Cont: The One Covid-19 Science and Medicine Thread Part 4

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The Cleveland Clinic study (12/22) that reviewed initial bi-valent vaccine efficacy over a 90 day period has been updated several times and now has 180 days of data. The new data includes periods where multiple variants went through providing additional effectiveness data. The main result is that the bi-valent vaccine is close to useless against XBB*.

Effectiveness of the Coronavirus Disease 2019 (COVID-19) Bivalent Vaccine
https://www.medrxiv.org/content/10.1101/2022.12.17.22283625v4
Estimated vaccine effectiveness (VE) was 29% (95% C.I., 21%-37%), 20% (95% C.I., 6%-31%), and 4% (95% C.I., -12%-18%), during the BA.4/5, BQ, and XBB dominant phases, respectively.
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This decrease is consistent with antibody studies that show even lower neutralization for the latter variants. There may also be some impact from vaccine waning since 80% of the vaccinations were delivered in the initial 90 days of the study.

The rather odd correlation between number of previous vaccine doses and increased probability of infection remains. However, the study's subjects were relatively young and there were few seriously ill among them so, even if accurate, the study says nothing about illness severity and there are numerous studies that show vaccinations continue to provide significant protection against hospitalization/death.
 
marting said:
The Cleveland Clinic study (12/22) that reviewed initial bi-valent vaccine efficacy over a 90 day period has been updated several times and now has 180 days of data. The new data includes periods where multiple variants went through providing additional effectiveness data. The main result is that the bi-valent vaccine is close to useless against XBB*.
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Given that being the dominant strain right now, it's not great news.

The good news is the continuing level of protection, which I'm guessing is part vaccine and part infection-gained antibodies.

It's almost reached the point where continual exposure will lead to less harm in the long term.
 
The Atheist said:
Given that being the dominant strain right now, it's not great news.

The good news is the continuing level of protection, which I'm guessing is part vaccine and part infection-gained antibodies.
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Yeah. Even though the vaccine appears to do squat in terms of stopping infection, it's effective at reducing hospitalization/death.

The only variant that might have a chance at this point is one showing up in India. But it's prevalence is still low so it may be founder's effect. A lot of variants popped up but quickly faded.

XBB, as immune escape as it is against vaccines, is less so against prior infection of Omicron variants. And while it's dominant, it is decreasing in prevalence almost everywhere with nothing else clearly in sight. So we are in for at least several good months. This might be the evolutionary endemic end.
 
marting said:
Yeah. Even though the vaccine appears to do squat in terms of stopping infection, it's effective at reducing hospitalization/death.
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That's really the only thing that matters - we can't put the genie back in the bottle and it's going to be with us forever, along with the other coronaviruses we're susceptible to.

As long as it circulates and isn't killing many, I think we're as good as it gets.
 
The Atheist said:
That's really the only thing that matters - we can't put the genie back in the bottle and it's going to be with us forever, along with the other coronaviruses we're susceptible to.

As long as it circulates and isn't killing many, I think we're as good as it gets.
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There is no doubt that this is what The Atheist thinks, but his criteria for what is meant by many have been peculiar and shifting.

despite 20.8% fewer COVID-19 deaths during March to December 2021 than during March to December 2020, YLL due to COVID-19 increased by 7.4% as the age distribution of decedents shifted downward (that is, to relatively younger persons); the median (interquartile range) age of COVID-19–involved deaths decreased from 78 years (68 to 87 years) to 69 years (59 to 80 years). Accordingly, YLL per COVID-19 death increased by 35.7% (Figure); YLL per death did not change by more than 2.2% for any other cause.
Shifting Mortality Dynamics in the United States During the COVID-19 Pandemic as Measured by Years of Life Lost (Annals of Internal Medicine, Letter, Jan 2023)
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Table. Leading Causes of U.S. Death and Associated YLL, March to December in 2020 and 2021

It would be interesting to see the corresponding numbers for 2022. My first thought when I saw this was that vaccinations might have something to do with it. The author has also considered this:
Further investigation should determine the extent to which this downward age shift in COVID-19 mortality is attributable to high early-pandemic COVID-19 death rates among older adults (for example, involving nursing homes and long-term care facilities), relatively higher vaccine coverage and adherence with nonpharmaceutical interventions among older versus younger adults later in the pandemic, age-related risk differences associated with coronavirus variant viruses, or other mechanisms.
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dann said:
There is no doubt that this is what The Atheist thinks, but his criteria for what is meant by many have been peculiar and shifting.
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More nonsense, but hey, I'll just let WHO speak to it.

Fantasy: OMG, young people are dying of covid!1!! Everyone wear a mask and panic!

Reality: WHO says,
The low priority group includes healthy children and adolescents aged 6 months to 17 years. Primary and booster doses are safe and effective in children and adolescents. However, considering the low burden of disease, SAGE urges countries considering vaccination of this age group to base their decisions on contextual factors, such as the disease burden, cost effectiveness, and other health or programmatic priorities and opportunity costs.
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I'm comfortable with "low burden".

As usual, I suspect your numbers are reflecting the unfortunate few younger people who have substantial comorbidities, or are immuno-compromised.

Given that a whopping 500* people are dying of covid worldwide each day, I certainly can't be arsed checking the numbers. I will note that you mention percentages, not actual numbers, and if two kids die this week and one last week, that's a whole 100% more!

*compare with other deaths per day totals:

Parkinson's Disease - 1000/day
Meningitis - 646/day

Dwarfed by diseases like diabetes - 4100/day, and 3200/day.

...and not a lot more than die in fires every day: 304.

I think we should definitely ban fire.

dann said:
Table. Leading Causes of U.S. Death and Associated YLL, March to December in 2020 and 2021

It would be interesting to see the corresponding numbers for 2022.
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Nope, even 2022 has no relevance to what's happening now.

It amuses me you keep bringing up irrelevant data from early in the pandemic to make a case for what's happening in 2023, because it proves beyond doubt you are clutching at straws to keep the panic alive, for reasons best know to yourself.
 
Dr.Sid said:
What panic ?
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Fair point - I can only think of one person panicking about it, but he is active in the thread, so you should be able to figure who I meant.

I spend a lot of time out and about - factories, workplaces, concerts, shops - and nowhere do I see anyone other than Chinese mums and their kids wearing masks. But I would note that they were doing this before the pandemic.
 
Puppycow said:
YouTube
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Like a lot of things about the pandemic, studies of what number of people are actually suffering from long covid, what their symptoms are, and what affect it's having on them, are sketchy.

For a start, the number of people with long covid is decreasing, almost halving in six months to Jan 2023: https://www.kff.org/policy-watch/long-covid-what-do-latest-data-show/

The data I have to go on is sick leave, and out of 1000 employees, we have zero cases of long covid, yet I'm confident almost every single one of that 1000 has had covid.

I think long covid is overstated and not as big a problem as some people tout it. Yes, I'm sure some people have it badly, and we see the odd case in the news, but they're very rare - about the same as ME/CFS, with which it shares a disturbing number of symptoms.

The rest of the world isn't about to go back to masking up because the odd person gets long covid.
 
The Atheist said:
Like a lot of things about the pandemic, studies of what number of people are actually suffering from long covid, what their symptoms are, and what affect it's having on them, are sketchy.

For a start, the number of people with long covid is decreasing, almost halving in six months to Jan 2023: https://www.kff.org/policy-watch/long-covid-what-do-latest-data-show/

The data I have to go on is sick leave, and out of 1000 employees, we have zero cases of long covid, yet I'm confident almost every single one of that 1000 has had covid.

I think long covid is overstated and not as big a problem as some people tout it. Yes, I'm sure some people have it badly, and we see the odd case in the news, but they're very rare - about the same as ME/CFS, with which it shares a disturbing number of symptoms.

The rest of the world isn't about to go back to masking up because the odd person gets long covid.
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Masking ? No. That's not good long term, and who knows if it even works against omicron. But vaccines ? Absolutely yes.
 
CIDRAP's Osterholm's party gets Covid-19

And then there's Michael Osterholm, wife, and guest at his 70th birthday. Celebrated with a dinner at the Osterholm's condo followed by a show. All with 5 shots each including 3 boosters. And all wearing N95's anywhere they felt at risk.

Osterholm, who does the CIDRAP Covid-19 update podcast, is one of those that remains exceptionally careful. He wears an N95 almost everywhere indoors when others are around. When getting together in small groups w/o masks, everyone first takes a rapid flow test. And he's avoided getting Covid-19 for over 3 years.

Until earlier in March.

Friday afternoon after dinner the three left Osterholm's condo to drive to a show. At the show, which was in a large room and lightly attended, all three used N95 respirators.

On Sunday afternoon all three had early symptoms of Covid-19 and tested positive in subsequent days. None of them have been counted as cases since self-administered rapid flow tests are not counted nor reported by health departments. Even when used to get a Paxlovid prescription as Osterholm did.

Osterholm speculates they were exposed in the elevator at his condo when they weren't wearing masks even though only the three were in the elevator and were in it half a minute.

Osterholm's discussion of this starts at 5:50 at this link:
https://www.youtube.com/watch?v=QglxOnYAS8Q
 
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Dr.Sid said:
Masking ? No. That's not good long term, and who knows if it even works against omicron. But vaccines ? Absolutely yes.
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I agree entirely. I don't even count unvaccinated people as people any more, except the unlucky few who can't have one.

Vaccinated people appear to have a much lower rate of long covid, but I'd really like to see some current research on the subject.

marting said:
On Sunday afternoon all three had early symptoms of Covid-19 and tested positive in subsequent days.
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That's a classic example of what I've been saying - it's unavoidable.

And I'm just not seeing the harm in vaccinated people. My mother-in-law is in a geriatric wing of a hospital, so she and her fellow patients aren't very well. Not immediately life-threatening conditions, but crook enough to be in hospital. Out of the 20 patients in her ward, only one is under 80, and he's 79.

Every single one of them caught covid last month and none of them required a transfer to ICU and none died.

The one thing that concerns me at this stage is insufficient use of Paxlovid due to cost.
 
The Atheist said:
I agree entirely. I don't even count unvaccinated people as people any more, except the unlucky few who can't have one.

Vaccinated people appear to have a much lower rate of long covid, but I'd really like to see some current research on the subject.



That's a classic example of what I've been saying - it's unavoidable.

And I'm just not seeing the harm in vaccinated people. My mother-in-law is in a geriatric wing of a hospital, so she and her fellow patients aren't very well. Not immediately life-threatening conditions, but crook enough to be in hospital. Out of the 20 patients in her ward, only one is under 80, and he's 79.

Every single one of them caught covid last month and none of them required a transfer to ICU and none died.

The one thing that concerns me at this stage is insufficient use of Paxlovid due to cost.
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Does anyone know how effective Paxlovid is?

Does it make mild illness go away more quickly or prevent mild illness becoming serious?

Is there any data that suggests it reduces mortality?

I am just wondering because I have not heard of anyone getting it in Japan. Literally nobody I know has taken it.
 
The Atheist said:
That's a classic example of what I've been saying - it's unavoidable.
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Yeah. Good example though of how infectious XBB.1.5 is. There isn't a lot of reseach out re XBBs but what there is indicates vaccines do squat in terms of preventing infections. That said, XBB prevalence has been decreasing in the States. Only one possible explanation. Most people have already had Omicron and it provides some infection immunity.. Seems prior Omicron infection wanes slower than vaccination but vaccination seems to provide additional protection against hospitalization/death. About 2x reduction here in San Diego. Down from ~10x through Delta. Good thing the bugger isn't as virulent as the early strains.
 
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