Coronavirus (Covid-19) informational thread

[poorcody]

I think I'm starting to see why the data is confusing based on what Gottlieb said. I think it is because the implications of testing positive have changed.

Clearly the chance of testing positive for the vaccinated has gone way up. Testing positive means they find virus in your nasal passages. Israel says your chance of "avoiding this" has dropped from the mid-90% range to around 40% after six months (and correlated with the delta prevalence). But the virus in your nasal passage may be inconsequential, because the body's immune system fights it only after it gets farther down into the respiratory track. That still seems to be highly effective for the vaccinated because serious illness is still rare.

The chance of passing the virus onto others is interesting. Despite the high viral load found in the nasal passages, for vaccinated people, the vaccine is still effective in blocking transmission, because you transmit by producing aerosols in the lungs, where your immune system has been able to mount a defense. For unvaccinated people, the amount of viral load in the nasal passages directly correlated to transmissibility because it migrated successfully to the lungs.

Bottom line: the vaccinated are more likely to test positive, but it is of little consequence to them or others.

 

[Mainsail]

I think I'm starting to see why the data is confusing based on what Gottlieb said. I think it has to do with the consequences of testing positive.

Clearly the chance of testing positive for the vaccinated has gone way up. Testing positive means they find virus in your nasal passages. Israel says your chance of "avoiding this" has dropped from the mid-90% range to around 40% after six months (and correlated with the delta prevalence). But the virus in your nasal passage may be inconsequential, because the body's immune system fights it only after it gets farther down into the respiratory track. That still seems to be highly effective for the vaccinated because serious illness is still rare.

The chance of passing the virus onto others is interesting. Despite the high viral load found in the nasal passages, for vaccinated people, the vaccine is still effective in blocking transmission, because you transmit by producing aerosols in the lungs, where your immune system has been able to mount a defense. For unvaccinated people, the amount of viral load in the nasal passages directly correlated to transmissibility because it migrated successfully to the lungs.

Bottom line: the vaccinated are more likely to test positive, but it is of little consequence to them or others.

Excellent summary. I don't think this has been very well communicated by the CDC....but, in fairness, it is rather complex for wide-spread dissemination to the general public. Clearly, there is a huge amount of confusion out there.

 

[iluvmacs99]

I would disagree with the notion that fully vaccinated can be easily infected. As poorcody’s post showed per the CDC’s presentation, vaccinated are much less likely to be infected than unvaccinated.

The US CDC chart that poorcody's post showed in the CDC presentation are an incidence report.

In epidemiology, "incidence" is a measure of the probability of occurrence of a given medical condition in a population within a specified period of time. Although sometimes loosely expressed simply as the number of new cases during some time period, it is better expressed as a proportion or a rate with a denominator.

What poorcody's post showed "only" that the probability that vaccinated people are much less likely to be infected than unvaccinated. It's not a certainty. That's because, below I will show you that this truth is busted.

Six cruise passengers test positive for COVID-19 despite vaccine requirement, testing

Four vaccinated adults and two unvaccinated minors tested positive for the coronavirus during routine end-of-trip screening on Royal Caribbean International's Adventure of the Seas. All six were quarantined right away, and flew home Friday.

www.seattletimes.com

In this case, the opposite is true. The incidence report on this cruise suggests that vaccinated people are easily infected by the virus vs unvaccinated. 4 vs 2. How do you explain this?

The explanation has to be with how testing is done and what how our immune system works.

The current PCR testing will turn positive if you have 3000 copies or more of the virus in your system. If you have less than 3000 copies of the virus, then your PCR test will be negative. So this is the first limitation of the PCR test; negative does not mean 0 copies (zero) of the virus in your system and explains why some people who truly experienced COVID symptoms kept getting negative PCR test.

Secondly, people don't really understand the difference between a relapse and a re-infection and sometimes I see people interchange the 2 terms together.

A relapse is when you have relapses in your initial recovery of the original infection; meaning that you recover from being symptomatic, got better, and then lapse back a few days or weeks back into symptomatic. A relapse means you have yet to fully recover from your initial infection.

A re-infection is when you have recovered fully from your initial viral infection only to be re-infected again.

When fully vaccinated and with the Delta variant; it's hard to tell if you are relapsing from an ongoing infection you don't know about or you got a new infection because sometimes they both can show no symptoms, or symptoms you would consider as not being COVID.

Now, the CDC used the term rarely infected; but that's not an accurate representation either because the current PCR test only confirm positivity when you exceed the 3000 copies of virus in your system threshold the test will show. So far, PCR tests we have today are not indicative that you have 0 copies of the virus.

Which was why you have cruise ship outbreaks among fully vaccinated people even they are tested negative with a PCR test.

And that's the reason why you need to wear a mask again, because you can still carry the virus, but the current PCR test can not say you have 0 copies of the virus in you right now even if you are fully vaccinated. This is what the CDC is telegraphing to people without really giving the full explanation why, because if you truly have 0 (that's zero) copies of the virus in you right now and you are fully vaccinated, why would you need to wear a mask if you are shedding nothing!?!

 

[Richard8655]

The cruise ship scenario is a single anecdote involving an extremely limited number of individuals. CDC data comes from a huge number of confirmed medical reports from across the country. There will always be anecdotal exceptions that often are the result of unidentified and unrelated factors.

 

[poorcody]

The Israeli data from that video:

Protection against testing positive over time:
Vaccinated in April: 75% protection
Vaccinated in March: 67%
Vaccinated in February: 44%
Vaccinated in January: 16%

Protection against symptomatic disease:
Vaccinated in April: 79%
Vaccinated in March: 69%
Vaccinated in February: 44%
Vaccinated in January: 16%

Protection against hospitalization:
Vaccinated in April: 88%
Vaccinated in March: 89%
Vaccinated in February: 91%
Vaccinated in January: 82%

 

[iOS Geek]

The Israeli data from that video:

Protection against testing positive over time:
Vaccinated in April: 75% protection
Vaccinated in March: 67%
Vaccinated in February: 44%
Vaccinated in January: 16%

Protection against symptomatic disease:
Vaccinated in April: 79%
Vaccinated in March: 69%
Vaccinated in February: 44%
Vaccinated in January: 16%

Protection against hospitalization:
Vaccinated in April: 88%
Vaccinated in March: 89%
Vaccinated in February: 91%
Vaccinated in January: 82%

Got my first dose in January and the second in February. Those first two "protection" categories...yikes...

 

[A.Goldberg]

A friend of mine was given the go-ahead by his oncologist to get the vaccine this past week. His markers had greatly increased this year so he was on chemo to get his markers down and the chemo got the job done. He's stage 4 with a rare form so it's unlikely that a miracle cure shows up - he's on the chemo for life program.

My mother is at the stage where I think that any kind of infection would kill her. My wife was weak for several days after the innoculation but she's in good shape. I think that someone would have to stay with my mother for several days in case of a response of just weakness. Something like a fever or the loss of use of her arm would be problematical as she only has full use of one arm. At any rate, it is her decision and she's said no up until now. I have two sisters from the west coast coming in this month and we'll see what they say and whether or not she changes her mind.

The explanation on the difference between Israel and the UK is that Israel followed Pfizer's guidelines with the gap of three weeks between doses. The UK (and Canada) wait 2-3 months between doses and this appears to greatly improve efficacy against getting infected. There is a video that I saw last night that shows the efficacy by month between Israel and the UK. This is why there is talk of getting a third dose in the United States and Israel. I sent a note to my oncologist yesterday asking about a third dose. I'm going to see him in a couple of weeks to get his answer unless he messages me before then. I suspect that I could get a third dose if I wanted to because the vaccination databases are at the state level so MA won't know that I was vaccinated in NH. But it would be nice if CDC moved on allowing older or immunocompromised people to get the booster.

If your mother had had issues with vaccines in the past and she’s made an informed decision with her doctors, I think that’s reasonable.

As for the progressive reduction in perceived Israeli vaccine effectiveness, the question is whether it is caused by a natural reduction in immunity (as you have proposed) or whether it is the progressive increase in the delta variant.

According to that video, according to his data, while there was an marked increase in symptomatic breakthrough infections in those vaccinated between Jan and April, in the same time period the vaccine’s protection did not decrease consistently.

Keep in mind those vaccinated earlier were the oldest and most vulnerable and those least likely to form the strongest immunity in the first place.

It will take some time to figure what exactly is going on here. And without Israel publishing their data it’s very hard to weed out confounding variables.

A question that’s always been in the back of my head is the quality control of the vaccines due to their rush into service and how improper shipping could damage the vaccines (they can be damaged if shaken, therefore rendered less effective). With mRNA being such a new technology I am sure there is a lot to learn about their quality control and evaluation.

 

[pshufd]

If your mother had had issues with vaccines in the past and she’s made an informed decision with her doctors, I think that’s reasonable.

As for the progressive reduction in perceived Israeli vaccine effectiveness, the question is whether it is caused by a natural reduction in immunity (as you have proposed) or whether it is the progressive increase in the delta variant.

According to that video, according to his data, while there was an marked increase in symptomatic breakthrough infections in those vaccinated between Jan and April, in the same time period the vaccine’s protection did not decrease consistently.

Keep in mind those vaccinated earlier were the oldest and most vulnerable and those least likely to form the strongest immunity in the first place.

It will take some time to figure what exactly is going on here. And without Israel publishing their data it’s very hard to weed out confounding variables.

A question that’s always been in the back of my head is the quality control of the vaccines due to their rush into service and how improper shipping could damage the vaccines (they can be damaged if shaken, therefore rendered less effective). With mRNA being such a new technology I am sure there is a lot to learn about their quality control and evaluation.

I'd assume that Canada and the UK followed a similar procedure in vaccinating their oldest first.

If the time between doses theory is correct, then the US should be seeing similar results to Israel in several months though there will be differences in that they have a higher proportion of their population with antibodies than we do.

I did have a look at a paper yesterday discussing the length of time between doses and it discussed the pros and cons of more time. The first dose does not provide great protection against Delta. The second dose does. If you wait a short time between doses, you get that high effectiveness in a short period of time but get waning protection down the road.

If you wait longer, then you get longer protection but your population is vulnerable in the time between doses and the two weeks to get to full vaccination.

It would appear that the ideal case would be to get two doses, spaced 3-4 weeks apart, and then another dose sometime after that.

 

[pshufd]

Reuters: Israeli President Isaac Herzog received a third shot of coronavirus vaccine, kicking off a campaign to give booster doses to people aged over 60 as part of efforts to slow the spread of the highly contagious Delta variant.

 

[pshufd]

The Pfizer COVID booster clinical trial is open but the nearest site to me is about five hours away and they are only taking people 65 and older.

There's also a trial at UPMC which is even further away. They are taking people 65 and over and giving a booster (any of the three vaccines), and also taking unvaccinated people and giving them two doses and then a booster a few months afterwards.

I could not find any really recent research on Pubmed on boosters but the UK has already ordered additional shots to be used when EUA for children arrives and as boosters. President Biden has already placed an order for the same purposes. I think that the initial orders are aimed at seniors and the immunocompromised.

 

[scubachap]

I'd assume that Canada and the UK followed a similar procedure in vaccinating their oldest first.

If the time between doses theory is correct, then the US should be seeing similar results to Israel in several months though there will be differences in that they have a higher proportion of their population with antibodies than we do.

I did have a look at a paper yesterday discussing the length of time between doses and it discussed the pros and cons of more time. The first dose does not provide great protection against Delta. The second dose does. If you wait a short time between doses, you get that high effectiveness in a short period of time but get waning protection down the road.

If you wait longer, then you get longer protection but your population is vulnerable in the time between doses and the two weeks to get to full vaccination.

It would appear that the ideal case would be to get two doses, spaced 3-4 weeks apart, and then another dose sometime after that.

Yes, it was all quite rigorously done. It went down in 5 yearly increments on the basis that age was the most predisposing factor. I think when it got to 60 all the vulnerable (over 18) were invited then it reverted back to age based increments. There was a bit of fudging for health care people and some areas worked through their groups a bit quicker than others (other areas considered this queue jumping - a cardinal sin here) which caused some grumbling and issues in the media but they got through everyone surprisingly quickly so the issues were ironed out before they really turned into any dissatisfaction.

There's now seems to be plans firming up for boosters in Sept(?) for the vulnerable and all over 50. I think it will be Pfizer for all - so many of us will be effectively mixing vaccines.

Just to add, it doesn't look like we'll be vaccinating under 18s but that might change.

 

[scubachap]

I did have a look at a paper yesterday discussing the length of time between doses and it discussed the pros and cons of more time. The first dose does not provide great protection against Delta. The second dose does. If you wait a short time between doses, you get that high effectiveness in a short period of time but get waning protection down the road.

If you wait longer, then you get longer protection but your population is vulnerable in the time between doses and the two weeks to get to full vaccination.

Also, bear in mind when comparing that in addition to the dose interval many, well most, that I know of us here in the UK got AZ. A lot of what I've read seems to suggest that the immunity with that one builds more slowly than the mRNA ones but might possibly(?) last longer. I'm no expert so that's something other people can discuss. (I referenced an article about that in a previous post if you're interested.) I'd just say that direct comparisons with Israel etc should perhaps take that into account that it's not an exact like for like comparison.

 

[pshufd]

Also, bear in mind when comparing that in addition to the dose interval many, well most, that I know of us here in the UK got AZ. A lot of what I've read seems to suggest that the immunity with that one builds more slowly than the mRNA ones but might possibly(?) last longer. I'm no expert so that's something other people can discuss. (I referenced an article about that in a previous post if you're interested.) I'd just say that direct comparisons with Israel etc should perhaps take that into account that it's not an exact like for like comparison.

We're at least a month away from Clinical Trial results (maybe even a lot longer) so this is academic unless the CDC authorizes a booster for the elderly or immunocompromised without the Clinical Trial results. I don't know whether or not they do this. Israel has committed to sharing all of their data so they are, in essence, doing a large-scale trial.

 

[scubachap]

Sorry, I might be confusing - I don't mean US / Israel comparisons - just when the UK is included in such discussions (which I've seen people refer to a few times) there would be obvious differences.

 

[iluvmacs99]

Sorry, I might be confusing - I don't mean US / Israel comparisons - just when the UK is included in such discussions (which I've seen people refer to a few times) there would be obvious differences.

Where I see it, there are obvious differences between the UK's approach compared to the US and Israel in terms of their COVID responses.

The difference between the gap in doses (UK is 8-12 weeks) as opposed to the US/Israel's 3 week gap in doses show clearly efficacy differences, being 8 weeks as the sweet spot. Canada had just recently gone down to 7 weeks as opposed to the UK gap schedule Canada followed in the past. This was the main reason why Canada was so slow in vaccinating its citizens and the source of many major complaints, out of fear of the Delta variant, but clearly as seen with our case numbers, the longer gap approach seemed to be better than the shorter gap approach. The gap communication had been poorly received in Canada. As I heard the radio station talking about it, it's clear even our professionals don't have a clear handle of what the longer gap meant, probably lacking the understanding and the follow up of the UK data. That's why the UK should be included in the discussion, because it's clear people think 3 week gap is the same as the 8-12 weeks gap in efficacy of the vaccine especially against the Delta variant, which is showing now to be clearly not. Which is why Israel is doing a 3rd booster shot and now US is considering that option for the senior population.

Also UK's freedom day, which was July 19th where masking mandate had been lifted seemed to show another possible trend. That is the possibility of reaching herd immunity, but it is too soon to tell right now.

All the scientists and politicians all over the world all want to know that 1 million dollar question. And that is; at what point will this pandemic end? I'm sure we are eager to await when we can put away our damn mask and be close together again. Again, that's a million dollar question, but the UK is of interest in this discussion, because they lifted COVID mandate, has a variety of AstraZeneca and Pfizer shots at the longer gap doses and are managing it as an endemic rather than a pandemic. So at what point is normality? Some scientists said that you need a population of 85-90% 18 and up or 12 and up to achieve herd immunity. The UK is almost very close to achieving that followed by Denmark and Canada close behind. The United Arab Emirates also achieved a high degree of vaccination, but their main vaccine is the Sinopharm followed by Pfizer and Sputnik V and they too are considering a 3rd booster shot of the Sinopharm. UK to many in the world is an interesting goal post for that COVID end game.

I think it's important to see what other countries are doing and using some of their ideas and measures to help your own, because the US CDC is not really the center of the Universe as what some of them might think. Which is why very few people in the world us the US CDC data, but rather prefer to use and quote the UK and Israel studies often.

 

[Richard8655]

This is interesting news today: Less than 1% of fully vaccinated people experience a breakthrough Covid-19 infection, analysis finds.

August 2, 2021 US coronavirus news

The Delta variant is wreaking havoc through much of the US, and an internal CDC document shows it spreads as easily as chickenpox. Follow here for the latest news.

www.cnn.com

 

[pshufd]

The gap information is actually hard to find. If you listen to the US media, they don't talk about it. US doctors don't talk about it. I follow a doctor in the UK and he's been doing a great job explaining how things are going around the world. He just received his million subscriber YouTube plaque. He does say, from time to time, that the CDC is behind the times as far as data goes.

 

[poorcody]

This is interesting news today: Less than 1% of fully vaccinated people experience a breakthrough Covid-19 infection, analysis finds.

August 2, 2021 US coronavirus news

The Delta variant is wreaking havoc through much of the US, and an internal CDC document shows it spreads as easily as chickenpox. Follow here for the latest news.

www.cnn.com

The caveat with that is the second sentence in the article: "The federal government only reports data on breakthrough infections that result in hospitalization or death." So in the U.S. data, breakthrough = hospitalizations. Unlike Israel and UK and others, the US stopped tracking non-hospitalization breakthroughs.

 

[Richard8655]

The caveat with that is the second sentence in the article: "The federal government only reports data on breakthrough infections that result in hospitalization or death." So in the U.S. data, breakthrough = hospitalizations. Unlike Israel and UK and others, the US stopped tracking non-hospitalization breakthroughs.

I think the CDC point is most valid. That breakthrough infections severe enough to threaten death or long-term health damage (i.e., requiring hospitalization) is practically non-existent in fully vaccinated people.

This is what's important, especially for those who still hold onto conspiracy-based doubts and refuse the vaccine. Important not to miss the forest for the trees.

 

[pshufd]

I think the CDC point is most valid. That breakthrough infections severe enough to threaten death or long-term health damage (i.e., requiring hospitalization) is practically non-existent in fully vaccinated people.

This is what's important, especially for those who still hold onto conspiracy-based doubts and refuse the vaccine. Important not to miss the forest for the trees.

The downside is that the CDC was blindsided by vaccinated people spreading it to other non-vaccinated or vaccinated people which wasn't expected. If we had tracked non-severe cases, we would have known this earlier. Instead, it was like we were all shocked that this could happen the previous week.

 

[iluvmacs99]

The gap information is actually hard to find. If you listen to the US media, they don't talk about it. US doctors don't talk about it. I follow a doctor in the UK and he's been doing a great job explaining how things are going around the world. He just received his million subscriber YouTube plaque. He does say, from time to time, that the CDC is behind the times as far as data goes.

I think the reason the gap information is very hard to find in the US and US media is because, the US still treats COVID as a respiratory disease and you see this in the media and the TV doctors still talk A LOT about nasal swabs, this and there where other countries are already accepting that COVID causes more damage than just the respiratory tract and they move on by focusing on finding effective COVID solutions.

And it's pretty clear also that unlike Israel and UK and other countries that track breakthrough cases for non-hospitalization breakthroughs, the US stopped tracking non-hospitalization breakthroughs. Other countries had accepted COVID is not only a respiratory disease and are tracking non-hospitalization breakthroughs for possible LONG Covid side effects even after being fully vaccinated. That's the new approach, because it's not what happened after you achieved herd immunity. It is what are you going to do with people who are suffering the after-effects of LONG Covid and what are they doing to the labor force; the shortage of workers and arrangements for those workers who face long term disability of COVID. Some European countries are already making adjustments to this. In the Netherlands, they are providing alternative positions for these LONG Covid workers, maintaining same pay rate and others benefits, but work at jobs that they can manage. What about the US? What sort of arrangements has the US being doing?

Did you know that a worker in Denmark working in Burger King makes $20/hr with full benefits and 5 weeks vacation compared to US worker working in Burger King making minimum wages and no benefits. And in Denmark at least, they are actually making arrangements to keep workers suffering from LONG Covid working at the same pay rate, but work at jobs that are more suitable for the debilitating conditions caused after COVID recovery.

COVID, unlike the common cold, is an all body disease. It affects not only the respiratory tract, but the nervous systems, the heart, causes blood clots, screws your brain and can cause early memory loss and other debilitating side effects that render a person inability to fully restore his or her full mobility in the work force. And that is because unlike the common cold or the flu, which when you achieved full recovery comes with no side effects, but with COVID it comes with some side effects. Many countries had found that some people who had achieved full recovery from COVID did not recover fully from the side effects of this disease. Many could not work even if they want to. This partially explains why there is such a shortage of workers. Main stream media now plays those who are receiving government stimulus checks and taking advantage of rent moratoriums as the villains, as dead beats, as lazy bums etc and yet failed to understand why are they not looking for work. They failed to see that there is a large number of LONG Covid sufferers who are clearly being ignored by US media, some US doctors and the administration; all focused on just getting those case numbers down and vaccination up at all costs. Unlike Canada, UK and other European all provide public healthcare to their citizens, so they are accountable to the public, the US is mainly private healthcare with a huge resistance towards public health care.

 

[pshufd]

President Biden has at least talked about this. US Disability isn't particularly attractive. I've looked into it and it's very hard to apply for and qualify for and the benefits are very small. It's basically another US program which nobody really wants but it might be better than nothing.

Some Americans with 'long Covid' may qualify for federal disability resources, Biden says

President Biden announced Monday that some Americans experiencing long-term effects of Covid may qualify for disability resources from the federal government.

www.cnbc.com

 

[pshufd]

Just watched NIH Director Dr. Francis Collins talking about booster shots. He thinks that it's more important to get everyone a first shot. He was asked about Israel and UK and he said that it's puzzling. No discussion at all about the gap issue.

 

[yaxomoxay]

Just watched NIH Director Dr. Francis Collins talking about booster shots. He thinks that it's more important to get everyone a first shot.

I don't disagree that first shots should be the priority, but in a less than ideal world in which people flat out refuse the vaccine I'd start boosters asap if the doses allow for it.

 

[iluvmacs99]

President Biden has at least talked about this. US Disability isn't particularly attractive. I've looked into it and it's very hard to apply for and qualify for and the benefits are very small. It's basically another US program which nobody really wants but it might be better than nothing.

Some Americans with 'long Covid' may qualify for federal disability resources, Biden says

President Biden announced Monday that some Americans experiencing long-term effects of Covid may qualify for disability resources from the federal government.

www.cnbc.com

Or it might not be enough for the US, especially with your country's lower vaccination rates. Long Covid is especially prevalent among unvaccinated people who had suffered COVID, recovered and then live on with the side effects or disability. Many European countries had already started to accept this as well as Canada, but these countries who all have public health care can not really ignore the people. I think Biden is caught now in between a rock and a hard place as I see he's facing a lot of challenges in what's going in the US.