*** OFFICIAL *** COVID-19 CoronaVirus Thread. Fresh epidemic fears as child pneumonia cases surge in Europe after China outbreak. NOW in USA (14 Viewers)

[The Commish]

Have a couple doctor’s appointments today at the hospital. First time I’ve been here in a few months, and mask usage inside the hospital seems to have lessened. For example, the technician who did my ultrasound wasn’t wearing one.

It didn’t bother me, but I’m most likely going to continue wearing mine. A random doctor’s office in an office park is one thing, but in an actual hospital there are too many germs floating around, and throwing on a mask for an hour isn’t much of an inconvenience. Still, interesting to note. I wonder if the hospital had any change in policy.

More broadly, I wonder if my assumption that masks in hospitals would be a permanent change was wrong

I have always hated hospitals for this very reason. It's really my only major hang up outside of heights. I absolutely HATE going into hospitals and HATE high places.

Way to crap on my “ER on the top floor of the Sears Tower” idea

I'd suffer with what I had or die from it...guaranteed!

 

[Dr_Zaius]

This week, an international team of virologists, genomicists, and evolutionary biologists may have finally found crucial data to help fill that knowledge gap. A new analysis of genetic sequences collected from the market shows that raccoon dogs being illegally sold at the venue could have been carrying and possibly shedding the virus at the end of 2019. It’s some of the strongest support yet, experts told me, that the pandemic began when SARS-CoV-2 hopped from animals into humans, rather than in an accident among scientists experimenting with viruses.

Do they address how they're convinced the transmission went raccoon dogs to humans and not the other way? After all, there were a bunch of confirmed covid-positive whitetail deer in the US in 2020, and yet clearly deer were not the source of the pandemic in the US. I couldn't find it in a quick skimming of the article, but I assume they're mainly relying on timing arguments to determine the causality arrow.

 

[Bogeys]

Have a couple doctor’s appointments today at the hospital. First time I’ve been here in a few months, and mask usage inside the hospital seems to have lessened. For example, the technician who did my ultrasound wasn’t wearing one.

It didn’t bother me, but I’m most likely going to continue wearing mine. A random doctor’s office in an office park is one thing, but in an actual hospital there are too many germs floating around, and throwing on a mask for an hour isn’t much of an inconvenience. Still, interesting to note. I wonder if the hospital had any change in policy.

More broadly, I wonder if my assumption that masks in hospitals would be a permanent change was wrong

I know my hospital changed the beginning of February from everyone in the hospital has to wear one to pre-Covid guidelines for masking (isolation protocols). Still feels weird to get up from the desk to go get water...I still reach for a mask that isn't on my desk anymore.

ETA: Still have to have a negative Covid test if you have any symptoms, which makes allergy season fun.

 

[Doug B]

It's complicated. lol But I think your final statement is true.

Slight bummer -- I was hoping consensus was at least coalescing, if not being reached.

I do remember the comparisons of the SARS-CoV-2 virus' cellular-level actions to those of HIV, from the first several months of the pandemic in 2020. Do you know if there is in fact consensus that recent variants (essentially, the Omicron family line) are less destructive to T-cells than the 2020 strains?

 

[jobarules]

American Masters | Dr. Fauci visits D.C. to battle vaccine hesistancy | Season 37

Dr. Fauci and the mayor of D.C. encourage residents to receive the COVID-19 vaccine.

www.pbs.org

cringey

 

[Leeroy Jenkins]

I am basically only masking at CVS, Medical Facility/Office, and public transportation.

 

[Nathan R. Jessep]

This week, an international team of virologists, genomicists, and evolutionary biologists may have finally found crucial data to help fill that knowledge gap. A new analysis of genetic sequences collected from the market shows that raccoon dogs being illegally sold at the venue could have been carrying and possibly shedding the virus at the end of 2019. It’s some of the strongest support yet, experts told me, that the pandemic began when SARS-CoV-2 hopped from animals into humans, rather than in an accident among scientists experimenting with viruses.

Do they address how they're convinced the transmission went raccoon dogs to humans and not the other way? After all, there were a bunch of confirmed covid-positive whitetail deer in the US in 2020, and yet clearly deer were not the source of the pandemic in the US. I couldn't find it in a quick skimming of the article, but I assume they're mainly relying on timing arguments to determine the causality arrow.

Good question. I'm not sure. There may be an answer to that. Will look around a bit.

 

[Nathan R. Jessep]

I do remember the comparisons of the SARS-CoV-2 virus' cellular-level actions to those of HIV, from the first several months of the pandemic in 2020. Do you know if there is in fact consensus that recent variants (essentially, the Omicron family line) are less destructive to T-cells than the 2020 strains?

Not that I have seen yet. I think part of the issue there is that the current strains are so different from the OG strains, it's hard to do a baseline comparison any more, especially when you throw in that some were pre- and post- vaccines.

 

[The Commish]

I do remember the comparisons of the SARS-CoV-2 virus' cellular-level actions to those of HIV, from the first several months of the pandemic in 2020. Do you know if there is in fact consensus that recent variants (essentially, the Omicron family line) are less destructive to T-cells than the 2020 strains?

Not that I have seen yet. I think part of the issue there is that the current strains are so different from the OG strains, it's hard to do a baseline comparison any more, especially when you throw in that some were pre- and post- vaccines.

Omicron represents a 2-3% change in the virus. I don't think there is going to be a significant improvement/threat to T-Cells. Will likely be very similar to the initial variants. This is why it's important to get the vaccines. More exposure to the antigens helps T-Cells solidify their plan of attack and solidify their defense from the virus.

 

[IC FBGCav]

To do what is best for me.

If you mean to avoid getting reinfected, then in hindsight with current knowledge here in 2023, you'd have assumed you were immune for a few months (maybe less), then taking precautions to avoid higher risk exposures again.

Well, we all know vaccine or not, multiple infections were likely. The vaccine efficiency is limited, so is natural immunity. All things being equal. Once I had covid, not sure taking a vaccine would have had improved my situation in any significant way.

 

[The Commish]

To do what is best for me.

If you mean to avoid getting reinfected, then in hindsight with current knowledge here in 2023, you'd have assumed you were immune for a few months (maybe less), then taking precautions to avoid higher risk exposures again.

Well, we all know vaccine or not, multiple infections were likely. The vaccine efficiency is limited, so is natural immunity. All things being equal. Once I had covid, not sure taking a vaccine would have had improved my situation in any significant way.

Post delta...prior to that, plenty of data suggesting the vaccines did a great job at preventing infection (90%+).

 

[Doug B]

The record LOW 7-day COVID deaths average in the US has for a long time been on July 9th, 2021 at 244 deaths. That was right before Delta ramped up.

Well, right now, going back 13 days, the 7-day average on March 9th, 2023 is currently at 241. The March 9th figure will rise a bit more ... but not much. There's been an ongoing decline in 7-day average COVID deaths since January 15th of this year, when the figure was at 595. And that decline has been a steady linear line downwards -- not slowing down in pace. I'm holding out hope that the 7-day US COVID deaths average can lock in below 200/day in April and -- wishful thinking here -- settle in below 100/day sometime in May.

 

[ignatiusjreilly]

The record 7-day COVID deaths average in the US has for a long time been on July 9th, 2021 at 244 deaths. That was right before Delta ramped up.

Well, right now, going back 13 days, the 7-day average on March 9th, 2023 is currently at 241. The March 9th figure will rise a bit more ... but not much. There's been an ongoing decline in 7-day average COVID deaths since January 15th of this year, when the figure was at 595. And that decline has been a steady linear line downwards -- not slowing down in pace. I'm holding out hope that the 7-day US COVID deaths average can lock in below 200/day in April and -- wishful thinking here -- settle in below 100/day sometime in May.

For a second I thought you were saying we were hitting a new high in deaths. But you're saying it's actually a low, right?

 

[Doug B]

For a second I thought you were saying we were hitting a new high in deaths. But you're saying it's actually a low, right?

Yikes -- you are correct. Fixed my post above.

 

[Terminalxylem]

Have a couple doctor’s appointments today at the hospital. First time I’ve been here in a few months, and mask usage inside the hospital seems to have lessened. For example, the technician who did my ultrasound wasn’t wearing one.

It didn’t bother me, but I’m most likely going to continue wearing mine. A random doctor’s office in an office park is one thing, but in an actual hospital there are too many germs floating around, and throwing on a mask for an hour isn’t much of an inconvenience. Still, interesting to note. I wonder if the hospital had any change in policy.

More broadly, I wonder if my assumption that masks in hospitals would be a permanent change was wrong

100% mask use in my hospital, and no timeline for removing them, FWIW.

 

[gianmarco]

Have a couple doctor’s appointments today at the hospital. First time I’ve been here in a few months, and mask usage inside the hospital seems to have lessened. For example, the technician who did my ultrasound wasn’t wearing one.

It didn’t bother me, but I’m most likely going to continue wearing mine. A random doctor’s office in an office park is one thing, but in an actual hospital there are too many germs floating around, and throwing on a mask for an hour isn’t much of an inconvenience. Still, interesting to note. I wonder if the hospital had any change in policy.

More broadly, I wonder if my assumption that masks in hospitals would be a permanent change was wrong

100% mask use in my hospital, and no timeline for removing them, FWIW.

We just removed them today.

 

[Terminalxylem]

Have a couple doctor’s appointments today at the hospital. First time I’ve been here in a few months, and mask usage inside the hospital seems to have lessened. For example, the technician who did my ultrasound wasn’t wearing one.

It didn’t bother me, but I’m most likely going to continue wearing mine. A random doctor’s office in an office park is one thing, but in an actual hospital there are too many germs floating around, and throwing on a mask for an hour isn’t much of an inconvenience. Still, interesting to note. I wonder if the hospital had any change in policy.

More broadly, I wonder if my assumption that masks in hospitals would be a permanent change was wrong

100% mask use in my hospital, and no timeline for removing them, FWIW.

We just removed them today.

Whether we should keep masking in healthcare facilities indefinitely is an interesting question, imo.

On the one hand, there are plenty of examples of nosocomial infections, including respiratory viruses, which can be mitigated by masks, to some extent.

And I’ve remained covid-free, despite a high risk profession. Heck, I just had my first cold in 3+ years, after multiple trips in the last four months (I mask in airports/planes, too).

On the other hand, it’s a little irritating to wear them, and it’s makes interacting with patients more difficult. Plus it creates a lot of waste.

I guess I’ll see what the future holds, but seems like the pros outweigh the cons.

 

[ignatiusjreilly]

Have a couple doctor’s appointments today at the hospital. First time I’ve been here in a few months, and mask usage inside the hospital seems to have lessened. For example, the technician who did my ultrasound wasn’t wearing one.

It didn’t bother me, but I’m most likely going to continue wearing mine. A random doctor’s office in an office park is one thing, but in an actual hospital there are too many germs floating around, and throwing on a mask for an hour isn’t much of an inconvenience. Still, interesting to note. I wonder if the hospital had any change in policy.

More broadly, I wonder if my assumption that masks in hospitals would be a permanent change was wrong

100% mask use in my hospital, and no timeline for removing them, FWIW.

We just removed them today.

Whether we should keep masking in healthcare facilities indefinitely is an interesting question, imo.

On the one hand, there are plenty of examples of nosocomial infections, including respiratory viruses, which can be mitigated by masks, to some extent.

And I’ve remained covid-free, despite a high risk profession. Heck, I just had my first cold in 3+ years, after multiple trips in the last four months (I mask in airports/planes, too).

On the other hand, it’s a little irritating to wear them, and it’s makes interacting with patients more difficult. Plus it creates a lot of waste.

I guess I’ll see what the future holds, but seems like the pros outweigh the cons.

It's hard to separate it from our current situation with Covid and mask mandates and such, but in general, doesn't it make sense that, in a location where large numbers of a) potentially sick/infectious people, and b) potentially vulnerable people are all congregating, we should at least take some minimally intrusive steps to try to limit transmission of respiratory diseases? The obvious precedent is in Asian societies where sick people are expected to wear masks in public. I wonder if people generally wear masks in Asian hospitals, either pre- or post-Covid.

 

[IvanKaramazov]

I've made my views on masking very clear and even I don't have any serious objection to hospitals requiring masks. (I'd prefer that they didn't, but I get it).

 

[Terminalxylem]

Have a couple doctor’s appointments today at the hospital. First time I’ve been here in a few months, and mask usage inside the hospital seems to have lessened. For example, the technician who did my ultrasound wasn’t wearing one.

It didn’t bother me, but I’m most likely going to continue wearing mine. A random doctor’s office in an office park is one thing, but in an actual hospital there are too many germs floating around, and throwing on a mask for an hour isn’t much of an inconvenience. Still, interesting to note. I wonder if the hospital had any change in policy.

More broadly, I wonder if my assumption that masks in hospitals would be a permanent change was wrong

100% mask use in my hospital, and no timeline for removing them, FWIW.

We just removed them today.

Whether we should keep masking in healthcare facilities indefinitely is an interesting question, imo.

On the one hand, there are plenty of examples of nosocomial infections, including respiratory viruses, which can be mitigated by masks, to some extent.

And I’ve remained covid-free, despite a high risk profession. Heck, I just had my first cold in 3+ years, after multiple trips in the last four months (I mask in airports/planes, too).

On the other hand, it’s a little irritating to wear them, and it’s makes interacting with patients more difficult. Plus it creates a lot of waste.

I guess I’ll see what the future holds, but seems like the pros outweigh the cons.

It's hard to separate it from our current situation with Covid and mask mandates and such, but in general, doesn't it make sense that, in a location where large numbers of a) potentially sick/infectious people, and b) potentially vulnerable people are all congregating, we should at least take some minimally intrusive steps to try to limit transmission of respiratory diseases? The obvious precedent is in Asian societies where sick people are expected to wear masks in public. I wonder if people generally wear masks in Asian hospitals, either pre- or post-Covid.

Universal precautions (handwashing, barrier methods when potentially infectious body fluids are identified) apply to all patients, with more intense isolation provided in certain situations (very immunocompromised patients, suspicion for specific infections, like MRSA and TB). The issue is, covid and other respiratory viruses can spread in pre- and asymptomatic patients. Pre-covid, we ignored the benefit of limiting this type of transmission, but I agree we probably shouldn’t.

Don‘t know how Asian hospitals have utilized masks historically, but am aware of international infection control far superior to the US. The Netherlands, for example, has a “search and destroy” policy for MRSA, which has limited the impact of that “superbug“ dramatically in comparison to neighboring countries. But that policy is expensive and labor intensive, so hasn’t been implemented elsewhere.

ETA: Looks like Japan has one to four thousand flu deaths annually, in comparison to ~35K for the US. So they have 1/10 the deaths in 1/3 the population, who are older, though probably healthier. When it’s all said and done, we’ll likely settle around 2-3x that number for covid deaths per year. But we are too stubborn/stupid to learn from the examples of others.

 

[Doug B]

When it’s all said and done, we’ll likely settle around 2-3x that number for covid deaths per year.

I wonder if in the long term, COVID will "cannibalize" other deaths? Like the number (or rate?) of overall deaths will stabilize at roughly pre-COVID levels, but COVID will be one more thing among many that can spell the end. So down-the-road COVID, instead of being extra deaths heaped on top the other killers, will take a few deaths from cancer and a few from heart disease and a few from other respiratory conditions, etc.

Another way to look at it is the cost in person-years. Seems that pre-vaccine, COVID was killing people who often had at least a decade or so left -- sometimes a lot longer than that. But maybe over time, COVID will kill fewer and fewer late-middle-aged and early-elderly folks and therefore cost society fewer person-years.

 

[Terminalxylem]

When it’s all said and done, we’ll likely settle around 2-3x that number for covid deaths per year.

I wonder if in the long term, COVID will "cannibalize" other deaths? Like the number (or rate?) of overall deaths will stabilize at roughly pre-COVID levels, but COVID will be one more thing among many that can spell the end. So down-the-road COVID, instead of being extra deaths heaped on top the other killers, will take a few deaths from cancer and a few from heart disease and a few from other respiratory conditions, etc.

Another way to look at it is the cost in person-years. Seems that pre-vaccine, COVID was killing people who often had at least a decade or so left -- sometimes a lot longer than that. But maybe over time, COVID will kill fewer and fewer late-middle-aged and early-elderly folks and therefore cost society fewer person-years.

You may be right. Despite all the nonsense about scores of young people dying after widespread vaccination, expected All-cause deaths have leveled off, with little excess in comparison to the last two winters. We’ll need some time to see if the trend continues.

 

[ignatiusjreilly]

When it’s all said and done, we’ll likely settle around 2-3x that number for covid deaths per year.

I wonder if in the long term, COVID will "cannibalize" other deaths? Like the number (or rate?) of overall deaths will stabilize at roughly pre-COVID levels, but COVID will be one more thing among many that can spell the end. So down-the-road COVID, instead of being extra deaths heaped on top the other killers, will take a few deaths from cancer and a few from heart disease and a few from other respiratory conditions, etc.

Another way to look at it is the cost in person-years. Seems that pre-vaccine, COVID was killing people who often had at least a decade or so left -- sometimes a lot longer than that. But maybe over time, COVID will kill fewer and fewer late-middle-aged and early-elderly folks and therefore cost society fewer person-years.

You may be right. Despite all the nonsense about scores of young people dying after widespread vaccination, expected All-cause deaths have leveled off, with little excess in comparison to the last two winters. We’ll need some time to see if the trend continues.

Considering that "score" = 20, that might actually be accurate

 

[Terminalxylem]

When it’s all said and done, we’ll likely settle around 2-3x that number for covid deaths per year.

I wonder if in the long term, COVID will "cannibalize" other deaths? Like the number (or rate?) of overall deaths will stabilize at roughly pre-COVID levels, but COVID will be one more thing among many that can spell the end. So down-the-road COVID, instead of being extra deaths heaped on top the other killers, will take a few deaths from cancer and a few from heart disease and a few from other respiratory conditions, etc.

Another way to look at it is the cost in person-years. Seems that pre-vaccine, COVID was killing people who often had at least a decade or so left -- sometimes a lot longer than that. But maybe over time, COVID will kill fewer and fewer late-middle-aged and early-elderly folks and therefore cost society fewer person-years.

You may be right. Despite all the nonsense about scores of young people dying after widespread vaccination, expected All-cause deaths have leveled off, with little excess in comparison to the last two winters. We’ll need some time to see if the trend continues.

Considering that "score" = 20, that might actually be accurate

If you click the ”WeeklyNumberByAge” tab in the data I linked, it’s really obvious when spikes occurred, and the likely explanation. Excess deaths were/are effectively nonexistent in people under 25, with small increases in ages 25-44 corresponding to the peaks of major covid strains. Absolutely nothing paralleling approval of the vaccine/boosters.

 

[ignatiusjreilly]

When it’s all said and done, we’ll likely settle around 2-3x that number for covid deaths per year.

I wonder if in the long term, COVID will "cannibalize" other deaths? Like the number (or rate?) of overall deaths will stabilize at roughly pre-COVID levels, but COVID will be one more thing among many that can spell the end. So down-the-road COVID, instead of being extra deaths heaped on top the other killers, will take a few deaths from cancer and a few from heart disease and a few from other respiratory conditions, etc.

Another way to look at it is the cost in person-years. Seems that pre-vaccine, COVID was killing people who often had at least a decade or so left -- sometimes a lot longer than that. But maybe over time, COVID will kill fewer and fewer late-middle-aged and early-elderly folks and therefore cost society fewer person-years.

You may be right. Despite all the nonsense about scores of young people dying after widespread vaccination, expected All-cause deaths have leveled off, with little excess in comparison to the last two winters. We’ll need some time to see if the trend continues.

Considering that "score" = 20, that might actually be accurate

If you click the ”WeeklyNumberByAge” tab in the data I linked, it’s really obvious when spikes occurred, and the likely explanation. Excess deaths were/are effectively nonexistent in people under 25, with small increases in ages 25-44 corresponding to the peaks of major covid strains. Absolutely nothing paralleling approval of the vaccine/boosters.

I know. I was just making a dumb joke about the fact that, even if "scores" of American were dying of something, that wouldn't actually have much significance

 

[Terminalxylem]

When it’s all said and done, we’ll likely settle around 2-3x that number for covid deaths per year.

I wonder if in the long term, COVID will "cannibalize" other deaths? Like the number (or rate?) of overall deaths will stabilize at roughly pre-COVID levels, but COVID will be one more thing among many that can spell the end. So down-the-road COVID, instead of being extra deaths heaped on top the other killers, will take a few deaths from cancer and a few from heart disease and a few from other respiratory conditions, etc.

Another way to look at it is the cost in person-years. Seems that pre-vaccine, COVID was killing people who often had at least a decade or so left -- sometimes a lot longer than that. But maybe over time, COVID will kill fewer and fewer late-middle-aged and early-elderly folks and therefore cost society fewer person-years.

You may be right. Despite all the nonsense about scores of young people dying after widespread vaccination, expected All-cause deaths have leveled off, with little excess in comparison to the last two winters. We’ll need some time to see if the trend continues.

Considering that "score" = 20, that might actually be accurate

If you click the ”WeeklyNumberByAge” tab in the data I linked, it’s really obvious when spikes occurred, and the likely explanation. Excess deaths were/are effectively nonexistent in people under 25, with small increases in ages 25-44 corresponding to the peaks of major covid strains. Absolutely nothing paralleling approval of the vaccine/boosters.

I know. I was just making a dumb joke about the fact that, even if "scores" of American were dying of something, that wouldn't actually have much significance

Yes, I understood. Did you know a few = 8, according to the Bible?

 

[The Commish]

When it’s all said and done, we’ll likely settle around 2-3x that number for covid deaths per year.

I wonder if in the long term, COVID will "cannibalize" other deaths? Like the number (or rate?) of overall deaths will stabilize at roughly pre-COVID levels, but COVID will be one more thing among many that can spell the end. So down-the-road COVID, instead of being extra deaths heaped on top the other killers, will take a few deaths from cancer and a few from heart disease and a few from other respiratory conditions, etc.

Another way to look at it is the cost in person-years. Seems that pre-vaccine, COVID was killing people who often had at least a decade or so left -- sometimes a lot longer than that. But maybe over time, COVID will kill fewer and fewer late-middle-aged and early-elderly folks and therefore cost society fewer person-years.

You may be right. Despite all the nonsense about scores of young people dying after widespread vaccination, expected All-cause deaths have leveled off, with little excess in comparison to the last two winters. We’ll need some time to see if the trend continues.

By the way.....for those wondering, SADS deaths for 2020 and 2021 are in line with what they've been for the decades it's been tracked....2022 results will be out later this year, but there's no indication that fact will change.

 

[Doug B]

Report: FDA Considers Authorizing Another Round of Updated COVID-19 Booster Shots for Some (US News & World Report 3/21/2023, also Wall Street Journal [paywall] 3/21/2023)

The agency is reportedly considering authorization of another shot for older Americans and others at high risk for severe COVID-19 within a matter of weeks.

The Wall Street Journal reported that the FDA is considering authorizing a second omicron-specific booster shot for people aged 65 and older or who have weakened immune systems. One source said that the decision is not yet final, noting that officials could change their minds.

...

The developments come after health officials in Canada and the United Kingdom this month recommended another COVID-19 booster shot in the spring for people at high risk for severe disease.

 

[Leeroy Jenkins]

Report: FDA Considers Authorizing Another Round of Updated COVID-19 Booster Shots for Some (US News & World Report 3/21/2023, also Wall Street Journal [paywall] 3/21/2023)

The agency is reportedly considering authorization of another shot for older Americans and others at high risk for severe COVID-19 within a matter of weeks.

The Wall Street Journal reported that the FDA is considering authorizing a second omicron-specific booster shot for people aged 65 and older or who have weakened immune systems. One source said that the decision is not yet final, noting that officials could change their minds.

...

The developments come after health officials in Canada and the United Kingdom this month recommended another COVID-19 booster shot in the spring for people at high risk for severe disease.

Makes sense with the deaths and hospitalizations being so heavily tilted to that demo.

Side note, you may recall an acquaintance of mine who caught Covid in Summer 2020 who was in the hospital for 100+ days and in a coma for much of that time. He still cannot walk on his own and is mostly bedridden. In the hospital again with a tube in his throat to help him breathe. People forget how bad Covid was pre-vaccine.

 

[Doug B]

Side note, you may recall an acquaintance of mine who caught Covid in Summer 2020 who was in the hospital for 100+ days and in a coma for much of that time. He still cannot walk on his own and is mostly bedridden. In the hospital again with a tube in his throat to help him breathe. People forget how bad Covid was pre-vaccine.

Accounts like these made me wonder if other severe respiratory infections were capable of similar effects at the far end of the bell curve.

I ran across this October 2018** NPR article about a 39-year-old man who was hospitalized for two months and placed in a medical-induced coma due to an influenza infection -- which almost all of us (me for sure) kind of write off as 'no big deal'. I understand that, statistically, this guy was one-in-a-million ... but the article still gives a lot to think about.

Consider that it was written in 2018, and mentally substitute 'COVID' wherever you see 'flu' or 'influenza':

Many flu-related deaths are caused not by the flu itself but by secondary infections and complications, including pneumonia and inflammation of the heart, brain or muscle tissues. And the flu can increase the risk of having a heart attack, according to a study published earlier this year.

** the 2017-18 flu season ended up with about 80,000 deaths in the U.S. That would be spaced out evenly over 365 days as 219 deaths/day but given seasonality, it was likely over 500 deaths/day at it's peak. Didn't hear very much about those deaths, did we?

 

[IvanKaramazov]

So we just went through a global pandemic that killed a million Americans and helped break our society, and the FDA can't decide whether it would be a good idea to allow people to take a booster tailored to the dominant variant.

Cool country.

 

[The Commish]

So we just went through a global pandemic that killed a million Americans and helped break our society, and the FDA can't decide whether it would be a good idea to allow people to take a booster tailored to the dominant variant.

Cool country.

I think you and I have been pretty much in lockstep with respect to our views of the FDA. I have been watching this organization pretty closely for the better part of 15 years. As of the pandemic, I have added the CDC to the list of grossly incompetent departments of our government as well. Both have done as much damage to the American people as the politicians have with regard to COVID. It's mindnumbingly stupid and quite unbelievable.

 

[Doug B]

So we just went through a global pandemic that killed a million Americans and helped break our society, and the FDA can't decide whether it would be a good idea to allow people to take a booster tailored to the dominant variant.

The FDA doesn't seem to be a monolith, though. It seems that the main advisory committee has some members that kinda-sorta don't believe in vaccinating your way out of a pandemic (remember, we were posting about them a few pages back). So there's considerable drag on what would otherwise be the easy approval of COVID vaccine initiatives.

Do we blame "the FDA" as an entity, or do we blame individual committee members who hesitate to approve even though the safety profiles are virtually perfect?

 

[The Commish]

So we just went through a global pandemic that killed a million Americans and helped break our society, and the FDA can't decide whether it would be a good idea to allow people to take a booster tailored to the dominant variant.

The FDA doesn't seem to be a monolith, though. It seems that the main advisory committee has some members that kinda-sorta don't believe in vaccinating your way out of a pandemic (remember, we were posting about them a few pages back). So there's considerable drag on what would otherwise be the easy approval of COVID vaccine initiatives.

Do we blame "the FDA" as an entity, or do we blame individual committee members who hesitate to approve even though the safety profiles are virtually perfect?

Yes....because it's structured in a way that allows this sort of junk.

 

[ignatiusjreilly]

When it’s all said and done, we’ll likely settle around 2-3x that number for covid deaths per year.

I wonder if in the long term, COVID will "cannibalize" other deaths? Like the number (or rate?) of overall deaths will stabilize at roughly pre-COVID levels, but COVID will be one more thing among many that can spell the end. So down-the-road COVID, instead of being extra deaths heaped on top the other killers, will take a few deaths from cancer and a few from heart disease and a few from other respiratory conditions, etc.

Another way to look at it is the cost in person-years. Seems that pre-vaccine, COVID was killing people who often had at least a decade or so left -- sometimes a lot longer than that. But maybe over time, COVID will kill fewer and fewer late-middle-aged and early-elderly folks and therefore cost society fewer person-years.

You may be right. Despite all the nonsense about scores of young people dying after widespread vaccination, expected All-cause deaths have leveled off, with little excess in comparison to the last two winters. We’ll need some time to see if the trend continues.

Considering that "score" = 20, that might actually be accurate

If you click the ”WeeklyNumberByAge” tab in the data I linked, it’s really obvious when spikes occurred, and the likely explanation. Excess deaths were/are effectively nonexistent in people under 25, with small increases in ages 25-44 corresponding to the peaks of major covid strains. Absolutely nothing paralleling approval of the vaccine/boosters.

I know. I was just making a dumb joke about the fact that, even if "scores" of American were dying of something, that wouldn't actually have much significance

Yes, I understood. Did you know a few = 8, according to the Bible?

I didn't, but you just reminded me of the time my wife got mad at me because she asked me to hand her a "couple of" something and I gave her two

 

[ignatiusjreilly]

So we just went through a global pandemic that killed a million Americans and helped break our society, and the FDA can't decide whether it would be a good idea to allow people to take a booster tailored to the dominant variant.

The FDA doesn't seem to be a monolith, though. It seems that the main advisory committee has some members that kinda-sorta don't believe in vaccinating your way out of a pandemic (remember, we were posting about them a few pages back). So there's considerable drag on what would otherwise be the easy approval of COVID vaccine initiatives.

Do we blame "the FDA" as an entity, or do we blame individual committee members who hesitate to approve even though the safety profiles are virtually perfect?

Yes....because it's structured in a way that allows this sort of junk.

My variation on Hanlon's Razor is never attribute to malice OR stupidity that which is adequately explained by poor structure or misaligned incentives

 

[Leeroy Jenkins]

So we just went through a global pandemic that killed a million Americans and helped break our society, and the FDA can't decide whether it would be a good idea to allow people to take a booster tailored to the dominant variant.

Cool country.

Looking backwards now, what country do we think ended up with the best overall COVID response?

 

[Nathan R. Jessep]

I found this interesting. I haven't read the entire thing yet, but wanted to share. You can click on any of the superscript and it will bring up the reference document (linked) at the bottom of the page (without losing your place where the superscript occurred in the document)

The Reality Gap

The failure to recognise the ongoing severity of COVID-19 is creating a reality gap that is being filled by groups peddling misinformation.

johnsnowproject.org

 

[-fish-]

So we just went through a global pandemic that killed a million Americans and helped break our society, and the FDA can't decide whether it would be a good idea to allow people to take a booster tailored to the dominant variant.

Cool country.

Looking backwards now, what country do we think ended up with the best overall COVID response?

Vietnam

 

[Whyatt]

So we just went through a global pandemic that killed a million Americans and helped break our society, and the FDA can't decide whether it would be a good idea to allow people to take a booster tailored to the dominant variant.

Cool country.

Looking backwards now, what country do we think ended up with the best overall COVID response?

The Project Manager of the General Contractor we routinely hired at work always would always tell me "Yeah we suck, but we are the best in the business". This may apply here.

More seriously, I'm not sure about the concern. A booster tailored to the dominant variant has been approved for months. It seems appropriate that approval of another dose is data driven - that's how its done worldwide.

 

[Terminalxylem]

So we just went through a global pandemic that killed a million Americans and helped break our society, and the FDA can't decide whether it would be a good idea to allow people to take a booster tailored to the dominant variant.

Cool country.

Looking backwards now, what country do we think ended up with the best overall COVID response?

Somewhere in Southeast Asia, maybe S Korea or Japan?

Minimized covid deaths (with reliable reporting), maintaining healthcare infrastructure, and society was able to function decently throughout the pandemic. Don’t think their economies were crushed, either, at least relative to the rest of the world,

And I doubt they’ve as many problems with antivax, militant anti-maskers, etc.

 

[Nathan R. Jessep]

Do we need a spring COVID-19 booster?

It’s been close to 6 months since the initial rollout of the fall (bivalent) booster. A lot of people are wondering: Do I need a spring booster? The answer hinges on more questions: What is the purpose of vaccines? Does that purpose change depending on age or health status?

yourlocalepidemiologist.substack.com

 

[fatness]

Report: FDA Considers Authorizing Another Round of Updated COVID-19 Booster Shots for Some (US News & World Report 3/21/2023, also Wall Street Journal [paywall] 3/21/2023)

The agency is reportedly considering authorization of another shot for older Americans and others at high risk for severe COVID-19 within a matter of weeks.

The Wall Street Journal reported that the FDA is considering authorizing a second omicron-specific booster shot for people aged 65 and older or who have weakened immune systems. One source said that the decision is not yet final, noting that officials could change their minds.

...

The developments come after health officials in Canada and the United Kingdom this month recommended another COVID-19 booster shot in the spring for people at high risk for severe disease.

Good, I'm glad they're keeping up with research, and I'm glad that it's closer to getting or not getting FDA approval based on the information they have.

Approval process: https://www.fda.gov/media/151716/download (pdf that opens in browser)

 

[ignatiusjreilly]

So we just went through a global pandemic that killed a million Americans and helped break our society, and the FDA can't decide whether it would be a good idea to allow people to take a booster tailored to the dominant variant.

Cool country.

Looking backwards now, what country do we think ended up with the best overall COVID response?

Somewhere in Southeast Asia, maybe S Korea or Japan?

Minimized covid deaths (with reliable reporting), maintaining healthcare infrastructure, and society was able to function decently throughout the pandemic. Don’t think their economies were crushed, either, at least relative to the rest of the world,

And I doubt they’ve as many problems with antivax, militant anti-maskers, etc.

Probably impossible to do, but I’d love to see an analysis that isolated a government’s response from a country’s response.

Take a country like New Zealand. They performed well during Covid (I assume, though I haven’t looked at any data recently) but they had a bunch of inherent advantages: small, isolated country with a single point of entry, high social cohesion, etc. So they should have done well, right?

I guess what I’m looking for is some kind of “performance above expectation”.

Like I said, probably impossible to do, and that’s assuming you could even have a consensus opinion on what the success metrics are (death rate per 10K, economic performance, improvement over time)

 

[Terminalxylem]

So we just went through a global pandemic that killed a million Americans and helped break our society, and the FDA can't decide whether it would be a good idea to allow people to take a booster tailored to the dominant variant.

Cool country.

Looking backwards now, what country do we think ended up with the best overall COVID response?

Somewhere in Southeast Asia, maybe S Korea or Japan?

Minimized covid deaths (with reliable reporting), maintaining healthcare infrastructure, and society was able to function decently throughout the pandemic. Don’t think their economies were crushed, either, at least relative to the rest of the world,

And I doubt they’ve as many problems with antivax, militant anti-maskers, etc.

Probably impossible to do, but I’d love to see an analysis that isolated a government’s response from a country’s response.

Take a country like New Zealand. They performed well during Covid (I assume, though I haven’t looked at any data recently) but they had a bunch of inherent advantages: small, isolated country with a single point of entry, high social cohesion, etc. So they should have done well, right?

I guess what I’m looking for is some kind of “performance above expectation”.

Like I said, probably impossible to do, and that’s assuming you could even have a consensus opinion on what the success metrics are (death rate per 10K, economic performance, improvement over time)

Not sure who’s best, but US definitely among the worst, considering our resources. That being said, the one thing we did exceptionally well, vaccine production, was pretty important.

 

[ignatiusjreilly]

So we just went through a global pandemic that killed a million Americans and helped break our society, and the FDA can't decide whether it would be a good idea to allow people to take a booster tailored to the dominant variant.

Cool country.

Looking backwards now, what country do we think ended up with the best overall COVID response?

Somewhere in Southeast Asia, maybe S Korea or Japan?

Minimized covid deaths (with reliable reporting), maintaining healthcare infrastructure, and society was able to function decently throughout the pandemic. Don’t think their economies were crushed, either, at least relative to the rest of the world,

And I doubt they’ve as many problems with antivax, militant anti-maskers, etc.

Probably impossible to do, but I’d love to see an analysis that isolated a government’s response from a country’s response.

Take a country like New Zealand. They performed well during Covid (I assume, though I haven’t looked at any data recently) but they had a bunch of inherent advantages: small, isolated country with a single point of entry, high social cohesion, etc. So they should have done well, right?

I guess what I’m looking for is some kind of “performance above expectation”.

Like I said, probably impossible to do, and that’s assuming you could even have a consensus opinion on what the success metrics are (death rate per 10K, economic performance, improvement over time)

Not sure who’s best, but US definitely among the worst, considering our resources. That being said, the one thing we did exceptionally well, vaccine production, was pretty important.

Don’t disagree with you on the US, but I also imagine there’s a strong Reverse Lake Wobegon Effect, where people are more likely to rate their own country’s performance as below average. Covid was an awful experience for just about every person in the world, so they’re likely to focus on the things their government did that contributed in any way to that awfulness

 

[Terminalxylem]

Don’t disagree with you on the US, but I also imagine there’s a strong Reverse Lake Wobegon Effect, where people are more likely to rate their own country’s performance as below average. Covid was an awful experience for just about every person in the world, so they’re likely to focus on the things their government did that contributed in any way to that awfulness

I’m using our deaths/million and vaccine coverage as metrics (correlated, I’m sure) - we look terrible in comparison to both Japan and SoKo.

 

[IvanKaramazov]

Don’t disagree with you on the US, but I also imagine there’s a strong Reverse Lake Wobegon Effect, where people are more likely to rate their own country’s performance as below average. Covid was an awful experience for just about every person in the world, so they’re likely to focus on the things their government did that contributed in any way to that awfulness

I’m using our deaths/million and vaccine coverage as metrics (correlated, I’m sure) - we look terrible in comparison to both Japan and SoKo.

Not disagreeing, but we need for somebody to do this analysis controlling for baseline health. People in Japan and Korea are generally healthier than most Americans, and they're nowhere near as obese. We know that mattered, probably a lot when it comes to excess deaths. That's not to say that policy decisions didn't matter too, just that we would have expected Japan to do better than the US because almost no matter what because the Japanese aren't all carrying around an extra 50 pounds that they don't need.

 

[ignatiusjreilly]

Don’t disagree with you on the US, but I also imagine there’s a strong Reverse Lake Wobegon Effect, where people are more likely to rate their own country’s performance as below average. Covid was an awful experience for just about every person in the world, so they’re likely to focus on the things their government did that contributed in any way to that awfulness

I’m using our deaths/million and vaccine coverage as metrics (correlated, I’m sure) - we look terrible in comparison to both Japan and SoKo.

Not disagreeing, but we need for somebody to do this analysis controlling for baseline health. People in Japan and Korea are generally healthier than most Americans, and they're nowhere near as obese. We know that mattered, probably a lot when it comes to excess deaths. That's not to say that policy decisions didn't matter too, just that we would have expected Japan to do better than the US because almost no matter what because the Japanese aren't all carrying around an extra 50 pounds that they don't need.

Yeah, that's what I was getting at with my "performance above expectation" idea. I also think social cohesion plays a huge role. In certain regions (Asia, Scandinavia) there's far more acceptance of the idea that you're all in this together, or that if the government suggests you do something, you go along with it rather than posting YouTube videos of yourself flaunting the recommendations. It seems intuitive that would lead to better outcomes, although I have no idea if there's data to back that up. And of course there was Asia's previous experience with SARS, which was still fresh in lots of people's minds

Then again, the Japanese government came out early during the pandemic and recommended the "Three Cs" -- avoid closed spaces with poor ventilation, crowded spaces and close-contact settings -- that IMO is way more effective messaging than the "stand six feet apart, wash your hands for 20 seconds and, um, check back with us for the current recommendations regarding masks" line we had here.

Like I said, probably impossible to tease out the inherent societal characteristics from the actions of the government

 

[Nathan R. Jessep]

actually ran across this one this weekend, somewhat relevant to the discussion above...

Study Shows Lack of Link Between High BMI and COVID Deaths

This is the Weight and Healthcare newsletter! If you like what you are reading, please consider subscribing and/or sharing!

weightandhealthcare.substack.com

They sought to answer two questions with their UR (umbrella review):​

​

1. What is the quality and certainty of evidence on the association between obesity and mortality in patients with SARS-CoV-2?​

​

2. What is the magnitude of the association between obesity and mortality in patients with SARS-CoV-2 demonstrated by SR-MAs (systematic review using meta-analyses) ​

​

They reviewed 24 SR-MAs from multiple countries. Ultimately they found that, while most SR-MAs did show an association between being higher weight and COVID mortality, there were serious questions as to the quality of the research that led to those conclusions.​

​

They found that “most SR-MAs had critically low quality, and…the certainty of the evidence was very low.” In fact, in terms of certainty of evidence, 21 of the 24 SR-MAs were classified as “very low.” In terms of quality, 66.7% of the SR-MAs were “critically low quality,” and 29.2% were “low” quality. Only one of the included SR-MAs reached the “moderate” quality level and it DID NOT find a significant link between being higher-weight and COVID mortality.​

ETA: Study here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9381948/