I’m getting a little tired of articles or chats with people where you get the impression that people think the vaccines will create some sort of covid-proof bubble around them. This is the only explanation I can find for people acting surprised that vaccinated people get sick. The whole point was to prime the immune system so that when exposed, the likelihood of extreme effects would be drastically reduced. That’s it.
(E: I don’t get why people downvote this - all of the benefits of vaccination are precisely due to what I describe. Lower likelihood of individual bad outcomes, which reduces burdens on healthcare, and ideally, reduces community spread by reducing the amount of virus that replicates in an individual and can be passed on. This is why I was one of the first in line when I could get the vaccine. Perhaps daring to critique people with unrealistic vaccine expectations is unacceptable?)
But all the regulations around us create this covid-proof impression.
Eg. where I live, hospitals consider introducing vaccination requirements for visitors. But that somehow defies logic. The vaccine only reduces symptoms (and might thus save yourself, or others, when extended with the hospital-bed-limit-thought), but it wouldn't stop you from transmitting the disease if you are infected (and vaccinated) but you aren't aware.
So I don't even blame the public, but rather the regulators. They ought to know better.
Edit: I might need to support this claim.
The most trustworthy source I found was this article by the JHU [1] (2021-08-02). While there are many that claim different numbers (ranging from stopping roughly 60% to 0%), for transmission, no one claimed that virus infection is influenced.
> The vaccine only reduces symptoms (and might thus save yourself, or others, when extended with the hospital-bed-limit-thought), but it wouldn't stop you from transmitting the disease if you are infected (and vaccinated) but you aren't aware
Are you sure about that? Even this article refers to a study which says that vaccinated people are 5 times less likely to test positive than non-vaccinated. _Some_ asymptotic transmission will still occur in the vaccinated but it's reasonable to expect that it happens to a lesser degree. I'd be very curious to see studies that claim that there's no difference in asymptomatic transmission between the vaccinated and unvaccinated.
"after an outbreak among vaccinated and vaccinated workers at the Singapore airport, tracking studies suggested that most of the spread by vaccinated people happened when they had symptoms"
The vaccines substantially help to reduce spread. Doesn't eliminate it, but obviously something a hospital would want to require.
The vaccine does a reasonable job at reducing transmission in the aggregate. It lessens the average viral load, shortens the average time a person is infectious, etc.
Treating transmission as a boolean ignores the large-but-not-100-percent improvement. Better to treat it as a distribution.
Ditto. My family and I are all fully 2 dose vaccinated, and I didn't go out from my house for nearly a month. I caught COVID(via my mother) last thursday.
The facilities are long overrun since a few months ago, so my symptoms which are:
blood coughing, nausea, chest pain, ~93%SpO2
are considered "quite mild" and "home quarantine only".
In the wake of other variants like Delta, I doubt that people who didn't/can't get the vaccine can be protected by herd immunity alone.
A few of my friends are getting breakthroughs too, which seems like a lot in comparison to the global statistics, so it might be just anomalies.
I don't think that's true. The vaccine still reduces the likelihood that you'll be infected so only allowing vaccinated visitors reduces the risk that COVID enters a hospital through visitors. I think the vaccine also reduces the likelihood that people with breakthrough infections infect other people
"Evidence demonstrates that the authorized COVID-19 vaccines are both efficacious and effective against symptomatic, laboratory-confirmed COVID-19, including severe forms of the disease. In addition, a growing body of evidence suggests that mRNA COVID-19 vaccines also reduce asymptomatic infection and transmission. Substantial reductions in SARS-CoV-2 infections (both symptomatic and asymptomatic) will reduce overall levels of disease, and therefore, viral transmission in the United States. ... Data from multiple studies in different countries suggest that people vaccinated with Pfizer-BioNTech COVID-19 vaccine who develop COVID-19 have a lower viral load than unvaccinated people.(41-44) This observation may indicate reduced transmissibility, as viral load has been identified as a key driver of transmission.(45) Two studies from the United Kingdom found significantly reduced likelihood of transmission to household contacts from people infected with SARS-CoV-2 who were previously vaccinated for COVID-19.(25, 46)"
"Two studies1,2 from Israel, posted as preprints on 16 July, find that two doses of the vaccine made by pharmaceutical company Pfizer, based in New York City, and biotechnology company BioNTech, based in Mainz, Germany, are 81% effective at preventing SARS-CoV-2 infections. And vaccinated people who do get infected are up to 78% less likely to spread the virus to household members than are unvaccinated people. Overall, this adds up to very high protection against transmission, say researchers."
"COVID-19 vaccines appear to help prevent transmission between household contacts, with secondary attack rates dropping from 31% to 11% if the index patient was fully vaccinated, according to a Eurosurveillance study yesterday. The population-based data looked at the Netherlands from February to May, when the Alpha variant (B117) was dominant and the available vaccines were by Pfizer/BioNTech, AstraZeneca/Oxford, Moderna, and Johnson & Johnson."
"There has been good news, too, on the subject of viral load in breakthrough cases. Researchers in Israel studied vaccinated people who became infected. The viral load in these breakthrough cases was about three to four times lower than the viral load among infected people who were unvaccinated. Researchers in the U.K. reported a similar result. They also found that vaccinated people who became infected tested positive for about one week less than unvaccinated people."
> I’m getting a little tired of articles or chats with people where you get the impression that people think the vaccines will create some sort of covid-proof bubble around them. This is the only explanation I can find for people acting surprised that vaccinated people get sick.
No, it’s because until the Delta variant became the most common variant, the vaccines essentially did create a covid-proof bubble around the recipient. The trials for Comirnaty and the Moderna vaccine both showed >90% effectiveness against PCR positive infections, not just against hospitalization and death.
> The trials for Comirnaty and the Moderna vaccine both showed >90% effectiveness against PCR positive infections
I don't believe the official trials for Moderna and Pfizer measured PCR positive infections at all. (They involved thousands of people, it was a time when PCR test were difficult to obtain; they remain expensive at that scale).
I have not heard of Comirnaty, not sure about that.
There may have been pre-delta studies that showed PCR infection effectiveness (Cite?), I don't think they were the official trials.
To the contrary, I don't think that's plausible. In the whole COVID-19 decision the question of the initial load has not been discussed well enough, IMO.
If you think about the virus passing your various layers of protection it is clearly a numbers game, IMO. A mask, even if imperfect, might reduce your initial viral load below a threshold that allows your immune system to kill all infected cells very quickly so you don't develop strong symptoms. The same goes for distance.
So I don't see any reason to not expect a certain "sterile" immunity after a vaccination. The way I see it, the vaccination should prevent some of the low-load infections completely, regardless of the virus variant.
“ To sum it up, I'd put my breakthrough case of COVID-19 right up there with my worst bouts of flu.”
Exactly. I see no reason why I’d take strong measures to avoid getting exposed to it (now that I and 90% of adults around me are fully vaccinated) when I never did the same for the flu. Somewhere along the way we seem to have lost sight of what constitutes a normal disease burden.
I don't know what policy around flu should be, but I'd like to share my data points about flu, for those who think flu is no big deal.
The last two times I had flu (first age 36, then a few years later), I was unable to work for an entire month each time.
For most of that time I struggled to get out of bed, and couldn't think much. I was too weak and tired, so I slept most of the time or did low energy activities, and relied on other people to bring me food. The first one meant I missed Christmas: My partner went to an all-day get together with our mutual friends, and I stayed home in bed, too ill to go.
My other flu story would be, a good friend and former employer got flu one day when he was visiting his wife and children (he normally worked in another country to them). Few days into it, he lay down on a sofa and died. I don't know the rest of the story, but I miss him. I think my life would be different if he were still around.
These experiences certainly gave me more respect for flu as a killer.
>Somewhere along the way we seem to have lost sight of what constitutes a normal disease burden.
Having relatives in the healthcare sector and hearing stories during bad flu waves (2020 was not the first year in recent memory where people needed to be treated in makeshift tents[1]) we do indeed have lost sight of the disease burden, but probably not in the way you imagine.
I was lucky to spent the first few months of the covid-19 pandemic in Japan, and I can tell you I did not see overrun hospitals at any point because people by and large take hygiene and avoiding the spread of infectious disease seriously.
I am skeptical whether you have drawn the correct conclusion from your experience in Japan. There seems to be something else going on beyond just taking hygiene seriously.
People can do that, stay home when sick. Then they just have fewer vacation days. At least, that's how it works for me. I suppose we could think of it as an incentive to remain healthy.
> Exactly. I see no reason why I’d take strong measures to avoid getting exposed to it (now that I and 90% of adults around me are fully vaccinated) when I never did the same for the flu.
It should really go without saying COVID-19 is much more transmissible than any recent version of the Flu. Comparisons of symptoms and severity in healthy adults has never been the sticking issue.
I'm disheartened to see people on HN of all places thinking solely as an individuals and not about the management of health care resources at a population level. Health care resources are finite and viruses like COVID can still spread exponentially even with current vaccination rates.
From the beginning, the goal has been to lower transmission, lower cases, and therefore lower the burden on the _world_ health care system to a tenable degree. Yes, there may be _more_ effective measures we can take at this point, such as ramping up vaccination, but at the end of the day, if you don't transmit the disease to others or end up in the hospital yourself, you are helping the cause.
tldr; Whether or not it poses a risk to _you_ is besides the point, in so far as the risk of overburdening the health care system remains.
The healthcare system also had more than a year and a half to build capacity to deal with this stuff? Why should society be required to bail out hospitals by adhering to arbitrary restrictions on their life?
> I'm disheartened to see people on HN of all places thinking solely as an individuals and not about the management of health care resources at a population level.
Individualism vs Collectivism is a debate that goes back a long time.
Your 'flattening the curve' argument is fear based.
I haven't seen any actual DATA besides media fear mongering that ICUs are 'almost' full for years now.
You are conflating two things. This guy's illness was about the same as worst bout of flu -- that doesn't mean that's necessarily typical, but let's say it is.
Currently, in most of the USA, your chances of getting covid are probably a LOT higher than that of getting the flu. Way more people are getting covid than getting a bad case of the flu.
So it's not quite the same.
If the chances of getting the flu were always this high, including the chances of really severe disease or death for some (say, those with organ transplants)... we probably would have been doing something different.
But I agree with you we shoudln't have to, don't need to, and can't sustainably simply shut down life forever.
I find the experts advice reassuring. IF you are vaccinated:
> Even with delta, the goal is not to go back to a lockdown mindset, though, says Malani. "My hope is that people who are fully vaccinated should really feel like this risk is manageable."
> "Feel good about spending time with your friends, or having a small dinner party, but make sure everyone is vaccinated," she says.
For now I am wearing a mask at the store (not that big a deal), and avoiding large public unmasked gatherings. In part because I want to try to help get community transmission rates a lot lower so we can then do more.
> Somewhere along the way we seem to have lost sight of what constitutes a normal disease burden.
Alternatively this pandemic may have permanently shifted what we consider to be a normal disease burden. Maybe we shouldn't accept tens of thousands of Flu deaths every year if there are some relatively simple changes we can make to reduce them.
> Exactly. I see no reason why I’d take strong measures to avoid getting exposed to it (now that I and 90% of adults around me are fully vaccinated) when I never did the same for the flu.
Because it's up to 10x more deadly than influenza, particularly for vulnerable populations.
Your link does not seem to support that Covid-19 is 10x more deadly than influenza in a vaccinated person, like the poster you are replying to. It’s 10x more deadly if you haven’t been vaccinated but the vaccines are showing 10-20x decrease in hospitalization and death, bringing the risk more into flu range.
That statement seems to be very obsolete. It claims "doctors and scientists are working to estimate the mortality rate". Well, that work has been done and the results were that you can find IFRs of anywhere between 0% and 1.6%, with a median of about 0.2%:
The flu is equally if not more deadly in populations without preexisting immunity (e.g. isolated tribes). Once people acquire immunity (preferable through multiple doses of vaccination), it’s really not any different than the flu.
Most seasonal upper respiratory illnesses don't routinely cause loss of smell or taste, which should be a clue to something more nefarious potentially going on. If I were the author I'd worry about subtle frontal brain injury.
For me, boosters and nasal vaccines can't come fast enough (nor can the ability to administer them to younger children).
At some point I think this virus will become like the flu in terms of public health implications, but I don't think it's quite there yet.
> now that I and 90% of adults around me are fully vaccinated
I'm curious, where did that 90% figure come from?
Around here, of the eligible population, about 1 of every 3 has no shot at all, one 1 out of 4 with just a single shot. If you look at the full population, including minors and other ineligible groups, the numbers are even worse.
That means if I go to the grocery store, I'm absolutely gonna be in proximity to someone unvaccinated at some point along the way.
> have lost sight of what constitutes a normal disease burden.
I don't think so. This is only "mild flu" for vaccinated people. We still have kept sight that people who can't be vaxed can die, and people who ignorantly chose not to vax are killing people because they clog the ICUs and prevent people from getting non-covid life-saving care.
So we haven't lost sight, people just choose not to see. You just can't teach some people to be unselfish and considerate.
> and people who ignorantly chose not to vax are killing people because they clog the ICUs and prevent people from getting non-covid life-saving care.
Honest question - would you provide information for that please? The two articles I've seen on that were both completely retracted within a few days of publication. I know unvaxxed people, and I want to have all available information before conversing with them.
The people who can’t be vaxxed have extremely low death rates. It’s possible RSV is actually a bigger danger to them than covid (and increases in youth suicides due to lockdowns appear to be higher than the number of lives saved from covid).
As to ignorant people filling ICUs, that’s not a risk where I live in SF that has near universal vaccination and relatively low hospitalization rates. The UK and Denmark have demonstrated you can love on with life after high vaccination rates are achieved.
My wife is a nurse and doesn’t follow up the data and she was in disbelief that her “risk” of serious/death was around 0.00005% or somewhere near that.
The “risk” is misleading because it’s the risk that you will catch it within a 90 day period based on the community spread in the UK at some point in the past (before Delta) times the risk that you will die if you catch it.
Since your wife is a nurse, she’s much more likely to be exposed than the average UK resident. I also think even in her case you likely added an extra zero or 2 based on what I’m seeing while playing around with it.
I think what most people want is what’s my risk of death assuming I get it, not that multiplied times the risk of being infected within only the next 90 days.
I’m personally way more worried about long-term cognitive symptoms than about dying. Obviously the jury’s still out on long term symptoms, but something like a quarter of people with symptomatic COVID seem to have some kind of cognitive symptom (mainly “brain fog” and/or short-term memory loss) 8 months later. https://www.medrxiv.org/content/10.1101/2021.03.18.21253633v...
NPR article honestly just sounds like fear-mongering. I am fine with showing how worse it can get, but nothing in the NPR article talks about the likelyhood of getting a bad case of COVID after vaccination. Objectively informing the public, it is not.
> "NPR article honestly just sounds like fear-mongering."
that's nearly all of npr (and nyt) now, especially the covid-related news that's 50+% of npr stories. i can no longer stomach more than their 10-minute hourly news summary on the radio these days.
The section "How high are my chances of getting a breakthrough case these days?" goes into that. If you're looking for a hard number, I don't think anyone can give you that because it's highly community specific.
I have no idea how you got fear-mongering from that article, though. My impress was that it's a reality check on what the vaccine is capable of and what one individual's breakthrough looks like.
Absolutely useless: the calculator doesn't even ask if you have been vaccinated! And the risks are calculated for someone in the UK - completely irrelevant if you are not (no NHS etcetera).
Was the calculator developed before Delta? Does it already include a factor for your chances of catching it, or is it the risk after you have caught Covid? So many glaring issues - it isn't designed to be informative to the general public.
The associated paper was published in October 2020, so yes this was developed well before delta (at least well before delta's arrival in the UK), most likely in the period between the first and second major peaks in the UK. Given the way academia works I doubt it has been updated significantly since then.
What's a parents' risk of having children that eventually die? What's your risk of driving and having a seizure at the same time and wiping out kids on the sidewalk? What's your risk that while leaving Home Depot you dropped a few nails on the ground and someone's car tire picked them up and now they'll have a blowout on the highway?
We can take this stupid premise to its logical end and never do anything out of fear that we might eventually harm someone else, but that's not how life has gone on for millennia. We have the vaccine which is the solution, by and large the data supports that the sustained overreaction is now disproportionate to the actual risks, time to let the science we supposedly all believe in aka natural selection run its course.
also tiny, since they have rigorous procedures and properly-deployed ppe for all sorts of transmissible infections, not just covid (and where masks can actually help, unlike most mask usage).
the treatment risk calculation is also entirely different, since "someone with a much, much greater risk of death" is already flirting with death in other material ways.
I don't understand the point you're trying to make. Should we stop having nurses treat covid patients so they don't spread it to people who are more likely to have severe reactions? Should we stop having nurses treat people with compromised immune systems and other health issues so they can treat covid patients?
As others have pointed out, that site generates a risk that isn't what most people think of as the risk of death, that is it gives the risk of catching and then dying of Covid during a 90 day period when Delta wasn't around.
For a more expected assessment of "risk of dying if I have covid", you can use this:
Looks like actual cases will make up a material portion of herd immunity. Columbia reports that up to 1/3 of Americans already had contracted COVID by the end of 2020:
That’s talking about herd immunity from vaccines. OP is talking about herd immunity from natural infection. So your links don’t invalidate the point, considering Israel research just proved that natural immunity is 13x more effective against Delta than Pfizer mRNA
Thanks. NPR used to have a pop-up asking if one wants to be tracked or go to the text-only version. Now they only offer getting tracked or some convoluted guide on “other options”.
So did I a few weeks ago. I was vaxxed in April. And then caught it in early August. Three days of sweating and chills, a week of coughing and loopy-head. Positive PCR test. 3 weeks later and I still have a chest-cough I can't shake.
Of course, if I didn't have the vaccine, I probably would be in an overflowing hospital close to death.
Very similar to you. Had double Pfizer. Felt like crap on a Sunday, felt worse on Monday so skipped work and took a lateral flow test which came back negative. Same symptoms but for maybe 5 days. Lost my sense of taste on day 3 which was also the day I tested positive (I didn't take a test on day 2). I stopped testing positive a few days later, but taste was lost for maybe a week.
I had a cough for maybe 10 days, which has just subsided. I can't tell if I have brain fog, as my cough was really preventing me from sleeping well.
One interesting observation: I was pretty ravenous the entire time. I had a fever and was sweating like a pregnant nun in church, but I never lost my appetite. If anything, it turbocharged.
All comforting data, as I have second degree acquaintances who have not recovered taste and smell 17 months after infection. I think it would be quite desirable to have stats with comparisons of these details (duration of adverse events) in all relevant different cases.
(Your «sweating like a pregnant nun in church» will remain with me and I must thank you.)
Assuming that you're between 18-49 years old, the CDC puts the infection fatality rate for that age group at 0.15%. So, unvaccinated, you would have a 99.85% chance of not dying. Being vaccinated, of course, further improves your odds.
The younger you are within that bracket, your odds improve even more. If you have no comorbidities, even better.
Basically, I wouldn't be worrying about death as any given young individual, but at a population scale, COVID is quite deadly. I'm personally much more worried about the other reported effects and lasting tissue damage.
That is a huge range of ages and varying risk levels - in effect, you are over-averaging.
****************
For a 45 year old caucasian male with no comorbidities non-smoker
0.16 (95% CI: 0.14 - 0.17 ) times the risk of dying from COVID-19 compared to the average risk for the US population
absolute rate of mortality of 1.3 (95% CI: 0.6 - 2.8 ) per 100000 individuals in subgroups of the population with a similar risk profile to yours during the period of 09/11/2021 - 10/01/2021. This estimate is calculated based on the CDC's Ensemble mortality forecast data..
95% CI: Error bounds with 95% confidence.
****************
For an 18 year old caucasian male with no comorbidities non-smoker
0.02 (95% CI: 0.02 - 0.02 ) times the risk of dying from COVID-19 compared to the average risk for the US population.
absolute rate of mortality of 1.3 (95% CI: 0.6 - 2.8 ) per 100000 individuals in subgroups of the population with a similar risk profile to yours during the period of 09/11/2021 - 10/01/2021. This estimate is calculated based on the CDC's Ensemble mortality forecast data..
> In my case, it was worse than expected, but, in the parlance of public health, it was "mild," meaning I didn't end up in the hospital or require oxygen.
> ...
> It was a miserable five days. My legs and arms ached, my fever crept up to 103 and every few hours of sleep would leave my sheets drenched in sweat. I'd drop into bed exhausted after a quick trip down to the kitchen. To sum it up, I'd put my breakthrough case of COVID-19 right up there with my worst bouts of flu. Even after my fever cleared up, I spent the next few weeks feeling low.
"Mild" can mean different things to different people. I doubt this description of "mild" fits most people's concept of the word, as it sounds like a severe case of the flu. The fact that these infections are happening against a backdrop of normalization efforts should give anyone who thinks we're out of the woods pause.
As the rate of infection increases, so does the risk to the vaccinated. It's another demonstration, once again, of how our public health system (and the CDC in particular) has failed us:
> ... "quantifying that [chance of symptomatic case in an unvaccinated person] in the U.S. is very challenging" because our "data is so shoddy."
Some time ago, the CDC stopped counting/sequencing "mild" breakthrough cases, so we're flying blind mostly. Maybe it's delta the reporter caught. Maybe something else. Who knows?
What's clear is that COVID-19 isn't going away any time soon. What's also clear is that it shares the tendency that all RNA viruses have to mutate at an extremely rapid rate. It has shown that it can change much faster than we can adapt.
> What's clear is that COVID-19 isn't going away any time soon.
This isn’t new information. It was obvious all the way back in March of 2020 that covid was here forever.
Life must go on. We cannot live with this myopic fixation on exactly one specific form of illnesses. These “experts” have already asked enough out if people. We’ve been asked to put our lives on hold for more than 1.7 years now.
Dragging any of this on after the first vaccines came out was unethical as hell. Vaccines were it. There is nothing else we can do besides attempt to build some myopic hellscape where our entire existence is centered around stopping the spread of covid.
> I doubt this description of "mild" fits most people's concept of the word
Hence the ' around mild in the title. But honestly sure they were sick but they did not seriously fear for their lives or require medical attention. Obviously being asymptomatic would have been more mild but in general this seems like a win.
People need to accept some level unpleasantness and risk in their lives.
Readit News
(E: I don’t get why people downvote this - all of the benefits of vaccination are precisely due to what I describe. Lower likelihood of individual bad outcomes, which reduces burdens on healthcare, and ideally, reduces community spread by reducing the amount of virus that replicates in an individual and can be passed on. This is why I was one of the first in line when I could get the vaccine. Perhaps daring to critique people with unrealistic vaccine expectations is unacceptable?)
Eg. where I live, hospitals consider introducing vaccination requirements for visitors. But that somehow defies logic. The vaccine only reduces symptoms (and might thus save yourself, or others, when extended with the hospital-bed-limit-thought), but it wouldn't stop you from transmitting the disease if you are infected (and vaccinated) but you aren't aware.
So I don't even blame the public, but rather the regulators. They ought to know better.
Edit: I might need to support this claim.
The most trustworthy source I found was this article by the JHU [1] (2021-08-02). While there are many that claim different numbers (ranging from stopping roughly 60% to 0%), for transmission, no one claimed that virus infection is influenced.
[1]: https://publichealth.jhu.edu/2021/new-data-on-covid-19-trans...
Are you sure about that? Even this article refers to a study which says that vaccinated people are 5 times less likely to test positive than non-vaccinated. _Some_ asymptotic transmission will still occur in the vaccinated but it's reasonable to expect that it happens to a lesser degree. I'd be very curious to see studies that claim that there's no difference in asymptomatic transmission between the vaccinated and unvaccinated.
"after an outbreak among vaccinated and vaccinated workers at the Singapore airport, tracking studies suggested that most of the spread by vaccinated people happened when they had symptoms"
The vaccines substantially help to reduce spread. Doesn't eliminate it, but obviously something a hospital would want to require.
Treating transmission as a boolean ignores the large-but-not-100-percent improvement. Better to treat it as a distribution.
I don’t see what you are blaming regulators for.
In the wake of other variants like Delta, I doubt that people who didn't/can't get the vaccine can be protected by herd immunity alone.
A few of my friends are getting breakthroughs too, which seems like a lot in comparison to the global statistics, so it might be just anomalies.
https://www.cdc.gov/coronavirus/2019-ncov/science/science-br...
"Two studies1,2 from Israel, posted as preprints on 16 July, find that two doses of the vaccine made by pharmaceutical company Pfizer, based in New York City, and biotechnology company BioNTech, based in Mainz, Germany, are 81% effective at preventing SARS-CoV-2 infections. And vaccinated people who do get infected are up to 78% less likely to spread the virus to household members than are unvaccinated people. Overall, this adds up to very high protection against transmission, say researchers."
https://www.nature.com/articles/d41586-021-02054-z
"COVID-19 vaccines appear to help prevent transmission between household contacts, with secondary attack rates dropping from 31% to 11% if the index patient was fully vaccinated, according to a Eurosurveillance study yesterday. The population-based data looked at the Netherlands from February to May, when the Alpha variant (B117) was dominant and the available vaccines were by Pfizer/BioNTech, AstraZeneca/Oxford, Moderna, and Johnson & Johnson."
https://www.cidrap.umn.edu/news-perspective/2021/08/study-ti...
"There has been good news, too, on the subject of viral load in breakthrough cases. Researchers in Israel studied vaccinated people who became infected. The viral load in these breakthrough cases was about three to four times lower than the viral load among infected people who were unvaccinated. Researchers in the U.K. reported a similar result. They also found that vaccinated people who became infected tested positive for about one week less than unvaccinated people."
https://www.scientificamerican.com/article/the-crucial-vacci...
No, it’s because until the Delta variant became the most common variant, the vaccines essentially did create a covid-proof bubble around the recipient. The trials for Comirnaty and the Moderna vaccine both showed >90% effectiveness against PCR positive infections, not just against hospitalization and death.
I don't believe the official trials for Moderna and Pfizer measured PCR positive infections at all. (They involved thousands of people, it was a time when PCR test were difficult to obtain; they remain expensive at that scale).
I have not heard of Comirnaty, not sure about that.
There may have been pre-delta studies that showed PCR infection effectiveness (Cite?), I don't think they were the official trials.
If you think about the virus passing your various layers of protection it is clearly a numbers game, IMO. A mask, even if imperfect, might reduce your initial viral load below a threshold that allows your immune system to kill all infected cells very quickly so you don't develop strong symptoms. The same goes for distance.
So I don't see any reason to not expect a certain "sterile" immunity after a vaccination. The way I see it, the vaccination should prevent some of the low-load infections completely, regardless of the virus variant.
It's kind of like Vaccine + mask + low exposure (social distance, short times, good ventilation) is your "armor class" against the virus.
If your armor is good enough, the chance of becoming infected IS very low.
Exactly. I see no reason why I’d take strong measures to avoid getting exposed to it (now that I and 90% of adults around me are fully vaccinated) when I never did the same for the flu. Somewhere along the way we seem to have lost sight of what constitutes a normal disease burden.
The last two times I had flu (first age 36, then a few years later), I was unable to work for an entire month each time.
For most of that time I struggled to get out of bed, and couldn't think much. I was too weak and tired, so I slept most of the time or did low energy activities, and relied on other people to bring me food. The first one meant I missed Christmas: My partner went to an all-day get together with our mutual friends, and I stayed home in bed, too ill to go.
My other flu story would be, a good friend and former employer got flu one day when he was visiting his wife and children (he normally worked in another country to them). Few days into it, he lay down on a sofa and died. I don't know the rest of the story, but I miss him. I think my life would be different if he were still around.
These experiences certainly gave me more respect for flu as a killer.
So your partner did not quarantine? Avoid non-essential trips? Wear a mask?
I don't think you'd disagree that our COVID precautions at _this_ point are incongruous with the past, but highlighting it for others reading.
Having relatives in the healthcare sector and hearing stories during bad flu waves (2020 was not the first year in recent memory where people needed to be treated in makeshift tents[1]) we do indeed have lost sight of the disease burden, but probably not in the way you imagine.
I was lucky to spent the first few months of the covid-19 pandemic in Japan, and I can tell you I did not see overrun hospitals at any point because people by and large take hygiene and avoiding the spread of infectious disease seriously.
[1]https://time.com/5107984/hospitals-handling-burden-flu-patie...
https://noahcarl.substack.com/p/why-have-there-been-so-few-c...
I've certainly enjoyed not getting the usual bouts of cold and flu my kids would bring home from school every winter.
I hope at least one lesson we take from COVID is "people should be able to take sick days rather than coming to work/school sick".
It should really go without saying COVID-19 is much more transmissible than any recent version of the Flu. Comparisons of symptoms and severity in healthy adults has never been the sticking issue.
I'm disheartened to see people on HN of all places thinking solely as an individuals and not about the management of health care resources at a population level. Health care resources are finite and viruses like COVID can still spread exponentially even with current vaccination rates.
From the beginning, the goal has been to lower transmission, lower cases, and therefore lower the burden on the _world_ health care system to a tenable degree. Yes, there may be _more_ effective measures we can take at this point, such as ramping up vaccination, but at the end of the day, if you don't transmit the disease to others or end up in the hospital yourself, you are helping the cause.
tldr; Whether or not it poses a risk to _you_ is besides the point, in so far as the risk of overburdening the health care system remains.
Individualism vs Collectivism is a debate that goes back a long time.
Your 'flattening the curve' argument is fear based.
I haven't seen any actual DATA besides media fear mongering that ICUs are 'almost' full for years now.
Currently, in most of the USA, your chances of getting covid are probably a LOT higher than that of getting the flu. Way more people are getting covid than getting a bad case of the flu.
So it's not quite the same.
If the chances of getting the flu were always this high, including the chances of really severe disease or death for some (say, those with organ transplants)... we probably would have been doing something different.
But I agree with you we shoudln't have to, don't need to, and can't sustainably simply shut down life forever.
I find the experts advice reassuring. IF you are vaccinated:
> Even with delta, the goal is not to go back to a lockdown mindset, though, says Malani. "My hope is that people who are fully vaccinated should really feel like this risk is manageable."
> "Feel good about spending time with your friends, or having a small dinner party, but make sure everyone is vaccinated," she says.
For now I am wearing a mask at the store (not that big a deal), and avoiding large public unmasked gatherings. In part because I want to try to help get community transmission rates a lot lower so we can then do more.
But I agree I'm not gonna do it forever.
Alternatively this pandemic may have permanently shifted what we consider to be a normal disease burden. Maybe we shouldn't accept tens of thousands of Flu deaths every year if there are some relatively simple changes we can make to reduce them.
Because it's up to 10x more deadly than influenza, particularly for vulnerable populations.
https://www.hopkinsmedicine.org/health/conditions-and-diseas...
https://www.who.int/bulletin/online_first/BLT.20.265892.pdf
There's a letter here in the BMJ that states it's comparable to flu:
https://www.bmj.com/content/371/bmj.m4509/rr
The nature of IFR calculations means there will likely always be very wide uncertainty intervals, however.
For me, boosters and nasal vaccines can't come fast enough (nor can the ability to administer them to younger children).
At some point I think this virus will become like the flu in terms of public health implications, but I don't think it's quite there yet.
https://hms.harvard.edu/news/how-covid-19-causes-loss-smell
The risk to younger children is minimal.
https://www.nature.com/articles/d41586-021-02423-8
Not quite. The worst bouts of flu are the ones that kill people. Some of the influenza A strains are no joke.
Dead Comment
Also, "Think of the children". those that can't get vaccinated but are now dying from the delta strain?
I'm curious, where did that 90% figure come from?
Around here, of the eligible population, about 1 of every 3 has no shot at all, one 1 out of 4 with just a single shot. If you look at the full population, including minors and other ineligible groups, the numbers are even worse.
That means if I go to the grocery store, I'm absolutely gonna be in proximity to someone unvaccinated at some point along the way.
I don't think so. This is only "mild flu" for vaccinated people. We still have kept sight that people who can't be vaxed can die, and people who ignorantly chose not to vax are killing people because they clog the ICUs and prevent people from getting non-covid life-saving care.
So we haven't lost sight, people just choose not to see. You just can't teach some people to be unselfish and considerate.
Honest question - would you provide information for that please? The two articles I've seen on that were both completely retracted within a few days of publication. I know unvaxxed people, and I want to have all available information before conversing with them.
Not news articles but the actual data you're using?
As to ignorant people filling ICUs, that’s not a risk where I live in SF that has near universal vaccination and relatively low hospitalization rates. The UK and Denmark have demonstrated you can love on with life after high vaccination rates are achieved.
https://www.qcovid.org/Calculation
My wife is a nurse and doesn’t follow up the data and she was in disbelief that her “risk” of serious/death was around 0.00005% or somewhere near that.
Since your wife is a nurse, she’s much more likely to be exposed than the average UK resident. I also think even in her case you likely added an extra zero or 2 based on what I’m seeing while playing around with it.
I think what most people want is what’s my risk of death assuming I get it, not that multiplied times the risk of being infected within only the next 90 days.
You have: 1. Chance of getting a disease 2. Chance of dying from said disease once acquired
Both have numerous factors that affect the result.
that's nearly all of npr (and nyt) now, especially the covid-related news that's 50+% of npr stories. i can no longer stomach more than their 10-minute hourly news summary on the radio these days.
I have no idea how you got fear-mongering from that article, though. My impress was that it's a reality check on what the vaccine is capable of and what one individual's breakthrough looks like.
Was the calculator developed before Delta? Does it already include a factor for your chances of catching it, or is it the risk after you have caught Covid? So many glaring issues - it isn't designed to be informative to the general public.
We can take this stupid premise to its logical end and never do anything out of fear that we might eventually harm someone else, but that's not how life has gone on for millennia. We have the vaccine which is the solution, by and large the data supports that the sustained overreaction is now disproportionate to the actual risks, time to let the science we supposedly all believe in aka natural selection run its course.
the treatment risk calculation is also entirely different, since "someone with a much, much greater risk of death" is already flirting with death in other material ways.
For a more expected assessment of "risk of dying if I have covid", you can use this:
https://www.economist.com/graphic-detail/covid-pandemic-mort...
Although it only shows "<0.1%" for anyone under 40s, so it doesn't break things down that fine (better for hospitalizations).
Deleted Comment
https://www.publichealth.columbia.edu/public-health-now/news...
Here’s why herd immunity from Covid is ‘mythical’ with the delta variant https://www.cnbc.com/2021/08/12/herd-immunity-is-mythical-wi...
The developer of the AstraZeneca shot says the Delta variant has made herd immunity impossible because vaccinated people can still transmit the virus https://www.businessinsider.com/delta-variant-made-herd-immu...
https://text.npr.org/1036356773
Of course, if I didn't have the vaccine, I probably would be in an overflowing hospital close to death.
I had a cough for maybe 10 days, which has just subsided. I can't tell if I have brain fog, as my cough was really preventing me from sleeping well.
One interesting observation: I was pretty ravenous the entire time. I had a fever and was sweating like a pregnant nun in church, but I never lost my appetite. If anything, it turbocharged.
All comforting data, as I have second degree acquaintances who have not recovered taste and smell 17 months after infection. I think it would be quite desirable to have stats with comparisons of these details (duration of adverse events) in all relevant different cases.
(Your «sweating like a pregnant nun in church» will remain with me and I must thank you.)
https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...
The younger you are within that bracket, your odds improve even more. If you have no comorbidities, even better.
Basically, I wouldn't be worrying about death as any given young individual, but at a population scale, COVID is quite deadly. I'm personally much more worried about the other reported effects and lasting tissue damage.
That is a huge range of ages and varying risk levels - in effect, you are over-averaging.
****************
For a 45 year old caucasian male with no comorbidities non-smoker
0.16 (95% CI: 0.14 - 0.17 ) times the risk of dying from COVID-19 compared to the average risk for the US population
absolute rate of mortality of 1.3 (95% CI: 0.6 - 2.8 ) per 100000 individuals in subgroups of the population with a similar risk profile to yours during the period of 09/11/2021 - 10/01/2021. This estimate is calculated based on the CDC's Ensemble mortality forecast data..
95% CI: Error bounds with 95% confidence.
****************
For an 18 year old caucasian male with no comorbidities non-smoker
0.02 (95% CI: 0.02 - 0.02 ) times the risk of dying from COVID-19 compared to the average risk for the US population.
absolute rate of mortality of 1.3 (95% CI: 0.6 - 2.8 ) per 100000 individuals in subgroups of the population with a similar risk profile to yours during the period of 09/11/2021 - 10/01/2021. This estimate is calculated based on the CDC's Ensemble mortality forecast data..
95% CI: Error bounds with 95% confidence.****************
Calculated using JHU's COVID-19 Mortality Risk Calculation https://covid19risktools.com:8443/riskcalculator
https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...
> ...
> It was a miserable five days. My legs and arms ached, my fever crept up to 103 and every few hours of sleep would leave my sheets drenched in sweat. I'd drop into bed exhausted after a quick trip down to the kitchen. To sum it up, I'd put my breakthrough case of COVID-19 right up there with my worst bouts of flu. Even after my fever cleared up, I spent the next few weeks feeling low.
"Mild" can mean different things to different people. I doubt this description of "mild" fits most people's concept of the word, as it sounds like a severe case of the flu. The fact that these infections are happening against a backdrop of normalization efforts should give anyone who thinks we're out of the woods pause.
As the rate of infection increases, so does the risk to the vaccinated. It's another demonstration, once again, of how our public health system (and the CDC in particular) has failed us:
> ... "quantifying that [chance of symptomatic case in an unvaccinated person] in the U.S. is very challenging" because our "data is so shoddy."
Some time ago, the CDC stopped counting/sequencing "mild" breakthrough cases, so we're flying blind mostly. Maybe it's delta the reporter caught. Maybe something else. Who knows?
https://www.newsweek.com/why-did-cdc-stop-counting-mild-asym...
What's clear is that COVID-19 isn't going away any time soon. What's also clear is that it shares the tendency that all RNA viruses have to mutate at an extremely rapid rate. It has shown that it can change much faster than we can adapt.
This isn’t new information. It was obvious all the way back in March of 2020 that covid was here forever.
Life must go on. We cannot live with this myopic fixation on exactly one specific form of illnesses. These “experts” have already asked enough out if people. We’ve been asked to put our lives on hold for more than 1.7 years now.
Dragging any of this on after the first vaccines came out was unethical as hell. Vaccines were it. There is nothing else we can do besides attempt to build some myopic hellscape where our entire existence is centered around stopping the spread of covid.
Hence the ' around mild in the title. But honestly sure they were sick but they did not seriously fear for their lives or require medical attention. Obviously being asymptomatic would have been more mild but in general this seems like a win.
People need to accept some level unpleasantness and risk in their lives.
Covid is endemic, and just like you probably don't know anyone who has never had the flu or the cold, it will be the same with this.
Get your vax! It'll likely keep you out of the hospital when you do get it.
Mask up all you want. Avoid crowds. Shun and shame people. You're still going to get it, just like everyone else.