S.Africa says vaccines, prior infection help mildness of Covid cases
reuters.com
reuters.com
Then break that down to "in hospital and vaccinated with X or having had a previous infection and recovered or unvaccinated and having had no previous infection."
We're not seeing that here in Australia... its all just about the number of new infections. plus a bit of info about Delta/Omicron. it feels like fear mongering not information clarity.
Further, we couldn’t contain delta. If Omicron is 10x more virulent (as claimed), then we have no hope. Masks didn’t help, Lockdowns didn’t help.
Luckily, these illnesses are treatable with the plethora of therapeutics that were discovered. Plus, the strains have become less lethal over time.
It is fear mongering on the part of media (to make money) and governments (to seize power).
I think you mean “10x more infectious” as virulence is how serious/deadly/damaging the infection is. Omicron is no more virulent and maybe considerably less virulent than previous strains.
Is the key difference that in an infectious disease expert context, virulent means severe and infectious means contagious?
I always thought virulent was ability to spread because that’s what viruses do, but that was way before the pandemic.
Some said that vaccination proved a 70% protection to infect someone. Makes sense since the time someone can infect others is shortened because of the quicker immune response. I still believe this to be a noble lie however, since we should have seen an effect, but the curves rose just as quickly in vaccinated/unvaccinated countries and as fast as in the first wave.
Our bureaucracy and inability to improvise in times of need will kill us all.
https://covid-19.ontario.ca/data?fbclid=IwAR2pRUq9GN9EEoDTm0...
In the last week daily cases have increased 50%. If this remains with the 1 in 40 case:hospitalisation ratio, then between Christmas and New Year we'll be looking at 2,000 new hospitalisations a day.
This time last year the ratio was 1 in 13 case->hospitalisations, so clearly things are far better.
However if cases are doubling every 4-5 days - with cases 4 days ago being abeing about 100k/day, in a few days time this will be 250k/day, and by christmas 700k a day. Before New Year it will naturally plataeu at 1.5m a day (because that's 1 in 6 of the population getting it in a week, and there just aren't enough uninfected people for it to go around.)
That seems to be the strategy the country is going for.
It's too late to stop it reaching 160k/day, which would be 4k hospitalisations a day - the peak of last year - based on October's admittance rates, and there's very little sign of attempts stop it going further, meaning we could be looking at 8k attempted hospitalisations come new year.
The main hope is that Omicron, combined with boosters (which already have a >80% uptake in over 60s) will reduce that 1:40 ratio
Further, have you seen the latest theory about the mechanism of Omicron? It grows faster in your bronchus/windpipe[0], and slower in your alveoli, so while the cytokine storm (immune response) side of the disease is still concerning, the risk of pneumonia is greatly reduced. I will not comment on cytokine storm vs pneumonia frequency in terms of long COVID or case severity as I am ignorant in this regard, but I can imagine people need the breathers less if they aren't dying of pneumonia, and I somewhat understood this to be a major issue for ICU capacity. This also explains the increased infectiousness to me, as your bronchus would emit comparatively larger viral loads with each breath than the alveoli if we still believe the droplet and not airborne theory.
[0] https://www.theguardian.com/world/2021/dec/15/omicron-found-...
80%+ of new cases were in fully vaccinated back in August.
https://www.nebraskamed.com/COVID/antibody-dependent-enhance...
Hospitalization matters for short-term policy, but long-term damage could end up affecting long-term healthcare policy even more in the coming decades
So, the trouble with that is that hospitalisation is a lagging indicator. By the time hospitalisation starts rising rapidly, you could lock everyone in their houses and it would still rise rapidly for another week or so. Which will probably overwhelm your hospitals.
Even in places with 95% vaccination, case counts are still _generally_ a reasonable indicator of where hospitalisation is headed; some fraction of those cases will convert to hospitalisations due to that vulnerable 5%, and due to people for whom the vaccination doesn't work very well (immunocompromised and extremely ill people, generally).
Exactly what should be done. Instead of reporting new cases most prominently, there should be reports on how cities like SF, with 80%+ vaccination rates, have 0, or single digit death averages over the last week. For massive population centers!
And laws, which take time, for good reason, to propose, debate and pass.
We can't run a country with by changing direction every time case numbers of one particular virus go up or down
What I now believe is missing, and would like to see, is the number of ICU COVID patients who are vaccinated and unvaccinated, as well as an age group breakdown. This is the type of data required to make informed decisions. If I had a teenage child, I’d be wanting to understand the true likelihood of them contracting COVID and ending up in an ICU bed, in order to make a decision about vaccinating them against it.
I’ll give you the technicality that you said “state” but still, we’re doing pretty good here in the territory!
I had my booster yesterday morning. I’m 45.
[0]: https://www.health.gov.au/sites/default/files/documents/2021...
It is the control group of the natural circumstance.
It seems like a pretty big gamble to not be cautious. Masking, vaccines, and avoiding indoor crowds in poorly ventilated spaces seems to be helpful. Probably best to at a minimum continue to do that until we have more concrete evidence.
Every new infection results in rolling the evolutionary dice a few hundred billion times, and is how we get diseases that evade our defenses, and new diseases in general.
Also, being hospitalized isn't the only bad thing about COVID.
That frames it as if that was a new and scary thing and not something that has been going on for millions of years.
The hospitalisations measurement, is I think sensible. I still think underlying case rate means something.
> I find that very scary, close to a "giving up" mentality.
Everyone can have a vaccine, there are multiple highly effective therapies and even the risk of death without intervention to the majority of people (under 55) is already astronomically low.
To put it in perspective, if you’re under 30 with asthma, your risk of death from the original covid variant (not the less lethal variants) is the same as being struck by lightening.
We haven’t given up, we’ve successfully mitigated fatalities until we have effective treatments and a vaccine. Now it’s time to move on.
This this month I did catch covid. I'm not even sure I'd class it as a bad cold, it was far less debilitating than the bug I had in November - although seems to be lasting longer (4 days of coughing so far). My last vaccine was in July (went positive literally the morning by booster was due).
I suspect most people have either had covid or know someone close who has, and see that the main problem is the effects of restrictions -- not going to work while waiting for results (leading to public transport cancellations for example), kids being kept off even though they feel fine. (One symptom of covid is a headache, but that's because I've been trapped in a house with 2 very energetic very excited children for the last 10 days)
Throw in the constant disregard for the rules that the government has shown, and I can't see the acceptance of restrictions surviving in the UK past January.
The brexity type people I'm 'freinds' with on facebook began covid all in favour of restrictions and vaccines. They are fortunatly still in favour of vaccines, but are increasingly shifting to being anti restrictions. Further restrictions will push them more into the Piers Corbyn echosphere, and that's a bad thing.
My brexity friends started covid feb 2020 - "There have been no white people die of Covid, white genetics are superior to chinese genetics and immune to covid - this is an EU conspiracy to punish the UK for brexit" - since then a few died of covid, most lost parent / aunt / uncle / family member.
Its still 100% an EU plot to destroy brexit.
So I think preventing all that loss of quality of life is also worthwhile.
https://www.medpagetoday.com/opinion/vinay-prasad/94646
https://www.businessinsider.com/delta-variant-made-herd-immu...
Whether that is a net benefit over the economic consequences of lockdowns and secondary effects of that I don’t know. I wouldn’t even know how to begin answering that question.
I’m just trying to say that there are other effects than death which seem more likely and impactful for longer for youthful people as they are more likely to get one of the other effects than they are likely to die from COVID.
In this case my eye care provider has seen more cases where patients lost eye sight after covid. Typically this amount of loss of eyesight is not observed over a single period of three weeks.
Mitigated, how exactly?
Well sorry to say that with Omicron that all bets are off. Two out of 3 mAbs don't work and the third isn't so great. And the covid pills are still a long ways off.
Even if hospitalisation rates are a small constant factor lower, doesn’t everyone remember from CS101 that O(k^x) is bad news bears and that constant factor ain’t gonna save your assignment once the problem size grows just a little more.
The total number of cases is very similar to a logistic curve that initially can be approximated by an exponential, but later it stabilizes and it looks like a step.
The number of active cases / hospitalizations is similar to the derivative of the logistic curve that initially can be approximated by an exponential, after some time goes to zero. It looks like a bump.
A smaller hospitalization rate means that hopefully the bump is low enough to not saturate the hospitals.
More about some simple models: https://en.wikipedia.org/wiki/Compartmental_models_in_epidem...
If you take an exponential growth of 1.5, quite a quickly spreading infection. And a hospitilization factor of 5% vs 0.05%:
day 20: 3.3k cases, 165 vs 1 hospitilization
day 25: 25k. 1.2k vs 13
day 30: 191k 9.5k vs 95
day 35: 1.5m 73k vs 728
day 40: 11m 550k vs 5528
So a 10M people country with ~5k. beds wouldn't have healthcare capacity due to the constant factor, while without they would be overwhelmed within a month.
That said, when I looked up studies on that the chances were about 1% for that to happen to me (at that time).
Are you suggesting how lethal it is when someone gets it is of no consideration?
On average, there are hospital beds (of any kind) available for about 0,3% of the population. If 5% of the cases are severe enough to require hospitalization, this means that hospitals get completely overwhelmed when 6% of the population are down with COVID simultaneously. And that's assuming that every hospital bed can be used, which is unrealistic.
Yes.
That this has to be explicitly stated here explains my surprise.
Day 1 - 1 cases
Day 11 - 1000 cases, 1 hospitalisation
Day 21 - 1 million cases, 1,000 hospitalisations
Day 31 - 1 billion cases, 1 million hospitalisations
Day 41 - 1 trillion cases, 1 billion hospitalisations
That would be awful. It would be impossible too.
It is possible to get to 100% population death if you assume 0.0001% death rate where the 99.9999% reinfected over and over untill they die. That assumes reinfection.
But as someone who is one of those data numbers, I care very much that I am a lot less likely to end up in hospital.
One of my sister-in-laws is a doctor working at a government hospital in South Africa. She and my brother both have Omicron right now. They caught covid in the first wave. Subsequently vaccinated with pfizer (brother), and Johnson (his wife). She had mild symptoms the first time around (Doctor's immune system); he was bed-ridden for days and even fainted at one point.
This time around she has zero symptoms, and he's got almost none.
The best move is not to play, professor falcon.
At least I'd like to be not on the side of big corp interests.
Now 1 in 1000 go into hospital, that's great from an individual basis and a population basis. Still means that 1 million infections leads to 1,000 hospitalisations.
It gets worse though, you can 'overclock' your healthcare system in a time of crisis, but that leads to burning out your machines, and thus ending up with less capacity afterwards. Generally the west has run our healthcare systems beyond 100% for nearly 2 years, and that means capacity has actually decreased. All the money in the world won't fix that in a short time - indeed it can make it worse in some cases (If you gave a nurse $1m to work 16 hour shifts for the 30 days, he would, and then he'd likely quit)
If you want to improve your healthcare situation, you need to go back in time 10 years and get more people training to work in healthcare. That means fewer people working in advertising or other key parts of the economy.
I see what you did there :).
Anyway, ~10 years ago I considered moving back to school for a nurse degree. I didn't and one of the reason was that I had not enough energy in me to fight for the degree and to fight the social and welfare system for the right to do it. Edit: It's a key part of the society and the promise of fulfilling rewards is great but the system doesn't like you. It glorifies your pain.
That's why I don't believe most nurses and health care workers who got out will ever get back as nurses. Maybe as medical secretaries or logistics but they won't get back in the trenches.
The official reason is that they must be used to long shift, so in case of a big emergency they can work long shifts. The problem is that once the big emergency arrives, you don't have spared professionals, because you don't need them because they are overclocked in normal times.
Another reason is that the shift change is dangerous because they have a lot of info in their mind that is not transmitted to the member of the next shift. This can be solved if they log all the data in some common system, but it's difficult to convince the doctors to follow a checklist during surgery. (Pilots following checklist avoid a lot of plane crashes.) (Each time a new doctor arrives, remember to tell him/her all the relevant info, don't assume the last doctor passed the info.)
If you want to be prepared for the next pandemic, make 6 hours shift mandatory. They will have an easy time fpr the next 90 years. Health care will be more expensive. Make a good shift change procedure. Once the next pandemic arrive, you can easily overclock the staff x2, increase the pay x3 to keep them happy, and call the heroes too.
Health systems in many places are optimized for efficiency, and on top of that were at or over capacity even pre-pandemic.
I find it shameful that this is still not addressed properly and publicly. If enough resources had been spent on addressing this issue, and doing everything we can to overprovision capacity (double healthcare worker compensation could be one part of that, for example), we should be able to handle this by now.
If, under normal condition, healthcare workers had a lot of slack, facilities were underused, and pay was higher, the situation wouldn’t be so grave. (wasn’t there an Ask HN thread the other day where many self-reported reviving cushy pay for only doing 2-8h of actual work in a given week, and others responding with how that’s all good?)
It's a question mainly used in a form or another by covid deniers to first shift the blame for hospitals saturation from the covid infection rate to government's downsizing of our health infrastructure and then to claim this downsizing is the main and only reason for hospitals saturation “so covid is not responsible for hospital saturation, see ? so let's stop the vaccine madness".
Whatever our hospital capacity is or should be or was it's not enough now to handle the situation.
If it was enough 2 years ago then we'd still be facing health worker's fatigue.
> Peaking power plants, also known as peaker plants, and occasionally just "peakers", are power plants that generally run only when there is a high demand, known as peak demand, for electricity.[1][2][3][4] Because they supply power only occasionally, the power supplied commands a much higher price per kilowatt hour than base load power. Peak load power plants are dispatched in combination with base load power plants, which supply a dependable and consistent amount of electricity, to meet the minimum demand.
> Although historically peaking power plants were frequently used in conjunction with coal baseload plants, peaking plants are now used less commonly. Combined cycle gas turbine plants have two or more cycles, the first of which is very similar to a peaking plant, with the second running on the waste heat of the first. That type of plant is often capable of rapidly starting up, albeit at reduced efficiency, and then over some hours transitioning to a more efficient baseload generation mode. Combined cycle plants have similar capital cost per watt to peaking plants, but run for much longer periods, and use less fuel overall, and hence give cheaper electricity.
> As of 2020, open cycle gas turbines give an electricity cost of around $151-198/MWh.
The issues is that the natural mechanism that incentivises the private sector to provide peak capacity is what some people call 'price gauging'. And that's a big taboo for 'sacred values' like anything to do with medicine or health.
I don't think this would work here though, since enlisting to work in a covid ward is a hard sell when you're not being drafted, and standard of care would suffer with all the inexperience.
Substantially raising nursing pay and increasing the powers of nurse practitioners would be a good idea though.
Many people would happily do some courses (and plenty of refreshers) to be a stand-by nurse or doctor who only gets activated for a few weeks every few years, if they get a few tens of thousands of dollars for that trouble.
Let's do some napkin math for my area: if you started such a company in 2008 and paid your doctors minimum wage to stand by and keep themselves trained, but not actually do any work, one such doctor would've cost you around 100k € until the start of the pandemic. I remember hearing some official on the TV saying we'd need another 300 doctors to keep everything running smoothly. Let's half that. Congratulations: your company is 15 million € in debt. Let's call it 20M € because obviously you need to make yourself at least a little rich too. So that's the bill you need to give the government in order to break even: 20M € for 150 under-trained medical personnel with basically zero work experience. Not a good business model, imo
Power plants are major capital investments. That capital has opportunity costs when it's just sitting idle. (Add in maintenance and deprecation etc.)
To continue the discussion, we should have a look at the economics of peaker plants.
> Let's do some napkin math for my area: if you started such a company in 2008 and paid your doctors minimum wage to stand by and keep themselves trained, but not actually do any work, one such doctor would've cost you around 100k € until the start of the pandemic.
Duh. Just because you (or me) can't come up with a decent business plan in two minutes of thinking, doesn't mean none exists.
First of all, I doubt any sane plan would involve paying people to sit on their hands and do nothing.
I imagine, you'd pay people a basic retainer to stay ready, and probably pay for their refresher courses every so often.
For some people, paying for the initial education and refresher courses alone would be payment enough to stand-by (and then a fat bonus, if they are actually called into action).
Silly example: someone who otherwise works as a nanny or with kids in general might want to be able to boast that they are fully qualified as a nurse and receive regular training.
(Flight attendants also usually come with some basic medical training already. And they were rather underemployed during this pandemic. So they might be good people to approach about such a retainer scheme.)
Smarter people than me will probably come up with better business plans.
Eg you might want to differentiate candidates by how quickly they could jump in. Being ready with 24h notice is much more demanding, than being able to be ready within a month. But the latter would still be useful, because training medical personal from scratch takes longer.
Some regulations are useful, some are insane. But going with a fine toothed comb over which is which would be too much for a short comment.
The core argument that I was addressing was that somehow the private sector wouldn't be able to provide peak capacity, ergo the government would by default do a better job.
Your further example of dropping the certification requirements to something sensible, perhaps at the simplest even by just allowing nurses to do more of what only doctors are allowed to do at the moment, would apply about equally well in a government hospital as in a privately run one.
Similar actually for how to organise stand-by/peak duty, even down to how you pay your personnel. Main difference is that I would assume that privately run outfits would (have to) pass on the extra cost at peak into 'gauged' prices, and governments would just make the tax payer swallow the pill. (Or more likely, would also just accept doing a bad job and having a bad system in place. Especially if they ban the competition.)
Can't they do research when idle?
Vaccination is neither prevents infection nor spreading. Its about efficiency of the response.
Vaccines frequently prevent infection and spreading. (And yes, they do this by way of priming the immune system.) For example, we eradicated Small Pox with vaccines: https://pubmed.ncbi.nlm.nih.gov/788150/
My understanding is that vaccines do reduce the chance of Covid spreading. But with the Omicron variant, they help a lot with preventing severe illness and only a little bit with helping reduce infectiousness. And Omicron is ridiculously infectious, so it's going to whip right through well-vaccinated areas just like everywhere else.
But in general, reducing the chance that one person infects another is one of the primary purposes of vaccines.
A recent study found that vaccinated people infected with the delta variant are 63 per cent less likely to infect people who are unvaccinated. ...
Others have worked out the full effect. Earlier this year, Ottavia Prunas at Yale University applied two different models to data from Israel, where the Pfizer vaccine was used. Her team’s conclusion was that the overall vaccine effectiveness against transmission was 89 per cent.
Quite. If "Y happens less frequently" then at least one instance of Y has been prevented. But some instances of Y still occur, so "Y can still happen". And if "Y can still happen" then some _clever_ person will say that "aha, Y has not been prevented from happening!"
I _can_ ride a bicycle. So can Mark Cavendish. But these are not equivalents.
None of this is binary, boolean, on-off. Sometimes it seems like this is being deliberately straw-manned with overly simplistic "all or nothing" thinking.
We know that the COVID-19 vaccines prevent a large percentage of infections. We also know that they don't prevent all infections. We know that they are still very worthwhile. We need risk reduction, harm reduction not nit-picky semantic arguments. Medicine is not Boolean logic.