8 votes

Weekly coronavirus-related chat, questions, and minor updates - week of August 9

This thread is posted weekly, and is intended as a place for more-casual discussion of the coronavirus and questions/updates that may not warrant their own dedicated topics. Tell us about what the situation is like where you live!

25 comments

  1. [2]
    balooga
    (edited )
    Link
    My kid spent all of first grade online. Their teacher was great, under the circumstances, but kids need human interaction. It was not good for social or emotional development. Now we're about a...

    My kid spent all of first grade online. Their teacher was great, under the circumstances, but kids need human interaction. It was not good for social or emotional development. Now we're about a month away from second grade, and we've been so excited about a return to in-person learning. No one more excited than my kid. The school has implemented many protocols about masking, distancing, hand-washing, etc., that we felt really positive about over the summer, what with vaccinations up and cases decreasing. We're grateful we don't live somewhere with a culture dominated by denialism and conspiracy theory.

    Even so, now delta is wreaking havoc with our plans. Earlier this year it looked like there might be vaccine approval for kids under 12 around September, just in time for school. Now the FDA is saying "midwinter" and that's only tentative. School district is charging forward with plans they made months ago, with no public acknowledgement that the situation has changed. I have this sinking feeling delta is going to absolutely blast through school populations in a couple months and administrators have their fingers in their ears today.

    I'm struggling to not be alarmist. I'm having a hard time assessing the actual risk. My kid has asthma and their pulmonologist has urged us to be vigilant. My biggest cause for dread right now is the fear that most of my peers (parents of my kid's classmates) have neither the resources nor the willingness to repeat the ordeal we went through last school year. They depend on the schools for childcare and meals. Another year at home simply isn't an option. And I'm not sure if we could do it either... we certainly don't want to, for the sake of our kid's development and our own sanity.

    I honestly don't believe that any amount of scary new public health data could sway the school district from the course they have set, at this late stage in the game. They are fully committed. For that matter, we have already committed to sending our kid in-person too. The train is in motion and there's no getting off. But knowingly sending my higher-risk kid into a potential super-spreader event five days a week, when children's covid hospitalizations are the highest they've ever been, feels reckless and irresponsible. I want to bail.

    Obviously I want answers, and direction, but I don't expect to find them here or anywhere. I just had to vent. This is really weighing heavily on me this morning.

    11 votes
    1. rosco
      (edited )
      Link Parent
      I'm really sorry to hear that. It does feel like folks are ignoring what feels eerily similar to last fall. I think the way you're handling the situation is really the best you can do and I hope...

      I'm really sorry to hear that. It does feel like folks are ignoring what feels eerily similar to last fall. I think the way you're handling the situation is really the best you can do and I hope the rest of the parents hold the school/school board accountable. Good luck!

      Also, not to stoke fear, but it does look like you aren't alone in your apprehension and people are starting to talk about it.

      2 votes
  2. [3]
    HotPants
    Link
    What Iceland’s rising Covid-19 case count tells us about vaccine efficacy This was posted earlier, but removed as it was deemed misleading. And this is a really misleading article. But it is...

    What Iceland’s rising Covid-19 case count tells us about vaccine efficacy

    This was posted earlier, but removed as it was deemed misleading.

    And this is a really misleading article. But it is misleading in a really interesting way.

    If we go to the source, two thirds of all infections are among the vaccinated.

    What is really crazy to me is how non-intuitive these numbers are. If 90% of the population is vaccinated, and the vaccine is 90% effective, you would expect half of all infections to occur from the vaccinated population. If 90% of the population is vaccinated, and the vaccine is 80% effective, you would expect two thirds of all infections to occur from the vaccinated population. (Refer to slide 11)

    Which is kind of hard to get your head around.

    And easy to misinterpret.

    10 votes
    1. [2]
      skybrian
      Link Parent
      Yeah, one way to think about is to look at the extreme: if 100% of the population were vaccinated and at least one person tested positive, that would mean 100% of infections were among the...

      Yeah, one way to think about is to look at the extreme: if 100% of the population were vaccinated and at least one person tested positive, that would mean 100% of infections were among the vaccinated.

      Since Iceland is one of the most vaccinated countries, the percentage is going to be on the high side.

      For every percentage there are two counts, for the numerator and denominator and sometimes it’s better to look at those counts individually and think about what they mean. And maybe count something different, to get a different perspective?

      8 votes
      1. HotPants
        Link Parent
        Slide 3 does a nice job of showing infections per 100,000 of vaccinated vs unvaccinated. Silver lining; I guess with half of American fully vaccinated, and most infections amoung the unvaccinated,...

        Slide 3 does a nice job of showing infections per 100,000 of vaccinated vs unvaccinated.

        Silver lining; I guess with half of American fully vaccinated, and most infections amoung the unvaccinated, it is unlikely that vaccine deniers will point to Iceland as proof of vaccine inefficiency?

        3 votes
  3. [7]
    skybrian
    Link
    An opinion piece from March: We need to start thinking more critically — and speaking more cautiously — about long Covid

    An opinion piece from March:

    We need to start thinking more critically — and speaking more cautiously — about long Covid

    First, consider that at least some people who identify themselves as having long Covid appear never to have been infected with the SARS-CoV-2 virus. […]

    Why does this matter? For one thing, if some proportion of long Covid patients were never infected with SARS-COV-2, it shows that it’s possible for anyone to misattribute chronic symptoms to this virus. That’s not particularly surprising, since the symptoms of acute SARS-CoV-2 are often not unique, and can be caused by other respiratory infections. But what’s more notable is that the late-December survey also found virtually no difference in the long-haul symptom burden between those with and without antibody evidence of prior SARS-CoV-2 infection (or any positive test), which undercuts the likelihood of a causative role for SARS-CoV-2 as the predominant driver of chronic symptoms in that cohort.

    After all, the symptoms reported as consistent with long Covid are associated with many conditions. Gastrointestinal symptoms, confusion and forgetfulness (“brain fog”), severe fatigue, hair loss, and headaches are surprisingly common, even in the general population. Sadly, physical suffering is prevalent in our society.

    Add to that the fact that the past year has produced skyrocketing levels of social anguish and mental emotional distress. Positing a potential link between psychological suffering and physical symptoms is at times derided as medical gaslighting. But there’s no question that mental suffering can produce physical suffering. A New England Journal of Medicine report showed that, across multiple continents, about half of people with depression also had unexplained physical symptoms, which often predominated over their mental ones. Sleeping problems, physical and mental slowing, persistent fatigue, and concentration problems (aka “brain fog”) are among the actual criteria for major depression in the current Diagnostic and Statistical Manual of Mental Disorders (DSM-V).

    8 votes
    1. [3]
      eladnarra
      Link Parent
      Personally, I think it's possible that studies looking at symptoms such as fatigue didn't ask the right questions to differentiate between post-viral fatigue and depression fatigue. When I first...

      Personally, I think it's possible that studies looking at symptoms such as fatigue didn't ask the right questions to differentiate between post-viral fatigue and depression fatigue. When I first fell ill 15 years ago, I scored moderately highly on a depression survey - but the only questions I answered in an affirmative were about fatigue, and they didn't nearly encapsulate the bone wrenching tiredness and flu-like symptoms I got after even mild exertion. I don't have long COVID, but I can imagine if you'd put me in a study comparing me to a group of people who'd been through a traumatic experience, but you didn't ask questions specific to post-viral fatigue, post-exhertional malaise, and autonomic nervous system dysfunction, we might look pretty similar. Tired, anxious, some stomach issues. Probably just depressed.

      It's definitely a good idea to approach things scientifically and not overreact, but since medical science is already bad at studying illnesses like mine (which mirrors long COVID), I'm not super confident they won't dismiss something that is actually there but they can't see because they don't know the questions to ask. Like... tons of so-called long COVID folks discuss high heart hearts upon standing, and many have been diagnosed with POTS or other forms of dysautonomia formally. Those conditions not only cause high heart rate - they can also cause fatigue, stomach issues/nausea, and brain fog. So why aren't we comparing tilt table (or NASA lean test) results between the groups, rather than just relying on subjective surveys? Ah well.

      8 votes
      1. [2]
        skybrian
        Link Parent
        Between dismissal and overreaction is simply admitting you don't know what's going on and accepting that the causes of some things are ongoing mysteries. And hopefully remaining curious, or at...

        Between dismissal and overreaction is simply admitting you don't know what's going on and accepting that the causes of some things are ongoing mysteries. And hopefully remaining curious, or at least encouraging those who try to figure it out.

        3 votes
        1. eladnarra
          Link Parent
          Yeah, that's the key - unfortunately a lot of doctors are pretty bad at saying "we don't know what's going on." If something can't be immediately figured out with some basic tests, well... guess...

          Yeah, that's the key - unfortunately a lot of doctors are pretty bad at saying "we don't know what's going on." If something can't be immediately figured out with some basic tests, well... guess there's nothing wrong, or it's "just" depression. Mental health is usually considered the default cause for currently unexplained conditions, rather than one option of many. (Doctors in my experience also generally aren't very well versed in the recent research into post-viral illnesses and common comorbidities like MCAS, connective tissue issues, CFS/ME, POTS/autonomic nervous dysfunction, and spine problems. Can't see what you don't know exists.)

          There's a lot of worry in the chronic illness community that if long COVID isn't a mental health condition, it'll still be treated as one - like CFS/ME in the UK, or MS before MRIs were used. It might be a bit of an overreaction, but when you've had a neglected illness for decades, long COVID kind of feels like you're watching a slow motion replay of your worst nightmare.

          5 votes
    2. balooga
      Link Parent
      Vox had a really good piece about the slipperiness of "long covid" back in April. Worth a read for some broader context about what might be going on here.

      Vox had a really good piece about the slipperiness of "long covid" back in April. Worth a read for some broader context about what might be going on here.

      6 votes
    3. [2]
      spit-evil-olive-tips
      Link Parent
      ‘What is happening to me?’ The teenagers trying to make sense of long Covid

      ‘What is happening to me?’ The teenagers trying to make sense of long Covid

      More than 100,000 Britons under 25 have endured months of debilitating symptoms, while doctors struggle to help and others fail to take them seriously. Four young people describe what it’s like

      6 votes
      1. eladnarra
        Link Parent
        Man... that's heartbreaking. I definitely know what it's like to feel as if you've been hit by a train, and how weird it is when simply sitting in a car for an hour becomes too exhausting.

        Man... that's heartbreaking. I definitely know what it's like to feel as if you've been hit by a train, and how weird it is when simply sitting in a car for an hour becomes too exhausting.

        4 votes
  4. kfwyre
    Link
    Schools are going to reopen in my area soon. I'm in an area with solid vaccination rates. When I compare the local data from this point last year to this point this year, it's both good and bad....

    Schools are going to reopen in my area soon. I'm in an area with solid vaccination rates.

    When I compare the local data from this point last year to this point this year, it's both good and bad. Hospitalizations and deaths are way down, but case rates are way up.

    We had a spike last year that started around October and carried through the winter, peaking in January. Currently, my area is trending upwards, and our new case count now, in August, matches what where we were at in late October of last year.

    I'm not really qualified to do anything but the weakest armchair analysis on this, but my gut takeaway is that it speaks to how infectious the delta variant really is. Even with widespread vaccination uptake in my area, we're seeing far more cases far earlier in the year than we did last year. I'm a little worried about what it looks like when we do roll around to October and everybody gets driven back indoors due to the approaching cold. That's a big part of what made our winter spike so bad last year.

    On the other hand, if the cases at large are less severe (and according to the data they are, with hospitalizations and deaths way lower), it seems like this spike, even if it somehow ends up larger than the previous one, may be less devastating overall.

    7 votes
  5. skybrian
    Link
    Why Is It Taking So Long to Get Vaccines for Kids? Here's the letter from the head of the American Academy of Pediatrics:
    • Exemplary

    Why Is It Taking So Long to Get Vaccines for Kids?

    As we get closer to that amorphous deadline, you can keep an eye out for signs of progress. The first milestone will come when the clinical trials in vaccines for kids stop accepting new participants. Once that happens, the company’s researchers can put all their effort into evaluating the trial itself. (For context, Pfizer finished enrolling 12-to-15-year-olds on January 22 and submitted its application to the FDA on April 9.) As of today, both the Pfizer and Moderna trials are still listed as “recruiting” in the National Library of Medicine’s clinical-trial database; you can check their status here and here, respectively. A more obvious milestone will be reached when either vaccine maker submits an application for an EUA. (Pfizer’s application for 12-to-15-year-olds was approved on May 10, a month after the company submitted it.)

    Late last month, The New York Times reported that Pfizer and Moderna were extending the recruitment phases for their clinical trials among young kids at the FDA’s behest, because the agency is concerned about having a large-enough sample size to detect rare side effects. Critics of the agency, including the leadership of the American Academy of Pediatrics, argue that this demand for more participants will make the authorization process drag on for longer than necessary, prolonging the harm caused to kids by not offering them the vaccines.

    Here's the letter from the head of the American Academy of Pediatrics:

    We understand that the FDA has recently worked with Pfizer and Moderna to double the number of children ages 5-11 years included in clinical trials of their COVID-19 vaccines. While we appreciate this prudent step to gather more safety data, we urge FDA to carefully consider the impact of this decision on the timeline for authorizing a vaccine for this age group. In our view, the rise of the Delta variant changes the risk-benefit analysis for authorizing vaccines in children. The FDA should strongly consider authorizing these vaccines for children ages 5-11 years based on data from the initial enrolled cohort, which are already available, while continuing to follow safety data from the expanded cohort in the post-market setting. This approach would not slow down the time to authorization of these critically needed vaccines in the 5–11-year age group.

    4 votes
  6. spit-evil-olive-tips
    Link
    Deep dive into stupid: Meet the growing group that rejects germ theory

    Deep dive into stupid: Meet the growing group that rejects germ theory

    While the depths of human stupidity on display across the Internet rival that of the Marianas Trench, the audacious ignorance on display in this group is truly stunning. In the group's current take on germ theory denialism, bacteria are merely scavengers and are a symptom of disease. Viruses are considered cellular debris and cannot cause disease or transmit from one person to another.

    According to the group members' delusions, there is only one disease in existence: toxemia. This disease is caused by toxic exposures that occur by leading a dirty, unnatural lifestyle, which causes damage to your terrain. All disease symptoms are merely a sign that your body is trying to "detox." If your body isn't able to detox, the disease will progress through seven levels, the last one being cancer. The type of symptom you're experiencing can help identify the kind of toxic exposure you've had. If you remove the toxic component of your diet or environment, you'll recover—though if you reach the seventh level, it can be hard to come back from.

    6 votes
  7. skybrian
    Link
    What Do Full Hospitals Really Tell Us About COVID?

    What Do Full Hospitals Really Tell Us About COVID?

    Louisiana was a leader in the specialty hospital business, having neither an effective CON process or state regulatory system. The public argument for specialty hospitals is more expertise and lower costs because of efficiency. The real model was no emergency room, and thus no way for un- and under-insured people to get into the hospital. All of the financial benefits of being a hospital without any of the responsibilities. So we get women's hospitals, orthopedic hospitals, etc., sucking the profitable work from community hospitals, without taking any of the burden of community care for the indigent. General hospitals are even allowed to close their ERs in Louisiana.

    The hospitals in Louisiana which take indigent patients and patients though the ER—pretty much all COVID patients—are slammed. The specialty hospitals have lots of staff and lots of beds and don't have much in the way of COVID patients, if there are any at all. They also do little to help the others. Thus Louisiana has a very small number of general beds that are available for COVID patients. It is a real crisis, but it is as much a crisis in health care resources as in COVID. While the Children's hospitals do have ERs, there are not many of them in Louisiana and there are very few total ICU beds. As another list member observed, you can have all the pediatric ICU beds full and still only have a tiny number of kids who are very sick.

    5 votes
  8. spit-evil-olive-tips
    Link
    Governor here in Washington state just announced a vaccine mandate for all state employees, as well as private-sector healthcare workers great. except... April 15th was the date that WA made it...

    Governor here in Washington state just announced a vaccine mandate for all state employees, as well as private-sector healthcare workers

    great. except...

    get fully vaccinated by October 18 as a condition of employment.

    April 15th was the date that WA made it generally available to everyone over 16. anyone not vaxed yet has had at least four months worth of opportunity. healthcare workers and people with comorbidities have had significantly more.

    now they get an extra 2 months? (closer to a month if you count the 3-4 weeks between first and second shot, but I strongly suspect that if someone has had their first shot and is scheduled for a second a few weeks after the deadline, they'll cut people slack)

    The mandate for state workers applies to agencies under the governor’s control, but not K-12 schools or colleges and universities – though some already have announced their own requirements.

    ...and they exempt what is probably the largest single category of state employees.

    as with virtually everything else we've done to try to contain covid - too little, too late.

    4 votes
  9. skybrian
    Link
    Israeli Health Ministry official: Most people will end up being infected with COVID [...]

    Israeli Health Ministry official: Most people will end up being infected with COVID

    “The [real] question is whether the infected person is vaccinated or not. It’s unavoidable that the pandemic will infect the majority of the population. It won’t disappear in another half a year,” Dr. Tal Brosh told the Kan public broadcaster.

    Brosh, who also heads the infectious disease department at Assuta Medical Center in Ashdod, said he doesn’t see a reason to shutter Ben Gurion Airport, arguing that would distract “from the main problem — morbidity within in the country.”

    “It can be just as dangerous to enter some cities within Israel,” he argued, though he acknowledged that there was some risk in keeping Ben Gurion open.

    [...]

    [...] health officials hope they’ll be able to prevent hospitals from overflowing, even if cases continue to spike. Because much of the decision to implement a national lockdown would be based on whether the hospital system can withstand the uptick in cases, the government hopes that the emergency proposal will, at the very least, buy additional time before a shutdown is required, or in the best case scenario, allow ministers to shelve such plans entirely, according to Channel 12.

    4 votes
  10. cfabbro
    Link
    Here’s why herd immunity from Covid is ‘mythical’ with the delta variant

    Here’s why herd immunity from Covid is ‘mythical’ with the delta variant

    Sir Andrew Pollard, head of the Oxford Vaccine Group, told British lawmakers Tuesday that as Covid vaccines did not stop the spread of the virus entirely — with vaccinated people still able to be infected and transmit the virus — the idea of achieving herd immunity was “mythical.”

    “I think we are in a situation here with this current variant where herd immunity is not a possibility because it still infects vaccinated individuals,” said Pollard, one of the lead researchers in the creation of the AstraZeneca-University of Oxford vaccine.

    “And that does mean that anyone who’s still unvaccinated, at some point, will meet the virus. That might not be this month or next month, it might be next year, but at some point they will meet the virus and we don’t have anything that will stop that transmission.”

    Danny Altmann, professor of immunology at Imperial College London, told CNBC that he also agreed with Pollard and that the herd immunity mathematical model could not easily be applied to an “unprecedented” virus like Covid that was still little understood with diverging, globally circulating variants emerging.

    “The whole herd immunity thing was one of those bits of medical textbook-speak that was adopted early on by policy advisors, then the press, then the public and has throughout been contorted and over-simplified,” he said Thursday.

    What was important, Altmann said, was that “the more people on the globe effectively vaccinated, the fewer viral copies we’ll have on the planet, thus the less spread and fewer lungs in which for virus to mutate and spread the next wave of variants.”

    4 votes
  11. [2]
    skybrian
    Link
    Ed Yong has another long read in the Atlantic about where we go from here and what the end game looks like: How the Pandemic Now Ends I didn’t find it all that surprising, but here is someone else...

    Ed Yong has another long read in the Atlantic about where we go from here and what the end game looks like:

    How the Pandemic Now Ends

    Here, then, is the current pandemic dilemma: Vaccines remain the best way for individuals to protect themselves, but societies cannot treat vaccines as their only defense. And for now, unvaccinated pockets are still large enough to sustain Delta surges, which can overwhelm hospitals, shut down schools, and create more chances for even worse variants to emerge. To prevent those outcomes, “we need to take advantage of every single tool we have at our disposal,” Bansal said. These should include better ventilation to reduce the spread of the virus, rapid tests to catch early infections, and forms of social support such as paid sick leave, eviction moratoriums, and free isolation sites that allow infected people to stay away from others.

    I didn’t find it all that surprising, but here is someone else saying most will get it:

    If SARS-CoV-2 is here to stay, then most people will encounter it at some point in their life, as my colleague James Hamblin predicted last February. That can be hard to accept, because many people spent the past year trying very hard to avoid the virus entirely. But “it’s not really the virus on its own that is terrifying,” Jennie Lavine, an infectious-disease researcher at Emory University, told me. “It’s the combination of the virus and a naive immune system. Once you don’t have the latter, the virus doesn’t have to be so scary.”

    4 votes
    1. FrankGrimes
      Link Parent
      I really want more studies on long Covid, and how often it's occurring in vaccinated people. If a vaccinated person is not at risk for any sort of protracted symptoms, I would be on board with...

      “It’s the combination of the virus and a naive immune system. Once you don’t have the latter, the virus doesn’t have to be so scary.”

      I really want more studies on long Covid, and how often it's occurring in vaccinated people. If a vaccinated person is not at risk for any sort of protracted symptoms, I would be on board with that quote. If vaccination status doesn't seem to change the chances of getting long Covid, then in my mind, the virus is still quite scary.

      7 votes
  12. kfwyre
    Link
    Los Angeles and Chicago schools will mandate teacher vaccinations

    Los Angeles and Chicago schools will mandate teacher vaccinations

    As schools prepare to reopen five days per week amid an alarming surge in the coronavirus, Los Angeles and Chicago, the second and third-largest districts in the nation, announced on Friday some of the strongest teacher vaccine mandates to date.

    Educators and school staff in both cities will have to be fully vaccinated by Oct. 15. School begins in Los Angeles on Aug. 16 and in Chicago on Aug. 30.

    4 votes
  13. skybrian
    Link
    27 people aboard a Carnival cruise test positive for COVID-19

    27 people aboard a Carnival cruise test positive for COVID-19

    Twenty-seven people aboard a Carnival cruise that reportedly departed from Texas tested positive for COVID-19 just before the ship made a stop in Belize City this week, according to the Belize Tourism Board.

    The positive cases were among 26 crew members and one passenger on the Carnival Vista, which is carrying over 1,400 crew and nearly 3,000 passengers, the board said in a statement. The ship arrived Wednesday in Belize City.

    All 27 were vaccinated, had mild or no symptoms, and were in isolation, according to the statement. The tourism board said 99.98% of the ship's crew was vaccinated, as well as 96.5% of its passengers.

    3 votes
  14. skybrian
    Link
    Breakthrough infections strike fear, worry in Marin’s music scene

    Breakthrough infections strike fear, worry in Marin’s music scene

    The good news is that 94% of eligible adults and kids 12 and older in Marin have gotten at least one shot. But you know things have taken a turn for the worse when even the fully vaccinated are getting sick.

    According to the county health department, 90% of those hospitalized in Marin are unvaccinated. But, in one unsettling case, a fully vaccinated music fan became seriously ill with COVID-19 and had to be hospitalized and put on a ventilator after an evening of live music at the No Name Bar in Sausalito. This week, her family and friends posted a plea on social media for thoughts and prayers as she fought for her life. She died on Thursday.

    Marin guitarist Michael LaMacchia and his band were on the bar’s stage that same evening, playing their weekly Friday night gig. Afterward, LaMacchia and all three members of his band — all vaccinated — became ill, testing positive for COVID.

    3 votes
  15. skybrian
    Link
    Iceland has been a vaccination success. Why is it seeing a coronavirus surge? […] […]

    Iceland has been a vaccination success. Why is it seeing a coronavirus surge?

    Many of the country’s recent infections have occurred among vaccinated people, but they’ve been overwhelmingly mild. So even as new cases multiplied, Iceland’s rates of covid-19 hospitalizations and deaths have remained low. Of the 1,300 people currently infected, just 2 percent are in the hospital. The country hasn’t recorded a virus death since late May.

    […]

    Matthiasson, the Icelandic hospital chief executive, said he had not expected this latest upswing in cases, especially when it seemed the country had vanquished the virus. His hospital has been stretched thin, even though it only treats two to three dozen covid-19 patients at once, because it always operates near capacity.

    Of the 65 virus patients admitted during this wave, he said, 40 percent are unvaccinated — more than four times the overall share of unvaccinated Icelanders.

    […]

    The government of Iceland has reinstated mask requirements for some indoor spaces and a 200-person capacity limit, which will both be in place until at least the last week of August. The measures took effect in late July, and the rise of new infections appears to have slowed in recent days.

    2 votes