11 April 2021 Blog Post: “Decoupling” COVID-19 Mortality from Cases

While there are known differences in overall efficacy of the three major COVID-19 vaccine available on the US market, Pfizer, Moderna, and Johnson & Johnson, on one metric they all perform flawlessly – they all prevent COVID-19 mortality at 100% efficacy.

As we watch Michigan struggle with rising case loads (currently 9 of the top 10 affected metropolitan areas are in Michigan, source:  https://www.nytimes.com/interactive/2020/04/23/upshot/five-ways-to-monitor-coronavirus-outbreak-us.html), it logically leads to concerns about the same potential uptick in cases occurring here in Los Angeles. One interesting difference between Michigan and our region is that, until now, Michigan did not suffer a mid-summer surge in the same way that we did here. This, I suspect, leaves a sizable susceptible population. The vaccine rollout in Michigan is equivalent to that here in California with 76% of accolocated vaccine having been distributed in both state (California ranking 30th and Michigan 31st).

Here in Los Angeles County new COVID-19 cases have continued to decline, now for the 12th week in a row and stand at 3.8 new daily cases per 100,000.  There is some plateauing to this decline, however, with its initial steep decline slowing in late February.

However, death rates have continued to plummet and are now at 0.08 new daily deaths per 100,000 population down from a high of 2.66 in mid January. The shape of this curve has turned even more sharply downwards over the last month (Figure 1 below).


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The decoupling of case and mortality rates most certainly represents a vaccine effect for two reasons. Firstly, with 100% efficacy against death, a vaccine effect in the population will first show among the outcome against which it provides greatest protection (similarly, hospitalizations should also show such a pattern). Secondly, we have targeted initial vaccination efforts among those at highest risk – particularly the elderly who have shown the highest COVID-19 mortality rates. It is for this reason that we see an amplified effect of vaccination.

At this point it seems that we continue to head the right direction as a County and can look towards additional reopening measures.

𝗦𝗶𝗴𝗻 𝗨𝗽 𝗳𝗼𝗿 𝗢𝘂𝗿 𝗡𝗲𝘄𝘀𝗹𝗲𝘁𝘁𝗲𝗿

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