COVID COVID-19 Coronavirus Containment Efforts

[Wrichik Basu]

In my country, the situation is worsening every day. Six days back, we were having ~ 145k new patients every day. Since yesterday, it has grown to > 215k. Higher deaths as well. People are not wearing masks anywhere. Neither does the Govt. have any plans for lockdown because of ongoing elections in many states (including mine). Essentially, no containment efforts.

A graph on the daily new number of COVID-19 patients (from a Bengali newspaper) is available here.

 

[WWGD]

In my country, the situation is worsening every day. Six days back, we were having ~ 145k new patients every day. Since yesterday, it has grown to > 215k. Higher deaths as well. People are not wearing masks anywhere. Neither does the Govt. have any plans for lockdown because of ongoing elections in many states (including mine). Essentially, no containment efforts.

A graph on the daily new number of COVID-19 patients (from a Bengali newspaper) is available here.

View attachment 281603

Ouch! Sorry to hear that. Worldwide, we hit the 3 million deaths milestone today, and stuck at 500,000+ cases, 10,000+ deaths daily.

 

[dlgoff]

I have a friend who still believes SARS-Cov-2 (and Covid-19) is not a serious threat. He believes he is young enough (late 50s), and he states that many acquaintances have had Covid-19 and survived. He believes the vaccine and precautions are unnecessary, so he takes chances. We still don't know who is and who is not vulnerable, but age and comorbidities are factors. I won't take a chance.

Do you still consider him a friend?

 

[WWGD]

Do you still consider him a friend?

Valid concern, but ostracizing someone for their ( absurd, nonsensical) beliefs is rarely if ever the way of bringing them around.

 

[StevieTNZ]

https://www.channelnewsasia.com/news/world/australia-death-blood-clots-linked-astrazeneca-covid-19-vaccine-14635410

Australia on Friday (Apr 16) reported its first death from blood clots linked to the AstraZeneca COVID-19 vaccine after the country's regulator said a 48-year-old woman's fatality was "likely" linked to the shot.

Australia's Vaccine Safety Investigation Group (VSIG), which held a late meeting on Friday, concluded the New South Wales woman's death was likely linked to the vaccination, the Therapeutic Goods Administration said in a statement.

 

[dlgoff]

Valid concern, but ostracizing someone for their ( absurd, nonsensical) beliefs is rarely if ever the way of bringing them around.

Agreed. Hopefully He will come around.

 

[WWGD]

Agreed. Hopefully He will come around.

I don't mean to preach to you; I can be a hot head and just blurt things in anger that I most likely should not.

 

[Vanadium 50]

I have a friend who still believes SARS-Cov-2 (and Covid-19) is not a serious threat. He believes he is young enough (late 50s), and he states that many acquaintances have had Covid-19 and survived. He believes the vaccine and precautions are unnecessary, so he takes chances. We still don't know who is and who is not vulnerable, but age and comorbidities are factors. I won't take a chance.

I wouldn't either, but, despite the comments on this thread, your friend is not being completely irrational. Being in the 40-49 age group reduces the probability of dying to about the same level as being vaccinated, just from being younger.

"I'm not going to get vaccinated" and "I'm going to get vaccinated and then run out and indulge in all the risky behaviors I've missed" have (in that age bracket) comparable risks. Yet one is less accepted than the other. Why is that?

 

[mfb]

"I'm not going to get vaccinated" and "I'm going to get vaccinated and then run out and indulge in all the risky behaviors I've missed" have (in that age bracket) comparable risks.

I don't think it's useful to compare COVID-19 to skydiving, drunk driving or whatever you have to do to get a comparable risk.

 

[Vanadium 50]

There is a paper out, "The lockdown effect: A counterfactual for Sweden". It claims that had Sweden locked down, they would have reduced infections by 75% and fatalities by 38%. That would have moved Sweden from the middle of the pack of European countries to the top quintile.

This has gotten some press, mostly along the lines of "Ha ha Sweden. We told you so."

I find the methodology very interesting. They weight the statistics of the other countries pre-lockdown until it matches Sweden, and then look at the post lockdown numbers for those countries. However, I did not think the paper itself was very good. I have two main objections:

(1) There is nothing magic about Sweden. They could and should have done this for every country, showing that the technique has predictive power. Apart from validating the technique, it would have allowed them to quantify the uncertainty in the method. is it good to 1%? 10%? A factor of two?

Furthermore, there's nothing magic about now. They should be able to calculate infections vs. time and deaths vs. time and compare.with what actually happened.

(2) If a lockdown reduces infections by 75% and fatalities only by 38%, somehow it means it increases the severity of the disease. Hmmm...

Of course, one could argue maybe this is just a demographic effect - that a lockdown preferentially protects a less vulnerable population. Fair enough, but I'd expect the paper to detail this.

I think a really good paper could be written along these lines. This paper, though, IMO isn't it.

 

[Vanadium 50]

Which numbers do you compare here?

Deaths per unit population by age and vaccine effectiveness.

We can argue about exactly where the lines cross, but cross they do.

 

[Vanadium 50]

I don't think it's useful to compare COVID-19 to skydiving, drunk driving or whatever you have to do to get a comparable risk.

I don't think I am comparing that to drunk driving. I think I am comparing it to going to a party without a mask.

 

[PeroK]

Deaths per unit population by age and vaccine effectiveness.

We can argue about exactly where the lines cross, but cross they do.

The lines cross, if at all, in children. For example, in January 2021 in the UK there were 39 deaths from COVID recorded for the age group 20-29. That's out of about 8 million people. That's just one month. With a bit of calculation I would say that without a vaccine about 200 people in the 20-29 age group would die before the pandemic naturally runs its course. That's one in 40,000.

The risk from the vaccine is about 25 times less, although both numbers are small - which ties in with the publicity that younger people need to be vaccinated only a little for themselves and mostly to protect others.

PS there are almost no deaths in people under 20.

 

[.Scott]

I just read another article about whether some counties with low vaccination interest will ever reach COVID-19 herd immunity.

This is a mis-placed concern. Communities with low interest in the vaccine commonly have low interest in other COVID precautions - and so they will certainly reach herd immunity. They're just choosing sick over stick.

 

[hmmm27]

If various gov'ts could find their collective balls, borders - country/province/city/etc - would be closed to people/shipments from places with worse stat's.

 

[Wrichik Basu]

We are seeing a great shortage of oxygen supply in our country. The central Govt. has prohibited use of O₂ for industrial and educational purposes, so that the supply can be diverted to hospitals only. The railways have arranged for special trains known as "Oxygen Express" for delivering cylinders very fast via green corridors. There is a shortage of remdesivir too; I read in the news some days back that people are buying the drug from the black market for 7 to 12 times the list price.

Most of the political parties (except one) have cut down their election campaigns to help curb the spread of the virus.

In the last 24 hours, 273,810 more people contracted the virus countrywide, with 1,619 deaths. The total number of active patients is 1,929,329.

 

[StevieTNZ]

NZ has banned all flights originating or transiting through India, as many in MIQ having arrived from that country were returning positive Covid results.

 

[mfb]

I don't think I am comparing that to drunk driving. I think I am comparing it to going to a party without a mask.

Do we have a COVID-19 death from someone vaccinated now? The vaccine reduces deaths to essentially zero, going to a party can't beat that.

 

[Vanadium 50]

Do we have a COVID-19 death from someone vaccinated now?

74. (In the US)

An interesting outcome is that the question of dying with Covid and dying from Covid is back. But many people have switched sides.

The vaccine reduces deaths to essentially zero,

That's not what the CDC statistics show. Their numbers are 5800 post-vaccination cases, 400 hospitalizations, and 74 deaths. If you took 5800 random unvaccinated cases, you would expect just over 100 deaths.

Sol, does the vaccine reduce the severity? Taking the numbers at face value, a little. However, you would expect deaths/case to be lower post-vaccination even if severity were unchanged, because the denominator has been redefined. Pre-vaccination, someone with antibodies is a "case", even if asymptomatic. Post-vaccination, someone with antibodies and no symptoms is not a "case" - it's "just the vaccine doing its job".

 

[Ygggdrasil]

That's not what the CDC statistics show. Their numbers are 5800 post-vaccination cases, 400 hospitalizations, and 74 deaths. If you took 5800 random unvaccinated cases, you would expect just over 100 deaths.

Sol, does the vaccine reduce the severity? Taking the numbers at face value, a little. However, you would expect deaths/case to be lower post-vaccination even if severity were unchanged, because the denominator has been redefined. Pre-vaccination, someone with antibodies is a "case", even if asymptomatic. Post-vaccination, someone with antibodies and no symptoms is not a "case" - it's "just the vaccine doing its job".

While I don't question the numbers (they are the numbers that the https://www.cdc.gov/vaccines/covid-19/health-departments/breakthrough-cases.html), they don't seem consistent with other reports that the vaccine does reduce severity of disease. For example, in real world data from Israel published in the NEJM, they saw 9 deaths among 4460 infections among vaccinated individuals (0.2%) but 32 deaths among 6100 matched unvaccinated control individuals (0.5%).

Similar reductions can be seen in the clinical trial data for the various vaccines. I wonder why the data from the US seem to show less efficacy at preventing infection to progressing to death.

 

[russ_watters]

I wouldn't either, but, despite the comments on this thread, your friend is not being completely irrational. Being in the 40-49 age group reduces the probability of dying to about the same level as being vaccinated, just from being younger.

"I'm not going to get vaccinated" and "I'm going to get vaccinated and then run out and indulge in all the risky behaviors I've missed" have (in that age bracket) comparable risks. Yet one is less accepted than the other. Why is that?

Speaking of riskier behaviors than skydiving, I just sent my manager an email saying I'm willing to go back to the office full time after being fully vaccinated (in about 6 wks). Surely being in the office is more than 20x more dangerous than being at home. 95% effective sounds (is) awesome and while I previously expressed that once I'm vaccinated I would no longer need to care about my COVID risk or the choices of others, now that it's closer to reality 95% doesn't sound like that big a number anymore. For example...

The new case rate criteria for starting to re-open, which we never achieved, was 3.5 per 100k per 2 weeks. The lowest in my area was 4, in late June. Right now we are at about 40 and rising. So by those numbers, doing something risky like eating near other people while vaccinated would only be about twice as safe as while unvaccinated last June, unless we can quantify the severity decrease on top of the 95% efficacy. Twice as safe does not sound like a big improvement...it's a lot smaller than 20x safer.

This is something I'll need to weigh unless the case rates start dropping again.

 

[Vanadium 50]

I wonder why the data from the US seem to show less efficacy at preventing infection to progressing to death.

The tyranny of mathematics. We have two firm numbers, a squsihy number, and a desire for a particular outcome from a public policy perspective.

Numbers vaccinated and number dead are pretty firm. The number of cases is not so firm, and it depends on the definition of a case, which has some flexibility and human judgement. What the public health officials want to tell the populace is that cases/vaccinated and deaths/cases are as low as possible.

Obviously, there's no definition of "cases" that minimizes both ratios. Different countries, different choices.

Also, different countries use different vaccines. While we are told that all three varieties have exactly the same protection, and exactly the same small risk of side effects (well, until one was pulled, anyway), maybe this isn't true.

 

[Vanadium 50]

Surely being in the office is more than 20x more dangerous than being at home.

Why do you think that? Only one person is allowed in my office (one on one meetings are held with me in my office and the other person in a chair outside my door) My office gets cleaned and disinfected daily. People who are in more often than me (I am slowly ramping up to weekly) get tested. At home you have to worry about whatever germs your spouse and kids drag in.

I'd be prepared to say it's riskier - but a factor 20 riskier?

 

[russ_watters]

Why do you think that? Only one person is allowed in my office (one on one meetings are held with me in my office and the other person in a chair outside my door) My office gets cleaned and disinfected daily. People who are in more often than me (I am slowly ramping up to weekly) get tested. At home you have to worry about whatever germs your spouse and kids drag in.

I'd be prepared to say it's riskier - but a factor 20 riskier?

I'm looking into acquiring one of those "spouse" things. Right now I have "girlfriend", which I don't keep in my house. This provides a buffer/enables quarantine in case of exposure.

My office today has very low occupancy, maybe 20 people in 30,000 Sq ft. Normally I'm in a cubicle with low walls and right now a checkerboard occupancy pattern. I'm speculating that by the time I get back it will be half occupied; maybe 100 people. I'm not sure when the checkerboard pattern will be discontinued. We don't do any testing, but we have exposure/quarantine protocols and internal social distancing.

Still, and I do mean this 90% seriously; my risk of exposure from my coworkers is exactly zero if I stay home and some non-zero number if I go into the office. I really don't know how to quantify the difference without a divide by zero error.

 

[russ_watters]

Also, different countries use different vaccines. While we are told that all three varieties have exactly the same protection, and exactly the same small risk of side effects (well, until one was pulled, anyway), maybe this isn't true.

We're told to get the first vaccine we can get, without considering the efficacy. I was already having mixed thoughts on that, but then the J&J vaccine got halted and the decision was re-made for me (my J&J vaccine appointment was for the day after the halt). The J&J vaccine is said to have between 66% and 75% efficacy. That's better than most flu vaccines but way, way worse than the 95% of the Pfizer/Moderna vaccines. To make it even more complicated, it takes 2 weeks to achieve full efficacy with the J&J vaccine vs 5 weeks for Pfizer/Moderna. I'd rather just stay home and wait 3 more weeks for the 95% than assume I'm good to go back to work/restaurants/parties after 2 weeks at 66-75%.

It's almost certainly better for policy to tell people to get the first available dose, but it's probably better for me to get the more effective one. Fortunately the J&J vaccine is going to end up as a small fraction of our first wave of vaccinations so "we" don't have to consider the ethics of that guidance if we don't want to...though it will matter for other countries, particularly less developed ones.

https://www.healthline.com/health-n...first-covid-19-vaccine-thats-available-to-you

 

[Vanadium 50]

I'm looking into acquiring one of those "spouse" things. Right now I have "girlfriend", which I don't keep in my house. This provides a buffer/enables quarantine in case of exposure.

When a young man gets married, he knows the true meaning of happiness.
But by then it's too late.

 

[Ygggdrasil]

We're told to get the first vaccine we can get, without considering the efficacy. I was already having mixed thoughts on that, but then the J&J vaccine got halted and the decision was re-made for me (my J&J vaccine appointment was for the day after the halt). The J&J vaccine is said to have between 66% and 75% efficacy. That's better than most flu vaccines but way, way worse than the 95% of the Pfizer/Moderna vaccines. To make it even more complicated, it takes 2 weeks to achieve full efficacy with the J&J vaccine vs 5 weeks for Pfizer/Moderna. I'd rather just stay home and wait 3 more weeks for the 95% than assume I'm good to go back to work/restaurants/parties after 2 weeks at 66-75%.

It's almost certainly better for policy to tell people to get the first available dose, but it's probably better for me to get the more effective one. Fortunately the J&J vaccine is going to end up as a small fraction of our first wave of vaccinations so "we" don't have to consider the ethics of that guidance if we don't want to...though it will matter for other countries, particularly less developed ones.

https://www.healthline.com/health-n...first-covid-19-vaccine-thats-available-to-you

One should exercise some caution in directly comparing the measured vaccine efficiencies in the trials for the various vaccines as the trials measured different outcomes and were done in different populations at different points in the outbreak:

"But comparing the efficacy of [the Pfizer and Moderna] vaccines to the efficacy of Johnson & Johnson’s is challenging because of differences in the designs of the Phase 3 clinical tests — essentially the trials were testing for different outcomes. Pfizer’s and Moderna’s trials both tested for any symptomatic Covid infection. Pfizer started counting cases from seven days after receipt of the second dose of vaccine, while Moderna waited until day 14 to start counting cases.​

​

J&J, by contrast, sought to determine whether one dose of its vaccine protected against moderate to severe Covid illness — defined as a combination of a positive test and at least one symptom such as shortness of breath, beginning from 14 or 28 days after the single shot. (The company collected data for both.)​

​

Because of the difference in the trials, making direct comparisons is a bit like comparing apples and oranges. Additionally, Pfizer and Moderna’s vaccines were tested before the emergence of troubling new variants in Britain, South Africa, and Brazil. It’s not entirely clear how well they will work against these mutated viruses."​

https://www.statnews.com/2021/02/02...eloped-by-pfizer-moderna-and-johnson-johnson/

I'd recommend reading the full piece linked above if you are interested in more about the differences between the various vaccines.

 

[mfb]

That's not what the CDC statistics show. Their numbers are 5800 post-vaccination cases, 400 hospitalizations, and 74 deaths.

That's out of 80 million, or 1/4 of the US population, and largely covering the high risk groups where we expect most deaths. Overall deaths are still ~500-1000 per day and were higher in the past. 74 deaths overall is close to zero compared to the unvaccinated population. The reduction of deaths is far better than the 95% efficacy for confirmed cases the phase III studies reported. Israel measured that first, the CDC numbers confirm it.

@jack action: Yes this is how good vaccines work.

If you took 5800 random unvaccinated cases, you would expect just over 100 deaths.

Vaccinated people are not representative for the general population.

 

[russ_watters]

One should exercise some caution in directly comparing the measured vaccine efficiencies in the trials for the various vaccines...
https://www.statnews.com/2021/02/02...eloped-by-pfizer-moderna-and-johnson-johnson/

I'd recommend reading the full piece linked above if you are interested in more about the differences between the various vaccines.

Thanks. That was informative, yet powerfully unhelpful (not your fault). It's somewhat shocking to me that such an important question evidently has no known answer.

A different take on the overall issue:
From a public policy perspective I think there is a good chance the current tack is going to backfire. If there is one thing skeptics are good at, it is finding discrepancies in a message -- even when they are unintentional and even sometimes when they don't exist.

While typing this Dr. Fauci appeared on my TV screen, with this exchange:
"So what we say to anyone who has doubts about getting a vaccine; it's up to you. Look at the data. The data speak for themselves."

Unfortunately it's not that simple and the data for some important parts of the issue are evidently not available or not useful/comparable.

 

[Vanadium 50]

Did I say that vaccines didn't work? Ever? You asked if there was a single death. I found 74, Yggdrasil found 9. Now you that you know the answer isn't what you expected you are free to argue that it's not important. But the number isn't zero.

From a public policy perspective I think there is a good chance the current tack is going to backfire.

Do you think backfiring matters? Right now, it's not as if there are piles and piles of vaccine and nobody wants to take it. When we get to the last 10%, do you think that they will even remember what nonsense was spouted months back, much less have it influence their behavior?