COVID Transmissions for 11-24-2021

Europe: vaccinated, recovered, or dead

Nov 24, 2021

Greetings from an undisclosed location in my apartment. Welcome to COVID Transmissions.

It has been 738 days since the first documented human case of COVID-19.

Today we’ll discuss the dire situation in Europe—and what it may portend for other places—and also the risks of COVID-19 in pregnant people.

Housekeeping: there will be no Friday issue of COVID Transmissions this week, due to the Thanksgiving holiday weekend in the US. If you’re celebrating, please enjoy—safely. That means being vaccinated and taking rapid antigen tests ideally both before and after you get together with people outside your household.

Bolded terms are linked to the running newsletter glossary.

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Now, let’s talk COVID.

COVID-19 in Europe is on the rise: Austria enters full lockdown

The New York Times has a summary of how dire the situation is becoming in Europe, and how dire it may become yet: https://www.nytimes.com/2021/11/22/world/europe/covid-europe-surge-protests.html

The German health minister has the quote of the day here, which has reverberated through the Internet to some degree—that by the end of the winter, nearly everyone in Germany will be “vaccinated, recovered, or dead.”

Those are the options available to everyone everywhere, by the way. COVID-19 is not going away. Vaccination is the only one of those options that you actually get to choose; when you get COVID-19, it’s out of your hands as to whether you will recover or die. I prefer to keep my agency, and avoid death. I recommend the same for others.

Austria, the country where plans were recently made to lock down only the unvaccinated, has changed course to a fuller lockdown of all citizens. The limited approach wasn’t working, I suppose? The reality is, most of these lockdown measures are really reactive. Governments act with uncertainty early on in resurgences—is it really a new wave? Or is just a blip in the data?—and so by the time a lockdown is being considered, it might really be too late to have the desired effect.

I understand that it is expected that total European deaths, including Russia, will surpass 2 million in the not too distant future.

The reason I share this is partly to communicate to European readers to be extra careful, but likewise to communicate to readers around the world that their own countries may go this direction as well. In my own country, cases are on the rise in various states. In the state where I live, daily new cases are up something like 30% since last week. In the city where I live, there have also been sharp increases in daily case counts.

In my local area, there is one saving grace—hospitalizations remain low by comparison to, say, about a year ago, when comparable case numbers were accompanied by huge daily hospitalization counts. What is the difference? This year, 78% of New Yorkers have at least one dose of a vaccine. Vaccines keep people out of hospitals. With thousands of new cases a day, defined by PCR and not by symptoms, we are seeing less than 50 new hospitalizations and under 10 daily deaths.

So my point is this: if you live anywhere, whether it’s Europe or a place for which the European situation is, for now, a cautionary tale, get your vaccination in order. Get it done if you haven’t finished it yet. Consider getting boosted, based on local recommendations for that. Protect yourself.

COVID-19 linked to higher rates of stillbirth and parental death

I’ve shared some articles here before about the extremely low rate of vaccination during pregnancy, and about the fact that COVID-19 vaccines have a great risk-benefit profile for both parent and child. Those past shares have focused on how the vaccines cause very few risks while offering the obvious benefit of parental protection from disease, along with some potential transfer of antibodies to the fetus.

I think it’s worth sharing this story from CIDRAP, which highlights a couple of studies which demonstrate COVID-19 risk in pregnancy really is a serious threat: https://www.cidrap.umn.edu/news-perspective/2021/11/covid-19-tied-higher-risk-stillbirth-maternal-death

COVID-19 elevates risks to the parent while pregnant, and also elevates risks to the fetus. Nobody wins by risking COVID-19.

Meanwhile the vaccines are effective and pose no elevated risk to pregnant people.

What am I doing to cope with the pandemic? This:

Playing: X-COM 2 War of the Chosen

I like strategy games when it comes to computer gaming. That’s not the only genre that I enjoy, but I definitely favor strategy. X-COM is a series where players run a squad of soldiers who respond to extraterrestrial threats on Earth, and X-COM 2 recasts this as resistance to an alien occupation. Stripping away the story particulars, it is a game where a squad of soldiers who are very fragile have to face off against other soldiers who can make fragile things break. X-COM is known for being unforgiving, and when you lose a soldier, they’re dead. That risk makes the game fun.

You can also form unreasonable attachments to your fictional soldiers, by customizing their appearance, promoting them, and making them into recruitment posters—all of which makes it worse when they die! An example:

Image is a completely fake person, pictured from the back with face turned in profile. She is wearing military-style pants in a dark color, has two glowing axes strapped to her back, a pauldron on her right shoulder with spikes, a gray combat helmet, and aviator glasses. At the bottom there is a caption reading “PROMOTED: She fights for YOUR Future!”

Yes, it can be a bit silly, but it’s fun.

I’ve been a fan of the series for a long while, but until recently I hadn’t tried out the expansion War of the Chosen for X-COM 2. I was making a mistake by not trying it sooner. Wow. It adds a number of mechanics that really improve the feel of the game, including things like unit cohesion, persistent enemies who adapt and improve in response to your tactics, and more. It’s great—if you’re into that sort of thing.

Carl shared the following in response to my comments about mRNA vaccines:

" What’s important to me here is that mRNA vaccines are an incredible technology, and I believe based on available data that they are superior to other technologies that have been deployed for COVID-19 vaccination."
The preliminary data from two widely-separated doses of the J&J vaccine shows efficacy comparable to the Pfizer product, does it not? Who knows what the efficacy after a third year-later booster (as with Pfizer & Moderna) would do? I mean, it's doing essentially the same thing: introducing nucleic acids into human cells causing them to manufacture spike protein.

My reply:

In the end my favoring mRNA vaccines here comes down to what it always comes down to--industrial scalability and agility. RNA synthesizers don't require bioreactors and as a result the whole process is less fiddly and subject to contamination and other quality problems. Yes, it's still fantastically technical and complicated, but we've seen how many difficulties manufacturing of biologic-derived vaccines has run into globally vs how many problems mRNA vaccines have run into. Multiple viral vector vaccines and protein subunit vaccines have had process or quality issues with scaling production; I cannot think of any similar examples for either of the mRNA vaccines despite billions of doses having been manufactured.
Technological superiority is not exclusively about clinical efficacy/effectiveness. That said, there are drawbacks that I'm sure come to mind immediately--temperature of storage not being the least of them. Needing freezers really limits where a product can be deployed, even if those freezers are only -20C instead of -80C. For those remote areas where there is no freezer or dry ice availability but ice packs are an option, other technologies will need to get used, no doubt.

The thread continues, but these are the key comments.

You might have some questions or comments! Join the conversation, and what you say will impact what I talk about in the next issue. You can also email me if you have a comment that you don’t want to share with the whole group.

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