We’re in a new world where the country’s leadership is emphasizing masks and social distancing.
But tomorrow is that holiday so universal that even we celebrate: the Super Bowl.
In light of that, I thought it useful to share a recent case study that is close to home.
Two friends of mine got together to meet a long-time friend they hadn’t seen in a while. Everyone felt fine. I don’t know if they validated “health” using thermometers and pulse oximeters, but they had every reason to know they were OK. They shared some time in the our mutual friends’ home. And since this wasn’t in public or on Federal property, everyone felt free to unmask.
A couple of days later, the long-time friend started feeling unwell. A couple of days after that, the long-time friend was truly feeling terrible. The day after that, day five, they got tested. On day six they got their result: they were infected with COVID.
Since the evening with friends fell just inside the danger window, the long-time friend called their buddies. Just to be on the safe side, they should get tested.
Our mutual friends both tested positive for COVID infection.
Now, it’s several days after learning they were infected before my friends let me know about their diagnosis. They are lucky that they “just” feel sick. They’ve been self-isolating since they learned the long-time friend had tested positive. They can still smell and taste.
They’re embarrassed.
Now, I happen to know at the time these friends met with the long-time friend that risk in their community was high. Kinsa Health Weather can show you the current risk in your community. For example, right now in Richmond, Virginia, the risk is 99 (very high). A couple of weeks ago, I had just learned about the Health Weather website, and was having “fun” putting in zip codes for folks I know. At the time, my local risk was a concerning 54, but it was lower than the risk in other counties for any of my family and close friends.
As we all prepare to celebrate that favorite holiday, with munchies (no masks) and lots of yelling and screaming (or at least laughing at the funny commercials), may we think about whether our respective counties are “safe” or not.
We’re late enough in this whole thing that I expect many are already set in their patterns of life and opinions regarding COVID. But I felt it was worth sounding a note of caution. So I’ll now go up on my mountain and sit under my leafy vine and wait for what will come.[ref]Jonah 4:6[/ref]
[Actually, I’m going to double-mask and go help another pair of long-time friends move.]
Thanks for the words of wisdom. I double mask these days too, with new strains and no way to get a vaccine yet, it’s the safe thing to do. I didn’t know about that website. Good to know.
I don’t understand the hysteria surrounding this virus. For most of us, it’s not that big a deal. If you’re high risk, stay home and let the rest of us live our lives.
Actually, I take that back. I DO understand the hysteria. It was designed to hurt President Trump and the powers that be accomplished their goal. Unfortunately, it destroyed our economy and is continuing that destruction today.
Thanks for this post. I think it can be helpful to see examples like this.
@Aaron,
I challenge your perception, given the way the virus has played out in the global community. But you are free to think what you want.
The virus seems to have different effects on different people. All five of my kids caught Covid, and only one of them was seriously ill. The other four had very mild symptoms. The youngest did not feel sick at all. My wife and I caught Covid in November and both had minor symptoms for a week or so and then felt fine. My father and stepmother stayed inside their homes having all their food delivered for eight months but they still caught the virus. My stepmother, in her late 70s, had mild flu like symptoms for a week or so, but my dad, who had a bunch of other sicknesses, was very ill for more than two months. He is 81. I think a lot of people make a lot of assumptions about this virus based on wild generalizations that are not born out by the actual data.
My wife and I both have professions which dictated early vaccinations. While we are now reasonably safe from the serious effects of this disease, we are still puzzled by those who refuse to take common sense measures to protect others in the community. We still mask up when in public, as we could asymptomatically spread the disease and we certainly do not want to be responsible in justifying others’ actions and attitudes.
This disease is certainly not fake and it is not going away soon. My wife watched three of her patients die in the last week. All three had years of life in them before catching this virus.
Geoff, I hope your father bounces back from this episode with no long-lasting effects.
A comment on why I picked Van Gogh’s “The Potato Eaters” to illustrate this post.
I thought “what’s a picture of people gathered in a home setting that was created long enough ago to no longer be covered by copyright?” And “The Potato Eaters” came to mind.
Looking at the picture anew, I realized they are sitting in the same ladder-back chairs I have in my own dining room. Fun!
You might consider today a “holiday,” but let’s remember the words taught by President Monson: “The Sabbath is a holy day, not a holiday.” Let’s also engage in activities that reflect our worship, and avoid making the 4-hour melodrama our focus for the day.
I remember the February Sunday when a friend was reverently playing the organ. Only if you listened carefully would you notice he was playing “Hail to the Redskins.”
The daughter who lives with us is autistic. There are various rituals that will be observed whether we want to or not. In order for our Sabbath to be restful, today that means we turn on the TV at 6:30p EST and partake. And I dare say there are one or two who read this blog who might also be tuning in. I just wanted to sound a word of caution, lest that portion who tune in might be tuning in with friends outside their own household and be open to suasion.
Old Man,
I’m quite confused by your comment. You state that you have been vaccinated but you also mention that you are concerned that you may asymptotically spread SARS Cov2. Granted, there is a small probability that your bodies may not have produced the necessary antibodies to fight off the disease post inoculation, but with every other virus known to man immunity from the virus prevents the transmission of said virus. Are you privy to some empirical study that suggests otherwise? If so, would you please provide the link.
PaulM,
For COVID, one could presume that one might not be contagious after achieving substantial immunity (the several weeks and two vaccinations that were studied). However no one has studied that. And even for those who have been vaccinated, there are still those who can contract the virus and suffer symptoms (if mild). This is the 5% or whatever residual don’t achieve substantial immunity.
Also, since COVID is one of those diseases were many get infected but don’t exhibit symptoms, there is no way to be certain your symptom-free person, even if vaccinated, is guaranteed to be safe for those who aren’t vaccinated.
As to empirical study, there are the two members of Congress who, though having received both doses of the vaccine, tested positive for COVID infection after the close quarters huddling with their unmasked fellow members of Congress. So it is possible to get infected even after having received the vaccine.
I would say, what are these studies that suggest that someone who is ostensibly immune from a virus necessarily doesn’t transmit the virus? Curious that such supposedly well-known facts are not being cited by those who have dedicated their lives to studying infectious diseases. Of course, that could be because they are scientists, and scientists rarely state anything in absolute terms.
PaulM,
A variety of factors affect immunity. The Pfizer vaccine showed efficacy of 95% at preventing symptomatic Covid infection after two doses. Asymptomatic infection is unknown. Efficacy against the various variants is unknown.
As long as the spread of the virus is high and we are in frequent contact with Covid positive individuals, wisdom (and public policy) dictates masking and social distancing.
Meg,
Your answer is surprisingly lazy. I conceded that the vaccines are not 100% effective. There is not a single empirical study that confirms asymptomatic spread. The only study that remotely addresses that issue with specific empirical evidence and a clearly identified population is this one,
https://www.ajtmh.org/view/journals/tpmd/103/4/article-p1608.xml?tab_body=fulltext
and it clearly does not support the notion of asymptomatic spread (p value is 0.6). And, please, name another respiratory virus that spreads without exhibiting symptoms. The symptoms are the very evolutionary characteristics that allow the virus to survive and reproduce.
Your empirical members of Congress are not empirical evidence or data– those are empirical anecdotes. Why you would even mention that is a bit of a head-scratcher.
As to your final challenge, every epidemiologist on the planet has been speaking about it (“it” being the notion that if one is immune one is not going to spread a disease) . The primary postulate upon which herd immunity is built is the notion that those who are immune to a disease are unable to spread the disease. I didn’t take you for an anti-vaxer but if that is what you want to argue we will just end up speaking past each other. If you want to throw that common adage out the window you are welcome to do just that but that approach is completely unjustified by the existing data. Not one epidemiologist contests this concept. The only disagreement among the “experts” is the most optimal way to achieve herd immunity– naturally or wait for a vaccine (which we have now).
Frankly, I’m the first to assert that we know very little about SARS Cov2 specifically which leaves us in the position of making a lot of assumptions about the behavior of the virus. But as evidence trickles in we learn that this particular virus behaves more and more like other corona viruses with which we are familiar which means, by inference, we know more about the general behavior of the virus than we are willing to admit. Sadly, much of our public policy wants to pretend that SARS Cov2 is so unique that we have to throw away everything we learned up to 2020 and start from scratch. You and far too many of my fellow humans seem to have fallen for the irrational narrative that we know so little about viruses in general that there is a boogeyman hiding around every corner waiting to jump out and sneeze in our face. Overall, the public has lost its collective mind and decided to ignore centuries of data and pick a new, insane path.
Old Man,
What you call wisdom I would describe as irrational. Without being able to appeal to any real data to substantiate your “wisdom” all you are doing is engaging in collective fear-mongering.
Hi PaulM,
Just so you know, someone other than me put this post on moderation. And someone other than me approved all your comments. And someone other than me deleted comments from folks responding to you.
As for your response, the vaccines currently approved in the United States were never tested to determine whether they mitigate asymptomatic transmission after vaccination. So there is no data for those vaccines to support or refute you assumption, according to my sister who is a physician and who was one of the persons who participated in the vaccine trials (and therefore knows what the protocol can and cannot prove).
The AstraZeneca vaccine was tested in a manner that supports evaluation of the assertions regarding whether it can mitigate post-vaccination asymptomatic spread. It does, against the normal COVID strains, but offers only minimal protection against illness against the South Africa strain (B.1.351). While it can mitigate severe illness leading to death, symptomatic illness would certainly support transmission.
Also, you ignored the OP, which relates the ability of COVID to be infectious before symptoms manifest.
Meg,
I specifically addressed the issue of asymptomatic spread but I will repeat what I stated above: There is no empirical evidence of asymptomatic spread of SARS Cov2. I am not stating that asymptomatic spread is impossible– just that we have no evidence that it is occurring, or, if it is, to what extent. I have looked far and wide for the data and as best I can tell it does not exist. The CDC has posted articles on its website but those are merely models that assume asymptomatic spread based on a citation to the article I linked above to support those assumptions. For context, if I cited a statistic with a p value of 0.6 as the basis for an assumption I made in one of my models (statistical modeling is my profession) I would lose all credibility with my clients and there is a good chance if word got out I wouldn’t get any more. If you are privy to research on the subject that I have somehow overlooked please (and I mean this in all sincerity) provide the reference.
The reason none of the vaccines approved in the US were tested for asymptomatic spread is because there exists no scientific basis to do so and no mechanism or framework for such a study. The lead virologist at BioNTech said as much back in December during an NPR interview. The AstraZeneca assertion that it “prevents asymptomatic transmission” is marketing fluff issued in the company’s own press release. The Lancet journal article where the original data was published makes no such claim and other reviews of the data are completely silent on the issue.
In addition, the AstraZeneca vaccine is not approved in the US so anyone who has been injected with either the Moderna or Pfizer vaccine has a much more potent solution coursing through their veins. The major difference is the use of MRna to develop the vaccine. AstraZeneca chose to use an older technology that uses another virus as the medium for eliciting immunity which may be a factor related to its weaker response. Lab tests have shown the Moderna and Pfizer vaccines to still be just as effective at preventing severe onset of B.1.351– you are more likely to get the sniffles but you will not land in the hospital or die– as with the “ordinary” version that has been circulating throughout NA and EU for the last year. But of course if one has the sniffles one is not asymptomatic by definition so I’m left scratching my head about the point you are attempting to make.
I have not ignored the OP. I am challenging the assumptions undergirding the OP. What I find troubling in general is that you do not recognize how many assumptions you made nor their magnitude.
I believe in rational, evidence-based decision-making and behavior. A year ago I supported the stay-at-home orders and other severe social distancing measures as a means to buy the world time to collect data. At this point, a lot of the data is in and it does not support most of the mitigation methods advocated by our politicians and public health officials. Expecting anyone with immunity, either via recovery or vaccine, to continue to adhere to mitigation behaviors despite those individuals presenting no threat to either themselves or others is irrational and mean-spirited. It’s political theater at its worst. We can and should do better.
Hi PaulM,
You appear to be dealing with a different set of facts.
When I took the CDC contact tracing course, it was made clear that transmission is possible up to two days prior to onset of symptoms. That would qualify as asymptomatic transmission.
The AstraZeneca vaccine testing protocol conducted regular tests of all subjects throughout the protocol. This was the reason they are able to make assessments of the post-vaccination infection rate, to include asymptomatic infection. The other testing protocols did not test subjects unless they became symptomatic. This is why they were unable to say anything about asymptomatic infection and therefore the possibility of someone vaccinated with their product being a asymptomatic carrier of the virus.
For what it’s worth, my family (who has lived together in the same household since the onset of COVID) watched the Super Bowl by ourselves. I really disliked the add showing one of the late-night hosts licking salsa off the end of a football. The Reddit ad was intriguing, but I couldn’t read it before it disappeared off the screen. We didn’t care who won or lost, but it was sad to see the Chiefs trounced so thoroughly. Patrick Mahomes threw some amazing passes as he went down. Too bad none of those connected, since football magic is always a joy to behold.
As the Super Bowl is now in the past, I leave you all to embrace whatever set of “facts” you’ve deemed correct. It will be interesting to see if the Super Bowl passes without a bump in infections (and deaths). And of course there are some who think all that data is fake news. But the promise of the gospel I believe and the God I worship is that there is one truth (delightful though the MCU multi-verse might be for entertainment). In the end, I am confident we will know what was truth and what was not truth. Calling me wrong will have no impact on whether or not what I was saying was actually wrong.
“Expecting anyone with immunity, either via recovery or vaccine, to continue to adhere to mitigation behaviors despite those individuals presenting no threat to either themselves or others is irrational and mean-spirited. ”
Then we would have the problem of people falsely claiming to be vaccinated or infected+recovered.
“Sir, we need you to wear a mask to enter the store.”
“I don’t need to, I’ve been vaccinated.”
“Sir, that may be true, but we have no way to ascertain that.”
“Trust me!”
—
And that will likely lead to implantable ID chips, were a scanner can instantly check a database for vax status.
And the computer/network system in charge of it all might be called “the beast.” Or “Sky Net.” It’s a toss-up.
But Book, that’s all going to happen anyway.
I caught the virus in July. I was achy and it was super annoying for about a week. Since then, outside of work and church, I don’t wear a mask. And I sleep just fine at night.