I'd expect that case fatality rate would significantly reduce after 60+ population (which is 90%+ of deaths) is vaccinated. However, even though more than 80% of 60+ got second dose already, case fatality rate is approximately the same. I don't have any good explanation for that.
Death usually comes 2 to 4 weeks after hospitalization which comes 1 to 2 weeks after infection. So the drop in death rates should be visible 2 to 4 weeks after the drop in hospitalizations, and should be less steep initially.
Vaccinated with a second dose means full immunity 1 week after, possible death 3 to 7 weeks after (1 + (1 to 2) + (2 to 4)). So a decline should start to be visible since last week maybe. But I wouldn't get nervous for another 2 to 3 weeks in case it doesn't fall sharply, data is always noisy and everything is spread out the more dependencies on previous events and times there are.
Right. But still, don't worry yet, worry when it hasn't shown improvement in a few weeks.
Edit: Also, when you look at the JHU data (e.g. via google), it shows a peak at Jan 15th in the number of cases followed by a steady decline. The number of deaths peaks on Jan 28th, followed by a similar, steady decline. Which is as expected, so I would say we are already seeing the effects on the number of deaths.
Sorry that I didn't look at the data earlier before replying.
I'm looking on case fatality rate: cases and death count are too volatile and depend on many factors.
My hypothesis (it's not mine but I agree with it): if population with high death risks is disproportionately vaccinated, at the level it can make visible effect on case count for this population, it should have effect on case fatality rate. Of course, multiple factors can reduce/slow down the decline, but it should be there. Reducing death probability by half for the 60+ people without changing anything else should significantly reduce case fatality rate.
The case fatality rate peaked at the end of November, slightly declined until mid-January, then grown a bit and is almost constant in last three weeks.
So, the options I see are: either no effect at all can be seen yet behind the noise (it's hard to believe for me), or there is some factor compensating for the case fatality rate reduction (I can think of what could increase fatality that much and exactly compensate the effect), or the hypothesis is wrong (I can't see why either)
After some thinking, I've got a theory: Deaths lag behind the infections by say 4 weeks. If the infections are falling after a peak, deaths are still rising or plateauing for 4 weeks. That means the ratio deaths/infections will produce a peak that lags the infection peak by 4 weeks, because the divisor is getting smaller while the dividend is still rising. Now if you look at the numbers for Israel, there is a plateau in the CFR for the last few weeks, it looks quite flat. However, e.g. Germany or Austria do have a pronounced peak there. The UK slightly less so.
So I would argue that we do see the CFR being lower than the peak we would expect without working vaccinations.
If I take a look on (rolling average) of cases and deaths, peaks are more or less at the same point (about 1 week for this peak and 2 weeks for the previous one, definitely not 4 weeks apart. In particular, now b)oth number of cases and deaths are decreasing.
Good points, and Vaccination itself has a lag effect as well, If i understand it correctly.
I've heard that someone vaccinated with 2nd dose today will not have the protection percentage for 10days+ or so - Which needs to taken into account with these figures.
The vaccination also does no good if you are already infected, and with the spike in infections in Israel coinciding with vaccination ramp up, those will be tricky to separate out.
If you vaccinate more people, you would expect that the cases that present at a physician will be selected to be the most severe. If the vaccine reduces most infections to very mild or asymptomatic cases, they will not be counted in the statistics at all.
So it would make sense that introducing a broadly effective vaccine would increase the case fatality rate. (You would also expect fewer severe cases, which is the whole point.)
A functioning vaccine should affect the CFR by changing the denominator of measured cases.
I am reminded of an analogy from improvements in battlefield medicine. As battlefield protocols (on-site treatment, rapid evacuation, etc.) have become more effective, battle fatality rates have fallen. But they have been replaced by a rise in severe chronic injuries like amputations.
> If you vaccinate more people, you would expect that the cases that present at a physician will be selected to be the most severe.
Most of cases both before and after vaccinations are not severe. Moreover, the share of severe cases seems to stay the same or even increase ( https://datadashboard.health.gov.il/COVID-19/general , I hope it can be google-translated or something).
As I explained in other reply ( https://news.ycombinator.com/item?id=26142482 ), I expected change in fatality rate due to disproportional vaccination of the group with most of the fatal cases. For 60+ fatality rate is very high, and many of them are vaccinated. For everyone else, the opposite. I agree that if only severe cases were registered, we should've been looking at case number instead (which would be more stable since almost all of those would be registered).
> the share of severe cases seems to stay the same or even increase
I can't read the dashboard, but as I indicated this is what you would expect if you have a vaccine that broadly works at controlling the most severe forms of the disease. Vaccinated people whose infections manifest as nothing or a day or two of lethargy are not going to get counted in the statistics.
> I expected change in fatality rate
your expected change in the fatality rate needs to take into account that the real-world denominator has changed and that will not be apparent if you just divide number of fatalities by number of cases. (Because vaccinated people may be more likely to be asymptomatic, and we expect them to not get sick enough to ever present as a case.)
It's important to look at the number of people hospitalized or dying.
One again, out of population who are responsible for 90% of deaths (and 10% of cases), more than 80% are vaccinated. Everyone else, like 25%. This got to result in disproportionate change in number of cases and number of deaths.
A good explanation is that the vaccine is not working. ( people are in denial)
I looked at the Pfizer numbers and my conclusion is the it's doing nothing.
It will take 6-8 weeks after large scale vaccination to start seeing the results. Deaths usually occur six weeks after infection, and it takes a week to reach full immunity after vaccination.
Remember that hospitalizations take at least 2-3 weeks post infection to occur, and that you don’t see protection from the first dose for at least five days or so.
So you’d expect hospitalizations to lag 18-26 days or so. Also the chart is not saying all those groups had vaccines: those under 60 largely haven’t been. The labels could have been clearer.
It’s just a chart of change in hospitalization by age from a starting date.
Actually, I was wrong. I checked the source paper. I believe the labels refer to cohorts from cities that were early in the vaccination campaign vs cohorts from cities that were late in the campaign.
So 0-59 late vaccinated means some vaccines but later in time and fewer in number.
I'm not sure that is true. As I understand it, it's a cohort of people of that age who live in a geographical area of Israel where vaccination was started early. So it includes people of that age who declined the vaccine/didn't get it fr other reasons.
Of course, you're also correct that another important factor is that some of the cohort are not yet fully protected.
Quote:
In order to distill the possible effect of the vaccinations from other factors, including a third lockdown imposed in Israel on January 2021, we compared the time-dependent changes in number of COVID-19 cases and hospitalizations between (1) individuals aged 60 years and older, eligible to receive the vaccine earlier and younger individuals (0-59 years old); (2) early-vaccinated cities compared to late-vaccinated cities; (3) early-vaccinated geographical statistical areas (GSAs) compared to late-vaccinated GSAs;
Obviously anecdotal, but my wife is a nurse and she's been hearing some frightening things about the vaccine. Young people getting it are basically bed-ridden for days and are calling out of work...one lady couldn't lift her arm anymore and is now getting physical therapy...one guy went out to dinner with his family after getting it and had complete memory loss of the entire dinner.
At what point does common sense risk to reward ratio come into play for young people?
This is what you say about something that looks like "good news" above:
> Serious question: How do we know any of this reporting is true?
> There's no data sources provided, no way to check follow up health (i'e. what if these people all dropped dead a week later), no way to prove the data isn't a complete fabrication, etc. Also, they make sure to use dynamic terms so we can't be sure these numbers have any valuable meaning at all (e.g. were Covid tests with drastically different cycle counts used?). Not to mention all of this reporting is praising a single vaccine producer in a billion dollar industry.
> I just read "How to Lie with Statistics" by Darrell Huff and this whole thing is the epitome of a manipulatable situation.
Combine the two and you no longer look "hey lets make sure people aren't lying to us," you just look like you have your own agenda.
So if you can lie with statistics, you can certainly lie even more with claimed anecdotes...
(The point of a vaccine is to trigger and train the immune system. The immune system revving up can cause symptoms of its own. If you get the fever of the immune system responding, without the lung damage cause you don't have the original actual virus, that's a huge win!)
it looks that way because it's a relative chart - exaggerates the uptick in hospitalizations of unvaccinated non-elderly people
If you toggle the 'relative' button you'll see the actual numbers - basically, hospitalization count for vaccinated elders is is decreasing, and the hospitalization of unvaccinated non-elders is slightly increasing.
I don't get it, the chart goes down after the lockdown starts, like they always have in the past year. How does it say anything about the effects of vaccination?
edit: nvm a different chart is shown when javascript is not activated
The chart shows that patients below age 60 have been hospitalized 80% more for severe Covid after vaccination.
Hard to not comment this cynically. That is bad.
Early vaccinated patients over 60 have 40% improvement. Keep in mind that the group older 60 is smaller in size compared to under 60, and the effect is smaller that adverse response in younger. Net negative.
That is hospitalisation in _regions_ where vaccination started early or late.
It does not explicitly discriminate between vaccinated people or non-vaccinated, only possibly by proxy of age.
People under the age of 35 were previously not included in the vaccination scheme.
At the same time, the two more infectious variants are spreading.
https://ourworldindata.org/grapher/israel-severe-hospitaliza...