How long can we wait while flattening the curve?

[frugalnacho]

I get the same "So I said to my people, 'slow the testing down please'" vibe about the usa and genetic sequencing.  Can't be blamed for new strains if you never sequence any samples in the first place. *taps temple* Let the other countries do the sequencing and discovering of mutated strains, then we can blame them and name the mutations after them. 

[Paper Chaser]

And yes @Paper Chaser , that absolutely plays a role here. Ours is a relatively wealthy area (for the region) and people can afford to keep kids at home when they get sick, which allows the schools to continue to stay open. I will not apologize or epxress remorse because I live in such an area.

Nor should you. I just wanted to mention that there are other factors besides political view that contribute to this pandemic. I'm not sure the "MAGA-ness" of an area really has much correlation, let alone causation for places with more viral spread. Stereotypically liberal parts of this country have been impacted by the virus in extreme ways just like stereotypically conservative locations have. There are plenty of Democratic politicians that have slipped up in very public ways, the same as Republican leaders have. It's not one side's fault while the other is blameless.

It's fine to criticize policies from leaders, but I'm just wary of consciously or subconsciously assigning blame to individuals in our communities who happen to be different from us in some way, while we pat ourselves on the back. That doesn't bode well for the future of our society.

Actually, in the USA, at least 25 of the top 30 states in Covid19 Cases per Million are reliably MAGA states. I'm not buying your both-sides-ism at all. This despite the fact that initial entry point of the virus into the USA was reliably big urban centers like Seattle, NYC, LA, and Boston. They had time to prepare and they still fucked it all up.

https://www.worldometers.info/coronavirus/country/us/

When you say "They still fucked it all up" you mean other Americans right? These aren't your enemy. Anytime I even suggest around here that seeing things in such a polarized way is harmful to our society, I get shouts of "Both-sides-ism!". You really think your world is going to get better by trying to shout louder than the half of the country with a different viewpoint than you? I live deep in Trumplandia, and I can tell you a huge part of the motivation comes down to these people feeling like "The Left" doesn't consider them to be equals. Not working together, or viewing yourself as superior in some way is only going to beget a deeper divide. Is your world better today because you think you've handled this better than other Americans in some other place? Are you making your part of the world better if you glare at the vehicle with the MAGA bumper sticker, or assume the family inside are stupid/contemptable people?

Besides MAGA tendencies, there could be other contributing factors as well right? Perhaps people in these states have demographic differences that could contribute to higher rates of infection or death? Older, less healthy, etc? Perhaps they have a higher percentage of "essential" workers, that cannot avoid going out in public? Perhaps medical care is generally worse? I don't think we know nearly enough to tie it all up neatly in a MAGA bow.

As you've already mentioned, we won't have clear enough data on this to really judge performance for another year or more. Sure seems like you've already formed your viewpoint though, based on limited or possibly inaccurate data.

[Shane]

And yes @Paper Chaser , that absolutely plays a role here. Ours is a relatively wealthy area (for the region) and people can afford to keep kids at home when they get sick, which allows the schools to continue to stay open. I will not apologize or epxress remorse because I live in such an area.

Nor should you. I just wanted to mention that there are other factors besides political view that contribute to this pandemic. I'm not sure the "MAGA-ness" of an area really has much correlation, let alone causation for places with more viral spread. Stereotypically liberal parts of this country have been impacted by the virus in extreme ways just like stereotypically conservative locations have. There are plenty of Democratic politicians that have slipped up in very public ways, the same as Republican leaders have. It's not one side's fault while the other is blameless.

It's fine to criticize policies from leaders, but I'm just wary of consciously or subconsciously assigning blame to individuals in our communities who happen to be different from us in some way, while we pat ourselves on the back. That doesn't bode well for the future of our society.

Actually, in the USA, at least 25 of the top 30 states in Covid19 Cases per Million are reliably MAGA states. I'm not buying your both-sides-ism at all. This despite the fact that initial entry point of the virus into the USA was reliably big urban centers like Seattle, NYC, LA, and Boston. They had time to prepare and they still fucked it all up.

https://www.worldometers.info/coronavirus/country/us/

When you say "They still fucked it all up" you mean other Americans right? These aren't your enemy. Anytime I even suggest around here that seeing things in such a polarized way is harmful to our society, I get shouts of "Both-sides-ism!". You really think your world is going to get better by trying to shout louder than the half of the country with a different viewpoint than you? I live deep in Trumplandia, and I can tell you a huge part of the motivation comes down to these people feeling like "The Left" doesn't consider them to be equals. Not working together, or viewing yourself as superior in some way is only going to beget a deeper divide. Is your world better today because you think you've handled this better than other Americans in some other place? Are you making your part of the world better if you glare at the vehicle with the MAGA bumper sticker, or assume the family inside are stupid/contemptable people?

Besides MAGA tendencies, there could be other contributing factors as well right? Perhaps people in these states have demographic differences that could contribute to higher rates of infection or death? Older, less healthy, etc? Perhaps they have a higher percentage of "essential" workers, that cannot avoid going out in public? Perhaps medical care is generally worse? I don't think we know nearly enough to tie it all up neatly in a MAGA bow.

As you've already mentioned, we won't have clear enough data on this to really judge performance for another year or more. Sure seems like you've already formed your viewpoint though, based on limited or possibly inaccurate data.

^^+1
All the Trump supporters I've talked with about it hate us, basically, because they believe we look down on them, think they're stupid, bigoted, racists. True MAGA believers will probably never change, but many other, more tentative, Trump supporters might. We'll never be able to win significant numbers of GOP voters over to our side, though, if we continue with the hyper-polarizing rhetoric. It just makes them dig in their heels, even more. Democrats are going to be in control of Congress and the WH for the next two years. Hopefully, the Biden/Harris Administration is going to be able to get some things done that the Democrats will be able to point to leading up to the 2022 elections. If not, Democrats will deserve to lose again. :(

[sui generis]

And yes @Paper Chaser , that absolutely plays a role here. Ours is a relatively wealthy area (for the region) and people can afford to keep kids at home when they get sick, which allows the schools to continue to stay open. I will not apologize or epxress remorse because I live in such an area.

Nor should you. I just wanted to mention that there are other factors besides political view that contribute to this pandemic. I'm not sure the "MAGA-ness" of an area really has much correlation, let alone causation for places with more viral spread. Stereotypically liberal parts of this country have been impacted by the virus in extreme ways just like stereotypically conservative locations have. There are plenty of Democratic politicians that have slipped up in very public ways, the same as Republican leaders have. It's not one side's fault while the other is blameless.

It's fine to criticize policies from leaders, but I'm just wary of consciously or subconsciously assigning blame to individuals in our communities who happen to be different from us in some way, while we pat ourselves on the back. That doesn't bode well for the future of our society.

Actually, in the USA, at least 25 of the top 30 states in Covid19 Cases per Million are reliably MAGA states. I'm not buying your both-sides-ism at all. This despite the fact that initial entry point of the virus into the USA was reliably big urban centers like Seattle, NYC, LA, and Boston. They had time to prepare and they still fucked it all up.

https://www.worldometers.info/coronavirus/country/us/

When you say "They still fucked it all up" you mean other Americans right? These aren't your enemy. Anytime I even suggest around here that seeing things in such a polarized way is harmful to our society, I get shouts of "Both-sides-ism!". You really think your world is going to get better by trying to shout louder than the half of the country with a different viewpoint than you? I live deep in Trumplandia, and I can tell you a huge part of the motivation comes down to these people feeling like "The Left" doesn't consider them to be equals. Not working together, or viewing yourself as superior in some way is only going to beget a deeper divide. Is your world better today because you think you've handled this better than other Americans in some other place? Are you making your part of the world better if you glare at the vehicle with the MAGA bumper sticker, or assume the family inside are stupid/contemptable people?

Besides MAGA tendencies, there could be other contributing factors as well right? Perhaps people in these states have demographic differences that could contribute to higher rates of infection or death? Older, less healthy, etc? Perhaps they have a higher percentage of "essential" workers, that cannot avoid going out in public? Perhaps medical care is generally worse? I don't think we know nearly enough to tie it all up neatly in a MAGA bow.

As you've already mentioned, we won't have clear enough data on this to really judge performance for another year or more. Sure seems like you've already formed your viewpoint though, based on limited or possibly inaccurate data.

^^+1
All the Trump supporters I've talked with about it hate us, basically, because they believe we look down on them, think they're stupid, bigoted, racists. True MAGA believers will probably never change, but many other, more tentative, Trump supporters might. We'll never be able to win significant numbers of GOP voters over to our side, though, if we continue with the hyper-polarizing rhetoric. It just makes them dig in their heels, even more. Democrats are going to be in control of Congress and the WH for the next two years. Hopefully, the Biden/Harris Administration is going to be able to get some things done that the Democrats will be able to point to leading up to the 2022 elections. If not, Democrats will deserve to lose again. :(

You know what's funny?  We hate them for the same reason.  For looking down on us. And for believing we are undeserving and less American than them.  I've been being told I'm not really American all my life.  BTW, the most recent member of my family arrived 4 generations ago.  But it's never good enough for them.  I'm undeserving and not "really" American.  I never will be, because I am not white and I am not Christian.  I've been trying to fit in with them since I was born, before I knew better than to try so hard to make them happy with my own degradation, so I know all about extending olive branches.  At some point, we are unwilling to be subordinate to them. The only thing that will make them happy, the only way we won't be "looking down on them" is if we stop being uppity and "know our place".  I have also lived amongst them too long not to know that there's no getting them to accept us, only to subordinate us again.  Because we are unwilling to accept their supremacy, we are "looking down on them" and "changing the culture" and a million other things they can't accept.  But I'm done accepting being subordinate to them and I'm sorry if they think that's divisive of me.  I guess we'll just have to be divisive if the only other option is my inferiority. 

I'm really sick of being told I need to go back to being an inferior species to satisfy a bunch of white men with "economic anxiety".

[Shane]

Not saying stereotypes of the MAGA crowd are incorrect. Fully agree that some Trump supporters are irredeemable POS, who will never come around, no matter what. Fuck them. I don't care about those people. If they commit crimes, like, say, maybe, attack the Capitol, or something, throw the book at them. Lock their asses up. Sometimes, though, in politics there's a difference between being right and winning. If we want to get up on our high horses and call out all the racists, bigots, misogynists, transphobes, Islamophobes, etc, on the other side, we'll be right, just like HRC was right when she labeled half of Trump's supporters Deplorables. HRC's Deplorables speech sure didn't do much to help her to get elected. If we want to really win, we'll pick and choose our words carefully. It's not about virtue signalling to get short term gains or 'likes' on social media. This strategy is about actually winning, which would enable Democrats to make real, substantive changes in people's lives in such a way that voters notice and understand exactly where those positive changes are coming from. If Biden could get just one major piece of legislation accomplished in the next two years that benefits all Americans, there's a chance Democrats could hold onto and solidify their majorities in both houses of Congress, which would give us two more years to hopefully get even more accomplished in the second half of Biden's first term. If, instead of concentrating on passing legislation that will make real, positive changes in all Americans' lives, Democrats' energy gets sucked into virtue signalling about how bad all those people on the other side are, I believe we are going to lose control of Congress in 2022 and, then, the GOP will take back the WH in 2024. I'd rather bite my tongue, a little bit, so that we can really win.

[sui generis]

Look, my life is a case study of the value of keeping my mouth shut about injustices or even just small slights in order to get the bigger win in the end, so I'm aware and have also been preaching the gospel of Dems just doing something that materially and obviously benefits Americans as quickly as possible (though, if only it was that easy. Obama was trying to do just that in 2008 and it ended up going pretty poorly).

But it also seems to me that people, and perhaps more pertinently the media, could also learn a lesson about keeping their mouths shut too, about all the white male resentment. Giving it so much attention does legitimize it in some ways. I was listening to an interview of an author the other day that had noticed two different news articles interviewing the same guy about being a trump voter. So he also went to talk to him. Can you imagine getting all that attention...3 interviews by the media...just because you are a white male who voted for Trump? Even magically solving the pandemic won't make much of an impact on how Americans FEEL about the pandemic if all the talk and media is about white men that don't really believe in the pandemic but are also simultaneously angry about how poorly the vaccine rollout has gone. Just doing good things for people is perhaps necessary, but is sadly wholly insufficient, to make people satisfied, much less actually happy.

[Shane]

Agreed, the media could do better. Not sure how that's ever going to happen, though, with the inherent incentives present in our current system, where media outlets only make money if people click on the 'bait'. Sometimes, it's frustrating for me to listen to even what I consider to be 'good' journalists, as they seem to always be pandering to the lowest common denominator, trying to make people fearful and angry. I don't know what the answer is, but I also agree that it's probably not as simple as Democrats' just 'doing something' like ending the pandemic or fixing the ACA, which would, obviously, be great accomplishments but, sadly, maybe not enough to really make a difference in the bigger picture. I wish Democrats in the U.S. Senate would do away with the filibuster, once and for all, so that Congress could finally get down to business and make some real changes for the better. Not sure what all it would entail, but if Democrats could make D.C. a state with two senators, who would most likely be Democrats, I think that might help to shift the balance in our country, for good. There's no way Republicans, when the inevitably, eventually, regain control of Congress, would ever be able to revoke D.C.'s statehood. Once it was done, it would be forever, and Democrats would pretty much be guaranteed two more seats in the Senate...

Sorry, everyone, for this diversion from the topic at hand.

[Abe]

I am concerned that the new variant identified in south africa will not be effectively quashed by the current round of vaccines. The J&J Vaccine was ~55% effective at preventing symptomatic COVID-19 in South Africa, vs 72% in the US. If there is a similar degree of loss with this new variant and the mRNA vaccines, we're looking at 60% efficacy. Obviously better than 0% (non-vaccinated), but there will likely be another hump to climb up and over before the pandemic is controlled. *Sigh*

[cerat0n1a]

The first million doses of the Oxford/AstraZeneca vaccine (manufactured in India) went on to a plane to South Africa this morning, so we should have some data on that pretty soon.

[GuitarStv]

So, I was in line buying groceries at Costco yesterday and saw a 70+ looking older Asian gentleman walk right up to the front and into the store.  I figured that they were letting elderly people in without making them stand in line.  Thought about it for a bit, and decided that it was probably a good thing to do.  The twenty minutes later I passed him in the store.  He had an odd combination of food in his cart for someone of his age (seven packs of hot dogs, two boxes of wine, lots of junk food) and was on his phone to someone, saying "they're out of Doritos, do you want me to substitute with Ruffles?".

My best guess is that he must have received his vaccine, and is now working for instacart (after deciding the vaccine made him invulnerable).  Makes me kinda impressed at the ballsyness and a little less charitable about the 'old people don't stand in line' policy.  Overall, it was a really weird thing to see.

:P

[RetiredAt63]

So, I was in line buying groceries at Costco yesterday and saw a 70+ looking older Asian gentleman walk right up to the front and into the store.  I figured that they were letting elderly people in without making them stand in line.  Thought about it for a bit, and decided that it was probably a good thing to do.  The twenty minutes later I passed him in the store.  He had an odd combination of food in his cart for someone of his age (seven packs of hot dogs, two boxes of wine, lots of junk food) and was on his phone to someone, saying "they're out of Doritos, do you want me to substitute with Ruffles?".

My best guess is that he must have received his vaccine, and is now working for instacart (after deciding the vaccine made him invulnerable).  Makes me kinda impressed at the ballsyness and a little less charitable about the 'old people don't stand in line' policy.  Overall, it was a really weird thing to see.

:P

Wow, I've only shopped at Costco once, back in the summer when cases were low.  And for my optician appointment and glasses, but that was in and out, no other shopping.

Lucky hm if he has had the vaccination.  I sure hope Ford has figured out how to get lots of people vaccinated once we start receiving vaccine again.  Ottawa Health did a really good job with their flu clinics, I would be fine going to one they set up for Covid vaccination.

[shuffler]

I am concerned that the new variant identified in south africa will not be effectively quashed by the current round of vaccines. ... If there is a similar degree of loss with this new variant and the mRNA vaccines, we're looking at 60% efficacy.

Hey Abe -

I know you're typically up-to-date on these things, so my apologies if I'm just repeating things you already know.

ArsTechncia has a page summarizing the state of knowledge of each of the covid variants, and they've said they'll keep it updated as more information becomes known.

https://arstechnica.com/science/2021/01/coronavirus-variants-what-they-do-and-how-worried-you-should-be/

Please scroll down to the "501Y.V2" section for the South African variant, and then the "Vaccine Efficacy" subsection.

Two recent (as in: this week) non-peer reviewed studies by the vaccine makers say:

"Despite this reduction, neutralizing titer levels with [501Y.V2] remain above levels that are expected to be protective,” Moderna said in a statement.

... and ...

[Pfizer and BioNTech] also saw a drop in neutralization from the vaccinees’ antibodies. “However, the Companies believe the small differences in viral neutralization observed in these studies are unlikely to lead to a significant reduction in the effectiveness of the vaccine,” they said in a statement.

... and further that if an updated vaccine should be required, the mRNA vaccine process should accommodate that within only a few weeks.  Though the approval process and manufacturing/distribution logistics would be a further and longer hurdle.

So hopefully that's good news for your Sunday morning.

[Abe]

That’s good news, thanks for sharing. I agree with your assessment. The vaccines do take a hit in terms of potency but hopefully not efficacy. they should be enough to reduce transmission.  Non-vaccinated people will take a bigger hit and that’s a concern in the short to medium terms since covid-recovered people will be vulnerable to the new strain. Generally they don’t need re-approval via clinical trials for minor modifications to proven vaccines, just data such as they’ve presented (but much larger samples). That should allow quick turn-around for vaccines to target the new variants. How that affects the manufacturing / distribution timeline is TBD. Hopefully it doesn’t slow things down too much!

This new variant will separate out the countries in that can get their act together for mass vaccination and ones that cant.

[American GenX]

The vaccines look like they aren't going to be as effective against the South African / Brazilian variant in "preventing" COVID-19, yet still very effective in preventing serious illness, hospitalization, and death.

The UK strain, while more contagious and possibly more deadly, appears to not evade antibodies produced from vaccine immunization or previous illness.

Moderna and Pfizer area already working on a booster to address the mutations in the variants.

[Michael in ABQ]

I've had a cold the last few days. So far the rest of the family has had very mild symptoms, some runny noses that lasted a day or two or mild sore throat. I've gone from that to getting some headaches and some coughing. My wife and I got tested for Covid on Saturday afternoon and just received negative results this morning (Monday). However, I'm going to get tested again as I had very mild symptoms at the time, really just a bit of runny nose and congestion. I'm not sure what the chances of a false negative are one day after starting to experience mild symptoms.

I'm working from home but our 4 kids are in school so we'll keep them home as long as any are having symptoms and until this second test comes back negative. At that point I'd be pretty confident it's just a regular cold. The last time I was sick was in the fall of 2019. Normally with all our kids we end up having some cold or disease run through the family every couple of months so it's been a nice respite for the last year or so.

[dougules]

Once they've got a modified vaccine for new variants, can they mix it with the vaccine for the old variant to give a two-in-one vaccine that covers both old and new?

Also, best guess, will a vaccine specifically for the new variant be as effective as the existing vaccine is for the old variant?

[maisymouser]

I've had a cold the last few days. So far the rest of the family has had very mild symptoms, some runny noses that lasted a day or two or mild sore throat. I've gone from that to getting some headaches and some coughing. My wife and I got tested for Covid on Saturday afternoon and just received negative results this morning (Monday). However, I'm going to get tested again as I had very mild symptoms at the time, really just a bit of runny nose and congestion. I'm not sure what the chances of a false negative are one day after starting to experience mild symptoms.

I'm working from home but our 4 kids are in school so we'll keep them home as long as any are having symptoms and until this second test comes back negative. At that point I'd be pretty confident it's just a regular cold. The last time I was sick was in the fall of 2019. Normally with all our kids we end up having some cold or disease run through the family every couple of months so it's been a nice respite for the last year or so.

Thank you for being so conservative and cautious with your illness. I am really glad to know there are people like you out there playing it on the safe side.

[waltworks]

Once they've got a modified vaccine for new variants, can they mix it with the vaccine for the old variant to give a two-in-one vaccine that covers both old and new?

Also, best guess, will a vaccine specifically for the new variant be as effective as the existing vaccine is for the old variant?

https://messaging-custom-newsletters.nytimes.com/template/oakv2?campaign_id=9&emc=edit_nn_20210201&instance_id=26625&nl=the-morning&productCode=NN&regi_id=57504982&segment_id=50744&te=1&uri=nyt%3A%2F%2Fnewsletter%2Fbbb05a80-af7c-5037-b53f-35ed99b5d44b&user_id=bfa991c17ff431e94b4ce6a6f177ff35

Key takeaways from the NYT article:

"all five of the vaccines — from Pfizer, Moderna, AstraZeneca, Novavax and Johnson & Johnson — look extremely good. Of the roughly 75,000 people who have received one of the five in a research trial, not a single person has died from Covid, and only a few people appear to have been hospitalized. None have remained hospitalized 28 days after receiving a shot.

To put that in perspective, it helps to think about what Covid has done so far to a representative group of 75,000 American adults: It has killed roughly 150 of them and sent several hundred more to the hospital. The vaccines reduce those numbers to zero and nearly zero, based on the research trials.

Zero isn’t even the most relevant benchmark. A typical U.S. flu season kills between five and 15 out of every 75,000 adults and hospitalizes more than 100 of them."

"What about the highly contagious new virus variants that have emerged in Britain, Brazil and South Africa? The South African variant does appear to make the vaccines less effective at eliminating infections.

Fortunately, there is no evidence yet that it increases deaths among vaccinated people. Two of the five vaccines — from Johnson & Johnson and Novavax — have reported some results from South Africa, and none of the people there who received a vaccine died of Covid. “People are still not getting serious illness. They’re still not dying,” Dr. Rebecca Wurtz of the University of Minnesota School of Public Health told me."

-W

[Paper Chaser]

Week over week hospitalizations are declining in 48 states and down 10% or more in 39 states:

[Laserjet3051]

Once they've got a modified vaccine for new variants, can they mix it with the vaccine for the old variant to give a two-in-one vaccine that covers both old and new?

Also, best guess, will a vaccine specifically for the new variant be as effective as the existing vaccine is for the old variant?

No to the first question. "Impossible to predict with any precision" to your second question.

[waltworks]

Thus far, the vaccines work more than well enough against the variants, folks. Don't get confused by the use of the term "effective" (total elimination of any symptoms at all) here.

-W

[MainstreamContrarian]

I’ve been researching and it seems to me that we are wasting about 8% of the Pfizer-BioNTech vaccine (40,000+ doses every day) by following the FDA’s guidance to discard partial doses left in each 6+ dose vial. 

I cannot find nor think of any valid scientific reason to throw away partial doses rather than pooling them and using them to vaccinate more people.

Does anybody know whether there is an actual scientific reason the FDA used to make its decision to disallow pooling of partial doses from multiple vials?  I am not really asking for speculation; the only justification I can find is in an FDA tweet from December 16 that says this is necessary due to lack of preservative in the Pfizer vaccine. 

But the FDA has been struggling with this issue and was forced in December to change its protocols from saying there were 5 doses in each diluted vial to acknowledging that there are actually 6-7 doses in each vial.  On December 16, the FDA Tweeted:  “[G]iven the public health emergency, FDA is advising that it is acceptable to use every full dose obtainable (the sixth, or possibly even a seventh) from each vial, pending resolution of the issue. “

However, the FDA went on to tweet that, “since the vaccine does not contain preservative, it is critical to note that any further remaining product that does not constitute a full dose should not be pooled from multiple vials to create one.”

While this may sound valid in the abstract, it makes no sense in the case of Pfizer‘s vaccine because there are already strict protocols as to how long the shot clinic can hold the vaccine once it’s thawed.

The outside limit is that all the vaccine in a given vial must be used within six hours from when it was diluted (and during that time period, the vials must be stored between 2°C to 25°C (35°F to 77°F)) and thereafter thrown away.

So, why can’t partial doses from different vials be combined as long as they have not been diluted for more than six hours?  Does anyone know whether there is a scientific reason for this?  Or is it just another FDA misstep?

[MudPuppy]

Because contaminants spread that way

[Paper Chaser]

I'm still wrestling with the sudden, mostly unexplained drop in cases in some parts of the US during the holidays, which many expected to cause massive spikes. Seems like India also had an unexplained drop in cases during some similar holidays last fall. I know that comparing different countries can be problematic because there are so many potential differences, and what works in one place may not in another, but it's interesting to read none the less:
 
https://www.npr.org/sections/goatsandsoda/2021/02/01/962821038/the-mystery-of-indias-plummeting-covid-19-cases?utm_source=pocket-newtab

"In a survey of COVID-19 cases in India's Punjab state, Das, the health economist at Georgetown, found that 76% of patients there did not infect a single other person"

"Serological surveys — random testing for antibodies — show that a majority of people in certain areas of India may have already been exposed to the coronavirus, without developing symptoms. Last week, preliminary findings from a fifth serological study of 28,000 people in India's capital showed that 56% of residents already have antibodies, though a final report has not yet been published. The figures were higher in more crowded areas. Last summer, another survey by Mumbai's health department and a government think tank found that 57% of Mumbai slum-dwellers and 16% of people living in other areas had antibodies suggesting prior exposure to the coronavirus."

"India's numbers went down exactly when experts predicted they would spike: in October, when millions of people gathered for the Hindu festivals of Diwali and Durga Puja. It's when air pollution is also worst, and experts feared that would exacerbate the pandemic too.

Cases have also declined despite what many thought would be a superspreader event: tens of thousands of Indian farmers camping out on the capital's outskirts for months."

[Bloop Bloop Reloaded]

Generally the 'worst case scenario' rarely eventuates and I think the US predictions have been a little overblown.

[Michael in ABQ]

I've had a cold the last few days. So far the rest of the family has had very mild symptoms, some runny noses that lasted a day or two or mild sore throat. I've gone from that to getting some headaches and some coughing. My wife and I got tested for Covid on Saturday afternoon and just received negative results this morning (Monday). However, I'm going to get tested again as I had very mild symptoms at the time, really just a bit of runny nose and congestion. I'm not sure what the chances of a false negative are one day after starting to experience mild symptoms.

I'm working from home but our 4 kids are in school so we'll keep them home as long as any are having symptoms and until this second test comes back negative. At that point I'd be pretty confident it's just a regular cold. The last time I was sick was in the fall of 2019. Normally with all our kids we end up having some cold or disease run through the family every couple of months so it's been a nice respite for the last year or so.

Thank you for being so conservative and cautious with your illness. I am really glad to know there are people like you out there playing it on the safe side.

Well, second test came back negative. I'd say that's pretty definitive at this point.

[OtherJen]

Generally the 'worst case scenario' rarely eventuates and I think the US predictions have been a little overblown.

We'll hit 500,000 COVID deaths this month. The epidemiological estimates last March ranged from 200,000 to 1 million deaths. Doesn't seem overblown from where I'm sitting (in the US, in an early epicenter).

[SunnyDays]

I’ve been researching and it seems to me that we are wasting about 8% of the Pfizer-BioNTech vaccine (40,000+ doses every day) by following the FDA’s guidance to discard partial doses left in each 6+ dose vial. 

I cannot find nor think of any valid scientific reason to throw away partial doses rather than pooling them and using them to vaccinate more people.

Does anybody know whether there is an actual scientific reason the FDA used to make its decision to disallow pooling of partial doses from multiple vials?  I am not really asking for speculation; the only justification I can find is in an FDA tweet from December 16 that says this is necessary due to lack of preservative in the Pfizer vaccine. 

But the FDA has been struggling with this issue and was forced in December to change its protocols from saying there were 5 doses in each diluted vial to acknowledging that there are actually 6-7 doses in each vial.  On December 16, the FDA Tweeted:  “[G]iven the public health emergency, FDA is advising that it is acceptable to use every full dose obtainable (the sixth, or possibly even a seventh) from each vial, pending resolution of the issue. “

However, the FDA went on to tweet that, “since the vaccine does not contain preservative, it is critical to note that any further remaining product that does not constitute a full dose should not be pooled from multiple vials to create one.”

While this may sound valid in the abstract, it makes no sense in the case of Pfizer‘s vaccine because there are already strict protocols as to how long the shot clinic can hold the vaccine once it’s thawed.

The outside limit is that all the vaccine in a given vial must be used within six hours from when it was diluted (and during that time period, the vials must be stored between 2°C to 25°C (35°F to 77°F)) and thereafter thrown away.

So, why can’t partial doses from different vials be combined as long as they have not been diluted for more than six hours?  Does anyone know whether there is a scientific reason for this?  Or is it just another FDA misstep?

You would think someone would realize that they can give 2 or more shots to the same person to make up a full dose from leftovers.  I don't like needles any more than the next person, but if it gets me a vaccine, I would do it.

[dougules]

I’ve been researching and it seems to me that we are wasting about 8% of the Pfizer-BioNTech vaccine (40,000+ doses every day) by following the FDA’s guidance to discard partial doses left in each 6+ dose vial. 

I cannot find nor think of any valid scientific reason to throw away partial doses rather than pooling them and using them to vaccinate more people.

Does anybody know whether there is an actual scientific reason the FDA used to make its decision to disallow pooling of partial doses from multiple vials?  I am not really asking for speculation; the only justification I can find is in an FDA tweet from December 16 that says this is necessary due to lack of preservative in the Pfizer vaccine. 

But the FDA has been struggling with this issue and was forced in December to change its protocols from saying there were 5 doses in each diluted vial to acknowledging that there are actually 6-7 doses in each vial.  On December 16, the FDA Tweeted:  “[G]iven the public health emergency, FDA is advising that it is acceptable to use every full dose obtainable (the sixth, or possibly even a seventh) from each vial, pending resolution of the issue. “

However, the FDA went on to tweet that, “since the vaccine does not contain preservative, it is critical to note that any further remaining product that does not constitute a full dose should not be pooled from multiple vials to create one.”

While this may sound valid in the abstract, it makes no sense in the case of Pfizer‘s vaccine because there are already strict protocols as to how long the shot clinic can hold the vaccine once it’s thawed.

The outside limit is that all the vaccine in a given vial must be used within six hours from when it was diluted (and during that time period, the vials must be stored between 2°C to 25°C (35°F to 77°F)) and thereafter thrown away.

So, why can’t partial doses from different vials be combined as long as they have not been diluted for more than six hours?  Does anyone know whether there is a scientific reason for this?  Or is it just another FDA misstep?

Somewhat related, I saw a clip with the CEO of Moderna, and he mentioned that were wanting to go up to 15 doses per vial because apparently just filling the vials is their main production bottleneck (so to speak) at the moment. 

Generally the 'worst case scenario' rarely eventuates and I think the US predictions have been a little overblown.

A good or even mediocre mitigation plan will look overblown.  You're basically saying the bullet wasn't deadly because you didn't die when you dodged and got hit in the arm.  We're having a historically light flu season up here, so that implies that a lot of Americans are taking it more seriously than you might think from what you hear about the bad behavior of some. 

[Watchmaker]

I'm still wrestling with the sudden, mostly unexplained drop in cases in some parts of the US during the holidays, which many expected to cause massive spikes.

I'd like to understand this as well. Here in my county we've dropped steady since the last week of November and have now had two days in a row with no new reported positives. I heard about a lot of gathering over the holidays, so I really expected a spike. I wonder if we got close to herd immunity in the subset of the population that isn't isolating so the virus isn't able to spread through that group well anymore?

[habanero]

We're having a historically light flu season up here, so that implies that a lot of Americans are taking it more seriously than you might think from what you hear about the bad behavior of some.

The reproduction number for the flu is generally estimated at around 1.25 or so - and that is without anyone hardly anyone caring about it so it prob doesn't take that much to get it below 1 in which case it never gets to a real thing.

In Europe this season its virtually non-existent afaik.

Accoring to the report from our national health authorities they don't know for sure if there has been a single case of domestic transmission so far this season. You can count all confirmed flu cases this season on the fingers of one hand, all related to international travel. This in a population of 5.4 millon.

[dandarc]

I'm still wrestling with the sudden, mostly unexplained drop in cases in some parts of the US during the holidays, which many expected to cause massive spikes.

I'd like to understand this as well. Here in my county we've dropped steady since the last week of November and have now had two days in a row with no new reported positives. I heard about a lot of gathering over the holidays, so I really expected a spike. I wonder if we got close to herd immunity in the subset of the population that isn't isolating so the virus isn't able to spread through that group well anymore?

Anyone have an example of a state this drop actually happened in? I just see a small dip right around the actual holidays which is quite easily explained by less people being tested on holiday weekends - testers and the data entry folks took some time off like many other people did. But maybe I'm picking bad states to drill in to see what you're talking about. Maybe spikes aren't as big as expected, but daily new cases undoubtedly rose everywhere I've looked at today.

[waltworks]

You can look at graphs to your heart's content at covidactnow.org

Here in UT, cases are about half the level they were at from November-early January. I perused a random half-dozen other states and it's roughly the same story - dramatically down, as is test positivity rate. It appears to be a widespread phenomenon in the United States, at least.

-W

[Abe]

Graphs below are cases per 100k (7-day moving average) from the week of Thanksgiving to 14 days after New Years (to account for incubation period).

15/52 states/territories had a decline in cases over this period, 2 had an overall steady level and 35 had increases. The majority of states with declines were hit with a surge just prior to the period in question, which suggests they had infected most people who would be at risk during the pre-holiday period, limiting the number of infections during the holiday period. Whether this is sustained is TBD.

 

[kenmoremmm]

conspiracy theorists would argue that the decline is because biden won. if trump had won, cases would still be going up...

[deborah]

It is because Biden won - he told everyone to wear masks...

[Paper Chaser]

I'm still wrestling with the sudden, mostly unexplained drop in cases in some parts of the US during the holidays, which many expected to cause massive spikes.

I'd like to understand this as well. Here in my county we've dropped steady since the last week of November and have now had two days in a row with no new reported positives. I heard about a lot of gathering over the holidays, so I really expected a spike. I wonder if we got close to herd immunity in the subset of the population that isn't isolating so the virus isn't able to spread through that group well anymore?

Anyone have an example of a state this drop actually happened in? I just see a small dip right around the actual holidays which is quite easily explained by less people being tested on holiday weekends - testers and the data entry folks took some time off like many other people did. But maybe I'm picking bad states to drill in to see what you're talking about. Maybe spikes aren't as big as expected, but daily new cases undoubtedly rose everywhere I've looked at today.

Indiana. And some other Midwestern states (Michigan was already mentioned once). This is typically "red"/conservative/Trump territory for those who may not know. I've noticed no significant change in mask wearing, public policy, etc during this time. Many people did downsize various holiday gatherings, but they still occurred. As noted, reporting of cases around the holidays is inconsistent. But hospitalizations and deaths are both much steadier data without drops for the holiday reporting so I think those are more informative metrics.

All data pulled from state dashboard here: https://www.coronavirus.in.gov/2393.htm

7 day average for cases in Indiana technically peaked 12-5, but that could just be a backlog of cases that weren't reported over the Thanksgiving holiday weekend. If one were to do a "line of best fit" for the "cases" curve to try and fill in the missing data for the holidays, it would probably peak sometime during the Thanksgiving weekend.

Hospitalizations peaked on 12-1-20 (seems to back up the idea that official peak in "cases" on 12-5 was likely just a data dump)

Deaths peaked 12-14-20 (the day the very first dose of COVID vaccine was distributed in the US.)

Positivity was highest in the spring, but the fall peak was 12-2-20 (seems to back up the idea that official peak in "cases" on 12-5 was likely just a data dump)

[Paper Chaser]

Covid tracking project does some regional data collection too, and it seems that as a whole, the Midwest region has been declining since mid-late November/early December.

Cases by region (Midwest peaked 11-20-20):
https://covidtracking.com/data/charts/regional-cases

Cases per million by region (Midwest peaked 11-19-20):
https://covidtracking.com/data/charts/regional-cases-per-million

Hospitalizations by region (Midwest peaked 12-1-20):
https://covidtracking.com/data/charts/regional-current-hospitalizations

Deaths by region (Midwest peaked 12-8-20):
https://covidtracking.com/data/charts/regional-deaths

Again, all of these dates were immediately before/during/after Thanksgiving, and declines continued through Christmas and New Years. All of those peaks came well before any vaccine distribution began anywhere in the US, in stereotypically "red" states, with no noticeable change in public behavior or government policy.

[kenmoremmm]

https://www.youtube.com/watch?v=zzbcG7CRYgQ
PBS documentary on china's handling of the virus. suggest watching at 2x speed
wonder if there'll ever be economic sanctions against china for this.

[jrhampt]

Covid tracking project does some regional data collection too, and it seems that as a whole, the Midwest region has been declining since mid-late November/early December.

Cases by region (Midwest peaked 11-20-20):
https://covidtracking.com/data/charts/regional-cases

Cases per million by region (Midwest peaked 11-19-20):
https://covidtracking.com/data/charts/regional-cases-per-million

Hospitalizations by region (Midwest peaked 12-1-20):
https://covidtracking.com/data/charts/regional-current-hospitalizations

Deaths by region (Midwest peaked 12-8-20):
https://covidtracking.com/data/charts/regional-deaths

Again, all of these dates were immediately before/during/after Thanksgiving, and declines continued through Christmas and New Years. All of those peaks came well before any vaccine distribution began anywhere in the US, in stereotypically "red" states, with no noticeable change in public behavior or government policy.

I think the covidiots theory posted a couple pages back might explain it.  Everyone who is out and about acting like there's no pandemic got covid already and the virus has fewer people to infect now since the rest are still being careful?

[waltworks]

https://www.youtube.com/watch?v=zzbcG7CRYgQ
PBS documentary on china's handling of the virus. suggest watching at 2x speed
wonder if there'll ever be economic sanctions against china for this.

Until you, and I, and every one else, stop buying Chinese made stuff, never.

I wondered if Covid would be enough for people to actually stop going to Wal-Mart. No such luck.

-W

[dandarc]

Covid tracking project does some regional data collection too, and it seems that as a whole, the Midwest region has been declining since mid-late November/early December.

Cases by region (Midwest peaked 11-20-20):
https://covidtracking.com/data/charts/regional-cases

Cases per million by region (Midwest peaked 11-19-20):
https://covidtracking.com/data/charts/regional-cases-per-million

Hospitalizations by region (Midwest peaked 12-1-20):
https://covidtracking.com/data/charts/regional-current-hospitalizations

Deaths by region (Midwest peaked 12-8-20):
https://covidtracking.com/data/charts/regional-deaths

Again, all of these dates were immediately before/during/after Thanksgiving, and declines continued through Christmas and New Years. All of those peaks came well before any vaccine distribution began anywhere in the US, in stereotypically "red" states, with no noticeable change in public behavior or government policy.

I think the covidiots theory posted a couple pages back might explain it.  Everyone who is out and about acting like there's no pandemic got covid already and the virus has fewer people to infect now since the rest are still being careful?

Also every one of the states singled out upthread (Indiana, Michigan, Utah) did show a post-December-holidays bump. Not as large as might have been feared, but it is there. And I think the level of holiday gatherings is overstated by many - TSA statistics indicate that travel was down by over 50% over the holidays. Midwest in particular has had the highest peak on a population-adjusted basis of any region - some states re-implemented restrictions in response to the spike right before Thanksgiving, notably in Michigan - on 11/18, a 3 week ban on indoor dining was announced.

So I think "the restrictions work" combined with "college students are stupid on the whole, but they went home before Thanksgiving almost everywhere" pretty well explains it.

[Jouer]

Re: the cases peaking in November or early December for some regions: could this be as simple as people spent time (large gatherings) with families at Thanksgiving instead of Xmas? Is thanksgiving more of a family gathering event in those regions?

Here in Canada, where Thanksgiving is in October and not as big of a deal, our peak was Jan 8. The start of the spike started mid-Dec (last minute xmas shopping) and there was a second spike a around new years (xmas day gatherings). It continued to rise until the 8th, where it's been decreasing ever since. We're down around mid-November numbers right now in a lot of Ontario.

[RetiredAt63]

This is going to be really useful on a community health basis, to see if a variant is in a particular community:

https://www.msn.com/en-ca/news/canada/this-will-save-lives-ottawa-scientists-can-now-detect-covid-variant-in-wastewater/ar-BB1drEe2?ocid=hplocalnews

[Michael in ABQ]

Another outbreak at work. I've been working from home almost exclusively since the last one around Thanksgiving but at lot of the people on my team were still in the office and had to get tested. All negative so far as the main group of people that are all testing positive were working in a different building.

[Abe]

Daily infection rates are almost down to the peak from the summer wave. This is real improvement as hospitalizations are going down. The death rate of known COVID-19 patients has been 1.7%
https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html

Houston area is almost below 100% normal ICU capacity.

Is this the new normal (at least until we have vaccinated everyone who wants and can have one?) Maybe so, but things should eventually improve. Israel has vaccinated 58% of citizens within its internationally recognized borders (not including Gaza and West Bank), and COVID-19 cases are dropping rapidly in preliminary reports.

The biggest question is how soon can we stamp out the variants that are more resistant to vaccine-induced immunity.

[kenmoremmm]

have there been any confirmed cases of someone that was infected with the original covid-19 virus, and then reinfected by a variant? in theory, if the US's total daily cases are dropping and this suggests a nearing of herd immunity, then the variant might not even matter as much.

[MudPuppy]

There have been many reinfections, but the US is lazy about checking variants etc

[Laserjet3051]

Apparently Iowans have waited long enough to flatten the curve:

https://www.msn.com/en-us/news/us/gov-kim-reynolds-lifting-iowas-mask-requirements-gathering-limits-sunday/ar-BB1dqU3G

[American GenX]

have there been any confirmed cases of someone that was infected with the original covid-19 virus, and then reinfected by a variant? in theory, if the US's total daily cases are dropping and this suggests a nearing of herd immunity, then the variant might not even matter as much.

Yes, sort of, the virus is always mutating, though, so it's not quite the original.  The chances of reinfection are much higher with variants with certain mutations such as those in the South African and Brazilian variants, which are both in the U.S. but combined have only been detected in a few states so far.  No, the U.S. is no where near herd immunity.  And the variants matter!