Coronavirus SARS-Cov2 (COVID-19)

[prasen9]

Vaccines cannot end things if they mutate. We will have protection if there is vaccine acceptance by a sufficient number such that we build herd immunity. *And* if there are no mutations. Also, these vaccine protection has a shelf-life. We may need a booster in six months. Or we may need it in a year. Or whenever. Covid will stay. The idea is to make the risks lower at the level of the common flu, etc.

[jai_in_canada]

Vaccines cannot end things if they mutate.

Well then "things" will never end. Viruses mutate.

We will have protection if there is vaccine acceptance by a sufficient number such that we build herd immunity. *And* if there are no mutations.

Well those are a couple of big IFs .. no ands (Edit: Sorry, I missed the big *And*) or butts or elseifs...!! And I will add another big booty IF ... IF the vaccines are effective. There is no real data on that other than sketchy data from hasty trials. The Chinese vax is now only showing 50% efficacy after it has been rolled out in bigger numbers. So the dream of protection is still... well, don't wake up.

We may need a booster in six months. Or we may need it in a year. Or whenever.

That says it all.

The idea is to make the risks lower at the level of the common flu, etc.

Careful, Prasen! Fauci might sue you for plagiarism.

Covid will stay.

Of course it will. Question is will it stay on as a worldwide raging all year round pandemic or will it stay on as an endemic seasonal virus? Right now it is a worldwide all year round pandemic that is still raging in waves completely out of control more than 12 months in. So the utopia of lowering the risk to that of the common flu is still far out of sight over the horizon - and they are already admitting that the vaccines are NOT the vehicle to get us there.

[prasen9]

In fact, vaccines are the only vehicle to get us there. Vaccines are building the immunity in people and fewer are or will be infected. There are very few cases of hospitalization among people who have been vaccinated. And, if the serious risk goes down, we go towards normalcy. There is no other solution. I mean okay, if we do not use vaccines, we will eventually die out and get herd immunity. That is a solution. Vaccines are accelerating our timeline to getting there. Yes, there will be other mutations and there will be other vaccines. This is what it is.

It will go from being a raging pandemic towards a seasonal flu. The slope of that reduction is what we do not know. And, it may not be linear.

[jayakris]

I hope Prasen has put some of JIC's concerns. I have nothing much more to add...

But here is a little observation on the place where we have done the highest level of vaccinations. Union territory of Ladakh that has reached 22% in vaccination (almost 1 in 4, which means a high fraction of the older population over 45 years of age).

First, looking nationally, we have so far done about 7% of the regular population and almost 24% of the population aged 45+ (85 million out of 350 million). About 25 million of that has been in the last week, so we had done 60M of 350M vulnerable population (88% of Covid deaths are from that population) till a week ago when we had done 5.5% of national population. Anyway, roughly three times the national fraction of all adults is the fraction of older adults (45+) vaccinated. Ladakh was at 20% of all adults, as of march 6th, a week ago. Roughly 40 to 60% of vulnerable adults had been vaccinated there a week to 2 weeks ago. The second wave started showing up in tests about 2 weeks ago and by the 6th, Ladakh had picked up 500 infections in the new wave. I assume at least 1/3rd if not half of the vulnerable adults had picked up some vaccine immunity by the time they got hit by the second wave.... As 6 weeks of vaccination of 60+ adults were already done by then, I think the even more vulnerable older adults (around 55% of the deaths in India) were already vaccinated in Ladakh. Probably 60-70% of them by 3-4 weeks ago itself.

So do we see any change in the death figures? Well.... Ladakh showed one death from the second wave, and that was yesterday. The first death since late January. They had 130 deaths out of the first 9850 people (which is roughly the national average of 1.3%) but out of at least 200 to 400 people who got infected until some 2 weeks ago, in the new wave, so far we have seen only ONE death. In total, ladakh has so far had around 1000 cases in the second wave, who would have got infected at some point since March 25th or so. Maybe only the first 500 or so till more than a week ago should be considered to check the death numbers. But even among them, we saw the first death only yesterday. Without vaccination, I would have expected at least 4 or 5 deaths by now at a CFR of around 0.80% that many states are showing.

Early numbers. So, it is too early for conclusions. I will check where Ladakh is, on the death count, after another 3-4 days or a week. If the death count stays low, it would be an indication of the effect of the vaccination done on the vulnerable old population.

I hope Ladakh won't show some 5-6 deaths in the next week and kill my good hopes! (EDIT: At least no deaths today; so one more day of hope)

[jai_in_canada]

In fact, vaccines are the only vehicle to get us there.

Not according to the scientists who put this together...unless you know something that they don't
https://www.bbc.co.uk/news/resources/id ... da6b0acb3f

There are very few cases of hospitalization among people who have been vaccinated.

What's "very few"? What is the hospitalization rate for the unvaccinated? What is the hospitalization rate for the vaccinated? How much data exists? Can you prove that it's a causal relationship rather than just a correlation? Is it the same for vaccinated people who were previously infected and vaccinated people who were not previously infected?

[jai_in_canada]

I hope Prasen has put some of JIC's concerns. I have nothing much more to add...

Yeah... no! His pick-me-ups don't work as well as yours.

Early numbers. So, it is too early for conclusions. I will check where Ladakh is, on the death count, after another 3-4 days or a week. If the death count stays low, it would be an indication of the effect of the vaccination done on the vulnerable old population.

I hope Ladakh won't show some 5-6 deaths in the next week and kill my good hopes!

Very early... too early .. exactly what you say. Will still be too early to tell in 3-4 days. And very small sample size
Even if the death count stays low how can we tell it was due to vaccine? It could be immunity from previous infection. The variant might be less deadly. The warmer weather might mean people are outdoors and more physically distanced...

Good try, Jay. But I think I need a booster pick-me-up.

Also, wrt Ladhak, altitude might be a factor.
https://www.liebertpub.com/doi/10.1089/ham.2020.0114
Are there fewer people traveling to/from those remote areas now than there were during the first wave? Could be a factor in infection and death rates.

[jayakris]

In fact, vaccines are the only vehicle to get us there.

Not according to the scientists who put this together...unless you know something that they don't
https://www.bbc.co.uk/news/resources/id ... da6b0acb3f

Very cheesy, but quite effective. As good a summary as there is (though they didn't prove or explain that vaccines don't get us there, even if they aren't foolproof nor are they the greatest thing since sliced cheese!).

[jayakris]

As I added above, no deaths today in Ladakh. Stay hopeful.

But we had +185.3K new cases in India. 1743K tests. Positivity 10.63. Even outside Maha/Chattis/Goa, it is as high as 7.55% now. And we had 1026 deaths. That corresponds to around 100K of cases we were having a few days ago. Somewhere around 1% or a bit below that, for CFR.

We need to expect 1500+ deaths on some day next week. That is really sad. I hope vaccinations have already started helping a lot of old people and that the death rate will come down slightly even next week and the week after. Like I said before, it is extremely unfortunate that the wave didn't wait another 3 or 4 weeks more to kick up (and that the warrior vaccinations wasted at least 3-4 extra weeks)

Vaccinations were pretty bad today, at only 2.65M doses to 2.26M people... I guess vaccine shortage is hitting the operation? Not sure.

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ICMR Update: 260,618,866 total tests... Tuesday tests: 1,411,758 (where are the extra 350K tests reported by the states going?)

[Omkara]

https://www.ndtv.com/india-news/uttarak ... ed-2412958

So the official answer is this is open air, our own people (unlike foreigners) and we now understand Covid.

Hope the current state of matters and the ones on the way, ends the current government like it did to Mr Trump. Unfortunately thousands will pay for it with their lives.

[jayakris]

^^^ My quick response was always "cancel the damn Kumbh mela"... But then, what do you do when canceling it could also cause extreme hardships to so many people whose livelihood depend on this event? It will also decimate the economy in places like Uttarakhand. I looked at some of the articles on the economic impact of Kumbh mela. Here is a 2019 (pre-Covid) article from Fortune, Why the Kumbh Mela is an economic blessing, that talks about 600K people's jobs depending on it and all that. The numbers are all over the place, but it doesn't look like it would be easy to make a decision to cancel this event.

All you can do is to hope that people will be sensible, which is always hoping for too much. At least the Tablighis had the excuse that they simply did not know about Covid. But Indians now seem to have decided that this is just another flu and are going to take the risks.

Let us just pray that people don't die in thousands due to Kumbh Mela.

[jayakris]

Why is TN plateauing at 80-88k testing? Really means that thry may be doong naam ke vaas testing rather than targeted testing! It has been in 80s for almost 2+ weeks now

Finally they raised it today. Up from 83 K yesterday and less than 88K for the last 2-3 weeks, to finally 97K today. Good!

[Omkara]

Problem is we don't have a health care system that supports an open economy during Covid. The stress it will put is humongous. You may not like Udhav now but wait. Already most states have crossed 7-8k daily and moving towards 11-12k. This is right time to stop economic activities past 8pm. Allow manufacturing but all malls, restaurants and public gatherings should get banned. But I guess something really bad has to happen or else how can one justify such a large step.

The next two months will be extremely painful for India.

[jai_in_canada]

The latest rumour making the WhatsApp rounds is that the RT-PCR test is returning a "lot" of false negatives because the test is not picking up the mutations.
Any one else hear/see that?
How would one know that a result was a false negative anyway?

[jayakris]

Delhi with 17K today. We are about to hit 200K today/tomorrow. I was hoping that we could be nearing a peak or something, but there is really no big sign of any of that even now. it looks like we are going to 250K by late this week or next week. It is out of control and we really may not have the capacity to do any more testing than around 2 million. Need to slow this down somehow. I don't know how.

[jayakris]

The latest rumour making the WhatsApp rounds is that the RT-PCR test is returning a "lot" of false negatives because the test is not picking up the mutations. Any one else hear/see that? How would one know that a result was a false negative anyway?

Quick answer: Stay away from WhatsApp, and do not believe even a word of anything that comes on WhatsApp.

But seriously... it is true that mutations can cause RT-PCR to become less accurate. USFDA had said this too earlier this year. Not terribly bad but there could be a bit more of false negatives (Not sure how much, but instead of around 4% or so, initially, it may have gone to 10% or something).

Man, what a Godawful virus.