COVID Transmissions for 9-13-2021
How not to use VAERS and other stories
Greetings from an undisclosed location in my apartment. Welcome to COVID Transmissions.
It has been 663 days since the first documented human case of COVID-19. In 663, Emperor Constans II tried to really retake Italy for the Roman (Byzantine) Empire. He became the first Emperor to visit Rome in more than two centuries. He tried to restore Rome as the seat of the Empire--except while visiting, he stripped several Roman temples of art and valuables, and had them sent back to Constantinople. Perhaps unsurprisingly, he didn’t quite succeed in restoring the Empire in all of Italy.
Today we’ll discuss a variety of topics--the Biden vaccine mandate, misuse of the VAERS database, and the story of some variants of concern.
As a reminder, the Jewish holidays are interfering with my schedule somewhat. The Wednesday issue may be the last one for this week, since Yom Kippur is on Thursday and I may take my newsletter-writing time for Friday off to recover and get back up to speed.
Bolded terms are linked to the running newsletter glossary.
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Now, let’s talk COVID.
Biden vaccine rules
I think by now most have heard that President Biden last week asked OSHA to draft a rule requiring all US employers with more than 100 employees to mandate vaccination or weekly testing. The penalty if they don’t will be hefty fines.
I’m going to level with you all: at this point, the choice is between getting vaccinated and being 95%+ less likely to die of COVID-19, vs getting COVID-19 every 6 to 12 months until it eventually kills you. It has become clear that new variants are good at escaping natural immunity, and that being vaccinated offers enough protection to be able to withstand the emergence of new variants even if you still get mildly ill. Being unvaccinated means waiting for the next variant, and the next variant, and the next variant that escapes whatever protection you may have, and each time hoping that doesn’t kill you. Meanwhile vaccination offers protection from the most serious outcomes, and your immunity will be stronger going forward in the event you do get mildly sick.
This is a choice between being protected from death and disability vs being an unprotected victim who also is likely to spread disease to others. To create an environment like a workplace that allows others to make that latter choice, and endanger their coworkers, really is something that should be seen as criminally irresponsible.
A number of right-leaning political entities decided to politicize this and describe it as some kind of rights violation. If it is, then I really wonder what they think of the smallpox vaccine mandates put in place by George Washington. I saw one politician cry, “Unvaccinated lives matter!”
Indeed they do--that is why we invented vaccination, because, as I’ve heard elsewhere, all lives matter. Before the vaccines, everyone was unvaccinated and hundreds of thousands of Americans died. Now, it is largely unvaccinated Americans who are dying, in their thousands. To protect them, we want everyone to get vaccinated.
The weekly testing “out” for all this, however, is something that I don’t really agree with. Not because testing is a bad idea, but because weekly isn’t frequent enough. It should be daily.
In my opinion, if an employee is showing up unvaccinated for in-person work around others, they should be tested each day they show up for such work. A once-weekly test tells me a person was negative on one day out of the week. The other 6 days matter too, and if you’re not going to protect yourself and others by getting vaccinated, at least protect others by getting tested. It is the responsible thing to do.
If by some chance you are not yet vaccinated, please do everyone around you a favor and get tested any day that you’re planning on being around other people. Also, wear a mask around other people. Also, just get vaccinated.
Is myocarditis more harmful in boys than COVID-19? No, it is not.
A “study” has been circulating--a preprint--that claims that myocarditis is more common in teen boys who get vaccinated than COVID-19 is in teenagers overall. I will not link this study, because it is utter garbage, and I’m not the only one to think so:
Why do people hate this study’s methods? Well, it’s because it cast an unreasonably wide net into a database called VAERS, which I’ve written about before. VAERS is the Vaccine Adverse Events Reporting System, which anyone can submit an adverse event to, and which will list any adverse event that happens after you are vaccinated. Think you got abducted by aliens after you got your flu vaccine? VAERS will list that. The CDC might contact you to ask you to retract the report, but it’ll go in there and stay there until you take it down.
Why is this database like this? It’s so that the health authorities in the US can collect any and all potential safety data that might be of interest. It is meant to cast a wide net to identify what might need further study. It is not a database that can be used to do human epidemiology.
And it certainly can’t be used to detect myocarditis if you just look for anything that includes any reference to something like “chest pain,” an incredibly nonspecific symptom. Which is what these researchers did.
There are ways to do this kind of research. This paper didn’t use any of them, and it should not be entering into the conversation about vaccine safety. News outlets that covered it should retract their articles and issue corrections. If you see it, don’t share it. This work is just wrong.
Unvaccinated are 21x more represented in NYC COVID-19 hospitalizations than the vaccinated
This really speaks for itself: https://gothamist.com/news/ny-releases-data-covid-breakthrough-infections-unvaccinated-make-21-times-more-hospitalizations
NYC isn’t even 60% vaccinated yet; we’re hovering around there, though. There certainly aren’t 21 times as many unvaccinated people in the city as vaccinated people. But there are 21 times as many unvaccinated people in the hospital in NYC with COVID-19 as there are vaccinated--an overrepresentation that’s happening because the vaccinated are protected. Vaccination is saving people from harm, and it’s obvious.
Mu variant appears to have come and gone in LA
I get asked a lot to comment on various variants of concern, and I usually refrain. This story is an example of why. Generally, I don’t write about a variant unless there are public health data that suggest it is doing something that fundamentally alters the epidemiology of COVID-19.
I haven’t talked a lot about the Mu variant that has been making headlines, and there’s a reason for that--the Delta variant seems to have out-competed it in various places, and since the Delta variant is currently dominant in many countries around the world, I doubt that Mu is going to replace it. Instead, I would expect that Delta will continue to displace Mu.
The same appears to be true of the Lambda variant.
This seems to be what happened in Los Angeles: https://ktla.com/news/local-news/mu-and-lambda-covid-variants-were-in-l-a-county-earlier-than-thought-but-delta-crowded-them-out/
With these variants, we are watching evolution happen in real time. Evolution is a genetic contest. Viruses that survive and replicate more than others are the winners. The winners get to keep existing, and the losers go away.
Delta survives and replicates in Los Angeles-like human populations better than Mu and Lambda, and Mu and Lambda went away. This tells me that Delta is a winner under current conditions. I can’t guarantee that this is what will happen in every place for every type of population, but LA is a pretty big, diverse place, and Delta seems to be the fittest available variant for that situation. The feature that seems to have made Delta a winner is its ability to find susceptible hosts; while Mu and Lambda were thought to modestly evade immunity, that doesn’t seem to be enough. Instead, it is Delta, which seems to have made large gains in terms of contagiousness, that has taken over. It is better, apparently, to be able to find many new hosts than to be marginally better at overcoming the immunity of each individual host. In a way this makes sense--to fight that fight against host immunity, the virus has to get into the host first. If one variant is getting into twice as many hosts, it’s going to have a big advantage.
In the future, I won’t be surprised to learn about a variant that displaces Delta, but for the time being, it looks like Mu and Lambda are unlikely to be candidates for doing so.
What am I doing to cope with the pandemic? This:
A brief respite with tabletop gaming
With all the rush to get everything ready for my parental leave, as well as to prepare for the baby herself, things have been moving at a steady and stressful pace for me lately. This weekend, I took a few opportunities, some along with my wife, to just play some games with friends. It’s not just that all work and no play makes Jack a dull boy--it also dulls Jack’s ability to get that work done efficiently.
My point is, remember to take time for recreation when you can, in the midst of all the stress out there. There’s a pandemic, we all have lives, we all have life events--if you have been burning the candle at both ends, sometimes it’s a good idea to force yourself into some R&R. A day or even an hour of recovery can have quite outsize impacts on everything else in life.
Carl Fink shared this tale of two school districts that I think is informative:
The Associated Press reports (https://www.usnews.com/news/best-states/north-carolina/articles/2021-09-07/north-carolina-schools-see-major-covid-spread-as-year-begins) that in North Carolina, Union County Public Schools has 5200 students in quarantine, while much larger Wake County Public School District has only 1300. Can you guess which one mandates mask-wearing?
Yeah, I thought you could. Those numbers are rounded, but it's four times as many. As it happens, Wake forest has four times as many students, so naively the ratio is 1:16. Obviously we can't necessarily compare different counties 1:1, but it sure seems interesting.
The Citizen-Times reports the vaccination rate in Union County is 51.9% at least one dose, 48% fully vaccinated against COVID-19. For Wake County those numbers are 70.1% and 66.25%.
https://data.citizen-times.com/covid-19-vaccine-tracker/north-carolina/37/
So, now I'm irritated at the AP for not mentioning that and forcing me to do my own research. The masking probably contributed but certainly is not solely responsible for the difference.
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Always,
JS
Hi, John. I thought I'd mention that Science-Based Medicine has not one, but two articles up today agreeing with you about the terrible Høeg et al. study, and going into more detail--one of them is by David "Length is a virtue" Gorski, after all.
https://sciencebasedmedicine.org/dumpster-diving-in-vaers-doctors-fall-into-the-same-trap-as-antivaxxers/?utm_source=rss&utm_medium=rss&utm_campaign=dumpster-diving-in-vaers-doctors-fall-into-the-same-trap-as-antivaxxers
https://sciencebasedmedicine.org/peer-review-of-a-vaers-dumpster-dive/?utm_source=rss&utm_medium=rss&utm_campaign=peer-review-of-a-vaers-dumpster-dive