Policy junk -- Old COVID policies overcome by new data

Last update: Thursday 9/30/21

A previous note on this blog referred to the "fog of war" to describe the conundrum faced by pandemic managers who must make important judgement calls based on unreliable data. Another martial insight also has unfortunate relevance for our mishandling of the COVID pandemic: 
"fighting the last war". Significant new variants have become new enemies with new advantages. But at times, our pandemic managers have continued to press old policies even when data about the new variant has signaled the start of a new kind of war that must be waged with new policies. This note considers two examples. In 20-20 hindsight one was understandable;  the other was an unforced error. 

FDA vs CDC vs "the science" vs. wisdom

Last update: Friday 9/24/21

The advisory panel of experts for the CDC recently recommended booster shots, but their recommendations contained substantial differences from the recommendations submitted by the advisory panel of experts for the FDA a few days before. There was also considerable disagreement among the experts on each panel. Fortunately, Dr. Rochelle Walensky, Director of the CDC, immediately modified the recommendations of the CDC panel so as to bring them into substantial agreement with the FDA recommendations. She made the modifications in order to avoid paralyzing confusion among potential booster recipients and booster administrators, e.g., hospitals, pharmacies, and other health care providers -- as to who was or was not qualified to receive the shots.

Massachusetts provides a glimpse of the endemic ending of our pandemic

Last update: Tuesday 9/21/21

As per the opening words of the previous note on this blog, we should expect that our pandemic will fade into a "forever" endemic wherein the number of new infections will remain more or less the same from one month to the next for some indefinite future time frame. Most people still believe that the Delta variant only survives because vaccine holdouts are infecting each other; they believe this because they also believe that there aren't enough Delta breakthrough cases to sustain the virus; and they believe this because data that could be used to estimate the percentage of new infections involving breakthroughs has not been available for most states. However, Massachusetts has been publishing this kind of data on a Webpage since 8/24/21 (perhaps earlier).

Protecting ourselves as our 18 month pandemic fades into a "forever" endemic

Last update: Friday 9/17/21

If we assume that there will be no more Delta surprises, i.e., variants that profoundly disrupt our vaccination and mitigation efforts ... a very big "if" ... then we should expect that our pandemic will fade into an endless endemic wherein the number of new infections will remain more or less the same from one month to the next for some indefinite future time frame. The endemic will be self-sustaining, like seasonal flu; it won't require boosts from travelers returning from countries having higher rates of infection. New infections will occur (1) among the unvaccinated holdouts and (2) as breakthrough infections among the vaccinated.

Tracking Delta breakthroughs ... Part 4 (Mitigation via testing and contact tracing)

Last update: Sunday 9/5/21

Why don't we know how many Delta  breakthrough infections occurred last month and where? Why don't we know which population segments are most likely to be infected by Delta, even if they have been fully vaccinated? Are cloth masks as effective in suppressing the spread of Delta as they were in suppressing previous variants?  Are breakthroughs more likely because (a) Delta is more transmissible, (b) vaccine effectiveness weakens after six to eight months, (c) encouraged by the CDC in May 2021, many people abandoned their mitigation habits just as Delta was becoming the dominant variant, or (d) some combination of (a), (b), and (c)?