COVID Get Vaccinated Against the Covid Delta Variant

[Evo]

TL;DR Summary

The Delta variant is serious. Here’s why it's on the rise.
The virus variant that caused infections to spike in the U.K. is now spreading in the U.S., and experts are very worried

Get vaccinated!

This week, the Centers for Disease Control and Prevention officially declared the Delta variant, a Coronavirus strain first detected in India, “a variant of concern.” This designation is given to variants shown to be more transmissible than the original strain, that can cause more severe disease and potentially reduce the effectiveness of treatments or vaccines.

Why was the Delta variant classified as a variant of concern?

The Delta variant, also referred to as B.1.6.1.7.2 [and] believed to have originated from India, is one of the most concerning variants … It is more likely to lead to disease, hospitalizations and possibly death.

The Delta variant looks like it might be up to 60 percent more infectious, which is why the CDC really put a bold label forward in calling it a variant of concern. They only do that when they think a variant is concerning enough that it could change the course of a disease or potentially pose a threat to someone who gets it.

https://www.yahoo.com/news/the-covid-19-delta-variant-what-you-need-to-know-151035628.html

The Delta variant already accounts for 18 percent of cases in Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming, and about six percent of cases nationwide. It has already spread to more than 70 countries and is now the most dominant variant in India, the United Kingdom, and Singapore. Last week, Delta caused more than 90 percent of the new COVID-19 cases in the U.K., leading to a 65 percent bump in new infections since May 1. On Monday, to curb Delta’s spread, the U.K. government decided to postpone “freedom day,” which would mark the end of public health restrictions.

The Delta variant is 60 percent more transmissible than the Alpha variant—first identified in the U.K.—which in turn was about 50 percent more transmissible than the ancestral Wuhan strain. “It’s a super spreader variant, that is worrisome,” says Eric Topol, founder and director of the Scripps Research Translational Institute. It has features that enable escape from the immune system and is perhaps more evasive than the Beta variant (B.1.351) first identified in South Africa, which was the worst until now, says Topol. “Plus, it has the highest transmissibility of anything we've seen so far. It's a very bad combination.”

Dismayed by the trajectory of Delta in the U.K., Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, warned President Joe Biden last week, “we cannot let that happen in the United States.”

The President echoed those sentiments, tweeting “Folks, the Delta variant—a highly infectious COVID-19 strain—is spreading rapidly among young people between 12 and 20 years old in the U.K. If you’re young and haven’t gotten your shot yet, it really is time.” A complete dose of a COVID-19 vaccine is still effective at preventing serious COVID-19 stemming from Delta infection.

https://www.nationalgeographic.com/...20210618&rid=6BB08808740E9FEDD2938054BB46CA41

 

[Ygggdrasil]

Preliminary data from Public Health England suggests 88% effeciveness of the Pfizer vaccine against the delta variant (B.1.617.2) vs 93% effectiveness against the alpha variant (B.1.1.7), so despite initial worries, the vaccines do still work well against this variant -- more reason to get vaccinated if you have not already.

Effectiveness of COVID-19 vaccines against the B.1.617.2 variant
https://khub.net/documents/13593956...iant.pdf/204c11a4-e02e-11f2-db19-b3664107ac42

Abstract

Background The B.1.617.2 COVID-19 variant has contributed to the surge in cases in India and has now been detected across the globe, including a notable increase in cases in the UK. We estimate the effectiveness of the BNT162b2 and ChAdOx1 COVID-19 vaccines against this variant.

Methods A test negative case control design was used to estimate the effectiveness of vaccination against symptomatic disease with both variants over the period that B.1.617.2 began circulating with cases identified based on sequencing and S-gene target status. Data on all symptomatic sequenced cases of COVID-19 in England was used to estimate the proportion of cases with B.1.617.2 compared to the predominant strain (B.1.1.7) by vaccination status.

Results Effectiveness was notably lower after 1 dose of vaccine with B.1.617.2 cases 33.5% (95%CI: 20.6 to 44.3) compared to B.1.1.7 cases 51.1% (95%CI: 47.3 to 54.7) with similar results for both vaccines. With BNT162b2 2 dose effectiveness reduced from 93.4% (95%CI: 90.4 to 95.5) with B.1.1.7 to 87.9% (95%CI: 78.2 to 93.2) with B.1.617.2. With ChAdOx1 2 dose effectiveness reduced from 66.1% (95% CI: 54.0 to 75.0) with B.1.1.7 to 59.8% (95%CI: 28.9 to 77.3) with B.1.617.2. Sequenced cases detected after 1 or 2 doses of vaccination had higher odds of infection with B.1.617.2 compared to unvaccinated cases (OR 1.40; 95%CI: 1.13-1.75).

Conclusions After 2 doses of either vaccine there were only modest differences in vaccine effectiveness with the B.1.617.2 variant. Absolute differences in vaccine effectiveness were more marked with dose 1. This would support maximising vaccine uptake with 2 doses among vulnerable groups.

Popular press summary: https://www.bmj.com/content/373/bmj.n1346

 

[Astronuc]

MIT's Technology Review echoes the concern about Delta.
https://www.technologyreview.com/2021/06/10/1026090/delta-covid-19-variant-more-infectious/

 

[atyy]

The increased fraction of new infections due to delta is probably not entirely due to it being more transmissible than alpha if there were no vaccinations. Some of it may be because alpha is less transmissible in a vaccinated population.

There's been much more data since May 25, but Jeffery Barrett outlined some of the issues in this tweet.
"Key question for policy, not yet fully answered, is how much due to:
1. vaccine efficacy
2. intrinsic transmissibility
3. human epidemiological factors"

As @Ygggdrasil posted above, the vaccine is still effective against delta, but the second dose is important. So the UK has been trying to bring second doses forward, eg. here is a tweet from Mark Ford on how to check availability, cancel the first appointment, then book an earlier second dose.

 

[PeroK]

Scotland and England played out a goalless draw in a soccer match in London, but the real winner is the Delta variant:

 

[pinball1970]

Scotland and England played out a goalless draw in a soccer match in London, but the real winner is the Delta variant:

View attachment 284685

A super spreader.
Ok, it's outside but that many people for 2 hours, no masks?
They will younger less likely to be vaccinated too.
Awful game too, I stayed in.

 

[atyy]

A super spreader.
Ok, it's outside but that many people for 2 hours, no masks?
They will younger less likely to be vaccinated too.
Awful game too, I stayed in.

Maybe https://www.bbc.com/sport/football/57404223 ?
Euro 2020: Fans at Wembley games required to show proof of vaccination or negative test before entry

"Uefa says UK-based ticket holders aged 11 or over can show proof of full vaccination, with both doses received at least 14 days before the match.

Those not fully vaccinated must show proof of a negative lateral flow test taken within the previous 48 hours."

 

[PeroK]

Maybe https://www.bbc.com/sport/football/57404223 ?
Euro 2020: Fans at Wembley games required to show proof of vaccination or negative test before entry

"Uefa says UK-based ticket holders aged 11 or over can show proof of full vaccination, with both doses received at least 14 days before the match.

Those not fully vaccinated must show proof of a negative lateral flow test taken within the previous 48 hours."

The sports venues themselves are taking precautions, but that photograph was taken in Leicester Square - where, if we are being cynical, fans who failed their COVID test and cannot go the stadium will gather, after having crammed maskless onto the national rail and London underground network!

Altogether now: "Bring it on, bring it on, bring it on ..."

 

[atyy]

The sports venues themselves are taking precautions, but that photograph was taken in Leicester Square - where, if we are being cynical, fans who failed their COVID test and cannot go the stadium will gather, after having crammed maskless onto the national rail and London underground network!

Altogether now: "Bring it on, bring it on, bring it on ..."

Any chance, you think, that it's just English fans, since presumably the Scottish ones would have had to pass or fail their test before travelling?

Hmmm, looking at the photo, looks like Scotland fans? I guess they might have been vaccinated or tested negative before making the trip?

https://www.skysports.com/football/...ans-not-to-travel-to-london-for-wembley-clash

https://www.scotsman.com/sport/foot...e-scotland-vs-england-game-at-wembley-3279081
"Despite police asking fans not to travel unless they have secured a booking in a venue to watch the game, up to 20,000 Scotland fans have traveled to watch Steve Clarke’s team at Wembley."

Huh, maybe you are right!

 

[PeroK]

Any chance, you think, that it's just English fans, since presumably the Scottish ones would have had to pass or fail their test before travelling?

There is no government or police action to prevent anyone who has failed a COVID test from doing anything. It's all effectively voluntary cooperation. Excepting the quaratine system for those entering the country in the first place.

In particular, there are no checks on anyone using public transport. Nor is mask-wearing enforced on public transport. Someone could fail a COVID test in Scotland, jump on a train to London, get on the underground and join the crowd in Leicester Square. No one is going to stop them or even ask them to wear a mask.

 

[atyy]

The vaccine effectiveness estimates for the delta variant cited by @Ygggdrasil were for symptomatic infections (ie. mild cases as well as those requiring hospitalization). There are updates by the UK PHS. For reducing hospitalizations, one dose is about 71% (AstraZeneca) or 94% (Pfizer) effective, and 2 doses are 90+% effective for both vaccines.

https://www.theguardian.com/world/2021/jun/15/the-covid-delta-variant-how-effective-are-the-vaccines
https://www.gov.uk/government/news/...ve-against-hospitalisation-from-delta-variant

 

[PeroK]

The vaccine effectiveness estimates for the delta variant cited by @Ygggdrasil were for symptomatic infections (ie. mild cases as well as those requiring hospitalization). There are updates by the UK PHS. For reducing hospitalizations, one dose is about 71% (AstraZeneca) or 94% (Pfizer) effective, and 2 doses are 90+% effective for both vaccines.

https://www.theguardian.com/world/2021/jun/15/the-covid-delta-variant-how-effective-are-the-vaccines
https://www.gov.uk/government/news/...ve-against-hospitalisation-from-delta-variant

And, in the past two weeks we have gone up from about 2,000 positive tests per day to over 10,000 per day. As you can see from the football scenes, the will to battle COVID has drained away and we'll just have to take the Delta variant on the chin.

The Prime Minister has promised full opening up on the 19th of July. It will be interesting to see what happens if the Delta variant is raging at that time.

 

[atyy]

One thing I don't understand about the UK - it started off with a terrible COVID-19 policy "herd immunity", but now it seems to be doing quite well overall - vaccination rates among the elderly are more than 90%, approaching 98% in some areas - and unlike the US which opened up only because it gave up persuading some a large fraction of its population to vaccinate - the UK, even with the delta variant, has a date for opening up (19 July) that even if delayed another month (till August) would still be based on having a large fraction of its population vaccinated, with extremely high vaccination rates among the vulnerable. So I think it's still looking good, relative to other rich countries. Normally, I would think the better policy would be due to a change in the government's science advisors, but that doesn't seem to have been the case? It's the same advisors, but they "repented" of their sins?

 

[PeroK]

One thing I don't understand about the UK - it started off with a terrible COVID-19 policy "herd immunity", but now it seems to be doing quite well overall - vaccination rates among the elderly are more than 90%, approaching 98% in some areas - and unlike the US which opened up only because it gave up persuading some a large fraction of its population to vaccinate - the UK, even with the delta variant, has a date for opening up (19 July) that even if delayed another month (till August) would still be based on having a large fraction of its population vaccinated, with extremely high vaccination rates among the vulnerable. So I think it's still looking good, relative to other rich countries. Normally, I would think the better policy would be due to a change in the government's science advisors, but that doesn't seem to have been the case? It's the same advisors, but they "repented" of their sins?

I can give you a personal view.

We did well getting in and ordering the vaccines early. The way the vaccination programme started really quickly was a huge success.

We were lucky that the start of mass vaccinations coincided with a trough in the case numbers. In any case, we had about the lowest rate (cases and deaths) among comparible countries for a couple of months.

There was always the chance of something like the Delta variant. You could argue that because we were doing so well, we relaxed on the Indian front. It was only about 40,000 people who flew in from India, I believe. In any case, instead of a minor inconvenience for 40,000 people, we have a resurgent pandemic affecting 68 million.

We seem to have the lowest vaccine hesitancy rate - by some margin over countries like the US and France. That said, without vaccinating children, I don't see that the Delta variant can be stopped. Currently the policy is not to vaccinate children. It's not clear when we will reach the point at which there is no one left who accepts the vaccine (we are currently at nearly 80% of the adult population (18+) have had at least one jab and nearly 60% have had two jabs.)

The UK situation has always been a balance between scientific advice and government policy. That said, we have no extreme mainstream politicians when it comes to COVID. But, generally, the government has always acted too late - it's almost a law of modern democratic politics that you can only act once that action is inevitable and never pro-actively. That's the way I see it. For example, we will only vaccinate children once it's completely clear that we must do it.

Overall, if the Delta variant spreads worldwide, then it could be very grim.

 

[atyy]

We seem to have the lowest vaccine hesitancy rate - by some margin over countries like the US and France. That said, without vaccinating children, I don't see that the Delta variant can be stopped.

But do we need it stopped? If vaccination rates among in adults are high enough, and gets to nearly 1`00% in the vulnerable groups, then given that 2 doses of the vaccine are still effective at reducing hospitalizations, even if the variant infects them, the death rate could still be markedly reduced, maybe enough not to stress the healthcare system. I think a similar view is expressed here by Christian Drosten, where the point of vaccination is not so much to prevent transmission, but to prevent severe disease, since we expect more variants to come along with immune escape such that vaccinated people will still become infected, but with much lower rates of severe disease, and higher rates of asymptomatic or mildly symptomatic cases. These asymptomatic or mildly symptomatic people will in turn infect others.

 

[PeroK]

But do we need it stopped? If vaccination rates among in adults are high enough, and gets to nearly 1`00% in the vulnerable groups, then given that 2 doses of the vaccine are still effective at reducing hospitalizations, even if the variant infects them, the death rate could still be markedly reduced, maybe enough not to stress the healthcare system. I think a similar view is expressed here by Christian Drosten, where the point of vaccination is not so much to prevent transmission, but to prevent severe disease, since we expect more variants to come along with immune escape such that vaccinated people will still become infected, but with much lower rates of severe disease, and higher rates of asymptomatic or mildly symptomatic cases. These asymptomatic or mildly symptomatic people will in turn infect others.

There is another factor: the more people who naturally get the virus, the more chance of further mutations. If we end up with, say, 10 million more people getting COVID in the UK, then we will probably have the Epsilon variant, and whatever that brings. It's much better to limit further cases to as few as possible. If it eventually circulates in low numbers, then that's not the same as an epidemic.

Moreover, no country wants to end up effectively isolated because it has some terrible variant that the rest of the world doesn't want.

Third, it's not clear yet what long term problems there may be with contracting the virus.

Finally, if it takes another 2 months for the UK to fully vaccinate everyone who wants it (and 3 months if we include children), then we ought to try to limit COVID until then. I don't like the idea of COVID raging among those who have not yet had the opportunity to get both jabs. And that's still a lot of people: there are 11 million people in the UK who have had one jab and waiting for the second.

 

[pinball1970]

There is another factor: the more people who naturally get the virus, the more chance of further mutations. If we end up with, say, 10 million more people getting COVID in the UK, then we will probably have the Epsilon variant, and whatever that brings. It's much better to limit further cases to as few as possible. If it eventually circulates in low numbers, then that's not the same as an epidemic.

Moreover, no country wants to end up effectively isolated because it has some terrible variant that the rest of the world doesn't want.

Third, it's not clear yet what long term problems there may be with contracting the virus.

Finally, if it takes another 2 months for the UK to fully vaccinate everyone who wants it (and 3 months if we include children), then we ought to try to limit COVID until then. I don't like the idea of COVID raging among those who have not yet had the opportunity to get both jabs. And that's still a lot of people: there are 11 million people in the UK who have had one jab and waiting for the second.

Yes and about 25 million with no jabs. That's a lot of bodies. Edit: I gave the wrong impression I think as I was in a rush. 'bodies' in this context was a reference to a population where the virus could infect unchecked, mutate and lead to something potentially worse than Delta.
That population would be a lot younger than Feb 2020 so less in hospital we would expect (ignoring long COVID) for @Evo

 

[atyy]

Finally, if it takes another 2 months for the UK to fully vaccinate everyone who wants it (and 3 months if we include children), then we ought to try to limit COVID until then. I don't like the idea of COVID raging among those who have not yet had the opportunity to get both jabs. And that's still a lot of people: there are 11 million people in the UK who have had one jab and waiting for the second.

I wasn't suggesting not to wait for 2 months. Certainly it's good to make sure everyone above 30 and maybe 20 who wants to be vaccinated has had 2 doses before opening up. My point was that if you could (hypothetically) get 100% coverage for those 30 and above, then there may not be any advantage in recommend vaccination to those below 17.

The reason for vaccinating those 17 and below would be if there's enough vaccine hesitancy in the older age groups. In that case allowing the virus to transmit to them would stress the healthcare system, so it's an advantage to vaccinate youths and children, so that infection doesn't spread so quickly.

 

[atyy]

https://www.bbc.com/news/live/uk-57543588
Nick Robinson interviewing Public Health England's Susan Hopkins.

"He asks first what is happening with the spread of the Delta variant in England. ...

Pushed on how many adults needed to be vaccinated by 19 July, to allow restrictions to be lifted, she suggests a figure of 70% could realistically be reached - adding that she is particularly keen to see all adults over 30 in England double-vaccinated by so-called "Terminus Day".

"We know two doses really protects against hospital admissions," she tells Nick Robinson.

She says that if admissions and discharges continue as they are currently, the NHS will be able to cope."

 

[atyy]

The delta (B.1.617.2) variant has an advantage over the alpha (B.1.1.7) variant in the UK. Secondary attack rates for delta are approximately 1.5 times those for alpha. Part of it is likely due to vaccine being less effective against delta than against alpha. First dose effectiveness for symptomatic disease is approximately 33% against delta, and 51% against alpha. Second dose effectiveness for delta and alpha are 88% and 93% respectively with the Pfizer vaccine; 60% and 66% respectively with AstraZeneca. (See @Ygggdrasil's post #2)

This interesting article by points out that because the UK used such a long interval between first and second doses, the difference in first dose effectiveness might have made a significant contribution to delta's advantage over alpha:
https://theconversation.com/covid-d...a-variant-an-evolutionary-helping-hand-162359
COVID: did a delayed second dose give the delta variant an evolutionary helping hand?
Jonathan R Goodman

 

[PeroK]

The delta (B.1.617.2) variant has an advantage over the alpha (B.1.1.7) variant in the UK. Secondary attack rates for delta are approximately 1.5 times those for alpha. Part of it is likely due to vaccine being less effective against delta than against alpha. First dose effectiveness for symptomatic disease is approximately 33% against delta, and 51% against alpha. Second dose effectiveness for delta and alpha are 88% and 93% respectively with the Pfizer vaccine; 60% and 66% respectively with AstraZeneca. (See @Ygggdrasil's post #2)

This interesting article by points out that because the UK used such a long interval between first and second doses, the difference in first dose effectiveness might have made a significant contribution to delta's advantage over alpha:
https://theconversation.com/covid-d...a-variant-an-evolutionary-helping-hand-162359
COVID: did a delayed second dose give the delta variant an evolutionary helping hand?
Jonathan R Goodman

I'd like to see the figures on how many of the recent COVID cases have been among people vaccinated only once. Until you see those figures, the conclusion of this piece is too woolly, IMO.

In any case, you'd really need a full mathematical model for the spread of the Alpha and Delta variants under the different vaccination policies. Otherwise, there is no way to quantify the evolutionary advantage. It might be negligible when you run the model.

 

[atyy]

I'd like to see the figures on how many of the recent COVID cases have been among people vaccinated only once. Until you see those figures, the conclusion of this piece is too woolly, IMO.

In any case, you'd really need a full mathematical model for the spread of the Alpha and Delta variants under the different vaccination policies. Otherwise, there is no way to quantify the evolutionary advantage. It might be negligible when you run the model.

Of course it's not a conclusion, just pointing out that while delta might be more transmissible, the degree to which it is more transmissible has not yet been quantified properly, with proper consideration of the effects of vaccination, so it may be quite a bit less than the 1.4 or 1.5 times advantage suggested by the raw secondary attack numbers.

 

[PeroK]

Of course it's not a conclusion, just pointing out that while delta might be more transmissible, the degree to which it is more transmissible has not yet been quantified properly, with proper consideration of the effects of vaccination, so it may be quite a bit less than the 1.4 or 1.5 times advantage suggested by the raw secondary attack numbers.

Yes, but I'd like to see some numbers!

For example, at the end of March we had 26.5 million people vaccinated only once, and 4.5 million twice. The alternative (given we'd done 7.5 million vaccinations in the previous two weeks) would have been approx: 3.5 million people only once and 16 million twice.

Crudely, at the end of March:

For Alpha we had 31 million people protected and 23 million (plus 14 million children) vulnerable.

For Delta we had only 4.5 million people protected.

Alternatively, we could have had:

For Alpha 19.5 milion people protected.

For Delta 16 million people protected.

It's all very plausible. but without those numbers the article seems a bit short on data to me.

 

[atyy]

Maybe the May numbers are more relevant, since that's when delta started increasing in the UK?

BTW, the article is not criticizing the decision to lengthen the time between doses.

 

[PeroK]

Maybe the May numbers are more relevant, since that's when delta started increasing in the UK?

BTW, the article is not criticizing the decision to lengthen the time between doses.

I had to fix the numbers above. I forgot that only half of the recent jabs would be first timers.

By the end of April the numbers were:

For Alpha: 34.5 million protected (at least once)

For Delta: 15 million protected (twice)

And we could have had:

For Alpha: 26.5 million protected (at least once)

For Delta: 23 million protected (twice).

 

[bob012345]

I asked my Congressman last week if they can propose that for people who refuse vaccinations after a certain deadline their insurance companies would be exempt from paying any incurred costs if they get sick. Make Covid susceptibility like a pre-existing condition for the unvaccinated.

 

[Evo]

This isn't a concern yet, more I'd say in the could be a "glitch" stage, but if found to be real, could Covid be mutating that quickly, India is mostly unvaccinated, and/or vaccinated by a less effective "home grown" vaccine. I believe ~77% effective against the Alpha. I'm tired, so I'm providing the rather iffy link. it was brought to my attention by another member.

Delta plus variant

The Delta plus variant is also being called B.1.617.2.1 or AY.1 strain. Out of the details emerging about the Delta Plus variant, the most noticeable one is the fact that the new strain is resistant to the monoclonal antibodies cocktail.

India continues to fight the second wave of Covid-19, which is seeing a decline in the cases. But the spread of the Delta variant, which has further mutated into another strain called Delta Plus has been reported from three states. So, the question is should we worry about the Delta Plus strain? But the Centre says, right now Delta Plus is a variant of interest only, it’s not a variant of concern yet.

"This is a variant of interest that has not yet been classified as a variant of concern. A variant of concern is in which we have understood that there are adverse consequences to humanity by an increase in transmissibility and severity. This is not known yet about the Delta plus variant," NITI Aayog Member (Health) V K Paul had said.

https://www.livemint.com/news/india...-3-states-should-we-worry-11624329344941.html

 

[Delta2]

A moderator please fix the typo in the title of this thread.

 

[Evo]

A moderator please fix the typo in the title of this thread.

It was a test, yeah, a TEST.

 

[Evo]

More information on the Delta Plus variant.

WHAT IS DELTA PLUS?

The variant, called "Delta Plus" in India, was first reported in a Public Health England bulletin on June 11.

It is a sub-lineage of the Delta variant first detected in India and has acquired the spike protein mutation called K417N which is also found in the Beta variant first identified in South Africa.

Some scientists worry that the mutation, coupled with other existing features of the Delta variant, could make it more transmissible.

"The mutation K417N has been of interest as it is present in the Beta variant (B.1.351 lineage), which was reported to have immune evasion property," India's health ministry said in a statement.

continued...

https://news.yahoo.com/explainer-delta-variant-coronavirus-k417n-094930268.html

 

[pinball1970]

More information on the Delta Plus variant.

continued...

https://news.yahoo.com/explainer-delta-variant-coronavirus-k417n-094930268.html

When does a blip become a spike, a spike become a surge, and a surge become a wave? Media terms mainly but a few countries are now going in the wrong direction.

Globally seems to be turning also

 

[Jarvis323]

More information on the Delta Plus variant.

continued...

https://news.yahoo.com/explainer-delta-variant-coronavirus-k417n-094930268.html

I know everyone wants to go back to normal, and many people seem to be under the impression that it's over, and vaccinated people don't need to worry about exposure anymore.

But for me, that seems to be a big mistake. Right now, there is still a lot of SARS-COV-2 out there. And the virus "wants"'access to vaccinated people. It needs that access so that it can learn to survive in the growing population of vaccinated people.

Now is a time to double down on containment efforts, so as to make our vaccination efforts most likely to succeed and limit risks of new disasters.

I got banned from the containment thread in gd, when I was arguing this point and suggesting that requireing masks is still useful even today, by claiming that giving the virus access to vaccinated people will help the virus to adapt, and not admitting I was wrong. Rive accused me of being deceptive.

Anyway that's my opinion.

 

[Jarvis323]

I asked my Congressman last week if they can propose that for people who refuse vaccinations after a certain deadline their insurance companies would be exempt from paying any incurred costs if they get sick. Make Covid susceptibility like a pre-existing condition for the unvaccinated.

I understand where this is coming from, but in practice this would be cruel. It's comparable to denying life saving care to undocumented immigrants.
Prexisting conditions shouldn't even be a thing in a compassionate health care system in the first place. I would understand not covering pre-existing conditions more, if health care costs weren't hyperinflated. Requiring a person to pay 120k or so, out of pocket, just for some life saving pills alone, for example, is just insane. They will just die.

The US health care system is brutally unforgiving and cold already. Also, some people can't get the vaccine.

I realize people are upset about anti-vaxxers, but I'm not comfortable with the level of dehumanization and death wishes people are placing on them.

Don't forget, a year ago many of you were anti-maskers, and people could have applied the same reasoning to be cruel to you.

 

[bob012345]

I understand where this is coming from, but in practice this would be cruel. It's comparable to denying life saving care to undocumented immigrants.
Prexisting conditions shouldn't even be a thing in a compassionate health care system in the first place. I would understand not covering pre-existing conditions more, if health care costs weren't hyperinflated. Requiring a person to pay 120k or so, out of pocket, just for some life saving pills alone, for example, is just insane. They will just die.

The US health care system is brutally unforgiving and cold already. Also, some people can't get the vaccine.

I realize people are upset about anti-vaxxers, but I'm not comfortable with the level of dehumanization and death wishes people are placing on them.

Don't forget, a year ago many of you were anti-maskers, and people could have applied the same reasoning to be cruel to you.

I disagree it is cruel if there are clear guidelines, deadlines and exceptions for hardship cases. There are no death wishes and people will not be denied life saving treatments. They just may have to pay for it or at least a greater part of it after the fact.

How can we as a rational society say that a person is free to choose not getting a free vaccine in the midst of a global pandemic and then just allow that person to spread it to other people also, some of whom, even some vaccinated people, may die, and there be zero consequences? Where is the compassion for the people who die as a result of others either ignorance or callousness?

 

[Jarvis323]

I disagree it is cruel if there are clear guidelines, deadlines and exceptions for hardship cases. There are no death wishes and people will not be denied life saving treatments. They just may have to pay for it or at least a greater part of it after the fact.

How can we as a rational society say that a person is free to choose not getting a free vaccine in the midst of a global pandemic and then just allow that person to spread it to other people also, some of whom, even some vaccinated people, may die, and there be zero consequences? Where is the compassion for the people who die as a result of others either ignorance or callousness?

I understand where you're coming from, but I don't think you've thought it through carefully.

If not being vaccinated becomes a terminating condition for a person's health care coverage, then yes they will be treated at an ER in the US, but when they develop organ damage and require lifetime treatment at a cost of 120k + per year for life, and they are not able to pay that, then they will likely not be afforded that treatment. The ER costs will likely already have bankrupted them, and they will possibly be homeless. As their organs fail them rapidly without treatment, the next time they go to the hospital and are afforded care will be when they see the ER again as they are dying.

It is better to openly argue for a direct punishment, than to sick a cruel loophole on people that may condem them to a life of poverty suffering and accelerated death, that will also affect innocent bystanders who have medical reasons not to get a vaccine, and will also set a dangerous precedent that could ruin a lot more lives in the future.

 

[bob012345]

It is better to openly argue for a direct punishment, than to sick a cruel loophole on people that may condemn them to a life of poverty suffering and accelerated death, that will also affect innocent bystanders who have medical reasons not to get a vaccine, and will also set a dangerous precedent that could ruin a lot more lives in the future.

The whole purpose of my idea is not to punish people for the sake of punishment but to induce them to get the vaccine. I am open to a cap on the consequences but it should be a strong enough motivation that most unvaccinated people will choose to get the shot.

 

[Fra]

The whole purpose of my idea is not to punish people for the sake of punishment but to induce them to get the vaccine.

Maybe some people remember the narcolepsy cases, triggered from swineflue, and in Sweden there was supposed to be a insurance that pays up to the order of a million dollars or so to anyone getting sick from the vaccine. Even if no money can give your health back, as far as I know, lots of people still hasn't received it. So from the public perspective, full responsibility has not taken (and maybe cannot/should not be taken) from the governement for damages cause by a mass vaccination with a vaccine who has been developed in a rush. This makes it unreasonable to force anyone.

I hear a lot of people reason like, they want the vaccine - but don't want to be first in line. Unfortunately stressful situations forces us to take risky decisions, as not taking actions due to lack of enough evidence as per regular standards is also a risk. Each individual needs to have the freedom to make their own risk assessment, no one else can or should do that for you.

If the choice given the right information is trivial, then sharing the "wisdom" by informing people better should be the way to go.

/Fredrik

 

[atyy]

@Fra what do you think of requiring health care workers to be vaccinated?

https://www.nytimes.com/2021/04/21/health/vaccine-nursing-homes-infections.html

https://ltccovid.org/2021/05/25/nat...d-practices-in-relation-to-covid-19-no-1-may/

 

[Fra]

@Fra what do you think of requiring health care workers to be vaccinated?

https://www.nytimes.com/2021/04/21/health/vaccine-nursing-homes-infections.html

https://ltccovid.org/2021/05/25/nat...d-practices-in-relation-to-covid-19-no-1-may/

Big questions I guess, but I see two components,

1) occupational health - workers who are "forced" to take at higher risk due to their occupation, that is also of extra importance during the pandemi itself. It seems reasonable and fair that they should get priority in vaccine lines to balance the risk they are also taking.

2) Your decisions affect other people - this is more tricky and involves also psychology. I guess there is a balance. The fact that our own decisions affects our own environment in general sense is I think unavoidable, but when the effects is more directed towards certain groups, I agree a discussion is needed. If unvaccinated workes are a clear and big threat (if it is, I don't know) then one can consider saying that these workes are temporarilty not allowed to work in that area until vaccinated (they get to work in a less critical area temporarilty). OTOH, if this is a big problem it perhaps also indicates that OTHER protective equipment is insufficient during patient contact?

About the general philosophy about decisions affecting the environment, one also has to accept that the environment tries to control your decisions as that decision to influences is also their free decision and part of the "game". That is fine. I just think that too much forcing will in the long term build-in tension among everyone. Anyone feeling forced, instead of getting "help to make their own informed rational decions" can also overreact and become hostile to the environment, and it can lead to bad development. But this then turns into sociology, psycholgoy and politics I guess. Do we want a well informed population that makes rational decisions, or do we want a dictator that rules a population of fools given not incentive to make own decisions? Both systems will work, but the latter will have a large built-in tension that sooner or later will blow up.

If the people don't trust politician or government we have a problem.

The argument that "because daddy says so" is easier to come up with, than to really try to EXPLAIN at the right level, and help reasoning. And accepting "argument due to authority" shouldn't be encouraged in the first place. I think one should treat the reasons for peoples decisions with respect and instead invite for discussions.

/Fredrik

 

[Fra]

but it should be a strong enough motivation that most unvaccinated people will choose to get the shot.

If a reasonably objective (probable benefit is >> the probable damage) is not strong enough motivation?
What is the problem we have at hand?

Except for a minority which may have various religious reasons for things, maybe educating people in rational decision help? If so, forcing them will be counterproductive I think. Taking their reasoning seriously and meeting their arguments may be better, but perhaps requiring more resources.

/Fredrik

 

[atyy]

https://www.researchsquare.com/article/rs-637724/v1
SARS-CoV-2 B.1.617.2 Delta variant emergence and vaccine breakthrough
Mlcochova et al (from Ravindra K. Gupta's group)

They summarize their findings in a Twitter thread.

"While there is substantial uncertainty in our estimates, we find that 𝘪𝘯 𝘔𝘶𝘮𝘣𝘢𝘪 the Delta variant was 10% to 40% more transmissible than previously circulating lineages, and able to evade 20 to 55% of the immune protection provided by prior infection with non-Delta virus."

"Summary:The Delta variant has significant immune evasion and fitness compared to Alpha. Vaccines will prevent severe disease/death in *most* people, but special measures may be needed for those who respond poorly to vaccination. Infection in vaccinated HCWs needs to be considered"

 

[Evo]

More on the Delta variant.

Dangerous Delta COVID-19 Variant Infecting Vaccinated Adults In Israel

But half of the adults infected had been fully vaccinated with the Pfizer vaccine, Balicer said.

About 90% of the new infections in Israel were likely caused by the delta variant, the Journal reported.

The World Health Organization on Friday also warned everyone, even those fully vaccinated, to “play it safe” and continue to wear a mask and maintain social distancing in light of the large numbers of people who remain unvaccinated and the emergence of the delta variant, which it called the “most transmissible” form of the Coronavirus identified to date.

“People cannot feel safe just because they had the two doses. They still need to protect themselves,” Dr. Mariangela Simao, WHO assistant director-general for access to medicines, said at a news briefing in Geneva. “Vaccine alone won’t stop community transmission.”

“People need to continue to use masks consistently, be in ventilated spaces, [use] hand hygiene ... [practice] physical distance, avoid crowding.”

continued...

https://www.yahoo.com/huffpost/dangerous-delta-covid-19-variant-011913549.html

 

[PeroK]

This begs the question: what is the plan to get back to normal life? If mass vaccination isn't enough, then what do we do?

 

[Ygggdrasil]

Some excerpts from some articles from STAT news on the topic:

How did those pandemics end? The viruses didn’t go away; a descendent of the Spanish flu virus, the modern H1N1, circulates to this day, as does H3N2. Humans didn’t develop herd immunity to them, either. That’s a phenomenon by which a pathogen stops spreading because so many people are protected against it, because they’ve already been infected or vaccinated.

Instead, the viruses that caused these pandemics underwent a transition. Or more to the point, we did. Our immune systems learned enough about them to fend off the deadliest manifestations of infection, at least most of the time. Humans and viruses reached an immunological détente. Instead of causing tsunamis of devastating illness, over time the viruses came to trigger small surges of milder illness. Pandemic flu became seasonal flu.

The viruses became endemic.

If the pattern holds, and it is expected to, SARS-2 will at some point join a handful of human coronaviruses that cause colds, mainly in the winter, when conditions favor their transmission.

https://www.statnews.com/2021/05/19...cientists-look-to-the-past-to-see-the-future/

Functional immunity, on the other hand, may be within reach. In fact, it’s the scenario Menachery sees as most likely.

Under this scenario, people whose immune systems have been primed to recognize and fight the virus — whether through infection or vaccination — could contract it again in the future. But these infections would be cut short as the immune system’s defenses kick into gear. People infected might not develop symptoms or might have a mild, cold-like infection.

“I’m a believer that if you’ve gotten Covid-19, then your likelihood of dying from a second Covid-19 case is very low, if you maintain immunity,” Menachery said.

Peiris agreed. “It won’t have the impact it has now. … It becomes manageable.”

https://www.statnews.com/2020/08/25/four-scenarios-on-how-we-might-develop-immunity-to-covid-19/

(the full articles are worth a read if you are interested in the subject)

The problem with SARS-CoV-2 has been that it has not necessarily been that it infects people, but that it causes deadly symptoms in a large number of people (especially in certain vulnerable populations). While the new variants seem to be able to at least partially evade some antibody-based humoral immunity to infect a small fraction of vaccinated individuals, other evidence suggest that the variants (so far) are not able to evade the cellular immune response mediated by T-cells that keeps infections from spreading out of control and causing severe symptoms. For example, here are a few studies on the topic:

Negligible impact of SARS-CoV-2 variants on CD4+ and CD8+ T cell reactivity in COVID-19 exposed donors and vaccinees
https://www.biorxiv.org/content/10.1101/2021.02.27.433180v1

SARS-CoV-2 variants of concern partially escape humoral but not T-cell responses in COVID-19 convalescent donors and vaccinees
https://immunology.sciencemag.org/content/6/59/eabj1750

CD8+ T cell responses in COVID-19 convalescent individuals target conserved epitopes from multiple prominent SARS-CoV-2 circulating variants
https://academic.oup.com/ofid/advance-article/doi/10.1093/ofid/ofab143/6189113

Consistent with the idea that T-cell responses and cellular immunity are not affected by the variants, most studies of the vaccines suggest that the vaccines are still very effective at preventing severe disease, hospitalization and death from the coronavirus.

The recent increase in COVID-19 cases in Israel could be an interesting test case. It will be interesting to see whether the recent uptick in cases are accompanied by any uptick in hospitalizations or deaths. If not, then Israel would show that vaccination is a successful strategy to exit the pandemic: with vaccination, SARS-CoV-2 becomes something like seasonal flu—still an ever-present danger and something that can be deadly, but not to the level that it requires massive disruptions to normal life.

Pre-pandemic, people tolerated ~10-60k deaths during typical flu seasons. If COVID-19 mortality could be reduced by a factor of 10-20 (which seems reasonable given the data we have on the vaccines), this would place COVID-19 mortality in the "acceptable" range for society.

 

[Evo]

@Ygggdrasil , so do they foresee a yearly SARS-CoV-2 vaccine like the flu vaccine now? If the scenario plays out as they hope, which seems reasonable.

I get my second dose of Pfizer in a few hours.

I went to Walmart yesterday because I had to go to the post office down the street from it, NO ONE WAS WEARING A MASK! I was the only one, it was standing room only in the post office, no masks, Walmart was crowded, no masks, not even the employees. I was the ONLY ONE! And I KNOW most of these people were not vaccinated. I live in a state where only ~40% of the population are vaccinated.

 

[Ygggdrasil]

@Ygggdrasil , so do they foresee a yearly SARS-CoV-2 vaccine like the flu vaccine now? If the scenario plays out as they hope, which seems reasonable.

I get my second dose of Pfizer in a few hours.

I don't think we have enough data to know how long immunity will last. Data from other coronaviruses suggests immunity could start to wane as soon as ~1 year after infection, though re-infections are much more likely to be asymptomatic. For example, see these two studies:

The time course of the immune response to experimental Coronavirus infection of man
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2271881/

Seasonal Coronavirus protective immunity is short-lasting
https://www.nature.com/articles/s41591-020-1083-1

Current data from observational studies I have seen don't see signs of waning immunity from vaccination or infection after ~ 8-9 months, though longer term data is definitely needed.

If annual booster shots are required, there are definitely plenty of companies working on them, and IIRC Pfizer and Moderna are running clinical trials on vaccine booster shots against some of the new variants. Various companies are also creating and testing vaccines that would vaccinate against both the flu and COVID-19.

Glad to hear you are getting your second shot! Hope you don't have side effects that were too bad (I just had a mild headache the day after my second shot).

 

[Fra]

SARS-CoV-2 variants of concern partially escape humoral but not T-cell responses in COVID-19 convalescent donors and vaccinees
https://immunology.sciencemag.org/content/6/59/eabj1750
...
Consistent with the idea that T-cell responses and cellular immunity are not affected by the variants, most studies of the vaccines suggest that the vaccines are still very effective at preventing severe disease, hospitalization and death from the coronavirus.

Thanks!

It made my head spin and I found these(non-COVID specific) as well:

Cross-Reactivity of T Cells and Its Role in the Immune System​

"The ability of the T-cell receptor (TCR) to recognize more than one peptide-MHC structure defines cross-reactivity. Cross-reactivity is a documented phenomenon of the immune system whose importance is still under investigation. There are a number of rational arguments for cross-reactivity. These include the discrepancy between the theoretical high number of pathogen-derived peptides and the lower diversity of the T-cell repertoire, the need for recognition of escape variants, and the intrinsic low affinity of this receptor–ligand pair. However, quantifying the phenomenon has been difficult, and its immunological importance remains unknown. In this review, we examined the cases for and against an important role for cross reactivity. We argue that it may be an essential feature of the immune system from the point of view of biological robustness."
-- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3595599/Why must T cells be cross-reactive?
"Clonal selection theory proposed that individual T cells are specific for a single peptide–MHC antigen. However, the repertoire of αβ T cell receptors (TCRs) is dwarfed by the vast array of potential foreign peptide–MHC complexes, and a comprehensive system requires each T cell to recognize numerous peptides and thus be cross-reactive. This compromise on specificity has profound implications because the chance of any natural peptide–MHC ligand being an optimal fit for its cognate TCR is small, as there will almost always be more-potent agonists. Furthermore, any TCR raised against a specific peptide–MHC complex in vivo can only be the best available solution from the naive T cell pool and is unlikely to be the best possible solution from the substantially greater number of TCRs that could theoretically be produced. This 'systems view' of TCR recognition provides a plausible cause for autoimmune disease and substantial scope for multiple therapeutic interventions."
-- https://www.nature.com/articles/nri3279

So it seems to me from laymen perspective that T-cell defense, somehow fits in between innate and the humoral system, although it's considered part of the adaptive system? ie. The Innate system is very unspecific, but the T-cell system is more specifi, but the humoral system is even more specific? Or am I rushing into a incorrect conclusion here?

It seems to me without the humoral system, the T-cell system would have to be EVEN more cross responsive, and likely increase the chance of autoimmune reations? It's amazing to see the beauty of evolution, and how all parts seems to play a crucial role?

/Fredrik

 

[atyy]

This begs the question: what is the plan to get back to normal life? If mass vaccination isn't enough, then what do we do?

The UK is ahead of Israel in terms of having had the delta variant, and it has a high vaccination rate that it is trying to increase. So we'll have to wait and hope the UK has good results. If it isn't enough, I'd guess that probably the first thing to do would be to give a third vaccine dose to the vulnerable groups.

Edit: Israel newspaper report on the UK: https://www.haaretz.com/israel-news...-but-hospitalizations-remain-stable-1.9943803 (apparently numbers in the UK are looking ok, although it is too early to be sure?)

 

[PeroK]

The UK is ahead of Israel in terms of having had the delta variant, and it has a high vaccination rate that it is trying to increase. So we'll have to wait and hope the UK has good results. If it isn't enough, I'd guess that probably the first thing to do would be to give a third vaccine dose to the vulnerable groups.

Edit: Israel newspaper report on the UK: https://www.haaretz.com/israel-news...-but-hospitalizations-remain-stable-1.9943803 (apparently numbers in the UK are looking ok, although it is too early to be sure?)

I think it is too early to tell. One problem is that the UK schools are severely disrupted with pupils off school with COVID. If eventually we have to live with the Delta variant and its successors, then okay. But, it probably means at least another 3-6 months of disruption in the meantime.

If there is no longer an unbearable strain on the health service, then that is a big relief. The hope was that with 80%+ of the adult population vaccinated we would be back to near normality. Despite the vaccination speed and success we are still a long way from normality.

 

[Rive]

...has a high vaccination rate that it is trying to increase.

Based on the example of the major variants so far, countries with high vaccination rate should look out for further possible outbreaks (countries with low vaccination rate) instead of chasing the 100%: since any new variant possibly can (and, in case of further carelessness: sooner or later it likely will) make their high vaccination rate obsolete.