Recent variants are significantly more transmissible and able to evade immune protection from current vaccines
If you're confident enough that the surge in UK hospitalizations from BA.5 won't be on our doorsteps in Canada/US in a few weeks, I want to ask what this is based on. Every single wave [in North America] was previewed ~ 6 wks before in UK. (See linked graph)
―Abdu Sharkawy M.D., July 2022
New Covid subvariants BA.4 and BA.5 are the most contagious yet – and driving Australia’s third Omicron wave. BA.4 and BA.5 are more infectious than previous Covid variants and subvariants, and are better able to evade immunity from vaccines and previous infections. So we’re likely to see a rise in case numbers.
The coronavirus subvariant known as BA.5 accounted for nearly 54% of [U.S.] Covid cases as of Saturday [July 2nd], according to the Centers for Disease Control and Prevention. A similar subvariant, BA.4, makes up 17% more. "They're taking over, so clearly they're more contagious than earlier variants of omicron," said David Montefiori, a professor at the Human Vaccine Institute at Duke University Medical Center.
The two subvariants also appear to evade protection from vaccines and previous infections more easily than most of their predecessors.
Montefiori estimated that BA.4 and BA.5 are about three times less sensitive to neutralizing antibodies from existing Covid vaccines than the original version of the omicron variant, BA.1. Other research suggests that BA.4 and BA.5 are four times more resistant to antibodies from vaccines than BA.2, which replaced the omicron variant as the U.S.'s dominant version of the coronavirus in April.
COVID spreads through droplets of varying size, including microdroplets that can remain in the air for hours. Transmission from asymptomatic people is very common.
When people with the COVID-19 infection breathe out, clear their throats, cough, sneeze, speak, or otherwise move air out through their nose or mouth, droplets of all different sizes, which can contain the virus, are ejected into the air. A substantial portion of people infected with SARS-CoV-2 - around 40 percent - wouldn't even know they are ejecting virus-laden droplets, as they may not exhibit symptoms. Droplets suspended in the air are called an aerosol. Droplets that are large can remain in the air for seconds to minutes before falling to the ground. Smaller droplets stay in the air longer – minutes to even hours.
―New Jersey COVID-19 Information Hub, September 2020
This means that it is not sufficient for attendees to rely only on isolating if they get symptoms.
A now-famous report from Imperial College London published on December 22 found that COVID-19 patients infected with Omicron had a 20 to 25 percent reduced risk of hospitalization compared to those with Delta, and a 40 to 45 percent reduced risk of a hospital stay that lasted one or more days—which the researchers used as an indicator of severe cases. That discovery helped fuel a narrative, popular in the media, that Omicron is mild. But Omicron was first detected in South Africa, a country with a relatively young population of people who are largely either vaccinated, already recovered from COVID-19, or both. That made it hard, experts tell The Scientist, to tell whether Omicron’s severity was really a step back from Delta’s, or if, instead, any new variant emerging this late into the pandemic would seem less severe due to the acquired immunity and clinical knowledge that’s built up over time.
―How Mild Is Omicron Really?. The Scientist. Dan Robitzski, January 2022
The researchers [from the LKS Faculty of Medicine at The University of Hong Kong] found that Omicron SARS-CoV-2 infects and multiplies 70 times faster than the Delta variant and original SARS-CoV-2 in human bronchus, which may explain why Omicron may transmit faster between humans than previous variants.
The newer subvariants [BA.4 and BA.5] can also bypass monoclonal antibody treatments, which use lab-made immune system proteins developed from earlier strains of SARS-CoV-2. “Most of those antibodies that have been made are now obsolete,” Bieniasz says. Only one such treatment made by Eli Lilly, specifically designed to work against Omicron, is now effective and in use.
―What to Know About the Newest, Most Contagious Omicron Subvariants. TIME, June 2022
A note on Covid: July 6, 2021, when vaccines were less prevalent, the US was averaging about 14,000 new infection per day. One year later, we’re at 114,000. One year ago, we were averaging 260 covid deaths per day; now we are closing in on 400 per day [in the US]!
I can warn you based on our patients. BA.5 may be the most dangerous strain yet or the reinfections are becoming more severe. But young people are getting pretty f*cked up from it.
—Alex Meshkin, G.E.D., July 2022
Finally, there is the “dose-response” effect of multiple reinfections. By that I mean with additional episodes of Covid, for every outcome there was a stepwise increased risk, both relative (left panel) and absolute (right panel).  Obviously these findings are worrisome since reinfection was quite rare before the Omicron wave hit, at 1% or less through the Delta variant wave. But now reinfections have become much more common. Why? The Omicron BA.2, BA.2.12.1, BA.4, and BA.5 have progressively increased immune escape and there is limited cross-immunity with BA.1, the Omicron version that about half of Americans got infected with early in 2022.
―A reinfection red flag — Why a new report is so troubling. Eric Topol, June 2022
Some people are especially vulnerable to the effects of COVID. This includes not only attendees, but their families after they return home. Attendees should not be put in the position of having to accept a higher risk of serious adverse outcomes for them and their families that could have been avoided if stronger protections were in place.
All people with serious underlying chronic medical conditions like chronic lung disease, a serious heart condition, or a weakened immune system seem to be more likely to get severely ill from COVID-19. Adults with disabilities are three times more likely than adults without disabilities to have heart disease, diabetes, cancer, or a stroke.
―CDC COVID-19 Information and Resources — People with Disabilities
―CDC COVID-19 Information and Resources — People with Certain Medical Conditions
It doesn't require a doctorate to understand the Biden administration is downplaying the short and long-term risks of COVID due to economic and political considerations. In fact, having a doctorate and certain career ambitions might be an impediment to understand that. I have sat in meetings where people who work for state and local health departments have explained that they wanted to implement mask mandates but were overruled by mayors or governors in overwhelmingly liberal jurisdictions.
―Justin Feldman (Health and Human Rights Fellow at Harvard), July 2022
Even the inadequate and politically watered-down CDC guidelines currently recommend indoor masking for Las Vegas:
―CDC COVID Data Tracker, Integrated County View, July 7, 2022
- Masks are required indoors and when unable to socially distance outdoors
- Full vaccination is required for all event participants and on-site vendors; you will receive an email several weeks before the conference with instructions on how to securely provide your documentation for advance verification.
- Testing will be required as well, at-home or PCR; depending on what the pandemic looks like closer to August. We are operating on the side of being as cautious as possible so that our attendees will be as safe and comfortable as possible.
Is testing accepted in lieu of vaccines?
No. Testing is required in addition to proof of fully vaccinated status. SafeAccess will accept either LFT/OTC tests, or PCR tests, from ~24h pre-conference, as proof of vaccination. In the US, all at-home/OTC LFT tests currently authorized by the US FDA are acceptable.
―RustConf 2022 FAQ — COVID-19 policies
Masks and Vaccination will be required at DEF CON 29 this year, thanks to the complications of COVID-19.
While the virtual portion will largely be the same as DEF CON Safe Mode, in-person DEF CON 29 will be guided by safety and number of attendees.
Vaccination and wearing a mask while in the DEF CON space will be required. No exceptions. Persons who are not vaccinated, including unvaccinated children, will not be admitted.
[...] There are still new variants on the move. There are still spikes in transmission and hospitalization. Masks are still the most effective way to protect people in indoor events. Barring a major change in the situation, we will not check proof of vaccination, but we will keep last year's mask requirement in place for DEF CON 30. Protecting the community is our first priority, and we want to make sure that everyone is as safe as we can make them. Everyone includes the healthy, the vulnerable and those who have immune compromised loved ones they need to protect.
―COVID Updates for DEF CON 30, May 2022
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The stated reason for removing the vaccination requirement for DEF CON 30 relative to DEF CON 29, is that "The US has largely stopped checking vaccine status for entry to indoor events, owing at least partly to the knowledge that the vaccines serve more to prevent severe disease than to curtail transmission." Actually, the evidence on whether vaccination directly impacts transmissibility is mixed, with some studies performed while the Alpha and Delta variants were dominant showing that there is some direct reduction in transmission after vaccination but that it wanes quickly. However, a more recent study of Dutch households did show a lasting direct reduction in transmission from vaccinated people infected with either Delta or Omicron:
We found an increased transmission for unvaccinated individuals, and a reduced transmission for booster-vaccinated individuals, compared to fully vaccinated individuals.
―SARS-CoV-2 Omicron VOC Transmission in Danish Households, December 2021
In fact, unvaccinated people with COVID were almost twice as infectious as vaccinated-and-boosted people with COVID in that study (see Table 2). It is also definitely the case that vaccination impacts transmission indirectly because vaccinated people are less likely to contract the virus.
#egos2022 conference kit includes Lego pieces, face mask, rapid tests and instructions to test, wear, and being safe
The HACS workshop was held in Amsterdam April 2022 over two days, indoors, with over 100 attendees from around the world. Masks (surgical or better) were required when not eating or drinking, and provided (N95s and others). Rapid antigen tests were provided, administered and verified each morning by organizers in a dedicated space before entering the workshop areas. Vaccination was verified before arrival to the conference. The workshop spaces were well spaced and decently ventilated, although we could not obtain specific metrics on HVAC ventilation grades or number of air changes over time. HACS reported one attendee that tested positive 2 days after the workshop.
I have been deeply concerned that the policy of optional masking at Zcon will not be adequate and will result in significant transmission at the event. I'm clinically vulnerable, and each time I catch COVID poses a substantial risk to my long-term health. Given the number of attendees, many others are likely to be similarly vulnerable. The transmissibility of newer variants (BA.4, BA.5, BA.2.75) is hugely increased over previous variants. Please require masks, and preferably also LFTs. (I personally have been taking an LFT every time I go out, to protect others. It's just routine and not onerous.)
I would like to quote the strong words of Dr. David Berger, a General Practitioner who has been an outspoken critic of failed public health policies and debunker of myths about COVID:
We are now infecting ourselves, and more critically, our children, repeatedly, with this virus that is rapidly mutating and changing its form, with no firm knowledge of the long-term consequences —which we can't have because we haven't had it for the long term— and if you looked simply in a risk management framework, that's insane. The risk that we're exposing ourselves to, is insane. And when we're doing it to the children we'd better watch out, because it's the children of today who write the history books of tomorrow, and they might be pretty pissed off with us. [...] Personally I just feel really at sea. Because so much of what I thought... I mean I've always been fairly circumspective, and a bit cynical maybe, but realistic. But now it just seems that anything's possible, and that we can convince ourselves of the craziest things. That humans should be farmed like battery chickens, rather than that we should, as doctors, take account of the humanity of all of us. And in talking about this I think particularly of anybody with a clinical vulnerability, anybody with diabetes, who is immunosuppressed on monoclonal antibodies or treatment for rheumatoid arthritis, or who's on steroids, or who has any other intercurrent morbidity, any other underlying illness. What we're effectively saying is "Well, you know, we've done our bit. We've protected you for two years, but it's just too much hassle now. We'll get on with it. The young and the fit, the vaccinated young and fit will probably be okay. Losses in that group, injury in that group will be acceptable. Rest of you, you know, do what you like and survive as you can." That's a pretty harsh position that we've adopted, really without a thought, and that everyone's taken on. It's old-style early 20th century eugenics. It's ableism. It says, those other people —the more frail people, the more vulnerable people, the people who do not fit to a certain ideal of physical perfection— tough luck.
This finally gets some way toward a doctor expressing solidarity with the anger in the disability rights community about the public health failures that have left us out in the cold. It's not hyperbole at all, as statistics about deaths and Long COVID among disabled and clinically vulnerable people show. By addressing the practical issues raised, Zcon3 will also be on the right side of history.
Conferences inherently create environments that facilitate the spread of disease, by bringing many people together from various parts of the world, most of whom will have been in recent close proximity to large numbers of people due to air travel. Given the infectiousness and immune-evasion capabilities of the new COVID-19 variants, it is a statistical certainty that there will be COVID-positive attendees at ZCon3. At this level of increased background risk, it is necessary to put into place measures to mitigate this risk. While no individual mitigation can eliminate risk, straightforward and noninvasive interventions like required masking and rapid testing as conditions for attendance help protect each of us both from the short-term discomfort (or worse) associated with an active infection, and the substantial long-term risks presented by COVID. Nobody wants to get sick at a conference, and nobody wants to suffer long-term cognitive (or other) harm. Please institute policies for ZCon3 that will protect attendees' health.
I am medically vulerable to death or disability from COVID. I have been given early COVID vaccinations because of my risk level. If I catch COVID, I will likely experience severe, disabling pain for multiple days. The 2022 flu season is also significantly worse than earlier years, so I have also been given a flu booster. I appreciate the work that the Foundation has already put into COVID safety at Zcon 3. But I will be much safer if we all protect each other with masks, rapid tests, and isolating sick people.
Although I’ve been really careful the last 2 years and followed the recommendations on how to avoid being at risk or “a risk” to others the best I could, I’ve been exposed to COVID and had to be in isolation many times until I got a negative test result and the isolation days had passed. I took a lot of precautions, but I’ve had favorable odds as well. I’ve learned we only know for sure that we do have COVID after testing positive with a PCR. The opposite it is not true. It’s not possible to be sure one is free of COVID. No matter how many times one tests “not detectable”. There are no “negative” test results. Anyone can test “not detectable” and experience symptoms a few moments after. We are gathering together after a long time. We are going to meet in person! Some will reencounter, others will meet each other for the first time. We will all share spaces, conversations, meals, drinks and, of course, memories. My main arguments for requiring masks at Zcon3 are inclusion, empathy, solidarity and privacy. I’m empathetic with those who have to be extra careful for themselves or their loved ones. The way of expressing that and have solidarity towards them is to wear my face mask responsibly. I wouldn't want anyone be left out because we can’t all make the small effort of wearing a face mask. Masks will also preserve our privacy. Since everyone will be wearing them, we won’t know if someone has to take extra precautions unless they disclose that themselves. Let’s be our very own masked anonymity set! We are coming to Zcon3 from almost every corner of the globe. We plan to have a great time and go back home to our loved ones. Let’s make sure we stick to that plan. Let's spread our knowledge and passion for Zcash, not COVID.
I would happily adhere to a mask requirement at the event, considering it's a large gathering of people from around the world at a populous tourist destination, because the event should be as inclusive as possible toward people who have health concerns and are worried about catching COVID. (I don't have a strong opinion about the other proposed policy changes in this document.)
I'm in favor of all the proposals below.
[Please add your statement here.]
Masks are very effective at reducing the risk of transmission, especially non-valved N95/FFP2 or N99/FFP3 masks. They are most effective when both an infected person and a potential infectee are wearing them.
Prior to the coronavirus disease 2019 (COVID-19) pandemic, the efficacy of community mask wearing to reduce the spread of respiratory infections was controversial because there were no solid relevant data to support their use. During the pandemic, the scientific evidence has increased. Compelling data now demonstrate that community mask wearing is an effective nonpharmacologic intervention to reduce the spread of this infection, especially as source control to prevent spread from infected persons, but also as protection to reduce wearers’ exposure to infection.
―What Are the Differences between FFP3, N95, And Surgical Masks? October 2021.
That is, although a vulnerable person can protect themself to some extent by wearing a mask, they are still at significant risk when breathing air near to an unmasked person who has COVID. We cannot know in advance who is infected; and so only universal mask wearing by all attendees of the conference can reliably reduce the risks for everyone.
Rapid antigen/lateral flow tests are highly effective in detecting transmissible COVID:
Professor Michael Mina (Harvard School of Public Health) said: "There is a spectrum of infectious amounts of the Covid-19 virus and we show that LFTs are likely to detect cases 90-95% of the time when people are at their most infectious. The tests could achieve even 100% sensitivity [if used correctly] when viral loads are at their peak and therefore catch nearly everyone who is currently a serious risk to public health."
Note that "rapid antigen test" and "lateral flow test" in practice refer to the same tests, as far as publically available tests from reputable sources are concerned. (Technically, the names refer to different aspects of how these tests work.)
PCR tests should not be required because they may show positive for a substantial period after recovering from COVID, when the person is no longer infectious:
After 10 days from symptom onset or a positive test result, the likelihood of infectiousness is low in individuals who are not immunocompromised. Fragments of inactive virus may however be detected by PCR in respiratory tract samples following infection for prolonged periods (frequently up to 90 days, sometimes beyond) when the individual is no longer infectious.
On the other hand, there is no reason not to accept a negative PCR test.
Antibody tests are the wrong kind of tests to use, because they detect whether you have ever had COVID, not whether or not you are currently infectious.
A stock of LFTs should be provided on site for people who find it difficult to source them due to shortages (although it is preferable to test before travelling as well as before the main conference).
The Palms has excellent air filtration, because Las Vegas casinos allow smoking inside. But it is still possible to catch COVID from someone seated nearby, particularly if they aren't wearing a mask.
Ideally, events should be outside, or inside with a high rate of fresh and filtered air exchange.
Meals are high-risk super-spreader events, because people remove masks, sit across from each other, and talk.
To lower the risk, meals and drinks should be held in a well-ventilated space, with well-spaced seating. The safest option is outside meals, with a 6 foot (2 metre) distance between people.
Some of us are considering skipping indoor group meals to reduce our risk.
Attendees should have completed the course of vaccinations and booster(s) recommended in their country of origin. For example, one option is to use the same requirements that were previously in place for travel into the US. That would include waiving the vaccination requirement for people who have a written medical exemption. (The argument here is that people with such an exemption are likely to be especially careful about COVID precautions, that they will be in a small minority of attendees, and that they are most in need of the requirement for others to be vaccinated.)
For the protection of other attendees, anyone who experiences COVID symptoms or has a positive test should stay in their rooms, or outside if there is a safe place to go away from others. People experiencing symptoms should take another LFT even if they have already tested negative.
It is reasonable for people who have already paid the conference fee and now find that they no longer wish to go, to be refunded this fee.
- Daira Hopwood
- Francisco 'Pacu' Gindre
- Taylor Hornby (+1 for masking & testing, +0 for a vaccine requirement)
- Sean Bowe (specifically in favor of a mask requirement)
- Teor
- Marek
- Deirdre Connolly
- Chelsea Komlo
- Conrado Gouvea
- Carter Jernigan (+1 for masking & testing, +0 for a vaccine requirement)
- Kris Nuttycombe (+1 for masking & testing, +0 for a vaccine requirement)
- Winfred K. Mandela (In favour of whatever it takes for attendees to feel comfortable)
- Ian Sagstetter (+1 for testing, +0 for a vaccine requirement)