Covid-19 #41: Collateral Damage

[Paxter]

24 minutes ago, The Anti-Targ said:

So have we been pretty immune, and I believe Australia.

The Labor States have been fighting the Feds tooth and nail on Covid. Even just this week the Aus PM was lambasting WA for its border policy. 

I mean, yeah, we aren’t talking Biden v De Santis but I wouldn’t say Australia has been immune politically or even close to it. They’ve just had a better pandemic, not least because of geographic positioning and historically strong border controls, as well as a fantastic health care system. Culturally we also have no problem with vaccines, which helps.

[Zorral]

"Covid cases are surging in Europe. America is in denial about what lies in store for it
The US thinks it will be ‘immune’ to what is happening in Europe. That’s wishful thinking"

https://www.theguardian.com/commentisfree/2021/nov/12/covid-cases-surging-europe-america-denial

Quote

 

.... That brings us to the United States, sitting in the zone of denial for the fourth time during the pandemic, thinking that in some way we will be “immune” to what is happening in Europe. That somehow the magical combination of mRNA vaccines with only 58% of the population fully vaccinated, a relatively low proportion of booster shot uptake, a start to vaccinating teens and children, and a lot of prior Covid, and little in the way of mitigation, will spare us. ...

.... We are already seeing signs that the US is destined to succumb to more Covid spread, with more than three weeks sitting at a plateau of ~75,000 new cases per day, now there’s been a 10% rise in the past week. ...

.... Now is the time for the US to heed the European signal for the first time, to pull out all the stops. ....

 

We won't though.

Also that idea of 'natural immunity' acquired through infection -- does not seem to be working, particularly not with Delta.  Also that 'natural immunity' fades much more quickly than does that from vaccination.  Beyond that too, it seems that at least 75% of a pop has to be vaccinated ... which includes children and adolescents, which it seems are driving up the infection rates in the UK.  And ... maybe here. Schools in NYC are closing again due to covid.

I am really hoping that here in the City at least, enough parents will want their kids to be vaccinated ... and kids who want to be, to help contain the coming 4th wave.  Yesterday I was hearing all sorts of kids' voices who called into the public radio station abut why they want the vax, why they got it or are getting it.  They came through as infinitely more intelligent, informed and articulate than your average gop legislator.

 

[rotting sea cow]

1 hour ago, JoannaL said:

It will be very interesting if high-vaccinated countries will be able to evade the next wave.

also, I think there is this far-off, sunlit other side. Perhaps some of the careless countries, with higher infection rates,  like UK, or Florida? will reach it as well soon. In the end immunization by infection will be better anyway. Some known virologist here said, that a yearly infection of everyone (like with the normal cold) will get us back on track to a normal life. The same virologist also strongly emphasized that if you meet the coronavirus in the end , you should definitly be vaccinated beforehand. So because about 15 mio idiots here dont get it, ours will not be a country on the other side soon.

Well, some random town in Ireland with the highest vaccination rate has also the highest incidence. Some random doctor speculates that it's the lack of natural immunity as that region hasn't been hit hard by COVID in previous waves.

https://www.irishtimes.com/news/ireland/irish-news/lack-of-natural-immunity-sees-waterford-hit-hardest-in-fourth-covid-wave-gp-says-1.4721710

Cases are building up in Portugal, Spain, Italy and elsewhere, we'll see soon enough how it pans out.

I don't think things will get as bad as in Romania, but Germany is in the way of having a winter as bad as the last one. Which is weird because we were speculating last year that vaccinating the 20% (the elderly) will solve 80% of the problem (Germany average COVID death age is 80 years). But now even vaccinating the 80% is not enough to prevent large surges and overwhelm the hospitals.

[Paxter]

2 minutes ago, rotting sea cow said:

I don't think things will get as bad as in Romania, but Germany is in the way of having a winter as bad as the last one. Which is weird because we were speculating last year that vaccinating the 20% (the elderly) will solve 80% of the problem (Germany average COVID death age is 80 years). But now even vaccinating the 80% is not enough to prevent large surges and overwhelm the hospitals.

I would still argue that vaccination has been pretty great at harm reduction, it just isn't enough on its own to stop intolerable pressure on health systems and certainly not enough to end the pandemic. Perhaps that will change as population-level vacc rates increase, but I'm not convinced. 

I read today that the CDC has officially (and finally!) stopped aiming for any particular level of "herd immunity". 

[Altherion]

13 minutes ago, Zorral said:

"Covid cases are surging in Europe. America is in denial about what lies in store for it
The US thinks it will be ‘immune’ to what is happening in Europe. That’s wishful thinking"

How many people are actually in this state of denial and wishful thinking though? We can all see that even in the most vaccinated states (e.g. Vermont), the number of cases has increased as the weather has gotten colder and it will almost certainly increase again with the holidays. The problem is that the CDC and FDA have more or less told people that they don't need boosters yet unless they're over 65 or have underlying medical or occupational risks so the booster uptake is relatively low.

The good news is that, as far as I can tell, the booster eligibility guidelines are pretty much being ignored by the vaccine providers. I got mine last Tuesday in preparation for Thanksgiving and nobody at the CVS asked me anything. I had also checked a Walgreens site and that did ask for a check mark saying that either one either has a medical or occupational risk, but it was worded so vaguely that pretty much anyone could answer Yes to the occupational part truthfully.

[Zorral]

5 minutes ago, Altherion said:

We can all see that even in the most vaccinated states (e.g. Vermont), the number of cases has increased as the weather has gotten colder and it will almost certainly increase again with the holidays.

And seemingly driven by, as quoted previously earlier in the week, driven by unvaccinated college students doing Halloween parties -- and we're now in the party season.  All those northern midwestern and Rocky Mountain states where Delta is currently and has been for weeks and weeks are are filled with virulent antimaskers and anti-vaxxers -- don't think their college age kids are different, and those parents aren't about to get their kids vaccinated:  

Quote

....children and adolescents, which it seems are driving up the infection rates in the UK.  And ... maybe here. Schools in NYC are closing again due to covid.

[JoannaL]

19 minutes ago, rotting sea cow said:

Well, some random town in Ireland with the highest vaccination rate has also the highest incidence. Some random doctor speculates that it's the lack of natural immunity as that region hasn't been hit hard by COVID in previous waves.

https://www.irishtimes.com/news/ireland/irish-news/lack-of-natural-immunity-sees-waterford-hit-hardest-in-fourth-covid-wave-gp-says-1.4721710

Cases are building up in Portugal, Spain, Italy and elsewhere, we'll see soon enough how it pans out.

I don't think things will get as bad as in Romania, but Germany is in the way of having a winter as bad as the last one. Which is weird because we were speculating last year that vaccinating the 20% (the elderly) will solve 80% of the problem (Germany average COVID death age is 80 years). But now even vaccinating the 80% is not enough to prevent large surges and overwhelm the hospitals.

Its quite easy to calculate. If everyone gets the virus till May (and most experts think so, if we dont go into lockdown, and perhaps even then, its delta, last winter it was the wildtyp) then thats 3 mio  unvaccinated adults older than 60 who will get infected. Lets say of these 3 % need medical care and half of these die, than thats 45000 deaths (just out of stupidity). you can add to that the ones with waning vaccination protection because old age, and because they didnt get the booster in time , and then the ones of the other 12 mio unvaccinated adults under 60 years (how likely is it to get a bad outcome? lets say 0,001?) all in all that could mean another 100000 deaths altogether until May , most of which could have been averted. Its so stupid and frustrating.

the vaccination of the old is still the way to go, if you compare the second wave (Dez/Jan) with the third - alpha-wave (March-May) , you will find the the infection to deaths ratio was much improved (roughly 60000 died in the second wave and 15000 in the third wave), though the infections number was comparable. This is because of vaccination, our vaccination rate in April /May (in the third wave ) was not high (lets say 10%? ),but we started with vaccinating the old and vulnerable and the effect on the death rate was immediate

[Gorn]

57 minutes ago, Zorral said:

Also that idea of 'natural immunity' acquired through infection -- does not seem to be working, particularly not with Delta.  Also that 'natural immunity' fades much more quickly than does that from vaccination. 

Actually, according to this study from Israel, it's the other way around. Previous infection + vaccine > previous infection alone > vaccine alone.

[Zorral]

Other studies say otherwise. Wotcha gonna do?

Other studies say this.

IOW, no matter what, getting vaccinated is the best defense against getting severely ill, hospitalization and / or death from covid.

[Gorn]

37 minutes ago, Zorral said:

Other studies say otherwise. Wotcha gonna do?

Other studies say this.

IOW, no matter what, getting vaccinated is the best defense against getting severely ill, hospitalization and / or death from covid.

Have you read the link you posted? It doesn't contradict anything I wrote. In fact, it confirms that immunity from vaccine + previous infection > vaccine alone.

Dismissing natural immunity, like you seem to be doing, is baseless and unscientific.

[HoodedCrow]

The thing is, you will not want to be dead or impaired from getting Delta, and then get the vaccine. However, if you survive, it is still good to be vaxxed. Am I mistaken?:)

[Padraig]

2 hours ago, JoannaL said:

the vaccination of the old is still the way to go, if you compare the second wave (Dez/Jan) with the third - alpha-wave (March-May) , you will find the the infection to deaths ratio was much improved (roughly 60000 died in the second wave and 15000 in the third wave), though the infections number was comparable.

That's a good example.  And why I think we maybe ok this winter.  But Delta is clearly showing how virulent it is.  So we are getting a lot more infections than the previous variants.  Partly neutralising some of the benefits of vaccination.

Did they ever decide whether Delta is deadlier or not?  It causes more illness, so leads to more deaths either way, but individually, I can't remember if you are more likely to get a serious case if you have Delta.

3 hours ago, rotting sea cow said:

Well, some random town in Ireland with the highest vaccination rate has also the highest incidence. Some random doctor speculates that it's the lack of natural immunity as that region hasn't been hit hard by COVID in previous waves.

Interesting.  I think natural immunity is playing a role.  Germany didn't have much of a summer wave but it is hit twice as hard now.  Similarly Romania.  Spain had a bad summer wave and now its one of the best countries in Europe.  Vaccination plays a role in that performance but the bad wave in summer probably helped get more people vaccinated also.

Ireland is a different case though.  We never got the summer wave under control (as we kept loosening restrictions) and went straight into the winter wave.  If you are vaccinated but you are in constant contact with people that have COVID, then you are going to get a breakthrough case.  That would be an interesting measure now.  Socialisation by country.  See is that a driver, now that restrictions are loosened.  I think Ireland would score quite high but who knows.

But the one demographic that is seeing a reduction in cases at the moment in Ireland is the 75+.  Presumably because of boosters.   And they are also more careful.

Booster numbers are quite low for most countries though.  Single digits.  In the US it is at 8%. Germany 4%.

28 minutes ago, Gorn said:

Have you read the link you posted? It doesn't contradict anything I wrote. In fact, it confirms that immunity from vaccine + previous infection > vaccine alone.

Yes.  I think the science has been very clear on this for the last 6 months.  Given Delta is so virulent, it is very difficult to avoid COVID, but if you are vaccinated, your risk factors are hugely improved and you are unlikely to get COVID for quite a while (but you do hear some people getting COVID multiple times).

Edited to add:

21 minutes ago, HoodedCrow said:

The thing is, you will not want to be dead or impaired from getting Delta, and then get the vaccine. However, if you survive, it is still good to be vaxxed. Am I mistaken?:)

Ideally get it before you get COVID, so you aren't dead or impaired when you do get sick.  But if you get vaccinted after COVID, you are decreasing your odds of getting another dose of COVID.  So its a win-win.

[Kalbear]

27 minutes ago, Gorn said:

Have you read the link you posted? It doesn't contradict anything I wrote. In fact, it confirms that immunity from vaccine + previous infection > vaccine alone.

Dismissing natural immunity, like you seem to be doing, is baseless and unscientific.

It does say, however, that natural immunity (whatever the hell that is) is not as efficacious as vaccination. 

[IheartIheartTesla]

One of the things that is sort of confounding in all this is how many of us may have had COVID and not known it. Dont have the time to read through all the studies and how they were designed to see if this plays a big role in the statistics or not.

But yes, getting COVID to prevent yourself from future COVID isnt a real strategy, so being vaccinated is still the best option regardless of whether you have or havent been previously infected.

[HoodedCrow]

We also know that there are fluctuations in reporting illness.( for example, DeSantis in Florida interfered).

[Gorn]

10 minutes ago, Kalsandra said:

It does say, however, that natural immunity (whatever the hell that is) is not as efficacious as vaccination. 

Where does it say this? I'm not being snarky, I just went back to the study to make sure I haven't missed anything.

All participants of the study were vaccinated. The study compares the antibody response in vaccinated people with and without previous infection. It doesn't compare vaccinated without infection vs. unvaccinated with previous infection (which the study from Israel, with a much larger sample size, does).

Of course everyone should get vaccinated, but immune response from previous infection shouldn't be disregarded.

[Kalbear]

3 minutes ago, Gorn said:

Where does it say this? I'm not being snarky, I just went back to the study to make sure I haven't missed anything.

All participants of the study were vaccinated. The study compares the antibody response in vaccinated people with and without previous infection. It doesn't compare vaccinated without infection vs. unvaccinated with previous infection (which the study from Israel, with a much larger sample size, does).

Of course everyone should get vaccinated, but immune response from previous infection shouldn't be disregarded.

I'll have to find the various studies, but my understanding is that for most people getting vaccinated has produced a significantly stronger immune response compared to getting infected alone, especially for those who were unsymptomatic. 

[Heartofice]

https://www.google.co.uk/amp/s/amp.theguardian.com/commentisfree/2021/oct/24/which-protects-you-more-vaccination-or-prior-infection
 

There are other studies that also mean it’s really not all that clear cut that vaccination gives you better protection against infection vs prior infection. 
 

Think the take away is that getting vaccinated is the least risky way to get protection, and getting the jab even if you’ve already had it gives even better protection. However I don’t think it’s all that obvious that vaccinating  everyone is necessary and I certainly am not on board with mandatory vaccine passports.

[Gorn]

1 minute ago, Kalsandra said:

I'll have to find the various studies, but my understanding is that for most people getting vaccinated has produced a significantly stronger immune response compared to getting infected alone, especially for those who were unsymptomatic. 

There's a difference in immune response between someone freshly vaccinated (situation that early studies observed) and someone who was vaccinated six months ago (situation that more recent UK and Israel studies observed, and which is closer to the current situation in the West).

[Mudguard]

50 minutes ago, Gorn said:

Where does it say this? I'm not being snarky, I just went back to the study to make sure I haven't missed anything.

All participants of the study were vaccinated. The study compares the antibody response in vaccinated people with and without previous infection. It doesn't compare vaccinated without infection vs. unvaccinated with previous infection (which the study from Israel, with a much larger sample size, does).

Of course everyone should get vaccinated, but immune response from previous infection shouldn't be disregarded.

You are correct.  The study cited in Zorral's article only compares two groups: vaccine alone to vaccine after infection.  It doesn't compare infection alone to vaccine alone.

This has been a major frustration of mine.  For some reason, many of the pro vaccine crowd seem to be under the impression that immunity acquired through recovery from infection is somehow significantly worse than immunity from a vaccine.  Generally, this hasn't been the case in the past, and I don't think there's strong evidence that this is the case now.  

Many people also find one or two studies that say something and think the issue has been settled or proven, without understanding that many of these studies, the vast majority which are not double blinded clinical trials but instead are merely retrospective or prospective cohort studies, are not designed to prove anything conclusively.  It is virtually impossible to control for all confounding factors in these types of studies. 

That's how you end up with people pointing to a couple of shit studies and concluding that masks don't work and that children don't pass on the virus to any significant degree, despite common sense telling you otherwise.  Both these things happened early on in the pandemic.  Now it's natural immunity is inferior to vaccine immunity, or worse, sometimes natural immunity is completely discounted, which makes no sense.

I've largely given up trying to explain things because it just doesn't appear to stick.