Yeah ACB jumping right into the deep end with her body count.
1 Like
1 Like
I will be shocked if we really end up with multiple vaccines with 90%+ efficacy. Scientific consensus prior to the recent announcements was that wasn’t likely. Even the Moderna and Pfizer vaccines were basing their efficacy on a very short time frame after being innoculated and a very small number of pozzes in either group. I know I had several people here tell me why that didn’t matter. Maybe it doesn’t, I’m not an expert but to me that data seems like a very poor way to sort out long term immunity from the vaccine which is what we should be after.
To be clear I’m not saying they don’t work. I just have serious questions about whether they will provide longer term immunity(impossible to know for sure until we see the long term) and whether or not they are really 90-94% effective. If we end up with a 80% vaccine where you need 2 shots a year there is no chance that ends Covid in USA #194. Even the people who are willing to get the vaccine largely won’t bother to get it every year. We can’t even get half of Americans to take the flu shot and if you bring it up to anyone you are likely to get the same conversation. It’s always some version of “the flu shot doesn’t work” and “everytime I get the flu shot it gives me the flu”.
The Vaccines have some pretty intense side effects as well. There is going to be a large enough group of people who take the first shot but skip the second. And when friends and family talk about the side effects others will be discouraged from taking it all together.
1 Like
It depends what your definition of ending COVID is.
USA #194 seems likely to be done with a lot of mitigation when the annual toll can be contained to something that doesn’t collapse the healthcare system.
Even the blue states are only acting now half-assed and when they fear healthcare is going to collapse.
If vaccines are available to everyone and work well enough combined with improvements in therapeutics and rapid testing availability to get caseloads down to where healthcare systems can handle it, the country isn’t going to blink if there is an extra 50k or w/e the range is of additional old/comorbid/minority skewed annual deaths in the background. That wouldn’t be ending COVID to me, but
probably is for USA in terms of distancing measures and mask mandates at large (and Supreme Court may throw out state level emergency measures out at that point anyways)
No idea if the current vaccine candidates can actually work that well. Promising but we don’t have enough information yet. I just don’t have any expectation that the US is going to battle towards what most posters here would consider as ending COVID.
1 Like
Steven Millman:
November 26th COVID Update: The Thanksgiving Update. Super-Spreader to End All Super-Spreaders
Short version: The Thanksgiving Day festivities look like they will kick off what will be by far the largest moment of disease spread anywhere in the world thus far. Deaths resulting from this will spike leading into Christmas.
tl;dr and amazingly depressing. Might want to skip this one tbh.
You may have heard pundits or medical experts talking about this Thanksgiving as a super-spreader event and begging folks not to celebrate outside of the people they live with. You might be wondering, how bad could this be? Bad. Really, really bad. I mean, Michael Bay with a huge budget bad. Here’s some simple math to help make it clear:
My survey research (the ones recently highlighted on CNBC and in the NY Times) suggest that 27% of Americans plan to attend Thanksgiving dinners with people outside of those they live with and that the average size of these events will be about 7.5 people. More than 60% of those hosting dinners say they are not asking for ANY precautions such as testing or quarantines prior to Thanksgiving. More than 80% of those attending such a dinner say they do not intend to take any precautions.
So let’s now play this out. According to Georgia Tech’s COVID-19 Event Risk Assessment Planning Tool, the probability of at least one person showing up to dinner at Thanksgiving is about 10% nationally and MUCH higher in some areas (lower in others). 27% of Americans is about 89,000,000 people. Divided by 7,5 per Thanksgiving dinner is 11,880,000 dinners where people are interacting with folks outside of their bubble. If ten percent of these have at least one COVID positive individual, that’s 1,180,000 potential spreader events in just that one day. Reduce that by the percent of people who intend to take precautions and that drops to about one million dinners. That’s a lot.
Thanksgiving dinners are essentially best-case scenarios for airborne disease spread. They involve a group of individuals sitting close together and spending several hours together indoors unmasked, often talking loudly. Residential homes do not have powerful ventilation systems and in much of the country it will be far too cold to leave windows open. These are near-perfect conditions for spread of an airborne virus like COVID-19. While it is not known exactly how many people in these homes would become infected, we can make an assumption about reasonable ranges of transmission. An average of one new infection per household where an infected person is present is likely a low-end estimate and an average of three would likely be a high-end estimate of spread. We can see what happens in both ends of this range.
A spread of one new infection per household would create one million new cases and a spread of three new infections per household would create three million new infections on Thanksgiving Day alone as generation one of the spread event. Once again, that’s a lot. Case mortality is just less than one percent, and if we assume 5x infected to cases confirmed, that would yield 200,000 to 600,000 new confirmed cases. Case mortality in the US right now is about 0.9% and climbing, which would yield 1,800 to 5,400 COVID deaths. This is on TOP of existing community spread and BEFORE considering how these newly infected individuals will the spread the disease further. For reference, the worst single day death toll in the pandemic thus far was just over 2,600 according to Johns Hopkins.
A spike in new cases will begin to show up in the data during the first week of December. This super spreader event is expected to be SO MUCH LARGER THAN PRIOR SPREAD EVENTS that it should be visible in the national data in it’s first generation, where all of the other super spreaders (Like Memorial Day and Sturgis) have needed to reach generation 3 or 4 to be seen as more than typical variance.Three weeks later, a visible spike in deaths will start to appear in the national data. That’s the week before Christmas.
These newly infected individuals will also spread the disease to new generations of hosts prior to symptoms appearing which will create a potentially massive 4th surge on the back of what is now, by far, the most explosive period of disease spread since the pandemic began. And if we haven’t learned our lesson by Christmas, we can start talking about the 5th surge.
I should also point out that these numbers are probably very conservative for several reasons. First, I do not take into account the fact that more than three million people are traveling which creates risk for disease spread. Second, there is very likely a correlation between the decision to attend a Thanksgiving under such dangerous conditions and other COVID risk behaviors meaning that the probability that someone shows up to a dinner infected is higher than the national averages. Third, many parts of the country are seeing their health care systems already overwhelmed with the worst of the 3rd surge far from over. This means that the case fatality rate is likely to rise substantially by the time these new sick individuals need intensive care. Finally, one major reason case fatality rates had been falling is that younger folks were the ones most likely to get infected. These Thanksgiving dinners may provide many new infections among the elderly who could then, in turn, spread the virus throughout elder communities.
If we launch new exponential spread these numbers all become immensely more dire.
Thanksgiving will almost certainly be a super spreader event orders of magnitude larger in scale than anything we’ve seen so far and will take place in every corner of the country.
It should go without saying that we should follow the guidance and NOT have Thanksgiving events beyond our own households. It’s not the tradition we look forward to, but if we’re smart we’ll all be here next year to celebrate in a world were spread is low and vaccines abundant. There’s no law against having another Thanksgiving in the summer when you can do it outdoors, right? Hell, I’m going to have a Thanksgiving party as soon as I’m vaccinated. Maybe a few of them. This is American and we can do that if we want to.
Please be safe. Don’t travel in the crowds, wear a mask, remain distanced. Vaccines are coming and we’ll get through this. Just be patient a little while longer.
As always, I’m not a medical professional just a professional statistician that’s not sleeping well.
12 Likes
I would be surprised if we get above 60% of the US adult population vaccinated by the end of 2021. At some point mask wearing and social distancing are just going to be done regardless of how many people are getting sick so our best hope of “getting back to normal” is that natural and vaccinated immunity is durable and long lasting.
I assume this what you meant, since there is no way more than a select few are getting it in the next 5 weeks.
1 Like
Thanks for posting these.
I do think he is underestimating cfr by a fair amount. Closer to 1.8-2% currently than 0.9%. He acknowledges that it could rise (older individuals catching it, strained healthcare system) but doesn’t acknowledge that his baseline cfr doesn’t lag deaths by ~28 days to correspond with cases. Curious what his thoughts are on that since his posts overall are very solid / well written.
2 Likes
Nope. This is merely a calculation of the concentration of air that you’re breathing that has been in other people’s lungs. I’m using this as a proxy for the droplets or potential viral load in the air. Another step would be modifying for mask usage, talking vs singing, etc, but then it stop being a pure airflow comparison.
There’s no reflection of community prevalence either, but this is probably more or less scalar (x time more prevalence means being in a situation with a given risk level is x time riskier).
My thinking is that instead of designing an airflow, you should focus on always having a fan blowing towards your head.
Set three box fans pointed upwards at a 45 degree angle near the doorway. One left, one center, one right. You would generally hang out on the right, your friend on the left, and then take turns in the center to swing. Whenever you’re standing in these spots, you’re directly in the blast of a fan blowing fresh air on you. I would be comfortable not wearing masks in such a situation, if the friend is a reasonably careful person in general and it’s not a tiny ass garage (I’m guessing a two car garage here).
The farther outside the door the fans can be placed, the better, but you want to make sure it’s a pretty direct and forceful blast of air on your face.
2 Likes
Covid seems to be closing in all around us now. For a long time, I only knew of one person in the area that had caught it. Now I know a lot of people including my wife’s boss and others in her workplace, my nephew, my niece’s boyfriend, multiple people my SIL works with (this is in NC, so more removed from us), and some friends of friends. It seems to be everywhere all of a sudden. How strange that the uptick coincided with opening schools - who could have seen that coming?
7 Likes
Pretty much any ventilation where you are bringing in fresh air is good. A small window fan blowing out imo is probably good. Just be sure the direction of suction doesn’t go across from person to person. A tissue or TP is a good direction indicator.
If you want more sophistication get a CO2 meter and make sure it reads <800 after you’ve been in the space.
low tech- crack something open and wear masks.
1 Like
She will be the queen of the 21st century dark ages when history books in 2300 are written
1 Like
Jury’s still out on Russia’s Sputnik vaccine. We’ll have to see what they wind up reporting in the journals, but this is encouraging.
1 Like
Do you know what ever happened with the vaccine China started giving to it’s military months ago? (I honestly don’t know if it was 2 months ago or 6 months ago, I’ve lost the ability to track time.)
1 Like
Haven’t heard anything. China has been an information black hole when it comes to COVID.
It’s the same around me. I mentioned a couple days ago that my stepmother is doing contact tracing and she’s been alluding to the existence of things she can’t explicitly say due to HIPAA. I’m basically back to a hard lockdown as of today, roughly the same as April. Time to hibernate and hope for a better Spring.
5 Likes
You can’t fuck up your protocols, see that the smaller sample sized protocol worked and declare total victory. That’s nonsense