Saturday, July 17, 2021

Weekend Reading: The Back to Risk Assessing Edition

I don't know if I'll have many links for you this week. I got frustrated/depressed by the news about the Delta variant spreading and the heat waves and floods and other climate-related disasters and I decided to spend less time on Twitter and am instead working on a jigsaw puzzle my parents lent me. My husband has already done this one so he is staying away and therefore it is taking me longer to do (which is a good thing since I was looking for an offline distraction).

I am on the fence about what to do about social media long term, but for now I am cutting back and that seems to help a bit.

I don't just delete my accounts because I have gotten some real value out of Twitter. I've learned a lot about various topics over the years, and it was how I was ahead of the game during this pandemic. Tweets that came across my feed were why I'd stocked up a bit on staples before the lockdown. They are why I bought and started wearing masks early. Tweets (and the articles linked in them) have helped me figure out how to keep my family safe while also not being complete hermits.

This is breaking down now, though. I very much want to find reliable information to help me figure out how to keep my unvaccinated 11 year old safe right now, and I am not finding that. Instead, there is a lot of yelling about whether we should be mad at unvaccinated adults or whether our anger/ridicule is keeping them from getting vaccinated. There are a lot of anecdotes about breakthrough infections among the vaccinated, but when I do find real data on that it is still very, very rare.

And today, I read this short article that indicates the vaccines for 5-11 year olds might not be approved until mid-winter. That's going to suck for a lot of elementary schools, particularly in places that are prohibiting mask mandates in school. (My school district sent out an email saying all kids and staff, vaccinated or not, will need to wear masks indoors but probably not outdoors.)

So... what are we doing? I am working on new rules for us based on these observations. I will put links where I have them, but I don't have as many links as I'd like:

  • The Delta variant is definitely easier to spread. I have seen scattered reports of outbreaks in outdoor events, but so far those are events where people are close together for long periods of time, like weddings and parties. I haven't yet found any systematic survey of the risk when outdoors, though.
  • Fully vaccinated adults and teenagers are still really well protected from infection, even with the Delta variant. If they do get sick, they are more likely to have mild symptoms and less likely to end up hospitalized. 
  • Older adults and people with compromised immune systems seem to be at higher risk of breakthrough infections. 
  • There was one anecdote I came across of a family like ours, where 3 out of 4 members are vaccinated. Their 11 year old got infected on vacation and then passed it to the rest. I think vaccinated household contacts of an infected person are at particular risk of breakthrough, but I haven't seen data on this.  It makes sense to me that the vaccinated parents of a sick child would end up sick, because their exposure rate would be so high. 
  • I saw a thread from a patient group that is tracking long COVID that indicated there are some long COVID cases among breakthrough infections. I have also seen plausible arguments from infectious disease experts that you'd expect fewer long COVID cases among the vaccinated who get sick, because there should be lower viral load. I think we just do not know yet what the risk of long COVID is for vaccinated people. 
  • Data from the UK indicates that kids do get long COVID.
  • Kids are also at risk for MIS-C, a covid-related disease that we don't really understand yet.

Looking at all of this, I think Petunia is the family member most at risk because she is completely unprotected. She has mild exercise induced asthma but no other risk factor, so if she gets sick, her risk of serious illness is low, but I have no way to assess her risk of long COVID or MIS-C. 

If Petunia gets sick, there is a good chance that the rest of us will, too. Our risk of serious illness is low but I don't really know what to think about our risk of long COVID.

Basically, we still need to be careful because the pandemic is not over and our vaccine protection cannot be complete until Petunia turns 12.

I wish all people who are eligible for vaccines would get them and that we'd all wear masks indoors until either transmission is really, really low or vaccines are available for everyone. But neither of those things will happen.

So what will our family do to keep safe? Here's my plan right now:

  • We all wear masks in any indoor public place. I bought another box of KF94s. Petunia will wear those while shopping, etc. The vaccinated people in the family can wear our cloth masks, but I wore a KF94 for a recent doctor's appointment and I think that if in doubt, I will err on the side of the better mask.
  • None of us will dine indoors at a restaurant until we are all vaccinated. We will eat outdoors at restaurants, though, looking for well-spaced patios.
  • If we go to an outdoor event, we will not be in close quarters with other people whose vaccination status we cannot know. While the kids were in Arizona last month, my husband and I went to a local rugby game. That felt fine because it wasn't packed, so we could sit more than 6 feet away from other people. I would not go to a crowded event right now.
  • We will still see vaccinated friends and family without masking, but will bias towards outdoor get togethers. Luckily, the weather in San Diego right now makes that an easy choice.

I wish I had prevailed in the discussion about where to take our vacation this year. I wanted to do a car trip here in California, but Mr. Snarky wanted to visit a new state. We settled on a trip to Washington state, with the majority of the time spent at National Parks. We will fly to Seattle. I am feeling far less good about this decision now than I did when we made the reservations but I think it is still not a very high risk.

We haven't cancelled our vacation but I am doing extra research to make sure I have a lot of restaurant options so that we can be sure we never eat indoors. As my kids got older, I starting doing less research ahead of a trip because they could roll with delayed meal times or a longer than expected walk a bit better. I am back to the level of research I did when they were toddlers. I don't mind doing this research (and even enjoy parts of it) so that's OK.

We'll all wear KF94 masks on the plane and the masks will go on when we enter the airport in San Diego and won't come off until we leave the airport in Seattle. We will hope that a flight between two cities with good vaccination rates will be OK, particularly since masks are still required on flights. And I will do my best not to worry.

OK, on to the minimal other links I have!

The stories coming out of Missouri are so sad.

On the impact of the child cash benefit. I hope we can make this permanent. 

This excerpt from Michael Bender's book about Trump supporters is definitely worth your time. It is interesting how the rallies made communities of like-minded people and how that filled a need for some people. This quote from one supporter who was at the Capitol on Jan 6, though, blew my mind:

“We weren’t there to steal things. We weren’t there to do damage. We were just there to overthrow the government.”

In recommended listening: Jamil Smith's interview with Kiese Laymon is excellent.

In happy things:

Do you know about the Alaska bear cams? There was a bearapalooza Wednesday night and it was awesome:

Puffin selfie!

Here's your bunny for the week:

Have a good weekend, everyone! 


  1. Socal Dendrite8:22 PM

    Yeah, our kids are 6 and 8 so we are in the same boat as you regarding partial family vaccination. But at least LA County walked back on the unmasking and made masking indoors mandatory for all again. (The honor system for vaccinated vs unvaccinated was just stupid.) We actually just got back from our vacation, which took us all the way to your neck of the woods :) By far the riskiest thing we did was to visit Legoland, which, like your flight, seemed like a better idea when we booked it than in the days leading up to it last week. I was definitely very nervous about it beforehand but it turned out better than I feared (fingers crossed anyway). The park was crowded in places but we avoided the crowded areas and wore KN95s for much of the time (sadly, very few others were wearing masks). It's about a week since we were there and no symptoms yet, touch wood. I hope you have a nice vacation, despite the concerns.

  2. Where we live in Melbourne, we have what the international community considers very "clean" data on the spread of Delta. This is because we have very few infections of Covid-19 and every single case is contact-traced and linked by genomic testing. Our contact tracers trace contacts by using self-reporting of daily movements from positive cases as well as their financial data, Mandatory QR code check-in to all venues and CC TV.
    Unfortunately we are last in the developed world with our vaccination by percentage of population. Only over 40s (and frontline health workers) have been offered it at this stage, and we only have AZ and Pfizer - but the AZ has been recommended mainly for 60s+ due to the clotting disorder - but the risk/benefit calculation on that is changing where we have a big (for us) outbreak in Sydney.

    Anyway, the reason I am commenting is that we have had several outdoor exposure sites at stadiums, where the capacity was limited with strict rules about seating. (These venues are the Melbourne Cricket Ground - and Aussie Rules football game and AAMI park - International rugby - Frace Vs Australia).
    Using CCTV that traced the movements of the positive cases (who had not been diagnosed at the time and were pre-symptomatic), the tracers think mostly it was passed on in toilets or eateries. But in a couple of cases, the only contact was fleeting outdoor contact as people moved through "pinch points" - the entry gates to enter the stadiums.
    So we do have verified spread outside. We also have verified spread (by CCTV) of fleeting contact (people just passing each other) in supermarkets, including where masks were mandatory.

    Delta is very scary and currently our whole state is locked down again (5th lockdown). We have learned to lock down hard and fast, and should have eradicated this outbreak by Tuesday which will be 2 weeks of lockdown. Our state's outbreak was seeded from Sydney, by removalists who broke the rules when they came to our state, Sydney took too long to lockdown and are now in a world of pain. Their contact traces had been able to keep on top of things previously, but Delta changes everything.


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