Monitoring Incidence of COVID-19 Cases, Hospitalizations, and Deaths, by Vaccination Status — 13 U.S. Jurisdictions, April 4–July 17, 2021

Link: https://www.cdc.gov/mmwr/volumes/70/wr/mm7037e1.htm?s_cid=mm7037e1_w

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Averaged weekly, age-standardized rates (events per 100,000 persons) were higher among persons not fully vaccinated than among fully vaccinated persons for reported cases (112.3 versus 10.1), hospitalizations (9.1 versus 0.7), and deaths (1.6 versus 0.1) during April 4–June 19, as well as during June 20–July 17 (89.1 versus 19.4; 7.0 versus 0.7; 1.1 versus 0.1, respectively). Higher hospitalization and death rates were observed in older age groups, regardless of vaccination status, resulting in a larger impact of age-standardization on overall incidence for these outcomes.

Within each age group, the percentage of vaccinated persons among cases, hospitalizations, and deaths increased with increasing vaccination coverage (Figure 1). As the prevalence of SARS-CoV-2 Delta variant surpassed 50%, the percentage of vaccinated persons among cases in each age group increased at rates corresponding to benchmarks for lower VE (i.e., from approximately 90% to <80%). Increases in the percentages of vaccinated persons aged ≥65 years among COVID-19–associated hospitalizations and deaths also appeared higher than expected. During June 20–July 17, age-standardized rates of cases, hospitalizations, and deaths among persons not fully vaccinated increased weekly; among fully vaccinated persons, case rates increased, but rates of hospitalizations and deaths remained largely unchanged (Figure 2).

Author(s): Heather M. Scobie, PhD1; Amelia G. Johnson, DrPH1; Amitabh B. Suthar, PharmD2; Rachel Severson, MS3; Nisha B. Alden, MPH3; Sharon Balter, MD4; Daniel Bertolino, MPH5; David Blythe, MD6; Shane Brady, MPH7; Betsy Cadwell, MSPH1; Iris Cheng, MS5; Sherri Davidson, PhD8; Janelle Delgadillo9; Katelynn Devinney, MPH5; Jeff Duchin, MD10; Monique Duwell, MD6; Rebecca Fisher, MPH4; Aaron Fleischauer, PhD11; Ashley Grant, MPH12; Jennifer Griffin, PhD4; Meredith Haddix, MPH4; Julie Hand, MSPH12; Matt Hanson, MD10; Eric Hawkins, MS13; Rachel K. Herlihy, MD3; Liam Hicks, MPH7; Corinne Holtzman, MPH14; Mikhail Hoskins, MPH11; Judie Hyun, MHS6; Ramandeep Kaur, PhD8; Meagan Kay, DVM10; Holly Kidrowski, MPH14; Curi Kim, MSPH6; Kenneth Komatsu, MPH7; Kiersten Kugeler, PhD1; Melissa Lewis, MPH1; B. Casey Lyons, MPH2; Shelby Lyons, MPH12; Ruth Lynfield, MD14; Keegan McCaffrey7; Chelsea McMullen, MS15; Lauren Milroy, MPH13; Stephanie Meyer, MPH14; Leisha Nolen, MD9; Monita R. Patel, PhD1; Sargis Pogosjans, MPH10; Heather E. Reese, PhD1; Amy Saupe, MPH14; Jessica Sell, MPH5; Theresa Sokol, MPH12; Daniel Sosin, MD15; Emma Stanislawski, MPH15; Kelly Stevens, MS8; Hailey Vest, MPH13; Kelly White, MPH13; Erica Wilson, MD11; Adam MacNeil, PhD1; Matthew D. Ritchey2; Benjamin J. Silk, PhD1

Publication Date: 10 Sept 2021

Publication Site: CDC, Morbidity and Mortality Weekly Report

Vaccinated vs Not vaccinated

Link: https://covidmitigationmonitoring.wordpress.com/2021/09/13/vaccinated-vs-not-vaccinated/

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Here is a fairly clear picture from the CDC of the impact of vaccination on infections (cases), Hospitalizations and Deaths, through July. You can see here that infections are increasing for vaccinated people, hospitalizations and deaths are increasing also, but to a much lesser degree. In all cases, the fully vaccinated people are experiencing infections, hospitalizations, and deaths at a much lower level than the Not Fully Vaccinated people.

That is the message we keep hearing, but I find that this picture tells the story better than the words.

Publication Date: 13 Sept 2021

Publication Site: Covid Mitigation Monitoring Project

Covid-19 Could Become Like the Flu if More People Get Vaccinated

Link: https://www.wsj.com/articles/covid-19-could-become-like-the-flu-if-more-people-get-vaccinated-11631439002

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Covid-19 might become a routine illness like a common cold or the flu one day, virologists and epidemiologists say. But it will take a lot to get there, and the ferocious spread of the Delta variant that has filled hospitals again shows how challenging that path could be.

More than 20 months after the pandemic began, people around the world are having to change the way they think about a disease that many public-health authorities once believed they could conquer. A terrifying emergency has become a long, grinding haul.

The supercontagious Delta variant has made the virus virtually impossible to get rid of. It has fueled surges in cases across the globe, even in countries like Australia that had largely kept the pandemic out.

…..

For Covid-19 to become mild, most people will need some immunity, which studies have shown reduces the severity of the disease. Infections provide some immunity, but that comes with the risk of severe illness, death and further spread of the virus, compared with vaccines. People could become vulnerable to SARS-CoV-2 if that immunity erodes or is weak, or if the virus mutates.

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A future Covid-19 could be less deadly than the flu, which kills up to a half-million people a year globally, because the most widely used Covid-19 vaccines are better than flu vaccines, said Dr. Garcia-Sastre, an influenza expert. The disease could still remain serious for people with weaker immune systems, doctors said.

Author(s): Betsy McKay

Publication Date: 12 September 2021

Publication Site: Wall Street Journal

A Cure for Government Incompetence

Link: https://www.city-journal.org/britain-successful-vaccine-program

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Almost everyone I know in Britain has been surprised—for once, pleasantly so—by the success of the country’s vaccination program against Covid-19. We are so accustomed to the abject failure of our public administration in almost everything, from its political dithering, followed by self-evidently wrong (and costly) decisions, to its bureaucratic incompetence and moral corruption, that when something goes right, we stand amazed. What, indeed, can explain why something should at last have gone right?

…..

The government decided that everyone should be immunized according to risk—first the oldest people and health workers, then the slightly less old and those with compromised immunity, and then the still less old, and so forth, until all adults will have been covered. By spring, more than half the population had received a first (and most important) dose of a vaccine. Almost no opposition to, or even criticism of, this manner of proceeding has arisen— unlike with almost everything else the government has done in its response to the pandemic—and the uptake of the vaccination offer has been high, except among some ethnic minority groups.

The government website to make a vaccination appointment could hardly have been better designed. It gave a large choice of locations, based on their distance from one’s home; we could select time and place. My wife and I chose the following day at noon at Ludlow Racecourse, where a large vaccination center was operating. We could have had our vaccination at my local doctors’ office, 300 hundred yards away from where we lived, but in a time of lockdown, we wanted a day out: so reduced have been our horizons of late that a drive of 20 miles or so seemed almost exciting.

Author(s): Theodore Dalrymple

Publication Date: Summer 2021

Publication Site: City Journal

Data Shows Less Alarming Picture of Delta

Link: https://www.nytimes.com/2021/09/07/briefing/risk-breakthrough-infections-delta.html

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How small are the chances of the average vaccinated American contracting Covid? Probably about one in 5,000 per day, and even lower for people who take precautions or live in a highly vaccinated community.

Or maybe one in 10,000

The estimates here are based on statistics from three places that have reported detailed data on Covid infections by vaccination status: Utah; Virginia; and King County, which includes Seattle, in Washington state. All three are consistent with the idea that about one in 5,000 vaccinated Americans have tested positive for Covid each day in recent weeks.

The chances are surely higher in the places with the worst Covid outbreaks, like the Southeast. And in places with many fewer cases — like the Northeast, as well as the Chicago, Los Angeles and San Francisco areas — the chances are lower, probably less than 1 in 10,000. That’s what the Seattle data shows, for example. (These numbers don’t include undiagnosed cases, which are often so mild that people do not notice them and do not pass the virus to anyone else.)

Here’s one way to think about a one-in-10,000 daily chance: It would take more than three months for the combined risk to reach just 1 percent.

Author(s): David Leonhardt

Publication Date: 7 September 2021

Publication Site: NY Times

New Study Shows Breakthrough Infection Risk Not All It’s Cracked Up to Be

Link: https://pjmedia.com/news-and-politics/rick-moran/2021/09/07/new-study-shows-breakthrough-infection-risk-not-all-its-cracked-up-to-be-n1476621

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According to data compiled by the Centers For Disease Control, approximately one in every 5,000 vaccinated Americans has tested positive for the coronavirus. That number is probably much lower in places with significantly fewer cases — like the Northeast, Chicago, Los Angeles, and San Francisco areas, where it is probably fewer than one in 10,000.

This is the first detailed data about so-called “breakthrough” infections — positive tests from people fully vaccinated. The data suggests that politicians and public health officials are wildly overreacting to the delta variant’s effect on the already vaccinated.

Author(s): Rick Moran

Publication Date: 7 September 2021

Publication Site: PJ Media

Israel is planning to administer FOURTH Covid shot which could be adjusted to fight new variants as country battles wave of infections despite hugely successful vaccine roll-out

Link: https://www.dailymail.co.uk/news/article-9959811/Israel-planning-administer-FOURTH-Covid-vaccine-adjusted-fight-new-variants.html

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Israel is set to begin preparations to administer fourth doses of the coronavirus vaccines as the country deals with soaring cases despite its trail-blazing roll-out of jabs. 

The country’s national coronavirus czar Salman Zarka said the country needs to prepare for a fourth injection, which could be modified to better protect against new variants of the virus.     

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‘It seems that if we learn the lessons from the fourth wave, we must consider the [possibility of subsequent] waves with the new variants, such as the new one from South America,’ he said at the time. 

‘Thinking about this and the waning of the vaccines and the antibodies, it seems every few months — it could be once a year or five or six months — we’ll need another shot.’

He added that he expects Israel to be given out vaccines that had been specially adapted to cope with different variants of the virus by late 2021 or early 2022.  

While Israel is seeing record case numbers in its fourth wave, the jabs are still protecting against severe illness with Covid deaths running at about half of the level of its second wave.

Author(s): Gemma Parry

Publication Date: 5 September 2021

Publication Site: Daily Mail UK

A Call for More Proportionality in Pandemic Coverage

Link: https://dicktofel.substack.com/p/a-call-for-more-proportionality-in

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My late wife spent the last two and half years of her life in a nursing home with a form of early onset dementia. While she was in her fifties, almost everyone else there was elderly. In each of the three winters she was in the home, the place was closed to visitors at some point because of flu. This added heartbreak to heartbreak, but it was entirely reasonable. Nearly three in four flu deaths in the last pre-pandemic season occurred among seniors. Someone aged 65 or more who contracted the flu had a chance of dying of it of about one in 120. (By contrast, while more than 85% of the breakthrough deaths are among those over 65, the COVID death rate for fully vaccinated seniors is one in about 25,000.)

That is to say that the risk of death from flu in a nursing home was almost a thousand times as large as the risk of death from COVID to the overall vaccinated population, and the risk of dying from the flu if you caught it as a senior was more than 200 times greater than the risk from COVID if you are currently disease-free, similarly aged and fully vaccinated.

Author(s): Richard J. Tofel

Publication Date: 2 September 2021

Publication Site: Second Rough Draft

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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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

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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when you’ve got really steep differences between subpopulations and the subpopulations are of very different sizes, the overall population average will be very different from simply looking at the average of the two populations.

Basically:

– The base risk rates for each group are extremely different (3.9 per 100K for young, and 91.9 per 100K for old)
– The percentage each subpopulation makes up in the larger population is very different (67% young, 33% old)
– The vaccination rates are very different by population (76% young, 92% old)

Author(s): Mary Pat Campbell

Publication Date: 19 August 2021

Publication Site: STUMP at substack

America’s Delta data problem

Link: https://www.axios.com/america-coronavirus-vaccines-delta-data-ababc99b-df6b-4ddb-b4b2-341733933a27.html

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The big picture: The Biden administration is ultimately trying to figure out how well-protected different demographics are against the virus, and for how long. From there, they can decide who should get booster shots.

But while the administration waits for more information, telling the public only that boosters aren’t necessary right now, drug companies and other countries are filling the data and communication void.

“Just think we live in a country which is incapable of telling us the percent vaccinated or unvaccinated who require hospitalization for covid. No less any more data about them. Or track breakthrough infections. Thanks @CDCgov,” tweeted Eric Topol, executive vice president of Scripps Research.

Author(s): Caitlin Owens

Publication Date: 9 August 2021

Publication Site: Axios

Why England’s sudden lifting of covid restrictions is a massive gamble

Link: https://www.technologyreview.com/2021/07/18/1029638/why-englands-sudden-lifting-of-covid-restrictions-is-a-massive-gamble/

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On Monday, July 19, the country is ditching all of its remaining pandemic-related restrictions. People will be able to go to nightclubs, or gather in groups as large as they like. They will not be legally compelled to wear masks at all, and can stop social distancing. The government, with an eye on media coverage, has dubbed it “Freedom Day,” and said the lifting of safety measures will be irreversible. 

At the same time, coronavirus cases are rapidly rising in the UK. It recorded over 50,000 new cases on Friday, and its health minister says that the daily figure of new infections could climb to over 100,000 over the summer.

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The UK’s vaccination program is still under way, but it has been broadly successful so far. In all, 68% of the adult population is fully vaccinated, and about 88% of adults have received their first dose (this includes the 68% who have had both doses). Just 6% of Brits are hesitant about getting a shot, according to the Office for National Statistics

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But the government seems to be betting that not all numbers are equally scary. It hopes that hospitalizations will stay low enough to stop the National Health Service from being completely overwhelmed. It is making the assumption that the link between cases and hospitalization rates has been weakened, if not broken. 

“This wave is very different to previous ones,” says Oliver Geffen Obregon, an epidemiologist based in the UK, who has worked with the World Health Organization. “The proportion of hospitalization is way lower compared to similar points on the epidemic curve before the vaccination program.”

Author(s): Charlotte Jee

Publication Date: 18 July 2021

Publication Site: MIT Tech Review