Another briefing from the DOH this week. More of the same basically and it is making me sick. As far as I am concerned these disgraceful liars would be better off saying nothing instead of the constant terrorization. The Commissioner once again used extremely misleading statistics to try to gin up maximum fear levels about children. If you talk about children as a percentage of cases without adjusting for vax levels, this is just despicably misleading. These jackasses are recommending that children be constantly tested, so we will have lots of false positives, low positives, closed schools, etc. If you are a parent of a school-aged child, do not get your child tested as recommended by DOH, if there are no symptoms. This craziness will lead to another year of children being deprived an educational and social experiences that are absolutely essential to their development. Anyone who participates in this terror program around children deserves a special place in hell for infinity.
And Minnesota data continues to mystify. I looked at the breakthrough data published every Monday. This week we are told there are 7171 cases, 584 hospitalizations and 60 deaths. The raw rates are around 8.1% for hospitalizations and .83% for deaths. By comparison, the rates for the rest of the cases are 5.5% for hospitalizations and 1.2% for deaths. Interesting pattern. The first thing to note, however, is that the number of breakthrough cases is very likely understated, more so than for non-breakthrough ones. Most must be asymptomatic so people aren’t getting tested and I would imagine vaxed persons are less likely to run in with every symptom and get tested. The second thing is that those who get symptomatic breakthrough infections are likely to be older and more susceptible to serious illness. Be nice if DOH would give us age structure to validate that. Also note that in regard to hospitalizations, they already told us that 50% were not for CV-19 treatment. So you can halve the rate, but I think the same thing is true with all hospitalizations. Interestingly, here is what a footnote to the breakthrough hospitalization data says: “** Total cases hospitalized includes patients admitted for any reason within 14 days of a positive SARS-CoV-2 test.” That is astoundingly broad. If they do that for all cases, hospitalizations are enormously overstated. The very astute lead reporter for the Strib pointed out that since a hospital may have to follow isolation protocols, it makes sense for resource planning, but it makes no sense if you are trying to give people an accurate picture of risk of severe disease. At a minimum DOH should break out real hospitalizations for treatment. I believe if you accurately counted only hospitalizations necessary for CV-19 treatment, you could be well under half of the current total. Even though I suspect the age structure skews old, the death rate for breakthrough infections is below that for non-breakthrough infections.
I think Sweden probably had the most rational response in the developed world. Thanks to a reader for summarizing the following stats, with commentary, comparing Sweden and the US: Share of cases that are Delta: Sweden = 99.5%, US = 95.4%. About the same, ok.Delta’s the bad one, right? People fully vaxxed: Sweden = 49%, US = 50%. About the same again…. 7-day avg cases per million: Sweden = 87, US = 416. Huh. That’s not what’s supposed to happen! 7-day average deaths per million: Sweden = 0.01, US = 2.22. Now, wait a minute!!! They don’t even MASK!!! Cumulative deaths per million: Sweden = 1452, US = 1883.. Unpossible!! They didn’t destroy their economy! They educated their kids, for gosh sake!!
Everybody acknowledges that children don’t get sick very often and it is pretty obviously due to innate immunity and perhaps some greater cross-reactive immune response from seasonal coronavirus infections. This article in Nature details some of that differential immune response. (Nature Article) Comparing children who got infected with those who didn’t and with adults, the researchers find that children’s upper respiratory tract has more pattern recognition cells tuned to virus detection and a more vigorous response to the presence of virus.
Given that children are in fact at incredibly low risk from CV-19, no reason to disrupt their lives, right. Apparently there is in the US, where it is more important to worry about teachers. In Europe, however reason prevails. Very few, if any, European countries mandate masks in school and all are committed to in-person schooling. For those trying to fight mask and other lunacy in schools, here is the European Union’s guidance related to schools. (EU Guidance) You will note the eminent reasonableness and rationality of the guidance, and the calm tone. Please note especially the section on masking students. If you are fighting on this, I would copy this verbatim and pass it on to school boards and ask how the science could be different in Europe versus the US. The virus doesn’t know where it is.
This is one of those garbage studies in which either the authors or the editors twist the actual findings to support some message, in this case one that the teachers’ unions likely wanted. The headline is that household transmission by children is associated by age. The real finding is that there is almost no transmission by children in their homes, although younger children, in this case up to age 3, are more likely to transmit, which only makes sense since those children hopefully are held and in close contact with parents. You have to read way down in the paper to see that only 12% of the youngest group were the index case among all children under 18. I am also very dubious about assessments that a child was in fact the index case. There is no indication in the paper of rigorous testing or tracing to determine whether in fact another member may have been the first infection, and there is no indication that any efforts were made to ascertain that the pediatric case was the source of transmission. Adults are frequently out of the house with many contacts so with no evidence that they could not have picked up the infection elsewhere, why is it treated as transmission by the child? Confidence intervals were quite wide, also suggesting lack of rigor in the findings. A weak study at best. (JAMA Article)
This one is for you Jeremy Olson. Jeremy is convinced that Delta is much more transmissible and results in higher viral loads. The study comes from China and looks at early Delta cases. (Medrxiv Paper) Only 167 patients with Delta were included, and a lower number had full case information, so small numbers. Symptom onset was said to be more rapid and the viral loads larger. The viral load comparisons were made to cases from early 2020. A positive test included cycle numbers up to 40, which is extremely high. The Delta secondary attack rate was a puny 1.4%. Most transmission occurred before symptom onset. Cases without full vaccination were more likely to transmit than those who had been fully vaccinated. 11% of the cases were severe or critical and there were no deaths. The time between infection and viral shedding was estimated at a mean of 4 days and the time between infection and symptom development at 5.8 days (incubation period). They estimated that an astounding 74% of transmission occurred before symptom development, but again they are working with very small numbers. And the Chinese use incredibly brutal suppression measures, which makes comparability to other jurisdictions questionable. And Jeremy, while they report that the cycle numbers, and viral loads, were much higher for Delta cases, the comparative swabs were taken after the peak of the original wave, while the Delta swabs were taken during the Delta outbreak. Vaccinated Delta cases had slightly lower viral loads. That low secondary transmission rate would not be suggestive of significantly greater transmissibility, although household secondary transmission was higher than in the early 2020 wave, although again, those measures were taken at a different stage of the wave and the household transmission of this supposedly wildly infectious strain was only 22%. And then this is from China.
How much transmission actually comes from people who are asymptomatic. This study purports to be a metareview on that topic. (SSRN Study) The researchers claim that symptomatic cases are infectious for an average of 14 days and asymptomatic ones an average of 9 days, but that most of the replication competent virus is emitted in the first four days in each group. They suggest that asymptomatics are responsible for much less transmission early in an epidemic but more in its later stages.
For those who are queasy about mRNA and adenovirus vector vaccines, people are working on live attenuated vaccines. This paper reports on one of these more traditional vaccines. (Medrxiv Paper) Note that this vaccine created a broad spectrum immune response to the viral genome, not one limited to the spike. The strength of the response was tied to higher doses of vaccine.
RSV is returning not just here but in other places, including Japan. This study, published by the CDC, details the rise of cases in that country at an unusual time of year, and notes that these rebound waves of non-CV-19 pathogens are likely due to excessive attempts to suppress the virus. (CDC Article)