COVID Hospitalization Stats Ain't What They Used To Be — And That's Good

It's been a while since I posted anything here, but this was so important, it was vital to get it out, on the grounds that it's important to change your opinion when the data changes. For a very long time, I've said that the "with COVID/of COVID" hospitalization and death dispute was mainly a distraction, one designed to minimize the disease burden from people who didn't want to believe the pandemic was worth all the bother others invested in it. It's now fair to say that COVID-19 hospitalization data isn't as meaningful as it used to be. Researchers tried to find out how many people were really in the hospital for severe COVID, but because it is a "must-report" disease, hospitalization counts include people in the hospital for other conditions who incidentally test positive for COVID-19. The way to understand this, then, is to get a handle on just how sick people with COVID are:

Instead of meticulously looking at why a few hundred patients were admitted to a pair of hospitals, they analyzed the electronic records for nearly 50,000 COVID hospital admissions at the more than 100 VA hospitals across the country. Then they checked to see whether each patient required supplemental oxygen or had a blood oxygen level below 94 percent. (The latter criterion is based on the National Institutes of Health definition of “severe COVID.”) If either of these conditions was met, the authors classified that patient as having moderate to severe disease; otherwise, the case was considered mild or asymptomatic.

The study found that from March 2020 through early January 2021—before vaccination was widespread, and before the Delta variant had arrived—the proportion of patients with mild or asymptomatic disease was 36 percent. From mid-January through the end of June 2021, however, that number rose to 48 percent. In other words, the study suggests that roughly half of all the hospitalized patients showing up on COVID-data dashboards in 2021 may have been admitted for another reason entirely, or had only a mild presentation of disease.

This increase was even bigger for vaccinated hospital patients, of whom 57 percent had mild or asymptomatic disease. But unvaccinated patients have also been showing up with less severe symptoms, on average, than earlier in the pandemic: The study found that 45 percent of their cases were mild or asymptomatic since January 21. According to Shira Doron, an infectious-disease physician and hospital epidemiologist at Tufts Medical Center, in Boston, and one of the study’s co-authors, the latter finding may be explained by the fact that unvaccinated patients in the vaccine era tend to be a younger cohort who are less vulnerable to COVID and may be more likely to have been infected in the past.

So that's mainly a good thing: it means nearly half people in the hospital aren't generally in the ICU for COVID, but that they're for some other reason. It would be interesting (but obviously much more complicated) to get similar numbers for deaths.

Administrivia: Sidebar Update

 Cleaned up some dead links and changed links on the sidebar.

India's Vaccine Nationalism Disrupts COVAX And More

 The horrific scenes coming in from India have vaulted that nation to the top of the single-day COVID-19 death tally, not a statistic you want to lead the world in, and this is just the official totals. (For various reasons, the actual number may be substantially higher.) Unsurprisingly, then, the country that has done more to mass produce vaccines than almost anyone else has announced an export ban through October as doses are being diverted to combat disease in India. The ban will affect, at least, Johnson & Johnson (made by Biological E), AstraZeneca's Covishield (Serum Institute and Dr. Reddy's), Novavax (Serum Institute), and Sputnik V (Dr. Reddy's). While we don't know which countries are affected here, the Reuters report makes it sound like it will be mainly south Asian nations and anybody hoping to get vaccines via COVAX, the WHO's distribution network (140 million doses were diverted from the latter). There's some hope from the US:

U.S. President Joe Biden said on Monday his country would export at least 20 million doses of the Pfizer (PFE.N)/BioNTech , Moderna (MRNA.O) and Johnson & Johnson (JNJ.N) shots, on top of 60 million AstraZeneca doses he had already planned to give to other countries.

But those are drops in the bucket compared to demand. Vaccine nationalism was always going to be a problem, and anyone claiming otherwise hasn't been paying attention.

The Importance Of Good Vaccines

 Cases, and somewhat more ominously, deaths are ramping up in Bahrain, one of the most vaccinated countries on earth:

The country relied heavily on the Sinopharm inactivated vaccine, which apparently puts it at greater risk for future reinfection. Along with nearby United Arab Emirates, Bahrain is offering people who did not get a good antibody response a third dose of the vaccine, which is highly suggestive. A recent Chilean study cited by the British Medical Journal claims Sinopharm's jab was only 3% effective after the first dose, with higher figures after the second. Given the sketchy data surrounding Sinopharm's vaccine, it's not a surprise we're seeing irregularities like this.

The Southern States' Vaccine Reluctance

 Call it vaccine hesitance, call it reluctance, call it whatever you want, but it's painfully obvious that the southern states are lagging the rest of the country (and especially the northeast and west) when it comes to getting vaccinated for COVID-19. Because the CDC only reports vaccines actually administered, and not whether they're first doses, I assembled my own map of first doses by state:

The southern states particularly are doing poorly, in the main:

Outside of Virginia, no southern state is even at 50% of the population yet, and many are below 40%. This means there will likely be another wave of infections, albeit deaths will be limited because of greater vaccine uptake among older groups, even there. The CDC reports that more than 80% of Americans 65 and up have been vaccinated, though without individual state reporting on age demographics, there could be large regional holes.

"I Continued To Cry For A Whole Month": Normalized Boy-Hate

 A couple months old story involving the usual (and in this case, literal) navel-gazing by Emily Ratajkowski, and not really on target for my "mothers shaming sons" tag ("feminists raising the enemy" it is), it really exposes the zeitgeist as to certain kinds of women airing their genuine loathing for men in public. The piece contains a story of a supposed friend whose gender reveal did not go so well for her mental health:

My friend who is the mother to a three-year-old boy tells me that she didn’t think she cared about gender until her doctor broke the news that she was having a son. She burst into tears in her office. “And then I continued to cry for a whole month,” she says matter-of-factly. After a difficult birth experience, she developed postpartum depression and decided that she resented her husband more than she’d ever imagined possible. She told me she particularly hated—and she made an actual, physical list that she kept in her journal, editing it daily—how peacefully he slept. “There is nothing worse than the undisturbed sleep of a white man in a patriarchal world.” She shakes her head. “It was hard to come to terms with the fact that I was bringing yet another white man into the world. But now I adore him and can’t imagine it any other way.” She also eventually learned to love her husband again. The sound of his perfect sleep next to her at night is now tolerable.

I get that some women have serious postpartum mental issues (and pregnancy can make you loopy as well). But this is extreme.

The States That Will Need Vaccine Bounties

 I recently came across a story about West Virginia offering young people a $100 savings bond as a bounty for getting the COVID-19 vaccines. It seems to me this will be necessary in a number of states, particularly in the south, intermountain west, and to some degree, even in the midwest. Here's a chloropleth map I just built of first vaccinations per 100 population:

(The CDC has a similar map, but it only tracks population-adjusted vaccines administered, which tells us little about the overall number of individuals vaccinated.) The states in trouble are Idaho, Wyoming, Missouri, Arkansas, Louisiana, Mississippi, Tennessee, Alabama, Georgia, South Carolina, and Indiana. I expect to see these states follow suit presently.