Coronavirus - those in China, and general discussion

[Guest realmayo]

On 12/30/2022 at 11:47 AM, Jan Finster said:

Omikron is a much less problematic strain

 

I hope you're right. Omicron in the West certainly appeared less deadly than the Delta variant. But I'm not sure it was less deadly than the original virus in Wuhan.

 

However, maybe - and hopefully - the version of Omicron in China is weaker than the previous Omicrons the rest of the world had.

 

This study found that although the hospitalisation rate for Omicron was considerably lower than for Delta, the outcome for hospitalised patients was the same as for Delta.

 

https://hub.jhu.edu/2022/04/26/omicron-delta-risk-study/

[alantin]

On 12/30/2022 at 1:47 PM, Jan Finster said:

I think it has dawned on everyone that the Chinese vaccine is not effective.

I’ve read that it’s not as effective but it’s ok against severe covid and death if you get three shots a couple of months apart.

 

But all of the vaccines wear out over time quite quickly if you don’t encounter the virus and most of the people in China got their last jab a year ago.

 

i have a friend in china who had the new inhalable vaccine as a booster a month ago and now both her parents in the same house are recovering from covid but she hasn’t had anything.

[abcdefg]

On 12/29/2022 at 10:46 PM, 大块头 said:

@abcdefg I recall you saying you were an ER doctor, right? There have been some unsettling posts on Reddit recently showing what it's currently like in Chinese hospitals... I wonder if you have any thoughts.

 

Right. Currently retired. The reports I've seen make me sad for the staff as well as for the patients. Very difficult situation. In all fairness, as @markhavemann suggests above, Chinese hospital outpatient departments can often appear chaotic to the casual observer even during the best of times due to organizational differences. 

 

"Combat-zone" video such as the one linked in your post can be extremely distressing. Unfortunately, I remember some nights in my own ER that looked about like this without any pandemics to blame. (Minus the yellow body bags.)

[Flickserve]

On 12/30/2022 at 7:47 PM, Jan Finster said:

I think it has dawned on everyone that the Chinese vaccine is not effective.

This is wrong. It protects against death and serious illness after three doses.

[Guest realmayo]

It's hard to know how much protection Chinese vaccines offer against death and serious illness after three doses, once you throw in the fact that we have a new type of Omicron and also a long time gap since many of those third doses were given. It's perfectly possible no one will ever know how effective the Chinese vaccines are right now.

 

And if I remember from a couple of years ago, when people refer to "serious" illness they mean intensive care, so plenty of people (unless I've misremembered) get hospitalised despite not having "serious" illness. And that's relevant if (a) the Chinese vaccines offer less effective protection against moderate illness, and (b) people are concerned about pressure on hospitals.

[alantin]

On 12/30/2022 at 9:52 PM, realmayo said:

 

It's hard to know how much protection Chinese vaccines offer against death and serious illness after three doses, once you throw in the fact that we have a new type of Omicron and also a long time gap since many of those third doses were given. It's perfectly possible no one will ever know how effective the Chinese vaccines are right now.

 

 

Malaysia has done comparisons since they use both chinese and western vaccines. I’m aware of studies published a year ago. We don’t know how effective they would be now against omicron but I haven’t really read anything that they wouldn’t be similarly effective against it as the western original ones. Similarly we don’t know how effective the western vaccines would be now against omicron in a population previously not exposed to the virus. I think the main problem is still that it has been so long since most people in China got their jabs and they haven’t been exposed to the virus since before now.

 

https://www.reuters.com/world/asia-pacific/sinovacs-covid-shot-highly-effective-against-serious-illness-malaysia-study-2021-09-24/

 

 

Edit: here is a new article just from today addressing this. They cite research done in Hong Kong during the outbreak this year which, if memory serves, was omicron.

 

Quote

In the study, Cowling and his team analyzed data from about 20,000 COVID cases, ranging from mild to fatal. They found that two doses of either vaccine offered a high level of protection against severe disease for adults under age 60. Specifically, two doses of the Pfizer vaccine offered 95 to 97% protection, while two doses of CoronaVac offered between 89 and 94% efficacy, the team reported in the Lancet Infectious Disease this past October. 

For older adults, the Pfizer vaccine proved significantly more effective after only two doses. Specifically, the Pfizer vaccine offered about 87-to-92% protection for this group while CoronaVac offered only 64-to-75% protection. But, Cowling points out, an extra booster – or third dose – of CoronaVac lifts the protection to about 98%, the same protection observed with three doses of Pfizer.

"There's a very good level of protection for three doses of either vaccine," Cowling says. And remember, health experts in the U.S. also recommend people over age 60 receive at least three doses of the Pfizer or Moderna vaccine as well.

Cowling thinks the misinformation about CoronaVac or Sinopharm may stem from early data, looking at the vaccines effectiveness against infection (not severe disease). 

 

Initial data found the Chinese vaccines have a lower level of protection against infection than the mRNA vaccines. "Something around 50 or 60% effective,' Cowling says. By contrast, at first, the Pfizer and Moderna vaccines showed extremely high levels of protection against symptomatic infections against the original strains of the virus.

But with the emergence of the immune-evading variants, such as delta and omicron, eventually all vaccines wound up being basically ineffective against infection, especially more than three to four months after the inoculation.

 

[alantin]

The vaccine politics that have attempted to discredit the other sides jabs has been idiotic on both sides when the most important thing has always been to get those jabs to peoples arms.

[Flickserve]

On 12/31/2022 at 3:52 AM, realmayo said:

It's hard to know how much protection Chinese vaccines offer against death and serious illness after three doses, once you throw in the fact that we have a new type of Omicron and also a long time gap since many of those third doses were given. It's perfectly possible no one will ever know how effective the Chinese vaccines are right now

 

No. Good scientific evidence already exists.

 

Whilst over time, effectiveness of vaccine will decline, this is not something that is unique to Chinese covid vaccines. Sorry to disappoint you. 

 

[Guest realmayo]

The scientific evidence you refer to - assuming it's the HKU study - involved third doses that were given just weeks before infection. People don't know how effective that third dose would be a year later.

 

From the FT:

 

Crucially, the HKU paper said it was too early to tell how long the protection from three doses lasted. Jin Dong-yan, a virologist at the university, said many of the third shots considered in the paper were given just before this year’s Covid wave in Hong Kong, so it did not demonstrate how CoronaVac held up against Omicron over time.

 

[A Brazil study looked at people with Omicron who had two Chinese vaccines, and then a booster either of the Chinese vaccine, or the Pfizer vaccine. Waning against severe Covid-19 after 120 days was only observed after the Chinese booster (i.e. waning not observed with the mRNA booster). ... Vaccine effectiveness against hospitalization and death was significantly higher in individuals aged ≥75 years who received an mRNA booster than a CoronaVac booster ≥60 days of booster dose (78.5% vs 51.4%, respectively).]

 

A Yale University study went further, suggesting that people who received two inactivated [Chinese] doses may need two mRNA boosters.

Akiko Iwasaki, a professor of immunobiology at Yale and an author of the paper, said the inactivated vaccines tended not to elicit much response from one of the immune system’s T-cells, known as CD8, meaning long-term protection might not be reliable.

“So people who have had two Sinovac vaccines would need two booster doses of mRNA just to bring the neutralising titres [numbers of antibodies] to a similar level of three mRNA vaccines,” she said.

 

On 12/31/2022 at 7:10 AM, Flickserve said:

Sorry to disappoint you. 

 

You have disappointed me! Anyone who suggests the science is settled disappoints me! But it's OK, this stuff is complicated.

 

Here's the link to the FT article, paywall jumped: https://12ft.io/proxy?q=https%3A%2F%2Fwww.ft.com%2Fcontent%2F729f1dc0-32d1-42c9-bb62-63a41f1e8de2

[alantin]

I wonder why they did all that vaccinating in China last year but then didn’t do booster campaign before opening up. It was expected already then that all vaccines lose their effect over time if there is no natural exposure to the virus, especially in older people and risk groups, which was why they have been given four or five shots here while younger and healthy people had only three.

 

Giving the jabs and then continuing zero covid for one and half years without doing any beefing up of health care or keeping that immunity up with boosters every few months seems like just another exercise in performative futility.

[Guest realmayo]

I guess they previously thought they could control (a) the virus (b) the people (c) the economy, allowing them to pick the ideal time to scale back zero-covid: but even if the rumours were true and they were aiming for April (after the Party meeting in October, after Winter), I'm not sure that would have given them enough time for the booster campaign you suggest.

 

Maybe it truly was important for them to roll out a more effective home-grown vaccine.

 

The vaccine politics is fascinating: most countries' leaders very publicly and visibly have urged people to get vaccinated. In China, although local officials were under pressure to vaccinate people, the leadership never seemed to take public ownership of the vaccine drive, as far as I'm aware. Almost like they didn't want to be associated with any perceived failure in the likely event that vaccines didn't work 100%.

[alantin]

On 12/31/2022 at 12:33 PM, realmayo said:

Almost like they didn't want to be associated with any perceived failure in the likely event that vaccines didn't work 100%.

Interesting point of view. I haven’t heard that before, but I think it makes sense. They also pushed their vaccines out in the beginning to score some kinds of points in international politics. Seems really similar to the dual circulation idea. Or I wonder if it is actually a part of it..

[Jan Finster]

Sorry for my unrefined statement regarding the vaccine.   I am glad it led to some great posts esp from RealMayo to bring nuance.

[Flickserve]

On 12/31/2022 at 4:15 PM, realmayo said:

Anyone who suggests the science is settled disappoints me!

That’s is definitely not me. 
 

My issue is that one cannot say vaccines are ineffective. There are different variations of effectiveness. It’s simply ludicrous to imply the vaccines are ineffective. 

[Flickserve]

On 12/31/2022 at 4:15 PM, realmayo said:

involved third doses that were given just weeks before infection.

And that proves the vaccines are effective. 

[Jan Finster]

On 12/31/2022 at 5:32 PM, Flickserve said:

There are different variations of effectiveness

 

Sure, but we compare it to vaccines from the west, not placebo. Effectiveness is indeed an iffy subject with COVID vaccines. Many people in the west are disappointed that their vaccination does not protect from infection, disease, transmission, etc. So, the question becomes, how many people do you have to vaccinate to prevent one death from COVID, etc.... really complicated....

[alantin]

On 12/31/2022 at 7:06 PM, Jan Finster said:

Many people in the west are disappointed that their vaccination does not protect from infection, disease, transmission, etc.

They do not understand what vaccines are. Health professionals have failed to educate them and they certainly weren’t helped by political actors spreading misinformation instead of getting people to get the jabs.
 

Over 90% effectiveness against serious disease and death persisting at least half a year and similar effectiveness against infection for a month or two in such a short time was a HUGE success! And to get several vaccines all performing similarly was just amazing!

 

Just compare to yearly flu vaccines that are about 40-60% effective against infection after one jab for the flu season and I hear no-one complaining that they aren’t 100%.

 

But at least here I didn’t see many news about people being hesitant to take the shots and that misinformation was limited by the government giving constant updates on the vaccinations, their efficacy etc. It may not have been the same everywhere.

[Jan Finster]

On 12/31/2022 at 6:47 PM, alantin said:

Just compare to yearly flu vaccines that are about 40-60% effective against infection after one jab for the flu season and I hear no-one complaining that they aren’t 100%.

 

Sure, but there are other examples. How many people are there, who have had proper tetanus or rabies vaccination and developed clinical tetanus or rabies? The same for many other vaccines (FSME, Japanese Encephalitis, etc). 

[TheBigZaboon]

As usual, when I think I should keep my mouth shut and butt out of conversations that don't concern me...

 

Thinking back over this entire experience from the last three years, we should probably realize that a new reality has completely reshaped the conversation. Terminology that was fixed in everyone's mind no longer has the same meaning (if it ever really did, seeing that ordinary conversations and specialist's conversations coexist in parallel universes). Most of us grew up in a world where Jonas Salk conquered poliomyelitis; where measles, mumps, and chicken pox were "eradicated" from our societies; and where we could look forward to the same kind of protection from any diseases lurking in the future. Because vaccines "worked," absolutely and infallibly. We mistook a view of an all conquering "vaccine" for what was really an amazingly well coordinated series of public health campaigns that coincided with a postwar baby boom that allowed all of these campaigns to be effectively carried out within a growing and flourishing public school system. The messiness of real-world epidemiology was hidden behind serendipitous coincidences that didn't really get factored into the public consciousness.

 

Maybe everyone is finding that today's "reality" is clashing with yesterday's "reality" and things are turning out to be a bit messier than we thought. Calm down a bit folks, and cut a little slack for the other person, whose experience is bound to be a tiny bit messier...

 

Just my snarky opinion...

 

TBZ

[Insectosaurus]

I'm not sure I get your point @TheBigZaboon . The imperfections of vaccines have surely been made clear several times over the last decades, through the deaths in HIV, malaria, flu, Ebola, and other diseases. The world has never been fully functioning and probably never will be. This pandemic was not the first and will not be the last. The reactions to it was something new, but that could probably be tied to several other factors. For example, we have much higher demands on health and safety than we have ever had before. In my country the pandemic has been considered over for almost a year and it feels almost exactly the same as it did before 2020.

 

Global health, education and wealth, have improved dramatically during the last decades.

 

On 12/31/2022 at 6:47 PM, alantin said:

But at least here I didn’t see many news about people being hesitant to take the shots and that misinformation was limited by the government giving constant updates on the vaccinations, their efficacy etc. It may not have been the same everywhere.

 

I think this is an important point. In Sweden there were quite large important immigrant suburbs where vaccination rates were too low. Several regions made personal calls, visits, etc. to the population of these areas to increase public understanding of how the vaccines work and clear out misunderstandings. I don't know if there has been an evaluation of the tactic, but as I understand it it worked quite well. Have similar campaigns been tried in China? The more personal, door-to-door tactic, that is. Rather than offering elders money, etc.