As I said originally, these tremendous differences between certain cities are puzzling. I’m not sure it says much about masks one way or the other. Part of the issue is that testing shows that about 1% of people test positive in SF vs. 13% in Detroit. That would seem to mean in one’s daily activities one is 13 times as likely to be exposed to someone who is infectious. Even if masks cut the risk substantially, it’s likely not enough.

But the real question is how and why things got this way and how/why, for example, Los Angeles had a similar outbreak a few months ago but now doesn’t.

Sure, if you define at risk as having a 0.1% chance (if that) of a seriously bad reaction. People take more risks than this on a daily basis.

I don’t disagree with any of this. But that’s why I want to enjoy it now, so that I haven’t lost the opportunity forever if in 10 or 20 years I am in poor health for some reason and life sucks.

Yep

Don’t these antibody treatments generally need to be administered in a hospital (or at least outpatient clinic) setting?

I have not spoken to clinicians about it but would expect the problem is partly that people don’t seek medical attention until it’s too late. You’d need to administer mAbs almost as a preventative measure, after exposure or a positive test but before the onset of serious symptoms, and then cost/benefit becomes a consideration.

The monoclonal antibody “cocktails” are infused I.V. and carry a bit more risk than vaccines because they are foreign proteins (i.e. potential antigens). But it’s not that different than outpatient cancer chemotherapy infusions for which we have “infusion centers” all over the U.S., usually in the outpatient departments of hospitals. And that’s the approach being taken some places with these COVID drugs. In Tucson, for example, Tucson Medical Center has set up an “infusion center” just for these drugs.

Although the research I posted just above is about using them preventatively in people having high risk of exposure (specifically, a family member with COVID), their first use was in people mildly sick but at high risk (obesity, high blood presdure . . . You know the list) for severe disease and in those cases they need to be given within 10 days of onset of symptoms (really the earlier the better).

The problem as I see it is first that many ERs just don’t want to be bothered taking up space with somebody laying around getting an IV infusion for a couple of hours so they don’t actively encourage that option. Second, if there’s an infusion center available, it may mean leaving the ER and driving to another location which may be some distance. The typical patient feels ill but not terribly ill (or they’d have been hospitalized). They just want to go home. So they are reluctant to go get the infusion. It’s too inconvenient but once they do begin to feel sick enough to be motivated it’s too late.

the antibody therapy also prevents you for getting the vaccine for a while, right?

I think so. It was on the questionnaire to evaluate eligibility.

yeah, although I don't know what happens if you say yes... lol.

In regards to LA, I really think the post holiday surges were due to people getting together in large groups for the holidays. There were COVID spikes after Thanksgiving and X-mas. LA County is the most populous county in the US after all, and plenty of transplants live here, and many traveled during the holidays and came back. And I'm sure a lot of mensos in SoCal got together in large family/friend gatherings.

Anecdotally, 2 people at my job caught COVID (that we know of), but both about a month apart. One of them talked to me and told me that he knows he got it over Thanksgiving, because he and his family and his in-laws all gathered at one house, and they all ended up getting it (most of the adults did, including his parents and his wife's parents, and some of his siblings). The other guy got it after X-mas, and yeah, he also went to a large family gathering. Maybe not coincidentally, both of them live outside of LA County, where people were less apt to wear their masks, and where in the beginning of the pandemic, they were less strict about the mask requirements---or didn't even have the mask requirements until it became a statewide thing or until their own numbers started surging.

Makes sense. If you have exogenous antibodies floating around they are going to take out the vaccine antigens so they can’t do their job of stimulating the immune system. But remember—the first use is somebody who already has COVID so they aren’t vaccine candidates anyway. And the new use is somebody with daily intimate exposure so at very high risk of getting it before any vaccine could work (typically weeks after the first shot).

From the Los Angeles Times:

Los Angeles County’s daily coronavirus cases continue to decline, as transmissions appear to slow

https://ca-times.brightspotcdn.com/d...tier-01.FO.jpg
Jasmine Aguilar and Adam Ziegenhals, both of Echo Park, have drinks at the Ham and Eggs bar in Los Angeles. (Francine Orr / Los Angeles Times)

By ALEX WIGGLESWORTH, RONG-GONG LIN II
APRIL 11, 2021 3:13 PM PT

Los Angeles County public health officials on Sunday recorded 546 new cases of the coronavirus and 10 related deaths amid signs viral transmission was continuing to decrease.

Both numbers are an undercount because there are reporting delays on weekends, officials said. Still, they welcomed the encouraging trend of declining case rates, hospitalizations and deaths.

There were 470 COVID-19 patients in L.A. County hospitals as of Saturday, a drop of nearly 28% from two weeks before, when there were 647, officials said.

Statewide, there were 1,799 patients hospitalized with COVID-19, a decline of about 22% from two weeks before.

California has also observed a dramatic slowing of the average number of deaths being reported daily. In recent days, California has reported an average of 105 to 120 COVID-19 deaths a day — the lowest such number reported since the autumn-and-winter wave began. At its worst, in late January, California was recording as many as 562 deaths a day, on average, over a seven-day period.

On Saturday, the state reached the latest milestone when the COVID-19 death toll exceeded 60,000, according to a Times tally of fatalities reported by county.

The death toll represents roughly 10.7% of COVID-19 deaths nationwide. California is home to about 12% of Americans.

The pandemic’s effect statewide has varied by region. Of California’s most populous regions, Los Angeles County has fared the worst. For every 100,000 residents, L.A. County has recorded 232 deaths; if L.A. County were a state, it would have the seventh-highest death rate.

The San Francisco Bay Area has fared far better; for every 100,000 residents, the Bay Area has recorded 79 deaths. If the nine-county Bay Area were a state, it would have the 45th-highest cumulative COVID-19 death rate in the nation of the 50 states, the District of Columbia and Puerto Rico.

The signs of progress came as the state prepared to dramatically expand the pool of people eligible to be vaccinated against the virus. The state will on Thursday formally open vaccinations to all residents 16 and older. Currently, the statewide criteria say that only people 50 and older, those with underlying health conditions, and workers in certain specified essential job sectors are eligible for the vaccine.

Many local jurisdictions have moved faster than the state.

The city of Los Angeles opened vaccine appointments to everyone 16 and older on Saturday. People who are seeking shots at city-run vaccination sites must provide valid identification and be a resident of Los Angeles County. City-run sites are open from Tuesday through Saturday.

Los Angeles County, overall, expects to receive about 323,000 doses of vaccine this week, a decrease of about 74,000 doses from last week due to reduced supply of Johnson & Johnson vaccine, public health officials said Sunday. Seventy percent of the doses are slated for sites in vulnerable communities, and 57% are needed for second-dose appointments, according to authorities.

Federal partners also send vaccine directly to some sites in the county, including pharmacies, health clinics and FEMA sites. When accounting for those doses, L.A. County vaccination sites were able to dole out about 700,000 doses last week, and hope to administer slightly over 500,000 this week, according to the public health department.

Meanwhile, Orange County health officials on Sunday reported 196 new coronavirus cases and eight additional deaths.

Link: https://www.latimes.com/california/s...ses-and-deaths

I think that's a very unfortunate trend. I'm a Californian but I got my shots in Tucson at Tucson Medical Center, no questions asked about residency. California provides all sorts of benefits even to illegal immigrants (there is even discussion of making up with a state benefit for their lack of eligibility for federal COVID "stimulus" checks). It sounds to me like you can be an illegal resident in LA County and get vaccinated but not an Arizonan temporarily living in the county.

I think all vaccination sites should vaccinate all comers who meet age/occupational criteria. If they are there, they are potentially local spreaders of the disease and users of local medical resources should they get sick.

Let's recall, the federal government is paying for these vaccines for everyone which is why everywhere they are free.

well, i didn't say that it affects an overwhelming majority. i said a substantial number:

https://www.health.harvard.edu/blog/...-2020100821133

Etcetera.

i realize that COVID is not Ebola, but its ease of contagion is precisely why it's so much more dangerous than other common viral infections. and i didn't say that developing chronic illness was unique to COVID. but even if the likelihood of chronic illness, once contracted, is the same or even lower than it is for other viruses, it's simple statistics to deduce that if significantly more people contract COVID, and each of those persons has the same or even a slightly lower chance of developing a related chronic illness, then the raw number of people developing COVID-related chronic illnesses will be higher than for other common viral infections like the flu.

well, Chicago gets its own allocation separate from the state, and suburbanites were gobbling up appointments in the city (some of course were also vaccinated as employees of city hospitals and such). The problem is that most suburbanites have cars and can easily drive to the city, but a lot of people in the city don't have cars and can't easily make it to a suburban site.

Yup, I could have predicted this:

https://notthebee.com/article/40-of-...nt-the-vaccine

Young, stupid, immortal, low-information and testosterone-saturated.

The vaccines were not developed quickly. They were either made by very traditional methods or, in the case of the m-RNA ones, based on a decade of previous research. The discussion of long term effects is a red herring: There's no scientific basis for any long term effects from the vaccine you wouldn't get in spades from COVID infection. Most such effects would likely be auto-immune: That is, parts of both the vaccine antigen and the virus are similar enough to human proteins that the antibodies you make against the one also attack the other. So if you want to avoid the vaccine and take your chances with the virus, I suppose you can go ahead. What I really don't understand is the military making this voluntary. It affects readiness. Nothing else that effects readiness is voluntary including other shots.

We are all becoming pussies (especially the Marines).

Ped (former Regimental Surgeon, 12th Marines).

I thought the same thing--it could be about how the vaccines are allocated. It's entirely possible that LA County is being issued only enough vaccinations for its 10 million residents. Considering there are another 8 million residents of the greater metropolis, it would be problematic for proper allocation if there was an unexpected surge in demand for vaccines in one part of the region and a bunch of unused vaccines in another.

The only reason I can think of that it's voluntary for now for the military is that they want to wait until supply is less constrained. But given that soldiers often live in congregate housing, it seems completely insane...

If I were a suburbanite and got COVID, I'd quickly make that drive to one of the country's best hospitals in Chicago--U. of Chicago, Rush etc--and take up a bed that could have gone to a city resident. So there's no percentage for city residents in keeping the vaccines from those suburbanites IMHO.

Besides, this time of year Arizona is full of Chicagoans. My next door neighbor is one such. And they are getting shots in Arizona. We are all one country. County by county selfishness is stupid.

These requirements aren’t really enforced.

When you make an appointment in Florida, it says you must be resident or seasonally resident and provide a driver’s license or other government issued ID. But in the confirmation email, it says that patients who are “unable or unwilling” to provide such ID will not be turned away from receiving the vaccine.

They want to dissuade overt vaccine tourism but it’s toothless. I’ve been here since early Feb so I’m getting it here. If you’re at your house in AZ you should be able to get it there. The number of people who would be willing and able to get on a plane just to get the vaccine is irrelevantly small anyway.