coronavirus

[LetterRip]

The reported share of COVID-19 cases among those not fully vaccinated ranged from 94.1% in Arizona to 99.85% Connecticut.
The share of hospitalizations among those with COVID-19 who are not fully vaccinated ranged from in 95.02% in Alaska to 99.93% in New Jersey. (Note: Hospitalization may or may not have been due to COVID-19.)
The share of deaths among people with COVID-19 who are not fully vaccinated ranged from to 96.91% in Montana to 99.91% in New Jersey. (Note: Deaths may or may not have been due to COVID-19.)

https://www.kff.org/policy-watch/covid-19-vaccine-breakthrough-cases-data-from-the-states/

And a comment by the person who posted the link,

For the states in the above summary, fully-vaccinated rates range from a bit under half (Alaska, Montane, Arizona) to 64% (Connecticut) of total population.

https://arstechnica.com/science/2021/08/pandemic-of-unvaccinated-rages-in-louisiana-florida-amid-breakthrough-concerns/?comments=1&post=40105454

Only some states are reporting on breakthrough cases, but that gives a pretty good idea.

[TheDrake]

DeSantis just threatened to defund schools that want students to wear masks.

[TheDrake]

300 people in my county are now enjoying their freedom in a hospital bed. Our vaccination rate is 52%. That won't be the peak.

[TheDrake]

Arkansas governor has a change of heart after watching his states hospitals fill up...

“In hindsight, I wish that had not become law,” Hutchinson said during a news conference. “But it is the law, and the only chance we have is either to amend it or for the courts to say that it has an unconstitutional foundation.”

The governor’s comments – a shift from his earlier defense of the measure – reflect the changing public health landscape across the US brought on by the highly transmissible Delta variant. On Tuesday, for the first time since February, more than 50,000 hospital beds across the country were occupied by Covid-19 patients, according to new data from the US Department of Health and Human Services. That number is more than triple what it was a month ago.

"Did I do that?"

[Wayward Son]

The Delta variant is not like the original Covid-19 virus.

“Physicians working in Covid hot spots across the nation say that the patients in their hospitals are not like the patients they saw last year,” the New York Times reports.

“Almost always unvaccinated, the new arrivals tend to be younger, many in their 20s or 30s. And they seem sicker than younger patients were last year, deteriorating more rapidly.”

“Doctors have coined a new phrase to describe them: ‘younger, sicker, quicker.’ Many physicians treating them suspect that the Delta variant of the coronavirus, which now accounts for more than 80 percent of new infections nationwide, is playing a role.”

(Emphasis mine.)

It's a new ball game.

[Lloyd Perna]

The Delta variant is not like the original Covid-19 virus.

“Physicians working in Covid hot spots across the nation say that the patients in their hospitals are not like the patients they saw last year,” the New York Times reports.

“Almost always unvaccinated, the new arrivals tend to be younger, many in their 20s or 30s. And they seem sicker than younger patients were last year, deteriorating more rapidly.”

“Doctors have coined a new phrase to describe them: ‘younger, sicker, quicker.’ Many physicians treating them suspect that the Delta variant of the coronavirus, which now accounts for more than 80 percent of new infections nationwide, is playing a role.”

(Emphasis mine.)

It's a new ball game.

Some blogger posts unattributed anecdotes from "Doctors" and you post it here like it's actually useful information?

Please.

[yossarian22c]

The Delta variant is much more contagious, more likely to break through protections afforded by the vaccines and may cause more severe disease than all other known versions of the virus, according to an internal presentation circulated within the Centers for Disease Control and Prevention.

Quote is behind a NYT paywall.

[TheDrake]

One fifth of UK hospitalizations are under 35. Is that good enough, Lloyd, or would you like another dozen references?

https://www.bbc.com/news/health-58095503

[Lloyd Perna]

Here's a link to the NYT article

https://web.archive.org/web/20210804133849/https://www.nytimes.com/2021/08/03/health/covid-young-adults-sicker.html

It's only marginally better the the version the blogger posted. It does actually name a few doctors with quotes.

Here's the first one.

“I don’t think there’s good evidence yet about whether it causes more severe disease,” Dr. Adam Ratner, associate professor of pediatrics and microbiology at the New York University Grossman School of Medicine, said of the Delta variant.

“This may be behavioral — a combination of the fact that we’re opening things up, and in some places they’re wide open and there are no masks, which is different from a year or 15, 16 months ago,” he added.

Oops, that's doesn't quite support the narrative.

Where is the science?

[Lloyd Perna]

One fifth of UK hospitalizations are under 35. Is that good enough, Lloyd, or would you like another dozen references?

https://www.bbc.com/news/health-58095503

Emphasis mine

One in five people being admitted to hospital in England with Covid is aged between 18 and 34, the new chief executive of NHS England has said.

So 4 out of five people are older than 35 or under 18.  Is that supposed to make us all panic? 

[LetterRip]

Younger people have drastically lower vaccination rates, so it isn't too surprising to see them have significantly higher rates.  Also generally higher risk behaviors (partying indoors; working out; karaoke; etc. all more common among the young age group).

[TheDrake]

Higher infection rates make some sense LR, but at least in popular understanding not hospitalization? Higher proportion could be explained by vaccination or behavior, but not hospitalization as a percentage of infected within the age group. I don't have those breakdowns relatively available.

In any event, the message that if you're young you needn't bother about vaccination or distancing seems pretty thoroughly refuted.

[Wayward Son]

Is that supposed to make us all panic?

No, we don't want anyone to panic.  We want everyone to be concerned.  We want everyone to be cautious, and to treat this deadly disease as a deadly disease.  We want everyone who can to get the vaccine, so it can go the way of smallpox and polio.  We want them to take simple steps to help slow the spread of the disease, even if they are inconvenient and they don't like them, for the good of everyone.

What we don't want is for people to ignore the disease, to stick their heads in...the sand, and pretend that it isn't serious, that it couldn't affect them and everyone they know and love, that it is some wild conspiracy by liberals and Democrats and lizardmen to take away their rights.  We want everyone to act like reasonable adults, and not like morons (to use Pelosi's phrase) who look for any half-assed excuse to be contrary while this pandemic is going around killing people. 

That used to be something we all expected from a vast majority of Americans.  What we don't understand is how and why that changed.  When did common sense and common cause become so rare in this country?

[TheDrake]

Maybe we just need to pass a law that you can't jump head first into a woodchipper and wait for people to assert their freedom.

[Fenring]

That used to be something we all expected from a vast majority of Americans.  What we don't understand is how and why that changed.  When did common sense and common cause become so rare in this country?

Two things. One, we already know that there is no 'common' sense, in terms of half the country thinks the other half is insane and evil. They do not agree in some cases on fundamental precepts and facts. So you can say bye-bye to sense being common. This element of it is not the fault of the people, although from a certain point of view they of course participate in its downfall.

The other thing is about classes of people. I have a strong suspicious that a lot of transmission happens among parts of the population that are innately less prone to care about their health. A lot of my work involves collaboration with blue collar types, whether in manufacturing, warehouses, etc, and these are the types of people whose cred comes from saying "eh" to things that make white collar people wince. Minor injuries, a cold going around, and other things like that - they are going to shrug it off, and would look weak if they shied away from someone to avoid getting a cold. When it comes to covid-19 I've seen plenty of instances already of blue collar people going "come one, I need to get back to work, I can't deal with that nonsense" when the issue is brought up. Around where I live, the biggest areas hit by covid during the flare ups were the agricultural sector, industry and warehouses, and schools. The school matter is separate and would need its own set of rules to be followed, but in the other cases it's some combination of low priority set on safety measures, and them just being difficult to implement, as well the workers themselves not caring so much. Hard to quantify how much blame to apportion to each. But you may well be looking at not just a certain political grouping causing the outbreaks (i.e. those damn right wingers), but actually a certain social/working demographic. Another group that can be culprits is religious groups, which is another can of worms. But in my area at least there seems to be minimal outbreak coming from, for example, the Christian community. The Jewish community had a lot, though, coming from gatherings in temple.

[msquared]

Well it looks like vaccinations are trending upwards the last week or so.  We hit 70%+ over 18 with at least one shot earlier this week and it looks like tomorrow we will hit 50% of the total population fully vaccinated.  Hope this trend keeps up.

[ScottF]

Anyone who thinks that hitting some magic majority vaccination number will stop the media and branch covidian alarmists from shouting about the [insert variant de jour here] because cases are still not at zero yet is dreaming. Vaccinations don't eliminate cases and aren't 100% effective, ergo we'll never "beat" the virus by zero-covid standards.

This plays perfectly into the pharma business plans, which have wisely taken a trick out of the software sales playbook and converted the covid vaccination business into a subscription model.
Until cases are zero (I guess zero cases is the new flattened curve?), you're going to need that 3rd and 4th booster. Just to be super-duper safe.

[yossarian22c]

Because the media made up the fact that COVID cases, hospitalizations, and deaths have tripled in my state in the last month. 

Enough vaccinations would effectively drive cases down to zero. That's why no one in the US has ever had small pox and I don't worry about my kids getting polio. Its why kids in my generation never got measles and kids in this generation never get chicken pox. Mass vaccination works! But we need almost everyone to get vaccinated to stifle the spread like that and apparently we have too many idiots around to ever get to that level of vaccination.

[msquared]

Or we get a yearly Covid shot, just like the flu.  And Covid levels are down at flu levels.

[TheDrake]

It must be very frustrating for people like Scott who would prefer the Great Purge where everybody gets as sick as they can, as fast as they can, many dying without hospital care.

As for economic incentive, a $3000 course of remdesivir is a pretty good one for pharma also. We're right in the sweet spot for vaccines, huge recurring client base. If everybody gets vaccinated that cash cow gets diminished.

[msquared]

Also, those drugs are for treating the disease not preventing it. Which is better: Peventing or "curing" after you get it?

[Lloyd Perna]

It must be very frustrating for people like Scott who would prefer the Great Purge where everybody gets as sick as they can, as fast as they can, many dying without hospital care.

As for economic incentive, a $3000 course of remdesivir is a pretty good one for pharma also. We're right in the sweet spot for vaccines, huge recurring client base. If everybody gets vaccinated that cash cow gets diminished.

That's a gross mischaracterization of what Scott has been saying.  But sadly, that has become the norm on this Forum.

[Crunch]

It must be very frustrating for people like Scott who would prefer the Great Purge where everybody gets as sick as they can, as fast as they can, many dying without hospital care.

As for economic incentive, a $3000 course of remdesivir is a pretty good one for pharma also. We're right in the sweet spot for vaccines, huge recurring client base. If everybody gets vaccinated that cash cow gets diminished.

That's a gross mischaracterization of what Scott has been saying.  But sadly, that has become the norm on this Forum.

Trump really broke these people.

[TheDrake]

I'll be happy to go back to scotts quotes to support my characterization, but sadly I doubt that it would make any difference in the absence of objective evaluation.

[Lloyd Perna]

Thank you - yes. My position is that high-risk people should be encouraged to vaccinate in the strongest terms - but not forced.

Healthy, young people should vaccinate only if they feel it's the best decision for them, which would most likely be for psychological and mental health reasons.

It now seems apparent that the main benefit to the vaccine is not getting sick, or having mild symptoms when infected. It does not appear to have a dramatic effect on transmissibility.

So if you're worried about getting deathly ill from Covid or just want to "feel safer", vaccinate early and often. If not, carry on.

Here is Scott's summarizing his position.  How do you get from there to he wants "everybody gets as sick as they can, as fast as they can, many dying without hospital care"

Please, provide quotes or admit you were wrong to attack Scott so unfairly.

[TheDrake]

"We're not going to be able to vax, mask or distance our way out of this, and it's not simply because of non-compliance.

Everyone will eventually need to get exposed to Covid, just like the flu. Vaccinations and natural immunity will protect the vast majority of people from severe illness, just like the flu. New mutations will happen no matter what but will be less dangerous than the original."

Everyone has to get exposed and the susceptible people, by definition, will be purged. Each of the above measures are designed to slow the spread, putting the two together suggests we also aren't putting a premium on "flattening" measures.

"People at high risk should get vaccinated. It's sad whenever anyone suffers needlessly. The idea that these two facts somehow turn into a movement requiring everyone to get vaccinated is asinine and anti-science."

This does refute my characterization that everybody get sick. He does suggest that people at high risk, as defined by him, should get vaccinated.

"This is highly unconventional, but maybe instead of reconstructing how and when humans gather, we should focus on helping fat people getting less fat and let our immune systems do their thing."

Don't slow down spread through social distancing, let's just see where the chips fall as people get infected based on their immune system. Fat blaming strongly suggests that they deserve to be purged.

Aggressively supporting reopening as early as June 2020, prior to vaccination. All of this adds up, to me, an indifference at best to the speed or magnitude of covid infections, especially when coupled with unfounded assertions that natural immunity is superior to vaccination.

[Lloyd Perna]

You failed.

[ScottF]

Fat blaming strongly suggests that they deserve to be purged.

Pointing out that fat people constitute the vast majority of the covid hospitalized and dead is called data analysis, not "fat blaming".

I suspect the word "fat" is potentially triggering to a lot of folks and makes it more difficult to have pragmatic dialogue. In the future I'll switch to obese or overweight if it helps remove some of the emotion.

I also believe smokers should be encouraged to stop smoking, as they are over-represented in fatal lung cancer cases. Should that also be interpreted as my tacit approval for them to be "purged"?

[TheDrake]

Fat blaming strongly suggests that they deserve to be purged.

Pointing out that fat people constitute the vast majority of the covid hospitalized and dead is called data analysis, not "fat blaming".

I suspect the word "fat" is potentially triggering to a lot of folks and makes it more difficult to have pragmatic dialogue. In the future I'll switch to obese or overweight if it helps remove some of the emotion.

I also believe smokers should be encouraged to stop smoking, as they are over-represented in fatal lung cancer cases. Should that also be interpreted as my tacit approval for them to be "purged"?

Except that several people pointed out that obesity is not a major factor in either hospitalization or death, but you refuse to acknowledge that. Or accept that anyone should lift a finger to help prevent the spread of the disease to those people.

[ScottF]

Except that several people pointed out that obesity is not a major factor in either hospitalization or death, but you refuse to acknowledge that.

I acknowledge that someone posted statistics that indicated obesity is an overwhelming factor in hospitalization and deaths and then proceeded to spin why those data didn't really mean what they indicated.

If you would honestly tell an obese person that statistically they're at no greater risk of hospitalization or death (of ANY cause) than a healthy-weight person, you should be ashamed of yourself.

Or accept that anyone should lift a finger to help prevent the spread of the disease to those people.

You're trapped in a cycle of poor mind-reading.

[Wayward Son]

So, in other words, you do data analysis, but very badly, so as to come the conclusions you want them to be.  Then accuse everyone else of "spinning."

Again, when 76 percent of everyone is fat, it is NOT indicative that fat people are more susceptible to Covid if 78 percent of those in the hospital are fat.  It's called the expected number if it had nothing to do with being susceptible or not.

I won't read your mind.  Explain to me why you can't understand something that simple in data analysis if it isn't because you don't want to. 

[TheDrake]

It's not even so much about whether obesity is a factor, you can find various sources that are credible at various stages of the pandemic stating as much.

I will ask scott flat out whether he thinks anyone should base masking, vaccinating, distancing on anything other than their own personal safety, or the safety of people that they know personally? Maybe I'm wrong, and he does think people should lift a finger to help others and I missed something that indicates that.

His approach to obesity appears to be telling people to lose weight, not to assist them with that process in any way. Again, I apologize if I missed something he said that suggests otherwise.

[LetterRip]

Looks like there is definitely a valid case for boosters among certain subpopulations, very interesting thread quoting the USCF Chair of the Dept of Medicine.  Worth reading the whole thing,

“... I’m double masking (cloth/surgical). No more indoor dining, & sadly no more poker w/ vaxxed pals. I’ll peel off protections as cases fall, particularly after my booster. You’ll make your own choices, but don’t underestimate Delta. As the CDC said, it’s a new war.”

“…anything other than universal indoor masking is simply bonkers”

Speaking of being unprotected, the next battleground will be over boosters. So much of Covid has pitted individual rights/choices vs. community need. There now seems little doubt that 4 groups will need boosters to deal w/ waning or inadequate immunity from vaccines:... (10/25)

a) Immunocompromised; b) Elders (?age); c) vax w/ J&J; & d) vaxxed >6 mths ago. My read of evidence: it would be reasonable to offer boosters to all 4 groups today – if the only issue was risks vs benefits to them as individuals. But as Dr. Ellie Murray explained, as a society… (11/25)

https://coronavirus.quora.com/Bob-Wachter-Chair-UCSF-Dept-of-Medicine-on-Twitter-I-m-double-masking-cloth-surgical-No-more-indoor-dining

[cherrypoptart]

Broken record time but stories like this really bring the point home.

https://news.yahoo.com/us-now-averaging-100-000-055607136.html

"FORT LAUDERDALE, Fla. (AP) — The COVID-19 outbreak in the United States crossed 100,000 new confirmed daily infections Saturday, a milestone last exceeded during the winter surge and driven by the highly transmissible delta variant and low vaccination rates in the South."

The media won't say it in any of their dangerous covid misinformation propaganda they're putting out (with their vaccine only approach that barely if ever mentions masks) so I will. Again.

One thing doesn't add up. They keep saying vaccination rates are too low but one fact that they don't want to admit is that more people are vaccinated every day than there have ever been.

"It took the U.S. about nine months to cross 100,000 average daily cases in November before peaking at about 250,000 in early January. Cases bottomed out in June, averaging about 11,000 per day, but six weeks later the number is 107,143."

So we had 11k per day in June and now we have over 107,000. Are fewer people vaccinated now than in June? We are averaging more cases today than we were way back in November. Were more people vaccinated back in November? No, not likely. Not even possible.

So what changed if it wasn't fewer people being vaccinated?

Well, Biden and his lapdogs at the CDC decided to make a totally political call based on no science whatsoever to take a victory lap and declare a big win and said it was safe for people to take their masks off, that's what happened. Vaccinated people supposedly but with a so called honor system anyone in their right mind knew meant a free for all.

So still nobody is calling them on it. Nobody except me. We're experiencing this man-made disaster right now because of that one call.

And I support the CDC going back to recommending masks even for the vaccinated but it's too little and too late. Obviously too late but better late than never. And too little because it's ridiculous that they are saying it only applies to areas with surges. That's dumb it should apply everywhere just like it did when we had 10x fewer cases than we are getting right now.

The word mask is in that story only once and it's in reference to DeSantis. Sure call him out on it that's fine but the White House and the CDC need to be called out too because they aren't much better.

[Mynnion]

I was extremely disappointed with the dropped mask mandate when the CDC announced it.  I think it was stupid to believe that the non-vaccinated would rush to get vaccinated if they could go maskless rather than just ignore the "IF" vaccinated portion of the recommendation.  I do hold them partially responsible for the current uptick however comparing that decision to DeSantis is off by an order of magnitude.  If those who were unvaccinated had followed the guidance things would be better.  With DeSantis he is actually mandating against masks.  Not the same thing.

The other reason for the massive rise is Delta which is at least an order of magnitude more contagious.

We gat that you are Pro-Mask.  I believe most of us are.  We are extremely cautious as a family.  Probably because most of us work in healthcare.  It does seem a little disingenuous that you continue to compare the failures of the GOP (anti-vax, anti-mask, fake virus, mild virus, anti mask prevaccine, blocking masks) with the failures of the current administration (optional masks when vaccinated revised to masking although still weak).

I will also fault the Dems for the manner in which they handled the early pandemic.  Knowing Trump if they had stroked his ego rather than attack him on COVID I think he could have been convinced to play the hero and use his platform to promote positive behavior rather than fight it.  Just a guess but both sides making COVID a medical issue a political one would have drastically reduced past and future infections.

[LetterRip]

One thing doesn't add up. They keep saying vaccination rates are too low but one fact that they don't want to admit is that more people are vaccinated every day than there have ever been.

There is something called 'herd immunity' - where the Ro for a virus drops below 1 because so many of the people have been vaccinated or have developed natural immunity from having been infected.  Once you have an Ro below 1, the number of infected people steadling drops without any further containment effort, with an Ro > 1 the number of infected continue to grow unless there is containment effort.  For the original COVID-19 - R was 2-4, for Alpha it was 3-5, for Delta it is 8-10.  The number of vaccinated for herd immunity depends on the initial Ro.  The formula is 1 - 1/Ro_initial.  So for Alpha Herd immunity required between  1-(1/3) and 1-(1/5) or 67%-80% of people vaccinated/immune.  For Delta  it is 1-(1/8) to 1-(1/10) so between 87.5% and 90% of people need to be vaccinated/immune before we reach herd immunity.

Herd immunity thresholds also depend on vaccine efficacy and how efficacy changes over time.  The above calculations assume 100% efficacy.  The lower the efficacy and the greater the drop in efficacy over time, the greater the percentage need to be vaccinated.

The 'effective R' drops significantly the more people are vaccinated even before herd immunity - so .  Also you can have 'local herd immunity'.  So a city with extremely high vaccination rates might be effectively herd immune, even if the rest of the country isn't.

So vaccination is the single most important thing a person can do, masking is useful and should be done also - particularly by the unvaccinated.

So we had 11k per day in June and now we have over 107,000. Are fewer people vaccinated now than in June? We are averaging more cases today than we were way back in November. Were more people vaccinated back in November? No, not likely. Not even possible.

So what changed if it wasn't fewer people being vaccinated?

If you look at the graph of cases from last July, there is a peak then as well - .  It is a combination of hot weather driving people indoors and 4th of July celebrations.  This year though we also have Delta.

That is the power of exponential growth - Delta is to the 10th power,  Alpha was to 4th power, original was to the 2nd power.

in 5 generations of delta starting with 10 people -  100, 1000, 10000, 100000, 1000000.
in 5 generations of alpha starting with 10 people - 40 160 640 2560 10240

With delta within a few seconds of hanging around someone you can likely catch it.  (There is video footage of someone who the only contact they had was walking by another individual)
With alpha you have to typically hang around a person for 10-15 minutes.

Well, Biden and his lapdogs at the CDC decided to make a totally political call based on no science whatsoever to take a victory lap and declare a big win and said it was safe for people to take their masks off, that's what happened. Vaccinated people supposedly but with a so called honor system anyone in their right mind knew meant a free for all.

CDC followed the science at that time - the evidence showed that vaccinated people had extremely little chance of catching or spreading COVID and so VACCINATED PEOPLE could safely go unmasked.  Certain idiotic governors banned mask or vaccination requirements entirely and many unvaccinated people decided to go unmasked.  It is still pretty safe for VACCINATED PEOPLE to go unmasked.  If ONLY VACCINATED PEOPLE went unmasked there would be essentially no spread.

So again it is only the UNVACCINATED CHOOSING TO GO UNMASKED - that is causing the spread.

And I support the CDC going back to recommending masks even for the vaccinated but it's too little and too late. Obviously too late but better late than never. And too little because it's ridiculous that they are saying it only applies to areas with surges. That's dumb it should apply everywhere just like it did when we had 10x fewer cases than we are getting right now.

The goal is is to keep community spread to the levels where it doesn't overwhelm hospitals.  Places with high vaccination rates should have low community spread, and thus have little need for reinstating mask mandates.

That said - the CDC should probably recommend based on community spread and vaccination rate.

[cherrypoptart]

Our governor in Texas is a massive disappointment. I was very pleased when relatively early on he went to a statewide mask mandate. That made a huge difference and cases came way down. Now he's gone not full DeSantis, but at least half DeSantis. I don't think he's going anti-mask but rather mostly leaving it up to locals and businesses to decide for themselves. Better than DeSantis but obviously not good enough. If Matthew McConaughey runs I'd be inclined to vote for him over the guy we have now, depending on a lot of other things. I don't think I'd make the masks a single issue issue but it'd be up there. I'm actually staying out of businesses more now just because people are not wearing masks. I wonder how much of that there is. I bet there are many more people avoiding going into dangerous maskless areas than there are that avoided them because they had to wear a mask.

[Mynnion]

I have regularly given blood and platelets my entire adult life.  2020 was an exception because of a significant accident that almost killed me.  I gave platelets again last week and was exceptionally disappointed that the Red Cross was not requiring masks for employees or donors.  I won't be donating again until that policy changes or COVID is behind us.  It is frustrating that an organization focused on health doesn't follow the current CDC guidelines.

[cherrypoptart]

"The goal is is to keep community spread to the levels where it doesn't overwhelm hospitals.  Places with high vaccination rates should have low community spread, and thus have little need for reinstating mask mandates."

That's their goal and it's shortsighted. The goal should be to reduce the opportunities the virus has to mutate into and spread a much more dangerous variant.

[TheDrake]

"I don't think he's going anti-mask but rather mostly leaving it up to locals and businesses to decide for themselves"

Local what? Not county, municipal, or school district. He's actively preventing them from deciding for themselves. That goes for employees as well as the general public.

[cherrypoptart]

It's not surprising that he's even worse than I give him credit for then. I hope we don't get a variant that makes everything so much worse but so far hoping has been ineffective just like our government.

[LetterRip]

That's their goal and it's shortsighted. The goal should be to reduce the opportunities the virus has to mutate into and spread a much more dangerous variant.

You misunderstand, preventing mutations is only possible with vaccination - if we get the Ro close to 1 with vaccination then masking might help push it over the edge.  Masking only somewhat delays variants - as long as you are unvaccinated you are essentially guaranteed to catch the delta variant of COVID-19 given how easily it spread.  For a virus with a low Ro you could eliminate variants by simply hygiene and personal protective equipment measures, but with this high an Ro it slows it but is unlikely to stop it.

[msquared]

71% over 18 with at least one shot as of yesterday. That is a whole 1% in less than a week. This is about the level we were back in April/May.  Hopefully the FDA will give full approval soon and this trend will continue, especially when the military and hospitals require the shot, as well as other companies.

[LetterRip]

I should clarify my statement above, since there is a nuance that should be mentioned even though it doesn't change the policy recommendations, etc much.

Masking of vaccinated individuals - while not reducing the mutation rate, does reduce the opportunities for 'selection'.  However, the benefit of reducing selection is proportional to the exposure volume.  The exposure volume during outings to the grocery store, etc. are relatively low - almost all of the exposure volume will be during things like being around infected family, boyfriend, house/roommates, and friends; or being in loud venues for extended periods, being at work, etc.  Since vaccinated people are generally not going to cut off all interaction with their family and housemates - the reduction in volume of exposure from being unmasked at a store is relatively trivial.  An infected family member for 2 weeks - and assuming you are at home 14 hours a day (sleep + meals and leisure time) = 14*14 =  196 hours of exposure.  The viral load exposure from a 10 minute shopping trip, will typically only have you in range of the infected person for up to 60 seconds.  assuming you go shopping 2 times a week then during a 3 month period or so - you will get 11760 minutes of exposure due to one infected family member; and 1 minute/trip * 2 trips/week * 4.5 weeks/month * 3 months = 27.  So 1/436th of your exposure will come from shopping.  However that isn't weighted for total virus in the air - a sick person at home will result in far higher concentrations of viral load - so it is more like 1/10,000th of viral load exposure will be from strangers during shopping trips.

So it really is negligible.  Now if you are going to bars/karaoke/choir practice/working out - etc. then absolutely strangers are a high source of viral load exposure - and everyone should wear masks in those venues - but in reality - those venues should be shut down until the pandemic is under control or changed to 'vaccine passport'.

[Fenring]

Now if you are going to bars/karaoke/choir practice/working out - etc. then absolutely strangers are a high source of viral load exposure - and everyone should wear masks in those venues - but in reality - those venues should be shut down until the pandemic is under control or changed to 'vaccine passport'.

What do you personally think is the optimal choice for events like these, maybe especially working out? There is a parallel problem in play at the same time as the issue of who will and won't vaccine, which is how long to do the people who have been dutifully complying just finally say enough is enough and stop trying. Putting aside whether some people are to blame for this morale issue, in terms of actual policy I wonder whether it's tenable even in the medium term to both expect and ask for mask-wearing at places like the gym. One can endure the 'war-zone' mentality for only a limited time, I suspect, before it becomes psychologically untenable. The viral danger actually becomes less and less relevant in the face of psychological breakdown and/or morale failure, where "can I do this any more" trumps "should I do this any more". But just as troubling as it is to request or require mask-wearing in highly inconvenient locations (wearing a mask when singing professionally, for instance, is absurd on a basic level), shutting down places like gyms or singing in places of worship even in the medium term may be more troubling. Which leaves vaccine passports, as unsavory as that sounds. So how would you legislate this if you could?

[LetterRip]

What do you personally think is the optimal choice for events like these, maybe especially working out?

Personally I'd only go early mornings if possible
1)  Hopefully most of the virus will have died overnight or been cleared away by the ventilation, or killed by any cleaning
2) Low density of people at that time of day
3) Early people tend to be doing the same strategy - avoid people

I'd avoid anything near stuff where people breath heavily and explosively.  (Some people breath explosively on lifts, others don't; some people are balls to the wall on cardio equipment, others aren't).
If at all possible I'd workout outdoors.
I'd wear a mask and glasses at all times - try to wipe sweat from my face without touching my face (such as using a towel or hem of my shirt).

For singing/karaoke - I don't think there is a good strategy - stay as far away from the stage as possible.

For bars - try venues that have an outdoor section, try to get a table for your group in the outdoors section as far away from others as possible.  If there is an air circulating fan that aims from outside the venue towards the venue - try to position yourselves in front of the fan so that the patrons are downwind of you.

But just as troubling as it is to request or require mask-wearing in highly inconvenient locations (wearing a mask when singing professionally, for instance, is absurd on a basic level)

You don't have to be in the spit zone to enjoy a singer.  Outdoor workouts are quite safe, but of course many places only have indoor equipment.

, shutting down places like gyms or singing in places of worship even in the medium term may be more troubling. Which leaves vaccine passports, as unsavory as that sounds. So how would you legislate this if you could?

Not sure.  Have to give it some thought.

[cherrypoptart]

There's an argument that I've seen smarter people than me allude to about the vaccinated people being the worst ones you want the virus in and giving it the chance to mutate.

As you say, nuance is important. The unvaccinated have a greater chance of producing a vaccine resistant mutation just because the virus has more chances to mutate in them but... that vaccine resistant mutation wouldn't necessarily have a competitive advantage in the unvaccinated so wouldn't be as likely to do better than non-mutated versions whereas if a vaccine resistant mutation occurs in a vaccinated person it has a definite competitive advantage so will be the one that multiplies in that person and then spreads among other vaccinated people especially if they think they are safe amongst each other and not wearing masks.

The vaccines help a lot but should be a backup in case masks, ventilation, social distancing, and other preventative measures fail. Thinking that vaccines are the end game with a virus mutating this fast courts disaster.

[Fenring]

Thanks for the answers, LR, but just as a small clarification, I was more asking what do you suggest society do about these types of venues, rather than what would be your personal strategy (i.e. for working out). For example, having a choir in temple masked is essentially silly, since the actual necessary element in the choir sound is...the sound. And especially its integrity and tone if the choir is any good. Muffle that and you may as well eliminate the choir (to say nothing of how insane it is to sing in a mask, which I can attest to). It's highly demoralizing to try to engage in such activities masked, so IMO a solution is needed that goes beyond the short-term warzone "we can tough it out" mentality. A real medium or long-term solution needs to be found that does not involve masks. Aside from the fact that it's non-functional in many cases, I don't think people will put up with it for long no matter what the CDC advocates for.

[yossarian22c]

Mass vaccination or mass sickness and death are the other options if people won't put up with masks and other mitigation strategies distancing.

[Fenring]

Mass vaccination or mass sickness and death are the other options if people won't put up with masks and other mitigation strategies distancing.

You shouldn't misconstrue "won't put up with" as meaning "don't care what anyone says" when I suggested it here. I actually mean they fully want to comply, and at a certain point won't be able to put up with it anymore, which is why I called it morale failure.