COVID-19: Chapter 7 - Brags, Beats, and Variants

Not in the larger northern liberal cities I dont think. Boston the one I follow most closely, has been shut down for months and isnā€™t opening until March at the earliest. Also most are hybrid i think.

Do you have a source for this? It contradicts what I thought I knew about the new variants/strains, but I havenā€™t followed every new development recently, so I could have missed something.

Osterholm said it but i canā€™t give you a written source.

Also this thread on twitter expressed real concern

They can change the vaccine but obviously backs up the timeline further and we will need stronger mitigation then we have seen in the USA for a longer period of time while we catch up with the variants if we donā€™t want to see worse stats than we have seen to date.

As another example Tom Frieden, who I also think is on the Biden COVID team, is suggesting that even brief trips to get prescriptions or food are now becoming unsafe without an N-95 mask and we need to eliminate those store trips as much as possible.

https://mobile.twitter.com/DrEricDing/status/1352058546163249152

Iā€™m not following the whole state, but all public Columbus city schools have been 100% virtual all year here in Ohio. There were 2 dates of potential first in October then November that they hoped for, but as each approached they pushed it back. Now apparently they are shooting for Feb 1 hybrid model. We shall see what happens in the next 2 weeks.

Canā€™t we just flip the switch on the mRNA vaccine machines to make vaccines to target the new variant? Obviously no one is going to even start thinking about that until at least 100 people a day are dying from the new variant, but it ought not to be a huge deal.

Youā€™d still have to go through all the clinical trial stages.

I generally agree with your sentiment (except for the last sentence). Plus there has been immense ā€œdisruptionā€ in millions of peopleā€™s lives across the country due to COVID and economic losses. To say that things could have been worse is a bit silly if you ask me.

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I donā€™t consider myself a pessimist. I think given where we started ending this by 2022 is a heroic effort by science and I think there is a return to (mostly) normality on the other side. Im pessimistic about the US recovering in anything resembling an equal way, but consider myself relatively optimistic on the eventual virus control front. Vaccines will
eventually help win the day.

If this was true youā€™d expect actual significant cases of reinfections. We have not. Itā€™s not like these variants are rare.

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If the infrastructure is already up and running, Iā€™m hoping the political will wonā€™t be there to kill another 100k people to satiate the bureaucracyā€™s hunger for paperwork. Thereā€™s a new sheriff in town!

So I canā€™t read these studies either, but again, itā€™s very important to note that the immune system is a lot more complicated than antibodies.

That Twitter thread buries the lede in favour of an alarmist headline:

https://mobile.twitter.com/DrEricDing/status/1352065252574294020

https://mobile.twitter.com/DrEricDing/status/1352065712207130628

Also from the NY Times article linked:

Even if antibody effectiveness were reduced tenfold, the vaccines would still be quite effective against the virus, said Jesse Bloom, an evolutionary biologist at the Fred Hutchinson Cancer Research Center in Seattle.

I know, I read it. I consider a reduction from 95 percent effective to 70-80 percent effective material, but maybe its not.

I just saw a story that said each store was going to do 100-125 shots per day. So with approximately 240 stores, thatā€™s 24,000 shots per day. Thatā€™s 720,000 shots per month. But since people need two shots apiece, thatā€™s effectively only 360,000 vaccinated by Publix in a given month. Florida has a population of like 22 million. And maybe we need 14 million or so vaccinated to get to herd. So if Walgreenā€™s and CVS can do similar numbers, then Iā€™m getting a little more optimistic. But I still think we need some mass vaccination efforts at large facilities. I feel confident though that Biden and company can make that happen.

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A 70-80% effective vaccine is a) still very good for herd immunity and b) going to be extremely effective in preventing severe disease, and in any case a drop in effectiveness of that magnitude is pure speculation. Basically I donā€™t see any need to worry from anything presented in that thread.

Back in the fall 70-80% was what a lot of people were hoping the vaccinesā€™ efficacy would turn out to be.

This. Wake me up when the T-cells stop working.

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Yep, I get that. Guess Iā€™d summarize my (very non expert but I stayed in this thread and other twitter thread last night) worries as

    • not confident in initial vaccine uptake rate. Reduction in effectiveness rate means uptake rate must increase and makes me pessimistic herd immunity is coming in 2021 even with perfect rollout. Also if different vax effected differently by mutations will complicate things as well as if/when we decide we need to update for new variants.
    • vax rollout will improve, but not overnight. Seems like it will take most of the year to vax population. How long the vax is good for still tbd. Seems most likely 8+ months, but might not leave much time to get everyone done before we need to revax. We also have to figure out whether vax reduces transmission but that doesnā€™t seem like it it will ultimately be a long-run risk.
  • -Fear of mutations.

In the short-run, very worried about what happens here with spread during the very likely outcome where the known new strains become dominant. On the positive side, we hopefully will be making progress vaccinating the vulnerable. On the negative side, we know what Europe did to semi successfully contain the newer variants and ehhhh not sure we do that!

Longer-term, I worry about the tail risk of what mutations can happen the longer we let this run out. Especially if we have high case counts and, in some countries, half dose vaccinated people. Reinfection point is, of course, a fair and one and point in favor of optimism. But one case was confirmed today, super hard hit parts of Brazil are exploding again, and Iā€™m not totally confident they are catching a meaningful portion of reinfections through surveillance in Brazil and South Africa (or evening US)

To me it all adds up to a likely very grim period ahead before things start to get better. I think we get better on a slower timeline than weā€™d all like and slower than was sort of ā€œbase caseā€ heading into the year that we could mostly put this behind us in 2021.

Iā€™m still reasonably confident that my family can get vaccinated this year and that I can see them for Christmas 2021. I donā€™t think Iā€™ll be going to football games in the fall nor do I expect a completely regular ā€˜21-ā€˜22 school year. I also think thereā€™s some non insignificant risk that death/hospitalization/reduction in quality of life numbers in 2021 get really bad and meaningfully worse than in 2020.

Sorry for the long winded post.

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yeah man, that 240 is just a beginning point for us as well. I think weā€™ve got over 900 stores in the state of Florida as well, so thereā€™s more room for expansion.

by no means should we be doing the lionā€™s share of vaccinations, but itā€™s a good place to work up from. as more doses become available weā€™ve got some options to get it into peopleā€™s arms, which is nice.

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