No post yesterday because I needed a mental health day. The ongoing stupidity of government responses, and especially what we are doing to children, is driving me batty. Back at it now.
That CDC hospitalization of children study continues to frost me. And I forgot to mention one of the most misleading aspects. Using per capita rates (event per unit of population) is appropriate in some contexts, but in others per case rates are more meaningful and less likely to be taken out of context. The authors of the CDC study intentionally used per capita rates because it allowed them to deliver the message they wanted to deliver, even though the data don’t support their terrorism. If they used case rates, it would not show any significant change in the proportion of cases among children over the course of the epidemic. But if you take a per capita rate for a specific period of time, it will ebb and flow as the general rate of spread ebbs and flows. So comparing a per capita rate for a specific age group for different time periods is very misleading unless you show the total per capita rate over the entire epidemic for context and you compare it among age groups. When that is all done, the CDC study is a big nothingburger, but they wanted terror.
And I also in my anger (which is not conducive to rational analysis) about the dismally bad Bangladesh mask study forgot one of my main points on reading it. The logical chain posited in the study is that 1) the intervention will increase mask wearing; and 2) the increase in mask wearing will reduce cases. Recall that the results supposedly showed that the intervention increased mask wearing, but that cloth masks made no difference in transmission, while surgical ones did, but only among the elderly. Here is the logical problem. They measured mask wearing by having someone observe it in public places, but the observers had no information about the age of those wearing the masks, so they were completely unable to actually assess that the increased mask wearing, which in the case of surgical masks supposedly slowed spread, but only among the elderly, actually occurred among the elderly.
And according to the DOH, and this is on a reported basis, not actual dates of events, but in the last week, 3260 out of 11,398 cases were breakthroughs, 147 out of 562 hospitalizations and 13 out of 42 reported deaths. Those respective percents are 28.6%, 26% and 31%. Dave Dixon is working on his attempts to match the timing, but it is apparent that we are heading toward at least a third of events being breakthrough related.
Schools are a focus of research with the controversy about in-person school, masking, etc. This study from Italy examined secondary transmission associated with schools. The overall incidence of cases was low and secondary transmission was very low at 4%, and remained low during the Alpha strain’s ascendance to dominance. (Medrxiv Paper)
Here is another study from Italy looking at schools and CV-19. Like the first one, it found a very low risk of either infection or transmission. It was a meta-review and found children were about 40% less likely to be infected and 70% less likely to transmit than adults. (Medrxiv Study)
Lockdowns, business and school closures, stay-at-home orders, are all really, really dumb, among other reasons because most transmission occurs in the household. This study from NYC shows that in areas with high levels of multi-generational households, lockdowns and school closures were linked to higher levels of cases among those aged 55 or older, who are the most vulnerable group. (Medrxiv Paper)
I keep saying Delta terrorism is unwarranted. The study from Norway finds no greater likelihood of hospitalization after infection from Delta as from Alpha. (Medrxiv Paper) In addition, partially vaccinated persons had a 72% reduced risk of hospitalization and fully vaxed ones a 76% reduction.
You want terror? I can give you terror. The new Mu variant (no it doesn’t come from cows) is all the rage and supposedly is way more transmissible and can evade the adaptive immune response from infection or vaccines. Delta move over. (Medrxiv Paper)
I also am always asking for more data on reinfection rates and events, so we can compare the effect of being infected versus vaccination. As we get more and more calls for vaccine mandates, it would seem important to also give people credit for adaptive immunity from prior infection. This study was a meta-review and analysis of research on reinfections. The authors summarized the research by noting that most persons had a lasting immune response after infection, including strong T and B cell responses, including memory cells. Reinfections were rare, with an overall rate of .2% in the six to eight months following infection. The reduced risk of a second infection was around 80%. So it looks to me so far, like natural immunity is probably at least as strong as the vaxed-induced one, and has a similar effectiveness against infection. (Medrxiv Paper)
I frequently praise Sweden’s epidemic response. Among other things the country did right was getting a lot of people vaccinated quickly, with a prioritization of the frail elderly, both in LTC and at home. According to this paper, those groups experienced a significant reduction in cases and deaths following vaccination. (Medrxiv Paper)
Another Israeli study which also shows declining antibody levels after vaccination through a six month followup, an association of those lower levels with risk of infection, and both lower antibody levels and greater risk of infection in those over age 65. (Medrxiv Paper)
And this US research also looked at vaccine durability. It found a higher likelihood of infection at 120 days following vaccination than immediately afterward. But the absolute number of cases was low and the risk of serious illness so low that a statistical analysis could not be properly done. Just want to point out that when you are looking at a cumulative statisic the proportion always gets higher as time goes on, it can’t get lower, so if there is any possibility of infection after vaccination, the proportion of those infections will rise once the population vaxed stabilizes. What is important is the trend, on a per capita basis, looked at month by month, for example, do we see a higher percent become infected in a given month over time. (Medrxiv Paper)