Archive for the ‘COVID-Herd Immunity’ Category

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

May 8, 2021

Daily new deaths sticky at ~700.
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Awash with vaccine … shots still plummeting.

May 7, 2021

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Did rationing priorities induce vaccine hesitancy?

May 6, 2021

A story of messaging and first impressions.
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Back in early February, Dr. Scott Gottlieb — a former FDA Commissioner — offered an observation that stuck in my mind.

In a WSJ op-ed, Gottlieb wrote:

One reason for the hesitancy may be that it was necessary to ration scarce doses at the start, causing many Americans to internalize the idea that some people may be more likely to benefit or more deserving than others.

Let’s unpack Gottlieb’s observation…

Initially, scarce vaccine supplies were aimed at the elderly in  long-term-care facilities (where the vast majority of covid deaths were accumulating) … and to covid-patient-facing healthcare professionals (especially those in direct contact with confirmed covid patients).

Made sense: Protect the most vulnerable and the most exposed.

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But, what about people further down the priority pyramid?

For example, youngsters were initially told (by no less than chief political-scientist, Dr. Fauci) their covid risk was miniscule, so they should go to the end of the line.

English translation: Party on!

Now, people scratch their heads wondering why twenty-somethings are ambivalent about the vaccine.

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Early on, vulnerable old-timers (like me) were getting bumped by an expanding list of mostly unionized “essential employees”.

The vast majority of these government-coined “essentials” were under 60 (i.e. low consequential covid vulnerability).

And, after the frontline healthcare workers, many of them were of questionable essentiality (e.g. virtual teachers who had made no near-term commitment to in person teaching).

See What do lawyers, prisoners and ‘the media” have in common?

The message to the rest: You’re not essential (and really not that vulnerable) so so don’t clog the system.

The new message: The fate of the nation depends on you getting vaccinated.

The predictable reaction: Why wasn’t I important before?

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More generally, people down the pyramid were  getting pounded with a clear message:

You’re not at risk … and, by the way, you’re not essential … so, there’s no pressing need to get you vaccinated.

Now, it’s their turn, and these people aren’t rushing the gates to their shots.

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A couple of takeaways…

> First impressions “anchor” peoples perceptions … “adjusting” those perceptions is always a challenge … especially if they’ve been given time to harden.

> Solidifying perceptions requires strong, clear, consistent messaging … don’t signal people one thing on one day and another thing on another day.

> None of should be surprising… it’s straightforward behavioral economics.

1st shots still plummeting …

May 6, 2021

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

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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

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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.

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

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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
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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.

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Supply > demand, herd date slipping, stockpile growing …

April 30, 2021

Cases and deaths stubbornly sticky.
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Herd date slipping as 1st shots continue to drop…

April 29, 2021

Cases and deaths stubbornly sticky.
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VAX: First shots continuing to drop … stockpile growing

April 28, 2021

Slowing demand (aka vax hesitancy)? J&J pause?
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April 27: COVID Dashboard

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April 27: COVID Dashboard

April 27, 2021

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April 26: COVID Dashboard

April 26, 2021

Herd immunity date slips as daily shots’ rate (total and 1st shots) declines
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April 23: COVID Dashboard

April 23, 2021

Vaccination Rate Dropping (Total & 1st Shots)
Herd Immunity Date Slipping into June
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April 21: COVID Dashboard

April 22, 2021

Heads-up: 1st shots decreasing as a percentage of total daily shots … so, herd immunity date slipping into June.

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April 20: COVID Dashboard

April 21, 2021

Heads-up: 1st shots decreasing as a percentage of total daily shots … so, herd immunity date slipping into June.

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April 20: COVID Dashboard

April 20, 2021

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April 19: COVID Dashboard

April 19, 2021

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COVID: How safe (or risky) to resume activities?

April 16, 2021

Here are my Covid 5-Ps of risk assessment
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Like most people who have been vaccinated, I’ve been recalibrating my Covid risk tolerance: What activities can I safely reactivate? What venues can I visit? What mix of people to beware?

Nudged by a New York Times article headlined What Can You Do Once You’re Vaccinated?, I’ve distilled down to my personal 5-Ps of Covid risk (or safety):

1. PREVALENCE

  • Community contagion?
  • Herd immunization?

2. PLACE (Venue)

  • Outdoors or indoors?
  • Ventilation? Shields?
  • Cleanliness? Sanitation?

3. PASTIME (Activity)

  • Intensity: Sweat? Spray?
  • Duration: Brief? Prolonged?

4. PEOPLE (Crowd)

  • Density: How many? How packed?
  • Familiarity: F&F? Strangers?
  • Behaviors: Known? Apparent?

5. PRECAUTIONS (Personal)

  • Healthy?
  • Vaccinated?
  • Masked?

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Some common sense hints

  1. Watch local case & vaccination rates
  2. Don’t frequent likely hot spots.
  3. Avoid crowds of strangers
  4. Don’t linger – keep moving
  5. Enjoy the outdoors
  6. Exercise at home.
  7. Distance from close talkers
  8. Wear a mask (just in case)

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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!

April 15: COVID Dashboard

April 15, 2021

Daily New Deaths metric drops below 750
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How will we know when we’re near-normal again?

April 13, 2021

Stay focused on the number of Daily New Deaths!
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Now that the country is getting vaccinated at a rapid clip, everybody is asking the same question: When can we resume “normal” life again?

The verbiage from the political-scientists and pundits ranges from ‘pretty soon’ to ‘probably never’.

Thanks guys.

Is herd immunity within reach or asymptotically impossible because of ”vaccine hesitancy”?

How many covid survivors now have “natural immunity”?

How long does natural or vaccine immunity last? Weeks? Month? Years?

Case counts spike then drop like a rock … with “scientific” explanations mimicking financial analysts’ head-scratching rationales for why the market went up (or down) each day.

My advice from the get-go has been — in the words of Nate Silver — to ignore the noise and focus on the signal … the covid-related death count.

Back in Jan.-Feb. 2020, Dr. Fauci was saying:

This not a major threat for the people of the United States, and this is not something that the citizens of the United States right now should be worried about.

I bought in to Fauci’s read of the situation, but said that I’d start worrying when daily covid deaths surpassed those of a a bad flu year.

The were about 80,000 flu-related fatalities in worst recent flu year.  Source

Spread across the entire year, that works out to about 250 deaths per day; spread across the usual 4 month flu season, that’s about 750 deaths per day.

Of course, we blew past those numbers … and stayed at sky-high levels for most of the past year.

Now, we’re coming back down … with enough people vaccinated or naturally immune that the trend and levels are likely to stick.

So, my advice: Take case counts with a grain of salt, be encouraged by vaccination rates and stay focused on the averaged number of daily new deaths (DNDs).

Based on the flu benchmark, when the weekly average of DNDs drops below 750, we’re probably near-normal … when it drops below 250, then giddyup … we’re there!

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For more detail. see:  MUST READ: How will we know when we’ve turned a COVID-19 corner?

April 13: COVID Dashboard

April 13, 2021

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April 9: COVID Dashboard

April 9, 2021

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April 8: COVID Dashboard

April 8, 2021

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April 7: COVID Dashboard

April 7, 2021

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April 6: COVID Dashboard

April 6, 2021

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April 5: COVID Dashboard

April 5, 2021

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April 4: COVID Dashboard

April 4, 2021

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Herd Immunity Projection details…

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April 2: COVID Dashboard

April 2, 2021

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Herd Immunity Projection details…

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April 1: COVID Dashboard

April 1, 2021

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Herd Immunity Projection details…

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March 31: COVID Dashboard

March 31, 2021

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Herd Immunity Projection details…

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March 30: COVID Dashboard

March 30, 2021

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Herd Immunity Projection details…

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March 29: COVID Dashboard

March 29, 2021

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Herd Immunity Projection details…

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VAX: Why are there more than 40 million doses stockpiled?

March 28, 2021

Early on, Team Trump (and the states) were widely criticized for having about 20 million “unused” vaccine doses sitting in inventory.

About half of the “distributed but not administered” doses was an oversupply to long term care facilities … and, about half was being held in inventory to ensure 2nd doses were available folks who had received their 1st doses.

Team Biden is way more efficient in vaccine distribution.

That must be so, because Biden says so (repeatedly) and the mainstream media confirms it.

But, the data seems to contradict…

Over the past month, the the stockpile of unused doses has about doubled … to over 40 million doses.

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States continue to clamor for more vaccine and have substantially boosted their vaccination rates, especially at mass vaccination sites.

So, what’s going on?

Best that I can tell, the excess doses originally shipped to Walgreens & CVS for long term care facilities has been redistributed to “public” vaccination sites — mostly retail pharmacies.

But, as a matter of policy, doses are still being held in reserve, earmarked for 2nd shots.

That was understandable at the beginning of the year when the vax companies were fine-tuning their processes and ramping-up their production.

But, now the vaccine manufacturers are producing at higher rates that are steadier and more predictable.

So, why not release the stockpile for 1st shots … and, handle 2nd shots “on the come.”

That would get us closer to herd immunity faster!

C’mon man…

March 28: COVID Dashboard

March 28, 2021

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Herd Immunity Projection details…

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March 27: COVID Dashboard

March 27, 2021

Daily New Covid Deaths Drop Below 1,000

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Herd Immunity Projection details…

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March 26: COVID Dashboard

March 26, 2021

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Herd Immunity Projection details…

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March 25: COVID Dashboard

March 25, 2021

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Herd Immunity Projection details…

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March 24: COVID Dashboard

March 24, 2021

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Herd Immunity Projection details…

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March 23: COVID Dashboard

March 23, 2021

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Herd date estimate below ….

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March 22: Herd Immunity Tracker

March 22, 2021

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Herd date calculation details  below…

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Update: Herd immunity forecast

March 15, 2021

We’ll reach the promised land by early June … maybe earlier!
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That’s later than Dr. Makary (“We’ll Have Herd Immunity by April”.) … but way sooner than Dr. Fauci, who’s still pitching Christmas (or just before the 2022 elections).

In prior posts, we’ve worked through the logic of our simple forecasting model.

See Herd Immunity: By the Numbers

Our foundational premise: People develop immunity to COVID in 2 main ways: (1) by surviving a COVID infection and developing “natural immunity, or (2) by getting vaccinated.

So, if those 2 groups add up to 200 million (80% of the 225 million adults 18 & over), we’ve reached the promised land: herd immunity.

Statistical note: There is some overlap between the 2 groups, namely people who get vaccinated even though they have survived Covid infections and likely have natural immunity.  Our forecast adjusts for the overlap.

Based on our assumptions (which are delineated below, after the table) and our calculations, we’ll most likely get to herd immunity before summer.

Specifically, in May in our likely scenario (think: 80% likely) … early June in our highly likely scenario (think: near certainty)

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Below are our key assumptions & calculations

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Makary: “Get the Vaccine, Wait a Month, Return to Normal”

March 11, 2021

From the doc who argues that herd immunity is right around the corner.
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Hopkins’ Dr. Marty Makary seems to be the only Fauci-contrarian that doesn’t get crushed by the mass and social media for  “spreading misinformation”.

My guess: It’s because he has a JHU credential, he cites real data and his views are very commonsensical.

Recently, he made a splash by declaring “We’ll Have Herd Immunity by April”.

In today’s WSJ, Makary strikes again with some heavy optimism re: the return to normalcy.

His foundational premise:

Throughout the pandemic, authorities have missed the mark on precautions … by focusing myopically on transmission risk and demanding “complete elimination of infection risk”.

As a result, the CDC “has lost a lot of credibility during the Covid-19 pandemic by being late or wrong on testing, masks, vaccine allocation and school reopening.

And now the CDC is being “ridiculously cautious” about the implications of the vaccines “stunning success”.

Specifically, he advises that, a month after their first dose, vaccinated people should keep wearing masks in public but, otherwise, go back to normal.

Besides the well publicized clinical test results (over 90% protection against symptomatic Covid with near-total protection against hospitalization and death), Makary cites “real life” evidence from Israel (whose vaccination program is months ahead of the rest of the world):

A study conducted by the Israeli Health Ministry and Pfizer showed that vaccination reduced transmission by 89% to 94% and almost totally prevented hospitalization and death.

Immunity kicks in fully about four weeks after the first vaccine dose, and then you are essentially bulletproof.

With the added safety of wearing a mask in public places  … there is little a vaccinated person should be discouraged from doing.

Makary concludes:

It’s time to liberate vaccinated people to restore their relationships and rebuild their lives.

In the process, “that would encourage vaccination by giving hesitant people a vivid incentive to have the shots.”

Well said, Dr. Makary.

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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!

VAX: What exactly did Biden promise?

March 3, 2021

Is “enough vaccine supply for every adult by the end of May”
a lay-up or a long-shot?

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I commend Biden for putting a quantitative stake in the ground.

That said, let’s parse his announcement to decode what it really means…

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First, how many people are we talking about?

There are 250 million adults 18 & over in the U.S.

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So, how much vaccine is required?

As of today, 26 million have been fully vaccinated (i.e. received 2 shots) … 52 million have received only the 1st of 2 shots.

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An obvious question: Is Biden talking about fully vaccinated or just “in the system” …. having received at least received one shot? More on that later.

As of today, there is over 24 million doses in the government stockpile.

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Presumably, that inventory is intended for the 2nd shots to be given to folks (like me) who have already received their first shots.

So, we can assume that we just need to consider new vaccination candidates.

That means that we need enough new supply to vaccinate just over 200 million people (250 million adults 18 & over less the 52 million already vaccinated and presumed scheduled for their 2nd shots).

The good news: J&J says that it will deliver 20 million 1-shot doses by the end of March and 100 million by summer.

That works out to about 75 million J&J doses by the end of May. (20 million in March plus 2/3s of the 80 million ‘by summer’ balance).

Since J&J is a 1-dose vaccine, that leaves 125 million adults to be vaccinated by the end of May.

So, we need about 250 million doses from Pfizer & Moderna to hit the goal (125 million adults times 2 doses).

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Are 250 million mRNA doses a long-shot or a lay-up?

There were 52.5 million doses delivered to (and from) the Feds in February.

Quant note: Cumulatively, there were 49.9 million doses delivered as of Feb.1 and 102.4 million delivered as of March 1 … the difference (52.5 million) was delivered in February,  Source  

So, at the February rate, we can expect at least another 150 million doses in the 3-month period March-April-May.

That leaves us about 100 million mRNA  doses short of having enough to have all adults 18 & over fully vaccinated by the end of May.

Said differently, it leaves 50 million adults partially vaccinated (i.e. having on 1 of their 2 shots).

Finishing them off will require another month’s supply (at the current delivery rate.

That pushes us out to June unless there’s a boost in vaccine manufacturing output.

Since the J&J-Merck manufacturing partnership requires a couple of months until it comes on line, it’s not clear where & how the additional supply will materialize.

So, if the goal is “fully vaccinated” , then May is aggressive … June is realistic … and, the difference is, in my opinion, rounding error.

Of course, the goal can be fudged to “at least one dose” … which may be doable by the end of May.

So, there should be enough supply to hit the available supply goal, plus or minus a couple of weeks.

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The big “but…”

Biden’s commitment is “available supply” … which is less daunting than getting all adults 18 & over “vaccinated”.

And, achieving an available supply goal simply requires continuing to deliver vaccines (to & from the government) at current run rates (plus the new incremental J&J supply).

But, converting the supply into “shots in arms” is likely to run into at least 2 challenges: (1) the last mile under-served populations (i.e. rural, inner city), and (2) demand creation among the vaccine hesitants.

These challenges may be more of an impediment than vaccine supply.

We’ll cover them in future posts…

WSJ: Operation Warp Speed’s Triumph

March 3, 2021

In today’s editorial, the WSJ says that Trump’s vaccine bet was government’s best pandemic decision.
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A bold move:

American governments, federal and state, have made many mistakes in the Covid-19 pandemic.

But the great success — the saving grace — was making a financial bet in collaboration with private American industry on the development of vaccines.

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A fast track to normalcy

That effort is now letting the country see the possibility of a return to relatively normal life as early as the spring.

President Biden announced that the U.S. should have enough vaccine supply for every American adult by the end of May.

[That’s months, or years, before Dr. Fauci and other experts said to expect the first doses of a Covid vaccine to be delivered.]

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False claims try to diminish the achievement:

Critics scoffed when President Trump set a target of having a vaccine approved by the end of 2020.

Kamala Harris suggested she would not take a shot recommended by the Trump Administration.

The Biden-Harris Administration has now changed to full-throated encouragement — though not before continuing to trash the Trump efforts.

President Biden and White House aides have repeatedly stated that they inherited little vaccine supply and no plan for distribution.

Both claims are false.

The claim that the administration inherited no vaccine program at all, initially propagated through the ministrations of a kindly reporter, is so at odds with the evidence that even the most friendly newspapers were obliged to call it out.

The supply was ramping up fast, and while there were distribution glitches at first, the real problem has been the last mile of distribution controlled by states [at their demand].

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Politically-inflicted complexity:

Governors like New York’s Andrew Cuomo tried to satisfy political constituencies that wanted early access to vaccines, adding complexity and bureaucracy that confused the public.

Mr. Biden is making the same mistake, asking states to give priority to educators (read: teachers unions), school staffers and child-care workers.

That is arbitrary and unfair.

A 30-year-old teacher who may still work remotely until September is at far less risk than a 50-year-old FedEx driver who interacts with customers all day.

The fairest, least political distribution standard is age.

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The big bet:

The Trump Administration’s Operation Warp Speed also contracted most of the vaccine supply for production before approval by the FDA: 200 million doses each of Pfizer and Moderna, and 100 million of J&J.

No one knew which technology would be approved first, if at all, so the Trump administration wisely bet on several [with firm advance orders and contract options to order more once the vaccines were approved and in distribution].

This was a grand strategy and the best money the feds spent in the pandemic.

Mr. Biden ought to give the vaccine credit where it is due — to U.S. drug companies and Operation Warp Speed.

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I couldn’t have said it better myself…

Herd Immunity: By the Numbers

February 25, 2021

Key: It’s not just people who get vaccinated who are in the immunized part of the “herd”
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Earlier this week, we dissected the WSJ op-ed by Hopkins Dr. Marty Makary who boldly claimed  that “We’ll Have Herd Immunity by April”.

Our basic conclusion: The claim isn’t as far-fetched as it sounds. It’s unlikely, but mathematically possible.

The essence of Makary’s logic is that people develop immunity to COVID in 2 main ways: (1) by surviving a COVID infection or (2) by getting vaccinated.

So, if those 2 groups add up to 200 million (80% of the 225 million adults 18 & over), we’ve reached the promised land: herd immunity.

The catch: Achieving herd immunity in just a couple of months requires two very bold policy shifts and supportive actions.

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