They're supplying regulators with more data often. At least that was reported a few months ago, that was part of the changes to accelerate the testing and approval processes.
Incidentally, mumps is something that is decreasing in prevalence because of coronavirus precautions. In normal times, 88% isn't quite enough for herd immunity to mumps and there are sporadic outbreaks. I (M35) got it last year even though I was vaccinated along with almost everyone from my age cohort and younger, and everyone significantly older is immune because they contracted it in childhood. But that outbreak which began in late 2018 went away very quickly in April-May 2020 [0]
Yes but those are near lifetime immunities. Not said (that I'm aware of) with these two covid vaccines is how long they protect for. If it is less than a year it will be very hard to get and keep people taking it.
That may be but they must have some indication of how strong a response those who got the vaccine are generating vs the time they entered the trial. Is there fall off? More or less than expected? How confident are they that immunity will last at least a year?
They don't really have an indication of that. The way these trials work is just that they send everyone out to live their lives and check infection rates in the experimental group against the control group, so there's no effective way to dig in deeper to the biomechanics of it. A standardized measurement of immune response could only be done through what's known as a "challenge trial", where participants are deliberately infected with a predetermined dose; some of these are in the works, but none have yet been approved or performed.
The cost of getting a booster every year is minuscule compared to the number of lives lost, not to mention the hit to the world economy.
A working vaccine is a huge W. If immunity only lasts 12 months instead of 10 years that just decreases the font size down to 64 point from 72 point. I'll take it.
Lifetime immunity doesn't make much economic sense. If you have a vaccine with people and governments from all over the world begging for you to sell it to them, vaccine as a service seems like a more efficient model than a one-time purchase.
Not for the market leader, and maybe not for number two. But if you're at the end of the pack, nobody buys from you and you look at the 10 billion people market you could get with a lifetime vaccine...
Which is why monopolies are bad. You don't have a pack anymore, and the leader(s) don't have incentive to do much disruption.
I just got a SHRINGRX vaccine which is rated 97% effective. The second dose provoked a much stronger reaction, perhaps because I had some antibodies from the first.
> In Moderna's trial, 15,000 study participants were given a placebo, which is a shot of saline that has no effect. Over several months, 90 of them developed Covid-19, with 11 developing severe forms of the disease.
> Another 15,000 participants were given the vaccine, and only five of them developed Covid-19. None of the five became severely ill.
What seems to be vague... They didn't contract Covid, but we're they exposed to it in a lab environment, or just set off on their way to be evaluated x months later?
I don't think they have started yet, but such trials are planned in the UK.
There's no easy blanket "unethical" ruling from on high. Obviously this isn't a risk-free thing to volunteer for, but it isn't risk free for nurses to go to work either, and thankfully, they still do.
Also, you'd possibly be giving an unrealistic dose in the lab. If you give someone 1000x the viral load they'd ever get in the real world, the vaccine might not work. Or might work but send the immune system into a crazy overdrive cytokine storm.
In all phase3 trials large groups of people, as similar to each other in all variables as possible, will be either given a placebo or the actual vaccine and then go back to their normal lives.
The trials have a set "Covid-19 cases" mark where the stop to evaluate. The Pfizer vaccine has 164 contractions of Covid-19 as their mark to conclude the research. This research seems to aim for 151.
The Moderna vaccine, which is based on similar mRNA technology as BioNTech’s, is expected to be assessed by the FDA on a final analysis of 151 Covid cases among trial participants who will be followed on average for more than two months.
If both groups are similar enough you can then say how effective the vaccine is in preventing it.
This, by the way, is why most phase 3 trials take place in the US and/or Brazil (among other places): the more Covid-19 is around the faster you can get to the set number of contractions and conclude the phase 3.
It is fine for it to be vague. It is implied because medical ethics and international humanitarian law preclude exposing subjects to a deadly virus, let alone for testing purposes, let alone in a blind study.
Additionally, you can apply common sense that if 15,000 people were exposed to the virus with no protection, more than 90 of them would become infected.
1. You have to have a control group, so half of test subjects would be exposed to the virus without having received the vaccine.
2. The highest-priority recipients for a vaccine are members of high-risk groups; it'd be pointless to run a challenge trial full of low-risk individuals.
So a challenge trial wouldn't just mean giving the virus to a few thousand vaccinated macho 20-year-olds. It'd mean giving the virus to unvaccinated 80-year-old care home residents.
> it'd be pointless to run a challenge trial full of low-risk individuals.
This is binary all-or-nothing thinking. It considers 90% the same as 0%, since both are not 100%.
Testing on healthy young people you learn how a normal immune system reacts to a vaccine candidate. High risk groups mostly have similar immune systems.
Even if somehow you could only vaccinate everyone under 60, that would do enormous good stopping the spread.
> This is binary all-or-nothing thinking. It considers 90% the same as 0%, since both are not 100%.
Thinking is not just "binary or not"; there are degrees. If exposing that group of people would be 90% pointless, it's not much less out of the question than if it were 100% pointless.
Another way of making the point: we did COVID challenge trials on monkeys first, because their immune systems are a decent model for that 80-year-old human's. Well, a 30-year-old human is an even better model of an 80-year-old human. A challenge trial on young people wouldn't prove everything, but it would give a high-information signal quickly.
Challenge trials also don't provide as much useful information.
Nobody is getting covid on purpose, in a lab. Being protective or unprotective against a lab dose isn't the same as being protective or unprotective against a real-world dose.
I don't think anyone has really proposed this. Challenge trials are much more about getting quick answers to efficacy of treatment -- ethically, it's at least somewhat defensible to expose a volunteer if you also have medicine/vaccine for them, even if you're not sure how well it will work. It would be wildly unethical to give the virus to folks just to see how much virus it takes to get sick.
"It would be wildly unethical to give the virus to folks just to see how much virus it takes to get sick."
Depends. If there are volunteers for it, (which I can imagine to be the case) - and the volunteers are fully aware of the risk - then it might be ethical to let them proceed and save millions of other people.
You might also get useful information about how people's immune systems react, when you give them too little of the virus to get infected. It's not only about figuring out the dose for the main trial. It also could have been done 6 months ago...
>They didn't contract Covid, but we're they exposed to it in a lab environment, or just set off on their way to be evaluated x months later?
This is what is referred to as a 'challenge trial'[0]. It is something the UK is apparently working on but afaik, neither of the current vaccine candidates have used any form of challenge trial. This is one of the difficulties with vaccine testing...if I were to vaccinate everyone in the world against small pox, how do I prove it's effectiveness?
Edit: for some fun, I figured I should link to the 'COVID challenge trial volunteers advocacy organization'. Yes, an advocacy group for people who want to be infected with COVID. https://1daysooner.org/
Well, given that 90/15000 = 0.6% in the control group developed the disease, you can consider the vaccine group as a Bernouili trial of n = 15000 with probability p = 0.6%. Then the probability of observing 5 or fewer cases is 3.4*10^-32, from the tail probability of the binomial distribution.
Of course, that's assuming that five guys from the vaccine group didn't get infected at the same after-ski party, or any funny business that violates statistical independence ...
Naive question: If the null hypothesis is that there is no difference, wouldn't that imply 95/30,000, p = 0.0031, putting the probability of observing less than 5 cases at a much more reasonable 1*10^(-14).
I think Fisher's exact test [1] is most commonly used in these types of trials. But the P-value roland (parent comment) provided also make sense to me. For the Fisher's test R says...
Covid NoCovid
_____ _______
Vaccine 5 1495
NoVaccine 90 1410
9.0e-22 one tailed
4.5e-22 two tailed
No, I think you must estimate p only using the cohort where people were not treated, otherwise you will underestimate the population fraction. In order to test if the null hypothesis is true, we can't assume that's its true when constructing the test.
I was thinking about this since I read the article. The number you state seems to be 0.5% of total subjects. To my understanding, this is not how "p < 0.005" is employed.
If we take the control group, we have P(Corona)=90/15000.
The likelyhood of getting as an extreme result in the vaccine group is then P(0 cases) + ... + P(5 cases) = [math and statistics] = the actual p-value.
How did you determine the statistical significance in your post?
I believe that, in different conditions, we should reasonably ask that more people be tested over a longer period of time.
But Covid is wracking absolute havoc on people's health, on the economy, and on everyone's lives. Personally, I plan to take the Pfizer or Moderna vaccine as soon as it is available. There are associated risks -- but in my estimation, they are not as bad as the risks of Covid infection or the downsides of continued social isolation.
> This is great, now get some safety testing done or else it can't really be responsibly deployed.
Safety testing is done in preclinical and phase 1 testing. They wouldn't be injecting something unsafe into 30,000 people. Phase 3 is mostly about efficacy.
With the first two vaccines above 90% efficacy, this does look very promising in general. If the other vaccines also turn out this well, this makes it look like a more optimistic timeline for vaccinating enough people to stop the pandemic is possible. Moderna is planning for 500-1000 million doses in 2021, BioNTech/Pfizer for up to 1.3 billion doses. Not sure how many more promising candidates there are that can be ready early in 2021, but I think there were a few more.
This vaccine is purely experimental. This technique has never been tried on humans before. It has been tried on animals and in several studies, led to severe long term side effects. Be advised.
You might find this article interesting: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5906799/ - especially under safety. I can see how some of those concerns might be present especially given that we didn't have large scale human mRNA tests.
It's a new type of vaccine that's never been been approved for use in humans before, was rushed through development and testing, for preventing a disease with a fatality rate between .3% and 1%. I'm worried. I hope there's a successful adenovirus vaccine.
The important part is that 15000 apparently did not get serious side effects, so clearly much less people experience problems from the vaccine than they would from the disease.
So now it’s time to stop delaying and start distributing these vaccines.
No. Timetables can be compressed for everything else but not for safety evaluation.
The number of people vaccinated is increased gradually. Even after phase III and approval, the monitoring for side effects continues and the vaccine can be withdrawn if necessary.
Vaccines can cause autoimmune responses detected months later. These two vaccines are RNA vaccines never used n this scale Residual DNA risk is probably not significant, but there is small potential blowback.
On positive side, RNA vaccines can open new era of programmable vaccines for viral infections and cancer treatments.
Remember that the threshold shouldn't be "fully safe", the threshold should be "better than the alternatives". If the alternative is COVID, that's a pretty low bar to clear. Given that we may have several vaccines to choose from it's worth a bit of effort to weed out any unsafe ones, but remember that every day of delay may cost thousands of lives.
15000 also becomes a much smaller number as you start to consider factors which may change how someone reacts to the vaccine (gender, race, age, preexisting conditions, etc)
> If the alternative is COVID, that's a pretty low bar to clear.
It's really not a low bar. A healthy 35-year-old has maybe 0.01% chance of dying, 1% chance of lasting side-effects from Covid. Untested medicines can be way more dangerous than that: thalidomide, for example, has a 50%+ chance of causing stillbirth or birth defects for pregnant women [0].
If you just vaccinate the old and sick, risky vaccines start to look more attractive. But those people also have a greater risk of side effects and are underrepresented in the clinical trials, and most vaccination strategies mooted so far for Covid are based on mass vaccination of healthy people. So it has to be really safe for that to work.
So may every day of rushing. These testing/approval protocols aren't designed simply to provide job security. They were much cheaper and quicker before events like this one: https://en.wikipedia.org/wiki/Thalidomide_scandal
If you are willing to wait for years. Waiting a few weeks or months is just going to cause more people to die from the disease and isn’t going to make any vaccine more safe.
For all previous vaccines all side effects happened within two months. (with most of them in less than 15 minutes). We have no way of knowing when an unknown side effect might wait 10 years to show up, but there is every reason to think that won't happen.
Trials for these drugs have already been running for months. They stared in July and over 15,000 people have already been vaccinated.
They started with with just handful of people, gradually increasing the number of people.
The likelihood of hitting some genetic combination that triggers some autoimmune reaction decreases as the sample size increases and no side effects are found.
So again, some vague conjecture about ‘likelyhoods’ and vague handwavy timeframes. While in reality chances are all of these people already got the vaccine months ago; the study started in June.
What is it that makes people lust for delays? Some irrational fear for side effects? The fear isn’t going away, there’s just more people dying every day you wait, both from corona and the measures.
No, these people aren’t wrong. People in politics who say well thank you, now we’re going to sit on it for a few months while we think about it are wrong.
I'm not implying these vaccines are unsafe at all, but when you're vaccinating close to the entire world' population (eventually), a side effect of 1 death for every 50,000 people vaccinated, might not be seen in a trial of 15,000. But vaccinate 6B people and that's 120,000 dead. So your vaccine can go from "safe" to "it kills people" pretty quick when you're treating millions of people.
Edit: And sure, Covid has killed more than 120,000, but what do you think will happen when people find out the vaccine kills people? They won't care it's 1 in 50,000, they'll just refuse any and all vaccines. Then what?
That's true. But currently just a fraction of global population got infected and already 1.3 million people died. I still think though they shouldn't rush and do enough research because any bad side effects would have long term effect for any other future vaccine treatments.
This is a big differentiator versus the Pfizer/BioNTech vaccine....
"Moderna had previously said their vaccines could ship at -20 degrees, refrigerated for up to 7 days, and kept at room temperature for up to 12 hours. Now, the company says they’ve devised a formulation that can stay refrigerated for up to 30 days and kept at room temperature for up to 24 hours."
The key takeaway here is that this one, unlike Pfizer's, appears to be easier to store as it remains stable at minus 20C for up to six months and can be kept in a standard fridge for up to a month.
Isn't the difference more due to tests levels and announcement precautions ? Pfizer's announced temperature looks like the one for very long term ARN storage while standard fridge for a month doesn't look like it should alter ARN much.
Who knows. Almost all therapeutic rnas have unnatural RNA bases or base linkages that are, for example, resistant to internal phosphatases/autohydrolysis to improve half life; half life can also depend on secondary structure, and of course as a sibling comment mentioned, it can depend on the stability of the lipid nanoparticles.
I read in the New York Times article that Moderna and Pfizer use different (proprietary) lipid solutions in the vaccines. It's possible that Pfizer is just being overly cautious and they don't need the ultra cold storage, but it's also possible that Moderna has a fundamentally better solution.
Agreed, but the Pfizer vaccine isn't as bad as most people think: you get 5 days are normal freezer temperatures. That is more than enough time to drive from their manufacturing location in Wisconsin (this might be a cold storage faultily and manufacturing elsewhere - I'm not sure) to anywhere in North America - so long as wherever you drive to already has people lined up to get the vaccine.
The above won't be hard to do for the first 3 months at least: just give the shot to health care workers as they come in for their scheduled shift. What gets hard is when you want to do a walk-in clinic: you need to figure out how much to order without knowing how many people will show up.
Note, don't take the above as a statement that Pfizer will (or should) ship at higher temperatures. While it works out on paper that they can, they have been putting effort into arranging really cold shipment for a reason: it is best to give the entire time stored at higher temperatures to the end clinic. Human logistics are the hardest part of this and this and really cold shipment gives more flexibility to the hardest part.
In any case: with both vaccines the hard part is ensuring people get their second dose on time after starting the shots! This is by far the most difficult logistical issue with either vaccine.
I would expect vaccination to be fully booked for a while, since it's going to be the most important thing in life to do for anyone not suffering from other serious issues and without anti-vaccination beliefs.
Please don't start creating this back-and-fourth. It's like saying "all drugs are good and have never had issues."
I'm concerned about a vaccine developed and tested in less than a year. There are safety concerns. There are people under 40 who may not consider the risk high enough to take. (Look at what happened in the the 1970s with the Swing Flu vaccine that wasn't very effective, and although safely administered to millions, left 3,000 ~ 4,000 is long term neurological issues).
I'm glad this vaccine is coming out and I think people in high risk groups should evaluate if they want to take the vaccine after weighing the risks. I do not want to see forced vaccinations for people who are concerned about safety.
2. That same source lays out why worrying about this risk is not rational (in this case)
3. No-one is seriously calling for forced vaccination for corona
4. (my opinion) by over-emphasizing the "personal choice" angle we are letting anti-vaxxination pseudo science and conspiracy beliefs spread without being challenged. Some things are more wrong than others and the science for the harm of vaccines has oveerwhelmingly failed to arrive. So using the term "without anti-vaccination beliefs" is fair in this case, since I will argue the only reason why you'd reject a vaccine that is recommended by a physician is an irrational belief not grounded in evidence
>>The New York State Bar Association (NYSBA) is recommending that the state consider mandating a COVID-19 vaccine once a scientific consensus emerges that it is safe, effective and necessary.
I've had lots of vaccines in my life, the thing is, all those were for diseases that had a high risk of crippling or killing me.
Why would I want a vaccine that is actually less effective than my chances of surviving?
If I get the vaccine, there's a 95% chance it'll work, if I get covid, there's a 97% chance i'll live.
All I know is, if you told someone they had a 97% chance of winning at a casino, they'd be down there in a flash.
Why would I choose to have some barely tested vaccine with not fully studied long term side effects made by companies who have extremely poor track records with medication in general?
Pfizer is bascially responsible for the oxycontin epidemic. Their reps bribe doctors into pushing their drugs.
Moderna's some secretive biotech company that just appeared out of nowhere with this whole covid thing.
What reason do I have to trust any of these companies over the 97% survival rate I can expect from getting covid?
It's the other way around - for any given chance of you getting COVID, there's a (to use your number) 3% mortality rate - if you take the vaccine - that outcome changes because you now have much smaller risk of infection, to 0.15% chance.
Your choice is between 3% and 0.15% - not 95% and 97%.
I don't think this individualistic way of looking at things is sound, though. First 3% mortality sounds way high - even given health system collapse (basically turning every ventilator survivor into a dead patient).
And on the other hand, mostly the old and those with pre-conditions will die - we alltake the vaccine to protect everyone. That way we might avoid a population wide 0.5% (or thereabouts) mortality rate.
That would still 1 in 200 - most people would likely know a handful of people dying from the disease if there's no mitigation.
Yeah, people die every day from all sorts of things. I'm still not sure why this particular cause of death is so terrifying to the world compared to every other cause of death out there.
Now say, were those numbers reversed and only 1 million out of 55 million recovered, I could see this level of panic and hysterics.
As it is, i've got a better chance of dying crossing the sketchy ass road I have to cross every day than dying o. covid.
Those elderly folks and people with pre-existing conditions, well if it's not covid, it'll be something else.
That's just kind of how it is when you're old or have pre-existing health conditions.
The thing is, if you have a pre-existing health condition, you're likely already used to being cautious. If you're old you already know even a cold can kill you.
Why is it the entire world must react and compensate for two specific groups of people who are already high risk and who already (hopefully )take precautions for themselve?
They're not children, they're adults.
That's the thing about living, one day it stops, whatever you do.
Honestly, it's selfish of those people to expect the entire world to cater to them so they feel a little bit safer.
It's insane. People can't work, can't run their businesses, told to stand in line like sheep, told who they can bring into their homes, who they can associate with, where they can go, to take some vaccine because...
A small percentage of the population is high risk?
That's justification for ruining the lives of countless people?
Yeah, I do know some people who died, not of covid though. My friend died of his cancer after being unable to go for treatments during covid and another friend with a heart condition who had their regular checkups repeatedly delayed due to covid and ended up dying of heart failure in their sleep. Again, this person did not have covid.
These people were supposed to be the people we're protecting through these.measures?
They died because of these measures.
They may have died anyway, they may have gotten covid and died without them, but that's not what happened.
It's completely fucked to make the majority of the world suffer in the name of protecting a tiny percent of people.
I don't give a fuck if it's selfish, it makes no sense. The cure should not be worse than the disease.
I live in a US state with essentially no lock down measures in place. Companies around me are going out of business by the dozen. These companies are not going out of business due to any government mandate they are going out of business because of economic uncertainty and people not spending as they dont want to go to places and potentially get sick. I used to spend ~$500 a month on eating out, I spend almost zero now as I dont want to take the risk. This has nothing to do with government choices and fully to do with mine. Now multiply this by tens of thousands of other people making the same choice and you will understand why an effective widely used vaccine is important for an economic recovery. Until the virus is under control I and many others will severely curtail our spending and there will be only a limited economic recovery.
In addition I dont go out as I have elderly relatives who I dont want to sicken, they dont expect it, its my choice. So blaming others for being selfish is really missing the point and is an illustration of not really understanding the current economic situation.
Your point is perfectly true, but there is also one more thing to consider. It is possible for the health care system to get overworked like they did in NYC and North Italy. There are signs it could happens in other places in the US now like Wisconsin.
At that point everything else suddenly becomes critical, because there is no ICU left.
Also, at least in CA, doctors/hospitals/dentists etc are only doing what is critical right now to avoid the whole hospital going into lockdown. That has large consequences for health outcomes and for the economy of those practises.
To add some data to that: there is a correlation between disease spread and GDP reduction, and it's the one that consistent with your anecdote: The economic impact is greater where the disease is left unchecked :
(unfortunately, the graph doesn't include countries like china, vietnam, and many other asian countries, because that would make the trend even clearer.)
average of 17 pedestrians are killed by cars in the US every day (data from 2018). Over 1,000 people per day are dying from covid in the US. So your odds of dying crossing the road on any given day are actually far, far less than your odds of dying from covid...
I think it's easy to look at a mortality rate of half a percent, and think "no big deal" - but it really is. One in every 200 people dying would mean most of us have a close connection to a couple of victims.
And there's already more dead from covid-19 in the US than casualties during the Vietnam War. Granted, more elderly people than young, but it's still a bit difficult to accept that it's insignificant.
Add to this what could happen with an exponential surge, with icus being over-run - and a) you'd end up being more likely to die from other causes, like a traffic accident - and b) many of the current covid-19 survivors would end up as casualties.
You sound like a child. No one is panicking, the problem is it's killing people and hospitalizing even more people to the point of overrunning hospitals.
Very very few hospitals have actually been overrun. Many were and still are empty (or flooding in with people who couldn't get treatment for other things during the lockdowns). The cases in NYC, Michigan and Kirkland (Seattle) were all due to orders that packed elderly care facilities with sick. Governors Whitmer and Cuomo made huge mistakes with their orders and neither is owing up to it.
The problem is that with the infection spreading exponentially you might have hospitals half empty one day and at 200% a week later.
Here in Czech Republic it looks like we managed to avoid running out of capacity during the ongoing second wave, but just. The measures taken included canceling any elective and non-life-threatening surgeries, drafting medical school students, many foreign doctors that came to help and moving covid patients in critical state from overloaded hospitals hospitals.
We even built two full field hospitals which we will thankfully not need as it looks like. BTW, building one of them took about a week - which you migh not have, once you hit exponential growth. Not to mention having spare medical personnel to run it.
> Your choice is between 3% and 0.15% - not 95% and 97%.
I would put it differently: if we become covid carriers, we become spreaders. Those 3% are, thus, applied to a large population comprised of everyone we interact ina daily basis.
Thus even if at most the likelihood that we die of covid is only 3% tops, the likelihood that at least one person that catches covid from us does is proportional to the number of people we infect.
With a 3% fatality rate, the likelihood that at least one person we infect will die can reach 80% if we spread it to over 50 people.
If we infect someone over 60, the likelihood that they will die from covid grows from that 3% to about 20%.
So unless you are infected while living in a bubble, the real risk is far higher.
> Why would I want a vaccine that is actually less effective than my chances of surviving?
Well, the vaccine hopefully doesn't kill you if it's ineffective, so the numbers aren't exactly comparable.
The reasoning in this comment is wild. Let's take it back to the math a moment:
Let's take your 3% chance of death (actually the population survival rate is significantly higher IIRC, but OTOH there's long haul COVID to consider too). If the vaccine is 95% effective, all else being equal you have a 3% chance of death without the vaccine, and a 0.15% chance of death with the vaccine. So the question becomes: is there a greater than 2.85% chance of the vaccine killing you or doing you crippling injury? If not, you're probably better off taking the vaccine.
Numbers depend on the age. Bulk of deaths are concentrated in older populations. CDC recently updated estimated infection fatality rates for COVID. Here are the updated survival rates by age group:
The CDC updated their pandemic planning scenarios[0] based on earlier studies in Europe plus some educated guesswork using data collected from the US through August 8. The numbers which you represent as the CDC’s sole official estimate of true IFR are only one of three possible sets of parameters that they provide for scenario modelling. Furthermore, the footnote on these estimates states “The estimates for persons ≥70 years old presented here do not include persons ≥80 years old”, since the underlying study they base the model on assumed that CFR = IFR for people ≥80 years old. Why they label this 70+ instead of 70–79 is beyond me, and I have no idea how sound the methodology is that they used to derive these estimates.
I would also mention that there are studies in peer review on patient populations in the United States which suggest IFRs closer to CDC planning scenario 4/5 than 3—for example, this one from Connecticut[1]:
We all hope for the best—that the lower bounds are true—but I think we should also be prepared for the reality that the upper bounds might be the correct ones, and act conservatively.
Also, you know, all IFR estimates assume that patients will actually be able to access care. Without hospitals, IFR approaches IHR, and the hospitalisation rates from the Connecticut study are grim: 0.8%, 2.68%, 3.09%, 12.43%, and 79.89%.
" if you told someone they had a 97% chance of winning at a casino, they'd be down there in a flash"
this is a bad analogy, what if you also told them that if they lost they were taken out back and shot? I bet a lot fewer people would show up. In this particular case, winning just means not dying, if I could increase my odds of not dying I would probably do so.
Also there is no proof that getting covid grants lifetime immunity, so lets assume immunity lasts a year, every year you now have a 3% chance of dying from covid using your numbers. 3% is not that low, there is a ~3% chance of rolling double sixes with 2 dice, and that happens all the time.
Your IJME link does not support in any way your assertion about the "danger" of the HPV vaccine. From the link, 30,000 were vaccinated. Three girls died for reasons that are never stated. The article provides that "there is no conclusive evidence of a causal link between the vaccine and the deaths."
I take the general gist of some of your points, but it might be worth reframing some of your logic. To take just one point, let's go to the casino: you have a 97% chance of winning...pretty great! The downside is that if you lose, we take you out back and shoot you. Do you still want to go?
In response to 3, many rational people are. And I agree with them. We have mandatory vaccinations for MMR and for dTAP. Have you ever heard of anyone catching diphtheria? A reasonable risk profile puts COVID-19 at higher risk than whooping cough, as the chances of getting it are so much higher, even if the fatality rate is lower.
"Mandatory" vaccination for children in the USA usually aren't: all states allow exemption for true medical reason, and [edit: --some--] almost all allow exemption on religious grounds. Sixteen allow exemption for parental objection.
> We have mandatory vaccinations for MMR and for dTAP. Have you ever heard of anyone catching diphtheria?
Not specifically, but DTaP vaccinates against pertussis which has seen epidemic-level outbreaks in the past decade in multiple states.
I'd expect any SARS-CoV-2 vaccinations to be targeted at adults for the foreseeable future, but who knows.
> No-one is seriously calling for forced vaccination for corona
There will be de facto mandatory vaccination, to a degree. This is a Canadian news source but read about the companies involved with creating this program (by the way—-it’s not Ticketmaster). It is definitely coming to America and already underway.
No coronavirus vaccine, no entry? Experts say it’s possible in pandemic’s next stage
In Europe, mandatory vaccinations do exist in some countries, for both children and adults. Also, in Croatia (which is part of the European Union), if you refuse to have your child vaccinated, it is legally considered to be child abuse. In Croatia, they have school doctors that literally come to the schools with nurses that not only ensure the health of all of the kids, but also have them vaccinated there. Homeschooling is also illegal in Croatia.
Physicians recommend many drugs that end up proving to have dangerous side effects. The anti-inflamatory Vioxx is just one that comes to mind without doing any research.
That's like saying that there have been unsafe cars in history without understand which cars and why and why they're unsafe.
There's a lot of unsafe stuff, but this example is so absurdly generalized that it seems either malicious or just so ignorant that it's not even a worthy position to take.
It is also not definitive that the 532 cases of Guillan-Barré were actually caused by the vaccine. In any large scale vaccination effort people die/get sick just because that is what happens in any large population.
> I did find a a source of 532 developing Guillan-Barré
You should have mentioned that the 532 cases of Guillan-Barré were found within the 48 million people receiving the swine flu vaccine.
Accordig to Wikipedia, the incidence of Guillam-Barré is about 2 per 100,000 people per year.
Statistically speaking, your example suggests that taking the swine flu vaccine is linked with a lower incidence of Guillam-Barre syndrome, nearly lowering it to about 60% of the baseline.
If we're allowed to play fast and loose with back-of-the-napkin statistics, your example contradicts your original claims, and indeed makes a strong case in favour of vaccination.
> No-one is seriously calling for forced vaccination for corona
Define forced. I'm not in favor of pinning people down and forcibly injecting them with something, but I am all for some kind of vaccination "passport", where if you don't have proof of vaccination you stop enjoying the benefits of society. No public schools or services, right for businesses to refuse service, etc. Or at the very least, a heavy tax fine or something a long those lines.
If people choose to not get a vaccine, that's fine. But its time we align incentives to eliminate these externalities being born from societal free-loaders who believe in quack-science.
The alternative is a high chance of becoming ill with COVID, which according to the data available so far is much riskier than the vaccine (1-2% hospitalization risk even for healthy young adults, evidence of long term issues at least in some people).
Unless of course your alternative plan is full isolation for years, in which case not taking the vaccine is the correct choice, but such isolation is only reasonable if you don't care about going outside anyway at all.
There's a recent quasi-exprimental study on that, showing that vitamin-d is likely one of the central factors in better outcomes for severe cases of covid-19:
According to this study, vitamin-d gives better outcome than the other treatments, including hospitalization:
"Regarding care dedicated to COVID-19, only the proportion of patients who received a bolus of vitamin D3 during or just before COVID-19 differed between deceased participants and survivors, with a higher prevalence in survivors (respectively 92.2 % versus 66.7 %, P = 0.023). In contrast, there was no between-group difference in the proportion of patients treated with corticosteroids, hydroxychloroquine or dedicated antibiotics, or hospitalized for COVID-19."
And this has to do with Vitamin-D's role with the ACE2 receptor. SARS-CoV-2 has a binding affinity to ACE2, aggressively invading cells with proportionally higher ACE2 receptors (including the lungs).
In fact, someone had tried injecting hrsACE2 into someone as a treatment -- that is, letting the virus bind to hrsACE2 instead of the ACE2 receptors in the cells.
A treatment with hrsACE2 isn't generally-available, and needs a lot more study. The logsitics in producing them at scale would need to be solved, if this is a viable treatment. But this looks promising to me.
There looks like treatments developing that can reduce the mortality or severity of COVID after contracting it, including possibly reducing long-term scarring from it. These treatments are coming out of better modeling and understanding on how COVID spreads in the body and kills people.
It isn't so binary or black and white -- vaccinate or risk dying. We're starting to get other options.
Some of those options, like monoclonal antibodies, are extremely expensive and hard to produce and distribute at scale, plus they only work early in the course of the disease. I'm not aware of any small-molecule drugs that have hopes of great efficacy on the horizon. You're not going to pump out 150K/day doses of MABs.
It really is vaccinate or risk dying. The other options are too expensive, too timing-dependent or too ineffective.
I’m not scared of a vaccine. I am not sure what words I used to give you that impression.
I do see a lot of people fixating on vaccines as if it will make everything better. Vaccines will help, but better if there are other treatments as well. I think that if mortality rates and long-term scarring decreases, then people won’t feel like their survival depends upon other people’s cooperation.
Presumably because any side-effects of new COVID treatments would only affected those who get a serious form of COVID while any side-effects of a vaccine would be applied to the entire population.
The strong asymptomatic spread of this virus, however, makes these decisions more complicated and less individualistic than “what happens to me if I catch it”.
Vaccines are the only way we can end the pandemic though. However great a treatment is, it won't stop anyone catching it or spreading it. If we're to be able to go back to anything resembling normal, we need to stop widespread transmission in the population, and the only way to do that without these restrictions is for an effective sterilising vaccine.
There won’t be enough vaccines to go around, so no one will be forced to take anything for at least a year. By then we might be at 60-70% of the population vaccinated, at which point the R0 of the virus would be much lower.
Don’t worry about it for now, the rest of us will take the risk so you don’t have to.
I feel like we are about to enter the variation on the prisoner's dilemma where we all get a massive benefit if at least 70% of us get the vaccine, but getting the vaccine has a cost (please roll a D20 to select your random side effect) so everyone has an incentive to be one of the shirkers.
I foresee things getting ugly as we collectively all get together to shame, bully and trick the shirkers into compliance.
The immunocompromised and the economy get a benefit if we get to 70% vaccinated; I get a benefit for myself just by getting the vaccine.
I’ll allow that there is seemingly a significant portion of the population who believes they don’t personally benefit from a vaccine, but your comment said -everyone- is incentivized to shirk: that’s just not true.
That is fair. But I think that the fraction of people who individually benefit from getting the vaccine is less than the 70% who need to get it, do there's going to be a gap that will need to be filled with lies, bullying and shaming.
Of course this depends on the unknown factor of how bad the side effects are, if they are nonexistent then it's a different story, but if they are on average as bad as a flu shot then it becomes tricky.
I suppose I'm really thinking in the context of countries like Australia which have essentially eradicated the virus. My risk of getting the virus right now is practically zero, so my only incentive to get vaccinated is that we can eventually reopen our borders once enough people are vaccinated. And personally I'm in no hurry to get flooded by foreign tourists anyway.
This is not how the Prisoner's dilemma works since not getting the vaccine is not a purely dominant strategy. You are neglecting to adjust the vaccination scenario payout to account for the fact that you personally are much less likely to get Covid-19 if exposed to someone infected. This benefit largely exceeds any cost of receiving the vaccine based on current data.
This is not a prisoner's dilemma. The expected payoff if you get vaccinated is still far higher than the cost, whatever the rest of the population does, so you can ignore the cost in your calculation. It's like if the situation for the prisoner was that if you stay silent you go free, but if you both stay silent you both go free and the rest of your gang gets a reduced sentence too. Why would you ever defect?
Agreed. I think vaccines are generally a good idea, but that there are risks involved in beta testing them.
Also, there are some interesting treatments targeting the ACE2 receptors that SARS-CoV-2 binds to which looks like they are reducing mortality rates, and perhaps long-term scarring in the lungs. Among these are Vitamin-D (which people are probably nutritionally-deficient anyways), and human recombinant soluable ACE2 (basically, injecting a form of ACE2 into the body so that the virus binds to that, instead of to cells with a lot of ACE2 receptors, thus short-circuiting the replication pathway). I would be interested to see if nutritionally-sufficient vitamin-d is better at preventing severe cases of covid-19 than masking or social distancing.
My own opinion is that it is foolish to pin all the hopes on a single strategy (prevention, via vaccination), which is not guaranteed to work or guaranteed to be safe. To add forced vaccination is folly. I think it is better to see a depth of prevention and treatment options (including vaccination).
The study described findings of antibody-dependent enhancement with the original SARS. I am no expert, but my understanding is that when test subjects were given the vaccine, and then later 'challenged' by the SARS virus, they developed a pathological response. In other words, taking the vaccine had a potential to make their response to SARS and potentially other coronaviruses worse.
The study I linked therefore recommended caution in giving the vaccine to humans.
Obviously this is something that vaccine researchers are aware of (see https://www.nature.com/articles/s41564-020-00789-5), but I think it's something that is perfectly rational to be concerned about given the time and money pressures available with SARS-CoV-2 vaccination.
Looking at your individual risk profile is a good way to decide who ought to get vaccinated first its a poor way to decide who gets vaccinated at all. There are some parties including those who are too young to vaccinate or who have poor immune systems whom are only protected by the surrounding population not passing around virii like baseball cards.
Having a large enough host population to sustain an outbreak means those vulnerable parties are fucked and the rest of the population even those for whom the vaccine is 90% effective are at still at some risk. Worse the selection pressure among millions of vectors to develop a strain that can infect the previously safe population is high and the possibility is real.
This is to say that the proper assessment of safety is the likely net effect on the entire population of an increasingly large portion of society not vaccinating.
Existing precedent would seem to suggest that its impossible to force you to vaccinate but possible to prevent you from participating in society if you do not. For example the state can put you in jail for not putting your kid in school but not let you do so unless you vaccinate your kid.
I would not be terribly surprised if people, especially vulnerable people argued that a work allowing anti vaxxers to work alongside them violated their right to a safe workplace.
Imagine one lawsuit from someones family that lost a baby or a family member resulting in an 7-8 figure settlement. There wont have to be a law. The lawsuits will be from anti vaxxers alleging that this violates their rights and will take place over the following 2 years after every major workplace in America adopts such rules giving American workers the choice between employment and remaining an antivaxxer.
A little, but when you are talking about my baby that is going to the part with older kids. A lot of kids do look at my baby first learning to crawl and run up to get a close look.
I'm not anti-vax by any means, but I would rather have 3 months of outcomes from widespread deployment prior to being vaccinated or having my low-risk family members be vaccinated.
That this vaccine is mRNA-based makes it likely safer than some other lightly-tested vaccines, but if you're young, healthy, and at low-risk of serious COVID infection, I'm not sure it's wise to be among the first in line for this vaccine.
Yes, of course it is, provided that the vaccine that I take would otherwise go un-given in that 3 month period. That seems unlikely to me as we are likely to be vaccinating as many people as we can manufacture doses during that period and the difference is "which" rather than "how many".
I leave my house about once a week, wearing a mask, to spend 20 minutes grocery shopping. My risk of contracting, contracting and dying from, or contracting and spreading the disease is extremely low and quite possibly lower than leaving that dose for someone else who is leaving their house and being around people more than 4 hours in those 3 months. Bonus is that someone at higher risk gets "my" dose and I get 3 additional months of population-wide study of safety, side-effects, and efficacy.
You're fine then, because the young, healthy and low-risk won't be able to access any vaccine for months after higher-risk people. It's probably closer to a year before the really low-risk people get any.
I presume that like most vaccines, there is a gap between you receiving it and developing immunity?
I hope everyplace offering vaccinations will have something in place to prevent anyone who comes in who is already infected but asymptomatic from infecting others there.
Given some states' track records on how they handled other things that attracted a lot of people, such as in-person voting, I'm not at all confident that we won't have some states that manage to turn vaccination clinics into super spreader events, which should be deeply embarrassing.
A good way to handle it is the way Kaiser handled flu vaccinations this year in western Washington. They had 10 minute windows available. You reserved online your spot in one of those windows. When you arrived a person at the door asked your name, checked you off the list, and gave you a pre-printed label with your information, and sent you in.
There were two or three people administering the vaccine, so two or three people for each 10 minute window. You went an stood in line with the others who shared your window, with the line very spread out.
When it was your turn you went in to get the vaccination, gave the person their your label, got vaccinated, and were sent out a side or back door so you would not cross paths with the people waiting or arriving.
Several food trucks have sprung up in my neighborhood that seem to have an even better impromptu system. You walk up to the window, they hand you a small device and send you back to your car. When your device lights up, you go to the pickup window. There is no line at all.
I don't know how many hundred dollars it cost them to buy a couple dozen devices or how much it costs to wipe each one down and put it back under the infrared/anti-cootie lamp each use. But there are orders going out the window about every 2 minutes and no customers within 50 feet of each other.
that's why we need to stop treating phone numbers as personal identifiers... nobody in the world would dream of using IPv6 addresses as personal identifiers
to this point you (everybody, really) should have a burner phone number
He points out that the standard being adopted by these studies for the point efficacy is 14 days after the second dose. That's honestly not too bad. It's no magic bullet, but it's survivable.
> I hope everyplace offering vaccinations will have something in place to prevent anyone who comes in who is already infected but asymptomatic from infecting others there.
I remember getting the vaccine and it was offered outdoors, with a line in a parking lot and a nurse having a tent or a table or something. So that was good (although we weren't wearing masks -- the level of concern and associated precautions with H1N1 felt high at the time but now seems pretty trivial compared to COVID-19).
I recently went to my doctor's office for a seasonal flu shot and the office had separated spaces in the waiting room, lots of air filters going, and all patients and workers wearing face masks. And I think they wouldn't allow more than 4 or 5 patients in the office at a time. So those same precautions would feel pretty decent to me for COVID vaccination.
Edit: I guess I'm reflexively thinking of San Francisco in imagining this -- the outdoor line-up seems perfectly fine here, but it might be pretty unpleasant in January in New York or St. Petersburg or Edmonton...
During covid time local clinic did drive through flu vaccination. It's as distanced as you can realistically expect. And with prebooking you're not overwhelmed.
FWIW, I found Kaiser's flu shot system to be a nightmare to navigate for my family. There were different appointment times for kids and adults, so it was going to involve multiple trips on multiple days.
We ended up just going to Target, which was much more risky, but actually something we could accomplish.
> other serious issues and without anti-vaccination beliefs
This was redundant. Anti-vaccination “belief“ is a serious, mental, issue.
Against HN rules, but it’s time to stop being so easy on people who try to distort science and reality and call them for what it is. You cannot have a eye to eye conversation with anti-vacciners, flat-earthers, climate-change deniers, election-fraud believers and Trump supporters.
The more leeway we give the more they try to win public opinion and damage our world.
Done right, being less tolerant of speech/behavior that can be detrimental to the common good does change minds for the better. Any "code of conduct" is precisely this: directly calling out detrimental behavior as vile with no tolerance for it. The fact that nearly half of voters in the United States support Trump does not change this.
How can you be sure that the censors will always be on the side of the angels?
Follow-up question: how can you be sure that you, personally, are on the side of the angels? Especially if you have never been allowed to hear the opposing point of view?
Seriously, the growing support for censorship in the previously libertarianish Tech community has been the worst development of the last decade.
Actually, I don't care for censorship. I'd rather let the idea be presented and let the intolerance for it drown it out by way of copious rebuttals, not removal. I won't know if I'm on the side of the angels, but I'll know I'm in good company and I'll have heard both sides at levels roughly proportionate to the size of the population interested in defending each side.
In hindsight, I see how citing codes of conduct implies support for censorship, when my actual intent was simply to demonstrate another example of "intolerance" having noble goals.
These are fine questions, and their answers should sit uncomfortably in all humans. But unless we are content to let human knowledge dissolve into meaninglessness, we must look to something external to our own reasoning to help decide what to believe. For me, I have drawn that line at Scientific Consensus because it has proved the most robust tool humanity has ever found for determining what is actually true. Is it perfect? No. Is it better than everything else? Undoubtedly yes. I think it must be the starting point and possibly the ending point for all discussions of this nature. To use another tool you must first convince me it is better than Scientific Consensus.
And this is the root of the divide, as far as I can tell. It's quite literally nerds and bullies all over again. Those who see the light and those who think you're a tool for doing so.
Netiquette 101: Don't feed the trolls. (But here we are.)
"ut unless we are content to let human knowledge dissolve into meaninglessness, we must look to something external to our own reasoning to help decide what to believe. For me, I have drawn that line at Scientific Consensus because it has proved the most robust tool humanity has ever found for determining what is actually true"
Well, I agree with the scientific consensus on a general base. But since science was not always right, I don't see a valid argument from there to censorship.
You want to censor ideas not covered by scientific consensus?
"and their answers should sit uncomfortably in all humans"
Because, also no. I do not feel uncomfortable. I am strongly against censorship. Open, unrestricted exchange of ideas. If the scientific way is the best (which I believe), then the crackpot approaches will fail naturally. But if you censor those other approaches, you might actually strenghten them.
Your plan is reasonable if human minds were genuinely and effectively open to letting the best ideas win. But they are not. Human minds care more about reputation than veracity and this has important ramifications for plans like yours: namely that they don’t work. Confirmation bias is real and pervasive and as completely in control of my mind as it is of yours. I encourage you to read Haidt’s The Righteous Mind and see if what you purpose still makes sense.
So you're saying that authoritarian measures are the way? Codes of conduct change minds if people are receptive, or they play along so that they don't get abused, and it looks like it's changed their mind.
From where I'm sitting, perceived authoritarian tendencies on the democratic side is a large part of what really motivates Trump voters. That's certainly a lot of the narrative, if you ever visit that side of the media landscape.
So is fighting misinformation a lost cause, or can we come up with some plan that doesn't involve a small group of people censoring it? Would some kind of distributed rating system like upvotes/downvotes be acceptable, or is the better course of action to be okay with letting all information -- even if specifically designed to trick people, not only the most gullible, but even the most discerning skeptics -- circulate?
I believe the government should not have a say in whether or not all information circulates, but ordinary people who build information sharing systems (and I don't just mean electronic ones) have an opportunity to figure this out. Should they not?
> That’s what censorship is. A small group of people will decide what is considered misinformation and will censor everything that goes against that
This is not censorship. Censorship is stopping you from expressing your thoughts. Not publishing your thoughts is not. You can say whatever you want but no newspaper is in any obligation to publish it.
Similar with social media, you can write whatever you want on your personal "page", but they are under no obligation to make sure it reaches other people's feed.
Is censorship really the greatest crime? Is there no intelligent way to facilitate the search for truth that doesn’t require us to get bogged down in accepting every possibility as equally plausible? Of course there is. One thing is certain. Crying “that’s censorship!” will not get us to that place.
There is a time in not that long ago recorded history where this would have risked settling on the conclusion that the Earth was the center of the universe (and it was flat), leeches and blood-letting were a treatment for diseases, and heavier than air flying machines were impossible.
If you’ll permit a scientifically inaccurate analogy here: sunlight is the best disinfectant.
I don't think authoritarian measures are an appropriate way for a government to operate, but in the context of whether something is "against HN rules" I think making it known that an idea is harmful is a good thing.
It all comes down to whether or not the community in question is one in which members can readily leave without cost. I don't agree with making anti-vaxxers change their ways by government force, but I'm into being intolerant of them in other ways to the point that they'll come around and obviate any need for governmental force in the first place.
Yes, it's a belief/acceptance/trust/whatever you want to call it. I believe demonstrated science is fact, but that's still a belief about the world. My parents are in scientific fields, I received a science and engineering based education, and generally have faith in the scientific method as performed by most scientists.
But we DO have to convince people, we have to convince people by showing them how it works, and letting them decide that that makes sense, you can't just mandate belief as a science authoritarian.
And science is still performed by humans, and we're fallible, and our incentives aren't always good, and every time there's a public failure of the process, and every time a scientist goes on record to shill for a company's chosen viewpoint, it dings the general public's faith in science and scientific experts in general.
You arguments here are the problem. I know that you mean well and in a perfect world what you say would make sense, but when you say “science is still performed by humans” is an opportunity for the school dropout to say, “see even between them they have doubts, the earth is flat”.
What’s the better alternative? If you don’t explain how we know the earth is roughly spherical, that’s the opportunity for that person to conclude “see, they can’t even refute it; look for yourself, sheeple...”
Don't you dare use the word "science" to justify censorship. The scientific method is completely incompatible with censorship of dissenting ideas. The scientific method is based on the idea that all knowledge is provisional and subject to change when new evidence comes in.
Saying "this is the currently accepted truth, censor everything else" is the opposite of science.
Your understanding of science is pretty bad if you seriously believe there are no rational objections (re: long-term effects) to consuming a drug that didn't even exist a year ago.
Well, tolerance has got us non-solutions like vaccine waivers for schools, and legislation that makes it easier for people who choose not to vaccinate their kids to spread easily preventable diseases. It also got us sick and dead kids.
Every single human being can be assumed to think they fall in the reasonable bunch. This is a combination of hardwired bootstrapping (seems unavoidable), self-serving biases, and the fact that most mistakes won’t be recognized even in hindsight (so much for saying hindsight is 20/20).
Let's also accept that many judgements on outcome are not only subjective but culturally biased. Assuming we both agreed on values and we were analyzing identical scenarios then you could argue that a difference in choice would boil down to differences in the effective use of reasoning
Most people disagreeing on most subjects have probably barely applied any sort of reasoning to get there.
Most pro-vaxxers have simply picked up the dominant opinion from the surrounding society -- not a bad heuristic in practice. Most anti-vaxxers have picked up an opinion from a persuasive single source and then read some other sources that back it up.
I admit I'm in the first category, I certainly vaccinate my own children, but I can't really claim that I've come to this decision after a thorough understanding of immunology, I have simply followed the path of least resistance.
You don't need a degree in immunology to be very skeptical of anti-vaxxers' claims. Reading a bit of history is enough to know what happens when vaccines don't exist.
The steelman version of antivaxxism isn't "vaccines shouldn't exist", it's "on an individual basis, the risk-reward ratio of certain vaccines is not worth it. I should personally not vaccinate myself or anyone I care about, and be a free rider on societal herd immunity"
That particular version of antivaxxism is the one I would have the most trouble refuting. It's especially troubling since if it were true then the powers that be would have every incentive to try to keep it quiet and attack anyone who suggests it.
I mean, I make the same judgement call every year for flu shots. Is it at least plausible that I would be better off overall making the same call for some other disease?
> (...) I should personally not vaccinate myself or anyone I care about, and be a free rider on societal herd immunity"
> That particular version of antivaxxism is the one I would have the most trouble refuting.
What's hard to refute? I mean, the exceptionalism argument only sticks with sociopaths who believe society exists only to serve their personal interests without having to contribute anything in return.
> it's "on an individual basis, the risk-reward ratio of certain vaccines is not worth it."
That's not really true though. The risks involved in getting a vaccine are much, much smaller than the risks involved in not getting the vaccine, especially with diseases like Covid.
The logistic problem will be a major blocker in most of the other parts of the world, for e.g. anywhere in developing world. Even though it might work for US, rest of the world will still have the logistic problem due to the temperature restrictions.
Flight from Wisconsin to any airport in the world in 24 hours. Plenty of time to distribute from then - especially as it’s cities (near airports) that are the main targets
IDK, put that shit in a properly insulated box stuffed with dry ice pellets, you'll maintain ultra-cold for three days easy with no electricity. So if you're loading a plane in Europe that spends 24 hours flying to $remote_destination, it still leaves you with 48 hours to do distribution by road, then you have another 5 days at normal freezer temperatures that is available for actually giving people the vaccine.
Not to downplay Pfizer's role in logistics here, but they didn't really develop the vaccine. They're the logistics+manufacturing branch of the joint Biontech-Pfizer venture in this, while Biontech did the RND.
I am assuming they are also responsible for the clinical trials, but I'm not sure about that. It would make sense, though, because navigating the approval processes of the different agencies requires very specialized experience and domain knowledge.
Yes, Biontech appears to be more of a long shot project aiming for a future where you can manipulate your immune system into fighting your cancer with a personalized vaccine. That's why they were in the unique position of having the skills for putting together an mRNA vaccine targeting the SARS-COV2 spike on very short notice without having established organizational knowledge of running those approval trials.
Moderna has the same setup. They just happened to be able and willing to raise huge amounts of money (and play ball with the .gov) to produce it themselves. It's also why Pfizer is claiming they can produce a billion vaccines over the next year while Moderna is only saying they can do 100 million.
Oh great, capitalism at it's best: there's an acute crisis, we might have the solution, but if we don't solve it vertically integrated we would have to share the spoils with a cooperation partner. This can't happen, quick! Bring in the investors!
Take a step back. Why did Moderna founders invest in research and technology? Are they selfless idealists? Probably not, at least that is not the only driving motivator. And even if they are, they still want the company to earn money in order to invest it into more research.
Bottom line is they want the company to be successful, so their long-term plan is to profit from making drugs. If they lived in a socialist economy where no such profit was possible, they would not have bothered, and then there would be no cure. If that is the world you prefer to live in, you have options (North Korea, Cuba and Venezuela currently, the rest having collapsed or transitioned to free market some time ago).
From the linked article: "Moderna said it could potentially manufacture 1bn doses by the end of 2021, adding to a further 1.3bn from Pfizer/BioNTech in the same timeframe."
Given the timelines and uncertainty, I don't think 1B and 1.3B are materially different. Both require 2 doses per vaccination.
I’m curious - why is there such a difference between them? What is it specifically about the pfizer one that requires a lower temp? Does anyone know what the other potential vaccines (Oxford in particular) will require?
A biologists might be able to provide more detail but some big molecules are just inherently more stable than others, it can be incredibly tricky to predict this up front since it depends on complex interactions within the molecule itself. These are the kind of problems that projects like Folding@Home try to solve with lots of computing power (though I think they focus more on proteins, not sure if they also do RNA).
Pfizer release their data ahead of Moderna. How is Moderna "ahead"?
And no, stability testing happens pretty early on. Pfizer would have definitely collected enough data at this point to say whether or not their vaccine is stable at higher temperatures.
Pfizer released a press release, but as far as I can tell that isn't as much data. Given the time I'd guess that the mathematicians at Moderna worked all weekend crunching numbers and writing a paper (which is what I'd do if I was a statistician there).
Pfizer is big enough to have/let a PR department do a press release during business hours. Of course given that Pfizer did a press release first Moderna for PR reasons needed to release more data to make a bigger splash.
No matter how you look at it, there is important data that will be in the FDA (and equivalent in other countries) submission that we don't have. There could be a "thats funny" thing burred, though odds are against it.
They are not identical, unless (unknown to me, but possible) Pfizer has released more since the initial press release. Pfizer (again at least in the initial release) said a number of infections, and "at least 90% effective". Moderna released a number of infections and the number in that who got the placebo vs vaccine.
The difference is not very big, but to those who like numbers it is big enough.
RNA is fragile. DNA is pretty stable. Proteins are somewhere in between but can be engineered to be very stable.
Most vaccines are a protein (originally a fragment from the (inactivated) virus, now more often a synthetically manufactured fragment of the virus).
These vaccines (Moderna & Pfizer) are delivered as the RNA that encodes a fragment of the virus (that your own body then uses to produce a fragment of the virus). The delivery mechanism is very different, but the viral fragment that your body sees is the same as it would if the protein was delivered directly, as is traditional.
RNA can't reliably survive on a surface for more than a few minutes (which is somewhat good news since coronovirus itself is an RNA virus), or more than a few days unrefrigerated, and is very sensitive to any contamination by bacteria or other organisms.
Traditional proteins are generally much less fragile both chemically and as food for other organisms. And sometimes a protein (vaccine) can be specifically engineered to be even more stable in room-temperature, dry, or other unforgiving conditions.
And none of this takes into account specific formulations, or other chemicals that are used to aide the delivery process. Much of this has to be measured empirically. It's not clear to me if there is some chemical difference between the Pfizer & Moderna vaccines, or if the different temps are just what they use as their protocol filed with the FDA.
Further, see /u/dnautics below, often RNA therapeutics aren't completely true RNA (they can have chemical features to enhance stability).
The bigger takeaway is that Moderna's vaccine doesn't produce CD8+ (T-Cell) responses. Pfizer's T-Cell responses are off-the-charts good. This could affect your immune system's memory ability and could offer longer protection. Both the Moderna and Pfizer vaccine offers CD4 T-Cell responses. CD8+ is a nice-to-have, so the Pfizer vaccine would be an A+ grade, and this Moderna one is a solid "A".
The 2nd key takeaway here is that while 5 patients in the vaccination group tested positive for coronavirus, none of them had severe disease. Which means to me that while this vaccine isn't a magic shield, if you do get it, it will keep you out of the hospital and probably make it a very mild experience.
Totally anecdotally, the 4 people in my family who got it are all 65+ with multiple underlying issues. It was a bad head cold for a week and half, all recovered. I know, sadly, that isn't the case for so many. I just don't know what to think.
This is exactly my point, and yet my comment gets downvoted.
People seem content with vaccines, meanwhile I want to understand WHY some people fair better than others. There's a far better solution than vaccines to be found, if people are willing to ask the question, and look for it.
Even in the 80+ population most people are okay. A sample of four is not big enough to see the catastrophic effects even fairly small hospitalization numbers have when millions get infected.
The immune system at its core is basically rolling dice like crazy for new random RNA source code that is compiled into molecule hardware that will hopefully work against the invasor somehow. It even has a mechanism to deposit samples of the invasor were the freshly rolled candidates are let loose. Apparently it's buying into the TDD paradigm. The dice are probably not rolled to try completely random RNA sequences with a D4 for each base, more like mashups of the existing library from previous infections. Different immune systems can come up with different solutions to the same virus and even the same solution can be stumbled upon very early or reached very late, only hours before EOL. The content of the existing library likely plays a decisive role and even more does the general bandwidth of mashup attempts. This apparently shrinks drastically from children to elderly. Maybe an evolutionary tradeoff to compensate for the weak library children have, maybe a side effect of the existing library.
(source: mostly stuff I read linked from the hn page, hopefully without excessive misreading)
> Which means to me that while this vaccine isn't a magic shield, if you do get it, it will keep you out of the hospital and probably make it a very mild experience.
With an n of 5, isn't this a premature conclusion?
If you compare the endpoint "severe illness"... 11 out of ~15000 ended up with severe illness on placebo, and 0 out of ~15000 ended up with severe illness in the treated group.
This corresponds to binomial 95% confidence intervals of (0.0004, 0.0013) and (0.0000, 0.0002). So it seems to prevent severe illness.
Whether it reduces the odds of severe illness IF YOU ARE INFECTED or purely reduces the odds of severe illness by preventing infection--- you're right, there's not nearly enough n to know.
> Which means to me that while this vaccine isn't a magic shield, if you do get it, it will keep you out of the hospital and probably make it a very mild experience.
Is that conclusion warranted given the small number of people who got it? Perhaps in another population one of those 5 will indeed have severe, hospital-needed symptoms?
If the immune reaction in the vaccinated was good enough to avoid symptoms but a few still tested positive then those five are surely not the only ones. What are the chances that a random person without symptoms would be getting tested exactly those days that a very mild infection lasts? Those studies don't observe the subjects with daily PCR or something like that (impossible for ten thousands) and most mild infections remain undiscovered. And mild, hard to discover infections aren't exceptionally rare even without a vaccine, as antibody testing studies have shown again and again.
The pressing follow-up question is this: how many of the control group were discovered with (and despite of) equally weak symptoms? The answer could be anything between many more and many less. If it's more (more discovered very mild cases amongst the placebo group) then the vaccine apparently prevents most infections from happening at all, but if it's less then the vaccine doesn't really reduce the number of infected (and infective), it only prevents bad outcomes (which usually remain undiscovered, even in a phase III trial group).
A vaccine that only prevents bad outcomes would still be very valuable, but only to the vaccinated themselves because it would not create a herd immunity effect. This virus is very good at spreading from a mild case, so if the vaccinated still get unnoticeable mild cases they would still serve the virus as stopovers.
Contract tracing is more likely to identify sources of infection when the people remember being in the same room with someone who had symptoms. This is also why public transport is virtually absent as a infection source in contact tracing data, but private parties are very prominent.
From what I've heard, virus concentration in the upper respiratory tract (i.e. where the aerosols come from) peaks two or three days before symptoms start.
Here in Germany there's the statistic of "75% of infection sources are not found by tracing" circulating hard through public discussions. I doubt that many of those untraceable infections could be coming from symptomatic carriers, given the level of awareness. Coughing people basically do not exist in the 2020 public. And tracing should still be good enough to recognize most cases when the source became symptomatic after the contact (which would very likely be before the receiver became aware of the infection, triggering tracing). I consider this a pretty strong indication of asymptomatic spread, or very weakly symptomatic (thresholds are very subjective).
I would be surprised if they didn't specifically test all participants in the trial for covid antibodies, symptoms or not. Does anybody know what validation was done?
In the Pfizer trial, all the subjects in the interim evaluation had symptomatic infection confirmed by PCR test. I'm not sure about Moderna, but it's likely to use the same or similar methods.
Depends a lot on the question of whether the antibody test can distinguish the immune system's reaction to the virus from the immune system's reaction to the vaccine (or in this case: to the proteins built from mRNA blueprints in the vaccine). If they can't, and this is quite likely given that they all target the same spike protein, the outcome would hopefully be positive for all of the vaccinated.
The immune system is extremely complicated, but very broadly: CD8+ T-cells (also known as killer T-cells) kill infected cells directly, whereas CD4+ T-cells (also known as helper T-cells) release signals that guide many aspects of immune response, including activating CD8+ cells
> so the Pfizer vaccine would be an A+ grade, and this Moderna one is a solid "A".
Right now, ease of rolling out a vaccine is more important than its effectiveness, within reason. As long as the vaccine is effective enough to slow the spread of the virus it will save lives -- the more people we vaccinate, the fewer potential spreaders there will be, and that should help us protect people who have not been vaccinated yet.
Today, we would probably be better off with an A grade vaccine that is easier to store and ship across the country than we would be with an A+ vaccine that is more picky about storage temperature.
Of course, we can probably have both vaccines at the same time once the manufacturing capacity spins up.
People are taking more risks because the vaccine is close[1]
When the vaccine is close you should be taking fewer risks. The potential cost to those risks stays the same, you can still kill your elderly relations and/or develop "long COVID" yourself. But the benefit is much less. Going back to normal life now only nets you a few weeks of normal life with the vaccine in sight vs an indefinite time without.
Also, the hope of a vaccine helps immensely with the mental stress of isolation.
The end is in sight! Hang in there folks, keep being careful!
That’s reading people’s mind. I do my own mind reading and I say that compliance to lockdown is down because people are fed up, and because the virus turned out to be nowhere near as dangerous as initially claimed by the media (I remember a headline dated from end of April from The Times claiming covid was as deadly as ebola...)
No the headline was a very misleading statement based on the fact that people showing up in ICUs with severe forms of covid had about the same death rates than Ebola.
And meanwhile some people actually took the time to look at the statistics. A lot of countries with lockdowns had more trouble than countries without lockdowns. e.g. Argentinia with masks and lockdowns has one of the worst curves of the planet... while Sweden is doing fine.
And COVID-19 is strictly following Gompertz-Mathematics - just like a seasonal corona-virus. For any usual outbreak (f'/f) is falling exponentially all the time... There are no visible trend-changes around most policy-changes.
And there's no statistical epidemiological evidence that masks did anything good. In some countries with masks things got a lot worse. (more efficient catch+inhale? Or catch+transmit without being infected?)
Most of the hype around COVID-19 is just cheating by using "reporting date" instead of "date of death" to make Gompertz-Functions look like seriously dangerous exponentials...
If you have some datasets that allow to compare "reporting date" with "date of death" it is astonishing to see how many reporting-anomalies appear around policy-changes...
What puzzles me is those serology studies in Spain and Italy that show that people who were locked down were infected at the same rate than essential workers who were not locked down (except, understandably, for healthcare workers). It seems to be a major data point on whether a lockdown actually has any impact and it seems to have been completely ignored.
I think you should take another look at Sweden's data. Sweden (and a lot of countries) were doing fine, likely because the weather is nice and people were spending their time meeting outdoors, where infection risk is way lower. Now that it is getting cold, their case counts are on the way back up as are their deaths. It is worth noting that most of my Swedish friends say that many people were staying home anyways, just because they did not have a government mandated lockdown doesn't mean many people did not decide to avoid the risk themselves.
There are plenty of datasets that include date of death instead of reporting date and they show the count of deaths increasing again as well, on a lag, just like you would expect.
The low fatality rate we have enjoyed recently has been partially a result of the availability of improved medical care. Unfortunately that is a stepwise function where once you have surpassed the amount of available care, the improvements we have made in care revert to some extent. We don't know how much.
I see that you only really post about COVID stuff on hackernews, and I don't know why anyone would bother, but what truly blows my mind is the amount of hubris it takes to sit at home, read a few news stories, and say "I know better than the majority of people who have spent their lives studying disease because I know some statistics and read a few articles that disagreed with the mainstream."
I just looked at the data for Sweden today. Looks like a seasonal outbreak starting mid-September (infection date).
Parameters of the curve look like the first wave (Gompertz-Exponent ~0,06) with less force.
Start is hidden under other smaller outbreaks, so it's not so easy to measure it exactly. But soon it should peak (if it hasn't already...).
If they don't do any nonsense that changes the mathematics of COVID-19 completely Sweden will be fine. The curve has normal size of a seasonal flu. Other countries in Europe are doing a lot worse.
The mathematics of COVID-19 is not that hard - and has been known since pretty much the beginning. No need for hatred and personal attacks..
Lets do some real mathematics.
1) Get good data (e.g. death by date).
2) Take a look at the Logarithm of the growthrate ln(f'/f)
3) Spot all those straight lines - those are the curves of outbreaks
4) Turn those lines into a working formula for an outbreak
5) Calculate predictions - evaluate trend-changes - look when new outbreaks happened.
It's just that simple. Results won't give you insight about the mainstream, but it will give some insights about reality.
Some countries are easier (Mexico, Germany, ...).. Some have more outbreaks and complications. But the basic principles of the mathematics of COVID-19 outbreaks around the globe are the same.
Calculating the new outbreaks of Sweden is more advanced because the start of the new curve is hidden behind another outbreak. But now there's at least enough visible to give good estimates.
Just because the media did a horrendously bad job at reporting on this virus does not mean it isn't a serious threat. We see now in the US how it can spiral out of control if we let it.
And a vaccine doesn't immediately solve the problem; distribution is a thing, plenty of people who will refuse to take the vaccine (especially early adopters). Basically, even if there was a vaccine released TODAY, it would still take at least six months before we can start going back to normal, and (I believe I read about) three years before we can consider the disease to have ran its course.
>plenty of people who will refuse to take the vaccine
Hopefully this doesn't turn into a very messy public fight given that I fully expect a lot of schools and workplaces to require vaccination to physically enter a school or an office.
People are taking more risks because it's been 9 months of restrictions.
The first month or so in the Bay Area people were super diligent. There was nobody on the streets, hardly anybody shopping. Within a month you noticed more people on the streets, by 6 months, traffic was 75% of what it was before Covid.
You can't expect people to put their lives on hold indefinitely, especially people at low risk. I know that in Canada 20-30 year olds accounted for the vast majority of new cases. They were just willing to take a chance.
And even though these two vaccines look promising, you won't get a significant number of people vaccinated until the second half of 2021. That's another 7-8 months away.
Reminds me of that movie scene in Apocalypse Now when they are getting mortared on the beach while trying to surf - "The tide doesn't come in for six hours, do you want to wait here for six hours?" - Lt. Col. Kilgore
It’s still indefinite until someone defines it, and I haven’t seen any public health official who’s willing to specify a date when things will be back to normal. Many aren’t even willing to say that we can go back to normal once we’re vaccinated.
I'm now at July. Before this I was at early 2022. Every successful trial pushes my date back a bit. If the oxford and J&J both successfully finish trials by the end of this year I might push back to as early as march.
Of course roll out matters. Rochester MN (Home of the Mayo clinic) might open before the rest of the country just because the ratio of health care vs everyone else is enough that they may as well vaccinate the whole town and let it open up.
Well it's still going to be until next Spring at the earliest when most of these vaccines will get widely distributed. A lot can happen in half a year...not to mention many of the people taking the most risks believe in some Bill Gates/Deep State conspiracy about vaccines.
" many of the people taking the most risks believe in some Bill Gates/Deep State conspiracy about vaccines"... oh, how many have you talked to?
Most people I know who are engaging in "risky" behavior when it comes to covid spread are either (1) just tired of being coped up and so being reckless (2) old enough that they don't want to spend 2 of their final years of life not seeing their family, and think the risk of catching it is worth it (3) young and relatively risk free (e.g. x3 flu mortality rate range) so don't worry about it for them or those they're seeing (others in the same boat).
You are putting words in my mouth. I said the majority of people engaging in risky behaviors believe the whole thing is "about control" and other conspiratorial nonsense. Most others are just following the recommendations as best they can.
At the rate we're going now, many of the people taking the most risks will be infected with the disease, if they haven't been already. Prior infection has largely the same effect as a vaccine.
I agree with you. We're in for a rough winter, at least in the US -- but it seems that there is a bright light at the end of the tunnel.
"Coronavirus in Scotland: People are taking risks because vaccine is close, says John Swinney"
This reminds me of the speculative rationalizations that are given after-the-fact whenever the stock market rises or falls.
So let me chime in with the speculation:
The biggest factor is probably the realization that COVID is not as big a personal risk as feared, no matter what the media or the government says. People are gladly using COVID as an excuse to work from home or avoid meeting their elderly relatives, but when it comes to avoiding infection in order to save "the system", enough people simply don't care anymore. It's too abstract.
Doesn’t feel that way in the Midwest. My Wisconsin relatives had been actively downplaying the existence (not just severity) of COVID until people they know started being hospitalized. So it goes, I guess - but the tone has changed.
Of course, the perceived risk is quite different from the statistical risk.
Currently, about one in 4000 Scots is hospitalized, which says that approximately only one in 40 Scots directly knows someone hospitalized with COVID, assuming they know 100 people each.
However, the chance of directly knowing someone that had a positive COVID test is 1 in 40, which says most Scots will know someone who had a mild case of COVID.
Exactly, early on we weren't sure what the risk of covid was to the average person. It feels like now their is enough data on cases, broken down by age, where you can assess your own risk.
If you are under 25, the risk to you from Covid is basically tiny. I can understand young people not accepting having their life destroyed from living under a lockdown over a virus that is unlikely to do them harm.
I think we need something smarter than a blanket lockdown that affects everyone the same regardless of age. How we are 9 months into this and still haven't figured out anything better is really disappointing. We are destroying peoples lives, income and mental health when for the majority of them there is no risk.
Even if the risk were greater, it would be unreasonable to assume that the age group of 15-25, which is most likely to die from risky behavior, could easily be convinced to change said behavior.
It may not be a risk to the young people, but they need to understand that their actions have consequences for the people around them (which is exactly why people are encouraged to wear masks). A lockdown may not be the best solution, but it surely makes it so young people have a harder time infecting those who are immuno-compromised.
"I think we need something smarter than a blanket lockdown that affects everyone the same"
We have this in NY and CA among other places. That the Midwest and South are going from "pretend everything is fine" to "full scale lockdown again" was a decision those states made. But NY and CA are still far from requiring a second full scale lockdown and are instead focusing on specific areas and counties.
Due to a limitation in technology, people are forced to take the population risk as their own, which aligns self interest with collective interest. However, that will not always be the case and, at some point, people will be able to see their own individual risks. I find it interesting that people have no problem justifying their selfishness by showing that they are just being selfish. It will be interesting to see how that will develop.
While you're being downvoted, I agree with you. The artificially low interest rates are a huge burden to society, so while I'm optimistic about the vaccine, I believe that getting back to a society based on savings instead of debt will be extremely painful.
I'm talking about the next 10 years, people are so focused on 2020 that they don't see the big picture, that the economy is getting worse every year, and it effects everybody, even people who have wealth...we're all connected.
And even on the healthcare side, we will have to deal with the consequences of the lockdown. Massive backlog in hospitals, cancer screening and vaccination campaigns not happening, obesity up, psychological consequences, and also the knockdown effect of disruptions and economic crisis on treatment and vaccination campaigns in developing countries.
The government orders are a huge part of it! Case in point, look at the employment numbers and other economic indicators from early April vs today. It was so, so much worse in April, yet the pandemic is mostly the same. But today we don’t have nearly as strict lockdowns.
These are only results of the US-specific lack of welfare protection mechanisms, not a lockdown per se - especially unememployment and to a lesser degree also the negative growth are significantly less accentuated in the other OECD countries.
The high unemployment was because of how the US structured the spring legislative response. Businesses were ordered to close, and that made employees eligible to collect unemployment insurance. A federal program paid those unemployed people $2400 a month (in addition to their unemployment insurance).
The US poverty rate went down during the period. So it wasn't a lack of welfare protection, it was just a (likely bad) implementation choice, paying individuals instead of paying businesses to keep them on payroll.
The lack of response since that expired in July fits your description though.
I know, I'm not from the US but I tried to follow the US development closely. Many other countries have furlough-like systems where workers get money in cases of force majeure like floods or a factory burning down, without losing employment. One usually gets payout as a percentage of regular wage (depends on the countries, I'd say it usually lies between 60 and 90% of net income). These institutions were already in place, and when lockdowns were ordered the government just had to inject more money into them. All the red tape and all logistics were already in place. Most countries also allow soft fade-outs (I'm lacking the proper word here, sorry), i.e. 80% furlough and 20% regular work in month 1, 50/50 in month 2 etc.
The big advantage of this approach (in addition to the obvious advantages for the workers) is that companies don't lose the organizational knowledge held by the workers: With whom to speak in case machine X fails, whom to approach in customer company Y for a new deal etc.).
The government orders have been overwhelmingly the largest piece of it! I wrote this a few months back; the secondary effects from government intervention, and they fear they've brought with them, have been far reaching and disastrous:
The citation for gunshot wound victims being counted as Covid deaths says it was 5 deaths, and it was only on the publicly-available dashboard to track deaths. Not being used for official reporting purposes. In my opinion it's kind of dishonest how you present that.
I'll admit it made me lose interest in reading much further because I don't trust you to have used the other 42 citations in good faith.
Anyway, that was just meant as constructive criticism. Just something to keep in mind in your writing in the future.
It was one account, but during that time period, there were tons of reports, every single week, from miscounted deaths. The No Agenda Podcast guys covered it pretty well.
If it's just a couple here or there, there are miscounts for sure. But with news report after news report from local stations, I think the issue might be enough to be statically significant, or at least warrant investigation and not outright dismissal.
Furthermore, Sweeden seems to be doing alright as far as fatality numbers across their population for the year, even though their covid orders were much more limited:
> because I don't trust you to have used the other 42 citations in good faith.
We're getting into this really interesting era where we're attacking people's views for their sources .. even though there has been obvious bias in all mainstream reporting for over a decade. If you're not willing to entertain viewpoints you don't agree with, that's on you, not on me.
Entirely reasonable of OP to posit bad faith on your part, especially given how you've reacted and the way you constructed a strawman to get upset about.
The secondary effects from a pandemic rampaging through society unchecked by government orders would be very bad as well. At some point people just stop showing up for their jobs and then you might even end up with a barter based anarchy were big cities would simply starve in absence of the required logistics.
Seriously? In my big city, people are generally behaving as if the disease doesn't exist, at least on weekends. Restaurants are pretty full, stores are busy. The only time it feels different is during weekdays, when the city is empty from forced WFH. When people are given the choice, they are choosing to go out in the world, risks and all.
I think a majority of people stopped giving a shit in June[1]. The government's continued lockdown policies are 100% at fault for continued economic distress.
Hmm, "counting the number of requests made to Apple Maps for directions" is different than people actually going places, though. If you look at the Google location data reports, the retail and recreation category was down 16% when the Apple graph was at its peak: https://www.gstatic.com/covid19/mobility/2020-08-14_US_Mobil...
> When people are given the choice, they are choosing to go out in the world, risks and all.
That could change pretty fast when hospitals have to start sending seriously ill home to die. That would still only directly affect a small minority, but the same people who feel safer than they should now would then start feeling more in danger than they should. There's a certain irony in how a lot of people think that the rules are unnecessary exactly because they do work.
And when exactly will it become an actual problem in the sense that it actually affects anyone's life? 1000 years? 10000 years? Like global warming is going to suddenly show its teeth on some random day and we'll all be sorry. You sound like someone preaching the coming rapture, thinking people are crazy for rolling their eyes and continuing on with their lives.
I'm a huge believer in alternative energy, but it's just nonsense to blame natural disasters across-the-board on climate change. It almost implies that the climate would be docile without human-introduced CO2. Plenty of bad weather events happened before climate change. The most deadly Atlantic Ocean hurricane on record was in 1780. The Dust Bowl droughts were the worst in American History.
I'm not sure the dust bowl draughts are a great example - they weren't product of global climate change - but I think they were very much the result of large scale "terra forming" - changing prairie to farm land?
At any rate, the question isn't so much - were extreme bad weather events bad before as well, more - are they getting worse and/or more frequent?
Given the projected temperature increase the wet bulb temperature will make vast areas around the equator deadly for humans. Millions will be affected in our lifetime or will be confined to spaces isolating from the harsh conditions.
Although the temp increase might happen during the colder times of the day so the wet bulb might never reach the deadly quantities.
I've been on here for 10 years. When did hacker news loose all resemblance to hacker culture? And i'm not a truther (thanks for making me use a word like that btw), maybe a rationalist is a better word. Let's all wake up an be afraid of asteroids too.
The actual words you used in your reply to my post (akin to "we may see someone affected by global warming in 10,000 years maybe and besides that I don't care") was just pure denialism.
Observing science has been part of the HN culture as long as I've been here.
Literally right now there's a bunch of island nations that will probably not exist in 30 years. Many coastal cities are getting worse floods every year, having to invest billions in measures to protect themselves.
Every drought means conflict, they mean war, refugees and instability. Sure, the first world will be shielded from the worst for some time, but this isn't a Hollywood movie, the pressure will keep increasing every year exposing every flaw in the system.
Corona has shown that our world does not deal well with pressure and you can't make a vaccine for food insecurity.
So if it's not your problem it's not a problem at all?
Nth order effects will make it your problem pretty quickly.
Many are blind to exponentially growing phenomena.
One good example is that a several degree increase can melt the Siberian ice and release methane stores equivalent to 100 years of maximal human CO2 footprint. That's already a massive nth order effect.
Like I said, I just don't really care and it's not going to affect my life. I'm all for improving technology and efficiency and believe that it will never truly be a life threatening issue and it's foolish to sit around and be afraid of it. You say it's going to be my problem but how? What would that look like exactly? Maybe in 1000 years it would literally be a problem but by then through the natural course of technological evolution it will just not be a problem. If freeman dyson, a man who solved some of the hardest problems of the 20th century, can say that there is little scientific rogor in our models, estimation and understanding of our affect on climate change, why should I pretend like you know what you're talking about?
But do you understand his argument? I’m pretty sure he would not disagree with projected temperature increase or wet bulb temperature estimates. They are already being measured and confirmed.
I’m pretty sure he would also agree with the estimate for Siberian methane stores. He would just be careful with predicting what happens when they get released.
The average temperature increase can have different effects and that is one of the lines of his argument.
If you do not care about the issue and don’t want to hear opposing opinion then do not leave a comment.
Several Pacific Islands, and some in the Indian ocean have already lost significant parts of their land. Just because something doesn't personally affect you does not make it a hoax.
We had devastating fires over Christmas in Australia, directly linked to global warming. https://www.bbc.com/news/science-environment-51742646 . (In fact we just went from one disaster to another here, the second being C19).
This is just the beginning. It will get far worse and then worse again, thanks to people denying it and saying we might think about maybe reducing our emissions gradually next decade sometime..
In South Australia they're talking about taxing EVs because they don't get to tax their owners by way of the fuel excise. There's zero regard for pollution, it doesn't even have a monetary value - high polluters aren't taxed at all, so they're taxing the solution not the pollution instead. (Contrast Norway).
This is why I said it's going to get far far worse. There's so many thick skins to get through, blocking and impeding what needed to be immediate action decades ago and still isn't.
Vaccine development has progressed far faster than I would have ever guessed. This might be a dumb question but what has enabled a COVID-19 vaccine to be developed in such short time? I was under the impression that developing a vaccine took on the order of 10s of years while this has been put together in 10s of months. I was also under the impression that this was because making vaccines for viruses was much harder than other treatments because interrupting the viruses reproduction chain is essentially requiring you to interrupt your cell's reproduction chain.
Is there some tool that has been used here that hasn't been available in the past? I know the FDA said they would allow skipping some preliminary testing to fast track a drug. Was that a huge help?
They talk about this being entirely self-funded.
I wonder about the lack of a cold vaccine - presumably the value would be enormous in terms of avoiding lost productivity. I’ve always been under the impression that a vaccine for the “common cold” is very difficult because of its rapid mutations, mRNA or not. I’m curious why COVID is going to be much different.
Early on I remember an epidemiologist/virologist interviewed on JRE saying that building a point-in-time vaccine isn’t difficult, building a human-safe vaccine with long term efficacy is what’s difficult.
There is a good reason to develop at least one rhinovirus vaccine, though: so we have the expertise to deal with a bad rhinovirus strain if one should arise later. The coronavirus experience - SARS, MERS, and now COVID-19 - seems to suggest that such groundwork on common virus types would be a good idea.
I know nothing about vaccine development, but I'd guess part of the answer is "It mattered."
People try way harder when the stakes are high, and everyone involved is at least a little terrified of being "the one who delayed it." That does wonders for cutting through pointless red tape and bureaucratic delays.
A minor example:
About ten years ago, a flash flood completely destroyed about thirty linear feet of the main road connecting the tourist district of Hershey, Pennsylvania to the rest of the town.
I assumed it would take weeks or months to repair, based on how long road work has usually taken in the area. It would have been a disaster for a lot of the local restaurants, economically.
IIRC, two days after the flood the road was back in order. It certainly didn't take more than a week.
Obviously, inventing a new vaccine is orders of magnitude more complex than fixing a road, but I think this aspect of human nature still applies.
This was the main interstate connecting the suburbs to the business districts in Atlanta. The traffic on alternate routes after the collapse was apocalyptical. However, the new replacement was built in record time (1 month). The teams were given cash bonuses and other incentives to finish ahead of schedule. Basically, when "it matters", things get done quicker.
The difference is we know how to make the bridge, and knew where to place it. A lot of the effort in a new bridge is work that didn't have to be done for that bridge because it was already done. No need to figure out what to do with traffic (which means no phases that must complete first). No need to dig new footings, just use the old ones. No need to do a new design - the old one was good enough.
The bridge collapsed because of a fire and there seems to be no reason to redesign bridges to resist a fire like that so a lot of effort was saved. If we decided fires were too common we wouldn't be able to replace bridges as quickly because we need to do engineering work first on a new one.
We know a lot about making viral vaccines too so we have a lot of companies so a couple different methods get used and at least a few of them pan out. It's like if we could have 20 companies try to build the same bridge without interfering with each other and whichever worked became real.
SARS-CoV2 is quite similar to the previous SARS virus, so the development for vaccines against that one could be reused. In this case the target was already known, every vaccine is targeting the Spike surface protein. So the existing knowledge allowed them to mostly skip the very first phase of development.
The mRNA platform the BioNTech/Pfizer and the Moderna vaccine use is new, and that is generally something that can lead to shorter development.
As far as I understand, the biggest difference here is simply doing more things in parallel that you usually would do sequentially. This adds more risk because you already waste money in later expensive steps that are unnecessary because a previous step turns out to already fail the vaccine candidate. The easiest example here is producing the vaccine before phase III trials are completed, that is pure risk (in part assumed by governments in this case). This is really a case of "money is no object", a vaccine is useful enough in this case that you can take a lot of financial risk and pour lots of resources into development compared to a less critical vaccine.
The other thing that the more pessimistic timelines assume is that not everything will work out. Any problem can delay a vaccine or kill a candidate entirely.
> Then, my administration cut through every piece of red tape to achieve the fastest-ever, by far, launch of a vaccine trial for this new virus, this very vicious virus. And I want to thank all of the doctors and scientists and researchers involved because they’ve never moved like this, or never even close.
> The NIH and HHS have also been working constantly with private industry to evaluate more than 100 potential treatments.
> The Food and Drug Administration has swiftly approved more than 130 therapies for active trials; that’s what we have right now, 130. And another 450 are in the planning stages. And tremendous potential awaits. I think we’re going to have some very interesting things to report in the not-too-distant future. And thank you very much to Dr. Hahn.
> Through a historic series of funding bills, my administration is providing roughly $10 billion to support a medical research effort without parallel. I especially want to thank Senator Steve Daines of Montana for his incredible work. He has worked so hard to secure additional funding for vaccine development. He has been right at the forefront.
He also goes on to discuss Operation Warp Speed [2] which, as far as I understand it, creates trials and determines a distribution plan.
Work started in _January_, as the dude was being impeached over nothing, and Nancy Pelosi was calling him a xenophobic bigot, while inviting people to party in Chinatown.
You have a lot of downvotes but no responses. Seems like the government actually supported this vaccine effort pretty well, I don't understand the problem.
I don't think people were downvoting because the government didn't provide support for the development of this vaccine, but because OP was quoting an extremely unreliable source on this topic.
Also a source that's trying to claim personal responsibility for the successes of others, where none is deserved. A government that had the capacity to develop treatments but choose not to would have been in dereliction of their duty; if there's ever been a clear, classic case for communal response, this is it. Claiming as success a response that only partially obstructed dealing with the virus is obscene; and even the parts that appear to be well-executed were clearly not due to exceptional executive action; many parts of government were involved, not least of which the bureaucrats (aka the deep state, those horrible people that actually keep things running).
Exceptional leadership would have been taking action December 2019 or early January - and as many south-east Asian countries show: even clear guidance and simple public health measure matter hugely; but people need to understand and support the measures, because it all hinges on real people changing their behavior; and creating controversy and abusing possible future treatments as distractions from actions that needed to be taken many months ago - and still do - undermines that.
And to cap it all off, the president is not working towards delivering those treatments and vaccines, because he's actively undermining the normal transition of power. Even if the election outcome were uncertain, gambling with people's lives like that shows a careless disregard for actually serving country - because an ethical person would at least work to protect others when it's not only their job, but easy, and conventional to do so.
Some, like the AstraZeneca virus, are old vaccines that they never finished developing, taken off the shelf and dusted down. That particular one is a modified SARS vaccine that never made it out of phase two trials, because the market for it disappeared. So by starting from here, they were able to save years of work.
The large number of infections is a major factor as well as what everyone else said. If you have a new vaccine for something rare it would be years before you can enough data to say if your vaccine works.
Coming up with multiple vaccine candidates was fast (it took days to weeks in this case). That's partly because some approaches are straightforward (like growing virus and then inactivating it), partly because there are ready-to-go platforms for vaccine development (e.g., adenovirus-vector and mRNA platforms), and partly because there's been work on closely-related coronaviruses (SARS-CoV-1 and MERS, from which people already knew how to genetically modify the spike protein to remain in its pre-fusion state).
In short, there were several vaccine candidates within days to weeks of the genome being decoded.
What takes time is testing the vaccine candidates for safety and effectiveness. Companies normally go step-by-step. They run a phase-I trial, then evaluate the results and decide whether to go on to a phase-II trial. If they run a phase-II trial, they again wait until the results are in and have been evaluated before moving on to a phase-III trial. That reduces financial risk. In this case, companies began preparing phase-III trials before the phase-II trials were even completed. You can begin enrolling people into the trials and producing the necessary doses before you even know whether the phase-II results are any good. One of the reasons they could do that was because the government was taking on the financial risk.
Technically, Moderna's phase-I trial is not even complete yet: [1]. It runs until November 2021. But Moderna moved forward onto the next phase as soon as it had enough data from the phase-I trial to justify doing so (I assume this meant some combination of safety and efficacy data).
These both use mRNA technology which is new but has heavily been invested in for years. SARS classic, MERS, and Ebola had all spurred development of tools for rapid vaccine development and that meant that a lot of the technical hurdles were accomplished before the crisis started, so the remaining work was still massive but within the range of possibility:
This is already a $10+ trillion pandemic in terms of economic destruction (we'll see economic damage spread out for more than a decade, so the final tally will be even higher). The vaccines are a couple billion dollars each, including manufacturing at scale. A lot of drugs now cost that to bring to market and don't have a small fraction of the positive impact on humanity.
If all that existed were market forces, Moderna and Pfizer could charge ten times what they are. They obviously knew the extreme blowback they'd suffer if they did that (including likely nationalization of their vaccines).
$20-$30 per dose in affluent nations is absurdly cheap to end this nightmare. That's a couple order-out pizzas.
One of the biggest part of the slowdown is communication between private companies which want to bring vaccines to the market and public agencies which want to make sure that it is safe.
To make sure that this is done most effectively, the US government announced "Operation Warp Speed" back in May which has helped private and public organizations work very effectively.
The biggest factor is almost certainly laws in many countries including the US which shield anyone and everyone involved in the making and distribution of a vaccine for COVID (or other pandemics) from any liability whatsoever for any and all consequences of the vaccine. Even if, to take it to the extreme, it kills people and they knew it would kill people and still sold it, they still can't be found liable in any way.
Other comments are correctly pointing out some corollaries of this, such as trials proceeding very quickly and trial phases being run almost in parallel; but the root cause all of this can happen is the legal immunity for the consequences.
Vaccine technology has been developing rapidly for a couple of decades. Biologists could leverage developments earlier conrona viruses like SARS-1 and MERS. Those were controlled before vaccines were deployed.
The tough nut are retroviruses like HIV. 40 years without a HIV vaccines. Though the related feline virus has a vaccine.
Why do you think companies will want people back in the office? Many have switched to work from home permanently, and the vast majority of workers won't want to go back either after having experienced it.
Maybe a good gauge is to look at studies that examine people's dislike of commuting. Google shows several results on this.
For some anecdata, our 5000 person software company held a survey early in the year and 30% said they wanted to be remote. Then the company shaped policies around that to allow remote work in the future. When the time came for people to proactively request to be remote, it turned out to be around 50% (and I assume that will rise as people figure out what they want, where they want to be, how life is during non pandemic shutdowns etc.).
I think what it ultimately comes down to is a significant number of people will want to continue to be remote; it's not just a few people.
I bet every company will go to a hybrid style setup. Thus requiring less physical space... so corporate RE still down. WFH companies like what? There's really no secret sauce in any of them, doubt their values go up that much.
They're still looking at late this year/early next year:
"Late-stage trial results of a potential COVID-19 vaccine being developed by the University of Oxford and AstraZeneca could be presented this year as the British government prepares for a possible vaccination rollout in late December or early 2021."
Given the amount of research happening around Corona-viruses, will we see a vaccine for the Common Cold? Will the vaccination of the Common Cold eventually "pay-back" the money spent on dealing with COVID-19 as fewer people will take time off work to recover from the Cold?
Yes I agree - but I read this [1] today, which talks about "universal" vaccines.
"RNA and DNA vaccines are so far experimental, but trials have been promising and many scientists believe it could be one of those two types that will be the model that goes into mass production to protect against COVID-19.
The attraction, say experts, is that they will potentially offer a step towards something that has been the holy grail of vaccine design – the universal vaccine.
The vaccines being trialed by the team from Pfizer, which tests show provides protection in 90% of cases, and from Moderna, which shows efficacy of 94.5%, are RNA vaccines. If either proves to be the winner in the race for a COVID vaccine, it will represent a seismic shift in vaccine technology."
Interesting. The next paragraph explains more what they mean by that:
"Jeffrey Almond, a visiting professor of microbiology at William Dunn School of Pathology, University of Oxford, told Sky News: 'All the current vaccines we have: diptheria, whooping cough, polio, measles, papillomavirus, you name it; all of them are very different. You don't have a generic process to make them. You have a dedicated factory, a dedicated process, very different technologies.
"'What RNA and DNA offer is an escape from that. We can make the RNA by a single process in a single factory. All we have to do is change the sequence of the RNA or DNA.'"
Very cool, but not necessarily "universal" in the sense you'd need to target all the different rapidly-mutating cold viruses.
> "We can make the RNA by a single process in a single factory. All we have to do is change the sequence of the RNA or DNA."
That's really interesting! Imagine RNA vaccine creation "as a service." Researchers order fully-formed injectable vaccines for animal trials just by submitting a sequence. It would be like AWS for vaccines.
No, the hope is even greater: your doctor orders a fully formed injectable vaccine for the specific cancer that is currently growing in your body. Nobody else has exactly that same mutation, so there is no point in animal trails as the vaccine will only be helpful to you.
This vaccine is a great help to the above: it proves conclusively that the idea is sound. Probably future mRNA vaccines can skip all the phase 1-2 trials and go directly to 3. And for rare diesease they can even skip phase 3.
It seems that we will, the success of the current vaccine trials are derisking mRNA vaccines generally, which will make it cheaper to develop modern vaccines.
> Well over 200 virus strains are implicated in causing the common cold, with rhinoviruses being the most common.
> Vaccination has proven difficult as there are many viruses involved and they mutate rapidly. Creation of a broadly effective vaccine is, therefore, highly improbable.
IIRC the virus in the rhinoviruses family mutates more rapidly than the virus in the coronavirus family.
> IIRC the virus in the rhinoviruses family mutates more rapidly than the virus in the coronavirus family.
This may be true, I don't know. I do know that my experience with coronavirus colds is that they hit much harder and have more severe symptoms compared to rhinovirus colds. So well worth taking out just the CV segment.
It's a conclusion from symptoms. Complete lack of upper respiratory involvement, heavy lung involvement, very hard immune response symptoms for 5 days(CV) vs copious runny nose, sneezing, stuffy head for 3 days (RV).
Yes if mRNA works well, we will probably get 95% effective vaccines within the next decade or two targeting diseases such as HIV, influenza, almost any virus basically.
Are you speaking from advanced knowledge? My understanding is that you still have to find a relatively stable binding site that doesn't have a high degree of similarity to human cell markers. So the mRNA technique is a great path from the identification of a binding site to a vaccine, with the difficulty of that identification not being particularly predictable.
HIV vaccines face tremendous challenges - almost 100% mortality rate if untreated, the fact that immune system activation helps the virus, very frequent mutations, lack of good targets for antibodies, etc. So don't hold your breath, mRNA is unlikely to help much in that case.
That's not the issue with HIV. The issue with HIV is that it's a retrovirus. It uses both reverse transcription and inscription enzymes to change your DNA.
A vaccine works to stimulate your immune system's "memory" that's evolved for treating infections. (That can be anti-bodies, but it's more complex .. also involves memory T-cells, the complement system, etc.)
When the same virus comes it, it will infect cells, but your body is much more prepared to handle it. The trouble with HIV is that it's the initial infection that can slowly inactivate an immune system over 2~5 years (not everyone though. Some people have HIV and never develop AIDS; known as Long Term Non-Progressives).
A vaccine wouldn't help at all with HIV. Keep in mind, the HIV rapid test checks for the presence of antibodies.
What we still don't know for both Pfizer/BioNTech and Moderna vaccines:
"A vaccine that prevents infection entirely provides indirect protection to others. If I can't get infected, I can't infect you. But it is possible to have a vaccine that prevents disease but individuals can still be infectious." (1)
In that case, those at risk are only protected when they receive a vaccine, but still aren't when just those who they are in contact with received it.
"Most Phase 3 trials are measuring efficacy to prevent disease as the primary analysis" (2)
Not infection.
The whole thread with more details, already written in September, before both announcements:
by: "Natalie E. Dean, PhD, Assistant Professor of Biostatistics at @UF
specializing in emerging infectious diseases and vaccine study design. @HarvardBiostats
PhD." (3)
It would seem at least reasonable to hope that one follows from the other. If our bodies fight the virus effectively, the viral loads we would shed ought to be lower. The period where high virus loads are found in our bodies will be shorter, requiring less hospitalisations, and thus chances to give it to other vulnerable people.
There are of course lots of hypotheticals here, and things to be concerned about, but a priori surely we should be hopeful it reduces infections too?
> The period where high virus loads are found in our bodies will be shorter
is precisely what can't be assumed in advance but must be measured, as there are known examples where the assumption doesn't hold at all (and that includes the flu vaccines).
(Not to mention that just "shorter" is by definition not "sterilizing", the transmission is then obviously still possible.)
If the virus is transmitted via the upper respiratory tract, and it is, it's less probable that the immune cells in blood can prevent the infection and viral shedding of the mucosa. The cells have to be first attacked and infected before the immune reaction can kick in. Even now, it is known that the highest infectiousness of SARS-CoV-2 is often before the symptoms are observable, i.e. before the immune reaction starts. That would also explain the existence of asymptotic carriers: their immune system already protects them, but they are still able to infect others.
Does this mean that if a lot of people refuse to take the vaccine then we could still be dealing with masks, social distancing and lockdowns to protect those that refuse the vaccine?
Maybe, but at some point it is their own stupid fault.
The real question is the 5-10% that the vaccines don't work for - are they completely unprotected and we should wear a mask to protect them, or does enough protection exist such that they only get mildly sick vs die. There isn't enough evidence yet, but what we have suggests the former.
That's an additional problem, also known from the flu vaccines: some of those vaccinated just can't develop enough immunity to be protected, and unfortunately there are more of such among the older population. We also don't know the numbers for that population for these vaccines.
I worry also for the times during which there are not enough vaccines for everybody who is willing to get one. And also for the times when the immunity by those vaccinated vanes -- in other vaccines that also happens faster among those who are older. These numbers we can't have now anyway, that will by definition take much more time to be known.
This is fantastic news! There is light at the end of the tunnel. We are a very resourceful species and I hope that at the end of all this we learn to have a little faith and trust in each other. Sometimes it takes a crisis to force us to innovate but we can do it when we have to. I really think that when we get around to recognizing climate change as an actual crisis, we will deal with it as well, because we will have to, and we have always had the capacity.
This is pretty typical. The big companies tend to invest in the little ones so that if the little one finds something good they can buy it and put the rigor of large scale manufacturing (and marketing of course) around it. If the little ones fail to find anything they can cut their losses without having the moral hit of laying people off.
BNTX's market cap is pretty large already, it's unclear how desirable a buyout would be by a Pfizer-type company. It seems better to split profits / contracts.
For now: Pfizer has already got what they want: a license to produce a useful vaccine. Conversely BioNTech also got what they need: someone able to run a large trail and scale up manufacturing while giving them some profit.
In a few years both companies will re-evaluate their relationship. Partnerships can last for years at times. Other times one company is bought. Other times they go their own ways. All are normal and mean nothing, though if you are an investor each has different implications.
The difference is in how the disinformation is propagated. In the past media companies would self censure idiotic or untrue ideas to protect their reputations and while you could find information if you looked hard, the things would tend to spread slowly. Social media doesn’t profit from reputation but from engagement, and untruth is more engaging.
In general, the further back you go, the less practical it would be for most people to avoid going into an office if they wanted to remain employed and to avoid doing most of their shopping in-person.
Travel was also significantly less than what it is now. 20 years ago it would have been a local epidemic with limited spread. 10 years ago would have been a pandemic but still limited in terms of spread.
It would have slowed the initial spread, but as we have seen, it only takes a single "superspreader" event to infect an entire country. Out of the various actions taken to fight the pandemic, closing borders was among the least effective. Basically, it only worked on islands and in combination with strong local actions (testing, tracing, quarantine, lockdowns, ...).
20 years ago wasn't the middle ages, air travel was a thing (9/11 was almost 20 years ago). In fact, it wasn't that different than it is today.
Oh my. Today's polarized online discourse. All right, let me be more precise, since multiple people seem to be jumping to the conclusion that I'm some rabid anti-mask, anti-lockdown, science-hating, Trump-voting neoliberal. I was hoping to contribute fruitfully to the discussion in short form, but seems like I'll need more words.
The coronavirus pandemic is a terrible natural disaster. We are right to take extreme measures to control it until proper mitigating measures become available, and we are very lucky that it did not happen ten years ago. Our societal surplus thankfully allows us to do the right thing and protect our weak and unlucky, as well as be more precautionary regarding long-term effects than others would have.
Reiterating my point -- if we were unable to use modern science and technology to combat the pandemic, the death toll and long-term health effects would be comparable to a minor global war. This would be a catastrophe that would be remembered for generations. It still will, but thankfully writ small.
Compared to other historical catastrophes -- the Black Death, the World Wars, five centuries of European warfare, Mao's Great Leap Forward, it would be a mild event, mostly because the death toll would hit the elderly and the weakened hardest. It would be bad, but it would not mean sacrificing a whole generation of our most ambitious young and capable people. It would certainly not be a catastrophe that threatened societies, although political follow-on effects would have lasting impact.
It's also worth noting that many authorities around the world have bungled the response terribly, both being ineffective in their measures and causing more economic damage than necessary. But that's dangerous territory to discuss, since you risk being branded and shut down with the terms I mentioned above.
(For reference, I made a fool of myself in my social circle in early March by suggesting 'extreme' quarantine measures before any Western governments did. I've been supportive of most science-based measures to slow and contain the pandemic, while at the same time being critical of many authorities' slow adaption of the best available science -- including lack of early mask recommendations and reluctance to consider aerosol contagion).
Without social media and news organizations forced to whore themselves for clickbait money it would have been just written off as "damn those two pneumonia seasons were really shitty" .
I often wonder this and perhaps it would be less bad because people were less mobile (or it'd spread slower) - but worse because of the presumably worse treatment options.
Perhaps we today would be 20 years ahead in terms of medicine and tech given the real pressure for innovation that would have been needed ('war is the mother of invention' - or something), but for a higher cost in casualties back then.
So many variables! - It's an interesting thought experiment.
People weren't that much less mobile 20 years ago. And it would have been much harder for many businesses to go virtual relative to today, a lot of online delivery was early days and certainly not at today's scale, etc. So "shelter in place" would probably have been much more limited. 10 years earlier and most of the things that let people stay at home would have been off the table.
20 years ago my boss orders my to work from home the next day because it was important for me to finish a critical piece without the distractions of the office. Of course as a programmer we have always been on the bleeding edge of this just be the fact that until our tools work we can't make anyone else's work.
100 years ago people regularly ordered things for delivery. Sure it wasn't online, but all online gives you is some time.
We actually had a milkman for a period when I was growing up.
Certainly, as you go back in time, there was a lot of local delivery especially in urban areas. Mail order, Sears catalog notwithstanding, less so. Just to pick one random example, ordering music, movies, or books pre-Amazon was really pretty limited.
20 years ago, some people could work from home at least some of the time; I did personally (for pretty much the first time). There was fairly decent broadband availability, etc. But just barely. Go back just another 5 years and it gets much harder.
>but all online gives you is some time
And a lot more types of goods available. Again, 25 years ago, it would not have been practical for people to have wholesale pivoted a huge amount of shopping online. (And companies like B&H Photo couldn't have scaled.)
20 years is probably just about the cusp of it barely being possible.
Newspapers were still pretty good at spreading nationwide narratives and fear back then, probably much better than current media because people couldn't talk back at scale.
I think it wouldn't have been as big of a deal. Most people had their minds made up about severity in early 2020 after seeing Wuhan and Italy. No amount of new data pointing to the fact that _those_ were in fact the outliers, and that COVID-19 is bad-but-not-apocalyptic will change their mind. I attribute this to the speed at which information travels now, and the way that social media works to reenforce existing beliefs rather than encouraging a constant reassessment.
Even ten years ago WFH and online school just would not have worked, this was when the iPhone 4 was hot new tech and most people still had single digit mbps internet. There's no chance that you could try the sort of 'online everything' we've been doing this year. The lockdowns become far less palatable when the consequence is clearly "no school or work for a long time".
Sure, but there's other cheaper/simpler methods of vaccinating against Covid-19. Moderna has the inside track with $2.5Bn of government funding and a wealthy country able to afford their more complex vaccine. We'll probably find that the Russian, Chinese and Indian vaccines all work in the next few months so the mRNA aspect is not essential.
What are you talking about? This isn't trolling. The president is a negligent menace, who, had he had any interest or capability to lead, would have done his job and enabled earlier prevention measures...
Does all the vaccine manufacturing happen in the same fabs / factories? Moderna says they can make a billion does by next year, Pfizer says the same, so does that mean we have 2 billion doses available? Or do they share factories and we get either of them but not both? And it seems like there’s many of these companies working on this, so if we have 10 promising vaccines from 10 big pharmas we can get 10 billion doses?
Good question. In a sane world, we'd be allocating the total manufacturing capacity (whatever it is) to maximize optimal vaccine production (whether that's only the most effective one, or a diversity of vaccines at certain proportions) without regard to intellectual property, but this is not a sane world.
One article said the reason of these vaccines can be stored more easily than the other is they use different proprietary formulations of inactive ingredients to carry the mRNA. Again, in a sane world, the most effective one would be shared, right? In the US, this is the kind of thing the Defense Production Act could be used for (instead of keeping meat plants open!!).
I’d assume that the developed countries take the vaccines that require super refrigeration and give the low-drama vaccines to the developing countries, but that’s just me being naively optimistic.
That would be rational, those with the least capacity to do the super refrigeration (developing countries also tend to be the hottest temperature-wise) get the one that need the least.
The dream of operation warp speed was to build a factory for each possible vaccine. Some npr about this. I haven’t seen a formal “here’s the 10 factories we built” picture, so not 100% sure how to confirm what happened?
Its mostly in the form of advanced purchases of product and grants. No one is building new factories. This is more about distribution and R&D grants than it is about factories.
> In July, Pfizer got a $1.95 billion deal with the government’s Operation Warp Speed, the multiagency effort to rush a vaccine to market, to deliver 100 million doses of the vaccine. The arrangement is an advance-purchase agreement, meaning that the company won’t get paid until they deliver the vaccines. Pfizer did not accept federal funding to help develop or manufacture the vaccine, unlike front-runners Moderna and AstraZeneca.
> April 16: HHS made up to $483 million in support available for Moderna's candidate vaccine, which began Phase 1 trials on March 16 and received a fast-track designation from FDA. This agreement was expanded on July 26 to include an additional $472 million to support late-stage clinical development, including the expanded Phase 3 study of the company's mRNA vaccine, which began on July 27th.
> May 21: HHS announced up to $1.2 billion in support for AstraZeneca's candidate vaccine, developed in conjunction with the University of Oxford. The agreement is to make available at least 300 million doses of the vaccine for the United States, with the first doses delivered as early as October 2020, if the product successfully receives FDA EUA or licensure. AstraZeneca's large-scale Phase 3 clinical trial began on August 31, 2020.
> October 16: HHS and DoD announced agreements with CVS and Walgreens to provide and administer COVID-19 vaccines to residents of long-term care facilities (LTCF) nationwide with no out-of-pocket costs. Protecting especially vulnerable Americans has been a critical part of the Trump Administration's work to combat COVID-19, and LTCF residents may be part of the prioritized groups for initial COVID-19 vaccination efforts until there are enough doses available for every American who wishes to be vaccinated. The Pharmacy Partnership for Long-Term Care Program provides complete management of the COVID-19 vaccination process. This means LTCF residents and staff across the country will be able to safely and efficiently get vaccinated once vaccines are available and recommended for them, if they have not been previously vaccinated. It will also minimize the burden on LTCF sites and jurisdictional health departments of vaccine handling, administration, and fulfilling reporting requirements.
> November 12: HHS and DoD announced partnerships with large chain pharmacies and networks that represent independent pharmacies and regional chains. Through the partnership with pharmacy chains, this program covers approximately 60 percent of pharmacies throughout the 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. Through the partnerships with network administrators, independent pharmacies and regional chains will also be part of the federal pharmacy program, further increasing access to vaccine across the country—particularly in traditionally underserved areas.
I believe that if Moderna found their vaccine didn't work they would license the Pfizer one as I assume their factories can be converted in a few months. Note that these are mRNA factories - I wouldn't expect a someone working on a different type of vaccine to be able to convert their factory. I would also expect that the process of conversion to produce a different vaccine will takes some months and cost us half a billion doses next year. This is just speculation though, there is no reason to make a license deal so we won't find out.
You can assume all manufacturers are watching each other. Some of the "getting ready to enter phase one trials" vaccines will probably be canceled as there is no point. If one of the promising candidates in trials fails Pfizer and Moderna will build (or license) more factory space because there is less competition for the demand.
> The trial involved 30,000 people in the US with half being given two doses of the vaccine, four weeks apart. The rest had dummy injections.
> The analysis was based on the first 95 to develop Covid-19 symptoms.
> Only five of the Covid cases were in people given the vaccine, 90 were in those given the dummy treatment. The company says the vaccine is protecting 94.5% of people.
Aren't those numbers way too small to make any statistically significant claims?
Not at all. That is why the N on these trials is so huge. 5/15000 vs. 90/15000 is going to be statistically significant anyway you slice it. It’s a 45-fold difference. You can approximate it yourself with a t test.
No. The full trial was on 30,000 people, every phase 3 trial picks a certain number of infections to stop at in order to draw results. Of the control group, 90 something got COVID, while only 5 of the vaccinated group got it in the same timespan. This is considered a big enough difference to call the vaccine effective (so far).
It’s not. I can’t remember all the details but if you read the moderna cove study 95 people after a month or two gives a very high statistical confidence.
The 94.5% value certainly seems like it has too many significant figures. If just 1 more person had happened to contract covid in the vaccinated group, the success rate would be reported as quite different.
1,421 comments
[ 3.4 ms ] story [ 204 ms ] threadI wonder what will be the consensus after other types of vaccines release their results.
https://www.cdc.gov/vaccines/vpd/mmr/public/index.html#:~:te...
"One dose of MMR vaccine is 93% effective against measles, 78% effective against mumps, and 97% effective against rubella.
Two doses of MMR vaccine are 97% effective against measles and 88% effective against mumps."
[0] https://www.hpsc.ie/a-z/vaccinepreventable/mumps/
The 5 year immunity level is not knowable.
The cost of getting a booster every year is minuscule compared to the number of lives lost, not to mention the hit to the world economy.
A working vaccine is a huge W. If immunity only lasts 12 months instead of 10 years that just decreases the font size down to 64 point from 72 point. I'll take it.
Which is why monopolies are bad. You don't have a pack anymore, and the leader(s) don't have incentive to do much disruption.
Pope Benedict almost died of shingles in August.
https://www.nytimes.com/2020/11/16/health/Covid-moderna-vacc...
https://www.bbc.co.uk/news/health-54902908
https://www.reuters.com/article/us-health-coronavirus-vaccin...
> In Moderna's trial, 15,000 study participants were given a placebo, which is a shot of saline that has no effect. Over several months, 90 of them developed Covid-19, with 11 developing severe forms of the disease.
> Another 15,000 participants were given the vaccine, and only five of them developed Covid-19. None of the five became severely ill.
https://edition.cnn.com/2020/11/16/health/moderna-vaccine-re...
There's no easy blanket "unethical" ruling from on high. Obviously this isn't a risk-free thing to volunteer for, but it isn't risk free for nurses to go to work either, and thankfully, they still do.
The trials have a set "Covid-19 cases" mark where the stop to evaluate. The Pfizer vaccine has 164 contractions of Covid-19 as their mark to conclude the research. This research seems to aim for 151.
The Moderna vaccine, which is based on similar mRNA technology as BioNTech’s, is expected to be assessed by the FDA on a final analysis of 151 Covid cases among trial participants who will be followed on average for more than two months.
If both groups are similar enough you can then say how effective the vaccine is in preventing it.
This, by the way, is why most phase 3 trials take place in the US and/or Brazil (among other places): the more Covid-19 is around the faster you can get to the set number of contractions and conclude the phase 3.
Additionally, you can apply common sense that if 15,000 people were exposed to the virus with no protection, more than 90 of them would become infected.
The Nazis did it, and US military does similar kind of shit (I reserve the word science) too.
It could have saved a huge number of lives, but that's not how the system works.
1. You have to have a control group, so half of test subjects would be exposed to the virus without having received the vaccine.
2. The highest-priority recipients for a vaccine are members of high-risk groups; it'd be pointless to run a challenge trial full of low-risk individuals.
So a challenge trial wouldn't just mean giving the virus to a few thousand vaccinated macho 20-year-olds. It'd mean giving the virus to unvaccinated 80-year-old care home residents.
This is binary all-or-nothing thinking. It considers 90% the same as 0%, since both are not 100%.
Testing on healthy young people you learn how a normal immune system reacts to a vaccine candidate. High risk groups mostly have similar immune systems.
Even if somehow you could only vaccinate everyone under 60, that would do enormous good stopping the spread.
Thinking is not just "binary or not"; there are degrees. If exposing that group of people would be 90% pointless, it's not much less out of the question than if it were 100% pointless.
You're right about the principle, of course. I just think it would be "10% pointless", and thus well worth doing.
Nobody is getting covid on purpose, in a lab. Being protective or unprotective against a lab dose isn't the same as being protective or unprotective against a real-world dose.
Depends. If there are volunteers for it, (which I can imagine to be the case) - and the volunteers are fully aware of the risk - then it might be ethical to let them proceed and save millions of other people.
They seem to talk about it right near the top of major news stories, so I guess they are proposing it:
https://www.bbc.com/news/health-54612293
You might also get useful information about how people's immune systems react, when you give them too little of the virus to get infected. It's not only about figuring out the dose for the main trial. It also could have been done 6 months ago...
This is what is referred to as a 'challenge trial'[0]. It is something the UK is apparently working on but afaik, neither of the current vaccine candidates have used any form of challenge trial. This is one of the difficulties with vaccine testing...if I were to vaccinate everyone in the world against small pox, how do I prove it's effectiveness?
[0] https://www.the-scientist.com/news-opinion/a-challenge-trial...
Edit: for some fun, I figured I should link to the 'COVID challenge trial volunteers advocacy organization'. Yes, an advocacy group for people who want to be infected with COVID. https://1daysooner.org/
https://en.wikipedia.org/wiki/Bernoulli_trial
Of course, that's assuming that five guys from the vaccine group didn't get infected at the same after-ski party, or any funny business that violates statistical independence ...
> The analysis was based on the first 95 to develop Covid-19 symptoms.
https://www.bbc.com/news/health-54902908
If we take the control group, we have P(Corona)=90/15000. The likelyhood of getting as an extreme result in the vaccine group is then P(0 cases) + ... + P(5 cases) = [math and statistics] = the actual p-value.
How did you determine the statistical significance in your post?
But Covid is wracking absolute havoc on people's health, on the economy, and on everyone's lives. Personally, I plan to take the Pfizer or Moderna vaccine as soon as it is available. There are associated risks -- but in my estimation, they are not as bad as the risks of Covid infection or the downsides of continued social isolation.
Safety testing is done in preclinical and phase 1 testing. They wouldn't be injecting something unsafe into 30,000 people. Phase 3 is mostly about efficacy.
What are the assessments of the HN crowd?
[0] https://www.youtube.com/channel/UCF9IOB2TExg3QIBupFtBDxg
So now it’s time to stop delaying and start distributing these vaccines.
The number of people vaccinated is increased gradually. Even after phase III and approval, the monitoring for side effects continues and the vaccine can be withdrawn if necessary.
Vaccines can cause autoimmune responses detected months later. These two vaccines are RNA vaccines never used n this scale Residual DNA risk is probably not significant, but there is small potential blowback.
On positive side, RNA vaccines can open new era of programmable vaccines for viral infections and cancer treatments.
The anti-vax nuts make discussion vaccination risks difficult because everyone pushes back to different direction just to be on the safe side.
Existing vaccine testing and approval process have more or less the the right balance. Sometimes vaccines are withdrawn, in general they are safe.
It's really not a low bar. A healthy 35-year-old has maybe 0.01% chance of dying, 1% chance of lasting side-effects from Covid. Untested medicines can be way more dangerous than that: thalidomide, for example, has a 50%+ chance of causing stillbirth or birth defects for pregnant women [0].
If you just vaccinate the old and sick, risky vaccines start to look more attractive. But those people also have a greater risk of side effects and are underrepresented in the clinical trials, and most vaccination strategies mooted so far for Covid are based on mass vaccination of healthy people. So it has to be really safe for that to work.
[0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4737249/
Source?
But even if it were "only" 1%, that is still a pretty easy bar to clear for vaccines.
>Where did you get these timeframes?
From government regulators in different countries. There are accelerated approval and fast track processes.
They started with with just handful of people, gradually increasing the number of people.
The likelihood of hitting some genetic combination that triggers some autoimmune reaction decreases as the sample size increases and no side effects are found.
What is it that makes people lust for delays? Some irrational fear for side effects? The fear isn’t going away, there’s just more people dying every day you wait, both from corona and the measures.
Pfizer has about a week longer to wait for that, before they can submit. I haven't seen anything about when Moderna has that, other than really soon.
Edit: And sure, Covid has killed more than 120,000, but what do you think will happen when people find out the vaccine kills people? They won't care it's 1 in 50,000, they'll just refuse any and all vaccines. Then what?
So yes, if by checking for 12 days you can prevent all these deaths, you should delay. If not you should not delay.
"Moderna had previously said their vaccines could ship at -20 degrees, refrigerated for up to 7 days, and kept at room temperature for up to 12 hours. Now, the company says they’ve devised a formulation that can stay refrigerated for up to 30 days and kept at room temperature for up to 24 hours."
https://endpts.com/moderna-says-its-vaccine-is-94-5-effectiv...
I'm not sure there's a real difference here.
They're extremely similar. Both are mRNA delivered via lipid nanoparticle vector.
The above won't be hard to do for the first 3 months at least: just give the shot to health care workers as they come in for their scheduled shift. What gets hard is when you want to do a walk-in clinic: you need to figure out how much to order without knowing how many people will show up.
Note, don't take the above as a statement that Pfizer will (or should) ship at higher temperatures. While it works out on paper that they can, they have been putting effort into arranging really cold shipment for a reason: it is best to give the entire time stored at higher temperatures to the end clinic. Human logistics are the hardest part of this and this and really cold shipment gives more flexibility to the hardest part.
In any case: with both vaccines the hard part is ensuring people get their second dose on time after starting the shots! This is by far the most difficult logistical issue with either vaccine.
Please don't start creating this back-and-fourth. It's like saying "all drugs are good and have never had issues."
I'm concerned about a vaccine developed and tested in less than a year. There are safety concerns. There are people under 40 who may not consider the risk high enough to take. (Look at what happened in the the 1970s with the Swing Flu vaccine that wasn't very effective, and although safely administered to millions, left 3,000 ~ 4,000 is long term neurological issues).
I'm glad this vaccine is coming out and I think people in high risk groups should evaluate if they want to take the vaccine after weighing the risks. I do not want to see forced vaccinations for people who are concerned about safety.
1. I couldn't find a source for your 3-4 k number,if you can point me to it I'd be greatful. I did find a a source of 532 developing Guillan-Barré https://www.newscientist.com/article/dn18014-swine-flu-myth-...
2. That same source lays out why worrying about this risk is not rational (in this case)
3. No-one is seriously calling for forced vaccination for corona
4. (my opinion) by over-emphasizing the "personal choice" angle we are letting anti-vaxxination pseudo science and conspiracy beliefs spread without being challenged. Some things are more wrong than others and the science for the harm of vaccines has oveerwhelmingly failed to arrive. So using the term "without anti-vaccination beliefs" is fair in this case, since I will argue the only reason why you'd reject a vaccine that is recommended by a physician is an irrational belief not grounded in evidence
That is not true:
https://nysba.org/new-york-state-bar-association-calls-upon-...
>>The New York State Bar Association (NYSBA) is recommending that the state consider mandating a COVID-19 vaccine once a scientific consensus emerges that it is safe, effective and necessary.
https://en.m.wikipedia.org/wiki/Dengvaxia_controversy
https://ijme.in/articles/deaths-in-a-trial-of-the-hpv-vaccin...
https://www.nationthailand.com/news/30352154
Vaccine manufacturers have a poor track record of releasing dangerous barely tested vaccines onto populations, causing deaths and avoiding lawsuits.
Personally, I am skeptical about this vaccine, or any other rushed out for a disease with a 97% survival rate.
https://www.worldometers.info/coronavirus/?utm_campaign=home...
I've had lots of vaccines in my life, the thing is, all those were for diseases that had a high risk of crippling or killing me.
Why would I want a vaccine that is actually less effective than my chances of surviving?
If I get the vaccine, there's a 95% chance it'll work, if I get covid, there's a 97% chance i'll live.
All I know is, if you told someone they had a 97% chance of winning at a casino, they'd be down there in a flash.
Why would I choose to have some barely tested vaccine with not fully studied long term side effects made by companies who have extremely poor track records with medication in general?
Pfizer is bascially responsible for the oxycontin epidemic. Their reps bribe doctors into pushing their drugs.
Moderna's some secretive biotech company that just appeared out of nowhere with this whole covid thing.
What reason do I have to trust any of these companies over the 97% survival rate I can expect from getting covid?
Your choice is between 3% and 0.15% - not 95% and 97%.
I don't think this individualistic way of looking at things is sound, though. First 3% mortality sounds way high - even given health system collapse (basically turning every ventilator survivor into a dead patient).
And on the other hand, mostly the old and those with pre-conditions will die - we alltake the vaccine to protect everyone. That way we might avoid a population wide 0.5% (or thereabouts) mortality rate.
That would still 1 in 200 - most people would likely know a handful of people dying from the disease if there's no mitigation.
Now say, were those numbers reversed and only 1 million out of 55 million recovered, I could see this level of panic and hysterics.
As it is, i've got a better chance of dying crossing the sketchy ass road I have to cross every day than dying o. covid.
Those elderly folks and people with pre-existing conditions, well if it's not covid, it'll be something else.
That's just kind of how it is when you're old or have pre-existing health conditions.
The thing is, if you have a pre-existing health condition, you're likely already used to being cautious. If you're old you already know even a cold can kill you.
Why is it the entire world must react and compensate for two specific groups of people who are already high risk and who already (hopefully )take precautions for themselve?
They're not children, they're adults.
That's the thing about living, one day it stops, whatever you do.
Honestly, it's selfish of those people to expect the entire world to cater to them so they feel a little bit safer.
It's insane. People can't work, can't run their businesses, told to stand in line like sheep, told who they can bring into their homes, who they can associate with, where they can go, to take some vaccine because...
A small percentage of the population is high risk?
That's justification for ruining the lives of countless people?
Yeah, I do know some people who died, not of covid though. My friend died of his cancer after being unable to go for treatments during covid and another friend with a heart condition who had their regular checkups repeatedly delayed due to covid and ended up dying of heart failure in their sleep. Again, this person did not have covid.
These people were supposed to be the people we're protecting through these.measures?
They died because of these measures.
They may have died anyway, they may have gotten covid and died without them, but that's not what happened.
It's completely fucked to make the majority of the world suffer in the name of protecting a tiny percent of people.
I don't give a fuck if it's selfish, it makes no sense. The cure should not be worse than the disease.
In addition I dont go out as I have elderly relatives who I dont want to sicken, they dont expect it, its my choice. So blaming others for being selfish is really missing the point and is an illustration of not really understanding the current economic situation.
At that point everything else suddenly becomes critical, because there is no ICU left.
Also, at least in CA, doctors/hospitals/dentists etc are only doing what is critical right now to avoid the whole hospital going into lockdown. That has large consequences for health outcomes and for the economy of those practises.
https://ourworldindata.org/covid-health-economy, and then specificaly this scatterplot: https://ourworldindata.org/grapher/q2-gdp-growth-vs-confirme...
(unfortunately, the graph doesn't include countries like china, vietnam, and many other asian countries, because that would make the trend even clearer.)
And there's already more dead from covid-19 in the US than casualties during the Vietnam War. Granted, more elderly people than young, but it's still a bit difficult to accept that it's insignificant.
Add to this what could happen with an exponential surge, with icus being over-run - and a) you'd end up being more likely to die from other causes, like a traffic accident - and b) many of the current covid-19 survivors would end up as casualties.
https://time.com/5843349/coronavirus-death-toll-100000/
Here in Czech Republic it looks like we managed to avoid running out of capacity during the ongoing second wave, but just. The measures taken included canceling any elective and non-life-threatening surgeries, drafting medical school students, many foreign doctors that came to help and moving covid patients in critical state from overloaded hospitals hospitals.
We even built two full field hospitals which we will thankfully not need as it looks like. BTW, building one of them took about a week - which you migh not have, once you hit exponential growth. Not to mention having spare medical personnel to run it.
Good luck surviving among a bunch of simians, who think they have figured it all out.
I would put it differently: if we become covid carriers, we become spreaders. Those 3% are, thus, applied to a large population comprised of everyone we interact ina daily basis.
Thus even if at most the likelihood that we die of covid is only 3% tops, the likelihood that at least one person that catches covid from us does is proportional to the number of people we infect.
With a 3% fatality rate, the likelihood that at least one person we infect will die can reach 80% if we spread it to over 50 people.
If we infect someone over 60, the likelihood that they will die from covid grows from that 3% to about 20%.
So unless you are infected while living in a bubble, the real risk is far higher.
Well, the vaccine hopefully doesn't kill you if it's ineffective, so the numbers aren't exactly comparable.
The reasoning in this comment is wild. Let's take it back to the math a moment:
Let's take your 3% chance of death (actually the population survival rate is significantly higher IIRC, but OTOH there's long haul COVID to consider too). If the vaccine is 95% effective, all else being equal you have a 3% chance of death without the vaccine, and a 0.15% chance of death with the vaccine. So the question becomes: is there a greater than 2.85% chance of the vaccine killing you or doing you crippling injury? If not, you're probably better off taking the vaccine.
0-19: 99.997% 20-49: 99.98% 50-69: 99.5% 70+: 94.6%
Edit - typo.
I would also mention that there are studies in peer review on patient populations in the United States which suggest IFRs closer to CDC planning scenario 4/5 than 3—for example, this one from Connecticut[1]:
We all hope for the best—that the lower bounds are true—but I think we should also be prepared for the reality that the upper bounds might be the correct ones, and act conservatively.Also, you know, all IFR estimates assume that patients will actually be able to access care. Without hospitals, IFR approaches IHR, and the hospitalisation rates from the Connecticut study are grim: 0.8%, 2.68%, 3.09%, 12.43%, and 79.89%.
[0] https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...
[1] https://www.medrxiv.org/content/10.1101/2020.10.30.20223461v...
Also there is no proof that getting covid grants lifetime immunity, so lets assume immunity lasts a year, every year you now have a 3% chance of dying from covid using your numbers. 3% is not that low, there is a ~3% chance of rolling double sixes with 2 dice, and that happens all the time.
That was Purdue Pharma, not Pfizer.
> We have mandatory vaccinations for MMR and for dTAP. Have you ever heard of anyone catching diphtheria?
Not specifically, but DTaP vaccinates against pertussis which has seen epidemic-level outbreaks in the past decade in multiple states.
I'd expect any SARS-CoV-2 vaccinations to be targeted at adults for the foreseeable future, but who knows.
Nope, I wonder why.
There will be de facto mandatory vaccination, to a degree. This is a Canadian news source but read about the companies involved with creating this program (by the way—-it’s not Ticketmaster). It is definitely coming to America and already underway.
No coronavirus vaccine, no entry? Experts say it’s possible in pandemic’s next stage
https://globalnews.ca/news/7457999/ticketmaster-covid19-vacc...
In Europe, mandatory vaccinations do exist in some countries, for both children and adults. Also, in Croatia (which is part of the European Union), if you refuse to have your child vaccinated, it is legally considered to be child abuse. In Croatia, they have school doctors that literally come to the schools with nurses that not only ensure the health of all of the kids, but also have them vaccinated there. Homeschooling is also illegal in Croatia.
There's a lot of unsafe stuff, but this example is so absurdly generalized that it seems either malicious or just so ignorant that it's not even a worthy position to take.
You should have mentioned that the 532 cases of Guillan-Barré were found within the 48 million people receiving the swine flu vaccine.
Accordig to Wikipedia, the incidence of Guillam-Barré is about 2 per 100,000 people per year.
Statistically speaking, your example suggests that taking the swine flu vaccine is linked with a lower incidence of Guillam-Barre syndrome, nearly lowering it to about 60% of the baseline.
If we're allowed to play fast and loose with back-of-the-napkin statistics, your example contradicts your original claims, and indeed makes a strong case in favour of vaccination.
Define forced. I'm not in favor of pinning people down and forcibly injecting them with something, but I am all for some kind of vaccination "passport", where if you don't have proof of vaccination you stop enjoying the benefits of society. No public schools or services, right for businesses to refuse service, etc. Or at the very least, a heavy tax fine or something a long those lines.
If people choose to not get a vaccine, that's fine. But its time we align incentives to eliminate these externalities being born from societal free-loaders who believe in quack-science.
Unless of course your alternative plan is full isolation for years, in which case not taking the vaccine is the correct choice, but such isolation is only reasonable if you don't care about going outside anyway at all.
https://www.healthline.com/nutrition/vitamin-d-side-effects#...
https://www.sciencedirect.com/science/article/pii/S096007602...
According to this study, vitamin-d gives better outcome than the other treatments, including hospitalization:
"Regarding care dedicated to COVID-19, only the proportion of patients who received a bolus of vitamin D3 during or just before COVID-19 differed between deceased participants and survivors, with a higher prevalence in survivors (respectively 92.2 % versus 66.7 %, P = 0.023). In contrast, there was no between-group difference in the proportion of patients treated with corticosteroids, hydroxychloroquine or dedicated antibiotics, or hospitalized for COVID-19."
And this has to do with Vitamin-D's role with the ACE2 receptor. SARS-CoV-2 has a binding affinity to ACE2, aggressively invading cells with proportionally higher ACE2 receptors (including the lungs).
In fact, someone had tried injecting hrsACE2 into someone as a treatment -- that is, letting the virus bind to hrsACE2 instead of the ACE2 receptors in the cells.
https://www.nature.com/articles/s41392-020-00374-6
A treatment with hrsACE2 isn't generally-available, and needs a lot more study. The logsitics in producing them at scale would need to be solved, if this is a viable treatment. But this looks promising to me.
It isn't so binary or black and white -- vaccinate or risk dying. We're starting to get other options.
It really is vaccinate or risk dying. The other options are too expensive, too timing-dependent or too ineffective.
I do see a lot of people fixating on vaccines as if it will make everything better. Vaccines will help, but better if there are other treatments as well. I think that if mortality rates and long-term scarring decreases, then people won’t feel like their survival depends upon other people’s cooperation.
There won’t be enough vaccines to go around, so no one will be forced to take anything for at least a year. By then we might be at 60-70% of the population vaccinated, at which point the R0 of the virus would be much lower.
Don’t worry about it for now, the rest of us will take the risk so you don’t have to.
I feel like we are about to enter the variation on the prisoner's dilemma where we all get a massive benefit if at least 70% of us get the vaccine, but getting the vaccine has a cost (please roll a D20 to select your random side effect) so everyone has an incentive to be one of the shirkers.
I foresee things getting ugly as we collectively all get together to shame, bully and trick the shirkers into compliance.
I’ll allow that there is seemingly a significant portion of the population who believes they don’t personally benefit from a vaccine, but your comment said -everyone- is incentivized to shirk: that’s just not true.
Of course this depends on the unknown factor of how bad the side effects are, if they are nonexistent then it's a different story, but if they are on average as bad as a flu shot then it becomes tricky.
I suppose I'm really thinking in the context of countries like Australia which have essentially eradicated the virus. My risk of getting the virus right now is practically zero, so my only incentive to get vaccinated is that we can eventually reopen our borders once enough people are vaccinated. And personally I'm in no hurry to get flooded by foreign tourists anyway.
Also, there are some interesting treatments targeting the ACE2 receptors that SARS-CoV-2 binds to which looks like they are reducing mortality rates, and perhaps long-term scarring in the lungs. Among these are Vitamin-D (which people are probably nutritionally-deficient anyways), and human recombinant soluable ACE2 (basically, injecting a form of ACE2 into the body so that the virus binds to that, instead of to cells with a lot of ACE2 receptors, thus short-circuiting the replication pathway). I would be interested to see if nutritionally-sufficient vitamin-d is better at preventing severe cases of covid-19 than masking or social distancing.
My own opinion is that it is foolish to pin all the hopes on a single strategy (prevention, via vaccination), which is not guaranteed to work or guaranteed to be safe. To add forced vaccination is folly. I think it is better to see a depth of prevention and treatment options (including vaccination).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3335060/
The study described findings of antibody-dependent enhancement with the original SARS. I am no expert, but my understanding is that when test subjects were given the vaccine, and then later 'challenged' by the SARS virus, they developed a pathological response. In other words, taking the vaccine had a potential to make their response to SARS and potentially other coronaviruses worse.
The study I linked therefore recommended caution in giving the vaccine to humans.
Obviously this is something that vaccine researchers are aware of (see https://www.nature.com/articles/s41564-020-00789-5), but I think it's something that is perfectly rational to be concerned about given the time and money pressures available with SARS-CoV-2 vaccination.
Having a large enough host population to sustain an outbreak means those vulnerable parties are fucked and the rest of the population even those for whom the vaccine is 90% effective are at still at some risk. Worse the selection pressure among millions of vectors to develop a strain that can infect the previously safe population is high and the possibility is real.
This is to say that the proper assessment of safety is the likely net effect on the entire population of an increasingly large portion of society not vaccinating.
Existing precedent would seem to suggest that its impossible to force you to vaccinate but possible to prevent you from participating in society if you do not. For example the state can put you in jail for not putting your kid in school but not let you do so unless you vaccinate your kid.
I would not be terribly surprised if people, especially vulnerable people argued that a work allowing anti vaxxers to work alongside them violated their right to a safe workplace.
Imagine one lawsuit from someones family that lost a baby or a family member resulting in an 7-8 figure settlement. There wont have to be a law. The lawsuits will be from anti vaxxers alleging that this violates their rights and will take place over the following 2 years after every major workplace in America adopts such rules giving American workers the choice between employment and remaining an antivaxxer.
Parents homeschool kids in states that force vaccinations. Parents get in trouble when they are registered to a school and the kid doesn't show up.
That this vaccine is mRNA-based makes it likely safer than some other lightly-tested vaccines, but if you're young, healthy, and at low-risk of serious COVID infection, I'm not sure it's wise to be among the first in line for this vaccine.
I leave my house about once a week, wearing a mask, to spend 20 minutes grocery shopping. My risk of contracting, contracting and dying from, or contracting and spreading the disease is extremely low and quite possibly lower than leaving that dose for someone else who is leaving their house and being around people more than 4 hours in those 3 months. Bonus is that someone at higher risk gets "my" dose and I get 3 additional months of population-wide study of safety, side-effects, and efficacy.
I hope everyplace offering vaccinations will have something in place to prevent anyone who comes in who is already infected but asymptomatic from infecting others there.
Given some states' track records on how they handled other things that attracted a lot of people, such as in-person voting, I'm not at all confident that we won't have some states that manage to turn vaccination clinics into super spreader events, which should be deeply embarrassing.
A good way to handle it is the way Kaiser handled flu vaccinations this year in western Washington. They had 10 minute windows available. You reserved online your spot in one of those windows. When you arrived a person at the door asked your name, checked you off the list, and gave you a pre-printed label with your information, and sent you in.
There were two or three people administering the vaccine, so two or three people for each 10 minute window. You went an stood in line with the others who shared your window, with the line very spread out.
When it was your turn you went in to get the vaccination, gave the person their your label, got vaccinated, and were sent out a side or back door so you would not cross paths with the people waiting or arriving.
I don't know how many hundred dollars it cost them to buy a couple dozen devices or how much it costs to wipe each one down and put it back under the infrared/anti-cootie lamp each use. But there are orders going out the window about every 2 minutes and no customers within 50 feet of each other.
Honestly, I'd prefer to be texted - no need to pass around a hot potato.
to this point you (everybody, really) should have a burner phone number
He points out that the standard being adopted by these studies for the point efficacy is 14 days after the second dose. That's honestly not too bad. It's no magic bullet, but it's survivable.
In the 2009 H1N1 flu outbreak
https://www.cdc.gov/flu/pandemic-resources/2009-h1n1-pandemi...
I remember getting the vaccine and it was offered outdoors, with a line in a parking lot and a nurse having a tent or a table or something. So that was good (although we weren't wearing masks -- the level of concern and associated precautions with H1N1 felt high at the time but now seems pretty trivial compared to COVID-19).
I recently went to my doctor's office for a seasonal flu shot and the office had separated spaces in the waiting room, lots of air filters going, and all patients and workers wearing face masks. And I think they wouldn't allow more than 4 or 5 patients in the office at a time. So those same precautions would feel pretty decent to me for COVID vaccination.
Edit: I guess I'm reflexively thinking of San Francisco in imagining this -- the outdoor line-up seems perfectly fine here, but it might be pretty unpleasant in January in New York or St. Petersburg or Edmonton...
We ended up just going to Target, which was much more risky, but actually something we could accomplish.
This was redundant. Anti-vaccination “belief“ is a serious, mental, issue.
Against HN rules, but it’s time to stop being so easy on people who try to distort science and reality and call them for what it is. You cannot have a eye to eye conversation with anti-vacciners, flat-earthers, climate-change deniers, election-fraud believers and Trump supporters.
The more leeway we give the more they try to win public opinion and damage our world.
Follow-up question: how can you be sure that you, personally, are on the side of the angels? Especially if you have never been allowed to hear the opposing point of view?
Seriously, the growing support for censorship in the previously libertarianish Tech community has been the worst development of the last decade.
In hindsight, I see how citing codes of conduct implies support for censorship, when my actual intent was simply to demonstrate another example of "intolerance" having noble goals.
Netiquette 101: Don't feed the trolls. (But here we are.)
Well, I agree with the scientific consensus on a general base. But since science was not always right, I don't see a valid argument from there to censorship.
You want to censor ideas not covered by scientific consensus?
"and their answers should sit uncomfortably in all humans"
Because, also no. I do not feel uncomfortable. I am strongly against censorship. Open, unrestricted exchange of ideas. If the scientific way is the best (which I believe), then the crackpot approaches will fail naturally. But if you censor those other approaches, you might actually strenghten them.
From where I'm sitting, perceived authoritarian tendencies on the democratic side is a large part of what really motivates Trump voters. That's certainly a lot of the narrative, if you ever visit that side of the media landscape.
1. Don’t even entertain their distorted reality
2. Put a stop on the spread of misinformation
Stopping your anti-vaccine post from going viral on social media is in no way any different than a scientific magazine refusing to publish the same.
> put a stop on spread of misinformation
That’s what censorship is. A small group of people will decide what is considered misinformation and will censor everything that goes against that
I believe the government should not have a say in whether or not all information circulates, but ordinary people who build information sharing systems (and I don't just mean electronic ones) have an opportunity to figure this out. Should they not?
This is not censorship. Censorship is stopping you from expressing your thoughts. Not publishing your thoughts is not. You can say whatever you want but no newspaper is in any obligation to publish it.
Similar with social media, you can write whatever you want on your personal "page", but they are under no obligation to make sure it reaches other people's feed.
Nice euphemism for censorship.
Social media is common people writing and reading. And they choose which people to follow etc.
"stopping a post to go viral" means in this context activily manipulating and interfering what information does and does not reach other people.
That is something very different than a newspaper refusing to publish a certain article.
If you’ll permit a scientifically inaccurate analogy here: sunlight is the best disinfectant.
It all comes down to whether or not the community in question is one in which members can readily leave without cost. I don't agree with making anti-vaxxers change their ways by government force, but I'm into being intolerant of them in other ways to the point that they'll come around and obviate any need for governmental force in the first place.
Beliefs? Science, and scientific evidence became “beliefs”
That’s the problem right here.
But we DO have to convince people, we have to convince people by showing them how it works, and letting them decide that that makes sense, you can't just mandate belief as a science authoritarian.
And science is still performed by humans, and we're fallible, and our incentives aren't always good, and every time there's a public failure of the process, and every time a scientist goes on record to shill for a company's chosen viewpoint, it dings the general public's faith in science and scientific experts in general.
Saying "this is the currently accepted truth, censor everything else" is the opposite of science.
My fear that is that not enough folks will take the vaccine. I've been hearing a lot about anti-vaxxers lately. interesting bunch.
Reason is not a universal attribute of human beings. Some of us have it. Some don't (they just simulate it more or less successfully).
Most pro-vaxxers have simply picked up the dominant opinion from the surrounding society -- not a bad heuristic in practice. Most anti-vaxxers have picked up an opinion from a persuasive single source and then read some other sources that back it up.
I admit I'm in the first category, I certainly vaccinate my own children, but I can't really claim that I've come to this decision after a thorough understanding of immunology, I have simply followed the path of least resistance.
That particular version of antivaxxism is the one I would have the most trouble refuting. It's especially troubling since if it were true then the powers that be would have every incentive to try to keep it quiet and attack anyone who suggests it.
I mean, I make the same judgement call every year for flu shots. Is it at least plausible that I would be better off overall making the same call for some other disease?
> That particular version of antivaxxism is the one I would have the most trouble refuting.
What's hard to refute? I mean, the exceptionalism argument only sticks with sociopaths who believe society exists only to serve their personal interests without having to contribute anything in return.
That's not really true though. The risks involved in getting a vaccine are much, much smaller than the risks involved in not getting the vaccine, especially with diseases like Covid.
COLD is the stock symbol and company that own temperature control storage facilities. They're international too and a REIT.
Do note I own this stock.
It’s not like aircraft are busy at the moment.
Bottom line is they want the company to be successful, so their long-term plan is to profit from making drugs. If they lived in a socialist economy where no such profit was possible, they would not have bothered, and then there would be no cure. If that is the world you prefer to live in, you have options (North Korea, Cuba and Venezuela currently, the rest having collapsed or transitioned to free market some time ago).
Given the timelines and uncertainty, I don't think 1B and 1.3B are materially different. Both require 2 doses per vaccination.
And no, stability testing happens pretty early on. Pfizer would have definitely collected enough data at this point to say whether or not their vaccine is stable at higher temperatures.
Pfizer is big enough to have/let a PR department do a press release during business hours. Of course given that Pfizer did a press release first Moderna for PR reasons needed to release more data to make a bigger splash.
No matter how you look at it, there is important data that will be in the FDA (and equivalent in other countries) submission that we don't have. There could be a "thats funny" thing burred, though odds are against it.
Pfizer hit their interim analysis point before Moderna did, but only by a few days.
The difference is not very big, but to those who like numbers it is big enough.
Most vaccines are a protein (originally a fragment from the (inactivated) virus, now more often a synthetically manufactured fragment of the virus).
These vaccines (Moderna & Pfizer) are delivered as the RNA that encodes a fragment of the virus (that your own body then uses to produce a fragment of the virus). The delivery mechanism is very different, but the viral fragment that your body sees is the same as it would if the protein was delivered directly, as is traditional.
RNA can't reliably survive on a surface for more than a few minutes (which is somewhat good news since coronovirus itself is an RNA virus), or more than a few days unrefrigerated, and is very sensitive to any contamination by bacteria or other organisms.
Traditional proteins are generally much less fragile both chemically and as food for other organisms. And sometimes a protein (vaccine) can be specifically engineered to be even more stable in room-temperature, dry, or other unforgiving conditions.
And none of this takes into account specific formulations, or other chemicals that are used to aide the delivery process. Much of this has to be measured empirically. It's not clear to me if there is some chemical difference between the Pfizer & Moderna vaccines, or if the different temps are just what they use as their protocol filed with the FDA.
Further, see /u/dnautics below, often RNA therapeutics aren't completely true RNA (they can have chemical features to enhance stability).
The 2nd key takeaway here is that while 5 patients in the vaccination group tested positive for coronavirus, none of them had severe disease. Which means to me that while this vaccine isn't a magic shield, if you do get it, it will keep you out of the hospital and probably make it a very mild experience.
People seem content with vaccines, meanwhile I want to understand WHY some people fair better than others. There's a far better solution than vaccines to be found, if people are willing to ask the question, and look for it.
(source: mostly stuff I read linked from the hn page, hopefully without excessive misreading)
With an n of 5, isn't this a premature conclusion?
This corresponds to binomial 95% confidence intervals of (0.0004, 0.0013) and (0.0000, 0.0002). So it seems to prevent severe illness.
Whether it reduces the odds of severe illness IF YOU ARE INFECTED or purely reduces the odds of severe illness by preventing infection--- you're right, there's not nearly enough n to know.
Is that conclusion warranted given the small number of people who got it? Perhaps in another population one of those 5 will indeed have severe, hospital-needed symptoms?
The pressing follow-up question is this: how many of the control group were discovered with (and despite of) equally weak symptoms? The answer could be anything between many more and many less. If it's more (more discovered very mild cases amongst the placebo group) then the vaccine apparently prevents most infections from happening at all, but if it's less then the vaccine doesn't really reduce the number of infected (and infective), it only prevents bad outcomes (which usually remain undiscovered, even in a phase III trial group).
A vaccine that only prevents bad outcomes would still be very valuable, but only to the vaccinated themselves because it would not create a herd immunity effect. This virus is very good at spreading from a mild case, so if the vaccinated still get unnoticeable mild cases they would still serve the virus as stopovers.
http://www.emro.who.int/health-topics/corona-virus/transmiss....
From what I've heard, virus concentration in the upper respiratory tract (i.e. where the aerosols come from) peaks two or three days before symptoms start.
Right now, ease of rolling out a vaccine is more important than its effectiveness, within reason. As long as the vaccine is effective enough to slow the spread of the virus it will save lives -- the more people we vaccinate, the fewer potential spreaders there will be, and that should help us protect people who have not been vaccinated yet.
Today, we would probably be better off with an A grade vaccine that is easier to store and ship across the country than we would be with an A+ vaccine that is more picky about storage temperature.
Of course, we can probably have both vaccines at the same time once the manufacturing capacity spins up.
When the vaccine is close you should be taking fewer risks. The potential cost to those risks stays the same, you can still kill your elderly relations and/or develop "long COVID" yourself. But the benefit is much less. Going back to normal life now only nets you a few weeks of normal life with the vaccine in sight vs an indefinite time without.
Also, the hope of a vaccine helps immensely with the mental stress of isolation.
The end is in sight! Hang in there folks, keep being careful!
1: https://www.thetimes.co.uk/edition/scotland/coronavirus-in-s...
And COVID-19 is strictly following Gompertz-Mathematics - just like a seasonal corona-virus. For any usual outbreak (f'/f) is falling exponentially all the time... There are no visible trend-changes around most policy-changes.
And there's no statistical epidemiological evidence that masks did anything good. In some countries with masks things got a lot worse. (more efficient catch+inhale? Or catch+transmit without being infected?)
Most of the hype around COVID-19 is just cheating by using "reporting date" instead of "date of death" to make Gompertz-Functions look like seriously dangerous exponentials...
If you have some datasets that allow to compare "reporting date" with "date of death" it is astonishing to see how many reporting-anomalies appear around policy-changes...
There are plenty of datasets that include date of death instead of reporting date and they show the count of deaths increasing again as well, on a lag, just like you would expect.
The low fatality rate we have enjoyed recently has been partially a result of the availability of improved medical care. Unfortunately that is a stepwise function where once you have surpassed the amount of available care, the improvements we have made in care revert to some extent. We don't know how much.
I see that you only really post about COVID stuff on hackernews, and I don't know why anyone would bother, but what truly blows my mind is the amount of hubris it takes to sit at home, read a few news stories, and say "I know better than the majority of people who have spent their lives studying disease because I know some statistics and read a few articles that disagreed with the mainstream."
Start is hidden under other smaller outbreaks, so it's not so easy to measure it exactly. But soon it should peak (if it hasn't already...).
If they don't do any nonsense that changes the mathematics of COVID-19 completely Sweden will be fine. The curve has normal size of a seasonal flu. Other countries in Europe are doing a lot worse.
Lets do some real mathematics.
1) Get good data (e.g. death by date).
2) Take a look at the Logarithm of the growthrate ln(f'/f)
3) Spot all those straight lines - those are the curves of outbreaks
4) Turn those lines into a working formula for an outbreak
5) Calculate predictions - evaluate trend-changes - look when new outbreaks happened.
It's just that simple. Results won't give you insight about the mainstream, but it will give some insights about reality.
Some countries are easier (Mexico, Germany, ...).. Some have more outbreaks and complications. But the basic principles of the mathematics of COVID-19 outbreaks around the globe are the same.
Calculating the new outbreaks of Sweden is more advanced because the start of the new curve is hidden behind another outbreak. But now there's at least enough visible to give good estimates.
https://www.thetimes.co.uk/article/covid-19-death-rates-are-...
Apparently that claim was based on this study: https://www.medrxiv.org/content/10.1101/2020.04.23.20076042v...
There are a few comments on that page about how that claim was misleading and/or inaccurate and mis-reported by the media.
Hopefully this doesn't turn into a very messy public fight given that I fully expect a lot of schools and workplaces to require vaccination to physically enter a school or an office.
"kill your elderly". Dont you feel bad for doing what you do? Seriously, please, reconsider the way you connect with fellow humans.
The first month or so in the Bay Area people were super diligent. There was nobody on the streets, hardly anybody shopping. Within a month you noticed more people on the streets, by 6 months, traffic was 75% of what it was before Covid.
You can't expect people to put their lives on hold indefinitely, especially people at low risk. I know that in Canada 20-30 year olds accounted for the vast majority of new cases. They were just willing to take a chance.
And even though these two vaccines look promising, you won't get a significant number of people vaccinated until the second half of 2021. That's another 7-8 months away.
Reminds me of that movie scene in Apocalypse Now when they are getting mortared on the beach while trying to surf - "The tide doesn't come in for six hours, do you want to wait here for six hours?" - Lt. Col. Kilgore
And now with the promise of a vaccine, the word "indefinitely" no longer applies.
Of course roll out matters. Rochester MN (Home of the Mayo clinic) might open before the rest of the country just because the ratio of health care vs everyone else is enough that they may as well vaccinate the whole town and let it open up.
Most people I know who are engaging in "risky" behavior when it comes to covid spread are either (1) just tired of being coped up and so being reckless (2) old enough that they don't want to spend 2 of their final years of life not seeing their family, and think the risk of catching it is worth it (3) young and relatively risk free (e.g. x3 flu mortality rate range) so don't worry about it for them or those they're seeing (others in the same boat).
I agree with you. We're in for a rough winter, at least in the US -- but it seems that there is a bright light at the end of the tunnel.
The new public messaging needs to be: "It Ain't Over Yet" kind of thing.
This reminds me of the speculative rationalizations that are given after-the-fact whenever the stock market rises or falls.
So let me chime in with the speculation:
The biggest factor is probably the realization that COVID is not as big a personal risk as feared, no matter what the media or the government says. People are gladly using COVID as an excuse to work from home or avoid meeting their elderly relatives, but when it comes to avoiding infection in order to save "the system", enough people simply don't care anymore. It's too abstract.
Currently, about one in 4000 Scots is hospitalized, which says that approximately only one in 40 Scots directly knows someone hospitalized with COVID, assuming they know 100 people each.
However, the chance of directly knowing someone that had a positive COVID test is 1 in 40, which says most Scots will know someone who had a mild case of COVID.
If you are under 25, the risk to you from Covid is basically tiny. I can understand young people not accepting having their life destroyed from living under a lockdown over a virus that is unlikely to do them harm.
In Scotland
I think we need something smarter than a blanket lockdown that affects everyone the same regardless of age. How we are 9 months into this and still haven't figured out anything better is really disappointing. We are destroying peoples lives, income and mental health when for the majority of them there is no risk."Okay, boomer."
We have this in NY and CA among other places. That the Midwest and South are going from "pretend everything is fine" to "full scale lockdown again" was a decision those states made. But NY and CA are still far from requiring a second full scale lockdown and are instead focusing on specific areas and counties.
The US poverty rate went down during the period. So it wasn't a lack of welfare protection, it was just a (likely bad) implementation choice, paying individuals instead of paying businesses to keep them on payroll.
The lack of response since that expired in July fits your description though.
The big advantage of this approach (in addition to the obvious advantages for the workers) is that companies don't lose the organizational knowledge held by the workers: With whom to speak in case machine X fails, whom to approach in customer company Y for a new deal etc.).
https://battlepenguin.com/politics/secondary-effects/
I'll admit it made me lose interest in reading much further because I don't trust you to have used the other 42 citations in good faith.
Anyway, that was just meant as constructive criticism. Just something to keep in mind in your writing in the future.
If it's just a couple here or there, there are miscounts for sure. But with news report after news report from local stations, I think the issue might be enough to be statically significant, or at least warrant investigation and not outright dismissal.
Furthermore, Sweeden seems to be doing alright as far as fatality numbers across their population for the year, even though their covid orders were much more limited:
https://www.statista.com/statistics/525353/sweden-number-of-...
> because I don't trust you to have used the other 42 citations in good faith.
We're getting into this really interesting era where we're attacking people's views for their sources .. even though there has been obvious bias in all mainstream reporting for over a decade. If you're not willing to entertain viewpoints you don't agree with, that's on you, not on me.
That's on you, not anyone else.
Fortunately we're getting into this really interesting era where I don't have to waste my time with their bullshit, nor with yours. Cheers.
I think a majority of people stopped giving a shit in June[1]. The government's continued lockdown policies are 100% at fault for continued economic distress.
[1] https://covid19.apple.com/mobility
That could change pretty fast when hospitals have to start sending seriously ill home to die. That would still only directly affect a small minority, but the same people who feel safer than they should now would then start feeling more in danger than they should. There's a certain irony in how a lot of people think that the rules are unnecessary exactly because they do work.
At any rate, the question isn't so much - were extreme bad weather events bad before as well, more - are they getting worse and/or more frequent?
https://www.worldweatherattribution.org/
Although the temp increase might happen during the colder times of the day so the wet bulb might never reach the deadly quantities.
Observing science has been part of the HN culture as long as I've been here.
This year has the most named storms on record and we still have 3 weeks left.
Every drought means conflict, they mean war, refugees and instability. Sure, the first world will be shielded from the worst for some time, but this isn't a Hollywood movie, the pressure will keep increasing every year exposing every flaw in the system.
Corona has shown that our world does not deal well with pressure and you can't make a vaccine for food insecurity.
Nth order effects will make it your problem pretty quickly.
Many are blind to exponentially growing phenomena.
One good example is that a several degree increase can melt the Siberian ice and release methane stores equivalent to 100 years of maximal human CO2 footprint. That's already a massive nth order effect.
Sometimes problems are not that simple.
I’m pretty sure he would also agree with the estimate for Siberian methane stores. He would just be careful with predicting what happens when they get released.
The average temperature increase can have different effects and that is one of the lines of his argument.
If you do not care about the issue and don’t want to hear opposing opinion then do not leave a comment.
This is just the beginning. It will get far worse and then worse again, thanks to people denying it and saying we might think about maybe reducing our emissions gradually next decade sometime..
In South Australia they're talking about taxing EVs because they don't get to tax their owners by way of the fuel excise. There's zero regard for pollution, it doesn't even have a monetary value - high polluters aren't taxed at all, so they're taxing the solution not the pollution instead. (Contrast Norway).
This is why I said it's going to get far far worse. There's so many thick skins to get through, blocking and impeding what needed to be immediate action decades ago and still isn't.
Is there some tool that has been used here that hasn't been available in the past? I know the FDA said they would allow skipping some preliminary testing to fast track a drug. Was that a huge help?
If these things work as they appear to do, it'll be even more impressive than putting a man on the moon.
Early on I remember an epidemiologist/virologist interviewed on JRE saying that building a point-in-time vaccine isn’t difficult, building a human-safe vaccine with long term efficacy is what’s difficult.
The ethical case for vaccinating against rhinoviruses isn't really there, even if it were viable to do so.
People try way harder when the stakes are high, and everyone involved is at least a little terrified of being "the one who delayed it." That does wonders for cutting through pointless red tape and bureaucratic delays.
A minor example:
About ten years ago, a flash flood completely destroyed about thirty linear feet of the main road connecting the tourist district of Hershey, Pennsylvania to the rest of the town.
I assumed it would take weeks or months to repair, based on how long road work has usually taken in the area. It would have been a disaster for a lot of the local restaurants, economically.
IIRC, two days after the flood the road was back in order. It certainly didn't take more than a week.
Obviously, inventing a new vaccine is orders of magnitude more complex than fixing a road, but I think this aspect of human nature still applies.
This was the main interstate connecting the suburbs to the business districts in Atlanta. The traffic on alternate routes after the collapse was apocalyptical. However, the new replacement was built in record time (1 month). The teams were given cash bonuses and other incentives to finish ahead of schedule. Basically, when "it matters", things get done quicker.
The bridge collapsed because of a fire and there seems to be no reason to redesign bridges to resist a fire like that so a lot of effort was saved. If we decided fires were too common we wouldn't be able to replace bridges as quickly because we need to do engineering work first on a new one.
The mRNA platform the BioNTech/Pfizer and the Moderna vaccine use is new, and that is generally something that can lead to shorter development.
As far as I understand, the biggest difference here is simply doing more things in parallel that you usually would do sequentially. This adds more risk because you already waste money in later expensive steps that are unnecessary because a previous step turns out to already fail the vaccine candidate. The easiest example here is producing the vaccine before phase III trials are completed, that is pure risk (in part assumed by governments in this case). This is really a case of "money is no object", a vaccine is useful enough in this case that you can take a lot of financial risk and pour lots of resources into development compared to a less critical vaccine.
The other thing that the more pessimistic timelines assume is that not everything will work out. Any problem can delay a vaccine or kill a candidate entirely.
From President Trump in May 2020 [1]:
> Then, my administration cut through every piece of red tape to achieve the fastest-ever, by far, launch of a vaccine trial for this new virus, this very vicious virus. And I want to thank all of the doctors and scientists and researchers involved because they’ve never moved like this, or never even close.
> The NIH and HHS have also been working constantly with private industry to evaluate more than 100 potential treatments.
> The Food and Drug Administration has swiftly approved more than 130 therapies for active trials; that’s what we have right now, 130. And another 450 are in the planning stages. And tremendous potential awaits. I think we’re going to have some very interesting things to report in the not-too-distant future. And thank you very much to Dr. Hahn.
> Through a historic series of funding bills, my administration is providing roughly $10 billion to support a medical research effort without parallel. I especially want to thank Senator Steve Daines of Montana for his incredible work. He has worked so hard to secure additional funding for vaccine development. He has been right at the forefront.
He also goes on to discuss Operation Warp Speed [2] which, as far as I understand it, creates trials and determines a distribution plan.
[1]: https://www.whitehouse.gov/briefings-statements/remarks-pres...
[2]: https://www.hhs.gov/coronavirus/explaining-operation-warp-sp...
https://twitter.com/IvankaTrump/status/1328324970854948866
Exceptional leadership would have been taking action December 2019 or early January - and as many south-east Asian countries show: even clear guidance and simple public health measure matter hugely; but people need to understand and support the measures, because it all hinges on real people changing their behavior; and creating controversy and abusing possible future treatments as distractions from actions that needed to be taken many months ago - and still do - undermines that.
And to cap it all off, the president is not working towards delivering those treatments and vaccines, because he's actively undermining the normal transition of power. Even if the election outcome were uncertain, gambling with people's lives like that shows a careless disregard for actually serving country - because an ethical person would at least work to protect others when it's not only their job, but easy, and conventional to do so.
In short, there were several vaccine candidates within days to weeks of the genome being decoded.
What takes time is testing the vaccine candidates for safety and effectiveness. Companies normally go step-by-step. They run a phase-I trial, then evaluate the results and decide whether to go on to a phase-II trial. If they run a phase-II trial, they again wait until the results are in and have been evaluated before moving on to a phase-III trial. That reduces financial risk. In this case, companies began preparing phase-III trials before the phase-II trials were even completed. You can begin enrolling people into the trials and producing the necessary doses before you even know whether the phase-II results are any good. One of the reasons they could do that was because the government was taking on the financial risk.
Technically, Moderna's phase-I trial is not even complete yet: [1]. It runs until November 2021. But Moderna moved forward onto the next phase as soon as it had enough data from the phase-I trial to justify doing so (I assume this meant some combination of safety and efficacy data).
1. https://clinicaltrials.gov/ct2/show/NCT04283461
Pfizer is in phase 3 and that's where they test tons of people.
Pfizer is more certain in efficacy.
1. Phase I: https://clinicaltrials.gov/ct2/show/NCT04283461
2. Phase III: https://clinicaltrials.gov/ct2/show/NCT04470427
https://www.research.ox.ac.uk/Article/2020-07-19-the-oxford-...
This is already a $10+ trillion pandemic in terms of economic destruction (we'll see economic damage spread out for more than a decade, so the final tally will be even higher). The vaccines are a couple billion dollars each, including manufacturing at scale. A lot of drugs now cost that to bring to market and don't have a small fraction of the positive impact on humanity.
If all that existed were market forces, Moderna and Pfizer could charge ten times what they are. They obviously knew the extreme blowback they'd suffer if they did that (including likely nationalization of their vaccines).
$20-$30 per dose in affluent nations is absurdly cheap to end this nightmare. That's a couple order-out pizzas.
To make sure that this is done most effectively, the US government announced "Operation Warp Speed" back in May which has helped private and public organizations work very effectively.
Other comments are correctly pointing out some corollaries of this, such as trials proceeding very quickly and trial phases being run almost in parallel; but the root cause all of this can happen is the legal immunity for the consequences.
The tough nut are retroviruses like HIV. 40 years without a HIV vaccines. Though the related feline virus has a vaccine.
I'm not sure how to qualify this statement without trading anecdotes. What kind of data do you have to back up this claim?
For some anecdata, our 5000 person software company held a survey early in the year and 30% said they wanted to be remote. Then the company shaped policies around that to allow remote work in the future. When the time came for people to proactively request to be remote, it turned out to be around 50% (and I assume that will rise as people figure out what they want, where they want to be, how life is during non pandemic shutdowns etc.).
I think what it ultimately comes down to is a significant number of people will want to continue to be remote; it's not just a few people.
I know more than one person running 100+ people offices who can’t wait to get everyone back into the office. Interesting to see where this ends up
"Late-stage trial results of a potential COVID-19 vaccine being developed by the University of Oxford and AstraZeneca could be presented this year as the British government prepares for a possible vaccination rollout in late December or early 2021."
https://www.reuters.com/article/uk-health-coronavirus-britai...
Pretty exciting stuff in any case.
"RNA and DNA vaccines are so far experimental, but trials have been promising and many scientists believe it could be one of those two types that will be the model that goes into mass production to protect against COVID-19.
The attraction, say experts, is that they will potentially offer a step towards something that has been the holy grail of vaccine design – the universal vaccine.
The vaccines being trialed by the team from Pfizer, which tests show provides protection in 90% of cases, and from Moderna, which shows efficacy of 94.5%, are RNA vaccines. If either proves to be the winner in the race for a COVID vaccine, it will represent a seismic shift in vaccine technology."
[1] https://news.sky.com/story/coronavirus-how-vaccine-research-...
"Jeffrey Almond, a visiting professor of microbiology at William Dunn School of Pathology, University of Oxford, told Sky News: 'All the current vaccines we have: diptheria, whooping cough, polio, measles, papillomavirus, you name it; all of them are very different. You don't have a generic process to make them. You have a dedicated factory, a dedicated process, very different technologies.
"'What RNA and DNA offer is an escape from that. We can make the RNA by a single process in a single factory. All we have to do is change the sequence of the RNA or DNA.'"
Very cool, but not necessarily "universal" in the sense you'd need to target all the different rapidly-mutating cold viruses.
That's really interesting! Imagine RNA vaccine creation "as a service." Researchers order fully-formed injectable vaccines for animal trials just by submitting a sequence. It would be like AWS for vaccines.
This vaccine is a great help to the above: it proves conclusively that the idea is sound. Probably future mRNA vaccines can skip all the phase 1-2 trials and go directly to 3. And for rare diesease they can even skip phase 3.
https://www.houstonchronicle.com/life/article/COVID-vaccine-...
> Well over 200 virus strains are implicated in causing the common cold, with rhinoviruses being the most common.
> Vaccination has proven difficult as there are many viruses involved and they mutate rapidly. Creation of a broadly effective vaccine is, therefore, highly improbable.
IIRC the virus in the rhinoviruses family mutates more rapidly than the virus in the coronavirus family.
This may be true, I don't know. I do know that my experience with coronavirus colds is that they hit much harder and have more severe symptoms compared to rhinovirus colds. So well worth taking out just the CV segment.
A vaccine works to stimulate your immune system's "memory" that's evolved for treating infections. (That can be anti-bodies, but it's more complex .. also involves memory T-cells, the complement system, etc.)
When the same virus comes it, it will infect cells, but your body is much more prepared to handle it. The trouble with HIV is that it's the initial infection that can slowly inactivate an immune system over 2~5 years (not everyone though. Some people have HIV and never develop AIDS; known as Long Term Non-Progressives).
A vaccine wouldn't help at all with HIV. Keep in mind, the HIV rapid test checks for the presence of antibodies.
"A vaccine that prevents infection entirely provides indirect protection to others. If I can't get infected, I can't infect you. But it is possible to have a vaccine that prevents disease but individuals can still be infectious." (1)
In that case, those at risk are only protected when they receive a vaccine, but still aren't when just those who they are in contact with received it.
"Most Phase 3 trials are measuring efficacy to prevent disease as the primary analysis" (2)
Not infection.
The whole thread with more details, already written in September, before both announcements:
https://twitter.com/nataliexdean/status/1310613702476017666
by: "Natalie E. Dean, PhD, Assistant Professor of Biostatistics at @UF specializing in emerging infectious diseases and vaccine study design. @HarvardBiostats PhD." (3)
1) https://twitter.com/nataliexdean/status/1310613711808278528
2) https://twitter.com/nataliexdean/status/1310613708557692928
3) https://twitter.com/nataliexdean
There are of course lots of hypotheticals here, and things to be concerned about, but a priori surely we should be hopeful it reduces infections too?
> The period where high virus loads are found in our bodies will be shorter
is precisely what can't be assumed in advance but must be measured, as there are known examples where the assumption doesn't hold at all (and that includes the flu vaccines).
(Not to mention that just "shorter" is by definition not "sterilizing", the transmission is then obviously still possible.)
If the virus is transmitted via the upper respiratory tract, and it is, it's less probable that the immune cells in blood can prevent the infection and viral shedding of the mucosa. The cells have to be first attacked and infected before the immune reaction can kick in. Even now, it is known that the highest infectiousness of SARS-CoV-2 is often before the symptoms are observable, i.e. before the immune reaction starts. That would also explain the existence of asymptotic carriers: their immune system already protects them, but they are still able to infect others.
The real question is the 5-10% that the vaccines don't work for - are they completely unprotected and we should wear a mask to protect them, or does enough protection exist such that they only get mildly sick vs die. There isn't enough evidence yet, but what we have suggests the former.
I worry also for the times during which there are not enough vaccines for everybody who is willing to get one. And also for the times when the immunity by those vaccinated vanes -- in other vaccines that also happens faster among those who are older. These numbers we can't have now anyway, that will by definition take much more time to be known.
The history of mRNA based pharmaceuticals is a fascinating one, Statnews have a great article on the topic: https://www.statnews.com/2020/11/10/the-story-of-mrna-how-a-...
In a few years both companies will re-evaluate their relationship. Partnerships can last for years at times. Other times one company is bought. Other times they go their own ways. All are normal and mean nothing, though if you are an investor each has different implications.
The New York Times made a great documentary on disinformation: https://www.youtube.com/watch?v=tR_6dibpDfo
Well worth a watch IMO
It would have slowed the initial spread, but as we have seen, it only takes a single "superspreader" event to infect an entire country. Out of the various actions taken to fight the pandemic, closing borders was among the least effective. Basically, it only worked on islands and in combination with strong local actions (testing, tracing, quarantine, lockdowns, ...).
20 years ago wasn't the middle ages, air travel was a thing (9/11 was almost 20 years ago). In fact, it wasn't that different than it is today.
A tragedy that was remembered for generations, but not the end of the world.
The coronavirus pandemic is a terrible natural disaster. We are right to take extreme measures to control it until proper mitigating measures become available, and we are very lucky that it did not happen ten years ago. Our societal surplus thankfully allows us to do the right thing and protect our weak and unlucky, as well as be more precautionary regarding long-term effects than others would have.
Reiterating my point -- if we were unable to use modern science and technology to combat the pandemic, the death toll and long-term health effects would be comparable to a minor global war. This would be a catastrophe that would be remembered for generations. It still will, but thankfully writ small.
Compared to other historical catastrophes -- the Black Death, the World Wars, five centuries of European warfare, Mao's Great Leap Forward, it would be a mild event, mostly because the death toll would hit the elderly and the weakened hardest. It would be bad, but it would not mean sacrificing a whole generation of our most ambitious young and capable people. It would certainly not be a catastrophe that threatened societies, although political follow-on effects would have lasting impact.
It's also worth noting that many authorities around the world have bungled the response terribly, both being ineffective in their measures and causing more economic damage than necessary. But that's dangerous territory to discuss, since you risk being branded and shut down with the terms I mentioned above.
(For reference, I made a fool of myself in my social circle in early March by suggesting 'extreme' quarantine measures before any Western governments did. I've been supportive of most science-based measures to slow and contain the pandemic, while at the same time being critical of many authorities' slow adaption of the best available science -- including lack of early mask recommendations and reluctance to consider aerosol contagion).
Perhaps we today would be 20 years ahead in terms of medicine and tech given the real pressure for innovation that would have been needed ('war is the mother of invention' - or something), but for a higher cost in casualties back then.
So many variables! - It's an interesting thought experiment.
100 years ago people regularly ordered things for delivery. Sure it wasn't online, but all online gives you is some time.
E.g. "milkman" is a word in English. Today, most people haul their own milk home from the supermarket.
Certainly, as you go back in time, there was a lot of local delivery especially in urban areas. Mail order, Sears catalog notwithstanding, less so. Just to pick one random example, ordering music, movies, or books pre-Amazon was really pretty limited.
>but all online gives you is some time
And a lot more types of goods available. Again, 25 years ago, it would not have been practical for people to have wholesale pivoted a huge amount of shopping online. (And companies like B&H Photo couldn't have scaled.)
20 years is probably just about the cusp of it barely being possible.
The pain and suffering it caused is hard to imagine and should not be downplayed.
Covid, as bad as it is, is almost three orders of magnitude off in deadliness (thus far, per capita).
+ ~94.5% of individuals achieve immunity. Better than Pfizer, though we need more data to be sure.
+ no significant side-effects.
+ no special deep freezing. -20C is good for 6 month storage, -2 to -9 for 30 days comparing to Pfizer -70C all the time.
Not so good:
- two doses needed, 4 weeks apart, immunity after one and a half month from first dose. Slow rollout. Pfizer results were after one month.
Still long-term immunity is a question for every vaccine. Luckily, if two vaccines works then likely other attempts will be successful.
> "which consists of a 2-dose schedule" [0]
[0] https://www.pfizer.com/news/press-release/press-release-deta...
Turns out, that was an extremely good bet.
One article said the reason of these vaccines can be stored more easily than the other is they use different proprietary formulations of inactive ingredients to carry the mRNA. Again, in a sane world, the most effective one would be shared, right? In the US, this is the kind of thing the Defense Production Act could be used for (instead of keeping meat plants open!!).
Not unless we fight for it I think.
https://www.nytimes.com/2020/11/10/health/was-the-pfizer-vac...
> In July, Pfizer got a $1.95 billion deal with the government’s Operation Warp Speed, the multiagency effort to rush a vaccine to market, to deliver 100 million doses of the vaccine. The arrangement is an advance-purchase agreement, meaning that the company won’t get paid until they deliver the vaccines. Pfizer did not accept federal funding to help develop or manufacture the vaccine, unlike front-runners Moderna and AstraZeneca.
https://www.hhs.gov/coronavirus/explaining-operation-warp-sp...
> April 16: HHS made up to $483 million in support available for Moderna's candidate vaccine, which began Phase 1 trials on March 16 and received a fast-track designation from FDA. This agreement was expanded on July 26 to include an additional $472 million to support late-stage clinical development, including the expanded Phase 3 study of the company's mRNA vaccine, which began on July 27th.
> May 21: HHS announced up to $1.2 billion in support for AstraZeneca's candidate vaccine, developed in conjunction with the University of Oxford. The agreement is to make available at least 300 million doses of the vaccine for the United States, with the first doses delivered as early as October 2020, if the product successfully receives FDA EUA or licensure. AstraZeneca's large-scale Phase 3 clinical trial began on August 31, 2020.
> October 16: HHS and DoD announced agreements with CVS and Walgreens to provide and administer COVID-19 vaccines to residents of long-term care facilities (LTCF) nationwide with no out-of-pocket costs. Protecting especially vulnerable Americans has been a critical part of the Trump Administration's work to combat COVID-19, and LTCF residents may be part of the prioritized groups for initial COVID-19 vaccination efforts until there are enough doses available for every American who wishes to be vaccinated. The Pharmacy Partnership for Long-Term Care Program provides complete management of the COVID-19 vaccination process. This means LTCF residents and staff across the country will be able to safely and efficiently get vaccinated once vaccines are available and recommended for them, if they have not been previously vaccinated. It will also minimize the burden on LTCF sites and jurisdictional health departments of vaccine handling, administration, and fulfilling reporting requirements.
> November 12: HHS and DoD announced partnerships with large chain pharmacies and networks that represent independent pharmacies and regional chains. Through the partnership with pharmacy chains, this program covers approximately 60 percent of pharmacies throughout the 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. Through the partnerships with network administrators, independent pharmacies and regional chains will also be part of the federal pharmacy program, further increasing access to vaccine across the country—particularly in traditionally underserved areas.
I believe that if Moderna found their vaccine didn't work they would license the Pfizer one as I assume their factories can be converted in a few months. Note that these are mRNA factories - I wouldn't expect a someone working on a different type of vaccine to be able to convert their factory. I would also expect that the process of conversion to produce a different vaccine will takes some months and cost us half a billion doses next year. This is just speculation though, there is no reason to make a license deal so we won't find out.
You can assume all manufacturers are watching each other. Some of the "getting ready to enter phase one trials" vaccines will probably be canceled as there is no point. If one of the promising candidates in trials fails Pfizer and Moderna will build (or license) more factory space because there is less competition for the demand.
> The analysis was based on the first 95 to develop Covid-19 symptoms.
> Only five of the Covid cases were in people given the vaccine, 90 were in those given the dummy treatment. The company says the vaccine is protecting 94.5% of people.
Aren't those numbers way too small to make any statistically significant claims?
And same as with the BioNTech vaccine, the testing continues until they have 160+ covid cases in one of the legs.