COVID COVID-19 Coronavirus Containment Efforts

[JT Smith]

It looks like the vaccines are effective at preventing symptomatic disease, and in the case that a vaccinated individual does get infected, the vaccines are very effective at preventing hospitalizations and death.

That was my question though. How effective are the vaccines when challenged with exposure? Vaccinated people have been infected, some have become seriously ill, some have died.

Vaccines aren't perfect, we all know that. I'm just curious how good they are. Could I slam dance with a group of contagious people without too much worry or would that be really dangerous?

 

[vela]

That was my question though. How effective are the vaccines when challenged with exposure? Vaccinated people have been infected, some have become seriously ill, some have died.

Are you talking about vaccines in general or the COVID-19 vaccines? In the Moderna clinical trials, none of the vaccinated individuals developed serious illness after the initial 14 days needed for the immune response to develop. I seem to recall the story was similar with Pfizer and J&J.

 

[JT Smith]

Are you talking about vaccines in general or the COVID-19 vaccines? In the Moderna clinical trials, none of the vaccinated individuals developed serious illness after the initial 14 days needed for the immune response to develop. I seem to recall the story was similar with Pfizer and J&J.

COVID-19. Although I wouldn't be surprised if there were other cases I only know about the ones in WA state. It's expected that some people will get infected, some experience more serious illness, and some die. It's a very small percentage in the report I read. But it conflates risk of exposure with risk of infection/illness/death. And that's the crux of my question: Assuming significant exposure, what is the risk?

Out of one million fully vaccinated individuals in Washington state, epidemiologists report evidence of 102 breakthrough cases since February 1, 2021, which represents .01 percent of vaccinated people in Washington. Breakthrough cases have been identified in 18 counties. The majority of those in Washington state with confirmed vaccine breakthrough experienced only mild symptoms, if any. However, since February 1, eight people with vaccine breakthrough have been hospitalized. DOH is investigating two potential vaccine breakthrough cases where the patients died. Both patients were more than 80 years old and suffered underlying health issues. Further investigation will help to identify patterns among people who have COVID-19 after vaccination, such as if a virus variant may have caused the infection.

https://www.doh.wa.gov/Newsroom/Art...ne-breakthrough-confirmed-in-Washington-state

 

[bhobba]

So while I'm happy for you guys, I don't think there is much we can learn from your model.

Valid counter-argument. The circumstances are entirely different. What I will say is our debt spike per person from Covid measures is the greatest in the world. I suspect that is something peculiar to our culture and other counties citizenry may not tolerate such debt.

Thanks
Bill

 

[bhobba]

I seem to recall the story was similar with Pfizer and J&J.

See:
https://pharmaceutical-journal.com/...hing-you-need-to-know-about-covid-19-vaccines

There was one case with the Pfizer trial of severe Covid. The rest none. Actual use in the UK, where they have done millions, is basically all are equally effective. Pfizer has an advantage in the frontline and aged care home residents group because the second dose is 3 weeks later, so they have maximum immunity quicker. This, for example, allows frontline workers to resume all duties quicker, bearing in mind where I live, only fully vaccinated front line workers can do so. There is also an issue with the Oxford vaccine and blood clots, but I will do a separate post about that.

Thanks
Bill

 

[Ygggdrasil]

That was my question though. How effective are the vaccines when challenged with exposure? Vaccinated people have been infected, some have become seriously ill, some have died.

Vaccines aren't perfect, we all know that. I'm just curious how good they are. Could I slam dance with a group of contagious people without too much worry or would that be really dangerous?

Disclaimer: I am not a medical doctor.

Based on my understanding of the vaccine, the vaccine should protect you if you were to socialize with contagious people. Of course, as you state, the vaccine is not perfect, so there is some risk of infection. However, that level of risk is certainly lower than the risk of getting infected if you are not vaccinated (~90% less risk, in the case of the Pfizer and Moderna mRNA vaccines). Furthermore, even if you do get infected, the vaccines lower the risk that the infection will lead to hospitalization or death.

It is difficult to calculate the exact risk because there are too many unknown factors and those factors can change over time (e.g. as the prevalence of various variants changes). The vaccines won't completely eliminate risk, but they can reduce it to very low levels (maybe to the extent that the most dangerous part of a trip to a slam dance might be the risk of dying in a car accident while driving to or from the slam dance rather than the risk of contracting and dying from COVID-19).

Here's a good picture of what a "return to normal" might look like:

Even if widespread vaccination can’t halt the spread of the virus, it promises a major step back toward normal. Preventing severe disease and death in the elderly and people with comorbidities such as obesity and hypertension—the most vulnerable—is still a resounding victory over the virus, many epidemiologists say.

Large swaths of the population might still become infected and develop minor disease or asymptomatic infections. That prospect worries some scientists and clinicians, who note that even mild cases can lead to the “long COVID” phenomenon of lingering symptoms. Hospitals, though, will not become overwhelmed with emergency cases and deaths will become increasingly rare.

To Corey, those metrics are the most relevant. “When will the ICU use and all of this decant so that we’re at the point where, yes, we can sort of tolerate this?” he asks.

“We’re not going to shut down this virus and end transmission,” agrees Nicole Lurie, an adviser to the Coalition for Epidemic Preparedness Innovations. “We have to make a decision as a society about how much of this we can and want to live with.” Society lives with influenza, after all, which remains endemic despite a vaccine. But Lurie stresses that flu is not an appealing model. It kills up to 60,000 people per year in the United States alone—a toll she would not want to accept from COVID-19.

Still, immunologist Brigitte Autran, a member of France’s Scientific Committee on COVID-19 Vaccines, says herd immunity isn’t needed to bring back normalcy. “The first goal is to have individual protection, and by summing the individual protections, to have a protection of the society that will allow countries to come back to almost real, true lives.”

https://www.sciencemag.org/news/2021/02/how-soon-will-covid-19-vaccines-return-life-normal

 

[Astronuc]

From NY Times, https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html (Updated daily, so information will be replaced)

At least 956 new Coronavirus deaths and 81,769 new cases were reported in the United States on April 9. Over the past week, there has been an average of 67,923 cases per day, an increase of 12 percent from the average two weeks earlier. As of Saturday morning, more than 31,107,200 people in the United States have been infected with the Coronavirus according to a New York Times database.

The cumulative total for deaths in US due to Covid-19 stands at 560,531 as of April 9.

https://www.nytimes.com/interactive/2021/us/new-york-covid-cases.html - note the clusters at universities and colleges.

 

[mfb]

Chattahoochee, Ga had 34,000 confirmed cases per 100,000 and it's still a hot spot?

Israel vaccinated over 60% of the population. New vaccinations (first dose) have slowed down significantly as most eligible people interested in getting a vaccine have one by now. New cases are down dramatically.
The UK seems to follow the same pattern at close to 50%. Clear downwards trend here as well.

For comparison: Germany, Italy and France added another peak in early April and Spain might be heading towards another peak.

Global vaccination doses will reach 10% of the world population in the next two days (but many of them are two-dose vaccines).

https://ourworldindata.org/covid-vaccinations

 

[pinball1970]

I received an alert regarding a study about wearing masks in school. The study used fluid dynamic models.

https://scitechdaily.com/new-resear...p-covid-spread-better-than-social-distancing/

Paper here.
https://aip.scitation.org/doi/10.1063/5.0040755

 

[russ_watters]

Chattahoochee, Ga had 34,000 confirmed cases per 100,000 and it's still a hot spot?

That has a question mark at the end, but is worded as a statement. Can you say where you heard of it, what the criteria is for being a "hot spot" and if that's really a question, what the question is? I've never heard of Chattahoochee, Ga., so I googled it, and I see that it isn't where the Master's Tournament is being held.

 

[OmCheeto]

That has a question mark at the end, but is worded as a statement. Can you say where you heard of it, what the criteria is for being a "hot spot" and if that's really a question, what the question is? I've never heard of Chattahoochee, Ga., so I googled it, and I see that it isn't where the Master's Tournament is being held.

I'm guessing I mentally inserted the commas and inflections differently, and interpreted what mfb said as 'why is it still a hot spot?'. Having also never heard of Chattahoochee, Georgia, US, I spent several hours yesterday analyzing their numbers.
Results:

1. They were #2 in the world for "Cases/Million/Day" for the week averaged from 3/28 thru 4/4. Guessing this is where "hot spot" came from.

2. They were also #2 in the world for "% Case total" as of April 4th.

3. Since I almost never look at cases, this kind of surprised me, and I looked at their "% death total", which showed a number 3 times too low. I thought that was very strange until I looked them up in wikipedia and found:

4.

a. "As of September 23, 2020, during the COVID-19 pandemic in the United States, the county had the highest infection rate of any county in the US, with 14,908 cases per 100,000 residents."

b. "The median age was 24.0 years."

c. "Although its population has declined, the county was notable in 2016 for having the highest proportion of millennials (persons 15–34 years old) of any county within the United States: 59.7%"
​

4.b. kind of answered my question as to why their case fatality rate was so far off, as their median age was lower than even the lowest of our territories.

------
Edit:
As usual, the Center for Systems Science and Engineering at Johns Hopkins University was my data source.
https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

 

[Ygggdrasil]

That has a question mark at the end, but is worded as a statement. Can you say where you heard of it, what the criteria is for being a "hot spot" and if that's really a question, what the question is? I've never heard of Chattahoochee, Ga., so I googled it, and I see that it isn't where the Master's Tournament is being held.

Looks like the data are from the NY Times link posted by @Astronuc in the post directly preceding the post you quoted:

https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html

 

[russ_watters]

Looks like the data are from the NY Times link posted by @Astronuc in the post directly preceding the post you quoted:

I'm guessing I mentally inserted the commas and inflections differently, and interpreted what mfb said as 'why is it still a hot spot?'. Having also never heard of Chattahoochee, Georgia, US, I spent several hours yesterday analyzing their numbers...

b. "The median age was 24.0 years."

c. "Although its population has declined, the county was notable in 2016 for having the highest proportion of millennials (persons 15–34 years old) of any county within the United States: 59.7%"

Thanks. This media fascination with identifying teeny-tiny outliers is bizarre to me, and while I've no interest in spending hours on their "case", I did see that the county is underfoot of Fort Benning, which is an Army base 10 times the population of the county itself. It's huge, a training center, populated by younger people, houses them in close quarters, and then sends them traveling throughout the country and world. So that would explain the weird demographics and high case load. But Crozby, TX, stand by because we're coming for you next!

 

[mfb]

I did see that the county is underfoot of Fort Benning, which is an Army base 10 times the population of the county itself.

That probably answers the question how the county can maintain so many nominal cases per capita: The population number in the denominator is not the number of people there.

 

[russ_watters]

That probably answers the question how the county can maintain so many nominal cases per capita: The population number in the denominator is not the number of people there.

Well, I don't think the soldiers get counted in either - that would be a big mismatch if they did. I did see a link where the Army said they weren't going to report their caseload anymore. So I do think their numbers are really townspeople - it's just that they have a lot of interactions with soldiers and their families.

 

[mfb]

I don't see how that would lead to a maintained high per capita rate. What's the scenario here?
Soldiers have a lower capita rate? Why would they preferably infect the civilians?
Soldiers have a similar or higher per capita rate? Why didn't they run out of infectious people already?

If that base doesn't enter the statistics directly, how would that base differ from a random other high population county nearby with a similar demographics?

 

[russ_watters]

I don't see how that would lead to a maintained high per capita rate. What's the scenario here?
Soldiers have a lower capita rate? Why would they preferably infect the civilians?
Soldiers have a similar or higher per capita rate? Why didn't they run out of infectious people already?

If that base doesn't enter the statistics directly, how would that base differ from a random other high population county nearby with a similar demographics?

I don't know either. I was guessing it is because soldiers have a high per capita rate and high "churn". Being somewhat of a training facility, they continuously circulate new infected people through the base and town. But there could also be a numerator/denominator issue. Even a tiny fraction of families (girlfriends?) living off-base, and turning-over every 2-3 years (for the long-term population) or more often could add significantly to the pool of "infectables". 1/3 reported infected is a really high number that is hard to achieve given the large number of missed infections in the early days of the pandemic. Regardless, the base demographics themselves are going to be weird and it is impossible for us to know for sure what they are or what their infection profile looks like.

 

[russ_watters]

Updates to my projections in this March 18 post:

• The Biden administration's current goal is to produce enough vaccines for every adult by the end of May. That's a touch vague, as current guidance is for the vaccine to be administered to at-risk teenagers 16+. If it includes everyone 16+, that's 260 million people. Figure 4 weeks for the emptying of the distribution pipeline and we could have every adult vaccinated by the end of June.

On track, but people declining the vaccine will of course prevent that from being achieved.

• The J&J vaccine is not currently ramping-up. There was an initial stockpile of 4M doses starting to ship on 3/1, but only 1.9 M have been administered so far, and over the past week the vaccination rate has actually dropped a bit. So I modeled that based on the assumption of a smooth ramp-up until J&J's projection of 95M doses shipped by the end of May is administered two weeks later (same link).

We're a bit behind what I was predicting overall, mostly due to the J&J vaccine continuing to not ramp up. It just started to ramp at the beginning of April, from about 100,000 doses administered per day, to 350,000 as of a few days ago. If it continues that ramp rate, it won't meet the 95M goal.

• 2nd doses of the Moderna & Pfizer vaccines are also not ramping-up. It's been fluctuating between 0.5 and 0.9 million per day for more than a month.

Now starting to ramp-up: currently about 1.2M per day.

• I have the total administered (1st + 2nd + J&J) continuing its current ramp rate. By the 2nd week in June it would reach 6 million per day if we don't run out of people to vaccinate. Currently it's about 2.5 million per day.

As I said, we're trending a little below my projections mostly due to the J&J vaccine, by about a week. But again, 6 million doses/day won't happen because we'll run out of people to vaccinate first. We could reach 5 million/day by the end of May, but that probably won't even happen. We're at 3 million/day now.

• There's 30 million doses of the AZ vaccine stockpiled. AZ has not applied for emergency use authorization yet, so there's a decent chance these doses don't factor into the USA's vaccination picture until we're well into the "everyone else" group if at all (more on that in the projections...).

The AZ vaccine will almost certainly not factor into the first wave USA vaccination picture.

Projections:

• By April 10, 131M will have received at least a first dose and 75M will be fully vaccinated.
• When the vaccine is opened up to "everyone else", that will include me. I'll be aggressive about scheduling, so I'll expect I can get at least the first dose (if a 2-dose vaccine) by April 10.
• By April 20, 155M will have received at least a first dose and 114M will be fully vaccinated. We will need to have transitioned to the "everyone else (>16)" eligibility by then or we'll start running out of people to vaccinate.

Actual April 10 numbers are 121M at least one dose, 74M fully vaccinated. These will go up by a couple million, as the CDC lists totals by date reported on their dashboard, but updates by date administered in a spreadsheet. Despite the 72hr required reporting time, the numbers for a particular date continue going up for weeks.

Biden wants everyone eligible by April 19. My state just announced they are opening-up eligibility to every adult tomorrow (so I was off by 3 days on that). I've seen in my graph of the running totals that the distribution pipeline is starting to lengthen, which may be a result of starting to "run out of people to vaccinate" in Phase 1.

• By May 10, even at 90% uptake we'll start running out of adults to vaccinate (everyone who wants one will have at least a first dose), and the rates will start to flatten or drop. I haven't modeled how that will look.
• By May 30, every adult who wants to be vaccinated will have been fully vaccinated (234 M) if everyone lines-right up for them (so the rates don't drop).

These are looking a week or so behind, but again we'll run out of people to vaccinate anyway before we get to them. We'll start to find out in a few weeks just how much vaccine hesitancy there is.

Side note: My area has been re-opening, too quickly. Case rates are too high, and they've been flat for the past few weeks even as restrictions are easing. As close as we are to the finish line, I think that's dumb and I'm not easing up on my protocols. I won't be doing any indoor dining, traveling, going to the gym or permanently returning to my office, etc. until I'm fully vaccinated or the case rates drop another order of magnitude. What's another month after 12? I believe tomorrow's my 1-year anniversary of work from home.

That remains my opinion. But I did go out to dinner for my dad's 78th birthday on Saturday.

 

[Astronuc]

Reuters - Majority of Brazil COVID-19 ICU patients aged 40 years or younger - report
https://www.reuters.com/article/us-...aged-40-years-or-younger-report-idUSKBN2C02UB

RIO DE JANEIRO (Reuters) - The surging COVID-19 outbreak in Brazil is increasingly affecting younger people, with hospital data showing that last month the majority of those in intensive care were aged 40 or younger, according to a new report.

The report, released by the Brazilian Association of Intensive Medicine (AMIB) over the weekend, is based on data from over a third of all the country’s intensive care wards. It found a significant increase in younger people being admitted to beds in Intensive Care Units (ICUs).

For the first time since the outbreak reached Brazil last year, 52% of ICU beds were filled by patients aged 40 or younger. That is a jump of 16.5% compared to the occupancy of that age group between December and February.

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.

 

[mfb]

It's a relative statement. Vaccinate older people first and the fraction of younger people in ICU increases, without anything negative happening. Without absolute numbers this isn't telling us much.

 

[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?