Archive for the ‘COVID – Return to Normalcy’ Category
June 10, 2021
A hopeful sign for herd immunity
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In yesterday’s post, we observed:
The political-scientists still refuse to acknowledge that the vast majority of covid survivors have developed protective antibodies.
The implication: The percentage of the population that has some degree of covid protection is higher than the current 64% of 1st-shot adults … probably way higher.
And, we cited Hopkins’ Dr. Marty Makary (who is right way more often than, say, Fauci):
More than 64% have received at least one vaccine dose and, of those who haven’t, roughly half have natural immunity from prior infection.
So, some 80% to 85% of American adults are immune to the virus.
Some in “the science community” may be skeptical.
But, right on cue, researchers at the Cleveland Clinic have reported out results from study that cuts to the chase.
Specifically, the researchers tracked 52,238 of Cleveland Clinic employees, recording their infection and vaccination status over a 5 month period.
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And, the data says…
> 2,579 (5% of the 52,238 total sample) had been infected with covid
> 28,102 (54% of the 52,238 total sample) got vaccinated (2-shots of Moderna)
> Less than 1% of the employees who were vaccinated subsequently caught covid
Note: The report stated “There was a “steady increase in cumulative incidence among previously uninfected subjects who remained unvaccinated” … but didn’t provide a specific number.
The infection rate in the vaxed group was in line with prior effectiveness results … in fact. better than previously reported from clinical studies.
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Here’s the big news…
> 1,359 of the Cleveland Clinic employees had a previously confirmed COVID infection but did not get vaccinated .
> NONE of these unvaxed covid survivors got infected with covid during the study period
To say the least, that’s statistically significant!
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The implications:
> The effectiveness of the Moderna vaccine was confirmed (at a higher level)
> At least in this large scale study, covid survivors appear to be protected (at least over the short-term) whether or not they get vaccinated.
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In other words, the Cleveland Clinic study seems to lend credence to Dr. Markary’s conclusion:
More than 64% have received at least one vaccine dose and, of those who haven’t, roughly half have natural immunity from prior infection.
So, some 80% to 85% of American adults are immune to the virus.
If we’re not at herd immunity levels, we’re pretty darn close!
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June 9, 2021
Life is heading back to normal regardless.
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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.
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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
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> 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
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> 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.
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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!
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June 7, 2021
So much for following the science …
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Welp, it looks like Biden’s goal of 70% adults getting 1st shots by July 4 isn’t the slam dunk that it initially seemed.
See Biden sets another low bar vaccination goal
With about a month to go, almost 12 million adults over 18 still have to get 1st shots to hit the target.
That works out to about 500,000 first shots per day … roughly the recent 7-day moving average of 1st shots … a number that has been declining and is being buoyed by teenagers (who don’t count against Biden’s target).
Recognizing that the goal is in jeopardy, Team Biden has thrown its weight behind a new program.
Last week, Biden announced “Shots at the Shop” an initiative bringing together 1,000 Black-owned barbershops and beauty salons across the nation to serve as vaccination locations … leveraging the trust and significance they have in Black communities. Source
OK, I understand the need to deliver healthcare to underserved communities … and to use credible messengers.
But, this program raises some obvious questions…
(1) Do we really want barbers and hair stylists to be dishing out medical advice?
They’re probably as spot-on as, say, Dr. Fauci … but still, is that a precedent that Biden wants to establish?
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(2) Is it a good idea to have groups of unvaccinated people converging on barbershops to seek counsel … and maybe get vaccinated?
Program proponents say: “You don’t have to be tethered to a hospital”
Hmm.
I don’t know about your’s, but my barbershop is small-spaced, indoors and not-to-be confused with a sterile operating room.
Bluntly, I avoided my barbershop like the plague during covid until I got fully vaccinated.
If I knew that it was a hang-out for the unvaxed, I would have continued my avoidance.
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(3) When did the vaccines suddenly become easy to store, easy to prepare and easy to administer?
Up to now, we’ve been told that (a) the vaccines need to be kept frozen at sub-zero temperatures (b) need a couple of hours of medically precise preparation (c) must be administered within a few hours after being thawed.
I started to wonder how it was possible for small, low volume retail pharmacies to to handle the constraints.
A medically-attuned friend advised me that (a) shipment batch sizes were reduced from about 1,000 doses to about 100. (b) some pharmacies already have deep freezers … others can get them for about $2,500 each (probably with some gov’t subsidies offsetting that amount) (c) pharmacists are well-able to safely perform the thaw and shoot process.
That’s pharmacies (and pharmacists), but it still begs the question …
Barbershops and barbers?
Excuse my skepticism, but this program just doesn’t sound very scientific to me.
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P.S. Some of the above vaccine storage & prep constraints are less limiting with the up-to-now problematic J&J vaccine.
But, that opens a bigger can of worms that we’ll address in a future post.…
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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
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May 18, 2021
What’s up with the covid cases and deaths data?
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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.
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”.
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.
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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.
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….
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May 14, 2021
Thanks to a couple of inspiring “coincidences”.
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Earlier this week, I was gifted the best-seller “Breath”. I finishing reading it yesterday.
The book’s central premise:
The way we breath is important to our health … and 90% of us breathe incorrectly, causing or aggravating a laundry list of chronic diseases.
The author provides the research support for several attitudes and techniques for better breathing … and better health.
Not surprising, wearing masks wasn’t on his list of remedies for bad breathing.
I was struck by the irony: Wearing masks for a year may have sheltered us from covid … but, may have also created a stockpile of unintended future heath problems.
Oh my.
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Then came the big announcement.
The nation’s chief political-scientists had an overnight epiphany regarding masks and advised: fuhgettaboutit.
Literally overnight, “the science” spun on a dime.
No more masking for eternity.
No more double or triple masking.
The new “guidance”: stow your masks … but don’t toss them in case the political landscape shifts, and our politically-sensitive scientists change their minds.
I like the long overdue direction, but it’s a head-scratcher.
There was no scientific evidence provided that we hadn’t known for weeks (or months).
So what motivated the change?
The obvious: A variant of the old “wag the dog” technique.
Given a crisis on the southern border, a labor force getting paid to stay home, a heating up of inflation, a hijacked gas pipeline, and a Middle East that’s on fire … maybe Team Biden just wanted to re-focus the spotlight.
Or, maybe I’m just being cynical…
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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?
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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.
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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..
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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.
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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:
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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May 3, 2021
Let’s get personal today…
Friends and family know that our 8 grandkids are the center of our universe.
As a sports-loving, doting grandfather, one of my favorite pastimes is watching the kids play sports — any kind, anywhere.
For the past year, I’ve been banned from most of the kids’ games — even though they were played outdoors and I was willing to mask-up and socially distant (even after getting vaxed).
I’d occasionally scofflaw into games … hanging in the shadows … and occasionally wearing the other team’s colors so my player-grandkids wouldn’t get in trouble for violating the attendance rules.
Well, much to my delight, the dam broke this weekend.
Not only did I get to legally attend little league baseball and travel soccer … but, I — and practically everybody else at the games — followed the long overdue CDC guidance and pocketed our masks.
It was refreshing to breathe freely again (without my glasses fogging) … and morale-boosting to see people’s smiling faces again.
As moon-walker Neil Armstrong once proclaimed:
“It’s one small step for man, one giant leap for mankind.”
For a couple of hours, things felt downright normal again.
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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
- Watch local case & vaccination rates
- Don’t frequent likely hot spots.
- Avoid crowds of strangers
- Don’t linger – keep moving
- Enjoy the outdoors
- Exercise at home.
- Distance from close talkers
- 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!
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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?
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April 7, 2021
Dateline: September 18, 2020
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Ballyhooed headline yesterday:
To paraphrase the Biden-gushing media: “Yes, Biden has saved the country.”
Big problem with the narrative, though.
A more appropriate headline might have read: “Fortunately, Joe didn’t f-k this one up.”
See Obama: “Don’t underestimate Joe’s ability to f–k things up.”
Why?
Well, it turns out that April was Operation Warp Speed’s timeline all along.
You know, the plan that Biden says that Trump didn’t have.”
For proof, flashback to Friday September 18, 2020 … the day that Trump boldly predicted that there would be enough vaccine available for all Americans by April (2021).
As reported by Kaiser Health News the following Monday:
Specifically, Trump said:
“Millions of doses will be available every month, and we expect to have enough vaccines for every American by April.”
But, of course, the “experts” and the Trump-hostile media guffawed:
To recap:
- Operation Warp Speed delivered.
- Trump was right.
- The “experts” were wrong.
Sound familiar?
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Just in case the September, 2020 news reports gets vaporized, here’s a hard copy of the KHN recap article (with specific citations)
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