COVID-19 Coronavirus Containment Efforts

[PeroK]

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.

In the UK we have 86% of the adult population vaccinated at least once and 66% twice. Our vaccination programme is winding down (we've done fewer than a million jabs this week). But, the cases are soaring. They have doubled since the start of July (from 25,000 per day steadily rising to over 50,000 today). They were down at 2,000 per day until the Delta variant took off in late May.

On the evidence of the UK the voluntary vaccination programme achievable in democratic societies is unable to prevent a pandemic (only lessen its impact). I.e. herd immunity if we ever attain it will be partly achieved by a significant proportion having achieved immunity through having been infected with the virus itself.

 

[Ivan Seeking]

In the UK we have 86% of the adult population vaccinated at least once and 66% twice. Our vaccination programme is winding down (we've done fewer than a million jabs this week). But, the cases are soaring. They have doubled since the start of July (from 25,000 per day steadily rising to over 50,000 today). They were down at 2,000 per day until the Delta variant took off in late May.

On the evidence of the UK the voluntary vaccination programme achievable in democratic societies is unable to prevent a pandemic (only lessen its impact). I.e. herd immunity if we ever attain it will be partly achieved by a significant proportion having achieved immunity through having been infected with the virus itself.

66% vaccinated is not sufficient. And the delta variant is believed to be far more contagious than the original strains.

We don't know that having the virus prevents reinfection later. Having the virus appears to prevent re-infection for some period of time but we don't know if that is months or years or decades. As I understand it, there are Corona Viruses [the so-called common cold] that you can catch year after year.

In the Seattle area we are over 80% fully vaccinated. But of course some rural areas are seeing a big increase in cases.

 

[Ivan Seeking]

LA County is having a big surge in cases and 100% of those hospitalized are not vaccinated or not fully vaccinated.

All COVID patients in LA County-run hospitals are unvaccinated, official says​

https://abc7.com/unvaccinated-covid19-los-angeles-county-hospitalizations/10887037/

 

[PeroK]

66% vaccinated is not sufficient. And the delta variant is believed to be far more contagious than the original strains.

That's as good as it gets! There is no point in holding out hope for herd immunity if it is practically unachievable. Whatever was the case for the original strains is largely irrelevant now that Delta is on the loose.

I notice that the US numbers have double since the start of the month, albeit from a modest 17,000 per day to 37,000 per day. There is no chance of achieving herd immunity in the US with your level of opposition to vaccination.

 

[BillTre]

Here's My Rant:

The "R" value is not is constant.
It reflects how likely an infection is likely to be passed onto a new host before the first victim is no longer contagious
A new variant, if it is a more effective infecter, will have a different (higher) "R" value, because it will more likely be able to infect a new host.
If there was a low "R" value with variant 1 (which infected 20% of the people, it was within 10 feet of, for at least 5 minute periods of time) predominant in the population, but then a more efficiently infecting variant 2 showed up (which infected 50% of the people, it was within 10 feet of, for at least 5 minute periods of time), then the "R" value for total infection would start to become larger (more likely to infect) as variant 2 becomes more common in the population of infecting viruses.

If there is a large population of unimmunized people (making up a large population of susceptible hosts), a variant with a great capacity to infect, could spread among the population, even if it was not able to spread among the immunized.
If that unimmunized population was in their own social bubble (a sub-population for purposes of details of virus transmission), perhaps with its own (less isolating) social standards of behavior, then that population could have its own higher "R" value, because their social setting is skewed toward interactions with similarly poor contributors to a lower "R" value.

 

[PeroK]

If that unimmunized population was in their own social bubble (a sub-population for purposes of details of virus transmission) ...

This is one flaw in the UK government's plan. Young people not only socialise more, but largely socialise with each other. Likewise, a class of secondary school children is 100% unvaccinated. It doesn't really matter how many adults are vaccinated if 30 children are in a class together.

 

[atyy]

This is one flaw in the UK government's plan. Young people not only socialise more, but largely socialise with each other. Likewise, a class of secondary school children is 100% unvaccinated. It doesn't really matter how many adults are vaccinated if 30 children are in a class together.

Maybe it's because they think children are at a low enough risk of having severe disease? And there is not likely to be any recommendation soon to vaccinate children under 12? So the main question is whether opening up should wait for vaccination of those in the 12-17 age group (for which vaccination is approved, but still not recommended in the UK, except for vulnerable groups - there's a similar policy in Germany)?

 

[PeroK]

Maybe it's because they think children are at a low enough risk of having severe disease? And there is not likely to be any recommendation soon to vaccinate children under 12? So the main question is whether opening up should wait for vaccination of those in the 12-17 age group (for which vaccination is approved, but still not recommended in the UK, except for vulnerable groups - there's a similar policy in Germany)?

I would vaccinate as many people as possible as quickly as possible. What we were doing, in other words. I don't understand why we've stopped.

If I was under 18, I'd want the vaccine, rather than taking a chance with the virus.

The current policy entails millions of children getting the virus. That must be more dangerous than vaccinations.

 

[PeterDonis]

If I was under 18, I'd want the vaccine, rather than taking a chance with the virus.

I'm not sure I would, in that position.

The current policy entails millions of children getting the virus. That must be more dangerous than vaccinations.

I'm not sure the virus is more dangerous to children under 18 than the vaccines are. Children under 18 are the lowest risk group for the virus (assuming no other health conditions--obviously parents should be looking at their particular child's risk profile, not just assuming an average one), but it's not clear to me that they are the lowest risk group for vaccine side effects. Since the side effects include life threatening ones (blood clots) and ones that can cause long-term issues (myocarditis), I don't think it's a slam dunk that we should just vaccinate everyone, particularly not for children under 18.

 

[PeterDonis]

I don't understand why we've stopped.

Because it's not "we" who are "vaccinating". It is individual people making the choice whether or not to get vaccinated. We have reached a point now where the vast majority of people who have no reservations about getting vaccinated, have gotten vaccinated; so now we are into the stage where we should expect the rate to slow down because now the people left are the ones who do have reservations.

 

[Astronuc]

BBC reports UK daily Covid cases pass 50,000 for first time since January
https://www.bbc.com/news/uk-57867990

There were 51,870 cases recorded - the highest figure since 15 January - and 49 deaths within 28 days of a positive test.

Earlier, England's chief medical officer warned hospital admissions could hit "scary numbers"

Prof Chris Whitty said the number of people in hospital with Covid was doubling roughly every three weeks.

 

[JT Smith]

I apologize if this question has already been answered in this long and active thread. What I am very curious about is how being vaccinated affects the odds of someone who has a mild or asymptomatic case of COVID developing long COVID. Are there any good data on this? It's an important question I think.

 

[Vanadium 50]

I don't think it's a slam dunk that we should just vaccinate everyone, particularly not for children under 18.

So I played a game with demographics. I took the US CDC data on vaccinations and on the age distribution of Covid deaths and convolved them.

I used a protection factor of 4 for one dose and 20 for fully vaccinated. I realize that this is the protection from contracting and doesn't include the reduction in severity.

With half the US population fully vaccinated, the US has achieved 75% of the protection it will ever get. Tne reason is that the vaccination rate is higher for the more at-risk. For the 75+ group, it's at 88%. It's even higher for the 65-74 group at 91%, which suggests that some of the reason the 88% isn't even higher is because for some reason these people can't be vaccinated.

If we vaccinated 100% of the under-18 population, and the Covid rates are twice what they are today over the next 12 months, how many under-18 lives would we save? About 220. The number of 15-year olds or younger? About 35. This is below fire, below drug overdoses, and well below drowning.

To my mind, it makes more sense to concentrate the efforts where there is risk. That would be the rural poor and African-Americans.

 

[PeroK]

Because it's not "we" who are "vaccinating". It is individual people making the choice whether or not to get vaccinated. We have reached a point now where the vast majority of people who have no reservations about getting vaccinated, have gotten vaccinated; so now we are into the stage where we should expect the rate to slow down because now the people left are the ones who do have reservations.

There are plenty of people in the UK who want the second jab now, but the government is making them wait the full 12 weeks, leaving them exposed to the Delta variant. Also, there must be plenty of families who would like their children vaccinated, but that also is disallowed by the government.

And certainly many head teachers want children to have the option to be vaccinated.

Ironically, the government is planning to require health and care-home staff to be vaccinated.

 

[PeterDonis]

There are plenty of people in the UK who want the second jab now, but the government is making them wait the full 12 weeks

Isn't that required to get full protection?

 

[atyy]

There are plenty of people in the UK who want the second jab now, but the government is making them wait the full 12 weeks, leaving them exposed to the Delta variant.

I thought the policy was changed about a month ago because of the Delta variant, to try to get as many second jabs in before opening up?
https://www.itv.com/news/2021-07-15/nhs-urges-people-to-bring-their-second-covid-jab-forward

 

[PeroK]

Isn't that required to get full protection?

The latest news is that the JCVI, who advises the government on vaccinations, has changed its policy and want to reduce it to 8 weeks. That's in an effort to get more people fully vaccinated before Monday, when the remaining restrictions are lifted.

Given that the date of 19th July has been known for months, it's absurd that it's taken them until the last minute to realize this.

We could have given millions of people the second jab in the past four weeks in preparation for the grand reopening on the 19th.

Yes, that might trade some long-term benefits for short-term term protection against the Delta. It's taken the JCVI until two days ago to come to this decision. It's seems obvious to me that we've frittered away an opportunity over the past four weeks.

 

[PeroK]

PS to put it another way: if we don't want to vaccinate under 18s and we want an 8-12 week delay between first and second jabs, then the date of July 19th had to be postponed.

 

[PeroK]

I thought the policy was changed about a month ago because of the Delta variant, to try to get as many second jabs in before opening up?

That's just recent. You can look at the figures for July. There have been lots of people calling for this change. It's only just happening at the last minute.

 

[PeroK]

I thought the policy was changed about a month ago because of the Delta variant, to try to get as many second jabs in before opening up?
https://www.itv.com/news/2021-07-15/nhs-urges-people-to-bring-their-second-covid-jab-forward

The figures are here:

https://coronavirus.data.gov.uk/details/vaccinations

If we look at first and second totals, we see that there has been an 11-week delay between the two. E.g. 15.3 million people had the first jab by Feb 14th and 15.5 million had both jabs by May 2nd.

There were 35.5 million first jabs by May 9th and that's where we are now. That's a 10-week delay. To get it down to 8 weeks we'd need to vaccinate another 2.5 million. That's hasn't happened.

Instead, we have done only 0.6 million second jabs this week. Which corresponds to the numbers 10-12 weeks ago.

Our vaccination capacity is about 3 million jabs per week. We last did that on the week ending June 20th. Since then the numbers have been: 2.5, 2.0, 1.7 million. And only 0.9 million so far this week.

My point in a nutshell is that is potential vaccine capacity gone to waste. We could have given another 3-4 million second jabs in the past four weeks.

 

[atyy]

That's just recent. You can look at the figures for July. There have been lots of people calling for this change. It's only just happening at the last minute.

I thought they decided to do this in May or June?

 

[mfb]

If we vaccinated 100% of the under-18 population, and the Covid rates are twice what they are today over the next 12 months, how many under-18 lives would we save? About 220. The number of 15-year olds or younger? About 35.

Death is not the only negative outcome. How many would get some long-term health problems? That's an important number to consider before we can come to any conclusion.

 

[PeroK]

I thought they decided to do this in May or June?

First, it says reduce to 8 weeks for the over 50's and vulnerable. But, the vast majority of them have been long double jabbed. Those are not significant numbers of people now. Only a few coming forward belatedly.

Second, if you look at the numbers, there has been no noticeable increase in second doses to use the spare capacity.

Third, although Johnson said he was worried about the Delta variant, he didn't take any decisive measures: he neither postponed lockdown easing, nor accelerating the vaccine schedule.

 

[PeroK]

There is some interesting data on this news page showing how few young people in England and the Netherlands have been vaccinated. The Dutch have recently opened up and infections have soared.

https://news.sky.com/story/covid-19...2355210?utm_source=pocket-newtab-global-en-GB

 

[Vanadium 50]

Here is the Netherlands data. I did my bets to align the top (deaths) with bottom (cases)

End of March is when they started vaccinating in earnest.

 

[Vanadium 50]

Death is not the only negative outcome. How many would get some long-term health problems? That's an important number to consider before we can come to any conclusion.

If you are talking about known heal;th problems, do you have anything that shows any where the young are more susceptible?

If you are talking about unknown health problems that might be discovered later, a) how do you make policy around that and b) how do you know this preferentially affects children and not the people who seem most affected by Covid?

 

[vela]

I apologize if this question has already been answered in this long and active thread. What I am very curious about is how being vaccinated affects the odds of someone who has a mild or asymptomatic case of COVID developing long COVID. Are there any good data on this? It's an important question I think.

I don't think there is a good data on this yet. I recall hearing on an interview just a day or two ago your question, and the person being interviewed (the surgeon general, I think) said they don't know the answer to that question yet.

 

[atyy]

End of March is when they started vaccinating in earnest.

https://www.rivm.nl/en/news/vaccionation-coverage-is-rising-while-data-is-increasingly-comprehensive
"The resulting figures show that more than 95% of people over 65 have now received at least one vaccination in 134 of the 352 municipalities."

https://www.rivm.nl/documenten/deelname-covid-19-vaccinatie-in-nederland
Figure 1 shows the percentages for one dose.
Figure 2 shows the percentages for full doses.

For the Delta variant, although one dose provides only about 30% protection against symptomatic infection, it provides about 60-70% protection against severe disease.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01358-1/fulltext

 

[russ_watters]

If we vaccinated 100% of the under-18 population, and the Covid rates are twice what they are today over the next 12 months, how many under-18 lives would we save? About 220. The number of 15-year olds or younger? About 35. This is below fire, below drug overdoses, and well below drowning.

How many people over 18 would it save? That's a really hard number to predict, but I suspect it is larger.

To my mind, it makes more sense to concentrate the efforts where there is risk. That would be the rural poor and African-Americans.

I agree. And we're at the point where going door-to-door with vans might help. But opening-up vaccinations at existing clinics to younger kids takes roughly zero effort. Even sending the vaccines to schools takes very little effort (I bet it's 100x cheaper than going door to door in a rural area). So we might as well do it too.

 

[Evo]

https://www.rivm.nl/en/news/vaccionation-coverage-is-rising-while-data-is-increasingly-comprehensive
"The resulting figures show that more than 95% of people over 65 have now received at least one vaccination in 134 of the 352 municipalities."

https://www.rivm.nl/documenten/deelname-covid-19-vaccinatie-in-nederland
Figure 1 shows the percentages for one dose.
Figure 2 shows the percentages for full doses.

For the Delta variant, although one dose provides only about 30% protection against symptomatic infection, it provides about 60-70% protection against severe disease.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01358-1/fulltext

I'm somewhat worried because my direct flight from New York to Edinburgh has been canceled, and now I have to go to Amsterdam and switch to a plane there with people from Amsterdam.

From the current CDC website

COVID-19 in the Netherlands
​

Level 4: Very High Level of COVID-19 in the Netherlands

Key Information for Travelers to the Netherlands​

• Avoid travel to the Netherlands.

https://wwwnc.cdc.gov/travel/notices/covid-4/coronavirus-netherlands

 

[Vanadium 50]

How many people over 18 would it save?

Would what save? Vaccinating the under-18 or the unvaccinated over-18's?

But opening-up vaccinations at existing clinics to younger kids takes roughly zero effort.

Are you sure you're not my boss? He feels prioritization means "do everything first!" Whom do we prioritize?

 

[atyy]

Level 4: Very High Level of COVID-19 in the Netherlands

Key Information for Travelers to the Netherlands​

• Avoid travel to the Netherlands.

https://wwwnc.cdc.gov/travel/notices/covid-4/coronavirus-netherlands

If you can't avoid the travel, one thing I might add to the CDC's recommendations is that the mask should be a medical/surgical mask.

 

[Ivan Seeking]

My GF was fully vaccinated months ago but it looks like she might have Covid. It came on fast. High temp etc. She couldn't get tested today but will tomorrow. I'm not aware of anything else going around.

 

[russ_watters]

Would what save? Vaccinating the under-18 or the unvaccinated over-18's?

Vaccinating the under-18, saving the over-18.

Are you sure you're not my boss?

I decline to answer that.

He feels prioritization means "do everything first!" Whom do we prioritize?

I propose we do one and un-restrict the other. Again, simply allowing the younger to get vaccinated to get vaccinated takes roughly zero effort. It barely even qualifies as a "do". But sure, if you want to force that: I few have $X available I propose we use $.01X to open vaccination to younger kids and the rest to fund door-to-door vaccinations. But if by "prioritize" you mean I should rank them so we should do one and not the other, I say...well...that's not how it works.

 

[PeroK]

I'm somewhat worried because my direct flight from New York to Edinburgh has been canceled, and now I have to go to Amsterdam and switch to a plane there with people from Amsterdam.

From the current CDC website

COVID-19 in the Netherlands​

​

Level 4: Very High Level of COVID-19 in the Netherlands

Key Information for Travelers to the Netherlands​

• Avoid travel to the Netherlands.

https://wwwnc.cdc.gov/travel/notices/covid-4/coronavirus-netherlands

The UK can't be far behind the Netherlands. We already have 50,000 positive tests per day; 100,000 is almost inevitable and 200,000 is possible.

Now may not be a good time to be traveling to and from the UK.

Edinburgh is overcrowded in July and August and the Festival is overrated!