I've not reviewed the Lancet article regarding immunity. Last paper I can recall on the subject, I was willing to accept an 8 month median value; 16 months is a bit of a game changer. IF it is correct. A consideration is that we do not yet have studies that will tell us what Delta did for immune response and cellular activation.
I think we're looking at a minimum of 4-6 months of relative quiet, or, 4-6 months where the public can think we've beaten the virus and drop all precautions, stop getting vaccinated and then wonder what hit them when the next variant arrives. We have to recall that only a fraction of the world's population is fully vaccinated, leaving a significant breeding ground for new variants. Statistically, some of those have to be evolutionarily better adapted to transmission and infection than what we've seen, and some will likely have protein conformational changes that affect how our existing antibodies respond.
We also have the quandary that the public now expects (I don't know why) sterilizing immunity to ALL variants of COVID-19 rather than protection from significant disease and death. I expect the next wave to be accompanied with complaints that we (scientists) missed the mark again.
i would expect that there will always be people who say scientists miss the mark. it’s been a constant theme throughout the pandemic. but there are a ton of people that also get it. i don’t think this battle will ever end
Thank you for mentioning Michigan. I am in the Mitten State and am wondering why our Delta numbers are lagging behind ... I fear that our wave is just building. Our vaccination rate is close to Alaska's and I am thinking we'll fare no better. It's a tight race to see if my 8 year old grandson can get the vaccine before getting Delta ... very disappointing to see that the pediatric vaccine discussion pushed back.
Michigan's transmission rate is slowly dropping. I suspect you've probably peaked, but time is still required to determine if this is a minor adjustment or the beginning of a trend of dropping cases.
I've stopped considering test positivity. There are too many confounding factors, but the simplest explanation is that testing is done for only a couple of reasons:
* To confirm what the clinician already suspects and guide treatment protocols
* Retesting to confirm the infection is still active
* Confirmation that a test was not a false positive
A lot of the same people, known or most likely positive are tested, often several times. And adding insult to injury, we are not testing for surveillance, so we are under-testing.
The transmission rate is over 1.00. In that case we expect the cases (incidence) to increase as well. Without actually studying Michigan, I suspect the majority of the public thinks the pandemic is effectively over (if they believed in it at all), that few are routinely wearing masks indoors, perhaps because they're vaccinated and think they're bullet-proof; Large-gathering venues like bars, restaurants and sporting events are wide open.
MI saw a spike when most of the Country was declining, in the March to May timeframe/ The lowest transmission rate, .65, was in June, and then it started to rise again, peaking in late July. In fact, it's been above 1.00 since early July, causing a relatively slow expansion of the case counts. Hospitalizations and ICU admissions continue a slow rise. It's sorta like a slow-moving car crash.
Invoking and using all available mitigation tactics is important if we're ever to be free of the virus. That's masks, social distancing in its varied forms (not just 6 foot physical distancing), self-quarantining when exposed or possibly infected, awaiting test results, and self-isolating when known to be infected. Avoiding large gatherings, if eating/drinking away from home, eating outside if at all possible. And vaccinations. And, for that matter, we need to see the whole world vaccinated.
We have safe and effective vaccines in this country and around the world. Now it's a matter of money and manpower to vaccinate the countries that can't afford to do that heavy lifting for themselves.
I appreciate your intel on positivity rates. We are woefully under testing here due to the what you said: the vast majority of people think the pandemic is over. I am doing all the mitigation layers and feel like a freak. We have three unvaccinated grandkids (all under 8) and are trying to keep them safe during this variant. You are preaching the good word to this choir! If only others had the ears to hear. Thanks for your response. It’s good to know someone out there knows all the best guidelines.
My daughters and I were praying before school this morning and my 11 year old prayed it would be ready for her soon and that it would not be some kind of trend for people not to get vaccinated. They just have to approve it for the kids.
Thank you for always providing easy to understand insights into where things stand from a population perspective. I'm cautiously optimistic that we will see progress in 2022. How widespread do we expect COVID vaccine requirements for students?
In my mind, it should be added to the mandatory vaccines list. Or, to directly answer your question, I expect it will be required in at least 50% of the schools nationwide, instead of the 100% that are warranted.
I feel so nervous that giving the wave decreasing pediatric vaccines will not be approved. I’d love to hear your thoughts, especially since this is different than what was touted in the media in the weeks leading up “shots in arms by Halloween” is clearly not happening. I still want to try to avoid my children getting this while unvaccinated due to age. Will factors like, exposure at later ages when unvaccinated be considered?
There's no good reason to tie the decrease in delta cases in the latest wave to approval of pediatric administration of the vaccines. What the committee could do is, considering the same sorts of data presented in the article and that I've considered, decline to recommend an EUA, but rather recommend a larger enrollment in the Phase 3 clinical trials to get solid data on safety, efficacy, and long-term adverse events. Increasing the trial size allows for end-points to be reached sooner, similar to how, during the first and second waves, the increased infection rate in the control-arm participants allowed reaching end-points more rapidly. However, I don't really see this as a rational decision.
I fully expect us to see vaccination of everyone above the age of 9-12 months on an annual or biennial basis at least until we get sufficient data on the duration and efficacy of cellular immunity.
I would like to address the term “seasonality”. I live in Massachusetts, my parents live in Florida. My observation has been that every time Massachusetts spiked, Florida was not bad, and Florida would spike and Massachusetts not bad… so we could not see each other for a long time. So what defines a season in the US? If the virus is more transmissible in air than on surfaces, perhaps the season is when the weather is so hot outside in Florida you are in AC indoors or the weather is cold in Massachusetts you stay indoors with the heat on. Maybe the focus needs to be on better building ventilation systems.
Thanks for the summary. While I am no epidemiologist, the explanations you offered fit with my hypotheses about contributing factors to the wave phenomenon. On a related but slightly tangential note - I was just reading about vaccine "patches" being developed that are much more efficient at generating immune response. Now just for mice, but the inventors seem to have the manufacturing process (3-D printing) figured out, so maybe in the next year or so we can get a "multi-patch" for COVID, Flu and whatever else we need to get vaxed for. :-)
Couldn't the waves be illusory? Before smoothing them out using rolling 7 day averages, these are extremely bumpy functions. Surely it makes sense to do a Fourier decomposition first, before speculating about such patterns.
Hey YLE, thanks as always for the quality updates. Really appreciated. May I suggest an edit in the update above, please add the word unvaccinated as indicated: "So if the majority of UNVACCINATED Americans were naturally infected in the 3rd and 4th waves of this pandemic"
Question: Do you think these findings will bolster the claims of those trying to rely on natural immunity as opposed to getting the vaccine? I am well aware that "natural" immunity is far too dangerous to rely upon, I am fully vaccinated, but for the "won't ever get vaccinated" folks?
it may. i truly think we’ve reached saturation for vaccines. there’s not much more we can do, on a population level, to get people to get a vaccine. we live in far too much of a reactive society.
I've not reviewed the Lancet article regarding immunity. Last paper I can recall on the subject, I was willing to accept an 8 month median value; 16 months is a bit of a game changer. IF it is correct. A consideration is that we do not yet have studies that will tell us what Delta did for immune response and cellular activation.
I think we're looking at a minimum of 4-6 months of relative quiet, or, 4-6 months where the public can think we've beaten the virus and drop all precautions, stop getting vaccinated and then wonder what hit them when the next variant arrives. We have to recall that only a fraction of the world's population is fully vaccinated, leaving a significant breeding ground for new variants. Statistically, some of those have to be evolutionarily better adapted to transmission and infection than what we've seen, and some will likely have protein conformational changes that affect how our existing antibodies respond.
We also have the quandary that the public now expects (I don't know why) sterilizing immunity to ALL variants of COVID-19 rather than protection from significant disease and death. I expect the next wave to be accompanied with complaints that we (scientists) missed the mark again.
i would surprised about the 16 month finding too.
i would expect that there will always be people who say scientists miss the mark. it’s been a constant theme throughout the pandemic. but there are a ton of people that also get it. i don’t think this battle will ever end
Thank you for mentioning Michigan. I am in the Mitten State and am wondering why our Delta numbers are lagging behind ... I fear that our wave is just building. Our vaccination rate is close to Alaska's and I am thinking we'll fare no better. It's a tight race to see if my 8 year old grandson can get the vaccine before getting Delta ... very disappointing to see that the pediatric vaccine discussion pushed back.
Michigan's transmission rate is slowly dropping. I suspect you've probably peaked, but time is still required to determine if this is a minor adjustment or the beginning of a trend of dropping cases.
Unfortunately, the MI numbers are increasing slowly. Our test positivity rate is over 11%.
I've stopped considering test positivity. There are too many confounding factors, but the simplest explanation is that testing is done for only a couple of reasons:
* To confirm what the clinician already suspects and guide treatment protocols
* Retesting to confirm the infection is still active
* Confirmation that a test was not a false positive
A lot of the same people, known or most likely positive are tested, often several times. And adding insult to injury, we are not testing for surveillance, so we are under-testing.
The transmission rate is over 1.00. In that case we expect the cases (incidence) to increase as well. Without actually studying Michigan, I suspect the majority of the public thinks the pandemic is effectively over (if they believed in it at all), that few are routinely wearing masks indoors, perhaps because they're vaccinated and think they're bullet-proof; Large-gathering venues like bars, restaurants and sporting events are wide open.
MI saw a spike when most of the Country was declining, in the March to May timeframe/ The lowest transmission rate, .65, was in June, and then it started to rise again, peaking in late July. In fact, it's been above 1.00 since early July, causing a relatively slow expansion of the case counts. Hospitalizations and ICU admissions continue a slow rise. It's sorta like a slow-moving car crash.
Invoking and using all available mitigation tactics is important if we're ever to be free of the virus. That's masks, social distancing in its varied forms (not just 6 foot physical distancing), self-quarantining when exposed or possibly infected, awaiting test results, and self-isolating when known to be infected. Avoiding large gatherings, if eating/drinking away from home, eating outside if at all possible. And vaccinations. And, for that matter, we need to see the whole world vaccinated.
We have safe and effective vaccines in this country and around the world. Now it's a matter of money and manpower to vaccinate the countries that can't afford to do that heavy lifting for themselves.
I appreciate your intel on positivity rates. We are woefully under testing here due to the what you said: the vast majority of people think the pandemic is over. I am doing all the mitigation layers and feel like a freak. We have three unvaccinated grandkids (all under 8) and are trying to keep them safe during this variant. You are preaching the good word to this choir! If only others had the ears to hear. Thanks for your response. It’s good to know someone out there knows all the best guidelines.
My daughters and I were praying before school this morning and my 11 year old prayed it would be ready for her soon and that it would not be some kind of trend for people not to get vaccinated. They just have to approve it for the kids.
Thanks for sharing. Nice to know that others believe in God and vaccines!
1000%
Thank you for always providing easy to understand insights into where things stand from a population perspective. I'm cautiously optimistic that we will see progress in 2022. How widespread do we expect COVID vaccine requirements for students?
In my mind, it should be added to the mandatory vaccines list. Or, to directly answer your question, I expect it will be required in at least 50% of the schools nationwide, instead of the 100% that are warranted.
i agree with Gerry
I feel so nervous that giving the wave decreasing pediatric vaccines will not be approved. I’d love to hear your thoughts, especially since this is different than what was touted in the media in the weeks leading up “shots in arms by Halloween” is clearly not happening. I still want to try to avoid my children getting this while unvaccinated due to age. Will factors like, exposure at later ages when unvaccinated be considered?
There's no good reason to tie the decrease in delta cases in the latest wave to approval of pediatric administration of the vaccines. What the committee could do is, considering the same sorts of data presented in the article and that I've considered, decline to recommend an EUA, but rather recommend a larger enrollment in the Phase 3 clinical trials to get solid data on safety, efficacy, and long-term adverse events. Increasing the trial size allows for end-points to be reached sooner, similar to how, during the first and second waves, the increased infection rate in the control-arm participants allowed reaching end-points more rapidly. However, I don't really see this as a rational decision.
I fully expect us to see vaccination of everyone above the age of 9-12 months on an annual or biennial basis at least until we get sufficient data on the duration and efficacy of cellular immunity.
Thank you.
I would like to address the term “seasonality”. I live in Massachusetts, my parents live in Florida. My observation has been that every time Massachusetts spiked, Florida was not bad, and Florida would spike and Massachusetts not bad… so we could not see each other for a long time. So what defines a season in the US? If the virus is more transmissible in air than on surfaces, perhaps the season is when the weather is so hot outside in Florida you are in AC indoors or the weather is cold in Massachusetts you stay indoors with the heat on. Maybe the focus needs to be on better building ventilation systems.
Great article. Tough to sit in late December read an early October post hoping that Delta was the last wave....
Thanks for the summary. While I am no epidemiologist, the explanations you offered fit with my hypotheses about contributing factors to the wave phenomenon. On a related but slightly tangential note - I was just reading about vaccine "patches" being developed that are much more efficient at generating immune response. Now just for mice, but the inventors seem to have the manufacturing process (3-D printing) figured out, so maybe in the next year or so we can get a "multi-patch" for COVID, Flu and whatever else we need to get vaxed for. :-)
Couldn't the waves be illusory? Before smoothing them out using rolling 7 day averages, these are extremely bumpy functions. Surely it makes sense to do a Fourier decomposition first, before speculating about such patterns.
Hey YLE, thanks as always for the quality updates. Really appreciated. May I suggest an edit in the update above, please add the word unvaccinated as indicated: "So if the majority of UNVACCINATED Americans were naturally infected in the 3rd and 4th waves of this pandemic"
Question: Do you think these findings will bolster the claims of those trying to rely on natural immunity as opposed to getting the vaccine? I am well aware that "natural" immunity is far too dangerous to rely upon, I am fully vaccinated, but for the "won't ever get vaccinated" folks?
it may. i truly think we’ve reached saturation for vaccines. there’s not much more we can do, on a population level, to get people to get a vaccine. we live in far too much of a reactive society.