We Need More Data. Stat.

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August 4, 2021 6:36 p.m.

I want to flag again what I discussed here yesterday. Only a handful of jurisdictions across the country are tracking and publishing COVID data broken down by vaccination status. As far as I can tell all of two states – Oregon and Virginia and one county, San Diego County in California – are tracking so-called breakthrough infections in any way that gives us a helpful understanding of the state of the pandemic.

Let me recapitulate some of what I discussed yesterday. Many states are occasionally or routinely publishing cumulative data on breakthrough infections since the beginning of mass vaccinations in early 2021. But that doesn’t tell us much because combining the situation in February and March with June and July confuses the issue. Other states are releasing data showing that a tiny fraction of 1% of the people who’ve been vaccinated in a given state or county have gone on to get infected, hospitalized or die. But again, that doesn’t tell us much. The relevant data is infections or hospitalizations broken down by vaccination status and that data available over a recent time period. For all the sample biases involved in testing, that gives us a concrete understanding of the efficacy of vaccines which can inform personal behavior and public policy.

The CDC decided several months ago to stop tracking breakthrough infections. They’re only tracking hospitalizations and deaths among the fully vaccinated. That seems like a significant mistake.

Here is one reason this is so important. Yesterday a Johns Hopkins epidemiologist, Allan Massie, wrote an OpEd in The Baltimore Sun about his experience with COVID. A bit over a week ago, Massie went to a house party with 15 attendees, all of them vaccinated. A day later the host showed signs of COVID and later tested positive. Over the new few days 11 of the 15 would also test positive for COVID.

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This comes after the much discussed outbreak in Provincetown, Massachusetts in which COVID seemed to spread widely among vaccinated partygoers. As we’ve discussed, a long weekend of hard partying in small buildings and indoor spaces with poor ventilation didn’t seem readily applicable to many other settings. But taken together these cases seem to suggest that COVID can spread readily among vaccinated people and that vaccinated people can get it without much trouble.

But are these cases at all representative?

Data from Virginia, San Diego and Oregon suggest that infections are at least 90% among the unvaccinated as recently as June and in Virginia as late as July. Los Angeles County announced recently that in June 20% of infections were among the vaccinated. In Virginia during the same month it was 4%. In Oregon it was 8%.

That’s a very big range.

But it’s not that surprising since you’re dealing with local county health departments or health departments in mid-sized states. They may have totally different testing strategies which could be skewing the data in various directions. That’s why we should be collecting this data in a much more comprehensive way. Otherwise we’re buffeted this way and that by anecdotes which may be representative and may not.

I think one reason this data isn’t being collected or published more systematically is that public health authorities want to keep the focus on what’s truly important: dramatically reducing hospitalizations and deaths. There’s little question that vaccines drastically reduce your odds of those bad outcomes and reduce infections almost as much. But symptomatic infections which can lead to long COVID and shed enough virus to get others infected too matter as well. We need to track these more effectively.

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