PlagueWatch 2020-23 - Coronavirus

[jimsumner]

Straight up Shakespeare. I'm doing a pants role and playing Friar Laurence.

I hope it turns out well. I keep rooting for these kids.

[MChambers]

I waffle between Malibu and Corvette.

I read this yesterday from a few days ago:


"FDA researchers conducted a new analysis of how frequently volunteers in the study were hospitalized for Covid. When researchers counted cases 28 days after vaccination, there were zero hospitalizations in the vaccine arm and 16 in the placebo arm. For the full analysis set starting with the first dose, there were six hospitalizations for those who received the vaccine and 42 for those who did not."


https://www.statnews.com/2021/02/24/...inst-covid-19/

What the don't explain is why to ignore the first 28 days after vaccination. Perhaps to equate to the ModernaPfizer timeline? I don't understand how you can ignore the 6 hospitalizations.

It just means that one's immune system needs time to build up immunity to the coronavirus after vaccination. This is true of all of the vaccines. None of them provide much protection in the first days after you receive a shot.

[rsvman]

It just means that one's immune system needs time to build up immunity to the coronavirus after vaccination. This is true of all of the vaccines. None of them provide much protection in the first days after you receive a shot.

Yep.

In the Pfizer trial the same thing was seen; that is to say, there were a fair number of cases in the vaccine group, but they occurred early after vaccination. In the case of the Pfizer vaccine, though, protection seemed to really pick up after 12 days had passed from receipt of the vaccine. If you looked at a graph of the vaccine group versus the placebo group, the lines were essentially identical through the first twelve days; thereafter, cases in the vaccinated group leveled off while infections in the placebo group continued upward at approximately the same trajectory.

[mkirsh]

Merck to manufacture J&J vaccine, per Washington Post

https://www.washingtonpost.com/healt...e-partnership/

President Biden will announce Tuesday that pharmaceutical giant Merck will help make Johnson & Johnson’s single-shot coronavirus vaccine — an unusual pact between fierce competitors that could sharply boost the supply of the newly authorized vaccine, according to senior administration officials.

[House P]

I read this yesterday from a few days ago:


"FDA researchers conducted a new analysis of how frequently volunteers in the study were hospitalized for Covid. When researchers counted cases 28 days after vaccination, there were zero hospitalizations in the vaccine arm and 16 in the placebo arm. For the full analysis set starting with the first dose, there were six hospitalizations for those who received the vaccine and 42 for those who did not."


https://www.statnews.com/2021/02/24/...inst-covid-19/

What the don't explain is why to ignore the first 28 days after vaccination. Perhaps to equate to the ModernaPfizer timeline? I don't understand how you can ignore the 6 hospitalizations.

Thanks for sharing the StatNews article. My only quibble is that statement "there were six hospitalizations for those who received the vaccine" may be a bit misleading. My understanding from skimming the J&J FDA submission is that 4 of the 6 hospitalizations in the vaccine group occurred less than 14 days after vaccination. As RSVman points out (below), all of the approved vaccines seem to have limited effect for the first 10-14 days. So we can probably discount these 4 early hospitalizations.

Here is the relevant table from the FDA submission.

JnJ-Table 18.jpg

If I am reading this correctly, 4 of the hospitalizations in the vaccine group occurred 1-13 days after vaccination, 2 occurred 14-27 days after vaccination, and 0 occurred 28 or more days after vaccination. This compares to 13, 13, 16 in the placebo group over the same timeframes.

This means that from day 14 onwards, there were 2 hospitalizations in the vaccine group and 29 in the placebo group. That translates to a VE of 93.1% (95% CI= 72.7% - 99.2%) for avoiding hospitalization.

I am not a statistician, but I would be surprised if any difference in the observed hospitalization rate (from 14 days onward) between the J&J and Pfizer or Moderna vaccines is statistically significant. On the other hand, the studies were likely underpowered to detect a difference in hospitalization between the vaccines, so we probably can't rule out a difference.

Yep.

In the Pfizer trial the same thing was seen; that is to say, there were a fair number of cases in the vaccine group, but they occurred early after vaccination. In the case of the Pfizer vaccine, though, protection seemed to really pick up after 12 days had passed from receipt of the vaccine. If you looked at a graph of the vaccine group versus the placebo group, the lines were essentially identical through the first twelve days; thereafter, cases in the vaccinated group leveled off while infections in the placebo group continued upward at approximately the same trajectory.

Here is the relevant figure from J&J's FDA submission. As with the Pfizer and Moderna vaccines, there was almost no difference in cases for the first 14 days. The lines diverge significantly 14 days.

JnJ-Figure 1.jpg

Another quirk I found after skimming the J&J FDA submission is that their definition of "moderate to severe/critical COVID" appears to capture nearly all symptomatic cases. According to the submission "There were only 4 centrally confirmed mild COVID-19 cases (1 in vaccine group, 3 in placebo group) with onset ≥14 days post-vaccination, indicating that the moderate to severe/critical primary efficacy endpoint definition captured almost all cases of symptomatic COVID-19."

[MChambers]

Another quirk I found after skimming the J&J FDA submission is that their definition of "moderate to severe/critical COVID" appears to capture nearly all symptomatic cases. According to the submission "There were only 4 centrally confirmed mild COVID-19 cases (1 in vaccine group, 3 in placebo group) with onset ≥14 days post-vaccination, indicating that the moderate to severe/critical primary efficacy endpoint definition captured almost all cases of symptomatic COVID-19."

Exactly. I've read mild criticisms of the Pfizer and Moderna trials, saying that they didn't really capture mild cases of Covid, because trial participants weren't asked about mild symptoms like loss of taste and smell. It's not clear to me that the efficacy rates of the three EUA vaccines reflect the same methodology.

Bottom line is that all three vaccines are pretty darned good at preventing severe cases of Covid after 14 days and even better 30 or more days out.

[LegoBatman]

So Texas is lifting all COVID related restrictions on businesses effective 3/10 and is also going to end the state wide mask mandate.

smh

[Nrrrrvous]

So Texas is lifting all COVID related restrictions on businesses effective 3/10 and is also going to end the state wide mask mandate.

smh

So you're saying you might extend your Spring Break to the East Coast a little longer?

[YmoBeThere]

So Texas is lifting all COVID related restrictions on businesses effective 3/10 and is also going to end the state wide mask mandate.

smh

Abbott needs to distract from the fiasco that occurred a couple weeks ago. This is one way to do that.

[budwom]

Abbott needs to distract from the fiasco that occurred a couple weeks ago. This is one way to do that.

That there is some serious doubling down. I'm nearly amazed...

[Kdogg]

That there is some serious doubling down. I'm nearly amazed...

I doubt this pushes the power outage out of the news and risks headlines of “Corona virus surges on TX” just before Easter. Let’s hope this gamble pays off.

[Skydog]

So Texas is lifting all COVID related restrictions on businesses effective 3/10 and is also going to end the state wide mask mandate.

smh

So we are going to get a large scale trial of some continuing restrictions (most of US) vs placebo/no restrictions (Texas). Will we get graphs like Pfizer's and J&J out of it?

[camion]

Abbott needs to distract from the fiasco that occurred a couple weeks ago. This is one way to do that.

To give Abbott his due, he did ask Texans to behave responsibly. I'm sure that will happen.

[sagegrouse]

Today marks the lowest totals in new cases since late October; lowest number of deaths in three months. All are seven-day averages per Worldometer. Numbers are just drifting downwards rather than decreasing sharply like two weeks ago. Seven-day average for new cases is 66,300; for deaths, 1,932.

[Bluedog]

So we are going to get a large scale trial of some continuing restrictions (most of US) vs placebo/no restrictions (Texas). Will we get graphs like Pfizer's and J&J out of it?

We have already seen this though. Florida has had all schools open, Disneyworld open, and pretty poor mask wearing throughout. It's a different world from a NY or CA. I've been told by those visiting it's a "culture shock." Do the numbers bear that out? I'm honestly not sure. But don't know why. (And data clearly shows masks work. Just don't know if it's clear that the states with fewer restrictions have fared much worse for whatever reason. Maybe they have.)

I would expect individuals' behaviors (mobility, non-mask wearing, etc) has a bigger impact than state restrictions or lack thereof, but there could be some correlation between the two. Probably depends on the restrictions. I think data has shown "highly controlled" environments (e.g schools) generally do not contribute to much increased spread. People hanging out with friends in their homes without masks certainly does...

[Stray Gator]

We have already seen this though. Florida has had all schools open, Disneyworld open, and pretty poor mask wearing throughout. It's a different world from a NY or CA. I've been told by those visiting it's a "culture shock." Do the numbers bear that out? I'm honestly not sure. But don't know why. (And data clearly shows masks work. Just don't know if it's clear that the states with fewer restrictions have fared much worse for whatever reason. Maybe they have.)

I would expect individuals' behaviors (mobility, non-mask wearing, etc) has a bigger impact than state restrictions or lack thereof, but there could be some correlation between the two. Probably depends on the restrictions. I think data has shown "highly controlled" environments (e.g schools) generally do not contribute to much increased spread. People hanging out with friends in their homes without masks certainly does...

I have not traveled extensively around Florida during the past year, but we live in Orlando and get out and about quite a bit -- 2-3 trips to grocery stores each week, probably the same number of shopping excursions into "big box" stores, regular appointments for haircuts and visits to our dentists and doctors, and picking up take-out food once or twice a week. I don't know where the people who characterized the environment in Florida as "culture shock" may have visited, but I can tell you that what they're describing is markedly different from what we're seeing around here.

During the past 3-4 months, I've seen a cumulative total of no more than 5 customers in the two Publix grocery stores or the Fresh Market we frequent who were not wearing a face covering. In the retail stores and barber shop and doctors' offices I've visited, I haven't seen a single individual above kindergarten age who failed to wear a mask. You mentioned Disney World. As it happens, my wife and I made our first trip since last March out to EPCOT two weeks ago to spend a day at the Festival of the Arts with our granddaughter before the event concluded. As you can see from the attached photos, everyone was complying with the mask requirement except when eating or drinking, during which they must be seated.

So while I can't attest to the level of compliance elsewhere around Florida, I can assure you that the reports of "pretty poor mask wearing throughout" are exaggerated, at least in the Orlando area.
PXL_20210221_195911813.MP -- Passing the Mexico pavilion at EPCOT.jpgPXL_20210221_193448628.MP -- Approaching the Italy pavilion at EPCOT.jpg

[Bluedog]

^Fair enough, Stay Gator. Thank you for your firsthand account. I think that also reinforcers the idea that "controlled environments" (grocery store, a theme park that has rules, etc.) leads to more compliance. The stories I heard were from a co-worker from Boston who went down to the west coast of Florida and frequented restaurants/bars...He is a young guy who had recently had COVID so he himself I think was not being very cautious but said what he saw was definitely not what he was accustomed to in Boston.

Regardless, I think it's fair to say Florida has been a state that has "opened up" more aggressively than most. The economy is certainly better for it. I have no idea if COVID cases are or not. California ain't letting Disneyland open still...

[sparv]

^Fair enough, Stay Gator. Thank you for your firsthand account. I think that also reinforcers the idea that "controlled environments" (grocery store, a theme park that has rules, etc.) leads to more compliance. The stories I heard were from a co-worker from Boston who went down to the west coast of Florida and frequented restaurants/bars...He is a young guy who had recently had COVID so he himself I think was not being very cautious but said what he saw was definitely not what he was accustomed to in Boston.

Regardless, I think it's fair to say Florida has been a state that has "opened up" more aggressively than most. The economy is certainly better for it. I have no idea if COVID cases are or not. California ain't letting Disneyland open still...

According to the NY Times, Florida has 1.9 million cases, and 8,900 per 100K. On a per capita basis, this puts them behind NY, NJ, RI, SC, DE, and GA. They've had 31,134 deaths, which is 0.61 per 100K. The per capita death figure puts them at #13, behind VA, AL, OK, AZ, TX, CA, GA, MS, DE, RI, NM, and MA.

[aimo]

during the past 3-4 months, I've seen a cumulative total of no more than 5 customers in the two Publix grocery stores or the Fresh Market we frequent who were not wearing a face covering.

I'm surprised you saw any unmasked people in Publix. Aren't they keeping their mask requirements going nationwide, regardless of local law? When I was in St. Pete in October, everyone was masked, and the local one is enforcing as well.

[Mtn.Devil.91.92.01.10.15]

I'm surprised you saw any unmasked people in Publix. Aren't they keeping their mask requirements going nationwide, regardless of local law? When I was in St. Pete in October, everyone was masked, and the local one is enforcing as well.

I'm not surprised. Every town, every store is different. Locally in Asheville, Publix seems to be better at enforcement than some other stores. But there's variation everywhere.