Delta Variant | Hacker News Reader

Delta Variant

unchartedterritories.tomaspueyo.com

301 pointstosh404 comments

The article purposefully conflates numbers to tell a narrative. I am talking only about EU, and at that southern EU which is where I've been following the numbers closely. Delta variant has been acting for up to 1 month in some regions, and as described in the article yes cases are up very quickly. However, the article says:

> COVID deaths [...] And if you think Europe or the US will be spared

This is not reflected at all with the current numbers and the author is mixing deaths in one country with infections in another. There hasn't been even a single uptick of deaths in EU so far that I've seen, and we are past the potential 2+ week delay from cases to deaths so if it was of importance for EU, we'd see a massive climb in death graphs. That is just not happening, so regarding deaths this seems, so far, not to be a concern at all for highly vaccinated countries.

Yes there are many other concerns for which we want to avoid more infections (saturation of hospitals, potential for more mutations, etc.) which are worth discussing, but this article is instead just conflating numbers. See a comparison taken 2 days ago of "infections" vs "deaths" in Spain, which includes this delta wave:

https://imgur.com/a/A9VFS4G

Another issue which this article ignores, and so does the fear mongering clickbait media, is how many asymptotic people we are testing now vs 6 months ago or a year ago.

It’s way more. The UK especially is testing like crazy. But that means a lot more cases appear in the statistics than before, even if the R rate is only marginally higher.

We simply don’t know what the actual r rate of all the different variants are because we had different test velocities as well. And this is crucial in whether we should be hysterical about Delta or not.

Also, wtf happened to cases in India? It’s not exactly all that catastrophic any more. In fact by the time the media had their 2 week India is dying narrative, cases declined. https://www.worldometers.info/coronavirus/country/india/

The test velocity has been fairly stable now for long enough to establish the delta variant R rate is significantly higher than with the previous variants.

We are definitely doing more testing in the UK than a year ago and it’s likely reflected in the case stats, but at the same time the rate of case growth during the last few weeks looks like a straight line up and that’s not a good thing.

We will likely see fewer hospitalisations than before due to a fairly successful vaccination effort, particularly with the edlerly, but as cases go up so does the number of people who may not die but end up with long covid. Also, the more people infected, the better breeding ground for the virus to develop new variants, and a higher chance of vaccine escape due to evolutionary pressure.

Comparing case counts in 2020 was one of the dumbest things I've ever seen.

It all depended on the availability of tests.

> even if the R rate is only marginally higher.

R is an exponent. Small changes in an exponent lead to huge differences in the result.

How does that change my point? The article says the original variant had an R rate of 2.7, and delta had one between 4 and 9.

That’s a big claim with no data.

And thanks I understand how exponential works.

> Also, wtf happened to cases in India? It’s not exactly all that catastrophic any more. In fact by the time the media had their 2 week India is dying narrative, cases declined.

Media may cry wolf, whether there is one or isn't. But trust me it was a tough time for India this time. I live in Bangalore. And for the "2 weeks" you mention, there was severe Oxygen shortage in hospitals in most cities. Patients could not get beds in time. There were queues outside funeral homes and graveyards. It was hell.

I am not the one to panic easily. And kept on going for my runs during the first wave in 2020, when Alpha was there. As the curve was so flat. Please note case numbers can't be compared, but you can compare positivity rate (positives/tested) and fatality chart[1].

The 2021 Delta wave in India was approximately 4 times severe by all measures. Because of the shortage of Hospital beds and Oxygen, many more people ended up dying than what normally would have.

I know several of my relatives including a 42 year old strong built man who died (his O2 count was 30 unfortunately by the time he got to the Hospital). There are numerous fund raisers going on for people who died. In few cases both the parents dying.

Yeah it was a short wave mercifully. But did a lot of damage. If you just search you can see images of bodies floating in rivers, as the people didn't have means to do last rites etc.

Also the actual span felt like 6 weeks. There was panic as the curve was so steep, and it was spreading like wild fire from the the west (Maharastra/Gujarat) etc to the east. And the peaks at different places were at different times. So the period starting April beginning to May 20th or so was pure nightmare.

Even if one was not affected by the virus. As thankfully in my family's case, there was this fear of not getting a hospital bed/Oxygen cylinder should there be a need.

Overall, I agree UK looks much better thanks to being vaccinated. Although I would say, one needs to keep observing for another month, before making a call, and if by then the fatality curve remains flat, then we can call it a big success.

PS: I got vaccinated after the wave. Only dose 1 yet. And ended up catching delta variant 2 weeks after that. Thankfully, a mild one. But I still wonder how I got it, as I remained very cautious through out. N=1, delta is very very contagious. But yes, if you are vaccinated, no need to worry too much.

[1] https://www.covid19india.org/ (Look at the bottom most curve on the right hand side for positivity chart of the two waves)

Edit: A point regarding fatality numbers in India in the 2nd wave. They were under reported by some multiple. There are various articles comparing total registered deaths during months of the 2nd wave in 2021 with previous years. And there is a sharp bump in the figures, which shows that fatality was severely under reported.

Edit2: Now the same playbook is playing out in un-vaccinated Indonesia unfortunately, with Oxygen shortages and everything. I think, in another month when we compare how delta plays out in UK and Indonesia, we would have several answers to questions of effectiveness of vaccines etc.

> mixing deaths in one country with infections in another

so basically like the last 15 months

there is a clear separation of critical thinkers on this planet such that we are almost two different species if it wasnt for the viable offspring

> so basically like the last 15 months

Yup. It started with conflating CFR and IFR (picking CFR of course because it is the bigger number). Comparing raw numbers between two regions that report their data completely different, etc.

Worse is when you show public data and get called "dangerous" because it doesn't fit the narrative that this all is the worst thing ever.

> picking CFR of course because it is the bigger number

And it changed over time. You remember hearing news media 3% at the beginning of the pandemic?

When did you hear them update it to <1%? Nope by that point they had moved to raw case counts, which by then then the higher statistic.

Selective reporting all day long.

Plenty of people (like my folks) still think that covid has a 4% “kill rate”.

“Well that is what the experts say” is what their source is.

It’s disgusting how this whole thing is nothing but raw appeals to authority the entire way down. Thinking for yourself, expressing doubt or skepticism or having hope and optimism gets met with scorn, shame and ridicule.

Now the question is how do we correct for this? How do we get the critical thinkers in the headlines and fear merchants on the sidelines?

Why would you? If you're a critical thinker who can exploit a knowledge advantage over the world, your life will get better faster than the life of non-critical thinkers, and they, in turn, will have their lives improve faster than that of a critical thinker fighting against the weight of non-critical-thinkers.

The optimal strategy for all people unable to determine if they're critical thinkers is to either go with the weight of opinion or to attempt to exploit their edge. The middle where you try to convince people is just free labour.

I still love to share the UK report about the Delta variant from mid of June.

Bottom-line: If you’re 2x vaccinated, hospitalization is highly unlikely for Alpha and Delta variants.

See this report, page 44 bottom: https://assets.publishing.service.gov.uk/government/uploads/...

The latest data is even more dramatic: across the UK, the IFR for Delta is ~1/10th that of Alpha, and the "infectiousness" is about the same.

https://twitter.com/EricTopol/status/1413537810296950786

https://assets.publishing.service.gov.uk/government/uploads/...

It is quite clear that for a vaccinated population, it isn't a threat. These are facts that simply aren't being reported by the news media. It's unfortunately quite common for talking heads to prefix "the highly infectious Delta variant" to any discussion, and never offer any context or nuance.

Your claim that the media is simply not reporting that vaccinated people are much better protected to the point of it basically not being a threat is not “a fact”.

Most media (except, of course, certain anti vaccine organs, which unfortunately seem to have infected an entire section of the mainstream US media) is reporting the significantly better outcomes for the vaccinated.

That being said, considering how small a percentage of people are vaccinated, it’s still a massive threat we cannot simply ignore.

We need to double down on vaccination even more. Delta only underscores that need that already existed.

> That being said, considering how small a percentage of people are vaccinated, it’s still a massive threat we cannot simply ignore.

It is definitely a massive threat to people who cannot get vaccinated if they want to. In my country, we passed that threshold months ago, so the vast majority of deaths are people who simply chose to not get vaccinated.

Vaccination still continues apace, but nowadays it's mostly people under 25, who are much less likely to be hospitalized. When the vaccinations per day start falling below the max we can physically vaccinate, that'll be the point where everyone who wants a vaccine has gotten one.

Unfortunately for the people who have legitimate reasons to not get vaccinated, there are enough people who distrust vaccines that we'll never be truly free of COVID.

> Your claim that the media is simply not reporting that vaccinated people are much better protected to the point of it basically not being a threat is not “a fact”.

> That being said, considering how small a percentage of people are vaccinated, it’s still a massive threat we cannot simply ignore.

OK, so your issue is that I've critiqued the media for sensationalism.

You think the media is not being sensational, because There Is a Major Threat. That's fine. We can disagree. The facts are still the facts, and people can interpret threats in light of those facts. You've now triple-responded to my comment with essentially the same thing. Maybe you're seeing this through an emotional lens?

(FWIW, I haven't seen any major news outlet report that the latest data for secondary transmission of "the Delta variant" indicates that it is not more contagious in the UK. That's a pretty big change, and it's new information. Even if you can find a single news source that has reported it, it's not widely known.)

> We need to double down on vaccination even more

I'm not sure what "double down" means, but I never said that people should not get vaccinated.

Except everywhere I see the media is reporting that 99% of infections are amongst the unvaccinated.

So they are all clearly reporting this. And the reality is that there are tens of millions of people who are not vaccinated who are extremely susceptible to the Delta variant.

It’s not clear to me what point you’re trying to make by insisting that it is significantly less dangerous to the vaccinated that isn’t being made by every news outlet and government agency that I have been following.

In the UK there are some communities with relatively low vaccination rates and it's shooting through them like wildfire. It's not a huge number of people in absolute numbers, but pretty rough on those communities.

Hospital admissions are also skewing a lot younger. Fortunately even if they do get hospitalised younger people are still less likely to die.

Still, deaths are happening. My wife is in health care and she hears stories of people swearing blind Coronavirus doesn't exist and that vaccines are a conspiracy, while dying of it.

Here’s the current top article under latest updates for COVID in the NYTimes.

https://www.nytimes.com/live/2021/07/13/world/covid-variant-...

Besides the headline, here are some other phrases in it pointing out the difference in impact on the vaccinated and unvaccinated.

> the recommendations of health experts, even as the virus’s Delta variant and other mutations fuel outbreaks in areas where vaccination rates are below the national average.

> Public health experts have said that a strong vaccination effort is critical for the United States to outrun the virus

When I listen to or read a media report on Delta “sweeping through country XYZ”, it seems to me that the media is breathlessly trying to generate clicks and views.

The (apparent) reality that Delta appears to have a lower IFR and that hospitalization rate for vaccinated people for Alpha or Delta is extremely low do not seem to get the same level of coverage as context for the click/view-generating reporting.

> Except everywhere I see the media is reporting that 99% of infections are amongst the unvaccinated.

Maybe they do this five paragraphs down. I almost never see this mentioned within the same paragraph as the "highly infectious" claim, which is always at the very top of the story.

> It’s not clear to me what point you’re trying to make by insisting that it is significantly less dangerous to the vaccinated that isn’t being made by every news outlet and government agency that I have been following.

Two things:

1) I am not "insisting"...I'm providing data. Nobody should believe me blindly. I am nobody.

2) If you already know these facts, great! Most people don't.

ok, three things:

3) I'm not sure why you're so prickly about the fact that I'm sharing factual information.

I wonder if it’s also misleading to only say that young adults have a rise in cases (due to less vaccination) and be fearful of that. The overall hospitalization and death is still lower (I think I read another article that talked about either in California or NY) because they’re better at handling covid. We need to present the hospitalization / death by age range for vaccinated and unvaccinated which if anyone has any data on that I would love to see it.

here you go https://assets.publishing.service.gov.uk/government/uploads/...

and we are past the potential 2-week delay from cases to deaths

Not everywhere. See here, for example: https://www.worldometers.info/coronavirus/country/netherland...

The Netherlands went from 550 cases/day at the end of June to 10,000 cases/day now. The Delta variant took less than two weeks to spread as much as the EU variant did in two months (Sep 1st - Nov 1st). Of course, it was helped a lot by the government deciding to open up bars, dancings and nights clubs on June 26th so it's not a fair comparison :/

Point is, we'll have to wait two weeks to see what effect this will have on the death rate. I expect the death rate to be a lot lower than in November, partly because of vaccinations but also because the age group that flocked to the bars and night clubs is a lot younger than the earlier wave victims.

Still, I don't expect our death rate to remain in the single digits as it has been since the beginning of June.

Still, the UK is quite a bit into the delta wave and the number of deaths have barely budged: https://www.worldometers.info/coronavirus/country/uk/

Barely budged? It's gone up by a factor of 5x since the beginning of April!

Are you looking at cases instead of deaths?

That is not surprising. UK targeted very high vaccination rates for those most likely to die from the disease.

> As of 4th July, 2,118,096 (93.8%) of the clinically extremely vulnerable (CEV) population have been vaccinated with at least one dose. This includes all CEV individuals, even if they were vaccinated as part of a higher priority cohort. Of those, more than 9 in 10 (2,046,244, 96.6%) have received a 2nd dose (90.7% of all CEV individuals).

https://www.england.nhs.uk/statistics/wp-content/uploads/sit...

It is a bigger issue in countries like the US where vulnerable populations are refusing the vaccine.

I'm intrigued to know where this 2 week delay comes from. That's comparable to the time from first infection to full symptomatic state, but (based on US data) I see a much longer envelope of at least 2-8 weeks. Maybe this start measured from symptomatic or even test results date, but with test times <24hrs that's unlikely shift the center more than a week.

I'd expect something closer to a 4-6 week delay in the statistics.

https://github.com/ctesta01/animated_covid_rates/blob/master...

IIRC during the first months of the pandemic most deaths showed a pattern where, from onset of symptoms, the disease would be unpleasant for ~7 days then the patient would seem to recover, and then suddenly worsen around day 10-14. New cases were typically detected around onset of symptoms, so I'd guess that's where we get the general assumption that deaths will trail new cases by 2 weeks.

I'd be curious whether we're detecting noticeably earlier than symptoms now, in countries like Australia with very proactive testing and contact tracing.

Yes most people who get it bad die after about 14-28 days. I don't know the detailed stats, but the average might well be 3 or 4 weeks or so, but the first of them start dying after 14 days. This means when you see an increase in infections the death rate starts to rise after about 14 days, as the leading edge of the rise in deaths starts entering the statistics.

4-6 week delay is what I observed earlier in the pandemic. Once people go onto ventilators they usually take a while to either get off them or die.

If you take the numbers from the UK (here https://coronavirus.data.gov.uk/) and filter to just the 2nd and 3rd waves (testing was poor in 1st wave; lots of people are vaccinated in the 4th) and compute the autocorrelation function between positive tests and deaths, you see a peak around 14 days.

Isn't it also the case that the Netherlands has vaccinated few of the younger groups, which are the same group that has had an explosion of cases. I can't find the reference right now, but the country rationally focused on older groups. If that's the case, cases may be high with very few deaths.

True, the planning is here (in Dutch, but luckily we use Arabic numerals): https://www.rijksoverheid.nl/onderwerpen/coronavirus-vaccina...

The first table is for non-medical personnel without high-risk indication. People under 30 have only been able to book their first shot since a month (but they were able to choose the J&J vaccine, which only needs one shot).

I hate having to be skeptical of this stuff, because the consequences of skeptics being accurate are even more horrifying than the pandemic. This is so challenging because when you look at each number he uses, and then compare it to its base rate, you can see why hesitancy levels are 30-50% in regions of developed countries. If you are among that cohort of people in your region who are not vaccinated, should you get it? Yes, and especially if you have co-morbidities or work with people who do. We need to seriously consider what the consequences of a controversial vaccination plan that requires 90% compliance for it to succeed are going to be if/when it fails. (I would even posit that number is closer to 70%)

If you talk to hesitant people, and there are a lot of them, the reason is a mistrust of the people leading the effort and managing the pandemic. Why mistrust? Many reasons, but the most challenging one is because of numbers that don't pass a smell test coupled with apopleptic ad-hominim aggression directed against anyone who questions them. This all but guarantees a 20%+ rejection rate from people who just dig in because they do not make health or other decisions based on fear and shame. There will be a defiant group of about 5-10% who you just can't reach at all, so if your plan needs them, you will need a new plan.

Calling people hesitant is patronizing and was probably the stupidest PR move of all time and the committee responsible for it will have to live with those consequences.

But instead of arming people with a litany of whataboutisms, I would say this to an unvaxed person: given your objections, how does getting the shot prevent you from resisting or even fighting a battle you percieve you need to fight against these authorities you do not trust? Polite euphemisms aside, let's call it what it is, because that's the crux of it.

If it does, you need to just act now and literally overthrow your governments in the next few weeks, but if you aren't going to act today and do that, then get a shot, and use the time to figure out how to depose these people that you do not trust in good time. If, as many hesitant people believe, there might be long term harm to them, your long term still involves a conflict to replace these people, but risk from hypothetical side effects still nets out of that equation.

My rationale to the so-called hesitant would be this: get the shot, and then use the time to organize and support your revolts against untrustworthy leaders and institutions, because once you are vaccinated, you can draw from the ranks of others who were also forced into it. Use this to unite people to your causes against untrustworthy authorities, because your skepticism comes directly from people using this to divide you. Take that from them, and then commit to organizing and scaling the change that has to come. Having the shot gives you skin in the game with the people you are going to need on your side.

This issue isn't the main battle, but I will absolutely support efforts to ensure trustworthy people get into positions of authority after this.

Great idea, just comply with evil so you can maybe fight it later. But right now, be sure to comply.

I'm glad you mentioned evil, because that's the conversation that isn't being had, and it's the personal belief factor that is driving a lot of private decisions. For us to spout talking points about noisy data just talks around these deeply held beliefs, and I think the only hope is from addressing those directly.

I happen to have some rare professional insight into how evil this all may get, but if it's as bad as I suspect, a small risk of rare side effects is really the least of your worries on that time horizon, and you can't do anything about it if you are on the target list.

If that's on your radar you need to know that doing nothing is not fighting evil. If you are going to fight, get out there and do it, but if you aren't going to do that now, then I'm recommending you take the benefits of a vaccine with some known risks and some unknown ones, keep your family and social connections who will otherwise write you off and isolate you when it counts, and then fight or continue to do nothing when you are ready.

Dismissing someones beliefs as conspiracy theories has never once convinced anyone of anything, so addressing how to effectively navigate a world with a belief is much more logical.

I don't think the reason to take it is scientific. Literally nobody who didn't invent it has taken it as the result of their own emperical research and discovery. I'm saying this vaccine is not the hill to die on. There will be plenty of other opportunity for that.

So just how evil can it get?

I don't really see this as a hill I'm dying on. More than half my friends are not taking it. My work doesn't care. I don't live in a dystopian city with vaxxine passports. My life, actually, has not been negatively affected at all by not taking this shot, other than the internet ridicule. So I don't really agree with your argument; it's not like I'm ruining myself.

There are many reasons people choose not to get the vaccine. What evidence do you have that the main issue is a distrust of authority?

The main authority on this, the FDA has not even officially approved the vaccine and likely won't for quite awhile. For some people it is logical to ask why other vaccines require 10year+ trials and for this a few months was sufficient.

While personally, I think the risk of the virus greatly outweighs the risk of getting the vaccine, I do not think we should force that choice on everyone. Either the FDA is ridiculously over-conservative in their other trials, or this one is extremely rushed. Can't have it both ways.

The FDA is ridiculously over conservative because of litigation, settlement, and insurance costs. They're not doing another thalidomide.

My premise is that the facts we choose for our opinions are for support of an underlying belief, and that this underlying belief is that the people running things are full of shit, if not deceptive. I can't change someones mind about that (and wouldn't try), but I'm addressing that concern directly vs. getting a shot.

> They're not doing another thalidomide.

I'd note that the FDA didn't do the first thalidomide. Thalidomide is one of the first big FDA success stories; it was rejected, despite being approved by numerous other countries and pressure from the manufacturer and politicians at the time. https://en.wikipedia.org/wiki/Frances_Oldham_Kelsey

Having been through an FDA process in a prior startup (although far from central at it; my role was at the outskirts), I can say the FDA is not ridiculously over-conservative. We did human pilots in another country, which was less bureaucratic. The processes there were both faster and more conservative in terms of safety. Doctors would look over our data and protocols and make reasonable decisions.

The FDA process took a long time, but wasn't all that effective at guaranteeing safety either. There was a ton of process.

I think you're attributing far too much rationality to an administrative government process.

They're supposed to be conservative though?

Anecdotally, my experience is that the main reason is distrust of authority. It's usually warranted distrust too. Authorities aren't trustworthy.

To answer your question:

(1) Most vaccines don't have 10+ year trials. A year is not even the fastest; the flu on 1957-1958 has a vaccine developed in 4 months.

(2) Most medical trials are slower since everything is done sequentially, since there is no rush. You can do an animal trial, a first-in-man, a small group, then a medium group, and so on. It's a better way to go.

(3) This vaccine has had over 3 billion doses administered. It's far better studied and validated at this point than the vast, vast majority of medical trials.

If you believe "the risk of the vaccine greatly outweighs the risk of getting the virus," can you provide any back-of-the-envelope numbers to back up that statement? From my perspective, the virus already killed half a million Americans, and likely brain-damaged millions. We have enough data on the vaccine to know it doesn't do that.

I am unvaccinated and probably will remain so for this particular vaccination. I don't truly believe that the risk of the vaccine outweighs the risk of the virus to me. It's more that I weigh the risk of covid at around zero, and the risk of vaccine at a question mark.

I cannot trust the institutions pushing this vaccine at all. At worst, I trust the opposite of what they say about anything politicized. But let's just say I don't trust them. In the absence of a trusted authority, I can only make this decision based on my own research. Unfortunately I am not qualified to interpret the data meaningfully, and I truly believe that if there was data suggesting that the vaccine was equally dangerous to the virus, it would be suppressed.

What remains is essentially a total vacuum of information. I then have to make decisions based on intuition and the error bars I perceive. What I expect is that the publicized covid numbers are better or equal to the reality, and the vaccine danger is worse or equal. The publicized numbers for covid give me essentially a zero risk of any problems, because I am young, fit and healthy. The real numbers are going to be even better. Meanwhile, the vaccine problems don't seem to be fewer for young people, but just kind of random. I also know what to expect from a respiratory virus, because I've had those a number of times. I have no idea what to expect from a MRNA vaccine, whether there could be problems that appear years later, etc, and I cannot trust any authority that says there is no risk.

There is also the aspect of direct action. If I get covid, darn that sucks but people get sick and that's life. If I get some bad side effects from an untrusted injection, I did that to myself and it will feel mentally much worse. All of this is to say, I don't care at all if I get covid, because I'll be fine. I won't inject myself with an untrusted medicine to avoid that.

Still, it hasn't passed the standard testing to show that it is safe and efficacious. That's why it is only allowed under EAU for the moment.

It has not passed the testing that a vaccine needs to have, to be FDA approved. Especially long-term effects testing, which I guess is us now. I doubt the tests will ever be completed now since the makers can already sell every dose they can make.

That said, I'm not too worried about the safety of the vaccine, but I certainly understand people who are.

I meant to say risk of virus greatly outweighs the risk of the vaccine. But I still disagree that we should force that choice on everyone.

1) Did that 1957-58 vaccine use existing tech? My understanding is that other RNA vaccines and therapies were already under FDA trials with ~10 year time-frames since the method is new.

2) Why is sequential better, because it is considered safer?

3) Yes, short-term we know it is extremely safe. But there are zero people that have had the vaccine much over 1 year. Long-term effects are unlikely but it's just not scientifically correct to say that this vaccine is better studied than any other just because of the number of doses administered. Duration matters a lot.

Also in the beginning "Depending on which figureyou use, it would put Delta’s R0 between 4 and 9" and toward the end he assume R0 of 8 when talking about herd immunity.

In the What About You section he doesnt even mention those that have had covid, only vaccinated and unvaccinated.

I'm not sure how you assess that he is conflating numbers to tell a narrative. Pueyo discusses fatality rates in the article, specifically that the vaccines appear to still be highly effective at preventing deaths (though much less so for infections) and that countries with high vaccination rates are not seeing high death rates even when infections are growing.

The only area where he says deaths are getting worse are for the unvaccinated: that fatality rates may be significantly higher for unvaccinated individuals due to a faster replication rate of the virus and therefore a much higher viral load.

I quoted it, the author warns that we should expect India-level deaths in Europe (that's the clear read from showing mass burning of bodies in India, talking about deaths in India, and saying "if you think Europe or the US will be spared").

But then shows infections growth (not deaths) to prove the point, so yeah it's conflating infections with deaths.

The article specified that high death rates might be expected for developing countries with low vaccination rates, not countries with high vaccination rates.

> So Delta, like Alpha before it, is both more transmissible and more fatal. Both of these effects have the same root: the virus is much better at binding to human cells, so it reproduces much faster.

> Are people dying more then? Not in Britain.

> But Delta is very hard in developing countries, especially in dense urban areas where the poor are forced to work but live in close quarters with many others. India, Argentina, Tunisia, South Africa, and Indonesia are very sad examples of this.

that's not the impression i got at all. the words did not say, "will be spared from the identical outcome as India" and it is obvious that US / EU have better vaccination/ medical infrastructure compared to India. The phrase is a qualitative expression only for the purposes of a blog post, this is not a medical journal article.

The problem I have with this article isn't the data, it's unclear what it tries to convey at all.

The first part of the article is an exposé of the evolution of the epidemic, transmissibility and fatality rates. Fine, but at this point, I haven't read any thesis, question, point, claim or argument he would like to answer or prove. It's just a wall of data.

Halfway through, he finally asks the million dollar question "How good are vaccines against Delta?"

That's where he has to retreat to the fact that any data about large populations available is limited:

> The best data we have is from Israel, which used Pfizer.

He then mentions percentages from an article from marketwatch.com and a briefing from technical briefing from the UK government, and goes on to extrapolate several claims based on those sources.

The takeaways in the latter part of his article are generic and have been repeated at nauseam by the medical community and health policy experts at large.

Thomas Pueyo isn't a medical or policy expert. He's a data analyst / publicist. Sure, he's entitled to write musings on his blog. But I don't regard him as an authoritative source because he's able to compile online graphs and stats into an piece which seems to be easily digestible on the surface level.

I thought it was odd, to see a chart like 'New Cases / 1000 people', instead of simply gross numbers. Gross numbers would have highlighted different states, placing 'blame' in a different way.

It does seem a narrative is being spun.

You still don't explain why: Conflating infections with deaths is meaningless where the mortality rate has gone down.

Please forward the discussion by showing how you would present the data.

I honestly don't know how to feel about Tomas Pueyo.

He's very opinionated about what he writes, and has gained good readership and influencer status on this topic. It's clear in his writings that he fancies himself as an "amateur of expert insight". He may be 100% correct. He may also be 100% wrong. It's hard to tell (let alone without invoking the conditional fallacy).

However, the most lasting impression I have of him is when he was invited in one of those "both sides" TV programmes in the UK on the basis that his "Hammer and the Dance" blogpost at the time became very popular. He was invited to debate with a renowned epidemiologist, who was part of the COVID-19 team advising the UK government at the time, and who was there to discuss the rationale for the policy after copious simulations by his research team. The epidemiologist was considered an expert and leading figure in his field. Meanwhile, Pueyo's self-described title on his blogpage at the time was "data visualisation expert" or something along those lines.

Now, like I said, he may be 100% correct (or not). This is not about making an "ad verecundium/hominem" argument. But all I remember from that TV debate is that his main argument tactic on TV was effectively interrupting all the time by saying "wtf", "people will die because of you" and visibly eyerolling and audibly sighing an awful lot, without offering much counterargument except by referring to his blogpost and the "obviousness of his claims". All this to the dismay and visible frustration of the epidemiologist who was trying to remain civil, objective, and doing his best to remain calm, relay the science as clearly as he could, while trying to avoid unnecessary panic and drama. Honestly watching it made me feel like you had just pitched the dalai lama in a debate against trump.

Pueyo has now changed his blogpage's tagline from "data visulisation expert" (or whatever it used to be) to "Understand the biggest problems and how to solve them". Forgive me if that doesn't sound as vague and grandiose to you as it does to me, but at best it doesn't come across to me as very humble from someone who, at the very least, is not particularly qualified for that description (then again, who is).

So, good on him for writing these blogposts and taking a stand, but while he may (or may not) be 100% correct (if there is such a thing), after that TV performance I witnessed, I'm taking his (otherwise professionally edited) blogposts with a large pinch of salt.

This is a lesson I don't see the general population learning very well over the past 5-7 years. Just because somebody throws a tantrum over their stance about a moral quandary does not make them better informed about its resolutions. And often there are no resolutions proposed anyway, which can be hard to notice beneath the sound and fury.

It also seems to be often the most natural approach taken by people who make a living from gaming the attention economy. It isn't about the merits of one idea or another but the engagement it generates from outrage, self-righteousness or other reactionary emotions.

The "solution" proposed is often "do what I want, and ignore that it doesn't solve the moral quandary".

>But all I remember from that TV debate is that his main argument tactic on TV was effectively interrupting all the time by saying "wtf", "people will die because of you"

Which was an apporpriate tactic given that the United Kingdom was one of the hardest hit countries in Europe and the entire world. Visible anger in the face of complete and abject failure of an expert class and in the face of a rapidly worsening pandemic was an entirely reasonable reaction and the situation was indeed obvious to anyone who didn't have his head up his own ass. You might remember all of this happened against the backdrop of a government that was willing to 'let the bodies pile up' to 'keep the economy going'.

The absolute veneration of "civility" as if being civil actually is worth anything in the face of tens of thousands dying as a result of hesistancy is mad. Any sane person should have been ragiung.

No, that is not an appropriate tactic; not in real life and 10x more not on TV.

It may come as a shock to you, but people do not like having their viewpoint challenged by such tactics. It's not very persuasive; if anything it entrenches opposition.

I haven't seen the debate you are referring to so I won't say much more, but there is a l a r g e space between being civil and "interrupting all the time by saying "wtf", "people will die because of you".

Disclaimer: I don't think this guy is legit, based on his cherry-picking of numbers and facts, and his over the top fear-mongering style.

> government that was willing to 'let the bodies pile up' to 'keep the economy going'

First, the UK mortality rate was only somewhat higher in 2020. In fact, it was lower than it had been in any year before 2009.

Second, even if that were true, you vastly overestimate the efficacy of such tactics in persuading people.

I got the same opinion just from the article. So sure of himself, giving advice to everybody and blasting alarming attitude, while real epidemiologists and doctors that I know are much less sure about predictions and almost never beat the drum of alarm. He's probably a case of Dunning-Kruger effect.

This was the epidemiologist who suggested Herd Immunity as a strategy for the UK?

Then regardless of how weakly he presented himself on TV, Pueyo was more right than that epidemiologist who civilly advocated for a policy that would've killed hundreds of thousands.

ive never heard of this author and i thought it was a good blog post. your post is for better or worse the definition of ad-hominem and also black-and-white thinking (100% right or 100% wrong). In the US, we are in a dangerous place where social distancing and masking have basically stopped, and with a much more contagious variant like Delta we're defintiely going to have a much bigger problem again in the coming months. I didn't see anything in this article that struck me as counterproductive towards preparing for the continuation of the virus.

Very well, I'll rephrase.

Yes, it was a good blog post.

> "this is the definition of ad-hominem"

It is not. Ad hominem would be "his argument is false because he is [personal attack]". Ad-verecundium would be the specific case where the personal attack is "he's not an expert in the subject".

Cautioning against grandiose claims by pointing out the author has made unverifiable grandiose claims before, which are objectively beyond their expertise, and was unable to defend them or reason properly against a peer with known expertise, is not an ad hominem. It's just skepticism. Having said that, good for him for doing his bit and writing the blog post. I've done far less.

> also black-and-white thinking (100% right or 100% wrong):

I think you are misreading this, so I apologise. I'm not advocating "splitting". The point of the "he may be wrong or right" part is that the only way to evaluate his claims of "what a public figure should do" etc, is via the conditional fallacy, i.e. "This is the correct course of action because IF you did the opposite, THIS would have happened". This is effectively an unverifiable claim, which is why, as a form of argument, it is fallacious. His claim in absolute terms, however, may in fact be true. Or false. We can never know.

Now obviously, you might say, "but he provides evidence for his opinion on what a public person should do". True. But here is where the earlier argument comes in. It's worth keeping in mind that this is a blog post, by a non-expert, who has shown inexperience against experts previously, and where he is free to take creative liberties to promote his view, as he has done in the past. It is not a scientific article that has undergone peer review, nor is it a disinterested exploration of the literature. It's purely an opinion piece (albeit a well-meant and well-presented one) backed by the evidence and visualisations he feels make his point and linear narrative best.

Which is absolutely fine for a blogpost. Kudos to him.

I've never heard of him either, and clicked around until I found some background on him. He has no medical or health care related education or experience. He's a tech guy with a blog.

Is seems kind of logical in hindsight: the first mutation of the predecessor bat/pangolin/whatever virus genome to cross over to humans is an MVP full of "compatibility bugs" that barely achieves R0>1. A few billion dicerolls later many of those "compatibility bugs" have found fixes.

Remember the hand washing phase of the pandemic? Aerosol transmission was basically ruled out because it was assumed that spread would have been much faster if it happened by aerosol. Turns out like it was aerosol all the time, just slowed down massively by all those "compatibility bugs" that are now slowly ironed out. Fortunately, our immune systems adapt as well (both individually and industrially, by ramping up mRNA capabilities and production)

> Remember the hand washing phase of the pandemic?

Guidelines need to be enumerated, like product releases.

So much angst would be avoided. When there's a disagreement, the parties (operating in good faith) could go meta and compare guideline versions. Which would help resolve differences.

"Oh, you're following guidelines USA-1.4. I see. FYI, last week our governor issued USA-NY-1.5, clarifying protocols for open air retail. All these revisions! Such a bother, I know. I'm so glad you and me are back on the same page. Be safe! We'll get thru this."

Even easier would be simply admitting they were wrong about the previous guidelines and explaining why, you know like grown ups.

They did. Repeatedly.

Further, many exposés and post mortems are in progress.

The Premonition https://www.amazon.com/Premonition-Pandemic-Story-Michael-Le...

Uncontrolled Spread: Why COVID-19 Crushed Us and How We Can Defeat the Next Pandemic https://www.amazon.com/Preparing-Inevitable-Normal-Survive-E...

Preventable https://www.amazon.com/Preventable-Leadership-Failures-Selfi...

Move on.

The problem is that the people admitting these mistakes were not necessarily the political figures advocating them to the populace at large. I imagine a fair bit of opposition to the safe vaccines we are able to enjoy is due to skepticism of political figures not owning up to their initial false statements. For example, I distinctly remember the former president stating loudly and repeatedly that Coronavirus was no big deal (paraphrasing), that it would disappear overnight, that the United States was well prepared for it, and so on. I do not recall any mea culpa's being issue: just one new bold statement after the next.

To be fair to our conservative friends, I'm sure this behavior is not limited to only one political party.

Only after being left with no choice or when politically convenient. Too little too late.

"Stop Flip Flopping"

Politicians have to appeal to people who crave stability above all else, and trying to do otherwise will just get them replaced by someone who knows how to appeal to stability.

I'm not sure that's actually the case here; anecdotally, but a lot of the criticism of the former president at the time came from his bold statements that he never bothered to correct. Though, to be fair, that's probably not the only reason his former supporters did not come out to vote for him in round 2.

> full of "compatibility bugs" that barely achieves R0>1

Did I miss something? COVID-19 was highly contagious from the beginning, thus the drastic measures, or not?

It is highly contagious. But not as much as say, the measles.

COVID19's main issue is that it takes anywhere from 5 to 14 days before you feel symptoms. During this window, it looks like you're still spreading COVID19 around.

Therefore: traditional means of preventing spread (ie: staying home from work and/or school) are ineffective. Measles or Ebola (or plenty of other diseases) have a much smaller window of spreading (because you feel sick sooner).

What's the latest on asymptomatic spread for covid-19? Last update I had seen was that this wasn't likely.

https://www.nature.com/articles/s41467-020-19802-w

Is there a human pathogen more contagious than measles? I remember reading this scenario that really gave me a sense of how contagious it is:

> The virus can linger in the air for about two hours after a person with measles has left the room. It can infect those who enter the room if they are unimmunized.

From: https://www.hopkinsmedicine.org/health/conditions-and-diseas...

It's the asymptomatic spread that has caused a lot of the problems and concern. People with ebola for example rarely spread it because they become so quickly and acutely ill. But with COVID, you're going about your normal life for days while spreading it unknowingly before symptoms hit (if they even hit at all).

> It's the asymptomatic spread that has caused a lot of the problems and concern.

Is there a lot of evidence of this? Last time I checked, asymptomatic spread was not well understood.

I used the wrong word! Most data shows people who have a truly asymptomatic infection do not frequently spread the virus. But much if not most of the transmission occurs from infected people while they are pre-symptomatic. Hence the ease of spreading the diseases, and the push by many health agencies to get people with no symptoms to wear masks and social distance in case they are infected but don't know it yet.

Here's a couple relatively recent links: https://wwwnc.cdc.gov/eid/article/27/4/20-4576_article

https://www.health.harvard.edu/diseases-and-conditions/most-...

This is also why vaccination is so critical and why "young healthy people" should not opt out: when you get the virus, even if it's a mild case, you are in effect donating processing power to what amounts to a global supercomputing project to evolve more virulent strains of COVID. That's how evolution works. The more chances the virus has to replicate, the more likely it is to become more virulent or even worse learn to evade the vaccine.

If the delta variant jumps the vaccine hurdle we are back to early 2020 but with something 2-4X as contagious.

Scientific literacy matters and know-nothing populist bullshit (regardless of whether it is "left" or "right" in flavor) is dangerous. There is no such thing as a "post-truth era." Being wrong carries the death penalty, eventually. Civilization insulates us quite a bit allowing a lot of people to go nuts with little consequence, but if enough people are wrong enough for long enough the wall collapses and the consequences arrive.

If you think this is fun, your kids and grandkids are gonna have a blast with 800ppm CO2 levels.

This raises a point that I have been pondering for a while.

When we are living in a "state of nature" we have a very small circle of concern, mostly around things like finding enough food, avoiding predators, and creating shelter. Having correct opinions about these subjects is a matter of life and death. But when we introduce society things get kind of unbalanced.

We start getting information about all kinds of events from outside our immediate surroundings, which is really exciting to the "opinion having" part of our brains. But we aren't really accountable for those opinions - we won't die if we think the moon landing is fake, or Obama is a lizard-person. So it allows for a lot of "mental rot" to accumulate unchecked.

The beliefs that have the most direct impacts on us are still heavily constrained though. Stuff like "My boss will fire me if I stop coming to work" or "I will be hungry later if I don't buy groceries" etc. largely keep society functional. But we don't actually have any sort of consensus reality - we just think we do because people's crazy beliefs don't usually impinge on the public sphere. And without any evidence to the contrary, we just sort of assume other people think roughly what we do.

But with issues like COVID-19, suddenly everyone's crazy opinions about which secret society is using 5G to control our minds actually matter a great deal. And as society becomes more interconnected, those things will matter more and more. How can we solve collective action problems like climate change or pandemic response when we can't agree on basic facts about the world? It seems possible that "society" as a whole might be an unsustainable condition. It can last long enough that we become dependent on each other, but then it destroys itself because of that interdependence.

That entirely depends on the selection pressure being applied. A vaccine that only targets the spike protein is a great way to select for a mutation with a different spike protein. Limiting human contact selects for strains that can infect during short periods of exposure… oops.

Vaccination means you don't need to limit exposure so much, which reduces selection for casual transmissibility. It also means the existing un-mutated virus has far less of an opportunity to "experiment" and mutate further.

> It also means the existing un-mutated virus has far less of an opportunity to "experiment" and mutate further.

You seem to be ignoring the time variable. If wide-spread vaccination slows the spread, then the spread lasts longer, unless and until the virus is totally eradicated.

> evolve more virulent strains of COVID.

More virulent virus does not always mean worse disease. It maybe that more virulent variants will be also causing less severe diseases. Hints of this are present now (low deaths/day) but we will see what the variants really do in the coming months.

> That's how evolution works. The more chances the virus has to replicate, the more likely it is to become more virulent or even worse learn to evade the vaccine.

Yes but this process happens in the whole interacting population, you can't blame just the unvaccinated people for this. The virus is likely to mutate towards variants that are better at infecting vaccinated people. Realistically, we can't stop this process without isolating everyone all the time.

Vaccination will protect most people who chose to get vaccinated from getting the severe disease. It won't stop evolution of the virus.

As a reader of HN for several years now, it blows my mind how polarized we all are on this issue. Something smells here, you're not allowed to question anything without being down voted to oblivion, one way or another.

Why?

Covid discussion has become equivalent to politics. Most people have strong opinions on the matter, these opinions usually correlate strongly to their favorite political party's stance, and few people have the experience or knowledge to evaluate scientific information rationally. It's a recipe for uninformed debate.

On top of that, in the US, the previous president was so politically polarizing that literally any statement he made was aggressively opposed by many people. A lot of SARS-CoV2 response got caught up in this dynamic.

Wide segments of the population are simply misinformed of basic scientific facts, and slick charlatans (like the author of this article) twist information in subtle ways to scare people. Terrified people are naturally going to be more volatile, and this has been exploited throughout the last year and half.

> Covid discussion has become equivalent to politics

It isn't equivalent, it is politics. In the end I suspect the last 15+ months will be a story of:

10% disease mitigation, 20% intellectual error, 30% media fear mongering and 40% politics.

It certainly feels like hangover from the Trump times, and yes, it's insanely political and quite hysterical.

Now, people overcompensate, if there is any questioning or hesitancy to take the vaccine, ask questions about origins etc you might be a...Trump guy, or a nut and so you need to be told by the Non-Trump guys what' up, by being downed.

It's Kind of like Post-Trum-Stress-Disorder, PTSD. It's really quite fascinating.

Nah, many people especially those not in the US care far less about Trump than this is making out to be the case. Every country has its political spectrum, and the discussion easily being political or becoming attached to one’s political stance doesn’t necessarily have much to do with one particular politician.

It's unfortunately pretty common for people adopt an "opposite of what That Guy said" stance on any particular issue.

Obviously, taking a position that is the opposite of an illogical person makes you just as illogical, but it's much easier than thinking.

It also feels nice to be part of the "smart crowd".

Also, let's face it, no one likes to lose karma :)

It is tribalism at work. Like if one takes a nuanced opinion and says "Maybe if loads of people are not dying and there's going to be no end to COVID, we should not lockdown again and again forever" You are then "them". The irrational COVID is a hoax, anti-vaxers, and get downvoted.

Unfortunately well educated knowledgeable people are falling prey to this tribalism as well. I don't view a pandemic as at all political. There's a balance as to what amount of financial, social, and loss of liberty pain we should take versus the harm COVID 19 causes. And there should be a healthy debate about that, and opinions should change with statistics coming out and changing conditions. Meaning hardline anti-vaxers should probably soften up a bit as the vaccines have been shown to be extremely effective and safe and hardline lock down the world adherents should look at the dramatic drop in deaths and hospitalizations, and compare the risk of COVID with other risks we take in our life like driving.

I think part of the problem people are having with the vaccines which have proven to be well-tested and safe is that there is already a non-insignificant portion of the populace that thinks most vaccines are unsafe by nature.

I've noticed this is not U.S. specific, so it is not a political polarization in the traditional sense.

The broader world-wide phenomenon, visible also here, is that most people got divided into two camps:

1) "COVID-19 is so dangerous that we must restrict freedoms", "the other camp is a harm to society's health"

2) "COVID-19 is not that dangerous, mortality below 2% (or even lower depending on how it is calculated) and young and healthy people are safe from it, so we must preserve the freedoms", "the other camp is destroying democracy and freedoms".

You can see this in U.S. and in Europe too.

Camp 1) was right at the start of the pandemic when we had little knowledge and people were dying in large numbers. But as time advances, treatments and vaccines are developed, the narrative naturally shifts. Eventually Camp 2) will be seen as the correct one.

Now we're somewhere in the middle it seems.

The way I see it, the camp 1 is at fault only if they are not revising their stance. Otherwise there is nothing to discuss and no two camps story at all. There is only one camp, camp 2.

If the War on Terror serves as any example, those freedoms and rights lost, will never be returned.

There are a few issues here.

1) COVID-19 is not a static, singular disease. Now that it is circulating widely in the human population it has the potential to mutate, as it already has several times. SARS had a mortality rate on the order of 10%. MERS was above 30%. Part of the miscommunication seems to come from camp 2 assuming that things will largely continue as they are, while those remaining in camp 1 are saying "If we let this keep going, things could get much worse".

2) What about people who aren't healthy and young? Do we just permanently shut immunocompromised people out of society?

3) Developing a vaccine is not the same as actually getting the population vaccinated, as the last six months have demonstrated. Nobody in camp 1 wants society to stay locked down for its own sake. If 99% or even just 80% of the population was vaccinated, I think you would find a huge majority of camp 1 move to camp 2. Unfortunately the attitude of camp 2 has turned out to be the biggest obstacle to actually getting that done.

I think both camps have solutions for these issues, but unsurprisingly, they don't agree on which is most appropriate.

> Eventually Camp 2) will be seen as the correct one.

That sounds somewhat overly deterministic. The situation is always evolving and you can’t predict what will really happen especially with new variants etc. Of course you may argue that no variant will ever be so dangerous as to warrant lockdowns in a country whose population is largely vaccinated, but a problem as this article pointed out (accurately or with exaggerations) is that if a large portion of the population refuses to be vaccinated, how things will play out doesn’t seem certain.

OK that's fair. Assuming the COVID disease impact does not get substantially worse than it has been, the camp 2) will be seen as the correct one.

I can't imagine why it would get worse. Immunity of people gets better with time, and so do treatments.

Your point is well taken: I want to argue with you that Camp 2 will never be seen as correct, but as I see restrictions lifted despite the large number of unvaccinated individuals which remain, I can't help but wonder if it will actually play out as you say.

Without debating the whole article, I found this one excerpt to be somewhat indicative of his writing more broadly:

"Unfortunately, I turned out to be right. The short explanation is that the viruses that tend to win do so because they reproduce faster. Such a virus will grow faster inside a person, and will make that person more infectious, faster. It will also kill that person faster."

This is a fairly vague statement with broad implications (and a pinch of hubris) supported with insufficient evidence. I appreciate that he is trying to simplify a complex issue into lay-mens terms but I worry that writing like this only adds fodder to the anti-science movement because it is full of quasi-truths.

> The short explanation is that the viruses that tend to win do so because they reproduce faster. Such a virus will grow faster inside a person, and will make that person more infectious, faster. It will also kill that person faster.

There is not a single part of this sentence that is actually true:

1) the Delta variant does not "reproduce faster", except perhaps in the broad sense that it (may) be more successful in a population than other strains.

2) the variant does not "grow faster inside a person". This is nonsense.

3) "will make that person more infectious, faster." Also nonsense. There's no evidence of this, nor any bioplausibility for the statement. There's limited evidence that viral loads are higher, but that isn't the same thing.

4) "it will also kill a person faster". There's no evidence of this, either.

This paragraph is exactly what's wrong with Pueyo, in a nutshell: he takes a tenable fact ("Delta is more fit in the population") and twists it in ways that sound plausible and scary to laymen, but that are absolutely not supported by science or evidence.

This is also in contrast to what I learned about illnesses - basically that the more “evolutionary successful” ones are the ones that are less dangerous, and kill the victim slower - think HIV or herpes.

Which, even logically, makes sense - it turns out that a mildly infectious alive person walking around is a better reproduction vector for the virus than a highly infectious dead person.

I think there is a base level of knowledge and a higher level of hunch/intuition type thinking that can lead someone to make leaps and lead them to discover something that others might not. I don't think this is that, but I feel its an important part of what makes us progress in science.

Indeed. The very distinct feature of initial SARS-COV-2 was that people had extremely large viral load, yet little symptoms (when compared to other regular viruses). Even if the virus evolves towards larger viral load, this does not mean that it will be more lethal.

I have to admit, I'm a little perplexed about all the discussion around the Delta variant. It almost feels like people are discussing this like it's a plot point in a novel, a new looming threat that comes after Act II, rather than a cold scientific fact.

As someone who lives in New York and has been vaccinated for months, should I worry about this? It seems like the answer to that question is no, I shouldn't.

Also notable is that walk-in instant and free vaccinations are available everywhere in the city, I see signs all the time when walking around, so anyone (who's older than 12) who isn't vaccinated is making a clear choice.

I really do get that other parts of the world don't fit this description, and that there's subtlety to this and it's complicated. Like I really get that.

But what are articles like this trying to convey? They seem to be telling me that I should feel differently than I do now, and that I should take different actions than I am taking.

But what are those arguments? What's the intent of writing an article like this?

I see the takeaways section at the end but it doesn't feel like it matches the tone of the rest of the article, which seems to clearly imply that letting your guard down on COVID is a mistake. The first sentence sends that message clearly, saying "I don’t think people are paying enough attention to Delta".

I disagree with that thesis statement, I think vaccinated people with no policy authority who are overwhelmed and often in mental crisis after a year of this shouldn't pay attention to Delta at all.

> anyone (who's older than 12) who isn't vaccinated is making a clear choice.

I might push back slightly on this. some data on 538 I saw a month or so back seemed to suggest a significant gap in people who say they plan to get the vaccine and people who have. I think the dirty secret is that if you’re poor or living in a rural place, making time to get the vaccine is a challenge. There’s a reason why when J&J came out there was a lot of talk of deploying it in rural communities.

I hear you and it's now inevitable that the news cycle will move beyond Delta soon as other variants take over from it. It's also inevitable that future dominant variants are going to be more resistant to the current vaccines as they evolve inside of vaccinated populations. That said, I think the article conveyed a lot of subtle but important points that some people miss in all the noise. One is that vaccination is increasingly important for protecting yourself regardless of the evolving situation and how many people around you do or don't get vaccinated. The other is that vaccines are unlikely to ever stop the spread of the virus but that's not a bad thing since we will be increasingly able to prevent deaths.

> The other is that vaccines are unlikely to ever stop the spread of the virus but that's not a bad thing since we will be increasingly able to prevent deaths

Letting it escape is not a bad thing? Are you kidding?

Think of what the Flu costs the world each year, now this on top ?

The only people who benefit from an escape are big pharmaceutical companies who will now sell you a 2 for 1 package, yearly flu shot and yearly Covid19 shot.

I think he meant that eradicating COVID is a fool's errand like eradicating common cold or flu is, but it's not the end of the world because it will be like seasonal flu, dangerous only for elderly/sick people.

I thought it was a very well put together article that summed up a lot of everything - especially if you were on the fence about getting jabbed. As a vaccinated person - exactly as he said, you probably don't need to worry:

"If you’re vaccinated, you’re mostly safe, especially with mRNA vaccines. Keep your guard up for now, avoid events that might become super-spreaders, but you don’t need to worry much more than that."

But maybe this is a good summary to send to those who aren't in your position yet?

If you are vaccinated, you're helping. But is there anyone out there that is not you?

I'm a fully vaccinated Canadian, and it matters to me because the vaccines are effective against Delta, but seemingly only barely so— and the longer it continues to circulate the better a chance it has of evolving further and then us all having to go into lockdown and wait for another booster shot that specifically targets whatever the new vector is:

https://www.theatlantic.com/health/archive/2021/07/3-princip...

> the vaccines are effective against Delta, but seemingly only barely so

What data are you looking at? Even the waist pessimistic data - Israel - shows the vaccine working at great effectiveness.

Fair fair, yeah perhaps "barely" is excessively dramatic— this is mostly just going from coverage like that in the Atlantic piece:

> But even against Delta, full vaccination—with a heavy emphasis on full—is effective. Two doses of Pfizer’s vaccine are still 88 percent effective at preventing symptomatic Delta infections, according to a U.K. study, and 96 percent effective at preventing hospitalization. (A single dose, however, is only 33 percent effective at stopping symptomatic infection.)

It's the "still" in there— basically that Pfizer effectiveness was 95% against OG COVID, and now thankfully it's "still" 88% against delta, but much lower than that and we're back to a place where the vaccine alone is not enough, it would only be able to work in conjunction with other measures like limiting contact.

Yes, it will evolve further, but human ACE2 receptors aren't evolving rapidly within a generation any time soon. There's a metaphorical window of possible mutations that will allow SARSCov2 to bind to receptors and a huge swath of that window clearly is taken up by protection from vaccines (especially mRNA ones). There is a finite space in which it could still evolve _and_ evade vaccines. That space is likely _extremely_ small. "Too much" evolution renders it ineffective at infecting humans.

Do you have a reputable source which elaborates further on this discussion? My impression thus far is that few are willing to assert with the confidence you're displaying here that we're out of the woods once vaccinated.

Indeed, Pfizer has announced that it is working on a booster that specifically targets Delta, so that says to me that there is very much still a concern here:

https://www.cnbc.com/2021/07/08/pfizer-says-it-is-developing...

  If you’re vaccinated, you’re mostly safe, especially with mRNA vaccines. Keep your guard up for now, avoid events that might become super-spreaders, but you don’t need to worry much more than that.
  
  If you’re not vaccinated though, this is a much more dangerous time than March 2020. The transmission rate is higher than it used to be, and if you catch Delta, you’re much more likely to die—or get Long COVID. You should be extra careful, only hang out with other vaccinated people, and avoid dangerous events.

You pretty much have it right. As a vaccinated person you probably don't have to take any different actions. You aren't the only person and for unvaxxed people this article might be what they needed to read or what their loved ones needed to read to try to convince them to get vaccinated.

> only hang out with other vaccinated people

This is irrational. 1) According to available data, if you got vaccinated or pulled through COVID, you are well protected against severe COVID illness in future (cell immunity lasts for years). 2) You can get infected with variants both from vaccinated and unvaccinated people. You can't hide from unvaccinated people forever.

  only hang out with other vaccinated people

I assumed this was a typo given that it was in the section addressing unvaccinated people. I believe he means to say that if you are unvaccinated your risk is lowered by only spending time with vaccinated people since the data shows that vaccinated people are considerably more protected from delta infection (although less so than earlier strains).

That said, I wish more papers and studies would talk about rates for those who pulled through a previous strain of covid and how bad it was when discussing immunities rather than focusing only on vaxxed vs unvaxxed.

I got vaccinated with J&J and I should then freak out? I've been frantically searching for a source to definitely tell me if it makes sense to get a shot of mRNA based vaccine too to no avail.

> As someone who lives in New York and has been vaccinated for months, should I worry about this? It seems like the answer to that question is no, I shouldn't.

No, you shouldn't be worried because you're vaccinated and living in an area of the country that's largely vaccinated. (Even if we don't reach herd immunity, 60% or 70% vaccination rates will protect you more than 30% vaccination rates).

On the other hand: Arkansas has a 35% vaccination rate and is already spiking. There are large swaths of this country which have straight up refused to get vaccinated and they're about to get what's coming for them...

The "Delta" storm has arrived on our shores. We've got one last good push (since it takes over a month to get vaccinated) before the Delta wave washes over our country. Its basically inevitable at this point (not even 70% or 80% vaccination rates will prevent the Delta-based pandemic), but we can at least vaccinate as many as possible to help mitigate the damage.

> As someone who lives in New York and has been vaccinated for months, should I worry about this? It seems like the answer to that question is no, I shouldn't.

The unfettered spread of variants in unvaccinated populations risks the rise of one that can evade your vaccine (https://science.sciencemag.org/content/371/6527/329). In areas where a variant is spreading rapidly, it might not be a bad idea to voluntarily mask in indoor crowds.

Content like this that fails to incorporate demographics as natural immunity goes in the “alarmist” bucket for me at this stage. We know the vaccines work against delta. If you are in a developed country and wanted a vaccine you have gotten one. The delta so far does not harm the young in any meaningful enough way to change our calculus around children.

The thing we ought to be worried about is what happens if a new variant pops up that hurts kids. I’d like to see analysis from a virologist on the odds of this happening given selective pressures.

The article ststes that there were 2M Covid deaths in India. Stats I saw yesterday said 400k. By comparison, the USA had 600k

The actual numbers in India are alleged to be an order of magnitude higher than the official numbers. There have been articles like [1] trying to estimate the actual numbers. The OP is likewise citing an article that's saying actual numbers are six times higher. I do not have access to the cited article to say more.

[1] https://www.nytimes.com/interactive/2021/05/25/world/asia/in...

The official Indian death numbers are a vast undercount by most accounts.

I believe he's referring to excess deaths.

Multiple sites seem to back you up. Example: https://covid19.who.int/region/searo/country/in

One question I hope some HNer can help me with, that I'm not seeing answered: How is _testing_ affected by these variants? This is relevant to me as I've had symptoms but tested negative with BinaxNow, and now have to decide on some activities.

the one thing I wanted to know "is aquired immunity from other strains effective against delta" isn't mentioned or discussed. perhaps the door knockers will have the answers I need.

I'm not sure what the end game is here. The original plan was "flatten the curve", which meant keep hospitals from getting inundated. Then it became wait for the vaccine. COVID is not going to go away. The vaccine has dramatically decreased the amount of people dying from it.

Cases going up without dramatic increases in death or hospitalization might not be a bad thing. The alternative is lockdowns that will never completely end the virus, and have a significant impact on our lives. It will just slow the spread over a very long time. There are ever present dangers that we just live with like the chances of getting in a car accident and dying, but we decide that these risks are low enough that we carry on normal life.

'There are ever present dangers that we just live with like the chances of getting in a car accident and dying'

Have you not noticed how we have put a lot of time, effort and money into increasing the safety of road travel? Do you just 'live with' the chance of dying in a car crash, or do you have technology like seat belts and air bags?

Yes and we put a lot of time into making a vaccine. What if I said too many people are dying of car accidents, and they can almost all be completely prevented by lowering speed limits to walking speed. We live with the risk because it is low enough and making everyone travel at extremely low speeds would have a very adverse effect on the economy and quality of life. Safety improvements have been implemented that have not had a very onerous impact on life like having an airbag and seatbelt. And they allow us to drive at reasonable speeds with a reasonable level of safety. But still 40k people a year die in the USA.

So if technology produces ways to make living with COVID less onerous and safer then why not? It is easy for us as mostly tech people to be like yeah lock that down forever. I am still getting paid full pay working from home, and my packages still come to the door. But for a lot of people it is a very large cost to pay. And eventually we will not be able to keep printing money out of it. People need to work and live.

And not like it should matter but I live in NY where we saw one of the worst spikes of death, am fully vaccinated, had a relative die of COVID, and know others that have. I also posted this early on https://news.ycombinator.com/item?id=22406702 So it isn't like I am nonchalant about the virus. It is just that there is a balance.

> There are ever present dangers that we just live with like the chances of getting in a car accident and dying, but we decide that these risks are low enough that we carry on normal life.

Because there are no other (tenable) options for car accidents. If there was a vaccine you could take that would prevent you from being harmed in a car accident, and it was cheap (free even) and available, the expectations around car accidents would be quite a bit different.

I've actually wrestled with this exact analogy as a way to measure the risks myself. There are options for car accidents - a "vaccine" you can take as it were. Wear a seatbelt. I think it's a good analogy. Some people don't like to wear them, but in general those that do are at lower risk and accept the remaining risk that they hurt or maim themselves or others - even children and elderly. Those that don't are at higher risk. The question I wrestle with is if vaccines are the seatbelt or masks or both.

In the end, that's what all the drama is: how we measure risk vs reward (perceived or actual) and handle it as individuals or society. Since this is a new and evolving risk, we struggle to put it into place relative to other "known" risks like traffic accidents, smoking, unhealthy eating, etc.

I think masks are the better analogy to seatbelts. It reduces your risk of injury and death, protects the other occupants in the vehicle (from your flying body), but only to a certain extent and offer no protection in various scenarios. In general its difficult to find a good analogy for vaccine's anywhere because they are a nearly miraculous tool. I think you are right about the unknown risk, but a subset of the drama is certainly a rejection of things like masks and vaccines given they are low effort / low risk / high reward vs an unknown level of risk (mutating virus).

I don't believe I advocated for people not getting vaccinated. I am saying should we keep having "lockdowns"? I do think having lockdowns perpetually is not a tenable option when there is no end in sight. Vaccines when compared to cars are the seatbelt equivalent. They do not cause economic and social harm, and save a lot of lives. People should indeed get vaccinated and most are.

Lockdowns are equivalent to restricting automobile travel or lowering speed to a extremely low limit. Sure they would be fine if there were a blizzard and lots of people were crashing. All one can do is wait for the snow to melt and then it would only be a temporary disruption.

But in the case of lockdowns there's no chance they are going to end the spread of COVID, they just slow it at best. And they have a very large cost, and it has been a long time. It would be as if the temporary restrictions to save lives during the blizzard were persisted when an ice age occurred.

Lockdowns aren't meant to end the spread of COVID, only to limit it until people can get vaccinated. Vaccine's are the end game. As discussed in the article, if people aren't willing to get vaccinated and gov't unwilling to force, then letting it spread (not lockdowns) is the other option. Assuming people want to get vaccinated in places where the vaccine is not yet abundant (most countries), then lockdown's until supply rises could make sense. Nobody is advocating for permanent lockdowns with no end game. The more general concern of Delta (or any variant) is that the existing vaccine won't work against it, and / or the continued spread will lead to _more_ variants. Its unfortunately an artifical problem in the US, since there's plenty of vaccine supply.

My question is why don't we have treatment? Yes we know vaccines are good as preventative but we also know that vaccines are vulnerable to mutations and waning efficacy over time. It's also somewhat burdensome to need to vaccinate all people all the time. Where is the research into effective treatments and why do we seem to prefer mass vaccination over acute treatments for the sick. Is it just much more difficult to formulate effective treatments or is the influence of capitalism pushing toward the solution that has the most customers and is the most profitable?

We have been, it’s just not published as much in the newspapers because it is niche medicine effective in the hospital setting. There are a few proven treatments that can be given early (antibody therapy) and a large host of treatments being studied.

If you google “nih covid treatment guidelines” you can read the official US 355 page pdf of the current treatments with summaries and more in depth.

Overall mortality in the hospital has improved quite a bit, by my estimate from ~10-15% to 5-10%, which may not seem like much but is 50% improvement in about one year! (Edit: I want make sure I point out that this is from a US medium sized city hospital viewpoint, there are biases in my view).

Apart from Hepatitis C, I don't know any viruses that can be cured other than waiting it out for the immune system to take care of it. Maybe that are more cases like that but I don't know of more.

So maybe it's hard to get rid of viruses? As an uneducated person in this subject, it looks that way to me.

No. We don't cure viruses, we cure diseases. A disease like COVID-19 is launched by the virus and some antivirals may be found to be effective in slowing down/stopping replication.

The severe cases of COVID-19 after a week have usually very little virus replication and the disease is about tissue inflammation, organ damage and immune system disorder. There are some treatment protocols for these and they are evolving.

In general, anti-viral treatments don't work very well. Antibiotics have worked great, but it's much harder to effectively target viruses with medicine (probably because they reproduce inside the cells of their hosts)

The short and unsatisfying answer is - Because the funding for infectious disease research has been shrinking for decades. The focus shifted to cancer and lifestyle diseases in the developed world which generate more income.

'move fast and break things' is not applicable when it comes to the human body. :)

Anti viral treatments are really hard to come across, it’s not like the world hasn’t been testing everything we could think of to use as a treatment, it’s just that the vast majority of chemicals that we know of or think might work don’t. Truly effective medicines are rare, finding them quickly is rarer still. Vaccines are also vastly cheaper as an intervention that treatments, currently Phizer is selling one dose for $19.50, for remdesivir it’s more like $500 for one dose and one patient needs about 6 doses for a full course of treatment. So the economic incentives are very much in favor of coming up with new treatments, rather than vaccines. It’s just really hard to do.

There is a _tremendous_ amount of research into effective treatments (and many more non effective ones, including Hydroxychloroquine). For viruses, treatments not very effective and / or _very_ expensive. Comparatively, vaccines are cheap, highly effective, and extremely safe. _Mass_ vaccination is not just preventative, but curative in the sense that if enough people get vaccinated, the virus literally goes away.

We have gotten a lot better at treating COVID patients since the first couple of months, as we figure out which interventions work and which don't. Stuff like putting patients prone made a surprisingly large difference in the mortality rate.

Drugs like antivirals are "vulnerable to mutations and waning efficacy over time" just like vaccines are, and they're a lot harder to make.

Which one is harder to make?

Antivirals. We've very few effective ones on the market.

I will say that on the vaccine front the data provided by Israel seems to be the worst results of the bunch, and while we can't completely rule out their results there is a good chance it's an underestimate of efficacy. Here are some efficacy estimates against Delta from other sources:

https://twitter.com/EricTopol/status/1414254993536786433

Highlights are (symtoms/hospitilization):

- Phizer: 79-88%/96%

- Moderna (one dose, not much data): 72%/96%

- Astra: 60-67%/92%

Are you aware of any results for the J&J shot? That's the one I got but it always seems to be left out.

Here you go, straight from the horses mouth. Take that as you will.

"A preprint submitted by the Company today to bioRxiv contains a new analysis from blood samples obtained from a subset of participants (n=8) in the Phase 3 ENSEMBLE study. These data showed that the Johnson & Johnson single-shot COVID-19 vaccine elicited neutralizing antibody activity against the Delta variant at an even higher level than what was recently observed for the Beta (B.1.351) variant in South Africa where high efficacy against severe/critical disease was demonstrated."

https://www.jnj.com/positive-new-data-for-johnson-johnson-si...

n=8?!? That's... um... nice for those eight people, I guess. It's sure not much to draw conclusions from, though.

(I also got J&J, so I hope they're right. But the sample size makes this little better than anecdote.)

Ain't that the truth. I opted for the J&J almost solely because the media & government strongly suggested it would be the "primary" vaccine going forward; given it only required one dose, scale-up would be easier, easier to transport, more people would end up with it, and thus I figure it would receive the largest scientific scrutiny for positive and negative side-effects going forward.

Far from it. Those of us who got it now feel like the weird step-children of the COVID pandemic, constantly left out of headlines and media. Though, I guess at least, it can very rarely cause an extremely dangerous nerve condition, so we got that going for us which is nice.

> I don’t think people are paying enough attention to Delta

In the US probably. In Europe Delta has been followed closely even in mainstream media for at least a month.

In the US the Delta variant has been in the news non-stop for months.

Once the vaccines began bringing the pandemic under control here, the Delta variant as the new big risk is what the news media began focusing on heavily. That began shortly after case counts exploded dramatically higher in India and gained coverage the further it spread around the globe.

The Netherlands has a decent vaccination rate (38.5% fully vaccinated, something like 66% has received their first shot). The delta variant is wreaking havoc here. The number of cases went from 500 to 10 000 in 3 weeks... Yes this coincided with very poor decision making on the government side (deciding to open all clubs/bars for people who had a negative tests), but still something to be taken serious.

So far the # of hospitalizations have stayed low, but if the delta variant continues to spread through groups of people who have been reluctant to vaccinate, this might change.

> wreaking havoc

> the # of hospitalizations have stayed low

Who shall I believe?

And doesn't the delta variant break through the first shot immunity (after a few weeks) but 2nd dose provides durable immunity.

And parts of the use (including my county) have >70% of 2 doses. (parts of) the US are in a completely different place vaccine wise compared to most of europe.

I recognize that the Delta variant is serious topic for much of the world, but as a vaccinated person in the US it feels more like media hysteria than anything else.

As the article states, for vaccinated people, the risk is low and the Delta variant is likely of little concern, especially when cases are as low as they've been since the start of the pandemic here in the US. However, it seems that the media is pushing the Delta variant as a narrative to help get people vaccinated but it's all falling on deaf ears of those who are specifically choosing not to get vaccinated. The stronger media coverage winds up making those who are vaccinated overly concerned about it, when they as protected as they will be from the variant.

For the unvaccinated countries and people, the Delta variant is definitely something to be concerned about. What we should be doing is trying to get vaccines rolled out to as many countries and people as possible, as that's our best tool for getting things under control.

As a vaccinated person - the risk of dying is quite low. That isn't the only criteria i use to decide if something should concern me.

The difference between 95% protective and 88% is more significant than you think if you live in a low vaccinated area. The more exposure to the virus you have the more likely it is you will get infected. It’s the spread we need to concern ourselves with, not just personal protection.

Can't everybody get vaccinated in the US unlike the EU where you have to wait for your turn and can't buy vaccines? That would explain the difference

In the EU for major countries you can get vaccinated any time, it's the same reasons as in the US some people just don't want to.

It's a bit more complicated. In France vaccination has only been open to everyone one month ago, (and those people − including me − only had one dose so far) and in the UK the waiting time between the first and second dose is roughly twice higher than in most countries, which means there's still a significant fraction of the population that just can't get fully vaccinated yet (my brother must wait another month before getting his second shot).

Some regions fast forwarded the government given the prevalent hesitancy among vulnerable populations.

Here it was open to everyone 2 months ago.

I've been able to book a time for vaccination for weeks now but the first free time wasn't until the end of July.

We're also about 7.75% ahead of the US when it comes to the percentage of the total population who has gotten their first dose, with the trend still being upwards. So I'd say that the problem isn't really willingness.

What major countries? I live in Spain and in most regions people under 30 still can't get vaccinated.

According to a few news sources, those in their twenties can now get vaccinated in Catalonia, Canary Islands, Castilla-La Mancha, Baleares/Navarra, and Madrid.

I don't know how accurate that is. It may depend on where/how you book the vaccine. I'm in my 40s and live in Madrid, and only got my first dose last week in the local health center rather than a large vaccine hub, because it hasn't been very well advertised. I assumed I still wasn't eligible.

You should just try booking a vaccine, worst that can happen is the system won't let you.

Right now in Germany vaccines are available in abundance, just today Berlin opened a Drive-In Vaccination Center at a furniture store and at Vaccination Centers in Saxony appointments are not needed anymore [1].

[1] https://www.tagesschau.de/newsticker/liveblog-coronavirus-di...

The author links the following paper as a source for his comments: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3868853. Unless I'm reading it incorrectly, the mortality rate of the infected, unvaccinated population is 0.5% (131 / 26,632), and the mortality rate in the infected, vaccinated population is 2.5% (33 / 1,410). Does this mean that the vaccine decreases your chance of contracting the virus, but increases your chance of dying if you do contract it?

(Note: I understand that the overall death rate from the paper is 0.002% for vaccinated population and 0.012% for unvaccinated population.)

I read an explanation in another context, that sounded plausible: Mostly people with symptoms get tested, and the vaccines are quite good at preventing symptomatic illness. Thus the share of infected individuals not caught by tests is larger in the vaccinated population, which makes mortality among the vaccinated look worse than it is.

source https://www.ijpr.org/health-and-medicine/2021-05-13/no-the-d...

> Does this mean that the vaccine decreases your chance of contracting the virus

Yes.

> but increases your chance of dying if you do contract it?

No, I think not. Scroll down to table 3, page 14.

No one under 60 who was vaccinated and fell ill died. No one under 60 who was vaccinated was even hospitalized.

But even in the most at risk group, age 75+, vaccinations reduced mortality by a factor of 10.

I think it's safe to claim that "breakthrough infections are rare, the vaccine still provides a level of protection if one occurs, but when breakthroughs occur the elderly are at the most risk of death"

But recent UK data is telling us something different:

https://assets.publishing.service.gov.uk/government/uploads/...

Page 16-17

Delta infections:

Vaccinated with 2 doses - 10,834, died 118 (only 2 in below 50 age group). Unvaccinated - 71,932. I'll add half of those with "unknown" vaccination status, so the total is - 79,111, died 257 (26 in below 50 age group).

Mortality rate for vaccinated: 0.01089 Mortality rate for unvaccinated: 0.00324

So apparently vaccinated have a 3 times higher probability of a lethal outcome. Not exactly what you'd want to see.

I think you’d need to separate out the populations by age demographics to make that hypothesis because the vaccinated population could be skewed towards older people.

Good point. I just checked the paper, and it's true that the vaccinated population had proportionally more 60+ year olds (by about 3x).

As I read through this more, It's a bit surprising that out of 805,124 people (includes uninfected) under the age of 45, there were only 5 deaths. Haven't looked into the data for a long time.

I'm guessing that vaccinated people get tested at a much lower rate when they're feeling cold like symptoms, so the denominator there is probably significantly reduced.

”Now, with Delta, it looks like the figures are 64%, 93% and 93% according to Israel, and 79% for symptomatic infection and 96% hospitalization according to the UK.”

I doubt these will turn out to be correct numbers. Looking at recent week’s data in Israel possibly paints another picture (keep in mind while parsing the numbers that there are plentiful many more vaccinated in the population than not in the age groups that gets hospitalized): https://docs.google.com/spreadsheets/u/0/d/1kiOrQxOtBg0__IoL...

Nevertheless, it is clear that vaccination helps and is important, but I have doubts about 90+% protection from hospitalization.

There are some statistical concerns with how Israel came up with their numbers, so I would put more faith in other countries results, at least for now. My best guess is that the 64% is for any detectable disease, not symptoms (i.e. you test positive but don't feel meaningfully different), which means the vaccines do their job at quickly eliminating the virus.

The more important result is although Delta is resistant to being neutralized by existing antibodies, it does not prevent it in serum-trials against vaccinated individuals, the like most biological systems the human immune system is exponential: starting from an effective antibody response, it can overwhelm any nascent infection (i.e. hospitalizations would not be expected to rise).

The number I've seen is a 3-5 fold reduction in the kinetics of neutralization [1] - this is concerning for whether you can spread it, but seems to my eye pretty consistent with hospitalization effectiveness remaining about the same.

[1] https://www.nature.com/articles/s41586-021-03777-9

Maybe. But I was commenting on the real hospitalization numbers and implied vaccine protection from comparing the ratios 1) hospitilized vaccinated vs hospitilized non-vaccinated [the linked spear sheet] and 2) vaccinated in relevant age brackets vs non-vaccinated in relevant age brackets.

Isn't there a Delta Plus variant now?

There is. It's also known as B.1.617.2.1 or AY.1 here:

https://www.who.int/en/activities/tracking-SARS-CoV-2-varian...

The good news is that the differences relative to "original Delta" seem to be pretty slight.

Yes. Few cases. So far.

Hmm @dang this doesn't seem controversial, or shouldn't be. We should be curious about the details of a dangerous strain of a virus, and learn more about it. I'm not sure if this deserves to be "[flagged]" but perhaps I'm missing the bigger picture.

I think it gets that tag after some threshold of flags and then has to be revived.

>controversial

I would say there is some contention going on in this thread.

This is a complex problem. The original post seems to be a collection of facts and information about a thing. The thread should have some discussion about what to do with this information, but of course there has been politicization of issues like this (bizarrely, since I'm not sure who benefits from the disinformation!) But in this case, the flags have the effect of just hiding an informational article, which may be the desired effect if you believe it is politically disadvantageous for facts to be shared and discussed.

There's no way for me to say all that without being on a "side" even if I really do not wish to be, and for the moderators, the issue might be similar, though I suspect some can break down the issue with a clearer lens.

This is just how it works on HN. It's not the first time an informative article has been flagged and it won't be the last.

All kinds of articles get flagged. You have to check in on /newcomments to find interesting discussions.

The question is, if some people stop believing in computer science and flag basic programming articles, would that have the same effect on CS and Math articles like it did with biology and statistics?

To be more general: Do politicians really have the superpower to stop the spread of any information through polarization?

I don't see any of the degredation of discussion that usually justifies flagging articles.

Almost every top level comment is grayed out - that's a sign of controversy.

Why is this flagged?

Can we provide the data necessary for young men to take one of the mRNA vaccines for Covid-19?

The question. What percentage of men under 40 have had a cardiovascular event, specifically myocarditis, after taking the Phizer or Moderns shot?

Primary reason I haven't been vaccinated yet.

> What percentage of men under 40 have had a cardiovascular event, specifically myocarditis, after taking the Phizer or Moderns shot?

https://www.health.harvard.edu/blog/new-information-for-pare...

> Doing the math, the Centers for Disease Control and Prevention (CDC) notes that for every million doses given, there have been 67 cases of heart inflammation in boys 12 to 17 (nine in girls of that age group), 56 in those aged 18 to 24 (six in girls), and 20 in males 25 to 29 (three in girls).

It's not exactly "under 40", but if you're in that 25-29 age group, it's 0.002%. If you're in that higher-risk 12-17s group, 0.0067%.

I'm fairly comfortable rounding that down to 0% for my personal risk evaluations, especially given "majority of cases have been mild".

Thank you for providing numbers.

Here, try numbers from an actual study:

"Clot risk to 18-39s from AstraZeneca vaccine is twice as high as Covid death risk, Euro study finds" - https://www.irishexaminer.com/news/arid-40328123.html

Those are not the numbers requested, given mRNA vaccines was specifically asked for.

They asked specifically about Pfizer/Moderna and myocarditis. You've got the wrong vaccine and the wrong condition.

Ah, nothing says "credibility" like reiterating the good old burning covid-corpses of india lie, or removing India from your scary looking chart of new infections, because it would show India's steady drop in new infections.

Hopefuly Thomas gets a bit more convincing scaredata for the Lambda Variant.

Some counterpoint. A lot of the assertions, particularly the fact that delta is dramatically more transmissible than ancestral type, are reported as fact in the mainstream, but the evidence for this particular claim is thin. It certainly is true that delta is outcompeting the other strains. But inferring higher transmissibility from observational or ecological studies is not really sound. Most of the increases can be explained by human behavior - a third to a half of Americans are not fully vaccinated, and people are going out, not wearing masks, etc. Determining higher transmissibility in the virological sense is a difficult experiment and I don't think is really being done.

This is discussed in some detail in TWiV[777], a discussion with Ron Fouchier. If you use influenza as a model, the picture looks completely different - new strains are coming up all the time and outcompeting the older ones, but that's just because people have developed immunity to the older ones (antigenic drifts). The new ones are not fundamentally different or more transmissible. For people who don't want to listen to the whole thing, the main point is also made in a NYT opinion piece[2].

Pueyo claims that alpha is 60% more transmissible than ancestral type, but again the evidence doesn't strongly support this. Indeed, a preprint just came out[3] in which alpha looks pretty much identical to ancestral type when it comes to viral loads and clearance.

I've really enjoyed and appreciated Pueyo's writings. In particular, I think "The Hammer and the Dance" was groundbreaking and we could still learn the lessons from it. But I think this one is a miss: it could present real insight, but instead mostly propagates conventional thinking.

There's a really interesting science communication aspect to delta: it's basically a proxy for the (very true) statement, "the virus is still dangerous." In fact, one prominent evolutionary biologist accused the NYT op-ed of verging on "delta denialism". Accurately communicating reality in a way that is useful to people is fantastically hard, and we just don't have an ecosystem for it. I think this is the reason I've become addicted to TWiV and other similar highbrow sources - I hate being fed partial information and feel compelled to learn more.

[777]: https://www.microbe.tv/twiv/twiv-777/

[2]: https://www.nytimes.com/2021/06/27/opinion/covid-vaccine-var...

[3]: https://twitter.com/BallouxFrancois/status/14149092626571141...

The article itself leads with the conventional media thinking about Delta, but to me it almost feels like it's a hook to lure in both those who follow or doubt the conventional thinking in order to lead them to develop a better understanding of the actual risks. I very much agree with you about the transmissibility. It's probably not much more transmissible but still enough to out-compete other variants, but there's a lot of other factors that greatly amplify the effective transmission rate. It's interesting the correlation between where the new variants spread and what type of vaccines were deployed there. Immunity against certain variants from past infection and vaccination is going to put pressure on variants to develop in a certain way. We'll probably soon see variants that are more transmissible against the Pfizer vaccine.

The evidence cited in the article is not just looking at prevalence graphs, it is a study that looks at within household transmission rates and thus public social distancing and mask wearing would have no effect.

And your [3] source explicitly warns against using their findings to compare infectiousness.

> I don't believe 'infectiousness" is necessarily the ideal term here. B.1.1.7 (Alpha) could be intrinsically more 'infectious' than previous 'non-variant' lineages in circulation (e.g. higher risk of initiating an infection with the same infectious dose of virions). 4/

Let me speak to the second criticism (I'm not sure I fully understand the first one). The quote in context from the paper is:

"there is no significant difference between B.1.1.7 and non-B.1.1.7 viruses in total infectiousness predicted by our model"

But "predicted by our model" is doing considerable work here, as the model doesn't take into account potential differences in what happens after someone is exposed to the virus, only what's measured in the study (viral shedding dynamics). So I think the critique of Prof Balloux is worth heeding: it would be a leap to conclude that alpha is definitely not more "infectious" than ancestral type when you take into account the broader meaning of "infectious." Even so, to my mind that places even more burden on demonstrating a biological mechanism.

It also refutes a major claim in TFA and calls into question the methodology used to support that claim: "In China, they estimated the viral load of Delta to be 1,000 times higher than that of the original variant." But when you look at viral load specifically, as is done in the Ke et al paper, you find no difference at all. A few things could be going wrong here, but my money would be on some problem in how that 1000 factor was "estimated."

Then don't extrapolate viral load to transmissibility like you did in your original comment. Stick to refuting the specific claims that you actually have evidence to address.

If you don't understand my summary of the first point, then read the source the article cited for the claim that delta is 60% more transmissible:

https://khub.net/documents/135939561/405676950/Increased+Hou...

Thanks for that citation. It is indeed among the strongest evidence for increased transmission. My point is that it is observational rather than biological evidence, which is not the same, and when you do observational studies, there can be many confounders.

Why did this get flagged? This is an important article that probably will change an unvaccinated individuals mind.

The author has no credentials in this area.

I've a feeling at the end of the day the only solution will be to scale up the number of medical facilities/personnel/equipment so we can cope with changing and mutating virus. With sufficient care, access to oxygen etc, we may still be able to handle the onslaught of new variants. Vaccines, while very important, will not be a magic bullet unless we can get them to enough people fast enough. This still remains a problem.

Medical facilities already take up a considerable fraction of total productivity. Vaccine production on the other hand is a tiny footnote in the grand scheme of things.

Vaccine output could be increased tenfold or more for less effort then it would take to increase medical facilities by only a few percentage points. It's a comparison like getting a second TV for seeing more frames per second vs trying to do the same by commissioning more oil paintings (from a really bad painter)

This is true for rich nations. In many poorer nations simple improvements to the healthcare system are far more realistic than creation of a new vaccine plant. mRNA vaccines are currently only produced by very few manufacturers, getting these vaccines to poorer nations is just not happening. In the mean time the vaccine will continue to mutate in these nations. The fact is many poorer nations lack basic equipment like oxygen generation units. This basically spells death for people who would otherwise recover. To put an example. Singapore has had 62K infections but only 32 deaths. Why? Its a small very rich nation. While there were large numbers warded in icu and requiring oxygen supplies, we had the equipment. By contrast anywhere else on earth we see far poorer survival rates.

FWIW, I’ve been fully vaccinated (Moderna) since March. I was just in Provincetown, MA for the usual yearly 4th of July celebration with 10K other gay men, and Delta ripped through everyone. I got breakthrough COVID, which I assume is Delta because the symptoms were much more like the common cold than classic COVID. I probably know ~150 people in that group, and at least 14 people I know got breakthrough COVID. Meanwhile back here in LA I found another 5 people (trainers and members) in my very small, outdoor gym got breakthrough COVID. Everyone I know is fine health wise, no hospitalizations, and it was more annoying than anything, but it does indicate anecdotally that Delta is not going to go well.

Does anyone, really, consider Pueyo relevant regarding Covid? My understanding is that he, a marketing expert, came up with hammer and dance which was used to push lockdown agenda. Lockdown did not greatly help reduxe cocid deaths and it introduced a lot of other problems such as delayed cancer diagnostics, mental health issues, compromised immunity in small children etc. This guy is a danger to public health.

Why the heck have we still banned children from getting the vaccine? This article doesn't address this 1 time, and this is IMO the most important issue related to covid today.

Quite frankly, I don't care if anti-vaxers get COVID (there is some nuance to this, but basically true).

There is only 1 large group in the US that is banned entirely getting a vaccine, and that is children. We need to find a way to un-ban this thing now. Vaccines are safe & effective.

Just let doctors and parents make their own decisions about giving children vaccines. I have 3 children, 6, 5, and 2. Covid is about half as dangerous as drowning for them. Sure, that isn't a ton, and not as much as the elderly, but I worry about them drowning! I would give all of them a smaller dose right now without hesitation. But I can't have that option, because the government has banned it.

We keep making the same mistake. "Lets ban vaccines for a long time, run tests, and let people die so that people have confidence in the vaccines." Then, here we are, with like half the country turned anti-vaxer. Banning vaccines is a complete and utter disaster from a policy perspective.

I see the article is well written. The problem is developed countries are doing nothing significant. They think if they vaccinate their population they are good. And they are supplying only some excess vaccines to developing countries which is like drop in bucket. And they are stuck on patents, greediness and all of these thing. I don't think the country where I live will have vaccines till 2023 and people here are already tired of multiple lockdowns and masks...

>They think if they vaccinate their population they are good.

What else do they have to do?

The article states that Israel is still seeing 90%+ protection against hospitalizations and death for those who are vaccinated, while the Delta variant spreads there.

Vaccination has been the answer all along. You may still get symptomatic COVID but the likelihood of it putting you in the hospital, or worse, is greatly diminished.

The biggest issues in developed countries who have been able to vaccinate everyone willing to get vaccinated are:

1) People choosing not to get vaccinated 2) Children, who either can't get vaccinated, or parents are unsure if it's a good idea

#1 seems simple -- lockdown post-vaccine was pretty much a non-starter most places and there isn't much evidence with this Delta variant that this was a wrong decision. Those at-risk who can't get vaccinated need to isolate. Those who can get vaccinated and choose not to are accepting the risk. With the vaccine still protecting at 90%+, I don't even see the anti-vax folks causing much external effect outside of their population.

#2 is trickier. Vaccinating children feels much riskier to me and I've not decided if my own kids should get the shots or not. Given that COVID has shown to be minimally impactful for children compared to adults as well as compared to other viruses children commonly get, it seems mostly unnecessary. However, if Delta proves to be more dangerous for kids, those who feel vaccines are fine for adults but are doubtful for kids, will really need to rethink things.

I think the richer countries helping pay to vaccinate the world is a good and smart thing to do.

Help get the rest of the world vaccinated, too.

Doesn't seem like that's a good idea, since the supply of vaccines is not infinite.

This whole thing is about selling as many vaccines as possible. Actually fixing the problem does not create wealth for shareholders.

>greediness

You cal that greediness, I call it markets functioning well /s

Not sure why science/math minded people are buying into any COVID Fears. The death rates are 1 percent, and it particularly targets old and obese people.

I have no problem getting vaccinated and paying for n95 masks for old and obese people.

But COVID reminds me of post 9-11 terrorist fears. Statistically insignificant and gets people glued to TVs. Instead of the military industrial complex winning tax dollars, big pharma wins tax dollars.

I just want a science based approach to these pandemics, instead we got hysteria.

A 1% death rate (10,000 micromorts) may not be Russian roulette but it’s scary high by modern standards. Compare with skydiving (8 per jump) or giving birth (120 or 170 micromorts, depending).

https://en.m.wikipedia.org/wiki/Micromort

Can you re-run those numbers to eliminate obesity and old age? These groups can wear n95 masks and lockdown.

If they can't comply with those orders, it wouldn't help if the rest of the population complied either.

> Not sure why science/math minded people are buying into any COVID Fears.

It's a way to feel important and make money. Exposure, likes, quotes, clicks. People love audience.

Kudos to scientists/science presenters who keep their cool and present a balanced view of COVID-related information despite the widespread censorship and hit pieces. I can recommend dr. Mobeen Syed's YT channel, he's bringing in interesting guests (often doctors) where they discuss all new knowledge on COVID treatments, vaccines etc.

> Not sure why science/math minded people are buying into any COVID Fears.

Oh simple. They actually understand math.

UK gov's statistics shows "delta" variant results in next to no deaths.

Meditation is great for Anxiety.

With more than 87% of the adult population with 1 dose and more than 66% fully vaccinated.

Sure and there are people in this thread implying that that's not a relevant factor and places like the UK and US are going to be seeing massive deaths soon.

And nobody talks about the natural immunity aspect either. Even if it just blunts the severity of the symptoms, places like florida probably have had ~30% of their population infected. I'm going to guess the "bad" people who didn't wear masks, got infected, are mostly part of the non-vaccinated percentage of the population. They could be added to any vaccine percentages from a pandemic response perspective (with downsides of being less accurate count, presumably less consistent immune response ect...).

the delta is even less virulent then past variants. it's only marginally more lethal than the flu. long covid is a fuzzy excuse to prolong the panic culture.

According to Wikipedia, this variant was first detected in India, in late 2020.

If it's that much more infectious than other variants, where was it til now?

"If exponential growth is so fast, why did my two pennies only turn into four?"

It's been in the UK news for some time now.

In Mexico (where I live) we had the first Delta cases a couple of months ago. It is now the main variant and comprises 90% of sequenced samples (although Mexico doesn't sequence enough samples).

https://outbreak.info/location-reports?loc=MEX

Assuming this is actually a genuine question:

Here are the per country ratios of different VOC/VOI: https://covariants.org/per-country

It took a while until it became dominant in India, and then a similar pattern repeats in each new country.

In india.

Since most countries limit travel, it'll take longer to get around

You're being downvoted, but that's actually a good question. An explanation that fits the fact is antigenic drift. A variant that's different but not necessarily that much worse will outcompete another variant in which the population has built up significant immunity. The difference in fitness doesn't need to be that large.

If the virus truly had a massively larger R0 value, as is asserted in TFA, then you'd expect it to catch fire extremely quickly as soon as it starts showing up, and everywhere it is found. Ron Fouchier (see TWiV 777 as cited elsethread) certainly believes that these huge R0 values are not plausible, and that antigenic drift fits the observable facts better.

Its Wiki page shows where it has been since then; https://en.wikipedia.org/wiki/SARS-CoV-2_Delta_variant#Histo...

It's all over, and was all over the news early 2021 already. Not sure what you are talking about

(Or which kind of media you consume to come to that conclusion)

Covid (original version) took several months to spread around the world without something public health measures to slow it down. The Delta variant took about the same time despite the fact that significant portions have a degree of immunity from the vaccines or previous exposure, and much less international travel.

These new variants were to be expected as the vaccines seem to be accelerating these mutations.

My understanding is that the COVID vaccines train the body to recognize the outer protein layer of the virus. In consequence when that changes (because of mutations and natural selection) the body becomes less effective at recognizing the virus.

Geert Vanden Bossche[1] has been warning about this for months now. He says it's possible at some point a new variant will come out that makes current vaccines completely ineffective.

[1] https://twitter.com/GVDBossche

I don't understand VDBossche's assertions - he seems to say that there isn't a single case of population level benefit from vaccination campaigns. But we have seen massive benefit from mass vaccination against Polio, Smallpox, Measles, Mumps, Diptheria and many more. This is on a par with arguing that gravity doesn't make things fall down.

It's worth noting that Delta appears to have emerged in India when and where there was very little vaccination - on the other hand there were a truck load of infections. This is how mutations happen; many cases occur... a mutation may appear and if we are unlucky it may spread. The key part for me is the "many cases occur" part - if the pandemic is brought undercontrol in the sense of few cases happening then there will be less mutations.

Honestly I have no idea, but a new variant called Lambda originated in Peru which is a relatively small country with only 32M.

Lambda was detected in August 2020, vaccination in Peru started in Feb 2021.

https://www.dw.com/en/fact-check-what-do-we-know-about-the-c...

> The earliest documented COVID-19 case caused by the delta variant (B.1.617.2) was found in the Indian state of Maharashtra back in October 2020

It doesn't seem that blaming this variant on vaccines makes much sense.

As far as I understand (I don't have any background in biology), mutations will happen regardless of whether people are vaccinated or not. There might be mutations that make the virus circumvent some vaccine protections, but those mutations would take place even if we weren't vaccinating people. Nothing about the vaccines "guides" the virus towards specific mutations. Mutations are random. If this is correct, why would not vaccinating people be better than vaccinating them? (In fact, the fewer people that get infected, the less room for the virus to mutate).

Is my understanding correct? Can anybody point out where I'm wrong?

Mutations are random, but the factors that result in a mutation leading to improved reproductive success are not. An organisms environment helps select for beneficial mutations.

I get that. I just don't see why an environment where half the people are vaccinated would lead to worse outcomes, even if mutations take place that can bypass the vaccine's protections.

It's not so much that vaccination is iatrogenic, it's that when you have a sizable percent vaccinated, but a sizable percent not, you're kind of in this worst of all possible worlds from an evolutionary standpoint.

If worldwide vaccination rates were very high, it would drive viral transmission down to negligible levels and effectively slow the rate of evolution by decreasing the viral population size to something very small.

If there were no vaccine, we'd be back where we were, but there would be no vaccine to evolve against as a selection pressure.

When you have, say, 50% vaccination, you have a sizable population to evolve in, and the vaccine as a pressure selecting random mutations.

If the vaccine is very effective in preventing asymptomatic transmission as well as symptomatic infection, it might not be such an issue. This might be why the delta variant seems to not be doing much in vaccinated individuals. But it seems vaccinated individuals do still transmit the virus asymptomatically at some nonnegligble rate, and then you have a sizable nonvaccinated population.

What I'm worried about now isn't so much the current state of the delta variant, it's where things are headed. Specifically, how this evolves in (1) the unvaccinated populations, and (2) what the future might hold for vaccine resistance in the future.

It's one reason I'm sort of angry with the FDA for playing this power game about approving a booster vaccine. It's not their job to evaluate the need for the booster, it's their job to evaluate the safety and efficacy of it. By the time they change their minds about need, it might be too late.

> It's not so much that vaccination is iatrogenic, it's that when you have a sizable percent vaccinated, but a sizable percent not, you're kind of in this worst of all possible worlds from an evolutionary standpoint.

How is this any different from natural immunity? The immunity conferred by vaccines won't put any more selective pressure for escape mutations than natural immunity would. And the only alternative here is for no one to get vaccinated, and therefore letting the virus run rampant through the population indefinitely. You aren't wrong about a sizeable portion of the population not being immunized quick enough may possibly result in escape mutations. But the only possible alternative fixes none of those issues, while also leaving the entirety of the public at risk.

It depends if the vaccine is sterilizing (destroys the virus) or leaky (symptoms are prevented but virus is not destroyed).

Leaky vaccines do change evolutionary pressure and increase the likelihood of escape variants.

For a case study in the worst case outcomes of leaky vaccines, see Marek's disease [1].

It seems like the mRNA vaccines are at least partially leaky, so there have been concerns raised and alarms sounded by researchers.

[1] https://en.wikipedia.org/wiki/Marek%27s_disease

If the argument is "we shouldn't use vaccines because of escape variants" then I don't see why we should fear escape variants more than we do any other kind of variants.

If the argument is "we should build up a big inventory of vaccines and infrastructure to deploy them to the population in a very short timespan" then I see some logic to that but it's not at all obvious that the math works out.

You are correct. Mutations are random. The only even remotely valid point made by those fearing vaccination effects is that vaccines may cause selective pressure where the random mutatations that escape vaccine-induced immunity become more dominant. But even that point doesn't mean vaccines shouldn't be employed because

1. The same selective pressure exists for natural immunity 2. The implication is that we shouldn't get vaccines, because we may get variants that get around our vaccines. This is like asking the fire department not to put our a raging house fire because it might cause water damage to the home.

Its also worth noting that none of the major variants observed so far came about after vaccines began being used on the population at large, and the above point about selective pressure at vaccine immunity is only an issue when large swaths of people aren't getting vaccinated, allowing the virus a large number of "shots on goal" to mutate in a way that eventually provides escape capabilities.

There is absolutely no logic to these arguments about vaccines causing mutations.

As far as I understand, and I don't understand much. Also I am not endorsing vanden Bossche because I don't understand much. Furthermore, just as everyone else, he is just trying to sell his vaccine over others'.

The issue is selective pressure. Yes, the virus will mutate. But under an mRNA vaccine, only the spike protein needs to mutate for the vaccine to be render useless. In other words: mutating the spike protein will give the virus access to very broad unimmunized population.

Up to that it makes perfect sense to me and my limited evolutionary knowledge. I can't tell wether is right or wrong. But it makes sense.

He goes further saying that antibodies from vaccines are more affine to the virus, even with mutated spike protein, this compromises the natural immune system, given it will try to fight off infection with useless vaccine-learnt antibodies rather than with natural antibodies. This will make the virus more deadly.

This seems off to me. I can't see the logic, but I will be happy to be corrected. How can something be ignored by the virus and be more affine to it?

Again, he says that all these issues are solved with his vaccine, once he finishes it.

> The issue is selective pressure. Yes, the virus will mutate. But under an mRNA vaccine, only the spike protein needs to mutate for the vaccine to be render useless. In other words: mutating the spike protein will give the virus access to very broad unimmunized population.

> Up to that it makes perfect sense to me and my limited evolutionary knowledge. I can't tell wether is right or wrong. But it makes sense.

The issue with this is that the spike protein has to mutate enough for vaccine induced immunity to fail to recognize it, but the spike protein is critical for the virus actually entering and infecting cells, and therefore there isn't a whole lot of mutating it can do while remaining functional.

On the other hand, there is some evidence that vaccines targeting more than just the spike protein (as well as natural immunity) may potentially be more at risk for the "antigenic sin" trap, in which the immune system fails to respond to mutated versions of a virus as well as it does to the original version it encountered.

>It looks like the risk of death is 2x higher for Delta than for the original variant:

2x of what ?

2x of low risk is still a low risk.

You literally quoted the answer to your question

The author mentioned the risk is 2x higher but what is the risk of the original variant itself ? The author didn't mention that.

The author spends a section on that, including a chart. Search for this passsage to see the chart:

The IFR (Infected Fatality Rate4) for the original variant was about 0.01% for those in their 20s and 0.2% for those in their 40s.

Direct link to the chart https://cdn.substack.com/image/fetch/f_auto,q_auto:good,fl_p...

Haven't read the piece but I have read a few things by this guy that made me panic. I don't know if he was right or wrong but he has a tendency to be overly bleak. Yes Covid kills, a lot. Also car accidents and air pollution kill a lot. I haven't gained anything from reading this guy despite all the good info, it hasn't given me any action items and I suspect a politician reading him won't gain anything either.

Why would anyone ever compare an exponentially spreading infectious disease with car accidents? They aren't even in the same realm of concern for public health.

And it's not like we've been passive about car accidents either. Billions have been spent worldwide on car equipment (seat belts, air bags, crush zones, …), road safety campaigns, traffic signs and road junctions. And it came with strict laws enforcement: there are thousands of people in jail right now for road-related felonies and crimes.

Why should we do nothing about Covid given that so much was done in car accidents?

Calling disease spread exponential is dishonest. It’s exponential for a time, but there is an upper limit (which is dictated by a ton of complex variables).

It's not dishonest if it's literally true, as you already admitted. This is like saying "it's dishonest to say drinking water is essential for health when obviously you'll die if someone sticks a hose down your throat and forces you to drink until you die".

I am saying I am not sure the amount of panic was proportional to the amount of actual deaths.

> At least 30.7% of deaths in India can be attributed to air pollution from fossil fuels--that means about 2.5 million people die every year after breathing toxic air.9

I mean who cares, all I know is how many Covid deaths they are having, probably Indian people themselves are much more aware of Covid than Air pollution. Why? Mostly because Covid is still new and pollution is old and boring.

Immediacy and individual actionability are also important factors in the difference between people's reaction to those two situations. COVID can kill you within days and you can wear a mask today to do something about it. Pollution might take 20 years and if you don't emit any pollution there's a billion other people around you that will.

"There's nothing I can do about it" is what many might say.

Because your parents aren't dying from air pollution tomorrow, but they might from COVID. And the vaccine can stop it, and there's a race between DELTA and the vaccine for your parents lives. The story is a bit different in the US, where its more about people not wanting to take it, and an often cited reason is that the virus is going way whether or not that get vaccinated (because other people are). If that story changes, then their reasoning is no longer valid.

‘Haven’t read the piece’

I have read two long articles by him, each around 1 hour read. So I have a good sense of what his writing is about.

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