Answers to Some Reader Questions

People email me questions and I try to answer them.  Some have longer sets of questions.  So here, doing my best to answer what I can, are some quick answers to questions I received in the past few weeks.

What is the risk of death from CV-19 at different age brackets?  Comparatively, those 80 plus are a thousand times, at least, more like to die of CV-19 than those 20 and under.  In terms of case rates, we have published those periodically and you can also calculate them in Minnesota from the weekly report page on cases, hospitalizations and deaths by age group.  The difference in death rates is really due to generally weaker health status and immune systems in the elderly.

How do different levels of policy affect different states or countries?  I assume this refers to efforts to limit spread.  I think the best research strongly shows that most of these efforts to suppress the virus have not worked, regardless of where they are tried.  Many states with extremely strong suppression measures have high death rates.  Some states with much less restrictive measures have lower rates.  It is hard to separate cause and effect, as a state with high case rates might be inclined to be more aggressive in suppression efforts, but there is no clear pattern to suggest that how aggressively a state tries to suppress transmission is associated with cases.  California and Florida being two extremes that are a good case in point.

Comparative death rates in the vaccinated and unvaccinated.  We just published this last week, by age group, so that is the best data I have at this point.  The vaccines appear to have a strong protective effect against death.  But, these analyses are seriously confounded by a time effect.  You really need “days at risk”, that is how long has it been since each person was fully vaxed or not.  And it is at least as confounded by not knowing prior infection status.  A person who is infected but not vaxed has some immunity, maybe better immunity than a vaxed person, so you really need to take those people out of the unvaxed group and put them in their own category.  And many vaxed people have already been infected, so is their greater protection due to being vaxed or having been infected?

How has CV-19 added to overall risk of death.  Excess death analyses are tricky.  Overall, in the early months of the epidemic there was excess death that was attributed to CV, offset somewhat by declines in certain types of death, for example, flu.  By mid-epidemic, it had become apparent that the response to the epidemic was causing deaths above average in middle-aged groups and older groups and many of these deaths are due to missed care.  Now in some countries, like Sweden, we are actually seeing deaths below expected.  This could be pull-forward effect, in which CV-19 contributed to the deaths of persons who only had a few months of life expectancy in any event.  A proper analysis would be by age group, by cause, and by place of death.

What are leading causes of death for each group and where is CV-19.  If we are talking about age, CV-19 is not likely the leading cause of death in any age group.  For children, it doesn’t crack the top ten, no matter what garbage data the CDC uses to try to put it tenth.  For older groups, it has been a significant cause of death, but much of that is substituting for flu deaths.

What percent of Minnesotan’s are vaccinated?  The state says 70% plus of adults, which is likely an undercount since they don’t have records for many people who were vaccinated.  The best source of data is on the situation update page of DOH, go to the vaccination section and follow the links.

Can vaccinated people transmit the virus?  Vaccinated people can get infected.  Research is inconsistent on whether their viral loads are as high or lower.  There are documented cases of transmission by vaccinated persons, but it appears that transmission risk from a vaccinated person may be lower.

Can people who have been boosted transmit?  Way too early, but I am going to assume yes.  It took a few months for the substantial lessening in vaccine effectiveness against infection to show up.  So let’s wait and see.

How does natural or infection-caused immunity compare to vaccination-derived immunity?  Here, I think the research is clear, infection-derived immunity is superior.

How does the combination of infection and vax immunity compare?  Research indicates this is an even higher level of protection.

What does the research say on masking?  Assuming we are talking about real data and research and not made-up CDC garbage, as I have said over and over, while a mask may provide protection against transmitting or being transmitted to in a specific encounter, over large numbers of encounters, they do nothing to limit spread in the community.  No one can wear an N-95 for an extended time without serious discomfort and other potential adverse effects.  I have gone into great detail on masks in prior posts.

Is there research to support mandatory masking in schools?  In my opinion, no, and I have covered the research extensively elsewhere.  But most importantly, we need to stop ignoring the harm caused to children by this never-ending masking.  It hurts their learning, it hurts their socialization, it causes anxiety.

Is this a crisis of the unvaccinated?  In the last two weeks we have presented data and written extensively on breakthroughs and the consensus is now swinging to eliminating the phrase “epidemic of the unvaccinated.”

Is there data to support claim the unvaxed are infecting the vaxed.  Minnesota, and other states, have spent a fortune on contact tracing with basically nothing to show for it.  So I am very reluctant to make general statements about which sub-population is infecting the other.  It appears that each group can transmit, but I strongly suspect that more transmission occurs from unvaccinated persons.

Hope that helps.