Despite the very sharp drop in wastewater numbers in the Boston area, daily covid deaths are ticking up towards last winter's peak. What can we learn from elsewhere? Well let's compare with the UK, which is a little further along the epidemic curve 1/n
I pick the UK not only because it's where I was born, but because the population is about 10x that of MA, meaning it's easy to do the math in your head, look at this 2/n
So per capita, MA is seeing roughly twice as many daily covid deaths as the UK right now. Lots of possible reasons for that, but this one is important. About 36% of the population in MA is boosted (from mass.gov/doc/daily-covi…) 3/n
And in contrast... (from @ONSons.gov.uk/peoplepopulati… note this is 'modeled' which will account for some of the difference but not all of it) 4/n
MA is one of the best vaccinated states in the country. But it is still important to get boosted, especially if you are older in an a group otherwise more vulnerable to severe illness. And imagine what we can expect in less well-vaccinated places 5/end
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What did I say last Friday about the Boston area peaking? The wastewater data are in, and the news is good. @MWRA_update and @BiobotAnalytics providing solid evidence, that importantly *can't* be put down to exhausted testing capacity or other factors 1/n
this is obviously good, but it's not out of the woods good. Many of these infections were in younger age groups. We are now starting to see more infections in older folks, who are more likely to require hospital care 2/n
this would be expected to lead to fewer but more consequential infections in terms of healthcare, and a curve there closer to a plateau. They might drop more quickly than that, and they did in S Africa, but there are more older people here (albeit they are more boosted) 3/n
Why are we not all chilled given vaccines work against severe illness even with omicron? Well in the US (and pretty much anywhere) we are yet to see infections of large numbers of older people, and healthcare is already stretched. Here goes 1/n
So a brief thread on the state of the pandemic in the Boston area. It is quite plausible that about 10% of the population is currently infected, more in some age groups than others. A *lot* of omicron. What next? 1/n
First that 10% figure. Earlier this week, the local school district tried pooled testing before reopening after the holidays. It didn't go well as 157/362 pools came back positive, that's consistent with about 5% of the population being positive
(we don't know exactly, because the individual swabs never got tested. But some pools will have had >1 positive swab by chance, so it is probably more than 5% although way short of some of the numbers in the email parents received. Not great communication there) 3/n
The local school district has done a phenomenal job of keeping education going while keeping transmission minimal in the last year. We all owe everyone involved a debt of gratitude. Recent experience with omicron however, is worth sharing. It's sobering if not very surprising 1/n
The plan was to test the community before returning to school after the winter break. A day of testing, and then the positive cases would be informed and don’t come to school. This is pretty smart in normal circumstances because... 2/n
...prevalence (the number currently infected/infectious) at a given time is not the same as incidence (the number infected in a given period). This would stop a larger number of infectious folks coming into the schools. Great plan. These are not normal circumstances 3/n
Thread worth your time from @JasonSalemi on the remarkable things going on in Florida - a state in which more than a *third* of pandemic deaths happened in the delta wave, which other states with more vaccination were better able to fend off. I will make a couple comments below
Note some of this dramatic vertical line is likely catchup from slower testing over the last weekend. That said, a subset of folks won't be seeking tests. Not clear how that evens out
and this shows hospitalizations starting at the same rate as the delta wave. This is not good *but* the crucial question is how long they continue to increase and whether there is a very sharp peak. There's one other thing...
I liked this because I greatly respect @sdbaral's commitment on these issues, but in the current circumstances I think it is a lot more complicated than this thanks to all the non-linear aspects of infectious disease 1/n
If folks making deliveries had to negotiate poisonous gas, or a horde of vicious venomous kittens from which others were insulating themselves, then sure. But that’s not so here. The force of infection in the community depends on opportunities the virus has for transmission 2/n
If staff in a grocery store are packing deliveries rather than working the till they are still exposed to their coworkers – but they are not being exposed to people who would otherwise be shopping and providing a highway for the virus into a new host, be it staff or customer 3/n