Thursday, September 02, 2021

Day 580: Long, Long, Long COVID

The rationalists are out in force on the controversial topic of Long COVID. Scott Alexander summarized the definitional chaos overnight, and Zvi summarized the meta impact on the COVIDosphere (as it were) today.

While Zvi continues to disbelieve in long COVID as anything more than just another long flu, and notes that a society-wide epidemic of depression and other mental illness is hiding (in plain sight) in the long COVID control group data. Scott, on the other hand, gives it too much credit by calling it a long Spanish Flu, though he agrees there's probably little to no long COVID in children. He also mentions that, otrangely, vaccination does not reduce the rate of long COVID in the infected.

PlagueBlog sides with Zvi; the only thing we need to fear is the fear of long COVID itself:
I agree with Scott’s view here that our worries about Long Covid strongly imply the need for more worry about Long Disease in general, and also Long Everything. The previous Aceso Under Glass post emphasized this point, that there’s lots of such risks in the background all the time, and this isn’t an especially big one.

More to the point, Long Covid Prevention has clearly reached crisis levels and really is a big deal, and seems more severe than Long Covid, and a huge percent of the population has this problem, so we need to do what it takes to stop this deadly syndrome in its tracks.
Massachusetts cases were up about a quarter of a percentage point again today.

Day 579 Retrospective: The Week That Dare Not Speak Its Name

It's been a summer of snarky remarks about orgies at Market Basket here at PlagueBlog Headquarters, but reading about Bear Week at Less Wrong reminded us that we have not properly blogged about the Provincetown delta scare that never was. It's perhaps too obvious here in Massachusetts what's going on in Provincetown all summer, but to the CDC a few non-fatal cases of delta during Bear Week has become an excuse to doubt the vaccine and send the nation back under the mask.

Bear Week was cancelled last year and (allegedly) toned down this year, but the bears still got an early start to it over the Fourth of July weekend and continued to party during the official dates of July 10th through the 18th. The CDC study's outbreak dates were July 6th through 25th, and their patient population was 85% male, or in other words, sick bears.

Believe it or not, the CDC's total failure to account for what we in the epidemiology field abbreviate MSM was not the only problem with the Provincetown study, nor was the other MSM's (mainstream media's) failure to report that it was Bear Week. Zvi at Less Wrong goes into more detail about the flawed report here and here.

From the second link, we must include Zvi's unrelated summary of our new social media COVID Stasi censors:
It’s about the new definition of misinformation, which as far as I can tell is information used to lead to a conclusion we don’t like.
Massachusetts cases were up a quarter of a percentage point again yesterday (Day 579).

Tuesday, August 31, 2021

Day 578: SpikeVax or StrikeVax?

Here at PlagueBlog we intended to report on the extra-metalness of SpikeVax, now shown to make twice as many antibodies as the less-metal-named Comirnaty. But the news overtook us that two vaccine leaders are leaving the FDA, apparently in protest of the Biden administration's recent foray into deciding who should get boosters and when.
A former senior FDA leader told Endpoints that they’re departing because they’re frustrated that CDC and their ACIP committee are involved in decisions that they think should be up to the FDA. The former FDAer also said he’s heard they’re upset with CBER director Peter Marks for not insisting that those decisions should be kept inside FDA. What finally did it for them was the White House getting ahead of FDA on booster shots.

FDA’s former acting chief scientist Luciana Borio added on Twitter, “FDA is losing two giants who helped bring us many safe and effective vaccines over decades of public service.”

“These two are the leaders for Biologic (vaccine) review in the US. They have a great team, but these two are the true leaders of CBER. A huge global loss if they both leave,” Former BARDA director Rick Bright wrote, weighing in on the news. “Dr. Gruber is much more than the Director. She is a global leader. Visionary mastermind behind global clinical regulatory science for flu, Ebola, Mers, Zika, Sars-cov-2, many others.”
Here in Massachusetts, cases were up almost a fourth of a percentage point today, after a dip down to a fifth daily since Thursday's high.

Friday, August 27, 2021

Day 574: Kids Still Unaffected

Despite some hand-wringing at The Atlantic, children remain statistically unaffected by COVID. Emily Oster (perhaps best known for Cribsheet: A Data-Driven Guide to Better, More Relaxed Parenting, from Birth to Preschool) has been blogging about the data to the end of reassuring freaked-out parents. As of her latest post, COVID is still barely even the flu for children:
The million dollar question: Does Delta change this? It is not completely clear. People, including the CDC Director, have cited more hospitalizations among children in heavily affected areas as evidence that Delta might be worse for kids. However, with more cases, we expect more hospitalizations. We saw this rise in pediatric hospitalizations last winter, as well, without Delta. Seeing more cases is different from saying that delta increases the hospitalization rate. There is also an increase in RSV in young children in many of the same areas COVID is spreading widely, complicating the analysis.

I would argue, though, that what we do know suggests the risks are in the same range. That the narrative that this is a new virus which is tremendously more dangerous for children is just simply not supported by the data.
Massachusetts cases were up a quarter of a percentage point yesterday, our biggest one-day jump since mid-April.

Monday, August 23, 2021

Day 570: Comirnaty

As rumored, the FDA approved Pfizer's COVID vaccine, Comirnaty, today, but only the first two jabs for those over 15. The rest of the protocol remains experimental, as does Moderna's far more pronounceable SpikeVax. The side effects of myocarditis and pericarditis, mainly in boys, got special attention.

P.S. Massachusetts cases were up about a seventh of a percentage point on Monday. (This number is derived from the merged weekend data and not indicative of much.)

Thursday, August 19, 2021

Day 566: Vexxed by the Unvaxxed

One-time skeptic and ongoing editor-in-chief of Skeptic magazine Michael Shermer recently wrote an article for Quillette about how vexxed he is by vaccine skeptics. After confessing to scolding an employee for her skepticism, he goes into the usual irrelevant risk analogies (yes, the vaccine is less risky than driving, but so is COVID itself), superficial political analysis (no, being pro-life doesn't automatically make you pro-vaxx anymore than it makes you anti-death-penalty), and conflation of vaccination against diseases of childhood with mass adult vaccination against a disease that barely affects children. Vaccine reluctance was summed up much better by a commenter (aptly pseudonamed Sane World):
There may be a fourth reason, not mentioned by the author, why people hesitate to get vaccinated. After the numerous drastic coercive measures of the last twenty months, many of which were previously unknown in liberal western democracies, some people may simply be tired of constantly being persuaded, exhorted, pressured, lied to, incited, coerced, bullied, humiliated, denounced, threatened, criminalized, and punished into submission to an increasingly totalitarian mode of government.
On the irony front, the governor of Texas has come down with COVID. Despite having just tested positive, being vaccinated, and showing no symptoms, he's being treated with Regeneron.

Massachusetts cases were up to a new local high of a fifth of a percentage point yesterday. Our governor remains uninfected.

P.S. Cases were up a fifth of a percentage point again on Thursday, and rumor has it that the Somerville city council Board of Health voted to put us back under the mask (indoors).

Tuesday, August 17, 2021

Day 563 Retrospective: Booster Shots

The New York Times reports that the Biden administration [sic] is recommending a booster shot of all three US vaccines after 8 months. At least they're waiting for the FDA to approve such a move, but it's unclear why a more relevant agency (the CDC, or at least the Surgeon General) is not doing the recommending. PlagueBlog would prefer medical advice on the matter as opposed to political advice, nor are we the only ones with doubts:
The regulatory path for additional shots is not entirely clear. Pfizer-BioNTech filed data to the F.D.A. on Monday that it said showed the safety and effectiveness of a booster shot. But the data was preliminary, from Phase 1 of a clinical trial. Moderna is on a similar track, exploring the safety and efficacy of both a half-dose and a full dose as a third shot.

The World Health Organization has called for a moratorium on booster shots until the end of September, saying available doses should be used to help countries that are far behind in vaccinations. But Israel is already offering third shots to those at least 50 years old.
Massachusetts cases were up a seventh of a percentage point on Monday. Our governor remains anti-mask, but is permitting cities and towns to gin up their own mask requirements.

Thursday, July 22, 2021

Day 538: Breaking Through

The New York Times addresses vaccine breakthrough cases:
An outbreak in Provincetown, Mass., illustrates how quickly a cluster can grow, given the right conditions. During its famed Fourth of July celebrations, the small town hosted more than 60,000 unmasked revelers, dancing and mingling in crowded bars and house parties.

The crowds this year were much larger than usual, said Adam Hunt, 55, an advertising executive who has lived in Provincetown part time for about 20 years. But the bars and clubs didn’t open until they were allowed to, Mr. Hunt noted: “We thought we were doing the right thing. We thought we were OK.”

Mr. Hunt did not become infected with the virus, but several of his vaccinated friends who had flown in from places as far as Hawaii and Alabama tested positive after their return. In all, the cluster has grown to at least 256 cases — including 66 visitors from other states — about two-thirds in vaccinated people.

“I did not expect that people who were vaccinated would be becoming positive at the rate that they were,” said Steve Katsurinis, chair of the Provincetown Board of Health. Provincetown has moved swiftly to contain the outbreak, reinstating a mask advisory and stepping up testing. It is conducting 250 tests a day, compared with about eight a day before July 1, Mr. Katsurinis said.

Health officials should also help the public understand that vaccines are doing what they are supposed to — preventing people from getting seriously ill, said Kristen Panthagani, a geneticist at Baylor College of Medicine who runs a blog explaining complex scientific concepts.

“Vaccine efficacy isn’t 100 percent — it never is,” she said. “We shouldn’t expect Covid vaccines to be perfect, either. That’s too high an expectation.”
Delta is doing a number on Israelis, who have determined that the Pfizer vaccine is now only 39% effective at preventing infection, though it continues to prevent 91% of serious illnesses and 88% of hospitalizations. Yes, those numbers are backwards; the article does not explain why 3% of cases are hospitalized for non-serious COVID.

Pfizer is due to finish long-term safety testing in May of 2023, not long after Moderna does. By then, we may even have an experimental vaccine against the common coronavirus.

In the US the CDC is holding firm on its no-mask guidance. While the delta variant has been shown to be big in Texas, our troubles are not all delta: Illinois reports more than six times as many gamma variant cases as delta variant ones.

Here in Massachusetts, cases are creeping back up and rose an entire thirteenth of a percentage point today, with cases averaging about 500 a day this week.