“Clean” RAGBRAI 2021?

Maybe not to early to get ideas on how to make RAGBRAI 2021 more sanitary, more CV19 compliant. Like RAGBRAI’s dirtiest challenge, keeping Kybos sanitary, do riders carry masks to slap on in crowded beer gardens, etc.? Maybe we can help make 2021 happen with the right ideas?

201 Replies

mootsman, February 20, 2021 at 8:16 am

David posted this in the “Thoughts- 2021 happening?” thread which makes it seem like RAGBRAI 2021 should be a relatively safe event this year. And it makes this thread of marginal use at best.

David, February 19, 2021 at 6:02 pm
For those that want to read the WSJ article.

Amid the dire Covid warnings, one crucial fact has been largely ignored: Cases are down 77% over the past six weeks. If a medication slashed cases by 77%, we’d call it a miracle pill. Why is the number of cases plummeting much faster than experts predicted?

In large part because natural immunity from prior infection is far more common than can be measured by testing. Testing has been capturing only from 10% to 25% of infections, depending on when during the pandemic someone got the virus. Applying a time-weighted case capture average of 1 in 6.5 to the cumulative 28 million confirmed cases would mean about 55% of Americans have natural immunity.

Now add people getting vaccinated. As of this week, 15% of Americans have received the vaccine, and the figure is rising fast. Former Food and Drug Commissioner Scott Gottlieb estimates 250 million doses will have been delivered to some 150 million people by the end of March.

There is reason to think the country is racing toward an extremely low level of infection. As more people have been infected, most of whom have mild or no symptoms, there are fewer Americans left to be infected. At the current trajectory, I expect Covid will be mostly gone by April, allowing Americans to resume normal life.

Antibody studies almost certainly underestimate natural immunity. Antibody testing doesn’t capture antigen-specific T-cells, which develop “memory” once they are activated by the virus. Survivors of the 1918 Spanish flu were found in 2008—90 years later—to have memory cells still able to produce neutralizing antibodies.

Researchers at Sweden’s Karolinska Institute found that the percentage of people mounting a T-cell response after mild or asymptomatic Covid-19 infection consistently exceeded the percentage with detectable antibodies. T-cell immunity was even present in people who were exposed to infected family members but never developed symptoms. A group of U.K. scientists in September pointed out that the medical community may be under-appreciating the prevalence of immunity from activated T-cells.

Covid-19 deaths in the U.S. would also suggest much broader immunity than recognized. About 1 in 600 Americans has died of Covid-19, which translates to a population fatality rate of about 0.15%. The Covid-19 infection fatality rate is about 0.23%. These numbers indicate that roughly two-thirds of the U.S. population has had the infection.

In my own conversations with medical experts, I have noticed that they too often dismiss natural immunity, arguing that we don’t have data. The data certainly doesn’t fit the classic randomized-controlled-trial model of the old-guard medical establishment. There’s no control group. But the observational data is compelling.

I have argued for months that we could save more American lives if those with prior Covid-19 infection forgo vaccines until all vulnerable seniors get their first dose. Several studies demonstrate that natural immunity should protect those who had Covid-19 until more vaccines are available. Half my friends in the medical community told me: Good idea. The other half said there isn’t enough data on natural immunity, despite the fact that reinfections have occurred in less than 1% of people—and when they do occur, the cases are mild.

But the consistent and rapid decline in daily cases since Jan. 8 can be explained only by natural immunity. Behavior didn’t suddenly improve over the holidays; Americans traveled more over Christmas than they had since March. Vaccines also don’t explain the steep decline in January. Vaccination rates were low and they take weeks to kick in.

My prediction that Covid-19 will be mostly gone by April is based on laboratory data, mathematical data, published literature and conversations with experts. But it’s also based on direct observation of how hard testing has been to get, especially for the poor. If you live in a wealthy community where worried people are vigilant about getting tested, you might think that most infections are captured by testing. But if you have seen the many barriers to testing for low-income Americans, you might think that very few infections have been captured at testing centers. Keep in mind that most infections are asymptomatic, which still triggers natural immunity.

Many experts, along with politicians and journalists, are afraid to talk about herd immunity. The term has political overtones because some suggested the U.S. simply let Covid rip to achieve herd immunity. That was a reckless idea. But herd immunity is the inevitable result of viral spread and vaccination. When the chain of virus transmission has been broken in multiple places, it’s harder for it to spread—and that includes the new strains.

Herd immunity has been well-documented in the Brazilian city of Manaus, where researchers in the Lancet reported the prevalence of prior Covid-19 infection to be 76%, resulting in a significant slowing of the infection. Doctors are watching a new strain that threatens to evade prior immunity. But countries where new variants have emerged, such as the U.K., South Africa and Brazil, are also seeing significant declines in daily new cases. The risk of new variants mutating around the prior vaccinated or natural immunity should be a reminder that Covid-19 will persist for decades after the pandemic is over. It should also instill a sense of urgency to develop, authorize and administer a vaccine targeted to new variants.

Some medical experts privately agreed with my prediction that there may be very little Covid-19 by April but suggested that I not to talk publicly about herd immunity because people might become complacent and fail to take precautions or might decline the vaccine. But scientists shouldn’t try to manipulate the public by hiding the truth. As we encourage everyone to get a vaccine, we also need to reopen schools and society to limit the damage of closures and prolonged isolation. Contingency planning for an open economy by April can deliver hope to those in despair and to those who have made large personal sacrifices.

Dr. Makary is a professor at the Johns Hopkins School of Medicine and Bloomberg School of Public Health, chief medical adviser to Sesame Care, and author of “The Price We Pay.”

#1327146

Joseph Schlau, February 20, 2021 at 9:06 am

When Could the United States Reach Herd Immunity? It’s Complicated.

By Matthew Conlen and Charlie SmartFeb. 20, 2021

With the vaccine rollout underway and coronavirus cases declining after a dark winter surge, it may seem as though the end of the pandemic is in sight. In reality, how soon could we get there?

One answer lies in herd immunity, the point when enough people are immune to the virus that it can no longer spread through the population. Getting there, however, depends not just on how quickly we can vaccinate but on other factors, too, like how many people have already been infected and how easily the virus spreads.

When Could the United States Reach Herd Immunity? It’s Complicated.

https://www.nytimes.com/interactive/2021/02/20/us/us-herd-immunity-covid.html?referringSource=articleShare

#1327147

mootsman, February 20, 2021 at 11:42 am

When Could the United States Reach Herd Immunity? It’s Complicated.
By Matthew Conlen and Charlie SmartFeb. 20, 2021

My bet is on this prof from John Hopkins published in the WSJ: Dr. Makary is a professor at the Johns Hopkins School of Medicine and Bloomberg School of Public Health, chief medical adviser to Sesame Care, and author of “The Price We Pay.”

Not the guys from the NYT. Many forum readers do not have online subscriptions to the NYT so it doesn’t let us read the article anyway.

This reply was modified 6 days, 13 hours ago by mootsman.

This reply was modified 6 days, 13 hours ago by mootsman.

This reply was modified 6 days, 13 hours ago by mootsman.

This reply was modified 6 days, 13 hours ago by mootsman.

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NYC Highwheeler, February 20, 2021 at 3:51 pm

As I posted in the other thread:
To be clear, that is not an article, that is an opinion piece. It meets no journalistic standards, it hasn’t been fact checked, and isn’t representative of anyone but the author. As the middle-aged kids these days say, “That’s just like, your opinion man!”

Looking at the Data on the Johns Hopkins website:
https://coronavirus.jhu.edu/data/cumulative-cases
As of Today, 2/20/21:
“Yesterday, the [United States] reported 108,275 new confirmed cases and 2,595 deaths.”
Which means that we are still losing 2,595 daily in the US, which translates to almost a million dead per year at current rates. Based on the graphs of new cases, we seem to be still doing worse then any time prior to November of 2020, before the massive winter spike. The “77%” dip has already ended, and cases are once again on the rise.

This reply was modified 6 days, 8 hours ago by NYC Highwheeler.

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mootsman, February 20, 2021 at 4:57 pm

I still listen to experts about where we’re going to be rather then stats for 1 day now. RAGBRAI is 5 months away yet so chill people. Cases around here continue to drop. My bet is RAGBRAI is happening.

This reply was modified 6 days, 8 hours ago by mootsman.

#1327164

Joseph Schlau, February 20, 2021 at 5:31 pm

I still listen to experts about where we’re going to be rather then stats for 1 day now. RAGBRAI is 5 months away yet so chill people. Cases around here continue to drop. My bet is RAGBRAI is happening.

If you Google Makary, he is a regular contributor to Fox News and the Wall Street Journal. A contributor is a paid commentator. You notice the WSJ article ends with a plug for one of his many books. The only way he gets to plug his book on Fox or WSJ is to present something controversial that grabs attention. His objectivity is thus compromised.

#1327175

Joseph Schlau, February 20, 2021 at 5:38 pm

In his article he states “Some medical experts privately agreed with my prediction that there may be very little Covid-19 by April but suggested that I not to talk publicly about herd immunity because people might become complacent and fail to take precautions or might decline the vaccine. But scientists shouldn’t try to manipulate the public by hiding the truth”

Any reputable scientific article will list sources. Using terms like some medical experts who privately agreed with me leaves the judgement up to his sole interpretation of what they said. If he fails to list his sources, then the reader is prevented from independently reviewing the data.

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Joseph Schlau, February 20, 2021 at 5:56 pm

Now add people getting vaccinated. As of this week, 15% of Americans have received the vaccine, and the figure is rising fast. Former Food and Drug Commissioner Scott Gottlieb estimates 250 million doses will have been delivered to some 150 million people by the end of March.

From CNBC

Gottlieb, a former FDA commissioner in the Trump administration, said he believes supply constraints will remain throughout February that justify having more narrow eligibility criteria. “But at some point in March, states are going to have to make decisions about how to open this up more widely,” predicted Gottlieb, who serves on Pfizer’s board of directors.

“If we continue to ration it based on more and more narrow slices of the population, it’s going to get harder to administer, so I think we’re just going to have to open this up to general availability, which is good news,”

NYTimes today

The CDC said on Friday about 42 million people have received at least one dose of a Covid-19 vaccine, including about 17 million people who have been fully vaccinated.

If 42 million total doses have been delivered so far, and new doses are being given at 1.7 million doses per day, then with 40 days to the end of March there will be only 68 million additional doses by the end of March. And these doses must cover first and second recipients.

Like, uh, am I missing something ? So how did we come up with 250 million doses by the end March ?

#1327178

GP_in_SD, February 20, 2021 at 6:52 pm

According to CDC stats, the 7 day average total vaccinations (1st and 2nd) is 1.8 million per day. The 7 day average of fully vaccinated is 850k per day. A total of 61 million doses have been given (injected into arms) to date, 18 million having received both doses. Granted, those numbers are surely down from what they would have been without the weather issues this last week but even if we suddenly jumped to 3 million doses a day starting tomorrow, that would add 115 million doses by the end of March or a total of 176 million doses. Maybe 100 million of those having received both doses. Even at that immediate near doubling of injections we still don’t come close to Gottlieb’s projection. JNJ could add to the effort in March but some reports have said they won’t add that much to the US effort until later this year. I guess I’d say possible to get to Gottlieb’s numbers but not probable.

As some local color, I live in Southern CA and the mass vaccination sites in San Diego and LA are frequently closing for 2 or 3 days at a time because they are running out of vaccine. Assuming those supply issues are eliminated soon, I still don’t see staffing, needles, other supplies etc being rampable to 2 or 3x current rates in such a short timeframe. We may already be maxed out in terms of staffing qualified to do injections.

Data at https://covid.cdc.gov/covid-data-tracker/#vaccinations

#1327180

LawnchairMan, February 20, 2021 at 8:33 pm

SFC JKL 2 said
“OMG! 400K dead.”
Are you saying that facetiously? As if 400 thousand deaths are no big deal? Really? Where is your empathy?
This is an online dictionary definition of a pandemic:
“(of a disease) prevalent over a whole country or the world.”
Since Covid-19 has infected and killed people across the country and the world I think it meets the definition.

You say, ” But yet death totals for the country haven’t increased at all.” What are you talking about? Covid deaths started at zero last Winter and increased at alarming rates until we have the horrific totals we have now. Just because death rates are falling off now doesn’t mean we didn’t have a pandemic. Trump did a terrible job with Covid. He said that the virus will be gone by April, claiming that when temperatures rise, “the virus” will “miraculously” go away. Had he taken it seriously from the start he could have saved hundreds of thousands of lives. He stopped travel from China, but we got the European strain. He finally stopped travel from Europe but left the UK open where his golf course is. Had he used masks and encouraged the county to do so, he would have saved lives and he would have been re-elected.

As far as Fuhrers go, let me remind you of our former president’s pledge salute. It was the same as the Heil Hitler salute. Our last president’s claim that the media is the enemy of the people is exactly what despots say to blind people to the truth.

#1327181

mootsman, February 21, 2021 at 7:59 am

There seem to be just 2-3 web-trolls out here with their fears getting the best of them. Not sure why they think they know more then the experts. Just don’t go on RAGBRAI. This forum is about RAGBRAI and bicycling. We even have a couple discounting experts from John Hopkins Medical School based on what exactly, the web-trolls expertise at finding other negative articles on the internet.

The RAGBRAI leadership will make the call in a few weeks. If they had the Sturgis Motorcycle Rally in 2020 we can have RAGBRAI. Research showed little transmission other then 1 ridiculous statistical study from San Diego State based on calculations rather then tracking actual cases.

Joe, NYC, your scared, we get it. So don’t go on RAGBRAI and go away from this thread which is about how to make RAGBRAI happen this year. And LCM, this thread is not about the politics either. The 3 of you go do your web-troll thing somewhere else.

#1327185

Joseph Schlau, February 21, 2021 at 9:16 am

Joe, NYC, your scared, we get it. So don’t go on RAGBRAI and go away from this thread which is about how to make RAGBRAI happen this year. And LCM, this thread is not about the politics either. The 3 of you go do your web-troll thing somewhere else.

First it was pirates, then it was bandits, and now it is trolls. What is the internet coming to.

Now, back to my rebuttal of the WSJ article. We’ll have a few comments on Sturgis later.

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LawnchairMan, February 21, 2021 at 9:24 am

I didn’t start making political comments until another contributor compared Biden to Hitler. I’m just pointing out that that comparison better fits a past president better. Perhaps you only object when the political comments don’t agree with yours. Why didn’t you complain about SFC JKL 2? If he stops, I will.

#1327188

Jboz, February 21, 2021 at 9:54 am

If he stops, I will.

Regarding political comments one finds objectionable on an Internet forum, to paraphrase an old Einstein quote in contemporary parlance:

Weak people escalate.
Strong people find common ground.
Intelligent people ignore.

#1327189

Joseph Schlau, February 21, 2021 at 10:19 am

In the Wall Street Journal piece, Dr. Makary also relied on the concept of herd immunity for an April opening.

“Herd immunity has been well-documented in the Brazilian city of Manaus, where researchers in the Lancet reported the prevalence of prior Covid-19 infection to be 76%” The term herd immunity is frequently mentioned throughout his opinion piece.

That Manaus example, though it is one of his key examples to substantiate his opinion, paints a different picture.

If you actually read the Lancet article, the scientists are trying to figure out which of 4 factors were responsible for a second wave that hit a city where the city which supposedly had a 76% herd immunity and failed to prevent a rebound. They are evaluating what went wrong.

An article in the BMJ challenges the herd immunity in greater depth

Manaus is the capital and largest city of the Brazilian state of Amazonas. It is the seventh largest city in Brazil with an estimated 2020 population of 2,219,580 distributed over a land area of about (4,402 sq mi). Located at the east center of the state, the city is the center of the largest metropolitan area in the North region of Brazil.

By contrast, the Chicago metro area has about 6 million people. The State of Illinois has about 12.6 million. At it’s worst time in November-December, Illinois had a 7 day average death toll of about 170 per day.

In Manaus, around 80 confirmed covid-19 deaths were reported each day in May 2020—Manaus was the first Brazilian city to dig mass graves.

In the second wave in January 2021 that number exceeded 100. The new heights of despair in a city that suffered so much with the first wave came as a shock to residents and public health experts alike.

If Illinois had a similar death rate, we would have been digging 500-600 graves per day.

Covid-19: Is Manaus the final nail in the coffin for natural herd immunity? BMJ article published Feb 12 2021.

Many thought a second wave was impossible in Brazil’s Amazon because of the severity of the first. A second crisis has stunned the city of Manaus, reports Luke Taylor, and raises questions around a new variant and the likelihood of natural herd immunity

It has alarmed researchers across the world too. Many thought a second wave impossible because of the scale of the previous outbreak. “The academic community thought they were close to herd immunity,” says Diego Rosselli, an epidemiologist at Bogotá’s La Javeriana University. “Once again, we had it wrong.”

Many thought a second wave was impossible in Brazil’s Amazon because of the severity of the first. A second crisis has stunned the city of Manaus, reports Luke Taylor, and raises questions around a new variant and the likelihood of natural herd immunity

https://www.bmj.com/content/372/bmj.n394

The obvious question is if Dr. Makary had both articles available to him, especially the Lancet article he partially quoted, then why are we getting such a different view.

Once again, just like the vaccination figures which were exaggerated, the bad news on herd immunity from Brazil was omitted.

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