All things political. Coronavirus Edition. (4 Viewers)

[Maxp]

I fear we are really going to be in a bad place due to the obvious cuts to the federal agencies that deal with infectious disease, but also the negative effect the Affordable Care act has had on non urban hospitals. Our front line defenses are ineffectual and our ability to treat the populous is probably at an all time low. Factor in the cost of healthcare and I can see our system crashing. What do you think about the politics of this virus?

 

[MT15]

I saw a tweet from an MD taking issue with a NYT story today that claims vaccinated people spread the Delta variant as much as unvaccinated people. He said that just isn’t true at all. That vaccinated people are safer when they get the virus and they spread it less.

Lapaz, I think you are looking at data that isn’t controlled.

I follow a lot of infectious disease docs on Twitter, several from my states largest hospital group, and when they talk amongst themselves they say that vaccinated people in good health shouldn’t fear getting Delta. It will most likely feel like a bad cold and some will think it’s just that. They say there are more breakthrough infections than are currently being captured because some vaccinated people have such mild or even no symptoms. And that with the way the Delta is so contagious, almost everyone who is unvaccinated will get it.

I don’t know how much these guys know, but they are in the field.

 

[Lapaz]

I saw a tweet from an MD taking issue with a NYT story today that claims vaccinated people spread the Delta variant as much as unvaccinated people. He said that just isn’t true at all. That vaccinated people are safer when they get the virus and they spread it less.

Lapaz, I think you are looking at data that isn’t controlled.

I follow a lot of infectious disease docs on Twitter, several from my states largest hospital group, and when they talk amongst themselves they say that vaccinated people in good health shouldn’t fear getting Delta. It will most likely feel like a bad cold and some will think it’s just that. They say there are more breakthrough infections than are currently being captured because some vaccinated people have such mild or even no symptoms. And that with the way the Delta is so contagious, almost everyone who is unvaccinated will get it.

I don’t know how much these guys know, but they are in the field.

I think we're all looking back at what happened over the last few months, but I think things have changed again. We almost have no choice but to look at past history, but the virus seems to have changed again.

With that said, I still want to look backwards over the last couple of months for the data that plots the percentage of people that die from Covid with and without vaccination as a fraction of the number of infected in each category, and that controls it for morbidities. I'm not a doctor, and some of the data is hard to understand, but I don't think it should be that hard to distill it down to those conditions. Like I said in an earlier post, the fraction of unvaccinated infected people that are dying in Virginia is almost 3 times lower than the fraction of vaccinated that died. Granted, there are about 40 times as many infected unvaccinated people, which makes the case for getting the vaccine to prevent catching Covid, but it doesn't make the case once you have it. I'm not arguing against vaccinations. I think they are (or have been) fantastic to prevent catching it, but I think we oversell it when we tell people that you are more likely to survive once you catch it, and the reverse may actually be true. Something may have changed based on the July 4th outbreak reports from Provincetown, Mass.

 

[MT15]

The stats you‘re finding are useless for your purpose, in my eyes, because they aren’t capturing all the breakthrough cases. They aren’t even trying to capture them. In order to know how many vaccinated people are actually getting the Delta variant they would have to do a survey of a population and test people with mild or no symptoms. They‘re just not doing that.

So, without knowing how many are actually getting breakthrough cases, you can‘t evaluate their figures, because they are only tracking the breakthrough cases that are severe enough to be diagnosed, or the few that are captured when, say, athletes are tested randomly. The docs I listened to were saying that breakthrough cases are being vastly underestimated for that reason.

Of course, there was one doc that said you could make the argument that someone who tests positive but is asymptomatic shouldn’t even be considered “infected” in the real sense.

 

[Goatman saint]

Of course, there was one doc that said you could make the argument that someone who tests positive but is asymptomatic shouldn’t even be considered “infected” in the real sense.

This is more the way I think.

 

[Lapaz]

The stats you‘re finding are useless for your purpose, in my eyes, because they aren’t capturing all the breakthrough cases. They aren’t even trying to capture them. In order to know how many vaccinated people are actually getting the Delta variant they would have to do a survey of a population and test people with mild or no symptoms. They‘re just not doing that.

So, without knowing how many are actually getting breakthrough cases, you can‘t evaluate their figures, because they are only tracking the breakthrough cases that are severe enough to be diagnosed, or the few that are captured when, say, athletes are tested randomly. The docs I listened to were saying that breakthrough cases are being vastly underestimated for that reason.

Of course, there was one doc that said you could make the argument that someone who tests positive but is asymptomatic shouldn’t even be considered “infected” in the real sense.

There are also asymptomatic unvaccinated people. I have heard people say that only severe cases are being counted as breakthroughs, but the Virginia Department of Health site that I used defined breakthroughs as any fully vaccinated person that is diagnosed with Covid, even if asymptomatic.

 

[MT15]

Yes, they can define it that way, but they aren’t capturing them unless they are testing a random sample of the population. I don’t know that they are doing that, are they?

For example, my state did such a program of testing at one point early in the pandemic. People were randomly selected and asked to go get both antigen and antibody testing. In this way they obtained the kind of information you would need to draw your conclusion.

My state hasn’t done such a study since before the Delta variant. According to the docs I have been following, it doesn’t sound like many places are. So your “breakthrough” cases are not being captured in total, because you’re not testing asymptomatic people unless they just happen to get tested for some reason.

 

[Lapaz]

Yes, they can define it that way, but they aren’t capturing them unless they are testing a random sample of the population. I don’t know that they are doing that, are they?

For example, my state did such a program of testing at one point early in the pandemic. People were randomly selected and asked to go get both antigen and antibody testing. In this way they obtained the kind of information you would need to draw your conclusion.

My state hasn’t done such a study since before the Delta variant. According to the docs I have been following, it doesn’t sound like many places are. So your “breakthrough” cases are not being captured in total, because you’re not testing asymptomatic people unless they just happen to get tested for some reason.

I don't know if Virginia is doing random testing, but I doubt it. My point is that the data they have for asymptomatic unvaccinated and infected people is as good as the asymptomatic vaccinated and infected. Most asymptomatic people only test themselves after being exposed or perhaps after being in a setting that could've gotten them infected. Granted, I think more vaccinated people will not get tested in that situation, since they believe they are safe. That's about to change, since many are now mandating weekly tests for unvaccinated, so we're about to get much better data.

One of the points I've made is that it appears that almost 3 times as many infected vaccinated people are dying in Virginia as a ratio of diagnosed cases. If we accept that fewer vaccinated and infected people are being diagnosed, since they aren't being tested, then that would improve the ratio, but those cases would have to more than triple the diagnosed and vaccinated cases to become improve enough to look better than the unvaccinated and infected ratio. Also, once you control for morbidities and age, then the calculus would also improve, but I haven't seen that controlled data. I suspect that vaccinated people are safer, because that is logical, however I think something has changed for the much worse even for vaccinated people, and it's not being reported that way.

 

[RobF]

I don't know if Virginia is doing random testing, but I doubt it. My point is that the data they have for asymptomatic unvaccinated and infected people is as good as the asymptomatic vaccinated and infected. Most asymptomatic people only test themselves after being exposed or perhaps after being in a setting that could've gotten them infected. Granted, I think more vaccinated people will not get tested in that situation, since they believe they are safe. That's about to change, since many are now mandating weekly tests for unvaccinated, so we're about to get much better data.

One of the points I've made is that it appears that almost 3 times as many infected vaccinated people are dying in Virginia as a ratio of diagnosed cases. If we accept that fewer vaccinated and infected people are being diagnosed, since they aren't being tested, then that would improve the ratio, but those cases would have to more than triple the diagnosed and vaccinated cases to become improve enough to look better than the unvaccinated and infected ratio. Also, once you control for morbidities and age, then the calculus would also improve, but I haven't seen that controlled data. I suspect that vaccinated people are safer, because that is logical, however I think something has changed for the much worse even for vaccinated people, and it's not being reported that way.

It's not being reported that way, because it's not that way. You might not have that controlled data, but other people do. The evidence indicates that you're very likely heavily underestimating how significantly age is a difference between those two cohorts.

E.g. in the UK, of Delta cases, the 28,773 fully vaccinated people split 53:47 under 50 : over 50. The 121,042 unvaccinated cases split 98:2 under 50 : over 50. That's not a typo. Where 47% of the fully vaccinated cases were over 50, just 2% of the unvaccinated cases are over 50.

Because the older population is much more likely to be fully vaccinated. That means they're less likely to be a case in the first place, but it does mean of those cases that do occur among vaccinated people, it's skewed heavily to the more elderly population, who have a higher risk profile to start off with.

But once you have that data, you can make the appropriate comparison: in the over 50 age cohort, between their vaccination status. And what you find is that of the 13,427 fully vaccinated over 50s, 1.6% have died, whereas of the 2,337 unvaccinated over 50s, 5.6% have died. That is a very significant difference, showing the effectiveness of vaccination in preventing death.

As vaccination roll out continues and the age cohorts become more similar, you'd see that becoming the case generally as well (assuming vaccine refusal isn't higher in younger age groups than older age groups to the point that the cohorts of vaccinated and unvaccinated cases remain that distinct in terms of age distribution).

(Source of data: Public Health England, SARS-CoV-2 variants of concern and variants under investigation in England, Technical briefing 19 (pdf)).

 

[Lapaz]

The du

It's not being reported that way, because it's not that way. You might not have that controlled data, but other people do. The evidence indicates that you're very likely heavily underestimating how significantly age is a difference between those two cohorts.

E.g. in the UK, of Delta cases, the 28,773 fully vaccinated people split 53:47 under 50 : over 50. The 121,042 unvaccinated cases split 98:2 under 50 : over 50. That's not a typo. Where 47% of the fully vaccinated cases were over 50, just 2% of the unvaccinated cases are over 50.

Because the older population is much more likely to be fully vaccinated. That means they're less likely to be a case in the first place, but it does mean of those cases that do occur among vaccinated people, it's skewed heavily to the more elderly population, who have a higher risk profile to start off with.

But once you have that data, you can make the appropriate comparison: in the over 50 age cohort, between their vaccination status. And what you find is that of the 13,427 fully vaccinated over 50s, 1.6% have died, whereas of the 2,337 unvaccinated over 50s, 5.6% have died. That is a very significant difference, showing the effectiveness of vaccination in preventing death.

As vaccination roll out continues and the age cohorts become more similar, you'd see that becoming the case generally as well (assuming vaccine refusal isn't higher in younger age groups than older age groups to the point that the cohorts of vaccinated and unvaccinated cases remain that distinct in terms of age distribution).

(Source of data: Public Health England, SARS-CoV-2 variants of concern and variants under investigation in England, Technical briefing 19 (pdf)).

That is good data that you presented. It indicates that over 50 year old vaccinated people in the UK are about 3.5 times more likely to survive Covid compared to similar unvaccinated, but that’s drastically lower than the 25 times that I’m frequently hearing. That was my point. I think we’re overselling the benefits once you’re infected. The Virginia data indicates you’re more likely to die once infected if you’re vaccinated, but it would probably also show a 3.5 times benefit once controlled for age and morbidities. I don’t think we’re getting accurate reports on the benefit of the vaccines after infected, because it would hurt the cause of getting more people vaccinated. I think it is bad to distort the truth, because it leads to distrust. Just tell us that once infected, we’re only about 4 times as likely to survive. That’s still good news, but not oversold. Maybe it used to be true that we were 25 times more likely to survive, but that doesn’t match recent data.

 

[samiam5211]

The du

That is good data that you presented. It indicates that over 50 year old vaccinated people in the UK are about 3.5 times more likely to survive Covid compared to similar unvaccinated, but that’s drastically lower than the 25 times that I’m frequently hearing. That was my point. I think we’re overselling the benefits once you’re infected. The Virginia data indicates you’re more likely to die once infected if you’re vaccinated, but it would probably also show a 3.5 times benefit once controlled for age and morbidities. I don’t think we’re getting accurate reports on the benefit of the vaccines after infected, because it would hurt the cause of getting more people vaccinated. I think it is bad to distort the truth, because it leads to distrust. Just tell us that once infected, we’re only about 4 times as likely to survive. That’s still good news, but not oversold. Maybe it used to be true that we were 25 times more likely to survive, but that doesn’t match recent data.

It’s hard to quantify how many vaccinated people get infected but are asymptomatic. Those won’t be tested, so the testing data is going to skew towards more severe cases.

No matter how much data we have, it’s going to be incomplete, so I wish they would not throw around numbers like 25-1 suggesting they have enough data to quantify it.

They should just say that it is better to be vaccinated, which is a safe conclusion even from the incomplete data we have.

 

[Goatman saint]

And yet when you hear doctors speaking, hospitals reporting like one of the people they have is vaccinated, and those usually have serious comorbidities also.
What is not being seen with testing is how many people who are vaccinated are simply not being infected, are asymptomatic or simply have a mild disease. If the only sample you are looking at is people who are in such a bad state they are going to the hospital and are fighting for their life, then yeah there’s your 1 vaccinated person who if they die it’s wow 100% of people vaccinated die.
This is where I’m having a problem with the data at this point. It’s just scattershot, random data. It seems all data also is being presented with an agenda behind it also. Get the vaccine, you won’t get sick being presented by those encouraging those to get vaccinated. Everyone who is vaccinated and comes to a hospital dies slanted to those who try to push back against vaccines. Where is just the raw data? Where is the community screening to see how many vaccinated are even testing positive?

 

[RobF]

That is good data that you presented. It indicates that over 50 year old vaccinated people in the UK are about 3.5 times more likely to survive Covid compared to similar unvaccinated, but that’s drastically lower than the 25 times that I’m frequently hearing. That was my point. I think we’re overselling the benefits once you’re infected. The Virginia data indicates you’re more likely to die once infected if you’re vaccinated, but it would probably also show a 3.5 times benefit once controlled for age and morbidities. I don’t think we’re getting accurate reports on the benefit of the vaccines after infected, because it would hurt the cause of getting more people vaccinated. I think it is bad to distort the truth, because it leads to distrust. Just tell us that once infected, we’re only about 4 times as likely to survive. That’s still good news, but not oversold. Maybe it used to be true that we were 25 times more likely to survive, but that doesn’t match recent data.

Well, still not quite! That data shows that the vaccines are effective in preventing death, but it doesn't indicates that's just being 4 times more likely to survive when infected. It'll be more than that.

Because even after we've broken it down into over 50s and under 50s, the cohorts still won't be identical. Specifically, in the UK, when Delta cases started, around the start of May, uptake of the vaccines in 75+ year olds was 95%, with around 90% of those already fully vaccinated (source)

By comparison, only around 17% of 50-54 year olds were fully vaccinated at that point.

Even now, after nearly three more months of vaccine rollout, there's still a significant difference (around 94% 75+ fully vaccinated, 83% 50-52).

Which means that even within just the over 50s, the vaccinated group of Delta cases will inevitably still be skewed towards being more elderly than the unvaccinated group. So the vaccinated group will still have a significantly higher average risk profile than the unvaccinated group (as I mentioned earlier, the over 75s had an up to 18% infection mortality rate).

And that said, typically when people are talking about your chances of dying of COVID in relation to having been vaccinated, that's a combination of your chances of getting it and subsequently dying from it. Vaccination isn't targeted as treatment for people currently infected, and as you've mentioned, it's effective against being infected in the first place, so that's the appropriate measure to talk about. The UK estimate of effectiveness against mortality is 95-99% for two doses of Pfizer (https://www.gov.uk/government/publications/covid-19-vaccine-surveillance-report). That's what the data is indicating.

So in conclusion, I don't think it's being oversold at all. These vaccines are genuinely remarkably effective.

 

[Lapaz]

Well, still not quite! That data shows that the vaccines are effective in preventing death, but it doesn't indicates that's just being 4 times more likely to survive when infected. It'll be more than that.

Because even after we've broken it down into over 50s and under 50s, the cohorts still won't be identical. Specifically, in the UK, when Delta cases started, around the start of May, uptake of the vaccines in 75+ year olds was 95%, with around 90% of those already fully vaccinated (source)

By comparison, only around 17% of 50-54 year olds were fully vaccinated at that point.

Even now, after nearly three more months of vaccine rollout, there's still a significant difference (around 94% 75+ fully vaccinated, 83% 50-52).

Which means that even within just the over 50s, the vaccinated group of Delta cases will inevitably still be skewed towards being more elderly than the unvaccinated group. So the vaccinated group will still have a significantly higher average risk profile than the unvaccinated group (as I mentioned earlier, the over 75s had an up to 18% infection mortality rate).

And that said, typically when people are talking about your chances of dying of COVID in relation to having been vaccinated, that's a combination of your chances of getting it and subsequently dying from it. Vaccination isn't targeted as treatment for people currently infected, and as you've mentioned, it's effective against being infected in the first place, so that's the appropriate measure to talk about. The UK estimate of effectiveness against mortality is 95-99% for two doses of Pfizer (https://www.gov.uk/government/publications/covid-19-vaccine-surveillance-report). That's what the data is indicating.

So in conclusion, I don't think it's being oversold at all. These vaccines are genuinely remarkably effective.

I know that overall the chances of dying with the vaccine is much lower than 4 times, but many reporters say that even if you’re infected, your chances of dying are 25 times higher. That’s the part that is oversold.

 

[superchuck500]

How is this “church”??

 

[Goatman saint]

Seriously time to end the religious exemption in the tax code

 

[Goatman saint]

I know that overall the chances of dying with the vaccine is much lower than 4 times, but many reporters say that even if you’re infected, your chances of dying are 25 times higher. That’s the part that is oversold.

Texas has seen nearly 9,000 COVID-19 deaths since February. All but 43 were unvaccinated people.

Preliminary data shows 99.5% of COVID-related deaths in Texas were among unvaccinated people, according to the Department of State Health Services.

www.texastribune.org

Less Than 0.001 Percent of Fully Vaccinated Americans Died From a COVID-19 Infection

Less than 0.004 percent of people fully vaccinated in the United States face hospitalization after a breakthrough case.

slate.com

looks like .001% of vaccinated breakthroughs are dying according to Slate and out of the 8787 Texan deaths, 43 were vaccinated all over 60 and all with significant health issues.


So, while I can’t find exact numbers nationwide, nor any specific data even at state level being published, what is out there highly suggests that unless you are over 60 and already have 1 foot in the grave, being vaccinated is still a tremendous protection.

 

[superchuck500]

I haven't heard the audio of this, but it's been tweeted about by several accounts, if this is indeed true, isn't this legally a call to violence and could she be charged for inciting it? (Legal question for Sir @superchuck500 Esq.)

Nope.

 

[Lapaz]

Texas has seen nearly 9,000 COVID-19 deaths since February. All but 43 were unvaccinated people.

Preliminary data shows 99.5% of COVID-related deaths in Texas were among unvaccinated people, according to the Department of State Health Services.

www.texastribune.org

Less Than 0.001 Percent of Fully Vaccinated Americans Died From a COVID-19 Infection

Less than 0.004 percent of people fully vaccinated in the United States face hospitalization after a breakthrough case.

slate.com

looks like .001% of vaccinated breakthroughs are dying according to Slate and out of the 8787 Texan deaths, 43 were vaccinated all over 60 and all with significant health issues.


So, while I can’t find exact numbers nationwide, nor any specific data even at state level being published, what is out there highly suggests that unless you are over 60 and already have 1 foot in the grave, being vaccinated is still a tremendous protection.

This is the misinterpretation that I've been pointing out. Yes, an extremely small percentage of vaccinated people are dying of Covid, however that's not the same AFTER a breakthrough (meaning you're diagnosed with Covid after being fully vaccinated). I've pointed out repeatedly that the Virginia data shows breakthroughs are more likely to die from Covid than unvaccinated Covid cases. We've discussed the likely underlying reasons, such as that the breakthroughs are probably heavily skewed to older, more vulnerable people, which is not given in the Virginia site, but is backed up by the Texas data you posted. So, yes the vaccine is fantastic, since it prevents people from getting sick, but you're wrong that only 0.001% of vaccinated breakthroughs are dying. You would be correct if you said that only about 0.001% of fully vaccinated people are dying of Covid, compared to about 0.8% of unvaccinated people. It used to be closer to 2%, but we've gotten better treatments, and more importantly most of the vulnerable people are vaccinated, so healthier people that are more likely to survive are getting sick, so it has dropped the death rate. I'm vaccinated, and I'm a huge advocate for vaccines, especially for adults, but I also like to keep the facts straight.