All: don't miss that there are now multiple pages of comments in this thread. To get there, click 'More' at the bottom of the earlier pages. Or like this:
(Once we've rolled out some long-suffering performance improvements, all of this should blissfully disappear, including this sort of comment. Thanks for your patience.)
- two doses needed, 3 weeks apart, immunity after one month from first dose. Slow rollout.
- -80C storage and transport needed. Challenging, but doable in developed countries, but still may slow down mass rollout. Not feasible in many developing countries.
I still wonder about long-term immunity. Anyone can share any insight?
The latest data (preprint, not peer reviewed etc etc) mention memory B and T cells up to 8 months after recovery from the illness. This means that an immunity of one year is probably likely. This would be probably enough to quench the spread, but not to eradicate the virus.
I think we can eradicate it by contact tracing. With 90% efficiency it will be extremely tough for the virus to spread. For any new cases you simply test everyone in the vicinity of the infected person.
But I don't think even that will be necessary. 90% efficiency reduces R so much, it will probably die out on its own.
The real problem is mutations that are not covered by the vaccine. If it mutates as efficiently as flu, it will be a challenge.
Contract tracing hasn't worked at scale anywhere. It's a nice idea conceptually, but the problem is psychological. People stop caring about tracing when 98% of all trace connections are false positives. If a person is infectious for a week and the r0 is around 1 then only 1 person of all the people they've been in contact with will actually contract the virus on average. The other 50+ people, assuming they can even be traced, get a false positive. Or to put it differently, people have to be called 50 times and get tested and self-isolate 50 times before they actually test positive. And for younger people 80% of cases are completely inconsequential. You might think 50 contacts is unrealistically high, but most people still go to work, to school, see friends, use public transportation, etc.
Covid19 would also be over if people with symptoms would just stay home. But that's clearly not happening either. We've got to be realistic about how people behave in the real world.
Mutations aren't a serious concern. Because when viruses mutate it's the strains that are more infectious and less lethal that win out.
There's also participation on the contact side. In Western countries, surveys indicate we can't convince even half of people to install a contact tracing smartphone app. According to my state's department of health, practical experience indicates we can't convince even half of people to pick up the phone and respond to a contact tracing interview.
> Covid19 would also be over if people with symptoms would just stay home.
No it wouldn't. One of the things that makes SARS-CoV-2 such a problem is that people get contagious long before they show symptoms. Similarly to for influenza and the common cold, many people get contagious without ever developing symptoms.
> According to my state's department of health, practical experience indicates we can't convince even half of people to pick up the phone and respond to a contact tracing interview.
More than anything I suspect this is a result of allowing so much unfiltered spam calls. If you only get one unexpected, unknown call a month you will almost always answer it. If you get three a day you will almost never answer it.
We are allowing private businesses and scammers to steal the “commons” of our societal attention. We are doing a very poor job of keeping useful communications channels open: almost every communication medium people rely on for important information gets cluttered with must-ignore spam, making it decreasingly likely an important message is actually received.
I got an automated message from my local states's department of health services. It simply said they're "trying to contact me and the interview will only take 5 minutes." However, having not scheduled any interviews with the government I had no idea what they were talking about, so I chalked it up to spam or polling attempts and ignored several similar calls.
I'm now wondering if it was an attempt at contact tracing. Had they simply stated what they wanted in the message I would have been pretty likely to call them back myself or answer a later call.
I have no idea where they got my cell phone number from, but the whole thing seems poorly handled at best. Anyone with legitimate business will state the nature of that business and allow for a return call. There's just so many solutions to this problem but nearly zero aligned with incentives.
It simply said they're "trying to contact me and the interview will only take 5 minutes."
Yep. That was probably about COVID. Health privacy laws prohibit even the vague mention of a condition. The caller has no way of knowing if they have the right phone number, and the last thing you want is "Attention, Rando McUltrarunner at 42 Crustacean Crest Drive, Cleveland, Ohio! You have been infected with COVID! Run, don't walk to your nearest testing facility!" on some stranger's voicemail. Or worse, "We are following up to see if you're doing well after your abortion" ending up on the voicemail or texting app of a 15-year-old girl whose parents might have access to her phone.
Source: Recently completed my company's mandatory annual HIPAA training.
Sadly, it breaks down. You ask someone if they are who they are, and that's about all you can do. Someone can lie. Has it ever happened? Probably, but I've never heard of it, and my legal department is pretty good about keeping up on these things. But the way the law is written, asking the question absolves the caller of legal liability.
It's not IT-grade authentication, but for wetware it works.
Privacy regulations (HIPAA) may forbid them from saying "Hey we think you might have COVID" on your voicemail, unless you've already filled out paperwork saying "It's okay to leave a message on my voicemail with detailed health information."
Your doctor's office can do it because you probably have an existing patient relationship, and you already filled out that paperwork on your first visit.
But in the situation of a cold-calling contact tracer, you haven't signed anything at all, so all they can say is "This is the health department and we want to talk to you."
I have seen some companies that call have pre-loaded Caller ID. Why don’t Apple or Google provide a service that guarantees that the Contact tracing service always calls with a Caller ID, and Apple/Google could even mark it as verified. I think many businesses would pay for this service as it saves money on having to contact existing customers and reduces fraud.
One thing that comes to mind, if a call comes in accompanied by screen message of a kind that I have never seen before I'd be twice as alarmed as with just some random unknown number calling. I might end up googling recently updated apps for news of a malware takeover instead of answering the call.
But it would be a good idea nonetheless, it only requires to be accompanied by a serious information campaign preparing first time receivers for the surprise.
Semi related, but some services (trapcall, for one) offer a very cheap service that punches through called ID spoofing via AMI, and offer blocking on public and private lists, really help.
I imagine contact tracers would at least leave a voicemail? I always let numbers I don't recognize and aren't local (my cell phone number is out-of-state and spam calls usually originiate from that area code, not my current local) go to voicemail since I assume if they're important, they'll leave a voicemail.
It's funny how you remain completely unaware of the merits of your country's set of laws unless you hear from how things are elsewhere. We do have spam calls, but they are rare enough that people bonding over spam call infuriation might reference one that happened a year earlier.
yeah it's a total shitshow in the United States; I get 20-25 spam calls a week unless I shell out for a service to block them (TrapCall, Robocaller, etc.)
I'm sure there are bills in the works, but those same bills are likely bundled along with completely unrelated nonsense.
That only works if you have and check your voicemail. Many people either don't have a voicemail or don't bother ever setting it up. When the carriers start charging you a lot of money to have a voicemail, plenty of people will forgo it, and instead say things like "if it's important enough they'll call back" or "they'll send me a text message".
I've got enough IRS and social security calls on my voice mail as to ignore them all too. If I don't know the voice and I'm not expected the call it is ignored.
> More than anything I suspect this is a result of allowing so much unfiltered spam calls.
Yep. I never answer unrecognized numbers anymore, and nobody I've talked to about it does, either.
Welcome to what society looks like when social trust declines. It will keep getting worse unless and until people discover that the commons actually matters and is more than something to scam and find some way to parasitically monetize.
People are contagious a few days before they show symptoms, but most infections are by unambiguously symptomatic people, because they carry the highest viral load. If symptomatic people stay home you cut down infections by 2/3rd if not more. R0 goes from 1.5 to 0.5 and that's sufficient.
> Available evidence from contact tracing reported by countries suggests that asymptomatically infected individuals are much less likely to transmit the virus than those who develop symptoms. A subset of studies and data shared by some countries on detailed cluster investigations and contact tracing activities have reported that asymptomatically-infected individuals are much less likely to transmit the virus than those who develop symptoms.
> No it wouldn't. One of the things that makes SARS-CoV-2 such a problem is that people get contagious long before they show symptoms. Similarly to for influenza and the common cold, many people get contagious without ever developing symptoms.
Agree with the main thrust of the point but if everyone did stay home for 14 days you may well eradicate the virus. Problem of course that its economically/socially/medically impossible to facilitate a complete 14 day lockdown.
Another reason why that synchronous 14 day lockdown would fail to eradicate the virus: unless you are going for total solitary confinement, intra-family transmission chains would be able to sustain the virus much, much longer than those 14 days. Even a household as small as a two child nuclear family could sustain the virus quite long if each infection happens to have a fan-out of one and happens rather late in the contagiousness window.
But that surely was only known positive isolation, not the blanket "everybody stay home" thing grandparent was suggesting. That's a huge difference particularly wrt (child)care: someone will take over until you are healthy again vs nobody can take over because everybody else is going through the same solitary confinement thing.
The big question is do they really work. Not according to country which measure traveller from china. We know in the long term. But trusting on their stat., not my default.
>if everyone did stay home for 14 days you may well eradicate the virus
This would not be possible. There are at least several species of animals (mikes, civets, and bats) than can transmit this virus. We would need to quarantine and test, or kill, each and every one of these animals to be sure we eliminate this virus, or else it will eventually make its way back to humans.
My opinion, based on what I read, is that this will be a bit of a scourge until such time as enough people have immunity from either catching it or getting vaccinated.
Over time, as this new coronavirus makes its way through the human population, the experts it to become less virulent in general and/or appear less often. [0]
> One of the things that makes SARS-CoV-2 such a problem is that people get contagious long before they show symptoms.
I also wonder how effective the vaccine is at preventing its receivers from even reaching that asymptomatic but already contagious stage. If "90%" is just "90% less reach symptomatic stage" then the percentage of receivers that are prevented from reaching contagiousness could be much lower.
This would basically mean that the virus is almost guaranteed to become endemic despite vaccination (unless another vaccine also removes the contagious stage quite well) and that everyone who doesn't get a vaccine will eventually test their immune system against the virus.
Natural immunity often follows a similar pattern. After a while you become susceptible to a light reinfection but the immune system will be in a very good position for a quick - but not instantaneous - victory on its second encounter with the virus. Under those circumstances, herd immunity effects fail to realize unless the first wave is so lightning fast that it fizzles out before the immune systems of early survivors (or the similarly vaccinated) fall back into standby mode.
don't know about other countries but in Switzerland somehow people do not get the codes for Covid app with positive test results. even if they had the app installed and running the crucial step of entering the official code is failing
I'll line up to get a vaccine because I trust in the scientific/medical community. I haven't installed my local contact-tracing app because ...
1) When I did try to install it said I need to update to a new OS, meaning my five year old phone likely wasn't good enough. 2) My local app doesn't provide alerts to me rather it alerts government contact tracers who today stated that they are only responding to alerts regarding medical/care home workers. I am neither. 3) My phone is not with me at work, the place where I interact with the most people by far, rendering the entire scheme basically useless.
In the US, people are going to work (or other events) WITH positive test results. Some because they won't get paid otherwise, others because they want to make a political statement, and some because they're ... well, I dunno why...
So, yes, even having people stay home after a positive test would be helpful, because currently, they aren't even doing that.
Oh, that's what they meant? That's not about signing documents at all, really. It's about whether they will agree to supervise their own quarantine, or whether the state has to do it. Then there was some stubbornness and/or misunderstanding in regards to making that decision and agreement.
"Some health departments have taken it upon themselves to enforce quarantine on people that just tested positive." doesn't really inspire the same kind of outrage.
Contract tracing seems to work just fine in the Asian countries that have successfully stopped the virus in its tracks, and if China's 1.3 billion people isn't at scale, I'm not sure what is.
But yes, it does require having few enough infected people to make it feasible, and places like the US and most of Europe are waaaaay beyond that point now.
China has also done mass testing when their contract tracing broke down.
If we could get high compliance with isolation of positives, the US/Europe could use mass testing to "reset" without lockdowns. Test all of Michigan across a couple days and you will identify a significant portion of the infected. Then do Wisconsin. Encourage people to limit travel during those periods and so on.
You wouldn't get to 0 in one cycle, but it would hammer the transmission rate.
I'd prefer not to get Covid19, but the real worrying thing about it is the potential for a worse disease. Say it's almost as transmissible but much more deadly. How will we respond?
I'm sure many people would do more to protect themselves, but I wonder how deadly it would have to be for some people, and how deadly would it have to be to make community minded cooperation the obvious path (this is a reasonable description of mask wearing…).
"Covid19 would also be over if people with symptoms would just stay home."
That is unlikely to be true. There are asymptomatic super spreaders. The fact that R0 is currently hovering around 1 is that society has greatly reduced contacts. Even in areas where social distancing is a mere suggestion, most people are not behaving completely normally (a good thing). Flights are super low, movie theater visits are super low, hotel occupancy is super low. Social distancing and contact tracing work. Better social distancing and contact tracing work better.
> Mutations aren't a serious concern. Because when viruses mutate it's the strains that are more infectious and less lethal that win out.
If only it worked that way! It doesn't, of course.
A random walk can lead anywhere in the adjacent landscape. That includes moving up in lethality without moving down in infectiousness. What you have written here is plausible-sounding nonsense; if it were true, the 1918 flu would never have occurred.
The good news is that influenza is almost pathologically mutation-prone, and coronaviruses are not.
The oft-cited theory about 1918 is that WWI upended the traits that were selected for in the virus. Whereas in peace time a more serious case would reduce the mobility of the victim, in war a serious infection would result in the patient (a soldier) being transported off the front lines, spreading the more serious version of the virus more.
Moving up in lethality while maintaining the same "infectiousness" still results in a real-world decrease in infection rate, as more infected hosts will die (and/or infected hosts will die more quickly), preventing them from spreading it further.
In the case of COVID-19, which is highly contagious, has a long latency period, and is in fact not especially fatal by the standard of diseases ending in -RS, this might be true on paper, but would be cold comfort in practice.
The claim becomes conveniently tautological when you equate "at scale" with "tracers getting overwhelmed". GP might argue that all successful tracing never reached scale. That would make it a completely worthless claim, but, well "truth" (big sarcasm quotes).
They didn't have to catch all cases. They reduced the fatality rate per capita by 90% compared to western countries. South Korea has less than 5% the cases per capita of the US.
And Japan. To be fair, Aus and NZ caught their epidemics very early, and are islands.
Korea and Japan appear to have contained theirs through the use of reverse contact tracing.
The big problem in the "West" (i.e. Europe and US) is that lots of people don't engage with the contact tracing system, which makes the epidemic almost impossible to control.
Any amount of community transmission will eventually lead to an out of control epidemic, unfortunately.
I keep hearing the 'they are islands' thing and it has never made much sense to me. Can you explain why being an island is intrinsically better than not being an island?
Does the size of the island matter? Does the location of the island matter? What if there are multiple islands?
Travel into islands is far harder than travel into cities in large land masses. You need to get a ticket on an airplane or a boat, which makes travel time a minimum of 1 hour usually and costs a whole bunch of money. This creates a natural barrier where people on islands don't interact with people on mainlands nearly as much.
Look into covid numbers and you'll notice cities even in the same country that are on an island of some sort have significantly less covid numbers, such as Hawaii or Vancouver Island in Canada.
How do you apply the “islands do better” logic to the UK or Hawaii? Hawaii might have done well by US standards, but it has performed badly compared to other islands.
The UK has not done well.
Yes. Also Australia is an island, but Victoria (my state) peaked over 700 cases/day and other states during the same period managed to keep their case numbers controlled at the same time (~10 cases / day in NSW iirc). It wasn't magic. We closed the state borders, making each state basically its own island. Victoria imposed strict lockdowns to get the case numbers down and the rest of the country went about business as usual.
I don't see why the same strategy wasn't used in Europe or the US. Its hard to control a virus when there's a constant stream of new cases coming over the border. I suppose its way too late for that now.
Islands don't really matter, but closed borders do. Europe has very different policies and rates of spread, but open borders mean that no country in the EU can eradicate Corona if the rest doesn't eradicate it at the same time. Case in point, Germany was at practically zero (around 1% positive tests with a 1% false positive rate) 6 weeks ago, currently it is lagging 3 weeks behind all its neighbors in the number of cases, rising exponentially.
porous border with Mexico? and by the time it arrived it was too late.
if you say Mexico is in your definition of North America then it should include all of central america, almost all these countries have a lot of land-based trade.
In Canada we have not had any cases related to truckers, but there's a lot of them who have to do the cross-border route, as well as people who commute daily across the border. heck in Canada and the US there are a few spots where crossing the border is necessity -- the only school is in the other country, nearest hospital, the local library, a popular golf course, etc.
or places like point roberts, extremely small but extremely isolated, or Hyder, Alaska.
A sea border is used more for trade -- Australia trades nearly as much with China as Canada does with the US! This idea that islands are somehow LESS dependent on foreign trade is afactual, you can see it in the 2019 import/export figures. And people have been barred for US/Canada crossings for those reasons for months. And there's not a lot of Coronavirus coming from Canada... So really, what advantages does an island have?
Not debating your point, but I want to point out that there is literally no overland travel between South America and North America because of the Darien Gap. If you want to get to the US from Bogota, you'll need to fly.
I guess the key point is being an “island” is not enough when you have 300M+ people with huge amounts of intermingling, and the virus has already taken hold.
Australia and NZ were able to control their outbreaks (even then with great difficulty in the case of my state of Victoria AU) because the populations are much smaller and the virus was not widespread when the severity of the threat became apparent.
> the virus was not widespread when the severity threat became apparent.
It was pretty bad in Victoria and it was an impressive effort to get it back down. Not many places have achieved success like that. To me the key was the population and its leaders having the will to fight.
I'm talking relative terms; our numbers were 50-100/day when they realised the problem was getting bad, and up to 700/day when we hit crisis point, but that's still lower than the figures that some U.S. and European cities had even back in March/April when the world was still yet to understand what was really going on.
And yep, I think what's happened here has been impressive, but we've had some factors in our favour that other parts of the world don't have.
Contact tracing is working extremely well here in New South Wales. But we have very low incidence of virus in the community, sufficient to get useful early warnings when DNA analysis picks up virus in the sewage system.
So once you're down to low levels of incidence in the community, given a robust well organised system, efficient contact tracing does prevent the virus from spreading in the community unchecked.
They have done very good at tracking and locking down the few cases that get out, even with very low mask use in the general community based on what I've seen. People were sensible when it mattered most.
> Contract tracing hasn't worked at scale anywhere.
I am not sure this is true. At least some articles I read attribute the successes in many Asian countries to aggressive contact tracing and quarantining. You don't ask people kindly to self-isolate, you move them to hotels and quarantine them. You don't ask them to remember their contacts, you aggressively investigate them using every source of data available.
I think an argument can be made that Europe simply got it wrong in the details. In order to find less invasive means of controlling covid that respect privacy we ended up limiting freedoms much more and for longer.
Taiwan did ask people kindly to self-isolate at home in most cases, and it worked extremely well. Certainly a lot better than telling travellers returning from high-risk areas to go straight to work the next day, as the brilliant minds in charge did in some other places.
> In order to find less invasive means of controlling covid that respect privacy we ended up limiting freedoms much more and for longer.
There is limited freedom during a lockdown, but a short sharp one can lead to almost complete normality soon after. Short and sharp or long and drawn out?
The drawn out option would seem a dubious freedom. My perspective is heavily skewed by being in NZ and reading US and UK news.
Yep. People seem to think that more lockdown = worse economy. NZ shows the relationship isn't so simple. A stricter lockdown seemed to work better from both a health perspective and an economic perspective.
It's a cultural thing. Asian cultures vary dramatically between each other (don't mistake Koreans, Chinese, or Japanese for each other -it won't end well), but they have one thing in common: They have a real sense of every person is part of a collective. Maybe it's because most Asian societies are quite crowded.
The US, on the other hand, has a real sense of everyone is an individual, to the point of actually considering people that follow rules and norms to be "sheeple" (see "antimaskers").
In the UK, and England specifically, another factor is ideology - vast amounts of money have been spent on outsourcing contact tracing even though the statistics suggest the result performance isn't very good. Meanwhile, local government run contact tracing has been really effective but seems to be starved of resources because they are public sector and therefore, apparently, must be bad at what they do.
Those comparisons are misleaidng and themselves the result of ideology - the local contact tracing and national contact tracing have different success rates in large part because they handle different kinds of contacts. Local contact tracing handles "complex" cases, which are generally things like workplace outbreaks where they have the help of employee records and attendance lists. National contact tracing handles all the other, less robustly recorded social contacts. I believe that in Canada, where all contact tracing is local, a lot of areas have recently abandoned tracing the kinds of contacts that are handled by the UK's national scheme altogether because they don't have the resources and it doesn't work well.
Contact tracing should not be the the responsibility of the individual, it should be the responsibility of the government (with cooperation of the individual of course). This is how Asian countries have succeeded at it. The US isn't even trying yet - I still don't think I can even get a rapid test where I live.
The 5-HTR1A gene affects whether we more easily make relative versus absolute judgments. And this seems to be true for everything from the length of lines, to quality of life. The allele that is most common in East Asia makes relative judgements easier, in America it is absolute judgements that are easier.
Politically, having the relative form of the gene encourages more community thinking while the absolute encourages more individualism. This leaning holds within whatever society you're in. But when a culture is dominated by one form of the gene, it will naturally shift the entire society.
Scanning the Wikipedia page for 5-HTR1A, it looks like most of the studies were done in the first decade of the 21st century, when the candidate gene (https://en.wikipedia.org/wiki/Candidate_gene#Criticisms) approach was at its height, before it became known that many of these studies were statistically underpowered and thus likely detecting noise. So I'd be skeptical of any associations between 5-HTR1A and personality unless there's been recent follow-up.
Did it work at scale, or did it work because it was employed early enough (along with other strict measures) that it didn't have to scale much? The latter is my understanding.
Luck of choice, human rights, data protection and privacy, collectivist society and strong government enforcement bodies are prerequisites for a successful contact tracing. I guess that work much better in Asia than in the "western world".
Yes, because Korea, Taiwan, and Australia can all be defined by lack of human rights and a collectivist society.
And yet, just like China, they have also beaten the virus. Meanwhile, Russia has failed on all counts.
The West has the laws on the books, and the legal precedent necessary to enforce them, when it comes to epidemics. What it lacks is the political will.
It doesn't matter how effective these measures are, or how bad an idea it is to let the virus run unchecked - under it's current leadership, states like Kentucky will never do what is necessary to get the virus under control, because these measures are anathema to it's current regime. And states like Washington won't either, because while those measures are not anathema to them, their governments are afraid of a backlash that will replace them.
This wasn't an inevitable outcome - nothing fundamentally stopped bipartisan cooperation on this point. Political expedience and the desire to own the libs did. Had the right not used the pandemic as an opportunity to grab power, and start a culture war, we wouldn't be where we are today.
Don't be partisan. The democrats pulled shenanigans too, like tacking on random stuff about green energy and international trade on the covid relief bill.
A Covid relief bill is not sufficient, or even necessary to stop Covid. Quarantine, lockdown, and widespread testing is. The bill just deals with some of the financial fallout.
And you can't blame the Democrats for choosing to make resistance to following best practices in disease control a wedge issue.
Don't equate the damage caused by 'a relief bill didn't pass because two parties couldn't agree on which pork could be added to it' and 'one of the parties is not following basic epidemic control practices'.
The financial aid is required in order to get public support for the lockdown.
Sweden squashed their cases down from a massive peak without any lockdowns or masks, but with a social welfare system that supported anyone who felt even slightly sick to stay home
"Contract tracing hasn't worked at scale anywhere."
It works 'at scale' in Taiwan/Korea if by 'scale' you mean 'large country' but yes, it does not work when there are many infected, it's best suited for when there only small numbers and the government can keep a lid on that.
But that's entirely possible. Remember that countries have local agencies and national numbers are not everything.
Ontario is only 12M people, British Coloumbia 5M people and they have active contact tracing of literally every patient.
So with 90% effectiveness, the numbers will be brought way down, and in many areas, the threshold of cases will be low enough that contact tracing can be enacted.
So about the 50 people - we have to basically still maintain a degree of isolation, and that's entirely possible.
We don't need to tell the grocery store workers to 'self isolate' because someone came into the store with COVID that's already happening, those are low-risk events.
During social isolation, people should absolutely not be contacting 50 people.
So masks, basic social isolation at very least (no unnecessary contact) can remain in place.
That's a false bargin. People did similar universally do the above in many nations and it had little benefit. In turn they have lost and entire year. In turn that is the foundation of circular logic as above
> Or at least 1.2 million people's worth of civilization…
1.x million natural deaths with an average age of 82 years old, in the UK.
It seems to be working here in New Zealand - we have an ongoing problem getting people to use the Covid app, but that just makes it easier, doesn't replace calling people on phones
Of course it helps to get the actual rate so close to 0 that the contact tracers are not overloaded
It worked really, really well in South Korea and New Zealand. Besides, that's just your opinion and epidemiologists agree that contract tracing plays a significant role in reducing the spread of COVID.
> Mutations aren't a serious concern. Because when viruses mutate it's the strains that are more infectious and less lethal that win out
What if it has the contagiousness of covid but the long term lethality of hiv? The long term lethality would have low evolutionary pressure to be less harsh to its host as the implications only follow after many infectious years.
Is there anything fundamentally prohibiting the emergence of such a virus, or are we just lucky?
Virusses mutate all the time. What if a normal flu virus mutates and kills us all? There is no reason to believe that covid is more likely to become more lethal compared to any other type of virus.
What you're describing is not a false positive as it is usually used. A false positive is a test that returns a positive result when the person does not actually have the virus. What you're describing is that most of the contacts return a negative test (and don't have the virus).
It's different now - because of the strict quarantine requests, coupled with the knowledge that there's no known treatment/vaccine, coupled with the fact that you have literally tens of thousands of cases per day - means that people don't cooperate that much, and the system is already over-stretched.
Also, "hasn't worked at scale anywhere is false" - AFAIK it worked fairly well in South Korea, Japan, New Zeeland, China.
People (rightly, or wrongly) don't trust technology enough, after the reputation Silicon Valley has built and can't shed, around privacy.
I'm on an Android phone, and sure, Citizen and a local State app can do the contact tracing. But what's Citizen doing with that data? It also requires interactivity (another Silicon Valley favorite thing to do - call out for people to perform actions via alerts and notifications).
It's a lower bar for people to wear masks than to accept to use an app for contact tracing, if you were to compare the policy actions. Now, you can have the contact tracers call people, but how many spam calls do you get that you ignore? And phishing attempts? I received numerous texts from "the Democrats" with a person's name, urging me to vote, from all sorts of US numbers, and asking for a reply. To this day I don't know how real that is.
There are too many people to blame for this state of affairs, but the greed and competition for eyeballs are the definite drivers.
Some of the contact tracing apps collect full GPS history; some just use the BLE token exchange mechanism. Unfortunately, the former is the mechanism my state has chosen to roll out in their app.
Luckily, contact tracing can be done efficiently the traditional way, by gathering the contacts of an infected person that tested positive and contacting them manually.
Maybe, but it doesn't sound targeted? I have no idea how it works in that back end, but I've never heard of emergency numbers being specific to individual phone numbers.
This vaccine targets the entire spike protein. It is very difficult, from an evolutionary point of view (very high affinity for the ACE2 receptor), that the spike protein would change so much that the vaccine would be completely ineffective.
So why are they slaughtering millions of animals, on the basis that any mutation might reduce the effectiveness of a vaccine? If you're right then Denmark is engaging in mass cruelty to animals on an epic scale.
They slaughter 80% of a given mink farm stock every year for their fur anyway — after raising in horrifically unpleasant stacked, cramped, caged conditions which are ideal for disease spread, mutation and recombination with coinfections.
Sweden already has around ten detected SARS2 outbreaks on mink farms and is planning not to cull the entire population for the above harvest cycle related reason; the survivors will have ‘more space to socially distance’ and a ‘resultantly lower herd immunity threshold’.
Dense factory farming of all kinds is a biohazard nightmare.
I believe the mass cruelty was farming minks on a massive scale. Culling them is likely merciful in comparison. Never mind the fact that I'd happily trade 10 million minks to save a few human lives.
I think both are mass cruelty. The way we treat animals is the slavery of our time, if not much worse.
We keep using words like "cull" instead of "kill" or "mass murder", as though it's not killing if the animal doesn't look like us. Just because you're more intelligent or more capable than a different kind of animal, that doesn't mean that your life is worth more than theirs. And it definitely doesn't mean your life is worth millions of times more than theirs.
>The way we treat animals is the slavery of our time, if not much worse
The woke police would like a word with you lmao...
>Just because you're more intelligent or more capable than a different kind of animal, that doesn't mean that your life is worth more than theirs
What kind of rinky dink PETA argument is this? If you have kids I hope you explain to them that in an emergency you are likely going to save the dog and not your child because "your life isn't worth more than the dog's."
No. It's addressing a nonsensical claim in the parent comment. It is relevant in the context of that comment. And it's no more an appeal to emotion that the original comment was - which is to say not at all.
You do understand the end state of effectively all animal farming is slaughter - right? This culling does absolutely nothing to make an already incredibly cruel process any more cruel.
Flu has a unique capability to recombine that allows it to mutate more readily than other viruses. Hoping that the more simple coronavirus will be less fortunate.
Ability to recombine is not unique to the flu. SARS-CoV-2 is suspected to have been formed through a recombination event in vivo. [1] Mutation rates can also be manipulated through selective pressure e.g. vaccine-based herd immunity. For example, a vaccine-resistant polio virus has recently emerged. [2]
The comment you respond to states "more readily." This is undoubtedly true. Influenza virus is designed to recombine at every single replication cycle. Coronaviruses as a whole do not do that. We have a lot of data on coronavirus mutation rates and they are dramatically lower (1000x) than influenza. The point is not that mutation/recombination can't happen (it can and will happen), it is just that this mutation/recombination is relatively rare and we will not get the standard twice-yearly seasonal flu effect where we have to tweak the vaccine every year.
Influenza undergoes recombination seemingly exclusively through reassortment whereas betacoronaviridae undergoes homologous recombination -- but to think of the latter as much less effective at producing genetic diversity may be incorrect.
> In fact, there is evidence of at least seven potential regions of recombination in the SARS-CoV genome in the replicase- and Spike-coding regions, with possible recombination partners that include porcine epidemic diarrhea virus (PEDV), transmissible gastroenteritis virus (TGEV), bovine coronavirus (BCoV), HCoV-229E, MHV, and IBV [1]
> Unlike other viruses that have emerged in the past two decades, coronaviruses are highly recombinogenic. ... For coronaviruses, however, recombination means that small genomic subregions can have independent origins, identifiable if sufficient sampling has been done in the animal reservoirs that support the endemic circulation, co-infection and recombination that appear to be common. [2]
> Recombination seems to be rampant in HCoV-OC43 viruses and contributed to originate the A to E viral genotypes, as well as viruses that do not belong to these major genotypes. [3]
Unfortunately, nature doesn't "design" anything, it's just the consequence of natural selection and fitness of new generations. While the mutation rate might low compared to influenza, the mutation rate is very high compared to something like a prokaryote, enough so that there's an article entitled "Why are RNA virus mutation rates so damn high?" We've already seen a gain of function mutation creating enhanced infectivity and a recombination event involving ferrets, so it's not a stretch that we might see a new more of this in the future. Whether or not it will impact the toxicity of the virus or whether or not its susceptible to a vaccine is up in the air, but once an effective vaccine exists strong selective pressure will be placed on versions of the viruses that evade it.
Check out Figure 1 of your cite [3]. Of course mutation rate is high compared to a prokaryote. The point is that coronaviruses (as proven by Fig. 1 of [3]) do not have a high mutation rate for an RNA virus. Indeed, the mutation rate is much lower than influenza.
> a vaccine-resistant polio virus has recently emerged
A perfect example of why we won’t be able to eradicate Coronavirus. Polio was an easier target with stronger reasons to wish it gone, and we have failed.
I wrote a post about it above. I live in the bluest of blue states, which in the other comments here, in that narrative, you expect cooperation and all this stuff. A false media narrative, if I do say so, but that's not the point - the point is no one trusts the folks behind the technology, nor do we trust random phone numbers.
So the Citizen App has contact tracing. But you have to check into the app, and furthermore, do you trust some private company with the information? About you? Your location and all this ? And contact tracing via government calling you - do you trust random numbers calling you and asking you questions? No one knows when Silicon Valley (in the case of the app) wants to steal some more of your private data, and no one knows when some phisher is phishing as opposed to some volunteer calling you up for contact tracing.
There's a breakdown of trust.
Oh, and saying, 'maybe this administration' is further evidence of that. I live in a blue state, and your perceptions are, I believe, wrong, about the magic around that or the cooperation of the citizenry.
Exactly this. I'm not installing anything on my phone, and I don't answer phone calls that are not from my contacts. I've never been tested because I don't trust the testing companies.
If I'm sick, I'll stay home. I wear a mask where I'm required to. That's the limit of my participation in this hysteria.
Well over 250,000 dead Americans with over 100,000 new cases per day and your word is "hysteria"? I'd rather use the word "crisis." In a bad year the flu kills 61,000 here. We're over four times that now and with no signs of slowing down.
And I'm really not sure what there isn't to trust about the testing companies.
I'm not that extreme. I'm happy with being tested, and I'll be happy with vaccines and so forth.
It's Silicon Valley and its entire "you signed an agreement, you belong to us" morality and "get your attention span" business model that I distrust. Well, that and phishing phone calls/texts (I seem to get those regularly, after all this time).
My belief is that contact tracing is a cultural non-starter here. There are people who protest with large, semi-automatic rifles because they don't want to wear masks inside private businesses.
There's absolutely no way they're going to trust a contact-tracing process championed by the government, even if there's no way for the government to access the data.
I suspect much of the population will continue to ignore the virus and winter weather will cause a spike that will cripple hospitals.
They don't mean make sure everyone is comfortable with it. They mean by force via executive order and penalty of fines or imprisonment. If people don't want to obey they will make you obey and a large part of the country thinks this is a great idea.
Are you kidding me? Its all over the news. Have you read a single article since the election? Literally every single article is talking about the executive actions he's going to take. And the consequences for violating an executive order are fines and imprisonment.
Maybe they should compare your throwaway account Ip with the rest of the account ips and see if this is a sock puppet account.
Select ip_addy as source_ip from account_log where account_name=throwaway4220 join account_log on ip_addy=source_ip
Ban you.
Please stop pushing your fantasy narratives and puppet accounts here please.
It appears one person's "extremism" is another person's "wisdom". If you've ever worked in state/federal government you'll get the sentiment. Sure it's speculative, but definitely not extremist.
Our rate of transmission is too high to do a nationwide contact tracing effort I think. We need to reduce the daily number of cases before we properly implement a contact tracing program.
Perhaps a better way to say this: we need to implement a national contact tracing program immediately so that when the transmission rate declines to manageable levels it is operational.
This disease will never be "eradicated" and it is not helpful to use that word to discuss policy decisions. Sars CoV-2 has numerous animal reservoirs and an incredible transmission rate. It will never be gone from this Earth.
We will get vaccines and we will come up with better treatments negating its effects, but this coronavirus is here to stay. It will be a fifth endemic human coronavirus.
There are a lot of coronaviruses and all tend to become mild overtime. In 1800, Influenza killed thousands of people daily. This endured through the 19th century,
Coronaviruses also have plagued humanity in the same way, for instance look up “bovine coronavirus”
Only time will tell. At the beginning of the pandemic the strategy was to simple hold out until a vaccine is found (Which is the strategy developed for influenza). Doing lockdowns reducing the infection rates to almost nothing or even eradicating it in some countries was seen as impossible. Yet that’s exactly what we did. I think eradication is possible.
Can't believe I had to scroll down this far to find this - but this is exactly true. Since the virus has a non-human animal reservoir that means that even if every human receives the vaccine, all it takes is re-transmission from the animal reservoir back into the human population after the immunity period expires.
This means we'll probably have to receive Covid vaccination on a regular basis along with the flu vaccine in order to maintain a permanent broad-scale immunity. At least until we have a radical new treatment for this family of viruses that can confer a "permanent" immunity - something that for now is in the realm of science fiction.
This is 90% protection against disease, not necessarily 90% protection against infection. There's an important distinction:
* Protection against disease means that you don't get sick. You may still contract the virus and spread it to others (the Salk vaccine against Polio works this way).
* Sterilizing immunity means that you can't even get infected, so that you can't pass the virus on to other people. It does not look like there's any information about sterilizing immunity in this press release.
Importantly, this means that even with this vaccine, the virus may still be able to spread, and only vaccinated people will be protected (i.e., no herd immunity).
> Importantly, this means that even with this vaccine, the virus may still be able to spread, and only vaccinated people will be protected (i.e., no herd immunity).
Can't we still hit herd immunity as a byproduct of this though? If everyone can pass it along without symptoms, then eventually everyone will have it...
Without sterilizing immunity, will the amount of virus a vaccinated individual carries match that of a non vaccinated individual, though? I guess what I (a layman) is asking is, even if the vaccinated individual contracts the virus, won't they spread less of it than someone truly sick?
Someone truly sick is likely to isolate at home, due to the social stigma if nothing else. Someone who is asymptomatic may continue as normal, spreading the disease more easily.
It depends on the virus and the vaccine. We'll have to wait for further data on this vaccine candidate.
The Salk polio vaccine does not prevent infection in the digestive tract, so you can still spread the virus, but it does prevent the virus from spreading beyond the digestive tract and causing paralysis. You could imagine something similar happening with a SARS-CoV-2 vaccine: that it would block infection in the lower respiratory tract but not the upper respiratory tract, allowing you to spread it by coughing and sneezing while never getting severe respiratory issues.
Contact tracing might work really well with a submissive populace. We don't have one.
Said another way: I don't think voluntary contact tracing will work in the U.S. And I don't think you can implement involuntary contact tracing in the U.S.
Contact tracing: must be required. I work someplace where we have been grappling with the legality of telling coworkers about infected colleagues (when exposed)—the government needs to create liability for failure to inform others as opposed to threatening liability for over sharing!
If I’m wrong, PLEASE provide a .gov link and I will personally make sure that our large academic org pulls out of reverse, and into first gear!
It can’t die out on its own. Animals are getting infected by it, meaning it will be around forever. But as long as we can tolerate it, that’s all that matters.
Animal reservoirs make it harder but not all animal reservoirs have as big of an effect. Birds don’t seem to be able to get infected which already is a very good sign.
Yes, and only/primarily/first at-risk groups, incl. at risk to themselves or others because of workplace in healthcare/residential home/etc. - but nothing firm I don't think.
We're still months away from all 20M (of a >60M population) people that vaccines have been ordered for being administered with them, (BBC reports 'up to' 10M doses 'may' be 'delivered' this year, i.e. 5M people max) so I suppose they still have plenty of time to decide the most effective pecking order.
I would assume the trials in kids will start soon. Though today I haven't heard of them so far. (kids are hard to test because each age reacts differently)
> With 90% efficiency it will be extremely tough for the virus to spread
Aren't you assuming 100% coverage at 90% effectiveness?
What if it's - say - only 50% coverage, at 90% effectiveness. That's not looking so good.
I'm still trying to understand why an otherwise young and healthy person would want to get take one, or more likely multiple, shots of a C19 vaccine, given the risk from C19 is so low. What's the benefit to them?
In HN-speak: how well does a C19 vaccine deployment scale?
To continue this... I don't think the flu vaccine is nearly 90% effective. I am pretty sure the flu vaccines hover around 60-70% effective. A 90% effective vaccine would stop the spread drastically to the point where it might just stop it wholesale. in addition the virus envelope is so fragile that it won't stay in the environment for more than a few days compared to something like the norovirus that can last for a long time on surfaces(iirc) because of a lack of a fragile lipid enclosure.
It's not possible to totally eradicate a virus that has animal reservoirs. The virus apparently jumped from bats to humans once before so it will probably happen again. We can't vaccinate all the bats.
Humans already eradicated a disease (I think it was a virus). It was done with a vacine of an altered version of the virus. The vacine itself was a virus which could infect others and spread among the population.
So, you don't really have to find every animal. Most should be enough.
There have been efforts to put vaccines into treats that various animals would eat. However not all vaccines can be delivered in this way, and even of those that can, getting the right animals to eat them is tricky.
> We can't vaccinate all the bats.
It is possible. It isn't "vaccination" as we traditionally know it but there are gels that take advantage of bats' grooming behaviour. Put gels that kill virii on some bats. Other bats groom these bats and the gel(s) get(s) into these bats [0]
I'm not sure about this vaccine, but it is a real possibility with other vaccines.
The injectable vaccine for polio stops the symptoms, but it doesn't stop the propagation of the virus from person to person.
The oral vaccine for polio also stops the propagation (that is better) but it is a live virus that can escape and produce polio in other unvaccinated persons (that is bad).
[So the current recommendation is to use oral version when polio is endemic, the injectable version when there has been no cases for a few years, and a mix of them in between.]
Normally when you get infected you get small number of viral particles in your system. Those then hijack your system to create more, and those new particles spread to other people through sneezing etc. In time your immune system learns how to recognise and kill the virus and eventually removes it from your system.
Now let's say you get vaccinated and you get that same small number of viral particles in your system. Your immune system will already know how to recognise and kill the virus, and immediately starts doing this. It doesn't multiply in your body, so it can't spread to others either.
I think we can control it well with a vaccine and contact tracing. But though this is not my area, I've heard experts say that "eradication" is unlikely, in that we've still only actually eradicated one human viral disease.
But if covid-19 was well enough controlled that most of us wouldn't come across an infected person in normal life, or need to think about it for months or years at a time ... I think that's good enough for most of us to think of it as "gone".
It seems that this is a subject of debate among experts. From what I understand, the disagreement is over when we can say that a reduction in cases to zero is "permanent" if animal reservoirs still exist.
> To date, the World Health Organization (WHO) has declared only 2 diseases officially eradicated: smallpox caused by variola virus (VARV) and rinderpest caused by the rinderpest virus (RPV).
> Although successful containment strategies eliminated transmission of SARS among people, the continued presence of an animal reservoir means that SARS is not yet an eradicated disease.
> ... the 2003 SARS epidemic was permanently reduced to zero as a result of deliberate efforts, requiring no further intervention methods. This is precisely the definition of eradication.
This is incorrect. They tested SARS patients over 17 years later and they still exhibited an immune response. As long as SARS-CoV-2 doesn’t mutate dramatically the body probably has long term immunity.
There was some response. Was it sufficient or not - it has never been verified. Attempts to vaccinate animals with SARS vaccines ended with terrible outcomes of ADE.
You’re talking about a vaccine, which was never successfully created for SARS. I’m talking about immune response from those that contracted SARS and recovered. You can’t compare a failed vaccine to actual survivors.
What I am saying is: 1) No one tried to check the suffiency response by attempting to reinfect the person, because that would grossly unethical; unless there was such attempt, we cannot say anything about the reponse, it even might have been cross-reaction from common cold antibodies 2) Even if there was the response, there was high chance of ADE. It does not matter was that immunity acquired through vaccination or natural infection; ADE does not pick and choose; weak immunity causes worse response than no immunity. Having said that, SARS-CoV-2 does not seem to produce ADE.
This vaccine is against the entire spike glycoprotein. Some in production vaccines are only against the RBD (the protein that actually latches onto ACE2). There are variants out there that have been shown to escape RBD antibodies. However, since this vaccine encodes the entire spike, there are other areas that antibodies can bind to. They stated in their press release that the vaccine elicits a Th1, CD4+, and CD8+ T-cell response against both the RBD and other areas on the spike. I think this is the most promising aspect. This means it should hopefully be effective against even escape variants.
Can you tell me why I shouldn't worry that vaccines which are made to flood the body with fake ACE2 proteins won't affect blood pressure, body water and sodium content? What happens to all the angiotensin II that connects to dummy ACE2 connectors?
I haven’t seen what you’re describing. I’ve seen hrsACE2 which is recombinant ACE2. That will both provide a target for the virus to latch onto as well as supplement the body’s actual ACE2 to complete the cycle which seemed to be more of the focus.
It's an interesting question, especially in light of the fact that the leadings viral vector candidates require a booster shot after the initial vaccination except the J&J candidate.
We'll almost certainly need an annual covid vaccination for the same reasons we get annual flu vaccinations - with our current medical technology we can neither rid the planet of the virus nor obtain permanent immunity.
I didn't get flu shots in the past mostly because the shot hurts more than the flu, but COVID is another animal and pretty scary. Maybe they could be combined into a single poke.
We'll almost certainly need an annual covid vaccination
In fact we have no idea how long this vaccine or any other [of the experimental covid-19 vaccines] will last for. They've got projections out to at least a year, but uncertainty becomes too great after that. It may last quite a long time, we don't really know.
for the same reasons we get annual flu vaccinations
No. We get annual flu vaccinations because flu viruses mutate significantly and quickly, so we're always getting vaccinated against new threats. Not against threats that we've forgot how to defend against.
[edited to clarify that the uncertainty is around the experimental vaccines; for old standards, we do have a very good idea]
You're right - I should have said "periodic vaccination", not annual.
Also yeah, there's a subtle difference between why we'd need periodic covid vaccinations vs flu vaccinations. But in the end the result is the same, we'll probably need to be re-vaccinated against covid over time.
Covid isn't going away because it has a non-human animal reservoir, so it's all about a strategy to prevent it's re-emergence into the sapiens reservoir. It's possible that periodic vaccinations of the population as a whole would be overkill and we could reactively immunize smaller populations as re-infection occurs.
Another interesting open question is what's the "failure mode" as our immunity wears off. Do we become vulnerable to the full danger again? Or can we expect to contract the virus again, but this time the body will be better able to jump to defense quickly, making the most severe cases less likely?
That is immunity after illness, isn't it? I would not be sure you can extrapolate that for immunity after a specific vaccination. The vaccine from Mainz / Mayence for example trains your immunity by introducing just parts of the shell / shell dna / rna. Could work even better for immunity or worse, one has to study that for every vaccine seperatly, I think.
The results came from the independent data safety and monitoring board that is analysing the trial results on PFE/BNTX's behalf. PFE/BNTX themselves don't currently have access to more data. But there is no reason to suspect that these results are not accurate.
At least this one has a decent looking 'n' value. The BBC also address this in part
> There are still questions - how long does immunity last, does the vaccine work as well in high-risk elderly people, does it stop you spreading the virus or just from developing symptoms?
I'd rate the news as "vibing" on a scale of clickbait to party for the world
The current n=94. The real n=43.5k data apparently will come later. Article doesn’t specify when, but “hopes” to have enough of the larger n analyzed to submit to regulators by 3rd week of November.
Thankfully safety is looking pretty good according to the press release. However I look forward to reading expert analyses of the actual data to confirm.
> However, the data presented is not the final analysis as it is based on only the first 94 volunteers to develop Covid so the precise effectiveness of the vaccine may change when the full results are analysed.
Thanks! Misread the 94, but the n=43.5k is also misleading since they have not analyzed all of the results and duration of the study vs exposure risk is still tbd. If the 94 participants that got COVID also abided by all the other precautions, such as masks, etc, then it stands to reason that the actual infection rate in the population approximating pre-covid behaviors may also be higher.
To be clear: 94 out of 43500 people in the trial got covid, and if the vaccine is rated at > 90% effectiveness, that means at least 85 of those 94 people were in the placebo group, and less than 10 people were in the vaccinated group.
FWIW, N=94 seems ridiculously small to me. I realize there's ethical concerns in increasing exposure etc but in my experience, that's in the ballpark of sample sizes where unacknowledged heterogeneity can be manipulated to distort findings.
I'm not suggesting Pfizer is up to something nefarious, just that the biomedical literature is littered with studies with N < 100 for the outcomes of interest and they don't replicate. The N > 40k in some ways is irrelevant if none of those participants have the processes in play. It's more like recruiting N >40k to get N=94 to study.
I'm also not suggesting with 90% effectiveness that there's probably no effect, just that my guess is a true value of 60% isn't outside the realm of possibility once you consider all the factors that could be in play besides the random sampling variation that's assumed by their tests.
Seems fine to me. 85 people from the placebo group caught covid. If the vaccine was completely ineffective you'd expect roughly the same number in the vaccinated group. The actual number was 9.
What you're saying is the 9 is pretty close to 34 (60% effectiveness). No, it isn't. You'd need to quadruple the number of vaccinated cases to get there. Even if you double them, you're still at 80% so I'd take that as the realistic worst case.
Edit: Also, this is BioNTech's vaccine, not Pfizer's. They partnered with Pfizer as they have the facilities and scale for a massive rollout, but it was developed by BioNTech. I wish they were getting more credit in the US & UK coverage.
Yes, but in other cases there have been "independent" reviews that weren't really independent, e.g. test makers who did their own test validation but got academics to do the writeup ... who worked at the university the manufacturer was spun out of. There's a lot of bad behaviour going on right now in the scientific world that would normally not be tolerated, but standards have dropped lot in the name of speed.
-80C is dry ice (frozen CO2) temperature. So you can carry vaccine vials around in a cooler with a block of dry ice. Pfizer has a dry ice shipping container good for 10 days. FedEx can ship that. Then the vaccine can be stored at refrigerator temperature for maybe 5 days. Dry Ice costs maybe $3/Kg.
The SF bay area has dry ice delivery.[1] Lagos, Nigeria has dry ice delivery.[2] Bismark, North Dakota has a dry ice plant.[3] It's not hard to get.
Coolers for holding items in dry ice are about $100 on Alibaba.[4]
It's still more difficult and expensive than the alternative.
It's not a big deal for the first world, but poorer nations may hold out for future vaccines that remain stable at higher temperatures and only require a single dose.
Merck is working on a one-dose pill, but that's not expected before mid-2021.
There's micro encapsulation for vaccines.[1][2] The vulnerable active molecule can be put inside a coating that is stable in storage but dissolves after injection.
>but poorer nations may hold out for future vaccines that remain stable at higher temperatures and only require a single dose.
Valid point, but I feel there's never been a better time for massively pushing this vaccine (after proper testing and regulatory approval, of course) to medium/low income countries.
Winter should make it much easier in managing the temperature range stability required for storing/shipping the vaccine, especially in countries around the equatorial region.
Doing it in late spring/summer will not be a good idea (assuming a better vaccine doesn't come out by then).
Having something is different than having something at scale and being able to effectively implement it. Logistics in less developed countries is already more difficult. Adding in specialty refrigeration requirements further complicates that. Large scale logistics should never be assumed or hand waved away. Mass toilet paper shortages in first world countries this year is a perfect example of how easy it is to massively disrupt logistic chains. What do you think shipping 100 million plus vaccines a month that require specialty refrigeration and dry ice will do to the supply of dry ice in Nigeria or Albania? Or the US for that matter? How many of those dry ice shipping containers does Pfizer have? How quickly can they be manufactured?
How many of those dry ice shipping containers does Pfizer have? How quickly can they be manufactured?
That's a big issue. The N95 mask shortage demonstrates that the US manufacturing industry has far less surge capacity for simple items than previously thought.
This is good news but I'm worried about the mutation already showing up in minks in Denmark. Minks apparently have a near identical respiratory system.
The tweet doesn't mention the claim of antibody resistance, and the article just says that the evidence for it is yet to be announced. The article says that no single mutation is likely to cause resistance but doesn't explain why there would be only a single mutation.
Yet another reason to move to a plant-based lifestyle. Covid came from some folks in China using exotic animals for some purpose. Now a new variant seems inevitable from animal populations. Is it worth the burgers and coats?
Are they though? Mass farming puts humans into orders of magnitude more contact with animals than wet markets. In the case of covid, a wet market led to the disease. There are plenty of cases — just about the majority of plagues — where a domesticated animal led to disease
In some ways the dangers are different, perhaps more manageable in some cases. For wet markets, it's the unknown from nature. In the case of Domesticated markets, it is more typically an issue either from failures in procedure (i.e. e.coli/listeria/salmonella) or because of over-industrialization (Mad Cow Disease)
And maybe it was aliens, we don't know yet. But it's not really helpful to suggest random theories without a shred of evidence on the off-chance that they might be accurate, because that rabbit hole has no bottom.
Fortunately it sounds very contained. All cases (fewer than 15) were confined to a single location and there haven’t been any more detected since September. So most likely the mutation is now extinct.
I’m not saying anything with certainty. However, a lot of work has been expended in trying to contain this cluster and currently this is how it looks with the data we currently have.
It's not just this cluster though. If it happens once it could happen again and we may not notice the next until it's too late. So here's hoping the vaccine catches all likely mutations too...
In my opinion this sounds extremely good. They say that 94 people got covid. We do not know how many of them were from the placebo group and how many were from the vaccinated group. But the wording "was found to be more than 90% effective" probably means that much more than 85 of the covid-patients came from the placebo group. The reason is that they need to be a few standard deviations away from the mean to make such assumptions with high probability. I think probably at most 2 patients of the 94 covid-patients came from the vaccinated group (only then you could make such a statement with high certainty). And that means that probably the vaccine is more than 97% effective. This would be extremely good news. But let's wait for the data.
Fortunately, it isn't the only vaccine in the pipeline. Curevac, another German company located pretty close to BioNTech, is also working on a similar vaccine which can be cooled in normal fridges, so is easier to roll out. They supposedly are only a few months behind.
The -80c storage should be no showstopper for all densely populated regions and these are where the vaccine is most urgently needed. Over time, there will be easier to handle alternatives or we just build more deep-freezers.
There's many vaccines in development, even some to be available as nasal sprays and oral vaccines. I'm hopeful that by the end of this year, we'll get 1 or 2 more vaccines successfully completing Phase 3, and then several more in 2021.
About the logistical part. Wendover did on Youtube a really great video explaining the cold chain in international shipping and what companies are already doing to be ready for it.
https://www.youtube.com/watch?v=byW1GExQB84
-80C storage is an issue, you are definitely right, but it is a common requirement for many biological samples and protein-based drug therapies. -80C lab freezers are not that expensive and all over the place. I used to work in biotech and, at one company, all of our intermediate drug substance storage was -80C. we had freezers big enough to drive a forklift into; one such a freezer could store millions of doses... and we had several.
There are numerous companies which specialize in -80C transport and shipping. These containers can be used as temporary (3-7 day) storage at destinations where they do not have infrastructure.
So this vaccine can be distributed to regions with the infrastructure to store it and we can preserve vaccines with less stringent requirement for developing countries, etc.
Because RNA is not a stable molecule. At lower temperatures, it's less likely for a given bond to reach the Gibbs free energy of activation, thus preventing degradation.
In a biological context, the vast majority of RNA use falls within the 'central dogma' of DNA -> RNA -> Protein. It is merely an intermediate, albeit one with important and complex regulatory processes.
In RNA viruses and other contexts where stability is required, the RNA is stabilized by its environment, namely by associating with special proteins.
> There are numerous companies which specialize in -80C transport and shipping. These containers can be used as temporary (3-7 day) storage at destinations where they do not have infrastructure.
But what kind of capacity can they handle? I imagine the scale of a Covid vaccine rollout would overhelm prior existing infrastructure
There are a lot of other things that need this treatment. There is also limited ability to make doses. If you don't already have the infrastructure in place, then you will get notified when you shipment is arriving, and you get a few days to administer it. You schedule everyone who will get a dose for their shot and they are in and out quickly. If it takes more than half a day to use up their entire shipment it is because some dosages are reserved for 3rd shift and will be administered 12 hours later. Then repeat 3 weeks latter.
Of course larger institutions already have everything in place and will get shipments with less warning (but they will also get smaller shipments since they don't have to get everyone done at once)
> -80C storage and transport needed. Challenging, but doable in developed countries, but still may slow down mass rollout. Not feasible in many developing countries.
True but it's also a bit more complicated than that. The YouTube channel Wendover Productions has a great video on the subject: https://www.youtube.com/watch?v=byW1GExQB84 (skip to 5:01 for the talk about the cold chain).
TL;DW, there are other factors:
- Whether the hospital is able to maintain the vaccine at the required temperature (many, especially the smaller ones, don't have the equipment)
- This is medical technology and unproven options (like buying a random box off Alibaba like someone suggested) are unlikely to be used
- Pfizer (vaccine in TFA) has developed a shipment container that uses dry ice and lasts 10 days but it can only be opened twice a day, for less than a minute at a time, so facilities administering vaccines need to be able to accurately predict how many they'll administer in a given day
- Pfizer's box is only built for multiples of a thousand doses and only lasts 10 days so isn't well-suited to smaller areas that can't administer 1000 vaccines in 10 days
This is all true but is missing some important detail - the box (shipment container suggests shipping container sized things, it's more of a flight case size thing) is meant for long distance transport, rather than local distribution. It holds the vaccines at -80C for ten days, and can be refilled with dry ice (which is widely available anywhere that has a carbonated drinks industry) to extend that period. The ten days is how long it's expected to be in continuous transit, worst-case. The vaccine must be thawed before use, and can be stored in a regular freezer for a few days, just not indefinitely.
Since the transport cases are reusable, and don't need to be completely populated, what will likely happen in rural areas is that they'll have a case for shipment, refill it with dry ice on site, and use a second case to transport a small number of doses to the point of use. Repeat until used up, refilling with dry ice every few days at a central location (less than a week's travel from administration sites). I don't think it's going to be a major problem in practice.
One point they made on NPR is that it's hard to imagine any sort of vaccine that would be as harmful as the virus itself, which is killing 1000 people per day.
The issue is that a vaccine would be given to billions of people, whereas the virus is only infecting hundreds of thousands per day. Because vaccines are given to healthy people that may never be exposed to the disease the bar for safety is different.
It's already in use around the world[1], but I haven't heard of how many people gain immunity thanks to it in percentage, nor if that one also requires multiple jabs.
Who knows. This is the first to track and announce scientific results. It may be better or worse, we don't know. Maybe numbers are being kept and we can figure out in a few years. Maybe the Chinese are not keeping track in any way and we will never know.
"unlike other COVID-19 vaccine trials, the study lacked a comparison arm featuring serum samples from patients previously infected with the coronavirus, complicating the task of interpreting whether the response is likely to confer immunity."
It seems that a vaccine needing a 2nd booster jab is also something that is quite common.
Anyhow, good news all around... The more viable vaccines we have, the more likely that the pandemic will be controlled sooner.
I like your optimism, and what you said isn't incorrect about Ebola at the time, but I don't think it's correct about our current situation. How many locations globally have this level of refrigeration? Given that there would be high demand for it, wouldn't prices on any available refrigerators exceed what even the most altruistic companies and organizations could pay?
This still needs to be solved. We have a lot of entrepreneurs, investors, and engineers reading this, so let's not be hasty in hand-waving over something serious.
We manage to get $1M cruise missiles anywhere on the globe quite quickly. If the world can mobilize for WWII - the US alone built 1,200 warships in a four year period, 2,700 Liberty ships, 300k aircraft, etc. - we can mobilize for a global pandemic... if we choose to.
The world didn't mobilized for ww2. One country mobilized and started to threaten the existence of all.its neighboring states, and those who managed to leverage geographical and climate barriers managed to prepare themselves to intervene.
This is by far not the challenge covid19 poses to the world. It wasn't when it was China's local and regional problem, and it is not after it spread out of China and became a pandemic.
Objectively, at most Covid19 causes a slight increase in the global death rate, and this is only observed during the initial spread before herd immunity kicks in. Ww2 killed about 90 million people in 6 years, while covid is bound to have killed about 1.3 million in one year.
The analogy is imperfect, but it's imperfect in both directions - we don't have to make 300k planes and fight Nazis, we "just" have to produce a bunch of vaccine and some freezers.
It should be substantially less difficult than winning WWII, which again - we were capable of scaling up industrially to accomplish.
> this is only observed during the initial spread before herd immunity kicks in
When will that be? NYC's new spike is demonstrating even their enormous outbreak didn't generate enough of it.
The US has the manufacturing capacity for ships and planes before WW II. Do we have any factories left making refrigerators? Or are we just going to have to order them from China?
I dealing some on the distribution side of this. NYT has a pretty good article explaining all the infrastructure that is being rolled out. (1)
Even dry ice in coolers is low tech but gets you a lot of time considering storage for the second booster dose will be centralized.
The risk is real though. Breaks in cold chain storage have inactivated vaccines have been documented to leading to outbreaks in other disease states. Still, at this point, from my boots on the ground perspective -- so far, so good.
>Breaks in cold chain storage have inactivated vaccines have been documented to leading to outbreaks in other disease states.
Surely there's got to be some existing shipping indicator to track if a shipment has exceeded the temperature limits during transit. Even just a vial filled with a liquid that freezes at e.g. -70C would work just by tipping it upside down when frozen.
> > Almost all developer countries, urban centres, where majority of people live anyway.
> At -80C?
Absolutely. This is a solved problem.
You can buy dry ice at your local supermarket. I buy meat from a ethical farming operation that ships their product in insulated packages packed with dry ice. There's almost always dry ice left over. I made a bottle bomb out of the remainder once.
Every major medicine manufacturing company will already have had supply chains in place to deal with this for other medicines.
Storage is a red herring. It won't last more than a day in any given medical facility.
You can buy dry ice at your local grocery store. You can probably buy a cooler to put it in. And you get a week to use it after thawing, so if there is a break in the supply chain you only need to detect it and announce a vaccination clinic to that area. There might be some small town that gets 100% vaccination early on just because the truck broke down nearby and so local doctors were suddenly called upon to vaccinate their whole town just to use doses that couldn't be shipped any farther.
The linked video claims Pfizer has a similar solution and the currently tested parameters limit the cooler can only be opened 2x per day, and not more than 1 minute at a time, and the box only lasts 10 days, and carries doses in multiple of 1000s.
A breakdown scenario in a rural area could mean 1000s of wasted doses
No. There isn't the ability to deliver more supplies than needed - at least not through the end of 2021. Until then every dose is urgently needed by several people only one of who can get it.
I'll happily wager the UK and US will over-order and then tacitly use the argument you have made to say that African countries are wasteful and don't deserve their supply.
US and UK may over order, but they will not get deliveries. Medical companies tend to have policies in place that will distribute to Africa ahead of richer countries if the richer countries are not seeing outbreaks. Obviously there is more money in the richer countries, so the early delivery will skew that way. However once enough are vaccinated (from all potentially passed vaccines) that a country can safely open they will start redirecting vaccines to poor countries.
Once the world is open the US and UK will be happy to say that they were able to cancel some unused vaccine supply if it turns out not needed. (which will be easy - between focusing on poor countries and moving production to something else (or winding down) as they recognize the need is gone they will be willing to end those contracts not completely filled. Politically it is a money saving move.
Of course the above assumes best (or at least) case. There are many ways things can go wrong. If all approved vaccines need a booster every 6 months things will be very different. (this is an unlikely but still possible very worst case)
I can't think of a rural area that is more than 2 hours drive from a city large enough to take thousands of doses.
They should be able to put out a general announcement and get thousands to get the vaccine if they need to. A lot of people who can get off work on short notice if there is an emergency. Obviously not everyone, but thousands can be redirected to someone else on short notice. Of course this requires emergency shipments to those who should have got the original, but the breakdown would require that anyway.
I don't know what the thawing protocol is though - this is a real concern that needs to be handled. I assume those who deal with the logistics have plans and backup plans that account for all of the above.
My understanding is that -80c cold storage isn't widely available. The Ebola outbreak might have shown how to get small numbers of doses into a warzone, but scaling this up might prove to be a logistical difficulty.
"Once a provider receives that vaccine, it really starts the clock that the vaccine needs to be administered within five days of when it's put in the refrigerator"
Sure it is. Any small city (> 50,000 people) has someone who can get you liquid nitrogen in far larger quantities than will ever be needed (thus stuff is used for a lot of industrial processes). Put it in a cooler from wal-mart and you have a week.
Any you get a week after thawing it to use is anyway, so you don't need the cold storage where the end user is. I don't know what the thawing protocols are of course.
i'm involved in some state government COVID vaccine projects. The issue is you can't just knock together cold storage like this, there's (naturally) a long process to get "approved" and "certified" for vaccine administration. Storage is one of these criteria, they're not going to hand over a batch of vaccine to some doc with a cooler of dry ice.
Of course not. they need to ensure the cooler is packed correctly - those standards exist.
Those I don't think the doc even needs a fancy cooler, if I understand correctly they need to thaw this first, by the time the individual doc gets it they need to be thawing it and then using it quick. (I don't know what thaw procedures are though)
So I appreciate that liquid nitrogen can keep things cool. And I appreciate that it can keep things cooler than the required -80c. (Nevermind that keeping it inside of a temperature range might be important as well).
But I think you're overlooking something rather important: Storing liquid nitrogen in a vacuum flask only keeps the liquid nitrogen cold for hours or days. It doesn't keep the thing cold that you're cooling with liquid nitrogen.
The week you get to use it is after the dose has been created. If it's brought below temperature for any length of time, it can presumably DESTROY the dosages affected by temperature.
"Regular temperature monitoring is key to proper cold chain management. Store frozen vaccines (Varicella, MMRV, and Zoster) in a freezer between -58°F and +5°F (-50°C and -15°C). Store all other routinely recommended vaccines in a refrigerator between 35°F and 46°F (2°C and 8°C). The desired average refrigerator vaccine storage temperature is 40°F (5°C). Exposure to temperatures outside these ranges may result in reduced vaccine potency and increased risk of vaccine-preventable diseases."
While you may call it a 'solved' problem, in reality, its a problem that every single pharma company in the world wants to avoid, due to the high costs and other challenges.
Source: I work in vaccines, and our company works on thermostable formulations, among other things.
Not really, if every airport runs a vaccination program that takes 2 months before someone can fly there's very little need for more global infrastructure. The problem with lockdowns, etc is reinfection mostly by air travellers.
This maybe _was_ the problem in the beginning of the pandemic. Now, it's in the general population and will spread even if you ban all airplanes and repurpose airports into petting zoos.
We already know how to drop the R value in a given place. It is pointlessly expensive to do so for long enough to eliminate the virus in any place that is going to be reconnected to the air network until travellers have a very low chance of infection.
Sure some places will find total vaccination the best option, but places with out the infrastructure and money can simply do one lockdown that isn't compromised again by air travel.
China is an example that would have left the pandemic if not for the need to resume Air travel.
One other factor to consider is that this is an mRNA vaccine, which is of a newer generation of technology in vaccine production.
From what I've read it is the first large scale adoption of mRNA vaccines so the really long term risks are less known. That said, theoretically mRNA vaccines should have a lot of advantages. Later in 2021 there may be a few other options for vaccines to take as well, so I'd do some research at least.
https://www.jpost.com/health-science/hadassah-bringing-15-mi... Israel is bying Russian vaccine shots, the head of Hadassah hospital says there is quite a lot of power politics involved in the discourse (Hadassah is one of the major hospitals in Israel)
https://www.berliner-zeitung.de/wirtschaft-verantwortung/cor... (in German) for the EU some producers of COVID vaccines got an exemption clause for liabilities, they say because of very tight development schedules (says an unnamed speaker of the European Comission)
Only time will tell. But usually, vaccines will induce longer immunity than the real diseases themselves because they have been optimized for immunogenicity.
There will be no eradication of the virus, certainly not world-wide, short of multiple waves of vaccinations. Not even with one type of vaccine, but more likely more than one.
Some of the developing world might get vaccinated with a cheaper, more traditional vaccine, but later. But there is no good vreason why you can't have huge vaccination campaigns with cooling trucks at least in their bigger cities.
Note it is at least 90%. Case number is likely too low to give a tighter estimate with high enough confidence. That is, even if no one vaccinated is infected they still can't claim a much higher effectiveness with confidence as there are only 94 cases. So they are giving just a lower bound.
Long term protection will be achieved by a significant % of the population being vaccinated at any given time, yielding herd immunity. Exciting news for the world!
If they’re managing to do it with just temperature and maybe glycerol, that’s great.
If it’s RNAlater, then that’s going to have safety issues. If it’s something else, how was the additive tested for long term safety? (Vaccines like this have been in the works for a long time. There has been time for safety studies.)
I don't read safety sheets often so I'm likely off base here, so please correct me if I'm wrong. My interpretation is that when used correctly it's safe.
Section 2 states it is non-hazardous.
Section 4 states it is not expected to present a significant ingestion/inhalation hazard under anticipated conditions of normal use.
Finally, Section 11 indicates that the Ammonium compounds present in RNALater may be harmful, but only when they are administered at LD50 concentrations.
Yes. Pfizer have published info on their logistics, there are details in the wall st journal. Basic idea is a little box of ~1000 doses goes in a big box filled with enough dry ice for up to ten days. Average delivery time will be around 3.
The mechanism of action is known, so potential side effects are largely predictable. I'm not an expert, but I don't see any reason to think there would be unexpected long term side effects from this sort of vaccination. Is there reason to think otherwise?
There is always some effect whenever any foreign molecule is injected in your blood. Simply knowing ONE 'mechanism of action' doesn't tell you the 'mechanism of reaction' or all the other cross reactions that happen. It also doesn't tell you what will happen when some one is already on medication for other health issues. The body is simply too complex to many any definitive statement like that.
So there are many reasons to think otherwise, but the simplest one is - Every single medication and vaccine that we've ever made has known side-effects. Not all side-effects are known right off the bat, and many take years to detect.
Do you have any examples of a vaccine that's had side effects not show up for years after it went into use? I'm not saying there hasn't been—I really don't know.
Aside - I re-read my earlier comment and I don't mean to come off as a crazy anti-vax person!
I work in vaccines, but I can't think of a vaccine that was completely recalled due to long-term safety issues of the top of my head. Most recalls happen because one lot or the other had some production issues. Certainly, vaccines are extremely safe by the time they get approved - because the approval process is careful, methodical and takes years.
However, in this case, if a COVID vaccine is approved by the end of this year or in the near-term, we won't have any long-term data, and so I do worry about those aspects, about the compounds used in the final formulation as well as the untested nature of RNA/DNA based vaccines.
How do we know that there are no significant long-term side-effects? These vaccines seem to be developed so quickly while others take years or even decades... I do not know if this is irrational fear, but I fear that this is rushed and there might be potentially serious side-effects that are missed.
Why am I being down-voted? Is it really of no concern?
Short-answer: we don't and can't, since you'd need to use the vaccine for a long time.
Better answer: the vaccines are new but the individual systems used to develop them are not, and we have historical trials of a lot of the same techniques which show no long term risks. The biggest unknown has always been the risk of triggering a short-term, unexpected primary immune response that causes harm to the recipient. In the vaccines being developed, that has generally not been found to be the case, and since they're based on the virus currently infecting people we would not expect a response worse then that (which is to say: the components of vaccine use are all well studied, these are understood and safe materials).
The other issue is when we talk about "rushing" vaccine research, this does not involve shirking safety research - i.e. consider the influenza vaccine which year over year is basically a new vaccine we develop quite quickly. What it does mean is that you overlap the stages of vaccine development: normally if you have a P3-trial vaccine, you'd wait till that trial was successful before building the factory to make it. Instead, companies are being paid (or paying themselves) to build facilities and scale up production as soon as they get to the P3 trial stage - financially it's a huge risk, since what they have might not work, or might have an unacceptable risk profile in those trials - which means all the investment is a dead-loss.
This is where government steps in (and has stepped in in places): by guaranteeing the investment on getting those facilities out, it means if your vaccine works then you're ready to go and it's in production right away - as opposed to being another year to 2 years down the line while you work on manufacturing.
I just ignore the down votes. You probably hitting the target.
This is of concern. The medical industry has a history of covering up the direct know effects of their medicine, AKA poisons. That system has been know for a very long time to lead with arrogance and it sometimes takes them a very long time to pull things they know are killing people. Its just too much $$$.
I for one agree with you. There is no rush to get vaccinated.
Personally, I doubt I will get it at all. The authorities have a very long way to go to win back my trust, after the chain of screwups over the last year.
We've seen that they will lie to us, we've seen that they apply rules to us that they themselves don't follow, and we've seen them take advantage of the situation for their own benefit.
It is a huge shame that so many people are not going to take it solely because they've betrayed our trust so many times that now that they might be doing something good, we won't cooperate.
You are getting down-voted too by people who do not even bother replying, probably some blind followers, government-loving NPCs.
You know how you could turn this against them to make them think twice about it? Get the Russian vaccines, or the Chinese. Yeah, do it! Suddenly they are not so keen... Now imagine if their beloved State made it mandatory to get Russian vaccines inside them. They would most likely be against it, and our votes would not be down... It is not even the votes I give a damn about, but the fact that we do not know THAT much of COVID-19 but people seem to believe the claims that we have extremely safe vaccines ready just within a few months. Yeah, they say that of the Russian vaccines, too, are you going to take it, down-voter? Would you like the State to make it mandatory for your kid to get vaccinated? I am curious.
My entire family tested positive for COVID-19, and my grandma most likely has it. None of us has/had symptoms. I do not want to get vaccinated. If you (not you, the down-voters) really care, go get vaccinated by the Russian vaccines.
My country plans to vaccinate the elderly, kids, and people with chronic diseases first, then the rest of the population. I really, really wonder how many people are going to have FORESEEABLE side-effects. I think they are also planning to make it mandatory.
P.S. I am not an anti-vaxxer, but these claims by pharmaceutical companies sound shady as heck. If they said they found the vaccine after 5 days and they claim it is super safe because 5 people did not die from it within 10 days, would it make you OK the vaccine? Come on. My problem is that. It is too quick, and too many promises of lack of side-effects, and lots of financial interest. For that I do not believe them. We (medical workers) even have to lie about people dying from COVID-19 so we (the hospital) get more funding. How about that? Governments put price control on the tests, which resulted in zero competition as it was not worth it for private businesses to continue testing. How about that?
The current understanding is that there will be likely no long-term immunity, just like the flu virus (as it mutates).
> -80 Degree Celsius storage and transport needed.
This is actually typical for vaccines storage/transportation needs. Unfortunately this will also means that it cannot be easily distributed into developing countries where supply chain requirements are largely unmet.
No, they showed an antibody response in the spring. That's the easy part. This is the real-deal clinical trial: they gave tens of thousands of people the vaccine candidate, tens of thousands a placebo, and then counted the resulting cases for months, as well as watching for side effects. The 90% reduction is in actual cases.
Problem is it is all from a press release. They can mangle words to be correct but very misleading. We will have to wait for the scientific paper which will take some time.
The complexity of the distribution of such a vaccine on such a large scale will be a major bottleneck in a return to a society without imposed pandemic measures. A much less sexy and more human bottleneck, which permits of far more classes of failure of getting the virus to people well. The distribution is important work which we will see being the subject of much criticism. I hope everybody can keep their expectations in check. Getting working vaccines is incredibly important, but this is just the first step. There are no easy fixes - we'll be in this situation for the foreseeable future.
> - two doses needed, 3 weeks apart, immunity after one month from first dose. Slow rollout.
Yeah, this alone is bad news.
Last year my parents got a two-dose shingles vaccine. The two doses are supposed to be separated by two to six months. My parents struggled to find their second doses in the window. Apparently there was limited supply and no one had the foresight to reserve second doses when people received their first, or even to prioritize second doses over first.
The covid vaccine will have much more demand and apparently a tighter window, and our health system isn't exactly well-coordinated right now, so I anticipate a lot of people will be unable to get the second dose with the proper timing.
It will be an incredible challenge, but there is at least some economy of scale on our side.
Wendover did a nice video[0] on this topic month ago, explaining how UPS/FedEx/DHL/… are already massively upscaling their cold chain infrastructure. Retrofitting planes, building giant freezers in transport hubs.
Thanks for sharing this. I learned a lot from watching this video and I have another channel to subscribe to now :)
One thing that I found interesting was how they identified today's announcement of the BNT162b2 vaccine candidate (back in September) as one that would require the massive investment in cold chain infrastructure. They also highlight Pfizer's engineering of a separate series of cold boxes that would keep the vaccine at temperature for up to 10 days, thereby enabling it to be shipped through standard logistics networks. Great stuff.
US. I believe they got these vaccines through pharmacy chains like Walgreens or CVS. This is one of several ways people get vaccines here—it's common for seasonal flu shots especially to be available at employers (medical staff travel from one employer to the next) and pharmacies (sometimes even grocery stores with in-store pharmacies) in addition to the general practitioners' regular clinics. I think for the first dose they got it wherever was convenient—probably the pharmacy where/when they were picking up a prescription—and for the second they looked everywhere for months.
People are going to discover where they sit on the global privilege scale. 1.3 billion doses next year and 50 million this year. Let's call it 1.4 billion by the end of 2021. The USA + Canada will get half (USA gets 100M guaranteed and the option of an extra 500M). I assume Europe gets the other half based on the numbers I'm seeing that UK has ordered. Africa, Asia, and South America will probably not see meaningful levels of this vaccine until 2022.
Developing countries have youth immunity. When you convolve covid hospitalization / IFR as function of age with age distribution, developing countries have no risk whatsoever from COVID. that's why Brazil and India are nearing herd immunity with basically no serious medical infrastructure saturation. Median age in Africa is 19... No fks given. Covid vaccine is just for old people/developing countries.
Coronavirus: Overwhelmed India hospitals turn Covid patients away. Hospitals in the country are struggling to cope with the number of patients they’re getting. Many are dying without getting the treatment they need. https://www.bbc.com/news/av/world-asia-india-53014213
At the time of writing (2020-11-09 12:04 UTC) the article uses "90% of people" and "90% protection" interchangeably. I assume it means "90% of individuals achieve immunity", rather than "individuals achieve 90% immunity".
EDIT: See child comment re: Pfizer press release.
EDIT 2: See [1] for said press release, which has more detailed information than the BBC article.
If new pfizer's vaccine has similar numbers, e.g. 90% after two shots and 80% after one shot, can it be more efficient to just use one shot, considering current race with time since we need to deliver vaccine to billions of people? Are there numbers for protection level after one shot somewhere? I couldn't find it at first glance.
I think the parent is asking (if 1 shot of this vaccine confers 80% immunity) would it not be better (for the purposes of curbing transmission) to give everyone a single injection now for 80% immunity among a broader population rather than giving half the number of people two doses for 90% immunity. The implicit constraint is that it will take a relatively long time to scale up production and distribution to the extent that we can get two doses to everyone.
I am sure I misunderstood something, but what does that 80% mean, and how does it differ from "the data we currently have shows that one shot of this vaccine is not likely to convey a decent amount of protection."?
Yep, maybe they had some data about protection level rising since first shot, fewer people getting sick already etc.
It's hard to understand from just the Figure 4 how much of that increase is booster shot and how much is just level rising with time, too bad they didn't investigate this. Having top level protection vaccine with 2 shots is of course great and may be what you would be aiming for in "normal" times, but when it's race against the time trading several efficiency percents for quicker population coverage may be worth it.
Yep, J&J one is the only candidate requiring one shot. Hopefully it will show some good results soon as well.
Out of 45,000 people, only 86ish people got infected in the trial arm? Isn't that too few? Even for the control arm, that's still only 774 people infected.
That's not true, population size absolutely 'enters into the math'. 9 vs. 85 does not give the same result independently of whether N=94, 200, 2k, or 2B.
It affects confidence, and potentially the result of the test entirely. I won't be more specific because stats was never a strong suit and my memory's hazy, but I remember enough to know it matters!
I'm thinking that 85/21,750 or 0.4% of the controls developed the disease (vs 0.04% of those who received vaccine).
It does seem low for the US where you have 3% of the population had disease already in 2020. Perhaps more data came from Germany? Or it could be they measure not just PCR +ve results, but antibody levels and/or severe symptoms?
No, it's probabilistic, about the 'amount of protection' from or 'decrease in likelihood' of contracting it, which is why generally people are happy / would have been happy even for a much lower percentage - protecting ~everyone a bit is higher impact than protecting a few people a lot.
It's the same as 'herd immunity', where each member is '90% immune' and as a result the herd is 'more immune' than if only 10% of its members were 100% immune.
The variations are enough to have differences in infectiousness and to allow us to trace the spread a bit, but as far as we know immunity to any of them is immunity to all of them.
I think someone should clarify the strands vs. genetic variations here.
Because the reports from Denmarks Mink fiasco indicated that antibodies were not as effective on the mutation that appeared there short time ago. This would contradict the one-fits-all immunity argument.
Maybe there is a slight semantic misunderstanding here, but in fact a "re-infection" is defined as such:
A patient must present a infection and the particular virus must be sequenced, and then present with an infection later on where the virus is again sequenced and identified as sufficiently different from the first sample. Otherwise it cannot be deemed a re-infection.
If these small differences in the genomic sequence are already a different strand, I don't know, not an expert.
But all 5 (?) cases known so far had a different sequence identified the second time.
> The genomes of the patient’s virus samples from April and June displayed significant genetic differences between them, suggesting that the patient was infected twice by 2 distinct COVID-19 infections.
I’d read of known second infections that are from different strains, but scientists also question lasting immunity from COVID-19 infection because other coronaviruses are seasonal.
My take is that this is a "correlation does not imply causality" case.
It was possible to positively identify a reinfection because the two infections were due to different strains. That was just the means of positively and objectively identify a reinfection. However, nothing was asserted regarding if the patient was immune to the first strain the first time around. In fact, it seems that the hallmark of reinfections is that they are far more critical than first infections. This also means that the first infections is far milder than the second one. Well, the thing about the immune system is that it is able to fight mild infections without developing immunity if they are too mild to trigger a full response from the immune system.
"Hard lockdown" has drastic socio-economic implications.
"No lockdown" has dramatic/catastrophic socio-economic implications. The easiest to understand: In very short time the ICUs are overrun and people die. A lot of people die.
"Soft lockdown" depends on the people to play along. Which seems more difficult than the people in charge thought it would be (and some still don't believe).
Notably I am not arguing here for what the "right" choice is. It is simply not that easy.
With no intervention, healthy people start to die because they cannot receive medical care. There is a lot of COVID care going on in hospitals other than ventilation. Ventilators are somewhat of a last resort.
We are on track for COVID to have 10x the deaths of the seasonal flu, and that is after the effects of the significant interventions that have happened here and around the globe.
This is incorrect. When hospitals are overrun, healthy people can't be treated and die. The old and obese die in higher proportions even when receiving treatment, but healthy young people often need treatment to survive.
> but as far as we know immunity to any of them is immunity to all of them.
OK. The longevity of the immunity is also an issue perhaps; at least they have written articles about people becoming re-infected; so even the people who do become immune may not stay that way forever...
> so even the people who do become immune may not stay that way forever...
In my country there have been hundreds of thousands of confirmed Covid infections. There have been <100 confirmed re-infections.
It's very early to draw the conclusion that people in general don't build up lasting immunity, and there is more than enough data to support that most people do build up immunity of several months at least. If the latter wasn't true you'd see much more re-infections.
The reporting on reinfection is actually a pretty positive sign. If 10% or even 1% of people could be reinfected, you’d expect to see huge numbers of reinfections, so the fact that the news is still reporting individual cases of reinfection suggests it won’t be a practical concern.
Perhaps its something like "90% percent of the individuals' immune system are successful in quick eliminating covid without any symptoms or adverse reactions".
I admit I know very little on how immunity to diseases work, but I imagine that with viruses there is a chance it'll progress to a full blown infection even if you are vaccinated in some cases.
I would assume something like with the influenza vaccine, where you have immunity to i think around 70% of currently available virus mutations, if the vaccine works.
That's a percentage on a different axis. Influenza is a diverse family of related viruses and strains vary much more than those of SARS-COV-2. No surprise given the very different time since taking foot in humans, and in addition to that (I think, working on weak knowledge here) that influenza is even part of a group of viruses that is prone to create mashup versions of itself when two strains meet in the same host. Think Dangermouse, Grey Album.
The way these studies (most of the big trials finishing up soon, and this one too) are set up is that they measure the percentage of people that will not get symptomatic covid-19, so the only thing that is measured is whether they get symptoms or not. So the result is that 90% (within a confidence interval) of people who are given this vaccine will not develop any covid symptoms. Transmission may be impacted, and the data will reveal hints about this, but it's impossible to draw hard statistical conclusions about that, and in general a different type of vaccine technology will be needed to end transmission and thus the pandemic. This will save countless lives though, and may end lockdowns, so a great day nonetheless.
Unfortunately, there's yet another property of vaccine performance: some prevent the virus from reaching any level of footing in the host, others only make the body's eventual response stronger, preventing initial footing to cause heavy illness. SARS2-COV is rather peculiar in how its transmission performance is particularly strong in early, mostly presymptomatic stages, so it's perfectly possible to end up with a vaccine that reliably protects carriers from disease, but does not remove them from the spread equations at all, or only very little.
Neither of those. It means you don't get sick if you get in contact with the virus.
Whether that means you're immune (i.e. not spreading the virus to others) is a different question that apparently hasn't been answered by this preliminary data yet. (And I can see this is more difficult to study.)
There's no such thing as "Covid infection". There's SARS-CoV-2 infection, which often causes CoVID-19 disease.
Pfizer is saying that their vaccine is effective at protecting against CoVID-19 disease. They haven't said anything about preventing SARS-CoV-2 infection yet, as far as I can see. The difference is important, because there are vaccines (such as the Salk polio vaccine) that only protect against disease, but not against infection. People get infected and pass on the virus without ever getting sick, so there's no herd immunity.
Pretty confident it's the former, which if the case, essentially ends the pandemic in a month after it's distributed, given that the R0 would drop precipitously.
The challenge will be reconciling this with the antivax crowd given that as the vaccine rolls out the rate of infection will come down correspondingly among the whole population (including the unvaccinated). They'll immediately claim that the virus is "going away on it's own" as opposed to the truth, which is that potential spreaders are being steadily removed from the susceptible population due to the vaccine.
While true, the approach they took is extremely similar to several other vaccine candidates which is a good sign that the approach works and other vaccines will be equally effective.
Not withstanding the rather enormous caveat of antivaxxers. They have grown significantly in number during this pandemic what with all the wild conspiracy theories. It’s worth checking that out.
Which is completely sufficient to vaccinate the elderly, teachers, immunocompromised, and healthcare workers in the Western world, and probably anyone else who really wants it.
There's no need to completely eliminate COVID - we don't aim for the same for regular influenza. We should aim to reopen economies as soon as possible instead.
Why aren’t we using _all_ the factories to make as many doses as possible? There should not be “companies” making these to their capacity. This should be a public effort
I would guess that a lot of the factories that are capable of producing these type vaccines also produce a lot of other important drugs and vaccines that we can't just put on the back-shelf without even greater harm.
You first: why aren't you making this in your garage right now?
For the most part the same answer as to why you aren't making it yourself also apply to most factories in the world. Only a few have the equipment, supplies, and experience to make it.
We should be clear about the goalposts. Reducing the transmission rate to a manageable level will be very easy with even just some fraction of the population being vaccinated. What exact percentage is unclear, but it's a lot less than 100%. No realistic number of anti-vaxxers can change that.
Eradicating the virus is a whole different goal, and there could be lots of different impediments to that. After all, we still get vaccinated for a large numbers of illnesses that we haven't eradicated but are just very rare. That's not a terrible endgame for COVID.
Letting this thing circulate seems dangerous given it introduces the possibility of a vaccine-resistant mutation. If anything it drives the evolution of the virus towards vaccine resistance similar to what happened with MRSA bacteria and antibiotics.
Note that they provided 'Confirmed COVID-19 in Phase 2/3 participants without evidence of infection before vaccination [ Time Frame: From 7 days after the second dose of study intervention to the end of the study, up to 2 years ]'
as their primary outcome in their study registration
>I'm feeling a deep-seated wave of relief that I never thought possible. Like waking up from a year-long nightmare. Thank God.
Moderna is also only weeks behind Pfizer/Biontech here with a very similar technology and manufacturing capability of hundreds of millions of doses. We'll be seeing the first EUA's by December, and shots in the arm before the end of the year. Pretty incredible that we can just science our way out of things like this. Humans are awesome.
They're already manufacturing millions of doses of the drug and have been for months. The military already has an action plan for distributing it nation wide. Realistically they're ready to go right now they are just waiting for FDA approval.
Lol you vastly overestimate the capabilities of the US Gov and Military. I wouldn't be remotely surprised if you can't get a dose if you want one until well into 2021.
The US military is (to make up a number) 85% logistics. Supply chain management is the one thing they absolutely excel at. We can move troops and keep them supplied even in the most remote, most dangerous areas of the world. It's what the military does.
What makes you say this, other than a knee-jerk 'US-bad'?
Well the government has handled logistics related to covid horribly so far. They were completely unable to distribute tests, even months after there were tens of millions stockpiled. They were similarly bad at distributing PPE. They couldn't even get toilet paper distributed properly. Of course there are major differences here, but I don't have a lot of faith.
Government != military. The military has its own logistics command that, like the parent comment mentions, is unbelievably well tuned. Vaccines are something they do extremely well-- every sailor, soldier and airman in the entire 5 arm military needs regular vaccinations, even when deployed. Can't have GI Joe catching a flu, giving to the rest of the battalion only to sitout the rest of the conflict. All the stuff you need to safely distribute a vaccine, they've got, and know how to use it. Things like a chain of custody to keep cold things cold, and SLAs to meet perishable goods requirements, transport and delivery from remote locations with little infrastructure, the command and management to ensure enough supply gets to where it needs to be, etc. From what my friends who served in the Navy & Air Force said, they don't fuck around with vaccines. You get lined up, jabbed or misted with the vaccine and sent on your way. There's no reason they can't scale up from hundreds of thousands of soldiers to millions of civilians.
Equipment can be bought. Cooling containers are not only available for every mode of transportation, they are standard and people handle them daily, even for air freight.
Other Good news: The cold transport requirement has been a known requirement since beginning of development, for at least the Moderna and Pfizer vaccines. And the Moderna and Pfizer vaccines have been among the leading candidates since March.
You probably won't get a dose until late 2021. This is because you are probably not in a high risk area where you can't isolate effectively. The first shots will go to doctors/nurses, moving down a risk scale. Next is up for debate.
I'm sure my company will do everything they can to ensure factory and retail workers will be next. Factory because shutting down our factory would be a disaster to our finances. Retail because all employees who are supposed to not go anywhere still get groceries, so protecting those workers reduces are contact. The the CEO is next, probably only slightly above the rest of us office workers who can stay home.
The problem is that "late 2021" is a date you just made up. The people deeply involved in vaccine development are talking about Spring and Summer of 2021 for a return to normalcy, with widespread vaccinations starting before the end of Winter. This is from people are Oxford, Moderna, various governmental health agencies, including our own reliably conservative Fauci. Where do you get "late 2021" from?
I made a somewhat educated guess. I'm not as educated as the people you name, but they too are just guessing. I'm trying to be reasonable though, and I don't have any reason to spread an optimistic hope.
If this is the only vaccine that passes trails - well they can't make it fast enough for a late 2021 opener. If some of the others also pass trails then early 2021 is a possibility (so long as you don't have some reason to prefer a specific vaccine as opposed to whatever you can get first)
I'm fine not getting a dose for months because I'm not in a high-risk group, and not working with high-risk individuals.
If we can vaccinate hospital workers and high-risk individuals, that will already make fatalities go down very quickly. That will help us get out of confinement faster.
Is getting COVID safe long term? There are plenty of viruses that cause issues in the long term. HIV causes AIDS, HPV and Hepatitis cause cancers years later. We have no clue on the long term effects of SARS-Cov-2, other than that it causes COVID-19 in the short term.
It's a choice between the pest and the cholera at this point.
edit: so the whole world is studying this virus 24/7 for almost a year and nobody detected anything, yet you think it might give us aids v2 ? Feel free to link any study that hints to anything remotely going in that direction because I couldn't find anything at all.
I'm guessing you're saying that based on the number of people that remain asymptomatic &/or don't die, but you are incorrect.
We already know there is a strong possibility the virus has a negative effect on cognitive ability even in people who don't get any serious symptoms [0]
Those might go away. They might not. There could be other effects we're unware of. What we do know is that you're unlikely to find any expert on this who will unequivocally say "no longer term effects".
Pre-print or published or not, it presents evidence that shows it's incorrect to assert there are no longer term effects of COVID. Even if peer review shows flaws that invalidate this particular study, research into the full effects of COVID are still underway, and we simply don't have the data required to assert "no longer term effects for most people"
> so the whole world is studying this virus 24/7 for almost a year and nobody detected anything
I think you might overestimate what we can detect, when it comes to how viruses interact with a living human body. Yes, the whole world is studying it 24/7, and we really do not have a clue on long term effects. Science is pretty good, but some problems are pretty difficult too.
30 years ago, we could not have this ubiquitous testing capability and probably could not develop these tests at all. 10 years ago, we would definitely not have this vaccine one year after patient zero. Today, we really have no clue on long term effects until they happen on a statistical scale. Science and biotech progress rapidly, but there are still a lot of things we can't do.
It's amazing how people have consistently acted throughout 2020 as if coronaviruses are entirely new, never seen before and everything known about the immune system or viruses has to be thrown out.
People have been getting infected with coronaviruses of various kinds for millennia. Nobody has ever linked a low severity cold-like infection with long term severe consequences, and given the sort of longitudinal study that would be required to establish such a link, any such claims would need to be treated very carefully.
It is amazing how wannabe public health experts, with zero expertise in virology, are failing to understand that difference just in handful of nucleotides may make the pathogen a completely different beast compared to its nearest relative. And we are not even talking about the nearest relatives, common cold coronaviruses diverged like many thousands years ago from the SARS1 and similar viruses.
Nonetheless, the original SARS-1 (which is way closer to SARS-2 than say OC43), is known to be causing long term, debilitating health complication among significant number of survivors.
It's not a completely different beast, is it? It's basically like a regular flu or severe cold, and yes rhinovirus can be deadly to the elderly, it's just nobody normally notices or cares because rhinovirus isn't "new". If anything it's actually less bad than flu because flu kills children too and this one doesn't.
Nonetheless, the original SARS-1 (which is way closer to SARS-2 than say OC43), is known to be causing long term, debilitating health complication among significant number of survivors
And yet it didn't turn into a worldwide outbreak, so one must ask how much value this classification scheme actually has, given that SARS-2 is really nothing like SARS-1 in either infectiousness nor severity.
I usually stop arguing when I know that no one reads the discussion, because it is pointless at this moment, for the reason of me having no intention to convince you in anything, if you fail to see obvious things. I think we need to stop - no one is reading our conversation anyway.
Sure we do. mRNA vaccines have been under development for over a decade now. And while none have been approved for human use yet, it's not for lack of safety data. There have been zero serious adverse events reported in the Moderna or Pfizer phase 1, 2, and 3 trials. The only side effects are mild fatigue, headache, and soreness that you would associate with an immune response. Furthermore there is no possible way that the vaccine can even cause long term effects; the mRNA breaks down naturally in the body almost immediately. Any side effects will be immediately present and related to acute immune response. Worrying about some vague long term "what if" problems that have no mechanism for action is just non-scientific magical thinking.
This is not how drug approval works. This will be distributed on a planetary scale. Even 0.001% of side effects can be a big issue at these scales. history actually has lots of evidence of "unquestionably safe" drugs, causing lots of pain eventually - read about Thalidomide, Aspirin and Reye syndrom etc. There is also chance of ADE, a very complex unpredictable phenomenon, which was present with the original SARS vaccines.
I think bringing up ADE is fear mongering at this point. In vaccines where we’ve seen ADE we usually see it in monkey trials and if not there, we see it in phase 3. SARS vaccines never made it to phase 3 because we kept seeing ADE early on and then it died out. To keep bringing it up at this point, when none of the hundred or so vaccines have seen it, seems a little ridiculous.
I agree, SARS-2 does not seem to produce ADE. However, it might be rare, but if it is there it is often fatal. On global scale this might be important.
>There is also chance of ADE, a very complex unpredictable phenomenon, which was present with the original SARS vaccines.
Again, apples and oranges. This is a completely different class of drugs compared to SARS vaccines from a decade ago. Those were based on live viruses, which the mRNA vaccines are not.
And? How can you make these kind of claims it has not been verified? Just because the mechanism is different it does not mean it is free from ADE. ADE is result of using improper antigen for creation of immune response. mRNA is not an antigen, the protein produced from it is. If you choose wrong antigen, and deliver it in any possible way, it will still create wrong immunity and will result in ADE.
It's kind of annoying to have to be fearful on public transport, having to avoid infecting older family members and therefore not seeing them, and much else. Then there's the risk to yourself with COVID, which varies based on your lifestyle, age, and good/bad genes. Clearly some percentage of the population die, and a bigger have long-term very unpleasant effects.
On the other hand, the vaccine can be discovered, 12 months from now, to cause an autoimmune reaction in some people and their immune systems attack their joints or something.
I think this pandemic teaches us all one thing - almost the entire world of understanding can be boiled down to probability.
There have been a few cases. However we think we understand why they happened and so it won't. Anything is possible.
If you are a doctor/nurse working in a covid ward we know for sure that the risk whatever happens long term is a lot less than the risk of getting covid. For someone like me who has no reason to go anywhere (I'm not even allowed in the office until this pandemic passes) I can afford to wait until there is more data - and I also have to because I'm low on the list of those who will be vaccinated because I'm relatively low risk of getting it.
I have no idea, that's why I am asking. I'm hoping someone could clarify with decent knowledge on the matter.
I vaguely remember this story (from years ago) about a drug or vaccine during the 70s, where apparently everything was fine but then kids (or kids of kids, can't remember) ended up with birth defects.
Be aware of availability bias here. If a medication did not make it into the news because of problems, we are a lot less likely to have ever heard of it.
Agreed. But in the case of Primodos, there were cover-ups with government involvement for decades. The end result was that Matt Hancock apologized. That was it. No holding to account. No fixing the system so it wouldn't happen again. That's what undermines my confidence in the system.
A more relevant example is Pandemrix, a flu vaccine launched in the EU in 2009. A year later it was discovered that it seems to increase the risk of narcolepsy in teenagers sixfold. The vaccine was produced and licensed in an expedited fashion because of a "pandemic" (of swine flu), which used a then-new and slightly experimental technique (adjuvants) which interestingly, German doctors flagged up as a risk and suggested the German government use a different H1N1 vaccine that was less experimental.
the people in the trial are the first batch. these vaccines are following all the standards we have set for vaccines just at an accelerated pace and with accelerated funding. i know a lot of people who are hesitant about this shot, but it does sound antivax to say you aren’t sure it’s safe
That 'just' is where the valid concern lies. Nine women cannot make a baby in one month, and one important reason vaccine trials take the time that they do is to observe for side effects within the test population. You can't give ten people a shot, watch them for a month, and draw conclusions on the effects that will show up in an individual in ten months time.
There is no shortcut for that, and there is an obviously huge pressure to cut corners.
I'm definitely not antivax. I've gotten pretty much every common vaccination. In my view there is a difference between antivax and a new drug or vaccine that has not been widely tested.
Yes, this is an incredible scientific achievement. Before calling all humans awesome, I have to point out though, that there are a lot of countries which managed the pandemic really well, especially in Asia, but most western industrial nations quite badly failed at this. A faster and better reaction to the outbreak would have helped a lot. Both with all the casualties which sadly were the consequence and with the ability to eradicate the virus via vaccinations.
Why is this a Biden vs Trump issue? They both have campaigned on Covid19 relief. Just because Trump isn't unconstitutionally forcing lockdowns, testing, & contact tracing doesn't mean he isn't doing anything. Pfizer and other vaccine makers got assistance with expediting their vaccine R&D, approval, & distribution as part of Trump admin's Operation Warp Speed. https://www.hhs.gov/about/news/2020/09/16/trump-administrati...
Trump was one of Big Pharma's biggest enemies and even got them to lower the drug prices. That was a big, big no-no. So it's no surprise that they hate him so much.
No, it won't. they are projecting 50 million doses to be ready in 2020 and 1.1 billion next year. That means that mom and dad and grandma are likely to get it within the next few months and that by mid next year, you'll probably have access to it if you are a healthy thirty year old.
Those 1.1 billion doses are not for the US alone. The vaccine was actually developed by Biontech in Germany before Pfizer was involved. Pfizer is the partner to scale up the studies and production. But you can assume that those doses are not US only. And then I'd doubt that a healthy 30 year old will get it in summer of 2021.
I believe 300M of them are accounted for by the EU vaccine purchase program. That said, it looks like those doses will be made in Europe; Pfizer seems set up to make it this in multiple facilities, which is a good sign.
Indeed. If you're in a low-risk group - no comorbidities, under 35 years old, not working in a front line role that exposes you to Covid, it's going to be a long time before you get the vaccine.
A vaccine is most effective if it manages to break chains of transmissions. That means you'd want to optimize for likely chains of transmissions, and not only for giving it to those vulnerably to the virus.
So grandma might need to wait, and the grandkids going to school might get it first, then healthy 20/30-somethings working in public facing jobs etc.
Look, I get that you find lockdowns an inconvenience but the real world isn’t a TV show where a cheap and easily distributed cure will be invented 10 minutes before the end of the episode. People will reliably die until a vaccine or highly effective treatment is widely available, and the only way to slow that is to rely on proven public health techniques.
While you’re being inconvenienced remember that you’re better off than most people who’ve ever lived. Isolation and fear of early death were a pervasive part of life until the 20th century brought vaccination and antibiotics, and we’re getting only a small reminder of what used to be normal.
The lockdowns are causing immense economic damage. Even the WHO has pointed out that one of the main things they do is make the poor poorer. I have a feeling that this cure will cause more damage than the virus.
This is a common misunderstanding encouraged by certain politicians but it’s misattributing the cause: the pandemic is causing the economic damage. Most of the businesses worst affected are ones like restaurants and bars, which were going to collapse as soon as their customers realized that patronizing them is inherently risky. For example, Sweden famously didn’t have lockdowns but still saw a major economic decline - perhaps a little better than some other countries in Europe but still ruinous without government bailouts. Even if it’s legal most people will change their buying habits.
The other mistake is assuming that this is endless. Countries which have strict safety measures are able to reopen after having controlled spread - Australia had a hard lockdown and has now gone without any cases for a while. In contrast, the United States’ leaders chose to squander the sacrifice of the spring lockdown by not making it effective and then relaxing restrictions before the viral spread was controlled, ensuring the maximal cost for minimal benefit.
You criticized the commenter for objecting to lockdown. Why are the people you refer to dying? Is it possible it is because they aren't quarantining and staying at home?
Until we have an effective prevention or cure, we have to reduce the chances of catching it, especially during the period where people are spreading it before they show symptoms. Since it spreads mostly from prolonged time breathing the same air, the point of lockdowns is preventing those situations from arising. Quarantining after you become symptomatic is too late and without legal weight too many people won’t avoid situations to stop community spread.
That matters because there are things that you have to do, and you don’t have a way to control other people’s decisions. Closing high-risk recreational activities means that someone can go shopping with less risk because the people near them weren’t hanging out at the bar the night before.
The vast majority of Americans live in households where someone has to physically go to work in order to feed their family. Many others must leave their homes to purchase basic essentials.
The value of a lockdown isn't in changing the behavior of those who are already voluntarily avoiding exposure -- its value is in changing the behavior of those who inconsiderately spread it to others during their essential travels outside of their house.
“ Latin American countries have long had some of the most scarring income inequalities in the world, and they are predicted to worsen. The informal labour market is huge, making up 54% of all work across the region (up to 70% in some countries, such as Peru). Informal workers have little access to social protection and have no choice but to continue to work daily to earn a living. The result is that their capability to follow quarantine and social distancing measures is limited. Informal workers also have less access to health care.”
…
“The increases in obesity and diabetes in Latin America are surely major contributors to the high mortality rates. In Mexico and Chile, more than 75% of the female population is overweight. Nutrient-poor and energy-dense processed foods are often the only type of food readily affordable to the most disadvantaged people.
Although some countries, including Brazil and Costa Rica, have a universal health-care system, most Latin American countries have large gaps in accessibility caused mainly by out-of-pocket health expenditure, which is 34% of total health spending.”
It's difficult to say because most places did lockdown. Everyone expected Sweden to Spiral out of control but they didn't. Neil Fergusons models predicted an order of magnitude more deaths there (https://www.aier.org/article/imperial-college-model-applied-...) .
"Sweden had more deaths than Norway and Finland" yes they screwed up sending people to care homes when it first hit - over half of their deaths occurred there. like most of the countries that got hit early. Plus a lot of dark skinned immigrants (vitamin D levels have been shown to be a big factor). Those alone account for a lot of the difference. There is little reason to believe that lockdown had a very positive effect.
Neil Ferguson is a popular target by people misrepresenting his research. There’s a reason why you’re citing a self-published essay by a guy with no relevant experience who gets a paycheck from the Kochs for general right-wing activism rather than peer-reviewed research by someone with public health or medical expertise.
Hypothesis about why Asia and nearby countries got affected so much less than the West, with what seems to be a decent data analysis. TLDR, exposure to bats in these countries and travel between them.
Victoria had an exploding case count that was set to match the rest of the world before the government did a hard lockdown. And not just the feel good ones they do in the US, the lockdown meant you could only leave the house for 1 hour a day for exercise within a 5km radius and anyone who absolutely had to leave the house had to show proof and wear a mask. The case count fell sharply only after these measures were put in place.
Nobody can 100% stay home. The more every does though the better the less than 100% works. When someone getting their prescriptions refills gets it they are just as sick as someone who goes to a bar and gets it. The only difference is someone who goes to a bar is out a lot more and so has a higher chance of getting it.
Actually, no - if one follows the 'religious logic' as you call it, we live in a Fallen World under the dominion of Principalities and Power of Darkness. It is from there that the virus came.
The 'God will smite thee' beliefs largely came about as a form of control over people, and do not line up with New Testament biblical teaching.
3 “You shall not eat any abomination. 4 These are the animals you may eat: the ox, the sheep, the goat, 5 the deer, the gazelle, the roebuck, the wild goat, the ibex,[a] the antelope, and the mountain sheep. 6 Every animal that parts the hoof and has the hoof cloven in two and chews the cud, among the animals, you may eat. 7 Yet of those that chew the cud or have the hoof cloven you shall not eat these: the camel, the hare, and the rock badger, because they chew the cud but do not part the hoof, are unclean for you. 8 And the pig, because it parts the hoof but does not chew the cud, is unclean for you. Their flesh you shall not eat, and their carcasses you shall not touch.
9 “Of all that are in the waters you may eat these: whatever has fins and scales you may eat. 10 And whatever does not have fins and scales you shall not eat; it is unclean for you.
11 “You may eat all clean birds. 12 But these are the ones that you shall not eat: the eagle,[b] the bearded vulture, the black vulture, 13 the kite, the falcon of any kind; 14 every raven of any kind; 15 the ostrich, the nighthawk, the sea gull, the hawk of any kind; 16 the little owl and the short-eared owl, the barn owl 17 and the tawny owl, the carrion vulture and the cormorant, 18 the stork, the heron of any kind; the hoopoe and the bat. 19 And all winged insects are unclean for you; they shall not be eaten. 20 All clean winged things you may eat.
Is this really a "correction"? It's not as though other parts of the Bible (or Koran) explicitly repeal said forbiddance (even though the most popular interpretations prefer to see it that way)
Seeing the light at the end of the tunnel means it's more important than ever to isolate and stop this third wave ASAP.
It's hard enough to see loved ones die or to suffer life long side effects if lockdowns only delay it. But to have it happen just a couple months before a vaccine was available would be incredibly hard.
The prospect of a vaccine should make isolation much more bearable mentally. We're past halfway, folks!
This is not a panacea, it will still take time to fully vet the data and it will likely be months before doses start going out and even more months after that until sufficiently large numbers of people have been inoculated before we can even approach normality.
"it will likely be months before doses start going"
Where do you get that it will take "months" between emergency approval and actual vaccinations? The communications out of the leading vaccine teams clearly state otherwise.
True. But seeing a potential path towards making a sifnificant dent to the uncontrolled spread of the virus is a welcomed respite from nearly a year of darkness.
EDIT: I upvoted you because you make a valid point. Things will not recover overnight. But at the same time, we can still celebrate the hope of a promising solution.
One of the lead doctors in the UK is saying life will start to look normal in Spring 2021 (albeit, I assume he was referring to the UK alone). There's good reason for cautious optimism & patience.
Science has done its job; now we need to push for coordination between infrastructure, government, and business to finish it.
>One of the lead doctors in the UK is saying life will start to look normal in Spring 2021 (albeit, I assume he was referring to the UK alone). There's good reason for cautious optimism & patience.
I'm sure they have no incentives to say that right. The reality is that the UK and many others are in the middle of a massive surge of cases. The idea that life will be "normal" a few months from now in Spring seems farcical.
depends. If this provides spread prevention as well, then places can start opening up in about 6 months as enough locals get vaccinated as to slow the spread to the rest. On the other hand if this provides only some immunity but you are more infectious (ie the body doesn't fight the virus off, just makes it less dangerous - I don't think this is possible but....) we can't open up for years as anyone vaccinated is a risk to everyone else.
Of course there are other vaccines in development. If any other them pass trails that changes things too. we can only speculate as to how.
No matter what though, there is now a real light at the end of the tunnel.
I'm glad we are going to have a vaccine, but I'm not so happy about 90%
I have built up in my head the idea of all the things I'm going to do 'once I get vaccinated', but at 90% that gets pushed off to "once most people get vaccinated". If it were by myself, I might push my luck. But I want to do those things with friends, or family. .9^n is pretty shitty odds once n gets to around 5.
There's a sort of rhetoric that's pointed out by 'Thinking, Fast and Slow' as a warning sign for agendas, and I've seen a bunch of them used by both sides this election cycle. But at the same time one of the defenses against these rhetorical devices is reframing: rephrase the bargain from another context and see if you'd still accept it. They don't seem to reconcile that in public discourse this reframing happens in public.
"If I go out for steak, I'm probably okay at 90%," versus, "If we have our family reunion at Disney World, there's a 50% chance we're all going to be attending a funeral in a month, even if everybody got the vaccine." You could call the latter shrill, sure, but "there's a 50% chance everything will work out fine," is self-deception. You're trying really hard not to look at all of the potential, statistically significant outcomes.
> "If I go out for steak, I'm probably okay at 90%," versus, "If we have our family reunion at Disney World, there's a 50% chance we're all going to be attending a funeral in a month, even if everybody got the vaccine."
How in the heck do you arrive at a 50% chance of someone dying? You might argue that there's a 50% chance of someone getting the virus (that's really debatable, it's not highly contagious), but even if someone did, their chance of survival is several orders of magnitude higher than 50% unless they are in a high-risk group...
0.9^n are the odds where you all go and get exposed simultaneously. When a large enough portion of the population is vaccinated, that prior probability goes way down.
I wake up long time ago when I realized the virus is not as dangerous as the media reported it. You too should wake up right now and live your life. Stop being afraid.
Three of my dead family members (edit for clarity: not my immediate nuclear family, but people I'm still close to) don't feel the same way (nor do those who were impacted by the hundreds of thousands of excess deaths in the US), but I'm glad you've found this whole thing to be overblown.
In my whole life (and I'm not young anymore) I have never known or been acquainted with someone who died of the flu. And I've also never known anyone who were still completely out five months after they had the flu, unlike a couple of young friends of mine who got Covid in March. One of them (<30) couldn't do a thing until October.
If my parents get the flu it's extremely likely they'll be fine in a week or two. Covid would be a completely different story.
That's such an excessively tired, debunked, and often (but not always, and not necessarily in your case) bad-faith contrarian talking point that this far into the pandemic I can't be bothered to get worked up about it any more.
Who said I was afraid? I'm literally locked in my house in England, and all of the pubs are shut, and I'm banned from hanging out with my friends or my family. I want all that to end. I want to get back to seeing the world and going to festivals and for everyone to be able to do the same. I want my elderly grandmother to be able to see us again without worry. It's nothing to do with me being afraid.
Oh bugger off, I'm not getting into the ins and outs of the safety protocols I've been observing my for seeing my grandmother on hacker news. I'm relieved about the vaccine. You do you.
I am as happy about the progress as you are, don't let these people bother you. I would also not endanger anyone else by giving in to my impulses for the instant gratification of having a beer with some buddies. This is going to be over one day and all we need to do is not make things worse in the meantime.
(Behaviour in these times seems to be a good indicator who has got some self-control and who has not, I think)
Why shouldn't I be afraid? If my parents get infected there's a close to 100% chance that they'll die, due to their existing conditions. And I have to visit them, so do others. There's a real risk of infection there.
Maybe you should be, but if they are in bad shape, the 100% figure will apply to many diseases. On a long enough time line, they will of course die, just like you and everyone else.
I see my parents regardless. They are happy to see me. There are always a risk of some kind regardless of covid. My parents are old too, they have high chance of death and likely also have some kind of existing condition. Covid or not they have high chance of death at anytime.
>I wake up long time ago when I realized the virus is not as dangerous as the media reported it. You too should wake up right now and live your life. Stop being afraid.
This is really exciting news. How did you find out? Shouldn't we alert the public?
But each new person who gets it is a potential spreader, which increases the likelihood of an at-risk person getting it. Someone who may be elderly or immunocompromised, who can be seriously hurt or killed by it.
Given the level of lockdowns we've seen so far, that is minimal. Especially if the government is smart enough to simply pay the wages of people who are forced to not work (which would also give a massive boost to the economy).
Do you understand that it is not percents? Those are ratios? Do you realize that for 70+ IFR is 5%, and for 50-69 is 0.5%? You can consider anything I cannot force ypu to tyhink otherwise, but something that kills 1 in 18 senior citizen is something of extreme public health concern.
Of course the number seems high if you focus on a particularly vulnerable group. All that matters is the IFR across the entire population, as the entire population is being harmed by lockdowns.
I know its a ratio. You can consider it too high/extreme, I cannot force you to think otherwise. I'm not against doing something about it. What I'm against is if the answer of 'doing something about it' is lockdown. To me this cure is worse than the disease.
I initially thought so too, but there are some big losers in the market today - think home delivery (Ocado) , entertainment (Netflix), and more interestingly specialist Covid test suppliers.
Zoom took a hit partly because of this, and partly because of an FTC settlement that is requiring them to beef up their security and open themselves up to security audits, as a result of them basically lying about how their encryption worked.
Based on this NYT article [1], some logistics companies planning to store and transport the vaccine are using freezers from Stirling Ultracold. It may just be a curiosity, but their freezers (as the name would suggest) use bona fide Stirling engines rather than the typical two-stage compressors used in most ULT freezers.
As someone in life science research who uses plenty of -80 freezers, I've always been curious about Stirling Ultracold. Maybe they're on to something after all.
Nit: Stirling cryocoolers, not Stirling engines. Thermodynamically, it's just reversed. You're driving mechanical/electrical power in to get a thermal difference, not dissipating a thermal difference to get mechanical work/electrical power out.
gas-liquide cycle freezers typically do not have enough of a temperature gradiants to work. Normal freon (R-whatever you have heard of) don't get cold enough. That isn't to say you can't make one, but stirling cycle is not much worse so just use it.
That company couldn't be more irrelevant to the discussion. They specialize in keeping airplane food at between +2c to +8c on the tarmac in places like Dubai.
Probably the airlines who will both be dealing with the logistics and be able to return to BAU quicker because of the vaccine. For example, American Airlines is up 25% premarket today and IAG (owner of British Airways) is up nearly 30%.
Dry ice manufacturers may be a better bet. Hard to change -70C/-80C freezer manufacturing capacity, but pretty easy to pump out more dry ice or LN2 for storage.
Since you mention it ... it's kind of hard to buy anything. I couldn't log in to my Schwab account this morning [1], and others are reporting problems with TD Ameritrade/Scottrade as well, and it seems to be affecting other brokerages, due to this high trading volume/volatility.
this is the only investment I find possibly useful. Liquid nitrogen is so common in industry that I don't think there will be a problem sourcing enough just from spare capacity.
The places that would need to worry about building cold chain infrastructure capacity probably won't have the cash for permanent installations on top of the money they'll need to buy the vaccine.
Better to invest in companies that make and lease refrigerated semi-trailers, I'd think.
Not really. Pfizer has bet big on this by preemptively manufacturing the vaccine. They're already filling freezers. Unless you're referring to the freezers some less equipped distribution centers/agencies will need you acquire?
A bit late; these companies already have vast stocks of the vaccine ready to be deployed once they get greenlit. They will be getting - and have already received - orders and reservations for tens, hundreds of millions of units of a potential vaccine, awaiting testing and approval; see https://www.dailymail.co.uk/news/article-8852159/The-video-w..., citing they're aiming to produce 1.3 billion doses next year.
They've made a terribly flawed assumption which drives that 90% number. VE is modeled using a beta binomial model with a fixed prior of an infection rate of 1.5% per year. Obviously this number is going to vary a lot depending on the sample. [1]
By putting a fixed point vs the appropriate wide ranging distribution as the prior, the model scores the results far higher than otherwise.
This is a non-result and it was wildly inappropriate to publish this as proof of any finding.
I don’t think that’s what the report is saying: The 1.5% is used to determine how long the trial will take to reach the required number of cases. Not sure what prior they were using, but my guess is that it’s conservative.
As far as I can tell attack rate assumption is there only to calculate desired sample size, and statistical analysis of vaccine efficacy is independent of attack rate assumption.
It seems to me exact prior is unspecified in protocol. The usual choice is uniform prior.
I agree that these people should be lauded for their achievements, but nowadays fame comes at the expense of 24h/day scrutiny of everything they ever done or did or said, which just fuels the fire of all those Cardinal Richelieus who are hell-bent on persecuting what they perceive as threats and reactionaries. I wouldn't wish that upon anyone.
Yep, scientists at this level are far too busy and obsessed with their work to have any interest in celebrity. I‘m sure there are a few exceptions, but I suspect they would rather be left in “peace“. They already have enough undergrads and unemployed post docs bothering them without the public‘s attention!
The markets? Spare me. What are the markets, a handful of rich in banks and large corporations? They are neither wise nor competent, why should every news story be suffixed by how "the markets" (swt) react?
> What are the markets, a handful of rich in banks and large corporations?
Glad you asked. No, "the markets" are not simply a handful of rich people, banks and large corporations. The markets are also more than just "stocks."
In fact, the majority of "the markets" is actually bonds, and most of those bonds are debt issued by nearly all the countries of the world (sovereign bonds). I think roughly 80 Trillion dollars, but don't quote me.
If you live in a country with roads, infrastructure, buildings, etc.--then the markets are responsible for everything around you.
But you seem to be complaining about stocks since they get the most media attention, so let's look at those.
You may not realize it, but the future of every single country with a socialized pension system, sovereign wealth fund, etc. depends on the returns of global stocks. They make up only a portion of most pension portfolios, but deliver nearly all of the returns. Everybody has a stake in them even if they don't realize it.
Are the markets all-knowing or perfectly efficient? Of course not. But it's literally the only place where you can measure how a global herd of humans are feeling about the state of the world at any given time with a single number. This makes it a default reference for journalists to cite, ie. "thing happened, this is what the humans and their algorithms collectively think about it."
The journalists are often wrong and don't understand what's happening, but this case seems to be pretty straightforward.
>If you live in a country with roads, infrastructure, buildings, etc.--then the markets are responsible for everything around you.
See, this kind of thing really gets to me. Here's you circa 1290: "If you live in a fiefdom with wells, irrigation, castles, etc. -- then your Lord is responsible for everything around you." See how fallacious that sounds when you transpose it this way?
The central issue is that you're justifying a thing from the context of the thing itself. You're explaining modern capitalism from the framework of modern capitalism. It's circular, and you get ridiculous things like "the markets built the roads". Ahm, no, workers built the roads!
>Are the markets all-knowing or perfectly efficient? Of course not. But it's literally the only place where you can measure how a global herd of humans are feeling about the state of the world at any given time with a single number.
They are a weighted way of seeing how some humans are feeling about things. A number that gives as much weight to 8 guys as it does to 3.7 billion. It's a pretty shitty indicator, I'd say.
> "your Lord is responsible for everything around you." See how fallacious that sounds...?"
Of course it sounds fallacious--you've constructed a straw man out of my original argument.
There's nothing circular about the concept of debt. It's a fundamental aspect of how our economy works. The way debt is raised is through markets. Again, this is not a controversial or political statement.
Of course workers built the roads. And they were paid to build those roads by debt raised via bond markets. Governments and organizations use debt to bring the future into the present and amortize large investments over long periods of time. The liquidity and demand for this debt in the global markets allows them to do this.
No marketplace for debt = no way to reliably execute big infrastructure projects for all but the richest of countries. The market (the demand for debt) is literally the enabler.
Nothing I've said here is a mischaracterization of reality.
> It's a pretty shitty indicator, I'd say.
Again, I'm not advocating that short term financial market gyrations have any explanatory power for the future. I'm simply explaining why journalists use it: because it's easy.
That's me again, but doesn't preclude my success...
However this 1995 paper (1) indicates that the S&P 500 behavior does "Granger Cause" changes in USA GDP. i.e changes in S&P 500 does predict changes in GDP from 1 to 3 quarters out. So that's the one legitimate reason to be encouraged by rising markets. Perhaps the woman who cuts my hair will be able to get off food stamps by spring.
Which is too bad. I'd rather have a pension and be assured of my income for however long I live than have to figure out how much to leave in my account for a future that I might not live to be old enough to enjoy.
Are you suggesting that the signal of the markets today has zero corellation with the promise of this vaccine? That seems like quite the position to take.
Or are you lamenting that much attention is given to something that is primarily driven by wealthy organizations? I guess I might sympathize with you there.
I'm not a vaccine expert, so when vaccine news comes out and the broader market reacts extremely positively to this news it just gives me confidence this is the real deal.
There has been other vaccine news in the past which my friends/family talk about excitedly but the broader market didn't budge much.
I don't see any problem in using it a general barometer for this sort of news.
>Great news and the markets are reacting very positively to the news as well which indicates to me this could be the beginning of the end!
I'd argue that has a lot more to do with the election uncertainty being over with. This is incredibly promising news, but probably not enough to account for SP500 jumping 400 points this morning.
S&P 500 is only up 90 points right now, and I don't see any evidence it was up 400 at any point today.
More generally, The DOW is way up, S&P up moderately, and NASDAQ only up a little bit. That looks like it may well be a result of vaccine news to me, which is less good for the big tech companies that make up the NASDAQ than the broader set of companies tracked by the DOW and S&P. I would expect an election related bump to have pretty equal effects on all three indices.
Yeah, setting aside all the politics and silliness, the science going on around this pandemic is remarkable. Going from nearly zero (yes, there was a bunch of research from SARS-Cov-1, MERS, and similar to build off of but nothing like this) to a functioning, tested, and mass manufactured vaccine in a year is absolutely jaw dropping. Even if it takes two years to distribute widely, three years to stomp out a pandemic is blindingly fast and a major credit to modern medical science, and the processes we have built up around it.
Although I want to agree, none of the companies started from zero.
All these new technologies, the techniques, the principles were in development since years if not decades.
Not trying to diminish the accomplishments achieved, great effort nontheless. Just saying nobody started from zero here, that would have been insane and frankly impossible.
> All these new technologies, the techniques, the principles were in development since years if not decades.
Yes, I first heard about intramuscular nucleic acid injection around the year 2000. At the time it was naked DNA and not RNA in a lipid nanoparticle suspension, but the principle was the same.
In particular BioNTech from the article was founded 2008. This is their first publicly available "product" - it applies their vision for cancer treatment to specific SARS-nCoV-2 proteins (arguably I don't know if they're working on other ideas as well).
They might be working on this particular vaccine since 2020, but AFAIK they have been working on the specific principle the vaccine uses since 2008.
True, but it's the first time we see those technologies in action. Some (many?) of the vaccine projects for example use paths that have previously been considered, played through in "toy" projects that never made it to production and so on, and now they are suddenly standing in the limelight, going live. For some sub-fields of biotech this must almost be like the mindboggling aviation had from roadshow curiosities to a major war factor in hardly more than a decade.
I don't really understand the underlying science but the nucleic acid based vaccine platforms seem really, really exciting. Getting an effective COVID vaccine is obviously huge, but the ability to rapidly develop vaccines in the future for emerging pandemics is amazing.
What I find more impressive is Moderna was finalized in February, and most of the other candidates were finalized by March.
If we could somehow develop rapid testing in some way, it's shocking to me that the vaccine could have entered mass production by the Summer.
There was a time where the only true way to test a new model Aircraft was to build one, but nowadays pretty much every characteristic is well understood by the time it enters service. To reach a similar point with vaccine testing will be important when the next pandemic hits.
I think the data is what indicates this is the beginning of the end. All of the leading Western vaccine candidates showed very strong Phase 2 results. Now, we have the first vaccine showing very strong initial Phase 3 results. This is basically the best case scenario.
The markets seem to wildly yo-yo with every piece of negative and positive news. Case in point: Zoom is currently down 10% but I’ll bet it will have rallied by the end of the day.
It's more than zoom, everything that's gone up from the pandemic is dropping: amzn, meli, jmia, se, shop, sq. The markets had them valued at a premium due to their monopolies in the pandemic but retail stocks are now trending up premarket: bbby, etc.
My point is that all of this is gut reaction to a headline, not a nuanced analysis of vaccine efficiency, roll out plans etc etc. Things could turn right around again once those details are resolved.
I am absolutely understanding why Zoom would drop on good vaccine news. It’s not a complicated connection!
My point is that the market overreacts to every piece of good or bad news, then settles down as the full implications become clear. There are still a lot of unanswered questions about the vaccine, how we handle rollout, etc etc etc. That’s not really considered in immediate reactions like this, it’s all gut feeling.
I remember that in March somebody posted here an entry saying that mutation of the virus will make vaccinations only useful in the short term. Were these concerns already addressed at this stage?
We have seen mutations due to minks recently which could make the vaccinations ineffective. These mutations might have been controlled but similar situations may arise in the next years.
For these reasons I am not entirely sure this is the beginning of the end.
Coronaviruses like SARS-COV-2 mutate relatively slowly and minimally compared to others. So mutation isn't expected to be a huge concern, unlike say influenza which mutates relatively rapidly and requires an annual tweak to the vaccines.
What's more, any new strains we do see spreading more widely will do so because their mutations confer a competitive advantage. In practice that usually means more drift towards higher infectiousness but less severe symptoms - the same mechanisms that have left us with 4 other endemic but mild common cold coroanviruses.
The new SARS-COV-2 vaccines may be a useful tool to get us over this hump where the virus is still novel to a large proportion of the population, but are unlikely to be required indefinitely.
It was said (arguably in the news, so, nobody knows if true) that the mutation found in the mink populations in Denmark has a significantly different response to antibodies, in particular, they are less effective.
This is why OP is asking and mentioning the minks in Denmark.
>I remember that in March somebody posted here an entry saying that mutation of the virus will make vaccinations only useful in the short term. Were these concerns already addressed at this stage?
Regardless of whether the mutations are significant enough to affect vaccine efficacy, it won't likely be a problem. These new mRNA vaccines have a development/production time measured in weeks and months, not years. It changes vaccines from a hardware problem to a software problem. Once the underlying delivery technology is proven safe and effective, reacting to new strains will be as swift as patching a codebase. It's hard to overstate what a massive advance in vaccine tech is happening here.
The basic idea is that now rather than needing to culture live viruses in chicken eggs, we can literally just encode the RNA for a specific antigen into a synthetic substrate and produce vaccines through a chemical process like any other drug. The RNA is then absorbed into your cells, and your own body creates the proteins which stimulate an immune response.
Considering Denmark is also one of the richest countries on earth we can neither expect other countries to a) detect such a mutation early and b) handle the issue promptly.
So I think it's somewhat likely that we'll see mutations emerge all over the world.
Whether this vaccine works depends on how early we get most people vaccinated. It may only be a short term patch, which we will see once it's rolled out, you can't really predict the long term without any measurements.
Well, stocks go up and down, nothing new. There are also too many investors who panicky buying and selling without much knowledge of the industries they buy/sell stocks.
Zoom has been doing up ~500% this year. The large fluctuations are expected. Online learning/work will continue to grow regardless of a vaccine. It's not going to be in a crazy rate like it has been this year because of covid. I'm not even talking about companies, cause that's a no brainer. I'm talking about education and hospitals. For example, the convenience of having a virtual appointment is great for both doctors and patients and it's not going away no matter what.
My opinion about Zoom. Selling because of a vaccine is pretty stupid. You should sell if you think they are over valued and not be able to compete with the big companies long term. One thing to pay attention to is their future plans. If they don't have plans to expand their product line I would worry long term. There's no problem for a company to pay for Zoom for video calls and for another company for things like slack/docs etc. But when you have companies like Google/Microsoft who package and integrate everything together, and can give you a good price for it too, then it's a concern. Google/Microsoft make many subpar products, and this year zoom showed it nicely. But they keep copying the important features and will eventually close the gap.
Well, stock prices move right? If everything was always perfectly priced in, they'd be constant. This movement or reaction is exactly that pricing in of future events given a change in information.
A vaccine was (and still is to some degree), in fact, unpredictable.
When will one be developed?
How effective will it be?
Will it have any negative side effects?
How hard will it be to manufacture and distribute?
All of these are important questions that were hard to predict. Today's announcement sheds some light on possible answers to these questions, so this new information is being priced into the market.
Yeah, but investors seem to want to hold on to stocks for as long as possible (dividends? I don't know how that works, as far as I know holding stock for dividends is nowhere near as profitable as speculating)
Reuters calculated [1] that the average holding period for stocks is down to 5.5 months recently. See the chart on that page, it has been as high as 8 years in the past.
Because of day traders and HFT, it's hard to say how long your average investor holds a stock, but it's fair to say that some hold it for a long time and others "speculate" most of the time. The speculators probably have a greater impact on the movement of a stock, but over time it must move in line with the performance of the company.
The price of a stock is thought to be a "risk adjusted present value" of the underlying company. Even if you could be 100% sure a company would make X dollars per year in perpetuity, the price would not be infinite. Instead each year of earnings is "discounted" by risk, inflation rate, the cost of borrowing money, the value of competing investments, and other factors.
If it was assumed by investors that Zoom would make lots of money for the next 5 years, and then make very little money, and this news meant they would only make lots of money for the next 3 years, then that will have an impact of 2 years worth of discounted earnings immediately.
(of course it's not like Zoom pays or is planning to pay a dividends but there's still an underlying value, for instance they could be purchased by a larger company that does pay dividends.)
It doesn't always work like that. It's clear to some folks that ZM will decline based on the fact that a COVID vaccine was virtually inevitable. However, there are lots of investors, mostly retail investors, that are willing to buy a stock without fully pricing that in. E.g. Tim's dad sees that Tim is using Zoom for school and decides it would be a good investment. Other investors are willing to buy ZM for short-term gain as long as they can get out before it crashes back to reality.
The same thing happened to Hertz, which even after declaring bankruptcy and almost certainly being worthless continued to trade at a healthy volume. In fact, Hertz tried to get approval to dilute and sell more shares to capitalize off the fact that people were buying their worthless stock.
Kind of, but two things: (1) the markets are irrational. And (2) real events (eg 100% certainty that we have a vaccine passing phase 3 right now) are different than 90% chance that we’ll have a vaccine in the next y months.
If a stocks price is $100, and tomorrow there will be a news event where there is a 50% chance it will be worth $50, and a 50% chance it will be worth $200, the trading value today should probably be around $125 (it's expected value or EV, $200 + $50 / 2).
When the defining event actually occurs, it will either move from $125 to $50, or $125 to $200.
So the news event in this example is priced in at $125, but there is still scope for big moves when certainty is realised.
Obviously in real life the values are never as certain. In the above example if the stocks ever trades < $125 before the event, you would make money in the long run.
EMH shouldn't be taken seriously as the market actors are compromised of irrational humans.
Just going to plug a book here that was an awesome read in my undergrad on that topic, and the history of quant finance over the 20th / early 21st centuries: https://byjustinfox.com/myth-of-the-rational-market/
everybody who knows about efficient market hypothesis knows that it's assumptions aren't applicable to the real world and it doesn't really matter; the real problem is those folks who mindlessly repeat propaganda about markets being rational or fair or generally doing the right thing when they clearly aren't.
The Pfizer press release says they 57% the way to statistical desired significance. They want the 164 of the placebos to catch covid, and 94 have done so far.
I thought it was 94 total not just the placebos. if it’s 90% effective 8 or 9 people who got the vaccine would catch it. Unless there’s some more statistics to the 90% figure
They have only done phase 1/2 trials and this one is phase 3.
Also, people trust US/EU research more. They have not been very forthcoming with data. The data that has been made available has been lacking in detail or has patterns that indicate either fabrication or sloppiness.
Both countries appear to be moivated by domestic and geopolitical political purposes. The US has also being doing that, but the medical establishment and regulatory bodies in the US are seen to be more independent of government than in China or Russia. Also, this is a German result, and people trust Germany more.
If it were just the German corporations we were trusting, this would be relevant. But at this point, while we do not necessarily trust the German government to be nimble, agile, or innovative, they are typically relatively by-the-book, as governments go. Certainly compared to China and Russia.
Trust. Russia and China lie through their teeth on everything and anything. It's irrelevant whether or not they are lying in this particular instance: they cannot be trusted.
Do you really perceive EU/US having the same level of independence of judges, newspapers and regulation bodies as Russia and China? Do you think that minority parties and voices are accepted to the same degree?
The difference is that placing trust in China/Russia means trusting in a narrative driven by a small group (the ruling elite), while placing trust in "the West" usually refers to the collective knowledge of scientific endeavours that tend to succeed better in a nation more friendly to liberal democracy.
It's a difference of degree. The US has done (way more than) its fair share of shitty things, no doubt about that. It's still a democratic government (a flawed one) which is miles better than the autocracy of Russia or the oppressive totalitarianism of the CCP.
"The West" is a bit more restricted in how much they can lie to their own citizens (even with the recent efforts from Mr Trump and Mr Johnson to change that for the worse).
Of course, in Mother Russia it is widely believed that everyone lies more or less, and those looking to expose "the truth" generally live dangerously, often with tragic results.
Not just Iraq war- Vietnam war (pentagon papers), Wikileaks, Snowden revelations- boggles my mind just how many people still have unflinching trust in their government, specially when a comparison to other countries come in. I don't know if it's nationalism or a hidden desire to feel superior or something else.
But given how these western countries handled covid, and the fact that China has a history of fighting viruses like it- I'd rather trust a Chinese vaccine over an American one, all else being equal.
America launched a fake vaccination campaign to catch osama-bin-laden; many villagers in surrounding areas are refusing to take vaccine because they have lost trust.
Western governments are no doubt better for their own citizens than say Russia or China, but we outsiders have absolutely no reason to trust one government over the others. Russia's vaccine has only passed phase 2- now that's a good point, "Trust" absolutely isn't.
I wasn’t aware of this. Looked it up and this in fact true. I imagine people from other countries are in fact weary of the US vaccine for this or similar reasons
This is much farther along than the Russia vaccine. They are also publishing their data publicly. I know they haven’t published this data yet, but they say they are going to, and they have a good track record of doing so.
You have to stop reading propaganda. If we had a vote around the world, russia and china together would win over the "west" by a long shot. It wasn't russia and china brutalizing the world for 500 years. It isn't russia and china destabilizing much of the world today.
We have to stop believing that the "west" is the world. It's going to bite us in the end one day. The only thing people around the world like is wealth. As china and russia get wealthier, even that won't matter as much.
Obviously because of the geopolitical concerns and pride. Truth is the first victim as usual. The Russian vaccine was indeed registered just after the 2nd phase trials, but according to its website the 3rd phase trial has started on August 25 (one month later than for BNT162b2) and involved more than 40k people (effectively the same number).
So those who claim that Russian vaccine is only on the 1/2 phase spread an outright lie. Both vaccine have approximately the same speed of development with minor differences between regulation and testing procedures.
> So those who claim that Russian vaccine is only on the 1/2 phase spread an outright lie.
Russian vaccine was announced back in August, when it was only on phase 1/2. In contrast phase 3 Pfizer/biontech had been well under way at that time.
Russia announced a not fully tested vaccine, proudly called it "Sputnik V". The exact words Putin used when announced it was: "As far as I know, a vaccine against a new coronavirus infection has been registered this morning, for the first time in the world". So geopolitical concerns and pride are correct assessment. No wonder it drew skepticism.
Neither. It is made of two replication-deficient human adenoviruses, Ad5 and Ad26, IIRC, which carry part or the entire spike protein (I need to check, I don't remember).
One shot is with Ad5, the other with Ad26. This is done because Ad5 is a "known" adenovirus by most population, that means that a sizable fraction has antibodies against it.
I think the Russian ones were approved after 'Phase 2' trials. Which are small scale trials. That's their call if they want to start vaccinating with 'half-tested' vaccines, but it doesn't meet the typical international standards which is usually completing Phase 3 trials.
None of those have announced positive results on a phase 3, have they? In effect, the Russian one is also in phase 3; they kind of pretended it wasn't, but are doing a very limited rollout that is for all practical purposes just a phase 3 trial.
Also, this one was developed in Germany and the trial is being run in Germany and the US; people might be forgiven for trusting a combination of the EMA and FDA, who will need to approve this, somewhat more than Putin's one.
They produced it within months; it's the clinical trials to prove its efficiency and safety that took a while.
I wonder if this experience has led to developments to speed up the development process (without compromising on safety); I hope so, because this is not the first and will not be the last time we see a worldwide pandemic like this.
I'm not sure it's fully possible to not compromise on safety one way or another when doing something like this quickly. Let's say a side effect is that 1% of women become sterile half a year after getting the vaccine - how would we possibly know that after testing for 3 months? All we can do is say it's very unlikely based on other vaccines with similar approaches, and monitor for effects on the reproductive system (or anything else unusual in the body) that is know to potentially lead to something like that down the line. In the end, we can (and probably must) decide that taking the time to disprove there being any long term negative effects, is more likely to cause more harm (because more covid-infections will happen in the meantime) than the good it is likely to do us. But it is still a higher risk than the usual approach where we test for longer.
I know you say that in mockery, but I'd rather be in isolation for longer and have a better idea what the long term of this looks like. Most other vaccines have the same process.
This isn't like being a test pilot in an experimental rocket. This is like buying a 2021 Honda Civic. Is it different from the 2020 Civic? Yes. Could there be some unforeseen malfunction? It's not impossible. But this is not a bold new world of experimentation. It's a vaccine, with a tried and true development process and that has already been administered to tens of thousands of people (likely tens of millions over close to 12 months before a shot gets to your arm).
Wouldn't this be the first mRNA vaccine approved for the public?
I know very little about the pharmaceutical underpinnings of mRNA vaccines and how theoretically likely adverse long-term results are, but I do think caution by laymen is not unwarranted for a new type of vaccine that has been fast-tracked through trials (albeit for good reason!)
Long term effects of covid seems awful though. This, as with any vaccine or medicament out there (or actual living for that matter) is a quest to hit a sweet balance:
- Yes, you can avoid covid and potential long effects of vaccine by living in a cave for the next 10 years.
- You can "gamble" on a 0.01% chance of getting any long-term effects from the vaccine in exchange of getting 90% safe from covid.
I take this "gamble" every year with a flu shot, because to me it sounds safer than getting flu followed by pneumonia.
If everybody waits for the other 99% of people to get vaccined before them, so we can a free-ride on the herd immunity, we would never reach herd immunity.
I don't know of any drug that is 100% safe. Heck, even a tampon could send you to the grave. For this kind of vaccinations, we should have a margin of confidence that, being similar to other vaccines in composition but just changing the viral load, long term effects should be similar. The Moderna vaccine is a different animal.
I feel like this is unnecessarily condescending towards the parent comment. There have been at least a few cases in US history of medications / vaccines having some amount of long term side effects that were not known until a few years had elapsed.
- Vaccine candidate was found to be more than 90% effective in preventing COVID-19 in participants without evidence of prior SARS-CoV-2 infection in the first interim efficacy analysis
- Analysis evaluated 94 confirmed cases of COVID-19 in trial participants
- Study enrolled 43,538 participants, with 42% having diverse backgrounds, and no serious safety concerns have been observed; Safety and additional efficacy data continue to be collected
- Submission for Emergency Use Authorization (EUA) to the U.S. Food and Drug Administration (FDA) planned for soon after the required safety milestone is achieved, which is currently expected to occur in the third week of November
- Clinical trial to continue through to final analysis at 164 confirmed cases in order to collect further data and characterize the vaccine candidate’s performance against other study endpoints
You want to have at least a nontrivial group of every race and ethnicity to ensure that you collect enough data to make sure it's also effective on everyone.
Additional challenges in the US are that many minority communities are distrustful of the pharmaceutical industry due to historical reasons and you typically need a concentrated effort to do outreach there to actually collect enough volunteers to meet your sampling concerns.
Fascinating logistics problem here - distributing a vaccine that needs to be stored at -80C.
This is significantly colder than the standard cold logistics chain. I believe Pfizer are working on a special transport box that can, unpowered, stay at the right temperature for a week as long as the box is only opened for something like 1 minute a day.
That's a good thing, but with a capacity of I believe 10k vaccine doses, anywhere with fewer than 10k people to vaccinate, or anywhere that can't keep the demand level for the vaccine at the right level each hour/day as they progress through their vaccine stock, will have a hard time. This is going to disproportionately affect small communities and developing countries.
We've got hard logistical challenges ahead regardless of these details, but they make this even harder. Given this it's probably important that we continue to develop more vaccines and diversify our strategy for immunity.
interesting... vid suggests that we have to use cryogenic techniques to store vaccine partly because there hasn't been enough time to test how they store at higher temperatures.
so perhaps the infrastructure requirements will relax as time goes on
This may be true for urban/suburban US/Europe/China/India, but this is not true for large parts of the world.
There are parts of rural US/Australia for example where despite people having cars, they may need to take a plane to get to a vaccine treatment centre with enough density to get stock. They may not be able to afford that travel even if the vaccine is free.
Much of the African population is spread over small communities where roads may not be reliable, let alone car access. If your minimum distributable unit is 10k vaccines, as it looks like it could be to begin with, that rules out a significant number of the population.
Yes and that's a good thing. I think it's still important to recognise that not everyone is as privileged as many of us here, and that an inclusive approach to distribution will be important for this vaccine.
Viruses also, naturally, take longer to reach harder to reach areas. Basically, if the vaccine will have trouble reaching a community, the virus will, too.
Besides the 90% protection, does the research or testing imply a reduced severity should one actually catch the disease by rolling a 92 on the dice? I'm presuming the white blood cells and t-cells can act as de-escalators but I don't really know.
-80C storage requirement may really complicate distribution logistics even in developed countries. We'd really need special locations to be setup to administer the vaccine, unless it's viable for some reasonable period of time at higher temperatures. Even something like 24-48 hours, so it can be transported on demand from centralized locations to doctors offices, pharmacies, etc.
Otherwise, medical cryo storage is highly specialized and expensive equipment. Definitely not what you'd find in a doctors office or pharmacy. It might be a more convenient option if the vaccine remains viable at much colder temperatures. Somewhat cheaper (though still not cheap) LN2 transport containers ~180C could be used to deliver it to locations, provide a supply of LN2 to keep it cold, and then warm on demand.
The point is, this isn't going to be a rollout that can be done without a lot of infrastructure planning way up front. If the data here is validated and it looks like it's going to get FDA approval, we need to begin planning that stage ASAP.
Reading some comments myself it seems to be more akin to:
"Yes it is nice, but not perfect", citing the concerns of that testing isn't complete yet and the duration is quite short.
For those wondering how their vaccines will be distributed among countries during the next year when supply is constrained... it seems complicated. Pfizer is a US company, but has at least one key ingredient from Austria, is made with technology from Germany, has manufacturing in US+Europe, etc.
Pfizer's CEO answered this question this morning on CNBC.
Pfizer has two separate manufacturing divisions- one in the US (Massachusetts, Missouri, Michigan) and one in Europe (Germany+Belgium).
They will be producing in parallel and he seemed to imply Europe manufactured->Europe distributed and US manufactured->US distributed initially (but didn't explicitly say this). But he then stated that it's important to share the vaccine across the world - "I hope that we will be able to ship to the entire world from these manufacturing sites without problems".
They have signed contracts with multiple governments in the world and in most cases have defined their monthly quantities distributed to those countries through 2021. I would guess these are public and am curious about the quantities and timelines for the various countries.
They are estimating to have 1.2 billion doses by the end of 2021 (enough for 600 million people, as each person needs two doses).
EDIT:
US: 100 million doses of this Pfizer vaccine (enough for 50 million people) by December 2020[1], but Pfizer now says they are only producting 50 million doses globally this year[2]
I would assume that the countries are the only ones with a factory that is capable of making this. Give me a few billion dollars and a year and I can set up another factory, but it would have been too risky an investment 1 year ago (before COVID), or even 3 months ago . Even now it is too risky an investment as the current factories can produce a lot of vaccine, and there are other candidates that also have factories, so odds are the world will be vaccinated before my 1 year factory comes online.
A 1 year factory build is extremely fast - freely trading money for time. A more reasonable schedule would be several years (a lot cheaper)
I think he cares about cost effective. He is expecting more than a year to get them running, but in return he can get far more vaccine. He has been working for years on getting various vaccines and has a good idea what the long game is by now.
Polymun from Klosterneuburg (near Vienna) are suppliers of Lipid-Nanoparticles used for mRNA vaccines.
Translated from:
"Bei der Impfstoff-Entwicklung von Pfizer und Biontech mischt auch die Klosterneuburger Firma Polymun mit. Die heimischen Experten liefern wichtige Teile für die Vakzine zu. Als eines von nur wenigen Unternehmen weltweit ist Polymun auf die Herstellung von Lipid-Nanopartikeln spezialisiert. Diese werden für die Herstellung von mRNA-Impfstoffen gegen Covid-19 gebraucht, da die verwendete mRNA ein geeignetes Transportvehikel braucht, um in den Körper eingeschleust zu werden."
"Polymun Scientific Immunbiologische Forschung GmbH is one of a handful of makers of lipid nanoparticles, microscopic vessels used to deliver genetic material into the body."
Pretty much. After Biden was announced as the winner, people were posting pictures on conservative subreddits showing thousands of people celebrating in the streets, and they said "It sucks that Biden won, but at least covid is over".
>Pfizer said it will wait until after the US election to file its COVID-19 vaccine with the US regulator, as it awaits important safety data to become available.
Yes, but if you read the source [0], they will wait until after the US election, but not for reasons related to the US election. Just because they expect their results to arrive after the US elections.
It's like saying that I will wait to have a baby until after the holiday period. Factually correct, but that baby will arrive in January irregardless of the holiday period. The holiday period is for sure not the reason for the baby to arrive in January.
And rightfully so. Don't forget that Biden winning wasn't a sure thing - so it's not like they were waiting until Biden won to announce it. The CEO specifically mentioned in September that they refused R&D money from the US Government in order to protect themselves from being politicized. In that vein, it was the right thing that the announcement was made (intentionally or not) after the election was concluded to minimize this news being politicized.
This is only a superficial solution to the cause of these zoonotic diseases, which is overpopulation. The problem is that with 7bil people disease will spread with increasing frequency, and areas of super population growth like Africa and India will suffer the most.
But because no vaccine for any coronavirus had ever been invented, this new vaccine and the new techniques used to make it must be celebrated as a technological breakthrough. Possibly the greatest medical breakthrough since the 19th century. Possibly Nobel prize winning material.
I'm 100% for vaccines and I trust in the scientific process more than anything else. That said, how weird is it for someone like myself (late thirties, healthy, no direct contact with any human being) to just... wait it out? I am not too eager to be among the first humans to take a rushed vaccine.
So, how rushed is this vaccine? Is there any precedent with other vaccines that were developed this quickly? Is there a known risk, or is the risk simply unknown?
There's a very good chance you will never be able to wait this out, SARS-CoV-2 could easily become another endemic coronavirus. In that situation you're getting to get exposed eventually unless you become a recluse, and you'll be better off with the vaccine than without it.
The vaccine was tested on 44,000 people and they will spend two more months watching for adverse effects. If it is shown to be safe after that period, it's extraordinarily safe for you to take.
Given we can't even get people to wear masks, regardless of efficacy I think we mainly have an education issue and half the country voted for "fuck that let's die." I think we need to spend as much time/money on a social campaign with mask mandates, social distancing, quarantine, contact tracing.
I think one of the reasons people won't wear masks is because they're mandated. Many are worried in the short-term about the spread of COVID-19, but after we come out of it the government has more power. I think it's important to understand and respect that other people have different priorities. In this case, the US was born out of fighting tyranny and that is a bigger concern to some because a tyrannical government could lead to more suffering and death than caused by COVID-19.
I liken it to the war on drugs, which used fear-mongering and propaganda to convince people that drugs are bad and that we need to lock up people that are making decisions regarding their own bodies and minds. Instead of educating people on the unbiased pros/cons of recreational and medical drug use, so that people are actually informed about the decisions they're making. Instead, we have a war on drugs that is fueled by corruption and labels non-violent offenders as criminals.
When it comes to the pandemic, there is a similar approach of fear-mongering and forced coercion. Those that refuse to wear a mask may just be people that have everyone's interest in mind because they believe they are rebelling against government trying to get more power, which they think is worse in the long-term.
I respect the mask requirements when, for example, entering the grocery story, but I also feel uncomfortable by the forced coercion, re-goalposting, and increase in government power. I believe the best approach forward is setting a good example and informing people on all aspects of the facts without bias.
It's just a mask. The "power" the government is applying to "coerce" you into wearing a mask must be weighed against the burden being imposed (extremely low, less than asking you to at least wear underwear in public/near schools) and the benefits (extremely high, masks work).
Give someone an inch and they'll take a mile. It's not that it's just a mask, it's potentially a small step towards seizing our freedoms.
I agree that it does seem a bit irrational when just focusing on masks, but not necessarily when we take all of the response to COVID-19 that we've seen so far. The goalposts have consistently been moving, so I don't find it unreasonable that people want to rebel against more coercion.
I still hold to my principle that it is better to inform people of the facts and lead by example. Mandates will alienate people and force an underground/blackmarket of activities and ideas.
Of course, do you think they would be hurting for money once they have a vaccine developed? The demand will always be there. They just took the risk with their own money. They have been in the business for decades and they know how to sell a prized drug - with or without a buyer already lined up.
A commitment to purchase doesn't mean much in a "seller's market". It will be profitable for the company either way - with or without a pre-contract.
Not necessarily, even if another company beats them to market and has a better vaccine - they will still get $2bln, it's easier to work when you are not under time pressure to beat the market.
Of course yes. Every person on earth will want this vaccine eventually. If the US wants to play games, they have tens of billions of units to sell elsewhere.
At this point this is obvious, but it took the pandemic getting out of hand to create the demand. When SARS hit many companies invested in vaccines and demand vanished. The purpose of the government guaranteed buy is to move up the timeline of when R&D starts.
In principle, yes, that would have been a good example of government intervention to stabilize market expectations. However, in practice that isn't what happened.
First, this is a line of research that began in January well before the pandemic actually got out of hand. Researchers started developing a vaccine as soon as there were indications that the transmission rate and fatality rate would be high.
Second, Operation Warp Speed was announced in early April. This was already long after the pandemic had gotten out of hand.
- The unblinded data came in yesterday (Sunday) from an independent group. They were expecting it to come in the third week of November, so this was earlier than expected.
- They did not take money from the current administrations Operation Warp Speed for development (only for distribution), although my understanding is that the government will be buying doses to deliver for free to Americans.
- They needed to have enough people who get infected in order to have meaningful data.
- Check out the video around 6 minutes to see what they say about this point.
- Overall, it seems more like "this was the soonest the science had something meaningful to say".
> But Pfizer CEO Albert Bourla says the timing had nothing to do with politics. In an interview with CNN Chief Medical Correspondent Sanjay Gupta, Bourla said he first learned about the results of the trial Sunday and he has yet to see the data, throwing cold water on the idea that there was any political motivation behind releasing the news after voters in the United States chose their candidate for president. Pfizer took several interim looks at the data during its vaccine trial, but it did not have enough infections in its test group to gain any meaningful data -- until Sunday, Gupta reported. If anything, the data came earlier than expected: In October, Bourla made a comment in an open letter on Pfizer's website, saying, "Based on our current trial enrollment and dosing pace, we estimate we will reach this milestone in the third week of November."
How will it work if multiple vaccines are approved and similarly effective? Does that allow us to roll out vaccinations more quickly, or are there shared bottlenecks in the supply chains? Would individuals get whichever is available in their city first, or are there other factors at play?
Apologies if this is answered somewhere else in the comments!
So, out of 43538 participants, 94 got sick in both groups (who got vaccine and who got placebo) together, and this translates to "at least" 90% immunity, with 95% confidence interval.
Who remembers statistics well enough to reverse the calculation and find out how many people got sick in both groups? There is a definite integer answer here.
That would be middle point - that is 50% chances that actual reliability is better than 90% reliable, 50% that it's worse. But we have 95% confidence interval. This is what my question was about.
On infinitely large number of cases, the numbers will be the same. But we only have 94. I think it's about 2 to 3 cases that they actually got from the group that got vaccine, but not sure.
Great news, but I think the importance of the -80 degrees centigrade storage requirement is underestimated.
Serbia, where I live, has ordered this vaccine. And our medical system is far from world-class, but leaps and bounds from less developed countries, and I honestly think logistics here will not be able to match those requirements. I've seen tetanus vaccines just being kept in regular, commercial, refrigerators. There have been cases where they have been switched off because they were not on UPSs or not up to standards. Vehicles equipped for transport are an issue by itself.
Germany is planning to establish centers for vaccination exactly to avoid problems with the continous cold chain. (People travel without issue at ambient temperature. They even prefer that to other temperatures;)
I would assume that other nations will adopt similiar solutions for vaccines that have ultra-cold storage requirements.
I'm not sure it can be used, since it is much colder than -80. I actually hope it can be, because there is quite a few liquid nitrogen facilities, usually near big medical facilities. Dry ice, quite rare. I've seen some for special effects, but declared at a higher temperature than -80.
In Uk I have recently recieved a vaccine, and it was in a commercial refrigirator. I don't know if they have a UPS, but it appears like a normal thing to do.
"However, there are logistical challenges as the vaccine has to be kept in ultra-cold storage at below minus 80C."
Does anyone know how many of the other vaccine candidates have this limitation? It seems to me that a vaccine with easier logistics might still end up having a bigger impact overall, despite not being the first - although that of course needs to be combined with the ease of production too (I don't know how easy it is to mass produce these new RNA vaccines compared to more traditional ones).
low temp storage was also required for the ebola vaccine and yet it was successfully administered to more than quarter of a million people in equatorial Africa
I know that several of the vaccine candidates require similarly cold storage for their entire distribution cycle until they are being used. Disclaimer: I work for big pharma.
So what does being injected an mRNA vaccine means ? My DNA will be permanently altered and permanently create fake covid proteins ?
will this add overhead to my biological processes, am I becoming less optimized ? Will my body consume more sugar ? will those generated proteins accelerate my ageing ?
What could go wrong ? (I don't think anything will go wrong but what does the science says ?)
> My DNA will be permanently altered and permanently create fake covid proteins ?
No, in fact, mechanisms in cells are in places so that "heteroduplexes" (meaning one filament of RNA and one of DNA paired together) are quickly degraded.
Secondly, the RNA doesn't even need to get to the nucleus, where the DNA is. All it needs is to land in the cytoplasm, where it will get processed by the protein synthesis machinery (ribosomes in primis) to produce the antigen.
RNA in the cell isn't that stable as well, so it will be ultimately get degraded.
That is all true as long as the RNA doesn’t replicate itself and only produces antigens. However, I couldn’t find any papers at all that discussed if any of the current mRNA vaccine candidates self replicate their RNA to amplify the antigen production. I’d love some good references that address that.
> Pfizer Inc. (New York, NY) in partnership with BioNtech (Germany) has also developed a saRNA prototype vaccine, although the details of this vector/formulation have not been disclosed yet.
AFAICS, this is not BNT162b2, which is the one that we are talking about. There are 3 other candidates, one of them is the self-amplifying one.
I'm currently recovering from Covid-19 and hopefully won't need it, however this line sounds a bit strange:
"It uses a completely experimental approach - that involves injecting part of the virus's genetic code - in order to train the immune system."
I did my flu (not Covid) vaccine shot about 3 weeks ago, just before catching the nastier one, and according to the doctors it works exactly that way, although this one of course doesn't contain parts of SARS-Cov2 but rather various other winter flu virii (H1N1-pdm09,CNIC1909,H3N2,IVR-208, etc).
So if the approach is the usual one, testing is likely where the most time is spent; that should speed up production a lot.
What they mean is that instead of injecting viral proteins or deactivated virus (as in a flu vaccine), they are injecting mRNA which causes your own cells to make a section of viral protein, which then triggers a strong immune response. This COVID vaccine will be the first major mRNA vaccine.
Thanks for the correction and good news!
Would the pandemic situation ease the access to it for everyone, or market laws (high prices) will prevail as usual?
The software engineer in me makes me very weary of this. All of our historic vaccines came from very bad circumstances and they were tested on people without any real guards, starting with Jenner's famous Horsepox treatments.
I'm fine with this vaccine being available for people who want it, but as someone who is low risk, I really hope this doesn't become mandatory. A lot of people aren't old enough to remember the Swine Flu vaccine and all the complications from that.
No one is talking about the safety here and that's disturbing. I don't see how a vaccine can be listed as safe with less than a year of testing. Traditionally it's an 8~12 year process.
Pfizer and BioNTech say they will have enough safety data by the third week of November to take their vaccine to regulators. Until then it is not possible for countries to begin their vaccination campaigns.
Anybody knows what's up with China-based Tosun, BioNTech's other partner next to Pfizer? Is it known whether Tosun will produce the vaccine, or is just not that much of a deal in China anymore?
Great. This is the one that has to be kept ultra cold. Hoping for good news about some of the other vaccines in Phase 3 trials soon.
The vaccine reportedly needs to be held in storage at -94° Fahrenheit (-70°c), and will last for only 24 hours at refrigerated temps between 35.6° and 46.4°. (about 2° to 8° c)
While it's a minor logistical challenge, it's simple enough to ship this in a liquid nitrogen dewar.
Even very small cities will have liquid nitrogen facilities. Shipping from the nearest city to most of the population sounds very doable in 24 hours.
Remember you only need to get most of the population to halt the spread. If there's some tiny village 3 days hike away in the rainforest, you can skip them.
Shipping hundreds of thousands of doses of vaccine at -80C is more than a “minor logistical challenge”. First, you’d never ship in a liquid nitrogen dewar. It would be a massive logistics bottleneck considering the weight of dewars and the volume you'd be shipping (Pfizer already has deals secured for hundreds of millions of doses). And plus, these are packaged vaccines - a glass vial with a label, in a paper box, with a folded product info sheet inside. You can't submerge the whole thing in liquid nitrogen.
Shipping at -10C is a major logistical challenge. Mentally it doesn't sound like like much, but that's envisioning a single vial to a single patient. Multiply that by one million and deliveries to not only NYC but to Booneville, Louisiana. Temperature excursions mean spoiled product - product that gets thrown out. -80C is way harder than -20C (there are no vaccines today that require -80C).
You can’t just throw it on dry ice and say “we’re good”. Even just packing it is complicated. You have a pallet sized box with 20,000 doses. You put it in a box and surround it with dry ice. Are all the vials the same temperature after 2 hours? Are you sure? You need temperature monitoring at multiple points in the package so you know when it’s been spoiled.
Your delivery gets held up for 12 hours at customs, are all the vials still -80C? Are you sure? What do you do when you deliver to hospital and find out they don’t have -80C storage, even though they said they did? Do you have an intermediary storage facility you can bring it to until you figure out a solution?
Do you have monitoring after it’s been delivered so it doesn’t spoil before administration? Correct thawing procedures? What happens if a dose is thawed and the patient doesn’t show up and it sits at room temp for an hour? Just throw it out? Or is it still good? Are you sure?
And to add on top of all this - you (as the manufacturer) might have all this figured out, but you need to make sure everyone along the logistics chain does too. Guaranteed you'd send emails and letters in advance, and have massive yellow stickers all over the shipment that says "Must be stored at -80C" and you'll have a customer call you a week later asking if the product that's been sitting at -10C is still good.
Here is a document from WHO that will tell you way more than you’d ever want to know about cold chain distribution. There is an entire section on how to appropriately stack the vaccine vials in the freezer so they stay the right temperature. Yeah, it's that complicated.
Even cold chain for today’s products is really fucking hard.
Derek Lowe had a good quote on this:
"Pfizer has provided these details to the CDC about shipping and storage of their candidate: the vaccine can be shipped in “dry ice pack” boxes, but that dry ice will need to be replenished within 24 hours of receipt. The shipping carton needs to be closed within one minute of opening, and not opened more than twice per day. Vaccine vials, once removed, can be kept at refrigerator temperatures for up to 24 hours or at room temperature for no more than 2 hours after thawing. So this is going to take a very organized approach to make sure that the vaccine is handled properly without wastage. We’re looking at a lot of dry ice and a lot of orders for ultra-cold freezers if this is the candidate that gets heavy nationwide distribution. And mind you, I’m talking about organized distribution in Little Rock and Long Beach. What about La Paz and Lahore? What about Lubumbashi? Even back inside the US, what’s the nearest source of dry ice in Shiprock, New Mexico or Oceana, West Virginia?"
But it's something that poor countries manage to do successfully with a reasonable reliability even on rural areas.
I am sure there will be plenty of new problems for that lower temperature. And a number of smart people will have to work really hard to solve them, a large amount of money will change hands and all that.
But I think the GP's point is that it's doable. It doesn't need any sci-fi tech or any large restructuring of humanity (and we already did some of the later for this virus).
I agree. I think sometimes it is hard to fully understand how complicated logistics can be. I mean that’s why people study logistics in school and companies pay money for professionals well versed in logistics.
Developing a safe and effective vaccine -- fundamentally hard.
Developing a nuclear weapon -- fundamentally hard.
Developing a quantum computer -- fundamentally hard.
Shipping something cold at a large scale? Hard, but not fundamentally hard. We'll solve it. There's no fucking way the vaccine effort is stopped by refrigeration needs.
I disagree. All problems you mentioned are fundamentally hard. It is unfair to say that a logistical challenge is easier simply because it involves refrigeration at scale as opposed to research, weapons development, or computing at scale.
That’s what’s incorrect. Yes, it’s not “put a man on the moon hard”, but you’re really underestimating how difficult it is.
I’ve worked in drug distribution for a few years and you’d be surprised the challenges to getting a room temperature drug to a patient in a developed country. None of the steps are hard, but when you introduce humans into the mix things go poorly pretty quickly.
Getting a -80C drug transported to a 2nd tier city in sub-Saharan Africa is not “easy”. Unless you’re willing to have half (or more) of your product spoil. Based on the demand and urgency for a vaccine for Covid, we can’t spare even 1 dose to spoilage.
Yes, it’s not a “we can’t figure this out” problem, but it’s a big enough problem to really bottleneck distribution. It’s going to take some pretty smart logistics people to make sure the process works all the way from Pfizer’s distribution center to the patient’s body.
All of your concerns are real. However it is important to remember that this is also routine. The amount of vaccine to ship this way is not that large compared to all the other things shipping in this way. Shipping companies already know how to handle this type of thing and have systems in place. They have the monitoring in place and systems to watch it because this is already done on a large scale.
Many supermarkets carry dry ice. Any city of >50,000 people will have a company supplying dry ice and liquid nitrogen. CO2 is a byproduct of several industrial process, so that market it glutted. It is easy to turn CO2 into dry ice (if you don't care about efficiency - with the supply being virtually unlimited there is no reason to care much)
"BioNTech CEO expects vaccine can be fridge-stored for two weeks"
"Speaking at an online media briefing on the purchase of an additional German production site, Chief Executive Ugur Sahin said tests have recently confirmed the genetic compound remains stable at 2 to 8 degrees Celsius for five days but he expects storability at those conditions to be two weeks or longer."
I wonder what will happen with the vaccine deals that governments have been doing. Like, what if they pre-ordered from one manufacturer whose vaccine proves inferior to the other ones?
There are not enough per-orders to vaccinate everyone even if they all pass trials, and nobody has the ability to manufacture enough to vaccinate the world alone in a reasonable time period anyway. If all the early vaccines pass trails we can start opening up the world in 6 months. If they is the only one we are more than a year away.
That said, all the deals are contingent on being effective. With this being 90% effective that sets a bar for the others. The FDA has previously said they need your vaccine to be 50% effective to approve it. However with this being 90% effective they are unlikely to approve one that is only 50% effective. Unlikely doesn't mean they won't: different allergic reactions; usefulness in different age groups; ability to ship to remote groups; difference in effectiveness to some minority: all are factors that may make some vaccine approved even if it is clearly the worse one to get overall.
Also interesting to note that this is a mRNA vaccine, where the production of antigen within the cell is induced by injecting a RNA sequence instead of a disabled virus.
Until your body kills the infected cells. Viruses stick themselves into your cells all over the place. It's how you get the common cold. Approximately 8% of your DNA is made of past viruses that humans and their ancestors caught.
If I dumped some random code into a computer program you were building, would you expect things to still work correctly? I’d love to know if that is wildly inaccurate...
Yes but... no one is dumping anything remotely random here :)
It's using existing building mechanism in cells to have it build a specific protein that will bind to a specific pathogen.
And lot of clinical tests to try to detect if those proteins being built have other effects than instructing the cells to create the antibodies we want.
It's roughly the same mechanism at work when you inject disabled pathogen and hoping that the cells will produce the same antibodies, it's just a faster, safer, more precise way to induce it.
Heck, it's even the same mechanism that occurs when your cells encounters a wild, random virus, like it may be happening a lot more than you think, and, well, you're still alive :)
By the way, you may be thinking under the assumption that the 'program' is the DNA, and that mRNA vaccines is changing it some way or another, which is not, this is not genetic therapy.
Almost all medicine does something weird and scary. Interfere with body chemistry, trick the immune system. Many vaccines are dead viruses - that's pretty scary too!
That scariness is exactly why we did trials for 6 months, and why 20,000+ volunteers were closely monitored for half a year to make sure this technique is not harmful.
Can some explain why Pfizer insists they were not part of the Operation Warp Speed ([1] “We were never part of the Warp Speed”), despite the fact that both Warp Speed [2] and Pfizer itself [3] had press releases in July that stated the opposite?
So the US Government gave them a put option for 100 million doses (or 50 million vaccines) with a strike of about $20 per dose. And they took that put option. This is a very valuable option that removes a lot of R&D risk. They didn't get an upfront cash amount, but saying they "were never part of the operation Warp Speed" sounds quite disingenuous to me.
> show 90% protection is achieved seven days after the second dose.
What is 90% 'protection'? Need to see the data, I don't think the hospitalization rate is above 10% of positive tests, vaccines often conflate 'reduction in symptoms/duration' with 'immunity'.
Does anyone have data on how many Moderna vaccines will be produced by the end of the year with Operation Warp Speed?
I've read somewhere that the vaccine uses similar tech to Pfizer, so I'm wondering how many vaccines will actually be available by end of year if both are this effective.
Hopefully this is rolled out to the most vulnerable people first (the 80+ category, or underlying health conditions). I assume there are so far zero repercussions from an ineffective vaccine (i.e no sudden resulting flu)?
I wonder if any of the other vaccine candidates offer 100% protection, or near it at least? Still, if everyone got this vaccine, then the infectiousness of the virus would be decimated, so if currently every infected person infects 5 people, in a vaccinated population they would instead infect 0.5 people, causing the pandemic to decline instead of accelerate exponentially like it does now.
We don't know that. It might be that your body just doesn't become symptomatic, but you are still able to spread. In this case everyone vaccinated should be considered a super-spreader because they will continue to do what they were before.
Note, the above scenario seems very unlikely. However we don't have enough data to rule it out.
Even though this hasn't been surmised yet from data, my impression is that vitamin D supplementation blunts the deadliness of the virus sufficiently enough to get back to normal, or near-normal (just wearing masks). If that's true it should be fast tracked way ahead of vaccination.
UK already ordered 30M out of the 50M avail for this year. So no going on winter break to Thailand just yet!
Wondering who will grab the next 20M, and how much this vaccine is being sold per dose.
(edit: PFE is currently trading +13% pre-market on the NYSE)
Small but important nitpick: since at least 2005 there is no "on the NYSE", the price you're likely seeing is the best price consolidated across all national market system venues, the primary listing exchange is mostly only an administrative entity in recent times. Actually some of the largest premarket trading is occurring on NASDAQ and a CBOE-owned exchange called BATS
Edit:
The article states
“ Pfizer believes it will be able to supply 50 million doses by the end of this year, and around 1.3 billion by the end of 2021.
The UK should get 10 million doses by the end of the year, with a further 30 million doses already ordered.”
So the UK will only get 10/50 Millionen doses produced this year.
Hard to say. What is in the contract? I don't know (I assume it is public but I don't know how to look this up). Different countries may have different contracts.
I wouldn't be surprised if the contract was only that X doses would be provided to the US market (as opposed to shipping to the market in Mexico...). In this case the government is only buying a spot in the shipping queue, and not any doses.
It could be that the doses were bought by the government only for the government (military and politicians), and the rest of us are on our own. (this seems unlikely - doctors should be first in line, but an obvious extension is the doses are for doctors/nurses and the leftover for the above)
It could be the government is buying all doses for their country and will distribute them for no extra charge. This is probably what Europe has done/will do - because they tend to have government health care for anything considered essential.
I wouldn't be surprised if all 3 of the above were in use by different countries. There is disagreement as to which is best on a political level.
Honestly? I think if you're not sure, you probably don't need it. I'm young, work from home, healthy. I have friends who are nurses -- they yearn for a vaccine. My grandparents and my parents know that they are at risk and would line up for one. I have a friend with diabetes who would feel like his life was back. I'd gladly take a vaccine if it became available -- would love to not worry about giving it to my parents, and contribute to herd immunity -- but for me personally the virus has never really scared me on a personal health level.
Oh, I have no intention of skipping the vaccine (you can see if you read my comment to the end). I was commenting more on the desire to get a vaccine early.
I'm not sure that's really needed, but if you want to I'd suggest getting something you can clean, like a silicone surgical respirator, as a cloth or paper mask would get pretty nasty after a while.
Why are people in the comments so interested in the reactions of stock markets? I don't understand. These are the same markets that cheer when job cuts and redundancies are announced. These are the same markets that cheer when horrible working conditions are enforced (see Tesla, Uber, Deliveroo, etc.)
Why should I take the markets seriously? It's just a bunch of rich people in the end.
If the markets react that means it is probably significant news, since the people who have millions at stake think this is enough to increase the future outlook of the top companies. You should take them seriously because the markets reflect the thoughts of hundreds of thousands of people who's salary depends on trying to find out what the future looks like. Not sure what would be a better indicator of whether news is significant or not.
Now of course what is good for top companies may not be good for individuals, so you can't just say that a stock price increase means people's lives are going to be better. But I think you can say that a stock market increase means the news you are seeing is more likely to be important.
But there are also people with millions at stake who are metagaming that other people will think this is important enough to increase the future outlook of top companies and thus changing their strategies to profit off them.
The market is a weighted function of an insane number of variables, and we know none of the weights. Any attempt at reading the market to understand those variables is going to be about as useful as trying to observe butterflies by looking at hurricanes.
The meta-strategies help market prices be accurate, faster, by beginning to move prices towards the “right” number in advance of information that would do the same thing. In the long run they don’t misinform.
This obviously excludes strategies based on fraud, misinforming the public, etc.
Accurate or right here means economically efficient, not correct according to the prediction of some simplified model. Such strategies very much obfuscate any attempt to find and measure causal links between particular events and stock price movements.
I could say the markets are up due to the vaccine news, or because the US election was called and people are seeking stability, or because the US election was called and the market prefers biden, or because investors are pricing in a Trump 2024 run, or because people just expected it to go up after any of those things, or because a collection of automated trading bots saw some arcane pattern in the data which has no real-world relevancy but they nevertheless have been trained to buy. None of those predictions are falsifiable.
Correct; the prices are based on the sum of all information, which is a list we do not have. And “the market” is of course a basket of individual prices, which are not measured the same by everyone.
Just because you don't find layoffs as ideologically palpable as shedding (some or all) the inefficiency incurred by covid doesn't make the markets wrong.
There's potential for a huge gain in efficiency here. The stock market is fundamentally a long bet (if you want to short the entire market you invest in things outside it). Of course the market is exited at the long term prospects of that.
Also, you're being a little disingenuous when yo say "These are the same markets that cheer when job cuts and redundancies are announced." When one under-performing company cuts jobs it tends to go up because costs are decreased. When a well performing company announces a mass layoff it tends to be a toss up because signals are mixed. When a ton of companies announce layoffs the market tanks because the signal being sent is things are getting worse all around. You're comparing a positive reaction to a single entity event (company announces layoffs) to a positive reaction for a market wide event (potential for covid to become less of a burden on the economy as a whole). You can't cross compare as if they're 1:1 like that.
> There's potential for a huge gain in efficiency here ... Of course the market is exited at the long term prospects of that.
IMHO this supports the OPs point, which is that the stock market in its current incarnation does not care about the lives of human beings.
Which is unacceptable. We collectively have enough creativity and intelligence figure out how to have a stock which can not only reflect corporate profit but also human well-being.
I think it begins by acknowledging market externalities - pollution being one of them - which allow for activities which are profitable within the shared fiction of the market, but which are, in our broader shared reality, ultimately destructive.
The Happinese/Well-being GDP also seems like an interesting idea.
I don't think the stock market should care about lives of human beings directly. It's not meant to do that.
I do agree that using the stock market as an indicator of quality of life, general well being of human beings or anything else than the financial viability of publicly traded companies is not a very good idea. That's a frequent mistake made by financial journalists and politicians alike, however, especially during election season.
A lot of people are invested in the stock market, not just rich people. Essentially anyone with a professional-class job has a retirement fund invested in stocks, at least in the US.
The top 1% own over 50% of equity in the country. The following 9% own about 30% of equity. All in all, that's the top 10% owning more than 80% of the equity in the country.
I disagree that a lot of people are invested in the stock market. Statistically, it's very few people.
It means that people who research this think that the news is correct. And unlike pundits, these people have skin in the game and win or lose based on the correctness of their assumptions. If the market were down today, it would be an indication that the news is hyping something that's doubtful.
It's a good indicator of what the world (well, people with capital) believe in. A very positive general market reaction might indicate that the news is correct. (Might.)
If only it's that accurate... IMO market participants just react to news because they expect others to act a particular way, and I as a participant would try to see how I could profit from how others act.
In this case, no one probably bothers to dig deeper, it's the BBC and it's good enough, everyone will think the world will soon be rid of Covid, so they will buy stocks, so I should also join the up wave...
The beauty of it is, you don't have to. The subtle truth is that, as a practical matter, you often have to care about "opinions" you don't respect or admire. Another's opinion is a fact, albeit a minor one, from your point of view. What's more, it's the legitimate output of a computation they performed based on a set of (weighted) inputs. The market is best seen as a machine that measures two things: which market is better (meta market), and within each market, which product is better, from the sole perspective of making money.
All things die, including businesses. Layoffs can be a good thing if the job is terrible, the business is a zombie. Can you imagine working at Sears? It's good to let bad businesses die because the alternative is worse. That said, humans like to get settled, comfortable, get a rhythm to life, and changing jobs (because of a business failure or whatever) is a HUGE stressor. And its uncertain if you don't know where you can "plug in" to the economy and get a job, so you're in a rush, and new employers rush you through onboarding and acquire all kinds of legal leverage over you, and so on.... And the American worker is not trained to examine their options from any perspective other than "Job Title" and "Salary". Even "Benefits" often get short shrift.
Anyway, long ramble short, you don't have to admire the minds that move money, but you should take them seriously. It's worth considering, though: what would it take to have your cake and eat it too? How would you make the "markets" more admirable, which in your case seems to mean "more moral"?
Why shouldn't companies lay off people they no longer need? You hire N people, you lay off X% of the least performing ones, you end up with a stronger company, and you can hire again.
I would add some clarifying quantifiers to your statement as not all rich people are rich because of markets knowledge. Inheritance of wealth is also an important contributor.
Thus far in 2020, Gallup finds 55% of Americans reporting that they own stock, based on polls conducted in March and April. This is identical to the average 55% recorded in 2019 and similar to the average of 54% Gallup has measured since 2010.
Because an effective vaccine would be really good for the economy so a positive market reaction indicates that people researching this stuff think the likelihood of an effective vaccine being ready in the near future is higher. So it's not cheering the market reaction, it's cheering the potential for an effective vaccine and the market reaction is just a signal that the vaccine is legit.
to add onto this, one of my entire classes at NYU "Covid and economic policy" we've literally just looked at science and how its effected the political and economic landscape. Yet, you say stuff like what you did here on hacker news and you get reported / flagged / greyed out. That is why I dont contribute here anymore, it's basically like reddit-lite
Yes. The most frustrating topic for me is to bring up is the evidence that dis-agrees with the man-made climate change hypothesis. Source, Weathermans Guide to the Sun by Ben Davidson. But I cant even get my long time friends to explore that evidence, let alone anyone on internet forums.
I mean, to be fair, the timing is interesting but I wouldn't go any further than that.
I don't think (and find it incredibly unlikely) there's any correlation per se, but quite a few people were hoping to hear certain news on the political front and the COVID front. They heard both in a pretty short window and I'd say that and the effects nationally are interesting.
Many many people are now feeling a lot of stress relief in a short period of time. Should be interesting how this effects morale around the country.
This is exactly the point of preregistered hypotheses.
Odds of conspiracy, with a clear hypothesis and confirmation of that hypothesis, go up drastically. That happened here.
It wasn't a super-unlikely hypothesis either. We're talking about announcing a result a few weeks earlier versus later. That's not an unreasonable decision for a blue-leaning businessperson or scientist to make.
What reduces odds are the number of preregistrations. There were dozens about this strong.
My own prior went from 1% odds to maybe 35% odds. Yours may be different, likely based on your prior based on where you fall on the political spectrum. Right-wingers will probably go 35% to 80%, and left-wingers from 0.01% to 1%.
Do any down voters want to step up and say they think the Trump Administration has competently handled the pandemic?
It's obvious to anyone willing to look at the facts, and to be honest with themselves, that this administration has done a terrible, terrible job of responding to the pandemic which has probably caused the unnecessary deaths of a lot of people.
And that's not a partisan thing to say. Or rather, it shouldn't be ...
> That's not an unreasonable decision for a blue-leaning businessperson or scientist to make.
Intentionally murdering possibly thousands of people (or tens of thousands? or what, who knows?!) for some assumed political gain is absolutely, 100% an unreasonable decision for any human to make. Intentionally delaying a vaccine would certainly be a crime, no? Not to mention absolutely abhorrent and completely evil.
That is not a "reasonable decision" to make by any stretch of the imagination.
> Intentionally murdering possibly thousands of people (or tens of thousands? or what, who knows?!) for some assumed political gain is absolutely, 100% an unreasonable decision for any human to make. Intentionally delaying a vaccine would certainly be a crime, no? Not to mention absolutely abhorrent and completely evil.
You mean delaying the announcement of a vaccine. They didn't delay the process.
No. I didn't write "Intentionally murdering possibly thousands of people" or "Intentionally delaying a vaccine"
I wrote "We're talking about announcing a result a few weeks earlier versus later."
And if that was the goal, I think it worked. It looks like Biden won by literally tens of thousands votes. An announcement a week earlier probably would have swung the election to Trump.
At a cost of zero lives.
If the vaccine works as announced, we're still weeks away from the end of the trial, and months away from widespread distribution.
In your conspiracy theory, surely, they'd just have announced after polls closed? Why wait for it to be called? Also, this vaccine was actually developed by a German company, who would likely resent their partner playing this game.
This timing is consistent with when we've been told we might see early results all along, really; it shouldn't be that surprising. Expect announcements from other teams over the next couple of months.
First business day after the election was called, but not after the election itself (i.e. people couldn't vote after 11/02). Or are you saying that they were planning on not releasing this at all in case of a Trump win and not just trying to influence the election?
The thought didn't even cross my mind that they'd hold the vaccine for political reasons. Just the press release. Holding the vaccine itself for political reasons would be murder on a mass scale.
In a double-blind, phase 3 trial only one group has on-going data access: the independent group conducting the study. No one else, including patients, doctors, and the business, has any knowledge of the results until they are "unsealed". That continues to be true throughout the entire trial even if preliminary results are unsealed at different points.
Precisely. They have seen 94 infections total so far, based on the statistics that’s likely to be almost entirely in the control group. Those infections are reported as they come in, so for example, perhaps last week there were 87 infections. The study ends once they hit ~150 infections, based on their sample size that will give them the confidence intervals they need to finalize.
So the difference between announcing preliminary results last week versus this week was their own internal decision on timing.
They intentionally kept the samples frozen in their lab until the day after the election. The most important vaccine in the 21st century, and they kept the samples on ice? That's incredible.
Ok, I have to partially take that back. According the Pfizer they intentionally did not confirm the data until last Wednesday.
> The first analysis was to occur after 32 volunteers — both those who received the vaccine and those on placebo — had contracted Covid-19. If fewer than six volunteers in the group who received the vaccine had developed Covid-19, the companies would make an announcement that the vaccine appeared to be effective. The study would continue until at least 164 cases of Covid-19 — individuals with at least one symptom and a positive test result — had been reported.
> In their announcement of the results, Pfizer and BioNTech revealed a surprise. The companies said they had decided not to conduct the 32-case analysis “after a discussion with the FDA.” Instead, they planned to conduct the analysis after 62 cases. But by the time the plan had been formalized, there had been 94 cases of Covid-19 in the study. It’s not known how many were in the vaccine arm, but it would have to be nine or fewer.
> Gruber said that Pfizer and BioNTech had decided in late October that they wanted to drop the 32-case interim analysis. At that time, the companies decided to stop having their lab confirm cases of Covid-19 in the study, instead leaving samples in storage. The FDA was aware of this decision. Discussions between the agency and the companies concluded, and testing began this past Wednesday. When the samples were tested, there were 94 cases of Covid in the trial. The DSMB met on Sunday.
Discussions between the agency and the companies concluded, and testing began this past Wednesday.
I don't think it's totally unbelievable that they waited until after the election to release preliminary results. Waiting a week or two wouldn't hurt the timeline, and would significantly damage Trump's campaign. If I worked at Pfizer that's what I would do.
At the risk of damaging Pfizers bottom-line, if someone manages to produce results before them, and at the risk of getting fired and sued for doing so.
It’s just such a fundamentally bizarre idea that I think it needs a lot more support than just “not totally unbelievable”. Most people don’t warp all their decisions around partisan politics.
We'll have to find out. If the virus is suppressed for 6-12 months, it's basically eradicated, and vaccination would only have to start once it starts spreading again.
The rate of spreading will depend on factors such as international travel and how much people will have learned from this period. I expect/fear that everyone will try to get life as before as soon as possible, so the extra delay after the vaccine wears off might be negligible.
If you get the virus, you only appear to be immune for a short time (6months, would have to look it up). This matches other coronavirus and how you can get colds multiple times a year.
In reality, a vaccine is probably going to offer a lower (but if this study is true, acceptable) level of protection. I wouldn’t be surprised if the protection drops exponentially after 2 months. Similar to the live virus
>In reality, a vaccine is probably going to offer a lower (but if this study is true, acceptable) level of protection. I wouldn’t be surprised if the protection drops exponentially after 2 months. Similar to the live virus
Serology reports for the Moderna vaccine (very similar technology) are showing 4-5 times higher levels of antibodies than those who actually contracted the virus.
But that's the democrat narrative as of a week ago: vaccine by EOY is too dangerous. Suddenly, a week later the same exact vaccine is perfectly OK and it's a scientific triumph. Is the attention span of the public _this_ short?
I think that they may have not released right before the election, but that's kind of the right thing to do. You shouldn't jolt voters with news like this, especially if there's no medical/public health benefit to doing so. That's exactly what Comey did in 2016 and it contributed to people being worried about voting for HRC.
A friend of mine (who is a nutjob), said a few months ago that even if the vaccine doesn't work, they can say it would work 80-90%, because that's the amount of people who don't show symptoms anyway.
I don't know anything about this, but now it happened in a way he said, so what do professional here think about this?
Essentially no vaccines are 100% effective, and 90% is actually much better than expected for covid vaccines. The people in the trial are being actively tested, so symptoms are largely irrelevant.
To be clear, these trials work by giving the vaccine to a bunch of people and seeing how many catch COVID. They're not challenge trials, where people are deliberately infected; your friend's conspiracy theory could kind of work with those (assuming that for some reason not everyone in the group was being regularly tested).
> because that's the amount of people who don't show symptoms anyway.
I don't think this is accurate. A large majority of people show no or relatively mild symptoms comparable to a seasonal flu or cold, yes, but that's not the same thing as no symptoms at all for a large majority.
The 90% is more like this. You have a twin who lives exactly the same life as you. You get vaccinated but anti-vax Andy doesn't. Andy is 10x more likely to get Covid than you are now.
The number in this specific trial is a 90% reduction in cases when comparing a vaccinated group to an unvaccinated one. So, if for example 10% of the unvaccinated got COVID in the trial timeframe, 90% effectiveness would mean only 1% of the vaccinated people did.
90% protection... Let's see what this really means - because I'm pretty sure we already have something on order of 80+% protection without a vaccine. I'd like to see % protection vs age.
>> because I'm pretty sure we already have something on order of 80+% protection without a vaccine
I think the way these studies are set up already accounts for that. In these trials they don't vaccinate just one group and then check how many people still got sick ('only 10% got sick so it 90% effective'), but instead they split the participants into a 'vaccinated' group and a 'placebo' group (double blind), then wait until X people in the total of all participants get sick, then compare how many of them got the vaccin and how many got the placebo. Since the total group is large, this should average out pretty much all variability in susceptibility to infection (assuming the participants are selected to include a wide range of attributes, of course).
I don't know how the maths work exactly but I think the 90% claim here means that if you take the vaccine you are 90% less likely to get sick from covid compared to someone else with comparable attributes.
Oh well let's not benefit from others brains knowledge, experience and computing power, let's instead think in isolation and cultivate our blind spot bias
I read this with a lot of hope. The -80 degree cold storage part won’t be easy. Most vaccines stored at medical offices are nowhere near that and are only around ~0 degrees C.
Freezer temps are only ~18 deg C.
Possibly will only be able to be administered at special sites or if they find a way to stabilize it at warmer temp.
According to Wikipedia (https://en.wikipedia.org/wiki/COVID-19_vaccine#Clinical_tria...) there are 8 COVID-19 vaccines in phase 3 trials. A week or so ago I read about an experiment in Brazil that compared 5 of them. So this Pfizer press release doesn't seem terribly exciting to me. I already knew it was very likely that at least one vaccine will be available to some people in a month or so.
I know a couple of people who are experimental subjects in COVID-19 vaccine trials (meaning that they may or may not have received a COVID-19 vaccine: it's double-blind, of course). It's an interesting question what happens to those people if they become elligible for real vaccination before the trial they are participating in has come to an end.
Everyone expected/hoped that there would be a vaccination within a month. However until now it was just hope: there was always the risk when all 8 of those ran their data they discover they don't work at all.
There were already some positive preliminary results from the five vaccines being tested in Brazil, so "don't work at all" was already ruled out, I think. Obviously the press release from Pfizer isn't going to mention the other vaccines, but a diligent journalist might look up the details and do some kind of comparison. Perhaps the diligent journalists need a bit more time to write their articles. Perhaps we should wait a day or two and consult a better source than the BBC.
I haven't heard about those other results so I cannot comment on them. I agree a journalist should know about them (unless they are so flawed in some way as to not be worth my time, which a good journalist should know but most don't).
Warp Speed didn't contribute to the development of this one; they have allocated funds to buy the vaccine though
Operation Warp Speed, the federal effort to rush a vaccine to market, has promised Pfizer $1.95 billion to deliver 100 million doses to the federal government, which will be given to Americans free of charge. But Dr. Jansen sought to distance the company from Operation Warp Speed and presidential politics, noting that the company — unlike the other vaccine front-runners — did not take any federal money to help pay for research and development.
“We were never part of the Warp Speed,” she said. “We have never taken any money from the U.S. government, or from anyone.”
That's just normal pre-purchasing, though, which would have happened regardless of that particular program. They also have a few hundred million doses ordered by the EU.
Amazing what's been done over the last few months because of Project Warp Speed. Thank you President Trump, Vice President Pence, and of course all of the medical companies that have been participating in these efforts.
> The data released by Pfizer Monday was delivered in a news release, not a peer-reviewed medical journal. It is not conclusive evidence that the vaccine is safe and effective, and the initial finding of more than 90 percent efficacy could change as the trial goes on.
The title is quite sensationalistic for such preliminary results. Especially when they have only been reviewed by an "outside panel of experts" [1] who sometimes have undisclosed conflict of interests.
It's a highly formalized clinical trial, it would be nonsensical to misrepresent or exaggerate the results. The preliminary analysis is based on 94 cases; not a huge number, but totally reasonable to draw conclusions from.
My point was the validation and peer-review. There are many possible confounding factors, including isolation and mask use.
Also I might have misread the protocol, since I'm no medical scientist, but wasn't the efficacy of the vaccine measured only in a 1 month timespan? Are we even sure the effects are long lasting?
I just don't want to get the hopes too high too soon. The crash after a positivity high can be quite bad. Reuters is even live streaming Wall Street because of this announcement!
The virus is (heavily) mutating folks.
Heavy mutations likely related to recombination with rhino-viruses.
This vaccine will likely be outdated when generally available.
Rate of mutations is directly proportional to number of viruses out there. We're having exponential growth in the amount of COVID19 (with a slow exponent, with social distancing, but exponential none-the-less). That we've seen mutations back when there was a tiny fraction of the cases we have today is a very bad sign.
If it jumps species, as we saw with mink, we may have a reservoir in nature with no control. It will mutate and periodically jump back to humans.
There are reported cases of people who built up immunity against the Chinese strain and got infected with the European strain while still having antibodies for the first one.
Danish are killing 17M minks because of a novel mutation that infected 12 people (reported).
Everybody also produces different antibodies, potentially targeting different aspects of the virus. Having a vaccine means you can make sure everyone gets the 'right' antibodies that generalize the best.
I wonder if the people scared of permanent damage caused by Covid (for which there is no evidence) will be equally scared of the permanent damage caused by this experimental vaccine (for which there is no evidence either).
In what way does thousands of people self-reporting new and ongoing medical issues after a positive COVID diagnosis not constitute evidence that this is happening?
Clinical trials are not the only form of evidence.
One of the striking things about "Long Covid" patients is that many of them didn't have severe covid symptoms (they didn't require hospitalisation, etc), and yet they have still had ongoing problems months later (some people have reported symptoms clearing up a few months later, some people still have unresolved issues).
I've read the UK study published from the publisher in Charlottesville and it's a case study of ~60 people (and there are 8 individual cause studies from that study) and almost all of them were either over 55, or were in high risk jobs (jobs were not mentioned for privacy). Many of the old had comorbidity.
If you read the actual papers and not the press releases on "long-covid" .. it's really small groups, and honestly, it could easily be nocebo or hysteria. It could be a real effect too (like lymes disease, where the immune system continues to overreact after the infection is gone).
It's really way too early to tell. Also, ANY virus can lead to permanent neurological damage in the elderly. It can happen for things that are minor infections for 30 year olds.
> In what way does thousands of people self-reporting new and ongoing medical issues after a positive COVID diagnosis not constitute evidence that this is happening?
What we see every single day in society by massive amounts of people. People getting ill from nocebos.
Given the issues we know around self-reporting why on earth would you believe it?
And given the massive amounts of hours and funding put into the coronavirus, the missing clinical data matters.
Getting away from the trolling of the op, pretending they didn't know about the deaths.
We know being on a respirator will cause damage. We know antibiotics or steroids or whatever causes damage. We know being in a coma will cause damage.
What's being talked about is new/additional/unknown damage caused by this virus. The real data on this is slim.
> We know being on a respirator will cause damage. We know antibiotics or steroids or whatever causes damage. We know being in a coma will cause damage.
> What's being talked about is new/additional/unknown damage caused by this virus. The real data on this is slim.
We know that similar viruses (e.g. SARS-COV-1) can cause long term damage to heart/lungs. We know that several viruses can cause post-viral chronic fatigue.
> The real data on this is slim.
I think what most people are calling for is more investigation into this. And in the meantime some caution is warranted regarding the possibility.
> several viruses can cause post-viral chronic fatigue
Right, and with over 95% of fatalities being people over 55, we know this virus affects the elderly disproportionally.
Furthermore, TONS of infections cause major neurological damages, strokes and other conditions in the elderly, which rarely (but sometimes) affects young people as well. A minor fungal infection can leave you with complications that lead to permanent disability.
What we are attributing to CoV2 may just be people who were alright at high risk for any infection, taking a particularly hit to this one.
Then please post some of that evidence. Evidence, not anecdotes -- of course there are individual cases among millions of infected, that doesn't mean it's a phenomenon worth caring about.
It is not impossible to monitor an adequate number of people who had Covid and see if they are getting better. If their state plateaus, that is evidence their condition may be permanent.
Experimental vaccine? I disagree.
Nearly 45,000 people have taken this vaccine, and they have been monitored for months to make sure no adverse reactions have happened.
Combine that with the fact that we live in 2020, and that our knowledge of vaccine science is much better than it was just a couple of decades ago, and it's hard to believe that this is an "experimental" vaccine.
45,000 doesn't scale up to 100 million or a few billions. The Swing Flu vaccine left major neurological problems in over 4,000 people, many of which were paid out in law suits. We still have vaccine courts.
Thankfully, the US antivax movement is not as strong in the rest of the world, and thankfully not everyone needs to be vaccinated for the R0 figure to drop considerably.
If cretins don't want to be vaccinated, it's their loss.
This isn't "antivax" ... Are all drugs that have been approve effective and safe? Including Viox?
We have had bad vaccines before (The 1960s Swing Flu) that lead to serious complications.
I got most of my shots (MMR, Polio, Meningitis, Hep B, Tetanus booster, etc.), but I would NOT take this one. It's been rushed through the process, and vaccine safety takes years. This is a brand new type of vaccine (mRNA), a type that has never been successfully deployed before, for a virus family that's never had a successful vaccine before.
Stop dismissing legitimate concerns as "antivax". Each vaccine is very different.
I'm not at high risk (<40) and I'm also a software engineer who has watched millions in losses from badly designed, badly implemented, rushed software. Skipping the 8 ~ 10 year set of standard tests for this vaccine does not increase my confidence.
I'll wait until I turn 48~49 and watch what happens with all the volunteers first before making my assessment based on all the available data.
Given that there will be a limited number of initial doses, healthy people have the luxury of taking a "wait and see" approach. It will be interesting to see if vaccines are mandated generally or for travel.
Hopefully there is more better scientific data on this vaccine before rushing it to top of HN and judgement. I am not sure how to explain 90% immunity from a disease in scientific language, because there are only two states a person get infected with COVID-19 or does not get infected with COVID-19. Not sure how this vaccine will make a person 10% infected and 90% not infected with COVID-19.
This is one of the vaccine Trump referred to in his debate, not sure how much it’s really useful or its another one like Sputnik and Coronavac.
I think the best details for Corona related vaccine efforts are from WHO. [1]
This was developed by a German company and will be widely distributed in the EU if approved, so will have to be approved by both the FDA and EMA. Now, if the FDA passes it and the EMA says 'no', that would be reason for concern, potentially, but assuming both bodies pass it that should be good enough for most people.
It’s a 90% reduction in cases in a vaccinated population vs unvaccinated. Basically how good is the vaccine at preventing symptomatic infection upon exposure
Real question I have is how well the study was conducted AND how long immunity lasts. Even if both were good here... we won’t have the vaccine widely available until mid to late next year.
https://news.ycombinator.com/item?id=25033844&p=2
https://news.ycombinator.com/item?id=25033844&p=3
https://news.ycombinator.com/item?id=25033844&p=4
(Once we've rolled out some long-suffering performance improvements, all of this should blissfully disappear, including this sort of comment. Thanks for your patience.)