If you're wondering how bad Delta really is, even in highly vaccinated SF (76% of >age 12 fully vaxxed) & still w/ a lot of masking (most folks in stores), we're seeing a pretty steep Covid uptick. Daily cases up 4-fold (10->42; Fig L), hospital pts doubled (9->19; R)(Thread 1/4)
Uptick mirrored @UCSFHospitals: Covid inpatients (we were at ~3 pts two-wks ago) now 13 (Fig L). Overall test positivity rate was well below 1%; it's now up to 2.6% (Fig R). Even more worrisome, test positivity rate in asymptomatic pts was ~0.15%, now up 6-fold to 0.9%. (2/4)
I don't have vaccinated/unvaxxed breakdown for SF & UCSF – I assume most severe cases are in unvaxxed. But even for vaxxed, w/ more Covid in air expect more breakthru cases. As for me, I'm back to double-mask in stores. Still indoor dining but might abort if trends continue.(3/4)
The SF # s are still fairly low, & are cause for caution, not panic. But this kind of uptick in SF (U.S.'s vaccination leader) shows that Delta is very real – the places w/ much lower vax rates may well get clobbered. Alas, doesn't seem like there are many persuadables left.(4/4)
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Covid (@UCSF) Chronicles, Day 1371
I haven’t X'ed much about Covid lately, mostly because things are fairly stable. But a lot of folks have asked me what I’m doing, Covid-wise.
So today: how I’m acting, & why. Graphic below shows my general approach; more details follow. (1/25)
How am I acting currently? Given a moderate uptick in Covid over the past two months, I’m back to masking in crowded and poorly ventilated places, particularly when I don’t need to talk. When I do mask, I always use an N95; I see no reason to wear a less effective mask. (2/25)
Examples of where I currently mask: crowded stores, airplanes or trains; elevators; and theaters. But given that today’s uptick is only moderate, I’m still OK with indoor dining (though will opt for outdoor if conditions allow) and for going maskless at holiday parties. (3/25)
Covid (@UCSF) Chronicles, Day 1249
While good data are far harder to come by than in the past, it’s clear that we’re experiencing another Covid uptick. Today: what that means and how you might choose to alter your behavior in response. (1/25)
First, the evidence for the uptick (I don’t say “surge” since I associate that with the massive surges of the past):
This curve of hospitalizations (a reasonable proxy for the amount of Covid in the community) shows a definite, but relatively mild, upward trend. (2/25)
Alas, one can't look at any single measure to quantify an uptick anymore. But all arrows now point in the same direction: up (⬆ wastewater,⬆ hospitalizations,⬆ deaths,⬆test positivity). Even my fave measure, @UCSFHospitals’ asymptomatic test positivity rate, is no… (3/25)
Until this week, I remained a NoVid, which I chalked up to being fairly cautious, fully vaxxed & a bit lucky.
This week my luck ran out. My case is a cautionary tale, particularly for the “just a cold” folks. Mine definitely was not...I literally have scars to show for it. (1/22)
I’ve got my 2nd bivalent in April, so my protection against a severe case was still strong, but the 2-3 month window of protection vs. getting Covid had passed. I've let down my guard a bit: still masking on planes & in crowded rooms, but I do now eat and drink indoors. (2/22)
This week, I was on clinical duty @UCSFHospitals. We are still required to mask in patient areas (good!). I felt fine until Sunday afternoon when, after leaving the hospital, I noticed a dry cough. By Sunday night, I felt flu-ish, with a sore throat, fever, and chills. (3/22)
Covid (@UCSF) Chronicles, Day 1161
With the Pub Health Emergency over, it's a good time to update you on my view of Covid & my current approach to Covid behavior – which is now based on 2 principles: 1) Is the risk worth it? 2) Can I live w/ the behavior for the long haul? (1/25)
First, let’s review today's situation. Since Omicron's emergence in 11/21, the biggest surprise has been the absence of surprises. Yes, we’ve seen a few variants that led to mild surges, but we haven’t had to interrogate our Greek dictionary for a new letter for 18 months. (2/25)
mRNAs still work great in preventing severe infection, and Paxlovid, home tests, & ventilation still work well too. Long Covid remains a concern, but we know that both vax & Pax lower its frequency, that most (though definitely not all) folks… (3/25) jwatch.org/na55957/2023/0…
Important @TheLancet systematic review finds Covid infection confers robust & long-lasting (good at 40 weeks) protection vs both symptomatic & severe Covid infection.(Weaker w/ Omicron, but still good.) thelancet.com/journals/lance…
How will results influence my behavior/thinking?(1/7)
a) I've been considering a Covid infection to be the equivalent of a booster in terms of protection against reinfection & severe disease (hospitalization/death). These study results indicate that it is at least that good, maybe even a bit better... (2/7)
b) We've been headscratching about why XBB variant didn't cause more of a surge, despite low uptake of the bivalent booster. It may be that immunity from all those 2022 Omicron infections kept it at bay (that's informed speculation – Lancet study ended before XBB spike)... (3/7)
Covid (@UCSF) Chronicles, Day 1038
Some folks continue asking what I'm doing viz Covid behavior...
Answer: I'm changing my behavior. In the Bay Area, I'm now OK with indoor dining & removing my mask for small group gatherings.
I haven't changed, the risk has. Here's how: (1/25)
Specifically, I haven't changed my perspective on balancing prudent caution with everyone's (including my) desire for "normal."
But, in the Bay Area at least, the Covid risk has come down considerably, and, by my way of thinking, this allows for a more permissive approach.(2/25)
Where I'm coming from: 1) I'm 65 & haven't had Covid 2) I want to live as fully as I can, but am comfortable taking reasonable steps to avoid infection 3) I'm fully vaxxed & had bivalent in Sept 4) My main fear is Long Covid, which I peg at ~5% probability per Covid case. (3/25)