147 thoughts on “Politics open thread, November 22-28

  1. 53-year-old here, and I’m ready, willing, and eager to get the vaccine ASAP. Gallup didn’t contact me for their poll.

  2. This past week our cleaners called and said they were sick, describing Covid like symptoms. I did a count of how many days since we last saw them and we have past the nine day mark. My kids have been understanding about protecting both sets of grandparents but some times it does grate on them.
    (I smile as I think of all the discussions – literally not hypothetically protecting the seniors is hard).
    In person school is good in that they get to see their friends, albeit in a Covid repellent environment.
    Less of wanting to go to friends houses to hang out. They did that over the summer but now hanging out indoors is risky.
    DH wants to see if there are side effects of the vaccine. But how are we to know if everyone balks at taking it.

  3. I’m not interested in being in the first round to get the vaccine. I’ll wait and see what, if any long term effects there are.

  4. Likewise, Berlin is planning to start with 400k doses of the vaccine, to be distributed at 6 sites, a couple of which are in places that were testing centers.

  5. I would be thrilled for us to get vaccinated by April. Or even June. When the days are short and the disease risk high, waiting is not an option.

  6. If I were in charge, I would consider vaccinating the highest risk ~20% of the U.S. population by September 2021 as a successful project. (~66 million people, probably 200 million doses considering waste/follow-up challenges)

    I have long been skeptical that low risk people will see a vaccine in 2021.

  7. On one of my FB pages, someone said they heard their hospital would make the vaccine mandatory in January. That idea shows a huge misunderstanding of production logistics and politics – I can’t imagine that any system will have sufficient vaccine (or social capital) to make it mandatory in 2021.

    It’s really interesting to see what happens here. If the government could get hold of 100k doses, that would totally change the dynamic of our economy. The two big hits in 2020 have been tourism (I think our largest sector) and foreign students (a very large sector). Vaccinate everyone at the border or require presence of antibodies, and both of those sectors can be almost instantly restored.

  8. The two-dose requirement and likely delay before vaccine is effective complicate vaccinating people at the border.

  9. That’s a good point. I’m sure someone is working on a plan. What interesting to me is that for some countries (SE Asia, Oz/NZ), relatively small amount of vaccine will make a big difference in eradicating/keeping virus out.

    I imagine our first doses will go to the thousands of people working with the quarantined and managed isolation people. That should decrease the risk of the virus leaking into the country from the steady stream of foreigners.

  10. I figure I will be fairly far down the line for getting my vaccine. I presume they will do people with major health risks and healthcare workers and police officers first, then probably older people in nursing homes and essential workers who face the public next.

  11. “The two-dose requirement and likely delay before vaccine is effective complicate vaccinating people at the border.”

    Locally, vaccination and a sufficient amount of time for the vaccine to be effective seems like a potentially very good replacement for current negative test result to avoid quarantine.

  12. I have been thinking about the vaccine priority list. Everyone seems to be talking about first responders and medical people treating covid as being top of the list. I’m fine with that.

    What I’m looking for here is transparency in making the list. If those two groups are first, where, honestly, does that place people like President, VP, Cabinet Members, Senators, Congresspeople, Military flag officers (Generals & Admirals), all the other federal political appointees? And a similar list for the states and localities (minus the generals & admirals). I realize in the scheme of things these people taken together are a pretty small number compared with ‘first responders and medical personnel’. No doubt they’ll be high on any list.

    Then there are: government employed essential workers, other essential workers (‘essential’ being another eye-of-the-beholder item) like trash haulers. Some might think they’re pretty far down the list but if you’ve ever been anywhere when the trash people are on strike you’ll think differently. Oh, and teachers, other school staff, military below admirals & generals.

    Again, I’m not advocating for any particular list, I just want to see some transparency. Wishful thinking, I know.

  13. Fred, I hope for more transparency and clarity about prioritizing vaccine. This morning I heard a radio host say he thought elementary school teachers should be high priority because young kids need to be in school. And then there’s the issue of how the different vaccines — the 95%, 90%, 70% effective, etc — will be distributed. Personally, I want the 95% one. :)

  14. The states were required to submit their vaccine distribution plans in October and it should be posted on your health department’s website. My state’s 42 pages is much more extensive than the “Priority: 1. Politicians 2. Football players and coaches 3. Bill Murray” that I expected. I expect that rollout nationwide will be rocky and then it will start to get better after a few months.

  15. @ Fred – I think there is actually tons of transparency in how the FDA task force is working on this issue. I’ve heard a lot from members of the task force on podcasts and other media about it – they’re openly answering questions and talking about it. The problem is that the nuts and bolts of the information may not trickle down to people who wouldn’t otherwise be looking for it. Will your local paper do a comprehensive write up of it? Probably not. Could you find the information if you devoted an afternoon to researching and reading? Yes.

  16. I will definitely get the vaccine – but I imagine I will be low on the priority list. I hope teachers are relatively high up on the priority list.

  17. @Fred – I hear you about the prioritization and what “essential” means. My DH is considered “essential” by his employer and the state. He won’t be getting the vaccine anytime soon. They’ll continue to test him 2x per week instead. He’s not “essential” in the sense of medical needs or infrastructure needs. He’s essential because his job is to manage and care for millions of dollars of technology. He can also work alone (which he does; the team has a rigid schedule of who can be where when), and isn’t in a priority group otherwise.

    I’d rather see my mom get the vaccine than my husband at this point. If she gets COVID, she will be in the ICU very quickly – she’s an asthmatic with poor lung capacity on a good day, add COVID and allergies and it’s bad…

  18. “And then there’s the issue of how the different vaccines — the 95%, 90%, 70% effective, etc — will be distributed.”

    The AstraZeneca data, particularly the dosage that appears to have 90% effectiveness, is good news for poorer countries because it is cheap ($4-5/dose v $40-50 for others) and does not have the cold storage problems that Pfizer and Moderna have. I hope that J&J gets similar data, as a one dose vaccine without cold storage issues would be such great news for poorer countries.

  19. Thanks to HFN for the tip to check state health website.
    I found an extremely detailed document, with lots of charts, including the estimated numbers of residents in each of the categories.
    Given that more than a million residents are over age 65, and another 1.8 million have serious health complications (probably lots of overlap in those categories), and 300,000 HCW/first responders, the rest of us — no matter how “essential” — are going to be way down the priority list. WCE, prisoners and those who work in prisons are listed ahead of the general public in priority.

  20. I hope people in prisons are a priority.

    Me too, although I expect that the virus will have swept through most prisons, killing off the “dry tinder” and leaving the rest with at least temporary immunity.

  21. 1453 have died.

    That’s okay, they are just prisoners and necessary sacrifice on the path to herd immunity.

  22. Some 4400 prisoners die each year behind bars.
    It’s important to keep the numbers in context.
    Also, it is very likely that the number of prisoners actually infected is substantially more than 200,000, because many correctional facilities didn’t (and still don’t) test inmates on a regular basis.

    There are differences of opinion among public health experts regarding who should receive vaccine priority, depending upon whether the goal is to reduce mortality (vulnerable seniors) or slow transmission (younger adults). https://www.scientificamerican.com/article/doing-the-touchy-math-on-who-should-get-a-covid-vaccine-first/

  23. Some 4400 prisoners die each year behind bars.
    It’s important to keep the numbers in context.

    So an additional 1453 dying from COVID is a very significant increase. Context is very important.

  24. Yes it is fair to move the placebo groups ahead of others. Other vaccine trial volunteers will probably get a similar option.

  25. MA draft vaccine document lists health care personnel first, then over 65s and other high risk, and then general population, with a future determination of prioritized critical subpopulations. A lot of pages on how supplies of vaccine will be allocated to the health care providers statewide to ensure the most efficient and equitable dissemination.

  26. NY’s distribution plan includes some straightforward charts but also mentions nuanced details in the text.

    Once the vaccine is first approved for use, New York State
    will use up-to-date data to determine which geographic
    areas of the state may derive a greater public health
    benefit to receiving early vaccine. This may include areas
    with higher historical burden of disease or areas that
    have the highest prevalence of COVID-19. In addition,
    individual factors for hospitals and nursing homes will be
    considered including cases per facility in prior 14 days, and
    vulnerability index of population served. New York will also
    consider whether the vaccine can be used effectively as a
    potential outbreak interruption strategy and if so, what the
    criteria will be.

    I appear to qualify for Phase 3 out five phases.

  27. “MA draft vaccine document lists health care personnel first, then over 65s and other high risk, and then general population”

    Interesting that there apparently is no priority given to essential workers outside of healthcare.

    Perhaps there aren’t any food processing plants in MA, but for states that have them, I would think workers at such plants should be considered essential and be given some level of priority.

  28. I have no dog in the vaccine fight. I’m perfectly content to wait my turn. My who MO during this crisis has been to simply, patiently wait.

  29. Finn, no. It’s the work that’s essential, not the specific workers doing it. It’s been obvious for months that they are disposable. Debbie wants a haircut and a muffin. For god’s sake, open up and let her in the gym before she gets a muffin top!

  30. “According to a preprint case study released by New Zealand health authorities, at least four of the infections occurred in-flight—all tracing back to one man who, at least by the time he stowed his belongings and took his seat, was presymptomatic but shedding active virus. The chain of transmission was confirmed afterwards via genomic analysis.”

    https://www.forbes.com/sites/williamhaseltine/2020/11/23/one-man-one-plane-seven-infections-and-counting-a-cautionary-tale-for-all-those-planning-air-travel/?fbclid=IwAR0iz7wt89mFDnzlXchH1MbbRq1GF-yv4F8iJZ9tmHxxf6LpkgEGmpZYmI8&sh=4f0672d135d1

  31. Thank you for sharing that, RMS. I think there will be a lot of interesting data that comes out the NZ experience because we are actually tying all the cases together and seeing the chain of transmission. A few notes — Air NZ (the only airline flying in in September, I think) – did not require masks on the plane. What’s also interesting – we haven’t seen a lot of these. Most airplanes contribute 1-2 cases to to NZ. If there was lots of plane transmission we would see a lot more (because I don’t think we are missing any).

  32. “An airplane cabin is probably one of the most secure conditions you can be in,” says Sebastian Hoehl of the Institute for Medical Virology at Goethe University Frankfurt in Germany, who has co-authored two papers on COVID-19 transmission on specific flights, which were published in JAMA Network Open and the New England Journal of Medicine, respectfully. Still, a handful of case studies have found that limited transmission can take place onboard. One such investigation of a 10-hour journey from London to Hanoi starting on March 1 found that 15 people were likely infected with COVID-19 in-flight—and that 12 of them had sat within a couple of rows of a single symptomatic passenger in business class. (The results were published this month in the U.S. Centers for Disease Control and Prevention’s journal Emerging Infectious Diseases.) Most of these flights occurred early on in the pandemic, however, and in the case of the March 1 flight, masks were likely not worn, the researchers wrote.” https://www.scientificamerican.com/article/evaluating-covid-risk-on-planes-trains-and-automobiles2/

    TSA screened more than a million passengers yesterday. We’ll soon see if there are significant numbers of new cases attributable to flights.

  33. One reason my parents flew on an airline that didn’t require a 72 hour Covid test is because, going to get the test done in the home country meant breaking their months long isolation and high possibility of infection in a line of people suspected to be Covid positive. They flew in spite of the risk because it was tough to continue without outside contact indefinitely in the home country.
    In the home country social distancing is very hard to come by. Mask wearing protects you only so much when you can’t distance.

    I would say an on the spot rapid test that is reliable is the way to go for airline safety measures.

  34. Air traffic is less than half the levels of 2019, but that means that millions of Americans are still flying every week. https://www.tsa.gov/coronavirus/passenger-throughput

    There is little evidence of massive COVID transmission aboard airlines, despite the reality that, despite screening efforts, it’s impossible to prevent all infected passengers from flying. https://www.washingtonpost.com/local/trafficandcommuting/nearly-11000-people-have-been-exposed-to-the-coronavirus-on-flights-the-cdc-says/2020/09/19/d609adbc-ed27-11ea-99a1-71343d03bc29_story.html

  35. OK, I have long been convinced of this, and even remember arguing it here – the evidence seems to be accumulating that a mutation made the COVID variant that headed to Europe and then to New York was more infectious than the original strain, and that is why those early outbreaks in Italy and New York were suddenly so hard to contain. The article doesn’t mention this specifically, but I have read that this mutation was not common in the earliest cases on the West Coast and that is why we didn’t see the same spread on the West Coast in March.

  36. Eh, they are looking for any excuse to hate on him. Unless the total size of the gathering would exceed 10, it is within “the rules.” I’d rather have a governor admit that he is having 3 relatives over for a smaller-than-usual Thanksgiving then listen to covid deniers like Joe Borelli brag about the huge gathering he is having in the hotspot that is Staten Island. Nothing like putting your family’s health at risk to own the libs.

  37. Louise – I agree in theory about rapid COVID testing. I keep hearing about the low accuracy of the rapid tests, though. It seems like your parents made a rational decision – getting tested is, in itself, a risk behavior.

  38. New research in Lancet — a systematic review and meta-analysis of SARSCoV2 viral load, viral shedding, infectiousness:

    “Although modellng studies estimated potential viral load peak before symptom onset—we did not identify any study that confirms pre-symptomatic viral load peak.”

    https://www.thelancet.com/journals/lanmic/article/PIIS2666-5247(20)30172-5/fulltext

    The researchers also confirmed that *no* study has been able to culture live virus from a person with a positive PCR test with a cycle threshold over 34. The PCR cycle threshold used in testing DOES matter. The New York Times, to its credit, reported on this issue way back in August. https://www.nytimes.com/2020/08/29/health/coronavirus-testing.html

  39. Cycle threshold is a right-wing dog whistle.

    Lowering the CT lowers the number of people considered infectious, but does not lower the number of people who are infected. If you have COVID fragments in your respiratory tract, you have COVID or recently had COVID.

  40. The New York Times must be a right-wing dog whistler!
    Who knew?
    Lowering the CT means that people who aren’t actually clinically sick and don’t have sufficient virus load to infect anyone else are NOT sent off to quarantine. Whether they count in the number of people who have been (not ARE CURRENTLY) infected is less important. Except that it gets us to the herd immunity threshold more quickly. It is likely that we will get there with natural infections before we get there with a vaccine.

    But the absence of evidence of presymptomatic viral load only makes it even more absurd to impose useless mask mandates.

  41. Science magazine is also a right wing dog whistler:

    I”n a study published this week in Clinical Infectious Diseases, researchers led by Bernard La Scola, an infectious diseases expert at IHU-Méditerranée Infection, examined 3790 positive samples with known CT values to see whether they harbored viable virus, indicating the patients were likely infectious. La Scola and his colleagues found that 70% of samples with CT values of 25 or below could be cultured, compared with less than 3% of the cases with CT values above 35. “It’s fair to say that having a higher viral load is associated with being more infectious,” says Monica Gandhi, an infectious diseases specialist at the University of California, San Francisco.” https://www.sciencemag.org/news/2020/09/one-number-could-help-reveal-how-infectious-covid-19-patient-should-test-results

    ObviousBot, you should stop posting misinformation. It makes some readers very angry.

  42. ObviousBot, you should stop posting misinformation. It makes some readers very angry.

    Pot, meet kettle.

    But apparently you don’t realize that what you posted doesn’t contradict what OB posted.

    OB: “Lowering the CT lowers the number of people considered infectious, but does not lower the number of people who are infected. ”

    S: “It’s fair to say that having a higher viral load is associated with being more infectious”

  43. “It can be observed that at Ct = 25, up to 70% of patients remain positive in culture and that at Ct = 30 this value drops to 20%. At Ct = 35, the value we used to report a positive result for PCR, 30. In any cases, these rare cases should not impact public health decisions.” https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1491/5912603

    Now, in layman’s terms, this data suggests that “positive” tests elicited with a CT>35 are not really positive, infectious cases and that we don’t need to worry about them. We certainly don’t need to quarantine/isolate people in those situations. Positive cultures can be found in fewer than 3% of those people.
    What am I missing here?

  44. “It can be observed that at Ct = 25, up to 70% of patients remain positive in culture and that at Ct = 30 this value drops to 20%. At Ct = 35, the value we used to report a positive result for PCR, 30. In any cases, these rare cases should not impact public health decisions.”

    Oh noooooooes. You misquoted!!

    “It can be observed that at Ct = 25, up to 70% of patients remain positive in culture and that at Ct = 30 this value drops to 20%. At Ct = 35, the value we used to report a positive result for PCR, <3% of cultures are positive. Our Ct value of 35, initially based on the results obtained by RT-PCR on control negative samples in our laboratory and initial results of cultures [8], is validated by the results herein presented and is in correlation with what was proposed in Korea [9] and Taiwan [10]. We could observe that subcultures, especially the first one, allow an increasing percentage of viral isolation in samples with Ct values, confirming that these high Ct values are mostly correlated with low viral loads. From our cohort, we now need to try to understand and define the duration and frequency of live virus shedding in patients on a case-by-case basis in the rare cases when the PCR is positive beyond 10 days, often at a Ct >30. In any cases, these rare cases should not impact public health decisions.

    You’re missing the part about persistent positivity after 10 days. Literally, it’s missing because you cut it out.

  45. “the absence of evidence of presymptomatic viral load”

    …should not be confused with evidence of the absence of presymptomatic viral load.”

    “makes it even more absurd to impose useless mask mandates.”

    Of course useless mandates are absurd. However, if the efficacy of mask usage is not established one way or the other, it is then not clear whether or not such mandates are useless, and therefore uselessness is not a valid rationale for judging such mandates to be absurd at that point.

  46. “Although modellng studies estimated potential viral load peak before symptom onset—we did not identify any study that confirms pre-symptomatic viral load peak.”

    This doesn’t address at all whether or not presymptomatic viral load is sufficient to be contagious.

  47. https://www.publichealthontario.ca/-/media/documents/ncov/main/2020/09/cycle-threshold-values-sars-cov2-pcr.pdf?la=en

    Critically, it has not been established that persons with PCR-positive specimens that cannot be cultured are not infectious. This is particularly important as in some laboratories it has been relatively difficult to culture SARS-CoV-2 compared to other viruses.
    […]
    Some experts have argued that Ct values should be provided routinely on laboratory reports to assist with clinical and public health decision making.4 This may be applicable in a limited setting where healthcare providers only receive reports from a single laboratory, and can be educated about the test performance and Ct value characteristics of a particular assay. However, in complex laboratory network environments, such as in Ontario, where specimens may be tested at one of several laboratories (> 40 laboratories conducting SARS-CoV-2 rRT-PCR in the province on a variety of different extraction and PCR platforms), utility of such reporting is questionable. Moreover, test results are received and reviewed by a myriad of healthcare providers, as well as patients, with varying understanding of Ct values. As such, the inclusion of Ct values on laboratory reports issued in Ontario (and Canada) is not recommended – they are of limited utility if used in isolation when interpreting the rRT-PCR result. In the rare, specific scenarios where it is thought that the Ct value might inform clinical or public health management, clinical and public health providers should contact the testing laboratory to discuss Ct interpretation, in the context of the epidemiology and clinical scenario, with the microbiology team.
    […]
    In general, specimens with Ct values well below the assay cut-off for positivity (e.g. Ct < 35 with the laboratory positivity cut-off for that assay set at Ct = 38) are less likely to be false positive. If in doubt, contact the testing laboratory to have the Ct value and report reviewed (provided the assay in use generates a Ct value). The amplification curve may also be reassessed to ensure no interpretive errors were made at the time of reporting.
    […]
    While the above steps are being taken, it is important to treat the patient as positive for COVID-19 and ensure that appropriate infection prevention and control and public health measures are in place.
    […]
    Notably, specimens from patients that were asymptomatic and had no epidemiological links to COVID19 cases had the lowest proportion of specimens confirmed by RdRp sequencing (5/32, 16% confirmed), which was significantly lower than that for asymptomatic patients tested with epidemiological links to multiple confirmed cases (16/32, 50% confirmed; Fisher’s Exact p= 0.007). This suggests that a high Ct positive result is more likely to be false positive when observed in an asymptomatic patient with no epidemiological links to cases during low community prevalence of disease. However, it is difficult to know exactly which patients among this subgroup are true positive versus false positive, as we know that not all true positive high Ct positive specimens are repeat positive when retested on the same or a different platform. Ct values in the absence of detailed clinical and epidemiological data cannot identify false positive results and their utility is limited to be supportive of investigating suspected false positive results in the right clinical context.
    […]
    The COVID-19 pandemic has led to large scale testing of asymptomatic persons with low pretest probability, a practice not previously employed for any respiratory viral pathogen. SARS-CoV-2 Ct values may be of use when interpreting positive laboratory results derived from patients with low pretest probability, in particular, asymptomatic persons with no epidemiological link to a confirmed COVID-19 case. The province of Ontario has produced guidance documents that facilitate risk-based patient management and follow up that do not rely on definitively concluding that a test is a true or false positive. Ongoing education regarding the increased possibility for false positive test results when testing high numbers of asymptomatic persons during periods of low community prevalence of SARSCoV-2, even when utilizing assays with excellent performance is required. This would benefit the healthcare community and potentially avoid unnecessary patient isolation, contact tracing and outbreak declaration. [Of note, they discuss community prevalence of 1% as related to low pre-test probability, which means this is not relevant to current issues in the United State]

  48. DD,
    Please identify any misinformation I posted. I’m trying to be accurate.

    You’ve posted numerous times that kids in school are at “zero risk” from COVID. You’ve said many times that college students and young, healthy adults have no risk from the virus. I can go on.

  49. Kids are at statistically zero risk from Covid. Do you seriously not understand that point? The data are clear.
    The reason schools are closed has nothing to do with children and everything to do with unions.

  50. “You’ve said many times that college students and young, healthy adults have no risk from the virus. I can go on.”

    Right. Statistically, that is true.
    Tens of thousands of college students have been tested for the virus. As of October 5, the number was at least 70,000. How many reported deaths? Zero. And only a handful of hospitalizations.

    Surely, if there *had* been a healthy college student who dropped dead of COVID, you would have posted the CNN link here. But it matters little, because the plural of anecdote is not data.

  51. “From our cohort, we now need to try to understand and define the duration and frequency of live virus shedding in patients on a case-by-case basis in the rare cases when the PCR is positive beyond 10 days, often at a Ct >30. In any cases, these rare cases should not impact public health decisions. ”

    You’re missing the part about persistent positivity after 10 days. Literally, it’s missing because you cut it out.”

    You missed the word “rare”. As in, “these rare cases should not impact public health decisions.”
    Which they should not.

  52. Finn, if mask mandates don’t work, they are useless.
    The data shows that they don’t work. See, e.g., California.
    Therefore, they are useless.

  53. Scarlett, at 7:36 pm, you decided to put things in “layman’s terms” for Denver? Seriously? I’m all for healthy egos, but that seems beyond healthy to me, given your level of medical training and his.

  54. The results of this study from UCL (and others) present more good news on COVID:

    “The researchers have so far identified 12,706 mutations in SARS-CoV-2, the virus causing COVID-19. For 398 of the mutations, there is strong evidence that they have occurred repeatedly and independently. Of those, the researchers honed in on 185 mutations which have occurred at least three times independently during the course of the pandemic.
    To test if the mutations increase transmission of the virus, the researchers modelled the virus’s evolutionary tree, and analysed whether a particular mutation was becoming increasingly common within a given branch of the evolutionary tree – that is, testing whether, after a mutation first develops in a virus, descendants of that virus outperform closely-related SARS-CoV-2 viruses without that particular mutation.
    The researchers found no evidence that any of the common mutations are increasing the virus’s transmissibility.” https://www.ucl.ac.uk/news/2020/nov/sars-cov-2-mutations-do-not-appear-increase-transmissibility

    Lead author Professor Francois Balloux (UCL Genetics Institute) is a great Twitter scientist to follow.

  55. There is a big blowup in Colorado. Some counties, including Larimer (a little north of Denver) have said they will not enforce the latest round of restrictions. The town/city of Longmont (which is in Boulder county next to Weld county) is wanting to pass a law that the town’s two hospitals will not treat COVID patients from counties that are not enforcing the restrictions.

    https://www.denverpost.com/2020/11/24/longmont-mayor-weld-county-residents-hospital-covid/

  56. Scarlett you made up a quote.
    You took words out of a long scientific passage so it would say what you meant.
    That’s called lying.
    You lied.
    You’re being manipulative with the group here.
    You are not arguing in good faith.
    You’re just arguing.
    And lying, you’re lying too.

    The article talks about a cohort of patients, studied in their lab, who have a positive PCR test and then another positive PCR test, often with high CT, 10 days later. Those patients are rare. That has nothing to do with any point you are trying to prove. It doesn’t say anything about presymptomatic spread, it doesn’t say anything about CT as used to diagnose COVID. That’s why you had to lie. That’s why you had to alter the quote.

    It’s not a discussion when you make things up and manipulate quotes.

  57. That son of a bitch. In March he wanted to shut down the liquor stores and pot shops. FROM THE AIRPORT, he tweeted, “Avoid travel if at all possible”.

    I can’t even. This is all AFTER all the drama about Gavin, and various other politicos who are all “The rules are for the little people.”

  58. Here’s the whole quote:

    “It can be observed that at Ct = 25, up to 70% of patients remain positive in culture and that at Ct = 30 this value drops to 20%. At Ct = 35, the value we used to report a positive result for PCR, 30. In any cases, these rare cases should not impact public health decisions.”

    High CT values are mostly correlated with low viral loads.
    Evidently, you disagree.
    Unlike these researchers, you want to make public health decisions based on the unicorns. The rare cases.

  59. THAT’S NOT THE FULL QUOTE. YOU ARE LYING!!!!!

    This is the full quote:

    “It can be observed that at Ct = 25, up to 70% of patients remain positive in culture and that at Ct = 30 this value drops to 20%. At Ct = 35, the value we used to report a positive result for PCR, 30. In any cases, these rare cases should not impact public health decisions. ”

    Another quote, from above, that you conveniently ignored:

    Critically, it has not been established that persons with PCR-positive specimens that cannot be cultured are not infectious. This is particularly important as in some laboratories it has been relatively difficult to culture SARS-CoV-2 compared to other viruses.

  60. Whoops. My mistake The full quote:

    “It can be observed that at Ct = 25, up to 70% of patients remain positive in culture and that at Ct = 30 this value drops to 20%. At Ct = 35, the value we used to report a positive result for PCR, 30. In any cases, these rare cases should not impact public health decisions. ”

  61. Wow. The HTML coding is editing out the middle of the quote because of the signs

    “It can be observed that at Ct = 25, up to 70% of patients remain positive in culture and that at Ct = 30 this value drops to 20%. At Ct = 35, the value we used to report a positive result for PCR, less than 3% of cultures are positive. Our Ct value of 35, initially based on the results obtained by RT-PCR on control negative samples in our laboratory and initial results of cultures [8], is validated by the results herein presented and is in correlation with what was proposed in Korea [9] and Taiwan [10]. We could observe that subcultures, especially the first one, allow an increasing percentage of viral isolation in samples with Ct values, confirming that these high Ct values are mostly correlated with low viral loads. From our cohort, we now need to try to understand and define the duration and frequency of live virus shedding in patients on a case-by-case basis in the rare cases when the PCR is positive beyond 10 days, often at a Ct greater than 30. In any cases, these rare cases should not impact public health decisions. ”

    I still think you are lying,

  62. Obvious Bot, considering that you are hiding your identity (unless you are a brand new poster) that is an ironic accusation.

  63. Has it been established that patients with positive tests but little or no virus cultured ARE infectious?
    That is another way of putting the issue.

  64. Rocky, that’s hilarious, in an ironic appreciation of hypocracy kind of way. I suppose he was there, realized it was a bad idea and, welp…

    Obvious Bot, not to defend the lies, but have you read through last week’s politics post? Several people, including Kerri and Scarlett, had some excellent things to say to Rhett about liking the beast.

  65. Rocky, I meant your post about the mayor. The thing about the planes—not at all funny. My kid needs his Christmas with grandparents!

  66. Here’s Mayor Dum-dum’s response to my (and everyone else’s) email.

    Below is a statement from Mayor Michael B. Hancock regarding his personal Thanksgiving travel:

    “I fully acknowledge that I have urged everyone to stay home and avoid unnecessary travel. I have shared how my family cancelled our plans for our traditional multi-household Thanksgiving celebration. What I did not share, but should have, is that my wife and my daughter have been in Mississippi, where my daughter recently took a job. As the holiday approached, I decided it would be safer for me to travel to see them than to have two family members travel back to Denver.

    “I recognize that my decision has disappointed many who believe it would have been better to spend Thanksgiving alone. As a public official, whose conduct is rightly scrutinized for the message it sends to others, I apologize to the residents of Denver who see my decision as conflicting with the guidance to stay at home for all but essential travel. I made my decision as a husband and father, and for those who are angry and disappointed, I humbly ask you to forgive decisions that are borne of my heart and not my head.”

    So I guess CV-19 doesn’t affect you if you’re making decisions from your heart.

    Asshat.

  67. Stolen from an excellent Twitter thread — this will be the last Thanksgiving for 2.8 million Americans. For those over 80, the possibility is much higher. Many of those people have been isolated from friends and family for many months. The hard truth is that we do not know who will be around for Thanksgiving next November. What we do have is right now–this moment–today. We aren’t promised one moment more. God forbid one of us isn’t sitting at that table next year, I can’t imagine grappling with that regret.
    And if, despite the overwhelmingly favorable odds, lightning strikes & COVID takes one of us out, we won’t regret that day for a second.
    Because if “safety” requires us to indefinitely forfeit the most valuable parts of our lives, what exactly are we trying to save?

    Happy Thanksgiving to everyone.

  68. 9/11 is considered to be the great tragedy of our generation. Less than 3,000 people died.

    More people have died from COVID in the last two days than died on 9/11. More than 85 times as many people have died from COVID as died on 9/11, and it will soon be over 100 times as many. Yet many people still insist this is nothing to be concerned about.

    Have a good Thanksgiving and try not to spread a deadly virus to your family friends.

  69. Because if “safety” requires us to indefinitely forfeit the most valuable parts of our lives, what exactly are we trying to save?

    Our lives so that in six months or so we can get the vaccine? But you do you.

  70. We do want to visit family this Christmas, in part because it may be my dad’s last. But we will do it safely, with masks and distancing and isolation and tests.

    Denver, the tragedy of 9/11 isn’t just the people who died that day. It’s also the huge rise in discrimination against Muslims, immediately and with lasting effects, and increased US bombing and military force in numerous countries. 9/11 ushered in a truly ugly part of our country’s history.

  71. SM, my point is that what we memorialized and have remembrances for every year are the people who died. We spendt hundreds of millions of dollars extra on the memorial in order to have it done by the 10th anniversary because it’s so important to remember the lives that were lost.

    And now about 90 times as many people have died from COVID and so many of the same people who grieved so much for the 9/11 deaths still don’t seem to care.

  72. In Houston, the nation’s seventh-largest public school district, which started the fall remotely, 42 percent of students failed two or more classes in the first grading period, compared to 11 percent in a normal year, The Houston Chronicle reported.

    In Chicago, the nation’s second-largest district, 13 percent of high school students failed math in the fall quarter, compared to 9.5 percent last fall, The Chicago Tribune reported. Students will return to classrooms there in January, according to the city’s current plan.

    And in Northside Independent School District in San Antonio, one of the nation’s 30 largest, the share of students failing at least one course in the first grading period increased from 8 percent last year to roughly 25 percent. More than half of students have opted to remain remote, and those students are disproportionately poor, said the superintendent, Brian T. Woods.

    “We’re obviously dealing with unprecedented learning loss and course failure,” he said, “and it’s going to take years to mitigate.”

    At the Fairfax County Public Schools, the largest district in Virginia and 11th-largest in the country, an internal analysis found that the percentage of middle school and high school students earning F’s in at least two classes had jumped from 6 percent in the first quarter a year ago to 11 percent this year. Fairfax County has brought back only a small fraction of its 188,000 students for in-person instruction.

    Already disadvantaged students appear to be faring worse in remote classes, putting them at increased risk of long-term disengagement and dropping out.

    Fairfax County found that students who had performed well before the pandemic were still doing well — better than predicted, in fact — while those who had struggled before were doing even worse now. Among students learning English and students with disabilities, the rate of failure had more than doubled.

  73. I am not surprised at the impact on learning. This is the Totebag and Totebaggers are education focused so will keep their kids learning all through. I mentioned back in the Spring how the kids in my neighborhood were playing outside almost all day long and had very little work to do. Also public schools here focus a lot on End of Grade testing in the Spring which I don’t think was done this year. End of grade tests at least prepare kids to meet minimum standards.
    I understand the access problems in the Spring but going to blanket Pass/Fail let everyone off the hook for accountability- students, teachers and parents, in areas
    where there were no issues with access or few cases of the virus.
    I am not an educator and don’t have an answer but as an interested observer, I noticed a difference once Pass/Fail was announced.

  74. “Covid seems to be out of control in Chicago.”

    Unfortunately, yes. Deaths are way up as well from the low-level we had all summer. It is not good. All the metrics are down slightly from early November – so let’s hope that trend continues. I have heard quite a few people who are pulling back from activities since things got bad again and tougher restrictions were put back in place. (e.g., closing indoor dining) It’s also gotten difficult to get a test again – very long lines, limiting to certain groups/symptoms, etc.

    Anecdotally, I have quite a few people in my wider circle who have been sick in the past 6 weeks – some quite seriously. It is really all over the board who has almost no symptoms and who ends up in the ER/hospital. One of my friend’s tween daughter was very sick and is still suffering from debilitating daily headaches 7 weeks after catching Covid, and then there are obese seniors who have had extremely mild symptoms. I have more than one close friend who is without a relative this holiday due to Covid. And I will say that at least one person I know is absolutely wrecked with guilt over a more vulnerable relative contracting the virus. (so I don’t relate to the – screw everyone, no regrets attitude at all)

  75. One of my friend’s tween daughter was very sick and is still suffering from debilitating daily headaches 7 weeks after catching Covid,

    How is that possible? Scarlett has assured us many times that kids are at zero risk from it.

  76. Louise, kids finally getting adequate outdoor play time is a very good thing. Idk how long it will take for schools to be able to meet regularly again, but it would be wonderful if sufficient outside time and movement during the school day were a lasting result of this experience.

    DD, I’m all for light-hearted teasing, but why looks & provoke, when we know what the ugly response will be?

    The closest I’ve come to knowing anyone who caught Covid, besides the kid at the primary school with a sib in my son’s school, is a guy in my parents’ wider social circle, in his 70s. One of their 6 kids came home for a while, but I believe he is now fully recovered

  77. I don’t think the choice is between ignoring the risks of covid or ignoring the risks of lockdown, but it seems that neither side is considering the very real costs of both lockdown and covid.

    Maybe the vaccine will be available in six months and that distribution will be relatively free of all the supply chain disruptions we have seen for everything else. That still leaves six more months of isolation, remote learning, and social disruption. Those are costs are huge.

    I have known quite a few people who have gotten covid. None of the people under 80 have died or even been hospitalized. I also know two teenagers who have died from the lockdown and many others who have been hurt. I may be heartless, but I don’t think the tradeoffs have been worth it.

    My son is not doing well with distance learning. The obvious hypocrisy of what is and is not allowed is obvious to him and anyone else who is paying attention. He and I know many kids who will not be returning to high school, they went to work and are not going back to school.

    “Totebaggers are education focused so will keep their kids learning all through.”

    I guess I’m not a totebagger, because I have not been able to do this.

  78. “I don’t think the choice is between ignoring the risks of covid or ignoring the risks of lockdown, but it seems that neither side is considering the very real costs of both lockdown and covid.”

    My anecdote is I have two elderly and otherwise high risk family members who seem to have recovered from Covid, although I don’t think they’re completely out of the woods yet. OTOH, I have another elderly family member who may suffer permanent damage because she was could not see a dentist in many months. Currently she’s unable to eat solid food.

  79. New cases seem to have peaked in Wisconsin, the Dakotas, Minnesota. After seeing a record high of 23 patients in mid-November, the 500-bed Wisconsin field hospital (actually built last spring but unused until now) is now back to 9.

  80. My anecdote is from my brother – the cohort of a friend’s 18 year old son had 1 successful suicide and 3 DUIs.

    We are grateful that DS had a challenging job this summer, and we had him PM our solar/roof/fumigation/AC/painting house project. He is almost done with his college applications, so we need another project/activity he can take on while he waits to hear the results in March. His public high school has been fully remote this Fall and was planning to go hybrid next semester. Our county needs to get back in the red zone for that to even be a possibility. The school board will finalize their decision on January 5th. We anticipate that he will be remote for the full year.

    My family, my brother’s family, and my 79 & 80 year old parents zoom twice a week. Every time my parents ask when we think a vaccine will be available. They hope that they are still even able to be active when things are safe enough for them to resume their gatherings and travel. They are still hosting their daily zoom happy hours with their friends.

    The neighbor with whom we share a back fence recently passed away. We don’t know from what. It was 2 weeks before his death was discovered.

  81. I don’t think the choice is between ignoring the risks of covid or ignoring the risks of lockdown, but it seems that neither side is considering the very real costs of both lockdown and covid.

    I’m not saying there should be a lockdown, just that people should use some common sense. For example, SIL’s husbands family insisted on doing their big T-day gathering with 20 people staying in the same house for the weekend. The host’s daughter’s boyfriend tested positive last weekend, so the daughter supposedly was quarantining in the house while 19 other people were there, including her 85 yo grandmother.

  82. The healthy 61yo brother of a woman I work with died from covid a couple weeks ago, and this week an ex girlfriend of a friend died. She was 51. A guy I work with was in the hospital with it and is now recovering at home but not yet back at work, that was 3 weeks ago.

  83. “I’m not saying there should be a lockdown, just that people should use some common sense.”

    Yes – agreed. There are very few Totebaggers who are in extreme lockdown, so I don’t know where the idea is coming from that anyone is really advocating for that. Some restrictions and prevention are a good idea – again, we can argue about what is a better balance for schools vs restaurants vs leisure travel and private gatherings. I am not trying to personally stay 100% locked down nor is that what I would like The Government to mandate, but whether or not I am likely to DIE, this is not a virus that I would like to catch nor is it something that I want to be responsible for spreading to others – particularly those who are at more risk than me. So I am willing to make some sacrifices in order to try to slow/stop the spread – like wearing a mask in public (which I hate as much as everyone else), limiting my contacts with people outside my household, seeing extended family members outdoors, not taking any trips, and yes – having my kid in remote school, etc. (As I said many times – I think that it is a mistake that our schools have been 100% closed since March – they should have found a way to be open at least for the youngest kids, diverse learners, if not hybrid when the numbers were low.) And one of my points with the examples is that one of the most frightening things to me is how random the symptoms seem to be for everyone – in both type and severity.

  84. “I don’t think the choice is between ignoring the risks of covid or ignoring the risks of lockdown, but it seems that neither side is considering the very real costs of both lockdown and covid.”

    Sounds very similar to what I’ve been saying all along—shutdowns should be determined intelligently, differentiated according what’s been shown to matter, not all or nothing.

  85. Summary of the election results- I was surprised to learn that Biden’s margin of victory in 3 key states was only 44,000. My area has a lot of alternative energy development (hydro, wave energy, windmills, solar optimization, small scale nuclear) and my techie friends and I are worried that the Democrats will mandate change before the technology is ready. As one friend put it, “Biden wants to shut down 70% of our electricity generation (from fossil fuels) and increase demand (from electric vehicles) by 20%. What could go wrong?”

  86. “ Biden’s margin of victory in 3 key states was only 44,000”

    The very good news is that this time around, the electoral college winner is also the winner of the popular vote. Biden got over 51%. Republicans lost the popular vote in 4 of the previous 5 elections.

  87. From the Atlantic article:

    “Amid the pandemic, the people they govern would generally be better served if they got to stay home, stay safe, and not worry about their bills. To govern, though, leaders also need to placate the other centers of power in American communities: local business associations, real-estate developers, and industry interest groups. These groups, whose businesses have cratered, have been vocal about their desire to see people go back to their jobs and pay their rent on time and in full. Just as these kinds of groups have developed an outsize influence on how policies are made on a national level, they also have significant sway in state and local politics.
    The best way to resolve this conflict would probably be to bail out workers and business owners. But to do that at a state level, governors need cash on hand; currently, most of them don’t have much.”

    The author doesn’t seem to have considered the reality that large numbers of people want and need to be in contact with others, and are unwilling to “stay home” and “stay safe” for months on end without end. Thanksgiving travel, for instance, had virtually nothing to do with needing to pay bills and everything to do with needing to be human.

  88. “Astra Zeneca details”

    I heard a couple days ago on a podcast that those trials included regular testing of all participants. So that makes those test results, in a way, even more encouraging than the previously announced results that only tested participants who were symptomatic.

    I also find it fascinating that an error may lead to a better vaccination protocol. I would think that the initial half-dose would lead to fewer side effects than an initial full dose, as well as stretch out supplies over more people and reduce cost per course.

  89. And one of my points with the examples is that one of the most frightening things to me is how random the symptoms seem to be for everyone – in both type and severity.

    Same. About half the people I know my age who have had the virus had fairly mild symptoms, although two still have not regained their sense of smell four months later. One made multiple ER visits where they would put her on oxygen and keep her for about six hours then send her home. A college student friend of a friend’s son died from it. In my parents’ cohort, there have been multiple lengthy hospitalizations. And over Thanksgiving, DH’s favorite cousin and her adult daughter were both admitted to the ICU with the virus. My sister mentioned a married couple she’s friends with who she described as the most athletic couple she knows who were both hit really hard and weeks later are still working on the goal of a walk around the block. I don’t want any part of this virus because I have no confidence that I would be a mild case. Even without shutdown orders in my community, I choose not to interact with too many people.

    On the flip side, a suicide prevention charity I support is doing outreach at my alma mater after there were three student suicides in a small window of time. So I agree with the point that the shutdown and isolation is doing real damage. The hypocrisy of some leaders makes it worse. I hope the transition to the new administration does not cause any slowdown in the vaccine distribution. People need to feel confident enough to resume more, if not fully normal, activity.

  90. “Tens of thousands of college students have been tested for the virus. As of October 5, the number was at least 70,000. How many reported deaths? Zero.”

    “A college student friend of a friend’s son died from it.”

    College students are clearly not at zero risk of death.

  91. “I hope the transition to the new administration does not cause any slowdown in the vaccine distribution. People need to feel confident enough to resume more, if not fully normal, activity.”

    TMK, the Pfizer and Moderna vaccines have not been shown to reduce the contagiousness of the immunized. Thus, even those immunized with those vaccines should, IMO, continue to use masks to minimize the chances of infecting others.

    The Astra Zeneca vaccine data, based on regular testing independent of symptoms, may reduce contagiousness by reducing infections, but trial data suggests it’s not 100% effective, thus those immunized with that vaccine should, IMO, continue to use masks.

    IMO, fully reopening schools and businesses are far more important than stopping mask use.

  92. “A college student friend of a friend’s son died from it.”

    College students are clearly not at zero risk of death.

    More than 28,000 people age 15-24 have died from all causes since February. 428 of those deaths “involved” COVID. There are more than 42 million Americans in this age group. https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm#AgeAndSex

    College students (or anyone in the 15-24 age group) have a .001% risk of dying of COVID. It’s not zero. Mea culpa.

    Meanwhile, *every* year, the flu kills previously healthy children and young adults in greater numbers than has COVID. https://www.cnn.com/2020/01/17/health/flu-ohio-teen-kaylee-roberts-death-eprise/index.html.

  93. “Meanwhile, *every* year, the flu kills previously healthy children and young adults in greater numbers than has COVID.”

    I hope one result of this pandemic is more widespread recognition of the dangers of flu, and more widespread mitigation against those dangers, e.g., vaccinations, mask usage, staying home when sick.

  94. Scarlett, you’re right. If young people aren’t dying from something, then it’s not a problem. If the police shoot an innocent person of color, it’s ok as long as they don’t die. If someone is sick from COVID for months, it’s okay because they didn’t die. Old Trump continuing to insist the election was rigged is okay because nobody died from voting. 226,000 people over the age of 45 dying from COVID is okay because they aren’t young. It must be great in your corner of the world where there are no problems because young people aren’t dying.

  95. “I hope one result of this pandemic is more widespread recognition of the dangers of flu, and more widespread mitigation against those dangers, e.g., vaccinations, mask usage, staying home when sick.”

    I agree. We are strangely complacent about influenza. The flu shot does a good job of protecting people, particularly children, from death from influenza.

    United has started delivering the vaccines across the US.

  96. We’ve had some work place conversations about this – we’ve always considered it okay for docs and nurses to get exposed to influenza, to not be careful with aerosol-generating procedures when the patient clearly has an infectious process. I suspect we will all be more careful with respiratory viruses when this is done.

    Of note, ERs in Asia often have a clean and a dirty side – if you come in with broken leg, you are “clean”. If you come in with fever, you are “dirty”. They seem to have a better handle on preventing hospital based spread of infection.

  97. Respiratory infections appear to contribute to heart attacks. Given how well the vaccine work is going, maybe we can create vaccines that include other coronaviruses.

    Even if it doesn’t turn out to prevent heart attacks, just preventing seasonal misery would be nice. I’ve been so lucky not to have a bad cold (“just” a bad cold) in years, but when you get them, they’re really miserable.

  98. Before this year, I never realized how much contagion occurred at the bridge club. Neither of us has had even a sniffle since March. Our kleenex consumption is a third of what it used to be, and I have seasonal allergies and 3 cats. We will probably wear masks and use liberal hand sanitizer at the clubs when they reopen or on trains and planes, at least for the rest of DHs life.

  99. Ada, my acquaintances in healthcare have also talked about the culture of coming to work sick among providers. The training is demanding and people are expected to work sick vs. canceling on 30 patients. I wonder if that culture will be affected and whether the culture of working sick is common elsewhere.

  100. WCE, the ND governor said its fine for nurses with COVID to work so that’s not going to help change the culture of working while sick.

  101. WCE at my office it was fairly common for people to come to work sick. I was not one to go in while sick, but with WFH, I always felt guilty taking off, even after surgery. With the open office it was particularly annoying to hear people coughing and sneezing.

  102. I would hope it would change the culture of working sick, but I doubt it. I think the pandemic has taught us that Americans are really resistant to personal inconvenience/sacrifice for the good of the whole. Most of my working time in the ER was as an independent contractor. Like so many Americans (and most doctors), no work = no pay. Unless we plan on restructuring that system, I don’t see people staying home when sick.

  103. Ada, I have worked in a similar culture without sick leave and the change in my job of being able to stay home and work when you’re “a little bit sick” has helped a lot.

    Early in my career, when it was a choice between using my two weeks of vacation time to see my out-of-state family or coming in with a cold, I sure as *&%^ was coming in.

  104. “We will probably wear masks and use liberal hand sanitizer at the clubs when they reopen “

    And perhaps better ventilate the venues as practical?

  105. “we’ve always considered it okay for docs and nurses to get exposed to influenza “

    Aren’t they typically immunized? TMK, most local hospitals have had policies that employees are either immunized or wear masks.

  106. “ERs in Asia often have a clean and a dirty side “

    The hospital where my kids were born had something like that going back at least to when they were born. Their pediatrician’s office also had a separate waiting area for those who are sick.

  107. “at my office it was fairly common for people to come to work sick. “
    “a choice between using my two weeks of vacation time to see my out-of-state family or coming in with a cold, I sure as *&%^ was coming in “

    It was also common in my office. The decision to combine separate sick leave and vacation leave balances into a single leave bank encouraged that. I was guilty of that too, but did mask up when I went in to the office while sick.

    As telecommuting became more feasible, we did see more people choose to WFH while sick.

  108. “Even if it doesn’t turn out to prevent heart attacks, just preventing seasonal misery would be nice.“

    As Scarlett has pointed out many times, the flu often causes hospitals to reach capacity. This affects those needing care for other reasons, so vaccines that protect against other coronaviruses would benefit many beyond preventing heart attacks or seasonal misery.

  109. Changing pay structures would likely change the US expectation to work while sick. Health care for everyone could do the same thing, in effect, by paying people to stay home sick.

  110. “WCE, the ND governor said its fine for nurses with COVID to work so that’s not going to help change the culture of working while sick. “

    Just because the governor said so doesn’t mean it’s going to happen.

    https://www.medpagetoday.com/infectiousdisease/covid19/89637

    IMO that governor is very cavalier WRT the health of HCW, not taking measures to minimize transmission, which results in more patients and thus more risk to HCW, but expecting them to bail out his failure to take measures to minimize spread by putting themselves at increased risk. Working while sick also means increased likelihood of increased exposure and thus increased risk of severe infection, and also increased risk of spread between HCW.

    HCW getting infected was totally predictable and should’ve factored into his policy decisions.

  111. “in effect, by paying people to stay home sick.”

    The company line for the reason for combining sick and vacation leaves into a single pool was that there was a lot of abuse of sick leave.

    How do you prevent that when you do pay people to stay home sick?

    In some jobs, you can evaluate them by their results. But those who abused sick leave were often in jobs where that wasn’t feasible, e.g., line workers.

  112. “I would hope it would change the culture of working sick, but I doubt it. I think the pandemic has taught us that Americans are really resistant to personal inconvenience/sacrifice for the good of the whole.”

    I agree with you on the second point.

    But the pandemic has also changed attitudes toward WFH, and many see WFH as convenient to themselves, so I think a lasting result of the pandemic will be a reduction in working sick in offices or other workplaces as more people choose to WFH while sick, and more employers support that.

  113. How do you prevent that when you do pay people to stay home sick?

    You trust your employees. Sure, some people will abuse it, but you have to be operating with the assumption that people are going to miss work because they are legitimately sick, so you have plans to handle it.

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