COVID-19 Coronavirus Containment Efforts

[Astronuc]

I was listening to an NPR program and interview with two doctors. One mentioned some good numbers, but I haven't seen the evidence.

GANDHI: I would go to dinner there. And the reason I would say that is there's now nine studies - there was just one out of yesterday from a nursing home setting - health care workers, nursing home, and also a very large study from the CDC that swabbed first responders and shows the risk of you carrying the virus in your nose after vaccination is reduced between 80 and 94%. And that rate will go down even more as our cases come down with vaccination. And then there's some very nice studies that show the immunoglobulin that goes into your nose and protects you, which is called IgA, are developed by these vaccines, are really generated by these vaccines. So it's very difficult to transmit the virus if you've been vaccinated.

I will still wear a mask in public for the foreseeable future.

 

[OmCheeto]

What, you're not giving them credit for choosing to be an island nation? That took considerable long-term planning!

So sad that that strategy didn't work for the UK.

 

[Vanadium 50]

In 2019 the UK had 144M passenger arrivals. In the same year, NZ had 12M.
Population density (K/hectare) UK 275, NZ 18.
Covid rate of the political entity with most entries: UK , 6.43% (EU), NZ 0.12% (Australia).

I think it is clear that the UK and NZ started from very different places, irrespective of policy.

Oh, I forgot "hotness of PM on a scale of 1 to 10", NZ 9 and UK -12.

 

[OmCheeto]

Ideally you would repeat the phase III trials with 10 different periods between the doses, but that's not realistic. It's generally expected that there is a large time range that leads to very similar results. The difference between 3 and 4 weeks is probably irrelevant.

One would think that with the world approaching 1 billion data points that an observational study would be adequate.

Being in full retirement mode, I decided to look at a smaller sample of only about 3 million data points.

Incredibly, only 200 breakthrough cases were reported out of 500,000 fully vaccinated people.
So breaking down whether 15 days vs 30 days between doses was better, would have been very problematic, IMHO.

 

[mfb]

One would think that with the world approaching 1 billion data points that an observational study would be adequate.

Vaccine approvals generally follow the methods of the phase III trials. Varying the schedule a lot would be outside that approval, or at least outside the conventional approval process. It could also increase vaccine hesitancy. See the discussion about the smaller first dose that was given by accident, or the discussion about the UK's approach with the delayed second dose.

 

[.Scott]

How do you stop something like this?

How do you stop "this" - followed by a 30 minute video.
You should probably be more specific. Such as:
How do we stop the kind of exponential COVID growth we are seeing in India?
How do we stop such inaccurate COVID projections?
How do we stop such interviews?

I only watched the first 6 minutes or so. Perhaps there was something else there to stop.

 

[.Scott]

I live in New Hampshire. 3 of 4 members of my household are "fully vaccinated" with the fourth scheduled for next month.
About 60% of the NH population have received at least one COVID vaccination shot and anyone (residents and visitors) is welcome to sign up for an appointment here.

Based on the daily COVID numbers, it appears we are closing in on herd immunity. My guess is that some sectors of the NH population, such as those over 55 or those who live in the northern parts, have already reached herd immunity.

I certain that vaccinating 60% of the population has the potential of stopping the virus - but only if it is targeted against those who are most likely to spread it.

 

[JT Smith]

I live in New Hampshire. 3 of 4 members of my household are "fully vaccinated" with the fourth scheduled for next month.
About 60% of the NH population have received at least one COVID vaccination shot and anyone (residents and visitors) is welcome to sign up for an appointment here.

Based on the daily COVID numbers, it appears we are closing in on herd immunity. My guess is that some sectors of the NH population, such as those over 55 or those who live in the northern parts, have already reached herd immunity.

I certain that vaccinating 60% of the population has the potential of stopping the virus - but only if it is targeted against those who are most likely to spread it.

You could have a kind local herd immunity. But then it means you have to remain within that population, whether it's age group, a state, or whatever. But travel somewhere else? Maybe not a good idea. And what about people coming into that local stronghold of vaccination?

https://www.nature.com/articles/d41586-021-00728-2

 

[Ygggdrasil]

I live in New Hampshire. 3 of 4 members of my household are "fully vaccinated" with the fourth scheduled for next month.
About 60% of the NH population have received at least one COVID vaccination shot and anyone (residents and visitors) is welcome to sign up for an appointment here.

Based on the daily COVID numbers, it appears we are closing in on herd immunity. My guess is that some sectors of the NH population, such as those over 55 or those who live in the northern parts, have already reached herd immunity.

I certain that vaccinating 60% of the population has the potential of stopping the virus - but only if it is targeted against those who are most likely to spread it.

Although I would tend to agree that high vaccination rates should prevent future outbreaks, there have been outbreaks of COVID-19 in areas of Brazil and India which were thought to have had high levels of immunity to the virus from prior infection:

Studies that tested for SARS-CoV-2 antibodies — an indicator of past infection — in December and January estimated that more than 50% of the population in some areas of India’s large cities had already been exposed to the virus, which should have conferred some immunity, says Manoj Murhekar, an epidemiologist at the National Institute of Epidemiology in Chennai, who led the work. The studies also suggested that, nationally, some 271 million people had been infected1 — about one-fifth of India’s population of 1.4 billion.​

​

These figures made some researchers optimistic that the next stage of the pandemic would be less severe, says Ramanan Laxminarayan, an epidemiologist in Princeton University, New Jersey, who is based in New Delhi. But the latest eruption of COVID-19 is forcing them to rethink.​

https://www.nature.com/articles/d41586-021-01059-y

After initially containing severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2), many European and Asian countries had a resurgence of COVID-19 consistent with a large proportion of the population remaining susceptible to the virus after the first epidemic wave.1 By contrast, in Manaus, Brazil, a study of blood donors indicated that 76% (95% CI 67–98) of the population had been infected with SARS-CoV-2 by October, 2020.2 High attack rates of SARS-CoV-2 were also estimated in population-based samples from other locations in the Amazon Basin—eg, Iquitos, Peru 70% (67–73).3 The estimated SARS-CoV-2 attack rate in Manaus would be above the theoretical herd immunity threshold (67%), given a basic case reproduction number (R0) of 3.4

In this context, the abrupt increase in the number of COVID-19 hospital admissions in Manaus during January, 2021 (3431 in Jan 1–19, 2021, vs 552 in Dec 1–19, 2020) is unexpected and of concern​

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00183-5/fulltext

There are a number of explanations for these outbreaks (including that estimates of the amount of immunity were wrong), and there are reasons to think that immunity for vaccination could be longer lasting and more effective than immunity from prior infections. However, these examples should provide some food for thought that widespread vaccination may not be completely sufficient to prevent future outbreaks.

 

[OmCheeto]

See the discussion about the smaller first dose that was given by accident, or the discussion about the UK's approach with the delayed second dose.

I'm sure I've seen those discussions, but wouldn't know where to find them now. No matter. It's a bit late in the game for that type of thing here. It might be something people from India could tinker with.

 

[russ_watters]

So sad that that strategy didn't work for the UK.

True, the UK made some very poor decisions, such as densely populating their island and locating it 20 miles off the coast of France...and then building a tunnel! What on Earth were they thinking?!

 

[pinball1970]

True, the UK made some very poor decisions, such as densely populating their island and locating it 20 miles off the coast of France...and then building a tunnel! What on Earth were they thinking?!

It would help if they did not do stupid stuff like this.

 

[WWGD]

It would help if they did not do stupid stuff like this.

Still, the number of cases, deaths seems to have dropped substantially recently.

 

[pinball1970]

Still, the number of cases, deaths seems to have dropped substantially recently.

It's not that recent, months of lockdown and 33 million first dose vaccines since Dec 2020 has brought the cases down but the number stubbornly refuses to drop to low levels. The graph has levelled off with around 2,500 cases per day.
This is probably schools back lots of testing there.
Those sorts of demos can act as potential spreaders, this one was well attended unfortunately.
We can assume these people will exhibit deliberately reckless behaviour on a daily basis not just in a demo.

 

[mfb]

True, the UK made some very poor decisions, such as densely populating their island and locating it 20 miles off the coast of France...and then building a tunnel! What on Earth were they thinking?!

Should have taken Brexit more seriously!

Spoiler

scnr

 

[OmCheeto]

Well this is interesting.
I'm sure population density is a factor in the spread of diseases, but it sure doesn't seem to show up graphically.

And it looks as though the current leading nations, as far as total mortality goes, is lead by the Balkanish region.

It's been quite a while since I've looked at whole nations, so this is new news to me.

 

[Ygggdrasil]

View attachment 281987

I'm curious about the source of this data as it seems inconsistent with some sources. For example, official CDC numbers say that there have been about 31.5 M COVID-19 cases in the US, which would be ~9.5% of the population (though because of the lack of testing early on in the pandemic, this is probably an underestimate). On the other hand, preliminary studies in India suggest that about 20% of the country's population has been infected.

Well this is interesting.
I'm sure population density is a factor in the spread of diseases, but it sure doesn't seem to show up graphically.

View attachment 282030

This analysis assumes the fraction of cases that end up resulting in deaths is constant across the regions analyzed, which may not be a correct assumption if looking at a wide variety of countries with varying levels of access to high quality medical care. What are the set of countries you are looking at?

And it looks as though the current leading nations, as far as total mortality goes, is lead by the Balkanish region.

View attachment 282034

It's been quite a while since I've looked at whole nations, so this is new news to me.

This data does not seem consistent with other analysis I've looked at. For example, looking at excess mortality, there are some major differences in the rankings across Europe (e.g. Serbia moves up a lot and Hungary moves down a lot):

https://www.ft.com/content/a2901ce8-5eb7-4633-b89c-cbdf5b386938

 

[OmCheeto]

I'm curious about the source of this data as it seems inconsistent with some sources. For example, official CDC numbers say that there have been about 31.5 M COVID-19 cases in the US, which would be ~9.5% of the population (though because of the lack of testing early on in the pandemic, this is probably an underestimate). On the other hand, preliminary studies in India suggest that about 20% of the country's population has been infected.

The data is from Johns Hopkins University.
I use the death data to extrapolate the infections using a 1% IFR, as the case data, as you acknowledged, was quite lacking. I import the data weekly, and generate my own graphs.

This analysis assumes the fraction of cases that end up resulting in deaths is constant across the regions analyzed, which may not be a correct assumption if looking at a wide variety of countries with varying levels of access to high quality medical care. What are the set of countries you are looking at?

It's the set of countries with populations over a million.

This data does not seem consistent with other analysis I've looked at. For example, looking at excess mortality, there are some major differences in the rankings across Europe (e.g. Serbia moves up a lot and Hungary moves down a lot):

https://www.ft.com/content/a2901ce8-5eb7-4633-b89c-cbdf5b386938

I don't have a subscription to Financial Times, so I don't use them as a data source.
The data for that map was, like before, extrapolated from the John's Hopkins database.

 

[Ygggdrasil]

It's the set of countries with populations over a million.

Using a set of countries that varied in quality of their reporting data and in their access to medical care, there's probably too much noise to see any signal that might exist. A better data set to analyze might be to look at the US by county (available here), though there there are also a lot of confounding factors (e.g. politics and culture also differ significantly with population density in the US).

 

[Astronuc]

For example, looking at excess mortality, there are some major differences in the rankings across Europe (e.g. Serbia moves up a lot and Hungary moves down a lot):

https://www.ft.com/content/a2901ce8-5eb7-4633-b89c-cbdf5b386938

For those nations that had a reduction (negative rate) of excess deaths, was this due to a reduction of influenza or other illnesses? Did wearing masks, social distancing and shutdowns reduce mortality due to more common/usual causes?

 

[OmCheeto]

Using a set of countries that varied in quality of their reporting data and in their access to medical care, there's probably too much noise to see any signal that might exist. A better data set to analyze might be to look at the US by county (available here), though there there are also a lot of confounding factors (e.g. politics and culture also differ significantly with population density in the US).

"Confounding factors" is why I don't try and write a PhD* worthy analysis of what's going on.

--------
* about 30 years ago, I did some piece work to help someone get his PhD.
Oh. My. God.
The number of numbers involved was astounding.

 

[Ygggdrasil]

For those nations that had a reduction (negative rate) of excess deaths, was this due to a reduction of influenza or other illnesses? Did wearing masks, social distancing and shutdowns reduce mortality due to more common/usual causes?

That seems likely (e.g. see this article from Australia):

"What we can see is that the causes that have the lowest numbers of deaths in comparison to previous years are mostly in the respiratory disease group so that can include chronic lower respiratory diseases, things like influenza and pneumonia."​

​

"It certainly points to a lack of transmission perhaps of some normal infectious diseases during the winter months that may have contributed to a lower-than-expected number of deaths during that period."​

​

The statistics do not include deaths referred to coroners, such as accidents, assaults and suicides, which Mr Eynstone-Hinks said usually accounted for about 10-15 per cent of deaths in Australia.​

https://www.abc.net.au/news/2021-01...esses-lower-than-usual-amid-covid-19/13041324

 

[Vanadium 50]

was this due to a reduction

There are some Euromomo graphs upthread which suggest that it's a reduction in the young, presumably a reduction in accidental deaths due to the lockdown.

There's also an undershoot after an outbreak among the very old, presumably because the post-outbreak (i.e. surviving) 85+ population is on average healthier than the pre-outbreak population. This can cause an effect on boundaries.

 

[Rive]

For those nations that had a reduction (negative rate) of excess deaths, was this due to a reduction of influenza or other illnesses? Did wearing masks, social distancing and shutdowns reduce mortality due to more common/usual causes?

In our case (Hungary) we had lower-than-average death rate for last summer, and also a few weeks when the difference between reported cases and average was negative for a few weeks (but that vanished later with data updates). The latter period was at the very start of the usual seasonal flu season. Which was absent, of course.

Regarding common causes - even traffic accidents went down. With all the hygiene requirements and mask wearing and such, the yearly average for the last year absolutely could not mirror the severity of the second wave (what made that kind of statistics the favourite for the government).

 

[PeroK]

Using a set of countries that varied in quality of their reporting data and in their access to medical care, there's probably too much noise to see any signal that might exist. A better data set to analyze might be to look at the US by county (available here), though there there are also a lot of confounding factors (e.g. politics and culture also differ significantly with population density in the US).

I don't think you should just ignore the rest of the world!

 

[morrobay]

This 3rd wave with about 24000 cases since April 1 is being blamed on a cluster from hiso-Thai nightclubs with the UK variant then the Thai new year celebrations. These nightclubs have negative social distancing:

 

[Astronuc]

Using a set of countries that varied in quality of their reporting data and in their access to medical care, there's probably too much noise to see any signal that might exist. A better data set to analyze might be to look at the US by county (available here), though there there are also a lot of confounding factors (e.g. politics and culture also differ significantly with population density in the US).

I don't think you should just ignore the rest of the world!

I don't believe that is being suggested or considered, but rather it is a matter of accessing 'good' and consistent data when "there are also a lot of confounding factors (e.g. politics and culture also differ significantly with population density in the US". Internationally, one might find it difficult to take datasets and compare on a more or less equal basis.

From Wikipedia, "As of 2016, there were 3,007 counties, 64 parishes, 19 organized boroughs, 11 census areas, 41 independent cities, and the District of Columbia for a total of 3,143 counties and county-equivalents in the 50 states and District of Columbia." It's difficult enough with 50 states and various territories, all of which had differing trends over the last year. https://en.wikipedia.org/wiki/County_(United_States)

 

[.Scott]

Meanwhile in NH: Still about 60% vaccinated. Last year at this time the numbers were just starting to peak. Most restrictions are gone - but almost everyone is using masks indoors in public. Numbers of infections per day still going down.

It's hard to tell whether "herd immunity" has really happened - but given that the "herd" seems to be willing to adopt some mask use indefinitely, the combination of vaccinations and previous infections may have gotten us there.

The rate of vaccinations seems to have stalled over the past 2+ weeks.
We will see.

 

[Vanadium 50]

seems to have stalled

"Stalled" has a negative connotation. "Reached a sustainable peak" has a positive one. Any reason you picked the word "stalled"? If the rate were falling, that would be cause for concern, but "stalled" implies flat, not falling.

 

[mfb]

If I interpret this graph correctly the rate of new vaccinations has dropped a lot. I don't know if there is some reporting delay, however. Many people should move from the first-dose group to the fully-vaccinated group within the next two weeks.

The vaccination rate of the first half of April wouldn't have been sustainable for long - NH would have run out of eligible unvaccinated people.

 

[OmCheeto]

If I interpret this graph correctly the rate of new vaccinations has dropped a lot. I don't know if there is some reporting delay, however. Many people should move from the first-dose group to the fully-vaccinated group within the next two weeks.

The vaccination rate of the first half of April wouldn't have been sustainable for long - NH would have run out of eligible unvaccinated people.

The New Hampshire website has the opposite. Fully vaccinated has leveled off over the last two weeks while first vaccinations are steadily adding up. Since I haven't been following New Hampshire closely, I can't say for sure, but Oregon takes nearly a month to get all the numbers collected, so I wouldn't worry about the latest 2 weeks of data.

 

[mfb]

That's odd as both sites agree on the current value. It's the past that is different.

The government website has 58.8% with at least one dose as of 4/29. The other tracker has 60.7% for the same date. That's close enough.
The government website has 46.6% with at least one dose as of 4/16. The other tracker has 58.2% for the same date.

The overall shape of the graph for the government website looks more plausible to me.

 

[Wrichik Basu]

We just crossed over 400k — there were 401,993 new COVID patients in the last 24 hours. 3,523 deaths as well; most people simply dying from the lack of oxygen.

The sad part is that our Govt. is still playing politics with the lives of the people. The vaccination program has also been halted as hospitals have not been able to procure their supplies. I have been trying to book a vaccine slot for myself since last week, but none are available.

 

[.Scott]

I was looking at this URL for the NH vaccination numbers: https://covidactnow.org/us/new_hampshire-nh/?s=1797716

Over the past two weeks, it has shown the 1st shot number approaching 60.0% asymptotically.
By I visited one of the mass vaccination sites yesterday afternoon (in Nashua, Hillsborough County). They said that they have been booked for the past two weeks and that pretty much everyone has been showing up for their appointments.

So I am ready to doubt the reported numbers - especially for Hillsborough County.

Looking closely at the first-shot vaccination numbers - NH reports 60.0% of the population. But when I calculate that number from the 10 counties (weighted by population), I get 48.6%.

So the numbers are wrong - especially for the most populated county, Hillsborough.

Too bad: I was hoping they might reflect something about what is required to reach herd immunity.

 

[OmCheeto]

So I am ready to doubt the reported numbers - especially for Hillsborough County.

Both your link and the CDC list the level of fully vaccinated in Hillsborough county at 19.2%.
I'm not sure where to find the county level 1st dose data at the either the CDC nor the New Hampshire state websites, so I can't comment about that.