Corona Virus: It's a Marathon, Not a Sprint

[malchior]

Yeah, I posted it in the masking thread. I actually haven't seen too much about it - not sure why.

I imagine LA has pockets with low vax rates. Maybe they are seeing outbreaks there?

[Smoove_B]

I imagine LA has pockets with low vax rates. Maybe they are seeing outbreaks there?

LA county is sequencing cases and ~50% of them are coming back as Delta, at least that was the story a week or so ago. They're probably looking at the rise in variant cases and know how many unvaccinated people there are then that are in danger. This is a last ditch effort to try and stop the inevitable. It's appropriate, though I don't know how it will be received.

If this is the plan for other parts of America...it's not going to end well.

[malchior]

Yup. Less than promising. I'm not super excited for the fall. And I know a lot of folks who are convinced this is over.

[Smoove_B]

I was also concerned about the Fall, but I'm now thinking the time table has moved up. I am guessing there are meetings right now at the CDC to discuss how to possibly message the need for states to re-adopt indoor masking guidelines over the next 8 weeks.

Telling everyone to go mask free when < 50% of population in the U.S. were vaccinated might go down as one of the biggest blunders of this pandemic - and that's no small feat given how it started.

[LawBeefaroni]

Telling everyone to go mask free when < 50% of population in the U.S. were vaccinated might go down as one of the biggest blunders of this pandemic - and that's no small feat given how it started.

[stimpy]

A coworker of mine has had long term issues from Covid.
He has not been back to work for months.

Another coworker, who refused to get vaccinated due to some underlying health issues, tested positive on Friday.

Myself and the other person in my department are both vaccinated, but I'm left wondering if we need to be concerned about exposure.
She went for a test today and will get results in 24 -72 hours. I'm thinking about waiting to hear her results.

Bottom line is, even when vaccinated, finding out someone you were in contact with tested positive is still reason to be worried.
It's still an unknown.

[El Guapo]

I was also concerned about the Fall, but I'm now thinking the time table has moved up. I am guessing there are meetings right now at the CDC to discuss how to possibly message the need for states to re-adopt indoor masking guidelines over the next 8 weeks.

Telling everyone to go mask free when < 50% of population in the U.S. were vaccinated might go down as one of the biggest blunders of this pandemic - and that's no small feat given how it started.

Strictly speaking the CDC said you can go mask free *if* you're vaccinated. Though how things have gone has been pretty predictable in that respect. I was at a store the other day that had a sign that said "You don't need to wear a mask if you're vaccinated, but are strongly encouraged to wear one if you're not." Like they couldn't even say you are required to wear a mask if you're not vaccinated?

I wonder if there was any plausible way for the CDC to do this that would've kept masks for the unvaccinated.

[Smoove_B]

I wonder if there was any plausible way for the CDC to do this that would've kept masks for the unvaccinated.

Ultimately, no - because the individual states are always going to make the final call.

However, from a practical standpoint they could have come up with specific metrics as guidelines. Namely a "calculation" that states could use to determine if it's appropriate to remove mask mandates for indoor locations. The evaluation would need to incorporate community vaccination levels and the percent of people unvaccinated that could be (but aren't for whatever reason). On top of that, surveillance data (measuring transmission levels, dominant strain circulating, etc...) -- all of which requires funding and testing.\

The NBA figured it out. The NFL figured it out. Movie and entertainment studios apparently figured it all out.

The general public? Unwilling to engage in any discussions about the greater good. My sense is that there's also no appreciation for the fact that this is still an evolving crisis. I know many are in the "pandemic's over, it's BBQ time" mentality, but that's absolutely not true at all. Trying to come back and present the new case for masking up in light of Delta (or whatever is coming next) just isn't going to sell.

I'm of the mind it's too late. ~30% of the population refuses to vaccinate and ~20% can't be vaccinated (too young, medical consideration) or is vaccine hesitant. For the ~46% of us that are vaccinated, we're trying to do everything we can to protect that ~20% from the ~30% and vaccines aren't enough.

[Isgrimnur]

Like they couldn't even say you are required to wear a mask if you're not vaccinated?

That's how people get shot.

[Jaymon]

I'll wear my mask as long as it takes to protect that 20%, but I am damn sick and tired of protecting that 30%

How much is my health insurance going to go up in cost because they have to pay for the unvaccinated?
is there going to start being a "unvaccinated person' line item on health insurance, just like there is a 'uninsured motorist" item on car insurance.


I'm just so angry at those people

[LordMortis]

Expanded my world to hit Target on the way home. Virtually no one was wearing a mask, not even employees. I'm not ready yet. Not even with numbers as low as they are.

[Smoove_B]

Bigger picture happenings in America:

This likely represents the Delta variant inflection point for the US, as cases start to increase in several states (log plot to show trend). Let's hope the rise is limited and without much in the way of hospitalizations and deaths. A lot more people vaccinated would sure help

That first peak is post-holiday impact and the second (I think) is post Easter.

[Ralph-Wiggum]

Good thing we don't have any holidays where people like to gather in close proximity coming up anytime soon...

[LordMortis]

I don't think it will be so bad outdoors. If it were earlier or later in the year and people moved inside while continuing to drink, I'd be more holiday concerned. As it goes, by comparison I'm OK, except with the stores. Oi, am I not OK with shopping right now.

[Smoove_B]

That'll be the rub - seeing if Delta is any more effective in outdoor transmission than OG SARS-CoV-2. In retrospect, that's likely what happened last summer. It wasn't until later in the season when southern states were driven indoors (for AC relief) because of higher temps and then the weather changed for everyone in the Fall that cases started to rise again.

I haven't seen any studies strongly confirming it, but from a purely observational standpoint that seems to be what happened. I thought we were going to see a bit of a bump in NJ because Memorial Day weekend was rainy. There was a bump in two of the coastal counties, but I'm not sure it's been linked to Memorial Day activities. Delta also hadn't been circulating here a month ago.

If Delta is going to be an issue for the next ~8 weeks, we could be going into the Fall with a higher amount of "seeded" cases ready to cause cluster outbreaks (like how our Spring 2021 had more cases than Spring 2020), but we're also looking at how many people are vaccinated and how many have already had COVID-19 (and aren't vaccinated)?

This is why epidemiologists get paid so much money (they don't) - to figure this stuff out.

[LordMortis]

Also you see post Easter. I see post St Pat's weekend. Of course, that's driven my my local glasses and having seen it happen two years in a row, which is also the glasses I see spending the day outside drinking and then being driven indoors cold, drunk, and close loud talking.

[Smoove_B]

Yeah it could be a mix of both as Easter was a bit early this year (4/4). It's honestly not as high as I would have expected to see (April bump), but that could be the impact of all those vaccinated in February (~50 million with one dose; ~25 million fully vaccinated).

As I said when this all started, there are going to be academics that make entire careers out of studying what happened and detailing out all these trends. It's going to be a topic in research for at least a decade or more.

[Smoove_B]

This is why epidemiologists get paid so much money (they don't) - to figure this stuff out.

In case anyone wants to see a rough attempt to math this:

How big of a wave of #COVID19 do we expect in the US from the Delta variant? Here I describe a simple approach to this question and attempt a rough back-of-the-envelop estimate. 1/16

He's not Nate Silver, but I'm confident he's reliable.

[El Guapo]

Smoove, looks like epidemiology is attracting some talent:



What's your time in the 200 meter race?

[coopasonic]

I'm sure he can come within 20 seconds a minute of her time...

[Smoove_B]

Yeah, her story is definitely making the rounds.

When I was at peak physical condition in high school (thanks wrestling coach!), I'm not sure I could have come within 20 seconds of her time. Smoove_B is not built for running (despite the pandemic being a marathon, not a sprint).

[coopasonic]

Speaking of marathons, my marathon of WFH ends officially one day short of 18 months. As of 9/7/2021 my employer is a hybrid workplace, M and F are WFH and the middle is in the office for most staff. No masks required for vaccinated staff, with self-reported vaccination numbers well ahead of the national average.

[Blackhawk]

From an Indiana perspective, and as an analog for most of the south, recommendations don't matter. Masks won't be coming back. There is no mechanism that is going to get people wearing them again.

That ship has sailed, and can't be counted on as a tool to address the pandemic.

[Isgrimnur]

I get the feeling that some of these small towns will no longer be economically viable.

[YellowKing]

From an Indiana perspective, and as an analog for most of the south, recommendations don't matter. Masks won't be coming back. There is no mechanism that is going to get people wearing them again.

I'd echo that even for the slightly more moderate NC. While Cooper's handling of the pandemic has been generally positive, putting in new mask mandates, however justified, would be political suicide IMO.

[Smoove_B]

I get the feeling that some of these small towns will no longer be economically viable.

I suspect many small/local businesses are holding on by the skin of their fingernails and when this next wave rolls through, depending on local vaccination levels and how many people are impacted (workers, customers), it might be the final nail. I would hope large-scale employers don't mothball their plans for remote working as I'm guessing there will be random school closures throughout the Fall and Winter, headed in 2022.

I mean, I'd like to be wrong on all this, but my gut is telling me that it's going to be a grim Fall and Winter for some parts of America.

[Smoove_B]

An excellent explainer article that covers the recent (6/21) study that was published linking brain damage to COVID-19 infection:

It can take years before scientists and physicians learn all the ways a new disease can affect people, both acutely while they have the disease and chronically with long-term issues that may not show up until years later. This reality has long been one of the concerns with Covid: Even in people with mild infections who fully recover, could there be lasting impacts on the heart, lungs or other organs that cause problems later, particularly given what we’ve already been learning about “long Covid”?

Unfortunately, evidence is building to say yes, though those issues won’t affect all people who had Covid, and we don’t yet know why they affect some people and not others. The most recent study to raise questions about long-term effects is one finding brain inflammation and other damage in the brain as a result of Covid-19 infection. The research raises far more questions than it answers.

...

They found damage in the brain tissue of the Covid patients that resembled the damage seen in diseases such as Alzheimer’s, schizophrenia, and depression. This damage was seen in a wide range of cell types. The patients with Covid-19 especially had damage in neurons linked to cognitive (thinking) ability.

The researchers did not find any evidence of the actual SARS-CoV-2 virus in the brain tissue. In other words, the physical virus itself does not appear to have penetrated the brain in these patients. However, the brain tissue of the Covid patients did have evidence of a much higher concentration of T cells than the brain tissue of the non-Covid patients. T cells are immune cells that patrol the body looking for pathogens. If the immune system suspects a part of the body is under attack, it will send more T cells to that area to check it out.

What does this mean:

This new study’s findings confirm previous research that has found lasting neurological effects from Covid-19 infection. It suggests that the symptoms people with long Covid have reported, such as “brain fog,” memory difficulties, fatigue and difficulty concentrating, may occur because of inflammation in the brain, but that’s not clear. It could be that the inflammation and the neurological effects are both caused by some other factor.

The specific effects the researchers found look similar to what occurs with cognitive disease (like dementia), schizophrenia, and depression. The researchers wrote that Covid-19 might therefore partially lead to the same physical processes that occur in the brain with other central nervous system diseases.

What about for people that are vaccinated that still get COVID-19?

The severity of the brain symptoms appears linked with the severity of infection, and vaccination reduces the likelihood and severity of infection. That means people vaccinated against Covid-19 are far, far, far less likely to develop neurological problems as a result of Covid-19.

As usual, it will take additional research to understand what all this means beyond what’s above.

[Smoove_B]

Still amazed at Ed Yong's ability to communicate. It's no wonder he's an award winning writer - even when using Twitter:

In a new piece, I lay out and explore 3 principles that now define the pandemic.

1) The vaccines are still beating the variants.
2) The variants are pummelling unvaccinated people.
3) The longer 2 continues, the less likely 1 will hold.

[El Guapo]

This is why epidemiologists get paid so much money (they don't) - to figure this stuff out.

In case anyone wants to see a rough attempt to math this:

How big of a wave of #COVID19 do we expect in the US from the Delta variant? Here I describe a simple approach to this question and attempt a rough back-of-the-envelop estimate. 1/16

He's not Nate Silver, but I'm confident he's reliable.

Nate Silver retweeted this, though, so now I'm not sure whether to take it seriously or dismiss the source out of hand.

[Alefroth]

That ship has sailed, and can't be counted on as a tool to address the pandemic.

Or any future ones, I suspect.

[Smoove_B]

Nate Silver retweeted this, though, so now I'm not sure whether to take it seriously or dismiss the source out of hand.

Trevor Bedford is a reliable source of information and has been since all this started. I am guessing Nate Silver blasted it out to get his army of experts to start picking it apart.

[El Guapo]

Nate Silver retweeted this, though, so now I'm not sure whether to take it seriously or dismiss the source out of hand.

Trevor Bedford is a reliable source of information and has been since all this started. I am guessing Nate Silver blasted it out to get his army of experts to start picking it apart.

The scoundrel retweeted it without comment.

[Smoove_B]

COVID-19 patients are being turned away from the overwhelmed Springfield region (Southwest MO) where cases are surging and taken to less-stressed hospitals in Kansas City and St. Louis.

I've seen updates from this morning indicating its continuing to escalate. I'm not going to lie, it's kind of blowing my mind that there are hospital systems on diversion this weekend because of a COVID-19 surge while other parts of America are partying and BBQing. To borrow from the great Corey Glover

I look at the T.V.
Your America's doing well
I look out the window
My America's catching hell

[Kraken]

I'm not going to lie, it's kind of blowing my mind that there are hospital systems on diversion this weekend because of a COVID-19 surge while other parts of America are partying and BBQing. To borrow from the great Corey Glover

I look at the T.V.
Your America's doing well
I look out the window
My America's catching hell

Mass. today has 98 covid patients hospitalized, with 28 of them in intensive care. We had one death. The 7-day positivity average is 0.42%. I don't mean to trivialize covid, but the situation is the best it's been since the pandemic took hold.

I have to wonder if Missourians and other red-staters realize that they have only themselves to blame, or even know that they're doing worse than average.

[Smoove_B]

I have to wonder if Missourians and other red-staters realize that they have only themselves to blame, or even know that they're doing worse than average.

I need to get more info because I'm not entire clear on the exact reason. There are definitely people in states like MO that are absolutely in the never-going-to-vaccinate demographic, likely tied to politics. However, what I don't have a handle on is how many people in these states that are seeing surges are in the "vaccine hesitant" and/or under-served (Isg!) populations that have barriers - like an inability to get to a location where vaccinations are being offered.

My point is, I feel nothing - and I truly mean this - nothing for the people at this point that are able to be vaccinated but have made the conscious decision to intentionally not vaccinate. I'm frustrated that their decisions potentially impact the health of everyone, but I also know my energy is better spent elsewhere, namely...

I am genuinely concerned for those that cannot be vaccinated (like kids), those that have lowered immunity and those that want to be vaccinated but are struggling.

[Smoove_B]

I already shared the story in Illinois, next it's a camp in Texas:

More than 125 adults and youth from a Galveston County church camp event have tested positive for COVID-19, the church said in a statement to its members.

The Clear Creek Community Church youth ministry camp was held at a facility near Giddings, Texas, last month.

"Unfortunately, upon return from camp, 125+ campers and adults reported to us that they tested positive for COVID-19," church officials said in a statement. "Additionally, hundreds more were exposed to COVID-19 at camp. And hundreds of others were likely exposed when infected people returned home from camp. We seek to remain in contact with those impacted. If you, or someone in your family, begins to have symptoms, please seek medical attention immediately."

Galveston County Health District officials said Friday they were investigating the outbreak at the five-day event that was attended by around 450 adults and children in sixth through 12th grades. The first case was reported to them on June 27.

Of note:

There was no word Saturday on if any of those infected had been vaccinated prior to the camp.

I'm not a betting man, but...

[Kraken]

Play stupid games, win stupid prizes.

[El Guapo]

What's the current thinking on how much a mask protects the wearer, as opposed to protecting others? As indoor mask wearing continues to decline in MA, I'm pondering how safe it is to take my kids into stores at the moment (obviously with them wearing masks). Vaccination rates are relatively high around here and cases are relatively low, but especially with Delta around I'm not sure.

[Kraken]

What's the current thinking on how much a mask protects the wearer, as opposed to protecting others? As indoor mask wearing continues to decline in MA, I'm pondering how safe it is to take my kids into stores at the moment (obviously with them wearing masks). Vaccination rates are relatively high around here and cases are relatively low, but especially with Delta around I'm not sure.

One other stat in addition to the ones I posted above: MA's infection rate is currently around 1:100,000. Enjoy the summer while it lasts, is how I see it. 'Course, I never get within 10' of any child if I can help it, but that was my policy before the pandemic.

[Smoove_B]

What's the current thinking on how much a mask protects the wearer, as opposed to protecting others?

The last big study I'm aware of was published back in January:

researchers at the University of Cambridge found that fabric face masks block 62.6 percent to 87.1 percent of fine particles, making them useful tools in the battle against the COVID-19 pandemic.

However:

there is limited information and studies on the effectiveness of non-medical grade masks in preventing SARS-CoV-2 transmission.

But:

The study findings showed that non-medical grade masks effectively blocked more than 50 percent of airborne particles. The simple fabric masks blocked between 50 percent and 75 percent of the particles. The filtration ability of the fabric masks differs markedly based on the design of the mask.

A simple two-layer thin cotton fabric masks blocked an average of 62.6 percent of particles, while the more sophisticated fabric masks with panels to cover the nose and chin and a PM2.5 filter blocked an average of 87.1 percent. Meanwhile, the N95 masks widely used in medical settings blocked about 99.6 percent of particles.

As Kraken pointed out, the levels of community spread are a big factor here as well and when levels are low, it's (generally) going to be safer to have them out and about. And yes, definitely enjoy the reprieve. Winter is coming.

EDIT: I guess some "study" was shared on JAMA for peer review, trying to show that masks are unhealthy for kids because it boosts CO2 levels or some other nonsense? I give up.