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Delta Variant

301 points| tosh | 4 years ago |unchartedterritories.tomaspueyo.com

404 comments

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[+] franciscop|4 years ago|reply
The article purposefully conflates numbers to tell a narrative. I am talking only about EU, and at that southern EU which is where I've been following the numbers closely. Delta variant has been acting for up to 1 month in some regions, and as described in the article yes cases are up very quickly. However, the article says:

> COVID deaths [...] And if you think Europe or the US will be spared

This is not reflected at all with the current numbers and the author is mixing deaths in one country with infections in another. There hasn't been even a single uptick of deaths in EU so far that I've seen, and we are past the potential 2+ week delay from cases to deaths so if it was of importance for EU, we'd see a massive climb in death graphs. That is just not happening, so regarding deaths this seems, so far, not to be a concern at all for highly vaccinated countries.

Yes there are many other concerns for which we want to avoid more infections (saturation of hospitals, potential for more mutations, etc.) which are worth discussing, but this article is instead just conflating numbers. See a comparison taken 2 days ago of "infections" vs "deaths" in Spain, which includes this delta wave:

https://imgur.com/a/A9VFS4G

[+] zpeti|4 years ago|reply
Another issue which this article ignores, and so does the fear mongering clickbait media, is how many asymptotic people we are testing now vs 6 months ago or a year ago.

It’s way more. The UK especially is testing like crazy. But that means a lot more cases appear in the statistics than before, even if the R rate is only marginally higher.

We simply don’t know what the actual r rate of all the different variants are because we had different test velocities as well. And this is crucial in whether we should be hysterical about Delta or not.

Also, wtf happened to cases in India? It’s not exactly all that catastrophic any more. In fact by the time the media had their 2 week India is dying narrative, cases declined. https://www.worldometers.info/coronavirus/country/india/

[+] vmception|4 years ago|reply
> mixing deaths in one country with infections in another

so basically like the last 15 months

there is a clear separation of critical thinkers on this planet such that we are almost two different species if it wasnt for the viable offspring

[+] sometimesokay|4 years ago|reply
I wonder if it’s also misleading to only say that young adults have a rise in cases (due to less vaccination) and be fearful of that. The overall hospitalization and death is still lower (I think I read another article that talked about either in California or NY) because they’re better at handling covid. We need to present the hospitalization / death by age range for vaccinated and unvaccinated which if anyone has any data on that I would love to see it.
[+] tremon|4 years ago|reply
and we are past the potential 2-week delay from cases to deaths

Not everywhere. See here, for example: https://www.worldometers.info/coronavirus/country/netherland...

The Netherlands went from 550 cases/day at the end of June to 10,000 cases/day now. The Delta variant took less than two weeks to spread as much as the EU variant did in two months (Sep 1st - Nov 1st). Of course, it was helped a lot by the government deciding to open up bars, dancings and nights clubs on June 26th so it's not a fair comparison :/

Point is, we'll have to wait two weeks to see what effect this will have on the death rate. I expect the death rate to be a lot lower than in November, partly because of vaccinations but also because the age group that flocked to the bars and night clubs is a lot younger than the earlier wave victims.

Still, I don't expect our death rate to remain in the single digits as it has been since the beginning of June.

[+] motohagiography|4 years ago|reply
I hate having to be skeptical of this stuff, because the consequences of skeptics being accurate are even more horrifying than the pandemic. This is so challenging because when you look at each number he uses, and then compare it to its base rate, you can see why hesitancy levels are 30-50% in regions of developed countries. If you are among that cohort of people in your region who are not vaccinated, should you get it? Yes, and especially if you have co-morbidities or work with people who do. We need to seriously consider what the consequences of a controversial vaccination plan that requires 90% compliance for it to succeed are going to be if/when it fails. (I would even posit that number is closer to 70%)

If you talk to hesitant people, and there are a lot of them, the reason is a mistrust of the people leading the effort and managing the pandemic. Why mistrust? Many reasons, but the most challenging one is because of numbers that don't pass a smell test coupled with apopleptic ad-hominim aggression directed against anyone who questions them. This all but guarantees a 20%+ rejection rate from people who just dig in because they do not make health or other decisions based on fear and shame. There will be a defiant group of about 5-10% who you just can't reach at all, so if your plan needs them, you will need a new plan.

Calling people hesitant is patronizing and was probably the stupidest PR move of all time and the committee responsible for it will have to live with those consequences.

But instead of arming people with a litany of whataboutisms, I would say this to an unvaxed person: given your objections, how does getting the shot prevent you from resisting or even fighting a battle you percieve you need to fight against these authorities you do not trust? Polite euphemisms aside, let's call it what it is, because that's the crux of it.

If it does, you need to just act now and literally overthrow your governments in the next few weeks, but if you aren't going to act today and do that, then get a shot, and use the time to figure out how to depose these people that you do not trust in good time. If, as many hesitant people believe, there might be long term harm to them, your long term still involves a conflict to replace these people, but risk from hypothetical side effects still nets out of that equation.

My rationale to the so-called hesitant would be this: get the shot, and then use the time to organize and support your revolts against untrustworthy leaders and institutions, because once you are vaccinated, you can draw from the ranks of others who were also forced into it. Use this to unite people to your causes against untrustworthy authorities, because your skepticism comes directly from people using this to divide you. Take that from them, and then commit to organizing and scaling the change that has to come. Having the shot gives you skin in the game with the people you are going to need on your side.

This issue isn't the main battle, but I will absolutely support efforts to ensure trustworthy people get into positions of authority after this.

[+] phkahler|4 years ago|reply
Also in the beginning "Depending on which figureyou use, it would put Delta’s R0 between 4 and 9" and toward the end he assume R0 of 8 when talking about herd immunity.

In the What About You section he doesnt even mention those that have had covid, only vaccinated and unvaccinated.

[+] mediaman|4 years ago|reply
I'm not sure how you assess that he is conflating numbers to tell a narrative. Pueyo discusses fatality rates in the article, specifically that the vaccines appear to still be highly effective at preventing deaths (though much less so for infections) and that countries with high vaccination rates are not seeing high death rates even when infections are growing.

The only area where he says deaths are getting worse are for the unvaccinated: that fatality rates may be significantly higher for unvaccinated individuals due to a faster replication rate of the virus and therefore a much higher viral load.

[+] RickJWagner|4 years ago|reply
I thought it was odd, to see a chart like 'New Cases / 1000 people', instead of simply gross numbers. Gross numbers would have highlighted different states, placing 'blame' in a different way.

It does seem a narrative is being spun.

[+] specialist|4 years ago|reply
You still don't explain why: Conflating infections with deaths is meaningless where the mortality rate has gone down.

Please forward the discussion by showing how you would present the data.

[+] tpoacher|4 years ago|reply
I honestly don't know how to feel about Tomas Pueyo.

He's very opinionated about what he writes, and has gained good readership and influencer status on this topic. It's clear in his writings that he fancies himself as an "amateur of expert insight". He may be 100% correct. He may also be 100% wrong. It's hard to tell (let alone without invoking the conditional fallacy).

However, the most lasting impression I have of him is when he was invited in one of those "both sides" TV programmes in the UK on the basis that his "Hammer and the Dance" blogpost at the time became very popular. He was invited to debate with a renowned epidemiologist, who was part of the COVID-19 team advising the UK government at the time, and who was there to discuss the rationale for the policy after copious simulations by his research team. The epidemiologist was considered an expert and leading figure in his field. Meanwhile, Pueyo's self-described title on his blogpage at the time was "data visualisation expert" or something along those lines.

Now, like I said, he may be 100% correct (or not). This is not about making an "ad verecundium/hominem" argument. But all I remember from that TV debate is that his main argument tactic on TV was effectively interrupting all the time by saying "wtf", "people will die because of you" and visibly eyerolling and audibly sighing an awful lot, without offering much counterargument except by referring to his blogpost and the "obviousness of his claims". All this to the dismay and visible frustration of the epidemiologist who was trying to remain civil, objective, and doing his best to remain calm, relay the science as clearly as he could, while trying to avoid unnecessary panic and drama. Honestly watching it made me feel like you had just pitched the dalai lama in a debate against trump.

Pueyo has now changed his blogpage's tagline from "data visulisation expert" (or whatever it used to be) to "Understand the biggest problems and how to solve them". Forgive me if that doesn't sound as vague and grandiose to you as it does to me, but at best it doesn't come across to me as very humble from someone who, at the very least, is not particularly qualified for that description (then again, who is).

So, good on him for writing these blogposts and taking a stand, but while he may (or may not) be 100% correct (if there is such a thing), after that TV performance I witnessed, I'm taking his (otherwise professionally edited) blogposts with a large pinch of salt.

[+] trts|4 years ago|reply
This is a lesson I don't see the general population learning very well over the past 5-7 years. Just because somebody throws a tantrum over their stance about a moral quandary does not make them better informed about its resolutions. And often there are no resolutions proposed anyway, which can be hard to notice beneath the sound and fury.

It also seems to be often the most natural approach taken by people who make a living from gaming the attention economy. It isn't about the merits of one idea or another but the engagement it generates from outrage, self-righteousness or other reactionary emotions.

[+] Barrin92|4 years ago|reply
>But all I remember from that TV debate is that his main argument tactic on TV was effectively interrupting all the time by saying "wtf", "people will die because of you"

Which was an apporpriate tactic given that the United Kingdom was one of the hardest hit countries in Europe and the entire world. Visible anger in the face of complete and abject failure of an expert class and in the face of a rapidly worsening pandemic was an entirely reasonable reaction and the situation was indeed obvious to anyone who didn't have his head up his own ass. You might remember all of this happened against the backdrop of a government that was willing to 'let the bodies pile up' to 'keep the economy going'.

The absolute veneration of "civility" as if being civil actually is worth anything in the face of tens of thousands dying as a result of hesistancy is mad. Any sane person should have been ragiung.

[+] effie|4 years ago|reply
I got the same opinion just from the article. So sure of himself, giving advice to everybody and blasting alarming attitude, while real epidemiologists and doctors that I know are much less sure about predictions and almost never beat the drum of alarm. He's probably a case of Dunning-Kruger effect.
[+] Leary|4 years ago|reply
This was the epidemiologist who suggested Herd Immunity as a strategy for the UK?

Then regardless of how weakly he presented himself on TV, Pueyo was more right than that epidemiologist who civilly advocated for a policy that would've killed hundreds of thousands.

[+] zzzeek|4 years ago|reply
ive never heard of this author and i thought it was a good blog post. your post is for better or worse the definition of ad-hominem and also black-and-white thinking (100% right or 100% wrong). In the US, we are in a dangerous place where social distancing and masking have basically stopped, and with a much more contagious variant like Delta we're defintiely going to have a much bigger problem again in the coming months. I didn't see anything in this article that struck me as counterproductive towards preparing for the continuation of the virus.
[+] usrusr|4 years ago|reply
Is seems kind of logical in hindsight: the first mutation of the predecessor bat/pangolin/whatever virus genome to cross over to humans is an MVP full of "compatibility bugs" that barely achieves R0>1. A few billion dicerolls later many of those "compatibility bugs" have found fixes.

Remember the hand washing phase of the pandemic? Aerosol transmission was basically ruled out because it was assumed that spread would have been much faster if it happened by aerosol. Turns out like it was aerosol all the time, just slowed down massively by all those "compatibility bugs" that are now slowly ironed out. Fortunately, our immune systems adapt as well (both individually and industrially, by ramping up mRNA capabilities and production)

[+] specialist|4 years ago|reply
> Remember the hand washing phase of the pandemic?

Guidelines need to be enumerated, like product releases.

So much angst would be avoided. When there's a disagreement, the parties (operating in good faith) could go meta and compare guideline versions. Which would help resolve differences.

"Oh, you're following guidelines USA-1.4. I see. FYI, last week our governor issued USA-NY-1.5, clarifying protocols for open air retail. All these revisions! Such a bother, I know. I'm so glad you and me are back on the same page. Be safe! We'll get thru this."

[+] davnn|4 years ago|reply
> full of "compatibility bugs" that barely achieves R0>1

Did I miss something? COVID-19 was highly contagious from the beginning, thus the drastic measures, or not?

[+] api|4 years ago|reply
This is also why vaccination is so critical and why "young healthy people" should not opt out: when you get the virus, even if it's a mild case, you are in effect donating processing power to what amounts to a global supercomputing project to evolve more virulent strains of COVID. That's how evolution works. The more chances the virus has to replicate, the more likely it is to become more virulent or even worse learn to evade the vaccine.

If the delta variant jumps the vaccine hurdle we are back to early 2020 but with something 2-4X as contagious.

Scientific literacy matters and know-nothing populist bullshit (regardless of whether it is "left" or "right" in flavor) is dangerous. There is no such thing as a "post-truth era." Being wrong carries the death penalty, eventually. Civilization insulates us quite a bit allowing a lot of people to go nuts with little consequence, but if enough people are wrong enough for long enough the wall collapses and the consequences arrive.

If you think this is fun, your kids and grandkids are gonna have a blast with 800ppm CO2 levels.

[+] bamboozled|4 years ago|reply
As a reader of HN for several years now, it blows my mind how polarized we all are on this issue. Something smells here, you're not allowed to question anything without being down voted to oblivion, one way or another.

Why?

[+] timr|4 years ago|reply
Covid discussion has become equivalent to politics. Most people have strong opinions on the matter, these opinions usually correlate strongly to their favorite political party's stance, and few people have the experience or knowledge to evaluate scientific information rationally. It's a recipe for uninformed debate.

On top of that, in the US, the previous president was so politically polarizing that literally any statement he made was aggressively opposed by many people. A lot of SARS-CoV2 response got caught up in this dynamic.

Wide segments of the population are simply misinformed of basic scientific facts, and slick charlatans (like the author of this article) twist information in subtle ways to scare people. Terrified people are naturally going to be more volatile, and this has been exploited throughout the last year and half.

[+] specialp|4 years ago|reply
It is tribalism at work. Like if one takes a nuanced opinion and says "Maybe if loads of people are not dying and there's going to be no end to COVID, we should not lockdown again and again forever" You are then "them". The irrational COVID is a hoax, anti-vaxers, and get downvoted.

Unfortunately well educated knowledgeable people are falling prey to this tribalism as well. I don't view a pandemic as at all political. There's a balance as to what amount of financial, social, and loss of liberty pain we should take versus the harm COVID 19 causes. And there should be a healthy debate about that, and opinions should change with statistics coming out and changing conditions. Meaning hardline anti-vaxers should probably soften up a bit as the vaccines have been shown to be extremely effective and safe and hardline lock down the world adherents should look at the dramatic drop in deaths and hospitalizations, and compare the risk of COVID with other risks we take in our life like driving.

[+] effie|4 years ago|reply
I've noticed this is not U.S. specific, so it is not a political polarization in the traditional sense.

The broader world-wide phenomenon, visible also here, is that most people got divided into two camps:

1) "COVID-19 is so dangerous that we must restrict freedoms", "the other camp is a harm to society's health"

2) "COVID-19 is not that dangerous, mortality below 2% (or even lower depending on how it is calculated) and young and healthy people are safe from it, so we must preserve the freedoms", "the other camp is destroying democracy and freedoms".

You can see this in U.S. and in Europe too.

Camp 1) was right at the start of the pandemic when we had little knowledge and people were dying in large numbers. But as time advances, treatments and vaccines are developed, the narrative naturally shifts. Eventually Camp 2) will be seen as the correct one.

Now we're somewhere in the middle it seems.

[+] skadamou|4 years ago|reply
Without debating the whole article, I found this one excerpt to be somewhat indicative of his writing more broadly:

"Unfortunately, I turned out to be right. The short explanation is that the viruses that tend to win do so because they reproduce faster. Such a virus will grow faster inside a person, and will make that person more infectious, faster. It will also kill that person faster."

This is a fairly vague statement with broad implications (and a pinch of hubris) supported with insufficient evidence. I appreciate that he is trying to simplify a complex issue into lay-mens terms but I worry that writing like this only adds fodder to the anti-science movement because it is full of quasi-truths.

[+] CPLX|4 years ago|reply
I have to admit, I'm a little perplexed about all the discussion around the Delta variant. It almost feels like people are discussing this like it's a plot point in a novel, a new looming threat that comes after Act II, rather than a cold scientific fact.

As someone who lives in New York and has been vaccinated for months, should I worry about this? It seems like the answer to that question is no, I shouldn't.

Also notable is that walk-in instant and free vaccinations are available everywhere in the city, I see signs all the time when walking around, so anyone (who's older than 12) who isn't vaccinated is making a clear choice.

I really do get that other parts of the world don't fit this description, and that there's subtlety to this and it's complicated. Like I really get that.

But what are articles like this trying to convey? They seem to be telling me that I should feel differently than I do now, and that I should take different actions than I am taking.

But what are those arguments? What's the intent of writing an article like this?

I see the takeaways section at the end but it doesn't feel like it matches the tone of the rest of the article, which seems to clearly imply that letting your guard down on COVID is a mistake. The first sentence sends that message clearly, saying "I don’t think people are paying enough attention to Delta".

I disagree with that thesis statement, I think vaccinated people with no policy authority who are overwhelmed and often in mental crisis after a year of this shouldn't pay attention to Delta at all.

[+] gfodor|4 years ago|reply
Content like this that fails to incorporate demographics as natural immunity goes in the “alarmist” bucket for me at this stage. We know the vaccines work against delta. If you are in a developed country and wanted a vaccine you have gotten one. The delta so far does not harm the young in any meaningful enough way to change our calculus around children.

The thing we ought to be worried about is what happens if a new variant pops up that hurts kids. I’d like to see analysis from a virologist on the odds of this happening given selective pressures.

[+] gentleman11|4 years ago|reply
The article ststes that there were 2M Covid deaths in India. Stats I saw yesterday said 400k. By comparison, the USA had 600k
[+] shireboy|4 years ago|reply
One question I hope some HNer can help me with, that I'm not seeing answered: How is _testing_ affected by these variants? This is relevant to me as I've had symptoms but tested negative with BinaxNow, and now have to decide on some activities.
[+] fitzie|4 years ago|reply
the one thing I wanted to know "is aquired immunity from other strains effective against delta" isn't mentioned or discussed. perhaps the door knockers will have the answers I need.
[+] specialp|4 years ago|reply
I'm not sure what the end game is here. The original plan was "flatten the curve", which meant keep hospitals from getting inundated. Then it became wait for the vaccine. COVID is not going to go away. The vaccine has dramatically decreased the amount of people dying from it.

Cases going up without dramatic increases in death or hospitalization might not be a bad thing. The alternative is lockdowns that will never completely end the virus, and have a significant impact on our lives. It will just slow the spread over a very long time. There are ever present dangers that we just live with like the chances of getting in a car accident and dying, but we decide that these risks are low enough that we carry on normal life.

[+] hattmall|4 years ago|reply
My question is why don't we have treatment? Yes we know vaccines are good as preventative but we also know that vaccines are vulnerable to mutations and waning efficacy over time. It's also somewhat burdensome to need to vaccinate all people all the time. Where is the research into effective treatments and why do we seem to prefer mass vaccination over acute treatments for the sick. Is it just much more difficult to formulate effective treatments or is the influence of capitalism pushing toward the solution that has the most customers and is the most profitable?
[+] colincooke|4 years ago|reply
I will say that on the vaccine front the data provided by Israel seems to be the worst results of the bunch, and while we can't completely rule out their results there is a good chance it's an underestimate of efficacy. Here are some efficacy estimates against Delta from other sources:

https://twitter.com/EricTopol/status/1414254993536786433

Highlights are (symtoms/hospitilization):

- Phizer: 79-88%/96%

- Moderna (one dose, not much data): 72%/96%

- Astra: 60-67%/92%

[+] littlestymaar|4 years ago|reply
> I don’t think people are paying enough attention to Delta

In the US probably. In Europe Delta has been followed closely even in mainstream media for at least a month.

[+] adventured|4 years ago|reply
In the US the Delta variant has been in the news non-stop for months.

Once the vaccines began bringing the pandemic under control here, the Delta variant as the new big risk is what the news media began focusing on heavily. That began shortly after case counts exploded dramatically higher in India and gained coverage the further it spread around the globe.

[+] jsbdk|4 years ago|reply
Can't everybody get vaccinated in the US unlike the EU where you have to wait for your turn and can't buy vaccines? That would explain the difference
[+] pattrn|4 years ago|reply
The author links the following paper as a source for his comments: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3868853. Unless I'm reading it incorrectly, the mortality rate of the infected, unvaccinated population is 0.5% (131 / 26,632), and the mortality rate in the infected, vaccinated population is 2.5% (33 / 1,410). Does this mean that the vaccine decreases your chance of contracting the virus, but increases your chance of dying if you do contract it?

(Note: I understand that the overall death rate from the paper is 0.002% for vaccinated population and 0.012% for unvaccinated population.)

[+] mrmanner|4 years ago|reply
I read an explanation in another context, that sounded plausible: Mostly people with symptoms get tested, and the vaccines are quite good at preventing symptomatic illness. Thus the share of infected individuals not caught by tests is larger in the vaccinated population, which makes mortality among the vaccinated look worse than it is.

source https://www.ijpr.org/health-and-medicine/2021-05-13/no-the-d...

[+] 35fbe7d3d5b9|4 years ago|reply
> Does this mean that the vaccine decreases your chance of contracting the virus

Yes.

> but increases your chance of dying if you do contract it?

No, I think not. Scroll down to table 3, page 14.

No one under 60 who was vaccinated and fell ill died. No one under 60 who was vaccinated was even hospitalized.

But even in the most at risk group, age 75+, vaccinations reduced mortality by a factor of 10.

I think it's safe to claim that "breakthrough infections are rare, the vaccine still provides a level of protection if one occurs, but when breakthroughs occur the elderly are at the most risk of death"

[+] programmarchy|4 years ago|reply
I think you’d need to separate out the populations by age demographics to make that hypothesis because the vaccinated population could be skewed towards older people.
[+] sauwan|4 years ago|reply
I'm guessing that vaccinated people get tested at a much lower rate when they're feeling cold like symptoms, so the denominator there is probably significantly reduced.
[+] havkom|4 years ago|reply
”Now, with Delta, it looks like the figures are 64%, 93% and 93% according to Israel, and 79% for symptomatic infection and 96% hospitalization according to the UK.”

I doubt these will turn out to be correct numbers. Looking at recent week’s data in Israel possibly paints another picture (keep in mind while parsing the numbers that there are plentiful many more vaccinated in the population than not in the age groups that gets hospitalized): https://docs.google.com/spreadsheets/u/0/d/1kiOrQxOtBg0__IoL...

Nevertheless, it is clear that vaccination helps and is important, but I have doubts about 90+% protection from hospitalization.

[+] haunter|4 years ago|reply
Isn't there a Delta Plus variant now?
[+] neogodless|4 years ago|reply
Hmm @dang this doesn't seem controversial, or shouldn't be. We should be curious about the details of a dangerous strain of a virus, and learn more about it. I'm not sure if this deserves to be "[flagged]" but perhaps I'm missing the bigger picture.
[+] throwitaway1235|4 years ago|reply
Can we provide the data necessary for young men to take one of the mRNA vaccines for Covid-19?

The question. What percentage of men under 40 have had a cardiovascular event, specifically myocarditis, after taking the Phizer or Moderns shot?

Primary reason I haven't been vaccinated yet.