Real-world information on Covid vaccine effectiveness

For the first time, we have some real-world data about how effective the Covid vaccines are. The good news is that a very small percent of fully vaccinated people get sick. The bad news is that the vaccines aren’t  a three-hundred percent effective suit of armor against serious disease. Or even quite one hundred percent.

Among the 77 million fully vaccinated people in the US, the Centers for Disease Control reports 5,800 Covid cases. That’s somewhere in the neighborhood of 0.0001%. Of that group, 7% were hospitalized and 74 died, and damn it I wish they’d give statistics either entirely in percentages or entirely in absolute numbers to dopes like me could compare them. I can get as far as saying that most of the cases have been either mild or asymptomatic. If you can translate, leave me a comment. Even if your answer’s wrong, I’m not likely to know. 

Infections in vaccinated people are called breakthrough infections, and it would be unusual if they didn’t happen. They were found in all age groups, although 40% were in people who were 60 or older, 65% were in women, and 29% were asymptomatic. 

Irrelevant photo: apple blossoms

So far, they haven’t identified what, if any, risk factors incline vaccinated people toward getting Covid or which (if any) variants are more likely to be involved, but believe me, someone’s staying up late crunching numbers. It’s also not clear how the asymptomatic cases were noticed, since it’s unusual to test fully vaccinated people who show no symptoms. It could be that they were hospitalized for other reasons and a Covid test was run as part of the admissions routine. Whatever the reasons, though, we can assume that the number of asymptomatic infections is an underestimate.

But didn’t they tell us that the vaccines were 100% effective against severe Covid? Yup, they did, and they weren’t lying to us. The odds of a fully vaccinated person getting a severe infection are so small that the sample would’ve had to be insanely large for a case to have surfaced. The people who ran the trial gave us the numbers they had. As real-world information comes in, those numbers change. That’s the annoying thing about the real world. Every so often, it doesn’t line up with our predictions.

I get a rightwing newsletter in my inbox every so often–it’s been interesting so I don’t unsubscribe, although I’m not the person they have in mind–and it’s fond of reporting on cases of people catching Covid after being vaccinated. The tone leans heavily toward See? We told you it didn’t work. If I could, I’d compare that 0.0001% of breakthrough infections with the percentage of unvaccinated people who catch Covid in the US, but we’ll need a person with some minimal mathematical competence to work it out. I asked Lord Google but he was in one of his moods. If you’d like percentages on many unrelated things, I can point you in the right direction. 

The conclusion, if you want one to put in your pocket and take it home, is that the vaccines aren’t 110% effective and we still need to be careful, but we can let go of the anxiety. The numbers are on our side here and the anxiety isn’t helping anyway.

There’s nothing like someone telling you not to be anxious to make you less anxious, is there?

The additional conclusion is, keep the mask. Even if you’re vaccinated, you can still spread the disease. You’re less likely to–if you have an asymptomatic case you’re likely to have a lower viral load–but you can still do some damage. Other people share this world with us. Try not to do them any more harm than you can help.

 

What’s the story on vaccines and blood clots?

The two vaccines that have been linked to very rare incidents of blood clots are based on a single technology–one they share with the Russian Sputnik V vaccine. Basically, they take an adenovirus–that’s a virus that causes colds–deactivate it, and turn it into a chariot for the vaccine to ride in on.

Vaccines are hopelessly vain. They can’t resist a grand entrance. Horses, polished metal catching the sun, noise, dust, cameras. 

The clotting problem seems–and we’re still at the stage of seems–to be related to that damn chariot. 

The clots happen in veins in the brain, in the abdomen, and in arteries, and at the same time the person’s level of blood platelets fall, and those platelets are the beasties that help our blood clot. We end up with blood clots happening at the same time as hemorrhages, which in everyday English means bleeding. That’s kind of like an elevator going up and down at the same time. 

Normally, you’d pour an anticoagulant called heparin into a person with a blood clot forming in scary places, but when you pair the clots with hemorrhages, you can’t do that.

What are the signs that a person’s getting a serious reaction to one of the vaccines? Severe headaches, abdominal or leg pain, or shortness of breath within three weeks after vaccination.

Every article about this says the clots are very rare. 

How rare is very rare? Last I checked, 222 cases had been linked to the AstraZeneca vaccine in Europe and Britain, along with 18 deaths. That’s out of 34 million people who’ve gotten the vaccine. Most of those were in women who were–okay, not young but under 60, which looks younger all the time. In the US, the Johnson & Johnson vaccine has been linked to 6 cases out of 6.8 million people who were vaccinated with it.

So how rare are the clotting problems? About the same as the chance of being struck by lighting in the UK in any year you choose. And that’s in a country that, by comparison with the American Midwest, doesn’t get a hell of a lot of lightning.

The risk of Covid, though, is no small thing. 

And if you’re inclined to roll the dice by going unvaccinated, the risk of having a blood clot after a bout of Covid is 8 times higher than after getting the AstraZeneca vaccine. The risk of clots after Covid is 100 times higher than after a normal infection.

 

Covid immunity and prior infections

And vaguely related to that is the news that having had Covid doesn’t give young people full protection from another bout of it. That’s from a study of 3,000 healthy U.S. Marines who were between 18 and 20 years old and unless the regulations have changed since last I looked had radically and irrelevantly short hair.

Even though the marines had antibodies, they didn’t have the level of protection that the vaccine offers: 10% got reinfected. That compares with 50% who hadn’t had an earlier infection, although in the previously infected group 84% of the infections  were asymptomatic or mild compared to 68% in the previously uninfected group.

The numbers of infections and reinfections were higher than would be likely outside of a military base because of the cramped living conditions and close contact.

The advice to people who’ve recovered from Covid is to boost your immunity with a vaccine.

The pandemic update from Britain: money, vaccines, and killing the virus

With Italy’s Covid death toll rising (it just beat Britain to Europe’s top spot), a bar in Rome banned any conversation about Covid, viruses, and lockdown. 

“We’ve been talking about the same thing for months,” manager Cristina Mattioli said. “It’s not at all about denial or not understanding the difficulty of what the world is going through, but just about giving yourself a break.”

They don’t throw people out if they break the rules, but they do show them a poster with a list of alternative topics they might want to consider.

“Customers found it funny,” Mattioli said, “with some saying they could finally have a coffee in peace. They started to have other conversations. What was also lovely is that it gave a cue to customers who don’t know each other to start chatting. Yes, we have to maintain a physical distance, but we can still chat to each other.”

I’m not ready to do that here at Notes, but I do know a reader or three who’s bailed out of the Covid posts. I understand the impulse. If I could bail out on the whole damn virus, I’d be happy to. I’m sure it’s a learning experience and all that, but ignorance wasn’t all that bad, really, was it?

Irrelevant photo: a day lily. Each flower blooms for a single day. We could spin all kinds of metaphors about the transience of all things, including beauty and including the pandemic (I hope), but we’ll skip that. It’s a flower. I needed a photo to fill the space.

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An Australian vaccine, the University of Queensland/CSL vaccine, has been abandoned because it set off false positives on HIV tests. It didn’t give anyone HIV–that’s the beast that causes AIDS–but somehow it made them look, on tests, as if it had. Which, given that HIV is still out there in the world and people do still get it, and more to the point if you have it you’ll damn well want to do something about it–

Yeah. You’d want a false positive only slightly less than a real one. So we have one less vaccine in the works, but many others still in development.

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The Peruvian trial of a Chinese vaccine was suspended after a volunteer developed neurological problems–trouble moving his arms (in two articles) and weakness in his legs (in one, which said that was among other symptoms, so these may not contradict each other). That “could correspond to a condition called Guillain-Barre syndrome,” the National Institute of Health said. They’re investigating to see if it’s related to the vaccine or has some other explanation.

The vaccine’s also being tested in Argentina, Russia, and Saudi Arabia–as far as I’ve read without this happening.

Peru has one of the world’s highest per capita Covid death rates.

China has four other vaccines in development, some of which are already being used on an emergency basis.

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British and Russian scientists will test a combination of the Oxford and Sputnik vaccines to see if that gives better protection than either one singly. The trials will start at the end of the year.

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Barcelona gave rapid Covid testing a serious challenge by throwing a free five-hour concert but only allowing people in if they tested negative–on the spot. People danced, bumped up against each other, hugged, and generally did things we wouldn’t have found remotely shocking last year at this time. 

They used hand sanitizer and they (mostly) wore masks, except in one area where they could have a single free drink.

A control group with the same number of people didn’t get in. The researchers will keep an eye on both groups to see if one has a higher incidence of the virus than the other. If I see any more news about how this works out, I’ll let you know. 

Why is this worth doing? Because rapid tests miss a fairly high percent of Covid cases. It’s possible that those people aren’t highly infectious. It’s also possible that they are. It all sounds like Russian roulette to me, but then I’m a zillion years old, on the cautious end of the spectrum, and never did take my music loud. 

Besides, I wasn’t invited. I’m sure it was an oversight. 

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The issue of who’s contagious for how long is a live one. Britain’s cutting the quarantine period for people who’ve tested positive or who’ve been in contact with someone who positive. It’ll go from fourteen days to ten. The theory is that in the last few days only 1% to 2% of infected people can still pass on the virus.

That’s 1% to 2% too many for me, but see above about the cautious end of the spectrum.

People, they say, are most infectious in the day or two before they develop symptoms. 

I suspect cutting the quarantine period is also about hoping more people will respect it if there’s less to respect, although at least part of the problem comes from people not being able to afford time off work. That won’t be fixed by shaving off four days off the recommended time.

There’s talk of eliminating the blanket quarantine altogether for people who’ve been exposed to someone who tests positive, replacing it with daily testing, and only asking people to quarantine only if they test positive themselves. 

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A system that uses LED lights to emit ultraviolet radiation may be a quick, cheap way to eliminate Covid (and pretty much anything else) from indoor air systems. The snag is that you can’t use it in the presence of actual human beings–or, presumably, non-human beings. I’m not sure what it does to them–or us, more accurately–but probably something not unlike what it does to the virus.

The only way to use it would be in an air conditioning or ventilation system. 

A related use of ultraviolet light involves using conjugated polymers and oligomers (whatever they may be), which when activated by UV light almost completely kill the coronavirus. They can be added to masks, clothes, paint, even sprays. They don’t wash away–at least not with plain water–and don’t leave a toxic residue when they break down. 

They could also be used–and this may be a potential use or an immediate one; I’m not sure which–to combat colds, flu, low grades, and cakes that don’t rise properly.

Yes, we’re playing spot-the-exaggeration today. I got myself into deep water with something I thought was so obviously a joke that no one would believe it. Next thing I knew, someone had referenced my claim that Druids worshiped the Great Brussels Sprout. 

I’m sadder but wiser now. So yes, part of that paragraph is a joke. And yes, it’s very sad when you have to tell people you’re making jokes.

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Matt Hancock, Britain’s health minister, announced that a new Covid variant may be associated with a faster spread of the disease.

Notice the wiggle words there: may be; associated with. If you dig into the speech he made to a massively bored-looking House of Commons, he even said, “We don’t know . . . ” But he also said the new Covid variant was growing faster than the version that we’ve come to know and love.

He didn’t say that growing faster may not mean that it spreads more easily or that it makes people sicker, but it would’ve been true if he had. Measuring the danger by comparing the spread of the variants would be like kicking over two cans of paint, looking at the pools on the floor, and deducing that blue spreads faster than red. 

Never mind. What he said wasn’t exactly inaccurate but it was misleading enough to sow bits of panic here and there: Covid’s mutating! Help, help, a horrible heffalump. 

The New Scientist reports that researchers are skeptical. Eric Topol of the Scripps Research Institute said, “This is going to require rigorous assessment before it can be confirmed. New variant sure, functionally significant unlikely. Suspect it will be refuted or seriously questioned.”

Missing words in quote to be found under couch. Have gone free range. From whence they send the news that coronaviruses generally need more than one mutation to hide from a well primed immune system. A lot more than one mutation.

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What else is happening in Britain? Well, the BMJ reports that it hasn’t been able to get information on the financial interests of the doctors, scientists, and academics who give the government pandemic advice. Do they have conflicts of interest? Do they stand to benefit from companies with government contracts?

Dunno. 

At first, the government wouldn’t even release their names. They’ve now done that but refused to let the BMJ see the financial interest forms they’d filled out, although in the interest of complete transparency the government did release a blank copy of the form.

At least someone has a sense of humor. Or else no sense of humor. I can’t tell which.

Patrick Vallance, the government’s chief scientific adviser and head of its Vaccine Taskforce, is reported to have had £600,000 worth of shares in GlaxoSmithKline, which signed a vaccine deal with the government worth we don’t know how much.

Another member of the taskforce, John Bell of Oxford University—who also headed the National COVID Testing Scientific Advisory Panel and chaired the government’s new test approvals group—was reported to have £773,000 worth of shares in Roche, which had sold the government £13.5 million of antibody tests.

The government assures us that neither of them had any involvement in those deals, so it’s okay. 

And I assure you that any resemblance to individual persons, either living or dead, is purely coincidental. 

Bell may or may not also be part of the Department for Business, Energy, and Industrial Strategy. A press release said he was. A spokesperson said he wasn’t.