J

Jeepers

Full Audioholic
Thanks for the link. These numbers from the paper look pretty good:

>>>Compared with two doses of the vaccine administered at least 5 months ago, receiving a third dose was estimated to have an effectiveness of 93% in preventing COVID-19-related admission to hospital, 92% in preventing severe disease, and 81% in preventing COVID-19-related death.<<<
All right.... but for how long ? What about a fourth etc... dose in half a year or later ?
 
M

Mr._Clark

Audioholic General
All right.... but for how long ? What about a fourth etc... dose in half a year or later ?
I’d get a booster if I could. Hopefully the Pfizer pill is available reasonably soon and it’s as effective as the trials seem to suggest

I see no point in getting worked up about possible additional boosters right now but you are of course free to do so if you want
 
davidscott

davidscott

Audioholic Samurai
WHO is warning the US not to get to complacent as Eastern Europe is now experiencing a huge surge. Just sayin...
On the other hand FLA (where I live) had zero new hospitalizations today so that is GREAT news.
 
TLS Guy

TLS Guy

Audioholic Slumlord
I have not posted for a while. The basic reason for this, is that the whole scientific/medical community has been very uncertain as to where we are in this pandemic.
So I only really want to post when there is a reasonable chance the information will be reasonably accurate and helpful.

In the earlier phases this has been much easier than now. The uncertainty arises around issues of watching the effect of vaccines, and getting handle on the effect of how the virus changes.

A major issue has been the severe limitations arising out of the lack of reliable laboratory means of assessing immunity. Current technology is close to useless in this regard. So we are reduced to crude time line evaluations as to who gets what, who gets ill from Covid-19, how badly and if they die. That may surprise some, but that is where we are.

Antibody tests are flawed, as they don't tell the whole story, as they measure neutralizing and non neutralizing antibodies. We have no ability to test on mass for just neutralizing antibodies. In addition we have no easy and reliable means to test T-cell immunity in broad swaths of the population. So that essentially limits us to crude outcome studies.

There was a recent editorial in JAMA decrying this problem.

So this has had the effect of not being able to accurately asses the immunity from vaccines, natural infection or both. When you add mutant variants the picture can become more clouded.

There was a recent key paper in Lancet from UK data that sheds some light on this problem. The Minnesota State Health department has stated doing tallies of breakthrough infections and deaths resulting from these events.

The bad news is that the vaccines seem to be only 34% effective at preventing breakthrough. However they still remain around 90% effective against hospitalization and death. The bad news is that breakthrough and asymptomatic infections result in as much initial virus shedding as in the non vaccinated. However, the duration of the shedding is significantly shorter.

This is another JAMA editorial on breakthrough infections.

We do not have good data on the differences in effectiveness of the different vaccines. This may be because it has not been accurately tracked. Data from Israel indicates the effectiveness of the Pfizer vaccines undergoes significant decline in the 2 to 3 month time frame and declines from then on. There is some suggestion the Modern vaccine is better. This is soft. Natural infection plus vaccination, appears to produce better, and longer lasting immunity.

The Delta variant has been a big issue, and thought to be the leading cause of the rising breakthrough infections.

This is the latest data from the Minnesota State Health department.

[The Minnesota Department of Health in the past week identified another 7,821 breakthrough coronavirus infections among more than 3.2 million fully vaccinated people in the state, including another 111 people who died of COVID-19 despite their immunizations. The state's breakthrough total as of Monday reached 64,844 infections — more than 2% of the fully vaccination population — and 483 COVID-19 deaths.]

Roughly 20% of Minnesotans over 18 have had booster doses of vaccine.

The UK leads us by about six weeks from the onset where the infection became pandemic.

The UK is now believed to be in transition from pandemic to endemic infection status at this time. If so we will follow soon.

However the case rate is worryingly high if the endemic infection rate, hospitalization and deaths remains at the current level. It has plateaued close to the midway point between the peaks and troughs of the pandemic for about a month now.

The problem is that it is keeping hospital occupancy at 94 to 95 percent. The waiting list for non urgent and semi-urgent care are totally unacceptable, with no solution in sight for this.

The public and the economy will not tolerate a return to restriction.

Hopefully the new antivirals, soon to go before the regulators will provide relief from this situation. I think this is the good news here. Vaccination, sensible individual low tech precautions, and antivirals will reduce Covid-19 infections to just a nuisance. That has to be the hope.

On a personal note. My wife's sister and her husband both had breakthrough infections, despite full vaccination, after a trip from where they live in Kingsland Herefordshire to Southampton in Hampshire. My sister in law is yet to recover her sense of smell. No hospital care was involved, but by all accounts the experience was very unpleasant for both.

My wife has just got back from her first outing delivering booster shots. A half million Minnesotans have received booster jabs so far.

I think that is the best I can do to shed some light on the state of play.
 
MaxInValrico

MaxInValrico

Audioholic
WHO is warning the US not to get to complacent as Eastern Europe is now experiencing a huge surge. Just sayin...
On the other hand FLA (where I live) had zero new hospitalizations today so that is GREAT news.
I don't trust Florida's numbers.
 
mtrycrafts

mtrycrafts

Audioholic Slumlord
I’d get a booster if I could. Hopefully the Pfizer pill is available reasonably soon and it’s as effective as the trials seem to suggest
...
Doesn't the pill used when you are infected and know asap. Then you get a prescription and then the pill? If so, all takes time and may be too late?
 
TLS Guy

TLS Guy

Audioholic Slumlord
Doesn't the pill used when you are infected and know asap. Then you get a prescription and then the pill? If so, all takes time and may be too late?
These antivirals seem to work best if given within 72 hours of onset of symptoms. They do not work after 5 days. You have to hit the time of antiviral replication.
They are not a replacement for vaccines, but an adjunct. We need all resources on deck here. It seems to me that the endemic infection rate is going to be high enough to cause ongoing chronic disruption, without either better vaccines, or adjunctive therapy.
 
M

Mr._Clark

Audioholic General
These antivirals seem to work best if given within 72 hours of onset of symptoms. They do not work after 5 days. You have to hit the time of antiviral replication.
They are not a replacement for vaccines, but an adjunct. We need all resources on deck here. It seems to me that the endemic infection rate is going to be high enough to cause ongoing chronic disruption, without either better vaccines, or adjunctive therapy.
Perhaps it would be possible at some point to get a prescription before one is infected so the pills are on hand when needed?
 
TLS Guy

TLS Guy

Audioholic Slumlord
Perhaps it would be possible at some point to get a prescription before one is infected so the pills are on hand when needed?
I think accurate diagnosis will be required. It needs distinguishing from other respiratory viruses. It will be a five day course at $500.00 for the course. That is the projected cost for the Pfizer antiviral
 
GO-NAD!

GO-NAD!

Audioholic Spartan
...
However the case rate is worryingly high if the endemic infection rate, hospitalization and deaths remains at the current level. It has plateaued close to the midway point between the peaks and troughs of the pandemic for about a month now.

The problem is that it is keeping hospital occupancy at 94 to 95 percent. The waiting list for non urgent and semi-urgent care are totally unacceptable, with no solution in sight for this.

The public and the economy will not tolerate a return to restriction.
...
Thanks for the update, Doc. Do you think we might need to revive the sanitarium concept for COVID cases in order to free up hospital space for all other care?
 
highfigh

highfigh

Audioholic Slumlord
All right.... but for how long ? What about a fourth etc... dose in half a year or later ?
I watched a clip showing info about efficacy dropping over time, posted by the London Times. The J&J was down to about 13% at 6 months, Pfizer was around 53% and Moderna was a bit higher.
 
TLS Guy

TLS Guy

Audioholic Slumlord
I watched a clip showing info about efficacy dropping over time, posted by the London Times. The J&J was down to about 13% at 6 months, Pfizer was around 53% and Moderna was a bit higher.
We just don't have the real world data on that. There are loads of antibody studies floating around. As I pointed out they are no more real use than contemplating your navel.

It is just too soon to have reliable data on effectiveness over time. Honestly, at this stage, the only data that could be reliable on making this judgement, is data showing who gets sick, how badly, and when. In addition what were they vaccinated with. That is really the only reliable data we have about immunity, and that has, and will, take time to accumulate. That is why we do need a reliable laboratory test for surrogate immunity. We are not remotely close to that yet. This is the biggest reason for so much uncertainty going forward. The more successful interventions we make, paradoxically the more confused and uncertain projections become.

The lay press and general public can not get their heads around this. Unfortunately this problem tends to undermine confidence of the public in science, especially if experts who should know better, pontificate on the basis of data that does not warrant their projections. We are awash in this, and it is a time to be cautious about a lot of so called expert projection.

This is a really hard problem to make the public understand and still keep them onside.
 
Last edited:
TLS Guy

TLS Guy

Audioholic Slumlord
Thanks for the update, Doc. Do you think we might need to revive the sanitarium concept for COVID cases in order to free up hospital space for all other care?
I don't think that would be helpful. The issue is that anyone seriously ill enough with Covid-19 to warrant hospital admission requires expert attention and complex resources. In addition these patients are unstable and could require transfer to ICU on very short notice.

A modern ICU is a very complex and formidable installation and very costly to set up. In addition multiple disciplines of highly skilled staff are required, who take years to train.

This is I fear may become a very significant and costly problem going forward. How bad it will be, will depend on the endemic infection rate, especially in the winter months when many other respiratory viruses are circulating.

Planning and staffing new medical facilities, especially if they are additions and not replacements is very costly. In that event planning and implementation is at least a 10 year project.

There is no doubt that cancer care, vascular and orthopedic care in particular have been serious disrupted by this pandemic. There is early data suggesting that is causing rising mortality from these other disease, especially late diagnosis and late treatment of cancer. So these deaths really do have to be added to the Covid-19 tally.

This problem is especially acute and intransigent in the UK, where medical facilities have been kept in just adequate and my be below for years. It has a bed crisis winter after winter.

However, it could be that this pandemic may lead to a situation where more medical facilities and staff have to be added long term. However because of the issues I raise in the previous post, it is far to soon to make that judgement. This just adds to the list of critical uncertainties this pandemic has thrown up.
 
GO-NAD!

GO-NAD!

Audioholic Spartan
I don't think that would be helpful. The issue is that anyone seriously ill enough with Covid-19 to warrant hospital admission requires expert attention and complex resources. In addition these patients are unstable and could require transfer to ICU on very short notice.

A modern ICU is a very complex and formidable installation and very costly to set up. In addition multiple disciplines of highly skilled staff are required, who take years to train.

This is I fear may become a very significant and costly problem going forward. How bad it will be, will depend on the endemic infection rate, especially in the winter months when many other respiratory viruses are circulating.

Planning and staffing new medical facilities, especially if they are additions and not replacements is very costly. In that event planning and implementation is at least a 10 year project.

There is no doubt that cancer care, vascular and orthopedic care in particular have been serious disrupted by this pandemic. There is early data suggesting that is causing rising mortality from these other disease, especially late diagnosis and late treatment of cancer. So these deaths really do have to be added to the Covid-19 tally.

This problem is especially acute and intransigent in the UK, where medical facilities have been kept in just adequate and my be below for years. It has a bed crisis winter after winter.

However, it could be that this pandemic may lead to a situation where more medical facilities and staff have to be added long term. However because of the issues I raise in the previous post, it is far to soon to make that judgement. This just adds to the list of critical uncertainties this pandemic has thrown up.
After I posed the question, I realized that setting up such facilities would also require staffing, which can't be conjured out of thin air. That, on top of the fact that many healthcare systems are shorthanded already.

Thanks for the response.
 
highfigh

highfigh

Audioholic Slumlord
We just don't have the real world data on that. There are loads of antibody studies floating around. As I pointed out they are no more real use than contemplating your navel.

It is just too soon to have reliable data on effectiveness over time. Honestly, at this stage, the only data that could be reliable on making this judgement, is data showing who gets sick, how badly, and when. In addition what were they vaccinated with. That is really the only reliable data we have about immunity, and that has, and will, take time to accumulate. That is why we do need a reliable laboratory test for surrogate immunity. We are not remotely close to that yet. This is the biggest reason for so much uncertainty going forward. The more successful interventions we make, paradoxically the more confused and uncertain projections become.

The lay press and general public can not get their heads around this. Unfortunately this problem tends to undermine confidence of the public in science, especially if experts who should know better, pontificate on the basis of data that does not warrant their projections. We are awash in this, and it is a time to be cautious about a lot of so called expert projection.

This is a really hard problem to make the public understand and
still keep them onside.
Why have so many in the medical professions decided that they won't be vaccinated, or don't want to? How many of them have cared for large numbers of COVID patients without becoming sick? If they had all keeled over, we could safely say that it's an indiscriminate killer, but that's just not true- it infects and kills those who are most susceptible to it and not the majority of the population. Look at the number of children who have died from COVID- it's a very small number. From the link, it shows that in the 0-4 age group, 206 have died and in the 5-18 age group, 474 have died, all between January 4 and October 30 of 2021. Why are they rushing to vaccinate the age group that is least vulnerable to this?


I would bet that most people who died from this didn't stay away from people who were infected either by force (the nursing home casualties in New York), by choice or through ignorance. Many people simply didn't believe it was real and I know two who were in that category, until they both showed symptoms at Christmas of 2020. Their son's father in law died from it- it's possible that he caught it from this couple because they were together before Christmas and he was found unresponsive shortly after New Year, 2021. He became incredibly forceful in his telling others to be vaccinated and sometimes resorted to shouting it, something I don't remember him doing in the >40 years we have known each other. Could be guilt, could be anger, could be some effect from the disease, since he became belligerent on other occasions. Many had serious health problems that were ignored, many just went out and did what they normally did but most should have stayed away from other people until the medical field had some kind of handle on the situation. The husband has been vaccinated and got his booster recently, but she hasn't because she's one of those people who are "allergic to just about everything" and has Asthma, although her case was very mild.

The media need to stop acting as if they know about many things- this is one. They make far too much noise and pollute the airwaves with their BS, to the detriment of the general population. It's time for them to shut their gobs and let the adults speak but I still want to know why so many medical professionals don't want the vaccine.

 
TLS Guy

TLS Guy

Audioholic Slumlord
Why have so many in the medical professions decided that they won't be vaccinated, or don't want to? How many of them have cared for large numbers of COVID patients without becoming sick? If they had all keeled over, we could safely say that it's an indiscriminate killer, but that's just not true- it infects and kills those who are most susceptible to it and not the majority of the population. Look at the number of children who have died from COVID- it's a very small number. From the link, it shows that in the 0-4 age group, 206 have died and in the 5-18 age group, 474 have died, all between January 4 and October 30 of 2021. Why are they rushing to vaccinate the age group that is least vulnerable to this?


I would bet that most people who died from this didn't stay away from people who were infected either by force (the nursing home casualties in New York), by choice or through ignorance. Many people simply didn't believe it was real and I know two who were in that category, until they both showed symptoms at Christmas of 2020. Their son's father in law died from it- it's possible that he caught it from this couple because they were together before Christmas and he was found unresponsive shortly after New Year, 2021. He became incredibly forceful in his telling others to be vaccinated and sometimes resorted to shouting it, something I don't remember him doing in the >40 years we have known each other. Could be guilt, could be anger, could be some effect from the disease, since he became belligerent on other occasions. Many had serious health problems that were ignored, many just went out and did what they normally did but most should have stayed away from other people until the medical field had some kind of handle on the situation. The husband has been vaccinated and got his booster recently, but she hasn't because she's one of those people who are "allergic to just about everything" and has Asthma, although her case was very mild.

The media need to stop acting as if they know about many things- this is one. They make far too much noise and pollute the airwaves with their BS, to the detriment of the general population. It's time for them to shut their gobs and let the adults speak but I still want to know why so many medical professionals don't want the vaccine.

What you say in not true. Data from the AMA shows that 96% of physicians were fully vaccinated by June 2021. For nurses 91% were vaccinated by August 2021.

Data for other heath care professionals we do not have good data for. However I suspect it similar to nurses for those in direct patient care.

I would personally recommend removing licenses from any health care professional who refuses vaccination on grounds of professional incompetence, and also abrogating their professional responsibilities.

We need as many vaccinated as possible, and that means children. They are super spreaders, and infect family members in particular. Sick children disrupt their schooling and their classmates. Teachers also are infected from them. A teacher we know died from Covid-19 age 48. In addition significant numbers of children are suffering from long lasting Covid-19 symptoms, with most having a neurological presentation. In addition Covid-19 is primarily a vascular infections, which we have never seen, or encountered before in the history of medicine. Therefore there are legitimate concerns that life expectancy of younger people infected may become significantly reduced as the result of vascular damage. There are cogent reasons to vaccinate everybody.

The Delta variant is so infectious, herd immunity will not be reached until in excess of 90% of the population are immunized.

As I said before, we are starting to transition to the endemic phase of the outbreak. However that rate of infection is tragically high, and far too many are going to hospital and dying still.

We have a 66% vaccination rate (over 70% one dose) of over 18 year olds in Minnesota. However the State epidemiologist rang the alarm bells today, as cases are rising fast again as the weather cools. We have almost a 10% positivity rate today. Area hospitals are at stress point again and this is adversely affecting needed and semi urgent treatment of non Covid-19 cases. 70% vaccination is just NOT good enough. We really do need to push for as close to 100% immunization of the population. Mandates do work. The evidence for that is overwhelming.

Our cases this week are going straight up on the graph. We are having over 4000 cases a day, and deaths are stubbornly over 30 cases a day. Death toll yesterday 34. This is a tragedy of enormous proportions, that we do not have under control yet. Tragically 27% of Covid-19 deaths are now in people below 60 years of age, and dropping.

We have to do better than this. We just can't go on loosing lives at the rate we are.
 
cpp

cpp

Audioholic Samurai
We have to do better than this. We just can't go on loosing lives at the rate we are
Its so difficult to do better, when so many mixed signals come out of our medical centers as doctors and nurses are not getting vaccinated and misguided direction from our GOVT and some have made this nothing but a political stance. Hard to do better when we have so much negativity in this world. .
 
Mikado463

Mikado463

Audioholic Ninja
Question for the experts here.............

With all the mandates for vaccination (to which I have no problem) and the potential job loss if one does not comply does the same apply to those on unemployment / welfare ? Don't get vaccinated, loss your benefits ?
 
M

Mr._Clark

Audioholic General
>>>Why have so many in the medical professions decided that they won't be vaccinated, or don't want to?<<<
Anecdotally, my brother is a doctor and he's not in a high risk group, but he got vaccinated as soon as possible. As he put it, "it's a no-brainer."

I've seen a number of social media posts that say something to the effect that "I know a top doctor who says the vaccines are not safe." These are often unverified so the claim is rather dubious, but these types of stories seem to spread like wildfire among those who are anti vax or vaccine hesitant.

I doubt that there's a single answer to your question (even if the premise is correct), but unvaccinated medical professionals are dying from COVID. The virus doesn't care if you're a medical professional.

Here's one example of an antivax doctor dying from COVID:

>>>A Twin Cities doctor spread misinformation about COVID-19. Then he died from it . . .
At his funeral, Foley’s son Logan confirmed his father’s death from COVID and that he was unvaccinated.<<<



Here's another example:

1636573281621.png


Here's another:

>>>Idaho Nurse Who Fell into Vaccine 'Misinformation' Dies of COVID, Leaving Behind 10-Year-Old Twins<<<


Here's an example of a nurse who was anti vax and died of COVID. It's not entirely clear if she was unvaccinated, but my best guess is she ws not based on her social media posts.

>>>Friends, colleagues grieve after young Lafayette ER nurse dies from COVID complications<<<


>>>It is unclear whether Guidry had been vaccinated, however, she tweeted the following: "This vaccine has been released using recombinant DNA faster than any vaccine in the world. It manipulates your DNA at the tiniest molecular level. Do. Not. Get. It. It's not safe."<<<

 

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