Coronavirus SARS-Cov2 (COVID-19)

[sameerph]

UK has 27,000 daily cases now but deaths are only in the range of 20+ daily. Even if you consider that deaths are a lagging indicator, UK was reporting about 10000+ cases 10-15 days back. So, death rate works out to low 0.2 %. Are they also going to reconcile and add more deaths as many of our states are doing. Because otherwise it would mean the virus there has become more or less like usual flew due to high number of vaccinations. It will be interesting to observe this in UK for next few days.

[jayakris]

^^^ I think 0.2% is pretty much the CFR after vaccination. The Punjab police numbers also turned out to be 0.2%, iirc. About 8 to 12 times fewer deaths than without vaccination. Mostly these are from some specific comorbidity conditions that causes death even under fairly non-severe Covid infections that can still happen after vaccination.

So, yes, we should expect to be living next year onward with that kind of CFR possibility from a Covid infection. But that is probably not much worse than the deaths that happen after regular common cold, typically in older people. Hopefully some medicines will also be found in the near future to cut that rate even further.

[jai_in_canada]

^^^ I think 0.2% is pretty much the CFR after vaccination. .... About 8 to 12 times fewer deaths than without vaccination.

CFR has NOT gone down in countries that have significantly ramped up vaccinations this year. This is true in countries with the current highest vaccination rates. For example, it has remained constant all this year in Israel (0.8%), UK (2.7%) and the US (1.8%) even as all three have very rapidly vaccinated a large proportion of their populations.

However, what HAS gone down as vaccinations have gone up is DAILY DEATHS PER MILLION. For example, in the US, it has gone down from 152.9 deaths/mil on Mar 01 to 6,4 daily deaths/mil on Jun 28. In the UK, it has gone down from 149 deaths/mil on Mar 01 to 1.79 deaths/mil on June 28. Huge savings in lives that is not being reflected in the CFR.

So CFR is not a good measure of vaccine effectiveness. It does not capture the full extent of deaths being reduced due to vaccinations.

What seems to be happening is that vaccinations seem to be reducing infections but then what is also happening is that deaths are reducing proportionately. As a result, CFR is remaining the same despite ever increasing population being vaccinated with first and second doses. For CFR to go down even as cases go down, death rates must drop at a FASTER rate than the rate at which new infections are dropping. That has not happened.

Said differently, vaccinations are saving enormous numbers of lives by reducing the number of people getting infected in the first place. However, those who do still get infected still have the same chance of dying as before the vaccination drive. Why is that? Well, who is getting sick despite increasing vaccinations? It seems to be (a) those who have been vaccinated but have compromised immune systems for which the vaccine is not a fully effective (b) those who have not been vaccinated. For both these groups, the chances of dying are still the same as before. These folks still need to take precautions like masking, distancing, avoiding poorly ventilated places, avoiding crowded places, practicing hand hygiene and maintaining respiratory hygiene.

In India, daily deaths per million has gone down from a peak of 20.3 deaths/mil on May 03 to 6.0 deaths/mil on Jun 28. In that time CFR has in fact gone UP from 1.1% to 1.3%. Given that the proportion of the Indian population that has been vaccinated at this point is still quite low, not all of the reduction in deaths/mil can be attributed to increased vaccinations in India, but some of it must be correlated.

[sameerph]

^^^ I think 0.2% is pretty much the CFR after vaccination. .... About 8 to 12 times fewer deaths than without vaccination.

CFR has NOT gone down in countries that have significantly ramped up vaccinations this year. This is true in countries with the current highest vaccination rates. For example, it has remained constant all this year in Israel (0.8%), UK (2.7%) and the US (1.8%) even as all three have very rapidly vaccinated a large proportion of their populations.

Jai, but then how do you explain 25-27K cases daily in UK and deaths of only 20-15 nos for last few days.

[jai_in_canada]

^^^ I think 0.2% is pretty much the CFR after vaccination. .... About 8 to 12 times fewer deaths than without vaccination.

CFR has NOT gone down in countries that have significantly ramped up vaccinations this year. This is true in countries with the current highest vaccination rates. For example, it has remained constant all this year in Israel (0.8%), UK (2.7%) and the US (1.8%) even as all three have very rapidly vaccinated a large proportion of their populations.

Jai, but then how do you explain 25-27K cases daily in UK and deaths of only 20-15 nos for last few days.

It could be because within a short time window of a few days the correlation may break due to the natural variation in both numbers, and that only over a longer time horizon can we see a smoothed out trend. It may also be because in the shorter time horizon death numbers trail case numbers by a couple of weeks - meaning that as the new wave builds in the UK the deaths may catch up with the cases. This happened in the waning of India's Wave 2.0 where deaths took 2 or 3 weeks longer to drop after cases had been dropping. Even after cases came down from 400k per day to 200k per day from early to late May, India's death numbers stayed at 4000 deaths per day for a couple more weeks and only then started dropping. May be the opposite is happening in the UK. Edit: It could also be that death reports are out of synch with case reports. And sometimes there are reconciliations from past periods etc. So the incoming number streams aren't exactly flowing in a steady rate.

In any case, if over a longer time horizon total cases drop and total deaths drop due to vaccination, which is what the stats seem to showing, isn't that great anyway, even if the CFR remains the same/higher/lower in the short run?

[suresh]

Big States 2/7/2021

KL - 12095 (from 119K tests for a TPR of just over 10%)
MH - 8753
TN - 4230 (TPR of 2.6% from 100% RTPCR)
AP - 3464
OR - 3222
KA - 2984
AS - 2453
WB - 1422

Total - 38623

Yes, we will be around 44-45K as Kumar suggests below.

[Kumar]

Big States 2/7/2021

KL - 12095 (from 119K tests for a TPR of just over 10%)
TN - 4230 (TPR of 2.6% from 100% RTPCR)
AP - 3464
OR - 3222
WB - 1422

Total - 24433 (MH + AS + KA to come)

So we will go down to 44-45k(low 45 being the high end)

[jayakris]

Jai, your data sources seem to be wrong on this. Please check. The CFR of vaccinated people, as of May 1st, which was the date when CDC stopped reporting the total number of breakthrough infections, was less than 1.00, so it had dropped to at least half (see this article)... More like 0.9%

But that is still not correct. As of May 1st, it was around 35% people vaccinated in the USA but a lot of the population much less vulnerable to death (under 50) had not been vaccinated, while a lot of the older population had been... The fully vaccinated (2-dose) population in April in the USA when these infections and deaths happened had much higher a fraction of older people, and so the CFR of the comparable un-vaccinated people was NOT 1.8% but more like 4.00% ... The anti-vaccine crowd has been consistently twisting data, hiding the fact of the effect of the prioritized vaccination of vulnerable population in US, UK, and Israel.

Here is a study summary that says that median age of those who died in the US (as of end of April) after breakthrough infections after 2 doses, was 82!! That tells you all you need to know.

Combine the pieces of info, and my guess is that the CFR of vaccinated people were probably at least 4 to 6 times lower in the US... That is, down from some 4 or 5 percent to 0.9% as of late April... If everybody is vaccinated and all the younger population added, the CFR of breakthrough infections in the USA will be less than 0.5%. But CDC stopped reporting the count of breakthrough cases, as they are unreliable and inaccurate - so we may not know until we look at cases later the year.

I have not looked into UK and Israel data. But Indian data so far has been rather clear on lower death rates. Starting from Ladakh's data that I had reported from a while ago. Then the Punjab police data I reported yesterday.

It is very easy to twist data and the anti-vaccine crowd has been routinely doing that. Hope you are not reading too much of their stuff?? ... You have been a bit of a vaccine-skeptic (not anti-vaccine) right from the beginning! It is good to ask the questions and not buy everything from the vaccine-mafia either, though.

[jayakris]

^^ Aha, this article that seems to have come out just a few minutes ago(!) saying almost exactly the items I was guessing and mentioning -- Some Vaccinated People Are Dying of Covid-19. Here's Why Scientists Aren't Surprised

[sameerph]

I think what happens in UK in next 15-20 days will give us further evidence. If the cases continue to go up and CFR remains below 0.5 %, we can say conclusively that high vaccination in a country makes a big difference in CFR.

US has not shown that much drop in CFR though. Still about 300-400 daily deaths with lower infections than UK.

[Kumar]

https://www.sciencemag.org/news/2021/07 ... g-covid-19

And the original paper
https://www.mdpi.com/2076-393X/9/7/693/htm

The NNTV is between 200–700 to prevent one case of COVID-19 for the mRNA vaccine marketed by Pfizer, while the NNTV to prevent one death is between 9000 and 50,000 (95% confidence interval), with 16,000 as a point estimate.

Very interesting numbers

[jayakris]

^^^ The paper has been retracted, Kumar. Apparently it was garbage-in-garbage-out, as per the links you provided.

[Kumar]

We may even be below 44K today. Our lowest number for Monday should be around 34k

Yes Jay ! Forgot to mention about retraction. I was primarily checking those NNTV numbers to see if that made sense in Indian context.
For example, India having vaccinated close to 60 million people(full vac), did we prevent 300k infections (assuming a number of 200) and around 4000 death (assuming 16000)

[jayakris]

India having vaccinated close to 60 million people(full vac), did we prevent 300k infections (assuming a number of 200) and around 4000 death (assuming 16000)

We have quite probably saved 3 or 4K deaths. Probably 300K to 500K infections too. But we had roughly 250K deaths and 3M infections in the second wave, so it was not much more than drops in the bucket.

[jai_in_canada]

Jai, your data sources seem to be wrong on this. Please check. The CFR of vaccinated people, as of May 1st, which was the date when CDC stopped reporting the total number of breakthrough infections, was less than 1.00, so it had dropped to at least half (see this article)... More like 0.9%

But that is still not correct. As of May 1st, it was around 35% people vaccinated in the USA but a lot of the population much less vulnerable to death (under 50) had not been vaccinated, while a lot of the older population had been... The fully vaccinated (2-dose) population in April in the USA when these infections and deaths happened had much higher a fraction of older people, and so the CFR of the comparable un-vaccinated people was NOT 1.8% but more like 4.00% ... The anti-vaccine crowd has been consistently twisting data, hiding the fact of the effect of the prioritized vaccination of vulnerable population in US, UK, and Israel.

Here is a study summary that says that median age of those who died in the US (as of end of April) after breakthrough infections after 2 doses, was 82!! That tells you all you need to know.

Combine the pieces of info, and my guess is that the CFR of vaccinated people were probably at least 4 to 6 times lower in the US... ...

It is very easy to twist data and the anti-vaccine crowd has been routinely doing that. Hope you are not reading too much of their stuff?? ... You have been a bit of a vaccine-skeptic (not anti-vaccine) right from the beginning! It is good to ask the questions and not buy everything from the vaccine-mafia either, though.

Jay, I myself calculated the CFR from cases and deaths for each of the countries that I mentioned. I looked at the data of countries that can be considered fairly reliable in their reporting and which have done a significant amount of vaccinations. And did the CFR calculations myself. Pure and simple. The data is very clear. CFR has not budged one bit for the UK, US and Israel as vaccinations ramped up to significant percentages of the respective populations. I did not quote any articles with their calculations, I did not combine pieces of information, I did not guess at vaccines resulting in saving x times more lives, and I have not read or listened to anything from the anti-vaccine crowd to come up with this conclusion.

In the end, and I repeat it for the 3rd or 4th time, it does not matter what the CFR is. If 1% of the cases resulted in fatalities when there were 100,000 cases per day, and it is still 1% of cases resulting in fatality when the cases drop to 1,000 cases per day due to effective vaccination, then the CFR is the same but the fatalities per million has dropped – and THAT is what matters. Don’t get hung up on the CFR because it is misleading. THAT is the metric that anti-vaxxers can twist. If you look at the data the way that I did and see that deaths per million have dropped 10 fold when 50% of the population has had even 1 shot, then there is no way to twist that data. If you read my note carefully you will see that I am actually giving huge props to the vaccination programs for saving massive numbers of lives. I am just cautioning that the CFR metric is not doing justice to improvement. It is those who are hooked on myopically looking at CFR that will end up playing into the hands of the anti-vaxxers. I am a vaccine skeptic regarding the claims of efficacy and safety from the vaccine makers from their clinical trials. That skepticism is based on information from 2 very reliable and credible sources who are highly trained and experienced in the fields of virology and vaccine development – not from some sports fans having fun discussing epidemiology . That is not the same as being an anti-vaxxer. I am also open minded enough to look at the data without preconceived notions and recognize benefits when they are there.

As for the median age of the vaccinated people who died being 82, I ask what is the median age of people who died without getting vaccine? In Canada, the majority that have died BEFORE vaccines were rolled out had been in long term care homes with age well above 80. It's not like vaccines are savings younger people's lives and the older people are dying from Covid-19 because they would have died anyway. Don’t buy everything from these articles. They are written by those with vested interests and sponsored by people with their own agenda to sell more vaccines at a higher price. Anti-vaxxers aren’t the only ones to twist the data.