Joshua and Mama, thank you for your honest and extremely worrisome comments re both the CDC and Dr Fauci. I’d like to add the American academy of pediatrics to the list. It has pushed for less distancing and fewer masks and full in person school throughout. My thoughts on DESE are well known and don’t need repeating.
Understandably, people listen to Fauci and others and hold onto their positive comments. I have found that, when I mention the drop in efficacy, there is either pushback or complete surprise tinged with doubt. We were told, as you have both said, that once vaccinated, life pretty much returns to normal. And it will take an act of Congress to now dislodge that belief. And I get it. Who wants to return to what was a year without parallel…at least in our lifetimes. Reality is a really difficult place to live at the moment. When our “experts” refuse to live in reality, how can the average person be expected to?
Dave, thank you for the update on masks and camp. I was sorry to hear the restrictions do not apply to all, but at least they apply to most.
Joshua, I wonder if you can answer my question.
If a youth/child has had covid, can they still get the Delta variant?
Short answer: I don’t know. My expertise is not epidemiology. Longer answer: I think it’s possible. How else to explain these repeated waves, which don’t appear to respect seasonality or our previously held notions of herd immunity? That is, reinfections among adults and children MUST be part of the equation. We hardly do genomic sequencing so that makes it difficult to firmly prove a reinfection. Yet, I find it very difficult to fathom that so many people, including children, are testing positive after repeated waves of infection.
Thank you, Joshua. As everyone knows, I’m truly concerned that we are even less prepared when school begins this year than last.
Agree. We could be doing more. Right now during the period that school is not in session. Air purifiers, for example. Installing windows that actually open. Obviously big infrastructure projects can’t be done in 2 months time. But smaller projects can. By the way, they’ll also help reduce other illnesses – some of the ones you’ve been referring to.
Vicki, I appreciate your post above. You explain the dynamics well. Nobody wants to return to 2020. Here’s my counter to that. You’ve heard it before, so I’ll try to be succinct: We’re not returning to 2020. But, as Dr. Van Kerkhove said, we should be “playing it safe, being smart about our behaviors.” And this applies to the vaccinated as well. Besides the vaccination push, which is obviously critical, officials should “use a targeted approach, not lockdowns, to ensure public health safety and to bring down transmission.” This includes mask-wearing in public indoor spaces, distancing to the degree possible, avoiding large indoor crowds.”
I’m afraid that what we’re now seeing in Arkansas (20% test positivity! 44% increase in hospitalizations in 14 days) is what’s coming soon to many states across the south, southwest, plains, mountain states. See link below. But,in mitigated form, it’s also coming to highly vaccinated states. The U.S. is not an exceptional country in this regard. We can’t escape what’s happening in other highly vaccinated countries. The rebound in cases is happening much faster than I thought it would in states like New York (highly vaccinated). https://twitter.com/EricTopol/status/1413705652984188928
I absolutely agree. I do know it doesn’t mean a return to 2020, but for some reason even the thought of reinstating even a small mask restriction sends people into turmoil with the belief that we will be back to square one.
In your post a couple of days ago, Dr Van Kerkhove said what you and we have said here for a while now. It frustrates me that it took so long for a voice of reason to speak out.
How are they all not sending the same message and sending it as clearly and reasonably as she did?? Why are our leaders,,,,,Biden, Baker, etc…..nog hearing her??
Joshua, did you say recently that VT has reinstituted some mask restrictions?
I know John Mattina. In the tweet below he’s careful to say he’s “only speculating.” Yet, he’s a very well-informed person. He used to work at Pfizer in a high-ranking policy position. I echo his tweet: https://twitter.com/John_LaMattina/status/1413859275835858944
Yet, the CDC and FDA continue to put out statements – based on outdated analyses based on data from April/May – that all is well and dandy with the vaccines. Again, nuance, guys. It’s okay to at least admit that you’re not sure if vaccine efficacy against contracting the virus is eroding. Vaccines still work very well against severe disease, but are in all likelihood losing efficacy at preventing infections. So, boosters are likely in the fall. AND, it’s important we all observe a modicum of safe behaviors. Why the hell is that so hard?
Meant to say John LaMattina.
Thank you. I have followed him on Twitter. I unfollowed Topol?? Can’t recall spelling. Sorry.
This is MGH. If I remember correctly, the one I posted last night was UMass memorial
Joshua, I’d love love your thoughts but only as time permits. Thank you
For me the issue is truth. If they would only tell the truth – even if the truth is “we don’t know yet..” it would empower individuals to make their own risk assessment. However by trying to control us with – ummm – outdated data and blanket statements that everyone vaccinated is “safe” and doesn’t need masks is taking away that right of each person to do their own calculus. As I was saying to my MGH doc friend – it’s a form of playing god. At least imho.
The FLOTUS is (or was) expected to represent the POTUS at the upcoming Olympics in Japan.
Joshua, with no spectators now no longer allowed, does this include foreign dignitaries as well?
Mama Mia, I very much concur with your post. Truth is really important. Sometimes the truth `hurts’ or is not exactly what we want to hear. Yet, it’s important our leaders level with us. We’re going to get through this. We’ve made some great strides. But, we’re not done yet. We’re in a better place now than we were in 2020. We’ll be in a much better place in 2022 if we play it smart and safe.
Vicki, on the need for a booster opinions differ. I think the U.S. needs to consider Israeli and UK data and the fact that the governments there have ordered boosters from Pfizer (and Moderna). I think they’re on top of things more than CDC.
Philip, I don’t know about foreign dignitaries at the Olympics. It’s going to be a spartan affair.
Israeli data demonstrates clearly that the Pfizer vaccine’s efficacy in preventing infections is eroding. We ignore this data at our own peril. The good news is only a small percentage of breakthrough infections get hospitalized. Still, it stands to reason that a fairly large percentage of folks – certainly the symptomatic, and perhaps asymptomatic, too – can transmit to others. https://twitter.com/itosettiMD_MBA/status/1413922415550291968/photo/1
It seems to me that there is something a bit odd about the choice of the two percentile columns on the right. As is discussed in that post, it seems to indicate that having the vaccine does nothing. Or maybe it is good news and this is what is meant by “herd immunity.”
Imagine replacing “Vaccinated” with “Left-handed.” Then you would expect the two percent columns to be very similar as is the case here. I understand that when many people are vaccinated, many cases will be in those vaccinated people. But I think that those two columns are misleading.
Perhaps the small percentage of unvaccinated people avoid exposure more than the vaccinated people. Does “vaccinated” mean “fully vaccinated?”
I think I am confused!
Agree. Upon further review, it is a bit confusing.
I think vaccinated means fully vaccinated (Pfizer in Israel). I do know that a slight majority of new cases in the past month have been among fully vaccinated folks, perhaps for the reason you cite in your penultimate paragraph. But, the table doesn’t just say majority it says vast majority. In any event, it does explain why Israel doesn’t want any tourists for the time being, even if they’re fully vaccinated.
Based on those Israel numbers, “on paper” they should have more than achieved herd immunity. Wish the U.S. could have those stats.
Why are cases rising there instead?
Joshua what do you mean a “spartan affair”? I never heard the tearm.
Agree. I thought they had achieved herd immunity several months ago. Evidently this is not the case. This said, though hospitalizations and ICU cases have risen in the past month it’s not anything like the UK or Portugal. So, in Israel we have plenty of instances of breakthrough infections – perhaps >50% of cases – but thus far not as much of an impact on hospitalizations. There’s some impact, but it’s muted.
My concern is NOT so much with the folks that get a breakthrough infection. Most will be fine. It’s that they (at least some of them) can pass it on to unvaccinated or partially vaccinated people. So, having a breakthrough infection in Arkansas is definitely worse than having a breakthrough infection in Massachusetts.
The tweet refers to 42% of cases in Israel being fully vaccinated folks. I’ve also seen the number 50% reported, as well as 56%. May have to do with the age of the data.
Philip, the word spartan in my post just implies the Olympics will have few if any spectators. No entourages. Little or no interaction with the locals.
Tokyo might as well have had the Olympics last year (2020) as scheduled.
Thanks Joshua for the explanation. 🙂
I’m unsure of the term herd immunity. I know we never achieved that with the 1918 virus. How can we achieve herd immunity when a virus continues to mutate
Great question. I’m not qualified to answer. This said, I’ve been doing a lot of reading on herd immunity. Herd immunity implies that a sufficient percentage of the population has been vaccinated and/or has natural immunity to form a protective ring, if you will, that only allows sporadic infection of those who aren’t vaccinated or don’t have natural immunity. It seems that there’s some arbitrariness involved. You’re not going to eradicate a virus by way of herd immunity, but you’ll get the numbers of cases down to a minimal level. Here’s where the arbitrariness comes in. In the U.S. is it 1,000 cases a day? 5,000 cases? And what about the distribution of those cases? My view on the pandemic is that until we get to less than 100 deaths a day, we’re still dealing with it. Why 100? Well, that would be the daily death toll in a bad influenza year.
Mutations always occur. It’s the transmission of all kinds of variants that is at least being disrupted by natural immunity and vaccination. We’re clearly not there yet. The virus, by way of mutating, is still able to find plenty of new hosts (and perhaps previously infected ones, too) on a daily basis. Enough so that the UK and other countries in Europe can see really significant surges in the span of weeks. I think we’ll see that here, too soon. We’re already seeing it to a degree.
Thanks, Joshua. With the variants getting around the vaccine, I suspect it may be a long way off
Also, did I ask you if you know how Ireland is doing? I apologize if I have asked already
If we never achieved herd immunity during the 1918 pandemic then how did it end? I know that there never was a successful vaccine, but I thought that we achieved herd immunity “naturally” if there is such a thing.
Never mind. Herd immunity was, in fact, achieved “naturally” in 1918.
Yes and no, Philip. The 1918 flu still rears it’s ugly head on occasion. It showed up again in a different form a year or so later. And then it reappeared as late as 1957, 1968 and 2009. See article. It has never gone away.
Also this …… HOWARD MARKEL: Let’s be clear about this term of herd immunity. And I’m telling you this is an old pediatrician. Herd immunity was never developed as a population kind of a measure when a virus spreads through a particular community. It was based on active immunity, giving people immunizations, giving lots of children immunizations, for example, for measles, mumps. And when you immunized actively, 90 or more of percent of a community, then when that infection came into that community, subsequently, it would not spread.
Teacher’s Unions support the CDC recommendation of no masks for teachers and students who have been fully vaccinated.
Now that surprises me. Needless to say I think that is foolish. If teachers are not masked, how risky is that for kids who are not vaccinated …..and there will be many.
Vicki, Ireland is doing remarkably well on two fronts: Vaccinations AND keeping transmission down.
Thank you. That is huge. The owner of barn where daughter trains and teaches is in Ireland and will be back this week. She has been very conscientious but helps to know this
C-19 for 7-11 is ready.
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Joshua and Mama, thank you for your honest and extremely worrisome comments re both the CDC and Dr Fauci. I’d like to add the American academy of pediatrics to the list. It has pushed for less distancing and fewer masks and full in person school throughout. My thoughts on DESE are well known and don’t need repeating.
Understandably, people listen to Fauci and others and hold onto their positive comments. I have found that, when I mention the drop in efficacy, there is either pushback or complete surprise tinged with doubt. We were told, as you have both said, that once vaccinated, life pretty much returns to normal. And it will take an act of Congress to now dislodge that belief. And I get it. Who wants to return to what was a year without parallel…at least in our lifetimes. Reality is a really difficult place to live at the moment. When our “experts” refuse to live in reality, how can the average person be expected to?
Dave, thank you for the update on masks and camp. I was sorry to hear the restrictions do not apply to all, but at least they apply to most.
Joshua, I wonder if you can answer my question.
If a youth/child has had covid, can they still get the Delta variant?
Short answer: I don’t know. My expertise is not epidemiology. Longer answer: I think it’s possible. How else to explain these repeated waves, which don’t appear to respect seasonality or our previously held notions of herd immunity? That is, reinfections among adults and children MUST be part of the equation. We hardly do genomic sequencing so that makes it difficult to firmly prove a reinfection. Yet, I find it very difficult to fathom that so many people, including children, are testing positive after repeated waves of infection.
Thank you, Joshua. As everyone knows, I’m truly concerned that we are even less prepared when school begins this year than last.
Agree. We could be doing more. Right now during the period that school is not in session. Air purifiers, for example. Installing windows that actually open. Obviously big infrastructure projects can’t be done in 2 months time. But smaller projects can. By the way, they’ll also help reduce other illnesses – some of the ones you’ve been referring to.
Vicki, I appreciate your post above. You explain the dynamics well. Nobody wants to return to 2020. Here’s my counter to that. You’ve heard it before, so I’ll try to be succinct: We’re not returning to 2020. But, as Dr. Van Kerkhove said, we should be “playing it safe, being smart about our behaviors.” And this applies to the vaccinated as well. Besides the vaccination push, which is obviously critical, officials should “use a targeted approach, not lockdowns, to ensure public health safety and to bring down transmission.” This includes mask-wearing in public indoor spaces, distancing to the degree possible, avoiding large indoor crowds.”
I’m afraid that what we’re now seeing in Arkansas (20% test positivity! 44% increase in hospitalizations in 14 days) is what’s coming soon to many states across the south, southwest, plains, mountain states. See link below. But,in mitigated form, it’s also coming to highly vaccinated states. The U.S. is not an exceptional country in this regard. We can’t escape what’s happening in other highly vaccinated countries. The rebound in cases is happening much faster than I thought it would in states like New York (highly vaccinated). https://twitter.com/EricTopol/status/1413705652984188928
I absolutely agree. I do know it doesn’t mean a return to 2020, but for some reason even the thought of reinstating even a small mask restriction sends people into turmoil with the belief that we will be back to square one.
In your post a couple of days ago, Dr Van Kerkhove said what you and we have said here for a while now. It frustrates me that it took so long for a voice of reason to speak out.
How are they all not sending the same message and sending it as clearly and reasonably as she did?? Why are our leaders,,,,,Biden, Baker, etc…..nog hearing her??
Joshua, did you say recently that VT has reinstituted some mask restrictions?
I know John Mattina. In the tweet below he’s careful to say he’s “only speculating.” Yet, he’s a very well-informed person. He used to work at Pfizer in a high-ranking policy position. I echo his tweet: https://twitter.com/John_LaMattina/status/1413859275835858944
Yet, the CDC and FDA continue to put out statements – based on outdated analyses based on data from April/May – that all is well and dandy with the vaccines. Again, nuance, guys. It’s okay to at least admit that you’re not sure if vaccine efficacy against contracting the virus is eroding. Vaccines still work very well against severe disease, but are in all likelihood losing efficacy at preventing infections. So, boosters are likely in the fall. AND, it’s important we all observe a modicum of safe behaviors. Why the hell is that so hard?
Meant to say John LaMattina.
Thank you. I have followed him on Twitter. I unfollowed Topol?? Can’t recall spelling. Sorry.
This is MGH. If I remember correctly, the one I posted last night was UMass memorial
Joshua, I’d love love your thoughts but only as time permits. Thank you
https://www.wcvb.com/article/dr-erica-shenoy-mass-general-need-for-third-covid-19-vaccine-dose/36988247
For me the issue is truth. If they would only tell the truth – even if the truth is “we don’t know yet..” it would empower individuals to make their own risk assessment. However by trying to control us with – ummm – outdated data and blanket statements that everyone vaccinated is “safe” and doesn’t need masks is taking away that right of each person to do their own calculus. As I was saying to my MGH doc friend – it’s a form of playing god. At least imho.
The FLOTUS is (or was) expected to represent the POTUS at the upcoming Olympics in Japan.
Joshua, with no spectators now no longer allowed, does this include foreign dignitaries as well?
Mama Mia, I very much concur with your post. Truth is really important. Sometimes the truth `hurts’ or is not exactly what we want to hear. Yet, it’s important our leaders level with us. We’re going to get through this. We’ve made some great strides. But, we’re not done yet. We’re in a better place now than we were in 2020. We’ll be in a much better place in 2022 if we play it smart and safe.
Vicki, on the need for a booster opinions differ. I think the U.S. needs to consider Israeli and UK data and the fact that the governments there have ordered boosters from Pfizer (and Moderna). I think they’re on top of things more than CDC.
Philip, I don’t know about foreign dignitaries at the Olympics. It’s going to be a spartan affair.
Israeli data demonstrates clearly that the Pfizer vaccine’s efficacy in preventing infections is eroding. We ignore this data at our own peril. The good news is only a small percentage of breakthrough infections get hospitalized. Still, it stands to reason that a fairly large percentage of folks – certainly the symptomatic, and perhaps asymptomatic, too – can transmit to others. https://twitter.com/itosettiMD_MBA/status/1413922415550291968/photo/1
It seems to me that there is something a bit odd about the choice of the two percentile columns on the right. As is discussed in that post, it seems to indicate that having the vaccine does nothing. Or maybe it is good news and this is what is meant by “herd immunity.”
Imagine replacing “Vaccinated” with “Left-handed.” Then you would expect the two percent columns to be very similar as is the case here. I understand that when many people are vaccinated, many cases will be in those vaccinated people. But I think that those two columns are misleading.
Perhaps the small percentage of unvaccinated people avoid exposure more than the vaccinated people. Does “vaccinated” mean “fully vaccinated?”
I think I am confused!
Agree. Upon further review, it is a bit confusing.
I think vaccinated means fully vaccinated (Pfizer in Israel). I do know that a slight majority of new cases in the past month have been among fully vaccinated folks, perhaps for the reason you cite in your penultimate paragraph. But, the table doesn’t just say majority it says vast majority. In any event, it does explain why Israel doesn’t want any tourists for the time being, even if they’re fully vaccinated.
Based on those Israel numbers, “on paper” they should have more than achieved herd immunity. Wish the U.S. could have those stats.
Why are cases rising there instead?
Joshua what do you mean a “spartan affair”? I never heard the tearm.
Agree. I thought they had achieved herd immunity several months ago. Evidently this is not the case. This said, though hospitalizations and ICU cases have risen in the past month it’s not anything like the UK or Portugal. So, in Israel we have plenty of instances of breakthrough infections – perhaps >50% of cases – but thus far not as much of an impact on hospitalizations. There’s some impact, but it’s muted.
Found this graph which depicts Utah, but also Israel. Shows a growing number of breakthrough infections in Utah – >10% of the total number of cases. https://twitter.com/Blitz20191/status/1411762212037971971
My concern is NOT so much with the folks that get a breakthrough infection. Most will be fine. It’s that they (at least some of them) can pass it on to unvaccinated or partially vaccinated people. So, having a breakthrough infection in Arkansas is definitely worse than having a breakthrough infection in Massachusetts.
The tweet refers to 42% of cases in Israel being fully vaccinated folks. I’ve also seen the number 50% reported, as well as 56%. May have to do with the age of the data.
Philip, the word spartan in my post just implies the Olympics will have few if any spectators. No entourages. Little or no interaction with the locals.
Tokyo might as well have had the Olympics last year (2020) as scheduled.
Thanks Joshua for the explanation. 🙂
I’m unsure of the term herd immunity. I know we never achieved that with the 1918 virus. How can we achieve herd immunity when a virus continues to mutate
Great question. I’m not qualified to answer. This said, I’ve been doing a lot of reading on herd immunity. Herd immunity implies that a sufficient percentage of the population has been vaccinated and/or has natural immunity to form a protective ring, if you will, that only allows sporadic infection of those who aren’t vaccinated or don’t have natural immunity. It seems that there’s some arbitrariness involved. You’re not going to eradicate a virus by way of herd immunity, but you’ll get the numbers of cases down to a minimal level. Here’s where the arbitrariness comes in. In the U.S. is it 1,000 cases a day? 5,000 cases? And what about the distribution of those cases? My view on the pandemic is that until we get to less than 100 deaths a day, we’re still dealing with it. Why 100? Well, that would be the daily death toll in a bad influenza year.
Mutations always occur. It’s the transmission of all kinds of variants that is at least being disrupted by natural immunity and vaccination. We’re clearly not there yet. The virus, by way of mutating, is still able to find plenty of new hosts (and perhaps previously infected ones, too) on a daily basis. Enough so that the UK and other countries in Europe can see really significant surges in the span of weeks. I think we’ll see that here, too soon. We’re already seeing it to a degree.
Thanks, Joshua. With the variants getting around the vaccine, I suspect it may be a long way off
Also, did I ask you if you know how Ireland is doing? I apologize if I have asked already
If we never achieved herd immunity during the 1918 pandemic then how did it end? I know that there never was a successful vaccine, but I thought that we achieved herd immunity “naturally” if there is such a thing.
Never mind. Herd immunity was, in fact, achieved “naturally” in 1918.
Yes and no, Philip. The 1918 flu still rears it’s ugly head on occasion. It showed up again in a different form a year or so later. And then it reappeared as late as 1957, 1968 and 2009. See article. It has never gone away.
Also this …… HOWARD MARKEL: Let’s be clear about this term of herd immunity. And I’m telling you this is an old pediatrician. Herd immunity was never developed as a population kind of a measure when a virus spreads through a particular community. It was based on active immunity, giving people immunizations, giving lots of children immunizations, for example, for measles, mumps. And when you immunized actively, 90 or more of percent of a community, then when that infection came into that community, subsequently, it would not spread.
https://www.history.com/news/1918-flu-pandemic-never-ended
Teacher’s Unions support the CDC recommendation of no masks for teachers and students who have been fully vaccinated.
Now that surprises me. Needless to say I think that is foolish. If teachers are not masked, how risky is that for kids who are not vaccinated …..and there will be many.
Vicki, Ireland is doing remarkably well on two fronts: Vaccinations AND keeping transmission down.
Thank you. That is huge. The owner of barn where daughter trains and teaches is in Ireland and will be back this week. She has been very conscientious but helps to know this
C-19 for 7-11 is ready.