COVID-19 Thread [V2.0]

[Machu Peach]

https://www.nature.com/articles/s41467-020-19802-w

 

A new study indicates that asymptotic spread is quite rare. This makes a lot of sense to me.

 

Thanks. Seems a positive sign as well. Especially along with some people's posts about how even after vaccine some people will get it but just not get sick.

 

Quick question though. I hope I didn't miss it if it was mentioned in there but this wouldn't be showing people who are 'presymptomatic' as not being able to spread? I struggled with the phrasing there so hopefully what I'm asking makes sense. Basically, getting at the issue of folks who don't know they have it for 4-5 days being spreaders before realizing it taking proper precautions, etc. I would read this study as being a separate issue than that?

This study doesn't really address the idea of 'presymptomatic.' The whole language of asymptotic vs symptomatic difficult to quantify; I'm sure 'presymptomatic' is even harder.

 

Personal pet peeve: The word 'subclinical' is usually used instead of 'asymptotic' because it's much more precise. For whatever reason 'asymptotic' and 'subclinical' seem to be used interchangeably by everyone with COVID.

[OldSchoolSnapper]

Finally, why aren’t more scientists and doctors talking about the obesity problem in the USA? It seems like a majority of people with life threatening symptoms are the elderly and the obese. In addition to all the talk about masks and social distancing, it might have been wise for scientists to tell Americans, over the last 8 months, to lay off the bacon cheeseburgers and beer and walk around the block a few times.

I guess I don't see how scientists and doctors aren't talking about the obesity epidemic. Is there anyone that doesn't know that the US has an extreme problem with obesity? Something like 300,000 deaths per year are due to obesity, independent of COVID.

 

I don't know about doctors and scientists, but the news certainly isn't, or is at best drastically understating the role of obesity for some reason I can't quite understand. There was a popular link going around a couple weeks ago about the "healthcare workers claimed by COVID." Literally all 10 of them were not just pudgy, but huge. No mention of it anywhere in the article.

 

The news is in the fear game. Always have been, always will be. They present numbers without any context, like hospital capacity, and leave out what regular capacity is. They're in love with case counts, but largely ignore the mortality, or obsess over death counts, but provide limited data on the breakdown of those deaths.

 

Most people here I would say are of above average intelligence and can figure this stuff out on their own, but most people don't take that extra step.

 

There is a reason each of the demographics under 50 drastically overestimates the chance of death by COVID when asked.

[OldSchoolSnapper]

"You can't tell me what to do!"- tons of Americans during this.

 

I shutter to think about how this current US population would have done during WW2.

 

Rationing wasn't the rose bed history has made it out to be. They had tons of problems with it in the 40s.

[3and2Fastball]

Any concerns about the safety of mRNA vaccines? As I understand it, they’ve never been utilized in humans before, right? Are any of the upcoming vaccines the traditional inoculation type?

They've been tested extensively in humans, though I don't believe any have been licensed. Mechanistically they're much simpler than traditional vaccines.

 

All vaccines, including these, are, by definition, inoculations.

 

Thanks for your response. When you say “they’ve been tested extensively in humans” do you mean other types of mRNA vaccines? Or this one in particular? Obviously there is no data on any longer term effects of a mRNA Covid Vaccine.

 

Having said that, I trust that the long terms effects would/will be less than the long term effects of catching Covid, and clearly (if the vaccines work) it will be much much better for the World health than this pandemic continuing on unchecked.

 

It is still crazy to think about rolling out millions of doses of a brand new vaccine technology that has never before been utilized before. This feels a little like, I imagine, 1720’s Boston. Hopefully our success will be as great as their’s was!

[homer]

Finally, why aren’t more scientists and doctors talking about the obesity problem in the USA? It seems like a majority of people with life threatening symptoms are the elderly and the obese. In addition to all the talk about masks and social distancing, it might have been wise for scientists to tell Americans, over the last 8 months, to lay off the bacon cheeseburgers and beer and walk around the block a few times.

I guess I don't see how scientists and doctors aren't talking about the obesity epidemic. Is there anyone that doesn't know that the US has an extreme problem with obesity? Something like 300,000 deaths per year are due to obesity, independent of COVID.

 

I don't know about doctors and scientists, but the news certainly isn't, or is at best drastically understating the role of obesity for some reason I can't quite understand. There was a popular link going around a couple weeks ago about the "healthcare workers claimed by COVID." Literally all 10 of them were not just pudgy, but huge. No mention of it anywhere in the article.

 

The news is in the fear game. Always have been, always will be. They present numbers without any context, like hospital capacity, and leave out what regular capacity is. They're in love with case counts, but largely ignore the mortality, or obsess over death counts, but provide limited data on the breakdown of those deaths.

 

Most people here I would say are of above average intelligence and can figure this stuff out on their own, but most people don't take that extra step.

 

There is a reason each of the demographics under 50 drastically overestimates the chance of death by COVID when asked.

 

 

1396 healthcare workers in the US have died from Covid. Not all of them were obese.

 

https://www.theguardian.com/us-news/ng-interactive/2020/aug/11/lost-on-the-frontline-covid-19-coronavirus-us-healthcare-workers-deaths-database

 

And I have to say I'm a little tired of people using that as a way to temper the seriousness of this disease. As if obese people had it coming or something. Stop doing it.

 

And yeah the media tends to use fear. Nothing new. But in this case there is some serious Boy Who Cried Wolf going on. The ripple effects on our healthcare system are real. My wife had her doctor's appt cancelled because her primary care was called in to work the covid unit (too many staff are sick or quarantined). My mom had to have her appt to get a cast for her broken wrist postponed because the doctor tested positive. We have a field hospital in West Allis, we have hospitals canceling electives, we have hospitals sending Covid patients home that would normally be hospitalized in order to make room for ones that are even worse, we have freezer trucks with dead bodies in El Paso, if you care to look there are stories every day from frontline healthcare workers at their wits end trying to deal with this...these are not fictionalized accounts or embellishments. This stuff is happening. It may not be as bleak as New York in April/May but it certainly is serious.

[tmwiese55]

I'd probably agree that after the initial making everyone aware of co-issues such as obesity it has probably faded a bit in the background. However, I'd tend to agree with it not being a huge topic since what does it matter, our obesity is the reality of the situation we're dealing with. We can't snap our fingers and change that or just say that's their problem and let them die.

 

But to way this topic was just brought up in this discussion. I believe the point was we've been telling the US (not just since covid) their weight is way out of control for 30+ years now and very few people care. We've been well aware of this problem for a long time. I guess I don't see the value in saying "told ya so" to them rather than doing what we can to help as many as we can in this situation.

[OldSchoolSnapper]

 

 

1396 healthcare workers in the US have died from Covid. Not all of them were obese.

 

https://www.theguardian.com/us-news/ng-interactive/2020/aug/11/lost-on-the-frontline-covid-19-coronavirus-us-healthcare-workers-deaths-database

 

And I have to say I'm a little tired of people using that as a way to temper the seriousness of this disease. As if obese people had it coming or something. Stop doing it.

 

Being obese isn't good. It's a driver of a million different health problems. It shouldn't be embraced. It leaves one more susceptible to complications that accompany a host of other health problems.

 

You're tired of that, and I'm tired of it being swept under the rug as though it's not the huge factor that it is here.

 

Obese people had it coming? Talk about a straw man. Stop doing THAT.

 

Obesity is a completely relevant part of the Covid conversation.

 

While we're on the subject of incomplete numbers. How many health care workers are there in the US? Give it context. Like the news should.

 

Nobody ever said everyone that dies is obese. It's about painting an accurate picture of risk. Something the news doesn't do.

 

The whole culture war is about fabric over our face and everyone immediately uses that as the reason the US has done so poorly. I'm sure it has nothing to do with the general population's terrible pre-existing health. The average Japanese male is 140 pounds, give me a break.

[3and2Fastball]

My comments re obesity had to do with wishing it was emphasized more in the media as to something that, if corrected, could help mitigate how seriously sick someone might get if they catch this disease.

 

Maybe I watch too much mainstream TV and there are other media places that give out the message that: we’re in a rough pandemic, this is the time to build up your health in whatever way you can. Exercise, lose excess weight, eat healthy, build up your immune system, do whatever you can so that if you do catch this disease you will have the best chance to survive.

 

I haven’t seen enough of that on TV or from political leaders. Wasn’t intended to point fingers

[OldSchoolSnapper]

My comments re obesity had to with wishing it was emphasized more in the media as to something that, if corrected, could help mitigate how seriously sick someone might get if they catch this disease.

 

Maybe I watch too much mainstream TV and there are other media places that give out the message that: we’re in a rough pandemic, this is the time to build up your health in whatever way you can. Exercise, lose excess weight, eat healthy, build up your immune system, do whatever you can so that if you do catch this disease you will have the best chance to survive.

 

I haven’t seen enough of that on TV or from political leaders. Wasn’t intended to point fingers

 

Obesity is a cause of things far more deadly than Covid and that doesn't scare people into being more healthy so I don't think it would be effective at all as some large scale weight loss motivator. Fat people know they're fat and contrary to the narrative a lot of folks like to push, the vast majority of them know it is very bad and would like to be smaller. It is very, very hard to go from obese to healthy weight. Some doctor saying 'lose weight' on TV isn't going to be the impetus.

 

It would present healthy people with a more realistic assessment of their actual risk of dying however, but that's boring. Again, people, when polled, drastically overstate their risk of death by Covid. I wonder why that could be.

[Machu Peach]

And I have to say I'm a little tired of people using that as a way to temper the seriousness of this disease. As if obese people had it coming or something. Stop doing it.

I'm quite tired of strawman arguments intended to insult others and derail an otherwise useful discussion.

 

No one here is evil. No one here wants others to die. No one here is indifferent to people dying (even if they have comorbidities) or the strain on health care works. Just because someone thinks differently than you do does not make them evil and it is inappropriate to state or imply otherwise.

[Machu Peach]

Thanks for your response. When you say “they’ve been tested extensively in humans” do you mean other types of mRNA vaccines? Or this one in particular? Obviously there is no data on any longer term effects of a mRNA Covid Vaccine.

 

Having said that, I trust that the long terms effects would/will be less than the long term effects of catching Covid, and clearly (if the vaccines work) it will be much much better for the World health than this pandemic continuing on unchecked.

 

It is still crazy to think about rolling out millions of doses of a brand new vaccine technology that has never before been utilized before. This feels a little like, I imagine, 1720’s Boston. Hopefully our success will be as great as their’s was!

Yep, other vaccine trials against far more difficult things to vaccinate against, such as HIV. They don't work well against HIV for various reasons specific to HIV, but the safety profile, like that of most vaccines, has been excellent. They're actually extremely simple compared to more traditional vaccine approaches, from an immune system point-of-view.

 

...and yes, the smallpox vaccine program is the gold standard. Hopefully we view this one the same way 10 years from now.

[homer]

And I have to say I'm a little tired of people using that as a way to temper the seriousness of this disease. As if obese people had it coming or something. Stop doing it.

I'm quite tired of strawman arguments intended to insult others and derail an otherwise useful discussion.

 

No one here is evil. No one here wants others to die. No one here is indifferent to people dying (even if they have comorbidities) or the strain on health care works. Just because someone thinks differently than you do does not make them evil and it is inappropriate to state or imply otherwise.

 

I never said anyone was evil. I never said anyone wants people to die. What a ridiculous accusation.

[Machu Peach]

And I have to say I'm a little tired of people using that as a way to temper the seriousness of this disease. As if obese people had it coming or something. Stop doing it.

I'm quite tired of strawman arguments intended to insult others and derail an otherwise useful discussion.

 

No one here is evil. No one here wants others to die. No one here is indifferent to people dying (even if they have comorbidities) or the strain on health care works. Just because someone thinks differently than you do does not make them evil and it is inappropriate to state or imply otherwise.

 

I never said anyone was evil. I never said anyone wants people to die. What a ridiculous accusation.

As if obese people had it coming or something.

Anyone that would think "obese people ha[ve] it coming" would be evil. It's not at all a stretch to say that you're using a strawman to insult and disrail.

[PeaveyFury]

I'd suggest we move on, guys. Doesn't seem productive to continue to go back and forth on what it seems like someone said.

[Machu Peach]

My comments re obesity had to do with wishing it was emphasized more in the media as to something that, if corrected, could help mitigate how seriously sick someone might get if they catch this disease.

 

Maybe I watch too much mainstream TV and there are other media places that give out the message that: we’re in a rough pandemic, this is the time to build up your health in whatever way you can. Exercise, lose excess weight, eat healthy, build up your immune system, do whatever you can so that if you do catch this disease you will have the best chance to survive.

 

I haven’t seen enough of that on TV or from political leaders. Wasn’t intended to point fingers

I see you meant. Yes I agree, it would be a terrific message, even if it weren't a pandemic.

 

We as a society have mostly shunned things like fat shaming, which is certainly a good thing, but we've still need to find effective, positive ways to encourage a more healthy lifestyle. People are generally aware of the health problems and most obese people badly want to lose weight, but it's still very difficult for them. I wish someone had a good answer.

[igor67]

Building on that given that to be blunt every public health level attempt to address the obesity epidemic has failed to bend that curve. Why would a public health official waste precious words and message time on highlighting that aspect? They can barely provide adequate time to telling people to consistently wash hands, social distance, and wear a mask. The communication/ education limits of public health should be a key part of every decision. Aside from those issues, to get people out of the somewhat obese to somewhat overweight groups is typically going to require ~20 lbs of weight loss. That's at least a 2-3 month endeavor. That is hardly an immediate thing to focus on in the early days of the pandemic.

 

If nothing else its worth understanding that given the correlations in Wisconsin bars should probably be closed permanently to address obesity. Not that I think it would change enough behaviors to alter average weight.

[OldSchoolSnapper]

Aside from those issues, to get people out of the somewhat obese to somewhat overweight groups is typically going to require ~20 lbs of weight loss. That's at least a 2-3 month endeavor. That is hardly an immediate thing to focus on in the early days of the pandemic.

 

We can't change our age at all but it is an explicitly stated risk factor and leverage is given to older employees at many companies that they should stay home. I know of several personal bankers in their 60s who were given clearance to work at home before the rest of the staff.

 

Of course, saying, "you're fat, you should work at home" is a quite a can of worms but I don't see pretending that it isn't a factor as a better course of action. If it were any other quality less socially sensitive it would be included in the game plan.

 

I think some kind of weight loss campaign using Covid as the motivator is a joke and a waste of everyone's time, but clearly stating it repeatedly as a major risk factor, like we have with many other things, should be done and hasn't been done. We are not talking about a fringe influence here. There is evidence it triples your risk of

hospitalization.

 

https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html

 

There's plenty of discussion about risk groups when it comes to age and different diseases. I have seen very little in regard to obesity. I've probably seen more people questioning and sympathizing with pregnancy as a risk factor despite there being no increased risk for that group that I'm aware of.

[FVBrewerFan]

I think using the carrot and stick approach with health insurance is worth trying. The carrot is already more common. Wellness is being promoted, and in some cases you get a reduction in premium. My guess is most people who need that the most are not taking advantage.

 

Which brings me to the stick. You should pay more if you're obese. Health insurance already factors in age and other criteria, why not weight? If you're obese, you pay $100 more a month for insurance, or whatever the amount. Not the whole answer obviously, but it may have some effect.

[young guns]

Which brings me to the stick. You should pay more if you're obese. Health insurance already factors in age and other criteria, why not weight? If you're obese, you pay $100 more a month for insurance, or whatever the amount. Not the whole answer obviously, but it may have some effect.

In a way I can't articulate, this sounds just so wrong to me.

[OldSchoolSnapper]

Which brings me to the stick. You should pay more if you're obese. Health insurance already factors in age and other criteria, why not weight? If you're obese, you pay $100 more a month for insurance, or whatever the amount. Not the whole answer obviously, but it may have some effect.

In a way I can't articulate, this sounds just so wrong to me.

 

It already exists. Lots of employers use health screenings and offer reduced premiums if you pass them. Mine has one but it is pretty easy to pass, you can fail 2/5 criteria and still get the full $700 credit. So you can fail BMI and waistline and still get the full premium. If you fail 3/5, you get a $350 credit. You can fail them all and still get some credit just for doing the screen.

 

All other forms of insurance are billed on risk. That there's a social sensitivity toward categorizing obesity as high risk is just silly; obesity is incredibly high risk and it's reasonable for the insurance company to bill it higher. It's important to point out that this is obesity, not merely being overweight or out of shape. I don't see a ethical dilemma about insurance being more costly for someone at a 30 BMI.

 

With that said, obesity really isn't a MAJOR health risk until later in life. There's not a high risk of death in the current calendar year for an obese 30 year old so the usual year-to-year employer plans don't put a lot of emphasis on it. The complications from it explode once you cross into the late 40s, 50s and 60s, though.

 

The point of contention seems to be that some think obesity should fall under the same category as something like a tobacco surcharge and others seem to think it should be treated as something like Type 2 diabetes, a pre-existing condition more or less beyond your control.

 

It's probably somewhere in between.

[TURBO]

Which brings me to the stick. You should pay more if you're obese. Health insurance already factors in age and other criteria, why not weight? If you're obese, you pay $100 more a month for insurance, or whatever the amount. Not the whole answer obviously, but it may have some effect.

In a way I can't articulate, this sounds just so wrong to me.

 

Why?

 

You get discounts on car insurance for a high grade point average (students), safe driving record (everyone else), hell, don't females get cheaper car insuramce than males just because they are female? (males have less accidents but the accidents they have typically cause more damage because of our risk taking stupidity....or so I have heard)

 

Why must we tiptoe around obesity?

 

There are discounts for certain companies if you don't smoke, why not discounts for being at a healthy weight?

 

Why should discounts for certain behaviors not be a factor in health insurance?

[OldSchoolSnapper]

Which brings me to the stick. You should pay more if you're obese. Health insurance already factors in age and other criteria, why not weight? If you're obese, you pay $100 more a month for insurance, or whatever the amount. Not the whole answer obviously, but it may have some effect.

In a way I can't articulate, this sounds just so wrong to me.

 

Why?

 

You get discounts on car insurance for a high grade point average (students), safe driving record (everyone else), hell, don't females get cheaper car insuramce than males just because they are female? (males have less accidents but the accidents they have typically cause more damage because of our risk taking stupidity....or so I have heard)

 

Why must we tiptoe around obesity?

 

There are discounts for certain companies if you don't smoke, why not discounts for being at a healthy weight?

 

Why should discounts for certain behaviors not be a factor in health insurance?

 

While I generally agree, you get into dangerous territory once a person or people is deciding what's a healthy weight and what isn't. It's awfully easy for the insurance company to decide this arbitrarily. At 6'1 and 205 I believe I'm overweight BMI but I've been weight training for 20 years and run races. Some form I fill out online doesn't care about that.

 

The insurance company isn't concerned with doing this honestly, they are concerned with remaining profitable while being forced to pay out claims for high-risk individuals. They do this by raising rates on people who they know likely won't have to pay claims on.

 

Obviously, all forms of insurance need lots of people who never file claims. Using this flat approach where everyone pays the same rate is one of the ways they're able to make it work. They need a pool of healthy people paying in. So letting very healthy people pay very low rates and crushing unhealthy people just isn't a viable way of doing it. The latter would be more inclined to just not have coverage.

 

So it has to be a very regulated and equitable way of administering these kinds of "penalties."

[stoutdude04]

Good point OSS. I do think there should be more rewards for people who are healthy or try to take healthy steps in their lives. Our district 'tries' to do these things, but often times it isn't worth the trouble of the paperwork. Make it worthwhile and more people will do it. As it stands now only the people that are already doing it are getting the extra credit.

[FVBrewerFan]

Which brings me to the stick. You should pay more if you're obese. Health insurance already factors in age and other criteria, why not weight? If you're obese, you pay $100 more a month for insurance, or whatever the amount. Not the whole answer obviously, but it may have some effect.

In a way I can't articulate, this sounds just so wrong to me.

 

It already exists. Lots of employers use health screenings and offer reduced premiums if you pass them. Mine has one but it is pretty easy to pass, you can fail 2/5 criteria and still get the full $700 credit. So you can fail BMI and waistline and still get the full premium. If you fail 3/5, you get a $350 credit. You can fail them all and still get some credit just for doing the screen.

 

All other forms of insurance are billed on risk. That there's a social sensitivity toward categorizing obesity as high risk is just silly; obesity is incredibly high risk and it's reasonable for the insurance company to bill it higher. It's important to point out that this is obesity, not merely being overweight or out of shape. I don't see a ethical dilemma about insurance being more costly for someone at a 30 BMI.

 

With that said, obesity really isn't a MAJOR health risk until later in life. There's not a high risk of death in the current calendar year for an obese 30 year old so the usual year-to-year employer plans don't put a lot of emphasis on it. The complications from it explode once you cross into the late 40s, 50s and 60s, though.

 

The point of contention seems to be that some think obesity should fall under the same category as something like a tobacco surcharge and others seem to think it should be treated as something like Type 2 diabetes, a pre-existing condition more or less beyond your control.

 

It's probably somewhere in between.

 

Right, I said it's already being done on the incentive side- just not the penalty side of things yet. It would be relatively easy, as obese has a definition and parameters. Difference between obese and overweight. I don't see a problem with it, as it's a choice just like smoking. I'm not real familiar with life insurance, but I know it's standard to have higher rates for smokers. So having higher health insurance rates for obese people isn't much a stretch. It's nt forcing anyone to change their lifestyle. You just pay more, that's all.

[tmwiese55]

Interesting topic I've never gone down the wormhole on before. Good info and takes by all and my reaction is it does seem insurance would be something new to try, nothing else has worked the last 30 years. I also don't see a problem with kind of singling out this issue, to me it's the same as singling out smokers which no one has a problem with.

 

On this overall obesity/overweight topic Bill Burr has had some good bits on it over the years. If you want some laughs this weekend, which everyone needs these days, go down a Bill Burr trail on Netflix. Top of my head I'd think this topic was more in one of the more recent ones.