COVID-19 Megathread 6: Return of the Omicron

[Calthrina950]

Multnomah County just re instituted a mask mandate. With a $1000 fine for anyone who violates. If that isn’t the definition of insanity then idk what is.

I saw the article on this. This mandate doesn't expire until January.

That's right, January.

I remember last year when they said the holiday season would be normal this year. But they lied. Again. This year, the whole holiday season is hosed again. Halloween, Thanksgiving, Hanukkah, Christmas, New Year's. All hosed. For the second year in a row.

When the employee mask mandate was reinstated at my job a week ago, I told several of my coworkers that the mandate would probably remain in effect for the rest of the year. Well, a least one benefit is that the mask will help me keep warm outside when it gets colder in a few months.

[compucomp]

Multnomah County just re instituted a mask mandate. With a $1000 fine for anyone who violates. If that isn’t the definition of insanity then idk what is.

I saw the article on this. This mandate doesn't expire until January.

That's right, January.

I remember last year when they said the holiday season would be normal this year. But they lied. Again. This year, the whole holiday season is hosed again. Halloween, Thanksgiving, Hanukkah, Christmas, New Year's. All hosed. For the second year in a row.

And who is "they"? You blame the public health authorities and the government? Did Fauci and Biden go into a lab and invent the Delta variant? Why are you so resentful that your holidays will be ruined when the "guilty party" is now and has always been the coronavirus? "They" lied? Given 1.5 years of this already shouldn't everyone realize that the trajectory of the pandemic is unpredictable and could take twist and turns in either direction, and public health authorities make pronouncements with the best information they have at any particular time? What, do you want Trump to take over again and just proclaim the pandemic over?

Never mind the fact that there are still exactly zero social distancing restrictions; it's just a mask mandate. This is absolutely an absurd response to Portland's action.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

I can’t agree with this either.
Once you are vaccinated, the threat of covid is much less than the threat of the flu or any number of other virus.

(checks notes)

Yup, completely ignoring long COVID.

Not to mention ignoring various other things such as potential future viral evolution, the unknown degree to which vaccine efficacy declines over time, and the fact that the efficacy of booster is still unknown (we can be hopeful, but hope is not a plan). But let's focus on long COVID, because that is IMO pretty clearly the most significant risk for young healthy vaccinated people, and it is a significant risk that you underestimate at your own peril.


Among other things, people who have been infected with COVID have been found by the most comprehensive study so far to have lost a couple of IQ points as a result (with small losses even:

https://www.news.com.au/technology/science/human-body/british-study-finds-intelligence-hindered-by-coronavirus/news-story/980383a23c88a98a97de8dc18e6f5a02

That includes mild cases where you naively wouldn't expect any serious long-lasting damage.



Is brain damage a significant thing?

Yup, loss of a few IQ points seems to be pretty serious and worth being careful to avoid. I value my brain. But maybe that is just me.


Can people who are vaccinated get long COVID? Does vaccination lower your chances of getting long COVID?

Yes, people who are vaccinated definitely get long COVID (including from very mild cases). The chances are not really well known yet, but a study a few days ago found that being vaccinated lowered the chance of getting long COVID by about 50%. Don't get me wrong, that is better than 0%, and I would gladly take 50% over 0%, but that is not the reduction from the base risk one would hope for. The base risk of long COVID is something like 10-30% (fairly wide variation because it has not been as well studied as one would hope and also long COVID is still not that clearly defined). A 50% reduction of that would put you at 5-15% chance of getting long COVID from a breakthrough infection. Another Israeli study a couple of days ago found that ~19% of vaccinated breakthrough infections resulted in long COVID (although small sample and this was a study of medical personnel/nurses, so it may not be representative of the general public).

So those both seem in the same general sort of range, but new information continues to come out and that is not at all determinate yet.

But anything remotely like a 5-15% chance is not a small chance. It is in a totally different league from the chance of death for e.g. young vaccinated people from COVID, and given the symptoms one would be foolish to ignore that.



Is the risk and/or severity of long COVID higher with Delta than with previous variants?

This is not yet known because not enough time has passed with the Delta variant being dominant. But it would be sort of surprising if that were NOT the case, given that everything else about the Delta variant seems to be worse.


Is there any precedent for this?

Yup, there was the same sort of thing with SARS-1. "Long SARS":

https://www.thefreelibrary.com/Outcomes+of+SARS+survivors+in+China%3a+not+only+physical+and...-a0369220546

There were studies ~10 years after SARS-1 that found that many SARS-1 survivors still had serious symptoms. I would be very interested to see follow-up on how they are doing today (and also how SARS-1 survivors have fared against COVID), but I haven't seen any such studies yet.


Is the cumulative probability of getting long COVID higher if you are re-infected with COVID, as GeorgiaModerate's relative was, higher than if you are only infected with COVID a single time?

I don't think we know yet, but it would stand to reason that to some extent or another, the answer to that is yes. We don't yet know if it is a great extent or a small extent.

And frankly, covid is likely going to be with us forever.  If you are vaccinated and still afraid of covid, you are going to be living in fear your entire lift.

What exactly do you mean by "living in fear"?

For example, when I drive a car, I am aware that there is a chance of getting into a car accident and dying or getting seriously injured (as well as killing or seriously injuring other people). This is something that I would like to avoid. Consequently, when I am driving I try to drive carefully and defensively, avoid excessive speeding especially in environments when it is unsafe, be sure to look over my shoulder when changing lanes, be careful about passing on single lane roads, etc. And yes, I do wear my seatbelt also. And when making travel plans for any long cross-country journeys, one small factor that I consider in deciding whether to fly or drive is the fact that flights are safer. So, am I "living in fear" of car accidents?

I have been taking and intend to keep on taking similar sorts of efficacious but low cost precautions with regards to COVID. They are not going to be 100% effective, but if everyone did this it would make a difference.

This behavior does have a cost. I probably get to my destination a few seconds slower. So, am I "living in fear"? After all, I am changing my behavior based upon risk and cost-benefit analysis. If there were 0 risk of car accidents and the like, then I would instead always drive as fast as I could, swerve to change lanes recklessly, and as a result could save some small amounts of time on my car trips (also giving me less time to listen to NPR tho ).

And frankly, covid is likely going to be with us forever.

If you get long COVID, yes, it could be with you forever. It would kind of suck to have chronic fatigue for potentially as long as the rest of your life, to name one symptom of long COVID. You know what that means, "chronic fatigue"? It doesn't just mean you are tired. The name makes it sound far less bad than it is. To anyone who doesn't know, look it up. Or honestly, maybe don't look it up. I would sort of rather not know that it exists and is a significant possibility, in a way.

I don't want anything at all approaching a 5-15% chance of that from infection. That is way too high of a chance to just sit back and passively accept.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

Deaths lagged cases by about two weeks in every previous surge; e.g. nationally cases peaked around Jan 13 and deaths peaked around Jan 26.  And cases have now been rising for well over a month.  

You apparently have not bothered to look and see that in fact deaths ARE going up:

https://www.worldometers.info/coronavirus/usa/florida/

https://www.worldometers.info/coronavirus/usa/texas/

As I mentioned earlier though, one would expect longer lag times for a virus with a higher R (because the median hospitalized patient will be more recently infected if infections are rising more rapidly).

There is also likely some degree of underreporting/delayed reporting of deaths (there was in previous surges, which subsequently got revised upwards, but only after the fact).

I know deaths are going up in states with lower vaccinations rates.  They are not going up in states with high vaccination rates.  That was the whole point of my post with the graphs.

Let's review what you said:

It is worth reminding people that there has been absolutely NO surge in covid deaths in blue America (with a small number of local exceptions).

Here's a graph from the Washington Post of the states with the highest current average deaths per 100k residents:

My interpretation of that was that you do not expect deaths to increase in "blue America" if cases keep rising.

If my interpretation of what you said is correct and indeed you would be surprised by deaths (and/or hospitalizations) going up in places like New York and California, then if I were you, I would be prepared to be surprised...

... because cases are already going up in blue states...

https://www.worldometers.info/coronavirus/usa/california/

https://www.worldometers.info/coronavirus/usa/new-york/

https://www.worldometers.info/coronavirus/usa/illinois/

In CA/NY/IL they are all going significantly up, and if you look at pretty much every other state (whether blue or red), you will see the same thing.

It is true that most of the deaths in "blue America" should be expected to occur among unvaccinated people, but your point was not about vaccination status, but about "blue states" vs "red states."

Additionally, some of the deaths in blue states will also be among vaccinated people. How much that is the case is TBD and depends upon how much vaccine efficacy declines over time and is lower for delta, which we don't yet know for sure, but we can look to other countries where we see some indications that efficacy does decline. Those indications are not 100% clear, but they are there nonetheless.

Wait for more data to come out before prematurely declaring victory and imagining that "blue states" have nothing to be worried about and that deaths are not going to rise in blue states also. That is, sadly, a false hope.

[pbrower2a]

It is worth reminding people that there has been absolutely NO surge in covid deaths in blue America (with a small number of local exceptions).

It never ceases to amaze me how after all this time, so many people STILL do not understand that hospitalizations and deaths lag cases.

In economics: a leading indicator is an economic measure or statistic that usually presages economic change. Leading indicators:

Components of the Conference Board's Leading Economic Indicators Index

Average weekly hours (manufacturing) — Adjustments to the working hours of existing employees are usually made in advance of new hires or layoffs, which is why the measure of average weekly hours is a leading indicator for changes in unemployment.

Average weekly initial jobless claims for unemployment insurance — The CB reverses the value of this component from positive to negative because a positive reading indicates a loss in jobs. The initial jobless-claims data is more sensitive to business conditions than other measures of unemployment, and as such leads the monthly unemployment data released by the U.S. Department of Labor.

Manufacturers' new orders for consumer goods/materials — This component is considered a leading indicator because increases in new orders for consumer goods and materials usually mean positive changes in actual production. The new orders decrease inventory and contribute to unfilled orders, a precursor to future revenue.

Vendor performance (slower deliveries diffusion index) — This component measures the time it takes to deliver orders to industrial companies. Vendor performance leads the business cycle because an increase in delivery time can indicate rising demand for manufacturing supplies. Vendor performance is measured by a monthly survey from the National Association of Purchasing Managers (NAPM). This diffusion index measures one-half of the respondents reporting no change and all respondents reporting slower deliveries.

Manufacturers' new orders for non-defense capital goods — As stated above, new orders lead the business cycle because increases in orders usually mean positive changes in actual production and perhaps rising demand. This measure is the producer's counterpart of new orders for consumer goods/materials component (#3).

Building permits for new private housing units.

Stock prices of 500 common stocks — Equity market returns are considered a leading indicator because changes in stock prices reflect investors' expectations for the future of the economy and interest rates.

Corporate equities as leading indicator with respect to GDP.

Money Supply (M2) — The money supply measures demand deposits, traveler's checks, savings deposits, currency, money market accounts, and small-denomination time deposits. Here, M2 is adjusted for inflation by means of the deflator published by the federal government in the GDP report. Bank lending, a factor contributing to account deposits, usually declines when inflation increases faster than the money supply, which can make economic expansion more difficult. Thus, an increase in demand deposits will indicate expectations that inflation will rise, resulting in a decrease in bank lending and an increase in savings.

Interest rate spread (10-year Treasury vs. Federal Funds target) — The interest rate spread is often referred to as the yield curve and implies the expected direction of short-, medium- and long-term interest rates. Changes in the yield curve have been the most accurate predictors of downturns in the economic cycle. This is particularly true when the curve becomes inverted, that is, when the longer-term returns are expected to be less than the short rates.

Index of consumer expectations — This is the only component of the leading indicators that is based solely on expectations. This component leads the business cycle because consumer expectations can indicate future consumer spending or tightening. The data for this component comes from the University of Michigan's Survey Research Center, and is released once a month.

coincident indicators:

There are four economic statistics comprising the Index of Coincident Economic Indicators:[5]

Number of employees on non-agricultural payrolls

Personal income less transfer payments

Industrial production

Manufacturing and trade sale

The Philadelphia Federal Reserve produces state-level coincident indexes based on 4 state-level variables:[6]

Nonfarm payroll employment

Average hours worked in manufacturing

Unemployment rate

Wage and salary disbursements deflated by the consumer price index (U.S. city average)

lagging indicators:

The components on the Conference Board's index are:

The average duration of unemployment (inverted)

The value of outstanding commercial and industrial loans

The change in the Consumer Price Index for services

The change in labour cost per unit of output

The ratio of manufacturing and trade inventories to sales

The ratio of consumer credit outstanding to personal income

The average prime rate charged by banks

Non-indicators

height of hem lines
whether the American League or National League team last won the World Series

Kind of like how, just a few pages back in this thread and just a week ago, people STILL didn't think that deaths would rise in Florida and Texas when cases were rising there but hospitalizations/deaths were still lagging (spoiler: they are rising now).

Deaths follow hospitalizations, which themselves follow "positive" tests for COVID-19, which follow activities that foster infections.

[Fmr. Gov. NickG]

What exactly do you mean by "living in fear"?

For example, when I drive a car, I am aware that there is a chance of getting into a car accident and dying or getting seriously injured (as well as killing or seriously injuring other people). This is something that I would like to avoid. Consequently, when I am driving I try to drive carefully and defensively, avoid excessive speeding especially in environments when it is unsafe, be sure to look over my shoulder when changing lanes, be careful about passing on single lane roads, etc. And yes, I do wear my seatbelt also. And when making travel plans for any long cross-country journeys, one small factor that I consider in deciding whether to fly or drive is the fact that flights are safer. So, am I "living in fear" of car accidents?

I have been taking and intend to keep on taking similar sorts of efficacious but low cost precautions with regards to COVID. They are not going to be 100% effective, but if everyone did this it would make a difference.

This behavior does have a cost. I probably get to my destination a few seconds slower. So, am I "living in fear"? After all, I am changing my behavior based upon risk and cost-benefit analysis. If there were 0 risk of car accidents and the like, then I would instead always drive as fast as I could, swerve to change lanes recklessly, and as a result could save some small amounts of time on my car trips (also giving me less time to listen to NPR tho ).

You haven’t been advocating for the equivalent of getting to your destination a few seconds later.
You’ve been advocating for the equilavent of not going to the destination at all because you are afraid of a car crash.

You are suggesting that people should not be going to big public events like concerts and birthday parties even if they are vaccinated.

If this is how you are thinking now, you are going to be missing out on a lot for years to come.
And this is indeed living in fear.

[roxas11]

Deaths lagged cases by about two weeks in every previous surge; e.g. nationally cases peaked around Jan 13 and deaths peaked around Jan 26.  And cases have now been rising for well over a month.  

You apparently have not bothered to look and see that in fact deaths ARE going up:

https://www.worldometers.info/coronavirus/usa/florida/

https://www.worldometers.info/coronavirus/usa/texas/

As I mentioned earlier though, one would expect longer lag times for a virus with a higher R (because the median hospitalized patient will be more recently infected if infections are rising more rapidly).

There is also likely some degree of underreporting/delayed reporting of deaths (there was in previous surges, which subsequently got revised upwards, but only after the fact).

I know deaths are going up in states with lower vaccinations rates.  They are not going up in states with high vaccination rates.  That was the whole point of my post with the graphs.

Let's review what you said:

It is worth reminding people that there has been absolutely NO surge in covid deaths in blue America (with a small number of local exceptions).

Here's a graph from the Washington Post of the states with the highest current average deaths per 100k residents:

My interpretation of that was that you do not expect deaths to increase in "blue America" if cases keep rising.

If my interpretation of what you said is correct and indeed you would be surprised by deaths (and/or hospitalizations) going up in places like New York and California, then if I were you, I would be prepared to be surprised...

... because cases are already going up in blue states...

https://www.worldometers.info/coronavirus/usa/california/

https://www.worldometers.info/coronavirus/usa/new-york/

https://www.worldometers.info/coronavirus/usa/illinois/

In CA/NY/IL they are all going significantly up, and if you look at pretty much every other state (whether blue or red), you will see the same thing.

It is true that most of the deaths in "blue America" should be expected to occur among unvaccinated people, but your point was not about vaccination status, but about "blue states" vs "red states."

Additionally, some of the deaths in blue states will also be among vaccinated people. How much that is the case is TBD and depends upon how much vaccine efficacy declines over time and is lower for delta, which we don't yet know for sure, but we can look to other countries where we see some indications that efficacy does decline. Those indications are not 100% clear, but they are there nonetheless.

Wait for more data to come out before prematurely declaring victory and imagining that "blue states" have nothing to be worried about and that deaths are not going to rise in blue states also. That is, sadly, a false hope.

cases are going up everwhere but lets not pretend for 1 second that CA/NY/IL are seeing the same  kind of crazy numbers of covid cases that is coming out of the deep south

There is a huge difference between what we are seeing in place like Illinois





Compared to what we are seeing in Florida right now

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

You haven’t been advocating for the equivalent of getting to your destination a few seconds later.
You’ve been advocating for the equilavent of not going to the destination at all because you are afraid of a car crash.

You are suggesting that people should not be going to big public events like concerts and birthday parties even if they are vaccinated.

If this is how you are thinking now, you are going to be missing out on a lot for years to come.
And this is indeed living in fear.

I would say that my desired "destination" is to live a happy and fulfilled life (at least insofar as possible in this rather screwed up world). To be sure, going to big public events can contribute to that, but it is not the same thing. There are other things that can function as pretty good, though imperfect, substitutes at least for the time being, such as smaller gatherings and televised/streamed concerts.

As one example, I don't think I lost out on much, if anything, of significance from the fact that the Olympics didn't have large in-person crowds (or tbh from the fact that it was delayed for a year - and I also don't think I would have missed out on much more if it had been delayed a bit longer until vaccinations were more widespread in Japan). IMO the benefit of there not being large crowds significantly outweighed any benefit from having large in-person crowds. The COVID situation is serious in Japan, with a large delta surge going on now that would be a lot worse if the Olympics had large in-person crowds.

People in Japan who might have attended the Olympics in person lost out on relatively more. But they also gained more from the pandemic not being made even worse there.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

There is a huge difference between what we are seeing in place like Illinois


Compared to what we are seeing in Florida right now

I certainly agree with that. But you could have said a similar thing about the way that cases surged in the south ("red states") in the summer of 2020, but things were relatively better in the north ("blue states").

This did not mean that northern/blue states were safe... it just meant that their big surges were coming later (i.e. when it got colder).

As far as Florida goes, just a reminder, but its vaccination rate is pretty much at the national average... The reason why cases, hospitalizations, and deaths are surging in Florida is not that it has an unusually low vaccination rate, because it doesn't.

The reasons why cases are surging there have a lot to do with climate (air conditioning) and tourism. By the time we get to winter, when the climactic conditions are different and it is very cold in the north, then things will be different. Any northern states that still have vaccination rates close to the national average are at grave risk of looking pretty similar to how Florida looks now, because they are going to have a lot more indoor air circulation as people try to keep warm (just as people have been trying to keep cool in Florida in the air conditioning).


edit -

More concretely ---

Currently, Florida is at 59% with 1 dose and 49% fully vaccinated. Illinois is at 63% with 1 dose and 49% fully vaccinated. That is a bit better, but not much. Michigan is at 53% with 1 dose and 49% fully vaccinated - which in fact is worse than Florida. So if you think that what is happening in Florida can't happen in blue states further north just because of vaccination rates, might want to think about that pretty carefully before betting anything important on it.

[Interlocutor is just not there yet]

All I'll say is that my sanity is much better having drastically cut down my reading of this thread.

Especially when it pertains to the "Stop living in fear" contingent. My head is aching from all the whiplash I'm getting

[Fmr. Gov. NickG]

The death rate in blue states probably will creep up a bit in the next few weeks.  But that will be because not everyone in those blue states is vaccinated, not because vaccinated people are dying.

The decision to not have fans at the Tokyo Olympics was reasonable because most people in Japan at the time the decision was made did not have access to a vaccine.

In contrast, demanding that a vaccinated person refrain from going to an outdoor concert where everyone else is also vaccinated is not reasonable.  

If that is your fear threshold for covid right now, you’re in for a pretty lonely decade at least.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

"Outdoor concerts" are not all created equal.

There is a big difference in terms of potential for transmission between e.g. this, Lollapalooza which just happened, with a huge crowd of people all very close to each other where they would be breathing right onto other people. In terms of airflow, that is in some ways a lot more similar to being indoors than "outdoors":



And this, an outdoor concert where there is a smaller and more spread out crowd, and everyone is not breathing directly onto other people:



This latter concert would probably not be too much of a problem, in particular if the people were careful there.

But the former is a significant risk, given that delta is much more easily transmissible than earlier variants. It is true that other things equal, being outdoors is much safer than being indoors, but context and specifics matter a lot, and remember that previous intuitions and experience about what is safe outdoors were based on the earlier virus which was only  ~1/2 or even ~1/3 as transmissible as delta.

[Calthrina950]

"Outdoor concerts" are not all created equal.

There is a big difference in terms of potential for transmission between e.g. this, Lollapalooza which just happened, with a huge crowd of people all very close to each other where they would be breathing right onto other people. In terms of airflow, that is in some ways a lot more similar to being indoors than "outdoors":



And this, an outdoor concert where there is a smaller and more spread out crowd, and everyone is not breathing directly onto other people:



This latter concert would probably not be too much of a problem, in particular if the people were careful there.

But the former is a significant risk, given that delta is much more easily transmissible than earlier variants. It is true that other things equal, being outdoors is much safer than being indoors, but context and specifics matter a lot, and remember that previous intuitions and experience about what is safe outdoors were based on the earlier virus which was only  ~1/2 or even ~1/3 as transmissible as delta.

You seem to be saying that there should be restrictions imposed on what kinds of outdoor gatherings should be held, and where. What is your view about events such as state fairs? Should those be proscribed? And how long should these restrictions be maintained for? Ought we to continue with restrictions until coronavirus cases have dropped significantly?

[roxas11]

There is a huge difference between what we are seeing in place like Illinois


Compared to what we are seeing in Florida right now

I certainly agree with that. But you could have said a similar thing about the way that cases surged in the south ("red states") in the summer of 2020, but things were relatively better in the north ("blue states").

This did not mean that northern/blue states were safe... it just meant that their big surges were coming later (i.e. when it got colder).

As far as Florida goes, just a reminder, but its vaccination rate is pretty much at the national average... The reason why cases, hospitalizations, and deaths are surging in Florida is not that it has an unusually low vaccination rate, because it doesn't.

The reasons why cases are surging there have a lot to do with climate (air conditioning) and tourism. By the time we get to winter, when the climactic conditions are different and it is very cold in the north, then things will be different. Any northern states that still have vaccination rates close to the national average are at grave risk of looking pretty similar to how Florida looks now, because they are going to have a lot more indoor air circulation as people try to keep warm (just as people have been trying to keep cool in Florida in the air conditioning).


edit -

More concretely ---

Currently, Florida is at 59% with 1 dose and 49% fully vaccinated. Illinois is at 63% with 1 dose and 49% fully vaccinated. That is a bit better, but not much. Michigan is at 53% with 1 dose and 49% fully vaccinated - which in fact is worse than Florida. So if you think that what is happening in Florida can't happen in blue states further north just because of vaccination rates, might want to think about that pretty carefully before betting anything important on it.

Not even I, am crazy enough to believe that blue states are somehow magically protected from covid lol

as you correctly pointed out blue states are currently doing a lot better, but that does not mean that they are somehow immune to what is going on in red states because the reality is no state is truly safe until we can get this virus fully under control

[Donerail]

As far as Florida goes, just a reminder, but its vaccination rate is pretty much at the national average... The reason why cases, hospitalizations, and deaths are surging in Florida is not that it has an unusually low vaccination rate, because it doesn't.

Currently, Florida is at 59% with 1 dose and 49% fully vaccinated. Illinois is at 63% with 1 dose and 49% fully vaccinated. That is a bit better, but not much. Michigan is at 53% with 1 dose and 49% fully vaccinated - which in fact is worse than Florida. So if you think that what is happening in Florida can't happen in blue states further north just because of vaccination rates, might want to think about that pretty carefully before betting anything important on it.

I would challenge the idea that those numbers are accurate. What that number reflects is the number of people who have received the vaccine from a location in Florida over the total state population; the assumption there is that one group is contained within the other. With Florida in particular, this is not a safe assumption because of the volume of travel and the number of seasonal residents. Florida's high vaccination rate likely reflects a large number of people who received vaccines there who are now not in Florida.

Florida has a large population of seasonal residents ("snowbirds"), many of whom who got one or both doses in the state before returning to their summer home in Massachusetts or Michigan or wherever. It's difficult to measure, but there were also widespread media reports of people from Latin America who traveled to Florida to get vaccinated. (I don't think it's a coincidence, for instance, that (after Sumter) the most-vaccinated county is Miami-Dade.)

The seasonality explanation falls flat for me because Florida is not the only state where it's hot right now. The vaccination rates in Arizona and Texas, for instance, are slightly lower than Florida's posted rate, but cases per capita and hospitalizations in Florida are more than double what we see in those states.

[Dr. MB]

I've got some concert tickets for October and gonna be annoyed if I have to wear a mask at it. But since it's inside I guess I'm not gonna get my hopes up.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

You seem to be saying that there should be restrictions imposed on what kinds of outdoor gatherings should be held, and where. What is your view about events such as state fairs? Should those be proscribed? And how long should these restrictions be maintained for? Ought we to continue with restrictions until coronavirus cases have dropped significantly?

I don't have all the answers, and I try to be careful to not say what I don't know with pretty good confidence.

But I would say that recognizing that not all gatherings are equally risky falls under the same general principle as was applied during the March/April 2020 period, where in many areas there were restrictions on some, but not all, gatherings (for example, banning gatherings of more than 100 people, but not less).

Of course, it is not really the number of people at a gathering per se that increases risk the most, it is the density at which people are packed together and the airflow/ventilation. The people best equipped to make recommendations for what sorts of events would be scientists at CDC or elsewhere who are best informed. But it is inherently tricky and difficult to draw a line between what would be a sufficiently safe and well-ventilated event and what would not be, and especially to do so in a concise and easily understandable way.

There was a good NY Times article explaining many of the risk factors and how scientific understanding of how COVID spreads (aerosols, not just droplets) has changed since the beginning of the pandemic, and the implications of that for what measures are most likely to be effective:

https://web.archive.org/web/20210618035441/https://www.nytimes.com/2021/05/07/opinion/coronavirus-airborne-transmission.html

Canceling large densely packed events is not ideal; in a perfect world we could have them all. But it is certainly less costly to society overall than alternatives such as shutting down businesses or having remote learning in schools, or as is apparently going to start happening in Texas, canceling "non-essential" medical procedures.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

There's some more (bad, but at this point not particularly unexpected) news on declining vaccine efficacy with some new research out from the Mayo Clinic, and it unfortunately looks like it is confirming the earlier findings from Israel of declining vaccine efficacy, in particular for the Pfizer vaccine but also to a lesser degree for Moderna.

In the USA in Mayo Clinic health sites in MN, WI, AZ, FL, and IA, Pfizer efficacy has dropped to 42% against infection, whereas Moderna vaccine efficacy has dropped to 76% against infection. The bad thing is that efficacy will probably continue to drop in future months, based on what has been reported from Israel where people were vaccinated earliest (primarily with Pfizer). This means that, unless all of this data is somehow totally wrong, many more vaccinated people are going to get breakthrough infections (although they will still be much less likely to be hospitalized or die). But we don't want vaccinated people getting infected and continuing to spread COVID, even if all the cases were mild and benign and even if things like long COVID did not exist, because this could lead to evolution of other variants that may not be so mild and benign for vaccinated people.

Speculatively, the reason why Moderna may be losing efficacy less quickly than Pfizer is that Moderna had larger doses of mRNA vaccine than the Pfizer jabs had.

Moderna may be superior to Pfizer against Delta; breakthrough odds rise with time

(Reuters) - The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19.

Moderna's vaccine may be best against Delta

The mRNA vaccine from Pfizer and BioNTech may be less effective than Moderna's against the Delta variant of the coronavirus, according to two reports posted on medRxiv on Sunday ahead of peer review. In a study of more than 50,000 patients in the Mayo Clinic Health System https://bit.ly/37Btmhf, researchers found the effectiveness of Moderna's vaccine against infection had dropped to 76% in July - when the Delta variant was predominant - from 86% in early 2021. Over the same period, the effectiveness of the Pfizer/BioNTech vaccine had fallen to 42% from 76%, researchers said. While both vaccines remain effective at preventing COVID hospitalization, a Moderna booster shot may be necessary soon for anyone who got the Pfizer or Moderna vaccines earlier this year, said Dr. Venky Soundararajan of Massachusetts data analytics company nference, who led the Mayo study.

Here's a link to the study:

https://www.medrxiv.org/content/10.1101/2021.08.06.21261707v1.full.pdf

If this is indeed correct, then it looks like we are probably going to need booster shots every 6 months or so(maybe it could be stretched a few months longer) for the indefinite future going forward. And we had better hope that those booster shots are in fact (and remain) actually effective.

We need now to not only vaccinate the entire world to prevent or at least slow down the evolution of new and potentially even more dangerous variants, but also need to make booster shots for the entire world, and potentially to keep making them indefinitely.

So far, in almost a year, only 30.2% of the world's population has received 1 dose and 15.6% is fully vaccinated. That pace is way too slow and needs to be massively sped up.



What Biden should do now is simple - invoke the Defense Production Act to ramp up vaccine production capacity as quickly as physically possible by 10x (or however much needed) so that we have the ability to produce something like 8 billion new vaccine booster doses every 6-12 months for the indefinite future, along with the ingredients/inputs needed to make those doses (and more in the immediate term for the billions of people across the world who are still unvaccinated and need 2 doses).

Also use the Defense Production Act to mass produce the specialized freezers and other such specialized equipment needed to store mRNA vaccines and potentially also otherfuture vaccines if they prove as/more effective, and fulfill other logistical needs so that vaccines can actually be administered. Start figuring out creative logistical solutions like ways to get mobile freezers onto Air Force C-130s, with batteries to keep the vaccines frozen. Then fly those into remote areas in the developing world which don't have electricity and start vaccinating.

Try and get European countries and others involved in helping to do this as well, but the USA is the only country with the ability to lead in making this happen.

Here's to hoping that Biden does this and shows that he is the right leader to meet the moment, and is more competent than Trump was in handling the earlier pandemic.

[emailking]

Glad I got moderna! Get whatever you can of course, but I had a choice between the 3 of them and man was that a hard decision.

[Torie]

All the sound and fury about individual "rights" and so forth aside, it seems obvious to me that the lesser evil is to have mask mandates with "teeth" in them as to enforcement and penalties, as opposed to locking down hospitals as to "elective" procedures, restaurants, bars, and so forth.

In that regard, Dan and I took the NYC subway the other day, where masks are mandated, and about 20% of the riders were not wearing masks (many of them looking like types who might well not be vaccinated), and to top it off, one muscled young man in a tank top fondling his girl friend, was smoking a joint. No enforcement personnel were anywhere to be seen. It scared the hell out of me. We will not be riding the MTA again anytime soon. While an inconvenience for us (for essential appointments we can use a car - far more expensive and less convenient but we are fortunate enough to be able to do that), for those who rely on the MTA to go to work, they are stuck between a rock and a hard place, while the spread of the delta virus is facilitated. I really feel for such people, and am concerned about them.

I simply see myself no other alternative or reasonable choices here, that are anything other than outright cruel and reckless.

Am I missing something?

[°Leprechaun]

Here is the map of states with the highest number of deaths as of today.

[Bandit3 the Worker]

All the sound and fury about individual "rights" and so forth aside, it seems obvious to me that the lesser evil is to have mask mandates with "teeth" in them as to enforcement and penalties, as opposed to locking down hospitals as to "elective" procedures, restaurants, bars, and so forth.

In that regard, Dan and I took the NYC subway the other day, where masks are mandated, and about 20% of the riders were not wearing masks (many of them looking like types who might well not be vaccinated), and to top it off, one muscled young man in a tank top fondling his girl friend, was smoking a joint. No enforcement personnel were anywhere to be seen. It scared the hell out of me. We will not be riding the MTA again anytime soon. While an inconvenience for us (for essential appointments we can use a car - far more expensive and less convenient but we are fortunate enough to be able to do that), for those who rely on the MTA to go to work, they are stuck between a rock and a hard place, while the spread of the delta virus is facilitated. I really feel for such people, and am concerned about them.

I simply see myself no other alternative or reasonable choices here, that are anything other than outright cruel and reckless.

Am I missing something?

If you're vaccinated, it shouldn't be a worry.

[Inmate Trump]

Mask mandates with financial and legal consequences if violated are necessary.

Vaccine mandates for every single person in the country.

Whiners can whine but they’re getting jabbed.  It’s time we force this on people because the situation won’t improve until we do.

[soundchaser]

https://twitter.com/EricTopol/status/1425095385157038080?s=20

Fingers crossed.

[Horus]

Mask mandates with financial and legal consequences if violated are necessary.

Vaccine mandates for every single person in the country.

Whiners can whine but they’re getting jabbed.  It’s time we force this on people because the situation won’t improve until we do.

Stop trying to force masks on the vaccinated. We need a vaccine mandate, and we need it now. Mask mandates are utterly pointless virtue signaling. It is the unvaccinated who are causing problems, no one else.