Vaccination blunts, but does not defeat Delta
sciencemag.org
sciencemag.org
It is very refreshing to talk to them because they, being good doctors, deal calmly and reasonably with probabilities rather than absolutes.
Very early, even before general public could get vaccines, all 3 of them told me to expect something like that - the virus mutates, it is expected to develop, the mutation for reproductive number going up is likely to occur - and it did - and the vaccines will likely be needing to adjust.
Even the highest levels of vaccination are no protection, and I am pretty tiny Israel in a sea of the largely unvaccinated is going to be swamped.
Your doctor friends were informing you about a phenomenon commonly referred to as "immune escape".
The current mRNA based SARS-CoV-2 vaccines are effective at preventing severe outcomes like hospitalization and death. However, they do not necessarily prevent infection or transmission - and they induce an immune response highly targeted toward the spike protein RBD [1]. Combined with mass vaccination strategies, these factors contribute to a situation that exerts tremendous selective pressure on the virus, and can result in convergent mutations that are advantageous for the virus in a large population of people [1][2]. These mutations can lead to partial or complete immune escape, which manifests as increased transmission or virulence, reduced vaccine efficacy, and reduced immunity in naturally infected individuals.
> Even the highest levels of vaccination are no protection
It's not quite accurate to say "are no protection". I would rephrase as:
Strategies for viral elimination should therefore be diversified across molecular targets and therapeutic modalities [1]
[1] Risk of rapid evolutionary escape from biomedical interventions targeting SARS-CoV-2 spike protein https://pubmed.ncbi.nlm.nih.gov/33909660/
[2] SARS-CoV-2 immune evasion by the B.1.427/B.1.429 variant of concern https://science.sciencemag.org/content/early/2021/06/30/scie...
According to this very article this isn't even really true any more. Of the currently hospitalized population in Israel 60% are fully vaccinated. With 78% of the population vaccinated that implies the protection is actually surprisingly weak.
" “There are so many breakthrough infections that they dominate and most of the hospitalized patients are actually vaccinated,” says Uri Shalit, a bioinformatician at the Israel Institute of Technology (Technion) who has consulted on COVID-19 for the government. “One of the big stories from Israel [is]: ‘Vaccines work, but not well enough.’”
Please see the first source I cited if you're interested in these ideas and want to hear more straight from the experts:
> "The spike protein receptor-binding domain (RBD) of SARS-CoV-2 is the molecular target for many vaccines and antibody-based prophylactics aimed at bringing COVID-19 under control." [1]
> "Such a narrow molecular focus raises the specter of viral immune evasion as a potential failure mode for these biomedical interventions. With the emergence of new strains of SARS-CoV-2 with altered transmissibility and immune evasion potential, a critical question is this: how easily can the virus escape neutralizing antibodies (nAbs) targeting the spike RBD?" [1]
> "Our modeling suggests that SARS-CoV-2 mutants with one or two mildly deleterious mutations are expected to exist in high numbers due to neutral genetic variation, and consequently resistance to vaccines or other prophylactics that rely on one or two antibodies for protection can develop quickly -and repeatedly- under positive selection." [1]
> "The speed at which nAb resistance develops in the population increases substantially as the number of infected individuals increases, suggesting that complementary strategies to prevent SARS-CoV-2 transmission that exert specific pressure on other proteins (e.g., antiviral prophylactics) or that do not exert a specific selective pressure on the virus (e.g., high-efficiency air filtration, masking, ultraviolet air purification) are key to reducing the risk of immune escape" [1]
> "Strategies for viral elimination should therefore be diversified across molecular targets and therapeutic modalities" [1]
Strategies for viral elimination should therefore be diversified across molecular targets and therapeutic modalities
Put another way: vaccines are a powerful and useful tool that can help us mitigate the pandemic, but if used indiscriminately they may actually work against us, so we need to proceed with caution and also use other tools where possible.
There's of course no reason to stop at indiscriminate use of it, we should employ whatever vaccine strategy seems to be best (in an empirical sense), and supplement with other measures, I'm going at the banality of the point.
The best strategy against escape variants available to us right now is to reduce transmission rates (especially to immunocompromised people) as much as possible with high vaccination rates.
https://www.thelancet.com/journals/laninf/article/PIIS1473-3...
The article you cited is in agreement with the literature I previously cited - as more people are infected the virus has more opportunity to mutate.
> The best strategy against escape variants available to us right now is to reduce transmission rates ... as much as possible with high vaccination rates
Your comment contradicts the mounting evidence we have available to us. Yes we need to use the vaccine tech we have at our disposal now - but in a highly targeted way, and supplemented by other viral elimination strategies that do not exert specific selective pressure on the virus.
I am planning on taking my Governor's cheekily endorsed thumbs up to get a 3rd shot. I'm going to get JJ because it's not the same RNA spike target.
That's probably better than a 3rd RNA shot (no reformulated)?
To be clear, right now there's no scientific literature that conclusively supports your suggestion here.
A better takeaway from my comment and OP would be that there is evidence we must diversify our viral elimination strategies at a population level.
It might actually be best to for you personally to stick with the same vaccines you had previously, but I'm going to stop there because you should consult your doctor for decisions like that.
Ultrapotent antibodies against diverse and highly transmissible SARS-CoV-2 variants
”Wang et al. identified four antibodies from early-outbreak convalescent donors that are potent against 23 variants, including variants of concern”
”The B cells isolated from donor-derived blood samples were sorted for antibody identification. This led to the identification of four potent neutralizing antibodies targeting the spike RBD. These antibodies showed a high affinity for the SARS-CoV-2 spike even at nanomolar concentrations.”
”The findings revealed that of 4 antibodies, two bound to RBDs in the “up position” and two bound to RBDs in the “down position.” Moreover, three out of four antibodies directly blocked the RBD – ACE2 interaction, and one indirectly inhibited the interaction through steric hindrance - the slowing of chemical reactions due to steric bulk.”
”By conducting multiple rounds of selection using combination treatments with two antibodies, it was observed that antibody combinations might reduce the risk of escape mutation acquisition and subsequent development of resistant viral variants.”
https://science.sciencemag.org/content/early/2021/06/30/scie...
The 2009 pandemic was significantly blunted because people born before 1957 had partial immunity from cross-reactive T-cells to H1N1 which was endemic in humans from 1918-1957. So after mutating in probably billions of pigs for 50 years the H1N1 virus that hopped back to humans was still sufficiently recognized by the immune system of older people to take any edge off of that pandemic.
I'm also fairly skeptical of the data coming out of Israel about waning immunity. Everyone is taking that data at face value while entirely ignoring the disclaimer: "(Potential confounders include the fact that the very oldest Israelis, with the weakest immune systems, were vaccinated first.)".
We really need a lot better data on much better matched cohorts to determine actual immune waning in the presence of the same viral variant.
it can be kind of slow on an individual level, but on a population level you will have some people who have evolved better defenses, or more resilient immune systems. If we can share that around that's the idea.
It's very interesting though about that immunity thing you say. People born then.
I guess the intuition is that the human immune system is an incredibly sophisticated, evolving capability that over time, and over the mass population, can respond to become resilient against a wide array of pathogens.
So if you could somehow capture the best of that (like, for illustration, take the immune system of the healthiest, most resilient person, 30 generations from now in the future) and convey that benefit to many other people, that would be truly awesome.
Sort of like an idea of training an AI, more iterations are better, the immune system of any one person at any one point in time, might not be so great, but the best immune system of the population after encountering many pathogens, is going to be really great.
How can we short circuit that "natural training" process and enhance the immune system? But I agree that attempts to do so might run the risk of creating or exacerbating autoimmune diseases...But I still think it's worth it.
When everyone starts realizing that vaccines and masks can't fully contain a spread, what's the next logical step to take?
Are people going to insist that you keep wearing your mask, take booster shots and live in fear for the next 50 years or are we going to collectively change our mindset from "Zero COVID" to accepting that COVID is just another risk factor in the world and move on?
But wait, now you have me thinking, what if speed limits, traffic lights and all that other stuff were optional? Shouldn't they be? I mean, if I want to risk dying in a car accident, that's my business, and if others are concerned about my reckless driving, isn't that what their own seatbelts are for? I'm not forcing them to drink behind the wheel, why should they force me to not drink? Bottom line, if they want to live in endless fear of me and other freedom loving drivers, I won't stop them, they can just stay off the roads for all I care. So why should there be any safety mandates...for anything? My state governor should follow in the footsteps of DeSantis and Abbott, and make it illegal for localities to even impose speed limits.
If it was, attendance at bars, restaurants, shows, etc. would not fall off a cliff when imposed.
Of course it is, I have been wearing mask for 2 years now. And I am wearing glasses.
Is washing your hands too much to ask too?
> If it was, attendance at bars, restaurants, shows, etc.
That was due to social distancing and lockdowns, not masks.
The masks? they made everything worse. They're incredibly bothersome to wear when its hot and humid, they induce psychological pressure on you via the feeling of being "smothered," and make every social interaction much harder to understand making each interaction more tiring to be a part of. It's equivalent to being in a Zoom conversation where you can't read all the subtleties of somebody else.
That's not even mentioning the blue collar labor force which has to wear these for 40 hours a week. My friends who work as waiters, bar staff, etc. still have to wear them during the day. The last thing they want to do when they get off work is to continue wearing them.
(all of this is relative to NYC, which had a ~31% closure rate for small businesses)
I understand some people here, such as yourself, don't think the masks are a big deal. But to the vast majority of the populace, they are a burden so bad its worth _moving cities and states to avoid_.
For (too) many people washing hands is indeed too much to ask...
> For (too) many people washing hands is indeed too much to ask...
This. This is why Covid is here to stay.
What is the mechanism for this harm?
https://www.frontiersin.org/articles/10.3389/fpsyg.2021.6694...
I for one feel it massively reduces the quality of my interactions and trust in people. I find it much harder to communicate properly. The long term consequences of this are not taken into account.
And I'm vaccinated, everyone in my country who wants to be vaccinated is. Why should I reduce the quality of my life for people who made a choice and took a risk? I actually don't mind that they made this choice, it's their risk. But don't destroy my quality of life for people who knowingly are taking a risk on their end.
Vaccination isn’t a magic talisman against infection, or against illness if infected, or against transmitting the disease if infected. It reduces the likelihood of each, all other things being equal, but it isn't a guarantee against any of them (and is less so against Delta, “Delta Plus", and apparently Lambda than other strains so far.
Masking further reduces both inbound and outbound transmission, and is just a basic precaution.
Long before covid mask wearing has been an insanely common thing to do when you're sick.
Masking in flu season isn’t uncommon in some parts of the world, and it was a lot more common during the 1918-1920 pandemic, so, “humanity” as a whole is not a constant.
Cultural variation aside, different respiratory viruses have different combinations of infectiousness and deadliness and responses to various countermeasures, so their are rational reasons the reactions to each, given a constant utility function, would differ. The common cold, the 2019 seasonal flu, the 1919 pandemic flu, and COVID-19 are all very different things.
Also cold/flu cases are way down due to people masking up and cleaning hands.
A lot of people complain about seatbelts being uncomfortable during driving, and yet its a law to wear them. Why?
Oh yes, I too take sick leave when I have runny nose until its gone
What does this mean? It means we are all going to get covid. Repeatedly. It is a new seasonal illness that will be with us, absent some magical technology. It is (or will be) endemic.
https://www.hsph.harvard.edu/news/features/what-will-it-be-l...
The point of the vaccination now is the same thing as always, to minimize the impact on society. Less hospitalizations and death, less days of our life spent ill, less misery.
People 100% should still get vaccinated, it is deeply stupid not to. It is particularly important the next several months as delta rips through the remaining unvaccinated population (which include those that can't, including under 12 year olds), because we want to avoid filling up hospitals and making our health care quit. For the same reason, we should wear masks and maybe try to reduce the time spent breathing each others air a bit. But the only ones that should live in fear are those unvaccinated that have never had covid and probably the old. But managing fear is something the old has to do anyway, comes with age ;)
By small chance, you mean 0% chance, right? Variants were already spreading by the time any vaccines were available. There are also billions of people who will likely not be vaccinated within the next couple years or so.
However, in hindsight, with animal populations being able to get infected, I think it probably was zero, although that gets well beyond my armchair "skills" ;)
Do you support mandatory mask-wearing and social distancing for the rest of our lives?
To be clear: that means no mandates.
Get people vaccinated.
Or else we're going to wind up "flattening the curve" again until we finally burn through enough dead people that everyone is effectively either recovered or immunized and then the endemic burden should be an order of magnitude lower.
And hospitals only have so much throughput going through the ICU and into the morgue that they can sustain, which is limited by burned-out human resources, that have been strained and quitting during the pandemic.
If you want to totally let it rip and destroy the ICUs then you better drive really fucking carefully for a few months and hope you don't get a poor diagnosis of something or other fairly nasty. Have a bit of a chat with your appendix and make sure its feeling happy and doesn't blow up.
Repeating this line doesn't really work anymore. I vaccinated myself and my whole family months ago, my county has ~80% full vaccination rate, anyone and everyone who could and wanted to, got a shot already.
Yet, there are 90 million people in this country that don't give a shit and will not vaccinate. Worse, soon the vaccine will probably wear out, and then the whole country will have to be convinced all over again to get a booster shot, who knows how many times, too. And then there is stuff like TFA that says that although vaccines are the best we've got so far, vaccinated people still end up in the hospital.
So although I'll personally line up for any booster shots the moment they become available, the reality is probably going to get much more complicated than vaccinating everyone and moving on.
Why would they if they just recovered from covid?
Possibly set aside X number of beds for covid patients, the rest of the ICU beds are for everything else. Out of covid beds? Well you've gotta wait for someone to die and then they'll see you.
They chose to "not live in fear", they can live - and possibly die - with the consequences.
I'm unaware of that being the current issue though. It seems to me hospitals are overrun with COVID patients, most of them their due to their own unwillingness to get vaccinated.
I get a flu shot every year and wear a seatbelt when I drive. Not living in fear of either. Taking reasonable precautions doesn't involve living in fear.
> or are we going to collectively change our mindset from "Zero COVID" to accepting that COVID is just another risk factor in the world and move on?
Look at the places (e.g., much of the US South) with high resistance to protective measures and the current status of the healthcare systems. Are we going to accept that being a permanent or at least frequently recurrent state worldwide and accept the COVID and non-COVID deaths from exhausting ICU space, and the high burnout we’ve seen in the healthcare field? Are we going to radically expand healthcare expenditures to expand capacity and attract/retain people in the field with that as the normal condition?
Respiratory viruses peak earlier before Winter in the tropics (ie. the South USA) whereas they peak during the Winter in the North.
Southern USA will peak and fall, and then this Winter you'll see the same thing in the Northern USA. Its just the seasonality of colds/flus which has been known for decades.
Be prepared because this Winter seasonal peak will be blamed on a new 'variant', and used to push either new lockdowns/restrictions, or booster shots.
No, California has 97% and Florida has 93%; California also has higher age 18-64 and 12-17 vaccination rates [0], has a number of local jurisdictions that have resumed indoor masking mandates (including many school districts for in-person education, with many of those that haven’t adopted mandates having parent-option virtual academies available) rather than a state government attempting to prohibit mask mandates. Countermeasures are more than just vaccines.
But, in any case, you didn’t answer the question: Are you willing to accept the degree of healthcare overload and the effects it is having on healthcare workers as a permanent or at least frequently recurrent state and accept the COVID and non-COVID deaths from exhausting ICU space, and the high burnout we’ve seen in the healthcare field? Is your plan to radically expand healthcare expenditures to expand capacity and attract/retain people in the field with that as the normal condition? Or are you willing to see the same load with dwindling capacity?
EDIT: forgot the link.
[0] https://www.nytimes.com/interactive/2020/us/covid-19-vaccine...
We should make it easier for more people to do it (people that don't have sick leave or aren't sure they can take it and so on).
We're already burning out our primary care enough for some to leave the profession, or worse.
Just because COVID is another risk factor, it doesn't mean we stop taking measures against it. The flu's a risk factor, yet we take flu shots, and don't go out french kissing strangers who's coughing, sneezing and having a fever.
Please dont abuse the name of a strategy that was never implemented.
What governments did was 'keep incidence below X by means of lockdowns', and 'relax restrictions if incidence is below X'.
This is a simple control system that keeps the incidence at X. Not below X.
Unfortunately X was chosen via hospital bed capacity, so it was quite high, about 500 cases / 100k per week. High enough to generate mutants. With X=5, the same lockdown measures would have been in effect for much the same time (they'd have been started a few weeks earlier). Also, for very low values of X, you might have been able to get away with just contact tracing or travel controls instead of lockdowns, so the average lockdown intensity over time, under zero covid, could have been lower than what we had. The point of zero covid is to have less lockdown!
Anyway, the idea was to buy time until you get the vaccine. Zero covid was never intended to be an indefinite duration program.
This is what zero covid really means (low X). I agree with everything else you said.
A vaccine is a fraction of the cost of treatment, and it has no long-term side effects. Even better, a vaccine reduces the chance for a virus to mutate.
Treatments, even if they work, are going to have side effects, and there are still unknown risks from a severe (unvaccinated) infection anyway.
Vaccines are a miracle of proactivity, and there's no reason to try to replace them with something expensive, risky, and reactive.
To make an analogy, does spraying every surface in a hospital with an antibacterial solution result in no bacteria or just make it more likely to see resistant bacteria? I’d guess it’s a function of how potent the solution was and how well every last surface was coated. If you start with a 10% solution, don’t achieve full coverage and keep ramping up slowly perhaps we’ll just see something like this: https://m.youtube.com/watch?v=plVk4NVIUh8
Agree with the rest of your post though.
At this point, it looks like our mRNA vaccines:
- leave a short enough window between doses to minimize mutations
- reduce viral load within a vaccinated person[2]
- prevent many transmissions entirely[3][4][5]
...which, added all up, appears to net out the way you'd expect: the vaccine reduces the risk of mutations.
1. https://www.npr.org/sections/health-shots/2021/02/10/9659409...
2. https://www.nature.com/articles/s41591-021-01316-7
3. https://www.cdc.gov/coronavirus/2019-ncov/science/science-br...
4. https://www.physiciansweekly.com/covid-19-breakthrough-infec...
5. https://www.scientificamerican.com/article/the-crucial-vacci...
How much do the treatments cost? Is it vastly different?
> No long term side effects.
How do you know? I thought the only study/data from Pfizer covered 6 months. That's not very long term? https://www.medrxiv.org/content/10.1101/2021.07.28.21261159v...
I don't think we need to replace vaccines, but large swathes of the population still don't have access. It seems very likely that a multi-modal approach would allow us to treat more people, faster.
Even Pfizer sees vaccination as well as treatment as the path forward: https://www.pfizer.com/science/coronavirus/antiviral-efforts
An average hospitalization costs $73,000 in the US, according to data collected from insurance claims[1].
That means that a single hospitalization costs the same as vaccinating 2,400 people (using your $30/shot estimate).
> How do you know? I thought the only study/data from Pfizer covered 6 months. That's not very long term?
Although I'm not an expert, a friend of mine is getting his PhD studying the immune system and explained it to me this way:
Any additional risk of mRNA vaccines would (with almost 100% certainty) occur shortly after vaccination[2], theorized to be as a result of a strong(er) immune response.
After the immune response has subsided, the vaccinated person's immune system would be hard to distinguish from someone who received a traditional vaccine because the goal of the vaccines is the same: to teach the immune system what the virus looks like[3][4] without actually requiring an active virus.
So to put that together, we can be fairly confident in an mRNA vaccine's long-term safety because its long-term effects are similar to other vaccines that we've studied for more than 100 years and because the mechanism of action subsides within a few months[5].
1. https://www.fairhealth.org/article/costs-for-a-hospital-stay...
2. https://www.muhealth.org/our-stories/how-do-we-know-covid-19...
3. https://www.health.harvard.edu/blog/why-are-mrna-vaccines-so...
4. https://www.vumc.org/viiii/infographics/how-does-mrna-vaccin...
5. https://www.uab.edu/news/health/item/12143-three-things-to-k...
1. https://www.sciencemag.org/news/2015/07/why-pandemic-flu-sho...
English is not my native language so maybe I didn't understand what you meant by that.
From that link:
> The flu vaccine is designed to trigger antibodies to influenza’s surface proteins, but if it elicits antibodies to the nucleoprotein as well, those might well latch on to the hypocretin receptor, and eventually lead to death of the cells, the researchers thought.
That couldn't just spontaneously happen a year after getting a vaccine.
Today, there are no particularly effective treatments. Monoclonal antibodies might do something, and cost a few thousand quid, but you wouldn’t want to be relying on them as an alternative to a vaccine.
I’m not personally ruling it out 100%, but is there even a proposed mechanism through which vaccine side effects could emerge like years later?
[0]: https://www.nationalgeographic.com/science/article/vaccines-...
What are the long-term side effects of the vaccine? Or are you saying that you expect us to discover some in the future?
Biology "certitude" is far from being as strong as a mathematical proof. Humans are different, and the complexity of interaction inside a single body are horribly complex.
I'm very surprised decades of science fiction litterature isn't enough to make people think twice.
In what way do you think millions of doctors, disease experts, and drug researchers have gotten that wrong? They have evidence that Covid is worse, but where is evidence to the contrary?
> I'm very surprised decades of science fiction litterature isn't enough to make people think twice.
Isn't it arrogant to assume that all the experts on vaccines are less informed or less cautious than you are, just because you've read sci-fi?
They didn't just think twice. They've done decades of research and testing, and they've closely monitored safety at every stage of rollout.
in general i would also be very skeptical of "scientific consensus" related by the media when you see how much bad press some doctor got for criticising public health politics (even when proved right later on).
Reminder of the Thalidomide drug:
> Thalidomide is a sedative drug discovered at the end of the 50s, which caused a worldwide tragedy. The drug has been prescribed to many pregnant women in order to relieve pregnancy nausea. It was later found that thalidomide caused irreversible damages to the fetus and thousands of children were born with severe congenital malformations. Many of them did not survive more than a few days after they were born.
Good news, then. Viral vector vaccines (like the J&J version) have been studied and tested since the 1970s, and mRNA vaccines (like Pfizer) have been studied since the 1980s[1][2].
What ingredient in Covid vaccines do you suspect will become the new thalidomide?
We know that the actual viral vector and mRNA components of the vaccines will degrade and disappear from the body in the short term[3], so it must be one of the other ingredients, right?
It's also important to weigh the completely unknown long-term effects of Covid against the well-known long-term effects of training an immune system with a vaccine.
1. https://www.muhealth.org/our-stories/how-do-we-know-covid-19...
2. https://ec.europa.eu/research-and-innovation/en/horizon-maga...
3. https://www.nebraskamed.com/COVID/where-mrna-vaccines-and-sp...
If those aren’t true then the risk is probably worth it as a raging infection would almost certainly be worse for the baby. I just wish there was some nuance in our government’s recommendations.
The claim that the spike protein is dangerous in and of itself is a fixture of anti-vax disinformation online.
https://www.usatoday.com/story/news/factcheck/2021/06/08/fac...
You can't say "The spike protein absolutely does not cause damage". That's going too far. Speaking as someone who doesn't pay attention to whatever the conspiracy theory of the day is, I have nevertheless always wondered about the effect of of proteins in the blood whose sole purpose is to breach cell walls. Your comment motivated me to do a quick google. There are in fact many reputable papers hinting at unpredictable spike protein effects. Here's three:
SARS-CoV-2 Spike Protein Induces Degradation of Junctional Proteins That Maintain Endothelial Barrier Integrity [0]
The SARS-CoV-2 spike protein alters barrier function in 2D static and 3D microfluidic in-vitro models of the human blood–brain barrier [1]
SARS-CoV-2 spike proteins disrupt the blood-brain barrier, new research shows [2]
[0] https://www.frontiersin.org/articles/10.3389/fcvm.2021.68778...
[1] https://www.sciencedirect.com/science/article/pii/S096999612...
[2] https://www.sciencedaily.com/releases/2020/10/201029141941.h...
A little perspective - one way or another, we're all going to be exposed to this damn spike protein eventually, and the vaccine is by far the safer way. If it does do something bad, we haven't noticed it yet, which presumably means it can't be that bad. I haven't seen any reports of people getting long covid from a jab.
"While it is true that the spike protein has 'superantigen' properties, which means it has the POTENTIAL to cause adverse effects, we know that it doesn’t cause these effects in many infected patients, it doesn’t cause many of these superantigen effects in most vaccinated individuals, and the levels are incredibly low in the blood, suggesting this shouldn’t be a concern," he said."
Many, most, etc. is a pretty far cry from "absolutely does not." I already said for most people it shouldn't be an issue. Could it be developmentally harming fetuses? Maybe we'll find out 10 years from now that they'll have a slightly lower IQ than they should.
Or maybe for adults we'll see an increase in autoimmune diseases a few years from now. Or, hopefully, there will be no widespread long term effects. These things take time to suss out. I'm so incredibly sick of absolutism reigning over everything now. It should be perfectly acceptable to have a nuanced opinion over who should take the vaccine instead of everyone or noone.
Vaccines are great. Therapies are also great. This is absolutely not wrong.
Where's my portable cold fusion generator?
Vaccines just fucking work right now. Much like wind and solar.
Effective antivirals are like thorium nukes and carbon capture. Very hard problems that nobody can adequately solve.
And here we are.
Since SARS-CoV-2 seems to be especially dangerous for people after reproductive age I don‘t expect the same pressure as with flu. It may influence our inverted age pyramid, though. And it may have influence on the number of highly educated people >50 and older people with disposable income. (I belong in this group)
And I don't agree with headline of "grim", as it was obvious a year ago this was coming. Who lost any excess weight in the past year?
I got both Pfizer/BNT shots as soon as I could, and I'll get the boosters as soon as I can too.
The belief that healthy living alone is enough to stymie a virus that we still understand relatively poorly is foolhardy. It's in the same category as juice cleanses and homeopathy as far as I'm concerned.
All the data and numbers show the risk is incredibly low for someone like you (provided you don't have an auto-immune disease)
No.
We don't understand why COVID hits some people harder than others. We don't understand why some people end up with "long COVID" sequelae and some don't. I don't particularly want to roll those dice from immunological naivety.
The vaccines were free. The biggest risk I would have faced was myocarditis, and the risk even for that is higher from a COVID infection than from the mRNA vaccines.
Furthermore, getting vaccinated means that we all get back to a place where COVID is less of a big deal societally. While the data does show that vaccinated individuals can transmit Delta, it shows that they do so for a shorter period of time, and anything we can shave off of R0 is a good thing. Perfect, enemy of good, etc.
Getting vaccinated was close to no skin off my back. I had a sore arm for a few days. The payoff is that I reduce the (admittedly small) risk I did have, and I'm part of the herd boxing COVID in.
What's the downside?
We don't know what we don't know. That's the downside. You've just taken an experimental drug which has yet to be approved by the FDA, and was designed using novel technology we haven't broadly tested on humans. What's more, the companies providing the shots cannot be held liable for these vaccines.
Who's to say we don't discover issues with mRNA delivery 5 years from now? That risk seems much higher to me than the risk of long COVID for individuals such as yourself (and me).
BNT/Pfizer has so little short- and mid-term downsides that it is difficult to properly spot them statistically, even after about a half billion vaccinations.
Both may have long-term downsides, but: all vaccinations we know didn‘t have any long term downsides. The problems were either visible immediately or they were relatively rare so that they were only detected after a significant number of people had been vaccinated. The downsides of Covid-19 are not rare compared to that, for any age. There is no reason to consider the vaccine more frightening than Covid19. On the other hand everything about the virus SARS-CoV-2 and the disease Covid-19 is experimental because this virus has not been tried on humans until now! The infection it causes is way more complex than the immune reaction BNT/Pfizer causes and it definitely would not have passed a phase-1 study.
If you are afraid of BNT you should basically panic about Covid-19.
The 'rona is in cats and deer, so it will be around for approximately forever. Vaccinated humans still get it and transmit it, though may have less severe symptoms. Will you please explain what you are boxing in?
(Slightly out of date as we've seen cases rise considerably since 8 days ago)
Would it? Do you have research on recent lifestyle changes and COVID?
Or are you just assuming that on-average stats relating to comorbities represent simple binary on-off switches?
And then lots of people will have gotten sufficient protection against it from their first vaccination.
Up to 90% of Native Americans died from smallpox and other imported diseases (3) and it's clear that their societies were in fact overcome.
They died a lot. To handwave "learn to live with" is naïve and facile. A virus can't care if we lose a double-digit percentage of population, but we're not choosing that course.
Don't mistake a disaster remembered 500 years later for "eh. it worked out ok" Don't confuse mass death with "learn to live with".
1) https://www.history.com/topics/middle-ages/black-death
2) https://www.britannica.com/event/Black-Death/Effects-and-sig...
3) https://www.encyclopedia.com/science/encyclopedias-almanacs-...
Please stop comparing the two.
The plague wiped out 1/2 of Europeans and Smallpox maybe the majority of Aboriginals. Or something like that.
Yes, 'we can survive' I don't think anyone doubts that.
The question is, is it going to kill several million Americans or more during it's run.
Hopefully not but I'm also someone can show us what the light at the end of this tunnel looks like.
The US has 622K fatalities on 37M cases, which is a 1.68% CFR (and is an undercount, because some current cases that will be fatalities aren't yet.) Of course, CFR isn't a constant, it varies with current healthcare overload and the lethality of different strains, among other factors.
In reality the fatalities are ‘people who died within a certain period after being tested positive’ and an enormous amount of cases without any symptoms go undetected.
Cases are a certainty basically by definition (now, if you want to do the usual thing and argue that we should look at IFR and not CFR, that’s a different story, but I’m not the one who introduced a false claim about CFR.)
> an enormous amount of cases without any symptoms go undetected.
By definition, if an infection goes undetected, its not a case.
That should cut down the fatality rate, along with the rest of the lifelong damage the virus causes, by at least an order of magnitude.
The goal was also to avoid the hospital system and ICUs collapsing, which should be a natural result of everyone getting vaccinated.
Vaccine boosters yearly or every other year were also always discussed as early as March 2020 to deal either with waning immunity or reformulations to address antigenic escape.
No, it didn't.
> (I am not a China fan or defender)
Then why are you making B.S. “rah rah China” claims that even Chinese state media doesn't?
The question really isn't whether vaccinated people get sick, or even whether they spread the virus, but whether they end up in the hospital. Right now, if you're vaccinated, you are extraordinarily unlikely to end up in the hospital.
> What is clear is that “breakthrough” cases are not the rare events the term implies. As of 15 August, 514 Israelis were hospitalized with severe or critical COVID-19, a 31% increase from just 4 days earlier. Of the 514, 59% were fully vaccinated. Of the vaccinated, 87% were 60 or older.
This is a bad interpretation by the article's author. At some point (at 100% vaccination rate) we'd expect 100% of people in hospital to be vaccinated.
Talking about "breakthrough" cases and how rare they are depends on the absolute number of infections. This article doesn't have that data but it does say this:
> Yet the country is now logging one of the world’s highest infection rates, with nearly 650 new cases daily per million people.
The population is 3.9m, so 2500 cases per day. According to https://ourworldindata.org/coronavirus/country/israel it is actually up to 6000 cases per day.
So there are probably 100K+ active cases. 303 (ie, 0.59 * 514) cases of vaccinated people is 0.26%. That's a pretty low rate.
Indeed it is a lot, but it's comparable to the worst flu seasons. Exact numbers on ICU utilisation are hard to find, but US hospitals have struggled in the past:
https://www.latimes.com/local/lanow/la-me-ln-flu-demand-2018...
https://www.healio.com/news/infectious-disease/20190205/bad-...
The population is 9.3 million, so 650 cases/million is indeed about 6000 cases per day.
I swear it said 3.9M before, but maybe I'm wrong.
I'm not an expert in this, so I cannot say how significant that issue is, but this is at least one potential downside that I am seeing to the vaccination being weaker for that variant.
EDIT: To clarify since some have misunderstood: I did not assert that the vaccination causes higher mutation, quite the opposite. I asserted that the absence of vaccination (entirely or effectively) gives more opportunity for mutation. I understand now that there are higher order effects that make this more complex.
One interesting thing about covid is that it seems to be the first time humanity has collected so much data (eg. contact tracing, phylogenetics through genome sequencing, etc.) about this kind of virus, and applied modern medical knowledge in trying to combat it.
It's very apparent that the overall response hasn't been nearly good enough, but it's probably also the best response there's ever been. (perhaps not the best ROI, though?)
That is not what I have written, please reread!
https://www.quantamagazine.org/how-vaccines-can-drive-pathog...
I now understand that there are second order effects that make this more complex, but I don't see the contradiction right here.
1. Likelihood of breakthrough infections.
2. Mutation rate.
3. Initial volume of infections.
For instance, if the likelihood of breakthrough infections is low enough to overcome the reproduction rate, the mutation rate is slow enough, and the initial volume of infections low enough, you'd expect that the virus would die out if enough people have had the vaccine, right?
On the other hand, if the likelihood of breakthrough infections were high, mutation rate were high, initial volume of infections high, makes sense that you would expect to see ongoing mutation.
Another way I think this might go is that mutations happen & breakthrough infections happen, but the breakthrough infections further boost immunity, and the severity never re-approaches the original severity of covid.
https://www.washingtonpost.com/health/2021/03/11/immunocompr...
Considering cross-immunization between variants with natural immunity, it might be more efficient to refrain from vaccines to give cross-immunity with a weaker variant.
I'm gladly corrected if I missed something!
Even if that variant is more lethal (from which you might expect a smaller R0), it might be prevalent because of an augmentation in R0 from vaccination (which might be lesser had people developed a more complete natural immunity).
It's an "ounce of prevention, pound of cure" type of situation
The number of children who are dying of covid has been ridiculously low for a virus that spreads so easily. Hasn't covid deaths for children under the age of 12 been under 1000 since the pandemic started?
The level of social isolation the elderly have unilaterally imposed on the youth is a travesty.
Our leaders however are not letting this crisis go to waste.
I find a lot of the discourse / antilockdown sentiment to be really confusing.
I understand lockdowns are a bad experience but are we not agreed that they save lives, and the quality of life (long covid)?
My sister had a very mild case of Covid last year after lockdowns started lifting and she went to the hairdresser (masked, obviously not vaccinated). She had the telltale loss of taste, but really no other symptom, and she recovered.
I saw her yesterday in person for the first time in a number of months and she looked so skinny I had to say something, it was worrying to me. She told me she has trouble eating anymore because everything tastes like shit. She says that things she used to love now taste the way cigarettes smell, and she simply can't stomach it.
Her words: "People need to realize that even if you don't die from Covid, it can change your life. I wish I never got this."
It's just that we're in a global plague right now and a large chunk of people just want to do whatever they want no matter if others are affected by their actions. Basically a stage of development such as children before they realize others are also people. It's like ten people walking a tightrope and the last one is jumping up and down. A non-infantilized society is one where we can expect everyone to be a grownup and avoid the bad quadrant of the prisoner's dilemma, and guess what? We've found out that you get an infantile society if people are just asked nicely
The elderly and well off want to minimize their risk at the expense of the young and the poor. Who do you think delivered your Amazon packages while you worked from home?
At both extremes a part of the population is unwilling to compromise and is willing to force another part to pay for their "freedom." In my opinion the yuppies obessively using instacart and Amazon are just as selfish as the Trump supporters and rednecks who may have denied covid existed. Both groups want what they want the cost be damned.
Edit: Looks like they had a huge spike in May but are now around 7-day avg of 20 cases. With 7 day average of deaths around 2-3. Vax rate 1st - 40% 2nd 2.9%
Looks pretty good.
Sweden has a rolling 7 of 500 ~ 700. Rolling seven of deaths 0. Vax rate 1st 69.5% 2nd 59.2%
Interesting because they never locked down.
To be clear, I don't mean some coordinated cabal, I just mean that society's views have drifted that way, we haven't had anything bad happen for years, the significance of individual freedom has been forgotten, we're well into turning on ourselves anyway. And so now with a push, there is a new majority, and we're seeing politicians take advantage of strong views and fall in line to represent them, disregarding safeguards and norms that we previously had in place but were not updated to contemplate something like this.
And now viewpoints that would have been intolerant and completely out of line with western democracy, and ridiculed as some mid 20th century authoritarianism are suddenly applauded all over social media.
NZ is currently thinking about increasing the gap to > 6 weeks because of this.
I wonder how much that would affect things.
The delta and lambda variants emerged, and they were both more transmissible, and more vaccine resistant, is that right? I mean, why do you need to evolve vaccine resistance and transmissibility at the same time? Seems weird, and given the 'shotgun' quality of antibodies across individual and population, particularly so.
Which lets me feel that we are applying some selective pressure with vaccines. Compared to the other virus mentioned, what's different is the scale and rate of vaccine roll out here is unprecedentedly greater. Maybe in the previous cases our immune system had already evolved stronger defenses by the time the vaccines were given, 'patching more holes in the dam' so to speak.
For the sake of clarity, the first viral genome of B.1.617 (eventually named Delta) was identified by India's variant tracking program on October 5, 2020, long before any vaccines were approved. India's case load was also quite low at this point, and the initial lockdown was being slowly rolled back.
https://www.independent.co.uk/news/world/americas/us-politic...
You can still get COVID when vaccinated. The symptoms you get are less intense, and therefore transmission is less likely (though definitely still possible).