Friday, August 13, 2021


David Wallace-Wells of New York magazine has been talking to COVID experts who are looking at the performance of the Delta variant and don't believe we're in a pandemic of the unvaccinated.
“The message that breakthrough cases are exceedingly rare and that you don’t have to worry about them if you’re vaccinated — that this is only an epidemic of the unvaccinated — that message is falling flat,” Harvard epidemiologist Michael Mina told me.... “If this was still Alpha, sure. But with Delta, plenty of people are getting sick. Plenty of transmission is going on. And my personal opinion is that the whole notion of herd immunity from two vaccine shots is flying out the window very quickly with this new variant.”

“We’re seeing a lot more spread in vaccinated people,” agreed Scripps’s Eric Topol, who estimated that the vaccines’ efficacy against symptomatic transmission, which he estimated to be 90 percent or above for the wild-type strain and all previous variants, had fallen to about 60 percent for Delta. “That’s a big drop.” Later, he suggested it might have fallen to 50 percent, and that new data about to be published in the U.S. would suggest an even lower rate. On Wednesday, a large pre-print study published by the Mayo clinic suggested the efficacy against infection had fallen as far as 42 percent.
Mina, the Harvard epidemiologist, believes that the vaccines aren't doing a very good job of preventing transmission by the vaccinated, because of the extreme transmissibility of Delta.
... my lab has probably done as much as anyone in the world at this point to really understand all of the confounding factors with viral loads. Now, I’m no oracle here. But what I do well is I look at, what should we expect from the immune system? What should we expect from viral kinetics and how would that play out in the population data? And if your peak viral load is at a billion or a trillion copies per milliliter, you’re going to transmit.

... I would say, tentatively, that, if we had a crystal ball, and we could say there are X number of people who have been exposed, then the probability of an exposure turning into an infection is, as an example, 30 percent lower amongst vaccinated.

... I’d say that there’s a very good chance that vaccines will help prevent an exposure turning into an infection. But amongst those who are getting infected and detected, the viral loads are really high. And we’re clearly seeing transmission happen. We’re seeing outbreaks happen amongst vaccinated groups.
He thinks the surges we're seeing now will happen will happen elsewhere, including highly vaccinated parts of the country, in part because the immunity of the vaccinated elderly is likely to wane. (He expects them to need booster shots.)
... Florida will get through this relatively quickly, because it’s burning through the state so quickly already. But by the time it gets to the Northeast and really takes over here, I think we’ll be pushing into late September, and we still have a lot of cases happening.

And at that point, we’re going to start seeing seasonality really take hold. So I think it will be very similar in fact to what we’ve seen across the world and across this country before — multiple waves, spatially segregated. That’s because we’re a large country with different kinds of attack for this virus and different strategies to control it. And so for the U.S. as a whole that just ends up creating a much longer duration wave than what we see in a smaller country like the U.K., for example.
If Mina and Topol are right -- especially about surges in vaccinated America -- one of the consequences will be political. Ron DeSantis and his rooting section, which includes not just the entire American right but much of the mainstream media, will expect liberals to eat crow, and blame themselves for the autumn and winter surges. President Biden, who staked so much of his reputation on his ability to contain the pandemic more effectively than Donald Trump, will begin to be perceived as a failure.

I already believe 2022 will be a good year for Republicans. The GOP knows how to fire up its voters for midterm cycles; Democrats usually don't. But if we're about to go through another bad pandemic year, and experience surges in blue and purple areas as well as red ones, then the party identified with vaccines and a strong belief in public health is likely to get blamed when public health measures don't seem to work. It's not our fault that we didn't know what Delta would be like, but that won't stop Republicans from saying that our approach has failed.

The worst predictions might not come true. If they do, voters might rally around the party that seems to care about doing the right thing. A combination of vaccines and natural immunity might allow us to feel reasonably safe in the spring of 2022 -- a few months before the midterms.

But bad COVID news in the next year could be bad for Democrats. Be ready for that.

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