Almost packed and off Moose writes:
<<<<I think this is being under reported. Feel ill, get and take a home test,
rest until better, and no reporting. I happen to have reported mine, because
I'm on some Gov't follow-up message thing, that asks me regularly, but I
suspect most don't. And, of <<<<course, symptomless cases don't get reported.
We don't do enough testing to really know. Delta is a different beast and a
very high R0. Ultra-vaxed Israel got in trouble as loosened travel restriction
when high levels of fully faxed adults was achieved early. Travelers soon
brought delta as protective immunity was beginning to wane and it took off.
Older people and immuno-compromised especially get in trouble even if double
vaxed and can even spread it if minimal symptoms --but less effectively.
Israel doesn't give a rat's arse about WHO opinion (nor should they) and began
boosters in mid July and this week all over 30 are eligible. Israeli health
officials had to make a speedy decision with uncertainly and incomplete data
but that is what health officials and physicians need to do. Clearly the
proper call.
There is a documented 6 fold drop in any symptomatic infections in the boosted
group. The green passport has been reconfigured granting them only to
triple-vaccinated and good for 6 mos only.
WS:
<<Glad your's was mild. My daughter had it a bit rougher. The fact vaccinated
<<people can carry the virus is fueling the exposure level.
<<<<Something of a new, and more troublesome state. What do we do know? Are we,
at least short term, immune? MikeG has suggested we get boosters a month after
the infections.
A booster a month later should provide a very robust protective immune
response. As the Pfizer vaccine has full approval it would not be
unreasonable to get it 30 days later by "off label" script or if you have the
patience
wait for the 8mos for last dose.
The immunocompromised can get it now and that is by attestation only and no
documentation required. You should have a boost by the moderate infection but
not as robust as a booster.
It is a mystery where the 8mos came from. Best I can find is a decision by
"senior health officials." It is all very opaque. I can visualize them
sitting around saying Hmm, considering
Re=Ro*(1-x*v), where x*v is the proportion of the population that is immune, x
is the percentage of people who are fully immune (i.e., vaccinated) and v is
the vaccine’s effectiveness, if we concentrate on the unvaccinated it will
result in less transmission more effectively. It is NOT quantum mechanics. A
few back of the envelope calculations confirm that if assume the booster even
goes from 65% to 95% effectiveness Re doesn't change that much with a booster.
Problem is that does not include the asymptomatic spread by those double vaxed
and other data from Israel that is just available. The other issue is that it
totally ignores all the MORBIDITY and MORTALITY in the breakthrough cases. I
see patients who have had terrible time with it including loss of taste and
smell that sometimes returns altered. Tell it to the families of the 1500 who
died double vaxed (as of end of July only) that we did the right thing not
proceeding with a 26 dollar shot. They won't walk this back and give it
earlier as the optics would be terrible for the officials even if the decision
was an EGREGIOUS error to wait 8 mos, IMO. We are awash in vaccine that will
expire soon anyway--put it into arms now. Delta isn't done with us, Israel is
a cautionary tale.
Yes, I am only an endocrinologist with a teaching position at Harvard Medical
School and not an infectious disease doc or epidemiologist, but this is
obvious to me.
End rant,
Mike
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