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>This information is interesting, but a poor basis on which to shift policy from vaccination to infecting the entire population and blessing the survivors.

Only if we were starting from a point of nobody having been infected already. In LA, Chicago, NYC, Miami, ~50% of the population has been infected[0]. If the Israeli study is accurate, then all of those people should be considered as immune as vaccinated, therefore not requiring any additional vaccination. That should absolutely shift policy wrt vaccinations.

0. https://www.publichealth.columbia.edu/public-health-now/news...

Those populations may not be comparable, the headline numbers are from people who were PCR tested to be positive, the population-wide studies are based on seropositivity and modelling. The Israeli study explicitly calls out that it may be undersampling asymptomatic infections.

Pfizer has a lot of supporters. Funny for a corporation that is making substantial profits from our taxes. Even funnier that no other treatments are even given to pacients - only this unique solution. Humanity has become a strange place.

It's good as a combination I think. You can get the vaccine to prevent major illness and death, and if you catch Covid as a breakthrough case, you'd be even more strongly immune thereafter, hypothetically.

How does it compare to natural immunity from a "breakthrough infection"? If risk of hospitalization is low and following immunity is stronger, that seems relevant to whether we some should get booster shots, esp when so many haven't been able to get their first round

Yes although the delta variant has undermined the efficacy of vaccines at preventing infection (from 91% to 66% [1]), it is still fairly effective at preventing severe outcomes such as hospitalization and death.

> but a poor basis on which to shift policy from vaccination to infecting the entire population and blessing the survivors

This is not at all what the paper is suggesting, and people should not be interpreting it as such. The fact is that a vast majority of people infected by SARS-CoV-2 will survive without any severe outcomes. In fact a significant proportion (at least 33% and up to 65% [2][3], perhaps even more [4][5]) will be completely asymptomatic.

This has implications for vaccine strategy because supply of doses is limited - these findings imply that individuals who are immunologically naive or vulnerable due to age and comorbidities should be prioritized for vaccination, rather than people who have already acquired robust and durable immunity from natural infection [6].

[1] https://www.cdc.gov/mmwr/volumes/70/wr/mm7034e4.htm

[2] The Proportion of SARS-CoV-2 Infections That Are Asymptomatic https://www.acpjournals.org/doi/full/10.7326/M20-6976

[3] Estimating the asymptomatic proportion of SARS-CoV-2 infection in the general population: Analysis of nationwide serosurvey data in the Netherlands https://link.springer.com/article/10.1007/s10654-021-00768-y

[4] Evaluating the massive underreporting and undertesting of COVID-19 cases in multiple global epicenters https://www.sciencedirect.com/science/article/pii/S253104372...

[5] Undiagnosed SARS-CoV-2 seropositivity during the first 6 months of the COVID-19 pandemic in the United States https://stm.sciencemag.org/content/13/601/eabh3826

[6] Model-informed COVID-19 vaccine prioritization strategies by age and serostatus https://science.sciencemag.org/content/sci/371/6532/916.full...

> This is not at all what the paper is suggesting, and people should not be interpreting it as such.

I don't think the OP meant that the paper is suggesting that, the article linked makes it clear that Senators (such as Rand Paul) are using this pre-print paper to suggest exactly that. Rand Paul has a lot of clout and influence over the various narratives in this country, especially against protective mandates. In his world, public policy would be non-existent, and the will of the people would be enacted through market forces (choosing to go to certain businesses based on their personal decisions to impose mandates as a business on their customers or employees). Then the market decides if we actually as a country naturally fight against the virus at all or instead help it spread, and further divide the country based on people's uninformed individual purchasing choices.

The science really doesn't enter the picture for Rand Paul, despite him being a medical doctor, because to him government intervention in anything is always inherently bad.

thanks you. I'm already seeing antivaxxers cherry pick the shit out of these stats.

Lies, damn lies and statistics hey?

Thanks for those important facts.

Anecdotally, I've seen many COVID patients experience re-infection after months on a COVID survival support groups on Facebook. ( assuming that people would not have any incentives to spread fake news on these kind of group ).

This is quite contradictory to the study. I'll guess we will have to wait for the peer-review process.

> Natural immunity comes with a 10--25x greater risk of death.

No it doesn't. There are O(100) deaths from O(1 billion) vaccinations. That's about 100000x lower risk than from Covid itself, not just 10-25x.

I'm looking for a source, though the 25x factor was part of the 29 July 2021 CDC leaked report.

I'm happy to correct / update my comment with a reputable source.

From US CDC:

Reports of death after COVID-19 vaccination are rare. More than 363 million doses of COVID-19 vaccines were administered in the United States from December 14, 2020, through August 23, 2021. During this time, VAERS received 6,968 reports of death (0.0019%) among people who received a COVID-19 vaccine. FDA requires healthcare providers to report any death after COVID-19 vaccination to VAERS, even if it’s unclear whether the vaccine was the cause.

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/ad...

As of 23 August 2021.

Note that 6,968 deaths is from all causes, not necessarily COVID-19. It's about 100x below the IFR of COVID-19.

The claim was "Natural immunity comes with a 10--25x greater risk of death". That's a statement about the chance of dying from the vaccine to the chance of dying from Covid.

The numbers you're actually using are something quite different: they're comparing the chance of dying from Covid if vaccinated, vs. the chance of dying from Covid if unvaccinated.

The only credible reports of Covid vaccine fatalities that I'm aware of were from the AZ and J&J ones, and seemed to be on the order of 100 cases in all European countries before the use of those vaccines was stopped at least for the at-risk group (young women).

If the chance of dying from the vaccine was only 10x lower than that of dying from Covid, we'd have millions of dead from the vaccine. We don't.

That's a statement about the chance of dying from the vaccine to the chance of dying from Covid.

Fair point. The risk from the vaccine itself is de minimus.

I've updated my comment to clarify.

If we are going with differentiating "all causes" then surely this should be done with infections as well? I don't have numbers on hand but the last CDC report I saw (March 2020 to 2021 I think it was) had only 740 deaths "from [Delta variant of] COVID-19" compared to a few hundred thousand of "all causes" (with COVID). Granted even if those numbers are accurately relayed by my memory (and I doubt they are) the Delta stuff didn't take off until much later, but I'm kinda just making a point here. What that point is I dunno, but I'd just like more apples to apples comparisons in these discussions.

The AP pegs the average mortality rate at 1.8% for COVID-19, or 1 out of 55 cases.[1] The CDC says the mortality rate for vaccination is 0.0019%, which my imperfect math says is about 1 out of 53,000 vaccinations.[2] These statistics indicate natural immunity on average exposes the person to roughly 1,000x data-derived historical risk of death on average, when compared to vaccination, so I'm not sure what is the source of the lower figures in the earlier post. In any event, as a risk-weighted matter vaccination and weak immunity still seems better than infection and subsequent strong immunity. Just sayin'.

[1] https://apnews.com/article/fact-checking-970830023526

[2] https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/ad...

This is not a valid comparison because you're using the case fatality rate (1.8%), and case means symptomatic illness (a majority of infections are not symptomatic). A fair comparison would use the infection fatality rate (IFR), which is the risk of death after being infected.

Recent meta analyses estimate a global average IFR of ~0.15% [1], which is extremely biased by age. All age stratified IFRs show risk that decreases by orders of magnitude with age. We're talking IFRs below 0.003% for healthy young adults and children [2][3].

I'm not advocating against vaccination, just illustrating that the risk-reward profile is different for everyone based on their age and health. If you want to derive useful probabilistic risk estimates, there are many complex factors to consider.

[1] Assessing the age specificity of infection fatality rates for COVID-19: systematic review, meta-analysis, and public policy implications https://link.springer.com/article/10.1007/s10654-020-00698-1

[2] Infection fatality rate of COVID-19 inferred from seroprevalence data https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7947934/

[3] COVID-19 antibody seroprevalence in Santa Clara County, California https://academic.oup.com/ije/article/50/2/410/6146069

The CFR (case fatality rate) is based on the number of reported cases, which falls short of the total number of incident cases.

The countries with the lowest CFR consistently report about 0.1% CFR. These countries also have the best surveillance, and this is likely near the actual IFR (incidence fatality rate).

The adjusted difference is closer to a 100x benefit for vaccination than a 1,000x. Both are of course immense improvements over no vaccination, at minimal risk.

> The AP pegs the average mortality rate at 1.8% for COVID-19, or 1 out of 55 cases.

This is nowhere near correct. The global median IFR for Covid-19 is somewhere around 0.3%. It varies substantially by region, but 1.8% is far higher than even the highest legitimate estimate.

https://apps.who.int/iris/handle/10665/340124

Your source is a sole paper with one author, the guy who "estimated that the coronavirus could cause 10,000 U.S. deaths if it infected 1%"

https://en.wikipedia.org/wiki/John_Ioannidis#cite_note-wp-28

Pardon the skepticism, but do you have any other sources?

> Your source is a sole paper with one author, the guy who "estimated that the coronavirus could cause 10,000 U.S. deaths if it infected 1%"

That's an ad hominem, and a complete mis-representation of what he said at the time. The "guy" is one of the most-cited scientists in the world, and the publication is from the WHO. You just don't like what he has to say, so you dismiss it.

But sure, how many other sources do you need? His work is entirely consistent with everyone else...

https://link.springer.com/article/10.1007/s10654-020-00698-1

> Our analysis finds a exponential relationship between age and IFR for COVID-19. The estimated age-specific IFR is very low for children and younger adults (e.g., 0.002% at age 10 and 0.01% at age 25) but increases progressively to 0.4% at age 55, 1.4% at age 65, 4.6% at age 75, and 15% at age 85. Moreover, our results indicate that about 90% of the variation in population IFR across geographical locations reflects differences in the age composition of the population and the extent to which relatively vulnerable age groups were exposed to the virus.

https://www.nature.com/articles/s41586-020-2918-0

> We find that age-specific IFRs estimated by the ensemble model range from 0.001% (95% credible interval, 0–0.001) in those aged 5–9 years old (range, 0–0.002% across individual national-level seroprevalence surveys) to 8.29% (95% credible intervals, 7.11–9.59%) in those aged 80+ (range, 2.49–15.55% across individual national-level seroprevalence surveys) (Fig. 2a). We estimate a mean increase in IFR of 0.59% with each five-year increase in age (95% credible interval, 0.51–0.68%) for ages of 10 years and older.

The CDC's current best estimate for US IFR for those under age 65 is 6,000 / 1,000,000 (0.6%). Reduce that by an order of magnitude for those under 50, and another order of magnitude for those under 18:

https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...

And finally, just to show you that the OP's estimate is widly wrong, here's a paper based only on China, from June 2020, citing a correct-for-the-time (but high for today) IFR of 0.66%:

https://www.thelancet.com/journals/laninf/article/PIIS1473-3...

> Our estimated overall infection fatality ratio for China was 0·66% (0·39–1·33), with an increasing profile with age.

I don't know where the AP is getting their numbers but the CDC estimated an average mortality rate of 0.6% for Americans.

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...

Most other countries have had lower mortality rates because the average American is older, and has more co-morbid conditions such as obesity.

For vaccinated patients the mortality rate is close to zero.

Maybe from John Hopkins[1]? According to them, U.S. had fatality rate of 1.6%, albeit they use confirmed infections of 38.7 million vs. CDC estimates of 120 million.

Edit: It seems like CDC is inflating their infection rates compared to almost every other source. According to this[1] they also are more in-line with John Hopkins infection rates.

To note, mortality is rather similar in all sources I can find, but only CDC says 120 million were infected.

[0] https://coronavirus.jhu.edu/data/mortality [1] https://ourworldindata.org/mortality-risk-covid?country=~USA

The CDC infection estimate is in no way inflated. If anything it's an undercount due to false negative test results.

So then why are all other sources showing much lower infection rates?

I can't find what the date ranges are for John Hopkins' data. OurWorldInData says Feb 2020-Aug 27, 2021. The CDC link from GP says February 2020–May 2021.

Your links give the fatality rate for confirmed cases, which is basically useless. For the most part only people with significant symptoms bother to get tested and counted as cases, which skews the fatality rate artificially high. What matters is the actual fatality rate over all infections. The CDC documented their estimation methods on their site if you want to get into the details.