COVID Get Vaccinated Against the Covid Delta Variant

[StevieTNZ]

Unfortunately the variant is delta, and four others have already caught it (including one fully vaccinated hospital worker) - https://www.stuff.co.nz/national/he...ng-total-cases-to-five-says-pm-jacinda-ardern

 

[Astronuc]

https://news.yahoo.com/georgia-couple-dies-covid-just-160221359.html

Martin and Trina Daniel fell ill with the virus around July 4 and their children, who also contracted COVID explained that their symptoms “quickly spiraled” out of control, ABCNews reported.

Martin passed away while at home on July 6 while Trina died shortly after being hospitalized that same night.

Two days!

I have to wonder if they got treatment other than supplemental oxygen.

In many states, like Florida and Texas, apparently the emphasis is on treatment after infection rather than prevention. The governor of Texas, Greg Abbott, developed COVID-19 after attending a gathering and apparently not wearing a mask. Abbott is vaccinated though and is receiving the Regeneron monoclonal antibody treatment.
https://www.wfaa.com/article/news/l...toms/287-22b6ea37-9784-42a2-8e54-03235f451882

Aug 17 - New cases are emerging at their highest rates since winter as the Delta variant sweeps across the country and Americans come to terms with the fact that Covid is not going away any time soon.

https://www.nytimes.com/interactive/2021/us/covid-cases.html

https://www.nytimes.com/2021/08/16/us/covid-delta-variant-us.html

 

[nsaspook]

https://news.yahoo.com/georgia-couple-dies-covid-just-160221359.html

Two days!

I have to wonder if they got treatment other than supplemental oxygen.

In many states, like Florida and Texas, apparently the emphasis is on treatment after infection rather than prevention. The governor of Texas, Greg Abbott, developed COVID-19 after attending a gathering and apparently not wearing a mask. Abbott is vaccinated though and is receiving the Regeneron monoclonal antibody treatment.
https://www.wfaa.com/article/news/l...toms/287-22b6ea37-9784-42a2-8e54-03235f451882https://www.nytimes.com/interactive/2021/us/covid-cases.html

https://www.nytimes.com/2021/08/16/us/covid-delta-variant-us.html

Hopefully the trend of reaching peak cases in high vaxx locations continues. Locally (near Portland Oregon) cases may have peaked. California is also peaking.

https://ktla.com/news/local-news/california-seeing-signs-covid-surge-is-slowing/

California enters a crucial phase in its battle against the Delta variant this week — the reopening of schools — with some hopeful signs: The number of people being infected and falling seriously ill with COVID-19 is no longer accelerating at dramatic rates and even beginning to flatten in some areas.

The rise in COVID-19 hospitalizations is also slowing. California on Sunday reported 7,166 people with COVID-19 in its hospitals, up 20% from the previous week. But that’s an improvement from late July, when there was a 50% week-over-week jump in hospitalizations, and still far below the wintertime peak of 22,000.

 

[BillTre]

Science magazine has a little article on Covid's evolution, here.
Don't think its open access, but might be.

Two things interested me,
A phylogeny of some of the variants:

Too bad the phylogeny is not showing much detail.

and where on the viral molecules the mutations fall:

 

[jim mcnamara]

@BillTre
The phylogenetic tree: https://nextstrain.org/ncov/gisaid/global
Version is zoomable with all kinds of other resources like references, genomic dataset downoads, etc.
https://nextstrain.org:
Cool toolset and access to other pathogen genomes.

I think this is a standard repository for researchers.

 

[Astronuc]

A pregnant mom-to-be lost her unborn twins to COVID-19 after she contracted the Coronavirus earlier [during July] this year, Texas health officials reported.

https://www.star-telegram.com/news/nation-world/national/article253570389.html
https://www.wane.com/community/heal...nces-fetal-fatalities-attributed-to-covid-19/

Meanwhile in Florida, people are going to makeshift clinics for Regeneron monoclonal antibody treatment. https://news.yahoo.com/were-very-sick-viral-photo-002311187.html

JACKSONVILLE, Fla. — Louie Lopez showed up to the downtown Jacksonville Main Library Conference Center in the early afternoon for a Regeneron therapy appointment. His primary care doctor recommended it after Lopez tested positive for COVID-19 and was experiencing moderate to severe symptoms.

While waiting in line for his turn, two other people got in the line behind Lopez. Both of them, he says, sat down on the floor immediately. They eventually laid down “sick and moaning.” Lopez, 59, told The Florida Times-Union, part of the USA TODAY Network, that the woman pictured in yellow was dragging herself on the floor as the line slowly moved forward.

Apparently some very ill people who should be going to hospital are instead coming to the clinic.

The therapy treatment is for people in the early stages of COVID-19 and the makeshift clinic where Lopez took the photo is not meant to serve as a full-fledged hospital. But amid rising COVID infections and increased worry, some people in more advanced stages of COVID have opted to go to makeshift clinics instead of hospitals due to potentially long waits.

Workers at the site said the clinic is not for very sick patients; people in that category should go to a hospital.

 

[atyy]

https://www.sciencemag.org/news/2021/08/grim-warning-israel-vaccination-blunts-does-not-defeat-delta
A grim warning from Israel: Vaccination blunts, but does not defeat Delta
Meredith Wadman

I'm not sure if the title is right. The UK seems to be doing ok! Maybe it's because the UK has higher seropositivity (due to natural infections and vaccinations) than Israel? The UK's seropositivity rate is in the report below, not sure what Israel's is.

https://assets.publishing.service.g...420/Vaccine_surveillance_report_-_week_33.pdf
Public Health England COVID-19 vaccine surveillance report Week 33
"Roche S seropositivity increased first in donors aged 70 to 84 and has plateaued since week 13, reaching 99.9% in weeks 28 to 31. Seropositivity has also plateaued since week 16 for those aged 60 to 69 reaching 98.9% in weeks 28 to 31. Plateauing in Roche S seropositivity has been observed since week 19 in those aged 50 to 59 reaching 99.1% in weeks 28 to 31 2021."

 

[morrobay]

https://www.sciencemag.org/news/2021/08/grim-warning-israel-vaccination-blunts-does-not-defeat-delta
A grim warning from Israel: Vaccination blunts, but does not defeat Delta
Meredith Wadman

60% of those gravely ill are fully vaccinated ?

 

[PeroK]

60% of those gravely ill are fully vaccinated ?

Almost all the older and more vulnerable in Israel are fully vaccinated. The important figure is how many are gravely ill, not what proportion are vaccinated. Especially compared to how many would be gravely ill if there had been no vaccine.

If everyone were vaccinated then 100% of those ill would be vaccinated.

 

[OmCheeto]

Almost all the older and more vulnerable in Israel are fully vaccinated. The important figure is how many are gravely ill, not what proportion are vaccinated. Especially compared to how many would be gravely ill if there had been no vaccine.

If everyone were vaccinated then 100% of those ill would be vaccinated.

It will be interesting to see how their 3rd dose program works out.
Amazing how fast they do things. They just started administering the 3rd doses 3 weeks ago.

ref: https://datadashboard.health.gov.il/COVID-19/general

 

[atyy]

Eran Segal: "Israel is reporting a 4-fold increase in protection from infection after a 3rd booster shot, compared to an age-gender matched cohort of 2 doses And 5-6 fold increased protection from hospitalization and severe disease 3rd dose now approved for all, tomorrow starting in 40+ y/o"

Israel's vaccine effectiveness for 60+ is about 88% against severe disease caused by the Delta variant. A 5-6 fold increase in protection would bring it to about 98%, which is excellent.

 

[morrobay]

The important figure is how many are gravely ill, not what proportion are vaccinated. Especially compared to how many would be gravely ill if there had been no vaccine.

That figure is 514 hospitalized severally or critically ill. 59% were fully vaccinated. I have no agenda on this, just restating from report that also says the hospitals are being stretched. And there are facts about these patients missing such comorbidities .Sure you can make counterfactual arguments.

 

[atyy]

That figure is 514 hospitalized severally or critically ill. 59% were fully vaccinated. I have no agenda on this, just restating from report that also says the hospitals are being stretched. And there are facts about these patients missing such comorbidities .Sure you can make counterfactual arguments.

@PeroK is correct.

The numbers you cite are from Israel. Most vaccinated serious cases are 60 years old or older, where the vaccination rate is approximately 90%

Let the vaccine reduce severe cases by r. In an unvaccinated population x fraction are severe cases. In a vaccinated population (1-r)x fraction are severe cases. If v of the total population is vaccinated, then the fraction of severe cases due to vaccinated people is z = [v(1-r)x]/[v(1-r)x + (1-v)x]. Solving gives r = [v - z]/[v(1-z)]. Using z = 0.60 as the vaccinated fraction of severe cases, and v = 0.9 as the vaccinated fraction of the 60+ population, gives r ~ 0.8, ie ~80% protection against severe illness by the vaccine.

You can see a more detailed calculation in https://www.covid-datascience.com/p...strong-when-60-of-hospitalized-are-vaccinated. Overall, these are consistent with protection against hospitalization or severe disease being estimated by Israel at various times to be at 88%, 91%, 93%. https://www.haaretz.com/israel-news...ata-preventing-hospitalizations-88-1.10021477

Currently, the Israel dashboard gives among the 60+, that 194.9/100000 serious cases among the unvaccinated, and 20.1/100000 serious cases among the vaccinated, which corresponds to 1-(20.1/194.9) ~ 89% vaccine effectiveness. [Edited after @hutchphd pointed out below that I interchanged the vaccinated and unvaccinated numbers]

See also the points made by Yair Lewis that most recent cases are from cities with vaccination rates above the national average, and hence using the national average may lead to an underestimate of vaccine effectiveness.

Israel's recent vaccine effectiveness estimates are broadly consistent with, but still seem a bit lower than the UK numbers of 91-98% protection against hospitalization. https://assets.publishing.service.g...420/Vaccine_surveillance_report_-_week_33.pdf (p7)

For comorbidties (not all data is from after Delta), see:
https://www.news-medical.net/news/2...fizer-vaccination-4025-immunocompromised.aspx
https://www.reuters.com/world/middl...through-cases-mostly-older-sicker-2021-08-20/

https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(21)00367-0/fulltext
BNT162b2 vaccine breakthrough: clinical characteristics of 152 fully vaccinated hospitalized COVID-19 patients in Israel
Brosh-Nissimov T, Orenbuch-Harroch E, Chowers M, Elbaz M, Nesher L, Stein M, Maor Y, Cohen R, Hussein K, Weinberger M, Zimhony O, Chazan B, Najjar R, Zayyad H, Rahav G, Wiener-Well Y. Clin Microbiol Infect. 2021 Jul 7:S1198-743X(21)00367-0.

 

[hutchphd]

Currently, the Israel dashboard gives among the 60+, that 194.9/100000 serious cases among the vaccinated, and 20.1/100000 serious cases among the unvaccinated, which corresponds to 1-(20.1/194.9) ~ 89% vaccine effectiveness.

My brain shut down an hour ago...are these backwards?

 

[atyy]

My brain shut down an hour ago...are these backwards?

Oops yes, will correct.

 

[Astronuc]

As Covid-19 hospitalizations increase, a greater number of Americans are deciding to get vaccinated
https://www.cnn.com/2021/08/20/health/us-coronavirus-friday/index.html

As Covid-19 cases rise among teens, so do vaccinations, CNN analysis finds
https://www.cnn.com/2021/08/18/health/covid-19-teens-vaccinations-rise-analysis-wellness/index.htmlEdit/Update:
AP - Though young and healthy, unvaccinated father dies of COVID
https://abcnews.go.com/Health/wireStory/young-healthy-unvaccinated-father-dies-covid-79576893

MONTGOMERY, Ala. -- Healthy and in their 30s, Christina and Josh Tidmore figured they were low-risk for COVID-19. With conflicting viewpoints about whether to get vaccinated against the virus filling their social media feeds and social circles, they decided to wait.

On July 20, Josh came home from work with a slight cough initially thought to be sinus trouble. On Aug. 11, he died of COVID-19 at a north Alabama hospital as Christina Tidmore witnessed a doctor and her team frantically try to resuscitate her husband.

Tidmore might have been less susceptible to serious consequences with the original or Alpha variant, but clearly the Delta variant is more severe. "Christina Tidmore also had COVID-19 but recovered. She said she and her husband were not anti-vaccine, but heard conflicting information — including, she said, from doctors." The couple have three children.

I wonder if mentions of the uncertainties about the effects of the vaccine or vaccine efficacy resulted in doubts (or anxiety) to the point of discouraging people form receiving the vaccine.

“Josh was completely healthy, active, not a smoker.” He would have turned 37 on Saturday.

Doctors say they are seeing a spike in cases among young adults and children as the highly contagious delta variant sweeps through unvaccinated populations. Medical officials say there is conflicting information on whether it makes people more severely ill or whether young people are more vulnerable to it, but it's clear the contagiousness means more young people and children are getting sick.
. . .

In the past four weeks, people ages 25 to 49 years, made up 14% of all COVID deaths in the state. And people 50 to 64 years made up about 29%.

The state is also seeing a surge in COVID cases among children, although deaths so far have been rare. The state this week set a record for pediatric hospitalizations with 50 children hospitalized with COVID-19.

In the past four weeks, 6% of cases of COVID-19 in Alabama have been among children under five while 8% have been among children between the ages of five and 17, according to the Alabama Department of Public Health.

 

[nsaspook]

IMO some important results on the effectiveness of virus transmission countermeasures like masks and ventilation.

https://aip.scitation.org/doi/10.1063/5.0057100

Experimental investigation of indoor aerosol dispersion and accumulation in the context of COVID-19: Effects of masks and ventilation

The results demonstrate that the apparent exhalation filtration efficiency is significantly lower than the ideal filtration efficiency of the mask material. Nevertheless, high-efficiency masks, such as the KN95, still offer substantially higher apparent filtration efficiencies (60% and 46% for R95 and KN95 masks, respectively) than the more commonly used cloth (10%) and surgical masks (12%), and therefore are still the recommended choice in mitigating airborne disease transmission indoors. The results also suggest that, while higher ventilation capacities are required to fully mitigate aerosol build-up, even relatively low air-change rates (2 h−12 h−1) lead to lower aerosol build-up compared to the best performing mask in an unventilated space.

https://www.sciencedaily.com/releases/2021/08/210819124528.htm

A new study is highlighting a need for widespread use of better face masks and the importance of good ventilation to mitigate the spread of COVID-19 indoors.

 

[atyy]

IMO some important results on the effectiveness of virus transmission countermeasures like masks and ventilation.

https://aip.scitation.org/doi/10.1063/5.0057100

Experimental investigation of indoor aerosol dispersion and accumulation in the context of COVID-19: Effects of masks and ventilation

I don't think the N95 is practical for most people in everyday settings (too uncomfortable)? So I think ventilation is a priority, then preferably a surgical mask (comfortable enough for most people, but expensive) or cloth mask?

A quick read seems to show their conclusions are consistent with https://www.medrxiv.org/content/10.1101/2020.04.16.20067728v1, but I'm not sure how to convert between their units of airflow (L/s/person) and the one in the paper you posted (ACH)?

In high risk settings, one would prefer an FFP3 (N99) if available.
https://www.bbc.com/news/health-57636360

 

[Sagittarius A-Star]

In USA, the sub-variant Delta AY.3 makes now 12.3 percent of all infections:
https://covid.cdc.gov/covid-data-tr...ryName=USCDC_2146-DM60904#variant-proportions

What do we know about the AY.3 variant, the Delta mutation that also makes Israel tremble
...
According to reports to the Israeli newspaper Haaretz by Tom Hertz, head of the Department of Microbiology, Immunology and Generics at the Ben Gurion University of the Negev, the Delta variant is showing to create more problems than he imagined: “We are identifying new versions of the Delta variant that feature new family mutations over previous variants. What allows it to spread in this way is a combination of vaccine attenuation over time and traits that allow the variant to evade some of the antibodies”.

Source:
https://then24.com/2021/08/19/what-...elta-mutation-that-also-makes-israel-tremble/

 

[artis]

What the experts think of this? I think it is generally a sound advice and interesting take on the situation.
Would love to hear some comments on the information told from 14:00 about the difference in the IgM and IgA and natural infection vs vaccine.

 

[atyy]

What the experts think of this? I think it is generally a sound advice and interesting take on the situation.
Would love to hear some comments on the information told from 14:00 about the difference in the IgM and IgA and natural infection vs vaccine.

I'm not an expert. But here are my thoughts anyway.
He's usually good, and this discussion is informed and thoughtful.
We discussed this a bit also in another thread.
Here is a link to the article: https://www.bbc.com/news/health-58270098: Covid: What’s the best way to top up our immunity?

However, on the minor technical issue of whether the vaccine really doesn't produce IgA at all, there are a couple of dissenting reports. If these are correct, it doesn't negate his discussion, which only depends on the vaccine producing long lasting protection against severe disease, although not against infection.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8011028/ (mostly guessing, no direct evidence)
https://www.biorxiv.org/content/10.1101/2021.03.11.434841v1 (seems to have direct evidence)

 

[Astronuc]

What the experts think of this? I think it is generally a sound advice and interesting take on the situation.
Would love to hear some comments on the information told from 14:00 about the difference in the IgM and IgA and natural infection vs vaccine.

Also, not a subject matter expert, but I apply the review process that I use in reading scientific literature on various subjects.

I notice that in the initial 7 minutes Campbell does not discuss age effects. That is, as people age, the immune system is diminished and some develop various co-morbidities. A vaccine helps the body to some extent to develop some immunity, which one does not otherwise have.

At around 6:45, Campbell mentions that the various vaccines, Pfizer, Moderna and AZ act on the spike protein (which can change by mutations/variants), and that seems enough to reduce the severity of infection, but it's one protein, or two, as opposed to the 28 proteins in the virus. At ~7:05, he talks about the lymphocytes, B and T cells.
https://en.wikipedia.org/wiki/Lymphocyte#T_cells_and_B_cells

Natural immunity helps protect one against the larger number of proteins, which he mentions as greater immunity - assuming one survives the initial infection. Those with compromised immune systems or immunodeficiency are less likely to survive. And then there is the chance of sequela (pl. sequelae), or the long term consequences of viral attack on different areas of the body beyond the respiratory tract. Lung damage is bad enough by itself.
https://en.wikipedia.org/wiki/Sequela

Regarding immunodeficiency - "Doctors may check immunoglobulin levels to see if a person has an infection or is protected from getting an infection (is immune to it). Doctors also use immunoglobulin tests to help diagnose immunodeficiencies (when the immune system isn't working as it should). Doctors may suspect an immunodeficiency in a child who gets a lot of infections or unusual infections."

https://kidshealth.org/en/parents/test-immunoglobulins.html
https://www.webmd.com/a-to-z-guides/immunoglobulin-test
https://www.hopkinsmedicine.org/health/conditions-and-diseases/immunoglobulin-a-deficiency

https://www.thermofisher.com/us/en/...ntibody-methods/immunoglobulin-iga-class.html

https://www.nationaljewish.org/pati...ces/the-difference-between-tests-for-covid-19Regarding natural infection vs vaccine, should one deliberately expose oneself to a natural infection as opposed to a third (or second) booster vaccination? Probably not. We are still learning about breakthrough infections caused by the Delta variant, and perhaps Delta-plus, and Lambda variant. Some fully vaccinated folks with Delta variant are becoming severely ill and some hospitalized, but the numbers appears to be much less than those who are unvaccinated. I'd rather face an infection with a third booster than without. Remember, each infections is chance for damage to lungs, blood system, and other organs, such as the heart. This is also the case with influenza. That is each infection can cause damage to the pulmonary system, which is a good reason to get an influenza vaccination each year.

 

[artis]

Well I guess the vaccine would have been better if it produced IgA just as much as it does IgM, because as far as I'm aware the IgM helps you stay out of trouble but the IgA would truly help to stop the spread as such because due to the leaky nature of this vaccine , vaccinated folks still get infected and it's just a "sandbox" for the virus to play out various tricks where it can then potentially learn to evade the "updated" immune response.

 

[artis]

I'd rather face an infection with a third booster than without.

Yes I get your point , but in case Covid stays around then it becomes the question how regularly will you boost yourself versus just getting out there and living life as usual with all the added risks that come with it.

 

[pinball1970]

Yes I get your point , but in case Covid stays around then it becomes the question how regularly will you boost yourself versus just getting out there and living life as usual with all the added risks that come with it.

Same as seasonal flu jab once per year?

 

[Laroxe]

Also, not a subject matter expert, but I apply the review process that I use in reading scientific literature on various subjects.

I notice that in the initial 7 minutes Campbell does not discuss age effects. That is, as people age, the immune system is diminished and some develop various co-morbidities. A vaccine helps the body to some extent to develop some immunity, which one does not otherwise have.

At around 6:45, Campbell mentions that the various vaccines, Pfizer, Moderna and AZ act on the spike protein (which can change by mutations/variants), and that seems enough to reduce the severity of infection, but it's one protein, or two, as opposed to the 28 proteins in the virus. At ~7:05, he talks about the lymphocytes, B and T cells.
https://en.wikipedia.org/wiki/Lymphocyte#T_cells_and_B_cells

Natural immunity helps protect one against the larger number of proteins, which he mentions as greater immunity - assuming one survives the initial infection. Those with compromised immune systems or immunodeficiency are less likely to survive. And then there is the chance of sequela (pl. sequelae), or the long term consequences of viral attack on different areas of the body beyond the respiratory tract. Lung damage is bad enough by itself.
https://en.wikipedia.org/wiki/Sequela

Regarding immunodeficiency - "Doctors may check immunoglobulin levels to see if a person has an infection or is protected from getting an infection (is immune to it). Doctors also use immunoglobulin tests to help diagnose immunodeficiencies (when the immune system isn't working as it should). Doctors may suspect an immunodeficiency in a child who gets a lot of infections or unusual infections."

https://kidshealth.org/en/parents/test-immunoglobulins.html
https://www.webmd.com/a-to-z-guides/immunoglobulin-test
https://www.hopkinsmedicine.org/health/conditions-and-diseases/immunoglobulin-a-deficiency

https://www.thermofisher.com/us/en/...ntibody-methods/immunoglobulin-iga-class.html

https://www.nationaljewish.org/pati...ces/the-difference-between-tests-for-covid-19Regarding natural infection vs vaccine, should one deliberately expose oneself to a natural infection as opposed to a third (or second) booster vaccination? Probably not. We are still learning about breakthrough infections caused by the Delta variant, and perhaps Delta-plus, and Lambda variant. Some fully vaccinated folks with Delta variant are becoming severely ill and some hospitalized, but the numbers appears to be much less than those who are unvaccinated. I'd rather face an infection with a third booster than without. Remember, each infections is chance for damage to lungs, blood system, and other organs, such as the heart. This is also the case with influenza. That is each infection can cause damage to the pulmonary system, which is a good reason to get an influenza vaccination each year.

Yes, it is confusing that age isn't mentioned, in the UK people ages 75 and older, despite representing only around 0.5% of new positive tests, account for around 45% of all hospital admissions and half of all deaths. This was of course the group offered the vaccine first and while the antibody response was high it might be expected to be falling now. Its perhaps the fact that at this age people are generally less able to tolerate significant health challenges.

The vaccines don't really induce antibodies against the whole spike protein, dendric cells chop the protein up and present a number of antigens to the immune cells, we actually produce a number of different antibodies, its suggested that some variants can evade some of these antibodies, but not all of them. Its true that natural infection will present many more antigens to the immune system, which might suggest a broader range of antibodies, but remember the main reason the spike was the vaccine target was that the antibodies targeting these antigens were the only ones that had a significant effect. We also have to consider that this virus actually attacks the structures responsible for developing immunity, it's this ability that is the principal cause of very severe illness and death. Even among the recovered, there are quite a few people who fail to develop an appropriate immune response, vaccines are more reliable. Its true that high levels of antibodies offer significant protection from infection, but people get caught up in the figures given for effectiveness. The reality is that there is no single figure to represent vaccine effectiveness antibody levels increase at different rates following 1st and 2nd vaccination, they continue to rise for several weeks after the 2nd and then start to decline quite quickly. We have usually lost a significant proportion by around 6 months, a booster at this point would clearly offer enhanced protection, but again this would be time limited.

This is why attention has shifted to the B and T cell response, these respond to infection by cutting short the time needed for an effective immune response. The virus is recognised very quickly, the variants don't change this and as the B cells reproduce and start producing antibodies, the process of refining these antibodies continues increasing their specificity to the infecting variant. So people can develop the infection, though even this is less likely because of the immediate T cell responses, but the illness is generally shorter and milder.

I've included a link to the current UK data which shows that the rate of infection remains high but the severity of infections and the numbers of deaths are very different. The latest population screening suggests that more than 90% of the population have antibodies at some level. I think the fact that this virus seems to be particularly promiscuous in the various cells it infects and the various species that can transmit it, we can forget the idea of herd immunity, though we can still make it manageable.

I saw some work suggesting that giving the AZ vaccine, which uses a viral vector, intranasally could be used as a booster while enhancing humoral immunity. I'll try to find the link.

https://www.ons.gov.uk/peoplepopula...icles/coronaviruscovid19latestinsights/deaths

 

[Astronuc]

More people hospitalized and more patients in ICU, many younger than 60 or 65.
https://theconversation.com/were-se...s-rise-that-affects-the-whole-hospital-165966

The need for separate wards for infectious diseases like SARS-Cov-2 and use of ICUs for COVID-19 patients puts a burden on any hospital, especially those at which ICUs fill to capacity. And it puts staff at risk.

The International Council of Nurses’ latest analysis shows the number of nurses who have died after contracting COVID-19 globally is greater than 2,200 – more than any other health-care worker. This data are from earlier this year, so we expect those figures to have risen since then.

I guess the number is just nurses, but I suspect to actual number to be higher.

In the US alone, Kaiser Health News reports "More Than 3,600 US Health Workers Died in Covid’s First Year"
https://khn.org/news/article/us-health-workers-deaths-covid-lost-on-the-frontline/

My doctor told me the other day that one patient, older than 65 decided not to get the vaccine, because the patient didn't believe in it and that it was not FDA approved (it was under EUA). Then the patient, with a number of health issue that put the person at risk for complication due to COVID-19 did test positive. The doctor arranged a monoclonal antibody treatment (the was EUA by FDA).
https://www.fda.gov/news-events/pre...izes-monoclonal-antibodies-treatment-covid-19
The monoclonal antibody treatment is more than 10 times the cost of the vaccine, which has been available for 7 months, so the patient could have received a vaccine and been fully vaccinated 6 months ago.

I read one story where a cancer patient was discharged from hospital and had to complete treatment at home because the hospital had to use the space for treatment of COVID-19 patients, most of whom chose to remain unvaccinated.

 

[Laroxe]

I don't think the N95 is practical for most people in everyday settings (too uncomfortable)? So I think ventilation is a priority, then preferably a surgical mask (comfortable enough for most people, but expensive) or cloth mask?

A quick read seems to show their conclusions are consistent with https://www.medrxiv.org/content/10.1101/2020.04.16.20067728v1, but I'm not sure how to convert between their units of airflow (L/s/person) and the one in the paper you posted (ACH)?

In high risk settings, one would prefer an FFP3 (N99) if available.
https://www.bbc.com/news/health-57636360

Really, I don't think the recommendation to wear masks is based on their ability to filter out the virus, that's an issue for people working in high risk environments. It's probably better to think of it rather like social distancing. Staying the recommended, 2 meters apart won't protect someone, but it does greatly reduce the risk, simply because of the way the airflow affects the dispersion of droplets / virus following exhalation. In the same way, simple masks alter the airflow, some droplets will be trapped but its the fact that exhaled air is directed into several streams and has to follow routes around the mask. This reduces the force and direction of exhaled air, its rather like increasing the distance, and by combining different strategies we can increase the cumulative risk reduction. Like other strategies it's not about avoidance, that is very difficult to achieve, it's about reducing the amount of exposure to the virus and not receiving a dose sufficient to cause infection. In fact, multiple small exposures over time might be useful to establish and maintain some immunity. The recommendation for simple masks should mean more people being willing to wear them, its a trivial requirement in terms of comfort or inconvenience, but somehow it's become a symbol of allegiance, but I'll avoid what I think this might be too.

 

[StevieTNZ]

Some humour - https://www.theguardian.com/world/2...-zealand-makes-hay-with-covid-ministers-gaffe

 

[Astronuc]

A 41-year-old Florida teacher whose doctor had advised her against getting vaccinated has died of COVID-19 complications after she was forced to return to in-person teaching where there was no mask mandate, local outlets say.

Kelly Peterson was not vaccinated against the Coronavirus because she had leukemia and her doctor advised against getting the shot in her already weakened state, her sister, Christin, told KTVU.

https://www.msn.com/en-us/health/medical/a-florida-teacher-who-couldnt-get-vaccinated-because-of-her-cancer-treatment-died-of-covid-19-her-union-says-she-caught-it-from-her-classroom-which-had-no-mask-mandate/ar-AANJ8WH

APNews (Aug 24) - The Latest: COVID hospitalizations surge in Washington state
https://apnews.com/article/business...rus-pandemic-10c81f06b6b8429c4cb276f400539866

OLYMPIA, Wash, — Washington state health officials say the number of hospitalized COVID-19 patients is doubling every 18 to 19 days in the state.

Dr. Umair Shah is the state secretary of health and said Wednesday that the surge driven by the delta variant of the Coronavirus has “stressed, stretched and strained” hospital resources across the state,.

One hospital official said hospitals throughout the state are facing their highest levels of occupancy ever, and the impact has been especially hard on regional and rural hospitals where there are no critical care beds left.

According to the state Department of Health, 1,346 people were hospitalized with COVID-19 on Tuesday. There have been more than 488,000 confirmed Coronavirus infections in Washington state during the pandemic, and 6,448 deaths related to COVID-19.

New NY governor adds 12,000 deaths to publicized COVID-19 tally
https://apnews.com/article/andrew-cuomo-health-coronavirus-pandemic-7312b49695e726eda8d59848e82271c5

The 'official' count of Covid-19 mortality today is 43432. The new governor of NY State is adding 12,000 to that number for a total of 55,432 deaths. This is more in line with the number the NY Times has been publishing, which as of today is 53,691 deaths. I presume it will take some time to get an 'accurate' number, from where I don't know.

The higher number is not entirely new. Federal health officials and some academic institutions tracking COVID-19 deaths in the U.S. have been using the higher tally for many months because of known gaps in the data Cuomo had been choosing to publicize.

But Hochul, who was lieutenant governor before being propelled to the state’s highest office, said it is vital to be fully transparent about the numbers.

“There’s a lot of things that weren’t happening, and I’m going to make them happen,” Hochul said Wednesday on MSNBC. “Transparency will be the hallmark of my administration.”

The Associated Press first reported in July on the large discrepancy between the figures publicized by the Cuomo administration and numbers the state was reporting to the CDC.

The count used by Cuomo in his news media briefings and on the state’s COVID-19 fatality tracker included only laboratory-confirmed COVID-19 deaths reported through a state system that collects data from hospitals, nursing homes and adult care facilities.

The last paragraph states what I suspected. The cases that have been reported are confirmed cases, and the cases being added to the total are probable.

. . . the tally excluded people who died at home, in hospice, in prisons or at state-run homes for people with disabilities. It also excluded people who doctors believed died of COVID-19 but never got a positive test to confirm the diagnosis. Such tests were scarce in the initial months of the pandemic, when hundreds of New Yorkers were dying each day.

From the NY State official site
https://covid19tracker.health.ny.gov/views/NYS-COVID19-Tracker/NYSDOHCOVID-19Tracker-Map?:embed=yes&:toolbar=no&:tabs=n#/views/NYS-COVID19-Tracker/NYSDOHCOVID-19Tracker-Fatalities

I did some screen captures to show the 'offical' tally, and the soon to be 'official' tally.

The way the page is set up, I haven't discovered how to capture each table on the screen.