A blood marker predicts who gets ‘breakthrough’ Covid(nature.com)
nature.com
A blood marker predicts who gets ‘breakthrough’ Covid
https://www.nature.com/articles/d41586-021-02096-3
153 comments
I'm glad they're confirming this, and it could be useful for determining who needs a booster the most, but yeah, it would be more surprising if this _weren't_ true.
It's a step in that direction, which is more than we had previously. It doesn't establish a cutoff threshold, but it does allow a doctor to say whether somebody's antibody level is closer to the group that got infected or the group that didn't. They could warn that person to be extra cautious and theoretically save lives based on this study alone. I find that newsworthy.
In my experience with immune related diseases, and reading about the immune system, the takeaway from all of it is "The immune system is ridiculously convoluted, and nothing necessarily makes sense or doesn't make sense"
Given that I can totally understand why they would investigate something that seems self-evident. I wouldn't have been even slightly surprised if they found that high antibody count meant higher susceptibility to re-infection. The immune system really is a spaghetti code mess of a system, and has seemingly as many intuitive as counter-intuitive behaviors.
Given that I can totally understand why they would investigate something that seems self-evident. I wouldn't have been even slightly surprised if they found that high antibody count meant higher susceptibility to re-infection. The immune system really is a spaghetti code mess of a system, and has seemingly as many intuitive as counter-intuitive behaviors.
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There was a time when I worked in the intersection of peripheral neuroscience and the immune system, studying the immune response of mammals to optogenetic therapies. It was a widely held belief that, in that problem space, the complexity of the immune system outpaced ambiguities and unknowns we had surrounding the PNS.
Basically, what I'm saying is take every statement you've seen in the media and documentaries about how complex the nervous system is, and consider that the immune system is considered equally incomprehensible today.
Not only is the immune system spaghetti code, but it likes to break all the time and, to our perspective, is full of weird and undefined behaviors.
There was a time when I worked in the intersection of peripheral neuroscience and the immune system, studying the immune response of mammals to optogenetic therapies. It was a widely held belief that, in that problem space, the complexity of the immune system outpaced ambiguities and unknowns we had surrounding the PNS.
Basically, what I'm saying is take every statement you've seen in the media and documentaries about how complex the nervous system is, and consider that the immune system is considered equally incomprehensible today.
Not only is the immune system spaghetti code, but it likes to break all the time and, to our perspective, is full of weird and undefined behaviors.
Well, if my bio 200 class taught me anything, it's that we don't have bodies that are created with cells all united to single goals or purposes.
Our bodies are microservice hell :D. We have a bunch of cells all performing their complicated jobs and duties working together in a crazy complex distributed system. Even the internals of the cells are a bunch of horribly stitched together glue code that just happens to work because of billions of years of pruning off the glue that doesn't work.
It's an incredibly complex chain of chemical reactions which has been selected of eons based on which chains of chemical reactions produce more of the same chains. It's madness.
Our bodies are microservice hell :D. We have a bunch of cells all performing their complicated jobs and duties working together in a crazy complex distributed system. Even the internals of the cells are a bunch of horribly stitched together glue code that just happens to work because of billions of years of pruning off the glue that doesn't work.
It's an incredibly complex chain of chemical reactions which has been selected of eons based on which chains of chemical reactions produce more of the same chains. It's madness.
Maybe one way to think about biology is: "An ongoing exercise in systems documentation." :P
Yeah. I did a lot of work with blood measures and every disease had some characteristic spike in n immune function. I worked in a lab with a ton of immunologists and we never knew what was going on. All we could say was activation of complement or strong TNF response or something else descriptive but not really helpful. Just too much dark matter in the immune system. My big hope is that the silver lining of COVID will be a much deeper understanding of the immune system. Certainly a ton of money is being poured into it. Fingers crossed, we could be entering a golden age for immuno-therapeutics.
Here here to the possibility of starting a golden age of immune related research and investment. IMO (as an autoimmune patient who reads a bunch about my disease/immune system and has done some computation biology work during my CS masters, but otherwise unqualified), immune system research is severely underfunded in relation to how involved it is in virtually ever bodily function.
I kinda feel like with other organs that are tangible and you can like see and feel (brain, kidney, heart, etc) are much more obvious choices to study and examine for pathology (ie plaque in the arteries, kidney stone). But an ephemeral system of on/off switches that communicate with each other to attack or not attack stuff? kinda makes sense that it is elusive and poorly understood.
my great hope is we are starting to enter a golden age of immuno-therapies, and it's not just because of COVID. Immunotherapy is genuinely the most exciting area of cancer therapies right now (again, IMO). between CAR-T cell therapies, proposed NK cell therapies, PD-1 inhibitors, etc, whats not to be excited about?
I kinda feel like with other organs that are tangible and you can like see and feel (brain, kidney, heart, etc) are much more obvious choices to study and examine for pathology (ie plaque in the arteries, kidney stone). But an ephemeral system of on/off switches that communicate with each other to attack or not attack stuff? kinda makes sense that it is elusive and poorly understood.
my great hope is we are starting to enter a golden age of immuno-therapies, and it's not just because of COVID. Immunotherapy is genuinely the most exciting area of cancer therapies right now (again, IMO). between CAR-T cell therapies, proposed NK cell therapies, PD-1 inhibitors, etc, whats not to be excited about?
As someone who is currently considering IL-17 inhibitors for psoriasis, this kind of comment fills me with dread. The claims for products like skyrizi make it seem like they have a very good idea of why it works and what the potential risks are, but if things are as complex as you say then how could that be true?
Ankylosing Spondylitis patient here who has tried and failed most NSAIDS, Sulfasalazine, and 3 TNF inhibitors. Don't feel dread towards this notion! The immune system is definitely super complex and spaghetti code like, but rheumatology and science in general is working it's way through reverse engineering it. Since TNF inhibitors have come out, lots of data on these monoclonal antibody drugs that inhibit specific parts of the immune system have been gathered. The short term and long term side effects are noted and increasingly understood. If your rheumatologist has a good bedside manner, they should give you some comfort in how widely many of these drugs are used, what is known, and what is unknown.
I'm not trying to make any claims that we are close to a full or maybe not even good understanding of how the immune system works, but science is definitely advancing towards reducing the unknowns. I've been through the ringer of all the treatments and currently am not able to find relief in any, but I'm just trying to offer some hopeful empathy as someone who has at times felt dread from having very rare side effects to a whole bunch of the medicines and I rarely feel dread in general despite the uncertainty and my pain.
As always, talk things through with your rheumatologist and GP if you have concerns.
I'm not trying to make any claims that we are close to a full or maybe not even good understanding of how the immune system works, but science is definitely advancing towards reducing the unknowns. I've been through the ringer of all the treatments and currently am not able to find relief in any, but I'm just trying to offer some hopeful empathy as someone who has at times felt dread from having very rare side effects to a whole bunch of the medicines and I rarely feel dread in general despite the uncertainty and my pain.
As always, talk things through with your rheumatologist and GP if you have concerns.
A main difference in this research is that it's very difficult to actually measure the levels of neutralizing antibodies. Traditional antibody tests aren't able to tell if you have high neutralizing antibody levels yet, as a BSL3 lab is needed to perform these experiments with live virus. Antibody levels aren't always a clear indication of level of immunity, so this was still an open question with COVID.
This study has serious implications for a recommendation for a third dose. It was known for a while that a 3rd dose increases levels of neutralizing antibodies, but this study now ties that increase to a significant boost in immunity which has implications for the new variants like Delta. It means that likely we don't need to wait 3-6 months for approval for a new strain specific booster. We can just use the doses we already have to bump up the neutralizing antibody level.
It also has implications for how long the 2-dose or 1-dose regimens are good for, since it has been known that the neutralizing antibody level does tend to dip after around 6-9 months, so this gives more evidence for the benefit of getting a booster after around 6 months to keep neutralizing antibody levels high.
This study has serious implications for a recommendation for a third dose. It was known for a while that a 3rd dose increases levels of neutralizing antibodies, but this study now ties that increase to a significant boost in immunity which has implications for the new variants like Delta. It means that likely we don't need to wait 3-6 months for approval for a new strain specific booster. We can just use the doses we already have to bump up the neutralizing antibody level.
It also has implications for how long the 2-dose or 1-dose regimens are good for, since it has been known that the neutralizing antibody level does tend to dip after around 6-9 months, so this gives more evidence for the benefit of getting a booster after around 6 months to keep neutralizing antibody levels high.
@brobdingnagians raised a question on genetic discrimination based on COVID-suceptability, which of course got downvoted into oblivion. But this is indeed an issue and a tough gray line to walk as technology continues to advance. (It's probably more like a fractal than a line.)
Do we end up in GATTACA, 1984, Brave New World, Dune, Black Mirror, or some combination? Maybe we figure out how to dodge most of those bullets and end up in Star Trek?
In the US, the Genetic Information Nondiscrimination Act of 2008 (GINA) may be of some tiny value on the particular point raised.
Do we end up in GATTACA, 1984, Brave New World, Dune, Black Mirror, or some combination? Maybe we figure out how to dodge most of those bullets and end up in Star Trek?
In the US, the Genetic Information Nondiscrimination Act of 2008 (GINA) may be of some tiny value on the particular point raised.
I'm confused at the genetics angle that both you and brobdingnagians took on this. I'll admit that I don't fully understand the science behind the article, and I'd like to be corrected if I'm wrong, but I don't see anything in the article that makes a direct link between the blood marker and genetics.
As far as the down votes go, it's a little strange that an article talking about new findings about our understanding of COVID prompted a response about the government controlling our bodies. Similar to the genetics angle, I don't see anything in the article that even suggests this information will be used to keep someone inside their house. I guess it could be, but I don't get the point. Should we stop the advancement of science because there's some remote possibility that the Government will use it to "tell us what to do"?
I mean you bring an interesting point, but at the same time, we now have an indicator that may tell us more about how one person might react to COVID. I don't see why that's causing us to worry about some 1984-ish dystopian future.
As far as the down votes go, it's a little strange that an article talking about new findings about our understanding of COVID prompted a response about the government controlling our bodies. Similar to the genetics angle, I don't see anything in the article that even suggests this information will be used to keep someone inside their house. I guess it could be, but I don't get the point. Should we stop the advancement of science because there's some remote possibility that the Government will use it to "tell us what to do"?
I mean you bring an interesting point, but at the same time, we now have an indicator that may tell us more about how one person might react to COVID. I don't see why that's causing us to worry about some 1984-ish dystopian future.
I didn't see the one that got downvoted. But I'm horrified that this one seems to be at the top.
Who's talking about genetics? This is about antibodies! It's not looking at the DNA of the immunized person. At all. It's not genetics. It's identifying the specific chemical results of their immunication, not the person. At all.
Do people not understand that? This is a ridiculous digression from the subject at hand, just to talk about some kind of Sci-Fi fantasy dystopia?
Who's talking about genetics? This is about antibodies! It's not looking at the DNA of the immunized person. At all. It's not genetics. It's identifying the specific chemical results of their immunication, not the person. At all.
Do people not understand that? This is a ridiculous digression from the subject at hand, just to talk about some kind of Sci-Fi fantasy dystopia?
Sorry about that; apparently this is why we can't have nice things. I just wanted to reply to the original downvoted comment, but when I couldn't because it got flagged, that triggered my contrarian response here.
But I don't think it's such a ridiculous digression from the subject at hand - The original article was just a "water is wet" study saying that the more antibodies you have floating around in your blood the better able you are to fight off a virus. When you have that kind of article people will naturally digress in their discussions. And with COVID, dystopia is never far off-topic. (Just depends on your politics whether you see it more like V for Vendetta, or more like Pandemic or maybe Omega Man.)
But I don't think it's such a ridiculous digression from the subject at hand - The original article was just a "water is wet" study saying that the more antibodies you have floating around in your blood the better able you are to fight off a virus. When you have that kind of article people will naturally digress in their discussions. And with COVID, dystopia is never far off-topic. (Just depends on your politics whether you see it more like V for Vendetta, or more like Pandemic or maybe Omega Man.)
>Do people not understand that? This is a ridiculous digression from the subject at hand, just to talk about some kind of Sci-Fi fantasy dystopia?
Welcome to Hacker News. I guarantee you almost no one bothered to read past the words "blood marker" in the title. You can tell because the article has pop-ups and no one is ranting about them.
Welcome to Hacker News. I guarantee you almost no one bothered to read past the words "blood marker" in the title. You can tell because the article has pop-ups and no one is ranting about them.
Do we have any evidence this is due to a genetic difference? Antibodies are an immune system response, and the immune system is a learning system. Past history has a big (and complex and hard to predict) impact on how it responds to things. It could be genetic I suppose, but my guess is it would not be.
As far as i can tell, the study did not collect any patient genotype information nor does it claim antibody expression differences were do to genetic deferences between patients.
That's why it's so important for us to come to terms with how we view privilege. Society currently only thinks a limited set of things - parental wealth, social status, skin color, etc. - are forms of privilege and we should work to reduce them (currently in the name of "equity"). Once society starts to understand that everything is privilege we need to rethink how we treat privilege, else we will continue destroying one another in the name of equity. Hard work, intelligence, willpower, perseverance are, at the root, all genetic. Environmental factors may influence these traits, but how you react to environmental factors is also genetic...unless you believe in religious concepts such as free will.
We need to stop treating privilege as something that needs to be corrected and instead focus on helping those most in need. The logical conclusion of equity is nothingness (if that's even a thing). Stopping short of that is simply giving more to one side at the expense of the other.
We need to stop treating privilege as something that needs to be corrected and instead focus on helping those most in need. The logical conclusion of equity is nothingness (if that's even a thing). Stopping short of that is simply giving more to one side at the expense of the other.
The first step is to use a word besides "privelege" since that's an ideologically loaded term that, regardless of the many definitions its believers and confused non-believers will offer you, is functionally a form of original sin that can never be truly wiped clean, requiring eternal penance from the privileged.
If you don't agree with that concept, you shouldn't cede the linguistic territory by using the term coined by the people who invented that concept
If you don't agree with that concept, you shouldn't cede the linguistic territory by using the term coined by the people who invented that concept
Michael Knowles latest book, "Speechless, Controlling Words, Controlling Minds", delves extensively into this subject. The PC culture partially wins by corrupting language; redefining words to mean new things, often the opposite of what they used to mean. "Privilege" is one of those corrupted words. So is "equity". These words used to mean something far different than they are being used for now.
Growing up I learned the phrase "it is a privilege, not a right" which applied to many things: drivers license and citizenship are two that come to mind immediately. It was explained to me that a right is something innate, that you simply HAVE - it can be temporarily unavailable to you through force or coercion or circumstance, but it is still yours. Privilege, on the other hand, is something you must earn and constantly prove yourself worthy of having through responsible action and behavior.
I do wish these definitions were still used.
I do wish these definitions were still used.
Agreed. Now privilege is used to describe fair treatment under the law and freedom from racial prejudice.
Calling them privilege, focuses attention on the wrong area and away from the real problem. It implies that to improve equity the solution is taking away these "privileges". It also implies some level of moral corruption for those enjoying the "privileges".
It is a race to the bottom where we punish everyone until their experience matches those with the most unjust treatment in society.
Calling them privilege, focuses attention on the wrong area and away from the real problem. It implies that to improve equity the solution is taking away these "privileges". It also implies some level of moral corruption for those enjoying the "privileges".
It is a race to the bottom where we punish everyone until their experience matches those with the most unjust treatment in society.
Every term used to describe social situations will become ideologically and politically loaded.
Originally it was a word used to describe what I mentioned in the other branch, social privilege, a general set of rules that affect you which enable concentration of means and power. It is not a result of these rules which was the main point of confusion.
It's not an original sin then, the rules can be changed to be more equitable. (Though some changes done under this name are either ineffective or wrong in principle.)
Then someone rightly decided to call whiteness a privilege (a complex of rules pertinent to people declared by society as white, by contrast with the opposite of them), and then somehow it was conflated with immutable characteristics. Yes, a person with light skin color might not actually be or act "white".
Another example: age cannot be changed (at least without), but ageism can. Age is not a privilege, set of rules pertinent to may be. (Some positive, others negative, protective or harmful.)
The opposite of privilege as sum total (which is beneficial rules) is mostly kyriarchy (set of oppressive rules, mostly hierarchies). Perhaps that is a better focus, at least for now.
Originally it was a word used to describe what I mentioned in the other branch, social privilege, a general set of rules that affect you which enable concentration of means and power. It is not a result of these rules which was the main point of confusion.
It's not an original sin then, the rules can be changed to be more equitable. (Though some changes done under this name are either ineffective or wrong in principle.)
Then someone rightly decided to call whiteness a privilege (a complex of rules pertinent to people declared by society as white, by contrast with the opposite of them), and then somehow it was conflated with immutable characteristics. Yes, a person with light skin color might not actually be or act "white".
Another example: age cannot be changed (at least without), but ageism can. Age is not a privilege, set of rules pertinent to may be. (Some positive, others negative, protective or harmful.)
The opposite of privilege as sum total (which is beneficial rules) is mostly kyriarchy (set of oppressive rules, mostly hierarchies). Perhaps that is a better focus, at least for now.
I’m not sure what you’re trying to say. For me, at least, rhetoric matters. I don't care for some as it were commentary on the state of language and ideology. If rhetorical poison is being deployed against my ideology, then I want to shed light on it stop it. Things, as most people understand them, are not becoming more equitable. That’s a real problem despite the obtuse linguistic tricks deployed to justify a post-modern agenda.
Now imagine a future world where (biological) age or skin color of an already living individual really can be changed on demand. But possibly at a huge cost.
Given the thread we are in and current strides in gene therapy, we might be there sooner than we expect.
Given the thread we are in and current strides in gene therapy, we might be there sooner than we expect.
Has anyone traced the history as to when equity, which has historically meant fairness, got corrupted to mean "equality of outcome", which is really the opposite of fairness?
I've recently discovered Thomas Sowell and I'm really itching to find time to read his book on the subject: Discrimination and disparities.
I've recently discovered Thomas Sowell and I'm really itching to find time to read his book on the subject: Discrimination and disparities.
Good question. It's interesting that we also use the word in the sense of a profit or return on an investment (e.g., "equity in your home"). I take that as a nod to its former meaning of "justly conducted," since without proper methods (in that sense "fair") business accounting would be impossible.
Equality of opportunity versus equality of outcome has been a debate for a long time.
Check out commentary on Jeffersonian versus Hamiltonian thinking for discussion that is more intellectual and less emotional.
Example: https://www.hoover.org/research/what-does-created-equal-mean
Check out commentary on Jeffersonian versus Hamiltonian thinking for discussion that is more intellectual and less emotional.
Example: https://www.hoover.org/research/what-does-created-equal-mean
Who says equity means equality of outcome?
Almost everyone nowadays who dabbles in the social justice business. Most people are already equal before the law, do have equal chances, do get equal treatment. But that wasn't enough, so now the demand is equal outcomes, not matter if it leads to inequality in chances, law and treatment.
Where do you get the idea that people "have equal chances"? I and my wife both have great jobs that both pay us well, and allow us to have the time to spend with our children where we are not stressed out about making end meet. We had the money to not think twice about sending our children to daycare, and then when the lockdowns hit, to a service that saw to them both being successful in online learning and with the ability to socialize with a pod of other children. I send my kids to piano, dance, swimming, and gymnastics lessons every week, and we will be back to German class once a week in the fall (maybe Hungarian again as well).
All of those things are absolutely giving my kids unequal chances above some of the kids in their school whose parents may be working several jobs an even then just barely making ends meet.
And the fact that my parents could provide much of what I am providing my kids to me was a big contributor to setting me up with the chances that allowed me the path I had to this successful career. Certainly I worked along the way, but others who worked just as hard (and were just as talented) did not active the finial stability that I now enjoy. And there is every reason to believe that the chances I am giving my children will wind up paying off in enhanced chances for their children.
On a statical basis (there are always outliers) wealth creates wealth. And the slaves that were released 150-odd years ago were released with nothing. Then we spent most of the time since that trying to make sure they had no voice (clear voting suppression), no property rights, no way to buy a house (redlining), inferior schools, and so many other hurdles and outright barriers to their advancement. Not to mention clearly unequal policing.
Looking at this pattern, how can I not credit, in some way, that my family is white? That in the 1950's and onwards they benefitted from the GI bill that help guarantee their mortgages, where black veterans were almost completely denied those same benefits? Because my family immigrated to the midwest initially, we were not one of the few families that directly benefited from slavery, but surely we benefited in aggregate from the work that was the only work available to black people at unequal pay.
We have made great strides in making the letter of the law more equal. On painting a patina of equality across our society. But the moment you scratch that surface and look at the outcomes it becomes very obvious that the real work of making a just society is far from done.
The one that always gets me the most are the repeated studies where they send the same resumes to companies, but change out the names from white sounding ones to black sounding ones, and suddenly the call-backs on them drop precipitously.
All of those things are absolutely giving my kids unequal chances above some of the kids in their school whose parents may be working several jobs an even then just barely making ends meet.
And the fact that my parents could provide much of what I am providing my kids to me was a big contributor to setting me up with the chances that allowed me the path I had to this successful career. Certainly I worked along the way, but others who worked just as hard (and were just as talented) did not active the finial stability that I now enjoy. And there is every reason to believe that the chances I am giving my children will wind up paying off in enhanced chances for their children.
On a statical basis (there are always outliers) wealth creates wealth. And the slaves that were released 150-odd years ago were released with nothing. Then we spent most of the time since that trying to make sure they had no voice (clear voting suppression), no property rights, no way to buy a house (redlining), inferior schools, and so many other hurdles and outright barriers to their advancement. Not to mention clearly unequal policing.
Looking at this pattern, how can I not credit, in some way, that my family is white? That in the 1950's and onwards they benefitted from the GI bill that help guarantee their mortgages, where black veterans were almost completely denied those same benefits? Because my family immigrated to the midwest initially, we were not one of the few families that directly benefited from slavery, but surely we benefited in aggregate from the work that was the only work available to black people at unequal pay.
We have made great strides in making the letter of the law more equal. On painting a patina of equality across our society. But the moment you scratch that surface and look at the outcomes it becomes very obvious that the real work of making a just society is far from done.
The one that always gets me the most are the repeated studies where they send the same resumes to companies, but change out the names from white sounding ones to black sounding ones, and suddenly the call-backs on them drop precipitously.
Who are "almost everyone?" Who are examples of prominent academics, for example, who say equity is equality of outcome? I'm not talking about randos on twitter.
I'm also curious to what your own personal definitions of equity and equality are,
I'm also curious to what your own personal definitions of equity and equality are,
The social justic argument is that this is explicitly not true and reforms are neccesary to make it more true: “most people are equal before the law, do have equal chances, do get equal treatment”.
But this argument often rests on inequality of observable outcomes.
Which would be logical evidence if - for instance - laws were selectively enforced.
This evidence is far from iron-clad, though. Especially its real meaning.
It is like seeing a red spot on a table. Is it strawberry jam? Is it blood? Is it result of someone injecting insulin? Is it the only evidence of a murder?
It is like seeing a red spot on a table. Is it strawberry jam? Is it blood? Is it result of someone injecting insulin? Is it the only evidence of a murder?
Yes you are echoing the GP not contesting it.
I’m not addressing the GP. The parent comment asserts that social equality has been achieved and the social justice movement (as a monolithic group) wants more than equality in opportunity, they want equality in outcomes. I’m merely saying that the initial assumption the parent makes is believed to be incorrect by the social justice movement (that equality of opportunity has been achieved).
But all opinions under the sun are available at our fingertips, so if we judge those who disagree with us by the most extreme of their similars, we’re not going to throw much light on these issues.
But all opinions under the sun are available at our fingertips, so if we judge those who disagree with us by the most extreme of their similars, we’re not going to throw much light on these issues.
What is your basis for equality of outcome being a bad thing? Can you give some examples of what you're talking about?
To me, equity should mean that (for example) a paraplegic can still access most or all of the spaces that a person who can walk can access, which means making sure they have access to a wheelchair and public spaces have wide enough unobstructed aisles for those in wheelchairs to get through. This requires us to examine outcomes, not impartially treat all people the same (since the vast majority of people with the ability to walk wouldn't need the same assistance a paraplegic would).
In a society like ours this also means some people have to make sacrifices - the owner of a hole-in-the-wall restaurant may face difficulties because their current capacity comes at the cost of having narrow aisles, and making their shop accessible would reduce capacity. In some countries (like the US) this is illegal and they can get sued for it. For the owner this is very bad, but the alternative (society is inaccessible to people in wheelchairs) is worse.
To me, equity should mean that (for example) a paraplegic can still access most or all of the spaces that a person who can walk can access, which means making sure they have access to a wheelchair and public spaces have wide enough unobstructed aisles for those in wheelchairs to get through. This requires us to examine outcomes, not impartially treat all people the same (since the vast majority of people with the ability to walk wouldn't need the same assistance a paraplegic would).
In a society like ours this also means some people have to make sacrifices - the owner of a hole-in-the-wall restaurant may face difficulties because their current capacity comes at the cost of having narrow aisles, and making their shop accessible would reduce capacity. In some countries (like the US) this is illegal and they can get sued for it. For the owner this is very bad, but the alternative (society is inaccessible to people in wheelchairs) is worse.
If the restaurant owner has to close up because he can't make enough revenue to be profitable with the accessible floor plan, who has benefitted? Not the owner, not the normally-abled customers, and not the disabled customers. I guess you can say that everyone got the same outcome though.
The challenge of course is that if there is no penalty for doing something harmful to a portion of the population, then people will keep doing it - probably indefinitely.
It might be easier to think of it as a evolutionary process. Adding in things like (enforced) laws around making space for wheelchair clients for a business will select against those that don't do it. That will inevitably result in churn (and cycle of life death/rebirth and associated pain and loss), but as long as there is sufficient presence of the 'species' (to extend the analogy) that does what you want, then it's the equivalent of weeding a garden. Sucks to be the weed, but if no one does it, it turns into a giant mess of bad stuff and everyone loses.
It's also important to not starve by 'weeding out' all your crops. It's a balance.
It might be easier to think of it as a evolutionary process. Adding in things like (enforced) laws around making space for wheelchair clients for a business will select against those that don't do it. That will inevitably result in churn (and cycle of life death/rebirth and associated pain and loss), but as long as there is sufficient presence of the 'species' (to extend the analogy) that does what you want, then it's the equivalent of weeding a garden. Sucks to be the weed, but if no one does it, it turns into a giant mess of bad stuff and everyone loses.
It's also important to not starve by 'weeding out' all your crops. It's a balance.
Equality of outcome tends to skew towards ignoring decisions or actions that individuals take (as they can and are influenced by the environment), and looking at the environment.
The tricky part is, the real world can’t be quantified or modeled in a way that is tractable to humans in a larger way (near as I can tell anyway), so the people and environment get squashed into coarse buckets like skin color, education level, etc. which not only don’t reflect any individuals actual circumstances, but can be gamed in various ways.
Since individuals also respond to the pressures they are under, it makes it easier and easier to see folks who become more and more helpless and take on a victim mindset (aka there is nothing I can do to get better, hold on while I finish this liter of vodka) - because it works in very real ways, and it’s the easy path. And you can’t reliably quantify something like that, it’s usually too subtle or subjective.
This can easily lead (without very careful and mindful leadership - which doesn’t scale, and often doesn’t get selected for either) to essentially co-dependence. If they try to improve, they lose support and/or get kicked out. If they get worse, they get more help.
There are of course plenty of examples of failure and dysfunction the other direction - insisting that someone who is fundamentally screwed by the environment ‘get better’ while not providing any support and/or dishing out beatings for every minor infraction.
And if you set your metric to ‘everyone has the same outcome/rewards’ - well, it is REALLY hard to do well. Fundamentally, you’ll never get a population to all perform the same. As a species we have a wide and diverse set of skills, predispositions, upbringing/parental influences, resources, and other attributes, and there is literally no way to make everyone equally successful at everything without maybe somehow making everyone equal on all those other fronts - which plenty of dystopian novels on THAT.
So if you can’t make everyone equally successful or identical or have the same upbringing/influences or resources, you can get ‘equal outcomes’ another way - anyone who sticks up above the pack gets smacked down until everyone is equal again, or any venue or opportunity that can’t be made equal gets banned. And that does scale, and also has the benefit of being easily measurable and doable. Which is why you see it so often.
Which is also pretty dystopian, as it’s enforced ‘lowest common denominator’ by definition, and tends to destroy any innovation or improvements and slowly (or not so slowly) suffocates the society. It’s easy to go down, it’s hard to go up.
For your example, if we wanted to be 100% sure that everyone in a wheelchair had equal access to everything without some massive improvement in technology - we’d need to pave every backcountry hike (and ban the ones that we didn’t want to spend the money on), ban rock climbing, ban most skydiving, etc.
Which would essentially destroy the experience one was theoretically trying to make equally available.
The tricky part is, the real world can’t be quantified or modeled in a way that is tractable to humans in a larger way (near as I can tell anyway), so the people and environment get squashed into coarse buckets like skin color, education level, etc. which not only don’t reflect any individuals actual circumstances, but can be gamed in various ways.
Since individuals also respond to the pressures they are under, it makes it easier and easier to see folks who become more and more helpless and take on a victim mindset (aka there is nothing I can do to get better, hold on while I finish this liter of vodka) - because it works in very real ways, and it’s the easy path. And you can’t reliably quantify something like that, it’s usually too subtle or subjective.
This can easily lead (without very careful and mindful leadership - which doesn’t scale, and often doesn’t get selected for either) to essentially co-dependence. If they try to improve, they lose support and/or get kicked out. If they get worse, they get more help.
There are of course plenty of examples of failure and dysfunction the other direction - insisting that someone who is fundamentally screwed by the environment ‘get better’ while not providing any support and/or dishing out beatings for every minor infraction.
And if you set your metric to ‘everyone has the same outcome/rewards’ - well, it is REALLY hard to do well. Fundamentally, you’ll never get a population to all perform the same. As a species we have a wide and diverse set of skills, predispositions, upbringing/parental influences, resources, and other attributes, and there is literally no way to make everyone equally successful at everything without maybe somehow making everyone equal on all those other fronts - which plenty of dystopian novels on THAT.
So if you can’t make everyone equally successful or identical or have the same upbringing/influences or resources, you can get ‘equal outcomes’ another way - anyone who sticks up above the pack gets smacked down until everyone is equal again, or any venue or opportunity that can’t be made equal gets banned. And that does scale, and also has the benefit of being easily measurable and doable. Which is why you see it so often.
Which is also pretty dystopian, as it’s enforced ‘lowest common denominator’ by definition, and tends to destroy any innovation or improvements and slowly (or not so slowly) suffocates the society. It’s easy to go down, it’s hard to go up.
For your example, if we wanted to be 100% sure that everyone in a wheelchair had equal access to everything without some massive improvement in technology - we’d need to pave every backcountry hike (and ban the ones that we didn’t want to spend the money on), ban rock climbing, ban most skydiving, etc.
Which would essentially destroy the experience one was theoretically trying to make equally available.
I’d caution you to recognize that the slippery-slope argument you are making requires an engineer’s adherence to an extremely strong definition of “equality of outcome”.
The ADA requires only “reasonable accommodation” which is why you can still have rock climbing walls. Not many people are suggesting that we break everyone’s legs for equity, either.
But most insidious about the slippery slope argument is the implication that since this absurd outcome is the inevitable consequence of addressing equity issues, that we should not try.
This is, respectfully, crap. Yes, we should not ban rock climbing walls. Yes, we should reduce thresholds to help those in wheelchairs. We don’t need a framework that survives being taken to an unreasonable extreme in order to make progress. We are reasonable people who can make judgment calls, not paperclip-making universe-destroying automatons.
The ADA requires only “reasonable accommodation” which is why you can still have rock climbing walls. Not many people are suggesting that we break everyone’s legs for equity, either.
But most insidious about the slippery slope argument is the implication that since this absurd outcome is the inevitable consequence of addressing equity issues, that we should not try.
This is, respectfully, crap. Yes, we should not ban rock climbing walls. Yes, we should reduce thresholds to help those in wheelchairs. We don’t need a framework that survives being taken to an unreasonable extreme in order to make progress. We are reasonable people who can make judgment calls, not paperclip-making universe-destroying automatons.
I take it you skipped the paragraph in the middle pointing out the nature of this and where I was pointing out the slippery slope?
The reality is there are a LOT of real world examples of this going all the way to the far poles, so this isn't hypothetical - and it often gets very murderey. Authoritarians of all stripes tend to take the approach of 'if it isn't working, do it harder', and 'if they don't like it, it's because they're bad/the enemy'. And authoritarians get power when people get scared or unhappy, more often than not.
The 'evening the playing field'/'equality of outcome' approach is literally what was used to justify taking out all the intelligensia and rich folks in Russia and China during the communist revolutions, the 'punish them harder because they keep failing' approach is what is being used to punish minorities in a number of states literally right now in the US - and I could go on.
I don't know why you would assume I think the ADA is a problem. The ADA is a reasonable setup - but it also doesn't guarantee, or attempt to guarantee, equalities of outcomes. It attempts to guarantee a reasonable level of equality of ACCESS and/or accommodations. Which is fundamentally different, and inherently has a reasonability test that can help shut down the real outlier stuff (like wanting to shut down all non-wheelchair accessible climbing walls or whatever).
It's the difference between everyone getting an interview (or an internship) vs everyone being promoted to VP - or it being illegal to have someone who is a VP (in the meaning we have today)
The reality is there are a LOT of real world examples of this going all the way to the far poles, so this isn't hypothetical - and it often gets very murderey. Authoritarians of all stripes tend to take the approach of 'if it isn't working, do it harder', and 'if they don't like it, it's because they're bad/the enemy'. And authoritarians get power when people get scared or unhappy, more often than not.
The 'evening the playing field'/'equality of outcome' approach is literally what was used to justify taking out all the intelligensia and rich folks in Russia and China during the communist revolutions, the 'punish them harder because they keep failing' approach is what is being used to punish minorities in a number of states literally right now in the US - and I could go on.
I don't know why you would assume I think the ADA is a problem. The ADA is a reasonable setup - but it also doesn't guarantee, or attempt to guarantee, equalities of outcomes. It attempts to guarantee a reasonable level of equality of ACCESS and/or accommodations. Which is fundamentally different, and inherently has a reasonability test that can help shut down the real outlier stuff (like wanting to shut down all non-wheelchair accessible climbing walls or whatever).
It's the difference between everyone getting an interview (or an internship) vs everyone being promoted to VP - or it being illegal to have someone who is a VP (in the meaning we have today)
I read your entire post, which is absolutely pointing out the slippery slope. And sure, many others have slipped down this slope.
What I am saying is that your proposed dystopia is not the inevitable result of considering equality of outcome, as you seem to be suggesting, and that one should be very careful when making slippery slope arguments for doing nothing.
Let’s be super clear: dystopias involving murderous authoritarian leadership claiming to act in the name of equity are a problem with murderous authoritarian leadership, not a problem with equity or desiring equitable outcomes, right?
The ADA is an outcomes-focused law, that’s why it comes up in this context. It doesn’t guarantee anything, but few people are arguing for guarantees, and that’s the straw man you’re arguing against.
What I am saying is that your proposed dystopia is not the inevitable result of considering equality of outcome, as you seem to be suggesting, and that one should be very careful when making slippery slope arguments for doing nothing.
Let’s be super clear: dystopias involving murderous authoritarian leadership claiming to act in the name of equity are a problem with murderous authoritarian leadership, not a problem with equity or desiring equitable outcomes, right?
The ADA is an outcomes-focused law, that’s why it comes up in this context. It doesn’t guarantee anything, but few people are arguing for guarantees, and that’s the straw man you’re arguing against.
The ADA is not an outcome (as in success) focused law though? It is a opportunity based law. There is nothing in the ADA saying that everyone with a disability needs to succeed to the same level as someone without that disability, rather that a reasonable accomodation must be made to give them the tools to TRY.
And for the rest, you lost context a bit - I was replying to the comment in the parent post to mine, which asked
'What is your basis for equality of outcome being a bad thing? Can you give some examples of what you're talking about?'
My point is that fundamentally, true equality of outcome (if taken to mean 'everyone gets the same rewards/has the same success') may naively sound nice, even very fair, but is not only impossible, but undesirable when you look at what it would take to try to get there (depending on the degree of course). And when people try to quantify what they mean by 'rewards' it also tends to be obvious that most people's concrete ideas (and scale) of rewards do not line up with each other.
And then gave some examples.
A rephrasing of the idea, is the saying "From each according to his ability, to each according to his needs" (Karl Marx), but there are a great many ways to put it.
There are many non-murderey areas that tend to be eas(ier) to balance, like education. If I've always wanted to be a mathematician, but have no knack for it, does that mean I get infinite tutoring? Most people would say no, and I can't think of anyone that has tried in practice. Many will say 'well, you can get x years of normal education, but if you fail out that's it'. Most will say 'well, you can apply, and if you have good grades, the state can cover it', etc.
Most of those fall on the spectrum of equality of opportunity (aka ability to try/take a swing). Equality of outcomes is when you say 'Everyone should be able to be a mathematician, so everyone (or x percent of everyone) must be a mathematician'. That... gets weirder. What if they don't WANT to be mathematicians? Do we make them? What if their background/interests don't line up, so they hate the studying, and keep failing the tests? Do we fake the numbers? Beat them until they comply? Fail a bunch of everyone else until the numbers match?
This is in no way to downplay very real issues with culture, racism, sexism, etc. that do happen. It's to point out the dangers of taking naive and course metric driven approaches to the problem.
When we're talking wealth, access to jobs and political leadership positions, etc. there is also a long history of it getting much, much uglier.
The particularly murdery/authoritarian examples happen because since it is fundamentally impossible for everyone to actually get the same rewards/outcomes in almost all cases and people can't all agree on what it would concretely mean to even get the same rewards/outcomes, the people in power either give up without succeeding and then get replaced (or rarely, has a coherent enough and smart enough power base that they can give a nuanced and sane answer that is not merely propaganda - looks like Sweden might have pulled that off?), or try harder. In government, try harder often means overpower resistance, purge dissenters, neutralize political opponents who don't support you - to various degrees of brutality. You see it everywhere, in the US, England, Russia, etc. In a revolution, that also usually means lining people up against a wall.
Especially if the power base/population is angry and unhappy, and particularly if it is large (since that typically means the spoils are large for the winners), and since the naive answers sound good, there is huge incentive for someone to also tell people what they want to hear while trying harder, even if they know it's bullshit, and use tools like propaganda, secret police, you name it. It also provides really effective cover to do nasty things in the name of doing the right thing.
There are some really recent historical examples of people getting all the power to try the hardest. Which tends to attract/filter for authoritarian types - probably especially the murdery ones after awhile. See Lenin vs Stalin (or really Stalin vs everyone else who could conceivably challenge his power)
Mao did multiple purges. The Khmer Rouge was.... particularly nasty. All of that was done in the name of helping the everyman and producing a just outcome for the everyday person.
And for the rest, you lost context a bit - I was replying to the comment in the parent post to mine, which asked
'What is your basis for equality of outcome being a bad thing? Can you give some examples of what you're talking about?'
My point is that fundamentally, true equality of outcome (if taken to mean 'everyone gets the same rewards/has the same success') may naively sound nice, even very fair, but is not only impossible, but undesirable when you look at what it would take to try to get there (depending on the degree of course). And when people try to quantify what they mean by 'rewards' it also tends to be obvious that most people's concrete ideas (and scale) of rewards do not line up with each other.
And then gave some examples.
A rephrasing of the idea, is the saying "From each according to his ability, to each according to his needs" (Karl Marx), but there are a great many ways to put it.
There are many non-murderey areas that tend to be eas(ier) to balance, like education. If I've always wanted to be a mathematician, but have no knack for it, does that mean I get infinite tutoring? Most people would say no, and I can't think of anyone that has tried in practice. Many will say 'well, you can get x years of normal education, but if you fail out that's it'. Most will say 'well, you can apply, and if you have good grades, the state can cover it', etc.
Most of those fall on the spectrum of equality of opportunity (aka ability to try/take a swing). Equality of outcomes is when you say 'Everyone should be able to be a mathematician, so everyone (or x percent of everyone) must be a mathematician'. That... gets weirder. What if they don't WANT to be mathematicians? Do we make them? What if their background/interests don't line up, so they hate the studying, and keep failing the tests? Do we fake the numbers? Beat them until they comply? Fail a bunch of everyone else until the numbers match?
This is in no way to downplay very real issues with culture, racism, sexism, etc. that do happen. It's to point out the dangers of taking naive and course metric driven approaches to the problem.
When we're talking wealth, access to jobs and political leadership positions, etc. there is also a long history of it getting much, much uglier.
The particularly murdery/authoritarian examples happen because since it is fundamentally impossible for everyone to actually get the same rewards/outcomes in almost all cases and people can't all agree on what it would concretely mean to even get the same rewards/outcomes, the people in power either give up without succeeding and then get replaced (or rarely, has a coherent enough and smart enough power base that they can give a nuanced and sane answer that is not merely propaganda - looks like Sweden might have pulled that off?), or try harder. In government, try harder often means overpower resistance, purge dissenters, neutralize political opponents who don't support you - to various degrees of brutality. You see it everywhere, in the US, England, Russia, etc. In a revolution, that also usually means lining people up against a wall.
Especially if the power base/population is angry and unhappy, and particularly if it is large (since that typically means the spoils are large for the winners), and since the naive answers sound good, there is huge incentive for someone to also tell people what they want to hear while trying harder, even if they know it's bullshit, and use tools like propaganda, secret police, you name it. It also provides really effective cover to do nasty things in the name of doing the right thing.
There are some really recent historical examples of people getting all the power to try the hardest. Which tends to attract/filter for authoritarian types - probably especially the murdery ones after awhile. See Lenin vs Stalin (or really Stalin vs everyone else who could conceivably challenge his power)
Mao did multiple purges. The Khmer Rouge was.... particularly nasty. All of that was done in the name of helping the everyman and producing a just outcome for the everyday person.
I'm not really sure how to respond to this. The phrase "equality of outcome" only means "everyone must have exactly the same success/income/wealth/accolades/etc" when taken to an untenable extreme, and very few people are making this argument. Most policy people are careful not to take "naive and coarse metric-driven approaches" to the problem, though of course there are plenty of examples of e.g., companies mandating diversity targets etc. that can be seen as naive and treating a symptom rather than a problem.
All that said, the person you originally responded to gave the example of being able to go to a restaurant in a wheelchair, which is exactly what the ADA covers, and it requires taking into account outcomes: asking "can we make reasonable accommodations so that all who would like to eat a restaurant can reasonably do so?" means looking at the outcome of whether a paraplegic (as in the original post) can access the restaurant. You can think of this as opportunity instead of outcome if you like, but it's the example in the original post that you responded to, so I'm not sure your accusation that I "lost the context a bit" is fair. (If anything, it seems that you took "equality of outcome" out of context from the post you are responding to.)
Now, the rest of your post makes it super clear that you are not arguing the same thing as I am.
When I, and I think most people (maybe not Marx?) say "equality of outcome," I mean things like people are equally listened to in meetings, considered for promotions, able to enter the fields they want to enter, able to rent accommodations, etc. and crucially that these things are irrespective of irrelevant attributes like race, gender, sexual orientation, etc., the issues that you note. But very few people are really arguing for ignoring relevant attributes, fewer still are arguing for entirely equal incomes, and basically no one is arguing that everyone "should be able to be a mathematician" despite having no aptitude for math.
I'm going to say it one more time, because you keep not responding to my point: as a society, we can favor equality of outcomes as in the examples above without also "purging dissenters", "neutralizing political opponents", or doing so "to various degrees of brutality".
Murderous authoritarianism simply does not inevitably follow from considering equality of outcomes. Mao, Lenin, Stalin, and the Khmer Rouge are not the inevitable result of considering equality of outcomes, and the argument that "equality of outcomes" is a bad metric because it's fundamentally impossible to improve it without turning into a murderous dictatorship is false, and you've provided zero evidence for it.
All that said, the person you originally responded to gave the example of being able to go to a restaurant in a wheelchair, which is exactly what the ADA covers, and it requires taking into account outcomes: asking "can we make reasonable accommodations so that all who would like to eat a restaurant can reasonably do so?" means looking at the outcome of whether a paraplegic (as in the original post) can access the restaurant. You can think of this as opportunity instead of outcome if you like, but it's the example in the original post that you responded to, so I'm not sure your accusation that I "lost the context a bit" is fair. (If anything, it seems that you took "equality of outcome" out of context from the post you are responding to.)
Now, the rest of your post makes it super clear that you are not arguing the same thing as I am.
When I, and I think most people (maybe not Marx?) say "equality of outcome," I mean things like people are equally listened to in meetings, considered for promotions, able to enter the fields they want to enter, able to rent accommodations, etc. and crucially that these things are irrespective of irrelevant attributes like race, gender, sexual orientation, etc., the issues that you note. But very few people are really arguing for ignoring relevant attributes, fewer still are arguing for entirely equal incomes, and basically no one is arguing that everyone "should be able to be a mathematician" despite having no aptitude for math.
I'm going to say it one more time, because you keep not responding to my point: as a society, we can favor equality of outcomes as in the examples above without also "purging dissenters", "neutralizing political opponents", or doing so "to various degrees of brutality".
Murderous authoritarianism simply does not inevitably follow from considering equality of outcomes. Mao, Lenin, Stalin, and the Khmer Rouge are not the inevitable result of considering equality of outcomes, and the argument that "equality of outcomes" is a bad metric because it's fundamentally impossible to improve it without turning into a murderous dictatorship is false, and you've provided zero evidence for it.
True point about the wheelchair example! I wasn’t using it in the sense of equality of outcome because it really doesn’t apply [https://edeq.stanford.edu/sections/equality-outcome ]. I took the question about equality of outcome and ran with it.
You obviously haven’t been listening to the same news, or were in the same corporate meeting rooms, or have dealt with the HR realities I have.
There are numerous large players right now making it very clear that equality for them is x percent of your workforce is female, or black, or white, etc, and they need to be paid on exactly a specific curve - or else. I’ve had friends who were told (for leadership positions at very well known companies) that they were more than qualified, but weren’t the right color or gender - just in the last year.
It has been made clear that compliance with expected distributions is required [https://www.dol.gov/newsroom/releases/ofccp/ofccp20210201]
And this isn’t a exaggeration. I’ve literally had very senior managers at a FAANG say to me (in diversity training!) ‘well, we have too many white guys here, so let’s start figuring this out’
What you are referring to is equal treatment - which is great! It is not equality of outcome by any definition I’ve seen used. I’ve always seen ‘x percent of workforce is y’ and ‘pay for x workers is z’. And that is exactly the coarse metric I am referring to. And it is, very clearly, being used in the real world right now to do the things you are saying no one is doing. My wife has endless complaints about it, as she is a female engineer and gets bombarded with recruiters that leave no shadow of a doubt they they are talking to her because she is a woman (and they only are interested in woman), and her actual skills are secondary - which pisses her off to no end.
And if you think you can go into any big tech company right now and complain if you notice this happening without being fired - then I have bad news for you. At least the brutality here is low though, and we don’t have to worry about getting shot over it! I’ll take that any day of the week. If you think a lot of the back and forth harassment going on politically isn’t to neutralize political opponents, then I’ve got a bridge to sell you.
And if you read it, I never, ever, said it was inevitable you would end up with a Mao or a Stalin. I said they tend to grow in conditions where the population is unhappy or scared, and is willing to listen to things that sound good but don’t work - and need people to ‘try harder’.
You obviously haven’t been listening to the same news, or were in the same corporate meeting rooms, or have dealt with the HR realities I have.
There are numerous large players right now making it very clear that equality for them is x percent of your workforce is female, or black, or white, etc, and they need to be paid on exactly a specific curve - or else. I’ve had friends who were told (for leadership positions at very well known companies) that they were more than qualified, but weren’t the right color or gender - just in the last year.
It has been made clear that compliance with expected distributions is required [https://www.dol.gov/newsroom/releases/ofccp/ofccp20210201]
And this isn’t a exaggeration. I’ve literally had very senior managers at a FAANG say to me (in diversity training!) ‘well, we have too many white guys here, so let’s start figuring this out’
What you are referring to is equal treatment - which is great! It is not equality of outcome by any definition I’ve seen used. I’ve always seen ‘x percent of workforce is y’ and ‘pay for x workers is z’. And that is exactly the coarse metric I am referring to. And it is, very clearly, being used in the real world right now to do the things you are saying no one is doing. My wife has endless complaints about it, as she is a female engineer and gets bombarded with recruiters that leave no shadow of a doubt they they are talking to her because she is a woman (and they only are interested in woman), and her actual skills are secondary - which pisses her off to no end.
And if you think you can go into any big tech company right now and complain if you notice this happening without being fired - then I have bad news for you. At least the brutality here is low though, and we don’t have to worry about getting shot over it! I’ll take that any day of the week. If you think a lot of the back and forth harassment going on politically isn’t to neutralize political opponents, then I’ve got a bridge to sell you.
And if you read it, I never, ever, said it was inevitable you would end up with a Mao or a Stalin. I said they tend to grow in conditions where the population is unhappy or scared, and is willing to listen to things that sound good but don’t work - and need people to ‘try harder’.
I first encountered the topic when I was in university in the early 2000s, and decided to focus all of my humanities requirements into Black Studies and Black Literature. The professors in these departments were early adherents of the current ideology, and back then it was a lot easier to see where the ideology came from.
My (admittedly shitty) take on it is that these professors benefited tremendously from race-based affirmative action policies, and gradually a set of ideas that were immune from attack and questioning evolved to justify it. The "equity" concept came from that. My favorite memory from these classes was being shouted at by a famous Black poet who was a guest speaker because I questioned her view that poor whites shouldn't be treated any differently than rich whites when it came to admissions. The level of instantaneous emotional reaction was something I had only previously seen when arguing with Biblical creationists. This was when I realized this was quasi-religious ideology that was so firmly attached to the identity of it's adherents that it rendered them incapable of properly assessing reality.
My (admittedly shitty) take on it is that these professors benefited tremendously from race-based affirmative action policies, and gradually a set of ideas that were immune from attack and questioning evolved to justify it. The "equity" concept came from that. My favorite memory from these classes was being shouted at by a famous Black poet who was a guest speaker because I questioned her view that poor whites shouldn't be treated any differently than rich whites when it came to admissions. The level of instantaneous emotional reaction was something I had only previously seen when arguing with Biblical creationists. This was when I realized this was quasi-religious ideology that was so firmly attached to the identity of it's adherents that it rendered them incapable of properly assessing reality.
What is helping people most in need other then giving more to one side at the expense of other?
I joke here, ultimately all society is a form of altruism. Equity is not equality and never has been. Equity in life means making it less likely that random events are liable to make it impossible to live a life. The other word for it is fairness.
We don't achieve that. We have many rules that are obviously stacked for some group or another, and these synergize with each other. The simplest one that is technically available to everyone is inheritance - but of course poor have nothing to leave to their children. Nations make rules that stack the deck for their citizens. Social roles, jobs and their interactions with status are often easily stacked too. And so on.
Genetics are often relatively weak compared to these rules - it mostly comes into play when comparing people from roughly similar backgrounds.
I joke here, ultimately all society is a form of altruism. Equity is not equality and never has been. Equity in life means making it less likely that random events are liable to make it impossible to live a life. The other word for it is fairness.
We don't achieve that. We have many rules that are obviously stacked for some group or another, and these synergize with each other. The simplest one that is technically available to everyone is inheritance - but of course poor have nothing to leave to their children. Nations make rules that stack the deck for their citizens. Social roles, jobs and their interactions with status are often easily stacked too. And so on.
Genetics are often relatively weak compared to these rules - it mostly comes into play when comparing people from roughly similar backgrounds.
> What is helping people most in need other then giving more to one side at the expense of other?
That's a great question and a lot more philosophical than I'm going to get into in HN comments. I was trying to emphasize how framing is important - focusing on reducing privilege is much different than helping those who are starving. Making LeBron James wear ankle weights will further equity in the NBA, but I don't think anyone wants that.
> The other word for it is fairness
Fairness in opportunity, or fairness in outcome?
Neither is possible with the randomness of the world. The only way to reduce the effect of randomness is to make us all exactly equivalent - I can't think of any good ways to do that.
> We have many rules that are obviously stacked for some group or another
Life is inherently stacked for some group or another. Even if we manage to make perfectly "fair" rules (which I don't believe is possible), there will still be disparities between however you want to define groups.
> Genetics are often relatively weak compared to these rules
Depending on the implementation of the rule, I somewhat agree. I don't think our science is advanced enough on the genetic side to determine how much of an impact these rules have.
That's a great question and a lot more philosophical than I'm going to get into in HN comments. I was trying to emphasize how framing is important - focusing on reducing privilege is much different than helping those who are starving. Making LeBron James wear ankle weights will further equity in the NBA, but I don't think anyone wants that.
> The other word for it is fairness
Fairness in opportunity, or fairness in outcome?
Neither is possible with the randomness of the world. The only way to reduce the effect of randomness is to make us all exactly equivalent - I can't think of any good ways to do that.
> We have many rules that are obviously stacked for some group or another
Life is inherently stacked for some group or another. Even if we manage to make perfectly "fair" rules (which I don't believe is possible), there will still be disparities between however you want to define groups.
> Genetics are often relatively weak compared to these rules
Depending on the implementation of the rule, I somewhat agree. I don't think our science is advanced enough on the genetic side to determine how much of an impact these rules have.
> but I don't think anyone wants that
I really hope that's true...
I really hope that's true...
Genetic determinism is pseudoscience that is generally associated with eugenism and scientific racism. Giving this much importance to genes is a fringe belief.
I'm an identical twin.
When you have a genetic duplicate of yourself walking around, it starts to make you wonder about how much is genetically determined vs other factors.
One thing I've noticed is that a segment of highly educated people seem to attribute far more to genetics than they should be.
Your statement "unless you believe in religious concepts such as free will" is pretty shocking, considering that you have embraced a science-based version of Calvinist fatalism.
That being said, I agree with your broader point of helping those in need. It should be noted that the concept of "privilege" isn't the presence of something, but the absence of discrimination and barriers.
When you have a genetic duplicate of yourself walking around, it starts to make you wonder about how much is genetically determined vs other factors.
One thing I've noticed is that a segment of highly educated people seem to attribute far more to genetics than they should be.
Your statement "unless you believe in religious concepts such as free will" is pretty shocking, considering that you have embraced a science-based version of Calvinist fatalism.
That being said, I agree with your broader point of helping those in need. It should be noted that the concept of "privilege" isn't the presence of something, but the absence of discrimination and barriers.
What do you think dictates the actions we take if not genetics? If your answer is free will, or something similar, I agree you might be right but I don't see how to discuss that further.
I think it's not a univariate problem. Our society is plagued by people who desperately want to simplify every problem into a univariate issue.
Genetics has an influence, along with many other factors, because reality is multivariate and complicated.
My twin is significantly overweight. Has been since we were 15. I'm not and haven't ever been. I always enjoyed working out, he didn't. Your univariate view of the world can't explain this.
My twin converted to Mormonism a few years ago. I'm not religious at all. Does genetics explain this?
Starting with our college years, he and I have divergent life experiences. I fathered a child at a very young age, and the child was born extremely premature, and I was subjected to a life and death medical crisis at this age. He wasn't dealing with that. My father views this as being a tremendously powerful factor in our rather potent differences today.
I don't seek to be antagonistic, but my entire life story defies your thesis. Doesn't mean you are wrong, but it certainly means that you are "overfitting" in the classic statistical modeling sense.
And to be fair and defend big chunks of your thesis, my twin and I do have a lot of similarities in our lives that are probably strongly influenced by genetics. But one thing we agree on is that a massive factor in both of us being successful is our difficult childhood. My mother was a schizophrenic who left us when we were toddlers, and doomed my father to raise 5 kids by himself. Our family's income put us below the poverty line, and we were subjected to a lot of trauma and occasional abuse when my father would relapse (alcoholism).
Coincidentally, my brother's ex-wife was a genetic determinist, and a big point of friction was her constant projection of our family history with mental illness onto every behavior she didn't like from my brother or myself. He got a small tattoo on his arm for his 35th birthday(against her wishes), for example, and she attributed this to mental illness. Because that's what univariate thinkers do: They explain reality with a univariate model, and make everything fit that. It's a shitty model, and if it was productized for data science reasons, it would fail miserably.
Genetics has an influence, along with many other factors, because reality is multivariate and complicated.
My twin is significantly overweight. Has been since we were 15. I'm not and haven't ever been. I always enjoyed working out, he didn't. Your univariate view of the world can't explain this.
My twin converted to Mormonism a few years ago. I'm not religious at all. Does genetics explain this?
Starting with our college years, he and I have divergent life experiences. I fathered a child at a very young age, and the child was born extremely premature, and I was subjected to a life and death medical crisis at this age. He wasn't dealing with that. My father views this as being a tremendously powerful factor in our rather potent differences today.
I don't seek to be antagonistic, but my entire life story defies your thesis. Doesn't mean you are wrong, but it certainly means that you are "overfitting" in the classic statistical modeling sense.
And to be fair and defend big chunks of your thesis, my twin and I do have a lot of similarities in our lives that are probably strongly influenced by genetics. But one thing we agree on is that a massive factor in both of us being successful is our difficult childhood. My mother was a schizophrenic who left us when we were toddlers, and doomed my father to raise 5 kids by himself. Our family's income put us below the poverty line, and we were subjected to a lot of trauma and occasional abuse when my father would relapse (alcoholism).
Coincidentally, my brother's ex-wife was a genetic determinist, and a big point of friction was her constant projection of our family history with mental illness onto every behavior she didn't like from my brother or myself. He got a small tattoo on his arm for his 35th birthday(against her wishes), for example, and she attributed this to mental illness. Because that's what univariate thinkers do: They explain reality with a univariate model, and make everything fit that. It's a shitty model, and if it was productized for data science reasons, it would fail miserably.
> My twin is significantly overweight. Has been since we were 15. I'm not and haven't ever been. I always enjoyed working out, he didn't. Your univariate view of the world can't explain this.
Yes it can. You were subject to different environmental factors. These differences can compound to produce very different results over time, but ultimately it is still genetic at the root.
I could respond to the rest of your post but I think this is the crux of your argument.
Yes it can. You were subject to different environmental factors. These differences can compound to produce very different results over time, but ultimately it is still genetic at the root.
I could respond to the rest of your post but I think this is the crux of your argument.
My twin brother and I shared a bedroom from birth until we left for college at 17. Exactly what different environmental factors can you identify between us that would have made him chunky at 15 when I wasn't? Or that made him not enjoy exercise and sports like I did from the age of 8 onwards? Are you going to admit that it pokes massive holes in your univariate theory, or simply continue to double down? Perhaps my side of the room had a dramatically different climate than his, right? It's as if your brain ignored the obvious to continue to support your absurdly simplistic genetic determinism.
It seems like your argument is now "there were differences but there's no way they were big enough to change how we developed". Unless you've got understanding that vastly exceeds current science, I don't think you can say which differences are relevant.
Biology and chemistry exist as disciplines because, even though the laws of physics theoretically explain everything about the universe, it is completely intractable to use them to do so — and it turns out we can construct explanations of the universe at higher levels of abstraction than fundamental physics, and then reason using those explanations.
Your argument seems to be that physics is all we need.
Your argument seems to be that physics is all we need.
"We need to stop treating privilege as something that needs to be corrected and instead focus on helping those most in need."
That is what equity work focuses on? It's not about tearing down and taking away, but about ensuring equal access and opportunity. It only takes away when unfair access has existed - a common example here are "legacy admissions" for university. Inherited spots, in a nutshell.
That is what equity work focuses on? It's not about tearing down and taking away, but about ensuring equal access and opportunity. It only takes away when unfair access has existed - a common example here are "legacy admissions" for university. Inherited spots, in a nutshell.
You have an outdated view on social justice issues -- in fact dangerously close to a view a classic liberal would hold. Current gestalt moved past this outdated view and is now about equal outcomes.
The ability to work hard is not earned, it is genetic. If equity is our goal, we need to make this ability equivalent across all people. I don't think that's what we want, so the term equity is incorrect.
Try reading comprehension. I said equal access and opportunity, not "equivalent across all people".
Also, [citation needed] on your genetics claim.
Also, [citation needed] on your genetics claim.
Um, is your argument that "we could technically classify these random other things as 'privilege' if we really stretch the word, therefore more obviously problematic things related to privilege like family wealth, social status, and race don't need to be addressed?"
Because that's how it reads.
You also built a straw man by deliberately misunderstanding the word "equity." The word has been clearly defined since the Middle Ages and means simply "share of ownership." i.e. To be equitable, a business must pay all its employees both salary and shares in the company. Same as us software devs get.
Because that's how it reads.
You also built a straw man by deliberately misunderstanding the word "equity." The word has been clearly defined since the Middle Ages and means simply "share of ownership." i.e. To be equitable, a business must pay all its employees both salary and shares in the company. Same as us software devs get.
Why is a lucky genetic draw less of a privilege than a large inheritance?
Look at it this way - how much would a rich heir pay to go from ugly and stupid to beautiful and intelligent? I can't imagine a sum large enough that they wouldn't be willing to trade it away.
Look at it this way - how much would a rich heir pay to go from ugly and stupid to beautiful and intelligent? I can't imagine a sum large enough that they wouldn't be willing to trade it away.
It isn’t about whether one is more of a ‘privilege’ than the other. It is about the source of the privilege. We are trying to correct privileges given by society, not the ones given by nature.
"We are trying to correct privileges given by society, not the ones given by nature."
We try to correct privileges given by nature all the time, especially helping disabled people.
We try to correct privileges given by nature all the time, especially helping disabled people.
[deleted]
They are using the now colloquial, perverted, definitions of privilege and equity. Under both these definitions GP’s comment makes sense. Society seems intent on using say whiteness as a genetic marker for privilege which then means those with the marker should be subject to equity correction policies such that the effects of the allegedly conferred privilege are negated. It’s not a straw-man.
Yeah, this is another of those "counterintuitive" takes that are so very popular. Expresses what sounds like legitimate concern about discrimination on the basis of genetics and then "flips the script" halfway through it to tearing down the entire idea of worrying about discrimination. Seductively intellectual nonsense.
> Society currently only thinks a limited set of things - parental wealth, social status, skin color, etc. - are forms of privilege and we should work to reduce them.
That is one way of looking at it. Another way of looking at it is that society reserves privileged status to specific groups and denies this status to others, and that things like parental wealth, social status, skin color, etc are _markers_ of this.
In the United States, I believe the latter aligns with the facts we can observe. This is basically the argument of Isabel Wilkerson in "Caste"[0]. I'm not really up for trying to make the case for why I find this view convincing right now, in this comment I just wanted to highlight that it is a different argument than the one you made. If Wilkerson is correct, the actual markers of privilege are quite arbitrary, and phenomena such as racism arise from this rather than being themselves the root issue. The goal then is not so much ending discrimination as it is tearing down the caste system that fuels it.
[0]https://www.isabelwilkerson.com/
That is one way of looking at it. Another way of looking at it is that society reserves privileged status to specific groups and denies this status to others, and that things like parental wealth, social status, skin color, etc are _markers_ of this.
In the United States, I believe the latter aligns with the facts we can observe. This is basically the argument of Isabel Wilkerson in "Caste"[0]. I'm not really up for trying to make the case for why I find this view convincing right now, in this comment I just wanted to highlight that it is a different argument than the one you made. If Wilkerson is correct, the actual markers of privilege are quite arbitrary, and phenomena such as racism arise from this rather than being themselves the root issue. The goal then is not so much ending discrimination as it is tearing down the caste system that fuels it.
[0]https://www.isabelwilkerson.com/
> Hard work, intelligence, willpower, perseverance are, at the root, all genetic. Environmental factors may influence these traits, but how you react to environmental factors is also genetic...unless you believe in religious concepts such as free will.
This is quite an extreme perspective. By this definition, the ability to read is genetic, the ability to walk is genetic, to talk, etc — these are all genetic, but nearly everyone learns these things because of the “environmental factors” you dismiss as “influence”.
We have way more in common, genetically, than we have differences. Privilege primarily comes from environmental and socially constructed factors, not genetics — unless you’re talking about the Olympic Games, and I’m not sure many are arguing for equity there with respect to genetic gifts (with perhaps the notable and wonderful exception of the Paralympics).
If you think the entire point of “equity” is to tear people down who have too much privilege, respectfully I think you arguing against a straw man and are missing the point.
This is quite an extreme perspective. By this definition, the ability to read is genetic, the ability to walk is genetic, to talk, etc — these are all genetic, but nearly everyone learns these things because of the “environmental factors” you dismiss as “influence”.
We have way more in common, genetically, than we have differences. Privilege primarily comes from environmental and socially constructed factors, not genetics — unless you’re talking about the Olympic Games, and I’m not sure many are arguing for equity there with respect to genetic gifts (with perhaps the notable and wonderful exception of the Paralympics).
If you think the entire point of “equity” is to tear people down who have too much privilege, respectfully I think you arguing against a straw man and are missing the point.
But the groups in need have a strong correlation to non-privileged groups and their history. Other than the general tenor of racial anxiety that runs through HN, I'm not sure how blood markers ends up in a discussion about privilege in western society.
>...Hard work, intelligence, willpower, perseverance are, at the root, all genetic.
Kind of leads down a dark path, but isn't surprising.
>...Hard work, intelligence, willpower, perseverance are, at the root, all genetic.
Kind of leads down a dark path, but isn't surprising.
It's pretty bizarre that an article saying "more antibodies means less infection" (with nothing to do with genetics) spawns a huge comment thread on privilege and racism.
Imagine topics as celestial bodies with certain gravity.
Gravity of the racism-privilege double star is pretty strong right now, at least in the Anglo-Saxon world. An innocent flyby is almost impossible.
Gravity of the racism-privilege double star is pretty strong right now, at least in the Anglo-Saxon world. An innocent flyby is almost impossible.
>Maybe we figure out how to dodge most of those bullets and end up in Star Trek?
Even in Star Trek society didn't dodge those bullets, they just plowed through them and learned from their past.
Even in Star Trek society didn't dodge those bullets, they just plowed through them and learned from their past.
About as much discrimination from having a peanut allergy, asthma, glasses or the many other genetic weaknesses to diseases, foods and other wise.
So going by previous experience nobody would really care in most of human societies. The caring only starts really when it's directly related to performance on a physical job (ex: lifeguard, industrial scuba diver) or it starts effecting your mental behavior.
So going by previous experience nobody would really care in most of human societies. The caring only starts really when it's directly related to performance on a physical job (ex: lifeguard, industrial scuba diver) or it starts effecting your mental behavior.
You are on Ark B.
Deal with it.
Deal with it.
So the big question - did those people who showed high levels of antibodies after vaccination have a) more symptoms from vaccination, b) less symptoms, or c) no correlation?
I had zero symptoms. I'd really like to know if that means my antibodies kicked ass, or were non-existent to create any kind of fever, etc.
I had zero symptoms. I'd really like to know if that means my antibodies kicked ass, or were non-existent to create any kind of fever, etc.
I asked my dad this who's a virologist, and he said this isn't known yet, but it's likely that there isn't really a correlation. The symptoms of the vaccine and the antibody production are caused by two different mechanisms. The first is the innate response which reacts to any antigen and triggers inflammation, fever, etc. The second is the adaptive immune response where your body develops memory B cells which produce neutralizing antibodies that bind to the spike protein and prevent it from entering a cell, and killer T cells which identify infected cells and kill them before the virus can replicate and spread. If you didn't get a fever from the vaccine, it just means that the innate response didn't cause noticeable symptoms, but it doesn't mean that the adaptive response wasn't strong.
A small amount of malaise, drowsiness, arm tenderness, and subclinical fever are expected after any vaccine. It's most probable that you did have symptoms but didn't notice them because you're a normal, active person with other things to think about.
But having zero symptoms, if that was the case, is unusual. It'd be interesting to have your blood tested for antibodies.
But having zero symptoms, if that was the case, is unusual. It'd be interesting to have your blood tested for antibodies.
I had zero symptoms too. I mean, I had very mild tenderness in my arm, but that was a symptom of the muscular trauma from the shot itself, not the actual vaccine.
Same. Sore arm after the first shot. NOTHING after the second.
You all are lucky, I had a pretty bad reaction from the second dose(pfizer) wiped out for two solid days, started feeling better and then boomerang fatigue hit, a half mile walk would leave me so tired I needed to rest for an hour after. I also had heart issues and as a runner(I run 20-30 miles a week) had to stop for almost 2 weeks. Interestingly enough I have a garmin watch and it showed my v02 max also drop by 10% during that time, Dr's attributed it to the vaccine but couldn't be sure. That being said I'll still get the booster if and when it arrives as I would rather deal with those side effects than severe covid or death.
I went hiking for 10 hours right after my shot. Maybe that helped.
Here is one peer reviewed publication that somewhat answers your question [1].
The relevant quote is "Vaccine recipients with preexisting immunity had systemic side effects at higher frequencies than those without preexisting immunity (fatigue, headache, chills, muscle pain, fever, and joint pain, in order of decreasing frequency)" [1]
Other notes from [1]:
- "We wondered what the response would be to the first vaccine dose in persons with previous Covid-19"
- "We took advantage of our ongoing institutional review board–approved, longitudinal PARIS (Protection Associated with Rapid Immunity to SARS-CoV-2) study to provide a limited snapshot of the antibody responses in 110 study participants with or without documented preexisting SARS-CoV-2 immunity (mean age overall, 40.0 years [range, 24 to 68; ≥60 years, 8%]; 67 seronegative participants [64% female] with a mean age of 41.3 years and 43 seropositive participants [59% female] with a mean age of 41.4 years)"
- "Repeated sampling after the first dose indicates that the majority of seronegative participants had variable and relatively low SARS-CoV-2 IgG responses within 9 to 12 days after vaccination"
- "In contrast, participants with SARS-CoV-2 antibodies at baseline before the first vaccine injection rapidly developed uniform, high antibody titers within days after vaccination"
- "The antibody titers of vaccinees with preexisting immunity were 10 to 45 times as high as those of vaccinees without preexisting immunity at the same time points after the first vaccine dose (e.g., 25 times as high at 13 to 16 days) and also exceeded the median antibody titers measured in participants without preexisting immunity after the second vaccine dose by more than a factor of 6"
- "Although the antibody titers of the vaccinees without preexisting immunity increased by a factor of 3 after the second vaccine dose, no increase in antibody titers was observed in the Covid-19 survivors who received the second vaccine dose"
- "Overall, both vaccines (156 participants received the Pfizer vaccine and 74 the Moderna vaccine) had no side effects that resulted in hospitalization"
- "Vaccine recipients with preexisting immunity had systemic side effects at higher frequencies than those without preexisting immunity (fatigue, headache, chills, muscle pain, fever, and joint pain, in order of decreasing frequency)"
- "Because a convenience sample was used and only participants with available data were studied, caution is needed until the full data set, including side effects occurring after the first as well as the second vaccine dose, can be assessed"
[1] Antibody Responses in Seropositive Persons after a Single Dose of SARS-CoV-2 mRNA Vaccine (April 2021) https://www.nejm.org/doi/pdf/10.1056/NEJMc2101667?articleToo...
The relevant quote is "Vaccine recipients with preexisting immunity had systemic side effects at higher frequencies than those without preexisting immunity (fatigue, headache, chills, muscle pain, fever, and joint pain, in order of decreasing frequency)" [1]
Other notes from [1]:
- "We wondered what the response would be to the first vaccine dose in persons with previous Covid-19"
- "We took advantage of our ongoing institutional review board–approved, longitudinal PARIS (Protection Associated with Rapid Immunity to SARS-CoV-2) study to provide a limited snapshot of the antibody responses in 110 study participants with or without documented preexisting SARS-CoV-2 immunity (mean age overall, 40.0 years [range, 24 to 68; ≥60 years, 8%]; 67 seronegative participants [64% female] with a mean age of 41.3 years and 43 seropositive participants [59% female] with a mean age of 41.4 years)"
- "Repeated sampling after the first dose indicates that the majority of seronegative participants had variable and relatively low SARS-CoV-2 IgG responses within 9 to 12 days after vaccination"
- "In contrast, participants with SARS-CoV-2 antibodies at baseline before the first vaccine injection rapidly developed uniform, high antibody titers within days after vaccination"
- "The antibody titers of vaccinees with preexisting immunity were 10 to 45 times as high as those of vaccinees without preexisting immunity at the same time points after the first vaccine dose (e.g., 25 times as high at 13 to 16 days) and also exceeded the median antibody titers measured in participants without preexisting immunity after the second vaccine dose by more than a factor of 6"
- "Although the antibody titers of the vaccinees without preexisting immunity increased by a factor of 3 after the second vaccine dose, no increase in antibody titers was observed in the Covid-19 survivors who received the second vaccine dose"
- "Overall, both vaccines (156 participants received the Pfizer vaccine and 74 the Moderna vaccine) had no side effects that resulted in hospitalization"
- "Vaccine recipients with preexisting immunity had systemic side effects at higher frequencies than those without preexisting immunity (fatigue, headache, chills, muscle pain, fever, and joint pain, in order of decreasing frequency)"
- "Because a convenience sample was used and only participants with available data were studied, caution is needed until the full data set, including side effects occurring after the first as well as the second vaccine dose, can be assessed"
[1] Antibody Responses in Seropositive Persons after a Single Dose of SARS-CoV-2 mRNA Vaccine (April 2021) https://www.nejm.org/doi/pdf/10.1056/NEJMc2101667?articleToo...
Unless you had a second test, it's also highly likely that you had a false positive test, especially since the incidence of COVID in the population is still not that high
https://en.m.wikipedia.org/wiki/Bayes%27_theorem
Read the section on drug testing to see what I mean. The probability of false positives when doing mass testing of mostly healthy individuals is much higher than you would intuit, so it's very possible that you never had the pathogen at all
https://en.m.wikipedia.org/wiki/Bayes%27_theorem
Read the section on drug testing to see what I mean. The probability of false positives when doing mass testing of mostly healthy individuals is much higher than you would intuit, so it's very possible that you never had the pathogen at all
Yes. If I recall correctly the midseason positivity rates of flu tests is something like 40 percent, which suggests doctors are performing a legitimate differential diagnosis before prescribing flu tests. At no point ever have positivity rates been remotely close to this with coronavirus, even though it was far more prevalent.
The result of any individual test performed on a healthy asymptomatic person as part of a nondiscriminating mass screening regime is pure noise.
The result of any individual test performed on a healthy asymptomatic person as part of a nondiscriminating mass screening regime is pure noise.
I meant I had zero symptoms from the vaccine, not covid itself.
I never had covid as far as I know.
I never had covid as far as I know.
I wonder if they also studied T-cell responses. Because depending on the T-cell responses, this might have different implications for how long the vaccine protects people.
T-cell based protection persists while antibody counts wane over time. If these break through cases are a model for people who had their last vaccine shot years ago, it might imply that you need to get vaccinated regularly to actually be protected from symptomatic covid infections. Nobody wants to be affected by symptoms for weeks, but apparently in these break through cases, 19% still had symptoms 6 weeks after their infection.
T-cell based protection persists while antibody counts wane over time. If these break through cases are a model for people who had their last vaccine shot years ago, it might imply that you need to get vaccinated regularly to actually be protected from symptomatic covid infections. Nobody wants to be affected by symptoms for weeks, but apparently in these break through cases, 19% still had symptoms 6 weeks after their infection.
I just found out this week that I don't have the antibodies even though I had the vaccine in March. I also found out that some of my specific T-cells are lower than normal. Likely a side effect from chemotherapy, which was finished in February. Just a PSA that these tests are not included with the normal white cell/neutrophils tests that they give cancer patients. So if you know someone, they might want to ask for an antibodies test and cd4/cd8 test
Was it a spike protein test? If you want to test the response to anything but a inactivated vaccine you have to test for antibodies to a provided component. No vaccine used in the US has anything but spike.
Just curious, did you get flu symptoms from the second dose of vaccine?
I had a bad fever for one night.
Extensive testing between late January and late April 2021 identified 39 workers who had become infected with SARS-CoV-2 despite being fully vaccinated. All had mild symptoms or none at all, but 19% still had some symptoms 6 weeks after diagnosis.
How is that possible?
7 out of 39 people is 17.9%
8 out of 39 people is 20.5%
How is that possible?
7 out of 39 people is 17.9%
8 out of 39 people is 20.5%
It's given as 7/36 (19.4%) in the supplementary material https://www.nejm.org/doi/suppl/10.1056/NEJMoa2109072/suppl_f... I guess 3 people didn't respond to the survey 6 weeks later?
No idea why anyone would downvote this comment. Thanks!
39 workers identified with COVID
36 responded to the survey about symptoms later.
Almost every study, even small and short-term ones, have some dropouts and people who don’t respond to follow ups
36 responded to the survey about symptoms later.
Almost every study, even small and short-term ones, have some dropouts and people who don’t respond to follow ups
Thank you, that's very informative. +1
Maybe they meant 18%.
perhaps the actual number is 19% of those with symptoms. This is an unfortunate reality of getting scientific data from news media - when they're not wrong, they're inaccurate.
It may also be 19% of the undisclosed number who had mild symptoms, excluding those who had none?
"The study, published in The New England Journal of Medicine on 28 July, draws on data from almost 11,500 fully vaccinated health-care workers...testing between late January and late April 2021 identified 39 workers who had become infected with SARS-CoV-2 despite being fully vaccinated. All had mild symptoms or none at all..."
TL;DR the Pfizer vaccine works, essentially 100% of the time as far as severe cases go, more than 99% never getting it at all. I'm glad they're doing the rest of this research, but this part is what I personally am most concerned with.
TL;DR the Pfizer vaccine works, essentially 100% of the time as far as severe cases go, more than 99% never getting it at all. I'm glad they're doing the rest of this research, but this part is what I personally am most concerned with.
"Two doses of the Pfizer/BioNTech or Oxford/AstraZeneca vaccine are estimated to be 96% and 92% effective against hospitalisation with the Delta variant, respectively
Vaccine effectiveness against symptomatic cases with the Delta variant is estimated to be 88% after both doses of the Pfizer/BioNTech vaccine and 67% after both doses of the Oxford/AstraZeneca vaccine."
Source:
https://www.ons.gov.uk/peoplepopulationandcommunity/healthan...
Vaccine effectiveness against symptomatic cases with the Delta variant is estimated to be 88% after both doses of the Pfizer/BioNTech vaccine and 67% after both doses of the Oxford/AstraZeneca vaccine."
Source:
https://www.ons.gov.uk/peoplepopulationandcommunity/healthan...
"A full course of the Pfizer-BioNTech vaccine is 64% effective at preventing symptomatic Covid-19, according to an early study by Israel’s health ministry reported Monday, much lower than previous estimates of nearly 90%.
The vaccine still appears to be highly effective, 93%, at preventing serious illness and hospitalization, the data shows, though this is also slightly lower than earlier studies suggested and for other variants."
Source: https://www.forbes.com/sites/roberthart/2021/07/06/pfizer-sh...
The vaccine still appears to be highly effective, 93%, at preventing serious illness and hospitalization, the data shows, though this is also slightly lower than earlier studies suggested and for other variants."
Source: https://www.forbes.com/sites/roberthart/2021/07/06/pfizer-sh...
Also important and useful, but that's a different percentage. That's the percentage reduction as compared to a non-vaccinated (hopefully otherwise matched) group. This is the percentage of the population (here, healthcare workers) who got it. Which, frankly, is the percentage I care more about, personally, although for Phase 3 testing of vaccines of course the percentage you're talking about is what matters.
Given that my daughter, who got the Pfizer vaccine, is unlikely to be exposed to covid-19 virus MORE often than a typical healthcare worker, this is good news. I wish we had as good a study for Moderna and J&J, but hopefully we get one soon.
Given that my daughter, who got the Pfizer vaccine, is unlikely to be exposed to covid-19 virus MORE often than a typical healthcare worker, this is good news. I wish we had as good a study for Moderna and J&J, but hopefully we get one soon.
There wasn't a set of unvaccinated health care workers as a control so the science doesn't prove that TLDR. The fact that there was no severe symptoms is encouraging though.
I'm also very happy that studies like this are being done. We need a whole lot more studies looking at this, long term immunity with B and T-cells, and comparing neutralizing antibody levels between vaccinated and unvaccinated who have been infected but show little or no symptoms.
I'm also very happy that studies like this are being done. We need a whole lot more studies looking at this, long term immunity with B and T-cells, and comparing neutralizing antibody levels between vaccinated and unvaccinated who have been infected but show little or no symptoms.
On a long enough timeline, 99% turns into a much lower cumulative probability number - even if it doesn't weaken over time.
That's why it's essential to work towards having the whole world vaccinated, and to understand that weakening so we can do boosters where appropriate.
That's why it's essential to work towards having the whole world vaccinated, and to understand that weakening so we can do boosters where appropriate.
Recent statistic I heard from an ER physician in Cincinnati, Ohio: several hundred people currently in the ICU city-wide with COVID (probably delta variant), only 2-3% of them are vaccinated.
Vaccinated people can get the delta variant (though with a lower probability of infection) but are often asymptomatic or have a very mild case. The vaccine is highly effective (>95%) at preventing severe COVID even if infection occurs. Unfortunately the vaccinated can spread delta even if they have no or mild symptoms.
In Ohio vaccination rates are high in the cities and low in rural areas, which unfortunately are also the areas under-served by hospitals.
Vaccinated people can get the delta variant (though with a lower probability of infection) but are often asymptomatic or have a very mild case. The vaccine is highly effective (>95%) at preventing severe COVID even if infection occurs. Unfortunately the vaccinated can spread delta even if they have no or mild symptoms.
In Ohio vaccination rates are high in the cities and low in rural areas, which unfortunately are also the areas under-served by hospitals.
The question will be whether Pfizer will become less effective for example 6+ months after getting it...
...also, being health-care workers, these 11,500 people were virtually guaranteed to be around someone sick with covid-19 more than a member of the general population.
To me as a layman, this reads as a "water is wet" study - what am I missing here?
It's confirmation that the vaccines work the way we expect them to work. Also, this may help identify people that need a (or more) booster shots, or people that should be more careful even though they were vaccinated. Also it provides an explanation for people getting Covid after vaccination (breakthrough Covid as they call it here). Now you can say to people that scream: "Look they got vaccinated and still got Covid!" what likely happened and why that doesn't mean the vaccine is not doing what is should, in the population.
For example the people without (or lower concentrations of) antibodies may share certain traits/attributes (like recently undergoing chemotherapy I read in this thread somewhere), if we know that, we can avoid vaccinating these people too early (and thus needlessly) after treatment and we know we should protect them in another way.
It may all seem obvious, but I can tell you (as somewhat of a scientist myself), that any of these things could easily have been found to be not true and we'd have had to deal with that. Biology is complex, if we would have had to change models of how we think the vaccine works, that could have real world implication for how we deal with (partially) vaccinated populations for example.
I wonder if one's reaction to the vaccine is a measure for the magnitude of one's immune reaction and related to the effectiveness of the vaccine. I for one slept for 14 hrs after my first shot and spend another half day in bed feeling like I had the flu after the second. I'd like to thing I'm well protected now, but who knows. Only studies like this one can prove such hypotheses.
For example the people without (or lower concentrations of) antibodies may share certain traits/attributes (like recently undergoing chemotherapy I read in this thread somewhere), if we know that, we can avoid vaccinating these people too early (and thus needlessly) after treatment and we know we should protect them in another way.
It may all seem obvious, but I can tell you (as somewhat of a scientist myself), that any of these things could easily have been found to be not true and we'd have had to deal with that. Biology is complex, if we would have had to change models of how we think the vaccine works, that could have real world implication for how we deal with (partially) vaccinated populations for example.
I wonder if one's reaction to the vaccine is a measure for the magnitude of one's immune reaction and related to the effectiveness of the vaccine. I for one slept for 14 hrs after my first shot and spend another half day in bed feeling like I had the flu after the second. I'd like to thing I'm well protected now, but who knows. Only studies like this one can prove such hypotheses.
in short, water is wet studies, and water isn't dry studies are important, in case water is only wet under certain conditions.
So this is more of a “is ice wet” study?
Good points, but I have to say that at least the summary article smells of reductionist science to me. It's both "water is wet" and "water is the only way to put out a fire" at the same time.
Even if there is a "statistically significant" correlation between (lack of) this particular marker and breakthrough infection, it is still at least as possible that immunity requires a coordinated response from several parts of the immune system, with no part particularly dominant. A weaker response by one part could be compensated for by another part. If you're not good at neutralizing the virus but you're really good at preventing it from entering, you may be just as ok as someone with opposite strengths.
Another way to say that is that there very well might not be a relevant threshold of this one marker, or the threshold may be so extreme as to be uninteresting. We might need to combine additional markers.
(I really ought to read the actual study before nitpicking on its reporting, though.)
Even if there is a "statistically significant" correlation between (lack of) this particular marker and breakthrough infection, it is still at least as possible that immunity requires a coordinated response from several parts of the immune system, with no part particularly dominant. A weaker response by one part could be compensated for by another part. If you're not good at neutralizing the virus but you're really good at preventing it from entering, you may be just as ok as someone with opposite strengths.
Another way to say that is that there very well might not be a relevant threshold of this one marker, or the threshold may be so extreme as to be uninteresting. We might need to combine additional markers.
(I really ought to read the actual study before nitpicking on its reporting, though.)
"Look they got vaccinated and still got Covid!"
And people still die with seatbelts. If these people were around 100 years ago we'd still be suffering from polio.
And people still die with seatbelts. If these people were around 100 years ago we'd still be suffering from polio.
I guess they're expecting the vaccine to, you know, confer immunity? Like how nearly every vaccine except the mRNA ones do
Maybe they're expecting the vaccine to stop the transmission of the virus to others? Like how nearly every vaccine except the mRNA ones do
Maybe they're expecting the vaccine to stop the transmission of the virus to others? Like how nearly every vaccine except the mRNA ones do
No vaccine has ever conferred absolute immunity to everyone.
The covid mRNA vaccines are extremely effective, far superior to the alternatives (the US is very fortunate to have never approved AstraZeneca), so I have no idea why you'd mention them in particular.
The covid mRNA vaccines are extremely effective, far superior to the alternatives (the US is very fortunate to have never approved AstraZeneca), so I have no idea why you'd mention them in particular.
"The delta variant is now the dominant strain of SARS-CoV-2 in Israel, where researchers now estimate that the two-shot Pfizer vaccine is only 39% effective in preventing an infection within the country."
Source: https://www.salon.com/2021/07/28/pfizer-vaccine-less-effecti...
Um yeah, they're great.
Source: https://www.salon.com/2021/07/28/pfizer-vaccine-less-effecti...
Um yeah, they're great.
It is not well known how many doses we need to get near full immunity. Some other vaccines require up to 3 doses https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html
Sounds like goal post shifting honestly. The mRNA clinical trials were done with 2 doses. It was sold as 90%+ effective on the 200 people they studied (erroneously claimed as over 40,000 people but I digress - that's information for only detailed oriented people to discover).
Now suddenly a 3rd is necessary? What happens when that fails, a second booster? A yearly vaccine like the flu shot (which barely works anyways)? Unfortunately for us humans, nature finds a way.
Speaking of nature, you know what confers full immunity? Having the infection and then recovering or having cross reactive immunity from a previous coronavirus strain.
Natural immunity is the undisputed champion of immunity.
Now suddenly a 3rd is necessary? What happens when that fails, a second booster? A yearly vaccine like the flu shot (which barely works anyways)? Unfortunately for us humans, nature finds a way.
Speaking of nature, you know what confers full immunity? Having the infection and then recovering or having cross reactive immunity from a previous coronavirus strain.
Natural immunity is the undisputed champion of immunity.
Remember, these vaccines were developed for the original variant, goal post have not been shifted. Reality is. Nobody imagined that r0 would grow from 2.5 to 6.4 in such short time. Even infection does not give full immunity but so far it appears to be better than vaccines. Besides it comes with very heavy cost without vaccination. With vaccination it might be possible without heavy losses.
You mean like adenovirus vector vaccines do or inactivated virus Sinovac?
There is nothing to do with mRNA vaccines here.
There is nothing to do with mRNA vaccines here.
Reference link has more details:
“ Results Higher levels of all immune markers were correlated with a reduced risk of symptomatic infection. Vaccine efficacy of 80% against primary symptomatic COVID-19 was achieved with an antibody level of 40923 (95% CI: 16748, 125017) and 63383 (95% CI: 16903, not computed (NC)) for anti-spike and anti-RBD, and 185 (95% CI: NC, NC) and 247 (95% CI: 101, NC) for pseudo- and live-neutralisation assays respectively. Antibody responses did not correlate with overall protection against asymptomatic infection.”
https://www.medrxiv.org/content/10.1101/2021.06.21.21258528v...
Does anyone know which units these use and how to convert to AU/mL?
Does anyone know which units these use and how to convert to AU/mL?
That's the study mentioned as "earlier data" in the Nature article. The newer study that the article is mostly talking about is the first reference, https://doi.org/10.1056/NEJMoa2109072 .
I believe these are AU. Only it's AU not as in astronomical units, but arbitrary units. And they are likely arbitrary in a different way than whatever values you have in mind.
These are used in cases where you can measure something, such as the how dark some liquid gets after some reaction, but cannot, or don't bother, to turn that into some "real" number such as the number/concentration of particles in the liquid causing the effect.
So these units are comparable across several experiments or measurements using the same protocol. Sometimes they are tied to the equipment used and can be compared to other data from the same equipment. But other than that, only the relative values or, as in this case, the finding of proportionality is meaningful.
These are used in cases where you can measure something, such as the how dark some liquid gets after some reaction, but cannot, or don't bother, to turn that into some "real" number such as the number/concentration of particles in the liquid causing the effect.
So these units are comparable across several experiments or measurements using the same protocol. Sometimes they are tied to the equipment used and can be compared to other data from the same equipment. But other than that, only the relative values or, as in this case, the finding of proportionality is meaningful.
Thanks for explaining! So in other words these cannot be compared with unrelated studies or test results.
Find experiments using the same instruments, and you can compare raw numbers, sometimes.
But, to get a general idea: just look at the values they got across their population, remove any extreme outliers, and put it next to some chart using units you want to convert to. Make sure they are on the same scale (i. e. linear or log). The mean and other quantiles should correspond.
Or, depending on what you're looking for, just eyeballing fig. 1 (https://www.medrxiv.org/content/medrxiv/early/2021/06/24/202...) itself might be enough. It shows (little surprise) that the bulk of measurements cluster in "safe" territory. That asignificant number of people show stronger reactions than that bulk, by sometimes orders of magnitude, but don't derive (much/yet) additional protection from it. And that a number of individuals show a weak response and are at risk, without that group being distinct from the rest in any specific way. Rather, it's a continuum
But, to get a general idea: just look at the values they got across their population, remove any extreme outliers, and put it next to some chart using units you want to convert to. Make sure they are on the same scale (i. e. linear or log). The mean and other quantiles should correspond.
Or, depending on what you're looking for, just eyeballing fig. 1 (https://www.medrxiv.org/content/medrxiv/early/2021/06/24/202...) itself might be enough. It shows (little surprise) that the bulk of measurements cluster in "safe" territory. That asignificant number of people show stronger reactions than that bulk, by sometimes orders of magnitude, but don't derive (much/yet) additional protection from it. And that a number of individuals show a weak response and are at risk, without that group being distinct from the rest in any specific way. Rather, it's a continuum
It is not exactly a novel development that infection is neutralized by neutralizing antibodies, and the way the article is written suggests the existence of some cross-sectional variation whereas the more plausible explanation is a longitudinal decline in neutralizing antibodies beyond a sterilizing threshold, despite a more durable presence of binding antibodies which may be responsible for diminishing the severity of breakthrough disease. This is also suggested by the fact the ratio of binding to neutralizing antibodies shortly after full vaccination is very high, something like 4-to-1, which ratio likely explains why the dosing had to be so violently high. What I think was unexpected is the pace of decline in neutralizing antibodies, and possibly also the rising threshold of sterilizing immunity under the newly prevalent variants.
One thing that bugs me with studies like this is the lack of prior study. Unless I am unaware, there isn't an ongoing study of a large random group of people to determine infection rates, hospitalization/death rates, and antibody levels before and after the vaccine/infection. A robust study like this would also bring clarity to the variant debate.
There is no apparent way to know if the people who were breakthrough infections had previously not been infected. It is possible the people who did not have breakthrough infections, may have had previous exposure/infection that prevented the breakthrough.
A large, long running random selection study is desperately needed to get any true sense of what has been going on the for the past year+. I am unsure if the University of Padua Vò Study is still ongoing. I hope so.
There is no apparent way to know if the people who were breakthrough infections had previously not been infected. It is possible the people who did not have breakthrough infections, may have had previous exposure/infection that prevented the breakthrough.
A large, long running random selection study is desperately needed to get any true sense of what has been going on the for the past year+. I am unsure if the University of Padua Vò Study is still ongoing. I hope so.
> The latest study does have drawbacks. It is based on a small number of cases among young and healthy adults, which limits its application, says Andrew Fiore-Gartland, a biostatistician at the Fred Hutchinson Cancer Research Center in Seattle, Washington. More studies from vaccine trials are expected soon, he says.
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I have yet to hear any news on some kind of mRNA-based booster based on the delta and gamma variants.
So genetics DO matter when it comes to vaccines.
and mostly probably life style
Was there ever a doubt about this? After all, if you don’t have a fairly standard human immune system the vaccine isn’t going to do anything at all for you.
So I know this isn't your point, but your comment made me think, does it actually require any type of human immune system? The vaccine exposes you to viral protein which causes an immune response. Wouldn't that work in other species no matter the implementation details of how their immune system generates that response?
Probably, but the article isn't about genetics.
The "blood marker" in question is anti-COVID antibody titer. That's not genetic. (It may turn out to have a genetic component, but that has nothing to do with this article.)
This seems self-evident, really - 'virus-blockers help block the virus' hardly seems newsworthy. IF they'd worked out the 'threshold of protection' mentioned at the end, that might be more interesting, but this article seems like it should be a footnote in that larger piece (when it comes) rather than something worth reporting on its own.