to eradicate it from the Earth even if the vaccines were sterilizing.

So what is the marginal benefits to society from everyone being vaccinated above and beyond everyone being vaccinated or having natural immunity?

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That depends on how many people chose to not be vaccinated. Germany currently has one of the biggest amounts of ICU beds per capita in the world. Yet ICUs still get inundate with unvaccinated people to a point where it starts to affect the medical care available to other people. That's where it starts to hurt society. I've linked and translated the relevant statistics for Germany elsewhere in this comment thread for the poster Ryan.

If the unvaccinated wouldn't show up in the ICUs, I couldn't care less about them choosing what-ever they feel right for them. It would still hurt society to some degree, as society would have to pick up the slack for the unfortunate, who have a bad outcome of the infection, but I'd consider this within the acceptable limits. We don't condone people smoking, drinking, binge-eating or performing high risk sports after all. And I totally support the "my body my choice"-motto.

Unfortunately that's not what's happening right now. Right now, in Germany, we are very close to a melt-down of the medical system, and numbers show, that, even with the same number of infections, there would be no such issue, if we were above 95% vaccination rate ...

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you can not be at 95% vaccination rate in time. Depending if 95% is the total population or the at risk population, I think you can not reach 95% vaccination regardless of time and incentive. 95% is just a huge percentage. This 95% is coming out of thin air, now that ICU saturation may be a problem. When it was not considered a likely issue, western europe countries were mostly self-congratulating about vaccination percentage, playing a pissing contest to see who got a few % more than it's neighbor, and speculate about how herd immunity will be reached real soon at 60, no 70 of adults, no 70 total, correction it's 85% now....well forget about herd immunity, it was never a possibility. This 95% of vaccination is neither realisticaly achievable nor, given the track record of covid prediction, a garantee of anything. You can predict the sign of the effect: more vaccination means less ICU beds busy, all other things being equal. Not a very accurate nor usefull prediction.

So I see one practical effect of this 95% number: Designate the unvaccinated as the sole responsible for the covid troubles. And the economic crisis. And the inflation. Add climate change and loss of hairs too, why not :-)

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You are arguing in bad faith here. The 70% figure was given before even the beta variant was discovered. And it was never said as a "truth", but always communicated as the bare minimum required, given the data we had. New variants with higher R values of course change that equation.

And yes: I agree that 95% of the eligible population is very hard to do unless mandated. But the virus doesn't care if we like it. We either do what we must, or we don't. Either way we have to deal with the consequences that come with it.

And yes: the unvaccinated are largely responsible for the current mess in the ICUs. It's them arriving there in large numbers. The vaccinated still only make up 10% of that, if adjusted for the amount of people vaccinated.

It was also largely them opposing what could fix this mess very easily. If everyone acts like an adult for a mere four weeks, this hole thing is over for months. We could stop this pandemic to New Zealand levels whenever we wanted to and then work a rigorous track&trace program with harsh lockdowns of small areas where ever the virus pops up. But again: coordination problems. Some part of the population never cared, some no longer care (me included), some can't be bothered ...

Now we will have to deal with the unrest leading to us losing all those lives we had saved compared to Sweden. I can already see how those who always wanted to go the Swedish route will claim how they always said it would be pointless to do anything, considering that ultimately we will probably match the Swedish death-toll per capita ...

But honestly: if they can't be bothered to get the vaccine, I can't be bothered to care about the spread of the virus after 1,5 exhausting years either. We apparently now need a few 100k deaths to learn a lesson. I can already see those who objected and obstructed all measures blaming the government for not bolstering up the health care system. They won't understand, nor want to hear, that even if we would have been able to double the numbers of employees in the ICU, which is in itself a ridiculous proposition already, this would have only bought us two to three weeks.

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This didn't age well at all. The vaccines don't stop transmission and *never did*. And they're more dangerous than all other vaccines combined. So f*** you and your arrogant authoritarian bullshit.

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Well, if you make up your own facts I guess in your fantasy world your comment makes sense. I won't even try to look up what you are actually referring to in my comment, considering your manners ...

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Your body is defective. It caries numerous communicable diseases. You and everyone else on the planet is mandated not to defecate outside of the designated locations. Do you have a problem with that mandate?

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I am defective because I can’t see well, and the government mandates I wear glasses when I drive. Why is this ok?

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I find the phrase "To mandate vaccines is to state that humans are all born defective," hilarious because it implies the slightest possibility that we're not all born defective in a multitude of ways.

They're saying it's an insult to claim that the microscopic defensive swarm that protects their bodies from constantly evolving enemies isn't also psychic. That we dare say we need to at least warn our immune system what it's up against and give it the chance to develop a variety of specialized weapons otherwise on its own. Meanwhile, we all have blind spots because our retinas are wired backwards, we have a nerve to our throats that loops under our aortas for no reason, and women have to squeeze their babies through their hips.

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We require people to do all sorts of things in order to prevent risks to others. It's why you can be pulled over for having a taillight out - it's dangerous to other people on the road. There's nothing stopping you from driving around with no taillights, but it's dangerous for everyone else.

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My point as well. But let's stop discussions with people who don't want to follow the general accepted rules - and as result make lives of billions misserable and risking millions of further deaths. In many countries one gets imprisoned on a lot less important things...

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"This feels like an isolated demand for rigor." It also feels like they are ignoring the whole "contagious disease" aspect of COVID. Your headache doesn't affect me (unless you're my husband.) Your ability to infect me with COVID does.

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I originally wrote "vaccines turned out not to be great on this contagion aspect", but realized I don't actually know. There are studies on viral load in breakthrough cases, but is there any data on how contagious these people really are?

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Once a break through happens, they apparently are as contagious as non-vaccinated. However, being vaccinated apparently shortens the length of time they are contagious. The infection rate of a vaccinated index patient apparently is roughly 50% of that of an unvaccinated index patient.

Add to this, that vaccinated people only have 30-50% probability to get infected in the same scenario in which an unvaccinated person gets infected, and you have a pretty good reduction in contagion.

Now add to this that being vaccinated reduces the risk for patients to require ICU care by approximately 80% and you can see why hospitals can operate normally with vastly larger incidence values in the population if everyone is vaccinated, as opposed to a population with large clusters of unvaccinated people.

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From 1796 to 2019 vaccines prevented vaccinated people from infecting unvaccinated people. Last couple years sure turned that on its head.

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I find that very unlikely. I've always thought that rare breakthrough cases of measles, mumps, polio, etc. could infect other people - let alone the much more common breakthrough cases of flu. What's changed now is that breakthrough cases of COVID are more common than breakthrough cases of anything else (except maybe flu), because there's a huge pandemic going on.

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"s that breakthrough cases of COVID are more common than breakthrough cases of anything else"

How do we know that for polio? IIRC only a very small percentage of even unvaccinated people will develop symptoms like paralysis. The vast majority of people will experience fever, fatigue, vomiting, stiff neck, headache, etc. If you'd been vaccinated as a kid and then felt shitty for 2 days you're not going to go tested for anything let alone polio.

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I think they were saying that the absolute number of breakthrough COVID cases is high compared to breakthrough polio cases, which is trivially true since there are no polio cases (in the USA) and many COVID cases.

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"The Salk vaccine had been 60–70% effective against PV1 (poliovirus type 1), over 90% effective against PV2 and PV3, and 94% effective against the development of bulbar polio."

If it's 60-70% effective than 30-40% of vaccinated people got polio. Keeping in mind that much like COVID polio was mild for most people. It wasn't like anyone who got polio ended up in an iron lung, I think it was well into the low single digits.

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That also stood out to me. We're a bunch of hairless apes creating by the alien process of evolution. We're barely able to hold together a civilization and stave off everything this uncaring universe throws at us to kill us. It is very inspiring to me that we made it so far, and I deeply hope we will make it even farther.

But to think that you have some kind of God-given right to survive a virus is very bizarre to me. There is absolutely no reason why humanity will only ever face threats that it can overcome. If we want to survive we really need to pull all the tricks. And the mRNA vaccines are just marvels of human ingenuity, that will allow us to hold on for a bit longer.

I pray that we never face an *actual* threat.

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Nov 23, 2021
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> your body develops six kidneys but only keeps two

very quick googling failed to find this one. Do you have a link explaining this one?

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Nov 23, 2021
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Wow, this made my day!

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I think a good analogy would be clothing. Mandating people not walk around nude seems like it is a "state-approved hoop" imposed because your naturally unclothed state is "defective".

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It's absolutely an assault on bodily autonomy--the right to use my body in the way I choose! I am now no longer wearing shirts outdoors since it is one of my only methods of protesting the government's mandates on my bodily autonomy. Nevermind that it's -20F outside.

This is slightly uncharitable but is basically how I view people who refuse to get vaccinated as a form of protest against even a valid example of government overreach. You're hurting yourself and making this whole damn thing last longer too.

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Nov 23, 2021
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This actually made me laugh out loud for real.

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In all seriousness, I find that state sanctioned mandate to wear clothes in public makes much less sense than vaccine mandate.

It seems to me that a most basic rule of thumb is to restrict actions with moderate-high value of harm to others compared to harm to oneself.

This value is much less for not wearing clothers when it is cold than for not being vaccinated during a pandemic.

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Requiring people not to shit on the floor seems like a better analogy.

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Yes, as nudist I would prefer allowing everybody to be nude but required to poop in a toilet, instead of everybody be clothed and poop anywhere the mood strikes.

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"Author briefly looks at 30 of the 66 studies, which we note is much better than most commenters, but still ignores the majority of studies, including the prophylaxis studies."

My reaction to that one is "Oh, person, try me!"

I trawled my way through that Cochrane meta-study of the various studies. A heap of them were "throw everything at the wall and see what sticks" where they dosed people up on ivermectin and whatever they had lying around in the dispensary cupboard; some of them were "you're not testing what you say you're testing when I read your paper" and at least one was "we done screwed up".

One of the positive ones recommended you take your ivermectin with a meal and alcohol, because that made it work better. So at least you get to have a nice steak dinner with a glass of wine, which should make the experience pleasant.

The positive results ranged from "mild" to "really great but it's in Florida". There's no way to say "All the studies or most of them anyway say this works fantastically".

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The longer Americans don't get their damn shots already, the stronger the argument against donating the leftover doses becomes: "we can't donate that vaccine, Dr. Scott in the Bay Area hasn't taken his yet! Would you vaccinate some random Nigerian before Dr. Scott?!"

And that's even assuming those shots *could* be donated. Poorer countries have been discarding doses left and right for months.

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Well, this explains why you were asking "who needs editors?" in the open thread.

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re. "To mandate vaccines is to state...."

This finally clarified to me why I've been getting so god damn HEATED about COVID-19 and global warming denialists in general, compared to other things.

It falls under the list of vague "social contract" things I expect everyone to do because I have to do them too.

Eg, I like being loud in public. I like fighting. I like driving fast on mountain roads. I like shooting guns in my back yard.

But, I don't do any of these things, in exchange for everyone else not doing these things; so when I see a defector (someone not getting a vaccine; someone driving perfectly buffed out brodozer with the fake lift and no liner) it pisses me off because: I wanna do stupid shit!

If I can't fight people in line at the grocery store and shoot squirrels at the park with a 762 and drink in public, YOU have to wear a mask and get your fucking shot.

We live in a civil god damn society where 90% of our individual liberty is sacrificed to protect our ability to live groups; and that's good because if we didn't idiots like me would try to box you for wearing a loud shirt or some equally dumb shit.

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Nov 23, 2021
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The social contract breaks down, we return to state of nature, and I box you in the grocery store line before stealing all the bourbon and burning it down on the way out.

Or, alternately, everyone publicly shames you for being a selfish piece of shit, you loose your job, your wife leaves you, and we all stand in a big circle and laugh at how dumb you are.

Or, in reality, Nothing really happens because you are utterly unimportant and literally nobody but your mom cares what happens to you or what you do.

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Nov 24, 2021
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That sounds like it leads to the "I fight you for groceries" outcome, not a "shake hands" outcome.

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Nov 24, 2021
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There are things between "indefinite worldwide mask mandate" and "no masks forever". You're engaging in very blatant splitting here.

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That's a pretty extreme case of putting words in my mouth, and if that's how you interpret my comment, I think that warrants skepticism of your ability to interpret the positions of other people who disagree with you as well.

The point Nah is making is not that masks in themselves are the lynchpin of civilization, but that the social contract which our civilization *does* rely on involved people mutually accepting obligations they don't like in exchange for other people respecting obligations towards them. From that standpoint, you don't mutually and respectfully agree to disregard parts of the social contract you don't like at your discretion, the social contract is what keeps you living in basically peaceful cooperation in the first place.

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I dunno, whatever the relevant penalties are in your jurisdiction, I guess.

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The problem is not everyone agrees on what shouldn't be allowed. You don't shoot squirrels at the park even though you want to, but why? What if everyone did want to do that and would have no problem with everyone else also doing it?

That's the problem we have now, except 50% of the people have a problem with you shooting squirrels and 50% don't and would also like to do it. And the government isn't even trying to put a number of this, it's just picking one based on ???

This would be defensible if there was an actual vote and the majority actually said "we want this, and we live in a democracy, so suck it up". But afaik even that hasn't happened.

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Go look at polls-- most Americans support the vaccine mandates. It's not everyone, sure, but it's definitely a majority.

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for 1, can you link some polls? I'm not familiar with the area myself so i wouldn't know what are good one.

For 2, come on. We both know polls are pretty much worthless for anything. See the Yes Prime Minister skit for that. It's trivial to change consensus based on a single word choice, plus polls are unlikely to capture the same demographics as those that vote.

For 3, even if true polls are not a substitute for the formal democratic process. We don't choose the president based on polls.

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https://news.northwestern.edu/stories/2021/10/survey-shows-most-americans-continue-to-support-vaccine-mandatesand-want-more/ was the first link on google when I looked up "how many people support a vaccine mandate" and you can search that yourself to see other websites-- I'm just mentioning my search to let you know I wasn't trying to cherry pick data.

Polls aren't worthless for anything, but yes, they are not a substitute for the formal democratic process. However, if we want to know "does the majority want this," which was the question you were posing earlier, than yes, polls can broadly tell us if Americans do want this. And when answering this question we do not have to think about some of the factors that make presidential polls have a higher relative MOE.

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Well, the problem is, like i mentioned in #2 i simply don't trust polls. :V

Going through and reading the actual data on the survey, it's actually not bad, so it updates my priors on the belief a bit. But it still has some problems

1. It was online only, which vastly limits who exactly sees it.

2. The response of the public is contradictory. 65% are in favor of a vaccine for everyone, but only 63% are in favor for giving it to children (who are presumably included in the everyone category).

3. I simply cannot believe that 45% of republicans are in favor of a vaccine mandate. Like seriously, 45%? Or Republicans? That's antithetical to their entire ideology!

Either i'm living in a bubble (very possible), or polls are completely worthless (much higher possibility. How were the polls on Brexit and the 2016 presidential elections?). But fair, i will retract my complaint that governments are not trying to put a number on this. I was incorrect there.

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Sure, it was online only, but polls usually correct for non-response. Also, a vaccine mandate "for everyone" presumably means adults, and even if you disagree that that's your interpretation, you have to admit that at least a good amount of respondents would interpret it that way.

And imo your priors are all out of wack. There were errors by individual pollsters, sure, but the poll models were pretty accurate. 538 gave Trump around a 1/4 chance of winning, and just because he won does not mean those polls were worthless-- he had a 25% chance to win. If pollsters gave Clinton only a 51% chance to win, and Trump won, you wouldn't say that the polls are bad-- just because Clinton had the bigger chance to win doesn't mean that because Trump won, polls are worthless. The whole "2016 election means polls are worthless" is just a really, really tired critique.

There's definitely a bigger chance you're in a bubble. We're all pretty much in bubbles. Scott talks about this all the time.

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Most Republicans had no issue with vaccine mandates a few years ago. The fact that *about* half do now is testament to how quickly a newly generated political controversy can morph into ostensibly philosophical principle.

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This strikes me as odd, because OWID reports only 59% of Americans are fully vaccinated (~70% at least one dose), lower than most other developed countries... surely very few unvaccinated support a mandate, while many of the vaccinated won't support a mandate.

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Devil's Advocate counter-argument: we only metaphorically signed the social contract because it had big exceptions in red to which liberties are fair game for regulation. Freedom to move around within one's home town to meet one's loved ones is one of them: locking people up is something we only do to our worst defectors (serious criminals) and preventing them from seeing loved ones is something we pretty much never do (see: the outrage about separating migrant children from their parents).

If I sign a contract allowing you to seize any of my inanimate possessions if necessary, but the contract specifically mentions that *obviously* my infant daughter is not included; and then you stroll in to seize my child; and you say, "oh come on you big crybaby, you didn't complain when I took your bedside table and your frying pan, and anyway it's for her own good, clearly you'd a bad influence on her given how much you're complaining right now"; then I have a pretty clear right to be upset and feel like you're breaking the rules of the arrangement.

In fact, if I may go a bit meta and speculative…

In general, I think the social contract is perceived as trumping a very loosely-defined "natural law"; controversial areas about the state's rights tend to come back to a nebulous category "things which nobody should be allowed to do to another monkey under any circumstances" (e.g. "tell you to get stabbed with a needle against your will", "forbid you from visiting your parents/siblings/significant other" – but also "kill you with premeditation" or "force you to go through with a risky pregnancy"!), as defined against the things which everyone would be allowed to do in a "moral, but anarchic human grouping", but which in an organised society we make special privileges of government enforcers (e.g. "kill enemies if they're currently threatening us and can't be peacefully subdued", "take a percentage of this year's earnings").

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In the United States, even at the peak of "lockdown" around March 24, people in the United States were perfectly free to move around within their town and meet their loved ones, as long as they were doing outdoor "exercise". Never once at any place in any of the United States was any of this ever banned.

And of course, 95% of the time since March 24 has been at far lower restrictions than we had on March 24.

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And never once was this wink-and-nudge "it's totally ok to practice your liberties as long as you lie about it" unequally enforced? No one was picked on for doing the thing everyone else did even though it was technically illegal? No one in government abused this power and no one who played along got punished anyway?

In a way, this half measure is even worse than a full measure. Because when people who did get away with it got caught, they just used their power to claim "nah it's ok it's in the spirit of the law" (citation: the dozens of times this happened with politicians), and when the people who didn't get away with it got caught, people said "well they were going against the law, so it's fine they get punished (citation: the times people picnicing alone or playing with their kids in the playground alone were arrested). You've just make the powerful even more above the law then they were already.

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What wink-and-nudge are you talking about? I assumed the person meant that they wanted to see their friends and family, and you were always encouraged to go out for a walk with your friends and family. Were they asking about doing something that was actually technically illegal? Because it didn't sound like they were.

(I'm also a bit curious about the politician cases - I thought the most prominent politician case was Gavin Newsom having an indoor unmasked dinner at a restaurant on a date when that was still legal, but he had just ordered a mask mandate to go into effect a week later.)

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