COVID COVID-19 Vaccine Progress: Are We Ready for Rollout in Australia?

[pinball1970]

Not sure if this is the right thread to post but I got a question which I tried to look up myself but couldn't find data.
What's the percentage of people that catch the corona virus and don't recover, i.e. they die? An average from all variants if possible..

A lot of variables in there Delta I am not sure what you get out of that one number.
When and where you were when you got COVID19 determines not just the variants but ones level of immunity and level of care you received at the time.
https://www.who.int/news-room/commentaries/detail/estimating-mortality-from-covid-19

 

[Laroxe]

Not sure if this is the right thread to post but I got a question which I tried to look up myself but couldn't find data.
What's the percentage of people that catch the corona virus and don't recover, i.e. they die? An average from all variants if possible..

A number of people have suggested that this is a complicated question to answer. The link might help to understand this, and the site has lots of international data. A major issue is that few places are continuing to monitor the background rate of infection, and most deaths occur in people who have other significant health problems.

It does seem that despite the huge amount of information we now have about this disease, it continues to defy many of the predictions about how it should behave. However, currently we seem to have managed the risk of serious disease and death, which is far less common, the issue now seems to be in the economic consequences of having large numbers of people ill.

https://ourworldindata.org/mortality-risk-covid

 

[Astronuc]

Not sure if this is the right thread to post but I got a question which I tried to look up myself but couldn't find data.
What's the percentage of people that catch the corona virus and don't recover, i.e. they die? An average from all variants if possible..

According to NY State numbers, which like all other numbers have an as-yet unquantified uncertainty, the mortality rate is about 1% based on confirmed (in healthcare facilities) deaths and confirmed positive (PCR) tests.

Cumulative and current day's testing/positive case statistics - https://coronavirus.health.ny.gov/c...oolbar=no&:tabs=n#/views/NYS-COVID19-Tracker/
Fatality - https://coronavirus.health.ny.gov/fatalities-0

Using July 18 numbers: Cumulative positive cases - 5689612, deaths - 56832 => ~1% mortality rate. However, consider 72480 deaths, which includes about 15648 persons dying outside of a healthcare facility, then the mortality rate with respect to confirmed positive cases is greater, ~ 1.27%. However, it is expected that there are many folks who are asymptomatic, and many of those may have not been tested, or tested negative, so they are not in the confirmed positive cases, where therefore may be undercounted. If roughly, an equal number of persons have been exposed to SARS-Cov2 without developing Covid-19 and were not tested, then the mortality rate would decrease by a factor of 2, or 0.5% confirmed deaths in healthcare facilities, or 0.63% including those dying outside of healthcare facilities. And of those dying outside of healthcare facilities, it's not clear if all were tested posthumously.

Other states have different reporting details, and it seems mortality rates are about 1% of confirmed infections. Of course, that is the aggreated population, i.e., all age groups. The mortality rates are much greater for those 65+, and lower for those younger. Deaths in the younger population do happen, but are relatively rare.

 

[jim mcnamara]

@Delta2 try https://www.worldometers.info/coronavirus/
Go to Greece in the spreadsheet: row #36

Every country has different mortality rates because of levels of vaccination --as an example. Other causes apply.
<edit for clarity>
Also, some countries are unable (or maybe unwilling) to release accurate numbers. India comes to mind. They report mortality at 374/million cases - an order of magnitude lower than most other countries.

 

[Sagittarius A-Star]

Pfizer and BioNTech want now target other COVID-19-proteins than the spike protein.

Pfizer and BioNTech Advance Next-Generation COVID-19 Vaccine Strategy with Study Start of Candidate Aimed at Enhancing Breadth of T cell Responses and Duration of Protection
...
NEW YORK and MAINZ, GERMANY, NOVEMBER 16, 2022 — Pfizer Inc. (NYSE: PFE) and BioNTech SE (Nasdaq: BNTX) today announced that the companies have initiated a Phase 1 study to evaluate the safety, tolerability and immunogenicity of a next generation COVID-19 vaccine candidate that aims to enhance SARS-CoV-2 T cell responses and potentially broaden protection against COVID-19. This candidate, BNT162b4, is composed of a T cell antigen mRNA encoding for SARS-CoV-2 non-spike proteins that are highly conserved across a broad range of SARS-CoV-2 variants and will be evaluated in combination with the companies’ Omicron BA.4/BA.5-adapted bivalent COVID-19 vaccine. These non-spike proteins have been chosen based on BioNTech's proprietary target prioritization platform and were designed into a vaccine candidate with the purpose of enhancing and broadening T cell immunity and potentially extending durability of protection against COVID-19.

BNT162b4 will be evaluated in a U.S.-based study (NCT05541861) enrolling approximately 180 healthy individuals between 18 and 55 years of age, who have received at least three doses of an mRNA-based COVID-19 vaccine.

Source:
https://www.pfizer.com/news/announc...xt-generation-covid-19-vaccine-strategy-study

 

[bhobba]

Every country has different mortality rates because of levels of vaccination --as an example.

They sure do. I found the data fascinating. Australia is generally considered to have, overall, managed the pandemic well. Taiwan was thought to have managed it the best - or at least in the top few - its economy grew during the pandemic. But as far as the death rate per million goes, there is not much in it. Australia - 613 deaths per million. Taiwan - 582. Converting it to percentages, it is 0.061% compared to 0.058%. Compare that to the flu - it has a death rate of 0.34% for reported cases. Obviously, with the flu, many cases never get reported. Since this is for reported cases and exactly how the world document calculated its figures is not made clear, drawing any conclusions can't be done. Within Australia, only 4% of deaths have had the 4th booster (and 40% of those eligible - those over 30 - have had the booster); the death rate is MUCH lower again if you have had the 4th booster, which is another complication. Another fly in the ointment is Omicron is MUCH more transmissible than the flu.

Another interesting statistic is Sweden's death state, which some are touting as having had the best response overall - 2045 per million. I have never understood this fascination with Sweden. Sure it did not interfere with the economy as much as Australia or have long draconian lockdowns like Melbourne, but neither did Taiwan (it had a single short one as far as I know), yet did better than Sweden or Australia (admittedly not much better than Australia).

Added Later: As discussed later in the thread, I originally concluded that this is much less deadly than the flu. It was unsound reasoning, as the death rate for flu was for reported cases. We do not know the exact methodology for the Covid cases from the world document. The text has been updated to reflect this.

Thanks
Bill

 

[FactChecker]

Compare that to the flu - it has a death rate of 0.34%. The Coronavirus is less deadly than the flu.

This doesn't sound right. The CDC puts the flu death rate in the U.S. at 1.8 per 100,000. That is 0.0018%
(see https://www.cdc.gov/nchs/fastats/flu.htm)

 

[bhobba]

This doesn't sound right. The CDC puts the flu death rate in the U.S. at 1.8 per 100,000. That is 0.0018%
(see https://www.cdc.gov/nchs/fastats/flu.htm)

I got it from the attached document:
'The 5 year average case fatality rate prior to 2020 (2015–2019) was 0.34%, suggesting that the low number of influenza notifications in 2020 had minimal impact on the 5 year average case fatality rate.'

But of course, as also noted, that is the percentage from reported cases. Many, of course, would not be reported. Thanks for picking up the clarification that was needed - much appreciated.

Thanks
Bill

 

[Rive]

Case fatality rate (based on a set of known cases) is just not the same as death rate (based on the whole population). I see no controversy here.

 

[Godot_]

[...] But as far as the death rate per million goes, there is not much in it. Australia - 613 deaths per million. Taiwan - 582. Converting it to percentages, it is 0.061% compared to 0.058%. Compare that to the flu - it has a death rate of 0.34%. The Coronavirus is less deadly than the flu. [...]

[Emphasis mine]

Still uncorrected (as of 20 Nov 2022)

Where's that "No controversy"?

That's the "Comparing-apples-with-oranges"-[insert preferred expletive] stuff that's being intentionally used and amplified by our anti-anything-meaningful movement over here*... ...getting gullible people angry, and some of these even killed.

Don't take this as an accusation, I assume it's been an honest mistake of sloppy reading/quoting. But still - this should've been corrected ASAP by bhobba - in the original post.* "over here" = Germany. I gather it's been even worse in the USA, which BTW can be seen in the mortality figures, too.

 

[bhobba]

Still uncorrected (as of 20 Nov 2022)

It has now been corrected. To be 100% clear, the flu statistics were of reported cases. The exact way statistics were calculated in the following was not made clear:
https://www.worldometers.info/coronavirus/

This is an example of something my stats professor said - Stats is like a bikini - it's the bits you do not see you often want to know about. Hence I apologise for my conclusion - it is much more nuanced.

Thanks
Bill

 

[Laroxe]

I noticed on Medscape that Australia has recommended against a 5th vaccine dose (3rd booster) based on evidence from Singapore that suggested death was very rare in people who have received at least two doses. They felt that a 3rd booster wouldn't add much to this effect an would have little impact on transmission.

https://www.medscape.com/viewarticle/984127

 

[FactChecker]

But still - this should've been corrected ASAP by bhobba - in the original post.

A paragraph has been appended to correct it. I would prefer that @bhobba also cross out the original erroneous statements because the appended paragraph at the bottom is easily overlooked.

 

[Astronuc]

My wife, who is potentially vulnerable, has had 5 vaccinations (2 original, 2 boosters, 1 bivalent (Omicron) booster). My son and I have had 4 vaccinations (2 original, 1 boosters, 1 bivalent (Omicron) booster).

My son did develop COVID-19 from exposure (probably Omicron earlier this year during the peak in January) at work. We had fortunately received the first booster (third vaccination) in December. Fortunately, neither my wife and I contracted the virus. My son had a mild case, and the symptoms were similar to a mild influenza infection: lethargy/fatigue, congestion/sneezing and coughing, mild fever; no shortness of breath or loss of taste/smell.

Meanwhile, my father, brother and sister-in-law, caught the virus (sister-in-law was apparently exposed on a trip to visit a daughter). They were all vaccinated (including boosters), but they were seriously ill. They took Paxlovid, but my brother had to stop after a bad reaction to it. They have recovered, but it seems to have taken a toll. Subsequently, we did a family gathering (family member wedding), which I attended with my kids (wife did not participate due to potential exposure to Omicron+). My sister and her husband both came down with COVID-19 the following week, so they were exposed some time during the trip to or from, or during the family gathering. Most people, including members of my family, were not wearing masks, whereas my children and I were. So far, I did not get infected, nor did a I bring hit home to my wife.

My sister and her husband had significant infections, with symptoms of severe coughing and fatigue/weakness, and loss of taste/smell. My sister informed me that that was sickest she'd been in a long time. She monitored herself with an oximeter.

Since then, several colleagues and friends have developed COVID-19 after attending functions with friends or family. My wife and I avoid most gatherings, and if we do, we where masks. We are now one of the few among family, friends and acquaintances, who have escaped SARS-Cov-2 infection.

 

[Astronuc]

With regard to comparing statistics, it's important to use the same basis (denominator in a ratio), e.g., an entire population, the subset expect or thought to be exposed or just those who tested positive, when looking at mortality rates. In the US, the mortality rate is about 0.95% of the population testing positive. Both the numerator and denominator involve uncertainties. For example, NY State publishes deaths due to Covid for those who die in a medical/care facility, currently 59302, and a greater number that includes folks who died outside of medical facility, 75509. There is the question whether some cases were actually Covid or some other cause, or a combination. Then there is the denominator, which could be the entire state/province/territory/national population, vs those who are or might have been exposed/infected, vs those whose infection was confirmed (e.g., by PCR test), and then the matter of false +/-. In NY State, the positive tests cases are currently, 6241416, or about 32% of the total state population. If the entire population was infected, but only 1/3 tested positive, then the mortality rate of 0.95% (based on + tests) would drop to about 0.32% (of the entire population). The mortality rate can be further divided by age group, comorbidity factors (which increase with age), and/or by those vaccinated and unvaccinated. Hospitalizations and deaths are greater in the unvaccinated population (according to reports from various entities: health departments and media).

I have looked in the local county, and our confirmed infection rate is about 27%, and the mortality rate is 0.9% of those infected, or about 0.3% of the county population, since March 2020. I followed some other counties in other states, and found a variation in mortality rates, some above 1%, some less, on the basis of reported infections. Until this pandemic, nobody was scrutinizing the data as we are now doing.

On influenza, the local and state health departments track numbers and generate some statistics, but with the flu, a lot of people get vaccines, so the number of cases are generally much lower than the number of cases of SARS-Cov-2 infections. In addition, the number of deaths from influenza seem to be much lower than number of SARS-Cov-2 infections. Finding good/reliable/meaningful data is hard because (in my experience) health department data is difficult to find readily. Websites keep getting updated/reformatted, and even then one has to know if the numbers are hard numbers (actual cases) or reported estimates (US CDC publishes annual estimates of deaths and expected cases).

And now the politicization of developing statistics and reporting it has further complicated the matter.

 

[Sagittarius A-Star]

With regard to comparing statistics, it's important to use the same basis (denominator in a ratio), e.g., an entire population, the subset expect or thought to be exposed or just those who tested positive, when looking at mortality rates. In the US, the mortality rate is about 0.95% of the population testing positive.

When comparing COVID statistics of different countries, one must also take into account the different age distribution in each country, because old people died more likely from COVID than young people.

Example:

Country	Median age	Population under 20 years old	Life expectancy
United States	38.5	24.7 %	77.4
Australia	37.5	25.3 %	83.3

Source:
https://www.worlddata.info/average-age.php

 

[Astronuc]

When comparing COVID statistics of different countries, one must also take into account the different age distribution in each country,

One of many factors, which also apply to comparing regions and states within a nation, or counties within a state. Population density, poverty and economic disparity, access to quality and affordable health care, health insurance (or lack thereof), . . . . are among other factors.

 

[bhobba]

A paragraph has been appended to correct it. I would prefer that @bhobba also cross out the original erroneous statements because the appended paragraph at the bottom is easily overlooked.

No problem.

Thanks
Bill

 

[bhobba]

I noticed on Medscape that Australia has recommended against a 5th vaccine dose (3rd booster) based on evidence from Singapore that suggested death was very rare in people who have received at least two doses. They felt that a 3rd booster wouldn't add much to this effect an would have little impact on transmission.

https://www.medscape.com/viewarticle/984127

Yes, that is true. We all will be eligible for the flu shot in March or April next year, and it is thought that is the best time to get the third booster. As I mentioned, only about 4% of those that die have had the second booster (and 40% of the eligible population, which is those over 30, has had the second booster), so it does protect significantly against death. But I can also confirm from my treating physician if you are severely immunocompromised, you can get a 5th booster at the doctor's discretion. I will see my Rheumatologist on December 12 and take his advice on the issue. I suspect while I am immunocompromised and further immunocompromised from the drugs I take, it is not severe enough to warrant a 5th dose. But we will see.

Thanks
Bill

 

[bhobba]

My son had a mild case, and the symptoms were similar to a mild influenza infection: lethargy/fatigue, congestion/sneezing and coughing, mild fever; no shortness of breath or loss of taste/smell.

Yes, that is a BIG problem. When Omicron broke out where I am in Brisbane, it swept through the Gold Coast a week or so before (for those that do not know where the Gold Coast is, it is a tourist destination about an hour's drive south of Brisbane but a bit north of Byron Bay where all the trendoids like Chris Hemsworth and his brother live), then hit Brisbane. But what they did on the Gold Coast is randomly test people for Covid. They found 90% of people that had it didn't even know it - most were asymptomatic, and some had a few mild symptoms:
https://www.abc.net.au/news/2022-02...cr-tests-queensland-health-symptoms/100771540

This has sparked a much-heated debate where I live about wearing masks etc., even if certain key occupations like being an MD need to be vaccinated. I won't go through the arguments except to mention one. They claim since getting it is not reduced by vaccination (they argue - and I disagree), and most people with it are walking around not even knowing they have it; why wear masks, have certain occupations where you must be vaccinated etc.? It can get quite heated. I believe it is well known that being vaccinated reduces your viral load if you get it, and you are infectious for a shorter period. There is even some evidence it does reduce transmissibility:
https://www.nature.com/articles/d41586-022-02328-0

But aside from that, the shorter period you are infectious must be beneficial to prevent the spread. Still, the debate rages, with each side retreating to its entrenched position, which in many cases seems to be based on political orientation rather than science.

Thanks
Bill

 

[Rive]

...prevent the spread...

At this point we (we, as the world in general) already past that (well, some countries who stalled the first few rounds and then skipped thorough vaccination may have some thrill left...). It may be considered as 'endemic' now. The question now is less about 'how to prevent it spreading' but 'how to live with it around'. And this means lot of adjustments to be made compared to the pandemic times.

Since it's not exactly clear how will Covid fare as an endemic disease, many of the answers are not clear yet. Previous answers may not apply. The adjustment will require lot of patience and personal consideration.

For example, that case fatality rate which was considered around 1% during the pandemic. With a population through some rounds of vaccines and waves of Covid the CFR is expected to be stabilize at a significantly lower value, but the exact number is not known yet: might became really comparable to the CFR of Flu by now. But without knowing this really important detail how could we prepare? And: for what exactly?

For debates like you mentioned, for now I might consider focusing on personal risk assessment/management/responsibility instead of general rules.

 

[bhobba]

For example, that case fatality rate which was considered around 1% during the pandemic. With a population through some rounds of vaccines and waves of Covid the CFR is expected to be stabilize at a significantly lower value, but the exact number is not known yet: might became really comparable to the CFR of Flu by now. But without knowing this really important detail how could we prepare? And: for what exactly?

I think it has, at least in Aus, stabilised at a significantly lower rate - especially for people taking it seriously; getting the 4th dose (second booster) seems to reduce CFR a lot. Aged care workers that come over to my place tell me while the law says they are in an occupation that needs a second booster, a number have had Covid - occasionally multiple times; their MDs tell them if they have had it, are young a fit, no need for the second booster. That raises an interesting issue of physicians overruling the law. For me, these rules are just strong suggestions that a doctor can always overrule for various reasons, but I am no lawyer. That said, it is getting pretty bad when this reaches the stage of a bun fight in a court of law - I hope we are beyond that. As an aside just listening to a story on if paracetamol should be restricted. Currently, it is freely available at chemists, supermarkets etc. They want it available on prescription only. There are arguments for and against. Personally, it is not a debate I am following because I consult my doctor about anything I put in my body - even simple vitamin C.

Thanks
Bill

 

[Laroxe]

I know I got infected around 4 weeks after my last booster, so the 4th shot, this was my 2nd natural infection and my first two vaccinations were Astra Zeneca, the last two a mRNA vaccine, so this last infection must have involved the virus swimming through an antibody broth. We know that the omicron variants are very good at antibody evasion and the initial infection gets established in the upper respiratory tract before blood born antibodies can have much impact. I think is pretty clear that the risk of serious disease has been largely contained so in well vaccinated populations, wearing masks and reducing exposure might in fact be counter productive. Allowing a fairly continuous exposure is probably the way to increase and enhance a very broad antibody response and the main vaccine development efforts seem to be focussing on broadly antigenic inhaled vaccines (India and China have each already approved one, as boosters). I imagine that the evidence that the highest levels of immunity, even though limited, is short lived, reducing exposure now could be counter productive.

know that there is more detail becoming available of the effects of immune modifying drugs in Covid 19 infection and it doesn't seem that there is a significant adverse effect on the response to infection, (exept in 1) in fact some of these drugs were used in treatment of sever Covid 19 infections. Another issue is in the the papers that have conducted risk analysis of young people receiving the Vaccine its been suggested that in the under 12 group the results do not favour boosters, in fact even in the primary vaccination the main aim was in the protection of others. My own view is that in areas in which vulnerable people may be exposed to risk, infection control procedures are perfectly appropriate.

I think the idea of restricting paracetamol and requiring Drs to prescribe it, following a period in which even seeing a Dr was like winning the lottery is one of the more stupid ideas among the large Covid 19 collection of stupid ideas, I've seen. I realize that governments across the world have relished the power Covid gave them to control behaviour of the people, but it needs to stop. A central idea of many of the discussions has been about who owns your body, you or the government and the willingness to use coercion and police control over public engagement has had a hugely damaging effect on public trust on all sorts of official agencies. There has just been a preliminary report published about related to pandemic preparedness following on from the G7 meeting in which our politicians gave away huge sums of our money and abdicated all the decision making about how its spent. Of course there were already pandemic preparedness plans in place before Covid 19 and the World Health Organisation had held up the USA and the UK as exemplars of good practice. Clearly we can be confident that the W.H.O. 's ability in coordinating the future efforts and allocating the funding.

Our own report among its recommendations suggested a ban on gain of function research on viruses, which they clearly haven't a clue about and which is important in finding out how viruses work.

You can sign up for a free account if needed.
https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(22)00098-4/fulltext

 

[FactChecker]

I think is pretty clear that the risk of serious disease has been largely contained so in well vaccinated populations, wearing masks and reducing exposure might in fact be counter productive. Allowing a fairly continuous exposure is probably the way to increase and enhance a very broad antibody response

One trade-off is that this would increase the "Petri dish" in which variants can develop. I am still afraid that a much more deadly and contagious version will develop.

I realize that governments across the world have relished the power Covid gave them to control behaviour of the people, but it needs to stop.

Why would they want to "control behavior" with a 15-minute shot a couple of times a year? Or why would governments want to tell people to stay isolated at home and not go about any business? In general, totalitarian governments have loved their displays of supportive crowds and parades. That is the opposite of the COVID-19 mandates.
But this is more of a political argument that probably should not be continued on this forum.

 

[bhobba]

But this is more of a political argument that probably should not be continued on this forum.

As I have always said, while it's great discussing this stuff here (without politics) as always, regardless of if you are at risk or not, don't think you should wear a mask; there are all sorts of personal choices you can make, see your doctor. They know your particular health situation the best. For example, in my case, my doctor said to wear a mask indoors when outside my home and stay home as much as I can. I know some of the statistics related to my diseases and Covid, so I have can have an informed discussion about his advice. I still take Vitamin C, Zinc, Quercetin, Vitamin D and a multivitamin. This dates back to the early days of the pandemic. My doctor's view is except for vitamin D, he doesn't think it will do much good - but no harm either. Take it if you like. Vitamin D is interesting. He believes living in the subtropics; you get more than enough vitamin D from sunlight. However, my Endocrinologist thinks it is a good idea - the min amount of Vitamin D we need is different to the optimum. He prescribed it for me, as he does for all his patients.

The bottom line is to consult your doctor and work out the best plan for you. If we get into a bad situation, the same thing happens, but the Government could be more proactive by sending a doctor to your house if you do not consult one. No violation of human rights; turn the doctor away if you like, but at least you have had the opportunity to see one. Of course, there are various legal issues about anyone entering your property without your consent. That varies from country to country. Here in Aus, police and other government officials can enter if they reasonably suspect you may have suffered some calamity, such as not answering correspondence. Besides, police are loathed to charge people with trespass if they have a reasonable excuse, even if technically they did trespass.

Thanks
Bill

 

[Astronuc]

CNBC reports Omicron boosters are weaker against BQ.1.1 subvariant that is rising in U.S., study finds
https://www.cnbc.com/2022/12/06/cov...weaker-against-bqpoint1point1-subvariant.html

Covid shots designed to protect against the omicron variant trigger a weaker immune response against the rapidly emerging BQ.1.1 subvariant than the previously dominant strain, according to a new lab study.

Scientists at the University of Texas Medical Branch, in a study published online Tuesday in Nature Medicine, found that the booster shots performed well against the BA.5 subvariant they were designed to target.

But the boosters did not trigger a robust response when faced with BQ.1.1, the scientists found. Antibodies were about four times lower against BQ.1.1 compared with BA.5. These neutralizing antibodies prevent the virus that causes Covid-19 from invading human cells.

People with a prior history of infection who received an omicron booster, however, had a stronger response to BQ.1.1. Antibodies that neutralize BQ.1.1 were nearly four times higher in this group compared with individuals with no history of infection who faced the subvariant, the scientists found.

About 42% of adults in the U.S. have a prior history of infection, . . . .

in my case, my doctor said to wear a mask indoors when outside my home and stay home as much as I can.

That has been my practice for the last two years.

 

[Laroxe]

One trade-off is that this would increase the "Petri dish" in which variants can develop. I am still afraid that a much more deadly and contagious version will develop.

Why would they want to "control behavior" with a 15-minute shot a couple of times a year? Or why would governments want to tell people to stay isolated at home and not go about any business? In general, totalitarian governments have loved their displays of supportive crowds and parades. That is the opposite of the COVID-19 mandates.
But this is more of a political argument that probably should not be continued on this forum.

I'm not sure that we can talk about how society can manage a pandemic without reference to political actions and the control exercised has gone well beyond simply getting the vaccination. We have seen limits put on personal contact, travel, education and work all based on an evolving evidence base, and the limits have been enforced by legal sanctions. It is in fact these limits and the accompanying advice that has been the focus of many of the discussions including the ones on this forum, I'm not sure it is even possible to separate out the political decision making from the underpinning evidence and there are already several inquiries being conducted into the way that evidence was used. We have in fact just seen the G7 meeting commit huge sums of money to the next pandemic response planning, to be administered by the W.H.O. presumably based on their previous successes
I would also suggest that the idea of the sudden appearance of a particular sort of pathogenic variant is unlikely to be effected by the infection rate, the already high rate of infection, both symptomatic and asymptomatic allows for a huge number of variants to emerge, and in fact emerging they are. However the alterations in the viral genome needed for such variant to arise would require a number of very specific mutations which would make any sudden appearance highly unlikely. There is also the fact that so far none of the variants seen can successfully evade the effects of the T cell mediated immunity. We are already at the stage in which circulating antibodies offer no significant protection from infection and its even suggested that this has acted as a significant selective pressure in the development of variants. We also know that while the vaccines do increase the T cell responses, it does appear that exposure to the actual virus has an effect that is both stronger and more broadly based. Exposure to a virus that was pervasive in the environment is likely to be far more effective and offer a more significant cumulative response than an annual vaccination. In fact current vaccinations don't lead to significant increases in tissue based immunity, whereas natural exposure does and its this that offers the best chances of a protective response in the longer term. This is reflected in the current interest in boosters that deliver the vaccine by inhalation that use some form of attenuated virus. They even tried using the Astra Zenica vaccine as an inhalation but didn't get an adequate response. Though both China and India have given limited approval for such vaccines.

 

[FactChecker]

I would also suggest that the idea of the sudden appearance of a particular sort of pathogenic variant is unlikely to be effected by the infection rate, the already high rate of infection, both symptomatic and asymptomatic allows for a huge number of variants to emerge, and in fact emerging they are. However the alterations in the viral genome needed for such variant to arise would require a number of very specific mutations which would make any sudden appearance highly unlikely.

I don't see the logic of this. I would think that $r$ times as many infections implies $r$ times as many virus organisms and $r$ times as many random variations. IMO, this should change the probability of a particular variant by a factor of $r$. But I am not an expert on this subject.

 

[Laroxe]

I don't see the logic of this. I would think that $r$ times as many infections implies $r$ times as many virus organisms and $r$ times as many random variations. IMO, this should change the probability of a particular variant by a factor of $r$. But I am not an expert on this subject.

Your right, but there are factors that need to be considered. The issue isn't really just about the frequency of mutations its how likely a new variant is to replace the current dominant variants which are highly infectious, establish infection very rapidly effectively avoiding the antibody response to infection and then as the antibody levels start to increase are largely resistant to their effects. It does seem to be the case that vaccines provide little if any protection from infection. The resultant symptomatic infections rarely cause the infected person to become sufficiently ill that they cause the person to reduce contact with others which might slow the spread. It seems that recovery from infection is largely down to T cell responses which appear to act against parts of the virus that are highly conserved, so far none of the variants have shown the ability to evade these responses. Its these responses that are responsible for the observed alterations in disease outcomes and reducing the risk of infection.
So the current variants seem to have achieved a very successful strategy, few viruses are capable of establishing an infection in less than 3 days and then allow the person to carry on their normal activities so encouraging transmission. The broad resistance to circulating antibodies suggests that the rate of infection is relatively unchanged by the vaccines. What is needed are vaccines that act in the tissues that serve as the access point for the virus, the cells lining the upper respiratory tract to get the best response would require the antigens to be present for a period of time, so there would need to be something like a live vaccine or a viral vector vaccine. This could stimulate tissue based immunity and act as a booster to the circulating B cells, this approach seems the one most likely to offer significantly better protection from infection though there are still question marks about the duration of this protection. Other parts of our immune response would continue to protect people from serious disease but the increased local immunity may explain why natural infection seems to offer better protection than vaccination even when antibody levels are similar.
There is an example of a disease caused by a virus (though a different type) that was so common in the environment that symptomatic disease was virtually unknown until improved hygiene reduced the exposure in young children, this is polio, which appears to be making something of a comeback. Even the aim of global eradication seems to have been over optimistic.

 

[FactChecker]

Your right, but there are factors that need to be considered. The issue isn't really just about the frequency of mutations its how likely a new variant is to replace the current dominant variants which are highly infectious, establish infection very rapidly effectively avoiding the antibody response to infection and then as the antibody levels start to increase are largely resistant to their effects. It does seem to be the case that vaccines provide little if any protection from infection. The resultant symptomatic infections rarely cause the infected person to become sufficiently ill that they cause the person to reduce contact with others which might slow the spread. It seems that recovery from infection is largely down to T cell responses which appear to act against parts of the virus that are highly conserved, so far none of the variants have shown the ability to evade these responses. Its these responses that are responsible for the observed alterations in disease outcomes and reducing the risk of infection.
So the current variants seem to have achieved a very successful strategy, few viruses are capable of establishing an infection in less than 3 days and then allow the person to carry on their normal activities so encouraging transmission. The broad resistance to circulating antibodies suggests that the rate of infection is relatively unchanged by the vaccines. What is needed are vaccines that act in the tissues that serve as the access point for the virus, the cells lining the upper respiratory tract to get the best response would require the antigens to be present for a period of time, so there would need to be something like a live vaccine or a viral vector vaccine. This could stimulate tissue based immunity and act as a booster to the circulating B cells, this approach seems the one most likely to offer significantly better protection from infection though there are still question marks about the duration of this protection. Other parts of our immune response would continue to protect people from serious disease but the increased local immunity may explain why natural infection seems to offer better protection than vaccination even when antibody levels are similar.
There is an example of a disease caused by a virus (though a different type) that was so common in the environment that symptomatic disease was virtually unknown until improved hygiene reduced the exposure in young children, this is polio, which appears to be making something of a comeback. Even the aim of global eradication seems to have been over optimistic.

You make a lot of statements that I have no way of evaluating whether they are true, and you do not reference any supporting data.
I would be very surprised if there was ever a realistic hope of global eradication for a virus that has animal hosts. Global eradication is very, very rare.

 

[Laroxe]

Once again your right, there have been so many discussions about Covid 19 with links to evidence that I sort of assume people have been following all the discussion's, assumption being the mother of well - most guesswork, I suppose. :) In fact guess work is very popular with Covid 19, there has been a huge amount of research on what is in effect a novel virus in a developing situation keeping up to date with this virus can be a real challenge. Even over the relatively short period since Covid 19appeared retraction watch has listed some 278 retractions and 16 expressions of concern. I would really recommend the you tube podcast This Week in Virology which is chaired by Vincent Racaniello, a Professor of Virology and usually involves a team of researchers or Clinical staff discussing the latest research. Its the most current source I can find and they also include various high profile guests.

I think you may have misunderstood my use of polio as a model for understanding how continuous exposure to a pathogen can protect against disease. Polio only becoming a serious problem after improvements in hygiene reduced natural exposure. With polio there is only humans that act as its host and there has and is an ongoing campaign that has the aim of eradication. Unfortunately the increases in polio and the evidence of the virus surviving for significant periods in sewage along with the evidence that vaccine derived virus is being transmitted as vaccination rates have waned has blunted some of the optimism.

This discusses the history of polio
https://www.britannica.com/science/polio/Polio-through-history

I don't think anyone expects Covid 19 to disappear its so far been identified in some 54 animal species and cross species transmission does occur. So the interest is in changes in the viruses transmission and disease severity. So first some of the latest figures (the video's are quite long so I've included some time indicators) In TWiV 957 from 9 minutes to 12 there are mortality figures. Then at 17 minutes to 27 minutes there is research on the latest estimates of vaccine effectiveness which is rather worrying.



In TWiV 959 at 24.50 to 26.15 there is more detail on the Omicron variant then at 27.30 there is more detail about the effects of the bivalent vaccines. If you let the video run they look at T cell responses and tell us that authorisation for most monoclonal's has been removed you can stop it at 37.



My somewhat uncharacteristic optimism about the likely evolution of this virus is based on what little we know about the crossover of previous Coronaviruses into the human population, a partial understanding of the fitness requirements for this virus to succeed and how the virus has developed so far. These are discussed at;
https://www.nature.com/articles/d41586-021-03619-8

Because of the limited information we have and the inherent uncertainty in predicting the future I thought I'd back this up by consulting the I Ching I got the hexagram "Harmony" it said, "Earth seems to be above heaven (the sky), and heaven is on earth. The gravity of matter merges with the upward radiation of light to create a condition of deep harmony." I don't know what that means but I suspect I might have to sing.

 

[bhobba]

In fact guess work is very popular with Covid 19, there has been a huge amount of research on what is in effect a novel virus in a developing situation keeping up to date with this virus can be a real challenge.

You bet. Here is the one I find most interesting. Many people correctly point out a lot of people die with Covid rather than of covid ie in many cases they have a number of comorbidities. What killed them, Covid or their comorbidities. But statistics allow us to 'bypass' the issue. Here in Australia it is recommended everyone over 30 should get the 4th dose. 40% have availed themselves of the offer. People are still dying with Covid (average over 7 days 34 per day, but unfortunately rising), which of course is both concerning and sad. But it does allows us to collect statistics. Only 4% of those that died (irrespective of with Covid or of Covid) have had the 4th dose. This gives a 90% less chance of dying if you have had the 4th dose irrespective of the with Covid or of Covid argument. Yet the argument of with Covid or of Covid still rages in popularist discussions. I point this out in such discussions but it makes no difference.

Here is a precis of the situation where I live in Brisbane from our local newspaper, The Courier Mail.

Start precis

The vast majority of Queenslanders infected during the state’s fourth wave are getting Covid for the first time. Chief health officer Dr John Gerrard said 80 per cent of cases reported during the current wave, which was declared in early November, were first infections. “As time goes on, it is natural that people who have not yet had Covid will become infected,” Dr Gerrard said “Given this, I am hopeful future waves will be even milder as hybrid immunity to Covid-19 becomes more widespread.” It comes after 13,632 new cases were recorded from December 1-7, up from 11,217 in the previous week. Fifteen deaths were reported in that period, while 320 people were hospitalised with eight in intensive care.

Dr Gerrard has renewed his push for Queenslanders to get up to date with their vaccinations due to the ongoing and widespread transmission of Covid in the community. He said the number of positive cases were expected to keep trending upward until the fourth wave peaked.“ It is encouraging to see the number of hospitalisations remain low in comparison to previous waves, but a large number of people aged over 60 not up-to-date with their vaccinations are being infected,” he said.

“People in this group are at significant risk of severe illness if they contract Covid, so it is vital they receive four doses of the vaccine.” Dr Gerrard said Queensland Health continued to track infections to inform its response to Covid and assist in determining what impact future waves may have on the community. Queensland’s top infectious disease expert Professor Paul Griffin said cases could further spike during the holiday period. Large gatherings will be happening all over Queensland, increasing the risk of Covid spreading. Large gatherings will be happening all over Queensland, increasing the risk of Covid spreading. “It’s party season and anecdotally we are hearing of people not wanting to test for the virus just in case they are positive and don’t want to miss out on events,” he said.

“Queenslanders need to know we are not over the wave and could see numbers continue to soar over the next few weeks with people attending festive gatherings, taking holidays and moving interstate.” In the week from November 17-23 the case numbers were 10,082. “It’s not a good sign that numbers are continuing to grow and the biggest issue is that we don’t really have a true indication of real numbers as Queensland’s testing rates are low,” Prof Griffin said. “We have debated as to when the wave will peak and it’s getting impossible to say with the information at hand. “We can only be sure the virus has not gone away and Christmas festivities and end of year holidays is not going to help the problem.” “We are not seeing enough masks. It just makes sense in some situations. Testing is so important and shouldn’t be disregarded especially at this time and of course vaccinations are vital. Keep up with jabs. Just remember we are still in this,” he said.'

End precis

Bottom line. Get the fourth dose and still take sensible precautions. If in doubt see your doctor. The pandemic, while greatly reduced, is still with us and we cant let our guard down.

Thanks
Bill

 

[Rive]

The pandemic, while greatly reduced, is still with us and we cant let our guard down.

Just to prevent any misunderstandings: this thing likely won't go anywhere and it'll stay with us from now on, indefinitely.

To prevent exhaustion, instead of keeping our guard up all the time maybe it would be better to think about preventive measures as the new way of life.

 

[pinball1970]

Once again your right, there have been so many discussions about Covid 19 with links to evidence that I sort of assume people have been following all the discussion's, assumption being the mother of well - most guesswork, I suppose. :) In fact guess work is very popular with Covid 19, there has been a huge amount of research on what is in effect a novel virus in a developing situation keeping up to date with this virus can be a real challenge. Even over the relatively short period since Covid 19appeared retraction watch has listed some 278 retractions and 16 expressions of concern. I would really recommend the you tube podcast This Week in Virology which is chaired by Vincent Racaniello, a Professor of Virology and usually involves a team of researchers or Clinical staff discussing the latest research. Its the most current source I can find and they also include various high profile guests.

I think you may have misunderstood my use of polio as a model for understanding how continuous exposure to a pathogen can protect against disease. Polio only becoming a serious problem after improvements in hygiene reduced natural exposure. With polio there is only humans that act as its host and there has and is an ongoing campaign that has the aim of eradication. Unfortunately the increases in polio and the evidence of the virus surviving for significant periods in sewage along with the evidence that vaccine derived virus is being transmitted as vaccination rates have waned has blunted some of the optimism.

This discusses the history of polio
https://www.britannica.com/science/polio/Polio-through-history

I don't think anyone expects Covid 19 to disappear its so far been identified in some 54 animal species and cross species transmission does occur. So the interest is in changes in the viruses transmission and disease severity. So first some of the latest figures (the video's are quite long so I've included some time indicators) In TWiV 957 from 9 minutes to 12 there are mortality figures. Then at 17 minutes to 27 minutes there is research on the latest estimates of vaccine effectiveness which is rather worrying.



In TWiV 959 at 24.50 to 26.15 there is more detail on the Omicron variant then at 27.30 there is more detail about the effects of the bivalent vaccines. If you let the video run they look at T cell responses and tell us that authorisation for most monoclonal's has been removed you can stop it at 37.



My somewhat uncharacteristic optimism about the likely evolution of this virus is based on what little we know about the crossover of previous Coronaviruses into the human population, a partial understanding of the fitness requirements for this virus to succeed and how the virus has developed so far. These are discussed at;
https://www.nature.com/articles/d41586-021-03619-8

Because of the limited information we have and the inherent uncertainty in predicting the future I thought I'd back this up by consulting the I Ching I got the hexagram "Harmony" it said, "Earth seems to be above heaven (the sky), and heaven is on earth. The gravity of matter merges with the upward radiation of light to create a condition of deep harmony." I don't know what that means but I suspect I might have to sing.

I'll watch all of this thanks.
My current status is 2x jabs then Covid followed by 3rd jab 2021. 4th jab last month.

I posted on the Strep deaths in the UK in TIL recently as COVID-19 lockdowns over two years has been implicated.

I still wear a mask on the bus although people look at me like I am from another planet. I do not particularly want another cold and certainly do not want flu (had my jab) or Covid.
I am seeing my GP next week for an asthma review and will discuss the best practice going forward.

 

[FactChecker]

Just to prevent any misunderstandings: this thing likely won't go anywhere and it'll stay with us from now on, indefinitely.

To prevent exhaustion, instead of keeping our guard up all the time maybe it would be better to think about preventive measures as the new way of life.

I'm not sure that there is a difference between "keeping our guard up" and "preventative measures". Your comment might just be saying that we might as well get used to it.

 

[Rive]

Your comment might just be saying that we might as well get used to it.

Matter of approach/attitude, yes.