Coronavirus

[wdolson]

We're not trying to contain this virus anymore. That ship has sailed.

I think at this point the endgame is inevitable. COVID is an endemic disease that will circulate continuously. Vaccination doesn't stop the virus, just downgrades it to a regular cold. Your "booster shot" will be periodic exposure to the virus and its variants.

Once everyone has gotten their initial immunity (via the shot or the virus), I don't think any further mitigation measures will serve any purpose.

The danger is how this is going to mutate. The last 18 months has shown that the virus keeps mutating into more and more severe strains. If we get to a mutation that has the triple threat of being extremely contagious, able to defeat immunity from prior infection or vaccination, and is highly lethal, we could see a worldwide event on par with the Black Death in Europe.

If Delta just mutates into a much more lethal variant we could see massive death toll among the world's unvaccinated, which is still quite high.

So far previous immunity is mostly holding the line against Delta, but this is probably not the worst variant we're going to see.

Another problem is people who can't get the vaccine. A friend has been told by more than one doctor that getting a vaccine might kill her. She has a history of auto-immune reactions and her system is very depleted right now. She's taking massive doses of vitamin D, but her D levels are still quite low, her blood pressure has been so out of control she's been in the emergency room a couple of times in the last month, and she has some other things out of whack. A contributing factor is being stuck at home the last year with a verbally abusive husband who has been getting more and more abusive.

COVID may end organ transplants and kill off anyone else with a compromised immune system. People with compromised immune systems are very vulnerable to COVID and they could get a serious case every time they are infected.

COVID becoming endemic will probably change the world in ways that are difficult to predict.

 

[Slipstream]

Vaccine efficacy wanes over time.

 

[scottf200]

If you've had the shot (or previously had the virus) it's basically just a cold. Let's face it we're all gonna get periodic exposure to this virus for the rest of our lives. I'm not sure there's anything to be done about it. Forget social distancing. Just get your periodic exposure so you don't lose all immune resistance.

Please remember there are a lot of people with autoimmune disease who have limited to no antibodies so it may not be 'basically just a cold' to many 1000s of people even if they are being proactive in this.

 

[bkp_duke]

The danger is how this is going to mutate. The last 18 months has shown that the virus keeps mutating into more and more severe strains. If we get to a mutation that has the triple threat of being extremely contagious, able to defeat immunity from prior infection or vaccination, and is highly lethal, we could see a worldwide event on par with the Black Death in Europe.

If Delta just mutates into a much more lethal variant we could see massive death toll among the world's unvaccinated, which is still quite high.

False - the virus is mutating to more contagious strains - but NOT more deadly strains. And that is EXACTLY what happens in most pandemics. Furthermore, if history is a teacher of anything pandemic-related, the viruses tend to drift towards LESS deadly strains. From an evolutionary standpoint, that makes sense and is expected (killing off the hosts eventually kills you off as a virus).

 

[AlanSubie4Life]

Vaccination doesn't stop the virus, just downgrades it to a regular cold.

Not exactly. It’s still much more deadly than a cold. Though perhaps less deadly than flu, assuming you have not been vaccinated for flu.

. Let's face it we're all gonna get periodic exposure to this virus for the rest of our lives. I'm not sure there's anything to be done about it.

Yeah, I agree it seems likely. For me what is to be done about it is to wait as long as possible, so that the science on the effects is more clear. It also provides the potential opportunity for even more boosters, which may help immunity further. We’ll see if I make it. I have significant exposure factors now.

I just assumed previous infections affect the vaxed and unvaxed in equal proportion.

Yeah, so did I. Probably 35% of LA County infected. So let’s say 17.5% infected but unvaccinated.

Kids are included in the case count ratio but excluded from % vaccinated. Adjusting for this would skew efficacy down a little more.

Whoops. Just took your number but missed that word….

0.12*0.5/(0.12*0.5+0.15*0.175+0.325) = 15%

Efficacy of about 82% fits to 20% of cases in vaccinated with above assumptions, but this does not account for significant exposure factors.

So I’ll stick with the 88% number until it becomes less solid (they did space out doses in the UK, which may have made it work better than in the US. No one knows yet…)

 

[madodel]

States scale back virus reporting just as cases surge

The trend of reducing data reporting has alarmed infectious disease specialists who believe that more information is better during a pandemic. People have come to rely on state virus dashboards to help make decisions about whether to attend large gatherings or wear masks in public, and understanding the level of risk in the community affects how people respond to virus restrictions and calls to get vaccinated.​

 

[shinytop]

My stupid governor stopped daily reporting when the numbers were going down. Now we are second most cases per capita in the country and he still won't allow any concessions to the virus. Local leaders are outlawed from making their own restrictions.

 

[AlanSubie4Life]

After doing a little travel to Sedona and seeing the willingness of people to pack into small unventilated spaces without masks, I am confident that Delta is probably not all that much more contagious relative to prior variants, and the astronomical rates of rise are mostly due to relaxation of efforts to slow the spread. I’m all for flattening the curve, I guess, if people don’t want to get vaccinated, but maybe people should slow their roll a bit so the hospitals can keep up! Not a very flat curve right now, though the long term average is impressively flat.

I’m also hopeful that this means masks are quite effective. I guess I’ll know in a few days!

 

[NikolaACDC]

Same as the very recent Alabama story.

COVID-19 patients in ICUs at a Florida hospital are 'begging' to be vaccinated, nurse says

"Patients in intensive care units (ICUs) with COVID-19 at a Florida hospital are "begging" to be vaccinated, a nurse told CNN.
The unnamed nurse, who works at the Baptist Medical Center in Jacksonville, Florida, said that patients, the overwhelming majority of whom are unvaccinated, are "at a loss" for what they can do to stay alive.

"Every single day... you're getting ready to intubate the patient in ICU, which means putting them on a ventilator, and they say, 'If I get the vaccine now, can I not go on the ventilator?'" the nurse told CNN's Randi Kaye.
She said that she has to repeatedly point out that the right time to get a COVID-19 vaccine is before they get sick.

"They're desperate because they're gasping for air, they can't breathe, they're scared, they feel like they're going to pass away," the nurse continued. "They're just asking for whatever they can do to possibly keep them from being put on a ventilator because once a patient gets on a ventilator, it's really hard to wean them off."

Three patients told Randi Kaye that they would get vaccinated if they survive their spell in the ICU, CNN reported.
"These are patients who chose not to get the vaccine but now desperately want it," Kaye said.

The number of COVID-19 patients at Baptist Medical Center is rapidly rising, according to CNN. There are 349 patients with coronavirus at the moment, and 74 are in the ICU, the media outlet reported.

Around 44 percent of the patients at the hospital are under the age of 40, and are staying at the hospital much longer because they are sicker, Kaye said.

An overwhelming majority (99.6 percent) have not yet received a COVID-19 vaccine, CNN added."

--------------
I was assuming that once stories like this come out that more and more people would get vaccinated.
Not holding my breath.

 

[NikolaACDC]

My stupid governor stopped daily reporting when the numbers were going down. Now we are second most cases per capita in the country and he still won't allow any concessions to the virus. Local leaders are outlawed from making their own restrictions.

He's all over the place.

Florida urged to ramp up vaccination effort amid ‘alarming’ Covid rise

"...DeSantis, who recently launched a line of campaign merchandise mocking masks and medical experts, was back home extolling the virtues of vaccinations.
“These vaccines are saving lives,” he said at a news conference at which he noted that more than 95% of new infections in Florida were of those who had not received a shot.
...
DeSantis has promised action: but only to convene a special session of the Florida legislature to block any move by the Biden administration to implement a mask mandate in the state’s public schools.
...
Physicians have welcomed DeSantis’s calls for more residents to get vaccinated, but their frustration has grown at what they see as mixed messaging, including his attacks on federal health officials – “quote-unquote experts”, in the governor’s words – who have criticized those skeptical of the vaccines.

Already this year DeSantis has issued a blanket pardon to anyone convicted of breaching local authority Covid mandates, and promised to use power handed to him by Florida’s Republican-dominated legislature to invalidate local emergency measures.

He has also sued the CDC, with mixed success, to try to prevent cruise lines from being able to require passengers to be vaccinated or comply with other health requirements. And in recent days DeSantis has stepped up his personal animosity towards Dr Anthony Fauci, the government’s leading infectious diseases expert. As well as fundraising off the “Don’t Fauci my Florida” beer koozies and T-shirts, DeSantis accused Fauci of attempting to “muzzle” his three-year-old son with a mask mandate.
...
“While DeSantis is traveling around bragging about Florida’s handling of the pandemic, or lack of, and making fun of Fauci, doctors here are feeling like we are back at square one.”
_______________________________

Tried and true tactic, cover all the bases. Later he can point to the actions and words of his that were not wrong and claim "see, I was right all along".
And the dumber of his followers will swallow it hook, line and sinker.

Though the way the numbers are ramping up in Florida he might have to relent soon and introduce some restrictions. We'll see.
Trump carried Florida with 371,686 more votes, DeSantis can let a lot more people die before it affects election outcomes.
He became Governor with only a 32,463 vote surplus. A lot tighter - but since he's planning to run for president it's not that important.

 

[NikolaACDC]

Referencing the same chart that AlanSubie4Life talked about before:

Former FDA commissioner: CDC 'doesn't know how to model' latest COVID-19 wave

"The CDC "doesn't know how to model this wave [of coronavirus infections], and has little practical idea of whether we're at the beginning, middle, or end" of the Delta variant-fueled surge, former Food and Drug Administration Commissioner Scott Gottlieb wrote Saturday.

He notes the agency is estimating that by Aug. 14, there could be an average of anywhere between 10,000 and 100,000 new infections per day, which means the current wave will have either subsided or be "raging out of control" by that point.

The wide-ranging and "deeply disappointing" forecasts highlight the need for an "action-oriented agency able to engage in assessing and mobilizing preparations against future risks," Gottlieb argues. The CDC, on the other hand, "has a retroactive mindset," Gottlieb writes, adding that it doesn't "do horizon scanning, make predictions and tie to policy recommendations, coordinate heavy lift capabilities like vaccination campaigns, engage in risk estimates, or collect intelligence on foreign areas of concern."

It may sound like harsh criticism, but Gottlieb explains this simply wasn't "the business [the] CDC was in." Instead, its "thorough" and "meticulous" data reporting and analysis skills are better suited for providing definitive answers in the long run rather than "partial info to inform current decisions in a crisis." An agency that can produce the latter is needed, Gottlieb says, whether it's a reformed CDC or a new joint operational command. "

 

[NikolaACDC]

A somewhat longer read with some insight into the minds of the 'willfully unvaccinated':

The New Yorker - Treating the Unvaccinated

"In Utah, and across the U.S., doctors are facing a wave of preventable COVID deaths—and trying to convince the hesitant that “it doesn’t have to be this way.”
...
"I used to think that fear could push many hesitant people to get vaccinated—that watching COVID put a friend on a ventilator would make one rush to get a shot. But fear seems to work in unpredictable ways. It’s possible to shift one’s gaze away from the gravely ill and onto those who contracted the virus but escaped unscathed. It’s possible to be more afraid of the vaccine than of the virus.
Perhaps the psychology of risk plays a role: for the willfully unvaccinated, it may be easier to accept the preexisting risk of contracting COVID than to embrace the incredibly small but unfamiliar risks posed by the vaccines. Many people seem to believe either that they won’t contract the virus or that their illness won’t be that bad—a natural and attractive view for younger Americans, but a risky one. Nearly ninety per cent of Americans over the age of sixty-five—people of all races, ethnicities, income brackets, and political persuasions—have received at least one dose of a COVID vaccine. Those facing the greatest risk seem to have an easier time taking an accurate measure of it."

 

[wdolson]

False - the virus is mutating to more contagious strains - but NOT more deadly strains. And that is EXACTLY what happens in most pandemics. Furthermore, if history is a teacher of anything pandemic-related, the viruses tend to drift towards LESS deadly strains. From an evolutionary standpoint, that makes sense and is expected (killing off the hosts eventually kills you off as a virus).

I recall you calling me out and telling me I was full of it in February or March of 2020 when I predicted that COVID was going to hit rural areas hard and rural hospitals would be overwhelmed.

In this case I don't believe it is certain a more deadly version of the virus will emerge, but I think it is very possible. A disease like Ebola tends to burn itself out fairly quickly because the symptoms are very dramatic and people don't tend to get mild cases where they can run around contagious but functional. Because the symptoms of Ebola are dramatic, others tend to stay away even if they don't know that much about infectious diseases.

COVID has a long incubation period. It appears Delta's is down to about a week from up to 2 weeks, but that's still longish. It's also been proven that people are contagious during the time it is incubating. In areas where there are Ebola outbreaks, everybody believes it's real. That's not true with COVID. There are some areas of the world where the population in total takes it seriously, but that's not the case in the United States. There is a large minority in the US who either don't believe COVID is real, or believe some loony conspiracy theory about it that leads them to take risky behavior.

Additionally the progression of the disease with COVID typically has someone go into the ICU with little warning after being sick for a couple of weeks. Someone can think they are stable or even getting better and suddenly with little warning they are teetering on the edge of life. With a long period of mild illness, there is plenty of time to spread it to others before dying.

Here is a plausible super spreader scenario for a killer version of COVID. Even if the vaccine stops this variant. Someone is planning on driving from Tampa to Southern California. At their going away party they get infected with a new killer variant of COVID. Even if they take their time driving cross country, they will pass through the northern half of Florida, Alabama, Mississippi, Louisiana, and well into Texas before they even feel the first symptoms. That's the part of the country where COVID denial is highest and vaccination rates are lowest. They spread the killer variant at every gas station, every restaurant, and every hotel/motel they stayed in. If they visited friends or family along the way, they spread it there too.

Even if they are feeling a bit ill by west Texas, they push on through spreading it in New Mexico, Arizona, and into California. When they get to their destination they are getting seriously ill and end up in the hospital a day later to die of the new variant a month later. Meanwhile the new variant's offspring are taking hold throughout the entire southern half of the US. International travelers to places like Disney World in Orlando take it back to their home countries where it takes off. If the country is well vaccinated only breakthrough cases will crop up and the outbreak might be contained, but among the deliberately unvaccinated in the US it rips through that population like a bandsaw. It also has a devastating effect on countries with poor access to a good vaccine.

And that's a variant that the vaccines stop. It would be far worse with a variant that also evaded the vaccines.

That driving scenario is not that far fetched. A friend of my partner recently moved back here from the Tampa area (in May). A friend of hers who promised to handle everything with her move screwed up and her car sat there for a month (he went radio silence on her). Another friend of hers from Sarasota volunteered to drive the car from Sarasota to Portland for her. She took almost two weeks because she did some sightseeing, but ultimately it was cheaper and faster than having it shipped. Her friend was vaccinated and she went north in Mississippi on up to North Dakota and across the country on I-90 instead of I-10 through Texas, but someone carrying a killer variant of COVID on a similar trip would be a super spreader event over 3000 miles long.

Unlike my prediction that COVID was going to hit rural areas hard, I am not sure about how it will mutate. It is possible Delta is the worst we're going to see. However the progression of this disease thus far has been towards more dangerous variants rather than it becoming more benign. I have read concerns from epidemiologists about a possible variant that defeats vaccine immunity. The variant from South Africa (was it Beta? I don't remember) had some ability to get around existing immunity.

There are anecdotal accounts from hospital workers that Delta is more deadly than previous variants, but that has not been proven one way or the other yet. It is possible that is just an impression that will not be proven out.

We don't know enough yet. In another year we may be looking back on 2020 and 2021 as two bad years and things are looking up, or we may be looking at a new phase of the pandemic as bad or worse than before. Could go either way.

 

[AlanSubie4Life]

Worldwide case rates of delta seem to be turning down in many countries, as expected. In some countries, it may be because of quite high seroprevalence rates (allegedly 90%+ in adults in the UK - Coronavirus (COVID-19) Infection Survey, antibody and vaccination data, UK - Office for National Statistics), but I think it's likely also due to additional measures taken at an individual level to protect from infection.

In the US, as compared to other locations, I think it's going to have a bit more room to run, in places that have lower vaccination rates, especially considering that the authorities here are actively discouraging self-protection and vaccination (this is different than in many other countries).

But, it does seem to increase the likelihood there will be a peak in just 3-4 weeks or so. (Though in the US it will depend on the state you're talking about - this is for a state like Florida which started surging in late June.) NPIs work (when people use them)!

There's a lot of talk right now (in the media) of models predicting a peak in October (The Delta Variant Will Drive A Steep Rise In U.S. COVID Deaths, A New Model Shows). I don't see how that's remotely possible given the current rate of spread and other limiting factors. We'll see I guess. I'm sure it is possible for there to be some places peaking then...but nationwide I don't see it. I still think August will see the final significant peak in the US (as usual, assuming no future significant immune escape).

 

[madodel]

Flew to Germany finally yesterday. Airport was crowded, most everyone had some sort of mask on. I flew on Lufthansa. Germany only allows N95, KN95 or surgical masks. This was announced repeatedly before boarding began. I don't recall getting any notification of this before being in the airport, but I only use KN95 and N95 so not a biggy, but I observed at least a dozen people having to be told during boarding that they wouldn't be allowed to board without the correct mask. No one argued they just either went to the counter to beg for a mask from Lufthansa or a machine near the gate. No issues on the plane other than a few people needing reminder to put their mask back on. I switched from my usual earloop KN95 to a head strap N95 as wearing the KN95 for several hours was irritating my ears. So far in Germany people all seem to respect the rules and wear masks indoors. I asked my daughter about anti-mask protests and at least here in Mannheim there hasn't been anything in months. Though vaccination has dropped off here as in the US, and my daughter commented that numbers show quite a few people never got their 2nd dose. So while about 60% have been vaccinated just under 50% are fully so.

Edit: Found this article about Germany probably not getting to herd immunity with the slow rate of vaccination. Herd immunity ‘unattainable’ in Germany, claims health expert.

 

[scottf200]

Ashish K. Jha, MD, MPH

Everyone agrees hospitals need to mandate vaccines
So who's doin it?
Yes, we're launching a hospital vaccine mandate tracker
See if your hospital is keeping patients safe
We're just starting -- so help us sort out whether your hospital is in or not

Hospital Vaccine Mandate Tracker - Global Epidemics

In a pandemic which has already cost too many lives and created too much hardship, hospitals must ensure that health systems are the safest place possible, by mandating Covid-19 vaccines for all employees. Do hospitals near you mandate staff vaccinations? Join us to track hospital safety across...

globalepidemics.org

https://twitter.com/x/status/1419712291294035968

 

[cwerdna]

California is requiring proof of Covid vaccination for state employees, predicting significant rise in hospitalizations

State employees working in a hospital setting who don't require proof of vaccination will be required to take a Covid test twice a week.

www.cnbc.com

 

[NikolaACDC]

Flew to Germany finally yesterday. Airport was crowded, most everyone had some sort of mask on. I flew on Lufthansa. Germany only allows N95, KN95 or surgical masks. This was announced repeatedly before boarding began. I don't recall getting any notification of this before being in the airport, but I only use KN95 and N95 so not a biggy, but I observed at least a dozen people having to be told during boarding that they wouldn't be allowed to board without the correct mask.
...
Edit: Found this article about Germany probably not getting to herd immunity with the slow rate of vaccination. Herd immunity ‘unattainable’ in Germany, claims health expert.

Any problem getting your vaccinations recognized?
Did you only have your typical US vaccination card?

 

[madodel]

Any problem getting your vaccinations recognized?
Did you only have your typical US vaccination card?

No problem with the CDC card. I didn't even have to take it out of the plastic holder but it was checked when I got my boarding pass and again at passport control after landing in Frankfurt. I had also had a COVID test done but with the vaccination card no one cared about the negative COVID test.

 

[wdolson]

It definitely looks like we're seeing a definite COVID surge. Interesting Sitka, Alaska is the worst in the country (per capita).