A friend texted me this week and asked, "Do you think we've reached the halfway point for US deaths?" After some thought, I responded, "No?" It's heartbreaking to think about another 350,000 people dying of Covid in the next year, but given where we are today, I can't say we won't see it.

In the coming week, 20,000+ will likely die from Covid. There is some evidence the current wave is peaking, but it's unknown how bad the New Year spike will be.

Let's talk about the new variants, the UK and the South African one. A big caveat is that all of the work around these viruses is happening in real-time, so a lot of what we know has big uncertainty bounds around it. Even trying to quantify something as basic as "how much more infectious are they?" is difficult because there are so many confounding variables.

Based on the analysis to date, it appears that this variant is significantly more contagious. It does not appear to be more deadly. What's dark is that in a vacuum, you'd rather get the one that spreads easier and doesn't kill as much, but on a society level, the higher spread one will cause more deaths. Most places barely have Covid under control, and many aren't even doing that good; a higher spread variant will spike the outbreaks everywhere, taxing an already overloaded system.

There is mixed data on how the new variants affect children. Based on what I've seen, I don't think anyone can draw any solid conclusions.

Credit goes to the UK who has done extensive genetic analysis throughout the pandemic and is the reason we know there is a new variant. While we have good overall testing in many places in the US, we don't have anywhere close on the sequencing front. As I said last week, it was likely here, and we've confirmed both variants across many states. It's here, and it's just a question of how far it's penetrated.

This week the UK approved the AstraZeneca / Oxford vaccine, and the entire process continues to be a mess. Their health agency is nowhere near as open as the FDA who conducts public meetings with data posted. As a result, there are still many unanswered questions about the vaccine's efficacy and the treatment patient pool. What's worse is the AZ CEO randomly claimed that the vaccine could be up to 95% effective WITH NO SUPPORTING EVIDENCE!

The UK said it was being approved as a 70% effective vaccine. Based on the previously released data, the error bars on that number are huge. AZ just finished fulling enrolling their trial in the US; the FDA will likely be keeping close tabs on it given the chaos of the UK approval.

I'll state it clearly if I had access to the AstraZeneca vaccine today, I would not take it; I just don't trust them. That's not to say I wouldn't in the future, but I will wait to see what the US FDA overseen trial says.

Gavin Newsom continues to disappoint. He held a big press conference this week to announce $2 billion in aid to try to get schools open in February?! Word to the wise, if you want to open schools, don't buy them plastic dividers; get the state vaccinated. If you have $2 billion, the single biggest thing you could do to help everyone is to put into vaccination efforts.

His team is worried about the growing calls for a recall, and they should be. Remember, after California's worst fires ever, the only thing Newsom did was stage a very dramatic photo op. We know how to control the fires, it's as simple as better forest management, but Newsom hasn't put forward a single rule change nor law to do that. If we recall Newsom and replace him with a sack of potatoes, at least no one will misunderstand that the governors' office might actually do something to help with Covid.

The vaccine rollout continues, and we're about where I thought we would be. Last week I said a few million more doses would go out this week, and we did at least 3 million more. Yes, we need to increase the rate of doses going out, but the data shows a healthy day by day increase in the number given. There are also reporting issues with the holidays, so it's probably even more.

This is not to give a pass to the government. Every single resource that can be used to administer more vaccines should be brought forth. This is the country's highest priority; we should have sites open 24/ 7 giving shots. The federal government has abandoned us at a critical time, but that was easy to predict; we should be more prepared than we are.

We are undoubtedly in a race to the finish. The new variant is here and spreading; every dose we get out is lives saved. I expect that next week we should see a large increase in the number of doses given daily. We need to get to ~2 million shots a day. I suspect by the end of next week we'll be at 500-750k a day.

It will be a hard week, do everything you can to avoid situations where you could contract or spread Covid. Stay safe out there.

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