1. So today I want to write a thread I've been nervous to write.
In January and February, according to CDC data, 42% of ppl who died of Covid were vaccinated.
It's possible that in the near future, a MAJORITY of people dying of Covid may be vaccinated.
2. How can this be? What does his mean?
Well, it does NOT mean that vaccines don't work (though seeing many Covid deaths among the vaccinated will make ongoing vax efforts harder). The vaccines work, but they're being asked to do too much & their effects are not equally felt.
3. Different populations are more or less at risk for Covid death. Elderly ppl are, by age, VERY at risk. They are also highly vaccinated. According to the NYT, about 91% of ppl over 65 are vaccinated, compared to just 73% of 18-64 yr olds. nytimes.com/interactive/20…
4. A vaccinated 65 year old, while better protected, is NOT free of Covid risk, especially since the US is asking vaccines to do WAY too much work.
Vaccines are a tool. They lower levels of sickness and death, but they do not stop them, nor do they stop transmission entirely.
5. We are doing WAY too much to hamper vaccine efficacy. They work work best when they encounter viruses as infrequently as possible.
But the lifting of non-pharmaceutical interventions (NPIs) like crowd size, mask, and vaccine requirements is overwhelming vaccines efficacy.
6. And in the absence of NPIs, people who are elderly, disabled, immunocompromised (or some combination) are NOT going to be as protected by a vaccine as people who are younger, able-bodied, and with robust immune systems.
7. The virus is getting more transmissible. As @EricTopol showed in the below sketch, Omicron (BA.1) was more transmissible than Delta, and BA.2.12.1 (the current dominant version of SARS-CoV-2 circulating) is more transmissible than the 1st Omicron. Now, some scary state data...
8. Here's data from the two states I live in most, Illinois and New York. The data shows rising hospitalizations, NY on the left, IL on the right.
Both show that RIGHT NOW, hospitalizations are at the same level now as they were with Delta—and rising.
9. Remember that, unlike last fall, there are few or no:
—mask rules
—crowd rules
—vax requirements for stores, movies, sports events
—there's NO MORE FREE TESTING OR TREATMENT for the uninsured
And—scary as it is—remember that BA.2.12.1 moves more & faster than Delta
10. The good news is that vaccines are responding well at preventing death (tho not necessarily at preventing long Covid), tho not equally for everyone.
The bad news is that the vaccines aren't working as well as they did during the Delta—and not just bc of fewer NPIs.
11. Vaccine efficacy is waning over time. And when it does, the effects of that lessening protecting will harm the elderly more than younger ppl, the disabled more than abled ppl.
The answer to waning efficacy are NPIs (almost all gone) and boosters.
And, hoo boy...
12. According to the CDC, we are woefully under-boosted.
About half (49.4%) of all eligible have gotten boosters, but only a third (32.3%) of those over 65 have!
Those vaccinated but un-boosted seniors (w waning immunity & less protection from NPIs) = vaccinated deaths.
13. Now, why have half the eligible general population not gotten boosted?
Why have 2/3 of SENIORS not gotten boosted?
It's NOT bc they are suddenly vax hesitant! They got vaccines!
It's bc, largely, the vast public health apparatus that vaccinated America has disappeared.
14. Money for Covid?
Gone.
The ability for the uninsured to get tested or treated for free?
Gone.
Mass vax centers?
Gone.
National advertising campaigns?
Gone.
What survived?
—Spending on war
—Middle/upper class ppl WFH
—Ppl who see Drs. anyway getting boosters.
15. What is emerging is what I have feared all along—what I have studied for a decade with HIV/AIDS, and what I see happening with SARS-CoV-2.
This is virus is not becoming "endemic" at this point necessarily; it is settling into what I call a "viral underclass."
18. But where it transmits and who it will hospitalize or kill will create two difrent groups.
For instance, only 8% of office workers are FT in Manhattan. They’re less likely to be exposed & more likely to be boosted, rest if infected, get Paxlovid nytimes.com/2022/05/10/bus…
19. At the same time, ppl who are undocumented line cooks might be vaxxed. But they don’t WFH but 100% in poorly ventilated kitchens. They are seeing unmasked ppl all day. They’re unlikely to be boosted & can’t afford testing or treatment.
They, too, may die while vaccinated.
20. In terms of boosting, the same dynamic is emerging w SARS-CoV-2 as I see w HIV/AIDS.
HIV is a slow acting virus. It can take yrs to make you sick, 10-15 yrs to kill you. Yet ppl (usually Black & homeless) will show up on death’s door in ERs & die of AIDS days later.
Why?
21. Because they’ve not seen a doctor in 10-15 years and never knew they had HIV let alone AIDS.
The uninsured can’t get Covid tests—even tho we KNOW not having access to healthcare means you’re more at risk for severe Covid sickness and death.
Ppl w insurance—already less at risk for Covid death—will get boosters at their annual checkups & enjoy protection. (Good.)
But ppl w/o insurance—already at MORE risk for Covid death—won’t get boosted & their vax efficacy will decrease . (Bad.)
23. THIS is how the viral underclass wil comprise a majority of Covid deaths. Despite getting jabbed in the largest mass vaccination campaign in US history, they’re largely denied boosters, NPIs, good ventilation, etc (and plagued by pre-existing social determinants of health).
24. It didn’t have to be this way!!
The US could have admitted we COULD vaccinate 4 million ppl a day (!) and pay for the healthcare ppl need & kept that infrastructure to deliver boosters & treat cancer and MS and HIV & anything else.
We could have learned, adapted & grew.
25. Instead, the infrastructure was dismantled and we got war, increased economic inequality, more oligarchy and a return to normal.
But normal produced a million deaths! The ruling class wanted to trick us into accepting ONE MILLION DEATHS as “normal.” scientificamerican.com/article/there-…
26. If you’d like to know more about the history of the viral underclass, and would like to learn from people I’ve learned from, reported on and loved who live in it, please check out my book 🙏🏾 bit.ly/viralunderclass and be in conversation w me this summer & fall about it
27. Some other reading and action resources:
Union your workplace. As workers, use your collective power to make your communities safer.
28. Learn about and support disability-centered activism, like the Disability Visbility project, who are doing such important work to create a world where pandemics are less likely to happen and less severe on humans when they do disabilityvisibilityproject.com
30. Read @wsbgnl, whose tweet showing nearly half (47.7) percent of Arizona’s Covid deaths inspired this thread. @wsbgnl is the clearest, sharpest, most precise and most ethical interpreter of data I’ve read on this site
36. Learn about abolition, and how it can create a world without policing, racism, ableism and violence—and which can allow wellness to flourish—by reading books like @dereckapurnel’s penguinrandomhouse.com/books/675803/b…
43. Librarians to the rescue. We are going to need more of this, please -- tho at the end of the day, we will need the state to step in and capitalists to step aside
45. For those carping abt probabilities, I do understand them & that we could think abt risk of death per 100K of ppl who are vaccinated vs 100K who are not vaccinated.
But that’s not what I’m interested in, nor does it answer the questions I think are most important right now.
46. Last September, President Biden called this a “pandemic of the unvaccinated.” This was wrong for many epidemiological (and ethical abs public health related) reasons. It gave ppl who were vaccinated the impression what they had to do was done; NPIs weren’t needed and
47. that the only reason the pandemic was lingering on was due to ppl who were unvaccinated. This was not true! Some very vulnerable ppl were unaware of their risks and made lethal decisions. Society largely failed to upgrade ventilation. Scapegoats were named & blamed.
48. But how can you call it a “pandemic of the vaccinated” (which is unfair to ppl who are unvaccinated for a variety of reasons, including infants) when 1/3, or even near 1/2 are vaccinated?
And to circle back to math: this can NOT be explained just by probability.
49. The share of vaccinated ppl *dying* has seemed to grow over time. It does not correspond with an increase in the percentage of ppl who are vaccinated (that’s been flat for a long time) against a decrease in a percentage of ppl who are unvaccinated (also flat).
50. What has changed;
— Who is vaccinated and BOOSTED and who is vaxxed and NOT boosted
—Whose vax have CONTINUED protection versus whose vax offer DECLINING protection
—The conditions of being in (or out) of the viral underclass have created more or less risk
51. Vax is but one tool (and the US has largely given up on increasing its use). There is SO MUCH MORE we can do— like NPIs, better ventilation, and addressing the root causes of what makes a viral underclass in the 1st place that would benefit EVERYONE bit.ly/viralunderclass
52. But we cannot do it by thinking of this as a “pandemic of the unvaccinated.” Not when so many for who are also vaccinated. Not when we need ALL the tools. Not when pandemics, by definition, are global and affect all 7 billion human animals (& often nonhuman animals, too!)
53. The “but statistical probability!!!” crowd really isn’t ready to deal w this. They see every person as a numerical widget & don’t account for waning vax protecting it impacts of class, race etc. Nor for inability to individually calculate risk. Universal precautions, plz!!!
54. Probability people: This is the goal. Cuba is pretty near full vaccination, they have universal healthcare and they STILL use NPIs. And look! 0 percent of their deaths are of vaccinated people, because…
A side note to the Berkeley law dinner fiasco: Professors shouldn't have work events with students in their homes!!!
This is a problem which extends beyond this situation. "Chemerinsky, who is Jewish, says that the incident is the latest in antisemitic attacks on him and that free speech does not extend to his home." OK, then don't have work events in your house! latimes.com/california/sto…
This is all so bizarre to me. UC Berkeley is a public university & this was a UC Berkeley event! Yet the professor is arguing the mortgage is in his & his wife's names & "No one has the right to come into my house, or yours, and disrupt a dinner." HE INVITED THE PERSON WHO SPOKE!
Cheap rent made Philip Glass possible too, who told me in 2012: “The problem is, when I came to New York, it’s much more difficult now. You could work 3 days a wk loading a truck or driving a cab, and you’d have enough money to live off of" the other 3+ weeks to do your art!
“Work," Glass said, "was a seasonal business! Can you imagine??? "You worked the weekends around the first of the month. And then you had the middle of the month to do your sculpture or your painting or your poetry or whatever you do." Cheap rent made that possible!
Manual labor, Glass said, was great—they didn't even own a van! No pressure, even for parking! "You were in great shape. You were physically very strong bc it was hard work but easy. Hard work but easy to do. Didn't take any brainpower & you didn't have to go to work every day."
As the sheriff evicted an elderly couple and was removing a handicapped woman with Parkinson's disease from their home, her partner doused himself with gas and set himself on fire. "This," Aaron Bushnell so presciently said, "is what our ruling class has decided will be normal."
The framing of this story is wild - the headline makes it about the neighbors' reactions, and the sub headline says the sheriff's office "saved one life today, but the outcome wasn't what they wanted." But the deputies' actions took a life, they didn't save any lives.
Their execution of an eviction also executed the end of one life right away and two lives, really -- what is going to happen to this elderly, disabled and now homeless woman? She already lost her home, and the eviction killed her partner and caretaker.
This is very sad, but I have some thoughts. I think Cecilia would have wanted the truth out there (I certainly do) as she didn't want anyone to feel shame about anything, but I think she'd be sad the major response is to arrest and prosecute the dealers. patch.com/new-york/new-y…
I never feel comfortable when young-ish people die and no one says why. It's usually because they died of overdose or suicide (or, going back a few decades tho sometimes still now, AIDS). Treating them as unspeakable only increases stigma.
Cecilia didn't do stigma.
She didn't do shame, and she wouldn't want other people to feel stigma or shame or to experience barriers to getting help. And when we don't talk about HIV/AIDS, suicide or drug addiction, we increase the barriers to people getting help.
I have been getting really angry at liberals lately. I am not wholly sure why, but it has something to do with feeling gaslit when they pretend like verifiable truths aren't true, in (likely vain) the hopes Biden will stay in power because it benefits them, if almost no one else.
It is provably true that 2.5 as many people have died of Covid under Biden than under Trump, even tho the latter had the vaccines & the former did not. And it's true that death by genocide, record homelessness, and this latest ban on gay pride flags happened under Biden.
Liberals pretend like this simply isn't true, or that it doesn't matter. But it is true, so either a) it doesn't matter to them that Biden has done these things or b) they don't think he could control them. But if he can't control it, then c), it doesn't matter who is president.
There is a video of an Israeli drone that is so disturbing, it is worse than the most horrifying, torture porn scene Hollywood could ever imagine. I can't fathom the terror of the last man killed, hunted after seeing his friends blown up, knowing the end is coming. But selfishly—
what I find equally is terrifying is that there isn't an elected Democrat in Washington, or federal spokesperson, who will condemn it. It could be narrated in all its horrors and Matt Miller or Kirby or Jean-Pierre will look bored and say, "Yeah, so what?"
They won't condemn it. They don't mind it. It's coming here! Even liberal San Francisco voters just gave their police department the right to use drones! Every horrifying thing we have seen in Israel, every depraved act of SAW-like torture used on Palestinians, it's coming here.