How close are we to everyone having antibodies, and what will that mean for the death rate?

According to this article from April, at least 58% of Americans have been infected with COVID (surely a lot more by now?), while 66% are fully vaccinated and 77% have received at least one dose (again, probably more by now.) https://www.cnbc.com/2022/04/26/at-least-58percent-of-us-population-has-natural-antibodies-from-previous-covid-infection-cdc-says.html

Obviously, there have been breakthrough infections as well as people getting the vaccine after having been infected, so it’s not surprising these numbers add up to more than 100%. But how many people are left who have neither been vaccinated nor infected?

It seems like we won’t achieve herd immunity, given how quickly the virus mutates and gets around the vaccines, and also given that immunity likely wanes quickly. But it also seems like relatively few people die or wind up in the hospital if they were vaccinated or previously infected. So how long will it take before we get there, and will we see a significant reduction in casualties when we do?

If you look at excess deaths (which I think is probably the best way to estimate Covid deaths since it’s the least subject to confounding factors), the death rate is back to normal

Now, that doesn’t quite mean that Covid isn’t a statistically significant threat anymore. One way to think about it is that there were a lot of excess deaths in the last 2 years and some of those were pulled forward, so the fact that we’re still seeing as many deaths right now as a “normal” summer means that Covid is still causing some deaths, but the rate is pretty low.

Like, imagine a universe without Covid. In that universe there’s an 80-something year old who died this summer from liver failure (or whatever). In our actual universe that person died 2 summers ago from Covid, so for the number of deaths right now to be the same as a “normal” year, someone else is dying of Covid this summer.

At some point we will either see a year with negative excess deaths, ie, fewer people died than an average year (per population), or we’ll never see it. If we see it, it means we’ve reached some kind of useful herd immunity to Covid. Everyone still alive has enough immunity that Covid stops being a statistically significant threat. If we never see it, it means that Covid (probably) continues to be a threat of some kind and we’re all effectively sicker and living statistically shorter lives. Or something else is killing us at higher rates and we never catch up.

Extremely few.

That graph is a bit hard to see on my phone; too many similar shades of red. But that’s an interesting way of looking at it. I guess it’s a bit complicated to try to parse COVID deaths from deaths from other causes, though it seems a lot of organizations are doing it. The CDC reports we’ve passed the one million mark in COVID deaths in the US, with a current 7-day average of 364 (down from 382 the previous week, so…progress?)

Most of the counts of covid deaths are “people who tested positive for Covid around when they died”. It generally greatly undercounted when testing was limited or otherwise not done, and probably slightly overcounted some cases where people had mild covid or died of something totally unrelated. That is, it counts “died with known Covid” rather than “died of Covid”.

Excess deaths is not a perfect measure either (it’s just measuring “died during Covid”), but I think it’s generally a better one.

I don’t think that’s true in the US (someone correct me if I’m wrong). I was under the impression that a covid death only counts if it is on the death certificate as a cause of death. Certainly, this was falsely low at the beginning of the pandemic because a lot of deaths were ruled pneumonia or maybe even cardiovascular deaths because of undertesting and underdiagnosing. I don’t think there are major overcounts in the US. In fact, sometimes worldometers is off from other counters like the CDC or Johns Hopkins because those counts are later corrected.

However, I remember reading that death counts in Denmark and the UK are falsely high during the ba.1 and ba.2 surges or 30 days beyond those surges because they count any death within 30 days of a positive covid test. Before omicron, it matched very well with later confirmed covid deaths. During omicron, there were a lot of people dying “with covid” who may not have died “of covid”. As far as I can tell, those overcounts have not been corrected in ourworldindata.org.

I think it varies based on which state health department is counting them.

For example, here’s how the state of Oregon counts them

Those first two bullet points are “died with Covid”.

The fact that different locations count them differently is another reason to think that the data is pretty noisy. Locations with political desires to influence the “covid death” count might adopt more or less strict criteria.

But they all have to report deaths in general.

Here’s a story about two men being reported as Covid deaths after falling off a ladder and being in a motorcycle crash, respectively. Did Covid contribute to their deaths? I mean, sure, possibly. It’s harder to balance and react quickly and so on when you’re sick. But also totally healthy people die in falls and vehicle crashes too.

To be clear: I don’t either, which is why I described this measurement as “greatly undercounted…slightly overcounted”. On net almost certainly undercounted by a lot.

I kind of wonder how the data’s being gathered. In my recent hospital stint for an infected arm, it was discovered that I tested positive for COVID as well.

I had some symptoms a week earlier, but they were super mild. Mild enough that I don’t think I’d have stayed home from work had this been say… 2018. And they lasted for like 3 days, and went away. In fact, compared to the actual Flu-A I had in April, COVID was just a non-event.

But the hospital insisted on treating me like I was a COVID patient- I felt like I had to remind them that I hadn’t come in for the COVID, but for the arm infection. My lungs were fine, my oxygen saturation was fantastic, etc…

I got a survey from the County a few days ago, and now I’m wondering if I’m classified as a hospitalized COVID case. Which is absurd- I was there for an arm infection, not COVID.

Anecdotally, the nurses said that of the vaccinated patients, the majority in the COVID ward were there for something else, and just happened to test positive. They also said that the unvaccinated were still getting hammered by COVID and severely ill.

I kind of think that at some point, between vaccinations and acquired immunity, COVID will be regarded in a similar light to the flu, especially if they keep the vaccinations up to date and infections remain mild like they currently are. The threat would be if people quit getting vaccinated because the infections are so mild. Stupid, but that’s what a lot of people do.

The thing with the excess deaths count, is there can be a lot of indirect effects. For instance, you could have someone who lost their job waiting tables because all the restaurants were closed, and as a result couldn’t afford something important, and died of that, without ever having covid. Or an elderly person who dies, in part, as a result of social isolation. Or someone who has some other disease, but can’t get hospital care for it, because the hospital’s full of covid cases. Those folks might never have even been infected… Do they count as “dying of covid”? Depends on precisely what question you’re asking.

On the other hand, you have cases like Colin Powell. You can say that he died of covid… but the reason why covid hit him so hard was because he already had multiple myeloma and Parkinson’s disease, and of course he was 84. Do you list the cause of death as covid, or multiple myeloma, or Parkinson’s, or old age? Assign each of those a percentage of cause? An 84-year-old with myeloma and Parkinson’s probably doesn’t have a very long life expectancy even without covid.

Good point.

Every year I attend a talk by the LA County Coroner and a few other professionals analyzing scuba diving deaths in the area. It sounds morbid, but the analysis offers good insights on how to stay safe while diving. But the last two years, they’ve opened with a talk about COVID and how it’s affected the Coroner’s office more generally, and how they’ve been handling it. This year, they talked about all the deaths they’ve seen that weren’t directly due to COVID infection, but likely due to or at least hastened by people avoiding seeking medical care, or being unable to get it timely, because of the strain of the pandemic. It’s probably too early to see the effects of two plus years of inactivity in terms of increases in heart disease etc., but that’s probably coming for us too.

I think @iamthewalrus_3 agrees with me that deaths are generally not being overcounted in the US even if some states follow the procedure in Oregon. That’s probably not true with hospitalizations. Several states and DC were reporting during the first omicron wave that up to half of their hospitalizations were simply people who tested positive, not people who were admitted due to complications with covid.

Back to the OP, last update of seroprevalence by the CDC in February had 96% seroprevalence in adults ( > 16 yr old). That number was already over 90% before the omicron wave. The omicrons may be milder variants, but the major disconnect between cases and ICU admissions or deaths is likely due to some level of immunity.

It amazes me that they can still see the difference between vaccinated and unvaccinated at the current levels of seroprevalence. I suspect that a lot of the vaccinated are boosted and/or had a recent infection that acted as a booster. They’re getting nice hybrid immunity. The unvaccinated are always a step behind in immunity. Maybe they never had covid. Or maybe they had it a year ago and it waned.

The challenge from now on looks like trickier variants and waning immunity from people who have been infected but won’t boost their immune system with a vaccine. I guess those people will just keep getting worse cases of covid compared to the boosted. Then they’ll wonder why they have so many health problems and never make the connection. :roll_eyes:

From the article I posted in the OP:

There may still be some room for debate, and there may be shifts with new variants, but the more I read, the more I think the evidence supports vaccine immunity over natural immunity. I’m not totally confident we’ll be able to adequately protect the elderly and medically fragile with vaccines ever after, but I do think those who refuse the vaccines are gonna have a real bad time compared to the rest of us.

That’s stunning, considering we’re still seeing 350-450 deaths per day. That’s like 150k deaths per year, which would be a very, very bad flu year.

What is driving that apparently is the higher infection rate. The fatality rate is indeed now that of the flu.

Is that accounting for vaccines and prior infections, though? A lot of people don’t get their flu shot every year, and many/most who get the flu haven’t had it in many years, if ever. So if the flu kills the same total percentage of people who catch it despite encountering more naive immune systems, that would make it at least a little less virulent.

A lot less virulent. During the height of the first wave of COVID, when everything was shut down, the flu basically went away.