CharonY

! Moderator Note Similar topics merged.

I don't think so, but I think it would be less confusing if I had said "less harmful" instead (more harmless is just weird). And exactly that data is missing, but may be incoming and only I have missed it. The latest data I have seen was mostly big picture view, i.e. how many folks infected and how many ending up in hospital. The affected cohorts were mostly vaccinated and young, so likely skewing the results. I.e. at this point it would be safer to assume that disease severity might be similar to Delta. In fact, considering that vaccine protection is lowered, as a whole it might be a bit worse, actually. There is in-vitro data suggesting at a mechanism while it is milder, but it is still difficult to be sure. Generally, higher transmissibility results in much higher number of net infections in the absence of interventions (as the spread sees exponential growth), so the much higher infection rates puts medical folks on high alert.

Not really my area but most look like daphnia.

In uni textbooks are used for reference. It is rare (in natural sciences at least) to have books in the class. You are supposed to use it to deepen your knowledge before and after lectures. The only books I remember used in class are reference books for botany and zoology, for identification of specimens. They are still tiny and portable.

The second edition Gottschalk would be from 1986. Why would folks carry reference books with them? Don't folks nowadays don't have a space to sit and read? Or do you mean high-school books? Are they actually heavy?

I don't think that follows. Textbooks in many cases are supplemental tools, though sometimes publishers like to push overworked faculty members to use their teaching solutions to save time (but I do not know many who actually uses them). But a good textbook is best used as reference material. And obviously more info is generally a good thing. Of course one could slim them down to the essentials, but especially for beginners that tends to be too compact. Some of the modern ones are geared to a different type of experience, specifically to make the information more relatable using some sort of narrative. While I dislike them personally, many younger students tend to prefer such styles. Also typically you have the option between ebook, hard and softcover (as well as loose leaflets). Personally I prefer hardcover, as if I decide to buy one, I use them for years. If seen only as a supplement to a single course, I think they are not used optimally. Also, often small, specialized textbooks can be quite a bit more expensive than big basic textbooks. Bacterial metabolism from Gottschalk is still my go-to, despite being quite old. However, it goes for the same price with around 300 pages as the more five-fold bigger Campbell Biology.

Comparing ongoing omicron infections with the previous wave it seems that in most areas we got data, we have lower hospitalization:infection ratio with omicron in many areas. However, it does not necessarily mean that omicron is intrinsically more harmless, it could for example reflect higher overall vaccination status. However, as transmission is higher, it could still mean that we might end up with overall more hospitalizations without additional measures to slow down transmission.

Well there is a big push by many universities to adopt open source textbooks. Though it does seem that most do not even read those, so not sure whether it is a big issue unless you make them mandatory (but again, I think the trend goes away from that).

I was always partial to "My favourite Bathtime Gurgles".

In recent times I have also seen massive grade inflation, anything below a B (as final degree for BSc or MSc) can be met with administrative issues, it is often easier to let it slide. I also noticed that labs have become less and less popular. They were my favourite part, as I always felt that I applied knowledge most in labs and accordingly learned more. But since you have to do something to earn a grade students consider them risky and they have fallen out of favour. Initially that was a trend observed in pre-meds, as they are obsessed with grades. But rather sadly I see even biology majors trying to avoid laboratory courses (in order to protect their grades). Don't get me wrong, active learning results in better grades, but requires more work. But students in recent times have made it clear they don't like it (we can clearly see it in evaluations). Unfortunately admin sees students as clients and are more interested to attract and retain them, rather than train them.

I am talking mostly about NA-students here (late high school, early college) and there are a lot of issues going on. But roughly speaking most students are: - hyper-focused on exams and exams only - focus more on grades than understanding - prefer memorization above anything else. Last thing I heard, high schools start to give out exam sheets that show a selection of questions that come up in these exams. They are utterly confused (and angry) that we do not do that in college - they do not work on problems. They google for answer and put the first thing they find in, regardless whether it is applicable or not. I.e. there is barely any learning involved for home assignments - they do not read textbooks. This is more relevant for complex topics to get the context surrounding a problem. But they get frustrated if they cannot learn in simple: question-> answer formats - interactive learning gives better outcomes, but student hate it (as seen from evaluations). In fact they get angry if they learned stuff that they actually did not need for the exam. Seriously.. - folks have almost stopped entirely asking for clarifications, typically the question will be something like "do I need to know this for the exam?" - any instructions that leave any degree of freedom (e.g. "work on this problem" vs "do this exactly like this and then the next step is this") will be met with resistance. Even if you have got one or two who enjoy this, there is often kind of a peer-mood that percolates through class and casts these things in a negative light. Not that at every students is like this, but implementing these types of lectures (or things that I did even 10 years ago) becomes an uphill struggle because you get so bloody many complaints. From what I have heard, in HS it is even worse, as at some point the parents also join in complaining. I think part of it is that folks are better at identifying what brings them short-term benefits and focus on that.

Unfortunately that approach likely would not work nowadays anymore.

So much of what I am going to say here is half-remembered discussions with a friend, who is a historian (with specialization in the middle ages), so I might get some things wrong. In Christian angelogy cherubim, seraphim and seats are those closest to god and do not interact with the human world. I.e. they are not the often depicted messengers of god. They are also not generally human (seats are often depicted as flaming wheels, cherubim have four faces of which only one is human, and so on). Typically "angels" in the Christian mythology refer to messengers of god, which are probably closests to malakim in Judaism. These were human-shaped and originally depicted as wingless. This depiction changed around the 4th century when these messengers started to get wings and were depicted as such since then. So to answer OP, the depiction of angelic beings changed over time and since around the 4th century they were created with wings, but likely not before.

A non-peer reviewed article from Imperial College suggests over 5-fold higher reinfection rate with omicron compared to delta. Clinical data is still limited for omicron but in their analysis they did not see lower severity (based on risk of hospitalization or symptoms). So not great news from that data slice. https://www.imperial.ac.uk/media/imperial-college/medicine/mrc-gida/2021-12-16-COVID19-Report-49.pdf

One thing that we observe in many data sets is that putting ordinance in place (e.g. masking mandates, limits of gatherings etc.) often slows down or reduces transmission events after some delay. Even in areas with poor adherence or very weak mandates it seems to have some effect. I have not looked into the lit (only at the data in a very non-data sciency way) but my suspicion is that simply making these public announcements reduces contact events as at least some folks become more careful. This also seems to be age-stratified to some degree, where especially younger groups tend not to care either way (i.e. infection rates seem to decline or slow down less than for the older age groups following such mandates). Conversely, lifting mandates seems to be seen as an endorsement of gathering and other potential risky behaviour, frequently associated with at least short, sometimes sustained spikes of case numbers.

No, you are misunderstand what I am referring to. With single-point lockdown I meant China in your original assertion: While it would be true that an early lockdown could have worked, it is often not feasible to react in time. For new diseases it takes time to realize that a) it is a new disease (China extended the timeline here because of suppression) and b) identify the agent (that was done rather quick though) and c) develop methods to diagnose them. Once we are at step c) in the modern world the disease likely has already crossed borders. The only ways would be either a better method for new disease detection or to lockdown at even the suspicion of an outbreak. The latter would unlikely to be practical. Perhaps to add a timeline to it, antibody tests have indicated that individual cases might have been in Italy as early as September 2019 (See Apolone et al. https://doi.org/10.1177%2F0300891620974755). SARS-CoV-2 was only identified Jan 2020 and the very first indication of clusters in China which were suppressed where also around September. Based on what we know about the original variant, it is likely that it was circulating earlier than that, before it created these clusters, but basically invisibly. While China had a reporting system, it was designed for SARS, so when folks tested negative, it stayed invisible. And again, I think the identification part is where we need to spend a lot of effort on. Otherwise, even if we close the doors really firmly, it will always be after some cows have already escaped the barn.

The timeline is a bit inaccurate- it was detected later on in Korea and Italy, but retrospective studies (i.e. looking back in time to check for evidence of infections) indicate that it was circulating already before the first cases were detected. In fact, the high fatality rate is likely associated with significant underestimate of ongoing cases (i.e. many positive cases were simply not detected, especially in the early months of the pandemic). You are correct that if other countries had followed a zero-COVID strategy going forward (as e.g. New Zealand), it might have burned out, or at least kept levels low enough that vaccines might have eradicated it. My point was that single-point lockdown at least for this pandemic, would not have worked. It would needed to be a more global effort. And if the a next major outbreak has similar characteristics (i.e. positive cases are not easily spotted before transmission happens) it is unlikely, regardless of country in which it happens, that we are able to detect it in time to lock down before it gets out of the country. In other words, we also need better surveillance measures to make public health measures to be effective.

Yes that is true, but the issue is that, it would have been insufficient to lockdown China alone. Once it was clear that it was a bigger outbreak virtually all countries had to lock down to ensure spread. If the next pandemic also has pre-symptomatic spread and/or diffuse symptoms, it would be the same issue. Detection would be after spread already happening. If it was less contagious and/or otherwise more visible, then actual contact tracing could work, as SARS and MERS have shown. That being said if all affected countries had adopted zero-COVID measures it might have stopped.

That would not have been feasible. When the first pneumonia clusters appeared, it was not clear that it was a new disease. Until it was identified and a test was developed, it was already spreading outside of China (based on a range of ancillary data including social media analyses of pneumonia cases, wastewater and blood bank analyses). The only way it would have worked if one was able to almost immediately identify a new virus, which would required population-wide genomic surveillance of almost all pneumonia cases. Alternatively one would need to lock down before diagnoses. That would basically mean repeated lockdowns throughout flu season, for example. In other words, the key element here would be better surveillance. Fundamentally I think yes. This is mostly based on a number of parameters, including direct health burden, but also strain on healthcare system and associated risk to health (as folks cannot get care for other conditions due to COVID-19), but also mental health burden especially for health care workers. Colleagues working in the health care system have been burned out for quite a while and how frustrated it is for them to see spike after speak leading to increased hospitalizations like clockwork. Adding on top that the longer we drag it out, the less compliance we are going to get (and further shifting the risk calculus). So overall I do think that public health is indeed hitting a breaking point or at least that we are very, very close to it. That being said, I would be more in favour of a gradual shift. I.e. starting with exclusion of unvaccinated folks, as we have seen that after such measures there is almost always an uptick in vaccinations. Surveys have found that there are a quite a number of especially younger folks who do not have specific body autonomy issues or anti-vaccinations sentiments. They just don't get vaccinated because they consider it not necessary for them and also an inconvenience. Creating inconvenience for being unvaccinated therefore changes their behaviour.

Unless I misunderstand you, but it seems to me that you argue the balance should be dependent on the political environment, whereas my argument would be dependent on the actual medical and public health situation. E.g. if hospitals are overwhelmed in a way that cannot be fixed, then the balance shifts towards a higher need for the public good (as the health burden is no increased). Unless you mean to focus on the political reality of the matter, i.e. that public health decisions in reality are actually dependent on politics (regardless whether they should or not) in which I agree. As mentioned above, the tipping point is the balance of activities vs public health burden. I.e. if 'mostly' still results in breakdowns of critical care or increased health burden (hospitalizations, long-term issues, death etc.), it is not enough anymore.

So that is an interesting argument. The aspect of body autonomy is, in many ways, complex. Fundamentally having control over your body is arguably a fundamental right and history has shown us terrible things when these rights were violated without consideration. Moreover, there are also aspects in which fierce arguments are made to limit those, such as in case of pregnancies. The situation specifically with vaccines is complicated as fundamentally we are balancing body autonomy with public health requirements. Ethics cuts both ways here. There are many thoughts around the issue ranging from how far we should be allowed to go to increase compliance. Reading through literature, it rather quickly is clear that there are no clear answers to the ethical question. One way to balance these issues is to find an equilibrium which balances of the right for autonomy with the severity of the public health measure. I think that for those living in a society there should be a tipping point where the common good takes precedence of the individual will. The tricky bit is mapping out where this point should be. It is not a perfect framework, but would at least take the public threat level into consideration rather than being an absolute. The best way, of course would be to inform and educate, but I am pretty sure we are talking about the bits where this approach does not work.

I would be careful about that. We do not have good age-stratified data on unvaccinated severe cases yet (there is another report from SA which I should spend more time on, but from skimming it seems not to be conclusive yet, either). Current data suggests that it is not worse and there is at best a careful perhaps on whether it could be milder on average. Each individual might still face severe consequences, especially in the older age segment. Moreover, from a public health perspective, if the virus is less virulent, but spreads faster, it can still have a similar or higher net burden than the more virulent variant. In fact, spread is the more critical value here, since if it manages to spread through the population in a way delta still couldn't, we could actually face much higher net hospitalizations. This is exactly the scenario public health officials are very afraid of. There can be rather complicated situations pertaining to it. For example, folks can be co-infected with different variants (in areas with extremely high prevalence of infections), but only one manages to fully settle in its host. But for the most part the assumption is that infected persons regardless of the variant are less likely to immediately catch a related infection again. This is related to the amount of neutralizing antibodies, which are not highly specific and therefore should protect against most variations out there.

I think the basis for the approach is the concept or proportionality. Public health groups have to carefully evaluate the various scenarios and look at the health burden in relationship to the necessary measures to alleviate them. Fundamentally the question is how many deaths are we alright with relative to measures to be taken. The burden of the measures themselves must also be taken into account as they themselves may pose public health risks. The issue here is that all we can do is follow best scientific estimates as we will only know in the aftermath how badly it has become. For this particular disease, it was pretty clear (at least among health professionals) that, if unchecked, it would in short order disrupt health care systems. In hindsight that has become true and is clearly one of the deadliest pandemic in modern times. So at least the properties of the disease would have warranted more rigorous measures compared to, say SARS or perhaps even Ebola, not because of mere death rates (both have higher case fatality rates) but were also easier to detect, which allowed other containment measures to be sufficient. But I guess we really can't have absolute certainty when it comes to these measures as at some point a judgment has to be made and clearly we cannot shut everything down each time we find a new virus. Conversely, it also means we need a more robust pipeline to make these evaluations and judgements and not hope that things politically align, as ultimately the biology determines the timeline in which we have to act.

I think the bigger point here is not whether measures are allowed. They certainly are. Likewise, policies are in place to encourage certain behaviour and discourage others. This is no different in a pandemic. But perhaps rather what potential limits are under the overall framework of human rights. In another thread there were comments indicating that it should be possible to essentially suspend human rights. In contrast, I think that effective measures are not only feasible but should in fact not be at odds with human rights in order to ensure public health and safety. Rather, the right for health is tightly interconnected to other human rights and therefore effective policies should fulfil these standards. In other words, it not a yes/no situation with regard to pandemic measure, but one should rather ask whether the measures are: improving public health (i.e. following science); deployed fairly and equitably; has enough measures in place to ease hardships and promote compliance. Enforcing safe vaccines against a deadly disease in public spaces would fall under that mandate, for example.

I don't think anyone here right now is arguing against it.