Leiter Reports: A Philosophy Blog

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:

COVID vaccines on campus

Many readers will  probably have seen that Indiana University's mandate for vaccination has survived a legal challenge, which is not surprising given that the Supreme Court has recognized the constitutionality of state-mandated vaccination more than a century ago.  Meanwhile, Boston College, a private Catholic university, is facing backlash because it has taken the reasonable and correct position that being Catholic is not grounds for a religious exemption from vaccination:

BC said in a statement that because Pope Francis told Catholics they have a moral obligation to take the vaccine, an exemption is not being granted to members of that faith. Other religious exemptions will be reviewed case-by-case.

All I can say is:  God bless them!  Exemptions from mandatory vaccination schemes are a classic case of burden-shifting exemptions, ones that imposes risks on others.   Very few religious traditions actually object to vaccination, and Catholicism is not one of them.

Alex Berenson, the world's dumbest journalist, redux

A good overview of the serial misinformation emanating from this malevolent buffoon, whom we've noted before.   Karl Kraus:  "No ideas the ability to express them:  that's a journalist!"

An overview of research on vaccine effectiveness against the Delta variant

Mostly good news, although it's clear that the vaccines do not work as well against Delta as they did earlier variants.

Vaccines and the Delta variant, and what lies ahead for America

Informative Twitter thread from a physician at the University of California, San Francisco; an excerpt:

If you’re fully vaxxed, I wouldn’t be too worried, especially if you’re in a highly vaxxed region....

[U]nvaxxed may well do OK for a while, probably through summer [due to the large number of vaccinated people]. But fall/winter now scares me a lot, much more than it did 2 weeks ago....

[F]or Delta, Pfizer dose 1 is only ~33% protective. https://gov.uk/government/news/vaccines-highly-effective-against-b-1-617-2-variant-after-2-doses This creates 2 problems: 1) People stay vulnerable until after shot 2 (& many let guard down earlier); 2) Loss in efficacy for dose 1 points to some degree of vaccine/immune escape. And – though this isn’t proven – I’d worry that a fully vaccinated elder, or someone whose immunity stems from an infection >12 mths ago, won’t be sufficiently protected over time, if immunity falls below a threshold needed to thwart Delta....

More on the COVID lab leak hypothesis

This looks to be a balanced evaluation of the evidence; bottom line is that the evidence doesn't rule out a leak from a virology lab, but the evidence is also compatible with a natural origin.

(Thanks to Dr. Roger Albin for the pointer.)

Sign of the COVID times...

...Chicago reported only 62 new cases of COVID in the entire city yesterday--that's by far the lowest daily total since testing began more than 14 months ago.

Did the coronavirus escape from a virology lab in Wuhan?

Here's a detailed and sober abductive argument that it did, although it's not conclusive.

(Thanks to Roger Crisp for the pointer.)

List of colleges now requiring students and/or employees to be vaccinated

At CHE.

How effective are the COVID vaccines?

Really effective.  (There's more at biologist Jerry Coyne's blog, where I first saw this.)

COVID indoor safety guidelines

This is interesting (it allows you to calculate risk and "best practices" for different scenarios).

(Thanks to Jeff Roland for the pointer.)

American College Health Association recommends all colleges mandate vaccination for COVID before fall enrollment

This is obviously sensible, and will give ammunition to schools in benighted states who will no doubt face opposition from local politicians of a certain flavor.  Colleges already mandate vaccinations for many illnesses, the only thing new here is the disease.

(Thanks to Jeff Roland for the pointer.)

Excess mortality due to COVID (directly or indirectly)

Useful representation of the data by sociologist Kieran Healy (Duke).

What the experts still want to know about COVID and the virus that causes it

Alas, there's still a lot to learn, from how long immunity lasts, to how variants will affect vaccines, to why some suffer "long COVID" while others don't even develop symptoms.

(Thanks to Dean Rowan for the pointer.)

University of California and California State University systems will require COVID vaccine as condition of enrollment...

...as well they should.  Every university in the country should follow suit, although I'm sure public universities in benighted states will face obstacles.

(Thanks to Robert McGarvey for the pointer.)

UPDATE:  And now the University of Maryland.  (Thanks to Peter Carruthers for the pointer.)  Feel free to add more in the comments.

Bolsonaro's crime against humanity

What a despicable monster.

Pfizer vaccine less effective against South Africa variant

UPDATE:   The news article misreports the results, probably because the lab itself communicates so poorly (you have to skip all the way down to #6 in the tweet thread for the point to finally be made clear).  In fact, there were no cases of infection by the South African variant two weeks after the second dose!  The variant did better than expected at infecting people before that time.  So, in fact, once fully faccinated, Pfizer is highly protective even against the South African variant!  Both the journalists and the lab deserve the blame here for poor communication of the results.  (Thanks to Matthew Noah Smith for calling my attention to this.)

Although how much less effective we still don't know:

A team from Tel Aviv University and the Clalit healthcare organization sequenced the swabs of 150 Israelis who tested positive for COVID-19 despite having been vaccinated.

In their study, the prevalence of the South African strain among vaccinated individuals who were infected despite their inoculation was eight times higher than its prevalence in the unvaccinated infected population. Though the number of such infections among the vaccinated was relatively small, the findings indicated that this variant was far more successful in getting through vaccinated individuals’ defenses than other strains.

“Based on patterns in the general population, we would have expected just one case of the South African variant, but we saw eight,” Prof. Adi Stern, who headed the research, told The Times of Israel....

The research, which has been posted online but not yet peer-reviewed, is likely to raise questions about Pfizer’s own real-world study, which found that in South Africa, despite the local strain being prevalent, the vaccine was 100 percent effective.

More good news about the Pfizer and Moderna vaccines

Here; an excerpt:

A new study suggests the messenger RNA vaccines produced by Moderna and the Pfizer-BioNTech partnership appeared to be 90% effective in preventing Covid-19 infection in a real-world setting....

The study followed nearly 4,000 health care workers, first responders, and other essential workers in eight U.S. locations as the first Covid vaccines were rolled out starting in December. Participants were tested weekly to look for all cases of Covid infection, even asymptomatic ones.

In the period from Dec. 14, 2020, to March 13, 2021, nearly 75% of the workers in the cohort received at least one dose of one of the mRNA vaccines...

Informative news article comparing COVID vaccines

Here.  All the vaccines are quite good, but Pfizer and Moderna results are really quite remarkable.

Rutgers University announces that COVID vaccination will be required for all students for enrollment next fall

Good for them.  They will give medical and (unfortunately) religious exemptions.  Other colleges and lower schools should follow suit.

(Thanks to Robert McGarvey for the pointer.)

"How dangerous are the new COVID variants?"

This is an informative journalistic piece, that also explains the mechanisms in virtue of which the variants are more contagious.

Vaccines should be able to end the pandemic, despite new variants

So say some Harvard researchers (let's hope they're right!):

“What we’re seeing is that these variants don’t seem to affect T-cell immunity all that much and they [the T-cells] seem to be as effective in recognizing these variants as they do the original virus,” [Harvared medicine professor] Alter said. “What that means is that we actually have very important backup mechanisms built into our vaccines that will continue to provide protection against these newly emerging variants.”

A case of reinfection with the South African variant of the coronavirus

The patient was much sicker the second time.  Alarming, and hopefully anomalous.

(Thanks to Jason Brennan on FB for the pointer.)

The future of COVID: short-term, medium-term, long-term

Informative, as usual, from STAT News.

McGill University announces return to in-person classes in fall 2021

Here.  Have other schools already announced fall plans?  Feel free to include links to announcements in the comments.