Breakthrough Cases May Be a Bigger Problem Than You’ve Been Told | Hacker News Reader

Breakthrough Cases May Be a Bigger Problem Than You’ve Been Told

nymag.com

19 pointsdbroockman58 comments

If the jab mitigates the symptoms but the (unaware) carrier can still transmit the virus to others, then doesn't that help the virus? It doesn't stop it, it gives it cover, a disguise.

similar to how in 2020, the asymptomatic persons were more risky (they wouldn't know they have the virus, and so spread more compared to symptomatic people who would take precautions); next the vaccinated people might be in the same category. once again comes to the spot: more vaccine coverage is needed.

Let's be real: what helps the virus is politicians (actually commercial landlords, the politicians are just the mouthpiece) wanting to go back to normal. Proper public messaging would insist on continued social distancing instead of going back to schools and offices in the fall.

Yes. The economic aspect has figured into calculations but there’s been no transparency around that fact. The news media are the worst in this regard. For those of us with very high risk loved ones who refuse to accept any facts that aren’t broadcast in full force through the usual dumbed down news outlets which I won’t name directly, it’s been a horrifyingly stressful month.

the usual dumbed down news outlets

You mean NPR where recently Atul Gawande was calling the pandemic a "pandemic of the unvaccinated" and urged everyone to take the vaccine?

He's right in a way, being vaccinated keeps you out of hospital, but it won't prevent you that much from catching the disease and developing post-covid syndrome. And you can still spread the virus in your community.

> He's right in a way, being vaccinated keeps you out of hospital, but it won't prevent you that much from catching the disease and developing post-covid syndrome

This is misinformation.

From the data we have available, vaccination prevents at least 80% of symptomatic infections with the Delta variant.

To characterize an 80% reduction in risk as “not that much” is simply trying to get people to give up on vaccines.

You see papers claiming an effectiveness against symptomatic infection against Delta of ~ 50 %, and the rise of cases in Israel as well as the Provincetown outbreak should really make us concerned.

The vaccine still prevents hospitalization and death, so that's reason enough to take it. But on its own it isn't enough to get R_0 below 1. The way everyone is behaving, they are asking for outbreak after outbreak.

Yes, it’s at 47% now if I’m up to date.

Wasn't it up around 75% in Providence RI? Yes, an outlier but it's indicative of the potential.

Guess it’s 42% for Pfizer according to this preprint.[1] That’s July, so presumably even lower now. I thought I saw 47% somewhere more official but can’t find it now.

[1]https://www.medrxiv.org/content/10.1101/2021.08.06.21261707v...

“ However, in July, the effectiveness against infection was considerably lower for mRNA-1273 (76%, 95% CI: 58-87%) with an even more pronounced reduction in effectiveness for BNT162b2 (42%, 95% CI: 13-62%).”

"Pandemic of the unvaxinated" should be relabled "Pandemic of the non-existent leadership." You don't get someone on board by marginalizing and alienating them.

Not naming names, but it’s easy to be left with the impression that if you are vaccinated and wear a mask, and your social circle are all vaccinated, that there is negligible risk. The media as a whole have not done much to rectify this false impression though they’ve chosen their words carefully to avoid being responsible for such misunderstandings. It’s frustrating to say the least. Reminds me of “Oceania has always been at war with Eastasia.”

Sweden "went back to normal" a long time ago. Their Covid deaths rate is near zero. The "it's bad so we need to x" reflex, where x is any of masking mandates, social distancing, or especially take kids out of school, is anti-science and anti-human.

Didn't Sweden have a lot more deaths than their neighbours?

Small price to pay for herd immunity and normalcy, if it actually worked.

Spoken like someone who didn't die.

Also ghoulish beyond belief.

So far 99.86% of Swedes didn't die of COVID-19.

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

How many have permanently reduced lung function, vascular disease or are living with long covid?

The death rate isn't the only metric, especially now with the vaccine.

What do you count as a neighbor? Sweden is 39th in the world by per capita death rate. Many other European countries have higher death rates, including some countries that took more extensive pandemic control measures.

https://www.worldometers.info/coronavirus/#countries

White exurban Atlanta (Randolph County) went back to normal as well, and now they are closing school because of a covid outbreak. I guess there isn't yet enough Delta variant in Sweden to make a difference. That, or the Swedish practice adequate mitigation (social distancing and masking).

I think you probably meant Cobb County, GA.

Randolph County, GA is farther away from Atlanta (~170 miles) than Chattanooga, TN (~120 miles). And as of 2010, Randolph County, GA was 61.8% black.

You are probably right. I mean the one near Marietta.

I'm living in Sweden right now (US citizen). We wear masks. I've been working from home at my employer's request for over a year now. Office buildings are pretty empty, restaurants are still mostly depending on takeout revenue. Our vaccination rate is higher than in the US, and we're still being sensibly cautious to prevent another wave. Sweden isn't the free-for-all zone you've been led to believe.

I was there at the end of 2020. Almost no one wore masks in Stockholm, even coming out of the subway less than 1%.

Things are not normal in Sweden.

https://www.thelocal.se/20210812/in-numbers-covid-19-cases-c...

You can't seriously expect people to continue social distancing. The virus is here to stay. It can't be eradicated because the vaccines aren't fully sterilizing and there are also animal hosts. The vast majority of us will eventually get infected regardless of what infection control measures we take. We'll just have to accept the risk and move on. Fortunately the vaccines are very safe and highly effective at preventing deaths.

It's not that hard to go outside to cafes and still social distance - but people are not doing it. That's the difference.

It's sad how some HN users seem to live in bubbles and are just completely disconnected from the way that most regular people live. Humans are social animals and most won't continue social distancing regardless of the consequences. There's more to life than cafes. Most of us don't even have an outdoor cafe nearby. Also weather is a thing.

You're welcome to complain that this is terrible and it shouldn't be that way. But at some point we have to put aside wishful thinking and exist in the real world.

Sure, base your entire argument on knowing absolutely nothing about me. You can still go to your climbing gym and climb and socialize without sitting 2 feet apart from all your friends. Like we used to do during the pandemic. But people are choosing not to do so now. There's more to life than HN usernames.

Welcome to the actual real world. Where you will eventually have to take responsibility for your choices despite your deep denial that your choosing to ignore social distancing is actually a subconscious reaction to feeling a lack of control or something and an intentional refusal to distance. That's why you politicize it.

I agree. I have both Moderna doses and finished 13 weeks ago. I just came out of isolation after contracting Delta 12 days ago. It felt like a head cold and was done in 3 days.

But the local health board said that my vaxxed family members were free to leave the house and go in public right away as long as they didn't have symptoms.

But you're also possibly contagious for 24-48 hours before symptoms. The logic here is really confusing.

The conflicting information derives from political decision making, not scientific reason. Not confusing at all from that perspective.

> If the jab mitigates the symptoms but the (unaware) carrier can still transmit the virus to others, then doesn't that help the virus?

You have assumed that "can" means "will do so at the same rate"

Which is not true. So, no, it does not help the virus.

Same question here: https://news.ycombinator.com/item?id=28151989

Is there any way to use this information to better protect one's self?

In terms of self protection nothing has changed. Get vaccinated if you haven't done so yet. If you have any treatable co-morbid risk factor conditions such as obesity or hypovitaminosis D then take steps to resolve those.

Everybody should get vaccinated and then get it now. The current Delta is close enough to the OG version that your body can crush it and then get a stronger immunity towards the future lineage of the virus.

If you stay in a bubble, by this winter there will be a variant that almost completely evades the vaccines and then you're back to square one.

Basically we should be continuously getting immunity against the newest.

Why should people with natural immunity from previous exposure get it? Natural immunity provides broader protection because antibodies are generated for more of the virus, instead of just the spike protein in the case of vaccines.

If there is negligible additional protection then why take the risk of vaccine injury?

Why can't antibody tests be regarded in the same way as vaccination for 'passport' purposes?

The CDC estimates about 110 million Americans have had COVID already. Why should they be vaccinated? Why not 'donate' the doses that would be have been used on them to other countries, to help people who have not been previously infected?

The science on this is clear, please update your stance.

Natural immunity is not as protective as vaccine induced immunity. It is in fact 2.3x more likely that you will get reinfected while unvaccinated, and a stronger immune response from the vaccine means fewer people end up hospitalized. See:

> Reduced Risk of Reinfection with SARS-CoV-2 After COVID-19 Vaccination https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e1.htm

From your link:

> these findings cannot be used to infer causation

Do you have more data to support your claims?

Not knowing the mechanism by which something happens doesn't mean it's not happening. I'm not sure what you're asking.

Previous time that "Natural immunity vs vaccine induced immunity" and vaccinating after covid was mentioned on HN:

https://news.ycombinator.com/item?id=28107854

tl;dr get the jab

> The science on this is clear, please update your stance.

You are conflating science with "stats".

> Natural immunity is not as protective as vaccine induced immunity.

If that is true and if the science is clear, then why is that the case? What is the biological mechanism behind that? Shouldn't natural immunity be better in most cases since your body is actually fighting the real disease? Since you say the "science is clear", can you explain the science behind it?

> It is in fact 2.3x more likely that you will get reinfected while unvaccinated, and a stronger immune response from the vaccine means fewer people end up hospitalized. See:

From your link...

"Finally, this is a retrospective study design using data from a single state during a 2-month period; therefore, these findings cannot be used to infer causation. Additional prospective studies with larger populations are warranted to support these findings."

So you say the science is clear and then you link to a study that explicitly says not to infer any causation?

You literally spread FUD and misinformation. As seems to be the case of so many invested in this covid narrative on both sides.

> Shouldn't natural immunity be better in most cases since your body is actually fighting the real disease?

And why should that be? Because natural is always better? See https://en.wikipedia.org/wiki/Naturalistic_fallacy

Vaccines produce a different and sometimes stronger response than the disease that they mimic, as they are literally designed to do.

In answer to your question: no, there is no "should" about it at all. it could go either way. And when it goes the wrong way, people try to redesign the vaccines until it goes the other way.

There is some evidence that COVID vaccines produce stronger responses. Links upthread.

> You literally spread FUD and misinformation

Please check yourself before flinging that accusation.

The reason for this global effort was because SARS-CoV2 was overrunning healthcare systems.

The CDC also said:

> Among the 469 cases in Massachusetts residents, 346 (74%) occurred in persons who were fully vaccinated

> Among five COVID-19 patients who were hospitalized, four were fully vaccinated

In other words, 80% of infections that require hospitalization are from vaccinated patients.

https://www.cdc.gov/mmwr/volumes/70/wr/mm7031e2.htm

> In other words, 80% of infections that require hospitalization are from vaccinated patients.

That means nothing unless you also know what percentage of the population are vaccinated.

Since you're interest in this topic, I'm sure that you have seen this graphic before:

https://twitter.com/jburnmurdoch/status/1418952126244478977

https://i.redd.it/km870p4xn1d71.jpg

Originally from the Financial Times of London, sorry i haven't soured it there, they have a paywall.

Let's not misrepresent incomplete data.

What's the risk of vaccine injury?

If the percentage chance of serious vaccine injury is many times less than the chance of somewhat serious covid or long covid... a logical person would take the vaccine.

If you just had covid and had a mild or moderate case, yes I could accept not getting a vaccine.

What i'm talking about is moreso that people should get vaccine immunity, and then get the delta so that we don't fall too far behind in general immunity.

Death, in the case of some younger (mostly women) people and the AZ vaccine. Canada and other countries literally don't use it for the reason, I believe the US hasn't certified it either. The Pfizer vaccine has been linked to some heart issues but mostly minor and with far less frequency.

(For the record, I got Pfizer)

I think he meant to ask about rates. The term risk is slightly ambiguous.

Death or long term disability is the risk of Covid.

The rates of those outcomes are extremely higher for the actual disease.

I Feel like a lot of people are falling into a “Both sides” or “fair and balanced” type trap by over indexing on that in theory the outcome could be the same, while ignoring the elephant in the room that the odds are vastly different such that there’s not really a comparison.

> The rates of those outcomes are extremely higher for the actual disease.

But the risk of catching the disease is less than 100%. So you need to weigh the risk of the vaccine versus your risk of catching the disease AND dying.

Do the probability of negative outcomes of AZ for women 20-40 versus the probability of catching Covid during a given timeframe AND dying for that same age group.

There's a reason many countries don't use AZ, and that some who do used it only for older patients. Canada for example doesn't even use AZ anymore. I believe it's still not approved for use in the US either. This isn't some conspiracy, lots of countries have highlighted the risks and don't use the vaccine.

Also this isn't an anti-vaxx post (I literally have 2 doses of Pfizer), it's a realistic post about the risks.

In the long run everyone's risk of catching the virus is close to 100%. It's now endemic (like several other coronaviruses) and no matter what you do you can't expect to avoid exposure forever. Just a question of when.

You realize that everything is a probability right?

There are people who choke and die on Hot Dogs every year. So there is a "risk of death from hot dogs"

Yet most reasonable people would not really care.

The same argument can be made for Covid itself too and is also an anti-vaxx argument. Everything we do has risks and we determine whether or not they're reasonable.

With vaccines, enough countries have said some have acceptable risk profiles (Pfizer and Moderna) and some are too risky (AstraZeneca).

Not at all actually. Since the statistical evidence shows covid "bad-effects" at a rate much much higher than vaccine "bad-effects".

So basically your entire argument is wrong.

You're missing that the probability of getting Covid is less than 1. And that bad symptoms from Covid are highly age dependent.

The AZ vaccine has been banned or disused in many countries (it's not even approved in the US!). Do you know something multiple world governments don't?

I think the most important advantage of vaccines is that you get them (J&J aside) twice, which helps build long term protection. Which is why it's recommended to get a single dose of a vaccine if you caught covid, bringing you up to two exposures as well.

Vaccine manufacturers are stating that people should probably get a third dose as an additional booster.

https://www.nbcnewyork.com/news/coronavirus/moderna-says-a-3...

Feels a lot like learning through spaced repetition

> Why can't antibody tests be regarded in the same way as vaccination for 'passport' purposes?

They are for the EU vaccine green pass. A certified recovery is counted the same as being vaccinated.

“I think the problem we have is people — whether it’s the CDC or the people that are doing the briefings — their big concern is, they just want to get vaccinations up. And they don’t want to punch any holes in the story about vaccines. But we can handle the truth. And that’s what we should be getting.”

Coming from Topol I find this particularly rich. He should include himself in that group. The breakthrough problem has been obvious for well over a month now. He has been one of those who have downplayed it. Besides Israel and other obvious international indications there have been notable incidence amongst medical professionals in the US. His podcast with Sam Harris, which I honestly could listen to is just one example of his participation in the groupthink. The downplaying of the vaccines’ lack of protection will have killed people, maybe not a significant number but the trolley lever was certainly pulled in that direction albeit for good (pro-vax) reasons.

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