Josh Marshall
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Are We Thinking the Right Way About What Constitutes Infection? 
One of the most interesting and clarifying discussions I’ve read in recent weeks is Dr. Monica Gandhi’s discussion of the difference between ‘colonization’ and ‘infection’ in thinking about what counts as a case of COVID. It’s conceptually interesting but also highly relevant both for the choices we make balancing risk as individuals as well as how we approach the vaccine phase of the pandemic in policy terms.
As Gandhi tells it, in many cases a vaccinated individual will be exposed to COVID and have the pathogen briefly colonize their nasal passages. But vaccine-induced immunity will fight and defeat the virus there. Is that an infection or a case? If you take a PCR test, you’ll test positive. But Gandhi says we’re confusing things by treating it as one.
Gandhi is an infectious disease specialist and we spoke with her this morning in an Inside Briefing about this and related topics.
If you’re a TPM member you can watch our full interview after the jump.
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This is perhaps a minor point. But I want to return to it. A key reason we’re experiencing the fourth COVID wave in the US – albeit one that has far less hospitalizations and deaths thanks to vaccines – is that way too many people still haven’t gotten vaccinated. From an epidemiological perspective we’re not nearly where we want to be. But as we talk about the political polarization over vaccines, things are a bit different.
Among Americans over the age of 18 fully 71% have gotten at least one vaccine dose.
We did a fascinating Inside Briefing this morning with Dr. Monica Gandhi discussing vaccines, different layers of the human immune system and what really counts as an infection. It’s really critical information when thinking about personal decisions about risk and about policies for society at large. Thanks to the Inside members who joined for the discussion. We’ll be publishing the full interview for all members either later today or at latest tomorrow. Don’t miss it.
Vaccines and Severe Cases in Israel
As we’ve been discussing there is a paucity of information on the precise effectiveness of vaccines vs the Delta variant and the contours of the pandemic in the new circumstances of the last eight weeks or so. We know in general that vaccines continue to be highly effective at preventing severe illness. But the details are not as easy as they should be to come by. This seems to be both the product of very new facts which studies are only catching up with and a continued paucity of good national data from the CDC. That vacuum is filled by anecdotal information.
The Folks at the Top Are the First To Go
I was raised by a man steeped in the life sciences. He wasn’t a climate scientist. He was a marine botanist who spent the first and last parts of his career teaching general biology at various colleges. But this professional description doesn’t capture the depth of the imprint on him and thus indirectly on me. For him it was an entire ethic and worldview, one rooted in evolutionary theory and furnished from various domains of knowledge: archeology, paleontology, paleo-zoology, ecology, astronomy in addition to biology.
A good run-down of the cataclysmic and imminent changes to the global climate sketched out in today’s big climate report.
Biden Is Having His Cake and Eating It Too
The much-heralded bipartisan mini-bill actually seems on its way to passage in the Senate. On the critical (and mind-numbing) vote to allow a majority vote, 18 Republicans ended up voting in the affirmative. It now seems very likely that Biden will get his bipartisan deal while also managing to pass close to his entire fiscal, infrastructure and climate agenda. If that happens – and it is likely to happen notwithstanding a few more months of haggling and drama – it will be a major, major accomplishment.
Yet in a guest opinion piece Friday in The New York Times Alex Pareene argued that it is in fact a “pyrrhic victory in a broken Senate.” I’m almost never in the practice of responding to people in the Editors’ Blog. But I wanted to do so in this case because Pareene is a gifted writer and incisive political observer. So it’s important to explain why he’s wrong.
As we’ve been discussing in recent days, I’ve been looking for apples to apples data on the trends of vaccine efficacy around the US. Changes are likely driven by the Delta variant. But some waning of immunity among the vaccinated could also be playing a role. So could expanding immunity among the unvaccinated – because so many of them are getting sick. That would reduce the difference in infection rates between the two groups even though protection from the vaccine remains unaffected.
Now we have some new information from Oregon.