Leiter Reports: A Philosophy Blog

60% of the U.S. population has now had Covid

I've love to see the class breakdown on this.  We all know the age breakdown, of course (my own father was an early victim of the Covid disaster in this country, which is wholly attributable to Trump and the Repugs).  Recall this post from early in the pandemic.  We hardly knew what was coming...

U.S. life expectancy continues its decline, thanks to the mishandling of Covid

Here; an excerpt:

The study -- published Thursday on the preprint server medRxiv, which means it has not been peer-reviewed -- found that after falling nearly 1.9 years in 2020, life expectancy in the US decreased another 0.4 years in 2021.  In the decade before the pandemic, life expectancy in the US changed by an average of less than 0.1 years annually, according to data from the US Centers for Disease Control and Prevention.

 

Changes to life expectancy amid the Covid-19 pandemic widened an existing gap between the US and other high-income countries, the new report shows. Among a set of 19 peer countries, life expectancy dropped only a third as much as in the US in 2020 (down 0.6 years, on average) and rebounded in 2021, with an average increase of about 0.3 years.

 

For yet another instance of American exceptionalism, we can thank the Republican Party, Tucker Carlson, Alex Berenson, and other pathological liars and ignoramuses.

It looks like Stanford epidemiologist John Ioannidis has lost his mind

We noted early on during the Covid fiasco one of his peculiar interventions, but his latest "publication" (basically trashing his critics for having lower citation counts) is bizarre.

 

What we'll lose when the COVID "public health emergency" ends

The government declared the emergency in late January of 2020, and with it came free vaccines, protections for medicaid patients, and a lot more.

(Thanks to David Rosenthal for the pointer.)

Heart disease risk increases substantially after Covid (even a mild case)

A rather disturbing report in Nature; an excerpt:

Even a mild case of COVID-19 can increase a person’s risk of cardiovascular problems for at least a year after diagnosis, a new study¹ shows. Researchers found that rates of many conditions, such as heart failure and stroke, were substantially higher in people who had recovered from COVID-19 than in similar people who hadn’t had the disease.

What’s more, the risk was elevated even for those who were under 65 years of age and lacked risk factors, such as obesity or diabetes....

Covid becoming "endemic" is not a good thing, and we don't know what that will be like

Many good points in this Atlantic essay; an excerpt:

What experts do agree on is that endemicity is not monolithic. The water in that tub might be hot or cold; the level it plateaus at can be very high or very low. The world’s pathogens run the gamut. Viruses such as herpes simplex 1, which causes cold sores and, less commonly, genital herpes, are considered endemic throughout the world. In the United States, HSV-1 affects, by some estimates, at least half of Americans, though most of the infections are asymptomatic or not terribly severe, especially among adults. Malaria, meanwhile, sickens more than 200 million people a year, and kills at least 400,000, most of them under the age of 5. That, too, is endemicity.

(Thanks to Dr. David Ozonoff for the pointer.)

Covid and religion

This is a curious set of findings.

(Thanks to David Ozonoff for the pointer.)

CDC guidelines give the unvaccinated substantial priority for antiviral treatments for Covid

MOVING TO FRONT FROM YESTERDAY--INFORMATIVE DISCUSSION IN THE COMMENTS!

This seems surprising; an excerpt:

Current therapies such as Sotrovimab, a monoclonal antibody with activity against omicron, and the oral agents, Paxlovid, and Molnupiravir, exist in very short supply. Already the demand has far outstripped our capacities raising the specter of rationing and a host of medical, social and ethical issues. 

The use and administration of these therapies — funded by the federal government without cost to the end user — are governed by the Centers for Disease Control and Prevention (CDC) and state prioritizations. Although immunosuppressed patients are appropriately atop the list, most unvaccinated patients will be granted the next highest level of priority.  

For example, a 35-year-old unvaccinated former smoker with asthma gains priority over a 66-year-old vaccinated cancer patient. Similarly, an unvaccinated 25-year-old smoker with depression takes precedence over a 64-year-old vaccinated patient with chronic pulmonary disease. Indeed, the highest priority on the CDC list does not include a single profile of vaccinated patients other than the immunosuppressed, regardless of other comorbidities. Based on current supplies, unvaccinated patients will receive most of these lifesaving medications.  

Beyond its inherent unfairness, the decision to prioritize unvaccinated patients for scarce therapies is based on assumptions regarding risk factors, and the data regarding which risk factors contribute to a poor prognosis is weak at best. It is this very paucity of evidence that explains the lack of clear prioritizations in the initial vaccine rollout. 

I'm curious what readers, and especially those working in and around bioethics, think about this.

How many cases of infection by the Covid virus are asymptomatic throughout?

It's surprisingly difficult to find a clear answer to this question.  Many studies that report X percentage being asymptomatic actually mean only that at the time of testing positive, the person was asymptomatic, not that they never developed symptoms.  Does anyone know the answer?  Is there an answer yet for Omicron?  Please post links in the comments (no need to format them, just paste the URL).

University of Chicago delays start of Winter Quarter one week...

...and the first two weeks of instruction thereafter will be online.  (The Law School is not delayed, so we will be online for three weeks.)   Chicago recorded over 5,000 new cases today, double from what it was a week ago, and five times what it was two weeks ago.   I'm sure the story is similar in many other places.  If the Omicron surge follows the South Africa pattern in and around Johannesburg, then we'll peak in about two weeks or so (at 20,000 new cases per day?) and it will start to decline...so we hope!

Setting health-care priorities during pandemics and other mass casualty events

The entire conference, featuring many philosophers, is online here.  The topic, alas, is rather obviously timely!  The schedule is below the fold:

The latest on Omicron, and the universities

Unfortunately, COVID continues to dominate the news.  Here's a round-up of some useful information:

(1)  Omicron infection symptoms are a lot more like the common cold than previous variants according to UK data:

“As our latest data shows, omicron symptoms are predominantly cold symptoms, runny nose, headache, sore throat and sneezing, so people should stay at home as it might well be Covid,” Spector said in Zoe’s latest report Thursday.

Fatigue was also mentioned.  Not mentioned as much:  fever and cough.  In the best-case scenario, this means Omicron is more like the coronaviruses that have long circulated without killing 1% of those infected.  But it's too soon to know if that's the case, or if the milder symptoms reflect the "immunity wall" built up in populations by vaccination and prior illness.  (See also this less hopeful report about Omicron severity from Imperial College London.)

"Why Omicron is scaring me"

Philosopher Gregory Pence, a leading bioethicist at the University of Alabama at Birmingham, gave permission to share these concerns:

The fact that cases of the Omicron variant are doubling every 2.5 days in England and Europe worries me, and the cases seem to be doubling despite 89% of the English having one “jab” and many others having natural immunity.

Yes, Omicron is less likely to hospitalize or kill you, but Pfizer-vaccinated people like me are 70% of the break-through infections, and who wants such an infection (and possible Long Covid)?

With 50+ million unvaccinated Americans, and break-through infections, 1000 cases in 25 days could create a million cases in America, and in another month, that’s potentially … well, you do the math.

What worries me is that folks like me who get infected will want anti-viral drugs or monoclonal antibodies all at the same time as millions get infected  in January/February and as burned-out staff at hospitals face a tsunami of hospitalized cases.

And what about all the people with “normal” problems like attacks of stroke, heart disease, cancer, and injuries?

I fear that we are going to need a triage system in place.

*************************************************************

Am I missing something here? Being too alarmist? I hope so.

British government data showed that two shots of Astra Zeneca, the primary vaccine in the UK, provides zero protection against infection by Omicron; two shots of Pfizer provides 35% protection.  However, Pfizer booster shots raise that to 75% (compared to 95% for Delta), at least for some period of time (we don't yet know how long the raised antibody levels last).  Of course, booster levels are low in the U.S.

I'm opening this for comments/links from readers about the issues raised by Professor Pence.

Useful overview of what we know so far about the Omicron variant...

...from Dr. Eric Topol (Scripps Research).

Get your booster!

Before the Omicron variant gets you!

ADDENDUM:  This is also useful on how to interpret the flood of studies Omicron that are now coming out.

Some more systematic (but still limited) data from South Africa on the severity of Omicron

Interesting and hopeful:

The South African Medical Research Council posted a report Saturday of the early experiences at several hospitals in Gauteng Province, where Omicron was first spotted in the country. Strikingly, most hospitalized patients who tested positive for Covid did not need supplemental oxygen. Few developed Covid pneumonia, few required high-level care, and fewer still were admitted to intensive care.

Experts caution against reading too much into these early reports, which are based on small numbers of patients....

A new study out of Germany on the powerful effectiveness of masks

Here; an excerpt:

If both the infected and the non-infected person wear well-fitting FFP2 masks, the maximum risk of infection after 20 minutes is hardly more than one per thousand, even at the shortest distance. If their masks fit poorly, the probability of infection increases to about four percent. If both wear well-fitting medical masks, the virus is likely to be transmitted within 20 minutes with a maximum probability of ten percent. The study also confirms the intuitive assumption that for effective protection against infection, in particular the infected person should wear a mask that filters as well as possible and fits tightly to the face.

The latest on Omicron from South Africa

It appears to be spreading twice as fast as Delta in the Gauteng province; that may mean it is more transmissible than Delta, or only that it is better at evading preexisting immunity.  There is evidence that Omicron can reinfect those who had earlier variants at a rate three times higher than previous variants did.   Less than one third of the population is vaccinated in South Africa, but there have been several previous waves of infection there, and one imagines those previously infected take fewer precautions.  So it is possible--but this is only speculation at this stage--that Omicron is outperforming Delta because it is infecting those who had recovered from earlier variants.   The big question, still, is how well vaccination protects against the Omicron variant.  I have not yet seen any data on breakthrough infections of Omicron; feel free to add relevant links in the comments.

An epidemiologist on the Omicron variant

This is informative; an excerpt:

The more complicated thing is that we don’t yet know what it’s going to do in very highly vaccinated populations. We know of a case from Israel in which a person who had received three shots transmitted to another person who had received three shots. I don’t want to overstate that single data point, but the fact that we have noted that happening already is important in terms of the ability of three shots to control transmission. Three shots can still be highly protective, though. I would fall off my chair if it turned out that the vaccines’ efficacy against serious illness was seriously affected....

About all we can exclude are the extremes. We know that it’s not very mild because hospitalizations are ticking up in South Africa. We know that it’s not incredibly serious, because hospitalizations are ticking up but not incredibly fast. So, all we can exclude is the extremes, and there’s a lot of room between those extremes for the virus to spring a nasty surprise upon us.

UPDATE:   More on the case of the Israeli doctors from the NYT, and this is good news (the one person it appears the doctor infected was someone he shared a 90-minute car ride with):

Scotland reports six cases of Omicron variant among people with no travel history...

...indicating "community transmission."  This fits with the speculation noted yesterday that, in fact, this variant has been circulating for awhile before South Africa and Botswana noticed it.  That would also suggest that it may not be destined to dominate Delta.  (See also Dr. Scott Gottlieb.)

UPDATE:  And here's a very optimistic take out of Australia.

ANOTHER:  This news clip of Dr. Gottlieb makes several good points, including (1) of the 61 passengers who arrived in Amsterdam from South Africa who tested positive, only about 20% had the Omicron variant (the rest were, presumably, carrying the Detla variant), suggesting that Omicron is not dominating Delta; and (2) South Africa changed its reporting protocols (on November 23) right around the time of the alleged Omicron variant spike in a way that may be quite misleading.

More on the Omicron variant

Again from Statnews:

Levels of Covid-19 in South Africa were subdued when the variant was first detected; since that time numbers have jumped. It’s possible that means Omicron has a growth advantage over Delta, but it’s also possible that it’s riding the new surge of cases, not driving it. Some scientists hypothesized that the rise in cases has been propelled by some superspreading events, explaining why a surge was first detected primarily in Gauteng province. Now, however, cases from the variant are increasing around the country, the WHO said, but some of the increase could be tied to which infections are being sequenced....

The Omicron variant of the coronavirus

MOVING TO FRONT FROM THIS MORNING--UPDATED

Oy veh.

UPDATE:  The W.H.O. has named the new variant Omicron, rather than Nu, as initial reports had suggested.

ANOTHER UPDATE:  From the European analogue of the CDC (my bolded emphases):

The variant is characterised by 30 changes, three small deletions and one small insertion in the spike protein, of these, 15 are in the receptor binding domain. This variant was first detected in samples collected on 11 November 2021 in Botswana and on 14 November 2021 in South Africa. As of 26 November 2021, travel-related cases have also been detected in Belgium, Hong Kong and Israel. The Omicron variant is the most divergent variant that has been detected in significant numbers during the pandemic so far, which raises concerns that it may be associated with increased transmissibility, significant reduction in vaccine effectiveness and increased risk for reinfections. As of 26 November 2021, ECDC has classified this variant as a variant of concern (VOC) due to concerns regarding immune escape and potentially increased transmissibility compared to the Delta variant.

ANOTHER (5 PM CST):   A typically informative analysis from Statnews.  Do read this.

The Covid wave in Europe will soon be coming to America

Dr. Eric Topol (Scripps) is worth following on Twitter for informed Covid news, and, alas, he's surely right about this too.  In Chicago, for example, daily new cases have doubled in the last two weeks (although are still well below where they were last November, a consequence of the vaccine no doubt).  This is increasingly an epidemic of the unvaccinated, of whom there are still at least one million in the city of Chicago.  UChicago requires everyone to be vaccinated, with limited exceptions for health and actual religious reasons.  In the law school, 99% of the students are vaccinated, and while there have been breakthrough cases among students this fall (classes are meeting in person, students sitting next to each other), they haven't turned into clustered outbreaks, no doubt due to the vaccine and the continued masking requirements.

 

Portable air filters work against the coronavirus

Interesting and good to hear!

Are COVID hospitalization numbers informative?

This is interesting; an excerpt:

The authors of the paper out this week took a different tack to answer a similar question, this time for adults. Instead of meticulously looking at why a few hundred patients were admitted to a pair of hospitals, they analyzed the electronic records for nearly 50,000 COVID hospital admissions at the more than 100 VA hospitals across the country. Then they checked to see whether each patient required supplemental oxygen or had a blood oxygen level below 94 percent. (The latter criterion is based on the National Institutes of Health definition of “severe COVID.”) If either of these conditions was met, the authors classified that patient as having moderate to severe disease; otherwise, the case was considered mild or asymptomatic.

The study found that from March 2020 through early January 2021—before vaccination was widespread, and before the Delta variant had arrived—the proportion of patients with mild or asymptomatic disease was 36 percent. From mid-January through the end of June 2021, however, that number rose to 48 percent. In other words, the study suggests that roughly half of all the hospitalized patients showing up on COVID-data dashboards in 2021 may have been admitted for another reason entirely, or had only a mild presentation of disease.

Political orientation, science denial, and COVID vaccinations

Philosopher Adrian Bardon (Wake Forest) comments.

Interview with Prof. Jeremy Fischer who resigned his post at Alabama/Huntsville over their inadequate public health measures

Here; an excerpt:

EA: In your resignation letter, you said you did not want to be complicit in a “moral atrocity.” Can you elaborate on what you consider to be the “moral atrocity” in this situation? Is it limited to UAH? What does it mean on a world scale?

JF: There is a good chance that classes and other in-person events on campus will accelerate COVID transmission in the wider community. This is a huge problem for a state like Alabama, in which only about 76% of senior citizens are fully vaccinated. (Compare that number with 99% in Vermont, 98% in Maine, 96% in Washington State and 95% in Maryland.) Already, as the school year begins, Alabama hospitals are packed with COVID patients and running out of ICU beds (and workers to staff them ).

In such circumstances, large institutions like schools and universities need to take all reasonable steps to minimize coronavirus transmission. (See, for example, the possible mitigation policies, numbered (1)-(8) above, as well as our petition demand to move at least some classes online and implement C.D.C.-recommended social distancing guidelines.) But, despite their modest efforts, the UA System failed to take even most of these steps. In my judgment, this failure is morally atrocious.

On getting a "mild" breakthrough COVID infection

There is some useful information here, about symptoms and duration in particular.

"I-reasoning" and "We-reasoning" during the COVID crisis

Philosopher Anne Schwenkenbecher (Murdoch U) comments.

Surgical masks in fact reduce the spread of the COVID virus

A large, randomized study done in Bangladesh offers strong evidence; surgical masks were also more effective than cloth masks.  An informative news account here; an excerpt:

Among the roughly 178,000 individuals who were encouraged to wear them, the scientists found that mask-wearing increased by almost 30 percent and that the change in behavior persisted for 10 weeks or more. After the program was instituted, the researchers reported an 11.9 percent decrease in symptomatic Covid symptoms and a 9.3 percent reduction in symptomatic seroprevalence, which indicates that the virus was detected in blood tests....

"A 30-percent increase in mask-wearing led to a 10 percent drop in Covid, so imagine if there was a 100-percent increase — if everybody wore a mask and we saw a 100-percent change," he said.

More on COVID vaccines and the Delta variant

This article out of Michigan is nicely done:

In the last 30 days, vaccinated individuals in Michigan have represented 28.1% of hospitalizations, and nearly 15.4% of COVID-19 deaths, according to data from the Michigan Department of Health and Human Services. That’s 6,151 out of 26,272 total cases, 198 out of 704 total hospitalizations, and 10 out of 65 deaths.

But it’s important to look at those numbers in context: Age remains the biggest risk factor for COVID hospitalization and death, and 82.5% of Michigan residents age 65 and older are fully vaccinated. That means the people at biggest risk of death and hospitalization are also people most likely to be inoculated.

Schools with "mandatory" mask policies: what is the enforcement mechanism?

MOVING TO FRONT FROM YESTERDAY--ADDITIONAL COMMENTS WELCOME

A professor elsewhere  at a school with a "mandatory" mask policy is wondering about how he should go about enforcing it, and is looking for suggestions.   Obviously asking for compliance is the first step, but what of the student won't comply?  What about a student who wears the mask inproperly (e.g, the nose is exposed) or frequently removes it to take a drink of water?   For those already teaching, how are you handling these issues?  If your school lacks a mandatory mask policy, what are you doing?

Is COVID vaccine efficacy waning?

This is an informative overview of what we know; some excerpts:

“[Vaccine] efficacy drops with Delta. That is indisputable,” says Leif Erik Sander, an infectious disease expert at the Charité University Hospital in Berlin. But exactly how much it drops differs across studies. In a report this week analyzing weekly reports on nursing home residents across the United States, researchers found that the messenger RNA (mRNA) vaccines made by Pfizer and Moderna had an efficacy against all infections that went from 75% pre-Delta to 53% after it took over. (The variant accounts for more than 90% of U.S. cases now.)  

A large study from the United Kingdom, posted as a preprint yesterday, used the Office for National Statistics COVID-19 Infection Survey, which regularly tests more than 300,000 randomly selected people across the United Kingdom. The study compared the numbers of fully vaccinated and unvaccinated survey participants who tested positive for SARS-CoV-2 during two time periods: December 2020 until 16 May, when the Alpha variant dominated, and 17 May to 1 August, when Delta was dominant. The researchers found that for the two main vaccines in use in the United Kingdom—the Pfizer mRNA vaccine and the adenovirus-based shot developed by the University of Oxford and AstraZeneca—protection against symptomatic infection decreased significantly for the Delta period, to 84% for Pfizer and 71% for AstraZeneca. They also found, consistent with other studies, that compared with breakthrough cases due to the Alpha variant, people with Delta breakthroughs had, on average, much higher viral loads in the nose or throat, suggesting they are more likely to spread the virus to others.

Who is vaccinated against COVID and who is not?

Interesting poll (based on self-reports, however) of the demographic breakdown of those who say they have been vaccinated against COVID:

• Whites: 66 percent
• Blacks: 76 percent
• Latinos: 71 percent
• Urban residents: 79 percent
• Suburban residents: 67 percent
• Rural residents: 52 percent
• White evangelicals: 59 percent
• Democrats: 88 percent
• Independents: 60 percent
• Republicans: 55 percent
• Republicans who support Trump more than party: 46 percent
• Republicans who support party more than Trump: 62 percent
• Democratic Sanders-Warren voters: 88 percent
• Democratic Biden voters: 87 percent
• Biden voters in 2020 general election: 91 percent
• Trump voters in 2020 general election: 50 percent
• White non-college grads: 60 percent
• White college grads: 80 percent

 

University of Iowa reverses course on what faculty can say about COVID matters

Iowa is another ass-backwards state (like Alabama), where the Repug leadership cannot cope with the reality which the public health catastrophe of COVID presents.   Fortunately, the University of Iowa decided to rescind purported restrictions on faculty speech related to masking and vaccines.  (Thanks to a philosophy professor there for the pointer.)  This presents a somewhat odd academic freedom issue.  Academic freedom does not authorize faculty to speak in the classroom about subjects unrelated to the discipline they are teaching; but the First Amendment prohibits public universities from dictating what viewpoints can be expressed.  For a  sober assessment of the First Amendment and academic freedom issues, see the comments of Keith Whittington (Princeton); an excerpt:

Signs of the COVID times: Rice shifts to on-line classes for now

MOVING TO FRONT FROM AUGUST 20--UPDATED

Here.  Texas, like Florida, is a disaster area, thanks in large part to Republican Governors who have thrown up obstacles to all sensible public health measures.

UPDATE:   Testing errors led to Rice administrators thinking the situation was worse than it really was.  (Thanks to Matt Lister for the pointer.)

New UK study of declining effectiveness (against infection) of the Pfizer vaccine

Story here; an excerpt:

DAYS SINCE SECOND DOSE	EFFECTIVENESS AGAINST HIGH VIRAL BURDEN INFECTIONS
	Pfizer-BioNTech shot	AstraZeneca shot
14	92%	69%
30	90%	67%
60	85%	65%
90	78%	61%

By roughly four and a half months after the second dose, Pfizer’s shot will probably be about on par with Astra’s at preventing infections with a high viral burden, said Koen Pouwels, an Oxford senior researcher who helped lead the study. There wasn’t a statistically significant difference in the Astra shot’s effectiveness over time. 

Vaccine boosters are coming

The evidence out of Israel is sobering.  As Dr. Eric Topol notes, boosters are already having an effect against Delta in Israel.  And boosters will be coming here as well.   Once the FDA officially approves the Pfizer vaccine (expecting in September, not sure when the others will get the seal of approval), you can ask your doctor to prescribe it for you.  I got my second shot in early April, and I plan to seek the "booster" not later than October.  Until then, I'm acting like it's May again (always masking indoors etc.), and you should too!

(Thanks to Michael DeNiro for the pointer to the first link.)

Tenured philosophy professor resigns position over university's mishandling of the COVID crisis

Jeremy Fischer, an Associate Professor of Philosophy at the University of Alabama at Huntsville, resigned his position today because of the university's failure to take adequate health and safety precautions in light of the terrible COVID situation in the state.  Professor Fischer's resignation letter is here:  Download 8.16.2021 Fischer Resignation StatementFINAL.   Professor Fischer had previously drafted a petition signed by more than 130 faculty and staff:  Download 000 UAH COVID Petition with Signatures to Administration FINAL UPDATED 8.16.21.

What a failure of leadership by the administration at Alabama/Huntsville.

ADDENDUM:  Professor Fischer kindly offered some details about what the university has and has not done in response to COVID (there is no vaccine mandate, of course): 

Delta variant producing different symptoms than earlier variants?

I've heard anecdotal reports to this effect, and reader Dean Rowan kindly sent along this news item, and the NYT has also reported on it.  The main takeaway is that some vaccinated people infected with Delta have mostly cold-like symptoms:  headache, stuffy nose, sore throat (as compared to fever, cough, and shortness of breath).

Study of vaccinated medical workers in Vietnam who got COVID

Interesting; from the abstract:

Findings: Between 11th–25th June 2021 (week 7–8 after dose 2), 69 healthcare workers were tested positive for SARS-CoV-2. 62 participated in the clinical study. 49 were (pre)symptomatic with one requiring oxygen supplementation. All recovered uneventfully. 23 complete-genome sequences were obtained. They all belonged to the Delta variant, and were phylogenetically distinct from the contemporary Delta variant sequences obtained from community transmission cases, suggestive of ongoing transmission between the workers. Viral loads of breakthrough Delta variant infection cases were 251 times higher than those of cases infected with old strains detected between March-April 2020. Time from diagnosis to PCR negative was 8–33 days (median: 21). Neutralizing antibody levels after vaccination and at diagnosis of the cases were lower than those in the matched uninfected controls. There was no correlation between vaccine-induced neutralizing antibody levels and viral loads or the development of symptoms.

Interpretation: Breakthrough Delta variant infections are associated with high viral loads, prolonged PCR positivity, and low levels of vaccine-induced neutralizing antibodies, explaining the transmission between the vaccinated people. Physical distancing measures remain critical to reduce SARS-CoV-2 Delta variant transmission.

Hospitalization rates and death rates per 100,000 people for the vaccinated and unvaccinated

The NYT has produced a useful chart showing the relative rates of hospitalizations and deaths for COVID based on vaccination status.  In Illinois, for example, the rate of hospitalization for COVID for the vaccinated is about 1 in 5,000, while for the unvaccinated, it is about 1 in 100.  The death rate from COVID for the vaccinated is about 1 in 20,000,  while for the unvaccinated it is about 1 in 1,400.   There is variation, but in all the states, the vaccinated fare much, much better than the unvaccinated.

Given the fluid situation with COVID, these two Twitter doctor/scientists are worth following

Eric Topol (Scripps) and Bob Wachter (UC San Francisco).

A cautionary note about COVID and what the fall may hold

15 vaccinated people attend a house party; the host gets sick with COVID the next day, as do 10 of the 14 guests over the following days.  As the author notes:

It’s not clear if our group got sick because of a particularly virulent variant, because the vaccine is wearing off or for some other reason. Without good data, we’ll never know.

It could also be that the vaccine is no match for extended indoor exposure to the Delta (or Gamma?) variant.  (Recall the case of the miners in South America.) 

COVID outbreak...at a beach?

MOVING TO FRONT FROM JULY 30--INTERESTING COMMENTS, BELOW (NOTE, IN PARTICULAR, THAT THE WEATHER WAS BAD THAT WEEKEND, SO MOST TRANSMISSION ALMOST CERTAINLY OCCURRED INDOORS)

This is allegedly why the Center for Disease Control in the U.S. has reinstituted mask mandates:

As of Thursday, 882 people were tied to the Provincetown outbreak. Among those living in Massachusetts, 74% of them were fully immunized, yet officials said the vast majority were also reporting symptoms. Seven people were reported hospitalized.

Before Provincetown, health officials had been operating under the assumption that it was extraordinarily rare for a vaccinated person to become infected with the virus. And if they did, they probably wouldn't end up passing it on to others, such as children too young to qualify for the vaccine or people who were medically vulnerable.

The idea that vaccines halt transmission of the virus was largely behind the CDC's decision in May suggesting vaccinated people could safely go without their masks indoors and in crowds, even if others were unvaccinated....

The Delta variant: both a higher viral load *and* a shorter incubation period

Informative.  The higher viral load has now been widely reported (and explains why it is more transmissible), but I hadn't seen the point about the incubation period before:  an average of four days, instead of six.

U.S. Court of Appeals upholds Indiana University vaccine mandate

A crisp and short opinion by my colleague Frank Easterbrook, which hopefully will influence any other court that has to consider these frivolous challenges.

Infection and vaccination in Singapore

Bear in mind that Singapore has fairly high vaccination rates (55% are full vaccinated, 75% have had at least one shot).  From the article:

Vaccinated individuals [BL:  not all fully vaccinated] accounted for three-quarters of Singapore's COVID-19 infections in the last four weeks, but they were not falling seriously ill, government data showed, as a rapid ramp-up in inoculations leaves fewer people unvaccinated.

While the data shows that vaccines are highly effective in preventing severe cases, it also underscores the risk that even those inoculated could be contagious, so that inoculation alone may not suffice to halt transmission.

"The Long Haul of Long Covid"

Philosopher and bioethicist Gregory Pence (Alabama) comments.

Farewell Delta variant, hello Gamma variant

The Gamma variant of the coronavirus--responsible for the devastating second outbreak of COVID in Manaus, Brazil earlier this year--is already four times more common than Delta in, for example, Illinois.  And while initial evidence is that the RNA-based Pfizer vaccine protects against Gamma, the CDC released yesterday an alarming report out of South America: