(2021-04-29) ZviM Covid 4/29 Vaccination Slowdown

Zvi Mowshowitz: Covid-19 4/29: Vaccination Slowdown. Compared to expectations, excluding inevitable self-inflicted cratering of our vaccination rate, this was mostly a best realistic case scenario week. Johnson & Johnson was unpaused.

Most of all, cases in America were down a lot, and it’s now clear that things are steadily improving.

The decline looks really bad though. Like the situation in India, it’s Malcom Reynolds-level worse than you know. When you look at first doses only, the lines are going straight down. If they go all the way to zero, many states and local areas won’t get to herd immunity from the vaccine.

The Numbers

Vaccinations

Whoops

This map now looks similar enough to the red vs. blue tribe map

What’s clear is that vaccinations are cratering, and it is due to the massively destructive, completely needless pause in the J&J vaccine. The damage is done, and resuming isn’t going to reverse that much of it.

the declines are much more pronounced in first doses and it seems plausible we will stall out not too far from where we are now.

will we have essentially destroyed normal life in substantial parts of the United States indefinitely because of one death and six blood clots?

It seems clear that the Northeast and other low-hesitancy areas will make it. It is not at all clear that the high-hesitancy states and areas are still on track to make it.

India

The straight line up continues, but there was never much hope that things would suddenly reverse

Oxygen is running out and the situation is increasingly dire. Without oxygen, a lot more Covid patients die. What happened?

Exponential growth happened. When you’re using half your oxygen capacity (and far more than half your available capacity given industrial needs) you’re less than one doubling away from disaster.

*What are we who are here in America doing about this crisis?

Mostly, we’re urgently pleading, with mixed success, for us to stop withholding life saving medicine that isn’t going to otherwise be used, and to stop using nationalistic barriers to prevent shipments of vital supplies.*

We are already sitting on one hundred million doses

Biden’s failure to devote a few billion to getting the world vaccinated is more striking each time he proposes a multi-trillion dollar new spending bill.

The good news is that the pressure has gotten to us, and we’re going to do the right thing. Like classic Americans, we’ll do it after having exhausted all alternatives

John Cochrane points out that another contributing reason we haven’t been able to export vaccines is the issue of liability. In America, we didn’t pay anything like what vaccines were worth let alone pay tiny amounts of money to allow for the manufacturing for massive additional quantities of vaccines, but we did at least give vaccine manufacturers immunity from liability if something went wrong. Places like India don’t extend those protections, so the pharma companies protected themselves by not allowing exports to places where they could be sued into oblivion for things the vaccines didn’t even cause, or things so rare they don’t matter.

We could also be worried about the look of ‘giving up our castoffs’ and giving India the ‘not as good’ vaccines we aren’t willing to approve ourselves, and have to explain why they’re good enough for Indians and not good enough for Americans. Either they’re good vaccines or they’re not, and giving them away puts us in a bind.

Another problem was that India literally refused to authorize the Pfizer vaccine without a trial done on Indians in India. Pfizer had to withdraw its application. Now that there’s a crisis, India is doing the commonsensical ‘approve anything anyone trustworthy has approved’ approach

Vaccines Still Work

The CDC is tracking breakthrough infections and deaths, meaning ones that happen post-vaccination. This Slate article summarizes the early findings: that such events do happen but they are extremely rare

Thread by Natalie Dean about the difficulty of avoiding bias in observational vaccination studies

Pausing Vaccines For No Reason Still Doesn’t Work

Johnson & Johnson is back. After only 10 days, permission has been given to resume vaccinations. I explicitly said last week I didn’t expect the resumption to happen this quickly, so count me as pleasantly surprised at the news

The problem is that the FDA successfully convinced Americans that the Johnson & Johnson vaccine is not safe, with a majority saying it was not even somewhat safe during the pause

The question is, how much of that effect does resuming permission undo?

What was the result? You can see it in the vaccination graph, but you can see it much clearer in the first doses graph:

there’s no way this is a coincidence.

Long Covid

The big known unknown of Covid has always been long Covid. There’s short term obvious reasons to be scared of Covid, but what about long term impacts? Data was always sparse. Now there’s a (preprint of a) nature paper about the matter that offers more concrete data.

Taken at face value, it looks like Long Covid is a really big deal

This study was in the Veterans Administration, so the population in question was relatively elderly and in relatively poor health. They attempted to find similar controls, but I am profoundly unsatisfied with the methodologies listed here.

My conclusion, after discussion and analysis, is that this study is largely measuring selection effects, and this makes it all but impossible to know how much of the effects are due to Log Covid versus the people who get symptomatic Covid and have that diagnosis confirmed starting out as sicker to begin with.

What we can update from this study is the evidential value of having had Covid

In Other News

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They settled on the slogan “It’s up to you.” I certainly can’t argue with that in general, but also no one involved believes it.

When I saw ‘it’s up to you’ I totally, totally interpreted it as ‘it’s optional.’

People aren’t stupid. Either something is optional, and they have a choice, or it isn’t and they don’t. You can try to send both messages but you’ll fail. So yeah, it’s optional. Or at least, for now it’s optional, until it isn’t.

This MIT paper on ‘guideline to limit indoor airborne transmission’ was also going around this week: That’s quite the spherical cow you have there. This assumes the absurd conclusion of automatic uniform mixing in indoor spaces, and then concludes that relative location in those spaces doesn’t matter

Meanwhile, we have cross-country runners in mandatory masks. Which certainly isn’t not insane. And YouTube pulls videos for having “disinformation” when they agree with European mask policy instead of American blue tribe mask policy.