Relaxation of Restrictions, Part XII *Read OP For Mod Warnings*

charlie14

https://www.boards.ie/discussion/comment/118093715#Comment_118093715

True, but I don`t know what that has to do with my replying to your post on Molnupiravir and it`s efficacy trial data.

floorpie

https://www.boards.ie/discussion/comment/118093806#Comment_118093806

Well if you're an epidemiologist who's publishing a work in Lancet on modelling from population data (as above), you need statisticians, machine learning experts, data scientists, and on and on, none of whom necessarily need to be epidemiologists.

charlie14

https://www.boards.ie/discussion/comment/118093664#Comment_118093664

That might clear up a few things on relation to those vaccinations and unvaccinated but even in the link you posted none of those considerations were taken into account either as far as I could see

Micky 32

https://www.boards.ie/discussion/comment/118093816#Comment_118093816

You’re saying you’re an epidemiologist? That’s a coincidence, so am i 😉😉😉. I’m a part time astronaut too. It was actually a pleasure sitting beside Mr Shatner on my recent trip 😆

astrofool

https://www.boards.ie/discussion/comment/118093807#Comment_118093807

You made up a quote in your reply that I didn't make, own that.

The effect is the same whether it's flat-earther, anti-vaxxer etc. A person is starting with a conclusion and solely focusing on the data that supports that conclusion and ignores or discredits the data that doesn't support it. This is exactly what floorpie is doing (e.g. going back to the original trial results for the vaccines and ignoring later data because there was no control) or the latest with ignoring the conclusion from the scientists who wrote the paper (which is fairly unequivocal) and trying to use that data to support a different conclusion. This is the conclusion from the certified scientists who wrote the dutch paper:

Our results indicate that vaccination confers protection against onward transmission from vaccinated index cases, albeit somewhat less for Delta than for Alpha. Vaccine effectiveness against transmission to unvaccinated household contacts is stronger than to vaccinated household contacts, with the latter already largely protected from infection, and especially from severe disease, by their own vaccine-induced immunity, but differences in risk behavior may also play a role. Possible waning of vaccine effectiveness against infection and against onward transmission could result in increases in SARS-CoV-2 circulation among populations with high vaccine coverage. As full vaccination remains highly effective in preventing severe disease, also for Delta, a high vaccination coverage remains the key to control the COVID-19 pandemic.

We can argue data points and vaccinated vs. unvaccinated but the data supports their conclusion, it's impossible to take the sum of all the data and make opposite findings, but that is what some people are trying to do (and they will try and focus on a data point or two that makes it look that way but it all falls apart pretty quickly).

floorpie

https://www.boards.ie/discussion/comment/118093828#Comment_118093828

going back to the original trial results for the vaccines and ignoring later data because there was no control

Yes. Lol. Exactly. The controlled data in the original trials told us a year ago, the things NPHET are now only finding out this week.

 This is the conclusion from the certified scientists who wrote the dutch paper:

Don't know how many times I have to say....the last line the conclusion people keep posting, i.e.:

"As full vaccination remains highly effective in preventing severe disease, also for Delta, a high vaccination coverage remains the key to control the COVID-19 pandemic."

is NOT a finding from the study 

😂

 The study was about transmission within households only, not pandemic control.

storker

https://www.boards.ie/discussion/comment/118093826#Comment_118093826

That can't be true. The people accompanying Shatner were wearing red shirts and we know what happens to them...

floorpie

https://www.boards.ie/discussion/comment/118093826#Comment_118093826

No I'm not an epidemiologist but I mean, it's not a big deal to be one. There are several vacancies in Irish universities now, you just need a degree or masters to start PhD in the area.

astrofool

https://www.boards.ie/discussion/comment/118093844#Comment_118093844

Does it make you feel better if the last line is omitted?

Our results indicate that vaccination confers protection against onward transmission from vaccinated index cases, albeit somewhat less for Delta than for Alpha. Vaccine effectiveness against transmission to unvaccinated household contacts is stronger than to vaccinated household contacts, with the latter already largely protected from infection, and especially from severe disease, by their own vaccine-induced immunity, but differences in risk behavior may also play a role. Possible waning of vaccine effectiveness against infection and against onward transmission could result in increases in SARS-CoV-2 circulation among populations with high vaccine coverage.

You also fail to mention that the last line directly references another paper to support it:

Considerations in boosting COVID-19 vaccine immune responses - The Lancet

Yes. Lol. Exactly. The controlled data in the original trials told us a year ago, the things NPHET are now only finding out this week.

Again, more misinformation and misrepresentation.

So, we know from those 2 papers that vaccines reduce household transmission by varying levels depending on vaccinated vs unvaccinated and depending on when the person got the vaccine (which also protects against severe disease and death). This seems to be a fairly good indication that to control spread of the virus that we should be getting everyone vaccinated (and what do you know, real world R numbers also indicate this).

Micky 32

https://www.boards.ie/discussion/comment/118093873#Comment_118093873

Oh right. I thought you were trying to claim you are some sort of expert in that field. So irrelevant to my OP.

floorpie

https://www.boards.ie/discussion/comment/118093899#Comment_118093899

No I didn't claim that. I'm an expert in my field, and like I say, fields are largely fluid now

https://www.boards.ie/discussion/comment/118093892#Comment_118093892

Well I partly agree, in that yes of course vaccination somewhat reduces transmission. As you know, I disagree that this means if everybody is vaccinated it will "control spread". Clearly, going by these recent papers, 100% vaccination is not sufficient to stop widespread infection and so on. It never would've been sufficient, and this was obvious going back to those trials you mention. A year later it is now obvious in the real world.

So if 100% vaccination is insufficient to control spread, what measure should we take? If it was always going to be insufficient, should other measures have been prioritised?

Micky 32

So what are you advocating for floorpie? Perpetual lockdown? So we can spend the rest of our days looking out the window and get excited about our weekly allowed out to the shops? ( i’m guessing you won’t answer this)

My bet is this virus will soon enough become endemic through vaccines and natural immunity.

astrofool

https://www.boards.ie/discussion/comment/118093937#Comment_118093937

All vaccination need to do is keep the R number down so that hospitals don't get overrun which is what they're doing at the moment in a relatively unrestricted society.

If hospital cases keep increasing there is a few options:

• boosters for the vulnerable, maybe others such as healthcare workers (already happening)
• Restrict the unvaccinated (taking up proportionately more hospital resources and already somewhat happening via COVID certs)
• Restrict the vaccinated
• Stop treating people in hospital (restrictions will come in before this happens, but part of the plan for the excess deaths crowd).

Other options are for better treatments that reduce hospitalisations or reduce stay length (e.g. viral suppresion pills from Merck and Pfizer) or vaccines with a better profile against transmission (likely nasal vaccines that are about 6 months away).

However, what has been important is getting everyone vaccinated, rolling out to the 5-11 year olds should also help with the transmission rates happening in primary school settings.

floorpie

https://www.boards.ie/discussion/comment/118093963#Comment_118093963

No my preference has always been - based on the fact that vaccination wont stop transmission, and based on the low risk to non comorbid people - vaccinate at-risk people only as much as needs be, and essentially remove all restrictions otherwise at times when hospitals are not likely to be overcrowded for other reasons. In other words we should have opened during spring/summer. It's too late now imo.

https://www.boards.ie/discussion/comment/118093976#Comment_118093976

I agree with everything you're saying, but:

However, what has been important is getting everyone vaccinated, rolling out to the 5-11 year olds should also help with the transmission rates happening in primary school settings.

This to me is a fools errand. We can already see that the risk of spread from unvaccinated -> vaccinated, is the exact same as vaccinated -> vaccinated. As such, vaccinating children wont reduce transmission back to their families, and children are at essentially 0% risk of sickness themselves.

The money wasted on all these vaccinations, adverts, campaigns, should be put to better use in expanding capacity by whatever means.

astrofool

https://www.boards.ie/discussion/comment/118093994#Comment_118093994

The cost of vaccinating 5-11 year olds (given we already have the vaccines and the personnel and the system to deliver them) will be miniscule compared to the cost of hiring lots of doctors and nurses on long term contracts to add extra capacity (and that's assuming that there is an excess of doctors and nurses out of work to hire, there isn't, so that will take time).

We also know that the transmission effects are greatest in the months after getting vaccinated and then wane, which is perfect for keeping the R number down to manageable levels until it becomes endemic (or not depending on mutations) and it becomes part of the annual flu vaccination program.

In the future the COVID vaccines will be part of the childhood vaccination program, the novel part of it won't be an issue and better treatments will handle the rest, till then, vaccines are by far the best option to manage the pandemic (the other option being heavy restrictions).

floorpie

https://www.boards.ie/discussion/comment/118094026#Comment_118094026

The cost of vaccinating 5-11 year olds (given we already have the vaccines and the personnel and the system to deliver them) will be miniscule compared to the cost of ...

That's what I meant by 'expanding capacity by whatever means'. If the funds saved by not vaccinating children is just enough to cover the cost of a recruiting drive for nurses, fine. Any minimal measure to begin improving capacity. This is the critical failure that needs to be addressed now, or we'll be in this situation every winter, regardless of vaccine coverage.

charlie14

https://www.boards.ie/discussion/comment/118093803#Comment_118093803

You didn`t give me two studies. In fact you jumped in without giving me any study telling me I was wrong and that the posts I was replying to were from two different studies without checking that they were actually from the same study.

floorpie

https://www.boards.ie/discussion/comment/118094063#Comment_118094063

I've already apologised because I thought you were involved in the discussion the last few days on this topic. I sent the two studies here:

https://www.boards.ie/discussion/comment/118093761#Comment_118093761

is_that_so

https://www.boards.ie/discussion/comment/118093762#Comment_118093762

Yet a drop in hospital numbers.

astrofool

https://www.boards.ie/discussion/comment/118094045#Comment_118094045

The uplift from getting people vaccinated far outweighs the costs involved, capacity should (and is) being increased but it's not an either/or situation, adding capacity takes a lot of time and we're already seeing from the numbers in ICU (50% unvaccinated with less than 10% of mostly younger and non-vulnerable adults unvaccinated in population) that the vaccination drive has saved the need for multiple ICU beds at a fraction of the cost and time it would take to add them to our health system.

For all the bluster that people go on about big pharma, vaccines are ridiculously cheap vs. the cost of treatment and you don't need doctors and nurses to administer them so vaccination capacity can be added quickly (as most countries have done), big pharma would much prefer to sell expensive treatments than cheap preventatives (and is one of the reasons why we didn't see many new vaccines over the years with most coming from altruistic programs such as the malaria vaccine).

prunudo

https://www.boards.ie/discussion/comment/118094185#Comment_118094185

Given the high percentage of cases amongst younger people and 5-12 in particular I think case numbers vs hospital numbers will contuine to widen. There really can't be that many at risk adults still unvaccinated.

is_that_so

https://www.boards.ie/discussion/comment/118094239#Comment_118094239

I agree and the at risk groups are lining up for their boosters.

floorpie

https://www.boards.ie/discussion/comment/118094232#Comment_118094232

The uplift from getting people vaccinated far outweighs the costs involved

I agree for vaccination generally, and for at-risk people with COVID-19 vaccination. However we've spent unfathomable amounts on this goal of 100% vaccination when most people are simply not at risk, when vaccination is not adequately preventing spread to at-risk people, and so I do not see what the uplift here is. I'm mostly talking about 2021, obviously in winter 2020 things were more fluid and there were more unknowns.

E.g. from Over €480 million spent on Covid-19 tests provided free of charge since start of pandemic (thejournal.ie), GPs set to make €2,500 a day from Covid vaccine scheme - Irish Mirror Online, Posting 'digital' Covid Certificates to cost €800,000 (irishexaminer.com):

Additionally, the health service has purchased two million “I got my Covid-19 vaccine” badges at a cost of €320,000.

...

The terms of the agreement will see GPs getting €35 a jab, or €60 to give two doses three weeks apart...It will cost the taxpayer €91million.

Data from the Central Statistics Office show that the government spent €26.4 billion on healthcare in 2020, including €2.4 billion related to Covid-19.

...

The Government is to spend just under €800,000 on posting physical versions of the State’s Covid Certificate to fully vaccinated people across the country.

Based on the data I believe much of this was essentially worthless. This effort should have been directed to the people actually at-risk from COVID-19, and to expansion of health capacity even if this expansion is incremental and takes many years.

This is ignoring the cost of division in society and destruction of business sectors, which we'll be dealing with for probably decades.

astrofool

https://www.boards.ie/discussion/comment/118094402#Comment_118094402

That seems a bit tangential, but the cost of getting the vaccination rollout is still miniscule compared to the health budget and, as said, it's not either/or, they're not curtailing spending on anything else to push vaccines, vaccines have enabled us to reduce restrictions and keep the R number at ~1, that has allowed society to reopen and businesses to come back, implying something else is disingenuous. If we took all we spent on vaccines for the non-vulnerable and tried to use that to expand health capacity (if it was either/or) we would have overrun hospitals and out of control cases or we would be back in severe lockdown.

Vaccines continue to be the best way out of the pandemic, that doesn't mean they are the only measure being taken and if it was just alpha and a few lesser variants, it would be long over by now, but the high vaccination rate in Ireland has allowed us to pretty much get back to normal even with delta, lower vaccinated countries are finding this out to their cost, high vaccinated countries with more expansive health systems are almost back to normality.

floorpie

https://www.boards.ie/discussion/comment/118094423#Comment_118094423

Don't get me wrong, I don't have the impression that 320k on badges is a lot in comparison to revenue. The spending just indicates to me that we believed vaccination would be an adequate primary measure.

we would have overrun hospitals and out of control cases or we would be back in severe lockdown.

That's essentially my point, we'll have overrun regardless of 100% vaccination. Or 100% + 100% boosters. It's not enough.

high vaccinated countries with more expansive health systems are almost back to normality

This is mixed. I think we'll have to wait until spring 2022 to assess this properly.

I'd still like to know the status of this: Mater hospital says it engaged with residents before starting to build 100-bed wing (irishtimes.com)

That to me is a good use of emergency measures and funds

astrofool

https://www.boards.ie/discussion/comment/118094475#Comment_118094475

I think barring driving up to the mater and taking a look, there doesn't seem to be any update there (which is a bit maddening, I imagine it's caught up in red tape as any building in this country tends to be).

We're not overrun right now and most people are living their lives normally, hospital cases are going up slowly but not exponentially as before and we're still seeing most hospitalisations and cases in the unvaccinated groups indicating vaccines are doing their job.

We should see the boosters start taking effect and potentially 5-11 year old taking effect in the next few months, further reducing R, post Spring, on the current trajectory, it doesn't look like there will be much in effect bar mask wearing (if even, UK has mostly dropped this) and travel passports.

And again, it's not either/or with the cost of the vaccine rollout, even if vaccines cost double (as they will in the future after the initial purchasing finishes for western countries at least) or triple, they'd still be paying their way, we'll also likely have nasal delivery of vaccines that will reduce transmission rates even further (and faster/cheaper to administer).

charlie14

https://www.boards.ie/discussion/comment/118094078#Comment_118094078

Fair enough but there would have been no need for an apology had you checked before accusing me of bad faith posting.

I`ll take a look when I have the time, but with you saying both studies came to the same conclusion I don`t know what I am even supposed to be looking for.

Edit. On reading back I see astrofool has saved me the trouble of going through that study by posting the conclusions they came to.

floorpie

https://www.boards.ie/discussion/comment/118095030#Comment_118095030

Fair enough but there would have been no need for an apology had you checked before accusing me of bad faith posting.

That's why I apologised. I can't go back and check posts easily on this new boards.ie

I`ll take a look when I have the time, but with you saying both studies came to the same conclusion I don`t know what I am even supposed to be looking for.

Well don't look if you're not interested. A few interesting differences is that in the UK study they PCR tested daily the people who were exposed to the virus. So the UK is looking at sars-cov-2 infection essentially, not COVID-19. The Netherlands study excludes people that report no symptoms after 2 PCRs.

Interestingly they both had the same finding to a different scale, i.e. that all configurations of infection have the same risk, except unvaccinated to unvaccinated:

In UK study, secondary attack rate, after the initial infection (to my reading) was:

Unvaccinated -> unvaccinated: 38%

Unvaccinated -> vaccinated: 25%

Vaccinated -> vaccinated: 25%

Vaccinated -> unvaccinated: 23%

In the Netherlands study, secondary attack rate, after the initial infection, was:

Unvaccinated -> unvaccinated: 22%

Unvaccinated -> vaccinated: 13%

Vaccinated -> vaccinated: 11%

Vaccinated -> unvaccinated: 12%

The point I made to you earlier was that 38% applies only for unvaccinated -> unvaccinated within the household. Secondly, the Netherlands paper does a better job disambiguating this, the UK paper is unclear.

floorpie

https://www.boards.ie/discussion/comment/118095030#Comment_118095030

Edit. On reading back I see astrofool has saved me the trouble of going through that study by posting the conclusions they came to.

Ok 😂 Weird

https://www.boards.ie/discussion/comment/118093892#Comment_118093892

Your last point is key. The delta variant has R0 of between 6 and 8. Current reproduction rate is 1.2. During first lockdown we got the reproduction rate from 2.5 to 0.6. So suppression of spread now is as much if not more than during the first lockdown. It’s not all down to masks and Hand sanitiser