When evaluating the effects of vaccines there are two complementary forms of evaluation:
1. Measuring the direct effects of the vaccine on the individuals vaccinated
2. Measuring the overall impact of the vaccine program on an entire population
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We focused on #2, aiming to show the real-life impact of a vaccination campaign on the dynamics of the COVID-19 pandemic at the entire population / country level
For example, we showed the impact of a vaccine program when a large proportion of the elderly population of a city is vaccinated, where the impact is measured in terms of total number of cases and hospitalizations among that city’s population
The impact of a vaccine program depends not only on vaccine effectiveness, but also on other factors, including national vaccine coverage, vaccine allocation in subgroups of different risk levels, and social mixing of groups that may affect transmission by indirect effects
פתיחה תייצר יותר מגעים בין אנשים, R יעלה מעל 1 ותהיה עליה במאומתים. מישהו חושב אחרת?
השאלה הגדולה היא מה יקרה לחולים קשה
מצד אחד, החיסונים עובדים ויורידו את מספר החולים קשה החדשים. מצד שני, העליה במאומתים תעלה בסוף גם את החולים קשה
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איזו מהמגמות תנצח?
אף אחד לא יודע
כי למרות שהחיסונים עובדים, אנחנו לא יודעים בכמה הם מורידים הדבקות ובכמה תחלואה קשה (80%, 95% או אולי אפילו 98%?)
ואת גודל העליה במאומתים גם אי אפשר לדעת, כי זה תלוי בכמה יפתחו ובאיך אנשים יתנהלו
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אז מה צריך לעשות?
קודם כל, לפתוח בהדרגה ולחכות בין צעד לצעד
כי גם אם החיסונים יורידו בטווח הקצר את החולים קשה, נותרו כ-400,000 מעל גיל 50 שלא חוסנו. ובגלל שלמאומת בגיל הזה יש 10% סיכוי להפוך לחולה קשה, להתפרצות תחלואה בלתי נשלטת עדיין יש פוטנציאל להמוני חולים קשה
When trying to identify the effects of the vaccination we’re hampered by the fact that right as the vaccination drive started Israel went into its 3rd lockdown following an unprecedented rise in infections (possibly due to the B117 strain).
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2-weeks after 30% of 60+ vac., drop of 25% in % of 60+ critically ill out of all cases
Cities with higher vac. rates have fewer critically ill
But many caveats and issues
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Caveats:
1.5% critically ill 60+ years old of all cases is low, but we reached this number several months ago. So while good and the timing consistent with a vaccine effect, it may also be due to pandemic fluctuations
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Also, lower fraction of critically ill out of cases could be due to an increase in the denominator, i.e., a rise in cases of the younger population. But this too may be a positive effect of the vaccines in reducing infections, and there are already positive such indications
Currently a major surge, but we project a plateau in critically ill in a week
Despite all this, Israel tightened its 3rd lockdown today
A thread on why this was the right decision to make now
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In 1-2 weeks, we expect a plateau in the critically ill due to:
1. Effect of the less strict lockdown imposed 10 days ago
2. Start of the vaccines effect
3. Striking similarity in critically ill rise in the 2nd and 3rd lockdowns. If a rerun, then plateau is a few days away
There are early signs for our projection of a plateau in the coming 1-2 weeks, since the Arab sector has already plateaued, and in the other sectors despite a >60% weekly rise in cases in children, 60+ rose only 10%
May also be the first effects of the vaccines. Too early to say
Numbers were still high when we exited 2nd lockdown
And we repeated the same mistakes of the second wave. When cases started rising in specific sectors, first the Arab sector, then the orthodox, we didn't put enough measures in these peak areas, so eventually it spread to all sectors and all cities