COVID vaccine works - we're saved!

I'm now in Washington DC - COVID is no more here. The only evidence of it is in the archaeology of signage - stickers reminding of distances between people that people no longer honour, elevators for four that now again have ten, mask symbols that people don't see anymore.Like New York, DC is returning to normal - the fountains around the memorials have been switched back on. The virus is still out there but the vaccines do look as though they've saved us. Either way, we're living with it now.

Except for the six million or so that are not living with it.

With covid case rates reported by states becoming an unreliable indicator of the pandemic's severity, I'm switching to hospitalizations. Here's the national map. The worst part of the country is the Northeast, with the Midwest next worse, but overall the country looks very good for hospitalizations, near the lowest levels since the pandemic began.Though we can no longer get an accurate read on case rates, they're probably pretty high, probably at least 100 cases per 100,000 per day as a 7-day moving average nationwide, about half the highest rate from last winter.There are several reasons I can think of that hospitalizations are low:

• More than half the country is vaccinated, and vaccinated people are hospitalized at about 1/10th the rate of unvaccinated people.
• We have better outpatient treatments than earlier in the pandemic, such as Paxlovid pills.
• The medical establishment has a lot more experience dealing with covid now.
• Omicron might be milder.

Here is today's map of current hospitalizations from the NYT: --Percy

… and a degree of immunity from prior infection

Yeah, that too.That reminds me, a coupled days ago a NYT article reported that it is becoming increasingly apparent that covid does not appear to be settling into a flu-like pattern as many expected. Rather than a once a year surge, it seems to be settling into a 2-3 times a year surge that doesn't align with the seasons and that can follow different patterns in different regions of the country or world.And the protection provided by infection and vaccination appears to begin waning after three months and is mostly gone after six months.--Percy

I'm sitting in that little red-orange area in northeastern Minnesota. That area is a small but most populated area of the county. The entire county population is about 11,000 (2020 census). The color shade seems to be the 50 to 60 per 100,000. Which for that area might be about 3 cases.Lake County, Minnesota Covid Case and Risk Tracker (Published 2021)

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Latest trends

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The community level of Covid-19 in Lake County is high based on cases and hospitalizations, according to the most recent update from the C.D.C. on May 19. Read more about the C.D.C.’s recommendations here.

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The number of hospitalized Covid patients has risen in the Lake County area. Deaths have remained at about the same level.

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Recent data on the test positivity rate in Lake County was not available.

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An average of 3 cases per day were reported in Lake County, a 47 percent increase from the average two weeks ago. Since the beginning of the pandemic, at least 1 in 5 residents have been infected, a total of 2,157 reported cases.

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It says 2021 in the link, but I think the data is current.Moose

In Canada now, Niagra.No masks here.

Using Moose's county as an example, 3 cases/day is undoubtedly a severe underreport because all across the country most people now take home tests and don't report positive results. Mostly the only cases coming to light are those of people whose symptoms are so serious that they go to a doctor, urgent care or emergency room. Something around 20 cases/day is more likely for Moose's county.With a population of 11,000 that puts the probability of any individual catching covid today at around .0018. That sounds like very little and nothing to worry about, but if the rate remains roughly constant, sometimes a little higher, sometimes a little lower, then tomorrow the probability is again around .0018. And the next day, too. What's the probability that an individual will catch covid once during the year if the rate remains roughly the same? That would be 1-(1-.0018)³⁶⁵, which is .482.Put in percentage terms, the probability of any given person catching covid in Moose's county over the course of the next 365 days if the rate remains roughly the same is around 50%. Around half the people in his county are going to catch covid over the next year. Naturally the brunt of infection will be felt by those who don't vaccinate or mask, and/or are older.With a mortality rate of around .1% (we still don't have an accurate measure for omicron) and a population of 11,000, that's 5 or 6 deaths. Somewhere around 20% of covid patients come down with long-covid, if not immediately afterward then within six months, so that's around 1100 people with long covid symptoms.The conclusion to take from this is that what sounds like a low case rate is actually going to have dire consequences.I don't want to seem to be singling out Moose's county, so let's go through the same exercise for my county here in New Hampshire, where there are very few masks, maybe 10% at most. We're at 40 cases per 100,000 right now, so the actual rate is probably around 300 cases per 100,000, which translates to 1242 actual cases per day or a probability of any individual catching covid at .003. What's the probability that an individual will catch covid once during the year if the rate remains roughly the same? That would be 1-(1-.003)³⁶⁵, which is .666.Put in percentage terms, the probability of any given person catching covid in my county over the course of the next 365 days if the rate remains roughly the same is around 67%%. More than half the people in my county are going to catch covid over the next year. Naturally the brunt of infection will be felt by those who don't vaccinate or mask, and/or are older.Using the same mortality rate as before, around .1%, and a population of around 400,000, that's around 270 deaths, and 53,000 people with long covid symptoms.The number of people who catch covid will be underreported because of people like my long-covid friend who three weeks ago undoubtedly came down with his second case of covid, but refused to be tested. We can't know for certain he had covid, but if he did the national statistics don't reflect it.And he's complacent about both protection and treatment. He is now weaker than ever. He still refuses to get vaccinated or wear masks. Over the course of the past two years the virus has forced him prematurely into retirement, left him with a pacemaker, rendered him unable to play the sport he loves, and has turned him into a recluse, yet he still does nothing. He's probably a bit toward the extreme end of the spectrum, but not by that much.And we now know that the protection provided by vaccines and infections begins to wear off after three months and have almost completely worn off after six months. Hence it isn't enough to catch covid once or vaccinate once like we do with the MMR shot (measles, mumps, rubella). Those who wish vaccination protection covid will have to get shots twice a year, or at least that's how it looks right now.At present California is around 70% vaccinated, one of the highest rates in the country, but unless the people of California get revaccinated about twice a year, within a year that rate will be much lower. It's probably already much lower.We can't blame the CDC for the high case rates and low vaccination rates because much of the country just won't listen, but we can blame the CDC for not sending the right message about best practices. Once they get the message right maybe they'll be able to figure out how to get people to listen.As I said, the country's covid rate is much higher than case rates indicate (waste water measures have been much more reliable here in the Northeast in places where they're available, for instance like Boston where rising case rates were indicated well before the reported numbers started rising). Everyone indoors, not at home, and not alone, should be wearing a mask. Everyone should get vaccinated twice a year, not just the "vulnerable population", because the "vulnerable population" is exposed to the "not vulnerable population." And the "not vulnerable population" label doesn't mean they're at lower risk of contracting the virus. It just means they're less likely to get very sick or die when they catch it. They'll still be a vector for the virus to people who are in the "vulnerable population." Half the country is acting like they don't care if old or vulnerable people die, especially including their own Mom and Dad and Grandpa and Grandpa and aunts and uncles and so forth. These people are a conundrum and a puzzlement. Mostly they just don't believe what they're being told about the virus. Many don't even believe it's real. We know who we have to blame for this.If our goal were to keep covid going at a much higher rate than necessary, then we're doing a great job.--Percy

Hope you're having fun. You're so close to Toronto I hope you have a chance to make it there - it's a wonderful city. Don't miss CN Tower and Casa Loma.Niagara County is in New York, but it's all I have figures for. Its case rate is 56 per 100,000, at the high end for current rates in the Northeast. Some form of overseas health plan might be a good idea. Costs seem to start around $250 and rise from there.Though I wonder how successfully American medical providers go after patients for unpaid medical expenses once they're back home.--Percy

In Saskatchewan (1679 miles or 2702 km west of you) many people who deal with the public (retail workers, etc.) are still wearing masks. Some of the public (not me) are too.No new cases (yet) today, seven-day average 101. Total cases 138K in a population of 1.174 million (2019). Total deaths 1,342. source

We're in Toronto tomorrow but sadly only to fly home :-(There's two sides to the Canadian Niagara, the beautiful Falls and the Parks behind them and the awful tourist crap in the town.Anyway, fireworks tonight, then home tomorrow. Hopefully COVID free.DC was lovely btw. Didn't make the Smithsonian so I have a reason to return. Sad to see that there's still evidence of the insurrection on the Capitol. But your institutions still stand.Your country seems to be just re-awakening, things are a bit clunky and a bit disjointed but it's spring, new buds etc.I wish y'all luck with it, you have a beautiful country.

Here's a comparison of my first case rate map from May 7 with the current one from today May 21. Comparison with the older map makes the changes stand out better. When I print maps from dates too close together the differences are too subtle: We are in a clear and obvious upsurge throughout most of the country. A large swath from the Midwest to the Northeast and extending as far down as North Carolina has gotten noticeably worse. Florida and California are both worse. Here's the nationwide case rate graph: Only two days have passed since I presented a map for the US of hospitalizations, so I won't do a side-by-side with it until a week has passed. Today's map looks pretty much like Thursday's--Percy

btw, we stopped off at Gettysburg on the way to Niagara. (No masks requirement there either.)It looked like a fairly close run battle, if Lee hadn't made a mistake, you'd still own slaves.

But did you also tour the Hersey Chocolate factory?

Niagara *and* Gettysburg? You are really getting around!Ah, Gettysburg. I'm a little bit of a Civil War buff. Did you take a tour of the battlefield? Yes, it was a close thing. If not for Picket's failed charge and some less well known small mistakes with huge impacts on the end of the lines, Gettysburg could have gone the other way.Union troops were still deploying before the battle when they lost probably their best commander in General John Reynolds, shot off his horse. Had Grant been in change of a losing Union army at Gettysburg he would have done what he always did, packed up and moved on to the next battle while interfering with Lee's supply and communication lines so far from home base, but Grant was still at Vicksburg. Meade would have equivocated and procrastinated, allowing Lee to march further into Pennsylvania wreaking mayhem.Would it have changed the war's eventual outcome? Unlikely. Grant took Vicksburg around the same time as the Battle of Gettysburg. A defeat at Gettysburg would have accelerated Grant's replacing Meade. It might even have ended the war earlier if Lee had allowed himself to become trapped in Pennsylvania.Urban centers today in Pennsylvania are definitely northern in character, but rural Pennsylvania is definitely southern. It's strongly redneck in character and derisively called Pennsyltucky.--Percy