Okay, I finally have a little time to summarize some of the interesting items in the “leaked” CDC deck that supposedly justified the recommendation for vaxed people to mask up. First, I want to acknowledge the tremendous job the agency has done in communicating during the epidemic. For example, right now the CDC is telling us that vaccination is the most important thing we can do and that getting everyone vaccinated will end the epidemic. It is also telling us that vaccinated people frequently get infected, have viral loads as high as unvaxed people, are as infectious and should wear masks forever. Really makes a lot of sense if you think about it.
The title of the CDC deck is itself deeply ironic and just outright belly-laugh inducing: Improving Communications Around Breakthrough Infections and Vaccine Effectiveness. Yes, I would definitely say that the CDC has met its objective of improving communication. The first substantive slide tells us that “Vaccine breakthrough infections may reduce public confidence in vaccines.” No, what reduces confidence in vaccines is not explaining clearly to the public what adaptive immunity is and what they should expect from a respiratory vaccine.
The CDC also says it is important to “update” communications saying that breakthrough infections are rare or or a small percentage of cases. DOH hasn’t figured this out yet. Over time, as more and more people get vaccinated, a higher percentage of cases, again from overly-sensitive PCR tests, will be among the vaccinated. That expectation should be set. According to the CDC data presented in the slide, as I would expect, while the vaccines do reduce infections, they have a noticeably powerful effect on hospitalizations and deaths, a truly massive reduction. Although again, we should be cautious here because the most vulnerable groups all along will continue to be vulnerable even after vaccination.
I would also note that contrary to the CDC’s own messaging around vaxed people masking, a slide says that the average viral load among infected vaccinated persons in 40% lower, that is consistent with UK data. Infected vaxed people also have a shorter period of shedding, fewer symptoms and shorter time with symptoms. Another slide confirms research findings that vaccines are not going to be as effective among nursing home residents.
Then we have a slide comparing Delta transmissibility to other diseases. This is just plain misinformation. Delta is at best somewhat more transmissible and is not anywhere near as transmissible as chickenpox or other diseases to which it is compared on the slide. They have the Delta R, or average number of people each infected person passes the virus on to, as between 5 and 10. They pulled this out of the location where their brains must be, down where the thighs begin. The UK data, which remains the best, suggests an ongoing R of slightly more than 1 for Delta.
Then they refer to two bad studies which don’t adjust appropriately for confounding factors, but supposedly show higher viral loads and more transmissibility of Delta. One is the Massachusetts outbreak I summarized earlier in the week and one is from India, which has also been criticized on methodological grounds. So much for being careful about the data and research you use. They go on to suggest it causes more severe disease, ignoring the UK data, which is the most comprehensive, finding a far lower hospitalization and death rate for Delta. Then we get the supposed research showing less effectiveness of vaccines against Delta, but that decline is not large.
Now we get to the punchline. Because Delta is so terrifying, we need non-pharmaceutical interventions even among the vaccinated. They have a little model to demonstrate this. Oh, look, here is what the model assumes about mask effectiveness. 40% to 60% for source control, 20% to 30% for personal protection. Say it loud, say it proud: Masks don’t work to slow community transmission. But then the next slide says “universal masking is essential to reduce transmission of the Delta variant.” Huh? But why am I surprised, these people would fail any basic logic test. And there you have it, the CDC’s basis for saying everyone should mask up forever.
And here is where you can find CDC data on breakthrough infections. Worth scrolling around and looking at the data. (CDC Data) Take a look at the hospitalizations and deaths. Notice a familiar pattern? Three-fourths are among those over 65. Notice that category in the footnote, one-fourth of all hospitalizations said to be for CV-19, weren’t. Notice the same footnote regarding deaths. One-fourth of all deaths among the vaccinated which are attributed to CV-19, aren’t actually due to CV-19. So why don’t you fix your stupid hospitalization and death reporting in general. If they did, looks to me like we would have one-fourth fewer hospitalizations and one-fourth fewer deaths.
And here is another data set from the CDC that is worth a peek, on the burden of illness from CV-19. (CDC Data) Note that through May the CDC is estimating that only one in 4 infections was detected and reported. Somehow, notwithstanding the data from their other data set, the CDC thinks it missed 44% of hospitalizations and 23% of deaths due to CV-19. That is garbage. Hospitals will do everything in their power to call a hospitalization one for CV-19, given how much more they get paid. But what is really interesting here is the outcomes data and the age structure of those outcomes. Once more we see basically no impact on children and almost all the severe illness among older Americans.
This study from the CDC looked at the effect of vaccination on testing positive among Philadelphia school employees. Employees who had one dose had lower rates of positivity and those who had two doses had much lower rates. One deficiency of the study is a failure to identify unvaccinated persons who had previously been infected. This may understate vaccine effectiveness. As a side note, African American and younger employees were much less likely to be vaccinated. (CDC Study)
Now here is one item from the CDC this week that is worth noting, consistent with the above study. Only 28% of African Americans have gotten vaccinated, according to the agency. Now tell us again how it is conservative Southerners that are the problem?