Vaccine

Ok. Let’s use the context dependent definition of herd immunity, and look at behavior. People this time.

Spain looks to be herd immune. Still some cases, but outbreaks mostly fizzle out.

Now suppose the party scene really gets popular in Madrid this year. Too much time cooped up, and it’s time to be social. More people, more alcohol, more hookups, less distance. All of a sudden, you have spikes in a variety of diseases, including covid.

What happened? The herd immunity threshold changed. People who used to be keeping 6 feet are now adopting a different behavior. Put one way, people got closer to each other and disease spread more easily. Put another way, people changed their behavior and that altered the herd immunity threshold.

It didn't change. The baseline you have to assume is normal human behavior. If NPIs are holding down infection rates and infection spike, they aren't at herd immunity under either definition (a) no more COVID or (b) low levels of endemic infection without spikes. Again, YOU may be happy living with restrictions in perpetuity. Most of the world is not because it's NOT part of the human condition. Otherwise what you are suggesting is NPIs forever, which BTW some of us from time to time have accused you of wanting and this is another piece of evidence that shows that yeah maybe you'd be totally fine with that. Finally, you are being antiscience....not even Fauci is using your definition....even espola's definition was better and more realistic.
 
It didn't change. The baseline you have to assume is normal human behavior. If NPIs are holding down infection rates and infection spike, they aren't at herd immunity under either definition (a) no more COVID or (b) low levels of endemic infection without spikes. Again, YOU may be happy living with restrictions in perpetuity. Most of the world is not because it's NOT part of the human condition. Otherwise what you are suggesting is NPIs forever, which BTW some of us from time to time have accused you of wanting and this is another piece of evidence that shows that yeah maybe you'd be totally fine with that. Finally, you are being antiscience....not even Fauci is using your definition....even espola's definition was better and more realistic.
”Can we acheive herd immunity with a 60% vax rate and 2019 behavior patterns” is a perfectly reasonable question.

It is just a different question from “can we achieve herd immunity”.

You claim to be asking the second, then insist on pivoting to the first.
 
”Can we acheive herd immunity with a 60% vax rate and 2019 behavior patterns” is a perfectly reasonable question.

It is just a different question from “can we achieve herd immunity”.

You claim to be asking the second, then insist on pivoting to the first.

No you are just making selective definitional changes to support your world view. No one considers a world with ongoing NPIs being necessary to maintain the status quo "herd immunity". You are going your magic wand waiving seeking to distinguish stuff to protect your world view, in this case when even Fauci has moved on.

And no one is asking about the 60% rate. The relevant subjects for vaxxed immunity were Singapore, Iceland, Ireland. For natural immunity, the one to watch is India. England now has 95%+ seroprevalence in adults....still not at herd immunity.
 
Well for Gibraltar dad had an excuse as to why cases were surging. It was the tourists fault.

Well what about VT? Highest vaxxed state in the nation.

Certainly looks like breakthrough cases are not rare.


Vermont is one of the most vaccinated states in the country and has served as a model for its COVID-19 response throughout the pandemic. But now, the state is experiencing its worst COVID-19 surge yet, with several factors -- including its own success -- to blame, officials said.

In Vermont, nearly 72% of residents are fully vaccinated against COVID-19 -- more than any other state, according to U.S. Centers for Disease Control and Prevention data. At the same time, it has the 12th-highest rate of new COVID-19 cases over the last week, state data released Tuesday shows.

Vermont has seen a "significant" increase in COVID-19 cases in the past week, Mike Pieciak, commissioner of the state's Department of Financial Regulation, said during a press briefing Tuesday.

The seven-day average for COVID-19 cases rose 42% as of Tuesday, according to state data.


Here they talk about the fact that a lack of natural immunity could be an issue.

Regarding the recent case surge, Vermont may also be a "victim of our success," Levine said Tuesday, pointing to a lack of natural COVID-19 immunity among unvaccinated residents "because we kept the virus at such low levels throughout the entire pandemic."

 
No you are just making selective definitional changes to support your world view. No one considers a world with ongoing NPIs being necessary to maintain the status quo "herd immunity". You are going your magic wand waiving seeking to distinguish stuff to protect your world view, in this case when even Fauci has moved on.

And no one is asking about the 60% rate. The relevant subjects for vaxxed immunity were Singapore, Iceland, Ireland. For natural immunity, the one to watch is India. England now has 95%+ seroprevalence in adults....still not at herd immunity.

Singapore isn’t doing permanent NPI. They were just smart about when to relax NPI. First NPI, then vax, then relax NPI.

The “relax NPI” step causes a case spike. A very small case spike that causes few deaths because it is a very heavily vaccinated country. So what?

Seems to be working out just fine for them. They will end up with a low case rate, low NPI endemic steady state that is dependent on some amount of boosters and new vaccinations. Sounds like success to me.
 
Well for Gibraltar dad had an excuse as to why cases were surging. It was the tourists fault.

Well what about VT? Highest vaxxed state in the nation.

Certainly looks like breakthrough cases are not rare.


Vermont is one of the most vaccinated states in the country and has served as a model for its COVID-19 response throughout the pandemic. But now, the state is experiencing its worst COVID-19 surge yet, with several factors -- including its own success -- to blame, officials said.

In Vermont, nearly 72% of residents are fully vaccinated against COVID-19 -- more than any other state, according to U.S. Centers for Disease Control and Prevention data. At the same time, it has the 12th-highest rate of new COVID-19 cases over the last week, state data released Tuesday shows.

Vermont has seen a "significant" increase in COVID-19 cases in the past week, Mike Pieciak, commissioner of the state's Department of Financial Regulation, said during a press briefing Tuesday.

The seven-day average for COVID-19 cases rose 42% as of Tuesday, according to state data.


Here they talk about the fact that a lack of natural immunity could be an issue.

Regarding the recent case surge, Vermont may also be a "victim of our success," Levine said Tuesday, pointing to a lack of natural COVID-19 immunity among unvaccinated residents "because we kept the virus at such low levels throughout the entire pandemic."

Area under the curve. Not moment in time. How does the total number of cases in VT rank?

So far, they have the second lowest total case rate in the nation. And they have the lowest covid death rate in the nation.

I’d say VT is doing ok so far.

Did a miss a memo where each of us tries to find the worst possible example to prove our point? First Grace brings up Singapore to argue against mask and vaccines mandates. Now you’re trying to point to Vermont as an example of failed covid policy.

Dang. Time for me to get with the program and launch the Chernobyl Initiative for Nuclear Power.
 
Singapore isn’t doing permanent NPI. They were just smart about when to relax NPI. First NPI, then vax, then relax NPI.

The “relax NPI” step causes a case spike. A very small case spike that causes few deaths because it is a very heavily vaccinated country. So what?

Seems to be working out just fine for them. They will end up with a low case rate, low NPI endemic steady state that is dependent on some amount of boosters and new vaccinations. Sounds like success to me.

1. You are changing your tune again. But it's a welcome change. At least you concede that despite the high vaxx rate and masks they still had a spike (so are not currently at herd immunity)
2. We don't know if they will end up with lower cases, or if the case rate just will fall due to seasonality and then rise again once they have new triggers such as seasonality.
3. You are the math guy and you asked the $1,000,000 way back when. The key question for whether a herd immunity threshold can be reached is if the breakthrough cases are high and if that number increases with time. All indications (both by studies and anecdotal) is that they are and they do.
4. which (now that we are on the same page finally) takes us to boosters. The big question with boosters is if it's 1 and done. Because if you have to keep going back at the well, then you are in flu shot territory. Only about 50% of Americans get the flu shot and the flu shot doesn't cause nearly the realm of reactions that the COVID shot does. In a countries like the US or Europe, if you try to force boosters plural, let alone a single booster, you are going to have significant civil unrest which will dwarf the little stuff we've seen so far. In Singapore, which is forcing the unvaxxed to pay for their own health care and which is effectively a police state, sure.
5. That leaves us with 3 things to manage this in the west: the drugs (in which case COVID really does become like managing the flu), natural immunity (not enough data on this yet but the stuff Dr. John presented is bad and all eyes will be on India if they get another delta wave), or a hypothetical better vaccine.
 
Area under the curve. Not moment in time. How does the total number of cases in VT rank?

So far, they have the second lowest total case rate in the nation. And they have the lowest covid death rate in the nation.

I’d say VT is doing ok so far.

Did a miss a memo where each of us tries to find the worst possible example to prove our point? First Grace brings up Singapore to argue against mask and vaccines mandates. Now you’re trying to point to Vermont as an example of failed covid policy.

Dang. Time for me to get with the program and launch the Chernobyl Initiative for Nuclear Power.

You are again missing the point.

The question isn't whether Vermont is doing better. Of course a highly vaccinated place will do better in death, hospitalizations and even cases. Vaccines good.

The question is whether a highly vaccinated place can have a spike (and therefore is not at herd immunity) despite the vaccines, and how prevalent are breakthrough infections (which you yourself identified as the $1,000,000 question).
 
You are again missing the point.

The question isn't whether Vermont is doing better. Of course a highly vaccinated place will do better in death, hospitalizations and even cases. Vaccines good.

The question is whether a highly vaccinated place can have a spike (and therefore is not at herd immunity) despite the vaccines, and how prevalent are breakthrough infections (which you yourself identified as the $1,000,000 question).

I didn’t miss your point. I just don’t agree that your point is at all important.

Yes, small case spikes are possible when circumstances change. Singapore had one. Vermont is having one. China will have one when they relax. Exactly as predicted by the models.

So what? You start at herd immunity, environment or behavior change, transmission rises, cases go up for a bit, natural immunity rises, cases fall, and you reach herd immunity again.

If you are the head epidemiologist for Singapore, this cycle deserves your full attention. For anyone else, why would you pick this to care about? We have a lot of work to do before we think about the case spike from ending NPI in a fully vaccinated population.
 
I didn’t miss your point. I just don’t agree that your point is at all important.

Yes, small case spikes are possible when circumstances change. Singapore had one. Vermont is having one. China will have one when they relax. Exactly as predicted by the models.

So what? You start at herd immunity, environment or behavior change, transmission rises, cases go up for a bit, natural immunity rises, cases fall, and you reach herd immunity again.

If you are the head epidemiologist for Singapore, this cycle deserves your full attention. For anyone else, why would you pick this to care about? We have a lot of work to do before we think about the case spike from ending NPI in a fully vaccinated population.

That's why you are avoiding the question. Because if there is no herd immunity (at least under the 2 definitions which are under general discussion as opposed to your fantasy), there is no point to mandating vaccines....it's an elusive target you are never going to reach because as time passes you continue to lose ground and you can't NPI forever.

As to the NPIs we have come to the limit of what people will accept: which is basically theater like going into a restaurant with a mask on with everyone else sitting there without one, kids going to school in masks on the weekdays but then forgetting about them on the weekends, and only extreme blues are using it in their personal gatherings when they go to friends house (see the Atlantic story, for example). The Ds are already set up to take enormous political damage because of it, and the economy is already creaking under the strain. The red states have moved on, Biden's vaccine mandate is set to be blocked by the courts, and you'd have significant issues if even Los Angeles tries to shutter the restaurants again. Police state Singapore can do it....the west is at the limit.
 
We are at a 60% vax rate. People would like to return to 2019 behavior. Most are.

Herd immunity under a 60% vax rate and 2019 behavior is where we are headed. Might as well ask what that looks like.

There's not a whole lot more you can do about it in a western nation, given what we've done to this particular points (lots a woulda coulda shoulda though). If boosters are required, even more unlikely you ever get there. If repeated boosters are required, forget it...it's over.
 
We are at a 60% vax rate. People would like to return to 2019 behavior. Most are.

Herd immunity under a 60% vax rate and 2019 behavior is where we are headed. Might as well ask what that looks like.
Ok, definitely my misunderstanding of what you were implying.

From my perspective, any definition of herd immunity should be based on what was normal behavior before the pandemic.
 
I didn’t miss your point. I just don’t agree that your point is at all important.

Yes, small case spikes are possible when circumstances change.
You did miss the point.

VT has the highest cases they ever have had since the beginning of this.

The point is the vaxx is not stopping the spread of the virus. If it did, in a state with the highest vax rate, they would not or should not be experiencing their highest spike in cases.
 
Ok, definitely my misunderstanding of what you were implying.

From my perspective, any definition of herd immunity should be based on what was normal behavior before the pandemic.
I’d certainly prefer we all choose a 95% vax rate, upgraded ventilation, and cloth masks for flu season. A lot fewer deaths that way.

But that’s not the path we picked. We chose a 60% vax rate, existing ventilation, and no masks. So we will get annual case and death spikes every winter, whatever is needed to create enough natural immunity to balance things out.
 
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