Coronavirus

[EVNow]

As I've stated time and time again, unless you nip it EXTREMELY early (say in the first 1000 cases), you are toast on trying to contain a pandemic-level virus that is airborne.

Check again. There are multiple countries that had thousand cases ( a day !) that are ok now. India just had a test cricket match with audience. S E Asia has done very well.

It comes down to attitude - if you don’t value life - irrespective of age, we get to what happens in US and Europe.

 

[JRP3]

Look state by state and how the containment measures varied so drastically. Despite this, there is no significant difference in the rates of infection.

I'm not following, cases per capita show a fairly obvious trend. States less likely to implement strong measures have higher per capita infection rates. Especially obvious in low population density states which should have had the easiest time with containment yet have some of the highest cases per capita. California would be 25th on the list and NY would be 33rd.

 

[AlanSubie4Life]

Because we've been so successful at stopping unauthorized immigration in the past?

I agree with everything you said. I’m just saying for legal immigration and business travel we ensure people are vaccinated! It’s a multi-faceted problem and you don’t have to solve it 100%. For the vaccine hesitancy, not related to getting arrested, yeah, have to try, since the worst hit groups will likely be the most hesitant.

Basically - this paper shows that above phenomenon, but you CANNOT make clinical conclusions based upon that data.

Yep, 100% agreed. Lots of potential sources of error in the paper, and opportunities to have clinical results differ. I’m still very optimistic that the mRNA vaccines work decently well against everything we have seen so far.

I'm not following, cases per capita show a fairly obvious trend.

Yeah. Youyang Gu did a thread recently. Correlation is not causation, but county-level election results in the 2016 and 2020 elections are the strongest predictor of outcome he has found thus far. There are a lot of caveats though! Obviously it matters when you start counting.

Halfway through the thread:
https://twitter.com/youyanggu/status/1362130023378018307?s=21

The idea that we have no agency in this is clearly false, in any case. But it is hard to educate people in this country (so much noise!), and it’s also hard to get them to act on that knowledge.

that is far too narrow a viewpoint that ignores that prior to the past 4 years they were very much a far left group.

For you as a physician, probably in coastal San Diego, your personal experience here likely has a selection bias. There’s little doubt that many of the anti-vaxxers you would see would skew to the left. But I’d caution against extrapolating that to the overall composition of the movement.

 

[JRP3]

I'd say there are plenty of loonies on both sides. I think the anti vax wave started with more left leaning groups but has more recently moved to the right.

Anti-vaccine sentiment is strongly associated with conspiracy thinking and protection of individual freedoms, traits that are finding a home among far-right groups.

“The first antivaxxers I ever met were left-leaning unschoolers when I was an unschooled teenager. They were very much a part of the early efforts to ‘stop the Food and Drug Administration’ from regulating alternative medicine. What has happened in recent years is that this demographic of homeschooling is being now recruited by the radical right on social media, and some are turning right. And this is very concerning.”

The Anti-Vaccine Movement in 2020

A new survey indicates that over 31% of individuals queried had no intention of getting vaccinated against infection with SARS-CoV-2.
According to the same source, the groups most likely to reject a COVID-19 vaccine are Black people, women, and those with conservative political leanings.

Which US demographics are more likely to refuse a COVID-19 vaccine?

 

[shinytop]

The movement shifted to the right when we had a right wing leader who insisted Covid was no worse than the flu and that it would be gone with warmer weather. Once the weak willed masses were convinced local leaders were lying the anti-vaxxer movement had a whole new direction of growth.

 

[Doggydogworld]

I'm not following, cases per capita show a fairly obvious trend. States less likely to implement strong measures have higher per capita infection rates. Especially obvious in low population density states which should have had the easiest time with containment yet have some of the highest cases per capita. California would be 25th on the list and NY would be 33rd.

View attachment 638279

You say "infection rates" but you quote case numbers. They are not the same thing! Especially if you try to compare areas which had big early waves (e.g. NY) when almost no testing was available.

Deaths (or total hospitalizations, if available) are a much better indicator of disease spread. CA, TX and FL have similar death per million rates (1230-1450) with vastly different lockdown approaches. SoCal and NorCal have much different mortality with the same state government restrictions.

North and South Dakota made it to 4th and 5th in deaths/million, but since fell to 11th and 8th respectively with no real change in countermeasures.

Ofcourse, with just simple common sense measures we could have wiped out Covid a long ago in US. We just needed lockdowns, contact tracing and strict quarantine for a month.

Without strict border control from mid-January the measures you list would have had little effect. Only one country with wide community spread shut this virus down. China did it with a severe lockdown and extreme privacy invasions which would cause mass rebellion here.

US style mild countermeasures only slow it down a bit.

 

[bkp_duke]

The movement shifted to the right when we had a right wing leader who insisted Covid was no worse than the flu and that it would be gone with warmer weather. Once the weak willed masses were convinced local leaders were lying the anti-vaxxer movement had a whole new direction of growth.

The problem is these ideals are based on half-truths. It is a fact that the Coronavirus does abate in the summer months. It's both UV and temperature sensitive. We use these principles for disinfecting surfaces that might have CV on them.

Unfortunately anti-vaxxers have taken this as a "it's 100% gone", not an abatement. So, again, half-truths (or less than half).

 

[JRP3]

Deaths (or total hospitalizations, if available) are a much better indicator of disease spread.

Deaths are not a better indication because treatment options were worse in the early stages of the pandemic so areas with higher levels of infection early would likely have a higher percentage of deaths. Hospitalizations might be better.

 

[AlanSubie4Life]

Deaths (or total hospitalizations, if available) are a much better indicator of disease spread. CA, TX and FL have similar death per million rates (1230-1450) with vastly different lockdown approaches.

It’s possible to cherry pick whatever. That’s why I like the correlation of winter wave vs. 2016 election results by county. Lots of outliers but the correlation is pretty clear. Still, plenty of confounders. Correlation does not causation make.

Basically can argue about this all day. But what is clear, without doubt, is that mitigation measures (when actually realized without theatre) really do work. That is clear from the significant attenuation of disease spread nationwide starting in April. Could have been a lot worse! People see people they know dropping dead, they change their behavior, and voila!

Regarding future trajectory, I’m going to keep an eye on North Dakota, South Dakota and see how they do. These areas should be at 50+% with some immunity now, and I am sure they are going to keep partial suppression measures in place until this is well and truly over. So they are now presumably at herd immunity for the measures currently in place. It’ll be interesting to see if we see any resurgence there. I don’t really expect it, but if it does, I guess I would expect B.1.357 (or equivalent). I guess I expect people who haven’t got it there to get vaccinated in the next couple months, so if there is a resurgence there, it’ll probably go through the same communities that have already suffered, while the vaccinated community does fine. Will be interesting.

 

[EVCollies]

Deaths are not a better indication because treatment options were worse in the early stages of the pandemic so areas with higher levels of infection early would likely have a higher percentage of deaths. Hospitalizations might be better.

Criteria for hospitalization changes both with time and during scarcity.

 

[Dave EV]

The US has been a FANTASTIC example of this. Look state by state and how the containment measures varied so drastically. Despite this, there is no significant difference in the rates of infection. My state of California has been on a relatively hard-core lockdown compared to other states, and we are still one of the hardest hit.

North and South Dakota made it to 4th and 5th in deaths/million, but since fell to 11th and 8th respectively with no real change in countermeasures.

Two somewhat unrelated posts above, but both also point to a fact that is directly correlated to COVID case rates (and eventually death rates):
Just because a govt imposes "hard-core lockdown", does not mean that all people are abiding by those rules, or that the rules are being enforced. A good example is that even here in California, I've seen and heard of many people holding multi-household get-togethers. Heard from an acquaintance of one small company making the bad decision to hold a Holiday party in December. Everyone who attended (about 20 people) got COVID.

Once Christmas had passed, it's pretty clear that more people stopped socializing and hunkered down, no matter where they live.

I think a lot of it is also the fact that the vaccine is rolling out and people can actually see the light at the end of the tunnel now, so maybe are more likely to hunker down. For sure I see more people wearing masks outdoors even in very low risk scenarios (walking through a suburban neighborhood with plenty of space to pass people), which I think is fairly extreme, especially compared to going to the store indoors, or even picking up a take-out order which often involves fairly close contact with others, even though it's typically very brief.

 

[JRP3]

Anti-vaxxers down under

 

[bkp_duke]

Anti-vaxxers down under

Damn, and here I thought the US had a lock on stupidity . . .

 

[SO16]

Elon Musk got 4,000 SpaceX workers to join a COVID-19 study. Here's what he learned. | Fox Business

 

[JRP3]

CO2 monitors can provide an idea of how well an area is ventilated

CO2 monitors can help prevent the spread of COVID-19, experts say

 

[PhysicsGuy]

I'm not following, cases per capita show a fairly obvious trend. States less likely to implement strong measures have higher per capita infection rates. Especially obvious in low population density states which should have had the easiest time with containment yet have some of the highest cases per capita. California would be 25th on the list and NY would be 33rd.

View attachment 638279

Thanks for this. Informative. Numbers would help in addition to ranking. How much difference is there between 1 and 15 and e.g, 33??

 

[brianhn1]

Elon Musk got 4,000 SpaceX workers to join a COVID-19 study. Here's what he learned. | Fox Business

Interesting article.

Discrete SARS-CoV-2 antibody titers track with functional humoral stability | Nature Communications

Discrete SARS-CoV-2 antibody titers track with functional humoral stability

• Yannic C. Bartsch,
• Stephanie Fischinger,
• Sameed M. Siddiqui,
• Zhilin Chen,
• Jingyou Yu,
• Makda Gebre,
• Caroline Atyeo,
• Matthew J. Gorman,
• Alex Lee Zhu,
• Jaewon Kang,
• John S. Burke,
• Matthew Slein,
• Matthew J. Gluck,
• Samuel Beger,
• Yiyuan Hu,
• Justin Rhee,
• Eric Petersen,
• Benjamin Mormann,
• Michael de St Aubin,
• Mohammad A. Hasdianda,
• Guruprasad Jambaulikar,
• Edward W. Boyer,
• Pardis C. Sabeti,
• Dan H. Barouch,
• Boris D. Julg,
• Elon R. Musk,
• Anil S. Menon,
• Douglas A. Lauffenburger,
• Eric J. Nilles&
• Galit Alter

Thanks to: "In this study we included 4300 volunteers all of whom were employees at Space Exploration Technologies Corp. (SpaceX) that were followed from April 2020, including SARS-CoV-2 receptor-binding domain (RBD) antibody testing, and detailed symptomatology."

 

[NikolaACDC]

Pfizer-BioNTech Shot Stops Covid’s Spread, Israeli Study Shows

"The Pfizer Inc. and BioNTech SE Covid-19 vaccine appeared to stop the vast majority of recipients in Israel becoming infected, providing the first real-world indication that the immunization will curb transmission of the coronavirus.
The vaccine, which was rolled out in a national immunization program that began Dec. 20, was 89.4% effective at preventing laboratory-confirmed infections, according to a copy of a draft publication that was posted on Twitter and confirmed by a person familiar with the work. The companies and Israel’s Health Ministry worked together on the preliminary observational analysis, which has not yet been peer-reviewed.
...
The early results on lab-confirmed infections are important because they show the vaccine may also prevent asymptomatic carriers from spreading the virus that causes Covid-19, something that hadn’t been clear so far."

 

[JRP3]

Thanks for this. Informative. Numbers would help in addition to ranking. How much difference is there between 1 and 15 and e.g, 33??

Go here and click the Tot Cases/1M pop column to sort United States Coronavirus: 28,707,292 Cases and 509,897 Deaths - Worldometer

 

[PhysicsGuy]

I'm no expert, but: (from the lancet)
...
Our analysis revealed that mobility patterns are strongly correlated with decreased COVID-19 case growth rates for the most affected counties in the USA, with Pearson correlation coefficients above 0·7 for 20 of the 25 counties evaluated. Additionally, the effect of changes in mobility patterns, which dropped by 35–63% relative to the normal conditions, on COVID-19 transmission are not likely to be perceptible for 9–12 days, and potentially up to 3 weeks, which is consistent with the incubation time of severe acute respiratory syndrome coronavirus 2 plus additional time for reporting. We also show evidence that behavioural changes were already underway in many US counties days to weeks before state-level or local-level stay-at-home policies were implemented, implying that individuals anticipated public health directives where social distancing was adopted, despite a mixed political message.
This study strongly supports a role of social distancing as an effective way to mitigate COVID-19 transmission in the USA....