Vaccination is highly protective against Covid-19

As in Europe, the US is currently experiencing a surge in Covid-19 cases and hospitalizations driven by transmission among the unvaccinated.  Two days ago, health officials in Vermont noted that 90% of Covid cases in Intensive Care Units are unvaccinated. Currently 74% of the Vermont population is fully vaccinated. This information allows us to do a simple calculation using only high school algebra to estimate the difference in risk of severe Covid infection among vaccinated compared to unvaccinated.

Let us say the infection rate among the unvaccinated is I and the relative risk of severe infection in vaccinated versus unvaccinated is R. So the infection rate among the vaccinated is R*I.

Let us assume a population of 100 in which 74 are vaccinated and 26 are unvaccinated. Then the number of severe infections requiring admission to ICU is 26*I unvaccinated and  74*R*I vaccinated. So the proportion of ICU cases who are unvaccinated is 26*I /( 26* I + 74 *R*I), and we know that this ratio is 0.9. So we can write:

                26*I / ( 26* I + 74 *R*I)  = 0.9    

Solving this equation for R:

                                        26* I       =  0.9 * (26*I + 74 *R*I)  

or                                         26      =  23.4  +  66.6*R

so                                      R       =   (26-23.4)/66.6    = 0.039

Thus the vaccinated have a risk of severe Covid infection that is 3.9% of that for the unvaccinated.  Inverting this, we can say that the unvaccinated have 1/0.039  = 25.6 times the risk of severe infection as the vaccinated.  The actual risk will vary somewhat in populations with the mix of Covid variants and the overall time since vaccination, but the figures from Vermont graphically illustrate the huge protection that full vaccination provides.  And the evidence is that this protection is definitely enhanced by getting a third booster shot.

A previous post I made on the importance of boosters attracted a couple of anti-vax comments claiming ^ that I was admitting the vaccine did not prevent Covid. I hope the simple analysis above of readily accessible data is adequate to clarify to anyone who thinks like this that the vaccine offers a huge level of risk reduction. And if you were vaccinated more than five or six months ago, get a booster! It improves the level of protection further.

Global, regional and country-level trends in religiosity and atheism: an update

In two earlier posts (here and here), I examined global, regional and country-level trends in religious belief and practice, and the prevalence of atheism. The analysis was based on data from the  World Values Survey (WVS) and the European Values Study (EVS), covering the period 1981 to 2020. Earlier this year, I discovered that the World Values Survey dataset has been updated. Some data collected using a mobile phone app in the most recent US survey was incorrectly coded and this mainly affected the religiosity categories.  Comparison of the US prevalences for religiosity show that the coding errors resulted in an overestimate of the atheist and non-religious categories as shown in the following table:

Comparison of religiosity prevalence estimates
 for USA in year 2020

I have now updated the previous analyses using the 2021 release of the combined data for the WVS and EVS in the Integrated Values Surveys (IVS) 1981-2021 [1-3]. In carrying out these updates, I also addressed some definitional issues which have resulted in mostly slight changes to estimates for other countries. The details of the updated analysis are described elsewhere.

The four religiosity categories have now defined as:

Practicing religious person: A religious person who believes in God* and is practicing**, OR a non-religious person who believes in God, is practicing, and rates the importance of God in the top 5 points of a 10 points scale.

Non-practicing religious person: A religious person who believes in God and is non-practicing OR a non-religious person who believes in God, is non-practicing, and rates the importance of God in the top 6 points.

Non-religious: A non-religious person who believes in God but rates the importance of God as any of three points at the not important end of a 10-point scale.

Atheist: A “confirmed atheist” and/or does not believe in God

* I have assigned all people who do not believe in God to the atheist category. This will include some religious people who practice non-theist religions such as Buddhism. This differs from the previous definition.

** Respondents are classified as “practicing” if they attend religious services or pray to God outside of religious  services at least once a month. Otherwise, they are classified as non-practicing.

For the 110 countries with IVS survey data for years 2000 or later, the prevalences of the four religiosity categories across survey waves were projected forward to 2020. The following plot shows the estimated prevalence of all religiosity categories in 2020 for countries ranked in descending level of irreligion (atheist + non-religious).

There are 18 countries where more than half the population are estimated to be atheist in 2020. These include China,  South Korea, Japan, Vietnam and Thailand, all Asian countries with Buddhist and non-theist religious traditions. They also include all the Scandinavian countries and European countries such as France, the Netherlands and the United Kingdom, as well as Australia and New Zealand.     At the other end are six countries where the prevalence of irreligion is estimated at less than 1% of the population.

Full time series of religiosity trends from 1980 to 2020 were imputed for the 110 countries using the same methods as before. The updated trends are generally similar to those previously posted (see here), except for the USA. The revised data for the USA shows that the prevalence of atheism has increased rapidly in the 21st century from around 6% to almost 23% in 2020 and the prevalence of non-religious has also increased from 2.2% to 6.9%.

The prevalence of irreligion (atheists and non-religious) has increased in the USA by an estimated 21.5 percentage points over the last two decades, the fourth largest increase of any country included in this analysis. The largest increase occurred in neighboring Canada with a 36.7% increase since year 2000.  Apart from two Asian countries (South Korea and Singapore) and Hong Kong, all the other countries in the top 20 for increase in irreligion since 2000 are high income countries. And apart from Chile, Australia and New Zealand, all of these are in Europe and North America.

I have also computed revised trends for the 11 culture zones used in previous posts (see here). The following plots show estimated religiosity trends for the world as a whole and for these 11 culture zones:

These plots illustrate the extreme diversity of religiosity trends across regions. Western countries (Reformed West, Old West, North America) are characterised by rapidly rising prevalence of atheism and corresponding decline in practicing religious. The former Eastern bloc countries (Returned West, Orthodox East) are characterised by a large drop in atheism prevalence and corresponding rise in religious categories following the collapse of the Soviet Union around 1991. More recently, atheism is rising and practicing religious falling in the Returned West, following a similar path to that taken by Western Europe.

The Orthodox East has had continuing decline in atheism and the non-practicing religious have become the dominant group at around 55% of the population, far more than the practicing religious. A 2018 Pew Research Center Report examined this more closely and found that for most people in the former Eastern bloc, being Christian (whether Catholic or Orthodox) is an important component of their national identity, with many people embracing religion in the post-Communist period as an element of national belonging, even though they are not highly religious.

Latin America, the Islamic East and Sub-Saharan Africa are the “religious” culture zones characterised by very high prevalences of practicing and non-practicing religious people and very low prevalences of non-religious and atheists. The Indic East also has very low prevalences of the irreligious, but in contrast to the other “religious” zones, has had a shift from practicing to non-practicing religious. This may very well be largely reflecting the increasing levels of Hindu nationalism in India. Iran and other Islamic countries generally report very low levels of atheism, 2.4% on average, and I suspect this is lower than reality because of the quite severe social and legal consequences in many Islamic countries. As discussed in a previous post, there is some evidence that irreligious respondents are fearful of being identified if they respond honestly to a telephone interview.

At global level, the prevalence of practicing religious has barely changed over the last 40 years, as has the prevalence of atheism, but there has been a shift from non-religious to atheist and to non-practicing religious, the latter reflecting mainly the change in former Soviet bloc countries. The relatively small changes in prevalence of religiosity at global level over the last 40 years conceal quite substantial changes in developed countries and in former Soviet countries, in opposing directions. The following table summarizes global changes in the prevalence of religiosity categories over the 40-year period 1980 to 2020.

The overall global prevalence of irreligion (atheist plus nonreligious) has declined somewhat, but a substantially higher proportion of the irreligious identify as atheist in 2020 compared to 1980. Is irreligion likely to increase in the future? If the economies of developing countries continue to grow, with decreasing levels of poverty, and education levels continue to improve, it is likely that religiosity in these countries will decline in the longer term. But if the pandemic and global heating crises derail the historical development trends, then population growth due to the higher fertility levels of Islamic and African countries will ensure that the overall religiosity of the world will increase in the future.  In an era of joint global environmental and pandemic crises, with rising populism and rejection of science and global institutions, it is entirely possible that the developing countries will not pass through the equivalent of the Western Reformation which resulted in freedom of thought and religion and decreasing levels of premodern religious values.

References

  1. EVS (2021): EVS Trend File 1981-2017. GESIS Data Archive, Cologne. ZA7503 Data file Version 2.0.0, https://doi.org/10.4232/1.13736
  2. EVS/WVS (2021). European Values Study and World Values Survey: Joint EVS/WVS 2017-2021 Dataset (Joint EVS/WVS). JD Systems Institute & WVSA. Dataset Version 1.1.0, doi:10.14281/18241.14.
  3. Haerpfer, C., Inglehart, R., Moreno, A., Welzel, C., Kizilova, K., Diez-Medrano J., M. Lagos, P. Norris, E. Ponarin & B. Puranen et al. (eds.). 2021. World Values Survey Time-Series (1981-2020) Cross-National Data-Set. Madrid, Spain  &  Vienna,  Austria:  JD  Systems  Institute  &  WVSA Secretariat. Data File Version 2.0.0, doi:10.14281/18241.15.

Booster shots and the current Covid-19 Delta wave

Switzerland is now offering a covid19 booster shot to to the 65+ and at-risk who has had their two covid19 vaccinations at least six months ago. It may soon be extended to all adults. I had my third shot last Thursday with no side effects (not even a localized sore spot) and was surprised to receive a Pfizer booster after being fully vaccinated earlier this year with the Moderna vaccine. The mRNA in both vaccines encode the same S-2P protein which differs from the covid19 spike protein by two amino acids only. These stabilize the spike protein so that it can train the immune system before it enters the host cell. I’ve been reading up on booster shots and will try to provide a brief summary below. If you want citations and more detail on the studies, see my professional blog here.

A large study of 1.14 million Israeli adults, aged 60 years and over who had received two Pfizer doses at least 5 months earlier, found that a third shot reduces the risk of infection by the dominant Delta variant by a factor of 11 compared to fully vaccinated people who have had two shots.  Receiving a different vaccine type as I did, further reduces the risk by around 30% or more. The booster shot lowers the risk of severe illness even more, by a factor of around 20 compared to those who have had two shots only.

Israel was the first country in the world to make available a third dose of the Pfizer vaccine to everyone aged 60 and over who had been vaccinated at least 5 months earlier. Since then, Israel has extended the booster program to the entire population. Booster doses per 100 people rose from zero at the end of July to over 40 per 100 currently.

Israel had a huge spike in infections this summer due to the combination of the highly infectious Delta strain, together with waning immunity in fully vaccinated people. Its clear from the following graph that the booster shots were definitely a game changer.  There was a very steep reduction in infections, hospitalizations and deaths among the people that got the booster shot. Israel went from over 11,000 new cases a day at the peak, down to a few dozen today. Before the booster campaign started hospitalizations were rising among vaccinated people whose immunity had waned, but the overwhelming majority of hospitalizations now are of people who are unvaccinated. During this period the fully vaccinated rate was fairly stable at a little above 60% of the population.

The same combination of waning immunity and Delta are now causing rising cases in Europe, as illiustrated in the following plot. Austria, Belgium and the Netherlands are currently the hardest hit (see graph below), with average daily new cases well over 1,000 per million, higher than any previous wave. In most of the countries on this graph, fully vaccinated rates are somewhere between 60 and 75%. That means around 25 to 40 percent of these populations are unvaccinated and their much higher susceptibility to infection is driving the latest surge in Delta infections.

Germany, Austria and the German-speaking region of Switzerland have the largest shares of unvaccinated populations in all of Western Europe. About one in four people over 12 is unvaccinated, compared with about one in 10 in France and Italy, and almost none in Portugal.

Governments are struggling to address this shortfall in vaccination levels. Austria has introduced a lockdown for anyone over the age of 12 who is not vaccinated and foreshadowed compulsory vaccination for all adults. Germany is considering new restrictions and in Saxony the unvaccinated are already barred from non-essential shops and other locations. The Netherlands has flagged that they will move to full lockdown for the unvaccinated but not the vaccinated. Switzerland has a referendum next weekend on whether to continue with the vaccine mandate which allows only fully vaccinated people to go to theatres, restaurants, gyms and other indoor public venues.

There were violent anti-lockdown protests in Netherlands a couple of days ago. Police in Rotterdam opened fire on the crowd and shot three protesters, after firing warning shots in the air. Can we continue to let such people cause wave after wave of infections, causing not only disabiliinty and preventable deaths in the vaccinated also, but limiting work, education and life opportunities for those doing the right thing and getting vaccinated?

Some commentators have raised the moral issue of whether it is just for people in countries like Switzerland to get booster shots, when the large majority of people in many developing countries still have no access to vaccination. Despite the best efforts of WHO to get the developed countries to provide funding for the purchase of vaccines for poor countries, there has been little response.

I totally support that initiative and would certainly vote for politicians who would make sure Switzerland steps up to help fund such efforts. However, if I did not accept a booster shot it is not going to get sent to a developing country so I see my duty to the community is to step up and have the booster to help end the current Delta wave in Europe. Perhaps there should be a popular initiative to force the Swiss government to provide more aid funding for vaccinations, rather than the one we will vote on next week, put up by anti-vax people to try to block action to safeguard us from further Covid waves and lockdowns.

A fourth Covid-19 wave hits Europe and Switzerland has a second referendum to end vaccine certificate requirements

Covid-19 cases rose by 7% and deaths by 10% over the last week in Europe, as it enters a fourth (or fifth) wave and currently accounts for about two-thirds of infections reported globally. Belgium and the Netherlands, which have fully vaccinated 73-74% of their populations, have the highest new case rates in Western Europe, almost double those of Britain. The fully vaccinated rate is Switzerland is 64%, higher than the USA at 57% but lower than Australia now at 69%.

I drove past the UN Palais de Nations yesterday, which had a crowd of around 2000 anti-vaccination protesters outside it, apparently concerned about loss of “freedom”.  The Netherlands has just reimposed a partial lockdown to address the rapidly rising case numbers and Switzerland won’t be far behind if the protestors have their way. I am way more concerned about the potential loss of freedom of association, ability to work and earn money, for students to attend schools and universities, ability to participate in social, sporting and cultural events etc etc than the freedom of a minority to be evidence-averse idiots who incubate the virus to continue to spread it and make life difficult for the vaccinated (who still have a small but non-zero risk of catching Covid from the unvaccinated in which it is spreading like wildfire).

Later this month, Switzerland will be holding its second referendum in less than six months on the Covid-19 law under which the government has made the Covid-19 certificate compulsory since September 13 to access indoor spaces (movie theatres, gyms, restaurants etc). This law was accepted by 60.2% of voters on June 13, and opinion polls indicate it will be accepted again. The Covid certificate has allowed the (intelligent) population to return to an almost normal social life. I’ve gone to the cinema, been training at the gym mask-free, and met up with friends for coffee, lunch or dinner.  All at risk if the anti-vax people get more support than before. The proposed revisions to the law also put other covid initiatives at risk. If passed, they would end government financial support for big events and end all government funding programs for the development of drugs or other important medical goods.

I find it impossible to understand or empathize with the anti-vax people who are prioritizing imaginary concerns in the complete absence of evidence over protecting the lives not only of themselves and those they love, but also others in the community. Millions of people have been vaccinated now, and we have a massive amount of data on side effects (rare and rarely severe or fatal) and the side effects of not being vaccinated (substantially higher risks of Covid-19 infection along with risk of long Covid or death). I can only think that it is one of the more appalling outcomes of the increasing partisanship and polarization in high income countries, in which large groups of the population have decided that those with differing political and social views no longer deserve to be considered human, and protection of their lives is of zero value. Fascism, concentration camps and the gulag lie just around that corner also.

While analogies are never perfect, and should not be over-interpreted, I can only think that the situation is analogous to one in which a substantial part of the drinking population decided that their hatred of more moderate drinkers and abstainers was such that they wanted to end drink-driving laws completely and be allowed to drive while drunk. The fact that they would be putting their fellow drinkers and families at risk did not offset the pleasure of seeing the “others” owned.

And any cognitive dissonance was ameliorated by their leaders and social media gurus who assured them that the evidence showing drink driving causes more car accidents is flawed and being pushed by a giant conspiracy involved the medical profession, public health professionals, scientists, news media and governments to take away their freedom to drive drunk.

Some mushrooms found in the woods of the Netherlands

I have just returned from a week in the Netherlands. I spent five days at a retreat in the woods of Lage Vuursche, situated south of Amsterdam not too far from Utrecht. Wandering in the woods, I came across some beautiful mushrooms and fungi. I had not brought a camera on this trip, but took these photos using my phone.

Shaggy ink caps (Coprinus comatus)
Fly agaric (Amanita muscaria)
Mature fly agaric (Amanita muscaria)
These shaggy ink caps look like they are melting. Ink caps autodigest their gills in order to release their spores. The mushroom liquifies itself, creating a black ink-like liquid that oozes out of the mushroom’s cap until eventually only a melting mass of black goo is left.
A Common Earthball (Scleroderma citrinum)
Young shaggy ink caps behind a couple of mature specimens
By the next day, the three young shaggy ink caps at the front will have grown taller and opened up like the one behind, which will have started to melt.

Competing at the SDFPF Powerlifting Championship 2021

Last weekend, I competed at the Swiss Drug Free Powerlifting Championship 2021, held in Basel on 25 September. This was my first national powerlifting competition since competing in the last SDFPF Championship in February 2019. The 2020 Championship was cancelled due to the Covid-19 pandemic.

During the pandemic I managed to lose around 10 kg bodyweight and competed this year in the 82.5 – 90 kg category at a body weight of 87.3 kg, almost 10 kg lighter than my weight of 96.5 kg in 2019. Despite my efforts to improve my squat and ensure that I squatted below parallel, I discovered by filming my squats in the week leading up to competition that I was only getting clearly below parallel around 50% of the time.

I opened my squat attempts conservatively at 90 kg, and succeeded in getting a below-parallel valid lift. However, I was disappointed to fail the next two attempts at 100 kg with inadequate depth.

For the other two lifts, I exceeded my anticipated results with a 100 kg bench press and 190 kg deadlift. These were both new Swiss records for the under 90 kg Master M6 age category (65-69 years), as was my powerlifting total of 380 kg. Below are short videos of the deadlift and bench press.

The powerlifting rules allow a fourth attempt to improve a record set at the third attempt, and I attempted a fourth deadlift at 197.5 kg. This did not get more than a few inches off the ground. But overall a 15 kg improvement on my 2019 deadlift, when I was 2 years younger and 9 kg heavier.

Powerlifting results can be compared across different bodyweight classes using Wilks or Schwartz/Malone weights and age can also be adjusted using McCulloch weights. I used Wilks and McCulloch to calculate the weights that would represent equivalent lifts to mine for a man in the age range 23-40 years with bodyweight 90 kg.  These are  144 kg for the squat, 160 kg benchpress and 304 kg deadlift, for a powerlifting total of 608 kg. This represents elite level for benchpress and deadlift, but far from it for the squat. The following graph shows trends over time for my powerlifting competition results, adjusted using Wilks/McCulloch weights to age 23-40 and bodyweight 90 kg. The bench press and deadlift show substantial improvement over time, the squat shows some modest improvement. If I continue to train for competition, squat depth will be a priority.

Afghanistan, the war on terror and the war on drugs

Watching scenes from Kabul airport recently felt like déjà vu for me. The Vietnam War ended in eerily similar scenes. I’ve been astonished to read more than one article that has described the events in Afghanistan as an unprecedented military defeat for the USA, or as a sign that the era of neoliberal intervention in foreign countries was over. If the USA did not learn anything from Vietnam, why would we assume it will this time when facts and evidence are even less valued than in the past. Several commentators have noted the intersection of the US war on terror and the war on drugs in Afghanistan. I have been engaged for nearly 20 years now in work to update global estimates of conflict deaths and global estimates of deaths attributable to drug use. I was curious to look a little more closely at relevant statistics.

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Conquest of the Wall of Death

Not far down the corridor from my office in WHO was a floor-to-ceiling bronze relief sculpture showing the struggle of Man against Death. It was a gift to WHO from the Vatican in 1966, and was located very appropriately, given that a major focus of my unit was to monitor trends and improvements in death rates and their causes.

The floor to ceiling sculpture occupies the wall of a corridor joining the two main office corridors on the 3rd floor of the WHO Headquarters in Geneva.It is approximately 5 metres wide and 3.5 metres tall.
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