Covid 19 increasing despite vaccinations

Andy Millar: 
 

Personally I find this a deeply unpleasant post. I cannot buy into the idea that it's ok to let 0.3% of the population suffer and die unnecessarily (and also that it's ok because many of those will be fat). 

Me neither.

BTW, Worldometer is not a WHO site. It is a data collection site in China, which I used for my Covid numbers before the JHU Dashboard was up and running.

I have spent much of my time since early February 2020 keeping up with the medical and epidemiological literature on Covid-19. I lead the SCSC working group on it.

The term “herd immunity” comes from immunology, and normally has been used to refer to the required efficacy of vaccines. It refers to the percentage of the population that needs to be immune to the disease for R to drop below 1. For the delta variant of SARS-CoV-2, it is 85%-90%, as far as anyone can tell.

The idea of just letting the virus spread until herd immunity was reached was apparently initial HMG policy (when it was thought that it lay around 65%-70%), until it was pointed out in mid-March 2020 by epidemiological modelling what that entailed in terms of NHS loading and deaths. Despite what NHS executives have said, there is also substantial evidence that the the NHS and ambulance service in many areas was indeed (what the rest of us would call) overwhelmed. 

People were also aghast at the social emergency in Lombardy, around Bergamo, in March 2020, where one of the most capable health services in the world was, in fact, overwhelmed. Indeed, they had problems even storing bodies until they could be buried or cremated. The scenes were ghastly.

Nevertheless, some British academics thought that the UK was close to “herd immunity” in Spring 2020, and promoted that view internationally, resulting in the Great Barrington Declaration (GBD). That is nowhere near a majority expert view in GB, for what I take to be obvious reasons.

The main problem is that bestowing the property of being “immune” on people who have had Covid-19, or who have been fully vaccinated, is facile. Quite apart from the efficacy of less than 100% for any vaccine, there are indications that any (vaccine- or illness-induced)  immunity, measured by antibodies, can wane quite fast (meaning well within a year).  It is not known at all what (form, or kind, or measure of) resistance to disease is conferred over the longer term by the rest of the immune system function. The original use of the concept of herd immunity was (a) dealing with a disease when immunity was conferred long-term, as with measles, mumps and rubella, or (b) immediately controlling an outbreak. We are in neither of those two cases with the Covid-19 pandemic. The majority expert view seems to be that it will become endemic.

Let's look at the difference between theory and practice. In my home city of Bielefeld, currently 87.5% of those eligible (over-12s) have been vaccinated, amounting to 77.5% of all residents. So we are “almost there”, are we? Well, our Rt is most definitely not below 1. Germany-wide, it was below 1 until 2021-09-25 but since then has been judged to be over 1, and currently is estimated at 1.28, with the 95% CI at 1.16-1.39 (from the RKI Friday report). So well over 1. In Bielefeld, numbers of infected have been rising again since 2021-10-12. The incidence (7-day rate of new infections per 100,000) was then just under 40. Now it is back over 70. We had 19 deaths in September; so far in October it is “only” 8. But the death rate runs some 3-4 weeks behind infection rates. 

It is at least as bad as a medium flu season, and we are only just into official flu season. Social distancing measures obliterated flu in 2020-21 but such measures have been relaxed and people don't seem to be paying that much attention to them any more. Some people are worried what is going to happen with health services when we are into flu season and as well are dealing with Covid-19 to at least a similar extent.

As a fully-vaccinated 70-year-old, David Spiegelhalter tells me I have the chances of severe disease of an unvaccinated 50-year-old. If HMG (or the government of any European country) decides to just “let it rip”, my cohort is going to be the one that suffers. That will result in an age war. It won't be pretty. There are plenty of 70 year olds with a lot of political clout.

I can't imagine any politician with a view to reelection taking that option. Thank heavens.

Andy Millar: 
 

Personally I find this a deeply unpleasant post. I cannot buy into the idea that it's ok to let 0.3% of the population suffer and die unnecessarily (and also that it's ok because many of those will be fat). 

Me neither.

BTW, Worldometer is not a WHO site. It is a data collection site in China, which I used for my Covid numbers before the JHU Dashboard was up and running.

I have spent much of my time since early February 2020 keeping up with the medical and epidemiological literature on Covid-19. I lead the SCSC working group on it.

The term “herd immunity” comes from immunology, and normally has been used to refer to the required efficacy of vaccines. It refers to the percentage of the population that needs to be immune to the disease for R to drop below 1. For the delta variant of SARS-CoV-2, it is 85%-90%, as far as anyone can tell.

The idea of just letting the virus spread until herd immunity was reached was apparently initial HMG policy (when it was thought that it lay around 65%-70%), until it was pointed out in mid-March 2020 by epidemiological modelling what that entailed in terms of NHS loading and deaths. Despite what NHS executives have said, there is also substantial evidence that the the NHS and ambulance service in many areas was indeed (what the rest of us would call) overwhelmed. 

People were also aghast at the social emergency in Lombardy, around Bergamo, in March 2020, where one of the most capable health services in the world was, in fact, overwhelmed. Indeed, they had problems even storing bodies until they could be buried or cremated. The scenes were ghastly.

Nevertheless, some British academics thought that the UK was close to “herd immunity” in Spring 2020, and promoted that view internationally, resulting in the Great Barrington Declaration (GBD). That is nowhere near a majority expert view in GB, for what I take to be obvious reasons.

The main problem is that bestowing the property of being “immune” on people who have had Covid-19, or who have been fully vaccinated, is facile. Quite apart from the efficacy of less than 100% for any vaccine, there are indications that any (vaccine- or illness-induced)  immunity, measured by antibodies, can wane quite fast (meaning well within a year).  It is not known at all what (form, or kind, or measure of) resistance to disease is conferred over the longer term by the rest of the immune system function. The original use of the concept of herd immunity was (a) dealing with a disease when immunity was conferred long-term, as with measles, mumps and rubella, or (b) immediately controlling an outbreak. We are in neither of those two cases with the Covid-19 pandemic. The majority expert view seems to be that it will become endemic.

Let's look at the difference between theory and practice. In my home city of Bielefeld, currently 87.5% of those eligible (over-12s) have been vaccinated, amounting to 77.5% of all residents. So we are “almost there”, are we? Well, our Rt is most definitely not below 1. Germany-wide, it was below 1 until 2021-09-25 but since then has been judged to be over 1, and currently is estimated at 1.28, with the 95% CI at 1.16-1.39 (from the RKI Friday report). So well over 1. In Bielefeld, numbers of infected have been rising again since 2021-10-12. The incidence (7-day rate of new infections per 100,000) was then just under 40. Now it is back over 70. We had 19 deaths in September; so far in October it is “only” 8. But the death rate runs some 3-4 weeks behind infection rates. 

It is at least as bad as a medium flu season, and we are only just into official flu season. Social distancing measures obliterated flu in 2020-21 but such measures have been relaxed and people don't seem to be paying that much attention to them any more. Some people are worried what is going to happen with health services when we are into flu season and as well are dealing with Covid-19 to at least a similar extent.

As a fully-vaccinated 70-year-old, David Spiegelhalter tells me I have the chances of severe disease of an unvaccinated 50-year-old. If HMG (or the government of any European country) decides to just “let it rip”, my cohort is going to be the one that suffers. That will result in an age war. It won't be pretty. There are plenty of 70 year olds with a lot of political clout.

I can't imagine any politician with a view to reelection taking that option. Thank heavens.