(2021-04-22) Zvi M Covid0422 Crisis In India

Zvi Mowshowitz: Covid-19 4/22: Crisis in India. The United States appears to have turned the corner. Despite our determination to sabotage vaccination efforts, they have taken only minor damage, and we are starting to see declines again in the number of cases.... Other places without our access to vaccines are not as lucky, and in particular India is in crisis. Things there are worse than they’ve ever been and rapidly getting worse, with the hospitals on the verge of collapse.

it is entirely the our responsibility for not accelerating vaccine production in time to help them. Even when we have vaccine we are unwilling to use, we refuse to use it to help where it is needed.

The Numbers

Vaccinations

You know what’s not good for vaccination rates? Suspending the use of vaccines. I hear that’s bad for vaccination rates.

Most states had double digit declines.

Without Johnson & Johnson, and with the increased vaccine hesitancy, things are going to be harder from here on in, and I have little hope that J&J vaccinations will be allowed to resume, nor do I expect us to agree to export the doses to a place that would actually use them any more than we’re letting go of our AZ doses. It’s at least kind of murder, and all kinds of foolish and destructive.

while I do think it’s unfair to attribute the entire deviation from the previous upward trend as being due to the suspension of J&J, I do think that’s most of it

Note of course that this still represents a steady stream of additional vaccinations, and that our situation will continue to improve.

Others, however, are not so lucky. In particular, the situation in India looks very, very bad.

India

Official deaths are lower than in the United States as well, but likely much, much higher than reported, and going vertical:

As always, share of positive tests is a key metric, and it has the same straight line. Yikes.

As there usually is, there’s a variant involved, this time it’s B.1.617.

being vaccine evasive wouldn’t explain what’s happening, because India doesn’t have that many people who are vaccinated.

What could this be other than the variant? So I went looking for what we know.

Here’s a Forbes explainer, which also notes that the variant has arrived in California. It seems there are a lot of different mutations in B.1.617 that are contributing to it being a bigger problem, part of which is making immune response more difficult

Zaynep comes through and hooks us up with the good news that the vaccines still look effective against B.1.617

I know that jumping to conclusions can backfire. But if something is probably concerning, that’s concerning. One shouldn’t remain unconcerned until there’s proof, that’s not how this works, that’s not how any of this works

What happens now, unfortunately, is presumably the collapse of India’s hospital system.

This was always on the table as an outcome, from the very beginning. There’s a maximum amount of baseline infectiousness, beyond which adjustment to stop it is not practical

The flip side is that there have been places with much higher positive test rates for quite a while. Mexico spent a long time around 50%, and many places in the United States may have been in worse spots than India is now, and turned things around or at least stabilized them via behavioral adjustments.

Vaccines Still Work

Pausing Vaccines For No Reason Still Doesn’t Work

Damage to public confidence was done quickly, and will be hard to reverse.

As noted last week, a brief pause was something that could be steelmanned.

You can’t argue for our current policy of keeping the blanket pause in place for weeks. We could mitigate most of the damage by restricting the ban to young women, putting a fig leaf over the whole thing and moving doses around between populations, but we aren’t even doing that.

Again, what is this new data we’re looking for? What about the current data is insufficient to reach the necessary conclusions?

It also has the standard splash damage that when a completely insane standard is applied in one area, it makes it impossible to think clearly about other areas

You could argue for a pause in actual almost anything if all it has to do is unintentionally kill two people when done millions of times.

The Next Strain: P.1

The bad news is that P.1 is growing as well, potentially faster than B.1.1.7 (there’s enough measurement error here that I wouldn’t be confident in that), and its advantages likely involve some amount of immune escape

The good news is that, unless the immune escape is much stronger than we think it is, we can totally get there, even with our vaccination pace slowing down due to regulatory sabotage

The number of people who live in areas where the refusal rate is going to be 30%+ looks very low. The worst this gets for places with a lot of people in them is roughly 20-25%, which means (if these calculations are correct) they can still get to 75-80% vaccinations.

What I found most interesting was also surprising to those who ran the focus group, which is that talk of booster shots pisses off such people:

You thought people who didn’t want to get vaccinated wouldn’t want fake vaccination cards when the cards are required in order to do things? Really?

In Other News

Interesting analysis says that English Strain’s relative infectiousness likely declined greatly over timeCovid 4/22: Crisis in India

The United States appears to have turned the corner. Despite our determination to sabotage vaccination efforts, they have taken only minor damage, and we are starting to see declines again in the number of cases.

Other places without our access to vaccines are not as lucky, and in particular India is in crisis. Things there are worse than they’ve ever been and rapidly getting worse, with the hospitals on the verge of collapse.