NYMag | But
holding all else equal, if vaccines were still doing a good job
preventing severe disease but a considerably worse job preventing
spread, wouldn’t that drive the gap wider between cases and
hospitalizations, or cases and deaths?
Yeah. But —
It’s a lot to hold equal.
What
I’m hearing — and I’ve been helping with a bunch of patients — is that
people who are breaking through are getting very sick. They’re getting
Regeneron antibodies.
There may be something to this waning immunity story. It’s fuzzy, but the people who are getting hit are more apt to be people who were vaccinated very early. I had a patient in recent days, who’s in her 70s. She got vaccinated in January. And, I mean, she almost died. I mean, it’s just terrible. I think — I hope — the monoclonals are going to save her life. But she was a healthy 70-year-old lady, and just following her case was illuminating — she thought she was protected, but she also wore masks everywhere. She was on guard and still got infected and desperately ill.
Most people aren’t being that careful.
The
vaccinated — who are now a very slight majority — those people just
think the pandemic’s over. There’s still this sense that if you’re
vaccinated, you’re good to go. I mean, I’ve even seen on television, you
know, some of our leading health experts, tell people it’s perfectly
okay to have indoor gatherings among vaccinated people. Well, it’s not
true. So we’re getting bad advice.
This booster thing is yet another issue, because we don’t even know if they’re going to protect against a Delta. I mean, everybody’s assuming it, but there’s no data. You know, there’s some neutralizing antibodies from the Pfizer report in 23 people and there’s an Israeli pre-print, it says there’s waning immunity without any neutralizing antibodies. So we’ll see. But these are just classic spike-protein boosters. There’s nothing special about them to handle Delta. So I don’t know. I mean, I suspect they’re going to provide some protection, but I’m not sure I’m so confident it’s going to be great.
What
about just the basic heterogeneity of the country? We’re so big, with
so many pockets of vulnerable people, even in states that are, from a
bird’s-eye view, well-protected. Could it be that what we’re seeing now
is just the disease burning through those populations very efficiently
and producing numbers that look large even in the national context?
I
think that’s true. I think heterogeneity is definitely playing a role,
but I also think the behavior is playing a substantial role. I mean, why
did Florida succumb? As you know, it’s basically at the national
average for vaccination, one percentage point below. But it’s been a
disaster there, and they have promotion from the leadership of the state
to do everything wrong. I mean, you know, they’ve mandated no masking.
But that should provide some hope, in the sense that other states will take a different course, presumably.
I don’t know.
Personally,
I put a lot of stock into the fact that, even in states where the
vaccination levels weren’t so high overall, that seniors seemed pretty
well-vaccinated — I think when we last spoke, a couple of weeks ago, in
the worst-vaccinated state, Mississippi, 76 percent of seniors had
gotten at least one shot. That’s not 99 percent but I would’ve thought
it would’ve shielded a lot.
I think for Alpha it would have been beautiful. But for Delta it’s just not nearly enough.
I mean, one of the worst signals that I’ve seen is San Francisco. San Francisco is like Vermont, they’re even a little higher than Vermont for fully vaccinated — it’s 70 percent of the population of San Francisco county and it’s going through a very substantial hospitalization spike, unlike Vermont.
And that’s a bad sign because San Francisco has been kind of a rock throughout the whole pandemic.
They’ve been incredible. Even when the rest of California was doing poorly.
Yeah.
Exactly. So I look at San Francisco as a bad bellwether for what might
be coming. Why are they doing so poorly right now for hospitalization?
Why is it so different than Vermont? If there’s that many people getting
so sick, something’s just not right. But it’s hard to explain all these
things, right? I mean, why, why did the U.K. on Freedom Day —
0 comments:
Post a Comment