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Jason last won the day on January 26

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About Jason

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  • Birthday November 22

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  1. This is a bit tricky. It is indeed very probably the case that if the AZ vaccine raises the risk of the rare type blood clot, the other adenoviral vector vaccines will as well, at least those using the Ad5 vector. Much less clear that it has anything to do with the reaction to COVID itself - while that's possible, if true then it should also affect the Pfizer and Moderna vaccines, which we haven't seen yet.
  2. Not quite. The number of excess deaths in Belgium is actually similar to the total number of COVID deaths. What is actually happening is that Belgium is counting COVID deaths more accurately than most other countries, which are missing some portion of their COVID deaths (in the case of many Latin American countries, a very large portion).
  3. Real short version is yes, it's bonkers. Longer explanation below. He constructs a plausible scenario where vaccination could result in more intense selection for "escape variants" than natural infection but the problem is that it depends on assumptions that aren't actually happening in practice. One of them is that the vaccines result in weaker immunity than natural infection, and the available evidence very strongly suggests this isn't the case - both from the high effectiveness of the vaccines in preventing infection and also from the levels of neutralizing antibodies being induced by vaccination being similar to that from infection. The other assumption builds from the first - that if the vaccines give weaker immunity then they will merely shift symptomatic infection to asymptomatic infection. This was a plausible (although not very likely) possibility a few months ago when we only had the data from the trials, which measured the reduction in symptomatic infections. However, since then the data shows that the vaccines achieve a similarly large reduction in asymptomatic infection (and therefore transmission) as they do for symptomatic infection. Since we know that the strength of vaccine-induced immunity is at least comparable to natural infection, and that the vaccines result in a very large reduction in COVID transmission, vaccination is actually going to reduce the risk of escape variants arising and being selected for, compared to allowing natural infection to occur. (He raises the example of the 1918 flu to suggest that natural infection doesn't result in escape variants, but it's a complete non-sequitur because that's a different virus, and we know that for COVID, escape variants were already becoming prevalent in some countries prior to their vaccination campaigns being underway. He's also cherry-picking the data even when considering only the flu, because many "escape variants" of the flu had in fact evolved prior to the advent of mass vaccination campaigns.)
  4. This has nothing to do with it - please don't speculate. The adenovirus vector used in the AstraZeneca had several years of previous safety testing that allowed for the expedited Phase III trials. The (possible) side effect in question is so rare that it almost certainly wouldn't have been detected in Phase III trials on a regular timeline. The overall rate of the rare blood clot has been 1 in 1 million, and while a few European countries have had a rate above that, many other countries have vaccinated several hundred thousand people without even a single event. You are conflating "rare" with "serious". The report is question is examining serious blood clots of any kind, not just the specific rare type believed to be potentially of elevated risk. To be clear, thromobotic events of all types happen somewhat less commonly than would otherwise be expected among people who have been vaccinated with the AZ vaccine.
  5. Yes, that sounds about right. We don't know for sure just how effective or ineffective the Pfizer and Moderna vaccines are against B.1.351 since the cited studies are in vitro measures of binding, but 30+ fold decrease in binding is...not a good sign. So the J&J vaccine at ~80% and Novavax at ~55% from real world tests, with both ~95%+ against severe disease is probably better protection. Also, he's definitely legit (for future reference).
  6. That is correct, age and mask acceptance don't come close to fully explaining it. There are indeed lots of components in play but I feel very confident that genetics is not one of them to any significant extent. Aside from mask-wearing, I've mentioned early travel restrictions/screening, thorough and rapid PCR testing made available before widespread community infection, and strictly enforced quarantines. The only two Western countries that have actually employed the above measures (Australia and New Zealand) have had a similar result. I've mentioned this before but apparently it merits repeating. If genetics was a significant factor the initial outbreak in Wuhan should have spread much slower than it did. Instead, all the indicators were that early spread was at a comparable rate as the initial spread after Western introductions. China only got it under control after they stopped trying to cover it up, and responded with a very complete and aggressive lockdown of the region. People weren't even allowed to leave their homes, except with special permission, and the military was deployed to deliver groceries so that people wouldn't have to leave except for medical emergencies etc. Similarly, if genetics was a significant factor we would have expected the strict measures in Australia and New Zealand to fail or at least be less effective, since they are majority-Caucasian like North American and Europe.
  7. I specified "East and Southeast Asia" above, which does not include India. India has in fact had infection rates many orders of magnitude larger than East/Southeast Asia, and their fatality rates are low because the population is very young. Age-adjusted IFR is about what you would expect. The average age of Indians is only 26.8.
  8. This can easily be explained by a mix of socioeconomic and cultural factors. Asian-Americans are much more likely to work in white collar jobs than other minorities. It's hard to gather statistics on this, but I feel very sure that on average Asian-Americans have been more mask-compliant and social-distancing compliant than other North Americans. While I know there are exceptions, my Asian family and friends have all behaved very differently than the norms for North America. Many of them already wore masks when sick prior to this pandemic, and when we first started hearing about it they ordered masks in bulk from overseas, while our governments here were still advising us not to wear masks, and the general thrust of conversation in North America was questioning whether masks even worked or expressing that they were too uncomfortable etc. (The general conversation on BOT was much more open to masks fairly early on, to the great credit of the BOT community.) We all know a great many Canadians and Americans still had dinners with extended family at Thanksgiving and Christmas, my Asian family and friends either didn't see extended family at all or if they did, they did it outside, wearing masks, for a brief period of time. (This was despite sub-freezing temperatures.) Similarly, none of us have seen any of our friends or done any risky activities such as indoor dining since the pandemic started. Again, this isn't typical North American behaviour. I know my family and friends is an inherently biased sample, but it's not a small one and I feel confident it's not completely unrepresentative. (Edit: another excellent point by @Taruseth above that could also explain a mortality rate gap, namely the age gap of white Americans vs Asian-Americans)
  9. The age profile of India is much younger than Western countries and when you look at age-adjusted IFR it's about what you would expect. Also, people in India are much genetically closer to Europeans than they are to East and Southeast Asians. Himalayas were a very strong barrier to migration prior to the modern era. Not "perfection" but easily all vastly better than Western countries aside from Australia and New Zealand, especially when you consider both goverment and societal responses. For example, mask compliance in Japan was observed to be around 99% with the exception invariably being "Americans or Europeans". This was back while our governments here in North America and Europe were still telling us not to wear masks. Japanese businesses were also very near-universally compliant with strict distancing and ventilation regulations, and a major reason for this is that unlike in the West it's normal for small businesses to keep several months or even years of cash on hand for operating expenses. Also, remember that if you're in a country surrounded by other countries that are using widespread community testing and enforced quarantine to crush COVID into oblivion, it becomes a lot easier to control COVID because there's no continual source of new introductions.
  10. South Korea really isn't a very unique case, our media just makes it seem that way by covering other countries in the region much less thoroughly. Every country in the region was vastly more prepared than the West, often in numerous different ways. Taiwan is a particularly notable example, which started screening all travellers at the end of December, before the sequence of the virus was even known. Basically anyone entering the country who either a) had travelled to China or b) had influenza-like illness regardless of travel history was required to enter a strictly enforced quarantine. When China released the sequence of the virus around January 7, Taiwan had PCR tests rolling out the next day. Vietnam is another notable example, (which despite having a GDP per capita of only about $2,700 USD) was introducing widespread community screening for COVID-19 (with same day results) by early February. Compared this to the US, where well into March the official CDC advice was to test for COVID only for patients with a travel history to China, and even then test results often took days. Other Western countries weren't much better. Most East and Southeast Asian countries prepared heavily for a pandemic like this after the prior outbreaks of SARS/MERS, not just South Korea. Taiwan's Vice-President was actually previously an epidemiologist (PhD from John Hopkins) who entered politics in the aftermath of SARS and was responsible for the extensive preparations made in Taiwan. A biological explanation just doesn't hold up to scrutiny when the initial outbreak in Wuhan spread so explosively and with a similar transmissibility as the initial outbreaks in the West, combined with the fact that majority-Caucasian countries that also responded quickly and aggressively did similarly well as East Asian countries.
  11. It's because the AZ and J&J vaccines use a viral vector that must actually be grown inside cell culture before being harvested, while the mRNA vaccines can be manufactured like any other chemical. This isn't persuasive at all. Genetics could be a minor contributing factor, but it's not going to be a significant cause of the massive disparities between the East and West (which is acknowledged by one of the researchers quoted in the article). It's also worth noting that the estimates of the transmissibility and severity of the illness from the initial explosive outbreak in Wuhan were consistent with the estimates of early spread in Europe and North America (before any mutations occured that increased transmissibility). The fact that the initial outbreak in Wuhan spread so quickly and only stopped when the Chinese government responded very aggressively to the virus is also very inconsistent with any significant genetic immunity, even without a comparison of that spread in Caucasian-majority regions. This is a probable factor for the fatality rate but shouldn't affect transmissibility. Some countries were affected dramatically more than others even within the region, consistent with how quickly and aggressively their governments/populations responded. But even the laggards in the region would benefit from the very aggressive responses of their neighbours, with whom the vast majority of their cross-border travel occurs. When you consider the global picture, the vastly more consistent factor has been how quickly and aggresively respective national governments responded. The two Caucasian-majority countries (Australia and New Zealand) that responded most quickly (with the earliest decisions to screen all travel, not just travel from China), and made it their goal to seek elimination (rather than "flattening the curve") have infection rates that are lower than most of East and Southeast Asia. The countries with the very lowest rates (Taiwan, Vietnam), were the very first countries in the world to heavily restrict travellers and introduce mandatory (and strictly enforced) quarantines, as well as widespread PCR testing for all arrivals and potential community exposures, several weeks ahead of the PCR tests being readily available in the West.
  12. I was aware of this, yes. The provincial government prefers to show its "support" by encouraging us all to go get COVID. I just remembered today that "red" now means up to 50 indoors instead of the old 10. Absolutely ludicrous. I'm sorry to hear you're personally affected by this bullshit, it's infuriating for me even in the abstract. Can't believe these morons are probably going to be re-elected. With it being 13 C today I'm going to be getting takeout to eat outdoors at a picnic table with my parents. (Really adds another level of insanity to be re-opening indoor dining right now.)
  13. It is deeply, deeply flawed to draw statistical conclusions for a very rare event from an arbitrarily small sample, unless there is some reason to believe there is something different about the samples that should cause a different result. Almost certainly no such reason exists, especially with the much larger and more genetically distanced populations of Britain and India having the same rate of 1 in 1 million. A rare event happening twice in the (arbitrarily) smaller sample is just something that happens from random chance ("bad luck"). There just haven't been enough vaccinations done in Norway and Denmark to draw conclusions, and it's almost certainly the case that if several million vaccinations were performed you would find a similar rarity as elsewhere. There are a great many places with that have administed only a small number of the AZ vaccines thus far that have reported none of these rare blood clots. If you decided to split the British or Indian vaccinations into arbitrarily small enough subsamples (remember that country boundaries mean absolutely nothing in the context of biology), you would find a similar result - some small samples with a higher rate and the rest with a zero rate. This may be true but has absolutely no grounding in reality. It's largely the result of the political interference happening in various European countries such as Denmark. The "precautionary principle" actually indicates that vaccines should proceed because even if the real risk of a blood clot were in fact 1 in 20,000 (which it almost certainly is not, even for Scandinavians-only) that would still be far less than the risk of dying from COVID. (and even smaller compared to risk of COVID illness) Recall that the additional risk of getting a blood clot from taking the birth control pill for a year is equal to 6 to 18 per 20,000. Regulatory authorities have (correctly) concluded that's a tolerable level of risk for a birth control pill. And somehow, 1 in 20,000 (and much more probably 1 in 1 million) is not acceptable for a vaccine against COVID? This is beyond absurd. Idiot politicians at work again. It's especially frustrating because if we wait just a little bit longer we'll be able to eat outdoors again anyway. And just a little bit longer and we'll start to have a lot of people being vaccinated. Makes no sense to do this right now when we're still mostly unvaccinated and the case counts are already starting to go up with the more contagious variants. I get that restaurants are hurting - government should give funds (even interest-deferred loans if need be) to tie them over rather than prematurely re-opening indoor dining. Honestly I bet any restaurant that makes it through this is going to do gangbusters business once we're all vaccinated.
  14. The overall rate of blood clotting (all types) is no higher after the AZ vaccine than it is in the general population, and is actually somewhat lower. Based on the extensive data from the UK, the rare subtype shows up after about 1 in 1 million vaccinations (out of 10M+ vaccines administered). Roughly the same rate was also found in India. (out of ~27M vaccines administered). It's very important to use the largest sample possible for very rare events. For perspective, each day approximately one in 150,000 adults gets a blood clot (that clogs a blood vessel) from various causes. Alternatively, one million women taking the birth control pill for a year results in 300-900 additional blood clots, above the baseline rate. (That's a relative increased risk of two to four times). European politicians should never have made a big deal of this, even if it were true that the AZ vaccine increases the overall risk of death from a blood clot (which is almost certainly not the case when considering the larger data set), that risk is absolutely dwarfed by the increased risk of dying from COVID in the absence or delay of vaccination.
  15. Yes. There's going to be some COVID deaths that are undetected and others that could potentially be classified as another cause, but the overall death statistics are compiled from death certificates of all causes. A death is a death, you can't just order all the bureaucrats in every locality in the entire country to start fudging those numbers without that getting leaked.
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