Weekly coronavirus-related chat, questions, and minor updates - week of September 12

My partner picked it up and tested positive yesterday. Not sure if he got it on his work trip or during a music festival we attended over the weekend. We're both fully vaccinated, though we haven't gotten the second booster yet. I have had no symptoms, and I haven't tested yet, but I'm going with the assumption that I do have it and have been cancelling my plans for the week. My partner has been less lucky. He's had a high fever, chills, and has felt weak/dizzy to the point of almost passing out today.

Fingers crossed he feels better soon (and that I don't catch it).

I got the new bivalent booster and my flu shot Friday after work. I was definitely one of the first people to get the new shot at that location, because when I checked in for my appointment the receptionist had to ask their manager how to code in the new booster on the computer.

Didn't feel anything other than arm soreness for the rest of Friday, and had only mild fever and chills overnight. It was uncomfortable, but not debilitating or anything. I was able to sleep through most of the night.

Woke up Saturday morning feeling okay and thinking all was well!

It was a false sense of security. A few hours into the day, ~20 hours after the shots, I was hit by really bad chills and fatigue. I piled blankets on top of me and spent most of Saturday in bed.

Woke up Sunday feeling much better. Thought things were over, but that was again another fakeout. Shortly after noon I got hit with a fatigue wave and had to go lie down again. No chills this time, but definite exhaustion. Spent most of the rest of the day in bed again.

The good news is that I woke up feeling fine this morning and that has maintained itself throughout the day. I think I'm all the way through it. I do feel like I need a weekend right now to recover from my non-weekend, but I'm also glad to be rid of the fatigue. It made me very sympathetic to anyone who has to live with chronic fatigue or long COVID.

Compared to my previous booster, this made me feel bad for less overall hours than the last one did -- those fakeouts were nice breaks from the side-effects. That said, the times where I did feel bad, I felt worse than the previous booster (possibly because of the flu shot?). In summary: shorter overall duration of ills but with higher amplitude.

Got hit with COVID some time in the last two weeks after avoiding it for 2.5 years. Symptoms now down to the apparently common lingering cough. I did have a fever last Monday, thankfully I can still taste and smell just fine.

400 Americans are dying each day (Your Local Epidemiologist)

COVID-19 remains the third leading cause of death in our repertoire of threats. And it’s largely preventable. In the U.S., death rates are not back to pre-pandemic times; excess deaths are still 10% above “expected.” This is changing our average life expectancy. In fact, the U.S. experienced the sharpest two-year decline in life expectancy in nearly 100 years.

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It’s abundantly clear the majority of deaths continue to be among the unvaccinated (20% of Americans are still without even one dose).

In addition, there is a clear dose response with vaccines: the more vaccine doses one has, the more that person is protected from death. According to the CDC, vaccinated people with one booster had 3 times the risk of dying compared to people vaccinated with two boosters. Unvaccinated people had 14 times the risk of dying compared to those with two boosters.

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Age continues to the be the strongest predictor of death. Specifically, unvaccinated 65+ year olds have, by far, the highest rates of death.

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The University of Michigan shared fantastic data on local hospitalizations (which we could roughly attribute to deaths). Among patients in the ICU and/or ventilators for COVID-19, about half are immunocompromised, have a significant underlying lung disease, or are over the age of 65 years. Also, 5 out of 6 people in the ICU are under- or un-vaccinated.

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Interestingly, age-adjusted racial disparities continue to attenuate. I would attribute this to two things: 1) massive community engagement on the ground to reduce disparities; and 2) Black and Hispanic adults were more likely to be in the “wait and see” category for vaccines compared to non-Hispanic Whites adults, who were more likely to be in the “never get vaccinated” group.

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While there is no difference with cases per capita, deaths per capita [is] strikingly separate along partisan lines.

Just got back from a work trip to a cancer center hospital in a major metropolitan center, and boy did it suck to wear N95 for a week. Even the hospital staff are doffing their masks when they're not face-to-face with patients. But I'm reasonably confident that I neither gave nor got COVID.

I'm too close to my last booster to run out and get the bivalent vaccine, based on recommendations to wait at least 5 months between shots. There are already idiots screaming "Untested!" about the bivalent vaccine because the human data aren't in yet, even though this is the same protocol that's been accepted for influenza vaccines for many years. I'd be delighted if COVID wasn't so prevalent that it's still mutating quickly, but 🤷.

Scientists debate how lethal COVID is. Some say it's now less risky than flu (NPR)

Gandhi and other researchers argue that most people today have enough immunity — gained from vaccination, infection or both — to protect them against getting seriously ill from COVID. And this is especially so since the omicron variant doesn't appear to make people as sick as earlier strains, Gandhi says.

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COVID is still killing hundreds of people every day, which means more than 125,000 additional COVID deaths could occur over the next 12 month if deaths continue at that pace, Fauci notes. COVID has already killed more than 1 million Americans and it was the third leading cause of death in 2021.

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The debate over COVID's mortality rate hinges on what counts as a COVID death. Gandhi and other researchers argue that the daily death toll attributed to COVID is exaggerated because many deaths blamed on the disease are actually from other causes. Some of the people who died for other reasons happened to also test positive for the coronavirus.

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"We are now seeing consistently that more than 70% of our COVID hospitalizations are in that category," says Dr. Shira Doron, an infectious disease specialist at the Tufts Medical Center and a professor at the Tufts University School of Medicine. "If you're counting them all as hospitalizations, and then those people die and you count them all as COVID deaths, you are pretty dramatically overcounting."

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In a new report from the Centers for Disease Control and Prevention published Thursday, researchers attempted to filter out other deaths to analyze mortality rates for people hospitalized "primarily for COVID-19." They find the death rate has dropped significantly in the omicron era, compared to the delta period.

But Fauci argues that it's difficult to distinguish between deaths that are caused "because of" COVID and those "with" COVID. The disease has been found to put stress on many systems of the body.

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A second reason many experts estimate that COVID's mortality rate is probably lower than it appears is that many infections aren't being reported now because of home testing.

The fatality rate is a ratio — the number of deaths over the number of confirmed cases — so if there are more actual cases, that means that the likelihood of an individual dying is lower.

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Many also point out that COVID can increase the risk of experiencing long-term health problems, such as long COVID.

"Even people with mild to moderate symptoms from COVID can end up with long COVID," Fauci says. "That doesn't happen with influenza. It's a totally different ball game."

But Gandhi also questions that. Much of the estimated risk for long COVID comes from people who got seriously ill at the start of the pandemic, she says. And if you account for that, the risk of long-term health problems may not be greater from COVID than from other viral infections like the flu, she says

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"It was really severe COVID that led to long COVID. And as the disease has become milder, we're seeing lower rates of long COVID," Gandhi says.

In fact, some experts even fear that this year's flu season could be more severe than this winter's COVID surge. After very mild or even nonexistent flu seasons during the pandemic, the flu hit Australia hard this year. And what happens in the Southern Hemisphere often predicts what happens in North America.