Cont: The One Covid-19 Science and Medicine Thread Part 3

[Aridas]

I think it's simply the case that more people have had Covid than not, thereby reducing the pool of potential victims.



Delta seems to still hold that 50-80% of people have no symptoms, so in a place like Florida, where testing is patchy at best, the numbers aren't going to mean much.

There's also the factor that, if it's significantly based on superspreaders, it's not unreasonable to expect that spreading from one superspreader to another is a much less steady spread and that there will be more flare-ups coinciding with changes that lead to more contact with previously unreached groups.

 

[The Atheist]

There's also the factor that, if it's significantly based on superspreaders, it's not unreasonable to expect that spreading from one superspreader to another is a much less steady spread and that there will be more flare-ups coinciding with changes that lead to more contact with previously unreached groups.

One thing we're showing perfectly with the delta strain, we can see with our low numbers, no matter who else someone passes it to, they will infect everyone in their household, unless the others are vaccinated.

 

[marting]

Covid breakthrough data in the USA is still sloppy, incomplete, and of varying quality. Johns Hopkins goes into detail on which states provide the best to worst (or none) reports.

https://coronavirus.jhu.edu/pandemi...te-of-state-level-breakthrough-case-reporting

This incomplete reporting and inconsistent formatting make it difficult to anticipate when the Coronavirus Resource Center will be able to report on breakthrough case data. States are significantly hampering efforts to define the national landscape of COVID-19 breakthrough cases by not reporting the data, or reporting it infrequently in atypical formats. The delta variant is already ravaging the United States, and other variants may arise in the future.8 We need detailed, real-time information on breakthrough cases to monitor for vaccine efficacy and to defend against new surges.

 

[marting]

One thing we're showing perfectly with the delta strain, we can see with our low numbers, no matter who else someone passes it to, they will infect everyone in their household, unless the others are vaccinated.

Yep, and is in stark contrast to prior variants. And I think in the UK where they tested everyone in a household with an index case, almost half the vaccinated tested positive though often not symptomatic.

 

[The Atheist]

More evidence that the delta surge coupled with vaccination stops the virus in its tracks, with North Africa now seeing cases dropping very quickly.

https://www.aljazeera.com/news/2021/9/18/north-africa-covid-cases-plummeting-after-summer-spike

 

[Samson]

More evidence that the delta surge coupled with vaccination stops the virus in its tracks, with North Africa now seeing cases dropping very quickly.

https://www.aljazeera.com/news/2021/9/18/north-africa-covid-cases-plummeting-after-summer-spike

Happy to check how the vax works, prefer no surge in
NEW ZEALAND

 

[marting]

Interesting study on Covid-19's transition into endemicity.

Immunological characteristics govern the transition of COVID-19 to endemicity

https://www.science.org/doi/full/10.1126/science.abe6522

One year after its emergence, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become so widespread that there is little hope of elimination. There are, however, several other human coronaviruses that are endemic and cause multiple reinfections that engender sufficient immunity to protect against severe adult disease. By making assumptions about acquired immunity from its already endemic relatives, Lavine et al. developed a model with which to analyze the trajectory of SARS-CoV-2 into endemicity. The model accounts for SARS-CoV-2's age-structured disease profile and assesses the impact of vaccination.

Also explores how other, more virulent SARS-CoV's would be best handled.

 

[rdwight]

Bull **** noted.

I said this before and now see some news reports backing me up:

More kids are hospitalized with Covid, but researchers aren’t sure if they’re sicker, tooWhat I posted earlier was that low fatalities and hospitalizations in kids was likely due to the fact we had a relatively small sample size and when more kids start getting infected as schools reopen we are going to see the numbers of serious COVID in kids go up simply because we will be seeing a more representative sample of kids getting infected.

And that is what we have now. There is an ongoing debate about whether or not the delta variant is causing more serious disease in kids. That may be true. And the increase in children's deaths might be a combination of both reasons.

But the bottom line, it's time to stop acting like the kids are OK. They need vaccinations and masks. And the idea there is some unknown risk of kids getting the vaccines that surpasses the risk they face from COVID is not supported by the evidence.

That article quotes doctors without providing any additional resources to look into if the information is accurate. Asymptomatic cases have dropped to 10% in kids from 44%? Has anyone seen this before?

From all CDC info I have seen, there is not really a significant change in rates of hospitalizations and deaths from pre-delta to now. So while you might find the seriousness more dire, wouldn't the CDC's outlook be the exact same? I see no statistical reason they would change.

Also I don't believe there is data yet that agrees with your last hilite. That might very well be the case, but there is a reason no vaccine is yet approved for under 12 year olds. There very well might be a cut off where adverse effects make the risk of vaccination not as straight forward as other age groups.

 

[The Atheist]

Ok, I'm going to firm up my suspicion that the delta strain cannot be stopped.

Auckland has been in hard lockdown for five weeks, and we're still seeing mystery cases popping up. Victoria tried it and it failed, now we're tried it, and it's failing.

The only way to deal with Covid from here on in is to vaccinate and let the disease go. This fits in perfectly with the endemic model above.

 

[marting]

Interesting outlier multi-breakthrough case. The poor woman had Covid-19 in 2020 but was luckily asymptomatic, got fully vaccinated in 2021 after which she caught the Alpha Covid-19 variant causing "mild" illness lasting 11 days. Then later she caught the Delta variant and was hospitalized 6 weeks with severe disease.

Severe SARS-CoV-2 Breakthrough Reinfection With Delta Variant After Recovery From Breakthrough Infection by Alpha Variant in a Fully Vaccinated Health Worker

https://www.frontiersin.org/articles/10.3389/fmed.2021.737007/full

These were confirmed breakthroughs with full genomic sequencing. A rather rare situation but the woman was unusually attentive and sought/requested medical details including serology verification of antibody levels. I haven't googled it yet but wouldn't be surprised if the anti-vax crowd is waving this study around.

On less of an outlier front, here's a study that indicates strong protection from re-infection for a year. Similar to early data from vaccines. Caveats are that it was before widespread circulation of Alpha and Delta.

Assessment of SARS-CoV-2 Reinfection 1 Year After Primary Infection in a Population in Lombardy, Italy

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2780557

 

[angrysoba]

Interesting outlier multi-breakthrough case. The poor woman had Covid-19 in 2020 but was luckily asymptomatic, got fully vaccinated in 2021 after which she caught the Alpha Covid-19 variant causing "mild" illness lasting 11 days. Then later she caught the Delta variant and was hospitalized 6 weeks with severe disease.

Severe SARS-CoV-2 Breakthrough Reinfection With Delta Variant After Recovery From Breakthrough Infection by Alpha Variant in a Fully Vaccinated Health Worker

https://www.frontiersin.org/articles/10.3389/fmed.2021.737007/full

These were confirmed breakthroughs with full genomic sequencing. A rather rare situation but the woman was unusually attentive and sought/requested medical details including serology verification of antibody levels. I haven't googled it yet but wouldn't be surprised if the anti-vax crowd is waving this study around.

On less of an outlier front, here's a study that indicates strong protection from re-infection for a year. Similar to early data from vaccines. Caveats are that it was before widespread circulation of Alpha and Delta.

Assessment of SARS-CoV-2 Reinfection 1 Year After Primary Infection in a Population in Lombardy, Italy

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2780557

Of course, in a same world, it is not one for the anti-vaxxers to wave about. It is one that should make them ashamed. They are of the belief that it is THEIR choice to get vaccinated or not. The fact that the vaccines are very good but not perfect is something that all vaccine proponents and advocates ALREADY KNOW. If everyone got vaccinated then incidents of the vaccinated getting Covid would be rarer. But it is THEIR selfishness that leads to other people getting sick.

 

[marting]

Of course, in a same world, it is not one for the anti-vaxxers to wave about. It is one that should make them ashamed. They are of the belief that it is THEIR choice to get vaccinated or not. The fact that the vaccines are very good but not perfect is something that all vaccine proponents and advocates ALREADY KNOW. If everyone got vaccinated then incidents of the vaccinated getting Covid would be rarer. But it is THEIR selfishness that leads to other people getting sick.

Nothing much surprises me coming out of the anti-vax CTers. Rather appalling though.

 

[Skeptic Ginger]

That article quotes doctors without providing any additional resources to look into if the information is accurate. Asymptomatic cases have dropped to 10% in kids from 44%? Has anyone seen this before?

From all CDC info I have seen, there is not really a significant change in rates of hospitalizations and deaths from pre-delta to now. So while you might find the seriousness more dire, wouldn't the CDC's outlook be the exact same? I see no statistical reason they would change.

Also I don't believe there is data yet that agrees with your last hilite. That might very well be the case, but there is a reason no vaccine is yet approved for under 12 year olds. There very well might be a cut off where adverse effects make the risk of vaccination not as straight forward as other age groups.

I don't see a link to your CDC assertion.

There are a dozen articles on the increasing hospitalization and fatalities of kids from COVID. I believe the one I cited did not conclude if it was the result of the delta variant or an increased number of pediatric cases. Bottom line is the same: more kids infected and we start to see than the very low rates of serious pediatric cases is not because COVID is so mild in kids. Rather it is because we weren't seeing the full impact of the virus on kids.

Now we are seeing what the real rate of serious COVID cases in kids actually is.

 

[rdwight]

I don't see a link to your CDC assertion.

There are a dozen articles on the increasing hospitalization and fatalities of kids from COVID. I believe the one I cited did not conclude if it was the result of the delta variant or an increased number of pediatric cases. Bottom line is the same: more kids infected and we start to see than the very low rates of serious pediatric cases is not because COVID is so mild in kids. Rather it is because we weren't seeing the full impact of the virus on kids.

Now we are seeing what the real rate of serious COVID cases in kids actually is.

Should have added those in. Both are from Sept 10th.

Trends in COVID-19 Cases, Emergency Department Visits, and Hospital Admissions Among Children and Adolescents Aged 0–17 Years

This analysis found that the percentage of COVID-19 hospitalizations resulting in ICU admission has remained near 20% since Delta became the predominant SARS-CoV-2 variant. A study of children and adolescents hospitalized for COVID-19 during March 2020–July 2021 found that the proportion of those patients admitted to an ICU during the pre-Delta period (March 1, 2020–June 19, 2021) and the Delta-predominant period (June 20–July 31, 2021) did not differ (26.5% and 23.2%, respectively) (9). This same study found a median length of stay of 3 days during the pre-Delta period and 2 days during the Delta-predominant period among hospitalized patients aged 0–17 years with COVID-19 (9).

Hospitalizations Associated with COVID-19 Among Children and Adolescents — COVID-NET, 14 States

Similar to another recent analysis, COVID-NET data suggest that indicators of severe disease among hospitalized children during an early period when the Delta variant predominated were generally similar to those observed earlier in the pandemic (8). Trends in outcomes will need to be monitored closely as more data become available. For example, whereas the point estimate of the proportion of hospitalized children who required IMV during the period of Delta predominance (9.8%) was higher than that earlier in the pandemic (6.1%), the comparison of these proportions was based on a relatively small number of children (16) requiring IMV during the period of Delta predominance, and the difference was not statistically significant (p = 0.06). Further, surveillance data limited to hospitalized persons cannot be used to assess whether increases in COVID-19–associated hospitalization rates among children and adolescents are due to increased community SARS-CoV-2 transmission or increased disease severity caused by the Delta variant.

Both studies have limitations they acknowledge. They also seem to point to the effectiveness of vaccines in the 12-17 range to limit severe outcomes. But both seem to fall into the risk of severity remaining the same as before, so it is not a matter of lack of cases to make that determination, but a matter of more overall cases due to returning to school and a more transmissive strain.

 

[Skeptic Ginger]

Should have added those in. Both are from Sept 10th.

Trends in COVID-19 Cases, Emergency Department Visits, and Hospital Admissions Among Children and Adolescents Aged 0–17 Years

Hospitalizations Associated with COVID-19 Among Children and Adolescents — COVID-NET, 14 States

Both studies have limitations they acknowledge. They also seem to point to the effectiveness of vaccines in the 12-17 range to limit severe outcomes. But both seem to fall into the risk of severity remaining the same as before, so it is not a matter of lack of cases to make that determination, but a matter of more overall cases due to returning to school and a more transmissive strain.

None of that contradicts what I posted. Same rate is not surprising but total numbers are.

From the first link summary:

COVID-19 cases, emergency department visits, and hospital admissions increased from June to August 2021 among persons aged 0-17 years. Emergency department visits and hospital admissions in a 2-week period in August 2021 were higher in states with lower population vaccination coverage and lower in states with higher vaccination coverage.

And the second:

Weekly COVID-19–associated hospitalization rates among children and adolescents rose nearly five-fold during late June–mid-August 2021, coinciding with increased circulation of the highly transmissible SARS-CoV-2 Delta variant. The proportions of hospitalized children and adolescents with severe disease were similar before and during the period of Delta predominance. Hospitalization rates were 10 times higher among unvaccinated than among fully vaccinated adolescents.

 

[jimbob]

More on Ivermectin

https://twitter.com/GidMK/status/1439802579509153799?s=20

In one study, every single person in the ivermectin group got better immediately, and every person in the control got much, much worse. In another, 100% of the ivermectin group stayed in hospital for a shorter amount of time than the control

Conversation
Health Nerd
@GidMK
·
2h
Today I decided to look at some of the terrible observational studies on ivermectin that I've mostly ignored, and wow

So far, one with Cohen's d of 2, another with d of 2.9

These are just...gibberish
Health Nerd
@GidMK
In one study, every single person in the ivermectin group got better immediately, and every person in the control got much, much worse. In another, 100% of the ivermectin group stayed in hospital for a shorter amount of time than the control
5:04 am · 20 Sep 2021·Twitter Web App
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Health Nerd
@GidMK
·
2h
Replying to
@GidMK
These studies are just so wildly implausible that it's hard to understand why no one has raised these questions before. Either a single ivermectin pill entirely cures COVID or there's something fishy there

Yes, even more fabricated evidence

 

[dann]

Ok, I'm going to firm up my suspicion that the delta strain cannot be stopped.

Auckland has been in hard lockdown for five weeks, and we're still seeing mystery cases popping up. Victoria tried it and it failed, now we're tried it, and it's failing.

The only way to deal with Covid from here on in is to vaccinate and let the disease go. This fits in perfectly with the endemic model above.

There is no doubt that Delta is more difficult to stop than the original version of SARS-CoV-2 or even the Alpha variant, but your argument seems to be that since it hasn't (yet) been stopped, it can't be stopped, and in order to strengthen the validity your suspicion, you would have to argue that all measures have been employed to no avail. So let's consider: Is Auckland fully vaccinated? Unless Auckland has received extremely preferential treatment, that doesn't seem to be the case:
Share of the population fully vaccinated against COVID-19, Sep 16, 2021

For some reason, people in Sweden who now argue that the Delta variant can't be stopped are almost exactly the same people who argued the same thing about coronavirus in general back in the spring of 2020 before all the interesting new variants appeared on the scene.

 

[Lplus]

There is no doubt that Delta is more difficult to stop than the original version of SARS-CoV-2 or even the Alpha variant, but your argument seems to be that since it hasn't (yet) been stopped, it can't be stopped, and in order to strengthen the validity your suspicion, you would have to argue that all measures have been employed to no avail. So let's consider: Is Auckland fully vaccinated? Unless Auckland has received extremely preferential treatment, that doesn't seem to be the case:
Share of the population fully vaccinated against COVID-19, Sep 16, 2021

For some reason, people in Sweden who now argue that the Delta variant can't be stopped are almost exactly the same people who argued the same thing about coronavirus in general back in the spring of 2020 before all the interesting new variants appeared on the scene.

They were right then, so just maybe they're right now....

 

[Puppycow]

Covid News: C.D.C. Study Shows Pfizer Vaccine’s Protection Wanes (NY Times)

The new study found that from two weeks after recipients got their second dose — a point at which they are normally considered fully vaccinated — to four months later, the Pfizer vaccine was 91 percent effective in preventing hospitalization. Beyond 120 days, though, its effectiveness fell to 77 percent.

The Moderna vaccine showed no comparable decrease in protection over the same time frame: It was 92 percent effective against hospitalizations four months after recipients’ vaccination, a level virtually identical to its 93 percent effectiveness before then.

The study said that not enough participants had received the one-shot Johnson & Johnson vaccine to compare its performance. Overall, though, the Johnson & Johnson shot has been 71 percent effective in preventing hospitalizations.

The C.D.C. study released on Friday supported some others that suggested the Pfizer vaccine may offer less protection from hospitalization over time. But the available data is far from unanimous.

Other studies have shown that Pfizer’s effectiveness against hospitalization has remained above 90 percent, despite the spread of the Delta variant and the lengthening time since people received their second shots. Pfizer has said that data from Israel suggest a falling effectiveness against severe disease, though it appears that Israel and the United States define “severe disease” differently.

The latest C.D.C. study was based on an analysis of roughly 3,700 adults hospitalized across the United States from March to August.

What could account for the difference between Pfizer's vaccine and Moderna's?

I seem to recall that the Moderna vaccine contains 100 µg of the mRNA active ingredient, compared to 30 µg in Pfizer. That's more than a 3-fold difference. Also, the timing between doses is 4 weeks for Moderna and 3 weeks for Pfizer. Could either of those things be relevant?

 

[Delphic Oracle]

There is no doubt that Delta is more difficult to stop than the original version of SARS-CoV-2 or even the Alpha variant, but your argument seems to be that since it hasn't (yet) been stopped, it can't be stopped, and in order to strengthen the validity your suspicion, you would have to argue that all measures have been employed to no avail. So let's consider: Is Auckland fully vaccinated? Unless Auckland has received extremely preferential treatment, that doesn't seem to be the case:

Share of the population fully vaccinated against COVID-19, Sep 16, 2021



For some reason, people in Sweden who now argue that the Delta variant can't be stopped are almost exactly the same people who argued the same thing about coronavirus in general back in the spring of 2020 before all the interesting new variants appeared on the scene.

We haven't yet stopped it.

The wider it spreads, the harder it is to stop it.

So "we're not going to stop it" is a reasonable conclusion.

The virus will have paths through many areas of partial immunity, ocassionally running rampant in isolated pockets as boosters wane and children without prior exposure grow into young adults, travelling and taking risks as they do.