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Breakthrough Infections, September 20

By September 22, 2021Commentary

The state of Minnesota is not making this easy, intentionally I think.  They are trying to minimize to the public how significant the number of breakthrough cases is.  Dave Dixon’s notes below further set forth some of the difficulties.  The basic problem is that a breakthrough case is not initially identified as such.  So the positive test comes in and it gets called a case and gets assigned to the appropriate date in the table of cases by date of specimen collection.  Then the state starts running all cases against their vaccinated database (and who knows how accurate that is or complete–what about people vaccinated out-of-state) and when they determine a person was fully vaxed (here is another thing they should report–all cases in anyone who is even partially vaxed), they add that person to the total of breakthrough cases to be reported on the next Monday.  Then you have to subtract that total from the prior Monday’s total to know how many new breakthroughs are being reported.  But unlike the other cases, you have no idea what day the breakthroughs actually came from.  Best estimate, and the state gave a little info on this, is two to four weeks lag.  So that is what we use.  But I suspect we are underestimating the proportion of cases and other events that are breakthrough.  And I also wonder how many cases are in the partially vaxed.

In any event, the charts below are best guess and likely in the rough range, which I again think is likely higher.  Here are Dave’s notes:

1. Breakthrough positive cases, hospital admissions, and deaths are published every Monday by the Minnesota Department of Health:
2. Breakthrough cases are defined as anyone who tests positive for covid 14 days or more after completing their vaccination shots.
3. Breakthrough hospital admissions include any vaccinated person who is admitted to a hospital for any reason, and tests positive for covid up to 14 days prior to admission.
4. Breakthrough deaths are vaccinated people who have a positive covid test and COVID-19 is listed on the death certificate or clinical history provides evidence for COVID-19.
5. DOH also reports the number of vaccinated Minnesotans as of a date 4 weeks prior to the date that breakthrough cases, hospital admissions, and deaths are published.
6. Matching up the breakthrough cases to the total cases in a week that ended 4 weeks prior to the breakthrough report gives strange results. For example, on 8/2/2021 the total announced breakthrough cases were 591 cases higher than the announced total the week before. However, 4 weeks before this date only 506 cases were announced for the week ending 7/5/2021. It is likely that either breakthrough cases are more recent than 4 weeks prior to publication, or they occur in a time period longer than 1 week.
7. News reports in the Star-Tribune have mentioned that breakthrough cases represent approximately 30% of total cases, for example here
8. Not fully understanding the timing of breakthrough cases we have chosen to present charts assuming that the breakthrough cases occurred up to 14 days prior to the date of publication, and that announced breakthrough cases essentially occur within one week. Charts generated with these assumptions generally match the 30% proportion of breakthrough cases that have been stated in the Star-Tribune.

Join the discussion 7 Comments

  • Neil Herring says:

    I think there’s broader issue impacting the number of “breakthrough” caes and that is the specific definition of a breakthrough case. In my view, testing positive for SARS-Cov-2 does not mean someone is a breakthrough case as the presence of the virus, or frankly a dead virus particle, is hardly the same as having the disease, Covid-19. Given the mess hospitals are making of reporting whether someone is hospitalized because of Covid-19 vs a hospitalization for something else entirely but has been found to have the virus present, I don’t think we can claim any knowledge about the %age of people who are hospitalized or are dying of Covid-19 whether or not vaccinated. Hats off to Dave for attempting to come up with a reasonable analysis but to me, without much better data, it’s all meaningless.

  • Jimi says:

    I have to wonder as well, WHY are the intentionally not making this easy? And also, should we be worried if there are rising breakthrough cases, and if they are rising, should that also provide evidence that adding vaccine mandates to anything will not be as effective as we think?

  • DuluthGuy says:

    So it appears that by the first chart, a person is roughly 1/2 as likely to test positive for COVID if their vaccinated as opposed to unvaccinated? Of course that would also assume that a vaccinated person and an unvaccinated person are just as likely to go get tested if they feel symptoms.

    I had a minor leg injury that I went to get checked out for this week. Under normal circumstances, I would have waited a few weeks to see if I could rehab the injury on my own, as it didn’t affect my life very much. But with the rumors of low staffing levels (due to unvaccinated employees quitting and vaccinated employees starting to quit due to being overworked), I decided to go in and get checked out. I could not believe how busy the clinic was when I went in. I don’t know if it’s just the time of year or if it’s people that put off medical issues that they normally would have gotten taken care of earlier if not for COVID. But I’ve never seen a clinic so busy. The doctor recommended surgery for me (my first ever surgery of any kind) and I was able to get in to have it done the next day due to a cancellation. I’m definitely glad I went in now instead of waiting.

  • J. Thomas says:

    Starting to see spread develop in ‘Deaths/100K’ chart between the vaxed and un-vaxed. Is the age pattern in this data bifurcated as they were in the the death charts from last year w/o the vaccine in play?

    • Kevin Roche says:

      Yes, and as I have said, I believe the age structure of events in a fully vaxed population will look just like the one in a fully unvaxed pop, but the absolute numbers will be lower. But we will see, it could be that the vax keeps hosps and deaths in the middle aged groups down. Certainly deaths in the elderly are up close to where they were before vax

  • J. Thomas says:

    Thanks, makes sense.

    Are you aware of any serious post mortem studies being conducted on the vaccinated vs. unvaccinated, or on anyone with an accurate C19 death cert?. I find it stunning that this seems to be a taboo subject while we’re spending billions for false PCR testing and media propaganda to scare people. How do we know what’s actually killing people unless we look for it?

  • Charles Kessler says:

    A small aside. Kevin raises the question of people vaxxed in “other states”. My wife and I live in MN, but were vaccinated at Mayo in LaCrosse WI. I suspect a large number of SE MN dwellers are in the same boat. What state gets credit for that vaccination?

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