I feel entitlement-vibes [LWN.net]

I feel entitlement-vibes

Posted Jan 29, 2025 17:39 UTC (Wed) by nix (subscriber, #2304)
In reply to: I feel entitlement-vibes by NAR
Parent article: FOSDEM keynote causes concerns

I'd say it's fairly reasonable to request some sort of policy to minimize disease spread at *any* large gathering in closed rooms, particularly when it has an actual reputation as a disease pit, particularly when the policy is as cheap and simple as "please wear a mask, particularly if you're showing disease symptoms".

(Covid-19 has absolutely not gone away and is not greatly less dangerous -- what has stopped, in a number of countries, is *vaccination* against it. Why am I not going to FOSDEM, well that's one reason. Not vaccinated for years, nobody will vaccinate me -- the UK government doesn't refund pharmacies enough to cover the cost of vaccination, so hardly any pharmacies provide vaccinations any more for anyone not in the age group that can get it on the NHS. I don't want to catch it *yet again*, the last bout took weeks to shake off. Don't particularly want to catch flu either. I doubt I'm the only person skipping FOSDEM for this reason.)

to post comments

I feel entitlement-vibes

Posted Jan 29, 2025 18:32 UTC (Wed) by bluca (subscriber, #118303) [Link] (11 responses)

> the UK government doesn't refund pharmacies enough to cover the cost of vaccination, so hardly any pharmacies provide vaccinations any more for anyone not in the age group that can get it on the NHS

In Scotland (sadly still part of the UK) I got the vaccine in a pharmacy just last month, so it should be possible, if you look around for one offering it. It should be easier of course

I feel entitlement-vibes

Posted Jan 30, 2025 10:42 UTC (Thu) by paulj (subscriber, #341) [Link] (10 responses)

Health is a devolved matter to the Scottish government, so health care is one of the big differences between England and Scotland. Scotland has its own NHS, and it puts more funding into health care, and funds more universal care policies. E.g., prescription medicines are free in Scotland (unlike England).

That said, the covid vaccines do not prevent infection - past a few months. Also, essentially 100% of people are now vaccinated, multiple times over. Everyone alive - other than some babies and young children - has been exposed to and infected by covid multiple times now. Your immunity is as good as it's going to get really, modulo senescence.

I feel entitlement-vibes

Posted Jan 30, 2025 10:49 UTC (Thu) by bluca (subscriber, #118303) [Link] (9 responses)

> Health is a devolved matter to the Scottish government, so health care is one of the big differences between England and Scotland. Scotland has its own NHS, and it puts more funding into health care, and funds more universal care policies. E.g., prescription medicines are free in Scotland (unlike England).

I am well aware of how the health service works in my country, thank you. Vaccine procurement, authorization, etc, is not devolved, and is largely dependent on the JCVI, so the only thing the SNHS can decide is whether to make them available for free or not and to whom, but private pharmacies can sell it (or not) to paying customers independently of it.

> Your immunity is as good as it's going to get really, modulo senescence.

This is illiterate nonsense. "Natural immunity" fades within months from the infection. Vaccines do not do great for infection prevention, but help MASSIVELY with lowering the severity of the illness if it is caught, and the likelihood of long-term effects such as long covid. Please stop spreading anti-vaxx nonsense on LWN, I'm sure you'll get plenty of "likes" from bots if you instead go do that on twitler or whatever it is called this week.

I feel entitlement-vibes

Posted Jan 30, 2025 11:04 UTC (Thu) by nix (subscriber, #2304) [Link] (3 responses)

> I am well aware of how the health service works in my country, thank you. Vaccine procurement, authorization, etc, is not devolved, and is largely dependent on the JCVI, so the only thing the SNHS can decide is whether to make them available for free or not and to whom, but private pharmacies can sell it (or not) to paying customers independently of it.

In large parts of England they have elected not to -- the cost of doing so is too high, and it was literally driving pharmacies bankrupt (which you'd think would have made it obvious that there was a lot of demand...). So they almost all stopped. I think last I checked there were two left providing vaccinations in all of Cambridgeshire, both with huge backlogs.

> This is illiterate nonsense. "Natural immunity" fades within months from the infection.

There are two distinct things going on here. Antibody levels drop fast -- this is a *good thing* because if you had the immediate post-infection level of antibodies to every disease you ever caught your blood would be a thick soup at best. The level you get after antibody ramp-up is the level you need to drive out an *established disease*, not defeat a newly-landed one). Antibody levels are really easy to measure, so have got most of the attention.

What probably does not fade so fast is T cell recognition of viral antigens: T cells have a remarkably long life (it can be decades!) and remain receptive as long as they live -- but can be killed off by other things, can go nuts attacking some other disease they are also receptive to and get exhausted doing that, etc. But if they survive all that, they will probably protect you from getting actually killed by covid for a long, long time. Not always -- this is statistical -- but probably.

Neither of these things really kick in fast enough to prevent viruses that replicate in the respiratory tract from getting in there, replicating, then going straight back out to infect someone else. That sort of immunity is very hard to attain, which is why no covid vaccine to date prevents transmission, and why the common cold is so incredibly hard to stop.

But, y'know, it's not just getting killed I want to be protected from! I don't much want to land in bed for three weeks feeling like death either, like I did last time I got covid (let alone the two months of being too enervated to do much work). And *that* is helped by reducing exposure, by, say, getting people who might be infectious to wear masks, or just not going to FOSDEM.

I feel entitlement-vibes

Posted Jan 30, 2025 11:46 UTC (Thu) by paulj (subscriber, #341) [Link] (1 responses)

Another factor is the imprinting if you keep being exposed to the same antigen. Your humoral immune system works on a form of rapid evolution, where B-cells (which later will produce antibodies, when stimulated) are "trained" and selected for in germinal nodes/centres (GCs). Your B cells go through rapid evolution in the GC, to try adapt to antigen collected in the GCs, with a selection pressure applied (at least in part) by T-cells. Different lines of B cells in the GCs will evolve to recognise different features of an antigen - it's a stochastic learning process. You end up with different lines of B-cells that have been trained to recognise different parts of different antigens _in different ways_.

There is evidence that repeated exposure to the same antigen will lead to this system becoming very specifically trained to that antigen - "imprinting". With rapidly evolving pathogens, with rapidly varying antigens, this is not per se a benefit.

E.g., (and without making a specific point about any particular disease), repeated immunisation with a vaccine that contains (or causes the manufacture of) 1 specific, unchanged, antigenic protein of a pathogen, is likely to lead to a population of B cells with a stronger bias towards that antigenic protein (kind of like doing ML with a large data-set except it's strongly biased to one feature). Yet, if that pathogen evolves rapidly in the wild it is likely to lead to mutations in that antigenic protein so as to evade those immune responses trained to that old version of that protein.

It is probably better to train your immune system with a /spectrum/ of antigens. Not just 1 protein from 1 version of a pathogen that was in the wild 3+ years ago (and has evolved numerous new, slightly different, lineages since). The literature suggests this is the case across a number of diseases, where we have some data on repeat exposure to unchanged v evolved antigens (be they from vaccinations or infection). That is NOT to say there is no value in immunisation by vaccination! But it does suggest there may be /diminishing/ value - even sometimes negative value - in repeated vaccination with old antigens (in the general sense). There is /some/ evidence in the literature this may be the case for ever-repeating covid19 vaccinations (all in the west present a subunit protein of the spike, with a very infrequently updated version of it). In tandem with vaccinations, we all are anyway - unavoidably - exposed to the full pathogen, through minor infections, when it comes to highly infectious respiratory pathogens such as SARS-CoV-2, so we will still get that wide exposure.

Then there are also T-cells, which directly kill pathogens, and also help mediate B-cell evolution. Some will last you pretty much a lifetime, as you say.

Things here are fascinatingly complex. There are many systems and interactions. There are trade-offs. Sadly, clever people on both sides prioritise politics over educating themselves and reading actual scientific information - instead getting their knowledge largely from popular political media, which is nearly always laughably simplified to point of just being incorrect - and that's true be it "Colbert" or "Fox News".

There is far too much knee-jerk idiocy on /both/ sides.

I feel entitlement-vibes

Posted Jan 30, 2025 11:56 UTC (Thu) by paulj (subscriber, #341) [Link]

Oh, "immune imprinting" and "original antigenic sin" are interesting terms to search for in your favourite tool to google scholarly articles - and then follow the thread of higher-prominence citing articles. There's a body of work on this in immunology predating 2020, and so generally free of the politicised stuff post-20, and it's interesting and informative.

Complexity. Trade-offs. They abound.

I feel entitlement-vibes

Posted Jan 30, 2025 12:04 UTC (Thu) by paulj (subscriber, #341) [Link]

> Neither of these things really kick in fast enough to prevent viruses that replicate in the respiratory tract from getting in there, replicating, then going straight back out to infect someone else. That sort of immunity is very hard to attain, which is why no covid vaccine to date prevents transmission, and why the common cold is so incredibly hard to stop.

There is /some/ evidence that nasal spray vaccinations have a degree of better efficacy for preventing covid infection than injected vaccinations. There are many different kinds of T-cells, and 1 variant is specific to the mucosa - a kind of front-line of defence, at the point of entry for respiratory infections. Nasal spray vaccines appear to stimulate immune responses in those mucosal cells a little bit better than muscular injections.

Been a while since I read into this though, and the evidence base was still preliminary and weak/suggestive at that point. I have not followed evidence since, and I do not know if stronger evidence now exists and if so whether it confirms or contradicts the earlier. (I don't think nasal spray covid vaccinations are widely used yet (??), in which case there is unlikely to be any strong evidence yet either).

I feel entitlement-vibes

Posted Jan 30, 2025 11:05 UTC (Thu) by paulj (subscriber, #341) [Link]

Authorisation, etc., may be centralised, I thought though you were talking about something connected to funding - free vaccines at pharmacies. If you meant private, sure, that's not "NHS Scotland".

You mentioned "natural immunity", not I. Vaccine immunity fares no better (it physiologically can not do better, for obvious reasons). Your rant there is completely off and disconnected from the body of published evidence - your illiteracy claim has the sense misplaced, if anything. But.. .that's not for LWN.

I feel entitlement-vibes

Posted Jan 30, 2025 11:08 UTC (Thu) by smurf (subscriber, #17840) [Link] (1 responses)

> This is illiterate nonsense. "Natural immunity" fades within months from the infection.

… unless you continue to be exposed to low-level background viral load. Granted that this probably is not the case for most of the troglodytes who only leave their cave once a year, for FOSDEM. :-P

> Vaccines do not do great for infection prevention,

Depends on the vaccine. They did super with smallpox (and would do the same with measles if it wasn't for the conspiracy nutcases).

I feel entitlement-vibes

Posted Jan 30, 2025 11:30 UTC (Thu) by bluca (subscriber, #118303) [Link]

> Depends on the vaccine. They did super with smallpox (and would do the same with measles if it wasn't for the conspiracy nutcases).

Yeah totally, was talking about the covid ones exclusively

I feel entitlement-vibes

Posted Jan 30, 2025 14:24 UTC (Thu) by Wol (subscriber, #4433) [Link] (1 responses)

> > Your immunity is as good as it's going to get really, modulo senescence.

> This is illiterate nonsense. "Natural immunity" fades within months from the infection.

And that's ill-informed arrogance.

The reason the common cold (AND CoVid!) is usually harmless is because it is so common. It comes round every few months in a slightly new variant and re-infects you. And because your body remembers the old variant it fights the new one off with ease. So your natural immunity IS as close to perfect as it can get. The virus is constantly changing, your immunity is constantly changing, there's a balance that shifts back and forth.

HINT: Even when CoVid was brand new, one of the factors that helped it spread so fast, was because the MAJORITY of victims did not know they'd been infected. It was just the unfortunate older people who got hit so hard because it was too different from anything they'd ever met before.

Cheers,

Wol

I feel entitlement-vibes

Posted Jan 30, 2025 14:33 UTC (Thu) by jzb (editor, #7867) [Link]

This is getting off-topic and unnecessarily heated. Let's end the COVID threads here -- all of them.

I feel entitlement-vibes

Posted Jan 29, 2025 18:43 UTC (Wed) by Wol (subscriber, #4433) [Link] (3 responses)

> (Covid-19 has absolutely not gone away and is not greatly less dangerous

Actually, Covid is just a new variant of the Common Cold. The problem is that word "new". Because we had never met it before, it spread faster, more easily, and was far more severe, especially in older people with weakened imune systems.

And of course, the press spread absolute nonsense because they're not interested in investigative journalism any more (not that the gutter press ever were). I remember someone (no names, no pack drill) saying "even our grandparents never saw anything like that". EXCUSE ME??? All four of my grandparents lived through the 1919 Spanish Flu epidemic which was *much* worse. (Admittedly both my maternal grandparents were children, my paternal grandparents were in their 20s.)

We had a very similar epidemic round about 1890 (just before my grandparents were born), that killed thousands upon thousands in the UK. And we now understand it much better because we realised that (a) the virus behind that epidemic was THE common cold virus (okay there are a fair few different viruses but that virus is now the one behind 30-40% of all cases of the Common Cold) and (b) Covid is almost the same virus. Which to some extent makes sense because kids (a) are used to meeting all sorts of new bugs, and (b) have strong immune systems. So kids never *seemed* to catch it. But older people with weaker but more experienced immune systems were knocked sideways because they'd never met this particular virus before. Older people don't have (that) much problem coping with new variants of old cold viruses because they don't change much, but a completely new cold virus is another story!

And talking of stories, those into Royal History may know that Princess Mary of Teck came from Denmark to marry the Prince of Wales (who she'd never met). When she arrived, she was told "The Prince of Wales has died," (from this very epidemic) "would you like to marry the new Prince of Wales?". To which she replied "I came to marry the Prince of Wales, so I'll marry him, whichever that Prince may be". And the couple are now known to history as King Geeorge V & Queen Mary.

Cheers,
Wol

I feel entitlement-vibes

Posted Jan 29, 2025 19:08 UTC (Wed) by jzb (editor, #7867) [Link] (1 responses)

Before this runs away into a tangent about how severe COVID is or isn't (or royal histories...) let's stop here. Thanks.

I feel entitlement-vibes

Posted Jan 30, 2025 11:18 UTC (Thu) by nix (subscriber, #2304) [Link]

(Taken to email to try to rectify some of the backwards assumptions in that reply, such as that "the common cold" is a type of virus rather than a description of symptoms...)

I feel entitlement-vibes

Posted Jan 30, 2025 10:21 UTC (Thu) by paulj (subscriber, #341) [Link]

The 08/09 winter season was worse than either of the "covid pandemic" winters in the UK.

I feel entitlement-vibes

Posted Jan 30, 2025 10:29 UTC (Thu) by paulj (subscriber, #341) [Link] (4 responses)

> particularly when the policy is as cheap and simple as "please wear a mask, particularly if you're showing disease symptoms".

Firstly, the evidence of efficacy of masks to protect against respiratory illness is not good. The best source of evidence in the field of medical interventions are the systematic analyses of the primary evidence base by the Cochrane Library, and the last 3 or so reviews they have done shows that - over the data from the primary studies - there is not evidence of efficacy (and the data is also poor). Tracy Greenhalgh (a prominent mask supporter), et al, would disagree with how the Cochrane review was framed, but their own systematic analysis came with the same result - no statistically significant protective effect.

Secondly, masks are not harm-free. They impede lip-reading for the hard of hearing (a family of member of mine found the pandemic very difficult for this reason - they rely on lip-reading). They create mountains of plastic waste. They lead to the inhalation of plastic micro-fibres.

So... efficacy: Questionable at best. No statistically significant effect in systematic reviews of the data. To be weighed against /definite/ harms. That can NOT be a basis for policies that /impose/ on people.

I feel entitlement-vibes

Posted Jan 30, 2025 14:17 UTC (Thu) by Wol (subscriber, #4433) [Link] (3 responses)

> So... efficacy: Questionable at best. No statistically significant effect in systematic reviews of the data. To be weighed against /definite/ harms. That can NOT be a basis for policies that /impose/ on people.

Efficacy at WHAT? Protecting the wearer? Or protecting other people?

Part of the see-sawing in the UK was the belief by the medical profession that CoVid wasn't air-born - as a result of a half-remembered TB study from a century before, that explicitly said its conclusions were specific to TB and should NOT be used for anything else.

And the above WHAT question - masks do not protect the wearer! But the evidence that they help prevent an infected person from spreading it is apparently quite strong. If you're infected, you shouldn't go out. But if do go out you should wear a mask. Not for your sake, but for other peoples'. And the face shields apparently, while a very good comforter, are pure ineffective placebo at both tasks.

Cheers,
Wol

Stop this

Posted Jan 30, 2025 14:35 UTC (Thu) by corbet (editor, #1) [Link]

Wol, you know that this is far off-topic for LWN. Why do we have to continue asking you to stop drawing out this kind of conversation? Don't do this, please.

I feel entitlement-vibes

Posted Jan 30, 2025 15:10 UTC (Thu) by paulj (subscriber, #341) [Link] (1 responses)

I am cognisant of the editors warnings, but I want to make a factual correction:

> the evidence that they help prevent an infected person from spreading it is apparently quite strong.

This is incorrect. We have primary R(C)?CT evidence for protective effect on wearers, and enough of it for Cochrane to have been able to conduct their systematic reviews - though, the body of data there is still, by their standards, poor. We do NOT (TTBOMK) have any substantive evidence for this novel "source control" theory (i.e., that even if they do not protect wearer, they protect others) for masks. I.e., we don't even have any RCT.

It stops here

Posted Jan 30, 2025 15:13 UTC (Thu) by corbet (editor, #1) [Link]

What part of "this is off-topic, please stop" is hard to understand here?

This article is now moderated; the bar for any new comments will be quite high.

I feel entitlement-vibes

Posted Jan 30, 2025 10:41 UTC (Thu) by NAR (subscriber, #1313) [Link] (1 responses)

I'm pretty sure that a "wear a mask" policy would be at least controversial as the lack of disease policy... I'm afraid catching a cold in winter is practically inevitable if someone goes to crowded spaces (public transport, school, etc.). In a previous decade I was single and rarely used public transport to commute - but nearly every time I did take the tram and underground, I caught cold. Now this problem is solved, the kids bring home all new germs from kindergarten/school, so I don't even need to leave home :-)

One can make precautions like getting vaccinated, wearing a mask or avoiding such places. Maybe the conference could be moved to spring.

I feel entitlement-vibes

Posted Jan 30, 2025 18:07 UTC (Thu) by laurent.pinchart (subscriber, #71290) [Link]

As far as I understand, one of the key reasons why the FOSDEM takes place on the first weekend of February is because the ULB campus is free of classes on the week before, as students are on a break after an intensive period of exams. This gives the organizers time to setup everything for the conference. Moving it to spring would be quite difficult, if not impossible (assuming of course it stays organized at the ULB, moving to a different venue would be an entirely different question).