No, there has been more research since January, which the article itself said was needed. — Xtrix

Which of the three facts you claim so obviously show vaccines reduce transmission did this 'research' only recently discover?

Until you realize that this article was last updated 8 months ago, and is originally from January. — Xtrix

Woah, so the way vaccines interact with viruses has changed since January! Those damn biological facts, they just won't stay the same from one minute to the next will they?

Yes, there's been some experiments which tentatively show the vaccine might reduce transmission. No, it's not via the playschool version of the mechanism you claimed was so 'obvious'.

The fact that the companies aren’t trying to cover up their own fuckup. — Michael

You know this how?

The fact that since the introduction of the vaccines the number of deaths, serious symptoms, and cases has dropped. — Michael

Correlation is not causation, there are many factors acting on the number of cases, serious symptoms and deaths, not least of which is the fact that most of the vulnerable are already dead.

The fact that there have been very few negative reactions to the vaccines. — Michael

Who collates and reports on those? What about longer term than just a few months? How can I trust that the vaccines I take will be the same as the one's which have been shown to be safe so far and not some corner-cutting cost-saving knock off to make the venture a bit more profitable. (Oh, and before you cry 'conspiracy', all those things have actually happened with real drugs in real life, charges brought, proven in court, fines paid).

I know this is a tough one, but think about it for a second. — Xtrix

Scientists do not yet know whether COVID-19 vaccinations will reduce transmission because this was not tested in the trials (here, here). Instead, they found candidate vaccines were able to prevent symptomatic and severe effects of COVID-19 (here), meaning future research would need to take this further (here). For instance, it would need to look deeper into how the vaccine works in the body – whether it prevents an individual getting infected altogether, or whether it simply stops a person becoming sick. With the latter, this could mean the virus continues to replicate in the nose and throat, and is still able to spread (here). — https://www.reuters.com/article/uk-factcheck-transmission-idUSKBN29N1UH

Ha, those idiot 'scientists'. Fancy them not even being able to understand your logic, you must be some kind of genius...

Just by way of checking how far you normally take this attitude... If a chemical company, say DuPont, had spilt some chemicals in your drinking water reservoir, but their scientists said it was fine, perfectly safe to drink. Their work was checked by some other academics and government officials sponsored and lobbied by the industry or offered lucrative consultancy jobs with DuPont when they finish their academic/government careers. Some other scientists said that the tests were statistically flawed. Filtering the water removes all the chemicals and is easy to do, costs nothing. Would you drink the water, or filter it?

If you answer here is any different to taking the vaccine, what do you think is different about the situation?

However, it is the place where you find me. — Metaphysician Undercover

Well, it's nice to have some company, but as ever I can't really make much sense of what you're saying, you may have to be a bit more explicit for me.

That's just the old problem of trying to identify some thing that corresponds to the word. Obviously, not all words function like that, and sensation, is just one such word. — Sam26

and

As I said...

We quickly learn what the word does. That doesn't require us to refer to any private 'sensation' at all. — Isaac

it's use (and associated conceptual responses) is a strategy to get something done within a social context. It might be the wrong strategy, it might not do what we expect it to do (same as any other response). In that case we've used the wrong model, we made a mistake reaching for the word "pain". — Isaac

I'm arguing against the identification of a word with a referent. (I doubt you'll have had a chance to read other posts I've made on the subject, but I've been quite vocal about that very error over the years).

People can nonetheless use words wrongly, it's not a free-for-all.

When we use the word "pain" we do so as a result of a modelling relationship with a non-exclusive set of triggering physiological signals, it's one of the outputs from the model, a tendency to say things like "I'm in pain". This is a strategy, a response to the signals to get something done. This response will downregulate the input signals in accordance with a prior expectation about the cause of those signals. So If I just saw my thumb get hit with a hammer, I'll be expecting pain and will start the responses before the c-fibre signals have even reached the cortico-limbic-striatal circuits. If, seconds later, those signals fail to materialise (for whatever reason) I'll adjust my model response and update my priors - in other words, I'll have been wrong about the only thing we could possibly say constituted being in pain.

Basically, if "I'm in pain" has any meaning at all, it has to serve a function in a language game which those involve understand, it can't just 'hang loose' unconnected to any social function. Our models are socially constructed so that where one on the responses is linguistic, they match these social functions. That has to link back to the effect we want the word to have (again, if there's no context dependant consequence in mind, the word is meaningless). So "I'm in pain" is a response which does something in a social context, and - being triggered by interocepted physiological states - it's those states we intend the word to act on. If this weren't the case, the saying of it would have no cause to be triggered by those states. So if we reach for that word and it doesn't have the intended effect on those states, we're wrong to reach for it.

Note this is not just us not having learned the right use of the word, since the modelling of the "I'm in pain" response at inappropriate times can result from nothing more than a misfiring of triggering signals, or an overlap with similar signals in a noisy part of the network.

What I'm saying is not that we can't treat "I'm in pain" as a simple functional expression, and therefore not amenable to being right or wrong, we can. I'm saying that there's an additional matter to be talked about when we speak of as pain responses modelled from what are typically pain triggers. Here we definitely have a moment when we decide, post hoc, if we're going to trigger the 'pain' responses or not and if we decide in such a way as to elicit an unexpected response, we change the prior (ie we consider ourselves to have been 'wrong' the first time). How do we speak about this psychology if not by saying that we decide if we're in pain and can be right or wrong about that?

So you believe that the vaccine is either more dangerous than the disease or ineffective? It’s neither. So this reasoning is fallacious. — Michael

Explain how you reconcile "it's neither" with "I don't trust the pharmaceutical industry"? Or are you just asserting that I should trust the pharmaceutical industry? You're presumably about to tell me they've done tests...the industry I don't trust...have done tests I know to be flawed...in a system I know to be criminally corrupt...

There’s enough to go around. I don’t know about wherever you live but the UK has ordered enough for every adult, and presumably some children too. — Michael

I didn't say "waste of vaccine", I said "waste of resources". We've had this argument already. Consequentialism isn't the only ethical system in town, it's not just about whether my actions will actually lead to the spending of resources elsewhere - it's morally wrong and I won't be part of it.

I can’t see anything like that for choosing to not be vaccinated. — Michael

I don't trust the pharmaceutical industry and I don't agree that giving vaccines to healthy people who have little chance of contracting the severe disease is a good use of limited resources. — Isaac

I don't know why everyone is asking the question over and over in such mock bafflement as if I hadn't answered it six times already.

Getting vaccinated is such a minor inconvenience that requires no lifestyle changes — Michael

Unless your lifestyle involves avoiding prophylactic medicine, in which case it does involve a change of lifestyle.

Ya, but when you say things like this, — Sam26

Yeah, I lose a lot of people at that point.

What do you think the 'sensation of pain' is, as an existent entity. What type of thing is it? On what grounds does it 'exist'?

If I were to say "I'm ill, I have some bad humors", you might say "humors don't really exist, they're an old theory of physiology, but modern science can find no such thing answering to the definition, so you're mistaken in saying you have them".

Modern science can find no such thing that answers to 'the sensation of being in pain'. That's the problem I'm attempting to address.

If you were vaccinated you would be even less likely to get infected and transmit the virus. — Janus

It's not normal to require people to take all action available to them to reduce any given risk. We normally only require that the rusk be reduced below an acceptable threshold. Do you think that in all your lifestyle choices I couldn't point to some action you could take to reduce the risks associated with them?

You haven't given any good reason why you shouldn't be vaccinated, and nor have you explained why you don't want to be vaccinated. — Janus

I don't trust the pharmaceutical industry and I don't agree that giving vaccines to healthy people who have little chance of contracting the severe disease is a good use of limited resources. — Isaac

I don't need a good reason why I shouldn't be vaccinated, it's not a default position. You need a good reason why I should, by which I mean some demonstration that it's unreasonable of me to hold a position that the risk I represent by my actions is below a normal acceptable threshold of risk.

And I said you couldn't possibly know what the death toll would have been or will be twenty years into the future. But you ignored those qualifications regarding the future. — Janus

I didn't ignore them, they are the entire point. I was refuting a response from ssu that we had made progress on the other causes of death - the drop in death rate after 20 years was cited in evidence. I was just saying that in 20 years the death rate from COVID would be that low too, the relevant comparison is the effort we're putting in right now.

Do you have any papers to cite in support of that claim? That may indeed be the more likely scenario, but who knows? Even the experts can't predict the future with certainty. — Janus

Of course - https://www.bmj.com/content/372/bmj.n494

Other social issues should be addressed of course, but the emergency now is the fight against covid. — Janus

The other issues are the fight against COVID - that's the point. And they come from the WHO's own agency responsible (as I've extensively quoted above).

I think you are going against the grain of expert opinion if you think that vaccination is a "small part". The consensus seems to be that without vaccines we might never get out of the next wave/ lockdown cycle — Janus

Yes, I'm aware of that. As I've argued extensively, there's no moral nor rational reason why one ought to adhere to the consensus opinion. Consensus among experts is not strongly predictive of the utility of a theory, membership of the set of theories considered by experts is.

You still haven't given your reasons for not wanting the vaccine. Do you have a rational reason or are you simply afraid of it? — Janus

I've discussed the matter extensively. I don't trust the pharmaceutical industry and I don't agree that giving vaccines to healthy people who have little chance of contracting the severe disease is a good use of limited resources. I don't see any moral imperative for me to take a vaccine since the outcome of my doing so is very unlikely to reduce harm relative to my not doing so. I'm very unlikely to need hospital treatment if I do get it, I'm very unlikely (given my hygiene measures) to pass the disease on (and the vaccine is only marginal in reducing transmission anyway), and there's little to no evidence that mass vaccination will do any more to stop the virus long term than naturally acquired immunity.

As I'm sure you're aware, the pharmaceutical companies have a track record of lying about both safety and efficacy, so they wouldn't even need the pressure from Donald Trump, or anyone in government.

As the Cochrane Foundation recently concluded...

all aspects of most high impact, industry-sponsored clinical trials remain influenced by industry and systematically produce more favourable efficacy findings and conclusions than research supported by other sources — Lundh A, Lexchin J, Mintzes B, et al.Industry sponsorship and research outcome. Cochrane Database Syst Rev

85% of vaccine clinical trials are sponsored by vaccine manufacturers and non-industry trials are over four times more likely to report negative or mixed findings than industry-sponsored trials — Manzoli L, Flacco ME, D’Addario M, et al. Non-publication and delayed publication of randomized trials on vaccines: survey. BMJ

the majority of panel members producing clinical practice guidelines have disclosed or undisclosed financial CoI [Conflicts of Interest] — Neuman J, Korenstein D, Ross JS, et al.Prevalence of financial conflicts of interest among panel members producing clinical practice guidelines in Canada and United States: cross sectional study. BMJ

Perhaps more pertinent to our current situation is the handling of the HPV vaccine. In an investigation Researchers found that "the involvement of the vaccine manufacturer, Merck,was particularly damaging".
Merck’s intervention in the policy process, included the provision of funds to an organisation of female legislators that introduced many of the bills to mandate HPV vaccination.
Most damningly, a principal investigator of HPV vaccine trials for Merck and GlaxoSmithKline agreed that “It seemed very odd to be mandating something for which 95 percent of infections never amount to anything”
Later reviews showed that design problems in the HPV vaccine trials, most of which were led by academics but sponsored by industry, made it difficult to evaluate the extent to which the vaccine prevented cervical cancer.
The program was stopped.
(Rees CP, Brhlikova P, Pollock AM. Will HPV vaccination prevent cervical cancer? J R Soc Med)

The FDA are not much better unfortunately

On June 7, the FDA approved aducanumab for the treatment of Alzheimer's disease. The drug received accelerated approval because it showed it could reduce the rate of amyloid plaque on scans. What remains uncertain is whether this reduction in plaque means Alzheimer's patients live longer or better lives -- and notably, the totality of the clinical trial data do not show that. Moreover, the drug has various side effects and a whopping price tag: $56,000 a year.
In response to the FDA's approval, three members of the Peripheral and Central Nervous System Drugs Advisory Committee who opposed approval of the drug, quit the panel in protest. Aaron Kesselheim, MD, JD, MPH, a Harvard professor called the drug "problematic," and argued that there was little evidence it would help patients. Writing in The Atlantic, Nicholas Bagley, JD, and Rachel Sacks, JD, MPH, estimate that if the drug is prescribed to just one-third of eligible patients, it would cost Medicare $112 billion a year -- a massive figure that dwarfs any other medication.

As to their current practices... From Pete Doshi, writing in the BMJ

On 28 July 2021, Pfizer and BioNTech posted updated results for their ongoing phase 3 covid-19 vaccine trial. The preprint came almost a year to the day after the historical trial commenced, and nearly four months since the companies announced vaccine efficacy estimates “up to six months.”

measuring vaccine efficacy two months after dosing says little about just how long vaccine-induced immunity will last. “We’re going to be looking very intently at the durability of protection,” Pfizer senior vice president William Gruber, an author on the recent preprint, told the FDA’s advisory committee last December.

But you won’t find 10 month follow-up data here. While the preprint is new, the results it contains aren’t particularly up to date. In fact, the paper is based on the same data cut-off date (13 March 2021) as the 1 April press release, and its topline efficacy result is identical: 91.3% (95% CI 89.0 to 93.2) vaccine efficacy against symptomatic covid-19 through “up to six months of follow-up.”

As an RCT reporting “up to six months of follow-up,” it is notable that evidence of waning immunity was already visible in the data by the 13 March 2021 data cut-off.

“From its peak post-dose 2,” the study authors write, “observed VE [vaccine efficacy] declined.” From 96% to 90% (from two months to <4 months), then to 84% (95% CI 75 to 90) “from four months to the data cut-off,” which, by my calculation (see footnote at the end of the piece), was about one month later.

But although this additional information was available to Pfizer in April, it was not published until the end of July.

The final efficacy timepoint reported in Pfizer’s preprint is “from four months to the data cut-off.” The confidence interval here is wider than earlier time points because only half of trial participants (53%) made it to the four month mark, and mean follow-up is around 4.4 months

Despite the reference to “six month safety and efficacy” in the preprint’s title, the paper only reports on vaccine efficacy “up to six months,” but not from six months. This is not semantics, as it turns out only 7% of trial participants actually reached six months of blinded follow-up (“8% of BNT162b2 recipients and 6% of placebo recipients had ≥6 months follow-up post-dose 2.”) So despite this preprint appearing a year after the trial began, it provides no data on vaccine efficacy past six months, which is the period Israel says vaccine efficacy has dropped to 39%.

Former FDA commissioner Scott Gottlieb, who is on Pfizer’s board [[b]says it all doesn't it? - my addition[/b]], said: “Remember, the original premise behind these vaccines were [sic] that they would substantially reduce the risk of death and severe disease and hospitalization. And that was the data that came out of the initial clinical trials.”

Yet, the trials were not designed to study severe disease. In the data that supported Pfizer’s EUA, the company itself characterized the “severe covid-19” endpoint results as “preliminary evidence.” Hospital admission numbers were not reported, and zero covid-19 deaths occurred.

In the preprint, high efficacy against “severe covid-19” is reported based on all follow-up time (one event in the vaccinated group vs 30 in placebo), but the number of hospital admissions is not reported so we don’t know which, if any, of these patients were ill enough to require hospital treatment. (In Moderna’s trial, data last year showed that 21 of 30 “severe covid-19” cases were not admitted to hospital; Table S14).

on preventing death from covid-19, there are too few data to draw conclusions—a total of three covid-19 related deaths (one on vaccine, two on placebo). There were 29 total deaths during blinded follow-up (15 in the vaccine arm; 14 in placebo).

Last year the FDA said it was “committed to use an advisory committee composed of independent experts to ensure deliberations about authorisation or licensure are transparent for the public.” But in a statement, the FDA told The BMJ that it did not believe a meeting was necessary ahead of the expected granting of full approval. Diana Zuckerman, president of the National Center for Health Research, who has also spoken at recent VRBPAC meetings, told The BMJ, “It’s obvious that the FDA has no intention of hearing anyone else’s opinion.

Same old, same old... fudging, deception, poor methodology...and this is the stuff they publish! With no requirement at all to publish null results, raw data sets nor statistical analysis methods.

A report from an analyst at Goldman Sachs came out a little while back about the Hep C treatment...

“GILD is a case in point, where the success of its hepatitis C franchise has gradually exhausted the available pool of treatable patients,” the analyst wrote. “In the case of infectious diseases such as hepatitis C, curing existing patients also decreases the number of carriers able to transmit the virus to new patients, thus the incident pool also declines … Where an incident pool remains stable (eg, in cancer) the potential for a cure poses less risk to the sustainability of a franchise.”

Or Ritalin as another example...

the number of children on medication for ADHD has grown to 3.5 million from 600,000 in 1990, according to the Centers for Disease Control and Prevention. A diagnosis is now found in 15 percent of high-school age children when, in fact, the true rate is closer to 5 percent, with only a small minority of that group truly needing to be medicated.

This gross over-diagnosis and prescription is a direct result of intense, multi-million dollar marketing campaigns by the drug makers, both through celebrity endorsements as well print and television ads that prompt patients and their families to ask doctors about those specific drugs. The result is to sway doctors to go for the easy, quick fix solution of a pill (when you have a hammer, everything you see is a nail). And the tactic has paid off, with a quintupling of stimulant sales since 2002, to over $8 billion in revenues.

The practice has created a situation of widespread drug abuse, affecting the long-term health and well-being of millions of young people. This mess has prompted long-time ADHD advocate Dr. Keith Conners to call the rising diagnosis rates a “concoction to justify the giving out of medication at unprecedented and unjustifiable levels,” that has resulted in “a national disaster of dangerous proportions.” — New York Times - The Rise in Ritalin

In 2012, GlaxoSmithKline was fined $3 billion fine and pled guilty to criminal charges of knowingly promoting anti-depressant drugs to children despite not being approved by the FDA to be used for off-label purposes in minors. In 2013 Johnson & Johnson were fined $2.2 billion for its promotion of off-label drugs. In 2009 Pfizer were fined $2.3 billion for illegally marketing Bextra, a painkiller. Note these were all illegal acts. Criminal activity.

Anyway, unlike the wisdom displayed in your previous deleting activities, I should have deleted all this but won't, it's not like all of this isn't common knowledge. If these deals were made with the arms industry or the tobacco industry, or some chemical giant there'd not be a soul just taking them at their word but medicines get a free ride I guess.

I'm not sure what you're getting at here. — frank

It think I do. Possibly, it's that clinging on to every second of life by our fingernails and "hang the expense" is pointless and undignified. People die when it's their time. The important thing is that they've had a good life. We too easily forget about giving people a good life and pour every expense into just extending it. We live in a world in which child labour is still part of the normal cycle of production, yet helping a 95 year old terminal cancer sufferer die is, mostly, illegal. It's a huge part of what's skewed our response to this crisis.

if the effort had not been put in the death toll would likely have been much. much greater by now and into the near future. — Janus

You don't know how great the death toll could be in twenty years; it's pure conjecture. — Janus

So do you have knowledge I'm not privy to? Or is there some other reason why you can say that the death toll would likely have been much much more "into the future", yet I can't possible know what the death toll would be?

If there were no vaccination program much more virulent strains might have emerged. They might anyway. — Janus

Do you have any evidence at all of this? The prevailing scientific opinion is that the virus will become a flu-like endemic disease.

I am really struggling to see what your position actually is. Are you against the vaccination program? Do you think there is a viable alternative to it in the situation we find ourselves in? — Janus

It's not that complicated - vaccination is a small part of a much larger raft of measures which are needed to combat the crisis now and into the future, it's a useful tool, not a panacea. There's absolutely no need to pursue anyone who doesn't want to take the vaccine for any reason (it's just not that important a tool, so long as a good number want it); and focusing all the media attention on anti-vaxxers as being to blame for the continuation of the crisis draws attention away from the huge amount of other actions which are required to protect us now and in the future, but which governments are more reluctant to take given the expense an unpopularity of many of them.

Pressure needs to be substantial and consistent to force governments (and the population) to take the steps necessary in terms of health investment, inequality, and public health improvements. That pressure is currently being pissed away in favour of righteous tribalism.

Some of this stuff would require a global government. — frank

https://unu.edu/news/news/reaffirming-the-uns-role-in-global-governance.html#info

it seems to me that Isaac is really adding a new language-game to the mix based on new information. It could be that the example (not sure at this point) of pain and doubting that one is in pain, is generally senseless, but that there are exceptions. — Sam26

Yes, that's exactly it. @Banno and I have been here before. When we talk about cognition, in the scientific sense, we need a language-game to talk about what we find, but that's often not the folk psychology that gives us many of the terms we use day-to-day.

So ↪Isaac
presents an example of someone doubting the applicability of the word "pain" to their present situation. That's not the same as doubting that one is in pain. — Banno

I maintain that it is the same. Being in X is what is undoubted, whether that x is 'pain' is a socially constructed judgement and can be mistaken. The reaching for the word "pain" is one of the responses to the stimuli. You're still assuming that there's a physiological/mental state that answers to the term 'in pain'. What if there wasn't? How would that change things?

Why are you doubting that you or someone else is using the word "pain" correctly? — Luke

Same reason I might doubt I'm using any word correctly - it's not having the effect I expect it to in the context I'm using it.

I don't see how the word could be used (in the sense we are using it here) without reference to the sensation. Pain is a sensation. — Luke

It isn't. There's no such thing as 'sensations'. They don't exist. No representation on earth, Non-entities...*

*Obviously I'm being rhetorical, it's a leading theory, that's all - other theories are available.

Decades later, people wish they had addressed the weaknesses of those health systems, because new threats keep coming. — Olivier5

Yep. And here we are, one public forum among many, talking about nothing but how ordinary people not taking vaccines and not wearing masks are to blame for it all. How do you think that's going to be played by government's wanting to avoid blame for their lack of completely foreseeable failure to adequately prepare?

The more efficient method is to let them die in their front yards gasping for breath? Or what? — frank

No, the more efficient method is

National leaders and leaders of international organizations and other stakeholders take early decisive action based on science, evidence and best practice when confronted with health emergencies. They discourage the politicization of measures to protect public health, ensure social protection and promote national unity and global solidarity.

We reiterate our call for heads of government to appoint a national high-level coordinator with the authority and political accountability to lead whole-of government and whole-of-society approaches, and routinely conduct multisectoral simulation exercises to establish and maintain effective preparedness.

National leaders, manufacturers and international organizations ensure that COVID-19 vaccines and other countermeasures are allocated in a way that will have the most impact in stopping the pandemic, that access is fair and equitable, and not based on ability to pay, with health care workers and the most vulnerable having priority access. Each country should get an initial allocation of vaccine sufficient to cover at least 2% of its population, to cover frontline health care workers.

Citizens demand accountability from their governments for health emergency preparedness, which requires that governments empower their citizens and strengthen civil society.

Every individual takes responsibility for seeking and using accurate information to educate themselves, their families and their communities. They adopt health promoting behaviours and take actions to protect the most vulnerable. They advocate for these actions within their communities.

Heads of government strengthen national systems for preparedness: identifying, predicting and detecting the emergence of pathogens with pandemic potential based on a ‘One Health’ approach that integrates animal and human health; building core public health capacities and workforce for surveillance, early detection and sharing of information on outbreaks and similar events; strengthening health systems based on universal health coverage with surge capacity for clinical and supportive services; and putting in place systems of social protection to safeguard the vulnerable, leaving no one behind.

Researchers, research institutions, research funders, the private sector, governments, the World Health Organization and international organizations improve coordination and support for research and development in health emergencies and establish a sustainable mechanism to ensure rapid development, early availability, effective and equitable access to novel vaccines, therapeutics, diagnostics and non-pharmaceutical interventions for health emergencies, including capacity for testing, scaled manufacturing and distribution.

Heads of government renew their commitment to the multilateral system and strengthen WHO as an impartial and independent international organization, responsible for directing and coordinating pandemic preparedness and response.
We call for sustained investment in prevention and preparedness, commensurate with the scale of a pandemic threat.

G20 leaders ensure that adequate finance is made available now to mitigate the current and future economic and socioeconomic consequences of the pandemic.

Heads of government protect and sustain the financing of their national capacities for health emergency preparedness and response developed for COVID-19, beyond the current pandemic.

The United Nations, the World Health Organization, and the International Financing Institutions develop a mechanism for sustainable financing of global health security, which mobilizes resources on the scale and within the timeframe required, is not reliant on development assistance, recognizes preparedness as a global common good, and is not at the mercy of political and economic cycles.

The World Bank and other International Financial Institutions (IFI) make research and development (R&D) investments eligible for IFI financing and develop mechanisms to provide financing for global R&D for health emergencies.

State Parties to the International Health Regulations (IHR), or the WHO Director-General, propose amendments of the IHR to the World Health Assembly, to include: strengthening early notification and comprehensive information sharing; intermediate grading of health emergencies; development of evidence based recommendations on the role of domestic and international travel and trade recommendations; and mechanisms for assessing IHR compliance and core capacity implementation, including a universal, periodic, objective and external review mechanism.

National leaders, the World Health Organization, the United Nations and other international organizations develop predictive mechanisms for assessing multisectoral preparedness, including simulations and exercises that test and demonstrate the capacity and agility of health emergency preparedness systems, and their functioning within societies.

The Secretary-General of the United Nations, the Director-General of the World Health Organization, and the heads of International Financing Institutions convene a UN Summit on Global Health Security, with the aim of agreeing on an international framework for health emergency preparedness and response, incorporating the IHR, and including mechanisms for sustainable financing, research and development, social protection, equitable access to countermeasures for all, and mutual accountability. — WHO-Global Preparedness Monitoring Board

Oh, and whinge about people not taking vaccines... they must have missed that one.

Although, the investment in this vaccine technology will ultimately save lives in the future because it will speed up response to the next asshole virus. — frank

Will it though? With rapidly dropping effectiveness against even minor variants of SARS-Cov-2, to what extent do you think it's going to be of any use against a completely different SARS altogether? We've still got to sequence the epitopes. Yes, we've got a cracking new delivery system, and that's not to be sniffed at, but as a response to epidemics in general, creating vaccines is an extremely inefficient method. As the WHO's Global Preparedness Monitoring Board have only recently reported. Our current vaccine/lockdown based methods have cost about 500 times more than non-pharmaceutical preparedness would have.

With all the attention firmly focused on vaccination, the chances of anything useful being done to prepare for the next one are remote.

So we are making progress? — Olivier5

No. HIV, poverty, tuberculosis, malaria, childhood obesity, heart disease, cancer, mental health issues, are all still ongoing causes of death and debilitation and we're still largely ignoring them (relative to covid).

We're not doing better, we've just created a system in which the cause with the most Facebook likes gets the fucking cavalry whilst everything else gets the home guard.

well funded. — Olivier5

$11 trillion spent on the COVID response so far.

$4 billion a year from the Global Fund against AIDS, Tuberculosis and Malaria.

It would take over 2000 years of investment to match.

And HIV has killed about ten times as many people as a proportion of the population.

You could try a little less naive cheerleading.

Just to make the observation note that this isn't just your average flu epidemic. — ssu

Who in their right mind would think that, believing the figures we've seen? There are groups who don't believe the official figures to varying degrees, but they're hardly going to be swayed by you quoting the official figures are they? Of those who are inclined to believe the official figures, do you think there's a single person who still thinks this is an average flu epidemic?

Every other epidemic (pandemic) has had far less deaths with (with the exception of HIV). — ssu

Which we'd expect given lower populations in the past. So adjusting for population size, certainly the Spanish flu counts, as does HIV, as you say, both of which dwarf COVID when looked at in terms of percentage of the population affected (2.5% for Spanish flu, 0.7% for HIV, 0.05% for COVID). So what you're saying is that COVID is killing more people than any other pandemic, except for the ones where it isn't. Well, can't argue with that.

Remind me again of the massive global effort to tackle the HIV crisis? There was that time we went into trillions of debt, and put huge social pressure on the wealthy to fund massive investment in healthcare infrastructure in the third world... oh no, wait there wasn't...I remember now, we did fuck all.

No, I'm talking about the first-person, doubting that they are using the word "pain" correctly — Isaac


First-person is you, not they. — Luke

I was referring to another person's first-person experience, but it makes no odds I could have said "I doubt that I use the word 'pain' correctly"

Someone that doesn't know or understand that there are far more Americans today than one hundred years ago has to go to himself or herself. It isn't misleading. — ssu

So your comment was meant to say "there's more deaths from Covid-19 now than deaths from Spanish Flu then, but this is completely unsurprising because there's more people now" So why post it? So that we can all nod in ennui at it's calculable typicality?

You're failing to take into account the fact that the figure would likely be much higher if "social, economic and political effort" hadn't been "put to reducing" it. — Janus

No. I said

we took no further steps at all — Isaac

...although, had I not, my comment would still have been true. In 20 year's time the death toll would be dramatically reduced.

The point I was making is that the death toll from various preventable causes prior to 2000 was higher than the death toll from Covid-19 now. The only action we took against those causes - despite their being completely preventable - was a very slow and incremental set of changes balanced against the many other contemporary calls on our social, economic and political energy which took 20 years to get us to the lower level of preventable deaths we enjoyed by 2019.

You're now talking in terms of third-person modelling — Luke

No, I'm talking about the first-person, doubting that they are using the word "pain" correctly (or any other response to their set of physiological triggers)

Wittgenstein says that it is possible for other people to doubt whether I'm in pain. But if you're the one who is obviously hurting, then doubt is misplaced. There is no hypothesis to be tested or knowledge to be gained from the perspective of the one who's in pain. — Luke

Yes. Wittgenstein was wrong (which we shouldn't be surprised about since he had no training in cognitive psychology and the models we use to show he was wrong weren't even around at the time he was writing). There is a hypothesis to be tested, it's how all modelling in the brain works - hypothesis testing. That much is not even really in question. The only question is over what proportion of the hypothesis testing there's some conscious awareness, which is the matter addressed by the papers I cited. Not a settled question, I'll grant, but an interesting one.

Maybe the "unpleasant sensation" of pain covers a wide range of sensations that causes some difficulties for scientists, but we all quickly learn what the word means. — Luke

We quickly learn what the word does. That doesn't require us to refer to any private 'sensation' at all.

"I'm in X" (where X is some mental state) is something which can't meaningfully be doubted, it wouldn't make any sense to say that I was not in some mental state, it would require denying that I had mental processes at all (an obvious contradiction), or denying that they are always in some configuration or other (which seems a logical impossibility). But "I'm in pain" where we've used a word in response to our particular mental state is something which can be doubted because the word is public object, it's use (and associated conceptual responses) is a strategy to get something done within a social context. It might be the wrong strategy, it might not do what we expect it to do (same as any other response). In that case we've used the wrong model, we made a mistake reaching for the word "pain".

I have an image of someone groaning in agony as the doctor says "no, no, she's not in pain...look at the signals we are getting..." — Banno

Ha! Yes. But actors, hypochondriacs... don't we already have a perfectly ordinary notion of people showing external signs associated with pain but without the 'sensation'? I don't see that removing the sensation from the picture makes the assessment of honesty or exaggeration any more problematic. What I'm doing is really akin to the way I treat qualia, it's just an unnecessary reification. There's just a purple thing and our tendency to use the word purple in response to it, we don't need 'the experience of purple', it's not playing any useful part in the discourse. Likewise with pain. There's this collection of physiological triggers and there's our tendency to respond to them in certain ways (saying "pain", screaming...), the 'sensation of pain' just drops out of necessity, we don't need it to explain what's going on.

I want to add
d) a sensation that is not private. — Banno

See my comments to Luke above. There's considerable doubt now that such simples as 'sensations' even exist. The prevailing model consists of non-exclusive sets of triggers, and non-exclusive sets of responses (all stochastic I should add - people get a bit jumpy when we start to talk about stimuli-response, and for good reason). The non-exclusivity of both inputs and outputs means that the modelling relationship is variable - ie there's nothing in the brain that can be called a 'sensation' of pain, only triggers, models and responses.

I think all three could be used as a public referent for the word 'pain', it's not like we have much trouble with non-exclusive sets in other areas of language ('game' as an obvious example). But the non-exclusivity opens the space for doubt. "Am I using this word right? Is it doing what I expect it to do in the circumstances?"

You started that post talking about the sensation of pain as a natural kind, but then you went on to talk about constructing models in terms of expressions of pain. — Luke

I'm denying that Wittgenstein's 'sensation of pain' is a simple, so I'm "talking about it" only insofar as I'm denying it is as Wittgenstein speaks of it. I'm sorry if that was not clear enough.

There's no such thing as a 'sensation of pain'. There's no consistent neural equivalent and psychologically there's a failure to link reports with any consistent physiology.

There's a set of physiological signals that are non-exclusively associated with a tendency to use the word "pain", and there's the modelling relationship between that set of physiological signals and a similarly non-exclusive set of responses. We can refer to this modeling relationship as 'the experience of pain' as it is consistent in it's output (the use of the word "pain", but this model is definitely socially constructed, and modified on the hoof - ie it can be doubted. The expression of pain is just some of that non-exclusive set of responses which form the 'output' half of the 'pain' model. Because, in this system, both the input signals and the output responses are non-exclusive set, the correctness of the model 'pain' can be doubted.

if the abstract to your primer is anything to go by, then it discusses emotions, not sensations. — Luke

The work on pain (and other sensations) is just more complex and behind paywalls. The paper I cited is a good introduction to the theory, it covers (as the title suggests) all interoception, it just focuses on emotions because that's the author's original field. I can provide the papers on pain perception, but you'll need journal access to read them.

Of course there are more Americans now than then. — ssu

Exactly. So it's a misleading statistic deliberately cited in terms designed to further the fear and panic. Yet you thought it a good idea to promote it. We fully expect any epidemic to kill more people these days because there are more people to kill. In addition, this epidemic targets mainly the elderly and America's demographic has shifted heavily in favour of this age group, and there's an obesity crisis in America which we would fully expect to make them much more vulnerable to any epidemic than they would have been otherwise (even without the fact that Covid seems to particularly target the obese). We might also expect a lower figure due to the improvements in medical care, but that's harder to quantify with variable access to care and the disease primarily affecting the already sick (ie those medical care has failed to actually cure thus far).

The question is what you think such a misleading statistic contributes to the discussion. Why post it?

Absolute global poverty has gone down. But that naturally isn't the politically correct news to say. Especially for Americans. — ssu

So? Vulnerability to COVID-19 would go down too if we just did nothing. If COVID kills 1,900 a day now, and we took no further steps at all, in 20 years time it would kill a fraction of that number. The point is we're pulling out all the stops to reduce deaths from this particular cause right now, not gradual steps to reduce it a bit over the next 20 years.

Again the point is the deliberate misuse of statistics. 1,900 people die every day from Covid. That just sounds a lot, anything over a thousand is a big number to most people. Out of context it's completely meaningless. Before Covid did you know, off the top of your head, how many people die every day from any given cause? No (or if you did, you're in a minority). So what use is the out of context figure? Is 1,900 a lot, normal, low...? No-one knows because presented without any comparative data it's useless, so again, why post it?

As far as my attempts to provide comparative figures are concerned - the issue is not that global poverty has gone down (my use of 'fuck all' was rhetorical - I might have said 'very little') it's that the number of deaths were seen as normal. In 2000 it was seen as normal to have 900 or so deaths per 100,000. By 2019 it was normal to have 800 or so deaths per 100,000. Now, due to a new cause of death on the scene, we're back up to 900,000 or so per 100,000, only unlike in 2000, when it was accepted as normal, this time it's being seen as something which every grain of social, economic and political effort must be immediately put to reducing. That is the relative comparison to make. That the causes of the deaths in 2000 were being dealt with slowly, eventually, as part of mixed approach to contemporary issues. The deaths in 2021 are being dealt with by the full force of social and economic pressure to the exclusion of all other contemporary considerations.

Of course, I'm sure that fact that the solution being used in 2021 has been provided by the largest, most powerful lobbying industry the world has ever seen has nothing whatsoever to do with that change of approach and is a complete coincidence.

Yes, but not with my recent questioning of your implication that there are no natural expressions or reactions. — Luke

I see, well on that you're right. If you want to call autonomous responses a natural kind then we'll have to say that there are some natural kinds. It's not how I'd define a natural kind, but that's fine. The point is that there are no natural kinds when it comes to the states we label with words like "pain" and emotion words.

I don't see what conscious processing and language use have to do with natural reactions/expressions. — Luke

As I said above, autonomous responses are not the sort of thing I'd class as a natural kind, so your question sounded like it was asking how we can tell the difference between autonomous responses and constructed states. If you mean to ask why I don't categorise autonomous responses as natural kinds, I don't know. I've just never come across them being described that way.

Explain to me how your autonomous reactions are different from natural reactions/expressions and maybe I'll read it. — Luke

Well, if we assume it's just a categorisation issue, then it's just a matter of the way I've learned to use the term. I don't think it's that relevant to the topic is it?

The point is that "pain" is used to describe a complex state, not an autonomous response, so when determining if it refers to a simple, what matters is whether such states are natural kinds. Whether autonomous responses are natural kinds seems immaterial.

I was only talking about natural expressions/reactions, not language. — Luke

But the subject here is language, no? The use of the word "pain".

How are you distinguishing those autonomous responses (such as "already pulled aware from the hot thing, or shielded the pain site") from natural expression/reactions? — Luke

By examining what's going on in the brain. Autonomous reactions don't have any connections to areas of the brain we know to be involved in conscious processing, language use etc.

Your account of why we don't actually say "I wasn't in pain, I was just cold and cross" is because we believe in natural kinds, not because there are natural kinds. I don't see how that's an account rather than an assertion. We might believe in natural kinds because there are natural kinds. — Luke

I provided a paper to indicate the support for the model, I can give more if you suspect I'm being dishonest in saying it's the prevailing model. I could give a full account here, but that would be considerably dry and totally off-topic, and it's better you read it directly from the scientists doing the work. What other kind of evidence were you expecting to raise my comment above the level of mere assertion?

Or alternatively, the actual statistical inference.

https://statmodeling.stat.columbia.edu/2021/04/25/is-it-really-true-that-the-u-s-death-rate-in-2020-was-the-highest-above-normal-since-the-early-1900s-even-surpassing-the-calamity-of-the-1918-flu-pandemic/

...but hey, who cares about anything like justified statistical inference when there's a drama we can milk.

The actual death rate in America today is about the same as it was around the year 2000. Remind me, what was the massive terrifying crisis around the year 2000 that we had to all fly into an hysterical panic about? Oh yes...it was heart disease, cancer, accidents, influenza and suicide... and what global unprecedented action did we take to minimise those deaths?...oh yes...fuck all.

About 50,000 people die every day because of the effects of poverty. What massive global action are we taking to prevent those deaths?...oh yes..fuck all again.

Well since you guys seem so much happier arguing against the entirely fictitious position that "we shouldn't trust experts" rather than saying anything substantive about the actual position that variance in degree of support within the cohort of experts is not well correlated with a theory's predictive power, I'll leave you to it.

You're implying that there are no natural human expressions or reactions. How are a tendency to say "ouch" or a tendency to withdraw from the perceived source [of pain] not natural expressions or reactions, but merely "something we construct"? Don't most animals tend to withdraw from perceived sources of pain? — Luke

A natural expression might result from some deeper subconscious network (a direct link from a sensory neuron to a motor neuron - via an association neuron - in the spinal cord). The part of the brain dealing with language doesn't even get a look in on this type of signalling, it gets the second hand messages from the proprioceptive neurons, and the eyes that it's body has already pulled away from the hot thing, or shielded the pain site. Reaching for the word "pain" to describe any of those goings on is a post hoc modelling of the signals telling us what just happened, not the real time signals as they're happening.

Beyond those autonomous responses, then yes, I am saying there are no natural human expression or reactions. It's probably the leading theory of affect cognition at the moment. You can read a primer here if you're interested.

Such general facts of nature (PI 142) are pivotal to Wittgenstein's work — Luke

Well, then scholars would be wise to listen to what scientists say about these facts then, no? It seems odd to say that such facts are pivotal to Wittgenstein's work and simultaneously hold that a philosopher who barely left his offices has a better grasp of those facts than the scientists actually working on them with the full arsenal of modern investigative technology at their disposal.

there's very strong evidence to support it. Why else do you think we don't actually say "I wasn't in pain, I was just cold and cross"? — Luke

I've just given an account of why - we have a cultural belief in natural kinds.

I think we addressed this long ago, but we might have a clearer example here. — Banno

Yes. Although, to be clear, we'd need to say that John was triggered by signal x. Un-triggered expressions can happen - the brain is almost certainly stochastic, which is why I always talk in likelihoods (tendency to behave as if...) rather than x causes y - but it would be a different proposition if we're saying John randomly says he's in pain despite having none of the traditional triggers. I get the feeling you're wanting to explore the version in which John says he's in pain in response to a different set of triggers to usual.

A tendency to reach for the word "pain" is one part of the model we might call {being in pain}, that model being a network of neural connections which make some set of action-responses much more likely given some set of triggering neural signals, one of those responses being to use the word "pain".

If John was reaching for the word "pain" in response to an unusual set of triggers, I'd probably be first inclined to think he had some form of aphasia, that he once upon a time had a more normal model, but some trauma has disrupted the network and now those signals produce a tendency to reach for the word "banana", and some other set of signals has become linked up to a tendency toward the word "pain".

Alternatively, if John was a very young child, I might assume he's learnt the word wrong, some mishearing has made him think it's appropriate to use it in response to signal x when, in fact it was a misunderstanding and we don't tend to use the word that way.

So the question is why I'd go for either of those two explanations rather than expand my list of normal triggering signals to include John's x.

Psychologically, it'd be because John's use of the word that way probably isn't working for him, it's not yielding the results he wants (he keeps getting sympathy when he wants a quick healthy snack and keeps getting yellow fruit when he wants some pain-killers). Maybe John is quite happy with his re-arrangement though, but even in that case it doesn't seem like an unreasonable assumption that most people wouldn't be, so we still need a model of pain-talk where this kind of response is considered in the category something's-gone-wrong.

Trying to relate that rather psychological way of looking at it back to philosophy and the PLA...we both agree, I think, that language primarily does stuff, it's not just a report, it's a social tool to get stuff done. So how's John going to get the stuff done he want's done in a society of other (biologically similar) humans all using "pain" in response to some loose (but still defined) set of triggers a, b, c, d, e, and f, when he's using it in response to trigger x? It seems to me that our shared biology (triggers a, b, c, d, e, and f are biological) is going to undermine his attempts to use the word "pain" and get the stuff done he wants to get done.

In terms of PLA, isn't John's use is exactly a case of sensation S? Haven't we learnt to use the word pain appropriately by trial and error, I use it here it should do this...no, that didn't quite work out as I expected...perhaps here, like this...all the while watching other humans in our social group to see how they react. If those other humans all share a similar biology, then they're all going to react with sympathy, medical treatment etc, to the use of the word "pain" in response to triggers a, b, c, d, e, and f (which indeed require sympathy, medical treatment etc to deal with them) - where such triggers are things like tissue damage signals, heat/pressure signals, or certain neuronal patterns to trigger mental pain (we don't really understand these yet so I've been deliberately vague).

For John to use the word pain absent of these triggers, he'd have to use it either a) randomly (accident) or b) in response to some other publicly measurable trigger (say, hunger), or c) in response to some private, potentially ever-changing, trigger (sensation S). (a) seems irrelevant to any discussion of language use, (b) is an error of use, if we're to have any rules about the use of terms with public referents, but also for John, would get his hunger dealt with by sympathy and pain killers, and (c) seems to run into the problems of the private language argument.

Have I missed an option?

If it is totally inconsequential to the problem at hand, why did you bring up "holding the government into account"? — Olivier5

You said you were trying not to undermine trust in your government by taking the vaccine, I was pointing out that holding the government to account is the usual method of not undermining trust, rather than the taking of prophylactic medicines.

That such a sentiment be justified in Congo doesn't make it justified where I live — Olivier5

No. It being justified makes it justified where you live.

France, right?

Is the French government immune to lobbying? Has it made decisions on global warming that are truly in the best interests of the people rather than the short term interests of industry? Does it's tax policy reflect social goods or the influence of the very wealthy? Do it's arms sales favour global stability or the arms industry?

When the French government were found guilty of failing to take sufficient action on climate change earlier this year were the courts wrong?

What exactly is it about the structure, history and objectives of your government that gives you such confidence in it's magnanimity?

I just meant that science doesn't really offer soapboxes to preach from. People make science into a church to back their misanthropy or what have you. — frank

I see, yes. Makes sense now.

they shared the guilt of the Mobutu regime, because they had done nothing to oppose it. — Olivier5

Interesting. To what extent did a lack of trust figure in their complicity, do you think?

You can do that and still take your shot. — Olivier5

Yes, and you can do it without taking your shot too, making the taking of your shot entirely inconsequential to the project.

Trust in institutions which have lost it can only be restored by a change in the structure or behaviour of that institution. We, as citizens, if we want such trustworthiness, ought to campaign for those changes by holding those institutions to account when they fail to meet the high standards we expect of them. Whether we follow their advice or not in the meantime is immaterial.

That's not what I am trying to do. As I explained, I am trying NOT TO UNDERMINE trust. I'm not trying to actively shore it up, but I don't want to contribute to its fall. — Olivier5

Holding a government to account according to high standards of transparency and freedom from corporate influence is traditionally held to be a mechanism for increasing trust, not undermining it.