Random discussion of Covid-19 not specifically related to restaurants or food

I’m going to repost a link to yesterday’s NYT article by David Leonhardt. (Originally posted by Robert.)

One in 5,000 - The New York Times (nytimes.com)

Your (Honkman) comments on this article would be of interest, even though it includes a (gasp) comparison with the flu in the course of discussion about “breakthrough” infections.

But that is not something specific to her. You can find many very good written synopses from different scientists around the different phases of the immune system on virus responses. Unfortunately neither she nor others have any new data how the immune response react specifically to covid

There should really have been an “almost” in there, but she wasn’t far off. Chances that a fully vaccinated person will get a breakthrough case of Covid bad enough to require hospitalization are around 1 in a million, as the NYT piece says, “of the same order of magnitude as risks that people unthinkingly accept every day, like riding in a vehicle.”

It looks like the many months of saying “pretty please get vaccinated” is morphing into “get vaccinated or else”.

It’s about time the federal government got forceful about it and stopped being wishy-washy with the “vaccine resistance”. Vaccination is the answer. Politely-called “hesitation” is the problem. It’s unfortunate that heavy-duty, serious coercion is necessary – but it is.

So I was encouraged to read today about Biden’s executive mandates regarding required and enforced vaccinations, prescribed to the full extent that as president he’s able to bring them into effect. The vaccination “resistance” will of course resist, but I hope Biden ends this “war” both successfully and gracefully.

I raise my glass to this necessary, quintessential national development. My hope is that all involved Americans will simply accept and flow with it: It will be of profound benefit to all of us if it succeeds in helping to suppress the virus in the US.

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Seems like something’s wrong with the math behind this “11 times more likely.” That doesn’t jibe with the stats from Los Angeles, where the unvaccinated are 14 times as likely to be hospitalized and account for all? almost all? the deaths.

http://www.publichealth.lacounty.gov/phcommon/public/media/mediapubhpdetail.cfm?prid=3315

The study was of reported cases from jurisdictions that tracked vaccination status.

If as reported unvaccinated people are 4.5 times likelier to be infected, that means they’re around 50 times more likely to die. Fucking incompetent CDC messaging strikes again.

I suspect that the more people are vaccinated in an area, the greater the disparity in hospitalizations and deaths will be.

The second and third studies were of hospitalized patients.

Yes, 4.5 x 11 = 49.5. A person has to first be infected before dying becomes a possibility. It’s a fraction of a fraction.

I also don’t appreciate that the CDC is playing “Consumer Reports” with the different brands of vaccines (WP article). I don’t think that’s helpful at all. They talk about prior data being outdated, but the current data will be “outdated” in another few months.

It does seem logical, though, that a higher dose of mRNA in a vaccine would effect a greater initial immune response.

I was surprised when they first came out that both of the mRNA vaccine manufacturers had tested with such short intervals (3 or 4 weeks) between the first and second shots. Hopefully that was just to get “shots into arms” more quickly, but a more cynical view is that it was to beat the other guy to market, since development was on a fast-track. The difference between them of just one week in terms of efficacy is probably insignificant in any case, I would think, although a somewhat longer interval (such as 2 months) might have been better with both.

The debate among scientists about the need for a third shot (“booster”) goes on…

I use quotes because the second shot was actually a booster; the third would be a second booster. (More confusion.)

There’s no debate among epidemiologists or anyone else looking at big picture. It’s more nationalist and populist politics vs. the cold facts of science.

The timing of booster shots isn’t that clear from a scientific standpoint and that’s less about politics

To quote the NYT article:

In the new review, published in The Lancet, experts said that whatever advantage boosters provide would not outweigh the benefit of using those doses to protect the billions of people who remain unvaccinated worldwide. Boosters may be useful in some people with weak immune systems, they said, but are not yet needed for the general population.

Previously from The Lancet:

The debate on COVID-19 vaccine equity has been long-running, and we have previously weighed in on the topic. However, the facts that (1) by Aug 9, only 12·6 million of the 4·46 billion doses administered globally were in low-income countries, (2) 3·65 billion have been administered in high-income (HICs) and upper-middle-income countries, and (3) WHO Director-General Tedros Adhanom Ghebreyesus actually had to issue a plea for a moratorium on third-dose boosters in HICs on Aug 4, mean that we, again, need to add our voice to the demand for equitable access to vaccines.

“No one is safe until everyone is safe” has become the mantra of the COVID-19 pandemic, with good reason. Unmitigated transmission means rampant viral replication, which in turn means infinite opportunities for the emergence of new, more transmissible variants that could escape natural or vaccine-induced immunity. …

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00486-2/fulltext

Both the Krause, et. al. article (Elsivier) and the Lancet editorial are very well written discussions, as is today’s NYT article. All three pretty much present the same general arguments against rushing into broad-based third-shot boosters for the general population in the US, with which I concur, but there are those who would disagree.

But as you can see from the link I provided that experts also don’t think booster shot are not necessary simply for scientific reasons. The current epidemiological data doesn’t really show that booster shots now would be beneficial

I don’t see that that study contradicts anything I said.

There is ongoing debate among epidemiologists - they are following the current scientific data which doesn’t clearly say that booster shots are necessary now (and if they might be necessary in the future is speculation)

I was talking about the consensus that to get the epidemic under control it would be more effective to vaccinate more people in poor countries than to give booster shots to people in rich countries.

I was also referring to that, but in addition there is ongoing debate among scientists that’s strictly in terms of the direct medical benefit of a third shot.

The confusing thing, and I think something that’s causing some cross-threading here (so to speak) is that there are two separate issues: (1) The medical benefit of a third shot in preventing serious infection; and (2) the global benefit of (at least) a first shot world-wide. I would think that the former falls within the purview of immunology and the latter in epidemiology (with some overlap in virology, vis-à-vis mutations).

That’s on the scientific side. I feel that there are also some serious moral issues involved with giving third shots in rich countries while the rest of the world waits for even one.

For the immunocompromised, sure, and probably the “elderly” (i.e, card-carrying 75+ Old Farts like me) with supposedly reduced immune system protection (which I’m not so sure is true, but that’s another matter). Absolutely I’ll get the frickin’ third shot if Dr. Fauci says it’ll be good for me. But should everyone else already fully vaccinated here in the US of A get one too? I’m not persuaded.

Holy cow:

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There is often a suicide clause in life insurances.

Another aspect which wasn’t covered in this discussion around booster shot that is brought up more and more by epidemiologists is the question which booster shot should be given, in particular in view of the delta variant. The companies (Moderna, BionTech) are already working on “improved” updates on the current vaccines to also cover delta better (which is from
a technology standpoint not that difficult and most likely wouldn’t require another approval by FDA). It might make more sense to use the currently available shots on those who haven’t been vaccinated yet (across the world) and put more emphasis on the improved boosters which could be available starting beginning of next year.

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