This is actually clever, but the sad thing is I’m not entirely sure what level you’re on.
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What would be the point of a six week lockdown? The virus would just explode again afterwards. The point of these measures is to buy time. If we’re not buying time for something (a universal mandatory vaccination program, for example), then there’s not much of a point. If your endgame is endemic status through mass infection, then you want to manage to hospital capacity, not lock down.
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Longish post, because I feel like the data I’m looking at is scarier than I would have expected. Going to condense each point to keep the thread readable.
Just to be clear, I know that I’m not an expert on this stuff, so I would be delighted to be shown that I’m looking at things the wrong way. Especially because I feel like I’m more concerned than the average poster here right now, which is the opposite of how I felt last year.
Also, this is a very U.S. and Ohio centric post.
Has there been an obvious break between cases and deaths? I'm not sure.
When I look at how cases and deaths are linked, I look at how average cases predict average future deaths, under the assumption that a case today has some probability of leading to a death somewhere in the range of 14-28 days from now. So on each day, I can measure average recent deaths as of that day (averaged over the last 60 days) divided by average cases (also over 60 days) as of 14 or 21 or 28 days ago.
I would have expected this metric, which I think of as “recent cohort CFR”, to fall significantly with vaccinations. But that hasn’t really happened. You can see a small decline, say from about 1.7% to about 1.4%, but that’s not nearly as much as I would have expected/hoped:
(Each of the 3 lines is just the lag between cases and deaths. So the Blue line assumes a 14 day lag, the maroon line assumes a 21 day lag, and the green line assumes a 28 day lag. But they all follow a pretty similar pattern, so I don’t think it’s super important which one is best.)
Now, this isn’t obviously a problem. I know there’s a huge sample selection issue - we don’t know what proportion of actual cases are actually being identified as a positive case. Moreover, we don’t know how the composition of that sample has changed over time. So maybe what’s happened is that, on average, it’s the symptomatic people who get tested (and test positive), and there’s a constant CFR among symptomatic people even though the overall CFR is declining when you consider the population of asymptomatic people who aren’t being tested at all (and therefore aren’t included in the case count or death count).
But from a first approximation, I expected this number to have dropped much more significantly than it has.
What about Delta and children? Is it more infectious?
Here, I’m using Ohio data because it gives age group breakdowns and for each reported case indicates whether the case was associated with a hospitalization or death. I’m happy to look at a different state if data is available, but I don’t know of any data like this at the national level.
Anyway, it’s not surprising that the proportion of cases among children has been increasing. (I’m using 0-19 because that’s the age group available. I wish it would break down more narrowly.)
So at this point, the “kid” category seems to be a pretty consistent 20% or so of total cases. Here, the increase isn’t necessarily scary. Mostly what’s happening is that there’s been a significant decline in cases among the elderly groups. For example, monthly cases among 80+ year olds in June/July 2021 were about 11.2% of monthly cases for that same group in January-May 2021. That number is 15.6% for the under 20 age group. So the real story is that cases have fallen dramatically across all age groups, just not as much among the under 20 (really the under 50) groups.
Not terribly surprising when you consider vaccine availability, as well as the general decline in desire to get vaccinated among younger folks.
We know the virus is now spreading rapidly again. But should we actually be worried about it? Is it still as dangerous?
This is the thing that I was most surprised by and most frightened by. (Again, this is Ohio data.) When you look at age-adjusted data, it looks like recent cases are much more likely to be associated with hospitalizations than they were in the past. And this is true for all age groups.
What I’ve done here is look at 3 time periods: June-December 2020, January-May 2021, and June-July 2021. These are kind of arbitrarily-chosen, but I wanted to get a sense for whether the Delta variant is likely to be more dangerous to people (kids especially), conditional on them being infected. I’m assuming that June/July 2021 would be the time period when the effect of Delta is likely to be most evident. Here’s what I see:
For each age group, a case in the “Delta period” of June/July 2021 (gray bar) is significantly more likely to be associated with a hospitalization than cases in either June-December 2020 (blue bar) or January-May 2021 (orange bar). For kids under 20, the hospitalization rate is now 2.1% compared to 1.0%. For 20-29 year olds, it’s now 2.7% vs. 1.1-1.3%. For my age group of 40-49, it’s now 5.7% vs. 2.7-3.1%.
This was scary to me. The only hope I have is something that the anti-vaxxers and truthers have been yelling about for the past year - that there’s a difference between being in the hospital with COVID vs. being in the hospital because of COVID. I think there might be a grain of truth in that, particularly if there’s been an increase to normal levels of elective/non-essential surgeries and other hospital visits, where each of those visits requires a COVID test. But man, I don’t like hanging my hat on that hope.
What about age-adjusted deaths?
This isn’t quite as bleak, but first a word of caution: we know that there are going to be more deaths associated with positive cases from June/July 2021. So the death numbers are definitely biased downwards for the most recent “Delta period”. (The same is true for hospitalizations, I guess, which means the previous discussion is bleaker than I described.)
The good news is that kids continue to experience virtually no deaths from COVID. I mean that almost literally - in the state of Ohio, there have been no reported deaths for the under 20 group since March of 2021, and only 7 since the start of the pandemic. But I think you do so an increased death rate among the middle-aged crowd:
So for my age group, the probability of a COVID death conditional on a case has gone up from 0.2% to 0.6%. (And again, that 0.6% is biased downward because some of the recently-identified cases will end up dying.)
The overall number loooks lower (1.2% now vs. 1.6%-1.8% in earlier periods), but I’m confident that the June/July 2021 number will end up being higher than previous periods once we have a complete set of data, which I think is still 2 months away.)
Summary
Even though vaccines are very effective, we’re still experiencing rapid growth in cases, and the Delta variant appears to be more dangerous in terms of both hospitalizations and deaths. So this is why I appear to be freaking out about things right now, even as the world is acting like everything is back to normal.
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hmmmm there’s another conclusion here using this same logic
Wrong thread my friend.
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This is very interesting stuff–thanks for sharing. One initial thought is that you might want to split out the pre/post-Delta categories a little more finely. I’m not sure if you’ve looked much at the CDC’s dashboard, but they have much more detailed information about variants than they used to (not down to the state level, but they do have regional estimates):
For a lot of June, Delta was likely a minority of cases in the Upper Midwest region. It would be interesting to see whether considering June and July reflects that trend. (Of course, I’m sure it would be a ton of work too!)
Thanks, I hadn’t seen that before. Looking here:
it seems like Delta was already a majority of cases (57%) for the two weeks ending July 3 and only 24% for the two weeks before that. So I guess you could argue that the real cut should be something like June 15-July 30, but I’d be stunned if that affected the numbers that much.
Of course that also raises the question of whether this latest round of latecomers would even be lining up for their shots without the fire of Delta and rising cases lit under their ass, or if approval for <12 would be dragging out for another year without it, etc. Would be incredibly frustrating if we lock down for 6 weeks and next to no progress gets made in vax rates.
I assume he’s talking about responsible countries where people want the vaccine but can’t get it. In USA#1, it makes little sense to lock down for six months if people aren’t going to get vaxxed and will get pozzed once the lockdown is lifted.
They are indeed kind to Republicans. Other Democrats who actually want to get shit done, however…
https://twitter.com/ryanlcooper/status/1421109546534281222?s=21
https://twitter.com/ryanlcooper/status/1421110178204856328?s=21
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Covid spreads from country to country and mitigating here for 6 more months while Mexico (20% vaccinated) gets a chance to catch up would save people in Mexico.
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I completely agree with you that lockdowns until the numbers are low and then test/trace should be the norm. In USA #1 not only are we not doing that we basically haven’t tried it beyond half ass attempts. Even if we did try it we would have Trumpers defying it and/or trying to kill elected officials over it. It’s not a realistically workable solution here. Add on 40% of the country who are never getting vaxed and I’m not sure any mitigation strategies will work here really.
As such it’s hard not to be on team let it rip. Let everyone get it and see who lives and who dies. In some ways it getting really bad again may be the only way out of this(I mean we are never truly getting out of this, it will be endemic especially here and especially in red areas). It might, someone page SSC, convince enough people to get vaxed to sort of get this under control. It might infect enough of the non-immune to get it sort of under control.
People scoffed at me saying 1 million+ were going to die from this in the US back earlier in the year. It seems clear we are going to get there whether it is by the end of the year or some point in 2022. We are likely already pretty much there based on excess death numbers. That’s beyond unfortunate but I really don’t see any policy in this country that can prevent that. The real problem is unvaccinated people doing nothing to protect themselves or others. They aren’t going to follow any government instituted mitigation anyways.
It’s good to see you back btw.
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https://www.nature.com/articles/d41586-021-02096-3
The study, published in The New England Journal of Medicine on 28 July, draws on data from almost 11,500 fully vaccinated health-care workers at Sheba Medical Center near Tel Aviv, Israel. Extensive testing between late January and late April 2021 identified 39 workers who had become infected with SARS-CoV-2 despite being fully vaccinated. All had mild symptoms or none at all, but 19% still had some symptoms 6 weeks after diagnosis.
For 22 of the 39 workers with ‘breakthrough’ infections, the authors were able to obtain antibody measurements taken either on the day the infections were detected or in the week before. The researchers also examined data from 104 fully vaccinated workers who matched infected workers for factors such as age but who did not get infected. Comparison showed that levels of neutralizing antibodies were lower among those who got infected — providing the first direct evidence of this effect, says Davenport.
Question for the super smart people: Do you think presence of symptoms after vaccination is more likely to represent a) higher levels of antibodies, b) lower, c) no correlation?
I had zero symptoms. So that puts me at one end of the spectrum, if there is a spectrum.
Also if it matters - I’ve always had a really good immune symptom and can go years at a time w/o a cold or flu, even when I was working in an open office.
I was going to say your pony died, but turns out your pony is fine, it’s just the moron that’s dead.
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Also if spidercrab’s CFR is accurate we will be heading to 1000+ deaths/day in 2-4 weeks and likely won’t look back for a while. 1000+ deaths a day from something now mostly preventable and people are not going to care. It’s absolutely sick.
If this was directed at me you are misreading me. I agree with you on what should happen. It’s just never happening in the US. Wanting strict lockdowns and the like here is like wanting UHC. Of course it’s the right position but it has a 0% chance of happening.
We have literally been living the expirament here this whole time. Almost everyone on this board has been against it.
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This is joke and only a joke
Do we still call people that leave the country for Canada Loyalists and Tories?
But yeah. Get the damn thing approved for all school age kids and then mandate the damn thing. Period.
It’s not at all clear that masks will do enough to control spread against Delta. It’s much more infectious than 2020 COVID.