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You can have a high case load in vaccinated countries and still have vaccines that reduce transmissions. Those two ideas don’t conflict.

It just means the vaccines we have don’t reduce transmission by 100% and you have a disease that is highly infectious. Just because a medical intervention doesn’t work 100% of the time doesn’t mean it’s 0% effective. Most interventions (vaccines, drugs, procedures, surgeries) don’t work at 100.0%.

From the data I’ve seen it appears the mRNA vaccines have some effect in reducing transmission while the other vaccines don’t. It is correct to say that the efficacy against transmission has dropped significantly, but that doesn’t mean it’s 0%.

This echos my partner’s experience (the treat covid in an icu). This was almost a year un with some plausible evidence and several countries saying they thought aerosol transmission was likely. Yet the key agencies and experts here were aggressively saying aerosol transmission was very unlikely.

It was criminal for way wait too long. If you look at the study of infectious diseases the aerosol transmission model has been discounted for way too long due to inability to “prove” it. If you can’t design an experiment to prove or disprove an idea that doesn’t make it automatically wrong. For example, the aerosol transmission model for influenza was flatly rejected for a long time, even when key scientists found it plausible and had some experimental evidence which wasn’t air tight. In covid’s case the CDC and other experts were grossly exaggerating their confidence that the aerosol transmission model was wrong. My partner was treating covid and in late 2020 after a lot of evidence indicated it was plausible, she still had infectious disease experts make fun of physicians for asking about aerosol transmission. They were grossly confidently incorrect about a theory that had no evidence on either side but had some plausibility (because similar diseases had aerosol transmission). Again, the way the community acted in an area of unknown where it was impossible to prove or disprove was very unscientific.

It was only over a year (with a lot of evidence) that the CDC said “aerosol transmission is maybe sorta kinda possible maybe”.

There are multiple ways to validate an idea, and sometimes you can’t design a blind rct. We know parachutes work despite never having proven it in an rct trial.