Corona Virus: It's a Marathon, Not a Sprint

[Zaxxon]

It's been less than ideal.

To say the least. Here's hoping things improve and/or a cause is nailed down soonish.

[Defiant]

It looks like John Cambell is one of those making this claim. He used to be (at least that was my impression when I took a look at his older stuff) much better on this stuff, but while he still supports vaccines, he went off the rails some time ago (possibly chasing his audience). I've been following Back to the Science, which has put out some videos addressing the problems with his videos and correcting the falsehoods/misunderstandings in his videos, like this video which touches on the Pfizer data.

[Smoove_B]

Sorry I've been MIA; shit's on fire, yo.

RE: Blackhawk's comments (which align with Zaxxon's thoughts, and others). All of the things you're suggesting are great ideas. Some of them are actually being pursued. Others are actively being stopped.

If we go back to the late 1900s (god, I feel so old) and examine the energy crisis we had in the 1970s and 1980s, there was a HUGE effort - quite similar to what you're referencing here - with respect to regulations, technological advancement, government incentives, etc... all to try and make residential homes and businesses more energy efficient. Oddly enough, it's these same incentives (that helped to insulate our buildings to a degree never seen) that are likely helping to fuel the ventilation issues we're seeing now with COVID-19. If I had the time, I guess I'd write something about unintended consequences. Or suggest that Americans are really motivated by money (and saving it), not so much about saving lives.

It took time (years) to be effective and legacy programs that were put into place still exist today (where the government offers financial incentives to insulate your home), which is impressive.

For the pandemic we absolutely want to address bigger picture issues, but as I mentioned earlier, they're not going to help us in the short term - which is what we need right now. Improving ventilation (whatever that means) isn't happening overnight. It's barely started after 2+ years of this. Money was made available to schools nationwide (via the federal government) to assess and improve ventilation (grant funding) but I have no idea how many schools actually took advantage of the program (in each state, % total, regionally, etc...) because it's so new.

Other bigger picture issue is that our national surveillance system is still busted. The ACA was amazing in that it allowed for unprecedented data sharing between federal, state and local public health agencies and private health providers. However, the states and locals needed to actually do it - they were empowered, it was a matter of enacting programs to use it. I've mentioned it before, but Chicago is one of the only places where I know it was aggressively pursued. People are (for whatever reason) just figuring out now that the CDC has no power to require, enforce, mandate or demand any type of data. All the information they receive is voluntarily provided by states to them. They're a collection agency that then processes the state level data into a national aggregate and releases it all back to us locals (and the nation) so that we can use it for bigger picture planning.

But if FL or TX decide they don't want to send data? Or that they want to send basic information (total numbers) instead of tables of information with all kinds of data points? That's what you get.

What we're experiencing now is largely the result of what happens after 100+ years of public health being a local (state) issue. Sure individual states could craft all kinds of laws and regulations to incentivize pandemic response, communicable disease surveillance and response protections but when other states are actively working against public health, there's nothing (bigger picture) that is going to overcome it.

I'm rambling here; apologies.

RE: What Lord Mortis and RM9 (and others) have observed, the best description I've seen is that SARS-CoV-2 is currently spreading through America like water sloshing around in a bathtub. Randomly surging in the Northeast, then a wave appears in the South. Then it sloshes over to the Midwest, then on to the Pacific Coast. And before you know it, another wave is sloshing up in the Northeast again, over and over.

What we're experiencing right now is arguably one of the single worst scenarios. Sure 95% fatalities would be worse, but we've collectively reached a level of acceptance. We hit ~120K new cases yesterday and hospitalizations (nationwide) are the highest they've been since February. But who fucking cares, am I right? That we somehow all just accept that this is the way things are now and that they can't be any better is mind boggling to me.

I'm now left wondering what could happen in October that will suddenly make people think, ok, now is the time for us to accept some type of proactive response. Do we need to get to 500k new cases a day? We're "only" at a ~550 deaths a day average at this point so what new number is actually acceptable in terms of doing something? I'm genuinely asking, because I don't know.

And shit, I haven't even talked about Long COVID yet. It's difficult to do so when everyone is saying "but hospitals aren't full and no one is dying" - everything is fine.

Oh hey, it's Scotch:30. I need a Tylenol.

[RunningMn9]

Again: the best tools aren't the only tools. You can put a screw in with a hammer. It won't hold as well, but standing there holding a screw and desperately asking for a screwdriver when everyone has said no won't hold anything at all.

You keep saying that. They keep saying that they are sorry to report that these are the only tools we have that do anything to positively impact an ongoing pandemic of this nature. You keep saying you want to use other tools because we refuse to use these tools, and they keep trying to tell you that we don't have other tools. You keep saying there must be other tools, and they keep telling you that there aren't - there are a finite number of tools to use to combat an active pandemic of this type - we've tried all of them as much as people are willing to try - which is what it is - but that doesn't mean that there are other tools we aren't telling about.

From here on out, it's just performative things to appear to be doing something. You don't have to be happy about it. I'm not. But you aren't going to get anywhere with "Stop relying on your education, experience, and expertise - give me a different answer."

Many of us got vaccinated. There are better treatments now than in Mar 2020. That's the plan. If another N people die, so be it. We've already accepted that, for all values of N.

[Zaxxon]

What we're experiencing right now is arguably one of the single worst scenarios. Sure 95% fatalities would be worse, but we've collectively reached a level of acceptance. We hit ~120K new cases yesterday and hospitalizations (nationwide) are the highest they've been since February. But who fucking cares, am I right? That we somehow all just accept that this is the way things are now and that they can't be any better is mind boggling to me.

As I've thought more about this lately, it makes complete sense. After all, Americans have been doing this same thing in many areas for quite some time now. An obvious example is our politics--we have numerous (numerous) examples now of folks elected to office with absolutely no ability (or desire) to actually hold that office and do what the job requires. It's performative to an extent it's never been before. And these folks are elected by a less-capable electorate enthralled by conspiracy theories and social-media tribalism to mind-boggling extent.

We're unable to do what's required to address the climate emergency, similarly stuck between disbelief, uncaring nonchalance, and tribalism.

Failing to address serious problems is kind of our thing.

Oh hey, it's Scotch:30. I need a Tylenol.

At least it's Cinco de Mayo, and drinking heavily is encouraged.

[Smoove_B]

Failing to address serious problems is kind of our thing.

Especially when it only affects a subset of the population. That's one thing that's been reinforced for me during the last two years. We can't get motivated to handle a pandemic. We sure as hell aren't going to do shit about global climate change. Pick whatever dystopian future movie or book that covers the wealthy elite living on islands or in boats or in air conditioned mountain bunkers while the general population toils in the hot, humid wasteland that's coming and that's where we're headed.

"Here I cannot but take notice that the strange temper of the people of London at that time contributed extremely to their own destruction.”
-A Journal of the Plague Year, 1722

Though maybe we'll get a nuclear winter to cool things off for a bit. HOPE

[LawBeefaroni]

Other bigger picture issue is that our national surveillance system is still busted. The ACA was amazing in that it allowed for unprecedented data sharing between federal, state and local public health agencies and private health providers. However, the states and locals needed to actually do it - they were empowered, it was a matter of enacting programs to use it. I've mentioned it before, but Chicago is one of the only places where I know it was aggressively pursued. People are (for whatever reason) just figuring out now that the CDC has no power to require, enforce, mandate or demand any type of data. All the information they receive is voluntarily provided by states to them. They're a collection agency that then processes the state level data into a national aggregate and releases it all back to us locals (and the nation) so that we can use it for bigger picture planning.

This is my life right now, coordinating data exchange for quality and VBC programs. There are robust mechanisms in place for getting dx and encounter data to HHS, state DPH, and private payors. And as mentioned, we already report census data to the city on a daily basis. We send lab and vital (BP, A1c for diabetics) data to a host of entities. It is not cheap but it can lead to increased reimbursement and more importantly, better quality/healthier patients which saves everyone money. HIPAA was supposed to make this universal for everyone, remember: the "P" stands for portability. The potential to report all this to the CDC is there. The problem is that no one wants to find the money to set it up.

If I had the time, I guess I'd write something about unintended consequences. Or suggest that Americans are really motivated by money (and saving it), not so much about saving lives.

It's a matter of convincing them that saving lives/reducing infection has a monetary benefit. Masking is essentially free. Vaccinations have a huge ROI. There'd be a lot of room to make the money argument, were it not for the extreme politicization of remediation methods.

[hitbyambulance]

what are the reliable infection spread maps? i used to use the NY Times one but i don't trust it any longer: https://www.nytimes.com/interactive/202 ... cases.html

[LawBeefaroni]

what are the reliable infection spread maps? i used to use the NY Times one but i don't trust it any longer: https://www.nytimes.com/interactive/202 ... cases.html

Is there reliable spread data? GI,GO.

[Smoove_B]

Do you not trust your local dashboard? Or are you looking for regional data (entire state, entire Pacific coast, greater NW area, etc....)?

[hitbyambulance]

Do you not trust your local dashboard? Or are you looking for regional data (entire state, entire Pacific coast, greater NW area, etc....)?

the local one is fine and i trust that. i was looking for the entire US. if that's not possible, i'll settle for 'greater area' maps.

[Blackhawk]

Again: the best tools aren't the only tools. You can put a screw in with a hammer. It won't hold as well, but standing there holding a screw and desperately asking for a screwdriver when everyone has said no won't hold anything at all.

You keep saying that. They keep saying that they are sorry to report that these are the only tools we have that do anything to positively impact an ongoing pandemic of this nature. You keep saying you want to use other tools because we refuse to use these tools, and they keep trying to tell you that we don't have other tools. You keep saying there must be other tools, and they keep telling you that there aren't - there are a finite number of tools to use to combat an active pandemic of this type - we've tried all of them as much as people are willing to try - which is what it is - but that doesn't mean that there are other tools we aren't telling about.

FWIW, the discussion, as I recall, originated in the premise that there were only two options: push masking/vaccinating/distancing/mandates, or sit back and do nothing.

We're mostly going in circles, but there are a couple of points: If you limit the discussion entirely to what can be done to stop the spread in Spring of 2022, then I agree with you - those are the only tools. And they won't work better than they already are, regardless of what the CDC does. Responsible people are going to be responsible, idiots are going to be idiotic. What change could be made in those areas has already been finalized in this tug-of-war between science and extremist politics.

So what the CDC can do is work on other strategies to mitigate the problem, and yeah - they're long-term. We're past immediate solutions. You keep saying that there are no other tools. I gave a bunch of examples, and Smoove's comments suggested (forgive me if I'm putting words in your mouth) that yeah, those are other tools, and that many of them are or were being used, or possibly could be. And if I can provide ten good ideas, the CDC can provide a hundred better ones. (Here's a bonus - update building codes to encourage hands-free maze style bathroom entrances.)

You keep saying you want to use other tools

There is nothing about 'want' here. I want people to listen to science, and thus to doctors, and thus to disease specialists. I want people to stop lying and deliberately misleading people to their deaths. I want the medias - news and social - to take responsibility. I want people to do the smart things - mask, vaccinate, distance, improve infrastructure related to prevention. But want, schmant. People aren't going to, regardless of the CDC's actions. And if that's true, then the CDC's limited resources (including financing, time, and manpower) are wasted in pushing those things. And it looks - and that's what the last dozen pages have been about - like they're doing exactly that. They've stopped investing in the strategies that haven't worked. Whether that's because they're working on Plan B, or because they have surrendered to stupidity is beyond me.

No, I wasn't talking about what I wanted. I was talking about what is effective. Short term, that's nothing. Long term, that's the more subtle, behind-the-scenes, low-publicity stuff I've been arguing for. So again, there are options other than the one that isn't working (masking, etc), and standing by and doing nothing.

[Smoove_B]

the local one is fine and i trust that. i was looking for the entire US. if that's not possible, i'll settle for 'greater area' maps.

Given the active effort to minimize data collection and reporting at a state and regional level, I'd be hard pressed to rely on anything at a national scale at this point.

That said, Covid Act Now seems to be making an honest effort though I don't know if they're sharing exactly what you're looking for.

[hitbyambulance]

That said, Covid Act Now seems to be making an honest effort though I don't know if they're sharing exactly what you're looking for.

i'll take it, thanks

[Little Raven]

It's been less than ideal.

This may be one of the masterful expressions of understatement I've ever seen on this forum.

I'm so, so sorry, RM9. I cannot imagine how old this must be getting for everyone involved. And I hope whatever is causing it stops soon.

[RunningMn9]

It would be less frustrating if there was any progress towards a definitive answer (or relief). However, it helps that she has a direct line to Smoove_B and is one day hoping to end up in one of his lecture slides (my son made it in this year by picking up a rare butt parasite last summer!).

[Smoove_B]

You *could* jump the line if you do something applicable to one of my other topics. Might I suggest a vacation to the SW and a possible case of coccidioidomycosis?

In related news, this OpEd in Science is making the rounds today and the final two paragraphs are rather applicable to the discussion we've had today:

Legendary public health leader Paul Farmer summed up this situation well: “Those whose lives are rarely touched by structural violence are uniquely prone to recommend resignation as a response to it,” he said. “In settings in which all of us are at risk, as is sometimes true of contagion shared through the air we breathe, we must also contemplate containment nihilism—the atti­tude that preventing contagion simply isn’t worth it.”

SARS-CoV-2 is rapidly mutating and recombining, and more variants and subvariants—potentially more pathogenic—are on the horizon. The world is still barely vaccinated, and even in wealthy countries like the United States, resources are inequitably distrib­uted. It absolutely ain’t over. And this is no time to drop the ball.

If the closing paragraph isn't foreshadowing, I'll don't know what is.

[Max Peck]

Pandemic killed 15M people in first 2 years, WHO excess death study finds

An estimated 14.91 million people worldwide died in 2020 and 2021 due to the COVID-19 pandemic, according to an analysis of global excess deaths released Thursday by the World Health Organization.

The estimate—with a 95 percent confidence interval of 13.3 million to 16.6 million—is significantly larger than the number of reported deaths directly caused by COVID-19 during that time, which was around 5.42 million by official counts. But, estimates of excess death try to capture the true toll of the pandemic—direct and indirect deaths. The estimate is done by comparing the number of deaths that occurred during a time period to those expected to occur in that period based on historical mortality data and modeling. Such modeling also accounts for historical differences, such as fewer traffic and influenza deaths during the pandemic due to movement and health restrictions.

Thus, excess death estimates aim to capture not only reported COVID-19 deaths, but unreported COVID-19 deaths, and deaths indirectly caused by COVID-19. Those can include people dying of preventable, non-COVID conditions because they delayed or avoided health care in fear of becoming infected, or because their healthcare system was overburdened with COVID-19 patients and unable to provide optimal care.

[Smoove_B]

Yeah, it's grim.

I was reading around online last night and someone made an excellent observation that has apparently not been widely communicated. I don't know how much people are following the mysterious development of hepatitis in kids (some of whom have died), but there hasn't been a definitive answer as to what's happening. Of course people are thinking it's related to prior exposure to SARS-CoV-2, but nothing yet has been proven. Instead, there's been focus on an adenovirus (a known actor) that also just happens to spread through the airborne route.

It's possible there's a new adenovirus variant or it could be some type of interaction between SARS-CoV-2 and the adenovirus. Or it could be completely unrelated to both and something else is happening.

The point with all this was to demonstrate that for 2+ years we've been wondering what our response would be to the next pandemic given what happened with COVID-19. Well...it's potentially technically here as kids are not only getting sick but dying from a suspected airborne viral infection. It's happening all over the world and randomly appearing at various times - which makes it a potential pandemic. The difference is we don't know for sure it's a virus, but there's strong evidence suggesting whatever is happening is related to an infectious disease agent being spread.

If only there was some way to protect kids - seemingly the highest risk group of people on the planet from this airborne transmission.

Maybe the next pandemic we'll do something...

EDIT: If anyone wants to read up on it, check here.

EDIT#2: And for the record, I would be amazed if there wasn't a direct connection between this "mysterious" hepatitis and SARS-CoV-2. We just need to figure it out.

[LordMortis]

EDIT#2: And for the record, I would be amazed if there wasn't a direct connection between this "mysterious" hepatitis and SARS-CoV-2. We just need to figure it out.

Just pray no one can come up with a link, no matter how specious to vaccination.

[Smoove_B]

Just pray no one can come up with a link, no matter how specious to vaccination.

None of the infected kids in the UK were vaccinated, so that ends that.

[LordMortis]

None of the infected kids in the UK were vaccinated, so that ends that.

[stessier]

Just pray no one can come up with a link, no matter how specious to vaccination.

None of the infected kids in the UK were vaccinated, so that ends that.

Did they play with any kids who were vaccinated and shedding spike proteins?

[Smoove_B]

Just pray no one can come up with a link, no matter how specious to vaccination.

None of the infected kids in the UK were vaccinated, so that ends that.

Did they play with any kids who were vaccinated and shedding spike proteins?

[coopasonic]

Pandemic killed 15M people in first 2 years, WHO excess death study finds

0.1% per year? I mean that's a start. Can we ramp it up? Throw in reduced birth rates and we may Thanos this place yet.

[Pyperkub]

Even the highly vaccinated Bay Area (and CA as a whole) is trending up...

San Francisco, Santa Clara, Marin and San Mateo counties — as well as Santa Cruz County — had all fallen within the U.S. Centers for Disease Control and Prevention’s “yellow” tier as of Friday morning, signaling that more than 200 cases were reported in the last week for every 100,000 residents although hospitalizations per 100,000 still remained below 10. The designation signals a medium level of coronavirus in each county, with the CDC recommending that high-risk individuals use face masks. Alameda, Contra Costa, Sonoma, Solano and Napa counties, along with the rest of California, were all in the “low” community tier, with fewer than 200 cases per 100,000 people. On the separate CDC “community transmission” rating, based on case numbers per 100,000 and test positivity rates, all nine Bay Area counties as well as the counties surrounding the San Joaquin River Delta and virtually the entire California coast, are classified as “high,” the worst level.

excellent news that hospitalizations aren't trending up, tho some of that is undoubtedly the lag factor, but also vaccination and treatment and virulence...

[Kraken]

This little snippet from the Globe's "How to navigate Covid risk" piece today:

Dr. Megan L. Ranney, an emergency physician and academic dean of the Brown University School of Public Health, said she rarely wears a mask indoors these days, because the rise in cases hasn’t overwhelmed hospitals.

But Ranney lives and works in Rhode Island, where community levels of COVID-19 are ranked “medium” by the US Centers for Disease Control and Prevention. For counties with high transmission levels the CDC recommends indoor masking.

Ranney cautioned that going maskless, while a reasonable choice in some regions, means a high likelihood of catching the virus. “If you have not had COVID in the last few months, expect to get it,” Ranney said. “That may not matter. If you are vaccinated and boosted and not high risk, you’re going to be, for the most part, OK.”

You're going to get covid. You'll be fine. Probably.

[Zaxxon]

Sad, but true.

[Max Peck]

For some value of probably, dependent on your social stratum.

[LordMortis]

You're going to get covid. You'll be fine. Probably.

If you continue to boost and spread isn't high and you aren't high risk. It may not matter.

Also if this is the new normal, than my new normal is to isolate for half a year and exercise reasonable caution for half a year, and feel horrible for the coming generations. I guess we've had a relatively privileged last few decades. I'm not old enough to remember bad small pox and polio was before my time. As bad as HIV has been, it's been, quite frankly small by comparison and everything else has been, quite frankly, exotic.

[Smoove_B]

In case you were wondering how things are going in VT

https://twitter.com/asosin/status/1522987259821232129

Vermont—the most vaccinated state in the US—now has 12/14 counties in the “high community level” and its hospital admissions are approaching its Omicron peak. Its experience reaching this level highlights some of the limitations of the CDC guidance.

There's a short thread detailing how it's rippling out and what's happening bigger picture.

[Defiant]

Thread on a UK child with Long Covid being taken to Germany where a doctor did a better job diagnosing the issue (because the normal UK blood tests are missing the issue), and the treatment appears to be giving some positive, if limited, improvement.

https://twitter.com/BinitaKane/status/1 ... 2088552448
https://twitter.com/BinitaKane/status/1 ... 0410055681
https://twitter.com/BinitaKane/status/1 ... 4017202177
https://twitter.com/BinitaKane/status/1 ... 9939600385

[Unagi]

When the CDC describes any risk level/stage as 'Mask Optional' right now, I just feel that's such a joke, and a breach of their responsibility. The Center for Disease Control should only be using the ranges between "Masks Recommended" to "Masks Required".
A neighbor can tell you about coming over to their house, and that it's "Masks Optional" if they want... but "Masks Recommended" should be the absolute bottom tier guideline for the CDC until this pandemic is 'undeclared'.

IMO

[Smoove_B]

If only we could have predicted this was coming:

For the first time in months, daily hospital admission levels and new COVID-19-related deaths in the United States are both projected to increase over the next four weeks, according to updated forecast models used by the Centers for Disease Control and Prevention.

The projected increases come after weeks of steady upticks in infections across the country, subsequent to the removal of masking requirements and mitigation measures in many states and cities.

The forecast now predicts that approximately 5,000 deaths will occur over the next two weeks, with Ohio, New York and New Jersey projected to see the largest totals of daily deaths in the weeks to come.

Bigger picture:

The forecast models show that 42 states and territories in hospital admissions across the country, including New York, Minnesota, Wisconsin and Florida, are projected to see increases in the next two weeks.

...

On average, more than 2,200 virus-positive Americans are entering the hospital each day -- a total that has increased by 20% in the last week, the CDC reports. This also marks the highest number of patients requiring care since mid-March.

[Smoove_B]

And the other big piece that dropped yesterday afternoon was the information related here, namely the realization that the Fall of 2022 is likely going to be a problem again:

The White House is preparing for as many as 100 million Americans to get infected with COVID-19 during a wave this fall and winter if Congress does not provide new funding for vaccines and tests, a senior administration official said Friday, warning new money is needed to have enough vaccines for everyone.

A senior administration official told a small group of reporters on Friday that the estimate is the median of a range of models from outside experts that the administration consults, meaning it is also possible significantly more Americans catch the virus, especially if there is a major new variant.

That compares with the roughly 130-140 million Americans who are estimated to have been infected over the omicron wave this winter, which led to a significant spike in deaths.

Trying so hard to understand how hard it's being downplayed right now (and has been for months) and the justification of trying to secure funding for the anticipated Fall 2022 surge. "Don't panic" but we have information suggesting that another 100+ million people could get COVID-19 this coming Fall and Winter - pretty close to what we endured during Fall/Winter 2021.

[Jaymon]

. "Don't panic"

Thats my secret, nowadays I am always panic

[Smoove_B]

We've reached the stage where places like D.C. and Vermont are joining Florida in trying to actively hide cases. D.C. hasn't reported a daily COVID update since 4/26 and Vermont just announced they're going to a weekly summary.

Maybe if we try harder to ignore it, that'll be the way out.

[Zaxxon]

[Smoove_B]

Most new cases in NJ (~4600) since January and our Governor is tweeting out that people need to keep washing their hands. I mean...that's important, but JFC it's an airborne virus. We know this; we've known this. Handwashing isn't how you primarily stop spread. His whole message is about personal responsibility. Can't mention the new forbidden 4 letter word that starts with "M". I really need someone high up to come out and verify this is being pushed at a federal level because what's happening now defies all rational explanation. Over and over we were told about how we'd "follow the science" and reinstate masks when it made sense. So I guess whatever happens during this 5th wave is just pretense to completely numb us out for what's going to happen during the Fall and Winter of 2023.

[Zaxxon]

It's not irrational, as we've been over many times now. It's bad, and we can dislike it, but it's pretty clear why politicians are acting as they are. They can do this and maybe get re-elected, or they can follow the science despite the populace at large very much not wanting that, and get voted out of office.

Either way, we're firmly in 'personal responsibility's town until the end of the pandemic (or perhaps an exceedingly bad turn to not-before-seen levels of hospitalizations and deaths).