Fear and Loathing, a Rat Flu Odyssey

[riser4]

Exactly this. Let's end the pandemic, then relax the restrictions.

Next you'll be saying something ridiculous like post first THEN smoke crack.

[old goat]

And....If it's not one thing... it's another....

The CDC was too cautious about what vaccinated people can do, doctors say. Now pendulum has swung in the opposite direction

Couple of TV docs and Trumps SG who didn't exactly distinguish himself in office.
Osterholm agrees with the CDC (I suspect he was involved in the decision)

As far as who botched the messaging--I'd say the media. The actual CDC site is pretty clear and convincing, but most people depend on the talking heads and their FB feed to interpret it for them and that's where the "confusion" comes in.

[huckbucket]

As far as who botched the messaging--I'd say the media. The actual CDC site is pretty clear and convincing, but most people depend on the talking heads and their FB feed to interpret it for them and that's where the "confusion" comes in.

Was wondering the other day why the CDC/govt didn't reserve dedicated PSA time on the three big networks to disseminate critical information which simultaneously would have improved their standing as a leader in setting public policy. Maybe that would have backfired, but not if it was done in an objective, science-driven way.

[old goat]

Was wondering the other day why the CDC/govt didn't reserve dedicated PSA time on the three big networks to disseminate critical information which simultaneously would have improved their standing as a leader in setting public policy. Maybe that would have backfired, but not if it was done in an objective, science-driven way.

Good idea.

[bodywhomper]

Osterholm agrees with the CDC (I suspect he was involved in the decision)

and other advisors, like Ashish Jha, disagree: https://twitter.com/ashishkjha/statu...13759338946562

[old goat]

Guy has had Covid, 2 shots, wears an N95, cloth mask, and goggles and intends to do so for at least 5 years.
https://www.nytimes.com/2021/05/17/n...masks-cdc.html

[bodywhomper]

so there's a culture, at least in my area, of not getting tested, especially if you have mild symptoms. The HS district will quarantine "close contacts" with a kid or staff that had a positive test, but there's no requirement for testing by the HS. In the winter, the County did not have the resources to contact trace outside of the senior facilities. We are in the midst of spring/early summer allergy season. i wonder if public health officials have modelled an expectation in testing frequency as a result of allergy season. I wonder how those models are performing compared to real data. I guess % positivity ratings would indicate something related to this.

[teledad]

Exactly this. Let's end the pandemic, then relax the restrictions.

At 700 US deaths a day, that's 250k per year - Covid is a major, entirely preventable killer. And vaccination does not confer invulnerability. Post-EUA vax protection studies range between 66% and 90% protective, suggesting a vaxxed death rate north of 25k per year. Not exactly "safe."

With 30+% of the US population refusing to be vaccinated (or to wear masks for that matter), and the difficulty of vaccinating populations in developing countries, it seems like "end the pandemic" unfortunately isn't an option on the table right now.

Is there data yet on the fatality rate for vaccine breakthrough infections? The phase 2&3 studies seemed to indicate almost 100% protection against hospitalization or death, which would bring down that 25K number substantially. The CDC seems to be suggesting the same (as well as that transmission from breakthrough infections is extremely unlikely), though I don't know if that's based on the trial data or something else.

[old goat]

With 30+% of the US population refusing to be vaccinated (or to wear masks for that matter), and the difficulty of vaccinating populations in developing countries, it seems like "end the pandemic" unfortunately isn't an option on the table right now.

Is there data yet on the fatality rate for vaccine breakthrough infections? The phase 2&3 studies seemed to indicate almost 100% protection against hospitalization or death, which would bring down that 25K number substantially. The CDC seems to be suggesting the same (as well as that transmission from breakthrough infections is extremely unlikely), though I don't know if that's based on the trial data or something else.

According to Walensky, the very low risk of transmission by vaccinated people is from recent data. I haven't tried to find the paper. The great majority of breakthrough infections involve low viral loads and many are transient.

Good point about the developing world--places like Africa and France--at some point we're going to have to accept that the global pandemic is likely to go on for years and that we have to open things up here before it's "completely" safe.

[old_newguy]

You can certainly justify any number of things to put COVID to bed, but continued business restrictions and closures will be increasingly difficult to get compliance with.

We tolerate more than 25k fatalities per year with diabetes and traffic crashes, so I don’t see a future where wholesale restrictions are viable unless hospital capacity is stretched.

I can see OSHA or public health maybe regulating employer enforcement of measures to reduce disease like mandatory sick leave if coughing or fever,etc.

I’m not sure what to do frankly. I’ve largely taken the position that I will follow what the state and fed scientists say to do. They are saying no more mask except in certain businesses once vaxxed. I didn’t substitute my gut feelings before, so why should I defer to some social media post now?

Edit - I will also add that my state has been quite aggressive and believable with their implementation of a science and metric based approach so far, so have no reason to believe that they are dropping the mask mandate in most situations lightly. I might be a little less inclined to go with their decision making of I lived in some other states.

[old goat]

While the CDC's new guidelines have little effect in CA, they do make me feel a lot more relaxed about the dick noses, people who get too close, being around people outside, and the pandemic in general. And feeling lucky about being in the US. (I've always felt that way, despite all that is fucked up, like 300 pound people who fill plastic shopping bags with gasoline being at the apex of the bell curve. Fortunately there are enough folks on the right tail of the curve to keep us breathing.)

[bigdude2468]

Exactly this. Let's end the pandemic, then relax the restrictions.

At 700 US deaths a day, that's 250k per year - Covid is a major, entirely preventable killer. And vaccination does not confer invulnerability. Post-EUA vax protection studies range between 66% and 90% protective, suggesting a vaxxed death rate north of 25k per year. Not exactly "safe." We spend $thousands extra on car safety features for marginal reductions in deaths. We ought to keep 50c masks and other pandemic measures until the numbers improve.

IMO, CDC has consistently acted to worsen and prolong the pandemic.

You are trying to make sense, as if what / we the Government does is rational. 480,000 tobacco related deaths each year, there's a preventable disease for sure. Unfortunately our two faced politicians are ok with it as long as they can collect the taxes, New York gets $4.35 per pack. But God help us for eating a Big Mac or drinking sugar laced soft drinks.

[RoooR]

Exactly this. Let's end the pandemic, then relax the restrictions.

At 700 US deaths a day, that's 250k per year - Covid is a major, entirely preventable killer. And vaccination does not confer invulnerability. Post-EUA vax protection studies range between 66% and 90% protective, suggesting a vaxxed death rate north of 25k per year. Not exactly "safe." We spend $thousands extra on car safety features for marginal reductions in deaths. We ought to keep 50c masks and other pandemic measures until the numbers improve.

IMO, CDC has consistently acted to worsen and prolong the pandemic.

The data on the vaccinations suggest they are way more effective than that at preventing hospitalization and death. Out of over 100,000,000 fully VAXed we're at less than 1000 deaths. That's not car crash territory. It's act of god territory. Of course since so many people will not get VAXed we'll continue to see somewhere between 25k-100k deaths a year for a long time.

[The SnowShow]

Red Rocks reopening to full capacity in June. Doesn’t that seem a little premature when CO is still averaging 1,000 cases a day?

[funkendrenchman]

Red Rocks reopening to full capacity in June. Doesn’t that seem a little premature when CO is still averaging 1,000 cases a day?

June 21st. I'd bet we'll be in the 300/day range by then if not less.

[The AD]

Out of over 100,000,000 fully VAXed we're at less than 1000 deaths. That's not car crash territory. It's act of god territory.

Not so sure about that. It's a great number, but consider the average amount of time those who are vaccinated have been vaccinated for. There just hasn't been time for many of them to contract Covid and die from it.

[The SnowShow]

June 21st. I'd bet we'll be in the 300/day range by then if not less.

Hope so.

[LongShortLong]

With 30+% of the US population refusing to be vaccinated (or to wear masks for that matter), and the difficulty of vaccinating populations in developing countries, it seems like "end the pandemic" unfortunately isn't an option on the table right now.

I agree. Though I did mean end it in the fashion of New Zealand or Australia. Even then, I don't see US society achieving this. The best I hope for is that my region attains a high vaccination rate such that we have no sustained transmission, and minimal introduced cases (from travel).

Is there data yet on the fatality rate for vaccine breakthrough infections? The phase 2&3 studies seemed to indicate almost 100% protection against hospitalization or death, which would bring down that 25K number substantially. The CDC seems to be suggesting the same (as well as that transmission from breakthrough infections is extremely unlikely), though I don't know if that's based on the trial data or something else.

There are several studies I've seen from UK, US, and Israel. Those I've read are consistent with the idea that vax reduces your chance of infection, and that once infected, outcomes are similar. Given several of the studies are small, and none are controlled the way the EUA studies were, it's possible to argue for a range of opinions. The pessimistic edge of that range could be 66% protection, and same outcomes once infected. The optimistic edge could be 95% protection, and better outcomes once infected.

The trick with guessing protection is how much does it change when someone knows they are vaccinated and with the variants - in the EUA trials, the vaccinees likely did not change their behavior much (b/c they were blind to whether they had the placebo), or could not change their behavior much (b/c CDC or workplace covid protective measures). Being in a EUA trial where my vaccination status is unknown is far different than knowing I'm fully vaxxed. The variants are an added wildcard.

As for outcomes in post-vax covid, I looked at some data released by WA's health department, and a CDC report on Chicago nursing facilities. In both cases, with small numbers, it appeared that hospitalization rates (5-10%) and death rates (1-2%) were similar to non-vaxxed covid. The argument that I'm unduly pessimistic is that these samples are small, and very likely biased toward older people who we know have worse outcomes. I'd say it's also reasonable to say these datasets support the idea that outcomes for old vaxxed infected people are similar to the outcomes among the general non-vaxxed infected. This is a roundabout way of saying outcomes among the vaxxed infected are better.

Should you believe a social media post over the CDC? Probably best to trust the CDC, as it's hard to know which of us nuts is right. I'm infallible , but those other guys...

[funkendrenchman]

I agree. Though I did mean end it in the fashion of New Zealand or Australia. Even then, I don't see US society achieving this. The best I hope for is that my region attains a high vaccination rate such that we have no sustained transmission, and minimal introduced cases (from travel).


There are several studies I've seen from UK, US, and Israel. Those I've read are consistent with the idea that vax reduces your chance of infection, and that once infected, outcomes are similar. Given several of the studies are small, and none are controlled the way the EUA studies were, it's possible to argue for a range of opinions. The pessimistic edge of that range could be 66% protection, and same outcomes once infected. The optimistic edge could be 95% protection, and better outcomes once infected.

The trick with guessing protection is how much does it change when someone knows they are vaccinated and with the variants - in the EUA trials, the vaccinees likely did not change their behavior much (b/c they were blind to whether they had the placebo), or could not change their behavior much (b/c CDC or workplace covid protective measures). Being in a EUA trial where my vaccination status is unknown is far different than knowing I'm fully vaxxed. The variants are an added wildcard.

As for outcomes in post-vax covid, I looked at some data released by WA's health department, and a CDC report on Chicago nursing facilities. In both cases, with small numbers, it appeared that hospitalization rates (5-10%) and death rates (1-2%) were similar to non-vaxxed covid. The argument that I'm unduly pessimistic is that these samples are small, and very likely biased toward older people who we know have worse outcomes. I'd say it's also reasonable to say these datasets support the idea that outcomes for old vaxxed infected people are similar to the outcomes among the general non-vaxxed infected. This is a roundabout way of saying outcomes among the vaxxed infected are better.

Should you believe a social media post over the CDC? Probably best to trust the CDC, as it's hard to know which of us nuts is right. I'm infallible , but those other guys...

Interesting.... everyone out there is saying it increases the odds of a better outcome. Hope that turns out to be the case.

I did read about Seychelles recently, and their cases have gone way up despite having a high vaccination rate (using lower efficacy vaccines). They have seen very little hospitalization.

"Around 37% of positive cases from the week to May 8 had been fully vaccinated, the government said, although it has not released data on which vaccines they received. The government hasn't released data on the age breakdown of Covid-19 patients.

Around 20% of those who were admitted to hospital for treatment had been vaccinated, but their cases weren't serious, the Ministry of Health said Monday. Almost none of the critical and severe cases requiring intensive care had been vaccinated, and no one who has been vaccinated has died of Covid-19.

Radegonde said Thursday that only two people in the country are in intensive care.

"The conclusion is that the vaccines are protecting the people. Those who have been vaccinated are not developing any complications," Radegonde said. "We remain confident that the vaccines -- both of them -- have helped the country. Things would have been worse.""

[old goat]

I'm confused. I thought the whole selling point of the vaccines is that they protect you from being hospitalized or dying. And you're saying the opposite?

He's not saying the opposite. The opposite would be the vaccines cause you to be hospitalized or die.
More to the point, if the vaccine greatly reduces your chance of getting symptomatic Covid, but once you get symptomatic disease you have a chance of being hospitalized or dying comparable to non vaxxed people, that still means a greatly reduced chance of being hospitalized or dying of Covid if you're vaxxed. But if you do get sick do see a doctor get treated. (I wonder if people who get sick after vaccination would respond to monoclonal antibodies, given that they already have their own antibodies that didn't seem to work. Of course breakthrough infection could mean that the patient's immune system doesn't work well, or that they have a resistant variant.

[Skidog]

I know some people who work in hospitals. I'm hearing all the short term nursing contracts are ending, covid wards are gone in many, and nurses are either back at their home hospitals or out of work looking. Also heard there was great $$ to be made, stuff like $100k/10month contracts. Nice quick money.

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[BC.]

I know some people who work in hospitals. I'm hearing all the short term nursing contracts are ending, covid wards are gone in many, and nurses are either back at their home hospitals or out of work looking. Also heard there was great $$ to be made, stuff like $100k/10month contracts. Nice quick money.

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Example of why I have tried to discuss with my stubborn child about skipping/changing from the Bio/PreMed/PA track.....and just go to Nursing School. (*Be a traveling nurse in a mountain town)....Too late now....

[bodywhomper]

Interesting “in the bubble” podcast from Monday, May 17 (yesterday) focused on what’s known about long covid. The guests were pulmonologist Lekshmi Santhosh and neurologist Jennifer Frontera Interesting part to me were observations of long covid from those that experienced mild symptom or were asymptomatic. Also, the host, Dr Bob Wachter, chair of the dept of medicine at ucsf, describes his surprise about the cdc’s recent announcement regarding masks, and he describes the current uncertainty around having long covid if you are vax and catch covid (mild or asymptomatic).

[bodywhomper]

Here's more elaboration of Dr. Bob Wachter's twitter post thread/thoughts on the CDC's announcement about masking, after he'd given a few days to think about it: https://threader.app/thread/1394464848503656451

He includes his own calculated risk assessment of situations.

[teledad]

I dug around on medrxiv and found a few studies that seem relevant to the post-vax death rate question:

https://www.medrxiv.org/content/10.1....14.21257218v1

This shows a 69% reduction in death rate for patients with COVID who had been vaccinated with Pfizer (both shots), and a 55% from AZ. This is in addition to the protection from infection provided by the vaccine.

https://www.medrxiv.org/content/10.1....21.21255873v1

This found that the mRNA vaccines were 98.7% effective against death (including the protection against infection) compared to an unvaxxed control population (and 97% against hospitalization). The vaxxed population was substantially older and had more co-morbidities than the unvaxxed control though, so those numbers may be on the low side.

Note that both studies found that protection against death and hospitalization was substantially lower for those who were partially (compared to fully) vaccinated, so if you're getting a two-shot vaccine be sure to get the second shot.