A super-spreading event of Omicron amongst triple-vaccinated healthcare workers | Hacker News Reader

A super-spreading event of Omicron amongst triple-vaccinated healthcare workers

medrxiv.org

48 pointslnyan74 comments

21 infections is classified as a 'super spreading event'? What is 100 or 1000 infections, a super duper spreading event?

> 21 infections is classified as a 'super spreading event'? What is 100 or 1000 infections, a super duper spreading event?

Wikipedia defines a super spreading event as an event where an infectious disease spreads much more than usual.

https://en.wikipedia.org/wiki/Superspreading_event

The study refers to a private social event attended by 33 participants comprised of triple-vaccinated healthcare workers, where 21 triple-vaccinated attendees contracted COVID.

Vaccine do not prevent spreading, their main advantage is reduce hospitalization and death

It’s all about probabilities. Vaccinated people have less of a viral load and infect fewer people. It’s never all or nothing. Reducing the r-value even by just 0.1 compounds in huge returns in exponential growth scenarios.

I can see that in theory, but when you look at the cases curve in the US pre and post-vaccination you can't really tell there has been a "huge" effect, I would even call that a failure, frankly if we had given everybody enough vitamin D to fix the significant average deficiencies, that would have a much more dramatic effect on reducing infection and spread. Maybe we could even have a vitamin D pass :P...

You’re not seeing how the delta variant would have spread in a fully unvaccinated population. Notice how the original variant and the more infectious alpha variant failed to thrive post-vaccine. There was some competition effect from delta but it isn’t as if one variant directly suppresses another. Delta would have ravaged the country without vaccination reducing its rate of spread.

Bulgaria has a very low vaccination rate (27%) and the curve doesn't look that much different from the US's: https://www.google.com/search?q=bulgaria+covid

It does seem better, but can we know for sure to what this can be attributed? Usually places that had an easier time in 2020 got worse this year, and vice-versa, which makes sense...

US vaccination rate is not great, and will be patchy (some places quite well vaccinated, some well below average).

A better comparison would be Bulgaria to Portugal.

The Economist tracks excess deaths, which is a more accurate measure of how deadly COVID is, especially in places with iffy stats.

Bulgaria looks like reporting is not reliable: https://www.economist.com/graphic-detail/coronavirus-excess-...

The research I saw shows the viral load of vaccinated people is the same if not higher.

https://www.ucdavis.edu/health/covid-19/news/viral-loads-sim...

Do you have other references?

First, vaccinated folks clear the virus faster, so the overall time of infectiousness is lower. https://globalbiodefense.com/2021/12/04/vaccinated-people-cl...

Second, fewer vaccinated people have breakthrough infections in the first place, so overall spread is lowered because of vaccinations.

arguable they will slow down spreading. though omicron makes it look negligible.

"Do not prevent spreading" suggests a kind of black-and-white perspective. This is not about fully preventing, it's about reducing the risk. Vaccines substantially reduce the risk of spreading or catching Covid.

https://www.newscientist.com/article/2294250-how-much-less-l...

Isn't without vaccines the death rate from Covid is around 4%? I read earlier 80% of unvaccinated in 2018-2020 stage, won't even show much symptoms. Singapore even gone thru extensive testing and their death rate was very low well below 1% and this was before availability of vaccines. So reducing the risk of that 4% chunk isn't significant.

The death rate is nowhere near 4%. The CDC estimated the infection fatality rate in the US at 0.6% back when almost no one was vaccinated. The vaccines and other improved treatments have now cut that risk way down.

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

> The death rate is nowhere near 4%.

Your own source shows quite clearly that the estimated death rate for >65yo lies between 3.8% and 4.0%.

The >65yo cohort is both the one reporting the lowest number of total infections (~18M) and the highest death count (~700k).

Yes and the CFR in people 20 - 30 appears to be about 0.01% (very roughly). Obviously some subpopulations are more or less vulnerable. Averaged over the whole population it generally comes to somewhat under 1%.

Check out the CFR for RSV (a common cold virus) or influenza in people over 80. Viruses that almost never incapacitate let alone kill healthy younger adults can often kill the medically weak.

There are fates worse than death, and so much in-between.

> There are fates worse than death (...)

...said the person who hasn't died of COVID.

Meanwhile, those who died from COVID typically undergo an excruciating death.

https://www.vox.com/2021/2/20/22280817/covid-19-deaths-us-nu...

And those with long covid — 20-30% of victims, last I read — typically undergo an excruciating life.

I think you misunderstood my point. I meant that the percent of deaths understates the suffering of our species.

> Vaccine do not prevent spreading,

Vaccines do not entirely prevent spreading. But nothing does.

Vaccines are not entirely useless to prevent spreading. It's one of the few measures that has an effect. Less so with Omicron, to be sure.

Would you say "When wearing a bulletproof vest, you can still be shot in the arm or head, so bulletproof vests do not prevent injury" (and might as well not wear one when in a dangerous situation)

Medicine is not Boolean logic, none of this is binary, all or nothing. We need risk reduction, not sweeping reductive statements.

Mask? Many places mandate that as though as it prevent spreading. So vaccines weren' exclusivity of that.

Admittedly these are preprint studies, but it seems the analogy with bulletproof vests doesn't hold:

Vaccinated and unvaccinated individuals have similar viral loads in communities with a high prevalence of the SARS-CoV-2 delta variant: https://www.medrxiv.org/content/10.1101/2021.07.31.21261387v...

No Significant Difference in Viral Load Between Vaccinated and Unvaccinated, Asymptomatic and Symptomatic Groups Infected with SARS-CoV-2 Delta Variant: https://www.medrxiv.org/content/10.1101/2021.09.28.21264262v...

Viral load is not the only factor; there is also a) how long that infectious viral load is present for, and b) chance of getting infected with that viral load in the first place.

No analogy is perfect, but I think that this one is instructive, as it breaks the binary logic.

The statement "vaccines don't prevent..." conflates two very different statements, i.e. "vaccines don't prevent all occurrence of $outcome" (which is often true but not the point) and "vaccines don't have any impact on $outcome, prevent any occurrences of $outcome" (which is false, but is often implied).

It's clear that COVID-19-Omicron is infectious to a crazy degree, but that's a different statement to "this defensive measure does nothing".

Only after they get a breakthrough infection, which is still presumably less likely when vaccinated. That still works very nicely with the bulletproof vest analogy.

I wonder if it would be less confusing if we simply stopped referring to these as vaccines and just as shots.

That would be the opposite of clarifying or helpful.

That is not the correct definition of a vaccine. Nobody would say that about a polio or diphtheria vaccine. COVID shots should NEVER have been called a vaccine.

They are instead similar to seasonal flu shots. Flu shots do not prevent spreading, their main advantage is reduce hospitalization and death.

Cancer immunotherapy candidates have been referred to as cancer vaccines for a long time without controversy, and they are generally not intended to prevent cancers. They are medicines that work via an immune response.

Sure, public health communication could use some improvement, but arguing over the definition “vaccine” I think is not productive

Ask someone why they'd support mandatory vaccination and generally you will hear: to stop unvaccinated people from spreading the disease. Definitions do matter here. Governments are leaning heavily on this misunderstanding.

I agree that definitions matter, and it’s important to have a clear discourse on policy implications of public health research.

But my point is that it’s incorrect to call the current Covid vaccines “not vaccines” just because they don’t 100% prevent transmission or infection. That’s only muddying the waters at the expense of a real discussion of the evidence and trade offs for any given policy position.

See pre-pandemic wiki, for example: https://web.archive.org/web/20170403082447/https://en.m.wiki...

> I agree that definitions matter, and it’s important to have a clear discourse on policy implications of public health research.

And yet, you insist on using "vaccine" to push mandates, knowing that most people think you're promising that that said "vaccine" will keep people from spreading covid, knowing full well that it doesn't.

Where am I pushing mandates? I think there are valid policy positions on both sides of the issue, and that you’re misrepresenting the logic of those who still are in favor of vaccine mandates.

You also haven’t offered any substantive counterpoint to my main point, which is that the widely accepted definition of vaccines is broadly consistent with the current coronavirus vaccines. The scare quotes aren’t necessary and detract from a reasonable discussion of their actual utility and tradeoffs

They're not scare quotes. I'm writing about word choice, so it's appropriate to use delimiters to make it clear exactly what word I'm writing about.

Most people think that "vaccine" has a specific meaning. It is dishonest to use that label for something that doesn't conform to that meaning when communicating with those people.

Ok, sorry if I misinterpreted your punctuation, the last instance is what read like scare quotes to me; maybe `backtick` is a better delimiter for this case

> Most people think that `vaccine` has a specific meaning. It is dishonest to use that label for something that doesn't conform to that meaning when communicating with those people.

I disagree that it’s dishonest, it’s the correct term.

I agree that if most people have a misunderstanding of what constitutes a vaccine, then failing to address that is going to lead to suboptimal public health communication.

It's not the "correct" term if you know that the recipient thinks that it means something else. (All communications happens at the receiver.)

It's dishonest because they think that you're promising something that they're not going to get AND you know it.

I take your point, but by correct I meant “consistent with the established definition,” which was the original context we started in

Like I said, maybe it’s not the optimal term to use in public health communications, and that could be because of dishonesty, but it could also be due to ineptitude or just failure to appreciate a widespread misunderstanding

It's not the "established" definition with the target audience. Your argument is basically "I don't speak Spanish, so I'll talk louder and add a long 'o" at the end of words when talking to someone who only speaks Spanish."

It's hard to find a public health organization that doesn't say that communicating with the public is a key goal and core competency.

So, are they: [1] Incompetent [2] Using a different definition of "goal", "communicating", "core competency", etc? [3] ????

Note that communications isn't the only problem.

One of the arguments for [1] is that the public health folk have long said "hey, we're necessary to avoid a repeat of the Spanish Flu." yet they were largely unprepared. (Then again, flu kills 30-80k Americans every year and most of the good transmission research was done in the late 40s...)

I think I agree, that these are definitely vaccines even according to traditional definitions, but the etymology is unduly impacting real world understanding IMO. To be clear, I did not put my point to refute yours but to perhaps add an additional perpendicular view on the subject of how we are talking about these things and how selective misunderstanding is allowed to persist.

Thanks for the thoughtful reply. I do agree that the public discourse has not been very productive, and the news coverage has been overconfident and one-sided in one way or another, especially around omicron lately.

> They are instead similar to seasonal flu shots.

"Flu shots", aka seasonal flu vaccine.

https://www.cdc.gov/flu/prevent/keyfacts.htm

It seems that your personal belief of what a vaccine is does not match the real concept of what a vaccine is and always was.

According to the CDC, here is the definition of vaccine/immunity: https://www.cdc.gov/vaccines/vac-gen/imz-basics.htm

Immunity: Protection from an infectious disease. If you are immune to a disease, you can be exposed to it without becoming infected. Vaccine: A product that stimulates a person’s immune system to produce immunity to a specific disease

> Vaccine: A product that stimulates a person’s immune system to produce immunity to a specific disease

I'm not sure you hit an eventual consistency thing while you read the source you cited, but the definition of a vaccine in it does not match your definition.

A vaccine, according to the CDC source you quoted, is:

> Vaccine: A preparation that is used to stimulate the body’s immune response against diseases. (...)

Keep in mind that your personal definition of a vaccine does not match how most vaccines work, if any vaccine at all.

From the CDC: Vaccine = "Produce immunity". Immunity = "you can be exposed to it without becoming infected" It's right there. This definition, and the most common understanding is that a vaccine means "without being infected".

Vaccines do prevent spreading [1]. The problem is that we didn't achieve herd immunity prior to Omicron.

The current COVID vaccine is not effective at preventing the spread of Omicron, specifically.

[1]: https://en.m.wikipedia.org/wiki/Smallpox_vaccine

Not in this case. The covid vaccines just turned the vaccinated into asymptomatic delta superspreaders. There was no likely endgame where we reach herd immunity with the current vaccines.

We knew that it would be impossible to achieve any meaningful level of herd immunity even prior to Omicron.

https://www.businessinsider.com/delta-variant-made-herd-immu...

So all vaccinated individuals are super-spreaders?

Traffic laws do not eliminate all car crashes.

I wonder if it might have to do with a lack of Vitamin D? I can't imagine people get a lot of sun in the Faroes in December?

Addressing a vitamin deficiency doesn't hurt, but it's taken a lot of data to figure out vitamin D's relevance to COVID. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8669943/#!po=1.... There are so many people with low vitamin D levels that it would be hard to blame any one outbreak on it.

It hasn't actually taken a lot of data it figure out vitamin D's relevance to COVID. While updated review articles are always appreciated, we had clear data from clinical studies over a year ago.

https://vitamin-d-covid.shotwell.ca/

They were visitors to the islands, not inhabitants.

Sometimes this feels like a dress rehearsal for the flu that wipes out 99% of humanity, but, thankfully they're all alive and none was admitted to hospital.

> but, thankfully they're all alive and none was admitted to hospital.

So it's like a dress rehearsal?

The last nail in the coffin for the argument of vaccinating young children. They have “statistical immunity” from covid itself and as this article shows, the notion that the vaccines significantly prevent transmission is fanciful at this point.

They don't - they significantly reduce hospitalizations.

If they get covid there is a chance of long covid as well as Multisystem inflammatory syndrome in children (MIS-C).

There are afaik no contraindications for children with the vaccine, so why not vaccinate them?

A province in Vietnam suspended the Pfizer vaccine after 100+ 15-17yo got sick:

https://e.vnexpress.net/news/news/120-children-hospitalized-...

They suspendend a batch of the vaccines, they still continue the vaccination of the children.

They are even thinking about using that specific batch for adults.

We vaccinate young children more to protect adults than to protect the children.

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