Coronamonomania Lives Forever, Part 101

I told you I would just keep going on this series, as the title is so apt.  Still trying to keep up with the research and data flow.  DOH has not held a briefing for weeks, so they clearly just want this to be over but at the same time are stonewalling attempts to get meaningful data out.  And many school districts continue to force kids to mask and endure other restrictions.  Time for a last push to end the nonsense.

Big Sigh!!!  I don’t why CDC keeps pushing these awful mask studies, except I do know why–they have to give some ammunition, even complete blanks, to the bitter-enders who actually think they have any impact on spread. This is the worst of the worst and has been ripped to shreds by others, but the best part is that the study itself says it did not reach statistical significance–that’s right CDC publishes a study claiming it shows masks work when the study itself says you can’t reach that conclusion.  Desperate.  I can go on, but what’s the point?  Self-reported mask use and type.  Self-reported no contact with an infected person.  Self-reported being in an indoor space. (unless there were a lot of homeless people in the study, which is possible in California, I assume everyone was in an indoor space at some time.)  They used a variety of interviewers who knew the infection status of the people they talked to.  Using interviewers is a dreadful study design.  Parents answered for children–seriously, you included that?  More of the positive cases were unvaxed, think maybe there is a correlation between mask-wearing and vax status?  Odds ratio quoted, which means look at the actual numbers–extremely small and almost no difference, hence the lack of statistical significance.  Incredibly wide confidence intervals, which is a sure tip-off of meaningless results. Whenever you see a CDC study, go first to the limitations section.  In CDC research it always will lead you to believe you can’t trust anything in the study.  So it is here.  If you want to read an even better demolition of the study see Vinay Pramad on Twitter or substack.  (CDC Study)

If you want a really good and understandable explanation of the adaptive immune response this article in Nature has it and helps explain why infection is better than vaccines at prompting one.  (Nature Article)

This article from the UK demonstrates why PCR testing can be so misleading and is such a bad instrument for determining policy on items like isolation.  I have beaten my head against the PCR testing wall since the start.  The authors found that many labs were using extremely high cycle number thresholds for a positive, meaning the supposed cases were very unlikely to actually be infectious.  They recommended, as I have, that all positive PCR tests should be reported with both the cycle number and with a standardized viral load measure based on that number.  Don’t hold your breath (unless you are Mayor Garcetti or one of the mask nuts) waiting for a change.  (PCR Study)

An enduring mystery of the epidemic is why some people, like my wife and I, can’t seem to get an infection, even though we are living as normally as possible and don’t mask unless absolutely forced to.  I strongly suspect it has something to do with a fast and effective immune response upon exposure, because everyone has to have been exposed at this point.  This is a fascinating study in which generally young volunteers were exposed to CV-19 in a “challenge” study.  The most astounding fact is that only slightly over 50% actually became infected.  For those that did, it took about 5 days from exposure to peak load and viable virus was present on average for 10 days.  The virus tended to first appear in the throat but showed up in much greater numbers in the nose.  There was no association between viral load and symptoms.  (RS Study)

The latest UK vaccine surveillance report is here.  (UK Report)   People somewhat thoughtlessly use the data in here to claim that vaccines have a negative effectiveness against infection, that is, vaxed people are more likely than unvaxed to be infected.  Frankly this is garbage.  This week in the report you will find a link to a blog post that does a good job of explaining why you can’t take the raw information about rates and make vaccine effectiveness, or non-effectiveness, claims.  Look, there is only one way to really determine vaccine effectiveness; all the other methods try to account for bias and confounders but that is difficult.  You would need a prospective study of a large group that adequately represented the characteristics of the population you are working with.  You would need to determine the prior infection status of everyone in the test group and ideally the date of that infection.  You would need not just age and other demographic factors but health status ones as well, because what you are trying to assess at a population level is whether the same individual has less, the same, or greater risk of becoming infected, hospitalized or dying if they were vaccination or not vaccinated.  Then you need to track these people watching what happens before and after they are vaxed, if they ever are.  Then you have a good basis for assessing vaccine effectiveness.  I don’t think the data shows strong effectiveness against infection, but it looks pretty darn good against hospitalization and death, especially for a respiratory virus vaccine.

This study from Sweden is yet one more looking at vaccine effectiveness in regard to Omicron.  After adjusting for appropriate factors, including prior infection, Omicron appeared to result in less serious illness among the vaccinated and unvaxed, but among the unvaxed there were still a significant number of hospitalizations and deaths, particularly in the elderly.  Note that in general across both variants and over time, vaccine effectiveness against hospitalization remained at around 90%.  Pretty darn good.  And a prior infection provided roughly the same protection as vaccination.  (Medrxiv Paper)

Switzerland chimes in with an older vaccine effectiveness study covering over 9 months and the Alpha to Delta variant transition.  Here age and other adjustments were also made, but not for prior infection or health status, and effectiveness against hospitalization and death was very high, particularly in older age groups, with moderate effectiveness against infection. Until the adjustments were performed, there appeared to be some positive correlation in some locations and age groups between vax and cases, which demonstrates the importance of identifying and considering all possible relevant factors.  (Medrxiv Paper)