Case Update, November 5, 2021; Vaccine mandate details released, Should you get a booster, do vaccines cause new variants?

This is a case update. I’ll also talk about the newly release v@¢¢¡ne mandate from OSHA, whether you should get a booster, and the question of whether v@¢¢¡nes lead to new SARS variants.

New cases in the US, California, and San Diego County are all fluctuating right now.  It’s hard to say if this represents the beginning of a new wave.  Most of us are feeling like the pandemic is basically over, but I will point out that in the post-Delta trough, we still have as many new cases per day as we did at the peak of last Summer’s wave.  Minnesota, Colorado, New Mexico, and Arizona are all experiencing increases in cases right now.

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, November 3rd, 2021
Endcoronavirus State Level Map, November 5th, 2021
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.

V@¢¢!ne mandate finally drops: In September, the President said he wanted government agencies to produce a mandate for v@¢¢¡nation.  Just this week, OSHA issued an Emergency Temporary Standard. This is official form of the v@¢¢¡ne mandate we’ve been waiting for.  The mandate conforms to the news you’ve heard, all employers with more than 100 employees must get v@¢¢¡nation status from all employees, and those who are not v@¢¢¡nated must be tested weekly.  The testing option means that the standard does NOT require that everyone be v@¢¢¡nated. Enforcement will begin January 4th, 2022.

Full length OSHA Emergency Temporary Standard.

As we saw last week, the CDC has known since July that a significant number of hospitalizations and deaths have occurred in fully v@¢¢¡nated individuals.  In addition to this, a recent Lancet paper from Singanayagam et al suggests that the transmission of Delta is less from v@¢¢inated individuals, but is still very significant. In light of this, I think all employees, regardless of v@¢¢¡nation status, should be tested regularly, although it would be impossible to test everyone every week. Ignoring the transmission threat from v@¢¢inated individuals is likely to lead to trouble. Everyone exposed to someone who tested positive for COVID should also be tested.

I saw a truly amazing thing on an OSHA FAQ page regarding v@¢¢ination. I checked it again just now to make sure it was still there.  Under the item “Are adverse reactions to the COVID-19 v@¢¢¡ne recordable on the OSHA recordkeeping log?” The answer reads:

DOL and OSHA, as well as other federal agencies, are working diligently to encourage COVID-19 vaccinations. OSHA does not wish to have any appearance of discouraging workers from receiving COVID-19 vaccination, and also does not wish to disincentivize employers’ vaccination efforts. As a result, OSHA will not enforce 29 CFR 1904’s recording requirements to require any employers to record worker side effects from COVID-19 vaccination at least through May 2022. We will reevaluate the agency’s position at that time to determine the best course of action moving forward.

In effect, an official government page is saying, we are asking you to ignore health information in order to get people to do what we want.  Some of you may be wondering why so many people are willing to ignore official calls to get v@¢¢¡nated, or are suspicious of government in general.  This is why. This also answers the question as to why it is so difficult to get clear information on adverse events. The government appears to have an official policy of ignoring these events.

Screenshot from OSHA FAQ on vaccines. November 5th, 2021

I’ll say again what I’ve said many times, I am not anti-v@¢¢¡ne.  I think many people with risk factors including age, obesity, respiratory or cardiac issues, those who work closely with the public, etc. should get v@¢¢¡nated. However, I am against a v@¢¢¡ne mandate.  I am not v@¢¢¡nated, mostly because of the ADE issue, and because I think I can avoid being infected.

I will also state what is obvious to many, but not to some that are making policy.  Lying or hiding information from the public will make people mistrust you.  You can sometimes force people to comply, but you cannot, even in principle, force people to trust you.  Trust must be earned. Once you lose it, it is very difficult to get back. 

This rule can be applied to any area of life.  Remember this if you’re a husband, wife, parent, child, pastor, politician, consultant, leader of a company, employee, or anything else where trust is required.  Trust is earned, and once broken, is very hard to get back. 

Should you get a booster?: Several people in the past few weeks have asked me if they should get a booster.  Right now, unfortunately, my best answer is “I don’t know”.  A booster may improve your immune response to the originally Wuhan strain of the SARS-2 virus, but the Spike protein from the v@¢¢¡ne is likely toxic on it’s own. In addition, the paper from Japan I wrote about some time ago suggests that another booster of the current variety is unlikely to provide complete protection against Delta.  Instead they recommend a Delta derived booster. 

Anyone who has had COVID or has been v@¢¢¡nated should get a Delta v@¢¢¡ne as soon as it is available to protect from any ADE related effects. Several companies are currently working on v@¢¢¡nes against Delta.

Does the v@¢¢¡ne create variants?: A nobel prize winning scientist is claiming that v@¢¢¡nation creates SARS variants.  I absolutely agree that v@¢¢¡nation creates selection pressures that can force viruses to gain new forms to avoid neutralization.  However, the very same can be said for natural immunity.  Both natural immunity and v@¢¢¡nation create selection pressures that can lead to new viral variants.  This is true of all viruses and other invading agents. In spite of this, our bodies are designed to use the immune system to fight off infection, and immunity has had a tremendous benefit, despite the selection pressure it poses. ADE is a rare exception to this rule. Our immune systems work much more quickly than viruses can adapt to them, which is why they are so effective at preventing infectious disease.

____________________________________
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.”
_______________________________________

Don’t fear, but be smart!
Erik

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.

________________________________________________
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.
________________________________________________

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.”
_______________________________________

Don’t fear, but be smart,
Erik

Case Update, October 19th, 2021; Project Veritas video on HEK293 cell lines.

This is a case update.  I’ll also talk about yet another Project Veritas video that may have you concerned. This discussion will deal candidly with the very controversial issue of abortion.

Cases continue to come down in the US, California, and San Diego County.  So far, we aren’t seeing any uptick from a possible Fall/Winter wave, except perhaps in Minnesota and Michigan. The rate of fall of cases is slowing down, however, suggesting that we may see a new persistent number of cases that is higher than we had before, as has been seen in other countries.

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 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.
Cases for India. Note the larger number of persistent cases after the Delta wave in May.
Cases for the Netherlands. Note the larger number of persistent cases after the Delta wave in July.

Yet another Project Veritas video was released last week, this time about the allegation that Pfizer used aborted fetal tissue to develop and/or produce the COVID v@¢¢!nes. Pro-life Americans are concerned about this development.  As a pro-life person myself, I wanted to provide some context to this issue.  I’m not going to tell you what to think about the issue, since it is largely a matter of conscience, but I do think when making moral decisions, it’s good to make them for the right reasons.

Scientists often use human cell lines to perform certain studies that require human cells that can be grown in a petri dish outside the body (doing biological things outside an organism is called in vitro, Latin for “in glass”).  Generally, human cells do not grow when removed from the body.  Human cells signal to each other and cells that are separated from others will undergo programmed cell death.  For human cells to grow in a lab, they need to be “immortalized” in some way.  This can be done in several ways.  You may have heard of HeLa cells, human cancerous fibroblasts taken from a patient, Henrietta Lacks, in 1951. These cells grow well in vitro and have been used by countless scientists in countless labs since then, including by me.  Another way is to use embryonic stem cells. 

Many in the US, including me, think it is unethical to collect fresh embryonic stem cells, because this usually requires an abortion. It can also be done after a miscarriage.  The HEK293 cell line was created using embryonic stem cells collected in the Netherlands in 1973.  The specific origin of the stem cells is unclear. Like HeLa cells, HEK293 cells have been very useful to scientists because they grow well in the lab and have other useful properties.

It does appear that Pfizer used these cells in the development of the current COVID v@¢¢!nes, and perhaps even in the manufacturing process.  I need to point out that no new cells were collected for this purpose.  The creation of the COVID v@¢¢!ne does not create a new market for embryonic stem cells.

As I’ve stated before, I am generally pro-v@¢¢!ne, but I am not getting the COVID v@¢¢!ne, mostly because of the ADE issue and because of the potential toxicity of the Spike protein.  However, when deciding how to think about an issue, it’s very helpful to develop your position based on facts and evidence rather than on assumptions.

As a matter of conscience, many pro-life people will take the position that taking a v@¢¢!ne which used HEK293 cells in any part of the process is unethical. I’m not going to ask you to violate your conscience.  I will say again, however, that the cells used to create HEK293 cell line were collected long ago, and no new tissue has been collected for this process.  For me, this means that getting the v@¢¢!ne would not be ethically illegitimate, at least not for this reason. I think people of good will can land on both sides of this issue.

Please let me know in the comments if you have questions.  You can help me be more clear.

Don’t fear, but be smart,
Erik

Case Update, October 5th, 2021; Project Veritas video regarding Pfizer

This is a case update. I’ll also discuss a new video from Project Veritas featuring interviews from employees of Pfizer.

The Delta wave continues to wane in the US, with cases overall continuing to go down sharply.  This is great news, but I have to caution that last year’s Fall/Winter wave started in October, so there is a chance we will see a new wave starting in the Northern states.  In fact, cases are starting to increase right now in Minnesota, Wisconsin, Michigan, and Maine, while they are going down in the Southern states.

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 3rd, 2021
Endcoronavirus State Level Map, October 5th, 2021

Cases are also going down in California and San Diego, although there was a spike in cases last week.  Since both regions saw the same spike, it suggests that the event causing the spike may have taken place in Southern California, but this is only speculation.

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.

Pfizer employees discuss immunity:  I always hate making politically charged posts, but this is another occasion when I must.  Project Veritas posted another video just yesterday.  In it, 3 scientists at Pfizer discuss the v@¢¢!nes, saying among other things that natural immunity is actually better protection against the virus than v@¢¢!ne mediated immunity. This is in agreement with the data from Israel published as a pre-print a few weeks ago.

As I’ve stated many times, for at risk people, a v@¢¢!ne is very likely to be of benefit. I have recommended that at risk people get v@¢¢!nated. If you’ve already had COVID, 1 dose of v@¢¢!ne is likely to provide extra benefit.  However, if you’ve had COVID, your natural immunity is likely to provide better protection than “full v@¢¢ination”.

They also make the claim that v@¢¢!nation benefit drops over time because the antibodies gained from v@¢¢!nation drop off over time.  I would also point out that another cause may be that new variants may diverge from the original Wuhan strain enough to makes v@¢¢!nes less effective, but this point is not addressed in this video.

One person even states “I mean, I still feel like I work for an evil corporation.” I want to make a comment about this.  It’s easy for us to blame big corporations for some of the decisions they make, since most of us aren’t in that position. I worked for Quest Diagnostics, a large medical testing company.  The vast majority of the people who worked there believed in the mission of providing high quality information to our client doctors and patients.  However, as with any large organization, there were those who were focused on profit, at times over the interests of the clients.  Most often this came in the form of passing over projects that would help patients, but would not bring in a lot of income. They would argue something like “We aren’t a charity.  We need to bring in money to survive as a business.”  This is of course partially true.  Director Spike Lee once commented in an interview that the most interesting conflicts are those in which both sides are correct.

Of course, a company or an individual can cross a line after which their actions become unambiguously wrong.  This often happens because they’ve made well intentioned compromises until they have lost their moral sensitivity. But I want you to remember something important.  The Presidents and CEO of companies work most directly for the board of directors. The board of directors works most directly for the shareholders. In our modern investment environment, which includes mutual funds, many of the shareholders don’t even know they are part owners of a company!  As far as they know, they just own a mutual fund.  As far as their mutual fund goes, they only care if it’s making them money, since they don’t know what companies they hold, or what their business practices are!  So the CEOs are ultimately working for people for whom profit is the only concern.  Folks, those people are you and me!

Yes, companies that behave unethically should be held accountable.  If Pfizer has misled the public, then they should be held accountable.  But we can’t forget that anyone who holds a mutual fund that includes Pfizer has a voice in this as well.  I will tell you that I am talking to myself as well.  I currently have no idea what companies are in the mutual funds that I own. We should all take the time an find out what companies we hold the most stock in, and consider finding out what they are doing.  You can then contact your mutual fund company and make suggestions about what they can communicate to these companies, or consider selling funds with stocks you don’t like. The small choices we make every day do have an impact.

V@¢¢!ne mandates:  V@¢¢!nes will certainly benefit at-risk individuals.  In addition, it is clear that countries with large v@¢¢!nation programs have had lower fatality rates during the Delta wave than other countries.  However, I am not v@¢¢inated, and am firmly against v@¢¢!ne mandates.  It is especially counter productive for hospitals and other organizations to be letting go of highly trained people who have chosen not to be v@¢¢!nated. I hope this new information will bring some balance to the current discussion.

Don’t fear, but be smart,
Erik

Case Update, September 29th, 2021

This is a brief COVID case update. The number of cases in the US is definitely going down right now. In California and San Diego County, there was an uptick in cases last week for some reason, at least using date from the Johns Hopkins site. This is not seen on the endcoronavirus site. Discrepancies in reporting may explain this difference.

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, September 27th, 2021
Endcoronavirus State Level Map, September 29th, 2021
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a logarithmic format to emphasize small numbers. Note that each number on the left is 10x higher than the one below it.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a logarithmic format to emphasize small numbers. Note that each number on the left is 10x higher than the one below it.
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 logarithmic format to emphasize small numbers. Note that each number on the left is 10x higher than the one below it.
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.

As I’ve said before, we may still see cases rise in the US now that we’re entering the Fall months. Look for cases to rise in the Northern states first. Whether this happens depends on how many people in the North are immunized, and how well immunization works against Delta.

Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.

World wide, the Delta peak is definitely losing steam. For most countries the Delta peak is over or is ending, but some are still struggling. Some countries who have done well early on, still struggled with Delta, like South Korea and Japan.

I have to admit, I predicted that the US would not see many deaths from the Delta peak. While the death rate during our Delta peak has been lower than for previous peaks, it has certainly been higher than I thought. Just wanted to point that out for full disclosure.

In most countries with large vaccination programs, the death rate has been lower during the Delta peak. But this has not always been true. Israel has a very high vaccination rate, as does the UK, but they have both seen higher death rates than the Netherlands during COVID, so the issue is more complex than just the vaccination rate. It will take some time to understand these relationships.

Don’t fear, but be smart,
Erik

Case Update, September 23rd, 2021; Project Veritas Video on Vaccines

This is a case update. With some trepidation, I’ll also discuss the new video by Project Veritas concerning vaccines.

It appears that the US has reached the peak of the Delta Variant, with cases clearly starting to come down.  On the other hand, as numbers start to come down in the South, we may already be starting to see increasing cases in the North, as Wisconsin, Pennsylvania, Ohio, and Iowa are experiencing increased cases right now.  If last year was any pattern, we may see large case numbers in the North as people start to spend more time indoors.

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, September 13th, 2021
Endcoronavirus State Level Map, September 23th, 2021
Endcoronavirus County Level Map, September 13th, 2021

California and San Diego County are continuing to improve. LA County has “achieved” something in the last week, improving enough to give up the spot as the county with the most cases since last Winter.  2 counties in Texas, Harris (Houston) and Tarrant (Fort Worth), have had more cases in the last 2 weeks than LA County.

Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a logarithmic format to emphasize small numbers. Note that each number on the left is 10x higher than the one below it.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a logarithmic format to emphasize small numbers. Note that each number on the left is 10x higher than the one below it.
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 logarithmic format to emphasize small numbers. Note that each number on the left is 10x higher than the one below it.
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.

Project Veritas released a video of a taped conversation between medical workers at a medical center in Phoenix. In it, the workers use, shall we say, colorful and scientifically imprecise language to suggest that the COVID vaccines are not performing as expected. 

There is a lot to say about this! First, let me say that available data is still insufficient to say with any certainty how many adverse effects there are, and of what kind.  I will speculate here, so keep in mind that I am mostly guessing, since I don’t have sufficient information to know exactly what’s going on.

Anecdotal evidence is based on the experiences of a few people, often relayed as a story or rumor.  This kind of evidence is an important pointer that something may be going on, but very often, it is insufficient to understand the situation with any clarity or as a foundation for policy.  At best, anecdotal evidence gives researchers the motivation to conduct a careful study of a situation so there can be more understanding.  At worst, they can cause rumors to overwhelm careful thinking, and lead to wrong conclusions in the minds of many.  This kind of evidence must be taken with a grain of salt, with final judgement reserved until more information is available.

My own thinking on adverse events has evolved a lot since the vaccines came out.  All vaccines carry risks, with a few adverse events happening with even routine vaccines like the flu.  On balance, vaccines have been extremely beneficial to individuals and society as a whole, effectively ending diseases like smallpox and polio. So when rumors of adverse reactions to the COVID vaccines first started coming out, I initially dismissed them as the standard rare event.

But then came the suggestion that the Spike protein itself was responsible for the vaccine’s toxicity.  While still not proven, this idea makes sense to me because it could explain the wide variety of reported adverse events. Increased inflammation aggravates the part of your body that is already under stress.  The Spike protein causes inflammation, so it’s no wonder that the vaccine causes strange and varying symptoms in some individuals. As someone with an auto immune disease, inflammation is a big deal for me.

Unfortunately, the vaccines cannot work without producing the Spike protein, because the protein is needed to produce a working immune response. The Spike protein is an unavoidable risk.

The recent Project Veritas video is a remarkable piece of anecdotal evidence.  It does not provide scientific or statistical evidence, but it does demonstrate that more information on adverse events is desperately needed. 

The most disturbing part of the video to me is the claim that adverse events are not being reported to the CDC VAERS system simply because the forms take too much time to fill out!  If true, this is frankly typical of a program from the CDC.  Since long before the pandemic started, the CDC has sought to keep tight control of information and guidance regarding the spread of infectious disease and related matters.  Legitimately, they try very hard to be accurate.  During a pandemic, however, information changes too quickly for this approach to be effective.  They are so careful to publish only accurate information, that information is often hopelessly out of date.  Ironically, in an effort to always be right, the CDC has usually been wrong. Nothing illustrates this better than the mixed messaging on masks.  Now almost everyone is hopelessly confused on this issue.

When there is a large vacuum of information, people will attempt to fill it with speculation. People from the federal government often complain about misinformation, but the CDC has contributed to it by leaving a huge hole for people to fill with guesses.

A form that takes 30 minutes to fill out is useless if no-one has the time to fill it out.  In response to the video, the CDC should immediately re-make the form, making it take only 5 minutes or even 30 seconds to fill out. Yes, they will be missing some information from each patient, but they’re getting nothing on them right now, so it will still be an improvement. Instead of making the necessary changes, the CDC will probably just call the video misinformation, and try to send it behind the Digital Curtain.

A note on the VAERS system: the system is meant to capture all data that may point to a vaccine producing a pattern of adverse reactions.  Any negative medical event that happens within a few days after a vaccination is recorded.  This even includes events that are unlikely to be attached to the vaccination. The hope is that patterns may be recognized by immunologists that will point to a problem with a vaccine.  For example, if you notice that a lot of people report hitting their head after a vaccination, this may suggest dizziness or disorientation.

Because of this practice not all adverse reactions are vaccine related.  Careful study of cases by a scientist may be required to notice patterns.  The data is not presented in a user friendly fashion!

Of course, the usefulness of this system is limited if a systematic problem, like a long form, is preventing events from being reported!

Vaccine rumors:  I still get questions about vaccine rumors like the following:

The vaccines will re-write your DNA
The vaccines will keep women from getting pregnant.
The vaccines will make you shed Spike protein into the environment

When addressing questions like this, I always ask “What evidence do you have that this is happening.”  Almost always, it’s just something they heard.  I can’t disprove that any of these things are happening.  Trying would take an enormous amount of time.  I can say, however, that I haven’t seen any evidence that they are. This doesn’t mean they aren’t happening! But if there isn’t any evidence for them, we don’t have to spend time and emotional energy worrying about them.

If you have any evidence, aside from persistent rumors, that any of above things or things like them are happening, please let me know.  If you see an article or blog post that argues for any of the above, they should contain actual data that supports these ideas, not just speculation.

Don’t fear, but be smart,
Erik

Case Update, September 13th, 2021; Israel data, Mu variant

This is a case update. I’ll also discuss a hack for poorly ventilated areas, the paper from Israel everyone is talking about, as well as the new variant, the Mu variant.

For the US, it definitely looks like we’ve cleared the peak for the US. Cases in many states have started to go down. States in which case numbers are still rising include Utah, West Virginia, Maine, and Pennsylvania. A word of caution is that COVID spreads indoors in poorly ventilated areas. Last Summer, we had large case loads in the South, and the winter had even larger case loads starting in the North. Both phenomena were probably caused by the virus spreading indoors, where there was air-conditioning and heating respectively. As Summer ends, we may end up seeing a large number of cases starting from the Northern states and spreading south, just like we did last Fall. If this happens, it will likely begin in October.

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, September 13th, 2021
Endcoronavirus State Level Map, September 13th, 2021

Cases continue to fall for California and San Diego County.

Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a logarithmic format to emphasize small numbers. Note that each number on the left is 10x higher than the one below it.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a logarithmic format to emphasize small numbers. Note that each number on the left is 10x higher than the one below it.
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 logarithmic format to emphasize small numbers. Note that each number on the left is 10x higher than the one below it.
Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.

Indoor virus filter: I recently heard a podcast from physician Mike Osterholm (Osterholm Update, Episode 66). He argued that indoor ventilation was actually much more protective than masks. For those who can’t ventilate a space well, he suggested making a large scale air filter (Corsi box) using a box fan and a MERV 13 air filter. This is equivalent to a number 10 Honeywell furnace filter like you’d get at Home Depot. If you have a space where people gather that you can’t ventilate, buy a filter roughly the same size as your fan and tape it firmly to the front of the fan. Make sure the filter supports are toward the fan blades. On a side note, he also argues as I do that loose fitting masks are nearly worthless, but N95, KN95, and KF94 respirators are very good.

Data from Israel: Lots of folks are talking about the pre-print paper from Israel (Gazit et al) on vaccination vs natural immunity (infection by COVID). The data was from a database of patient information. They compared breakthrough infections (a person who was vaccinated and later was infected with Delta) to reinfection (a person who was infected with a previous SARS-2 variant and was then infected with Delta). They did this as a whole and also in a time matched way, meaning that the date of likely infection was around the same as the date of the 2nd dose of vaccine. Note that the vaccines are against the original Wuhan strain, so the paper is also discussing the rate at which Delta infects those who had natural vs vaccine exposure to non-Delta strains.

The results show that naturally infected people were almost 6 times less likely to get infected by Delta than vaccinated people, and 7 times less likely to have symptoms. The results are even more striking for the time matched data. For these patients, naturally infected people were 15 times less likely to get infected, and 27 times less likely to be symptomatic. Over all, it looks like natural immunity is better than vaccination for resistance to the Delta Variant.

Protection from Delta infection from vaccination and natural immunity. Protection from vaccination is arbitrarily given a value of 1, while other categories are shown in fold increased protection.

They did another study comparing natural immunity to natural immunity plus 1 dose of vaccine. Those previous infected with COVID AND having 1 dose of vaccine were about half as likely to be infected with Delta. Or you could say that having 1 dose of vaccine made them almost twice as resistant to reinfection.

Protection from Delta infection from vaccination and natural immunity. Protection from natural immunity is arbitrarily given a value of 1. Natural immunity plus 1 dose of vaccine gives 1.88 fold increased protection.

Some cautions are in order. Countries are not responding to the Delta Variant in exactly the same way. As discussed before, countries with large vaccination programs are seeing much fewer deaths due to Delta than other countries. However, rates of infection in vaccinated people by Delta seem to be higher in Israel, suggesting a slightly different version of Delta is in that country. Some reports suggest the Pfizer vaccine is only 39% effective against Delta in Israel.

The Mu Variant: News is only starting to circulate regarding the Mu variant (pronounced “mew”). First detected in Colombia in January 2021, this variant is currently classified as a Variant of Interest, not a Variant of Concern, suggesting it does not have characteristics that are very different from other versions, and may not have a large impact. A recent paper from Italy suggests that currently available vaccines do neutralize Mu, although with less efficiency. On the other hand, a WHO press release suggested that it may be able to escape immune responses raised to other variants. Since there is some disagreement, more studies will need to be done.

Don’t fear, but be smart!
Erik

Case Update, September 8th, 2021

This is a brief case update. Last week may represent a lowering of cases in the US, and we may finally have reached the peak of the Delta Wave in the US. Deaths continue to increase but they are proportionally lower than for previous waves. Endcoronavirus shows many counties and states in the country finally recovering from Wave 5.

Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format. Wave names are mine, not necessarily endorsed by healthcare officials.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.
Endcoronavirus County Level Map, September 8th, 2021.
Endcoronavirus State Level Map, September 8th, 2021

A word of caution on interpreting some case graphs that you may see. As you can see on my graphs, there is usually a disproportionately higher number of cases reported on Friday and Monday, and a lower number reported on Sunday. Some maps will report very high cases for an area (see Endcoronavirus state map for Louisiana) but zooming in on the map shows that the very high peak just shows cases for Fridays. So look for this when interpreting some data you might see.

Endcoronavirus State Level Map, September 8th, 2021. Delta wave in this view appears to be higher than the Fall/Winter wave.
Endcoronavirus State Level Map, September 8th, 2021. Clicking on the Louisiana graph on the Endcoronavirus state map gives you this graph. Note that the average case number is not nearly as high as is suggested by the higher days. This is not true for every state, so check your own state’s information.

California and San Diego County both continue their downward trend in new confirmed cases. It’s still to early to say, but deaths in San Diego County may have already peaked for the Delta peak. If this is the case, then deaths due to Delta have been very low. Hospitalizations have been proportionally as high as the Winter peak during the Delta Wave, however, at least in San Diego County.

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 by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County.
Weekly update, San Diego County, 9/1/21
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.

Many have been interested in the Israel data on vaccination. The paper associated with that data has finally been pre-printed. I haven’t had a chance to read it myself yet, but I’m providing the link in case you’re interested in it.

Don’t fear, but be smart,
Erik

Case Update, September 1st, 2021; FDA approval for Pfizer vaccine, 2 shots of vaccine, or 1 after COVID infection improve protection from Delta.

This is a case update. I’ll also discuss the potential for a Fall peak, new branding for the approved Pfizer vaccine, and whether you should get a vaccine shot if you’ve had COVID.

In the US, cases continue to rise, but the rise is slowing. Numbers from this last weekend suggest we may be seeing a peak in cases, but it’s too early to say. Deaths from the Delta peak are increasing also, but are proportionately less than for previous peaks.

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.

We are starting to see fewer cases in the South. Last year, the Summer peak was centered in the warmer states, California to Florida, and then we had a very large wave starting in the North starting in October. With cases still high at the start of September, we may see another large surge of cases in the North as we head into Fall.

Endcoronavirus County Level Map, August 31st, 2021. New cases slowly receding in the South and growing in the North. Michigan, Missouri, Nebraska still appear to not have strong outbreaks as of now, likely because of large case numbers during the UK variant wave in the Spring of 2021.
Endcoronavirus State Level Map, August 31st, 2021

New cases continue to fall in California and San Diego. Tentatively, it even looks like deaths are falling as well.

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

The Pfizer vaccine recently received FDA approval. The confusing part, is that legally speaking, the approved vaccine is not the same legal entity as the Emergency Authorized vaccine. The Pfizer vaccine we’re used to is called “Pfizer-BioNTech COVID‑19 Vaccine”. The FDA approved one is called “COMIRNATY (COVID-19 Vaccine, mRNA)”. I’m not a legal expert at all, but my understanding from watching some legal analysis is that the original vaccine is still only EUA authorized, and has some liability protection for Pfizer. However, Pfizer does not have liability protection for the COMIRNATY vaccine. According to the approval letter from the FDA, the formulations of the 2 vaccines are the “same formulation” and “can be used interchangeably”.

So why the name change? An analyst I watched said that Pfizer would like to continue to use the original vaccine under the new approval, but avoid liability. So those getting the vaccine now would still be getting the vaccine with liability protection for Pfizer. If you want to get a 3rd shot, you may want to wait until the legally approved COMIRNATY vaccine is available. Again, I am not a legal expert, so my analysis may be wrong on this.

If all this is true, you may regard this as a dirty trick by Pfizer. I try not to be cynical about things that I have only a vague understanding of, but if you thought that, I couldn’t disagree with you.

2nd shot improves protection against Delta, even for those with natural immunity. In a video by Dr. Roger Seheult, he argues that another shot greatly improves the immune response to the Delta variant. This follows both for those with only a single shot of the Pfizer vaccine, or with natural immunity. All this to say, if you’ve had COVID, 1 shot of a vaccine will help protect you from a breakthrough infection from the Delta Variant.

From Planas et al, 2021. Data suggests boosted binding of antibodies to Delta Variant after natural immunity (COVID infection) and 1 shot of the Astra Zeneca or Pfizer vaccine.
From Planas et al, 2021. Data suggests boosted binding of antibodies to Delta Variant after 2 shots of Pfizer vaccine.

Don’t fear, but be smart,
Erik

Possible low efficacy of current vaccines against Delta, possible Delta enhancement in the future.

This post is detailed, but adds an important new set of facts regarding the Delta Variant, the current vaccines, and prospects for a new booster shot.

You may have heard commentators in the last few days talking about the reduced efficacy of the current set of vaccines. There has also been a lot of discussion about a study from Israel about relatively high numbers of Delta COVID cases among vaccinated individuals.

First a little background on antibodies. Your immune system is making a random set of new antibodies all the time. In an ingenious mechanism, your immune cells “mix and match” pieces of a gene in your immune cells, producing the ability to make a zillion (scientific language for a whole lot) of different antibodies. Your body is basically making different “keys” that can fit into the “lock” of some new protein.

When you get an infection, several different antibodies may bind to the invading agent, on different regions, so you may be protected by several different “keys”. When this happens, a bunch of different things happen, including the manufacture of Memory B cells which makes just the antibody that binds to a particular protein. These cells get activated if you get re-invaded by something with that protein. All this to say, if you’ve had COVID, or been vaccinated, your body will have B cells with antibodies on them that bind to different parts of the Spike protein.

Before I say anything else, I want to repeat that I have not been vaccinated, but have recommended that high risk individuals get vaccinated! I’ve also pointed out many times in the past few weeks that countries with large vaccination programs have lower death rates due to Delta than other countries!

Literally 30 minutes after Thursday’s post on vaccine myths, a doctor friend of mine sent me a pre-print paper from a lab in Japan. Please note, this is a pre-print paper and has not yet finished peer review! The paper describes experiments using antibodies derived from patients infected with the Wuhan strain, as well as with the Delta Variant. They then studied binding of these antibodies to artificial viruses. The paper argues that Delta variant viruses are less neutralized by vaccines against “wild-type” or Wuhan strain vaccines. While the “wild-type” antibodies against Wuhan can neutralize a region of the Delta Spike protein called the Receptor Binding Domain (RBD) (Figure 1C), other antibodies binding to another region of Delta Spike protein actually enhance infectivity. Figure 1D from the paper shows negative levels of “neutralization” for antibodies that bind the N-terminal domain of the Spike protein. The paper calls this “enhanced”. Yes, this is the ADE I’ve been talking about.

Figure 1 from Liu et al 2021.

They suggest that with rapid changes in COVID variants, a new version of Delta is going to be able to use the ADE pathway in the near future, when Wuhan era antibodies will no longer be able to neutralize a mutated Delta strain.

To sum that all up in simpler language, it basically says that Delta is more infectious because it is partially using the ADE method of infection. Future versions may be less prone to be neutralized by Wuhan antibodies, making them fully enhanced. If this happens, we may have more severe disease in those who get infected with this new enhanced Delta.

They conclude by saying a booster against the Wuhan strain will not be effective in improving protection from Delta, and that a new vaccine against Delta will be required.

The material in the paper may help to explain why we have been seeing lowering levels of vaccine effectiveness in some countries.

Just to be very clear, they are not saying that this new enhanced Delta exists now, just that it may exist in the future.

I will pay close attention to this issue. If you have already been vaccinated or had COVID, a new Delta vaccine will be your best defense against possible ADE arising from a possible enhanced Delta.

If an enhanced Delta arises, and you have had Wuhan COVID or a Wuhan vaccine, and you haven’t had Delta, then you may be at greater risk for severe disease.

If you have had COVID since July 2021, you are likely already immune to the Delta variant, and this will not be an issue for you.

I am fully aware this complicated. Also, the CDC has rarely if ever discussed this possibility, so unfortunately, most of the people you talk to about this will not believe it. I am sharing this with you so you can make wise decisions for you and your family.

Some companies are already working on Delta versions of the vaccine. If you have had the current vaccines, or had COVID, you should get the Delta vaccines as soon as they are available.

Of course, discuss your medical history with your doctor before making medical decisions.

Another note on misinformation: My post from last Thursday generated a lot of discussion regarding censorship and misinformation. I argued strongly that the dangers of misinformation do not outweigh the benefits of free speech. Many of you are pro-vaccine and others are suspicious of the vaccine. I would simply urge this:

1) If you use the words “misinformation” and “disinformation” in a post or in a discussion, please come ready with evidence to support whatever claim your making! Don’t just throw out this word, support it!

I recently saw a video with a pro-vaccine medical person saying “we just need to keep pounding this information into people”. That is the wrong approach. With someone who is not yet convinced to get a vaccine, “pounding” away on them is just going to raise their defenses and exasperate you. Instead, gently show them your reasons for believing what you do! Explain to them what the data means. You may not convince them, but you may move them toward being more open to your view.

2) If someone makes a claim that sounds unfounded or that you don’t trust, don’t just tell them they’re wrong or make a counter claim, ask them to provide evidence, or where they got their information. You don’t have to do their homework for them! If they can’t produce any evidence, you are under no obligation to counter it. I’ve saved myself A LOT of work with this approach. It’s OK that they just heard it somewhere IF their source is reliable and has evidence themselves. You can still ask them to provide you with a link or something to that person’s statement. However, “I just heard it somewhere” is not evidence.

Part of the reason I’m not so worried about “misinformation” for myself is because of my regular use of suggestion #2.

Don’t fear, but be smart!
Erik