CharonY

You mean the unreferenced wikipedia link vs the references I have given above? I mean, you do you, but it is funny that the link you provided actually does not support your claim (and it is actually in the range of the references given so no big discrepancy there, really). I will concede that the comment regarding underestimation based on CFUs is a bit technical and is more of an ongoing discussion in the community whereas safety regulations still rely on this method (the alternative techniques we have been using is based on flow cytometry, which is becoming more prevalent in food and water testing). So the estimate of 10-100 cells given above (but not 1) is a fair estimate, if you choose to ignore the above caveat regarding the limits of plate counting. And I do apologize to OP for taking it so far off-topic.

In the graph there were actually three periods when taxes went down. The clearly did not refer to the amount of reduction, but the fact that reductions happened. There are also economic reasons why taxes go up in certain countries in certain periods which is not caused by governmental desires to increase taxes: I am not sure what the graph you posted means. It appears that income is rising faster than taxes since the 2000s whereas taxes where much higher and rose more sharply with income until the 70s/80s? (by eyeballing it)? Also, it looks like the values are not inflation-adjusted, so basically any non-normalized monetary plot would go up over the years.

Could you clarify that? To me a claim of "always increases" would indicate that values only go up. If there are periods where it decreases it would invalidate that claim.

One can only hope. This pandemic has been a bit disillusioning. I suspect I should focus on the positive parts, but it is hard to see things opportunities to do something to slip through one's fingers over and over and seeing no willingness to change the approach.

I mean there were arguments that seatbelts were unsafe and similar things in the past: https://www.businessinsider.com/when-americans-went-to-war-against-seat-belts-2020-5 At this point I am almost convinced that in human history there are no original discussions left anymore. We just keep rehashing old things and convince ourselves that somehow we are making progress.

To me that sounds a lot like ideological waffling. If the issue is laid out as a health order and non-compliance is fined I do not see how blameworthiness is a principle. One could argue whether one should have health orders or regulations at all, as one would put blame on those who violate those orders. But that would seem a bit silly. I also do not see how fines for lack of vaccination lead to denial of health care. Folks have been fined for breaking various rules and I do not see vaccination as something fundamentally different from that perspective. Another example would be drug abuse. It is a behaviour that is under penalty, yet in Canadian law there are provisions that ensure that folks requiring medical treatment because of drug abuse are actually treated like everyone else. So while clearly drug abusers are blamed for their behaviour (and criminally persecuted, no less), the health care system survived it. As such it does look like another case of slippery slope fallacy. It is not to say that penalties for vaccinations may be a great solution and there might be better ways. I just find these specific arguments not very convincing.

Well, not mine, but that is exactly it. How the public act is a complex confluence of internal factors and includes but is not exclusively based on government responses. As you may have noticed, the USA did not suddenly became sane after the government switched. In contrast, the Trump administration likely did cater to anti-vaccination folks so much in part because they wanted to cater to their base. After all, pretty much the whole top of the GOP were first in line to get the vaccine, while questioning their effectiveness in front of their voters.

I suspect they might be referring to some misinterpretations that have been circulating in social media apparently (I have not seen the posts, but have been made aware of them). Basically a pre-print found that vaccinated folks who got infected produced fewer antibodies targeting the N-protein of the virus. In this context I think it is helpful if we get away from the notion of "strong" vs "weak" immune responses. The problem is that a "strong" response, can actually be harmful (cytokine storms are the most famous example). What we need is an "effective" response. I.e. a response that helps clearing the pathogen without or with minimal harm to the patient. Going back to the results, current vaccines target the S-protein of the virus. In other words, once an infection is detected, the vaccine-primed immune system will predominantly mount responses to this target. If effective, the response to the N-protein is going to be weaker than in folks who are not vaccinated, because, well, they don't need it. The virus is predominantly cleared using the S-protein as target. I.e. phrasing it as either a strong or weak response can create a bit of a misunderstanding of how things actually work and how effective the overall response is going to be to avoid serious illness.

No, I was referring to the minimal infective dose and I was also referring to adult dosages as unless I missed something we were not talking about children. But more importantly, for children the numbers are even less certain than for adults. A challenge is that to establish these values, the most accurate way is to feed people defined doses. But generally you cannot do it with children and also you don't do it in cases where serious illness is likely (as is with EHEC). There, we use a few ways to provide estimates, but obviously a large error bar is attached to those. While I have seen a study which estimated something between 10-100 cells, if you look a t more estimates, the values are pushed up closer to 500 for EHEC. For Shigella dysenteriae there is actually a paper with volunteers (very small cohort) where a dose of 10 cells caused symptoms but that is probably close to the lower limit. While the numbers might be reasonable and make sense given the reported dosages for adults (and obviously children are more susceptible), I note that they are still higher than one bacterium (and therefore significantly higher in adults) and perhaps more problematic, it is unclear where the values come from as no studies are cited. But given the issues I mentioned above, it is unlikely that one can establish ID1 or ID50 doses with EHEC in humans. There is one estimate that places the minimal infective dose in the area of S. dysenteriae (and considering the actions of the Shig toxin might not be entirely unreasonable). But to provide an example how these estimates are done. One of the lowest values I am aware of were reported by Tilden et al. (Am J Pub Health, 1996 86:1142-1145). Here they investigated bacterial titer in salami from which folks got sick and based on self-reporting of patients of how many slices of salami they consumed and the bacterial load they found in samples they estimated numbers between 2-45 cells causing the disease. As you can imagine, each step is rather prone to errors. Moreover the data is based on four patients, of which 3 were under the age of five. Another issue is that traditionally, bacterial titer is estimated from colony forming units, isolated from food. Newer analyses which focuses more on microscopic analyses indicate that these may often result in lower actual bacterial presence (depending on from which matrix you isolate and how you cultivate the colonies). I will say that due to lack of data the original estimate I provided (10-100) as lower bound might not be entirely unreasonable, but there is good reason to believe that it is at least somewhat higher. There is no data to support single-cell infections, however (which would be almost impossible to assess in either case).

One of the reasons why Japan had better outcomes despite lack of restrictions was that folks for example wore masks without mandate. Meanwhile, in Canada you see uptick in signal whenever such mandates are lifted. Behavioural responses are critical in a pandemic.

As with all bacterial infections, it needs to overcome defenses, find a niche to colonize and compete with existing bacteria. Every part in our body that can be colonized, already is. A lone bacterium arriving in the gut even after passing the stomach will face billions and of others already occupying the niche and denying them nutrients. Pathogens have nifty tools to carve a niche, by e.g. using toxins and/or effector proteins that mess with the host and remodeling the environment for them. Even so, a single cell has little chance to be successful in acquiring enough resources to compete. Therefore, often pathogens use quorum sensing to regulate pathogenicity factors. If they are alone, they try to stick around but cause no disease. But once there are enough coming in, they communicate with each other and start producing toxins and other factors, which make the host sick. BTW, my wife, who is more on the clinical side mentioned that infectious dose I mentioned was likely an underestimate based on an error in one early paper on EHEC. About 500-700 cells are more likely, which is still considered very low for a food-borne pathogen. In folks with stomach acid issues they might be lower, but just physically a single cell (except of in vitro, perhaps) is unheard of.

Actually, up on re-reading OP there non-government factor such as population compliance has been mentioned. And I believe I vaguely remember a short discussion in this thread regarding behavioural norms (though I might be confusing it with something else). Nonetheless given the scope of OP I think a broader discussion makes a lot of sense. After all, a great governmental plan is pretty much meaningless if the population does not follow it.

All of the ones mentioned are able are food-borne diseases, i.e. they are able to survive and multiply after ingestion (which is why I listed them, though intestinal infection with C. botulinum is perhaps less common). But as I mentioned, a single EHEC is very unlikely to establish infection (for a variety of reasons, some related to the pathobiology and expression of the mentioned Shiga toxin, which is partially regulated via quorum sensing and requires some cell density in order to establish successful infections and to compete with the existing microbiota, which includes other E. coli), though 10-100 is pretty much at the lower end of observed dosages for bacteria.

I do not think they can be as low as a single bacterium, but EHEC has been reported as low as 10-100 bacteria. However, much of its action is due to the Shiga toxin. Among gut infections I would probably be more worried about Clostridium difficile which is extremely difficult to get rid off (due to high resistance to antibiotics). The toxin of Clostridium botulinum is of course famously nasty though luckily not that common. Listeria are also nasty, with a case fatality perhaps around 5x that of EHEC. They can grow slowly at low temp, but typically do not exhibit gastrointestinal symptoms. Instead often unspecific symptoms of inflammation are found making it often very difficult to diagnose. One should also make sure that the lines are not e.g. leaching lead. One thing I learned from colleagues who are specialist for water safety is that in many first world countries (including Canada, USA and perhaps also Australia) there are often surprisingly few mandatory regulations. Now, I proceeded to put my fingers in my ears and pretended not to have heard it, so I am a bit hazy on the details but my faith in drinking water has been shaken a little bit. But from what I understand is that while the overall guiding principle is that the water is safe to drink, it can vary regionally what it means in terms of e.g. bacterial load or how frequently the sources are tested for such or other contaminations (or which contaminations are regular tested for).

I am not entirely sure what relevance that has. If we focus on Canada, in the smallpox epidemic in Montreal (1880s) resulted in mandatory vaccination efforts which were almost immediately met with riots. In response to the Vaccination Act passed shortly after the epidemic. Various anti-vaccination groups formed in response and among them the Anti-Vaccination League of Canada. Throughout the early 1900s lengthy back-and-forth between medical boards and the anti vaccination group(s) followed, with many arguments that we see today (i.e. harm of vaccines, limits of personal freedom etc.). There was far more dismissal of layperson at the time with call for trust in the medical profession, but otherwise, well much of it could be facebook posts. Incidentally there were also hiccups in vaccine rollout and so on. Based from these movement, numerous successor groups formed, and persisted through postwar times and after effective end of smallpox in 1979 they focused on pertussis vaccines. Some of their "successes" include the amendment of to an 80s act which barred children from folks if they were unvaccinated to allow exemptions based on conscience, on top of religious exemptions. There were also other, international groups throughout starting from the beginning of mass vaccinations and having various impact on legislature. I.e. there were many, many organized anti-vaccination efforts in Canada, and chances are that you simply have not followed those discussions. Probably in part because you were young and not directly exposed to anti-vaxxers. Nowadays folks overshare and they seem to be everywhere as a result. To me it seems that is what Quebec is doing. They mandate the vaccine and if you don't comply (and have no exemption) you'll be fined. I am not sure what the alternative is beside jailing or forcibly injecting, both of which would probably even more problematic (I mean, some have mentioned using modified blowdarts...).

Perhaps you could explain the difference a bit better. From the report it seems that unvaccinated folks would suffer a financial penalty and in various reports they were called "fine", "tax", "fee" or simply "penalty". So I am not entirely sure why you think that it is not a fine. Other countries are imposing penalties, too and, as mentioned it has happened in the past. I kind of fail to see a difference that you seem to see in what Quebec is doing, so perhaps you could elaborate the issue a bit. I have not seen details on the mechanism of the penalty so I am hazy how it is supposed to impact health care system. That's fair, but I think we have drifted quite a bit in various direction in the rather lengthy thread, since we are back on track, I suppose the intermission won't hurt too much

The latter part is quite critical and age is also an issue. A parent (~80s) of a friend died shortly before vaccines became available. While the infection was diagnosed, the complications set in so fast that they died before much could be done. Another elderly relative of a colleague was fully vaccinated but got infected. Detoriation was much slower but the hospital ran out of ventilators... Looking at infection numbers we are measuring (and estimating the part that we are not measuring), I get chills (hopefully just a psychological reaction) just thinking what would have happened if Omicron hit us without vaccines.

Depends a bit on study and reporting as well as the precise distinction between obesity and overweight. But looking at obesity brackets of BMI >30, studies often find perhaps a 5-8% difference between these countries. It should also be noted that not only obese folks are at risk, there is a steady increase of risk with increasing BMI (though it jumps a bit when we get to BMI >35). Nonetheless, the obesity/overweight levels in UK (~65%) are close enough to the US that they alone would explain observed differences. It is interesting to note that in many countries vaccination rates jump a bit with major events (such as vaccination mandates or new variants), indicating that some holdouts are not fundamentally opposed to vaccination but that they are doing a kind of personal cost/benefit calculation. Some surveys have shown that the ability to go to clubs or similar venues contributed quite a bit to vaccination willingness. Based on anecdotes from students quite a few (even after such a long time in the pandemic) they still assumed that it was not important for them and only decided to get vaccinated because they needed it e.g. for travel or getting on campus. That, somewhat frighteningly, highlights how badly informed the presumed next generation of intellectual elites is.

Absolutely, my wife has used some old headlines as well as some snippets of discussions and articles from the 1918 pandemic in her classes. And only after discussion she revealed from when these articles where from. The fun bit is that many students picked up on the old arguments (e.g. vaccine safety, or the idea of naturally boosting your immune system) while thinking that these are new ideas based on latest science, showing the circular nature on how we are dealing with outbreaks. Yes that's how I feel. Sometimes it goes so fast, I hardly trust my own memories. I now slowly understand why some older folks kept archives of newspapers at home...

Oh gosh, if we had a child we would be done for. It is hard enough to keep the students safe (in the lab) and instead of winding down our COVID-19 work (as funding agencies were suggesting) things are picking up (been writing reports until 4AM and decided to just continue). I hope you all stay healthy!

On top of that, testing has been a bit of a problem in the US. While tests are always underestimating the true spread of SARS-CoV-2, the UK has a better and somewhat more centralized system in place. Especially during the ongoing Omicron surge, many areas in the US are likely disproportionately underreporting cases. I.e. in the US we are likely looking at a far more severe spread. The analysis in the article only looks at hospitalization per population and not relative to cases, and therefore misses on important context.

I think part of it is that we often build narratives for our own personal histories and then also apply them to the past and future. It sometimes feels that we only have a short-lived bubble of reality and anything beyond that is susceptible to distortions of own memories as well as external narratives (I don't think I am expressing myself clearly here, but right now I am too tired to try to formulate it properly). In a way, the amount of information we got nowadays made us remember less, not more, I feel sometimes.

Also, starting in Victorian times in the UK and elsewhere vaccines against e.g. smallpox were mandatory. Fines were implemented due to non-compliance. It was basically the same issue as now. If there was a slippery slope, we would expect progression somewhere. Yet here we are pretending that this new, indicating that no slope is present. We are back at the top of the presumed slide again. Moreover tax burden have gone up and down over the long term, when accounting for inflation. See below a plot of tax burden in Canada, which clearly refutes the always increases parts. While there is discussion to be had regarding impact, we should make sure we keep the facts straight. Moreover, we have over 100 years of precedence of pretty much the same discussion, so it is not like we are in entirely new territory. Rather than a "it's starting" situation we are in a "it's happening again" sort of thing. Perhaps the next pandemic will happen soon enough that we don't forget, but considering all we have seen i am prepared to assume that we will be absolutely surprised again on all levels and rehash all points. I will say that it is unclear whether fines are more effective than e.g. mandates and social media likely has changed the game.

! Moderator Note Please keep all the very similar topics contained to this thread.

I do not disagree, though I do see that a surprising number of students are unwilling or unable to, say, read the syllabus. It is annoying if you spend 10 minutes explaining what they are supposed to do (with slides) and the next question is basically asking how you are supposed to do it without any indication that they listened to what I was just talking about. Bonus points if the answer is actually on the slide that is still on.