Psaki: Even After Vaccine, You Still Need to Social Distance and Wear Masks

I'm the one who is reading.

CDC states that those who are vaccinated need to follow the same guidelines.

You aren't reading, AT ALL!

 

I don't particularly care what the CDC "guidelines" are. I'm unlikely to infect anyone ergo it's retarded to wear a mask.

 

How exactly do you stop "feeding" a virus that has a long incubation period and is supposedly getting more contagious over time? Lockdowns haven't worked, and the restrictions (curfews and heavy limits on capacity) in place haven't worked either.

It seems more like just improving hygiene standards and cleaning standards are the better approach and are much easier to get people to comply with. Encouraging social distancing and wearing masks are ok as well.

 

Good point. I should rephrase. The version that was killing lots of people would be more deadly today. It is true that the Spanish Flu does still technically exist as the modern flu, but the version of it that originally infected people in 1918 eventually mutated into a less lethal version.

 

AND ANNUAL COVID VACCINE BOOSTER SHOTS FOR YEARS TO COME !!!!

 

Fair enough on the different factors you mentioned, but given all the tools we now have, why would more restrictions be necessary? It sounds like we have things mostly in control as things currently stand.

Depends on the state. It was pretty strict for some time in California and Michigan. Maine also went a bit overboard. Illinois wasn't exactly loose either.

I'm glad NC was much more loose about it.

But another issue with restrictions is that they aren't evenhanded. Nevada infamously kept casinos open while banning church gatherings, for example. And then when multiple officials have been caught in multiple states violating their own restrictions, it's hard to take them seriously. It all becomes clear that it's political posturing and favoritism toward certain interest groups.

Fair enough.

Is that figure an estimate, or is that representative of the number of people who find out they have hypertension after getting checked out? I understand that many people end up finding out they have conditions they didn't know about before, but that's just life in general. Shi# happens. On the other hand, if someone knows they have a condition but still risks their health, that's their decision. In a free country, people are allowed to make bad decisions -- they just have to live (or die) with the consequences.

I hope you're right, but I've learned to expect just about anything from the feds.

Where I live must be different from a lot of areas then. I live in a mid-size city, and most places I go to are pretty active. That being said, I do have to admit that it does seem like a lot of people in this area don't take the social distancing thing very seriously (or masks for that matter). I wear a mask when I go out and socially distance, but I can't say that I'm particularly worried.

I know people who have died from complications caused by COVID-19, but they were not very healthy beforehand. They were also older. I'm not saying this makes them worth less in terms of their lives, but it's not as shocking as having someone young and healthy die. I'm not trying to be callous about all this, because I understand that it sucks when anyone you care about dies, but there are different levels of grief that are affected by factors like this. When an old and feeble person dies, there's a feeling of "it was their time." You think about the things they accomplished in life. When a young and healthy person dies, it's a feeling like they were cheated out of a long life.

Fair enough. I'm not against rolling out the vaccines or making PSA's but I do like the current approach of letting states make their own decisions. I just hope that the feds continue to allow this approach.

 

You're unlikely to infect others because you have almost no contact with people?

 

OK, good, you issued a number of "fair enoughs" - I think you may be realizing that I'm not unreasonable and I'm quite fair, and I'm not talking about this from a partisan standpoint. I don't even have a party. I'm an independent, centrist, unaffiliated voter. My only interest here is to talk about it from the medical standpoint.

You ask, why would more restrictions be necessary? But where did I advocate for more restrictions? I'm saying, what I advocate for is good masks (not a flimsy paper mask you find at Walmart, and not homemade cloth masks with loose fit, and much less, neck goiters or bandanas, but rather, N95s, or at least KN95s, possibly double-masking with an ASTM level 3 surgical mask), worn the right way, and good social distancing; attention to indoor spaces especially the poorly ventilated kind, hand hygiene, that is, the simple measures that are consistent with a good economy but do decrease transmission to a certain degree. Not enormously but to a certain degree.

Now, when we did engage in lockdowns in April/May, I think we botched it. We did a huge hodgepodge of heterogeneous measures that didn't always make sense (like you noticed yourself with the casinos versus the churches - by the way I've mentioned elsewhere that even though I believe that large church gatherings are unwise, I don't think we can restrict them, on constitutional grounds; the SCOTUS seems to agree with me). We did it for a short time. We reopened too soon and erratically, despite indicators being bad.

I see the economic impact of lockdowns... but if we did want to do them, then we should have done them right. Botched lockdowns is the worst of two worlds: not only you damage the economy but you also don't control the pandemic, which then damages more the economy.

In any case, like I've said multiple times here on PF, I don't really favor authoritharian measures. What I've always favored is a strong educational campaign, and our leaders leading by example. Again, I'm not being partisan, but when Trump tried to mock people for wearing mask several times, it wasn't helpful and it created this over-politicizing of masks. Also, when Governor Newsom tells people not to dine out, and then he is caught dining out with no social distancing... it's not right either.

So, the thing is, we never had an educational campaign... and our leaders set a terrible example. No wonder we are one of the worst hit countries in the world.

The 100 million Americans with hypertension is an estimate based on sampling. But again, it's not even just the people who ignore that they have underlying conditions. It's the fact that people are notorious for reaching for easy pleasure rather than taking unpleasant measures to be healthier. Look at obesity. We have 40% of our adult population who are obese. Do these people suddenly start eating salads and grilled white meat? No, they stuff themselves with greasy burgers and fries. So when you say "let them decide, the ones with risk factors will be more careful", no, unfortunately, they won't. Just look at the Sturgis motorcycle rally. 500,000 people, most of them obese (bikers are notorious for obesity), flocking to a small town and spending days cajoling inside crowded bars... Did you see the study by two statisticians who estimated how many infections could be attributed to the Sturgis rally? How many people there made good decisions because they were at risk???

No, you'll say, that's fine, their are doing it at their own peril, and if they croak, they brought it on themselves... sure, one can say so (although I don't; as a physician I lament any death) but the problem is, they don't just infect themselves... they infect other people too. They went home from the Sturgis rally and infected a bunch of people... So that's extremely irresponsible behavior.

Now, I can't agree at all with your idea that "oh well, the dead are old anyway." First, that's not true. There are PLENTY of victims of Covid-19 that are a long younger than you imagine. Sure, a 90-year-old grandpa, it's probably his time to go... and while his children and grandchildren will be sad and will miss him, they will cherish the memories of his long life. But here are MANY people who died of Covid-19 in their 50's and 60's, and that's too early. There are also a much smaller but still shocking number of even younger people who died. And like I said, death is not all.

It is a grave mistake to suppose that Covid-19 is only a problem for the elderly and the gravely infirm. You know, hypertension and diabetes certainly shorten life spans but with modern medicine people can still live 7-8 decades with diabetes and hypertension... even obesity. But all three conditions will make Covid-19 much more lethal. And regarding the elderly, sure, they die... and young people typically don't die... but young people are also coming out of this with SEVERE consequences.

That's the point that surprisingly people just want to deny and ignore. Here is another study:

Oito em cada dez pacientes apresentam disfunções cognitivas (terra.com.br)

Sorry that the link above is in foreign language. It's because the research was done at the Medical School of the University of São Paulo, Brazil (the best medical school in all of South America and one of the best in the world). I suppose you can use Google Translate. But here is what it says (I do speak their language; I worked in Brazil for a couple of years, in a visiting professorship):

8 in each 10 patients who survived Covid-19 came out of it with cognitive dysfunctions. 62.7% with short term memory problems. 26.8% with long term memory problems. 92.4% with visual perception issues. People had cerebral hypoxia, strokes, encephalitis... A lot of Covid-19 survivors complain of what they call "brain fog."

And brace for it, this has happened regardless of age, and regardless of underlying conditions, and even in asymptomatic patients. Even in young patients.

I have already mentioned the University of Ohio study, right? Here it is:

https://jamanetwork.com/journals/jamacardiology/fullarticle/2770645

Of 26 competitive athletes, 4 (15%) had CMR findings suggestive of myocarditis and 8 additional athletes (30.8%) exhibited LGE without T2 elevation suggestive of prior myocardial injury.

So 45.8% of the healthiest and youngest individuals ever, college athletes, with heart damage! Most of them with mild or asymptomatic disease. Some of them will likely silently progress to heart failure in a few years.

Come again? Is this a problem just for the elderly and frail???

So, what's the problem with these brain lesions, heart leasions...? Is't that they don't immediately kill, for the most part (although young people have died of post-Covid strokes). So these people do not get to the death stats... but their quality of life, productivity, and life span may have been irreparably damaged.

Finally, let me remind you of something else. The Epstein-Barr virus, the agent of mononucleosis, the kissing disease. Pretty benign, right? After all, almost anybody dies of acute mononucleosis (except some morons that continue to engage in extrenuous exercise instead of bed rest when their spleens are enlarged; the organ can rupture and cause massive internal hemorrhage - but as long as people rest, nothing happens. A few days later they fully recover. Benign virus, right?

Wrong.

Subsequently, we discovered that the EB virus goes dormant, never goes away, and years later causes a number of fatal cancers, including several forms of lymphoma, and several serious auto-immune diseases. Not fun, huh?

Viruses are tricky, especially an aggressive one like the SARS-CoV-2 that attacks the endothelial layer of blood vessels everywhere (brain, liver, kidneys, lungs, heart), increases coagulability, and induces immuno dysfunctions (another growing concern is auto-immune diseases triggered by the SARS-CoV-2). Like the example of the EB virus shows, viruses are best avoided... once they get in, some of them can be very tricky. And we're just now starting to understand the mid-term and possible long-term consequences of the SARS-CoV-2. The disease has only existed for some 14 months... so like with the EB virus, we don't know what the future holds.

 

For now. It all depends on the behavior of the new variants. The P.1 variant is causing re-infection in numbers that are suspected to be close to 30 to 40% of the population, in the Brazilian city of Manaus, where the population had been previously thought to have reached herd immunity with 75% of them having had Covid-19 from the previous strain. Guess what, this new variant is just plowing through the population again. And it is 50% more infectious than the previous one. It doesn't seem to respond to natural antibodies acquired by having been infected with the previous strain. The mutations that seem to be responsible for these behaviors, the E484K (evades antibodies) and the N501Y (more infectious), are also found in the South African variant, and the UK variant which is doubling every ten days in the United States and is projected to be the dominant strain here by March, does have the N501Y but up to recently didn't have the E484K, but now we're seeing cases of the UK strain (B.1.1.7) WITH the E484K so it may start behaving just like the P.1 (Brazilian) and the B.1.351 (South African) strains.

This is definitely NOT over... stay tuned.

 

As someone who taught computer technology to high school students and adults, and coached high school sports, I'm convinced we can teach people how and when to sport high-quality respirators that employ filters on exhalation ports.

 

I'm ok with that, and I actually use N95s when I go out. I thankfully had a stockpile before COVID, but I didn't expect to have to use them.

Well, the WHO and Fauci made some serious errors as well. The WHO initially said that it didn't spread human-to-human and even spoke against travel bans in the beginning. Fauci told people masks weren't needed and later claimed it was for the benefit of healthcare workers getting them instead.

So when health organizations and officials either screw up by accident or outright lie, then you can't blame part of the public for distrusting them.

I can agree to an extent, but even the reporting of these things is politicized. The "reopen" protesters were shamed for holding protests, while the BLM protesters were given a pass. They even made the claim that no infections could be tied to the BLM protests, which was an obvious lie.

So, when everything becomes political, it's only natural for people to view much of the situation as a way to pay favors to one political side or as a way to manipulate the public.

That's a lot of information to take in, and I appreciate you sharing it. I don't think we're that different in our preferences for how to deal with this, but I just tend to be very skeptical of authority. I've seen how corrupt this government is, so I prefer to find ways to minimize their presence.

 

Not good news. We're going to kill off a lot of older people in many countries.

We need to deliver a lot more vaccinations. Worldwide.

 

Good for you.

I know! I was - and still am - very mad at Fauci and the WHO for these blunders, and I said precisely that, as well: they squandered trust, which is a commodity in a pandemic.

Agreed. Me, I've ALWAYS said that BOTH unmasked political rallies by Trump AND BLM protests were unwise and stupid in the middle of a freaking airborne pandemic.

But see, this is a PANdemic. This thing hit right wing governments like the current ones in the UK and Italy and Brazil... all the way to the very leftist ones like in Venezuela, and everything in-between. So when people insisted on the "liberals vs. conservatives, Trump vs. Biden" stuff regarding this pandemic, I wanted to laugh if it weren't more appropriate to cry... because of the 211 or so countries in the world, only ONE had a Trump and a Biden and a GOP and a Democratic party... while the other 210 countries were ALSO having to face the same virus... and people here seemed to be looking at our own colective navels, not realizing that politicizing this thing was the worst possible way to approach it. No wonder we have the worst total of cases and deaths in the entire world...

Well, yes. If you really look into the MEDICAL data minus the political hysteria, you'll learn that this virus is quite aggressive and dangerous. But anytime one says so, one is suspected of being a leftist partisan. That's how bad the politicizing is. We are facing a bug, a germ... a freaking virus... one that doesn't differentiate between Republicans or Democrats, leftists, centrists, or rightists, whites, blacks, Asians, or Hispanics... we're all on the same boat... and we keep being silly and fighting each other around this, instead of uniting to fight off a common enemy. It's disgusting. We as a people have failed as much as our politicians.

 

I agree with much of your post, although I disagree on one part. I don't think our numbers are really that bad. And we also have to assume that the numbers China is providing are bogus. They claim only about 80,000 of their people died from this, but this is the same country that lied about the virus in the beginning.

Also, testing rates aren't universal. The US has a higher testing rate than most nations in the world. So, of course, we're going to have higher infection rates -- officially. The actual infection rates of many other countries (particularly the poorer ones) is probably a lot higher than what's listed, because testing is done less and because they have worse diseases to worry about.

 

No, not really. We are only #21 in tests per million of the population, and being the richest country in the world, that's not good. So testing doesn't explain it all. 20 countries are proportionally testing more than we do.

Sure, there are A FEW countries that lie in their stats, and I definitely include China in those (Russia too), and some other countries have little diagnostic capacity.

But no, a large number of countries report a relatively accurate count and we're doing a lot worse than they are.

Anyway, here is why I say not really: we have 4% of the world's population... and 22% of the world's deaths, at least the reported ones. There is no freaking way to consider that this is a good result.

I mean, where is American exceptionalism??? I had hopped that we'd be the BEST country in the world regarding our Covid-19 response, not one of the worst.

There was a study published recently by an Australian think tank. It looked at the quality and efficacy of the Covid-19 response in all countries that were deemed to have accurate data reporting, according to a number of indicators... China was excluded from the analysis for this very reason (data not reliable).

So, they looked at about 100 countries. We placed #96. Only behind us, Mexico, Colombia, South Africa, and Brazil. We were below freaking Bolivia!!!!

I don't have the link on me right now but I've posted it more than once a few days back in my posting history.

 

Two probable is the equivalent of two likely reinfections. The “possible” are not confirmed. Even if you count them the vast majority of test subjects were not infected, verifying what I’ve posted is correct and your position that I’ll quote again below is incorrect.

The study I presented and the study you presented are solid evidence your claim is incorrect. There is quite a lot of evidence immunity that prevents infection exists for C19.

But there is a preponderance of evidence that sterilizing immunity to SARS-COV-2 is not only possible, but prevalent. The sampling for PCR tests in the studies we have provided are upper respiratory tract sourced. There were exposed individuals who had no upper respiratory tract infection. There was no virus living or replicating there.

And we have immunogenicity data from trials as well as from sources like my Israeli link showing immunogenicity of vaccines is superior to that observed after natural infection. It’s patently absurd to claim there is no evidence for sterilizing immunity from C19 vaccines.

So your solution is to give them misinformation? To try and scare them into wearing masks? While convincing another demographic to not get vaccinated?

No, that’s not the way to approach this. As I said, we provide accurate, up to date information and let people make up their own minds.

None of my links intimated uninfected individuals are infecting others.

I’m trying to figure out where ideas like this quote from you originate.

It’s clear the majority of individuals who develop immunity to SARS-COV-2 can not be infected. The only way such individuals could infect others would be if they are non infected “carriers” or “transmitters”. You are the third person on PF to float this theory (perhaps unintentionally in your case). When I see multiple people make very similar statements in direct conflict with overwhelming evidence I figure there is a well somewhere they are all drawing from. I’m just curious what that well may be.

Of course some vaccinated individuals will be infected. That’s not in dispute. The problem is telling people everyone who is vaccinated or recovered can still be infected and/or infect others when all evidence shows only a small percentage can be infected. I’m for full disclosure and honesty about what vaccines can and can’t do. That means we tell people they CAN prevent infections, not that there is no evidence they can.

 

Various high-quality respirators have filters made for their exhalation valve(s), so what's your beef? Or you can make your own.

 

I think it's a matter of 2 things:

1) We are exceptionally unhealthy among First World citizens. This is largely due to lifestyle.
2) We have a healthcare system that discourages people from seeking preventive care and encourages people to put off care due to expense.

Add those 2 things together, and even a better system of restrictions would still result in a lot of deaths comparably.

 

Where did I call for a lockdown?

My reference to feeding the virus: those who refuse all precautions, won't wear masks or maintain a distance, are allowing the virus to continue to spread. As it gains strength, it mutates into stronger and/or more contagious strains. We need to stop feeding it.

 

You are right. But precisely because we are so unhealthy, we should have reacted to this with a lot more concern, and a lot stronger measures (and by this, I don't mean authoritharian stuff... but rather, increased means of production for tests and PPE via Defense Production Act, hiring an army of contact tracers (or, well, using our Army reserves), implementing much stricter travels bans from abroad (the countries that did the best in that study I was mentioning were the ones that shut down their borders), strong educational campaign for the population, distribution of high quality masks, coherent/truthful/transparent set of guidelines, etc.

During WWII we put aside all domestic political differences and fought a common enemy, united as a people, with our men volunteering to fight, our women engaging in the production effort, etc.

It seems like now all that we do is point fingers at each other, and half of us scream "my freeeeeeeedoms" and refuse to wear a simple public health helpful little device like a facemask, thinking that they are making some sort of macho point or are waving some sort of political banner.

Meanwhile it was sufficient for the Japanese government to merely ASK their population to wear masks, and 97% did.

There is no way to hide the fact that we failed as a people. I blame everybody. Both parties. The feds, the governors, the mayors, Congress, the CDC, the FDA, and we the people... everybody. We put together a pitiful display of incompetence.

I should say, at least we did well in the matter of R&D for vaccines. That's pretty much the only bright spot.

 

The issue to me is the fact that people can just say they got vaccinated and then not wear a mask. It’s just easier to convince everyone to keep wearing them vs dealing with that nightmare. Better practical solution in addition to the reality that no one knows much about the vaccine and it’s effectiveness over time in mass settings.

 

Fair enough. I'm not against basic precautions.

 

Well, you're not going to find unity in a country that is highly culturally diverse or promotes identity politics. During WW2, we were less diverse and promoted nationalism rather than identity politics.

 

We also have a system that leaves tens of millions of people with inadequate care.

 

That ties into the expense thing I mentioned. And the VA system is notoriously bad as well.