Hello friends,
I’m back from Portugal and had a great trip up and down the coast. Although relatively windy, I thought it was nice and warm. Not quite warm enough for my Brazilian girlfriend though! Let’s get back at it!
Welcome to a new edition of Weekly Crystallizations, a weekly newsletter where I highlight tweets from people making sense of what’s going on in the world today!
In this week’s edition:
Swedish study shows waning of vaccine effectiveness *against severe disease*
The latest on natural immunity vs. vaccine induced immunity
Vaccinating children, and why it’s probably a bad idea
New variant
COVID-19
A new Lancet study from Sweden (out as a pre-print) has come out, looking at vaccine effectiveness. What the authors find is that vaccine effectiveness against infection wanes with time (which we already knew) and disappears after 211 days.
Vaccine effectiveness of BNT162b2 against infection waned progressively from 92% (95% CI, 92-93, P<0·001) at day 15-30 to 47% (95% CI, 39-55, P<0·001) at day 121-180, and from day 211 and onwards no effectiveness could be detected
What is a bit more controversial is that they also find that vaccine effectiveness against severe disease wanes as well, after some more time (this we didn’t know).
For the outcome severe Covid-19, effectiveness waned from 89% (95% CI, 82-93, P<0·001) at day 15-30 to 42% (95% CI, -35-75, P=0·21) from day 181 and onwards…
Waning of protection against infection can be seen in The Netherlands as well. This graph shows the vaccine effectiveness against infection on the y-axis and the time since a certain age group reached a 50% vaccination rate. What you see is the same pattern of linear waning over time for all age groups.
Such results will undoubtedly activate the vaccine proponents to fast track boosters and the vaccination of children.
As most readers will know, I’m skeptical more vaccinations (booster or otherwise) are the answer. For one because it’s not clear that that actually works as a strategy. See Chile:
Secondly, because even if it works. How long does it work? Cases in Israel have dropped since their booster campaign, but how long will that last? And will our immune systems respond in the same way to a second booster? And what does increasing vaccine coverage do with the evolutionary dynamics of the virus? These are all pertinent questions that remain unanswered.
The only way out of the pandemic is herd immunity. Maybe that’s not achievable and we’re left with some degree of endemicity like the flu. That said, it sure looks like the Indian province of Uttar Pradesh (from the country that spawned the Delta variant) has achieve herd immunity. How? I believe because the Delta variant ripped through the population, killed a bunch of people, but also equipped 70% of the population with natural immunity. Enough, so it seems, to induce herd immunity.
The UK on the other hand, reports that more than 95% of people have spike antibodies, and thus some degree of immunity. But most of that immunity is vaccine induced. You can see their cases have plateaued at historically high levels. In other words: definitely not herd immunity.
The case that natural immunity is broader, and offers better and longer protection is in my view becoming unassailable.
Natural Immunity
Here’s a recent article by a professor of Microbiology that gives a good overview of the literature. In his overview he also links to this article listing 96 papers that are supportive of the claim that natural immunity is better than vaccine-induced immunity. The argument in a nutshell:
Natural immunity triggers mucosal immunity that is local to the airways, the vaccines, being injected in the deltoid, don’t demonstrate this local effect.
Natural infection leaves viral debris which stimulates a continued maturation of the immune response, whereas the vaccination does not.
Natural infection induces an immune response against a wide range of epitopes in the virus whereas vaccine-induced immunity is based on the spike protein alone.
Natural infection leads to more cells being involved in triggering an immune response, which leads to a stronger immune response than that triggered by vaccination.
It would seem that any sane and rational government would want to make it easy for such protected individuals to move and interact freely. Unfortunately in most countries only a PCR test proving a COVID infection gets you a COVID certificate. And they tend to expire after 6 months.
This isn’t all ignorance or incompetence. There do seem to be some inherent challenges in determining whether a previously infected individual is actually protected. It’s not completely clear what a measurement of antibodies says about real life protection. How high do the antibody levels need to be? Which ones are more protective? And how long do they provide a reliable defence?
But even if it’s not clear right now, it would seem that there should be considerable focus on figuring that part out (and there seems not to be). So that natural immunity can be at the very least one of the tools used to slay the pandemic.
A friend asked why vaccination cannot be considered a risk-free way of getting this protective natural immunity. The problem is original antigenic sin. Once you’ve been vaccinated, your immune system’s response will always be biased to your initial exposure.
How strong or problematic this bias will turn out to be is still an open question. But there’s a strong argument to be made that by vaccinating SARS-CoV-2 naive individuals, you are hampering their immune response for life.
Perhaps the vaccines can be updated to address this. @gerdosi seems to think so. But it remains to be seen.
Unfortunately equipping people with a hampered immune response for life is exactly what various countries have now decided to do with children by enrolling them in mass vaccination campaigns. This is particularly egregious because children are at negligible risk of COVID-19 and long COVID. By vaccinating SARS-CoV-2 naive children you are potentially hampering their immune response to SARS-CoV-2 for life. Maybe that turns out not to be such a big problem. But maybe it does. I’d rather expose the older population to such guesses — educated or otherwise.
Vaccinating children
Various governments have either started vaccinating children or at least started the discussion around doing so. This includes the American FDA who recently published a cost-benefit analysis of vaccinating children ages 5-11.
Here’s a pretty convincing takedown of the FDA’s of this analysis by Toby Rogers (banned from Twitter). Some highlights:
COVID-19 rates in children ages 5 to 11 are so low that there were ZERO cases of severe COVID-19 and ZERO cases of death from COVID in either the treatment (n= 1,518) or control group (n= 750).
The follow up period was intentionally too short. This is another well-know trick of the pharmaceutical industry designed to hide harms. Cohort 1 appears to have been followed for 2 months, cohort 2 was only monitored for adverse events for 17 days.
Pfizer intentionally wipes out the control group as soon as they can by vaccinating all of the kids who initially got the placebo. They claim that they are doing this for “ethical reasons”.
Some impressions from the recent FDA advisory meeting by @sarabeth345, which map on well with my impressions so far (so either an interesting signal or confirmation bias at play):
Experts aren’t sure to what extent vaccines prevent transmission
Experts do not know how long any purported benefits will last, and therefore also have no idea whether, or when, or how often, booster(s) will be recommended.
More than 40% of children in US have recovered from covid and have natural immunity.
One of the UK’s scientific committees looked at the question of vaccinating children earlier, and advised against. They estimated that vaccinating 2.7 million 12-15 year olds would prevent 7 ICU admissions. The government overruled this decision and has proceeded to vaccinate children anyway.
All in all the implicit risk-benefit analysis done by governments, or the explicit one done by the FDA, all seem highly suspect. Everything seems to be viewed through a vaccine-lens. And I have to say I share @akheriaty’s conclusion here.
New variant
A new variant has been detected which has been colloquially labeled Delta+. Some experts weighed in on Twitter on what to make of it.
Delta is a variant of SARS-CoV-2. AY4 is a subvariant derived from delta and AY4 S:Y145H is a subsub variant in which the spike gene (S) is mutated from a tyrosine (Y) at position 145 to a histidine (H)
What seems clear now is that the increase in prevalence is not due to a fluke, like a competitive advantage conferred by a chance event (founder effect). The prevalence is increasing because of certain mutations that confer this strain with a competitive advantage over the circulating Delta strain.
It’s probably not going to make a big difference compared to Delta, according to @wanderer_jasnah, because we’re already “turbofucked” and can’t get more “turbofucked”.
By which he means that Delta is already so transmissive, non-pharmaceutical interventions (NPI), such as lockdowns, masks and social distancing, will at best delay the spread, not prevent it. So we’re basically waiting until Delta has finished ripping through the world population.
Although I agree with that assessment, I don’t agree with his proposed intervention: vaccinate as many people as possible.
Getting to herd immunity is the only way out of the pandemic, and vaccines aren’t going to get us there.
Instead an exit strategy out of the pandemic will likely need to rely heavily on natural immunity. Here’s that graph comparing Uttar Pradesh with the UK again.
And in terms of getting turbofucked, it’s worth considering other scenarios that I would consider even more turbofucked. What if Delta sweeps the globe, dies out, and leaves space for more immune-evading variants to subsequently sweep the globe?
Is this realistic? I asked Biostatistics professor Jeffrey S Morris, and author of covid-datascience.com.
Not fully crystallized
There’s a weirdly sudden uptick in ER consultations in Germany for cardiovascular and neurological at the end of April 2021.
There are multiple possible explanations for this. Some involve hospital backlogs (but why the jump then?). Only some hypotheses would involve vaccine adverse side effects. @bitbutter explores that hypothesis by plotting the vaccine rollout in Germany. And you could make a case that there’s an uptick in vaccines during the same period.
I’ve been trying to learn more about how many deaths are associated with the vaccines. This data is surprisingly hard to come by in Europe.
@waukema dives into the German data. The Paul Ehrlich Institute (which monitors vaccine safety) reports a rate of 20 serious adverse events for every 100,000 vaccinations and 1,802 total deaths.
However, they also have an app (called Safevac) which proactively asks people after their vaccination whether they’ve experienced symptoms. Obviously it can’t ask whether they’re still alive, so we only have data on adverse events. But interestingly enough the rate of adverse events reported through the app is almost 10x as high as reported by the institute itself.
If you assume this is indicative of an underreporting bias of 10x across all events, including deaths, you arrive at a total amount of vaccine deaths of 17,317. (For comparison, Steve Kirsch arrives on an underreporting bias of ~40x for vaccine deaths in the VAERS system in the US.)
Resistance
Protests in Switzerland.
Port of Genoa blocked by protests.
Misc
Crypto
Web3 is gradually seeping its way into the conventional internet and computing infrastructure.