The global average of reported cases and deaths continue to decline across the world. There are a few exceptions, most notably in Taiwan, Portugal, Australia, and the United States. It’s not entirely clear if we can continue to judge the global situation by comparing per capita case rates across countries. Many countries are winding down systematic testing efforts and enormous country-to-country variability exists regarding at-home antigen testing, like availability, usage, and official reporting. The true story will soon (if not already) be inaccurately reflected in the case graphs that we’ve become so accustomed to following.
Thank you for your posts. I send people to them all the time. One literally said, "She is pure gold."
I'm working as a volunteer on a COVID-related issue: getting Evusheld to the immunocompromised. Gov't bought 875,000 doses 6 months ago and only 1/8 of it has been distributed to patients. Problem seems to be that too few patients and doctors know of its usefulness. I hope you'll put in a little mention of Evusheld and what it does in a blog post now and then, to raise awareness.
"If you’re high risk, please consider getting a prescription of Paxlovid" Just a couple of questions: 1) How is "high risk" defined in this case? I'm 74 but have no other risk factors, wear an N95 mask in all public indoor situations, and have had both boosters. Am I considered "high risk"? 2) Is Paxlovid something I should have on hand just in case I get infected, or should I ask my PC doc for it if and only if I test positive?
We're off on a two week European trip in two weeks, so I'm wondering whether or not I should just have some on hand. Thanks.
Very disheartening that vaxed and boosted folks are on the wrong side of the odds - even still being careful. Great fodder for those who avoid vaccines. Thanks as always for the update.
EXCELLENT Post! Question: early on, the statistics were that males did much worse with COVID-19 infections than women in most age groups. What are the current stats for women vs. men for things like: [1] current stats overall? [2] age-adjusted overall? [3] those protected by full vaccination? [4[ Etc.. THANK YOU!
I don't think we're out of the woods yet and undoubtedly with this large a reservoir of infected people and animals, the virus will continue to select for more transmittable variants, despite our countermeasures. To repost an earlier remark, and thinking numerically about it. It seems to me that the pandemic, far from being over, rang the planet like a bell setting up disequilibria everywhere and it will take a while, maybe three to five years for things to settle down to a new normal (which won't be the old one - it's gone) even if the virus were to disappear today. In effect, the planet itself has long covid.
Thanks for another informative post! A few comments:
1) Given that daily cases are vastly undercounted, by at least one order of magnitude, what is the value in continued publication of the surge chart? Individuals who use it to assess risk will quickly be misled, increasing the likelihood of poor decisions and infection.
2) Given that it’s possible to adjust the daily case chart based on sampling so that it more closely reflects reality, why doesn’t the CDC do this? They could footnote their assumptions for full disclosure. Instead, they continue to publish a chart that makes it appear they have the pandemic under control, which they do not. This chart is worse than worthless, it leads to risky behavior and unnecessary transmission. Either fix the chart for accuracy or retire it.
3). The NYT recently published an article stating that once symptoms begin, vaccinated individuals who use home tests are more likely to test false-negative for several days. I know several vaccinated and boosted people who become symptomatic, test negative at home, wait a day or two, and test negative at home again. They do everything right, assume they don’t have Covid, and go back to work or school, right at the moment they are becoming most infectious. So while it’s great that vaccines and boosters are preventing severe illness and death, are they inadvertently increasing transmission? While this early-false-negative phenomena has always been true for home tests, its even more pronounced with omicron, especially for vaccinated/boosted individuals where the vaccines "mask" a true positive in the early days. Here’s the NYT article (click “show more” to see full article): https://www.nytimes.com/explain/2022/coronavirus-questions#at-home-covid-test-negative
4) Are vaccines and boosters really preventing hospitalization and death today? Or did previous surges take out the “low hanging fruit” (most vulnerable) and those who are left are healthier and/or have natural immunity?
Thank you for keeping up with all this. Your posts help me to protect myself, despite mask-fatigue, and I pass the info on. I am double-boosted and intend to continue with further immunization when they become available. Dying on a ventilator does not attract.
Can you address what is known about flying now that there's no mask mandate? Any new empirical evidence? My spouse just got COVID after air travel, and that was his primary exposure. He and his colleague both took the same plane on Thursday (that sat on a runway for a while), and they haven't seen each other since. They came down with it today (4 days later) on antigen test. They were wearing KN95s. Are people with N95s actually avoiding it? I have to go to a conference in 3 weeks. If I actually avoid COVID from my spouse, I'm wondering if a N95 will be good enough or if I'm just as likely to get COVID.
In your paragraph “battle of Omicron” you noted BA.4 and BA.5 are gaining traction and they are reinfecting folks with Omicron. Hence their ability to spread quickly. The key question is what about the folks that aren’t getting infected with “old Omicron” and or the new variants. Are they not getting infected because they are not exposed, or their immune system does better? Since we cannot do random controlled tests and have to rely on vagaries of observed data, this is hard to answer, but it is a critical question despite structural data issues.
Second, it is important to be careful with models that are conjecture, for example the real COVID rate, even if they have fancy math. Additionally, what we don’t get when a COVID positive test is reported is “how sick” is the person.
“Massive” case surge needs to be defined. Massive in that your chances are 1 in 10 of going to a movie and leaving with COVID or 1 in 10,000. Risk needs to be made real.
I have been a big proponent of vaccines – love the MRNA technology. At this point my suggestion is to stop reporting separately on the unvaccinated. It isn’t helping and there are now data complications. We don’t separately report on folks with diabetes.
Yes I do a ton of analytics without borders and have been since 1977 when I joined IBM at age 23. This work have covered planning and scheduling to colon cancer.
This is getting more and more frustrating as time goes on. I'm 77 years old, vulnerable and really want to continue living for a "few" more years. There's no one to trust anymore. Except you. Protection from four shots is waning, leaving us more vulnerable to new variants. Guess I should continue to mask up, avoid crowds and strangers until our medical professionals figure this out.
As best I can determine, if I wear a nanofiber respirator mask at all times when I am indoors that has claimed protection of 98%, and if I fit it properly so that I can not feel any leaks around the edges even when I puff a breath, then I should be completely safe against the covid virus, regardless of how many people near me are emitting the virus into the indoor air, regardless of my personal risk level, and regardless of the fact that I am indeed vaccinated and twice boosted. Am I missing something? Why don’t 98% masks suffice?
Case rates among the boosted are also increasing bc the population of people who are most likely to be boosted -- the elderly and people with weakened immune systems -- are also more vulnerable to infection due to age/health. I'd imagine we're going to approach a leveling off soon where we see more hospitalizations/deaths are among the boosted than the unvaxxed, as a function of the a priori higher risk presented by age and co-morbidities.
Once again - thank you for all your data driven, fact based work! I’m still wondering about the more difficult to answer question around longer term immunity (B and T cells). I know it’s not easy to measure (like antibody levels) but I really do wonder why there hasn’t been more data that shows long term durability.
Wonderfully thoughtful post, Katelyn - thank you! Denominators question: In the Y-axes labeled incidence/100,000 population - is that the whole population (of whatever region)? If so, where can we find charts where the denominators are various statuses of prior infection, vaccinated, not vaccinated, etc.? Some preprint papers sort of get at this question. Does getting that information depend on rigorous analysis of large datasets of people's entire continuum of healthcare? For example, in health insurance claims or large healthcare systems in which members access essentially all of their healthcare? Setting up standardized queries takes a lot of work by people who deeply understand the nuances of using real-world (that is, non-clinical trial) evidence, but once set up could be run periodically for updates. Or is this already happening?
As someone who has Covid at Easter I am wondering if when people get reinfected after omicron, do we know if their course of illness is similar to what they had before? I “just” had a cold though I tested positive for 2 weeks. Would another bout likely be similar?
Thank you for your posts. I send people to them all the time. One literally said, "She is pure gold."
I'm working as a volunteer on a COVID-related issue: getting Evusheld to the immunocompromised. Gov't bought 875,000 doses 6 months ago and only 1/8 of it has been distributed to patients. Problem seems to be that too few patients and doctors know of its usefulness. I hope you'll put in a little mention of Evusheld and what it does in a blog post now and then, to raise awareness.
Our site is at rrelyea.github.io/evusheld/
It's a free public service -- no registration, no charge, just go there and get the information you need.
"If you’re high risk, please consider getting a prescription of Paxlovid" Just a couple of questions: 1) How is "high risk" defined in this case? I'm 74 but have no other risk factors, wear an N95 mask in all public indoor situations, and have had both boosters. Am I considered "high risk"? 2) Is Paxlovid something I should have on hand just in case I get infected, or should I ask my PC doc for it if and only if I test positive?
We're off on a two week European trip in two weeks, so I'm wondering whether or not I should just have some on hand. Thanks.
Very disheartening that vaxed and boosted folks are on the wrong side of the odds - even still being careful. Great fodder for those who avoid vaccines. Thanks as always for the update.
EXCELLENT Post! Question: early on, the statistics were that males did much worse with COVID-19 infections than women in most age groups. What are the current stats for women vs. men for things like: [1] current stats overall? [2] age-adjusted overall? [3] those protected by full vaccination? [4[ Etc.. THANK YOU!
I don't think we're out of the woods yet and undoubtedly with this large a reservoir of infected people and animals, the virus will continue to select for more transmittable variants, despite our countermeasures. To repost an earlier remark, and thinking numerically about it. It seems to me that the pandemic, far from being over, rang the planet like a bell setting up disequilibria everywhere and it will take a while, maybe three to five years for things to settle down to a new normal (which won't be the old one - it's gone) even if the virus were to disappear today. In effect, the planet itself has long covid.
Thanks for another informative post! A few comments:
1) Given that daily cases are vastly undercounted, by at least one order of magnitude, what is the value in continued publication of the surge chart? Individuals who use it to assess risk will quickly be misled, increasing the likelihood of poor decisions and infection.
2) Given that it’s possible to adjust the daily case chart based on sampling so that it more closely reflects reality, why doesn’t the CDC do this? They could footnote their assumptions for full disclosure. Instead, they continue to publish a chart that makes it appear they have the pandemic under control, which they do not. This chart is worse than worthless, it leads to risky behavior and unnecessary transmission. Either fix the chart for accuracy or retire it.
3). The NYT recently published an article stating that once symptoms begin, vaccinated individuals who use home tests are more likely to test false-negative for several days. I know several vaccinated and boosted people who become symptomatic, test negative at home, wait a day or two, and test negative at home again. They do everything right, assume they don’t have Covid, and go back to work or school, right at the moment they are becoming most infectious. So while it’s great that vaccines and boosters are preventing severe illness and death, are they inadvertently increasing transmission? While this early-false-negative phenomena has always been true for home tests, its even more pronounced with omicron, especially for vaccinated/boosted individuals where the vaccines "mask" a true positive in the early days. Here’s the NYT article (click “show more” to see full article): https://www.nytimes.com/explain/2022/coronavirus-questions#at-home-covid-test-negative
4) Are vaccines and boosters really preventing hospitalization and death today? Or did previous surges take out the “low hanging fruit” (most vulnerable) and those who are left are healthier and/or have natural immunity?
Thank you for keeping up with all this. Your posts help me to protect myself, despite mask-fatigue, and I pass the info on. I am double-boosted and intend to continue with further immunization when they become available. Dying on a ventilator does not attract.
Can you address what is known about flying now that there's no mask mandate? Any new empirical evidence? My spouse just got COVID after air travel, and that was his primary exposure. He and his colleague both took the same plane on Thursday (that sat on a runway for a while), and they haven't seen each other since. They came down with it today (4 days later) on antigen test. They were wearing KN95s. Are people with N95s actually avoiding it? I have to go to a conference in 3 weeks. If I actually avoid COVID from my spouse, I'm wondering if a N95 will be good enough or if I'm just as likely to get COVID.
In your paragraph “battle of Omicron” you noted BA.4 and BA.5 are gaining traction and they are reinfecting folks with Omicron. Hence their ability to spread quickly. The key question is what about the folks that aren’t getting infected with “old Omicron” and or the new variants. Are they not getting infected because they are not exposed, or their immune system does better? Since we cannot do random controlled tests and have to rely on vagaries of observed data, this is hard to answer, but it is a critical question despite structural data issues.
Second, it is important to be careful with models that are conjecture, for example the real COVID rate, even if they have fancy math. Additionally, what we don’t get when a COVID positive test is reported is “how sick” is the person.
“Massive” case surge needs to be defined. Massive in that your chances are 1 in 10 of going to a movie and leaving with COVID or 1 in 10,000. Risk needs to be made real.
I have been a big proponent of vaccines – love the MRNA technology. At this point my suggestion is to stop reporting separately on the unvaccinated. It isn’t helping and there are now data complications. We don’t separately report on folks with diabetes.
Yes I do a ton of analytics without borders and have been since 1977 when I joined IBM at age 23. This work have covered planning and scheduling to colon cancer.
Again, love your newsletters
This is getting more and more frustrating as time goes on. I'm 77 years old, vulnerable and really want to continue living for a "few" more years. There's no one to trust anymore. Except you. Protection from four shots is waning, leaving us more vulnerable to new variants. Guess I should continue to mask up, avoid crowds and strangers until our medical professionals figure this out.
As best I can determine, if I wear a nanofiber respirator mask at all times when I am indoors that has claimed protection of 98%, and if I fit it properly so that I can not feel any leaks around the edges even when I puff a breath, then I should be completely safe against the covid virus, regardless of how many people near me are emitting the virus into the indoor air, regardless of my personal risk level, and regardless of the fact that I am indeed vaccinated and twice boosted. Am I missing something? Why don’t 98% masks suffice?
Case rates among the boosted are also increasing bc the population of people who are most likely to be boosted -- the elderly and people with weakened immune systems -- are also more vulnerable to infection due to age/health. I'd imagine we're going to approach a leveling off soon where we see more hospitalizations/deaths are among the boosted than the unvaxxed, as a function of the a priori higher risk presented by age and co-morbidities.
Once again - thank you for all your data driven, fact based work! I’m still wondering about the more difficult to answer question around longer term immunity (B and T cells). I know it’s not easy to measure (like antibody levels) but I really do wonder why there hasn’t been more data that shows long term durability.
Question - is there a point on the case curve where most of the spread is in households vs the community? Is this something anyone has tried to model?
Wonderfully thoughtful post, Katelyn - thank you! Denominators question: In the Y-axes labeled incidence/100,000 population - is that the whole population (of whatever region)? If so, where can we find charts where the denominators are various statuses of prior infection, vaccinated, not vaccinated, etc.? Some preprint papers sort of get at this question. Does getting that information depend on rigorous analysis of large datasets of people's entire continuum of healthcare? For example, in health insurance claims or large healthcare systems in which members access essentially all of their healthcare? Setting up standardized queries takes a lot of work by people who deeply understand the nuances of using real-world (that is, non-clinical trial) evidence, but once set up could be run periodically for updates. Or is this already happening?
As someone who has Covid at Easter I am wondering if when people get reinfected after omicron, do we know if their course of illness is similar to what they had before? I “just” had a cold though I tested positive for 2 weeks. Would another bout likely be similar?