Archive for the ‘COVID – vaccine’ Category

More re: college vaccine mandates … liability?

June 16, 2021

Northwestern student reportedly dies of heart failure after getting vaccinated.
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Yesterday morning, we explored the ethics of college vaccine mandates.

Then, yesterday afternoon, I caught a chilling, related story:

  • Northwestern is one of roughly 450 colleges requiring that students get vaccinated.
  • In compliance, 19 year old Simone Scott got vaccinated.
  • On May 16, two weeks after getting her 2nd vaccine dose, she suffered a case of apparent myocarditis-induced heart failure … a known but rare side effect of the vaccine.
  • Despite heroic medical efforts — including a heart transplant — Simone died on June 11.
  • Her doctors have not specified the vaccination as causal, but have provided no alternative explanation.

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My questions:

  1. Why hasn’t this story been widely reported?
  2. To what extent is Northwestern (and other colleges)  liable if they coerce students to get vaccinated … and the  students suffer severe, potentially fatal side effects.

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Regarding, the lack of media coverage, the answer is fairly obvious.

First, the story would certainly throw  some cold water on the current push to get everybody vaccinated.

Second, yesterday’s reporting was by Alex Berenson — a former NY Times reporter — with a history of challenging Facebook-approved covid orthodoxy in books and on a web site bannered “Unreported Truths”.

Said differently, the MSM brands him a conspiracy theorist — despite his data-rich, fact-based analyses.

My take: reading and listening to Berenson, he strikes me as a fairly balanced reporter who tells it like it is … and doesn’t tow either party’s line.

That said, I encourage everybody to read Berenson’s detailed account of Simone’s story … and draw your own conclusions.

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My take on the liability question …

For sure, colleges and universities are going to be subject to ethical challenges and  headline-quality lawsuits over liability in the albeit rare cases when vaccination side effects take a toll.

It’s easy to foresee things getting pretty messy … very fast.

And, it’s only a matter of time until “the issue” spreads to corporate vaccine mandates.

Are college vaccine mandates ethical?

June 15, 2021

That’s a question posed in a WSJ opinion piece by a medical ethics prof and a lawyer…

The essence of their argument:

The central canon of medical ethics  is the free and informed consent of the research subject.

The current trio of vaccines are operating under emergency use authorizations, not full approval.

Courts have ruled that, in such situations, group members cannot be coerced into “serving as guinea pigs for experimental drugs”.

Never before have colleges insisted that students or employees receive an experimental vaccine as a condition of attendance or employment.

I think the authors make a compelling case … and, they deftly handle the usual counter-arguments.

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But, elementary schools require pediatric vaccinations.

True, but those vaccines are fully approved for use (i.e. not experimental) … and justified as directly protecting the recipient students from infection and significant health risks.

But, data consistently shows that “for those under 30, the risks of serious morbidity and mortality are close to zero … and. that the vaccines pose “an excess risk for heart inflammation”

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But, vaccinating college students protects against transmission to potentially vulnerable groups, both directly and by building herd immunity.

A person may freely choose to accept medical risks for the benefit of others, as when one donates a kidney for transplant.

Those who make such sacrifices for others must truly be volunteers, not conscripts drafted by college administrators.

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But, faculty and staff will resist resuming classes unless they feel safer.

Yeah, but they have the opportunity to protect themselves by  getting vaccinated.

The burden need not be shifted to students … especially those who are low risk, especially if they are covid survivors with natural immunity.

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The entire WSJ article is worth reading:
College students aren’t guinea pigs.

Cleveland Clinic: “Natural immunity” is for real…

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…

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> 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!

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

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!

If you can’t trust your barber, who can you trust?

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).

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Recognizing that the goal is in jeopardy, Team Biden has thrown its weight behind a new program.

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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.…

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

June 7, 2021

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

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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

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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

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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…

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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).

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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…

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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)

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click for a full-size, printable PDF

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

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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.

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

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> 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.

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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?

Currently, which states have the highest (and lowest) covid death rates?

May 27, 2021

Cumulative death rates — since the beginning of the pandemic — are largely irrelevant.

What matters now is recent covid activity!

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Yesterday, we pointed out that, in total, there were just under 22,000 covid deaths in the US over the past month.

Disaggregating that number…

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.

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The high death counts are not just a matter of states’ big populations.

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).

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Today, let’s dig a little deeper on the state death rates over the past month….

Michigan — which tops the above Top 10 list — had more than triple the national average rate of covid deaths over the past month (215 deaths per million versus  to 67).

Pennsylvania and New Jersey follow with more than 100 deaths per million in the past month.

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Re-sorting the data, below are the 10 states with the highest death rates over the past month.

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3 states that are in the Top 10 for number of deaths aren’t in the Top 10 for death rates: California, Texas and Ohio … suggesting that their high death counts are largely population driven

7 states (highlighted in light red above) are in the Top 10 for number of deaths and the Top 10 for death rates… suggesting that high death rates are a major contributor to their high fatality counts.

3 states that didn’t make the Top 10 for death counts, do make the Top 10 in death rates: Hawaii, Kentucky and Maryland … raising obvious concern.

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Flipping the data, here are the states that have had the lowest death rate over the past month:

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Note that these low death states are relatively small,  geographically diverse and politically skewed (8 Red, 4 Blue).

Note: West Virginia made a significant downward adjustment to its reported  fatalities and is excluded in this ranking.

Click here for a list of all stats’ data

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OK, enough for the descriptive data…

What’s going on with the recent death rates?

A popular hypothesis is that states with high vaccination rates have have low death rates  … and vice versa.

Spoiler alert: It’s not vaccination rates.

Stay tuned … we’ll dig into the Vaccination – death rate relationship tomorrow.

May 27: COVID Dashboard

May 27, 2021

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

> Deaths hovering between 500 and 600 per day

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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.

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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

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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

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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)

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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?

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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

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

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.

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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”.

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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.

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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….

Fauci: Slim majority of NIH employees have been vaxed…

May 17, 2021

Finally, an answer to a question that I’ve been asking.
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Frankly, when it comes to vaccine efficacy & safety, I don’t find testimonials from politcos, Hollywood celebs or sports stars to be very compelling.

The relevant info, in my opinion, comes from doctors and subject matter scientists: Have they (and their immediate family) been vaccinated? If yes, which brand of vaccine?

I’ve been frustrated getting credible numbers re: healthcare professionals. Best guess: 60% overall, 70% front line, 80% doctors.

See Why have so few healthcare workers been vaccinated?

And, there has been a data void re: employees at NIH or the CDC.

That is until now.

Last week, during a hearing, Sen. Burr asked Fauci and Wolensky a direct question: How many employees in your agencies have been vaccinated?

I wouldn’t think that there would be any vax-hesitants walking those halls…. so, I’d expect the number to be near 100%.

WRONG!

When asked, Fauci stammered, then said “a little more than half”.

What?

That’s barely about the national average (which includes the media- labeled  “Neanterthal Trump supporters”)

Wolensky ducked the question: ‘There’s no Federal requirement for us to collect and report those numbers”.

Anybody remember Gore’s “There’s no controlling authority” defense for taking foreign campaign contributions?

English translation: “An embarrassingly low number.”

Here’s the 1-minute clip of the Q&A exchange.

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For sure, the clip won’t find it’s way into any vax- inspirational PSAs.

But, it’s gotta give pause to people yet to be vaccinated if the vaccine is being shunned by a statistically significant number scientists who are working on the vaccines and constantly pouring over the data re: efficacy and safety.

Do they know something that they’re not telling us?

Hmm…

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P.S. I’m fully vaccinated (Moderna) … and don’t regret my decision.  Now, I’m rooting for high mRNA vaccination rates, but not holding my breath.

Why aren’t more healthcare workers getting vaccinated?

May 17, 2021

Specifically, what’s the percentage of doctors who have gotten vaccinated?
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Let’s start with a basic fact: Frontline healthcare workers (very broadly defined) — along with long-term care patients — were the top priority for initial (and continuing) covid vaccinations.

But, according to a recent KFF-Washington Post survey …

Despite their first-dibs on the vaccines, only a 52% slim majority of “frontline healthcare workers” have gotten vaccinated.

That’s hardly a mobilizing inspiration for folks who are still unvaccinated, so let’s drill down on the numbers.

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According to the KFF-WaPo survey, the combined vaccination rate for healthcare workers varies widely by it’s component parts.

Only about 40% of administrative and “patient care” healthcare workers have gotten vaccinated.

But, about 7 in 10 “diagnosis & treatment” professionals (think: doctors & nurses) have gotten vaccinated.

The latter is an important number since doctors and nurses (a) have had ready access to the vaccine (b) are most likely to be frequently and directly exposed to covid, and (c) should be the most “in the know” re: the vaccines efficacy & safety.

So, the pivotal question: Is 70% a high number that should inspire confidence or a hard ceiling on the percentage of the broad population’s likelihood of getting vaccinated?

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Anecdotally, whenever I bump into a doc, I ask if they’ve been vaccinated, which brand, what about their staffs”?

So far, in my very small sample, all docs have been vaccinated (Pfizer or Moderna), as have the clear majority of their staffs.

Among the vax-hesitant staffers, the resistance rationales: (1) current workplace protocols have, for a year, kept them from being infected so why fret now? (b) their personal health considerations prevail (e.g. immune system disorders, current or hoped-for pregnancies ) and (c) they “wait & see” uncertainties about the long-run effects of the vaccines.

The latter could be a bit worrisome: Do they know something that we don’t know?

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For what it’s worth …

I’d like to see the numbers broken down by “doctors only” and all other “prescribers & treaters”.

In fact, expecting the doc’s number to be closer to 100%, it (along with a parade of doc testimonials) should be center-stage in an marketing program to cut vax-hesitancy.

That would be more compelling than a showcase of politicos and celebrities.

COVID Deaths pass grim milestone: 600,000

May 17, 2021

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May 16: COVID Dashboard

May 16, 2021

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May 14: COVID Dashboard.

May 14, 2021

MASKS OFF ! MASKS OFF!!  MASKS OFF!!!

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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?

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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..

May 13: COVID Daily Dashboard

May 13, 2021

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COVID: Daily Dashboard

May 12, 2021

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COVID: Daily Dashboard

May 11, 2021

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1st vax shots down 65% from early peak…

May 10, 2021

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

May 9, 2021

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

May 8, 2021

Daily new deaths sticky at ~700.
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Let’s put vax rates in context…

May 7, 2021

Less than 50% of Americans get flu shots!
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Currently, over 80% of Americans 65 and older have gotten covid vax shots; almost 60% of adults over 18 have gotten jabbed …

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How does that stack up to the take-up rate for flu shots?

According to the official CDC numbers …

> Over the past decade, annual flu vaccination rates among adults over 18 have ranged from 37% to 48% … averaging about 45%.

> Our covid vaccination rate is already about 15 percentage points over that average …. driven by the 83% vax rate among folks over 65 … which is about 20 percentage points higher than historic averages.

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Note that only about 1/3 of adults 18 to 49 get flu shots … and it’s likely that the take-up rate is lowest among the younger adults in the 18 to 49 bracket?

All of this sounds pretty familiar, doesn’t it?

But, geez, this is a pandemic and vax effectiveness rates are very high?

So, shouldn’t covid vax rates be much higher?

Well, they are for the most consequentially vulnerable group — those over 65.

But, for the others, vaccination rates seem to be reverting to the historic means for flu shots.

Which suggests that classical vax-hesitancy reasons — e.g. fear of needles and side effects, perception of invincibility — make be kicking in.

We’re all creatures of our past experiences, right?

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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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.

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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.

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

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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
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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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Why aren’t more healthcare workers getting vaccinated?

April 30, 2021

Key number that I’d like to know: percentage of doctors who have gotten vaccinated (with which brand).
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Let’s start with a basic fact: Frontline healthcare workers (very broadly defined) — along with long-term care patients — were the top priority for initial (and continuing) covid vaccinations.

But, according to a recent KFF-Washington Post survey …

Despite their first-dibs on the vaccines, only a 52% slim majority of “frontline healthcare workers” have gotten vaccinated.

That’s hardly an inspiration for folks who are still unvaccinated so let’s drill down on the numbers.

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According to the KFF-WaPo survey, the combined vaccination rate for healthcare workers varies widely by it’s component parts.

Only about 40% of administrative and “patient care” healthcare workers have gotten vaccinated.

But, about 7 in 10 “diagnosis & treatment” professionals (think: doctors & nurses) have gotten vaccinated.

The latter is an important number since doctors and nurses (a) have had ready access to the vaccine (b) are most likely to be frequently and directly exposed to covid, and (c) should be the most “in the know” re: the vaccines efficacy & safety.

So, the pivotal question: Is 70% a high number that should inspire confidence or a hard ceiling on the percentage of the broad population’s likelihood of getting vaccinated?

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Anecdotally, whenever I bump into a doc, I ask if they’ve been vaccinated, which brand, what about their staffs”?

So far, in my very small sample, all docs have been vaccinated (Pfizer or Moderna), as have the clear majority of their staffs.

Among the vax-hesitant staffers, the resistance rationales: (1) current workplace protocols have, for a year, kept them from being infected so why fret now? (b) personal health considerations prevail (e.g. immune system disorders) and (c) “wait & see” uncertainties about the vaccines.

The latter is a bit worrisome…

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For what it’s worth …

I’d like to see the numbers broken down by “doctors only” and all other “prescribers & treaters”.

In fact, expecting the doc’s number to be closer to 100%, it (along with a parade of doc testimonials) should be center-stage in an marketing program to cut vax-hesitancy.

That would be more compelling than a showcase of politicos and celebrities.

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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Did Team Biden blunder big on the J&J roll-out?

April 28, 2021

Obvious answer: yes … but it’s unlikely that the MSM will tag Biden with the loss.
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Let’s start with the basics:

The Pfizer and Moderna vaccines were approved and launched by the Trump administration.

The J&J vaccine was developed under the auspices of Trump’s Operation Warp Speed.

But, the J&J vaccine was approved by the Biden administration (on Feb. 27).

Now, let’s advance the story…

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In a mid-March statement, Biden said:

“You know, when we came into office (Jan. 20), we began working with the (manufacturing) team at J&J to accelerate and add capacity to their manufacturing and production efforts.

Got it? Team Biden was on the manufacturing case.

The outcome: In early April, 15 million doses of the J&J vaccine failed quality control and had to be tossed.

Workers at an Emergent Technologies plant in Baltimore manufacturing two coronavirus vaccines (for J&J and Astra Zeneca) accidentally conflated the ingredients several weeks ago, contaminating up to 15 million doses of Johnson & Johnson’s vaccine. Source

Nice job, boys.

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Then in mid-April, reacting to 8 reported cases of blood-clotting (out of about 8 million shots administered), Team Biden’s med-science regulators “paused“ the distribution and administration of the J&J vaccine “in an abundance of caution”.

As Paul A. Offit, a vaccine expert at Children’s Hospital of Philadelphia told the Washington Post:

If I hear the phrase ‘abundance of caution’ one more time, I’m going to jump out of my window.

After 2 weeks of review, Biden’s crack med-science team got out their calculators and concluded that, perhaps, they were panicking over an apparent one-in-a-million occurrence.

Maybe, there was the proverbial “no there there”.

So, they lifted the J&J  vaccine halt.

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No harm, no foul, right?

WRONG!

As Lawrence Gostin, a global health law professor at Georgetown University, put it politely:

In the short to medium term, at least, the Johnson & Johnson vaccine has taken a reputational hit.

J&J has had major production problems at its Baltimore plant and (given the risk-induced halt)  people (might be) more hesitant to take it. Source

Or, as another med-science pundit put it more bluntly: Team Biden “all but gutted the enthusiasm for Johnson & Johnson’s vaccine.”

So, how bad is the “reputational hit”? The slide in enthusiasm?

According to a Washington Post poll, only 28% of unvaccinated adults now think that the J&J vaccine is “very” or “somewhat” safe.

Performing a common sense test, WaPo reframed the question and  found that 3 out of 4 unvaccinated adults would be unwilling to take the J&J

Common Sense Test: Raise your hand if you’d line up for a vaccine that you thought was somewhat safe.

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Now, that’s a problem … a big problem.

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What if?

Imagine that Team Trump had:

  • approved the J&J vaccine
  • supervised production of the vaccine
  • encountered production quality issues
  • dumped 15 million contaminated doses
  • halted administration of the vaccine due to health risks
  • lifted the ban (as daily 1st shots started dropping like a rock)

All of which combined to make 75% of unvaccinated people unwilling to take the vaccine.

I’m going to go out on a limb on this one and guess that the media would be publicizing this situation differently if Team Trump owned it.

But, it’s Biden, so …

What do you think?

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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Is Trump blowing his “vaccine legacy”?

April 26, 2021

That’s a question that Politico is asking after chatting with former Trump aides
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For openers…

Polls consistently report that so-called “vaccine hesitancy” is highest among Republicans and Blacks.

I’m a bit baffled about the GOP numbers since practically all of my Republican friends have been vaccinated … the couple who haven’t been vaxed have very legitimate medical reasons (e.g. immune system disorders).

For now, I’ll put my personal sample aside (as I always advised students to do), and stipulate that a large number of Republicans are vax-hesitant.

Trump hasn’t been visible pitching the “get vaxed” message to his supporters.

As one pundit observes: “We have the odd spectacle of Joe Biden creating a massive PR campaign for the vaccines Trump helped develop, while Trump himself refuses to get in front for his own success. It’s a lost opportunity (for Trump and the Republican party).”

So, why might Trump be staying on the sidelines?

(more…)

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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Bueller Effect: Vax side effects will increase … guaranteed.

April 22, 2021

Biden plan laden with unintended consequences.
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On Wednesday, without acknowledging the accomplishments of the Trump administration, President Biden took a victory lap since the U.S. is blowing past the 200 million shots mark.

For the record, note that 192 million of the doses are Pfizer and Moderna – approved and launched by the Trump administration.  Only about 8 million are J&J — spurred by Operation Warp Speed, but approved, launched and stutter-stepped by the Biden administration.

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After patting himself on the back, Biden announced a new plan to boast vaccination interest among the still-to-be-vaccinated population:

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In a nutshell, companies large & small will be incentivized (i.e. “pressured”) to give employees paid time off to get vaccinated  … and paid time off to recover from any vaccination after effects.

Sounds reasonable until you ask: “Any likely unintended consequences?”

About 80% of vax recipients report minor after effects such as fatigue, headache and muscle pain that usually dissipate after a good night’s sleep.  Source

When pressed, only about 10% to 15% of vax recipients say that their side effects that were “significantly noticeable,” Source

My hunch: The prevalence of claimed  “significantly noticeable” vax after effects will sky-rocket when vax recipients are offered the prospects of a couple days of paid vacation (twice if the get Pfizer or Moderna shots)

It’s human nature … it’s Freakanomics (aka Behavioral Economics) … it’s the law of unintended consequences … it’s the Bueller Effect

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The possible ultimate irony: The likely spike in vacation-incentivized claims of “significantly noticeable” after effects may end up inducing a higher level of vaccine hesitancy among people who are already fearful of side effects. 

I guess that Biden hasn’t read Freakonomics

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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Studies: Fauci’s endorsement hardens net vaccine hesitancy…

April 21, 2021

Time to put him out to pasture?
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Dr. Fauci — the nation’s foremost political-scientist — continues to be ubiquitous on TV, pitching that getting vaccinated is a “no brainer” and that, to paraphrase, all Republicans are morons.

Loyal readers know that I’m not a big fan of Dr. Anthony Fauci —  Biden’s chief political-scientist — who is always certain (but often wrong), occasionally evidence-based (except when the data goes against him), straight-shooting (depending on the political winds).

For full chapter, verse and sources re: Fauci’s many mis-steps, see

Here are a couple of more logs to throw on my Fauci fire.

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I’ve been doing a doing a deep dive into vaccine hesitancy — why some people are reluctant to take the Covid vaccines — and how the resistance might be softened.

Note: For the moment, I’ll skip over the thornier question: Should the resistance be softened? I’ll have more on that subject in future posts.

I came across the COVID States Project Report #36: Evaluation of COVID-19 vaccine communication strategies.

Note: The 50-state COVID-19 project is “a multi-university group of researchers with expertise in computational social science, network science, public opinion polling, epidemiology, public health, communication, and political science.”

Here’s what caught my eye in the report

The researchers queried study participants on whether public endorsements (i.e. televised vaccinations or public service messaging) by an array of personalities would make the subjects more or less likely to get vaccinated.

For example, predictably, an endorsement by Trump made Democrats less likely to get vaccinated and an endorsement by Obama (or Biden) made Republicans less likely.

Less predictably, a vaccine endorsement by Dr. Fauci resulted in only small reductions in vaccine resistance among Democrats, but increased and  strengthened vaccine resistance among Republicans.

According to the researchers, the Fauci finding “contrasts with unspecified scientists and respondents’ personal physicians, whose endorsement reduce vaccine resistance across the board.”

So, the researchers conclude that Fauci has taken on a partisan association that has substantially reduced his credibility and effectiveness as a messenger.

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That finding brought to mind an interview with Frank Luntz who presented some focus group video footage re: vaccine hesitancy among Republicans.

Disclosure: The interview was on Fox; Luntz leans right but usually exhibits anti-Trump tendencies.

The headline from the focus group:

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Click to view a worthwhile 1-minute video clip that brings the comments to life:

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Luntz’s conclusion: Fauci — “who keeps changing his mind and moving the goalposts” — has no credibility whatsoever among Republicans … if you want reluctant people to get vaccinated, the message must be delivered by their personal physicians.

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Bottom line:

Both the impartial 50 States Project and the Luntz focus group reach the same fundamental conclusions:

>  If you want to overcome vaccine hesitancy

>  And, if Republicans are, in fact, the problem (i.e. more reluctant to get vaccinated than Democrats)

> Then one of the last people you want pitching the merits of getting vaccinated is Fauci

> Especially if he’s dishing inflammatory, condescending messages like “Getting vaccinated is a no-brainer”.

To summarize more bluntly: Yes – it’s time to put Fauci out to pasture.

Amen.