In the end we never were in control of the situation but people cannot accept that.
And there are plenty of countries around the world which have done a much better job than SF of testing, contact tracing, vaccination, etc. We can compare e.g. Sweden to other Nordic countries to see what an abysmal failure the Swedish “herd immunity” strategy turned out to be.
* * *
“We haven’t tried anything and we’re all out of ideas” is easy to sell to grumpy people tired of a really shitty year or two, on the back of an unprecedented wave of anti-public-health propaganda, but it is an absolutely terrible pandemic response.
What do you believe this comparison means? I'm not sure its saying much of anything. Perhaps you could come up with another similar sized city, with same socioeconomic/population-type makeup, with same latitude and seasonality profile to compare against? I'm not familiar with SF data sources on this, but I'm curious if you can provide a source for current IFR? My state here in southeast US's IFR is .012. That includes people who died in car accidents, of poisonings, of falls and other injurious actions while having tested positive for COV in last 28 days. My county is comprised of mostly older folks (median age 44), small at 186K people, and we haven't had a COV death registered in the last 11 months.
>We can compare e.g. Sweden to other Nordic countries to see what an abysmal failure the Swedish “herd immunity” strategy turned out to be.
Can you show some data sources for this? Everything I'm seeing is pointing to Sweden's last 2 flu seasons (encompassing COVID years) showing the same or lower all cause mortality than their previous 15-20 years. With 2018 being the major outlier not just in Sweden but all around the world, for which we still have no explanation.
> IFR is .012
Do you mean CFR (case fatality rate)? IFR (infection fatality rate) is always only speculative, because we don’t ever have complete knowledge of the number of infections.
In total throughout the pandemic SF has had ~670 Covid deaths and ~54,000 confirmed Covid cases for a population of ~880,000.
For the same population, the USA average would be ~2090 deaths and ~110,000 confirmed cases. Except those are both dramatic underestimates of the relative numbers because SF has consistently had a much lower percentage of positive tests, and hasn’t had anywhere near the US gap between confirmed Covid deaths and total excess deaths.
In science you're really meant to use all the data because the problem with this sort of cherry-picking is that it can go both ways. Florida removed all its restrictions and was predicted to become a bloodbath just like they predicted that for Sweden. It didn't happen, results appear to have been unaffected by the changes. Studies that look at all the data find no correlations between lockdowns and COVID mortality (but lots of correlations with other bad problems).
0.012 is the San Francisco CFR. 0.016 is the USA CFR, if we go by confirmed cases/deaths as reported by the New York Times.
The IFR should be substantially lower than either of these; many deaths go uncounted, but a far larger proportion of infections never get a confirmed positive test. I would guess IFR to be in the 0.004–0.008 range. (Which is still scary high!) I’m sure if you do a search of the academic literature you can find more careful analysis and better informed estimates. It obviously varies from place to place and is substantially dependent on demographics and availability of medical care.
* * *
Florida was a bloodbath! It has had among the worst outcomes anywhere in the USA since mid 2021. Tens of thousands of avoidable deaths after the universal free availability of extremely effective vaccines and better understanding of viral transmission. The state government not only stopped any state-level public health action, it actively prevented state/local public health departments and local governments from acting. It is hard to imagine a more complete failure of state leadership.
Florida has had something like 4x more Covid deaths than San Francisco, per capita. And if we only look at deaths after widespread vaccine availability, Florida has had >10x more.
Of course, the virus eventually burned through a large majority of the unvaccinated population, and without enough remaining hosts to infect, flamed out. Fingers crossed that future virus variants don’t have enough immune escape to burn back through the state again.
Yet, despite being significantly "older" than CA, it did significantly better than CA in 2020 with regards to all-cause-mortality. 2021, seems to be a different story at this point and I'm very curious as to the 10% difference between years (certainly seems to imply the virus has not burned through the population, assuming the virus had anything to do with mortality).
The usual credible figures I see for IFR are between 0.1% and 0.3% - higher figures tend to be using bad methodologies like including estimates from the very first days of the pandemic when people were trying to estimate IFRs using random Chinese media reports, etc. If you restrict yourself to more rigorous methodologies and sample sizes, IFR falls a lot.
As for Florida being a "bloodbath", lol. That word doesn't mean what you think it means. Nowhere has been a bloodbath, and if there's one thing that's been consistently true about Covid data it's that you can make anywhere seem worse or better than anywhere else by choosing what to compare against. Use all the data and Florida seems pretty good, especially as Europe is busy proving that vaccines appear to have accomplished nothing at all in terms of total numbers, despite the many claims of efficacy.
If we take 330 million people as an estimated US population, an IFR of 0.012 and 0.44 of everyone infected (CDC estimate from 1 October), that would be 1.74 million deaths. But the number of Covid deaths in the USA is probably only around 1 million (CDC estimate is 920 thousand as of 1 October), putting the US IFR at ~0.006. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...
I’d estimate a US IFR somewhere in the 0.004–0.008 range. We missed counting a significant number of Covid deaths, but we didn’t miss 60% of them. (In US counties with the highest proportion of elderly people, the IFR might locally be closer to 0.012.) But that is still a very high IFR!
Covid is a scary, scary disease. Deadly, highly contagious even before symptoms, and indistinguishable from common respiratory diseases during the part of the infection when most spread happens. Fortunately we have extremely effective vaccines (if only we can convince everyone to take them), and spread takes place almost always between unmasked people indoors making it relatively inexpensive to dramatically reduce the reproductive rate of the virus by avoiding indoor spaces and wearing masks when they are inevitable.
Getting really tired of hearing this. To a HEALTHY human, it’s like a bad cold. Me and my family have had it in the last month and confirmed with tests so I know what we had. It’s gone through a bunch of friends too and the worst they experienced was feeling miserable in bed for a couple of days.
I have no doubt that for some it IS scary, but let’s not chuck around emotive language that isn’t an accurate description in the majority of cases.
Yes, I do live in one of these older counties and specifically in my region of the county. Obviously words such as 'scary' are useless and subjective. Anti-biotic-resistant strep nearly killed me 3 years back, so to me, that was a scary disease. The COVID I had was milder than my yearly flu, and this is effect on the overwhelming majority of the population even considering the obesity rate in the US. Scary is not the word I would use.
> But that is still a very high IFR!
I mean, perspective is everything. What are you comparing this IFR to? I consider this a very low IFR, especially when you realize what we in the US classify a "COVID death". We do not count deaths of any other diseases using the same methodology as we have with COVID as far as I'm aware, and I believe this is the primary reason for our inflated mortality vs. most of the rest of the world.
The wave started leveling off about 2 weeks after and the rules are still in force.
Not sure where you got your information.
What expert are you? What are your numbers to determine that corona without measurements would not create a new york or Italy event across Germany?
There is probably a reason why you are not a virologist. Or do you have your own model numbers?
They're so proud that they can answer the question about what happens to the pond that is half-covered by sea lilies the next day but never think about what happens the day after that.
tldr: There is no persistent exponential growth in nature.
https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus...
Index page: https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus...
what would make sense is a steady and controlled Durchseuchung with specific protection of vulnerable people (like old and sick) - b/c the best immunity is gained by infection.
but Durchseuchung never sounded good - that's why that term got so popular. it sounds ugly and brutal. but it's what was happening all the time with many diseases in the past thousands of years.
In a nutshell, the German government and every other country on earth is doing what you propose, except that they are vaccinating at the same time and try to keep the curves flat (but your use of "slow" also suggests this, so it's not clear what else you're suggesting).
No, this is only true if the R value is constant in time. Not all functions with a positive first derivative are the exponential function.
Because otherwise the growth is indeed exponential, yeah?
Of course, the epidemic curve described by that function would indeed bounded below by an exponential function on part of its range, but the same is true of any function with positive derivative, and calling for example f(x) = x^2 exponential for that reason makes the term meaningless.
This is presumably what the OP meant by “as long as R>1, the curve is exponential”. But this is literally equivalent to saying “as long as f’(x) > 0, f is exponential” which is just not a useful concept.
The initial spreading will be exponential in the beginning - as every actual curve illustrates - if the disease is left unchecked as OP suggested, until R_t values go down again due to immunity. That's all I meant to say.
[1] https://www.sciencedirect.com/science/article/pii/S002251932...
exponential in the beginning == this part of the function can be approximated by a function ae^xb where a>0 and b>1
vs.
first derivative bounded away from zero in the beginning == any function that increases, including linear functions with constant first derivative and polynomials with linear first derivative
Or do you think all increasing functions are the same..?
It is easy to show that for any function whose derivative is continuous and positive at 0, there is an exponential function (properly translated such that they agree at 0) that has similar properties.
You should be specific about what properties you're talking about. What you're saying is that any function increasing function grows faster than some exponential function on a finite interval.
Still, you can observe f(x) on x ∈ [0, 1] and see that it is growing linearly. And you can observe g(x) on ∈ [0, 1] and see that it is growing exponentially.
I do not see the value in discussing the rate of exponential growth of f. Where as for g, there is a parameter with value ln(2).
If data looks like f, don't try to fit an exponential function to it (whether it's a least-squares fit, or any other objective f > g.
Are you trying to say anything else?
That doesn't help if you die of the infection first, and COVID is extremely lethal among the demographics that most need the direct benefits of immunity.
Source? I think there's plenty of peer-reviewed scientific articles claiming the opposite.
http://www.hopkinsmedicine.org/health/conditions-and-disease...
Here you can find linked three studies by the CDC that support the idea that natural immunity is harder to get and less effective (besides, as others have said, there's the non trivial chance of side effects or not even surviving the virus)
I don't care about what the "experts" think or say, I care about studies.
Update: https://www.nature.com/articles/d41586-021-02795-x#ref-CR5 reports many studies that claim that we should be vaccinating people after a natural infection to get "super immunity", but that is different from what the OP was claiming (natural immunity > vaccine immunity)
Also probably true without the vaccine first, but the initial survival rate without vaccination is a lot lower.
https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v...
What if we all respected the first confinement? 6 weeks everybody at home, period.
The disease would be gone.
But no, oh no. People just can't be reasonable. So instead of 6 weeks, we've been dealing with this shit for almost two years.
And now you blame those who are unvaccinated, while vaccinated people go partying and spread the disease.
No, you should blame unreasonable people.
I don't know how many other people this has happened to but I too have my doubts as to whether there was ever any hope of containing this.
If taken literally, how is that supposed to work? People working for the emergency service still need to work, and they certainly can't work from home. Same for most of the medical sector, nursing services etc. and of course the various bits of infrastructure. Some industries cannot be easily shut down (you cannot stop or start a steel works on a whim). Most people involved in food production, too. Maybe you can blame people for not keeping at least two weeks of provisions (although blaming them won't change anything), but expecting them to go six weeks without buying any food or other provisions is certainly unrealistic. Things break, and not all of them can be left for up to six weeks to be fixed. (If your fridge breaks, or the heating breaks or your roof springs a leak, that cannot really wait. Same if things break in any of the critical industries and services that cannot be shutdown and need to keep working). All this residual activity still needs some amount of transportation and all the infrastructure that that entails. Etc.,etc. …
Delta. Omicron.
Our technology sucks and is slow, we can't achieve R < 1 this way.
The mRNA technology would let us inject omicron-specific boosters tomorrow, but then there is a lot of other safety hurdles that have to be met before it gets authorized and then distribution hurdles to convince people to take it…
Mathematically, we will get to R=1 this way, some day or another, with some percentage of people getting it via illness and some via vaccination. The choice is still ours on how and when.
At this point I'm less worried about covid and more worried about the global rise in authoritarian trends.
So you say that at some stage there will be vaccines for COVID-19 that are not nMRA (Pfizer, Moderna) or Viral vector (AstraZeneca)
Why? The people who are happy with vaccines are fairly happy with these vaccines and might refine them, but not about to dump them entirely for a different technique. in fact mRNA vaccines are the new hot thing.
And the people who really aren't happy with these vaccines, will never be happy. They'll find a way to object.
So what's the incentive for such a classical vaccine? Who's going to root for it?
Moderna and Pfizer (1) and AstraZeneca (2) are getting ready for the next round, still using their current technologies. They're not planning on going back to "classical vaccines" for COVID-19.
1) https://fortune.com/2021/11/29/covid-19-omicron-vaccine-prot...
2) https://www.independent.co.uk/news/uk/omicron-oxford-covid-a...
Vaccination is of course imperfect and cannot be the sole measure, but we can't achieve R < 1 without a lot of it.
So then what happened summer 2020?
It's technically true that this worked then, but 2020 is gone, not to return. a) new COVID strains were inevitable and b) prolonged strict lockdowns unpalatable and c) mass vaccination has a huge benefit. As part of a multi-pronged strategy, of course. Depending on only one measure, be it lockdown or vaccination, is not going to work.
Delta came out of India. Omicron came out of South Africa. How do mandates in the West stop variants elsewhere?
And variants aside, the vaccinated are still getting sick and dying at significant rates [1]. This vaccine is not the slam-dunk our "experts" promised. Until some miracle cure comes along, R < 1 is simply not possible.
If you think full vaccination is a necessary goal despite all this, OK fine. You know what might go a long way in terms of achieving mass vaccination? Open sourcing the vaccine recipe. Not just the RNA sequence. The whole recipe.
This should be a no-brainer.
Governments have no qualms with mandating lockdowns, masks, and vaccines for the masses.. but for some reason they hit the brakes when it comes to mandates for pharma. Not only is this a good idea in terms of improving supply side logistics, but also for the sake of re-building trust.
But no, common sense is too hard and "blame and shame" is too easy.
Being unvaccinated does not harm the vaccinated.
Hospital collapse has been liminal for 2 years now, it's a manufactured crisis. Instead of bolstering our healthcare staff and paying our front line workers more, we have done.. the exact opposite. We funnel tons of money to pharma, while frontline workers have effectively had their pay cut in half.
We're quite literally being force fed lies. But I guess that doesn't matter because at the end of the day the Milgram experiment prevails and all these attempts to question the narrative and hold authority accountable is pointless.
[1] https://assets.publishing.service.gov.uk/government/uploads/...
page 15
This is, on average over large numbers, not correct. Higher rates of disease spread harms everyone, the vaccinated included.
> This vaccine is not the slam-dunk our "experts" promised.
Which expert promised you that?
> it's a manufactured crisis ... We're quite literally being force fed lies ... Milgram experiment ... question the narrative
Cranks write like this. That is a shame as some of your other points are very correct, particularly around the need for Intellectual property waiver, which some have been calling for for some time, to no avail (1). BTW, they don't generally call it "open sourcing" in that field.
Hospitals genuinely are in crisis and doing difficult triaging, anyone working in them can tell you that.
1) https://reliefweb.int/report/world/time-runs-out-break-trips...
https://www.businessinsider.com/who-says-no-evidence-coronav...
> Moderna's chief medical officer, Tal Zaks, said last month that he believed it was likely the vaccine would prevent transmission but warned that there was not yet "sufficient evidence" of it.
https://www.nytimes.com/2021/04/01/health/coronavirus-vaccin...
> The Centers for Disease Control and Prevention on Thursday walked back controversial comments made by its director, Dr. Rochelle P. Walensky, suggesting that people who are vaccinated against the coronavirus never become infected or transmit the virus to others.
> Cranks write like this.
Apologies I'm new to being a social pariah, being under pseudo house arrest, and psychosis in general.
I don't want hospitals to collapse. I'm afraid if we give up this freedom now, we'll never get it back. I'm afraid of the unknown and putting my life in the hands of people (our dear leaders) that really have never cared about my health before.
Even now its not about care for my own health, but for "the greater good".
But there's no easy fix to help us now, because it takes a long time to train doctors, nurses and other staff, or actually build hospitals. Yes, the crisis is entirely predictable but also entirely real. It is possible, even likely for a "liminal" crisis to persist at that level, as the safety valve that keeps it there is that patients without sufficient care just die off. These are the "excess deaths". Yes, I am appalled.
This is BTW one way how "Being unvaccinated could harm the vaccinated": If I (very much vaccinated) need urgent treatment for any reason, and can't get it because all the beds are full of unvaccinated COVID patients, then I am harmed thereby.
If your main concern right now is the "freedom" implications and the "we've been lied to narrative" not the actual deadly pandemic then you have been misdirected, and should reconsider your media diet away from conspiracy-mongers.
Yes, we need to take the good of others into account. Like it or not we live in a society and our actions impact others. This pandemic is making it clear to those who can see, that stubborn selfish refusal, and paranoid anti-mask and anti-vax "freedom" rhetoric harms not just yourself, but also those around you. Rugged individualism is a complete bust in this context. Collective action is what works.
This deadly pandemic is not deadly for everyone.
People over 50 make up 1/3 of the population but 93% of covid deaths. I imagine this number is roughly proportional for hospitalizations by the same age groups. We can do some handwavy math and say if everyone under 50 was unvaccinated, they would only ever take up 7% of ICU beds.
Is 7% the difference between collapse or not? "One size fits all" doesn't make sense.
Further, I'm so confident I will never get sick and be hospitalized with covid that I'm happy to forgo my right to an ICU bed. Thus I'm decoupled from the dilemma. Or at least in an ideal world I would be able to make that choice. This was my assessment the first time I got covid, and now I likely have some level of immunity, so I'm even more confident now.
And as far as your hospital scenarios go, my point is we haven't seen the things you describe materialize. I'm sure there are a handful of cases, which is a tragedy, but if it's marginal then we shouldn't hold it up as a liminal crisis like we have been.
> Yes, we need to take the good of others into account. Like it or not we live in a society and our actions impact others.
Tell me the magic number for risk tolerance. If everyone self-quarantined from driving, and we switched to a delivery only economy, we could drastically reduce the number of motor vehicle fatalities. Do we not owe that to the greater good? What about for climate change? We should continue living like we did in 2020 forever.
> Collective action is what works.
It always works when your leaders are competent and have your best interests in mind. My country doesn't even recognize natural immunity, which I envy the UK for.
But free choice works too. Look at Florida, Sweden, people will still choose the vaccine. You don't need a mandate.
> If your main concern right now is the "freedom" ...
I can't believe the "vaccinated" are completely unconcerned by the trends regarding freedom right now.
You know its not an either/or situation, you can be concerned about both, right?
Look at Howard Springs Australia. Look at the vaccine passports. Look at the thread you're posting in. You probably think you're exempt. But immunity wanes, and variants will continue to emerge.
Governments never relinquish their emergency powers once they're enacted. This is just the latest "WMDs in Iraq". I can't speak for the UK, but in the US we still have the patriot act, and we just recently pulled out of Afghanistan.
20 years later we still live under the boogeyman of terrorism. Imagine if all the money we put into the war on terror went into better healthcare and other social goods?
All of this is to say, I don't have absolute trust in the vaccine or the plan or the people in charge, I don't trust them to make good decision nor to be honest.
If you want me to be onboard with "the plan", governments need to tell me - What's in the vaccine. - Exactly when they'll declare this over. - That they'll undo all of their emergency powers afterwards.
Otherwise, just like the war on terror, this will never be over no matter how much we comply.
The idea that most people "not at risk" is wrong.
The idea that collective action is all about trusting government is wrong, it's primarily abut supporting the other people in your community. it's a very USA'ian line of thinking to jump to "Imma screw over my fellow citizens because the government can't be trusted. Freedom!".
The idea that Florida and Sweden are good examples is wrong.
And as above, the idea that the "freedom" implications and the "we've been lied to narrative" not the actual deadly pandemic is wrong. Do not confuse the one crisis (of democratic ideas) with the other (of infectious molecules) or your responses will not be appropriate. They operate at completely different levels of abstraction.
The idea that "we haven't seen the hospital scenarios you describe materialize" is, in my local area, wrong.
> Look at Howard Springs Australia. Look at the vaccine passports. Look at the thread you're posting in. You probably think you're exempt
I have no idea of the point you're trying to make, and please to make no assumptions at all about me.
I googled "Howard Springs" but I have no idea what crazy talking point I am supposed to be nodding along with now.
> governments need to tell me - Exactly when they'll declare this over
You can't vote on the virus's timeline. The only politicians who have tried to declare "it's over" are charlatans.
> governments need to tell me - What's in the vaccine.
Do I need to go into the reasons why this is paranoid delusional, confused idiocy? Governments don't design or manufacture the vaccines. Without a bio-medical background that you and I both lack it's just not comprehensible. And lastly, can you not google the layman's explainers and research papers? I understand why you didn't post this line alone in a comment - it would be flagged and deleted.
All in all, I feel like someone at a party who has engaged a stranger in conversation, and now regrets it, as they speak a lot but say absolutely nothing worth hearing.
I hope you stay safe, healthy, and have a wonderful holiday this year.
It would help if you explained what is wrong.
As it looks now, you just don't like what the stranger said and declare him not worth listening.
To me it is clear that vaccine passports is clearly not working and all this has become a big failure for politicians who don't know how to exit this failed strategy therefore double down on their plans.