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Between the vaccinated and the previously infected, how is the virus still finding hosts?
no one ever said vaccines and surviving previous infections meant you'll never get it and or spread it again.

vaccination is going to limit the rate of growth, and the impact when infected. It may also mutate around the vaccination and previous infection protections. We're going to be living with it possibly forever.

Oh boy… time to shut down the whole world for 3 weeks.

Edit: Arr! This post is a sinking ship! But really, most countries are locking down and getting rid of the virus. Just not at the same time… that’s a shame, because it just moves all around the world in waves. In Australia we eliminated COVID several times, just to catch it from India and the US… over and over.

Yes, we have a few vaccines here. But not available to anyone except medical professionals. Vaccination rate is very low, perhaps the lowest in the world. Yet in between lockdowns and catching COVID from other countries, we live normally. Isolation of 2-3 weeks easily defeats COVID, even if delta strain and hundreds of cases, without vaccination. Global coordinated isolation seems like the safest and fastest way to end the pandemic. It works in Australia.

Unfortunately, many of the world's major countries, including the USA and most countries of Europe, lack the political will for anything more than halfassed quasi-lockdowns that just drag things out.
> lack the political will

In other words, countries outside the USA and many in Europe lack a culture of freedom.

We _are_ going to be living with it forever... most likely it will become endemic after a a while and circulate among the population like the common cold or the flu. But that is many years off.

https://doi.org/10.1126/science.abe6522

There's no reason it would have to be that way. We could eradicate any given influenza strain or individual cold virus if we really wanted to.
The problem with that is that various bird species act as an influenza reservoir. Unless you want to perform extinction-level mass culling of birds, you're not going to be able to wipe it out for any significant amount of time.
Assuming universal vaccination, that specific strain is actually pretty much going to be wiped out. You're going to see other strains replace it, yes, but if we had in theory a 90% effective vaccine against every single strain of influenza we would be able to completely stop human transmission of influenza for a very long time.
Good news: none of us will have to live with this forever!
There is a good overlap between those two groups, looks like.

Plus the delta strain seems to be causing more symptomatic cases(but still very few hospitalizations and deaths) in vaccinated folks than the previous strains. So that's causing more spread.

Remember that vaccination status isn't uniformly distributed, so communities with 35% of people fully vaccinated, even with 20% of that having had it, will still see it spread with ease, especially as restrictions are dropped.

That said, herd immunity thresholds vary massively. They're much lower in, say, Wyoming, than NYC.

- CDC estimates that ~114 million Americans have been infected

- Approximately 158 million Americans have been vaccinated

If you generously assume no overlap between these populations, that leaves ~56 million pristine hosts. Vax resistance is clustered geographically, so those 56 million are more likely to be near other unvaccinated people. 56 million is a lot of people.

If you assume any meaningful number of people have been vaccinated after being infected, there could quite easily be 100 million or more latent hosts in the US.

(Also vax effectiveness is not 100% so we expect some number of folks to contract the disease after being fully vaccinated.)

If you got coronavirus, you can be reinfected, too - especially with the P.1 variant [1].

[1] https://pubmed.ncbi.nlm.nih.gov/33909850/

For the downvoters, this is Araraquara city study. A 2nd city adding to the case study first found in Manaus city.

Even if you think that Manaus city's study was poorly done, the fact that this is a 2nd study in a 2nd city with similar results adds on to the evidence.

The author list does not seem to match the Manaus city, aside from Ester C Sabino (who was 1st author in the Manaus study, but seems to be a much later author in this newer study). I'm assuming they got Sabino to discuss the other study in the context of this one.

US vaccination rate is 43.7% (both doses for vaccines which require that).

US coronavirus antibody seroprevelance rate was 22.0% as of late April 2021.[1] The data runs about 2 months behind.

(Don't add those directly; there's overlap.)

The 22% figure comes from a CDC national epidemic surveillance program. They take random samples from commercial blood labs, using samples taken for other medical purposes, and test them for antibodies. The test used now can distinguish between people who have had the disease and those vaccinated. So this is a low cost way to track the epidemic.

There's state by state data for both vaccinations and seroprevelance, and it varies a lot by state.

[1] https://covid.cdc.gov/covid-data-tracker/#national-lab

Because Republican (Trump) propaganda has convinced millions of conservatives not to get vaccinated. Fewer than 50% of Republicans have been vaccinated and of those, 75% say they will never get it. This is compared to over 85% of Democrats who have received at least the first vaccination shot.
Vaccine is only 64% effective against Delta variant.
Importantly, it's still 93% effective in preventing hospitalizations [1].

[1] https://www.cnn.com/2021/07/06/health/israel-pfizer-efficacy...

Hmmm, 7% requiring hospitalization = not odds I want to take.
It's not 7% requiring hospitalization - it's that only 7% who would have been hospitalized had they developed an infection are hospitalized if they catch covid (relative, not absolute odds)

For the record, ~2% of flu symptomatic illnesses result in hospitalization (https://www.cdc.gov/flu/about/burden/index.html), so unless you are terrified every winter, this probably shouldn't be considered that high of a risk.

Yes obviously, I'm not an idiot. The point is that people round up anything above 90 as being 100, when actually low 90s is pretty bad.

Arguably you did this too: 2% vs 7% don't round down to the same thing: one is 3.5 times higher.

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It’s not a 7% chance of hospitalization. It’s the normal hospitalization rate times 0.07. If you’re 40 years old, that means your chance of hospitalization is around 0.05%, or 50 in 100,000.[1] The risk is even lower if you’re healthy (no obesity, diabetes, heart disease, etc).

1. I calculated this by taking the cumulative hospitalization rate (https://www.statista.com/statistics/1122354/covid-19-us-hosp...) and assuming that 20% of Americans have gotten covid, then taking 7% of that. It’s not perfect but it’s within a factor of 2 of the real risk.

And for the flu it is about ~40 in 100,000 also: https://www.cdc.gov/flu/highrisk/disparities-racial-ethnic-m...
Y'all are assuming these variants follow the same statistics. It's too soon to know and they don't have to. Indeed, the latest reports are that most hospitalizations are coming from young people, which I'm hoping is due to lack of vaccination and not some new characteristic of these variant (s).

Sorry if this sounds like fear-mongering, it's just caution.

You are assuming that the 2021 flu variants are anything like what we have seen before. And influenza mutates much more readily that Sars-cov-2. We just don’t know.
What odds do you want to take?
Not sure how important that stat is considering it still means that vaccinated folks are able to spread it.

If 36% of vaccinated people get it, they probably aren't wearing masks and are going to spread it very easily to people who may not be vaccinated. Not everybody is unvaccinated by choice, especially depending on the area you live in. Just seems a little premature to open everything back up with a more infectious strain going around.

Getting the virus is not at all the same thing when vaccinated as when not.

Even when it rises to the level of noticeability, it is much milder for the vaccinated.

Which vaccine?
They're referencing a new Israeli study on Pfizer's vaccine.

Since Pfizer (and likely Moderna) are less effective vs Delta, it means we need to push our vaccination rates higher to protect our unvaccinated population (who are largely immunocompromised: such as cancer patients).

> We're feeling pretty good right now because it's the summer. But come winter, if we still have a significant percentage of the population that is unvaccinated, we're going to see this virus surge again

Does anyone have more information on why it's a bigger issue in the winter? Is it because people spend more time indoors in the winter where spread will be more likely while in the summer people will spend their time outside where spread is less likely?

Yep, that’s the theory. You can look to this past winter as an example — things got way worse than they were over the summer
I have to guess that the busy travel season of Thanksgiving, Christmas, and New Year plays a part as well. These are peak crowd-gathering holidays, at least in the U.S. Lots of visiting relatives, lots of transiting through crowded airports, lots of cramped airliner cabins and recycled air, etc.
The strange truth is we don't know why disease waxes and wanes with the seasons. There's a lot of hypothesis but they've mostly been disproven. In particular any thoughts about the weather and how it impacts behavior are eliminated due to the fact that we have two hemispheres that are in opposite seasons and constant international travel.
I’d love sources/anything to show how the seasonal hypotheses have been disproven.
"Eliminated" was probably too strong, but here's some relevant scientists talking about how we don't understand why seasonal disease is seasonal.

https://www.sciencemag.org/news/2020/03/why-do-dozens-diseas...

>Even for well-known seasonal diseases, it’s not clear why they wax and wane during the calendar year. “It’s an absolute swine of a field,” says Andrew Loudon, a chronobiologist at the University of Manchester. Investigating a hypothesis over several seasons can take 2 or 3 years. “Postdocs can only get one experiment done and it can be a career killer,” Loudon says. The field is also plagued by confounding variables. “All kinds of things are seasonal, like Christmas shopping,” says epidemiologist Scott Dowell, who heads vaccine development and surveillance at the Bill and Melinda Gates Foundation and in 2001 wrote a widely cited perspective that inspired Martinez’s current study. And it’s easy to be misled by spurious correlations, Dowell says.

My belief is it's simply that immunity tends to be more depressed with the cold. Less sun, less vitamin d, perhaps some ingrained cycle due to expected lower food availability, slower metabolism, etc. Basically hibernation.
So rather than a straightforward explanation you think it’s wrong and rather it’s “depressed immunity” of which there is no data to back up?
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Viruses degrade much slower in the cold, which is almost certainly part of it too.
Sunlight also gives us vitamin D, and kills airborne viruses.
Not one covid vaccine is FDA approved yet.

If it can keep mutating it seems a healthy life style will protect you more universally than targetted vaccines that are longer relevant.

(Down votes coming for having a critical thought that doesn't support the orthodoxy)

FDA approval is a rightfully slow process but we have an absolute ocean of data to support safety and efficacy. Vaccines appear to work fairly well against the delta variant , and sensible lifestyle choices and vaccination are hardly exclusive.

It feels like, especially with your addition in parentheses, that your goal here is simply to anger people.

The GP has a good point - corners have been cut with trials. Minimizing that fact doesn't change reality.

A friend of mine is in the hospital with corona now, after getting the first vaccine dose about a month ago. Anecdotal, but still very concerning.

> your goal here is simply to anger people

The truth angers many people, especially the left. That's just too bad.

This is a terrible, uninformed take. Had we seen any serious unwanted side-effects during the EUA authorizations the FDA would withdraw the authorization, and the vaccines have continued to have excellent track records across over a hundred million patients!

No known variant incl. delta shows full antigenic escape, and we have plenty of evidence of the protective benefit of vaccination in patient outcomes. Coronaviruses are slow-evolving RNA viruses (due to their proofreading enzymatic activity, single strand, etc.), and though we are certainly seeing a period of new host adaptation, SARS-COV-2 is almost certainly not going to be like H1N1 influenza.

How many people have the vaccines killed? This isn't rhetorical, I want the hard numbers.
Three people have died from thrombosis with thrombocytopenia after receiving the Johnson & Johnson vaccine.

That's the entire count of reasonably directly attributable deaths.

Buddy, this is human medicine, you don't get the luxury of "hard numbers" as if there was an SQL table in the sky you could just query. There is the CDC's VAERS reporting system, but it doesn't define reality:

When you administer a vaccine to hundreds of millions of people, you will statistically expect some numbers of deaths to occur shortly after administration just by chance. Each such case then requires careful investigation to determine if there was a particular immune-linked syndrome that could be explained by a side-effect of vaccination.

In fact, most deaths argued to be due to the vaccines are frail, elderly patients (80+) in long term care facilities. The most concerning side-effect of the RNA vaccines are extremely rare cases of myocarditis and pericarditis seen in young people which are est. ~12 cases per million - we're talking ~500 total reports (not deaths) in the US. Contrast this with the 15,000 child hospitalizations and ~300 child deaths due to covid.

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We need one more winter to burn through the rest of the population. There's no way around it unfortunately, in my view. I got the vaccine, forcing people to get the vaccine isn't going to do much either.

I was in NYC for the entirety of 2020 so I'm not trying to minimize here, but the fear mongering and doom and gloom is really starting to get old. If you got the vaccine, resume living normally, wear a mask on public transit (heck wherever you want) but move on. People who decided to not get the vaccine made that choice, if they pay the price... so be it... Move on...

Agree. You can get vaccines on a walk-in basis almost everywhere now (in the USA at least). We have more vaccine than people who want it. Everyone who wants to be vaccinated is vaccinated. Time to drop all the drama and get back to normal.
Except cancer patients: whose immune system is so compromised their bodies can't afford to get vaccinated (and even if they were vaccinated, there's a low chance that their immune system would protect them).

Their only hope of survival in these times is for everyone they meet to be vaccinated: for herd immunity.

Immunocompromised individuals exist. As a society, we're supposed to vaccinate ourselves to protect our most vulnerable.

This is an extremely narrow-minded and potentially harmful view.

For health reasons that I'm not going to discuss online, my partner has been unable to get the vaccine. The amount of people who have stopped wearing masks in our apartment, at the grocery store, etc. has really started to increase where we live. Knowing that these people are still able to get infected with the delta variant and easily spread it is terrifying. She desperately wants to get the vaccine but can't, so every day is more and more terrifying for her. I have the vaccine but I'm still scared to go out without a mask on because I don't want to get it from somebody who isn't wearing a mask and spread it to her, so I'm not even able to "resume living normally".

I know it might not seem fair to you to put the world on hold for a few people who can't get the vaccine for one reason or another, but you also need to know that it is not always "by choice" and that the price may be people's lives.

How is that view narrow minded? Your partner is a very small group of exceptions to the OP statement.
It just irks me that the OP statement was worded in a way that implied that anybody who isn't vaccinated basically deserves to get infected and die. Lack of empathy for people who may be in rough situations.
To be fair, the Vaccine isn't really that effective against spreading the Delta variant. Data from Israel shows only 64% effectiveness (https://www.wsj.com/articles/pfizers-covid-19-vaccine-is-les...). Luckily it is still 94% effective in preventing serious illness.

What I'm trying to say is that even with 100% vaccination rate, it's not clear that new variants wouldn't spread around the population and continue to infect everyone around us.

Statistically, a 60% efficacious vaccine, if the only available option, would have been a welcome sign of relief. Remember that the influenza seasonal vaccines are only about that effective, and they do a significant amount of good. 94% is more than we were asking for and expecting. Seasonal influenza is a big deal but not a total crisis for a reason. It’s reasonable to say that a moderately effective vaccine for SARS-CoV-2 significantly decreases the chances of an exponential growth fueled outbreak or total Wild West mutation.
Yes, that's the point of the vaccine. Even if you get <insert variant here> you have a far lower likelihood of being hospitalized.

Check mate science, move on. Living in fear of the unknown is a fools errand.

This is how you play into the hand of the insane people who think covid was a "government plant" to sow compliance lmao.

I sincerely hope that she’s able to get the vaccine somehow. I hope that we can convince people to get vaccinated too. I hope that we can stop the pandemic with as little loss of life as possible. I really personally hope that your partner stays safe and isn’t infected throughout this.

That being said, many people are treating it as a political issue, or feel the risk is low enough for them that they don’t need to get vaccinated. Many people have never taken the pandemic seriously, and still don’t.

We need solutions that either inoculate people who are eligible or can convince people to voluntarily get inoculated, because the economic effects of lockdowns and other pandemic controls are far too destructive to apply unequally or over a long period of time. The efficacy of things like lockdowns also goes down over time. If we want these tools to work for future outbreaks and pandemics, we can’t always use them.

I sincerely hope your partner is able to stay safe. I hope that you can find a way through this together. Unfortunately, it’s just extremely difficult to get people to collectively work on this problem.

In a way, news articles like this don’t help. We should really reserve alarms for quantifiable metrics and risks, not hypotheticals. It just adds fuel to the fire for many, and that isn’t helping get people vaccinated faster.

Harmful to your circumstances. I don't live with someone who is immunocompromised and I did my part by receiving the vaccine and wearing a mask in areas of high density. As a result, I'm going back to as normal a life as possible because I enjoy living. And again, I acknowledge the risks, I lived a few blocks from Mt. Sinai West where a literal semi-trailer was used to contain dead bodies.

> This is an extremely narrow-minded and potentially harmful view.

One could argue the same of your response.

> I have the vaccine but I'm still scared to go out without a mask on because I don't want to get it from somebody who isn't wearing a mask and spread it to her, so I'm not even able to "resume living normally".

Please explain how this is my problem or why I should be concerned for your irrational fear. This is a statement that appears to both highly entitled and rooted in emotion - not reason or evidence.

I wish the best for you and your wife. To be clear, I'm not a political person and don't intend any of my arguments here to be perceived as such.

> Please explain how this is my problem or why I should be concerned for your irrational fear.

Put simply, it's not irrational.

TranquilMarmot given your circumstances, have you considered moving to a remote location where you are highly unlikely to ever encounter humans again?

If you're looking for a solution, that's one potential option. However, emotionally charged arguments tend to lack any trace of an actual solution. Imparting the challenges of your life on others unfortunately probably isn't going to have effective outcomes.

I'm going to sleep now.

You may want to look at usernames before responding.
It's been considered and would be ideal for us, yes. But that isn't a very feasible solution at the moment due to financial constraints, needs to be near medical facilities, etc.
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Yes, my response is definitely narrow-minded because of course I am prioritizing the well being of those close to me. I say this sincerely, not sarcastically!

My partner and I also enjoy living, it's just a huge bummer that you seem to be of a mindset that even if your actions negatively affect others you don't seem to care. As somebody else said, this is not an irrational fear in any way (it comes from an understanding that has been reached through research and data) and calling it that shows your complete lack of empathy.

There is no such thing as being "not a political person". All of your actions have consequences, even if those consequences affect people you don't know.

> I'm still scared to go out without a mask on because I don't want to get it from somebody who isn't wearing a mask

Unless you're wearing a respirator, your mask probably isn't that effective at stopping you from getting infected, especially with more contagious variants. This is a bit hand-wavy, but you can see from infection data just how relatively ineffective masks are compared to vaccines; SF was heavily masked last summer, and despite lots of closures, daily cases were still significantly higher (and growing) a year ago compared to today. With the caveat that it depends a lot on where you are, you're safer without a mask and the ~50% immunity the average US community has than with a mask any time in the past year.

> I know it might not seem fair to you to put the world on hold...the price may be people's lives.

Putting the world on hold for another 9 months also takes away lives in a less obvious way.

I do get where you're coming from, it makes sense, and it's a shitty situation.

Yeah, there really is no perfect solution to any of it. It has been very frustrating to see the "people who have not gotten the vaccine deserve to get infected and potentially die" rhetoric get spread online.

Like yeah, I understand that things should go back to normal. We don't have to be assholes about it though.

I hear you. I live in a so-called "purple" state where the vaccination rate is 50%. The state law is to wear a mask in public if you're not vaccinated. It's based on an honor system. Almost no one is wearing a mask any longer. We're having 4th of July parades, fireworks with thousands in attendance - things are back to "normal" and no one is wearing a mask. As others have commented I think there's going to be hell to pay this Winter. We'll see.

As for me, I'm fully vaccinated and I only wear my mask to the grocery store, figuring that's where everybody has to go to get food including those who through no fault of their own aren't able to get vaccinated. Otherwise I'm pretty much "back to normal" too (well, almost - I see no reason to go to restaurants and movies anymore, there's something that changed during the lockdown).

is this the average hacker news comment nowadays?

Why overloading our medical facilities again somehow going to level out some imaginary part of the population you think needs to magically die?

Note that that is "burn" in the sense of giving people enough immunity to prevent future hospitalization spikes. We likely can't achieve herd immunity for a disease this naturally infectious, factoring ability to mutate.

(R0 for Delta is 5 to 8 -- and our vaccine is only 64% protective against infections making the 80% herd immunity threshold impossible to reach).

The current vaccine is only 64% effective, but new safe and effective mRNA vaccines can be made on a very short timescale compared to other vaccines (as seen by the initial COVID-19 vaccines themselves).

The problem isn't having a vaccine available that's protective enough... it's getting enough holdouts to actually take it before another mutated variant takes over.

5-8 seems extraordinarily high. We should be thankful the delta mutations weren’t already present from the beginning…
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This seems to be the strategy the UK is taking. In the next few weeks they plan to be lifting most restrictions and mask requirements. They estimate cases could reach 100,000 per day, but due to the number of people already vaccinated the hospitalisations should be manageable. Feels a bit like they are going all in, hope they have a good hand and aren't just bluffing...

https://www.bbc.co.uk/news/explainers-52530518

> And it's crucial to increase vaccinations in other countries, says Saad Omer, a vaccine researcher at Yale. "The world has to get its act together," Omer says. "Otherwise yet another, potentially more dangerous, variant could emerge."

Where I live, approx. 1/3 people claimed to want to avoid the vaccine a month or two ago. We’re up to maybe 75% vaccination rate, so many changed their minds. It’s hard to focus on other countries when your own citizens are holding out