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just how much are covid cases up in the US?
when you adjust for testing levels (which have been dropping rapidly) the US data look ominous
PCR testing for covid is an iffy process. it’s nearly always far too sensitive and we do not sort by clinical presentation. but, the thing about such errors is that they at least stay fairly consistent so even if it provides a difficult metric for accurate prevalence counts, we can generally at least compare the data to itself.
the problem with doing this in “cases” is that testing levels vary so widely. if you have 1000 people 100 of whom have covid and you test 200, you find 20 cases. if you test 400 people, you find 40. this has not made covid more prevalent. reporting that “covid doubled” would be wrong. you just looked for it harder. this is called “sample rate” and to get real case data, we need to control for it because, to bang on a favorite drum of mine: reporting incidence without controlling for sample rate is tantamount to lying.
sure, such adjustment is never exact, but it’s a helluva lot better than raw cases.
for much of early covid, testing levels were constantly rising. this made raw case counts overstate the rise in prevalence. in many cases, it literally inverted the slope of the series (for example making winter of 2020-21 look higher than peak from spring 2020. it wasn’t.)
now, testing levels are dropping. and this is understating case counts by wide margins.
that which is, in reality, much higher than the past looks lower.
and this is masking the impact of OAS and inflating relative CFR both of which have profound implications.
this is raw cases in the US and testing numbers.
to look at this, you’d think case counts are flat from mid may at a level about 25% below the peak from last summer. but this is a sample rate illusion.
the reality is very different.
i normalized the testing rate on this series to 5 per day per 1000 people and adjusted all case data to reflect this. this means that the absolute numbers no longer really map to anything (as current testing rate is about 1.5) but it does make the whole series comparable to itself in a manner that it was not previously.
as can be seen, LOTS of things change.
we can now see that winter peak 2020-1 was lower than the april 2020 peak.
we can also see that current case levels are rising fast and early this summer.
the absolute level is VERY high and has already eclipsed the summer seasonal peak from last year by ~100%.
we’re not “down 25%” we’re “up 100%” and rising fast.
we’re already above the 2020-21 seasonal peak for winter and look to have a real shot at reaching/exceeding the seasonal peak from winter 2021-22, a peak that was over 3X as high as the prior year’s.
that’s deeply aberrant and it’s being masked by a plummeting testing rate.
US case counts are exploding.
this next one gets a little busy, but it’s also quite revelatory.
green lines are peak to peak or peak to current. red are from 6/27/22 to the same date a year and 2 years before so you can see where we are in expected seasonal cycle.
the peak of winter in 2020-1 dropped about 25% from prior year.
then vaccination started. the next winter peak was 2.29X.
the summer peak in 2021 was over 1.5X the size of the prior unvaxxed year.
and this year, in the post booster omicron age, is going absolutely wild.
it’s over 10X the same day last year.
it’s ~2X last year’s summer PEAK and peak cases are a solid 6 weeks away, maybe 8 if seasonality holds.
it looks to have a real shot at making new all time highs.
prior to vaccination, peaks were lower than prior year.
since vaccination, they have ALL been higher.
and the extent to which they are higher is increasing with each peak.
you can see the wild expansion of multiples of last year here. this is the same sample rate adjusted series but divided by the same day last year to show the multiple of cases now vs then. a number below 1 indicates contraction vs last year. a 2 means twice the cases, etc.
the trend here gets deeply ominous. each successive peak is getting higher. the waves are getting bigger, not smaller.
2.2X, then 3.4X, then 11.6X each new seasonal peak of acceleration vs prior year is blowing out.
(note that this year’s surge is considerably earlier than last year’s and so this 10-11X rate is likely inflated and ought to compress some as it starts to comp against the surge from 2021 instead of the trough, but even if it halves, 5-6X is terrifying.)
this is not herd immunity, it’s the herd getting more and more vulnerable.
and that does not happen like this in the wild. not at this magnitude.
we’re watching water flow uphill. and when you see this, you need to start looking for an external driver.
many keep trying to call this a change in the intrinsic infectivity of covid, but i suspect this is probably wrong or, at least, mostly wrong. i know i keep posting this chart like some sort of broken record, but that’s because i think it’s REALLY important.
because the chart you just saw looks a lot like this chart but with the next surge added onto the end.
it shows you that as omicron hit, the risk ratios for the vaxxed and especially for the boosted blew out. they were not only far above the unvaxxed, but were rising higher and higher by the month. the confluence here is past provocative.
the UK stopped reporting this series. look at the US prevalence data and perhaps you’ll get some intuition as to why. relative risk ratios doubled from ~2 to ~4 over an 8 week span despite (or perhaps because) their switching to reporting triple dosed instead of double.
this shatters the “more intrinsically infectious” narrative. it might be a little bit so, but mostly, it’s the vaccines. it’s not 3.4X, much less 11X as infective.
no way. no how.
and the vaxxed vs unvaxxed data was laying out the driver clearly until they stopped reporting it.
the data is flat out telling us that the huge genetic jump to omicron was a sharp selection for an OAS variant advantaged by the vaccine driven herd antigenic fixation stemming from leaky vaccines. omi is not a descendant of delta, it’s a throwback to a far earlier common ancestor. it got plucked off the “failed variant” pile by a powerful new evolutionary selector.
that’s what leaky vaccines do: they select for OAS and ADE.
it’s WHY we don’t use them.
and these vaccines look to induce strong antigenic fixation rendering your immune system a one trick pony unable to adapt to new variants of this pathogen.
to my knowledge, herd antigenic fixation has never happened before in humans. if this is what’s happening now, things are going to get pretty dramatic.
the math around this and how milder variants (and omi is much less virulent which is probably a part of why it spreads better) can get really sinister and can make vaccines that are causing more overall death than would have otherwise occurred (even in the vaxxed) look like they are working because relative effect ignores a rise in incidence rate.
and we’re starting to see signs of this. the highly vaxxed US northeast saw more old people in hospital this winter than the year before despite a milder variant and sky-high vaxx rates.
many saw second spikes this spring that exceeded winter.
this is omicron jumping the vaccinated and rapidly rarifying into new and increasingly optimized sub-lineages to infect the vaccinated.
and it’s starting to become a summer issue as well.
looks what’s happening to over 70’s in the US. nearly all vaxxed, mostly boosted.
it’s 2.3X the number as on the same day last year and rising rapidly. season should barely be beginning but counts have been rising for months. it’s at 10.5. last summer’s peak was 14.4
i would not advise taking the under on peak to peak seasonal counts. if this exceeds the feb peak, then you know we’re into serious failure.
this could be mostly a “hospitalization with” vs “for” signal or a sign of high nosocomial transmission. whether it winds up leading to a rise in deaths vs last year (not yet occurring) is hard to call. omi is much intrinsically milder and CFR is being elevated by lower cases count capture due to lower sample rate.
gatopal™ and fellow substacker eugyppius is finding the same issues by doing a clever analysis of germany where the low vaxx and boosted east is not seeing the surge the high vaxxed west is.
this is all leading to some strong conclusions.
omicron is much milder than prior strains, more so even than appears in the data. intrinsic CFR is likely down about a full log. (90%)
but omi is spreading like wildfire because it’s optimized to infect the vaccinated. their antigenic fixation has frozen their immune response and it’s clear that variant based boosters are not going to help. fixated is fixated.
and this is getting worse over time likely due to continuing selective pressure in an immune fixated herd. (how bad it can get is anyone’s guess. i’m not sure we even have a valid past model for this process)
prevalence is swamping declines in virulence and this is starting to show up in hospitalization data. whether that’s scary or incidental is not yet clear.
whether it makes it into deaths eventually is hard to predict with any confidence. it would likely take a huge jump in infectivity to counteract the drop in CFR, but when we start talking about 10X jumps in prevalence, this becomes possible, at least mathematically. (whether and to what extent that 10-11X is amplified by seasonal shift remains to be seen)
it is the vaccines driving covid evolution and superspread and they are failing faster by the day.
the reported cases data is masking this, but the magnitude of what’s starting to happen will be too big to hide from the general public much longer.
when you’re quad vaxxed and on your fifth round of covid and it feels worse than your fourth, even the stalwart “trust the experts” crowd starts to notice…
this may be a bumpier summer than many were planning.