I feel like we're in the "gaslighting" phase of the pandemic. The "it's over" narrative is predominant, with the aid of the CDC. Personally, I've never felt more at risk. I don't see a positive solution to this public health pandemic preparation or even in managing the current pandemic. The calvary isn't coming, we're on our own. And that is very, very scary.
J'accord. Even political leaders who have exercised good discipline in this pandemic are going to find it very difficult to reimpose mandates if ba.2 causes a massive increase in infections as it is likely to do in various locales.
I sincerely hope that you consider a job in the government where we could sorely use you. Maybe a high ranking job at that. My preference would be a 'lessons learned, what worked/what didn't" advisory group. Until then, man the watchtowers for us, it likely won't be even 25 years before the next big one strikes.
This is great. I'm glad to see you talking about how we cannot directly compare ourselves to other countries. I've been looking at other countries' average age, obesity rates and %vaccinated. UK comes the closest to all three. But as you point out, we're the only one without a national health service. Since July of last year, we've had DOUBLE the hospitalizations and deaths compared to the UK for each wave. I wonder why the news acts as if we're somehow immune to new variants and waves we see in the EU? American exceptionalism at work?
What are the current theories why the strategies used in 2020 have stopped working in 2022 for Vietnam, South Korea, Hong Kong, New Zealand, etc?
I'm reading the article about Vietnam from March 2021 you linked (https://ourworldindata.org/covid-exemplar-vietnam), and by hindsight it reads like a propaganda piece (which is fine, propaganda can be negative or positive, and we expect governments to push propaganda that presents them favorably and effective).
It goes on about how wonderful they are at contact tracing, testing, confinement, etc - but if that were the case, why did that strategy fail now? Did they get bad at contact tracing? Did doing more tests make things worse?
Why not consider another hypothesis: these measures only appeared to work because they were performed in island nations which were able to close their borders (with the DMZ South Korea is effectively an island)
That would explain the following problems with the dominant theory:
1) Why contact tracing, mass testing, lockdowns, failed to replicate anywhere that wasn't an Island (See: Germany for example, another instance where we praised contact tracing when it appeared to work [1], but since then we leave them out of the examples of "doing it right")
2) How these contact tracing programs could appear to work when by hindsight they were based on an incomplete understanding of how the virus behaves (i.e., early thinking focused on droplet transmission over airborne, using the wrong type of masks, fomite transmission, not realizing how far the virus could travel, etc) - for example, we didn't know in early 2020 that the virus could travel up through an HVAC system and infect another person in <5 minutes [2], so it seems unlikely that the contact tracing model was accurate. Consider the Vietnam contact trace model defined close contacts as "people within 6 feet or 30 minutes contact" - assumptions we know are incorrect.
3) Why South Korea had 10,000-15,000 excess deaths in 2020 despite only recording <1,000 Covid deaths [3], and another 15,000 excess deaths in 2021.
4) Why these countries receive so much praise for testing when in fact they had among the lowest testing rates in the world until their cases started skyrocketing in 2022 [4] - consider the Vietnam article noted above, where they proudly note " Between July 23 and September 24, more than 700,000 tests were conducted" - yet during the same time period the US was doing ~900K tests per day. Even scaling for population (US is roughly 3.4x Vietnam), the US did nearly 20x the tests than Vietnam. (South Korea in that same 63 day time span probably did ~500K tests)
I feel like we are letting our faith in these measures cloud our judgment, and we stopped being disinterested and neutral.
If something works, then it works. It can be replicated. I am increasingly seeing a pattern where we are always crediting these various measures when things go well, and then giving excuses for them when things go badly. It reminds me of prayer. It can't be falsified.
Thanks Katelyn. I often think about other countries who have had similar past experiences and should in theory have had a comparable response to SARS-CoV-2 (particularly other East Asian countries). I'd be curious to see some kind of similar analysis where THOSE countries are compared to Vietnam and SK. I don't believe we have enough unity in this country to ever learn from this disaster and be able to execute meaningful change. I would love to be proven wrong though.
Thanks for the link! It's definitely morbidly entertaining. I wonder what China, Japan, and Vietnam did that was different than SK. I honestly have no idea. I'm so burned out from keeping track of everything for League of Science Superfriends and keeping friends and family informed, I needed a mental health break while the US is in more of a yellow zone (which is about to change again). These days I'm barely reading anything except YLE.
Thank you for doing this so regularly....you provide pertinent, succinct info, giving the global perspective. It is VERY much appreciated!!! A hospital medical director
Thanks for that post. Wasn’t there a pandemic response that was part of homeland security after the H1N1 epidemic? I think it was removed a few years before the Covid 1 epidemic began?
Yup, and I benefited mightily from it in 2009. Easy access to Tamiflu for me and everyone I lived with (I was the only one who actually got sick, my doc prescribed it for the whole family as prophylaxis)
A few weeks later I got a temp job at the state health department's call center for H1N1.
Adding: my personal experience with swine flu in 2009 is leaving me rather dissatisfied with the "test to treat" approach as a sustainable, optimal strategy. I was never tested in 2009, but the proof was in the pudding: the meds worked, so whether or not I had H1N1 or some other strain was irrelevant, and testing would have cost precious time (I was very ill, and symptom onset was sudden). I was presumed to have H1N1 based solely on symptoms (including a chest X-ray which revealed a hot mess) and community prevalence. I should hope that we ultimately pivot to this approach, especially if Paxlovid turns out to be an effective treatment for most viruses in the "picornavirus-like supercluster".
Dear Katelyn - Regarding the projected uptick in C19 infections, I found that the John's Hopkins projections are significantly higher than the IHME, for example, for Switzerland for March and April 2022, and the IHME Covid Switzerland projections don't appear to show a significant uptick. Can you explain the discrepancy or why you prefer to use the Johns Hopkins numbers over IHME. Thanks very much.
Wonderful work, Katelyn-thank you! Question: Do we understand the biology part of why the case-fatality rate for MERS and SARS-CoV-1 was much higher than for SARS-CoV-2? And did these earlier pathogens also cause "long" MERS or SARS? Seems that whatever the (biology part of the) reason would lead to insights about how infection with SARS-CoV-2 works, and how our immune system functions (or dysfunctions)...
I feel like we're in the "gaslighting" phase of the pandemic. The "it's over" narrative is predominant, with the aid of the CDC. Personally, I've never felt more at risk. I don't see a positive solution to this public health pandemic preparation or even in managing the current pandemic. The calvary isn't coming, we're on our own. And that is very, very scary.
"gaslighting" perfect explanation
J'accord. Even political leaders who have exercised good discipline in this pandemic are going to find it very difficult to reimpose mandates if ba.2 causes a massive increase in infections as it is likely to do in various locales.
Appreciating these wider scope reports. Thank you!
I sincerely hope that you consider a job in the government where we could sorely use you. Maybe a high ranking job at that. My preference would be a 'lessons learned, what worked/what didn't" advisory group. Until then, man the watchtowers for us, it likely won't be even 25 years before the next big one strikes.
This is great. I'm glad to see you talking about how we cannot directly compare ourselves to other countries. I've been looking at other countries' average age, obesity rates and %vaccinated. UK comes the closest to all three. But as you point out, we're the only one without a national health service. Since July of last year, we've had DOUBLE the hospitalizations and deaths compared to the UK for each wave. I wonder why the news acts as if we're somehow immune to new variants and waves we see in the EU? American exceptionalism at work?
What are the current theories why the strategies used in 2020 have stopped working in 2022 for Vietnam, South Korea, Hong Kong, New Zealand, etc?
I'm reading the article about Vietnam from March 2021 you linked (https://ourworldindata.org/covid-exemplar-vietnam), and by hindsight it reads like a propaganda piece (which is fine, propaganda can be negative or positive, and we expect governments to push propaganda that presents them favorably and effective).
It goes on about how wonderful they are at contact tracing, testing, confinement, etc - but if that were the case, why did that strategy fail now? Did they get bad at contact tracing? Did doing more tests make things worse?
Why not consider another hypothesis: these measures only appeared to work because they were performed in island nations which were able to close their borders (with the DMZ South Korea is effectively an island)
That would explain the following problems with the dominant theory:
1) Why contact tracing, mass testing, lockdowns, failed to replicate anywhere that wasn't an Island (See: Germany for example, another instance where we praised contact tracing when it appeared to work [1], but since then we leave them out of the examples of "doing it right")
2) How these contact tracing programs could appear to work when by hindsight they were based on an incomplete understanding of how the virus behaves (i.e., early thinking focused on droplet transmission over airborne, using the wrong type of masks, fomite transmission, not realizing how far the virus could travel, etc) - for example, we didn't know in early 2020 that the virus could travel up through an HVAC system and infect another person in <5 minutes [2], so it seems unlikely that the contact tracing model was accurate. Consider the Vietnam contact trace model defined close contacts as "people within 6 feet or 30 minutes contact" - assumptions we know are incorrect.
3) Why South Korea had 10,000-15,000 excess deaths in 2020 despite only recording <1,000 Covid deaths [3], and another 15,000 excess deaths in 2021.
4) Why these countries receive so much praise for testing when in fact they had among the lowest testing rates in the world until their cases started skyrocketing in 2022 [4] - consider the Vietnam article noted above, where they proudly note " Between July 23 and September 24, more than 700,000 tests were conducted" - yet during the same time period the US was doing ~900K tests per day. Even scaling for population (US is roughly 3.4x Vietnam), the US did nearly 20x the tests than Vietnam. (South Korea in that same 63 day time span probably did ~500K tests)
I feel like we are letting our faith in these measures cloud our judgment, and we stopped being disinterested and neutral.
If something works, then it works. It can be replicated. I am increasingly seeing a pattern where we are always crediting these various measures when things go well, and then giving excuses for them when things go badly. It reminds me of prayer. It can't be falsified.
[1] https://www.bmj.com/content/369/bmj.m2522
[2] https://www.washingtonpost.com/food/2020/12/11/korean-restaurant-coronavirus-airflow-study/
[3] mortality.org shows 309K deaths in South Korea in 2020, when projections would have placed deaths between 287K and 301K.
[4] https://ourworldindata.org/coronavirus/country/vietnam#how-many-tests-are-performed-each-day
Thanks Katelyn. I often think about other countries who have had similar past experiences and should in theory have had a comparable response to SARS-CoV-2 (particularly other East Asian countries). I'd be curious to see some kind of similar analysis where THOSE countries are compared to Vietnam and SK. I don't believe we have enough unity in this country to ever learn from this disaster and be able to execute meaningful change. I would love to be proven wrong though.
Jillian, if you haven't already, it is extremely interesting to pick and choose countries and compare cases, hospitalizations and deaths. https://ourworldindata.org/explorers/coronavirus-data-explorer?zoomToSelection=true&time=2020-03-01..latest&facet=none&pickerSort=asc&pickerMetric=location&Metric=Confirmed+cases&Interval=7-day+rolling+average&Relative+to+Population=true&Color+by+test+positivity=false&country=USA~GBR~CAN~DEU~ITA~IND
Thanks for the link! It's definitely morbidly entertaining. I wonder what China, Japan, and Vietnam did that was different than SK. I honestly have no idea. I'm so burned out from keeping track of everything for League of Science Superfriends and keeping friends and family informed, I needed a mental health break while the US is in more of a yellow zone (which is about to change again). These days I'm barely reading anything except YLE.
Same, two years of doing this full-time was not all that great for life balance. I feel a coming need to re-engage though.
I absolutely agree. My hope is that by shutting up at strategic times, people will trust me when I start speaking up again.
Nice - thank you
Thank you for doing this so regularly....you provide pertinent, succinct info, giving the global perspective. It is VERY much appreciated!!! A hospital medical director
Thanks for that post. Wasn’t there a pandemic response that was part of homeland security after the H1N1 epidemic? I think it was removed a few years before the Covid 1 epidemic began?
Yup, and I benefited mightily from it in 2009. Easy access to Tamiflu for me and everyone I lived with (I was the only one who actually got sick, my doc prescribed it for the whole family as prophylaxis)
A few weeks later I got a temp job at the state health department's call center for H1N1.
Adding: my personal experience with swine flu in 2009 is leaving me rather dissatisfied with the "test to treat" approach as a sustainable, optimal strategy. I was never tested in 2009, but the proof was in the pudding: the meds worked, so whether or not I had H1N1 or some other strain was irrelevant, and testing would have cost precious time (I was very ill, and symptom onset was sudden). I was presumed to have H1N1 based solely on symptoms (including a chest X-ray which revealed a hot mess) and community prevalence. I should hope that we ultimately pivot to this approach, especially if Paxlovid turns out to be an effective treatment for most viruses in the "picornavirus-like supercluster".
Dear Katelyn - Regarding the projected uptick in C19 infections, I found that the John's Hopkins projections are significantly higher than the IHME, for example, for Switzerland for March and April 2022, and the IHME Covid Switzerland projections don't appear to show a significant uptick. Can you explain the discrepancy or why you prefer to use the Johns Hopkins numbers over IHME. Thanks very much.
Wonderful work, Katelyn-thank you! Question: Do we understand the biology part of why the case-fatality rate for MERS and SARS-CoV-1 was much higher than for SARS-CoV-2? And did these earlier pathogens also cause "long" MERS or SARS? Seems that whatever the (biology part of the) reason would lead to insights about how infection with SARS-CoV-2 works, and how our immune system functions (or dysfunctions)...