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The Delta Surge May Collapse Faster Than You Think

— ZDoggMD explains the reason why

MedpageToday

ZDoggMD breaks down the complexity of the Delta variant and offers the possibility of hope.

Following is a rough transcript (note that errors are possible).

ZDoggMD: Hey, are you guys detecting a pattern here? Every time things start to look better, all of a sudden the news is like, "Oh my God, Delta, we're all gonna die!" Look at the surge, mask mandates are back. Here, where I live, now I've got to wear a mask indoors, even though I'm vaccinated. Maybe the vaccines don't prevent transmission.

Oh my God! Who's getting paid for that? The news, they love that, they love that stuff, you guys. But here's an interesting truth. Look what happened in Great Britain. All right, I'm linking here to an , where he lays this out. In Great Britain, they had their Delta surge starting in May. And what they found were cases were rising dramatically. People were starting to freak out. Now this is a very highly vaccinated population, more so than the U.S., actually, above like, you know, 60 percent-ish, I believe. And what they found was, it went like this: the cases plummeted. In fact, one of their top epidemiologists, Neil Ferguson, was like, "Well, you know, it appears that we're going to have hundreds of thousands of cases a day again, it's inevitable." Except that the only thing that was inevitable was that he was wrong.

Like 26 of the 28 predictive models gathered by CDC in January, when things were going haywire, 26 out of 28 couldn't predict accurately, even within the range of possibility, what happened 2 weeks later, and that was their job. So it tells you we have no idea what we're doing when it comes to predicting a complex dynamic of a pandemic, but there's probably good news in that. Delta crashed in Great Britain. And it's still not clear why, but we're gonna talk about some theories. But there's, it's not just Great Britain, the Netherlands, same thing. India, remember when India was in the news and then it wasn't? Why do you think it wasn't?

Because cases plummeted, 400,000 a day, which, by the way, is a vast underestimate of what's actually going on, down to like 40,000-ish. And it was like this. Why? Let's talk about that. What's going on with Delta? Why is it likely actually that Delta cases are gonna plummet in the U.S. as well? It's not assured, we know how bad it is to predict, but why is it likely? And what does this all mean? All right, so in Great Britain, you have a population where they preferentially early on vaccinated elders and people at highest risk. So you've already sucked out the most vulnerable in terms of death, from the population that could be infected now with Delta, because we know Delta can infect vaccinated people. But they don't care, because they don't die, they don't get hospitalized, at very, very, very tiny rates. Right now, it really is a pandemic of the unvaccinated with Delta.

So, what happens in Great Britain? It used to be older people getting infected, dying, vulnerables, etc. Now, during this latest Delta surge, it's younger men mostly, and there's less hospitalizations, less death, because they're lower risk to begin with. And the elders have been vaccinated. So what happens? You get a bunch of young people like, "Oh, everything's opened up." You have the European football league happening, whatever that is. I believe we call it soccer in the United States. Watch "Ted Lasso", if you haven't, by the way, great show. And there was this massive sort of spreading of this very contagious variant, Delta. Then what, this is what happens, right? We seem to think, oh, mask mandates and closing schools and, you know, aggressive government intervention and edicts are what changed the dynamics of a pandemic. They probably have like this much effect.

This is what happens. People go, "Oh, there's a lot more cases now. Oh, I'm hearing about hospitals maybe getting a few more admissions, and some friends of mine got sick. I'm gonna probably not go to that thing, or I'm gonna wash my hands, maybe keep my distance a little bit. Maybe I'll voluntarily throw a mask on." And what happens? The dynamics of the pandemic change, because of natural human response to what they feel is the ebb and flow of the thing. And this is probably happening everywhere, right? Probably happened in India, probably happens here in the United States. We see a bunch of cases happening again, we hear from friends who got sick and we go, you know what? I'm gonna take a few more precautions than I was before. And when things cool down, people open up, it doesn't necessarily mean that, you know, it's a mask mandate or something like that.

Now the next thing is there are random events, between weather, why do you think Florida's surging right now? Because it's their winter. This is what I mean by that, in winter, in the northern latitudes, we go inside to stay warm and there's dry air, there's no humidity, there's poor ventilation. Respiratory viruses tend to thrive, like SARS-CoV-2, but what happens in the South, in the Southwest, and in Florida, it's the opposite. In the summer when it's really hot, people go indoors, air conditioning, less humidity indoors, more transmission, so you see a surge in Florida, right? Now, what we need to look at is what is going on with the deaths, because if more and more young people are being infected, why?

Because that's the third piece of it. The natural and vaccine-induced immune dynamics. So, if you've vaccinated some of the most vulnerable people, elderly people, people at high risk, etc, the next group of people that's susceptible, who haven't gotten vaccinated out of choice now are the younger people. So, they'll get infected with a highly contagious variant in a wave as they open up and mingle with each other again. And some of them will get sick and die. But most of them won't, because they're generally lower risk, and you'll see a surge in cases, some hospitalizations and deaths. And then what happens is, as that population starts to get natural immunity and they change their behavior automatically, cases plummet.

And it's a very complex give and take dynamic. It's not just, oh, we locked down and therefore, right? So, what does that mean? Well, it means that if you look and there's other events too, right, there's random superspreader events that can change the dynamics, there's weather like we talked about, and then there's our natural behavior. And then this immunity, well, so what's probably gonna happen now in the U.S., well, if you look at what's happening in Britain and you extrapolate it to the U.S., which you can't directly, we would end our surge and collapse it by the beginning of September. If we look at what happened in the Netherlands, we're gonna collapse our surge imminently.

Now what's going on in the U.S., it's much more complicated cause we keep worse data. We have a lower vaccination rate than Great Britain. And so we have pockets of people that are dry tinder that this brush fire of Delta is gonna burn through. And mostly that's younger people. There are some elders that still have chosen not to be vaccinated. They're gonna be at high risk, right? Now what about vaccinated people who still get infected? Seems like CDC is freaking out over this thing that happened in this tiny town, which, by the way, is super artificial, because it was a bunch of vaccinated people packed together. I've talked to people who were there, they're all packed together with no precautions. Yeah, some of them are gonna get infected. How many got hospitalized? Like almost none. So, the vaccines do what they're supposed to do, which is prevent you from dying and getting really sick.

Now they may not prevent infection and they may not prevent transmission, why? Because it's a mucosal virus that seems, especially Delta, it replicates a lot in the nasopharynx, in the nose and the mucosal membranes there, which means that, you know, the vaccine works in the blood. It's an IM vaccine that generates blood antibodies and that sort of response. So the virus can still start to replicate and take up home in the nasopharynx and make you a little sick before you get that blood protection. Unlike measles, where it's mostly bloodborne, so you have plenty of defense from a vaccination, sterilizing immunity, same with like smallpox, things like that. So this is different, it's a mucosal respiratory virus. So in this article, he also talks about, well, what about the possibility of nasal vaccines that are administered by a spray that you can mail to people that are refrigerator or room temperature stable, that induce IgA-mediated immunity in the mucosa, you could actually get potentially fully protective immunity, even from infection, but only a tiny fraction of vaccines under development actually involve that. Eric Topol wrote a piece in Scientific American about that. So, the idea then that we ought to be worried about locking down and mask mandates and all this other stuff, instead of just telling Americans what's up. Hey, Delta's infectious.

If you get vaccinated, you're probably not gonna die. Get vaccinated, if you don't want to get vaccinated, then take your risks, take whatever precautions you want and let's move on because when the fall comes, if I hear smack about not opening schools because of Delta, right, I'm gonna be pretty mad on behalf of children who've been screwed during this whole pandemic, and we're gonna continue to screw them. And they're screwed by people, by parents who freak out about their safety, but will not get them an effing flu shot every year, when flu kills so many kids. We just don't understand risk at all. And you know what, as someone who went out the first month and got vaccinated, has my family vaccinated, has my 13 year-old vaccinated, and she wanted to get vaccinated, who's done all this, it pisses me off when I have to read in my stupid local paper that mask mandates are back, right? I'll wear a mask voluntarily if I think community spread's a lot and I can protect other people from me. I don't need the government to tell me to do that. We need to be honest with people. We need to have rational dialogue. We need to stop shaming people. We just need to be clear about what risk is, what it means.

Look at other countries, see what's going on with the dynamics. Be humble in the face of what we don't know. When 26 of our 28 models failed to predict 2 weeks ahead. They have one job. They can't do it. It means it's too complex. And we don't yet fully understand it. But I'll tell you one thing we do understand, from everything we've seen so far, and I'm telling you this as someone who had to be convinced, these vaccines actually work for what they're designed to do. So, if you're worried, stop worrying, just stop overthinking it, go get the vaccination. If you don't want to, hey, that's cool too. You're just gonna take a different kind of risk.

All right, guys. That's, I didn't mean to get all agitated like that, but I gotta be real with you. I'm pissed. I'm tired of it. You're tired of it. We're all tired of it. If you're super tired of it, leave a comment, tell me how tired of it you are. If you're a jerk in the comments, you're getting blocked forever.

All right. I now have a person to do that, because I've, I'm tired of this. We need to have rational, you can disagree with me, do it compassionately, persuasively. Don't throw a bunch of ad hominem attacks around, all right? And if you really like what we do and you wanna help us do what we do, join us in our Supporter group on Locals. So go to zdoggmd.locals.com and sign up there. We have a great discussion group, very alt-middle thinkers. We share ideas, you can post there if you're a paying member, it's like $5 a month or whatever you wanna pay. And we do live shows just for you. So that's it. That's all, share the video and we out, peace.

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