Thank you to the reader who pointed out that I can’t count and have a little room left before I hit 100.
Minnesota’s death numbers are truly bizarre. Yesterday, three deaths from mid-February were reported. That is 6 months ago. So half the deaths aren’t recent. Every death was of an LTC resident. Likely the three recent ones were vaccinated, probably the ones in February as well, but that was still early in the vax program. All the deaths were old people as well. Does anyone not understand now that this will continue to be disease of the frail elderly?
And Dr. Osterholm is definitely seeking a place in the rational pandemic response hall of fame. He has now said the unthinkable, that cloth, and paper, masks generally are ineffective. GASP!!! I believe he was never a mask zealot. But of course, then he went backwards by suggesting maybe we should all wear N95 respirators. If you have ever had one of those on, you know that is a simply absurd idea, so absurd that I think, and hope, that the good doctor was having one on the mask religionists. (OH Comments)
The country is in a state of complete confusion about the effectiveness of vaccination and how dangerous Delta is or isn’t. Worst messaging ever. And the DOH perpetuates it in every briefing. After going on and on about how effective the vaccines are, we are told we still need to mask up. And while I agree that the vaccines are effective, the statistics they use to show this are very misleading. Using per capita numbers isn’t particularly accurate when the population is shifting from one category to another and the time periods being compared contain a large shift in those categories.
Everything is pretty much about vaccines these days. But here is one study from Japan looking at the effectiveness of the euphemistically named “non-pharmaceutical interventions”. (Medrxiv Paper) Regions with high infection rates were compared with low ones, and the prevalence of supposedly good behaviors like mask-wearing, hand-washing, etc. The thing I want to point out is that two of the interventions showed no effect–one of them was mask wearing; no association with lower infection rates.
This study was done among Air Force cadets. (Medrxiv Paper) These are almost all healthy young people, 85% of whom were vaccinated at the time of the study. Vaccine effectiveness was estimated at 91% in preventing infection, but we seem to be learning that this effectiveness declines over time, although effectiveness at reducing serious disease remains robust. As with most studies, prior infection was not taken into account in either group.
Another study suggesting antibody levels decline within a few months after vaccination, similar to what has been found in regard to infection, but as the authors note, B memory cell populations remain robust. (Lancet Article)
Similar conclusions in a study from Japan of around 250 vaccinated persons. While the antibody count declined, we can assume there is still a substantial B memory cell population. The authors also noted limited evidence of adverse events from vaccination. There was variability among individuals in regard to neutralization of different variants. (Medrxiv Paper)
Just showing how contradictory research can be, this study from Qatar looked at viral loads in persons who were vaxed and unvaxed, as well as those who had been previously infected and were reinfected. (Medrxiv Paper) Remember higher cycle numbers mean lower viral loads. Compared to unvaxed persons who were infected, people vaxed with Pfizer had cycle numbers 1.3 points higher, people vaxed with Modern had cycle numbers 3.2 higher and reinfected persons had cycle numbers 4 higher. These points correlate to substantial changes in load. The differences were consistent across both unsymptomatic and symptomatic infections. So we again see that prior infection has at least as good protection as vaccination. These lower viral loads mean people are likely less infectious. Interestingly, their appear to be many more breakthrough infections than reinfections. This was a large study so I find the results more credible than the Wisconsin study summarized below.
This paper comes from France and examines vaccine effectiveness in long-term care facilities, with a focus on variants, in this case Beta. (Medrxiv Paper) This is obviously a highly vulnerable group and there was a significant outbreak in the facilities, which included several deaths. Vaccination, however, was associated with 49% effectiveness against infection and 80% against severe illness.
This study is somewhat contrary to several others, in that it finds that viral loads in unvaccinated persons and those who were vaccinated are similar. (Medrxiv Paper) The study comes from Wisconsin and apparently most of the infections involved Delta. It was a somewhat small study and one issue is relative time of testing, which may confound viral load comparisons. If vaxed people are less likely to be symptomatic, they may get tested at a different point in their viral load curve than do unvaxed persons. And if more infections among the vaxed are asymptomatic, only the ones with higher viral loads may be getting tested, so the true distribution of cycle numbers is unknown. Another aspect of the study that is puzzling is that 39% of all cases were among the vaxed population in Dane county and 27% in other counties. That seems quite high.