UK Reports

A brief digression.  The Afghanistan situation is heartbreaking and devastating to the American image.  You won’t see that in most US papers which are an official arm of the Democratic party, including the one in my home town, because they are doing their best to downplay what is occurring.  But I would encourage you to go look at the UK papers or the English language editions of other European papers.  Biden is being eviscerated, in one sense deservedly so, because this is disastrous, but let’s don’t pick on the senile old man, he can’t help himself.  This guy is simply incapable of being President and he has to go now, which God help us, means the walking idiot Harris would become President.  She is stupid to put it charitably.  Congratulations to everyone who voted to put us in this mess.

And I cannot tell you how much my heart breaks for the people of Afghanistan who are being time-warped from progress toward a civilized country back to the stone age.  So much suffering and misery.  Can you imagine that you so frightened for your infant that you give it up and pass it over barbed wire fencing to a soldier?  That will be the enduring image of this complete, utter debacle.  What does it mean to be human if we don’t feel some obligation to our fellow humans, regardless of arbitrary national geographical divisions?  Biden can and should rot in hell forever for what he has done here.

I use a lot of UK data on things like Alpha and Delta because it does way better reporting than the US does.  The country has some ongoing briefs and reports that help track trends over time.  One important report has been on variants of concern.  The 21st technical brief in this series was released but it was a disappointment in some ways for what was missing compared to earlier versions.  (UK TB)    None of the critical data on viral loads and no data on secondary transmission.  Hopefully that will be made up for in the next release.  What it does continue to show is that Delta is far less serious than Alpha, its predecessor was.  For example, it led to less visits to the physician.  And it resulted in fewer hospitalizations (the UK does an excellent job of distinguishing hosps for CV-19 and with CV-19, in what follows I am referring to real hospitalizations), a fifth fewer for under 50 year-olds, and about 35% less for the over 50s.  The death rate was basically nonexistent for Delta in the under 50s, and less than half that of Alpha in the over 50s.  But for these raw numbers vax status is not incorporated so they are not true apples to apples, many more people had been vaxed by the time Delta became prevalent.

When you look at hospitalizations, you see that 1/3 of the hospitalizations for Delta cases in under 50 year-olds, and half for over 50s, were not admissions for treatment of Delta.  Now some of these are people who may have had symptoms but not a positive test before admission, but most are likely people who just incidentally test positive on admission and who never need or get treated for CV-19 while at the hospital.  There is data comparing Delta cases and outcomes among vaxed, partly vaxed and unvaxed persons, but no data is given on the number of total people in the population who are fully vaxed, partly vaxed or unvaxed, and you would really need that almost on a daily basis.  But just in terms of case rates, hospitalization and death is much rarer among the fully vaxed than the unvaxed.  And I again want to note how even among the unvaxed, a huge percentage of hospitalizations are not for CV-19.

You can see how much less serious Delta must be in the weekly surveillance report released by the UK Public Health Agency as well.  (UK Surv. Rpt.)    I invite you to compare the chart of cases, in which you will see that this summer’s wave nearly reached the winter heights, when Alpha was more present; with the chart of hospitalizations, where you will observe that hospitalizations remained at perhaps a fifth the level; and with the chart of deaths, which were at about 1/15 the level.  Vaccinations play a significant role in this change, but it also validates the finding that Delta is not Alpha, or even the original strain.  Also some interesting data on reinfections in that report. Reinfections skew toward women, and are relatively even across age groups, except among the 80 plus cohort, where they are higher.  Overall, the country is running at over a 1% reinfection rate.  No word on how many of the reinfected people may have been vaccinated.  As I keep saying the best measure of comparative adaptive immune response from infection versus vaccination will be comparing reinfection and breakthrough infection rates, on an adjusted basis.

This isn’t an official UK government report, but is a paper from Oxford on the effectiveness of vaccines against Delta.  (Delta Paper)   The paper suffers a potential methodological weakness in being a household survey and we aren’t told who declined or dropped out, although the homes were randomly selected, and PCR testing was conducted among household residents on a predetermined schedule.  The analysis was split into the Alpha period, 12/1/20 to 5/16/21, and the Delta period, 5/17/21 to 8/1/21.  Vaccine effectiveness was said to be reduced against Delta for the AstraZeneca vaccine, but not the Pfizer one.  The Pfizer vaccine supposedly provided greater protection against Delta than being previously infected.  Protection was greatest among those with both prior infection and vaccination.  Protection afforded by the Pfizer vaccine appeared to lessen over time.  Vaccine effectiveness tended to be greater with younger age.  More serious infections, as measured by viral load or symptom status, appeared to be less impacted by vaccination.  During the Alpha wave, cycle numbers were higher and viral loads lower in infections among vaccinated persons, but the same was true for persons with prior infection but not vaxed.  Delta was said to create higher viral loads, even among vaccinated persons, with less difference between vaxed and unvaxed persons.  I cannot square the supposed higher viral load with the less severe outcomes.