Somehow I missed publishing this post, which was why I thought I was up to 98 before, so this was supposed to be 97, but now it is 98. The comments are a little out of date order. I am trying to fix the post numbering but I may be unsuccessful, so who knows if this will show up as 97 or 98 or there will be two of each.
Dr. Osterholm is not only out of the Axis of Evil, he is now a potential nominee for the Hall of Fame for pandemic sanity. Listen to his podcase episode 62. (OH Podcast) Generally a breath of fresh air in terms of humility on our ability to control CV-19.
I can’t tell what is going on at the federal level. I don’t think they are competent enough for the suggestion that they want the epidemic to seem to be continuing so they can keep their fraud and abuse facilitating voting rules in place. And handling of the epidemic was literally the only issue on which the mystery actual president had a positive rating, so why are they destroying that with their pathetically bad message. The best explanation I have is that they really want people to get vaccinated, so they came up with the incredibly counter-productive and stupid message that the Delta variant is dreadful and even vaccinated people are getting infected and infectious, and then coupled it with even worse messaging that vaccinated people needed to wear masks and social distance and everything else, giving people a big incentive to get vaccinated, right? As I keep saying, we really need lots more government involvement in everything, because it is so good and competent.
And our state bozos are in some ways keeping their heads pretty low, I think the IB is terrified about what is happening to his re-election chances, so he is just trying to avoid the whole mess, while the DOH does its usual lousy job of communicating and disclosing data.
Finally, the national media and the Dems are terrified of Ron DeSantis and his sane, balanced approach to the epidemic, so they are picking on Florida in the latest case wave. Florida is interesting, because while cases are up, hosps and deaths are not up that much, and as usual, I am dubious about “cases” which likely reflect a lot of low PCR positives. The truth is that mobility everywhere has increased dramatically, so there are lots more contacts between people and contacts are what drive transmission opportunities, so exposure to the virus increases and some people actually get infected. This is all part of what we can expect as we learn to live with instead of trying to eradicate the virus.
Meanwhile, the teachers’ unions efforts to deprive children of a meaningful education were wildly successful. I assume that was the intent, because you have to assume that people intend the outcomes of their actions and it is the teachers’ unions that kept kids out of school. A McKinsey report finds an enormous drop in educational attainment, four months on average in regard to reading and five months in regard to math, and of course that drop is even higher among minority children. (WSJ Article) (McK Report) As the report notes, once children get behind, it has lifelong consequences. But at least Dem politicians are getting their campaign contributions.
An outbreak in Provincetown, Massachusetts supposedly triggered some of the CDC’s concerns that led to it saying vaccinated people should get masked. Here is the initial report on the outbreak, which, while CDC doesn’t say this, occurred at a traditional gay festival time, with rampant partying. (CDC Report) No one should be surprised if lots of diseases get spread every year in connection with this event. Kind of like Sturgis, right, and I am sure we will see all kinds of blaming articles about the gay community’s recklessness in being superspreaders. Anyhow, 469 cases were identified, 74% occurred among supposedly fully vaccinated persons and 90% of sequenced specimens were Delta. Cycle numbers were supposedly similar among the vaxed and unvaxed, although the median was higher in the vaxed. 80% of cases among the vaxed were symptomatic. Four of the five persons who were hospitalized were vaxed and there were no deaths. Note the very low hospitalization and death rates in this outbreak. As usual the few cases of serious illness were concentrated among those with prior health issues. Not a representative population, but again, vaccination does not stop exposure, it should allow a person to clear the virus quickly and prevent serious illness.
And here is a report of another Delta-driven outbreak in Finland. (ES Article) Of note is that this outbreak occurred in a hospital. There were 58 cases in patients and 45 in health care workers, and 18 deaths among the patients, but the average age of death was 80. One person who died was fully vaccinated. Note that there was universal masking. Fat lot of good it did. In general, the vaxed people had less symptomatic infections, and while transmission was hard to trace, it did appear that there may have been transmission from vaxed individuals. What it really shows is that, as expected, vaccination is less effective among the elderly, especially the frail elderly.
This study helps explain why it could be that infection provides a better adaptive immune response than vaccination. The researchers tracked the long-term development of B memory cells following infection. For as long as 6 months after infection, the variety and intensity of development of these cells continued. In comparison, vaccination of people who have not been infected led to development of strong B memory cells, but more specific to the vaccine prompted protein sequences, as opposed to the broader array of targets from natural infection. (Medrxiv Paper)
These researchers also compared the response to Delta infection among those persons who were vaccinated and those who were not. (Medrxiv Paper) There were 218 people in the study, 71 were fully vaccinated, 130 were unvaccinated and the rest were in between. The vaxed group was significantly older, notwithstanding this it was less likely to develop severe disease. Initial PCR test results showed similar cycle numbers in vaxed and unvaxed patients, but the viral load decreased faster in vaxed individuals. There was a strong antibody response in vaxed patients, but it was decreased in Delta infections versus prior strains. Vaxed persons were three times less likely to show symptoms, and to have fewer symptoms if symptomatic
More research from Israel on breakthrough infections. (Medrxiv Paper) The researchers were assessing the durability and length of protection by vaccination, which they did by comparing the date of vaccination with infection rates. During the time of the study, Delta was the dominant strain in the country. Previously infected but now vaccinated persons were excluded from the study. Positive tests from June 1 through late July were included. The early vax group had received the second dose by the end of February and the late vax group between then and the end of April. Individuals in each cohort were matched on a variety of characteristics, including age. A second analysis took individuals by the month in which they were considered to be fully vaccinated. The total number and rate of breakthrough infections was not high, but the late vaccinees had a much lower rate of infection than did the early ones. The same trend was noted in the month-by-month analysis. The results suggest a worrying tendency of protection from infection to decline over time. Not clear from this paper if that also applied to serious disease, but other data from Israel would suggest it doesn’t.
This is a technical but important paper on how accurate assessments of vaccine effectiveness from clinical trials. The paper does an excellent job of assessing potential biases that could influence those measurements, and other issues that could provide conflicting estimates when the vaccines begin real-world use. (Medrxiv Paper) Among key factors are asymptomatic and undetected infections and imperfect PCR tests.