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Comment by jansan | Hacker News Reader

The Google COVID-19 statistics for Israel show that cases and deaths are declining, but not at a faster rate than elsewhere in the world. Reported deaths lag behind sometimes for weeks and new deaths were caused by infections weeks ago, so vaccination may not have much effect on deaths, yet. But the number of positive tests should have gone down considerably with 50% of the population vaccinated. Are all these aymptomatic cases or do the is this due to part of the population not keeping any rules? Does anybody have information why the numbers are sill that high?

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Exactly. I don't understand why it is so unpopular to ask this obvious question?

The numbers are falling all over the western world; probably because the policy response is largely same and maybe also because the virus' natural cycle is at the same stage.

Given how much further Israel is, one would have expected it to stick much more out in the statistics.

But it does not?

It's not that hard to think of reasons why, even as effective vaccinations go up, deaths/cases may not decline in perfect symmetry. For example, certain groups may start caring less once the most vulnerable have been vaccinated, restrictions may be eased as more people are vaccinated, certain groups may be less likely to want vaccinations so a local epidemic occurs... etc.

I live in Israel.

There a three big points to make:

1 - There is a delay. While now we have more and more vaccinated people, much of the current cases in the hospital got infected before that.

2 - It changes from community to community but in general we have many people that are really not "disciplined". Either they believe coronovirus does not exist or it won't get them or that god will save them or the herd immunity is high enough (when it isn't)... excuses all over

3 - The vaccinations are not evenly distributed in the population (for lack of demand, supply is there). While in some places you have 70% in other communities you have 2%. (and those with 2% act like there's no coronavirus, see point 2)

> Either they believe coronovirus does not exist or it won't get them or that god will save them

You can take case of yeshivas (religious schools): some have 80% of infected and recovered students. So when authorities come to the head of the school with a story about deadly virus, they don't understand each other. And examples of 90 years old elders dying from COVID-19 are meet with question "What you expected them to do instead at this age?"

> While in some places you have 70% in other communities you have 2%. (and those with 2% act like there's no coronavirus, see point 2)

I've come to notice this over the last year. We now effectively live in two completely diverged realities. In one, coronavirus is a serious danger that affects our behavior and dominates every aspect of life, where we follow the news of new vaccines and declining case numbers with gratitude and relief, hoping to god that life can return to normal some day. In the other reality, COVID is just a flu. Maybe you might get it but it's not a big deal. Life goes on as normal and you are happily taking advantage of deals on travel, low crowds, and you get annoyed at being reminded to wear your mask. Meeting with friends, going to church, eating at restaurants. All of this is fine because you've convinced yourself it's no big deal.

It's bizarre, and it has torn many of my personal relationships apart. I'm not sure how we ever fix this.

Which reality, in your opinion, is the real one according to measurements?

Both are real, to different people, in different communities.

Exactly my point. I don't know enough to make a value judgement one way or the other, simply pointing out how shocking it is when you come into contact with someone from an alternate reality to your own.

And I don't mean real as in "belief", I mean real as in actual factual reality.

So it's not an "alternate" reality (that's usually used as pejorative), it's a different situation to your own.

I'm so surprised that the "just a flu" crowd has endured for so long. Deaths are rare, but at least among the people I know who've had it, severe reactions are common place. Plenty of people consider this the worst illness they've had in their life to this point, many considered hospitalizing themselves, and I know people who have been saddled with fatigue, muscle soreness, and shortness of breath months later. Those that have had mild symptoms count themselves lucky. Surely at this point, everyone knows someone who has had a bad bout of covid. Of course, people don't necessarily advertise that they've had covid since generally they get it by doing something irresponsible and regrettable in hindsight, so maybe that's why some people lack this context.

I'm somewhere in between. For myself, because I'm young and healthy, I'm not overly concerned about catching it myself.

However, I can also appreciate that in aggregate, the medical impact is higher than a normal flu. Hospitals have been overwhelmed (in Italy most famously, but here in Iceland it was also dicey for a bit around the peak). In that sense, I see it as being socially irresponsible not to take low-cost/low-effort preventative measures (mask/sanitizer).

Where it gets murkier for me is in the shutdown of businesses. I'm not sure I really have an opinion one way or the other on that. On one hand I can appreciate it sucks hard for those impacted. On the other, Iceland's second wave originated from an outbreak in a bar, so some kind of precautions are clearly needed. On the other other hand, at that time life was back to normal, so even normal precautions were completely ignored, so maybe we could have kept businesses open but just with precautions, which is the path we're taking now which seems to be working so far, though right now we're quite strict on international travel.

And though I've been drawing observations from anecdotes in Iceland, Iceland's numbers have never been very high because there just aren't that many people. Maybe the optimal approach is different in a higher-density location like New York.

IMO the solution to merging the realities is to humbly admit although we have statistics, none of us have all the answers. There is no one-size-fits-all solution.

Also, IMO, relationships are far more important than politics, especially politics as transitory as pandemic response. I argue with family about our differing perceptions of the pandemic, but at the end of the day I still believe they're doing the best they can and how wrong I think they are about some things is totally irrelevant to the relationship.

The numbers are falling all over the western world; probably because the policy response is largely same and maybe also because the virus' natural cycle is at the same stage.

Probably the latter. Mortality doesn't seem to be affected by (covid specific) policy:

https://www.nber.org/system/files/working_papers/w27719/w277...

https://ideas.repec.org/p/wai/econwp/20-06.html

https://www.thelancet.com/journals/eclinm/article/PIIS2589-5...

(there are lots of studies like these, I just picked three more or less at random)

Interesting. In Luxembourg at least you can see the clear seasonal variation and also the enforcement of stricter lockdowns pretty much 1:1 in death rates and infection rates, accounting for the ~2-3 week delay in infection intervals.

Same in Greece:

https://www.worldometers.info/coronavirus/country/greece/

Lockdown started in November, and relaxed on Jan 15 or so.

Well, as I saw in Luxembourg you surely can’t experience any of the vaccination effects yet. Is there a government there or what is going on?

For vaccinations? Nope, too few people have been vaccinated. But the claim above was for <<lockdowns>>, for which we do have data.

When do you consider Luxembourg's lockdowns to have started and ended? Looking here:

https://ourworldindata.org/coronavirus-data-explorer?zoomToS...

... the curves look pretty similar to that of many other countries. There was apparently (according to Wikipedia) one between Nov 23rd and Dec 15th but that appears to have made no real difference, in fact, numbers per million were stable during those dates when they had previously been falling.

There an extra consideration to add here perhaps: the US experienced a post Christmas and New Year spike. That would be less pronounced in Israel where the vast majority does not celebrate Christmas and takes the New Year less seriously. (Hanukkah, the Jewish holiday of the similar time was earlier this year. And although some Arabs celebrate Christmas, many others are Muslim and do not)

Also Hanukkah is not a major holiday in Judaism. It gets inflated importance in the US because of proximity to major Christian holidays.

The major holidays in Judaism were 5 months ago, just when the lockdowns started.

Israel is dealing with a more aggressive strain right now (the UK mutation).

What they have found, according to our news sites at least, is that it is causing a lot more of the under 65 group to become severely ill. Some groups are more affected than others (for instance they are seeing that a relatively large amount of women who are in their late term of pregnancy are hit hard by this variant)

Making matters a bit worse is that the anti-vaccine propaganda has been quite successful in some areas, with some anti-vaxxers going as far as to book appointments only to intentionally not show up so that the vaccine is wasted.

In Hebrew, but interesting to look at if you want to follow the vaccination campaign https://datadashboard.health.gov.il/COVID-19/general

The 94% effectiveness isonly reached one week after the second shot. Only 27% got the two shots. Also Israël recently got the UK strain which is far more transmissible.

Israel has many different population groups.

The Haredi population is acting like covid doesn’t exist and has insanely high numbers of cases.

I suspect that despite the vaccine working well on your everyday science-trusting Israeli, the Haredi population is throwing off the average significantly.

Source: I have family there.

Recently the police tried to enforce the lockdown Bnei Brak (a city with a lot of Haredis). The Haredi rioted against this, yelled “Nazis” at the police, and burned down a bus.

https://youtu.be/hG8ly4_zOt0

It’s not that simple. I am a non-heredi Israeli, but I live next to a Heredi neighborhood. Yes a lot of Heredim are breaking the rules, but so are a lot of non-heredi. I have yet to see any proof that the heredim are breaking them at a much larger scale than the other non-heredi groups.

What is significant is that they live in much more densely populated areas with much larger families. Every infection is amplified by the number of people who come in contact with that infected person and this is likely what we are seeing with the heredi population. In the heredi community it is not unusual for 10+ people to live under the same roof.

It has absolutely ravaged their older populations with one study estimating that 1 in 73 of the heredim over the age of 65 have died from COVID. Unfortunately among some of their communities the anti-vaccine propaganda has been very effective, but this is something the government is actively working to counter.

| I have yet to see any proof that the heredim are breaking them at a much larger scale than the other non-heredi groups.

What about the weddings and funerals involving 1000s of people?

There is no denying that some of them are breaking the rules and yes the weddings and funerals in which there were 100s to 1000s of people are obviously bad, but that is not proof they are breaking the rules on a larger scale than the non-heredi population.

Just this past weekend the police shut down two nature parties/raves around the town I live in. This happens every weekend. Does that mean the “seculars” are breaking the rules on a larger scale than anyone else? Of course not. You and I do not have enough information to know who is and who is not breaking the rules.

The data for age group specific data is available freely in the UK. I did a quick analysis in R, and even though all over 75 and most over 70 have been vaccinated, I didn't see any increase in the rate of descent compared to other age groups. So not quite having a public health impact in overall numbers just yet (it's the lockdown that is doing that), but I have no doubt it will eventually. I wonder if part of it is that people are more willing to abide by the rules, now that we have possible way out of it.

My Dad, in the second-tier group of vulnerability [UK], only got his first jab last week and has to wait 11 weeks for his second.

We still have a fair way to go before all vulnerable groups have had two jabs.

Yes, some areas are at different stages of the vaccine rollout. One jab provides excellent protection. 10 days after the pfizer jab gives you around 90-95% protection. Most of my colleagues who are more knowledgeable on vaccine science feel that a 12 week gap will provide better overall immunity - most vaccines are given months apart for boosters. The 3 week gap of the trial was likely a design constraint of rushed trials.

> So not quite having a public health impact in overall numbers just yet (it's the lockdown that is doing that), but I have no doubt it will eventually.

I guess to the extent that people are actually following the lockdown rules, that substitutes pretty well for a vaccinated population. The advantage of vaccination (at least in theory) is that you can maintain those rates without being locked down.

In short, yes. There was a massive drop in elderly people developing COVID-19 symptoms but an increase in younger people.

The vaccination rate at younger individuals is far lower than elder ones, also the vaccine created a false sense of safety for everyone.

Israel had a pretty large population that doesn’t want to be vaccinated so to get this number they compared people that were vaccinated against people that weren’t.

It turns out that almost all people that get sick are the people that were not vaccinated.

> But the number of positive tests should have gone down considerably

> "Israeli study finds 94% drop in -> SYMPTOMATIC <- COVID-19 cases with Pfizer vaccine"

Asymptomatic cases still spread the virus.

They’re not saying there’s no decrease in asymptomatic cases, they’re saying they didn’t check for that. AstraZeneca’s study in the UK did surveillance testing of their study participants and found a significant drop in asymptomatic cases as well. Reasonable to assume the same is true with the Pfizer and Moderna vaccines.

I find it inexcusable that moderna and pfizer decided to not test for asymptomatic at all, instead focusing on the subjective criterion of being symptomatic

Asymptomatic infection doesn't seem to exist. The current status of this belief amongst even the most panicked researchers is that "more data is needed":

https://www.bmj.com/content/371/bmj.m4851

But a large scale study in Wuhan found no cases of asymptomatic transmission, and the same findings have been found elsewhere. NB: there is a difference between asymptomatic and pre-symptomatic. The latter sometimes can transmit.

I think when people here say Asymptomatic they are probably talking about people that had a very mild symptoms maybe a bit of sniffles or a blocked nose not the scientific Asymptomatic of no symptoms at all

Ah. Well if that's how people are using the term, what I said wouldn't apply to that. The term asymptomatic is clearly defined as "no symptoms at all and never develops any". Presymptomatic means "no symptoms at all but eventually develops some". I don't think there's a technical term for bit of sniffles/light cough beyond mild symptoms.

It isn't sufficiently researched if asymptomatic, vaccinated cases still spread the virus in the same amount. The virus load spread by a vaccinated person can be expected to at least be lower, maybe even negligible or nonexistent.

Also, see the sibling comments about the difference between asymptomatic and pre-symptomatic.

This is amongst a study of 600k Israelis, which is about 6% of the population. I believe their deal was that the entire population would be supplied the vaccine in exchange for their medical data, which is why Israel far ahead of most of the world in vaccination rate. But its still only 70% done if my googled source isn't way off. So still too early to see large scale effects.

it's not 70% done, it's about 70 vaccines per 100 people, at 2 vaccines per person it should be 140 vaccines per 100 people to get to 70% of the population vaccinated.

I saw an article that the ICU no longer has elderly folks - they were prioritized for the vaccine.

It's now younger people in the ICU: the vaccine started going out as the more contagious (and harmful) British variant started spreading in Israel.

From this article:

>Researchers at the Weizmann Institute of Science, who have been tabulating national data, said on Sunday that a sharp decline in hospitalisation and serious illness identified earlier among the first age group to be vaccinated - aged 60 or older - was seen for the first time in those aged 55 and older.

>Hospitalisations and serious illness were still rising in younger groups who began vaccinations weeks later.

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