Riobard

I thought that as well, reasonable interpretation, until I realized that over the last 6 days of surveillance the ratio of cases fully vaxx’d to non-vaxx’d is 8:25, not a good showing. If the ratio for vaxx:prevaxx were known that might explain it. The problem is not knowing that ratio and its progression over the 40 days. But as more are vaxx’d, the less non-vaxx’d there are to take a percentage share of daily diagnoses. I realize now the uptake is somewhat staggered as there are cases late in the period among the <14 days following 2nd dose. Thanks for the input. The MOH report will diminish in relevance and I doubt the MD will reply to my questions seeing as they are buried among hundreds of comments in his social media feeds. LOL. Folks have also asked for even basic rough info on the vaccination products used. I suppose he does not want more people then going off and trying to calculate efficacy. He put this report on FB but not Twitter and does not answer any comments.

So I put this as a comment, one of hundreds made by others on this report, on the gov’t doctor’s FB: The denominator is 426 vaccinated HCWs, not 430K+ HCWs in the nation of which some of the whole collective of HCWs received vaxx. 244 non-infected were included as it is a small cohort inoculated with 1st dose on the same day (presumably)?? This makes the CoV rate among the HCWs correctly vaccinated 2.1%, not 9+31 vaccinated out of 430K+, which would be negligible. What is totally confusing is that in the later days of the 40-day period the share of infections is high among those that had been fully vaccinated for at least 2weeks. The design needs to be clearly elaborated in order to interpret the pie chart and histogram. Does ‘none’ mean non-vaccinated or non-infected? If it means non-vaccinated, why were so many partially or even fully vaccinated HCWs infected relative to the non-inoculated? And that makes 9/142 = 4.9% of the fully vaxx’d HCWs infected.

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Sorry, @spoon, the confusion is not resolved. Another article says the 438,000 vaccinated is in total pop, not specifically HCWs. Also, the guy put 244 non-infected into the calculation so the denominator has to be 426, not 438,000 ... this puts the vaxx’d HCWs at 2.1% infected at the point immunity should have been conferred, suggesting it was a small cohort all vaccinated on the first of the 40 days and followed for CoV status. There is no way 438,000 could have been simultaneously vaccinated on March 7th. So this now means a contradiction in the screenshot above from The Star. He said the fully properly vaccinated HCWs had negligible incidence. There is now a paywall so I cannot return to it. My worry is that he was so intent on underscoring the importance of additional vigilance following the period of vaxx up to sufficient protective immunity that he royally messed up the data.

I just sent the Malaysian doctor my questions via Messenger. —— Addendum: I found the answer, maybe the doctor will need to correct the apparently misinterpreted tweet from the other source.

But this Tweet from what appears to be an official local epi Twitter site, @spoon ... then they posted a USA example of breakthrough infection. Is it meant to be sarcastic? If so, why would they add the part about preventing severity and death? Maybe the doctor did not present the actual HCW Ndenominator because it was not precisely known. On the doctor’s Facebook page (Noor Hisham Abdullah) one English comment on the low incidence after all, but it follows some Malay comments so I cannot really figure out that thread. BTW, in either case the numerator is 182, not 426. ————

[Sorry, the system would not allow my script after I quoted you in the previous field.] The rate (proportion) of infection among the fully vaccinated HCWs is 2.1% over a brief time period. The rate within the vaccination assignment arm in Pfizer\BNT over a longer time period is .043%. Vaccination among these Malaysian HCWs did not work well because they were 48 times as likely to acquire CoV compared to those vaccinated in the efficacy trial and were 13 times as likely to acquire CoV as the (mostly) unvaccinated general population. Vaccinated HCWs in the Brazilian CoronaVac efficacy trial also had a similar incidence, close to 2%. However, that was consistent with the unvaccinated general pop. Yet it suggests that in the real world Malaysia HCW setting the mRNA products were no better than CoronaVac. Though no placebo control or non-vaxx’d HCW group to truly assess the effectiveness in the Malaysia study. Perhaps the Malaysian HCWs were in a high concentration of incidence. They really take a hit. How many people would want to risk a 1/50 chance of going to work and getting infected shortly following the recommended vaxx dose cycle? CDC just reported an estimated .009% breakthrough infections among those fully vaccinated, over 2,000 times these Malaysian HCWs.

@spoon, vaccinated, not vaccinated, post-vaxx duration aside, 43% CoV incidence among HCWs is 269X background cumulative incidence for Malaysia’s genpop (.16%) over the same 40 days. The higher rates in HCWs in other studies are usually up to 2-fold, not well over 200-fold. That would cripple any health care system. The report and illustration do not make sense. It seems impossible to me unless the HCWs had volunteered to be exposed to almost inevitable infection. Was it a ‘challenge’ study? The wording says “were infected” ... semantically that could mean they were planfully exposed as opposed to ‘they acquired infection randomly’.

Wise move. Break the circuit. It’s the UK variant and it may be inflated by cross-border travel from Cambodia. Thailand will have to revert back to 14-day quarantine; 10 days is too leaky wrt to a strain that is more contagious, with a longer contagion period, than original wild-type CoV. This is likely partly the cascade effect of an identifiable quarantine breach in Cambodia in February, with cases surging there now about 25% higher rolling incidence than Thailand after having had a negligible volume of cases since the pandemic commenced. Thailand scaled back quarantine duration April 1st. They didn’t see the newer smaller leaves coming and switched to a rake with tines spread too far apart. Hindsight is 20:20. It’s all happening very quickly. I would not be surprised if this scuppers Thailand’s plan for local cluster vaxx for the tourism spot Phuket in order to deploy the limited supply to infection hotspots.

I am returning to this basically because I had questioned the value of CoronaVac. Not that I should be considered an influencer either way, but I should point out that this vaccine now seems to be proving itself reasonably well in overall real-world effectiveness, 67%, in Chile and is acquiring much acceptance particularly in Brazil. Also large reductions in hospitalization and death. The good PR reduces hesitancy there and that can compensate somewhat for lesser efficacy relative to some of the other vaccines. It also appears to come with minimal side effects / adverse events. I did not want to trash-talk it a while ago and then fail to report more recent news about it as well as my increased optimism about this Sinovac product.

Addendum: the occurrence of the rare clots of concern is not that common with COVID apparently. So there are clots and there are clots. But 10x greater risk with COVID than vaxx for the worrisome clot types with the long 4-word label , according to Oxford U.

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I found it on Hooman Noorchashm’s recent Twitter feed. But the feeds of a few ‘armchair’ yet qualified clinicians and epidemiologists that I and many others respect, as they seem to relentlessly jump on every COVID story that comes out and unpack it objectively, without an apparent personal agenda of their own, make no mention of this one. ——- Because the thromboembolism factors are quite widespread in COVID itself, and the onset of associated problems occur on a variable timeline, retrospectively testing for nucleocapsid-specific antibodies that confirm previous infection prior to vaccination among those vaccinated presenting with the clotting syndrome won’t necessarily tell you whether the clotting is precipitated by vaccination as opposed to the clotting emerging latently, temporally coincidental to post-vaxx, as an aspect of having had COVID. It may be that the rare clotting shows glaringly following vaccination because vaccination is an easily identifiable singular antecedent. In contrast, the same clinical phenomenon, while known, is obscured or buried among many other symptoms or complications requiring primary attention among folks sick with COVID. So you won’t have had a news cycle that was just sayin’: BTW, you def don’t want COVID cuz apart from the risks of needing intubation you may get antibodies clumping platelets together. Also different political animals.

And that is why Brazilian ‘trade’ should be a bona fide tax-deductible medical xpense.

Rio mayor now infected, and symptomatic again, with New CoV after having had CoV Classic 11 months ago.

On another note, as somebody that pushed for health education literature for the general public that did not exceed, for example, the Flesch-Kincaid 5.0 literacy level, the brief CDC quote above fails. OK OK, somebody may now take a swipe at me. LOL. But this forum is not representative of average community literacy.

The Phase3 trials assess for baseline SARS-CoV-2 status and stratify accordingly for analyzing efficacy and vaccination response. Pfizer/BNT had 6.2% with prior infection. J&J had 9.8%. These research subjects are identifiable, and clinical sequelae associated specifically with CoV exposure history are evaluable. However, the rarity of clotting that leads to acute illness may not yield much additional info by going back to that cache of serum samples that is small relative to real-world uptake. Noorchashm did have a very compellingly persuasive 5 minutes with Tucker Carlson of Fox News. So his concerns are not totally “buried”. He did hold back, though, in pointing out the obvious, that proximal profit margins would depreciate if those recovered from CoV were bypassed for inoculation.

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Dunno. Whenever Brazil 2.0’s many off-limits aspects, too many to list right now, are cleared, I guess, and flights are greenlit. Apparently as a Canadian I cannot transit through USA returning from Brazil, Panama connections are currently wonky and likely also subject to restrictions, and the EU is recommending all its member countries join the ones banning flights to and from Brazil.

See, I cannot submit ... guess the system sees me as exclusively ativo and will allow other ‘characters’ of questionable repute. ;>D

My Twitter feed reveals case reports about the syndrome, eg one just published in NEJM, that suggests causal factors other than the past/recent CoV infection one. It’s probably too complex an issue to attempt to unravel in discussion here on the Board. Also, the author Noorchashm does not list an institutional affiliation. Though it would likely be important to follow his simple to execute recommendation. You could spend days following feeds of high-profile clinician scientists on this ... Eric Topol, Eric Feigl-Ding, Hilda Bastian, loads of others, and get many varied opinions.

I touched on this theme this here in the forum months ago when referring to ADE ... antibody-dependent enhancement of disease, and I had added that the FDA EUA submissions had referenced it ... that it is a consideration about which little is known viz COVID. Know your natural immunity status by antibody testing and your CoV infection status by viral testing (as many cases are asymptomatic or paucisymptomatic), at the point of inoculation planning prior to actually pursuing artificial immunity, at least prior to the first (sole) shot of a 2-dose (single-dose) regimen. What is cray-cray is those jabbing you protecting themselves from transmission because you may be infected and contagious at the time. The meta message being: you are about to be inoculated possibly too late against a disease that you may currently have, but seeing as you are here, roll up your sleeve. Why would you want the huge payload of immune system stimulation with a compounding of simultaneous virus and a viral facsimile? Additionally, some of the limited vaccine stock could be (have been) deployed to those without any protective immunity, saving more lives at a point of product scarcity. The population percentages of those with protective natural immunity can be quite substantial where prevalence has been high. This doctor authoring the piece suggests screening for nucleocapsid antibodies after the fact, investigating the clotting, as regular antibody testing would conflate natural and artificial immunity. For pre-vaxx purposes ... note that I am far from being an expert ... I believe the generic antibody tests are fine. I think they target the antibodies specific to the viral spike protein. My personal go-to has been the Roche CoV antibody assay. Mind you, I tend to get sore throats likely related to allergies so that is one feature that has propelled me at times into getting (free) local viral tests, followed occasionally by the pricey antibody test I have to pay for in Quebec. I also checked that I did not have natural infection antibodies prior to receiving my first dose in an all-blind placebo-control RCT. I quarantined assiduously to ensure I would not have been recently or currently infected at the point of inoculation.

There’s a difference. I just cannot remember what it is. And inertia prevents me from investigating and trying to roll back to basic. Maybe I will at the next annual charge.