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

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3) there's a recent Mayo Clinic study that shows a marked difference in efficiency between Moderna and Pfizer (but it's not peer reviewed yet).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

i've decided to trust the scientist with the furry avatar who worked on the vaccine that i got

I'm terrible at interpreting data and stats, but ... how is it that all of these very smart experts can disagree on how to read and interpret numbers?

they seem to disagree with one person

I don't think it's radical to think that efficacy is lower for delta though

In FL as well and my 9 yr old just started school today, in person, masked of course. I am terrified that we made the wrong decision, but we didn’t have many other options. If something happens I will wish we had just said, “let’s just keep her out of school this year and try again for 4th grade next year.”

how is it that all of these very smart experts can disagree on how to read and interpret numbers?

Because the topic of how to interpret numbers like this is the entire academic discipline of statistics, whose problems are very hard and the answers to which not everyone agrees on.

Just sat through my local school board deciding (on a 5-4 vote) not to follow any health protocols at all this year. It wasn't a surprise. It also makes us the only large system in our state NOT requiring masks, which makes us a control group of sorts in a real-time COVID experiment. I have to hope at this point that the anti-maskers are right and it will be fine, because what choice do I have.

Public forum was the usual mix of sane sober people saying obvious things ("listen to literally every public health expert on the planet") and crazy people crazy-ing. My favorite was the lady who thought she'd discovered a conspiracy because "they already know what they're going to name the next variant!" No one took the trouble to explain the Greek alphabet to her.

Oh, and the WORST thing was a cute lil 6th grad girl who got up to speak, all blonde ponytails and standing on her tiptoes, and confidently read a very articulate statement that you could charitably say she had help with about all the reasons masks are bad and dumb. And then at the end, she went into a thing about how her family had just gone on vacation in Mexico and had to take COVID tests to come back in, but there are a lot of illegal immigrants crossing every day and who knows how much COVID they're spreading ...

I half expected her to start in on "Tomorrow Belongs to Me." It was some creepy stuff.

:(

MASSIVE news here:

https://www.aegworldwide.com/press-center/press-releases/aeg-presents-require-proof-full-vaccination-us-concertgoers-and-event

This is bound to have cascading effects on showgoing. Note the key point -- negative tests are not going to be accepted as an alternate after the implementation date, it's proof or nothing. Key part:

The vaccination policy, limited only as required by law, will be in full effect nationwide no later than October 1, 2021. Several venues have already been following local government vaccination mandates, with others anticipated to come in the weeks leading up to October 1. The date was chosen specifically to allow time for any eligible unvaccinated ticketholders and staff to reach fully vaccinated status should they choose to do so.

SF in general is also about to require it hands-down:

https://www.sfchronicle.com/bayarea/article/San-Francisco-to-become-second-U-S-city-to-16382500.php

This honestly is putting my mind at a relative ease (relative), in that I had always been intentionally holding off on going to shows of any sort until the very end of September. This timing is ultimately accidental but I am glad for it.

good

Surprising for the company that was founded by the same guy who underwrites the right-wing Examiner papers.

Ed Yong:

Even at the low end of the CDC’s estimated range for Delta’s R0, achieving herd immunity would require vaccinating more than 90 percent of people, which is highly implausible. At the high end, herd immunity is mathematically impossible with the vaccines we have now.

This means that the “zero COVID” dream of fully stamping out the virus is a fantasy. Instead, the pandemic ends when almost everyone has immunity, preferably because they were vaccinated or alternatively because they were infected and survived. When that happens, the cycle of surges will stop and the pandemic will peter out. The new coronavirus will become endemic—a recurring part of our lives like its four cousins that cause common colds. It will be less of a problem, not because it has changed but because it is no longer novel and people are no longer immunologically vulnerable. Endemicity was always the likely outcome—I wrote as much in March 2020. But likely is now unavoidable. “Before, it still felt possible that a really concerted effort could get us to a place where COVID-19 almost didn’t exist anymore,” Murray told me. “But Delta has changed the game.”

If SARS-CoV-2 is here to stay, then most people will encounter it at some point in their life, as my colleague James Hamblin predicted last February. That can be hard to accept, because many people spent the past year trying very hard to avoid the virus entirely. But “it’s not really the virus on its own that is terrifying,” Jennie Lavine, an infectious-disease researcher at Emory University, told me. “It’s the combination of the virus and a naive immune system. Once you don’t have the latter, the virus doesn’t have to be so scary.”

Yeah, I linked that Atlantic article in the outbreak thread, it's a good one.

I wish music venues in Austin would require proof of vaccination

of course, that's nearly impossible when shit like this is happening

UPDATE: Fresa’s says they will no longer be requiring proof of vaccination for indoor dining after TABC informed them it was a violation of SB 968, prohibiting vaccine passports, which was signed into law in June. https://t.co/MA0X8rD9XM

— MelanieTorre (@melanietorre) August 12, 2021

welcome to The Republic of Fresa’s, may i take your order?

BREAKING: WFOR is reporting that 4 teachers from Broward county have died of covid in a single day.

Three were unvaccinated. We don’t know the status of the 4th. pic.twitter.com/uT4XW7irc5

— Brianna Keilar (@brikeilarcnn) August 13, 2021

ugh that's so sad

Yeah, and all unvaccinated.

Apparently before the schools even opened, though, tbf.

There was an NPR story on Case Western, which had been offering vaccines incentives. With incentives, vaccination hovered around 70%. When the school decided to require vaccination, immediately leapt up to 95% or so.

It’s exposing the kids to infected and contagious adults once the schools open that’s the concern. That many teachers dropping in one day probably doesn’t mean that they were the only four dumb enough to still be unvaxxed.

With incentives, vaccination hovered around 70%. When the school decided to require vaccination, immediately leapt up to 95% or so.

This is why all businesses/municipalities that aren't insane need to mandate vaccination. Posting bullshit on social media is one thing. Only the truest of true believers are willing to forego their job in order to own the libs.

Only the truest of true believers are willing to forego their job in order to own the libs.

The vulnerability of elected officials to this kind of public mania makes cowards of most of them. After all, they are 'public servants' and accountable even to idiots and the insane.

otoh, the strict hierarchy of business, where the big boss capo di tutti capi lays down the law and all subordinates must either comply or be shown the door allows far greater latitude to the owning class to make this happen. If the Fortune 500 CEOs all made a pact to jump over this cliff together, the anti-vaxxers would secretly fume and complain, but their power to resist would dissolve in an instant like dew in the summer sun.

A few weeks ago our local health department released its vaccination numbers, and for a very educated, relatively affluent place I was shocked that the local numbers were so low, implying only around 60% or so vaxxed, and perhaps as low as 30% of eligible 12-18 year olds vaxxed. A lot of people smelled a rat and questioned the data, with one dude going so far as to dig up and analyze different numbers from the state. He did the math, and came up with something a lot more promising and more expected, indicating closer to 80% of eligible 12+ have been vaccinated, and at the high school specifically close to 90% of eligible staff and teachers. Just another example of different groups and health departments getting totally different results with what one presumes are the same numbers. Or are they the same numbers? Who the fuck knows. It definitely doesn't pass the smell test when the same Illinois department of health that keeps calling fully vaxxed people I know to remind them of their second shot they got months ago would have better numbers than our local health department, but here we are.

Based on FB I do kind of feel like my(vaccinated, middle-aged) peers have stopped trying to avoid spreading COVID altogether, while I persist in my (admittedly pretty mild) regime of wearing a mask when I go in a store, getting takeout or eating outside rather than eating in the restaurant, not going to sporting events for now, etc. Rational/irrational fear is they think I'm being weird and uptight about it.

huh dunno why you’d be worried about spreading a deadly disease, seems weird

We have to wear masks indoors again in Philadelphia, which is a relief.

I am supposed to be giving an outdoor reading this week, and am becoming slightly nervous about the situation, especially as the forecast calls for rain and the venue is *technically* the patio of a usable indoor space. Going to have to ask my friend, who also hosts, what he thinks we should do if it's dumping rain...but since he has a young child and so does one of my fellow readers, I doubt he'd move it inside.

OK, everyone start your clocks: both kids back in the high school today, full capacity, 3400+ students and staff in relatively tight quarters, everyone masked and overwhelmingly (80-90%+) vaxxed. Let's see how it goes.

Good luck, everyone.

fwiw, the handful of very modest, very small outbreaks last year at the school (when it was at reduced capacity, still masked but on partial reopening in the spring of course much less vaxxed) all were spread and traced to outside the school - parties, mostly - so we'll see how things fare under new conditions. More virulent strains, but mostly vaxxed population, both in and out of school. More densely packed, but everyone still wearing a mask, perhaps less cautious, but perhaps (hopefully) slightly less of a need for caution.