Mostly Apolitical Thread for Discussing/Venting our Rational/Irrational COVID-19 Fears and Experiences in 2020

xp to dmac: very prominent health officials in places with reputations for good governance and great data/monitoring have been wrong throughout, including very recently.

like this is the main guy in the UK. he's wrong all the time!

COVID cases have fallen to 33K per day (7-day average) since Neil Ferguson, perhaps the UK's most prominent epidemiologist, said it was "almost inevitable" that cases would hit 100K/day.https://t.co/zE6fYgw2eh pic.twitter.com/pzFgU2gmBg

— Nate Silver (@NateSilver538) July 28, 2021

I don't care that the prediction is wrong, I'm sure this stuff is hard to predict. It's that he's consistently so overconfident. Now he says he's "positive" the pandemic will be over by October. Well, probably. But there are downside risks: new variants, waning immunity, etc. pic.twitter.com/rfoWbCtwoh

— Nate Silver (@NateSilver538) July 28, 2021

and here's the big guy at UCSF highlighting that he has no idea what's going to happen next

Covid (@UCSF) Chronicles, Day 504

To me, the most confusing time in the pandemic was May 2020, as we exited lockdown and nobody quite knew what they should & shouldn’t do (clean the mail? touch the dog?).

But now is giving May 2020 a run for its money. (🧵1/25)

— Bob Wachter (@Bob_Wachter) August 4, 2021

you can always touch the dog

I saw one expert theory stating the large "football effect" on cases had less to do with outdoor transmission and more to do with people packing into pubs/restaurants to watch the matches.

Only a thorough system of contact tracing could provide useful numbers by which to test this theory, but new cases of covid (esp. delta) overwhelmed our ability to do contact tracing long ago.

This is one frustration I feel about the current 'delta' surge in the USA. It is glaringly obvious that delta variant is extremely contagious and that it can infect fully vaccinated people at a much higher rate than other variants, but how those breakthrough cases relate to an individual's exposure to high risk environments is not known. Maybe most of the breakthroughs happen in people who believed vaccination allowed them to completely resume 'normal life', including traipsing around unmasked in high risk situations. Or maybe there's no obvious pattern. Nobody can say.

I do get annoyed at people using polio and smallpox to insinuate we can easily get COVID down to Covid-Zero.

polio spread through fecal matter in water and food, and on occasion, saliva. it was not very easy to spread. (it's also not eradicated, but it's much more rare now obv)

smallpox, unlike COVID, didn't often spread in enclosed settings, spread more through droplets, required longer close-contact to spread, and while it was incredibly infectious, viral shedding didn't start until you witnessed the signature rash appear on your skin, which means you'd never unwittingly transmit it to other people. it spread more slowly and less easily than COVID.

A whole lot of Scottish fans came down to London to watch the England v. Scotland game and ended up taking the Delta variant back to Scotland.

Probably, but there was a whole lot of Delta in Scotland already. Glasgow in particular was an early hotspot.

England, well at least the North, has pretty much decided it's all over it seems. In Manchester, Liverpool & Leeds at the weekend i'd say mask wearing in shops / indoor settings was at around 2%, in stations, 5% and on (packed) trains around 10% max. I hope this is not in Scotland's imminent future but i fear this attitude may spread as fast as Delta. Depressing.

There's just so much anger out there. Obviously you've got the rabid anti-maskers and the rabid anti-vaxxers, but not even just that. I'm sensing more and more anger from the folks who've been doing the "right stuff" since the start - masking up, putting their lives largely on hold, distancing, getting the vaccines as soon as they were ready - only to be told, "well, sorry, 35-40% of this country are selfish assholes so you are just going to have to get right back to doing all of those things! maybe some day things will be better?" *shrug*. Obviously things are constantly evolving and few could have predicted the delta wave to hit us so hard at the exact time people were dipping their toes back in the "more normal" waters, but it's easy to understand the anger and frustration. Idk if I really have a point, I'm just sensing more anger on all sides and it kinda feels like a tipping point. Into what, I couldn't say, but things feel really... unsettling, to try and label it best I can without overstating it too much.

35-40% of this country are selfish assholes

lol this has been a rallying point for yeeeeeeears. There's always been that smack your forehead frustration in the face of so many assholes feeling.

I said before I'd rather have four more years of Covid than four more years of Trump, because my own simmering anger was driven more by the latter than the former. Now, because of Trump (or at least his followers) we could end up with both, if only in practice. *More* Trumpism and *more* Covid. Which of course is ironic, given his loose credit for getting the vaccine programs going full steam ahead. On the plus side, his unmasked and unvaxxed minions are among the most likely to be hurt be continuing Covid, so maybe the tipping point will be enough of them dying to boost those slim blue margins in states like Georgia. And of course there is always the chance Trump himself could get it again, which would be sweet.

But I wouldn't want to get political in this neutral space.

we're still in the Trump-era. he may not be President but DeSantis = basically an extension of his body at this point.

He's everywhere, like the blob.

Tipsy posted in the other Covid thread:

I just told my poker circle I'm out of in-person games for now — we have up to 10 people crammed into a tiny room with limited ventilation, and the host of the game is in a demographic risk group, so I don't feel totally comfortable there (much as I enjoyed the game's in-person return).

Similar boat here, with an in-person game that moved online from March of last year through May. They've had a few games in person that I couldn't make it to, so I'm feeling both some obligation to go this week and also a chance to see friends I haven't seen in forever. Everyone's vaccinated, but I'm still a bit uncomfortable, knowing it's not worth the risk.

Can you move it outside?

Might work, since it's only 5-7 people. Haven't been to the house where it's happening, so not sure of the setup.

Sky News Australia has quietly deleted at least 31 videos that question the public health response to Covid-19 or promote unproven treatments as the broadcaster prepares for its chief executive, Paul Whittaker, to appear at a Senate inquiry on Friday

this isn't new information, but few people have been connecting the dots of the random studies and actually laying it out like this:

QUICK THREAD ON VACCINES & DELTA: Friday's @PHE_uk report said that viral load in infected vaccinated people was similar to that of uninfected people.

As has been pointed out by others, this does *not* mean all is lost and vaccines don't work.

10 tweet thread explaining why!

— Prof. Christina Pagel (@chrischirp) August 9, 2021

Thanks

this is precisely what Wallensky fucked up and is continuing to fuck up.

She's basically said "Vaccinated people who get infected spread the disease just as much as the unvaccinated", when the truth is closer to "Vaccinated and unvaccinated often have similar viral loads when initially infected, but vaccinated individuals rid themselves of the disease much faster and are not contagious for as long a period as the unvaccinated. As a result, they may shed less viral load than the unvaccinated later in the course of infection".

The conclusion ("we should start masking indoors") is absolutely correct, but the dots to get there have been wrong the whole time. I'm guessing Director Wallensky thinks that if we add the caveats, people will use them as excuses not to mask, but...there's a LOT of resistance to masking now from vaccinated people who previously NEVER resisted, so....clearly she was wrong. I have vaccinated friends who have not resumed masking and I cannot figure out why.

I really think that officials need to find a way to provide free rapid testing kits to families. if you catch infection early, you can really reduce the possibility of spreading to other people than if you basically only get tested if you're displaying symptoms, by which point you've probably already infected people.

i've taken 3 tests in a week. no symptoms, and the first time it was just to make sure I was doing the test right, but I figure regular testing doesn't hurt. figuring I'll do two a week unless I have a week where I never leave the house.

https://www.reuters.com/business/healthcare-pharmaceuticals/moderna-may-be-superior-pfizer-against-delta-breakthrough-odds-rise-with-time-2021-08-09/

I haven't yet availed myself of rapid home tests. Anyone have a brand or online source to recommend?

I use BinaxNOW

That or quidel are the usual recommendations

We have quidel but we’ll probably switch to the other one when we run out on the basis that they’re $20/2 rather than $25/2

I'm getting a self test from CVS tomorrow. Anyone have tips for the swabbing?

i had a pharmacist do mine last week. previously i’d always done it myself and i used to do both tonsils plus the nose and i really poked that stick way the fuck up there. she only put it in my nose, just as far as the swab. just er, the tip, as it were. swished five circles in left nostril, five in right. it was a binaxNOW test.

NB i’ve never had it in the ear before

yeah teh five circles....oof, I was more brutal than the doctors who have swabbed me in the past. pulled out a huge mo'fuckin' booger it was gross

There was a good NPR piece this morning on kids and covid, which of course didn't and really couldn't come to any conclusion beyond "wear a mask." On the one hand, the CHOP doctor cited a rise in covid cases and even emergency room visits among kids under 12, but at the same time he was pretty vague about how sick most of them were (which is understandable, I suppose, because he doesn't want to downplay the possible if not probable risks) and also eventually acknowledged that there is some future as yet determined number of cases (and one presumes deaths) that we as a society will accept as normal before everything else goes back to normal, too. Right now that number is I guess in the tens of thousands, which is not out of the realm of possibility, given how many annual car deaths and flu deaths and deaths from smoking and alcohol related illnesses, etc., that we accept now.

the lateral flow tests don't go as deep up the nose IIUC (never had a PCR myself)

this is creepy. there's no way this isn't DeSantis's voice in these Tweets

Wrong again. The number of cases @CDCgov released for Florida today is incorrect. They combined MULTIPLE days into one. We anticipate CDC will correct the record. https://t.co/nbKnBNLzvU

— Florida Dept. Health (@HealthyFla) August 10, 2021

and btw there is no way in hell their explanation makes any sense and I do not accept it

But, like, why?

JUST IN: Southwest Airlines, American Airlines, and Delta Air Lines will NOT REQUIRE employees to get vaccinated, breaking with United Airlines' mandate that workers get vaccinated by October 25th or face getting fired.

— Pete Muntean (@petemuntean) August 10, 2021

It’s union stuff. Similar to what I’ve heard from teachers’ unions. Mandates would have to be part of contract negotiations. The airlines are calculating that it’s not worth pushing the issue.

Delta is famously non-union and United is Union so that’s not the whole story.

my friend sent her three kids back to school (masked). this was yesterday. already:

*One kid in quarantine cos his classmate had COVID. doesn't look like he was masked.
*Her 5 year old daughter worried about unmasked classmate.

single mother of three who is immuno-compromised and yes, vaccinated, but....a breakthrough could be rough.

I want to put my hands around so many throats and choke away.

esp since now she has to wait a few days to test him because today would likely be a false positive.

Ugh, having just finished up our two week quarantine off an exposure, I can confirm it's nervewracking for sure. I can only imagine even harder for a single mother. I fear this school year is going to mean a lot of people are going to have to scramble for two weeks of childcare at the drop of a hat, it's going to be a struggle for lots of people.

so Topol, one of my favorite sources, writes this:

There needs to be truth-telling about the reduced protection of mRNA vaccines vs symptomatic Delta infections.
It was 95% pre-Delta.
Many are claiming it's still ~80%.
It isn't.
50-60% is best estimate from all sources (not US, since we don't have the data) pic.twitter.com/ep608YW0J7

— Eric Topol (@EricTopol) August 11, 2021

I can't for the life of me tell if he's trying to be over-cautious in his estimates, or trying to make a point that we don't truly know the real range of efficiency (and it is a *range*).

but here's what I am having trouble with (and hoping a caek or caek-adjacent can comment):

1) i don't see others in his field confidently jumping to adopting this estimated efficiency drop
2) there are definitely other post-delta studies that have been run that do not show such a low efficiency, including in the last week. the Israel studies were roundly criticized for their poor methodology.
3) there's a recent Mayo Clinic study that shows a marked difference in efficiency between Moderna and Pfizer (but it's not peer reviewed yet). there's also a recent San Diego study that seems to have slightly better news for efficiency.
4) the studies he is latching onto for decreased efficiency include AstraZeneca, which isn't used in the US, and the REACT study doesn't break out how many people had Pfizer vs AZ. almost no studies include Moderna because they're not US studies. for a while we've assumed Moderna and Pfizer are the same, but Mayo Clinic study making it worth taking another look?
5) the React study measured efficiency at preventing asymptomatic and symptomatic infections, whereas other studies only focused on symptomatic

All this is to say - is he right, or is he a little rogue here? I don't think it's controversial to say the efficiency has dropped against Delta, as obviously breakthrough cases are more common now. I also don't know that, with the pandemic roaring as much as it is now, that having efficiency boiled down to a slim ten-percent range is necessarily helpful - the fact is, the virus is everywhere, and being unmasked and exposed to it, even vaxxed, can put you at risk for it, and at least for a little while, you can spread it, even if the vaccine rids the virus out of your system quickly. I do think continuing to insinuate it's 80% or higher could be harmful in causing people to take more risk that they wouldn't have if they had thought it to be lower.

for me, the desire to know if it has truly dropped that severely has more to do with my range of risk tolerance I can accept, even though I am masking and am not packing into saunas with people.

in either case, the CDC stopping tracking breakthroughs for non-hospitalized was a fucking mistake.

meanwhile, Nate weighs in, but he's been getting skewered by experts lately for his cringe takes (this one seems...less controversial):

I think there's a lot of uncertainty. A lot of these studies don't have rigorous controls in place as compared to e.g. clinical trials. Relatedly it's an issue that a decent chuck of the unvaccinated population in some countries likely have some immunity from natural infection.

— Nate Silver (@NateSilver538) August 11, 2021

It's a bit...soon to worry about drops in efficacy tbh or at least to muse aloud on Twitter

btw I found pretty quickly some supposed "experts" I followed early in my Twitter-medical journey are complete kookos who have been disowned by the community and wound up dropping them.

there is a lot more of this than we think which is scary.

(Topol isn't one of them, obviously, but Marty Markary is one)

I also don't know that, with the pandemic roaring as much as it is now, that having efficiency boiled down to a slim ten-percent range is necessarily helpful

I would say it doesn't matter that much whether it's helpful because it's very likely impossible.

When do schools have summer holidays in the US? In England all kids are off from ~end of July to start of Sept.

Some schools have started already, some starting in mid-August. I would say most schools start sometime between the middle of August and Labor Day (first weekend of September).

Hate seeing the case numbers explode before schools even start in many places. Illinois just went from 2,900 new cases yesterday to almost 4,000 today. Shit looks bleak and I'm super nervous about my son going back to school in two weeks.

Gotta be honest, I feel pretty fucking low about this all. I'm no COVID zero or nothing kind of guy, but it feels like we are never going to get our arms around this.

My younger daughter starts high school Friday, my other daughter starts her senior year Monday.

Yes we will. Stop. Eventually this will become something we live with. We're in a much better place than in fall '20 or even most of spring '21.

I understand how this shit gets amplified if all you do for hours is read Twitter.

Hug your kids. Hang out with your friends outdoors. You'll be fine.

Neanderthal and I live in fucking Florida with five-digit case loads every day. It's awful. Yet delta will burn through the unvaccinated zombies as if they were firewood.

I've got two >> 12 y/o nieces who return to school wearing masks on Aug. 23. All I can do is hope they're okay.

But we're not as a country like we were a year ago when, my god, the only mitigation was one lockdown after another, no vaccine in sight.

I'm in no way suggesting things are worse than previous peaks and in some ways are indeed better, but sending my unvaccinated kid back into school full time when case loads are double what they were when school started last fall (when it was 100% remote) does not make me feel good about the situation, that's for sure.

tbh we'd have been in a similar situation if our overall numbers were better because these kids don't qualify for jabs

from earlier, Topol definitely getting a little pushback on his efficiency estimate from earlier, from peers (including Dr Rasmussen, who he works with regularly and is a friend):

Dr Angela Rasmussen (Virologist)

Delta concerns me period. I'm fully vaccinated and still wear a mask in public spaces. But generally no, since many of these studies aren't directly comparable.

— Dr. Angela Rasmussen (@angie_rasmussen) August 11, 2021

Ashish Jha (Physician, appears on network news a LOT)

Eric -- my best estimate has been 75-85% efficacy against symptomatic disease

Going by CDC slides from 2 weeks ago that used that range (PHE 79%, Canada 87%, Israel 64%)

Wondering what data you find more compelling. Am happy to revise down if better data suggests as much

— Ashish K. Jha, MD, MPH (@ashishkjha) August 11, 2021

Jason Pogue (infectious diseases clinical pharmacist - think he's way too harsh here though)

No matter how frequently he says it, the data do not support this. His own (selective and somewhat irrelevant) table doesn’t even support it. I am 100% in agreement with truth telling. Truth (currently) says vaccines work similarly against delta. https://t.co/rZkIL84iNM

— Jason Pogue (@jpogue1) August 11, 2021

Chise (Senior Scientist, Vaccine development - warning, she worked on Moderna vaccine)

Thank you for saying this. I absolutely agree.

— Chise 🧬🧫🦠💉 (@sailorrooscout) August 11, 2021

Muge Cevik (Virology clinician and scientist, though sometimes seems to veer into smug "I hold the keys" territory)

I think this is not necessarily correct. 50% efficacy is based on REACT data (left) where it includes infection, and as you can see the CIs are quite large. PHE data (right) suggest it’s 88% for symptomatic delta. https://t.co/HXRSz63Jz9 pic.twitter.com/bXIgLJelnS

— Muge Cevik (@mugecevik) August 11, 2021

Ryan McNamara (research associate scientist)

Lot of respect for @EricTopol, but I respectfully disagree with this interpretation. Detection of viral RNA is not the same as symptomatic disease state, and vaccines effectiveness was quantified against the latter. The table used here is focused on the former. https://t.co/RffDZ8bIqb

— Ryan McNamara 🧬 (@Ryan_Mac_Phd) August 11, 2021

Idk if he's actually wrong, or if some of the people above are cranks (tell me if you know they are!). he is one of the best at sounding the alarm at things like the FDA's slowness to give full approval to vaccines, championing vaccination, and calling out the dearth of data that we have on breakthrough infections here. but he might be wrong on this one.

I am bored.

good news

This is fantastic. A recent study out of the University of Maryland presents the first evidence that full vaccination against COVID-19 actually SUPPRESSES emergent mutations of SARS-CoV-2 Delta variants therefore successfully debunking the myth that vaccines promote mutations.

— Chise 🧬🧫🦠💉 (@sailorrooscout) August 11, 2021