Vaccine hopes rise as Oxford jab prompts immune response among old and young
reuters.com
reuters.com
>You will be compensated for your time, the inconvenience of having blood tests and procedures, and your travel expenses. The total amount compensated will be approximately £235 - £625 depending on the exact number of visits and whether any repeat or additional visits are necessary.
They deliberately do not pay large amounts, because the money is not supposed to overly-incentivize the participation, to avoid ethical issues where someone might choose to participate in something very unsafe only because the reward seems so large.
It's kind of like non-pay electoral offices. You only get candidates that can afford not to work. In medical trials, you get the kind of people that are willing to, for example, get infected with the common cold and have you blood drawn 6x a day for 4 days for about 80 bucks a day. It was not horrible, but often uncomfortable. Study recruiters still call me, and now that I have a decent paying job there is no way I would ever consider doing those kinds of studies again. Simply not worth it.
Thinking otherwise is willful ignorance, and this is clearly exploitation of lower income groups.
>Until now, this vaccine has only been tested on laboratory mice and other animal species and this is the first time that the vaccine will be given to humans.
Is it possible to know which species those are?
https://www.nih.gov/news-events/news-releases/investigationa...
Noise in the data - you want as clean a population as you can get. If you start including people with chronic conditions, as soon as someone in your trial dies you get to play a game called "prove that it wasn't the vaccine that killed them".
Same with people over 55 years old - they are known to respond differently to vaccines. The worst thing in the world would be showing a 49.4% reduction in Covid infection rate (the FDA wants 50% minimum) and then being forced to do a bunch of handwaving about how your results were skewed by the 55+ patients in your study and "by gosh, I swear it would be over 50% if we adjust for them using this methodology we just made up". Nobody will believe you and you'll be relegated to "that vaccine that almost works".
Ethics - Kids aren't (well, very rarely) dying from Covid, but they could die after getting your experimental vaccine. Kids sickened by experimental drugs makes for bad press, not only you, but also the FDA. Easier to just exclude them for now.
It varies by disease. Can anyone really say what the % is/would be for covid-19?
In addition, to question of "can anyone really say for covid-19", I suppose the answer is 'No, but I would trust that the consensus of the scientific community of infectious disease experts is the best estimation we can get.'
Obviously "herd immunity" is more of a gradient than a cut-off, and it's much easier to approach it if we can vaccinate everyone, but we can definitely speed up the process (including the months-long process to even get the vaccines to everyone) if we can start vaccinating some people early.
Look up “swiss cheese model covid-19”
REALITY: Assuming 75-90% efficacy vaccine, vaccination is non-random and population is heterogeneous. You want to vaccinate everyone who agrees to take it. Just like with children diseases, there will be clusters of anti-vaxxers, or people just don't bother and they are often clumped together, travel around the world and spread the disease.
Each extra person getting vaccinated adds protection, both for that person and the larger society.
i suspect you may already know the answer to your question; of course not everyone needs to be vaccinated - that's the job of any reasonably healthy immune system and this virus, which has not been properly isolated by the way, and that comes directly from the CDC, is not particularly dangerous, and that comes directly from the WHO
any thinking human being knows that masks are, at best, largely ineffective at preventing transmission, as is "social distancing" - the way governments are handling this "pandemic", which by definition is not a pandemic, is killing far more people and ruining far more lives that the virus ever will
the question then becomes, why? why are we being asked, and compelled in many case, to wear ineffective masks? why are being threatened and arrested in some cases for not distancing when there is no creditable scientific evidence to support that distancing works?
furthermore, the rt-PCR "test" that is used by many labs to diagnose COVID-19 is not a test - it is a procedure designed to amplify a tiny amount of RNA or DNA - it was never designed to test for this or any other virus and it does not produce a binary result, so in the end , we have NO idea how many cases there are, and it gets worse than that because apparently PCR is looking for any corona virus, alive or dead! that means that anyone that's ever had a cold can test positive (along with people that died in motorcycle accidents, fallen down stairs, or got shot in the face apparently)
the number of 'cases' is meaningless and the survival rate is exceedingly high, and if we make an adjustment for the radically inflated number of deaths, it becomes very questionable whether there even is a "novel" corona virus or whether it's the flu
lastly, even if one is not reasonably healthy, or just doesn't wish to spend a lot of time being sick, all that required is high-dose vitamin C along with D3 (and zinc wouldn't hurt) - what's a high dosage? 4 grams+ / hr. for an adult, not that it's critical because no one has ever died from vitamins (minerals is a different story)
READ: Coronavirus (COVID-19, SARS-CoV-2) news and resources – index – 12Bytes.org https://12bytes.org/articles/health/covid-19-coronavirus-inf...
> any thinking human being knows that masks are, at best, largely ineffective at preventing transmission, as is "social distancing"
> it becomes very questionable whether there even is a "novel" corona virus or whether it's the flu
You know, I live in Adelaide, where we haven't had a single locally-acquired case in several months. I've been wondering how almost every other city on the planet has been screwing things up so badly when we've not really done all that much apart from having a quick reaction and social distancing appropriately.
My question is now answered: those cities have people like you, willing to spout even the most blatantly abject conspiratorial nonsense for the sake of advertising your own website.
Please show some responsibility for the lives of those around you.
I'm celebrating that following the science here has taken us from > 700 new cases per day, to our second consecutive day of zero (and lockdown ending less than 3 hours from now)
Source: My partner is an infectious disease specialist and we talk about this pretty much daily because I'm so curious.
Doesn't change the fact that, when you're developing a new drug, you want to test it in a way which will cause the least harm. You don't begin trials with those most at risk for obvious reasons. The primary goal of this phase it to asses the safety of the vaccine candidate.
I'm also unaware of any disease that isn't more threatening to people in relatively poor health.
At this stage they still need to ensure the drug is safe, so they test it on healthy people first.
My intuition on this has become that the more certainty there is that you are to die without treatment, the easier it is to try relatively risky new treatments on you (with your consent). But say having stage IV pancreatic cancer is very different than having a comorbidity for a disease you haven't contracted yet.
Additionally with something like a vaccine, you are very interested in what it will do to the general population, not just the most vulnerable, because it should be rolled out to the general population. Anything screening program, you have to pay attention to the unlikely side effects since the denominator will be large.
Finally, you do these trials in phases because you need to find out if it is safe for humans first, then if it is effective.
Another is that when someone is already sick, they are more likely to not do well with any particular new drug (pretty much nothing is 100% effective for 100% of people), so you'd have to have some way to trying to discern whether the fact they got worse or even died is related to the new drug vs. just a natural progression. This can get complicated to measure.
And specifically for this particular thread, this is a vaccine, not a cure -- so in any case, when we say "least healthy" in this context, we're not talking about giving it to people who are already diagnosed with the virus, but rather to those who are _at most risk of complications_ from the virus, _if they were to contact it_. So it would be giving a drug to people who _don't_ immediately "need" it to survive, but who are still most at risk from any side effects.
I've got a 90yr grandma, she shouldn't be the first to try new stuff injected I to her body. Is that not obvious?
Drug trials always start from learning more about safety of treatment (as opposed to efficacy) and once deemed statistically safe, you move to test for efficacy.
I assume you're thinking about treatments who could give a chance to those who have little hope/time for surviving. There's probably a chance they can benefit from taking experimental drugs but if we know little about it (because they are early in trial phases) we less confident this treatment will be useful and worst, we maybe not learn much from why it failed
It's already hard to prove it on healthy candidates, it's pretty much impossible on candidates whose immune system is already weakened by previous conditions.
You are also evaluating the intended effects (as opposed to side effects), so you can see if it is actually doing what we want it to do, and how well. We could find out that the vaccine is very effective at preventing covid infections. But we could find out that it does not reduce the rate of covid infections, but does reduce the severity, or we could find out it does not reduce anything for reasons we don’t yet understand.
Once that is done, we will have a good understand of A. the level of benefit and B. the level of harm. From there we can make an educated decision to proceed or not. If we do, then it is approved and given to the general population, including those at risk. It is at this stage that the effects on at risk groups can be studied, during the ongoing monitoring of the approved drug.
Hopefully this answers your question and shows why this is the best way to do it.
Yes, but at this stage there is no drug. You're in the process of making the drug. And you don't want to test your beta versions on sensitive subjects.
Once nothing obviously bad happens, you can expand the test circle.
If the drug turns out to harm people, a healthy person may be able to deal with it and recover. While a person that is barely hanging on to life may be pushed over the edge. There's no data to support a new drug raises the survival rate. It may in fact lower it from low to zero. During testing you generally want to kill as few people as possible.
Once more data has been collected on the drug, then the balance starts to shift toward giving it to at risk groups.
You don't test your new med on the group is most likely to die.
The proper calculation would be probability of infection * probability of death in the intervening months before we collect data on the efficacy of various options vs expected outcome if they just take the oxford vaccine now.
The users chance of survival is already quite high in the intervening period and while the benefits of the oxford vaccine are highly hypothetical they are also largely contingent on vaccinating everyone. People are liable to only see IF it works a 30% - 60% effectiveness, lower for some with worse immune systems. The real benefit is decreasing the spread of the virus until it dies out not merely the individuals benefit which will never happen if it turns out it doesn't work.
Worse it may be most apt to kill or harm those who are also most vulnerable to covid.
At worst the patient trades a very good chance of survival for a substantial downside with no upside and a future vaccination with a different vaccine they ought to have waited for.
As an example, the patient who got the first heart transplant:
“As a result of heart attacks in 1965, approximately only one third of his heart was still functioning. In late October, he went into a diabetic coma, but regained consciousness. […] He was also suffering from kidney and liver failure.”
This is preventative medecine, as far as I know, most vaccines cannot be given to someone who already has the disease.
So it makes sense to target healthy people first, to test out the vaccine side effects, make sure there aren't many or bad ones, and then test out if the vaccine works. And then once you know it has low side effects and works, you can risk testing it on more compromised individuals.
I had to think a while - sickle cell anaemia and malaria. I’m sure there will be others.
But in general, good health leads to better outcomes, and we know that's the case with covid.
(Source: John Barry's The Great Influenza)
"Spanish" flu was a notorious example: older people are believed to have had some amount of immunity from old strains, and the cytokine storms which made that strain so deadly are actually a consequence of having an active, robust immune system.
Doctors can get COVID then spread it to their patients. A vaccine, even just for healthy people, would negate this chain of events.
It's proving it doesn't make healthy people unhealthy (see https://www.cdc.gov/vaccinesafety/concerns/guillain-barre-sy... and specifically the 1976 flu vaccine, for example).
Since healthy young people are more likely to get Covid, it might be this is the fastest avenue to knowing how effective the vaccine is.
But I am not a doctor or infectious disease expert or vaccine researcher.
So I am assuming this is the control group.
Clinical trials are phased. Typically you start with a very small group of people to evaluate toxicity (e.g. below treatment levels of a drug), then a slightly larger group looking for side effect, then a significantly larger group looking for desired effects, and finally a broad group looking for safety and efficacy.
After that a phase 3 study is done on tens of thousands of people from all possible demographics.
And the smallpox one can leave an even bigger scar. I suppose they don't want the liability for that which could impact the model's income
> excluded groups on the trial (page 3,
Now that you mention it I had heard of the British Page 3 tradition but it didn't occur to me at the time.
And thank you for volunteering.
I guess the reason is that the study is narrowly tailored to vaccine approval requirements?
I would imagine that volunteers would also be willing to get tested, though perhaps the worry is that such a requirement might cause more of them to drop out of the study.
[1]: https://interactive.news.sky.com/2020/covid-19-coronavirus/t...
Kind of difficult to prove efficacy if you don't know how many people in your trial were infected with the disease you're trying to vaccinate against though. But do bear in mind as mentioned in other comments this participant was not in the phase 3 trial, and phase 3 is where the immunity given by a vaccine is tested. Phase 1 and phase 2 are much more constrained studies intended to determine if it's safe to give the vaccine to enough people to evaluate immunity.
I am unsure if they will have some lower bound for acceleration for this vaccine, since the downsides might not be apparent for a long time.
Something is probably going to work. The big question is how well. A 50% effective vaccine might be an overall lose - only half are protected but more than that abandon masks and social distancing.
The Johnson and Johnson vaccine, if it works, is the easiest to use of the early leaders. One dose, and it doesn't need to be refrigerated to dry-ice temperatures like some of the others. The Merck/IAVI vaccine is only in phase I, but it's a pill. If that works and is highly effective, it will be possible to wipe the virus out worldwide in a second round of immunizations.
[1] https://www.nytimes.com/interactive/2020/science/coronavirus... (or https://archive.is/D6C68)
I remember a similar argument being used against face masks. (That they are not perfect, and may cause harm by giving false sense of security.) Perhaps we should be more careful about perfect being the enemy of good.
That isn't enough for herd immunity (at around 60%) and real vaccination rate will be even lower.
There is also no chance in hell that Germans will allow a government-mandated vaccine. It's unconstitutional and there is heavy opposition to government-mandated anything throughout all of society.
So we will be stuck with this virus. But you're free to get the vaccine yourself for your own protection.
At a considerable cost. There's a large number of people for whom the vaccine won't work when it has been taken correctly or who cannot take the vaccine because it will react very badly with their chemotherapy or whatever.
This "let Darwin deal with the anti-vaxers" solution, though initially attractive, ends up being sociopathic when you dig into it.
Many states make them (usually with fairly broad exemptions, often including belief-based) requirements for public schools, though.
Bodily autonomy is arguably the most important human right.
Bodily autonomy is about being in control of what happens to your body — it does not mean you have carte blanche to do whatever you want with your body.
Well, thankfully we haven't done this today either. This virus appears to affect more than just those that die from it, and that group of victims already includes more than a "tiny percentage of bubbleboys."
https://www.healthline.com/health/mental-health/sociopath#di...
Once a vaccine is available and a large share of the population either has been vaccinated or has the opportunity to be vaccinated maintaining the current measures can't be justified anymore.
The question is how long does it last? Even if it lasts only 6 months, that’s still 6 months of protection.
"The pandemic will only ever be over once the disease has been eliminated and there are no COVID19-related deaths or long-term effects anymore."
"Either the vaccine works in 100 per cent of cases or it doesn't work at all."
"It's either complete immunity for life or no immunity at all."
You can get the disease, recover, and then catch it again.
There are other factors such as frequency of exposure and viral load.
It’s not like the flu where you catch it and you develop a resistance.
When you've had an infection with one of those rather harmless yet still pesky other coronaviruses - otherwise known as the common cold - you're also immune, for a limited period of time, that is.
https://www.healthline.com/health-news/how-long-does-immunit...
EDIT no mention of it in Nature's covid roundup [0]. They must be censoring the research. I've tried googling the author and he seems to be some form of contrarian.
No bars, no restaurants, no concerts or sporting events, no public transport, no airports, no religious gatherings, no hospitals, etcetera.
The same is true for other vaccines. See for example [the figure on this page](https://www.gavi.org/vaccineswork/qa-ola-rosling-gapminder): in this survey, in Germany, 13% said they believe vaccines are not safe in general, but only 3% of babies are not getting the measles vaccination.
So let's hope many of the people that currently are not planning to get the vaccine, will change their mind and actually do so in the end. I think good information campaigns in the media and testimonies of friends that have received the vaccine will do a lot to mitigate this problem.
It honestly seems borderline unethical to give people a placebo vaccine.
https://www.statnews.com/2020/09/03/placebos-arent-needed-ch...
Also, there is a very strong risk, given the global situation, that the longer placebo-controlled trials go on, the less reliable the data will be, because control-group subjects will ignore the rules of the study and go get vaccinated as soon as it's broadly available just in case. So even just looking at data quality and excluding other considerations, placebos have major risks that probably outweigh the benefits of administering them for months or years like a usual vaccine trial would.
It's only unethical to withhold the vaccine if you know that it's safe and effective. The whole point of the study is to figure out if that's the case. It's possible for vaccine candidates to be ineffective, or even harmful (e.g., antibody-dependent enhancement).
The inactivated polio vaccine, for example, does not prevent infection. It just prevents disease. That means that it cannot confer herd immunity (vaccinated people can act as asymptomatic carriers, leaving unvaccinated people at risk), but for most people who are vaccinated, it eliminates the most serious consequence of polio infection - paralysis. The SARS-CoV-2 vaccines might end up being the same, conferring protection from disease but not from infection, and even that would be important.
Without a placebo group, how will you measure effectiveness and safety? You need to monitor a statistically equivalent group of people to determine the difference in rates of infection and disease, and to look for side-effects.
It’s spreading like wildfire to people following best practices too all over the world. It only takes a small subset not following these practices to spread it all over.
> Would the researchers not want people to go out and live their normal lives?
That would be great for the trials (assuming both the vaccinated and placebo groups behaved identically). But most people would consider it unethical for researchers to encourage the trial participants to increase their likelihood of exposure to the virus. People who sign up for vaccine trials are not signing up to get CoVID-19.
You may still have increased risk taking behavior if you don't tell them whether they got the real vaccine or placebo, but it will be equally increased across the experiment and control groups.
Having them expose themselves more to the virus is a "good thing" (though tell them how long should they wait for the immunity to set in)
Yes, with the control group you would have a base for how many people you would have expected to be infected, so there's that, but you "could" get that from other observations
No, if they change their behavior, you couldn't.
Why are so many people commenting when they clearly don't understand knowledge-creation/statistics/methodology?
Because (a) we want to understand. and (b) reasonable experts differ on what constitutes proper methodology which is constantly being improved.
Surely the effect size of a useful vaccine is large enough that modified behaviour of the vaccinated does not matter at all. We're not looking for a small incremental improvement in contraction rate of the virus here, we're looking for a very large percentage of those who have been administered the vaccine not getting covid. Yeah it could change behaviour but so what? How is that going to bias the result to suggest it isn't working if it is? (or vice-versa)
You talk about knowledge-creation and answer with a dogmatic tautology.
Then people wonder why anti-scientific sentiment is at high levels...
Anti-scientific sentiment is at high levels because you don't get someone to personally explain basic statistical concepts that you could have googled yourself?
Getting this number for a distribution of people as similar as possible to the people in the experimental group is, in fact, the primary purpose of having a control group. There is no better way to predict this number, as you can't predict how likely a particular person is to catch coronavirus at a particular time, in a particular location.
You also need a control group to get the number of various medical problems expected in the experimental group, even if the vaccine doesn't cause them. This also depends on time, place, and behavior.
So, if you create a reason for people in the control group to behave differently from experimental group, for instance by letting people find out which group they are in, you defeat the purpose of having a control group.
I'm not denying there's the need for a baseline to compare to, but the need to have an dedicated designated group to be the 'official control'. I agree it makes things easier statistically.
> So, if you create a reason for people in the control group to behave differently from experimental group
Yes and here lies a minor catch, both those groups might behave differently from the population in general (even though they aren't "supposed to")
Really it's about measuring how likely vaccinated participants are to contracting the virus than those that received the placebo.
A real vaccine, with side effects that are similar to what is expected of the covid-19 vaccine. It is a well tested and safe vaccine and it will protect you from meningitis but not from covid-19.
They are doing that exactly for the reason you are mentioning. Of course, participants are aware of the nature of the placebo they might receive.
wtf?! a placebo should by definition have no effect at all
In fact, there are even placebo surgeries. They put you to sleep, cut you open, and stitch you back without actually doing anything inside your body. It is far from nothing, the anesthesia and the incision are real. It is important because you want to compare the effect of the actual operation to everything else that is involved in a surgical procedure.
(Needless to say, running an invalid vaccine trial also has very bad consequences: it would delay the actual deployment of a working vaccine to the general public, resulting in millions of unnecessary person-hours of potential virus exposure.)
AMA?
I guess I'm risking it because someone has to. Vaccine trials are incredibly safe and highly regulated. In reality, the worst-case was that it didn't work rather than my head exploding.
But it is just a piece of paper that the team printed out, and I think I lost it.
loses the single most important medical document that's going to save his life
The likelihood of it being of diagnostic usage is pretty low anyway. A vaccine is highly unlikely to cause the sort of reaction that means I won't be conscious.
It's worth pointing out that during a pandemic, while participating in a trial does carry a risk, so does not participating. A participant has some substantially greater probability* than the general population of avoiding an infection which apparently carries a risk of death or long term debilitating effects.
* You'll have to incorporate the probability of being in the control group, of course, but the overall probability is still significant.
My life can begin to go back to normal potentially months before it otherwise would.
Howso? Socialization is a multi-party dynamic. Folks might not care/believe you if you state 'I'm vaccinated' until it's widely accepted.
You'd have to ask my friends. But they're all more interested and curious than suspicious!
It's interesting because that's, not once, ever been a concern. If people don't want to spend time with me until vaccination is more widespread, then that's fine. But the intersection between those who don't trust that I've been vaccinated and those who don't trust vaccination anyway is probably pretty large...
Participating also carries risks beyond simply that of the vaccine. Being exposed to any kind of healthcare setting is extremely dangerous right now. I'm taking part in the Moderna trial, and honestly I'm considering dropping out before the second injection. The risk of going into a clinic multiple times where I hear people coughing all over the place is starting to seem unacceptable to me given that I'm fairly certain I've been given the placebo.
It's a risk tradeoff, different between the phases. I'd probably volunteer for a phase 3 trial if one was available in my area. Phase 1 would be a bit too hot for me.
I wasn't interested in Phase I. My trial is Phase II/III. I was by no means the first to be vaccinated. Any major, common, reactions had already been pretty safely discounted.
That's currently due for March 2021, but things change quickly.
Have you experienced any side effects, even mild like injection pain or fatigue? I'm in the Moderna study and feel pretty disappointed that I may have gotten the placebo.
Double blinded placebo controls are critical to clinical trials so you shouldn’t be disappointed one way or the other. Even if you are in the control group you’ll have the opportunity to get the vaccine after you’ve helped prove its efficacy and safety.
But what happens if a vaccine gets approved while you’re in a trial and not sure if you got the placebo? Well, you can drop out and just get the approved vaccine.
Of course that will trash the original trial you were in.
After the second jab, I had no side-effects.
It's been quite a few months now since my first jab and I have no long-term effects whatsoever.
The control for Moderna is just saline, which is why I'm fairly certain I got it. No side effects whatsoever, not even soreness.
How often are your follow-ups?
Mild fever for 48 hours that meant I was too tired to exercise, but I was more than fine to work. (I'm a software engineer. I think if I had a more manual job, I would've struggled!)
My follow-ups are every 2 months at a local hospital. They take general observations, ask about side effects and take a small blood sample (presumably to test for antibodies)
So the side-effects I had could be due to that vaccine, I don't know.
Yes, in theory it would make me test positive for an antigen test. So I'm barred from donating blood as my sample would show as positive for COVID-19 antibodies.
Wow, if they're insisting on COVID-19-antibody-free blood for donations that's going to cause problems as a greater percentage of the population gains antibodies to it. I guess they'll have to change to a specific test for current infection.
This is a rule only for those in the trial. If I donate blood today, having had the vaccine, and the blood donation service checks my blood for antibodies and informs me that I had COVID-19 (or so they think!), then I will have been unblinded in the trial which isn't allowed.
This isn't the case for the general population. I'm also not allowed to take part in any other antibody tests that might accidentally unblind me in the trial.
- When will the vaccine be ready?
After the Phase 3 efficacy data is reported, assuming that the data shows that the vaccine prevents COVID or reduces COVID severity. This happens after enough people in the trial get sick with COVID. Then they unblind the groups and see if the people who got sick were in the control group or the vaccinated group. Essentially we are all waiting for a few 10s of people to get COVID. You can guess that the UK, South Africa and Brazil trials are getting very close to this since those trials have been running for months, but the US trial has recently started and is being run separately and wouldn't be very close yet. So the UK would probably have the first chance of approving this vaccine.
- What do we know about vaccine effectiveness so far?
So far, they've published initial safety data and immune response data in both healthy young adults and now in older adults. That all looks good - basically, the vaccine generates a lot of antibodies in everyone who takes it. So in theory, it should work. Separately, other groups have done testing to verify that the vaccine is operating the way it should at a biological level. There were also very early animal tests to show that the vaccine reduced the severity of COVID and prevented serve lung symptoms. In those tests, the vaccine didn't totally prevent transmission, but the animals were injected with a large amount of virus and it's not clear how humans will react in the real world (hence the wait for Phase 3 trail results).
- If it works, how long would immunity last?
No one knows until we wait and find out. But people vaccinated with the experimental SARS-1 vaccine still show antibodies over 10 years later, so the hope is that it could be long lasting.
- Didn't they have to stop this trial at one point because someone got sick?
Actually, at least 3 adverse events have occurred. Early on, one person got symptoms consistent with typical vaccine side effects, but it was determined that the person had a previously undiagnosed, unrelated disease. Second, there was the highly publicized case where a patient suffered temporary spinal inflammation and recovered shortly. It is unclear if this event is related to the vaccine, but trials in all countries have resumed so the various government agencies seem satisfied. Third, a patient in Brazil died of COVID but it was reported that the patient was in the control group and hadn't received the vaccine. Very little information from these cases is reported because of health privacy laws, so some of this information comes from media reports as opposed to official announcements. None of it seems inconsistent with a normal vaccine trial.
- Would you feel comfortable taking it yourself?
Yes, I did (I'm in the trial). No side effects worse than a flu shot personally.
I'm assuming you also don't know if you got the active substance or a placebo?
You don't want to bias the study by revealing that information. People who knew whether they'd gotten the real thing might behave differently.
Yep. In the UK, they used an existing, unrelated vaccine with similar side effects as the control so it wasn't obvious which one you got. In some countries and for some of the other vaccine trials, they are just using saline as the control so it seems like a lot of those people would know.
You can tell the difference in getting a vaccine shot and a shot of saline?
Some trials are going to use an unrelated vaccine as placebo (I think they're using a Meningitis one)
This year I actually had a moment as I was preparing for bed that night when I went "Oh shit what's this?" because I felt a bump that hadn't been there before on one arm. It was the tiny sticking plaster the nurse applied after the injection to cover the site. That was the first time since leaving the clinic I'd even remembered I got a jab that day. I peeled it off, put it in the waste and went to bed.
A lot of the things that happen are psychosomatic, so those would happen even if it was saline (or, I suppose they might not happen if you believe it was just saline even if it was really the active vaccine) but there are effects above this baseline in some people some of the time.
This seems rather worrying as these Phase 1 and Phase 2 trials are pretty small, no? What are the odds these patients got this from the vaccine vs whatever else they had going on?
I just can't shake the fact that this particular vaccine seems to have some safety issues. We'll see in Phase 3 if this shakes out, but I would like to understand why governments feel safe about these developments.
Keep in mind they pause anytime anything serious happens to anyone in the trial to give them time to make sure the vaccine didn't cause it. Pauses are a good thing - they are a sign they are following the protocols and not just pushing something through.
Now (soon, hopefully) people can acquire immunity through a vaccine, instead of through a virus that leaves long-lasting damage to the body (in particular, but not limited to, the brain).
However, the efficacy of this vaccine (and all the other candidates) still needs to be clarified - ie is it like a measles vaccination (~90% efficacy) or the flu vaccines (~ 25% - 50% I believe).
- Efficacy of at least 60%
- Lower bound of efficacy (confidence interval) >= 30%
- Minimum safety data for at least one or two months post vaccination (I don't remember if it's one or two)
- At least five severe cases in the control arm
- Requirements for the trials to go on even if efficacy is found for an additional year after the trial end (for most of the trials, this means two years in total)
> One in 20 people with coronavirus are likely to have symptoms for eight weeks or more, according to a new study by King's College London.
> The research, which uses data from the COVID Symptom Study App, suggested so-called "long COVID" affects around 10% of 18 to 49-year-olds who become unwell with coronavirus.
Whole study is here: https://www.kcl.ac.uk/news/study-identifies-those-most-risk-...
The actual study seems to say 1 in 20 have symptoms for eight weeks, which might be closer to what you could fairly describe as “long-term”, but says nothing about the severity (though I haven’t waded through the whole article).
Anyway, the drop-off from 10% having symptoms at 4 weeks to 5% at 8 weeks is encouraging - it intuitively suggests that the negative symptoms aren’t permanent, even if they take a long time to go away.
Long term health effect claims are being made all over the show - if this is the measure that is outrageous reporting.
Most people would worry about 'long term health effects' as they'd usually assume that it's going to go on for years.
I feel a lot of Covid effects are being massively overblown because people aren't aware that other more common viruses that we don't worry about can have these "long term" effects as well.
Those 4 week and 8 week statistics are part of an attempt to understand what's going on. It doesn't mean 8 weeks is considered long covid.
They are worried about effects where people got it months ago and are still disabled from it. Things like still struggling to walk upstairs 6 months after getting covid.
And that young, fit people are reporting it, not just "old".
The worry is that it doesn't appear to be getting better for them yet. The greatest worry is that people who get it might never recover, or might take years to recover. We can't know yet.
Flu and other viruses affect some people that way, but it's a small number of unlucky people. The worry is that the number affected by long covid in this way are a much larger number of people.
My fear is that this is super, super, super rare, but figures are including long term as low as 8 weeks, so we have absolutely no idea how small / large the number of people having this critical level of long term effect actually is.
There are plenty of anecdotes to be found of people reporting debilitating long-covid symptoms for 6 months so far. That's "still sick since I had it back in March/April".
(It hasn't been around for a year so nothing can be said about that timescale yet.)
That's significant enough that public health officials are talking openly about it as a concern, so it's not just a few isolated anecdata.
There are some reports suggesting neurological impairment. Along with observed blood changes (thickening), which is concerning regarding long term damage for rational reasons. If that turns out to be true, that sort of damage tends to never completely recover. Rather you learn to adapt and live with it.
However, they stating they're also counting 8-10 weeks as long term, so the stats are obviously way inflated. I'd really like to know the number of people having the extreme effects, without the media trying to inflate the figure.
Judging from our response to Covid-19, if this had actually been the collectively-feared zombie virus, the pandemic would have been far worse than any fictional account has manage to capture so far.
World War Z
Walking Dead
Shawn of the Dead *
28 Days Later
The Last of Us
What's worse than the above?
* (ok maybe not this one)
In what percentage of people who get COVID-19 is there long-lasting damage to the body? What other conditions did the people who get long-lasting damage to the body have? How does these numbers compare with other diseases?
Would appreciate citations.
And this is one kind of neurological effect. This is a more global view of how the virus could affect the brain:
https://www.scientificamerican.com/article/what-we-know-so-f...
And I'm not even touching the subjects of damage to the heart, clotting problems, etc.
However, those covid-induced strokes definitely affect the brain.
https://www.thestar.com/life/health_wellness/2010/09/02/sars...
They shouldn't be off the hook completely. They should still have to show they have conducted a responsible level of testing and checking for the circumstances, that they are continuing to refine that verification even after widespread deployment, and to motivate that to be done all levels requires some degree of moral hazard remains in place for them. In other words there should be some sharing of risk. Imho.
If there is some sharing of risk, but no profit to be had (and ultimately profit is what buffers you against risk) then why would you be involved at all? Let some other company take the risk?
So this isn't like we are relying on AZ to create it, test it and sign it off. National agencies will ultimately sign off on whether it can be used or not. Given the high profile nature of this vaccine you can be sure that results will be widely studied, and the opportunity to hide results they don't like will be limited given we all know the trials are occurring.
Looking good, but still months away from rolling out.
That's the part I'm referring to by "not caring" - just ignoring the close orders, especially since "two weeks to slow the spread" has been so completely abandoned.
I encourage you to visit one of the no-lockdown states like Florida or South Dakota sometime and see how much of a complete falsehood this is.
* What law? In the US, the lockdowns were under emergency powers of the executive branch, which are supposed to only last a limited time (30 days where I am, for example). Several of these were challenged and found to be unlawful.
* The US lockdowns were originally only mean to prevent hospitals from being overloaded. We are way way past that point where that was an issue - all the emergency capacity has been dismantled for months.
* As sibling comment implies, something like half the states in the US aren't under any lockdown now, businesses there aren't having issues staying open, and their stats are no worse than the locked-down states.
* Speaking of preventable deaths, suicide and overdose are climbing where lockdowns are still in place.
In some cases there have been legal challenges to those laws so there aren't givens but even if those are successful, my point was that even if you do re-open you can't force customers to come back when they feel unsafe. Even in the states where restrictions have been relaxed, a large number of people are not comfortable hanging out at a bar or restaurant — the problem being the risk of a serious disease, not the countermeasures deployed against it.
> The US lockdowns were originally only mean to prevent hospitals from being overloaded. We are way way past that point where that was an issue - all the emergency capacity has been dismantled for months.
The lockdowns were, as clearly communicated at the time, intended to slow community spread. Avoiding hospital overload was part of that but so was avoiding large numbers of people getting a serious disease with potentially life-changing impact when they don't need to.
> As sibling comment implies, something like half the states in the US aren't under any lockdown now, businesses there aren't having issues staying open, and their stats are no worse than the locked-down states.
And that commenter was wrong just like you are wrong. Anyone who follows this issue knows that the cases have been rising recently (~35%) and there's a noticeable correlation with the states which re-opened high risk activities and those who did not.
For example, they mentioned South Dakota which is at an all-time peak:
https://www.nytimes.com/interactive/2020/us/south-dakota-cor...
Compare with, say, New York which is roughly 20 times larger even before you account for density differences:
https://www.nytimes.com/interactive/2020/us/new-york-coronav...
A common cause of error here are people looking at the all-time cumulative stats rather than the last week or two and missing that while, say, NYC was hit early with quick community spread in a dense environment and thus had a brutal spring but the increased lockdown have kept levels low since then.
This is demonstrably false. Some places are already back to life as normal, like Florida and Sweden, with no business closures. And in spite of this they still have lower deaths per capita than some places with heavy lockdowns like New York, Peru, Belgium and Spain.
Even if we had a vaccine ready for the roll-out today, I don't see us going back to normalish until late 2021 at earliest.
As with any vaccine, you'd need about 80% of the population to vaccinate in order for herd immunity to kick in. I feel like we're gonna have trouble reaching that amount for years to come.
Getting a working vaccine is only step 1 towards eradication path, not the end goal.
We're not going to eliminate the virus completely. That's a given, we should stop aiming for that.
If we get to a point where there's a stable number of daily deaths then we're good. (like we have for literally every single fatal illness.)
Smallpox. And if you consider within the borders of a given country, a dozen others (polio, measles, mumps, rubella, chickenpox).
Fair enough. I would consider a virus eradicated when the general population gives zero thought to it, and effectively no one dies from it. Doesn't meet the strict medical definition, but I thought the description of "If we get to a point where there's a stable number of daily deaths then we're good" was overly pessimistic.
That's not how it works. Just because you don't see an outbreak for a while, that is never a reason to stop immunizing children. Pathogens can and do have natural reservoirs. This is why when some idiots stopped taking the Measles vaccines we had an outbreak here in the US.
Deaths is the only relevant measure.
You can also corroborate this by comparing it to new hospitalizations, which are also up.
“Deaths is the only relevant measure” - not sure where to start with this except to say that this is not at all what epidemiologists seem to think and I won’t address it further without some very dramatic reasoning and evidence.
No, it suggests that you’re doing more testing, and finding more cases. Which, exactly as the OP said, is a metric that can be manipulated by doing more testing.
The whole reason we emphasize positivity rate is to try to compensate for the inherent bias in reporting raw case counts.
There have been far more cases than we have ever formally detected with testing. There’s plenty of room to increase that number by testing more people, but it will not affect hospitalizations or deaths - which is exactly what we’re seeing.
Positive test rates measure what was happening about a week ago. Hospital admissions reflect activity a week or two before that, and deaths often get reported a month or more after the events that caused people to get infected.
You have to look at all the data to get an idea of what is happening.
"If it bleeds, it leads"
I don't know about you but I'm feeling like simply "getting to a stable number of daily deaths" doesn't cut it. Also, that statement alone doesn't make sense to me - a fatality rate of 50% could potentially maintain a stable rate of daily deaths... Of thousands.
https://covid19.healthdata.org/global?view=infections-testin...
https://covid19.healthdata.org/united-states-of-america?view...
But notice, in the latter chart, that in the US the number of infections is predicted to peak in January and then start going down. It seems plausible that by March, we'll achieve some level of herd immunity, relative to the precautions that are currently being taken. We might have a situation like Europe over this pas summer, with small numbers of cases until a second spike in Fall/Winter 2021. That would buy us the spring and summer to roll out a vaccine.
Of course, I'm far from sure that this is what will happen -- but it certainly seems plausible to me.
For example, I'm a professor at the University of South Carolina. Here we've had around 2,500 confirmed Covid cases, and perhaps around 10,000 cases in actuality. Nearly all of them happened in the first few weeks of the semester, and now the positive test rate is extremely low.
Looking around town, it's pretty clear what happened. There are some students that have acted like nothing is happening, partying and drinking constantly. That population has presumably hit herd immunity already. Meanwhile, there are many students (and staff) that are exercising precautions, and not venturing out a lot, and probably few of them have contracted the disease.
Now, we can't just go back to normal, or else cases would spike among this second group -- but locally it seems that we can afford to relax a bit.
And, also, we're at 8.8 million confirmed infected -- the actual numbers are presumably much higher.
Literally, right now we are seeing case rates explode, but the number of casualties is paradoxically very low because it's mostly the younger cohorts getting sick - which is probably a social function of things like 'back school' and 'risky behaviours' among younger groups.
If we could get everyone 50+ vaccinated, we may be largely safe - maybe not 'back to normal safe' - but the combination of 'partial herd immunity', 'much lower rates of hospitalization' etc. may mean we can 'kind of get back to normal'.
At minimum younger people who have had covid are looking at a lot more regular check-ups for the rest of there life.
There's not a single peer-reviewed study showing a significantly higher frequency of long-term adverse effects in healthy individuals compared to other respiratory illnesses.
You don't need to eradicate the virus, just stop it affecting the most vulnerable. Everybody else can then carry on as normal (albeit with a slight chance of getting a nasty flu-like illness).
Not to mention that we already know about long term side effects that have nothing to do with a specific age group, and that there's a chance of re-infection.
If we just vaccinated 65+ year olds, we'd cut deaths by 80X%, where X is the effectivelness of the vaccine. Even if the vaccine was only 80% effective, that's still 65% reduction.
Add in people with dangerous conditions, heart conditions, cancer, morbidly obese, etc., and you could probably knock it down further.
And as the percent of the population with immunity rises, the spread will slow quite a bit.
We don't need heard immunity to open back up.
Because of this high dispersion rate, it may make sense to earmark a certain amount of vaccine doses for people who are not themselves at risk of complications when contracting Covid, but who are at risk of becoming a superspreader.
(Disclaimer: I'm not an epidemiologist.)
At least then we stand a chance of getting the economy back on its feet.
For instance, I'm a vulnerable person because of preexisting conditions, so I'll likely be offered a vaccine relatively soon after approval. But that won't have a large impact on economic recovery: I'm in the home office in a single-person household and don't have any care obligations, so I'm at a comparatively low risk anyway. And I won't change my current behavior until the disease is fully gone anyway.
The US has five million people who tested positive and have recovered. Likely also another 30-50 million who were never tested because their symptoms were to minor. And another 66-165 million who have cross reactive T-cells.
Some researchers have concluded that the herd immunity threshold for sars-cov-2 could be as low as 10% or as high as 50%. I don’t think anyone sees it as high as 80%.
The mayo clinic suggests it could be 70%, and I have seen others suggest 80%. I have not seen anyone suggest as low as 10/20% so I think that suggestion is a huge outlier and even the paper you link says as much.
One of the papers hypothesized that this demonstrates why areas like NYC got hit so hard initially and have remained stable since. Seroprevalence surveys back in the early summer indicated that between 20-30% of NYC residents had contracted Covid already. The lockdowns obviously blunted the surge, but unlike other areas of the country, as NYC has opened back up, there hasn't been much of a second wave at all. With more than 2/3rds of the population still without any kind of exposure to the virus, you would expect a dense city like NYC to see a large increase. The paper concluded that this is evidence that might suggest that the herd immunity barrier is far lower than initially estimated. I've seen some papers suggest something closer to 20-50%, but nothing so low as 10%. I'll see if I can dig up some of the preprints to post here.
Wrong. The herd immunity threshold (HIT) for influenza is 33%-44%. HITs are different for every infectious disease. Current estimates for COVID-19 are 60-75%.
Furthermore, I know of at least 3 leading statisticians that hypothesized (very early on) that the variance of infection trends pointed to pre-existing immunity in various populations. The evidence supporting this is mounting.
"I think the first thing we to review is who is Peter Doshi? And why is he so insistent on getting this data?
Peter Doshi received his BA in anthropology from Brown University, MA in East Asian studies from Harvard University, and Ph.D. in history, anthropology, and science, technology and society from the Massachusetts Institute of Technology. Those would be fine credentials for someone who is going to teach history or anthropology."
https://www.skepticalraptor.com/skepticalraptorblog.php/pete...
What's there to deal with? Let people make that personal choice and leave them alone.
The most we're going to get out of a vaccine is a tool that can be used in conjunction with physical distancing, and masks, to keep the infection rate and hospitalization rate sustainable.
Even with a vaccine, COVID-19 will remain one of the leading causes of death among the sick and elderly. The percentage of chronically ill people who live, and the percentage of people who make it past age 65, will plummet.
Everyone who's alive now will almost certainly need to socially distance (and should wear an N95/KN95 mask in public indoor spaces) for the rest of their lives.
What's happening now is humanity's normal.
Is it? Current studies, AFAIK, give very variable attack rates, from low zeros to around 30%. Only higher if due to close contacts for longer periods of time (carriers, fishing boats, meat packing plants). This preprint on trasmission dynamics and evidence from September[1] has lower figures.
> Everyone who's alive now will almost certainly need to socially distance (and should wear an N95/KN95 mask in public indoor spaces) for the rest of their lives.
I wonder how we're even supposed to build a society that can live without any or very reduced form of contact. I think it's socially unsustainable.
[1] https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3692807
By then it will kill at least a million people at the current trajectory. So US needs to start acting more aggressively now.
Can you also share some of those sources you mention? Thanks!
> Two of those companies, Moderna and Pfizer, are now in Phase 3, large-scale clinical trials. The 30,000 volunteers in each of the trials are getting two doses, with Moderna spacing their shots out 28 days apart and Pfizer spacing theirs out by 21 days.
> AstraZeneca is expected to start Phase 3 trials this month. Their Phase 1 and Phase 2 trials used two doses given 28 days apart.
Okay good so just lets get it shipped!
A: Quite data driven (and frustrated when data's not there)
B: Former work history in monetary policy a fan of fan-charts (i.e. central projection isn't the only thing, there is a spread from the central projection).
C: Not willing to over-speculate on either side.
D: Perhaps not a super people person, but not negative either, see A. Quite nuanced if others listen, and would listen to those advising him keenly. And starkly aware of causes of death that are not Covid-19, but linked and accelerated due to it - avoiding hospitals, mental distress, etc.
All in all, not a bad choice for a health secretary. Reading between the lines, I'd give it 2-3 months until this is rolled out.
The AstraZeneca vaccine is based on an adenovirus vector, which has never been approved for use in humans. It uses a weakened live virus that can (and apparently has, in the case of the J&J vaccine, which is using very similar tech) cause serious adverse systemic reactions. From what we've seen so far, the safety profile for these vaccines is far worse than the mRNA/lipid nanoparticle based vaccines coming from Moderna and Pfizer/Biontech.
It's also not really news. We know that a vaccine will prompt an immune response. Dozens of others in progress have already shown this with phase 1 and phase 2 data. The question is how strong, how long lasting, and how safe is it, along with the question of real world efficacy data from placebo controlled trials.
The worrying trend is the ,,signed contracts with governments'' part even though the clinical trial results are not out yet. It seems that vaccination gets highly political, just like how EU made a mistake of paying for Remdesivir even though we knew that it's not worth it at that point.
There is no evidence to prove the vaccine has caused any serious adverse effects so far. If that were the case, it is unlikely the Data Safety and Monitoring Board (DSMB) and U.S. Food and Drug Administration (FDA) would recommend resuming the trial.
> After a thorough evaluation of a serious medical event experienced by one study participant, no clear cause has been identified. There are many possible factors that could have caused the event. Based on the information gathered to date and the input of independent experts, the Company has found no evidence that the vaccine candidate caused the event.
https://www.jnj.com/our-company/johnson-johnson-prepares-to-...
There's also no evidence to prove that it wasn't. Furthermore, the AstraZeneca vaccine was halted for a case of transverse myelitis, a very common (and serious) adverse reaction seen in DNA/adenovirus based vaccines like ChAdOx1 [0]. These complications have not been seen at all in the mRNA based vaccines, since they do not involve a live virus.
[0] https://medcitynews.com/2020/10/report-fda-takes-closer-look....
Also, the AZ trial was given the go-ahead along with the J&J trial.
https://www.reuters.com/article/us-health-coronavirus-astraz...
[nature.com] https://www.nature.com/articles/d41586-020-02633-6
On a separate note - the voting on this thread at the moment seems pretty wild with some seemingly innocuous comments being downvoted. I don't get it.
Glass half empty: We don't know how the immune response measured relates to protection from or lessening of the infection. This is what the ongoing trial is trying to find out.
This is, IIRC, the second report of successful immunogenicity in older people. There was a (small) cohort of > 65 year old people tested with Pfizer / BioNTech's vaccine in the Phase 1 trial, and even there immune responses were found and measured.
There are tests that can be run to show an immune response.
One thing I’ve learned is it’s extremely hard to get doctors to run the tests. AND there are a whole lot of them. AND I’ve run into many doctors that are 10-20 years out of date with treatment and diagnosis protocols.
As in, current recommendations are that test X isn’t reliable. Use test Y. Doctor refuses to run any test because you’re the wrong gender. AND The moment you see someone in a practice your banned from seeing anyone else in the practice. So second opinion means going to 20 miles to another center.
Oh, and it’s 3 months+ to get a single appointment. You may need two dozen appointments until they narrow in on the issue.
That something is possible still leaves a massive gap of getting it done.
> Without a strong mucosal response, injected vaccines may be less likely to produce so-called sterilizing immunity, a phenomenon in which a pathogen is purged from the body before it’s able to infect cells, Dr. Durbin said. Vaccinated people might be protected from severe disease, but could still be infected, experience mild symptoms and occasionally pass small quantities of the germ onto others.
https://www.nytimes.com/2020/07/14/health/coronavirus-nasal-...
If you're about repost right-wing canards about how it's less deadly for children, please review salient facts about infectious diseases, such as the fact that they are infectious. The goal of vaccinating younger people is to protect those whom they might infect.
That's extremely rare, if it happens at all.
> The goal of vaccinating younger people is to protect those whom they might infect.
You want to subject children to a medical procedure that they won't even benefit from?
Less than 80 people under age age of 15 have died from COVID. Child deaths from COVID are essentially zero.
In the same timeframe about 110 died from influenza. Immunizing children for influenza also seems unnecessary.
This is still good news. But it should be put in perspective, this does not automatically translate to "this vaccine will work fine in both young and old". It just means we can have some higher hopes that it will.
Only RCT results of the real infections will show if it really works. (RCT for the vaccine is running and first results are expected soon.)
Injecting a disease into volunteers is called a human challenge trial. It is a type of RCT, but it is not what is being discussed here.
What you're referring to (voluntarily infecting people) are challenge trials, which are also being discussed, but are still somewhat ethically dubious.
There are already a bunch of vaccines going through this process.
Challenge trials is where you purposefully infect subjects. TheY are highlY controversial but according to Oxford, would speed up the research and they are planning to do one.
Though, sometimes people think vaccines just prevent someone getting a disease. Stop it completely in its tracks. That's true for some, but it's not that simple for others.
Unfortunately a measured immune response does not ensure:
- That the virus can't be transmitted to others
- That you are less likely to catch and replicate the virus
- That you can't get ill from the virus
- That you can't get "long covid" symptoms
- That you can't die from covid
- That the immune response lasts for more than a few months (this is why we keep getting some of the same cold viruses; our immunity to them doesn't last)
- That the R number goes down (if it doesn't prevent transmission)
- That the R number doesn't go up (if people change behaviour in response to knowing they or other are vaccinated)
- That the virus won't evolve a workaround in response, like the rapidly mutating flu viruses
An immune response certainly suggests those things. But we can't be certain from immune response alone. Consequences need to be measured as well. We'll have a real solution when those sorts of things can be demonstrated, but it will take much longer to find out unfortunately. Probably we have to deploy a vaccine on a large scale somewhere before we can even find out how effective it is in the ways that ultimately matter.
Still, if a vaccine combined with uptake and people's behaviour reduces R below 1.0 at scale, that's enough to be a breakthrough. The greater the reduction the better, but 1.0 is the magic number.
Even if there's one good vaccine, having multiple good vaccine types in the world will be better. The virus is less likely to evolve a defence against multiple vaccines than against a single type deployed everywhere.
The fact this vaccine targets the spike protein is also good news, because even if the virus evolves, there's evidence that the spike protein is key to its harmfulness, so any evolved strains that keep it will likely trigger an immune response, and evolved strains that change the spike protein seem likely to be less harmful too.
To make the virus for the vaccine you need to use a different virus that when it replicates it creates copies of the actual virus used in the vaccine.
Think about it as a self extracting archive that creates copies of an uncompressed file (the actual vaccine) the file that it outputs doesn't have the information to reconstruct the self extracting archive itself.
I guess the thought is that a really unlucky evolutionary accident would be when the other virus capable of replicating and the vaccine meet in a body, and by chance transfer some of those instructions across. I presume that's rare or never seen, but I don't know, and (with a safety-engineering mindset on) I'd automatically consider that a "chance" unless it is ruled out by something.
> In extremely rare cases, natural mutations can cause a reversion to virulence. In this case, the virus can revert to wild type or develop into an entirely new strain.
Now, the Oxford vaccine is not an attenuated virus as is usually meant by that term.
On the other hand, it's not the same as an "inactivated virus" vaccine type either, where a virus is broken apart.
It's a different sort which doesn't fall into either of those categories. It's described as a "weaken adenovirus" and "replication-deficient" because of replication genes being deleted, and spike protein coding added. (There's no coronavirus at all, just the spike protein. This is completely different from other vaccines.)
The replication-deficient adenovirus has been studied thoroughly, not just for Covid but earlier as well. There are good reasons they selected it.
I will certainly take that vaccine when it's available, if that counts as any sort of endorsement.
I have high confidence in the people engineering and studying it. (I'm in Oxford, btw ;-) But can you really generalise the observations of inactivated virus vaccines to this relatively new kind? I think no, it has to be studied and monitored with care. Thankfully, I think they are doing exactly that.
Personally I would argue that the standards should be kept to even when the world is on fire, I mean they do exist for a reason.
s/year/month/gI mean, its better news than the alternative, but I think "Oxford vaccine produces zero immune response" would be a far less likely outcome.
Edit1: Just to throw in more info, Oxford plans to scale this up for mass production with Serum Institute of India and AstraZeneca.
Australia is part of this group that will be manufacturing all the dosages locally and independently.
Can you? Do you have any examples of successful vaccines that are only given in one region because they have been proven ineffective in a different region?
This is because the distribution of certain alleles, fundamental for the immune system, is heavily biased geographically [1].
I work in an area where we make agreements with university’s. It’s often shared IP or publicity. Alternatively, one can publish, once the other makes profits. Or it could be something in between.
In this case, I bet everyone is doing this pro-Bono from a future profit perspective, because the government is paying for all of it.
I’m expecting that once this thing is ready there’ll be a logistical effort for the history books to roll it out. See what they can do with the military involved, like the nightingales.
I heard a lot of bluster about testing here in Ontario in the spring, but here we are in the fall with rationing of tests again.
I think the "military involved" piece is key, especially if you're talking about the US. It's maybe a bit trite at this point, but a lot of comparisons were made about the stark contrast in how quickly a national response mobilized in response to BLM protests vs the pandemic. The basic takeaway being: executive priorities matter, and even Trump has made it clear on a number of occasions that getting the vaccine out is important to him.
Re: Waterloo region, I work at Google Waterloo, so although I don't live in KW (I'm in rural Flamborough) most of my coworkers do. I had one who showed up at 7am to get a test, lineups were around several blocks and they shut the whole thing down because people were getting rude. He then had to wait a bit and drive to Guelph. People were driving out from Toronto to London, Woodstock, etc. to get tests.
In our industry if we provisioned data centres or server instances like this, we'd be in a bit of trouble, no?
EDIT: FWIW I have a political leaning and bias towards a strong public sector and am a big believer in public service. I'm not one of those "government can't do anything right" and "less government is better" types. But I do think that several decades of "government can't do anything right" people being a dominant cultural and political force now means that government can no longer do anything right. We're losing our ability to act collectively :-(
Or at least I hope so.
Oh, they are. Just don't ask too many questions about money disappearing in the darker corners of such effort.
There's no way (AFAICT) to link to it directly, but try charting "Total tests completed in the last day" and "Under Investigation": https://data.ontario.ca/dataset/status-of-covid-19-cases-in-...
History isn't always happy and positive, you know.
It's actually an "indeterminate way to go". Assuming it is "long" has no factual basis. Phase 3 results could be released literally any day now, and good results would lead to government approvals in the following weeks.
Because GPs (in England, I don't know about the other nations) should have enough stock. They are prioritising higher need first, and then the expanded programme later in the year, and then anyone else who wants one after that.
If you're not priority need you can try a pharmacist.
Aside: It was, for the NHS, an exceptionally efficient process. I was given an exact time slot and was in and out in less than three minutes.
I think if you are unlucky it can be hard to get, but it is rolling out fast and many people are thankfully able to get it.
If this was rolled out properly people would be actively contacted by phone, etc. with assistance on how to get it. That's the kind of aggressive roll-out I'm hoping we see if/when a COVID19 vaccine becomes available.
They have massively expanded the flu jab programme in the UK this year (to try and avoid hospital overloading) so thats one of the reasons flu jab is in short supply. Apparently its mainly a logistics problem, the doses are there, somewhere, see: https://www.theguardian.com/society/2020/oct/04/gp-surgeries...
Other vaccines can be stored at -20C, usually.
The flu vaccine is generally about 50% effective, and only about 50% of (Americans) say they will definitely or probably get a vaccine. If that holds, then combined, that would only cover 25% of the population. Well below herd immunity.
Yes, it would be an improvement, but we should really be embarking on a heavy public awareness campaign that, once available (and assuming a low risk profile) that vaccination is the responsible and safe thing to do.
Nature has a good article that goes into depth a bit here: https://www.nature.com/articles/d41586-020-02948-4
Basically, there are reasonable estimates that the range could be anywhere from 20% - 70%.
The effect also greatly depends on which portion of the population gets vaccinated. If (in an imaginary world) the most at-risk 50% of the population got vaccinated, we could reasonably expect Covid to actually become something like the flu.
Finally, I expect this is something that'll gain acceptance over time. There are some not unreasonable factors that could cause people to be nervous about a Covid vaccine initially, that will be softened over time. Things like it being developed under the supervision of politicians who could be motivated to rush it out, or just being developed faster than any vaccine ever.
Or, on the flipside, continued travel restrictions for individuals who haven't been vaccinated. Americans traveling to certain tropical countries have been required to get specific vaccines for years, I wouldn't be surprised if over the next few, travel to Europe or even Canada requires a Covid vaccine.
The basic principle of a vaccine is that it contains proteins that are the same as (or similar to) some of the protein building blocks of the actual virus. Your body learns an immune response to these proteins, which it can reactivate when it encounters the real thing.
Many potential vaccines target the same spike proteins on the outside of the virus. I guess you could say those produce "the same immune response" in that sense.
At least, that's how I understand it from what I've heard. Others should please correct me if I'm wrong.
The nature of the response varies. Some candidates are more efficient at eliciting the production of antibodies, while others also activate cellular immunity (T cells).
I think the British media goes for the colloquial version a bit more, but it's hard to say for sure.
I sympathize with your pain of learning a new language (or system or whatever): It's hard to tell if it's a mistake on their part, a mistake on your part, some kind of regionalism, some kind poetry...
Oxford develops the vaccine with public money. We also, god willing, need to manufacture billions of them and transport them around the globe.
For that manufacturing, give me a solid existing multinational with a proven manufacturing record and base please, not some non-profit startup.
The laws need to change.
Socialized risk and privatized profits. A capitalist's dream.
To go back to your highway analogy, its as if the government contracted for the entire interstate highway system to be built and then let various private companies charge a perpetual toll to use the roads in addition to the money they made for building it.
Its not an accounting trick, its a perpetual royalty on the taxpayer's expense if the drug works (and a profit even if their drug never passes Phase 3 clinical trials).
(i) e.g. privatization of telephone networks
(ii) e.g. toll roads and bridges
Depending on where you live, you could very well be under the impression that the roads belong to delivery companies, taxis, etc. (private companies that make money off them) as they are effectively useless to everyone else (= the public) while they are constantly blocking them.
The 'public' wanted that by voting in the lawmakers making that possible.
That's how democracy works.
Also we're not talking about physical things, but something 'intellectual' like software, so the comparison is inaccurate.
More accurate would be IT research done in a publicly funded university.
Noam Chomsky has quite a bone to pick about toll roads
In this case the building is publicly funded for a profit AND the final result donated in “perpetuity” to make it a private TOLL road.
Double dip?
(I’m ok with subsidizing the research, and even negotiating a bulk manufacturing contract with an agreed margin... but a patent? Isn’t that bending too far?)
If the government paid for all of that (including opportunity costs + a decent margin), then the government should have asked for the patent rights (or at least a commitment on pricing).
Has any serious journalist looked into exactly what the world governments paid for and exactly what the deals with the drug companies look like?
All I can find are biased opinion pieces devoid of actual information.
Incidentally, if you want serious journalism, the FT is worth paying for.
I know a lot of people, Americans in particular, are weary of 'big pharma' and for-profit healthcare. And Americans have good reason for that mistrust. But this isn't just an American issue.
Other governments such as the EU and India will force their hand if needed for the public good. As they've done countless times in the past. We just need to get this developed and manufactured as fast as possible.
And the linked article said the clash was between this pharmaceutical behemoth or a startup from the university. I'll take the behemoth now.
"The scientists’ small biotech company—a spinout partially funded by Oxford—was refusing to hand over intellectual-property rights. To outflank their bosses, the scientists asked a London investment banker to help explore other potential deals."
Edit: german Wikipedia suggest that the contraction is only expected to be 3% but because of the numbers involved even that doesn't really matter for the argument.
Hopefully there is some other significant differentiating characteristic or attribute to justify this state of affairs between society and big pharma, that would distinguish it from the same analysis you would use to pay a ransom or protection fee.
We are talking about a company providing a service. They might not have invented the vaccine but they are providing the means to bring it from proof of concept into mass production. The commenter seemed to think that this isn't worth money.
I argue that you get quite a bang for the buck.
In the case of farm subsidies it’s grown to the point of being actively unhealthy both in economic terms and the actual root cause of the obesity epidemic. Without sufficient calories you can’t have an obese population due to physics. Medical subsidies have resulted in a host of related problems not just in economic costs, but also in what research gets done and how efficient that is.
The cost of Medical studies in the US has grown wildly out of proportion because their a profit center. This perversely slows down the rate of medical research, even in the case of emergencies like covid 19.
On average your looking at ~90B in net profits from farming, the subsidies however are much harder to track down. Ethanol subsides for example are often excluded as are insurance, tariffs etc.
There are a lot of ways to slice this up. “Overall agricultural subsidies in 2010 were estimated at $172 billion by a European agricultural industry association; however, the majority of this estimate consists of food stamps and other consumer subsidies, so it is not comparable to the 2005 estimate.” https://en.wikipedia.org/wiki/Agricultural_subsidy#United_St...
One example of this is Americans for example pay 3 billion dollars more for sugar than international market rates. But, only a fraction of that directly ends up in farmers pockets. You can either take the full 3 billion as a government subsidy or exclude most of it. Similarly, propaganda and what’s allowed in food lunch programs gets tricky.
So, I am not endorsing any specific estimate, just saying the total industry profits are approximately the same as the total subsidy. Add up just direct federal subsidies gets you lower numbers especially if you try an exclude state, ethanol, R&D, loans, Education, tax breaks, and other less obvious handouts.
PS: Silly me, I forgot about all the little exceptions in environmental, immigration, labor laws, use of federal lands, etc.
Sure you can, you just have starving poor people too.
It’s very possible for some percentage of the population to starve even during a food surplus, but starving people will bid up the cost of food to the point where you can’t get a 40% of the population to have a surplus in a famine in any society that we know about.
Here is the official definition for the minimum to qualify as a famine:
“At least 20% of households in an area face extreme food shortages with a limited ability to cope The prevalence of acute malnutrition in children exceeds 30% The death rate exceeds two people per 10,000 people per day“
That’s killing off over 7% of the population per year.
My larger point is that for-profit pharma/healthcare is not a healthy marketplace (... or at best, it's an immature one). In the not-so-distant past (in America, up until the Civil War or thereabouts), firefighting was mostly privatized (meaning not government-run) [0], and brigades would compete (literally sometimes fighting in the streets, covering the hydrant to impede rival brigades, etc.) to claim the prize of the insurance payout for saving a building [1], which doesn't really serve the interests of the victims of fires.
I think the incentives of for-profit firefighters are not all that dissimilar from the incentives of modern pharma companies today (i.e. pay us to save your building from this fire, vs pay us to research this vaccine), and I would hope to evolve this pharma industry and this marketplace (of "demand" for life/health, vs "supply" of pharma research and resources) into something more mature and with fewer perverse incentives in the long-run.
---
[0] https://en.wikipedia.org/wiki/History_of_firefighting#United...
[1] https://en.wikipedia.org/wiki/History_of_firefighting#Modern...
Edit: people don't seem to understand that there are several stages in pharma development... (1) research, (2) trials, (3) scaling production. It sounds to me that even if (1) and (2) are "paid for" (with public money), (3) is still non-trivial and therefore expensive.
And "we" are already paying for it. Let's not let them double-dip.
These things cost money, and you assume your taxes are covering them in full. They don't.
No one is claiming otherwise. And back to normal is still a long ways off.
If you’re admitting we’re giving them money for a thing, it’s paid for. I don’t know why you quote it like that, transfer payments of public money to private institutions is a thing, is it up for debate it happens?
Also cost is emotional. Does it have to be 20 billion or is the government handing out cheddar for consulting jobs later?
There’s more too it than high school capitalist theory. Just because you can’t for $20 billion doesn’t mean someone else couldn’t for $5.
But we hide the work in private accounts. Humanities work, built towards by countless hands and minds.
Yeah ok we get it, Murray Rothbard; You’re only 1 in 7 billion. Why does your theory matter? Roll up them sleeves. What? He’s dead? In the bin with it, no need to carry water for a dead man.
Then there is the logistical effort of manufacturing the vaccine at the scale and speed required. There are huge capital investments and risks associated with doing that. If a company wants to do that and seek the profits from that, great. Literally everyone comes out ahead. You, me, the government, the manufacturer, distributor, and every other business or person in the economy.
What is the alternative? We create a government agency that specializes in manufacturing and distributing pharma products?
Yes. Why don't you think that would work?
We can't educate our kids at an acceptable level without billions of dollars being donated on top of all the tax collected, we can't figure out how to make medicare work responsibly despite literally being able to control costs, what do you think makes drug manufacturing any different?
If we as a people collectively agreed that we are as smart as other countries, there’s no reason we can’t have a functional government that can handle public education and vaccine efforts and keep us safe and maintain our infrastructure and everything else we expect our government to do for us.
School funding happens at the state level too, not just the federal grants.
Chicago is in Illinois, which has had a lot of flip-flopping between red and blue governors and has an infamous history of governors going to jail for corruption.
Also I'm not claiming that Democrats haven't done shitty things. Daley bankrupted Chicago and privatized a lot of our public services while running as a Democrat and some of those jailed governors were democrats, but I do think the GOP is more homogeneous in its efforts to break down the government. I mean privatizing everything is a platform they openly campaign on!
If your claim that prosperity has nothing to do with who is in charge were true, we wouldn't see a pattern of blue states outperforming red states economically or a national pattern of economic growth after a democrat president and decline after a republican president.
Coincidentally, I live in Chicago and used to live in California. People love to use both places as punching bags when talking about national problems, despite one being a state and the other a city! It's different types/scales of problems.
And why hasn’t California added free public education or expanded housing in the last 20-30 years then?
Plus, democrats are conservatives, so, it's not like they're automatically leftists just because they're blue.
No, there is not free public education anymore so in California than Texas.
> It's worth pointing out that there are literally millions of Trump supporters here
Don’t try to blame them. They have no power at the state and even the extremely Trump-devoid Bay Area (iirc <10% support) has failed to offer anything approximating a solution to housing or good education. The answer to shitty schools in the bay was a lottery to make sure everyone got to suffer the shit, rather than you know... fixing the shitty schools.
worked just fine for penicillin during world war 2
Many governments have proven that they will put the public's need over these companies need. They've broken patents and pressured companies before and they will obviously do it again.
There are more governments in the world than the American one.
For now speed is of the essence and this it's wonderful news they've set another step.
Developing vaccines is a long, treacherous journey on a narrow ledge with cliffs on either side from start to finish. Infectious diseases research has seen a sharp decline in funding and commercial interest in general. Because of how little we know about the body, most research doesn't generate results that can be turned into money. The only way to continue to support research is via public funds and grants. The public funding of science has been a major contributing factor for our advancements in this kind of research.
I suggest that we should give merek the for profit monopoly, but allow for non profit manufacturing. If another organization wants to make the vaccine but not derive profit from the process, let them.
Manufacturing takes time and money to develop. Revenue should pay for those costs. The non-profit gains experience, but no profit. The for-profit gains profit. If the for-profit decides to raise prices too high, there will be a willing and capable competitor waiting in the wings.
Now we can disagree on term length, but, a temporary monopoly to a company is what a patent is defined as and lasts 20 years.
My proposal is to have a company parallel develop processes so we can have competitor after expiry immediately. The competitor can't profit from it, but it can do work at 0 cost.
Rant. Prime time TV is now pharma pushing their drugs with the occasional programming jammed between the ads. All those ads are coming from their extreme markups. Placebo and manufacturing artifacts aside, a molecule is a molecule, buying generics should be the default. It is bad enough, but the real disgrace is pharma salespeople masquerading as GPs prescribing meds according to who is sponsoring them. Instead of telling people about the active ingredient they send them to buy BRAND. At least this is my experience in the 2nd world.
Certainly some of those are new uses for existing drugs, but drug trials ain't cheap either.
Often repeated, but the data doesn't bear it out, especially in aggregate.
https://www.raps.org/getattachment/5578195e-ed51-4f03-8adc-c...
https://www.raps.org/news-and-articles/news-articles/2019/7/...
Not-for-profit manufacturing would have to be done by the government itself, wouldn't it? Otherwise, what other entity would and could actually pay to set that up?
Why is the corporate "right to make profit" sacrosanct when nothing else is?
This is a clear case of Eminent Domain. All mandated, mandatory, Covid-19 related products must be offered at cost, or even better, we should just nationalize drug companies. We're all in this together and companies need to adjust to "new normal" as well.
The book author’s expected profits would plummet as it would be the wild west in production.
What you’re really saying is “we should pay massively less for vaccine development”. Which again, sounds nice, but....why would anyone have developed a vaccine? It’s a complex project which costs billions and has taken 12+ months while taking resources away from competing projects.
The public money is an incentive to get people to put those considerations aside and devote all their resources to vaccine development. This is a sensible public investment in a return to normalcy.
If you don't like that, vote someone in power who regulates that more.
The problem with these discussions is that nobody tells their opinions to their representative, they just blurt it out into the 'aether' on a rando internet forum.
True change starts with calling your representative. If they don't do what you ask them to, then have other people ask as well. Finally, have them vote them out of office if a sufficient ammount of people want the same thing that the representative won't do (eg. represent their constituents).
That's an awful lot of assumptions on your part. I have voted out someone who didn't represent these values in exchange for someone who does. I don't need to contact my representative on this specific issue because I already know where she stands, but if we were in disagreement I would (and have).
Posting about it on the internet is to garner additional support and discussion... you know the entire reason HN exists?
Just a notion I've been pondering. Sure, taxation could do the same job. Hypothetically. Hollywood accounting and such.
Maybe straight up royalties would be less prone to gamification.
There's no(t necessarily a) question of any non-profit startup there. The problem is that the people who paid for the development of the product should also hold rights over the product. If the vaccine was developed with public money, it should be publicly available -- not necessarily (but yes, also to) non-profit startups, but also to any other manufacturer in the pharmaceutical industry, since they (allegedly, in any case...) pay taxes, too, and have therefore invested in this product.
If Merck wants to use their proven manufacturing base with an excellent delivery track record (which nobody is denying, after all), that's great. They can:
1. Put their money into the development of said vaccine, or
2. Acquire the license to manufacture it, at a reasonable price, like they do with any technology that wasn't developed using public money, or
3. If we don't want stuff that's already been paid for with public money to be sold to manufacturers, which I don't disagree with at all, then, sure, they should get it for free -- but in that case they shouldn't be the sole owner of the rights towards that product, either.
(Edit: FWIW, I'm all for 3. I've worked in the medical industry and I know full well that there's a great deal of work that goes between first-stage research and final production, and that it's incredibly hard and expensive to take the result of a publicly-funded research program and turn it into a product. That doesn't change the fact that said research programs are publicly-funded -- their results should be available to anyone who paid for them. If someone wants exclusive rights to the result of some research program, then they're welcome to pay for it themselves.)
As it stands now, they own the rights (including licensing rights!) to a bunch of products that they haven't paid for at all.
All the suits blabber on and on and on about how the government should keep its nose out of their business. How about they tell the government where to stick it when it's about paying for their research, too?
The government did this. They are the ones who put the restrictions in place. They are the ones who choose not to remove them.
The government pulled a fast one on most people: They broke our leg, they handed us a crutch, and we thank them.
Don't pretend the vaccine is our savior. The government has the power to end the restrictions at any time but they choose not to.
Sounds like the media panic is working.
They also have 0 experience in developing a vaccine and it's transport.
But I guess they can transport some tanks and troops quickly, sure.
This kind of thinking is worrisome to me. It sets a horrible precedent. Previously in times of war private business would be forced into helping the people fight a common enemy. These days a war on a virus has zero help from business and they essentially have a position of power to sit on their hands taking billions of public subsidy and then take the people's money and effort for their own.
Why do we take this with such apathy? Why is it that a country run by the people for the people has no power in the populace hands? We are doing everything we can to help, committing billions of dollars which represents millions of hours of public production to solve a problem that CEOs only want to assist in if they can up their share price.
Since we care so much about our health and the health of loved ones why have we not used these unprecedented times to reform the healthcare industry?
We are paying twice for this. Once to fund the research, which we then give away, and then again for the manufacture and distribution which is priced as if the pharma did all the research. These vaccines are going to cost anywhere between $15 and $37 a shot. You cannot tell me that's how much these vaccines cost to make in quantity. Why is there any profit at all? Let's get ourselves out of this shit without encumbering any more debt on top of an economy that is already falling into a black hole.
This stuff is morally corrupt, and to say 'who cares' makes me sad. We should care, maybe we accept the shit we have, but we should care about it. This stuff should be criticized, we should use our agency to change what is wrong, not to support it.
Every day I fear we are all fucked. This sort of thinking is why we deserve the likes of Trump and Boris. We bring this crap on ourselves and then moan about it.
You talk about getting back to 'normal', well we slowly sold normal. These decisions do not have zero impact on the future, they affirm a shitty attitude and set the path for future generations who won't know any better.
/rant
Let them make a profit when we are thriving not while everyone else is suffering and making sacrifices.
Governments will pay a lot to get their economies going again. That burden will in turn fall on taxpayers one way or another; whether it's directly via taxes or budget cuts or indirectly via inflation or debt service.
My response is that we're getting the vaccine for free in return.
That said, I'm not sure that it's actually going to be free. That's just what I heard. I should point that out - I don't want to propagate bad info.
That's what you paid for, not for production, not for distribution, not for anything else.
You didn't pay taxes for a free vaccine, because you don't pay remotely enough taxes for that to be viable at all. Unless every country on earth takes their fair share of blind-faith financing a single company.
"Merck proposed giving Oxford around 1% of royalties, according to people familiar with the negotiations, with a sliver of that going to Vaccitech."
Is would seem “US BigParma” are not involved, as AstraZeneca is a British/Swedish company.
For example, Russians owns a bunch of funds in US mutual funds, and us big oil owns a lot stakes in Russian oils. So the whole idea that we are still living in the idea of nation state is over! Private company (like Federal reserve) has their own military.
Trump signed the moon mining order: https://www.space.com/trump-moon-mining-space-resources-exec...
We are pretty much back to West/East India Company ( https://en.wikipedia.org/wiki/East_India_Company ) in the process of becoming a multi-planetary civilisation.
Most things are hidden behind attorney-client privilege and ran by a hand full of law-firms for the elite rich people. Someone who have managed billions dollars for the public and private sector has once said no body really know who owns the debt of the planet.
Personally I support more transparency let everything come out and let the people judge. There is the risk of anger of mop and chopping off some heads like the French did. Truth will set you free, at first if fucking piss you off. Hope everyone will exercise some constrains and respect the due process even for those who have done so much bad things.
This is very disappointing. A lot of people are posting on this thread based on this misinformation.
https://innovation.ox.ac.uk/technologies-available/technolog...
the public sector doesnt have the agility or flexibility to do such a thing but they definitely have the money and incentives to make it happen.
the two combine to create a big, powerful, fast-moving machine that solves a problem.
I've only been following the market for about a year, but its a weird thing.
It's good news, but is this really news at this point?
https://www.nbcnews.com/health/health-news/volunteer-astraze...
They don't release more details officially due to patient confidentiality, but the unofficial word was that a young doctor treating COVID patients died of COVID during the trial, but was in the control group and did not receive the vaccine. It is very sad whenever a doctor dies trying to save others, but especially because they may still be alive if they had been randomized to the vaccination group (of course we don't know that for sure though, since the vaccine may still prove to be effective or ineffective).
eagle screeches
are we there yet?
Does this comment really read as flamebait? The article is about vaccines. A vaccine has to be administered to everyone to work. But I’m very skeptical that it’s actually going to happen given the way our medical system works here. So, I predict that there’s a good chance we won’t get herd immunity. I just don’t see how that’s flamebait. It’s more, known facts and extrapolation.
You can look up the moderator commentary on 'facts' and flamebait (tldr is, you can flamebait with facts) but these aren't even facts - free vaccine has been the stated official plan in the US for months.
US healthcare differences are a classic flamewar topic and nationalistic flamewar is particularly ugly and pointless. Your comment wasn't thoughtful/substantive, it was snarky/hyperbolic. Ergo flamebait.
Our old are going to get sick from vaccines, so the young are going to get it anyway. Next year under 50 year olds will line up for their vaccine.
Meanwhile 1.5 years worth of old, obese, and sick people will have died from coronavirus.
Wouldn't it have been better if healthy kids and adults caught it in q2 2020?
(Please no ancedotes of a sick 5 year old child dying from "coronavirus", statistics are necessary when discussing billions)
Not a good idea to catch it just to get immune.
In what percentage of people who get COVID-19 are there bad long-term effects? What other conditions did the people get bad long term effects have? How does these numbers compare with other diseases?
Would appreciate citations.
As you said there are scarce data yet, but the risks are scary. In these conditions, it's obvious one should avoid relying on a herd immunity induced by the virus.
And you could cite a claim you are making. Without numbers it is hard to say if this is a good basis for decisions.
As I said, we are in the presence of a huge risk and there is no "reassuring numbers" anywhere to counterbalance that.
As one reference on the risks I'm speaking of, here is an article about the action of the virus on the nerve cells:
https://www.scientificamerican.com/article/what-we-know-so-f...
By the way, between "relying on virus-induced herd immunity" and just keeping safe with mask and waiting for the vaccine to come, why the rush to get the virus??
There is a risk, there is the possibility to wait it over. So why just not do that and wait the safe solution?
There is no safe solution, it's a decision between protecting the 0.5% old, obese, and sick or the 99.5%
How to avoid it is the real discussion.
I could avoid it easily until now because everybody wears a mask here.
In some cases or in some countries, this is not possible, or too much people are infected already, and lockdown becomes the best solution.
Nobody is saying that lockdown is the only solution in every case, and absolutely nobody is even thinking that lockdown is making people happy.
(To avoid misunderstandings, evidence does not mean your unverified opinions).
I'm particularly interested in your methodology for arriving at 0.5%, so a detailed data dump on that from you would be very useful.
Correlation versus causation.
We're in the middle of a major health emergency. Why are you attributing those to the effects of lockdowns, rather than the effects of the pandemic? You don't think that the risk to personal health of a potentially lethal virus, seeing older friends and relatives dying, and worrying about the risk of health systems collapsing are causing any of the above?
In March, someone I know in Italy passed on the virus to his grandfather, who died at home. All the ambulances in the area were tied up for hours. You can imagine the effect on his mental health. I doubt the impact was comparable to the effects of intermittent lockdowns.
A uk study suggests 12% have symptoms longer than 30 days. Beyond that, hard to say. We also don’t havea good measure of invisible damage: do survivors have reduced lung function from pneumonia? Damage to endothelium predisposing to pneumonia? Too soon to tell.
About 20% of people are hospitalized.
There is a difference between the level of illness experienced by those who are vaccinated Vs those who get infected, so more old people will die as a result of infection than would die as a result of vaccination.
So no, it would not be better for healthy adults and kids to get it in Q2 2020. Also how do you propose that you only infect the healthy adults and kids?
That said, my guess would be normal reinfections would be less severe, more like a cold. There have been some severe reinfections but any reinfection under six months suggests something atypical in the immune response.
Also SARS-Cov-1 produced a longer immune response so that may happen here.
But lifelong sterilizing immunity seems pretty unlikely based on what we know so far. The vaccines aren’t aiming at sterilizing immunity actually, their goal is to greatly lower the severity of the infection.
You can get limited immunity from the common cold after being infected but you are just as likely to catch it 12 months later anyway. With covid that means we are dealing with it annually, which our health services cannot keep up with.
"Common cold" and "flu" is not 1 virus, but hundreds of different viruses which is why you get them repeatedly. You do build immunity though. It's why children always have a cold and adults a lot less common.
If you can't get immunity from the infection, how will the vaccine work?
If we let everyone get it in Q2 2020, millions would have died when we ran out of ventilators.
and nowhere that I'm aware of came close to running out of ventilators. New York, one of the hardest hit places in the world may have used a third of their available ventilators. They used around 1/2 of the ventilators they reported available to them in 2015 so it wasn't even close to being the limiting factor in healthcare.
How do you explain countries like Belarus, Serbia and Sweden, or parts of the US like South Dakota, where no or very lax measures were taken but what you describe didn’t happen?
In fact, is there any evidence that this happened anywhere, or is it all just conjecture based on modeling?
Seems to me that there is good basic evidence right there for Sweden's approach being much more deadly.
We can argue back and forth about the relative value of freedom vs lives or whether Denmark will ultimately have as many dead etc. But right now, it seems that controlling numbers saves lives...
https://www.google.com/search?q=sweden+covid+deaths&rlz=1C1G...
Also, the CFR is likely intrinsic to the virus, modified slightly by patient population and type of medical care available (both of the latter are probably very similar between the two countries). So any differences in CFR between the two countries mostly reflects the testing issue.
If you do want to compare the two countries, then compare the per capita death rate from covid (assuming everyone who dies in both countries actually gets a covid test - that might not be the case for old people who die at home, where even in developed countries, their primary doctor will just issue a death certificate saying “old age” or “heart attack” in the absence of any information to the contrary. )
1. You cannot just rely on how many sick people happen to be tested. Every single serology study implies a IFR of well under one percent. I am willing to bet that it will end up between 0.1 and 0.6 % for any developed country.
2. You cherrypick your data if you compare Sweden with Denmark or Germany and not with France or the UK.
My hypothesis is that countries that protect the elderly, and especially nursing homes, well have much fewer deaths. In every country this is were the deaths are concentrated.
As an abstract mathematical problem if somehow herd immunity could be achieved without a vaccine then it sounds like a fine idea. The fact is that immunity after infection does not last long enough to achieve significant enough immunity to get to a useful herd immunity. This of course is what all the medical experts understand which is why Europe is going through lockdowns and Putin has been hiding in a bunker. There have been strict lockdowns in China and most other major governments have taken some sort of similar response, even Sweden eventually. There is almost nothing all of these governments have ever agreed on so universally.
Don’t expect a reply justifying my comment on HN with robust data, I have better things to do with my time like play in a park.
No.
We have one population. There's no way to segment it to allow people at low risk to catch the virus without also allowing people at high risk to get it.
How do you think it could work otherwise?