The delta variant is wreaking havoc on most of Texas — but not El Paso. Here’s why.

[DrQ]

El Paso was where the notorious "PIT" existed, where COVID-19 patients died.

It was horrid last year, but there seems to be hope:

Helgesen and others say much of the credit can be attributed to the area’s high vaccination rate, widespread compliance with masking and social distancing, and a strong partnership among local community and health care leaders.

And yes, they acknowledge natural immunity:

There may be a high level of natural immunity among local residents, which medical experts say appears to keep COVID-19 sufferers out of the hospital in the slight chance they are reinfected, health experts say.

AND:

And while COVID-19 patients, most of whom are unvaccinated, took up more than 30% of hospital capacity in some areas and more than 20% statewide last week, in El Paso they accounted for only 7% of patients in local hospitals.

El Paso's main spike was pre-Delta variant. Hopefully, once we get past Delta, Mu will not be as bad.

The delta variant is wreaking havoc on most of Texas — but not El Paso. Here’s why.

High vaccination rates, geography and a sense of community in the wake of 2019’s Walmart shootings help keep El Paso’s delta numbers low, experts and locals say.

www.texastribune.org

 

[DannyTS]

El Paso was where the notorious "PIT" existed, where COVID-19 patients died.

It was horrid last year, but there seems to be hope:
View attachment 40140



And yes, they acknowledge natural immunity:


AND:


El Paso's main spike was pre-Delta variant. Hopefully, once we get past Delta, Mu will not be as bad.

The delta variant is wreaking havoc on most of Texas — but not El Paso. Here’s why.

High vaccination rates, geography and a sense of community in the wake of 2019’s Walmart shootings help keep El Paso’s delta numbers low, experts and locals say.

www.texastribune.org

Good they acknowledged natural immunity. If you look at the big spike from November, the natural immunity must play a huge role. It also strengthens the idea that many areas with high covid in the past have embraced the vaccines at a higher rate which makes it very difficult to determine the actual cause for the current under/over-perfomance. If the health officials offered ANY data on total immunity for every community (natural and acquired) ... but that would be too much transparency. I guess the less they release the better they can control the narrative.

The data should be structured into four groups: natural immunity and vaccinated, natural immunity not vaccinated, vaccinated not previously infected, unvaccinated not previously infected.

 

[DrQ]

Good they acknowledged natural immunity. If you look at the big spike from November, the natural immunity must play a huge role. It also strengthens the idea that many areas with high covid in the past have embraced the vaccines at a higher rate which makes it very difficult to determine the actual cause for the current under/over-perfomance. If the health officials offered ANY data on total immunity for every community (natural and acquired) ... but that would be too much transparency. I guess the less they release the better they can control the narrative.

The data should be structured into four groups: natural immunity and vaccinated, natural immunity not vaccinated, vaccinated not previously infected, unvaccinated not previously infected.

In a perfect world, maybe. But those are not easily quantifiable without intrusive testing.

Vaccination rates are quantifiable, the rest are SWAGs.

 

[DannyTS]

In a perfect world, maybe. But those are not easily quantifiable without intrusive testing.

Vaccination rates are quantifiable, the rest are SWAGs.

We already have data on tens of millions who tested positive, why not include those at least? Are you saying those are SWAGs?

 

[DrQ]

We already have data on tens of millions who tested positive, why not include those at least? Are you saying those are SWAGs?

They are incomplete, people have been asymptomatic without being tested. It is a SWAG.

 

[DannyTS]

They are incomplete, people have been asymptomatic without being tested. It is a SWAG.

Again, they can use the data from the 42,900,906 people who tested positive so far. I guess they do not want people to know too much lol.

 

[JIMinNC]

Again, they can use the data from the 42,900,906 people who tested positive so far. I guess they do not want people to know too much lol.

Instead of "they" not wanting people to know too much, I think the real issue is the fragmented medical data system. Most likely even "they" don't know the answer. To cross-tab the data into the four groups you suggested in post #2 above would require that every testing reporting system and and every vaccine delivery system share data to a central clearing-house down to the individual patient level. We do know total tested infections down to the county level, we know vaccinations down to the county level, and we know total population at the county level. What we don't, and probably can't know, is which of those vaccinated people have also had Covid. We don't know the overlap. I don't think anyone is keeping the data a secret - I think we honestly don't know because the multiple vaccine tracking systems don't interface with the myriad of testing systems. These systems are all required to report summary statistics to the CDC, but the summary stats are insufficiently detailed to allow the necessary cross-tabulations to determine the overlap between the vaccinated group and the natural infection group down to the individual level.

We do know is this:

Total US Population: 331 Million

% Fully Vaccinated: 182 Million (55%)
Recorded Natural Infections: 43 Million (13%)

So, if there were NO overlap between the two groups (which is obviously not the case), still only about 68% of Americans are either fully vaccinated or have some protection based on past natural infection, leaving 32% or about 105 million people still vulnerable to severe disease and death. Since we know that some people have had a natural infection and are also vaccinated the true size of the vulnerable population is certainly larger than the 32%/105 million. How much larger we don't know, but even if it were only 32%, that's still a lot of fresh timber for Delta or other variants to burn through.

This same summary kind of analysis could be done at the state and county level as well.

The combination of vaccinated plus natural infection is one reason I think Hawaii experienced a significant surge in Delta cases despite their high vaccination rate. Until early July, Hawaii had by far the lowest cumulative rate of natural infection in the U.S. because of their isolation and because they have had some of the most stringent mitigation measures in the country. They also have one of the highest vaccination rates in the country (66% fully vaccinated according to Hawai Dept of Health, even though the CDC numbers are a bit lower. Not sure I understand the data discrepancy). But my theory is that because of their very low cumulative natural infection rate (which is a good thing) they need a much higher vaccination rate to achieve the same level of population protection as a state like, say California, that has relatively high vaccination but also has had periods of high natural infection. The combination of natural + vaccine protection in places like California, New York, and Massachusetts is possibly significantly higher that the same natural + vaccine number in Hawaii.

 

[JIMinNC]

I'll also add to the above, that the numbers I used are based on known/tested infections. It's commonly assumed that testing is not catching many mild or asymptomatic infections, so in reality true natural exposure is likely higher than the 42 million/13% I used above. How much higher depends on which "expert" you talk to. That adds even more uncertainty to any attempt to determine what portion of the population has some immunity/protection based on either vaccination or natural exposure.

 

[DannyTS]

Instead of "they" not wanting people to know too much, I think the real issue is the fragmented medical data system. Most likely even "they" don't know the answer. To cross-tab the data into the four groups you suggested in post #2 above would require that every testing reporting system and and every vaccine delivery system share data to a central clearing-house down to the individual patient level. We do know total tested infections down to the county level, we know vaccinations down to the county level, and we know total population at the county level. What we don't, and probably can't know, is which of those vaccinated people have also had Covid. We don't know the overlap. I don't think anyone is keeping the data a secret - I think we honestly don't know because the multiple vaccine tracking systems don't interface with the myriad of testing systems. These systems are all required to report summary statistics to the CDC, but the summary stats are insufficiently detailed to allow the necessary cross-tabulations to determine the overlap between the vaccinated group and the natural infection group down to the individual level.

We do know is this:

Total US Population: 331 Million

% Fully Vaccinated: 182 Million (55%)
Recorded Natural Infections: 43 Million (13%)

So, if there were NO overlap between the two groups (which is obviously not the case), still only about 68% of Americans are either fully vaccinated or have some protection based on past natural infection, leaving 32% or about 105 million people still vulnerable to severe disease and death. Since we know that some people have had a natural infection and are also vaccinated the true size of the vulnerable population is certainly larger than the 32%/105 million. How much larger we don't know, but even if it were only 32%, that's still a lot of fresh timber for Delta or other variants to burn through.

This same summary kind of analysis could be done at the state and county level as well.

The combination of vaccinated plus natural infection is one reason I think Hawaii experienced a significant surge in Delta cases despite their high vaccination rate. Until early July, Hawaii had by far the lowest cumulative rate of natural infection in the U.S. because of their isolation and because they have had some of the most stringent mitigation measures in the country. They also have one of the highest vaccination rates in the country (66% fully vaccinated according to Hawai Dept of Health, even though the CDC numbers are a bit lower. Not sure I understand the data discrepancy). But my theory is that because of their very low cumulative natural infection rate (which is a good thing) they need a much higher vaccination rate to achieve the same level of population protection as a state like, say California, that has relatively high vaccination but also has had periods of high natural infection. The combination of natural + vaccine protection in places like California, New York, and Massachusetts is possibly significantly higher that the same natural + vaccine number in Hawaii.

I agree with most of your comment. Where our views diverge is the reason why we do not have better public data about the natural immunity. Yes, the system is fragmented but they cannot tell me that the individual states do not know the names of the people who got tested positive and the names of those that got the vaccine. How difficult is to match the two? The fragmented system does not seem to prevent the communities, the states and the CDC from announcing the number of infections, hospitalizations and deaths separately for the vaxxed/unvaxxed. Why do they track those but they have no interest when it comes to those with natural immunity? The same problem in Canada. Do you think that the provincial governments (in charge with about everything related to health care) don't know who tested positive and who got the vaxx? Of course they do. In that case, where is the public data and discussion about it?
And how come restrictions continue in cities where 80-85% of the population is vaccinated and we may also have additional natural immunity? OK, this is another discussion for another time.

If you think that the fragmentation of the data is the problem, how about other countries aside from Canada or the US? Have you seen the information from Israel that is known to have a top notch health care database? Where is the WHO guidance concerning the collection and analysis of this kind of information?

In the US 43,404,877 people have tested positive so far and they can start to match the names anytime. Mentioning those that may have had covid but were never tested is a red herring. If there was the will that group could be discussed separately. Those who want it could get an antibody test.

Like yourself, I think that there is an overlap between those that got covid before and those that got the vaccine. Yet, it may be less than anticipated if you look at the numbers. Who are those that have a lower rate of vaccination? The young and healthy. How has worked essential jobs and may have practiced less social distancing?? Typically the young and healthy.

Why have the health officials avoided talking about natural immunity like a pest, denying its potency until it has became too difficult to deny? I can only draw one conclusion. All this has little to do with the data, and everything to do with the will.

 

[JIMinNC]

I agree with most of your comment. Where our views diverge is the reason why we do not have better public data about the natural immunity. Yes, the system is fragmented but they cannot tell me that the individual states do not know the names of the people who got tested positive and the names of those that got the vaccine. How difficult is to match the two? The fragmented system does not seem to prevent the communities, the states and the CDC from announcing the number of infections, hospitalizations and deaths separately for the vaxxed/unvaxxed. Why do they track those but they have no interest when it comes to those with natural immunity? The same problem in Canada. Do you think that the provincial governments (in charge with about everything related to health care) don't know who tested positive and who got the vaxx? Of course they do. In that case, where is the public data and discussion about it?
And how come restrictions continue in cities where 80-85% of the population is vaccinated and we may also have additional natural immunity? OK, this is another discussion for another time.

If you think that the fragmentation of the data is the problem, how about other countries aside from Canada or the US? Have you seen the information from Israel that is known to have a top notch health care database? Where is the WHO guidance concerning the collection and analysis of this kind of information?

In the US 43,404,877 people have tested positive so far and they can start to match the names anytime. Mentioning those that may have had covid but were never tested is a red herring. If there was the will that group could be discussed separately. Those who want it could get an antibody test.

Like yourself, I think that there is an overlap between those that got covid before and those that got the vaccine. Yet, it may be less than anticipated if you look at the numbers. Who are those that have a lower rate of vaccination? The young and healthy. How has worked essential jobs and may have practiced less social distancing?? Typically the young and healthy.

Why have the health officials avoided talking about natural immunity like a pest, denying its potency until it has became too difficult to deny? I can only draw one conclusion. All this has little to do with the data, and everything to do with the will.

I suspect you may be underestimating the challenges the widely-distributed data in the US healthcare system provides for the kinds of statistics you would like to see. I have several doctors, but none of their systems talk to each other unless they are part of the same health system. Same for hospitals, pharmacies, and clinics. The individual-level data you seek exists, but it lives on a myriad of independent databases held by each provider - all with different file formats and database structures.

Since the vaccine delivery started as more of a top-down project through Operation Warp Speed, I suspect we are closer to the consolidated data you seek there, but even there it may not be as easy as you think. For example, my wife and I got our vaccines from different providers in NC. My provider signed me up for the NC Vaccine Management System where I have access to my vaccine records online. All my wife got was the paper CDC card.

Testing is likely an even bigger challenge because it has always been a more bottom-up process where states have struggled to even collect summary data from the myriad of testing providers. And it's that testing data we would really need to accurately map who has natural infection over the vaccines records. I don't think the states receive patient-level data for all the positive/negative tests that are done, just summary stats. Once someone is hospitalized and/or dies, that data can be tracked better, and I suspect that is why we know vaxed/unvaxed stats for hospitalizations and deaths, but not for all positive tests. Most of the numbers on breakthrough infections are estimates or anecdotal reports from specific events/locations (like the infamous Provincetown July 4 celebration).

 

[DrQ]

I suspect you may be underestimating the challenges the widely-distributed data in the US healthcare system provides for the kinds of statistics you would like to see. I have several doctors, but none of their systems talk to each other unless they are part of the same health system. Same for hospitals, pharmacies, and clinics. The individual-level data you seek exists, but it lives on a myriad of independent databases held by each provider - all with different file formats and database structures.

Add to that, one person may account for multiple positive COVID-19 results AND wasn't DANNYTS that brought into question the COVID testing process on this site? NOW - they want to use the data? Let me look up the word hypocrite.

 

[Superchief]

The combination of vaccinated plus natural infection is one reason I think Hawaii experienced a significant surge in Delta cases despite their high vaccination rate. Until early July, Hawaii had by far the lowest cumulative rate of natural infection in the U.S. because of their isolation and because they have had some of the most stringent mitigation measures in the country. They also have one of the highest vaccination rates in the country (66% fully vaccinated according to Hawai Dept of Health, even though the CDC numbers are a bit lower. Not sure I understand the data discrepancy). But my theory is that because of their very low cumulative natural infection rate (which is a good thing) they need a much higher vaccination rate to achieve the same level of population protection as a state like, say California, that has relatively high vaccination but also has had periods of high natural infection. The combination of natural + vaccine protection in places like California, New York, and Massachusetts is possibly significantly higher that the same natural + vaccine number in Hawaii.

I think your theory can also be applied to why states with lower surges earlier in the pandemic surged at a later time. They had fewer people with the acquired immunity. People in areas with lower Covid incidence may also have decided to delay vaccination because it wasn't as big of a problem in their area. I also think weather conditions have an impact. The South and desert areas surge more during the summer when people spend more times indoors, while northern areas surge in winter.

 

[DannyTS]

Add to that, one person may account for multiple positive COVID-19 results AND wasn't DANNYTS that brought into question the COVID testing process on this site? NOW - they want to use the data? Let me look up the word hypocrite.

I looked up the word. According to the definition, a person who claimed last year that the tests were highly accurate, the database rock solid but who wouldn't rely on them now to prove natural immunity because they are no good.


Do not confuse the high number of amplifications with the fact that those people have been infected at one point, but their body had won the battle at the time of testing. What I said last year was triggered by the article in the New York Times. Several top virologists from Massachusetts said that those that test positive with a high number of CT amplifications are actually not cases, they should not be counted and contact traced, because the viral load is just too low for practical reasons. I was ridiculed at the time for that position. Fast forward to 2021, the CDC changed the guidance and lowered the number of amplifications. The number of amplifications is also commonly used now to estimate the viral load. Thank you, apologies accepted.

 

[DannyTS]

I suspect you may be underestimating the challenges the widely-distributed data in the US healthcare system provides for the kinds of statistics you would like to see. I have several doctors, but none of their systems talk to each other unless they are part of the same health system. Same for hospitals, pharmacies, and clinics. The individual-level data you seek exists, but it lives on a myriad of independent databases held by each provider - all with different file formats and database structures.

Since the vaccine delivery started as more of a top-down project through Operation Warp Speed, I suspect we are closer to the consolidated data you seek there, but even there it may not be as easy as you think. For example, my wife and I got our vaccines from different providers in NC. My provider signed me up for the NC Vaccine Management System where I have access to my vaccine records online. All my wife got was the paper CDC card.

Testing is likely an even bigger challenge because it has always been a more bottom-up process where states have struggled to even collect summary data from the myriad of testing providers. And it's that testing data we would really need to accurately map who has natural infection over the vaccines records. I don't think the states receive patient-level data for all the positive/negative tests that are done, just summary stats. Once someone is hospitalized and/or dies, that data can be tracked better, and I suspect that is why we know vaxed/unvaxed stats for hospitalizations and deaths, but not for all positive tests. Most of the numbers on breakthrough infections are estimates or anecdotal reports from specific events/locations (like the infamous Provincetown July 4 celebration).

Let's take for example Kentucky. All the test results have been reported to the KDPH. Why can't they provide the total immunity for Kentucky? The database is solid, they just do not want to use it.


"In compliance with 902 KAR 2:020, the Kentucky Health Information Exchange (KHIE) provides a service
to automate reportable disease electronic laboratory reporting (ELR) to the Kentucky Department for
Public Health (KDPH)."

This is from a CDC study looking at previously infected in Kentucky who also got the vaccine.

"Kentucky residents aged ≥18 years with SARS-CoV-2 infection confirmed by positive nucleic acid amplification test (NAAT) or antigen test results† reported in Kentucky’s National Electronic Disease Surveillance System (NEDSS) during March–December 2020 were eligible for inclusion. NEDSS data for all Kentucky COVID-19 cases were imported into a REDCap database that contains laboratory test results and case investigation data, including dates of death for deceased patients reported to public health authorities (3). The REDCap database was queried to identify previously infected persons, excluding COVID-19 cases resulting in death before May 1, 2021. A case-patient was defined as a Kentucky resident with laboratory-confirmed SARS-CoV-2 infection in 2020 and a subsequent positive NAAT or antigen test result during May 1–June 30, 2021. May and June were selected because of vaccine supply and eligibility requirement considerations; this period was more likely to reflect resident choice to be vaccinated, rather than eligibility to receive vaccine.§ Control participants were Kentucky residents with laboratory-confirmed SARS-CoV-2 infection in 2020 who were not reinfected through June 30, 2021. Case-patients and controls were matched on a 1:2 ratio based on sex, age (within 3 years), and date of initial positive SARS-CoV-2 test (within 1 week). Date of initial positive test result refers to the specimen collection date, if available. The report date in NEDSS was used if specimen collection date was missing. Random matching was performed to select controls when multiple possible controls were available to match per case (4).

Vaccination status was determined using data from the Kentucky Immunization Registry (KYIR). Case-patients and controls were matched to the KYIR database using first name, last name, and date of birth. Case-patients were considered fully vaccinated if a single dose of Janssen (Johnson & Johnson) or a second dose of an mRNA vaccine (Pfizer-BioNTech or Moderna) was received ≥14 days before the reinfection date. For controls, the same definition was applied, using the reinfection date of the matched case-patient. Partial vaccination was defined as receipt of ≥1 dose of vaccine, but either the vaccination series was not completed or the final dose was received <14 days before the case-patient’s reinfection date. Using conditional logistic regression, ORs and CIs were used to compare no vaccination and partial vaccination with full vaccination among case-patients and controls. SAS (version 9.4; SAS Institute) was used for matching and statistical analyses. This activity was reviewed by CDC and was conducted consistent with applicable federal law and CDC policy.¶"

Public Health Reporting - Kentucky Health Information Exchange

khie.ky.gov

Reduced Risk of Reinfection with SARS-CoV-2 After COVID-19...

This report describes COVID-19 reinfection among vaccinated and unvaccinated persons in Kentucky.

www.cdc.gov

No, I am not buying they cannot provide the total immunity for any city, any community, any state or for the whole country. The problem is the will, like in Canada and elsewhere and because the scope may not be public health. Instead they are firing nurses with natural immunity because they are not on the "correct" side and not because of the science or lack of data. If the global history is any guidance, this is not a hopeful sign for the future.

Edited to add:
For the purpose of contact tracing, Kentucky (and the other states) have been using the database of people who tested positive. Of course they have the information.

https://chfs.ky.gov/agencies/dph/covid19/CTT%20FAQs.pdf