Archive for the ‘COVID-19 Tracking’ Category

Barely noticed: COVID deaths pass the 1 million mark in U.S.

April 18, 2022

The good news: Daily deaths down to historic flu levels.
=============

Everybody has covid fatigue and wants to get on with getting on … Inflation, Ukraine, border crisis, and Hunter’s laptop have been stealing the headlines … finally, Fauci seems to be less omnipresent on TV … so it’s understandable if you didn’t notice that U.S. covid-related deaths passed the tragic  1 million milestone in late March.

image

=============

From the get-go, I’ve argued that we should all stay focused on the number of Daily New Deaths as the key Covid metric.

See: How will we know when we’ve turned a COVID-19 corner?

So how are we doing on that measure?

For reference, a high flu season averages about 500 deaths per day during the roughly 4 month flu season.

We’re now running at a rate of about 400 daily Covid-related deaths … in line with historic flu death rates.

image

My take: We’ve passed a tragic milestone … and while any deaths are too many … we can finally breathe a little easier.

Biden: “As promised, I crushed the virus … and you can take your masks off”

March 1, 2022

Will he dare to say that?
==============

It’s ok to cheer on the latter point.

Miraculously, the science changed last week … and the CDC was able to issue new guidance that let’s most people (including school kids!) to toss their masks.

About a year late and, coincidentally, just in time for Biden’s SOTU address.

Whatever.

Let’s cheer the revised guidance!

==============

But, what about the broader claim: “I crushed the virus”?

Remember when Biden taunted that Trump was responsible for all the Covid deaths while he was president?

Soon America will have accumulated 1 million Covid-tagged deaths … currently at 973.119 and counting.

I doubt that Biden will point out that the majority of the deaths have happened under his watch … despite Trump handing him 2 approved vaccines that were in production and ready for distribution.

image

=============

And, I doubt that Biden will mention CNN’s headline:

image

Point-of-fact, almost 1,500 people are still succoring to Covid-tagged deaths each day … many because Biden had put the development and distribution of therapeutic drugs on the back-burner.

==============

And, I doubt that he’ll mention that his CDC was forced to admit that it had been hiding data on Covid hospitalizations, vaccine effectiveness and breakthrough infections … politically fearing that the information might be “misinterpreted” by non-government scientists … and the public at large.

image

============

Finally, I doubt that that Biden will spotlight the Johns Hopkins study that concluded:

Lockdowns have had little to no effect on COVID-19 mortality.

But, they imposed enormous economic and social costs.

==============

Bottom line: We’re finally at a good spot on Covid … but I’ll cringe if Biden claims that he “crushed the virus”.

We’ll see if “Straight- shooting” Joe shoots straight on this one.

NYT: “CDC withheld critical data on vax effectiveness”

February 21, 2022

Political “throttling” and fear that data was flawed and might be misinterpreted.
=============

Point of emphasis: This is coming from the New York Times !

Two full years into the pandemic, the agency leading the country’s response to the public health emergency has published only a tiny fraction of the data it has collected.

The agency has withheld critical data on boosters and hospitalizations.

For more than a year, the CDC has collected data on hospitalizations for Covid-19 and broken it down by age, race and vaccination status.

But it has not made most of the information public.

The performance of vaccines and boosters, particularly in younger adults, is among the most glaring omissions in data the C.D.C. has made public.

When the C.D.C. published the first significant data on the effectiveness of boosters in adults younger than 65 two weeks ago, it left out the numbers for a huge portion of that population: 18- to 49-year-olds, the group least likely to benefit from extra shots, because the first two doses already left them well-protected.

The agency has repeatedly come under fire for not tracking so-called breakthrough infections in vaccinated Americans

=============

When challenged, the CDC didn’t deny the allegations, but rather, offered up 3 explanations for why they withheld the data:

> Data isn’t accurate enough.

The collected data was “sampling data“ that was “not yet ready for prime time” because “data systems at the C.D.C., and at the state levels, are outmoded and not up to handling large volumes of data.”

> Data might be misinterpreted.

“The agency has been reluctant to make those figures public because they might be misinterpreted (by anti-vaccine groups) as indicating that the vaccines were ineffective.”

> Data is politically throttled

“The C.D.C. is a political organization as much as it is a public health organization. The steps that it takes to get (data) released are often well outside of the control of many of the scientists that work at the C.D.C.”

===============

But, not to worry since the C.D.C. has received more than $1 billion to modernize its data collection and systems.

That works for the data accuracy defense  … but does nothing to heal the self-inflicted wounds: fear of what the “unwashed” will do with the data … or, screening the data for political reasons.

It’s hard to “follow the data and the science” when the scientists are withholding the data.

Trust but verify, right?

Finally, the CDC has released some interesting data…

February 16, 2022

In case you missed it, last week the CDC released a study (with data!) on vaccine efficacy.

Specifically, the CDC researchers looked at emergency room and urgent care visits and hospitalizations in large participating medical centers in  10 states.

The data was gathered from August 2021 thru January 2022, when both delta and omicron variants were in circulation.

=============

WaPo’s headline:

image

“mRNA booster shots  lose effectiveness after about four months — but still provided significant protection in keeping people out of the hospital during the omicron surge.”

In numbers, the boosters provide 91% protection from hospitalization right after vaccination … and 78% protection 4 months out.

image

My opinion: That’s formidable protection … and, not really new news.

=============

Drilling Down

What I found more interesting (with some new news) was buried in the report’s exhibits.

Teaching Point: I used to tell students to always start cases by going through the exhibits before even starting to read the case narrative.

Here’s my recap … below are my takeaways…

image

> Again. the data was collected from large participating medical centers (and their urgent care affiliates) in  10 states. A representative sample, reporting high quality (consistently defined) data.

> Over the 6-month study period, 241,204 patients (row 3, column 1) visited an Emergency Room (ER) or Urgent Care Center (UC).

> Of the 241,204 … 54% had been vaccinated, 46% hadn’t. That’s roughly the country’s mix with minimal skew one way or another.

Point of interest: That mix doesn’t sync with the widespread narrative that ERs and UCs being entirely overrun with unvaccinated people.

==============

> Of the 241,204 ER/UC visits … 61,826 (25.6%) tested positive for covid.

The 1 in 4 number strikes me as being low low  since, I presume, the vast majority came to the ER/UC with covid-like symptoms 

> Drilling deeper, 14.4% of the vaccinated patients tested positive; 38.8% of the unvaccinated patients tested positive.

So, in a relatively balanced sample, unvaccinated patients accounted for about 70% of the positive covid results.

==============

> Of the 241,204 ER/EC patients, 93,408 (38.7%) were hospitalized;

> Of the 110,873 unvaccinated patients, 32.6% were hospitalized; of the 130,131 vaccinated patients 40.9% were hospitalized.

In other words, a higher percentage of vaccinated patients ended up being hospitalized.

Now, that’s interesting, isn’t it?

=============

Drilling down on Demographics

> Patients visiting ERs & UCs were split 72.5% under 65 and 27.5% 65 and older.

> 73.9% of the 65+ were vaccinated; only 46.5% of the <65 were vaccinated

> Commensurately, only 19.3% of the 65+ tested positive for covid; 28% of the <65 tested positive

> But, 75% of the 65+ were hospitalized; only 24.9% of the <65 were hospitalized

> Of those who were hospitalized, only 23% had tested positive for covid.

Said differently, over 2/3s of the hospitalized patients were admitted to the hospital for something other than covid.

That, in my opinion, is the most interesting number!

Covid death counts are still high!

January 7, 2022

The percentage of infections resulting in hospitalization or death has declined, but…

…. as I used to preach to students: a little number times a very, very large number is a large number.
=============

In prior posts, I’ve encouraged readers to stay focused on the number of Daily New Deaths DNDs).

MUST READ: How will we know when we’ve turned a COVID-19 corner?

=============

It’s not news that the number of covid cases has skyrocketed.

These days, everybody knows somebody who has tested positive for covid … or, has suffered covid-like symptoms without a confirming covid test.

Our personal observations are captured in the reported aggregate numbers.

image

=============

There’s a tendency to characterize the spike in cases as low severity annoyances … minimizing the reality that covid-related deaths are still accumulating at the pandemic’s average rate.

Specifically, we’re currently averaging about 1,250 covid-related deaths per day.

image

Let’s put the 1,250 in perspective …

> Since the start of the pandemic in early 2020, there have been about 850,000 covid-counted deaths … that averages out to 1,300 daily deaths.

> At the 2 prior peaks — April 2020 and January 2021 — the daily death rate reached about 2,250 and 3,500, respectively.

> Historically, the number of flu-related deaths averages about 250 per day during the flu season.

So, while the current daily death count is less than half of the count during the prior peak periods, it’s 5 times the average number of in-season flu deaths.

And, the numbers add up.

Since the prior trough in July 2021, there have been about 225,000 covid-related deaths … that’s about 1/4 of the total covid-related deaths to date.

=============

Bottom line: We’re not out of the woods yet, folks.

Stay focused on the daily death counts.

Postpone any victory celebrations until we get down to the 250 flu-related deaths benchmark … and stay at or below that number.

MUST READ: How will we know when we’ve turned a COVID-19 corner?

January 6, 2022

Stay focused on the number of Daily New Deaths!
==============
This is a relevant excerpt from a long ago prior post (May 2020)
==============

From the begining of the Covid pandemic, I’ve focused on Daily New Deaths (DND) as my key metric.

Why is that?

First, saving lives is our paramount objective, right?  If yes, caused fatalities should be our focus metric.

Second, I think that most other metrics that are being bandied about are quite problematic.

Counting deaths — while a bit macabre — is a more reliable process than counting, say, the number of infected people.

Sure, I’d like to know the number of people infected with COVID-19.

But, unless everybody — or at least a large statistical sample — is tested, the number of confirmed cases is subject to disqualifying statistical issues.

Most notably, who is being tested and who isn’t? What about the asymptomatic “hidden carriers”? What are the criteria for confirming a COVID infection? What about false positives (and false negatives)? How to standardize the reporting processes across states? How to keep governmental units from fudging the numbers?

Importantly, if testing increases, then confirmed cases goes up.

Is that an indication of more virus spread or just a reflection of more testing?

I sure can’t tell … and, I doubt that anybody else can with any degree of reliability.

=============

Again, counting fatalities is probably the most reliable metric.

Fatalities are discrete events – so they’re countable.

Still, even deaths may have some counting imperfections.

For example, many non-hospitalized people die and are buried without autopsies.  Some may be uncounted COVID victims.

On the other hand, some people may die and be diagnosed with COVID infections. That doesn’t necessarily mean that COVID killed them.  That’s especially true with COVID since it’s most deadly for people with other health problems.

And, as we stated above, the definition of COVID deaths has changed over the course of the pandemic:

COVID-related” means “COVID present”, not necessarily “COVID caused” … and , along the way, “present” was redefined from “confirmed” to “presumed”

Further, COVID deaths are a function of two drivers: the incidence of the virus … and, the nature, level and timing of therapeutic healthcare.

Said differently, more effective therapeutic healthcare will dampen the death toll.

==============

Bottom line: “Daily New Deaths” is the number we should be watching.

If it shows a consistent downward trend, then we’ll know we’ve turned the corner.

If it stays stable (at a high level) or turns upward, we’ll know that we’re in deep yogurt.

===============

Next up: So, how are we doing?

So, do rapid tests work … or not?

January 4, 2022

With covid prevalence spiking, as usual, CDC guidance muddies the water.
============

A couple of weeks ago, with omicron spreading like wildfire and workforces getting depleted by quarantined workers, Biden finally left his bunker and promised January home-delivery of 500 million hard-to-find antigen rapid tests.

Current reporting is that orders are “in the process” (i..e. they have not yet been officially placed) for 250 million in the last half of January and 250 million in February and March.

That works out to about 1 test per month for every adult.

Biden assured that the testing surge would be another game-changer (akin to getting LA ports to stay open nights & weekends to unclog supply chains) … and that he was, of course, “following the science” …

So, it seems reasonable to conclude that his homeboy scientists advised him that the antigen rapid tests worked.

That is, except for CDC Director Wolensky who told CNN that the CDC doesn’t “actually know how well rapid tests perform and how well they predict transmissible presence of the virus”.

So, do the rapid tests work … or not?

==============

On that question, Epidemiologist Michael Mina published the most informative piece that I’ve found…

Dr. Mina’s overall conclusion:

Antigen tests are extremely sensitive for very contagious people.

When taken at peak viral load, these tests approach 100% sensitivity.

Here’s his visual recap … click it to enlarge it.

image

My takeaways:

> In the first couple of days after getting infected, neither the PCR nor the antigen tests are sensitive enough to detect the infection.

> Around the 5th day after getting infected, the tests are able to detect the virus.

> PCR tests may be able to detect the virus a day or two sooner than the antigen test … but, since the PCR tests require a day or two for processing & reporting, antigen and PCR tests are practically equivalent for early detection.

> Infectees have the highest viral load (and are most contagious) from day 6 to day 12 after getting infected.

> During days 6 to 12, when infectees are most contagious, both PCR and antigen tests are reliably able to detect the virus.

> After day 12, as the level of viral load quickly diminishes, PCR tests are able to detect the residual, non-contagious levels of the virus … but, the less sensitive antigen tests do not.

=============

Again, according to Dr. Mina’s research and analysis:

When taken at peak viral load (when infectees are most contagious), antigen tests approach 100% sensitivity.

Accordingly, Dr. Ashish Jha, the dean of Brown’s school of public health, calls antigen tests “contagiousness tests” … and says that they are very good at detecting people who are still infectious to others.

They won’t detect every speck of virus that their PCR counterparts are attuned to do, but they can detect the important part — if someone is producing enough of the virus that they’re likely to spread it.

=============

Bottom line

If I could get my hands on in-home rapid tests, I would confidently use them…

(1) When I’m exhibiting any symptoms (e.g. fever or sniffles)

(2) After the rare occasions when I’ve attended an indoor gathering with non-family members.

(3) Before visiting my grandkids … for re-assurance that  I’m not contagious.

But, first step is getting my hands on some of the in-home tests!

And, as I like remind readers…

DISCLAIMER: I’m not a medical professional or scientist — just a curious, self-interested guy.  So, don’t take anything that I say or write as medical advice. Get that from your doctor!

Why is the CDC so reactionary, illogical and, uh, unscientific?

January 3, 2022

Their most recent isolation “guidance” is a case in point.
=============

With covid-omicron spreading like wildfire and seeming to close in on all of us (me included) … and with workforces getting depleted by quarantined workers, the CDC stepped in to save the day by issuing revised isolation guidelines, specifically:

Given what we currently know about COVID-19 and the Omicron variant, CDC is shortening the recommended time for isolation for the public.

People with COVID-19 should isolate for 5 days and if they are asymptomatic or their symptoms are resolving (without fever for 24 hours), then…

People should follow that (isolation period) by 5 days of wearing a mask when around others to minimize the risk of infecting people they encounter. CDC

Let’s unpack that guidance…

=============

First, when does the clock start running?

For somebody who who develops symptoms, I guess it’s when “the” symptoms first present themselves.

My questions:

(1) Do cold-like sniffles count as “symptoms”? What’s the best indicator that I may have caught it? How indicative is a fever?

(2) What to do if I am officially symptomatic? Isolate, for sure … but, go see a doctor?

Note: At local walk-in clinics, people are waiting 4 to 6 hours in a room filled with 50 to 100 sick-likely people.  Sounds like a recipe for disaster, right?

=============

What about infectees who are asymptomatic?

For them, I guess that the clock starts for when they test positive.

Let’s pretend that they’re inclined to get tested (say, because other members of their household are symptomatic or have tested positive … or because their employer or airline requires a test).

These folks can’t do-it-themselves now because of the scarcity of in-home rapid tests.

Of course, they have the option of waiting in line for a couple of hours to get a “commercial” PCR test.

Note: Lines are running around the block at local testing sites.  Again, sounds like a recipe for disaster since most of the people in line are symptomatic.

===============

Once the clock starts…

OK, this part of the CDC guidance is pretty clear: isolate for 5 days.

But, things get murky after that isolation period.

The CDC says:

After infectees isolate for 5 days, if they are asymptomatic or their symptoms are resolving (e.g. no fever for 24 hours), then…

They should follow that (isolation period) by 5 days of wearing a mask when around others

The criteria “asymptomatic or symptoms resolving” is most problematic.

=============

What about rapid tests?

In the UK and several other countries, that free-of-isolation criteria is supplemented by the need for a negative covid test … rapid tests qualify.

So, why isn’t the CDC advising a negative covid test?

Cynics observe that the omission of negative tests in the guidance is simply cover for the Biden Administration’s slow-roll on the development and production of antigen rapid tests.

The official CDC announcement says:

The guidance is motivated by science demonstrating that the majority of transmission occurs early in the course of illness, generally in the 1-2 days prior to onset of symptoms and the 2-3 days after infection. CDC

More specifically, CDC Director Rochelle Walensky told CNN that the CDC chose five days because that’s typically the period when individuals are most infectious.

“Those five days account for somewhere between 85 to 90 percent of all transmission that occurs”

So far,so good.

But then she added:

“We opted not to advise the rapid test for isolation because we actually don’t know how our rapid tests perform and how well they predict whether you’re transmissible during the end of disease. Source

Say, what?

So, if I have this right…

Biden has ordered up 500 million in-home rapid tests … but the CDC doesn’t “actually know how well rapid tests perform and how well they predict transmissible presence of the virus”.

If that isn’t dizziness-inducing enough, Dr. Fauci, Biden’s chief political scientist, was his usual ubiquitous self on Sunday TV hinting that the CDC would soon be adding a testing requirement after all. Source

=============

My take: It would be a lot easier to “follow the science” if “the science” weren’t so reactionary, illogical, impractical and, well, unscientific.

If 100% were vaccinated, would we be out of the woods?

December 9, 2021

Or, would we morph to a “pandemic of the vaccinateds”?
=============

Biden keeps blaming (shaming?) the persistence of the coronavirus on the folks who “stubbornly” refuse to get vaccinated.

That raises the headlined question: “If we got to the point that 100% of the population was vaccinated, would the coronavirus finally be vanquished?

Let’s put aside politics, religion and even the debate on natural immunity … and just run some numbers.

=============

Starting Point

Early-on we were told that the vaccines were roughly 90% effective against symptomatic infections.

English translation: Comparing matched samples of fully vaccinated and unvaccinated study participants … roughly equivalent in their natural susceptibility and their viral exposure … 90% a fewer vaccinated people became symptomatically infected (as compared to the symptomatically infected unvaccinated participants).

Currently, the CDC is reporting that about 70% of the adult population (18 and over) has been vaccinated.

About 225 million Americans fall into the 18 and over category.

=============

Step 1

To illustrate the math, we’ll use the 70% and 225 million numbers.

There are about 67.5 unvaccinated adults (100% minus 70% = 30% times 225 million equals 67.5).

And, assuming full vaccine effectiveness (90%), there are 15.75 million vaccinated adults who are medically equivalent to the unvaccinated adults (225 times 70% times 10% equals 15.75).

Let’s coin the sum of those 2 groups UnVaccinated Equivalents or “UVEs”..

So, at full vaccine effectiveness (90%), we have 83.25 million UVEs  (67.5 + 17.5 equals 83.25) … that’s about 37% of the over 18 adult population.

But, the vaccines have waning effectiveness, right?

=============

Waning Effectiveness

It has been reported that, over the course of 6 months, the vaccines lose about half of their effectiveness.

image_thumb8
Source

To keep the arithmetic simple, we’ll assume that 6 months after full vaccination, the vaccines wane to 50% effectiveness.

To start, let’s assume that everybody who is vaccinated got vaccinated exactly 6 months ago (and hasn’t gotten a booster shot).

That would raise the number of UVEs (unvaccinated equivalents) up to 146.25 million (equal to 65% of 18 and over adults)   … the 146.25 million is made up of 67.5 million unvaccinateds and 78.5 million vaccinateds whose vaccine effectiveness has waned (225 times 70% times 50%).

Let’s get more realistic…

==============

Base Case

The prior scenario assumed that all people were vaccinated exactly 6 months ago.

But, not all vaccinateds got vaccinated exactly 6 months ago … they got vaccinated over the course of 6 months … and, thus, theyare at varying stages of vaccine “wanedness” … somewhere between 90% full effectiveness and 50% waned effectiveness.

If we assume that the vaccinations were evenly spread over the 6 months (rather than all on day one) then the average vaccine effectiveness among those who have been vaccinated would be about 70% (the average — halfway between 90% and 50%).

That would give us 114.75 million UVEs (equal to about half of all adults)   … made up of 67.5 million unvaccinateds (225 times 30%) and 47.25 million vaccinateds with waned vaccine effectiveness (225 times 70% times 30%)

Let’s call that our base case.

===============

What if 100% vaccinated?

Now let’s bump the fully vaccinated rate up to 100% and see what happens…

There would be no unvaccinated adults, but there would be UVEs (unvaccinated equivalents) — the vaccinated adults with waned vaccine effectiveness.

How many of them?

Using the above logic and numbers, there would be 67.5 million UVEs (225 times 100% times 30%) … fully vaccinated adults whose vaccine effectiveness has waned … rendering them roughly equivalent to an unvaccinated person.

=============

Rscap

Note that the 67.5 million UVEs is — coincidentally, using the above assumptions — the same number as the number of unvaccinateds who are currently walking around.

And, it implicitly assumes that everybody gets a booster every 6 months … to keep resetting the effectiveness clock.

To be fair, this estimate doesn’t adjust for any accumulated effectiveness that comes with successive booster shots or pre-existing natural immunity).

=============

The bottom line

Based on these rough estimates, we won’t move above our current level of coronavirus exposure even if 100% of the population gets vaccinated.

So, Biden will eventually lose his talking point of a “pandemic of the unvaccinated” … and, unless there’s a marked improvement in the vaccines’ “durability”. we’ll morph to a “pandemic of the waned vaccinated”

That’s not a medical or philosophical point … It’s simple (?) arithmetic.

Right now, how many folks in your community are carrying Covid infections?

December 7, 2021

Make your guess, then read on…
===============

The likelihood that any of us get infected by covid starts, in theory, with its “prevalence rate” — the percentage of people walking around with a current (and possibly contagious) infection.

That’s why I’ve been so interested in that number.

To that point, researchers reporting in the science magazine Nature say:

On December 31, 2020,  0.77% of the U.S. population had a contagious infection.

That’s about 1 in every 130 people on average.

In some places, it was much higher.

In Los Angeles, for example, nearly 1 in 40 (or 2.42%) had a SARS-CoV-2 infection as they rang in the 2021 New Year.

OK, that at least gives us an order of magnitude.

We can expect that about 1 in 100 people we bump into have a covid infection and may be contagious .

The rate is higher in hot spots — communities and venues.

So, is 1 in 100 a high number or a low number?

It probably overstates the risk since (a) not all infected people are contagious (b) not all contagious people transmit the virus at the same severity level (c) some people are more immune than others (i.e. naturally or via vaccinations), and (d) some people mitigate more effectively than others.

So, the likelihood of getting infected is probably much lower than the community prevalence rate, but it’s certainly not zero.

So, keep your guard up.

NIH Director: Many more Covid infections than official tallies show

December 6, 2021

And, some other CDC numbers that might surprise you.
===============

Being a numbers guy, a post in the NIH Director’s Blog caught my eye: COVID-19 Infected Many More Americans in 2020 than Official Tallies Show

The specifics:

A recent article published in Nature offers a comprehensive estimate that puts the true number of (covid) infections by the end of 2020 at more than 100 million.

That’s equal to just under 1/3 of the U.S. population of 328 million.

That big number piqued my curiosity: The study was on nearly year old data … what’s the current number?

I was pleased to discover that the CDC regularly posts an Estimated COVID-19 Burden containing data re: cumulative infections, symptomatic illnesses, hospitalizations and deaths.

Here’s my analysis- tweaked extract from the current CDC tabulation of covid infections:

image

Some takeaways…

==============

Infections

> The CDC currently pegs the cumulative incidence of infections over 146 million

> That total translates to almost 45,000 per 100,000 population.

> Since there is some double-counting — i.e. persons who have been infected … and then re-infected … the percentage of covid-infected Americans is less than 45% … probably only slightly less.

==============

Infection Rate

> Surprisingly (to me), the infection rate is highest among those aged 18 to 49

image

> The infection rate is lowest among those 65 and over — probably reflecting the high (and early) vaccination rate in that group

> And, the estimated infection rate is next lowest among those under 18 …. who haven’t been authorized for vaccinations until recently … hmmm.

==============

Hospitalization Rate

> Across all ages, 5.12% of infections result in hospitalization.

> There’s a very strong correlation between age and likelihood of hospitalization (if infected), e.g. rate is 1% if under 18

image

=============

Death Rate

> Across all ages, .63% of infections result in hospitalization.

> Death rate is practically zero (.002%) which equates to about 1 in 40,000 for those under 18 who get infected … and not much higher for those 18 to 49

> Middle age death rate is only .58% … about 1 in 170 who get infected

> But, the death rate is almost 4% for those 65 and over … about 1 in 25 who get infected

image

=============

Technical note:

The covid infection rate estimates are pivotally dependent on estimates of the so-called ascertainment rate —  the percentage of total cases that are confirmed via testing.

The Nature researchers estimate that only about 25% of all infections are confirmed via testing. 

Conversely, 75% are mild or asymptomatic infections that aren’t subjected to (or confirmed by) testing.

Early on, the ascertainment rate was pegged at about 10% … suggesting that total infections were about 10 times the number of confirmed cases.

That multiplier is now pegged at about 4 times confirmed cases since more asymptomatic infections are being detected by forced surveillance testing (e.g. for employment or travel)

More: About infection and transmission…

October 7, 2021

Earlier this week we posted

1. The CDC web site says that it is very rare for a vaccinated person to get infected and transmit the virus.

2. Fauci opined a similar view in a CNBC interview … but equivocated when confronted with some compelling anecdotal evidence and couldn’t brandish CDC data to the contrary.

3. CDC Director Walensky told CNN that we should expect “tens of thousands of breakthrough infections and hundreds of thousands of daily cases.”

Today, let’s try to square the circle of opinions with some data…
=============

Protection from Hospitalization & Death

In late 2020, when Pfizer applied for its original vaccine Emergency Use Authorization, the company presented clinical trial results that evidenced 90% or better protection against hospitalization and death.

Subsequently, when Pfizer applied for a booster shot EUA, the company presented data indicating that the efficacy of its vaccine in preventing hospitalization only wanes slightly … from around 90% shortly after 2nd shots to about 85% six months later.

Bottom line: high efficacy, slow waning with respect to hospitalizations & deaths.

image_thumb5
Source

That’s a strong commendation for the efficacy (and durability) of the vaccine … but, it’s a relatively weak case for boosters.

=============

Protection from Infection & Transmission

In 2020, when Pfizer applied for its original vaccine Emergency Use Authorization, the company was silent on protection against infection and transmission.

The simple reason: Their clinical trials didn’t measure whether the vaccines prevented infection and transmission.

Fast forward to 2021 …

In its recent application to get an Emergency Use Authorization for booster shots, Pfizer did submit data indicating that effectiveness against infection starts high (90% immediately after the 2nd shot) …  but it wanes down to around 40% six months later.

image_thumb8
Source

That’s both good news and bad news.

The high initial protection against infection (which is very good news) …  was common-sensically inferred by many … but there wasn’t data to prove it. Now, there’s confirmatory data!

But, there’s also some bad news:

There’s a relatively fast-paced waning of the infection protection (from 90% down to 40%).

That’s a pretty strong case for boosters since any infection brings with it (1) the threat of “long covid” complications (2) the accompanying risk of hospitalization and death (3) the likelihood of transmitting the virus to others.

=============

About Transmission

More specifically, the data is on point regarding viral transmission … since infection is an obvious prerequisite to transmission.

Early on, soon after people get vaccinated, the risk of infection is very low, so the risk of transmission is very low.

But, as the vaccine’s protection from infection wanes, the transmission risk (among vaccinated people) increases.

The impact is, shall we say, statistically significant.

Tomorrow, we’ll work the numbers….

Fauci: CDC is flying blind on post-vax infections…

October 4, 2021

My bet: you know somebody who has been vaccinated and then tested positive for covid.

Even if not, you must have heard stories about public figures who have been victims of these are so-called “breakthrough infections”, e.g. Justice Kavanaugh, who tested positive last week despite being fully vaccinated.

Reasonable to ask: “What the hell is going on”.

=============

That’s the essence of a direct question that CNBC’s Sarah Eisen posed to our nation’s chief political-scientist Anthony Fauci.

image

For openers,  Eisen disclosed that she was recently infected with covid despite being fully vaccinated … as were  2 of her fully-vaccinated family members … and her 2 unvaccinated children.

Then, Eisen pointed out that, contrary to her family’s experience, the CDC website declares:

“The greatest risk of transmission is among unvaccinated people who are much more likely to get infected, and therefore transmit the virus.

Fully vaccinated people get COVID-19 (known as breakthrough infections) far less often than unvaccinated people.”

Then she intimated that the CDC was “too casual” about breakthrough infections … and asked pointedly if the CDC had data to support the conclusion that  COVID breakthrough infections are rare.

Fauci’s answer: “They’re working on it”:

Well in the past the CDC has not tracked real or asymptomatic infections.

The CDC is now scrambling to change this.

There are studies being done that would give the kind of breakthrough infections data you’re talking about.

English translation: No they don’t have the data.

Eisen pounced:

“How can the CDC keep saying COVID breakthrough infections are rare if they have no data? The bottom line is that we can still get it and transmit it, right?”

Flustered, Fauci just started shuffling shells around the table to play out the interview clock…

Oh my.

=============

click to view a 1-minute excerpt of the interview

More covid math: What about booster shots?

September 24, 2021

In yesterday’s post, we squeezed some data from Israel’s Dept. of Health.

image

Analyzing that data, we concluded:

> Vaccinated patients accounted for almost 65% of Israeli covid deaths in August

> But, the death rate among the unvaccinateds (181.7 covid deaths per million unvaccinated adults) was more than double that of the vaccinateds (81 covid deaths per million among vaccinated adults)

> So, the implied effectiveness of the vaccine (protecting against death from covid) was 55%

OK, let’s move the ball forward…

=============

The case for boosters

Let’s assume that our analysis of the Israeli data is correct and the implied death prevention effectiveness rate of the Pfizer vaccine has, in fact, waned down to 55%.

Question: What if the vaccinated Israelis had all gotten 3rd shots that boosted their protection back up to, say 90%?

From yesterday’s analysis, we concluded that the monthly death rate among unvaccinated Israelis (in August) was 181.7.

So, at a 90% effectiveness rate — if all were boosted — we would only expect 18 deaths per million vaccinated people (1 – 90% = 10% of the unvaccinated rate).

At that rate, about 300 of the 389 vaccinated deaths would have been saved (18 deaths per million x 4.8 million boosted vaccinateds= 86.4; 389 – 86.4 = 302.6).

That’s about a 75% reduction in vaccinateds deaths… and about a halving of the total death count (218 + 389 = 607; 302.6 / 607 = 49.8)

Those are pretty compelling numbers in favor of booster shots…

============

But, Pfizer’s numbers differ

Here’s an interesting twist to the story…

In Pfizer’s booster application, the company presented data indicating that the efficacy of its vaccine only waned slightly

Specifically, Pfizer claimed  that it’s vaccine’s effectiveness  against hospitalization (and, presumably, death) declines from 96.2% percent at seven days after dose 2 to 90.1% two months later to 83.7% six months later.

image
Source

Stating the obvious: 83.7% is a high level of effectiveness … and much higher than 55%.

Think about that for a minute, though…

Based on Pfizer’s data, the vaccine is highly effective preventing hospitalization and that effectiveness does not wane very much over 6 months.

So, presuming that the grand objective is prevention of hospitalization and deaths, Pfizer’s data seems to weaken its  case for booster shots.

Sure, it’s always better to have more immunization than less … but, is a boost from 84% to 90% statistically or operationally significant? Is it worth the cost and incumbent risks?

Hmm.

=============

CAUTION

Don’t draw any hard conclusions yet!

There’s much more to the story that we’ll get into next week.

============

DISCLAIMER: I’m not a medical professional or scientist — just a curious, self-interested guy.  So, don’t take anything that I say or write as medical advice. Get that from your doctor!
============

Thanks to DF for pointing me to the Pfizer data

 

How good is your covid math?

September 23, 2021

Let’s put it to a test, estimating vaccine effectiveness on some real life data …
==============

In yesterday’s post, we channeled Dr, Marty Makary’s conclusion that “The CDC has failed in its primary function to deliver data to guide our pandemic response.”

Often, the CDC has relied on data from Israel.

Israel was one of the first countries to start vaccinating … and is doing the best job, by far, of systematically gathering, analyzing and reporting vital data that can be squeezed to draw clarifying conclusions.

For example, below is a chart that Israel’s Dept. of Health recently released.

The key summary statistic: Vaccinated people accounted for 64% of Israeli Covid deaths in August.

image

Is that good news or bad news?

Specifically, what do the numbers say about the efficacy of the vaccines? Good or bad?

Take a minute, think about those questions … and maybe, crunch a few numbers before reading further

(more…)

Makary: The CDC is failing to provide actionable Covid data…

September 22, 2021

Johns Hopkins Dr. Marty Makary’s recent WSJ opinion piece struck a chord with me.

Paraphrasing his basic point:

The CDC has failed in its primary function to deliver data to guide our pandemic response.

Remarkably, the CDC, an agency with 21,000 employees, does not have much of a rapid response team.

Though the CDC is a very large organization, staffed with thousands of trained researchers …  it most often just reacts to data from other countries (usually Israel) and regurgitates ad hoc observational studies with questionable scientific rigor (from places like Kentucky and Cape Cod).

Makary asks: Why isn’t the CDC producing (and reporting) the research that policy-makers (and the public) need for decision-making?

=============

My take: 20 months since the onset of the pandemic, “the science” is far behind the learning curve and hasn’t even developed what consultant’s call a “coherent theory of the case”.

Individual pieces of the puzzle seem to change shape based on the latest research study … from who knows where … done by who knows who.

And, there doesn’t seem to be much thought given to how the pieces fit together.

So, it’s not surprising that the research plan — if there is one — seems haphazard and incomplete.

Save for the near-miraculous vaccine development, we don’t seem to know much more than we did when the pandemic first hit.

And, taking the booster indecisiveness as an example, we don’t even have a clear picture of how the vaccines should be deployed, e.g. Should people with natural immunity be vaccinated? is it better to have more people partially vaccinated or those already vaccinated “boosted”?

=============

Makary concludes: “The CDC’s failure to report meaningful data has left policy makers and the public flying blind.”

Thankfully, Israel has its act together re: data collection and analysis … so the CDC has something to work with.

=============

For the record:

> The CDC has 21,000 employees and a $15 billion annual budget.

> It has data on more than 40 million Americans who have tested positive for Covid and 200 million who have been vaccinated.

> The data include the vaccine type, dosing schedule and vaccination date.

But, somebody has to turn the data into actionable information.

The CDC isn’t doing it…

COVID: So, where are we?

September 9, 2021

Recently, like many (most?) Americans, I haven’t been paying particularly close attention to the COVID stats.

So, I thought it was time to take a look…

=============

Vaccinations

There have been incremental gains since I last looked:

> 78% of those 18 and over have have gotten at least 1-shot … up about 10 percentage points since July 4

> 92% of Seniors have have gotten at least 1-shot … that’s essentially all Seniors when you consider naturally immune and medically disqualified

> 55% of teenagers (12 to 18) … that’s almost 14 million of them

image

=============

Deaths

We’ve consistently touted the death count as the truest measure on COVID’s impact.

The current 7-day average is 1,128

> That’s about 4.5 times the July 4 low point (255) … which is coincidentally, about the level 0f in-season flu deaths in a typical year.

> But, the current rate (1,128) appears to be peaking … and, it’s about 70% lower than the all-time COVID peak on Jan 16  (3,515)

image

=============

ICU Capacity & Utilization

Currently, according to JHU, there are approximately 85,000 ICU beds.

image
Source: JHU

Of 85,000 ICU beds, about 66,000 (79%) are currently occupied.

Of the 66,000 currently occupied ICU beds, about 25,000 (38%) are  occupied by COVID patients…  the other 42,000 are occupied by non-COVID patients.

The 25,000 ICU beds currently occupied by COVID patients are 15% below the all-time COVID peak (Jan. 17, 29,000 beds)

But, current COVID case rates (150,733 per day) are 40% lower than the Jan.12 peak (254,358) … indicating that a higher percentage of cases are requiring hospitalization. (15% versus 11%).

That said, that’s bad, but …

The CFR (case to fatality ratio) is currently .7% … roughly 1/2 of the January peak CFR (1.3%).

So, that’s where we are….

Update: COVID Dashboard

July 29, 2021

Since Team Biden seems to have its collective hair on fire, I thought it would be good to put things in context by looking at the data …

=============

From the jump, we’ve argued that the most reliable Covid metric is the death rate.

The COVID death rate is now below the average number of flu-related deaths during the flu season… and far down from past peaks.

image

=============

Vaccination rates stalled at 500,000 per day, down from 4 million per day at the peak.

image

=============

Over 90% of vulnerable seniors have been vaccinated; over 70% of people 18 and over have gotten at least one shot.

Over 10 million teens (42%) have been vaccinated.

image

Draw your own conclusions re: whether it’s time to hit the panic button.

 

COVID: So, where do we stand now?

July 16, 2021

We haven’t  checked the numbers in awhile, so…
=============

Vaccinations

Close to Biden’s original goal of 70% of adults … almost 90% of seniors (over 65) … almost 40% of teenagers (just under 10 million).

image

Central question: What’s the upward limit in vaccine compliance?

WSJ: “With each day, as more Americans are vaccinated, an unvaccinated person’s likelihood of encountering the disease or spreading it goes down, as does his incentive to accept the risk of vaccination. ”

Especially given recent trends in Covid death rates…

=============

Covid-related deaths

The covid death rate continues to hover around 250 … roughly the in-season death rate associated with the flu … and down 66% from a month ago; down 66% from 3 months ago; and down 92% from the mid-January peak.

image

=============

Covid cases

The confirmed case count has turned up from its trough … roughly double what it was a month ago … worth closely watching, but not hair-on-fire time.

Keep in mind that the current rate is still down 66% from 3 months ago … and down 89% from the mid-January peak.

image

=============

Bottom line: Farther along than most people imagined possible, but not out of the woods yet…

Update: COVID Dashboard

July 7, 2021

COVID death rate is now below the average number of flu-related deaths during the flu season.

image

=============

Vaccination rates stalled at 1 million per day, down from 4 million per day at the peak, but…

Almost 90% of vulnerable seniors have been vaccinated; over 2/3’s of people 18 and over.

9 million teens (37%) have been vaccinated.

image

On balance, it looks like we’re in pretty good shape…

Don’t fret if Biden’s 70% goal isn’t reached…

June 9, 2021

Life is heading back to normal regardless.
=============

Biden-Fauci promised that we could have small family BBQs on July 4 if 70% of adults get at least their 1st shot of a vaccine.

It’s looking like we’ll fall short of Biden’s goal.

But, not to worry.

If you’ve been out recently, you’ve probably noticed that many (most?) folks don’t care what Biden & Fauci have to say any more.

Americans are responsibly easing back into life and guess what: case counts are dropping and covid deaths are dropping (albeit, slowly).

That’s an entirely rational approach since…

> There’s no magic number re: herd immunity or its close cousin: adult vaccinations.

There’s no specific herd immunity threshold.

Best evidence is Fauci’s constant rising of the herd immunity requirement from 60% to 70% to 80% to 85% to whatever he’s pitching on MSNBC today.

Said differently, there’s no covid  on-off switch set at 70% vaccinations.

=============

And, vaccination rates are only part of the story…

> The political-scientists still refuse to acknowledge that the vast majority of covid survivors have developed protective antibodies.

Some number of unvaccinated people fall into that category.

The implication: Some 80% to 85% of American adults are immune to the virus: More than 64% have received at least one vaccine dose and, of those who haven’t, roughly half have natural immunity from prior infection. Source

==============

> Transmissibility is not fixed: It can vary based on a population’s behavior, demographics and health.

We’ve seen this in action with Covid-19, which has spread far more quickly in some populations, as a result of differences in disease-mitigation efforts, housing density, age, occupations and both community and individual  health conditions.   Source

============

> More specifically, transmissibility is, in the final analysis, a local dynamic.

A national vaccination rate may be an interesting barometer, but it’s not determining.

Said differently, some communities will likely reach the herd immunity threshold, even if the entire United States does not. Source

Conditions in New York and New Jersey have little impact on, say, Wyoming.

Viral spread in dense urban areas has little relevance to sparsely populated rural areas.

===========

The bottom line: Don’t fret over Biden & Fauci’s faux thresholds.

Pay attention to conditions in your local community.

If the number of hospitalizations and covid deaths keep declining … then get on with getting on.

DISCLAIMER: I’m neither a medical professional nor a scientist — just a curious, self-interested guy.  So, don’t take anything that I say or write as medical advice. Get that from your doctor!

Why are so many old people still dying of covid?

June 8, 2021

With an 86% vaccination rate, shouldn’t fatalities be closer to zero?
=============

I still think that the covid death rate, while itself a bit fuzzy, is still the cleanest covid severity metric.

So, I’m trying to understand why covid death rates — which have dropped  from pandemic highs  — are stubbornly hovering near 600 per day.

image

Who’s dying?

One might expect them to be relatively young and unvaccinated.

Certainly not vax-prioritized seniors, right?

============

Let’s look at some data…

The CDC doesn’t report the demographics of daily new covid deaths … or, at least, I can’t find it.

So, I’ve tried to decompose the cumulative data that is reported…

Below is data for February 2021 (about 6 weeks into the vax rollout) and May 2021 (the most current) … and, calculated data for the period between those 2 dates.

image

Cumulatively since the start of the pandemic, the 65 & over cohort accounted for around 80% of covid-related fatalities.

OK, that’s not new news.

Most notably, the senior cohort has still been accounting for a 75% share of covid deaths over the past couple of months.

Said bluntly, the vast majority of covid deaths are still among those 65 & over.

What’s going on?

Are all of these deaths are coming from the 14% of seniors (roughly 8 million) who haven’t been vaccinated?

Or, are the vaccines’ effectiveness rates being overstated — and not preventing  90% of fatalities, as promised?

Hmm.

Something just doesn’t smell right…

================

I wish the CDC, et. al,, would start reporting more meaningful data.

Case in point: I’d like to see daily covid deaths broken down by age (seniors young adults, teens, kids) … and by their vaccination status.

But, as usual, I won’t hold my breath.

WaPo: Biden’s goal of 70% by July 4 looks out of reach …

June 7, 2021

…. as the pace of shots slows drastically.
=============

Not my words, straight from the Washington Post  … here’s the data … 11.5 million shots needed in 28 days … below current running rate.,

image

==============

image

June 3: COVID Dashboard

June 3, 2021

Now that the Memorial Day holiday is in the books and data reporting seems to have caught up…

> Daily confirmed case counts below 20,000; deaths still hovering around 600 per day.

Implication: The CFR (case fatality rate) has soared to around 4% (chart below) … why?

> Vaccination rate still falling despite … and that number is buoyed by teenage vaccinations (now over 6 million)

Note: about 13 million adults over 18 need to get 1st shots to hit Biden’s target of 70% by July 4

image

image

image

May 29: COVID Dashboard

May 29, 2021

> Slight uptick in covid deaths

> Almost 1 in 4 teens 1st shot vaccinated

> Over 18 vaccinations still slowing

image

image

image

So, why are covid death rates higher in some states?

May 28, 2021

A common hypothesis is that there’s a strong correlation between death rates and the percentage of a state’s population that that is vaccinated.

The hypothesis seems reasonable, so I decided to to test it…

==============

Below is a scatter chart of the 50 states … on the horizontal axis is the current vaccination rate (% of residents 18 and over who have received at least 1 shot) on the vertical axis is the past month’s covid death rate (deaths per million residents).

image

To the naked eye, the chart is more buckshot than correlation.

Arguably, there’s a slight positive relationship … with emphasis on “slight” since the R-squared is a mere .0325 … which is, for all practical purposes, not statistically different from zero.

Let’s dig a little deeper…

================

Below is a matrix that puts names names on the above dots.

The rows are vaccination rates — over 60% at the top (good), under 40% at the bottom (bad).

The columns are the  past month’s covid death rates — left is under 40 deaths per million (good), right is over 0 deaths per million (bad).

So, for example, the states in the blue quadrant have high vaccination rates and low death rates.

The states in the red quadrant have low vaccination rates and high death rates.

Those are to be expected.

But, there are a lot of states in the orange (high death rates despite high vax rates) and yellow quadrants (low death rates despite low vax rates)

image
click for a full-size, printable PDF

=============

Let’s look at the top rows … the states that have vaccinated the highest percentages of their residents.

image

A couple of observations:

> Nearly all of the states in the top 2 rows (high vaccination rates) are Northern Blue  states … most with dense metro population centers.

> A majority of these high vaccination rate states still have high death rates … and, in aggregate, these states account for a disproportionate share of current covid deaths.

See Nums: 10 states account for 2/3′;s of covid deaths

> Most of the current high death rate states have had high death rates from the get-go … vaccinations  may have cut the death rate from previously high levels, but the states are still challenged.

> Two states — Massachusetts & California — have currently low death rates substantially below their pre-vax levels … likely attributable to vaccinations, but there may be other factors in play.

==============

What about the bottom rows – the low vaccination rate states?

image

> Generally, states with low vax rates are Red states with dispersed populations … more rural … with many in sunnier Southern climates.

> Michigan and Wisconsin are outliers to the general rule … Michigan is particularly interesting since it has been one of the most locked down, masked states … yet, the state has a relatively low vax rate (which their wacky gov has laid off against supply constraints) … and still has a sky high death rate.

==============

Bottom line: Covid death rates are a lot more complicated than simply tying them to vaccination rates.

Are the most vulnerable being vaccinated? What other factors are in play?

We’ll keep thinking about it … your thoughts?

May 27: COVID Dashboard

May 27, 2021

> 1st vax shots drop to 700,000 / day

> Deaths hovering between 500 and 600 per day

image

image

image

Nums: 10 states account for 2/3’s of the past month’s covid deaths…

May 26, 2021

I’ve been digging into the surprisingly slow decline in the daily covid rates.

Let’s start with some state-by-state data…

Relevant time series data is hard to find, but I was able to find month ago cumulative covid deaths by state that I could match against current cumulative totals to calculate the number of deaths in the past month.

And, the answer is…

In total, there were just under 22,000 covid deaths in the US over the past month.

Data check: That’s about 750 deaths per day

10 states — which house about 1/2 of the US population — accounted for about 2/3’s of the total covid deaths in the past month.

image

Of course, the death count is a function of states’ population and their death rate (usually reported per million residents).

So, highly populated states  states are heavily represented in the Top 10, e.g. Florida, California, Texas and New York.

But, it’s not just a matter of population.

The death rate in Top 10 states is running about 20% higher than the national average … and is about 50% higher  than in the other 40 states (79.7 deaths per million  versus 51.4).

A couple of the Top 10 states had death rates that were below the national average: California, Texas and Ohio.

So, their presence on the Top 10 list can be mostly attributable to population.

Conversely, a couple of Top 10 states are still on fire…

Leading the pack: Heavily locked-down Michigan — which tops the Top 10 list — had more than triple the national average of covid deaths over the past month (215 deaths per million versus  to 67).

Pennsylvania and New Jersey each had more than 100 deaths per million in the past month.

Hmmm.

So, what explains the variance in death rates across states?

Spoiler alert: It’s not vaccination rates.

Stay tuned … more to come.

May 26: COVID Dashboard

May 26, 2021

> Vaccination rate slowing after initial teenage surge

> Death rate continues slow decline

image

image

image

May 25: COVID Dashboard

May 25, 2021

> Death rate continuing slow decline

> Initial surge of teen vaccinations waning

> Vaccine stockpile growing … over 80 million doses

image

image

image

May 23: COVID Dashboard

May 24, 2021

> Approx. 1 in 5 teens have been vaccinated

> Cases declining faster than deaths 9which are still hovering slightly under 600 per day)

image

image

image

May 21: COVID Dashboard

May 21, 2021

> Slim majority of 18 to 65 year olds vaccinated … pivotal demographic!

> 4 million teens (16%) have been vaccinated … not exactly a groundswell given vax availability

> Death toll still hovering around 600 per day … why not a faster decline?

image

image

May 20: COVID Dashboard

May 20, 2021
  • Cases (& testing) declining
  • Deaths hovering around 600 per day
  • Daily 1st vax shots under 1 million
  • Unused vax stockpile accumulating

image

image

image

image

I’m all for mask freedom, but gotta ask…

May 18, 2021

What’s up with the covid cases and deaths data?
=============

To be crystal clear: I’m thrilled that the mask mandate has been ditched … and, I’m supremely confident that it’s not coming back.

But, I’m puzzled by “the data” that “the science” followed to make last weeks surprise mask announcement.

So, let’s drill down …

Below is our standard chart of cases & deaths — indexed to November 1st ( just to keep the series plotted on a common chart).

Unpacking the numbers, covid-related deaths peaked at about 2,000 per day in January … and have ranged around 650 for the past 6 weeks or so.

For reference, a high flu season averages about 500 deaths per day during the roughly 4 month flu season.

My take: We shouldn’t declare victory against covid until the death rate drops below 500, for sure or, more conservatively, below 250.

image

I’ve longed argued that the daily death count is the purest metric of covid severity.

That said, let’s look at the case numbers that Biden , Fauci and Wolensky like to point to.

Note that cases peaked at about 200,000 per day right around Biden’s inauguration.

Then, case counts dropped quickly and sharply, almost miraculously, to under 100,000 … hovering around 65,000 for the past couple of months.

That is, until about a month ago … when case counts turned down again …  to its current level of about 35,000 … which Biden says justified “relaxed guidance”.

image
Source: Bloomberg

So why have case counts dropped so much since Inauguration Day?

It could be that Biden is a miracle worker … or, it could be that the vaccines are kicking in … or, it could be another reason.

============

Below is the JHU chart that tracks the number of daily covid tests.

Note how closely the number of tests and the number of confirmed cases seem to track.

In the month after Biden’s inauguration, testing dropped by 25% from about 2 million per day to under 1.5 million per day … and hovered there for a couple of months.

But, in the past month, testing has fallen to just over 1 million per day …. a 33% drop.

image
Source: JHU

Let’s recap …

> Testing peaked around inauguration day … and so did cases.  Coincidence?

> After a couple of months of level testing and cases, both data series turned down again in the past couple of weeks.  Another coincidence?

Maybe I’m missing something….

COVID Deaths pass grim milestone: 600,000

May 17, 2021

image

image

image

May 16: COVID Dashboard

May 16, 2021

image

image

image

May 14: COVID Dashboard.

May 14, 2021

MASKS OFF ! MASKS OFF!!  MASKS OFF!!!

image

=============

image

image

Was your home a covid petri dish?

May 13, 2021

Early on in the pandemic, it was noticeable that:

(1) covid was spreading among locked down families — especially high density, multi-generational households and

(2) workers in some open businesses  — think: grocery stores — weren’t experiencing pandemic levels of covid consequences.

Said differently, people confined to ostensibly protective “bubbles” were getting infected … but customer-facing workers weren’t.

Is this just Fauci-shunned non-projectible anecdotal evidence … or a relatively broad based truth?

=============

Casey Mulligan  — a University of Chicago economist — studied that question and recently published his results in a research paper:

The Backward Art of Slowing the Spread? Congregation Efficiencies during COVID-19

Conventional public health wisdom held that  lives would be saved by shutting workplaces and schools and telling people to stay home.

But, Mulligan found the opposite to be true:

Micro evidence contradicts the public-health ideal in which households would be places of solitary confinement and zero transmission.

Instead, the evidence suggests that “households show the highest transmission rates” and that “households are high-risk settings for the transmission of [COVID-19].

How can this be?

Mulligan argues that after the first months of the pandemic, organizations that adopted prevention protocols became safer places than the wider community.

Schools, businesses, and other organizations implemented a range of prevention protocols – from adjusting airflow to installing physical barriers to monitoring compliance to administering their own testing services  – that households did not, and perhaps could not

But, households were bubble-fortresses isolated from the virus, right?

Wrong.

Few households were strictly “bubbled off” completely.  The bubbles were routinely breached.

One or more members of practically all households would venture out to work or run errands — being exposed to the virus.

If the outside venturers happened to catch the virus, the other household members would be close-contact sitting ducks.

Without the business-level precautions, penetrated homes became veritable petri dishes for the virus.

============

Mulligan’s conclusion:

Officials forgot that organizations are rational and look for cooperative solutions that improve the welfare of the group, such as reducing the risks of communicable disease.

Gee, who would have thought that self-interested private enterprises would be more creative, more efficient, more practical and more successful than government bureaucrats’ ivory-tower edicts..

May 13: COVID Daily Dashboard

May 13, 2021

image

image

image

COVID: Daily Dashboard

May 12, 2021

image

image

image

COVID: Daily Dashboard

May 11, 2021

image

image

image

1st vax shots down 65% from early peak…

May 10, 2021

image

image

image

Daily cases’ average drops below 40,000 … but CFR up to 1.8%

May 9, 2021

image

image

image

Shots drop below 2 million … 1st shots still plummeting.

May 8, 2021

Daily new deaths sticky at ~700.
=============

image

image

image

Awash with vaccine … shots still plummeting.

May 7, 2021

image

image

image

1st shots still plummeting …

May 6, 2021

image

image

image

Biden sets another low bar vaccination goal…

May 5, 2021

Is he a slacker? Or, a math-denier? Or, does he know something that we don’t know?
=============

Yesterday, Pres. Biden chest-pounded a new vaccination goal:

image

So, how ambitious is the new goal?

Here’s the back of the envelop:

There are about 250 million Americans over 18

70% of 250 million is 175 million

According to the once reliable CDC, about 145 million adults (over 18) have already gotten 1st shots

That makes the “go get” number 30 million 1st shots

We’re currently averaging just under 1 million shots per day.

So, it should take about 30 days to close the gap.

That puts us in early June… not July 4

=============

So, what the heck is going through Biden’s mind?

> Is he intentionally setting a low bar (like the 100 million doses in his first 100 days) to ensure another end zone celebration?

> Did he just mouth the teleprompter wrong again (ala “no one earning less than $400,000 will pay a penny of taxes”)?

> Or, has he officially jumped on the new-new math that doesn’t have right answers?

> Or, does he know something that his advisors won’t let him tell us?

Hmmm.

=============

P.S. I’ve adjusted the official HomaFiles’ daily dashboard calculations to reflect Biden’s new goal.

image

Awash in vaccine … what to do?

May 4, 2021

Back in early February, Dr. Scott Gottlieb — a former FDA Commissioner — offered a projection that stuck in my mind.

In a WSJ op-ed, Gottlieb wrote:

After early challenges, vaccine delivery is keeping up with supply.

But by the end of March, the monthly vaccine supply may reach 100 million doses.

With improved delivery, at some point, perhaps in April, supply will start exceeding demand.

Sure enough …

For example, at a micro level…

Back in February when I was in the heat of my vax hunt, CVS “offered” covid vaccinations at about a dozen stores in Maryland.

I say “offered” because “availability” was scarce and scoring an appointment had about the same odds as winning lotto.

See VAX: I got mine … and it wasn’t easy!

Today, CVS offers shots at more than 100 locations … and the vast majority of them have vaccine available on any given day.

image

Aggregating up to the macro level, the CDC reports that the stockpile of doses “distributed” but not yet “administered” is over 70 million doses … and growing.

image

About 40 million doses are, in effect, being held in reserve for second shots.

image

Given the large, free flow of supply from Pfizer and Moderna, It’s not evident why these 40 million need to be sequestered for future use.

And, even if there is a just reason, it still leaves a stockpile of over 30 million doses … compelling evidence that supply is now exceeding demand … by a lot!

Which validates Gottlieb’s February warning:

The challenge won’t be how to ration a scarce resource, but how to reach patients reluctant to get vaccinated.

Yep, that’s where we are … and, it should have been anticipated.

Fewer than 1 million 1st shots…

May 4, 2021

Over the past week, the average number of 1st shots has dropped below 1 million … pushing the herd date into July
=============

image

image

Herd date slipping as 1st shots continue to drop…

May 3, 2021

60% of shots are 2nd doses … now only 1 million 1st shots per day … half of mid-April peak.

image

image


%d bloggers like this: