Thank you for including the side-by-side maps of the old/new color-coding system from the CDC. I wonder if you would consider talking more in a newsletter about the changed coding systems (especially as covidactnow.org has now also aligned with the new CDC guidelines). This is not my field, so I do find it a bit overwhelming. I appreciate good data and felt like I had a handle on which numbers to watch and what they meant. Now, I feel like everything is upside down and I'm not sure what to look at and what numbers to starting thinking about mask vs no-mask, for example. I could use help establishing a new baseline and understanding of what the current levels and shared data mean for me as an individual.
So, we are no longer in 2020 mode, nor the original Omicron flood stage, thunderstorm mode, but are living in the constant drizzle mode.
As, community masking has largely become unsustainable, and one-way masking become the rule, maybe a refresher on masking and indoor air quality is in order?
Also, anyone know of any organized indoor air quality advocacy groups?
FWIW, I have written my local government asking what they doing to insure indoor air quality in commercial buildings with they White House guidance as reference. No response yet.
Yes, I feel like this is an area that has been largely ignored, especially by schools (at least in my district). But it is more sustainable. Most people are not going to want to stay masked, distanced, or away from crowded events. And the air quality/filtration has so many other benefits beyond COVID.
Thank you again, as always, Dr. Jetelina. Has any of this changed your recommendation for a second booster for those of us who are high risk but not in the CDC’s moderate-severe immunocompromised category? I’m working directly with the public (in my own N95 and doing my best with portable HEPA air purifiers and distancing when possible) but I’m now 7 mos. out from my booster and getting really worried.
It would be great to see some regualar comparisions of long term death rates from flu versus recent periods of deaths from Covid, i.e.3 mos., 6 mos. etc. Is that possible?
Thank you again! You’re my go to! I’m curious about any updates around T and B cell protection and vaccine durability and if anyone has looked at the degree of individual variability around lasting protection? Unlike the measles vaccine which seems to have pretty universal durability I’ve heard (anecdotally) that RNA vaccines may be more susceptible to individual variability.
Thank you, another well written article. Some general observation
Simply reporting the change in the number of reported events (covid positive – infected, serious illness, visit to hospital, short stay in the hospital, long stay in the hospital, long covid, death) as a percentage of the number of events from a prior time period – the growth rate – isn’t helpful in assessing risk. If the number of events was 1 in 10,000,000 and goes to 5 in 10,000,000 that is a 5-fold increase – but not a substantial change in my changes of getting this event.
Typically, if one assumes some type of exponential growth rate, then this early take off can be projected to be “serious” risk and health care workload numbers. However, as we saw with omicron there are boundary conditions that limit growth. The challenge is estimating the future pattern, not reporting on the transaction data that we have been able to collect in a manner unacceptable to anyone during precision manufacturing.
The same challenge applies to classifying a variant as having a “fast spread rate” simply based on data. This is what analytics folks call a data driven disaster. The first question is “why” does the variant appear to have “faster” spread numbers at this point in time. If I isolated everyone, the spread would end. The variant doesn’t travel 3 miles by uber to knock at a door and infect this person. The second question is what the limiting factor is. Omicron burst on the scene, based on the data reported infected 50% of the population, then stopped? What about the other 50%.
I would content the true challenge is in understanding the cellular mechanisms. For example, how do we help children with long covid.
Just chiming in that you seem to write exactly the article I need the same day or week I need it to advise my organization. Your indirect reach is better than you might think.
Thanks for your great post. Here’s another theory as to why cases might be undercounted: as the virus continues to mutate, tests are less capable of detecting infection. Hopefully the CDC or somebody is keeping track of this.
And an anecdote: a friend (vaxed, single boosted) returns Friday from a trip to the northeast (NY, DC) and wakes up on Saturday with Covid symptoms (day 0, right?). Takes home test on day 0, result is negative. Takes PCR test on Sunday (day 1?), still negative. Assumes she has the flu, because PCR is gold standard. Nobody at testing site tells her to keep testing through day 5, Thursday. So if she does have Covid, it’s never confirmed with a test.
If vaccination rates are lower in the south, is anyone also tracking their rate of natural immunity? At some point, it’s possible people who are vaxed will be more likely to catch infection because the unvaxed are protected by natural immunity. I am not an anti-vaxer (double boosted here). I’m just curious. It stands to reason that anyone who has already had Covid is less likely to get the vaccine, especially when it comes to children, because they believe they already have protection and the vaccine is redundant. I’m not saying this thought process is valid, but there are certainly people who follow this line of reasoning.
Your posts are always timely and seem to read my mind. Thank you for the p.s. I have been going crazy since Moderna posted they were submitting in Mar and then complete radio silence for the past month after!
Thanks for this letter - my first. I think it's great. And it's good that somebody knowledgable and with good communications skills is doing this! Can we see somehow what sewage systems are collecting data and what their coverage area is?
Absolutely brilliant. Thank you for your work and sharing with us in plain text what we are facing.
Thank you for including the side-by-side maps of the old/new color-coding system from the CDC. I wonder if you would consider talking more in a newsletter about the changed coding systems (especially as covidactnow.org has now also aligned with the new CDC guidelines). This is not my field, so I do find it a bit overwhelming. I appreciate good data and felt like I had a handle on which numbers to watch and what they meant. Now, I feel like everything is upside down and I'm not sure what to look at and what numbers to starting thinking about mask vs no-mask, for example. I could use help establishing a new baseline and understanding of what the current levels and shared data mean for me as an individual.
Great commentary but will note that all variants with increased transmissibility by definition escape immunity - not n either or-
thanks for your comment. i should have said "intrinsic transmissibility" to make it clearer.
Not sure how to reach you- would love to interview you for Healio Rheumatology - I am easy to reach at calabrl@ccf.org Cleveland Clinic
Always love your articles, thank you.
I so appreciate every bulletin from you. You are amazing! Thank you!
Thank you. You are the best!
Dr. Jetelina, thanks for your continuous and helpful updates. Much appreciated.
So, we are no longer in 2020 mode, nor the original Omicron flood stage, thunderstorm mode, but are living in the constant drizzle mode.
As, community masking has largely become unsustainable, and one-way masking become the rule, maybe a refresher on masking and indoor air quality is in order?
Also, anyone know of any organized indoor air quality advocacy groups?
FWIW, I have written my local government asking what they doing to insure indoor air quality in commercial buildings with they White House guidance as reference. No response yet.
Yes, I feel like this is an area that has been largely ignored, especially by schools (at least in my district). But it is more sustainable. Most people are not going to want to stay masked, distanced, or away from crowded events. And the air quality/filtration has so many other benefits beyond COVID.
Thank you again, as always, Dr. Jetelina. Has any of this changed your recommendation for a second booster for those of us who are high risk but not in the CDC’s moderate-severe immunocompromised category? I’m working directly with the public (in my own N95 and doing my best with portable HEPA air purifiers and distancing when possible) but I’m now 7 mos. out from my booster and getting really worried.
It would be great to see some regualar comparisions of long term death rates from flu versus recent periods of deaths from Covid, i.e.3 mos., 6 mos. etc. Is that possible?
Thank you again! You’re my go to! I’m curious about any updates around T and B cell protection and vaccine durability and if anyone has looked at the degree of individual variability around lasting protection? Unlike the measles vaccine which seems to have pretty universal durability I’ve heard (anecdotally) that RNA vaccines may be more susceptible to individual variability.
A T-cell post has been on my to-do list for a while. I will try and get to this soon!
Thank you! If anyone can find and make sense of the data it’s totally you. You’re amazing!
Thank you, another well written article. Some general observation
Simply reporting the change in the number of reported events (covid positive – infected, serious illness, visit to hospital, short stay in the hospital, long stay in the hospital, long covid, death) as a percentage of the number of events from a prior time period – the growth rate – isn’t helpful in assessing risk. If the number of events was 1 in 10,000,000 and goes to 5 in 10,000,000 that is a 5-fold increase – but not a substantial change in my changes of getting this event.
Typically, if one assumes some type of exponential growth rate, then this early take off can be projected to be “serious” risk and health care workload numbers. However, as we saw with omicron there are boundary conditions that limit growth. The challenge is estimating the future pattern, not reporting on the transaction data that we have been able to collect in a manner unacceptable to anyone during precision manufacturing.
The same challenge applies to classifying a variant as having a “fast spread rate” simply based on data. This is what analytics folks call a data driven disaster. The first question is “why” does the variant appear to have “faster” spread numbers at this point in time. If I isolated everyone, the spread would end. The variant doesn’t travel 3 miles by uber to knock at a door and infect this person. The second question is what the limiting factor is. Omicron burst on the scene, based on the data reported infected 50% of the population, then stopped? What about the other 50%.
I would content the true challenge is in understanding the cellular mechanisms. For example, how do we help children with long covid.
Yeah, it does seem that it never makes it past 50%. I'm also noticing that the people I know seem to be falling into two categories:
- never getting Covid
- repeatedly getting Covid
Just chiming in that you seem to write exactly the article I need the same day or week I need it to advise my organization. Your indirect reach is better than you might think.
Thanks for your great post. Here’s another theory as to why cases might be undercounted: as the virus continues to mutate, tests are less capable of detecting infection. Hopefully the CDC or somebody is keeping track of this.
And an anecdote: a friend (vaxed, single boosted) returns Friday from a trip to the northeast (NY, DC) and wakes up on Saturday with Covid symptoms (day 0, right?). Takes home test on day 0, result is negative. Takes PCR test on Sunday (day 1?), still negative. Assumes she has the flu, because PCR is gold standard. Nobody at testing site tells her to keep testing through day 5, Thursday. So if she does have Covid, it’s never confirmed with a test.
If vaccination rates are lower in the south, is anyone also tracking their rate of natural immunity? At some point, it’s possible people who are vaxed will be more likely to catch infection because the unvaxed are protected by natural immunity. I am not an anti-vaxer (double boosted here). I’m just curious. It stands to reason that anyone who has already had Covid is less likely to get the vaccine, especially when it comes to children, because they believe they already have protection and the vaccine is redundant. I’m not saying this thought process is valid, but there are certainly people who follow this line of reasoning.
Your posts are always timely and seem to read my mind. Thank you for the p.s. I have been going crazy since Moderna posted they were submitting in Mar and then complete radio silence for the past month after!
Thanks for this letter - my first. I think it's great. And it's good that somebody knowledgable and with good communications skills is doing this! Can we see somehow what sewage systems are collecting data and what their coverage area is?
here is some information from a previous post! https://yourlocalepidemiologist.substack.com/p/wastewater-taking-surveillance-to?s=w