Severity of Disease Among Adults Hospitalized with Laboratory-Confirmed COVID-19 Before and During the Period of SARS-CoV-2 B.1.617.2 (Delta) Predominance — COVID-NET, 14 States, January–August 2021

Link:https://www.cdc.gov/mmwr/volumes/70/wr/mm7043e1.htm?s_cid=mm7043e1_w

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Excerpt:

What is already known about this topic?

The SARS-CoV-2 B.1.617.2 (Delta) variant is highly transmissible; however, whether it causes more severe disease in adults has been uncertain.

What is added by this report?

Analysis of COVID-NET data from 14 states found no significant increases in the proportion of hospitalized COVID-19 patients with severe outcomes during the Delta period. The proportion of hospitalized unvaccinated COVID-19 patients aged 18–49 years significantly increased during the Delta period.

What are the implications for public health practice?

Lower vaccination coverage in adults aged 18–49 years likely contributed to the increase in hospitalized patients during the Delta period. COVID-19 vaccination is critical for all eligible adults, including adults aged <50 years who have relatively low vaccination rates compared with older adults.

Author(s): Christopher A. Taylor, PhD1; Kadam Patel, MPH1,2; Huong Pham, MPH1; Michael Whitaker, MPH1; Onika Anglin, MPH1,2; Anita K. Kambhampati, MPH1; Jennifer Milucky, MSPH1; Shua J. Chai, MD3,4; Pam Daily Kirley, MPH4; Nisha B. Alden, MPH5; Isaac Armistead, MD5; James Meek, MPH6; Kimberly Yousey-Hindes, MPH6; Evan J. Anderson, MD7,8,9; Kyle P. Openo, DrPH7,8; Kenzie Teno, MPH10; Andy Weigel10; Maya L. Monroe, MPH11; Patricia A. Ryan, MS11; Justin Henderson, MPH12; Val Tellez Nunez, MPH12; Erica Bye, MPH13; Ruth Lynfield, MD13; Mayvilynne Poblete, MA, MPH14; Chad Smelser, MD15; Grant R. Barney, MPH16; Nancy L. Spina, MPH16; Nancy M. Bennett, MD17; Kevin Popham, MPH18; Laurie M. Billing, MPH19; Eli Shiltz, MPH19; Nasreen Abdullah, MD20; Melissa Sutton, MD20; William Schaffner, MD21; H. Keipp Talbot, MD21; Jake Ortega, MPH22; Andrea Price22; Shikha Garg, MD1; Fiona P. Havers, MD1; COVID-NET Surveillance Team

Publication Date: 29 October 2021

Publication Site: MMWR at CDC

Simpson’s Paradox and Vaccines

Link:https://covidactuaries.org/2021/11/22/simpsons-paradox-and-vaccines/

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Excerpt:

So what the chart in the tweet linked above is really showing is that, within the 10-59 age band, the average unvaccinated person is much younger than the average vaccinated person, and therefore has a lower death rate. Any benefit from the vaccines is swamped by the increase in all-cause mortality rates with age.

I have mocked up some illustrative numbers in the table below to hopefully show Simpson’s Paradox in action here. I’ve split the 10-59 age band into 10-29 and 30-59. Within each group the death rate for unvaccinated people is twice as high as for vaccinated people. However, within the combined group this reverses – the vaccinated group have higher death rates on average!

I and others have written to ONS, altering them to the concerns that this data is causing. It appears from a new blog they have released that they are aware of the issue and will use narrower age bands in the next release.

Author(s): Stuart Macdonald

Publication Date: 22 Nov 2021

Publication Site: COVID-19 Actuaries Response Group

Why Puerto Rico leads the U.S. in COVID vaccine rate — and what states can learn

Link:https://www.npr.org/2021/10/27/1049323911/puerto-rico-leads-the-us-in-covid-19-vaccine-rates-and-what-states-can-learn

Excerpt:

It’s in Puerto Rico, where more than 73% of the total population is fully vaccinated. The U.S. national average is just over 57%.

The high vaccination rate stands in contrast to Puerto Rico’s initial vulnerability to the coronavirus. Four years after Hurricane Maria destroyed the electricity grid, power outages still occur regularly. Many municipalities face a shortage of health care facilities and workers.

The U.S. territory responded with some of the strictest pandemic measures in the country, including nonessential-business closures, stay-at-home orders and mask mandates.

……

Its successes aside, Feliú-Mójer noted that COVID-19 has still killed over 3,200 people in Puerto Rico. And she remains concerned about vaccine equity — particularly in rural communities or among older adults who can’t get out of their homes or don’t know how to make an appointment. She says the high overall vaccination rate can hide gaps in coverage.

“You have to look beyond that big number,” she said in a separate interview with NPR. “But then you look at certain municipalities like Loíza, a town in coastal northern Puerto Rico that’s predominantly Black and [a] very poor municipality. Their vaccination rate is about 55%. And so when you look at some of the social determinants that impact communities like Loíza, then they’re not doing as well.”

Author(s): PATRICK JARENWATTANANON, AYEN BIOR, SARAH HANDEL

Publication Date: 27 October 2021

Publication Site: NPR

COVID-19 Vaccination and Case Trends by Age Group, United States

Link:https://data.cdc.gov/Vaccinations/COVID-19-Vaccination-and-Case-Trends-by-Age-Group-/gxj9-t96f

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[created by Mary Pat Campbell, using the data]

Excerpt:

Trends in vaccinations and cases by age group, at the US national level. Data is stratified by at least one dose and fully vaccinated. Data also represents all vaccine partners including jurisdictional partner clinics, retail pharmacies, long-term care facilities, dialysis centers, Federal Emergency Management Agency and Health Resources and Services Administration partner sites, and federal entity facilities.

Author(s):CDC, NCIRD

Publication Date: accessed 19 Oct 2021

Publication Site: data.cdc.gov

The Racial Gap Among the Vaccinated Has Essentially Disappeared

Link:https://reason.com/2021/10/14/the-racial-gap-among-the-vaccinated-has-essentially-disappeared/

Excerpt:

According to a new survey from the Kaiser Family Foundation, as the rate of U.S. adults who report having received at least one dose of the COVID-19 vaccines continues to climb, the rates among racial groups are now basically identical, comprising 71 percent of white adults, 70 percent of black adults, and 73 percent of Hispanic adults. President Joe Biden’s proposed mandate for all private-sector employees to be vaccinated has yet to take effect, so this is a good sign for the efficacy of general persuasion over a top-down mandate.

Author(s): Joe Lancaster

Publication Date: 14 Oct 2021

Publication Site: Reason

Russia breaks record again for COVID-19 deaths, infections

Link:https://apnews.com/article/coronavirus-pandemic-business-russia-pandemics-vladimir-putin-b9fcbf2f0391771c5248f67b6491804e?utm_medium=AP_Europe&utm_campaign=SocialFlow&utm_source=Twitter

Excerpt:

Russia’s daily tolls of coronavirus infections and deaths surged to another record on Friday, a quickly mounting figure that has put a severe strain on the country’s health care system.

The government’s coronavirus task force reported 32,196 new confirmed coronavirus cases and 999 deaths in the past 24 hours.

The record for daily COVID-19 deaths in Russia has been broken repeatedly over the past few weeks, as fatalities steadily approach 1,000 in a single day. It comes amid increasing infections and a reluctance by authorities to toughen restrictions that would further cripple the economy.

The government said this week that about 43 million Russians, or just about 29% of the country’s nearly 146 million people, are fully vaccinated. Authorities have tried to speed up the pace of vaccination with lotteries, bonuses and other incentives, but widespread vaccine skepticism and conflicting signals from officials stymied the efforts.

Author(s): VLADIMIR ISACHENKOV

Publication Date: 15 Oct 2021

Publication Site: AP

Weekly COVID-19 age-standardised mortality rates by vaccination status, England: methodology

Link:https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/methodologies/weeklycovid19agestandardisedmortalityratesbyvaccinationstatusenglandmethodology#age-standardised-mortality-rates

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Excerpt:

Age-standardised mortality rates are calculated for vaccination status groups using the Public Health Data Asset (PHDA) dataset. The PHDA is a linked dataset combining the 2011 Census, the General Practice Extraction Service (GPES) data for pandemic planning and research, and the Hospital Episode Statistics (HES). We linked vaccination data from the National Immunisation Management Service (NIMS) to the PHDA based on NHS number, and linked data on positive coronavirus (COVID-19) Polymerase Chain Reaction (PCR) tests from Test and Trace to the PHDA, also based on NHS number.

The PHDA dataset contains a subset of the population and allows for analyses to be carried out that require a known living population with known characteristics. These characteristics include age-standardised mortality rates (ASMRs) by vaccination status and the use of variables such as health conditions and census characteristics.

Author(s): UK government, ONS

Publication Date: Accessed 27 Sept 2021

Publication Site: Office of National Statistics

COVID and Simpson’s Paradox: Why So Many Vaccinated People are Among the Current Wave of Hospitalizations

Link: https://marypatcampbell.substack.com/p/covid-and-simpsons-paradox-why-so

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Excerpt:

There you have it — for this slice of time, the beginning of August 2021, Israel shows that the vaccines reduced risk 80%+, for all age groups.

Yes, if you just do an aggregation at the whole population level, it looks like a 67% reduction. That’s the “magic” of Simpson’s Paradox. For any given age group, the percentage reduction is much larger. But due to the relative risks by age, even with such high reductions, the overall population result shows a smaller improvement.

Takeaway: COVID vaccines greatly reduce risk

This is the main takeaway: the COVID vaccines greatly reduce the risk of adverse outcomes.

By the way, this is also true of the annual flu vaccines, which range in efficacy based on how well the vaccine that year matches up with the strains circulating, and which strains are circulating (some strains, even if you formulated the vaccine perfectly, still infect.) I could give you flu/pneumonia death rates by age groups, and you would see that flu/pneumonia is a big killer of the elderly. Get your flu vaccines, please.

But, we should also expect a lot of people hospitalized with COVID to be vaccinated old folks. Just because of the huge risk slope by age, which will still exist after vaccination.

Author(s): Mary Pat Campbell

Publication Date: 19 August 2021

Publication Site: STUMP at substack

Five truths about covid that defy our intuitions

Excerpt:

1. If a large share of hospitalised people are vaccinated, that’s a sign of success. It has been common to see headlines noting that a substantial minority of people who have been hospitalised or even killed by Covid have been fully vaccinated. These numbers suggest vaccine failure is alarmingly common. The fallacy only becomes clear at the logical extremes: before vaccines existed, everyone in hospital was unvaccinated; if vaccines were universal, then everybody in hospital would be vaccinated. Neither scenario tells us whether the vaccines work.

So try this. Imagine that 1 per cent of the unvaccinated population will end up in hospital with Covid over a given time period. In a city of a million people, that would be 10,000 hospital stays. Now let’s say that 950,000 people get fully vaccinated, that the vaccine is 95 per cent effective against hospitalisation, and that the vaccine doesn’t reduce transmission (although it does). Here’s the arithmetic: 500 of the 50,000 unvaccinated people end up in hospital. A total of 9,500 of the vaccinated people would be at risk of a hospital visit, but the vaccine saves all but 5 per cent of them. These unlucky 475 still go to hospital. The hospital contains 500 unvaccinated and 475 vaccinated people — almost half and half — which makes it seem as though the vaccine barely works. Yet when 95 per cent of people take a 95 per cent effective vaccine, hospital visits fall from 10,000 to fewer than 1,000.

Author(s): Tim Harford

Publication Date: 19 August 2021

Publication Site: TimHarford.com

CDC warns of a “significant decline” in vaccine effectiveness for some, prompting booster dose decision

Link: https://www.cbsnews.com/news/covid-vaccine-booster-shot-cdc-effectiveness/?mc_cid=7fce136b2d&mc_eid=983bcf5922

Excerpt:

New data being released Wednesday by the Centers for Disease Control and Prevention warns of a “significant decline” in vaccine effectiveness against infection from COVID-19 in nursing home residents, as the highly contagious Delta variant of the virus causes a spike in hospitalizations among mostly unvaccinated Americans.

The release came as the Biden administration says it is preparing to offer booster shots for all Americans who got the Pfizer or Moderna vaccines, eight months after their second dose, beginning the week of September 20.

“Given this body of evidence, we are concerned that the current strong protection against severe infection, hospitalization and death could decrease in the months ahead, especially among those who are at higher risk or who were vaccinated earlier,” CDC Director Dr. Rochelle Walensky said at a briefing Wednesday.

Author(s): ALEXANDER TIN

Publication Date: 18 August 2021

Publication Site: CBS News

Israeli data: How can efficacy vs. severe disease be strong when 60% of hospitalized are vaccinated?

Link: https://www.covid-datascience.com/post/israeli-data-how-can-efficacy-vs-severe-disease-be-strong-when-60-of-hospitalized-are-vaccinated

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Excerpt:

These efficacies are quite high and suggests the vaccines are doing a very good job of preventing severe disease in both older and young cohorts. These levels of efficacy are much higher than the 67.5% efficacy estimate we get if the analysis is not stratified by age. How can there be such a discrepancy between the age-stratified and overall efficacy numbers?

This is an example of Simpson’s Paradox, a well-known phenomenon in which misleading results can sometimes be obtained from observational data in the presence of confounding factors.

Author(s): Jeffrey Morris

Publication Date: 17 August 2021

Publication Site: Covid-19 Data Science

Pandemic of unvaccinated continues to rage as states set new COVID records

Link: https://arstechnica.com/science/2021/08/pandemic-of-unvaccinated-continues-to-rage-as-states-set-new-covid-records/?mc_cid=7fce136b2d&mc_eid=983bcf5922

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Excerpt:

At least five states have exceeded their previous peaks of seven-day averages for new daily cases—Florida, Louisiana, Hawaii, Oregon, and Mississippi. Seven states have exceeded their most recent peaks in hospitalizations—Arkansas, Florida, Hawaii, Louisiana, Mississippi, Oregon, and Washington.

Florida in particular has been ablaze with COVID-19. The Sunshine State exceeded its previous record average of around 16,000 new daily cases, which was set in January. The state is now averaging just under 22,000, according to data reported by the Centers for Disease Control and Prevention. As for daily hospitalization tallies, Florida is currently at its all-time record of around 15,000, exceeding its previous highest peak of around 12,000 last July.

Federal health officials noted last week that shipments to Florida containing COVID-19 treatments, including monoclonal antibodies, increased eightfold over the past month. On Tuesday, the Florida Hospital Association reported that it soon expects 75 percent of hospitals in the state to reach critical staffing shortages.

Author(s): Beth Mole

Publication Date: 17 August 2021

Publication Site: Ars Technica