5 ms·
Here’s a couple exercises to test your intuition about this disease. —————————— Year on year risk 1. Pick an area with good covid stats. The google data on c
by graeme 5y ago
Here’s a couple exercises to test your intuition about this disease.
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Year on year risk
1. Pick an area with good covid stats. The google data on cases/hospitalizations/icu/deaths will do
2. Compare the stats for each with the numbers exactly one year ago. You may be surprised to find that unless the country is Qatar, every number will be worse than year on year. Including hospitalizations, icu and deaths
Like other respiratory viruses, SARS-Cov-2 is seasonal. You may recall that last year around this time, Florida and Texas had big waves before the north. And America had a big wave before Europe. Europe declared victory late summer 2020.
This is a surprising conclusion. Going into winter we appear to be in a worse position compared to last year.
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Relative vs. Absolute Risk of severe disease post vaccine
Here’s another exercise. Most reading this are likely vaccinated, as am I. You surely read that this vaccination has ~95% efficacy against severe disease. Great! I’ll take those odds. But what do they mean in absolute risk terms?
Let’s say that last year your local area had 1,000 cases a day, and had the wild type variant. At that level you had a certain risk tolerance. Now, relative to unvaccinated you back then, you have a 20x lower risk. But, it is 2021:
1. Delta seems to have a 2x odds ratio for hospitalization (source below). Oops. Your absolute risk reduction is only 10x.
2. Your local area has more cases now. See the first exercise. So if your area has 5x more cases, a typical multiple, then your absolute risk reduction for severe disease compared to same time last year is only 2x less. Oops.
Now, your peak risk will probably stay lower, as in a lot of places it is implausible that peak caseloads will hit 5x their peak loads. Among other things, ICU capacity would break before then. But this exercise is still valueable, as the merely relative protection of vaccination is unintuitive.
Oh, and the risk of an unvaccinated person compared to same time last year? 10x more! That preserves 95% efficacy.
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No one knows the future. Maybe these waves all peak, we hit the happy land of immunity as a herd, and we have a normal future.
But I say it is futility to declare victory over a respiratory pathogen until your country makes it through at least one winter with the level of restrictions you’d like. Summer is easy mode.
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Sources:
1. Delta hospitalization. This is actually relative to alpha, which may itself have had a higher hospitalization odds ratio relative to wild type: https://www.cidrap.umn.edu/news-perspective/2021/08/sars-cov-2-delta-variant-doubles-hospital-risk-study-shows https://www.cidrap.umn.edu/news-perspective/2021/08/sars-cov...
2. Country stats. For quickly checking a country, google is fastest. But they generally pull from our world in data, which is the best aggregator: https://ourworldindata.org/coronavirus https://ourworldindata.org/coronavirus
- sprafa 5y agoIm not sure we’ll “go back” to the happy days anymore. Even with booster shots my impression is we have a deadly disease that’s here to stay. But people lived with constant plague for hundreds of years, we just convinced ourselves we’d “left that behind” and that might not be true anymore. HIV and COVID demonstrate modern plagues can still come and overwhelm us. No one ever went back to pre-HIV, we still use condoms. We just don’t let people die of it quite so easily anymore. But there was never a moment where HIV has stopped being a problem or having ended the possibility of non-deadly unprotected sex. Maybe COVID is the same - we will remember the pre COVID days as this wonderful time where we didn’t have to shoot RNA onto our arms every six months.
- lamontcg 5y agoInfluenza is also a deadly disease that is here to stay. If you knock down its ability to cause severe disease by a factor of 20 or so and it becomes just another viral pneumonia, then we don't have a pandemic any more. If everyone would just get vaccinated, we'd be there and it'd be over by now. Doomerism is counterproductive and doesn't help that.
- 650 5y agoWhat do you mean everyone? BC, Canada and Israel have some of the highest vaccination rates in the world. Yet cases continue to rise and restrictions are getting tighter.
- graeme 5y agoAnd as I wrote in my initial post, it is summer. This is the easy time!
- lamontcg 5y agoWhat do you mean what do I mean by everyone? I MEAN EVERYONE https://i.imgur.com/fTTBLia.gif https://i.imgur.com/fTTBLia.gif 100%, Including kids under-12. The one thing delta really changed was that we're all either getting vaccinated or getting infected and recovering. What we're doing now is dragging it out while the virus burns through the unvaccinated population still trying to flatten the curve to keep the hospitals from getting knocked over. We could have no restrictions tomorrow if everyone were fully vaccinated today.