The world is nowhere near the end of the pandemic, says famed epidemiologist Larry Brilliant (2023 Update)

India is curious. Only 8% of the population has been fully vaccinated but cases peaked over a month ago.

Worldometer shows total deaths at just 307 PPM.

More contagious than measles?

Nobody is offering me one.

It lets the virus multiply, which does give to a chance to mutate. The more virulent variants do get selected, and do tend to take over.

The US managed to pull the same kind of trick before vaccination got under way.

Rich countries have aircraft to take infected out to infect new communities. Even the US took quite a while to get the epidemic out into the boonies.

The process is slower in poor countries, though Peru has now managed to get to 5,883 death per million population. The US used to be a world leader but now 1900 ppm leaves it at 21st. The new outbreak in Australia has got us up to 36 ppm deaths, but we still languish at 167.

We hope to get most of the population vaccinated by the end of the year. The third world will probably clock up a few more deaths before they start getting enough vaccine doses.

Yeah. I'd bet that in the vast countryside where many Indian poor live, nobody is really counting. Even in the urban areas, few are counting.

Most of the third world is like that.

In these places, herd immunity will be achieved the old-fashioned way.

Joe Gwinn

Or maybe delta has changed the game.

Look at the Netherlands; a huge fast spike with relatively few deaths.

For the worse. But still this is nothing like the plagues of ancient times.

Netherlands has a real medical system, and vaccines.

Joe Gwinn

If people don't get sick enough to go to the hospital they don't get counted. In the dirt-poor countryside they die and don't necessarily get counted ever. Years from now someone will do a proper analysis based on excess deaths and other indicators (some deaths will be deferred and will show up later) and we'll have better numbers.

Deaths are strongly correlated with age. India has a median age in the

20s. Africa is much younger again.

No. It's much better than the original. It rips through a population in about a month and fades away, and doesn't kill many people. No time for vaccines or masks or lockdowns.

I wonder if it will basically immunize India. It looks like it has.

That didn't prevent the recent spike.

We are all lucky in this. The ancient plagues killed a major fraction of the population.

It will most certainly do that, the old-fashioned way. But most of the action will not make it to the news, even within India. A large fraction of the Indian population is dirt poor, and far from the big cities.

Probably Delta, working its way through. But deaths didn't get all that high, likely due to vaccinations.

In lots of places, the rise in cases was clearly exponential, doubling every week or so, but deaths were far lower than in the initial waves.

Joe Gwinn

I would imagine that the first wave was pretty bad, but the original variants were soon running out of susceptible. The new variants are finding some success, but are hindered by family immunity in the survivors of the first wave.

Yeah, this has to help. We are lucky here. Many viruses in that family mainly attack the young.

Joe Gwinn

Wrong. The first wave frightened everybody into self-imposed lockdown, even where the politicians weren't willing to risk the damage to the economy (which got wrecked anyway).

Not an evidence-based claim.

It doesn't have to be. We can churn out a lot more vaccine than the first world needs, and once we've got the first world to herd immunity levels (which may take some arm-twisting) we can keep the production lines going.

Delta does seem to be better at infecting the young than earlier variants were..

Rich or poor, something must explain the radical drop-off of reported cases - down over 10:1 - since May 8.

Reported deaths dropped radically too, with the usual 2 week lag.

A sensible strategy, which we didn't use, is to let it rip among healthy young people and maximally protect the old and compromised, and get it over with. Hard lockdowns kill more people in poor countries than the virus itself.

Delta has changed the game alright.

It is much more infectious, and will hospitalise, kill or seriously harm about twice as many unvaccinated individuals as any previous strain.

Red states will be in serious trouble when Delta hits the USA. They can reach herd immunity the old fashioned way but it won't be pretty.

That is a very good advert for their high proportion of vaccinated individuals in the population (and they had to close all their nightclubs to halt the rapid exponential growth curve). The Dutch have followed a more pragmatic approach than neighbouring Belgium but their control of Delta is primarily down to the high proportion of the most vulnerable who have been vaccinated and a strong sense of following what rules there are to prevent spreading Covid to the letter.

They are amongst the least vaccine sceptical nations on Earth!

By comparison Belgium has way more and stricter Covid rules but breaking such government rules has always been a national pastime!

Sensible, according to a guy who thinks Trump makes sense? And who thinks bulls improve china shops?

Data source? And, what is a 'hard lockdown' and what poor countries have implemented one?

Google is your enabler, and you are a serial abuser of its ability to dredge up muck. Poor countries do not generally rely on international trade for food, clothing, shelter; the 'trickle-down' theory you apparently want to offer is a bit of handwaving without clarification. I'm unconvinced, because unlike John Larkin, whit3rd is sometimes a skeptic.

These are both things that you have claimed in the past, and so far as I am aware have not retracted. Are you indicating that you make claims that you do not believe to be true?

Yikes:

"The study found the Pfizer vaccine was only 42% effective against infection in July, when the Delta variant was dominant."

As one expert noted, a narrow-target vaccine selects for viruses that are immune to the vaccine. A real infection confers better immunity.

Maybe the vaccines created delta.

Moderna is 3x stronger dose. So, it works better with just one-shot.

You get the same immunity eventually, with or without vaccine, when you encounter the real virus. However, having the vaccine first suffers less health damages.

Not just delta, since we don't really have much of it in the USA, mutations have better chances of evading the vaccine. But vaccine definitely did not create delta or variants. Currently, the strongest variant is E484Q + D614G (56%). So called Delta (D=452R+478K+681R) is around 15%.

USA______________|_417N_452R_478K_484Q_501Y_570D_614G_681R_|___W___A___B___C___D___E___O

2020/06__________|___0%___0%___0%___0%___0%___0%___0%___0%_|_99%__0%__0%__0%__0%__0%__0% 2020/07__________|___0%___0%___0%___0%___0%___0%__99%___0%_|__0%__0%_99%__0%__0%__0%__0% 2020/08__________|___0%___0%___0%___0%___0%___0%__99%___0%_|__0%__0%_99%__0%__0%__0%__0% 2020/09__________|___0%___0%___0%___0%___0%___0%__99%___0%_|__0%__0%_99%__0%__0%__0%__0% 2020/10__________|___0%___0%___0%___0%___0%___0%__99%___0%_|__0%__0%_99%__0%__0%__0%__0% 2020/11__(__977)_|___0%___0%___0%___0%___0%___0%__99%___0%_|__0%__0%_99%__0%__0%__0%__0% 2020/12__(__873)_|___1%___1%___0%___1%___0%___0%__99%___0%_|__0%__0%_99%__1%__0%__0%__0% 2021/01__(_2682)_|___5%___4%___1%___5%___1%___0%__99%___1%_|__0%__3%_91%__4%__1%__0%__0% 2021/02__(_4927)_|___3%___9%___2%___1%___2%___0%__98%___2%_|__0%__7%_90%__1%__2%__0%__0% 2021/03__(11927)_|__15%__25%__15%___1%__15%___1%__85%__14%_|__0%_11%_73%__0%_14%__1%__0% 2021/04__(24080)_|__52%__58%__52%___4%__55%___3%__45%__52%_|__0%__6%_39%__0%_52%__3%__0% 2021/05__(27592)_|__67%__70%__66%___4%__70%___3%__30%__66%_|__0%__4%_26%__0%_66%__3%__0% 2021/06__(12070)_|__61%__63%__59%___5%__62%___3%__38%__59%_|__0%__4%_32%__2%_59%__3%__0% 2021/07__(20731)_|__25%__27%__25%__37%__28%___3%__68%__25%_|__0%__2%_32%_34%_24%__3%__5% 2021/08__(10715)_|__16%__20%__16%__59%__17%___2%__76%__16%_|__0%__3%_15%_56%_15%__2%__8% _________________|_417N_452R_478K_484Q_501Y_570D_614G_681R_|___W___A___B___C___D___E___O W=WuHan_A=452R+614G_B=484E+614G_C=484Q+614G_D=452R+478K+681R_E=478K+501Y_O=Other

There's really no such thing as a highly targeted vaccine because the protein complexes the antibodies are looking for are so broad in scope. Then you need to watch the research endpoints, some are no infection at all, or infected but very mild case, or infected but didn't require hospitalization. In this case it sounds like they're using no infection at all. The Pfizer people are actually better off since they were allowed exposure to a very mild infection for which they will easily develop an antibody defense. They're now immune to Delta. The Moderna vaccinees were deprived of that exposure and are therefore probably more susceptible to yet another mutated Delta. There are bunches of Delta's, it's a whole family, not just a single virus.

"Neutralizing antibody levels are highly predictive of immune protection from symptomatic SARS-CoV-2 infection", Nature Medicine volume 27, pages 1205–1211 (2021).

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Decoder: mRNA-1273 (Moderna, mRNA in liposome), NVX-CiV2373 (Novavax, DNA in virus shell), BNT162b2 (Pfizer/BioNTech, mRNA in liposome), RAD26+RAd5s (Russian, DNA in virus shell), nCoV-19 (Astra Zeneca/Oxford, DNA in virus shell), Ad26.COV2.s (J&J/Janssen, DNA in virus shell), and CoronaVac (Chinese Sinovac, killed COVID19).

Not really, in the sense that *any* increase in herd immunity increases selective pressure, which yields variants, from vaccine or from infection and recovery.

Joe Gwinn