Thursday, July 29, 2021

What you need to know about the Delta variant

Jonathon V. Last, Editor of The Bulwark tells us about Everything Delta. His report is based on a conversation between Bill Kristol and Ashish Jha.

Bill Kristol sat down to talk with Ashish Jha, who’s dean of public health at Brown. Their conversation is very much worth your time.

But there are a few bits I want to flag for you:

[T]he biggest thing about the Delta variant that I think has been a bit of surprise is just how contagious it is. It is way more contagious than any variant of this virus, and that really changes things. And it changes things in terms of how much population immunity you need. It changes things in terms of what the breakthrough infections are for the vaccinated… .

we are starting to see some data around the durability of the vaccines, at least as far as preventing breakthrough infections. And this is preliminary data from the UK, preliminary data from Israel, maybe a little data from the US, that as you get six, seven months out of vaccinations, you start seeing some more breakthrough infections, particularly in elderly people.

So what does it mean to say that the delta is “more contagious”?

So if you start with the original strain, the original Wuhan strain from last year, from 2019, 2020, the Alpha variant, which was the one originally from the UK, B117, that was a super contagious variant. If you remember back in March, April, we were like, “it’s a race between the variant and the vaccine.” We were trying to beat the Alpha variant. And that we thought was 50 to 70% more contagious than the original Wuhan strain.

This one is, and again, people have different numbers, kind of in the 60 to a hundred percent more contagious than the Alpha variant. All right, so what does that all mean? And how do you think about it? There are a couple of ways of thinking about it. One is, if you look at the amount of virus in the nose, throat of a patient with Delta variant, it’s about a thousand times more virus than what we saw with the previous strain. So it’s a lot more with a much higher viral load.

Another way people think about this is where the original Wuhan strain virus, the average person might have infected two or three people, about three people. The Alpha, we thought the average person infects four to five. The Delta variant now, the average person may be infecting six to eight. And if you think about exponential growth, 1, 3, 9, 27, 81, that’s pretty substantial growth. 1, 6, 36, three, four generations of spread and it’s massive, you just get to much higher numbers, much, much faster with the Delta variant.

Okay, so you combine the increased contagiousness of delta with the unexpected number of anti-vaxxers and what you get isn’t great. But the third piece here is the vaccines being slightly less durable than expected.

In general, the vaccines have performed better than initial expectations in just about every way, but the biggest unexpected bonus was the extent to which they cut down on transmission. The durability problem is the first time they haven’t overperformed. But whatever. If people need booster shots, that’s not the end of the world.

But when you add it all up, what does it look like going forward? Not great.

Three things—a much more contagious variant, fewer people vaccinated [than we hoped], and now some waning immunity—means this is a very different situation than we thought we were in a few months ago. This means the next few months are going to be pretty tough. A lot of Americans are going to get infected. A lot of vaccinated Americans are going to get infected. Most vaccinated Americans are going to do extremely well, the unvaccinated Americans are not going to do extremely well. And we’re in for a bumpy few months.

One last thing: Here’s Jha giving a pretty nice layman’s explanation for how being vaccinated works to help you avoid really bad outcomes with COVID:

the vaccine has, essentially think of it as, it’s an army, and it has two kind of main things. It has the antibodies, which are your active forces. They’re the ones that would protect you from getting infected. Then you have your reserves, the T-cells and the B-cells, and they kick in once an invasion has happened, once you’re infected.Three things—a much more contagious variant, fewer people vaccinated [than we hoped], and now some waning immunity—means this is a very different situation than we thought we were in a few months ago. This means the next few months are going to be pretty tough. A lot of Americans are going to get infected. A lot of vaccinated Americans are going to get infected. Most vaccinated Americans are going to do extremely well, the unvaccinated Americans are not going to do extremely well. And we’re in for a bumpy few months.

Your T-cells and B-cells are still doing fabulously well with the Delta variant, that’s why we’re not seeing a lot of hospitalizations and deaths among vaccinated people. But the problem is when the amount of virus that shows up is just much, much larger, because of this huge viral load, your antibodies can get a bit overwhelmed and that’s why we’re starting to see more breakthrough infections: you just don’t have enough antibodies and they do wane over time… .

So you’re having lunch with your friend indoors at a restaurant, your friend is unvaccinated and infected, what would your risks be if you were unvaccinated of picking up the virus from your friend, and then how much does the vaccine knock it down? And we think based on the best data that your vaccine knocks it down about 80, 90%, so that’s pretty good.

The problem is that when there’s very little infection in the community, it’s fabulous. But when you imagine that you’re having lunch with an infected friend every day, one of those times …

in May and June, I had lunch and dinner indoors with vaccinated friends several times and felt very comfortable doing so. And in the last 10 days, two weeks, when a friend reaches out for dinner, I’m like, “Let’s see if we can find an outdoor place to have dinner.” Not because I’m worried, because all my friends are all vaccinated, but I don’t know that I want to be in a packed restaurant where other people may be unvaccinated.

And here’s why, and this is really important, because people say, “Well, what’s the big deal?” I actually have had colleagues who’ve had breakthrough infections, and one of them had fevers for about three days, 103, felt pretty lousy. About a week later he was mostly back to normal, but just felt like he was kind of wiped out for a week.

And my thought was, “I don’t want that.” If I could avoid a week of my life being wiped out by an annoying viral infection, I don’t want that. So it’s not so much that I’m terrified that I’m going to die or get hospitalized. It’s easy enough to avoid and there’s a lot of Delta starting to spread the country, I think I’m going to stick with mostly being outdoors for a little while until this Delta surge subsides.

Be smart about this stuff.

Monday, July 26, 2021

Unless we as a nation act -- 'The unvaccinated will set the country on fire over and over again.'

On that theme, here is some of what Charlie Sykes wrote today in The Bulwark.

Responses should match circumstances. And in the last week, it has become obvious that the milder responses — including relying on the honor system — are no longer getting the job done. Daily coronavirus infections in the United States have climbed 145 percent in just the last two weeks.

Obviously, the surge requires a new strategy. Writing in the Wapo, Dr. Leana Wen writes that the federal government needs to “use this opportunity to — finally — incentivize vaccination.”

It could say that areas with high vaccine uptake do not need to reimplement mask mandates, and mandate vaccination on planes and trains and in federal buildings. And it can finally get behind a vaccine verification system that would allow restaurants, gyms, workplaces and universities to create safe, maskless environments where everyone is vaccinated.

One obvious starting place: mandating the vaccine for all health care workers.

Medical groups representing millions of doctors, nurses, pharmacists and other health workers on Monday called for mandatory vaccinations of all U.S. health personnel against the coronavirus, framing the move as a moral imperative as new infections mount sharply.

[Tweets Kyle Griffin:] Alabama Republican Gov. Kay Ivey on the rise in COVID cases in her state: “Folks are supposed to have common sense. But it’s time to start blaming the unvaccinated folks, not the regular folks. It’s the unvaccinated folks that are letting us down.”

Every infected person, anywhere in the world, offers the coronavirus another opportunity to morph into a new variant. The more infections there are globally, the more likely new variants will arise.

The United States will be vulnerable to every one of them until it can immunize millions of people who now refuse to get the vaccine, are still persuadable but hesitant, or have not yet gained access. The unvaccinated will set the country on fire over and over again.

Pelosi - 'This is about seeking the truth.'

Distinguished pol of the week: Someone finally put their foot down observes Jennifer Rubin in the Washington Post.

And with thanks to Sherry, Scriber’s Editor-at-Large.

BEGIN QUOTE

There were many outstanding figures worthy of recognition this past week. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told Sen. Rand Paul during a hearing on Tuesday that the Kentucky Republican didn’t know what he was talking about when he accused the National Institutes of Health of funding research that resulted in the coronavirus pandemic. “And I want to say that officially,” Fauci declared to the amusement of many tired of the persistent Paul’s unfounded accusations and belly-aching about lifesaving pandemic restrictions.

Rep. Liz Cheney (R-Wyo.) on Wednesday said what any honest observer should acknowledge: House Minority Leader Kevin McCarthy (R-Calif.), given his peddling of propaganda about Jan. 6, would be unfit to serve as speaker should the GOP win back the House. “The rhetoric we have heard from the minority leader is disingenuous. … At every opportunity, the minority leader has attempted to prevent the American people from understanding what happened.” She added, “Any person who would be third in line to the presidency must demonstrate a commitment to the Constitution and a commitment to the rule of law, and Minority Leader McCarthy has not done that.”

But House Speaker Nancy Pelosi (D-Calif.) outshone them all by deciding she would not allow two obstreperous Republicans to throw the select committee investigating the Jan. 6 insurrection into chaos. She accepted three of McCarthy’s appointees (one of whom voted against accepting the electoral count) but rejected Rep. Jim Jordan (R-Ohio) (infamous for shouting utter rubbish about Ukraine during the impeachment hearing) and Rep. Jim Banks (R-Ind.) (who has absurdly tried to blame Democrats for the violence at the Capitol).

"As you know, well over 100 people were injured. Some died. It was a horrible, horrible thing. I’ll never forget the trauma it caused, not only for our members, but for our staff and for the people who work in the Capitol to make our work here possible,” Pelosi emotionally recounted at her Thursday news conference.

She offered a bipartisan commission to investigate the events. The Republicans in the Senate filibustered it. She offered a committee, but McCarthy offered two unhinged and unserious figures to serve on it. And even though she offered to keep his three remaining Republicans (and may appoint more Republicans), McCarthy withdrew all five in a huff.

Pelosi made clear she was in no mood to let the committee become a farce: “This is about seeking the truth.” She explained that given her “respect for the integrity of the investigation, with concern that the American people want to know the truth, and in light of statements and actions taken by them, I could not appoint them.” She added, “I said that while this may be unprecedented, so was an attack on the Capitol. I’m not going to spend any more time talking about them.”

Finally, someone is willing to put their foot down. Someone is refusing to let Republicans make a mockery of the House, of the investigation into the insurrection and of an assault on the Constitution. Republicans can try that routine on right-wing media, but not on a committee designed to hold people — perhaps some GOP members — responsible for an unprecedented, violent insurrection sparked by the disgraced former president and others.

Hopefully, the American people comprehend just how reckless, irresponsible and wildly dishonest the MAGA Republicans are. For defending the House, protecting the integrity of the committee and exposing McCarthy as a dangerous pawn in the former president’s attempt to undermine our democracy, we can say, well done, Madam Speaker.

END QUOTE

Thursday, July 22, 2021

The Costs of the Anti-Vaxxers Among us

Trump Country Rejects Vaccines Despite Growing Delta Threat. President Biden missed a July 4 target for shots after politically conservative areas balked.

“There hasn’t been enough research done on it, and I’d rather take my chances with the virus than I would to get the vaccine. I trust my immune system,” [the niece] said in an interview. “If I get it, and it’s my time to die, then I get it and it’s my time to die.”

I, your Scriber, heard that one from one of the pickle ball players the other day.

Jonathon V. Last published this Bulwark piece in his “Triad” column today (July 22).

The Costs of Anti-Vaxxers

From CBS This Morning: “Many states are facing another surge of COVID–19 cases. David Begnaud spoke with a COVID–19 patient in a Louisiana hospital who says he won’t vaccinate because there are too many issues with the vaccine.”

The reporter asks this very fine, high-IQ citizen if, knowing what he knows now, he could go back in time to take the vaccine and avoid getting sick, being hospitalized, and almost dying—would he get the vaccine?

Dude does not even hesitate for a second.

Hearing that, I wondered: Who is paying for the costs of his hospitalization? I hope he has health insurance. And if he does, he’ll pay some out-of-pocket minimum to meet his deductible. Then the insurer will reach a negotiated settlement with the hospital. And then, next year, the insurance company will pass on the costs of that large payment to the rest of its customers.

The people in the insurance pool who got the vaccine will pick up the tab for the treatment of the people who got sick after refusing to get the vaccine.

That’s conservative, rugged individualism, circa 2021.

And it’s a pretty sweet deal, too. You can make whatever damn fool choices you want, and someone else—the hospital, your insurance company, your neighbors paying into the insurance pool—will pick up the tab.

Why would these people ever change?

Why, indeed?

Sunday, July 4, 2021

The storm might be here.

This is a must-read - if you care about the dangers to our democracy being manufactured hourly by Trumpist hoodlums. You will see why that label includes the ex-president and the right-wing members of congress.

Luke Mogelson chronicled the Jan 6 insurrection for the New Yorker in Among the Insurrectionists The Capitol was breached by Trump supporters who had been declaring, at rally after rally, that they would go to violent lengths to keep the President in power. A chronicle of an attack foretold.

For example:

… When Chris Krebs, a Trump appointee in charge of national cybersecurity, deemed the election “the most secure in American history,” the President fired him. Joe diGenova, Trump’s attorney, then said that Krebs “should be drawn and quartered—taken out at dawn and shot.”

Published in the print edition of the January 25, 2021, issue, with the headline “The Storm.”

Saturday, July 3, 2021

An In-Depth Look at How a Mob Stormed the Capitol

The New York Times has published an investigatory video about the Jan 6 capitol riot. This is a must view!

NY Times reports on the Day of Rage: An In-Depth Look at How a Mob Stormed the Capitol. A six-month Times investigation has synchronized and mapped out thousands of videos and police radio communications from the Jan. 6 Capitol riot, providing the most complete picture to date of what happened — and why.

Here is the link: https://www.nytimes.com/video/us/politics/100000007606996/capitol-riot-trump-supporters.html

A Republican Senator who told the truth about the election

Tim Alberta, in The Atlantic, reports on The (Republican) Senator Who Decided to Tell the Truth. A Michigan Republican spent eight months searching for evidence of election fraud, but all he found was lies.

Thanks to Scriber’s Editor-at-Large (Sherry). Snippets follow.

… a Republican state senator who chairs the [Michigan state] Oversight Committee, had released a report detailing his eight-month-long investigation into the legitimacy of the 2020 election.

"Our clear finding is that citizens should be confident the results represent the true results of the ballots cast by the people of Michigan,” [Ed] McBroom wrote in the report. “There is no evidence presented at this time to prove either significant acts of fraud or that an organized, wide-scale effort to commit fraudulent activity was perpetrated in order to subvert the will of Michigan voters.”

For good measure, McBroom added: “The Committee strongly recommends citizens use a critical eye and ear toward those who have pushed demonstrably false theories for their own personal gain.”

A little while earlier, when discussing the scourge of social media, Ed McBroom joked about quitting Facebook to keep his sanity. Then he rattled off the incoming fire he’s been dealing with daily—not just social-media posts and messages, but angry emails and texts from random numbers. Some people accuse him of being in league with Biden; others claim that China bought him off. Occasionally the screeds get nasty and downright threatening, though he said the most disturbing communications of that nature are delivered in middle-of-the-night phone calls. The senator knows that people can locate his farm easily enough, and worries about being gone so much during the week, leaving Sarah and Susan alone with the 13 children. (Both women, he noted, are trained and highly qualified to operate the collection of rifles that hung in a cabinet behind us.)

Still, whatever fleeting dread he feels about personal backlash is diminished by his concern for the country’s sudden epistemological crisis. Not long ago, McBroom said, he would have defaulted to dismissing any notions of mass societal irrationality. He is not dismissive anymore. He sees large portions of the voting public rejecting the basic tenets of civic education and sequestering into “this alternate world” of social media. He hears from constituents about “enemies” on the other side of political disputes and a looming civil conflict to resolve them. And he wonders, as an amateur historian, whether the “very real trouble” we’re in can be escaped.

"It’s easy to look at the current status of American culture, American politics, the American church, and be really apoplectic right now. It’s very easy to give in to that sense of panic,” McBroom told me. “But we go through different cycles in this country. I’m hoping we’re in a cycle of riots and demonstrations on and off, [and not] the cycle where we end up in civil war. I’ve encountered some folks who are like, ‘Maybe it’s time to rise up’—you know, ‘refreshing the tree of liberty with the blood of patriots,’ that stuff. And I say to them, ‘Are you seriously going to go looking for people with biden signs in their yards? I mean, is that what you’re going to do? Make a list? Is this what this is coming to? You’re ready to go out and fight your neighbors? Because I don’t think you really are. I think you’re talking stupid.’”

McBroom closed his eyes and took a heavy breath. “These are good people, and they’re being lied to, and they’re believing the lies,” he said. “And it’s really dangerous.”