re: The Atlantic really mad at Twitter. They have no answer for #DiedSuddenly.

quote:

---

For all the complaints about the failure of institutions, I've yet to see very much in the way of attempting to fix those institutions at all.

---

Accountability is usually the prescription for fixing an institution. You up for that? Since you attempted to lay this at the feet of conservatives, is the left up for that?

quote:

---

Nothing about this situation makes me believe that any real portion of the population will retreat to empiricism,

---

Yeah, that’s what happens when the people the public trusts to be empiricists shite the bed. They’ve done a lot of damage that won’t be undone any time soon.

quote:

---

what a circumambulated way of saying the virus effects different genetic makeups. isn't this what us "anti-vaxxers" have said from the beginning?

---

That is clearly not what I'm saying. I'm saying that the longer the virus exists with without curtailed transmission, the higher the certainty that it will adapt.

quote:

---

meaning that we choose not to get the vaccine because we don't want it messing up our immune system

---

But the virus has shown more evidence of real immune dysfunction.

quote:

---

which we can all agree that not all immune systems are the same.

---

Well, human immune systems are mediated by HLA serotypes, which are the most polymorphic in the human genome. Which is why I usually mention that human infectious diseases link the people with the strongest immune systems to those with the weakest. Human immunophysiology has to do this due to the extremely high degree of pyrogenic and pathogenic material it deals with on a daily basis.

quote:

---

would it be fair theory to say that the vaccines work fine for people who are more susceptible respiratory viruses.

---

I think the virus itself operates, on some level we haven't deduced yet, on HLA serotypes. This is why I mention the wide quality of infection between family members in other posts, as one possible explanation for the wide difference in how two siblings might deal with a disease is differences in HLA serotypes, which are the most likely genetic loci to be different between two closely related individuals.

I don't think there is a predefined susceptibility other than what the age-cohort CFR indicates, which is that COVID is extremely deadly for age-specific cohorts, and that increase in the quality of disease correlates directly to the types of cellular injury. We had one patient under 40 who passed from COVID where the infection activated an underlying autoimmune hepatitis, and the only reason we found out about that autoimmune is that, as an academic hospital, we were allowed to order tests, specifically Anti-Liver-Kidney Microsomal-3 antibodies (I think), which you wouldn't get to order in a community hospital. That patient had a history of alcohol use, but no signs, symptoms, or labwork of underlying disease until after infection.

What I mean to suggest here is that underlying cellular insult, which all adults have, manifest differently with COVID, so that on a singular level, making comparisons between the quality of infection between two individuals becomes exceedingly hard.

quote:

---

for people who are less likely to be affected by these viruses, covid 19 inoculations might alter the genetic makeup and cause issues.

---

Well, like I've pointed out, cellular injury mechanisms in the human body are patterned and characteristic, meaning that if such things exist, they would exist broadly. I'm skeptical that vaccination is altering anything about your genetic make-up though.

quote:

---

Yeah, that’s what happens when the people the public trusts to be empiricists shite the bed. They’ve done a lot of damage that won’t be undone any time soon.

---

You wouldn't believe it if going by our patient census.

quote:

---

What do you mean by this?

---

As in, we've had a full patient load every day for the last few years.

quote:

---

you appear to be doing the TigerDoc 2-step where he wrings his hands and gazes at his navel over the scientific ignorance and skepticism of the peons while ignoring the factors that caused them to distrust the experts to begin with.

---

But the factors at a base level are where broadly I think people agree. The fundamental issue is regulatory capture, but very few have even shown an interest in fixing that.

quote:

---

The flu shot really hasn’t been that controversial in the past. Plenty of people got it who have no idea how it worked, but if they bothered to inform themselves they understood it was a best guess at the prevalent strains. Some years were better than others, people understood that. They didn’t expect miracles and the medical community didn’t try to sell them one.

---

But there are plenty of vaccine controversies which closely emulate the language used by vaccine skeptics. The chapter 'Vaccination is Un-American' in the book Smallpox: A History is a good resource to track that rhetoric. This point really doesn't tackle the reality of the actual language vaccine skeptics use.

quote:

---

Now a lot of those same people are distrustful of not only the Covid vaccine but some of the other ones. That wasn’t caused by the people, that was caused by medical/government authorities flushing their credibility down the toilet

---

Well, here you completely removing the actual agency of people to justify their behavior, when nothing in the world truly justifies vaccine skepticism broadly. If the pandemic was mishandled by institutions, that applies to the current situation and it is exceedingly silly to then somehow apply that skepticism backward, for no real reason other than the same institutions are involved.

No one is forcing them to make this decision, and they should be held to account like everyone should. Why you are going out of your way to give them the benefit of the doubt is honestly weird.

My view is that the people who were vaccine skeptics were the ones who were initially COVID skeptics, who repeated the '99.9%' survivability line without understanding that we regard a CFR of above .1 as an incredibly serious infection. And that the CFR worldwide has remained well-above that 0.1% threshold should undermine the notion that the pandemic is over. It isn't by any stretch of the imagination.

quote:

---

The flu shot really hasn’t been that controversial in the past. Plenty of people got it who have no idea how it worked, but if they bothered to inform themselves they understood it was a best guess at the prevalent strains. Some years were better than others, people understood that. They didn’t expect miracles and the medical community didn’t try to sell them one.

---

The public health authorities are going to argue back that the particular nature of SARS-CoV-2 having the combination of critical thresholds of transmissibility, morbidity/mortality potential, low levels of community resistance, and no proven treatments justify a different kind of communication with the public than with seasonal flu.

Other countries where the pandemic response wasn't filtered through ideological media have had considerably less backlash. It can't be just the medical community or we'd see the same thing everywhere to this large degree. There is a real anti-vaxx movement and it's influential and has capitalized on the fractured media environment and politicized response.

quote:

---

No one is forcing them to make this decision, and they should be held to account like everyone should. Why you are going out of your way to give them the benefit of the doubt is honestly weird.

---

I’m just telling you what is and why. I’m not defending it, I don’t have an issue with vaccines. If you want to continue to just complain that they’re wrong, knock yourself out. I don’t know how something can be fixed without understanding the root cause but maybe regaining trust isn’t a priority for you.

quote:

---

If you want to continue to just complain that they’re wrong, knock yourself out.

---

Well yeah thats what I'm going to continue to do.

quote:

---

I don’t know how something can be fixed without understanding the root cause but maybe regaining trust isn’t a priority for you.

---

I don't think it will be mediated by their interactions with a pedantic nerd on a message board. Regardless, if I'm not seeing evidence of that lack of trust at the ground level, and only see it online, what am I to conclude?