This year we kill it: Corona Virus Thread Mark II

[asda fasda]

I can't speak for the US, but I know it is legal in Canada. Case in point is a rabies vaccine. Before I can work as an Animal Health Tech, or with many different species of wild animal, I must have a rabies vaccine. If I don't have it? I won't be hired/can't work. There is no reason employers can't use the same logic with a COVID vaccine.

Not sure how it looks in Canada and US but this kind of requirements in Poland are established in law or at least in standards issued by oversee agency. No employer can established its own requirements about medical issues, vaccination etc. Moreover we have pretty much closed catalogue of information the employer can asked from potential employee, and it doesn't include any question about medical history so in fact they are prohibited to even asked if you are vaccinated.

[snowblizz]

Within the european union I assume.that privacy laws would make that rather difficult for standard businesses. Since gathering unnecessary data is one of the triggers:

"General Data Protection Regulation Article 5(1)(c) states that personal data shall be “adequate, relevant and limited to what is necessary in relation to the purposes for which they are processed.” So, personal data that is excessive or unnecessary cannot be collected and processed."

Gathering personal data to fuel a vendetta against Anti Vaxxers would most likely fall under that I believe.

Besides the downright creepiness of unqualified and unchecked people getting insights into other people's life.
Imagine living in a small town and your Aldi cashier starts the rumour you are obviously terminally ill and will die soon since you have a medical vaccine exception. Yeah no thanks to that.

Actually in this case your vaccination status would not be unnecessary data. The government shuts down the business based on whether or not your clients are healthy. In fact your entire industry depends on this not happening in the aggregate. Which means it is an absolute necessity for your business to know whether people are potential typhoid Mary's or not.

[Tyndmyr]

The math is that the Herd Immunity Threshold is 1-1/R0. So for Covid (taking the 3.5 estimate), that means we would need 71% immunity in the population, whereas measles requires up to 94%. So yes, 71% is less than 94%. However, that also means that if 100% of people had the Astra Zeneca vaccine, it would just barely be enough, because the AZ vaccine is about 6 times less effective than Moderna/Pfizer (70% versus 95%), and something like 10 times less effective than the MMR vaccine (70% versus 97%).

It's somewhat lower. Resistance from actually getting the disease stacks with vaccination, and a fair number of people have had the disease(some estimates are around 71 million).

Additionally, that is a very conservative estimate. Measles vaccination is, as you noted, is below that mark, and also isn't 100% effective. And yet, measles is very rare. The US as a whole is sub-1000 cases in any given year. Such a rate for Covid would be an effective end to the pandemic.

The problem is literally anti-vaxxers and other people who refuse to get the vaccine for non-medical reasons. Measles has actually experienced a resurgance almost entirely due to these sorts of people.

Anti-vaxxers are not great, but they're not essential for this particular effort. The virulence is far lower than for measles. We can largely ignore them and still beat this with a large margin to spare.

Even if it *was* only reduced to the infection rate of measles, that would be a win. If covid were only infecting perhaps 900 people per year, a bad year for measles in the US, we'd be looking at single digit numbers of deaths. Compared to where we've been, that's pretty much nothing. And since covid is vastly less infectious than measles, we can probably outperform that easily.

A few percent of the population refusing vaccines isn't that crucial, making the vaccines for the other 90-odd percent is. Right now, mostly people are just waiting on available appointments.

I can't speak for the US, but I know it is legal in Canada. Case in point is a rabies vaccine. Before I can work as an Animal Health Tech, or with many different species of wild animal, I must have a rabies vaccine. If I don't have it? I won't be hired/can't work. There is no reason employers can't use the same logic with a COVID vaccine.

Specific legalities probably vary greatly from place to place. However, in the US, the covid vaccines are approved under an emergency use authorization, and all such authorizations explicitly forbid the mandating of them, and require that it be the individual's choice if they wish to take it or not.

We do have some jobs that require vaccines as well, but there's a huge difference between emergency authorizations and fully approved vaccines. This is, incidentally, the reason why the US military cannot require troops to take them. Masks are kind of a different thing, since masks don't require the approvals drugs do(and anyways, many masks were already in common use). This doesn't prohibit strongly encouraging vaccination, of course, and many places do so, often offering time off to go get the vaccine. That *seems* to be okay, given how common it is.

TLDR: If you're in the US and contemplating some sort of vaccine mandate for your employees, you should probably find an actual lawyer that specializes in this.

[NichG]

It's somewhat lower. Resistance from actually getting the disease stacks with vaccination, and a fair number of people have had the disease(some estimates are around 71 million).

Additionally, that is a very conservative estimate. Measles vaccination is, as you noted, is below that mark, and also isn't 100% effective. And yet, measles is very rare. The US as a whole is sub-1000 cases in any given year. Such a rate for Covid would be an effective end to the pandemic.

If you need 70% population immunity (from any source) to keep Covid outbreaks from growing, and you have the ability to sustain (administratively, culturally, in terms of effectiveness of available vaccines, etc) say a 65% population immunity from vaccination specifically, then as the population turns over - as people are born and die - you can expect that at any given time, even say a century from now, about 5% of your population will go through the experience of having Covid at some point in their life (in practice more like 10% if you have periodic outbreaks rather than slow burn, because of how overshoot works) as long as Covid isn't eradicated world-wide. If you only get 60% population immunity from vaccination rather than 65%, that number doubles. If you get 70%, its zero in the limit of an infinite population.

A few percentage points can have an outsized effect when you're sitting very close to threshold, especially magnified by time. Given that the numbers are pretty close, precaution makes sense until we actually hit e.g. zero cases per day for a month. If that does in fact turn out to be easy to achieve, great. But saying 'it will be easy, so lets relax now' is exactly how we've drawn out this pandemic in the past.

[pendell]

So apparently there are Big Party-going plans for when vaccination reaches that critical herd immunity point.

Some have dubbed it “slutty summer” or “the whoring ’20s.” Others have proclaimed that we’re in for a “Shot Girl Summer,” inspired by the viral Megan Thee Stallion song “Hot Girl Summer.” No matter what you call it, 1967’s Summer of Love isn’t going to have anything on 2021. With all New Yorkers over 16 eligible to be vaccinated and bars and restaurants opening, city dwellers have one thing planned for this summer: getting it on.

Well, as a married man this isn't going to be of interest to me, but I hope other people are careful and remember there are other diseases in the world besides COVID

Respectfully,

Brian P.

[snowblizz]

So apparently there are Big Party-going plans for when vaccination reaches that critical herd immunity point.



Well, as a married man this isn't going to be of interest to me, but I hope other people are careful and remember there are other diseases in the world besides COVID

Respectfully,

Brian P.

They won't. But on the upside repopulating after a crisis is a time-honoured tradition of human societies.

[sihnfahl]

And the Brazilian CoronaVac trial has come back with its finalized results:

"There were 253 confirmed COVID-19 cases in the cohort: 85 cases (11.0/100 person-year) among 4,953 participants in the vaccine group, and 168 cases (22·3/100 person-year) among 4,870 participants in the placebo group. The primary efficacy against symptomatic COVID-19 was 50·7% (95%CI 36·0-62·0). The secondary efficacy against cases requiring assistance (score ≥3) and moderate and severe cases (score ≥4) were 83·7% (95%CI 58·0-93.7) and 100% (95%CI 56·4-100.0) respectively."

[monomer]

And the Brazilian CoronaVac trial has come back with its finalized results:

"There were 253 confirmed COVID-19 cases in the cohort: 85 cases (11.0/100 person-year) among 4,953 participants in the vaccine group, and 168 cases (22·3/100 person-year) among 4,870 participants in the placebo group. The primary efficacy against symptomatic COVID-19 was 50·7% (95%CI 36·0-62·0). The secondary efficacy against cases requiring assistance (score ≥3) and moderate and severe cases (score ≥4) were 83·7% (95%CI 58·0-93.7) and 100% (95%CI 56·4-100.0) respectively."

Those confidence intervals look huge, though they seem to be in line with those from the Astra-Zeneca trials using a 12-week dosing interval (82.4% efficacy with 95% CI from 62.7%-91.7%)*. I can't find the confidence interval for the AZ vaccine in how well it prevents severe symptoms and death, which is pretty disappointing since they have been touting 100% effectiveness.

*Note: These numbers seem to be off from other reports since it is only for Symptomatic cases of Covid-19. The efficacy drops somewhat when asymptomatic cases are included.

[sihnfahl]

Those confidence intervals look huge

The problem with Brazil is that this study was not a General Public study, but utilized health care workers.

Who more than likely have already been exposed...

[Sermil]

The problem with Brazil is that this study was not a General Public study, but utilized health care workers.

Who more than likely have already been exposed...

If it was a randomized trial, shouldn't matter. The control group was just likely to have been exposed.

[pendell]

Well, that's a problem

The FDA and CDC have announced that they are calling for an immediate pause on the use of the single-dose Johnson & Johnson vaccine on Tuesday after discovering six cases in the United States of a rare and severe type of blood clot that developed about two weeks after the vaccine was administered in these patients.

"[The] CDC will convene a meeting of the Advisory Committee on Immunization Practices (ACIP) on Wednesday to further review these cases and assess their potential significance," read a joint CDC and FDA statement that was issued on Tuesday morning. "[The] FDA will review that analysis as it also investigates these cases. Until that process is complete, we are recommending a pause in the use of this vaccine out of an abundance of caution. This is important, in part, to ensure that the health care provider community is aware of the potential for these adverse events and can plan for proper recognition and management due to the unique treatment required with this type of blood clot."

Glad we still have Pfizer and Moderna.

Respectfully,

Brian P.

[Strigon]

They pause vaccinations to investigate a half-dozen blood clots out of who-knows-how-many recipients, yet people (my father included) still insist there are huge numbers of people dying that are being covered up.
Delusion is a heck of a drug, amirite?

[sihnfahl]

They pause vaccinations to investigate a half-dozen blood clots out of who-knows-how-many recipients, yet people (my father included) still insist there are huge numbers of people dying that are being covered up.
Delusion is a heck of a drug, amirite?

Not necessarily. Especially here in the US.

You've probably seen the reports of State governments caught or believed to have reduced the number of COVID deaths through data manipulation (remember when the conspiracy was that they were counting the numbers UP to get more COVID relief funds?) thanks to being in our lovely northern neighbor.

It doesn't take a great leap for them to go: Okay, if they're lying about the true impact of COVID, they're willing to lie about the impact of the vaccines in order to get more people vaccinated.

[sktarq]

A few percent of the population refusing vaccines isn't that crucial, making the vaccines for the other 90-odd percent is. Right now, mostly people are just waiting on available appointments.

Meh I'm not really sure about the whole waiting on appointments thing.
I just got my first shop an hour ago.
I figured that until about now when they opened it up to everyone over over 18 (and emancipated minors over 16) it would be booked up solid for weeks. and I'm not really a priority goop so I wouldn't want to grab a shot when other people need it more but I figured I may as well sign up.... But I had basically all time slots open for my choice when I signed up yesterday...including next day (today). and while I was in my 15 min post shot wait the staff were chatting away saying it was a slow day. And a quick check when signing up told me I had many options locally for appointments even within 48hrs. I mentioned to a couple friends who had similar stories in OR and CO...so while still at a plural of anecdote it is still something to consider
So while I'm sure there are areas on the USA that do have highly limited supply. And I doubt we have reached any sense of large scale demand limiting being more important that supply limiting but i do think it is something that could be on the near term horizon...by no means for sure but possible. Demand issues are something that now something we need to pay attention to now.

[NichG]

It wasn't too hard to get an appointment here in WA, but it also wasn't totally open. Most of the local drugstore appointments were taken, but something like 5% of the drive-thru mass vaccination appointments in the area next week were still open so I was able to get a slot (one was totally booked, the other had openings during working hours and I'm basically still on Japan time, so it was fine).

[NichG]

In terms of hesitancy and supply vs demand, I guess a better indicator would be if the rate of vaccination is slowing down or speeding up. It's a bit tricky to get that from data since a numerical second derivative is going to be quite noisy, but when I look at that and smooth over a 28 day period, it looks to me that only seven states are currently slowing down in their vaccination rate. With a 14 day window its 23 states, but it looks very noisy: if I choose different days of last week to stop the analysis at, only 12 of those states show as slowing down all 7 times when I use the 14 day smoothing, whereas 4 of the 7 states show as slowing down for all of the stop dates using the 28 day smoothing.

That said, sigmoid fits to the current vaccination profiles are perhaps a bit less happy. New Hampshire totally fails to fit (says that 25000% of the population will be vaccinated eventually there), but it looks like other states fit a sigmoid pretty well, and there's a range of final vaccination fractions from 35% to 100%, with an average (not population weighted) of about 62%. That said, in terms of fit parameters, the asymptote of a sigmoid is the most sensitive to late-time data, so I don't think I'd trust that number all that much.

[sktarq]

In terms of hesitancy and supply vs demand, I guess a better indicator would be if the rate of vaccination is slowing down or speeding up.

Now you see I wouldn't say that is a particularly good indicator. Mostly because it needs there to be both supply and demand for a shot to be given. If there was a supply disruption to the vaccine supply, say Moderna's vaccine being pulled from the market for example, the vaccination rate would go down. If there is a rumour that the vaccine causes people to get sleeping sickness and people stop signing up the vaccination rate would also go down. Or if the supply goes up and there is still more demand than the supply can meet then the vaccination rate would go up but wouldn't tell us how much more supply could readily be absorbed in current demand circumstances. And while we may want to think that the demand for the vaccine is "everyone" or "nearly everyone" I won't assume that. We have already seen plenty of vaccine anxiety and vaccine resistance being documented and surveyed but we have little idea of how much that will turn into action. So while it is obvious that programs for raising demand are needed and are being put into place we have little idea of how big those programs really need to be. Thus looking for even the first areas where vaccine supply becomes higher than vaccine demand is a key bit of information and what is driving the vaccination rate is nearly as important as the vaccination rate itself.

Looking for data that shows areas where the limit to vaccination rate is supply limited vs areas where it is demand limited is going to be hard...particularly as all areas will start out as supply limited so demand limit data will have no hard reference. I'd actually look things like how long is the average dose held at the final distribution centre perhaps, what percentage of available appointments are filled, rate-of-vaccination/%vaccinated curves, and high vs low risk ratios perhaps would be the types of data that may be more useful though I'm not sure how much of that information is easily available to the public.

[Tyndmyr]

Now you see I wouldn't say that is a particularly good indicator. Mostly because it needs there to be both supply and demand for a shot to be given. If there was a supply disruption to the vaccine supply, say Moderna's vaccine being pulled from the market for example, the vaccination rate would go down.

Given that the J&J vaccine got pulled, and at least some vaccination locations were relying wholly on it, and had to temporarily shut down until they could get more, yeah...that may just be a supply chain hiccup screwing up the data.

[NichG]

Now you see I wouldn't say that is a particularly good indicator. Mostly because it needs there to be both supply and demand for a shot to be given. If there was a supply disruption to the vaccine supply, say Moderna's vaccine being pulled from the market for example, the vaccination rate would go down. If there is a rumour that the vaccine causes people to get sleeping sickness and people stop signing up the vaccination rate would also go down. Or if the supply goes up and there is still more demand than the supply can meet then the vaccination rate would go up but wouldn't tell us how much more supply could readily be absorbed in current demand circumstances. And while we may want to think that the demand for the vaccine is "everyone" or "nearly everyone" I won't assume that. We have already seen plenty of vaccine anxiety and vaccine resistance being documented and surveyed but we have little idea of how much that will turn into action. So while it is obvious that programs for raising demand are needed and are being put into place we have little idea of how big those programs really need to be. Thus looking for even the first areas where vaccine supply becomes higher than vaccine demand is a key bit of information and what is driving the vaccination rate is nearly as important as the vaccination rate itself.

Looking for data that shows areas where the limit to vaccination rate is supply limited vs areas where it is demand limited is going to be hard...particularly as all areas will start out as supply limited so demand limit data will have no hard reference. I'd actually look things like how long is the average dose held at the final distribution centre perhaps, what percentage of available appointments are filled, rate-of-vaccination/%vaccinated curves, and high vs low risk ratios perhaps would be the types of data that may be more useful though I'm not sure how much of that information is easily available to the public.

If we did see slow-down, I agree it'd be hard to (absolutely) tell the difference between whether the slowdown was due to supply or demand without external context. However, if we see positive acceleration in vaccination rates in most states, it seems hard to draw the conclusion 'we're currently demand bottlenecked' from that. Also, supply and supply fluctuations are highly correlated between states since its federally determined, so state-to-state variations will be more informative about changing logistical circumstances and changing demand.

We could instead look at the daily 'share of doses used', which is conveniently accessible (unlike tracking individual doses or things like that which aren't so readily available). It's a bit less quantitative, but for most states that looks like a linear increase from January till the end of February, an overshoot which quickly relaxes, then basically flat. Different states flatten out at different fractions of shares used, which suggests logistical variations rather than supply/demand variations to me, since those doses do eventually get used, just at a different lag compared to when they're sent to the state. Running out of demand would mean that the share of doses used would fall, not just that it would be low and constant. There's a sort of weekly timescale ringing pattern on the curves which makes numerical derivatives a bit noisier, so instead I fit a linear function to the last ~50 days of data.

In that case, the slopes are basically distributed around zero, with the largest negative slope being a reduction of 8% per month in the share utilized, and the largest positive slope being an increase of 15% per month in share utilized. The mean is an increase of 0.7% per month. Since I don't have any kind of generative model for this, uncertainties have to be bootstrapped somehow; I can compare how much these numbers change if I only use the last 25 days of data, for example, and that gives me an RMS difference of around +/- 3.7% per month. There are 11 states below -3.7% per month, 6 states above 3.7% per month, and the rest within error of basically keeping level.

In terms of the two analysis (using the 14 day smoothing, consistent drop in vax rate for 7 days), 17 states show up total, and 8 show up in both analyses. So there is some correlation here, but not incredibly strong agreement, which suggests this might be detecting different but related things. Some of this is going to depend on significance thresholds for including or excluding a state, which I'm playing fast and loose with here.

[Bartmanhomer]

So when will the pandemic be over?

[Mystic Muse]

So when will the pandemic be over?

Answer unclear, check back later.

[Bartmanhomer]

Answer unclear, check back later.

Ok. I'll come back later.

[NichG]

For the world as a whole, probably Summer 2023 at the earliest...

[Tyndmyr]

So when will the pandemic be over?

*Shakes magic eight ball* August.

In reality, I have no idea, it just all depends on how fast people get vaccinated and such. If your area is ahead or behind, your area may be at risk more/less time. It'll probably remain a threat in at least some areas for quite some time.

[sihnfahl]

For the world as a whole, probably Summer 2023 at the earliest...

If ever. Vaccine hesitation plus delivery access may make it endemic in some regions, like polio is.

And also depends on mutations that reduce vaccine efficacy that develop in unvaccinated areas.

[Tvtyrant]

*Shakes magic eight ball* August.

In reality, I have no idea, it just all depends on how fast people get vaccinated and such. If your area is ahead or behind, your area may be at risk more/less time. It'll probably remain a threat in at least some areas for quite some time.

Yeah like my home state will be done soon. We have 4 million people, 2.5 million have got the first shot and 1.1 million both. They just opened up the shots to everyone, by June I imagine everyone who wants a shot will have one and the local pandemic will be over. The rural counties will probably suffer a bit as they are both elderly and a hotbed of anti-vaccine sentiment even before covid, but the cities will be finished pretty quick here.

[Tyndmyr]

Yeah like my home state will be done soon. We have 4 million people, 2.5 million have got the first shot and 1.1 million both. They just opened up the shots to everyone, by June I imagine everyone who wants a shot will have one and the local pandemic will be over. The rural counties will probably suffer a bit as they are both elderly and a hotbed of anti-vaccine sentiment even before covid, but the cities will be finished pretty quick here.

Yeah, the US is at like 40% vaccinated total( https://ourworldindata.org/covid-vaccinations if you like to dabble with stats), and some states are of course above average. By nation, we're doing quite well, with only a couple countries ahead of us(congrats to Israel and the UK). Unfortunately, that means a lot of countries are well behind.

Honestly, doing the cities first isn't the worst effect. They're inherently denser, and population density is linked to spread. Long as the supply keeps up, we'll start having largely safe areas fairly soon.

But the gap between when the first area is safe to the last can be....long. No doubt donation drives and stuff will happen when we get to that point.

[comicshorse]

Yeah, the US is at like 40% vaccinated total( https://ourworldindata.org/covid-vaccinations if you like to dabble with stats), and some states are of course above average. By nation, we're doing quite well, with only a couple countries ahead of us(congrats to Israel and the UK). Unfortunately, that means a lot of countries are well behind.

Honestly, doing the cities first isn't the worst effect. They're inherently denser, and population density is linked to spread. Long as the supply keeps up, we'll start having largely safe areas fairly soon.

But the gap between when the first area is safe to the last can be....long. No doubt donation drives and stuff will happen when we get to that point.

Is that 40 % received both doses ? Cause the UK is putting a big gap between the two doses to get maximum people with the first shot. So we've got 62% who've received the first shot but only 19% who have had both

[Tvtyrant]

Is that 40 % received both doses ? Cause the UK is putting a big gap between the two doses to get maximum people with the first shot. So we've got 62% who've received the first shot but only 19% who have had both

Nah, we are trying to get second shots in fragile populations as much as possible. I think the UK strategy is probably better but this is where we are.

[sihnfahl]

Is that 40 % received both doses ?

No, just single dose. 26% of the US has gotten both, so around 86 million people.

65% of the 65+ age group is fully vaccinated, with about 80% having at least one dose.