Interesting article on excess deaths. There was a May WHO report. Below article talks about some corrections made but it had some nice graphics. China's not on the graphic so if I'm reading it right, it's saying India is the big under reporter of Covid deaths.

COVID death tolls: scientists acknowledge errors in WHO estimates

Funny story. I got the latest booster a few weeks back. It was the fancy new Pfizer "updated" booster, and my first dose of anything that wasn't Moderna. Back when I got my first vaccine dose, I noted that I had chills, but oddly no fever. I repeatedly checked my temp, but for the most part I was 98ish or even 97ish. It is a simple battery operated thermometer, and the readout changes color to Green, Yellow or Red based on your temp. I'd watch it until it changed colors, and then read it.

Fast forward to this time around. I'm taking my temperature while multitasking, tying my shoes. The thermometer turns green, but I'm busy. I just leave the thermometer in place and carry on. Then it turned Yellow and then red. Finally it beeped. It beeped. In short, that was the day I most recently learned how to take my temperature.

Article talks about latest China outbreak and challenges in containment. My sense is this latest outbreak is more broad than just a big city.

https://www.cnbc.com/2022/11/23/chin...ions-soar.html
But the signs, hints of reopening is what caught my eye. Not sure what the fine-tuning measure are mentioned below. But it wouldn't surprise me if Xi continued with the zero-Covid either. Nice to be king.

Was planning to get my bivalent booster in early Dec but got it yesterday at Publix pharmacy. Like you, I've been a Moderna guy but made a conscious decision to get Pfizer just to change it up some. They gave me my "sticker" but my vaccination card only has room for 4 (front & back) so it's full. Wondering where to put it now. Should have asked for another card.

Like the prior 4 shots, no adverse side effects other than a sore shoulder this morning.

FWIW, I remember a time when you had to go to Dr to get a flu shot, not a pharmacy. This model works pretty well. Publix also gives other vaccination shots, I've been wanting some updates like for Hepatitis.

Great interview with Fauci.

https://www.cbsnews.com/news/anthony...pt-11-27-2022/
I do think there should be a truly bipartisan investigation on the whole Coronavirus ordeal (and not just Fauci, CDC). There are obviously things that could have been improved on, mistakes made etc. and people (other than Trump) to be held accountable for. Let it all come out.

If they want to form a committee to examine the pandemic response an how we could handle it differently moving forward, fine. It really isn't hard to look at the numbers and see that disinformation from the right is the leading reason why it was worse than needed to be.

The problem is there is no interest from the right to do that. all they want to do is placate their base. Throw them red meat by dragging Fauci to hearings so they can hopefully get a soundbite from him they can distort. McCarthy is spineless, but he isn't stupid, and he knows if he wants to be speaker he will have to allow this to happen despite how bad it makes the caucus look.

Fauci vs. Boebert, Gaetz, MTG, Gym, etc...will be laughable. He will eviscerate them.

In a vacuum, in a hypothetical state with a properly functioning government, this sounds like a very reasonable next step. With the asshats running our current show in our current country, it sounds like a pointless nightmare.

A root cause analysis and lessons learned so that we can develop a plan for the next pandemic would be a very beneficial thing. I mean, yes, we had a pandemic plan in the past but this would be based off of real world experience and real world conditions - the plan could be greatly improved. Of course, nope, that's not what it's going to be

SI

I didn't know that China's elderly population was so under vaccinated.

I know some countries (e.g. Indonesia I think) decided to vaccinate the younger pop before the elderly at the beginning, and when vaccines were in short supply. But I would have thought, with China's authoritarian approach, their elderly would have been largely vaccinated by now. In US, the initial 2 dose is 94% for 65+.

https://www.cnbc.com/2022/11/29/chin...two-weeks.html
Did some more googling on why. Interesting on the pre-requirements ...

Elderly Chinese Demand Money to Help Make Vaccination Quotas

an authoritarian government can more expressly engage in the "worth it" calculations that other, more accountable, governments would find repugnant

scarcity of medical treatment resources is a tough situation, both ethically and politically

I'm not sure what thread this goes into, but I am interested to see how Downtown Raleigh is coming back.

When the pandemic hit, a LOT of local lunch places shut down. And when I started back in the office, it was actually mostly boarded up storefronts. It was kind of weird when you noticed it.

And now I am seeing that every single place has construction going on in that "someone is moving in soon" way.

I guess the bean counters looked at the numbers and decided that there is now enough in person work in this mid-sized Southern city to justify building out.

I guess we are back.

Annapolis feels very much "back" but it's a poor bellwether, I reckon, as it's a destination place rather than a routine place. People just flirting with rejoining social society would go to a place like Annapolis... the nothing-special town 10 miles outside Annapolis is the real place to watch, I think. Mixed bag there, from what I can see around here at least (in a county that had government-mandated masking and the like, and just narrowly re-elected the leader who did all that stuff).

Between the tourist appeal, the state government, and the Naval Academy, I've always assumed that Annapolis generally has enough stable revenue streams to be a positive outlier from most other cities/towns (feel free to correct me if I am missing something there).

Generally true, but even that town really slowed down... once the bank branches and other local business cooled off during the pandemic, and restaurants and bars were either closed or really limited, it got awfully quiet. So it did change, but less than most places, and bounced back more rapidly overall, no surprise.

The state legislature doing a couple years' worth of mainly online meetings/hearings during the winter/springtime sessions also put a dent into the local hospitality industry as well.

Where's the "like" button so I can mash it multiple times?

Coronavirus (COVID-19) Updates - Texas Medical Center

It looks like Houston is about to climb our annual winter surge peak. We've had a nice lull over the past couple of months but that's about to end. Wastewater samples have been going up for a month now and case positivity has jumped from 2.6 to 3.2 to 5.0 over the last 3 weeks. I expect a more gradual climb with another week or two before we get into double digits like we had in 2020 rather than just going vertical like last year (2.8 -> 7.1! -> 17.3!! -> 29.2!!!).

I can't speak to the rest of the country, as the effects have a very local flavor, but here it's very cyclical. We have an acute winter peak with a pretty steady drop off and a more rounded summer peak. Sure, vaccines have introduced some noise, but the pattern is pretty obvious.

SI

One one hand, I wouldn't mind China continuing their self-inflicted economic harm and incenting global manufacturers to share the wealth elsewhere. But on the other hand, it'll be good for majority of the population (... and I can plan to visit China next year).

I read somewhere that China was reaching out to mRNA vaccine providers. I hope that happens as there will likely be an uptick in deaths because of the reopening.

https://www.cnbc.com/2022/12/01/chin...or-change.html

The hospital tracking in MD is showing the same trend... most facilities are back into their "yellow alert" zone and running short on space.

And just this morning, saw a guy getting grumpy because he was asked to put on a mask at a doctor's office. Because, you know, covid is cancelled.

I wonder if we will ever go back to no masks in hospitals or doctors offices. We would all be better off if we don't.

Sent from my SM-G996U using Tapatalk

My wife and I have talked about always wearing a mask when flying, similar to what you see in parts of Asia. Like, it just makes sense - who wants to fly to vacation just to spend the first three days sick and missing everything. That's happened way too often in my life, especially at Christmas.

SI

This got me even as a kid when I would go to the pediatrician and we had to sit in the designated SICK AREA. I mean, thanks -- you're putting all of us in one nice space to spread whatever we have with each other AND to our parents. (I mean, it makes sense for those who are well and don't have to go into that area, at least. But man, good luck to you otherwise.)

It's happening for real. I personally would have waited until after Chinese New Year because of the expected mass travel will be much greater than past 2 years (what's 2-3 more months?) -- primarily forcing more vaccinations/boosters, getting consistent SOPs in place, creating contingency plans, training more health professionals & maybe building more hospitals in 30 days for the inevitable surges, producing a change campaign (e.g. you asked for it, it's coming, ready or not and btw get vaccinated) etc.

China eases some of its Covid restrictions, in significant step toward reopening | CNN

Good luck to the Chinese people. Gonna visit sometime soon.

I can see an argument parents being very leery. But when it comes down to needing blood for an operation for your child, it's like a no brainer.

Baby whose parents refused vaccinated blood undergoes lifesaving heart surgery | CNN
This part I do wonder. If parents were able to get themselves or their donors lined up to give the right type of blood, why not? Why is it impractical to have a directed donor(s)?

"Police were called in by the hospital on Thursday after the baby’s parents prevented doctors from taking blood from him for testing, or performing a chest X-ray or an anesthetic assessment, RNZ reported."

I'm sure with the extensive research performed by these parents that they should have been able to perform the surgery themselves. Why not? How is that impractical?

The argument I'd go with is that if you start allowing a distinction between vaccinated and unvaccinated blood, you add a whole level of work and complexity to surgeries that's completely unnecessary. That's how you destroy public health systems.

100%. At least in the US directed donor blood is fine (although in my experience they only hold it for a specific recipient for a very short time and only if it’s not urgently needed elsewhere), but I’m guessing that’s not what they were really asking for until they wanted to make a point and make themselves sound more reasonable.

It’s also entirely possible there was a medical reason that blood from a family member wasn’t viable for whatever reason.

this isn't freedom it's anarchy.

It's only going to get worse with Chinese New Years coming up and the expected weeks long travel period. Other articles are saying China is not prepared for the sudden loosening of restrictions. We've been surprised before but yeah, I would have done more prep.

China's zero-Covid easing: Cases explode in Beijing leaving streets empty and daily life disrupted | CNN

FYI, every US address can get 4 more free tests.

Takes about 30 seconds to sign up:

COVID.gov/tests - Free at-home COVID-19 tests

Damnit, you beat me to it

At this point, the most reliable measures by far of caseload are by testing wastewater systems... the chronic underreporting and odd testing has broken down as reliable means of detecting spread. That's not a shock, but it's just become harder to convey to a community that they ought to be taking precautions... at one point some people started to comprehend the importance of your local positivity rate, etc - but those metrics are close to useless now, if your main question is "how risky is it to be walking around in the grocery store?" and that makes communicating the risks, when the real answer is "pretty risky, mask up at the very least."

COVID is still pretty serious, even for those without an underlying age or health condition placing them in a vulnerable category. Bringing it to your family and friends, especially those who are vulnerable is a really big deal. Anyone unvaccinated is at greater risk of very serious illness. Long COVID is a serious and sometimes deadly thing affecting a lot of our neighbors and friends and it's still not clear how much long term risk you face with each case, even "minor." The US is still watching a 9/11 worth of our countrymen die from this every week.

I can't think of anywhere to go that's worth that degree of abject misery. YMMV.

Potential New Treatment for “Brain Fog” in Long COVID Patients < Yale School of Medicine

Sounds like there is progress in addressing the brain fog issue that so many people who've had Covid experience.

If you have a large enough data set (Houston does but not many places do), then I think case positivity rate is still the best "now" indicator whereas wastewater is a bit of a leading indicator.

hxxps://yourlocalepidemiologist.substack.com/p/long-covid-an-update-and-gauging (hxxp'd because putting the http caused it to paste the whole thing, somehow)
Also, Katelyn Jetelina (Your Local Epidemiologist) did a follow up on her Long COVID series that, once again, got my wife and I into a lunchtime argument (my wife badly wants to see the positives and reads scientific papers for a living while I'm the stat person in our household who is more pessimistic about this so it leads to all sorts of fun).

Jetelina tries to take the long COVID data and tries to compare it to other risks. She leans on a meta-analysis which is coming in at like a 6% chance of long COVID. However, that 6% number has so much larger error bars than other things like, say, car accidents or dog bites, where there is more concrete data. So you're taking pretty fuzzy data and then trying to compare it to something much more precise. And this is before we get into the other studies that come in a higher 10-30% range for long COVID (Prevalence and Correlates of Long COVID Symptoms Among US Adults | Infectious Diseases | JAMA Network Open | JAMA Network 404 - The webpage you are requesting does not exist on the site - Office for National Statistics.

So I get drug into a lunchtime discussion downplaying our risks on faulty data from a spouse who should know better because it's her damn field of expertise. Good times.

Also, if anyone can figure out the dog bite data being referenced - that doesn't make any sense to me. She claims "needing reconstructive surgery after a dog bite: 1 in 400". But that second link shows 337K dog bites in a year, which swags out to a 1 in 1000 risk of getting bit by a dog, if you assume the US population of 332M. It also shows 27K reconstructive surgeries in a year, so that means 1 in 12 chance of needing surgery after getting bit. But then that balloons your odds of needing reconstructive surgery in a year out to 1 in 12K not 1 in 400.

SI

MWRA (Boston-area) wastewater SARS-CoV-2 viral levels seem to be punching through post-Omicron record highs. (through 12/12/22)https://t.co/zqaZgL4LK5 pic.twitter.com/qK4bdJAFM5

— Nicholas Bauer, PhD ��‍���� (@BioTurboNick) December 14, 2022

Wastewater Viral Load Across City of Houston - Texas Medical Center
Ours are heading that direction but not there yet. Then again, we seem to peak a little later than most places and our numbers top off in early-mid January so so we still have a long way to go.

Covid-19 Positivity Rate Across TMC Hospital Systems - Texas Medical Center
Our case positivity numbers are trending more like 2020 than 2021, but, again, it's early. The number dump next Tuesday should tell us more about which direction it's heading.

SI

Don't know why vaccination rate is so low for one of the most vulnerable groups. Probably a story here on where the breakdown was. Seems kinda late (bivalent booster came out in Sep) but better late than never.

https://www.cnbc.com/2022/12/15/covi...n-booster.html

It's likely the 2nd section you bolded, Edward.

Yes, agreed. I meant why it took so long for approval ... asked in Nov, just got approval today.

I've read similar reports but, although increased deaths is logical from the re-opening, it's still hard to understand the true impact, numbers etc. I guess time will tell (e.g. when excess deaths are calculated).

China shifts how it counts Covid deaths as crematoriums fill up | CNN
The low official death rates is because of how it's defined ...

I think I'll wait

Quote:

Gonna visit sometime soon.

I just got mine in the mail yesterday.

In MD, beds committed to acute COVID cases had hovered around 400 for months. This month it has spiked up to 600 or so. Months ahead look kinda grim, as everyone expects the bad/cold weather plus holiday meet-ups will put lots of extra people into confined spaces and that's kindling for this fire we're still feeding.

Same.

The government has been pretty efficient in sending these things out

I can believe the nos (for Dec only) but the link is short on details on how it got the "internal minutes". Hard to believe China released this information. It is Reuters, so some credibility there ...

China estimates COVID surge is infecting 37 million people a day - Bloomberg News | Reuters

I don't know if I mentioned this at the time on FOFC, but this is a fairly comprehensive analysis of the cost of remote/hybrid instruction the first two years of COVID closures on schoolkids, particularly those in high-poverty areas.

https://cepr.harvard.edu/files/cepr/...f?m=1651690491

I saw it referenced again in the Twitter Files report on censorship of discussion of COVID, which I also think is a good read.

How Twitter Rigged the Covid Debate

Spoiler Alert: it didn't necessarily start with the Biden administration.

I don't think that this is really likely going change much of anything. The local departments of health along with the pharmacies that supply nursing homes have been coming in and giving the vaccinations since they hit the market. I would say the percentage of nursing home residents that has not been offered the vaccination is extraordinarily low. I would say zero, but it seems like in my experience we are only offering the vaccinations roughly every 3 months so anyone that came in prior to the last offering would not have been offered it.

The real answer is we can't give these people a vaccination (even the ones that can't speak for themselves) without approval. I'm not going to get into politics here, but you can imagine when you are dealing with an elderly population how they tend to lean politically, and I think you can probably put two and two together. Also keep in mind that if you have to call family for approval you are likely going to be dealing with someone aged say 40-70 and again..you know politics and all. The whole virus just became way too political for the healthcare system to control at this point.

Shutting down schools in the spring of 2020 was the right move. Too many unknowns. I was critical of our schools when they reopened early in the fall, but there just weren't that many outbreaks. Kids had it, they traced it and quarantined kids around them, and there were very few shutdowns. It worked. The areas that just decided no schools could open for the entire 20-21 school year screwed up.

It's good that we offered to supply mRNA vaccines to China. Not sure what else we can do.

China sees Trojan horse in refused US vaccine offer – Asia Times
Sure we probably want to show 'em up. But I'm thinking its more for humanitarian purposes and also to reduce chance for a deadlier mutation.

This is interesting:

Suicidology update: School closures & Child suicide

These economists *really* analyse the data in technical ways to demonstrate the key point i made way back:

Child suicide dropped tremendously when "school shutdowns highest," & increased when schools opened

/1 https://t.co/FCPntLPWXK pic.twitter.com/NicpgfvNwn

— Tyler Black, MD (@tylerblack32) December 26, 2022

China is loosening restrictions for citizens to travel outside the country (in addition to foreigners coming in).

I checked the CDC travel website and the rules for inbound are:


It also shows Chinese vaccines Sinovac/Sinopharm are approved/accepted. TBH I'd feel a lot better if we required the western vaccines.