(2022-12-08) ZviM Covid 12/08/22 Another Winter Wave

Zvi Mowshowitz: Covid-19 12/08/22: Another Winter Wave. Cases will for a time double or triple from where they are. Combined with the flu and RSV, this will mean that while our health care systems will hold, they will be under substantial strain that impacts quality of care.

the number of worthwhile additional precautions to take, overall, will not be zero.

We should not worry that this will be anything like last winter

The Numbers

Cases

We likely have something like five weeks left before this peaks, with future weeks unlikely to see larger increases than we are seeing now. That puts the realistic bad scenario peak at something like 250% of current levels, similar to the peak in July 2022

Booster Boosting

By all accounts and statistics there’s a lot of flu out there right now, with hospitalizations from it on par with Covid. If you haven’t gotten your flu shot yet, seems like a thing well worth doing

He then adds five ethical arguments against further mandates. The emphasis on serious adverse events ignores the issue of non-serious adverse events. I remain skeptical of the claimed rare adverse events, but look at that NNT: something like 37,000 boosters per hospitalization prevented. Let us assume that, on average, a booster given to a random person knocks you on your ass for a day. That’s one hundred years, an actual lifetime,of knocked-on-ass time for every hospitalization prevented.

Physical World Modeling

we should remember that we endlessly obsess over other ‘risks’ to our health when by far the biggest preventable danger is a failure to get our basic house in order: Exercise, diet, healthy weight, social support, stress management, emergency savings, clean air, including a massive risk impact if you get Covid.

Long Covid

Another example of how not to measure Long Covid

In other words, 14% of Swedish people have an undiagnosed chronic condition of some kind

I can totally believe that

In Other Covid News

Permanent Midnight

There are two stories here.

In the wake of Covid prevention, our children face a mental health crisis. Then again, they already faced a mental health crisis by reasonable standards. If it’s not getting better now under normal conditions, what does that tell us?

The numbers are stark. Are they, though? I followed a link in the post, to here.

The increase was bigger among children, yet even in its peak relative increase (again in October, right after school starts up again) they only quote 11%. If 111% of previous levels of children killing themselves is a ‘crisis’ then why exactly is 100% of previous levels not a crisis?

I think that our implementation of ‘remote learning’ made things dramatically worse for children. I also think that the core ongoing crisis has little to do with the pandemic and that officials are looking to use it a scapegoat.

China

Monkeypox Redux: Total failure or a model response?

The public health outcome was a great success.

A classic fallacy in public health is to equate the goodness of the outcome with the goodness of people’s actions

Public health can have a big impact on the margin while having little control over the grand arc of outcomes

most of our decisions did not in the end much matter, given initial conditions, and it all came down to one or a few big decisions. In the case of Covid, that would be Operation Warp Speed – both going fast and not going faster.

My model is that Monkeypox was one of those situations.

There was most certainly room for improvement.

If we had gotten the best possible response from public health once cases started happening, we would have peaked sooner with less cases

If we had gotten the best possible response including preparing for this very predictable scenario in advance then we would have had even less trouble. In percentage terms this could be noticeable. In absolute terms, mostly not.

There was also lots of room to have botched things more.

I still think that, given what we know now, the risk of sustained spread outside of the most vulnerable communities was always quite low, and that those communities were always going to respond to conditions on their own reasonably soon no matter what Official Public Health did.

In this particular scenario the stakes turned out to be relatively low, the core outcomes predetermined, our worst fears never seriously in play.

what if this had been a very different scenario?

If this had been a harder problem, ‘total failure’ would absolutely be the fair description of our response. Thus, I think it is most helpful to view our response here as a failure

Other Medical and Research News

The CDC will be that much harder to fix with everyone working remotely... problem that was already next to impossible. Organizations like the CDC, that are long established with dysfunctional cultures that protect themselves against change, are mostly not fixable, you need to replace and start over BITFD

You know how every damn time you check out at CVS you have to click an extra time and perhaps feel a little bit bad because they ask you for a donation to the American Diabetes Association? it is so much worse than that... Thus: A public service announcement. Whenever any retailer asks you for a ‘donation’ to anything, you say no, and downgrade the ethics of the retailer and also the charity.

Texas rural hospitals (26%) at risk of closure, over a third have negative margins. The economics did not work before and even more do not work with newly increased labor costs.