Most news articles I see focus solely on the number of vaccinated people when estimating how far away countries are from herd immunity, which seems odd to me. Left out in the discussion seem to be the unvaccinated but already infected. As far as I know, prior infection confers at least some degree of immunity.
It may also be the case that those inclined to be skeptical of vaccines were also the ones who exposed themselves to infection most during the pandemic, through disdain for social distancing, mask-wearing, etc. In other words those still unvaccinated in Western countries with easy access to vaccines have a pretty good chance of having been infected by now.
Adding those two populations together would seem to indicate that most Western populations are already at herd immunity by this point, which would mean that these surges can be reasonably expected to become smaller and smaller. Unless of course some totally new variant capable of evading all existing vaccines and immunity from prior infection emerges.
The herd immunity threshold changed with Delta, which I've heard has an R0 of 8-10 (compare 3.5-4.5 for the UK Alpha variant, and about 2.5 for the original strain). Instead of 60% vaccination, you'd need 90%, and will likely overshoot that.
It wouldn't surprise me if the UK's cases are now dropping because they reached that threshold, but I doubt the US is there now. Probably Delta will blow through literally all the remaining unvaccinated people and that'll be the last surge, at least unless we get a vaccine-resistant strain.
These are very good points. I'd add that herd immunity isn't a clearly defined threshold, either. It's the point at which the effective R in a population is < 1 -- AKA exponential decay. With a circulating virus, depending on how much below 1 you get, exponential decay might take a few months or even a few years to get down to elimination.
The current dip in the UK is trending toward the former. But it's further complicated by the fact that levels of immunity in the population will continue to oscillate up and down. (Nevermind that once schools open in September, 20% of the population with relatively sparse vaccination will be mixing in large cohorts).
Another factor in herd immunity is vaccine efficacy - which is somewhere between 86% and 95% for the mRNA vaccines (and will continue to change). A herd immunity threshold of 90% presupposes a vaccine with 100% efficacy - when your vaccines are not that effective (not to mention, losing effectiveness over time) it bumps the threshold even higher.
Right now, much of the population has some level of "sterilising immunity" from the first round of vaccines and previous infection (i.e. having enough circulating antibodies to potentially block symptomatic infection and transmission). But everything we know about existing respiratory viruses (and indications so far this year) suggest antibodies will wane.
Of course, indications are most people will come away with robust cell-based immunity. (Those plucky T-cells and B-cells). But eradication for the UK looks *very* close to impossible given the near-total-abandonment of public health measures recently.
That it at odds with prior studies that found ~12 month reinfections with coronaviruses, but it is with considerably better methodology.
And it is simultaneously: not clear that vaccines produce sterilizing immunity, not clear it is necessary to do that at all, and not clear if how much measurements of NAbs correlates with sterilizing immunity.
I can tell you a story about how delta reaches 90-100% thresholds of herd immunity in this wave and burns itself out and we don't see it much again for 3-5 years in countries like the US/UK. Or I can tell you a story about how it keeps coming back every year with 2 or 3 waves. Anyone who tells you they know which of those outcomes must be correct probably knows a lot less about virology than they think they do (even if they have a degree). I'm reasonably hopeful its the former, but I never predicted delta and thought we'd be virus-free this summer and was wrong.
Even in the worst case though the vaccinated/recovered are never going back to 2019 levels of susceptibility to severe outcomes, so we're looking at a steady drip-drip-drip of people killing themselves to avoid vaccination up until we get bored with that and they pretty much disappear (that's where T-cells and B-cells and cross reactive partial immunity to all future variants comes in).
Setting up two likely scenarios is a very reasonable way of approaching future development, both scenarios sound likely to me.
We could look at the flu for clues, in that case every year will have one or more variants that are the most prominent.
I'd argue that in the age category with the most infected (10-29 years old) in the UK, that these people are not killing themselves due to their young age.
And the elderly have already gotten the vaccine and are thus up to eight times more likely to not get infected.
Flu is a bad example --- it has 8 "segments" (basically "chromosomes") that get reassorted among the offspring when a cell is infected by multiple strains, leading to a crude form of "sexual recombination". (The numbers after the "H" and "N" indicate the variant-numbers of the Hemagglutinin and Neuraminidase "segments" that the flu-variant got; a cell infected by H1N1 and H2N5 will also produce some H2N1 and H1N5 offspring in addition to H1N1 and H2N5, leading to very rapid genepool evolution)
By contrast SARS-CoV-2 only has a single chromosome, and so it primarily evolves via "genetic drift". While it's _possible_ for a cell infected by multiple SARS-CoV-2 variants to generate "chimeric" offspring via a process called "crossover" AKA "homologous recombination", that mechanism is much less effective than the simple segment-reassortment that drives flu evolution.
Like the 1918 H1N1 second wave mutation that caused ARDS in 20 year olds?
We still have no idea how that happened, but with this coronavirus evolving to be more transmissible/virulent that is still on the table. If it can evolve to become more transmissible but at the cost of triggering ARDS like that, then it will face evolutionary pressure to do so.
And hospitalization rates of 20-29 year olds aren't anywhere near as good as the fatality rates. While the death rate drops by a factor of 2 every 8 years, the hospitalization rate drops by a factor of 2 every ~15 years. And delta has 2x the hospitalization rate of alpha across age/sex/deprevation/comorbidity matched controls. It should still be about a 1-in-50 chance of hospitalization for 20-29 year olds. There's no proof that number can't continue to get worse.
> eradication for the UK looks very close to impossible given the near-total-abandonment of public health measures recently.
I don't support the recent abandonment of restrictions, but could that policy, followed up by stricter restrictions in a few months time actually be helpful for eradication? Eradication is likely a hopeless prospect in the UK anyway, because there is no political will for closing the borders. But it's interesting to conjecture.
The ship has sailed on eradication. We're ALL going to get Delta at some point now, it's just a question under what circumstances (and whether the antivaxxers will have sufficient numbers to denial of service the healthcare system as they die).
That's by no means certain; even ignoring the possibility of effective countermeasures, a more transmissible variant could displace it (if we’re lucky, it could also be one producing less severe disease, the way it was when Epsilon variant for a while displaced most others in California, before Delta, which is more transmissible than Epsilon, took hold.)
Tangential question: what is the mechanism by which we observe ‘displacement’ of earlier strains? Is it just the exponentially higher transmission factor of the variant that is making it relatively disappear? Or are they somehow also get out-competed directly?
The former: once you have COVID you're immune to it. Unless a strain totally evades the antibody response of recovered individuals (very unlikely), then they're no longer capable of spreading it.
So if there's overall less replicants of one strain then the other, then the population will effectively select for the more infectious one. Actual geography of course is also key here though: if a carrier flies over to an unexposed area with any strain, it's going to take over if the other one doesn't make it there.
Add to that, the more it multiplies and spreads, the more chance of mutations leading to more variants. Needing updated vaccines, booster shots of existing, and/or higher rates needed to reach herd immunity.
Didn't the UK have another lockdown for this wave too?
Herd-masking seemed like a no-brainer from the beginning. It will be really hard to go back to that in the US after the CDC giving the all clear to go maskless.
>at least unless we get a vaccine-resistant strain.
...which will happen promptly. The selection pressures are perfect. You already have a variant with vaccine breakthrough, circulating in a partially vaccinated population.
I don’t know if you can make that bet - evolution of the virus needs to conserve the current mode of cellular entry and attachment and fitness of spike appears to be the main driver at present - and then spike mutation has driven drift from the original vaccine target leading to a degree of immunity ‘escape’.
So the question is, is the virus now in a local minima where it is highly adapted for spread (ie big increase in R0 from ‘original’ virus) and are those selective pressures in a situation where the virus can’t jump into a full immunity escape mode without climbing down off mount improbable and taking another face?
My bet would be that the selective pressures may continue to drive fitness for reproduction, but won’t lead to immunity escape because spike is too conserved
I'll echo that this is a reasonable assessment. In evolutionary hill climbing, the fitter a protein the fewer paths there are to climb higher [0]. Art Poon has some interesting work that effectively maps viral phenotype space by looking at compensatory mutations [1]. He induces deleterious mutations in page phage, grows them until they recover fitness and then assesses if they regained fitness by reversion or compensation. The worse a deleterious mutation, the more likely a compensatory mutation is to arise.
The more optimized the covid spike becomes, the harder it is to get better. What frightens me are polymerase mutations.
Mutations in the genetic replication machinery of the virus. All the world's worst and most untreatable diseases tend to have very fast, but very low quality polymerases.
This means they replicate quickly, and generate mutagenic variants quickly. HIV and Ebola have this in common.
Delta is already selecting for viral load over vaccine escape - if it keeps getting faster then it could become more dangerous, but it would also increase the rate it can explore it's genetic "phase space".
Rather than increasing efficiency, I'd be concerned about loss of function in the error checker. This would spike the mutational rate (and the mutational load).
Interesting, thank you. If I understand correctly, viral load mutations are the current and quickest path to spreading faster, currently. It hasn't selected as fast for vaccine escape, yet, which is not to say it isn't trending in that direction with delta?
Or, we're kinda f'd with regular transmissions at the moment, and vaccine escape is a possible accelerant?
The problem is closer to whether the spike protein is near an local maxima for infectivity since it's involved in binding to ACE receptors. Since mutations in COVID seem to conserve the spike protein region, it presently looks quite likely that it can't be changed very much without performing worse. Hence the viral replication optimum: spreading to more individuals makes the virus dominate the population quicker.
Evolution does whatever leads to more of the successful thing existing, so viral loading was a pretty obvious move: the question is whether there's any vaccine-evasion which doesn't compromise that advantageous (Delta suggests yes, but its possible that's as far as it can actually go).
I don't know or haven't seen any evidence that polymerase mutations are responsible for the increased R0 of Delta, although it's certainly possible.
What we do know is that the Spike protein is essential for COVID cellular binding.
We also know that spike has mutated between 'vanilla' COVID of 18 months ago and what all vaccines target, and Delta.
This makes sense, because the spike (or S) protein wasn't optimised for binding to Human ACE2 receptors; over time mutations in S (ie with Delta) have lead to increases in binding affinity with ACE2, the result being that Delta is more likely to infect a cell with the same viral load as 'Vanilla'. This would be a perfectly acceptable reason for the uptick in viral loads in Delta and infectivity and hence R0.
We are lucky/the vaccine researchers are smart in that S is quite antigenic (that is, triggers a good immune response, although in a 'natural' infection people will produce antibodies to many parts of the COVID virus), and because the selection pressures driving improvements in ACE2 binding affinity of S have not lead to such a great conformational change that antibody responses are useless (ie antibody-antigen affinity is decreased in Delta, but still effective), our vaccines against the earlier S protein are still effective.
Because of the way evolution generally works, pressures driving S evolution tend to end in a local minima (or maxima, depending on your way of looking at it - i tend to think in terms of conformational entropy so hence Xornot and my use of different terms for the same concept) - or as I mentioned earlier, 'Climbing mount improbable', a term coined by Dawkins in the book of the same name.
It is because it is very hard to get out of these local minima that the human body is full of such oddities, such as an eye that is designed with the nerves in front of the photoreceptors, resulting in a blind spot - it's easier to adapt around the minima to reach a new optimum then it is to reinvent the eye with the nerve in the position that would be logical from a functionality standpoint)
Therefore, it is very very unlikely that the S protein, or the virus, will be able to mutate to a S protein that is so radically different that it escapes antibody-antigen affinity from the vaccines we have today - the S protein would basically have to be completely redesigned, which is really unlikely to occur by the gradual process of evolution. Ie the chances of shaking the RNA coding for S into a new functional protein that works and is a completely new, novel shape, is infinitesimal.
So - basically, total vaccine escape is really really unlikely. Like, number of grains of sand on earth unlikely, if not more so. But polymerase mutations could increase the rate at which the grains of sand are sifted.
It is not something that I personally would lose much sleep over - we don't have any evidence from nature that I am aware of (ie flu virus etc) of highly conserved/selected proteins all of a sudden spitting out a completely new model - basically new diseases that we worry about come from species shifting (ie... let's just say SARS to avoid a debate about COVID origins)
Measles, polio, and smallpox beg to differ. The varicella vaccine is fairly new, but I haven’t heard of a vaccine-resistant strain evolving. Pertussis seems to be an odd duck, and its vaccine is not as effective as people would like.
History is mixed here, but most of the mandatory vaccines seem to be extremely effective and to work well for at least decades.
Those also have low breakthrough rates (assisted by high vaccination percentages), giving it relatively no opportunity to evolve. They also had millennia to reach (and then work to maintain) peak fitness, while COVID is still encountering beneficial mutations somewhat frequently.
Presumably also the human species had time to co-evolve some resistance to these illnesses. I shudder to think at the cost... hundreds of millions of lives for smallpox alone...
I'm not sure if it's inevitable given how crucial the spike protein is and how strongly it is being conserved. Even with the Delta variant, which is much more infectious and contagious, the vaccines are only modestly less effective and still highly effective at preventing severe illness and death.
I also kept in mind that amount of R0 for the "Indian variant", until last week I saw it halved to 4..5×.
Then you realize that a transmission rate among the timid in ShyFleetersLand and the compulsive in LetsHugLand cannot be the same. Then you realize that that very average number needs explanations of the underlying model to be meaningful - it comes from societal behaviour not just from intrinsic viral properties.
> Probably Delta will blow through literally all the remaining unvaccinated people and that'll be the last surge, at least unless we get a vaccine-resistant strain.
I think you're right, but that will still happen over years in multiple waves. Barring some sudden uptick in people changing their mind about vaccination.
> It wouldn't surprise me if the UK's cases are now dropping because they reached that threshold, but I doubt the US is there now.
Given the enormous US Covid outbreak, the US is likely not far away. We're at 70% adult vaccination and had a minimum of 100 million prior Covid infections. Also throw in tens of millions of people that likely have natural immunity to Covid.
The biggest question with Delta is going to be the matter of repeat infections and how long the vaccines, the vaccines + prior infections, and prior infections (without vaccination) all hold up against it. To say nothing of what variations will follow next after Delta. Is there actually herd immunity to be found with Delta, or will people just keep getting variations of Covid from here forward. I don't believe there will be herd immunity for any nations, there will just be far lower mortality rates due to prior virus exposure and the vaccines. Some non-trivial % of the vaccinated population will continue to get Covid. If there was a chance to squash Covid with the early strain via herd immunity, those days are very long gone.
The great lie still being persisted for the benefit of the agitated public, is that Covid is going to go away courtesy of vaccinations. The authorities have pitched that to the public from the early days of the vaccines to try to max out the vaccination rates. Do this and Covid goes away. The vaccines are never going to stop Covid, they're going to continue to dramatically reduce the mortality rates (which is critical, however the public still doesn't widely grasp the reality of the forever Covid future yet).
If the forever-COVID reality for 95+% of the population is "you really, really ought to get that annual booster shot" (instead of "get the flu shot iff it's convenient"), that's not actually so terrible.
If it becomes century-long endemic in the population, kids are exposed to it, likely creating a productive exposure-related immune reaction until they're old enough to get an mRNA vaccine.
Definitely. I don't think it's terrible at all given the alternative is tens or hundreds of thousands of additional people dying from Covid per year in the US. I guess we'll soon see the extent to which the public can be convinced to get booster shots every year. The governments of the world will have their jobs cut out for them, there will be a lot of resistance to forever Covid vaccinations as time goes on (and very lucrative for big pharma; Pfizer, BioNTech and Moderna are going to make a stupid amount of money over the next few years).
What will be interesting to find out in the near future, is if high vaccination rates + prior infections reduce Covid deaths below, say, 50k people in the US every year, or whether we're forever stuck with a sizable population killer no matter what (short of implementing elaborate forever cultural systems of lockdown; as in, those counter measures will have to become ingrained deeply into the culture, accepted and automatic). The next decade is going to be very weird and interesting on that front.
Vaccination is great but in addition to that we could also cut the ongoing death toll through public health campaigns to eliminate hypovitaminosis D. This could be done relatively cheaply.
From a public health perspective, the total number of deaths in a pandemic is less important than the timing of the case load. Too many cases in too short a period of time causes havoc in the health care system, and then helps lead to deaths from conditions unrelated to the pandemic (because hospital care is unavailable).
It may sound callous, but in terms of first priorities, reducing the total number of deaths from COVID19 has never been our #1 priority (to the extent that we've had any clearly formulated priorities at all). The implicit goal, as we were all saying in the spring of 2020, was/is "flatten the curve".
The actions of my local government align with that. Keep the hospitals from being overwhelmed, but if you die because you didn’t get vaccinated, too bad so sad. Which seems the right way to handle it. Allow folks their individual freedom as much as possible, but don’t break the health care system.
I don't think they need to be. At least not within reasonable bounds.
There's certainly an interesting discussion to be had surrounding individual freedoms vs the common good in a pandemic, but I'm not sure as to what extent we can even have those discussions while an embarrassing number of people feel that just being asked to wear a covering over their face in public spaces is an intolerable violation of their personal freedoms. When even the smallest requirements intended to protect the public's health are treated as if they were the harshest forms of oppression imaginable there simply isn't any room left for debate.
Still, for the population that believes a degree of concession can be reasonable and appropriate under such extreme conditions as a global pandemic I think it is possible to strike a good balance between individual freedom and individual and collective responsibility. I think we can work to protect freedoms while also insisting on some measures to help reduce the spread of a virus.
It doesn't have to be an either-or situation at least.
It's probably going to end end up the same as the Spanish Flu influenza variant, occasional localized outbreaks which are much less severe than the original pandemic.
U.S. is only at 50% fully-vaccinated, with several states in the high 30s to 40s. I could believe 70% with at least one shot but haven't seen any statistics to that effect; it doesn't matter much since Delta is still pretty dangerous to partially-vaccinated people. We had 35M recorded COVID cases; I'd believe about a 2:1 undercount, so about 70M total cases (~22%). Vaccines + previous cases was likely past herd immunity for the original variant (hence why cases dropped dramatically after vaccines came out), but with Delta's increased herd immunity threshold we should expect another 50-70M cases within the next few weeks.
Just for clarity, that's "70% of American adults".
18% of Americans are 15 or younger [1], below the youngest approved vaccine age (the Pfizer vaccine is approved for teenagers as young as 16), so that's (0.18 + (1-0.18) * (1-0.7) = ) ~42% of Americans who haven't even received 1 shot, and 58% who have.
(There may be some error in that, if far more or far less than 70% of non-adult vaccine-eligible people (teenagers aged 16 or 17) have gotten at least one shot, but it probably doesn't change the overall percentage that much.)
Need to redo some numbers, Pfizer has been approved for ages 12 & up for a couple of months now [1]. Our World In Data lists that ~50% of American population is already fully vaccinated.
...to be quite interesting for covid-19 vaccination information. For example, the state with the lowest rate of at-least-one-dose vaccinations for people 65 and up is West Virginia, at 83.1%. Most states are 90+% or better for that age group.
It's 70% adult vaccination at one shot or more (I specified adult in my comment). That's all over US news today. The US is at 165m fully vaccinated (or 50%), most of which are of course in the adult segment.
A very large number of those adults also aren't going to need two doses to reach high levels of protection (against severe outcomes), due to prior infections. One mRNA vaccine dose + prior infection will get you there.
Combined with the recent surge in vaccinations due to Delta concerns, the US will probably see the same drop-off that Britain has by late August - early September.
> The great lie still [...] is that Covid is going to go away courtesy of vaccinations. The authorities have pitched that to the public from the early days of the vaccines
That is (1) outrageously hyperbolized and (2) completely wrong. Delta wasn't known to have this level of transmissibility until the last three weeks. People, experts, doctors, "authorities", whatever, you want to label them 100% believed sincerely that we were on a path to the elimination of the outbreak.
Cut the bullshit, basically. Yeah, yeah, I know it's HN and everyone wants to think they're smarter than everyone else. But you aren't. You're retconning brand new science to make prior understanding into a "big lie". That's really awful.
The relevant experts - virologists, epidemiologists, etc. - neither believed nor claimed that we were on a path to the elimination of the outbreak. They've consistently stated that the virus will be around for at least years, probably decades, possibly forever.
To be clear, I meant "elimination of the outbreak" in the sense of an endemic virus that produces a steady case rate. Clearly no, no one expected this disease to be eradicated.
Well, you and I didn't. I know quite a few people who've been talking since June about how they're comfortable doing suchandsuch "as soon as Covid is gone", and I'm not sure what they could mean by that other than eradication. It would seem to me that by an endemic standard, the Covid outbreak was gone from the US between May and July and has only just recently made a resurgence.
That seems nitpicky. There are lots of non-eradicated endemic diseases (ebola, malaria...) that are objectively much scarier than covid. But we don't freak out about them because they are well-controlled and rare. A covid mitigation regime that keeps its R0 under 1 and its outbreaks local and non-spreading would be very much the goal here.
> It would seem to me that by an endemic standard, the Covid outbreak was gone from the US between May and July and has only just recently made a resurgence.
Pffft. Yeah, not even close. At its lowest, the covid death rate was 5x higher than average deaths from influenza over the past decade.
At what specific death rate would you be comfortable saying "okay cool" and treating Covid the same way as other diseases?
I don't mean for this to be a trick question. 5x the flu is within my comfort zone, but 2x or 1x or even 0.5x could all be reasonable answers. The answer that's not reasonable, but is by far the most common answer I've gotten, is that no Covid deaths are acceptable and we should never stop taking extreme measures to suppress them.
Gah. Influenza kills more people in the US than any other infectious disease, and frankly it isn't even close. You aren't making any sense here. I cited that number, clearly, as an UPPER bound beyond which we couldn't possibly view an outbreak as acceptable.
I don't view a statement that puts 100k deaths/year as within your "comfort zone" as a serious attempt to engage, sorry.
I dunno. I'm not gonna browbeat you with more arguments for my risk tolerance if you're not interested in them, but I think you're avoiding looking reality in the face here; there's a lot of people an order of magnitude more risk tolerant than me who wanted to open crowded bars in February or earlier. A policy that expects restrictions will remain in place as Covid deaths fall, but can't offer any explanation for why they should remain in place or when they'll no longer be needed, seems doomed to the same kind of mass defection we saw in mid-2020.
People aren't necessarily risk tolerant they largely are utterly incapable of grasping relative magnitude of risk and largely believe that gains in freedom will accrue to them and costs will accrue to other people.
Yeah, but a politician can’t say that…so the experts close to the politicians tend to follow the political narrative instead. The ugly result is a lack of trust in the experts, the science, and the politicians when there are setbacks to that political narrative.
Yeah. This has been my impression, too. I’m not aware of anyone who thought vaccines were a path to total elimination. But then, my only news source is HN and some science YouTube channels.
Where did you "hear" it has an R0 of 8-10? It's not time to be imprecise.
If you're referencing the CDC's case study from Provincetown, I think it's important to point out that the R value cited is the R value during Bear Week, not on average.
When people present R0 as a property of the pathogen, you can take it as hot panicky air.
From wiki: "R0 is not a biological constant for a pathogen as it is also affected by other factors such as environmental conditions and the behaviour of the infected population."
And learned the difference with Rt today (which some others are quoting, eg for Alberta), is that Rt is computed, while R0 is a guess based on a model, to try to normalize Rt so that it is more comparable over time and place. So I thought that was cool!
Look, just fresh in came an article from Shabir A. Madhi, Dean Faculty of Health Sciences and Professor of Vaccinology at University of the Witwatersrand; and Director of the SAMRC Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand
COVID-19 herd immunity? It's not going to happen, so what next?
> we would need to get close to 84% of the global population developing protection against infection (in the absence of non-pharmacological interventions) in as brief a period of time as possible
(...also, there, you find «the reproductive rate [...] is probably closer to six rather than three»)
The UK Office for National Statistics actually puts out estimates for the prevalence of covid antibodies (from both vaccines and infections combined), and you are right on the money!
They estimated that as of June 14, 89.8% of the population would test positive for antibodies.
I don’t know any specifics about this, so this as an attempt at asking questions of what to possibly expect from those numbers. Alberta seems to be 63% vaccinated, which seems to put them well above average for the US? And it looks like those numbers are currently computed for the day before the latest surge in cases took off?
Edit: later learned the parent is talking about R0 and you are talking about Rt, so those numbers are not directly comparable anyways.
Interestingly, you can get multiple-wave dynamics even when very far from population-level herd immunity, and even without taking into account changes in behavior (for example, [1]). That's because of stochasticity in the process due to the fact that (1) most people infect no one, but some people infect many ("overdispersion") and (2) the population is not well mixed.
In practice, of course, people respond to news about Covid waves and that contributes to the wave-like dynamics. Furthermore, new variants of the virus will be able to reach people that were "cautious enough" for a previous variant. That alone would also give you wave-like dynamics, basically every new variant would affect increasingly harder to reach people.
Anyway, the point is, seeing these waves is super natural and expected and we can't deduce anything about population-level immunity from them without looking really really closely.
> and it may also be the case that those who have a tendency to be skeptical of vaccines also were the ones most out and about and exposing themselves during the pandemic, i.e. the ones with the highest chance of being infected.
Sure, _maybe_.
> [...] would seem to indicate that most Western populations are already at herd imnmunity by this point
Given that infections are still rising pretty hard, what indicates to you that we are _at_ this point, and not, say, 6 months out?
> Adding those two populations together would seem to indicate that most Western populations are already at herd immunity by this point
That's assuming that nobody who got covid later got vaccinated (or got it before the vaccine kicked in). That seems like a very unrealistic assumption to me. On the other side, there are probably a lot more cases than are reported.
You're right that it almost certainly matters for heard immunity, but i think you need a much more complex model to know how much of an effect it has.
CDC estimated that 1/4 covid infections had an associated positive test. I did the same kind of napkin math you're referring too for Floridia a few months back and they'd could have been at 80% of the population with some level of immunity.
But napkin math probably isn't a good way to run a pandemic response. Just like herd immunity doesn't really matter at an individual level.
Not as sensationally reported is that, fatality rate (the proportion of people who die of those who tested positive) appears to be falling slightly, and is at its lowest in 2+ months.
I think that's because of different vaccine uptake by age cohort. People 65+ have always been most likely to require intervention and they are also the most vaccinated age cohort - ~80% vaccinated in the US. [0]
I don't know what the point of such conjecture is. Of course we don't know how much immunity comes from infection, and it is quite clear from the spread of delta that we are nowhere near herd immunity in the developed world, even in places like Israel. I had a coronavirus called a cold last year; does that mean I'm immune this year? Unlikely in the long term with COVID. The entire concept of herd immunity may be a mirage: if the (rare) breakthrough infections in vaccinated people like me spread just as much virus as unvaccinated, then there may be a huge potential for incubating new strains among the mRNA-ed that may elude all our current vaccines. And unlike a lot of viruses, the latest variants may be just as lethal as the earlier ones. Usually viruses become more transmissible and less lethal in response to rational behavior in their hosts--but humans are proving we're not rational.
This is true, however those studies are for the initial SARS-COV-2 strain and doesn't make any mention of the variants.
It's also worth noting that's a study of ~200 people. Given then times we're in it's an excellent sign and possible reason for cautious optimism and I'm sure a larger scale study is much harder to pull off in the midst of the pandemic.
That said, I have yet to see a study on the rate of reinfection of any of the variants against people who had already been infected with the initial strain, and how well that is survived, etc.
> Usually viruses become more transmissible and less lethal in response to rational behavior in their hosts--but humans are proving we're not rational.
I was under the impression viruses became less lethal because if they became more, they'd kill off their hosts and be less likely to spread.
There's a chance you get some super virus that becomes both more transmissible and lethal, but that is very rare (from what I can see).
> I was under the impression viruses became less lethal because if they became more, they'd kill off their hosts and be less likely to spread.
Only if the lethality is negatively impacting their fitness. If it can spread to another host quickly, who cares if the previous host dies. There's no selective pressure against it.
Which is why Delta is scary. Not just because of the higher viral load, but new strains could be more lethal and still not be selected against.
It depends. It’s hard to model and even think about the selection pressures accurately. West Nile virus showed a marked increase in virulence in corvids recently as did rabbit hemorrhagic disease.
And let’s not forget about Mareks disease, where a non-sterilizing vaccine is thought to have contributed to a massive increase in virulence, killing nearly 100% of unvaccinated chickens now vs causing mild disease decades ago.
Does that not assume that you’re symptomatic at the same time you’re spreading the virus? With covid you appear to be able to spread before you know you have it. Given that, what force would cause the virus to be selected for less lethality?
With a different presentation of disease where symptoms and spread occur concurrently then there would be a pressure on the virus selecting for strains that arent so lethal a carrier has no chance to spread. In covid’s case, that pressure doesn’t exist as far as i can see?
> I had a coronavirus called a cold last year; does that mean I'm immune this year?
There are supposedly over 200 different viruses that can cause the common cold (https://www.nih.gov/news-events/nih-research-matters/underst...). So it's quite possible for immunity to any individual strain to last a very long time and still get multiple colds per year.
> Usually viruses become more transmissible and less lethal in response to rational behavior in their hosts--but humans are proving we're not rational.
Our own "rationality" doesn't matter much, if a virus leaves you bed-ridden or dead, that makes it very hard for you spread it regardless of your choices. The fact that we have so many different viruses which essentially cause more or less the same "common cold" proves that there is very strong evolutionary pressure for a virus to behave this way.
You're missing the point because the media (and their pharmaceutical advertisers) have framed everything in terms of vaccination, as if the human immune system is incapable of surviving COVID and it's variants.
All viruses get less lethal as time goes on, not stronger, despite all the fear porn that has been indoctrinated into the public over the last year and a half.
Certain viruses maintained their lethality as time went on. Smallpox was very lethal throughout time. Influenza lethality ebbs throughout history. I don't think we can or should depend on less-lethal, common-cold-like symptoms from Covid-19 at any point.
SARS-CoV-2 does cause common cold like symptoms in the vast majority of cases, just like other coronaviruses. In particular it's quite similar to HCoV-OC43. The only reason those other endemic coronaviruses don't kill many people is that most of us get infected as children and build up some immunity.
There actually is. The evolutionary selection pressure on most coronaviruses exists throughout its infectious stage. So in order to be more infectious for longer the coronavirus would become less symptomatic and so less serious.
But with C19 we are aggressively isolating people with symptoms. This focuses evolutionary selection pressure on the initial infectious stage. In order to be more infectious the virus increases viral load and shedding, causing more serious symptoms; which would be an evolutionary disadvantage, except isolation renders this disadvantage moot.
Also natural immunity general focuses on the nucleus of the virus, vaccine immunity is to the spike. So this forces mutations in different proteins, which has different results.
Highly-deadly diseases will kill their hosts quickly, limiting their spread. Therefore, one of two things will happen:
• A less-deadly variant will emerge, spread faster, and outcompete its more deadly cousin.
• The deadly disease will kill enough of the population that its R number drops below 1, and thus the deadly disease will die out.
Therefore, observed diseases will tend to get less deadly over time.
---
If you look at the data, we're firmly in “kill enough of the population” town (to the extent you can stretch this model to our situation). The variants we're seeing spread are getting more virulent over time, not less, because:
• we don't want to die and we're doing stuff about that, meaning any model with “most individuals infected are removed from the model” in it is a flawed model; and
• we have fast long-distance travel, so any population model that relies on Euclidean locality is a flawed model.
Here's the thing: even if the virus is less lethal, if it results in more hospitalizations, we are headed for lockdown again if hospital capacity starts getting threatened: all of the routine heart attack, stroke, laceration/crush emergencies we need to deal with routinely will be unable to find adequate care if anti-vaccine holdouts are storming the hospitals for ventilators, or even just inpatient observation. And if our politicians responsibly do lock down to head this off, they probably STILL won't understand how the power was in their own hands to stop it. Businesses will shutter again, kids will miss even more school, and the hospitality industry will again stumble because people refused to understand that even a small number of non lethal hospitalizations spread over the entire population is enough to overwhelm healthcare infrastructure.
> All viruses get less lethal as time goes on, not stronger.
Wrong. It's generally the case, because a virus that keeps its host walking around will tend to infect more people than a virus that sends them straight to the morgue.
SARS-Cov-2 is unusual in that it's asymptomatic infectious period is really quite long. It's straight-to-morgue capabilities could become much more prevalent with hitting its infectivity too badly.
Australia definitely doesn't have or has ever had herd immunity and our total cases since the beginning are only 30k. Which represents only 0.12% of our countries population.
We've faced strict lockdowns and limited access to vaccines to which makes us a ticking time bomb if we were to let current cases go rampant.
Further, there was an argument way back, that the number infected but symptom-free was much higher than estimated. This would be enhanced by a hypothesised variant, that is more contagious, but less harmful - it would theoretically dominate, because its spread would be unimpeded. I don't know if these arguments have been tested; nor how to test them.
Separately, the physical social graph is not uniform, but complex. There can easily be narrower channels that have a lower probability of conducting infection. Thus, the spread will slow after the easy routes have been exploited.
>
Further, there was an argument way back, that the number infected but symptom-free was much higher than estimated.
This argument was made many, many times over the past year and a half by people insisting that <their area has hit herd immunity and everything is fine and we can fully re-open>.
Inevitably, like clockwork, the wave of COVID that would follow would dwarf the previous one.
The only thing that has broken this pattern has been mass vaccinations. It seems that high rate of antibody sero-prevalence in the population only protects you from COVID on paper.
See North and South Dakota, who after initially receiving a first huge wave before there were vaccines, never encountered any significant second wave. They are the best candidates I've seen for a possible herd immunity all the way back to December.
Interesting! That does look promising. South Dakota has 762k people and 125k positive tests. The CDC assumes that 1 in 4.2 infections were reported, so that would be 525k people infected total. 52.8% of people got vaccinated. Assuming there's no correlation between getting vaccinated and getting infected (which I'd assume isn't 100% correct), you can assume that of the 295k uninfected, 156k got vaccinated. So that'd be a total of 525k infected+156k vaccinated and not infected = 681k = 89.4% immunity.
>> It may also be the case that those inclined to be skeptical of vaccines were also the ones who exposed themselves to infection most during the pandemic, through disdain for social distancing, mask-wearing, etc.
> Left out in the discussion seem to be the unvaccinated but already infected. As far as I know, prior infection confers at least some degree of immunity.
We don't know how much, though. There are cases in which vaccine performs better than a natural infection, there are cases in which the vaccine performs worse than natural infection. Without time for a study, it's impossible to know where we lie with Covid.
Without time for a study, wouldn’t it make sense to assume the most common thing, that a natural infection provides more immunity than the vaccine? Taking the line of reasoning where we assume the worst case scenario until proven otherwise, would it be reasonable to assume long term medical issues from the vaccinations?
> Without time for a study, wouldn’t it make sense to assume the most common thing, that a natural infection provides more immunity than the vaccine?
No, actually; the actual infection sometimes misfires, leaving dud spike proteins outside the cells. If the immune system finds those first, it'll attack the dud spike proteins instead of the still-functional spike proteins, attacking all the viruses that failed to get into the cells instead of all the viruses that might succeed. The mRNA vaccine doesn't produce real, active viruses, so it doesn't have this problem.
> Taking the line of reasoning where we assume the worst case scenario until proven otherwise, would it be reasonable to assume long term medical issues from the vaccinations?
Assuming the worst-case scenario until proven otherwise doesn't work like that. You have to look at the entire range of uncertainty, and choose the worst-case scenario for each question.
Example: you want to know, worst-case, how many people will die from car crashes on a road in a year, so you assume that the cars involved in collisions are travelling at the fastest recorded speeds on that road (or in the 90th percentile of speeds on similar roads, or something). But if you want to know, worst-case, how long it'll take to travel the road, you should assume there'll be loads of traffic jams, or the road will be closed.
So here's a worst-case scenario if people don't get vaccinated, bounded by my amateur knowledge of epidemiology: there's a large enough infected population passing the disease around for a really deadly, fast-spreading variant to emerge, and its antigens are different enough from normal that everyone currently vaccinated is susceptible, hundreds of millions of people die, and COVID becomes a seasonal (but much more deadly) illness, killing hundreds of millions again every few years until it reaches an equilibrium of sorts. (A real epidemiologist would know more, which would probably lead to a less apocalyptic worst-case scenario prediction – but it might lead to an even worse one.)
Here's a worst-case scenario if people do get vaccinated: everyone is vaccinated, COVID-19 starts going away, then a month later, it turns out that the vaccines – and real COVID-19 infections (there's no mechanism in the vaccines that isn't also in SARS-CoV-2, excluding the needle / delivery mechanism) cause some complicated, heretofore-unknown-to-science time-delay mechanism that causes a severe allergy or autoimmune condition. Thousands die before we identify the problem, and tens of thousands die before our politicians get their acts together and authorise the mass distribution of anti-allergy / immunosuppressant medication (which we already have manufacturing plants and distribution networks for). We live with the aftermath, but getting infected would've been just as bad.
This second scenario is a lot less realistic than the global apocalypse one, because I had to pull side effects out of my ass. If the vaccines caused chronic fatigue syndrome, which is the only COVID-19-induced disorder caused by a mechanism that the vaccines could share (because we don't know what causes it), it would've started happening already. But it hasn't. Assuming some arbitrary thing we have a fair bit of evidence against is not how you do worst-case scenarios, and it certainly shouldn't be how you do actual planning.
I don't understand your first point, what does that have to do with the immune system getting geared up for an infection months or years later?
The second point, your worst case scenario doesn't even address the worst concerns of people who don't want to take the vaccine. They don't trust that spike proteins are the only things in the vaccine. The worst case scenario is not that the vaccine acts like the virus but that it acts different than the virus. And then you get conspiracy stuff like new world order types deliberately introducing things to the vaccine that will make it harder to have kids or stuff. And unfortunately our trusted organizations telling white lies to the public to elicit the behavior they want hasn't helped this trust issue.
But this is all moot for two reasons. First, because someone actually did a study and found that the immune response from infection was ~10 times stronger than from the vaccines[0]. Second, because we've already selected for a virus that is highly contagious and can infect vaccinated people, and will thus continue to be selected to specifically infect vaccinated people since most potential hosts are vaccinated at this point.
In summary, we might have to all be infected, nearly all at once, for this to be over, or just get lucky and the dominant strains will be attenuated to the point where they aren't a major problem.
> The worst case scenario is not that the vaccine acts like the virus but that it acts different than the virus.
Worst-case scenarios should be constrained by your knowledge. I know what's in the Pfizer vaccine, so my worst-case scenarios have to be constrained by that. But sure:
“Worst-case”, somebody's poisoning the vaccines. This leads to severe side-effects from some batches, which the statisticians take entire weeks to notice because they're all asleep on the job. Vaccine roll-out stops pretty-much everywhere, but nobody's able to trace down the saboteur. A dozen new, highly-transmissible and virulent variants emerge, with different antigens to each other and to the vaccines, so vaccinating the populace becomes intractable.
You see that this scenario is incompatible with “everyone gets vaccinated”. The bad stuff largely comes from “people don't get vaccinated”; the only way everyone*'s going to get vaccinated is if the vaccines don't suddenly get poisoned or otherwise become dangerous.
* except the immunocompromised, and others who don't get vaccines for health reasons.
I can't do a “worst-case scenario” where the vaccines are already poisoned, because they're not. It'd be bloody obvious if they were, given how big a sample size the statisticians have to work with. That would be even more blatantly fictional than my “tens of millions die every year” scenario.
I got the vaccine, and recommend others to do so. The reason I have this debate is because the people who are so offended by anti-vaxxers constantly straw-man them instead of being sympathetic and trying to understand them. Like you are straw-manning me, implying that some obvious poison that immediately makes people sick is what I am talking about. Telling people they are stupid is not going to win them over, and forcing them to vaccinate will entrench their opinions and convert more to their point of view.
Try to understand, they don't trust the government, they don't trust the CDC, they don't trust Pfizer and they don't trust you. Yes you have an official list of ingredients that someone with an appropriate degree can understand. But what's the stuff in the actual needle that you are so intent on making sure gets injected into them? Seems perfectly reasonable to them that some PhDs in some pharma companies are really worried about global warming and a coming Idiocracy. Why not put something in the vaccine that reduces fertility for the unwashed masses?
Maybe it sounds crazy to you and me, but a lot of people hear experts saying seemingly ridiculous things (like needing a vaccine for a disease you already got and recovered from), see how everyone falls in line with the narratives as they come and go, watch mainstream news and social media restrict all alternative points of view. And they don't trust the system. And its clear to them that this system they don't trust, also doesn't like them. From that perspective, of course they don't want the people who lie to them and hate them to have the authority to stick some chemicals and DNA (I know, mRNA) in their arm.
The only thing that'll convince those people is for authority figures to become trustworthy.¹ I don't see that happening any time soon.
So who're left? The people who are concerned about vaccines because other people are, rather than because of (misplaced in this instance, but not in general) scepticism of the claims of untrustworthy, powerful people. Those people can be reassured by thought experiments, because they're assuming dangers due to incompetence moreso than malice.
¹: I suppose an argument from game theory might, but only if they think the vaccine-poisoning enemy is in it for the long run, so the threat of the truth coming out in (e.g.) 20 years would be enough to dissuade them from something like that. If they think the enemy's plans are shorter-term, or they can afford the loss of face, I don't think there's any way to convince them short of convincing them that the industry behind “non-addictive” heroin, thalidomide (developed by a Nazi war criminal!!) and the contaminated blood scandal is totally cool and in no way out to get you.
> Assuming the worst-case scenario until proven otherwise doesn't work like that. You have to look at the entire range of uncertainty, and choose the worst-case scenario for each question.
It seems to me the worst case scenario is always applied when looking at things like natural immunity from prior infection, long covid, etc
If you model Sars-Cov-2 after Sars-Cov-1 or MERS then you would be lead to believe natural immunity lasts around 5+ years.
Where is worst case scenario not applied? Anything to do with vaccines. We're not even allowed to question it.
We are extremely conservative on one side of the coin, but not the other. Why?
And selection is useless if the “gene pool” is small enough that the selection pressure just eradicates the disease entirely. If we get the R number to something like ⅒ and hold it there for a few months? Disease eradicated, job done, everybody goes home.
Because lockdowns are detrimental to society (mental health, division, etc). Why can't we take a level headed approach. It seems like our approaches don't take into any consideration past experiences with similar viruses, or leverage data. We have a lot more data this time around.
Those are already the complications associated with not vaccinating, so putting them on the table again would double-count them.
Not sure I agree with their ‘hundreds of millions (per year)’ figure. That seems like unnecessary fear-mongering. But maybe ‘hundreds of thousands’ or ‘millions’, which is still not great.
I'm not fear-mongering; I'm just a pessimist. My scenarios are “unbelievably unrealistic” and “apocalyptic sci-fi”, respectively, but I wanted to make sure I got an upper bound on the worst-case. I don't know much about the topic, so I had to go into “I know this is unrealistic” territory for that.
The number of cases of reinfections in hospitals is tiny, so the natural immunity looks like a given to me by now, you don't need a study (now it may be that re-infections are asymptomatic, but even if it is the case, that's a good enough protection).
So in case of the lower IFR would implicate there must be many reinfections. And those reinfections are still deadly. It would imply immunity isn't long-lasting. So best to keep routinely boosting your immunity through vaccines. This would probably be the least favorable scenario.
In the case of the higher IFR would implicate there's still some herd immunity to go. It also implicates infections are more deadly. So better boost herd immunity by getting the vaccine. This would actually be the more favorable scenario if we're going to be able to beat Covid.
I don't see why we should care about number of cases in countries with freely available vaccines.
Disease (as reflected by hospital admissions) and death are what we care about. And those numbers are continuing to trend in the right direction.
The US media is just addicted to fear at this point. With a more boring/traditional president in the office and the covid panic waning, there is a news vacuum. And the media is trying to fill that vacuum with the delta variant. But you can calm your nerves just looking at the data yourself and not reading anything the media has to say.
I don't disagree that the media is fear-mongering for clicks (see inaccurate reporting of CDC report) but in this scenario, there's something actually happening here.
If somebody who refused to get vaccinated gets sick, you can say it's their fault. But some people can't get vaccinated, and for others who did get vaccinated the vaccine will have no effect - these will still be at risk until (if ever) herd immunity is reached...
People under 12 are at such a low Covid risk it’d be more ethical for us to send those vaccines abroad where they can be put to productive use saving lives.
Not sure on the numbers, but immunocompromised people (undergoing cancer treatment for example) often can't build antibodies after a vaccine. Those people are really vulnerable and depend on an immune herd.
Deaths have absolutely plummeted, and correlations have very clearly broken from previous "waves". But in order to extract compliance from the population, there needs to be a call to action, so the goalposts were moved to infections, as opposed to hospitalizations/deaths.
This and similar arguments begin from an assumption of bad faith by scientists.
It’s unbecoming.
You should care about the number of cases because each case is a potential for a new mutation that could be the one that bypasses vaccines or becomes more deadly or …use your imagination.
Nobody cares about controlling you, and if they did they wouldn’t use facts covid they would just use tanks.
> Nobody cares about controlling you, and if they did they wouldn’t use facts covid they would just use tanks.
This is a really great way to cause revolt. Why do you think China retains such an iron grip over information? It’s how you control a large population.
From my experience it can take a month or two until the plug is pulled, a lot of people who are discharged to LTACs also don't make it but it takes a bit
Long Covid. It's not just death and hospitalisations. From The Lancet:
"Patients with Long COVID report prolonged, multisystem involvement and significant disability. By seven months, many patients have not yet recovered (mainly from systemic and neurological/cognitive symptoms), have not returned to previous levels of work, and continue to experience significant symptom burden."
The Lancet actually played a major role in promoting anti-vaccine sentiment.
They were the ones who initially published Andrew Wakefield's now-discredited research [1] linking the MMR vaccine to autism. This research and the media attention it garnered massively undermined public trust in vaccines in both the UK and US.
It took them over a decade to officially retract the article.
In the UK we're not vaccinating under 18s in volume - not yet anyway. I really don't want my kids to take part in the Great Adolescent Long Covid Experiment.
Hopefully! Although I think "no clear evidence yet" isn't the same as "no problem". From the article itself there is a lack of clarity/conclusiveness:
"Children can experience SARS-CoV-2 postviral syndromes, but it is unclear to what extent these individuals are affected by long COVID"
We've been learning new stuff about COVID for 18 months now. I suspect we'll continue learning more about it for a long time to come. And I'm not keen to bet my kids' wellbeing on "it'll be fine" if I can avoid it (and they may yet catch it anyway - one can't wrap them in cotton wool).
Just saying - I prefer caution over complacency really.
Because an uptick in cases always has resulted in an uptick in hospitalizations and death.
Maybe you think things have changed (and indeed: I think vaccinations have changed the pattern of cases -> hospitalizations -> death). But ultimately: cases give us a glimpse of what is to come 3 or 4 weeks earlier.
And lo-and-behold, the Florida hospitalization counts are now kicking up dramatically. Good thing we got the news out weeks ago about Delta, so that public opinion can start changing (and now people are beginning to get vaccinated, which should lessen the number of hospitalizations).
Similarly: UK hospitalizations are in fact dropping now!! (coinciding with the drop in case counts 3 or 4 weeks earlier). So even in highly vaccinated countries like UK, case# remains our best predictor for hospitalization counts.
---------------
USA is too late however: we let up on our vaccinations and this surge is going to catch a lot of us by surprise. Hospitals are filling up again.
The vaccinations are coming in too late to stop this current surge (July / August timeframe). But the vaccinations will help us prevent a winter surge.
My gut feel is that everyone has stopped doing lateral flow tests and reporting those tests: noone wants to be isolating now the summer holidays have started, and many people are now ignoring track and trace because they're scared of the possible "pingdemic". I know many people who have stopped scanning in to venues. I reckon many suspect they may have Delta but because the holidays have started and they've been cut loose from gov mandates of mask wearing etc, that the "crowd responsibility" factor has almost totally dissipated.
There may be evidence otherwise but I suspect actual figures are far higher than is being reported.
> My gut feel is that everyone has stopped doing lateral flow tests and reporting those tests: noone wants to be isolating
Okay that's easy to check: data should show a reduction in positive tests roughly on par with the reduction in number of tests.
Recent peak value of tests per day was 16.42 per 1000 citizens on Jul 17th. At that time there were 630.57 positive test results per million citizens.
On July 28th (latest data) tests declined to 13.46 and positive cases to 443.45. That's 18% fewer tests and 30% fewer positive cases, ballpark twice as much.
I don't think your gut is telling you the full story.
If we're going by anecdotal evidence, I know many more people that get the flu every year than that got covid-19. But I don't think my (on average) responsible acquaintances with (on average) workable-from-home jobs tell the whole story.
You're right though that the numbers somewhat suggest that we're managing to beat the Delta variant. Is it due to vaccinations? The vaccination rate has been slowing for months now, yet the UK still had that spike. The difference in people that decided to get vaccinated between early June (start of positive cases spike) and July 21st (when the decrease set in) is 9%. (from 59% to 68%). It doesn't seem to me that a few percent more vaccinations explains everything. A percentage in the upper 60s, for first vaccinations no less (not even a full vaccination), should not be enough to beat Delta from what I heard about the R0.
(Data source is the same OWID link, you can configure it to show vaccination data.)
I'm not saying it's due to vaccinations, I'm saying it's what you would expect given our pace of vaccinations. All we have are correlations.
The reason I say this is that we have a relatively small population of unvaccinated people, and so with the high R0 of Delta, you'd expect it to rip through these unvaccinated pockets quickly and burn out, which is what we're seeing.
I'd expect a few more Delta mini-waves similar to this in the coming months.
A UK person I know said they won’t install the “pingdemic” app because they would have to isolate every five minutes; instead they just use the camera app and pretend. And that’s a vaccinated person who’s pretty cautious. I would assume it’s a widespread sentiment,
i think schools closing, euros ending, the nhs covid19 app ping and holidays starting are actually contributing to a lower number. scotland’s early school holiday should correlate at least part of this hypothesis.
a couple of q’s thou:
1. where do you report lateral flow tests? i do mine at home every day as my work sent out boxes of them.
2. if a lateral flow is positive, aren’t you supposed to do another and then a pcr test?
That's exactly what happens. False positives with lateral flow tests are not unknown. In fact, if the prior probability of having covid is less than about 0.5%, you still have <50% probability of having covid even with a positive lateral flow.
This is a more friendly presentation of the same data, though note there’s a lag in the ONS data as it’s from ongoing sampling rather than self reported tests. At time of writing this is up to 30 July (next update 6 August):
It really makes me wonder why the authorities don’t do proper randomized surveys? It is obvious that the testing numbers will go up and down as the population goes scared and then goes don’t care.
UK Citizen here, my parents have been part of the ONS random survey for about 18 months now, every 2 (or so) they have a visit at their doorstep from the ONS who test both of them, they let them know the results via the NHS app and they get £25 of vouchers for each visit.... They have to be honest about who they have been in contact with, where they have been (E.g. supermarket) and if they wore a mask...
This data goes into modelling for how the government should make decisions about easing lockdowns etc. The UK has some of the best genomic sequencing in the world which is why we are able to identify variants so quickly.
It's just a shame it took the government 1 year to get ready and lied to us in the meantime.
The UK is one of the few countries in the world that does have proper randomized studies of Covid-19 prevalence, and has done since close to the start of the pandemic. Unfortunately the results lag behind the actual number of new infections by long enough that we wouldn't expect the drop in cases to cause a corresponding drop in the numbers coming of those studies just yet.
there is some sort of on going testing with a set group that I've been told was randomly choosen.
My sister/ husband and neice (uk based) are currently being tested once a month since the outbreak (mid 2020 ish) and they where told that they was picked at random,
All of them have had covid - and probably would not have been discovered without this testing - since all their cases have been asymptomatic
They're a lagging indicator, as are deaths. So, eventually.
If you stare at the government's site https://coronavirus.data.gov.uk/ hospital admissions seem to have levelled off, and maybe deaths are levelling off but it's too early to be sure.
People get infected (and begin testing positive) first, then some of them get sick (a few more will seek a test and be positive) and then some of those seek hospital admission or call for advice and the advice for their symptoms is "get to hospital" and almost all of the people who eventually die get admitted to hospital first, in some cases dying after weeks of attempted care.
I think there's room for some pessimism without going so far as your parent poster, cases may be down but not as much as it seems. Lots of people seem to have gone off around the country on holiday which seems crazy to me, but clearly didn't make things much worse. People can choose not to seek a test while they're alive, but corpses have no say in what the post mortem data says.
Looking at the official data[0], the number of daily hospital admissions is still increasing: https://i.imgur.com/XkbImVg.png
But hospital admissions usually lag behind the number of infections. If in a week or two admissions are still going up while the number of new infections drops, then this theory may be correct.
Hospital admissions usually are a bit delayed, but yes, presumably people won't be holding off on being admitted to the hospital the way they would hold off on getting tested if GP is right. (Personally I'm not sure how many more people will now, as compared to a few weeks ago, decide that testing is more of a nuisance than helpful for protecting your loved ones, but then I'm not from the UK so what do I know.)
At least provide data if you're going to be like "it's just a flu". I'm willing to believe you mean well if you are only talking about people that are fully vaccinated 14+ days ago, but in general this sounds like an excuse.
The ONS regularly tests a random selection of people. Their results typically trail the daily infection numbers by two weeks.
Notably, the most recent ONS samples demonstrated a sharp rise in cases. The suggestion is that cases are actually surging, but most are now either asymptomatic or at least very mild, and thus not reported.
I guess we'll find out shortly whether that's the case.
The US CDC does this by re-using random anonymous blood samples drawn for other purposes, and by using test data from blood banks. The current data collected is for the presence of antibodies indicating people who've been infected. Not those vaccinated; they can distinguish that. This is cheap to measure, but runs about 6 weeks behind. Data here.[1] US average from late June is about 22% of the population. That's roughly how many people actually had the disease.
That data should show the Delta variant surge as the data comes in.
I still can't find a useful number for people with antibodies prevalent because either infected or vaccinated, although that is apparently tested.
Which ONS data are you referring to? The currently published data indicates the wave has at least plateaued, as I read it, in all but the youngest age groups.
They are talking about the survey data, which doesn't rely upon the normal testing regime. They randomly contact and test individuals irrespective of their symptoms status, which is different from the normal testing regime that gets reported daily. I believe its a 20k sample size. The survey takes a lot longer time compile
In particular, it's worth noting that the ONS survey tries to estimate an answer to the question "in the given time period, what proportion of the population would have tested positive?"
Because people tend to continue to test positive for a reasonable period of time after they are first infected, this should be a lagging indicator of any peak in new infections having occurred.
That summary seems to show infections plateauing in every age group except school kids. (And of course, with schools breaking up since then they're probably both less likely to get infected and less likely to get tested.)
The ONS data doesn't show a sharp rise. If anything it is levelling off. I think tomatocracy is right - because the ONS survey measures current infections rather than newly discovered infections it is likely to lag a bit and will probably start to drop soon.
This gives me hope for Canada, where I am, won't face too many issues even as we slowly start to tick up from the bottom since major reopening happened, allowing indoor dining etc.
In the last week, we've passed the UK in number of fully vaccinated people, but that's going to be slowing down as we start running of people who got their first dose during the big surge in shots here. Unfortunately, at 64% of the total population getting a first dose, the steep straight line in first doses suddenly curved to a much shallower straight line, to a rate similar to the current UK and US ones.
It doesn't help that Alberta, our country's Texas, has decided to fully open everything and get rid of their requirements. Starting 2 weeks from now, you won't even have to self-isolate if you test positive for COVID-19.
> Starting 2 weeks from now, you won't even have to self-isolate if you test positive for COVID-19.
This is a loaded question, but since covid is and will be endemic, when do we get on with our lives and start facing the mountains of other public health issues? It seems like our vaccination effort was extremely successful and had an amazing effect and there isn’t likely to be any radical new intervention for years to come.
I'd imagine not too long after safe and effective vaccines are authorized for children under 12. At that point the majority of those who actively want protection will be able to get it. This is not the same as saying _all_ who want protection will get it, since no vaccine is 100% effective, and some people who would like to be vaccinated will not be able to because of health conditions or other circumstances, but I suspect society as a whole will decide "close enough."
I'm not saying I necessarily agree with that -- I think the number of "people who want protection but can't get it" will be uncomfortably large -- but this is my guess of when society as a whole will decide to move on.
Honestly, I think this means the future looks like the present, but more so. The places that will be hit the hardest will be more working class and in places that under invest in health and welfare. That's already the current trend, certainly in the US -- look at where medicaid expansion following the ACA has and hasn't happened, for instance, and who has access to decent health care and who doesn't. In some ways I think we're lurching back to previous centuries, where diseases like cholera, dysentry, typhus, etc were endemic, and could certainly affect the wealthy and professional classes, but were primarily scourges of the working class.
In the US, 340 children under 17 have died from Covid. Total. During the same period, 187 have died from the flu, and over 51,000 children have died from all causes:
The reason the vaccines aren't being approved for children is that there is compelling evidence that children are at greater risk from the vaccines than the virus. This is why (for example) approval for vaccination of children and teenagers is split across Europe, and the UK has restricted access to only children with known vulnerabilities:
> At that point the majority of those who actively want protection will be able to get it.
This is less about what the children want, and more about anxious adults want, and that is unconscionable. Kids are largely at the mercy of their parents, so it's essential that the regulatory bodies tread carefully on this issue. We don't need kids to be vaccinated to reduce Covid to a manageable seasonal illness on par with the flu.
> The studies did not evaluate rates of less-severe illness or debilitating ‘long COVID’ symptoms that can linger months after the acute phase of the infection has past. “The low rate of severe acute disease is important news, but this does not have to mean that COVID does not matter to children,” says paediatrician Danilo Buonsenso at the Gemelli University Hospital in Rome. “Please, let’s keep attention — as much as is feasible — on immunization.”
Death is not the only bad outcome to be avoided.
> The reason the vaccines aren't being approved for children is that there is compelling evidence that children are at greater risk from the vaccines than the virus.
A Nature article [0] says:
> Most of those affected have recovered, and the data suggest that the risk of these conditions is “extremely low”, says paediatrician David Pace at the University of Malta in Msida — about 67 cases per million second doses in adolescent males aged 12–17, and 9 per million in adolescent females in the same age group.
There are ~48 million kids under 12 in the US. Assuming they are evenly split between male and female, that would mean 1,824 cases of myocarditis and pericarditis if 100% of them were vaccinated. Given that nowhere near 100% of children have been exposed to COVID and yet 340 have died, I don't see clear evidence here that the vaccine is more risky than not being vaccinated.
> Death is not the only bad outcome to be avoided.
And this is yet another illustration of the point I was making about fear, uncertainty and doubt: the Nature article didn't say that there is proof that children will have "long Covid"...it says that these particular studies didn't address the question.
By this standard, anyone can make up any speculation of something that might happen to children someday, and we'll use that speculation to demand fearful responses, indefinitely. There is no end to this logic.
Fortunately, the well-controlled evidence is increasingly pointing to the conclusion that "long Covid" is not a serious risk to children -- and that, more generally, Covid appears to be similar to other viral infections in terms of long-term symptoms:
Again, lots of hysterical speculation in this area, not much good data. But the better the data gets, the less legitimate the early, speculative claims appear.
> There are ~48 million kids under 12 in the US. Assuming they are evenly split between male and female, that would mean 1,824 cases of myocarditis and pericarditis if 100% of them were vaccinated.
The myocarditis issue disproportionately affects young boys. Your calculation is incorrect.
> Given that nowhere near 100% of children have been exposed to COVID and yet 340 have died, I don't see clear evidence here that the vaccine is more risky than not being vaccinated.
Be that as it may, the UK and about half of the EU countries disagree with your assessment, including a number of experts here in the US, as well:
> By this standard, anyone can make up any speculation of something that might happen to children someday, and we'll use that speculation to demand fearful responses, indefinitely.
You are also speculating, but simply about different things. You're speculating about harm from the vaccine, or about infection that don't happen. One way to avoid going down that speculation rabbithole is to defer to experts whose job it is to weigh the pros and cons and crunch the numbers.
"The American Academy of Pediatrics (AAP) recommends vaccinating all children ages 12 and older who are eligible for the federally authorized COVID-19 vaccine."
"Yes. Experts, including those at Johns Hopkins, believe that the benefits of being vaccinated for COVID-19 outweigh the risks. Although COVID-19 in children is usually milder than in adults, some kids can get very sick and have complications or long-lasting symptoms that affect their health and well-being. The virus can cause death in children although this is rarer than for adults."
> The myocarditis issue disproportionately affects young boys. Your calculation is incorrect.
I took that into account when calculating.
> including a number of experts here in the US
At national scale, you can find experts that will tell you anything. The consensus opinion of the major US health authorities is that the vaccine is a net benefit for children.
> You are also speculating, but simply about different things. You're speculating about harm from the vaccine,
No, I've provided evidence of that. It's not speculation: young boys are seeing disproportionate levels of vaccine-induced myocarditis
> One way to avoid going down that speculation rabbithole is to defer to experts whose job it is to weigh the pros and cons and crunch the numbers
Indeed, that's all I've done here.
> "The American Academy of Pediatrics (AAP) recommends vaccinating all children ages 12 and older who are eligible for the federally authorized COVID-19 vaccine."
We're talking about kids under 12.
> "CDC recommends everyone 12 years and older should get a COVID-19 vaccination to help protect against COVID-19."
We're talking about kids under 12.
> Experts, including those at Johns Hopkins, believe that the benefits of being vaccinated for COVID-19 outweigh the risks.
And other experts disagree with those experts (the ones I linked to, above). Now what?
That's the problem with blind appeals to authority...you can always find another authority. I'm getting pretty tired of seeing news reporters credulously using the phrase "experts say", and applying no critical thought to what they're actually saying.
In this case, you can find legitimate "experts" on both sides of the debate, and both deserve to be heard.
Here you say listen to both arguments, which seems right. Above your tone was ‘don’t vax kids because the UK and half of Europe say not to’ which does make one wonder, ‘what about the other half?’
The UK is often on the wrong side of health vs. quackery, in recent decades originating then spreading more ‘expert’ FUD to set back global disease eradication than perhaps any other first world country. That doesn’t mean the UK is mistaken now, but it does indeed suggest a more careful and less credulous deconstruction of “the UK’s” balance of belief.
> Above your tone was ‘don’t vax kids because the UK and half of Europe say not to’ which does make one wonder, ‘what about the other half?’
I don't think that was my tone, but interpretation is up to the reader, I guess.
An accurate, concise statement of my opinion is that the vaccines should probably not be approved for kids under 12 at this time, and that this does not meaningfully affect our ability to get past the current hysteria, which we should be doing with great haste.
I agree there is a lot of hysterical speculation, around everything from the initial high death rates to the supposed benefits of HCQ. And slowly we have need to attempt to re-evaluate the data, when it is possible. I really wonder how we could get that data more accurately in the future, without all of the inherent privacy implications and dangers from collecting it.
The article also mentions that most of those myocarditis have already recovered while none of those dead came back to life (I am assuming so anyways). Since I see you post to COVID questions often, what would you consider to be "more risky?" It is clear teens are on the low end of personal risk from COVID, but they also put others at increased risk of complications, such as their parents, in addition to their own mild risks.
> Since I see you post to COVID questions often, what would you consider to be "more risky?" It is clear teens are on the low end of personal risk from COVID, but they also put others at increased risk of complications, such as their parents, in addition to their own mild risks.
This depends so heavily on personal circumstance that all I can say is "consult with your doctor". There are kids for whom the tradeoff is obviously in favor of getting the vaccine, and others for whom it isn't.
From a high-level perspective, I tend to agree with the logic outlined here (same link as in previous comment):
Yes, PCP involvement is wise. Reading deep into that link, I notice it says their advice (for 1 dose) is predicated specifically on the drop in infectivity rates in June, implying that that the more virulent delta strain that began circulating shortly after publication meant we should vaccine all eligible teens with 2 doses now. I think that is too strong perhaps, but I am not too certain what we know about it. Even most of the counter-example countries have changed their position (Germany today, Israel before the article, their link Netherlands for seems to have actually said teens should be vaccinated as soon as doses were available). Do you agree with that assessment of the link?
Having a personal experience with this, I now strongly suspect that we have a severe gap in data collection, and failures of the medical system where I'm at to properly capture side effects. This might be in part because of medical professional cultural hesitancy to attribute effects to vaccination. The bucketing of symptoms may also affect this, not all heart related side effects are myocarditis, but that's what everyone is looking at.
In my case, with no prior history of any heart conditions, I experienced a racing heartbeat, crushing chest pain and pain that radiated from my chest to my head beginning 2-3 days after the vaccination. Doctors I saw were generally skeptical that this could be caused by the vaccine; their first instinct was to discount any possibility that it might be vaccine related.
I'm now significantly more distrustful of public vaccination campaigns for covid-19, and the side effect data for such. There seems to be a strong incentive, or some underlying cultural bias to underreport this.
A complete loss of sense of taste, or chronic fatigue are both entirely possible outcomes with children, and at this time, it's not clear at all how long these effects last.
Conversely, the effects of myocarditis, while unpleasant, are fairly well understood (and at least one physician I've spoken to was of the opinion that the vaccine related risk was overstated, as the base rate in that age group was bound to be higher than reported, due to the mild nature of most cases, so some of the elevated rates appear to be due to closer post-vaccination scrutiny).
The highest quality study on this to date [1] found no difference in the prevalence of long term symptoms between kids that had covid and kids that didn't.
He states that '4% seropositive having symptoms after 12 weeks', but omits to mention that 2% of seronegative have symptoms after 12 weeks too...
Also he doesn't mention the 9%/10% rate split at 4 weeks, or the symptoms:
Tiredness, Headache, Congested or runny nose, Stomachach, Sleep disturbances, Cough
So he's making the case for child vaccination on the basis of 2 extra seropositive children having one or more of the above symptoms.
And, BTW, the study authors themselves note the limitations as follows:
'Limitations include the relatively small number of seropositive children, possible misclassification of some false seropositive children, potential recall bias, parental report of child’s symptoms, and lack of information on symptom severity.'
The study authors concluded that:
'Seropositive children, all with a history of pauci-symptomatic SARS-CoV-2 infection, did not report long COVID more frequently than seronegative children. This study suggests a very low prevalence of long COVID in a randomly selected population-based cohort of children followed over 6 months after serological testing.'
The Louisiana government had a press conference today where doctors from children's hospitals claimed their hospitals are full, especially the ICUs. [0]
Even if kids don't die and just get sick enough to take up beds that still puts stress on limited hospital resources that other children need.
The CDC data doesn't seem to show an unusual surge in hospitalizations for kids (0-17) [1].
But the LDH data does show a significant increase in cases for kids [2] (and local news has reports from local hospitals citing highest-ever covid-positive child patients [3]).
Of course if the nymag article is correct and it's just a short spike then that would be a relief for many people.
The reason to not want children to get COVID is that they will spread it to their parents and grandparents, who are more vulnerable. It’s not about whether the children will die, which everyone agrees is very low probability.
It’s an interesting point, and I’m relatively neutral on all the underlying empirical claims. But taking the assumptions as a given, doesn’t this violate the Hippocratic Oath?
Physicians are ethically forbidden from recommending a medical treatment that’s a harm to the patient, even if it’s in the interest of society.
>Physicians are ethically forbidden from recommending a medical treatment that’s a harm to the patient, even if it’s in the interest of society.
Vaccines work at the population level, physicians don't check if you're going to benefit, society benefits. That is still ethical, depending on the ethical framework. I don't think doctors truly hold the Hippocratic Oath as ground truth, most probably don't believe in Apollo, for example.
It's not about preventing. It's about reducing probabilities. The vaccines do not prevent kids from getting it. They do not prevent adults from getting it. They do not prevent people from spreading it. They do not prevent people from getting hospitalized or dying from it. They decrease the chances of all of the above happening.
This is a perfect illustration of the point. In the face of ample documented evidence of the actual risk, your response is to speculate wildly about future events that are completely inconsistent with what we know.
The "give up and let it be endemic forever" defeatism attitude appears very statistically foolish.
It's likely, yes, but why on earth would we want to just accept that?
The flu, for instance, bounces around in severity and kills tens of thousands per year in the US. Few of those are kids, so what? If we're happy to let the virus continue to transmit in any populations, it'll change in various ways. One year a variant may pop up that'll be more harmful to those kids. At some other point a variant may pop up that'll be more elusive against adult immunity, etc. Over years, how many lives does that add up to? Why wouldn't we aggressively try to vaccinate as many people as possible before those things happen?
Success wouldn't be guaranteed even if people weren't opposed to it for various spurious reasons but it would be nice if we believed we could accomplish hard things...
> The "give up and let it be endemic forever" defeatism attitude appears very statistically foolish.
Well first, that has nothing to do with what I wrote. I made a very specific argument about how fear -- hysteria, really -- is driving our reaction to what is right to do for children.
But second, it isn't "statistically foolish"...it's just a basic understanding of biology and our rather poor history of eradicating viral diseases. Statistics don't come into play here either way.
Reasonable people can disagree on whether or not Covid can be eradicated, but you have to be delusional to think that this will be accomplished on any sort of timeline that is relevant to our lifetimes.
Since there are animal reservoirs for SARS-CoV-2, the virus will always be endemic regardless of what we do. That's not defeatism, just scientific reality.
From delta, we clearly have evidence that on a short timeframe a version with _wildly_ enhanced transmissibility has evolved. So speculating that changes will continue is reasonable. Additionally, we know that leaky vaccines and continued spread may cause greater pathogenicity.
> we clearly have evidence that on a short timeframe a version with _wildly_ enhanced transmissibility has evolved. So speculating that changes will continue is reasonable.
So let's be clear: the claim is that the virus can mutate, therefore, any particular outcome is equally likely?
If I speculate that the virus will mutate into a hemorrhagic fever, like marburg or ebola, is that reasonable?
If I speculate that the virus will lose its pathogenicity, is that reasonable?
I'd find it helpful if you provided some thoughts on determining what's reasonable and what's not reasonable to expect from future variants. As I understand it, a virus dramatically changing its mode of transmission -- say going from respiratory to a hemorrhagic fever -- doesn't really happen. But we also have a decent understanding of how covid gets transmitted now, so have some way to anchor expectations. You're saying it's not reasonable for covid to evolve to become more likely to cause illness in children. If that's true that's great news, but I really have no way to evaluate such a claim. Why is that unreasonable? Wouldn't we need more insight into why children are currently less affected to speculate on how reasonable it would be for that to change?
I notice your profile you have a biology background. I don't, and am guessing most people here don't either, so I'd find it helpful to get an explanation of why you find a change that puts children at more risk unlikely (and I bet others would too).
> You're saying it's not reasonable for covid to evolve to become more likely to cause illness in children. If that's true that's great news, but I really have no way to evaluate such a claim. Why is that unreasonable? Wouldn't we need more insight into why children are currently less affected to speculate on how reasonable it would be for that to change?
The short answer is that evolution is random. It isn't an intentional process. The virus isn't trying to become more infectious, or deadlier, or...anything, really. It's just a random process, filtered by some outside force(s). And in this case, the relevant outside forces acting on the virus are: 1) the human immune system's ability to see the virus, and 2) the virus' ability to bind to our cells.
If you're vaccinated (but not previously infected), your immune system can basically only efficiently recognize a bunch of little chunks of the spike protein of the virus -- the piece that allows the virus to bind to your cells. So any random mutations to that spike protein are potentially beneficial, in that they can maybe hide the virus from your immune system, or maybe increase how tightly the virus binds to your cells, or they can be potentially detrimental, in that they can maybe cause the virus to bind less tightly to your cells, or make the spike protein misshaped or something. Or they can do nothing at all.
These are essentially the only "forces" related to vaccines that are guiding the evolutionary process: forces that attempt to change the structure of the spike protein to either escape the immune system, increase cellular affinity, or decrease cellular affinity. The vaccines do nothing to influence anything else. All other dimensions are random, with respect to the vaccine.
Viruses are pretty stupid. If you want to imagine that the virus could become "more fatal" (somehow; it's not clear how this would happen), it has to be done within this framework. There was to be some process that is selecting for the viruses that are "more fatal", and that process needs to be somehow more efficient when only a fraction of the human population recognizes the little bits of the spike protein encoded by the vaccines.
Can this happen? Sure, anything is possible. Is it plausible? No, not really.
> the claim is that the virus can mutate, therefore, any particular outcome is equally likely?
No.
Did you actually read the study I linked?
Outcomes that enhance transmissibility are always being selected for. Things like higher viral load in the vaccinated.
That which spreads, spreads.
All things being equal, pathogenicity is neutral and gets down-selected when the pathogenicity conflicts with the ability to spread. But with two different populations, the feedback loop that of down-selective pressure against spread limitations due to pathogenicity may be broken.
If it spreads in one population which requires characteristics that make it lethal in the other population.
Yes. It makes the general argument (not specific to Covid) that is known to any evolutionary biologist: partial selective pressure causes an organism to evolve away from that pressure. It's why we tell people to take their entire course of antibiotics.
It in no way implies that the organism will evolve to do anything else. You wrote this:
> Additionally, we know that leaky vaccines and continued spread may cause greater pathogenicity.
This is NOT supported by evidence, except in the completely silly sense that the virus "may" do anything, if it is allowed to continue existing.
If we partially vaccinate, SARS-CoV2 "may" evolve legs and do a little dance...but it probably won't (...and for that matter, it probably will hit an upper limit on transmissibility as well. But now I am speculating, if only in an evidence-based manner.)
I provided source evidence documenting an example of the mechanism and result of what I'm saying. Get back to me when you can provide a source example case of a virus evolving legs and doing a little dance and then we can consider the probabilities equivalent.
You provided a source showing that a chicken virus escaped selective pressure, in chickens, grown in a lab. Let's not overstate the relevance of your "evidence" to SARS-CoV2 amongst the human population.
But as I said, there's nothing terribly surprising about the idea that pathogens mutate to escape selective pressure. It's right out of biology 101. It would be tremendously surprising if those pathogens became more virulent, which is what you're trying to claim.
First, I'll note that my initial comment was in the context of "when do we get on with our lives", which I took as a different question from "when _should_ we get on with our lives." What I think we _should_ do is not the same as what I think we _will_ do. Plenty of debate to be had around the "should" question of course, but it is a different question.
That noted, and since I did engage in your comment on the risk to children, I am curious about your statement that my response is inconsistent with what we know. As I understand it, we don't actually know why children have been less susceptible to illness so far, do we? I've seen plenty of theorizing, but I haven't seen any reporting indicating these are more than theories so far. If there's some reliable reporting on this topic I missed, I'd definitely be happy to see it!
> As I understand it, we don't actually know why children have been less susceptible to illness so far, do we?
Well, everything is a theory, but the most plausible one I've seen is that ACE2 expression is age-dependent. Young kids don't have much of the receptor the virus needs.
The response to controlling people and taking away their freedom in the name of COVID has been ran deliberately and openly run through fear mongering. It's no wonder people keep defaulting to that, but we must actively reject and counter fear mongering.
It was actually the perverse effects on viral selection created by World War I. The relatively mild first wave turned into a deadly second wave because soldiers who became mildly ill stayed put in the trenches, while those who had severe cases were put on trains and sent to crowded field hospitals, where they spread the more lethal variants.
If they simply suppress symptoms without reducing transmission, the current vaccines being administered may have a similar perverse evolutionary effect (although at least they're not actively selecting for worse strains).
It's as if, as long as people survive in some form, we shouldn't care.
There has been an uptick of other diseases, including diabetes. Pancreas cells also have ACE-2 receptors and get infected.
It's extremely irresponsible to dismiss the virus' effect on children at this stage.
EDIT: we are also conflating our vaccines, which are manufactured, stable, controlled and much more understood, with a virus, which is multiplying, uncontrolled and mutating. We don't mess with viruses.
This is not FUD, we simply need to be careful with pathogens.
TL;DR: there's not much evidence that these things you are concerned about are happening in children, and the best evidence suggests that they are not.
This discussion about all of these things that might/could/maybe/possibly happen to kids who get Covid, but we don't have evidence for it? That's called "speculation".
If I had to guess (and maybe I shouldnt be speaking as I didnt downvote), its a combination of "It's time to stop with fear, uncertainty and doubt, and deal with facts" followed by unsubstantiated "compelling evidence that children are at greater risk from the vaccines than the virus."
The "time to stop with fear" and to stop catering to "anxious adults" can equally apply to this persons crusade to not vaccinate children. A mild mannered moderate can both not be scared of their children having a severe covid reaction AND get their child a jab when its available, if risk assessment reveals there to be benefit.
> its a combination of "It's time to stop with fear, uncertainty and doubt, and deal with facts" followed by unsubstantiated "compelling evidence that children are at greater risk from the vaccines than the virus."
The links I provided -- particularly the last three -- document the points I made regarding relative risk. You just have to read them.
I did make some effort to comb through your links, and I didn't see anything regarding the risk you mention.
You said, your last 3 links in particular. The third to last is the CDC about covid not vaccines.
The Bloomberg article said "The British position is driven by fears of rare cases of myocarditis -- an inflammation of the heart muscle -- and pericarditis -- an inflammation of membranes around the heart -- in younger people who have had the Pfizer and Moderna vaccines."
The VOA article said "Those opposed to vaccinating teenagers argue the risks of adverse reactions outweigh the benefits."
So I ask, what substantiation do you have. Because all youve given is fear. Is there a case of myocarditis death after a vaccine? 79% of young people (around 1000 total) have recovered. Are you expecting the rest not to recover?
Im curious how you calculate risk? Covid deaths 17, mrna vaccine deaths 0? How is the vaccine a greater risk? Are you comparing long term side effects? How do you have those statistics? I still contend that your claim that children are at "greater risk" (of what?) from the vaccine is unsubstantiated at this point. What you are doing is exactly what you accuse others of doing, instilling fear over reason.
Our biggest remaining group is the 12-and-under population (which needed a new set of tests to figure out the new dosage. Young children weigh much less than an adult and therefore need much lower doses...). The current estimates are maybe October before this children are authorized.
Isn’t it standard practice to set isolate if one has any highly contagious disease? Like the actual flu? Maybe it’s not a law but it sure is a sensical cultural norm and is just the polite thing to do as well.
At least where I've lived, no, the standard practice is to "work through" the illness and give it to everyone you come in contact with while talking about how it's no big deal because your immune system is strong and you aren't a pussy.
The UK has, or had a strong culture of "it's just a cold, I'm actually fine, I'm Ok to work today, really".
I am hoping that this bad habit has died unmourned during the COVID pandemic. I have no intention of of commuting to an office when I have a cold, and every intention of telling others who have one to go home already.
For vaccinated people covid is not at all like the actual flu, it is very much a cold at worst. That is the kind of disease I and the poster above me were referencing
For unvaccinated people it can be quite a bit worse than the flu. The degree of empathy afforded those folks seems to be a subject of active debate I guess...
Other than people with compromised immune systems, or people who are trying not to spread the virus to small children for whom the vaccine isn't approved yet.
I'm all for being annoyed people who could get the vaccine but decided not to, but we shouldn't throw the actual babies out with the proverbial bathwater, right?
We're not talking about literally killing them. We're talking about leaving them to their own devices. They can get vaccinated at any time. Why should the rest of us be locked down, now that we have effectively ended the overrun of hospitals?
Wasn't that what this was all about? Who cares if people get the coronavirus? All that matters is not developing severe SARS-Cov-2.
What about my posts has given you the impression that I care about the people who could get vaccinated but haven't? I've repeatedly expressed my annoyance there. However, we should do our part to minimize spread at least until kids can get the vaccine. In particular, it seems to be the case that the Delta variant can spread from a vaccinated person to an unvaccinated one, so if there's widespread infection people could get it, then give it to their kids.
Anyway, all I'm doing is sticking to restaurants that have outdoor seating, wearing my mask in stores, and keeping distant from strangers on the sidewalk, so it is pretty relaxed compared to the height of the non-vaccinated pandemic.
I agree that there are an awful lot of really unsympathetic people who haven't gotten vaccinated, but that seems like an unfortunate side-issue. We can ignore them all and say: sure, but there are still people who have compromised immune systems, etc, so we should try to minimize the spread for them (of course, people who have really compromised immune systems are also used to avoiding situations where they can get sick I guess, so this is a team project). Even if the majority of people who aren't vaccinated are annoying, the existence of good people is a sufficient condition to be careful.
For me, this doesn't necessarily mean totally isolating, though -- just things like wearing a mask in stores, dining outside when I want to go to a restaurant, etc.
My school actually used to give out awards for it, which always used to annoy me as I generally had 100% attendance excepting 1 or 2 days off for illness each year.
> Maybe it’s not a law but it sure is a sensical cultural norm and is just the polite thing to do as well.
OP is clearly talking about Alberta changing the laws about self-isolation. At some point, we are going to have to transition to using the same 'cultural norm' framework in dealing with Covid that we do with the flu.
Alternatively we could take this as a chance to re-frame some of the dysfunctional pre-existing cultural norms around respiratory infection. Especially the widespread notion that only wimps and slackers use sick days.
At some point we will "get on with our lives" but that doesn't mean that we will be able to ignore COVID-19. As with any highly infectious and dangerous disease there will still be a public health response to outbreaks. The hope is that with a high proportion of people vaccinated we won't see many outbreaks.
For example, in Australia we have a 92-94% vaccination rate against measles (differs slightly by state) with the disease considered eliminated in 2014 [0]. Even still, in 2019 there was a small outbreak in Western Australia that lead to a big contact tracing effort and some forced isolation/quarantine of close contacts [1].
> when do we get on with our lives and start facing the mountains of other public health issues?
We (or at least, public health authorities; indiviudal citizens whose attention doesn't drop below the top story in the news are a different story)... haven't stopped facing the mountains of other public health issues.
Since when is Texas a pejorative? By itself it would be a world top-15 economy, and its pandemic performance was not an outlier or exceptional. If anything it, along with Florida, demonstrated that extremely strict lockdowns don't correlate to better outcomes. Nothing like Alberta.
The death rate in Florida is 180/100k [1]. That's pretty close to the national average. If the entire US had gone like Florida, then instead of 613k deaths, we'd have 590k. So, yes, Florida was better than average despite not having a severe lockdown. But Florida also has fairly separated populations: a lot of old people very likely to get vaccinated, and a lot of young people very likely to survive.
For comparison, Oregon had a pretty hard lockdown. Its death rate is 68/100k. If the entire US had that same death rate, 390,000 Americans would still be alive today.
If you look at the data, it is clear that lockdown is not the only thing affecting death rate. But it also seems pretty obvious that social distancing did have a significant impact on the number of people who died. There are thousands of Americans that are dead today because people wanted to go to a party, or a restaurant, or a wedding.
>There are thousands of Americans that are dead today because people wanted to go to a party, or a restaurant, or a wedding.
And there are tens of thousands of Americans who willingly gave their lives fighting in wars so that Americans (and citizens of various allied countries) could still do such things and live freely. A life driven just by fear of death is barely a life at all.
Deaths in the US (like in the UK) are barely moving unlike during the other waves b/c of elderly vaccination rates. I really doubt this will budge the aggregate fatality rates much at all.
The numbers I've seen are that death rate per capita has been lowering California than Florida so far, so while I think investigation should be done about about "were the outcomes so much better to justify whatever additional cost[0]" I haven't seen anything suggesting that public health measures haven't had any effect.
We should, of course, also wait until things have actually settled down and we don't keep having more periodic surges...
[0] how costly, exactly, things have been is another question that needs more investigation, especially for all types of interventions. E.g. if, after 2022, nowhere in the US institutes another Covid mask mandate or lockdown, all the folks hysterical about how "Covid is just an excuse for democrats to take your freedoms away and never give it back" should rethink a few things.
Florida also has a lot more residents in the vulnerable 65+ age group. So all else being equal we would expect Florida to have a much higher death rate.
On the flip side, Florida has year round warm weather and sunshine. Not only does that sanitize viral particles, but it makes it easier to move socialization outdoors.
India's per-capita deaths are lower than Floria. And sunlight sanitizing the air might be bunk, but being able to socialize more outdoors is very much not. India's population density is nowhere close to Florida's.
'Pray for rain' type politicians and Taliban style government. (Rick Perry, the Bushes, Paxton and Abbott)
Cronyism run rampant.
Some of the most corrupt corporations.
The electrical grid collapse, Refinery explosions,
West Fertilizer Company explosion, Result of letting corporations 'regulate themselves'
Cowboyism/Ignorance as a virtue.
One the most polluted states.
The only reason Texas can be in the world top 15 economy is due to population and landmass size, along with its dependency on oil. But given Texas is second in state population behind California and California is #5 in the world, I'd argue it's not doing as well as it could be.
Oh, and the weather in Texas is less preferable to having a weasel clamp down on your balls.
Okay Mr. Facts, show me the breakdown of vaccine rates by different groups. And then tell me about how all those groups lean Republican. Because in my state it is groups who overwhelmingly vote democrat who make up the vast majority of unvaccinated. But I have a feeling that bashing Republicans for not getting vaccinated is a lot like publicly pronouncing your hatred of pineapple pizza. Just something the cool kids do.
And when you say complete disregard for the virus/vaccine, show me some facts that back it up. Like "complete disregard" means no republicans got vaccinated? None of them said vaccines work and to please get vaccinated? Like share some of these facts that you base this on and show me it isn't your political bias.
Who cares about "your state" which is clearly just anecdata? This is a national trend where Republicans shun mask mandates and vaccines. That article above provides more links for the vaccine related claims
> when you say complete disregard for the virus/vaccine, show me some facts that back it up
How's this for size - Florida (you know, a famously Republican state with a Republican governor) is threatening to withhold EDUCATION FUNDING from school districts that have mask mandates: https://www.politico.com/states/florida/story/2021/07/30/des...
I could go on, but you are being very emotionally charged and disregarding a lot of very obvious rhetoric to try and make a blatantly false point.
When Texas removed mask mandate in March there were such claims as well ("it will be so bad, Texas is doomed"), but nothing happened and cases continued to go down as in rest of the country.
> It doesn't help that Alberta, our country's Texas, has decided to fully open everything and get rid of their requirements. Starting 2 weeks from now, you won't even have to self-isolate if you test positive for COVID-19.
I wonder how well the models account for the "oh shit" factor of people being exposed to enough news about a development like Delta that they change their behavior. All around me people are quietly going back to their early-pandemic habits of distancing and mask wearing despite shedding those habits well before the CDC said they should.
Oh fun: the game where everyone puts their pet biases forward in an attempt to explain the behavior of a poorly understood complex system.
It reminds me of the financial news. "Commodities markets are spooked as backlash to latest Justin Bieber video mounts!"
In all seriousness, apart from the vaccination rate and strictly enforced lockdowns, I have yet to see an explanation for cases going up or down in a particular region that isn't contradicted by the results in some other region. I think we should just admit that except for vaccines and physically forcing 90% of the population into isolation, we don't have a clue what works and what doesn't.
As a tangent, one way to get much more accurate data in a much quicker way is to accept human challenge trials.
We don’t even know the answer to whether delta is vaccine resistant. With challenge trials it would be dead simple. Take 10,000 vaccinated volunteers, randomize into a delta and alpha groups. Spray them in the face with Covid. Compare rates one week later. Question answered immediately with statistical certainty.
Right now, we’re trying to answer questions like this using nothing other than extremely messy observational data that’s subject to all sorts of uncontrollable confounding variables.
The lockdown thing doesn't work as well as you'd think either.
We have nearly the world's toughest lockdown in Sydney, and weeks later the cases are higher than ever.
Same thing happened here in Melbourne last year, with "officially" the toughest lockdown in the world, for 120 days. It was absolutely miserable.
It eventually works - but the UK eventually saw a similar precipitous decline, along the same timeframe, while only relinquishing restrictions.
The only common thread is that in 5-8 weeks, the spike reverses and plummets, regardless of policy.
(Lockdowns may keep the spike much lower, along with the general spread. But I'm more interested in why they seem to have no effect on arresting or reversing the spread once it takes hold.)
Perspective: Aussie, plugged in, watching the West and India closely.
The lockdown works pretty well in other countries. It's just people in Sydney being ignorant. There are still house parties and carefree people. The anti-lockdown protest didn't help, but it wasn't totally unexpected considering the incompetence of the NSW gov. A lot of Aussies don't want to get vaccinated too, which is an important part to reduce infections. I got my Pfizer shot months ago, because people either didn't turn up or cancelled.
> There's a lot of evidence about what worked what didn't work
If that was true why can I take the population adjusted graphs for any interesting statistic, overlay several countries or states, and see the shape of them all is basically the same?
I would assert that for any of these non-pharmaceutical interventions to have been worthwhile the effect on such charts should be absolutely noticeable to any layman on the street. If you need PhD level math to tell a country who "did it right" apart from a country who "did it wrong"... it probably means that it wasn't worth "doing right".
Adjust for population and the nature of the country (ie values freedom highly), and then testing rates, and you'll see it's not as unique as you think.
Many other countries had huge death rates but didn't test much before and don't test the dead, unlike the States.
Then control for age and obesity, the two factors that make a population most vulnerable.
Please show me a chart where competent governments like NZ, Japan, Australia, China and Indonesia are somewhat similar to incompetent ones like Brazil, USA or South Africa.
I remember reading that the deaths in countries corresponded pretty tightly with obesity levels in the population. If that's true, that throws lots of "evidence" right out the window.
I saw a doctor on YouTube (just a private guy with his own channel) apply this same reasoning to Florida. Right now is Florida's "winter": meaning, people tend to stay indoors with the windows closed (to avoid the oppressive heat of the July and August).
It's not clear that even lockdowns work long term. With a single exception, all the countries that initially did well by having lockdowns early had worse later spikes because they had no herd immunity at all. And the last country is probably lying.
I'd support this by noting that the numbers in Scotland surged earlier then started declining earlier (where universities and schools go on summer holidays weeks before England). When English schools later broke up for summer, numbers there started declining too.
So no doubt numbers will start going up again when school returns, and will do so first in Scotland - as the virus burns through the young, unvaccinated population.
The staggered school return times you mention could be one factor (as could better weather resulting in outdoor socialising instead of indoor). The effect when schools return (~2 weeks from now in Scotland) might be muted however as hundreds of thousands more vaccinations will have been done in the parent-age population. In Scotland, for example, over 90% of adults have received the first dose, and 72% the second (implying that ~18% are in the waiting period for the 2nd). Perhaps we should expect to see a spike in cases in children, but not so much among their parents.
Did we not see the same effect last year (probably for the reasons you mentioned)? Numbers declined in summer, but then massively rose again in Oct-Nov.
I think this Autumn will reveal whether the vaccinations are giving us the protection needed to gradually open up society again.
For my part I really hope it does, as it will also encourage other countries to do the same and give the vaccination campaign a worldwide boost.
Let’s hope the peak just gone is the last big spike. In the final analysis I imagine the British public’s _willingness_ to get the jab will be seen as an enormous success factor, on top of the vaccine itself’s efficacy. This willingness merits study. High social trust of the NHS, historic common understanding of vaccines and everyone knowing someone affected by the virus all play their part. As an aside, I believe this to have been the NHS’ finest hour, and in future “the pandemic” will replace “the war” as the lynchpin reference point in time, as it were.
The UK government definitely seems to consider the British public's willingness to get vaccinated to be one of the key parts of the success story, from what I've seen. I will also say that their handling of issues like the AstraZeneca blood clotting issue has been really good compared to the shitshows elsewhere - careful, measured, with really clear communication about what they know and why it justifies the decisions about whether to vaccinate people with it.
It is possible, but there's still large cohorts of the population (ie under 18s) who have not had the virus and are not vaccinated, you would expect that when they go back to large scale mixing in schools together that transmission will increase among them and case numbers will go up.
And this isn't really an issue so long as the overwhelming majority of the old and vulnerable are vaccinated. But there still the potential for scary looking case numbers but not so much death numbers.
You have coronavirus symptoms. During the middle of a surge in cases, the government has announced that all coronavirus restrictions have ended and everybody can go back to normal. The vast majority of older and vulnerable people have been fully vaccinated.
Do you:
A: get a test and risk having to isolate
B: not get a test and live your life like normal as the government said you should
IMO it was most likely the Euros football/soccer championship leading to a lot of mixing in crowded spaces among younger men who maybe didn't yet have the vaccine or we're from backrounds that are the sort that typically ignore this sort of thing.
Yep, I know someone who went to one of the Euro matches. They got covid, and they also said that the facebook groups for supporters were absolutely full of people who had also gotten covid.
yes because the matches were all-over europe so same people who were in a packed pub a few days earlier were now on a plane to some other european country to watch the next match.
further, the borders remained open so people mixed at home and then went on holiday/visited family etc. UK is a major international transport hub and also has a large population of Indian descent so we likely "imported" delta from India relatively early as a result and then likely helped seed it in other western nations.
They should have put India on the red list several weeks earlier than they did when it was obvious for anyone to see what was going on, but they delayed for unknown reasons
Tentative signs the virus has burned out, either through infections or vaccinations. The wave has been entirely confined to the younger age brackets who are far less vaccinated.[1]
Being in central London right now, through anecdotal evidence I don't think we've suddenly become less sociable.
The Massachusetts study is rather confusing about delta and vaccination, but I think it emphasizes that demographics of who is socializing is skewed. So it might have burned out among those in the nightlife and still be highly dangerous among pensioners.
Your right, I forgot about y13 being the last year. Y11 is GCSE year which ends at 16. I’m not sure why the the age brackets don’t go up to Y13, when school ends.
Also lots of previously vaccinated people were exposed, but didn’t get infected.
Doesn’t mean their immune system did nothing though. I’d wager a lot of UK population basically got an ”organic 3rd vaccine dose”. My prediction is they have probably the highest immunity rates in the world atm
> a lot of UK population basically got an ”organic 3rd vaccine dose”.
Isn't that how the vaccination regime is supposed to work, actually? With two jabs in, contracting Covid still comes with something like 4%..20% hit rate.[ß] However, with two jabs the risk of hospitalisation is mercifully low, and roughly half of the cases are asymptomatic.
So instead of vaccinated people overloading the NHS, when they do get unlucky, they are much more likely to get through with only mild symptoms. For majority that "organic 3rd dose" works as a booster shot. They can still infect others, though...
NB. As far as I know, there are no good studies on how Long Covid manifests in a vaccinated population. I think the working assumption is that very mild symptomatic Covid also ends up with less severe Long Covid, but have heard of no data to back that up.
ß: Depending on the study, the vaccine in question and the variant. IIRC 2xPfizer provides ~88% protection against Delta, 95%+ against earlier non-Beta variants; 2xAstraZeneca provides 60%+ protection against Delta, 90%+ against non-Betas.
As far as I know, long covid is directly related to how sick you get. you hear all these stories of people being bed bound for a week or more, high fever, struggling to breathe, etc etc.
I'd think it sounds quite a lot like those people were really rather ill. I don't think people should expect to go back to running marathons or whatever a week after fighting to survive
It's the same for flu and other major viral infections. It can take a while to get back to full health - I don't think covid is anything new here? Just the usual "you almost died"?
Right many types of viral infections can cause post viral fatigue syndrome. This is nothing really new, it's just getting more attention now because of the sudden surge of cases.
The UK had a perfect storm of factors contributing to the severity of the Covid pandemic in that country: highly internationally mobile population, highly internally mobile population, a global travel hub, high population density, culture of close social mixing, no culture of mask wearing, colder climate leading to more indoor living, higher than average levels of elderly people, obese people, and of the ethnic groups most impacted by the virus, low appetite for strict enforcement of lockdowns, and low levels of government control over everyday living.
Other countries had some of these factors. Few if any had all of these factors.
What happened next? The vaccines turned out to be really effective.
The UK certainly doesn't have all of them for a start.
The lock-downs had high levels of compliance, just a lot of people moaning from their sofa (or whatever soapbox they have available, reach varies greatly, inversely with intelligence in many cases).
Population density, travel hub, obesity levels, delayed first lock-down would be my list.
Probably both. We should remember what was the 1st approach to the Covid problem by Johnson (that is, well over one year ago): he wanted to achieve herd immunity without having enough vaccines or not having them at all, and initially there were no imposed lockdowns or infection prevention rules. The point is that along the extremely high death toll caused by that approach, a huge percentage of people over there might have caught the virus without symptoms, therefore becoming immune to a 2nd infection or at least immune to nasty symptoms. So it's entirely possible that the herd immunity was eventually achieved, although many, including me, would agree the price to pay has been not fair.
>he wanted to achieve herd immunity without having enough vaccines or not having them at all
Instead he managed to brew an exciting new variant, which is what every health official was warning against.
And I'm guessing that unless the majority of the population are rapidly inoculated then exciting new strains could constantly evolve until we have something truly nasty.
I don't really see how the level of immunity could be low enough in June to allow rapid growth, and then suddenly be high enough in mid-July to cause rapid decline. Wouldn't we expect a population close to herd immunity to see slow growth, and a population just over herd immunity to see a slow decline?
I think it does mean that the virus spreads slower (although the exact amount will also depend on factors like how vaccinated people are distributed among the population). Whereas in an unvaccinated population, each infected person might spread the virus to (say) five others, in a 70% vaccinated population, on average 3.5 of those others would be vaccinated, so the virus would only spread to 1.5 others. This gives a slower rate of growth. Once that rate of growth falls below 1, herd immunity is achieved. When you are close to herd immunity, that rate should be just a little above 1, leading to slow but positive growth.
I think that the question isn't slow or fast, it's exponential or not exponential. If you are getting 9 infections for every infection then that's a bit exponent. But, 2 for every infection is also an exponent - just a smaller one. Once you get below 2 for every infection then you are in the territory of slow growth - but not for long and not everywhere. The UK had a patchy delta wave, my guess is that when the non herd immune demographics and areas started to get herd immunity (drop below 2) then the breaks really slammed on.
The collapse (unexpected by almost everyone) happened after "freedom day", when masks were no longer mandatory and it became legal to stand at the bar in a pub. Probably co-incidence.
It has to be a coincidence. It happened almost the exact day, maybe even a little earlier.
It should take about a week to start seeing the effect of a change in policy. From incubation time to testing to results. Usually, we count two weeks to be sure.
Also people ditch the mask when they are "close enough" to the day. I saw the masks drop as early as a month before that date. I really don't think 100% of the shoppers in my grocery stores were vaccinated.
There are many coincidences and spurious correlations in the world. It's informative to propose a falsifiable mechanism behind a correlation which can be tested independently.
I could reframe your hypothesis in a falsifiable way such as "perhaps ending lockdowns in the UK caused individuals to spend more time outdoors or in open air restaurants rather than smaller closed doors activities such as dinner parties", or "perhaps ending lockdowns in the UK caused people to spend more time in other locations rather than large shared ventilation apartment complexes".
More likely the causality goes the other way: if the models hadn't predicted (as they did) that cases would peak around that time, "freedom day" would have been scheduled for later.
> “Something strange is happening in Britain,” the Washington Post declared this week. “COVID cases are plummeting instead of soaring.” A few weeks ago, when the country’s new daily-case total was around 60,000, the prominent British epidemiologist and government adviser Neil Ferguson declared that a rise to 100,000 a day was inevitable, and that 200,000 a day was possible. The country is now at 27,000 and falling.
That's showing hospitalisations rather than cases, and most scenarios show the peak in early August. Hospitalisations lag cases, and it looks like early August will be right: we haven't seen the peak yet.
It's bit early to be sure yet (the UK fall in cases has slowed greatly in the last week), but if that turns out to be true "the models predicted that cases would peak around that time" would still be OK for the purposes of this thread: the point is that it's unsurprising that cases began to fall within a week or two of "freedom day".
The shape of the curve in the UK[1] is very unlike most viral transmission models.
Most models predict initially exponential growth of rate of infection per day, before a flattening off to a steady number of cases per day,and eventually a declining number of cases per day.
Yet in the case of the UK. there is exponential growth, followed by very sudden exponential decay, with no gradual flattening off phase.
It appears that the sudden "switch" is likely caused by a large unmodelled effect.
Possible causes I see:
* Schools stopped on that day, and >half the transmission was occurring in school age children mixing with their peers. That would cause the graph we see.
* Schools stopped that day, and lots of people were only testing themselves as a requirement for attending school. Now that school is over, they have stopped testing. That would also cause the graph we see, but real infection rates would now be higher than suggested by test results. this hypothesis is backed up by the daily number of tests done seeing a big shift (previously few tests were done on friday and saturday, now it's more even).
* The weather changed and now people are spending more time outdoors, reducing transmission.
* It's summertime and a lot of people are taking summer breaks rather than working.
* Another variant, or maybe a totally different virus, is spreading which isn't picked up by current tests (and displacing the current one by causing cross-immunity).
Neil Ferguson was a hack at the beginning of this pandemic, and he's a hack now. Absolutely bunk science. Glad that the media can now at least tell the truth.
Just want to point out so much of what we are doing now is essentially because of his suggestions.
I thought it was pretty obvious that the reason why our last wave here in the Netherlands has dropped as quickly as it rose is that we first let go of too many restrictions too fast and then immediately reinstated the biggest ones. Basically all the kids were going to festivals for a week or two before the government finally realized that was a bad idea until we've vaccinated them as well and we should still apply some restrictions.
I read this and think it's well written. I see it's published in The Intelligencer, which is apparently an offshoot of NYMagazine. I'm not particularly familiar with either, but I hadn't realized that news-type things would be discussed in them.
Does anyone here have anything to say about their quality or their relevance to people who don't live in NY?
New York Magazine is certainly centered on New York City, but like many other New York-named publications (including the unrelated New York Times newspaper and the New Yorker magazine), it is actually national in scope. And many of the stories can even be international, insofar as culture and a not insignificant American export.
It has always been well-regarded, think of it as a more puckish New Yorker (although in recent years, The New Yorker has certainly taken on more personality, especially online), and I would argue, was one of the first “prestige” magazines to really embrace online and digital expansion. It took until well into the 2010s for a lot of the Condé Nast and Hearst publications to even integrate their digital and print newsrooms, with digital often being treated as an afterthought. New York Mag really embraced online early and as a result, didn’t have the same identity issues once the bottom dropped out of print’s profitability. It used to be a weekly magazine but swapped to biweekly seven or eight years ago.
I’ve been a subscriber since I was in college (which was before I moved to New York City), which coincided with the online push and the reign of editor-in-chief Adam Moss (who was EIC from 2004-2019), and since 2004, I believe NYMag has won more National Magazine Awards (which are sort of the magazine world’s equivalent of the Pulitzer Prizes, albeit with less prestige) than any other publication.
There are several “verticals” for New York Mag, which include Vulture (culture), The Cut (lifestyle and more of a focus on women), Grub Street (restaurants and bars), Intelligencer (tech, politics, ideas).
Vox bought the magazine a few years ago, but it operates relatively independently from the other Vox media sites (Vox, The Verge, etc.), at least as far as editorial content goes. (I’m sure they share resources like HR and some ad sales stuff, same as Conde and Hearst and Meredith.)
*I don’t and have never worked at New York Mag, but as a former New York City-based journalist, I have friends who do or have worked there and I’ve met Pam Wasserstein, the former CEO (current president of Vox Media), socially a few times.
One would never know by reading the headline of major UK newspapers that cases are going down. When cases are up, you get alarming headlines. When cases are down, the same newspapers will find something else to be alarmed about. Thanks god there is internet, and I can follow the underlying numbers directly.
I see lots of guesses about the decline in the U.K. usually one of:
1. Schools closing (~2 weeks earlier in Scotland than England)
2. Euros [football tournament] ending (Scotland fell out ~2 weeks earlier than England)
3. Hot weather (leading to events outdoors or more ventilation or less going out or something else bad for the virus)
4. The “pingdemic” where the contact-tracing app tells many people to self-isolate
5. The end of a big burst of weddings scheduled when restrictions were due to ease
6. Herd immunity
7. Maybe lots of people went on holiday and mostly kept to themselves.
8. Some statistical anomaly hiding case numbers that are not falling (eg fewer tests->fewer total positive cases)
I don’t really believe 7 or 8 and everything else feels too unsupported. Perhaps time will tell what the cause is but I think I am weakly optimistic about current trends. We shall have to see.
"Ferguson looks foolish now"
Ferguson has looked foolish for over 20 years, every public pronouncement he has made has been pessimistic by orders of magnitude. Why the government and the public still listen to this charlatan is a mystery.
The idea that a “nasal vaccine” would help stop nasal infections is so laughable. However you deliver the vaccine, it’s an antibody generator. That’s part of the adaptive immune system, not the innate system that the nasal mucus membrane is part of. The antibody response kicks in long after nasal exposure, when the virus has proceeded on past the mucus membrane and begun multiplying in cells all over the body.
People in the summer in the UK spend plenty of time outside, I would think the winter is when things get interesting again. Let’s hope we’re out of the woods but the luck of the uk government isn’t something I’d bank on!
>all the more conspicuous for happening just two days after the country’s pandemic restrictions were [...] lifted
Lateral flow tests just happened to run out on the day restrictions were lifted. [0] And tada numbers plummet right when gov is taking massive heat for dropping restrictions in the middle of a surge.
Yes really - that is how the current UK gov rolls.
The fact that the author is trying to extrapolate other countries future trajectory based on that is rather amusing.
There are plenty of tests available since then, we picked some up recently. This was a temporary blip, if anything. You can see the testing rate on the gov dashboard [0] and it hasn’t really changed enough to account for the fall in cases.
Do we have conclusive numbers on how long these vaccines last? I’m reading that Pfizer lasts about 6 months? There’s no way there won’t be a surge again next summer if that’s the case.
There are no conclusive numbers on how long they last, because there has not been a significant drop-off in efficacy yet.
There is some evidence that booster shots after 6 months can provide better even better protection than the second shot after 3-4 weeks, but it's not clear whether they will be necessary yet, especially when so much of the world is still desperate to get the first two shots in peoples' arms.
There's been enough drop-off in the Pfizer vaccine that Israel is starting boosters for people 60+. Their estimate is that protection against mild disease has dropped to 40% and protection against hospitalization to 88%. https://swprs.org/covid-vaccines-the-good-the-bad-the-ugly/
There has been shown a little bit of drop-off, but that is in the range of 95% to 80-90%, so still strong. Hard to say because the mutation in circulation have changed.
> thanks to widespread vaccination of the elderly, however fast this disease spreads it will ultimately inflict a much, much smaller death toll than earlier waves, because vaccination has probably eliminated 90 percent or more of the country’s total COVID-19 mortality risk.
This claim does not appear to be grounded in any factual basis: A double-blind randomized trial for an mRNA vaccine with 44k participants showed nearly identical all-cause mortality in vaccinated vs. placebo groups after six months [1]. The delta wave will almost certainly be less fatal, but there is no evidence to indicate that widespread vaccination is the primary causal factor, or even a contributing factor, for the reduced mortality.
That is a dramatic misrepresentation of that preprint. The number of deaths is small enough that it is hard to draw inferences from it, and that was not the endpoint of the study. Rather, the key finding is a vaccine effectiveness of 97% against severe disease.
A preprint that did address deaths[1] found a vaccine effectiveness of 98.7% against death. This is not consistent with your claim of "no evidence."
That preprint is not an RCT. The study I cited is an RCT. And the RCT shows no effect on deaths.
And yes, it does show a dramatic effect on infections and serious illness. This is great, and we should shout it from the rooftops! But a journalist writing that vaccines are the reason Covid mortality will drop 90% is projecting, not reporting facts.
> This claim does not appear to be grounded in any factual basis
No factual basis in that paper but you seem to be saying "no factual basis at all" which is flat-out wrong, indeed basing such a claim on one paper is disingenuous: Absence of evidence in 1 chosen paper is not evidence of absence in general.
You only have to compare the linkage between cases and deaths in UK waves 1 and 2, with the much lower level of deaths for comparable numbers of cases in wave 3, to see the "much, much smaller death toll" staring you in the face.
Your chosen paper is also largely irrelevant before we even get there; it's about mRNA vaccines, whereas the UK's program has leaned heavily on AZ, which is not.
While this is a literal interpretation of all-cause mortality from the paper, I’m not sure this is the right take away.
There was such a dramatic reduction in overall cases in the vaccination group that deaths are probably more statistical noise in both groups than being tied to covid one way or another.
Currently deaths and cases have diverged dramatically in the population and this might be more indicative of the real world vaccine performance as it pertains to reducing death.
In this study the vaccine reduced Covid-19 infection rates by like 90%, and essentially eliminated severe cases. This is great!
But the same number of people died in each group. So vaccines do not reduce Covid-19 mortality, period. Does this mean vaccines are a waste of time? No, of course not! It just means we should be precise and correct in the claims we make based on statistics, and not fudge them to say things that sound good but are not true.
EDIT: Fair enough, I'm making the same sloppy mistakes... this study doesn't say anything, positive or negative, about vaccine effects on mortality. But it certainly doesn't support the journalist's claim. It does support the claim that vaccines dramatically reduce infection rates and severity, which is great and reason enough to get vaccinated.
I don’t follow the logical leap. It’s clear the paper doesn’t demonstrate a difference, you’re right.
I do think it’s disingenuous to say that the vaccine categorically doesn’t prevent deaths, if it can prevent infections that would lead to deaths, that’s a good outcome. Additionally, the real world performance in the general population is showing a massive divergence in deaths and cases in elderly populations after the coverage of vaccines. That may be from some other variable and not vaccines, but I’m not sure that I would be able to suggest an alternative cause.
Did I categorically say that the vaccine doesn't prevent deaths? I simply cited a study which shows no effect, and scolded the journalist for making a claim that doesn't seem to have solid scientific support. I'm not making a statement about vaccines, I'm making a statement about journalists playing fast and loose with science.
> That may be from some other variable and not vaccines, but I’m not sure that I would be able to suggest an alternative cause.
This is why we do science. Your lack of imagination about causal relationships is not evidence for or against any particular causal relationship.
2 people in the placebo group died with a covid infection and 1 in the vaccinated group. That is way to little data to even remotely make such a bold claim.
Or, if I follow your flawed logic, Covid vaccines reduce mortality by 50%!
The bold claim is the journalist in this article who said that vaccines are the reason we should see a 90% reduction in mortality. That is an optimistic projection, not a fact-based statement. That's all. Christ, people think I'm anti-vaccine just for being pedantic about science reporting...
Pasting the rebuttal to that point from the comments of the linked paper:
Those are all-cause death. The number of covid-related deaths were 2 in the placebo and 1 in the vaccine arms. There simply weren't many covid deaths during this part of the trial (probably because most of the participants were <55 years old).
Median age was 51, so seems like there would have been at least a decently sized cohort over 55 (although I don't have to actual data to confirm).
But anyways, my original point was that the journalist is being dishonest by claiming that vaccination among the elderly is the reason mortality should drop by 90% compared to prior waves. This RCT certainly doesn't provide any evidence to support that statement, and it is the largest study of its kind so the only conclusion I can make is that the journalist is just projecting without facts.
This does not seem like a useful source to draw this conclusion. 14/15 persons of both group died, but I do not see whether it was related to Covid. edit: 2 unvaccinated people with covid died 1 vaccinated. Point stands.
45.000 people is simply too small a number to draw such a conclusion. However, we are currently collecting a large amount of worldwide data, and that shows very strong reduced mortality and hospitalization on the vaccinated population. This is much higher quality data to draw conclusions on.
It may also be the case that those inclined to be skeptical of vaccines were also the ones who exposed themselves to infection most during the pandemic, through disdain for social distancing, mask-wearing, etc. In other words those still unvaccinated in Western countries with easy access to vaccines have a pretty good chance of having been infected by now.
Adding those two populations together would seem to indicate that most Western populations are already at herd immunity by this point, which would mean that these surges can be reasonably expected to become smaller and smaller. Unless of course some totally new variant capable of evading all existing vaccines and immunity from prior infection emerges.