Let's stop repeating COVID myths

Last update: Monday 11/1/21

Unfortunately, valid assertions about the original coronavirus variant that was dominant throughout 2020 are being repeated by the media with regards to the Delta variant in late 2021. Those old "facts" are now myths, remnants of a bygone age. One obsolete "fact" stands head and shoulders above the rest -- the assertion that by vaccinating a large enough percentage of the population, e.g., 80 or 90 percent, we will achieve herd immunity and the pandemic will end shortly thereafter. The media pundits seem to understand that Delta is far more contagious than its predecessors. But many of the pundit doctors on television fail to grasp the strategic implications of the fact that Delta also produces far more so-called "breakthrough" cases than previous variants.  These highly contagious breakthroughs will make herd immunity impossible to achieve.

Delta breakthroughs are not rare

At first, the CDC claimed that vaccinated persons were rarely infected. Indeed, there was little evidence of breakthrough cases in 2020 or in the first few months of 2021 when new variants became dominant. But then came Delta; more specifically, then came the large number of breakthrough cases that exploded in the summer resort community of Provincetown, Massachusetts, during the July 4th celebration of our "independence" from the virus, a celebration that the CDC had encouraged Americans to observe by abandoning their masks and social distance mitigations. 

• "Vaccinated Americans May Go Without Masks in Most Places, Federal Officials Say", Roni Caryn Rabin, Apoorva Mandavilli and Noah Weiland, NY Times, 5/13/21

Huddling close together in bars, restaurants, parties, and other indoor spreader events without masks, over 900 Provincetown vacationers were infected, more than 700 of whom were fully vaccinated. 

• "Outbreak of SARS-CoV-2 Infections, Including COVID-19 Vaccine Breakthrough Infections, Associated with Large Public Gatherings — Barnstable County, Massachusetts, July 2021", Centers for Disease Control, 7/30/21 
  
  
• "‘It’s Nowhere Near Over’: A Beach Town’s Gust of Freedom, Then a U-turn", Ellen Barry and Beth Treffeisen, NY Times, 8/1/21
  
  
• "How Provincetown, Mass., stress-tested the coronavirus vaccine with summer partying and delta", Hannah Knowles and Randy Dotinga, Washington Post, 8/5/21
  
  
• "Why Provincetown’s Response to Its Covid Outbreak Was So Effective", William Hanage and K.J. Seung, NY Times, 8/27/21

One doesn't have to be an expert in "the science" to recognize that 700 breakthroughs in one vacation town over the course of one holiday weekend means that Delta breakthroughs are not rare. Smaller clusters in other parts of the country quickly confirmed this conclusion:

• "27 people test positive for coronavirus on Carnival cruise ship", Hannah Sampson, Washington Post, 8/13/21 ... Note: one breakthrough was a passenger, the rest were members of the crew.
  
  
• "More than 200 staff members at 2 San Francisco hospitals have tested positive, most in breakthrough Delta infections.", Eduardo Medina, NY Times, 7/31/21 
  
  
• "‘We Are a Complete Outlier’: HBS Moves Some Classes Online Amid Covid-19 Outbreak", Claire H. Guo and Christine Mui, Crimson Staff Writers, Harvard Crimson, 9/28/21 ... Note: HBS = Harvard Business School ... All students, faculty, staff, and researchers are required to be vaccinated ... Contact tracers found transmission was linked to indoor socializing off campus among individuals who weren’t masked.

Breakthrough cases are hard to detect

As will be seen, only mandatory testing will produce accurate estimates of the number of breakthrough cases in a community.

• Mandatory testing -- Test everyone in the community at least once each week thereby catching all infections, including asymptomatic and mild cases.  Obtain the  vaccine status of everyone tested to identify the breakthrough cases
  
  Mandatory testis is mostly employed by organizations that can compel all members to be tested, e.g., K-12 schools, universities, hospitals, airlines, restaurants, and cruise ships. 
  
  
• Voluntary testing -- People who volunteer to be tested will most likely be those afflicted with moderate to severe symptoms. Obtain the vaccine status of everyone tested to identify the breakthrough cases 
  
  Delta infections of vaccinated persons are overwhelmingly mild or asymptomatic. Asymptomatic and mild cases are unlikely to volunteer to be tested, if only because most of them will won't suspect that they have been infected; hence this method will grossly underestimate the total number of breakthrough cases. 
  
  
• Mixed mandatory testing, contact tracing, and voluntary testing ... Begin with persons who are tested via mandate and test positive; then perform contact tracing to identify others who were in contact with infected persons during that person's period of contagion. Encourage the contacts to volunteer to be tested. Obtain the vaccine status of everyone tested to identify the breakthrough cases.
  
  When persons tested via mandate are a large percentage of the total population, the estimates of breakthrough cases will be more accurate; conversely when the mandated test groups are a small percentage of the total population, the estimates of breakthrough cases will be less accurate. 
  
  

Why the CDC's myth of "rare" Delta breakthroughs is often "confirmed" by new "facts"

No states have mandated periodic testing of all residents, and only a few states have set up robust contact tracing operations. Therefore most state level data about infections will be based on voluntary testing. 

Our vaccines are highly effective, so only a small percentage of vaccinated persons will become moderately infected or severely infected (or die). State level breakthrough data will therefore count the small numbers of vaccinated persons who were moderately infected or severely infected, which is why these people volunteered to be tested. When the CDC or any other organization aggregates state level data to national totals, they will invariably conclude that breakthroughs are a national rarity.  All of which reminds us of the continuing relevance of one of the oldest principles of info tech ==> GIGO, GIGO, GIGO, i.e., garbage in, garbage out ... :-(

A new CDC myth: All breakthroughs are caused by the declining effectiveness of vaccines

Upon learning about the mega-cluster of breakthrough cases in Provincetown, the CDC immediately issued guidance that reversed its previous lifting of pandemic restrictions. Wearing masks was once again a high priority, especially in areas of high transmission of the virus

• "Interim Public Health Recommendations for Fully Vaccinated People", Centers for Disease Control, 7/28/21
  
  
• "Outbreak of SARS-CoV-2 Infections, Including COVID-19 Vaccine Breakthrough Infections, Associated with Large Public Gatherings — Barnstable County, Massachusetts, July 2021", Centers for Disease Control, 7/30/21 

Given that the CDC was still employing data about infections that was largely based on voluntary testing, the only areas of high transmission that its data would identify would be areas wherein there was high transmission among unvaccinated persons. The CDC's own data would not have identified the high transmission of the disease among the vaccinated vacationers in Provincetown. 

As the weeks passed the CDC began to focus on the notion that breakthroughs were caused by waning effectiveness of our vaccines, ignoring the more obvious explanation that the mega-cluster in Provincetown was caused by the vacationers huddling close together in bars, clubs, parties, and other spreader events without masks.

• "Vaccine Effectiveness Against Infection May Wane, C.D.C. Studies Find", Apoorva Mandavilli, NY Times, 8/18/21

The CDC cited evidence that the effectiveness of our highly effective vaccines declines after about six months. Maybe so. Other vaccines lose their effectiveness as time goes by, so this is not a surprising possibility. 

But this six month time frame does not fit the timing of the mega-cluster. Readers may recall that when President Biden took office in late January, there had been so little distribution of the vaccine under his predecessor that Biden's biggest initial efforts involved ramping up the distribution process. His super-charged distribution did not hit full stride until March 2021. The Provincetown celebrations were held in early July 2021. So the lion's share of the participants would have been vaccinated in March, April, May, and June. In other words most of their vaccinations would have been less than four months old. Their vaccinations would have been close to full effectiveness, i.e., preventing severe illness and death, but not preventing infection -- which is exactly what their vaccinations did. 

Bottom line: the huge number of breakthrough infections in Provincetown were caused by vacationers adhering to the CDC's previous suspensions of masks and social distancing, not by declines in the effectiveness of their vaccinations.

Booster-mania

The World Health Organization (WHO)  has argued that it is in the self-interest of wealthy nations to forego the acquisition of additional vaccines for booster shots while large portions of the world's population have yet to receive their first shots. The WHO argues that unvaccinated billions provide fertile grounds for the corona virus to evolve ever more powerful variants. 

• "‘Act now’ on global vaccines to stop more-dangerous variants, experts warn Biden", Dan Diamond and Yasmeen Abutaleb, Washington Post, 8/10/21 

On first hearing, this sounds like a more persuasive argument than simply asking wealthy nations to do the humane thing by foregoing boosters so that millions of people in other nations can avoid severe illness and death. But wealthy nations might also reduce their own risks of severe illness and death by foregoing boosters while wearing masks and maintaining social distancing.

Common sense suggests that more lethal variants might actually be more likely to evolve in high vaccination communities than in low vaccination communities. Delta is currently very effective at wounding and killing unvaccinated persons, so new mutations have little advantage to be gained among the unvaccinated. However in highly vaccinated communities, the fittest variants will be the ones that "learn" how to evade our vaccines. All the virus needs is opportunity to infect more vaccinated persons, opportunities provided by highly vaccinated communities in which most people do not wear masks and and maintain little or no social distancing, as did the hundreds of breakthroughs at the Provincetown July 4th celebrations.

• "The coronavirus is still mutating. But will that matter? ‘We need to keep the respect for this virus.’", Joel Achenbach, Ben Guarino and Aaron Steckelberg, Washington Post, 10/25/21 

The medical profession has pleaded guilt and regret for overprescribing antibiotics in the last century, thereby facilitating the evolution of "super" bugs against which we now have few defenses remaining. Are we going to let the doctors do this again with regards to COVID variants? As we abandon masks and social distancing in our rush to embrace universal access to endless boosters, why don't we recognize where this process might lead? 

Herd immunity is no longer possible

If we abandon masks and social distancing, Delta's ability to infect both the vaccinated and the unvaccinated will convert the entire U.S. population into a vast breeding ground on which more deadly variants can evolve ... Welcome to Jurassic Park .. :-(

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Related notes on this blog:

• "Acceptable costs of living with the virus", Last update:  10/24/21
  
  
• "Protecting ourselves as our 18 month pandemic fades into a "forever" endemic", Last update:  9/17/21