Northern Europe during Pandemic -- Summers 2020 & 2021 & onwards

[UFO]

Originally Posted by Dockhead

Big Pharma hit the ball out of the park with the vaccines. Just an unbelievable achievement. I can't even imagine where we would be without it. I guess 10 years ago this would have been impossible so I guess mankind is really lucky.

Giant kudos also to the UK with the unbelievable vaccine rollout. Best in the world but for only Israel, AFAIK. Imagine how different this would all look if the UK were rolling it out like, say, Finland. Some European countries haven't even started!

As to whether to stop the vaccination program with over 50's -- you're a medical doctor and I'm not, so obviously huge respect for your position. But don't we want to stop the virus from circulating? If we stop vaccinating in May and allow the virus to continue circulating, why that's where new mutations will come from, isn't it? With the new risk of infection of vaccinated risk-group people? Why wouldn't we want to just snuff it out? Herd immunity will be within spitting distance by that time.

I know you're circumspect about safety of the vaccines, but is there any single reason to believe that they are not safe? Considering the apparently 100% effectiveness of the vaccine against serious illness and hospitalization (not to mention death), surely the hypothetical risk of some heretofore unknown side effect of the vaccine, is worth it to prevent harmful effects of long COVID for even young people. Not to mention the beneficial effect of faster herd immunity.

Vaccines can and do cause the evolution of viruses. Vaccines are not a magic bullet, if you really think this is going to disappear just because they vaccinate a certain %, I fear that you are in for a rude awakening.



You talk about Long Covid, What about Long Vaccine? No one knows the long term side effects of these new vaccines, more to the point no one really knows the long term side effects of traditional vaccines as there have been no serious studies on it in regards to vaccinated Vs Un-vaccinated. Why have there not been government studies on the massive increase in Chronic illness in the last 30 years with the control groups of vaccinated and un-vaccinated? Probably because the answer is not what they want and not profitable. Funny how just coincidentally this increase matches the massive increase in the vaccine schedule for children over that time frame. There have been plenty of university studies on Vaccinated Vs Un-Vaccinated which are pretty damning for vaccinations in regard to chronic illness.

[GordMay]

Originally Posted by UFO

... No one knows the long term side effects of these new vaccines, more to the point no one really knows the long term side effects of traditional vaccines as there have been no serious studies on it in regards to vaccinated Vs Un-vaccinated. Why have there not been government studies on the massive increase in Chronic illness in the last 30 years with the control groups of vaccinated and un-vaccinated? Probably because the answer is not what they want and not profitable. Funny how just coincidentally this increase matches the massive increase in the vaccine schedule for children over that time frame. There have been plenty of university studies on Vaccinated Vs Un-Vaccinated which are pretty damning for vaccinations in regard to chronic illness.

Which is it?

[GordMay]

Withholding approval of vaccines, for many years, to look for long-term health conditions would not be practical, and withholding an effective vaccine, while long-term studies are being done wouldn’t be ethical.
A more practical approach is to look at health conditions themselves, and at the factors that cause them. Scientists are already working to identify risk factors that can lead to conditions like cancer, stroke, heart disease, and autoimmune diseases such as lupus or rheumatoid arthritis. Thousands of studies have already been done looking at hundreds of potential risk factors. If immunizations were identified as a risk factor in any of these studies, we would know about it. So far, they have not.
We learn about a vaccine’s safety during clinical trials before it is licensed, and monitor it continually, as millions of doses are administered, after it is licensed.
We also know there is not a plausible biologic reason to believe vaccines would cause any serious long-term effects. Based on more than 50 years of experience with vaccines, we can say that the likelihood that a vaccine will cause unanticipated long-term problems is extremely low.

FWIW: A Google Scholar search on “long term studies of vaccine” returns about 2,620,000 results.
➥ https://scholar.google.ca/scholar?q=...=1&oi=scholart

[Seaworthy Lass]

Originally Posted by Dockhead

As to whether to stop the vaccination program with over 50's -- you're a medical doctor and I'm not, so obviously huge respect for your position. But don't we want to stop the virus from circulating? If we stop vaccinating in May and allow the virus to continue circulating, why that's where new mutations will come from, isn't it? With the new risk of infection of vaccinated risk-group people? Why wouldn't we want to just snuff it out? Herd immunity will be within spitting distance by that time.

I am not a “medical doctor”. I am no more than a retired full time cruiser and I have been for a long time. My opinion is no more valid than anyone else’s here. This is a new virus and although we know a lot more than we did a year ago we still know very little. The issues are complex and there is still a lot of guesswork, both with prevention and treatment.

You raise lots of good points. Yes, reducing infections will reduce the risk of mutation. This increases every time a virus replicates. That is certainly one consideration and I suppose every little bit helps.

Putting issues of vaccine safety aside for the moment, my personal thoughts are that rapid herd immunity through vaccination is a difficult goal to achieve in this instance, particularly for countries where the number of cases has been low. The numbers simply don’t make sense to me. If the risk of transmission goes down by around 70% that leaves 30% of those who are vaccinated still transmitting if infected.

Those under 20 seem to be mainly symptom free or minimally affected and in the US, for example, they make up close to 30% of the population:
https://www.infoplease.com/us/census...hic-statistics
Why unnecessarily expose healthy children to any risk at all with a vaccine?

So if you could persuade 80% of those over 20 to be vaccinated (56% of the population in the US) and vaccines turn out to be around 70% effective, which initially seems could be the case, then only around 39% of the US population is not transmitting the virus when exposed.

How is herd immunity to be achieved unless this is combined with a high percentage of post-infection immunity in those unvaccinated? Where am I going wrong with my numbers?

From general reading, I think COVID-19 is likely to become an endemic problem in the shortish term and of relatively minor concern if the minority who are at high risk continue to be vaccinated. Vaccines can apparently be easily tweaked if the virus mutates. In time the rest of the population will become exposed (possibly with minimal symptoms if they are young and healthy) and develop some natural immunity. “Herd immunity” to some degree will occur of its own accord without mass vaccination.

Originally Posted by Dockhead

I know you're circumspect about safety of the vaccines, but is there any single reason to believe that they are not safe? Considering the apparently 100% effectiveness of the vaccine against serious illness and hospitalization (not to mention death), surely the hypothetical risk of some heretofore unknown side effect of the vaccine, is worth it to prevent harmful effects of long COVID for even young people. Not to mention the beneficial effect of faster herd immunity.

This is a new virus, new technology, so far with no data released for studies over 90 days following the first dose of a vaccine. All vaccines have side effects, some minor, some more severe but rare. Some do not become apparent until well after a vaccine has been fully approved.

eg From Wikipedia:
https://en.wikipedia.org/wiki/Vaccination
“Certain vaccines have had adverse outcomes identified after being used in mass vaccination programs. In 1976 in the United States, a mass vaccination program swine flu vaccine was discontinued after cases of Guillain–Barré syndrome. William Foege of the CDC estimated that the incidence of Guillain-Barré was four times higher in vaccinated people than in those not receiving the swine flu vaccine. Dengvaxia, the only approved vaccine for Dengue fever, was found to increase the risk of hospitalization for Dengue fever by 1.58 times in children of 9 years or younger, resulting in the suspension of a mass vaccination program in the Philippines in 2017. Pandemrix a vaccine for the H1N1 pandemic of 2009 given to around 31 million people was found to have a higher level of adverse events than alternative vaccines resulting in legal action.”

Here we are dealing with very new technology for COVID-9 vaccines such as the Pfizer and AstraZeneca. They do not even have “tried and true” modes of action. I am just cautious, particularly when mass vaccination is being promoted.

Very little is clear cut medically, despite people thinking or wishing this is the case.

[GordMay]

Originally Posted by Seaworthy Lass

... You raise lots of good points. Yes, reducing infections will reduce the risk of mutation. This increases every time a virus replicates. That is certainly one consideration and I suppose every little bit helps.

Putting issues of vaccine safety aside for the moment, my personal thoughts are that herd immunity through vaccination is a difficult goal to achieve, particularly for countries where the number of cases has been low. Firstly, the numbers simply don’t make sense to me. If the risk of transmission goes down by around 70% that leaves 30% of those who are vaccinated still transmitting if infected.

Those under 20 seem to be mainly symptom free or minimally affected and in the US, for example, they make up close to 30% of the population:
https://www.infoplease.com/us/census...hic-statistics
Why unnecessarily expose healthy children to any risk at all with a vaccine?

So if you could persuade 80% of those over 20 to be vaccinated (56% of the population in the US) and vaccines turn out to be around 70% effective, which initially seems could be the case, then only around 39% of the US population is not transmitting the virus when exposed.

How is herd immunity to be achieved unless this is combined with a high percentage of post-infection immunity in those unvaccinated? Where am I going wrong with my numbers? ...

Herd Immunity is when a large enough portion of the population is immune, thus protecting people who are not immune, because there are so few susceptible people left to infect.
This is because an individual who is not immune is much less likely to come in contact with a diseased individual, since most people will not become infected. For herd immunity to be effective, a critical fraction of the population must be immune to the disease.
This can effectively stop the spread of disease in the community. It is particularly crucial for protecting people who cannot (or will not) be vaccinated.

In order to calculate this critical fraction, we need to use the basic reproduction number. The basic reproduction number tells us on average how many people that one infected person will infect.
For diseases that can cause epidemics, the basic reproduction number is scarily high. For example, measles has a reproductive number of about 12. We need to somehow lower the basic reproduction number below 1 to stop the spread of the disease.

The basic reproduction number, R-0 is calculated by multiplying the probability of transmission, p, by the number of people that the infected individual will come into contact with while contagious, k.
However, not everyone that the infected person contacts can contract the disease. If a certain fraction of people are vaccinated, f, then they will not contract or spread the disease assuming the vaccine is 100% effective. Then the number of at risk individuals is (1-f)*k.
The adjusted reproduction number is now p*k(1-f) or R-0*(1-f).
Using some algebra and setting the adjusted reproduction number to 1 gives us the critical fraction of the population that must be immunized to stop the spread of the disease.
f = 1-(1/R-0)

The Tricky Math of Herd Immunity for COVID-19
➥ https://www.quantamagazine.org/the-t...nity-20200630/

[Seaworthy Lass]

Originally Posted by GordMay

Herd Immunity is when a large enough portion of the population is immune, thus protecting people who are not immune, because there are so few susceptible people left to infect.
This is because an individual who is not immune is much less likely to come in contact with a diseased individual, since most people will not become infected. For herd immunity to be effective, a critical fraction of the population must be immune to the disease.
This can effectively stop the spread of disease in the community.......

This basically agrees with what I have read on this subject.

The % of the population that needs to be immune (developed either via vaccination or post infection etc) for herd immunity to develop will vary with the R0 number and this depends on population/location/social characteristics, as well well as viral specific ones, and it will not be static. For this reason, in my last post I did not specify the likely %, but most figures I have seen estimate this at roughly around 60-70%. With the B117 variant the figure will be higher than before.

Originally Posted by GordMay

.....It is particularly crucial for protecting people who cannot (or will not) be vaccinated.

I would modify that with the addition of the word “vulnerable” before “people”. If there is negligible risk of severe illness and death, why do we need to protect the non vulnerable?

Unfortunately, yes, there are some vulnerable people who cannot be vaccinated due to an increased risk of vaccine side effects. Herd immunity would improve the outcome for these individuals, however, it exposes millions of young, healthy people not affected severely by COVID-19, with a large number of potential life years, to possible adverse reactions. The mRNA and DNA vaccines have very different modes of action to other vaccines. Up until last year they had never been approved for human use. They have only been tested for an extremely short time with the hope (not certainty by any means) that they are relatively safe long term.

In my opinion it would be better for the vulnerable people who cannot be vaccinated to be currently assisted by governments both financially and practically to help reduce their risks by other means.

[UFO]

Originally Posted by GordMay

Which is it?

Serious as in Government rather than some University doing a study which everyone conveniently ignores.

[Singularity]

Originally Posted by Seaworthy Lass

...
This is a new virus, new technology, so far with no data released for studies over 90 days following the first dose of a vaccine. All vaccines have side effects, some minor, some more severe but rare. Some do not become apparent until well after a vaccine has been fully approved....

...Here we are dealing with very new technology for COVID-9 vaccines such as the Pfizer and AstraZeneca. They do not even have “tried and true” modes of action. I am just cautious, particularly when mass vaccination is being promoted.

Very little is clear cut medically, despite people thinking or wishing this is the case.

I suggest drawing a distinction between what happens in the laboratory vs what gets injected under the skin.

Frankly it doesn't matter how the laboratory sticks a bunch of amino acids together (i.e. the technology to both determine which sequences to make and how to stick them together). Once they're together, they're basically molecular Tinker Toys (proteins). Once the proteins are injected into the body, all the body/immune system recognizes is foreign material that it has to respond to/contend with...the body could care less about what happens in the lab (i.e. the technology...there's no "tooling marks" on the molecules).

Consider acetacylic acid (aspirin). You can make it in the lab or you can extract its analogs from willow tree bark. Some people see "natural" molecules as somehow different than "lab manufactured" molecules. While it's true that "natural" derived chemicals are often not 100% pure, thus containing extra chemicals that provide a so-called entourage-effect (not found in 100% pure primary chemicals), with vaccine development there's no parallel.

The mechanism of action for vaccines are always the same, which is to say that they work in ways far more complicated than just making antibodies, and we are ?generations away from having the know-how and technology to describe the finite types of mechanisms of actions that people seem to assume we have knowledge of. Notably, even with old medications that have been used billions of times we can't describe all the ways that they work. But they increase survival, so we use them.

[Seaworthy Lass]

Originally Posted by Singularity

I suggest drawing a distinction between what happens in the laboratory vs what gets injected under the skin.

Frankly it doesn't matter how the laboratory sticks a bunch of amino acids together (i.e. the technology to both determine which sequences to make and how to stick them together). Once they're together, they're basically molecular Tinker Toys (proteins). Once the proteins are injected into the body, all the body/immune system recognizes is foreign material that it has to respond to/contend with...the body could care less about what happens in the lab (i.e. the technology...there's no "tooling marks" on the molecules).

This is not how COVID-19 mRNA and DNA vaccines work.
There are no proteins injected into the body as you state, synthetic or natural.

In simple terms, genetic instructions are instead injected and these enter our cells.

In the case of a COVID-19 DNA vaccine such as the Oxford-AstraZeneca vaccine, the DNA instructions to produce the Sars-CoV-2 spike protein enters our cell nuclei (carried in this case by an adenovirus vector) and this results in production of mRNA that enters the cell’s cytoplasm and this in turn leads to the virus spike protein being produced by our cells. It is the spike protein our bodies are induced to actually make that generate the immune response.

In the case of COVID-19 RNA vaccines such as the Pfizer and Moderna vaccines, the process is shortened as RNA itself enters the cytoplasm of our cells (carried by a lipid nanoparticle vector) and instructs our cell to produce the virus spike protein.

Originally Posted by Singularity

The mechanism of action for vaccines are always the same, which is to say that they work in ways far more complicated than just making antibodies, and we are ?generations away from having the know-how and technology to describe the finite types of mechanisms of actions that people seem to assume we have knowledge of. Notably, even with old medications that have been used billions of times we can't describe all the ways that they work. But they increase survival, so we use them.

Previous viral vaccines have induced an immune response in a variety of ways eg by injecting inactivated virus, or a weakened form of the live virus, or a toxin the virus produces or part of the virus, etc.

Injecting genetic instructions for our cells to produce part of the virus that will in turn elicit the immune response is a very different and totally new mode of action.

[Seaworthy Lass]

Originally Posted by Singularity

.....Consider acetacylic acid (aspirin). You can make it in the lab or you can extract its analogs from willow tree bark. Some people see "natural" molecules as somehow different than "lab manufactured" molecules.

I think you mean acetylsalicylic acid.

I considered ignoring this paragraph, as it is getting way off topic, but this is not necessarily correct. Many compounds that have an identical chemical composition can be produced to rotate plane polarized light differently as they are chiral ie mirror image stereoisomers (= entaniomers). A large % of today’s drugs are chiral. The two forms (dextro and levo) can have very different pharmacological effects.

So compounds produced in a lab need not be the same as those found in nature, even with the same molecular composition.

[Dockhead]

In Finland, there is an expectation that the vaccination program will accelerate considerably. By July (optimistic) or September (pessimistic), the Finnish health authorties expect 80% of Finns to be vaccinate. See: https://www.hs.fi/kotimaa/art-2000007794086.html


This is very good news. Finland is now vaccinating at about the European average rate. Maybe Europe will be vaccinated already by this summer?


Then all the more this will really be over. Just make it through the next few months somehow.

[Dockhead]

The numbers today on daily infections:



So except for Estonia and possibly Latvia, it's generally going in the right direction.

UK especially impressive, down to 252 from a peak of nearly 900. Now nowhere in the region except Estonia and Latvia are over 300.

In Sweden the authorities are frustrated that cases are not falling faster, but they are not doing all that badly at 277. Denmark second wave completely gone with new infections below 100, and Germany nearly so. This is great news.

What concerns death:



Germany is steadily down but still surprisingly high at nearly 7, considering the low daily infection rate.

UK still very high at over 12 but steadily down. Latvia worrying at about 11 and not coming down. Estonia still going up. Sweden down to nearly 5. Finland, Norway looking very good, and Denmark already coverging towards them.

If the big acceleration in vaccination rate predicted in Finland applies to the whole region, then the situation should be getting better and better as spring starts. Just trying to hold on here a little. The very tight border restrictions are a real headache. I have an international flight tomorrow; it is a major hassle. Can't wait for this to end.

[Dockhead]

Some more really good news:

https://www.nytimes.com/2021/02/10/w...ction-cdc.html

Some science showing high effectiveness of tight-fitting masks against virus transmission.

This doesn't prove anything conclusively, as other science has not shown such results, but it adds weight to the idea that masking really helps, something which seems common sensical, but which has not been conclusively proven.

One issue here is WHAT type of masks are we talking about. Simple surgical masks may really not do much good, so this study might not necessarily contradict the earlier ones.

This is not a big problem in this region -- quality N95 respirators are freely available here, stacked up on tables in every pharmacy and selling for €8 for a box of 10. Many, maybe most people are using these over surgical masks, and I have been wearing them religiously since last summer. Don't know how much available they are in other regions.

[Dockhead]

Interesting article in the Economist, comparing pandemic measures in Texas vs those in California:

https://www.economist.com/united-sta...r=nl_special_3

California with a left-wing government has pursued extreme lockdown while Texas with a right-wing government has used much lighter measures. As an aside -- one reason why the issue of pandemic measures is so often so politicized, is because of this American style gang warfare, with certain sets of policies associated with certain politics, making choice of pandemic measures not something people are capable of having reasonable conversations about. Sadly many of our threads on here have suffered from this. For the record, it is different in Europe where different pandemic measures don't really have political implications. If anything, somewhat the opposite political associations as the U.S., with the right-wing governments of the UK and Poland using the most rigorous lockdowns on the planet, whereas very left-wing (by American standards) Scandinavian governments using the lightest measures on the planet. One reason why there is such a disconnect in these conversations on here between Americans and Europeans.

The authors of the Economist piece seem quite surprised that the light touch in Texas has achieved more or less the same results as the heavy handed California measures. The set of graphs comparing the numbers has the title "No Right Answer".

But this lines up with what we see in Europe. In fact with only one or two exceptions, the least affected countries in Europe are using the lightest measures, whereas the hardest hit countries are using the hardest measures. Now one shouldn't jump to conclusions -- cause and effect no doubt are running in both directions, so this doesn't prove that light measures are more effective. But it does prove that light measures are not an obvious failure, as some people would like to believe.

[Exile]

Originally Posted by Dockhead

Interesting article in the Economist, comparing pandemic measures in Texas vs those in California:

https://www.economist.com/united-sta...r=nl_special_3

California with a left-wing government has pursued extreme lockdown while Texas with a right-wing government has used much lighter measures. As an aside -- one reason why the issue of pandemic measures is so often so politicized, is because of this American style gang warfare, with certain sets of policies associated with certain politics, making choice of pandemic measures not something people are capable of having reasonable conversations about. Sadly many of our threads on here have suffered from this. For the record, it is different in Europe where different pandemic measures don't really have political implications. If anything, somewhat the opposite political associations as the U.S., with the right-wing governments of the UK and Poland using the most rigorous lockdowns on the planet, whereas very left-wing (by American standards) Scandinavian governments using the lightest measures on the planet. One reason why there is such a disconnect in these conversations on here between Americans and Europeans.

The authors of the Economist piece seem quite surprised that the light touch in Texas has achieved more or less the same results as the heavy handed California measures. The set of graphs comparing the numbers has the title "No Right Answer".

But this lines up with what we see in Europe. In fact with only one or two exceptions, the least affected countries in Europe are using the lightest measures, whereas the hardest hit countries are using the hardest measures. Now one shouldn't jump to conclusions -- cause and effect no doubt are running in both directions, so this doesn't prove that light measures are more effective. But it does prove that light measures are not an obvious failure, as some people would like to believe.

Almost a year or so into this thing, we are starting to see similar patterns comparing statistics, for e.g., between Florida and NY. The politicization of the public health response in the US has been nothing short of grossly irresponsible if not insane. It seems like it's been more about short-term political point scoring at the expense of simply telling the truth (no matter how muddled), with the principal casualty being even less confidence in politicians and public health officials. Reminds me of the quip about how it's always preferable to have questions that can't be answered than answers that can't be questioned.

Given some of the knowns and many other unknowns about the best responses to this crisis, I've personally -- like most others -- erred on the side of caution and compliance, but not because I necessarily assume politicizations are acting in the public's best interests as opposed to their own careers. Instead, I and most others come to similar conclusions based on a weighing of the risks, benefits & costs, and conclude that mask usage, social distancing, and other measures are sensible whether there's definitive proof of their efficacy or not. Restrictions on businesses or houses of worship? Definitely thornier, and I've been hesitant to reach conclusions or even judge. Yet others who reach different conclusions are all too often vilified, ridiculed, or shamed, with disapproval often accompanied with self-serving and often misplaced accusations of ignorance or being "anti-science". All too often these critics are simply adopting the "science" that happens to coincide with their personal point of view or political agenda and, as we're increasingly finding out, this often leads to inaccurate representations of the "science" as a whole.

All too predictably, and as we see the pandemic (hopefully) wane, we're already seeing this same sort of simplistic and divisive approach to those who question the safety or efficacy of the vaccines. Rather than simply recognize some of the additional unknowns and therefore potentially heightened risks with a new, gene-based technology, we are often told that these vaccines work exactly the same way as all others throughout history, and that anyone who pushes back on this obvious mistruth is an "anti-vaxxer" or doesn't care about their fellow human beings. There are obviously no guarantees but it seems more likely than not that these vaccines will perform as promised, and I for one will likely sign up as soon as I'm eligible. But this will be an individual decision based on evaluating all the available science (to the extent I can), and also applying it to my personal circumstances. There's no need to selectively distort the science in an effort to insure that the largest number of people ultimately get vaccinated. This is likely to occur in any event, but any attempts at manipulation by politicians, health officials, or others will only result in further erosion of peoples' confidence when it comes to the next pandemic or other crisis. There are far too many these days who are bestowing themselves with way too much undeserved expertise, either to claim the moral high ground for themselves or because they assume ignorance on the part of others.

It's heartening to read that this level of political polarization and dysfunction doesn't exist everywhere, and that there is a much healthier alignment of rhetoric and reality than what is tragically occurring in the US. Americans need to get back to challenging each others' opinions on such complex issues rather than attacking each other based on tribal-like party affiliation or a whole host of other, often immutable traits we are being told keep us apart. Some level of political bias is a natural human condition and isn't necessarily unproductive, but left undisciplined and unchecked it can only result in further polarization, dumbing down of complex issues, and ultimately poor decisionmaking.