COVID-19 treatment and vaccine update thread

[Zaxxon]

All of my parent/in-law/grandparental units are now either vaccinated or scheduled to get their first shot within the next two weeks. Progress...

With vaccination rates continuing to slowly rise, it looks like the US is tracking toward approximately 100M doses administered by spring break in mid-March. I wonder what the inevitable case spike will look like in late March. Is 100M enough to significantly blunt the effect of dumb spring breakers?

Obviously it's not nearly enough to prevent a spike, but I don't have a solid grasp of what to expect with 100M shots, or say 40M fully vaccinated plus another 30M previously infected and recovered.

[Blackhawk]

Can you get the 1 shot type now and in some time...like maybe a few months....get one of the 2 shot types?

I can't imagine them, with the way things are, double-vaccinating people when some people aren't vaccinated at all.

[stessier]

Can you get the 1 shot type now and in some time...like maybe a few months....get one of the 2 shot types?

I can't imagine them, with the way things are, double-vaccinating people when some people aren't vaccinated at all.

Given the current state of the roll out, though, it's almost a certainty you could if you tried.

[Blackhawk]

That's true. And if you could live with the fact that you got vaccinated twice while people who couldn't get vaccinated died...

Well, sadly, I suppose you'd fit in with modern society pretty well.

[LordMortis]

All of my parent/in-law/grandparental units are now either vaccinated or scheduled to get their first shot within the next two weeks. Progress...

With vaccination rates continuing to slowly rise, it looks like the US is tracking toward approximately 100M doses administered by spring break in mid-March. I wonder what the inevitable case spike will look like in late March. Is 100M enough to significantly blunt the effect of dumb spring breakers?

Obviously it's not nearly enough to prevent a spike, but I don't have a solid grasp of what to expect with 100M shots, or say 40M fully vaccinated plus another 30M previously infected and recovered.

One would hope vaccination rate plus previously infected rate should make a big dent... One would hope... If we hit 35 million vaccinated (100 Million/2 - half vaccinated) and we add in better social hygiene than 2020 and we add in 28 Million reported infections, one would really have to hope things are getting better. But it's not just spring breakers that will contribute. It will be a full nation suffering from a year's worth of pent up spring fever. Everyone wants this done and those willing to break ranks are growing. Spring? Where the days are beautiful but the nights are still chilly and they take the party indoors... Heh.

[Zaxxon]

Oh, I know it'll help. I guess my question (for the Smooves of the world) is--do we have any quantifiable idea of *how much* it'll help given the likely numbers and given that many, many people will likely be very, very dumb in about a month?

Do we see a spike that's 1/2 what we saw at Christmas? 1/4th? 1/10th?

[LordMortis]

Oh, I know it'll help. I guess my question (for the Smooves of the world) is--do we have any quantifiable idea of *how much* it'll help given the likely numbers and given that many, many people will likely be very, very dumb in about a month?

Do we see a spike that's 1/2 what we saw at Christmas? 1/4th? 1/10th?

Warmer. Outdoors. The question will be, are we down to March 2020 levels in areas that were infected in March 2020 and are we still dropping instead of spiking... One would hope... Being self centered and part of the second wave after the NY wave was in full swing I'm looking at where we are hoping to see a better March 2021 than we had for March 2020 in spite of the fact that I know we're going to be nearly as bad in behavior in 2021 as we were 2020. The later because people are done with this shit (no matter if this shit isn't done). The former because people refused to accept the seriousness of this shit.

[Jaymon]

A Few Covid Vaccine Recipients Developed a Rare Blood Disorder

One day after receiving her first dose of Moderna’s Covid vaccine, Luz Legaspi, 72, woke up with bruises on her arms and legs, and blisters that bled inside her mouth.

She was hospitalized in New York City that day, Jan. 19, with a severe case of immune thrombocytopenia — a lack of platelets, a blood component essential for clotting.

The same condition led to the death in January of Dr. Gregory Michael, 56, an obstetrician in Miami Beach whose symptoms appeared three days after he received the Pfizer-BioNTech vaccine. Treatments failed to restore his platelets, and after two weeks in the hospital he died from a brain hemorrhage.

It is not known whether this blood disorder is related to the Covid vaccines. More than 31 million people in the United States have received at least one dose, and 36 similar cases had been reported to the government’s Vaccine Adverse Event Reporting System, VAERS, by the end of January. The cases involved either the Pfizer-BioNTech or Moderna vaccine, the only two authorized so far for emergency use in the United States.

Hematologists with expertise in treating immune thrombocytopenia said they suspected that the vaccine did play a role. But they said that cases after vaccination were likely to be exceedingly rare, possibly the result of an unknown predisposition in some people to react to the vaccine by developing an immune response that destroys their platelets. The disorder has occurred, rarely, in people who received other inoculations, particularly the measles-mumps-rubella one.

“I think it is possible that there is an association,” Dr. James Bussel, a hematologist and professor emeritus at Weill Cornell Medicine who has written more than 300 scientific articles on the platelet disorder, said in an interview. “I’m assuming there’s something that made the people who developed thrombocytopenia susceptible, given what a tiny percentage of recipients they are.”

He added: “Having it happen after a vaccine is well-known and has been seen with many other vaccines. Why it happens, we don’t know.”

I'm going to have to research this more.
Me and some of my family members have a rare blood disorder. Not "immune thrombocytopenia", but a different one that also involves lack of clotting.

[Daehawk]

I need a new mask but Im not really one to trust stuff like this from online places like Amazon. Ive seen packs of like 50 black medical mask for $10 but that seems cheap and who makes medical masks black? My current mask is a farmers market stall bought double cloth one where the ear loops have stretched. It wont stay up. But I began to not be happy with it before that. It looks cool but I didn't feel it was super protective. For now Im just going to tie a knot near the ends to make it fit tighter.

But I do need a mask or masks. And I cant afford a good one. But Id like the best crap i can get.

[Ralph-Wiggum]

My 100 year old grandmother in NC got her second dose the other week. She had a mild reaction but nothing a Tylenol couldn't clear up. My parents, also in NC, who are in their 70s have also both been vaccinated; my dad got his second dose last week (no reaction) and my mom is scheduled to get hers this weekend. She had a bit of a reaction to the first dose at the injection site, but otherwise was fine. One if my brothers (CC) and his wife, both in their mid 40s, in TX have also now been vaccinated. So in the immediate family that just leaves my oldest brother (NY, late 40s) and me (SC, early 40s) and neither of us have any idea when we might be eligible. The whole every-state-makes-their-own-rules really makes it a crapshoot.

[ImLawBoy]

FWIW, my arm is sore as hell at the injection site. Worse than any other vaccine I've ever had. That's it, though, so not too bad. My parents get their second doses coming up soon. My sister (early 50s) got hers a while ago in TX.

I suppose it's too late for the feds to fully take over the vaccination rollout. I'm in disbelief that MHS and her daughter don't qualify already. In Illinois, to make things even more fun, they've opened things up to people with "underlying conditions", except Chicago does it differently than the rest of the state, and they aren't opening it up to underlying conditions yet. I got mine because I'm considered a caregiver for my son, despite the fact that my son wouldn't qualify yet (even if he were old enough). It's all weird.

[LordMortis]

I'm going to have to research this more.
Me and some of my family members have a rare blood disorder. Not "immune thrombocytopenia", but a different one that also involves lack of clotting.

My mothers side of the family has a rare blood protein that our blood like mud, so clotting, not a problem... Unless you look at hemophilia on my fathers side... D'oh!!!!

[gilraen]

Ive seen packs of like 50 black medical mask for $10 but that seems cheap and who makes medical masks black?

Our Costco sells 50 masks for $10, and they are black.

[Smoove_B]

Oh, I know it'll help. I guess my question (for the Smooves of the world) is--do we have any quantifiable idea of *how much* it'll help given the likely numbers and given that many, many people will likely be very, very dumb in about a month?

Do we see a spike that's 1/2 what we saw at Christmas? 1/4th? 1/10th?

It's a good question. Cases are dropping right now and no one seems to know why. It's not vaccination and it's certainly not "herd immunity", so there's still some etiological elements we don't understand. There are guesses, but the answer might actually be, "it's complicated".

I've seen a few modelers concerned that this spring is going to be worse than we're thinking because our baseline number of cases is different in Spring 2021 vs Spring 2020 (where we ended up having a significant dip nationwide late spring into summer).

I guess everything I've seen is suggesting vaccination is helping, but it's going to likely be 5= months of insane vaccinations (so: June) before we can really see an appreciable impact nationwide.

So much depends on where you live and what's happening. I'm thrilled to see so many people here getting vaccines. My own parents finally started their shots last week. But me? I'm guessing it'll be another month before I get my first shot and for my wife? Maybe April or May. Once again the patchwork nature of public health and public health response is going to change how people view this, and that's unfortunate.

[$iljanus]

After a clown show rollout, MA's government is getting pressured to do what they should have done all along -- set up a central registry and contact people when an appointment is available for them. Of course that will take awhile to set up and implement. Meanwhile, we're still near the bottom in % of residents immunized. Since neither Wife nor I are in the current risk cohort, we haven't even tried to navigate the system. Our number is supposed to come up in April.

The hospital system I get my medical care from has been really good about letting me know about eligibility and said they would reach out to me when I was eligible...until Baker turned into the hungry hungry hippo and gobbled up all the vaccines for use in the 4 (or 5 now?) mass vaccination sites in the state. Now I'm told to sit tight.

[Zaxxon]

Oh, I know it'll help. I guess my question (for the Smooves of the world) is--do we have any quantifiable idea of *how much* it'll help given the likely numbers and given that many, many people will likely be very, very dumb in about a month?

Do we see a spike that's 1/2 what we saw at Christmas? 1/4th? 1/10th?

It's a good question. Cases are dropping right now and no one seems to know why. It's not vaccination and it's certainly not "herd immunity", so there's still some etiological elements we don't understand. There are guesses, but the answer might actually be, "it's complicated".

I've seen a few modelers concerned that this spring is going to be worse than we're thinking because our baseline number of cases is different in Spring 2021 vs Spring 2020 (where we ended up having a significant dip nationwide late spring into summer).

I guess everything I've seen is suggesting vaccination is helping, but it's going to likely be 5= months of insane vaccinations (so: June) before we can really see an appreciable impact nationwide.

So much depends on where you live and what's happening. I'm thrilled to see so many people here getting vaccines. My own parents finally started their shots last week. But me? I'm guessing it'll be another month before I get my first shot and for my wife? Maybe April or May. Once again the patchwork nature of public health and public health response is going to change how people view this, and that's unfortunate.

Good info. Also, today I learned that etiological is a word.

I have internally calibrated myself to expect a late June vaccination for myself. if April or May happen, I'll be ecstatic. In the meantime, I just hope to see the vaccinations/day counter continue to slowly tick upward.

[El Guapo]

Oh, I know it'll help. I guess my question (for the Smooves of the world) is--do we have any quantifiable idea of *how much* it'll help given the likely numbers and given that many, many people will likely be very, very dumb in about a month?

Do we see a spike that's 1/2 what we saw at Christmas? 1/4th? 1/10th?

It's a good question. Cases are dropping right now and no one seems to know why. It's not vaccination and it's certainly not "herd immunity", so there's still some etiological elements we don't understand. There are guesses, but the answer might actually be, "it's complicated".

I've seen a few modelers concerned that this spring is going to be worse than we're thinking because our baseline number of cases is different in Spring 2021 vs Spring 2020 (where we ended up having a significant dip nationwide late spring into summer).

I guess everything I've seen is suggesting vaccination is helping, but it's going to likely be 5= months of insane vaccinations (so: June) before we can really see an appreciable impact nationwide.

So much depends on where you live and what's happening. I'm thrilled to see so many people here getting vaccines. My own parents finally started their shots last week. But me? I'm guessing it'll be another month before I get my first shot and for my wife? Maybe April or May. Once again the patchwork nature of public health and public health response is going to change how people view this, and that's unfortunate.

What are the main theories for the drop, at least as to the U.S.? Seems like the most likely explanations are some combination of seasonality + people getting more cautious as cases hit highs and/or because vaccination is in sight + some vaccination effect?

[Smoove_B]

Seems like the most likely explanations are some combination of seasonality + people getting more cautious as cases hit highs and/or because vaccination is in sight + some vaccination effect?

Plus seroprevalence - how many people have been exposed and have developed partial immunity. Remember, we have no idea the true number of cases and deaths, even almost a year later. We're likely significantly underestimating and that's not something we're going to fix any time soon.

The seasonality element is interesting for sure, but there's really strong arguments for and against it. Even with behavior, in some places no one is doing anything and in others we're still in a modified reduced existence. It's too early for vaccination to be causing rates to drop this quick, so it's probably some wacky combination of a number of things - including things we don't understand or have figured out.

As I said waaaaaay back in March of last year. Normally I love this stuff - learning about new diseases and how they move through populations. Experiencing it as part of a novel pandemic isn't nearly as enjoyable.

[LordMortis]

Also, today I learned that etiological is a word.

I knew that one! Today I learned seroprevalence is a word. Firefox thinks I'm wrong.

[jztemple2]

I need a new mask but Im not really one to trust stuff like this from online places like Amazon. Ive seen packs of like 50 black medical mask for $10 but that seems cheap and who makes medical masks black? My current mask is a farmers market stall bought double cloth one where the ear loops have stretched. It wont stay up. But I began to not be happy with it before that. It looks cool but I didn't feel it was super protective. For now Im just going to tie a knot near the ends to make it fit tighter.

But I do need a mask or masks. And I cant afford a good one. But Id like the best crap i can get.

This pack of masks from Amazon is what I'm wearing. Supposedly they are disposable but since I just wear them when shopping or going in and out of a store I get a lot of wear out of just one mask. They have a nose wire to allow you to pinch it in. Ten masks in a pack, $4.99 and one day shipping from Amazon Prime.



UPDATE: Forgot to mention that I've been using them since last July, haven't had one that was poorly made.

[Zaxxon]

Interesting write-up by Kottke.

[LordMortis]

Interesting write-up by Kottke.

Post holiday spread and isolating from cold make the most sense to me. Looking at national and local rates all the huge decline is to me is we are down to pre-thanksgiving levels, while having already spread conferred immunity/harm to a chunk of those that broke ranks in that time.

[Blackhawk]

The idea that those concerned with safety and those who are not are almost functioning as separate populations was interesting.

[Daehawk]

I need a new mask but Im not really one to trust stuff like this from online places like Amazon. Ive seen packs of like 50 black medical mask for $10 but that seems cheap and who makes medical masks black? My current mask is a farmers market stall bought double cloth one where the ear loops have stretched. It wont stay up. But I began to not be happy with it before that. It looks cool but I didn't feel it was super protective. For now Im just going to tie a knot near the ends to make it fit tighter.

But I do need a mask or masks. And I cant afford a good one. But Id like the best crap i can get.

This pack of masks from Amazon is what I'm wearing. Supposedly they are disposable but since I just wear them when shopping or going in and out of a store I get a lot of wear out of just one mask. They have a nose wire to allow you to pinch it in. Ten masks in a pack, $4.99 and one day shipping from Amazon Prime.

UPDATE: Forgot to mention that I've been using them since last July, haven't had one that was poorly made.

Hmmm thats good and cheap. Not stylish But fine for prevention of the crude. Also I could qualify for Prime at the $6 price point. Just not sure id use it for anything else...but never know. Ill see the start of next month.

[Isgrimnur]

The idea that those concerned with safety and those who are not are almost functioning as separate populations was interesting.

reddit Tales from your Server and Tales from the Front Desk are full of those stories.

[El Guapo]

Massachusetts expanded eligibility to 65+. Adding a million people to the eligiblity has led the website to crash.

What's curious is this is the error page:



Leads me to think that at least one of you worked on the page...

[Blackhawk]

No, it was someone from quadrapusoverlords.com .

[El Guapo]

No, it was someone from quadrapusoverlords.com .

I assume the other four tentacles are behind the four that we can see.

[Daehawk]

Read that as testicles.

[Unagi]

Read that as testicles.

Read that as tentacles.

[Moat_Man]

No, it was someone from quadrapusoverlords.com .

I assume the other four tentacles are behind the four that we can see.

I thought it was a fourktopus.

[El Guapo]

No, it was someone from quadrapusoverlords.com .

I assume the other four tentacles are behind the four that we can see.

I thought it was a fourktopus.

Seriously though - what is that supposed to be? My best guess is a confused octopus on a cloud. But like...why would that be the error image?

[Moat_Man]

No, it was someone from quadrapusoverlords.com .

I assume the other four tentacles are behind the four that we can see.

I thought it was a fourktopus.

Seriously though - what is that supposed to be? My best guess is a confused octopus on a cloud. But like...why would that be the error image?

I'm with you for it being a confused octopus on a cloud. I get the cloud part but the octopus doesn't make any sense. It's not like the state mollusk is an octopus. (spoiler alert, Massachusetts doesn't have a state mollusk). They don't even range much north of cape cod because of the colder water.

[Paingod]

I've had Herpes Simplex since I was a stupid 16-year old that kissed a girl with an outbreak. In times of stress I might get a cold sore. In times of great stress I might get 4 to 6 at once.

After the COVID vaccine (where I felt like crap for around 36 hours), I had an outbreak on par with a high stress event, although it also included the skin next to my mouth - which is a spot I've never had sores on. It's always been the lips. All focused on the left side on my face.

Never been so glad to wear a mask all the time.

[Unagi]

No, it was someone from quadrapusoverlords.com .

I assume the other four tentacles are behind the four that we can see.

I thought it was a fourktopus.

Seriously though - what is that supposed to be? My best guess is a confused octopus on a cloud. But like...why would that be the error image?

It’s the Cloud Kraken and he has come to represent great trouble in the cloud.


But really I think it’s an Octopus Cloud app.

[stessier]

When I saw it before I read any thoughts on it, I saw a person flexing both arms while clicking their heels together.

[Daehawk]

Pfizer Vaccine Is Highly Effective After One Dose and Can Be Stored in Normal Freezers, Data Shows

The Covid-19 vaccine developed by Pfizer Inc. and BioNTech SE generates robust immunity after one dose and can be stored in ordinary freezers instead of at ultracold temperatures, according to new research and data released by the companies.A single shot of the vaccine is 85% effective in preventing symptomatic disease 15 to 28 days after being administered, according to a peer-reviewed study conducted by the Israeli government-owned Sheba Medical Center and published in the Lancet medical journal. Pfizer and BioNTech recommend that a second dose is administered 21 days after the first.

[Anonymous Bosch]

Here's an interestingly optimistic -- and likely controversial -- WSJ op-ed from a professor at the Johns Hopkins School of Medicine and Bloomberg School of Public Health (and here's hoping his prediction holds true):

We’ll Have Herd Immunity by April

Covid cases have dropped 77% in six weeks. Experts should level with the public about the good news.

Amid the dire Covid warnings, one crucial fact has been largely ignored: Cases are down 77% over the past six weeks. If a medication slashed cases by 77%, we’d call it a miracle pill. Why is the number of cases plummeting much faster than experts predicted?

In large part because natural immunity from prior infection is far more common than can be measured by testing. Testing has been capturing only from 10% to 25% of infections, depending on when during the pandemic someone got the virus. Applying a time-weighted case capture average of 1 in 6.5 to the cumulative 28 million confirmed cases would mean about 55% of Americans have natural immunity.

Now add people getting vaccinated. As of this week, 15% of Americans have received the vaccine, and the figure is rising fast. Former Food and Drug Commissioner Scott Gottlieb estimates 250 million doses will have been delivered to some 150 million people by the end of March.

There is reason to think the country is racing toward an extremely low level of infection. As more people have been infected, most of whom have mild or no symptoms, there are fewer Americans left to be infected. At the current trajectory, I expect Covid will be mostly gone by April, allowing Americans to resume normal life.

Antibody studies almost certainly underestimate natural immunity. Antibody testing doesn’t capture antigen-specific T-cells, which develop “memory” once they are activated by the virus. Survivors of the 1918 Spanish flu were found in 2008—90 years later—to have memory cells still able to produce neutralizing antibodies.

Researchers at Sweden’s Karolinska Institute found that the percentage of people mounting a T-cell response after mild or asymptomatic Covid-19 infection consistently exceeded the percentage with detectable antibodies. T-cell immunity was even present in people who were exposed to infected family members but never developed symptoms. A group of U.K. scientists in September pointed out that the medical community may be under-appreciating the prevalence of immunity from activated T-cells.

Covid-19 deaths in the U.S. would also suggest much broader immunity than recognized. About 1 in 600 Americans has died of Covid-19, which translates to a population fatality rate of about 0.15%. The Covid-19 infection fatality rate is about 0.23%. These numbers indicate that roughly two-thirds of the U.S. population has had the infection.

In my own conversations with medical experts, I have noticed that they too often dismiss natural immunity, arguing that we don’t have data. The data certainly doesn’t fit the classic randomized-controlled-trial model of the old-guard medical establishment. There’s no control group. But the observational data is compelling.

I have argued for months that we could save more American lives if those with prior Covid-19 infection forgo vaccines until all vulnerable seniors get their first dose. Several studies demonstrate that natural immunity should protect those who had Covid-19 until more vaccines are available. Half my friends in the medical community told me: Good idea. The other half said there isn’t enough data on natural immunity, despite the fact that reinfections have occurred in less than 1% of people—and when they do occur, the cases are mild.

But the consistent and rapid decline in daily cases since Jan. 8 can be explained only by natural immunity. Behavior didn’t suddenly improve over the holidays; Americans traveled more over Christmas than they had since March. Vaccines also don’t explain the steep decline in January. Vaccination rates were low and they take weeks to kick in.

My prediction that Covid-19 will be mostly gone by April is based on laboratory data, mathematical data, published literature and conversations with experts. But it’s also based on direct observation of how hard testing has been to get, especially for the poor. If you live in a wealthy community where worried people are vigilant about getting tested, you might think that most infections are captured by testing. But if you have seen the many barriers to testing for low-income Americans, you might think that very few infections have been captured at testing centers. Keep in mind that most infections are asymptomatic, which still triggers natural immunity.

Many experts, along with politicians and journalists, are afraid to talk about herd immunity. The term has political overtones because some suggested the U.S. simply let Covid rip to achieve herd immunity. That was a reckless idea. But herd immunity is the inevitable result of viral spread and vaccination. When the chain of virus transmission has been broken in multiple places, it’s harder for it to spread—and that includes the new strains.

Herd immunity has been well-documented in the Brazilian city of Manaus, where researchers in the Lancet reported the prevalence of prior Covid-19 infection to be 76%, resulting in a significant slowing of the infection. Doctors are watching a new strain that threatens to evade prior immunity. But countries where new variants have emerged, such as the U.K., South Africa and Brazil, are also seeing significant declines in daily new cases. The risk of new variants mutating around the prior vaccinated or natural immunity should be a reminder that Covid-19 will persist for decades after the pandemic is over. It should also instill a sense of urgency to develop, authorize and administer a vaccine targeted to new variants.

Some medical experts privately agreed with my prediction that there may be very little Covid-19 by April but suggested that I not to talk publicly about herd immunity because people might become complacent and fail to take precautions or might decline the vaccine. But scientists shouldn’t try to manipulate the public by hiding the truth. As we encourage everyone to get a vaccine, we also need to reopen schools and society to limit the damage of closures and prolonged isolation. Contingency planning for an open economy by April can deliver hope to those in despair and to those who have made large personal sacrifices.

[hitbyambulance]

Here's an interestingly optimistic -- and likely controversial -- WSJ op-ed from a professor at the Johns Hopkins School of Medicine and Bloomberg School of Public Health (and here's hoping his prediction holds true):

discussion on this opinion is here in the other thread

[Lorini]

nvm