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You bored
Yeah.

I guess we can disagree on this, but my view is that high amounts of viral replication in proximity to high levels of vaccination is worse than a virus that 100% infects vaccinated people (due to 100% vaccination rate), in rapidly non-existent quantities (assuming herd immunity is reached).

I bet that is what a model of viral mutation would also say.

Seems to me you want to minimize the number of infections in vaccinated/immune people - which means you want 100% of infections in vaccinated/immune people (again, assuming near or at herd immunity).
 
Here’s an alternative article:


It’s 50 cases out of 7,500 employees at SF General Hospital (75-80% vaccinated) and 183 out of 35,000 UCSF employees (84% vaccinated).

Apparently the vast majority are thought to be general community acquired cases rather than workplace acquired.

In other words, not much of a story….
Yep, pretty close to what you would expect for 80% effective. (0.2*0.84*35k/(0.2*0.84*35k+0.16*35k) = 50% of cases expected to be in vaccinated individuals (actual number was 83% I think?). Assigning any precision beyond that is a lost cause since the exposure risks to the vaccinated may have been higher than to the unvaccinated, some people already immune but unvaccinated, etc.
 
And now, as Paul Harvey would say...the rest of the story...


95% vaccinated in residents of P-town is estimated. (Vaccination rate in exposed individuals is unknown, though likely still very high.)

It's important to make sure everyone gets vaccinated, if we want to see the end of this. And in the meantime, it is also important to be careful to reduce spread, so that we can get to zero COVID. That may include wearing masks. The vaccines work. They work even better with a mask (N95 preferred)! I don't see why the public health people are having such a hard time communicating this very likely true statement (should have been the message all along and they should not have dropped mask recommendations, without clear (and very strict) metrics guiding automatic return of recommendations for wearing a mask again). They seem held back by not having any data to back up statements. But it's fairly clear that everything is working nearly exactly as you would expect.

I agree that the study should not have been used to change national policy. The new policy is the policy that should have always been in place even without Delta (with modifications - it's still not right).

 
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"The Walt Disney Co. said in a statement that it will be requiring all salaried and nonunion hourly employees in the U.S. who work on site to be fully vaccinated."

That's one way to get rid of the union...
 
Here come the numbers people. IHME says a peak of 300,000 cases a day.

I’m very comfortable taking the under on 300k (7-day average). But my 80k 7da is definitely going to be a bit low.

I don’t think we’ll peak proportionally to the UK (wouldn’t that be 230k 7da?) for various reasons, but maybe 130-150k 7da? I definitely underestimated so far though so who knows?

I bet some of these bad spots are close to peak. Florida started early, mid-June or so, so they might peak in another week or so. Though the lack of measures do make one wonder. Fortunately private businesses will ignore the government.
 
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I imagine Gov. Abbott's goal is that because he knows that Covid affects minorities and lower income people more than the wealthy, by actively discouraging mask wearing, more people who are likely to vote against him are going to be unable to vote. It seems the Conservative platform is us vs. them, so the fewer of the them there are, the better.

That has seemed to be the thinking in some quarters the last year or so. At least some Republicans are realizing that a fairly large segment of the people refusing to get the vaccine now are likely Republican voters, so they are doing a 180 on the anti-vax rhetoric.

Bill Maher had a discussion about the people refusing to get the vaccine on his show Friday. They grouped the resisters into three groups: people of color skeptical of any "cure" coming from white people due to past lies, the super organic crowd who were the original anti-vaxxers in general, and a segment of the right who believed the political lies.

It looks like the first two groups are changing. There is a lot of out reach going in the minority communities where resistance is high and they are making progress convincing people that they are safe and this isn't a trick. There is some weakening of the anti-vax lefties too, possibly in part because they find themselves in the same camp with people of the opposite political ideals.

The biggest hold out group is the people who are believing the political lies. So the wiser Republicans are realizing that they need to change their tune because while the people who actually die will be small, the people who get seriously ill and survive along with their friends and families might decide they don't want to vote for the people who made them sick anymore.

You are really betting on a ~1% fatality rate among a voting population to swing an election? It's not like this thing has the fatality rate of Ebola.

There are elections where the margins have been that thin, but it is crazy thinking.

Earlier in the pandemic people who were more likely to vote Democrat than Republican were among those deemed essential workers who had to go to a job that put them in more danger (food production, other critical supply production, critical retail workers, delivery people, etc.) People who were more likely to vote Republican were less likely to have to be exposed to the virus. Most white collar workers were able to work from home and a lot of other right leaning blue collar people didn't work in critical industries that needed to keep going. So there seemed to be some indifference from at least some right leaning politicians to the plight of people who weren't likely to vote for them.

I know personal freedom is a meme among that crowd. Personally I'm a pretty big social libertarian as long as someone is not harming others or putting someone else at risk. In a deadly pandemic, everyone is a potential risk to everyone else. It sucks, but it's reality.
 
I don't see why the public health people are having such a hard time communicating this very likely true statement (should have been the message all along and they should not have dropped mask recommendations, without clear (and very strict) metrics guiding automatic return of recommendations for wearing a mask again).
It's called political pressure from a certain class of politician. They are afraid of losing their jobs by promoting something that goes against their politician's world-view.
 
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The snapshots below are from this morning, thus represent data ending July 31, 2021. The graphs have the same time scale and cover roughly 17 months from Mar 2020 to July 2021.

1627847295662.png


What I would have called the 4th spike in US cases doesn't stand out on the deaths chart and the increase in deaths corresponding to the 5th spike above has just barely started it's uptick. Can't even see it yet (nothing definitive).

Also interesting how the 2nd and 3rd wave on both graphs are similar in magnitude but the 1st wave was much worse in deaths than it was in cases and the 4th wave is the inverse of that (to a lesser extent).

1627847335095.png
 
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n deaths corresponding to the 5th spike above has just barely started it's uptick. Can't even see it yet (nothing definitive).

Will be about 1/10th as deadly as the prior waves on a per case basis, most likely. Due to vaccination rates in the vulnerable being very high…
but the 1st wave was much worse in deaths than it was in cases
Underascertainment (no testing).
the 4th wave is the inverse of that (to a lesser extent).
Vaccines work!

They are afraid of losing their jobs by promoting something that goes against their politician's world-view.

No matter what, hopefully they will all grow a pair, and in a few weeks after breaking this delta wave, I sure hope it is all hands on deck to get EVERYONE else vaccinated. I am tired of the nonsense. Mandates for everyone. This is America - and mandates equal freedom.
Lots of outreach and support also needed to find and vaccinate the people who are just too lazy to get it done, or have fears about missing work, etc. No one will be forced to get vaccinated of course - but mandates will ensure they are free to make the choice they want, but are encouraged to make the right choice.

When the cases start coming down in September (and now of course - just saying when the urgency has passed, we need to ramp up the urgency level for vaccination), we should be pushing to vaccinate 4 million people a day. Invoke wartime footing - whatever is necessary. I don’t have any great ideas other than it should be the absolute number one priority of all of the federal gov’t and state governments.

Just need to do everything we can to create freedom for all.

We don’t have a lot of time to avoid the winter wave. Mandates for all, freedom for all.
 
Vaccines work!

While vaccines did help greatly, a big part of the inverse between US wave 1 and US wave 4 is better health care. Just as one example, ventilator settings were not optimal during wave 1, a lot of undertrained staff were making life and death decisions. Those institutions and their staff have improved the level of car dramatically in the last 16 months.

I'm no health care expert so I can't list all the changes they have made but I do remember the discussions during wave 1 about how no one knew the correct care procedures for Covid-19 cases that were severe.
 
is better health care.
Compare wave 3 and 4. There have been no substantial changes in standard of care other than greater availability of mAb therapies between those waves.

The main reason there was not more of a bump in wave 4 was because the elderly and most vulnerable were substantially protected by March. Not completely, but substantially. In my opinion.

The other issue there is there’s a long tail of mortality from wave 3 which is tailing off, and that cancels any rise in mortality from wave 4. So there is likely more of a rise in mortality from wave 4 than is apparent. (Superposition makes it difficult to see and you’d have to have data on every pair of illness onset and death dates to separate the two waves.)

It’ll be easier to see the mortality increase due to wave 5 because we are starting from a lower baseline with a much lower impact of the long mortality tails. The rise in mortality is already visible. It will keep increasing. Hopefully we’ll soon see the CFR drop (people who track this haven’t seen it yet - I’m not sure how to explain that other than long mortality tails screwing up their estimates - the CFR should drop due to the younger age profile of the infected who are unvaccinated - however that could be offset by substantially increased virulence of delta - I hope it is not).
 
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Initially, we did not have the vaccine and a lock down made sense. I really think that since the vaccine is available, we should do what the party of 'personal choice' wants, which is let it rip and get this thing behind us. Statistically, a good number of unvaccinated will die due to illness or inability to get care - they made their choice. Oh, and hospitals should have segregated bed for vaccinated vs unvaccinated in a 70/30 split (since that's the vaccination rate so far)... the unvaccinated side should fill up quickly and then we can turn away new patients even though we have empty beds on the vaccinnated side (exception for those who are unvaccinated for medical reasons). As more people get vaccinated, we can adjust that ratio upward. This is called Tough Love and demonstrates Personal Responsibility. Win-win in my book.

Some may disagree but I also think many of those unvaccinated are intentionally not getting the vaccine to try and get more in entitlements. The fed not renewing the eviction moratorium is a good thing - again, because we have the vaccine now.
 
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I really think that since the vaccine is available, we should do what the party of 'personal choice' wants, which is let it rip and get this thing behind us.
Problem is it will not really be over after this wave if we don’t get more vaccination. The winter will bring a different set of dynamics and other people still not infected will be exposed in new ways and we will have another wave - barring a strong vaccination push.

Do we really want another wave? It is quite constricting of people’s freedom to have another wave. I want more freedom.
 
Problem is it will not really be over after this wave if we don’t get more vaccination. ...
How much of a difference do think it will make getting more vaccinated versus not? Personally I don't think it will make much of a difference. There will still be an issue come winter if people are forced back to work in close quarters. It might be flu, a variant, or something else.
 
How much of a difference do think it will make getting more vaccinated versus not? Personally I don't think it will make much of a difference. There will still be an issue come winter if people are forced back to work in close quarters. It might be flu, a variant, or something else.
It will certainly make a difference in how many people die or have organ damage.