Coronavirus

[AlanSubie4Life]

presented experiences to you (pedi's stopping recommending the vaccines to their patients), and you reply with lol's and sarcasm, instead of wondering why trained physicians made that decision.

I was laughing at your suggestion that your recommendations and the recommendations of those pediatricians you have discussed this with mirror those of most pediatricians. That’s all.

Anyway I provided data. Seems like a pretty clear picture to me.

I guess it is an echo chamber.

the decision by physicians not to press their patients to be vaccinated is understandable for that group.

No idea whether this is happening, in any case.

Seems to me the intent is to use minimal risk interventions to reduce disease.

Not clear it would be contraindicated even for a child who has had COVID multiple times (might be even more recommended!).

 

[bkp_duke]

I was laughing at your suggestion that your recommendations and the recommendations of those pediatricians you have discussed this with mirror those of most pediatricians. That’s all.

Anyway I provided data. Seems like a pretty clear picture to me.





No idea whether this is happening, in any case.

But you didn't provide data. ANY data needs to account for:
1) CFR for the current circulating Serotype (Omicron and variants). Prior data is going to skew to higher CFR.
2) Accounts for prior vaccination and/or prior infection. This alone reduces the CFR by a staggering amount, given that anyone in the USA that hasn't been infected OR hasn't been vaccinated is effectively a unicorn.

What you are quoting (I believe from the CDC) is aggregate data to date, which includes Serotype 1, and when people were not vaccinated and had no prior infection. That's a situation which would be totally different than what we find ourselves in now.

Anyway, have a nice evening, I'm going to watch Star Trek Picard before my road trip tomorrow to SF (frown on the drive, not the show)

 

[AlanSubie4Life]

This is what things look like when the virus is endemic, and lethality has dropped.

Yes thankfully.

What you are quoting (I believe from the CDC) is aggregate data to date, which includes Serotype 1, and when people were not vaccinated and had no prior infection. That's a situation which would be totally different than what we find ourselves in now.

I said I was too lazy!

Anyway it is easy enough to do delta measurements with the prior data I provided several months (and years) ago here (easily found) and get exactly that. It’s all screen capped, everything needed.

I always provide data! And if I don’t I always say I am too lazy, and provide the means.

I certainly hope CFR has dropped substantially! And I believe it has.

 

[PACEMD]

There is a risk in the males adolescent age or higher for myocarditis. It's not trivial, and the fatality rate in that group is still pretty much zero.

We see what we want to see and what we look for, don't we? Like "concussions" and "sepsis". School systems are now tripping over the pericarditis/myocarditis bandwagon for athletes so we focus our stare. Interesting phenomenon in and of itself. Like the concepts of concussion and sepsis, both of which no longer have definitions or applicable meanings.

 

[Norbert]

But you didn't provide data. ANY data needs to account for:
1) CFR for the current circulating Serotype (Omicron and variants). Prior data is going to skew to higher CFR.
2) Accounts for prior vaccination and/or prior infection. This alone reduces the CFR by a staggering amount, given that anyone in the USA that hasn't been infected OR hasn't been vaccinated is effectively a unicorn.

What you are quoting (I believe from the CDC) is aggregate data to date, which includes Serotype 1, and when people were not vaccinated and had no prior infection. That's a situation which would be totally different than what we find ourselves in now.

Anyway, have a nice evening, I'm going to watch Star Trek Picard before my road trip tomorrow to SF (frown on the drive, not the show)

In SF, you are still going to see a few masks. What you are maybe not going to see is the percentage of vaccination.

Infection rate in SF is currently about 0.29x the national average.

EDIT: By my calculation, total COVID deaths in SF, extrapolated to the US population, would be less that 500,000. Compare that to 1,150,000 actual.

 

[Dave EV]

In SF, you are still going to see a few masks. What you are maybe not going to see is the percentage of vaccination.

Had some blood work done today here in southern California. The lab requires masks and surprisingly everyone except one person was wearing one.

At the grocery stores, still see a few as well. Though I'm still surprised to see cloth masks around. Though better than nothing, the data clearly shows that surgical masks and then KN95/N95 masks as being far superior. I consider that a failure in government health messaging. There should be no doubt at this point that if you are masking, you should be using KN95 or N95, well fitted masks.

 

[JRP3]

Most people here can't grasp that the current circulating viral strain is so far different in genetic sequence that it bares only moderate genetic similarities to the original strain.

Yes it's been pretty obvious since XBB became dominant. Hospitalizations and deaths continue to drop as do wastewater levels, though there is a slightly concerning recent leveling off in Northeast wastewater levels which has stopped the downward trend. Comparing to Feb last year wastewater levels are still higher but deaths much lower, (about 3x lower).

 

[JRP3]

Thoughts?

A new analysis of genetic sequences collected from the market shows that raccoon dogs being illegally sold at the venue could have been carrying and possibly shedding the virus at the end of 2019. It’s some of the strongest support yet, experts told me, that the pandemic began when SARS-CoV-2 hopped from animals into humans, rather than in an accident among scientists experimenting with viruses.

The Strongest Evidence Yet That an Animal Started the Pandemic

A new analysis of genetic samples from China appears to link the pandemic’s origin to raccoon dogs.

www.theatlantic.com

 

[AlanSubie4Life]

But you didn't provide data. ANY data needs to account for:
1) CFR for the current circulating Serotype (Omicron and variants). Prior data is going to skew to higher CFR.
2) Accounts for prior vaccination and/or prior infection. This alone reduces the CFR by a staggering amount, given that anyone in the USA that hasn't been infected OR hasn't been vaccinated is effectively a unicorn.

What you are quoting (I believe from the CDC) is aggregate data to date, which includes Serotype 1, and when people were not vaccinated and had no prior infection. That's a situation which would be totally different than what we find ourselves in now.

Anyway, have a nice evening, I'm going to watch Star Trek Picard before my road trip tomorrow to SF (frown on the drive, not the show)

Coronavirus

That’s great, you can make that choice and I’m glad it worked out. Many countries do not recommend it. The WHO says there is no evidence healthy children or teens need a booster. CNBC link So it is not at all fringe or misinformation for parents to question it (especially second doses of mRNnA...

teslamotorsclub.com

Just before Omicron took off, vaccines available for some children.

Cases: 8.67million
Deaths: 1133

CFR: 1 in 7653

Total Now:
Cases: 16.644million
Deaths: 2145

Incremental (Entire Omicron era with vaccines available ):

Cases: 7.97 million
Deaths: 1012

CFR: 1 in 7875

Caveats:
1) deaths are removed from counts sometimes by CDC so initial numbers and current numbers are slightly higher than actual. Minimal impact on results.
2) Cases only. Ascertainment rates have of course changed a significant amount (but note ascertainment has always been a problem, so likely overall decrease in ascertainment is probably down by factor of 3 at most, identifying maybe 1 in 5 cases - note that there are 16 million cases on a pop of 70mil so that is 1 in 5 so clearly ascertainment can’t be worse than that!).
3) All the other caveats discussed here which we all know now.

I think it is a pretty fantastically poor performance to see no change in CFR with a “more mild” Omicron and with vaccines available. Likely IFR is down by a factor of 2 or 3 or so. Pretty bad. Still 1 in 10k kids identified with COVID dies (hard to know exact current incremental rate; would have to look at a more recent post of mine with the datapoint to calculate the slope).

Note that about the same number of children have died from Omicron as died from Delta and the OG virus.

Worth nothing that 0-4, the age group affected by the booster dose post that started this discussion, is by far the most vulnerable to COVID in age groups under 18. I think these data would suggest it is extremely advisable for parents to get their tots vaccinated, whatever about older children.

 

[AlanSubie4Life]

Thoughts?

The Strongest Evidence Yet That an Animal Started the Pandemic

A new analysis of genetic samples from China appears to link the pandemic’s origin to raccoon dogs.

www.theatlantic.com

Nothing new here except the sequences. This has been known as the likely source since early 2022; raccoon dogs were identified then by Worobey et al as the most likely source.

Whether it is, who knows. We’d need to see the evidence for the lab leak to be able to evaluate that possibility.

The animal market hypothesis is supported by the location of cases being centered on the market, not the lab, and the fact there were two distinct starts a week or two apart (a key supporting factor!) A strong circumstantial case.

However it is impossible to know with a lot of certainly at this point what happened, without more information. But the current evidence available to the public supports the animal market hypothesis. It could easily be the lab - we’d just need the data to support that.

Definitely either is possible. We’ll probably never know.

I strongly believe the animal market was the source, but could totally change my mind - it could definitely be the lab if the evidence supported it being the lab!

In the end it doesn’t matter much - we should avoid virus likely to cause pandemics spreading from labs, and we should avoid animal markets that are likely to cause pandemic virus to spread.

It’s not like if it turns out to be the lab, we are going to say “actually those animal markets are totally cool and not a problem. Please keep selling raccoon dogs!”

 

[Krugerrand]

At this point, everyone has either had it, or been vaccinated. The IFR in that case is in the neighborhood of the common cold. My friends in the hospitals are just not seeing anyone hospitalized with this anymore, but we know it's endemic.

You do you, but medically, I'm not recommending further boosters for this thing. The data just don't support that medical decision tree any longer for those previously vaccinated or with documented infection.

So, even if you’ve never gotten COVID, but were vaccinated originally (say the first two and one booster) you’re not recommending further boosters - like a bivalent one? Ever? Or less frequently?

 

[Norbert]

Nothing new here except the sequences. This has been known as the likely source since early 2022; raccoon dogs were identified then by Worobey et al as the most likely source.
....

The report isn't out yet, but I think this understates the significance virologists give to the new data.

This is from the NYT article: https://www.nytimes.com/2023/03/16/science/covid-wuhan-market-raccoon-dogs-lab-leak.html

But the genetic data from the market offers some of the most tangible evidence yet of how the virus could have spilled into people from wild animals outside a lab. It also suggests that Chinese scientists have given an incomplete account of evidence that could fill in details about how the virus was spreading at the Huanan market.

 

[AlanSubie4Life]

The report isn't out yet, but I think this is understates the significance virologists give to the new data.

This is from the NYT article: https://www.nytimes.com/2023/03/16/science/covid-wuhan-market-raccoon-dogs-lab-leak.html

When I said “the sequences” I mean the fact that they found RNA intermixed with animal DNA.

This is just the least surprising thing ever given Tweets from a year ago (though it is good additional circumstantial evidence, no doubt!). That is all I meant.

https://twitter.com/x/status/1497623166134358019

The info in the additional uploaded sequences provides additional circumstantial evidence that raccoon dogs could have been the source.

Alternatively, it could be that someone working at the lab had a special fascination with raccoon dogs kept in squalid conditions, and came to visit them frequently, fawning over the cutie-pies in their cages, even when ill with a “mild flu,” yet kept to himself when at home (they only went to the market). That would be a possible explanation too. This may be the top secret evidence that the Energy Department has. (Can see why it might be low confidence.)

 

[Norbert]

When I said “the sequences” I mean the fact that they found RNA intermixed with animal DNA.

This is just the least surprising thing ever given Tweets from a year ago (though it is good additional circumstantial evidence, no doubt!). That is all I meant.

https://twitter.com/x/status/1497623166134358019

The info in the additional uploaded sequences provides additional circumstantial evidence that raccoon dogs could have been the source.

Alternatively, it could be that someone working at the lab had a special fascination with raccoon dogs kept in squalid conditions, and came to visit them frequently, fawning over the cutie-pies in their cages, even when ill with a “mild flu,” yet kept to himself when at home (they only went to the market). That would be a possible explanation too. This may be the top secret evidence that the Energy Department has.

If you are saying: it is new evidence, not a new theory (compared to 2022). However there does seem to be a step up outside of being conclusive.

 

[AlanSubie4Life]

If you are saying: it is new evidence, not a new theory (compared to 2022). However there does seem to be a step up outside of being conclusive.

Yes. It is new evidence. They had swabs from the stalls likely selling raccoon dogs a year ago, positive for C19, as covered in that thread. Now they have evidence of swabs intermixing C19 with raccoon dog DNA. So just sort of confirming that the raccoon dog area is actually where the swabs came from. I guess that is how I view it. Maybe I am missing something.

I still like the theory about the raccoon-dog-loving lab worker though. It is possible!

 

[bkp_duke]

So, even if you’ve never gotten COVID, but were vaccinated originally (say the first two and one booster) you’re not recommending further boosters - like a bivalent one? Ever? Or less frequently?

IF they adjust the vaccine (i.e. I think the bivalent one covers the latest strain) then yes. But what I was boosted with in Dec was pretty much worthless. I boosted, had an immune response (1 day of fatigue and malaise) and then got COVID 3 weeks later when travelling. The coverage of the original vaccine to current variants isn't that good. Hopefully newer boosters are against the current circulating sequence, as the variants out now have gone through "immune escape" of the original vaccines. They provide some limited coverage, but getting the vaccine and subsequently still getting COVID is pretty common (we didn't see that with the original vaccine and earlier variants).

With that said, I fall in the middle here as "it's probably not going to hurt you, if you have concerns get boosted". Just temper your expectations. The seriousness of infections has also dropped, death and hospitalization are far less prevalent.

Travelling, further responses will be delayed by SF and LA traffic.

 

[bkp_duke]

So, even if you’ve never gotten COVID, but were vaccinated originally (say the first two and one booster) you’re not recommending further boosters - like a bivalent one? Ever? Or less frequently?

IF they adjust the vaccine (i.e. I think the bivalent one covers the latest strain) then yes. But what I was boosted with in Dec was pretty much worthless. I boosted, had an immune response (1 day of fatigue and malaise) and then got COVID 3 weeks later when travelling. The coverage of the original vaccine to current variants isn't that good. Hopefully a new

Coronavirus

That’s great, you can make that choice and I’m glad it worked out. Many countries do not recommend it. The WHO says there is no evidence healthy children or teens need a booster. CNBC link So it is not at all fringe or misinformation for parents to question it (especially second doses of mRNnA...

teslamotorsclub.com

Just before Omicron took off, vaccines available for some children.

Cases: 8.67million
Deaths: 1133

CFR: 1 in 7653

Total Now:
Cases: 16.644million
Deaths: 2145

Incremental (Entire Omicron era with vaccines available ):

Cases: 7.97 million
Deaths: 1012

CFR: 1 in 7875

Caveats:
1) deaths are removed from counts sometimes by CDC so initial numbers and current numbers are slightly higher than actual. Minimal impact on results.
2) Cases only. Ascertainment rates have of course changed a significant amount (but note ascertainment has always been a problem, so likely overall decrease in ascertainment is probably down by factor of 3 at most, identifying maybe 1 in 5 cases - note that there are 16 million cases on a pop of 70mil so that is 1 in 5 so clearly ascertainment can’t be worse than that!).
3) All the other caveats discussed here which we all know now.

I think it is a pretty fantastically poor performance to see no change in CFR with a “more mild” Omicron and with vaccines available. Likely IFR is down by a factor of 2 or 3 or so. Pretty bad. Still 1 in 10k kids identified with COVID dies (hard to know exact current incremental rate; would have to look at a more recent post of mine with the datapoint to calculate the slope).

Note that about the same number of children have died from Omicron as died from Delta and the OG virus.

Worth nothing that 0-4, the age group affected by the booster dose post that started this discussion, is by far the most vulnerable to COVID in age groups under 18. I think these data would suggest it is extremely advisable for parents to get their tots vaccinated, whatever about older children.

I like those odds. CFR during H1N1 in 2009 was as high as 1 in 1200 (symptomatic cases - i.e. those seeking medical treatment):

Case fatality risk of influenza A(H1N1pdm09): a systematic review

During the 2009 influenza pandemic, uncertainty surrounding the seriousness of human infections with the H1N1pdm09 virus hindered appropriate public health response. One measure of seriousness is the case fatality risk, defined as the probability of mortality ...

www.ncbi.nlm.nih.gov

The question in your data is what do they define as a case? With H1N1 it was seeking medical care. Are the CDC numbers you quote the same, or just any positive test (i.e. laboratory CFR, which is always lower than symptomatic CFR).

 

[Norbert]

Yes. It is new evidence. They had swabs from the stalls likely selling raccoon dogs a year ago, positive for C19, as covered in that thread. Now they have evidence of swabs intermixing C19 with raccoon dog DNA. So just sort of confirming that the raccoon dog area is actually where the swabs came from. I guess that is how I view it. Maybe I am missing something.

We'll have to see for the report, but maybe it does just that: Put them as close together as they possibly could be: within millimeters. Yet still not an infected animal, as apparently regarding animals there is no data either way (or it is kept hidden).

I still like the theory about the raccoon-dog-loving lab worker though. It is possible!

Or you could have a reverse theory: The same lab worker brought the virus from the market into the lab, and then it looked like a lab leak.

 

[AlanSubie4Life]

I like those odds. CFR during H1N1 in 2009 was as high as 1 in 1200 (symptomatic cases - i.e. those seeking medical treatment):

I don’t!

I was surprised at how little the CFR has changed actually. It is pretty sad given the existence of effective vaccines. I would guess half of the deaths were probably avoidable.

And H1N1 was no joke, and there were a lot of people upset at the response to it, claiming not enough was done.

Are the CDC numbers you quote the same

Undoubtedly not. Unclear which way things would go, of course. There would be significantly less health-care seeking with H1N1 presumably. Diagnostics were scarce. Etc. I’m not sure about the estimates for number infected. Has been discussed here before.

No idea how IFRs compare. I would guess COVID probably quite a bit higher given the much higher mortality.

In any case, unusually high mortality in both cases and undoubtedly a swine flu vaccine early on would have been very helpful and strongly advised.

 

[Norbert]

This article in 'Science' has some information that others don't, regarding the whole situation:

Science | AAAS

www.science.org

"Unearthed genetic sequences from China market may point to animal origin of COVID-19
French scientist finds previously undisclosed data from Chinese research team"