Covid-19 #34 - Alpha, Delta, It’s All Greek to Me!

[Padraig]

4 hours ago, Week said:

What a shocking turn of events. Those that crowed about nearing herd immunity and irrelevance of case rates were wrong - as was pointed out - all along. Herd immunity is a pipe dream and new cases, in any significant number in any population, lead to variants that increases the risk of dangerous variants. 

We can always hope that it will mutate into something that is even more transmissable but not at all serious.   Probably not particularly likely but I don't believe it has to become more dangerous.

6 hours ago, The Anti-Targ said:

Interestingly though, with the tight border restrictions the effect on the economy has not been loss of jobs and increased unemployment. It's lots of job vacancies and no one to fill them. We are basically at the capitalist definition of full employment (4% unemployment).

Some jobs must have been lost though?  So what industries grew to compensate?  I'd say health care but you didn't have COVID like the rest of the world.

In unrelated news, Germany has effectively revealed what vaccines are being lined up for 2022.  For a population of 85m, it expects 205m vaccines.  One could extrapolate to an EU level and get around 1.1bn doses.  But they also gave the manufacturers.  450m Pfizer/Biontech, 150m Moderna, 150m Sanofi, 150m Novavax, 100 J&J, 50m Valneva.  Roughly.

https://finance.yahoo.com/news/1-moderna-j-j-bulk-180203222.html

And that ignores options.  Obviously, only 3 of those are approved.  No Aztrazeneca, which is hardly a surprise.  Or Curevac.  The latter is looking at a second generation vaccine, which will see trials begin in Q3, so it may return at some stage.   There is an outstanding order for 220m doses, so i'm not sure what happens with that.  It will at least need an approved vaccine.

Given J&J's issues, i'm a little surprised it remains on the list.  But there are still advantages of a 1 dose vaccine and we know a lot more about the blood disorder issues by now.  They obviously did well on the lobbying front.

I don't think the Novavax order was ever officially signed but, given the provisional agreement, we weren't going to see many doses until 2022.  It is interesting to see Valneva back.  The demise of Curevac probably helped.  Being French probably helped too!  There is an article below about its return.  It will be interesting to see how the contract will be constructed given the EU's concerns regarding it being made (mainly) in the UK.  But its not like it is getting an AZ sized order.  And it is good that different technologies are being encouraged.  2 mRNA, 2 Subunits (Novavax and probably Sanofi but it also has a mRNA vaccine in the pipeline), 1 adenovirus and 1 inactivated.

https://fortune.com/2021/06/30/france-valneva-covid-19-vaccine-eu-deal/

Quote

Unusually, the candidate isn’t being compared with a placebo. It must show superiority to Astra’s vaccine on a two-dose schedule given four weeks apart based on immunogenicity data rather than efficacy—the number of infections prevented—as Astra’s has already been shown to protect against symptomatic COVID-19.

The trial was further complicated by the U.K.’s decision to restrict use of the Astra shot to people over age 30 when the trial started and later to the over-40s due to the risk of rare blood clots. For that reason, younger adults in the study have only received the Valneva inoculation.

 

[Week]

1 minute ago, Padraig said:

We can always hope that it will mutate into something that is even more transmissable but not at all serious.   Probably not particularly likely but I don't believe it has to become more dangerous.

I'm using the term dangerous in reference to relative danger to people - including both virulence and transmission. Certainly it's more likely to be the latter. 

[Altherion]

6 hours ago, The Anti-Targ said:

I read an article that quoted one of our leading epidemiologists who has said he thinks with the delta and other more contagious variants that we may never reach herd immunity. His modelling indicated that to get to herd immunity with the new variants needs >95% vaccination in the population, which is basically impossible.

That number does not seem plausible. 95% is comparable to what is required for measles and the latter is way more contagious than any coronavirus variant. Something was probably misunderstood somewhere along the way.

[IheartIheartTesla]

But measles doesnt mutate the way COVID does, so that does bring up the percentages required for that elusive beast 'herd immunity'.

Still, I havent heard about 95% (which is basically the same number as that touted for measles, making one suspicious). I think some experts think that instead of 70%, it may be closed to ~85%

[Impmk2]

Possible source of confusion when people start throwing around these numbers is eligibile adults (most countries are only vaccinating 16/18+) vs total population.

95% of the adult population may well only be 80% of the total population in many countries. Which would be far from the rate required to give herd immunity from measles.

[SpaceChampion]

First vaccine dose on Cinco de Mayo, second dose on Canada Day! today.

[Padraig]

Overall things look increasingly fragile.  The Atlantic has a long article on Delta.

Quote

Worryingly, a recent study documented several cases during India’s spring surge in which health-care workers who were fully vaccinated with AstraZeneca’s vaccine were infected by Delta and passed it on.

Politico has the state of play in Europe on the vaccination front as we enter the second half of the year. 

More on vaccine negativity in Romania.  At 24% full vaccination.  It has sold 1m Pfizer doses to Denmark because there is no demand and it has halted further imports (except J&J).

Spikes in COVID are cropping up all over the place now (although some countries are still showing decent declines).  The European football championship is definitely not helping, with even well performing countries like Finland suffering from having games in Russia.

https://yle.fi/uutiset/osasto/news/thl_chief_more_than_half_of_finlands_cases_linked_to_st_petersburg_returnees/11999546

Cases are going to go way up.  Lets just hope hospitals are spared the worst of it.  But that's not mentioning the increasing cases in Africa now, while South America is still doing badly.

[The Anti-Targ]

The big difference, I think, comparing measles and COVID-19 is that with a measles vaccination you are immune from both illness and becoming contagious. Whereas with the COVID-19 vaccine you are not protected from becoming mildly ill, nor does it completely stop you from being infectious. Therefore you can't just look at the basic R number for Measles being 16 (I think) and the basic R number of the Delta variant being 6 (according to the article I read) and say the herd immunity level for the Delta variant must be lower than for measles.

So, for measles in a 100% vaccinated population the R number will be almost zero. For COVID-19 in a 100% vaccinated population the R number is >0.

If the Delta variant R number in the COVID-19 vaccinated population is, say, 0.5, but the measles R number in the measles vaccinated population is, say, 0.05 then this changes the herd immunity dynamic between these two diseases quite substantially. Even if the difference is 0.3 vs 0.1 it still makes a difference in how you figure out the herd immunity vaccination rate.

 

[Gorn]

On 6/30/2021 at 1:42 PM, DireWolfSpirit said:

I feel like public health agencies and governments need to adopt more of a club attitude and stop pussyfooting around with carrot incentives.

Maybe a host of penalties or denied privileges if you aren't getting vaccinated.

Not vaccinated then no DMV license renewals, not vaccinated then delayed tax returns, not vaccinated then no admittance to health facilities, not vaccinated then no passports, no use of airports, no use of public transport, no federal or state employment and so on and so forth with whatever penalties they can come up with. It's a legitimate public health threat to have these unvaxxed idiots floating around.

It's time to take a farrrrr more forceful stance with these non compliants. 

I don't know, I'm strongly pro-vaccination, but what you're suggesting makes me seriously uncomfortable. I take individual bodily rights seriously - being pro-choice is not just about abortion, if you understand my point. People have the right to choose what to do with their bodies, even if those choices are objectively wrong. 

[Prue]

It would probably suffice to demand current negative tests from all of those who aren't vaccinated, for all sorts of events/locations and to travel. Tests that everybody who could have had a vaccination would have to pay for. Whereas vaccination should remain free. Saving money is a good incentive.

[RhaenysBee]

Today we’ll reach 5.5 million vaccines (first,  not both). That’s less than 60%, worlds away from herd immunity. And on the following day, masks won’t be mandatory ANYWHERE, except for hospitals and doctor’s offices. Public transport will be mask free. I am very close to actually crying. 

 

[DireWolfSpirit]

2 hours ago, Prue said:

It would probably suffice to demand current negative tests from all of those who aren't vaccinated, for all sorts of events/locations and to travel. Tests that everybody who could have had a vaccination would have to pay for. Whereas vaccination should remain free. Saving money is a good incentive.

Eta: wrong quote

[DireWolfSpirit]

4 hours ago, Gorn said:

I don't know, I'm strongly pro-vaccination, but what you're suggesting makes me seriously uncomfortable. I take individual bodily rights seriously - being pro-choice is not just about abortion, if you understand my point. People have the right to choose what to do with their bodies, even if those choices are objectively wrong. 

Do you think people with the HIV virus should be free to practice unsafe sex? Or should it just be their right to choose with a behavior that can endanger the innocent.

From my perspective choosing to not vaccinate endangers the innocent, I'm good with heavy penalties on people that endanger the rest of the public, similar to DUI measures might be another appropriate approach imo.

[Heartofice]

2 hours ago, DireWolfSpirit said:

Do you think people with the HIV virus should be free to practice unsafe sex? Or should it just be their right to choose with a behavior that can endanger the innocent.

From my perspective choosing to not vaccinate endangers the innocent, I'm good with heavy penalties on people that endanger the rest of the public, similar to DUI measures might be another appropriate approach imo.

Sorry this comparison doesn’t work. HIV is basically deadly to everyone who catches it. Covid is mostly harmless to the majority of people who catch it. 
 

If you vaccinate those in the at risk demographics then you have basically protected them. That’s where the focus should always be.

[Gorn]

5 hours ago, DireWolfSpirit said:

Do you think people with the HIV virus should be free to practice unsafe sex? Or should it just be their right to choose with a behavior that can endanger the innocent.

From my perspective choosing to not vaccinate endangers the innocent, I'm good with heavy penalties on people that endanger the rest of the public, similar to DUI measures might be another appropriate approach imo.

So you think denying emergency appendectomy to someone for reasons of "being a dumbass" is a proper and measured response?

The number 1 thing that vaccines do is protecting the person being vaccinated from disease. If someone chooses to forgo that protection, well, I'm fine with the consequences of their choice catching up to them when the next wave comes. What I'm not fine with is going to "fascist dystopia" levels of societal response.

[Gorn]

Or to put it in other words: remember the start of the pandemic, when idiots were comparing Covid to a flu or a common cold? Well, for vaccinated population, that is literally true right now. If you're fully vaccinated, your risk of death or serious illness from Covid is now somewhere between "seasonal flu" and "common cold" levels.

From this point on, Covid is mostly unvaccinated people's problem (at least in the Western countries with easy access to vaccines). And if they want to keep going as they are, natural selection will take care of things.

[A wilding]

Yes we can hope that this is true (though we should not forget the vaccinated vulnerable), but we do need to remember the risk of further mutation.

For example, the Delta variant has already evolved to the point where people who have has only one vaccination are still somewhat vulnerable. And right now this variant is basically being allowed to run rampant through the UK, which currently has some 45 million people who have had only one vaccination. As an attempt to push it into evolving to be more resistant to vaccines this could hardly be bettered.

[ljkeane]

15 minutes ago, A wilding said:

And right now this variant is basically being allowed to run rampant through the UK, which currently has some 45 million people who have had only one vaccination. 

Er, it’s about 12 million people.

[Altherion]

12 hours ago, The Anti-Targ said:

The big difference, I think, comparing measles and COVID-19 is that with a measles vaccination you are immune from both illness and becoming contagious. Whereas with the COVID-19 vaccine you are not protected from becoming mildly ill, nor does it completely stop you from being infectious. Therefore you can't just look at the basic R number for Measles being 16 (I think) and the basic R number of the Delta variant being 6 (according to the article I read) and say the herd immunity level for the Delta variant must be lower than for measles.

So, for measles in a 100% vaccinated population the R number will be almost zero. For COVID-19 in a 100% vaccinated population the R number is >0.

If the Delta variant R number in the COVID-19 vaccinated population is, say, 0.5, but the measles R number in the measles vaccinated population is, say, 0.05 then this changes the herd immunity dynamic between these two diseases quite substantially. Even if the difference is 0.3 vs 0.1 it still makes a difference in how you figure out the herd immunity vaccination rate.

Your point is partly taken, but some of this is not entirely correct and some we do not know yet. First, with the Pfizer and Moderna vaccines, you are protected from becoming mildly ill and/or infectios to a considerable degree. The studies reporting efficacy in the 90s and 80s are for becoming infected, not for becoming symptomatic (there's a long list in the middle of this article from the end of May). Second, the vaccinated people who do become infected are significantly less infectious than they would be if they were not vaccinated (it's not clear exactly how much though). Third, transmission from one fully vaccinated person to another is very rare.

In other words, the mRNA vaccines are not quite as good as the measles vaccine, but they're not that far off. If every adult was vaccinated, R would not quite be 0, but it would be low enough to end community transmission pretty quickly.

1 hour ago, Gorn said:

Or to put it in other words: remember the start of the pandemic, when idiots were comparing Covid to a flu or a common cold? Well, for vaccinated population, that is literally true right now. If you're fully vaccinated, your risk of death or serious illness from Covid is now somewhere between "seasonal flu" and "common cold" levels.

This is not true for everyone. There is a variety of conditions which require medicine that suppresses the immune system. For example, for people with organ transplants, there's a fairly large chance that the vaccine has no effect at all. Unfortunately, these people are also the ones who are almost guaranteed to have serious complications from the disease and have a dramatically higher chance of dying. In fact, they would have the same issue with other infectious diseases except that we've vaccinated pretty much everyone for everything else.

[Zorral]

"White House launches ‘surge response’ teams to delta variant hot spots
Highly transmissible variant remains ‘greatest threat’ to U.S. response, officials warn"

https://www.washingtonpost.com/health/2021/07/01/surge-response-teams-delta-variant-covid/

Quote

 

. . . .The highly transmissible variant, first identified in India, is the “greatest threat” to ending the U.S. outbreak, posing special risk to unvaccinated people, the nation’s top infectious-disease expert, Anthony S. Fauci, said last week. Los Angeles County public health authorities this week urged vaccinated, as well as unvaccinated people to wear masks again inside restaurants, stores and other public indoor spaces.

The White House-coordinated teams will include a mix of virtual support and on-the-ground personnel, helping deploy additional supplies as requested by local officials, such as testing or therapeutics. Staff will come from the CDC, the Federal Emergency Management Agency and the Office of the Assistant Secretary for Preparedness and Response in the Department of Health and Human Services. The White House also may ramp up paid promotions about the benefits of vaccination in areas that officials deem high risk. All the vaccines authorized in the United States have been shown to be highly protective against the virus, preventing severe illness and death from the delta variant.

The CDC already has deployed a response team to Mesa County, Colo., which has experienced a surge of cases linked to the variant. That team is helping support state officials’ efforts to investigate the spread of the outbreak. Another team is preparing to deploy to Missouri. . . .

 

It's so frustrating, what I hear via professional-friendship associated circles.  Things like this, "My unvaccinated daughter's family [in Utah] went to a big family reunion in Colorado.  Many people at the reunion are sick with Covid.  My daughter and grand-daughter came down with it four days after getting back here.  They are really sick, though at home.  They've been really sick for two weeks now.  I'm trying to help by leaving off food."  And so on and so forth.  None of this would have happened if her stupid daughter and family had gotten vaccinated.  But they wouldn't. Yay tRumpty and God and protect my fertility!