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I think it boils down to two questions:

- What is the average level of risk to someone taking reasonable personal precautions?

- What level of state-sponsored violence is justifiable to further reduce that risk?

Governments and societies have been acting out-of-control and it needs to stop.

If people don't want to take personal precautions, they should be at liberty to assume the additional risk.



> - What is the average level of risk to someone taking reasonable personal precautions?

Depends on how full hospitals get. We all get into accidents. We fall and hit our heads, we might get a heart attack, a pregnancy might suddenly go bad and a C-section (or worse surgery) is needed.

As COVID19 fills up hospitals around the country, the risk isn't from Omicron itself anymore, as much as it is from an overburdened health care system.

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The big example was the Montana train derailment last summer. It was difficult (but possible) to get all of the injured to an appropriate hospital, many being forced to go to hospitals hours away because the nearby hospitals were full of COVID19 patients. But this new wave of Omicron is even worse than the summer of 2021 by any measurement.

> - What level of state-sponsored violence is justifiable to further reduce that risk?

While the health care system of the USA is technically a free market, with a mix of for-profit hospitals (and charity / religious hospitals, and a few state-sponsored ones for groups like veterans)... people expect hospitals / health care systems to be functional.

Since the state is ultimately responsible for the health care of its local population (whether they want to be responsible or not), its important to take actions needed to keep our hospital open.

The state will pull in the national guard, they will call in Navy hospital ships, they will declare emergencies to help. From that perspective, asking everyone else to get vaccinated or booster-vaccinated is just more of the same, its another action to minimize hospitalizations. Forced vaccinations are far more effective than national guard in this situation.

> Governments and societies have been acting out-of-control and it needs to stop.

I know someone who went to work while testing positive for COVID19. The amount of apathy and callousness the "individual" has in this situation knows no bounds.

"Individualism" is now selfishness. Its more important to save a few hours of PTO / leave rather than protect your fellow customers or coworkers from the disease.

People have lost their goddamn minds over this. They ignore the hospitalization stats, they ignore the overflowing morgues. They focus on selfish self-centered action rather than community.


How many of the COVID-19 patients currently in hospitals really need to be there, and how many would be triaged out if more urgent cases presented? If a hospital has bed space, why would they not admit a COVID patient? It's money, and they are a business for the most part that wants to maximize revenue.


> How many of the COVID-19 patients currently in hospitals really need to be there, and how many would be triaged out if more urgent cases presented?

https://www.wbaltv.com/article/covid-19-emergency-actions-ma...

Hospitals in my area have cut 20% of surgeries (ie: triaged out care to make room for COVID19). The governor has deployed National Guard to the hospitals to help out with tasks.

Are you just blind to the issues happening right now? This is happening, this is happening now. Take off your blindfolds and talk to a damn nurse or doctor. This is happening all over the place as far as the eye can see.

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Just call up your local-clinic and ask them for a flu-shot. Stand in line for 4-hours for things _COMPLETELY_ unrelated to COVID19, and come back and tell me that its fake. Go ask the receptionist "why is the line so long", and they'll tell you: COVID19.

I know because I done it. (Well, not for a flu-shot but for a TDAP. Nearly the same thing)


yeah, but... you know... of course they're prioritizing all the COVID patients first, before anyone else, because they get more money from the government for 'COVID' patients!

/s

That was an actual exchange I had with someone a few weeks ago with this same scenario. They'd gone from 'it's all faked' to "well, yeah, there may be people there now, and they're taking resources from non-covid patients, but the govt wants it that way, that's why they pay hospital more for covid patients! they're incentivizing people getting covid!"

I don't think it makes any sense at all, but interactions like these are more signs to me that it's harder to have meaningful interactions 'across the divide' these days.


> Just call up your local-clinic and ask them for a flu-shot. Stand in line for 4-hours for things _COMPLETELY_ unrelated to COVID19, and come back and tell me that its fake.

Note that this varies by where you are. Locally, there is no health care crunch: it's easy to get a flu shot or other vaccine with no wait, and ICUs still have capacity despite a huge increase in cases. We're probably screwed in a few weeks since there's only about a 60% vaccination rate here and the most recent surge didn't start until maybe two weeks ago.


A good way to address your point would be to compare the situation to Canada.

In the province of Quebec, where we have a highly vaccinated population, the intensive care units (ICUs) in all hospitals will be full within two weeks, if the rate of transmission and hospitalization continue this way. Demand greatly outstrips supply.

In Canada, the financial incentives for hospitalization and discharge are very different. Physicians get paid by a complex mix of hourly pay in addition to a fee-for-service schedule, both paid by the government. Hospitals get paid by the type of patient they admit, and their length of stay, but not always in a straightforward way.

In Canada, because of the remuneration system, physicians are the most influential decision-makers in deciding who gets to use the ICU. Roughly, no one doesn't get admitted "because they can't pay", and no one gets admitted "because they have money" .

Since hospitals are overwhelmed in Quebec, physician's incentive would be to discharge patients rather than admit. Their hourly wage wouldn't rise if they got more patients. Indeed, there is some evidence that as ICU capacity drops, physicians start discharging patients from the ICU earlier.

I should be fair to physicians in Quebec: their behaviour reflects a deep concern about the public health emergency rather than their financial gain.

I believe that, in Canada, all hospitalized patients in the ICU really need to be there.

Source: I have been studying hospitalizations due to COVID-19 illness in Quebec, Canada, and providing forecasts to the local government since the start of the pandemic.


I fell like this rhetoric is fixed and is not changing with arrival of new data


"Triaged out" doesn't mean "doesn't need to be here". It just means "less likely to die tonight if not in ICU", if it is at the point where you are talking about "triage".


People don’t agree to go to an ICU for funsies.


But those machines are sooooo coool. Also, they give you ketamine to intubate, so more fun!


The historical concern is that icus have been overfull. Those people need to be there. This is conspiracy fud.


Do the hospitals have any obligations in this in terms of scalability and sustainability of their workforce?

I understand that adding a doctor or nurse isn't immediate.

Just as I understand that if a production system I oversee crashes under load, it may not have been foreseeable.

But if the system is still crashing under load in five years? Ten years? At what point is it my fault?

The U.S. healthcare spending in 2020 was $4.1 trillion. I still see the same 100 ICU beds cited as capacity in our local COVID updates.


> But if the system is still crashing under load in five years? Ten years? At what point is it my fault?

The Maryland hospital system can support a bit over 10,000 hospitalizations. Over 3000 of those hospitalizations are COVID19 right now, and our cases continue to grow exponentially.

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Our hospital systems don't _normally_ get hit with 3000+ cases of a singular disease. Compared to other parts of the country, we have more hospital space, nurses and more, and we're still feeling stressed from all of this.

You _cant_ have enough hospital space during a pandemic. You just can't. The disease grows too fast, you get hit with way more cases than you've ever seen in the past 10, 20, 30, 50, 100 years. It doesn't make sense to design a system with 100-years worth of slack. It makes more sense to ask the public to do actions to cut back on hospitalizations during these rare 1-in-a-hundred-year situations.


> Forced vaccinations are far more effective than national guard in this situation

And Chinese style hard lockdowns of whole cities are even more effective than that. Doesn't mean I want the government to have that power.


Jacobson v. Massachusetts 1905.

The state has a right, (7-2 decision, hardly controversial) to forcibly vaccinate its citizens against Smallpox.

It doesn't matter what you "want". There's well over 100 years of precedent on this particular issue. Go fight with history if you're really pissed.


OK, so now people are framed as fighting against history. What does that change?

Everything is just as controversial and the issues are the same.

Jacobson v. Massachusetts said the solution to compulsory vaccination is democratically repealing policy and law. This is exactly what these people want and are fighting for


> OK, so now people are framed as fighting against history. What does that change?

Are you complaining that I'm using rhetorical techniques against you? The smallpox and 1918 flu pandemics from 100 years ago are guidance for what is going on today.

We can look at how our grandfathers solved the issue in their time, and compare-and-contrast with what worked today. As you mentioned, it was controversial back then. Both you and I have arguments we can borrow from them.

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How about instead of arguing against history, you actually take those arguments and use them for yourself? Or perhaps you recognize that the arguments said 100+ years ago weren't actually that strong or powerful.

> Jacobson v. Massachusetts said the solution to compulsory vaccination is democratically repealing policy and law. This is exactly what these people want and are fighting for

Cool.

Now explain how you'd get rid of smallpox in the early 1900s.


It seemed like you felt including that case precedent somehow reframed the discussion. I don't see that it adds anything


> It seemed like you felt including that case precedent somehow reframed the discussion. I don't see that it adds anything

You're welcome to add whatever you think adds to the discussion.

Or do you just sit around and counterpunch in discussions, never actually contributing directly? There's a reason why sitting around and just countering arguments is called the "fallacy fallacy" / "Argument from fallacy".

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I bring up smallpox and "Jacobson v. Massachusetts" for a few reasons.

1. We defeated smallpox. It took decades, but it was soundly defeated.

2. Legally, there's a strong set of arguments that prove that these measures are constitutional.

3. There were big controversies in the early 1900s over these arguments, and we can replay those arguments again if you so desire. In effect, we know that the state's right to protect our health care system trumps the individual's choice on whether-or-not to get the vaccine.


Jacobson was not force vaccinated. he paid a $5 fine following the ruling.


My point: compulsory vaccination laws are legal and have been upheld by the supreme court. I dare you to find a proper legal counterexample.


your original comment was that the state has a right to forcibly vaccinate citizens. i am simply contending that was not a result of jacobson v ma.


> - What level of state-sponsored violence is justifiable to further reduce that risk?

This is the line I'm responding to.

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You know damn well that libertarians do this bullshit when playing with "use of force" language in these discussion.

A fine is "government use of force" to a libertarian. I'd rather not get stuck in the weeds over such details. But you're trying to pin me from the other side, and I don't appreciate it.


Also, chances are we’re going to exit this pandemic (whenever that happens) with a severely reduced medical system. We’re burning through medical personnel at an unsustainable rate, and we’re all going to suffer a diminished level of care until replacements can be retrained and hired.


News flash: hospitals are businesses, and like all businesses, they are most profitable when running at close to capacity, therefore they're at close to capacity most of the time because staffing is sized accordingly.


Which raises the separate point that they should probably not be businesses. A lot of our difficulties here go back to this privatized approach.


You imply that running any enterprise (public or private) at near capacity is a bad thing, but in fact it's an economic necessity. You also imply that making these public enterprises would make it possible to run them at less than near capacity, but it's pretty clear from rationing in, e.g., the UK, that this is not so. The reason public health care is run at near capacity is the same as private healthcare: wasting resources is silly.

Yes, I referred to profit, because profit is what "not wasting resources" translates to for the capitalist, but the real underlying moving force is economic and real regardless of ideology.


No.

We largely imply that Denmark's hospitals are more efficient than US hospitals. In terms of cost, in terms of how much they can handle, in terms of number of COVID19 cases, etc. etc.

Even if we cut down to highly-developed parts of the USA, such as New York vs Denmark specifically (rather than including all of the lesser-developed rural areas which puts the US at a disadvantage), we're clearly not as good at health care as Denmark.


Efficient or not, they must run at close to capacity. The comment I was replying to said "Depends on how full hospitals get", and, my response is that they're always close to full, and that is true regardless of whether they are public or private institutions. Please don't interject points that are not on-topic.


Why not just charge unvaccinated people for their hospital bills? Then overburdened hospitals become profitable hospitals.


Let's do the same with every other risky behaviour then. Smokers, drug addicts, overweight people, people doing lots of outdoor sport, people who don't wear the appropriate personal protection at work,...


I believe that is how car insurance works is it not? And yes there are different tiers of insurance for those who need to cover more things and those who cover fewer things. If the feedback mechanisms are completely detached from your premiums then you'd have no incentive to actually improve anything.


Unfortunately, the unvaccinated apparently are a bigger voting group / voting bloc than we expected, and have considerable political power.


From what I understand most of the insurance covering COVID regardless of deductibles was a voluntary thing, and some have started billing for unvaccinated hospitalizations (within the constraints of the plans of course).


> If people don't want to take personal precautions, they should be at liberty to assume the additional risk.

I agree, the problem is no one is making them assume the risk. If they truly assumed the risk of not getting vaccinated, one of a few things would happen:

1. The risk of not getting vaccinated would be priced into their health insurance premiums and their costs would skyrocket.

2. If they require hospitalization, they should be turned away at the door if there is insufficient capacity. Alternatively, they can be hospitalized but discharged the minute their presence begins to strain resources. They could even be refused assistance generally.

3. If I can suggest that my infection came from person X (e.g. I was around them when they had the virus), then they should be liable for damages.

None of those things will happen, because people don't want to assume the risk that comes with their choices, they want to offload it onto other people. They want to be able to not be vaccinated then scream for help when they get in trouble and have the healthcare system ride to the rescue.


> - What is the average level of risk to someone taking reasonable personal precautions?

How much risk to others is acceptable? Even though someone who follows reasonable personal precautions, but decided not to vaccinate and, therefore, has a higher risk of being a carrier and infect someone else who also followed reasonable precautions but cannot vaccinate for medical reasons. That second person now faces a 3% risk of dying a horrible death. Even if the second person is fully vaccinated, the chances of dying are non-zero, and increased because another person decided not to be vaccinated.

If we could contact-trace perfectly, would it be fair to charge person A with reckless endangerment, because person A didn't take all available measures to prevent further deaths? If person B dies because of person A, should we call it manslaughter?


>If people don't want to take personal precautions, they should be at liberty to assume the additional risk.

I agree to a point. If their personal choices endanger others, then it's less about their liberties and more about how their choices impact others negatively.

Another part of the problem is more human in nature. People are tired of others crying about their own freedoms in regards to vax, but declaring other's freedoms are their choice as well. You know the political party I'm speaking of.


>"What level of state-sponsored violence is justifiable to further reduce that risk?"

What is this referring to? Can you say what instances of "state-sponsored-violence" have occurred in the pursuit of risk reduction?


What violence?


How about Emmanuel Macron, french prime minister, wanting to "...piss them off. And we will continue to do this, to the end. This is the strategy.”"


This is violence?


@torstenvl:

> What level of state-sponsored violence is justifiable to further reduce that risk?

@oauea:

> What violence?

torstenvl was specifically referring to state vaccine "mandates". Any state mandate must be enforced through violence or it has no effect.

Lest you believe that state mandates do not require violence, consider what happens if people refuse the vaccine. You can order them to get daily tests, but what if they refuse that? Eventually physical force (violence) will be required.


> Any state mandate must be enforced through violence or it has no effect.

I don't see how that is really true. The state can, for example, refuse to provide you services if you're not vaccinated. If you're not allowed to enter a government building while unvaccinated without a justification, so as not to endanger the civil servants in that building, I'd hardly call that "violence".


Any real world examples?


Getting people fired from their jobs because they didn't want the vax is a form of state power. State power is ultimately backed up with police and prisons, where violence by them on you is legal.


Australia is forcibly imprisoning people in quarantine facilities.



Throw shit at the police and they're going to react. Pretty normal and expected and has nothing to do with covid.


Preventing them from going to the bar without a mask?




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