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Andrew Noymer 🇺🇦 Profile picture
Andrew Noymer 🇺🇦
@AndrewNoymer
Medical/health demography, [historical/social/*] epidemiology. Public health. Arsenal.
Dec 19, 2022 • 8 tweets • 2 min read
Goalpost-moving, a short thread. 0/7 I remember a few years back there was a measles case at UCI Medical Center. They pulled out all the stops. Negative-pressure room, PPE, yada-yada. Lots of sturm und drang about how contagious it is. 1/7
May 27, 2022 • 6 tweets • 2 min read
We need to speak more candidly about the covid vaccine effectiveness.

This is the dashboard from UC, Irvine. To work here or be a student, requires being vaxxed AND boosted. Ostensibly, all of these — 408 active cases, of which 64 incident yesterday — are vaxxed and boosted. Yes, there are a small number of granted exemptions, and, yes, some people may be non-compliant (especially as regards boosters, though that's speculation on my part).

But there *has* been enforecement, including at least one non-vaxxed tenured faculty member being fired.
Mar 11, 2022 • 4 tweets • 1 min read
The big pandemic of the 19th century was the cholera outbreaks in large European cities. Hamburg and London, especially.

mini-THREAD. These cholera epidemics helped John Snow make case for modern germ theory of disease. Also spawned massive & costly public health response: clean drinking water.

Ppl were provided w/ clean(er) drinking water, whether they wanted it or not; society (writ large) footed the bill.
Aug 24, 2021 • 6 tweets • 2 min read
Let's talk Junes. Short thread.

June 2020. Pandemic was still new and chaotic. Here in California, our first big wave was brewing (would peak in July). We didn't have the devastaion in March/April that NY etc. had had.

We were hoping for seasonality, but no... summer wave. cont'd

So, in June 2020, we didn't know that much. There were diverging opinions about whether the fall would bring more and when the wave(s) would peak.

❦

June 2021. California has low community transmission; very low. Statewide color-coded tier system is scrapped.
Apr 29, 2021 • 15 tweets • 3 min read
Thread on why mRNA vaccines may be giving better immunity vs. SARS-CoV-2 than surviving natural infection.

disclaimer: we still don't understand the long-term correctness of the claim that vaccines are better protection than natural infection.

TL;DR: it's different kind of vax In this thread I will offer some speculation as to why it's scientifically plausible that the vaccines offer better protection than surviving natural infection.

This is what it is, speculation.

As I said in the parent tweet, it remains to be seen how true this phenomenon is.
Mar 28, 2021 • 6 tweets • 2 min read
Regional covid epidemiology in the US of A.

A short 🧵.

Living in California, I have been increasingly optimisitc of late. Pic related.

But... ... continued

But, New York and New Jersey, OTOH, are giving me the heeby jeebies...

... my thinking *before* this pandemic was that the next pandemic would see rapid spread, leading to regions being in phase with one another. Ex., there has not been a ground-stop of aviation.
Mar 28, 2021 • 4 tweets • 1 min read
CALIFORNIA UPDATE.

Counties.

Covid deaths per million residents; minimum 100 covid deaths:

Imperial 3,916
Los Angeles 2,284
San Bernardino 1,815
Stanislaus 1,804
Tulare 1,745
Riverside 1,733
San Joaquin 1,661
Fresno 1,610
Kings 1,592
Merced 1,580

continues... California counties, covid deaths per million population

continued:

Orange 1,479
Madera 1,465
Kern 1,350
Ventura 1,139
Shasta 1,122
Sutter 1,074
San Diego 1,059
Sacramento 1,038
Santa Clara 998
Santa Barbara 983

continues...
Feb 10, 2021 • 4 tweets • 1 min read
CALIFORNIA. Update.

Counties. Covid-19 deaths per M population (minimum 100 deaths):

Imperial 3,151
Los Angeles 1,817
Stanislaus 1,590
Tulare 1,419
Riverside 1,393
Merced 1,336
Fresno 1,265
San Joaquin 1,234
Madera 1,199
Kings 1,169
Orange 1,072

continues... California. Counties, cont'd

San Bernardino 1,006
Shasta 911
Sacramento 877
San Diego 853
Santa Clara 813
Ventura 803
Santa Barbara 779
Yolo 771
Kern 740
Marin 697
Monterey 668
Butte 640
Alameda 631
San Luis Obispo 627
Santa Cruz 583
San Mateo 581

continues...
Dec 13, 2020 • 5 tweets • 3 min read
Remember this 👇🏻 chart?

I received request for a breakdown by age groups.

I forget who it was; sorry.

Well, ask and ye shall (sometimes) receive.

*THREAD*: All-cause mortality, weeks 1 thru 35 (early Sept). 2015–20, BY AGE, w/trend-line and 95% prediction interval. Here is ages 0–24 (L) and 25–44 (R).

Deaths and 95% prediction interval. Input data from @NCHStats.
Oct 19, 2020 • 9 tweets • 3 min read
#minimodel (👇🏻) guesstimate of Covid-19 infection fatality rate is less than 0.3%, which is in the same ballpark as IFR of flu (0.1%, also an estimate).

In this THREAD, I will explain how this fact has been misconstrued/misused to mean Covid-19 pandemic is a nothingburger. I'm thinking here of crowd jumping up+down "see! the IFR is same as flu!!!".

Covid-19 IFR is indeed around that of flu. I don't say "low", since everything relative. IFRs are in the same ballpark.

But C-19 will kill far more people in the same time period than flu.

continues
Oct 19, 2020 • 4 tweets • 2 min read
Friends, as you know I've advocated #masks for long time. Certainly longer thn @CDCgov & people at my... place of employment.

Qualitatively, I believe they work. How much they protect is hard to quantify, however.

Today, saw something thought provoking in this vein.

continues: Anti-masker in inbox wondered what we say in a year, when (in his words/imagination of future), consensus changes against masks.

If can't quantify good masks do, how we know benefit isn't marginal?

Valid question, but #PrecautionaryPrinciple says not to play no-mask roulette.
Sep 25, 2020 • 4 tweets • 1 min read
Let's talk about emerging C-19 narrative of "shield sensitive groups". Thread will be USA-centric; I live in US of A, so.

This is C-19 strategy emphasizing nursing homes/elderly, & a euphemism for everyone else to "[keep calm and] carry on".

It won't work. Especially in USA. Why won't it work?

Where I live, Calif, 26% of C-19 mortality has been in people younger than 65, and 7% has been in people 18–49.

C-19 mortality in CA has been disproportionately felt by the Latinx population and elsewhere in the USA, Blacks have been in a similar position.
Sep 21, 2020 • 5 tweets • 2 min read
So... going off @Worldometers data, the COVID-19 deaths per million population (as of today) is 591 in Italy, and 620 in Florida.

In March, I was worried about the impending mortality impact of COVID-19 in the US of A.

And no place worried me more than Florida...

1/ 2/
No place worried me more than Florida because of its famously old population structure. (For my friends overseas who don't pay attention to US demographics, many people from all over the USA move to Florida in their retirement, because of its mild winters.)
Aug 23, 2020 • 7 tweets • 1 min read
Convalescent serum: the new hydroxychloroquine. Convalescent serum has a long and successful history in fighting disease.

But that doesn't mean that it will necessarily succeed for *any* disease.

It needs to be studied better before make any all-in bets.
Aug 18, 2020 • 4 tweets • 2 min read
Orange County, Calif.

occovid19.ochealthinfo.com/coronavirus-in…

My first update after some days off.

SITREP:

The ICU numbers are looking MUCH better than July. Good news!

I'm old enough to remember 2-digit ICU numbers, but this is progress.

Projected days until 2,000th COVID-19 death: 70. Image I have switched from doing a forecast of days until the 1,000th death, to days to the 2,000th death.

Basically, this is because the 1,000th death is too close, already. It is destined to happen. Early September sometime.

The 2,000th death on the other hand is...

continues
Aug 5, 2020 • 4 tweets • 2 min read
Latest:
*VERY* crude math:

USA: 4,918,420 cases; 160,290 deaths

Figure 10× under-reporting factor, all-infections:cases

Unadjusted (wrong!) infection-fatality rate abt 0.33%

~70% of pop will get it eventually; 328m pop'n

➡️ 740,000 deaths

Not a forecast. Just a gut-check. The #MiniModel declines again, 740,000 deaths.

Today the USA surpassed 160k deaths, and is nearing its 5 millionth confirmed case.

More info on the minimodel, in this thread:
Jul 30, 2020 • 5 tweets • 2 min read
I have received some ribbing #OnHere for using logarithmic vertical scale.👇🏻

Friends, I know you can handle it.

Have also heard "but the trolls...". I don't care about the trolls. The trolls can fuck off.

I will explain in this short thread some of the virtues of log scale. Image Without log scale, it's hard to plot deaths and cases on the same coordinate system. Cf. examples below.

And since the death to case ratio is such an important quantity, it's important to see how they relate — and it's really nice to see this on the same axes.

continues. ImageImage
Jul 30, 2020 • 4 tweets • 2 min read
Latest:
*VERY* crude math:

USA: 4,568,037 cases; 153,840 deaths

Figure 10× under-reporting factor, all-infections:cases

Unadjusted (wrong!) infection-fatality rate abt 0.34%

~70% of pop will get it eventually; 328m pop'n

➡️ 770,000 deaths

Not a forecast. Just a gut-check. Minimodel holding steady at 770,000 deaths.

The recent increase in deaths has stabilized the death-to-case ratio somewhat, even in the face of >60,000 daily cases. This is why the minimodel is not declining every day.

Decomposing the minimodel:
Jul 27, 2020 • 7 tweets • 2 min read
AN EXPERIMENT.

Pandemic mortality shortcasting.

I have been skeptical #OnHere about medium-range (3–6 month) mortality forecasts. Too many hidden pitfalls.

Partly so that I can take a deeper dive on the numbers, I am going to try my hand at one-week mortality numbers for USA. Pandemic mortality shortcasting, cont'd

A few notes, FIRST.

(1) One-week forecasts are easier than 3-month forecasts. If mine are successful — and that remains to be seen — then it won't be a great feat. One week is the blink of an eye.

continues...
Jul 25, 2020 • 4 tweets • 1 min read
Just to be clear: When you hear that a decline in place X is due to herd immunity, it means that that place won't have a second wave. No fall wave. No winter 2020–21 wave. No spring 2021 wave. A trickle of cases is consistent with H.I., but second wave is not.

So, we shall see. Image I'm on the record as saying that I don't believe New York City and other places have reached herd immunity yet. We shall see. I shall be glad to be wrong on this one.
Jul 15, 2020 • 4 tweets • 2 min read
Latest:
*VERY* crude math:

USA: 3,545,077 cases; 139,143 deaths

Figure 10× under-reporting factor, all-infections:cases

Unadjusted (wrong!) infection-fatality rate abt 0.39%

~70% of pop will get it eventually; 328m pop'n

➡️ 900,000 deaths

Not a forecast. Just a gut-check. Minimodel down to a nice round number: 900,000

However, I am #OnTheRecord as saying that — on an excess mortality basis — the USA won't escape with fewer than 1,000,000 deaths.

continues...

more about the minimodel in this thread: