PlagueWatch 2020-23 - Coronavirus

[sagegrouse]

Thanks Richardjackson! Yes, the vaccines have been truly spectacular. After googling, it appears it was the AstraZeneca and Novavax vaccines that have greatly reduced effectiveness against the S African variant. So if that's the case, do we know why Fauci recommends mask wearing for the fully vaccinated "because of the variants"?

It's "coach speak" -- MD version. People who've been vaccinated need to continue wearing masks to avoid setting bad examples to others who haven't been vaccinated. It's a public health measure, in that mask-wearing by the population as a whole reduces infections. He just can't express it in these terms.

[richardjackson199]

It's "coach speak" -- MD version. People who've been vaccinated need to continue wearing masks to avoid setting bad examples to others who haven't been vaccinated. It's a public health measure, in that mask-wearing by the population as a whole reduces infections. He just can't express it in these terms.

This. Agreed.

A population wearing masks is effective pushing down the spread of infections. A population getting vaccinated is effective pushing down the spread of infections. Both together at the same time is better than only one until we reach herd immunity.

[LasVegas]

This. Agreed.

A population wearing masks is effective pushing down the spread of infections. A population getting vaccinated is effective pushing down the spread of infections. Both together at the same time is better than only one until we reach herd immunity.

I’ve worn a mask since the start of this, and worked on a Covid floor, but I don’t want to do it all the way to herd immunity. Once everyone in the public can get it, wait a few weeks and then lift everything. If you haven’t received it by then, sorry for you. You’ve been given the chance and haven’t done it.

[-jk]

How times change. WWII lasted just under 4 years and people went through a lot more hardship (rationing, etc.) than having to wear a mask. Add to it that most of that dying was occurring elsewhere and it's really an indictment of who we've become as a nation.

The Spanish Flu history suggests things haven’t changed much.

-jk

[kexman]

I’ve worn a mask since the start of this, and worked on a Covid floor, but I don’t want to do it all the way to herd immunity. Once everyone in the public can get it, wait a few weeks and then lift everything. If you haven’t received it by then, sorry for you. You’ve been given the chance and haven’t done it.

Kids under 12 will not get the vaccine until possibly 2022.

[Reisen]

Wow, massive news this morning, as the J&J rollout is going to be paused due to concerns over blood clots. We definitely did not need this, and it places more pressure on Pfizer and Moderna to keep ramping up supply.

I’m not an anti-vaxxer (getting my second Moderna shot this week), but it also pours some fuel on that flame. One of the clotting cases occurred during the J&J trial.

I have to think that, even if J&J shots start back up, public preference will shift toward the mRNA vaccines.

[TNDukeFan]

https://edition.cnn.com/world/live-n...fde9fda08fe953

6 possible cases of clotting out of 6.8 million doses administered. My wife is scheduled to have J&J tomorrow afternoon, so this is an interesting development, to say the least.

[budwom]

And the ever increasing case count really isn't good news at all...

[CDu]

And the ever increasing case count really isn't good news at all...

The only positive news is that deaths continue to decline for now. We are about a month since the recent nadir of daily cases nationally, yet we haven't seen the daily death rate hit its bottom. I would have expected that to have happened about a week ago, but we're still declining.

If the deaths continue to decline, then the case count loses some of its concern. That suggests that the vaccination program is working.

We still have less than half of the adult population partially vaccinated, and less than 1/3 are fully vaccinated. But in the 65+ population, we're up to almost 80% with at least 1 dose and almost 2/3 have been fully vaccinated. So it's quite possible that the increase in cases is happening predominantly in a younger population (since the younger population is just now starting to get vaccinated). And that would explain the divergence of deaths from cases.

Now, we're not at the point where that theory is the only explanation. It could be that deaths start to tick back upwards over the next week or two. If so, then the worry is legitimate. But if the deaths continue to decline over the coming weeks, then that is a good indicator that the vaccines are working appropriately.

[MChambers]

https://edition.cnn.com/world/live-n...fde9fda08fe953

6 possible cases of clotting out of 6.8 million doses administered. My wife is scheduled to have J&J tomorrow afternoon, so this is an interesting development, to say the least.

I got the J&J vaccine back in February; my daughter, who is 25, got the J&J 12 days ago.

Both the J&J and the AstraZeneca vaccines use an adenovirus (different ones) to deliver the spike protein, so it's concerning that both have been linked to the blood clot issue. OTOH, the blood clots seem to be a lot more rare than Covid-19. Let's hope this pause is just out of an abundance of caution.

[sagegrouse]

The only positive news is that deaths continue to decline for now. We are about a month since the recent nadir of daily cases nationally, yet we haven't seen the daily death rate hit its bottom. I would have expected that to have happened about a week ago, but we're still declining.

If the deaths continue to decline, then the case count loses some of its concern. That suggests that the vaccination program is working.

We still have less than half of the adult population partially vaccinated, and less than 1/3 are fully vaccinated. But in the 65+ population, we're up to almost 80% with at least 1 dose and almost 2/3 have been fully vaccinated. So it's quite possible that the increase in cases is happening predominantly in a younger population (since the younger population is just now starting to get vaccinated). And that would explain the divergence of deaths from cases.

Now, we're not at the point where that theory is the only explanation. It could be that deaths start to tick back upwards over the next week or two. If so, then the worry is legitimate. But if the deaths continue to decline over the coming weeks, then that is a good indicator that the vaccines are working appropriately.

Here are seven-day averages for deaths and new cases each Monday back to February 22 that seem to show that the deaths are declining even though cases are now inching upwards.

Date	 Deaths 	 New Cases 
22-Feb	 2,043 	 69.6 
1-Mar	 2,002 	 69.1 
8-Mar	 1,641 	 58.8 
15-Mar	 1,304 	 55.7 
22-Mar	 1,027 	 57.1 
29-Mar	 1,011 	 64.7 
5-Apr	 820 	 65.7 
12-Apr	 747 	 69.9

While there are lags between new cases and deaths, see that the new cases are generally in the same range, but deaths have declined sharply.

[TeacherTom]

How long after the vaccine does the blood clot occur? I haven’t been able to locate the answer.

[mph]

How long after the vaccine does the blood clot occur? I haven’t been able to locate the answer.

The articles I read said the cases were within ~14 days. That’s very similar to the AZ/Oxford data and suggests that a similar mechanism is at work.

My wife received J&J about 4 weeks ago so I’m relieved even though I know her risk would be very low even if she was in the 2 week window.

[House P]

The only positive news is that deaths continue to decline for now. We are about a month since the recent nadir of daily cases nationally, yet we haven't seen the daily death rate hit its bottom. I would have expected that to have happened about a week ago, but we're still declining.

If the deaths continue to decline, then the case count loses some of its concern. That suggests that the vaccination program is working.

We still have less than half of the adult population partially vaccinated, and less than 1/3 are fully vaccinated. But in the 65+ population, we're up to almost 80% with at least 1 dose and almost 2/3 have been fully vaccinated. So it's quite possible that the increase in cases is happening predominantly in a younger population (since the younger population is just now starting to get vaccinated). And that would explain the divergence of deaths from cases.

Now, we're not at the point where that theory is the only explanation. It could be that deaths start to tick back upwards over the next week or two. If so, then the worry is legitimate. But if the deaths continue to decline over the coming weeks, then that is a good indicator that the vaccines are working appropriately.

Hospitalizations have also crept up 10% or so in the past 2-3 weeks. Here is a plot of nationwide COVID hospitalizations from the NY Times.

Hosp 2021-04-13 090135.jpg

Hopefully the vaccine rollout will continue to accelerate and the uptick in hospitalizations will be short-lived.

Here is a hospitalization graph from the UK, where they are a bit ahead of us (50% vs 35%) in terms of the % of the population with at least one shot. FWIW, they are way behind us in terms of the % of the population which is fully vaccinated, but that doesn't seem to be hurting them in terms of cases, hospitalizations, and deaths.

Hosp-UK 2021-04-13 090527.jpg

[TeacherTom]

My wife had it at the beginning of March. Thank you! I feel a bit better about it now.

[MChambers]

Here's a good blog piece by an epidemiologist about the J&J pause, putting the blood clot issue into better perspective:

https://emily-smith.net/2021/04/13/jj-vaccine-pause/

[Tripping William]

At 5/6th’s vaccinated (teenage son awaits 2nd Pfizer dose), we decided it was time to take the travel plunge last week. N95 masks for the airports and planes. Did most of our cooking/eating in our rental cabin, and ate outdoors at the other times. Dallas and Charlotte airports were pretty crowded, but everyone in masks. Other places were hit-and-miss. It was a bit surreal, but we never felt unsafe. And no one showing any signs of having contracted COVID. Thankfully.

[JasonEvans]

Can I ask what we all think of the decision to halt the JnJ vaccine because 6 people out of 7 million got blood clots and 1 person died?

I really want to hear someone, anyone, argue that this was something less than colossally stupid messaging by the CDC and FDA.

There is absolutely no question that stopping this vaccine rollout (and the resulting vaccine hesitancy we will see) this is going to cost hundreds, maybe thousands of lives... if every single person in America got the JnJ vaccine, this blood clot problem would (in theory) result in 47 deaths.

Someone please explain to me how this is not the single stupidest decision by US health experts since, "wearing a mask won't help you, but it helps people around you."

[JasonEvans]

Here's a good blog piece by an epidemiologist about the J&J pause, putting the blood clot issue into better perspective:

https://emily-smith.net/2021/04/13/jj-vaccine-pause/

This chart should tell you all you need to know about this issue (pay careful attention to all the extra zeros in the decimal points in this image):



Worth noting that the JnJ vaccine is far, far less prevalent than the AZ one (6 in 7 million versus 4 in 1 million).

I'm not a health expert and would love to hear from others who know more than I do about this... but it sure feels like the decision to unnecessarily alarm the public about the JnJ vaccine and halt distribution of it is mindbogglingly stupid.

[MChambers]

Can I ask what we all think of the decision to halt the JnJ vaccine because 6 people out of 7 million got blood clots and 1 person died?

I really want to hear someone, anyone, argue that this was something less than colossally stupid messaging by the CDC and FDA.

There is absolutely no question that stopping this vaccine rollout (and the resulting vaccine hesitancy we will see) this is going to cost hundreds, maybe thousands of lives... if every single person in America got the JnJ vaccine, this blood clot problem would (in theory) result in 47 deaths.

Someone please explain to me how this is not the single stupidest decision by US health experts since, "wearing a mask won't help you, but it helps people around you."

I think it's a horrible overreaction. They'll probably release the vaccine next week, but the damage will be done in terms of public opinion.