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COVID again.
Aug. 1st, 2021 04:12 pmI haven't posted about COVID for awhile, partly because everyone is sick of the topic but mostly because it seemed pretty clear how the game was going to play out. But just as we were rounding third base and heading for home plate, the delta variant arrived. There were concerning mutations before, but this one is a game-changer. In fact, it has me wondering exactly how much a virus has to mutate before we stop calling it a "variant" and give it a new major release number.
This isn't just a little more drift towards increased virulence - the symptoms are different and everything we've learned so far about how to protect ourselves from infection is called into question. People are catching it outdoors now, something that was actually pretty rare with the OG virus. There are now documented cases of people being infected by passing an infected person in the mall. The chances of household spread have jumped from a surprisingly anemic 25% to 90%. A crew of airplane cleaners was reportedly infected - is it actually spreading through surface contact now? Do masks even work any more?
I've been trying to process the new information and figure out what it actually means. How should I change my behavior? Does it make a difference if I make that evaluation based on my own personal welfare or the general welfare of society? And is this the worst twist that COVID could have taken, or is it not as bad as it sounds?
THE BAD NEWS
My first reaction was to start masking up and avoiding crowds again, hoping that this spike will peak and crash within a couple of months. That's a revision of my initial strategy of just trying to ride out the pandemic without getting infected.
But maybe that's not the right strategy anymore. If everybody is going to catch it, maybe now is as good a time as any. I'm relatively freshly vaccinated and in good health. A mild case of delta variant on top of a recent mRNA vaccination might just put the cherry on the top of lifetime immunity to this virus.
It's highly unlikely that the SARS-2 virus is going to kill me now, or even make me very sick. But there's still Long COVID to worry about. There's not enough known about that, but it doesn't sound like having a mild case makes you any less likely to have lingering symptoms. So maybe the best approach is to hunker down and wait it out until there's a booster shot available, especially one tailored to the variants.
And why exactly is the government urging people to mask up and take precautions rather than just get vaccinated and let it play out from there? What do they think the end game is? Are they counting on the whole thing burning itself out in another 6 months? Another year? Or are they assuming that there will eventually be a booster that could protect the entire population?
This isn't just a little more drift towards increased virulence - the symptoms are different and everything we've learned so far about how to protect ourselves from infection is called into question. People are catching it outdoors now, something that was actually pretty rare with the OG virus. There are now documented cases of people being infected by passing an infected person in the mall. The chances of household spread have jumped from a surprisingly anemic 25% to 90%. A crew of airplane cleaners was reportedly infected - is it actually spreading through surface contact now? Do masks even work any more?
I've been trying to process the new information and figure out what it actually means. How should I change my behavior? Does it make a difference if I make that evaluation based on my own personal welfare or the general welfare of society? And is this the worst twist that COVID could have taken, or is it not as bad as it sounds?
THE BAD NEWS
- In Provincetown, MA (one of the most vaccinated states in the country) almost 900 people got infected over Fourth of July. 75% of them were fully vaccinated. Remember when we thought 50 people was a big infection cluster?
- Anecdotal reports from hospitals around the country strongly suggest that the delta variant makes people sicker. Younger people (including an increasing number of children) are ending up in intensive care. And they get sicker faster - average time from onset to hospitalization is shorter, and from initial hospitalization to ICU.
- The R0 of this variant is tentatively estimated at 5-9, which is approaching the virulence of chicken pox. Chicken pox virus wafts on the wind. Do you know what percentage of adults in the US have had chicken pox? 95%. Think about that. Pretty much every unvaccinated person is going to get this. Sources who are still describing the delta variant as "twice as contagious" need to get with the program. More like 3 or 4 times.
- There are clearly way more breakthrough infections with Delta than the government wants to admit. Data from Israel, where they seem to be more committed to distributing actual facts than the US health care establishment, has found that the Pfizer vaccine is just 39% effective at preventing infection now that delta is the dominant variant there. This compares to about 90% effective with the original virus. That is a stunning decline.
- And vaccinated people who get infected can spread the virus, which rarely happened with the earlier variants. That's what really changes the whole social calculus. Now vaccinated people can infect other vaccinated people.
- The vaccines really are effective at preventing serious illness and deaths, even the J&J vaccine. Only 3% of people coming into hospitals with COVID now have been fully vaccinated. And I think that includes the population that was hospitalized for reasons unrelated to COVID and just turned out to have it when they were routinely tested.
- Vaccination rates are finally going up in states like Missouri, Alabama, and Arkansas. A lot. Nationwide, it's up 26% from 3 weeks ago. In Alabama and Arkansas the vaccination rate has doubled. I suppose it's only a matter of time before even Florida Man takes notice of what is going on and rethinks things.
- It looks like India and the UK have peaked out and are headed back down again. I've analyzed these graphs before and noted that the time from the top of a steep peak back down to baseline is usually 6-8 weeks, pretty much independent of mitigation steps. It's usually pretty symmetrical - 6 weeks up and 6 weeks back down. It will be interesting to see if the pattern holds, especially with 2 countries in such different situations vaccination-wise.
- It's not really as communicable as chicken pox. There's an overlap between the highest R0 estimates for COVID (5-9.5) and the lowest estimates for chickenpox (8.5-12). It's moving up into the hideously contagious category, but probably not quite that contagious. Yet.
My first reaction was to start masking up and avoiding crowds again, hoping that this spike will peak and crash within a couple of months. That's a revision of my initial strategy of just trying to ride out the pandemic without getting infected.
But maybe that's not the right strategy anymore. If everybody is going to catch it, maybe now is as good a time as any. I'm relatively freshly vaccinated and in good health. A mild case of delta variant on top of a recent mRNA vaccination might just put the cherry on the top of lifetime immunity to this virus.
It's highly unlikely that the SARS-2 virus is going to kill me now, or even make me very sick. But there's still Long COVID to worry about. There's not enough known about that, but it doesn't sound like having a mild case makes you any less likely to have lingering symptoms. So maybe the best approach is to hunker down and wait it out until there's a booster shot available, especially one tailored to the variants.
And why exactly is the government urging people to mask up and take precautions rather than just get vaccinated and let it play out from there? What do they think the end game is? Are they counting on the whole thing burning itself out in another 6 months? Another year? Or are they assuming that there will eventually be a booster that could protect the entire population?
