This Is Bullshit: Silver Takes the Gold for COVID Guff [UPDATE-1]

[NB: Check the byline, thanks. Update at bottom of post. /~Rayne]

I’m sure my neighbors wondered what the hell was going on here Friday. The weather was nice enough that my windows were wide open exposing those within hearing to my vented spleen. There was so much crap in my social media I couldn’t help yell, “Bullshit, bullshit, absolute bullshit!” I can only hope they thought I was yelling about the Olympics.

What really set me off was dangerous twaddle from someone who should long ago have learned not to opine without data.

Because he refuses to stick to his lane using data to support his case, Nate Silver has become anathema, all of his own doing. His bullshit tweet Friday about COVID can get people killed if they pay him any heed at all.

No data offered here to support this swag – it’s pure opinion.

For the last couple of months we’ve known we haven’t been dealing with the same virus variant which began the pandemic; we’re now up against a far more transmissible version the features of which researchers are still analyzing.

In its pandemic coverage, the Washington Post reported the Centers for Disease Control acknowledged in an internal memo “the war [against COVID] has changed”:

… The document strikes an urgent note, revealing the agency knows it must revamp its public messaging to emphasize vaccination as the best defense against a variant so contagious that it acts almost like a different novel virus, leaping from target to target more swiftly than Ebola or the common cold.

It cites a combination of recently obtained, still-unpublished data from outbreak investigations and outside studies showing that vaccinated individuals infected with delta may be able to transmit the virus as easily as those who are unvaccinated. Vaccinated people infected with delta have measurable viral loads similar to those who are unvaccinated and infected with the variant. …

In other words our past assumptions about SARS-C0V-2 no longer work; this isn’t a virus with a replication factor of R2 (in which one infected person infects two more on average) but an R-naught much higher.

Let’s revisit what was known at the end of June this year about the Delta variant in this explainer I’ve shared before:

It’s the change in charge and in the amino acid described in Rob Swanda’s video above which may be responsible for both the high level of virus load found in both unvaccinated and vaccinated individuals. Think of the electrostatic charge as acting like a magnet, attracting more virus to receptors, combined with a change to the spike protein which may allow the virus to attack host cells more quickly and not be recognized quite as rapidly by vaccinated persons’ immune systems. You’ll grasp why vaccinated persons are infectious and spreading the virus along with unvaccinated carriers.

For another overview which offers a fairly basic explanation of the process by which viruses mutate and then disperse as well as an overview of the Delta variant, see this MedCram video from July 20:

If you watch this video, do pay special note to dates on materials cited. There’s one graph in particular addressing the spread of Delta in the UK based on data from June; the spread of Delta is so aggressive that data wasn’t accurate by the time of this video a month later.

This article in BBC provides a graph showing the trend from mid/late June in the UK; Delta’s spread continued along that rapid uptick, resulting in more hospitalizations though vaccinations kept the rate from matching the last COVID surge. The MedCram video (at 5:17) does attribute the increase to the Delta variant.

Note also the differences in population testing positive for Delta – now much younger – and the admissions. While vaccinated individuals are still unlikely to need hospitalization as documented outbreaks like that in Provincetown MA show, they can still get the virus. We still don’t yet know what the long-term repercussions are among vaccinated individuals who have asymptomatic or mild cases of COVID. We do know that previous variants have caused damage among infected individuals even though they had asymptomatic or mild cases, and younger people including children were among those who were injured.

But now that we know vaccinated persons can both be infected with Delta and spread it, vaccinated persons can’t simply “choose to live [their] life ~however [they] want under COVID” because they pose a danger to individuals who can’t be vaccinated or are immune compromised.

That’s someone like Montel Williams, living with a compromised immune system, fully vaccinated, did everything right to protect himself, and yet someone infected him through thoughtless carelessness:

Don’t listen to bullshit from unqualified hacks who don’t have skin in the game. Pay attention to credentialed virologists, epidemiologists, public health professionals who are on top of the data related to COVID and the peer-reviewed research about its variants.

Above all continue to wear masks and maintain some level of social distancing even if you’re vaccinated, not just because you may become mildly ill but because you may infect others who may not be able to be vaccinated — particularly children — or who may be immune compromised.

This tweet shows the difference between an infected young teen’s lungs and health lungs; imagine this happening to younger children, unable to be vaccinated while vaccines have yet to be approved for use among those under age 12:

Prevent this from happening to more children by encouraging vaccination. The sooner we reach 70% or more vaccinated, the faster we can halt the emergence of the next highly-transmissible and damaging SARS-CoV-2 variant.

UPDATE-1 — 2:40 PM ET 31-JUL-2021 —

When some denialist throws a 99% survival rate statistic in your face, sit them down and share this.

Oh, was I suppose to provide a trigger warning? COVID doesn’t provide them, oops.

The video above only addresses patients who’ve been hospitalized. At least one recent study suggests an average 13-14% of persons who recover from COVID have symptoms lasting weeks and months, some of which are debilitating and reflect permanent damage COVID does to the body.

Freedom. Woo. Choose to live your life however you want. Good luck getting out of bed freely after hospitalization, or keeping your job while suffering from brain fog and other cognitive impairment found in long COVID.

75 replies
  1. Rayne says:

    I know, I know, it feels like all this has been said before and yet we apparently need to go there all over again.

    This shit is personal, Nate Silver, you mothertrucker — I’m fully vaccinated and living with an autoimmune disorder and I really, REALLY don’t want to end up in Montel Williams’ shoes because some mediocre white dude with an excess of confidence and a bad case of Dunning-Kruger thinks they can write everyone a permission slip to go back to a normal that no longer exists.

    • Alan Charbonneau says:

      I’m surprised that Silver opined without data—he usually (but not always?) uses data in his analysis.

      In any event, this article from Lucian Truscott IV is right in line with your article:

      “If you get down in the weeds of the CDC findings, you find that the lack of immunity provided by the current vaccines has to do with the way the antibodies produced by the vaccines act within the body. When the COVID vaccines are injected, the antibodies produced by the human immune system appear mostly in the blood. ‘Some antibodies may make their way into the nose, the main port of entry for the virus, but not enough to block it,’ the Times reported Friday. ‘The Delta variant seems to flourish in the nose, and its abundance may explain why more people than scientists expected are experiencing break-through infections and cold-like symptoms.’”

      “Vaccinated people can spread the virus almost as easily as unvaccinated people because the so-called ‘viral loads’ in their noses and upper respiratory tracts can be nearly as strong as in unvaccinated people. When vaccinated people become infected, the virus attempts to travel from the nose and throat into the lungs. This is where the antibodies built up by the vaccines go to work, preventing a severe enough infection to need hospitalization. ”

      • Rayne says:

        That detail, right there which Lucian notes — the Delta variant seems to flourish in the nose — is EXACTLY why masks are necessary right now, why we should never, ever have let up with masking even with the vaccines distribution.

        Every time I read or hear of someone complaining of a summer cold I wonder if it’s really a mild case of COVID.

        • Ken Muldrew says:

          With an R_0 of around 5 or so, cloth masks are likely to be far less effective than they were for the initial strain. Fortunately, however, governments around the world realized at the start of the pandemic that we had a critical bottleneck with PPE manufacturing and they used emergency powers to get corporations to make N95 masks like crazy so that we would be prepared for the current situation [insert emoticon that means “we will never learn until it’s too late”].

          • subtropolis says:

            Wearing a mask is primarily about containing the virus that one may already be harbouring. It may provide some personal protection, but it’s really about cooperating so that the one person in the room who has been infected is not easily infecting the others.

            • timbo says:

              It’s also about demonstrating that one is conscious that this is actually an important issue. And also, wearing a mask also keeps one on their toes when it comes to other areas of hygiene, etc. It’s about a culture of being cognizant this it ain’t just about the mask itself.

        • Alan Charbonneau says:

          Yes, that item caught my attention as well. I think of “asymptomatic carrier” as someone with a covid infection—I.e. an infection in their bloodstream, lungs, etc that simply had not expressed itself with symptoms.

          But having the variant only in the nose is, in effect, sequestering the virus from the rest of the body. It’s like you don’t even have it. My understanding is that it doesn’t get into the blood because the vaccine built antibodies there. So, with it in the nose, it may as well be in an incubator.

          From an evolutionary perspective, this ensures it’s survival. It’s host is mobile, keeps it alive, and is only a sneeze away from finding another host.

          It’s as though the virus is in hibernation in your nose; like you are carrying it around in a test tube. Scary stuff.

          • Hika says:

            This phenomenon of Covid (or any other disease) being localized to the site where it entered the body is called “colonization” rather than infection. [I learnt that just the other day from a couple of doctors tweeting.]

  2. Leoghann says:

    I guess I completely missed what credentials Nate Silver has in national permission-giving. While statistics do play a part in tracking an epidemic, it’s the virology that contributes the most. Silver has even lost some of his luster as a statistician since his lousy streak of predicting election results started in 2016. And, in his role as a civilian with an individual opinion and an education in a totally unrelated area, I could give less than a shit what he thinks about what I should do.

    Nearly forty years ago, for an assignment on mob rule versus public consensus in a college government class, I wrote about the “Spanish” flu epidemic of a century ago. Knowledge about virology and epidemiology has grown exponentially since 1984, rendering some information that my researched turned up no longer particularly valid. But one thing I thought was ironic, and still do, is that that particular flu virus actually had its worst effect on young, healthy adults. One of its characteristics was to directly attack the immune system in a way that it would turn against itself. In healthy people with strong immune systems, the virus could almost destroy respiratory systems, and often caused death withing 3-4 days. Those with weaker immune responses did not get that autoimmune response, and thus only had to fight the respiratory symptoms. Early research into the effects of Covid-19 have indicated that those who had seemingly recovered, but developed new, sometimes seemingly unrelated symptoms that caused their death or incapacitation, were attacked by that same autoimmune response. The reports of the Delta variant to attack younger and healthier people, including children, and making them much sicker, makes me wonder if this mutation has developed that characteristic of the 1918-19 influenza virus.

    • bmaz says:

      No, you did not miss anything there. Nate was valuable as a baseball data guru. He is out over those proverbial skis with political opinion. He is not good at that.

    • Ginevra diBenci says:

      The 1918 flu pandemic was deadly to younger people because their immune systems hadn’t “seen” it before. Their older neighbors had weathered a late-19th-century outbreak, developing antibodies that protected them in 1918,while these young adults proved helplessly virginal from an immune perspective.

      • timbo says:

        My understanding is that it was folks in late youth to middle age that were most significantly group effected by the pandemic of 1918-19.Thus, it was breadwinners and folks in the prime of their adult life that were struck down. Of course, back then, if you made it to old age, you were likely one tough cookie and your immune system was probably effectively more robust, on average, than those of us alive today.

        • Rayne says:

          Other way around. Spanish flu deaths among the young were due to cytokine storms — aggressive response to the virus. Older persons who’d been exposed to an earlier similar flu had a more efficient response, not more robust.

          Many COVID deaths can be similarly described as aggressive over-reaction swamping the body. The vaccines work by providing the body a target, more or less, on which the immune system can train a more efficient response.

  3. Kilian says:

    Thanks, I fully agree that those vaccinated still need to take additional measures to protect others and themselves.

    I was surprised by the 70+% vaccination threshold in the last sentence, though. My understanding is that the higher transmissibility of the delta variant requires a significantly higher threshold. Here in Germany the RKI released new estimates that a vaccination rate of 85% for ages 12-59 and 90% for ages 60+ is needed to prevent a 4th wave in autumn/winter. [1] Should an even more transmissible variant emerge and become dominant, full herd immunity could even become unreachable. Characterizing herd immunity as an average vaccination rate that needs to be achieved is also not without issues because in reality there are “pockets of susceptibility and pockets of immunity”. [2]

    But that just underscores your point that there is no going back to the old normal and that we have to get used to a new normal that includes vaccinations, masks, distancing etc.

    I’m a long time reader (I came across the blog in 2015 if I remember correctly when I got more interested in US politics ahead of the 2016 election) but this is my first comment. Thanks everyone here for writing, I’ve learned a lot!

    [1] Only available in German but with the scientific details:
    As an English source, Deutsche Welle reported the same numbers when Merkel visited the RKI:

    (I don’t know yet how to make nice links here, that’s why I added the links as I did)

    • Rayne says:

      I say 70% because I’m taking into consideration roughly 20% of population which is too young for the current vaccines (under age 12) and the remaining adult population which is either unable to get the vaccine due to immune disorders or other conflicting health care problems, and the residual authoritarian idiots who won’t ever get the vaccine.

      I’m trying to resign myself to an autumn-into-winter surge because of idiotic leaders like Florida’s Governor Ron DeSantis who signed an order prohibiting school districts instituting mandatory mask wearing. At least universities are beginning to catch on, like University of Michigan and Michigan State University which yesterday instituted mandatory vaccinations for all students, faculty, and staff.

      Welcome to emptywheel – comment more often. No worries about the links, they work just fine. ;-)

  4. Hika says:

    Spot on, Rayne. I have immune-compromised 80 year old parents and I know I’ll be an orphan one day but I don’t want that to happen because some fit young individual couldn’t handle wearing a mask and keeping out of arm’s reach.
    As to Nate suffering the effects of D-K, I have to agree. One of the greatest benefits in my education was gaining an understanding of the (small) bounds of my competence – and one of my degrees is in mathematics with a particular focus on probability and statistics. The key difference between an expert on the mathematics of statistics and an expert in a particular scientific subject is that the subject expert knows intimately the data being fed into the statistical models, and so really understands the scope/limitations of the statistical analysis so much better than someone who simply knows how to do the sums. Or, as you put it, understanding how Covid is going involves input from epidemiologists and virologists and not so much baseball pundits who hash together political polls.

    • Alan Charbonneau says:

      “The key difference between an expert on the mathematics of statistics and an expert in a particular scientific subject is that the subject expert knows intimately the data being fed into the statistical models, and so really understands the scope/limitations of the statistical analysis so much better than someone who simply knows how to do the sums.”

      Yep. About 15 years ago, I went back to night school to study math. I read a lot of posts on a newsgroup from Herman Rubin, an emeritus professor of statistics at Purdue. He stated something similar. He pointed out that engineers would choose a differential equation that could be solved in closed form rather than using the proper equation even if it needed to be modeled.

      He would criticize PhDs who knew all of the statistical techniques & software, but not the underlying problem. Rather than properly understand the problem and the approach required, they’d reach for one of their statistical “tricks” and find a solution, even if it was the wrong solution.

      • BobCon says:

        One of the easy tells for whether someone is serious or not about data is how seriously they take the very small and very large numbers. When someone treats 1% and 0.001% the same, or conflates 1,000 and 1,000,000 you need to watch out.

        The sign of an expert is they do the work necessary to tease out these distinctions and understand the implications. Hacks can’t, or won’t, accept the difference.

        The financial collapse of 2007 happened in large part because quants got sloppy and collapsed a lot of risk factors that were close to zero into pure zero, and extended them from large pools of money into geometrically larger pools.

        The same faulty thinking is what Silver has been doing with Covid, and we’re facing the same results.

        • harpie says:

          I’ve just been transcribing notes from a 12/29/20 phone call between Trump and DoJ [about the election]:

          [DOJ to TRUMP]: We are doing our job. Much of the info you’re getting is false [underlined in original]
          [on] MI – report says 68% error rate – but reality is it was .0063% error rate – less than 1 in 15K.

        • Alan Charbonneau says:

          “One of the easy tells for whether someone is serious or not about data is how seriously they take the very small and very large numbers.”

          Yes. One of prof Rubin’s examples was a long-tailed probability distribution. I can’t remember the numbers, but it was something like 70% of a cumulative distribution was comprised of 1-in-1-million individual probabilities. He asked a poster, how do we treat them? Do we simply ignore them?

          He was a smart guy. He got his PhD in math from the University of Chicago when he was 21. He would’ve received it at age 19, but was drafted for WWII. 😁

  5. arbusto says:

    Seeing more articles about Covid moving to endemic. Wonder if the aluminum hat crowd will ever care enough for family and friends to rejoin our fractured society.

  6. d4v1d says:

    If I were to suggest an edit, the part about credentialed experts “who are on top of the data” might more accurately say something about being immersed in volumes of complex data that defies simple interpretation.

    At altitude, the cdc vectors in the most effective direction in the way a 747 does -deliberately, but it doesn’t turn like a fighter. Unfortunately, the civic leaders and certain entrenched media stars (the aforementioned Nate Silver comes to mind) navigate like the evergivem.

    h/t Rayne, ace fighter pilot

  7. skua says:

    We’re getting pretty mild touches of a COVID epidemic here.
    Delta is running at ~200 new cases a day in one state. Bet there are those who wish they had that problem. Fortune, and the need to keep the lucrative mining industry COVID-free, has my state vigorously and successfully defending its zero-COVID approach.

    Most interviews being played by the media are based on the same premise as interviews from a year ago, pre-delta; “Although the variant we are facing currently is less than a year old, we feel confident enough to speak as if we have certainty about how this will all play out.”
    Anyone pushing that barrow needs to be marked as unreliable.

  8. Pete T says:

    Oh, it’s real all right.

    Daughter in law, wife of my oldest son, they with one year old daughter was informed the other day that two girl friends she spent time with the day before started feeling poorly and both tested positive the day after the mingle. Everyone had been vaxed and were masked when they mingled. So, it’s about time for daughter in law to start a series of tests on top of the stress that entails.

    Let me close by stating: screw Gov. Ron Desantis just because.

  9. Icantremember says:

    Thank you for this post. I’ve been increasingly upset/angered by the coverage I’ve seen about the variant in general. I have a son who is too young to be vaccinated (as of now) and who is at increased risk due to having spent his first months of life on a NICU ventilator. As his school prepares to throw him (and all the other unvaccinated younger kids) into the ring this fall while simultaneously lifting mask mandates for the older kids’ “mental health” (which is just as important as not dying, you know!) I am beyond frustrated that the people making these bad decisions about my kid’s safety have a veritable mountain of pull-quotes from “credible” public figures who either totally misunderstand the reality we’re in, or have just had enough of the pandemic and are charging toward “normalcy” at all costs.

    [Welcome back to emptywheel. Your last couple comments were under username “JMNY.” /~Rayne]

  10. RWood says:

    While I applaud your efforts here and elsewhere, I doubt it will reach the anti-vaxxers.

    Example: A high school friend I’ve kept in contact with recently survived his own battle with Covid. ICU for 32 days. ECMO. Pacemaker. Ventilator. They called the family twice when they thought he was close. Somehow he made it out alive. He now has heart and lung damage for life and will be declaring bankruptcy soon as he was switching jobs when it happened and he had a lapse in coverage.

    Before all this he was a dedicated cult member. Covid was a hoax and we were all sheep. Refused the vaccine and was proud of it.

    He jumped right back on the trump train as soon as he got home.

    • Rayne says:

      Some will surely jump on my ass as soon as I say this but I can’t worry about the denialists. They are choosing disability and death. What I resent is that their personal choice is given legitimacy over the rights of those who can’t consent (ex. children and some disabled) to exposure while expecting the rest of us to pay for the outcomes from their choices without our consent.

      I have to worry about the people who mean well, want better, and trust morons like Nate Silver.

      • Bill Crowder says:

        At some point, the health of those who choose to pay attention to science and the experts has to be given preference over the abstract “rights” of those who don’t believe in science. The consequences of not doing so are too awful to do otherwise.

        My reading comments to media (NYT for example) and talking to family and friends leads me to think science believers are getting fed up and are willing to go to greater protective measures.

        Most common comment I hear? Fuck ’em.

        • CWolf says:

          Whenever a clot of anti-vaxxer dies, the collectives IQ of what remains of society rises a bit.

    • BobCon says:

      I agree that the antivaxxers are the bottom of the barrel for worrying about.

      The critical thing is not universally lumping together opponents and non-compliers. That’s why beating back the Silverist mindset is so critical.

      There are a huge number of people in this country who aren’t opposed to health measures in any serious way. They are simply tuned out and do whatever they see other people doing. They are working 14 hours a day, or they’re busy taking care of their kids, or they’re just not interested. Many still don’t realize that shots are completely free, they don’t even realize Delta is out there, and they are easily swayed by someone who is supposedly authoritative because they only rarely hear from real authorities.

      They may only catch five minutes of the news a week while listening to the car radio, if that, and getting bad opinions like Silver’s head in the sand stuff out of the public discourse is critical to increasing compliance by low information members of the public.

      The deniers desperately want everyone to think that every unvaxxed person is antivax, because it makes their side appear to be much more powerful than it really is. Understanding the actual breakdown between the hardcore and the uncommitted is critical to controlling both the virus and the political movement hoping to exploit it.

    • Leoghann says:

      We’ve been seeing news items for 18 months about cultists who, when their loved ones died from Covid, threatened their doctors and hospitals with legal action because Covid was listed as the cause of death, and were furious because, to them, Covid doesn’t exist.

  11. nord dakota says:

    There’s that whole thing about how humans aren’t good at risk assessment. I’m vaccinated and so is my son. I started wearing masks to places where required last summer, had been working from home, don’t have much of a social life anyway and the people I do see are all vaccinated. Last November I was invited to go out to eat with my nephew’s family, my brother in law, 2 nieces and the SO of one of the nieces. I was planning to go but started thinking about Covid possibilities–everyone in that group except for the one niece and her SO had been very cautious (nephew and his wife take care of BIL who has health problems and lives next door to them). I decided against going. Five days later the one niece and her SO both contracted Covid from SO’s child who spends weekends with them. (Idiot niece also went to her job as a restaurant cook the day after she developed a sever headache–she’s not a covid denier, she’s just clueless sometimes).

    Anyway, a few weeks ago my son (31, also vaccinated) started getting tests because of weakness in one leg along with balance issues. Last week neurologist said classic MS although there are more tests before they make the dx official (his MRIs show loss of myelin in brain and spinal cord so we know that’s being damaged, the pending tests are just to rule out some other possibilities). So he just had 5 days of prednisone infusions, and a few days ago he travelled to Michigan (3 states away) for work. While he was gone I heard the news about viral loads in noses. I know that with MS treatment will affect immune system so we get to worry about Covid as well as MS.

    I do wonder sometimes if we will be emerging into a state where new diseases emerge more and more often as one of the consequences of human impact on the planet along with patterns of human population and behavior as our numbers continue to grow.

    • Rayne says:

      I do wonder sometimes if we will be emerging into a state where new diseases emerge more and more often as one of the consequences of human impact on the planet along with patterns of human population and behavior as our numbers continue to grow.

      Pretty sure a number of scientists expect just this model, increasing emergence of new disease threats in part because of population growth encroaching on undeveloped environment, as well as changes in conditions due to climate change.

      Very sorry to hear your son’s health is challenged. There is so much new research into MS which will change therapy over the next 5-10 years, though; I hope it catches up to his needs sooner rather than later.

      • Molly Pitcher says:

        I am curious about what impact climate change is having on the seeming increase in zoonotic diseases ? SARS, MERS and now Covid 19 all seem to have originated in the animal world and crossed over to humans.

          • Yancy says:

            Climate change, as well as the migration of refugees, plus resource development/removal/destruction leads to the encroachment of people on areas and species that significant populations of humans had not previously interacted with or been exposed to…
            I think it is all, if not interrelated, contributory.

            Global climate crises have increased exponentially, exceeding even the predictions of climate scientists worst case scenarios.
            Have we already passed the tipping point?

            I hope GenZ will be our sanity and our salvation, but I hate that my young adult children are forced to cope with the consequences we as a civilization have bequeathed to them. The world’s current political situation doesn’t inspire, either.

            I do not expect my organ transplant recipient family member to make it through this pandemic.
            Sorry for the pessimism.

  12. P J Evans says:

    Thanks to sites like this, when CA decided the vaxxed could go without masks in mid-June, I kept mine on. And in mid-July, when my county said fck it, wear a mask indoors, I was not surprised. (The businesses I go to hadn’t lifted their mask rules.) Even when pharmacies are doing vaccinations, they still want you to make an appointment, which requires a smartphone or a computer – and they aren’t reaching people who have neither, or aren’t comfortable with either.

  13. greengiant says:

    A difficult week. I posted about masking and breakthroughs and one responded their parent vaccinated in January was on a ventilator.
    A social media post about 15 vaccinated people meeting up and 7 coming away with Delta.
    50 percent of cases in Israel were fully vaccinated. The catch was that a big fraction of cases were under 20. In each of the older age groups 70 or 80 percent or more were fully vaccinated.
    Now Barnstable County Mass. Breakthroughs 87 percent males median age 41. Living like it is 2019 does not work. See the Dutch Aspen Valley nightclub event with over 180 cases out of about 600 attendees.

  14. Duke says:

    So much for indoor concerts and sporting events.

    I have a feeling we are merely in an eye of the hurricane. Back to mask it or casket.

  15. Rugger9 says:

    It does make me wonder how much of a heads up CDC had given the FDA about the Delta variant, because as safe and effective as these vaccines have proven to be it is very unusual for FDA with all of this history to not have pulled the full approval trigger. Maybe they’re waiting on Delta or boosters (Israel is running those now), but full approval undercuts a key excuse for not vaccinating, and opens the door for government mandates that could survive court challenges.

    • Rayne says:

      There are two possible reasons which aren’t mutually exclusive and there may be other reasons:
      — Once the vaccine is approved as standard schedule, the insurance companies will be in the mix and they’ll do the least possible;
      — We don’t yet have a Biden-appointee at the helm of FDA, only an Acting Director. David Kessler is rumored to be Biden’s choice but Big Pharma isn’t onboard because Kessler is big into real oversight of drug approvals.

      So federal government needs to get its legal eagles on this and find a way to establish a mandate which will survive lawsuits.

      • RWood says:

        If you are hospitalized with Covid for 6 to 10 days, you can expect to pay between $89,874 and $155,619. If you need ECMO, a ventilator, or cardiac care it’s even more. Many bills are reaching mid-six figures with extensive follow-up care. A Remdesivar treatment alone cost $15,000.

        One patient in Seattle had a bill totaling $1.1 million dollars. $400,000 for six weeks in the ICU, and $82,000 for a month on a ventilator. And that’s only the beginning.

        Insurance only cuts it down to a little under half for most.

        And what if you don’t have insurance?

        The insurance companies are already looking at BILLIONS in losses for this pandemic. Sooner or later they are going to start looking for ways to avoid that.

        They can’t do that you say? They already are. Restaurants and other businesses are suing their carriers for denying them their “business interruption insurance”. How long do you think it will be before they start doing that to individual policyholders?

        Is the vaccine available in your area? Have you publicly stated that you are refusing to get it? That may be all they need to label your sickness “Avoidable” and deny your claim.

        The ones that manage to survive and walk out of the hospital will find themselves bankrupt when the bill arrives. They’ll also have a “pre-existing condition” for the rest of your life, so good luck finding affordable healthcare with that.

        We know they don’t care about their own life, the life of those around them, including their own family, but imagine all of them living on the streets this time next year.

        All because they refused to get a free vaccine.

        Will the insurance companies do this? Let’s look at the numbers.

        “In April 2020, a Kaiser Family Foundation study projected that the cost of treating just COVID-19 cases for the uninsured would range from $13.9 billion to $41.8 billion. If even close to 30 percent of Americans get COVID-19 because they refused to get vaccinated, we’ll see a massive spike in health-care costs.”

        You only need to ask yourself what the insurance company values more, you, or their $41 billion dollars?

        A better question would be “Why would they NOT do this?”

        • Rayne says:

          The people who won’t get vaccinated under an insurance industry regime are the same ones who don’t have adequate or no health care now. They won’t cost the insurance industry anything because they’re already denied other care.

          It’s like voter suppression all over again — it’s health suppression.

    • Raven Eye says:

      According to an interview I heard, one of the requirements for full approval is that the manufacturer must satisfy the entire scope of the production, logistics, and vaccination processes. Things like the packaging and labeling, transportation, storage, shelf life (before and after vials are unsealed), syringes, instructions, etc., etc. That normally occurs following completion of the medical requirements. I wouldn’t be surprised if a lot of this has been or is being front loaded, but everything still must be reviewed and completed in order to get final approval.

  16. Parker Dooley says:

    Retired general internist here — not a virologist or epidemiologist.

    So, Nate Silver — Nature’s next pitch, the “omega” strain — transmissibility of delta & lethality of SARS or MERS?

    By the way, we will never be rid of this plague because it has a zoonotic reservoir, e.g cats, non-human primates, ferrets & who knows what other species, all forming a reserve army of carriers and petri dishes for evolution of new variants. Probably the pathway by which the common cold variants of coronavirus became relatively harmless was by killing off the cohort of individuals whose immune systems could not handle it — as happened with native American and Pacific Island populations by the “usual childhood disease” measles (as Rayne well knows).

    And Rayne, thanks in particular for the ICU nurse’s comments. What do people think the mortality rate would be without modern, technological medical care? My daughter does that job in Duluth, and I am increasingly worried about the likelihood of her contracting delta.

    • Rayne says:

      The zoonotic reservoir has been on my mind — it’s nightmare fuel. Read something just in the last 24 hours that at least half the samples taken from my state’s wild deer herd test positive for COVID exposure. Not that hunters get into deer breathing space but how might the virus mutate in Cervidae (ex. other deer species)? Will it cross over to Bovidae (ex. cattle, buffalo) and then back into a new form to humans through herding and abattoirs?

      We may be totally fucked.

      WRT the ICU nurse: You have no idea how many times I have thanked the gods of the timeline that my mother has retired from nursing. I can only imagine her fury if she had to deal with intubating denialists day in and out, knowing there’s worse ahead for many of them who survive.

      • Parker Dooley says:

        Rayne, I didn’t know about the deer. Dozens of them around where I live. And I thought all I had to fear from them were tick-borne illnesses, prions and car wrecks.

        Editorial in this week’s JAMA entitled “Potential Covid-19 Endgame Scenarios: Eradication, Elimination. Cohabitation, or Conflagration?” Doesn’t seem to recognize the role of air travel & tourism.

        This is truly shaping up to be a catastrophe.

        • Rayne says:

          Wow. That editorial has to be one of the most simplistic assessments I’ve read to date.

          Kofman A, Kantor R, Adashi EY. Potential COVID-19 Endgame Scenarios: Eradication, Elimination, Cohabitation, or Conflagration?
          JAMA. 2021;326(4):303–304. doi:10.1001/jama.2021.11042

          This calls to mind a specific quote by one of my favorite authors and thinkers, Ursula Le Guin: “Science fiction is not predictive; it is descriptive.” I’ll believe sci-fi authors at this point over MDs who clearly haven’t thought as deeply as they should have about the risks ahead.

          Imagine what happens when something thaws (or has already thawed) from the permafrost which combines with and accelerates the SARS family of coronaviruses. Jeebus.

      • Epicurus says:

        We use vaccines and walls, such as masks and segregation, as our prime defensive measures against viral diseases. See the movie I Am Legend as a great example. They are ancient and slowly developed technologies, but effective when used in certain ways and for populations that wish to use them. The US and other countries have sub-populations that do not wish to use them.

        Future viral control technologies will be based on Edward Fredkin’s digital physics, i.e. some form of nanocytes as hunter-killer agents will be developed and employed that will recognize a given virus through its electrical signature or cellular structure and destroy it, or electrical interrupt mechanisms will be developed to disable the viral RNA sequencing. It won’t happen in my lifetime but I can see it clearly in Dr. McCoy’s work in StarTrek movies. We are only “f….d” in the short term because we are dependent on slowly developed vaccines, masking, and distancing/segregation.

        • P J Evans says:

          I am not going to worry about what future methods will be used for viruses, because I don’t live in the future. What we have now are PPE/masks, distancing, hygiene, and vaccines, and we have to use them, because that’s ALL we have.

        • Rayne says:

          mRNA is far more efficient. Use of CRISPR to develop a biological sweeper agent is next most likely. Nanocytes aren’t likely in next couple decades because other more effective methods exist already.

          We are fucked because the human mind is weak when it comes to propaganda.

          • Epicurus says:

            mRNA and CRiSPR are methods that teach cells in the body to create desired proteins and to alter genomes to fight viral invaders among other uses. They shore up body mechanisms by making cellular changes in/to the body. They are defensive measures against invaders.

            Nanocytes or electrical interrupt mechanisms would be non-cellular altering measures that attack viral invaders. They do not make cellular changes to the body. They are offensive measures against viral invaders.

            mRNA and CRISPR are more effective because that is what we have now. I said above I won’t see nanocyte technology applied in my lifetime but it will most surely come, just as mRNA and CRISPR applications have come and people will choose which combination of offensive and defensive measures they wish.

            I made the “worry about the future” comment not as annoyingly insensitive or slow to understand but as a recognition of what this site tries to do, I think. This site discusses current events but looks to the future in all things as in how do we stop situations like the Capital riots or climate change or animal to human disease transmission from happening in the future. It tries to be an enlightenment site.

            I don’t think we are “f…..d”. I often reference Daniel Kahneman’s book “Thinking, Fast and Slow” for its description of how our thinking is susceptible to propaganda and how the mind also pushes through that susceptibility to reach great heights and progress. I think that is the future. I think that process is something about which we should worry.

        • Rayne says:

          It will be wholly unsurprising to me that an infectious variant will arise from a domesticated animal or several. It’s just a matter of time given how badly the pandemic was handled under Trump and how poisoned the entire body of discourse has become around the likely evolutionary paths this virus will take.

          I’m actually surprised we haven’t seen an extremely infectious variant arise in the U.S. just as Delta arose in India and Lambda from Peru.

          • Eureka says:

            I think that last item falls under you don’t find what you don’t sequence…my money’s on LA (for whatever reason, of the flaring states — tho the writers would call for FL and rightfully so) for something (having been) percolating-competing w/Delta. The sequencing surveillance is so uneven.

            I broached the subject of “Delta plus” trending with exhausted hcw en route to work and was told STOP I DO NOT WANT TO HEAR IT. [I yelled out “South Korea- two cases” as a parting soother. ~LOL~]

            • Rayne says:

              Said just that tonight with my youngest who is ill and waiting for their PCR test results. They said nobody’s getting tested like they did last year — they’d gone through it two different times after exposures last summer/fall and had to wait in line for 4 hours. This time they simply walked in but nobody was being tested. With +60% vaccinated it’s not a priority and that’s frustrating. We should be encouraging random testing across the population as a preemptive measure, running sequences on whatever is found.

              • Eureka says:

                I hope they get good news.

                I was just thinking lately about how they’re not publicizing the testing sites anymore: lots of folks just going to ER to get tested — that was the trend some weeks ago anyway — which is a waste of resources esp. when the sites aren’t rocking and the hospitals are. Now they’re getting a bunch of “walking well”: “I have COVID and I don’t feel good.” “Welp, maybe shoulda got a vaccine.” On top of the sundry critically ill, of course.

                Which reminds me re the video in your post: too bad they didn’t also show the required suctioning and secretions therefrom (sound on) *but also the guttural pain face that goes with it*. I assume they didn’t have consent from the patient/family to film the face.

                Yikes, help us all…

          • P J Evans says:

            Duck, chickens, or pigs would be my guess for likely places – we know that a lot of viruses cross those lines into people. Not usually in the US, though; more likely China/India.

            And on a Twitter thread about the next version of the virus, there was an idjit from Spain arguing that the vax isn’t sufficiently tested, government is pushing it without evidence, etc, and all the sources are non-science news media. (Reported several of the more egregious lies, but expect no action.)

            • Rayne says:

              I agree that duck/chickens/pigs are likely sources of a nextgen mutation, but less likely in the US than in other parts of the globe. I wouldn’t be surprised if cats were the source in the U.S. given how closely pet owners live with them and that SARS was sourced to civet cats (suborder Feliformia).

              The Spanish anti-vaxxer thinks the math doesn’t count:

              The biggest vaccination campaign in history is underway. More than 4.21 billion doses have been administered across 180 countries, according to data collected by Bloomberg. The latest rate was roughly 41.9 million doses a day.

              In the U.S., 347 million doses have been given so far. In the last week, an average of 681,373 doses per day were administered.

              (source: Bloomberg, More Than 4.21 Billion Shots Given: Covid-19 Tracker, August 3, 2021, 4:31 PM EDT)

    • Rayne says:

      That dunking was in 2017 and it was nearly a month after Trump’s inauguration — a little too late when ideally Silver would have been tracking states of candidates’ coverage all through the election season and what that coverage did to public perception reflected in polling data.

      I’m not cutting Silver any slack for stupidly encouraging vaccinated people NOW to act in ways which may result in greater numbers of sick, disabled, and dead.

      • Mike Sax says:

        Ok I missed it was from 2017 lol-as it was at the top of a search I did just yesterday.

        Honestly since he has made himself the resident contrarian expert on where the Covid experts are overdoing raising public concerns I’ve largely checked out of his Twitter feed. He is-or at least was-a very good polling analyst-too bad he doesn’t seem interested in that anymore.

        This is a perfect example of the folly of his position-IF folks are urged to needlessly wear masks a few more weeks-where is the harm? Whereas if they are told they need not wear them when we’re not out of the woods there’s considerable harm.

        The risk is clearly all on the side being too sanguine rather than towards showing overabundance of caution

  17. Wm. Boyce says:

    I’m keeping my mask on when around others for the foreseeable future. Customers who come into my home workshop have all felt the same. We all will die, but this illness is really one I don’t want to contract.
    And thanks, Rayne, for your collection of knowledge.

    “There was so much crap in my social media I couldn’t help yell, “Bullshit, bullshit, absolute bullshit!”

    Isn’t this the daily norm for social media? It and the internet in general are making people dumber every day. The tide of bullshit rises ever higher.

  18. skua says:

    I’ll add another real possibilty that would heavily bias towards caution.
    That being that both getting infected and also the severity of infection may depend on the number of COVID19 viruses that arrive in a short time span on a person’ respiratory epithelia (surface cells in the nose, throat etc).

    Having unmasked people interacting will increase the average viral payload that is delivered.
    This incease could be transformative.

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