The case numbers this week were clearly bad news. The raw count was somewhat bad news, and the positive test percentage increase was very bad news. It would be easy to treat the whole shift as fully ‘real,’ attribute it all to Delta, and panic.
I do not think that is the correct interpretation. What we are seeing matches what we saw a year ago, so a lot of this is a seasonal and regional change that has nothing to do with Delta. It’s also likely that some of the shift in percentages comes from data being wonky rather than the underlying conditions. Not only do we have alternative explanations, the size of the shift doesn’t match the incremental change in the amount of Delta out there, even if (as I suspect) it’s a rather dramatic takeover, with Delta’s share of the pandemic in America rising 25%+ in a single week.
It’s also going to be tempting to attribute seasonal weather effects to the local vaccination rate, since the two are highly correlated. Differences in vaccination rates in different areas matter a lot, but that’s not central to what is happening this week.
Thus I am still expecting some regional outbreaks, and am still not expecting nationwide problems, but one must ask about whether the winter is going to bring trouble the way last winter did. The hopeful answer is that vaccinations will be far enough along by then to not matter, and the second hopeful answer is that even if it’s bad it won’t be anywhere near as bad as last time. The vaccination numbers this week were quite good.
Still, I miss the confidence I had two weeks ago. Let’s run the numbers.
The Numbers
Predictions
Prediction from last week: Positivity rate of 1.8% (unchanged) and deaths fall by 8%.
Result: Positivity rate of 2.4% (up 0.6%) and deaths decline by 8%.
The case numbers reflect a <10% jump in cases, yet we have a 30% jump in positivity rate. This suggests some combination of a decline in testing and quirky data. I’m no longer confident that the positivity rate is the best measure of the state of the pandemic in America, and am relying on case counts more. A lot of that is no longer fearing that case counts are being manipulated the way they clearly were some of last year, or worries about testing supplies.
Prediction for next week: Positivity rate of 2.7% (up 0.3%) and deaths decline by 5%.
I expect a lot of this effect to be seasonality rather than Delta, but cases likely will rise for a bit. Deaths should still be declining somewhat.
Deaths
| Date | WEST | MIDWEST | SOUTH | NORTHEAST | TOTAL |
| May 20-May 26 | 615 | 948 | 1279 | 631 | 3473 |
| May 27-June 2 | 527 | 838 | 1170 | 456 | 2991 |
| June 3-June 9 | 720 | 817 | 915 | 431 | 2883 |
| Jun 10-Jun 16 | 368 | 611 | 961 | 314 | 2254 |
| Jun 17-Jun 23 | 529 | 443 | 831 | 263 | 2066 |
| Jun 24-Jun 30 | 550 | 459 | 706 | 186 | 1901 |
This is exactly on track as an average, and I’ve come to accept that week to week numbers in regions bounce around. If anything, it’s surprising that the death numbers nationwide have been so steady when there’s clearly a lot of data collection timing issues and random fluctuations going on. Deaths lag by several weeks, so the bad news from the last few weeks hasn’t had an impact yet, nor has Delta’s increased lethality mattered much yet, but it’s likely that will stop soon, and we won’t get much lower than this for a while.
Cases
| Date | WEST | MIDWEST | SOUTH | NORTHEAST | TOTAL |
| May 13-May 19 | 39,601 | 45,030 | 63,529 | 34,309 | 182,469 |
| May 20-May 26 | 33,890 | 34,694 | 48,973 | 24,849 | 142,406 |
| May 27-June 2 | 31,172 | 20,044 | 33,293 | 14,660 | 99,169 |
| Jun 3-Jun 9 | 25,987 | 18,267 | 32,545 | 11,540 | 88,339 |
| Jun 10-Jun 16 | 23,700 | 14,472 | 25,752 | 8,177 | 72,101 |
| Jun 17-Jun 23 | 23,854 | 12,801 | 26,456 | 6,464 | 69,575 |
| Jun 24-Jun 30 | 23,246 | 14,521 | 31,773 | 6,388 | 75,928 |
I found a new site this week that offers a great view of the data, so here’s the week over week changes by state:
It’s hard to read here, so consider clicking through to see it there. Those are dramatic increases in southern states, and the map makes it very clear that these differences are not primarily about how many people each state has vaccinated so far. The big difference is north versus south, and it looks a lot like this map:
Things have been record-breakingly hot in many places recently, especially the Pacific Northwest, but that only happened in the past few days and it was sufficiently dramatic (both record breaking and >100F) behavioral patterns likely went straight to ‘don’t go outside at all for any reason’ rather than a bunch of meetings indoors.
Also worth remembering this from last year, which tells a very similar story so far.
| Date (2020) | WEST | MIDWEST | SOUTH | NE ex-NY | NY | Total |
| June 4-June 10 | 35487 | 24674 | 55731 | 16622 | 6071 | 138585 |
| June 11-June 17 | 41976 | 22510 | 75787 | 12905 | 4986 | 158164 |
| June 18-June 24 | 66292 | 26792 | 107221 | 10922 | 4524 | 215751 |
| June 25-July 1 | 85761 | 34974 | 163472 | 11890 | 4413 | 300510 |
| July 2-July 8 | 103879 | 40139 | 202863 | 13376 | 4850 | 365107 |
| July 9-July 15 | 108395 | 53229 | 250072 | 15199 | 5077 | 431972 |
| July 16-July 22 | 117506 | 57797 | 265221 | 16037 | 4880 | 461441 |
| July 23-July 29 | 110219 | 67903 | 240667 | 21301 | 4707 | 444797 |
| July 30-Aug 5 | 91002 | 64462 | 212945 | 19152 | 4632 | 392193 |
| Aug 6-Aug 12 | 93042 | 61931 | 188486 | 17091 | 4478 | 365028 |
| Aug 13-Aug 19 | 80887 | 63384 | 156998 | 16358 | 4499 | 322126 |
Last year at this time we saw an explosion in cases. This year we are seeing a halt in the decline in cases. That’s not good, but it’s also not a reason to panic. Nor is it reason to attribute the shift entirely to Delta. I am curious why there is so little discussion elsewhere of these obvious patterns this time around, when seasonality has been a talking point in the past.
(Actually, I don’t wonder all that much, because the official Very Serious Person narrative wants to worry as much as possible about Delta, so it would ignore alternative explanations.)
Vaccinations
We picked up an additional 0.8% of the population getting their first dose, and 1.3% of the population got their second dose. The uptick from last week gives hope that we may be in something approaching a short-term steady state, or perhaps talk of Delta has convinced some hesitant people to get the vaccine. That makes sense, since the selfish value of being vaccinated is no longer rapidly approaching zero. It’s becoming increasingly clear that there will be social benefits for some time.
If we can sustain this pace of vaccinations, that is excellent for our ability to close things out. It’s happening in spite of a lot of headwinds. Vaccine misinformation, misrepresentation of information and hesitancy continues to frustrate. There has been quite the abundance of self-inflicted wounds, and giving them attention is always a double-edged sword.
Thus, while I hesitate to give the topic attention and the results could easily be misinterpreted, this seems like useful data:
Looking at the comments, it’s clear that this did not sufficiently disambiguate ‘severe’ and that the category still mostly covered people who got knocked on their ass for two days.
Plus we have to worry about anti-vax people voting combined with the lizardman constant. I’d similarly be unsure whether to say none versus mild for my shots. So this seems consistent with ‘essentially zero side effects other than some people being knocked on one’s ass for a day or two, which occasionally got considered severe.’ It also is clearly inconsistent with the conspiracy theories anti-vax people (and the person everyone needs to stop asking me about) are throwing around.
Hopefully that will be the last I need to say on that matter in any form.
In other good news, mix-and-match vaccines, as one would expect, work quite well, and we finally have a study on that (study).
The control was one shot of AZ for completely insane You Fail Mathematics Forever reasons.
But that’s fine, because we don’t need a control when we’re measuring antibody response, and the whole control group was fetishistic Science(TM) rather than a source of meaningful data.
As an alternative, we have at least one health official in Australia, who happens to be the QLD chief medical officer, talking obvious nonsense:
The idea that AZ poses a greater risk than getting Covid makes zero statistical or mathematical sense, and framing the issue that way indicates that blame avoidance and Sacrifices to the Gods of responsibility are what matters here rather than any attempt to do math on a physical world model.
It would be one thing if they had plenty of mRNA vaccines to use instead. They don’t.
It would be a somewhat different thing if you couldn’t mix and match shots. You can.
That’s all before concerns about population-level effects.
Thus, this should come as no surprise:
I think we can lay to rest the hypothesis that Australia did better than other countries because it was more sane and has wiser systems for making decisions. Australia did better for other reasons, including being an island, that led to a different equilibrium. Now that we are in the vaccination phase of the pandemic, Australia is utterly failing.
Delta Variant
This Nature post provides a perspective of how many are thinking about Delta. As usual, there’s talk about whether the new variant will take over and whether it can be prevented by some magical force, rather than how quickly it will take over and the need to accept that reality, but mostly the reality is being accepted here.
They are worried about Africa:
I continue to not be as worried, because I do not expect that we are approaching the limits of Africa’s control systems. I expect there to be enough slack to absorb Delta without things going critical. I’m not super confident in that, but I do think it’s a solid favorite (~75%).
As estimates of prevalence of Delta go, using this seems like a reasonable method:
Alpha was previously on the rise, so if it declined from 70% to 42%, it’s safe to say that variants that are substantially more infectious than Alpha are replacing both it and the remaining 30% (to the extent that it wasn’t already such variants), so if we think Gamma is mostly similar to Alpha as we did last time, that provides a lower bound for Delta of 40% by mid-June.
Contrast that with last week’s calculation from another source via taking the numbers from Delta directly, which had it at 30%. That’s a reasonably big gap, since here 40% is a lower bound, and if the previous mix included a bunch of stuff less infectious than Alpha we’d expect this to be closer to 45%-50%. And that was two weeks ago, so if it was 40% then it’s presumably more like 70% now. If that math seems quick, keep in mind that we didn’t even break 1% until April.
In other news, look at where that other source is after its last update:
This continues to be consistent with the sequencing data there being accurate but effectively delayed. Note that P.1/Gamma is now declining rapidly as well. Over the last 60 days they have Delta at 11%, but over the last 30 days they have it at 21%, which means it was something like 1% in the previous 30, and 30 days from whatever ‘now’ is in that calculation it implies Delta will be above 80% barring geographic barriers slowing things down.
If we estimate that the infections observed now are happening in something like a 65% Delta 30% Alpha/Gamma 5% Other world, with the remaining others largely similar to Alpha, then we’ve absorbed two thirds of the transition from Alpha to Delta, and three quarters of the transition from the old strain to Delta. Going forward, one should expect the share of old strains to be cut in half every ten days or so, and Delta to be almost all infections in most regions by August 1.
Olympics in Japan
The Olympics are here, and Japan is not exactly fully vaccinated, as they’ve been delaying things quite a bit, with Moderna and AZ not even being approved until May 21.
Once again I’m going to come out in favor of doing things that scale, are central to the experience of life and bring lots of people joy, even when they’re not fully ‘safe.’ Any athlete going to the Olympics who wants to be vaccinated, one hopes, has already been vaccinated – if not, it would be trivial to take care of that. Same goes for those who need to be in the Olympic village, it’s not that many people.
What’s crazy is allowing a bunch of spectators who aren’t vaccinated into indoor events, and it looks like there will be 10,000 spectators per event, whether indoors or outdoors.
The idea that something not being ‘the safest way’ means someone is ‘not on board’ continues, and reflects a mindset we need to move past. The safest way to do most everything is to not do it at all, yet things must be done.
One way to think about whether the spectators are providing enough value is to look at the ticket revenue. There are 330 events, so assuming everything sells out, tickets are going to average $121 per full event, many of which are over multiple days. That’s not that much money, so my instinct is they need to charge a lot more at least for indoor events, to justify the health risks involved.
It’s always important to think about base rates…
…where Japan continues to outperform the United States. If Delta wasn’t involved I’d say that this is all basically fine, but it remains to be seen if Japan can handle Delta in its current state, and this could take substantial time ‘off the clock’ for vaccinations to catch up.
The Olympics cost about $12 billion to host and can leave a lasting legacy. If one thinks that the Olympics will be remembered for a long time, I understand taking the full risk, but I still wouldn’t have substantial crowds at indoor events, especially minor ones. Why ask for that kind of trouble?
In Other News
A bunch of people this week mentioned how bad it was that people were making base rate errors, and using ‘some vaccinated people got infected’ as the latest scare tactic in full How to Lie With Statistics mode. Nothing to see here that we didn’t expect.
Thread in praise of the excellent Microcovid project. I disagree with some of the Microcovid calculations but having any plausible calculations at all was the important element here, giving certain types of people a way to both do any of the things ever and not do many of the stupider things. That doesn’t mean the paralysis before that wasn’t a failure mode that requires investigation and correction. The general solution might be ‘if microcovid does not exist it would be necessary to invent it so people have a Schilling estimate to converge on’ and that’s not great but better to know it than not know it.
A good way of framing what Zeynep and I both point out about the question of the origins of Covid-19: What matters is how such an event could have occurred, rather than the way it actually did occur. If the plane could have crashed due to a faulty part, but it turned out something else caused this particular crash, the part is still faulty and we need to fix the root cause of that failure.
If Gain of Function research puts us in danger, that’s enough reason to ban it, whether or not it actually did kill millions of people this particular time around.
Zeynep also points us to this paper about potential lab leaks explicitly warning against exactly the things we frequently do… from 2015.
No, we can’t know for certain that vaccines provide years-long immunity without waiting those years, but I do think the extrapolation process here is mostly reliable, and a much less misleading statement than the typical ‘provides protection for up to X months’ where X is how many months we’ve had the time to check, which then gets quoted by media as if X is an upper bound rather than a lower bound.
Marginal Revolution previews/reviews the new Michael Lewis book about those preparing for a pandemic, and what they did during the early days of pandemic they’d prepared for. The book, titled The Premonition, if Alex’s summary is accurate, holds the CDC (Delenda Est) in even lower regard than I do, as our heroes who see the pandemic coming are stymied every step of the way, preventing them from having most of their potential impact, while we don’t so much as quarantine or even test those returning from China, let alone take reasonable precautions. As Alex notes, it’s weird to have a (true) story of lone heroes fighting the good fight against the system to stop a global catastrophe, who then completely and utterly lose. A story at least as worth telling as when they win, but definitely hard on the cliche structure.
Paper about long term past effects of pandemics in Sweden over 220 years.
Not Covid
If your goal is to avoid claims that our elections are full of fraud and tabulation errors, and/or you don’t want to ruin ranked choice voting for the rest of us, may I suggest perhaps making more of an effort to not do things like this, as happened in the NYC mayoral election:
Thus, the Evergreen Tweet: I hope we will hear the end of this, but fear that we will not.
Don't Worry About the Vase 
I think you’ve got a classic Tyler/Alex mix-up in the paragraph on the review of The Premonition.
In the interest of saying something non-nitpicky to justify the comment, I am very excited for the Olympics, and hope they might give the world a bit of a win. If things do start to go wrong, it would be a good test of Japan’s control system and general attitude which so far have seemed abnormally effective. Hopefully they stay that way.
Corrected, and for the record nitpick comments are fine.
There were two mixups I presume, and it seem’s you fixed one.
“if Tyler’s summary is accurate”
I am now fully vaccinated with the mRNA vaccine. I want to give up on washing the floor near my door every time I come back from a walk to my flat (to avoid spreading the virus on the floor inside), and give up on disinfecting the groceries I get 2-4 times per week. How much will it increase my risk of infection given the spike in delta variant? Will it be closer to going from 0.01% to 0.2%, or to going from 0.5% to 10% infection risk per year?
Also, if I had two shots of the mRNA vaccine, if I can use daily saline gargling/nasal wash to reduce the initial viral load, and if I can use the FLCCC protocol in case of having symptoms backed up with the positive PCR test, does it mean that an overall chance for severe course and death is so small that I should basically ignore Covid-19 the way we ignore seasonal flu, and fully come back to regular functioning?
washing the floor and disinfecting groceries has always had a low impact: Sars-CoV2 spreads mostly through the air.
Now that you’re vaccinated you can go back to living your life as you did before all of this started.
But if you’re reading this blog, you probably already know this.
Echoing Alexander, those are not reasonable or effective precautions. Washing the floor does nothing. Washing your groceries does almost nothing. The nasal stuff seems wholly unnecessary even if it’s effective. Returning to regular functioning is fine.
You can see the infection rates in your area, you can see vaccination rates, and the relative protection is still ~95% vs. infection, and you can do math to see what the average level is, while noting that to get average effectiveness you can take average risk, which at this point mostly means ‘living normally.’
…But Zvi, I heard the virus can handle doorknobs. What kind of lock do I need to put on my screen door to keep the virus out?
How could saline gargling and nasal washouts be “unnecessary even if effective”? Wouldn’t there be bulk benefits in spending 5 minutes each day on reducing the negative effects of dust, pollen, air pollution, various viruses (Covid-19, flu, cold) and other pathogens?
The rest makes sense to me.
I mean, if you think it’s just good practice in general, then that’s fine, but you should probably either have been doing it in 2019 or not doing it now.
More seriously, the mRNA vaccines are sufficiently more effective than the flu vaccine that the IFR from Covid post mRNA vaccination is lower than the IFR from seasonal flu post flu vaccination, so I am inclined to think that anything that is not reasonable as a precaution against the flu, is not reasonable as a precaution against COVID, once you are fully mRNA vaccinated.
I don’t see why the IFR should be the relevant metric — a vaccine reducing the probability of infection by 99% but not reducing the probability of fatality given infection at all would still be pretty damn impressive.
The entire worry for someone not very old at this point would be long covid, which is reasonably something one might worry about more than long flu, but yes I’ve been basically ignoring Covid personally.
I’ve been developing a crank conspiracy theory for a while, but especially after reading that MR review of The Premonition: what if the US “expert” high-level policy in January-March of 2020 was to basically ignore covid and hope nobody noticed, on the assumption that anything we could possibly try against it would be a) ineffective and b) massively expensive and inconvenient?
Obviously this would never have made the public record, or even private emails, so I’ll likely never have proof. However, the level of disinterest shown by the disease prevention people (Fauci on down), toward even actually finding out how much covid was here, was so aggressive and nonsensical that it makes more sense as a deliberate strategy than as the incompetence most people have attributed it to.
So my baseless speculation is that at some time in late December or early January 2020, Fauci and friends got together in a completely private, off-the-record meeting to talk about the new coronavirus, and determined a few things (all of which could be concluded from information available at the time):
– it was likely already spreading in the US, or would be soon.
– it may possibly have leaked from a partially US-funded virus lab.
– cases were mild/nondistinct enough in some healthy people, and transmission was fast enough, that we would be unable to stop it within the country by identifying and isolating sick people.
– US entry control was not capable of stopping it at the border, if it wasn’t already inside.
– US citizens/admin would never cooperate sufficiently with the heroic measures required to somehow change all this.
– vaccines might take years, or never show up.
– most cases are difficult to distinguish from other common respiratory diseases without a test, and most severe/fatal cases affect the already sick or elderly.
And (again, completely off the record) they concluded that the best possible course of action was to issue the necessary public proclamations of Utmost Seriousness, while meanwhile blocking any attempt to actually figure out the real spread of the disease in the US, and expect that it would pass through like a couple winter’s worth of particularly bad flu seasons and most people would not notice.
Obviously this did not happen, and they had to course-correct very hard last March, but it explains a lot about official agency actions last winter, I think. Again we’ll likely never know the real story, but the more I’ve thought about this one, and read about early US pandemic response, the more sense it’s made to me.
Some individual people may have been thinking that but I do not believe such people have the ability to cooperate/coordinate in the ways required to execute this strategy even if it made sense. If it did make sense, you would have acted differently in other ways to try and minimize damage, and we saw no signs of that.
In general, conspiracy theories involving such people are not to be believed because such people aren’t capable of executing/coordinating to pull it off.
I don’t agree with this rebuttal as it’s generally used, but it especially doesn’t seem to apply to this case. The whole point is they didn’t have the ability, and made public fools of themselves repeatedly.
In other cases there are usually “coordination” methods that don’t require any explicit communication at all. e.g. I and other unconnected people submit fake ballots, you see that the fake ballots are for the candidate you like, decide Stopping Orange Hitler is more important than the rule of law, and say nothing while recording them.
I would argue it was less of a coherent strategy and more of a sort of unofficial agreement to not look for covid all that hard, and interfere with anyone who did, unless/until things got real bad and couldn’t be ignored (which, obviously, happened).
Again, though, baseless speculation :)
I’d guess this may have been the powers’ that be initial plan, until they saw what was happening in Europe in late February/early March. Then they had to scramble & figure out what can still be done within the context of US life that stops short of martial law.
Yep! That’s basically my theory too
Is the original strain (“covid classic”) now extinct in the US? If not, when do you project it will be?
Extinct is a strong threshold (0 cases) and we won’t know when we hit that. It’s likely being cut in half each week or so at this point. My guess is it’ll be a few more months before it goes to actually zero at that rate, but who can know.
Hi, I’m a 20 year old living in Australia, Covid here seems to be very different from everywhere else so I thought I’d write some stuff in response to your comments on the Queensland’s CMO AstraZeneca remarks. It ended up being much longer than expected, been meaning to get a blog for a while so might post it there but for now you can read it at: https://gist.github.com/tomiam8/a5a71d5d321e4889c3ab12e863790f97
Thank you, that was very informative – I’d love it if other people did similar things for other places. I’ll aim to respond in full next week or in its own post.
On the blood clots, I think you made a simple math error – from your source I got the following:
For people aged under 50, there have been 3.1 cases of clotting per 100,000 first doses.
That’s not the fatality rate, that’s the case rate. So even if we think that this statistic is accurate – frankly I don’t, but it would be reasonable to claim that it was – the math still says you’re off by a factor of 3+, likely a bunch more. I kept reminding people over and over that when AZ was suspended, there weren’t initially 6 deaths, there were 6 CASES and 1 death.
The statement also shows concern about blameworthiness and ruining one’s ‘perfect record’ rather than legit concern. I agree that the new context (which I wasn’t aware of) makes the statement otherwise seem less crazy, because he’s taking back an otherwise even crazier impression from a crazy policy, but the total net amount of crazy is still not low. Plus, I think we largely agree the whole vaccination thing was botched all around.
It also illustrates the idea that the costs of the lockdowns were basically being ignored. I think on reflection Australia (probably) did the essentially right thing to do full containment if it is going to work, and it had a high chance of working if implemented, but that’s a math question, and I doubt math was ever seriously done.
I do think implementation of lockdown as you describe it was quite good. I agree that Australia did some impressive things locking down, in terms of actually doing things you wouldn’t have thought were thinkable, but also some not-thinkable things happened in lots of other places, and USA state borders were semi-closed in many places without similarly good justification, as were European borders.
I wish everyone there the best of luck with Delta; you still have to survive for many months before you’ll have enough vaccinations even if things go well. It’s good to know it’s been caught and contained once already, but I do worry there’s essentially still time for things to on net have not gone well.
Finally, I’d note that I’m not saying that the response wasn’t better, or that choices don’t have consequences. It’s more about the gears causing the choices.
Thank you for your response, I’m looking forward to any future posts (either the full response or just your normal posts, they’ve been very informative and interesting)!
Re: statistics are for blood clots, not deaths – yep, thanks for pointing that out, can’t believe I missed it; I’ve added a comment noting this to my original response. The original ATAGI (Aus. Technical Advisory Group on Immunisation) statement (https://www.health.gov.au/news/atagi-statement-on-revised-recommendations-on-the-use-of-covid-19-vaccine-astrazeneca-17-june-2021) itself says TTS / clots has a 3% Australian fatality rate, so all age groups have at least a few orders of magnitude different risks between AZ-clot-death and Covid-deat, some of them (eg 40-50 age group) a very large difference.
I think ATAGI does a lot of math / logical wheel cog turning… and then mostly (although not entirely) ignores the result for political reasons? The ATAGAI statement links to a calculation of expected number of blood clots vs avoided deaths and hospitalizations for each age group at three different levels of covid spread ( https://www.health.gov.au/resources/publications/covid-19-vaccination-weighing-up-the-potential-benefits-against-risk-of-harm-from-covid-19-vaccine-astrazeneca pg 9).
For every scenario except the first, hospitalizations prevented by AZ are an order of magnitude larger than TTS cases, including the level of infection that occurred in Melbourne’s second wave. So, the cost-benefit calculation seems to strongly favor AZ, unless you assume Australia can avoid any major waves of covid. So, ATAGI states ‘[their] advice is specific to the context that there is currently no or limited community transmission in most of Australia and would be different in other countries.’ which, while at least acknowledging the assumption, ignores that the timescale to vaccinate people is much larger than the timescale of a covid wave, and you won’t be able to vaccinate most people in time. Finally, given increasing the age recommendation from over 50s to over 60s occurred in the political aftermath of a 52yr old woman dying, I agree that it seems the vaccine age decisions were made for the wrong reasons (also – no calculation of lockdown / border closures ongoing harm).
Personally, that means I need to re-evaluate my decision, and it turns back into is it worth waiting for Pfizer for the increased protection or not. I think my position should be *at least* to get a vaccine as soon as my government allows me to mix and match, or if the chance of wide-scale covid spread becomes decent (eg if cases/day > 100). I’m still thinking on if it makes sense to get vaccinated anyway.
Re: was the full-containment decision made based on math or just because:
I think the electorate forced a full-containment strategy, with politicians forced to do that or lose elections, after Australia happened to eliminate Covid in the first wave. While the math should have been done, I don’t think public opinion does math for anything, and this is interestingly different from ‘governmental groups should make decisions logically’. Some evidence towards that view for how much the electorate likes containment: The WA (Western Australia state, not Washington state) Premier (aka Governor) was well known for being by far the most aggressive with closing internal state borders, and the most pro-containment government generally. In early 2021 they had a state election, and for the strong pro-containment position the government was re-elected with the largest majority in any Australian election – 89.8% of lower house seats, 70% 2 party preferred support (ie 70% prefer government compared to main opposition party). The opposition party conceded/acknowledged they would lose the election 16 days before it took place! The election was called with 0.7% of the vote counted 45 mins after polls closed. So the electorate really liked containment – not just in WA but in Australia generally – and so any self-interested politician (ie all of them) did containment. The decision to contain after Australia had eliminated it was made by the electorate, not by the politicians. You could still investigate the decision to eliminate initially however.
I think if you really wanted to argue for the ‘Australia is just insanely sensible and has good decision making processes’, you could start picking individual decisions that were made well… and there are quite a few of those, but also there’s a lot of those everywhere, and there’s also plenty of bad decisions.
So I’m not really sure where this leaves us.I think some people overseas might have had a tendency to go ‘Australia is doing well. Australia makes decisions well! Australia is great country all around!’ because, it’s another country, you don’t have time to read endlessly about all it’s nuances. I think I missed that that view might exist, because it is certainly a wrong one (Australia’s fine but there’s plenty of bad political and covid decisions, the vaccine’s just one large enough that it’s easily noticeable from overseas). And that’s not to say that Australia does have some institutional differences that are good (Ranked choice + compulsory voting! Except for New York…). The same way that ignoring the ‘good half’ of Australia’s decisions because of its specific lucky conditions is bad, ignoring the specific lucky conditions is also bad.
One question in particular – how forcefully were lock-down restrictions imposed in other countries (were there fines? how often were people fined?)? It’s been hard for me to get an accurate feel for that, and I suspect that could be a major cause of some differences that were compounded *a lot* by those lucky conditions (and doesn’t reflect Australia having superior decision making processes).
Thank you for the well wishes.
I’m currently estimating a 25% chance this current Delta wave will represent the hardest part of Covid for my state, potentially Australia, by far, and a 50% chance that it still won’t be eliminated in 1.5 month’s time and my state will move to a lockdown similar to Melbourne’s 2nd. Ie, I agree with your worry that things will turn south.
Thanks again for responding, sorry for writing so much!
Not a problem, I appreciate the perspective. In terms of whether to take AZ yourself, I agree that if you can get Pfizer later it’s a 100% no brainer, but that if it locks you out of Pfizer for a long time it’s not clear – ideally you can AZ now then booster Pfizer later.
I think the story you tell is very much a story of path dependence, and of circumstance, in both good and bad ways, rather than core differences good or bad.
In terms of how the restrictions are enforced elsewhere, it’s hard to tell even when you’re here, and it varies a lot. But most people in areas I’ve been mostly followed the rules.
@TheZvi the population-level vaccine efficacy study for Ontario, Canada is out. It shows surprising performance for AstraZeneca, even with Delta. AZ appears to out-perform Pfizer on quite a few dimensions. Caveat: error bars, of course.
Still, AstraZeneca does appear to be an excellent choice, if the risk of blood clots doesn’t bother you (which it probably shouldn’t).
These results also flatly contradict the whole media hysteria about Delta being more vaccine-resistant. Makes one wonder about vaccination campaigns moving second doses forward because of Delta. This happened in Ontario and the UK, if I’m not mistaken. More revolving door advice, and media hysteria driven policy?
https://globalnews.ca/news/7937843/second-covid-shots-ontario-hotspots-delta-variant/
Yeah, big error bars but I have yet to see anything that makes me concerned about vaccine effectiveness.
What do you think about trial (or generally non-mRNA) vaccines? In particular I received a trial vaccine (both doses) and the study organizers told me I could opt to get an mRNA vaccine from the NHS (warned me of more side effects though), so I’m wondering whether to take that or stay in the study (remaining tests in 6/11 months). Especially with the high & rising COVID numbers in the UK [200 (500) cases/week/100k, in my region (city)].
I got the (inavtivated adjuvanted) trial vaccine (no placebo) by Valneva (VLA2001, [1]), and they don’t plan to release data until September. From the Phase 1/2 press release [2] they quote a GMT of 530.4 (95% CI: 421.49, 667.52), which seems like a high number compared to Pfizer & Sinopharm [3] but I have low confidence in my skills to understand this but also the press-release not selectively reporting.
[1] https://valneva.com/research-development/covid-19-vla2001/
[2] https://valneva.com/press-release/valneva-reports-positive-phase-1-2-data-for-its-inactivated-adjuvanted-covid-19-vaccine-candidate-vla2001/
[3] https://www.cdc.gov/library/covid19/pdf/2020_10_27_Science-Update_FINAL-Public.pdf
Relevant quote from press release: “[The Geometric Mean Titres] of neutralizing antibody titres measured two weeks after completion of the two-dose schedule was at or above levels for a panel of convalescent sera (GMT 530.4 (95% CI: 421.49, 667.52)).
With a GMT ratio of vaccine vs. convalescent sera ≥ 1 vaccine efficacy has been reported above 80% for other vaccines[1].
VLA2001 induced broad T-cell responses across participants with antigen-specific IFN-gamma producing T-cells against the S-protein, M and N protein detected in 75.6 %, 35.6% and 48.9% of study participants, respectively.”
My answer is that we thank you for your service, and you should stay in the trial.
Trials are ludicrously important and valuable, and to screw them up by essentially leaving them mid-trial in such a fashion does a huge disservice in place of a great service. Don’t do it. There isn’t even a control group.
From a purely selfish perspective, an mRNA booster shot would indeed improve your chances, since either the new vaccine works as well or better (and thus mRNA booster does little or nothing), or it doesn’t work as well (in which case the booster will help), but please don’t do that.
> My answer is that we thank you for your service, and you should stay in the trial.
Thanks, I’ll do exactly that then.
> it’s likely that will stop soon, and we won’t get much lower than this for a while.
Hopefully not as much as you’d think. Vaccinating most of the old people will drive the CFR right down. Cases in the UK have been rising much faster than deaths, (even accounting for a 2 week lag). In the past few months, CFR has fallen from over 1% to approx. 0.3%.
(graph: https://imgur.com/a/aPuNo9q)
“ The idea that AZ poses a greater risk than getting Covid makes zero statistical or mathematical sense…”
Come on. You’re just straight-up wrong here. In the (very specifically identified!) subset of population being talked about, there is significantly less risk of COVID than the average, and it’s completely believable that clotting risk outweighs it. To pretend that there’s no mathematical justification is really, really silly.
Source:
https://junkcharts.typepad.com/numbersruleyourworld/2021/04/the-statistics-behind-the-jj-blood-clot-decision.html
When I ran the numbers for me and mine, two orders of magnitude difference between (expected dead because we all get AZ vaccination) and (expected dead if we halt vaccination until enough non-AZ comes forward to finish, and an outbreak of delta or something worse breaks containment and hits everybody in the meantime).
Admittedly I used risk probability numbers from the UK for AZ and non-vaccination fatality numbers, which which yielded about 10/million dead of AZ and 1000/million dead of SARS-CoV-19. If you tweak it right and squint properly you might even get the gap down to *one* order of magnitude. No thanks.
I live *in* Queensland, and it’s not believable at all. Try harder.
Zvi, did you notice the negative psychological impact of the pandemic when interacting with friends and strangers? In March 2020, I was expecting that the common threat may bring people together and boost their caring nature, emphasizing the common human identity and our common goals regardless of belonging to specific interest groups. That might have been the case in the early days, but over the course of the time, I’ve noticed that people are meaner, more selfish, polarized and aggressive than they were before. Is it just my pessimistic bias, or am I correctly identifying these trends in both the US and Europe? If so, when/how can we recover from that?
I haven’t noticed that. People are somewhat more physically wary but I haven’t noticed what you’ve noticed.
Tom, I’m not sure what qualifies this as a ‘crank conspiracy.’ It’s incredibly clear that elite consensus until March was that COVID-19 was at first ‘just the flu’ and not worth taking any drastic action over, and then basically unstoppable however damaging. You can view the Dominic Cummings testimony for confirmation of this from the highest levels of at least the UK government (I don’t believe the U.S. would be much different).
Zvi, I don’t think this requires imagining any secret coordination at all. It was simply the consensus strategy stated openly in high level government meetings. There were many reasons to think that lockdowns would be either intolerable or ineffective.
That said, I don’t believe the CDC essentially made tests that didn’t work. That particular element has all the marking of undeserved institutional arrogance.
In the UK it was stated openly, in the USA it wasn’t dared said explicitly as far as I know. In general, saying it explicitly is a very different animal than doing it implicitly.
What evidence is there of greater lethality from Delta?
This is interesting: https://forum.effectivealtruism.org/posts/dYiJLvcRJ4nk4xm3X/covid-how-did-we-do-how-can-we-know-1
“What matters is how such an event [a lab leak] could have occurred, rather than the way it actually did occur.”
This is one of those Rationalist points with a nice logical foundation–that entirely misses the mark on human psychology. Lab leaks are a common occurrence, as everyone now knows. Everyone in virology, epidemiology, and bio-defense has known this for decades. All of these people have long known not only that such an event could have occurred, but that lab leaks in general–from all biosafety levels–have happened many times. Given this evidence of *actual* failure, why would *hypothetical* failure through known security weaknesses have more effect on policy? As a psychological matter, proof or strong circumstantial evidence that the Covid-19 pandemic was consequent upon a lab leak would be far more likely to move policy in decisive fashion. Whether we will ever get to this level of evidence given Chinese mendacity and the covering fire the American ruling class has provided for its Chinese ruling class friends is something I gravely doubt. Of course, if we do reach the point of psychologically well-motivated action, then we ought to think through the various ways in which a lab leak could have occurred in order to block all avenues of future escape.
Having said all that, let’s dig deeper into darkness. Does any of this matter in a world in which the Biological Weapons Convention has no enforcement or surveillance mechanisms? The Soviets had a very impressive bio-weapons program 30 years ago. The march of biotech advances since then empowers still more sophisticated options for bio-weapons designers. One might consider gain of function one type of research on bio-weapons, a type that happens to have a superficial (and very weak) medical justification. Those bio-weapons that lack any such justification are researched in the deep bowels of the MIC with no oversight, no accountability–a globally scattered, self-improving flock of black swans. I read far too little about this associated threat in the context of pandemic preparedness, Covid-19, the lab leak hypothesis, etc. Is there a more important point of context for such discussions than this one?