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Cause for cautious optimism?


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2 minutes ago, Psoque said:

 it is impossible to prove or disprove what you are trying to say. 

 

The latter half of that is rather elegant.  I tip my cap.

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31 minutes ago, Psoque said:

Without knowing how many of seemingly healthy and asymptomatic people are getting infected and/or re-infected, it is impossible to prove or disprove what you are trying to say.  I do not know of any studies that estimates the rates of re-infection, especially among those who are asymptomatic.  Perhaps you can share this information with us??

Happy to. Large study from the U.K. in the Lancet. I’m screenshottimg the relevant (to this discussion) conclusion and here’s the link. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00675-9/fulltext
 

I find it baffling that so many are so resistant to the scientific reality that natural infection confers protection. 

B6DDA101-0076-492E-91F8-B10BBDF5817E.png

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2 hours ago, sierrafloridacruiser said:

Happy to. Large study from the U.K. in the Lancet. I’m screenshottimg the relevant (to this discussion) conclusion and here’s the link. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00675-9/fulltext
 

I find it baffling that so many are so resistant to the scientific reality that natural infection confers protection. 

B6DDA101-0076-492E-91F8-B10BBDF5817E.png

A few relevant points from this particular observational study are the following:

 

1.  This is an observational study that comes with various limitations inherent to the study design.  For example it is hard to really know the distinguish between re-infection and persistent infection unless previously infected and certified to be virus free for sufficient time (and we don't know what that time is, by the way) is intentionally inoculated with the virus again.

2.  The immunity gained from infection lasted the average of 7 months, meaning that the duration of natural immunity was not very long (the authors describe the duration of immunity as "short to medium term") for many of those observed in this study.

 

So, my assessment of this issue (the reliability of immunity from actual infection from this coronavirus, and how long does the immunity last) from this particular study and others is that.

 

1.  Yes, many people who recover from (symptomatic) infection do gain natural immunity for some time.

2.  The duration of natural immunity from this infection is not necessarily very long, meaning that a history of symptomatic infection in any given individual does not always guarantee immunity.

 

Furthermore, I don't think this study or any other study I know of support the notion that immunization of relatively healthy and younger population is counter-productive.  I also don't think that some of the smart people who are actively studying this and other viral diseases are ignoring the fact that acquired immunity is negligible. 

 

My professional opinion is and has been that those who are vulnerable to severe illness AND those who are capable of acting as reservoirs of this virus/effective spreaders of the virus should be vaccinated.  I think the real challenge is knowing what is the best way to accomplish both goals, especially in countries with limited vaccine supply and/or delivery infrastructure.

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6 hours ago, sierrafloridacruiser said:

Happy to. Large study from the U.K. in the Lancet. I’m screenshottimg the relevant (to this discussion) conclusion and here’s the link. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00675-9/fulltext
 

I find it baffling that so many are so resistant to the scientific reality that natural infection confers protection. 

 


It’s not baffling to me at all.  Look at India if you need an example.  They thought that the prior infections of such a large portion of their population would help control the B.1.617 variant — and then it didn’t.  
 

Prior infection provides you some degree of immunity to the variant you were infected with and in many cases similar variants, but not all of them.  It’s too early to tell to what degree the original formulations of the vaccines work against B.1.617, but at least one of its mutations is making the antibodies from the earlier variants highly ineffective.

 

Vince

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4 hours ago, BWIVince said:


It’s not baffling to me at all.  Look at India if you need an example.  They thought that the prior infections of such a large portion of their population would help control the B.1.617 variant — and then it didn’t.  
 

Prior infection provides you some degree of immunity to the variant you were infected with and in many cases similar variants, but not all of them.  It’s too early to tell to what degree the original formulations of the vaccines work against B.1.617, but at least one of its mutations is making the antibodies from the earlier variants highly ineffective.

 

Is India having large numbers of people with prior natural infection getting re-infected?  Can you please provide a link?  If that’s not what you are saying, then it’s not material to the point I was making. 
 

We have the same uncertainty about vaccine protection from variants. 

 

 

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7 hours ago, Psoque said:

A few relevant points from this particular observational study are the following:

 

1.  This is an observational study that comes with various limitations inherent to the study design.  For example it is hard to really know the distinguish between re-infection and persistent infection unless previously infected and certified to be virus free for sufficient time (and we don't know what that time is, by the way) is intentionally inoculated with the virus again.

2.  The immunity gained from infection lasted the average of 7 months, meaning that the duration of natural immunity was not very long (the authors describe the duration of immunity as "short to medium term") for many of those observed in this study.

 

So, my assessment of this issue (the reliability of immunity from actual infection from this coronavirus, and how long does the immunity last) from this particular study and others is that.

 

1.  Yes, many people who recover from (symptomatic) infection do gain natural immunity for some time.

2.  The duration of natural immunity from this infection is not necessarily very long, meaning that a history of symptomatic infection in any given individual does not always guarantee immunity.

 

Furthermore, I don't think this study or any other study I know of support the notion that immunization of relatively healthy and younger population is counter-productive.  I also don't think that some of the smart people who are actively studying this and other viral diseases are ignoring the fact that acquired immunity is negligible. 

 

My professional opinion is and has been that those who are vulnerable to severe illness AND those who are capable of acting as reservoirs of this virus/effective spreaders of the virus should be vaccinated.  I think the real challenge is knowing what is the best way to accomplish both goals, especially in countries with limited vaccine supply and/or delivery infrastructure.


 

The observation period of this phase of the study was seven months. It’s an ongoing study. But the data does not support your contention that duration of natural immunity “is not necessarily very long”. Immunity from infection is similarly protective to that provided by the vaccine.  Could we find out additional data in the future that changes that assessment?  Yes.  But that’s true of the vaccines as well. We don’t know how long vaccine induced immunity will last. But up until now, both natural immunity  and vaccine induced immunity are preventing all but very rare reinfection/infection. 

I am pro-vaccine, have already been vaccinated, and helped family and friends get appointments back when they were in short supply. As previously stated, the vaccines are miraculous. But there is an risk-reward matrix at the individual level, especially when we are using a new vaccine approved by a EUA rather than the more typical rigorous process. Hand waving away the scientific reality of infection-induced immunity, and treating every single person as having the exact same risk of bad outcomes from this virus is not sound science. It something else entirely. 

 

And while we now have an abundance of supply here in the US, it’s the opposite in many parts of the world. I’m reading people advocate for all sorts of coercion, including mandates, to vaccinate those in our country Who have an infinitesimal risk (for infection, for spread, and for any negative outcomes), while billions of people who are at extremely high risk of death go completely unvaccinated. Baffled. 

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I really like this new website from the USA CDC to find who provides the COVID-19 vaccines.

 

https://www.vaccines.gov

 

I applaud the strategy which has been to get the vaccine to as many local places as possible near where people live including pharmacies in grocery stores and drug stores with pharmacies.

 

President Biden mentioned with the review by the FDA and hopefully approval to vaccinate children as young as 12 the plan is to get the vaccines to pediatricians so parents can consult with their pediatrician and if they are ready to proceed to get the child vaccinated at the office.  Same goes for getting vaccinations to physicians for adults.

 

The USA will take steps as the President noted to continue to purchase more and more vaccine so it can be distributed in time to other countries so there is a recognition that it is critical to not only get those living in the USA vaccinated but to assist countries around the world.  I am happy to see this.

 

While we continue to be cautious where we live our community continues to open things up and that is good and gives me optimism.  For example, where we live most recently meeting rooms have been opened with the requirement to wear a mask and our fitness center continues to expand classes offered while also requiring masks and social distancing. This is a far cry from where we were a few months ago. 

 

And look for this summer for a lot of travel between flying, driving and cruising.  

 

We just all have to do it wisely.

 

And we do need as many people as possible to get vaccinated.  It's not just for oneself but to prevent someone from passing it on to other people.  

 

Keith

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1 hour ago, sierrafloridacruiser said:


 

The observation period of this phase of the study was seven months. It’s an ongoing study. But the data does not support your contention that duration of natural immunity “is not necessarily very long”. Immunity from infection is similarly protective to that provided by the vaccine.  Could we find out additional data in the future that changes that assessment?  Yes.  But that’s true of the vaccines as well. We don’t know how long vaccine induced immunity will last. But up until now, both natural immunity  and vaccine induced immunity are preventing all but very rare reinfection/infection. 

I am pro-vaccine, have already been vaccinated, and helped family and friends get appointments back when they were in short supply. As previously stated, the vaccines are miraculous. But there is an risk-reward matrix at the individual level, especially when we are using a new vaccine approved by a EUA rather than the more typical rigorous process. Hand waving away the scientific reality of infection-induced immunity, and treating every single person as having the exact same risk of bad outcomes from this virus is not sound science. It something else entirely. 

 

And while we now have an abundance of supply here in the US, it’s the opposite in many parts of the world. I’m reading people advocate for all sorts of coercion, including mandates, to vaccinate those in our country Who have an infinitesimal risk (for infection, for spread, and for any negative outcomes), while billions of people who are at extremely high risk of death go completely unvaccinated. Baffled. 

I cannot tell from your writings if you are someone with good scientific background, or someone who reads a lot, both, or neither, but in my opinion, the issue of whether to vaccinate those who have recovered from previous infection is a very complex and multifaceted (immunology, epidemiology, human behavior, economy, etc.) issue.  So I apologize if I am repeating something you already know.

 

We still don't know how long the naturally acquired immunity from this virus lasts, and for that matter, we don't know exact variation in the efficacy of this immunity within the population.  The same can be said for the vaccine-induced immunity, but for that, we are capable of collecting the data much easily, and this continues to be collected.  So far, it appears to be effective at least 6 months on the Pfizer vaccine.  And it is the case with the observational study we discussed, I insist that the current data does not prove that immunity from either infection or vaccines are long lasting (beyond 6-7 months).  I certainly hope they last longer, but we just don't know.

 

And for practical purposes, since the safety data from the currently available vaccines are very good, I personally don't see any reason not to vaccine those who recovered from the infection, whether they recovered from it 3 months ago or 9 months ago, as long as the supply/distribution infrastructure allows it (and it is now the case in the US).  The reason CDC initially discouraged vaccination of those who were within 3 months of recovery from the infection was that the vaccine supply and distribution infrastructure was limited.  But as we start having more available vaccines as well as we start building a population of people who has been virus-free for a longer period of time, there is a good reason for everyone to be vaccinated because the assumption, based on how immunity from infections from other viruses (including coronaviruses similar to this one) could wane over time.  This issue is even more complicated by the fact that the antigenic profile of the virus population appears to be changing.

 

Issues like what I outlined above are not widely discussed in regular news outlets, and they are not explained in papers published in professional journals either because it is assumed that those who read it know it already.

 

In regard to whether we should be vaccinating those who are at a lower risk of death/hospitalization, I insist that they should be vaccinated as long as the supply and distribution infrastructure allows it.  I don't think it is all-or-nothing issue.  In the population where the mortality/morbidity is a real problem among those with preexisting conditions, giving more of the vaccines to the elderly/co-morbid may be a good idea to help the healthcare infrastructure from becoming all bogged down.  However, to break the cycle of rapid spread of the virus, there should be some amount of targeted immunization to those seemingly healthy individuals because they are the ones who are actually doing the most of the spreading.  The public health community in the US did not think about this issue when they initially encouraged the influenza vaccines to just the elderly/co-morbid, which resulted in less than satisfactory results.  This recommendation has been scrapped a while ago for a good reason.

 

And finally, unless we have a good grasp of the data on the real incidence (number of symptomatic AND asymptomatic cases in the population), it is extremely difficult to really make any meaningful estimate of the several important numbers, including the rate of re-infection, and if that is contributing to the reservoir of the virus in the population.

 

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Posted (edited)

I thought folks on here were educated.  I keep seeing posts regarding "goals" set by the government in terms of vaccination that are less than softball; maybe whiffleball.  Let's not forget the original goal of 100,000,000 doses in first 100 days when we were already administering 1,000,000 doses per day.  Now we have goals of 70% of adults (apparently 160,000,000) vaccinated by 4 July.  There haver already been 247,000,000 doses administered and we are still administering over 2,000,000 doses per day.  At that rate that is 370,000,000 doses by 4 July.  Even if you discount J&J single dose vaccine, we will be well past 70% of adults with one dose and 160,000,000 fully vaccinated by 4 July.  And let's not forget that Pfizer will be approved for 12-15 year olds by next week that is going to start another surge in vaccination.

Edited by mrlevin
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Posted (edited)

Mrlevin, You are not as educated as you think. Biden on December 8th said when he is in office he will set a goal of vaccinating 100,000,000 in first 100 days when at that time only about 500,000 we’re vaccinated per day. Let’s not politicize what has been factually accomplished in the last 100 days.

Edited by Jimmycruiser
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Mrlevin, also the goal was 160,000,000 fully vaccinated not just one dose but two for total of 320,000,000 doses by July 4th and the goals were meant to under promise and over deliver, a refreshing change.

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The goad is 70% of the adult USA population eligible to receive the vaccinations will have at least one dosage by July 4.  Right now we are at  56.7%.  He was not speaking about children.  In fact, if you added in the children when this is approved the percentage would lower but he was speaking about Adults.

 

While we were doing very well and were above 2 Million daily vaccinations this has dropped off and we have had some days the past two weeks with daily vaccinations closer to 500,000.  This is why our President spoke the other day and continues to push. The challenge includes:  

 

-  Making vaccines available to those who can't travel long distances to get them and they are doing just that by deploying them to local groceries with pharmacies, and to local drug stores.  

 

- Making it easy for those people who have no internet access/computers or just can't deal with them so many places are now offering walk ins.  

 

- Continuing to emphasize the importance of getting vaccinated to encourage those reluctant to get the vaccine to get it.

 

- And once the vaccines are approved for the next children age group getting them vaccinated and a series of things are being done there such as planned deployment of vaccines to Pediatricians.

 

This is not a walk in the park. Wish it was so we could get this darn virus behind us.  

 

A goal should be achievable but should involve a push and that has been the case here.

 

This is an important goal.

 

CDC just put out a report that based on modeling we could be in a lot better shape by later this summer but key to this is adhering to recommended practices and people getting vaccinated.

 

For USA citizens there is something special about July 4 and it is not all about hot dogs and hamburgers.  It is when the United States won its freedom.  The July 4th goal was set for vaccinations because fo many it is a time for get togethers with others and the idea was if people are vaccinated they could get together.  I would just add my own opinion which if we hit 70% by July 4 we won't be home free but we will truly be at a time where you can see us getting our independence from COVID-19.  

 

Keith

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Fortunately cruise ships are returning to German ports. Kiel is allowed to operate and some blue cruises are planned to start this month from there.


In Germany some „Länder“ (states) are lifting restrictions due to lower COVID incidence. Kiel belongs to one of those „Länder“. Hotels and restaurants will start operating there again and this allows for cruise ships to resume sailings from this port.

Ivi

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On 5/4/2021 at 7:11 PM, sierrafloridacruiser said:

We’ve had 150 million infections worldwide over the last 16 months. If reinfection was a common occurrence, we would know it. And there have been actual studies done, and they all have the same outcome - re-infections are rare. Then they usually throw in the caveat of but it’s just too soon to tell how long natural immunity will last. Well, that’s true of the immunity from the vaccines too. 
 

 The CDC and public health officials are making a huge mistake (among many) of not addressing this head on, especially with the millions of healthy younger people who already have natural immunity from a COVID infection. Those shots would be put to far better use in the arms of older, more vulnerable people all over the globe where they don’t have enough vaccines. 

 

Gee tell that to the people in Manaus, Brazil!

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4 hours ago, AtA said:

Gee tell that to the people in Manaus, Brazil!


…or India!  Being infected with the earlier strains of COVID-19 are next-to-useless against B.1.617.  😞 
 

Vince

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On 5/9/2021 at 4:35 AM, BWIVince said:


…or India!  Being infected with the earlier strains of COVID-19 are next-to-useless against B.1.617.  😞 
 

Vince

 

India appears to be encountering a number of exceptionally worrisome Covid variants.  One example is a new N440K variant in the southern Andhra Pradesh region which has a short incubation period and rapidly progresses to a critical stage.  All age groups are prone to serious consequences.

 

South Indian N440K Covid Variant

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Further good news from here in the UK. We have now given first vaccine doses to over two thirds of our adult population and over one third are now fully vaccinated. Whilst our daily new cases appear to have currently plateaued, hospitalisations and deaths continue to consistently decline. Indeed, I today found out that our local major hospital currently has no covid patients, whereas at the peak of our second wave it had to transport patients to other hospitals, as it was so overburdened. We are also, on schedule, moving next Monday to our next stage in releasing lockdown, so, all in all, we are doing pretty well. 

My take, as supported by our scientists, is that the key has undoubtedly been the vaccination strategy, whereby those most susceptible to covid were vaccinated first with an extended gap between the two doses, coupled with very low vaccine resistance and the slow release of lockdown measures.

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1 hour ago, kool kruiser said:

My take, as supported by our scientists, is that the key has undoubtedly been the vaccination strategy, whereby those most susceptible to covid were vaccinated first with an extended gap between the two doses, coupled with very low vaccine resistance and the slow release of lockdown measures.

While this is not yet apparent in Canada as a whole, it appears British Columbia is tracking the UK with a similar approach to the vaccine. Our numbers began to improve as the vaccination activity ramped up in the past few weeks. Good news on lots of doses coming in this week too.

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On 5/11/2021 at 5:17 PM, kool kruiser said:

Further good news from here in the UK.

 

Did you see the rather uplifting documentary on Channel 4 a couple of nights ago entitled 'Jabbed'.

It follows the work of the 'UK Vaccine Taskforce' over 15 months, instigated by Sir Patrick Vallance (of No.10 briefing fame !) and led by an incredible no nonsense woman named Kate Bingham.  (I'm sure some of our US friends would enjoy watching this if available).

 

To me - a bit of an old cynic - I have to say I was really awestruck by the whole project and what they have  managed to achieve. Yes - like many countries the UK didn't get it right in the first wave of Spring 2020 - which is very sad for many - however the past few months of vaccination, coupled with a pretty effective lockdown this time, has IMHO been really quite remarkable. 

 

In the district where i live - of around 100,000 people - the rolling daily average of cases for the past few weeks has been .... ONE !  And I had my second jab today so as you can probably tell i'm feeling quite buoyant today !

 

On a very serious note - the real test of the vaccination success of first world countries will be how serious they will get in supporting less able countries out of this pandemic. As has been said we aren't safe until we are all safe ! 

 

To bring it back to cruising, I have today been looking at booking a B2B Endeavour itinerary in West Africa in March 2022. 12 countries, two of which are rated as RED by the UK FCDO, and the remainder as AMBER.  Unless things improve dramatically then forget cruising to many countries like this in 9 months time.

 

The key contributor to making these countries 'safe' is surely the vaccines, and they will not be able to deliver this without some serious help.   

   

 

   

 

   

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19 hours ago, machotspur said:

 

Did you see the rather uplifting documentary on Channel 4 a couple of nights ago entitled 'Jabbed'.

It follows the work of the 'UK Vaccine Taskforce' over 15 months, instigated by Sir Patrick Vallance (of No.10 briefing fame !) and led by an incredible no nonsense woman named Kate Bingham.  (I'm sure some of our US friends would enjoy watching this if available).

 

To me - a bit of an old cynic - I have to say I was really awestruck by the whole project and what they have  managed to achieve. Yes - like many countries the UK didn't get it right in the first wave of Spring 2020 - which is very sad for many - however the past few months of vaccination, coupled with a pretty effective lockdown this time, has IMHO been really quite remarkable. 

 

In the district where i live - of around 100,000 people - the rolling daily average of cases for the past few weeks has been .... ONE !  And I had my second jab today so as you can probably tell i'm feeling quite buoyant today !

 

On a very serious note - the real test of the vaccination success of first world countries will be how serious they will get in supporting less able countries out of this pandemic. As has been said we aren't safe until we are all safe ! 

 

To bring it back to cruising, I have today been looking at booking a B2B Endeavour itinerary in West Africa in March 2022. 12 countries, two of which are rated as RED by the UK FCDO, and the remainder as AMBER.  Unless things improve dramatically then forget cruising to many countries like this in 9 months time.

 

The key contributor to making these countries 'safe' is surely the vaccines, and they will not be able to deliver this without some serious help.   

   

 

   

 

   

Although I did not see the programme to which you refer, I can certainly relate to and definitely agree with all that you say. Yes, it was a brave and momentous decision for our PM to bring in Kate Bingham from the private sector and back her fully, ignoring any potential pushbacks from the civil service mandarins. I broadly know the beautiful area where you live. I believe that in our county of Dorset the population is approx 400K and although our cases are a tad higher, the last published statistics, a few weeks ago, showed weekly hospital admissions of 4. No recent stats, so the figure now is almost certainly even lower. Also, we have had no covid deaths at all in at least the last 9 days.

Edited by kool kruiser
typo
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  • 2 weeks later...

Having conducted a little research, my previous post substantially underestimated the Dorset county's population, which I now gather is close to 800K. Anyways, due, I am sure, to our vaccination programme, we now have zero hospitalisations due to covid and no deaths in the last three weeks or so.

Also, today saw more good news. Our scientists have stated that it appears that two doses of either the Astra Zeneca or Pfizer vaccines afford very significant protection against symptomatic illness arising from the new Indian variant. Indeed, it seems that these vaccines have proved their efficacy against all of the variant strains that have emerged.

We have now fully vaccinated over 40% of our adult population, with over 70% having received their first dose. It now seems likely that all adults will be offered their first vaccination before the targeted date of 31 July.

Spread the word, get vaccinated as soon as you are able !!

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Today the USA archived a fully vaccinated rate of 50 percent of those who can now be vaccinated. 
 

The goal is 70 percent of those eligible to get at least on dose by July 4th 

 

Let’s do it. 
 

We can. 
 

Keith. 

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