On January 23, 2020, in a Facebook thread about Covid, I said, "The likelihood of a pandemic is at an all-time low in human history….These SARS-like things will always grab headlines, but body count will continue to be tiny."
Wow, I fucked that one up.
In general, I subscribe to the notion of "Strong opinions, weakly held," and this was no different. Six weeks later, I had already started to modify my behavior and cancel events. Then lockdown came, and I started to post to Facebook with my overview of what was happening. A year later, I post every week with a website and newsletter to boot.
But what a difference a year makes. This month we will produce 132 million doses of the Covid vaccines in the United States, which's triple what we did last month. Some of this increase is just the production improvements the biotech companies have come up with. The rest of the increase is from the Biden administration utilizing the Defense Production Act to prioritize supplies for the vaccine; this should have been done last fall.
This week we continued to average 2.5 million doses a day, and we had our first 3 million-plus dose day!
The rollout in Europe continues to be a disaster, and they're heading into a new lockdown to combat the 4th wave. The cause is their utter failure to administer vaccines. They've administered 1/3 of the vaccines we have in the US, and their daily rate is falling.
A big part of this is fear-mongering and regulatory incompetence. When you inoculate millions of people, some will have heart attacks, blood clots, or get hit by lightning. This isn't because of the vaccine; it's just that in a million people in a week, these things will happen anyway; this isn't a surprise for any competent medical expert.
But not in Europe. A few people who received the AstraZeneca vaccine got blood clots at a rate lower (!) than the general population. As a result, most of Europe stopped vaccinating people, only to overturn the pause a few days later. Beyond losing critical days of doses, they've now added more hesitancy into the population. Worse still, Europe, due to other screw-ups early on, really only has access to the AstraZeneca vaccine. I fear it'll make them much, much longer to get their epidemic under control.
One term you may start to read is "breakthrough cases." A breakthrough case is when someone who has been vaccinated gets covid. This is coming up in discussions about the new variants. It's important to remember that we expect that some people who have been vaccinated will get Covid. The 95% for mRNA and 65% for J&J are how effective they are at preventing symptomatic infection.
I continue not to be worried about the variants. More work this week in the lab suggests that the Moderna vaccine is still highly effective against the ones we are most concerned with [prior work suggests the same for the Pfizer one].
Also, work this week came out on how effective prior infection is at long-term immunity. For most people, it seems to be 80% protective vs. 95% for mRNA and 65% for J&J. In the elderly prior infection is only about 50% protective.
The two strains that likely caused the surge in California in the winter [B.1.427 and B.1.429] were added to the CDC "Variants of Concern" list. The only other ones that have reached that level are 117, 351, and P.1. I suspect that the NY strain [B.1.526] all be added in the coming weeks.
So the variants aren't a concern for vaccinated, but they are extremely concerning for unvaccinated populations. They are either more infections, more deadly or both. Only about 25% of the US has had their first dose, but many places are opening up and having problems.
Michigan, New York, and Miami are all either no longer dropping in case count or increasing. They all had extremely high base rates to begin with. To put it in perspective, New York is basically fully open today with a case rate almost as high as SF ever had.
I'm lucky to live in SF. Our daily case count is the second-lowest of major metros in the nation [only Honolulu is lower]. Over 37% of SF adults have been vaccinated, and another 10-15% have had Covid. About 1% of residents are getting their first shot every day, so we're on track to be at herd immunity in six weeks. I cannot wait to get back out there; it's going to be an incredible summer.
This week we "loaned" 4 million doses of the AstraZeneca vaccine to Mexico and Canada. It's not yet approved here, but we have a factory and have been hoarding doses. This is the right call; we likely won't even need them.
Moderna has started a trial for 6-month-olds - 12 years old; it should be done by the fall.
I'm confident enough that we're near the end that I registered my company for a booth at World of Concrete. It's in Vegas in early June and will be the first major conference since lockdown started.
As we come to the end of lockdown, I know these final few weeks can feel like an eternity. It's been a long year, and opening up invites us to start to process it all, which can be painful. This week also brought horrific violence against the Asian American community. All in, it can be a lot to handle.
As always, I'm here if you want to talk. Even if we haven't spoken in years, reach out.
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