Case update, October 25th, 2021; Vaccination vs Cases, Do Vaccine Mandates Exist?

This is a case update.  I’ll also discuss a new paper regarding v@¢¢!nation and new cases, as well as v@¢¢!ne mandates.

New cases for the US continue to go down. 

Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.
Endcoronavirus County Level Map, October 23rd, 2021
Endcoronavirus State Level Map, October 25th, 2021

For California and San Diego County, however, there is a persistent higher case number, and the numbers for last week may even reflect a very slight increase in new cases.

Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.
Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County. Graph is presented in a linear format.
Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County. Graph is presented in a linear format.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.

The very large wave from last Fall and Winter started in October.  We may be seeing the very beginnings of a Fall wave.  Hopefully our Summer Delta wave will have provided some extra immunity.

V@¢¢!nation and new cases:  A paper came out in September regarding the correlation between v@¢¢!nation rates and new cases.  The study compares data in 68 countries and 2947 US counties that had 2nd v@¢¢!ne doses available. 

The most interesting figure features a piece of data called a “linear regression”. This kind of data compares 2 variables and shows visually if they are related.  In the below hypothetical example, the 2 variables, the number of tests in a day and the number of confirmed cases in a day, shows a high correlation between these 2 things. Notice that the line plotting the relationship between data points goes from bottom left of top right as the values of each variable increase.

A linear regression plot with hypothetical data. Good correlation gives an R squared value between 0.95 and 1. If the variables are negatively correlated, the R squared value will be between -0.95 and -1.

The paper shows a linear regression plot with the percent of the population that is fully v@¢¢!nated on the x-axis, and the per capita confirmed case rate on the y-axis. If v@¢¢!nation strongly protects individuals from infection, new cases would go down as v@¢¢!nation went up.  In this case, the plot line would go from top left to bottom right (the green line).  Instead, it appears that there is little correlation between percent v@¢¢!nation and cases, producing the black line.

V@¢¢!nation vs cases produces black line, showing little correlation between the 2 variables. The green line was added by me and shows hypothetical data that would show strong correlation. From Subramanian et al.

They also have a box plot with US counties showing the new per capita case loads arising from counties with various levels of v@¢¢!nation. While counties with high v@¢¢¡nation rates do have fewer cases, the impact is not as profound as might be expected, and the difference between counties above 50% v@¢¢!nation rate is likely not statistically significant.

Box plots showing v@¢¢¡nation vs per capita cases in US counties. V@¢¢¡nation rates are groups in blocks for this view. Notice that very little difference exists between counties above 50%. From Subramanian et al.

It should be noted that this study was performed in September with data mostly from August.  This is during the Delta wave in the US and many Western countries.  The Delta variant may be different enough from the original Wuhan strain to enable the Delta virus to avoid neutralization by Wuhan induced immunization.

It has long been rumored that v@¢¢!nation does not prevent infection, and this paper seems to support this view. In spite of this, most scientists, including me, still hold that v@¢¢!nation does reduce the chance of hospitalization and death in infected patients.  This is still true.  However, a power point published by the CDC shows that this protection is diminishing as well.  In January, hospitalization and death among v@¢¢!nated individuals was essentially 0%, but now 9% of hospitalizations are among v@¢¢!nated people, and 15% of deaths.

From CDC powerpoint.

Why is this happening?  There are likely multiple factors. Certainly, the Delta variant is not the same virus as the Wuhan strain.  The different Spike protein makes it more infectious, and may not be recognized by an antibody against, the Wuhan strain.  It may even be triggering the Antibody Dependent Enhancement (ADE) pathway in some patients.  Also, it is becoming clear that v@¢¢!ne mediated immunity has been going down over time, necessitating a booster.  The paper from Liu et al argued that given the differences in Delta, a booster against Delta would be much more effective than another booster against the Wuhan strain.

V@¢¢!ne mandates: I still believe that v@¢¢!nation is a good choice for some with risk factors like age, obesity, diabetes, or respiratory problems.  However, I remain against v@¢¢!ne mandates because they do not take into account the medical history of individuals, the data that natural immunity is significantly better than v@¢¢!ne mediated immunity, and also the potential danger of ADE.  In addition to these scientific reasons, I have also felt an increasing orneriness on my own part.  Orneriness is not a good reason to make scientific or medical decisions, but policy makers should realize that it is a powerful reason for many.

For myself, I have chosen to not be v@¢¢!nated, but to remain careful to not be infected.  I continue to wear a mask indoors when there is poor ventilation. 

President Biden mandated v@¢¢!nation for federal agencies soon after taking office.  He announced in September that he would seek v@¢¢!nation mandates for private companies with more than 100 employees.  While many assume that a mandate for private companies is in effect now, as of this writing, no such mandate for private companies actually exists, either by law or by executive order. Companies that have enacted v@¢¢!ne mandates as of now have done so voluntarily.

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Update: November 5th, 2021

The official vaccine mandate was released on November 4th 2021 and is scheduled to be enforced starting on January 4th 2022. Details are on my November 5th post.
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Updated November 23rd, 2021:

No COVID case update this week. Like last week, new cases are persistent in the US, California, and San Diego County. 

However, just wanted to note that the 5th circuit has placed a second stay on the OSHA vaccine mandate until further notice.  OSHA has suspended efforts to enforce the mandate. Text on the OSHA website reads:

“On November 12, 2021, the U.S. Court of Appeals for the Fifth Circuit granted a motion to stay OSHA’s COVID-19 Vaccination and Testing Emergency Temporary Standard, published on November 5, 2021 (86 Fed. Reg. 61402) (“ETS”). The court ordered that OSHA “take no steps to implement or enforce” the ETS “until further court order.” While OSHA remains confident in its authority to protect workers in emergencies, OSHA has suspended activities related to the implementation and enforcement of the ETS pending future developments in the litigation.”
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Don’t fear, but be smart,
Erik

3 thoughts on “Case update, October 25th, 2021; Vaccination vs Cases, Do Vaccine Mandates Exist?

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