Analysis – Saturday, 2 October 2021

Trend Continues
USA remaining too high, Western EU going down but how long before things go bad again?

Thirty percent of non-vaccinated adults below the age of 60 are enough to drive a winter wave. At the currently low vaccination rate, this would be Germany, Britain and France. Spain and Denmark would probably be spared.

Germany, and potentially other countries, just discovered that its hospitalisation numbers lag behind reality by several weeks as demonstrated in this graph. This was known for a long time. Unfortunately, most German states now use this number to decide about new restrictions.

Vaccination-wise, Tunisia has a real chance to catch up with the northern countries by the end of the year.

Summary

 Daily incidence, deaths and ICU occupancy are 7-day averages per 100K people based on reported numbers.
Actual number might be higher. Arrows = tendency.
Daily death projections from 29 September for the time period until the end of January 2022 assume the continuation of current measures.
See explanations on the help page.

 Daily
Incidence
Daily
ICU
Daily
Deaths
Daily
Pos. Rate
Average
Excess 
Death  
Death
Projection
USA33.3 ↘︎6.4 ↘︎0.574 →09.2 % ↓15.5 %→↗︎
WA State38.4 ↘︎3.1 ↘︎0.568 ↗︎ 09.7 %↘︎→
Britain50.8 ↗︎1.3 ↘︎0.176 ↘︎03.6 % ↗︎13.8 %↗︎
France07.6 ↓2.4 ↘︎0.083 ↘︎01.2 % ↘︎13.5 %↗︎
Germany09.7 ↘︎1.7 ↘︎0.071 ↗︎05.7 % ↓06.1 %↑→
Tunisia04.6 ↘︎2.7 ↘︎0.236 ↘︎07.7 % ↓21.6 %

Remarks On Protection By Prior Infection

A recent study coming out of Israel found that natural immunity to SARS-CoV-2 plus one dose of the BioNTech vaccine gave better protection against breakthrough infections with the Delta variant than immunity through two courses of the vaccine alone (PDF). 

This is great news but not completely unexpected. 

The study was conducted solely in silico by querying the Israeli central health database, which is very powerful and which is the reason why so many Covid-19 vaccine trials were conducted in this country.

The number of subjects in each arm of the comparison groups was therefore high. The nature of querying existing databases makes the study retrospective. This means that researchers must content themselves with factors (e.g. smoking, prior diseases, severity of the diseases) to what was already entered. In prospective studies, factors important to a study are usually covered by more questions on a health questionnaire. In the case of Covid-19, this would include symptoms specific to this disease. 

Thus, people with asymptomatic disease are underrepresented in the present study because these factors are either not found in the database or can be assessed only by proxy. This is the study's biggest flaw. A proper representation of this group could alter the results in each arm in a way that differences could become statistically irrelevant or only marginally relevant.

The take-home-message for me is on a very different level though. If prior natural infection infers great protection, especially with a "booster" vaccine jab, what happens when we turn around the events?
I talk about a non-infected person who gains immunity through double vaccination but is then infected naturally by the virus. This infection would, in most cases, not cause severe symptoms but would it also generate an even greater immunity than the vaccine alone?

If this were indeed the case, some of us, and, over time, all of us, could get infected by the virus and Covid-19 would no longer be a threat.


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