Coronavirus Sars-CoV-2/Covid-19 Megathread

[alfred russel]

Are we not posting crap from the atlantic anymore?

https://www.theatlantic.com/ideas/archive/2021/09/pandemic-australia-still-liberal-democracy/619940/

Australia is undoubtedly a democracy, with multiple political parties, regular elections, and the peaceful transfer of power. But if a country indefinitely forbids its own citizens from leaving its borders, strands tens of thousands of its citizens abroad, puts strict rules on intrastate travel, prohibits citizens from leaving home without an excuse from an official government list, mandates masks even when people are outdoors and socially distanced, deploys the military to enforce those rules, bans protest, and arrests and fines dissenters, is that country still a liberal democracy?

Enduring rules of that sort would certainly render a country a police state. In year two of the pandemic, with COVID-19 now thought to be endemic, rather than a temporary emergency the nation could avoid, how much time must pass before we must regard Australia as illiberal and unfree?

Covid is here for the long term. That was obvious 16 months ago but is blindingly so now.

[alfred russel]

It's still one virus, even if it has different variants.

The variants have different genetic structures, which in practical terms changes their transmissibility and lethality. There are open questions to how much cross immunity you get between the strains.

Whether you want to lump them together as one virus or separately is semantic. Just like if you want to lump all cancers together or break out the various types.

[Valmy]

1 in every 500 people in the US are now dead from the Coronavirus

Similarly, about 7,000 in every 500 people in the US are dead from cancer and 12,000 in every 500 are dead from heart disease.

So what are you saying? The US is now populated by the undead?

[The Brain]

1 in every 500 people in the US are now dead from the Coronavirus

Similarly, about 7,000 in every 500 people in the US are dead from cancer and 12,000 in every 500 are dead from heart disease.

So what are you saying? The US is now populated by the undead?

Only way for you guys to get some brains.

[alfred russel]

1 in every 500 people in the US are now dead from the Coronavirus

Similarly, about 7,000 in every 500 people in the US are dead from cancer and 12,000 in every 500 are dead from heart disease.

So what are you saying? The US is now populated by the undead?

Tim is using all time deaths from covid in his numerator and current living people in his denominator. Figured that would be cool in my comparison too.

[Sheilbh]

So despite a lot of political support for it the JCVI do not recommend vaccinating 12-15 year olds based on their analysis of the health/infection perspective - though they note the governments may wish to seek additional advice around social impacts as that's outside their remit. Though they still recommend that 12-15 year olds with certain medical conditions are vaccinated and have expanded the list of conditions that should trigger a vaccine:

Independent report
JCVI statement on COVID-19 vaccination of children aged 12 to 15 years: 3 September 2021

Published 3 September 2021
Contents

Introduction

Some COVID-19 vaccines available in the UK are currently authorised for use in those aged 12 years and over. The Joint Committee on Vaccination and Immunisation (JCVI) has previously advised an offer of first doses of Pfizer-BNT162b2 vaccine to all 16 to 17 year olds. People aged 16 and 17 years are moving towards adulthood, higher education and/or the workplace. Their social behaviour and social mixing patterns are different compared to children aged 12 to 15 years, and throughout the pandemic rates of infection have been consistently higher in 16 to 17 year olds compared to younger children. Those aged 16 to 17 years can also provide informed consent for their own vaccination.

JCVI has also previously offered advice regarding the vaccination of children aged 12 to 15 years with underlying health conditions (see Annex A below).

The current update relates to JCVI's review of considerations for the vaccination of children aged 12 to 15 years who do not have underlying health conditions that put them at increased risk from COVID-19. A precautionary approach was agreed given the very low risk of serious disease in those aged 12 to 15 years without an underlying health condition that puts them at increased risk. Given this very low risk, considerations on the potential harms and benefits of vaccination are very finely balanced.

Considerations

The potential benefits of vaccination in children and young people were set out in the previous advice (JCVI statement on COVID-19 vaccination of children and young people aged 12 to 17 years: 4 August 2021). Key points of consideration include that admission rates in children with underlying co-morbidities were substantially higher than those in healthy children – evidence which prompted advice on vaccination of children aged 12 and over who are at clinical risk. The extent of any indirect benefits is highly uncertain given our current understanding of the impact of vaccination on transmission in the short and medium term. Understanding of the current and future role of schools on wider transmission, due to the previous use of non-pharmaceutical interventions, increases this uncertainty about the potential impact of vaccination.

On 26 August, 1 September and 2 September 2021, JCVI met, in collaboration with experts from overseas, to review updated evidence relating to the epidemiology of COVID-19 in the UK and safety data related to myocarditis following COVID-19 vaccination in the UK, US and Canada. There is increasingly robust evidence of an association between vaccination with mRNA COVID-19 vaccines and myocarditis. This is a very rare adverse event. Available data from the US and Canada indicate the reporting rate of myocarditis is higher following a second dose of mRNA vaccine, compared with the first dose. No association with prior SARS-CoV2 infection and myocarditis following vaccination has been identified.

The available data indicate that the clinical manifestations of myocarditis following vaccination are typically self-limiting and resolves within a short time. However, the clinical picture is atypical and the medium to long-term (months to years) prognosis, including the possibility of persistence of tissue damage resulting from inflammation, is currently uncertain as sufficient follow-up time has not yet occurred.

Advice

This advice is not based on assessments of vaccine availability, future supply or costs associated with delivery of a programme. When formulating advice in relation to childhood immunisations, JCVI has consistently held that the main focus of its decision should be the benefit to children and young people themselves, weighed against any potential harms from vaccination to children and young people. In providing its advice, JCVI also recognises that in relation to childhood immunisation programmes, the UK public places a higher relative value on safety compared to benefits.

The available evidence indicates that the individual health benefits from COVID-19 vaccination are small in those aged 12 to 15 years who do not have underlying health conditions which put them at risk of severe COVID-19. The potential risks from vaccination are also small, with reports of post-vaccination myocarditis being very rare, but potentially serious and still in the process of being described. Given the rarity of these events and the limited follow-up time of children and young people with post-vaccination myocarditis, substantial uncertainty remains regarding the health risks associated with these adverse events.

Overall, the committee is of the opinion that the benefits from vaccination are marginally greater than the potential known harms (tables 1 to 4) but acknowledges that there is considerable uncertainty regarding the magnitude of the potential harms. The margin of benefit, based primarily on a health perspective, is considered too small to support advice on a universal programme of vaccination of otherwise healthy 12 to 15-year-old children at this time. As longer-term data on potential adverse reactions accrue, greater certainty may allow for a reconsideration of the benefits and harms. Such data may not be available for several months.

JCVI has considered commentary from stakeholders on the benefits of vaccination on the operation of schools and the educational impact of the pandemic on children and young people. JCVI is constituted with expertise to allow consideration of the health benefits and risks of vaccination and it is not within its remit to incorporate in-depth considerations on wider societal impacts, including educational benefits. The government may wish to seek further views on the wider societal and educational impacts from the chief medical officers of the 4 nations, with representation from JCVI in these subsequent discussions. There is considerable uncertainty regarding the impact of vaccination in children and young people on peer-to-peer transmission and transmission in the wider (highly vaccinated) population. Estimates from modelling vary substantially, and the committee is of the view that any impact on transmission may be relatively small, given the lower effectiveness of the vaccine against infection with the Delta variant.

Delivery of a COVID-19 vaccine programme for children and young people is likely to be disruptive to education in the short term, particularly if school premises are used for vaccination and there is potential for a COVID-19 vaccine programme to impact on the efficiency of roll-out of the influenza programme. Adverse reactions to vaccination (such as fevers) may also lead to time away from education for some individuals.

Table 1: prevented per million first vaccine doses
Paediatric intensive care unit (PICU)    2.39
Hospitalisations    87.01
Paediatric inflammatory multisystem syndrome temporally associated with SARS-COV2 infection (PIMS-TS)     15.31

Table 2: prevented per million second vaccine doses
PICU    0.16
Hospitalisations    5.74
PIMS-TS     12.67

Table 3: prevented per course
PICU    2.54
Hospitalisations    92.76
PIMS-TS       27.72

Table 4: myocarditis risk per million
First dose    3 to 17
Second dose    12 to 34

As I've said - I'm a little concerned we're an outlief on this. On the other hand I am reluctant to go against the advice of the JCVI - unless the wider questions on education/social impacts are really overwhelming.

[Eddie Teach]

1 in every 500 people in the US are now dead from the Coronavirus

Similarly, about 7,000 in every 500 people in the US are dead from cancer and 12,000 in every 500 are dead from heart disease.

So what are you saying? The US is now populated by the undead?

Tim is using all time deaths from covid in his numerator and current living people in his denominator. Figured that would be cool in my comparison too.

The US has only been around two and a half centuries, you're saying 38 times the current population has died from those two diseases.   

[alfred russel]

1 in every 500 people in the US are now dead from the Coronavirus

Similarly, about 7,000 in every 500 people in the US are dead from cancer and 12,000 in every 500 are dead from heart disease.

So what are you saying? The US is now populated by the undead?

Tim is using all time deaths from covid in his numerator and current living people in his denominator. Figured that would be cool in my comparison too.

The US has only been around two and a half centuries, you're saying 38 times the current population has died from those two diseases.   

I made the numbers up without any thought. I was only trying to point out that Tim was using a numerator of total dead and denominator of current alive and that isn't a great metric.

[Valmy]

1 in every 500 people in the US are now dead from the Coronavirus

Similarly, about 7,000 in every 500 people in the US are dead from cancer and 12,000 in every 500 are dead from heart disease.

So what are you saying? The US is now populated by the undead?

Tim is using all time deaths from covid in his numerator and current living people in his denominator. Figured that would be cool in my comparison too.

Well surely that would only be comparable if we used data from the same time frame?

But anyway the point is is that lots of people have died of Covid, just as lots of people have died of heart disease and cancer. Generally when a disease gets discussed as comparable to heart disease and cancer you are talking about something pretty serious.

[Barrister]

So back here in Alberta, back in June with plummeting case numbers and growing vaccination rates, the government basically opened everything up and declared that 2021 would be the "best summer ever".

But now we have the delta variant and case numbers are rapidly increasing.  We're at probably half of our peaks from waves 2 and 3 with numbers still rising.

But now here's the thing.  Both the Premier, and our Chief Medical Officer of Health, have been nowhere to be heard for weeks now.  The CMOH used to give daily updates and answer questions from the media.  The Premier was usually not far from a tv camera.  Now the CMOH and Premier both post on Twitter - the CMOH just posts the daily case numbers, the Premier various feel-good news about the province - but nothing in person, and certainly not in public.

So it's not at all clear what the strategy is.  Do they have modeling that suggests the case numbers should start to level off soon?  Is the plan to just let the virus rip through the unvaccinated (and if they die it's their own damn fault)?  Are they going to introduce new restrictions soon?

Because the "Best summer ever" is now over.  Kids are going back to school.  Starting next week all GOA employees have to return to work.

So after I complained that the Premier hadn't spoken to the public, he did a Facebook live stream where he answered pre-selected questions from the public.

They're also set to make some announcements at 11:30.  At a minimum there will be a liquor sales curfew and public servants return to work will be delayed.  There is also a possible return of the mask mandate, although that would likely be hotly contested within the government.

[alfred russel]

Well surely that would only be comparable if we used data from the same time frame?

But anyway the point is is that lots of people have died of Covid, just as lots of people have died of heart disease and cancer. Generally when a disease gets discussed as comparable to heart disease and cancer you are talking about something pretty serious.

I have two deeply held hatreds that drive many of my posts on languish:

-hatred of what i perceive to be excessive covid restrictions
-hatred of Tim

I understand that this is a covid thread and the comment being responded to also related to covid. I understand that may lead  you to think my post was motivated by the former. But it was really motivated by the latter. I'm always excited to go down the totally unproductive rabbit hole of arguing about our response to covid, but in this case i really was just trying to give tim a hard time.

[Sheilbh]

Interesting chart of actual hospitalisations against the various projections by different universities/modellers for SAGE/government in early July - this is updated semi-regularly by Graham Medley who's a professor of infectious disease modelling and chairs the SAGE modelling group (log axis to make it a little clearer):


Not sure this is anywhere near a peak yet - plus offices are starting to go back now, schools are back after the summer holidays and universities will open in the next month - but it looks like we've been at the better end of the projections and for hospitalisations, getting rid of all restrictions doesn't seem to have made a huge difference.

[Barrister]

Alberta is resorting to out-and-out bribery - $100 if you get vaccinated between today and mid-October.

Also:

-provincial workers "return to the office" set for next week is on hold
-provincial mask mandate indoors is back
-liquor sales not allowed after 10pm
-unvaccinated people are "strongly recommended" to limit their social interactions

[alfred russel]

Alberta is resorting to out-and-out bribery - $100 if you get vaccinated between today and mid-October.

Also:

-provincial workers "return to the office" set for next week is on hold
-provincial mask mandate indoors is back
-liquor sales not allowed after 10pm
-unvaccinated people are "strongly recommended" to limit their social interactions

So the message for the next pandemic is "hold out on getting vaccinated -- bounties will eventually come along"?

Glad you guys are following the science and limiting liquor sales after 10pm.

[Barrister]

Alberta is resorting to out-and-out bribery - $100 if you get vaccinated between today and mid-October.

Also:

-provincial workers "return to the office" set for next week is on hold
-provincial mask mandate indoors is back
-liquor sales not allowed after 10pm
-unvaccinated people are "strongly recommended" to limit their social interactions

So the message for the next pandemic is "hold out on getting vaccinated -- bounties will eventually come along"?

Glad you guys are following the science and limiting liquor sales after 10pm.

That is the risk - that if there is another pandemic people might hold off for cash bribes.  On the other hand if it works it is probably money well spent.  (Oh and it isn't actually cash - it's a debit card I believe).

"No liquor after 10" makes more sense than you think.  It basically shuts down nightclubs which can be a prime vector for spread.

They did mention that ICU beds are at 95% capacity (almost all unvaxxed people), so we'll see if they actually have to bring in more restrictions.