233 thoughts on “Lancet anti-booster Article: Lame-o.”

1. “has provided credible evidence of substantially declining protection against severe disease”
   .
   Credible, substantial, severe. Meh. Those are rather carefully chosen words to infer no evidence. Lying without lying. Guess what happens if you don’t give boosters? You don’t get evidence. Circular.
   .
   If the boosters reduced severe disease by even an additional 2% that is a rather large pile of bodies. It is true maximum effectiveness globally is by giving people first inoculations instead but this is not a zero sum game, one can do these things simultaneously.
   .
   The problem with most of the the third world seems to be logistics and nobody is arguing against increasing production. Why can’t they write an op-ed on that instead. The US has been off of max vaccinations for months now, those vaccines are going somewhere.
   .
   This virtue signaling on vaccine equity will be ignored just like all the previous ones were. The authors will likely be first in line for their booster but won’t be taking selfies.

2. FDA Says Covid-19 Vaccines Remain Effective Without Boosters
   Agency scientists express skepticism that an apparent diminished protection is rendering the vaccines ineffective
   https://www.wsj.com/articles/fda-says-covid-19-vaccines-remain-effective-without-boosters-11631726504
   .
   “FDA scientists wrote Wednesday that they considered concerns that recent studies that show diminished levels of antibodies and weaker protection against symptomatic Covid-19 may result in additional severe disease, and that the contagious Delta variant has further spread the virus. Yet they expressed skepticism that an apparent diminished protection is rendering the vaccines ineffective, as some observational studies have suggested Pfizer-BioNTech vaccine’s diminished protection against symptomatic disease or against Delta, while others haven’t.”
   .
   I don’t think the argument is causing them to be “ineffective”, the argument is boosters make them “even more effective”.
   .
   It’s going to be laughable if the administration tries to force vaccine mandates while the FDA won’t authorize boosters. I doubt the FDA is remotely prepared for the amount of blowback they will get if they don’t authorize boosters.

3. According to the Lancet article’s logic, people who have infection acquired immunity shouldn’t get vaccinated at all. I doubt the authors even considered this conclusion considering the more or less general move to ignore infection acquired immunity.

4. Tom,
   I agree. There is no reason why we should avoid the boosters if the remain “effective” (with ‘effective’ defined as some number less than 100%). The question is whether the booster provides material additional efficacy with low risk of side effects. The Israeli data suggest they do.

   It’s utterly idiotic to require vaccine to become ineffective before giving boosters.

   Sadly, the Lancet authors have created a “language” by simply making claims about “the” goal of vaccines. But it’s nuts. Vaccines and boosters are useful if they provide some material benefit without risks that overwhelm those benefits.
   .
   Ignoring benefits as “the wrong kind” is morally wrong. I should be able to protect myself against being sick two weeks, getting long covid, having brain fog and a host of other issues that infections open one too. I shouldn’t be limited to protecting against “hospitalization” and “death” only!

5. Is there anything different about the boosters, or are they just a third dose of the same vaccine?

6. I just don’t see the point of the boosters. So far as I can tell, a high level of circulating antibodies helps fight an upper respiratory tract (URT) infection. But circulatory immune memory is not nearly as effective against an URT infection although a secondary immune response should still protect one from severe illness.
   .
   Yeah, it would be nice to avoid a head cold. But not at the price of injecting an experimental vaccine every 8 months, with a possibility of severe side effects each time. That does not seem reasonable. At least not to me.
   .
   On the other hand, if we get a nasal vaccine that induces long lasting mucosal immunity, then I am very interested. Progress is being made: https://stories.uh.edu/2021-intranasal-covid-vaccine/index.html

7. MikeN, At least for Pfizer, the third dose is the same as the first two (30 ug), per Pfizer’s submission to the FDA.

8. Two FDA employees who deal with vaccines resigned, citing the Lancet article. Their complaint is that booster risk should not be dismissed, and they should be recommended primarily to immune compromised individuals.

9. MikeN,
   If they resigned, based on the content of the Lancet article, they have no critical thinking skills.

   that booster risk should not be dismissed

   No one advocating boosters has said risks shoule be “dismissed”. Of course one should consider risk just as one did for the original vaccine roll out and just as one does for other medicines. That doesn’t mean one should just pearl clutch at “what ifs there is a risk?”.

   I read the paper and note the authors of the paper cite nothing suggesting there are risks specific to boosters. One of those authors is Gruber former of the FDA who announced her intention to retire in November. Evidently whatever risk there may be she can’t seem to provide evidence they exist in that Lancet paper. Her coworker Krause — also retiring– is a lead author of the paper. And whatever concerns he has of risk he also didn’t manage to show any evidence they exist.

   Yes. I’m aware these two people left the FDA.

   Of their retirement, MSNBC write

   That story is certainly plausible — but it is more likely that their decisions to leave reflect a growing tension between career officials who have been pushed to the brink and felt at times irrelevant or unsupported.

   That is: They are disgruntled to no longer be the “big whigs” they were before.
   https://www.msnbc.com/opinion/why-these-covid-vaccine-scientist-resigned-fda-n1278207

   If there are concrete risks, the two of them should tell the world what they are and provide evidence. Instead, one is the lead author of a prominent article that somehow manages to describe no concrete risks to those who take the vaccines. That they left the FDA is not “evidence” of risks and should carry pretty much no weight in favor of the position they advance in their opinion piece.

10. MikeM

    I just don’t see the point of the boosters. So far as I can tell, a high level of circulating antibodies helps fight an upper respiratory tract (URT) infection.

    The evidence from Israel points to an 11 fold increase in protection against infection and a 15 fold increase in protection against severe infection. I see this as “the point” of boosters. I’m not sure how measurments of antibodies one might dub as “high” vs “medium” or “low” negates this.

11. MikeM

    But not at the price of injecting an experimental vaccine every 8 months, with a possibility of severe side effects each time. That does not seem reasonable. At least not to me.
    .

    I don’t see injection as a big deal. But I guess if you see it as a “price” you wouldn’t get a booster. I see this as a trivial thing to do and it’s certainly less of a bother than getting a head cold (or, ahem… worse.)

12. MikeN

    Is there anything different about the boosters, or are they just a third dose of the same vaccine?

    Current proposals appear to be they are just the same. Future ones might be different– but of course that would require approval too.
    There is some work on lower dosages. There is some work on boosters that match delta spikes.

13. Lucia,
    IIRC, the proposed Moderna booster is lower than the original doses… I think 1/3 or 1/2 the original. The Pfizer booster appears to be the same dose. I guess too many side effects for Moderna injection at the higher dose. One of my sons became quite sick for 30 hours with the second Moderna dose.

14. Thanks Steve, I thought the lower does was a “might happen in the future” thing.

15. I think the main issue at the FDA is whether it has been proven that the booster makes a substantial difference in severe disease outcomes. They are skeptical of the data they have seen. It’s not exactly clear what problem they have with the Israeli data beyond NIH (Not Invented Here).
    .
    This is a common thing at the FDA, clearly proving efficacy before one can market a drug, usually a good thing. The difference now though is that what happened in the south with delta has a very good chance of happening elsewhere in the US this winter and the booster might make a difference without much added risk. Waiting 5 months until efficacy is proven has more risk. Ultimately I think they will approve it.
    .
    Apparently the Moderna booster will be half strength. That’s what it is in the UK and what Moderna wants. The Pfizer vaccine has only 30% of the same “stuff” that Moderna does. They just guessed different on initial dose.

16. The Israeli data was published in the New England Journal Of Medicine yesterday.
    https://www.nejm.org/doi/full/10.1056/NEJMoa2114255
    .
    “At least 12 days after the booster dose, the rate of confirmed infection was lower in the booster group than in the nonbooster group by a factor of 11.3 (95% confidence interval [CI], 10.4 to 12.3); the rate of severe illness was lower by a factor of 19.5 (95% CI, 12.9 to 29.5). In a secondary analysis, the rate of confirmed infection at least 12 days after vaccination was lower than the rate after 4 to 6 days by a factor of 5.4 (95% CI, 4.8 to 6.1).”
    .
    Same thing, basically this just means it was peer reviewed. The NYT covered it and had some bizarre takes, it’s getting pretty weird from the “vaccines are the greatest thing ever and you should be forced to take them” crowd.
    .
    https://www.nytimes.com/2021/09/15/health/covid-booster-shot-data.html
    .
    “What the Israeli data show is that a booster can enhance protection for a few weeks in older adults — a result that is unsurprising, experts said, and does not indicate long-term benefit.
    “What I would predict will happen is that the immune response to that booster will go up, and then it will contract again,” said Marion Pepper, an immunologist at the University of Washington in Seattle. “But is that three- to four-month window what we’re trying to accomplish?””
    ““If you really use infection as an outcome, you probably need a booster every six months, which is unrealistic and unattainable,” said Dr. Peter Chin-Hong, an infectious disease expert at the University of California, San Francisco. “I don’t care about symptomatic disease — I care about severe disease.””
    “When the Israeli figures are broken down by age, only people above 60 show a notable drop in efficacy against severe illness, noted Dr. Celine Gounder, an infectious disease specialist at Bellevue Hospital Center and a former adviser to the Biden administration.”
    .
    ???. It also doesn’t indicate there isn’t a long term benefit. There isn’t long term data yet, because … duh.
    .
    “Two scientists who lead the F.D.A.’s vaccine branch said they would leave the agency this fall, in part because of their unhappiness over the administration’s push for booster doses before federal researchers could review the evidence.”
    “Other experts questioned that premise, saying there is no data to suggest that the drop in transmission would be significant enough to justify boosters.”
    .
    Here’s the data, review away. What data are they referring to? It’s all so strange, now they seem not to care about infections. Perhaps they weren’t listening to their own mouths when they yammer endlessly about masks and social distancing for vaccinated people.

17. Tom Scharf,
    “it’s getting pretty weird from the “vaccines are the greatest thing ever and you should be forced to take them” crowd.”
    .
    Truth is, it has always been pretty weird with that crowd. If people have the option to get a booster, and that booster reduces risk of infection or severe illness by a factor of 10, then there is only 10% as much motivation to force those who don’t want the vaccination to get one. I honestly think the Biden Administration is full of crazy people.

18. And for goodness sakes, somebody get Russell lined up for a booster. Maybe he will bitch about flogging people only 10% as much after a booster.

19. Tom

    This is a common thing at the FDA, clearly proving efficacy before one can market a drug, usually a good thing.

    Yes. Usually a good thing. And some at the FDA are so used to thinking of it as “a thing” that they no longer think about when and why it is a good thing. Ordinarily, we are not in a pandemic. The harm of delay is numerically small. It’s important to those few who could benefit.
    .
    But in this case, (which was also the case for first approval) there are great harms associated with delay of something that is efficactious. So the balance should be toward approval as long at there is no evidence of harm. That’s why I’m pointing out the Lancet article points to zero evidence of concrete harm. If this thing does no harm and might even a little good then it should be approved. Of course we don’t have certainty. But they have the balance backwards given the fact that we have a pandemic.
    .

    And for goodness sakes, somebody get Russell lined up for a booster.

    Absolutely. Even if it turns out the only “good” is peace of mind, that’s still a benefit!

20. Tom

    for a few weeks in older adults — a result that is unsurprising, experts said, and does not indicate long-term benefit.

    Oh. Sheesh! Well, of course, we only have empirical evidence for the time frame since the vaccines were given!! But this assumption of magically vanishing immunity of boosters with perpetual protection from the original vaccine requires nearly magical thinking!

21. Thanks Lucia for pointing out the Lancet fatuousness.
    On a different note better than boosters of the same vaccine would be an orderly extra cover by one dose of any other covid vaccine at 6 months and a third at 12 months.
    As I pointed out a year ago the benefit of multiple different vaccines is that they each individually add a little bit of different protection to individuals.

22. Ohworse and worse!!

    “What I would predict will happen is that the immune response to that booster will go up, and then it will contract again,” said Marion Pepper, an immunologist at the University of Washington in Seattle. “But is that three- to four-month window what we’re trying to accomplish?””

    Uhm… as opposed to what? Less protection for those 4 months with continued less protection if we don’t take a booster? Do these people have zero critical thinking skillzzzzzz? (Ok.. rhethorical.)

    “If you really use infection as an outcome, you probably need a booster every six months, which is unrealistic and unattainable,”

    Huh? It’s not unrealistic or unattainable. We have excess vaccine!

    said Dr. Peter Chin-Hong, an infectious disease expert at the University of California, San Francisco. “I don’t care about symptomatic disease — I care about severe disease.””

    Oh? Well sheesh. I guess he must think we don’t need shingles vaccines! Cuz normally people do care about symptomatic disease. And beyond that: Why shouldn’t what Icare about matter. If he doesn’t want a booster because he doesn’t care about “symptomatic disease he doesn’t need to take one. But why in the heck should he let his mere preference drive what other people with different preferences are able to get? There is no good reason other than he wants wants to impose his preferences!

    “When the Israeli figures are broken down by age, only people above 60 show a notable drop in efficacy against severe illness, noted Dr. Celine Gounder, an infectious disease specialist at Bellevue Hospital Center and a former adviser to the Biden administration.”

    News flash: I’m over 60. Are you going to permit people my age to get boosters? It’s sounding like you are saying that even though it would benefit me, you are against it because it won’t benefit others.

    It’s all so strange, now they seem not to care about infections.

    And yet, every infection results in a possibility of mutation. And every infection results in a possibility of transmission to someone who is not vaccinated.
    .
    We can’t really force everyone to get vaccinated. But boosters appear to make those who get them avoid infection– and so reduce overall mutation rate. And by avoiding infection make us not transmit to others. How have these “good things” suddenly come to not matter? It makes no sense and my head is spinning.

23. The link to the Lancet article isn’t working.
    I am wondering if the letter I saw is not referring to the Lancet paper as I wrote, but instead IS the Lancet paper.

24. Mike:
    I think I fixed the link:
    https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02046-8/

25. MikeN:
    I do think the story is:
    Two FDA employees resigned claiming it has something to do with boosters. Those two were among the authors of the Lancet article. One is the main author.
    .
    One might have hoped they could make a good case for their opinion when writing that long article. But really, it’s not a good case. My view is: they have an old “FDA POV”. They don’t like others treading on FDA toes. They are grumpy. Much of the reason they resigned (and wrote the letter) is they are used to being able to enforce the FDA view.
    .
    Mind you: The ‘FDA view’ is ok in some instances. But when it is, it ought to be possible to explain why it’s right without the argument being “it must be right because we are so upset that we resigned and then wrote an opinion column in the Lancet.”

26. “But boosters appear to make those who get them avoid infection– and so reduce overall mutation rate.”
    –
    I think the mutation rate is pretty much built into the virus.
    Some viruses mutate frequently and others hardly at all.
    Partly a fault of the replication mechanism, how many copies are made and how faithful to the original they are.

    Certainly there will be less virus around to mutate so the overall number of mutations that are able to occur will be less.

    Mutation is an adaptive mechanism and usually does not lead to nasty, people killing strains. Most mutations do nothing or weaken the virus which helps it spread because it no longer causes concern to its targets but still gets them.
    Preventing mutation is not necessarily the best strategy.

27. Lucia,
    The FDA POV may be suitable in some instances, but those are IMO few and far between. Mostly the FDA is the world’s most overbearing nanny-bureaucracy, and destructively, obscenely self-important… as the authorship of the Lancet article shows. I am convinced that broad defunding of the ‘drug’ part of the FDA, and clear legislative direction of the criteria to be used in drug approvals, are both needed to protect the public from the nightmare the agency has become. Like many bureaucracies, the FDA has lost its way; approving a vaccine booster for pandemic ought not be treated like approving yet another erectile dysfunction drug.

28. angech

    I think the mutation rate is pretty much built into the virus.

    The rate-per-viron replication is. But the overall rate per unit time is not. If no one is infected, their are no virons, and the rate per unit time goes to zero.

    Certainly there will be less virus around to mutate so the overall number of mutations that are able to occur will be less.

    That’s my point.

    Preventing mutation is not necessarily the best strategy.

    It doesn’t have to be “best” to be useful.

    And of course the “bad” mutations are only a subset of the overall mutations. But the probability of a bad mutation is still proportional to the overall mutation rate. So getting that down is useful.

    Reducing the rate of mutation/year is useful. It means we don’t need to develop new vaccines as quickly. Reducing infections would be useful if possible. So this “new” attitude among the anti-booster promonents who seem to think cases don’t matter is unwise.

29. Moderna study released yesterday https://investors.modernatx.com/news-releases/news-release-details/moderna-highlights-new-clinical-data-its-covid-19-vaccine
    Compared the breakthrough rate of those with the moderna vaccine in the first trial (July-Dec 20) 162/14.7k to those who were in the placebo group and were vaxed between Dec 20 – march 21. 88/11.4k. The study was July to August 21 with an 8 month average from vax in the second group compared to an average 13 month on the first. Looking like a strong case for yearly boosters at least. Assuming boosters are effective.

30. One thing that bothers me is how arbitrary some of the public health expertise has been over this pandemic. Different takes on protests, the overt focus on some public events (Sturgis), the CDC’s social justice vaccine priorities, this latest counterintuitive and counterfactual take on boosters. How does one go from continuous outgroup behavior shaming to “why would we want a booster if they only protect for four months in the middle of a national delta outbreak heading toward winter?”. These are the things that lower confidence in institutions. This is just bizarro-land social dynamics at play.
    .
    It’s hard to separate a media bias from a public health bias, but there is some strange things happening from the combination of the two. If we are lucky the FDA will rise above this nuttiness and do the right thing. We did see the CDC’s vaccine priorities overruled. Sanity usually prevails.

31. Andrew P,
    The incidence of severe cases was low in both groups: about 0.5% chance of a severe breakthrough case per year. Unfortunately, without looking at ages of the people with severe illness, we can’t say exactly how much protection is being provided; younger members of the study groups are unlikely to have severe illness, even if unvaccinated, so I imagine the severe cases are pretty much limited to the elderly in the study groups.

32. The NYT today:
    “Marion Gruber, who directs the F.D.A.’s vaccines office, suggested at the Friday meeting that the evaluation the F.D.A. makes depends on strong clinical studies, and on how boosters doses are performing against currently circulating virus variants, something the agency said in an analysis this week it had little of in Pfizer’s application.”
    .
    Why the f*** does the FDA/CDC have “little data”? Perhaps they should ask the US’s public health agencies that question. Maybe nobody in the 15,000 CDC employees with their $12B budget noticed a pandemic was ongoing or that boosters were imagined long ago?
    .
    In the FDA model Pfizer has to do all the work, and they did all that work on a large scale in Israel. But it is an observational study with all the usual drawbacks. Some at the FDA just blithely say “the US is not Israel”, come back later when you have the gold standard study for the target population and we will reconsider. I will submit that this is exactly the type of crap I have seen from career FDA employees.
    .
    I would tend to agree with others that this seems to be a turf war at the FDA between the old guard who are being a PITA to keep the old standards in place during a fast moving pandemic. They probably know they are going to lose and are in a level 10 bureaucrat CYA maneuver.

33. Andrew P (Comment #205945): “Looking like a strong case for yearly boosters at least. Assuming boosters are effective.”
    .
    Not a strong case. They report a 36% difference for positive tests, but there could be a difference in the tendency to getting tested. Severe cases (undefined) matter much more and may be more reliable, but the numbers were too small to draw a reliable conclusion.

34. Something curious about the Israeli study. They found a case rate among the “no-booster” group of 864 cases per million person days and among the “booster” group of 93 cases per million person days. Spectacular!
    .
    But according to the Financial Times cumulative cases in Israel increased by 1316 per 100K from July 30 to Aug. 22. That is a rate of 572 cases per million person days in the general population, which includes many unvaccinated. Lower than in the no-booster group.
    .
    I think that indicates that either something is wrong or they are studying an extremely non-representative group of people, beyond just being 60+.

35. There is also some weird trends in the Israeli data like instantaneous differences within a day of getting a booster which also suggest the groups are different. Observational studies always seems to have these type of problems. The people who run to the front of the line to get vaccines are no doubt a self selected group in multiple ways. The question is whether they did enough work to normalize these out or whether the overall difference in outcomes is big enough to remove that question. At this point it is a judgment call, I wouldn’t call it a clear and convincing level which is what the FDA likes to see. I would say it is closer to very likely helpful, but not easily quantifiable in the general population, but with low risk.

36. Tom

    but not easily quantifiable in the general population, but with low risk.

    Given that this is a pandemic and the disease is contagious the “low risk” should make approving boosters for those who want them almost a no brainer. The could at least approve them for the over 60 and let those who want them start getting them before winter.
    .
    I mean: there actually is a big risk of illness if immunity does wane and it’s at least plausible they are. They’ve always speculated that both natural or vaccine induced immunity might not be permanent– this was a worry from the start. The mitigating factor for that was we would be able to get boosters if it happened. I don’t understand why they think the conservative “no harm” stance is to wait for absolute gold standard proof.
    (They are just going to drive everyone to eating horsepaste!)

37. Tom

    Marion Gruber, who directs the F.D.A.’s vaccines office,

    If only she resigned effective immediately. She and her coauthor want to have their cake and eat it to. The “announce” retirements to promote their case but stay in powerful positions to enforce it.

38. She also went public before the decision was made in order to try to influence it. The FDA probably has rules about spouting off publicly on issues the FDA hasn’t decided on yet which is likely why she had to resign if she wanted to do it. Why she gets to stay in her job for now is not obvious. I’m not impressed.

39. The panel voted 2-16 against boosters for those over 16 years old, ha ha. What a joke. We will see what the FDA does. They might vote differently on other age groups.
    .
    I think this will explode politically if they don’t allow it. I can easily imagine a delta wave killing lots of people over the winter and the FDA having to justify this decision in front of congress. It’s going to get ugly.

40. Tom,
    Let’s hope the at least allow boosters for over 60. That would allow it to start going into arms and blunt a potential bulge. And older are more vulnerable anyway. Of course, it might turn out to have been unnecessary, but so?

    I might be SOL anyway. I got J&J. Dammit!

    I definitely think Gruber should have been required to resign immediately if she wanted to make pronouncements about Covid boosters to the general public by way of a Lancet article.

41. Oh. Heavens.

    https://www.cnn.com/world/live-news/coronavirus-vaccine-booster-news-09-17-21/index.html

    “I don’t think a booster dose is going to significantly contribute to controlling the pandemic,” said Dr. Cody Meissner, a professor of pediatrics at Tufts University School of Medicine.

    “It is very important that the main message that we still transmit is that we have got to get everyone two doses. Everyone has got the get the primary series. This booster dose is not likely to make a big difference in the behavior of this pandemic.”

    Why is “controlling the epidemic” the issue for the freakin’ FDA!? Why is their “main message” the issue? It shouldn’t be. The questions for the FDA should be:
    1) Can a booster provide material benefit to the person who wants to get it? and
    2) Does the booster have risks that outweigh the material benefit?

    This decision is not supposed to be about “messaging”! People shouldn’t be deprived of vaccines that can protect them as individuals merely because protecting themselves might not “control the epidemic”!!!
    Oy!

42. https://www.wsj.com/articles/fda-panel-to-weigh-covid-19-booster-shots-as-health-officials-debate-need-11631871003

    The FDA said this week that Pfizer’s analysis of a third dose met its criteria for a safe and effective vaccine. Yet the agency also said vaccines cleared in the U.S. currently provide sufficient protection against severe disease and death from Covid-19 without additional doses. The FDA also said that the decision over booster authorization should consider whether existing dose regimens protect against variants.

    If the FDA thinks it met the criteria for a safe and effective vaccine that should be enough for approval!

    Pfizer’s application includes data from more than 300 subjects in its clinical trial who received a third dose and showed significant increases in neutralizing antibodies, which are important in the immune response against Covid-19.

    No new serious safety concerns were found in people who received the booster shots, Pfizer said, and reported side effects such as fatigue or fevers were similar to what was previously reported in trial subjects.

    .
    Not seeing why they don’t get approved. Other than turf war and FDA mulishness.

43. On twitter: Sounds like they voted unanimously to allow boosters for 65+ and those at risk of severe….

45. Lucia,
    The FDA advisory panel rejected across-the-board boosters for the Pfizer vaccine, and accepted boosters for those over 65 (or with serious health issues putting them at risk).
    .
    Those under 65 are probably out of luck for now. I got the Pfizer vaccine back in March, so I will sign up for a booster as soon as it becomes available. I probably won’t be as bullet-proof as someone who had the illness (assuming I didn’t… not sure about that), but I should be pretty safe…. except for all the normal causes of death for people my age.

46. “It is very important that the main message that we still transmit is that we have got to get everyone two doses.”
    .
    I didn’t quite follow the unvaccinated might change their mind if we reject boosters argument. I grow weary of message sending by overly self important public officials.
    .
    There will probably be an epidemic of cheating to get boosters depending on how the FDA ultimately limits the authorization. The places that provide vaccines will not want to be the vaccine police and my guess is most people who want one will get one.

47. Tom Scharf,
    “There will probably be an epidemic of cheating to get boosters depending on how the FDA ultimately limits the authorization.”
    .
    I expect it will be a pandemic of cheating to get boosters. I could get one tomorrow if I wanted at any of half a dozen local pharmacies… if I was willing to say I didn’t already get two doses. There is zero possibility the pharmacy can check what happened in Florida 6 months ago at a crowded vaccination site in St. Lucie County.
    .
    When the Federal government and the MSM spend 18 months trying their very best to scare the bejezus out of the entire country about the virus, there are going to be a lot of panicked people who want a booster shot.

48. MikeM, the unusual disparity is explained if the Israeli study includes in ‘no-booster’ the unvaccinated.

49. MikeN (Comment #205966): “the unusual disparity is explained if the Israeli study includes in ‘no-booster’ the unvaccinated.”
    .
    Both groups were already fully vaccinated.

50. STeveF,
    Illinois has a registry, but I can request my records. Walgreens and CVS can’t. So even if they have me registered (which they may) I don’t think the vaccine givers could check. So I could go in and lie right now.
    .
    My insurance might ultimately catch it. In that case, maybe someone would stick me with a bill. But I could claim to be uninsured. And if I’m fine with risking and ultimately getting stuck with a bill (of how much?) I guess I could get a booster.

51. >we can’t say exactly how much protection is being provided; younger members of the study groups are unlikely to have severe illness, even if unvaccinated, so I imagine the severe cases are pretty much limited to the elderly in the study groups.

    Yes, but the original study group characteristics were balanced between placebo and non-placebo so the overall groups should have roughly the same % of elderly members. It does show the protection wanes. Whether a booster helps enough to be beneficial is yet to be determined. That will need further study.

52. Personally, I give no more credence to FDA than I give to NASA with respect to climate issues. If people want a booster, more power to them. However, I think generally the potential danger of taking boosters endlessly is being underplayed by most people.

    An example of the way that the govt is lying and manipulating statistics is Joe Biden’s statement that there was only a 1 in 5,000 chance of breakthrough infections for those vaccinated. Left out was that it was 1 in 5,000 PER DAY. (Really 7 % per year) See 11:56 of Berenson interview (many other interesting things in it) at this link. https://podcasts.apple.com/us/podcast/clay-travis-and-buck-sexton-show-h3-sep-17-2021/id1498106610?i=1000535803348

    Additionally, when animals were tested there was a problem with antibody dependent enhancement which is the process where vaccine makes it easier for virus to attack body. (Mentioned by Berenson. Explained here https://en.wikipedia.org/wiki/Antibody-dependent_enhancement#COVID-19) So far, this problem hasn’t arisen in humans.

    My intuitive concern is that there are a number of diseases caused by overactive immune responses. (Rheumatoid arthritis and Scleroderma for example) and that over 20 to 40 years younger people are looking at receiving something 20-40 of antibodies from a new source. (spike proteins) Who knows how they may interact together or whether a new one will accidentally be very dangerous? Simply my concern for the unknown based on a little knowledge of rheumatoid arthritis and scleroderma.

    Also, as a matter of public policy, it is worth considering that it may be better for very low risk people (say healthy 40 and unders) to get the disease (with statistically a very low rate of serious problems) rather than the vaccine. Natural antibodies are about 25 times more effective than vaccines and if we get a big block of people with natural immunity, in the long run there may be lower deaths. Of course, any young person that would want a vaccine should get it.

53. About 10 minutes after above posting, I saw this. Apparently, things are not going well in Israel which has been highly vaccinated.

    ……

    Health Ministry Director-General Nachman Ash said Tuesday that the current wave of coronavirus infections is surpassing anything seen in previous outbreaks and that he is disappointed that a recent downward trend appeared to be reversing….

    Pointing out that there is an average of 8,000 new infections each day, with occasional peaks over 10,000, he said, “That is a record that did not exist in the previous waves,” including the massive third wave at the end of last year.” https://www.timesofisrael.com/health-ministry-chief-says-coronavirus-spread-reaching-record-heights/

54. JD, I’ve noticed in the past that the rhetoric out of Israel’s health ministry is wildly alarmist compared to a sober review of the numbers they claim to be talking about. They seem to take a view that very good is really bad because they compare it against perfect. Noone really cares about numbers of infections. It’s outcome they are worried about and there is no better booster shot than catching the virus as a mere inconvenience. Harping on about rising case numbers without proper context is the alarmists favorite tactic.

55. JD Ohio (Comment #205972): “I think generally the potential danger of taking boosters endlessly is being underplayed by most people.”
    .
    Exactly right.
    ———–

    JD Ohio: “An example of the way that the govt is lying and manipulating statistics is Joe Biden’s statement that there was only a 1 in 5,000 chance of breakthrough infections for those vaccinated. Left out was that it was 1 in 5,000 PER DAY. (Really 7 % per year).
    .
    Indeed. And breakthroughs are surely under counted, since people with mild infections usually never get tested. The vaccinated have even less reason to get tested. Eventually, we are all going to get a visit from the Wuhan virus.
    —————-

    JD Ohio: “My intuitive concern is that there are a number of diseases caused by overactive immune responses.”
    .
    An example is covid. Severe disease is not a result of the virus running amok; it is the result of the immune system running amok. Repeatedly poking the immune system with a stick might not be wise.
    ————-

    JD Ohio: “Also, as a matter of public policy, it is worth considering that it may be better for very low risk people (say healthy 40 and unders) to get the disease (with statistically a very low rate of serious problems) rather than the vaccine.”
    .
    Yes. We don’t really know what we are doing, so the fewer guinea pigs the better. Every person who gets vaccinated is a potential Petrie dish to breed a variant that can evade the vaccine.
    ———-

    p.s. – I did not look at the Berenson video. Partly that I don’t usually watch videos and partly that he is a fairly regular guest on Tucker Carlson’s show. I don’t trust the guy (Berenson, not Carlson).

56. MikeM

    JD Ohio (Comment #205972): “I think generally the potential danger of taking boosters endlessly is being underplayed by most people.”

    I’ve been taking flu vaccines endlessly for a long time now. Maybe that’s underplaying, but it’s a fact.

57. MikeM

    Yes. We don’t really know what we are doing, so the fewer guinea pigs the better.

    They are guinea pigs either way. In one case, they are tested with vaccine. In another, they are tested with getting infected. Then, perhaps, we learn which way is less harmful. But both groups are “guinea pigs” in the sense of participating in this “test”.

    Every person who gets vaccinated is a potential Petrie dish to breed a variant that can evade the vaccine.

    Every person who is infected is a Petrie dish. Not just “potential”. And the more the virus multiplies, the bigger more generous Petrie dish they are. That’s why we see the variants emerging mostly coming from countries with big outbreaks not from countries where vaccination is keeping things in check!

58. DaveJR (Comment #205977): “Noone really cares about numbers of infections. It’s outcome they are worried about”.
    .
    You might think that no one should care, but people do care. A higher rate of infections leads to more hospitalizations and deaths.
    .
    For Israel, the picture for deaths is less dire than for infections. They have had 13,300 cases and 82 deaths per 100K population, for a CFR of 0.6%. They are now at, per 100K, 0.3 deaths/day and about 100 cases/day for the last 2-3 weeks. So a CFR of 0.3%. So the death picture is half as bad as the case picture. Not encouraging. Maybe it is the vaccine, or maybe the dry tinder has been already been consumed.

59. lucia (Comment #205980): “Every person who is infected is a Petrie dish. Not just “potential”. And the more the virus multiplies, the bigger more generous Petrie dish they are.”
    .
    Not at all the same.
    .
    Let’s say I want to breed an antibiotic resistant bacterium. I set up three Petrie dishes, each with a suitable medium and inoculum. In the first, no antibiotic. In the second, a very high dose of antibiotic. In the third, antibiotic at about the LD50. Only the third has any reasonable chance of success. Because only in that one is the virus reproducing under evolutionary pressure.
    .
    People who have been neither infected nor vaccinated are like the first dish. Note that almost all transmission from such people occurs before they get a strong adaptive immune response. It is likely, but not certain, that people who have been infected are like the second dish, because they probably have mucosal immunity. People who have been vaccinated are possibly like the third dish. They develop a high viral load and become infectious in the presence of the antibodies.
    .
    Is that analogy appropriate? Some virologists think it is. Maybe it isn’t. Like I said, we don’t really know what we are doing.
    .
    The second difference is that antibodies from the vaccine have a very narrow target. That makes it relatively easy for the virus to mutate to evade the antibodies. Antibodies from infection have much broader targets, so the virus needs many mutations to evade them.
    .
    Finally, everyone who gets infection has different natural antibodies. So a virus that evolves to avoid one host’s antibodies is still vulnerable to other peoples’ antibodies. But the vaccine gives everyone pretty much the same antibodies. If I get infected and the virus mutates to avoid my antibodies, then it can probably also avoid yours.
    .
    The vaccine designers are assuming that since the vaccine targets the binding region of the spike protein, any mutation that evades the antibodies will be unable to enter human cells. They will probably be proven right. But if not, we are putting all of our eggs in one basket.

60. lucia (Comment #205980): “not from countries where vaccination is keeping things in check!”
    .
    And what countries might those be? I am not aware of any.

61. Lucia — I’ve been taking flu vaccines endlessly for a long time now. Maybe that’s underplaying, but it’s a fact.”

    The difference is that the old flu vaccines are not designed the same as the covid vaccines.

62. Mike M wrote: “You might think that no one should care, but people do care. A higher rate of infections leads to more hospitalizations and deaths.”
    .
    Of course. They care about cases because they are used as a proxy for outcome. In the absence of proper information, the assumption of outcome is based on media fear mongering and, for a great many people, probably hasn’t changed since March last year.
    .
    “So the death picture is half as bad as the case picture. Not encouraging.”
    .
    I disagree, because the CFR is only a partial assessment of the risk of death. A drop from 82 to 0.3 deaths per 100k from covid would seem to me to include all risk variables, and that would seem to be very substantial indeed.

63. JD Ohio,
    It’s true the old and new vaccines use different “platforms” and so have differences.

    Still, I’m not hearing a mechanism for why the differences with the new ones should trigger auto-immune disorders. If it’s just “it’s different, so we don’t know”. That’s true. But the old ones certainly stimulate the immune system every year. So that feature is presumably the same.

64. MikeM

    And what countries might those be? I am not aware of any.

    We haven’t had the situation they saw in India. That’s “in check” to me.

65. MikeM

    People who have been neither infected nor vaccinated are like the first dish. Note that almost all transmission from such people occurs before they get a strong adaptive immune response. It is likely, but not certain, that people who have been infected are like the second dish

    This whole sequence makes mutation worse without vaccines! In the “without” vaccine case you have two sets of petrie dishes: The people who got sick after recovering and those who are sick before recovering. In the vaccinated case, you only have the equivalent to recovered.
    .
    So: your own argument makes not vaccinated worse for mutation!
    .

    Finally, everyone who gets infection has different natural antibodies. So a virus that evolves to avoid one host’s antibodies is still vulnerable to other peoples’ antibodies. But the vaccine gives everyone pretty much the same antibodies. If I get infected and the virus mutates to avoid my antibodies, then it can probably also avoid yours.

    A particular strain of the virus gives everyone pretty much the same antibodies too! Those are the ones against that virus!

66. DaveJR (Comment #205985): “A drop from 82 to 0.3 deaths per 100k from covid would seem to me to include all risk variables, and that would seem to be very substantial indeed.”
    .
    82 is cumulative deaths to date. 0.3 is per day. The peak last winter was 0.7/day per 100K. And the current wave might not have peaked.

67. Lucia: “Still, I’m not hearing a mechanism for why the differences with the new ones should trigger auto-immune disorders.”

    We don ‘t know the mechanism (as far as I know) for why organic solvents cause scleroderma in some people, but they do. (I had 2 cases in my workers’ compensation practice that I won and doctors agreed on. Can’t remember whether my cases involved Trichloroethylene or Perchoroethylene (sp in both cases) but there was solid evidence as to cause and effect.) In my mind, not a good idea to be stimulating the immune system over and over.

    Although, I am speculating with respect to auto immune diseases, there is a known mechanism where the vaccines can make Covid worse, Antibody Dependent Enhancement. In fact, the mnra vaccines caused this reaction in animals. Possible, that for instance, the 35th booster will cause this reaction in people.

68. You are certainly in a good position when having gained natural immunity by surviving a “natural” covid infection. You would be very unwise to do that without a vaccination first. It is true that for the under 40 group the risk is much smaller but going to a covid party or something to get natural immunity while unvaccinated would be insane IMO.
    .
    I wish we had better data for reinfection statistics for the vaccinated, vaccinated + infected, and unvaccinated + infected. There are definitely some open questions here. There seems to be a reluctance to report or study this, not sure what. Perhaps it is in progress.

69. JD,
    I know that something can exist even if we don’t know the mechanics yet. But if something has not yet been observed, we have no mechanism to expect it and it has also not been observed in similar treatments, then I consider the worry that something might be a problem to be simply speculative. It’s basically in the category of we can never know everything, which is certainly true.
    .
    I don’t other people taking the more cautious view, but I like to ask if they have anything more concrete.
    .
    In the case of organic solvents: We have observed problems. So we know they happen. So that’s empirical evidence.
    .
    Yes. It is possible that eventually a booster can cause a reaction in people. I’m not going to say it’s impossible. I just want to know the category of worry.

70. Vaccinations are certainly limiting outbreaks. The alternate world of no vaccines would be ~2X R more exposure, just more fuel to burn. There is still enough unvaccinated fuel for delta to burn through.
    .
    People care about infections because they lead to severe outcomes on a predictable basis. They are the leading indicator. Mild cases are not a health threat except in their ability to transmit to more vulnerable people.

71. “The second difference is that antibodies from the vaccine have a very narrow target. That makes it relatively easy for the virus to mutate to evade the antibodies.”
    .
    It depends. If the vaccine target is wisely chosen such that a virus mutation cannot compete successfully without the voided target of the vaccine then vaccination is superior. So far that is the case with covid, we shall see what the future holds. It will not be surprising to see a variant evolve after global immunity reaches a relatively high level. In this case a less transmissive but immunity avoiding variant will be * more transmissive * in the target population and win the contest.

72. It will not be surprising to see a variant evolve after global immunity reaches a relatively high level. In this case a less transmissive but immunity avoiding variant will be * more transmissive * in the target population and win the contest.

    More transmissive relative to the one the target population has immunity to. This is true of all diseases and why mutation rate is always an issue.

    “Vaccines” aren’t the cause of this. This is true with all viruses all diseases and happened before vaccines existed.

    It could even, hypothetically, be a mechanism that causes a symptomatic disease to vanish. If a mutation happens that results in a immunity avoidant variant arising, it transmits and gives immunity to the symptom causing variant then the symptomatic disease can vanish. In the past, the reason for the disease vanishing would have been just as mysterious as it’s first emergence.

    Given the unknown history of some diseases, it’s possible it might have happened. We don’t know what “sweating sickness” was, what caused it nor what made it vanish!
    https://en.wikipedia.org/wiki/Sweating_sickness

    I’m sure there have been other diseases through out time.

73. Tom Scharf (Comment #205991): “You are certainly in a good position when having gained natural immunity by surviving a “natural” covid infection. You would be very unwise to do that without a vaccination first.”
    .
    Maybe. It might be that once vaccinated, an infection will only trigger the immune response to the vaccine. Then you have no different immunity from what you had before the infection. That has been known to happen. It is called “antigenic original sin”.
    .
    Maybe the vaccines are limiting outbreaks. We have no way of knowing what would have happened without them. They are certainly not having the predicted effect.
    .
    I think that using the flu vaccine as justification for repeated injections is poor salesmanship. Widespread flu vaccination has not reduced deaths from influenza. There are respectable experts who claim that they do not reduce the burden of influenza and that the CDC calculations of effectiveness are worthless. I have not really looked into the issue. Two years ago, I’d have been skeptical. Now, not so much.

74. MikeM

    Maybe. It might be that once vaccinated, an infection will only trigger the immune response to the vaccine.
    […]It is called “antigenic original sin”.

    Your description of “antigenic original sin” appears opposite the one here:
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5086450/

    It sounds like they are saying :
    1) The person gets sick. They form natural antibodies to that version of the virus.
    2) When the person get vaccinated, they form stronger antibodies to the *original* virus from their *infection*. So the vaccine doesn’t work for them.

    But they still retain their immunity to the *original* virus they were infected with. It makes vaccines useless for them. But the initial trigger is having gotten sick in the first place.
    (Not saying this couldn’t be triggered by a vaccine. But in the article, it’s the real infection that triggers the whole “original sin” bit.)

75. Mike M,
    ” It might be that once vaccinated, an infection will only trigger the immune response to the vaccine. Then you have no different immunity from what you had before the infection.”
    .
    Do you mean an immune response to the same antigen as was targeted by the vaccine? That is possible, but I suspect the response would likely become broader, if only because many different antigens are presented with an actual infection. But even in the case that a person’s immune system only produced antigens to the same target as the vaccine, the person’s immunity would have to be boosted, since the antibody titer would surely increase compared to before infection.
    .
    I am reasonably sure most people in the States over 45 YO will get a booster vaccination if it becomes available. I sure will.

76. lucia (Comment #205997),

    Original antigenic sin works both ways. You have an immune response to a certain antigen. Then when you get infected with a similar antigen, your immune system might say “Hey! I know you!” and generate a secondary response to the original antigen rather than a primary response to the new antigen. The original antigen could be either the pathogen or a vaccine.
    .
    When it happens with influenza (I don’t think that is clearly established that it does), the original antigen is usually the virus. With pertussis, it is the vaccine.

77. MikeM,

    and generate a secondary response to the original antigen rather than a primary response to the new antigen

    Yes. But your original post made it sound like vaccination after infection might “erase” the orginal immunity and now only have immunity to the vaccine. It’s the fact that you are responding to Tom that makes it sound like that’s what you were saying

    Tom Scharf (Comment #205991): “You are certainly in a good position when having gained natural immunity by surviving a “natural” covid infection. You would be very unwise to do that without a vaccination first.”
    .
    Maybe. It might be that once vaccinated, an infection will only trigger the immune response to the vaccine. Then you have no different immunity from what you had before the infection. That has been known to happen. It is called “antigenic original sin”.

    So I assumed that the “once vaccinated” referred to vaccinated after an infection and you thought that in that series, the person loses their original immunity and now only has the one from the vaccine.
    .
    I guess that’s not what you meant, but it’s how I read it in context.

78. MikeM

    They are certainly not having the predicted effect.

    Sure they are. They are saving lives and reducing severe illness. Those were predicted effects and they are happening.

79. “They are certainly not having the predicted effect.”
    .
    “predicted” is doing some mighty heavy lifting here. If you are talking about sterilizing immunity then that didn’t happen but I don’t remember that being predicted, if you are talking about near elimination of the virus through herd immunity then that didn’t happen either due to the delta variant, if you are talking about protection from severe disease then that absolutely did happen and that is more consistent with what vaccinations against respiratory viruses normally do.

80. Lucia, what is stopping you from getting a booster?

    Is it Illinois, FDA, something else?

    In Virginia you can get boosters easily.

81. Mike N

    As far as I can tell, I could get one by lying. I may resort to that, but I’ve been waiting until it’s “authorized”.

    Can you get one without lying in Virginia?

82. lucia,

    Can you get one without lying in Virginia?

    Dunno about VA, but I’m pretty sure you can in TN. But since I haven’t been through the process, I don’t know if they ask whether you’ve been vaccinated previously.

    I had a discussion with my Primary Care Physician this week about what I should do about getting vaccinated. He and I reached the same conclusion, we simply don’t have enough data to make an informed decision. I blame that on the CDC and the WHO.

    For one thing, there should be an option for someone who has had a positive COVID-19 test to only get one shot of Pfizer or Moderna and be considered fully vaccinated, i.e. a booster shot. At the moment, my only choice to minimize my risk of a reaction that could put me out of action for a day or two is the J&J vaccine. If I were living in NYC and had to show proof of vaccination to dine out, go to the theater, etc. that’s what I would do. But being in TN, I don’t have that problem.

    For another, all the serum antigen tests should be testing for IgA as well as other COVID related immunoglobulins like IgG and IgM. AFAICT, very few of them do and thus most have zero ability to distinguish between vaccine and infection acquired immunity. I think that’s at least partly on the CDC as well.

    I also see people commenting who insist that the vaccines don’t produce T and B cell responses. We should know this for certain by now. I think somebody does, but hardly anyone is reporting it. I’m pretty sure I’ve seen statements for Pfizer, Moderna and J&J that their vaccines do produce B and T cell responses, but I don’t know how they know this. Which raises an additional question, if you can test for it, then why aren’t we testing the general population? Is it too expensive? I dunno.

83. I’m pretty sure that Arctic Sea ice has bottomed out for the year at a higher level than most recent years. It’s above the 2010-2019 average. I’ll look at the moving average in a few days.

84. This says that T and B cell protection is durable:
    https://www.nature.com/articles/d41586-021-02532-4

    I am pretty sure that those tests are much more expensive.

85. Durham has finally dropped a shoe in the Trump Russian collusion hoax.

    https://www.wsj.com/articles/john-durham-cracks-the-russia-case-fbi-michael-sussmann-clinton-campaign-11631917159?mod=hp_opin_pos_1

    John Durham on Thursday indicted a Clinton campaign lawyer from 2016 for lying to the FBI, but this is no ho-hum case of deception. The special counsel’s 27-page indictment is full of new, and damning, details that underscore how the Russia collusion tale was concocted and peddled by the Clinton campaign.

    Merrick Garland will dutifully sweep this under the rug if he can.

86. DeWitt Payne (Comment #206007)
    September 18th, 2021 at 4:04 pm
    I’m pretty sure that Arctic Sea ice has bottomed out for the year at a higher level than most recent years. It’s above the 2010-2019 average. I’ll look at the moving average in a few days.

    Great news but for the last 2 years it has been a yo-yo.
    Worse it has shown extremely slow recovery early on.

    If it ever returns to the 70’s AGW is gone as a theory.
    If natural variability is as big as I think I wish it would go the other way for several years

87. DeWitt,
    “Merrick Garland will dutifully sweep this under the rug if he can.”
    .
    He certainly can, and almost certainly will. The chance of that lawyer actually being vigorously prosecuted like Trump’s associates were (for the same crime!) is very near zero. He may enter a guilty or no-contest plea, with the understanding there will be no consequence beyond a small fine. Just like with Clinesmith falsifying a submission to the FISA court: no real consequence for willful admitted deception. The fix is in for all who opposed Trump, regardless of their crimes.
    .
    I suppose it is good the whole dishonest scam is being documented for future historians. Even if it only confirms what most voters recognized in 2016: Hillary is unprincipled and utterly dishonest.

88. MikeN,
    I should add: the other reason I’m waiting is I got J&J. So I know they are studying boosters AND that some are studying mixing vaccinations. Those studies should be released soon. So I want to read what they found!
    Israel has no data on this!

89. angech,
    “If it ever returns to the 70’s AGW is gone as a theory.”
    .
    I doubt that would make much difference. There is certainly warming caused by infrared absorbing gases we add to the atmosphere, so AGW will never be gone. What will happen (I hope) is that CAGW (with the key being C for catastrophic) will gradually be recognized as a gross exaggeration of future warming… and especially a gross exaggeration of warming’s consequences. Endlessly discredited predictions like an ice-free arctic ocean by 2020 (or 25, or 30, etc), island nations not disappearing beneath the waves, crops yields not falling, meter-plus sea level increases by 2100 not happening, etc, ought to have an impact on the credibility of catastrophic projections.
    .
    The problem is that advocates for draconian energy policies (and the drop in material wealth those policies will cause) see those draconian policies as straightforward “good” policies, which should be adopted *independent* of whether or not catastrophic projections are credible. Climate ‘science’ and its catastrophic projections are, and always have been, primarily motivated by politics and advocacy, not science. No amount of refutation will change the minds of those advocating draconian policies. The best we can hope for is that a majority of voters will ultimately recognize that the projections are rubbish, and the crazies are then mostly ignored.

90. “I doubt that would make much difference. There is certainly warming caused by infrared absorbing gases we add to the atmosphere, so AGW will never be gone”
    –
    I am more of a contrarian than a skeptic as I find I am too gullible at times.
    Your comment is correct as are the consequences.
    I have no argument with GHG per se.
    By the way thank you for your advice a few comments back,
    Steve F.
    Will the General [M] resign soon?

91. angech,
    I doubt Miley will resign, even though I think he should be sitting in a prison cell for insubordination.
    .
    The level of animosity toward Trump by the ‘establishment’ may be difficult for people outside the States to appreciate. Those who acted covertly (and overtly) to keep Trump from exercising power, no matter how outrageous or even illegal, like Miley’s antics, have been protected by the MSM, government employees, and many elected politicians. These people fully accept the ‘ends justifies the means’ when it comes to stopping Trump from acting, pointing to Trump’s sometime erratic behavior (and his nutty tweets) as justification.
    .
    The danger is that when an elected president wants to change the way the ‘ruling establishment’ runs the country and is actively blocked by that establishment, they are undermining both the rule of law and the Constitution…. a constitution structured specifically to avoid the emergence of just such a ruling class. If someone with many of Trump’s policy views, but smarter and without his many personal flaws (say Florida governor Ron DeSantis) is elected president, I fear the country could actually fall apart.

92. We don’t actually know what Miley did. Woodward’s account is apparently based on a single anonymous source. During the Trump administration, we had many examples of how unreliable such sources can be.
    .
    It should not be too hard to check. Official calls with foreign governments have many witnesses, with transcripts kept. It should not be too hard to determine if there were unofficial calls to China. If so, the content hardly matters; Miley belongs in prison. There should also be plenty of witnesses to any illegal orders he may have given to U.S. military personnel. One good thing about bureaucracies: Lots of documentation.
    .
    Maybe the source lied to Woodward. Maybe the source was Miley himself (it seems that is the prevailing theory). Those are not mutually exclusive. He might well have thought that the story would make him look good. After all, much of the corporate media are heaping praise on the guy. THAT is scary!

93. I’m no fan of Milley’s. This said, a couple of things bear remembering:
    1) Trump appointed Milley against Mattis’s advice. To some extent this was a self inflicted wound.
    2) I don’t think the call to China was off books. It might be as Steve says that Milley himself was the source who made an innocuous call appear sinister because he thought it might make him look good, since Orange Man Bad.
    Trump had his strengths and weaknesses. IMO, one of his weaknesses was that he didn’t always choose the right people to elevate.

94. mark bofill,
    I agree that Trump made plenty of horrible personnel choices, starting with his cabinet appointments. In fairness to Trump, I suspect the stories these people told him when interviewed were very different from what they really thought…. that is, lots of them were trying to get appointed to simply block Trump from taking policy actions they disagreed with. Trump completely lacked political experience, and so wasn’t able to identify people who shared his policy preferences, or even people who were qualified to act as policy advisors. This all caused him long term problems with a staff opposed to Trump. If elected, DeSantis will not have that problem.

95. Mark wrote: “I don’t think the call to China was off books.”
    .
    Whether it was off the books or not. Calling a belligerent military force threatening allies in the region and effectively telling them you’re not a threat is a really dumb thing to do. China upping the ante since them might be viewed as a direct consequence of this.
    .
    Threats only work if people believe they will be carried out.

96. Dave,
    It might have been like that. It might have been relatively innocent too. We are not at war with China. There is nothing necessarily sinister about the U.S. government clarifying ambiguous situations to avoid unintended conflict.
    I doubt Milley did anything treasonous. I suspect Milley did something fairly routine and tried to glamorize it, or Woodward sensationalized it. But I can’t prove any of it. It just seems like the simplest explanation to me.

97. I don’t know enough to make a judgment call, and I don’t trust the source to know what actually happened. There was never a point where we were close to a real conflict with China so the whole thing is rather confusing.
    .
    Everything Trump goes through a reality distortion field. The MSM sees the right as their main enemy, they still jabber endlessly about Trump and Jan 6th. Their take on this subject is in line with this vision. Places like the Washington Post, NYT, and CNN can’t take a neutral look at anything like this these days. They can’t even ponder the question whether this could be a bad thing. Maybe it wasn’t.
    .
    One thing for sure, they seem very worried about the rubes and their own place in the establishment elite. Trump shook them to their bones. Their fashionable and overt disdain for common white people was an epic miscalculation which was both unnecessary and self destructive to their own goals. The latest example of that is their anger at the (uneducated white) unvaccinated but being rather careful to give a free pass to the unvaccinated in their own base (Tuskegee).

98. mark bofill (Comment #206021): “There is nothing necessarily sinister about the U.S. government clarifying ambiguous situations to avoid unintended conflict.”
    .
    That is true. But any such communication must be approved by Milley’s civilian superiors. They say that they approved nothing like what was reported by Woodward. That should be looked into and should be easily resolved.
    .
    mark bofill: “I doubt Milley did anything treasonous. I suspect Milley did something fairly routine and tried to glamorize it, or Woodward sensationalized it.”
    .
    I am inclined to agree re China. But there are two more issues. One is the possibility that Milley was the source of the story. If so, he MUST be fired, at a minimum.
    .
    But far more serious is the business of Milley possibly giving orders to various military commanders, supposedly because of a sick fantasy that Trump might do something insane. I am pretty sure that would be a violation of the law, maybe even treason.
    .
    As I understand it, the Joint Chiefs are not military commanders, they are advisors to the President. They can’t give orders to anyone other than their own staffs. It would be against the law for Milley to tell General McKenzie of CENTCOM to do this or that in, say, Afghanistan. He might discuss what should be done with McKenzie, but McKenzie’s orders would have to come from the President via the appropriate *civilians* in the Defense Department. That is an essential part of civilian control of the military.

99. Mike,
    I don’t have any quarrel with anything you’ve said there, near as I can tell. Looks correct to me.

100. UK covid data gets interesting
     .
     Summer of 2021 80% UK vaccinated
     .
     The death rate is FAR more important to me than numbers of mild flu like symptoms or no symptoms at all as is the vast majority of covid cases.
     .
     between the 19th August 2021 and the 26th August 2021 are as follows from a portion of the post.
     ..
     .
     Unvaccinated population – 6 deaths
     Partly vaccinated population – 2 deaths
     Fully vaccinated population – 34 deaths
     .
     And this with vaccinated being 80% of the UK population.
     .
     https://www.naturalnews.com/2021-09-19-80-of-covid-19-deaths-vaccinated-people.html.
     .
     https://publichealthscotland.scot/media/9030/21-09-08-covid19-publication_report.pdf

101. Ed Forbes,
     The % vaccinated among the elderly in the UK is very high….. approaching 100%. This is the age group where a breakthrough illness is more likely to be serious or lead to death. The remaining unvaccinated are mostly younger people who are less likely to have severe illness. Statistics for deaths are pretty much meaningless without any consideration of age along with vaccination status. We should note also that the UK’s CFR is somewhere near 0.4%, while in the USA it is closer to 1.2%, with the most likely explanation the difference in vaccination among those over about 50. The vaccines reduce serious illness and deaths.

102. SteveF,

     We should note also that the UK’s CFR is somewhere near 0.4%, while in the USA it is closer to 1.2%….

     I don’t see how that can be correct. The population adjusted case rates aren’t that different, 10.88% UK and 12.87% US, nor is the population adjusted fatality rate, 0.2075 US and 0.1979 for the UK. That would make the overall CFR for the UK 1.86% and 1.61% for the US. Unless you have a different definition for CFR or are only looking at recent deaths.

     In which case, from May 1 to yesterday (worldometers.info), the CFR for the UK is 0.25%. The UK’s surge started earlier than the US so the minimum case rate between surges for the US was June 21 and the CFR so far is 0.86%. IMO, that difference will increase because our surge started later.

     Ed Forbes,

     One week of data isn’t enough to draw any conclusions, the numbers are too small and the noise factor is too high. It’s pretty clear to me from the above data that the much lower recent CFR in the UK is almost certainly the result of their higher vaccination rate.

103. DeWitt,
     I was looking at recent deaths versus recent cases, not the whole of the pandemic. The difference in vaccination rates, especially for older people, is driving the difference in recent fatalities per case.

104. Trump’s presidency took his first hit when Chris Christie endorsed him. At the time I thought it was the establishment hedging its bets.

105. SteveF,

     I was looking at recent deaths versus recent cases

     Yes. That became obvious once I ran the numbers, which were in my post.

106. The UK’s higher total immunity rate you mean. The UK does have some very low death rates now relative to the US and Israel.
     “According to PHE’s national Influenza and COVID-19 surveillance report published on September 9, 2021, seroprevalence data indicates that approximately 97.7% of blood donors aged 17 and over have antibodies to SARS-CoV-2.”.
     Blood donors are self selecting, but that is a high number.
     .
     Here a US based estimate I found (ironically from a UK media site, not reported by our MSM that I can find).
     https://jamanetwork.com/journals/jama/fullarticle/2784013
     “In this repeated cross-sectional study that included 1 443 519 blood donation specimens from a catchment area representing 74% of the US population, estimated SARS-CoV-2 seroprevalence weighted for differences between the study sample and general population increased from 3.5% in July 2020 to 20.2% for infection-induced antibodies and 83.3% for combined infection- and vaccine-induced antibodies in May 2021”
     .
     Taken together it is possible that you have to have immunity levels >90% before your death rate will start going down. Relatively high infection rates are not stopped even at these levels. It’s a bit speculative. I’m assuming the chances of death on reinfection are much lower.

107. Tom Scharf,
     Thanks for that link; very informative article. Based on testing of blood donor samples, they estimate that by May 2021 there had been 2.1 total covid infections for each confirmed case; a bit over 20% of the populace had infection acquired resistance, and a total of 83% had either infection or vaccine acquired resistance. I believe those are percentages for the adult (blood donor) population, not the entire population including kids.

108. The NYT’s takes their eye off the culture wars for 10 seconds and writes a good story on Israel assassinating an Iranian nuclear scientist using a remote controlled machine gun. Well done.
     https://www.nytimes.com/2021/09/18/world/middleeast/iran-nuclear-fakhrizadeh-assassination-israel.html

109. In my daily update email from the NYT, they referred to Sen. Joe Manchin as:

     the West Virginia Democrat who profits from polluting industries, will shape President Biden’s climate legislation.

     For one, name an industry that doesn’t pollute. But if we’re talking just about CO2, then the entire state of West Virginia ‘profits from polluting industries’. So, if he doesn’t fold, he’s indeed representing his constituents, not just himself. Also, pretty much every Senator and Representative of either party profits from their position.

110. DeWitt,
     “In my daily update email from the NYT…”
     .
     Like Vito said, “Keep your friends close but your enemies closer.”

111. Very good, readable paper on why pathogens readily evolve drug resistance but not vaccine resistance:
     https://royalsocietypublishing.org/doi/10.1098/rspb.2016.2562

     It is our contention that vaccine resistance has evolved less often than drug resistance because (i) vaccines act early and (ii) vaccine-induced immunity generates potent multi-target attacks … Nevertheless, pathogen evolution has reduced the efficacy of some vaccines. In this section, we argue that the benefits conferred by one or both of these features were missing for the three human vaccines where resistance is known to have emerged. Similar patterns are found for the documented cases of resistance evolution against animal vaccines.

     Early action is important for two reasons:

     The evolutionary benefit of treating infections early was noted over a century ago [50], but to reduce costs and side effects, drugs are typically administered therapeutically, meaning only after symptoms of disease arise. At the start of therapeutic treatment, the pathogen population within a host can be enormous, having already accumulated genetic diversity and become transmissible. Indeed, empirical studies have shown that the larger a microbe population is at the time of treatment, the more likely is the evolution of drug resistance

     Note that the Wuhan vaccines allow large populations of virus and therefore large genetic diversity and transmission, thus undermining the advantage of prophylaxis and making the vaccine operate more like a therapeutic treatment.
     .
     They are also very narrowly targeted, unlike traditional vaccines. For example:

     approximately 100 unique tetanus-toxoid-specific antibodies can be observed in healthy humans after receiving a tetanus-toxoid booster vaccine, with these antibodies being unique between subjects

     .
     It is a 2017 paper, but they indirectly comment on the Wuhan vaccines:

     Recent vaccine development for several diseases has, therefore, focused on inducing the production of broadly neutralizing antibodies that target conserved rather than variable antigens [96]. Yet resistance to broadly neutralizing antibodies can rapidly evolve [97]. We argue that the multiplicity of antigens and epitopes targeted by broadly neutralizing antibodies is likely to be a key factor in determining whether resistance to such vaccines will evolve.

     .
     We shall see.

112. It makes Manchin’s job much easier when the usual suspects denigrate him. I can say with some certainty that the attempts by liberals to prevent WV from burning its own coal for its own energy is not taken very well by its citizens. Personally I don’t know why Manchin doesn’t just switch parties. The left knows they can easily push him to do this and have to tread carefully.

113. Tom “ I don’t know why Manchin doesn’t just switch parties.”
     .
     He has more power to set his agenda as a Democrat than as a Republican in the current power structures. He is playing the same role in the Senate as did the late John McCain.

114. Mike M,
     That’s an interesting article. But it only tells us what everyone agrees on: Viruses can evolve to escape immunity. We know this happens. It happens for Flu— vaccine or no vaccine. It may be the case that it can escape vaccines more easily than natural immunity, but that doesn’t put the balance on the side of deciding to let everyone get sick. And much that is in the article still points to the advantage of vaccines.

     Note that the Wuhan vaccines allow large populations of virus and therefore large genetic diversity and transmission, thus undermining the advantage of prophylaxis and making the vaccine operate more like a therapeutic treatment.

     “Large” is doing a lot of work here. And you aren’t pointing to any reference.

     My understanding population of virus in a vaccinated person who gets ill is MUCH less than in an unvaccinated person. Although PCR tests show similar peaks, they also show the virus declines MUCH more quickly in the vaccinated person— so the total number of irons is less. And, of course, PCR tests amplify and so can trigger of dead virus. AND it’s only the virus in the nose. There are strong reasons to believe there is less virus in the rest of the body. So the total number of virons over time is likely much less.

     MUCH less virus in a vaccinated person would result in MUCH LESS mutation over time. So that puts the vaccines in the “good” camp.

     And of course, as your article discusses “early action”, the vaccines do provide “early action”— that is before one is infected.

     The need for vaccines that target parts of the virus that evolve slowly has been discussed elsewhere (and here.) We know there is the potential for viruses to escape the vaccines. This article is saying that but no one thinks otherwise.

     So yes, it would be good if bit Pharma worked on new vaccines. They are doing that. But the balance still appears to be toward getting vaccines rather than having people get sick. (The same goes for treatments. No one has suggested the solution to penicillin resistant gonorrhea is to not treat it!)

115. Latest round in the FL school mask opt-out battle: An administrative law judge will hear preliminary arguments today to see if the most recent suit (this time against the FL Dept of Health) can go forward, based on claims of violations of the equal rights amendment. Administrative law judges in Florida evaluate the legality of administrative rules. In this case, the judge is a conservative Republican, selected by the DeSantis administration. The suit will almost certainly not be allowed to proceed. If it is allowed to proceed, there will be a full hearing on Sept 24.
     .
     The left never tires and never gives up, no matter how many times they lose in court. I find it bizarre.
     .
     DeSantis has only to keep the opt-out rules in place until either the Fl legislature passes a law explicitly giving DeSantis the power to remove school board members from office who refuse to obey the law, or reality on the ground (rapidly falling cases and deaths in FL) makes additional lawsuits moot, so no court, State or Federal, will entertain them.
     .
     In other developments, the Biden administration will restrict use of Federally purchased monoclonal antibody treatments for covid, reducing shipments to states that are resisting Biden’s vaccination and masking mandates. DeSantis has responded by contacting a different suppler of monoclonal antibodies to make up for the shortfall in Federally purchased monoclonal antibodies. The treatment apparently costs $1,200…. which is a bargain considering the cost of a hospital stay and the fact the treatment eliminates more than 80% of hospitalizations if someone receives the treatment shortly after diagnosis for covid. Somewhere around 100,000 people in FL have received monoclonal antibody treatment.

116. the Biden administration will restrict use of Federally purchased monoclonal antibody treatments for covid, reducing shipments to states that are resisting Biden’s vaccination and masking mandates.

     Is this true? It would be bad enough to restrict them. But it’s just evil to do it based on states “resisting” Biden’s vaccination and masking madates. Individuals who fall ill still require care.

     And, beyond that, it’s just stupid-evil. Those who do get ill still may have worn masks or even gotten vaccinated. Vaccines do have protective effects, but mask… they really aren’t a strong protection against infection.

117. The whole vaccine equity argument reminds me of what we used to hear as children way back when: Eat your vegetables, there are starving children in [fill in the country of choice]. The idea that doses of vaccines that would be used in the developed world as boosters would otherwise have been available to people in other countries is ludicrous.

     The problem is that the idea that there are a fixed number of doses in, effectively, a zero sum game is wrong. I believe there is now sufficient manufacturing capacity to supply vaccine to everyone in the world within a year at most. It’s not availability, it’s logistics. We can’t even get a lot of people in the developed world to get vaccinated where there is no delivery problem anymore. Good luck getting people vaccinated in, say, Africa.

118. The national media has stopped covering the FL school mask debate coincidently with the significant drop in cases in the state. I’m sure this is a totally spurious correlation. Wouldn’t want any inconvenient questions being asked.
     .
     The drop in covid surges is still mysterious to me. They don’t necessarily just burn out because of lack of available hosts, and there doesn’t seem to be a sudden step change in behavior. I don’t think they know the answer and the models are just curve fitters to existing data and have not done well in prediction. I still suspect there is a significant factor X that people don’t understand yet.

119. lucia,

     Is this true?

     Unfortunately, yes.

     https://www.politico.com/news/2021/09/14/biden-covid-antibody-treatments-511825

120. FL’s monoclonal antibody treatments supply has been cut in half.
     https://www.cbsnews.com/news/monoclonal-antibodies-covid-19-treatment-florida-texas-states/
     .
     “Seven states — Alabama, Florida, Texas, Mississippi, Tennessee, Georgia, and Louisiana — made up 70% of orders for monoclonal antibodies in recent weeks, according to the spokesperson for the Department of Health and Human Services, which manages supplies of the treatments purchased by the federal government.”
     “Of those states, only Florida has fully vaccinated more than half of its total population, according to the Centers for Disease Control and Prevention. The others rank in the bottom 10 states for vaccinations nationwide. All seven rank among the top half of states with the highest rates of daily COVID-19 hospitalizations in recent weeks.
     “Given this reality, we must work to ensure our supply of these life-saving therapies remains available for all states and territories, not just some,” said the spokesperson. Instead of providers ordering the drugs directly from the federal government’s supplier, AmeriSourceBergen, doses of monoclonal antibodies are now being allocated by HHS to state health departments, “based on COVID-19 case burden” and demand for the drugs.”
     .
     We must stop giving these drugs to the places that need them the most! Not fair! Apparently there is an oncoming supply shortage.

121. Oh, and New Jersey and New York are no longer #1 and #2 on the deaths/million list. They are #2 and #4 and falling. Mississippi (Republican Governor) and Louisiana (Democrat Governor) are #1 and #3 and rising. Needless to say, you hear a lot about Mississippi, but not much about Louisiana.

122. “ ..FDA’s Vaccines and Related Biological Products Advisory Committee after 8 hours of testimony voted 16-2 against Joe Biden’s proposed COVID-19 booster shot program.
     .
     During that hearing, Dr. Steve Kirsch, director of the COVID-19 Early Treatment Fund, claimed that the injections are killing more people than they’re helping.
     .
     “I’m going to focus my remarks today on the elephant in the room that nobody likes to talk about: that the vaccines kill more people than they save,” Kirsch said via teleconference…”
     .
     “.. Viral immunologist and biologist Dr. Jessica Rose noted that, based on the VAERS data, the vaccine risks outweigh the benefits in young people, especially children, pointing to a thousand-fold increase in adverse reactions to the injection in 2021 compared to over the last decade…..There’s an over 1000% increase in the total number of adverse events for 2021 and we are not done with 2021,” Rose said..”
     .
     https://humansarefree.com/2021/09/fda-vaccine-hearing-vaccines-killing-more-than-saving.html

123. lucia (Comment #206046): “Is this true? It would be bad enough to restrict them. But it’s just evil to do it based on states “resisting” Biden’s vaccination and masking madates. Individuals who fall ill still require care.”
     .
     Yes, it is true. They *say* that they are distributing the treatment more “equitably” based on population. But that is also perverse. And we can be certain that they would not be doing that if blue states had a greater need.
     .
     Disgusting.

124. Lucia,
     “But it’s just evil to do it based on states “resisting” Biden’s vaccination and masking mandates. Individuals who fall ill still require care.”
     .
     Yes, profoundly evil. But it gets worse: there is now a threat by the Biden administration to force the alternative supplier (Glaxo Smith Kline…. that the Federal government did not choose to supply monoclonal antibodies under contract) to sell *only* to the Federal government, so that defiant states like Florida can’t purchase monoclonal antibody treatments for sick people. Yes, Biden is a) demented, b) evil, and c) a racist. Most of the people who have refused vaccination in the states Biden is targeting are black and Hispanic, not Republican.
     .
     On current pace, I do believe Biden will face impeachment hearings should Republicans gain control of the House in 2022… as well he should.

125. Ed Forbes,
     Steve Kirsh is not even remotely believable on covid treatments, nor on vaccinations, and the advisory panel did not act on his very crazy statements. The panel did recommend approval of boosters for those over 65, and are asking for additional data on younger people. His suggestion that the vaccines actually kill more people than they save is total rubbish.

126. I tried to find that elephant quote but YouTube was busy scrubbing it from the Internet, ha ha. I saw a link to it in the FDA open comments presentation on Reddit, now that is gone. Oh brother. It was something about the relative rates of heart attacks in the study groups or something.
     .
     It sounded like total BS but apparently the Ministry of Truth doesn’t want my impressionable mind to be poisoned by such words. It’s a good thing this censorship power will only ever be used for the good of mankind because some people would misuse this type of power to further their own agenda. It’s best to leave this to anonymous benevolent committees where there is no accountability.
     .
     I wonder if they ever considered an opt-out from their misinformation filter? Best not to allow that either, people can’t be trusted to make critical judgments, only people on benevolent committees can do this because they are smarter than everyone else and incorruptible.

127. Tom Scharf,
     Yes, the claim was “71 times more heart attacks” after the covid vaccination than any other type of vaccination. No reference, and no way to check. Obviously most other vaccinations are for kids, so no heart attacks are expected, while covid vaccines were administered to people of an age where a heart attack is not unusual. I read a series of Kirsh statements… he seems to me unhinged at best, e loopy-crazy-nuts at worst.

128. In same article, I notice overall supply of monoclinal antibody drugs (how come vaccine gets labelled “experimental” and these arent?) has been increased by 50%. I also wonder that if government was trying max value for health dollar, then vaccine looks way cheaper than these drugs.

     How is “now being allocated by HHS to state health departments, “based on COVID-19 case burden” and demand for the drugs.”

     not

     “giving these drugs to the places that need them the most”?

     Nowhere could I find in that article statements that suggest the allocation is being based on vaccination uptake.

129. The CBS article I linked to seemed to be complaining they were used in states with low vaccination rates which was a rather odd line of reasoning. It can be read as “wasted on the anti-vax rubes”. I think this was just the journalist’s take though. As far as I can tell they are anticipating a shortage and some rather dumb people made some rather dumb public comments. However FL’s allocation was actually reduced, not sure if this was because of reduced cases, reduced demand, etc.
     .
     When the vaccine first became available there was a debate on whether they should be sent to states with the worst outbreaks first, but that was canned for per capita state distribution.
     .
     Vaccinations cost way less than these drugs which are only a little helpful to prevent very expensive hospitalizations and there is no easy way to predict who needs them the most as they must be used early after diagnosis.

130. Tom, I think this is the 8 hr FDA meeting referenced. Bit of a slog to find specific points
     .
     https://www.youtube.com/watch?v=WFph7-6t34M

131. Phil Scadden (Comment #206060): “I notice overall supply of monoclinal antibody drugs … has been increased by 50%.”
     .
     Yes. And in spite of that places like Florida are getting their supply cut.
     —————

     Phil Scadden: “how come vaccine gets labelled “experimental” and these arent?”
     .
     Since when? The vaccines are rarely referred to as experimental. The monoclonal antibodies are not always referred to as experimental. How is that unfair?
     .
     Both have been used while still experimental. The difference is that the antibodies have been used to treat people who are actually sick and are at risk. An appropriate use for an experimental treatment. The vaccines are being given to everyone, at risk or not. An inappropriate use for an experimental treatment.
     ————–

     Phil Scadden: “I also wonder that if government was trying max value for health dollar, then vaccine looks way cheaper than these drugs.”
     .
     Not obvious. The antibodies cost maybe 10-20 times as much as the vaccines. But far fewer doses are needed.

132. NYT: “The government-supplied monoclonal antibodies, made by Regeneron and Eli Lilly, have been shown to significantly shorten patients’ symptoms and reduce their risk of being hospitalized — by 70 percent, in the case of Regeneron’s antibody cocktail.”
     .
     That’s more effective than I thought. I’m surprised I had to search as hard as I did to find this effectiveness data in an ocean of political commentary. It’s either $1200 or $2100 depending on the brand you get.
     .
     I suppose the numbers make better sense if you consider this an “on-demand vaccine” only for those diagnosed. I think you are better off with a vaccine but I’d have to examine it more closely with looking at how it works the worse your infection gets.

133. Phil Scadden,
     I think it is very clear that the restriction in antibody doses to certain states is at least in part due to politics, not health care. The states that have relatively few cases are in little need of many doses, while states (like Florida) with lots of cases really do need the doses. If there were a clear shortage of doses available, that would be different, but as far as I am aware, there is no shortage, and none has been claimed. Some 1.8 million additional antibody doses were already ordered.
     .
     WRT cost: Mike M is right. The number of people who need antibody treatment is a small fraction of the number of cases. Since the ‘delta surge’ there have been about 1.1 million confirmed cases in Florida, and probably about an equal number of un-confirmed cases, but only about 90,000 monoclonal antibody doses administered. The total doses of vaccine administered in Florida is about 20 million.
     .
     In any case, the cost for even a brief hospitalization is many times higher than the monoclonal antibodies, so they clearly save money, even at US$1200 per dose.

134. FL – maybe their case no.s are dropping? Is there any data on supply to state versus need? Saying that it is Biden limiting supply to low vax states ergo Biden is evil without evidence is going to far.

     “since when” – Maybe http://rankexploits.com/musings/2021/possible-variant-breakthrough-etc/#comment-203132

     (but was really to referring to rants by antivaxxers).

     As far as I can see one infusion of monoclinal antibodies are 50 to 100 times the cost of vaccine. Because high vax rates also reduce spread, they are more effective overall as well.

135. Phil Scadden,
     If there is a shortage of monoclonal antibody, then the Biden administration could just show everyone the numbers and make a reasoned case. They didn’t do that, even though they could easily have done so.
     .
     Florida’s case numbers are clearly dropping; the ‘delta surge’ is declining. The cut in monoclonal antibody treatments was from already requested deliveries, and as far as I know not based on case numbers.
     .
     I don’t know the fully loaded cost of vaccination (purchase, distribution, administration), but I would be surprised if it were less than US$30 per dose. Considering that there have been about 20 million doses administered in Florida, that is about US$600 million cost. It is unclear if the quoted cost for antibody treatment includes administration, but the often quoted price of US$1200 times 90,000 is US$108 million. Even if the true cost were double that figure, the total would still be far below what has been spent on vaccines. What has been spent on vaccinations (and monoclonal antibodies) is a tiny fraction of what has been spent paying people to not work. You can agree or disagree that paying people to not work is a good thing, but talk of controlling costs ought to begin with where the majority of money has been spent. It is not on medications.
     .
     And once again, the cost for hospitalization is much, much higher than the monoclonal antibody, so it makes perfect sense to use the monoclonal antibody to keep people from needing hospitalization.
     .
     Biden is going to get a lot of push-back on this, just as he has with his vaccine mandate proposals.

136. Steve, I am not quite sure where your 90,000 comes from, but to compare cost of vaccine versus monoclinal antibodies, then you need to estimate the no. of antibody doses you would need if there wasnt any vaccinations (which would mean far more cases).

     Of course, I totally support using monoclinal antibodies for as many people hospitalized as possible. I agree that it make $$ sense as well as humanitarian sense. I dont think anyone (even a democrat) would think otherwise.

     However, from my perspective I am so far hearing usual “democrats evil, public service cant be trusted noise” rather than evidence. Deliberately penalizing states for low vax rates seems so massively unlikely, that I think much stronger evidence is needed than “absence of evidence”. Cuts to existing allocation is not evidence of anything except policy change without data on demand from other states.
     I would change my mind and agree the distribution is evil, if state allocations are shown to not match case load and need, but that needs data on the allocations. Or a leak where some official is shown to be ordering punishment of low vax states.

137. Phil,
     I get what you’re saying. Maybe you’re right. There is Psaki saying this though:

     “Just seven states are making up 70 percent of the orders. Our supply is not unlimited. And we believe it should be equitable across states, across the country,” Psaki said.

     “Our role as the government overseeing the entire country is to be equitable in how we distribute, we’re not going to give a greater percentage to Florida over Oklahoma,” she added.

     It sounds to me like Psaki is saying that Florida isn’t going to get a greater percentage than Oklahoma, even though Florida’s demand is greater than Oklahomas.

     I would change my mind and agree the distribution is evil, if state allocations are shown to not match case load and need

     It might be that Psaki is full of cheese whiz. This has happened before. But if we take her at her word, IMO she is essentially saying that the policy is not intended to be ‘state allocations are to match case load and need’.

138. Another factor in the relative costs of monoclonal antibodies and vaccines is the fact that vaccinated people are now approaching 1/3 hospitalizations and deaths. So probably about 1/3 of the monoclonal antibody cost is for treating vaccinated people.

139. Oklahoma vaccination rates look low to me (lower than Florida) while no. of new cases per 1000 looks high and higher than Florida. Even with a smaller population, if it has low access to antibodies now, then a more equitable distribution could affect Florida. Still doesnt fit the “Biden is punishing states with low vax rates” narrative.

140. Mike M. “vaccinated people are now approaching 1/3 hospitalizations and deaths.”

     That is bombshell number. Nothing I have seen from UK or US sources so far have come even close to 30%. Where is your source for that?

141. Don’t misunderstand me Phil.
     I’m not making any sort of argument that has anything to do with relative vaccination rates. I am making the observation that Psaki said in an unqualified way “ we’re not going to give a greater percentage to Florida over Oklahoma“.
     Make of that what you will. Personally, I don’t take much of what Psaki says at face value, so I don’t blame you if you choose to ignore her. Still, she’s not saying the distribution will be to those places that need it most. She’s saying the distribution will be equitable and one state is not going to get more [a greater percentage] than another.
     Shrug.

142. Phil,
     The key word from the Biden administration is “equitable”. If the administration were in a position to show a shortage of monoclonal antibodies, requiring allocation on a most-needed basis, then they ought to have done that. They absolutely have not done that.
     .
     They have instead complained that certain states (all of them happen to oppose most of Biden’s policies, covid and otherwise) have been ordering 70% of the monoclonal antibodies that have been ordered by all the states. Nowhere does the administration say that 70% is out of line with the medical need in those 7 states. Nowhere does the administration say that other states have been unable to order monoclonal antibodies because of usage by those 7 states.
     .
     The optics are bad, the failure to show justification for their policies even worse. I fully expect they will never offer justification.

143. Phil Scadden (Comment #206075): “That is bombshell number. Nothing I have seen from UK or US sources so far have come even close to 30%. Where is your source for that?”
     .
     No it isn’t. Numbers from UK and Israel have been higher. What I cited are from Minnesota, but numbers are hard to come by.

144. “Nowhere does the administration say that 70% is out of line with the medical need in those 7 states. Nowhere does the administration say that other states have been unable to order monoclonal antibodies because of usage by those 7 states.”

     But that is still argument from absence of evidence. Using data from here https://carlsonschool.umn.edu/mili-misrc-covid19-tracking-project/download-data
     I make total hospitalizations 19th sep at 89379. Hospitalization in those 7 states = 39253. ie 70% of infusions going to 42% of the hospitalized.

     That 70% is maybe old data and Florida dropping, so go back to Aug 19 instead. Slightly better at 47% of hospitalizations.

     I think it is reasonable to believe that maybe infusions are not currently be distributed equitably by need. I dont think it is reasonable to believe that some Democrat deep-state is out to kill Republicans on evidence to date.

145. Mike M. That looks suspiciously to me like a abuse of statistics. Suppose 100% of population was vaccinated, then breakthrough cases would account for 100% of people in hospital. Horrors, dont get vaccinated – not. There is missing context.

146. Phil,
     Infusions are given to people at risk (mainly elderly) with confirmed covid infection *at risk of severe illness*. They are not necessarily hospitalized. Once again, if there is a reasoned case for restricting doses to certain states, it is incumbent on the administration to make that case. They have not. In these circumstances, combined with talk of ‘equity’, they have at least a moral obligation to do that. Considering that Democrats never give Republicans the benefit of the doubt (ever), there is zero reason for Republicans to give Democrats that benefit. They have to show the damned numbers and make the rational argument. I am waiting. I’m not alone.

147. Phil Scadden (Comment #206080): “That looks suspiciously to me like a abuse of statistics. Suppose 100% of population was vaccinated, then breakthrough cases would account for 100% of people in hospital. Horrors, dont get vaccinated – not. There is missing context.”
     .
     You are the only one abusing statistics or ignoring context. I never said anything about the efficacy of the vaccine, I only pointed out that vaccination does not eliminate the need for monoclonal antibody treatment since about 1/3 hospitalizations and deaths are among the vaccinated.

148. According to DeSantis, at the Broward county (Fort Lauderdale) monoclonal clinic (where DeSantis had a press conference), 69% of the people who received the monoclonal antibody treatment were *both* over 65 and had breakthrough cases of covid (they had already been vaccinated). I suspect most of the remainder were not vaccinated. I await evidence showing that the monoclonal treatments were not medically needed, or that a shortage of monoclonal antibody treatments demands ‘triage’ distribution. BTW, Broward County has 61+% of the entire adult population fully vaccinated, and 73+% with at least one dose, and well over 80% of those over 65 fully vaccinated.

149. Phil Scadden,

     Your arguments are silly. If some states were having trouble getting enough serum to treat people, the administration could easily justify their action on that basis and the governors of those states would be happy that they can now treat their citizens.
     .
     Yes, some states are using the treatment in greater ratio relative to their case numbers. The reason is that Democrats are mostly opposed to treating people who get sick whereas Republicans tend to support that. Some Republicans governors have a laissez-faire attitude, while others are more activist in helping their citizens. Those lucky citizens are more likely to get treatment.

150. SteveF (Comment #206083): “Infusions are given to people at risk (mainly elderly) with confirmed covid infection *at risk of severe illness*. They are not necessarily hospitalized.”
     .
     They may not have been hospitalized before being prescribed the treatment, but they are then hospitalized for a couple days to receive the treatment. But maybe not in Florida; I have heard that DeSantis has been setting up facilities just for that purpose.
     .
     I am getting more and more envious of Floridians.

151. Mike M,
     ” I have heard that DeSantis has been setting up facilities just for that purpose.”
     .
     Yes, there are clinics set up to avoid hospitalizations. The administration of the antibody takes only 30 to 60 minutes. I expect there is an observation period to ensure there is no chance of allergic reaction.

152. Phil,
     ” I dont think it is reasonable to believe that some Democrat deep-state is out to kill Republicans on evidence to date.”
     .
     As I pointed out above, many (if not most) of the people who are put at greatest risk if antibody treatment is restricted are blacks and Hispanics, who have by far the lowest vaccination rates in the USA, and not just in Republican controlled states. Those groups are not heavily Republican. The ‘punishment’ would seem to be targeted at states that politically oppose Biden’s policies in general… and those are Republican controlled.

153. Florida is using a lot of these treatments because the Governor actively promoted them and set up free state run sites to give them out.
     .
     US politics is such that there is a knee jerk reaction to treatments that they must be quackery and must be stopped. Once these people figured out that they might be useful then it turned instantly to they must be rationed for the people on my team. It’s all so tiresome and it really takes effort just to find out what the facts on the ground are now.
     .
     As for the moment there doesn’t seem to be any * effective * rationing going on (as in nobody is being denied treatment yet) but there appears to be a threat to do so if the supply gets low, which is reasonable. The reason supplies are getting low is because a lot of people are using them and that is a good thing. The reason people are using it a lot is because they are being promoted by the government and they appear to be an effective treatment.

154. I don’t think that 30% vaccinated hospitalized number is correct. Every report I have seen shows that to be at 10% or less.
     .
     It is certainly possible that a very highly vaccinated region could get to that number, or that an age group such as 75+ could get to that number because of the high number of vaccinations.
     .
     There is also the “hospitalized with covid, not from covid” being around 20% of cases so that is also a factor. Some vaccine evangelists compute the numbers dishonestly and get 99+% which I think is also misleading.
     .
     Israel does get to those kind of numbers though (60% of hospitalized are vaccinated). 87% of hospitalizations are in the 60+ age group and that age group is >90% vaccinated. It’s possible but the US numbers I have seen still show nothing close to 30%.
     .
     It’s a meaningless number though as you have to bin by age group and account for the vaccinated ratio to get to the meaningful effectiveness number which has been covered ad nauseum.

155. Whew. Trudeau has been re-elected in Canada. I think we can all breathe a big sigh of relief now.

156. lucia,

     From today’s online WSJ:

     J&J Says Covid-19 Vaccine Booster Two Months After First Shot Increases Protection
     Trial participants in the U.S. who received a second dose eight weeks after the first had 94% protection against the illness

     The article also states that the longer the delay between the first and second shot, the greater the effect. I really wish there was more data on a booster shot for people who had been previously infected.

157. Steve. As I said, I have strong prior against belief that administration would act to deny treatment by restricting supply. I need strong evidence to shift the belief. Using hospitalization as proxy for need, it is plausible that access has not been based on need, but not strong evidence one way or the other. If hospitalization in those 7 states had been close to 70% however, I would have considered that evidence of evil to restrict them now.

     That the administration doesnt respond to right-wing media demands for numbers does not seem to be strong evidence to me, because I am not sure that response would likely even if they had such numbers. Would the media bother to report the numbers if it didnt seem interesting to their audience? Since the media in US is so balkanised, I use google news in incognito mode to try an impression on what is going on. I havent seen this show up in headlines yet (heard about it here), so doesn’t seem to be a big talking point needing administration attention. That could change. If I search news for monoclinal antibodies for period BEFORE the administration acted, then I see headlines about supply getting short.

158. According to USA Today, 43% of the 300,000 delivered doses of monoclonal antibodies have been administered. The remainder is in inventory. An additional 700,000 doses have been ordered but not yet delivered. So if those figures are accurate, total administered doses is about 130,000, and 170,000 remain available. My understanding is that the 700,000 ordered doses are to be delivered by year end.

159. Steve, interesting but not necessarily informative about supply. Doses inventoried in Florida don’t help say Oklahoma.

     I would also note that HHS says rationing is temporary till supply improves and that States can order more, but no guarantee that they will be supplied. That seems consistent for a supply issue. If HHS are lying and acting on a White House directive to needlessly ration, then I would expect a whistleblower any time now.

160. Another things I dont understand..
     “The ‘punishment’ would seem to be targeted at states that politically oppose Biden’s policies in general… and those are Republican controlled.”

     How exactly are Biden’s supposed actions supposed to damage his opponents popularity and bolster his own? If true, it looks like a gift for DeSantis.

     As I understand the situation, we have two hypotheses.

     1/ There is temporary supply shortage of infusions due to surging demand and HHS have moved to balance supply to need.
     2/ There is a byzantine conspiracy through White House and HHS that will somehow reap political benefits to Biden by restriction of supply to given States.

     I dont have any problem deciding which I think is the most probable.

161. Phil,
     I am easy to convince: they just need to show the data and make a reasoned case. That isn’t even a big ask. It is the kind of thing most any responsible government would do; responsible is the key word here.

162. Phil,
     I don’t think your two options capture the range of options at all.
     It’s not a byzantine conspiracy. Maybe somebody said that in the thread above and I missed it, if so, feel free to point it out and I will apologize handsomely. I’m going to go out on a limb and suggest that nobody thinks that.
     Biden and Republican governors are having a pissing contest. It’s politics, nothing more, is my opinion.
     [Edit: Nope, I checked. In your comment above is the first appearance of the word ‘conspiracy’ on this thread.]

163. I see Lucia and others put forward the idea that it’s evil for the administration to restrict availability of supplies for treatment if its punitive.
     It doesn’t require a conspiracy for this to be punitive. All it requires is for the administration to be pissed off at various governors.
     There is certainly precedent. Trump clearly did this. If you wish to believe President Biden, the lifelong politician, is of such moral fiber that he’d never stoop to such a thing, well, I guess that’s fine. I don’t think that’s extremely realistic.
     However — it is not some conspiracy to kill Republicans. It’s no conspiracy at all. It’s a President who’s pissed off at some governors. It happens.

164. DeWitt,
     That makes me want to sneak out and get a booster before it’s authorized. 🙂

165. 1/ There is temporary supply shortage of infusions due to surging demand and HHS have moved to balance supply to need.

     HHS says they are considering equity of current and future needs.
     They are restricting Florida supplies now because some states might need them in the future, those states run by a party that has demonized DeSantis for considering using this treatment.

166. Maybe in your country, but in the States, very close to 100% of bureaucrats are dedicated Democrats (which is why there were so many whistleblowers during Trump’s time in office).
     .
     For example: You may remember that during Obama’s time in office, the head of the internal revenue service department that approves non-profit corporations was actively blocking incorporation of groups that were associated with ‘conservative causes’. Oddly enough, no whistleblowers in the IRS came forward, and only multiple complaints to Congress by groups being blocked allowed the malfeasance to come to light. The official (Lois Lerner) was not prosecuted and was allowed to retire on a full pension when the extent of her targeting of conservatives groups came to light. There were obviously many bureaucrats who were aware of what Lerner was doing, and many helping her do it….. they agreed with her illegal actions, so said nothing. It takes no leap of faith to imagine most people in the Biden administration and Federal bureaucracy want to punish Republican governors for resisting many Biden administration policies.

167. Mark, I am pretty ignorant of US politics works (or doesnt) but the statements about supply, demand are from the HHS not the White House. To imply that this is a pissing contest and no supply shortage actually exists means, to me, that HHS bureaucrats are complying with a White House order to lie through their teeth. Really? Is this what the public service in US does? No whistleblowers?

     A pissing contest between governors and President makes sense when both are playing to the people they need to vote for them. I am not sure how it works in this case, and yes, a lifelong politician should know that better than an outsider. Elections are won by persuading people that dont automatically vote for the same party every time. This contest would suit DeSantis but I cant see how it helps Biden.

     Steve – I am easy to persuade to your point of view with same the data. Just that what data is available doesnt seem to point that way at the moment.

168. Phil,
     OK. Well, like I said, maybe you’ve got this one right and I’ve got it wrong. It happens. ~clears throat~ More than I like to think about, actually.

169. “It takes no leap of faith to imagine most people in the Biden administration and Federal bureaucracy want to punish Republican governors for resisting many Biden administration policies.”

     But what would that achieve? How does it win any swinging votes?

     And yes, I guess it is different here. Requiring a public servant to lie (unless clearly in national interest eg about a covert operation) would a fast path to ending your political career, whatever your or their political colour.

170. lucia,

     According to the article, a second shot of J&J vaccine does exactly what you want. It drastically reduces the risk of a symptomatic infection. It looks much like they should have planned on a second dose after two months, like the Shingrix shingles vaccine, but J&J was the last to start their phase three trial and adding a second shot after a relatively long delay would have put them even farther behind.

171. Phil,
     “But what would that achieve? How does it win any swinging votes?”
     .
     Democrats have near zero chance of carrying the 7 states specifically identified as having monoclonal antibody treatments restricted. They are Republican dominated states. The motivation is to make his support stronger among *Democrat* dominated states, where voters loath Republican governors like DeSantis in Florida, and especially loath resistance to the Biden administration’s preferences for vaccine mandates, mask mandates, etc. It stinks of politics.
     .
     BTW, HHS is headed by political appointees who run their agency exactly as the Biden administration directs…. they can’t go for a bathroom break without approval from the White House. I suspect this is different from your country.

172. If voters loath GOP, then you dont need to anything to get their support other than make the right noises. The bare-minimum to stop them becoming disaffected and which doesnt compromise your appeal to swingers. Surely that is how politics works in every democracy. My problem is understanding how faking a supply issue would result in appeal to swingers.

     And yes, very different in our country. Public service guards independence and governments don’t get a say in appointments. No churn when government changes, not even to head of Prime Ministers department. Government does get to appoint board of Crown companies (private dividend-paying companies but 100% owned by government), but directors usually serve their term.

173. Phil Scadden (Comment #206114): “My problem is understanding how faking a supply issue would result in appeal to swingers.”
     .
     I don’t think it has anything to do with winning votes. It has to do with punishing those dastardly Republican ant-vaxers. Even if the people who suffer are vaccinated and/or minority Democrat voters.
     .
     It does seem that there was something of a supply crunch. But I don’t see how they can justify significantly cutting supply to some state while they say they are significantly increasing supply. They are refusing to give a coherent explanation of their actions. At best, the administration is giving the finger to states while saying “we can do whatever we like”. At worst, they are deliberately killing people.

174. Mike: “It has to do with punishing those dastardly Republican ant-vaxers.”

     My prior on that is extremely low. It appears to be interpretation without any convincing evidence and at serious odds with how politics is played.

     Increasing supply is “ordering a whole lot more” which isnt going to get fulfilled immediately whereas they have said the restriction is only temporary until supply improves.

     https://www.forbes.com/sites/jemimamcevoy/2021/09/10/nation-short-on-supply-of-key-covid-treatment-desperate-states-told-to-reduce-requests/?sh=2e3fdf5b6737

     “This will just be temporary while the federal government continues “actively working to procure more products,” the official said.

     “The HHS official highlighted that the seven states asked to reduce their orders can ask for more if they need it, but noted the federal government “probably” wouldn’t be able to fulfill the request.

175. Phil,
     “My problem is understanding how faking a supply issue would result in appeal to swingers.”
     .
     Nobody ever said there is *no* supply issue. The issues with restricted access are all related to disclosure and data. Here is the question: should people with covid today, at risk of serious illness or death (who also live in ‘bad states’ that resist Biden administration policies) not get treatment so that doses can be reserved for people who may get covid in the future (and who live in states that don’t resist Biden administration policies)? And yes, any real restrictions may well end up killing people in the next few weeks.
     .
     It seems a judgement call that should be justified with hard data, analysis, and reasoning. Instead, we get rubbish arm waves about the need for “equity” and no factual explanation; no numbers, just political messaging. There is zero trust among Republicans in the Biden administration. Any reasonable government would work to increase trust. They are doing the opposite, refusing to disclose factual justifications.

176. Phil,
     I think you are giving President Bidens administration a little too much credit. I think your model of Biden is a model of a rational actor, doing things in keeping with getting re-elected if nothing else.
     Personally, I don’t see that. Reversing Trump’s border policy was not consistent with this model. The Afghanistan withdrawal was a fiasco for the administration and is not consistent with this model.
     I don’t know how the administration is making decisions, but I think their track record shows its something other than the rational self interest of an experienced politician in possession of his faculties.
     It’s ok that we disagree of course.

177. Also, regarding public servants and politicians in the US, I think we get a certain percentage of ideologues and grifters, respectively. Trump and the Clintons are examples on the politician side.
     There is more to it than I can explain in a comment. There is a sentiment on the Left in the US that history is on their side, and that their ends justify whatever means. Certainly lying is par for the course in political life here.

178. Also, the Dem party in the US has to satisfy the more extreme among their base, progressives a d activists. The things that satisfy extremists can be irrational. Look at the messes in California for an example.
     There’s a lot to it. Just scratching the surface here.

179. One more example of this : defund the police. It’s a political loser nobody supports. Dems adopted this position In the wake of emotional, well publicized events, driven by activism and ideology.
     In the US there’s more to it than rational policy.

180. Phil Scadden (Comment #206117),

     American politics (especially the Left) and government (dominated by the Left) has become deeply dysfunctional. See mark’s comments above.
     .
     Also, when I wrote “It has to do with punishing those dastardly Republican antivaxers”, I was being sarcastic. I suppose I should have said “It has to do with settling scores and acting in accord with ideology”.

181. This is pretty much a nothing-burger. If people are denied treatment while other states have adequate supply then it changes. It may eventually happen but that seems a way off. We had long lines on vaccines for a while.
     .
     Some background:
     .
     Beltway politicians and the elite media pointing out southern states (not a subtle code for Republican rubes) were using most of the supply and asserting rationing may be necessary was a mistake and the opposing political party did what they always do when handed a gift, they made a public stink about it.
     .
     I’m not from the south but I live there now and I can tell you with 100% certainty that there is a bias against the south in the elite media and DC. They (we) are viewed as poorly educated, racist, and unsophisticated. Like all stereotypes some of this is earned and some of it isn’t. The use of the term “southern states” is triggering to use sophisticated terminology, ha ha.
     .
     The other part to the politics here is the very real fact that people in large governmental organizations do lean left and so non-appointed government spokespeople and their official positions can sometimes sway into anti-Republican rhetoric if not checked properly. This is primarily due to the Republican platform of small government, lower budgets, and individual liberty. This clashes with the left’s true believer vision of big government solving society’s problems. This is real but should not be overstated, most bureaucrats don’t care much but don’t like it when government unions (their paychecks) are threatened.
     .
     The thinking that big government is a growing and pervasive threat is common on the right. In the US there is an old joke “I’m from the government and I’m here to help”, now roll the eyes. We still cash our social security checks on the right though, ha ha.

182. Mark wrote: “One more example of this : defund the police. It’s a political loser nobody supports.”
     .
     Ah, yes. They so much didn’t support it, they even went out and actually did it in many jurisdictions. Then, when it starts to come back to bite them, they claim it didn’t really happen, and the real threat to the police funding are republicans, by not supporting a massive spending bill meant for just about everything except funding the police.

183. It’s over!
     .
     Is The Worst Over? Modelers Predict A Steady Decline In COVID Cases Through March
     https://www.npr.org/sections/health-shots/2021/09/22/1039272244/is-the-worst-over-modelers-predict-a-steady-decline-in-covid-cases-through-march
     “The delta surge appears to be peaking nationally, and cases and deaths will likely decline steadily now through the spring without a significant winter surge, according to a new analysis shared with NPR by a consortium of researchers advising the Centers for Disease Control and Prevention.”
     .
     In other news, there will be a national meeting of “Modelers Who Can’t Learn From The Past” next month.

184. Tom Scharf (Comment #206128) quoting NPR: “The delta surge appears to be peaking nationally, and cases and deaths will likely decline steadily now through the spring without a significant winter surge, according to a new analysis shared with NPR by a consortium of researchers advising the Centers for Disease Control and Prevention.”
     .
     Now I am really worried about the coming winter surge, although I suppose there could be a first time for the CDC being right. And Biden will nail his next foreign policy decision.

     ————
     Tom Scharf: “In other news, there will be a national meeting of “Modelers Who Can’t Learn From The Past” next month.”
     .
     🙂
     Modelers Anonymous?

185. If they don’t yet understand seasonality its unclear how they came to the conclusion that there won’t be a winter surge. I’ll give them credit for at least trying to make a prediction, that is a first step to building confidence.
     .
     My guess continues to be that all regions in the US will get to more or less the same (infected + vaccinated) immunity level sooner or later. If you aren’t in the top third of that list, you probably have a delta surge in your future.
     .
     This is unlike climate models which are now used routinely for post hoc extreme event attribution. “Our models, which are known to make a speculative prediction of stronger hurricanes in the future, confirm that the last strong hurricane was caused by climate change, and thus our speculative models are confirmed because a single strong hurricane occurred!”.

186. Tom Scharf,
     “Modelers Predict A Steady Decline In COVID Cases Through March”
     .
     Well, that is something of a first. Of course, if cases and deaths fall as that article predicts, all the school mask madness ought to end. But I’ll go out on a limb and project that many school districts in Democrat controlled states will be forcing kids to wear masks even after the pandemic is over, and maybe forever. I also project the Biden administration will never declare the pandemic over, no matter how low the case rate is. You know what they say: never let a crisis go to waste. To which I add “and never let it end.”

187. Steve,

     I also project the Biden administration will never declare the pandemic over, no matter how low the case rate is. You know what they say: never let a crisis go to waste.

     I don’t know about that. I think President Biden’s administration would be glad for a success story to tell to voters. Midterms are coming.

188. SteveF: ” I also project the Biden administration will never declare the pandemic over, no matter how low the case rate is. You know what they say: never let a crisis go to waste.”

     It’s possible to declare victory in the pandemic, and still claim a need for increased spending (to one’s favored groups) and/or regulation in order to mitigate the pandemic’s consequences. For example, housing: one might argue that landlords are still behind even though there’s been some $$ directed at them, and that renters who haven’t paid rent for 18 months (and can’t afford to make up that deficit) should be protected from eviction. There are always individual cases which can be cited for such policies.

189. OMG I love the annual Foreign Object Debris (FOD) training everybody at my workplace is required to complete.

     The reason for formally reporting FOD incidents is to:
     a. Make sure the blame doesn’t fall on you
     b. Create a framework for investigation and corrective action
     c. Create more administrative work for the HR department
     d. All of the above

     Being a FOD Detective means
     a. You’re always on the lookout for FOD during assembly and inspection.
     b. You carry a badge.
     c. Setting up secret surveillance on co-workers
     d. You get longer breaks and free donuts.

     My desire to select some of these wrong answers just for laughs torments me… I bet this factor alone is responsible for half the training tests that fail.

190. mark bofill,
     I assuem the answer

     to the first is (d) (all of the above) and the answer
     to the second is (e) all of the above!

     What the heck is “Foreign Object Debris”? Is pieces of meteors? Really: What is it?

191. Lucia,
     I’m so glad you asked. Now I feel like the 15 seconds I spent perusing that powerpoint was not totally wasted.

     Foreign Object Debris: Any substance, debris or article alien to a vehicle or system which would potentially cause damage.

     Not to be confused with Foreign Object Damage:

     Foreign Object Damage: Any damage attributed to a foreign object that can be expressed in physical or economic terms which may or may not degrade the product’s safety or performance characteristics.

     Of course me being anyplace near the actual production lines in this building would certainly already constitute several rule violations and problems that would require serious review by at least two or three serrrious committees. I do enough damage with the software I think. 🙂

192. Lucia,
     It is stuff on a runway or taxi-way which should not be there, and which could damage planes. But I don’t see why programmers would have that training.

193. Mark,
     cross-posted. Your answer is better.

194. Steve, that too. In fact the powerpoint always highlights the Concorde story as an example. In the context at this facility, it’s for the factory people. We solder and assemble lots of stuff here. So – any crap that isn’t supposed to end up in the product that does is FOD. Solder balls, dust, screws, wicking wire, broken bits of tool, what have you.
     [Edit: As to why programmers get this training, I quote the training material:

     FOD Applies to ALL activities and ALL personnel within the plant.

     hmm. I wonder if I could categorize some of the junk I dislike that other developers put into the codebase as FOD and get something done about it..]

195. Mark,

     Maybe a really obscure algorithm nobody but the original programmer can understand. But if described accurately, that might be FUBAR instead of FOD.

196. mark bofill (Comment #206136): “The reason for formally reporting FOD incidents is to:
     a. Make sure the blame doesn’t fall on you”
     .
     I initially thought that was serious before I realized it was meant as a “wrong” answer. It reminded me of the “supervisor safety training” I had to periodically endure. That had nothing to do with how to make my lab safer; it was *openly* about how to make sure my @$$ was covered if something bad happened.

197. Steve,
     Yup!

     Mike,
     ~grins~ Would that we were so honest in our training.
     .
     I’d probably pay much more attention to looking for FOD defects if I got free donuts and privileges to surveil my coworkers out of the deal. Welll… The free donuts anyway.

198. mark, I had to endure FOD training annually as well. There was at least some utility in that training for me, as we occasionally had deliverable hardware in the lab, and there were opportunities, such as swapping circuit cards, for introducing FOD. But I was correctly kept far away from items such as soldering irons with which I might inflict serious damage.

     Thanks for reminding me of another reason to be happily retired.

199. Harold,
     Yeah. They don’t let me play with soldering irons either. Although I pinch hit in lots of different capacities (I get paid the same rate no matter what, so it doesn’t bother me) and sometimes get to play with hardware. I still haven’t gotten over deliberately shorting and overvolting a rather expensive piece of equipment we produce here while validating a test procedure. It was hard to force myself to do that, after a lifetime of trying my darndest never to let stuff blow up because of a short if I could possibly help it. [Edit: The equipment was designed to withstand it, and sure enough it did fine.]
     I’m starting to think being retired might be OK at some point. 😉

200. I’ve “let the smoke out” of many devices, but electronics are harder to destroy than one would think. Typically what kills them is connecting power/GND in reverse, although they can be protected against that as well.
     .
     Powering up is realistically a pretty violent procedure and nobody ever looks close at that. This is why most deaths occur here. Powering down also puts devices into a less threatening unknown state that can cause them to go into undefined states. Electronics are pretty tough because they have to be, anything that dies easily is designed out.
     .
     One of my recent mistakes was to cut a big lithium ion battery cable with wire cutters. I’ve done this multiple times now. This can short out the battery and it puts epic amount of current through the wire cutters and electro-welds a huge gash in the wire cutter blade.

201. epic amount of current through the wire cutters and electro-welds a huge gash in the wire cutter blade.

     ~grins~ That is awesome. But I’m glad I haven’t done that. But that’s still awesome.

202. Tom Scharf (Comment #206150): “One of my recent mistakes was to cut a big lithium ion battery cable with wire cutters. I’ve done this multiple times now. This can short out the battery and it puts epic amount of current through the wire cutters”
     .
     That sounds like the sort of mistake that one makes *once*. One way or another.

203. I once wired a 440V motor controller for operation at 230V. When done, I ‘tested’ the controller …… by connecting to the original 440V line. We call that the ‘blue smoke’ test: the blue smoke that comes out within a second confirms the device was in fact correctly wired for 230V, and proves that you have to do it again….$600 wasted.

204. We used to have routine ‘blue-smoke’ tests from reversed polarity when connecting circuit boards backwards during testing. It only stopped when all circuits were modified to include reverse polarity protection diodes…. you lose some supply voltage from the diode’s forward voltage, but it is better than frying expensive circuit boards.

205. I don’t believe in an afterlife. If I’m wrong and it turns out I go to Hell (as I no doubt richly deserve), it could be that some part of my eternal suffering will involve my unwilling or unintentional destruction of electronics I’m trying to get working. I don’t know why it bothers me so much, but. It really bothers me.

206. Sorry, didn’t mean to hijack the threads.

207. I don’t think it’s possible to hijack anymore. 🙂

208. Mild annoyance at the WSJ’s news side:
     .
     Fed Officials See ‘Transitory’ Inflation Lasting Quite a While
     https://www.wsj.com/articles/fed-officials-see-transitory-inflation-lasting-quite-a-while-11632389401
     .
     At least they put this farce into scare quotes. They have been doing this for a while now. I see this spin on inflation as protection for Biden’s ludicrous spending plans. Anyone who lived through the 1970’s isn’t going to be fan of massive government spending in an inflationary economy.

209. If you put a big fat reverse polarity Zener diode on your main supply input it can survive hooking up a power supply backwards. If your power supply’s current capability is too large it will smoke the diode and then the board though. Mostly people don’t do this though, although I have done it on several boards, especially if they use expensive components.
     .
     Hooking up supplies backwards (or reversing 5V, 24V, etc.) is the number one cause of board deaths in my experience, but I do a lot of custom development. You learn pretty early that you check supply connections carefully before the first board power up. You can also use a current limiting bench supply to limit initial disasters.
     .
     When I worked in the space defense industry I heard stories of people wiring supplies wrong and destroying flight hardware worth $100K’s.
     .
     Today’s top end desktop computer processors are pretty crazy, they literally use 100A at ~1V.

210. Last spring, one could reasonably argue that the CPI increase was transitory. IIRC, the CPI was up 5.2% over the year before (ouch!) but 2020 is hardly a reasonable baseline. The was up 5.2% over two years; although 2.6%/yr is a bit high, that could be easily explained by a few dislocations.
     .
     But that argument is getting weaker. The two year CPI increase is now over 3%/yr. And it seems that the price increases are now much more broad based. So it seem that the expected inflation is arriving.

211. >Also, the Dem party in the US has to satisfy the more extreme among their base,

     That applies to Republicans as well.

212. I was reading (don’t remember where) that the main thing which has kept government spending and easy Fed money from driving high inflation since 2008 is a re-inflation of asset bubbles….. both the stock market and housing have had seemingly insane price increases, suggesting substantial downside risk of bursting bubbles.
     .
     I have noted that over the past couple of years non-bank lenders (and even banks) are back to offering loans to businesses under terms that for a long time after 2008 were simply not available. The situation with asset prices and loans reminds me a bit too much of the 2006 to 2007 period. Goods have had relatively low price increases due to better logistics and improved technology (eg falling prices for ever more powerful computer hardware, ever increasing farm productivity, increasing factory automation, and of course, ever more cheap Chinese goods). Seems to me the economy is at some risk of both general price inflation for goods and sudden drops in (speculative) asset prices.

213. Some background on why Israel’s covid rate continues to remain high:
     https://www.science.org/content/article/israel-s-struggles-contain-covid-19-may-be-warning-other-nations
     .
     “A significant portion of the new infections is occurring in the 2 million Israeli children who are younger than 12, for whom vaccines are not yet approved. Whereas this group represented 24% of new infections on 14 August, that number had risen to 42% in the week ending 16 September. “There are two parallel forces driving this proportion up: school opening, and gradually increased protection of the older population,” Balicer says. More than three-quarters of Israelis who are 60 and older have received boosters.
     Israel’s case count likely reflects a third factor, too—extensive testing, says Dvir Aran, a biomedical data scientist at the Israel Institute of Technology (Technion). Since school started children must get tested if there was a confirmed case in their class. This means that many more children are getting tested.” (His 2-year-old daughter is now in quarantine with her mother, separated from him and her siblings, because a preschool classmate tested positive.”

214. MikeN,
     Yes, that applies to Republicans as well.

215. AOC wandering around in tears after Iron Dome gets funded. I can’t fathom that.
     Iron Dome kills zero people. Zero zilch nada none empty set nill. It does nothing but save civilian lives. Frequently, too.
     What on earth is there to shed tears over? Surely not this.
     .
     The woman lives in an alternate reality.
     .
     [Edit: My answer to my rhetorical question is — there is nothing to shed tears over. The realization that her influence in Congress is smaller than she wishes it was, perhaps. Her tears, my heartfelt relief.]

216. Oh, I see now. From Jezebel:

     AOC reportedly broke down crying on the House Floor after changing her vote from “no” to “present” at the last minute, which many reporters speculated was a necessary strategic move to position herself to run for Senate in New York.

     She was crying because she sold out her noble ideals. Heh.

217. mark bofill,
     “The woman lives in an alternate reality.”
     .
     She is absolutely bonkers. She shouldn’t be elected to a local school board, and certainly not Congress. When something passes the House with 400+ votes, you can be certain only the extreme fringe are voting against it; in this case, a blatantly anti-Semitic and unhinged rump of the Democrat party is in opposition.

218. mark,
     Here is the weird thing: Israel has been offering reasonable peace deals since at least the Clinton administration. The Palestinians are not and have never been interested in peace, so they walked away from every offer. They will NEVER accept anything but elimination of Israel as a Jewish state. So the Palestinians are becoming ever more irrelevant in the Middle East. That we have a few crazies in Congress who agree with the Palestinians means only those crazies should also be ignored. But you knew that. BTW, AOC has as much chance of being elected to the Senate over Chuck Schumer as I do….. and I don’t even live in NY. More evidence of AOC’s bonkers take on reality.

219. mark bofill (Comment #206169): “What on earth is there to shed tears over?”
     .
     It was a defeat for her friends: the Palestinian terrorists. I am not kidding. AOC and the rest of the Squad want Israel wiped off the map. I suppose it is because Jews are privileged white people and Palestinians are oppressed brown people. The falsity of that is irrelevant to people like AOC.

220. Steve,
     I agree. I hope she has no chance of defeating Schumer. I wasn’t aware she aspired to that until I bumped into the reference I linked. I’ll have to research a little.

     Mike,
     Yes. It’s like the standard left view taken to an insane extreme. I have a hard time articulating it properly. The Palestinians fire rockets at civilian populations of Jews, of all people; it staggers me to imagine how powerful the Squad mindset has to be to overcome that fact, given that there is worldwide sympathy for the Holocaust. But this extreme leftism manages it. The Israelis refuse to be victims, and apparently that’s enough to make them oppressors.

221. Steve,
     You remember correctly. In 2000 and in 2008 the Palestinians refused to come to an agreement, I read.
     Well, it’s like the Bee says. One side wants to kill Jews and on the other side are Jews who don’t want to die and neither side will compromise.

222. mark bofill (Comment #206175): “The Palestinians fire rockets at civilian populations of Jews, of all people; it staggers me to imagine how powerful the Squad mindset has to be to overcome that fact, given that there is worldwide sympathy for the Holocaust. But this extreme leftism manages it.”
     .
     Remember that we are talking about people who insist that men can have babies and that testosterone is irrelevant to athletic success. And that burning down black-owned businesses furthers racial justice. And that we don’t need police. And that there is nothing wrong with rich, mostly white people partying maskless while being served by poor, mostly black and brown people who are required to wear masks. And it is too depressing to go on.

223. I don’t recall whether these numbers were posted here. Poll by the NYT.
     .
     What are the chances somebody with covid must be hospitalized:
     :
     Democrat
     zero: 2%
     1-5%: 10%
     6-10%: 14%
     11-19%: 6%
     20-49%: 28%
     50%+: 41%
     .
     Republican
     zero: 4%
     1-5%: 26%
     6-10%: 15%
     11-19%: 5%
     20-49%: 23%
     50%+: 28%
     .
     Independent
     zero: 3%
     1-5%: 20%
     6-10%: 13%
     11-19%: 5%
     20-49%: 25%
     50%+: 35%
     .
     This is the problem, right here, responsible for far far more than just covid alarmism. The smartest people in the room, convinced that everyone else is an ignorant pleb reading fake news are, in fact, the most ignorant people around reading fake news.
     .
     The second problem is that those who have taken on the task of disseminating information, from government departments to the media, have failed at every level. I’d go as far to suggest that the vast amount of information given out on the subject, that has utterly failed to inform people of basic facts, is an actual success for them, given how useful fear is to those who claim power and make a fast buck.

224. DaveJR,
     What is the actual chance? My guess is about 4% to 5% of diagnosed cases (over the whole pandemic) have ended with hospitalization. The number has to be lower now due to acquired resistance (either from vaccination or from having had the illness).

225. This implies about 2.2 million hospitalizations (666 per 100K cumulative):
     https://gis.cdc.gov/grasp/COVIDNet/COVID19_3.html

     The Financial Times gives 12.8K positive tests per 100K, 42M total. So just over 5% hospitalized. But with ~1/3 of those being hospitalized for something else and 3-4 infections per positive test, it would be more like 1% of those infected being hospitalized because of the virus.

     Addition: At the link above, you can select “cumulative” in the upper left and below that set “view rates by” to “sex” and you will also get the overall numbers.

226. The correct answer was 1-5%.

227. I guess this can be filed under the “too good to check” for right wing news sources, ha ha:
     .
     NYT:
     Chris Cuomo Sexually Harassed Me. I Hope He’ll Use His Power to Make Change.
     https://www.nytimes.com/2021/09/24/opinion/chris-cuomo-cnn.html
     .
     They have a smoking gun email. CNN is being put in a pretty unfortunate position, I feel so sorry for them, not. She says he doesn’t want him fired, but demands he do the walk of shame on air. The NYT comments are hilarious, it would seem whose team you are on is a factor in how this is interpreted. I don’t think we will be seeing an army of Handmaid Tale’s costumes outside of CNN this afternoon.

228. DaveJR,
     Those results look a lot like those of the Franklin Templeton-Gallup poll published last December. [Although the link shows only Dem/Rep answers, not independent.] Are you citing a recent poll, or this older one?

     P.S. Fascinating point in the poll results (linked above) about the effect of numeracy on people’s responses.

229. Yes, it was the gallup poll, not sure whether it was more recent than you suggest . Maher presented the numbers to Kimmel, resulting in the kind of laugh you might expect from someone suddenly placed in an rather uncomfortable position.
     .
     The results are both shocking and unsurprising, displaying the systemic failure of our trusted sources of information. Such sources often bemoan people’s lack of trust whilst those who trust them most are far more wrong than everyone else *sigh*.

230. The media just doesn’t report the actual rates of infection and hospitalization in an understandable way for most people. They also fail to convey the magnitude of the age disparity. There are a lot of reasons for this, but I suspect it’s mostly just numeric incompetence from journalists. Did you have future journalists in your Calculus class in high school? I thought not.
     .
     Some of it also is the selling of fear that is standard practice in today’s journalism financial model, but you can’t also report what you don’t understand.

231. Tom Scharf,
     ” Did you have future journalists in your Calculus class in high school?”
     .
     My second daughter was gifted in both math and language (National Merit, combined SAT of over 1500 for math and verbal), and took all kinds of advanced HS classes. She was interested in architecture, until she realized in college how much work was involved; switch second year to a combined journalism and literature major. You never know what kids will do.
     .
     I suspect the biggest reason covid statistics are not accurately reported by the MSM is that they recognize that would a) not follow the “bleeds leads” rule, and b) would immediately reduce public support for the covid policies people on the left almost universally prefer (AKA public control of nearly all individual actions). Same reason the CDC and the Biden administration don’t accurately report the covid statistics…. they just don’t want people to conclude that the pandemic is ‘not so bad’ as to be more important than personal liberty, which would cause more resistance to their preferred policies.

232. A favorite in the “doublespeak” competition. Commerce Secretary asked semiconductor firms for sales & inventory figures:

     What I told them is, ‘I don’t want to have to do anything compulsory but if they don’t comply, then they’ll leave me no choice.’

233. Harold,
     That’s pretty choice.

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