Covid 19/Coronavirus

[nightflameauto]

Everytime I hear the Lambda variant it just makes me wanna watch Revenge of The Nerds on repeat.

 

[MFB]

I thought Lambda was changed to Delta-Plus because it didn’t sound scary enough?

Nah, too many people were trying to sign up for it thinking it was a rewards program when you buy flights

 

[mbardu]

Not sure if already shared, but found a preliminary paper (not peer-reviewed as it was published on medRxiv) on other effects the Pfizer vaccine has on the immune system, including production of inflammatory cytokines after vaccination w/ non-specific stimuli:

https://www.medrxiv.org/content/10.1101/2021.05.03.21256520v1.full.pdf

Short read

Anybody remember when a few researchers were saying "maybe despite those absolutely bonkers short-term protections against Covid-19, we should be careful because the novel vaccines could have longer term unexpected effects on the innate immune system" and they were quickly called antivax conspirationists? With the very scientific argument that "everybody knows vaccines don't have long term effects". Pepperidge farm remembers...

It's just one preprint study, but I guess maybe it is actually worth a look so that's good to see.

 

[Drew]

When any drug company CEO is talking about such things, you also have to remember that they're speaking with dollar signs in their eyes. Even if what they are saying has a seed of truth, they'll exaggerate it as much as they possibly can because they want boosters, new vaccines for variants, and every other possible avenue towards more $$$$ pouring into the corporate coffers.

Dude's probably masturbating furiously over Delta right now.

Though, devil's advocate... Covid is probably not THAT lucrative for drug companies, and could potentially be a net money loser.

For one, most of the vaccines on the market were develioped with government support (I think Pfizer was the exception) and are being sold to the US government at cost. They're breaking even on R&D, but that's about it.

For the other, covid has actually caused most hospitals to LOSE money, for the simple fact that keeping covid patients alive is now a full time job which means they're not doing the sort of routine procedures that are generally profit centers for hospitals. I'm getting this mostly at the hospital level rather than the drug company one (my fiancee and a few of her friends work at different Boston area hospitals and have pretty good transparency into the economic consequences), and they've all seen sharp revenue declines. I have to assume the same is largely true from a drug standpoint, and selling covid vaccines and treatments is simply less profitable than prescribing all the sort of lifestyle ailment drugs for indigestion, high cholersterol, high blood pressure, etc, as well as stuff like anasthesia and antibiotic regiments for elective surgery, etc.

People in the conspiracy camp keep talking about hospitals padding covid numbers to make more money, but honestly that's pretty nonsensical - if they could, they'd be far better off using those beds for the usual routine surgeries and whatnot, since per patient they make a fuckload more turning a bed over a couple times a week for inpatient surgery than they do keeping someone on a ventilator two weeks.

 

[mbardu]

Though, devil's advocate... Covid is probably not THAT lucrative for drug companies, and could potentially be a net money loser.

For one, most of the vaccines on the market were develioped with government support (I think Pfizer was the exception) and are being sold to the US government at cost. They're breaking even on R&D, but that's about it.

For the other, covid has actually caused most hospitals to LOSE money, for the simple fact that keeping covid patients alive is now a full time job which means they're not doing the sort of routine procedures that are generally profit centers for hospitals. I'm getting this mostly at the hospital level rather than the drug company one (my fiancee and a few of her friends work at different Boston area hospitals and have pretty good transparency into the economic consequences), and they've all seen sharp revenue declines. I have to assume the same is largely true from a drug standpoint, and selling covid vaccines and treatments is simply less profitable than prescribing all the sort of lifestyle ailment drugs for indigestion, high cholersterol, high blood pressure, etc, as well as stuff like anasthesia and antibiotic regiments for elective surgery, etc.

People in the conspiracy camp keep talking about hospitals padding covid numbers to make more money, but honestly that's pretty nonsensical - if they could, they'd be far better off using those beds for the usual routine surgeries and whatnot, since per patient they make a fuckload more turning a bed over a couple times a week for inpatient surgery than they do keeping someone on a ventilator two weeks.

Covid is not lucrative for everyone, but it is lucrative for many

~~~~~~~~~~~

Moderna ($MRNA) earnings report: https://investors.modernatx.com/new...rts-second-quarter-fiscal-year-2021-financial

Revenue: Total revenue was $4.4 billion for the three months ended June 30, 2021, compared to $67 million for the same period in 2020. Total revenue was $6.3 billion for the six months ended June 30, 2021, compared to $75 million for the same period in 2020

Revenue up from 75 Million to 4.4 Billion and they're not making a killing? Net Income of ~2.8B on gross revenue of ~4.2B and we're to believe that they're selling at cost?

Sotck price is up +480% year over year.

inb4 "But companies like Merck without a Covid product are not benefitting". Or "J&J is not benefitting as much". Yeah, that's the point, some companies with better "COVID products" profit more than others which are not positioned well in the market, that's free market. The better the Covid product they sell, the more they are profiting off of the situation. Hence MRNA.
Some people are definitely making a profit.

~~~~~~~~~~~~

Some individual hospitals maybe are losing money (although it'd be interested to actually see a report because any serious hospital losing money in the US is pretty surprising), but if they are, could it be the exception rather than the rule?

HCA healthcare ($HCA) - ( biggest group of hospitals in the US) earnings report: https://investor.hcahealthcare.com/...021-Results-Raises-2021-Guidance/default.aspx

Despite low surgery admissions in 2020 full year, they did not lose money. Financial performance in 2020 was also the same as financial performance in 2019 - which was already very good. 2021 is already setting new earnings records.

Stock price is up +90% year over year, compared to $SPY "only" up 29%

~~~~~~~~~~~~

But just like the "8 Million people could die next year in the US unless everyone gets vaccinated !!!", people buy that stuff with "likes" while the sources are right there for everyone to see.

I don't get the compulsive need to lie, make stuff up or embellish the arguments. The truth is like 2 clicks away, anyway. Is it just knowing that people are not even going to bother to check? Is it because we get the warm fuzzies from arguments that fit our bias, even if they are exaggerations or untruths? At best (best), the above previous post is misleading and selective generalization.

It's perfectly fine to say "people profiting from something doesn't mean it's bad". It's OK to say that the "hospitals padding covid numbers to make more money" argument is a dumb conspiracy. But why on top of that make up easily disproven things as if that made the point stronger? Why use the tactics of the conspirationists you're trying to disprove?

 

[estabon37]

Though, devil's advocate... Covid is probably not THAT lucrative for drug companies, and could potentially be a net money loser.

For one, most of the vaccines on the market were develioped with government support (I think Pfizer was the exception) and are being sold to the US government at cost. They're breaking even on R&D, but that's about it.

For the other, covid has actually caused most hospitals to LOSE money, for the simple fact that keeping covid patients alive is now a full time job which means they're not doing the sort of routine procedures that are generally profit centers for hospitals. I'm getting this mostly at the hospital level rather than the drug company one (my fiancee and a few of her friends work at different Boston area hospitals and have pretty good transparency into the economic consequences), and they've all seen sharp revenue declines. I have to assume the same is largely true from a drug standpoint, and selling covid vaccines and treatments is simply less profitable than prescribing all the sort of lifestyle ailment drugs for indigestion, high cholersterol, high blood pressure, etc, as well as stuff like anasthesia and antibiotic regiments for elective surgery, etc.

People in the conspiracy camp keep talking about hospitals padding covid numbers to make more money, but honestly that's pretty nonsensical - if they could, they'd be far better off using those beds for the usual routine surgeries and whatnot, since per patient they make a fuckload more turning a bed over a couple times a week for inpatient surgery than they do keeping someone on a ventilator two weeks.

See, this highlights aspects of what is collectively called the US Health Care system that show how disconnected a lot of those parts seem to be. Again, I'm an 'outsider' and have no expertise in this field, so take the following with a massive rock of salt.

To the best of my knowledge hospitals operate fairly independently in the US (quick Google result: 58% private non-profit, 21% private for-profit, 21% government owned). That means weirdly close to 80% of the hospitals in a country of over 300 million people operate independently of any given level of government. In Australia, our number is around 47% private and declining (Australia has a private health care system on top of the national Medicare system for people that want to have coverage for very specific health concerns or just 'extra comfort' if they spend a fair bit of time in health care).

Here's the thing, though: our pharmaceutical industry doesn't anywhere near as independently as the US's. I've never seen pharmaceuticals as being a major aspect of health care until I started seeing more American media; it's just part of a service here. And that's the important thing: we see health care as a service, like education, public transport, general infrastructure.

That a hospital has to think at all about whether it can afford to remain open in not just the wealthiest country on Earth, but in a country that has America's level of pharmaceutical profits is complete insanity. That there are financial incentives in health care at all is a tragedy, and that anyone can even conceive of the argument that hospitals are trying to make money and for it to sound normal shows how broken the system is. I swear some of the people in this conversation now were having these conversations in this space ten years ago and were making the argument that a national-level health emergency would cripple the country. For the US's sake I hope it's another hundred years before the next pandemic, because I can't see your health care system surviving this happening again in the near future.

 

[mbardu]

See, this highlights aspects of what is collectively called the US Health Care system that show how disconnected a lot of those parts seem to be. Again, I'm an 'outsider' and have no expertise in this field, so take the following with a massive rock of salt.

To the best of my knowledge hospitals operate fairly independently in the US (quick Google result: 58% private non-profit, 21% private for-profit, 21% government owned). That means weirdly close to 80% of the hospitals in a country of over 300 million people operate independently of any given level of government. In Australia, our number is around 47% private and declining (Australia has a private health care system on top of the national Medicare system for people that want to have coverage for very specific health concerns or just 'extra comfort' if they spend a fair bit of time in health care).

Here's the thing, though: our pharmaceutical industry doesn't anywhere near as independently as the US's. I've never seen pharmaceuticals as being a major aspect of health care until I started seeing more American media; it's just part of a service here. And that's the important thing: we see health care as a service, like education, public transport, general infrastructure.

That a hospital has to think at all about whether it can afford to remain open in not just the wealthiest country on Earth, but in a country that has America's level of pharmaceutical profits is complete insanity. That there are financial incentives in health care at all is a tragedy, and that anyone can even conceive of the argument that hospitals are trying to make money and for it to sound normal shows how broken the system is. I swear some of the people in this conversation now were having these conversations in this space ten years ago and were making the argument that a national-level health emergency would cripple the country. For the US's sake I hope it's another hundred years before the next pandemic, because I can't see your health care system surviving this happening again in the near future.

Oh boy...
If you're shocked to see for profit hospitals in the US, wait until you hear about for profit prisons who pay off judges to get more occupancy / legal slave labor.

The whole country is quickly becoming a dystopian kakistocratic hell hole for the current generations.

 

[mbardu]

https://pix11.com/news/texas-school...tpfAV92XPTm9-Vu65WelnNfqV4FiCa1nyUSKaByU3Mzag

Oh nooo, who could have seen that coming!?
How could acting like Covid is over and reopening everything (including in person full-capacity schooling) have consequences ?!?

That and the above reminded me of this:

 

[spudmunkey]

Did that article say when the first person died? How far back was that first death? My brain assumed the same month, but I re-read it and didn't see a mention of it.

 

[mbardu]

Did that article say when the first person died? How far back was that first death? My brain assumed the same month, but I re-read it and didn't see a mention of it.

The articles don't give actual dates as far as I can tell.
The more "precise" you'll get is that the second death came "days after" the first one.

 

[bostjan]

Did that article say when the first person died? How far back was that first death? My brain assumed the same month, but I re-read it and didn't see a mention of it.

McCormick passed away Aug 24. Chansler passed away Aug 29.

 

[Drew]

That a hospital has to think at all about whether it can afford to remain open in not just the wealthiest country on Earth, but in a country that has America's level of pharmaceutical profits is complete insanity. That there are financial incentives in health care at all is a tragedy, and that anyone can even conceive of the argument that hospitals are trying to make money and for it to sound normal shows how broken the system is. I swear some of the people in this conversation now were having these conversations in this space ten years ago and were making the argument that a national-level health emergency would cripple the country. For the US's sake I hope it's another hundred years before the next pandemic, because I can't see your health care system surviving this happening again in the near future.

In general, I think your post is on/fairly close to the mark, and that there's a lot you're saying I agree with. I'll say too I probably would agree with your overall point, that health care in the US is ripe with examples of poor management, and can and should be significantly streamlined.

The devil is in the details, though.

I don't think the fact most hosptals are for-profit is really the root of the issue here - at the end of the day, medical care (especially now, with overloaded hospitals) is just one more example of a scarce resource, and it has to be allocated somehow. Centralized planning at this scale is incredibly tough, and in theory an efficient free market for health care should do a pretty good job of directing care to where need is greatest, with some general caveats about capitalism and intergenertional transfer of resource that makes most markets in the US not especially free, in practice.

Where we run into problems, though, are for all the free market metaphors used to describe our current system by most critics and supporters alike, nothing about American healthcare functions like a free market.

Remember that most healthcare is obtained through health insurance, most health insurance is obtained through an employer, and only part of the cost of coverage is borne by the insured. Further, while there are a large number of health insurers in the country, they are all organized at the state level and have limited-to-no ability to compete over state lines, so in any given state you might have two or three major health insurers working at scale, and there are pretty huge economies of scale when it comes to competing for the health insurance business of an entire company. In pratice, the health coverage market is often a duopoly or triopoly in America, with end cstomers rarely seeing options from more than one or two poviders, with a handful of total plans open to them.

Next, remember that most insurance companies operate within a preferred "network" where reimbursement rates go up pretty significantly if you go out of network. Insurance companies negotiate contracts with hospitals with agreed-upon rates for various procedures, and then turn around and charge their members a given rate per procedure, reimbursing the rest. There's no up-front transparency into what an procedure will cost, save that if you do it in-network it will be mostly/entirely covered once you exceed a deductible, and if you d it out of network it's going to cost you a fixed percentage of whatever your bill says when you're done.

The upshot of all of this is, from the sake of someone with insurance, they've chosen from one of a handful of available plans, made available to them through their work from one or two insurers. Those insurers will then tell them which hospitals they need to choose from. When they go to a hospital for a procedure, they're not told what it will cost, the cost when they eventually get a bill is more or less arbitrary and may as well be made up because it's not what the insurance company will pay the hospital and it's not what the patient will pay the insurance company. They're not given a range of options with different costs to treat a condition, they're not given a range of providers who will do it for different prices, and once they exceed their deductable, they don't actually pay for care over and above their insurance premium in most situations, so there's no incentive to self-ration and choose care the most likely to offer the greatest benefit for the least price.

In short, nothing at all about health care in America functions at all like a market. The whole thing reminds me of The Hitchhiker's Guide to the Universe, and the Trattitoria Drive where the impossible calculations necessary to move a spaceship faster than the speed of light can only happen when they're preformed on the tab of a bill in a simulacrum of a small town Italian trattitoria where no one has any idea how they come up with the final value at the bottom of the bill, anyway. It's stark raving insane.

But, in theory, an actual healthcare marketplace could probably work pretty well and would help control costs, if only we had one.

 

[TedEH]

Vaccine passports took effect in Quebec today. Also, a bunch of pamphlets taped up protesting the loss of freedoms, to go with it of course.

 

[zappatton2]

Vaccine passports took effect in Quebec today. Also, a bunch of pamphlets taped up protesting the loss of freedoms, to go with it of course.

Yeah, Ontario is pretty far behind on the passport thing, but it's an inevitability. What I wonder; for those of us who don't carry devices, what exactly are we to do? I've already printed off my second vaccine confirmation, but I'm pretty sure that won't suffice.

I know I'm not the only one in this boat either, plenty of older folks don't carry iPhones, so are there plans to accommodate them? I haven't been able to find info on this online.

 

[bostjan]

I thought the "vaccine passports" could be either digital or paper.

If they are going to go digital only here in VT, then I'm out. There's no way I can afford an iPhone.

 

[thebeesknees22]

Vaccine passports took effect in Quebec today. Also, a bunch of pamphlets taped up protesting the loss of freedoms, to go with it of course.

I personally am totally fine with the passports. Especially since 90% of the people in the gym don't respect the mask mandates. (..although I highly doubt they'll even bother enforcing the vaccine passport either)

I'm guessing a lot of business will just shrug at it. tbh

 

[jaxadam]

This is interesting...

https://pubmed.ncbi.nlm.nih.gov/34375047/

 

[CovertSovietBear]

The efficacy of vaccine passports lies in usage + enforcement, which I guess depends on the culture. Mostly everyone respects the mask laws here in northern CA, only a few people at the gym pull the mask down off their nose.

 

[zappatton2]

Well, looks like Ontario will need proof of vaccination for public areas, starting Sept 22nd.

 

[mbardu]

This is interesting...

https://pubmed.ncbi.nlm.nih.gov/34375047/

No! You're not allowed to post that link!
We're only allowed to call Ivermectin a horse dewormer and to mock people who try to get it.
Only the "all vaccine for everyone" approach is allowed here, and we have to shape opinion to that in every possible way

In all seriousness though, that study itself is pretty controversial.
People who push back argue (and they're not wrong) that the meta analysis is not very consistent in how it measures its primary outcomes, and that it could easily be skewing results. Plus one of the studies reference was based on wrong data. There is at least one other meta-analysis out there that IIRC concludes that argues there is no positive effect of Ivermectin.

Until we have something more conclusive, we should still be very cautious before saying Ivermectin works to any extent, just like we needed to be so for HCQ.
The ongoing Oxford study, if done well and showing no results could easily put an end to the discussion. But "cautious" doesn't mean we need to insult even the idea of looking into its efficacy. This actively discourages even the work we could conduct to actually conclusively verify.