There no longer exists any real debate. Effectiveness of the vaccines have waned over time but as stated in the article "Our findings support the conclusion that COVID-19 vaccines remain the most important tool to prevent infection and death."

A charitable interpretation of GP would be that he referred to ending of restrictions (masks, testing, papers please, lockdowns etc.) after a vaccine becomes widely available. These hopes have certainly been raised by politicians in late 2020 and early 2021 ("just have to get herd immunity through the vaccine and we're done"[1]). However, the reality is that e.g. in Germany case numbers and incidence numbers are reaching new all-time-highs every day now despite 70-75 % of all people being vaccinated.

These hopes were probably based on experiences with "normal" vaccines, which are apt to eradicate diseases through sterile immunity (though there are a bunch of exceptions to this, it's not like we're getting rid of the flu and some other stuff by vaccinations [2]). However, we since learned that a vaccine providing sterile immunity against COVID-19 seems to be off the table (as none of them are), so herd immunity against COVID-19 will likely never be a thing and eradicating COVID-19 is just not possible.

[1] Herd immunity was THE talking point in early 2021 in Germany. Also, remember a few countries trying to get herd immunity by intentionally letting the virus spread (great britain cough cough)?

[2] Sterile immunity seems to be difficult with respiratory diseases (flu, covid, cold, pertussis come to mind). Naively I'd guess that's because the critters have some time to multiply on the surface of the airways and be infectious before the immune system gets a chance to nuke 'em. If that's the explanation though I'm kinda wondering why the herd immunity theory was so common, so it's probably more complicated than that.

> However, the reality is that e.g. in Germany case numbers and incidence numbers are reaching new all-time-highs every day now despite 70-75 % of all people being vaccinated.

COVID cases are nearing all-time highs, but COVID deaths remain significantly lower than before. Source: https://ourworldindata.org/coronavirus-data?country=~DEU

Which is great, but we're still seeing a large influx to ICUs which will cause problems allocating ICU beds shortly (unless the trend reverses). To get that trend reversal high incidence districts are getting more restrictions again.

Ironically we also had a reduction in ICU capacity during COVID because working conditions didn't improve so people reasonably resigned instead of being continually exploited. There has also been a huge increase in hostility towards nurses, doctors and medical personnel in general (mostly driven by the small but aggressive anti-vaxx "community"), which certainly doesn't help retain people.

> we're still seeing a large influx to ICUs

Is this true? I've heard claims in both directions but seen no sources for either.

> mostly driven by the small but aggressive anti-vaxx "community

Same question as above. There's a massive push to fire all the essential workers that took the brunt of the pandemic early on if they happen to believe the growing body of evidence showing that they don't need the vaccine if they've already recovered.

That certainly doesn't help retain people either.

> Is this true? I've heard claims in both directions but seen no sources for either.

https://www.dw.com/en/germany-hospitals-reach-critical-pande...

https://covid19.healthdata.org/germany?view=resource-use&tab...

https://www.thelocal.de/20211108/german-states-bring-in-toug...

https://www.dw.com/en/covid-german-health-chiefs-call-for-st...

https://thegermanyeye.com/hospitals%3A-the-intensive-care-un...

...

Thanks for the links. I get a strong sense from these sources that cases are ticking up in Germany and government is considering more restrictions. I get less strong of a sense that ICUs are primarily filling with severe covid patients. Seems reasonable that if cases are going up, hospital admission (including ICU beds) would go up, but its hard to conclusively validate that from these.

Maybe the second deep link isn't working correctly, but look at the ICU beds used for COVID-19 patients graph. Also the first link. Also from yesterday: "Meanwhile, German authorities issued threats of a new lockdown, while a top virologist called for immediate action in the face of overburdened hospitals. ... Several hospitals have said in recent days that they are again working at their limits and have ICUs so full of COVID-19 patients that they cannot admit new patients at the moment. Charite said Tuesday it had to cancel planned surgeries due to the number of staff members caring for people with COVID-19. Authorities have said most of latest patients are unvaccinated."

https://www.dw.com/en/coronavirus-digest-france-tightens-vac...

For every English article mentioning this situation, there are 100 in German.

I did see the graph from your second link and the projected stats going up and to the right, but I wasn't sure how to interpret it in isolation (for example, what does a graph of ICU usage over time look like historically?)

The media landscape on this topic seems so polluted and untrustworthy that I can't help but wish for some kind of straightforward data supplement to go with statements like

> Several hospitals have said in recent days that they are again working at their limits and have ICUs so full of COVID-19 patients that they cannot admit new patients at the moment

where I can read that and then compare it to a spreadsheet and say yep that adds up. Your second link isn't quite that for me (and I realize its an unrealistic expectation). Another poster in this thread linked to something that was closer, but also didn't quite make the case imo.

Anyways, appreciate the links. It seems clear something is going on in Germany, and I may need to get a hold of my skepticism a bit.

> we're still seeing a large influx to ICUs

The summer waves clobbered various hospital systems in the US on a region by region basis. Winter is likely to be worse. For example, right now Minneapolis is under heavy load, ICUs at >95% across the board. https://covidestim.org concurs, the Midwest is undergoing a wave.

https://datacentral.kitsapsun.com/covid-19-hospital-capacity...

Thanks for the link. I'm not sure if it's showing a large influx due to covid though. For example, the top row in your second link shows 98% beds full, but n/a for covid patients. The second row says 75% ICU beds full, but only 14 positive for covid in the 7 day avg, and its not clear what of those are ICU patients.

It also isn't clear if these are patients in hospital for covid or they just happen to have covid (click on the links in the column headers to see the inclusion criteria).

Agreed, it's not a perfect resource. The other tool I know of is https://coronavirus.jhu.edu/region/us/minnesota, but its resolution is only state level, can't dig in at county or hospital level. Between 30% covid ICU at state level and red hospitals concentrated in Minneapolis, I'm making a guess that it's probably a covid wave hitting Minneapolis.

Unless you've been infected already. Natural immunity is as good or better than the vaccine.

This is does not appear to be true:

"Antibodies elicited by mRNA-1273 vaccination bind more broadly to the receptor binding domain than do those from SARS-CoV-2 infection"

* https://www.science.org/doi/10.1126/scitranslmed.abi9915

> These findings suggest that among persons with previous SARS-CoV-2 infection, full vaccination provides additional protection against reinfection. Among previously infected Kentucky residents, those who were not vaccinated were more than twice as likely to be reinfected compared with those with full vaccination. All eligible persons should be offered vaccination, including those with previous SARS-CoV-2 infection, to reduce their risk for future infection.

* https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e1.htm

I don't know enough about immunology to say whether "binding more broadly" confers more immunity or not.

It would certainly go against prior knowledge about human immune responses for a single spike protein (vaccine) to elicit a greater immune response than _the actual virus_.

That CDC study is so bad I'm surprised they had the gall to publish it with the conclusion they did. Testing positive says nothing about severity of infection.

> were about five times more likely to test positive for the infection than people who had been vaccinated

Testing positive is not a very good metric. Were they hospitalized? Was it severe? Did they even get sick, or just test positive?

They even admit to a sampling flaw in the discussion:

> Second, persons who have been vaccinated are possibly less likely to get tested. Therefore, the association of reinfection and lack of vaccination might be overestimated.

The best study on this so far is from Israel with a much larger sample in a highly vaccinated country. Here's a Harvard doctor discussing the contradictory studies.

https://brownstone.org/articles/a-review-and-autopsy-of-two-...

> For a low-risk person, which includes most people with natural immunity, a 35% risk reduction is more marginal in terms of absolute risk.

> Based on the solid evidence from the Israeli study, the Covid recovered have stronger and longer-lasting immunity against Covid disease than the vaccinated. Hence, there is no reason to prevent them from activities that are permitted to the vaccinated. In fact, it is discriminatory.

I found a Feb 2021 piece from Derek Lowe a good 30k ft overview of how the immune system works. tl;dr it is stochastic, with a wide range of antibodies having different effects against an infection, some of them even negative (OAS). Usually the aggregate effect is positive, and the infection is cleared out.

"It's important to realize, though, that all immune responses to a viral infection generate a mixture of neutralizing and non-neutralizing antibodies. That's one of the things about the immune system - it revs up production of a wide variety of antibodies, selected from the untold billions of them circulating around in your bloodstream. Some of them bind to one part of the pathogen, and some to another. And they bind in different conformations, sticking to different parts of the surface of the invading virus from different directions."

It is conceivable that a targeted vaccine is more effective at shutting down an infection than natural immunity by focusing the immune system to produce a narrow band of very effective antibodies. The tradeoff is that a virus mutation can create a catastrophic situation where the same antibodies are less effective, possibly having negative efficiency enhancing the infection. The risk is amplified by vaccinating the entire population with the exact same protein sequence, creating hundreds of millions of living incubators for the virus to learn how to evade the narrow antibody response.

We are creating a biological landscape prone to black swan events. Good luck convincing any total vaxer that this is a very real risk. They will laugh and sneer and maybe call you criminal because obviously the data shows the vaccines are safe and effective. "Hahaha, I've been told that we're all going to be dead by now, look at those peddling conspiracy theories." Just like the Wall Street crowd created the run-up to the 2008 crisis. Who could have possibly predicted that CDOs were prone to a black swan?

https://www.science.org/content/blog-post/antibody-dependent...

> We are creating a biological landscape prone to black swan events. Good luck convincing any total vaxer that this is a very real risk. They will laugh and sneer and maybe call you criminal because obviously the data shows the vaccines are safe and effective.

If you don't survive the problems of today, then there's no point in worrying about tomorrow's possibilities because you're dead.

The data does show that the COVID vaccines are generally safe and pretty effective. Not 100%, but the perfect is the enemy of the good, and so let's try to improve our lot now so we have a chance to fight for later.

Generally speaking, under 50 populations survive covid fairly well. Under 18 survive almost perfectly, with a higher survivability rate than drowning. Therein lies the problem: we expose the young(er) populations to a black swan event.

Please spend a few minutes to refresh on the data. Some nice dashboards from Singapore (ongoing delta wave), but also e.g. King County, WA (Seattle) shows similar data, though you have to drill down a bit (Demographics tab, then Deaths metric). For example in the past 30 days a total 12 deaths in the under 50 population, for a total of 10% of total covid deaths. Or, since the pandemic started, a death rate of 22/100k or less in all age groups <50, going as low as 0-3/100k for under 30s.

This is not to say that people, especially the elderly, should not get vaccinated if they choose so. It is only a reminder that there is a perception problem around covid and that the long term risk calculus is more complicated.

https://www.moh.gov.sg/covid-19/statistics

https://kingcounty.gov/depts/health/covid-19/data/daily-summ...

Not sure how you could draw that conclusion. The vaccines have been instrumental at reducing the incidence of severe symptoms, hospitalization, and death.

Yes, a lot of laypeople were expecting them to outright prevent infection at much higher rates, but that was never the deal from the start. Consider that the clinical trial protocols only called for testing participants for COVID if they started showing symptoms; the numbers presented were never about preventing infection entirely.

The lower percentages quoted in the article are still pretty fantastic, despite their drop from the initial 90%+ numbers from the clinical trials. Remember that the clinical trials were also done pre-delta variant. It's pretty impressive that they've held up so well against delta.

>"Yes, a lot of laypeople were expecting them to outright prevent infection at much higher rates, but that was never the deal from the start."

What was the deal? It seems like there was a lot of vague verbiage forecasting, and un-falsifiable predictions (which is unfortunately the norm).

> Yes, a lot of laypeople were expecting them to outright prevent infection at much higher rates, but that was never the deal from the start.

It wasn't just laypeople, it's trivial to go back and find prominent public health officials promising that vaccinated people will not transmit the disease, the vaccines will be 100% effective against death, etc. They shouldn't have been saying that given that what you say about the trials is true, but hey, they haven't paid any price for getting it wrong since this whole thing began so why would they now?

In general I have noticed there's this pattern where the public will sometimes be clearly and strongly led to believe a certain thing, but if it later turns out to be false, 100% of the blame is placed on the masses. If there's any rebuke for the officials or institutions which led them into error it's always in the most vague and general terms, with no one ever indicted (or, heaven forbid, punished) by name.

?

I thought the unvaccinated were dying against vaccinated literally 99:1

Am I misinterpreting what you're saying?

https://www.npr.org/2021/07/16/1017002907/u-s-covid-deaths-a...

https://medicalpartnership.usg.edu/covid-19-staggering-stati...

https://www.cnet.com/health/99-of-covid-deaths-are-now-of-un...

https://www.al.com/news/2021/08/99-of-alabamas-2379-covid-de...

https://www.reuters.com/world/europe/italy-says-99-covid-dea...

The 99:1 numbers are very strange. Latest data from UK, which admittedly has a higher vaccination rate than US, gives a death ratio of 1:9 unvax:vax. Caution, Simpson's paradox is at play, older populations where the bulk of the deaths are, are significantly more vaccinated than younger populations. Unfortunately it is really difficult to find equivalent detailed reports (breakdown by age, date & vax status) in US either federally (CDC) or at state level.

https://assets.publishing.service.gov.uk/government/uploads/...

Edit. Oh, I see now. From the fourth article: "99% of Alabama’s 2,379 COVID deaths from January to June were unvaccinated". Alabama had a covid wave in Jan, which then subsided. Mass vaccination only started in Jan, by the time the wave was over maybe 10-20% of the population was vaccinated. The numbers are dominated by the pre-vaccination wave, plus VE is high early on which limits the vaccinated deaths. Verdict: technically correct, but highly misleading.

https://usafacts.org/visualizations/coronavirus-covid-19-spr...

https://usafacts.org/visualizations/covid-vaccine-tracker-st...

> The numbers are dominated by the pre-vaccination wave

YES this right here is such a deliberate sleight of hand by the media, and as GP demonstrated they get away with it a lot!

> 1:9 unvax:vax

Shouldn't this be the other way around? 9 unvaxxed dying for every 1 vaxxed? Otherwise I'm not seeing the quoted claim in the report you linked.

The closest I've been able to find for the U.S. is this Connecticut report on hospitalization. Unfortunately it omits unvaccinated deaths, but we see hospitalizations at a rate of 4:1 (unvax:vax)

https://www.thelancet.com/journals/laninf/article/PIIS1473-3...

Good call. Turns out I did make an error, reading just the >80 column thinking it's 'total', because it happened that that line dominated the table. There are definitely more vax deaths than unvax covid deaths in week 40-44 in UK, but the ratio is smaller that 1:9. Brb, running excel to sum the whole columns. Table 4b, page 19 for raw data.

Edit: The totals come at 669 unvax deaths vs. 3011 vax deaths. The raw numbers ratio is roughly 2:8 unvax:vax. This is not VE, as it is not adjusted to vax levels in the population. It is just a sanity check of certain claims in the US media.

  age    unvax   double vax
  <18    7       0
  18-29  9       5
  30-39  24      9
  40-49  56      46
  50-59  104     126
  60-69  157     355
  70-79  131     822
  >80    181     1648
  total  669     3011

FWIW, all of those articles were from July and August, before Delta began ripping through the population.

I believe with Delta, the ratio is closer to 19:1.

But uh...still certainly a damn good reason to get vaccinated.

> I believe with Delta, the ratio is closer to 19:1.

I don’t doubt your statement but do you have any sources or articles about this? I’d like to learn more detail.

Ridiculous. Vaccines have turned the tide.

We don't have much to compare against since the vaccine is so ubiquitous at this point, but I would bet Delta did more to turn the tide by out competing the original deadly variant.

The vaccine certainly helped, but the tide would have turned regardless. The Amish are a good example of a completely unvaccinated community that "beat" Covid.

> We don't have much to compare against since the vaccine is so ubiquitous at this point, but I would bet Delta did more to turn the tide by out competing the original deadly variant.

We can compare areas of low versus high rates of vaccinations:

> The incidence of SARS-CoV-2 infection, hospitalization, and death is higher in unvaccinated than vaccinated persons, and the incidence rate ratios are related to vaccine effectiveness.

* https://www.cdc.gov/mmwr/volumes/70/wr/mm7037e1.htm

> The Amish are a good example of a completely unvaccinated community that "beat" Covid.

This works well if you're isolated away from the rest of society, and less so if you wish to mingle with everyone else. So if you wish to enact a self-imposed lockdown you're free to do so, but good luck with your social life.

> This works well if you're isolated away from the rest of society

It's counter intuitive, but due to their religious practices they are all frequently in contact with each other.

Covid reportedly "ripped through" the Amish communities early on because they never locked down and continued going to church.

Being rural didn't prevent them from getting exposed to Covid, it's just their traditions resulted in early development of natural immunity.

Consider many rural populations are self isolating since the beginning of time, and not so much as the Amish but 99% in that direction when compared to the city centers.

'Rurality' does not seem to be a guarantee of anything:

"Rural Americans more likely to die from COVID-19"

* https://www.cidrap.umn.edu/news-perspective/2021/09/rural-am...

"Covid is killing rural Americans at twice the rate of people in urban areas"

* https://www.nbcnews.com/health/health-news/covid-killing-rur...

Seems once it (eventually) gets into a community, it can spread quite quickly, and the more isolated nature of the community means reduced readily-available treatment options.

What, from this article, led you to this conclusion?

Nothing. GP started with that conclusion.

no. this is provably false, and no reasonable observer has arrived at this conclusion.