Yeah, first realised this when it became clear that all the "breakthrough infections" (with the 0.1% rate for fully vaxed) were actually "breakthrough hospitalizations" and that the US was not actually tracking the former consistently.
For the second point I guess it depends on the jurisdiction, there was a nice chart from the CDC in an Ars article indicating how you should still expect a relatively higher rate of vaccinated people in hospital when the vaccination rate is high (and also less people in hospital overall!).
"17 patients are in the emergency department of the hospital and seven of them are unvaccinated. There are seven in intensive care and three are unvaccinated. Five are on a ventilator and two of them are unvaccinated."
Those numbers are typical of the daily news: most of the hospitalized are usually vaccinated. You're going to have all kinds of followup questions like which vaccine did they get, what percentage of the population got which vaccine versus got hospitalized, etc. I'm just sharing this so you can see how you can't possibly gather all of those details quickly, especially when the situation is in flux.
Plus, given that this is peak tourism season for Iceland and a lot of folks here are from out of the country right now, you'd probably want a breakdown of what percentage are foreigners versus residents, and that's not available as far as I'm aware.
Even though half of hospitalisations are vaccinated people, it is important to consider that we are now 71% vaccinated (84% for people over 12 years old). This means you have roughly a 1:25000 chance of ending up in hospital if your vaccinated, versus a 1:3000 chance if you're unvaccinated.
In terms of infections the present wave is far worse than earlier waves, but our hospitals are handling it, and as a result we haven't needed as strict lockdown measures. I imagine most other countries will take the same approach, and as a result COVID will become a part of human society as a season flu.
If you aren't willing to get vaccinated, I suggest you get COVID as soon as possible, as prognosis gets worse with age and COVID isn't going away. More so, as someone who has had both COVID and a vaccine, I strongly suggest just getting vaccinated. One day of feeling glum is far better than a multi-week flu and months of lingering effects (sensory, physical and mental).
Your probabilities are confounded by asymptomatic cases, in both the vaccinated and unvaccinated populations.
In regularly tested populations, the number of asymptomatic cases can be quite high (50%). Unless they are tested and identified they will never be counted.
It seems perfectly reasonable to care more about symptomatic cases and a lot more about cases requiring hospitalization.
Sure, let’s do the research to learn more about the disease including asymptotic cases, but I’m going to be honest: if anyone in my family had an asymptotic case, I’d be happy about rather than upset at this point.
That CDC estimate is based on a simple probabilistic multiplier model from data up to Nov 2020 [0].
More recent meta-analyses [1] and large population-based serological studies [2] suggest a lower bound for the asymptomatic proportion to be at least ~33%. For young adults the upper bound for asymptomatic rate is likely between 65%-90% (95% CI) [2]. Considering other recent evidence that cases may be massively underreported [3], the true asymptomatic proportion could be even higher than what has been suggested.
Here is what the Kaiser Foundation says about the U.S.:
> Almost all (more than 9 in 10) COVID-19 cases, hospitalizations, and deaths have occurred among people who are unvaccinated or not yet fully vaccinated, in those states reporting breakthrough data (see Figure 2).
Also, what is the world is going on in that preprint[0]? I can not follow their conclusions in Table 1 model 1.
Looking at Table 1 - Model 1, it looks like the 40+, early vaccinated cohort has only a 15%-30% chance of being infected as compared to the 40+, late vaccinated cohort.
The paper itself says they did some adjustments for co-morbidities, but has no description of what they did. So it looks like the paper's conclusion is directly the opposite of what's being shown in the Table 1 - Model 1.
Plenty of things are left out, indeed. to add to the list of missing, important numbers:
> so if you are vaccinated you can get infected
Yes, you _can_, but at what rate compared to unvaccinated people? It's not the same, real-world data shows that.
> What's the mix of vaccinated and unvaccinated people in the hospital
This number is meaningless without also knowing what percentage of the people are vaccinated. Compare:
"80% of the people in hospital have $foo, and 80% of the general population has $foo" - $foo has no bearing at all on hospitalisation.
"80% of the people in hospital have $spon, and 5% of the general population has $spon" - $spon is clearly linked to the majority of hospitalisations.
"45% of the people in hospital have $bar, and 5% of the general population has $bar" - $bar is linked to higher rates of hospitalisation, _despite_ not being the majority of hospitalisations.
Spoiler: for some age groups in the UK now, "being unvaccinated" is much like $bar.
Headlines about e.g. the Provincetown outbreak that say "most people hospitalised here are vaccinated" without further clarification, are somewhere from meaningless to misleading.
> Yes, you _can_, but at what rate compared to unvaccinated people? It's not the same, real-world data shows that.
The phase 3 trial endpoints were symptomatic infection not asymptomatic infection. The small samples in those studies showed effectively zero efficacy against asymptomatic infection. While the breakthrough cases are largely blaming delta variant being vaccine evading, the real world results dont appear out of line with the mid 2020 clinical trials.
Of the group receiving an initial half-dose of COVID-19 vaccine, 7 of 1,120 (0.6%) participants in the vaccine group and 17 of 1,127 participants (1.5%) in the control group had asymptomatic infections, equating to a vaccine effectiveness against asymptomatic spread of 59%. In those who received two standard doses, 22 of 2,168 participants (1%) in the vaccine group and 23 of 2,223 in the control group (1%) had asymptomatic infection, indicating a 4% vaccine effectiveness against asymptomatic spread.
> This number is meaningless without also knowing what percentage of the people are vaccinated.
I dont get why this is not constantly reported? For the last year 'vaccine efficacy' has been talked about constantly - here we can have a real world, real time calculated vaccine efficacy, stratified by age, race, weight, height, favourite color, with out the excuse of, 'its a tiny rushed clinical trial' and nobody seemingly wants to know.
If vaccinated and unvaccinated are hospitalised are hospitalised with infections at similar rates (like is happening in the UK) then it'd prove that current vaccines are indeed ineffective long-term, as they already fail to stop the delta variant.
Not necessarily; as a previous poster commented, it does depend on the ratio of vaccinated against unvaccinated as well.
If a population has 1000 vaccinated people and 100 unvaccinated, and ten of each end up in the hospital, it looks like the odds of ending up in the hospital are equal, since there's ten of each. However, in the vaccinated group it is only one out of every 100 that ends up in the hospital, while in the unvaccinated group it's one out of every 10.
This is why I was complaining about overview numbers being unavailable; typically you hear only one set of numbers but not the context that would let you interpret those.
Note that per capita it's much lower among fully vaccinated people.
Around 6:20 you can see the stark difference in hospitalisations and deaths between the (mostly unvaccinated) UK 2nd wave, and the (largely vaccinated) 3rd wave.
One paper I’ve seen in rural California reports numbers split between vaxed and unvaccinated. Those numbers suggest the unvaccinated are infected at a rate ~ 100x the vaccinated.
Additionally, most days I’ve seen suggests that vaccinated parties are still less likely to end up in the hospital.
I am assuming the reports you have mentioned are hospitalisaions thus ... are hospitalised at a rate ~100x
The proportion of asymptomatic infections among the included studies ranged from 1.4% to 78.3%. [1] So hard to draw too many conclusions from hospitalisation rates as to the infection rate (and virus carrier / transmitter)
>Hospital beds are filling up again. What's the mix of vaccinated and unvaccinated people in the hospital?
An even better question is, how many are obese or have similar detrimental self-inflicted health conditions? All the data up to this point shows that obesity is more highly correlated with severe illness than vaccination status.