COVID-19 Coronavirus Containment Efforts

[mfb]

Long COVID in a prospective cohort of home-isolated patients

We found that 52% (32/61) of home-isolated young adults, aged 16–30 years, had symptoms at 6 months, including loss of taste and/or smell (28%, 17/61), fatigue (21%, 13/61), dyspnea (13%, 8/61), impaired concentration (13%, 8/61) and memory problems (11%, 7/61).

The sample size is not large, but it's following most (82%) who tested positive in Bergen (Norway) in February to April 2020, so it largely avoids sampling bias issues.

 

[atyy]

https://www.factcheck.org/2021/06/s...ter&utm_medium=social&utm_campaign=social-pug

"Shi, however, has https://www.sciencemag.org/sites/default/files/Shi%20Zhengli%20Q&A.pdf denied having the virus or any of its potential precursors and says that no one in the lab has tested positive for the coronavirus, nor do they have antibodies against it. If that’s true, then there’s no way SARS-CoV-2 came from her.

...

As it stands, though, some scientists, while still supportive of further investigation, say there is little to no reason to suspect a lab is the source of SARS-CoV-2 — and focusing too much on the possibility is diminishing the chances of finding out what happened.

“If we’re going to get the answer, we have to do it with some degree of diplomacy,” Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said in a podcast with the New York Times. “Because if we want to be part of the team that goes out there and finds out is there a connection with an animal that might have been brought in for many, many, many miles away into the Wuhan markets, we’re going to have to do that in collaboration with the Chinese.”"

 

[nsaspook]

More outbreaks and 'lockdowns' in Australia.


What is their Covid-Zero exit strategy?


At what point do you decide to open up like Singapore did?

https://www.business-standard.com/a...fe-with-covid-19-pendemic-121062400135_1.html

The deadly coronavirus may never go away, but it is possible to live "normally with it in our midst", Singapore's three ministers of a multi-ministry task force on coronavirus said on Thursday as they outlined plans for the country's transition to a new normal.

They said with enough people vaccinated, COVID-19 will be managed like other endemic diseases such as the common flu and hand, foot and mouth disease in Singapore.

A road map is being drawn up to shift to this new normal, and it will be done in tandem with achieving certain vaccination milestones, said the co-chairmen, Minister for Trade and Industry Gan Kim Yong, Minister for Finance Lawrence Wong and Minister for Health Ong Ye Kung.

The priority in the next few months will be to prepare Singapore for life with COVID-19 as a recurring, controllable disease, they were quoted as saying in a report in The Straits Times.

"It has been 18 months since the pandemic started, and our people are battle-weary. All are asking: When and how will the pandemic end?" said the ministers.

 

[Ygggdrasil]

More outbreaks and 'lockdowns' in Australia.

What is their Covid-Zero exit strategy?

At what point do you decide to open up like Singapore did?

Australia's vaccination rate is much lower than countries like the US or Singapore, so they have a lot of work to do before they can start opening up:

https://ourworldindata.org/explorer...true&Align+outbreaks=false&country=USA~SGP~AU

 

[morrobay]

https://www.abc.net.au/news/2021-06...t-spread-in-fleeting-moment-nsw-vic/100238680. Is "fleeting contact" for real? Reports of delta variant transmission in 5 to 10 seconds while just walking by an infected person. Are there any virus transmission studies in past with other viruses that would support this claim?

 

[atyy]

At what point do you decide to open up like Singapore did?

Singapore has not yet opened up, those are just early plans. Our vaccination rate among the elderly is low (~70% in early May) compared to the US (87% in June), Israel (~90% in April), and the UK (greater than 90% in June)

 

[mfb]

https://www.abc.net.au/news/2021-06...t-spread-in-fleeting-moment-nsw-vic/100238680. Is "fleeting contact" for real? Reports of delta variant transmission in 5 to 10 seconds while just walking by an infected person. Are there any virus transmission studies in past with other viruses that would support this claim?

This seems to be based on one to three cases. I'm sure there have been infections from an affair, illegal activities or other secret contacts, so we should expect a handful of cases where people claim they just walked past each other because that's the only thing captured on camera. Or maybe the infection happened elsewhere and contact tracing found an unrelated event.

 

[atyy]

https://www.abc.net.au/news/2021-06...t-spread-in-fleeting-moment-nsw-vic/100238680. Is "fleeting contact" for real? Reports of delta variant transmission in 5 to 10 seconds while just walking by an infected person. Are there any virus transmission studies in past with other viruses that would support this claim?

That article also refers to the kappa variant (B.1.617.1), but at least from the UK data, that may not be as transmissible as delta, so maybe it is more what @mfb said in post #5327.

One thing to note is that although airborne transmission (compared to droplet transmission) is still thought to be rare, it is increasingly likely as ventilation (with outdoor air replacing indoor air) becomes poorer.

 

[nsaspook]

Singapore has not yet opened up, those are just early plans. Our vaccination rate among the elderly is low (~70% in early May) compared to the US (87% in June), Israel (~90% in April), and the UK (greater than 90% in June)

I know those are plans but they also seem to pretty firm decisions on a path forward in the near term future from an isolation based strategy. Australia seems to be Covid Limbo due to the slow vaccine rates and the increasing power of variants to evade quarantine measures resulting in a continuous series of restrictions to keep community spread to near zero.

https://www.theatlantic.com/interna...ovid19-zero-asia-hong-kong-quarantine/619231/

The variants now spreading in some Asian countries, says Andrei Akhmetzhanov, an assistant professor at National Taiwan University’s College of Public Health, are a result of higher incidence of disease in countries that had struggled to contain the virus earlier in the pandemic. Now these harder-hit countries are protected by vaccines, but others that did a much better job of suppressing the virus initially are not and, perversely, are more vulnerable to the threat of new variants.

Pollack told me he took “a little bit of offense” to the narrative of life reverting to pre-pandemic norms in some countries, while others seemingly remained trapped in the onerous routines of pre-vaccine life. Without the luxury of the vaccine, he said, the U.S. would see its “number of cases skyrocketing,” and the situation would be “unbelievably disastrous.”

The US paid a very high price early for those pre-pandemic norms with very few of the variants in the world today originating from the US.

 

[atyy]

I know those are plans but they also seem to pretty firm decisions on a path forward in the near term future from an isolation based strategy. Australia seems to be Covid Limbo due to the slow vaccine rates and the increasing power of variants to evade quarantine measures resulting in a continuous series of restrictions to keep community spread to near zero.

The variants are more transmissible, but I'm unsure whether that really explains evasion of quarantine measures. Maybe that's the reason in Australia, but in Sinagpore we're still having a (relatively small) third wave now with tightened measures compared to March this year, which I wonder whether it is due in part to quarantine measures not being quite properly implemented. One way to tell would be if we knew whether there are many more clusters seeded by delta than by other earlier variants, relative to the number of arrivals of the various variants from overseas.

Another reason I'm not sure delta is that much more transmissible is that one estimate of its advantage (ie. is it due to increased transmissibility or to increased resistance to vaccines) indicate that when resistance to vaccines is taken into account, the transmissibility increase of delta likely lies between 1.1 and 1.4 times. The top end of the range would be quite an advantage, but the middle of the range is not that big.

 

[Rive]

Or maybe the infection happened elsewhere and contact tracing found an unrelated event.

While this kind of 'mistake in measurement' may happen, it's also can be expected that with strict protective measurements in place simple 'random' events with low chance to get more attention.
I don't know if it happened already, but I think there will be cases reported about suspected surface transmissions too.

 

[atyy]

https://www.bloomberg.com/news/feat...a-lab-scientist-at-wuhan-institute-speaks-out
The Last–And Only–Foreign Scientist in the Wuhan Lab Speaks Out
Virologist Danielle Anderson paints a very different picture of the Wuhan Institute.

 

[Astronuc]

A Missouri woman who refused to get a COVID-19 vaccine because she was afraid of its side effects died in hospital last month after contracting the Delta variant, her mother told local news outlets.

Tricia Jones, a 45-year-old mother of two from Kansas City, died on June 9 after a month in hospital on a ventilator.

Her mother, Deborah Carmichael, told local media that Jones was concerned about the vaccine after hearing "a lot of horror stories."

"She was afraid of the side effects, I think ... I, myself, when I had the shot, it was rough, so it scared her and freaked her out. So she didn't want to do it. I couldn't convince her," Carmichael said, according to Newsweek.

https://www.yahoo.com/news/missouri-woman-didnt-want-covid-144312388.html
Another unnecessary and preventable death.

She must have gotten sick during late April by virtue of being on a ventilator from early May through early June. And she was relatively young.

 

[Vanadium 50]

An interesting article in Morbidity and Mortality Weekly Report, titled Disparities in COVID-19 Vaccination Coverage Between Urban and Rural Counties — United States, December 14, 2020–April 10, 2021, by Murthy et al.

Fully 1/3 of all people receiving vaccinations got vaccinated (first dose) in a county other than the one on which they live. One-tenth received it in a non-adjacent county.

In rural Vermont (VT #1 in vaccination), 80% of those vaccinated went to another county.

 

[Astronuc]

Fully 1/3 of all people receiving vaccinations got vaccinated (first dose) in a county other than the one on which they live. One-tenth received it in a non-adjacent county.

In rural Vermont (VT #1 in vaccination), 80% of those vaccinated went to another county.

That would be my wife and me. In my case, I used Walgreens, although not the one about 1/2 km from my house, but one about 40 km away, because of availability and schedule. Once one got the shot, then one is/was supposed to return to the same facility. I give the state a D grade with respect to the vaccination program; it was poorly coordinated.

 

[Vanadium 50]

I also used Walgreens, and again, not the one within walking distance, but more lie 8 km rather than 40. It seems to be the 5th closest to me. I could have gotten it at work, and by "work" I mean a great big tent outside of work - I would not be allowed inside.

I am not surprised at the logistics complications. We have been told that the one thing you must absolutely never, ever, ever do is mix vaccines. So we set up a distribution plan that in theory makes this impossible: you get both doses at the same place, each place has just one kind of vaccine, and you can't schedule Dose #1 until your site is assured a Dose #2 will be there when needed.

This worked according to plan - it appears the number of mingled vaccines is in the 10^-7 ballpark. We don't know how many more people would be vaccinated if they had easier access. The 5th nearest Walgreens to French Lick, Indiana (yes, that's a place) is 35 km away. Now, how many more people would have been vaccinated if we allowed a mingling rate of 10^-6 or 10^-5? We will never know. We don't even know if it is better to not be vaccinated at all than to be vaccinated with two different products, although I have my suspicions.

 

[Vanadium 50]

Another interesting paper is Bradley et al. Are We There Yet? Big Data Significantly Overestimates COVID-19 Vaccination in the US arXiv:2106.05818v1.

The point of the paper is that we have survey data that allows one to estimate vaccination rates, and despite very large data sets, the surveys don't predict the data well. The authors argue, paraphrasing, you can't replace good data by lots and lots of bad data. Well, you can. You just shouldn't.

Some technical issues are identified - for example, vaccination rates are negatively correlated with rurality, and rurality is negatively correlated with home internet access, so one would expect that surveys overestimate vaccination rates,

They note that the fraction of vaccinated (V), hesitant (H) and willing (W) individuals must sum to 1, and discuss three models of who is undersampled:

• uptake: W and H are both higher than surveys report
• hesitancy: H is twice as large as the surveys show (the shy Tory effect)
• access: W is three times as large as the surveys show, possibly due to correlations like I mentioned above.

They stress that the data do not distinguish between these scenarios. They point out that if the effect is access, 20% of the population are willing but have found barriers - distance, time, whatever, to be too great, (To them I would say "Who cares about some waitress in a diner in Pig's Knuckle, Arkansas? If she were important, she'd be living in Manhattan, where the 5th nearest Walgreens is 2000 feet away, and her job as a Social Media Influencer would let her take off half an hour whenever she wants!")

 

[atyy]

We don't even know if it is better to not be vaccinated at all than to be vaccinated with two different products, although I have my suspicions.

I'm sure we all guess that it should be better to mix than not to be vaccinated (same reasoning as still giving at least one vaccine dose to those who have been infected once before). Anyway, there's been reports about a trial which showed that mixing AstraZeneca with Pfizer was better than two doses of AstraZenrca: https://www.aljazeera.com/news/2021...hod-boosts-immune-response-of-astrazeneca-jab

 

[russ_watters]

An interesting article in Morbidity and Mortality Weekly Report, titled Disparities in COVID-19 Vaccination Coverage Between Urban and Rural Counties — United States, December 14, 2020–April 10, 2021, by Murthy et al.

Fully 1/3 of all people receiving vaccinations got vaccinated (first dose) in a county other than the one on which they live. One-tenth received it in a non-adjacent county.

In rural Vermont (VT #1 in vaccination), 80% of those vaccinated went to another county.

That's interesting, but I'm struggling to find meaning. That was during the first and second phases. A lot of old people got vaccinated at home, whereas the people who work with them got vaccinated at the same place, which is their place of work (nursing homes). Hospitals, similar. Do people tend to work in the county where they live?

I was in the 'everyone else' group and got my vaccines in different places, neither of which is the county of my residence.

 

[russ_watters]

Once one got the shot, then one is/was supposed to return to the same facility.

I am not surprised at the logistics complications. We have been told that the one thing you must absolutely never, ever, ever do is mix vaccines. So we set up a distribution plan that in theory makes this impossible: you get both doses at the same place, each place has just one kind of vaccine, and you can't schedule Dose #1 until your site is assured a Dose #2 will be there when needed.

No, not impossible, just not convenient (not to be confused with "inconvenient"). I got my two vaccines from different chains in different counties because I wanted a shorter drive for the second. It was plenty easy to do.

 

[Vanadium 50]

Do people tend to work in the county where they live?

Not in NYC or DC, for sure. LA is another story. LA County is more populous than 41 states.

but I'm struggling to find meaning.

I don't have an answer other than "those were not the numbers I expected". I don't think they were the numbers the vaccine planners expected either.

 

[AlexCaledin]

"Salivary glands were reported as a virus reservoir for prevalent diseases such as herpes... Viral replication within the SGs seems to be an efficient dissemination strategy as the contaminated droplets expelled during coughs, sneezes, and speech are mainly composed of saliva excreta...
. . .
Our findings demonstrate that salivary glands are a reservoir for SARS-CoV-2"

https://onlinelibrary.wiley.com/doi/10.1002/path.5679
________________________________________________________________________
- does that mean that the usual injection vaccines may be quite ineffective against the virus replication in that main SG reservoir?

 

[Astronuc]

Do people tend to work in the county where they live?

There was a 10 year period when I commuted 47 miles one way to work in a different county, then a period of 20 years where I lived 7 miles from the office, so I worked in the same county (two companies in two different states). Then another 3 year period where I lived about 2 miles from my office, but now I work remotely, so technically work in the same county in which I live.

My parents did most of their lives.

 

[atyy]

"Salivary glands were reported as a virus reservoir for prevalent diseases such as herpes... Viral replication within the SGs seems to be an efficient dissemination strategy as the contaminated droplets expelled during coughs, sneezes, and speech are mainly composed of saliva excreta...
. . .
Our findings demonstrate that salivary glands are a reservoir for SARS-CoV-2"

https://onlinelibrary.wiley.com/doi/10.1002/path.5679
________________________________________________________________________
- does that mean that the usual injection vaccines may be quite ineffective against the virus replication in that main SG reservoir?

I'm not sure about the specifics of salivary glands, but that reminds me of similar discussions about the vaccine being able to reduce the severity of disease even if it does not prevent infection. Immunity that prevent reinfection is called sterilizing immunity, and is due to neutralizing antibodies reaching appropriate parts of the body.

https://www.statnews.com/2020/08/25/four-scenarios-on-how-we-might-develop-immunity-to-covid-19/
https://www.nature.com/articles/d41586-020-02400-7
https://www.frontiersin.org/articles/10.3389/fimmu.2020.611337/full (includes discussion of salivary glands)
https://www.biorxiv.org/content/10.1101/2020.05.21.108308v1

 

[Astronuc]

VOX, July 6, 2021 - How Taiwan held off Covid-19, until it didn't
https://www.vox.com/videos/22561185/pandemic-playbook-taiwan-covid-19-vaccine-quarantine

In December 2019, Taiwan‘s government learned that at least seven atypical pneumonia cases had been reported in Wuhan, China. Because of Taiwan’s proximity to China and the number of back-and-forth flights between the two countries, it was expected to have the second-highest number of Covid-19 cases worldwide.

Instead, Taiwan has had one of the lowest Covid-19 death rates in the world [through 2020 and into May 2021]. Thanks in part to a sophisticated, digitized health care system and a mandatory two-week quarantine for all travelers, life in Taiwan went on with relative normalcy. But then, in May 2021, a new wave of cases threatened the country’s success.

 

[Ygggdrasil]

Here's a nice article in published in the journal Nature with some outlooks on the future of SARS-CoV-2, drawing from our experience with other similar viruses:

After the pandemic: perspectives on the future trajectory of COVID-19
Telenti et al. Nature. Published online July 8, 2021
https://www.nature.com/articles/s41586-021-03792-w

Abstract:

There is a realistic expectation that the global effort in vaccination will bring the severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) pandemic under control. Nonetheless, uncertainties remain about the type of long-term association the virus will establish with the human population, particularly whether the Coronavirus disease 2019 (COVID-19) will become an endemic disease. Although the trajectory is difficult to predict, the conditions, concepts, and variables that influence this transition can be anticipated. Persistence of SARS-CoV-2 as an endemic virus, perhaps with seasonal epidemic peaks, may be fueled by pockets of susceptible individuals and waning immunity after infection or vaccination, changes in the virus through antigenic drift that diminish protection, and reentries from zoonotic reservoirs. Here, we review relevant observations from previous epidemics and discuss the potential evolution of SARS-CoV-2 as it adapts during persistent transmission in the presence of a level of population immunity. Lack of effective surveillance or adequate response could enable the emergence of new epidemic or pandemic patterns from an endemic infection of SARS-CoV-2. There are key pieces of data that are urgently needed in order to make good decisions. We outline these and propose a way forward.

 

[Astronuc]

Delta variant's rise plunges Europe into uncertainty — and offers a warning to the U.S.
https://news.yahoo.com/delta-varian...and-offers-a-warning-to-the-us-090002409.html

BARCELONA — Last month, as Europe finally lifted COVID-19 restrictions, the mood was jubilant across the continent. Outdoor mask mandates and curfews were dropped, Americans were cleared to resume travel to tourist mainstays, and hopes rose that life would quickly return to normal.

The swift spread of the Delta variant, however, has upended all of that wishful thinking and is offering a warning to the U.S.

Fast becoming the dominant strain of COVID-19 across Europe, Delta is wreaking havoc in Spain, Portugal and the United Kingdom. Spain alone reported nearly 44,000 cases on Tuesday, doubling the number recorded one week ago. Trying to blunt the effect of the strain that is expected by August to account for 70 to 90 percent of all cases in the EU, countries on the continent are clamping on new restrictions to counter a mutation that is at least twice as infectious at the variety that shuttered the world in 2020.

In France, President Emmanuel Macron announced on Monday that patrons must now present “health passes” showing full vaccination or a negative COVID test to enter bars, cafés, restaurants, theaters or museums. Greece and Portugal have imposed similar requirements for those wishing to dine out or check into hotels. In the Netherlands, nightclubs and discos, closed for a year, opened for mere days before Prime Minister Mark Rutte ordered them shut again.

Seems like we're on another upswing.

https://news.yahoo.com/superspreader-explosions-continue-plague-pandemic-090018886.html

 

[mfb]

Germany's case counts are still low for now. One +1500 outlier with the last update (some artifact of the weekly cycle probably), but otherwise the last two weeks were below 1000 per day.

The race is vaccinating more people vs. unvaccinated people spreading the delta variant.

 

[Astronuc]

ABC News is reporting more severe COVID-19 cases in children. The Delta variant is suspected. Mississippi health officials report 7 children in ICU of whom two are on ventilators.



New York state has reported one more fatality in a child 0-9 years of age after months without a fatality in that age group. The number are small (16 fatalities), but a couple of parents lost their child.

​

Delta variant about 58% of COVID-19 cases in US: CDC​

 

[Vanadium 50]

The number are small (16 fatalities), but a couple of parents lost their child.

That is sad, but I think it needs to be placed in perspective. That's about the number of children killed by lightning every year (slightly more - lightning is 12 or 13) Do we ban outdoor activities?

Rare events make for good "Man Bites Dog" attention-grabbing stories. They do not make for good public policy.

Since I have the floor...let me also rant against the delta bugbear. I would argue that there is no action that should be taken for delta that shouldn't also be taken for "regular". India's problem with Demon Delta wasn't that it was delta. It was that their vaccination rate was under 5% at the start of their wave.

While I hate to say good things about Canada in general and Ontario in particular, Ontario is half fully vaccinated and something like 80+% of those eligible have received at least one dose. Covid there is mostly delta, and deaths are down to ~5/day. (Down from a peak or 60-65). That's 1.6% of the total deaths - on par with Parkinson's.

Vaccinate and delta will not be a problem.

 

[jack action]

In California, unvaccinated people are required to wear masks in indoor public settings and businesses. Scientifically speaking, I don't get the logic behind this policy.

As of now, a vaccine is easily available, so the only excuse for not being vaccinated is that you don't want to. People who are vaccinated are protected, so unvaccinated people take a risk that only concerns themselves. To me, that feels pretty much like the best democratic referendum you can have.

But even assuming the state is concerned with everyone's health (vaccinated or not), then shouldn't the mask be mandatory for everyone, since vaccinated people can still most likely spread Covid? Even worst, since more of them would be asymptomatic compared to unvaccinated people getting Covid, wouldn't there be more of them unknowingly spreading the coronavirus? If one had to choose between the two groups, one might even argue that it would be better if vaccinated people wear masks.

 

[Ygggdrasil]

In California, unvaccinated people are required to wear masks in indoor public settings and businesses. Scientifically speaking, I don't get the logic behind this policy.

As of now, a vaccine is easily available, so the only excuse for not being vaccinated is that you don't want to. People who are vaccinated are protected, so unvaccinated people take a risk that only concerns themselves. To me, that feels pretty much like the best democratic referendum you can have.

The government can require people to wear safety belts in cars even though not wearing a safety belt largely affects only the non-wearer's safety.

Furthermore, in the context of pandemics, there are costs to the rest of society if large numbers of people get sick. As seen in California during winter 2020, large outbreaks of COVID-19 can quickly fill emergency rooms at hospitals, which can prevent or deter others from getting care. Outbreaks of disease also have major economic consequences if they necessitate quarantine of exposed individuals or shutdowns of businesses.

But even assuming the state is concerned with everyone's health (vaccinated or not), then shouldn't the mask be mandatory for everyone, since vaccinated people can still most likely spread Covid? Even worst, since more of them would be asymptomatic compared to unvaccinated people getting Covid, wouldn't there be more of them unknowingly spreading the coronavirus? If one had to choose between the two groups, one might even argue that it would be better if vaccinated people wear masks.

According to the CDC: "A growing body of evidence indicates that people fully vaccinated with an mRNA vaccine (Pfizer-BioNTech and Moderna) are less likely to have asymptomatic infection or to transmit SARS-CoV-2 to others. Studies are underway to learn more about the benefits of Johnson & Johnson/Janssen vaccine. However, the risk for SARS-CoV-2 infection in fully vaccinated people cannot be completely eliminated as long as there is continued community transmission of the virus." (see also this article from GAVI). Yes, the vaccine is not perfect, but neither are masks. Both can do a good job of protecting individuals for being infected and reduce transmission of the virus.

 

[jack action]

Yes, the vaccine is not perfect, but neither are masks. Both can do a good job of protecting individuals for being infected and reduce transmission of the virus.

So, from a scientific point of view, everyone should wear it?

 

[Ivan Seeking]

So, from a scientific point of view, everyone should wear it?

At some number the notion of herd immunity kicks in. From what I gather, if you have 80% or greater protection through masks or vaccinations, then you won't have a pandemic.

 

[Vanadium 50]

Scientifically speaking, I don't get the logic behind this policy.

They aren't listening to scientists, so must be punished.