TallGuyJohninBKK

To be counted as a COVID death in those CDC statistics, the death has to have COVID as the underlying (main) cause or a contributing cause as coded on the death certificate. "Provisional data are non-final counts of deaths based on the flow of mortality data in NVSS. Deaths include those with COVID-19, coded to ICD–10 code U07.1, as an underlying or contributing cause of death on the death certificate." Source link:

Although U.S. COVID deaths and hospitalizations have been declining lately, and are much down from their peaks of early 2023 a year ago, COVID is still killing more than 200 Americans per day, each and every day, in the U.S., more than 1,500 per week right now. Source link: "Data during recent periods are incomplete because of the lag in time between when a death occurs and when a death certificate is completed, submitted to NCHS, and processed for reporting. This delay can range from 1 week to 8 weeks or more, depending on the jurisdiction. The most recent 3 weeks of mortality counts are shaded grey and mortality rates shown as dotted lines because NVSS reporting is <95% during this period."

More on why the CDC's latest guidance is at odds with what the science shows on transmissibility of COVID even now: Covid Taught Us a Lot. The CDC Now Wants Us to Forget It. ... "the guidelines outlined by the Post’s three sources would run counter to the available research on Covid and other respiratory illnesses—presumably in order to satisfy economic and political interests. The consequences both for contagion and public trust, should the agency follow through on these plans, could be severe. ... Crucially, Covid symptoms do not seem to correspond with contagiousness. “We knew surprisingly early on in the pandemic that asymptomatic individuals can shed virus and can transmit the virus to others,” said Sorrell. With omicron, only 22 percent of vaccinated people had a fever, and it was even less common among those who had a booster; even so, 80 percent of patients still tested positive after five days, one study found. Some 40 percent of kids are still contagious after symptoms resolve; one-quarter are contagious after seven days, and 10 percent are still contagious after 10 days." https://newrepublic.com/article/179304/covid-cdc-guidelines-isolation-symptoms

One problem with the CDC's policy change is that science shows that people 24 hours after their COVID symptoms have begun improving -- the CDC's new cutoff for ending recommended isolation -- can and will continue to be contagious to others around them. Some experts disagree on guidance change It’s reasonable to want to treat Covid-19 like other respiratory viruses, said Dr. Ellie Murray, an assistant professor of epidemiology at Boston University’s School of Public Health, “but you can’t just discard the science.” ... Murray notes that we’ve learned a lot about how respiratory diseases spread and how best to control them during the pandemic. But instead of applying those lessons to help protect people from other infections like the flu, she says, this rolling back of precautions is sending a harmful message. “It’s undermining the whole rest of the public health system,” she said. “Because what people are hearing is, ‘Actually, diseases aren’t as bad as we’d said they were, and we don’t actually need to do anything. It’s not actually that bad if some people die.’” https://www.cnn.com/2024/03/01/health/cdc-covid-isolation-recommendations/index.html

I think the CDC's policy change here is a recognition of several things: 1. Protection against COVID is better now than it was in past years, because of the partial/temporary immunity gained from prior infections and vaccinations at the society levels. Along with better medical treatments and methods of care. 2. That their policy on isolation is and was only a recommendation, and people and entities weren't required to follow it, and in fact, probably weren't mostly following it in real life these days. Still, there are a good number of folks out in the public health community who believe the current CDC policy change is ignoring what the actual science continues to show about COVID and its infectiousness and transmissibility. Why Are We Still Flu-ifying COVID? The diseases are nowhere near the same. ... "In 2023, COVID hospitalized more than 900,000 Americans and killed 75,000; the worst flu season of the past decade hospitalized 200,000 fewer people and resulted in 23,000 fewer deaths. A recent CDC survey reported that more than 5 percent of American adults are currently experiencing long COVID, which cannot be fully prevented by vaccination or treatment, and for which there is no cure. ... Dropping the current COVID-isolation guideline—which has, since the end of 2021, recommended that people cloister for five days—may likewise be dangerous. ... That means a return to a world in which tens of thousands of Americans die each year of flu and RSV, as they did in the 2010s. With COVID here to stay, every winter for the foreseeable future will layer on yet another respiratory virus—and a particularly deadly, disabling, and transmissible one at that. The math is simple: “The risk has overall increased for everyone,” Landon said. That straightforward addition could have inspired us to expand our capacity for preserving health and life. Instead, our tolerance for suffering seems to be the only thing that’s grown. https://archive.is/9wY9Z

There were instances when some public figures overstated what the data was showing at the time.... And then they were corrected by the U.S. CDC: CDC reverses statement by director that vaccinated people are no longer contagious April 2, 2021 The CDC later told the Times Walensky was speaking broadly during the interview. “It’s possible that some people who are fully vaccinated could get COVID-19. The evidence isn’t clear whether they can spread the virus to others. We are continuing to evaluate the evidence,” a CDC spokesman told the Times. The CDC study found the two mRNA vaccines prevented 90 percent of infections two weeks after patients received the second of two doses, including asymptomatic and presymptomatic infections. Following a single dose of either vaccine, the participants’ risk of infection dropped by 80 percent. https://thehill.com/changing-america/well-being/546234-cdc-reverses-statement-by-director-that-vaccinated-people-are-no/ The truth was out there and was told repeatedly as to what what occurring and found during that period of time.

No, society wasn't "lied to" about the vaccines.... though some politicians did overstate what the data was showing in the early going. Fact Check: Preventing transmission never required for COVID vaccines’ initial approval; Pfizer vax did reduce transmission of early variants "To get emergency approval, companies needed to show that the vaccines were safe and prevented vaccinated people from getting ill. They did not have to show that the vaccine would also prevent people from spreading the virus to others. Once the vaccines were on the market, independent researchers in multiple countries studied people who received the Pfizer-BioNTech vaccine and did show that vaccination reduced transmission of variants circulating at the time." ... Evidence continued to build in 2021 that the mRNA-based vaccines prevented infections and onward transmission of the virus (https://www.science.org/doi/10.1126/science.abl4292 , opens new ta). But with the advent that year of the coronavirus Delta variant, plus waning immunity from vaccines delivered at the start of the year, protection against infection and transmission was seen to be dropping, although not eliminated, as previously described by Reuters Fact Check (https://www.reuters.com/article/factcheck-coronavirus-vaccines-idUSL1N2SA1FZ). The newest family of Omicron variants has further eroded vaccine effectiveness against infection and transmission (https://www.reuters.com/business/healthcare-pharmaceuticals/how-omicron-highlights-fading-hope-herd-immunity-covid-2022-01-20/) . But even Omicron does not escape vaccine protection completely. https://www.reuters.com/fact-check/preventing-transmission-never-required-covid-vaccines-initial-approval-pfizer-2024-02-12/ Things were different in the early going with the original variants of the virus. And there were valid reasons for the original optimism about greatly reducing transmission, based on studies at the time. Israeli studies find Pfizer COVID-19 vaccine reduces transmission February 19, 2021 JERUSALEM (Reuters) - Pfizer's COVID-19 vaccine greatly reduces virus transmission, two Israeli studies have found, shedding light on one of the biggest questions of the global effort to quash the pandemic. Data analysis in a study by the Israeli Health Ministry and Pfizer Inc found the Pfizer vaccine developed with Germany's BioNTech reduces infection, including in asymptomatic cases, by 89.4% and in symptomatic cases by 93.7%. https://www.reuters.com/article/health-coronavirus-israel-vaccine-int/israeli-studies-find-pfizer-covid-19-vaccine-reduces-transmission-idUSKBN2AJ08J/

Previously reported in fuller form and detail here:

It's pretty pathetic when the two main appeals RFK Jr. has going for him are his longstanding fringe campaign against vaccinations, which is based on a documented history of blatant misinformation, and his having the Kennedy family name, where his own Kennedy relatives have politically disowned him. That's a candidate for U.S. president? Vaccine Misinformation: "this doesn't change the fact there are also countless examples of Mr Kennedy spreading conspiracy theories, making false or misleading statements, and sticking by his positions regardless of the evidence presented to the contrary. https://www.bbc.com/news/world-68447223 Kennedy Family: Kennedy family members call RFK Jr.’s independent bid ‘dangerous to our country’ 10/09/23 “The decision of our brother Bobby to run as a third-party candidate against Joe Biden is dangerous to our country,” read a statement signed by four of Kennedy’s siblings — former Maryland Lt. Gov. Kathleen Kennedy Townsend (D), former Rep. Joseph Kennedy II (D-Mass.), Rory Kennedy and Kerry Kennedy. “Bobby might share the same name as our father, but he does not share the same values, vision or judgment. Today’s announcement is deeply saddening for us. We denounce his candidacy and believe it to be perilous for our country,” the statement continued. https://thehill.com/homenews/campaign/4245980-kennedy-family-members-call-rfk-jr-s-independent-bid-dangerous-to-our-country/ AND (well before COVID, since his anti-vaccines stance isn't just limited to COVID vaccines) Kennedys pen op-ed refuting RFK Jr.’s ‘tragically wrong’ vaccine beliefs 05/08/19 Three relatives of Robert Kennedy Jr. lashed out at the son of the former senator, calling his anti-vaccination advocacy “wrong” and “dangerous” in an op-ed published Wednesday. ... The three warn that despite Kennedy Jr.’s valuable work on environmental advocacy, his speaking out against vaccinations, including a meeting with then-President-elect Trump to discuss “vaccine safety,” has helped spread “dangerous misinformation” about vaccines through social media. https://thehill.com/policy/healthcare/442647-rfk-jrs-family-writes-op-ed-openly-refuting-his-tragically-wrong-vaccine/

I spent about an hour hanging out at the arrivals area at Suvarnabhumi in Bangkok last weekend waiting to meet an incoming family member. Could have sworn I was actually in the arrivals area at Beijing airport, given the numbers / share of Chinese who were flowing out of the BKK arrivals area.

Simple trespassing is a more serious legal offense than physical assault in Thailand? That sounds like a pretty peculiar interpretation of the law.

https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2024-02-28-29/04-COVID-Link-Gelles-508.pdf

A new study has some worrying findings that suggest covid may have longer-term effects on cognition and memory — and that these lead to measurable differences in cognitive performance. The study, published Thursday in the New England Journal of Medicine, found that participants who recovered from covid symptoms had a cognitive deficit equivalent to three IQ points compared with those who were never infected, while participants suffering from unresolved covid symptoms lasting 12 weeks or more experienced a loss equivalent to six IQ points. But researchers also stressed that the greater cognitive decline associated with persistent symptoms may not be permanent, as participants in this category who had recovered by the time they took part in the study were found to have cognitive deficits comparable to those who recovered quickly. (more) https://archive.is/EWkOu https://www.nejm.org/doi/full/10.1056/NEJMoa2311330 Even fully recovered survivors of mild COVID can lose IQ points, study suggests The New England Journal of Medicine posted a study by Imperial College London researchers showing that COVID-19 patients recovering from short-term symptoms experienced similar small deficits in memory, thinking, or concentrating ("brain fog") as those who had longer-term symptoms. The investigators calculated a global cognitive score across eight tasks using online self-reports of cognitive function among 112,964 adults participating in a study in England. They compared the results of COVID-19 survivors with those of their uninfected counterparts. ... Virus strain, infection severity A multiple regression analysis showed that COVID-19 survivors whose symptoms had resolved in less than 4 weeks or at least 12 weeks had comparable small deficits in cognitive function—or the ability to think—compared with uninfected participants (−0.23 and −0.24 standard deviations [SD], respectively). COVID-19 survivors demonstrated greater deficits than uninfected controls (−0.42 SD). (more) https://www.cidrap.umn.edu/covid-19/even-fully-recovered-survivors-mild-covid-can-lose-iq-points-study-suggests

Monovalent XBB.1.5 vaccine shows 51% protection against COVID hospitalization A new interim estimate of vaccine effectiveness (VE) of the monovalent (single-strain) XBB.1.5 COVID-19 vaccine shows the shot was 51% effective in preventing emergency department and urgent care visits among adults without compromised immune systems. ... Compared to adults who did not receive the monovalent XBB.1.5 COVID-19 vaccine, recipients were most protected in the first 7 to 59 days after vaccination, with VE dropping slightly 60 to 119 days after an updated dose. ... In both networks combined, VE against COVID-19–associated emergency department or urgent care visits among all adults was 51% ... during the first 7 to 59 days after an updated dose and 39% ... 60 to 119 days after vaccination. VE against COVID-19–associated hospitalization was 52% ... and 43% ... respectively. https://www.cidrap.umn.edu/covid-19/monovalent-xbb15-vaccine-shows-51-protection-against-covid-hospitalization Interim Effectiveness of Updated 2023–2024 (Monovalent XBB.1.5) COVID-19 Vaccines Against COVID-19–Associated Emergency Department and Urgent Care Encounters and Hospitalization Among Immunocompetent Adults Aged ≥18 Years — VISION and IVY Networks, September 2023–January 2024 February 29, 2024 What is added by this report? Receipt of an updated COVID-19 vaccine dose provided increased protection against COVID-19–associated emergency department and urgent care encounters and hospitalization compared with no receipt of an updated vaccine dose among immunocompetent U.S. adults during a period of multiple cocirculating SARS-CoV-2 Omicron lineages. What are the implications for public health practice? These findings support CDC recommendations for updated 2023–2024 COVID-19 vaccination. All persons aged ≥6 months should receive updated 2023–2024 COVID-19 vaccine. https://www.cdc.gov/mmwr/volumes/73/wr/mm7308a5.htm

XBB.1.5 vaccine safe in older adults In a research letter published in JAMA earlier this week, a nationwide cohort study of more than 1 million Danish adults aged 65 years and older showed no increased risk of 28 adverse events following vaccination with the monovalent XBB.1.5-containing COVID vaccine. In Denmark, the XBB.1.5-containing vaccines were recommended as a fifth COVID-19 vaccine dose to people aged 65 years and older, with vaccination beginning October 1, 2023. Using a nationwide database of 1,076,531 people (mean age, 74.7 years; 53.8% female), of whom 902 ,803 received an XBB.1.5 vaccine as a fifth dose, the authors found no significant association between the vaccine and adverse events. https://www.cidrap.umn.edu/covid-19/monovalent-xbb15-vaccine-shows-51-protection-against-covid-hospitalization https://jamanetwork.com/journals/jama/fullarticle/2815787

Why Older Adults Need Another COVID-19 Shot February 29, 2024 Older adults should get the COVID-19 vaccine more frequently than previously recommended, according to new guidance from the U.S. Centers for Disease Control and Prevention (CDC). Health officials are urging people ages 65 and older to receive another vaccine dose in the spring, or at least four months after their most recent dose. CDC director Dr. Mandy Cohen announced the decision after a CDC advisory committee, which is made up of independent vaccine and infectious disease experts, voted 11-1 to make the change. “An additional vaccine dose can provide added protection that may have decreased over time for those at highest risk,” she said in a statement. The decision is based on data presented by CDC scientists that showed current hospitalization rates for COVID-19 are highest among seniors, with the biggest spikes occurring among those 75 years and older. People 65 and older account for 67% of hospitalizations due to COVID-19. (The CDC previously recommended that most people get a COVID-19 vaccine once a year. ) (more) https://time.com/6836390/older-adults-covid-19-vaccine-2024/

It looks like the National Health Service in the U.K. also will be running an XBB-focused COVID vaccines campaign this spring for older residents, but with a higher minimum age than the U.S.: Preparing for a successful spring 2024 COVID-19 vaccination campaign Date published: 21 February, 2024 Eligible cohorts in spring 2024 adults aged 75 years and over residents in care homes for older adults individuals aged 6 months and over who are immunosuppressed (as defined in the Green Book, chapter 14a; tables 3 and 4) "This includes those who turn 75 years old by 30 June 2024. These people will be eligible for a vaccination at any point in the campaign. People who are admitted to an older adult care home or become immunosuppressed by 30 June are also eligible." ... Campaign start and end dates "Visits to older adult care homes and eligible housebound patients should begin 15 April 2024. For all other eligible cohorts, vaccinations should start by 22 April 2024 and end on 30 June 2024." Supply and deliveries "We will be using XBB.1.5 vaccines throughout the spring 2024 campaign, as deployed in the Autumn 2023. non-mRNA vaccines will not be supplied in the NHS programme." https://www.england.nhs.uk/long-read/preparing-for-a-successful-spring-2024-covid-19-vaccination-campaign/

From the CDC yesterday: "Adults 65 years and older are disproportionately impacted by COVID-19, with more than half of COVID-19 hospitalizations during October 2023 to December 2023 occurring in this age group." “Today’s recommendation allows older adults to receive an additional dose of this season’s COVID-19 vaccine to provide added protection,” said [CDC Director] Mandy Cohen, M.D., M.P.H. “Most COVID-19 deaths and hospitalizations last year were among people 65 years and older. An additional vaccine dose can provide added protection that may have decreased over time for those at highest risk.” https://www.cdc.gov/media/releases/2024/s-0228-covid.html

fyi, forum health moderator @Sheryl has lately identified a government hospital travel clinic in Bangkok as being a confirmed source of the newer monovalent, XBB-targeted COVID vaccines from Pfizer. I've also confirmed the details with them, and will be doing a separate thread on the subject here shortly. The only catch is, unlike prior no-cost government COVID vaccine offerings, the travel clinic COVID vaccine requires payment that all-in should come to about 2,500 baht per dose. But the good news is they're making the newer Pfizer vaccine available to all foreigners, both resident expats and also foreign tourists. (FWIW, Thais are being required to pay there also as well.) The beginning of the discussion of this is located in the following thread below. But as I mentioned above, I'll also soon be doing a separate, standalone thread on the subject.

Vaccine advisers to the Centers for Disease Control and Prevention (CDC) recommended that people ages 65 and older receive an additional dose of the current monovalent (single-strain) COVID-19 vaccine this spring. The vote from the Advisory Committee on Immunization (ACIP) targets a group at higher risk for COVID-19 hospitalization and death. Immunity is known to wane following vaccination as well as infection, and it's been almost 6 months since the CDC weighed in with its last advice, which was that people ages 6 months and older receive the updated COVID vaccine targeting the XBB.1.5 variant. Though COVID activity is currently trending downward in the United States, experts said it's likely that virus circulation will likely continue at significant levels in the months ahead. ACIP made similar spring booster recommendations in 2022 and 2023. (more) https://www.cidrap.umn.edu/covid-19/cdc-advisers-recommend-spring-covid-booster-seniors Older Adults Now Able to Receive Additional Dose of Updated COVID-19 Vaccine For Immediate Release: Wednesday, February 28, 2024 Today, CDC Director Mandy Cohen endorsed the CDC Advisory Committee on Immunization Practices’ (ACIP) recommendation for adults ages 65 years and older to receive an additional updated 2023-2024 COVID-19 vaccine dose. The recommendation acknowledges the increased risk of severe disease from COVID-19 in older adults, along with the currently available data on vaccine effectiveness. Previous CDC recommendations ensured that people who are immunocompromised are already eligible for additional doses of the COVID-19 vaccine. Data continues to show the importance of vaccination to protect those most at risk for severe outcomes of COVID-19. An additional dose of the updated COVID-19 vaccine may restore protection that has waned since a fall vaccine dose, providing increased protection to adults ages 65 years and older. Adults 65 years and older are disproportionately impacted by COVID-19, with more than half of COVID-19 hospitalizations during October 2023 to December 2023 occurring in this age group. (more) https://www.cdc.gov/media/releases/2024/s-0228-covid.html

AFAIK, the only place where vaccine-related serious blood clotting was a very RARE problem was with the AZ vaccine (and with the similar, little used J&J vaccine in the U.S.) ... and generally not with the mRNA vaccines. That's part of the reason why the AZ vaccine was never approved in the U.S., and ultimately ceased to be used in places like the U.K. -- while use of the mRNA vaccines continued apace. There is no evidence that mRNA vaccines are linked to blood clots By Reuters Fact Check August 27, 2021 https://www.reuters.com/article/factcheck-mrna-clots/fact-check-there-is-no-evidence-that-mrna-vaccines-are-linked-to-blood-clots-idUSL1N2PY1K2/ https://health-desk.org/articles/there-s-no-evidence-that-mrna-vaccines-are-linked-to-blood-clots "the mRNA vaccines have not been associated with any kind of clotting problem." "in fact, evidence suggests COVID-19 vaccination prevents blood clots by protecting against COVID-19, which raises the risk of clotting." https://www.factcheck.org/2022/03/scicheck-post-misconstrues-public-health-awareness-campaigns-about-blood-clots/

fyi, I sent the following email query to the Mahidol Clinic on Wednesday, and got the subsequent reply: Q. I am asking is the XBB COVID vaccine available from your clinic for RESIDENT foreigners who live here in Thailand long-term? Though you could also let me know if the same vaccine is or isn't available from your clinic for visiting foreign tourists? A. Yes, we also provide the vaccine for expats or foreigners as well.

Sorry, no! Funding statement "Funding was provided by the BC Ministry of Health, Alberta Health and Wellness, Public Health Ontario, the Ministère de la santé et des services sociaux du Québec and the Public Health Agency of Canada. The views expressed herein do not necessarily represent the view of the Public Health Agency of Canada. Funders had no role in data analysis, interpretation or the decision to publish." https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2024.29.7.2400076

The fall COVID-19 vaccine cut the risk of COVID-19 illness by about half for people who’d never caught the virus before, and by 67 per cent for those with a previous infection, according to new research from the Canadian network that has long tracked the performance of the annual flu shot. This is the first time the Canadian Sentinel Practitioner Surveillance Network, which is comprised of hundreds of primary care providers in British Columbia, Alberta, Ontario and Quebec, produced mid-season estimates of the effectiveness of immunization against COVID-19. For people with hybrid immunity against COVID-19 – meaning they’ve had a jab and an infection – the shot targeting the Omicron XBB.1.5 variant performed slightly better against COVID-19 than the flu shot did against influenza. (more) https://archive.is/RjF6a#selection-2499.0-2515.226 https://www.cidrap.umn.edu/covid-19/canadian-data-show-moderate-good-vaccine-efficacy-against-covid-flu https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2024.29.7.2400076 "The updated autumn 2023 monovalent XBB.1.5 vaccine protected comparably well, reducing the risk of medically attended COVID-19 by about half overall, and by about two-thirds among previously infected individuals. Ongoing VE monitoring with increased time since vaccination and evolution in variant contribution is warranted."

A new study based on 4,605 participants in the Michigan COVID-19 Recovery Surveillance Study shows that the prevalence of long COVID symptoms at 30 and 90 days post-infection was 43% to 58% lower among adults who were fully vaccinated before infection. ... The 30- and 90-day timeframes were meant to compare two different definitions of long COVID. The US Centers for Disease Control and Prevention defines the condition as new or persistent symptoms 4 weeks after infection, while the World Health Organization definition defines it as 12 or more weeks after infection. ... Overall, 32.2% of adults with PCR-confirmed COVID-19 reported 30-day long COVID and 17.5% reported 90-day long COVID in the study. The prevalence of 30-day long COVID was 43% lower among the vaccinated group... The adjusted prevalence of 90-day long COVID was 58% lower among the vaccinated group. (more) https://www.cidrap.umn.edu/covid-19/study-shows-43-58-lower-prevalence-long-covid-among-vaccinated-people https://www.sciencedirect.com/science/article/abs/pii/S1047279724000310