COVID-19 (Wuhan Novel Coronavirus) Pandemic Master Thread

[PlatinumGuy]

I think this number is wrong. From what I can see, the highest death tolls in LTCFs were in April 2020. I think the mistake you're making is taking a stat that is not time specific (1/3 of all Covid deaths are from LTCF) and smoothing the percentage. In reality, the LTCF deaths made up a larger percentage of the deaths early in the pandemic. While they are still a very significant number of the current deaths, I don't believe they are still 33%.

I had this argument with @avromie7 here before. In April LTC deaths were ~50%, now they are 30%, and are still being reported as 1000/day.

In absolute numbers, weekly LTC deaths were higher in the past few months than April, although proportionally they are less compared to the rest of deaths.

https://covidtracking.com/nursing-homes-long-term-care-facilities

(Yes I understand this data runs counter to my position that 1000/day LTC deaths are mostly eradicated already, I think the current reports are assigning deaths from a few weeks ago to LTCs, and there is a major NY dump on Jan 28)

[PlatinumGuy]

This is the crux of our argument. I think you're not realizing how much of the problem is still concentrated in a tiny amount of people (3m LTC, 10m 85+, 25m 75+, 55m 60+), which is why it's much easier and quicker to vaccinate them.

You would have a very valid point if the 25-45yo cohort was the same size and vaccine was as effective in preventing transmission as it is in preventing hospitalization and severe outcome.

[Lurker]

I had this argument with @avromie7 here before. In April LTC deaths were ~50%, now they are 30%, and are still being reported as 1000/day.

In absolute numbers, weekly LTC deaths were higher in the past few months than April, although proportionally they are less compared to the rest of deaths.

https://covidtracking.com/nursing-homes-long-term-care-facilities

(Yes I understand this data runs counter to my position that 1000/day LTC deaths are mostly eradicated already, I think the current reports are assigning deaths from a few weeks ago to LTCs, and there is a major NY dump on Jan 28)

Excluding the week of the dump, the average from Dec 3 til Feb 4 is 796 a day, or around 25% of the daily deaths over that period. Your point stands, in terms of the oversized immediate value of vaccinating the older demos. However, as the death tolls start (IYH) to decline within the next week or so, 25% of 1500 deaths a day isn't saving 2000 lives per day.

[PlatinumGuy]

However, as the death tolls start (IYH) to decline within the next week or so, 25% of 1500 deaths a day isn't saving 2000 lives per day.

It gets from 3500 to 1500 because of vaccines IMO. Those are exactly the 2000 I'm talking about.

(Yes, I believe vaccines are driving down cases bc much of the testing was surveying LTC/HCW and a lot of the infection and spread was from HCW, so the effects are compounded exponentially)

[Lurker]

This is the crux of our argument. I think you're not realizing how much of the problem is still concentrated in a tiny amount of people (3m LTC, 10m 85+, 25m 75+, 55m 60+), which is why it's much easier and quicker to vaccinate them.

You would have a very valid point if the 25-45yo cohort was the same size and vaccine was as effective in preventing transmission as it is in preventing hospitalization and severe outcome.

No, I don't think you're understanding my position. I absolutely agree that in terms of biggest value in short term death tolls, vaccinating the elderly is the right way to go. However, when looking at the pandemic as a whole, I think the longer it goes on and the more people become infected, the greater the longer term damage will be, whether in death tolls, health issues, economic issues, and general quality of life issues. I also believe that the longer it goes on, the higher the risk of other mutations gaining a foothold (this is pure speculation on my part). My argument is that we should be less focused on the immediate death tolls right now, and more on getting the pandemic stopped as quickly as possible, and I think the way to do that is to reduce the risk among the most mobile demographics first.

[Lurker]

It gets from 3500 to 1500 because of vaccines IMO. Those are exactly the 2000 I'm talking about.

(Yes, I believe vaccines are driving down cases bc much of the testing was surveying LTC/HCW and a lot of the infection and spread was from HCW, so the effects are compounded exponentially)

Except the models predicted this decline. You can see my posts from November. This is where the second wave naturally ends. Just like it will pick up again in 4-6 weeks.

ETA: IMO, the danger of your post and prediction is that people will confuse correlation with causation. The numbers are going down as predicted, and it has nothing to do with the vaccinations (see case counts), but it will be attributed to them. The issue with that is no one will expect the third wave. And when cases start to rise and the deaths lag, people will (again) point to the lack of deaths and say the vaccines are working, it's not as dangerous. And then it's too late. Again.

[PlatinumGuy]

(Yes, I believe vaccines are driving down cases bc much of the testing was surveying LTC/HCW and a lot of the infection and spread was from HCW, so the effects are compounded exponentially)

The fall in cases seems pretty symmetrical to the rise in vaccinations. Vaccines started on Dec 15, cases peaked Dec 24. Correlation doesn't prove causation, but the numbers clearly fit my narrative.



https://covid19-projections.com/infections/us-home1.html

No, I don't think you're understanding my position. I absolutely agree that in terms of biggest value in short term death tolls, vaccinating the elderly is the right way to go. However, when looking at the pandemic as a whole, I think the longer it goes on and the more people become infected, the greater the longer term damage will be, whether in death tolls, health issues, economic issues, and general quality of life issues. I also believe that the longer it goes on, the higher the risk of other mutations gaining a foothold (this is pure speculation on my part). My argument is that we should be less focused on the immediate death tolls right now, and more on getting the pandemic stopped as quickly as possible, and I think the way to do that is to reduce the risk among the most mobile demographics first.

I think most lockdowns and restrictions are directly correlated to rising hospitalizations and deaths. I consider the pandemic over when I can be vaccinated, borders, restaurants, shuls etc are open, and Covid isn't directly impacting my life.

You very well may be right that long term effects in younger people will end up being more detrimental than elderly deaths, but then we're just defining the end line differently.

[Lurker]

The fall in cases seems pretty symmetrical to the rise in vaccinations. Vaccines started on Dec 15, cases peaked Dec 24. Correlation doesn't prove causation, but the numbers clearly fit my narrative.

See my edit.

I think most lockdowns and restrictions are directly correlated to rising hospitalizations and deaths. I consider the pandemic over when I can be vaccinated, borders, restaurants, shuls etc are open, and Covid isn't directly impacting my life.

You very well may be right that long term effects in younger people will end up being more detrimental than elderly deaths, but then we're just defining the end line differently.

THIS is the crux of our argument. I think our approach is too short-sighted.

[PlatinumGuy]

ETA: IMO, the danger of your post and prediction is that people will confuse correlation with causation. The numbers are going down as predicted, and it has nothing to do with the vaccinations (see case counts), but it will be attributed to them. The issue with that is no one will expect the third wave. And when cases start to rise and the deaths lag, people will (again) point to the lack of deaths and say the vaccines are working, it's not as dangerous. And then it's too late. Again.

The third wave will happen because of vaccine hesitancy and overconfidence. The similarity to 1918 is in a similar overconfidence after a drop.

THIS is the crux of our argument. I think (y)our approach is too short-sighted.

Perhaps, but it's only short sighted bc people choose not to believe reality and behave accordingly, so that doesn't concern me as much.

[Lurker]

Perhaps, but it's only short sighted bc people choose not to believe reality and behave accordingly, so that doesn't concern me as much.

People not behaving accordingly will change the reality, and it is the responsibility of leaders to be proactive and not reactive.

[PlatinumGuy]

People not behaving accordingly will change the reality, and it is the responsibility of leaders to be proactive and not reactive.

If enough of the high risk are vaccinated, hospitals aren't at threat, and society can continue as if nothing happened. The fact that there will be problems for many individuals who choose to behave irresponsibly out of overconfidence is morally a much smaller problem IMHO than having the responsible individuals life affected by a need to lockdown in order to keep hospitalizations/death lower.

[Lurker]

society can continue as if nothing happened.

IMO, this is at odds with

many individuals who choose to behave irresponsibly out of overconfidence

If people can't behave normal without precautions, then society cannot continue as if nothing happened. As long as most of the country is unvaccinated, which will most definitely be the case before and during the third wave, then there are still issues with any large gatherings. I don't avoid Covid because I don't want to kill Grandma. I avoid Covid because I don't want to get Covid, I don't want my kids to get Covid, and I don't want to give anyone else Covid. Normal doesn't happen until at least the summer, possibly fall. If another 5-10 million people get Covid before then, that's a problem to me.

[AsherO]

People not behaving accordingly will change the reality, and it is the responsibility of leaders to be proactive and not reactive.

That ship has sailed...

[PlatinumGuy]

If people can't behave normal without precautions, then society cannot continue as if nothing happened. As long as most of the country is unvaccinated, which will most definitely be the case before and during the third wave, then there are still issues with any large gatherings. I don't avoid Covid because I don't want to kill Grandma. I avoid Covid because I don't want to get Covid, I don't want my kids to get Covid, and I don't want to give anyone else Covid. Normal doesn't happen until at least the summer, possibly fall. If another 5-10 million people get Covid before then, that's a problem to me.

From my perspective, if you can get a vaccine if you want to, and the government doesn't have to impose any restrictions limiting services, life is pretty much normal for you, and the problem is only for people who chose not to get vaccinated or avoid gatherings, which is morally not as much of a problem IMHO.

[PlatinumGuy]

Here is data suggesting somebody who gets infected after being vaccinated is much less likely to know (less symptoms + less testing motivation), and thus much more likely to transmit it (other than a difference in live viral loads)

https://twitter.com/kalksteinnir/status/1360080468029427712
https://twitter.com/kalksteinnir/status/1360080471116443648
https://twitter.com/kalksteinnir/status/1360080474165694464


If true, it would mean vaccinating half of the 25-45 age cohort may not have any impact on lowering spread, but vaccinating half of the 60+ is likely to remove a lot of the overall severe illness

[AsherO]

Here is data suggesting somebody who gets infected after being vaccinated is much less likely to know (less symptoms + less testing motivation), and thus much more likely to transmit it (other than a difference in live viral loads)

https://twitter.com/kalksteinnir/status/1360080468029427712
https://twitter.com/kalksteinnir/status/1360080471116443648
https://twitter.com/kalksteinnir/status/1360080474165694464


If true, it would mean vaccinating half of the 25-45 age cohort may not have any impact on lowering spread, but vaccinating half of the 60+ is likely to remove a lot of the overall severe illness

But doesn’t shedding peak pre-symptomatically?

[Lurker]

Here is data suggesting somebody who gets infected after being vaccinated is much less likely to know (less symptoms + less testing motivation), and thus much more likely to transmit it (other than a difference in live viral loads)

If true, it would mean vaccinating half of the 25-45 age cohort may not have any impact on lowering spread, but vaccinating half of the 60+ is likely to remove a lot of the overall severe illness

There's an important caveat missing: "and thus much more likely to transmit it [if they are infected]." Presumably, the Rt changes with mass vaccination. Only those who are infected may be more likely to spread it, but there should be fewer infected to spread it to begin with. And that's before the possible difference in viral load, like you said. I'd rather have a fraction of the people spreading a fraction of the virus, even if it may get to a high risk person, than have that many more people spreading larger amounts of the virus.

[Lurker]

But doesn’t shedding peak pre-symptomatically?

His point is that since there is no difference in people spreading the virus whether they are vaccinated or not, and they may even be more likely to transmit it due to a decrease in precautions, our current strategy of vaccinating the high risk is the most cost efficient method to mitigate the net damages in terms of more severe illness, hospitalizations, and deaths.

[PlatinumGuy]

There's an important caveat missing: "and thus much more likely to transmit it [if they are infected]." Presumably, the Rt changes with mass vaccination. Only those who are infected may be more likely to spread it, but there should be fewer infected to spread it to begin with. And that's before the possible difference in viral load, like you said. I'd rather have a fraction of the people spreading a fraction of the virus, even if it may get to a high risk person, than have that many more people spreading larger amounts of the virus.

Its hard to know the numbers at this point. If 50% are immune from becoming infected, and the other 50% spread it 3x as much (natural Rt is around 3), overall spread and prevalence may be higher with a vaccine than without. If the vaccine prevents infection 90% of the time, then you’re still ahead. The number may not also be black and white, it could be 30% are still susceptible after vaccination but only with a higher viral load, etc. (posted a thread above)

The uncertainty is a sufficient reason to avoid this path.

But doesn’t shedding peak pre-symptomatically?

In theory, yes. Asysomtopmatics definitely shed, those vaccinated likely shed less, but the million dollar question is how much less

[Lurker]

Its hard to know the numbers at this point. If 50% are immune from becoming infected, and the other 50% spread it 3x as much (natural Rt is around 3), overall spread and prevalence may be higher with a vaccine than without. If the vaccine prevents infection 90% of the time, then you’re still ahead. The number may not also be black and white, it could be 30% are still susceptible after vaccination but only with a higher viral load, etc. (posted a thread above)

The uncertainty is a sufficient reason to avoid this path.

I'm not understanding the math. 50% get vaccinated, and 50% are still taking precautions. The ones who may be more likely to spread it are the ones who are vaccinated, who are less likely to get infected to begin with. If they aren't infected, 3x doesn't mean anything. The other 50% are still wearing masks, and their chances of coming in contact with an infected person are now much lower, so I don't see how the risk of spread would be higher. And again, we're not even going to try to quantify how much a potential lesser viral load could impact this.