Totally agree that targeting Covid-vaccination campaigns on the elderly and other at-risk cohorts makes a lot of sense. That said, bear in mind that the younger, less-at-risk population constantly interacts with the at-risk population... so what we really need is for *everyone* to do the right thing for the sake of society in general. So once again, we need to ask ourselves -- or yourselves, I'm a Brit in the US ;) -- why far, far higher percentages of the general population in other wealthy countries simply go out and get themselves re-vaccinated once they know a new formulation is available. (Answer: because the US is the only rich country where for many that decision is predicated on politics and breathtaking ignorance. God help us all when Trump is re-elected.)
Hi Peter. In general, the CDC's rationale for flu shots has less to do with decreased transmission than preventing severe disease (though I suspect they do in the short term). For Covid shots, certainly we've seen that in the post-Wuhan original variant era, transmission was a lot easier despite vaccines (although again a lot of this is due to waning of circulating immunoglobulins, which is why protection against Covid pneumonia does not wane in the same way). All to say...yes vaccines are a community action in the short term, but the main reason they are recommended is to prevent severe disease.
ACIP will meet at the end of February and may approve a second shot, until they do, no pharmacy will give it.
So last week the post was flu admissions are more than COVID for older people— not holding up? Also due to the recent surge, deaths are over 2000/week right now. Not sure how that compares to flu deaths.
Ah good point on the discrepancy between last week and this week.
Last week was looking basically at late December and January. "peak season."
Flu is extremely seasonal. So it's like basically gone other than November-March. Covid seems to have a big seasonal component to it too, but not as drastic. So it has been hospitalizing people year round, but much more so during that Nov-March period.
As a result, the *cumulative* number of hospitalizations since October is higher for Covid (today's post) in older folks, but when all 3 big viruses are "in season" (Dec-Feb being the window for the peak), flu has the edge.
So both things are true, but they answer slightly different questions. Thanks for asking!
Where did you find the statistic on the deaths in the last weeks. I can't find much of anything on the CDC website except they refer us to the NVSS website which shows deaths reported by cause, but the data is very lagged since those deaths are compiled using death certificates. I would very much like to monitor the current death rates in something more like real time as you seem able to do. Thanks,
Katelyn Jetelina just put out a state of affairs report that is so helpful and shows the discrepancy of the flu vs COVID hospitalizations— the one showed more flu was from a subset of urban sites. I strongly recommend getting her newsletter: your local epidemiologist
We should crowd source this: I’ve been checking the BNO news feed, but it requires going onto Twitter which I try to avoid. Does anyone have a better source? I try and listen or read Osterholm’s CIDRAP podcast.
BNO newsfeed post from yesterday: Weekly U.S. COVID update:
What is BNO and where does its data come from? Especially Covid deaths. And what does “Average” refer to? Thanks for sharing- no offense intended but it’s hard to evaluate the reliability of any data. A recent article in STAT quoted a leading CDC researcher in the article about the VE rate being 54%. She referenced Covid as still causing hundreds of deaths a week. Not only is that vague but also suggests at least less than 1000 which seems very unlikely. But … who knows? Why are public health authorities- notably the CDC - so reluctant to publish their best estimates on deaths!
Relating to the comment by Eric, but writing separately to highlight the issue: A quotation from the CDC web site: "People Who May Get an Additional Updated COVID-19 Vaccine:
People aged 6 months and older who are moderately or severely immunocompromised may get additional updated COVID-19 vaccine doses 2 or more months after the last recommended COVID-19 vaccine. Talk to your healthcare provider for more information." I'm in that category, and talked to my primary care provider, who recommended that I get a second shot (the first of the current vaccine was in September) because of the waning effect and upcoming travel (to help care for a relative undergoing chemotherapy). BUT: pharmacists at both CVS and Walgreens told me that despite what the CDC says, the FDA has approved only one shot per person of the latest (monovalent) vaccine, and they have to abide by FDA rules, not CDC guidelines. So it looks as if we older higher-risk folks (and anyone caring for them) just have to wait it out, hoping that indeed the efficacy doesn't wane as fast as was thought, and continuing to take all precautions.
Hugely important issue and one that can’t be stated too often . And in the strongest terms. Especially for the huge numbers of those 30+ million - yes, that’s right, check the census numbers - who are over 65. When is the FDA and its advisors going to focus its recommendations and approvals on that fact, since most of our medical system will be so intransigent until they do!
I think the CDC just released some data on waning which was (I hear) pleasantly surprising in terms of waning (i.e., less than expected). But I have not yet assessed those data myself. In the past, the waning by 6 months has been enough to warrant boosts in high risk people, so it's a good question.
Definitely something for your wife to discuss with her doc though.
Totally agree that targeting Covid-vaccination campaigns on the elderly and other at-risk cohorts makes a lot of sense. That said, bear in mind that the younger, less-at-risk population constantly interacts with the at-risk population... so what we really need is for *everyone* to do the right thing for the sake of society in general. So once again, we need to ask ourselves -- or yourselves, I'm a Brit in the US ;) -- why far, far higher percentages of the general population in other wealthy countries simply go out and get themselves re-vaccinated once they know a new formulation is available. (Answer: because the US is the only rich country where for many that decision is predicated on politics and breathtaking ignorance. God help us all when Trump is re-elected.)
Hi Peter. In general, the CDC's rationale for flu shots has less to do with decreased transmission than preventing severe disease (though I suspect they do in the short term). For Covid shots, certainly we've seen that in the post-Wuhan original variant era, transmission was a lot easier despite vaccines (although again a lot of this is due to waning of circulating immunoglobulins, which is why protection against Covid pneumonia does not wane in the same way). All to say...yes vaccines are a community action in the short term, but the main reason they are recommended is to prevent severe disease.
ACIP will meet at the end of February and may approve a second shot, until they do, no pharmacy will give it.
So last week the post was flu admissions are more than COVID for older people— not holding up? Also due to the recent surge, deaths are over 2000/week right now. Not sure how that compares to flu deaths.
Ah good point on the discrepancy between last week and this week.
Last week was looking basically at late December and January. "peak season."
Flu is extremely seasonal. So it's like basically gone other than November-March. Covid seems to have a big seasonal component to it too, but not as drastic. So it has been hospitalizing people year round, but much more so during that Nov-March period.
As a result, the *cumulative* number of hospitalizations since October is higher for Covid (today's post) in older folks, but when all 3 big viruses are "in season" (Dec-Feb being the window for the peak), flu has the edge.
So both things are true, but they answer slightly different questions. Thanks for asking!
Jan,
Where did you find the statistic on the deaths in the last weeks. I can't find much of anything on the CDC website except they refer us to the NVSS website which shows deaths reported by cause, but the data is very lagged since those deaths are compiled using death certificates. I would very much like to monitor the current death rates in something more like real time as you seem able to do. Thanks,
Katelyn Jetelina just put out a state of affairs report that is so helpful and shows the discrepancy of the flu vs COVID hospitalizations— the one showed more flu was from a subset of urban sites. I strongly recommend getting her newsletter: your local epidemiologist
I have her news letter and it’s terrific!
She’s amazing, great communication
We should crowd source this: I’ve been checking the BNO news feed, but it requires going onto Twitter which I try to avoid. Does anyone have a better source? I try and listen or read Osterholm’s CIDRAP podcast.
BNO newsfeed post from yesterday: Weekly U.S. COVID update:
- New cases: 248,733 est.
- Average: 301,282 (-30K)
- States reporting: 50/50
- In hospital: 21,665 (-3K)
- In ICU: 2,304 (-144)
- New deaths: 2,570
- Average: 2,425 (+120)
What is BNO and where does its data come from? Especially Covid deaths. And what does “Average” refer to? Thanks for sharing- no offense intended but it’s hard to evaluate the reliability of any data. A recent article in STAT quoted a leading CDC researcher in the article about the VE rate being 54%. She referenced Covid as still causing hundreds of deaths a week. Not only is that vague but also suggests at least less than 1000 which seems very unlikely. But … who knows? Why are public health authorities- notably the CDC - so reluctant to publish their best estimates on deaths!
Relating to the comment by Eric, but writing separately to highlight the issue: A quotation from the CDC web site: "People Who May Get an Additional Updated COVID-19 Vaccine:
People aged 6 months and older who are moderately or severely immunocompromised may get additional updated COVID-19 vaccine doses 2 or more months after the last recommended COVID-19 vaccine. Talk to your healthcare provider for more information." I'm in that category, and talked to my primary care provider, who recommended that I get a second shot (the first of the current vaccine was in September) because of the waning effect and upcoming travel (to help care for a relative undergoing chemotherapy). BUT: pharmacists at both CVS and Walgreens told me that despite what the CDC says, the FDA has approved only one shot per person of the latest (monovalent) vaccine, and they have to abide by FDA rules, not CDC guidelines. So it looks as if we older higher-risk folks (and anyone caring for them) just have to wait it out, hoping that indeed the efficacy doesn't wane as fast as was thought, and continuing to take all precautions.
Hugely important issue and one that can’t be stated too often . And in the strongest terms. Especially for the huge numbers of those 30+ million - yes, that’s right, check the census numbers - who are over 65. When is the FDA and its advisors going to focus its recommendations and approvals on that fact, since most of our medical system will be so intransigent until they do!
What are the steps to get this to the “people” who make those decisions?
I mean, some of them read this newsletter.
Yes!
Now there's the bigly question
Hi Eric--
I think the CDC just released some data on waning which was (I hear) pleasantly surprising in terms of waning (i.e., less than expected). But I have not yet assessed those data myself. In the past, the waning by 6 months has been enough to warrant boosts in high risk people, so it's a good question.
Definitely something for your wife to discuss with her doc though.
Our public health authorities need to be more proactive on this as we’ve discussed before. I consider it callous and irresponsible.