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

[Smoove_B]

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.

But here's the thing - masking and mask mandates had been overwhelmingly popular by the general public, even now. This myth that the general public doesn't want masking continues to permeate the discussion. Did support drop when the CDC came out and said masks were no longer necessary? Absolutely. But people want guidance - guidance that makes sense.

Instead, it's the minority of vocal lunatics that are running the asylum - and influencing politicians.

EDIT: The last major poll I can find (from a month ago) finally had masking support drop below 51% (to 44%) in early April - which shouldn't be a surprise as the "let it rip" philosophy continued to be pushed at all levels for months at that point as we came out of the Winter '22 Omicron wave. Now we are reaping what's come from that (as the next wave starts) and...everyone is just shrugging shoulders now, presumably because hospitals aren't overrun. I'm sure hospital staff appreciate our efforts here.

And for my own state, he was just re-elected. So I guess he's providing cover for the DNC? It's gross.

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).

Unless something changes, I doubt we're ever going to see hospitalizations and deaths at the levels previously seen. Instead, we're going to have 10s of millions of people permanently disabled. I think I saw a study earlier this week about how ~10% of people in the UK that had 3x shots and acquired COVID during the 4th wave now have some type of Long COVID diagnosis. That's...not an insignificant number of people - especially when our own models in the US are saying we're staring down another ~100 million infections this winter.

EDIT #2: Since federal, state and local government officials can't or won't say it, I will. All people in areas where spread is high right now should be wearing N95 masks indoors around strangers, full stop. Businesses. Transportation. Schools.

[Kraken]

Some experts think Mass. might be nearing this spike's peak.

“It’s too early for me to be confident we are peaking, but I do think we are getting close,” said Matthew Fox, a professor of epidemiology and global health at the Boston University School of Public Health. “I don’t think this will be a very strong or prolonged wave because we have so much built-up immunity from immunization and prior infection.”

Dr. Scott Gottlieb, former commissioner of the US Food and Drug Administration and a Pfizer Inc. board member, said Wednesday on CNBC-TV that “there’s clearly a wave of infection going through the Northeast right now” but “it seems to be peaking right now.”

If this is as bad as it's going to get, it's...not that bad. But,

Experts have warned that the virus has defied predictions in the past and raised concerns about the impact of the arrival of the Omicron subvariants BA.2 and BA.2.12.1. With tests of Eastern Massachusetts waste water indicating that cases may increase in the coming days, specialists said it’s too soon to stop taking precautions.

“I do think we should prepare and in some circumstances we may need to temporarily reinstate masking to protect the vulnerable,” Fox said.

But experts also think this wave won’t continue forever. The closely watched University of Washington Institute for Health Metrics and Evaluation model predicts that COVID-19 cases in Massachusetts will peak in about two weeks, with hospitalizations peaking about two weeks after that.

Justin Lessler, a professor of epidemiology at the Gillings School of Global Public Health at the University of North Carolina Chapel Hill, said, “my intuition is things shouldn’t go up too much further” in Massachusetts. “I certainly think it’s reasonable to believe the wave is probably going to be cresting soon.”

He said the current rise in cases is likely driven by a combination of factors, including the subvariants’ increased transmissibility and ability to escape immunity, and the public dropping precautions such as masking.

What will slow the virus down? It could run out of unprotected targets. After the Omicron wave, “the effect of that preexisting immunity is going to start asserting itself at some point,” along with the state’s high vaccination rates, Lessler said.

Another factor working in our favor could be the seasonality of the virus, he said.

[Zaxxon]

The guidance from the CDC today is still to wear masks 'in public places where there are a lot of people around,' to choose just one example. Pick an NHL or NBA playoff game and note the % of people wearing masks. Or check out the rate of mask-wearing on public transit, where masking is also still strongly encouraged. Polling is great, but actions speak louder. Even going back to last August, when masking in schools was still a top recommendation, a minority were doing it around here, and today it's my kids, and nearly only my kids.

The best analogy I can come up with is the trolley problem, only the conductor's controls don't adjust the track. Instead, they call in a fleet of small birds which attaches itself to a line on the train, and pulls to adjust the train's trajectory. Oh, and if the driver calls in the birds, his chances of being fired rise.

Either way, those fuckers on the track are dying.

I am entirely with you, Smoove. I'd much prefer we collectively mask up and try to nip this emerging wave in the bud. But that. Isn't. Going. To. Happen.

[El Guapo]

Some experts think Mass. might be nearing this spike's peak.

There's definitely a local spike. In the past half week two kids in my son's (4th) grade tested positive, and three kids in my daughter's (7th) grade tested positive, plus a couple kids in the neighborhood.

At this point the school is requiring masks in mass gatherings (e.g., the auditorium) but optional in classrooms and small group settings. I'm not 100% sure on whether there has been in-school transmission, but even with the school having a new facility, good ventilation systems and ample space, I assume it's inevitable that everyone in the school will get it without a universal mask mandate.

[malchior]

That's...not an insignificant number of people - especially when our own models in the US are saying we're staring down another ~100 million infections this winter.

This model has now been politicized because...whatever. Why not. Why not fight over yet another thing, right? I don't know how historians in some future era are going to be able to explain how such a highly educated society became this stupid.

It was a stern and startling warning from the White House's new Covid response coordinator: In the fall and winter, the US could potentially see 100 million new Covid-19 infections if Congress doesn't approve federal funding to fight the pandemic.

That warning from Dr. Ashish Jha, who said the projection was based on a range of internal and external models, jolted some public health experts and even came a surprise to some top Biden administration officials, with sources telling CNN that the grim forecast -- and details of where exactly that 100 million number had been derived from -- was not discussed with some key officials intimately involved in the administration's work to fight Covid before Jha's TV interview over the weekend.

As of Thursday morning, the White House had not yet released the underlying data that it says supports its projection. A senior administration official had told CNN on Monday that the 100 million infection number is a moderate one that falls somewhere in the middle of more conservative and extreme projections and is based on an underlying assumption of no additional resources or extra mitigation measures being taken, including new Covid-19 funding from Congress, or dramatic new variants.

The timing of Jha's announcement -- as the White House is trying to pressure Congress to approve billions of dollars in new Covid funding -- has also raised some concern among experts about whether political considerations were a driving factor behind making the public projection.

[Zaxxon]

Cyrus Shahpar (COVID Data Director for the WH) also went off on this a bit earlier today.

https://twitter.com/cyrusshahpar46/stat ... jufjGfJTGQ

But now we're in the wrong thread.

[Smoove_B]

I am entirely with you, Smoove. I'd much prefer we collectively mask up and try to nip this emerging wave in the bud. But that. Isn't. Going. To. Happen.

I think I'm just looking to reiterate that this is a choice - all of this. We're not powerless to stop it from getting worse. We're not powerless to stop tens of thousands of more deaths.

At this point the school is requiring masks in mass gatherings (e.g., the auditorium) but optional in classrooms and small group settings. I'm not 100% sure on whether there has been in-school transmission, but even with the school having a new facility, good ventilation systems and ample space, I assume it's inevitable that everyone in the school will get it without a universal mask mandate.

This is why things will never work - adopting nonsense, BS policies like this. The virus doesn't magically stop spreading in a classroom. Oh, there's 100 people here? I should be wearing a mask. But now there's only 30? Totally safe for me to be raw-dogging the air inside.

Also, it's beyond insane to acknowledge (formally) a million COVID deaths and then stand around like this:



looking at the numbers today.

[Smoove_B]

Just for my MA OOers:

https://twitter.com/maiamajumder/status ... 6625566720

In Massachusetts, we're currently reporting ~2x as many daily COVID cases as we were at the peak of the delta surge.

We were rightly concerned during delta, but now, our policymakers have their heads in the sand.

Pretending like the pandemic is over = prolonging the pandemic.

And as @ambilinski notes, daily deaths from COVID have exceeded a reasonable threshold, too. If we use a bad flu+RSV year as a bar for deaths per capita, we’re past it in Massachusetts.

Long story short: COVID is *not* the flu.

[Kraken]

Some experts think Mass. might be nearing this spike's peak.

There's definitely a local spike. In the past half week two kids in my son's (4th) grade tested positive, and three kids in my daughter's (7th) grade tested positive, plus a couple kids in the neighborhood.

At this point the school is requiring masks in mass gatherings (e.g., the auditorium) but optional in classrooms and small group settings. I'm not 100% sure on whether there has been in-school transmission, but even with the school having a new facility, good ventilation systems and ample space, I assume it's inevitable that everyone in the school will get it without a universal mask mandate.

"Everyone will get it" is national policy now. As Wife's Aunt Jeanne likes to say, "Just walk it off."

We're going to a concert next week because Wife has expensive tickets and fuck it. We'll be masked, but it still feels like a saving throw with minuses.

[Max Peck]

It appears that our BA.2 wave has peaked.

[Unagi]

And just to allow someone to correct my read of that graph.

If not for waste water testing, the blue area of positivity testing - is what people would think the ‘spike’ looked like. And what people do think the spike looks like everywhere waste water testing data isn’t as readily available.

These are the graphs I show my friends/family.

I suggest they pretend they live in Ottawa, and admit where they really live is likely worse off.

[Max Peck]

Most of the old measures of how bad things are (in terms of community spread) here are more or less worthless. Positivity only reflects cases that were actually tested, and PCR testing is restricted to designated high risk groups and those who are already so sick that they end up being hospitalized. Hospitalization and ICU numbers are divided into "with COVID" and "for COVID" and only "for COVID" is reported. Outbreaks are only reported if they occur in medical or long-term care facilities. The wastewater monitoring is the only thing I can look at and get an idea of the relative state of things, so for example I can see that the amount of virus in the community has peaked and is dropping off but is still a little higher than the peak of the original Omicron wave.

Basically, the wastewater monitoring is the only metric left that the provincial government hasn't been able to tune in order to minimize the appearance of severity. All the changes were implemented in late 2021 and early 2022, probably (IMO) to shape public opinion on the government's handling of the pandemic leading into the provincial election next month.

[LordMortis]

And the little bit of lightening up I've been doing is now going back to my social outlet is gaming with one or two people. Hospitializations are now noticeably trending back up. The lagging indicator I feared and its concurrent with reported cases in my county being almost back up to almost 50/100,000/day.

https://www.bridgemi.com/michigan-coron ... s-and-maps

[Smoove_B]

You must be looking at the wrong maps.

EDIT: This one is better If you scroll down into his #4, he mentions Michigan specifically.

https://twitter.com/JasonSalemi/status/ ... 3571712000

1. Based on this week's @CDCgov transmission levels, 89% of the US population lives in a county classified as "substantial" or "high".

This is compared to 46% 4 weeks prior.

2. Nearly 1 in 3 people now live in an area with medium or high risk (based on hospital capacity and COVID hospital admission rates).

We had more than a doubling in the number of people in a "high" level area in which the CDC recommends masking in public indoor settings.

[LordMortis]

stuff

I think the maps are similar and the concerns as well. This last month has seen substantial increase in both reported cases and hospitalizations so I am I am retreating back to my right next to ultra high caution levels which I was slowly easing out of, with the hope that we are trending to summer level of contagion. I was ready to for vaccinated summer level of caution. Now I'm not, especially as I've seen how much everyone else around me has totally moved on in spite of the metrics in hand.

[malchior]

Maps 6 and 7 are what drives me crazy. We know what is going to happen - hospitalization levels are going to increase nationwide again over the next 2 months. Unless you are a doctor or nurse you don't see it in front of their eyes so it must not be happening. Meanwhile immunity is waning even for vaccinated folks.

[Blackhawk]

And what people do think the spike looks like everywhere waste water testing data isn’t as readily available.

I just assume it looks like a backwards letter "L."

Interestingly, Bloomington, which is about 50 miles east of me and is the 'Berkley of Indiana' has just opened two monitoring plants. Bloomington/Monroe County frequently take steps (on a variety of issues) that rest of the state won't touch. It won't be ideal data, but it will be data.

[Blackhawk]

Oh, and for a comparison, here's the official Indiana data:



We won!

[Zaxxon]

Congrats on your post-pandemic status! You did it!

[Blackhawk]

Congrats on your post-pandemic status! You did it!

Betcher sorry ya left now, aintcha?

[TheMix]

Have I mentioned that my sister, who is a nurse in Texas, told me the other day that "the pandemic is over... it's just like the flu now... something we'll have to live with..."

I bit my tongue. It's that or I accept that I no longer have a sister.

[Smoove_B]

Just to circle back and detail how absolute boned we are, courtesy of Dr. Topol:

The real number of cases is likely at least 500,000 per day, far greater than any of the US prior waves except Omicron. The bunk that cases are not important is preposterous. They are infections that beget more cases, they beget Long Covid, they beget sickness, hospitalizations and deaths. They are also the underpinning of new variants.

...

Second, it is about the reduction in vaccine effectiveness that we are now encountering. Obviously, a breakdown of protection from transmission occurred with Omicron with “breakthroughs” in people with vaccination occurring quite commonly. That, and reinfections, were an unusual phenomenon (~1%) before Omicron. Now we are seeing people with 4 shots who are getting breakthrough infections, even at 1-2 weeks from their most recent shot, when there should be the maximal level of neutralizing antibodies induced. That’s not a good sign, relative to the 95% vaccine effectiveness we had against symptomatic infections against the ancestral, D614G, Alpha, and Delta (with a booster) strains.

...

But it’s overly optimistic to think we’ll be done when Omicron variants run their course. Not only are they providing further seeding grounds for more variants of concern, but that path is further facilitated by tens of millions of immunocompromised people around the world, multiple and massive animal reservoirs, and increased frequency of recombinants—the hybrid versions of the virus that we are seeing from co-infections. As difficult it is to mentally confront, we must plan on something worse than Omicron in the months ahead.

If that's all too much:

To recap, we have a highly unfavorable picture of: (1) accelerated evolution of the virus; (2) increased immune escape of new variants; (2) progressively higher transmissibility and infectiousness; (4) substantially less protection from transmission by vaccines and boosters; (5) some reduction on vaccine/booster protection against hospitalization and death; (6) high vulnerability from infection-acquired immunity only; and (7) likelihood of more noxious new variants in the months ahead

In closing:

But well beyond the use of boosters and vaccines, and easy, rapid access to Paxlovid, we absolutely need an aggressive stance to get ahead of the virus—for the first time since the pandemic began—instead of surrendering. That means setting priorities, funding, and the realization, unfortunately, that the pandemic is far from over. Our Covid vaccines and medications are an order of magnitude more effective than what we have for influenza, but even our current level of deaths (we have already had over 175,000 Covid deaths in 2022), no less what may be in store, is still >10-fold in excess of seasonal flu (about 30,000 per year). That is totally unacceptable, nearly totally preventable loss of lives at scale.

Humans naturally get tired, but they shouldn’t be foolish or outsmarted by a virus.

[malchior]

https://mobile.twitter.com/DrEricDing/s ... 5275287556

[Smoove_B]

Yeah, been following it for a while. Still so many unanswered questions.

In light or rising hospitalizations, NYC Health Department just released "really strong recommendation" for indoor masking in public spaces. If only there was something above a "really strong recommendation". Like a "Hey, we're super serious!" announcement, though maybe that's too aggressive.

Bars and restaurants have to be really wondering why they didn't push back against indoor smoking bans. All they had to do was support "really strong recommendations" against smoking indoors and then shrug their shoulders.

[LordMortis]

Yeah, been following it for a while. Still so many unanswered questions.

In light or rising hospitalizations, NYC Health Department just released "really strong recommendation" for indoor masking in public spaces. If only there was something above a "really strong recommendation". Like a "Hey, we're super serious!" announcement, though maybe that's too aggressive.

Bars and restaurants have to be really wondering why they didn't push back against indoor smoking bans. All they had to do was support "really strong recommendations" against smoking indoors and then shrug their shoulders.

Perhaps we could Senator Collins to express concern? Or perhaps they can just take at all the way to double super duper ultra mega strong recommendation.

Also, you know what's cool? As I'm getting older and have all these masks laying around, I'm starting to do my yard work while masked. It really helps with my breathing and allergies, and probably poisons me less when I'm chemically deciding which flora can go where, because we've decided grass is good and other flora is only very selectively good in some places, so bonus!

[El Guapo]

Yeah, been following it for a while. Still so many unanswered questions.

In light or rising hospitalizations, NYC Health Department just released "really strong recommendation" for indoor masking in public spaces. If only there was something above a "really strong recommendation". Like a "Hey, we're super serious!" announcement, though maybe that's too aggressive.

Bars and restaurants have to be really wondering why they didn't push back against indoor smoking bans. All they had to do was support "really strong recommendations" against smoking indoors and then shrug their shoulders.

Maybe they can touch base with my kids' school. The latest health update e-mail had even more boldface in their strong mask recommendations. There's always going all caps, if that's not too aggressive.

Also, they're switching to weekly update e-mails to the school community on covid cases, as opposed to a separate e-mail each time someone tests positive. Too cumbersome to send out individual e-mails when there are so many new cases, I suppose.

[Smoove_B]

It's my unofficial impression that K-12 schools are doing everything they can to hold it together and stay open - pretend that everything is fine. They're just trying to get to the last day of the school year and hoping they can forget about it for 2+ months.

I honestly don't know how they're going to be able to ignore it as the peak for the NE is likely going to be within the next two weeks, but I guess we'll see.

[Zaxxon]

T-9 days for my kids' school...

[Blackhawk]

my kids' school hasn't said the word 'masks' since the mandate was removed. But I'm not going to stress about it anymore. My last kid is out of school in four days. Forever. It isn't that I don't care about the kids still stuck there, or that I'm unaware of the impact that the daily superspreader event has, it's that after two plus years of struggling with the district to not be morons, I'll no longer be directly exposed to it. In fact, after graduation I don't see myself being in that county more than a couple of times a year - and then only to pass through on the way somewhere else.

My son had his last performance of his school career yesterday. It took place inside the gym. I did an approximate headcount of the attendants, based on seats per section, number of sections occupied, and how full they were. I'd estimate that there were ~700 adults and ~100 kids. With the exception of the mask on my face, there were exactly (I counted three times to make I didn't lose track) zero.

[coopasonic]

I'm not dying until I get to play the next XCOM game and that's final. To my knowledge I have yet to contract COVID. I have also never been tested for COVID or had any known exposure to COVID. I may be the luckiest man on earth considering my wife works in a hospital with COVID patients and my kids have been going to school in person since September 2020, one of them still wears a (mostly useless cloth) mask.

[YellowKing]

I've somehow dodged it as well (I think), despite my wife working in the school system right beside the nurse's office and having two kids in school/daycare.

I thought I may have had it after a weekend trip in April. I was sick for about a week, which is highly unusual for me. Mostly fatigue, slight cough. Two home tests came back negative though. So who knows.

[Smoove_B]

"It's not going to be a mild nuisance with the amount of morbidity and mortality it causes."

Looks like the NYT piece from yesterday is starting to sink in.

https://twitter.com/CPita3/status/1526371232760971266

What an absolute nightmare this article paints.

A bunch of experts saying, "whoops, turns out herd immunity by infection doesn't work.. you're going to get infected multiple times a year with mortality/morbidity risk unknown. Godspeed."

Zero solutions provided.

NYC mayor said yesterday that until hospitals are at a critical stage, there's no need to mask. We have learned absolutely nothing and how hospital personnel in places like NYC aren't just walking off the job, I have no idea. Two years ago they were heroes. Now? Just deal with this constant "less than critical" level of sickness and death so we all can do whatever we want.

EDIT: Just received word that my state will no longer be investigating COVID cases for people aged 19-64. Anyone in that age range will have their case automatically closed out by the reporting system, because clearly they're fine.

[malchior]

NYC mayor said yesterday that until hospitals are at a critical stage, there's no need to mask. We have learned absolutely nothing and how hospital personnel in places like NYC aren't just walking off the job, I have no idea. Two years ago they were heroes. Now? Just deal with this constant "less than critical" level of sickness and death so we all can do whatever we want.

They've been boiled along with the rest of the frogs.

[coopasonic]

So I shouldn't really be worried about my retirement savings? I guess that's a relief.

[Zaxxon]

So I shouldn't really be worried about my retirement savings? I guess that's a relief.

So many things that will be a bigger problem for you when the apocalypse comes. So nah, put retirement worries on the back burner.

[malchior]

My friend was supposed to go to a show tonight - he was probably spared yet another COVID infection because the entire headlining band had a COVID-19 outbreak.

[LawBeefaroni]

Had an in-person today with people from Dallas and Jacksonville. They both came straight from the airport. They had to call and have me bring down masks to get in the building because they hadn't worn one their entire trip.

[Smoove_B]

I was wondering today (random pandemic thoughts) that maybe it's going to take national hospital, doctor, nurse, support staff, etc.. associations speaking out - like collectively coming out and saying they're not going to be able to deal with surges ever 4+ months forever. That states and locals have to start stepping up and doing what they can to limit spread when there's an indication surges are happening.

I'm watching what's happening in NYC (and to a lesser degree NJ) and I just don't get it. Sure, it's not as bad as it was in 2020 or even the Omicron winter. But the idea that we're all just supposed to ride out this next wave and collect the pieces on the other side, because freedom? I see plenty of individual doctors and support staff saying it on social media, but not hospital systems or state/national associations. Maybe I'm just not tapped into the right groups and they're being ignored too.

[Smoove_B]

For the first time in six weeks (is there something happening?), the White House will hold a Covid-19 briefing. Maybe they're going to tell us it's really, really over. But make sure you wash your hands.

It's happening right now and I'm trying to watch, but not sure if I can stay present.

[Blackhawk]

I wait with baited breath...

Spoiler:

I read that eating bait will prevent COVID.